JPH0521913U - Intracorporeal treatment tool - Google Patents

Abstract

(57) [Abstract] [Purpose] The rotation operation of the proximal operation unit for rotating the forceps at the sheath tip is reliably transmitted to the forceps, and stable and reliable operation can be performed without deteriorating its operation. The purpose is to provide forceps. [Structure] A slider 2 of an operation section 13 provided at the base of the flexible sheath with an operation wire 14 which is inserted into the flexible sheath 11 and operates a forceps section 12 at the distal end of the sheath.
In the biopsy forceps 10 operated by 1, the slider 2
A stopper member 27 attached and fixed to the base end of the operation wire 14 is fitted in the device 1, and fixing means for preventing rotation of the stopper member 27 with respect to the operation slider 21 is provided. Therefore, the hand side operation unit 13
Is reliably transmitted to the forceps portion 12.

Description

[Detailed description of the device]

[0001]

[Industrial applications]

 The present invention relates to a body cavity treatment instrument such as biopsy forceps used endoscopically in a body cavity.

[0002]

[Prior Art]

 BACKGROUND ART Conventionally, for example, a biopsy forceps that is endoscopically inserted into a body cavity to collect tissue in the body cavity is known. In this biopsy forceps, an operating portion is attached to the proximal end of the flexible sheath on the proximal side, and a forceps portion is provided at the distal end of the flexible sheath. When changing the rotation angle of the forceps at the distal end of the sheath, the flexible sheath is twisted to rotate the forceps at the distal end by rotating the entire operating portion on the proximal side. There is. In order to improve the rotational operation performance of the forceps portion, in Japanese Unexamined Utility Model Publication No. 2-223633, a multi-strand sheath is used as a part of the flexible sheath to enhance the transmission strength of the rotational force.

[0003] Specifically describing this type of biopsy forceps, as shown in FIGS. 12 and 13, the flexible sheath 1 leaves the distal end side portion with a single-strand coil sheath 1a, while the proximal side portion is left. It is composed of a multi-winding coil sheath 1b having high transmission strength of a rotational force. A forceps section 2 is provided at the tip of the flexible sheath 1, and the forceps section 2 is driven and operated by an operation wire 3 inserted into the sheath 1.

A proximal end of the operation wire 3 on the proximal side is connected to a slider 5 that slides on the outer periphery of the operation section body 4. As this connecting structure, the cylindrical stopper member 6 attached to the proximal end of the operation wire 3 is fitted into the slit portion 7 in the sliding guide portion of the operation portion main body 4 together with the pressing member 8, and the slit portion 7 And the pressing member 8 is housed in the engagement space between the inner surfaces of the pressing member 8 in a loosely fitted state. That is, the cylindrical stopper member 6 attached to the proximal end of the operation wire 3 has a structure fitted so as to be rotatable in the storage space.

Further, as another connecting structure, in Japanese Utility Model Laid-Open No. 2-272396 shown in FIGS. 14 to 15, the cylindrical stopper member 6 attached to the proximal end of the operation wire 3 is arranged in the axial direction. The holding members 8a and 8b, which are substantially divided into two, are sandwiched, and the holding members 8a and 8b are screwed and fixed to the slider 5. In this case as well, the cylindrical stopper member 6 attached to the proximal end of the operation wire 3 has a structure fitted so as to be rotatable in the space of the housing portion.

[0006]

[Problems to be solved by the device]

 As described above, in the conventional operation portion, in order to rotate the forceps portion 2 at the distal end of the sheath 1 to change its direction, the entire operation portion main body 4 on the proximal side is rotated, but the operation wire 3 Since the distal end of the operation wire 3 is fixed to the treatment portion, the portion near the distal end of the operation wire 3 follows the rotation of the forceps portion 2 and similarly rotates.

