JP3615989B2 - Endoscope treatment tool raising device - Google Patents

Description

[0001]
BACKGROUND OF THE INVENTION
The present invention relates to a treatment instrument raising apparatus for an endoscope for changing a protruding direction of a treatment instrument protruding outward from a distal end of an insertion portion.
[0002]
[Prior art]
In a side-view endoscope or the like, generally, a treatment instrument raising base for changing the protruding direction of the distal end portion of the treatment instrument inserted through the treatment instrument insertion channel is disposed at the distal end of the insertion section. The treatment instrument raising base is operated by a remote operation from an operation unit connected to a base end of the insertion unit via an operation wire inserted through the operation unit.
[0003]
In such an endoscope, when a treatment instrument that allows high-frequency current to flow is used, the high-frequency current leaked to the treatment instrument raising base is transmitted to the operation section, and the operator can operate the operation section such as the treatment instrument raising base operation lever. Risk of burns when touching placed metal parts.
[0004]
Therefore, conventionally, the surface of the treatment instrument raising base, the surface of the portion in contact with the treatment instrument raising base, and the like have been formed of an electrical insulating material (Japanese Utility Model Publication No. 57-60601, Japanese Utility Model Publication No. 62-90602).
[0005]
[Problems to be solved by the invention]
However, such a structure in which the surface of the treatment instrument elevator base or the surface of the part that comes into contact with the treatment instrument elevator base is made of an electrical insulating material is insufficient in mechanical strength and easily damaged, or the parts processing is complicated. It was not practical because it became.
[0006]
Therefore, an object of the present invention is to provide an endoscope treatment tool raising apparatus capable of achieving a burn prevention of an operator when using a high-frequency treatment tool with a highly practical structure.
[0007]
[Means for Solving the Problems]
In order to achieve the above object, the endoscope treatment instrument raising device of the present invention is disposed at the distal end of the insertion portion in order to change the protruding direction of the distal end portion of the treatment instrument inserted into the treatment instrument insertion channel. In a treatment instrument raising apparatus for an endoscope in which a treatment instrument raising base is operated by a remote operation from an operation section connected to a proximal end of an insertion section via an operation wire inserted and disposed in the insertion section. In addition, an electrically insulating coating is applied to the entire length of the operation wire, and a cylindrical stopper made of an electrical insulating material is fixed to the proximal end portion of the operation wire, and the cylindrical stopper is fitted into a wire driving member disposed in the operation portion. Thus, the operation wire is connected to the wire driving member.
[0008]
Note that an electrically insulating coating may also be applied to a wire guide in which an operation wire is inserted so as to be able to advance and retreat in the axial direction and is inserted through the entire length of the insertion portion.
[0009]
DETAILED DESCRIPTION OF THE INVENTION
Embodiments of the present invention will be described with reference to the drawings.
FIG. 4 shows an endoscope, and a bending portion that is arbitrarily bent by a remote operation from an operation portion 3 connected to a base end of the insertion portion 1 is provided at the distal end of the insertion portion 1 covered with a flexible tube. 4 is formed. Reference numeral 6 denotes a bending operation knob disposed in the operation unit 3.
[0010]
A treatment instrument insertion channel 2 made of an electrically insulating tube material such as a tetrafluoroethylene resin tube is inserted through the entire length from the insertion portion 1 into the bending portion 4. The proximal end of the treatment instrument insertion channel 2 is connected to the treatment instrument insertion port 7 projecting in the vicinity of the connecting portion with the treatment instrument 3. The distal end of the treatment instrument insertion channel 2 is located at the distal end portion 1 a of the insertion portion 1.
[0011]
Various treatment tools 100 are inserted into the treatment tool insertion channel 2, and here, as the treatment tool 100, a so-called high-frequency treatment tool for performing treatment through a high-frequency current is inserted.
