JPH0871082A - High Frequency Incision Resecting Tool for Endoscope - Google Patents

Abstract

(57) [Abstract] [Purpose] The present invention can secure the connection strength of the treatment portion with respect to the operation wire, while keeping the outer diameter of the connection portion thin, and secure good operability of the treatment portion. In addition, it is another object of the present invention to provide a high-frequency incision resecting instrument for an endoscope, which is easy to assemble. According to the present invention, a sheath, an operation wire that is slidably inserted in the sheath, and uses a stranded wire in which side strands are twisted around the outer periphery of a core wire, and a side of the operation wire on the extreme end side. In a high-frequency incision cutting tool for an endoscope, which has a treatment section formed by removing a strand and exposing the core wire, and operating the treatment section with the operation wire, of the exposed core wire, to the operation wire. The connecting pipe was covered only on the end portion to be connected, and fixed by an adhesive.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an endoscopic high-frequency incision resecting instrument which is endoscopically introduced into a body to treat a body part.

[0002]

2. Description of the Related Art According to FIGS.
An example of the conventional high-frequency incision resecting tool for an endoscope shown in Japanese Patent No. 1 will be described. In general, this type of high-frequency dissector has a
An operation wire is inserted through a flexible sheath, and a treatment section is provided at the tip of the operation wire.

By the way, this type of high-frequency incision cutting tool is
It is inserted into a body cavity through an insertion channel formed in an endoscope and is used for operation under observation by the endoscope. The sheath and the operation wire inserted through the sheath are inserted through the insertion channel. While being guided, the endoscope is complicatedly curved according to the bending of the insertion portion of the endoscope, and various remote operations are performed in this curved state. It is necessary to secure strong and hardness. On the other hand, the wire forming the treatment section needs to be softer than the operation wire in terms of passing the guide mechanism at the distal end of the endoscope and operating in the body cavity.

In order to meet such conditions, Japanese Patent Publication No.
In the conventional example disclosed in Japanese Patent Publication No. 7-811,
As shown in FIG. 8, a stranded wire 3 composed of a core wire 1 and a side strand 2 arranged on the outer periphery of the core wire 1 is used as an operation wire 4, and the side strand 2 at the tip of the stranded wire 3 is used. Is removed and the exposed portion of the core wire 1 is used as the wire portion 5 forming the treatment portion. That is, the wire portion 5 forming the treatment portion folds the core wire 1 in the middle, and fixes the folded tip 6 of the core wire 1 and the tip 7 of the operation wire 4. As the fixing method, as shown in FIG. 8, only the adhesive 8 is used, or
Further, as shown in FIG. 9, the pipe material 9 is externally provided over both end portions of the folded core wire 1 and the outer peripheral portion in the vicinity of the tip end 7 of the operation wire 4, and is similarly fixed with a fixing agent or the like. is there.

Further, as shown in FIG. 10, in addition to the above structure, in the structure in which the folded tip of the folded core wire 1 is not guided to the tip of the operation wire 4, the side strand 2 is frayed at the tip of the operation wire 4. It was also fixed with a fixing agent so that it would not occur.

[0006]

However, the above-mentioned conventional ones have the following drawbacks in the method of fixing the distal end of the operation wire. (1) For fixing with only the adhesive as shown in Fig. 8, a slightly larger amount of the adhesive is used to ensure the fixation, and then the excess outer peripheral portion is scraped off with a file etc. A process is required. Further, since the twisted wire made of thin strands is used, each strand of the strand of wire is likely to be damaged during the finishing work, which may reduce the tensile strength. .

Further, when fixing the folded back tip of the exposed core wire and the tip of the operation wire only with a fixing agent, both are easy to move during the fixing work, so that the workability of the assembly is poor and the variation in strength is large. However, there is also a problem that it is not suitable for use in a portion where force is applied. Moreover, the number of defective products was high.