However, in reality, a phenomenon occurs in which the sheath 1 that transmits the rotation of the operation portion main body 4 is twisted in the middle thereof. Therefore, when the forceps portion 2 is rotated, the rotation of the operation portion main body 4 on the hand side is prevented. It is not transmitted to the forceps portion 2 at the tip as it is. That is, the rotation amount of the forceps portion 2 is smaller than the rotation amount of the operation portion main body 4.

However, since the stopper member 6 of the operation wire 3 is rotatable relative to the pressing members 8, 8a, 8b, the difference in rotation thereof causes the operation portion main body 4, the slider 5, the pressing member 8, and the pressing member 8, The stop member 6 does not follow the overall rotation of 8a and 8b. As described above, the distal end of the operation wire 3 follows the rotation, whereas the proximal side of the operation wire 3 does not follow the rotation of the operation section body 4. Therefore, the operation wire 3 includes the forceps section 2 and the proximal side. Twisting occurs between the operating part. As a result, it was found that the amount of actuating force of the forceps portion 2 by the operation wire 3 becomes large and stable operation corresponding to the pushing and pulling operation of the operation wire 3 cannot be obtained.

The present invention has been made in view of the above-mentioned problems, and its purpose is to ensure that the rotation operation of the proximal operation portion for rotating the treatment portion at the distal end of the sheath ensures that the treatment portion at the distal end is rotated. (EN) Provided is a body cavity treatment instrument capable of performing stable and reliable operation without being transmitted and the operation thereof being deteriorated.

[0010]

[Means and Actions for Solving the Problems]

 The present invention provides a flexible sheath at least a part of which is composed of a multi-sheath, and an operation wire which is inserted into the flexible sheath and operates a treatment portion provided at the distal end of the flexible sheath. An intracorporeal treatment instrument comprising: an operation section main body provided at a base of the flexible sheath; and an operation slider connected to a base end of the operation wire to slide the operation section main body, wherein the operation slider A stopper member fixedly attached to the proximal end of the operation wire is fitted therein, and fixing means for preventing rotation of the stopper member with respect to the operation slider is provided. Therefore, the rotation of the proximal operation unit is surely transmitted to the treatment section at the tip.

[0011]

【Example】

 1 to 7 show an endoscopic biopsy forceps 10 as a treatment tool in a body cavity according to a first embodiment of the present invention. FIG. 2 shows the entire endoscopic biopsy forceps 10. The biopsy forceps 10 for an endoscope includes a flexible sheath 11, a forceps portion 12 as a treatment portion provided at a distal end of the sheath 11, and an operation portion 13 connected to a base portion of the sheath 11. An operation wire 14 extending between the operation portion 13 and the forceps portion 12 through the inner cavity of the sheath 11 is provided. The forceps portion 12 has a pair of biopsy cups 12a and 12b, which can be opened and closed by a remote operation by pushing and pulling the operating wire 14 with a slider 21 as described later. Has become. The operation wire 14 is provided with a Teflon coat 14a on its outer peripheral portion, which reduces the frictional force with the inner surface of the flexible sheath 11 to improve its operability.

The flexible sheath 11 is left only as a relatively flexible sheath portion 11a made of a stainless single-piece close-wound coil only at its tip side portion, but by rotating the operating portion 13 as a whole, In order to maximize the rotation followability of transmitting the rotation to the forceps portion 12, the proximal side portion is configured as a relatively hard sheath portion 11b made of a stainless steel multi-thread closely wound coil. Further, the single-strand wound sheath portion 11a has a bent portion 11c formed in the vicinity of the forceps portion 12 thereof.

FIGS. 1 and 4 to 7 show details of the operation unit 13. That is, the operation section 13 has an operation section body 20 connected to the proximal end of the flexible sheath 11 and an operation slider 21 that slides on the outer periphery of the operation section body 20. Therefore, between the operation section main body 20 and the slider 21, there are fitted pressing members 22a and 22b which are substantially divided into two parts in the axial direction and in the vertical direction. The pressing members 22a and 22b are half ring portions 24a and 24b each having an external thread 23 cut on the outer circumference thereof, and a slit portion fitting integrally formed on the inner peripheral portions of the half ring portions 24a and 24b. It is composed of joint parts 25a and 25b. The male screws 23 of the pressing members 22a and 22b are screwed into the female screws 32 on the inner surface of the slider 21 to integrate them.

