JP5764514B2 - Endoscopic high-frequency treatment instrument - Google Patents

Description

  The present invention relates to a high-frequency treatment instrument for an endoscope that performs treatment such as hemostasis using a high-frequency current using an endoscope.

  For example, a bipolar hemostatic forceps as an endoscopic high-frequency treatment instrument opens and closes a pair of high-frequency electrodes (cups) arranged at the distal end of a sheath that is passed through an endoscopic treatment instrument guide tube. A device used to perform hemostasis by cauterizing and coagulating the tissue in the vicinity of the grasping part by operating with the operation part provided and passing a high-frequency current while grasping a living tissue such as a blood vessel with the high-frequency electrode. is there. The electrode needs to be able to rotate around the axis of the sheath for positioning with respect to the target biological tissue, and two wires are required for reciprocation to supply a high-frequency current to the electrode.

  As such a bipolar hemostatic forceps, for example, as described in Patent Document 1, one of a pair of high-frequency electrodes is used as a fixed electrode, and the other is rotatably supported as a movable electrode. It is known that only one electrode is opened and closed by connecting the slider with a wire and sliding the slider. However, in such a single-open type, when the electrode is rotated around the axis of the sheath, the center position between the two electrodes is displaced, so that it is difficult to position the electrode at the target position and there is a problem in operability. .

  For example, in Patent Document 2, each of the pair of electrodes is pivotally supported so that both of the pair of electrodes can be opened and closed, and a pair of wires is provided between each electrode and the slider of the operation unit. By connecting and sliding the slider, both the pair of electrodes are rotated to open and close. The high-frequency current is supplied to the electrodes via the pair of wires, and each wire is inserted into a pair of guide holes formed in a multi-lumen tube inserted into the sheath, and rotation around the axis of the electrode sheath is performed. This is done by rotating the multi-lumen tube within the sheath. However, the multi-lumen tube has a problem that it is difficult to process and the cost is high.

  As a technique not using an expensive multi-lumen tube, as described in Patent Documents 3 and 4, one of a pair of electric wires (wires) for supplying a high-frequency current to the electrode is used as a torque wire with high rotational transmission, By rotating the torque wire within the sheath, the electrode is rotated around the axis of the sheath.

JP 2009-119083 A JP 2007-215896 A JP 2009-142513 A JP 2010-68981 A

  However, in the thing of patent document 3 and 4, since it is the structure which wound the comparatively small diameter non-torque wire around the comparatively large diameter torque wire, or arranged in parallel, it depends on one wire (torque wire) The other wire (non-torque wire) obstructs the transmission of the rotational force, and the responsiveness of the rotation operation around the sheath axis of the electrode (the followability of the electrode rotation with respect to the rotation operation in the operation unit) is insufficient, and the sheath Since this responsiveness changes depending on the state of curvature, there is a problem that operability is poor.

  This invention is made | formed in view of such a point, and it aims at providing the high frequency treatment tool for endoscopes which can improve operativity.

  An endoscopic high-frequency treatment instrument according to the present invention includes an outer sheath, an operation portion provided at a proximal end of the outer sheath, and a substantially cylindrical conductive member attached to a distal end of the outer sheath. The fixing member has a pair of opposing arm portions protruding toward the base end portion and the distal end side, and the base end portion is attached to the fixing member so as to be rotatable around the axis of the fixing member. The electrode support member, the first electrode and the second electrode that are rotatably supported by the arm portions of the electrode support member in a state of being electrically insulated from each other, and the insulating property inserted through the outer sheath An inner sheath, a conductive drive wire inserted through the inner sheath for transmitting a rotational operation force and a slide operation force by the operation portion, and a hook attached to a distal end of the drive wire A conductive member composed of a genus member and a conductive insulating member, one end of which is attached to the metallic metal member and the other end is attached to the first electrode, and the conductive first member is electrically connected to the first electrode. A one-wire member, a second wire member having one end attached to the hook insulation insulating member and the other end attached to the second electrode, rotation of the electrode support member relative to the fixed member, and the electrode support member of the second electrode Between the return electrode attached to the electrode support member and the outer sheath and the inner sheath, which abuts on and electrically conducts each of the fixing member and the second electrode regardless of rotation with respect to And an electric wire having a distal end thereof conducted to the fixing member.

  In the endoscope high-frequency treatment instrument of the present invention, the base end portion of the electrode support member has a substantially cylindrical neck portion, the neck portion has an annular groove recessed from the outside, and the annular groove has a C-ring. The member can be loosely fitted in a rotatable manner, and the neck part into which the C-ring member is loosely fitted is inserted into the fixing member, so that the C-ring member is attached to the fixing member.

  In the endoscope high-frequency treatment instrument of the present invention, the return electrode has a substantially annular ring portion that contacts the C-ring member, and a protrusion formed on one of the C-ring member and the ring portion. By making point contact with the other, it is possible to conduct each other.

  In the endoscope high-frequency treatment instrument of the present invention, the electrode support member has a fitting groove on each outer side of the arm portion, and the return electrode is erected on the ring portion, It can be made to have a pair of side plate parts to fit.

