JPS6232944A - High frequency incision cutter - Google Patents

Abstract

(57) [Summary] This bulletin contains application data before electronic filing, so abstract data is not recorded.

Description

DETAILED DESCRIPTION OF THE INVENTION <Industrial Application Field> The present invention relates to a high-frequency incision and resection tool used for treatment inside the body using an endoscope.

<Conventional technology> Conventionally, high-frequency incision and resection tools used in endoscopes have been
As disclosed in Japanese Patent No. 5-126811, a snare wire was inserted into the inside of one mantle tube.

That is, as shown in FIGS. 7 to 8, a ring-shaped stopper 2 is provided at the inner tip of the mantle tube 1, and a snare wire 3 is freely pushed and pulled inside the mantle tube 1 and the stopper 2. It is inserted. One end of the snare wire 3 is folded back, and a slider 4 is fixed to the folded end portion. The slider 4 has a hole 5 through which the other side of the snare wire 3 is inserted, and the snare wire 3i is inserted into the hole 5.
A locking member 6 provided at C is configured to lock in this hole 5.

As shown in FIG. 8, this high-frequency incision and excision tool is configured such that, after the slider 4 contacts the stopper 2, when the snare wire 3 is further pushed toward the distal end side of the mantle tube l, the snare wire 3
forms a snare loop at the tip. This snare loop has a semicircular shape consisting of an arc and a chord with the bent portion 3a of the snare wire 3 as the boundary. Then, a polyp or the like is taken into the snare loop, the snare wire 3 is pulled and tightened, and a high-frequency current is passed through the snare wire 3 to perform excision surgery.

<Problems to be Solved by the Invention> In the case of the above-mentioned interceptive high-frequency incision and excision tool, the length of the string portion of the snare loop is the same as the position of the stopper 2 and the snare wire 3.
The disadvantage is that the length is uniformly determined by the length of the folded portion.

Therefore, there have been inconveniences such as not being able to grasp a subject such as a large polyp, or failing to grasp a small subject due to busy schedules.

<Means to solve the problem> It has a double jacket tube, a snare wire is inserted through the inner jacket tube, the position of the inner jacket tube can be adjusted with respect to the outer jacket tube, and a fixing means is provided. High frequency incision and resection tool.

<Function> The length of the string portion of the semicircular protrusion of the snare wire can be changed.

<Example> The present invention will be described in detail below based on the drawings.

FIGS. 1 and 2 are diagrams showing a first embodiment of the present invention.

The first mantle tube 10 is made of resin such as Teflon, has an opening converged at its tip, and has a cylindrical hard tip 11 made of metal or the like fitted inside the opening. .

A cylindrical opening 12 made of metal or the like is fitted into the proximal end of the first mantle tube IO, and a tightening screw 13 is attached to the opening 12.

A second mantle tube 14 made of a resin of 17 μm or the like is inserted into the first mantle tube 10 , and the snare wire 3 protrudes from the tip of the second mantle tube 14 . Second
A cylindrical stopper 15 is attached to the distal end of the mantle tube 14, and a base 17 in which a concave groove 16 is formed with a certain pinch is attached to the proximal end. This base 17 has an insertion hole 18 formed in the longitudinal direction, and a fixing part 19 for fixing to an operation member (not shown) is formed at the end.

The snare wire 3 and the operating wire 20 are inserted into the second mantle tube 14 . The tip of the snare wire 3 is retroactively deformed at the bent portion 3a and folded back, and a slider 4 is fixed to the end of the folded snare wire 3. The slider 4 is provided so as to be freely inserted into the inside of the second mantle tube 14, and has a hole 5 through which the other end of the folded snare wire 3 can be freely inserted. Further, a locking member 6 is fixed to the snare wire 3 at a position facing the slider 4 at the tip side through a hole 5. The snare wire 3 passes through the hole 5 of the slider 4 and extends toward the base end, becoming a thicker operating wire 20 on the way and reaching the base end. The snare wire 3 and the operating wire 20 are formed by extending the central wire of the operating wire 20 as it is, and the wires at the periphery have their tips fixed by banks 21. An operating pipe 2.2 is attached to the base end of the operating wire 200, and is coupled to an operating section (not shown) via a fixing section 23 of the operating pipe 22.

Next, the operation of this embodiment will be explained.

