WO2022049855A1 - Endoscope treatment tool - Google Patents

Endoscope treatment tool Download PDF

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Publication number
WO2022049855A1
WO2022049855A1 PCT/JP2021/022066 JP2021022066W WO2022049855A1 WO 2022049855 A1 WO2022049855 A1 WO 2022049855A1 JP 2021022066 W JP2021022066 W JP 2021022066W WO 2022049855 A1 WO2022049855 A1 WO 2022049855A1
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WO
WIPO (PCT)
Prior art keywords
tip
sheath
treatment tool
endoscopic treatment
operation wire
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PCT/JP2021/022066
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French (fr)
Japanese (ja)
Inventor
知輝 小杉
友朗 村上
Original Assignee
朝日インテック株式会社
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Filing date
Publication date
Application filed by 朝日インテック株式会社 filed Critical 朝日インテック株式会社
Publication of WO2022049855A1 publication Critical patent/WO2022049855A1/en

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/221—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions

Definitions

  • the technology disclosed herein relates to a basket-type endoscopic treatment tool.
  • a basket-type endoscopic treatment tool is known as a medical device for crushing and recovering foreign substances such as stones in the body cavity of the bile duct (see, for example, Patent Document 1).
  • the basket-type endoscopic treatment tool consists of a flexible tubular sheath, an operation wire arranged in the sheath so as to be able to move forward and backward along the axial direction of the sheath, and a basket connected to the tip of the operation wire. It has a part.
  • the basket portion is composed of a plurality of wires, and when the operation wire is in a predetermined reference position, the basket portion is housed in the sheath in a reduced diameter state.
  • the state of such a basket portion or an endoscopic treatment tool is referred to as a “diameter-reduced state”.
  • the basket portion protrudes from the tip of the sheath and becomes a cage-shaped enlarged diameter.
  • the state of such a basket portion or an endoscopic treatment tool is referred to as a “diameter-enlarged state”.
  • the tips of the plurality of wires constituting the basket portion are collectively held by the tip tips.
  • the tip tip provided at the tip of the endoscopic treatment tool is rotated in the circumferential direction in order to pass through the side of the foreign body and enter the back side. May be desired.
  • the tip tip is connected to the operation wire via the basket portion, and even if the operator rotates the operation wire in the circumferential direction, the rotational torque is smoothly applied to the tip tip. It may not be possible to rotate the tip as desired because it is not transmitted.
  • the sheath and the tip tip are not integrated at all, so that the rotational torque is not transmitted to the tip tip even if the operator rotates the sheath in the circumferential direction. do not have.
  • This specification discloses a technique capable of solving the above-mentioned problems.
  • the endoscopic treatment tool disclosed in the present specification includes a sheath, an operation wire, a basket portion, and a tip.
  • the sheath is a flexible tubular member.
  • the operation wire is arranged in the sheath so as to be able to advance and retreat along the axial direction of the sheath.
  • the basket portion is connected to the tip of the operation wire and is composed of a plurality of wires.
  • the basket portion is housed in the sheath in a reduced diameter state when the operation wire is in the reference position, and protrudes from the tip of the sheath when the operation wire moves from the reference position to the tip side. It is configured to increase the diameter.
  • the tip tip collectively holds the tips of the plurality of wires constituting the basket portion.
  • a convex portion is formed on one of the base end surface of the tip and the tip surface of the sheath, and the operation wire is the reference on the other side of the base end surface of the tip and the tip surface of the sheath.
  • a concave portion that can be fitted with the convex portion when in the position is formed.
  • the number of the concave portions may be the same as the number of the convex portions or larger than the number of the convex portions. According to the present endoscope treatment tool, since the number of concave portions is the same as the number of convex portions or larger than the number of the convex portions, the convex portions can be easily fitted to the concave portions. Therefore, according to the present endoscopic treatment tool, the time required for fitting the tip and the sheath can be shortened, and the efficiency of the procedure using the endoscopic treatment tool can be improved.
  • the tip portion of the sheath may be curved with respect to the axial direction of a portion other than the tip portion of the sheath.
  • the sheath is rotated in the circumferential direction to orient the tip in the desired direction. Can be done. Therefore, it is possible to easily select the body cavity into which the endoscopic treatment tool should enter at the bifurcation point of the body cavity such as the bile duct. Therefore, according to the present endoscopic treatment tool, the efficiency of the procedure using the endoscopic treatment tool can be effectively improved.
  • the convex portion may be tapered from the bottom to the top, and the concave portion may be tapered from the top to the bottom. According to this endoscopic treatment tool, the convex portion can be fitted into the concave portion extremely easily. Therefore, according to this endoscopic treatment tool, the time required for fitting the tip and the sheath can be effectively shortened, and the efficiency of the procedure using the endoscopic treatment tool can be effectively reduced. Can be improved.
  • the concave portion has a shape having a notch extending in the circumferential direction of the sheath, and the convex portion is fitted with the concave portion and has a shape with respect to the concave portion. It may be configured to have a protrusion that engages with the notch of the recess when it rotates relative to the circumferential direction of the sheath.
  • the convex portion and the concave portion are fitted by pulling the operation wire toward the base end side, and the convex portion is further rotated relative to the tip tip in the circumferential direction.
  • the operability for rotating the tip tip in the circumferential direction can be effectively improved.
  • the technique disclosed in the present specification can be realized in various forms, for example, in the form of an endoscopic treatment tool, a method for manufacturing the same, and the like.
  • Explanatory drawing schematically showing the structure of the endoscopic treatment tool 100 in the first embodiment.
  • Explanatory drawing schematically showing the structure of the endoscopic treatment tool 100 in the first embodiment.
  • Explanatory drawing which shows the detailed structure of the tip tip 40 and the sheath 10 in the endoscopic treatment tool 100 of 1st Embodiment
  • Explanatory drawing which shows the detailed structure of the tip tip 40 and the sheath 10 in the endoscopic treatment tool 100 of 1st Embodiment
  • Explanatory drawing which shows the detailed structure of the tip tip 40 and the sheath 10 in the endoscopic treatment tool 100 of 1st Embodiment
  • Explanatory drawing schematically showing the structure of the endoscopic treatment tool 100a of the second embodiment.
  • Explanatory drawing schematically showing the structure of the endoscopic treatment tool 100b of the third embodiment.
  • FIGS. 1 and 2 are explanatory views schematically showing the configuration of the endoscopic treatment tool 100 in the first embodiment.
  • FIG. 1 shows a vertical cross-sectional configuration (YZ cross section) of the endoscopic treatment tool 100 in a reduced diameter state, which will be described later
  • FIG. 2 shows the endoscopic treatment tool 100 in a enlarged diameter state, which will be described later.
  • the vertical cross-sectional configuration (YZ cross-sectional configuration) of is shown.
  • a part of the endoscopic treatment tool 100 is not shown. Further, in FIGS.
  • the Z-axis positive direction side is the distal end side (distal side) inserted into the body
  • the Z-axis negative direction side is the proximal end side (near) operated by a technician such as a doctor.
  • the rank side ).
  • the end portion on the distal end side is referred to as "tip”
  • the distal end and its vicinity are referred to as “tip portion”
  • the end portion on the proximal end side is referred to as "tip portion”.
  • base end and the base end and its vicinity are called a "base end portion”.
  • the endoscopic treatment tool 100 of the present embodiment is a so-called basket-type endoscopic treatment tool, and is inserted into a body cavity BC such as a bile duct to crush or recover a foreign body FB such as a stone. It is a medical device used for.
  • the endoscope treatment tool 100 includes a sheath 10, an operation wire 20, a basket portion 30, a tip tip 40, a base tip 50, and an operation section 60.
  • the sheath 10 is a long tubular member having flexibility.
  • the sheath 10 has, for example, a flexible tube 11 made of resin or metal, and a substantially annular sheath tip 14 joined to the tip of the tube 11 and made of, for example, metal (stainless steel or the like).
  • the operation wire 20 is a long wire member, and is arranged in the space 12 in the sheath 10 so as to be able to advance and retreat along the axial direction of the sheath 10 (Z-axis direction in the examples of FIGS. 1 and 2). ..
  • the operation unit 60 has a main body unit 61, an operation pipe 62, and a grip portion 63.
  • the operation pipe 62 is a rod-shaped member connected to the base end of the operation wire 20.
  • the grip portion 63 is a member connected to the base end of the operation pipe 62 and gripped by a technician.
  • the main body 61 is a substantially cylindrical member connected to the base end of the sheath 10.
  • the hollow portion 65 of the main body portion 61 communicates with the space 12 of the sheath 10, and the operation pipe 62 is accommodated in the hollow portion 65 so as to be able to move forward and backward in the axial direction.
  • the main body 61 is provided with a water supply port 66 configured so that a syringe or the like (not shown) can be attached to the space 12 of the sheath 10 to supply the chemical solution or the like.
  • the basket portion 30 is connected to the tip of the operation wire 20 and is composed of a plurality of (four in this embodiment) wires 32.
  • Each wire 32 is made of, for example, metal.
  • the tips of the plurality of wires 32 constituting the basket portion 30 are collectively held by the tip tips 40.
  • the base ends of the plurality of wires 32 constituting the basket portion 30 are collectively held by the base end chips 50 provided at the tips of the operation wires 20.
  • the basket portion 30 is connected to the tip of the operation wire 20 via the base end tip 50.
  • the tip 40 and the base tip 50 are made of, for example, a metal (stainless steel or the like).
  • the plurality of wires 32 constituting the basket portion 30 are self-urged so as to be curved and bulge outward. Therefore, as shown in FIG. 1, the basket portion 30 is housed in the space 12 of the sheath 10 because the operation wire 20 is located at a relatively proximal position (hereinafter referred to as “reference position”). Then, the basket portion 30 is pressed by the inner peripheral surface of the sheath 10 to be in a reduced diameter state.
  • a reduced diameter state such a state of the basket portion 30 or the endoscopic treatment tool 100 is referred to as a reduced diameter state.
  • the basket section 30 protrudes from the tip of the sheath 10 and the diameter is expanded by the self-urging force. And it becomes a basket.
  • a state of the basket portion 30 or the endoscopic treatment tool 100 is referred to as a diameter-expanded state.
  • the endoscopic treatment tool 100 has a reduced diameter state in which the basket portion 30 is accommodated in the space 12 in the sheath 10 in a reduced diameter state as the operation wire 20 advances and retreats, and the basket portion 30 has a sheath. It is configured so that it can be switched between a diameter-expanded state in which the diameter is expanded by protruding from the tip of 10.
  • FIG. 3 shows the appearance configuration of the tip tip 40 and the sheath 10 in the reduced diameter state
  • FIG. 4 shows the appearance configuration of the tip tip 40 and the sheath 10 in the enlarged diameter state. Shows the cross-sectional configuration (XY cross-sectional configuration) at the position of VV in FIG.
  • the tip tip 40 has a tip portion 41 and a columnar portion 42.
  • the tip 41 is a substantially hemispherical portion located on the tip side of the tip 40 and whose outer diameter decreases toward the tip.
  • the columnar portion 42 is a substantially columnar portion extending from the vicinity of the center of the proximal end surface of the cutting edge portion 41 toward the proximal end side.
  • the outer diameter of the columnar portion 42 is smaller than the outer diameter of the base end of the cutting edge portion 41.
  • a convex portion 43 is formed on the base end surface of the tip tip 40.
  • the convex portion 43 is a columnar portion extending from the proximal end surface to the proximal end side in the cutting edge portion 41.
  • the XY cross-sectional shape of the convex portion 43 can be any shape, but is, for example, a substantially rectangular shape.
  • the tip tip 40 has four convex portions 43 arranged at substantially equal intervals around the outer periphery of the columnar portion 42 (see FIG. 5).
  • the space between the two convex portions 43 adjacent to each other in the circumferential direction can also be regarded as the concave portion 45. That is, four recesses 45 are formed on the base end surface of the tip tip 40.
  • the sheath tip 14 constituting the tip of the sheath 10 has the most proximal end portion 15.
  • the most proximal end portion 15 is a substantially cylindrical portion located on the most proximal end side of the sheath tip 14.
  • a convex portion 16 is formed on the tip surface of the sheath tip 14.
  • the convex portion 16 is a columnar portion extending from the distal end surface to the distal end side of the most proximal end portion 15.
  • the XY cross-sectional shape of the convex portion 16 can be any shape, but is, for example, substantially a fan shape.
  • the sheath tip 14 has four convex portions 16 arranged around the outer periphery of the most proximal end portion 15 at substantially equal intervals (see FIG. 5). Each convex portion 16 is adjacent to each convex portion 43 formed on the tip tip 40 in the circumferential direction of the tip tip 40. The space between the two convex portions 16 adjacent to each other in the circumferential direction can also be regarded as the concave portion 17. That is, four recesses 17 are formed on the tip surface of the sheath tip 14.