(2) Next, as shown in FIG.
Both ends of the core wire of the book, and the connection pipe is fitted over the distal end of the operation wire to be externally installed, and in the method of fixing these with a fixing agent or the like, in the outer peripheral portion of the operation wire,
Since the pipe material is arranged, the outer diameter of the portion of the pipe material becomes large, and the hard portion is present at this connecting portion. Since this hard portion is also a portion that operates at a position corresponding to the angle portion in the endoscope insertion portion, there is a drawback that it is caught in the inner cavity of the sheath and smooth operation cannot be performed. In particular, it is remarkable when the sheath is strongly curved by the endoscope.

The present invention has been made in view of the above problems, and it is an object of the present invention to secure the connection strength of the treatment portion with respect to the operation wire while keeping the outer diameter of the connection portion thin. Another object of the present invention is to provide a high-frequency incision resecting instrument for an endoscope that ensures good operability of the treatment section and has good assembling properties.

[0010]

In order to solve the above problems, the present invention uses a sheath and a stranded wire slidably inserted in the sheath and having side strands twisted around the outer circumference of a core wire. High frequency incision resection for an endoscope, which has an operation wire and a treatment section formed by an exposed core wire by removing a side strand on the extreme end side of the operation wire, and operating the treatment section with the operation wire. In the device, a connecting pipe is covered only on an end of the exposed core wire that is connected to the operation wire, and is fixed by a fixing agent.

[0011]

【Example】

<First Embodiment> With reference to FIG. 1, description will be given of a high frequency incision cutting tool for an endoscope according to a first embodiment of the present invention.

(Structure) FIG. 1 (a) shows the entire high-frequency incision resection tool for an endoscope, and FIG. 1 (b) shows a distal end portion forming a treatment portion of a hexagonal loop. It is shown.

This high-frequency incision cutting tool comprises a sheath 11 and
An operation wire 12 slidably inserted into the sheath 11, an operation portion 13 connected to the proximal end of the sheath 11,
The treatment section 14 installed at the distal end of the sheath 11 is mainly configured. The sheath 11 is composed of a coil 15a made of stainless steel or the like, and an outer tube portion 15b formed by extruding an electrically insulating material such as ethylene tetrafluoride on the outer periphery of the coil 15a.

The operating wire 12 is a core wire 1 formed by twisting a plurality of conductive wires made of, for example, stainless steel.
6 and side strands 17 wound around the outer periphery of the core wire 16 and made of a plurality of strands of stainless steel or the like. That is, the main body of the operation wire 12 has a relatively strong structure made of a twisted wire.

Further, a treatment section 14 in which a loop-shaped incision wire section is formed by a core wire 16 remaining after removing the side strand 17 at the distal end section of the operation wire 12
Is configured.

Next, with reference to FIG. 1B, the tip will be described in detail. First, the side strand 17 at the tip of the operation wire 12 is removed, and the core wire 16 remaining in the exposed state is bent in the middle thereof. Further, the core portions 16a and 16b, which are two in number, are provided with symmetrical bent portions 18 at several positions, thereby forming the treatment portion 14 made of a wire forming a hexagonal loop. Bent portions 18 are formed immediately before and after the bent portion 19 of the core wire 16, respectively.

Next, the tip 20 of the folded-back core wire portion 16b is guided to the stepped tip surface 21 of the operating wire 12, and the core wire portion 16a is led out from the distal end of the operating wire 12.
The base end portion and the tip end portion of the folded core wire portion 16b are aligned along the direction of the operation wire 12, and the ends of the respective core wire portions 16a and 16b are joined so as to be aligned with the tip end 21 of the operation wire 12.

