JPS622005Y2 - - Google Patents

Description

[Detailed description of the invention] The present invention is an improvement of a high-frequency dissection device for an endoscope that is introduced into a living body cavity, for example, a narrow tubular part, through an endoscope and performs high-frequency electrical dissection of tissue under direct vision of the endoscope. Regarding.

This type of incision instrument is used by being inserted into, for example, the bile duct opening into the duodenum. Two through holes are drilled near the tip of a flexible tube that can be inserted into the forceps channel of an endoscope, and a conductive wire for electrical incision inserted into the flexible tube is inserted into the two through holes.
One end of the conductive wire is engaged in one of the holes, and the other end is pushed out to expand the conductive wire between the holes (push type), or pulled to bend the flexible tube and make the conductive wire equivalent to the string of a bow (pull type), and in this state a high frequency current is passed through the wire to cut the tissue in the living cavity.

By the way, the flexible tube of this incisor is usually made of synthetic resin material, but when the conductive wire is energized, the electrical heat generated burns the area around the hole, enlarging the hole, and the direction of the conductive wire becomes unstable. There was a problem with becoming.

The present invention was developed to solve these problems, and by applying an electrically insulating coating to the conductive wire on at least one of the two through-hole passage parts of the flexible tube, the through-hole can be enlarged. It is characterized by being designed to prevent

The invention will now be described with reference to illustrated embodiments.
In Fig. 1, reference numeral 1 denotes a flexible tube with an open tip that has flexibility and electrical insulation properties that can be inserted into the forceps channel of an endoscope. Two through holes 2 and 3 are bored at a distance. This flexible tube 1
A contrast medium injection port 4 is opened at the rear end, and the rear end is integrated with the holding part 5.

A conductive wire 6 for electrical incision is inserted into the flexible tube 1 so as to be able to move forward and backward, and its tip exits from the tube 1 through the front through hole 2 and then passes through the rear through hole 3. Guided inside again, the through hole 3
It is substantially locked to the flexible tube 1 at the folded portion 6a. The rear end of the conductive wire 5 is integrally connected to a conductive pipe 7, and the conductive pipe 7 is slidably held in the holding part 5 via an O-ring 8 that prevents leakage of the contrast agent. An operating section 9 is integrally provided at the end exposed from the holding section 5. Reference numeral 10 indicates an adapter for connecting a high frequency power source to the conductive pipe 7.

Therefore, the exposed portion 6b of the conductive wire 6 from the tube 1 has its rear end turned back to the folded portion 6a.
A linear part 6 that is locked in the through hole 3, and a curved part 6d that goes in and out of the through hole 2 continuously from the straight part 6c.
It is made up of. In this embodiment, this curved portion 6
d is intended to be used for electrical cutting, and the electric insulating coating 11, which is a feature of the present invention, is applied to approximately the lower half of the linear portion 6c and the folded portion 6a, that is, the passage portion of the through hole 3. There is.

3 and 4 show the through hole 2 of the flexible tube 1,
An example is shown in which the electrically insulating coating 11 is applied to the conductive wire 6 in both passage portions of No. 3.

In this way, the through holes 2 and 3 of the conductive wire 6
If an insulating coating 11 is applied to at least one of the passage parts of the conductive wire 6, the diameter of the through holes 2 and 3 will not expand due to electrical heat generation of the conductive wire 6, so that the direction of the conductive wire 6 can be fixed. It does not become unstable and can improve durability.

In addition, FIG. 2 shows a case where the treatment is performed by pushing out the flexible tube 1, and FIG.
Each example shows a case where the treatment is performed by subtracting. That is, the dissecting device of the present invention is inserted into the forceps channel 20 of an endoscope and, together with the channel 20, for example, bile duct 21 and pancreas 22.
It is guided to the papilla portion where two tubes are open. Then, under the direct view of the endoscope, the operating part 9 is pushed out against the holding part 7 to expose the curved part 6d of the conductive wire 6 to the outside by the required amount necessary for incision, and in the case of FIG. The entire tube 1 is pushed into the bile duct 21 while a high frequency current is applied, and the opening of the bile duct 21 is electrocuted by the curved portion 6d.
FIG. 4 shows that the tube 1 is first inserted into the bile duct 21, the exposed portion 6b of the conductive wire 6 is bulged outside within the bile duct 21, and then the entire tube 1 is pulled out. This is the case when performing an incision procedure.

The insulating coating 11 can be extended by an appropriate amount beyond the passages of the through holes 2 and 3 in order to prevent tissue damage or bleeding that does not require incision during such electrical incision.

In the above embodiment, the present invention is applied to a push-type or pull-type dissection device in which the exposed portion 6b of the conductive wire 6 has a special shape. Moreover, it can be carried out regardless of the shape of the conductive wire 6. FIGS. 5 and 6 show an embodiment in which the present invention is applied to another general incisor, and the same components as above are given the same reference numerals.

In summary, according to the present invention, since the electrically insulating coating is applied to the part where the conductive wire passes through the hole, there is a risk that the area around the hole in the flexible tube will burn and expand due to electrical heat generated by flowing high-frequency current. This allows the directionality of the conductive wire to be maintained over a long period of time, increasing durability. Furthermore, the insulating coating strengthens the conductive wire and makes it stiffer, which can further contribute to improving durability.

[Brief explanation of the drawing]

FIG. 1 is a longitudinal sectional view showing an embodiment of the high-frequency cutting device for an endoscope according to the present invention, FIG. 2 is a partially cutaway perspective view showing the state of use of the cutting device of FIG.
Figure 4 is a vertical sectional view showing another embodiment of the present invention and a partially cutaway perspective view showing its usage condition, and Figures 5 and 6 are another embodiment of the present invention. FIG. 1...Flexible tube, 2, 3...Through hole, 6...
...Conductive wire for electrical incision, 6a...Folded portion, 6b...Exposed portion, 6c...Straight portion, 6d...
...Curved portion, 11...Electrical insulation coating.

Claims (1)

[Scope of utility model registration request] An electrodissection wire is inserted into a flexible tube that is introduced into the body cavity through an endoscope, and this conductive wire is exposed to the outside of the tube between two through holes near the tip of the flexible tube. A high-frequency dissection device for an endoscope, characterized in that the conductive wire is coated with an electrically insulating coating on at least one of the two through-hole passing portions of the flexible tube. .