JP3934459B2 - Endoscopic sputum treatment device - Google Patents

Description

[0001]
BACKGROUND OF THE INVENTION
The present invention relates to an endoscope scissors-like treatment tool having a scissors-like treatment piece that opens and closes like a scissors at its tip.
[0002]
[Prior art]
Endoscopic scissors-like treatment tools include biopsy forceps, grasping forceps, hemostatic forceps, scissor forceps, and many others.
[0003]
FIG. 9 shows the distal end portion of the biopsy forceps for endoscope. The flexible sheath 91 is operated by advancing and retracting the operation wire 92 inserted and arranged in the flexible sheath 91 in the axial direction from the hand side. A pair of scissors-like treatment pieces 93 arranged at the distal ends of the scissors are configured to open and close in a scissors shape around the support shaft 94.
[0004]
In such an endoscopic saddle-shaped treatment instrument, it is difficult to directly open and close the saddle-shaped portion of the saddle-shaped treatment piece 93. Therefore, the saddle-shaped treatment piece 93 extends backward from the shaft support portion. A driving arm portion 93a to be taken out is integrally connected, and by driving the driving arm portion 93a, the hook-shaped treatment piece 93 is opened and closed in a hook shape around the support shaft 94.
[0005]
[Problems to be solved by the invention]
As shown in FIG. 10, when the treatment instrument is passed through the treatment instrument insertion channel 50 of the endoscope, the saddle-like treatment piece 93 of the treatment instrument insertion channel 50 is located at a place where the treatment instrument insertion channel 50 is bent. It is bent in a state where the head is swung around the support shaft 94 along the bend.
[0006]
Then, the drive arm portion 93a integrally connected to the saddle-shaped treatment piece 93 is rotated behind the support shaft 94, and the protruding end portion of the drive arm portion 93a pushed out sideways is thereby treated as a treatment instrument. The treatment instrument insertion channel 50 may be damaged by being rubbed strongly against the inner wall surface of the insertion channel 50.
[0007]
SUMMARY OF THE INVENTION Accordingly, an object of the present invention is to provide a safe endoscopic scissor-like treatment tool that does not cause damage to the treatment instrument insertion channel even if the treatment instrument insertion channel of the endoscope is bent. .
[0008]
[Means for Solving the Problems]
In order to achieve the above object, the scissors-like treatment instrument for an endoscope of the present invention has a pair of scissors-like treatment pieces arranged at the distal end of the sheath, and an operation wire inserted and arranged in the sheath with an axis line from the hand side. In an endoscopic saddle-shaped treatment instrument configured to open and close in a saddle shape by moving back and forth in a direction, the saddle-shaped treatment piece moves in a direction opposite to the opening direction from the closed state in which it is straight forward Is provided with a swing regulating stopper.
[0009]
Drive arm portions located in the support body attached to the distal ends of the sheaths are integrally connected to the rear of the pair of saddle-shaped treatment pieces, and the swing regulating stopper is provided with one saddle-shaped treatment piece. Any piece may be used as long as it restricts the movement of one hook-shaped treatment piece so as not to push the protruding end of the drive arm portion of the other hook-shaped treatment piece from the support body.
[0010]
In addition, two support shafts individually supporting a pair of scissors-like treatment pieces are rotatably provided in parallel with a space between each other, and one spacer held by the two support shafts is a pair of scissors. If it is disposed between the treatment pieces and the swing regulating stopper is formed on the spacer, sufficient strength can be obtained without cost.
[0011]
The left and right side surfaces of the spacer are formed in a shape that is recessed by approximately half at positions where the left and right side surfaces are different from each other, and the drive arm portions of the pair of scissors-like treatment pieces are separately disposed in the recessed portions. A swing regulation stopper may be formed in the portion where it is not.
[0012]
The operation wire is two conductive wires that are electrically insulated from each other, and the spacer is formed of an insulating member that electrically insulates between the pair of hook-shaped treatment pieces. The pair of scissors-like treatment pieces may become the positive electrode and the negative electrode of the high-frequency treatment instrument by connecting the to the high-frequency power source.
[0013]
DETAILED DESCRIPTION OF THE INVENTION
Embodiments of the present invention will be described with reference to the drawings.
FIG. 2 is a side sectional view of a distal end portion of a bipolar high-frequency treatment instrument for endoscope to which the present invention is applied, and FIG. 3 is a plan sectional view. However, in each drawing, a plurality of portions having different cross-sectional positions are shown in one drawing.
[0014]
Reference numeral 1 denotes a flexible sheath having a diameter of about 2 to 3 mm and a length of about 1 to 2 m, which is inserted into and removed from a treatment instrument insertion channel of an endoscope (not shown), for example, a tetrafluoroethylene resin tube It is formed by an electrically insulating tube such as.
[0015]
An electrically insulating support body 2 made of, for example, hard plastic or ceramic is connected and fixed to the distal end of the flexible sheath 1, and a slit 3 that opens to the front side has a certain width. It is formed with.
[0016]
Two support shafts 5 made of stainless steel rods are fixed in parallel to the front end portion of the slit 3 so as to cross the slit 3 at positions away from both sides of the central axis of the support body 2. .
[0017]
A pair of hook-like electrodes 4 (hook-like treatment pieces) made of a conductive metal such as stainless steel are supported by the support body 2 independently of each other by two support shafts 5 so as to be openable and closable. Yes. Reference numeral 9 denotes a rotation support hole formed in the bowl-shaped electrode 4 so that the support shaft 5 is rotatably fitted. In FIG. 2, the state in which the saddle electrode 4 is closed is indicated by a solid line, and the open state is indicated by a two-dot chain line.
[0018]
An insulating spacer 6 for electrically insulating the pair of hook-shaped electrodes 4 is disposed between the two hook-shaped electrodes 4 in the tip portion of the slit 3 formed in the support body 2. Has been.
[0019]
The rear portion of each saddle-shaped electrode 4 has a driving arm portion 4a integrally extending behind the rotation support hole 9, and two connecting holes 7 formed near the protruding end of the driving arm portion 4a. The leading ends of the conductive wires 8 are passed through and connected.
[0020]
Each of the conductive wires 8 is provided with an electrical insulation coating over the entire length, and the conductive wires 8a exposed only at the tip portions are engaged with the connecting holes 7 so as to be in contact with the bowl-shaped electrodes 4, respectively.