Then, only the outer circumference of the joint between the base end of the one core wire portion 16a folded back into two and the tip end of the other core wire portion 16b is made of a material such as stainless steel, The connection pipe 22 having an outer diameter substantially equal to that of the operation wire 12 and a total length of about 2 mm is fitted. With the base end of the connection pipe 22 and the ends of the core wire portions 16a, 16b externally provided in this manner being in contact with and aligned with the step end surface 21 of the tip end portion of the operation wire 12, they are brazed or the like. It is fixed by a fixing means using a fixing material. The tip end of the other core wire portion 16b may be aligned by merely bringing the tip end surface 21 of the operation wire 12 into contact with the step end tip surface 21. Further, if a predetermined strength can be obtained, it may be fixed by tightening and fixing means such as caulking.

Next, referring to FIG. 1 (a), the structure of the high-frequency incision resection tool other than the tip will be described. A base end of the operation wire 12 is guided into the operation part 13, and an operation pipe 25 is externally provided at the base end of the operation wire 12 for the purpose of preventing buckling in the operation part 13. These are also detachably fixed to the slider 26 by means not shown. Further, the slider 26 is provided with a plug 27 for connecting a cord (not shown) from a high-frequency generator (not shown) to electrically connect with the operation wire 12.
The slider 26 is slidable with respect to the main body 28 of the operation unit 13. By moving the slider 26 back and forth, the operation wire 12 can be slid back and forth with respect to the sheath 11.

By the way, the proximal end of the sheath 11 is detachably fixed to the distal end of the main body 28 of the operating portion 13 by using a screw cap 29.
May be formed only by a tube made of the insulating material such as tetrafluoroethylene. In this case,
You may connect with the operation part 13 by the structure as shown in (c). That is, the engaging portion 32 for fitting the sheath 11 formed of only the tube is formed at the tip portion of the connecting member 31 provided in the main body 28, and the sheath 11 is provided on the outer periphery of the engaging portion 32. The base end portion of is pressed and tightly fitted, and the coil 33 as a spring is wound around the outer circumference of the base end portion of the press-fitted sheath 11 in a pressure contact manner. Thereby, the press-fitting portion 34 for detachably fixing the sheath 11 to the connecting member 31 is configured. In this way, by fixing the coil spring to the fixing portion of the tube material forming the sheath 11, the tube is stably fixed.

(Operation) When this high-frequency incision resecting tool is used, first, the portion of the sheath 11 is led out into the body cavity through the insertion channel of the endoscope previously inserted into the body cavity. Next, the slider 26 is advanced to the distal end side with respect to the main body 28 of the operation portion 13, and the treatment portion 14 is projected from the distal end of the sheath 11. The wire of the treatment portion 14 expands itself into a hexagonal loop state by spring elasticity of the bent portions 18 and the like at several places. A living tissue such as a polyp is placed in and hooked in the expanded treatment section 14.
In this state, by moving the slider 26 to the front side, the wire of the treatment section 14 is pulled in from the distal end of the sheath 11 to some extent, and the living tissue is tightly bound by the wire section of the treatment section 14. Then, the treatment section 14 is energized with a high frequency while binding the living tissue. By this operation, the excision of living tissue such as polyp is completed.

(Effect of Embodiment) By making the outer diameter of the connecting pipe 22 between the treatment portion 14 and the operating wire 12 substantially the same as the outer diameter of the operating wire 12, there is no protruding portion on the outer circumference, and the inside of the sheath 11 is eliminated. The movement of the is smooth, and even if the endoscope is at a high angle, it is possible to reliably move it back and forth. Further, since the wire of the treatment portion 14 and the operation wire 12 are connected via the connection pipe 22, the assembly work can be easily performed, and the connection strength of the connection portion can be sufficiently secured. In particular, since the core wire portion 16 of the operation wire 12 is used and folded back, the loop wire of the treatment portion 14 is integrally formed.
The connection strength can be increased.

<Second Embodiment> With reference to FIG. 2, an endoscopic high-frequency dissection / resection tool according to a second embodiment of the present invention will be described.

