JP5137544B2 - Endoscopic high-frequency treatment instrument - Google Patents

Description

  The present invention relates to a high-frequency treatment instrument for an endoscope.

  An endoscopic high-frequency treatment instrument that is passed through a treatment instrument insertion channel of an endoscope and used for EMR (radioendoscopic mucosal resection) or the like is an electrically insulating flexible material in which conductive wires are inserted and arranged. An electrically insulating flexible distal tube is provided at the distal end of the base tube so as to be rotatable around the axis.

  The tip tube is formed with a pair of electrode passing holes for exposing the exposed electrode mechanically and electrically connected to the conductive wire to the outer surface, and the exposed electrode is exposed to the outer surface between the pair of electrode passing holes. Then, the conductive tube is rotated around the axis from the base end side of the base tube so that the tip tube rotates around the axis with respect to the base tube, and the orientation of the exposed electrode is arbitrarily changed from the proximal side. Be able to.

In addition, a linear indicator is provided at an appropriate position on the back side of the tip tube so that the orientation of the exposed electrode can be grasped even when the exposed electrode is not directed to the observation window side of the endoscope and cannot be observed. (Patent Document 1).
JP-A-2005-334000

  In the invention described in Patent Document 1, the surface of the tube colored in black is scraped off linearly in a direction parallel to the axis, or an indicator is formed on the outer surface of the tip tube, and a linear indicator is provided. ing.

  However, if the indicator is provided in such a manner, it takes a considerable amount of cost just to attach the indicator, and the indicator of the invention described in Patent Document 1 is used for grasping the orientation of the exposed electrode. Although useful, it is not possible to confirm how much the exposed electrode is submerged under the mucous membrane, so there is a risk that the submucosa will be incised too deeply.

  The present invention can provide an indicator for grasping the orientation of the exposed electrode at a low cost on the distal tube, and can easily confirm how much the exposed electrode is submerged under the mucosa, An object of the present invention is to provide an endoscopic high-frequency treatment instrument capable of safely performing mucosal incision and the like.

  In order to achieve the above object, an endoscopic high-frequency treatment instrument of the present invention has an electrically insulative flexible proximal end of an electrically insulative flexible base tube through which a conductive wire is inserted and arranged. The tip tube is rotatably connected around the axis, and the tip tube is formed with a pair of electrode passage holes through which a wire-like exposed electrode that is mechanically and electrically connected to the conductive wire passes. The exposed electrode is exposed to the outside of the distal tube between the pair of electrode passage holes, and the distal tube rotates about the axis relative to the proximal tube by rotating the conductive wire around the axial line from the proximal end side of the proximal tube. In the configured endoscopic high-frequency treatment instrument, a material tube in which a muscle visible on the outer surface is formed in a straight line over the entire length is used as a material of the distal tube, and the electrode passage hole has a predetermined positional relationship with the muscle. Are those formed.

  The proximal end portion of the distal tube may be loosely inserted into the distal end of the proximal tube, and a pair of electrode passage holes are formed at intervals in the longitudinal direction of the distal tube so that the exposed electrode is connected to the distal tube. You may expose to the outer surface of a tip tube along a longitudinal direction.

  The muscle may be arranged at a position corresponding to the back side of the tip tube when viewed from the exposed electrode. In that case, the muscle is deleted from the tip tube in a region having a predetermined positional relationship with the position of the exposed electrode. Also good.

  More specifically, the streaks may be deleted in the entire region where the exposed electrode is exposed on the outer surface in the longitudinal direction of the tip tube, or the streaks are exposed on the outer surface in the longitudinal direction of the tip tube. It may be deleted in the entire area behind the exposed area.

  The pair of electrode passage holes may be formed at intervals in the circumferential direction of the tip tube, and the exposed electrode may be exposed on the outer surface of the tip tube along the tip surface of the tip tube. Further, the streaks may be deleted in a predetermined state in the tip tube, or the streaks may be deleted at regular intervals in the longitudinal direction.

  In addition, the streaks are formed in a V-shaped cross-sectional shape that gradually spreads outward in the cross section perpendicular to the axis of the material tube. It may be reduced corresponding to the height, and the streaks may be deleted so that the width changes at regular intervals in the longitudinal direction.