  • An example of a method for crushing a foreign body FB in a body cavity BC using the endoscopic treatment tool 100 of the present embodiment is as follows. First, by operating the operation unit 60 and pulling the operation wire 20 toward the base end side, the endoscopic treatment tool 100 (basket unit 30) is brought into a reduced diameter state (state shown in FIGS. 1 and 3). At this time, the convex portion 43 of the tip tip 40 and the concave portion 17 of the sheath tip 14 are fitted to each other. The endoscopic treatment tool 100 in this state is inserted into the channel of the endoscopic device previously inserted into the body cavity BC of the patient, and is allowed to enter the vicinity of the foreign body FB.
  • the endoscopic treatment tool 100 is advanced so that the tip 40 passes through the side of the foreign body FB and reaches the back side of the foreign body FB.
  • the operator operates the operation unit 60 to rotate the sheath 10 in the circumferential direction.
  • the convex portion 43 of the tip tip 40 and the concave portion 17 of the sheath tip 14 are fitted to each other. Therefore, when the sheath 10 is rotated in the circumferential direction, the tip tip 40 becomes the sheath 10. It rotates integrally with (sheath tip 14) in the circumferential direction. Therefore, even when the foreign matter FB is relatively large, the tip tip 40 can be smoothly advanced to the back side of the foreign matter FB.
  • the basket portion 30 is projected from the tip of the sheath 10 to expand the diameter (see FIG. 2).
  • the foreign matter FB is captured in the internal space of the expanded basket portion 30.
  • the foreign matter FB is sandwiched between the tip tip 40 and the sheath tip 14 and tightened to crush the foreign matter FB.
  • the foreign body FB in the body cavity BC can be crushed by using the endoscopic treatment tool 100.
  • the foreign matter FB may be collected by transporting the foreign matter FB to the base end side with the foreign matter FB captured in the basket portion 30.
  • the endoscopic treatment tool 100 of the present embodiment includes a sheath 10, an operation wire 20, a basket portion 30, and a tip tip 40.
  • the sheath 10 is a flexible tubular member.
  • the operation wire 20 is arranged in the sheath 10 so as to be able to advance and retreat along the axial direction of the sheath 10.
  • the basket portion 30 is connected to the tip of the operation wire 20 and is composed of a plurality of wires 32.
  • the basket portion 30 is housed in the sheath 10 in a reduced diameter state when the operation wire 20 is in the reference position, and protrudes from the tip of the sheath 10 when the operation wire 20 moves from the reference position to the tip side. It is configured to increase the diameter.
  • the tip tip 40 collectively holds the tips of a plurality of wires 32 constituting the basket portion 30.
  • the convex portion 43 is formed on the base end surface of the tip tip 40, and the operation wire 20 is a reference position on the tip end surface of the sheath tip 14 constituting the tip of the sheath 10. (That is, when the diameter is reduced), a concave portion 17 that can be fitted with the convex portion 43 is formed.
  • a convex portion 16 is formed on the tip surface of the sheath tip 14 constituting the tip of the sheath 10, and the operation wire 20 is a reference position on the base end surface of the tip tip 40. It can also be considered that the concave portion 45 that can be fitted with the convex portion 16 is formed when the convex portion 16 is formed (that is, when the diameter is reduced).
  • the endoscopic treatment tool 100 of the present embodiment when the operation wire 20 is in the reference position due to the presence of the convex portion 43 and the concave portion 17 (or the convex portion 16 and the concave portion 45) that can be fitted to each other.
  • the sheath 10 is rotated in the circumferential direction (that is, in the reduced diameter state)
  • the tip tip 40 is integrated with the sheath 10 and rotates in the circumferential direction. Therefore, according to the endoscopic treatment tool 100 of the present embodiment, the operability for rotating the tip 40 in the circumferential direction can be improved.
  • the endoscopic treatment tool 100 of the first embodiment since the number of concave portions 17 formed in the sheath tip 14 is the same as the number of convex portions 43 formed in the tip tip 40, the convex portions 43 are formed. It can be easily fitted into the recess 17. Therefore, according to the endoscopic treatment tool 100 of the first embodiment, the time required for fitting the tip tip 40 and the sheath tip 14 (sheath 10) can be shortened, and the endoscopic treatment tool 100 can be used. It is possible to improve the efficiency of the procedure using.
  • FIG. 6 is an explanatory diagram schematically showing the configuration of the endoscopic treatment tool 100a of the second embodiment.
  • FIG. 6 shows a detailed configuration of the tip tip 40a and the sheath tip 14 in the endoscopic treatment tool 100a of the second embodiment.
  • the same configurations as the endoscopic treatment tool 100 of the first embodiment described above will be described by adding the same reference numerals. Is omitted as appropriate.
  • the endoscopic treatment tool 100a of the second embodiment has a different number of convex portions 43 formed on the tip tip 40a from the endoscopic treatment tool 100 of the first embodiment. Specifically, in the endoscopic treatment tool 100a of the second embodiment, the number of convex portions 43 formed on the tip tip 40a is one. The number of recesses 17 formed in the sheath tip 14 is four, as in the first embodiment. Therefore, in the second embodiment, the number of concave portions 17 is larger than the number of convex portions 43.
  • the number of the concave portions 17 formed on the sheath tip 14 is larger than the number of the convex portions 43 formed on the tip tip 40a, so that the convex portions 43 are formed. It can be easily fitted into the recess 17. Therefore, according to the endoscopic treatment tool 100a of the second embodiment, the time required for fitting the tip tip 40a and the sheath tip 14 (sheath 10) can be shortened, and the endoscopic treatment tool 100a can be shortened. It is possible to improve the efficiency of the procedure using.
  • FIG. 7 and 8 are explanatory views schematically showing the configuration of the endoscopic treatment tool 100b according to the third embodiment.
  • FIG. 7 shows the appearance configuration of the tip tip 40b and the sheath tip 14b of the endoscopic treatment tool 100b in the reduced diameter state in the third embodiment
  • FIG. 8 shows the diameter expansion in the third embodiment.
  • the appearance configuration of the tip tip 40b and the sheath tip 14b of the endoscopic treatment tool 100b in the state is shown.
  • the same configurations as the endoscopic treatment tool 100 of the first embodiment described above will be described by adding the same reference numerals. Is omitted as appropriate.
  • the shape of the convex portion 43b formed on the tip tip 40b and the shape of the concave portion 17b formed on the sheath tip 14b are the shapes of the endoscope of the first embodiment. It is different from the treatment tool 100. Specifically, in the endoscopic treatment tool 100b of the third embodiment, the convex portion 43b formed on the tip tip 40b has a shape that tapers from the bottom (boundary position with the cutting edge 41) toward the top. Is. In the present embodiment, the convex portion 43b has a substantially trapezoidal shape in the radial direction of the tip tip 40b.
  • the recess 17b formed in the sheath tip 14b has a shape that tapers from the top to the bottom (the boundary position with the most basic end portion 15).
  • this can be rephrased as having a shape in which the convex portion 16b formed on the sheath tip 14b tapers from the bottom portion (the boundary position with the most basic end portion 15) toward the top portion.
  • the recess 17b has a substantially trapezoidal shape in the radial direction of the tip tip 40b.
  • the convex portion 43b formed on the tip tip 40b has a shape that tapers from the bottom to the top, and the concave portion formed on the sheath tip 14b. Since the 17b has a shape that tapers from the top to the bottom, the convex portion 43b can be fitted into the concave portion 17b very easily. Therefore, according to the endoscopic treatment tool 100b of the third embodiment, the time required for fitting the tip tip 40b and the sheath tip 14b (sheath 10) can be effectively shortened, and the time required for fitting the sheath tip 14b (sheath 10) can be effectively shortened. The efficiency of the procedure using the treatment tool 100b can be effectively improved.
  • FIG. 9 and 10 are explanatory views schematically showing the configuration of the endoscopic treatment tool 100c according to the fourth embodiment.
  • FIG. 9 shows the appearance configuration of the tip tip 40c and the sheath tip 14c of the endoscopic treatment tool 100c in the reduced diameter state in the fourth embodiment
  • FIG. 10 shows the diameter expansion in the fourth embodiment.
  • the appearance configuration of the tip tip 40c and the sheath tip 14c of the endoscopic treatment tool 100c in the state is shown.
  • the same configurations as the endoscopic treatment tool 100 of the first embodiment described above will be described by adding the same reference numerals. Is omitted as appropriate.
  • the shape of the convex portion 43c formed on the tip tip 40c and the shape of the concave portion 17c formed on the sheath tip 14c are the shapes of the endoscope of the first embodiment. It is different from the treatment tool 100.
  • the recess 17c formed in the sheath tip 14c has a shape having a notch 18 extending in the circumferential direction of the sheath 10. In the present embodiment, the notch 18 is provided at the position of the bottom portion in the recess 17c.
  • the convex portion 43c formed on the tip tip 40c engages with the notch 18 of the concave portion 17c when the convex portion 43c rotates relative to the concave portion 17c in the circumferential direction with the convex portion 43c fitted to the concave portion 17c. It is a shape having such a protrusion 46. In the present embodiment, the protrusion 46 is provided at the position of the top of the protrusion 43c.
  • the concave portion 17c formed in the sheath tip 14c has a shape having a notch 18, and the convex portion 43c formed in the tip tip 40c has a notch. It has a shape having a protrusion 46 that engages with 18. Therefore, the convex portion 43c formed on the tip tip 40c and the concave portion 17c formed on the sheath tip 14c are fitted by pulling the operation wire 20 toward the base end side, and the sheath tip 14c (sheath 10) is further fitted to the tip.
  • FIG. 11 is an explanatory diagram schematically showing the configuration of the endoscopic treatment tool 100d according to the fifth embodiment.
  • FIG. 11 shows a vertical cross-sectional configuration (YZ cross-section) of the endoscopic treatment tool 100d in a reduced diameter state according to the fifth embodiment.
  • YZ cross-section vertical cross-sectional configuration
  • the endoscope treatment tool 100d of the fifth embodiment has a sheath 10d different from that of the endoscope treatment tool 100 of the first embodiment.
  • the tip portion P1 of the sheath 10d is in the axial direction of a portion other than the tip portion P1 of the sheath 10d (hereinafter, referred to as “main portion P2”). It is curved with respect to.
  • the tip portion P1 of the sheath 10d is composed of the sheath tip 14 and the tip portion of the tube 11d
  • the main portion P2 of the sheath 10d is composed of a portion other than the tip portion of the tube 11d. Has been done.
  • the tip portion P1 of the sheath 10d is curved.
  • the fact that the tip P1 of the sheath 10d is curved with respect to the axial direction of the main portion P2 means that the tip of the sheath 10d is not located on the extension of the central axis of the main portion P2, and the sheath 10d is It includes a form bent at a predetermined position (a form shown in FIG. 11), a form in which the tip side of the sheath 10d is bent in a curved shape with a constant or changing curvature from the predetermined position, and the like.
  • the entire basket portion 30 is contained in the tip portion P1 of the sheath 10d in the reduced diameter state.
  • the sheath 10d is placed in a reduced diameter state.
  • the tip 40 can be oriented in a desired direction. Therefore, for example, as shown in FIG. 11, at the bifurcation point BI of the body cavity BC such as the bile duct, the body cavity BC to which the endoscopic treatment tool 100d should enter can be easily selected. Therefore, according to the endoscopic treatment tool 100d of the fifth embodiment, the efficiency of the procedure using the endoscopic treatment tool 100d can be effectively improved.
  • the body cavity BC to which the endoscopic treatment tool should be advanced can be easily selected by using the guide wire together, but in that case, the procedure becomes complicated and the cost is disadvantageous. Further, since it is necessary to provide a guide wire guiding means at the tip of the endoscopic treatment tool, the passability of the endoscopic treatment tool is reduced. In addition, by bending the tip tip, it is possible to easily select the body cavity BC in which the endoscopic treatment tool should be advanced, but in that case, the front projection area of the tip tip becomes large and endoscopy is performed. The passability of the mirror treatment tool is reduced. According to the endoscopic treatment tool 100d of the fifth embodiment, the efficiency of the procedure using the endoscopic treatment tool 100d can be effectively improved without causing these problems. It is more advantageous than those configurations.
  • the configuration of the endoscopic treatment tool 100 in the above embodiment is merely an example and can be variously modified.
  • the basket portion 30 is composed of four wires 32, but the number of wires 32 constituting the basket portion 30 is another number (for example, six wires, eight wires, etc.). You may.
  • the proximal ends of the plurality of wires 32 constituting the basket portion 30 are collectively held by the proximal end chips 50 provided at the tips of the operation wires 20, but the plurality of wires 32 are held together.
  • a predetermined portion on the tip end side from the proximal end may be collectively held by another chip member.
  • the portion of the plurality of wires 32 located between the tip tip 40 and the other tip functions as the basket portion 30. Even in such a configuration, it can be said that the basket portion 30 is connected to the tip of the operation wire 20.
