JPH09192141A - High frequency opener like endoscope - Google Patents

Abstract

PROBLEM TO BE SOLVED: To easily and surely cutoff and sample a diseased part by attaching a wire on the loop of a top end part snear wire, connecting the snear wire and the wire through a movable connection part and providing the root of the loop with a stopper part for concentrating the loop. SOLUTION: Insulated wires 3 more than one are arranged in the shape of loop on the loop of a snear wire 1, and a movable connection part 4 is formed so that the wires 3 can be positioned on the loop of the snear wire 1 while keeping the gap between the snear wire 1 and the wires 3. Further, a stopper 6 is attached for clamping the diseased part by squeezing the wires 3. All the top end parts enter a sheath tube 2 and when the top end parts once get out of the sheath tube 2, the loop diameter is reduced simultaneously with the move of the stopper 6 and connection part 4 to the top end side of the snear wire 1 with the guide of the top end of the sheath tube 2. Then, the cut diseased part is held between the connection part 4 and the stopper 6 in the shape of loop.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a treatment tool for endoscopically removing and collecting a tumor in a body cavity.

[0002]

2. Description of the Related Art In recent years, benign and malignant tumors such as polyps formed in the gastrointestinal tract of the body such as the esophagus, stomach and large intestine are often found early with the development of endoscopy. The number of cases in which polyps and tumors are removed and harvested endoscopically is also rapidly increasing. In particular, endoscopic polypectomy is being applied as a minimally invasive treatment,
Aging society, Westernization of dietary habits has spread rapidly along with the increase in cases of polyps and cancer.

Here, endoscopic polypectomy will be described. As shown in FIG. 4, an endoscope 13 for observing the inside of a body cavity, a high-frequency incision tool for inserting the forceps hole 9 of the endoscope 13 and squeezing and excising a lesioned part 8, a high-frequency power supply device 12
The high-frequency power supply device 12 to the ground counter electrode 1
1 is brought into contact with a part of the body such as a foot, and the other is connected to the snare wire 1 of the high-frequency incision device, and a high frequency is applied to burn away the tissue of the part in contact with the snare wire 1. The high-frequency incision tool will be further described. A snare wire 1 having a loop-shaped tip inside a sheath tube 2 serving as an outer cylinder.
And a rear end operation unit 5 for operating the snare wire tip so that the snare wire tip can be put in and out of the sheath tube,
The snare wire 1 is hooked on a lesioned part 8 such as a polyp, the snare wire 1 is pulled into the sheath tube to squeeze the lesioned part 8, and a high-frequency current is passed through the snare wire 1 to burn it off, thereby simultaneously excising the lesion and stopping hemostasis. Be seen.

The resected lesion is taken out by inserting a recovery forceps 14 as shown in FIG. 5 into the forceps hole 9 of the endoscope 13, grasping the lesion, and withdrawing it together with the endoscope from the inside of the body. afterwards,
Pathological examination of lesions is the most important information for determining future treatment policy such as malignancy or benign judgment and the depth of cancer lesion. However, when grasping the lesion after resection with the recovery forceps 14, in the endoscope 13 provided with a one-channel forceps hole, the snare used for resection must be removed from the forceps hole once and replaced with the recovery forceps 14. This is troublesome and time consuming for the surgeon because it must be done.

Occasionally, the lesion may move and be lost due to respiratory movements or the like while the snare is replaced with the recovery forceps 14. Especially in the large intestine, it is difficult to find the excised lesion due to unevenness of the digestive tract, and because the operability of the endoscope is poor compared to the upper digestive tract, it is not possible to collect it and pathological examination becomes impossible. is there. Also, depending on the size of the lesion, it may not be possible to take it all at once, and it may be divided into two parts and collected, or there may be multiple polyps.
Since the collection is repeated, the burden on the operator, the treatment time becomes longer, and the burden on the patient becomes heavy. On the other hand, if the forceps hole is a two-channel endoscope, one can be used by inserting a snare on one side and a recovery forceps on the other side. However, since the pain of the patient at the time of insertion increases and the price is expensive, it is not widely used in general hospitals.