The upper and lower half ring portions 24a and 24b have the same shape, but the upper and lower slot fitting portions 25a and 25b are slightly different from each other at the ends on the opposite side of the half ring portions 24a and 24b. That is, as shown in the best state in FIG. 1, the upper slit fitting portion 25a has an end portion on the opposite side to the half ring portion 24a, which has a substantially L-shape extending downward. The lower slot fitting portion 25b is simply an elongated plate-shaped portion. These upper and lower slotted fitting portions 25a and 25b are formed so as to form an engaging space portion 28 when the pressing members 22a and 22b are integrally abutted, as will be described later, so that the slit fitting portions 25a and 25b face each other at a substantially central position thereof. Notches 26a and 26b are provided. An engaging space portion 28 is provided between the notches 26a and 26b, which is fitted with the stopper member 27 attached to the proximal end of the operation wire 14 to hold the stopper member 27 so as to prevent the stopper member 27 from coming off and rotating. Is formed.

As shown in FIG. 5, the stopper member 27 has a square cross section, and the engagement space portion 28 is also formed in an irregular shape corresponding thereto. Further, the front and rear end surfaces of the engagement space portion 28 (notches 26a, 26b) corresponding to the front and rear ends of the stopper member 27 also come into contact with the front and rear ends of the stopper member 27, respectively, so that the engagement space portion 28 is prevented from coming off. It is supposed to be. In addition, the operation wire 14 is inserted into the abutting end face portions of the slit fitting portions 25a, 25b located on the half ring portions 24a, 24b side from the notches 26a, 26b to have a semicircular cross section. Grooves 29 are provided respectively.

The thickness of the upper and lower slot fitting portions 25 a and 25 b is slightly smaller than the spacing between the slot portions 30 formed in the operation section body 20. That is, as shown in FIG. 4, when the pressing members 22a and 22b are assembled with the operation wire 14 and the stopper member 27 held therebetween, the operation portion main body 20 is formed between the pressing members 22a and 22b. It has a semicircular cross section that is smaller than these gaps so that it can freely pass through the semicircular gaps.

The operation unit 13 as described above is assembled as follows. First, the upper and lower pressing members 22a and 22b are moved in the direction of arrow B from the position shown in FIG. 7, the operation wire 14 is sandwiched in the groove 29, and the stopper member 27 is sandwiched in the notches 26a and 26b. Further, the upper and lower slit fitting portions 25a and 25b are fitted to the slit portion 30 of the operation portion main body 20. In this state, the slider 21 is moved in the direction of arrow C, and the male screw 23 provided on the outer circumference of the half ring portions 24a, 24b of the pressing members 22a, 22b and the inner circumferential surface of the tip end portion of the slider 21 are provided. It is screwed onto the female screw 32. By doing so, the operation unit 13 is assembled.

Next, the operation of the endoscopic biopsy forceps 10 will be described. First, the sheath 11 is introduced into a treatment tool insertion channel of an endoscope (not shown), and the forceps portion 12 at the tip thereof is positioned inside the body cavity. When the forceps portion 12 is opened and closed, the slider 21 of the operation portion 13 located outside the body is pushed and pulled. Here, the operation wire 14 connected to the slider 21 by pulling the slider 21 toward the operator side is pulled in the direction A shown in FIG.

Then, the forceps portion 12 including the biopsy cups 12a and 12b is closed. Further, by further pulling the operation wire 14, the bent portion 11c of the relatively flexible distal end side sheath portion 11a made of the single-thread close-wound coil is linearly extended. Further, by the operation in the opposite direction, the bent portion 11c of the single-thread tightly wound sheath 11a returns from the straight state to the bent state, and when further advanced, the forceps portion 12 is opened.

