JP5437772B2 - Medical treatment tool - Google Patents

Description

  The present invention improves the mechanical strength characteristics of the joint portion of the operation rope in the joint using the joint member of the operation rope and the distal end portion of the operation rope or the connecting member of the hand operation portion using the joint member. The present invention relates to a medical treatment tool and the like.

  The distal end of the medical treatment instrument to be inserted into the body or the hand operating section transmits the hand operation to the distal end via the operating rope, so the mechanical strength characteristics of the joint between the connecting member and the operating rope are considered. Thus, it is necessary to satisfy the safety of the human body when treating the lesion, and various proposals have been made for this purpose.

Patent Document 1 discloses a joining technique of laser welding the tip of an operation wire as an endoscope to the inner periphery of a state-of-the-art node ring, preventing deterioration due to annealing for local heating as much as possible, The purpose is to make the connection work easy and to be done in a short time.
However, even in a short time, it is “welding” between the fine wire operation wire and the node ring by laser light, the fine wire melts and the mechanical strength of the operation wire before welding cannot be maintained.

Patent Document 2 discloses a joining technique in which a bending operation wire and an insertion tip are “brazed and fixed” in a vacuum environment or an inert gas environment as an endoscope, and the bending operation wire is disconnected due to the occurrence of rust. The purpose is prevention.

However, in general, for example, gold brazing (JIS Z3266) having a melting point of 895 ° C. to 1030 ° C. is used for brazing stainless steel, and in such a case, the metal strands that constitute the bending operation wire are melted and welded. In addition, there is no disclosure of brazing material in such a patent document, and there is no disclosure about the correlation between the melting temperature of the brazing material and the mechanical strength characteristics of the bending operation wire. This is an idea of using brazing as a simple means of fixing.

JP 61-293419 A JP 2001-149307 A

In a conventional medical endoscope, when joining an operation rope and a connecting member of a rope receiver of a node ring or a bending piece using a stainless steel wire for the operation rope, a brazing material or the like as a joining member is simply There is only a technical idea only as a fixing means, and an operation rope formed by twisting a plurality of high-stretched metal strands with a high degree of processing of stainless steel wire, and this strongly-processed metal strand There is no technical idea regarding joining using a eutectic alloy which is a joining member at the time of brazing or soldering in consideration of the mechanical strength characteristics due to the heat effect of the operating rope used.
Further, in medical treatment instruments such as a medical endoscope snare and medical endoscope forceps described later, the operation rope is joined to the distal end portion of the operation rope and the connection member, or the proximal portion of the operation rope is connected to the connection member. The same applies to bonding.
The object of the present invention is to perform a strong wire drawing process using an austenitic stainless steel wire for the metal wire of the operation rope, and to improve the tensile breaking strength characteristics due to the heat effect on the strongly processed metal wire. By utilizing the joining member not only as a fixing means, but also by disclosing a new joining technical idea that improves the joining strength while improving the tensile breaking force of the operating rope, An object of the present invention is to provide a medical treatment tool that can be operated safely.

According to the first aspect of the present invention, the connecting member of the distal treatment section of the operating rope inserted through the flexible tube or the connecting member of the hand operating section and the operating rope are joined using the joining member. Then, in the medical treatment instrument that operates the distal treatment section by the operation of transmitting the operation force of the operation rope by pushing, pulling, or rotating the hand operation section, the operation rope is solidified. And an austenitic stainless steel wire that does not contain Mo as a component and is formed by twisting a plurality of drawn metal strands having a total area reduction of 80% to 99.5%. The joining member is made of a eutectic alloy having a melting temperature of 180 ° C. to 495 ° C., or the operating rope is subjected to a solution treatment and using an austenitic stainless steel wire containing Mo as a component, Total area reduction is 80% to 99 .5% wire-drawn metal strands are used to form a twisted structure, and the joining member is made of a eutectic alloy having a melting temperature of 180 ° C. to 525 ° C. A medical treatment instrument characterized in that a connecting member is joined using the joining member.
With this configuration, the tensile breaking force of the operation rope at the joint is improved by utilizing the heat of fusion of the joining member to obtain a high mechanical strength characteristic, and the bonding strength between the operation rope and the connecting member is increased. It is possible to improve and provide a medical treatment tool that can be operated safely by an operator.

According to a second aspect of the present invention, in the metal strand of the operation rope, the total area reduction rate in the wire drawing of the metal strand of the operation rope is 90% to 99.5% , and the connecting member The electropolishing treatment or the plating treatment containing the same composition component as that of the joining member is applied to at least the joint portion of the distal treatment instrument or the joint portion of the hand operation portion of the operation rope to be joined with the joint rope. The medical treatment tool according to Item 1.
With this configuration, it is possible to improve the wettability with the bonding member at the bonded portion and improve the tensile strength of the operating rope while further improving the bonded strength of the bonded portion.

According to a third aspect of the present invention, in the operation rope, a metal strand having a strand diameter of 0.008 mm to 0.200 mm is used as a core member and a side member, and a side member is provided on the outer periphery of the core member. It is composed of a spiral rope having a twisted configuration in which nine from one are spirally wound in one direction, and the strand diameter of the core material is 1.07 to 2.12 times the strand diameter of the side material, It consists of the said rope for operation, It is a medical treatment tool as described in any one of Claims 1-2.
With this configuration, it is possible to further improve the joint strength of the joint using an operation rope with improved tensile breaking force, and further improve the operating force transmission performance to the tip part, especially by pushing and rotating operations It is possible to provide a medical treatment tool that has been allowed.

The invention according to claim 4 is characterized in that the eutectic alloy as the joining member is composed of a composition containing either gold or silver and has a melting temperature of 217 ° C. to 525 ° C. It is a medical treatment tool as described in any one of -3.
With this configuration, it is possible to improve the tensile breaking force of the operating rope using the heat of fusion of the joining member, and improve the joining strength of the joined portion.

According to a fifth aspect of the present invention, the medical treatment tool according to any one of the first to fourth aspects of the present invention is configured such that the operating force of the operating rope is reduced by pushing, pulling, or rotating the hand operating unit. The medical treatment is characterized in that after the treatment loop of the distal treatment section is expanded or contracted by a transmission action, the affected area is excised by applying a high-frequency current to the operation rope and the distal treatment section. A medical endoscope snare which is a treatment instrument for endoscope or a high frequency snare for medical endoscope, and the invention according to claim 6 is the medical treatment according to any one of claims 1 to 4. The tool pushes, pulls, or rotates the hand operation part to transmit and manipulate the operating force of the operation rope, and opens and closes the forceps cup of the biopsy forceps of the distal treatment part to collect a living tissue, Alternatively, after opening and closing the forceps cup, the operation rope, and The medical endoscope forceps are medical endoscope treatment tool, characterized in that the forcep cups is a high-frequency current to ablate the affected area, or a hot biopsy forceps for medical endoscopes.
This configuration prevents interruption of the operator's procedure in an inoperable state due to insufficient tensile rupture strength of the operating rope, and facilitates the expansion / contraction of the loop of the distal treatment section or the opening / closing action of the biopsy forceps cup. While maintaining high operability and high-frequency energization, excision of the affected area, collection of living tissue, hemostasis, etc. by energizing action of the operating rope and high energizing action of the joining member containing gold or silver components Of medical endoscope snares, medical endoscope high-frequency snares, medical endoscopic forceps, and medical endoscopic hot biopsy forceps it can.