[0012]
The distal end portion 100a of the treatment instrument 100 protrudes laterally from the distal end portion 1a of the insertion portion 1, and a treatment instrument raising base 5 for changing the protruding direction is incorporated in the distal end portion 1a of the insertion portion 1. Yes. The treatment instrument elevator 5 is swing-operated by an operation wire that is advanced and retracted by an elevator operating knob 8 provided in the operation unit 3.
[0013]
FIG. 5 is a perspective view of the distal end portion 1 a of the insertion portion 1 and shows a state in which the insulating cap 11 is removed from the distal end portion main body 12. The tip portion main body 12 is made of stainless steel, and portions other than the observation window 9, the illumination window 10, and the treatment instrument guide groove 14 on the outer peripheral surface thereof are covered with an electrically insulating cap 11. The insulating cap 11 is made of, for example, fluororubber or plastic.
[0014]
Since this endoscope is a side-view type endoscope, the observation window 9 and the illumination window 10 are arranged on the side surface of the distal end portion main body 12, and the treatment instrument raising base is disposed in the treatment instrument guide groove 14 formed in parallel therewith. 5 is arranged to be swingable in the front-rear direction.
[0015]
6 is a side sectional view of the distal end portion 1a of the insertion portion 1 in the central plane of the treatment instrument guide groove 14, and FIG. 7 is a combined side sectional view of the distal end portion 1a viewed from the opposite side (a plurality of different cut ends). 8 is a cross-sectional view taken along line VIII-VIII in FIG.
[0016]
As shown in FIG. 8, a cover lens 9a is attached to the observation window 9 portion, and a right-angle roof prism 9b is disposed on the inside thereof. Reference numeral 10 a denotes a light guide fiber bundle in which an emission end face is disposed inside the illumination window 10.
[0017]
The treatment instrument elevator 5 is arranged in a treatment instrument guide groove 14 having a certain width formed in the distal end body 12 along with the observation window 9 and the illumination window 10, and rotates around the elevator drive shaft 13. It swings by doing.
[0018]
The distal end of the treatment instrument insertion channel 2 is connected in communication with the inner part of the treatment instrument guide groove 14. The treatment instrument raising base 5 is formed as a single metal part such as stainless steel. Therefore, it is excellent in strength and easy to manufacture parts.
[0019]
On the outer surface side of the outer wall among the side walls of the distal end portion main body 12 positioned with the treatment instrument guide groove 14 interposed therebetween, an elevator drive chamber 20 is formed to be recessed. The elevator drive chamber 20 accommodates an elevator drive lever 21 integrally connected to the elevator drive shaft 13 at a right angle.
[0020]
A thin metal plate 23 covers the opening of the side surface of the elevator drive chamber 20 and is fixed to the tip end body 12 by four screws 24. The elevator drive lever 21 and the elevator drive shaft 13 are also made of stainless steel.
[0021]
The operation wire 22 is a stranded wire formed by twisting stainless steel fine wires, and an outer surface thereof is coated with an electrical insulating material such as tetrafluoroethylene resin or polyimide resin.
[0022]
The operation wire 22 passes through a guide hole 32 formed in the distal end main body 12 so as to open from the rear toward the elevator drive chamber 20, and the tip of the operation wire 22 of the elevator drive lever 21 is in the elevator drive chamber 20. It is connected to the end.
[0023]
And the raising base drive shaft 13 and the treatment tool raising base 5 are connected by fitting of the square shaft and the square hole so as not to rotate relatively, and are fixed to each other by a fixing screw 13a.
[0024]
With such a structure, when the elevator drive lever 21 swings around the elevator drive shaft 13 by the advance / retreat movement of the operation wire 22, the movement is transmitted as it is to the treatment instrument elevator 5 via the elevator drive shaft 13. Thus, the treatment instrument elevator 5 swings back and forth, and the protruding direction of the distal end portion 100a of the treatment instrument 100 inserted into the treatment instrument insertion channel 2 can be changed.
[0025]
The distal end portion 1 a of the insertion portion 1 configured in this way is connected to the front side of the bending portion 4. The bending portion 4 is configured by rotatably connecting a number of node rings, and 41 is a state-of-the-art node ring. Reference numeral 42 denotes an outer rubber tube, and 43 denotes a bending operation wire.
