JP4542559B2 - Endoscopic treatment tool - Google Patents

Description

  The present invention relates to an endoscope treatment tool that is inserted into a body through a channel of an endoscope and performs a treatment such as removal of a tissue or cell at a predetermined site in the body.

  When grasping a living tissue of an affected part with an endoscopic treatment tool such as a forceps, the direction in which the forceps piece arranged at the distal end of the treatment tool is opened and closed may be arranged differently. . In such a case, normally, the proximal end side of the coil sheath is rotated from the hand side through the operation portion while the endoscope treatment instrument is inserted into the body cavity, and this rotation is transmitted to the distal end side of the coil sheath. A method of rotating the forceps piece fixed to the tip of the coil sheath is used.

  However, when the forceps piece is rotated by such a method, a frictional force is generated between the endoscope channel and the tube sheath or between the tube sheath and the coil sheath, and the operation wire in the coil sheath is twisted. For this reason, the rotation of the coil sheath on the proximal side becomes difficult to be transmitted to the distal end side of the coil sheath. This causes a problem that the angle adjustment of the treatment tool tip as desired cannot be performed.

In order to cope with such a problem, Patent Document 1 proposes a method in which an attachment is attached to the distal end of an insertion portion of an endoscope and a part of the opening of the channel is covered by this attachment. In the technique described in Patent Document 1, a part of an opening of a channel is blocked by an attachment to form a substantially non-circular deformed hole, and a treatment tool tip is passed through the deformed hole. This restricts the direction of the tip and restricts the rotation of the projected treatment tool tip.
JP 2006-288941 A

  However, the technique described in Patent Document 1 is based on the premise that an attachment is attached to the insertion portion of the endoscope, and there is a problem that the angle adjustment of the distal end of the treatment instrument cannot be substantially performed unless the attachment is used. It was.

  The present invention has been made in view of the above-mentioned problems of the prior art, and its purpose is to adjust the angle of the tip without attaching a special member such as an attachment to the tip of the endoscope. It is an object of the present invention to provide an endoscopic treatment tool that can realize the simplification.

In order to achieve the above object, the present invention provides the following means.
The endoscope treatment tool according to the present invention is connected to a flexible tube, an operation member that is inserted into the flexible tube and is rotatable with respect to the flexible tube, and is connected to a distal end of the operation member. And a treatment function member that is rotatable with respect to the flexible tube, and is disposed between the treatment function member and the flexible tube, and disposed between the treatment function member and the flexible tube. A rotation suppression unit that suppresses rotation of the treatment function member with respect to the flexible tube in a state in which rotation with respect to the flexible tube is allowed, and the rotation suppression unit is opposed to an end surface portion of the flexible tube. wherein on the surface of the flexible tube side of the treatment function member is constituted by a plurality of projections provided in pairs, respectively, wherein Rukoto to.

  Since this treatment instrument for endoscope includes a rotation suppression unit that suppresses rotation of the treatment function member relative to the flexible tube, when the treatment function member is rotated via the operation member, the treatment function member is moved by the rotation suppression unit. The rotation is suppressed. In other words, the treatment function member is directly restricted in rotation by the rotation suppressing portion, and thus rotates by a relatively small angle. As a result, the angle of the treatment function member can be easily adjusted.

Furthermore, in this endoscope treatment tool, when the treatment function member rotates relative to the flexible tube, if the projection on the treatment function unit side gets over the projection on the flexible tube side, the projection becomes the flexible tube. The treatment function member rotates relative to the flexible tube until it comes into contact with the next protrusion on the side. In other words, the processing function member rotates intermittently by the angle at which the protrusions are separated.

In addition, the endoscope treatment tool according to the present invention is characterized in that a biasing member that biases the plurality of pairs of protrusions toward each other is provided.
In this endoscopic treatment tool, when the treatment function member rotates relative to the flexible tube, the projection on the treatment function member side first strikes the projection on the flexible tube side, and the projection on the flexible tube side Push it away. At this time, the biasing member is deformed, and the protrusion on the flexible tube side is allowed to move in a direction away from the protrusion on the processing function member side. Thereafter, when the protrusion on the treatment function member side gets over the protrusion on the flexible tube side, the protrusion on the flexible tube side is returned to the original position again by the biasing member.
Hereinafter, the biasing member is deformed as needed, and relative rotation at a predetermined angle with respect to the flexible tube of the protrusion treatment function member, which is determined by the angle at which the protrusions are spaced apart, is allowed.