According to a seventh aspect of the present invention, the medical treatment instrument according to any one of the first to fourth aspects of the present invention is configured such that the operating force of the operating rope is reduced by pushing, pulling, or rotating the hand operating section. A clip device for a medical endoscope, which is a medical endoscope treatment tool, wherein the clip of the distal treatment section is detached and placed in the body by a transmission action.
With this configuration, even if the tension of the rope for operation is increased by providing multiple clips for the distal treatment section, it prevents inoperability due to insufficient tensile breaking strength, smoothing the clip detachment operation, and quick procedure response. It is possible to provide a medical endoscope treatment tool with a clip device.

According to an eighth aspect of the present invention, the medical treatment instrument according to any one of the first to fourth aspects of the present invention is configured to reduce the operating force of the operating rope by pushing, pulling, or rotating the hand operating section. A medical endoscope characterized in that a high-frequency current is applied to the operation rope and the knife portion while a knife portion of the distal treatment portion is guided to a desired position by a transmission action to cauterize and incise the affected living body tissue. This is a high-frequency knife for a medical endoscope that is a treatment instrument for a mirror.
This configuration prevents the operator from interrupting the procedure in an inoperable state due to insufficient tensile break strength at the joint with the connecting member of the operating rope, and improves the smooth operability of the tip treatment section to the knife section Of the high-frequency knife that can respond quickly to procedures such as excision of the affected area and hemostasis by the energizing action of the operating rope and the high energizing action of the joining member containing gold or silver components. A medical endoscope treatment tool can be provided. In addition, if supplemented, a clear visual grasp of the lesioned part can be used to eliminate insufficient bonding strength due to blackening of the bonding member by optionally using a bonding member described later when injecting physiological saline. .

The perspective view which shows the whole medical treatment tool (medical endoscope) of this invention. Sectional drawing which looked at the insertion part front end side of the medical treatment tool (medical endoscope) of this invention from the side. The assembly | attachment figure of the bending piece of the front-end | tip of the medical treatment tool (medical endoscope) of this invention, and the rope for operation. The assembly | attachment figure of the bending piece of the front-end | tip of the medical treatment tool (medical endoscope) of another Example (connecting member of a tubular rope receiver), and the rope for operation. The block diagram of the rope for operation used for the medical treatment tool of this invention. Total area reduction ratio and tensile breaking strength characteristic diagram. The temperature and tensile breaking strength characteristic figure of the metal strand used for the rope for operation. The block diagram of the snare for medical endoscopes, and the high frequency snare for medical endoscopes. The forceps for medical endoscopes and the hot biopsy forceps configuration diagram for medical endoscopes. The block diagram of the clip apparatus for medical endoscopes. The block diagram of the high frequency knife for medical endoscopes.

  An embodiment of the present invention will be described with reference to the drawings.

FIG. 1 shows an overall perspective view of a medical endoscope 1 that is a medical treatment instrument according to a first embodiment of the present invention. The medical endoscope 1 includes a hand operation unit 2 and a hand operation unit 2. An elongated insertion portion 4 connected to the distal end and inserted into the body, and a treatment tool hole that allows the medical endoscope treatment tool 11 of the medical endoscope 1 to enter and exit from the hand portion of the operation portion 2. 10 and a universal cord 8 having a connector 9 detachably connected to a light source device (not shown). The hand operation unit 2 is provided with a bending operation knob 3 for freely bending the distal end portion and a remote switch 12 for controlling a video processor (not shown).
The insertion portion 4 has a structure in which the flexible tube portion 5, the bending portion 6, and the tip configuration portion 7 are connected in series from the hand portion. The medical treatment tool of the present invention refers to both a medical endoscope and a medical endoscope treatment tool. The medical endoscope treatment tool includes a snare, a forceps, a clip, a high-frequency knife, and the like, which will be described later. Refers to the treatment tool.

The distal treatment section in FIG. 2 is composed of a bending section 6 and a distal end constituting section 7. The bending section 6 has a plurality of short cylindrical bending pieces 18 arranged in series and connected rotatably via a rivet 19. Each bending piece 18 is cut inwardly on an arc at an intermediate portion in the axial direction of a short cylinder at a portion substantially orthogonal to the axial direction of the rivet 19 to form a pair of rope receivers 22.
The operation rope 20 is inserted through the rope receivers 22 inside the plurality of bending pieces 18, and is joined using the joining member 21 at the most advanced distal bending piece 18a and the connecting member 22a of the distal rope receiver. Yes.
Then, the proximal portion of the operation rope 20 is inserted through the insertion portion 4 and the proximal operation portion 2 up to the bending operation knob 3 of the proximal operation portion 2 shown in FIG. The bending portion 6 can be bent up and down in FIG. 2 by pulling and pulling the operation rope 20 by rotating the operation knob 3. If another pair of rope receivers (not shown) are arranged in the front and back directions in FIG. 2 orthogonal to the pair of upper and lower rope receivers 22 in FIG. The structure can be bent in four directions. Such a structure may be used.
The outer periphery of the bending piece 18 is constituted by a blade 23 braided with a wire, and the outer periphery thereof is covered with an outer tube 24 made of synthetic resin.

  In the distal end configuration portion 7, an image guide fiber 26 is inserted into the base tube 25, and an objective lens 27 is disposed on the distal end side. The channel tube 28 connected to the connection pipe 29 is connected to the treatment tool hole 10 leading to the hand portion of the hand operation unit 2, and in addition to forceps such as biopsy forceps, a high-frequency snare, Various medical endoscope treatment tools 11 such as a clip device and an injection needle can be moved in and out, so that a lesion can be treated.

  FIG. 3 shows an assembled view of the most advanced tip bending piece 18a and the operating rope 20. The tip bending piece 18a is cut in an arc shape inward at a substantially middle portion of the short cylindrical long axis direction to form a protruding shape. The operation rope 20 is inserted into the connecting member 22a of the pair of distal end rope receivers, and the distal end portion 20a of the operating rope 20 is joined using the joining member 21 at the connecting member 22a of the distal end rope receiver.

And the operation rope 20 used for the medical treatment tool of the present invention uses a spiral rope or a strand rope described later, and FIGS. 5A and 5A show the medical endoscope of the first embodiment of the present invention. An embodiment of the spiral rope of the operation rope 20 to be used will be shown.
The operation rope 20 of the embodiment of the present invention is formed by twisting a plurality of metal strands having a strand diameter of 0.008 mm to 0.200 mm, and in the operation rope 200 of the spiral rope embodiment A, A core material 200A is composed of a core material 200A having one metal strand having a strand diameter (wire diameter) of 0.13 mm and six metal strands having a strand diameter (wire diameter) of 0.11 mm. The side material 200B is twisted on the outside, and the twisting direction is continuous with respect to the longitudinal direction to form a one-way spiral winding, that is, the spiral rope twisting structure 1 × 7 (core The outer rope diameter D after twisting is 0.35 mm, and the rope pitch (P in the drawing) is 2.5 to 15 times the outer rope diameter D. Here, the spiral rope is a rope formed by twisting three or more metal strands into a strand (bundle), and is named (1 × n), where n is the number of metal strands. Show.

Then, the core material 200A of the operation rope 200 is drawn by drawing a solidified austenitic stainless steel wire having a wire diameter of 0.46 mm using a plurality of dies until the wire diameter becomes 0.13 mm. The tensile breaking strength is improved from about 70 kgf / mm @ 2 to 232 kgf / mm @ 2 by work hardening of wire processing.
The area reduction rate at this time is 92.0%. Further, the side material 200B is substantially the same as the core material 200A.