  In the endoscope high-frequency treatment instrument according to the present invention, one of the side plate portions of the return electrode is a substantially annular washer member having conductivity, which is interposed so as to be rotatable around the rotation axis of the second electrode. Through the second electrode.

  In the endoscopic high-frequency treatment tool of the present invention, the operation section includes a tip cap having a substantially cylindrical space into which a proximal end side of the outer sheath is inserted, and the substantially cylindrical space in the tip cap. A substantially cylindrical conductive sleeve pipe attached to the outer sheath, and a small diameter inserted into the proximal end portion of the outer sheath to which the outer sheath is attached and the proximal end of the electric wire is electrically connected A conductive SK pipe having a tip tube portion and a through hole through which the inner sheath is inserted and rotatably inserted into the sleeve pipe; and a distal end side of the sleeve pipe. And a conductive coil spring provided so that a distal end thereof is fixed to the sleeve pipe and a proximal end thereof is pressed against a step surface on a proximal end side of the tip tube portion of the SK pipe. Using It is possible.

  In the endoscope high-frequency treatment instrument of the present invention, the electrode support member has a through hole extending from the base end portion to the bearing portion of the second electrode on one inner side of the arm portion, and the return electrode includes the return electrode A substantially annular ring portion that abuts on the C ring member, and is erected on the ring portion, is exposed at the bearing portion of the second electrode through the through hole, and is electrically connected to the second electrode It can have a pin part.

  In the endoscopic high-frequency treatment instrument of the present invention, the metal metal member is formed in a substantially cylindrical shape and is welded and fixed to a distal end of the drive wire, and the metal insulating member is distant from the metal metal member. The hook insulation insulating member is inserted from the distal end side, and has a recessed portion in which the vicinity of the other end of the first wire member is disposed, and the first wire member has the other end of the first wire member in the recessed portion. In a state of being in contact with the bottom surface of the part, it can be welded and fixed to the metal metal member and electrically connected to the drive wire through the metal metal member.

  In the endoscope high-frequency treatment instrument of the present invention, the rotation operation force for rotating the electrode and the slide operation force for opening and closing the electrode by the operation unit are transmitted via the drive wire and the jumper member, and the first wire member is further transmitted. To the first electrode and to the second electrode via the second wire member. The high-frequency circuit is formed by a drive wire, a first wire member, a first electrode, a second electrode, a return electrode, a fixing member, and an electric wire. An inner sheath is interposed between the electric wire and the drive wire, the drive wire can rotate within the inner sheath without receiving interference from the electric wire, and transmission of rotational force by the drive wire is hindered by the electric wire. Absent. Accordingly, the responsiveness of the electrode rotation operation (followability of the electrode rotation with respect to the rotation operation in the operation unit) can be improved, and the change in the responsiveness due to the bending state of the sheath is reduced, thereby realizing high operability. be able to.