In the endoscope treatment tool according to the present invention, the operation member has a coil sheath inserted into the flexible tube and connected to the distal end of the treatment function member. The coil sheath and the flexible tube The urging member is disposed between the two.
In this endoscopic treatment instrument, an urging member is disposed between the coil sheath and the flexible tube, so that the space between the coil sheath and the flexible tube can be effectively used, and the apparatus can be downsized. Can be realized.

According to the present invention, the angle of the distal end can be adjusted by the treatment tool itself without attaching a special member such as an attachment to the distal end of the endoscope, thereby facilitating the procedure.

Embodiments of an endoscope treatment tool according to the present invention will be described below with reference to the drawings.
<First Embodiment>
FIGS. 1-6 has shown 1st Embodiment of this invention, FIG. 1 is a side view which shows the state by which the treatment tool for endoscopes which concerns on this invention was assembled | attached to the endoscope. In this figure, reference numeral 100 denotes an endoscope. The endoscope 100 includes an endoscope insertion portion 101 that is inserted into the body, and a distal end portion of the endoscope insertion portion 101 that is provided at the proximal end of the endoscope insertion portion 101 via an angle wire (not shown). And an operation unit 102 that performs a bending operation. A channel 103 is formed inside the endoscope insertion portion 101. An imaging means for observing the inside of the body is provided at the distal end of the endoscope insertion portion 101, and a distal end opening of the channel 103 is formed. The proximal end side of the channel 103 extends to the vicinity of the side portion of the operation unit 102 and is opened there to become an insertion port 104. The endoscope treatment tool 1 according to this embodiment is inserted into the channel 103 from the insertion port 104.

The endoscope treatment tool 1 includes a tube sheath 2 as shown in FIGS. 2 and 3. A coil sheath 3 made of a multi-strand coil is inserted into the tube sheath 2 so as to be rotatable with respect to the tube sheath 2. An operation wire 4 is inserted into the coil sheath 3. The operation wire 4 is made of a metal wire such as stainless steel or steel having excellent mechanical characteristics, and can be moved forward and backward with respect to the coil sheath 3. Further, as shown in FIG. 2, a treatment portion 6 having a pair of forceps pieces 5 is provided at the distal end of the coil sheath 3. The treatment section 6 includes a cover member 7 that covers the proximal end side of the forceps piece 5, and the forceps piece 5 is rotatably attached to the cover member 7 via a pin 5 a. The distal end portion of the operation wire 4 is connected to the proximal end portion of the forceps piece 5. Then, when the operation wire 4 is advanced and retracted with respect to the coil sheath 3, as shown in FIG. 3, the forceps piece 5 rotates around the rotation pin 5a to open and close.
Here, the treatment section 6 constitutes a treatment function member for appropriately performing treatment on the affected area, for example, and the coil sheath 3 and the operation wire 4 constitute an operation member for operating the treatment section 6.

  On the base end side of the cover member 7, a plurality of protrusions (rotation suppression portions) 8 are provided at equal intervals in the circumferential direction so as to face the end surface of the tube sheath 2. The protrusion 8 has an inclined portion 8a that gradually expands on both the left and right sides from the top to the base, and is formed in an isosceles trapezoid shape.

A tube connecting member 9 is attached to the distal end of the tube sheath 2 by inserting a part thereof into the tube sheath 2. A plurality of protrusions (rotation suppression portions) 10 are provided at the tip of the tube connection member 9 so as to face the protrusions 8 on the cover member side. Like the protrusion 8 on the cover member side, the protrusion 10 has an inclined leg 10a having an inclined portion 10a that gradually expands from the top to the left and right sides. The protrusions 10 are paired with the protrusions 8 on the cover member side, and the angles of the corresponding inclined parts 8a and 10a are set to the same value.
In this embodiment, four protrusions 10 are provided at equal intervals in the circumferential direction.
Here, the protrusion 8 on the cover member 7 side and the protrusion 10 on the tube connecting member 9 side, which are biased so as to be engageable with each other by the coil spring 11, rotate the treatment portion 6 with respect to the tube sheath 2. In the permitted state, a rotation suppressing unit that suppresses the rotation of the treatment unit 6 with respect to the tube sheath 2 is configured. The rotation suppression force by the rotation suppression unit is set to be larger than the static friction force between the coil sheath 3 and the tube sheath 2 when the coil sheath 3 rotates relative to the tube sheath 2.