  Further, the core material 201A of the operation rope 201 according to the embodiment B of the present invention has a wire diameter of 0.23 mm by using a plurality of dies for an austenitic stainless steel wire having a wire diameter of 0.76 mm. After the primary wire drawing process is performed until it becomes, and then the primary low temperature heat treatment is performed at 450 ° C. for 30 minutes, the secondary wire drawing is performed until the wire diameter is 0.168 mm, and then the secondary low temperature heat treatment (at 450 ° C. as described above). 30 minutes), when the wire drawing is performed to a wire diameter of 0.13 mm, the total area reduction is 97.1%, and a core material 201A having higher tensile breaking strength can be obtained. . The side material 201B is substantially the same as the core material 201A.

  Then, the rope 202 for operation composed of the core material 202A and the side material 202B having a total area reduction rate of 99.5% by the manufacturing method similar to the above-mentioned Example B is set as Example C, and the core materials of Examples A to C. Tables 1 and 2 summarize the manufacturing process of the side members. The core material of Examples A and B and the material of the metal wire of the side material are SUS304 materials of austenitic stainless steel wire, and the material of the core material of Example C and the metal wire of the side material. Used a SUS316 remelting material. In addition, the total area reduction rate referred to here is a value obtained by expressing the difference in cross-sectional area between the wire diameter of the solidified wire and the final finished wire diameter in the wire drawing process as a reduction rate. In addition, the tensile breaking strength means a value obtained by dividing the maximum value when a tensile force is applied to the wire and the wire is broken by the cross-sectional area of the wire.

According to Tables 1 and 2, both the core material and the side material have a total area reduction of 80% or more, and show the highest tensile breaking strength in Example C of 99.5%.
And the core material and side material of the metal strand used for the operation rope of the present invention are drawn to a total area reduction of 80% to 99.5% using a solution-treated austenitic stainless steel wire. It is characterized by having gone. It should be noted that it is desirable to use a remelting material, which will be described later, in the strong work drawing with a total area reduction of 95% or more. The reason why the total area reduction is 80% or more is that it becomes an inflection point where the tensile strength at break increases from 80%. (Refer to Fig. 6, Spring 3rd edition Maruzen Co., Ltd., p. 63, Fig. 2.82)
Then, an inflection point was found at which the tensile strength at breakage increased more rapidly with the total area reduction rate of 90% as a boundary.

  Table 3 shows a comparison of the tensile strength at break after adding a temperature of 450 ° C. using only the total area reduction rate using the same manufacturing method as in Example A or B. The increase ratio in the table indicates the ratio based on the value of the maximum tensile breaking strength when the total area reduction is 70%. For example, when the total area reduction is 90%, the increase ratio is 1.31 (256/196).

According to Table 3, when the total area reduction rate is 80%, it increases 1.12 times the value when the total area reduction rate is 70%, and when the total area reduction rate is 90%, it becomes 1.31 times. Clearly, an inflection point at which the tensile strength at break is increased when the total area reduction is 80%, and an inflection point at which the tensile elongation at break is increased at 90% is shown in FIG. It is considered that the nonlinear characteristic as shown in FIG.
The reason for this is that a fibrous structure appears as the degree of processing increases due to wire drawing by strong processing with a total area reduction rate of 80% or more, and when the total area reduction rate is 90% or more, this fibrous structure develops remarkably. This is probably due to the fact that
The reason why the total area reduction is 99.5% or less is that, when the degree of workability is higher than this, even if a remelting material described later is used, voids begin to form in the structure and become brittle, This is because, due to the shortage, breakage of the metal wire of the side material is likely to occur particularly in the twisted configuration, which is considered as the limit of wire drawing and twisting.
Therefore, in order to join the eutectic alloy of the joining member 21, which will be described later, to the operation rope by melting heat while improving the tensile breaking strength of the metal strand, the total area reduction is from 80% to 99.99. 5% or less is preferable, and more preferably, the total area reduction rate is 90% to 99.5%. In order to obtain a higher tensile breaking strength and stably form a twist, the total area reduction rate is 90%. % To 99%.

  The reason why “Solution-treated austenitic stainless steel wire was drawn” was to obtain an austenitic structure with good workability, and the austenitic stainless steel wire was refined by heat treatment using transformation points. This is because the crystal grains can be refined only by cold working, and the tensile breaking strength can be improved by exhibiting remarkable work hardenability by wire drawing. Also, the reason for using austenitic stainless steel wire is that martensitic stainless steel wire exhibits quench hardenability by heat treatment and is easily affected by heat. This is because the twisted configuration of the fine wire and the extra fine wire cannot be formed as in the above-mentioned embodiment, and the ferritic stainless steel wire has a problem of temperature brittleness (sigma brittleness).

Next, in FIG. 3, the distal end portion 20a of the operation rope 20 and the connecting member 22a of the distal end rope receiver of the distal bending piece 18a are joined by melting and heating the joining member 21.
The joining member 21 is a eutectic alloy having a melting temperature of 180 ° C. to 495 ° C., or an eutectic alloy having a melting point of 180 ° C. to 525 ° C. when the metal strand of the operation rope 20 includes Mo described later. Is used. The eutectic alloy here refers to a special alloy having the lowest melting point (melting temperature) obtained by changing the component ratio of the alloy, and specifically, an alloy material containing gold or silver. 80% by weight of gold as a tin-based alloy material, the balance being tin and a melting temperature of 280 ° C., and 3.5% by weight of silver as a tin-based alloy, the balance being tin and a melting temperature of 221 ° C., and 88% by weight of gold, The balance is germanium, a melting temperature of 356 ° C., a eutectic alloy composed of silver, tin, and indium and having a melting temperature of 450 ° C. to 472 ° C. Table 4 shows typical examples.

  The reason why gold is used as the joining member 21 is to improve corrosion resistance and spreadability, the reason why silver is used is to adjust the melting point, and the reason why tin is used is to reduce the melting point and to operate the rope. 20 for improving wettability, and the reason for using indium and copper is to improve wettability, and the reason for using germanium is to suppress the coarsening of the intermetallic compound grains and to increase the bonding strength. This is for the purpose of preventing the decrease in the thickness. Lead and antimony are not preferable from the viewpoints of incompatibility with the human body and difficulty in workability.

  The reason why the melting temperature of the joining member 21 is 180 ° C. to 495 ° C., or 180 ° C. to 525 ° C. is that the tensile breaking force of the work rope 20 that has been work-hardened when the temperature falls below 180 ° C. When the temperature exceeds 495 ° C., the characteristics of the austenitic stainless steel wire of the metal strand used for the operation rope 20, or when it exceeds 525 ° C., the austenitic stainless steel wire containing Mo Due to the nature, when each austenitic stainless steel wire is heated to 520 ° C. or 800 ° C. exceeding 540 ° C., a sensitization phenomenon occurs, and as described later, the tensile fracture strength characteristics are extremely lowered, and this phenomenon This is because the mechanical strength characteristics of the operating rope 20 are maximized.

This structure has the following specific effects.
When the operation rope 20 and the connecting member 22a of the tip rope receiver of the tip bending piece 18a are joined using the eutectic alloy as the joining member 21, the core material and the side of the manipulation rope 20 by the heat of fusion at the time of joining. Even a rope formed by twisting a thin wire such as a material can improve the tensile strength characteristics and the like and can be firmly joined without lowering the tensile strength characteristics.