  • the number of convex portions 43 (and concave portions 45) formed on the tip tip 40 and the number of concave portions 17 (and convex portions 16) formed on the sheath tip 14 are merely examples and are arbitrary. It can be changed. Further, in the above embodiment, when a plurality of convex portions 43 (and concave portions 45) are formed on the tip tip 40, or when a plurality of concave portions 17 (and convex portions 16) are formed on the sheath tip 14. , Each convex portion 43 (and concave portion 45) or concave portion 17 (and convex portion 16) is arranged substantially evenly in the circumferential direction, but it is not always necessary to have such a substantially even arrangement.
  • the convex portion 43b formed on the tip tip 40b has a substantially trapezoidal shape in the radial direction of the tip tip 40b, but other as long as it has a shape that tapers from the bottom to the top. It may have a shape (for example, a shape that tapers so that the side surface becomes a curved surface).
  • the recess 17b formed in the sheath tip 14b has a substantially trapezoidal shape in the radial direction of the tip tip 40b, but as long as it has a shape that tapers from the top to the bottom. Other shapes (for example, a shape that tapers so that the side surface becomes a curved surface) may be used.
  • the notch 18 is provided at the position of the bottom portion in the recess 17c, but the notch 18 engages with the protrusion 46 of the convex portion 43c. As long as possible, it may be provided at another position (for example, a position intermediate between the top and the bottom in the recess 17c).
  • the protrusion 46 is provided at the position of the top of the convex portion 43c, but the protrusion 46 is notched in the recess 17c.
  • a plurality of notches 18 in the recess 17c may be provided, and similarly, a plurality of protrusions 46 may be provided as long as they can be engaged with the notches 18.
  • the sheath 10 has a tube 11 and a sheath tip 14, and the sheath tip 14 is formed with a recess 17 that fits with the convex portion 43 of the tip tip 40.
  • the tip surface of the tube 11 may be formed with a recess that fits with the convex portion 43 of the tip tip 40.
  • the entire basket portion 30 in the reduced diameter state, is contained in the tip portion P1 of the sheath 10d, but only a part of the basket portion 30 on the tip end side is contained in the tip portion P1 of the sheath 10d. It may be accommodated and the remaining portion of the basket portion 30 may be accommodated in the main portion P2 of the sheath 10d.
  • the tube 11 is formed of a flexible tubular structure formed of resin or metal, but may be formed of a coil body.
  • a convex portion 43 is formed on the base end surface of the tip tip 40
  • a concave portion 17 is formed on the front end surface of the sheath tip 14, and the convex portion 43 and the concave portion 17 can be fitted to each other.
  • the concave portion 45 is formed on the base end surface of the tip tip 40
  • the convex portion 16 is formed on the distal end surface of the sheath tip 14, and the concave portion 45 and the convex portion 16 are fitted to each other. It can be rephrased as a configuration that is possible.
  • a convex portion is formed on one of the proximal end surface of the tip tip 40 and the distal end surface of the sheath tip 14 (sheath 10), and the other end surface of the distal end tip 40 and the distal end surface of the sheath tip 14 (sheath 10).
  • a concave portion that can be fitted to the convex portion may be formed.

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Abstract

Provided is an endoscope treatment tool, wherein operability for rotating an end tip is improved. The endoscope treatment tool comprises: a tubular sheath that is flexible; an operation wire disposed so as to be able to advance and retract inside the sheath along the axial direction of the sheath; a basket section that is connected to the tip of the operation wire; and an end tip. The basket section is constituted of a plurality of wires, is accommodated in a compressed diameter state inside the sheath when the operation wire is in a reference position, and is configured so as to protrude from the tip of the sheath and expand in diameter when the operation wire moves from the reference position towards the tip. The end tip retains the tips of the plurality of wires constituting the basket section. Either one of a base surface of the end tip and a tip surface of the sheath is formed in a convex shape, and the other one of the base surface of the end tip and the tip surface of the sheath is formed in a concave shape that can engage with the convex shape when the operation wire is in the reference position.

Description

内視鏡用処置具Endoscopic treatment tool
　本明細書に開示される技術は、バスケット型の内視鏡用処置具に関する。 The technology disclosed herein relates to a basket-type endoscopic treatment tool.
　胆管等の体腔内の結石等の異物を破砕したり回収したりするための医療用器具として、バスケット型の内視鏡用処置具が知られている（例えば、特許文献１参照）。バスケット型の内視鏡用処置具は、可撓性を有する管状のシースと、シース内にシースの軸方向に沿って進退可能に配置された操作ワイヤと、操作ワイヤの先端に接続されたバスケット部とを備える。バスケット部は、複数のワイヤから構成されており、操作ワイヤが所定の基準位置にあるときには、シース内に縮径した状態で収容されている。以下、このようなバスケット部または内視鏡用処置具の状態を、「縮径状態」という。また、医師等の手技者による操作に伴い操作ワイヤが上記基準位置から先端側に移動すると、バスケット部は、シースの先端から突出して籠状に拡径した状態となる。以下、このようなバスケット部または内視鏡用処置具の状態を、「拡径状態」という。バスケット部を構成する複数のワイヤの先端は、先端チップによってまとめて保持されている。 A basket-type endoscopic treatment tool is known as a medical device for crushing and recovering foreign substances such as stones in the body cavity of the bile duct (see, for example, Patent Document 1). The basket-type endoscopic treatment tool consists of a flexible tubular sheath, an operation wire arranged in the sheath so as to be able to move forward and backward along the axial direction of the sheath, and a basket connected to the tip of the operation wire. It has a part. The basket portion is composed of a plurality of wires, and when the operation wire is in a predetermined reference position, the basket portion is housed in the sheath in a reduced diameter state. Hereinafter, the state of such a basket portion or an endoscopic treatment tool is referred to as a “diameter-reduced state”. Further, when the operation wire moves from the reference position to the tip side due to the operation by a technician such as a doctor, the basket portion protrudes from the tip of the sheath and becomes a cage-shaped enlarged diameter. Hereinafter, the state of such a basket portion or an endoscopic treatment tool is referred to as a “diameter-enlarged state”. The tips of the plurality of wires constituting the basket portion are collectively held by the tip tips.
　バスケット型の内視鏡用処置具を用いた施術の際には、縮径状態の内視鏡用処置具を内視鏡チャネルに挿通し、体腔内の異物付近において操作ワイヤを先端側に押し出すことによってバスケット部を拡径状態とし、籠状になったバスケット部内に異物を捕捉した後、操作ワイヤを基端側に引き寄せることによって異物を先端チップとシースの先端との間で挟んで破砕したり、異物を捕捉した状態で回収したりする。 When performing a procedure using a basket-type endoscopic treatment tool, insert the endoscopic treatment tool in a reduced diameter into the endoscopic channel and push the operation wire toward the tip near a foreign body in the body cavity. By doing so, the diameter of the basket part is expanded, foreign matter is caught in the basket-shaped basket part, and then the foreign matter is sandwiched between the tip tip and the tip of the sheath by pulling the operation wire toward the base end side and crushed. Or, collect foreign matter in a captured state.
特開２０１９－１０７１８３号公報Japanese Unexamined Patent Publication No. 2019-107183
　例えば体腔内の異物が比較的大きい場合には、内視鏡用処置具の先端に設けられた先端チップを異物の横をすり抜けて奥側に進入させるために、先端チップを周方向に回転させることが望まれることがある。しかしながら、従来の内視鏡用処置具では、先端チップがバスケット部を介して操作ワイヤに接続されており、手技者が操作ワイヤを周方向に回転させても該回転トルクが先端チップに円滑に伝達されないため、先端チップを所望の通りに回転させることができないことがある。また、従来の内視鏡用処置具では、シースと先端チップとは何ら一体化されていないため、手技者がシースを周方向に回転させても該回転トルクが先端チップに伝達されることはない。このように、従来の内視鏡用処置具では、先端チップを周方向に回転させるための操作性の点で向上の余地がある。 For example, when the foreign body in the body cavity is relatively large, the tip tip provided at the tip of the endoscopic treatment tool is rotated in the circumferential direction in order to pass through the side of the foreign body and enter the back side. May be desired. However, in the conventional endoscope treatment tool, the tip tip is connected to the operation wire via the basket portion, and even if the operator rotates the operation wire in the circumferential direction, the rotational torque is smoothly applied to the tip tip. It may not be possible to rotate the tip as desired because it is not transmitted. Further, in the conventional endoscopic treatment tool, the sheath and the tip tip are not integrated at all, so that the rotational torque is not transmitted to the tip tip even if the operator rotates the sheath in the circumferential direction. do not have. As described above, in the conventional endoscopic treatment tool, there is room for improvement in terms of operability for rotating the tip in the circumferential direction.
　本明細書では、上述した課題を解決することが可能な技術を開示する。 This specification discloses a technique capable of solving the above-mentioned problems.
　本明細書に開示される技術は、例えば、以下の形態として実現することが可能である。 The technology disclosed in the present specification can be realized, for example, in the following form.
（１）本明細書に開示される内視鏡用処置具は、シースと、操作ワイヤと、バスケット部と、先端チップとを備える。シースは、可撓性を有する管状の部材である。操作ワイヤは、前記シース内に前記シースの軸方向に沿って進退可能に配置されている。バスケット部は、前記操作ワイヤの先端に接続されており、複数のワイヤから構成されている。バスケット部は、前記操作ワイヤが基準位置にあるときに、前記シース内に縮径した状態で収容され、前記操作ワイヤが前記基準位置から先端側に移動したときに、前記シースの先端から突出して拡径するように構成されている。先端チップは、前記バスケット部を構成する前記複数のワイヤの先端をまとめて保持する。前記先端チップの基端面と前記シースの先端面との一方には、凸部が形成され、前記先端チップの前記基端面と前記シースの前記先端面との他方には、前記操作ワイヤが前記基準位置にあるときに前記凸部と嵌合可能な凹部が形成されている。本内視鏡用処置具によれば、互いに嵌合可能な凸部および凹部の存在により、操作ワイヤが基準位置にあるときに（すなわち、縮径状態のときに）、シースを周方向に回転させると、先端チップがシースと一体となって周方向に回転する。従って、本内視鏡用処置具によれば、先端チップを周方向に回転させるための操作性を向上させることができる。 (1) The endoscopic treatment tool disclosed in the present specification includes a sheath, an operation wire, a basket portion, and a tip. The sheath is a flexible tubular member. The operation wire is arranged in the sheath so as to be able to advance and retreat along the axial direction of the sheath. The basket portion is connected to the tip of the operation wire and is composed of a plurality of wires. The basket portion is housed in the sheath in a reduced diameter state when the operation wire is in the reference position, and protrudes from the tip of the sheath when the operation wire moves from the reference position to the tip side. It is configured to increase the diameter. The tip tip collectively holds the tips of the plurality of wires constituting the basket portion. A convex portion is formed on one of the base end surface of the tip and the tip surface of the sheath, and the operation wire is the reference on the other side of the base end surface of the tip and the tip surface of the sheath. A concave portion that can be fitted with the convex portion when in the position is formed. According to this endoscopic treatment tool, the presence of ridges and recesses that can be fitted to each other causes the sheath to rotate circumferentially when the operating wire is in the reference position (ie, in the reduced diameter state). Then, the tip tip is integrated with the sheath and rotates in the circumferential direction. Therefore, according to the present endoscope treatment tool, the operability for rotating the tip tip in the circumferential direction can be improved.
（２）上記内視鏡用処置具において、前記凹部の個数は、前記凸部の個数と同じまたは前記凸部の個数より多い構成としてもよい。本内視鏡用処置具によれば、凹部の個数が凸部の個数と同じまたは前記凸部の個数より多いため、凸部を凹部に容易に嵌合させることができる。そのため、本内視鏡用処置具によれば、先端チップとシースとの嵌合に要する時間を短縮することができ、内視鏡用処置具を用いた手技の効率を向上させることができる。 (2) In the endoscopic treatment tool, the number of the concave portions may be the same as the number of the convex portions or larger than the number of the convex portions. According to the present endoscope treatment tool, since the number of concave portions is the same as the number of convex portions or larger than the number of the convex portions, the convex portions can be easily fitted to the concave portions. Therefore, according to the present endoscopic treatment tool, the time required for fitting the tip and the sheath can be shortened, and the efficiency of the procedure using the endoscopic treatment tool can be improved.
（３）上記内視鏡用処置具において、前記シースの先端部は、前記シースの前記先端部以外の部分の軸方向に対して湾曲している構成としてもよい。本内視鏡用処置具によれば、操作ワイヤが基準位置にあるときに（すなわち、縮径状態のときに）、シースを周方向に回転させることにより、先端チップを所望の向きに向けることができる。そのため、例えば胆管等の体腔の分岐点において、内視鏡用処置具を進入させるべき体腔を容易に選択することができる。従って、本内視鏡用処置具によれば、内視鏡用処置具を用いた手技の効率を効果的に向上させることができる。 (3) In the endoscopic treatment tool, the tip portion of the sheath may be curved with respect to the axial direction of a portion other than the tip portion of the sheath. According to this endoscopic procedure, when the operating wire is in the reference position (ie, in the reduced diameter state), the sheath is rotated in the circumferential direction to orient the tip in the desired direction. Can be done. Therefore, it is possible to easily select the body cavity into which the endoscopic treatment tool should enter at the bifurcation point of the body cavity such as the bile duct. Therefore, according to the present endoscopic treatment tool, the efficiency of the procedure using the endoscopic treatment tool can be effectively improved.