(Structure) This high-frequency incision cutting tool comprises a sheath 41 and an operating wire 42 having the same structure as that of the first embodiment described above, and a treatment portion 43 is connected to the distal end of the operating wire 42. ing. The treatment portion 43 is formed by removing the side strands of the operation wire 42 and leading out the remaining core wire 44, as in the first embodiment. The core wire 44 is bent in the middle, and bent portions 46a and 46b are formed immediately before and after the bent portion 45, respectively, and two bent portions 46c and 46d are formed in the folded wire portion. In the state shown by (4), spring elasticity that expands by itself is given to form a treatment portion 43 that expands in a half-moon shape. The three bent portions provided in the wire portion on the folded back side may be two or less or four or more, but preferably three or more.

A connection pipe 47 made of a material such as stainless steel having an outer diameter substantially the same as the outer diameter of the operation wire 42 is arranged at the exposed base end portion of the core wire 44. The operation wire 42 is butted against the step end surface. Then, this portion is fixed by a fixing means such as brazing or adhesion. Further, if a predetermined strength can be obtained, it may be fixed by tightening and fixing means such as caulking.

A sliding member 5 slidably installed in the sheath 41 at the wire portion on the front side of the core wire 44 where the core wire 44 is folded back.
0 is slidably connected, and the sliding member 50 is connected and fixed to the tip of the folded back wire. Since the sliding member 50 is slidable within the sheath 41,
In particular, the sliding member 50 is formed in a spherical shape, and two parallel through holes 51 and 52 are formed in the sliding member 50. A wire portion on the front side of the core wire 44 to be folded back is slidably inserted into the one through hole 51. The other through hole 52
In the state in which the tip of the folded wire portion is inserted, the wire portion is fixed thereto by caulking or the like.

Further, a pipe 53 as a stopper having an outer diameter which is located at the tip end side of the sliding member 50 and which does not pass through the through hole 51 of the sliding member 50 is provided at the wire portion on the front side of the core wire 44 where the core wire 44 is folded back. It is fixed.

On the other hand, the coil 15a, which constitutes the core material of the sheath 41, is provided with a projection 55 which is located near the tip of the sheath 41 and is formed into a circumferential projection by being deformed by caulking or the like. The protrusion amount of the portion 55 forms an inner diameter through which the sliding member 50 cannot pass. The other structure is the same as that of the first embodiment described above.

(Operation) In the case of using this high-frequency incision cutting tool, first, the portion of the sheath 41 is led out into the body cavity through the insertion channel of the endoscope previously inserted into the body cavity. Then, as in the first embodiment described above, the operation unit 13
When the slider 26 is moved forward to the tip side, the core wire 44 is projected from the tip of the sheath 41 to some extent, and the sliding member 50 is abutted on the protrusion 55. As a result, the core wire 44 can no longer project. Further, when the slider 26 is moved forward, only the core wire 44 is projected. As a result, the lengths of the wire portions on both sides of the folded core wire 44 are different, and the treatment portion 43 spreads in a half-moon shape as shown in FIG.

The excision of the polyp or the like is performed in the same manner as in the first embodiment, except for the mechanism of pulling the core wire 44 into the sheath 41. When the slider 26 is pulled toward you, the pipe 53 hits the sliding member 50 at a certain position, and at this point, the two wire portions of the core wire 44 on the tip side of the sliding member 50 have the same length. Further, when the slider 26 is pulled, the pipe 53 thereof abuts on the sliding member 50, so that the two wire portions of the core wire 44 are simultaneously drawn into the sheath 41, so that the polyp can be bound. Other functions are the same as those of the first
The same as the embodiment of

Although the sliding member 50 has a spherical shape in this embodiment, it may have the shape shown in FIG. 3 or 4. The sliding member 50 shown in FIG.
1, 52 is a flat member that is short in the length direction, and has a semicircular rounded peripheral sectional shape. The sliding member 50 shown in FIG. 4 is formed of a short columnar member in which the lengths of the through holes 51 and 52 in the lengthwise direction are increased, and both end edges of the peripheral portion are rounded.