FIG. 7 shows that, in general, an austenitic stainless steel wire is used as the bus bar of the metal wire, and the metal wire after the final wire drawing with a total area reduction of 95% or more is subjected to heat (each temperature is 30 minutes). The drawing shows the tensile strength at break. In the case of SUS304 material, the illustrated a is shown, and in the case of SUS316 material, the illustrated b is shown.
According to this, SUS304 material began to increase in tensile strength at 180 ° C due to the heat effect, showed the highest tensile strength at about 450 ° C, and the effect of improving tensile strength at 495 ° C was noticeable. If it exceeds 520 ° C., the tensile strength at break will decrease more rapidly than normal temperature (20 ° C.). The SUS316 material containing Mo shows the same tendency as the SUS304 material on the low temperature side, but shows the highest tensile rupture strength characteristics at about 480 ° C. on the high temperature side, and the effect of improving the tensile rupture strength properties to 525 ° C. is remarkable. In addition, when the temperature exceeds 540 ° C., the tensile strength at break decreases more rapidly than normal temperature (20 ° C.).
The reason why the tensile strength at break is abruptly decreased is that, as described above, when the austenitic stainless steel wire subjected to the solution treatment is heated from 800 ° C. to 800 ° C., the carbon This requires energy for precipitation and migration of chromium, causing a sensitization phenomenon. In particular, in an ordinary SUS304 austenitic stainless steel wire having a carbon content of 0.08% or less, the temperature is about 700 ° C. for about 4 to 5 minutes. This is because a sensitization phenomenon appears and the tensile strength at break is extremely reduced.

In order to have such tensile breaking strength characteristics, the low temperature heat treatment temperature range of the SUS304 metal strand is preferably 180 ° C. to 495 ° C., and for example, SUS316 material containing Mo (Mo is 2 wt% to 3 wt%). The low temperature heat treatment temperature range of the metal wire is desirably 180 ° C. to 525 ° C.
Therefore, the melting temperature of the joining member 21 is matched with the desirable low temperature heat treatment temperature range. As described above, the present invention focuses on the tensile strength at break due to the temperature of the austenitic stainless steel wire with high work drawing and a high total area reduction rate, and the metal strand used for the operation rope 20 is a fine wire, Focusing on the fact that the heat capacity is very small and easy to be affected by heat, the tensile breaking strength in the twisted state of the metal wire of the operation rope is greatly improved by utilizing the heat of fusion of the joining member 21. And a new technical idea that can be joined.

  And the chemical component of the austenitic stainless steel wire of the metal strand used for a present Example is C: 0.15% or less, Si: 1% or less, Mn: 2% or less, Ni: 6% -16 in weight%. %, Cr: 16% to 20%, P: 0.045% or less, S: 0.030% or less, Mo: 3% or less, the balance being iron and inevitable impurities. Thus, by using the above method without using high silicon stainless steel (Si: 3.0% to 5.0%) or precipitation hardening stainless steel wire, high strength austenitic stainless steel wire metal. A strand can be obtained. C is preferably 0.005% or more for improving the tensile strength at break, and is preferably 0.15% or less from the viewpoint of suppressing intergranular corrosion.

The core material or side metal wire used in the operation rope 20 of the medical endoscope 1 of the present invention is an austenitic stainless steel wire having a strand diameter of 0.008 mm to 0.200 mm, particularly tensile fracture. In order to enable wire drawing with a strength of 300 kgf / mm 2 or more and a total area reduction of 95% or more, SUS304 material or SUS316 material using a remelting material is desirable.
The reason for this is that the cause of disconnection when drawing a stainless steel wire is most often oxide inclusions as well as surface flaws, and this tendency becomes more prominent as the wire becomes finer and finer.
And the chemical component is low in the components of Al, Ti, Ca and O which are inclusion generating elements, and also suppresses S which causes a decrease in wire drawing due to the action of sulfide. The specific chemical components of the austenitic stainless steel wire are, by weight, C: 0.08% or less, Si: 0.10% or less, Mn: 2% or less, P: 0.045% or less, S: 0 0.010% or less, Ni: 8% to 12%, Cr: 16% to 20%, Mo: 3% or less, Al: 0.0020% or less, Ti: 0.10% or less, Ca: 0.005% or less , O: 0.0020% or less, with the balance being Fe and inevitable impurities.
And as a manufacturing method of a remelting material, it is the manufacturing method etc. of the electroslag remelting which used the flux for the ingot after melting of stainless steel. Even when a triple melting material is used, the same effect as described above can be obtained.

  Then, when the operation ropes A to C of the operation ropes 200 to 202 and the bending pieces are joined using the joining member 21, the melting and heating time of the joining member 21 and the assembling time are taken into consideration. Table 5 shows the relationship between temperature and tensile breaking force. The time of 5 seconds indicates the average time during which the rope is melted and heated at 180 ° C. or higher when it is bonded and fixed using the bonding member 21, and 60 seconds is again due to the bonding and fixing operation (redoing operation). Time including reheating at 180 ° C. or higher is shown. Here, the tensile breaking force of the rope means the maximum load when the rope is broken by applying a tensile force to the rope.

According to Table 5, considering the melting and heating time of the joining member 21, even when heating is performed at 450 ° C. for 5 seconds, the tensile breaking force of the operating rope 200 is about 16.5 kgf to about 17.1 kgf. .6%, and the tensile breaking force of the operating rope 201 is increased by about 4.9% from 24.7 kgf to 25.9 kgf, and the tensile breaking force of the operating rope 202 is further increased from 25.6 kgf to 25.7 kgf. It becomes 0 kgf and increases by about 5.5%, and the increase rate of the tensile breaking force tends to increase with the increase of the total area reduction rate.
And as mentioned above, in order to join the eutectic alloy of the joining member 21 while improving the tensile breaking force of the operating rope by the heat of fusion, the total area reduction rate of the metal strands used for the operating rope is 80% to 99.5% is desirable, preferably 90% to 99.5% or less, and 90% to 99% is desirable in order to stably obtain a bending operation rope having a high tensile breaking force.
The reason for this is that a metal strand having a total area reduction ratio exceeding 99.5% is insufficient in elongation, and disconnection of the metal strand used for the side wire is likely to occur during twisting.

An embodiment of another spiral rope of the operation rope 20 of the present invention is shown in FIGS. FIGS. 5B to 5E show Examples D to G, respectively, and the twist configuration of the spiral rope is 1 × 8, 1 × 9, 1 × 10, and 1 × 19, respectively. Further, although not shown as another embodiment, it is 1 × 3, 1 × 12, or the like.
The core diameters of the metal wires of the core material and the side material are both 0.008 mm to 0.200 mm, and the core material and the side material are formed by twisting and forming metal wires having the same wire diameter. May be. In addition, when arranging the wire diameter (wire diameter) and the wire diameter ratio (core material / side material) of the core material and the side material of the other examples of the examples D to F and the twist configuration 1 × 7, Table 6 is obtained.

According to Table 6, for example, Example F (illustration (D)) has a twist configuration of 1 × 10, the core material is one metal strand having a wire diameter of 0.18 mm, and the side material has a wire diameter of 0.1. It consists of nine 085 mm metal strands and the wire diameter ratio is 2.12. Similarly, in another embodiment of the twisted configuration 1 × 7, the core material has a wire diameter of 0.122 mm, the side material has a wire diameter of 0.114 mm, and the wire diameter ratio is 1.07.
And as shown in the said each Example, the wire diameter of the core material uses the large diameter wire 1.07 times to 2.12 times the wire diameter of the side material. The same wire diameter may be used for both the core material and the side material, but the reason for using a thick wire for the core material is that when a tensile force is applied to the operating rope 20, the tensile force applied to one core material is More than the side material composed of several pieces, the structural difference is greater (the side material is a spiral structure that is easy to elongate, whereas the core material is a straight structure that is easily subjected to a tensile force load). For this reason, a thick wire is used for the core material to increase the cross-sectional area and reduce the tensile stress applied to the core material, thereby preventing the core material from breaking early and improving the tensile breaking force as a rope. It is.
And if a core material and a side material are less than the wire diameter ratio 1.0 of the same wire diameter, the load of the tensile force added to a core material will increase, and the tensile fracture force of the rope by the early fracture | rupture of a core material will be reduced. Moreover, if it exceeds the said upper limit (wire diameter ratio 2.12), the rigidity of a core material will increase and a repeated bending fatigue-proof characteristic will be inferior. Note that the wire diameter ratio of Examples A to C is 1.18.
Therefore, the wire diameter ratio (core material / side material) is preferably 1.0 times to 2.12 times, more preferably 1.07 times to 2.12 times, and still more preferably 1.18 times to 2. .12 times.