It is a top view which shows the whole structure of the high frequency treatment tool for endoscopes of embodiment of this invention. It is sectional drawing along the AA line of FIG. It is a perspective view which shows the structure of the operation part of the high frequency treatment tool for endoscopes of embodiment of this invention. It is a cutting perspective view showing composition of an operation part of a high frequency treatment instrument for endoscopes of an embodiment of the present invention. It is sectional drawing which shows the structure of the operation part of the high frequency treatment tool for endoscopes of embodiment of this invention. It is the top view which shows the structure of the distal end vicinity of the high frequency treatment tool for endoscopes of embodiment of this invention, and shows the state which closed the cup. It is the side view which shows the structure of the distal end vicinity of the high frequency treatment tool for endoscopes of embodiment of this invention, and shows the state which closed the cup. It is the side view which shows the structure of the distal end vicinity of the high frequency treatment tool for endoscopes of embodiment of this invention, and shows the state which closed the cup. It is sectional drawing along the BB line of FIG. It is a perspective view which shows the structure of the distal end vicinity of the high frequency treatment tool for endoscopes of embodiment of this invention. It is a cutting perspective view showing composition near a distal end of a high frequency treatment instrument for endoscopes of an embodiment of the present invention. It is the side view which shows the structure of the distal end vicinity of the high frequency treatment tool for endoscopes of embodiment of this invention, and shows the state which opened the cup. It is a top view which shows the structure of the distal end vicinity of the high frequency treatment tool for endoscopes of embodiment of this invention, and shows the state which opened the cup. It is a disassembled perspective view which shows the rotation mechanism around the sheath axis line of the high frequency treatment tool for endoscopes of embodiment of this invention. It is a disassembled perspective view which shows the rotation mechanism around the sheath axis line of the high frequency treatment tool for endoscopes of embodiment of this invention. It is a disassembled perspective view which shows the rotation mechanism around the sheath axis line of the high frequency treatment tool for endoscopes of embodiment of this invention. It is a perspective view which shows the rotation mechanism around the sheath axis line of the high frequency treatment tool for endoscopes of embodiment of this invention. It is sectional drawing which shows the rotation mechanism around the sheath axis line of the high frequency treatment tool for endoscopes of embodiment of this invention. It is a side view which shows the rotation mechanism around the sheath axis line of the high frequency treatment tool for endoscopes of embodiment of this invention. It is sectional drawing which shows the vicinity of the 2nd electrode of the high frequency treatment tool for endoscopes of embodiment of this invention. It is a disassembled perspective view which shows the structure of the distal end vicinity of the drive wire of the high frequency treatment tool for endoscopes of embodiment of this invention. It is a perspective view which shows the structure of the distal end vicinity of the drive wire of the high frequency treatment tool for endoscopes of embodiment of this invention. It is sectional drawing which shows the structure of the distal end vicinity of the drive wire of the high frequency treatment tool for endoscopes of embodiment of this invention. It is a cutting | disconnection perspective view which shows the structure of the operation part of the high frequency treatment tool for endoscopes of the 2nd Embodiment of this invention. It is sectional drawing which shows the structure of the operation part of the high frequency treatment tool for endoscopes of the 2nd Embodiment of this invention. It is a perspective view which shows the structure of the distal end vicinity of the high frequency treatment tool for endoscopes of the 3rd Embodiment of this invention. It is a cutting | disconnection perspective view which shows the structure of the distal end vicinity of the high frequency treatment tool for endoscopes of the 3rd Embodiment of this invention. It is a perspective view which shows the structure of the distal end vicinity of the high frequency treatment tool for endoscopes of the 3rd Embodiment of this invention. It is a disassembled perspective view which shows the rotation mechanism around the sheath axis line of the high frequency treatment tool for endoscopes of the 3rd Embodiment of this invention. It is a perspective view which shows the rotation mechanism around the sheath axis line of the high frequency treatment tool for endoscopes of the 3rd Embodiment of this invention. It is a side view which shows the rotation mechanism around the sheath axis line of the high frequency treatment tool for endoscopes of the 3rd Embodiment of this invention. It is sectional drawing which shows the rotation mechanism around the sheath axis line of the high frequency treatment tool for endoscopes of the 3rd Embodiment of this invention. It is a perspective view which shows the structure of the resin wax of the high frequency treatment tool for endoscopes of the 3rd Embodiment of this invention. It is a perspective view which shows the structure of the resin wax of the high frequency treatment tool for endoscopes of the 3rd Embodiment of this invention. It is sectional drawing which shows the structure of the distal end vicinity of the high frequency treatment tool for endoscopes of the 3rd Embodiment of this invention. It is a perspective view which shows the structure of the distal end vicinity of the drive wire of the high frequency treatment tool for endoscopes of the 3rd Embodiment of this invention. It is sectional drawing which shows the structure of the distal end vicinity of the drive wire of the high frequency treatment tool for endoscopes of the 3rd Embodiment of this invention. It is a perspective view which shows the structure of the electrode of the high frequency treatment tool for endoscopes of the 3rd Embodiment of this invention. It is a perspective view which shows the structure of the electrode of the high frequency treatment tool for endoscopes of the 3rd Embodiment of this invention. It is a perspective view which shows the structure of the insulation spacer of the high frequency treatment tool for endoscopes of the 3rd Embodiment of this invention. It is a side view which shows the structure of the forceps part of the high frequency treatment tool for endoscopes of the 3rd Embodiment of this invention. It is sectional drawing which shows the structure of the forceps part of the high frequency treatment tool for endoscopes of the 3rd Embodiment of this invention. It is a perspective view which shows the structure of the electrode of the high frequency treatment tool for endoscopes of the 4th Embodiment of this invention. It is a side view which shows the structure of the electrode of the high frequency treatment tool for endoscopes of the 4th Embodiment of this invention. It is a side surface which shows the structure of the forceps part of the high frequency treatment tool for endoscopes of the 4th Embodiment of this invention. It is sectional drawing along the A-A 'line | wire of FIG. FIG. 46 is a cross-sectional view taken along line B-B ′ or D-D ′ in FIG. 45. FIG. 46 is a cross-sectional view taken along line C-C ′ of FIG. 45. It is a cross-sectional perspective view along the E-E 'line of FIG.

  Hereinafter, a bipolar hemostatic forceps as a high-frequency endoscopic treatment tool according to an embodiment of the present invention will be specifically described with reference to the drawings. However, the present invention is not limited to the bipolar hemostatic forceps, but can be applied to a bipolar knife including a pair of high-frequency electrodes that can be opened and closed.

  As shown in FIG. 1, the bipolar hemostatic forceps of the present embodiment is generally configured by including a sheath portion 1, an operation portion 2, and a forceps portion 3. An operation portion 2 is provided at the proximal end of the sheath portion 1, and a forceps portion 3 is provided at the distal end of the sheath portion 1.

  The operation unit 2 includes a base 21 and a slider 22 slidably attached to the base 21, and the forceps unit 3 includes a pair of high-frequency electrodes (a first electrode 31a and a second electrode 31b) provided to be openable and closable. A cup 31 is provided. In the operation unit 2, the cup 31 can be opened by sliding the slider 22 toward the distal end side (lower side in FIG. 1) with respect to the base 21, and conversely, the slider 22 is moved to the base end side with respect to the base 21. The cup 31 can be closed by sliding it upward (in FIG. 1). Further, the operation unit 2 includes a pair of electric wires (cables) 24a and 24b and a plug 24 provided at the tip thereof, and these electric wires 24a and 24b are connected to the high-frequency power supply device (not shown) via the plug 24. Are electrically connected to each other to receive a high-frequency current. As will be described in detail later, the electric wire 24a is electrically connected to the electrode 31a, and the electric wire 24b is electrically connected to the electrode 31b.

