JPH08299349A - Treatment tool for endoscope - Google Patents

Abstract

PURPOSE: To prevent the shape of a basket part from abruptly getting small, even when the basket part starts to be drawn into a sheath, by forming an effective capture space of the basket part composed of a wire toward the front and to surely capture a calculus, or the like even in a narrow space, by forming the capture space toward the tip side. CONSTITUTION: In this treatment tool for an endoscope which is provided in the tip of a wire inserted into a sheath 2 so as to freely advance and retreat, and has a basket part 6 which is so constituted as being widely opened and freely expanded/contracted by an elastic wire 3 having a plurality of bending points, a plurality of bending points contain more than three outward bending points and at least half of the outward bending points are arranged toward front part of the axial central position.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an endoscopic treatment instrument such as a basket forceps that is inserted into a body cavity to hold a foreign substance, or a high-frequency snare that excises a polyp in the body cavity.

[0002]

2. Description of the Related Art Basket forceps for grasping foreign substances such as stones generated in a body cavity such as the bile duct and the bladder are known. As shown in Japanese Utility Model Publication No. 61-9601, a general basket forceps constitutes a basket portion which is elastically expanded by a plurality of elastic wires having bending points. Further, Japanese Utility Model Publication No. 5-46426 proposes that the elastic wire of the basket portion is formed into a substantially octagonal shape as a whole. In Japanese Utility Model Publication No. 6-91, the elastic wire in the outward direction of the elastic wire is proposed. The number of bending points is greater than the number of bending points inward.

[0003]

However, in the basket shape shown in Japanese Utility Model Publication No. 61-9601 and Japanese Utility Model Publication No. 5-46426, the position of the maximum opening width of the trapping space in which the calculi should be taken is the position of the basket. Located near the center of the section. When using this to supplement a calculus, when the calculus was taken into the elastically expanded basket portion and then started to be pulled into the sheath, the spread of the basket portion became small immediately. Therefore, in the process of drawing the elastic wire of the basket part,
The movement of the elastic wire is apt to be unstable and becomes unstable, and the capturing work is troublesome. In addition, in the shape of the expanded basket part, the front part of the basket part is relatively narrow and narrow, so that a useless space where calculi cannot be captured is formed relatively large on the tip side part, resulting in a particularly narrow space. It was difficult to capture the calculi in the body cavity.

Furthermore, in the Japanese Utility Model Publication No. 6-91, in which the outward bending points are provided more than the inward bending points, the trapping space is located further rearward, and the above-mentioned one is used. There was a similar problem with.

The present invention has been made in view of the above-mentioned problems, and an object thereof is to form the effective trapping space of the treatment portion made of an elastic wire to a front side so that the treatment portion is a sheath. Even if it starts to be pulled in, the shape of the treatment portion does not suddenly become small, and by forming the capture space large toward the distal end side, a treatment tool for an endoscope that can reliably capture stones etc. even in a narrow space is provided. Is to provide.

[0006]

The present invention is provided at the distal end of an operating wire that is inserted into a sheath so as to be able to move back and forth.
In a treatment tool for an endoscope having a treatment section configured to be capable of expanding and contracting using an elastic wire having a plurality of bending points, the plurality of bending points of the elastic wire are three or more outward bending points. And at least half of the outward bending points are located in front of the axially central position of the treatment portion. With such a configuration, the trapping space of the treatment portion can be set further forward, and the treatment portion does not immediately become small even when the treatment portion is started to be pulled into the sheath, and smooth contraction is performed. In addition, it is possible to reliably capture the captured matter even in a narrow space.

[0007]

【Example】

<First Embodiment> (Structure) With reference to FIG. 1, a calculus grasping basket forceps according to a first embodiment of the present invention will be described. In the calculus grasping basket forceps 1 in this embodiment, the tips of a plurality of elastic wires 3 inserted into a flexible sheath 2 made of a tube are bound by a tip tip 4. A portion of the elastic wire 3 that is inserted into the sheath 2 constitutes an operation wire that can move back and forth. In addition, you may comprise by connecting each proximal end of the some elastic wire 3 to the distal end of another operation wire. A plurality of bending points 5a to 5e are provided in the vicinity of the tip of each elastic wire 3 from the tip 4 to the base end at certain intervals. These plural elastic wires 3 form a basket portion (treatment portion) 6 that elastically opens. The basket portion 6 is pushed and retracted from the distal end of the sheath 2 by advancing and retracting each elastic wire 3 with respect to the sheath 2 by an operation by a hand operation portion (not shown) provided on the proximal end side of the sheath 2. It is like this. The basket portion 6 is elastically opened by the basket portion 6 protruding from the distal end of the sheath 2, and the basket portion 6 is contracted accordingly by retracting the basket portion 6 into the sheath 2.