Next, a strand rope will be described as another embodiment of the operation rope 20.
The strand rope here means a rope in which three or more strands are twisted together, and is called (m × n), where m is the total number of strands and n is the number of metal strands in the strand. . For example, as an example of another strand rope, when the total number of strands is 7 bundles using the spiral rope twist configuration 1 × 7 of Example A, 7 × 7 (illustration (F)), similarly When the total number of strands is 7 bundles using the twist configuration 1 × 8 of Example D of the spiral rope, it becomes 7 × 8 (not shown).
About the Example of the rope 20 for operation of this invention, both the said spiral rope and a strand rope are included, and the metal strand to be used is the same as that of each said Example AC.
The spiral rope is used when the medical treatment instrument is inserted into the body with relatively little meandering and requires a high tensile force, and is particularly suitable when a push operation force and a rotation operation force are required. On the other hand, the strand rope is used when there is a large amount of bending meandering, a light operating force and a high bending stress resistance, and is particularly suitable when a repeated bending fatigue resistance characteristic is required. Which one to select is determined by the relationship between the degree of bending meandering and the required operability.

In addition, after supplementing the core material and the side material at a constant twist pitch, the operation rope 20 is subjected to a short time low temperature heat treatment (from 380 ° C. to 550 ° C. for 2 seconds to 10 seconds), Or after a straightening process using a spinner straightening machine or a roller leveler type straightening machine that applies a known bending and twisting after twisting, a short time low temperature heat treatment (from 380 ° C to 550 ° C for 2 seconds to 10 seconds) is added. After that, even if the joining member 21 is used for joining, a certain effect can be obtained.
And by using the said construction method, the linearity of an operation rope can be improved and the operativity of a medical treatment tool can be improved more. This reason can be considered to be because the concentrated stress generated locally in the operation rope is averaged by the short-time low-temperature heat treatment after twisting or straightening.

And the joining member with the rope 20 for operation which comprised the core material and the side material which carried out the strong wire drawing process and improved the tensile fracture strength characteristic using this solid solution-treated austenitic stainless steel wire, and twisted the side material No. 21 is a eutectic alloy having a melting temperature of 180 ° C. to 495 ° C. in the same temperature range in which the effect of improving the tensile breaking strength of the operating rope 20 is noticeable, or the metal wire of the operating rope is Mo. In the case of an austenitic stainless steel wire containing, an eutectic alloy having a melting temperature of 180 ° C. to 525 ° C. is used.
As a result, it is possible to perform the joining while improving the tensile strength at break using the melting heat of the eutectic alloy. Note that the melting temperature of the joining member 21 is 180 ° C. to 495 ° C. or 180 ° C. to 525 ° C. If the melting temperature of the joining member 21 is within this range, the tensile breaking strength of the operating rope is improved by using the heat of melting, and the bending This is because the piece 18 and the operation rope 20 can be firmly joined.

The tensile breaking strength of the distal end portion 20a of the operating rope 20 at the joint portion with the connecting member 22a of the distal end rope receiver is increased by the melting heat of the joining member 21, and the tensile stress increases with the increase in the tensile breaking strength. As a result, the resistance to repeated bending fatigue of the operating rope at the joint is improved.
Thus, there is no risk that the operation rope 20 and the connecting member 22a of the tip rope receiver are detached due to repeated bending fatigue applied to the joint portion of the tip portion 20a of the operation rope 20 during the operation of the surgeon. In addition, if a silver solder having a melting temperature of 605 ° C. to 800 ° C. and a gold solder having a melting temperature of 895 ° C. to 1030 ° C. are used, as described above, the core material or the side material may be sensitized. The brittle or annealed state significantly reduces the tensile breaking strength, and the lower end of the tensile breaking strength and bending stress causes the distal end portion 20a of the operating rope 20 to move away from the connecting member 22a of the distal end rope receiver. There is a risk that the risk of falling off increases, the bending operation knob 3 becomes inoperable, and the medical endoscope becomes inoperable.
Then, a gold solder having a melting temperature of about 880 ° C. and having a gold content of 74.5 wt. In this case, the same problem as described above is likely to occur when a silver solder having a melting temperature of 780 ° C. of 72% by weight of silver and 28% by weight of copper is used.

Next, the distal end portion 20a of the operating rope 20 has a predetermined length along the longitudinal length of the connecting member 22a of the distal end rope receiver, for example, the longitudinal length of the connecting member 22a of the distal end rope receiver. Is 2 mm to 100 mm, it is desirable to perform electropolishing. Or you may grind with sandpaper etc.
The reason for polishing the distal end portion 20a of the operation rope 20 before melting the eutectic alloy of the joining member 21 is that the metal wire that has been drawn (particularly the area reduction ratio is 90% or more) in strong working is particularly important. The rope for operation that is twisted and configured to be used has an extremely poor wettability with the joining member 21. In order to prevent this, the oxide film is removed by electrolytic polishing or the like to improve the wettability. This is to improve the bondability by 21. Moreover, you may use the rope 20 for operation which gave electrolytic polishing etc. over the full length beforehand. In addition, if we supplement, the reason why the wettability with the joining member 21 of the operating rope is extremely deteriorated is that the fibrous structure of the surface portion of the metal strand that appears as the degree of processing of the strong wire drawing increases. This can be attributed to the development and formation of an oxide film.

Further, the portion of the distal end portion 20a of the operation rope 20 has a predetermined length along the longitudinal length of the connecting member 22a of the distal end rope receiver, for example, the longitudinal length of the connecting member 22a of the distal end rope receiver. If it is 2 mm, a plating process of about 1 mm to 10 mm, or a bonding member 211 may be impregnated in the gap between the core material and the side material and fixed to the outer periphery of the side material, and then the bonding member 21 may be melted and fixed. Good. In such a case, it is desirable to use a material containing the same composition component as the eutectic alloy of the joining member 21 as the material used for the plating process. For example, if the joining member 21 contains a component containing gold or silver The material to be plated is preferably gold plating or silver plating.
Then, the tip portion 20a of the operation rope 20 may be impregnated and fixed in advance, and the joining member 211 used in this case is preferably the same or the same type of eutectic alloy as the joining member 21. In addition, the joining member which is the eutectic alloy of the same kind here means that the weight percent of the total of one or two identical composition components is 50 weight percent or more of the whole. And A2 are the same, or A1 and B1 are different.

