JP5481114B2 - High frequency knife for endoscope - Google Patents

Description

  The present invention relates to an endoscope high-frequency knife.

  As a high-frequency knife for an endoscope, a rod-shaped high-frequency electrode and a rod-shaped high-frequency electrode capable of swinging around a support shaft are attached to the distal end of a flexible sheath that is inserted into and removed from the treatment instrument insertion channel of the endoscope. The thing of the structure provided with the link mechanism for a head drive is widely used.

  In such a high-frequency knife for an endoscope, the operation wire operates the link mechanism by operating the operation wire inserted and arranged in the flexible sheath in the axial direction from the proximal end side of the flexible sheath. Thus, the rod-shaped high-frequency electrode swings (for example, Patent Document 1).

JP2007-202874A

  The conventional endoscope high-frequency knife as described above employs a structure in which the tip of the operation wire is connected to a link arm formed integrally with the rod-shaped high-frequency electrode, and when the operation wire is advanced or retracted. The connecting portion between the operation wire and the link arm is largely rotated around the support shaft.

  Therefore, as the operation wire moves back and forth, the tip position of the operation wire swings around the support shaft in the direction opposite to the swinging direction of the rod-shaped high-frequency electrode, and as a result, the forward / backward force acting on the operation wire ( In particular, the pushing force will escape to the side.

  Therefore, the rod-shaped high-frequency electrode may not be able to swing the rod-shaped high-frequency electrode even if the rod-shaped high-frequency electrode is only in light contact with the inner wall of the body. Furthermore, the degree of malfunction was large. In addition, in order to swing the rod-shaped high-frequency electrode, the operation wire has to be moved back and forth with a large stroke.

  The present invention provides a high-frequency knife for an endoscope that can reliably swing the rod-shaped high-frequency electrode without losing the advancing / retreating force of the operation wire and that can be realized with a small operation stroke. For the purpose.

  In order to achieve the above object, a high-frequency knife for an endoscope according to the present invention includes a rod-shaped high-frequency electrode that can swing around a support shaft at the tip of a flexible sheath, and a rod-shaped high-frequency electrode that swings. And a link mechanism for driving, and a distal end of a conductive operation wire inserted and disposed in the flexible sheath so as to be capable of moving forward and backward in the axial direction is connected to the link mechanism, and the operation wire is connected to the flexible sheath. The distal end of the operation wire is a high-frequency knife for an endoscope configured such that the rod-like high-frequency electrode swings by operating the link mechanism by moving the axial direction forward and backward from the proximal end side A guide piece that guides the connecting piece movably only in the axial direction of the distal end portion of the operating wire is provided with a connecting piece that connects the link mechanism to the axial direction of the distal end portion of the operating wire. There are those provided at the tip portion of the flexible sheath.

  The link mechanism extends rearward from the base end of the rod-shaped high-frequency electrode and is rotatably supported by the support shaft in the vicinity of the rear end portion and is rotatably connected to the driven link on the distal end side. The drive link may be provided, and the vicinity of the rear end of the drive link and the tip of the operation wire may be connected by a connecting piece.

  Further, both the connecting piece and the link mechanism may be formed of a conductive material, and a high frequency current may be supplied from the operation wire to the rod-shaped high frequency electrode via the connecting piece and the link mechanism. Further, it may be formed on a fixed link or a fixed substrate fixedly arranged at the distal end portion of the flexible sheath. Further, biasing means for biasing the link mechanism may be provided at the distal end portion of the flexible sheath so that the rod-shaped high-frequency electrode is directed in the axial direction of the distal end portion of the flexible sheath.

  According to the present invention, the connecting piece for connecting the distal end of the operation wire and the link mechanism is provided in a direction perpendicular to the axial direction of the distal end portion of the operation wire, and the connecting piece is provided only in the axial direction of the distal end portion of the operation wire. Since the guide long hole that is movably guided is provided at the distal end portion of the flexible sheath, the distal end of the operation wire always advances and retracts straight in the axial direction of the sheath along the guide long hole. The rod-like high-frequency electrode can be reliably swung without losing the advance / retreat force of the wire, and this can be realized with a small operation stroke.

