JP4589476B2 - Endoscopic wire loop treatment tool - Google Patents

Description

[0001]
BACKGROUND OF THE INVENTION
The present invention relates to a wire loop type treatment instrument for an endoscope which is used by being inserted into and removed from a treatment instrument insertion channel of an endoscope.
[0002]
[Prior art]
FIG. 6 shows a distal end portion of a conventional general endoscope high-frequency snare, and an elastic wire is attached to the distal end of an operation wire 2 that is inserted into the flexible sheath 1 so as to be movable forward and backward in the axial direction. A wire loop 3 is connected through a connection pipe 4.
[0003]
As a result, when the operation wire 2 is moved back and forth in the axial direction, the wire loop 3 enters and exits into the distal end of the flexible sheath 1, and the wire loop 3 is looped out of the flexible sheath 1 by its own elasticity. Swelled by being pulled into the flexible sheath 1.
[0004]
[Problems to be solved by the invention]
However, in the conventional endoscopic high-frequency snare having the above-described structure, the inner diameter dimension d of the flexible sheath 1 is such that the connection pipe 4 connecting the wire loop 3 and the operation wire 2 can smoothly advance and retract. Must be.
[0005]
For this reason, the flexible sheath 1 becomes thicker, and there is a restriction that it can only be used with an endoscope having a thick treatment instrument insertion channel. It may be pulled into the flexible sheath 1 as it is, causing troubles in the polyp excision, or the polyp may not come off.
[0006]
In addition, silver brazing, welding, or caulking is performed to connect the wire loop 3 and the operation wire 2, so that the strength of the elastic wire forming the wire loop 3 at the adjacent portion is reduced, and when used. In some cases, the applied force could break the wire.
[0007]
Accordingly, the present invention provides a wire loop treatment instrument for an endoscope that can achieve a reduction in diameter of a flexible sheath that is directly linked to improved functions, and is excellent in the durability of an elastic wire and is easy to manufacture. The purpose is to do.
[0008]
[Means for Solving the Problems]
In order to achieve the above object, the wire loop type treatment instrument for an endoscope of the present invention has a wire loop made of an elastic wire at the distal end of an operation wire that is inserted in a flexible sheath so as to be movable forward and backward in the axial direction. By connecting and operating the operation wire in the axial direction, the wire loop moves in and out of the distal end of the flexible sheath, and the wire loop swells in a loop shape by its own elasticity outside the flexible sheath, and is flexible In a wire loop type treatment instrument for an endoscope that is narrowed by being drawn into a sheath, a twisted wire formed by twisting a plurality of thin metal wires as an elastic wire forming the wire loop is used. A pair of elastic wires extending from the rear end are twisted in the direction opposite to the twisting direction of the elastic wire without being fixed at the rear end portion of the wire loop, thereby forming an operation wire. It is intended.
[0009]
The wire loop may be formed by bending back one elastic wire at an intermediate point, or the wire loop may be formed by fixing two elastic wires at the tip portion.
[0010]
Further, the flexible sheath may be made of an electrically insulating material, and a high-frequency current may be supplied to the wire loop through the operation wire. A plurality of wire loops may be combined to form a cage. In order to form the basket, a plurality of elastic wires may be arranged, and the operation wire may be formed by twisting a plurality of pairs of elastic wires into one.
[0011]
DETAILED DESCRIPTION OF THE INVENTION
Embodiments of the present invention will be described with reference to the drawings.
FIG. 1 shows a distal end portion of a wire loop type treatment instrument for an endoscope according to a first embodiment of the present invention, and 1 is a flexible sheath made of, for example, a tetrafluoroethylene resin tube or the like. Then, it is inserted into and removed from the treatment instrument insertion channel of the endoscope (not shown).
[0012]
3 is a wire loop formed by bending back one conductive elastic wire 23 at an intermediate point, and forms a curvilinear loop spreading several centimeters when no external force is applied. .
[0013]
As the elastic wire 23, for example, a stainless steel stranded wire having a diameter of about 0.2 to 0.5 mm is used, and a plurality of (for example, 3 to 7) thin stainless steel fine wires are twisted.
[0014]
The wire loop 3 can be elastically deformed and constricted by applying an external force, but when the external force is removed, the wire loop 3 returns to the original loop shape due to the elasticity of the elastic wire 23.
[0015]
A flexible operation wire 2 is inserted and disposed in the flexible sheath 1 so as to be movable forward and backward in the axial direction. The operation wire 2 is formed by twisting a pair of elastic wires 23 extending from the rear end of the wire loop 3.
[0016]
However, the twisting direction of the pair (two) of elastic wires 23 forming the operation wire 2 is opposite to the twisting direction of the elastic wires 23. Further, the elastic wire 23 is not fixed at the boundary portion 5 between the wire loop 3 and the operation wire 2, and the twist of the operation wire 2 is stable in proportion to the force with which the wire loop 3 tries to spread due to elasticity. Details of this part will be described later including the manufacturing method.
[0017]
FIG. 2 shows a base end portion of the flexible sheath 1, and a connection base 6 attached to the base end of the flexible sheath 1 is connected to the operation unit 10 and extends from the connection base 6. The proximal end portion of the wire 2 is inserted into a metal connection pipe 7 and fixed integrally therewith, and the connection pipe 7 is connected and fixed to the operation member 11 of the operation unit 10 by, for example, a set screw 12 or the like.
[0018]
As a result, by operating the operation member 11 in the operation unit 10, the operation wire 2 advances and retracts in the axial direction in the flexible sheath 1, and the wire loop 3 enters and exits the distal end of the flexible sheath 1. It expands and contracts.
[0019]
Since the operation wire 2 is formed by twisting a pair of elastic wires 23 forming the wire loop 3, the pushing force applied to the operation wire 2 from the operation unit 10 is easily transmitted to the wire loop 3.
[0020]
The operation unit 10 is provided with a connection terminal for electrically connecting a high-frequency power cord (not shown) to the operation wire 2, and a high-frequency current can be supplied to the wire loop 3 through the operation wire 2.
[0021]
FIG. 3 shows the manufacturing process of the wire loop 3 and the operation wire 2 in order. First, as shown in FIG. 3A, one elastic wire 23 is bent back in the opposite direction at the midpoint, and a pair ( Two).
[0022]
Then, both elastic wires 23 are overlapped in parallel at a position where the boundary portion 5 between the wire loop 3 and the operation wire 2 is placed, and firmly fixed with a vise 200 or the like with a hard rubber or the like interposed therebetween. The length of the wire loop 3 portion is, for example, about 3 to 10 cm.
[0023]