  As shown in FIG. 2, the sheath portion 1 includes a tubular outer sheath 11, a tubular inner sheath 12, a drive wire 13, and an electric wire 14. The outer sheath 11 is made of a flexible hollow tube, and in this embodiment, a tube made of an insulating resin is used. The inner sheath 12 is formed of a flexible hollow tube, and in this embodiment, a tube formed of an insulating resin is used. The resin material forming the outer sheath 11 and the inner sheath 12 is not particularly limited as long as it is an electrically insulating material, and includes polyethylene, polypropylene, polyvinyl chloride, polyurethane, polyamide, polyester, polycarbonate, polyethersulfone, fluororesin, and the like. Can be used.

  The drive wire 13 is inserted into the inner sheath 12, and the inner sheath 12 is inserted into the outer sheath 11. The drive wire 13 can rotate and slide (slide movement in the direction along the axial direction) around its axis within the inner sheath 12.

  The drive wire 13 is made of a flexible and conductive wire (torque wire), and the drive wire 13 can be a single wire made of metal such as stainless steel. However, a wire rope or a wire tube may be used as the drive wire 13. Here, the wire rope is a rope made of a stranded wire formed by spirally twisting a plurality of wires made of a metal wire such as stainless steel. Moreover, a wire tube is a tube which consists of a hollow strand wire formed by twisting a plurality of wires made of metal wires such as stainless steel in a spiral shape so as to be hollow. The drive wire 13 is a power transmission member for transmitting a sliding force for opening and closing the cup 31 and a rotational force for rotating the cup 31 around a sheath axis for adjusting its posture. Although details will be described later, the proximal end of the drive wire 13 is electrically connected to the electric wire 24 a of the operation unit 2, and the distal end is electrically connected to one electrode 31 a constituting the cup 31. Has been.

  An electric wire 14 made of a metal such as stainless steel having conductivity is inserted between the outer sheath 11 and the inner sheath 12. In addition, although mentioned later for details, the proximal end of this electric wire 14 is electrically connected to the electric wire 24b of the operation part 2, and the distal end is electrically connected to the other electrode 31b which comprises the cup 31. ing.

  As shown in FIGS. 3 to 5, the operation unit 2 is configured to include a base 21, a slider 22, and a tip cap 23. The base 21 has a ring portion 21a and a guide portion 21b having a guide groove. The slider 22 is attached to be slidable back and forth along the guide portion 21 b of the base 21. A tip cap 23 is attached to the tip (distal end) of the base 21. The base 21, the slider 22 and the tip cap 23 are mainly formed from an insulating resin.

  The distal end cap 23 has a substantially cylindrical space inside the distal end portion side, and the outer sheath 11, the inner sheath 12, the drive wire 13, and the electric wire 14 through a penetration portion formed at the distal end of the distal end cap 23. The proximal end of the sheath part 1 provided with is inserted. A substantially cylindrical sleeve pipe 25 made of a conductive metal such as stainless steel is attached in the substantially cylindrical space in the tip cap 23, and the SK pipe 26 rotates in the sleeve pipe 25. Interpolated as possible. The SK pipe 26 is made of a conductive metal such as stainless steel, and has a thin-walled and small-diameter tip tube portion 26a on the distal end side.

  The outer sheath 11 is attached to the SK pipe 26 in a state where the distal end cylindrical portion 26a of the SK pipe 26 is inserted inside the proximal end. The inner sheath 12 is inserted so that the vicinity of the proximal end thereof reaches a proximal end of a through hole formed in the longitudinal direction of the SK pipe 26. The drive wire 13 further extends through the through hole of the SK pipe 26, and its proximal end is fixed to a sleeve 27 provided on the slider 22 with a screw 28. The proximal end of the electric wire 14 inserted through the portion between the outer sheath 11 and the inner sheath 12 is electrically connected to the tip of the tip tube portion 26a of the SK pipe 26 by laser welding, brazing, or the like. Yes.

  Although not shown, the proximal end of the drive wire 13 is electrically connected to the electric wire 24 a at a fixing portion by a screw 28 with the sleeve 27 of the slider 22. Further, the sleeve pipe 25 is electrically connected to the electric wire 24b. Therefore, the electric wire 14 is electrically connected to the electric wire 24b via the SK pipe 26 and the sleeve pipe 25.

  With such a configuration, the slider 22 is slid back and forth (up and down in FIG. 1) with respect to the base 21 in the operation unit 2, and the drive wire 13 can be slid in the axial direction within the sheath portion 1. By rotating the operation portion 2 with respect to the sheath portion 1 (outer sheath 11), the drive wire 13 can be rotated around the axis within the sheath portion 1.

  As shown in FIGS. 6 to 13, the forceps portion 3 includes a cup 31 including a first electrode 31 a and a second electrode 31 b that are a pair of high-frequency electrodes, a resin wax (electrode support member) 32, and a return electrode 33. , A C ring (C ring member) 34, a fixing bracket (fixing member) 35, and the like.