The plurality of bending points 5a to 5e formed near the tip of each elastic wire 3 are two inward bending points 5a and 5e with the bending vertices formed inward, and the bending vertices are formed outward. And three bent points 5b to 5d facing outward. Then, by protruding from the tip of the sheath 2, the basket portion 6 expands to the maximum due to the elasticity of each elastic wire 3 itself as shown in FIG. 1, and such a basket portion 6 has a length L in the axial direction. Three bending points 5b to 5d which are located in front of the center line 7 of the basket portion 6 and which face outward
There are two bending points 5b and 5c. That is, there are three or more outward bending points, and more than half of them are located in front of the position ½ of the axial length L of the basket portion 6. (Operation) When using the calculus grasping basket forceps 1, the sheath 2 thereof is inserted into the body cavity, for example, the bile duct via the channel of the endoscope. When the basket portion 6 is largely pushed out from the sheath 2 by pushing the elastic wire 3 directly through the operation wire by the operation at the hand operation portion, the basket portion 6 expands like a basket as shown in FIG. Then, the calculus is collected by wrapping the calculus in this bulge. (Effect) Here, each elastic wire 3 forming the basket portion 6 is provided with three bending points 5b to 5d bent outward, and two bending points 5b and 5c of the bending points 5b and 5c are formed at the center line 7 of the basket portion 6. Since it is arranged in front of the position, the basket-like inflated basket portion 6 has a rounded shape, and the effective catching portion is located in the front. For this reason,
The trapping space is formed closer to the tip side, so that stones and the like can be trapped easily even in a narrow space.

Further, the effective trapping space of the treatment basket portion 6 composed of the elastic wire 3 is formed at a position further forward, and even if the portion of the treatment portion is started to be pulled into the sheath 2, the treatment portion of the treatment portion is not removed. The shape does not decrease suddenly.
In other words, the expanded basket-like shape does not become small immediately after the treatment basket portion 6 starts to be drawn into the sheath 2,
Since the elastic wire 3 does not disturb the movement and a stable contracting action can be expected, it becomes possible to easily and reliably perform the work of capturing the calculus and the like. <Second Embodiment> (Structure) With reference to FIG. 2, a calculus breaking basket forceps 8 according to a second embodiment of the present invention will be described. In the calculus crushing basket forceps 8 of this embodiment, a basket portion 6 is provided via a binding member 10 at the tip of an operation wire inserted in a flexible sheath 9 made of a metal closely wound coil. The basket portion 6 is formed by bundling the base ends of a plurality of elastic wires 3 by the binding member 10 and connecting to the tip of the operation wire, and the tip of the elastic wires 3 are bound by the tip 4. A cylindrical tip member 20 having a plurality of crushing teeth is attached to the tip of the sheath 9.

In this embodiment, the first to sixth bending points 5a are directed from the tip 4 toward the binding member 10.
~ 5f are provided. These six bending points 5a-5
In f, the first bending point 5a and the fifth bending point 5e are inward bending points, and the second to fourth bending points 5b to 5d and the sixth bending point 5f are outward bending points. Has become. And 4
Of the two outward bending points, the two bending points 5b and 5c are located in front of the position of the center line 7 of the treatment basket portion 6. (Operation) When using the calculus crushing basket forceps 8, as in the case of the above-described first embodiment, the sheath 9 is inserted into the body cavity, and the basket portion 6 is projected from the distal end of the sheath 9 and inflated. . Then, after the calculus is taken into the bulged basket portion 6, the operation wire is pulled to draw the basket portion 6 into the sheath 9, the calculus is tightened, and the calculus is pressed against the crushing teeth of the tip member 20. Tighten and crush. With this, the same effect as that of the first embodiment can be obtained. <Third Embodiment> A calculus grasping basket forceps according to a third embodiment of the present invention will be described with reference to FIG. 3. This embodiment is the calculus grasping basket shown in the first embodiment. The forceps 1 is modified in the following points, and other than that, it is the first
Is the same as the embodiment described above. That is, all three outward bending points 5 b to 5 d are located in front of the position of the center line 7. The base end of the basket portion 6 is bound by a binding member 10. The operation and effect of this embodiment are the same as those of the first embodiment. <Fourth Embodiment> (Structure) A high frequency snare according to a fourth embodiment of the present invention will be described with reference to FIG. The high frequency snare 11 has a loop 14 formed at the distal end of an operation wire 13 inserted in a flexible sheath 12 having electrical insulation. Loop 1
Reference numeral 4 is formed by folding back one conductive wire having elasticity and making the folding point the tip. A plurality of bending points 15a are provided on both wire portions of the loop 14, respectively.
-15d. The bending points 15a to 15d are one inward bending point 15a and three outward bending points 15b.
.About.15d, and within the range of the axial length L of the loop 14, there are all three outward bending points 15b to 15d in the portion located in front of the center line 16. Of course 1
The one inward bending point 15a is the axial length L of the loop 14.
It is provided at the leading edge in front of the center line 16 within the range. (Operation) When using this high-frequency snare 11, as in the case of the above-described embodiment, it is inserted into the body cavity through the endoscope, and the distal end of the sheath 12 is guided near a lesion site such as a polyp and then operated. Push wire 13 out and loop 1
Stick out 4 and spread. Then, the loop 14 is hung on the polyp, and the operation wire 13 is pulled to bind the polyp tightly.
By applying a high frequency current, the polyp is excised by the high frequency current.