It is side surface sectional drawing of the front-end | tip part of the high frequency knife for endoscopes which concerns on 1st Example of this invention. It is a fragmentary sectional perspective view of the front-end | tip part of the high frequency knife for endoscopes which concerns on 1st Example of this invention. It is side surface sectional drawing of the front-end | tip part state in which the rod-shaped high frequency electrode shakes the neck in the high frequency knife for endoscopes which concerns on 1st Example of this invention. It is a perspective view of the front-end | tip part state in which the rod-shaped high frequency electrode shakes the neck in the high frequency knife for endoscopes which concerns on 1st Example of this invention. It is a perspective view of the modification of the front-end | tip part of the high frequency knife for endoscopes which concerns on 1st Example of this invention. It is side surface sectional drawing of the front-end | tip part of the high frequency knife for endoscopes which concerns on 2nd Example of this invention. It is side surface sectional drawing of the front-end | tip part of the high frequency knife for endoscopes which concerns on 3rd Example of this invention. It is side surface sectional drawing of the front-end | tip part of the high frequency knife for endoscopes which concerns on the 4th Example of this invention. It is a single-piece | unit perspective view of the front-end | tip frame body of the high frequency knife for endoscopes which concerns on the 4th Example of this invention. It is side surface sectional drawing of the front-end | tip part of the high frequency knife for endoscopes which concerns on the 5th Example of this invention.

Embodiments of the present invention will be described below with reference to the drawings.
FIG. 1 shows a tip portion of an endoscope high-frequency knife according to a first embodiment of the present invention.
Reference numeral 1 denotes a flexible sheath that is inserted into and removed from a treatment instrument insertion channel of an endoscope (not shown), and is formed of an electrically insulating flexible tube such as a tetrafluoroethylene resin tube. Yes.

  A conductive rod-shaped high-frequency electrode 2 is disposed at the most distal end portion of the flexible sheath 1 so as to swing around a support shaft 3. The rod-shaped high-frequency electrode 2 is formed in a straight rod shape, and is disposed so as to project straight from the distal end of the flexible sheath 1 toward the front thereof. However, as shown in FIG. 5, the tip portion 2 a of the rod-shaped high-frequency electrode 2 may be formed in a bent shape.

  Returning to FIG. 1, reference numeral 4 denotes a distal end frame that is fixedly disposed by means of adhesion or the like in a state inscribed in the inner surface of the distal end of the flexible sheath 1, and is fixed to the distal end frame 4 at both ends. A fixed link 5 is disposed in the front end frame 4.

  As shown in FIG. 2 showing the inside of the front end frame 4 in an easy-to-understand manner, the plate-like fixed link 5 formed in the shape of three sides excluding the lower side out of the four sides forming the trapezoid has a rear end portion (each In the vicinity of the upper end portion in the figure, it is fixed to the front end frame body 4 by the fixing pin 6 and is fixed to the front end frame body 4 by the support shaft 3 described above in the vicinity of the front end portion.

  Further, a link mechanism 10 for swinging and driving the rod-shaped high-frequency electrode 2 is disposed in the distal end frame 4. The link mechanism 10 includes a driven link 11 that is formed integrally with the rod-shaped high-frequency electrode 2 and a drive link 12 that is rotatably connected to the driven link 11 and the link connecting pin 13 on the distal end side.

  The driven link 11 is integral with the rod-shaped high-frequency electrode 2 and is formed in a plate shape extending rearward from the base end of the rod-shaped high-frequency electrode 2, and the vicinity of the rear end portion thereof is connected to the support shaft 3 (more accurately. Is supported by the support shaft 3 in a freely rotatable manner.

  Reference numeral 7 denotes a conductive operation wire that is inserted into the flexible sheath 1 so as to be movable forward and backward in the axial direction. The operation wire 7 is formed of, for example, a stranded wire obtained by twisting a plurality of fine stainless steel wires, and is advanced and retracted in the axial direction by an operation at an operation portion (not shown) connected to the base end of the flexible sheath 1. be able to.

  The distal end of the operation wire 7 is connected to the link mechanism 10. That is, the connecting pin 8 fixed to the distal end of the operation wire 7 is connected to the rear end portion of the drive link 12 so as to be rotatable around the axis of the connecting pin 8.

  The connection pin 8 is attached in a direction perpendicular to the axial direction of the distal end portion of the operation wire 7, and the connection pin 8 is connected to the axial direction of the distal end portion of the operation wire 7 (that is, the distal end portion of the flexible sheath 1). The guide long hole 9 is formed in the fixed link 5 so as to be movable only in the axial direction of the fixed link 5.

