JP3556514B2 - Medical equipment - Google Patents

Description

[0001]
TECHNICAL FIELD OF THE INVENTION
The present invention relates to a medical device such as a treatment tool for an endoscope, and more particularly to a medical device configured to transmit a driving force to a treatment unit via a transmission member inserted through a long sheath from an operation unit.
[0002]
[Prior art]
Generally, a treatment tool for an endoscope includes an elongated sheath that is inserted into a channel of the endoscope and introduced into a body cavity. A treatment section is provided at the distal end of the sheath, and the treatment section is driven by pushing and pulling an operation wire inserted into the sheath from a hand operation section. Thus, in order to open and close the treatment section at the distal end of the sheath, for example, the biopsy cup, the operating wire inserted into the sheath is pushed and pulled to operate the treatment section at the distal end. In use, when operating the treatment section, the operation wire in the sheath moves, but at this time, frictional resistance is generated between the operation wire and the inner surface of the sheath. In particular, if the sheath is meandering or curved, the frictional resistance between the inner surface of the sheath and the operation wire increases, and a large amount of force is required to pull and advance the operation wire. In extreme cases, the operation wire may not move. In such a case, the amount of force applied to the operation unit is not transmitted to the forceps unit, so that the cup cannot be freely operated and an accurate biopsy operation cannot be performed.
[0003]
[Problems to be solved by the invention]
U.S. Pat. No. 5,571,129 proposes a method of applying a resin coating to the outer peripheral surface of an operation wire.
[0004]
However, in this method, in order to prevent contamination of the operation wire, the outer peripheral surface of the operation wire is coated with a resin, and the wire is simply sealed. The clearance with the inner surface decreases. As a result, the movement of the operation wire is more inhibited than before the resin coating is applied, and the operation wire is less likely to move.
[0005]
In addition to the above-mentioned prior art, as a technique for coating the outer peripheral surface of the operation wire with a resin, a technique for insulation purpose known in German Utility Model G82930264, Japanese Utility Model Publication No. 58-160010 is disclosed. And the object for preventing the buckling of the operation wire known in Japanese Utility Model Application Laid-Open No. 54-18992 and for improving the suction performance by sealing around the operation wire. . However, none of them consider the easiness of movement of the operation wire, and none of them was satisfactory with respect to the operability of the operation wire.
[0006]
The present invention has been made in view of the above-mentioned problems, and its purpose is to reduce the frictional resistance between the outer surface of the operation wire and the inner surface of the sheath and to operate the operation wire for driving the treatment section. It is an object of the present invention to provide a medical device that can be operated with a light force.
[0007]
[Means for Solving the Problems]
The invention according to claim 1 is characterized in that a long sheath, a treatment section arranged at the distal end of the sheath, an operation section arranged near the sheath, and an operation section inserted through the sheath and from the operation section. In a medical device having a transmission member that transmits a treatment driving force to the treatment unit ,
Outer layer of resin material is coated on at least part of the outer peripheral surface of the transmission member, and forming fine irregularities made of only the same material as the material of the outer layer at least on part of an outer surface of said outer layer A medical device characterized by the following.
[0008]
The invention according to claim 2 is the medical device, wherein the transmission member is a flexible metal wire, and the sheath is a coil.
[0009]
The invention according to claim 3 is the medical device, wherein the head of the minute unevenness has an average of 1 to 15 microns.
[0010]
According to the present invention, the small irregularities formed on the outer surface of the resin film reduce the contact area between the inner surface of the sheath and the outer surface of the transmission member, and reduce the frictional resistance between the two. Becomes lighter.
[0011]
BEST MODE FOR CARRYING OUT THE INVENTION
[First Embodiment]
A surgical incision forceps according to a first embodiment of the present invention will be described with reference to FIG. 1, FIG. 2, FIG. 3, and FIG.
[0012]
(Constitution)
FIG. 1 shows the surgical incision forceps 1. The incision forceps 1 has a sheath 2 formed of a straight rigid tube, and a portion of the sheath 2 is used as an insertion portion for introducing into a body cavity.