This structure has the following specific effects. In other words, the joint strength between the distal end portion 20a of the operating rope 20 and the connecting member 22a of the distal end rope receiver is strengthened, and the joint strength is increased by the fusion-integrated fixation at the joint portion between the joint member 211 and the joint member 21. It can be greatly improved.
The reason why the distal end portion 20a of the operation rope 20 is plated or impregnated and fixed with the joining member 211 in advance is that the joining member 21 of the operation rope 20 whose wettability is extremely deteriorated by the wire drawing of the strong working. This is for improving the wettability and enabling a strong bond. When the joining member 211 is melted and fixed in advance, the joining member 211 is inserted through the connecting member 22a of the tip rope receiver, and then the welding member 211 is irradiated with a laser beam to remelt the joining member 211 to remelt the tip rope receiver. The connecting member 22a may be joined. In such a case, the joining member 211 needs to be formed thick on the surface of the distal end portion 20a of the operation rope 20 to such an extent that the valleys of the twisted strands cannot be seen, and each operation rope 20 of the present invention is implemented. It is desirable to use the same or the same kind of eutectic alloy as the joining member 21 used in the example. Thereby, the assembly | attachment operation | work of joining with the connection member 22a of the tip rope receiver and the tip part 20a of the operation rope 20 in a joining process can be simplified.

  Next, the structure of the connecting member 22a of the distal end rope receiver of the operating rope 20 is fixed to the inner peripheral side distal end portion of the distal bending piece 18a by using the connecting member 221 of the tubular rope receiver of the short tubular body. After inserting the tip 20a of the rope 20 for use, the joining member 21 may be used for joining. In this case, from the viewpoint of improving the bonding strength, the connecting member 22a of the distal end rope receiver of the distal bending piece 18a or the connecting member 221 of the tubular rope receiver is formed of the same or the same material as the operation rope 20. More desirable. Here, the same kind of material refers to the same kind of material as long as the prefix is the same steel material regardless of any of the steel type symbols in the JIS display (regardless of either austenitic SUS304 or martensitic SUS403). Say. Therefore, the stainless steel material and the aluminum steel material are different materials. Most preferred is the same material.

  Next, other examples 2 to 7 of the medical treatment tool of the present invention will be described below.

FIG. 8 shows the medical endoscope high-frequency snare 13A of the second embodiment which is the medical endoscope treatment tool of the present invention. FIG. 8A shows the distal treatment section 17, which is connected to the hand operation section 2. The connecting member 221 of the tubular rope receiver joins the treatment loop 17A and the distal end portion of the operating rope 20 to the distal end portion of the operating rope 20 using the joining member 21 at the tubular body or the tubular body end portion. Has been.
The figure (B) shows the hand operation part 2, and the hand operation part 2 is flat plate shape which has the terminal 30 connected to the operation part main body 2A provided with the guide groove 2D and the finger ring 2C, and the high frequency generator (not shown). The connecting member 222 has a hole portion 32 into which the proximal end of the operation rope 20 is inserted, and the proximal portion of the operation rope 20 is inserted into the hole portion 32. The operation rope 20 is joined to the hole 32 using the joining member 21. A reinforcing pipe 2E is provided outside the hand portion of the operation rope 20 to prevent buckling, and is connected to the slider 2B. In addition, illustration (C) (D) shows the partially expanded view of the rope 20 for operation of the front treatment part 17, and the connection member 221, and illustration (E) and (F) are for operation of the hand operation part 2. A partially enlarged view of the rope 20 and the connecting member 222 is shown.

  Then, by moving the slider 2B in the front-rear direction (the left-right direction in the drawing) along the guide groove 2D, an operation force is applied to the operation rope 20 connected to the slider 2B, and the treatment loop 17A is insulated with a fluorine resin or the like. It is housed in a sheath 241 made of material (slider 2B is moved to the right side in the figure) or is expanded outside the sheath 241 (slider 2B is moved to the left side in the figure), and the affected part is supplemented by the treatment loop 17A. The terminal 30 is connected to the high-frequency device, and the connection member 222, the operation rope 20, the connection member 221, and the treatment loop 17A are energized to remove the affected area and perform treatment such as hemostasis.

The operation rope 20 and the connecting members 221 and 222 are joined to each other inside the connecting members 221 and 222 using the joining member 21 or at the end.
In such a configuration, the operation rope 20 of the present invention is formed by twisting a metal wire that has been subjected to strong drawing using a solidified austenitic stainless steel wire, In addition, by using the joining member 21 having a melting temperature that matches a certain temperature range for improving the tensile breaking strength of the twisted rope, the joining member 21 is not simply used as the fixing means, but the operation rope 20 for the joining portion. It is possible to improve the joint strength of the joint portion while improving the tensile rupture force.

  If supplemented, the reduction in wettability of the joining member 21 due to the strong wire drawing, the improvement of the joining property by performing treatment such as electrolytic polishing on at least the joint portion of the operation rope, and the connecting members 221 and 222. By using the same or the same kind of material as the rope for operation using stainless steel, the difference in thermal expansion between them is reduced, and the wettability with the joining member is equalized to ensure strong joining with the joining member. Can be improved. The difference from the medical endoscope snare 13 (Example 3) is mainly the presence / absence of the terminal 30 joined to the high-frequency device, the presence / absence of insulation (for example, the material of the sheath 241), and the like.

  FIG. 9 shows the medical endoscope forceps 14 of Example 4 which is the medical endoscope treatment tool of the present invention. FIG. 9A shows the distal treatment section 17, which is connected to the hand operation section 2. The distal end of the operating rope 20 is connected to a biopsy forceps 17B composed of a pantograph mechanism at the distal end thereof, and has a flattened connection pin hole 221Z (illustration (C)). The substantially cylindrical connecting member 221 </ b> A is joined to the distal end portion of the operation rope 20 in the substantially cylindrical cylinder or the cylindrical end portion using the joining member 21. The figure (B) shows the hand operation part 2, and the hand operation part 2 is connected to the operation part main body 2A provided with the guide groove 2D and the finger ring 2C, and the substantially cylindrical connection connected to the hand part of the operation rope 20. The slurder 2B provided with the member 222A, and the substantially cylindrical connecting member 222A is joined to the proximal portion of the operation rope 20 with the joining member 21 in the substantially cylindrical cylinder or at the end of the cylinder. . A reinforcing pipe 2E is provided outside the hand portion of the operation rope 20 to prevent buckling, and is connected to the slider 2B. In addition, illustration (C) (D) shows the partially expanded view of the rope 20 for operation of the front-end | tip treatment part 17, and connection member 221A, and illustration (E) and (F) are for operation of the hand operation part 2. The partially expanded view of the rope 20 and the connection member 222A is shown.

  Then, by moving the slider 2B in the front-rear direction (the left-right direction in the drawing) along the guide groove 2D, an operation force is applied to the operation rope 20 connected to the slider 2B, and the forceps cup of the biopsy forceps 17B is opened ( The slider 2B is moved to the left side in the figure) and closed (the slider 2B is moved to the right side in the figure) to supplement the affected part and perform treatment such as excision. The difference between the forceps 14 for medical endoscope (Example 4) and the hot biopsy forceps 14A for medical endoscope (Example 5), which is a medical treatment instrument using high-frequency energization, is the same as in Examples 2 and 3 described above. In the same manner as in Example 5, in the case of Example 5, the terminal 30 similar to that of Example 2 above is determined by the presence or absence of the terminal 30 to be joined to the high-frequency device and the presence or absence of insulation (for example, the material of the sheaths 241 and 242). For example, the terminal is connected to the connecting member 222A in the slider 2B. (See FIGS. 8E and 8F)

  According to this configuration, Examples 4 to 5 obtain the operation rope 20 in which the metal strands having high strength tensile breaking strength characteristics by the strong wire drawing work are twisted as in Examples 1 to 3 described above. In addition, the heat of fusion of the joining member 21 can be used to improve the tensile breaking force of the operation rope 20 at the joining portion, and the joining member 21 can be joined together with the high conductivity characteristics of the joining member containing a gold or silver component. Thus, it is possible to provide a medical endoscope treatment tool having high operability.