The snare wire 3 can freely move forward and backward within the second mantle tube 14 by pushing and pulling the operating pipe 22 at its base end. When the snare wire 3 is pushed toward the distal end of the second mantle tube 14, the slider 4 comes into contact with the stopper 2, and the folded portion of the snare wire 3 no longer moves forward. That is, the position of the bent portion 3a of the snare wire 3 is determined. When the operating pipe 22 is further pushed forward, the snare wire 3 forms a semicircular snare loop with the folded portion as the string. In the snare loop, the length of the string B shown in Fig. 1 is constant, and the shape of the arc part is the operating pipe 22.
It is busy changing due to the push and pull of

If you want to change the size of the snare loop, that is, change the length of the string B, for example, as shown in FIG. 10 toward the proximal end. Then, the second mantle tube 1
The position of the stopper 15 at the distal end of No. 4 is set back from the opening at the distal end of the first mantle tube 10. Accordingly, since the length of the folded portion of the snare wire 3 is constant, the chord length B' of the snare loop becomes shorter by the amount that the second mantle tube 12 is retracted, as shown in FIG.

The second mantle pipe 14 is fixed by tightening the tightening screw 13 of the mouth 12 provided at the base end of the first mantle pipe 100 into the recess of the mouthpiece 17 provided at the base end of the second mantle pipe 4. Engagement with the groove 16 is performed from K.

This allows the surgeon to change the length of the string of the snare loop depending on the size of the polyp, and perform the surgery using the snare loop of the optimum size.

Next, a second embodiment of the present invention will be described with reference to FIGS. 3 and 4. Here, description of parts that overlap with the first embodiment will be omitted.

In this embodiment, a tightly wound coil 24 is provided on the inner peripheral surface of the first mantle tube 10 made of synthetic resin.

As a result, a compressive force is applied to the mantle tube 10 of the heat removal 1, which has a polyp, etc. taken in and bound by the snare wire 3, but the tightly wound coil 24 reliably absorbs this compressive force without shrinking, and prevents the force at the operating part from being applied. is reliably transmitted to the snare wire. Therefore, the binding of polyps and the like becomes firmer, and high-frequency ablation becomes easier and more reliable.

A third embodiment of the invention will be described with reference to FIGS. 5 and 6. Here, description of parts that overlap with the first embodiment will be omitted.

In this embodiment, a rotary ring 25 is rotatably provided at the mouth 12 of the first mantle tube 10 . The inner circumferential surface of the rotary ring 25 is threaded and engages with a thread provided on the outer circumferential surface of the base 17 of the second sleeve 14 .

Thus, by rotating the rotary ring 25, the second mantle tube 14 can be moved back and forth to any desired position and fixed using the screw.

According to this embodiment, the length of the string 13 of the snare loop of the snare wire 3 can be set to an arbitrary length, thereby making it possible to create a snare loop of an optimum size.

The present invention is not limited to the above-mentioned embodiments, but may be any device as long as the amount of protrusion of the snare wire can be changed by changing the relative position of the doubled mantle tubes.

<Effects of the Invention> According to the present invention, the amount of protrusion of the string portion of the snare wire can be made variable, so the size of the snare loop can be changed, making it possible to change the size of the snare loop, making it possible to make the most of the operation It is possible to create a snare loop that is easy to perform, and it is possible to provide a high-frequency incision and resection tool that is extremely convenient for the operator.

[Brief explanation of the drawing]

Fig. 1 shows a first embodiment of the invention, Fig. 2 shows another state of the first embodiment of the invention, and Fig. 3 shows a second embodiment of the invention. 4 shows another state of the second embodiment of the invention, FIG. 5 shows the third embodiment of the invention, and FIG. 6 shows the M3 embodiment of the invention. Diagrams showing other states, ta7 diagram is a diagram showing the conventional technology,
FIG. 8 is a diagram showing the conventional snare wire shown in FIG. 7 in an open state. 2.15...Stopper, 3...Snare wire 4
・・・・・・・・・・・・・・・Slider, 10...
First mantle tube 12 --- Mouth (fixing means) 1
４・・・・・・・・・・・・Second mantle tube holder

Claims (1)

[Scope of Claim] A high-frequency incision and resection instrument used for in-body treatment using an endoscope, comprising: a first flexible mantle tube; and a flexible mantle inserted into the mantle tube so as to be freely advanced and retractable. a snare wire that is inserted into the second mantle tube so as to be freely retractable and whose tip end is folded back by a certain length; a slider that can be freely inserted into the mantle tube; a stopper that is attached to the distal end of the second mantle tube and abuts the slider; and adjusting the relative positions of the first mantle tube and the second mantle tube. and a fixing means that can be fixed at the position.