As shown in FIG. 3, a small diameter portion 3 a is formed on the distal end side of the coil sheath 3 by cutting to a predetermined thickness over the entire circumference. The said tube connection member 9 is arrange | positioned at the outer peripheral side of the small diameter part 3a. A coil spring 11 is interposed between the small diameter portion 3 a of the coil sheath and the tube sheath 2. One end of the coil spring 11 is in contact with the base end side step portion 3aa of the small diameter portion 3a, and the other end is in contact with the end surface 9a on the base end side of the tube connecting member 9, whereby the coil spring 11 constantly urges the coil sheath 3 and the treatment portion 6 attached integrally with the tube sheath 2 toward the proximal end side (Y direction in FIGS. 2 and 3).
The coil sheath 3, the cover member 7, and the forceps piece 5 are each made of a conductive material, and the coil sheath 3 and the treatment portion 6 are electrically connected.

On the other hand, as shown in FIG. 4, an operation unit 13 for performing various operations is connected to the proximal end of the coil sheath 3.
The operation portion 13 includes an operation distal end portion 14 connected so that the proximal end side of the coil sheath 3 rotates integrally, an operation main body portion 15 extending from the operation distal end portion 14 to the proximal end side in the axial direction of the coil sheath 3, The operation main body 15 is inserted, and the slide main body 16 is supported so as to be movable back and forth with respect to the operation main body 15. The operation main body portion 15 is provided with a connection portion 17 for connecting to a high-frequency power source (not shown). The connection part 17 includes an electrode terminal 18 extending in a columnar shape, and a cable (not shown) extending from the high-frequency power source is connected to the connection part 17 so that the cable and the electrode terminal 18 are electrically connected. It has become.
Further, as shown in FIG. 5, the proximal end portion of the operation wire 4 is attached to the slide portion 16 via the wire attachment portion 19. Then, when the slide portion 16 is advanced and retracted with respect to the operation main body portion 15, the operation wire 4 is advanced and retracted with respect to the coil sheath 3.

Next, the operation of the endoscope treatment tool 1 in the present embodiment configured as described above will be described.
First, the insertion part 101 of the endoscope 100 is inserted into the subject, and the insertion part 101 is sent to the vicinity of the treatment part. Further, the sheath part 3 is inserted into the subject via the forceps channel formed in the insertion part 101 and is sent to the treatment part. Then, a cable from the high frequency power source is connected to the connection portion 17. Then, the slide portion 16 is retracted so that the forceps pieces 5 are opened to each other, and the treatment target portion is arranged between the forceps pieces 5.

Here, it is examined by an endoscope whether or not the opening / closing direction of the forceps piece 5 arranged at the distal end of the endoscope treatment tool 1 matches the direction of the affected part to be grasped. If they are different, the treatment section 6 at the distal end is rotated.
Specifically, the operation unit 13 is rotated around the axis. Then, the proximal end side of the coil sheath 3 also rotates integrally with the operation unit 13, the rotation is transmitted to the distal end side of the coil sheath, and the treatment unit 6 attached integrally to the distal end of the coil sheath also tries to rotate.

At this time, as long as the protrusion 8 on the cover member 7 side of the treatment portion 6 is engaged with the protrusion 10 on the tube connection member 9 side, the rotation of the treatment portion 6 is performed as long as the protrusions 8 and 10 are engaged with each other. It is suppressed.
When the operation unit 13 is further rotated, the twist of the coil sheath 3 increases, and as a result, the torque acting on the treatment unit 6 increases. As the torque increases in this way, slip occurs between the inclined portions 8 a and 10 a facing the protrusion 8 and the protrusion 10, and at the same time, the treatment section 6 and the coil sheath 3 resist the urging force of the coil spring 11. Then, it moves to the tip side (X direction in FIGS. 2 and 3). Along with this, the treatment portion 6 is gradually rotated with respect to the tube sheath 2 by the amount of slippage between the inclined surfaces of the protrusion 8 and the protrusion 10. When the top of the protrusion 8 and the top of the protrusion 10 come into contact with each other, the protrusions 8 and 10 are disengaged from each other, and there is nothing that restricts the rotation of the treatment section 6. Rotates at a stroke until the projection 8 on the cover member 7 side abuts on the next projection 10 on the tube connection member 9 side.