[0013]
An operation section 4 having a grip 3 is provided at a proximal end portion of the sheath 2. The operation unit 4 is provided with an operation lever (higane) 5. The operation lever 5 is pivotally attached to the upper portion of the grip 3 by a connection pin 6 at an intermediate portion thereof and is rotatably mounted. The operation lever 5 has an end portion adjacent to the grip 3 as a finger hook portion 7. The finger of the hand holding the grip 3 is hung on the finger hook portion 7, and the operation of rotating the operation lever 5 is performed. The other end of the operating lever 5 is provided with a joint 9 for connecting the proximal end of an operating rod 8 as a transmission member inserted into the sheath 2. By rotating the operation lever 5, the operation of moving the operation rod 8 with respect to the sheath 2 can be performed.
[0014]
On the other hand, a distal tip 11 is fixedly attached to the distal end of the sheath 2. The distal end tip 11 is provided with a treatment section 13 having a pair of scissors (pieces) 12a and 12b for incising a tissue. Each of the scissors 12 a and 12 b is pivotally attached to the tip 11. The distal ends of the operating rods 8 are connected to the base arms of the pair of scissors 12a and 12b via an opening / closing link mechanism (not shown). The pair of scissors 12a and 12b is closed by pulling the operation rod 8, and is opened by pushing the operation rod 8 in reverse.
[0015]
The operating rod 8 is inserted into the sheath 2 as shown in FIG. 2, and the operating rod 8 is configured as follows. That is, the operation rod 8 has a metal hard core (shaft) 15 as an inner layer, and an outer surface of the core 15 is covered with a resin outer layer 16 over at least the entire region located in the sheath 2. The outer layer 16 is formed by melting and extruding the material.
[0016]
As shown in FIGS. 3 and 4, the outer surface of the outer layer 16 has a plurality of minute protrusions 18 and recesses in a form that enhances the slidability with the sheath 2 at least over the entire region located in the sheath 2. 19 are formed. The convex portions 18 here are formed in a triangular pyramid-shaped mountain shape as shown in FIG. 4, and the vertices of each convex portion 18 are respectively arranged at intersections of a plurality of obliquely imaginary lines as shown in FIG. The so-called obliquely arranged arrangement is evenly distributed. In addition, the portion in which the minute protrusions 18 and the recesses 19 are formed is not limited to the case where the small protrusions 18 and the recesses 19 are formed over the entire outer layer 16, but may be formed only in a part of the outer layer 16 in accordance with the necessity of enhancing the sliding property with the sheath 2. May be formed.
[0017]
The average value (roughness) of the difference between the heights of the convex portions 18 and the concave portions 19 is 5 microns, and the average density of the convex portions 18 per 1 mm 2 is about 1,000. I have. In addition, the protrusions 18 are not limited to being arranged in a regular positional relationship, but may be arranged in an irregular positional relationship to some extent.
[0018]
In addition, the height of the unevenness is 5 microns, but if the value is between 1 and 15 microns, a good sliding is exhibited, and more preferably the value between 3 and 5 microns is stable and high. Slip property can be obtained.
[0019]
On the other hand, when the height of the irregularities is smaller than 1 micron, the irregularities are made of resin when the inner surface of the sheath 2 is in contact with the inner surface of the sheath 2. Further, when the operation rod 8 is larger than this, when a large force is applied to the operation rod 8 in a direction perpendicular to the center axis thereof, the operation rod 8 is easily broken starting from the concave portion 19, In the case where the inner surface of the sheath 2 forms a rough surface, the convex portion 18 is hooked on the inner surface of the sheath 2 so that it becomes difficult to slip.
[0020]
Here, the outer layer 16 is formed to have a thickness of 50 microns from the top of the projection. However, the film thickness does not need to be particularly uniform.
[0021]
As a material for forming the outer layer 16, the main component is a resin having some flexibility, for example, polyethylene, polypropylene, or polyester such as polyethylene terephthalate or polybutyl terephthalate, polyamide, polyacetal, vinyl chloride, or poly (vinyl chloride). Fluororesins such as tetrafluoroethylene, tetrafluoroethylene / hexafluoropropylene copolymer, tetrafluoroethylene / verfluoroalkylvinyl ether copolymer, ethylene / tetrafluoroethylene copolymer, and mixed materials thereof are conceivable. .