  As shown in FIGS. 14 to 19, the resin casing 32 is configured by a pair of arm portions 32 a and 32 b that are opposed to each other at a base end portion having a substantially cylindrical neck portion 32 c. . An annular groove 32d that is recessed from the outside is formed in the neck 32c of the resin wax 32. Through holes 32e and 32f are formed in the vicinity of the tip portions of the pair of arm portions 32a and 32b, respectively. A fitting groove 32g is formed on the outer side of each of the pair of arm portions 32a and 32b.

  The return electrode 33 is formed of a conductive metal such as stainless steel, and as shown in FIGS. 14 to 19, as shown in FIGS. And a pair of side plate portions 33a and 33b facing each other. Through holes 33e and 33f are formed in the vicinity of the tip portions of the side plate portions 33a and 33b, respectively.

  The return electrode 33 is formed in the hole of the slip ring portion 33c so that the pair of side plate portions 33a and 33b are fitted along the fitting grooves 32g formed in the pair of arm portions 32a and 32b of the resin casing 32. The neck 32c of the resin casing 32 is inserted and attached to the resin casing 32 integrally. As shown in FIGS. 14 and 19, the slip ring portion 33 c of the return electrode 33 slightly protrudes on the opposite side to the pair of side plate portions 33 a and 33 b (lower side in FIG. 19, C ring 34 side). A pair of protrusions 33d (only one is shown in FIG. 19) is formed. These protrusions 33d are formed at 180 ° counter electrode positions. However, the number of the protrusions 33d may be one, or three or more may be disposed at equiangular intervals. Further, instead of providing such a protrusion 33d on the slip ring portion 33c, one or more protrusions may be provided on the corresponding end surface of the C ring 34 to make point contact.

  The C-ring 34 is formed of a conductive metal such as stainless steel, and as shown in FIGS. 14 to 19, a member formed by bending a substantially strip-shaped metal flat plate into a substantially C-shape. It is. The C ring 34 is loosely fitted in an annular groove 32d formed in the neck portion 32c of the resin casing 32 with a slight clearance (clearance), and the C ring 34 is attached to the annular groove 32d of the resin casing 32 in a state where the resin casing 32 It can be freely rotated with respect to 32.

  As shown in FIGS. 14 to 19, the fixing bracket 35 is a substantially cylindrical member formed of a conductive metal such as stainless steel, and has a small diameter portion 35 a and a large diameter portion 35 b. doing. The distal end of the inner sheath 12 is inserted and fixed to the inside of the small-diameter portion 35a of the fixture 35 (see FIG. 9). The small-diameter portion 35a of the fixture 35 is inserted inward from the distal end of the outer sheath 11, and is adhered and fixed to the outer sheath 11 (see FIG. 9). In addition, the distal end of the electric wire 14 wired in the portion between the outer sheath 11 and the inner sheath 12 is electrically connected to the end of the small diameter portion 35 a of the fixing bracket 35.

  As shown in FIG. 14, the resin electrode 32, the return electrode 33, the C ring 34, and the fixture 35 are disassembled, and the return electrode 33 is returned to the resin electrode 32 as shown in FIG. 15. Then, as shown in FIG. 16, the C ring 34 is fitted into the annular groove 32 d formed in the neck portion 32 c of the resin wax 32. After that, as shown in FIG. 17, the resin casing 32 to which the return electrode 33 and the C ring 34 are attached is inserted into the inside of the large diameter portion 35 b of the fixing bracket 35 with the neck portion 32 c being inserted into the fixing bracket 35. The end face of the large-diameter portion 35b and the protrusion 33d of the slip ring 33c of the return electrode 33 are brought into contact with each other, and in this state, the C ring 34 is welded to the fixing bracket 35, whereby the return electrode 33 and the C ring 34 are The attached resin wafer 32 is attached to the fixing bracket 35.

  Thereby, the resin casing 32 and the return electrode 33 can rotate around the axis line with respect to the fixing bracket 35, and the fixing bracket 35 and the return electrode 33 are kept in an electrically conductive state regardless of the rotation position. Be able to. Since the C ring 34 and the return electrode 33 are in point contact via the protrusion 33d of the slip ring part 33c, the friction of the resin ring 32 and the return electrode 33 are smoothly rotated while maintaining a reliable conduction. To be made.

  As shown in FIGS. 6 to 13, the first electrode 31 a and the second electrode 31 b constituting the cup 31 are arranged in a substantially X shape, and a pair of resin waxes 32 are arranged at the intersections with each other. It is rotatably supported between the arm portions 32a and 32b. The first electrode 31a and the second electrode 31b are insulated from each other by an insulating spacer 36 made of an insulating resin. That is, the first electrode 31a and the second electrode 31b have a through hole formed in the middle portion thereof, and a pair of cylindrical shaft portions 36a (see FIG. 11) projecting on both sides of the insulating spacer 36 are respectively provided. Each is supported rotatably by being inserted into the corresponding through hole. Then, a substantially cylindrical king pin 37 is inserted into the shaft portion 36 a of the insulating spacer 36, and both ends of the king pin 37 are supported by the through holes 33 e and 33 f of the side plate portions 33 a and 33 b of the return electrode 33.

