JPS6264355A - High frequency inciser - 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 is directed into a body cavity using an endoscope.
The present invention relates to a high frequency incision and removal tool for incising and removing IJ-p and the like.

[Conventional technology]

Conventionally, this type of high-frequency incision and excision tool was developed in U.S. Pat.
The configuration is as disclosed in Japanese Patent No. 6811. That is, as shown in FIGS. 18 and 19, a snare wire 2 is inserted into the inside of one mantle tube 1. The tip end portion of the snare wire 2 is folded back midway to form a bent portion 3. A slider 4 is fixed to the tip of one of the folded parts. This slider 4 has a hole 5 formed therein through which the other folded portion is inserted. Furthermore, a locking member 6 is attached to the middle of the other folded portion, and this locking member 6 forms a trap so that it still contacts the slider 4. Further, a stop horn 47 is provided at the distal end of the mantle tube 1.

When this high-frequency incision and cutting tool is used, the 18th
Push the snare wire 2 forward from the state shown in the figure, but
As a result, the slider 4 advances as shown in FIG. 19 and stops when it hits the stopper 7. Further, when the snare wire 2 is pushed toward the tip side, the tip portion of the snare wire 2 forms a semicircular roof ''8 consisting of an arc and a chord with the bent portion 3 as a boundary. Therefore, a polyp or the like is introduced into the loop f8, the snare wire 2 is pulled and tightened, and a high frequency current is supplied to the snare wire 2 to perform incision and excision.

[Problem that the invention seeks to solve]

In the case of the conventional high-frequency incision and cutting tool described above, the length of the string portion of the loop 8 of the snare wire 2 is uniformly determined by the position of the strut horn #7 and the length of the folded tip portion of the snare wire 2. In other words, the size of the loop 8 could not be changed arbitrarily. Therefore, there has been the inconvenience of failing to grasp an object such as a large polyp, or conversely failing to grasp a small object.

The present invention has been made in view of the above problems, and its purpose is to be able to arbitrarily adjust the size of the snare loop depending on the thickness of the target object, and to also adjust the size of the snare loop to suit the thickness of the target object. It is an object of the present invention to provide a high-frequency cutting and cutting tool that can be set reliably.

[Means for solving problems]

A snare wire 22 that is folded back halfway inside the sheath 11
A high-frequency incision is provided in which a slider 24 is attached to the tip of one end of the folded snare wire 22 through which the snare wire 22 is inserted so as to be freely advanced and retracted, and a fixing means is provided for fixing the stone/base 16 to which the slider 24 is applied so that the position can be adjusted back and forth. It is a cutting tool.

[Effect]

By changing the front and back position of the stopper 16, the snare wire 22
When the slider 24 is moved forward, the locking position of the slider 24 changes, and the size of the snare loop 2-9 protruding from the sheath tip also changes.

〔Example〕

1 to 3 show a first embodiment of the present invention.

In the figure, reference numeral 11 denotes a flexible sheath made of electrically insulating resin such as Teflon. This sheath 1
A stopper moving tube 12 is connected to the base end of the stopper.

A protective tube 13 is fitted over the proximal end of the sheath 11 and the outer periphery of the tube 12 for moving inside the strut.

Further, a base 14 is attached to the base end of the stone 5 moving tube 120. Each of these members constitutes the υ sheath assembly 15.

An annular stop horn 4 is provided inside the stopper moving pipe 12.
16 is inserted, and these horns 16 are connected to the tube 1.
2 in the front and back direction. This strut horn #16 has a protruding portion 18 with a threaded portion 17 formed on its outer periphery.
is provided, and this protrusion 18 is connected to the stopper moving tube 12.
The protective tube I3 extends through a long hole 19 formed along its length and projects to the outside.

A nut 21 is screwed onto the protruding tip of the protruding portion 18, and constitutes a fixing means for fixing the stopper 16 at any position in the front-rear direction by tightening the nut 2.