  When the protrusion 8 on the cover member 7 side gets over the protrusion 10 on the tube connecting member 9 side in the process of rotating the treatment part 6, the treatment part 6 is moved to the distal end side (in FIG. 3) by the biasing force of the coil spring 11. The projection 8 on the cover member 7 side is brought into a position where it can be engaged again with the projection 10 on the tube connecting member 9 side. Hereinafter, with the further rotation of the operation unit 13, the treatment unit 6 rotates intermittently every 90 degrees.

As described above, the treatment section 6 is surely rotated 90 degrees by one rotation, so that the angle adjustment of the treatment section 6 is facilitated.
The direction in which the forceps piece 5 arranged at the distal end of the endoscope treatment tool 1 is opened and closed by the above method matches the direction of the affected part to be grasped, and then the slide part 16 is advanced to close the forceps piece 5. And hold the treated portion. In this state, a high frequency current is applied to the treatment section 6 to cauterize the treated section, thereby performing various treatments such as hemostasis and incision.

  In the first embodiment, in order to engage the protrusion 8 on the cover member 7 side and the protrusion 10 on the tube connection member 9 side, the tip of the coil sheath is between the tube sheath 2 and the coil sheath 3. Although the coil spring 11 is arranged on the side 3, the present invention is not limited to this. For example, as shown in FIG. 6, the coil spring 11 is arranged in the insertion hole 14 a in the operation tip 14, and this coil spring 11, the base end surface of the tube sheath 2 may be urged toward the distal end side. In this case, since various members are arranged on the distal end side of the tube sheath 2, it is relatively troublesome to secure an arrangement space for these members, but a coil soup ring is arranged on the proximal end side of the tube sheath. With this configuration, there are relatively few interfering members, and the advantage that the space for arranging the coil spring 11 can be easily secured is obtained.

In the first embodiment, two protrusions 8 on the cover member 7 side and four protrusions 10 on the tube connecting member 9 side are provided. However, the present invention is not limited to this. For example, the cover member Two protrusions 8 on the 7 side and six or eight protrusions 10 on the tube connecting member 9 side may be provided. Further, one protrusion 8 on the cover member 7 side may be provided, and two or more protrusions 10 on the tube connection member 9 side may be provided.
Further, in the first embodiment, the treatment instrument that applies a high-frequency current is described as an example. However, the present invention is not limited to this, and a simple forceps without flowing a high-frequency current may be used. The present invention can be applied to other treatment tools such as a knife.
Second Embodiment

FIG. 7 shows a second embodiment of the present invention. This embodiment is different from the first embodiment in the configuration of the rotation suppressing unit that suppresses relative rotation of the treatment unit 6 with respect to the tube sheath 2.
That is, in the first embodiment, the rotation suppressing portion is configured by the projection 8 on the cover member 7 side and the projection 10 on the tube connection member 9 side that are urged to be engaged with each other by the coil spring 11. However, in the second embodiment, the rotation suppressing portion is configured by the elastic cover member 21 interposed between the tube sheath 2 and the coil sheath 3.
In the second embodiment, the same components as those used in the first embodiment are denoted by the same reference numerals, and the description thereof is omitted.

  More specifically, an elastic collar member 21 is rotated at the distal end of the tube sheath 2 integrally with the tube sheath 2 in a state where the proximal end side small diameter portion 21a is inserted into the tube sheath 2. It is fixed. The elastic collar member 21 is made of an appropriately elastic material such as natural rubber or synthetic rubber, and the inner diameter thereof is set slightly smaller than the diameter of the small diameter portion of the coil sheath 3. For this reason, the elastic collar member 21 is elastically in contact with the coil sheath 3 with a tightening margin, and appropriately applies a frictional force when the distal end side of the coil sheath 3 rotates relative to the tube sheath 2. Yes. The frictional force at this time is set to a value equal to or larger than the static frictional force generated between the tube sheath 2 and the coil sheath 3 when, for example, the operating portion on the hand side is rotated in a normal use state. Yes.

  According to the second embodiment, the elastic cover member 21 interposed between the distal end of the tube sheath 2 and the coil sheath 3 is used to adjust the angle of the treatment section 6 by rotating the operation section on the hand side. A friction force is generated between them. For this reason, the treatment section 6 is rotated little by little while the rotation is suppressed by this frictional force. For this reason, rotation skipping can be prevented, and the angle adjustment of the treatment portion 6 can be easily performed as in the first embodiment.