On the other hand, there are cases where it is desired to change the rotation direction of the forceps portion 12 depending on the condition of the affected area. In this case, the operating portion 13 on the proximal side is rotated as a whole. At this time, the rotation is transmitted to the forceps portion 12 on the tip side through the case 11 to rotate the forceps portion 12. At this time, since the tip of the operation wire 14 is fixed to the forceps portion 12, the operation is performed. The portion near the tip of the working wire 14 follows the rotation of the forceps portion 12 and similarly rotates. On the other hand, at the proximal end of the operation wire 14, the operation wire stopping member 27 is fixed in the pressing members 22a and 22b by the above-mentioned fixing means so as not to rotate relative to the pressing members 22a and 22b. Therefore, following the rotation of the operation portion 13, the proximal end of the operation wire 14 including the pressing members 22a and 22b and the stop member 27 is similarly rotated. Therefore, since the flexible sheath 11 and the operation wire 14 are entirely rotated simultaneously with the rotation of the operation portion 13, only the operation wire 14 is not twisted.

According to this structure, however, the forceps portion 12 can be driven and operated while the operation wire 14 is not twisted, so that the forceps portion 12 can be stably operated. In addition, since this forceps device can bend the flexible sheath 11 near the forceps portion 12 by pushing and pulling the operation wire 14, it is effective for selective insertion into the bronchus, for example. is there.

8 to 9 show an operating portion 13 of the endoscopic biopsy forceps 10 according to the second embodiment of the present invention. The points of the fixing means different from those of the first embodiment will be described. The inner end surfaces of the notches 26a, 26b of the pressing members 22a, 22b are so-called kamaboko circumferential surface shapes, that is, substantially semicircular recessed axial directions. A groove 35 is formed along the line. A stopper 36 having a so-called semi-cylindrical shape, that is, a substantially semicircular cross section is fitted and fixed in the groove 35 in one of the pressing members 22a and 22b. The axial length of the stopper 36 is shorter than the length of the notch 26a. The stopper 36 is located at the front end portion of the notch 26a and is fitted in the groove 35 and fixed by adhesion. On the other hand, the peripheral surface of the stopper member 27 in this embodiment is formed as a cylindrical peripheral surface, and notch plane portions 37, 37 are formed on the peripheral surface of the front end portion of the stopper member 27 corresponding to the stopper 36. ing. That is, the cutout flat portions 37, 37 are formed on the front end portion of the stopper member 27 on the opposite sides on the circumference thereof facing the center of the circle. In addition, a short columnar elastic member 38 is axially overlapped and fitted together with the stopper member 27 into the engagement space 28 formed by the notches 26a and 26b.

When the operating portion 13 is assembled, the notch 26a of the one holding member 22a is positioned at the tip end side in advance, and the stopper 36 is fitted into the groove 35 and fixed by adhesion. In this state, one notched flat surface portion 37 of the stopper member 27 faces the stopper 36, and the stopper 36 and the elastic member 38 are clamped and fixed in the notches 26a and 26b of the holding members 22a and 22b. .. At this time, the stopper 36 is assembled so that the flat surface portion of the stopper 36 faces either the notched flat surface portion 37 or 37 of the stopper member 27. Thus, the pressing member 22a and the stopping member 27 are non-rotatably connected via the stopper 36.

According to this configuration, when the stopper member 27 is clamped and fixed in the notches 26a and 26b of the pressing members 22a and 22b, the notched flat portions 37 and 37 of the stopper member 27 and the horizontal portion of the stopper 36 are provided. However, at this time, it is sufficient to align with either one of the cutout flat portions 37, 37 of the stopper member 27, which facilitates the assembly work.

When the operating slider 21 is operated back and forth, the stop member 27 moves back and forth in the notches 26a and 26b of the press members 22a and 22b, and the stop member 27 and the press members 22a and 22b are moved. There is a collision sound that hits each other, but by inserting the elastic member 38 at the rear end of the stop member 27 as in the present invention, this collision sound is not generated and the operator feels discomfort during operation. Never give.