[0006]

DISCLOSURE OF THE INVENTION The present invention has been made as a result of various studies in order to solve the problems that the excised lesions in conventional endoscopic excision such as polyps cannot be immediately recovered and the treatment takes a long time. The object of the present invention is to provide an endoscopic high-frequency incision tool for easily and reliably excising and collecting lesions such as polyps.

[0007]

In a high-frequency incision instrument for endoscopically excising a lesion such as a polyp occurring in a tissue in a body cavity, a wire portion whose tip is a snare wire, a sheath tube, and a sheath tube are passed through the rear end. A high-frequency incision device comprising a rear end operation part for advancing and retracting a tip snare wire into a sheath and storing it in a sheath tube, wherein one or more wires are attached to a loop of the tip snare wire,
The snare wire and the wire are connected to each other at one or more points by a movable connection part, and a stopper part for consolidating the loop is provided at the root of the loop, which is an endoscopic high-frequency incision device.

Further, at least one wire is provided on the dome on the loop root of the snare wire at the tip end of the snare and on the opposite side thereof, and at least one wire is provided on the loop root of the snare wire at the tip end of the snare and the opposite side. The above-described wire is arranged in a dome shape, and the wire is fixed to the snare wire or slidably fixed so as to intersect the wire, which is an endoscopic high-frequency incision tool.

[0009]

BEST MODE FOR CARRYING OUT THE INVENTION A schematic view and a sectional view of an endoscopic high-frequency incision tool according to the present invention are shown in FIGS. 1, 2 and 3. In both cases, the high-frequency incision tool for excising a lesion has the same structure as a conventional high-frequency incision tool, and an auxiliary tool for recovery is attached.

In FIG. 1, one or more insulative wires 3 are arranged in a loop shape on the loop of the snare wire 1 so as to keep the space between the snare wires and to keep the wire 3 positioned on the snare wire circle. A movable connecting part 4 is provided, and a stopper 6 for striking the wire 3 and gripping a lesion part is further provided. All the distal end portions enter the sheath tube 2, and once the sheath tube 2 is removed, the stopper 6 and the connecting portion 4 move to the distal end side of the snare wire 1 with the distal end of the sheath tube as a guide, and at the same time the loop diameter becomes small and the excised lesion Is gripped by the connecting portion 4 and the stopper 6 which are on the loop.

In FIG. 2, a stopper 6 is provided at the root of the loop at the tip of the snare wire, and at least two wires 3 are fixed to the tip of the snare wire on the opposite side from the stopper 6, and the snare wire 1 is housed in a sheath tube. If the stopper 6 is stored in the sheath tube,
Alternatively, as shown in FIG. 2b, the stopper 6 having an outer diameter that can be inserted into the forceps hole of the endoscope 13 is set along the outside of the sheath tube 2. When the snare wire 1 is taken out from the sheath tube 2 and the snare wire 1 is pulled into the sheath tube, the distal end of the sheath tube serves as a guide, the stopper 6 moves to the distal end, and the excised lesion is grasped by the wire 3.

In FIG. 3, a horizontal wire 3'is connected to the snare wire 1 so as to intersect the vertical wire 3, and the horizontal wire 3'is movably fixed to the snare wire 1 and the sheath tube 2 is attached. When the snare wire 1 is stored in the
When exits from the sheath tube 2, the stopper 6 is guided by the sheath tip and moves to the tip of the snare wire 1, and the excised lesion is grasped in the bag-shaped wire. At this time, it is preferable that the intersecting portion of the vertical wire 3 and the horizontal wire 3'is fixedly or movably connected, and may not be fixed as long as the shape of the wire can be maintained by taking in and out the snare.