（４）上記内視鏡用処置具において、前記凸部は、底部から頂部に向けて先細りする形状であり、前記凹部は、頂部から底部に向けて先細りする形状である構成としてもよい。本内視鏡用処置具によれば、凸部を凹部に極めて容易に嵌合させることができる。そのため、本内視鏡用処置具によれば、先端チップとシースとの嵌合に要する時間を効果的に短縮することができ、内視鏡用処置具を用いた手技の効率を効果的に向上させることができる。 (4) In the endoscopic treatment tool, the convex portion may be tapered from the bottom to the top, and the concave portion may be tapered from the top to the bottom. According to this endoscopic treatment tool, the convex portion can be fitted into the concave portion extremely easily. Therefore, according to this endoscopic treatment tool, the time required for fitting the tip and the sheath can be effectively shortened, and the efficiency of the procedure using the endoscopic treatment tool can be effectively reduced. Can be improved.
（５）上記内視鏡用処置具において、前記凹部は、前記シースの周方向に延びる切り欠きを有する形状であり、前記凸部は、前記凹部と嵌合した状態で前記凹部に対して前記シースの周方向に相対回転すると前記凹部の前記切り欠きに係合する突起部を有する形状である構成としてもよい。本内視鏡用処置具によれば、操作ワイヤを基端側に引き寄せることによって凸部と凹部とを嵌合させ、さらに、シースを先端チップに対して周方向に相対回転させることによって凸部の突起部を凹部の切り欠きに係合させることにより、いわゆるロック状態となり、先端チップとシースとを引き離す方向の荷重が加えられても両者の嵌合が解除されることを抑制することができる。従って、本内視鏡用処置具によれば、先端チップを周方向に回転させるための操作性を効果的に向上させることができる。 (5) In the endoscopic treatment tool, the concave portion has a shape having a notch extending in the circumferential direction of the sheath, and the convex portion is fitted with the concave portion and has a shape with respect to the concave portion. It may be configured to have a protrusion that engages with the notch of the recess when it rotates relative to the circumferential direction of the sheath. According to this endoscopic treatment tool, the convex portion and the concave portion are fitted by pulling the operation wire toward the base end side, and the convex portion is further rotated relative to the tip tip in the circumferential direction. By engaging the protrusion of the protrusion with the notch of the recess, a so-called locked state is obtained, and it is possible to prevent the fitting of the tip and the sheath from being disengaged even when a load is applied in the direction of separating the sheath. .. Therefore, according to the present endoscope treatment tool, the operability for rotating the tip tip in the circumferential direction can be effectively improved.
　なお、本明細書に開示される技術は、種々の形態で実現することが可能であり、例えば、内視鏡用処置具やその製造方法等の形態で実現することができる。 The technique disclosed in the present specification can be realized in various forms, for example, in the form of an endoscopic treatment tool, a method for manufacturing the same, and the like.
第１実施形態における内視鏡用処置具１００の構成を概略的に示す説明図Explanatory drawing schematically showing the structure of the endoscopic treatment tool 100 in the first embodiment. 第１実施形態における内視鏡用処置具１００の構成を概略的に示す説明図Explanatory drawing schematically showing the structure of the endoscopic treatment tool 100 in the first embodiment. 第１実施形態の内視鏡用処置具１００における先端チップ４０およびシース１０の詳細構成を示す説明図Explanatory drawing which shows the detailed structure of the tip tip 40 and the sheath 10 in the endoscopic treatment tool 100 of 1st Embodiment 第１実施形態の内視鏡用処置具１００における先端チップ４０およびシース１０の詳細構成を示す説明図Explanatory drawing which shows the detailed structure of the tip tip 40 and the sheath 10 in the endoscopic treatment tool 100 of 1st Embodiment 第１実施形態の内視鏡用処置具１００における先端チップ４０およびシース１０の詳細構成を示す説明図Explanatory drawing which shows the detailed structure of the tip tip 40 and the sheath 10 in the endoscopic treatment tool 100 of 1st Embodiment 第２実施形態の内視鏡用処置具１００ａの構成を概略的に示す説明図Explanatory drawing schematically showing the structure of the endoscopic treatment tool 100a of the second embodiment. 第３実施形態の内視鏡用処置具１００ｂの構成を概略的に示す説明図Explanatory drawing schematically showing the structure of the endoscopic treatment tool 100b of the third embodiment. 第３実施形態の内視鏡用処置具１００ｂの構成を概略的に示す説明図Explanatory drawing schematically showing the structure of the endoscopic treatment tool 100b of the third embodiment. 第４実施形態の内視鏡用処置具１００ｃの構成を概略的に示す説明図Explanatory drawing schematically showing the structure of the endoscopic treatment tool 100c of the fourth embodiment. 第４実施形態の内視鏡用処置具１００ｃの構成を概略的に示す説明図Explanatory drawing schematically showing the structure of the endoscopic treatment tool 100c of the fourth embodiment. 第５実施形態の内視鏡用処置具１００ｄの構成を概略的に示す説明図Explanatory drawing schematically showing the structure of the endoscopic treatment tool 100d of the fifth embodiment.
Ａ．第１実施形態：
Ａ－１．内視鏡用処置具１００の構成：
　図１および図２は、第１実施形態における内視鏡用処置具１００の構成を概略的に示す説明図である。図１には、後述する縮径状態の内視鏡用処置具１００の縦断面構成（ＹＺ断面）が示されており、図２には、後述する拡径状態の内視鏡用処置具１００の縦断面構成（ＹＺ断面構成）が示されている。図１および図２では、内視鏡用処置具１００の一部分の図示が省略されている。また、図１および図２において、Ｚ軸正方向側が、体内に挿入される先端側（遠位側）であり、Ｚ軸負方向側が、医師等の手技者によって操作される基端側（近位側）である。本明細書では、内視鏡用処置具１００およびその各構成部材について、先端側の端部を「先端」といい、先端およびその近傍を「先端部」といい、基端側の端部を「基端」といい、基端およびその近傍を「基端部」という。 A. First Embodiment:
A-1. Configuration of endoscopic treatment tool 100:
1 and 2 are explanatory views schematically showing the configuration of the endoscopic treatment tool 100 in the first embodiment. FIG. 1 shows a vertical cross-sectional configuration (YZ cross section) of the endoscopic treatment tool 100 in a reduced diameter state, which will be described later, and FIG. 2 shows the endoscopic treatment tool 100 in a enlarged diameter state, which will be described later. The vertical cross-sectional configuration (YZ cross-sectional configuration) of is shown. In FIGS. 1 and 2, a part of the endoscopic treatment tool 100 is not shown. Further, in FIGS. 1 and 2, the Z-axis positive direction side is the distal end side (distal side) inserted into the body, and the Z-axis negative direction side is the proximal end side (near) operated by a technician such as a doctor. The rank side). In the present specification, for the endoscopic treatment tool 100 and each component thereof, the end portion on the distal end side is referred to as "tip", the distal end and its vicinity are referred to as "tip portion", and the end portion on the proximal end side is referred to as "tip portion". It is called a "base end", and the base end and its vicinity are called a "base end portion".
　本実施形態の内視鏡用処置具１００は、いわゆるバスケット型の内視鏡用処置具であり、胆管等の体腔ＢＣ内に挿入され、結石等の異物ＦＢを破砕したり回収したりするために用いられる医療用器具である。内視鏡用処置具１００は、シース１０と、操作ワイヤ２０と、バスケット部３０と、先端チップ４０と、基端チップ５０と、操作部６０とを備える。 The endoscopic treatment tool 100 of the present embodiment is a so-called basket-type endoscopic treatment tool, and is inserted into a body cavity BC such as a bile duct to crush or recover a foreign body FB such as a stone. It is a medical device used for. The endoscope treatment tool 100 includes a sheath 10, an operation wire 20, a basket portion 30, a tip tip 40, a base tip 50, and an operation section 60.
　シース１０は、可撓性を有する長尺の管状部材である。シース１０は、例えば樹脂や金属により形成された可撓性のチューブ１１と、チューブ１１の先端に接合され、例えば金属（ステンレス等）により形成された略円環状のシースチップ１４とを有する。操作ワイヤ２０は、長尺のワイヤ部材であり、シース１０内の空間１２に、シース１０の軸方向（図１および図２の例では、Ｚ軸方向）に沿って進退可能に配置されている。 The sheath 10 is a long tubular member having flexibility. The sheath 10 has, for example, a flexible tube 11 made of resin or metal, and a substantially annular sheath tip 14 joined to the tip of the tube 11 and made of, for example, metal (stainless steel or the like). The operation wire 20 is a long wire member, and is arranged in the space 12 in the sheath 10 so as to be able to advance and retreat along the axial direction of the sheath 10 (Z-axis direction in the examples of FIGS. 1 and 2). ..
　操作部６０は、本体部６１と、操作パイプ６２と、把持部６３とを有する。操作パイプ６２は、操作ワイヤ２０の基端に接続された棒状の部材である。把持部６３は、操作パイプ６２の基端に接続され、手技者により把持される部材である。本体部６１は、シース１０の基端に接続された略円筒状の部材である。本体部６１の中空部６５は、シース１０の空間１２と連通しており、該中空部６５には、操作パイプ６２が軸方向に進退可能に収容されている。なお、本体部６１には、図示しない注射器等を取り付けてシース１０の空間１２内に薬液等を送液できるように構成された送水口６６が設けられている。 The operation unit 60 has a main body unit 61, an operation pipe 62, and a grip portion 63. The operation pipe 62 is a rod-shaped member connected to the base end of the operation wire 20. The grip portion 63 is a member connected to the base end of the operation pipe 62 and gripped by a technician. The main body 61 is a substantially cylindrical member connected to the base end of the sheath 10. The hollow portion 65 of the main body portion 61 communicates with the space 12 of the sheath 10, and the operation pipe 62 is accommodated in the hollow portion 65 so as to be able to move forward and backward in the axial direction. The main body 61 is provided with a water supply port 66 configured so that a syringe or the like (not shown) can be attached to the space 12 of the sheath 10 to supply the chemical solution or the like.
　バスケット部３０は、操作ワイヤ２０の先端に接続されており、複数の（本実施形態では４本の）ワイヤ３２から構成されている。各ワイヤ３２は、例えば金属により形成されている。バスケット部３０を構成する複数のワイヤ３２の先端は、先端チップ４０によってまとめて保持されている。また、バスケット部３０を構成する複数のワイヤ３２の基端は、操作ワイヤ２０の先端に設けられた基端チップ５０によってまとめて保持されている。これにより、バスケット部３０は、基端チップ５０を介して操作ワイヤ２０の先端に接続されている。先端チップ４０および基端チップ５０は、例えば金属（ステンレス等）により形成されている。 The basket portion 30 is connected to the tip of the operation wire 20 and is composed of a plurality of (four in this embodiment) wires 32. Each wire 32 is made of, for example, metal. The tips of the plurality of wires 32 constituting the basket portion 30 are collectively held by the tip tips 40. Further, the base ends of the plurality of wires 32 constituting the basket portion 30 are collectively held by the base end chips 50 provided at the tips of the operation wires 20. As a result, the basket portion 30 is connected to the tip of the operation wire 20 via the base end tip 50. The tip 40 and the base tip 50 are made of, for example, a metal (stainless steel or the like).
　バスケット部３０を構成する複数のワイヤ３２は、湾曲して外側に向けて膨らむように自己付勢されている。そのため、図１に示すように、操作ワイヤ２０が比較的基端側の位置（以下、「基準位置」という。）に位置するためにバスケット部３０がシース１０の空間１２内に収容された状態では、バスケット部３０はシース１０の内周面によって押圧されて縮径した状態となる。以下、このようなバスケット部３０または内視鏡用処置具１００の状態を、縮径状態という。また、図２に示すように、手技者による操作部６０の操作に伴い操作ワイヤ２０が基準位置から先端側に移動すると、バスケット部３０がシース１０の先端から突出し、上記自己付勢力によって拡径し、籠状になる。以下、このようなバスケット部３０または内視鏡用処置具１００の状態を、拡径状態という。このように、内視鏡用処置具１００は、操作ワイヤ２０の進退に伴い、バスケット部３０が縮径した状態でシース１０内の空間１２に収容された縮径状態と、バスケット部３０がシース１０の先端から突出して拡径した拡径状態と、の間を切り替え可能に構成されている。 The plurality of wires 32 constituting the basket portion 30 are self-urged so as to be curved and bulge outward. Therefore, as shown in FIG. 1, the basket portion 30 is housed in the space 12 of the sheath 10 because the operation wire 20 is located at a relatively proximal position (hereinafter referred to as “reference position”). Then, the basket portion 30 is pressed by the inner peripheral surface of the sheath 10 to be in a reduced diameter state. Hereinafter, such a state of the basket portion 30 or the endoscopic treatment tool 100 is referred to as a reduced diameter state. Further, as shown in FIG. 2, when the operation wire 20 moves from the reference position to the tip side due to the operation of the operation section 60 by the operator, the basket section 30 protrudes from the tip of the sheath 10 and the diameter is expanded by the self-urging force. And it becomes a basket. Hereinafter, such a state of the basket portion 30 or the endoscopic treatment tool 100 is referred to as a diameter-expanded state. As described above, the endoscopic treatment tool 100 has a reduced diameter state in which the basket portion 30 is accommodated in the space 12 in the sheath 10 in a reduced diameter state as the operation wire 20 advances and retreats, and the basket portion 30 has a sheath. It is configured so that it can be switched between a diameter-expanded state in which the diameter is expanded by protruding from the tip of 10.