  As shown in FIG. 20, a metal washer (washer member) 39 made of a conductive metal such as stainless steel is inserted into the through hole 32 f of the arm portion 32 b, and the king pin 37 is located at the center of the metal washer 39. The return electrode 33 is supported by the through hole 33f of the side plate portion 33b through the through hole. The metal washer 39 is sandwiched between the side plate portion 33b of the return electrode 33 and the second electrode 31b, that is, one surface thereof is on the inner surface of the side plate portion 33b of the return electrode 33 and the other surface is the second electrode. The second electrode 31b is kept in electrical conduction with the return electrode 33 through the washer 39 regardless of the rotation of the second electrode 31b. . The through hole 32e of the arm portion 32a is not provided with such a conductive washer. Therefore, the first electrode 31a is electrically insulated from the return electrode 33 (side plate portion 33a). It keeps the state.

  The power transmission mechanism between the distal end of the drive wire 13 and the first electrode 31a and the second electrode 31b constituting the cup 31 is as shown in FIG. 9, FIG. 11, FIG. It is configured to include a metal work member 19, a work insulation member 15, a work washer 16, a pair of straight lines 17 a and 17 b and a pipe 18.

  The bush metal member 19 is a substantially columnar member formed of a conductive metal, and has a hole 19a for inserting the distal end of the drive wire 13 on the proximal end side thereof. The distal end of the drive wire 13 is inserted into 19a, and is connected and fixed in a state of being electrically conducted by laser welding or brazing. Moreover, the jumpy metal member 19 has a concave portion 19b for attaching the straight line 17a to the distal end side thereof.

  The jumpsuit insulating member 15 is a substantially columnar member formed of an insulating resin, and has a single hole 15c having a relatively large diameter on the proximal end side and a hole 15c from the distal end side. It has a pair of relatively small diameter holes 15a and 15b. The hole 15c of the bush insulation member 15 is a hole for inserting and fixing the bush metal member 15 and the lock washer 16, and the pair of holes 15a and 15b are holes for inserting and fixing the straight lines 17a and 17b, respectively. A part of the proximal end side (hole 15c side) of the hole 15b into which the straight line 17b is inserted is a medium diameter portion 15d formed slightly thicker. A pipe 18 is inserted into the middle diameter portion 15d.

  The collar washer 16 is a substantially disk-shaped member made of an insulating resin, and has a recess 16a for passing a straight line 17a.

  The straight lines 17a and 17b are each formed from a single wire made of a conductive metal such as stainless steel. On the proximal end side of the straight line 17b, the pipe 18 is fixed in a state of being inserted through the hole 15b of the jumper insulating member 15, and the portion where the pipe 18 is fixed is inside the middle diameter portion 15d of the jumper insulating member 15. Be placed. The proximal end side of the straight line 17a passes through the hole 15a of the jumper insulating member 15 and the recess 16a of the jumper washer 16, and is positioned in the recess 19b of the jumper metal member 19. The connection is fixed in an electrically conductive state by attaching or the like. The joint washer 16 and the joint metal member 19 are inserted into the hole 15c of the joint insulation member 15, and are fixed to the joint insulation member 15 by an adhesive 19c. Thereby, the straight line 17a is electrically connected to the drive wire 13 via the metal metal member 19. On the other hand, the straight line 17b is insulated from the bush metal member 19 because the bush washer 16 as an insulating member is interposed.

  As shown in FIGS. 9 and 11, the distal end of the straight line 17a is attached to a hole formed near the proximal end of the first electrode 31a, and the distal end of the straight line 17b is The second electrode 31b is attached to a hole formed in the vicinity of the proximal end.

  When the slider 22 is slid to the distal end side with respect to the base 21, the drive wire 13 is slid to the distal end side, and the straight line 17 a and A sliding force is transmitted to the straight line 17b, the first electrode 31a is rotated in a direction away from the second electrode 31b via the straight line 17a, and the second electrode 31b is moved from the first electrode 31a via the straight line 17b. The cup 31 can be opened by being rotated in the direction of separation. On the contrary, when the slider 22 is slid to the proximal end side with respect to the base 21, the drive wire 13 is slid to the proximal end side along with this, and via the jumper metal member 19 and the jumper insulating member 15, A sliding force is transmitted to the straight line 17a and the straight line 17b, the first electrode 31a is rotated in the direction approaching the second electrode 31b via the straight line 17a, and the second electrode 31b is rotated via the straight line 17b. The cup 31 can be closed by being rotated in the direction approaching the first electrode 31a.

  When the operation portion 2 including the base 21 and the slider 22 is rotated around the axis of the sheath portion 1 (outer sheath 11), the drive wire 13 is rotated along with this, and the metal metal member 19 and the bush insulation member 15 are rotated. Rotational force (torque) is evenly transmitted to the first electrode 31a and the second electrode 31b via the straight line 17a and the straight line 17b, and the resin casing 32 rotates with respect to the fixing bracket 35, so that the cup 31 is desired. It can be adjusted to the posture (rotational position).

  As described above, the rotation operation force for rotating the electrode and the slide operation force for opening and closing the electrode by the operation unit are transmitted via the drive wire and the contact member composed of at least the contact metal member and the contact insulating member. Furthermore, it is transmitted to the first electrode via the first wire member and to the second electrode via the second wire member.