  According to the present invention, as a material for the tip tube, a material tube in which a line visible on the outer surface is formed in a straight line over the entire length is used, and the electrode passage hole is formed in a predetermined positional relationship with the line. Therefore, it is possible to provide an indicator for grasping the orientation of the exposed electrode at a low cost on the distal tube, and to easily check how much the exposed electrode is submerged under the mucosa. Etc. can be performed safely.

  An electrically insulating flexible distal tube is rotatably connected around the axis at the distal end of an electrically insulating flexible proximal tube through which a conductive wire is inserted. A pair of electrode passage holes through which a wire-like exposed electrode that is mechanically and electrically connected to the conductive wire passes are formed, and the exposed electrode is exposed to the outside of the distal end tube between the pair of electrode passage holes. In the high-frequency treatment instrument for an endoscope configured so that the distal end tube rotates about the axis with respect to the proximal tube by rotating the conductive wire from the proximal end side of the proximal end side, as the material of the distal end tube, A material tube in which visible stripes are formed in the axial direction straight over the entire length is used, and electrode passage holes are formed in a predetermined positional relationship with the stripes.

Hereinafter, with reference to the drawings illustrating the examples and the like of the present invention.
FIG. 4 shows the overall configuration of the endoscope high-frequency treatment instrument of the first reference example of the present invention, wherein 1 is a base side inserted into and removed from an endoscope treatment instrument insertion channel (not shown) It is a tube, and is formed of an electrically insulating flexible tube such as a tetrafluoroethylene resin tube. In the base tube 1, a flexible conductive wire 2 such as a stainless steel stranded wire is inserted through the entire length so as to be rotatable around the axis.

  The distal tube 3 provided in a state of being connected to the distal end of the base tube 1 is also formed of an electrically insulating flexible tube such as a tetrafluoroethylene resin tube. The proximal end portion is loosely inserted into the distal end of the proximal tube 1, and the distal tube 3 is connected to the proximal tube 1 so as to be rotatable around the axis. A wire-like exposed electrode 4 connected to the tip of the conductive wire 2 is exposed on the side surface near the tip of the tip tube 3.

  A first finger hook 12 for engaging the operator's first finger is provided at the proximal end of the operation portion main body 11 in the operation portion 10 connected to the proximal end of the proximal tube 1. In addition, a second finger hook 13 for engaging the operator's second finger and third finger is disposed so as to be rotatable around the axis with respect to the operation portion main body 11, and the second finger hook 13 is electrically conductive. The base end of the line 2 is connected.

  As a result, when the second finger hook 13 is rotated with respect to the operation unit main body 11 in the direction around the axis, the conductive wire 2 rotates in the direction around the axis in the proximal tube 1, and the distal end tube 3 becomes the proximal tube. Rotate in the direction around the axis relative to the tip of one.

  Further, a high frequency power cord connecting terminal 14 that is electrically connected to the proximal end of the conductive wire 2 is attached to the second finger hook 13. As a result, by connecting a high-frequency power cord (not shown) to the high-frequency power cord connecting terminal 14, a high-frequency current can be applied to the exposed electrode 4 through the conductive wire 2.

FIG. 1 shows the tip tube 3 portion. The exposed electrode 4 of this reference example is used by independently pulling out the core wire of the conductive wire 2 formed of a stranded wire. Therefore, the exposed electrode 4 is mechanically and electrically connected to the conductive wire 2, and the tip of the core wire forming the exposed electrode 4 is returned to the proximal tube 1 and wound around the conductive wire 2.

  In the vicinity of the distal end of the distal tube 3, a pair of electrode passage holes 5 for exposing the wire-like exposed electrode 4 to the outer surface are formed at intervals in the longitudinal direction of the distal tube 3, as shown in FIG. As shown, the exposed electrode 4 is exposed on the outer surface of the tip tube 3 in a direction along the longitudinal direction of the tip tube 3 between the pair of electrode passage holes 5.

  Further, as shown in FIG. 3, the muscle 6 functioning as a linear index is located at the tip of the tip tube 3 as viewed from the pair of electrode passage holes 5 (that is, viewed from the exposed electrode 4). It is formed so as to be visible from the outer surface in a direction parallel to the axis of the tube 3. The streaks 6 need only have a different color from the other parts of the distal tube 3, and in the case of the same color, it is sufficient to make the density or brightness different from each other.