Ａ－２．先端チップ４０およびシース１０の詳細構成：
　図３から図５は、第１実施形態の内視鏡用処置具１００における先端チップ４０およびシース１０の詳細構成を示す説明図である。図３には、縮径状態における先端チップ４０およびシース１０の外観構成が示されており、図４には、拡径状態における先端チップ４０およびシース１０の外観構成が示されており、図５には、図３のＶ－Ｖの位置における断面構成（ＸＹ断面構成）が示されている。 A-2. Detailed configuration of tip tip 40 and sheath 10:
3 to 5 are explanatory views showing a detailed configuration of the tip tip 40 and the sheath 10 in the endoscopic treatment tool 100 of the first embodiment. FIG. 3 shows the appearance configuration of the tip tip 40 and the sheath 10 in the reduced diameter state, and FIG. 4 shows the appearance configuration of the tip tip 40 and the sheath 10 in the enlarged diameter state. Shows the cross-sectional configuration (XY cross-sectional configuration) at the position of VV in FIG.
　図３から図５に示すように、先端チップ４０は、最先端部４１と、柱状部４２とを有する。最先端部４１は、先端チップ４０において最先端側に位置し、先端方向に向かって外径が小さくなっていく略半球状の部分である。柱状部４２は、最先端部４１における基端面の中心付近から基端側に延びる略円柱状の部分である。柱状部４２の外径は、最先端部４１の基端の外径より小さい。上述したように、バスケット部３０を構成する複数のワイヤ３２の先端は、先端チップ４０によってまとめて保持されているが、より詳細には、複数のワイヤ３２の先端は、先端チップ４０の柱状部４２によってまとめて保持されている。 As shown in FIGS. 3 to 5, the tip tip 40 has a tip portion 41 and a columnar portion 42. The tip 41 is a substantially hemispherical portion located on the tip side of the tip 40 and whose outer diameter decreases toward the tip. The columnar portion 42 is a substantially columnar portion extending from the vicinity of the center of the proximal end surface of the cutting edge portion 41 toward the proximal end side. The outer diameter of the columnar portion 42 is smaller than the outer diameter of the base end of the cutting edge portion 41. As described above, the tips of the plurality of wires 32 constituting the basket portion 30 are collectively held by the tip tips 40, but more specifically, the tips of the plurality of wires 32 are the columnar portions of the tip tips 40. It is held together by 42.
　また、先端チップ４０の基端面には、凸部４３が形成されている。凸部４３は、最先端部４１における基端面から基端側に延びる柱状の部分である。凸部４３のＸＹ断面形状は、任意の形状とすることができるが、例えば略矩形である。本実施形態では、先端チップ４０は、柱状部４２の外周廻りに略等間隔に配置された４つの凸部４３を有する（図５参照）。なお、周方向に隣り合う２つの凸部４３の間の空間を、凹部４５と捉えることもできる。すなわち、先端チップ４０の基端面には、４つの凹部４５が形成されている。 Further, a convex portion 43 is formed on the base end surface of the tip tip 40. The convex portion 43 is a columnar portion extending from the proximal end surface to the proximal end side in the cutting edge portion 41. The XY cross-sectional shape of the convex portion 43 can be any shape, but is, for example, a substantially rectangular shape. In the present embodiment, the tip tip 40 has four convex portions 43 arranged at substantially equal intervals around the outer periphery of the columnar portion 42 (see FIG. 5). The space between the two convex portions 43 adjacent to each other in the circumferential direction can also be regarded as the concave portion 45. That is, four recesses 45 are formed on the base end surface of the tip tip 40.
　図３および図４に示すように、シース１０の先端を構成するシースチップ１４は、最基端部１５を有する。最基端部１５は、シースチップ１４において最基端側に位置する略円筒状の部分である。また、シースチップ１４の先端面には、凸部１６が形成されている。凸部１６は、最基端部１５における先端面から先端側に延びる柱状の部分である。凸部１６のＸＹ断面形状は、任意の形状とすることができるが、例えば略扇形である。本実施形態では、シースチップ１４は、最基端部１５の外周廻りに略等間隔に配置された４つの凸部１６を有する（図５参照）。各凸部１６は、先端チップ４０に形成された各凸部４３と、先端チップ４０の周方向に隣り合っている。なお、周方向に隣り合う２つの凸部１６の間の空間を、凹部１７と捉えることもできる。すなわち、シースチップ１４の先端面には、４つの凹部１７が形成されている。 As shown in FIGS. 3 and 4, the sheath tip 14 constituting the tip of the sheath 10 has the most proximal end portion 15. The most proximal end portion 15 is a substantially cylindrical portion located on the most proximal end side of the sheath tip 14. Further, a convex portion 16 is formed on the tip surface of the sheath tip 14. The convex portion 16 is a columnar portion extending from the distal end surface to the distal end side of the most proximal end portion 15. The XY cross-sectional shape of the convex portion 16 can be any shape, but is, for example, substantially a fan shape. In the present embodiment, the sheath tip 14 has four convex portions 16 arranged around the outer periphery of the most proximal end portion 15 at substantially equal intervals (see FIG. 5). Each convex portion 16 is adjacent to each convex portion 43 formed on the tip tip 40 in the circumferential direction of the tip tip 40. The space between the two convex portions 16 adjacent to each other in the circumferential direction can also be regarded as the concave portion 17. That is, four recesses 17 are formed on the tip surface of the sheath tip 14.
　図３および図５に示すように、操作ワイヤ２０が上記基準位置まで引き寄せられ、内視鏡用処置具１００（バスケット部３０）が縮径状態にあるときに、先端チップ４０の凸部４３とシースチップ１４の凹部１７とは互いに嵌合可能である。すなわち、図３および図５に示す状態では、先端チップ４０の各凸部４３は、シースチップ１４の各凹部１７に嵌まっている。先端チップ４０の凸部４３とシースチップ１４の凹部１７とが互いに嵌合すると、結果として、先端チップ４０とシースチップ１４とが嵌合し、先端チップ４０とシースチップ１４とが一体的に回転する状態となる。なお、この状態は、シースチップ１４の凸部１６と先端チップ４０の凹部４５とが互いに嵌合している状態（シースチップ１４の各凸部１６が先端チップ４０の各凹部４５に嵌まっている状態）と換言することができる。 As shown in FIGS. 3 and 5, when the operation wire 20 is pulled to the reference position and the endoscopic treatment tool 100 (basket portion 30) is in the reduced diameter state, the convex portion 43 of the tip tip 40 The recess 17 of the sheath tip 14 can be fitted to each other. That is, in the state shown in FIGS. 3 and 5, each convex portion 43 of the tip tip 40 is fitted in each concave portion 17 of the sheath tip 14. When the convex portion 43 of the tip tip 40 and the concave portion 17 of the sheath tip 14 are fitted to each other, as a result, the tip tip 40 and the sheath tip 14 are fitted, and the tip tip 40 and the sheath tip 14 rotate integrally. It will be in a state of doing. In this state, the convex portion 16 of the sheath tip 14 and the concave portion 45 of the tip tip 40 are fitted to each other (each convex portion 16 of the sheath tip 14 is fitted into each concave portion 45 of the tip tip 40). It can be rephrased as (the state of being).
Ａ－３．内視鏡用処置具１００の動作：
　本実施形態の内視鏡用処置具１００を用いた体腔ＢＣ内の異物ＦＢの破砕方法の一例は、以下の通りである。まず、操作部６０を操作して操作ワイヤ２０を基端側に引き寄せることにより、内視鏡用処置具１００（バスケット部３０）を縮径状態（図１および図３に示す状態）とする。このとき、先端チップ４０の凸部４３とシースチップ１４の凹部１７とは互いに嵌合している。この状態の内視鏡用処置具１００を、予め患者の体腔ＢＣ内に挿入された内視鏡装置のチャネルに挿入し、異物ＦＢの付近まで進入させる。さらに、先端チップ４０が異物ＦＢの横をすり抜けて異物ＦＢより奥側まで到達するように、内視鏡用処置具１００を進行させる。このとき、異物ＦＢが比較的大きいために先端チップ４０の通過が容易ではない場合には、手技者は操作部６０を操作することによりシース１０を周方向に回転させる。上述したように、縮径状態では先端チップ４０の凸部４３とシースチップ１４の凹部１７とが互いに嵌合しているため、シース１０を周方向に回転させると、先端チップ４０は、シース１０（シースチップ１４）と一体となって周方向に回転する。そのため、異物ＦＢが比較的大きい場合であっても、円滑に、先端チップ４０を異物ＦＢより奥側まで進行させることができる。 A-3. Operation of the endoscopic treatment tool 100:
An example of a method for crushing a foreign body FB in a body cavity BC using the endoscopic treatment tool 100 of the present embodiment is as follows. First, by operating the operation unit 60 and pulling the operation wire 20 toward the base end side, the endoscopic treatment tool 100 (basket unit 30) is brought into a reduced diameter state (state shown in FIGS. 1 and 3). At this time, the convex portion 43 of the tip tip 40 and the concave portion 17 of the sheath tip 14 are fitted to each other. The endoscopic treatment tool 100 in this state is inserted into the channel of the endoscopic device previously inserted into the body cavity BC of the patient, and is allowed to enter the vicinity of the foreign body FB. Further, the endoscopic treatment tool 100 is advanced so that the tip 40 passes through the side of the foreign body FB and reaches the back side of the foreign body FB. At this time, if the foreign matter FB is relatively large and it is not easy for the tip tip 40 to pass through, the operator operates the operation unit 60 to rotate the sheath 10 in the circumferential direction. As described above, in the reduced diameter state, the convex portion 43 of the tip tip 40 and the concave portion 17 of the sheath tip 14 are fitted to each other. Therefore, when the sheath 10 is rotated in the circumferential direction, the tip tip 40 becomes the sheath 10. It rotates integrally with (sheath tip 14) in the circumferential direction. Therefore, even when the foreign matter FB is relatively large, the tip tip 40 can be smoothly advanced to the back side of the foreign matter FB.
　次に、操作ワイヤ２０を先端側に押し出すことによって、シース１０の先端からバスケット部３０を突出させて拡径させる（図２参照）。その後、操作ワイヤ２０を基端側に引き寄せることによって、拡径したバスケット部３０の内部空間に異物ＦＢを捕捉する。この状態で、操作ワイヤ２０を基端側にさらに引き寄せることによって、先端チップ４０とシースチップ１４とで異物ＦＢを挟み込んで締め付け、異物ＦＢを破砕する。以上の方法により、内視鏡用処置具１００を用いて体腔ＢＣ内の異物ＦＢを破砕することができる。なお、異物ＦＢを破砕する代わりに、バスケット部３０内に異物ＦＢを補足した状態で基端側に搬送することにより、異物ＦＢを回収してもよい。 Next, by pushing the operation wire 20 toward the tip side, the basket portion 30 is projected from the tip of the sheath 10 to expand the diameter (see FIG. 2). After that, by pulling the operation wire 20 toward the base end side, the foreign matter FB is captured in the internal space of the expanded basket portion 30. In this state, by further pulling the operation wire 20 toward the base end side, the foreign matter FB is sandwiched between the tip tip 40 and the sheath tip 14 and tightened to crush the foreign matter FB. By the above method, the foreign body FB in the body cavity BC can be crushed by using the endoscopic treatment tool 100. Instead of crushing the foreign matter FB, the foreign matter FB may be collected by transporting the foreign matter FB to the base end side with the foreign matter FB captured in the basket portion 30.