  According to the above-described embodiment, the first electrode 31a, which is one high-frequency electrode constituting the cup 31, is connected to the high-frequency power supply device (not shown) via the straight line 17a, the metal jumper member 19, the drive wire 13, and the electric wire 24a. The second electrode 31b which is electrically connected to one of the electrodes and the other high-frequency electrode is a metal washer 39, a return electrode 33, a C ring 34, a fixture 35, an electric wire 14, a sleeve pipe 25, an SK pipe 26, an electric wire. It is electrically connected to the other pole of the high-frequency power supply device (not shown) via 24b. Transmission of power for opening and closing the cup 31 and rotation about its axis is performed by the drive wire 13, and the electric wire 14 and the drive wire 13 are separated by the inner sheath 12. Does not interfere with sliding or rotating motion. Accordingly, it is possible to improve the responsiveness of the rotating operation of the cup 31 (following performance of the electrode rotation with respect to the rotating operation in the operating portion) and the responsiveness of the sliding operation, and the change in the responsiveness due to the curved state of the sheath is reduced. High operability can be realized. Since the electric wire 14 and the drive wire 13 are separated by the inner sheath 12, there is no electrical interference.

  Further, the C ring 34 is loosely fitted in the annular groove 32d of the neck 32c at the base end portion of the resin wax 32, and the neck 32c in which the C ring 34 is loosely fitted is fitted to the large diameter portion 35b of the fixing bracket 35. Since the C ring 34 is attached to the fixing bracket 35 by being inserted, the resin casing 32 can be stably and rotatably supported on the fixing bracket 35.

  Further, the return electrode 33 has a substantially annular slip ring portion 33 c that contacts the C ring 34. The slip ring portion 33 c is provided with a protrusion 33 d, and the protrusion 33 d is in point contact with the end surface of the C ring 34. Therefore, the frictional resistance can be reduced, and the cup 31 can be smoothly rotated while maintaining a good electrical connection state.

  The resin casing 32 has fitting grooves 32g on the outer sides of the pair of arm portions 32a and 32b, and the return electrode 33 is erected on the slip ring portion 33c and is fitted to the fitting grooves 32g. Since the side plate portions 33a and 33b are provided, when these are combined, the resin casing 32 is reinforced by the return electrode 33, and the rigidity of the resin casing 32 can be improved. Thereby, the sliding force and rotational force from the drive wire 13 can be transmitted with high efficiency.

  In addition, the side plate portion 33b of the return electrode 33 is electrically connected to the second electrode 31b via a conductive metal washer 39 that is rotatably provided around the rotation axis (king pin 37) of the second electrode 31b. As a result, the electrical conduction state can be stably maintained without hindering the rotation of the second electrode 31b around the king pin 37 associated with the opening and closing of the cup 31.

  Next, a second embodiment obtained by improving a part of the above-described embodiment (hereinafter referred to as the first embodiment) will be described with reference to FIGS. In addition, about the same component as 1st Embodiment mentioned above, the same code | symbol is attached | subjected and the description is abbreviate | omitted.

  In the above-described embodiment, a structure in which the SK pipe 26 is rotatably inserted in the sleeve pipe 25 inserted in the tip cap 23 is adopted. With this structure, the sleeve pipe 25 and the SK pipe 26 are separated from each other. It is possible to ensure conduction. However, there is a clearance (gap) between these two members (sleeve pipe 25 and SK pipe 26) that does not interfere with rotation, and there is a possibility that poor contact may occur depending on manufacturing errors. It cannot be completely denied. Therefore, in the second embodiment, the coil spring 41 is additionally provided in the sleeve pipe 25, so that the reliability of conduction between these members is further improved.

  That is, the coil spring 41 is inserted on the distal end 25 a side of the sleeve pipe 25. The coil spring 41 is made of a conductive material such as stainless steel. The distal end 41a of the coil spring 41 is welded and fixed to the distal end 25a of the sleeve pipe 25 by laser welding or the like. Therefore, the coil spring 14 is electrically connected to the sleeve pipe 25 at least in this fixed portion. The proximal end 41b of the coil spring 41 is in pressure contact with the stepped surface (stepped portion) 26b on the proximal end side of the distal end cylindrical portion 26a of the SK pipe 26 by its own urging force in a state compressed to an appropriate load. doing. The proximal end 41b of the coil spring 41 is an end turn to ensure sufficient contact (conduction) with the step surface 26b. Note that the distal end 41a of the coil spring 41 may also be an end turn. With this configuration, the SK pipe 26 electrically connected to the electric wire 14 at the distal end 26c of the distal end cylindrical portion 26a is in a conductive state with the sleeve pipe 25 via at least the coil spring 41 without hindering rotation with respect to the sleeve pipe 25. Can always keep.

  The length, diameter, wire diameter, number of turns, pitch, spring constant, compression length, etc. of the coil spring 41 do not inhibit the rotation of the SK pipe 26 in the sleeve pipe 25 and are always in conductive contact with the SK pipe 26. As appropriate, it is selected. The specifications of the coil spring 41 are specifically selected so that the load is about 0.05 to 1N in the assembled state (a state in which the coil spring 41 is compressed by a predetermined amount). If the load is less than 0.05N, conduction may become unstable, and if the load exceeds 1N, smooth rotation may be hindered.