Next, as shown in (B), the two elastic wires 23 extending rearward are rotated around their respective axes in a direction in which the twisted state is further tightened. In the twist direction of the stranded wire, there are right-handed and left-handed (generally referred to as “S twist” and “Z twist”), but if the elastic wire 23 is S twist (right hand), (B) In the step, a right-handed rotation is given to the elastic wire 23.
[0024]
The number of rotations at this time is, for example, about 120 rotations with respect to a length of 2 m. The twist of each elastic wire 23 is increased in the elastic deformation region, and the twist is restored to the original state by removing the applied rotational force. Return.
[0025]
Next, as shown in (C), the operation wire 2 is formed by twisting the two elastic wires 23 extending rearward from the boundary portion 5 in the direction opposite to the twisting direction.
[0026]
At this time, it is not necessary to apply a force to each elastic wire 23. If the two elastic wires 23 are arranged side by side in parallel with each other being untwisted and then the rotational force is removed, the twist of each elastic wire 23 is reduced. By the operation of returning to the original state, the two elastic wires 23 are twisted in the direction opposite to the twisting direction and settled in a natural state.
[0027]
By doing so, the rotation of the strands of each of the two elastic wires 23 and the rotation of the twisting are offset, and the two elastic wires 23 can be easily twisted together without disturbing the twisted state. .
[0028]
Moreover, since the two elastic wires 23 are returned to the stable state, the phenomenon that the wire loop 3 rotates when the operation wire 2 is pushed and pulled does not occur.
[0029]
Next, as shown in (D), if the connecting pipe 7 is attached to the proximal end of the operation wire 2 and the wire loop 3 on the distal end side is formed in a predetermined shape, the wire loop 3 and the operation wire 2 are completed. .
[0030]
Finally, as shown in (E), if the wire loop 3 is inserted into the connecting base 6 attached to the proximal end of the flexible sheath 1 from the wire loop 3 side, the wire loop 3 is narrowed and the flexible sheath 1 is inserted. 1 passes through the state shown in FIG. Since the operation wire 2 is in a twisted state, it is easily passed through the flexible sheath 1.
[0031]
In the endoscope high-frequency snare configured as described above, the inner diameter d of the flexible sheath 1 is less than the operating wire 2 by 0.2 so that the operating wire 2 composed of the two elastic wires 23 can smoothly advance and retract. It is appropriate that the size is about 1 to 0.5 mm.
[0032]
Therefore, even if the diameter of the elastic wire 23 is 0.5 mm, if the inner diameter of the flexible sheath 1 is 0.2 mm larger than that, the inner diameter d of the flexible sheath 1 may be 1.2 mm. Therefore, if the thickness of the flexible sheath 1 is 0.3 mm, the outer diameter is reduced to 1.8 mm, and the flexible sheath 1 can be inserted into and removed from the treatment instrument insertion channel having an inner diameter of 2 mm.
[0033]
Since the inner diameter d of the flexible sheath 1 can be reduced, when the operation wire 2 is pulled to bind the polyp with the wire loop 3, the polyp is not drawn into the flexible sheath 1, and the polyp The resection procedure can be performed safely and quickly.
[0034]
In addition, the boundary portion 5 between the wire loop 3 and the operation wire 2 remains a continuous elastic wire 23 in a natural state without being heated by brazing or the like, so that there is no local strength reduction and stable durability. Have.
[0035]
FIG. 4 shows a high-frequency snare for an endoscope according to a second embodiment of the present invention, in which two elastic wires 23 are used as materials, and they are connected to each other by silver brazing or plasma welding at the tip portion 3a. The wire loop 3 is formed by being fixed. Other configurations are the same as those in the first embodiment.
[0036]
In this embodiment, the ends of two long elastic wires 23 are fixed to each other, and then, similar to the process of the first embodiment shown in FIGS. The wire loop 3 and the operation wire 2 are formed by twisting the elastic wires 23 in the direction opposite to the twisting direction.
[0037]
FIG. 5 shows an embodiment in which the present invention is applied to an endoscopic basket-type foreign body collecting tool, where the wire loop 3 portion is formed by a plurality of pairs (for example, four) of elastic wires 23, and the operation wire 2 is All the elastic wires 23 are formed by twisting in the direction opposite to the twisting direction of the elastic wires 23.
[0038]
Also in this case, at the time of manufacture, the ends of the two long elastic wires 23 may be fixed together and then the four elastic wires 23 may be twisted together, or first, the elastic wires after 23 and the twisting by two further elastic wire 23 of each the two may be twisted into a single.
[0039]
【The invention's effect】
According to the present invention, a twisted wire formed by twisting a plurality of fine metal wires as an elastic wire forming a wire loop, and a pair of elastic wires extended from the rear end of the wire loop are twisted together to operate the wire. As a result, the boundary between the wire loop and the operation wire can be prevented from becoming thicker than the thickness of the operation wire itself, so that the flexible sheath can be formed thin.
[0040]
As a result, it is possible to use even an endoscope in which a thin treatment instrument insertion channel is incorporated, and when polypectomy is performed, the polyp is not drawn into the flexible sheath, so that the polypectomy can be performed safely and securely. Can be done quickly.
[0041]
In addition, since the twisting direction of the operation wire is opposite to the twisting direction of the elastic wire, the rotation of the strands of each of the two elastic wires and the rotation of the twisting are offset. The wires can be easily twisted together without disturbing the twisted state, and the wire loop does not rotate when the operation wire is pushed and pulled, making it easy to use.
[0042]
Furthermore, since the boundary portion between the wire loop and the operation wire remains a natural elastic wire that is not heated by brazing or the like, a stable durability can be obtained without a local strength reduction. .
[Brief description of the drawings]
FIG. 1 is a plan sectional view of a distal end portion of a high-frequency endoscope snare according to a first embodiment of the present invention.
FIG. 2 is a side cross-sectional view of a proximal end portion of the endoscope high-frequency snare according to the first embodiment of the present invention.
FIG. 3 is a schematic view showing a manufacturing process of the endoscope high-frequency snare according to the first embodiment of the present invention.
FIG. 4 is a plan sectional view of a distal end portion of an endoscope high-frequency snare according to a second embodiment of the present invention.
FIG. 5 is a cross-sectional plan view of a tip portion of an endoscope basket-type foreign material collecting tool according to a third embodiment of the present invention.
FIG. 6 is a plan sectional view of a distal end portion of a conventional endoscope high-frequency snare.
[Explanation of symbols]
DESCRIPTION OF SYMBOLS 1 Flexible sheath 2 Operation wire 3 Wire loop 5 Boundary part 23 Elastic wire