[0026]
The metal tip portion main body 12 is not directly connected to the state-of-the-art node ring 41 of the curved portion 4, but the state-of-the-art node ring 41 is bonded to the rear end portion of the end portion main body 12. It is screwed and connected in a state where it is fitted to the electrical insulating block 31 fixed with an agent or the like.
[0027]
The electric insulating block 31 is formed of an electric insulating material such as polycarbonate or plastic such as modified PPO or ceramics, and a small screw 34 for fixing the most advanced node ring 41 is embedded in the electric insulating block 31. Screwed into a metal collar 33.
[0028]
Therefore, the member constituting the bending portion 4 and the distal end portion main body 12 are electrically completely insulated, and even if a high-frequency current leaks to the treatment instrument raising base 5 which is a single metal part, the bending portion It is not transmitted to the 4th side.
[0029]
The operation wire 22 is inserted into a wire guide 36 inserted and disposed over the entire length of the insertion portion 1 including the inside of the bending portion 4 so as to be movable back and forth in the axial direction. FIG. 36 shows a tip fixing portion.
[0030]
The wire guide 36 has a configuration in which an electrically insulating tube 36a made of, for example, a tetrafluoroethylene resin is passed through a coil pipe 36b in which a stainless steel wire is tightly wound with a constant diameter over the entire length.
[0031]
Then, the distal end portion of the wire guide 36 is bonded and fixed to a non-metallic (electrically insulating) connecting tube 37 that is fixed to the metallic distal end body 12 and penetrates the electrical insulating block 31. Has been.
[0032]
FIG. 1 shows the internal structure of the operation unit 3. 6 a is a bending operation mechanism that is operated by the bending operation knob 6 in order to advance and retract the bending operation wire 43, and an elevator drive mechanism 50 that is operated by the elevator operation knob 8 is disposed along the bending operation mechanism 6.
[0033]
1 is a partial front sectional view of the elevator drive mechanism 50, and FIG. 2 is a partial sectional side view thereof. In the figure, reference numeral 53 denotes a guide cylinder formed of a metal pipe, which is fixed to the frame 3a in the operation unit 3 with screws.
[0034]
In the guide tube 53, a wire drive rod 52 (wire drive member) made of a metal bar is disposed so as to be movable forward and backward in the axial direction. A cylindrical stopper 59 is fixed to the proximal end of the operation wire 22 drawn from the proximal end of the wire guide 36.
[0035]
The cylindrical stopper 59 is formed in a cylindrical shape by, for example, ethylene tetrafluoride resin, polyimide resin, or other electrically insulating plastic material, and the cylindrical end of the operation wire 22 is cylindrical so as not to protrude. The stopper 59 is inserted and joined so that both are fixed.
[0036]
As shown in FIG. 3 showing the III-III cross section, the cylindrical stopper 59 is fitted in a groove formed in the wire drive rod 52, and a hole formed in the axial position of the wire drive rod 52. The operation wire 22 is pulled out from the front.
[0037]
With such a configuration, the operation wire 22 is connected and fixed in an electrically insulated state with respect to the wire drive rod 52. The space formed in the groove in which the cylindrical stopper 59 is fitted is filled with an electrically insulating adhesive A so that the cylindrical stopper 59 does not rattle.
[0038]
A connecting pipe 56 is screwed to the other end side of the wire drive rod 52, and a link 58 that is rotatably connected to the tip of the wire driving rod 52 via a pin 57 is driven by the elevator operation knob 8.
[0039]
A metal stopper 54 is fixed to the proximal end of the coil pipe 36b of the wire guide 36 by, for example, soldering, and the stopper 54 is locked to a support member 55 fixed to the frame 3a.
[0040]
The end of the electrical insulating tube 36a of the wire guide 36 protrudes from the end of the coil pipe 36b by a predetermined length (for example, several millimeters to several centimeters), and the metal parts in the operation unit 3 such as the stopper 54 Electrical insulation with the operation wire 22 is ensured.
