JP4085148B2 - High frequency snare - Google Patents

Description

[0001]
BACKGROUND OF THE INVENTION
The present invention relates to a high-frequency snare that is fed into a body cavity through an endoscope to cauterize and incise a part of the body cavity mucosa.
[0002]
[Background]
Currently, biopsy (biopsy) and treatment are performed using an endoscope.
[0003]
In this case, a high-frequency snare as an electric knife is inserted through an endoscope, and a raised lesion such as a polyp is removed by this high-frequency snare and taken out of the body. Such a biopsy is particularly effective with polypectomy. be called.
[0004]
This high-frequency snare is an ultra-thin flexible tube that can be inserted into an endoscope, and a conductive snare loop with the tip of the wire in a loop shape is movably inserted. The end facing the snare loop is connected to the wire. It is an electrode part for energizing.
[0005]
When performing polypectomy, insert an endoscope into the body cavity of the subject, send a high-frequency snare to the body cavity through the endoscope, and while looking at the endoscope, hook a snare loop on a raised lesion such as a polyp in the body cavity, By pulling the wire without changing the position of the flexible tube, the target lesion is bound between the snare loop side end of the flexible tube and the snare loop, and the wire is connected to the high-frequency power via the electrode connected to the high-frequency power source. By energizing the current, cauterized lesions are cauterized and are picked out of the body by grasping forceps or the like.
[0006]
[Patent Document 1]
Japanese Laid-Open Patent Publication No. 4-146743
[Problems to be solved by the invention]
When polypectomy is performed using a high-frequency snare having such a snare loop, there is a problem that it is impossible or difficult to apply the snare loop when the head of the polyp is large.
[0008]
Further, when the snare loop is applied to a polyp or the like, there is a problem in that it is difficult to determine whether or not the snare loop is applied at an appropriate portion with respect to the polyp.
[0009]
An object of the present invention is to provide a high-frequency snare that can reliably perform a polypectomy even when the head of a polyp or the like is large, and that can perform a polypectomy without performing confirmation at a blind spot such as a polyp. Is to provide.
[0012]
In addition, the incision can be performed by grasping only the near-side tissue that is clearly visible with the tip opened, and the incision can be performed without confirming the back-side portion that is a blind spot.
[0013]
[Means for Solving the Problems]
To achieve the above object, the high-frequency snare of the present invention, a flexible tube is slidably inserted into the flexible tube, and an operating wire connected to the electrode, provided at the distal end of said operating wire And a tip treatment tool formed of a pair of gripping members whose tips can be opened and closed ,
In a high-frequency snare that is sent into a body cavity through an endoscope, cauterizing and incising part of the body cavity mucosa,
The flexible tube is inserted into an insulating outer cylinder and is slidably and rotatably inserted into the outer cylinder, and the operation wire can be slid inside, and the distal treatment instrument is slid with respect to the outer cylinder. A conductive inner cylinder that allows rotation ;
The outer cylinder is contactable to the electrode and the inner cylinder by penetrating the outer cylinder inner surface is to enable energization to the operating wire is attached to Rutotomoni,
A sliding handle is provided at the base end of the outer cylinder,
A stopper and rotation handle is provided at the base end of the inner cylinder in a state of protruding from the base end of the outer cylinder,
A handle having a stopper is projected and formed at the base end of the stopper-rotating handle,
A sliding puller for an operation wire, which is slidably engaged with the handle and is movable between the stopper / rotation handle and the stopper, is attached .
[0014]
According to the present invention, since the distal treatment instrument is formed by a pair of gripping members whose distal ends can be opened and closed, unlike the case of a snare loop, there is no need to insert a polyp or the like in the loop, Even when the head is large, it is only necessary to open the tip and grasp the tissue, and a neck such as a polyp can be incised directly.