(Effects of Embodiment) Generally, in this type of meniscus high-frequency incision cutting tool, depending on the shape of the sliding member 50, reliable operation may not be possible. In the second embodiment, since the sliding member has a spherical shape or a shape similar thereto, such a malfunction can be reliably prevented. Further, since the connection pipe 47 having an outer diameter substantially the same as the outer diameter of the operation wire 42 is disposed at the proximal end of the exposed core wire 44 and securely fixed by means such as brazing, it does not affect the operation. In addition, it is possible to prevent the side strands from being frayed by a reliable assembly work. Other than this, the same effects as those of the first embodiment can be obtained.

<Third Embodiment> A high frequency incision resecting instrument for an endoscope according to a third embodiment of the present invention will be described with reference to FIG.

(Structure) In this embodiment, in the core wire 44 of the treatment portion 43 provided at the distal end portion of the operation wire 42 in the above-mentioned second embodiment, the leading edge formed immediately before and after the bent portion 45 respectively. Bent portions 46a, 46 of
b is shifted vertically with respect to the loop surface of the treatment portion 43. The other structure is the same as that of the second embodiment.

(Function and effect) As described above, the most advanced bent portion 4
If the 6a and 46b are not vertically displaced, the two bent portions 46a and 46b collide with each other as shown in FIG. 6A, and the resistance when retracted into the sheath 41 increases. However, according to this embodiment, since the most advanced bent portions 46a and 46b are vertically displaced with respect to the loop surface thereof, the treatment portion 43 is drawn into the sheath 41 as shown in FIG. 6 (b). Sometimes, the bent portions 46a, 4
6b does not overlap, so good operation can be maintained.

The means for displacing the bent portion can be similarly applied to the bent portion 18 immediately before and after the bent portion of the core wire 16 in the treatment portion 14 in the first embodiment described above.

<Fourth Embodiment> Referring to FIG. 7, description will be given of a high frequency incision resecting instrument for an endoscope according to a fourth embodiment of the present invention.

In this embodiment, a straight line portion 6 is provided at a certain distance from the tip of the connecting pipe 22 in the first embodiment described above.
The only difference is that the treatment unit 14 is configured as 0. The other structure is the same as that of the first embodiment.

By providing such a straight portion 60, since the core wire 16 is always positioned straight with respect to the connection pipe 22 during assembly, the workability of assembly is improved. Further, it is convenient when assembling by an automatic machine, and particularly, its effect is exhibited. (Additional Notes) According to the above description, the following matters can be obtained.

1. A sheath that has been electrically insulated on the outer peripheral surface side, an operation wire that is slidably inserted in the sheath and uses a stranded wire in which side strands are twisted around the outer periphery of the conductive core wire, In the high frequency incision resecting instrument for an endoscope, which has a treatment section formed by removing the side strand on the extreme end side of the operation wire and exposing the operation wire, and operating the treatment section with the operation wire. 2. A high-frequency incision cutting instrument for an endoscope, characterized in that the connecting pipe is covered only on the end connected to the operation wire, and is fixed by a fixing agent.

2. Slidably inserted in the sheath,
A sliding member having at least one through hole, the exposed core wire is slidably inserted into one through hole of the sliding member, and the core wire inserted through the one through hole was bent from the middle. The high frequency incision resecting instrument for an endoscope according to claim 1, wherein the treatment portion is formed by fixing the tip of the core wire portion on the bent tip side to the sliding member.

3. The sliding member has at least two through holes. The core wire is slidably inserted into the one through hole, the inserted core wire is bent, and the tip of the core wire portion on the bent tip end side is bent. The high frequency incision cutting instrument for an endoscope according to claim 2, wherein the treatment agent is formed by fixing the adhesive agent to the other through hole by a method other than the adhesive agent or the adhesive agent.