Claims (4)

A wire loop made of an elastic wire is connected to the tip of an operation wire that is inserted in the flexible sheath so as to be movable back and forth in the axial direction, and the wire loop is flexed by moving the operation wire forward and backward in the axial direction. For endoscopes that go in and out of the distal end of the flexible sheath so that the wire loop swells in a loop shape by its own elasticity outside the flexible sheath and is drawn into the flexible sheath A wire loop type treatment instrument, wherein two pairs of the elastic wires are arranged so as to form a basket-like basket by combining two wire loops,
A twisted wire formed by twisting a plurality of fine metal wires is used as the elastic wire, and the two pairs of elastic wires extending from the rear end of the wire loop are fixed at the rear end portion of the wire loop. without, twisted by two twisted direction opposite of said elastic wire, the further the elastic wires each other one by two is twisted one become the operating wire to continuously without the basket and joint A wire loop type treatment instrument for endoscope characterized by the above. The wire loop type treatment instrument for an endoscope according to claim 1, wherein the wire loop is formed by bending back one elastic wire at an intermediate point. The wire loop type treatment instrument for an endoscope according to claim 1, wherein the wire loop is formed by fixing two elastic wires at a distal end portion. 4. The endoscope wire loop according to claim 1, wherein the flexible sheath is formed of an electrically insulating material, and a high-frequency current can be passed through the wire loop through the operation wire. Mold treatment tool.

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