[0015]
In addition, the incision can be performed by grasping only the near-side tissue that is clearly visible with the tip opened, and the incision can be performed without confirming the back-side portion that is a blind spot.
[0016]
Further, the flexible tube is composed of an insulating outer cylinder and a conductive inner cylinder which is inserted into the outer cylinder so as to be slidable and rotatable. In addition, the inner cylinder can be drawn into the outer cylinder, and the current density can be increased by concentrating the current in the incised tissue while reducing the contact area between the treatment tool and the tissue.
[0017]
In addition, by attaching the electrode so as to penetrate the inner surface of the outer cylinder so as to be in contact with the inner cylinder, even when the flexible tube is a double cylinder, the operation wire can be reliably energized, and the inner cylinder Rotation of the tip treatment instrument can be freely rotated.
[0024]
DETAILED DESCRIPTION OF THE INVENTION
Hereinafter, embodiments of the present invention will be described in detail with reference to the drawings.
[0025]
1 to 3 are diagrams showing a high-frequency snare according to an embodiment of the present invention.
[0026]
The high-frequency snare 10 is fed into a body cavity through an endoscope, cauterizing and incising a part of the body cavity mucosa, and has a flexible tube 12, an operation wire 14, and a distal treatment instrument 16. .
[0027]
The flexible tube 12 has an outer cylinder 18 and an inner cylinder 20.
[0028]
The outer cylinder 18 is formed of an insulating sheath such as tetrafluoroethylene, and a sliding handle 22 is provided at the proximal end.
[0029]
The inner cylinder 20 is a conductive one made of a metal coil sheath or the like, and is inserted into the outer cylinder 18 so as to be slidable and rotatable.
[0030]
Further, an insulating stopper / rotation handle 24 is attached to the proximal end portion of the inner cylinder 20 in a state of protruding from the proximal end of the outer cylinder 18, and a stopper 26 is attached to the proximal end of the stopper / rotation handle 24. A handle 28 having a protrusion is formed in a protruding manner, and a ring 30 for placing a thumb on the base end of the handle 28 is rotatably attached.
[0031]
The operation wire 14 is made of metal such as stainless steel, and is slidably inserted into the inner cylinder 20. A metal rod 32 is attached to the base end side, and the handle 28 can slide on the base end of the metal rod 32. A slidable pulling handle 34 is attached, which is engaged with the stopper 24 and is movable between the stopper / rotation handle 24 and the stopper 26.
[0032]
The distal treatment tool 16 is provided at the distal end of the operation wire 14 and protrudes from the distal end of the inner cylinder 20.
[0033]
The distal treatment instrument 16 is formed of a pair of gripping members 36 that are shaped like gripping forceps and whose distal ends can be opened and closed. By sliding a pulling handle 34 for sliding along the handle 28, the inner cylinder Advancing and retreating from the tip of 20 enables gripping and release.
[0034]
Further, as shown in FIG. 2, a stopper 38 that prevents the distal treatment instrument 16 from being buried in the inner cylinder 20 is formed in an expanded state near the distal end of the distal treatment instrument 16. It is completely buried in the inner cylinder 20 so as to prevent a gripping part such as a polyp from being broken by tightening the distal treatment instrument 16.
[0035]
Further, the diameter L of the distal treatment instrument 16 is set to 0.5 to 1.0 mm.
[0036]
Further, as shown in FIG. 3, an uneven portion 44 that meshes with each gripping member 36 is formed at the distal end of the distal treatment instrument 16, whereby a polyp or the like can be reliably gripped by the distal treatment instrument 16. I am doing so.
[0037]
Further, a socket 40 is attached near the base end portion of the outer cylinder 18, and an electrode 42 is attached in the socket 40 so as to penetrate the inner surface of the outer cylinder 18 so as to be in contact with the inner cylinder 20. It is possible.
[0038]
The electrode 42 has a structure capable of energizing by elastically contacting the outer surface of the inner cylinder 20 from the inner surface of the outer cylinder 18, and the inner cylinder 20 freely rotates with respect to the outer cylinder 18 to conduct electricity. Sex is to be maintained.