A snare wire 22 is inserted through the inside of the sheath assembly 15 so as to be freely advanced and retracted. This snare wire 22 is particularly folded by providing a bent portion 23 in the middle thereof, and each folded end portion is inserted into the arm of the strut 16. A slide finish 24 is attached and fixed to the tip of one folded end. Further, the slider 24 is formed with a through hole 25 through which the other folded end of the snare wire 22 is inserted. The tip of the other folded end that passes through the stopper 16 and the through hole 25 is connected to the operating pipe 26 .

A retracting member 27 is fixedly attached in the middle of the folded end of the side to which the operating piping fzt;ItC is connected, so that it comes into contact with the slider 24 when the operating piping fze is retracted. The distal end portion of the operating pipe 26 is inserted into the stone moving pipe 12 and the mouthpiece 14 so as to be able to move forward and backward. Furthermore, a fixture 28 is provided at the base end of the operating knob f 26 to be connected and fixed to an operating slider of an operating device (not shown). Further, the base 14 is attached and fixed to a mounting portion of the operating device.

The snare wire 22 is connected to a high-frequency generator by a cord via a fixture 28, which is attached to the operating slider on the operating device side.

Next, the operation of this first embodiment will be explained.

First of all, before using it, check whether it is Strato J? Select 16 positions. That is, loosen the nut 21 and move the stock 4'16 to an appropriate position in the front and back. At this time, the protrusion 18 moves along the long hole 19, so the stopper 16 often rotates within the tube 12.

The position of this stopper 16 is determined by actually operating the stopper 16 as shown in FIG. , slider 2
It is determined by selecting the length B of the string of the snare loop f29 in a state where the snare loop f29 is pressed against the armpit 16 of the snare loop.

Then, in this position, the nut 21 is tightened to fix the string/glue 16.

If the length B of the string of the snare loop 29 is to be made larger and rounder, the position of the string 16 may be moved further forward and fixed as shown in FIG. Tsumashi, Stotsuno 41
By selecting the position 6, the size of the snare loop 29 can be freely adjusted.

On the other hand, the thus adjusted sheath 11 is connected to an operating device, and the sheath 11 is introduced into the body through the channel of the endoscope. When the snare wire 22 is advanced by operating the operating device, the slider 24 is first fixed at one end to the stopper 16, but the other end is further advanced and the snare loop 29 form. Therefore, this snare loop F29 is applied to the polyp, which is the target site. After that, the snare wire 22 is reversely pulled toward the proximal side, the snare loop 29 is closed, and the neck of the polyp is tied tightly. Furthermore, when the polyp is tightened while flowing a high-frequency current, the retracting member 27 still contacts the slider 24 and the snare wire 22 is drawn into the sheath 11, thereby excising the polyp.

4 and 5 show a second embodiment of the present invention. This embodiment differs from the first embodiment in the fixing means for the strut horn #16. That is, a plurality of cuts 31 are provided from the elongated hole 19 toward the circumferential direction of the stopper moving tube 12 and the protective tube 13. These three notches are arranged at intervals in the front and back, and if the protrusion 18 of the stock/416 is fitted into any one of these three cuts, the stock/mother 16 will be placed at that position. can be fixed.

6 to 13 show a third embodiment of the present invention.

FIG. 6 shows a sheath assembly 15, in which a cap 14 is fixedly attached to the proximal end of the sheath 11, and a protective tube 13 is fitted onto the proximal end of the sheath 11. There is. A slide tube 31 is fitted into the interior of this base 14.

Further, the snare wire 22 inserted into the sheath 11 is constructed in the same manner as in each of the above embodiments. The tip of one end bordering on the bent portion 23 is the slide tube 3.
1, and the other end is connected to the slide tube 3.
1 and is connected and fixed to the operation pipe 26. It should be noted that the tip of the operating pie f26 is slidably fitted into the slide tube 3. Further, a large-diameter locking portion 32 is formed at the proximal end of the slide tube 31.