Ａ－４．第１実施形態の効果：
　以上説明したように、本実施形態の内視鏡用処置具１００は、シース１０と、操作ワイヤ２０と、バスケット部３０と、先端チップ４０とを備える。シース１０は、可撓性を有する管状の部材である。操作ワイヤ２０は、シース１０内にシース１０の軸方向に沿って進退可能に配置されている。バスケット部３０は、操作ワイヤ２０の先端に接続されており、複数のワイヤ３２から構成されている。バスケット部３０は、操作ワイヤ２０が基準位置にあるときに、シース１０内に縮径した状態で収容され、操作ワイヤ２０が基準位置から先端側に移動したときに、シース１０の先端から突出して拡径するように構成されている。先端チップ４０は、バスケット部３０を構成する複数のワイヤ３２の先端をまとめて保持する。また、本実施形態の内視鏡用処置具１００では、先端チップ４０の基端面に凸部４３が形成され、シース１０の先端を構成するシースチップ１４の先端面に、操作ワイヤ２０が基準位置にあるときに（すなわち、縮径状態のときに）凸部４３と嵌合可能な凹部１７が形成されている。なお、本実施形態の内視鏡用処置具１００では、シース１０の先端を構成するシースチップ１４の先端面に凸部１６が形成され、先端チップ４０の基端面に、操作ワイヤ２０が基準位置にあるときに（すなわち、縮径状態のときに）凸部１６と嵌合可能な凹部４５が形成されていると捉えることもできる。 A-4. Effect of the first embodiment:
As described above, the endoscopic treatment tool 100 of the present embodiment includes a sheath 10, an operation wire 20, a basket portion 30, and a tip tip 40. The sheath 10 is a flexible tubular member. The operation wire 20 is arranged in the sheath 10 so as to be able to advance and retreat along the axial direction of the sheath 10. The basket portion 30 is connected to the tip of the operation wire 20 and is composed of a plurality of wires 32. The basket portion 30 is housed in the sheath 10 in a reduced diameter state when the operation wire 20 is in the reference position, and protrudes from the tip of the sheath 10 when the operation wire 20 moves from the reference position to the tip side. It is configured to increase the diameter. The tip tip 40 collectively holds the tips of a plurality of wires 32 constituting the basket portion 30. Further, in the endoscopic treatment tool 100 of the present embodiment, the convex portion 43 is formed on the base end surface of the tip tip 40, and the operation wire 20 is a reference position on the tip end surface of the sheath tip 14 constituting the tip of the sheath 10. (That is, when the diameter is reduced), a concave portion 17 that can be fitted with the convex portion 43 is formed. In the endoscopic treatment tool 100 of the present embodiment, a convex portion 16 is formed on the tip surface of the sheath tip 14 constituting the tip of the sheath 10, and the operation wire 20 is a reference position on the base end surface of the tip tip 40. It can also be considered that the concave portion 45 that can be fitted with the convex portion 16 is formed when the convex portion 16 is formed (that is, when the diameter is reduced).
　そのため、本実施形態の内視鏡用処置具１００では、互いに嵌合可能な凸部４３および凹部１７（または、凸部１６および凹部４５）の存在により、操作ワイヤ２０が基準位置にあるときに（すなわち、縮径状態のときに）、シース１０を周方向に回転させると、先端チップ４０がシース１０と一体となって周方向に回転する。従って、本実施形態の内視鏡用処置具１００によれば、先端チップ４０を周方向に回転させるための操作性を向上させることができる。 Therefore, in the endoscopic treatment tool 100 of the present embodiment, when the operation wire 20 is in the reference position due to the presence of the convex portion 43 and the concave portion 17 (or the convex portion 16 and the concave portion 45) that can be fitted to each other. When the sheath 10 is rotated in the circumferential direction (that is, in the reduced diameter state), the tip tip 40 is integrated with the sheath 10 and rotates in the circumferential direction. Therefore, according to the endoscopic treatment tool 100 of the present embodiment, the operability for rotating the tip 40 in the circumferential direction can be improved.
　また、第１実施形態の内視鏡用処置具１００では、シースチップ１４に形成された凹部１７の個数が先端チップ４０に形成された凸部４３の個数と同じであるため、凸部４３を凹部１７に容易に嵌合させることができる。そのため、第１実施形態の内視鏡用処置具１００によれば、先端チップ４０とシースチップ１４（シース１０）との嵌合に要する時間を短縮することができ、内視鏡用処置具１００を用いた手技の効率を向上させることができる。 Further, in the endoscopic treatment tool 100 of the first embodiment, since the number of concave portions 17 formed in the sheath tip 14 is the same as the number of convex portions 43 formed in the tip tip 40, the convex portions 43 are formed. It can be easily fitted into the recess 17. Therefore, according to the endoscopic treatment tool 100 of the first embodiment, the time required for fitting the tip tip 40 and the sheath tip 14 (sheath 10) can be shortened, and the endoscopic treatment tool 100 can be used. It is possible to improve the efficiency of the procedure using.
Ｂ．第２実施形態：
　図６は、第２実施形態の内視鏡用処置具１００ａの構成を概略的に示す説明図である。図６には、第２実施形態の内視鏡用処置具１００ａにおける先端チップ４０ａおよびシースチップ１４の詳細構成が示されている。以下では、第２実施形態の内視鏡用処置具１００ａの構成のうち、上述した第１実施形態の内視鏡用処置具１００と同一の構成については、同一の符号を付すことによってその説明を適宜省略する。 B. Second embodiment:
FIG. 6 is an explanatory diagram schematically showing the configuration of the endoscopic treatment tool 100a of the second embodiment. FIG. 6 shows a detailed configuration of the tip tip 40a and the sheath tip 14 in the endoscopic treatment tool 100a of the second embodiment. Hereinafter, among the configurations of the endoscopic treatment tool 100a of the second embodiment, the same configurations as the endoscopic treatment tool 100 of the first embodiment described above will be described by adding the same reference numerals. Is omitted as appropriate.
　第２実施形態の内視鏡用処置具１００ａは、先端チップ４０ａに形成された凸部４３の個数が、第１実施形態の内視鏡用処置具１００と異なっている。具体的には、第２実施形態の内視鏡用処置具１００ａでは、先端チップ４０ａに形成された凸部４３の個数は１つである。なお、シースチップ１４に形成された凹部１７の個数は、第１実施形態と同様に４つである。そのため、第２実施形態では、凹部１７の個数は凸部４３の個数より多い。 The endoscopic treatment tool 100a of the second embodiment has a different number of convex portions 43 formed on the tip tip 40a from the endoscopic treatment tool 100 of the first embodiment. Specifically, in the endoscopic treatment tool 100a of the second embodiment, the number of convex portions 43 formed on the tip tip 40a is one. The number of recesses 17 formed in the sheath tip 14 is four, as in the first embodiment. Therefore, in the second embodiment, the number of concave portions 17 is larger than the number of convex portions 43.
　このように、第２実施形態の内視鏡用処置具１００ａでは、シースチップ１４に形成された凹部１７の個数が先端チップ４０ａに形成された凸部４３の個数より多いため、凸部４３を凹部１７に容易に嵌合させることができる。そのため、第２実施形態の内視鏡用処置具１００ａによれば、先端チップ４０ａとシースチップ１４（シース１０）との嵌合に要する時間を短縮することができ、内視鏡用処置具１００ａを用いた手技の効率を向上させることができる。 As described above, in the endoscopic treatment tool 100a of the second embodiment, the number of the concave portions 17 formed on the sheath tip 14 is larger than the number of the convex portions 43 formed on the tip tip 40a, so that the convex portions 43 are formed. It can be easily fitted into the recess 17. Therefore, according to the endoscopic treatment tool 100a of the second embodiment, the time required for fitting the tip tip 40a and the sheath tip 14 (sheath 10) can be shortened, and the endoscopic treatment tool 100a can be shortened. It is possible to improve the efficiency of the procedure using.
Ｃ．第３実施形態：
　図７および図８は、第３実施形態の内視鏡用処置具１００ｂの構成を概略的に示す説明図である。図７には、第３実施形態における縮径状態の内視鏡用処置具１００ｂの先端チップ４０ｂおよびシースチップ１４ｂの外観構成が示されており、図８には、第３実施形態における拡径状態の内視鏡用処置具１００ｂの先端チップ４０ｂおよびシースチップ１４ｂの外観構成が示されている。以下では、第３実施形態の内視鏡用処置具１００ｂの構成のうち、上述した第１実施形態の内視鏡用処置具１００と同一の構成については、同一の符号を付すことによってその説明を適宜省略する。 C. Third embodiment:
7 and 8 are explanatory views schematically showing the configuration of the endoscopic treatment tool 100b according to the third embodiment. FIG. 7 shows the appearance configuration of the tip tip 40b and the sheath tip 14b of the endoscopic treatment tool 100b in the reduced diameter state in the third embodiment, and FIG. 8 shows the diameter expansion in the third embodiment. The appearance configuration of the tip tip 40b and the sheath tip 14b of the endoscopic treatment tool 100b in the state is shown. Hereinafter, among the configurations of the endoscopic treatment tool 100b of the third embodiment, the same configurations as the endoscopic treatment tool 100 of the first embodiment described above will be described by adding the same reference numerals. Is omitted as appropriate.
　第３実施形態の内視鏡用処置具１００ｂは、先端チップ４０ｂに形成された凸部４３ｂの形状、および、シースチップ１４ｂに形成された凹部１７ｂの形状が、第１実施形態の内視鏡用処置具１００と異なっている。具体的には、第３実施形態の内視鏡用処置具１００ｂでは、先端チップ４０ｂに形成された凸部４３ｂは、底部（最先端部４１との境界位置）から頂部に向けて先細りする形状である。本実施形態では、凸部４３ｂは、先端チップ４０ｂの径方向視で略台形状である。また、シースチップ１４ｂに形成された凹部１７ｂは、頂部から底部（最基端部１５との境界位置）に向けて先細りする形状である。なお、このことは、シースチップ１４ｂに形成された凸部１６ｂが、底部（最基端部１５との境界位置）から頂部に向けて先細りする形状であると換言することができる。本実施形態では、凹部１７ｂは、先端チップ４０ｂの径方向視で略台形状である。 In the endoscope treatment tool 100b of the third embodiment, the shape of the convex portion 43b formed on the tip tip 40b and the shape of the concave portion 17b formed on the sheath tip 14b are the shapes of the endoscope of the first embodiment. It is different from the treatment tool 100. Specifically, in the endoscopic treatment tool 100b of the third embodiment, the convex portion 43b formed on the tip tip 40b has a shape that tapers from the bottom (boundary position with the cutting edge 41) toward the top. Is. In the present embodiment, the convex portion 43b has a substantially trapezoidal shape in the radial direction of the tip tip 40b. Further, the recess 17b formed in the sheath tip 14b has a shape that tapers from the top to the bottom (the boundary position with the most basic end portion 15). In addition, this can be rephrased as having a shape in which the convex portion 16b formed on the sheath tip 14b tapers from the bottom portion (the boundary position with the most basic end portion 15) toward the top portion. In the present embodiment, the recess 17b has a substantially trapezoidal shape in the radial direction of the tip tip 40b.
　このように、第３実施形態の内視鏡用処置具１００ｂでは、先端チップ４０ｂに形成された凸部４３ｂが、底部から頂部に向けて先細りする形状であり、シースチップ１４ｂに形成された凹部１７ｂが、頂部から底部に向けて先細りする形状であるため、凸部４３ｂを凹部１７ｂに極めて容易に嵌合させることができる。そのため、第３実施形態の内視鏡用処置具１００ｂによれば、先端チップ４０ｂとシースチップ１４ｂ（シース１０）との嵌合に要する時間を効果的に短縮することができ、内視鏡用処置具１００ｂを用いた手技の効率を効果的に向上させることができる。 As described above, in the endoscopic treatment tool 100b of the third embodiment, the convex portion 43b formed on the tip tip 40b has a shape that tapers from the bottom to the top, and the concave portion formed on the sheath tip 14b. Since the 17b has a shape that tapers from the top to the bottom, the convex portion 43b can be fitted into the concave portion 17b very easily. Therefore, according to the endoscopic treatment tool 100b of the third embodiment, the time required for fitting the tip tip 40b and the sheath tip 14b (sheath 10) can be effectively shortened, and the time required for fitting the sheath tip 14b (sheath 10) can be effectively shortened. The efficiency of the procedure using the treatment tool 100b can be effectively improved.
Ｄ．第４実施形態：
　図９および図１０は、第４実施形態の内視鏡用処置具１００ｃの構成を概略的に示す説明図である。図９には、第４実施形態における縮径状態の内視鏡用処置具１００ｃの先端チップ４０ｃおよびシースチップ１４ｃの外観構成が示されており、図１０には、第４実施形態における拡径状態の内視鏡用処置具１００ｃの先端チップ４０ｃおよびシースチップ１４ｃの外観構成が示されている。以下では、第４実施形態の内視鏡用処置具１００ｃの構成のうち、上述した第１実施形態の内視鏡用処置具１００と同一の構成については、同一の符号を付すことによってその説明を適宜省略する。 D. Fourth Embodiment:
9 and 10 are explanatory views schematically showing the configuration of the endoscopic treatment tool 100c according to the fourth embodiment. FIG. 9 shows the appearance configuration of the tip tip 40c and the sheath tip 14c of the endoscopic treatment tool 100c in the reduced diameter state in the fourth embodiment, and FIG. 10 shows the diameter expansion in the fourth embodiment. The appearance configuration of the tip tip 40c and the sheath tip 14c of the endoscopic treatment tool 100c in the state is shown. Hereinafter, among the configurations of the endoscopic treatment tool 100c of the fourth embodiment, the same configurations as the endoscopic treatment tool 100 of the first embodiment described above will be described by adding the same reference numerals. Is omitted as appropriate.