4. The high-frequency incision resecting instrument for an endoscope, wherein the fixing means other than the fixing agent in the third item is caulking. 5. Second, wherein the sliding member is spherical
The high frequency incision resecting instrument for an endoscope according to any one of 4 above.

6. The core wire is folded back, and the base end side and the folded back end of the core wire are simultaneously fitted and fixed by the connection pipe,
The high frequency incision resecting instrument for an endoscope according to item 1, wherein a treatment portion is formed.

7. The high frequency incision cutting instrument for an endoscope according to claim 1, wherein the connection pipe is fixed by abutting against the extreme end of the operation wire. 8. The high frequency incision cutting instrument for an endoscope according to claim 1, wherein an outer diameter of the connection pipe is substantially equal to an outer diameter of the operation wire.

[0046]

As described above, according to the present invention, since the connecting pipe is externally provided at the exposed end of the core wire and fixed by the adhesive, the outer diameter can be increased while securing the connecting strength of the connecting portion. Since it can be pressed down thinly, good movement operation can be performed even when the endoscope has a high angle. Furthermore, it has the advantages that it is easy to assemble and is easy to assemble.

[Brief description of drawings]

FIG. 1 shows a first embodiment of the present invention, in which (a) is a schematic external view of the entire high-frequency incision and resection tool for an endoscope according to the embodiment, and (b) is the same high-frequency wave. Sectional drawing which shows the front-end | tip part of an incision resection tool, (c) is sectional drawing of the connection part of the sheath and operation part of a high frequency incision resection tool.

FIG. 2 is a cross-sectional view showing a distal end portion of a high frequency incision resecting instrument for an endoscope according to a second embodiment of the present invention.

FIG. 3 shows a modified example of a sliding member of a high-frequency dissection / cutting tool for an endoscope according to a second embodiment of the present invention, (a) is a front view of the sliding member, and (b) is the same ( a) A sectional view taken along the line AA in the middle.

4A and 4B show another modification of the sliding member of the high-frequency dissection / cutting tool for an endoscope according to the second embodiment of the present invention, FIG. 4A is a front view of the sliding member, and FIG. Sectional drawing which follows the AA line in the same (a).

5A and 5B show a treatment portion of a high-frequency incision cutting instrument for an endoscope according to a third embodiment of the present invention, FIG. 5A is a plan view of the treatment portion, and FIG. 5B is a side view of the treatment portion.

6 (a) and 6 (b) are explanatory views of an inserted state in the sheath of the treatment portion of the high-frequency incision resection tool.

FIG. 7 is a side view of a treatment portion of a high-frequency incision cutting instrument for an endoscope according to a fourth embodiment of the present invention.

FIG. 8 is a cross-sectional view of a tip portion of a conventional high-frequency incision cutting tool.

FIG. 9 is a cross-sectional view of a treatment portion of another conventional high-frequency dissection / cutting tool.

FIG. 10 is a cross-sectional view of a treatment portion of still another conventional high-frequency dissection / cutting tool.

[Explanation of symbols]

11 ... sheath, 12 ... operation wire, 13 ... operation section, 1
4 ... Treatment part, 16 ... Core wire, 16a, 16b ... Core wire part,
17 ... Side strand, 22 ... Connection pipe, 41 ... Sheath, 42 ... Operation wire, 43 ... Treatment part, 44 ... Core wire,
46a, 46b ... Bent portion, 47 ... Connection pipe, 50 ... Sliding member.

Claims (1)

[Claims] 1. A sheath, an operation wire that is slidably inserted in the sheath, and uses a stranded wire in which side strands are twisted around the outer periphery of a core wire, and a side strand on the extreme end side of the operation wire. In a high-frequency incision resecting tool for an endoscope, which has a treatment section formed of an exposed and removed core wire and operates the treatment section with the operation wire, connects the exposed core wire to the operation wire. A high-frequency incision resecting instrument for an endoscope, characterized in that a connecting pipe is covered only on an end portion and is fixed by a fixing agent.