  Next, FIG. 10 shows the medical endoscope clip device 15 of Example 6 which is the medical endoscope treatment tool of the present invention, and the clip 17C of the distal treatment section 17 is housed in the introduction tube 33. Then, the operating rope joined to the connecting member 222B in the slider 2B and the joining member 21 by moving the slider 2B of the hand operating part 2 to the right in the figure along the guide groove 2D. 20, an operating force is applied, and the force is transmitted to the hook-shaped connecting member 221B joined to the distal end portion of the operating rope by the joining member 21, and the clip 17C is detached from the hook-shaped connecting member 221B and detached, and the affected part is removed. In addition, the blood vessels are closed to stop the hemostasis. Incidentally, FIG. (C) is a longitudinal sectional view showing a clip state of the blood vessel 34 by the clip 17C.

Next, FIG. 11 shows the medical endoscope high-frequency knife 16 of Example 7 which is the medical endoscope treatment tool of the present invention, and the knife portion 17D of the distal treatment section 17 is inserted into the body to the affected area. After approaching, the slider portion 2B of the hand operation portion 2 is moved in the left direction in the figure along the guide groove 2D, so that the connecting member 222C having the terminal 30 that can be connected to the high frequency device in the slider 2B and the joining member 21 are joined. An operating force is applied to the operating rope 20 that is being operated.
A force is applied to the substantially cylindrical connecting member 221C joined to the distal end portion of the operating rope 20 by the joining member 21, and the rod-like electrode portion 172D and the flat electrode portion 171D joined to the distal end side of the connecting member 221C The plate-like electrode portion 171D of the knife portion 17D made of the above is brought into contact with the affected area to treat the living tissue for cautery incision. Note that the medical treatment instrument of the seventh embodiment has a function of causing the physiological saline to pass through the internal space 243A of the sheath 243 from the syringe 31 and ejecting from the distal treatment section 17 to clarify the bleeding part.
And in Example 6, 7, the joining method of the rope 20 for operation and connection member 221B, 222B, 221C, 222C using the joining member 21 is the same as that of the said Examples 1-5.

  By this structure, Example 6, 7 obtains the operation rope 20 which twisted and comprised the metal strand which has the high strength tensile breaking strength characteristic by the strong wire drawing like the said Examples 1-5. In addition, the heat of fusion of the joining member 21 can be used to improve the tensile breaking force of the operation rope 20 at the joining portion, and the joining member 21 can be joined together with the high conductivity characteristics of the joining member containing a gold or silver component. Thus, it is possible to provide a medical endoscope treatment tool having high operability.

  In a medical treatment instrument using physiological saline, when a joining member containing a silver component is used, silver sulfide or the like is formed by contact with physiological saline, and blackening starts. However, the corrosion progresses further and the bonding strength decreases. For this reason, it is a more desirable joining form to use the joining member 21 of a gold eutectic alloy from the viewpoint of preventing the joining strength from being lowered due to the progress of corrosion and preventing blackening. This is because the physiological saline is passed through the inner hole of the channel tube of the medical endoscope, and the objective lens at the tip is washed, and the physiological saline is applied to the lesion to clarify the lesion. The same problem also occurs when spraying, which is a technical problem common to medical endoscopes and medical endoscope treatment tools. By this method, this technical problem can be solved.

Further, in addition, particularly in the sixth and seventh embodiments, the operation rope 20 that makes it easy to control the clip 17C or the knife portion 17D of the distal treatment section 17 to a desired affected position by pushing and rotating the hand operation section. The spiral rope is more desirable than the strand rope, and more preferable is an aspect in which the core material uses a large diameter wire in a certain range rather than the side material as described above.
The reason for this is that the pushing operation and rotating operation of the hand operating part are greatly influenced by the characteristics of the rope for operation, particularly the straight core material. The larger the core wire diameter is, the larger this value is, so that the buckling resistance is improved and the pushing operation force is improved. In addition, in the case of rotational operation, the torsional resistance moment is proportional to the cross-sectional secondary pole moment, and this value increases as the wire diameter increases, and as a result, the ability to transmit rotation to the tip can be improved. Because.

Next, a method for manufacturing the medical treatment tool of the present invention will be described below.
Join the connecting member of the distal treatment section of the operating rope inserted through the flexible tube, or the connecting member of the hand operating section and the operating rope using the joining member, and press the hand operating section, In the method of manufacturing a medical treatment tool for operating the distal treatment portion by pulling or rotating and operating the operating force of the operating rope, the operating rope is a solution treated austenitic stainless steel wire A process comprising a rope formed by twisting a plurality of metal strands having a total area reduction ratio of 90% to 99.5% using a wire, and a predetermined after electropolishing the twisted rope. A step of long cutting, a step of electropolishing after cutting the twisted rope by a predetermined length, and a step of inserting the cut end of the operating rope into the hole of the connecting member of the tip treatment portion And or In the step of inserting the proximal portion of the operation rope that has been cut later into the hole portion of the connecting member of the proximal operation portion and the joint portion of the operating rope inserted into the connecting member, 180 ° C. to 1 495 When the joining member made of a eutectic alloy having a melting temperature of 0 ° C. is melted or the metal element wire of the operating rope is an austenitic stainless steel wire containing Mo, the joint member having a melting temperature of 180 ° C. to 525 ° C. A method for manufacturing a medical treatment instrument comprising the steps of melting the joining member made of a crystal alloy and joining the connecting member and the operating rope using the joining member.
With this configuration, a plurality of metal wires that have been subjected to strong wire drawing are twisted together to form an operation rope, and wettability with a joining member by strong wire drawing is improved, and a connecting member Focusing on the correlation between strong working of austenitic stainless steel wire and tensile breaking strength of low-temperature heat treatment, joining the tensile breaking strength of an operating rope with a high tensile breaking strength due to strong work drawing By utilizing the heat of fusion of the joining member at the time, it is possible to manufacture a medical treatment instrument composed of a new technical idea that can be joined with further improved tensile fracture strength.

Further, the operating member inserted into the flexible tube is joined to the connecting member of the distal treatment section or the operating member of the hand operating part and the operating rope using a joining member, and the hand operating part In the method of manufacturing a medical treatment instrument for operating the distal treatment section by transmitting, operating, pushing, pulling, or rotating the operating force of the operating rope, the operating rope is a solution treated austenite A process comprising a rope formed by twisting a plurality of metal strands drawn with a stainless steel wire with a total area reduction of 90% to 99.5%, and the twisted rope is electropolished. A step of cutting a predetermined length after cutting, a step of electrolytic polishing after cutting the twisted rope by a predetermined length, and then connecting the distal end portion of the operating rope cut by the stainless steel material of the distal treatment section A step of inserting into the hole portion of the material, or a step of inserting the proximal portion of the operating rope cut thereafter into the hole portion of the connecting member made of stainless steel material of the proximal operating portion, and the step of inserting into the connecting member When the joining member made of a eutectic alloy having a melting temperature of 180 ° C. to 495 ° C. is melted at the joint with the operation rope, or the metal strand of the operation rope is an austenitic stainless steel wire containing Mo From the step of melting the joining member made of a eutectic alloy having a melting temperature of 180 ° C. to 525 ° C. and joining the connecting member made of the same or the same kind of material and the rope for operation by the joining member. It is the manufacturing method of the medical treatment tool characterized by becoming.
With this configuration, in joining the operating rope and the connecting member, paying attention to the correlation between the strong work drawing of the austenitic stainless steel wire and the tensile break strength of the low temperature heat treatment, the high tensile breaking by the strong work drawing The tensile breaking strength of the operating rope having strength is improved by utilizing the heat of fusion of the joining member at the time of joining, and the operating rope and the connecting member are made of the same or the same material. By reducing the difference in thermal expansion between them, and making the wettability between the rope for operation and the joining member, and the wettability between the connecting member and the joining member substantially uniform on the joining surface, the member of the joining part By making the bonding force between them uniform, higher bonding strength of the bonding portion can be obtained.