　第４実施形態の内視鏡用処置具１００ｃは、先端チップ４０ｃに形成された凸部４３ｃの形状、および、シースチップ１４ｃに形成された凹部１７ｃの形状が、第１実施形態の内視鏡用処置具１００と異なっている。具体的には、第４実施形態の内視鏡用処置具１００ｃでは、シースチップ１４ｃに形成された凹部１７ｃは、シース１０の周方向に延びる切り欠き１８を有する形状である。本実施形態では、切り欠き１８は、凹部１７ｃにおける底部の位置に設けられている。また、先端チップ４０ｃに形成された凸部４３ｃは、凸部４３ｃが凹部１７ｃと嵌合した状態で凹部１７ｃに対してシース１０の周方向に相対回転すると凹部１７ｃの切り欠き１８に係合するような突起部４６を有する形状である。本実施形態では、突起部４６は、凸部４３ｃにおける頂部の位置に設けられている。 In the endoscope treatment tool 100c of the fourth embodiment, the shape of the convex portion 43c formed on the tip tip 40c and the shape of the concave portion 17c formed on the sheath tip 14c are the shapes of the endoscope of the first embodiment. It is different from the treatment tool 100. Specifically, in the endoscopic treatment tool 100c of the fourth embodiment, the recess 17c formed in the sheath tip 14c has a shape having a notch 18 extending in the circumferential direction of the sheath 10. In the present embodiment, the notch 18 is provided at the position of the bottom portion in the recess 17c. Further, the convex portion 43c formed on the tip tip 40c engages with the notch 18 of the concave portion 17c when the convex portion 43c rotates relative to the concave portion 17c in the circumferential direction with the convex portion 43c fitted to the concave portion 17c. It is a shape having such a protrusion 46. In the present embodiment, the protrusion 46 is provided at the position of the top of the protrusion 43c.
　このように、第４実施形態の内視鏡用処置具１００ｃでは、シースチップ１４ｃに形成された凹部１７ｃが切り欠き１８を有する形状であり、先端チップ４０ｃに形成された凸部４３ｃが切り欠き１８に係合する突起部４６を有する形状である。そのため、操作ワイヤ２０を基端側に引き寄せることによって先端チップ４０ｃに形成された凸部４３ｃとシースチップ１４ｃに形成された凹部１７ｃとを嵌合させ、さらに、シースチップ１４ｃ（シース１０）を先端チップ４０ｃに対して周方向に相対回転させることによって先端チップ４０ｃの凸部４３ｃの突起部４６を凹部１７ｃの切り欠き１８に係合させることにより、いわゆるロック状態となり、先端チップ４０ｃとシースチップ１４ｃとを引き離す方向の荷重が加えられても両者の嵌合が解除されることを抑制することができる。従って、第４実施形態の内視鏡用処置具１００ｃによれば、先端チップ４０ｃを周方向に回転させるための操作性を効果的に向上させることができる。 As described above, in the endoscopic treatment tool 100c of the fourth embodiment, the concave portion 17c formed in the sheath tip 14c has a shape having a notch 18, and the convex portion 43c formed in the tip tip 40c has a notch. It has a shape having a protrusion 46 that engages with 18. Therefore, the convex portion 43c formed on the tip tip 40c and the concave portion 17c formed on the sheath tip 14c are fitted by pulling the operation wire 20 toward the base end side, and the sheath tip 14c (sheath 10) is further fitted to the tip. By engaging the protrusion 46 of the convex portion 43c of the tip tip 40c with the notch 18 of the recess 17c by rotating the tip 40c relative to the circumferential direction, a so-called locked state is obtained, and the tip tip 40c and the sheath tip 14c are in a so-called locked state. Even if a load in the direction of separating the and is applied, it is possible to prevent the two from being disengaged from each other. Therefore, according to the endoscopic treatment tool 100c of the fourth embodiment, the operability for rotating the tip 40c in the circumferential direction can be effectively improved.
Ｅ．第５実施形態：
　図１１は、第５実施形態の内視鏡用処置具１００ｄの構成を概略的に示す説明図である。図１１には、第５実施形態における縮径状態の内視鏡用処置具１００ｄの縦断面構成（ＹＺ断面）が示されている。以下では、第５実施形態の内視鏡用処置具１００ｄの構成のうち、上述した第１実施形態の内視鏡用処置具１００と同一の構成については、同一の符号を付すことによってその説明を適宜省略する。 E. Fifth Embodiment:
FIG. 11 is an explanatory diagram schematically showing the configuration of the endoscopic treatment tool 100d according to the fifth embodiment. FIG. 11 shows a vertical cross-sectional configuration (YZ cross-section) of the endoscopic treatment tool 100d in a reduced diameter state according to the fifth embodiment. Hereinafter, among the configurations of the endoscopic treatment tool 100d of the fifth embodiment, the same configurations as the endoscopic treatment tool 100 of the first embodiment described above will be described by adding the same reference numerals. Is omitted as appropriate.
　第５実施形態の内視鏡用処置具１００ｄは、シース１０ｄの構成が、第１実施形態の内視鏡用処置具１００と異なっている。具体的には、第５実施形態の内視鏡用処置具１００ｄでは、シース１０ｄの先端部Ｐ１が、シース１０ｄの先端部Ｐ１以外の部分（以下、「主部Ｐ２」という。）の軸方向に対して湾曲している。なお、本実施形態では、シース１０ｄの先端部Ｐ１は、シースチップ１４と、チューブ１１ｄの先端部とから構成されており、シース１０ｄの主部Ｐ２は、チューブ１１ｄの先端部以外の部分から構成されている。すなわち、本実施形態では、チューブ１１ｄの先端部が湾曲している結果、シース１０ｄの先端部Ｐ１が湾曲している。また、シース１０ｄの先端部Ｐ１が主部Ｐ２の軸方向に対して湾曲しているとは、シース１０ｄの先端が主部Ｐ２の中心軸の延長上に位置しないことを意味し、シース１０ｄが所定の位置で折れ曲がった形態（図１１に示す形態）や、シース１０ｄにおける所定の位置より先端側が一定または変化する曲率で曲線状に曲がっている形態等を含む。なお、本実施形態では、縮径状態において、バスケット部３０の全体が、シース１０ｄの先端部Ｐ１内に収まっている。 The endoscope treatment tool 100d of the fifth embodiment has a sheath 10d different from that of the endoscope treatment tool 100 of the first embodiment. Specifically, in the endoscopic treatment tool 100d of the fifth embodiment, the tip portion P1 of the sheath 10d is in the axial direction of a portion other than the tip portion P1 of the sheath 10d (hereinafter, referred to as “main portion P2”). It is curved with respect to. In the present embodiment, the tip portion P1 of the sheath 10d is composed of the sheath tip 14 and the tip portion of the tube 11d, and the main portion P2 of the sheath 10d is composed of a portion other than the tip portion of the tube 11d. Has been done. That is, in the present embodiment, as a result of the tip portion of the tube 11d being curved, the tip portion P1 of the sheath 10d is curved. Further, the fact that the tip P1 of the sheath 10d is curved with respect to the axial direction of the main portion P2 means that the tip of the sheath 10d is not located on the extension of the central axis of the main portion P2, and the sheath 10d is It includes a form bent at a predetermined position (a form shown in FIG. 11), a form in which the tip side of the sheath 10d is bent in a curved shape with a constant or changing curvature from the predetermined position, and the like. In the present embodiment, the entire basket portion 30 is contained in the tip portion P1 of the sheath 10d in the reduced diameter state.
　このように、第５実施形態の内視鏡用処置具１００ｄでは、シース１０ｄの先端部Ｐ１がシース１０ｄの主部Ｐ２の軸方向に対して湾曲しているため、縮径状態においてシース１０ｄを周方向に回転させることにより、先端チップ４０を所望の向きに向けることができる。そのため、例えば図１１に示すように、胆管等の体腔ＢＣの分岐点ＢＩにおいて、内視鏡用処置具１００ｄを進入させるべき体腔ＢＣを容易に選択することができる。従って、第５実施形態の内視鏡用処置具１００ｄによれば、内視鏡用処置具１００ｄを用いた手技の効率を効果的に向上させることができる。 As described above, in the endoscopic treatment tool 100d of the fifth embodiment, since the tip portion P1 of the sheath 10d is curved with respect to the axial direction of the main portion P2 of the sheath 10d, the sheath 10d is placed in a reduced diameter state. By rotating in the circumferential direction, the tip 40 can be oriented in a desired direction. Therefore, for example, as shown in FIG. 11, at the bifurcation point BI of the body cavity BC such as the bile duct, the body cavity BC to which the endoscopic treatment tool 100d should enter can be easily selected. Therefore, according to the endoscopic treatment tool 100d of the fifth embodiment, the efficiency of the procedure using the endoscopic treatment tool 100d can be effectively improved.
　なお、ガイドワイヤを併用することによっても、内視鏡用処置具を進行させるべき体腔ＢＣを容易に選択することができるが、その場合には、手技が煩雑になると共にコスト面でも不利となり、さらに、内視鏡用処置具の先端にガイドワイヤ案内手段を設ける必要があるために、内視鏡用処置具の通過性が低下する。また、先端チップを湾曲させることによっても、内視鏡用処置具を進行させるべき体腔ＢＣを容易に選択することができるが、その場合には、先端チップの前面投影面積が大きくなって内視鏡用処置具の通過性が低下する。第５実施形態の内視鏡用処置具１００ｄによれば、それらの問題を生じさせることなく、内視鏡用処置具１００ｄを用いた手技の効率を効果的に向上させることができる点で、それらの構成より有利である。 It should be noted that the body cavity BC to which the endoscopic treatment tool should be advanced can be easily selected by using the guide wire together, but in that case, the procedure becomes complicated and the cost is disadvantageous. Further, since it is necessary to provide a guide wire guiding means at the tip of the endoscopic treatment tool, the passability of the endoscopic treatment tool is reduced. In addition, by bending the tip tip, it is possible to easily select the body cavity BC in which the endoscopic treatment tool should be advanced, but in that case, the front projection area of the tip tip becomes large and endoscopy is performed. The passability of the mirror treatment tool is reduced. According to the endoscopic treatment tool 100d of the fifth embodiment, the efficiency of the procedure using the endoscopic treatment tool 100d can be effectively improved without causing these problems. It is more advantageous than those configurations.
Ｆ．変形例：
　本明細書で開示される技術は、上述の実施形態に限られるものではなく、その要旨を逸脱しない範囲において種々の形態に変形することができ、例えば次のような変形も可能である。 F. Modification example:
The technique disclosed in the present specification is not limited to the above-described embodiment, and can be transformed into various forms without departing from the gist thereof, and for example, the following modifications are also possible.
　上記実施形態における内視鏡用処置具１００の構成は、あくまで一例であり、種々変形可能である。例えば、上記実施形態では、バスケット部３０は、４本のワイヤ３２により構成されているが、バスケット部３０を構成するワイヤ３２の本数が他の本数（例えば、６本、８本等）であってもよい。また、上記実施形態では、バスケット部３０を構成する複数のワイヤ３２の基端が、操作ワイヤ２０の先端に設けられた基端チップ５０によってまとめて保持されているが、該複数のワイヤ３２における基端より先端側の所定の箇所が他のチップ部材によってまとめて保持されていてもよい。このような構成では、該複数のワイヤ３２における先端チップ４０と該他のチップとの間に位置する部分が、バスケット部３０として機能する。このような構成においても、バスケット部３０は、操作ワイヤ２０の先端に接続されていると言える。 The configuration of the endoscopic treatment tool 100 in the above embodiment is merely an example and can be variously modified. For example, in the above embodiment, the basket portion 30 is composed of four wires 32, but the number of wires 32 constituting the basket portion 30 is another number (for example, six wires, eight wires, etc.). You may. Further, in the above embodiment, the proximal ends of the plurality of wires 32 constituting the basket portion 30 are collectively held by the proximal end chips 50 provided at the tips of the operation wires 20, but the plurality of wires 32 are held together. A predetermined portion on the tip end side from the proximal end may be collectively held by another chip member. In such a configuration, the portion of the plurality of wires 32 located between the tip tip 40 and the other tip functions as the basket portion 30. Even in such a configuration, it can be said that the basket portion 30 is connected to the tip of the operation wire 20.