  The guide long hole 9 has a certain width that allows the connecting pin 8 to slide smoothly inside thereof, and extends axially in the “trapezoid upper side portion” of the fixed link 5 (that is, the distal end frame body 4 and the flexible sheath 1). It is formed straight in the direction of the axial line of the tip portion.

  As a result, the distal end portion of the operation wire 7 is movable within a range in which the connecting pin 8 can move within the guide slot 9, and the guide slot 9 is provided at a substantially axial position of the distal end portion of the flexible sheath 1. Thus, the operation wire 7 advances and retreats in the front-rear direction without deviating from the substantially axial position of the flexible sheath 1.

  When the connecting pin 8 moves in the guide slot 9, the rear end portion of the drive link 12 moves with it, and the drive link 12 and the driven link 11 from the positional relationship with the support shaft 3 whose position does not move. The orientation of the rod-shaped high-frequency electrode 2 provided integrally connected to the tip of the driven link 11 changes.

  The connecting pin 8 and the link mechanism 10 (that is, the driven link 11 and the drive link 12) are formed of a conductive metal material such as stainless steel. Therefore, a high-frequency current can be passed from the operation wire 7 to the rod-shaped high-frequency electrode 2 via the connecting pin 8 and the link mechanism 10. The high frequency power cord is electrically connected to the operation wire 7 in an operation unit (not shown).

  In the endoscope high-frequency knife of the embodiment thus configured, as shown in FIG. 1, in the state where the operation wire 7 is pushed from the proximal end side to the distal end side, the connecting pin 8 is the guide length. The rod-shaped high-frequency electrode 2 is positioned straight in front of the flexible sheath 1 depending on the posture of the drive link 12 and the driven link 11 at that time, which is located in the foremost portion of the hole 9.

  When the operation wire 7 is pulled from the proximal end side, as shown in FIG. 3, the connecting pin 8 is retracted in the guide slot 9, and from the accompanying posture change of the drive link 12 and the driven link 11, The rod-shaped high-frequency electrode 2 gradually swings its head sideways.

  When the connecting pin 8 reaches the rear end portion of the guide slot 9, as shown in FIGS. 3 and 4, the rod-shaped high-frequency electrode 2 is inclined obliquely forward, for example, by about 45 °. Stop and no longer shake your head.

  The flexible sheath 1 and the distal end frame 4 are formed with slits 15 in accordance with the swing range of the rod-shaped high-frequency electrode 2, and the rod-shaped high-frequency electrode 2 is moved in the middle of the swinging operation. 4 and the flexible sheath 1 are prevented from colliding with each other. The ends of the link mechanism 10 (the driven link 11 and the drive link 12) for swinging the rod-shaped high-frequency electrode 2 also enter the slit 15.

  When the operation wire 7 is pushed again from the base end side, the connecting pin 8 whose movement range is restricted by the guide slot 9 moves straight forward along the guide slot 9 and the rod The link mechanism 10 operates so as to return the cylindrical high-frequency electrode 2 to the state facing straight forward, and the rod-shaped high-frequency electrode 2 projects straight forward at the axial position of the flexible sheath 1 as shown in FIG. Return to the state to do.

  In such an operation, the distal end of the operation wire 7 to which the connecting pin 8 is attached only advances and retreats the substantially axial position of the flexible sheath 1 (and the distal end frame 4), and the direction deviates from the axial position. It is not suitable for.

  As a result, the rod-like high-frequency electrode 2 can be reliably swung without losing the advance / retreat force (especially the pushing force) of the operation wire 7 and with a small operation stroke (that is, the movement distance of the operation wire 7). It can be realized.

  Then, a high frequency current is applied to the rod-shaped high-frequency electrode 2 from the operation wire 7 via the link mechanism 10 and the rod-shaped high-frequency electrode 2 is swung to cauterize the living tissue in contact with the rod-shaped high-frequency electrode 2. Thus, an incision or the like can be performed.

  FIG. 6 shows the distal end portion of the endoscope high-frequency knife according to the second embodiment of the present invention, and the rod-shaped high-frequency electrode 2 is directed in the axial direction of the distal end portion of the flexible sheath 1. A biasing means 16 for biasing the link mechanism 10 is provided. Other configurations are the same as those of the first embodiment.