  For such a tip tube 3, a long tube (for example, about 1 to 30 m) in which the muscle 6 that is visible on the outer surface is formed over the entire length straight in the axial direction is used as a material, and is suitable for use as the tip tube 3. A pair of electrode passage holes 5 are formed in a predetermined positional relationship with the muscle 6 by cutting into a predetermined length. Accordingly, the muscle 6 serving as an index for grasping the direction of the exposed electrode 4 can be provided in the distal tube 3 at a very low cost.

5 and 6 show the tip tube 3 portions of the second and third reference examples of the present invention, and the streaks 6 correspond to the positions of the pair of electrode passage holes 5 (that is, the positions of the exposed electrodes 4). The region having the predetermined positional relationship is deleted from the tip tube 3. In addition, the raw material tube of the front-end | tip tube 3 is the same as the above-mentioned 1st reference example, and the stripe | line | muscle 6 is formed over the full length in the axial direction (hereinafter the same).

Specifically, in the second reference example shown in FIG. 5, the muscle 6 located on the back side of the tip tube 3 when viewed from the pair of electrode passage holes 5 is not exposed to the exposed electrode 4 in the longitudinal direction of the tip tube 3. It is deleted in all areas exposed on the outer surface and not deleted in other areas. Other configurations are the same as those of the first reference example.

In the third reference example shown in FIG. 6, the muscle 6 located on the back side of the tip tube 3 when viewed from the pair of electrode passage holes 5 is exposed to the outer surface in the longitudinal direction of the tip tube 3. It is deleted in all areas behind the existing area. The streak 6 is not deleted in the region where the exposed electrode 4 is exposed on the outer surface. Other configurations are the same as those of the first reference example.

In the second and third reference examples configured as described above, the exposed electrode 4 can be grasped from the back side of the distal end tube 3 by the muscle 6 up to the longitudinal range where the exposed electrode 4 is provided. It is possible to easily confirm how much is submerged under the mucous membrane, and to perform a mucosal incision safely.

FIG. 7 shows the tip tube 3 portion of the fourth reference example of the present invention, and the muscle 6 located on the back side of the tip tube 3 when viewed from the pair of electrode passage holes 5 is in a predetermined state in the tip tube 3. Has been deleted. More specifically, the streaks 6 are deleted at regular intervals in the longitudinal direction. Other configurations are the same as those of the first reference example.

  Thus, since the index in which the muscle 6 is deleted at a constant interval in the longitudinal direction has a function as a ruler, as shown in FIG. It can be easily confirmed from the observation window 51 of the mirror 50, and mucosal incision or the like can be performed more safely. Reference numeral 52 denotes a treatment instrument insertion channel.

Figure 9 shows a material tube 3A of the distal tube 3 of the actual施例of the present invention, the muscle 6, formed in a V-shaped cross section spread gradually outwardly in the axial and vertical section of the material tube 3A Has been. W is the width of the stripe 6 visible from the outside.

As a result, when the material tube 3A is scraped from the outer peripheral surface side, as shown in FIG. 10, the width W ′ of the stripe 6 seen from the outside decreases corresponding to the scraping depth, and as shown in FIG. If the muscle 6 in the distal tube 3 is deleted so that its width changes at a certain interval in the longitudinal direction, it is easy to determine how much the exposed electrode 4 is submerged under the mucous membrane as in the fourth reference example. Can be confirmed.

FIG. 12 shows a tip tube 3 portion of a fifth reference example of the present invention, and a pair of electrode passage holes 5 are spaced apart in the circumferential direction of the tip tube 3 (for example, at a position approximately symmetrical by 180 °). Is formed. In FIG. 12, one electrode passage hole 5 does not appear.

In this reference example, the exposed electrode 4 is exposed on the outer surface of the distal tube 3 along the distal surface of the distal tube 3. The muscle 6 is formed in the tube made of the material of the tip tube 3 as in the above-described reference examples and examples. Thus, the present invention provides various high-frequency treatments for endoscopes in which the arrangement of the exposed electrodes 4 is different. Can be applied to tools.