Further, it is more desirable that the step of joining the connecting member and the operating rope in the method for manufacturing the medical treatment instrument comprises a joining step in a vacuum environment or an inert gas environment.
This is because even after the autoclave sterilization of the medical treatment instrument, the operation rope having high strength due to residual flux can be joined while preventing a decrease in tensile breaking strength.

Next, an assembly of the medical endoscope 1 having the treatment instrument hole 10 which is a medical treatment instrument and the medical endoscope treatment instrument according to the second to seventh embodiments will be described with reference to FIGS. .
The assembly includes a bending portion in which a distal end treatment portion 17 connects a plurality of bending pieces 18, and the bending piece 18 a on the distal end side and the distal end portion of the operation rope 20 are joined using the joining members 21 and 211. 6, the bending portion 6 is bent and deformed by the operation of transmitting the operating force of the operation rope 20 by operating the hand operation portion 2, and the treatment tool hole 10 is provided in the hand operation portion 2. The medical endoscope 1 that is the medical treatment instrument according to any one of 4 to 4 and the medical endoscopic treatment instrument 1 according to Examples 2 to 7 are caused to enter and exit from the treatment instrument hole 10. This is an assembly of a medical endoscope 1 and a medical endoscope treatment tool characterized by performing partial therapy.
This configuration prevents the interruption of the procedure when the medical endoscope and the treatment tool for medical endoscope are inoperable due to insufficient tensile breaking strength of the operating rope and insufficient tensile breaking strength at the joint. Thus, it is possible to provide an assembly capable of handling various procedures for a lesioned part smoothly and quickly while having high operability. And, supplementally, the operation rope can be pushed more easily and the operability of the rotation operation can be improved by using a metal wire having a diameter larger than that of the side material. Improvement of current-carrying characteristics by using a joint member with high-current-carrying characteristics that improves the treatment of the affected area by applying high-frequency current, and, in addition, medical endoscope for cleaning the objective lens or accurately recognizing the lesion. By selecting and using a joining member containing a gold component for preventing blackening at the joint by passing physiological saline through the inner tube in the sheath of a treatment tube for a medical endoscope, etc. An assembly having a high degree of operability can be provided.

[Effect of the invention]
As described above, the medical treatment tool of the present invention is formed by twisting using a plurality of high-strength drawn metal strands having high tensile breaking strength, and includes an operation rope having high tensile breaking strength. Further, by using the heat of fusion of the eutectic alloy, which is a joining member having a melting temperature range matched with the temperature range in which the tensile breaking strength is improved by strong work drawing, the tensile breaking force of the operating rope is further improved. However, it is possible to firmly join the connecting member.

  Further, using the medical endoscope of the present invention provided with a treatment tool hole, each medical endoscope treatment tool is moved in and out of the treatment tool hole, and a treatment corresponding to the condition of the lesioned part is performed. It is possible to provide a medical treatment instrument assembly having a high degree of operability to a person, and can greatly contribute to rapid treatment. There are the above various effects.

DESCRIPTION OF SYMBOLS 1 Medical endoscope 2 Operation part 3 Bending operation knob 4 Insertion part 5 Flexible tube part 6 Bending part 7 Tip structure part 10 Treatment tool hole 13 Snare 13A for medical endoscopes High frequency snare 14 for medical endoscopes Endoscopic forceps 14A Medical endoscope hot biopsy forceps 15 Medical endoscope clip device 16 High-frequency knife for medical endoscope 18 Bending piece 20 Operation rope 20a Operation rope tip 21 Joining member 22 Rope receiver 22a Connecting member 221 for the tip rope receiver Connecting member for the tubular rope receiver

Claims (8)

Join the connecting member of the distal treatment section of the operating rope inserted through the flexible tube, or the connecting member of the hand operating section and the operating rope using the joining member, and press the hand operating section, In the medical treatment instrument for operating the distal treatment section by transmitting or operating the pulling or rotating operation force of the operating rope,
The operating rope is a plurality of metal strands that have been subjected to solid solution treatment and drawn using an austenitic stainless steel wire that does not contain Mo as a component, with a total area reduction of 80% to 99.5%. The joining member is made of a eutectic alloy having a melting temperature of 180 ° C. to 495 ° C.
The operation rope is a plurality of metal strands that have been subjected to a solid solution treatment and drawn using an austenitic stainless steel wire containing Mo as a component and having a total area reduction of 80% to 99.5%. The joining member is made of a eutectic alloy having a melting temperature of 180 ° C. to 525 ° C.
A medical treatment instrument comprising the operation rope and the connecting member joined together using the joining member. The total area reduction ratio in the wire drawing of the metal wire of the operation rope is 90% to 99.5% ,
Electrolytic polishing treatment or plating treatment containing the same composition component as that of the joining member is applied to at least the joint portion of the distal treatment tool or the joint portion of the hand operation portion of the operation rope to be joined to the connecting member. The medical treatment tool according to claim 1. The rope for operation uses a metal wire having a wire diameter of 0.008 mm to 0.200 mm as a core material and a side material, and 6 to 9 side materials are unidirectionally spiraled on the outer periphery of the core material. It consists of a spiral rope with a twisted configuration that is wound around
The strand diameter of the core material is 1.07 to 2.12 times the strand diameter of the side member, and the operation rope is used. Medical treatment tool.   The eutectic alloy which is the said joining member consists of a composition containing either gold | metal | money or silver, and a melting temperature is 217 degreeC to 525 degreeC, It is any one of Claims 1-3 characterized by the above-mentioned. Medical treatment tool.   The medical treatment tool according to any one of claims 1 to 4, wherein the distal operation unit is pushed, pulled, or rotated to transmit the operation force of the operation rope. A medical endoscope snare of a medical endoscope treatment tool for enlarging or contracting a treatment loop and then excising an affected area by energizing a high-frequency current to the operation rope and the distal treatment section, or A medical treatment instrument characterized by being a high-frequency snare for a medical endoscope.   The medical treatment tool according to any one of claims 1 to 4, wherein the distal operation unit is pushed, pulled, or rotated to transmit the operation force of the operation rope. A medical endoscope that opens and closes a forceps cup of a biopsy forceps and collects a living tissue, or opens and closes the forceps cup, and then excises the affected part by energizing a high-frequency current to the operation rope and the forceps cup. A medical treatment instrument characterized by being a medical endoscopic forceps for a medical treatment instrument or a hot biopsy forceps for a medical endoscope.   The medical treatment tool according to any one of claims 1 to 4, wherein the distal operation unit is pushed, pulled, or rotated to transmit the operation force of the operation rope. A medical treatment instrument characterized by being a medical endoscope clip device for a medical endoscope treatment instrument in which a clip is detached and placed in the body. The medical treatment tool according to any one of claims 1 to 4, wherein the distal operation unit is pushed, pulled, or rotated to transmit the operation force of the operation rope. A high-frequency knife for a medical endoscope of a treatment instrument for medical endoscope that cauterizes and incises an affected living body tissue by applying a high-frequency current to the knife portion while guiding the knife portion to a desired position. A medical treatment instrument characterized by that.