[0021]
The two conductive wires 8 are inserted through the entire length of the flexible sheath 1 so as to be movable back and forth in the axial direction, and are connected to the base end of the flexible sheath 1 as shown in FIG. In the unit 10, the operation wheel 11 is moved back and forth in the axial direction.
[0022]
Therefore, the conductive wire 8 also functions as an operation wire for opening and closing the saddle-shaped electrode 4 by remote operation, and if the two conductive wires 8 are bundled together in the flexible sheath 1, they are integrated. Good.
[0023]
The proximal end portions of the two conductive wires 8 are divided and connected to the positive and negative power cords of the high-frequency power source 20 in the operation unit 10. By turning on the high-frequency power source 20, the pair of saddle-shaped electrodes 4 is connected. One of them becomes a positive electrode for high-frequency current, and the other becomes a negative electrode.
[0024]
The insulating spacer 6 shown in FIGS. 4 and 5 with the state of the single body changed in direction is formed of a single part made of, for example, hard tetrafluoroethylene resin, other plastic material, ceramic, or the like. A support hole 6a through which the two support shafts 5 pass is formed to penetrate in parallel in the left-right direction, and electrode passing portions 6b are formed in the left and right side surfaces by denting the positions that are different from each other by approximately half. .
[0025]
Then, as shown in FIG. 6 illustrating a VI-VI cross section in FIG. 2, the support shaft 5 is passed through each support hole 6 a of the insulating spacer 6, whereby the insulating spacer 6 is slit in the support body 2. 3 is held in a stable state. FIG. 7 is a perspective sectional view of the portion.
[0026]
In addition, in the electrode passage portions 6b formed to be recessed on both the left and right sides of the insulating spacer 6, the peripheral portions of the rotation support holes 9 of the drive arm portions 4a of the pair of saddle electrodes 4 are fitted in a state where they are not fixed. Each saddle-shaped electrode 4 is supported so as to be rotatable about a support shaft 5 passed through the rotation support hole 9.
[0027]
The bipolar high-frequency treatment instrument for an endoscope configured in this way has a blood vessel sandwiched between a pair of saddle-shaped electrodes 4 and energizes a high-frequency current to thereby place a tissue located between the pair of saddle-shaped electrodes 4. Only the high-frequency current flows, so that the tissue can be cauterized and coagulated to stop hemostasis or incision.
[0028]
As shown in FIGS. 4 and 5, the insulating spacer 6 is formed with recessed electrode passage portions 6 b on the left and right side surfaces, but the wall portion rising from the bottom surface restricts swinging with respect to the bowl-shaped electrode 4. It is formed as a stopper 6s.
[0029]
As shown in FIG. 2, the swinging restricting stopper 6 s is configured such that the driving arm 4 a comes into contact when the saddle electrode 4 tries to move in a direction opposite to the opening direction from the closed state in which the saddle-like electrode 4 faces straight forward. Thus, the swing of the bowl-shaped electrode 4 is regulated.
[0030]
However, there is no need to prevent each hook-shaped electrode 4 from swinging in the direction opposite to the opening direction from the straight closed state, and as shown in FIG. When one of the hook-shaped electrodes 4 is pushed by the external force F, the protruding end 4z ′ of the drive arm 4a ′ of the other hook-shaped electrode 4 ′ is not pushed out of the outer tangent line 100 of the support body 2. Any device that restricts movement may be used.
[0031]
By doing so, when the treatment instrument passes through the treatment instrument insertion channel (not shown) of the endoscope, the protruding end 4z of the drive arm portion 4a does not touch the inner peripheral surface of the treatment instrument insertion channel. Even if the treatment instrument insertion channel passes through a bent portion, there is no risk of damaging the treatment instrument insertion channel.
[0032]
In this embodiment, the swinging regulating stopper 6s is integrally formed with the insulating spacer 6 held at the distal end portion of the support body 2 by passing the two spindles 5, so that the parts cost and the assembly cost are reduced. A stopper having sufficient strength can be obtained without generating extra.
[0033]
In addition, this invention is not limited to the said Example, For example, this invention is applicable also to the various normal treatment tools which do not use a high frequency.
[0034]
【The invention's effect】
According to the present invention, the treatment tool for an endoscope is provided by providing the swing regulating stopper for regulating the movement of the saddle-like treatment piece from the closed state in which the saddle-like treatment piece is straight forward to the direction opposite to the opening direction. Even if the insertion channel passes through a bent portion, there is no risk of damaging the treatment instrument insertion channel, and it can be used with confidence.
[Brief description of the drawings]
FIG. 1 is an enlarged side view of a distal end portion of a bipolar high-frequency treatment instrument for an endoscope according to an embodiment of the present invention.
FIG. 2 is a side composite sectional view of a distal end portion of an endoscope bipolar high-frequency treatment instrument according to an embodiment of the present invention.
FIG. 3 is a plan composite sectional view of the distal end portion of the bipolar high-frequency treatment instrument for endoscope according to the embodiment of the present invention.
FIG. 4 is a single perspective view of an insulating spacer of the bipolar high-frequency treatment instrument for endoscope according to the embodiment of the present invention.
FIG. 5 is a single perspective view of an insulating spacer of a bipolar high-frequency treatment instrument for an endoscope according to an embodiment of the present invention.
6 is a cross-sectional view taken along the line VI-VI in FIG. 2 of a bipolar high-frequency treatment instrument for an endoscope according to an embodiment of the present invention.
7 is a perspective view of a cross-sectional portion shown in FIG. 6 of a bipolar high-frequency treatment instrument for an endoscope according to an embodiment of the present invention.
FIG. 8 is an overall configuration diagram of a bipolar high-frequency treatment instrument for an endoscope according to an embodiment of the present invention.
FIG. 9 is a side view of a distal end portion of a conventional endoscope scissors-like treatment tool.
FIG. 10 is a side view of a distal end portion in a state where a conventional endoscopic scissors-like treatment instrument passes through a bent portion of a treatment instrument insertion channel of an endoscope.
[Explanation of symbols]
DESCRIPTION OF SYMBOLS 1 Flexible sheath 2 Support main body 3 Slit 4 Spider-like electrode (sheath-like treatment piece)
4a Drive arm portion 4z Protruding end portion 5 Support shaft 6 Insulating spacer 6s Swing restriction stopper 8 Operation wire