[0041]
With this structure, when the elevator control knob 8 is operated, the operation wire 22 advances and retracts in the wire guide 36 via the elevator drive mechanism 50, and the treatment instrument elevator 5 arranged at the distal end portion 1a swings. Thus, the protruding direction of the distal end portion 100a of the treatment instrument 100 can be changed.
[0042]
Since the operation wire 22 is electrically insulated from the elevator drive mechanism 50 and the wire guide 36 disposed in the operation unit 3, a high-frequency treatment instrument is used as the treatment instrument 100, and the treatment instrument is used. Even when a high-frequency current leaks to the elevator 5, there is no possibility that the operator having the operation unit 3 will be burned.
[0043]
Note that the surface of the coil pipe 36b of the wire guide 36 may be coated with an electrical insulating material in order to ensure electrical insulation.
[0044]
【The invention's effect】
According to the present invention, an electrically insulating coating is applied to the operation wire over the entire length, and a cylindrical stopper made of an electrical insulating material is fixed to the proximal end portion of the operation wire, and the tube is attached to the wire drive member disposed in the operation portion. Since the operation wire is connected to the wire drive member by fitting the shaped stopper, the high-frequency current is transmitted to the operation section even when a high-frequency treatment instrument is used and a high-frequency current leaks to the treatment instrument raising base at the distal end. Because there is no, there is no fear that the surgeon with the operation section will be burned.
[0045]
Since all members that require strength, such as the members around the treatment instrument raising base at the tip and the wire drive member of the operation unit, can be formed of metal parts, there is no problem in strength and parts can be manufactured easily. It has high practicality such as.
[Brief description of the drawings]
FIG. 1 is a partial front sectional view of an internal structure of an operation unit according to an embodiment of the present invention.
FIG. 2 is a partial cross-sectional side view of the internal structure of the operation unit according to the embodiment of the present invention.
FIG. 3 is a cross-sectional view taken along the line III-III in FIG. 1 of the embodiment of the present invention.
FIG. 4 is a side view showing an overall configuration of an endoscope according to an embodiment of the present invention.
FIG. 5 is a partially exploded perspective view of the distal end portion of the insertion portion according to the embodiment of the present invention.
FIG. 6 is a side sectional view of the distal end portion of the insertion portion according to the embodiment of the present invention.
FIG. 7 is a composite side sectional view of the distal end portion of the insertion portion according to the embodiment of the present invention.
8 is a sectional view taken along line VIII-VIII in FIG. 7 according to the embodiment of the present invention.
FIG. 9 is an enlarged cross-sectional view of the tip fixing portion of the wire guide according to the embodiment of the present invention.
[Explanation of symbols]
DESCRIPTION OF SYMBOLS 1 Insertion part 2 Treatment tool insertion channel 3 Operation part 5 Treatment tool raising base 8 Raising base operation knob 12 Tip part main body 22 Operation wire 36 Wire guide 50 Raising base drive mechanism 52 Wire drive rod (wire drive member)
53 Guide cylinder 59 Cylindrical stopper

Claims (2)

In order to change the protruding direction of the distal end portion of the treatment instrument inserted into the treatment instrument insertion channel, the treatment instrument raising base disposed at the distal end of the insertion portion is inserted through the operation wire inserted in the insertion portion. In the endoscope treatment instrument raising device which is activated by remote control from the operation unit connected to the base end of the unit,
An electrically insulating coating is applied over the entire length of the operation wire, and a cylindrical stopper made of an electrical insulating material is fixed to a proximal end portion of the operation wire, and the cylindrical stopper is attached to a wire driving member disposed in the operation portion. A treatment instrument raising device for an endoscope, wherein the operation wire is connected to the wire driving member by fitting a wire. The treatment instrument for an endoscope according to claim 1, wherein an electrically insulating coating is also applied to a wire guide in which the operation wire is inserted so as to be movable back and forth in the axial direction and is inserted and disposed throughout the insertion portion. Upper device.

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