FIG. 7 shows the operating device 33 for mounting the sheath assembly 15. This operating device 33 has a mounting section 36 provided at one end of an operating section main body 35 consisting of a pair of left and right guide rods 34, 34;
4 is attached and fixed. Further, an operation slider 37 is attached to the operation section main body 35 so as to be movable back and forth. This operation slider 37 is provided with a locking portion 38 that locks the fixture 28 of the operation pipe 26 . This locking portion 38 can be attached and detached using a button 39. Furthermore, this operation slider 37 is provided with a plug 40.

On the other hand, a stopper 39 is mounted between the guide rods 34, 34 of the operation section main body 35, located between the mounting section 36 and the operation slider 37. As shown in FIGS. 9 to 12, this stopper 39 is made of a single-shaped block material, and saw teeth 42 are formed on the left and right lower surfaces of the upper head 40, and each of the saw teeth 42 corresponds to each of the above-mentioned ones. Each of the guide rods 34 is engaged with saw teeth 43 formed on the upper surface of the guide rod 34. 8 to 10 show the locked state. Further, the saw tooth 39 is mounted between the guide rods 34 so as to be able to move up and down, and when it is positioned on the upper side as shown in FIGS. 11 and 12, the saw teeth 41 and 42 are disengaged from each other. It can be slid forward and backward. In addition, a click protrusion 44 is provided on the side surface of the middle part of the stop horn 416, and when the stone flat 39 is pressed down in the state shown in FIG. In the state shown in Figure 11, the guide rod 3
It is adapted to be engaged with a click groove 45 formed on the inner wall of 4.

In addition, the stopper 39 has a small hole 46 on the upper side and a large hole 4 on the lower side.
7 are formed in succession. Then, when the stopper 39 is pushed down, the small hole 46 is located at the center of the operation section main body 35, and the locking part 32 of the slide tube 31 passing through it is locked. Further, when the stopper 39 is pushed up, the large hole 47 is located at the center of the operating section main body 35, and the locking portion 32 of the slide rod 3 can be inserted therethrough.

Therefore, this sheath assembly 15 and the operating device 33 were
Use assembled as shown. When assembling, first install the stone/439 as shown in Figures 11 and 12.
Push up as shown in the figure to position the large hole 47 at the center of the operating section main body 35. Then, for attachment, the base 14 of the sheath assembly 15 is attached and fixed to the part 36. At this time, the locking portion 32 of the slide tube 3 is inserted into the large hole 47 to form a penetrating state. After this, push up the struts etc. 39 and make the small hole 4.
Position the slide tube 31 at the part 6. In this state, the locking part 32 hits the stone holder 39, and it becomes impossible to move forward any further. In addition, the fixing device 28 of the operation/conceiving idea 26
is engaged with the engagement portion 38 of the operation slider 37.

When using the device assembled in this way, when the operation slider 37 is moved forward, the snare wire 22 moves forward, and furthermore, the slide tube 31 moves forward as well. Then, the locking portion 32 of the slide tube 31 hits the stop horn 439K, and further advancement is prevented. Furthermore, when the operation slider 37 is moved forward, the snare wire 22 protrudes from the distal end of the sheath 11 to form a snare loop 29. The string length B of the snare loop 29 at this time is determined by the position of the strut horn 439. Further, this length B is determined by the front and rear positions of the stopper 39.

FIG. 13 shows a state in which the armpit 39 is in the forward position. However, if the position of the stopper 39 is moved forward, the length B
becomes longer by 1, and if it is later, it becomes shorter. Then, as shown in FIGS. 11 and 12, the position of the strut horn base 39 is determined by pushing it up one step to release the saw teeth 42 and 43, sliding it forward or backward, and then pushing it down again to engage it. can be fixed in a selected position.

14 to 17 show a fourth embodiment of the present invention.

This embodiment has a slide tube 31 similar to that of the third embodiment. A fixed body 5θ is provided on this slide tube 31, and a V-groove 5 is provided on the outer periphery of this fixed body 50.
form 1. Furthermore, the guide rod 34 of the operating section main body 35
A slider 52 that can be moved back and forth and a ring-shaped stopper 53 located further forward are attached to the part.