[0039]
Further, by applying a hydrophilic coating to the inner surface of the outer cylinder 18, the inner cylinder 20 can be rotated more easily and the distal treatment instrument 16 can be further freely rotated.
[0040]
Next, when using such a high-frequency snare 10, the thumb is inserted into the ring 30 while being fed into the body cavity through the endoscope, and the slide puller 34 is operated with another finger. When the puller 34 is slid to the distal end side, the distal treatment instrument 16 advances from the distal end of the inner cylinder 20 via the operation wire 14 and the gripping member 36 is opened.
[0041]
In such a state, it is only necessary to grip a polyp or the like with the distal treatment instrument 16, and in this gripping operation, the distal treatment instrument 16 can be freely rotated by grasping and rotating the stopper / rotation handle 24. Can be operated easily.
[0042]
In addition, when the handle 34 is slid toward the stopper 26 in a state where the distal treatment tool 16 can grip a polyp or the like at a predetermined angle, the distal end of the gripping member 36 is closed and the polyp or the like is gripped.
[0043]
In this case, since the concavo-convex portion 44 is formed at the tip of the gripping member 36, a polyp or the like can be securely gripped, and since the stopper 38 is formed on the gripping member 36, the gripping member It is possible to prevent 36 from being pulled more than necessary into the inner cylinder 20 and to prevent a gripping portion such as a polyp from being torn off.
[0044]
In this state, the slide handle 22 is operated to maintain the inner cylinder 20 and the distal treatment instrument 16 as they are, and the distal treatment instrument 16 and a polyp are drawn into the outer cylinder 18 so that the distal treatment instrument is In a state where the contact area of 16 and the polyp is reduced, the current is concentrated in the tissue to be cut and the current density is increased to cauterize and cut.
[0045]
Thus, it is not necessary to pass the entire polyp through the loop, and since the distal treatment instrument 16 opens and captures the tissue, the neck of the polyp or the like can be directly incised.
[0046]
The present invention is not limited to the above-described embodiment, and can be modified into various forms within the scope of the gist of the present invention.
[Brief description of the drawings]
FIG. 1 is a cross-sectional view of a high-frequency snare according to an embodiment of the present invention.
FIG. 2 is a partial side view of the distal treatment instrument as seen from the II direction in FIG.
FIG. 3 is a partial front view of the distal treatment instrument viewed from the III direction in FIG. 1;
[Explanation of symbols]
DESCRIPTION OF SYMBOLS 10 High frequency snare 12 Flexible tube 14 Operation wire 16 End treatment tool 18 Outer cylinder 20 Inner cylinder 36 Holding member 42 Electrode 44 Concavity and convexity

Claims (1)

A flexible tube, an operation wire that is slidably inserted into the flexible tube and connected to an electrode , and a pair of gripping members that are provided at the distal end of the operation wire and that can be opened and closed. A tip treatment tool
In a high-frequency snare that is sent into a body cavity through an endoscope, cauterizing and incising part of the body cavity mucosa,
The flexible tube is inserted into an insulating outer cylinder and is slidably and rotatably inserted into the outer cylinder, and the operation wire can be slid inside, and the distal treatment instrument is slid with respect to the outer cylinder. A conductive inner cylinder that allows rotation ;
The outer cylinder is contactable to the electrode and the inner cylinder by penetrating the outer cylinder inner surface is to enable energization to the operating wire is attached to Rutotomoni,
A sliding handle is provided at the base end of the outer cylinder,
A stopper and rotation handle is provided at the base end of the inner cylinder in a state of protruding from the base end of the outer cylinder,
A handle having a stopper is projected and formed at the base end of the stopper-rotating handle,
A high-frequency snare characterized in that a sliding puller for an operation wire, which is slidably engaged with the handle and is movable between the stopper / rotation handle and the stopper, is attached .

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