  The biasing means 16 of this embodiment is a leaf spring, one end of which is fixed to the distal end frame 4 and the other end is in contact with the drive link 12, and the rod-shaped high-frequency electrode 2 as shown by a two-dot chain line. When the head is tilted forward, the biasing means 16 is bent and acts to return the drive link 12 to the original position, which may be easy to use. A spring or other urging means other than the leaf spring may be used.

  FIG. 7 shows the distal end portion of the endoscope high-frequency knife according to the third embodiment of the present invention. Contrary to the first embodiment, when the operation wire 7 is pulled from the proximal end side. The link mechanism 10 is configured such that when the rod-shaped high-frequency electrode 2 projects straight forward at the distal end of the flexible sheath 1 and is pushed in, the rod-shaped high-frequency electrode 2 swings obliquely forward. . Other configurations are the same as those of the first embodiment, and can be selected and used according to the operator's preference and application.

  8 and 9 show the distal end portion of the high-frequency knife for an endoscope according to the fourth embodiment of the present invention, in which a fixed substrate 105 is arranged in place of the fixed link 5 of the first embodiment. It is. Other configurations are the same as those of the first embodiment.

  The fixed substrate 105 is formed integrally with the distal end frame body 4 at a substantially diameter position of the distal end frame body 4, and a shaft hole 3 ′ in which the support shaft 3 engages and a guide long hole 9 are formed in the fixed substrate 105. ing. By configuring in this way, the configuration is clear and there is a merit in terms of strength.

  FIG. 10 shows the distal end portion of the endoscope high-frequency knife according to the fifth embodiment of the present invention, in which the drive link 12 is formed by an extended portion of the operation wire 7. However, the distal end portion of the operation wire 7 is fixed to the connecting pin 8 at the boundary with the drive link 12.

  Further, the plate-like fixed link 5 is arranged straight in the axial direction of the distal end portion (that is, the distal end frame 4) of the flexible sheath 1. Other configurations are the same as those of the first embodiment, and there are the same functions and effects as those of the first embodiment.

DESCRIPTION OF SYMBOLS 1 Flexible sheath 2 Rod-shaped high frequency electrode 3 Support shaft 4 Tip frame 5 Fixed link 6 Fixed pin 7 Operation wire 8 Connection pin (connection piece) 9 Guide long hole 10 Link mechanism 11 Drive link 12 Drive link 13 Link connection Pin 15 Slit 16 Biasing means 105 Fixed substrate

Claims (4)

The tip portion of the flexible sheath, and swing operable rod RF electrode around the spindle, with a link mechanism for oscillating driving the rod RF electrode is provided, the flexible sheath by the tip of the retractably inserted arranged conductive operation wire in the axial direction is coupled to the link mechanism, it is moved back and forth in the axial direction the operation wire from the proximal end of the flexible sheath within in endoscopic high-frequency knife that it is configured such that the operation wire is the rod-shaped high-frequency electrode by operating the link mechanism is a swing operation,
A connecting piece for connecting the leading end of the operating wire and the link mechanism,
A fixing member fixed in the distal end portion of the flexible sheath, having a guide slot for guiding the connecting piece so as to be movable in the axial direction, and a bearing for holding the support shaft;
With
The link mechanism is
A follower link extending rearward from the base end of the rod-shaped high-frequency electrode and having a rear end rotatably supported by the support shaft;
A drive link in which a rear end is connected to the operation wire via the connection piece, and a front end is connected to the driven link at a position closer to the front end of the driven link than the support shaft;
Have
When the operation wire is advanced and retracted in the axial direction, the drive link rotates the driven link about the support shaft through a connection point with the driven link, thereby causing the rod-shaped high-frequency electrode to move. Swinging around the support shaft,
High-frequency knife for endoscope. The connecting piece and the linkage be formed together with the conductive material, a high-frequency current is supplied from the operation wire to the rod-shaped high-frequency electrode through the connecting piece and the link mechanism,
The high-frequency knife for an endoscope according to claim 1. The guide slot is
Wherein in the distal portion of the flexible sheath is formed in a fixedly arranged fixed link or a fixed substrate,
The high-frequency knife for an endoscope according to claim 1 or 2 . Biasing means for biasing the linkage mechanism such that suited the rod RF electrode in the axial direction of the distal end portion of the flexible sheath is provided in the distal end portion of the flexible sheath,
The high-frequency knife for endoscopes according to any one of claims 1 to 3 .

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