　上記実施形態において、先端チップ４０に形成された凸部４３（および凹部４５）の個数や、シースチップ１４に形成された凹部１７（および凸部１６）の個数は、あくまで一例であり、任意に変更可能である。また、上記実施形態において、先端チップ４０に複数の凸部４３（および凹部４５）が形成されている場合、または、シースチップ１４に複数の凹部１７（および凸部１６）が形成されている場合、各凸部４３（および凹部４５）または凹部１７（および凸部１６）は周方向に略均等に配置されているが、必ずしもこのような略均等配置である必要はない。 In the above embodiment, the number of convex portions 43 (and concave portions 45) formed on the tip tip 40 and the number of concave portions 17 (and convex portions 16) formed on the sheath tip 14 are merely examples and are arbitrary. It can be changed. Further, in the above embodiment, when a plurality of convex portions 43 (and concave portions 45) are formed on the tip tip 40, or when a plurality of concave portions 17 (and convex portions 16) are formed on the sheath tip 14. , Each convex portion 43 (and concave portion 45) or concave portion 17 (and convex portion 16) is arranged substantially evenly in the circumferential direction, but it is not always necessary to have such a substantially even arrangement.
　上記第３実施形態では、先端チップ４０ｂに形成された凸部４３ｂは、先端チップ４０ｂの径方向視で略台形状であるが、底部から頂部に向けて先細りする形状である限りにおいて、他の形状（例えば、側面が曲面となるように先細りする形状）であってもよい。同様に、上記第３実施形態では、シースチップ１４ｂに形成された凹部１７ｂは、先端チップ４０ｂの径方向視で略台形状であるが、頂部から底部に向けて先細りする形状である限りにおいて、他の形状（例えば、側面が曲面となるように先細りする形状）であってもよい。 In the third embodiment, the convex portion 43b formed on the tip tip 40b has a substantially trapezoidal shape in the radial direction of the tip tip 40b, but other as long as it has a shape that tapers from the bottom to the top. It may have a shape (for example, a shape that tapers so that the side surface becomes a curved surface). Similarly, in the third embodiment, the recess 17b formed in the sheath tip 14b has a substantially trapezoidal shape in the radial direction of the tip tip 40b, but as long as it has a shape that tapers from the top to the bottom. Other shapes (for example, a shape that tapers so that the side surface becomes a curved surface) may be used.
　上記第４実施形態では、シースチップ１４ｃに形成された凹部１７ｃにおいて、切り欠き１８が凹部１７ｃにおける底部の位置に設けられているが、切り欠き１８は、凸部４３ｃの突起部４６と係合可能である限りにおいて、他の位置（例えば、凹部１７ｃにおける頂部と底部との中間の位置）に設けられてもよい。同様に、上記第４実施形態では、先端チップ４０ｃに形成された凸部４３ｃにおいて、突起部４６が凸部４３ｃにおける頂部の位置に設けられているが、突起部４６は、凹部１７ｃの切り欠き１８と係合可能である限りにおいて、他の位置（例えば、凸部４３ｃにおける頂部と底部との中間の位置）に設けられてもよい。また、凹部１７ｃの切り欠き１８は複数設けられてよく、同様に切り欠き１８と係合可能である限りにおいて、突起部４６は複数設けられてもよい。 In the fourth embodiment, in the recess 17c formed in the sheath tip 14c, the notch 18 is provided at the position of the bottom portion in the recess 17c, but the notch 18 engages with the protrusion 46 of the convex portion 43c. As long as possible, it may be provided at another position (for example, a position intermediate between the top and the bottom in the recess 17c). Similarly, in the fourth embodiment, in the convex portion 43c formed on the tip tip 40c, the protrusion 46 is provided at the position of the top of the convex portion 43c, but the protrusion 46 is notched in the recess 17c. As long as it can be engaged with 18, it may be provided at another position (for example, a position between the top and the bottom of the convex portion 43c). Further, a plurality of notches 18 in the recess 17c may be provided, and similarly, a plurality of protrusions 46 may be provided as long as they can be engaged with the notches 18.
　上記実施形態では、シース１０がチューブ１１とシースチップ１４とを有し、シースチップ１４に、先端チップ４０の凸部４３と嵌合する凹部１７が形成されているが、シース１０がシースチップ１４を有さず、チューブ１１の先端面に、先端チップ４０の凸部４３と嵌合する凹部が形成されていてもよい。 In the above embodiment, the sheath 10 has a tube 11 and a sheath tip 14, and the sheath tip 14 is formed with a recess 17 that fits with the convex portion 43 of the tip tip 40. The tip surface of the tube 11 may be formed with a recess that fits with the convex portion 43 of the tip tip 40.
　上記第５実施形態では、縮径状態において、バスケット部３０の全体が、シース１０ｄの先端部Ｐ１内に収まっているが、バスケット部３０における先端側の一部分のみがシース１０ｄの先端部Ｐ１内に収まり、バスケット部３０における残りの一部分がシース１０ｄの主部Ｐ２内に収容されるとしてもよい。 In the fifth embodiment, in the reduced diameter state, the entire basket portion 30 is contained in the tip portion P1 of the sheath 10d, but only a part of the basket portion 30 on the tip end side is contained in the tip portion P1 of the sheath 10d. It may be accommodated and the remaining portion of the basket portion 30 may be accommodated in the main portion P2 of the sheath 10d.
　上記実施形態では、チューブ１１は、樹脂や金属により形成された可撓性の管状構造で形成されるが、コイル体で形成されるとしてもよい。 In the above embodiment, the tube 11 is formed of a flexible tubular structure formed of resin or metal, but may be formed of a coil body.
　上記実施形態では、先端チップ４０の基端面に凸部４３が形成され、シースチップ１４の先端面に凹部１７が形成され、凸部４３と凹部１７とが互いに嵌合可能である構成を採用しているが、上述したように、該構成は、先端チップ４０の基端面に凹部４５が形成され、シースチップ１４の先端面に凸部１６が形成され、凹部４５と凸部１６とが互いに嵌合可能である構成と換言することができる。すなわち、先端チップ４０の基端面とシースチップ１４（シース１０）の先端面との一方に、凸部が形成され、先端チップ４０の基端面とシースチップ１４（シース１０）の先端面との他方に、操作ワイヤ２０が基準位置にあるときに（縮径状態にあるときに）該凸部と嵌合可能な凹部が形成されている構成であればよい。 In the above embodiment, a convex portion 43 is formed on the base end surface of the tip tip 40, a concave portion 17 is formed on the front end surface of the sheath tip 14, and the convex portion 43 and the concave portion 17 can be fitted to each other. However, as described above, in the configuration, the concave portion 45 is formed on the base end surface of the tip tip 40, the convex portion 16 is formed on the distal end surface of the sheath tip 14, and the concave portion 45 and the convex portion 16 are fitted to each other. It can be rephrased as a configuration that is possible. That is, a convex portion is formed on one of the proximal end surface of the tip tip 40 and the distal end surface of the sheath tip 14 (sheath 10), and the other end surface of the distal end tip 40 and the distal end surface of the sheath tip 14 (sheath 10). In addition, when the operation wire 20 is in the reference position (when the diameter is reduced), a concave portion that can be fitted to the convex portion may be formed.
１０：シース　１１：チューブ　１２：空間　１４：シースチップ　１５：最基端部　１６：凸部　１７：凹部　１８：切り欠き　２０：操作ワイヤ　３０：バスケット部　３２：ワイヤ　４０：先端チップ　４１：最先端部　４２：柱状部　４３：凸部　４５：凹部　４６：突起部　５０：基端チップ　６０：操作部　６１：本体部　６２：操作パイプ　６３：把持部　６５：中空部　６６：送水口　１００：内視鏡用処置具　ＢＣ：体腔　ＢＩ：分岐点　ＦＢ：異物　Ｐ１：先端部　Ｐ２：主部 10: Sheath 11: Tube 12: Space 14: Sheath tip 15: Most base end 16: Convex 17: Concave 18: Notch 20: Operation wire 30: Basket 32: Wire 40: Tip tip 41: Cutting edge 42: Columnar part 43: Convex part 45: Concave part 46: Protrusion part 50: Base tip 60: Operation part 61: Main body part 62: Operation pipe 63: Grip part 65: Hollow part 66: Water supply port 100: For endoscope Treatment tool BC: Body cavity BI: Branch point FB: Foreign matter P1: Tip part P2: Main part

Claims (5)

  1. 　内視鏡用処置具であって、
    　可撓性を有する管状のシースと、
    　前記シース内に前記シースの軸方向に沿って進退可能に配置された操作ワイヤと、
    　前記操作ワイヤの先端に接続されたバスケット部であって、複数のワイヤから構成され、前記操作ワイヤが基準位置にあるときに、前記シース内に縮径した状態で収容され、前記操作ワイヤが前記基準位置から先端側に移動したときに、前記シースの先端から突出して拡径するように構成されたバスケット部と、
    　前記バスケット部を構成する前記複数のワイヤの先端をまとめて保持する先端チップと、
    を備え、
    　前記先端チップの基端面と前記シースの先端面との一方には、凸部が形成され、前記先端チップの前記基端面と前記シースの前記先端面との他方には、前記操作ワイヤが前記基準位置にあるときに前記凸部と嵌合可能な凹部が形成されている、内視鏡用処置具。     It is a treatment tool for endoscopy,
    With a flexible tubular sheath,
    An operation wire arranged in the sheath so as to be able to advance and retreat along the axial direction of the sheath,
    A basket portion connected to the tip of the operation wire, which is composed of a plurality of wires, and when the operation wire is in a reference position, it is housed in the sheath in a reduced diameter state, and the operation wire is the operation wire. A basket portion configured to project from the tip of the sheath and expand its diameter when moved from the reference position to the tip side.
    A tip tip that collectively holds the tips of the plurality of wires constituting the basket portion, and
    Equipped with
    A convex portion is formed on one of the base end surface of the tip and the tip surface of the sheath, and the operation wire is the reference on the other side of the base end surface of the tip and the tip surface of the sheath. A treatment tool for an endoscope in which a concave portion that can be fitted with the convex portion is formed when the position is located.
  2. 　請求項１に記載の内視鏡用処置具であって、
    　前記凹部の個数は、前記凸部の個数と同じまたは前記凸部の個数より多い、内視鏡用処置具。     The endoscopic treatment tool according to claim 1.
    An endoscopic treatment tool in which the number of concave portions is equal to or greater than the number of convex portions.
  3. 　請求項１または請求項２に記載の内視鏡用処置具であって、
    　前記シースの先端部は、前記シースの前記先端部以外の部分の軸方向に対して湾曲している、内視鏡用処置具。     The endoscopic treatment tool according to claim 1 or 2.
    An endoscopic treatment tool in which the tip portion of the sheath is curved with respect to the axial direction of a portion other than the tip portion of the sheath.
  4. 　請求項１から請求項３までのいずれか一項に記載の内視鏡用処置具であって、
    　前記凸部は、底部から頂部に向けて先細りする形状であり、
    　前記凹部は、頂部から底部に向けて先細りする形状である、内視鏡用処置具。     The endoscopic treatment tool according to any one of claims 1 to 3.
    The convex portion has a shape that tapers from the bottom to the top.
    The concave portion is a treatment tool for an endoscope having a shape that tapers from the top to the bottom.
  5. 　請求項１から請求項４までのいずれか一項に記載の内視鏡用処置具であって、
    　前記凹部は、前記シースの周方向に延びる切り欠きを有する形状であり、
    　前記凸部は、前記凹部と嵌合した状態で前記凹部に対して前記シースの周方向に相対回転すると前記凹部の前記切り欠きに係合する突起部を有する形状である、内視鏡用処置具。     The endoscopic treatment tool according to any one of claims 1 to 4.
    The recess has a shape having a notch extending in the circumferential direction of the sheath.
    The convex portion has a shape having a protrusion that engages with the notch of the concave portion when the convex portion is fitted to the concave portion and rotates relative to the concave portion in the circumferential direction of the sheath. Ingredients.
PCT/JP2021/022066 2020-09-03 2021-06-10 Endoscope treatment tool WO2022049855A1 (en)

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Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPS617685Y2 (en) * 1978-08-29 1986-03-10
JP2004135945A (en) * 2002-10-18 2004-05-13 Olympus Corp Manipulation tool for endoscope
JP2006314714A (en) * 2005-05-16 2006-11-24 Olympus Medical Systems Corp Lithomyl
US20180078243A1 (en) * 2016-09-16 2018-03-22 Krishna Rocha-Singh, M.D. Bone marrow harvesting device

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPS617685Y2 (en) * 1978-08-29 1986-03-10
JP2004135945A (en) * 2002-10-18 2004-05-13 Olympus Corp Manipulation tool for endoscope
JP2006314714A (en) * 2005-05-16 2006-11-24 Olympus Medical Systems Corp Lithomyl
US20180078243A1 (en) * 2016-09-16 2018-03-22 Krishna Rocha-Singh, M.D. Bone marrow harvesting device

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