[0022]
Here, the resin material to be coated may be any resin as long as it is a resin. In particular, if the above resin is used, it is easily available and the productivity is high. More preferably, polyethylene, polypropylene, and polyamide are inexpensive and exhibit high slip properties. When heat resistance is required, fluorine resins such as polytetrafluoroethylene, tetrafluoroethylene / hexafluoropropylene copolymer, tetrafluoroethylene / verfluoroalkylvinyl ether copolymer, and ethylene / tetrafluoroethylene copolymer are used. preferable.
[0023]
The outer layer 16 is coated on the outer periphery of the core 15 by extrusion, and the projections 18 and the depressions 19 are formed in a predetermined form at the time of molding by adjusting the temperature at the time of molding. There is no limitation on the forming method, such as forming unevenness by blasting or the like after applying a smooth coating. However, in consideration of productivity, the forming method of the present embodiment is preferable.
[0024]
(Action)
Since the operation rod 8 is covered with a resin outer layer 16 having fine irregularities formed on the outer surface thereof, the operation rod 8 comes into point contact with the inner surface of the hard tubular sheath 2 at the convex portion 18, so that the operation rod 8 is operated. The frictional resistance between the rod 8 and the sheath 2 is reduced, and the operation rod 8 can be moved and moved back and forth with a light force.
[0025]
(effect)
Since the operation rod 8 can move forward and backward with respect to the sheath 2, the scissors 12 a and 12 b of the treatment section 13 at the distal end of the sheath 2 can be opened and closed lightly. In addition, since the force applied to the operating rod 8 by the operating lever 5 in the operating unit 3 is not attenuated and efficiently and immediately transmitted to the treatment unit 13 at the distal end, the incision by the scissors 12a and 12b is appropriately performed in response to the hand operation. I can do it.
[0026]
[Second embodiment]
A biopsy forceps according to a second embodiment of the present invention will be described with reference to FIG. 5, FIG. 6, FIG. 7, and FIG.
[0027]
(Constitution)
FIG. 5 shows the surgical incision forceps 21. The surgical incision forceps 21 has a tightly wound coil sheath 22 and serves as an insertion portion for introducing the coil sheath 22 into a body cavity. An operating section 23 is provided at the proximal end of the coil sheath 22, and a biopsy treatment section 24 is provided at the distal end of the coil sheath 22. The operation section 23 has an operation section main body 25 and an operation slider 26, and the operation slider 26 is connected to an operation wire 27 inserted through the inner cavity of the coil sheath 22. The biopsy treatment section 24 has a pair of openable and closable biopsy cups 24a and 24b. The pair of biopsy cups 24a and 24b opens and closes in conjunction with the pushing and pulling operation of the operation wire 27.
[0028]
The operation wire 27 is formed of, for example, a single wire made of stainless steel. As shown in FIG. 6, the outer peripheral surface of the operation wire 27 is covered with an outer layer 17 made of resin. The operation wire 27 is movably inserted into the lumen of the coil sheath 22.
[0029]
As shown in FIGS. 7 and 8, a large number of minute projections 28 and depressions 29 are formed on the outer surface of the outer layer 17 covered with the operation wire 27 over substantially the entire surface thereof. Each convex part 28 is formed in a streak shape in parallel at equal intervals, and the streak of the convex part 28 is formed spirally with respect to the outer peripheral surface of the operation wire 27 as a whole. Further, as shown in FIG. 8, the cross-sectional shape of the convex portion 28 is semicircular, and the bottom surface of the concave portion 29 is formed flat.
[0030]
Further, unlike the first embodiment, the difference between the protrusions 28 and the recesses 29 is about 10 μm on average, and the thickness of the outer layer 17 is uniform at 5 μm. As described above, fine irregularities are formed on the surface of the outer layer 17 in such a manner as to enhance the slidability with the coil sheath 22.
[0031]
Since the outer layer 17 in this embodiment does not need to electrically insulate the operation wire 27 similarly to the first embodiment, the pinhole 30, that is, the member of the operation wire 27 is partially The part exposed on the surface is formed.
[0032]
Further, as the resin material for forming the outer layer 17, the same resin as that of the first embodiment is used.
[0033]
(Action)
This is the same as the first embodiment.
[0034]
(effect)
In addition to the effects of the first embodiment, the fine concave portions 29 have a surface on which dirt is unlikely to adhere due to the formation of streaks and projections. Further, since the streaks of the concave and convex portions are formed in a spiral shape, a function having high slipperiness in the axial direction is achieved.