Next, the material will be described. There is no particular limitation as long as it is an insulating material or a covered insulating material other than the snare wire, and heat generation due to high frequency causes heat resistant material or structure. To explain further, the sheath tube 2 slides well within the forceps holes of the snare wire 1 and the endoscope 13, and the distal end is operated by rotating the tube, changing the direction, or operating remotely.
Rigid polyvinyl chloride resin, fluororesin, polyethylene resin, polypropylene resin are preferable, but these resins and other resins may be tubes combined with metal coils or meshes to have rigidity, and are not particularly limited. It is not done.

The tip wire has an outer diameter of 0.1 to 1.0 that can be housed in the sheath tube together with the snare wire 1.
mm single wire or mini rope, nylon or fluorine-based plastic or metal wire coated with an insulator, or fiber such as silk is preferable, but the loop shape has good resilience and does not bend or bend. If there is, it is not particularly limited. It is necessary that the stopper 6 can collect wires and that the stopper 6 does not loosen when grasping a lesion. For example, resin such as polyvinyl chloride resin, urethane resin or rubber such as natural rubber, silicone rubber or isoprene rubber is suitable. However, it is not particularly limited.

On the other hand, the snare wire 1 is a conductive material capable of passing a high frequency current, and has a diameter of 1 when the loop is opened.
It is the same size as a commonly used snare of 0 to 35 mm, and has an outer diameter of 0.2 to access the sheath tube.
A single wire or mini-rope is preferable with a stainless steel wire of ~ 1.0 mm, but it has a certain degree of rigidity such as restoring ability to maintain the loop shape of the snare and operability of the wire by remote control, and it comes in contact with bodily fluid in the body cavity. However, the material is not particularly limited as long as it is hard to rust and hard to affect the body.

[0016]

EFFECTS OF THE INVENTION Regarding recovery after excision of a lesion, which was a problem with the conventional high-frequency incision tool When the high-frequency incision tool of the present invention is used, excision and recovery of a lesion can be performed without impairing the operability of the conventional high-frequency incision tool. At the same time, removal of polyps etc. became easy. In particular, since the lesion can be reliably recovered, it will be valuable data on future treatment policy through pathological examination and the like.

[Brief description of the drawings]

FIG. 1 is a general view showing a high-frequency incision tool used in the present invention, wherein a shows a state in which a snare wire is opened, and b shows a state in which a lesion is cut.

FIG. 2 is an overall view showing a high-frequency incision tool used in the present invention, in which “a” shows a state in which a snare wire is opened, “b” shows an example when the snare wire is stored, and “c” shows a portion where a lesion is excised. FIG.

FIG. 3 is an overall view showing a high-frequency incision tool used in the present invention, where a is a state in which a snare wire is opened, and b is a diagram in which a lesion is excised.

FIG. 4 is a view showing a use situation of the high-frequency incision tool.

FIG. 5 is a view showing a forceps for recovery.

[Explanation of symbols]

 1 snare wire 2 sheath tube 3 wire 4 connection part 5 rear end operation part 6 stopper 7 connection cord 8 lesion part 9 forceps hole 10 body 11 counter electrode plate 12 high frequency power supply device 13 endoscope 14 recovery forceps

Claims (3)

[Claims] 1. A high-frequency incision instrument for endoscopically excising a lesion such as a polyp generated in a tissue in a body cavity, the tip of which is a wire portion having a snare wire, a sheath tube, and a sheath tube, and a rear end portion thereof. A high-frequency incision device comprising a rear end operation part for advancing and retracting a snare wire and storing it in a sheath tube, wherein one or more wires are attached on a loop of the tip snare wire, and the snare wire and the wire are movable connection. The endoscopic high-frequency incision device is characterized in that it is connected to one or more places with a portion, and a stopper portion for consolidating the loop is provided at the root of the loop. 2. The endoscopic high-frequency incision instrument according to claim 1, wherein at least two wires are formed in a dome shape on the loop root of the tip snare wire of the snare tube and on the opposite side thereof. 3. At least two or more wires are arranged in a dome shape on the loop root of the snare wire at the tip of the snare tube and on the opposite side, and two or more wires are attached to the snare wire so as to intersect the wires. Item 1. The endoscopic high-frequency incision instrument according to Item 1.