Claims (4)

A pair of saddle-shaped treatment pieces are rotatably supported independently of each other so as to open and close like a saddle toward the front by a support body disposed at the distal end of the sheath, and the pair of saddle-shaped treatment pieces are driven to open and close Thus, the drive arm portion integrally formed and connected to each of the saddle-shaped treatment pieces is disposed between the slits formed in the support body and at a position rearward from the rotation center axis of the pair of saddle-shaped treatment pieces. the state Ri by to advance and retreat operation axially operating wire that is inserted and arranged within the sheath from the proximal side, to the drive arm section the pair of beak-shaped treatment piece closed falls within the support body The pair of saddle-shaped treatment pieces are opened and the drive arm portion is configured to switch from the state of protruding from the support body .
When the pair of saddle-shaped treatment pieces are in a closed state, one of the saddle-shaped treatment pieces moves in the direction opposite to the opening direction, thereby pressing the other saddle-shaped treatment piece and integrally connecting to the other saddle-shaped treatment piece. as the projecting end of the formed drive arms are not pushed out of the support body, for regulating the operation of moving the opposite direction to the opening direction from the closed state in which the respective beak treatment piece facing forward straight beak treatment instrument for an endoscope, characterized by comprising a swing regulation stopper, the. Two spindles for individually supporting the pair of saddle-shaped treatment pieces are provided in parallel with a space between each other, and one spacer held by the two spindles is provided with the pair of The endoscopic scissors treatment instrument according to claim 1 , wherein the scissor treatment tool is disposed between the scissors-like treatment pieces, and the swing restriction stopper is formed on the spacer. The spacer is formed in a shape in which approximately half of the left and right side surfaces are indented at a position where the left and right side surfaces are different from each other, and the drive arm portions of the pair of scissors-like treatment pieces are separately arranged in the recessed portions. The scissors-like treatment instrument for an endoscope according to claim 2, wherein the swing regulating stopper is formed in a portion where the head is not. The operation wire is two conductive wires that are electrically insulated from each other, and the spacer is formed by an insulating member that electrically insulates between the pair of saddle-shaped treatment pieces. The endoscopic sputum treatment instrument according to claim 2 or 3, wherein the pair of scissors treatment pieces become a positive electrode and a negative electrode of the high frequency treatment instrument by connecting the conductive wire to a high frequency power source.

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