10 to 11 show a third embodiment of the present invention. In this embodiment, the cylindrical stopper member 27 is clamped and fixed in the notches 26a and 26b of the holding members 22a and 22b similar to those of the second embodiment, and then the slider 21 and the holding member 22a are fixed. A screw hole 41 is formed in the slider 21 and the pressing member 22a to reach the stopper member 27 through the holes 22b and 22b, and the stopper member 27 in the slider 21 is tightened and fixed by the set screw 42 screwed into the screw hole 41. Is. That is, according to this, the stopper member 27 can be fixed to the pressing member 22a and integrated with the operation portion main body 20. Others are the same as those in the above-described embodiment.

The present invention is not limited to the above embodiment. The fixing means of the stopper member 27 and the pressing members 22a and 22b of the operation portion 13 described in the above embodiments may be applied to the operation portion having the shape shown in FIGS. 12 and 13.

[0028]

[Effect of the device]

 According to the present invention, the operation slider is fitted with the stop member attached and fixed to the proximal end of the operation wire, and the fixing means is provided for preventing the rotation of the stop member with respect to the operation slider. , The operation wire is not twisted between the treatment section and the operation section. Therefore, a stable operation of the treatment portion by the operation wire can be obtained.

[Brief description of drawings]

FIG. 1 is a cross-sectional view of an endoscopic biopsy forceps according to a first embodiment of the present invention.

FIG. 2 is also a perspective view of the endoscopic biopsy forceps according to the first embodiment of the present invention.

FIG. 3 is a sectional view of the vicinity of the distal end portion of the endoscopic biopsy forceps according to the first embodiment of the present invention.

FIG. 4 is a cross-sectional view taken along the line I-I in FIG.

5 is a cross-sectional view taken along the line II-II in FIG.

6 is a cross-sectional view taken along the line III-III in FIG.

FIG. 7 is also a perspective view showing exploded parts around the operating portion of the endoscopic biopsy forceps according to the first embodiment of the present invention.

FIG. 8 is a sectional view of the vicinity of an operating portion of the endoscopic biopsy forceps according to the second embodiment of the present invention.

FIG. 9 is also a perspective view showing exploded parts around the operation portion of the endoscopic biopsy forceps according to the second embodiment of the present invention.

FIG. 10 is a cross-sectional view of the vicinity of the operation portion of the endoscopic biopsy forceps according to the third embodiment of the present invention.

FIG. 11 is an exploded perspective view of the parts near the operation portion of the endoscopic biopsy forceps according to the third embodiment of the present invention.

FIG. 12 is a cross-sectional view of a conventional endoscopic biopsy forceps in the vicinity of an operation portion and a distal end portion thereof.

13 is a sectional view taken along the line IV-IV in FIG.

FIG. 14 is a cross-sectional view of an operating portion and a distal end portion of another conventional biopsy forceps for an endoscope.

15A is a sectional view taken along line VV in FIG.
14B is a sectional view taken along the line VI-VI in FIG. 14.

[Explanation of symbols]

11 ... Sheath, 12 ... Forceps part, 13 ... Operation part, 14 ... Operation wire, 20 ... Operation part body, 21 ... Slider, 2
2a, 22b ... Pressing member, 26a, 26b ... Notch, 2
7 ... Stopping member, 28 ... Engaging space portion, 36 ... Stopper,
42 ... Set screw.

Claims (1)

[Scope of utility model registration request] 1. A flexible sheath, a multi-strand sheath that is a part of the configuration of the flexible sheath, and a treatment section that is inserted into the flexible sheath and provided at the distal end of the flexible sheath. Body cavity treatment tool having an operation wire for activating the operation unit, an operation unit main body provided at the base of the flexible sheath, and an operation slider that is connected to the proximal end of the operation wire and slides the operation unit main body In the body cavity, the operation slider is fitted with a stop member attached and fixed to the proximal end of the operation wire, and fixing means for preventing rotation of the stop member with respect to the operation slider is provided. Internal treatment tool.