Similar to the first embodiment and the like, the loop 14 has a rounded shape so that the space for the effective trapping portion is located more forward, and even when the loop is started to be drawn into the sheath 12, it immediately becomes. The loop 14 does not become small, and a polyp can be reliably captured and treated even in a narrow area. <Fifth Embodiment> A high frequency snare according to a fifth embodiment of the present invention will be described with reference to FIG. This high frequency snare 1
1 is a modification of the high frequency snare 11 of the fourth embodiment. That is, in this embodiment, three outward bending points 1
Among 5b to 15d, two bending points 15b and 15c are located in front of the position of the center line 16. The remaining outward bending point 15d is different from that of the fourth embodiment in that it is located behind the position of the center line 16. The effect of this embodiment is the same as that of the fourth embodiment. <Sixth Embodiment> A high frequency snare according to a sixth embodiment of the present invention will be described with reference to FIG. This high frequency snare 1
Reference numeral 1 is a modification of the high frequency snare 11 of the fourth and fifth embodiments. That is, in this embodiment, there are five bending points 15a.
15e to 15e and three outward bending points 15b to 15d
Two of them, the bending points 15b and 15c, are provided in front of the position of the center line 16. The operation and effect of this embodiment are the same as those of the fourth and fifth embodiments.

The present invention is not limited to the above-mentioned embodiment, and various other modified examples can be considered within the scope of the gist thereof. [Supplementary Note] (1) An endoscope having a treatment section that is provided at the tip of an operation wire that is inserted into a sheath so as to be able to advance and retreat, and that can be expanded and contracted by using an elastic wire having a plurality of bending points. In the treatment instrument, the plurality of bending points include three or more outward bending points, and at least half of the outward bending points are located in front of the axial center position of the treatment portion. A treatment instrument for an endoscope, which is arranged. (2) The endoscopic treatment tool according to the above item 1, wherein the endoscopic treatment tool is a basket-type grasping forceps. (3) The endoscopic treatment instrument according to the above item 1, wherein the endoscopic treatment instrument is a high-frequency snare. (4) The endoscopic treatment instrument according to any one of the second and third supplementary items, wherein the total number of inward bending points is in front of the axial center position of the treatment portion.

[Purpose, Effect and Prior Art of Supplementary Items] (Purpose) The second objective is to reliably capture stones and foreign matters. The third item is intended to reliably capture a tissue such as a polyp. The fourth item is intended to position the capturing portion more forward. (Effect) The basket in the second item and the snare loop in the third item do not become small by a little pulling in, and the effective catching portion is located further forward, so that the target can be reliably caught even in a narrow area. . The fourth term achieves more reliable trapping by positioning the effective trapping portion further forward. (Prior Art) The same as the prior art of the present invention.

[0014]

As described above, in the endoscopic treatment tool of the present invention, a plurality of bending points including three or more outward bending points are provided in the elastic wire portion constituting the treatment section. Since at least half of the outward bending points are provided in front of the central position of the treatment portion, it is possible to form an effective trapping portion in front of the treatment portion, and capture even with a small amount of retraction. The part does not become small, and foreign matter, polyps, etc. can be reliably captured even in a narrow space.

[Brief description of drawings]

FIG. 1 is an explanatory view of a treatment portion of a calculus grasping basket forceps according to a first embodiment of the present invention.

FIG. 2 is an explanatory view of a treatment portion of a calculus grasping basket forceps according to a second embodiment of the present invention.

FIG. 3 is an explanatory view of a treatment portion of a calculus grasping basket forceps according to a third embodiment of the present invention.

FIG. 4 is an explanatory diagram of a treatment portion of a high frequency snare according to a fourth embodiment of the present invention.

FIG. 5 is an explanatory diagram of a treatment portion of a high frequency snare according to a fifth embodiment of the present invention.

FIG. 6 is an explanatory diagram of a treatment portion of a high frequency snare according to a sixth embodiment of the present invention.

[Explanation of symbols]

DESCRIPTION OF SYMBOLS 1 ... Basket forceps for calculus grasping, 2 ... Sheath, 3 ... Elastic wire, 4 ... Tip tip, 5a-5e ... Bending point, 6 ... Basket part, L ... Axial length, 11 ... High frequency snare, 1
2 ... sheath, 13 ... operating wire, 14 ... loop, 15a
~ 15d ... Inflection point, 16 ... Center line.

Claims (1)

[Claims] 1. An endoscope having a treatment section which is provided at the distal end of an operation wire which is inserted into a sheath so as to be able to move back and forth, and which can be expanded and contracted by using an elastic wire having a plurality of bending points. In the treatment tool, the plurality of bending points of the elastic wire include three or more outward bending points, and at least half of the outward bending points are located in front of the axial center position of the treatment portion. A treatment tool for an endoscope, characterized in that