It is side surface sectional drawing of the front-end | tip tube part of the high frequency treatment tool for endoscopes of the 1st reference example of this invention. It is a top view of the front-end | tip tube part of the high frequency treatment tool for endoscopes of the 1st reference example of this invention. It is a bottom view of the tip tube part of the high frequency treatment tool for endoscopes of the 1st reference example of the present invention. It is a whole block diagram of the front-end | tip tube part of the high frequency treatment tool for endoscopes of the 1st reference example of this invention. It is a bottom view of the tip tube part of the high frequency treatment tool for endoscopes of the 2nd reference example of the present invention. It is a bottom view of the tip tube part of the high frequency treatment tool for endoscopes of the 3rd reference example of the present invention. It is a bottom view of the tip tube part of the high frequency treatment tool for endoscopes of the 4th reference example of the present invention. It is the schematic of the use condition of the high frequency treatment tool for endoscopes of the 4th reference example of this invention. It is a cross-sectional view of a section perpendicular to the axis of the material tube of the tip tube of the real施例endoscopic high-frequency treatment instrument of the present invention. Is a cross-sectional view of a section perpendicular to the axis of the state after the material tube of the real施例tip tube of the endoscopic high-frequency treatment instrument is scraped partly of the present invention. It is a bottom view of the distal tube portion of the endoscopic high-frequency treatment instrument of the real施例of the present invention. It is a perspective view of the tip tube part of the high frequency treatment tool for endoscopes of the 5th reference example of the present invention.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Base side tube 2 Conductive wire 3 Tip tube 3A Material tube 4 Exposed electrode 5 Electrode passage hole 6 Muscle

Claims (9)

An electrically insulating flexible distal tube is provided rotatably connected around the axis at the distal end of an electrically insulating flexible proximal tube through which a conductive wire is inserted. Is formed with a pair of electrode passage holes through which a wire-like exposed electrode mechanically and electrically connected to the conductive wire passes, and the exposed electrode is exposed to the outside of the tip tube between the pair of electrode passage holes. In the high-frequency treatment instrument for an endoscope configured such that the distal end tube rotates around the axis with respect to the proximal tube by rotating the conductive wire around the axis from the proximal end side of the proximal tube.
As the material of the tip tube, a material tube in which a line visible on the outer surface is formed over the entire length in the axial direction is used, and the electrode passage hole is formed in a predetermined positional relationship with the line,
The streaks are formed in a V-shaped cross-sectional shape that gradually spreads outward in the cross section perpendicular to the axis of the material tube, and when the material tube is scraped from the outer peripheral surface side, the width of the streaks visible from the outside is reduced. It will decrease corresponding to the cutting depth,
A high-frequency treatment instrument for an endoscope , wherein the muscle is deleted so that the width changes at a constant interval in the longitudinal direction .   The high-frequency treatment instrument for endoscope according to claim 1, wherein a proximal end portion of the distal tube is loosely inserted into a distal end of the proximal tube.   The pair of electrode passage holes are formed at intervals in the longitudinal direction of the tip tube, and the exposed electrode is exposed on the outer surface of the tip tube along the longitudinal direction of the tip tube. The high-frequency treatment tool for endoscope as described.   The high-frequency treatment instrument for an endoscope according to claim 2 or 3, wherein the muscle is disposed at a position corresponding to the back side of the tip tube as viewed from the exposed electrode.   The high-frequency treatment instrument for endoscope according to claim 4, wherein the muscle is deleted from the distal end tube in a region having a predetermined positional relationship with the position of the exposed electrode.   The high-frequency treatment instrument for endoscope according to claim 5, wherein the muscle is deleted in the entire region where the exposed electrode is exposed to the outer surface in the longitudinal direction of the distal tube.   The high-frequency treatment instrument for endoscope according to claim 5, wherein the muscle is deleted in the entire region behind the region where the exposed electrode is exposed on the outer surface in the longitudinal direction of the distal tube.   The high-frequency treatment instrument for an endoscope according to claim 1 or 2, wherein the pair of electrode passage holes are formed at intervals in the circumferential direction of the tip tube.   The high-frequency treatment instrument for endoscope according to claim 8, wherein the exposed electrode is exposed on the outer surface of the distal tube along the distal surface of the distal tube.

Images