[0035]
[Third embodiment]
A third embodiment of the present invention will be described with reference to FIG. This embodiment is a modification of the above-described second embodiment.
[0036]
(Constitution)
In this embodiment, the outer layer 17 is not formed on the operation wire 27. Instead, the inner layer 31 is formed on the inner surface of the coil sheath 22. The inner layer 31 is made of the same resin material as that of the above-described embodiment, and the inner surface of the inner layer 31 has the same minute unevenness as that of the second embodiment. Other configurations are the same as those of the second embodiment.
[0037]
(Action)
This is the same as the first embodiment.
[0038]
(effect)
In addition to the effects of the second embodiment, since the gap between the strands of the coil sheath 22 in which the inner layer 31 is closely wound is filled, the possibility that dirt remains in the gap is reduced, and the inside of the coil sheath 22 is easily cleaned.
[0039]
[Fourth embodiment]
A fourth embodiment of the present invention will be described with reference to FIG. This embodiment is another modification of the above-described second embodiment.
[0040]
(Constitution)
Also in this embodiment, the outer layer 17 is not formed on the operation wire 27. Instead, a flexible resin tube 35 is placed over the operation wire 27 inserted into the inner cavity of the coil sheath 22. The operation wire 27 forms a gap with the inner surface of the tube 35 and is housed in the tube 35.
[0041]
In addition, minute irregularities similar to those of the second embodiment are formed on both the inner and outer surfaces of the tube 35. Other configurations are the same as those of the second embodiment.
[0042]
(Action)
This is the same as the first embodiment.
[0043]
(effect)
In addition to the effect of the second embodiment, since the operation wire 27 is housed in the tube 35, the operation wire 27 is less likely to buckle.
[0044]
[Fifth Embodiment]
A bipolar high-frequency incision forceps for an endoscope according to a fifth embodiment of the present invention will be described with reference to FIGS.
[0045]
(Constitution)
FIG. 11 shows the bipolar high-frequency incision forceps 41 for an endoscope. The high-frequency incision forceps 41 includes a sheath 42 made of a flexible resin tube, and an insertion portion for introducing the sheath 42 into a body cavity. There is. The material of the sheath 42 is formed of a flexible resin such as polytetrafluoroethylene and polyethylene.
[0046]
Two flexible twisted stainless steel wires 43 are inserted into the lumen of the sheath 42. These stainless wires 43 are operation wires connected to a slider 45 at the base end side of the operation portion 44. These stainless wires 43 are connected to a high-frequency terminal 47 provided on the slider 45. The slider 45 is slidable back and forth along the operation section main body 46.
[0047]
An outer layer 48 made of the same resin material as in the first embodiment is formed on the outer peripheral surface of the stainless wire 43. The outer layer 48 has minute irregularities formed on the surface thereof as in the first embodiment.
[0048]
The distal end portion of the stainless wire 43 is disposed so as to be able to protrude and retract from the distal end of the sheath 42, and the distal ends of the two stainless steel wires 43 are connected by a tip 49. Then, as shown in FIG. 11, a loop-shaped loop portion 50 is formed at the distal end portion connected by the tip 49. The loop portion 50 is habit-formed in advance so as to spread in a ring shape when protruding from the distal end of the sheath 42. In addition, the outer layer 48 is formed on at least the outer periphery of the region inserted into the sheath 42 except for the portion forming the loop portion 50 of the stainless wire 43.
[0049]
(Action)
The operation wire 46 has an outer layer 48 on the outer surface of the twisted stainless steel wire 43, and maintains a structure in which the stainless steel wire 43 is not easily frayed. Further, when a high frequency is applied to the stainless steel wire 43, the electric insulation is improved by the outer layer 48.
[0050]
(effect)
In addition to the effects of the first embodiment, the electrical insulation inside the sheath 42 is improved, and the medical staff does not have to worry about a leakage accident while using the present treatment tool.
[0051]
The present invention is not limited to the embodiments described above. According to the description of the above embodiment, at least the following items and items obtained by arbitrarily combining them can be obtained.
[0052]
<Appendix>
1. A long sheath, a treatment section disposed at the distal end of the sheath, an operation section disposed near the hand of the sheath, and a treatment drive force that is inserted into the sheath and transmitted from the operation section to the treatment section. In a medical device having a transmission member,
A resin outer layer is coated on at least a part of the outer surface of the transmission member, and minute irregularities are formed on at least a part of the outer surface of the outer layer in a form to enhance slidability with the sheath. Medical equipment.