  In the example shown in FIG. 7, the elastic collar member 21 has an integral structure. However, the present invention is not limited to this, and as shown in FIG. 8, two members, that is, an outer collar body 30 and an inner elastic collar portion. The elastic collar member 32 may be configured as described above. In this case, the outer collar body 30 may be made of, for example, stainless steel, and the inner elastic collar portion 31 may be made of a resin material. In this case, the elastic collar portion 31 is fixed to the color main body portion 30 by an appropriate bonding means such as an adhesive or a coating.

Further, as shown in FIG. 8, a washer 33 is interposed between the elastic collar member 21 and the proximal end step portion 3aa of the coil sheath small diameter portion 3a, so that the elastic collar member 21 is located between the proximal end step portion 3aa. The frictional force may be reduced.
For example, when the diameter of the distal end portion of the coil sheath 3 is reduced by machining, the proximal end side step portion 3aa of the coil sheath small diameter portion 3a may remain as a rough processed surface. In this case, an unexpected frictional force may be generated between the base end side step portion 3aa which is the processed surface and the elastic collar member 21. At this time, the frictional force is difficult to calculate and management becomes extremely troublesome.
However, if the washer 33 is interposed between the elastic collar member 21 and the proximal end step portion 3aa of the coil sheath small-diameter portion 3a as described above, the frictional force between them can be almost eliminated. Management of the frictional force generated between the collar member 21 and the coil sheath 3 is facilitated.

  In the second embodiment, the elastic collar member 21 is fixed to the tube sheath 2, and a frictional force is generated between the fixed elastic collar member 21 and the coil sheath 3. However, the present invention is not limited to this. Instead, the elastic collar member may be fixed to the coil sheath 3 side, and a frictional force may be generated between the elastic collar portion and the tube sheath 2.

It is a side view which shows the case where the treatment tool for endoscopes of 1st Embodiment which concerns on this invention is integrated in an endoscope. It is a front view of the front-end | tip part of the treatment tool for endoscopes. It is sectional drawing of the front-end | tip part of the treatment tool for endoscopes. It is sectional drawing of the base end part of the treatment tool for endoscopes. It is sectional drawing cut | disconnected from the direction different from FIG. 4 of the base end part of the treatment tool for endoscopes. It is sectional drawing of the principal part which shows the modification of the treatment tool for endoscopes of 1st Embodiment. It is sectional drawing of the front-end | tip part of the treatment tool for endoscopes of 2nd Embodiment which concerns on this invention. It is sectional drawing of the front-end | tip part which shows the modification of the treatment tool for endoscopes of 2nd Embodiment which concerns on this invention. It is sectional drawing of the front-end | tip part which shows the other modification of the treatment tool for endoscopes of 2nd Embodiment which concerns on this invention.

Explanation of symbols

  DESCRIPTION OF SYMBOLS 1 Endoscope treatment tool 2 Tube sheath (flexible tube) 3 Coil sheath (operation member) 4 Operation wire (operation member) 5 Forceps piece 6 Treatment part (treatment function member) 7 Cover member 8, 10 protrusion (rotation suppression) Part) 11 coil spring (biasing member) 21 elastic collar member

Claims (3)

A flexible tube;
An operation member inserted into the flexible tube and rotatable relative to the flexible tube;
A treatment function member that is connected to the distal end of the operation member, is rotatable with respect to the flexible tube together with the operation member, and is disposed at the distal end of the flexible tube;
A rotation suppression unit that is interposed between the treatment function member and the flexible tube and suppresses the rotation of the treatment function member with respect to the flexible tube in a state in which the treatment function member is allowed to rotate with respect to the flexible tube. When,
Equipped with a,
The rotation inhibiting unit, the surface of the flexible tube side of the surgical function member of the end face portion opposed to that of the flexible tube, characterized Rukoto is composed of a plurality of projections provided in pairs, respectively Endoscopic treatment tool.   The endoscopic treatment tool according to claim 1, wherein a biasing member that biases the plurality of protrusions forming the pair in a direction in which the protrusions approach each other is provided.   The operation member has a coil sheath inserted into the flexible tube and connected to the treatment function member at a distal end, and the urging member is disposed between the coil sheath and the flexible tube. The endoscope treatment tool according to claim 2, wherein:

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