The slider 52 is provided with a tightening screw 54 that engages with the V-groove 51 of the fixed body 50. In other words, the slider 52
and the slide tube 31 are integrated and move back and forth. Further, as shown in FIG. 14, a fixing screw 55 is threaded onto the stopper 52, and the stopper 52 can be fixed to the guide rod 34 by means of the fixing screw 55.

Thus, the stopper 52 can be moved back and forth relative to the operating section main body 35 by loosening the fixing screw 55. Then, it can be fixed by tightening the fixing screw 55 at an arbitrary position. The slider 52 integrated with the slide tube 31 reaches the stopper 52 and is prevented from moving further. Corresponding to this position, the string length B of the snare loop 29 is determined. For example, as shown in FIG. 17, by changing the position of the stop horn 452, the length B can be changed.
can be changed.

〔Effect of the invention〕

As explained above, according to the present invention, the size of the snare loop can be arbitrarily selected, so that it can be used in a state that suits the size of the object to be processed, such as a leap. therefore,
It is possible to avoid the inconvenience of having a snare loop that is difficult to apply to the object to be processed, or of the snare loop coming off when closing. Further, the size of the snare loop can be easily and reliably selected.

[Brief explanation of the drawing]

1 and 2 are side sectional views of the sheath assembly of the first embodiment, FIG. 3 is a perspective view of the proximal portion of the sheath assembly, and FIGS. 4 and 5 are the side sectional views of the sheath assembly of the first embodiment. FIG. 6 is a side sectional view of the sheath assembly of the third embodiment, FIG. 7 is a plan view of its operating device, and FIG. 8 is its same. A side sectional view of the assembled sheath assembly and operating device, FIG.
10 and 11 are perspective views of the stock and groove portions, FIG. 12 is a sectional view of the stopper portion, and FIG. 13 is a sectional view of the sheath. 14 is a side sectional view of the assembled body and operating device, FIG. 14 is a side sectional view of the fourth embodiment, and FIG. 15 is a side sectional view of the first embodiment.
4 is a sectional view taken along the line xv-xv in FIG. FIG. 16 is a sectional view taken along the line XM-xv in FIG. 14, FIG. 17 is a side sectional view of the fourth embodiment, and FIGS. 18 and 19 are side sectional views of the tip of the conventional one. It is. 11... Sheath, 15... Sheath assembly, 16.
...Stocks 9.22...Snare wire, 29...
Snare loop f, sy...Stotsuno J? . Applicant's agent Atsushi Tsuboi No. 1S Figure White Figure 19 Procedural amendments December 3, 1939 Commissioner of the Patent Office Kuro 1) Akio Tono1, Indication of the case Patent application No. 1988-2048202, Invention Name: High-frequency incision and excision tool 3, Person making the amendment Relationship to the case Patent applicant (037) Olympus Optical Industry Co., Ltd. 4, Agent: QUBE Building 7, 3-7-2 Kasumigaseki, Chiyoda-ku, Tokyo, Contents of the amendment (1) Details Change "Button 39" on page 10, line 19 of the book to "Button 4"
Correct to 8. (2) "Stopper 16" on the 4th line from the bottom of the page 1]
” is corrected to “stopper 39”. (3) Replace each "stopper 52" in the 18th line of the same page 14, the 20th line of the box on the same page, the 2nd line of the 15th page, the 6th line of the same page, and the 10th line of the same page with the "stopper 53". Correct to. (4) Correct the number "39" in FIGS. 7, 8, and 13 to "48" as shown in the attached drawings.

Claims (2)

[Claims] (1) A flexible sheath, a snare wire that is inserted into the sheath so as to be freely advanced and retracted and is folded back in the middle, a slider attached to the tip of one of the folded ends of the snare wire, and a snare wire that is moved forward. A high-frequency incision and excision tool comprising: a stopper that regulates the size of the snare loop that the slider hits; and a fixing means that adjusts the front-rear position of the stopper and fixes it at the selected position. (2) The high-frequency cutting and cutting tool according to claim 1, wherein the stopper and fixing means are incorporated into the proximal side of the sheath.