[0053]
2. 2. The medical device according to claim 1, wherein the transmission member is a flexible metal wire, and the sheath is a coil.
[0054]
3. 2. The medical device according to claim 1, wherein the head of the fine irregularities has an average value of between 1 and 15 microns, preferably between 3 and 5 microns.
[0055]
4. 4. The medical device according to any one of items 1, 2 and 3, wherein the fine irregularities are formed by a large number of grooves.
[0056]
5. In the medical device of any one of Items 1, 2, 3, and 4, the resin film is made of polyethylene, polypropylene, polyamide, polyester, polyacetal, vinyl chloride, polytetrafluoroethylene, tetrafluoroethylene / hexafluoropropylene copolymer, A medical device comprising a material containing at least one of a fluoroethylene / verfluoroalkylvinyl ether copolymer and an ethylene / tetrafluoroethylene copolymer.
[0057]
6. The medical device according to any one of Items 1, 2, 3, 4, and 5, wherein the method of forming the resin coating and the unevenness is extrusion molding.
[0058]
7. 9. The medical device according to any one of Items 1, 2, 3, 4, 5, and 6, wherein an electrical treatment is performed by energizing the metal wire, and the resin coating covers at least the metal wire. A medical device, wherein the covering portion is electrically insulated.
[0059]
【The invention's effect】
As described above, according to the present invention, the transmitting member that is inserted into the sheath and transmits the treatment driving force to the treatment section advances and retreats with a small amount of force in the sheath. It is transmitted sufficiently to the drive unit, and effective treatment can be performed lightly.
[Brief description of the drawings]
FIG. 1 is a side view schematically showing an entire scissors forceps for surgical operation according to a first embodiment.
FIG. 2 is an enlarged longitudinal sectional view showing a portion A of an insertion portion of the scissors forceps.
FIG. 3 is an enlarged surface view showing a surface portion of an outer layer covering the outer periphery of the operation rod in the scissors forceps.
FIG. 4 is a cross-sectional view of an operating rod of the scissors forceps and an outer layer covering the operating rod.
FIG. 5 is a side view schematically showing an entire endoscope biopsy forceps according to a second embodiment.
FIG. 6 is a longitudinal sectional view of a portion B of a coil sheath of the endoscope biopsy forceps.
FIG. 7 is an enlarged front view showing a surface portion of an outer layer covering the outer periphery of the operation wire in the endoscope biopsy forceps.
FIG. 8 is a sectional view of an operation wire and an outer layer covering the operation wire in the biopsy forceps for an endoscope.
FIG. 9 is a longitudinal sectional view of a coil sheath part of a modified example of the endoscope biopsy forceps according to the second embodiment.
FIG. 10 is a longitudinal sectional view of a coil sheath portion of another modification of the endoscope biopsy forceps according to the second embodiment.
FIG. 11 is a side view schematically showing the whole of a bipolar high-frequency incision forceps for an endoscope according to a fifth embodiment.
FIG. 12 is an enlarged cross-sectional view of a portion C shown in FIG. 11 of the bipolar high-frequency incision forceps for an endoscope.
[Explanation of symbols]
DESCRIPTION OF SYMBOLS 1 ... Surgical incision forceps 2 ... Sheath 4 ... Operating part 5 ... Operating lever 8 ... Operating rod 13 ... Treatment part 15 ... Core (shaft)
16 outer layer 18 convex part 19 concave part

Claims (3)

A long sheath, a treatment section disposed at the distal end of the sheath, an operation section disposed on the proximal side of the sheath, and a treatment driving force inserted through the sheath and applied by the operation section to the treatment section. In a medical device having a transmitting member for transmitting,
Outer layer of resin material is coated on at least part of the outer peripheral surface of the transmission member, and forming fine irregularities made of only the same material as the material of the outer layer at least on part of an outer surface of said outer layer A medical device characterized by the following. The medical instrument of claim 1, wherein a metallic wire the transmission member is flexible, medical instrument, wherein the sheath is a coil. According to claim 1 or claim 2 wherein the medical device, wherein the device that drop of the minute irregularities is between the average 1 micron of 15 microns.

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