  Next, a third embodiment obtained by improving a part of the above-described first embodiment will be described with reference to FIGS. In addition, about the same component as 1st Embodiment mentioned above, the same code | symbol is attached | subjected and the description is abbreviate | omitted.

  In the third embodiment, the configuration of the forceps portion 3 of the first embodiment described above is improved. As shown in FIGS. 26 to 28, the forceps portion of the third embodiment includes a cup 131 including a first electrode 131 a and a second electrode 131 b that are a pair of high-frequency electrodes, a resin wax (electrode support member). ) 132, a return electrode 133, a C-ring (C-ring member) 134, a fixing bracket (fixing member) 135, and the like.

  As shown in FIGS. 29 to 34, the resin wax 132 is constituted by a pair of arm portions 132 a and 132 b that are opposed to each other at a base end portion having a substantially cylindrical neck portion 132 c. . An annular groove 132d that is recessed from the outside is formed in the neck 132c of the resin wax 132. Through holes 132e and 132f are formed in the vicinity of the distal ends of the pair of arm portions 132a and 132b, respectively.

  The return electrode 133 is made of a conductive metal such as stainless steel, and as shown best in FIG. 29, the return electrode 133 is erected on a substantially annular slip ring portion (ring portion) 133c. It has a single pin part (wax conducting wire) 133b.

  The return electrode 133 is formed by inserting the neck portion 132c of the resin casing 132 into the hole of the slip ring portion 133c so that the pin portion 133b is inserted along the through hole 132g formed in the arm portion 132b of the resin casing 132. It is attached to the resin casing 132 integrally.

  The C-ring 134 is made of a conductive metal such as stainless steel, and as shown in FIGS. 29 to 32, a slight gap is formed in the annular groove 132d formed in the neck 132c of the resin wax 132. It is loosely fitted with (clearance), and the C-ring 134 can be freely rotated with respect to the resin casing 132 while being attached to the annular groove 132d of the resin casing 132.

  As shown in FIGS. 27 and 29 to 32, the fixing bracket 135 is a substantially cylindrical member formed of a conductive metal such as stainless steel. The distal end of the inner sheath 12 is inserted and fixed to the inside of the fixture 135 (see FIGS. 27 and 32). The fixing metal 135 is inserted inward from the distal end of the outer sheath 11, and is adhered and fixed to the outer sheath 11 (see FIGS. 27 and 32). Moreover, the distal end of the electric wire 14 wired in the part between the outer sheath 11 and the inner sheath 12 is electrically connected to the end of the fixing bracket 135 (see FIG. 32).

  As shown in FIG. 29, from the state where the resin casing 132, the return electrode 133, the C ring 134 and the fixing bracket 135 are disassembled, as shown in FIGS. The pin portion 133b of the return electrode 133 is inserted into the through hole 132g of the arm portion 132b, the return electrode 133 is attached to the resin casing 132, and then the C ring 134 is inserted into the annular groove 132d formed in the neck portion 132c of the resin casing 132. Fit. After that, the resin bag 132 to which the return electrode 133 and the C ring 134 are attached is inserted into the neck of the fixing bracket 135 with the neck portion 132c, and in this state, the C ring 134 is welded to the fixing bracket 135 to return. The resin cloth 132 to which the electrode 133 and the C ring 134 are attached is attached to the fixing bracket 135.

  Thereby, the resin casing 132 and the return electrode 133 can rotate around the axis with respect to the fixing bracket 135, and the fixing bracket 135 and the return electrode 133 are kept in an electrically conductive state regardless of the rotation position. Be able to.

  As shown in FIGS. 26 to 28, the first electrode 131 a and the second electrode 131 b constituting the cup 131 are arranged in a substantially X shape with each other, and at a crossing portion of each other, It is rotatably supported between the arm portions 132a and 132b. The first electrode 131a and the second electrode 131b are insulated from each other by an insulating spacer 136 made of an insulating resin.

  As shown in FIG. 38 and FIG. 39, the first electrode 131a and the second electrode 131b have a through hole 131c formed in an intermediate portion thereof. A direction (hereinafter referred to as a longitudinal direction) in which a plurality of (for example, three) crests 131d extending in a direction along the rotation axis of the two electrodes 131b (hereinafter sometimes referred to as a lateral direction) is substantially orthogonal to the lateral direction. And tip convex teeth 131e are formed. A single front end vertical groove 131f is formed along the vertical direction in the central portion of the front end convex tooth 131e.

  The first electrode 131a and the second electrode 131b are formed with a through hole 131c at an intermediate portion thereof, and a through hole 131g for attaching the first line member 117a or the second line member 117b is formed on the rear end side. Is formed. In addition, a protrusion 131h is formed on one surface of the first electrode 131a (the surface that contacts the insulating spacer 136) (see FIG. 39). Note that a protrusion 131h similar to the first electrode 131a may be formed on the second electrode 131b.

  The insulating spacer 136 has a substantially cylindrical shaft portion 136a having a through hole 136b in the center portion on one surface side (see FIGS. 35 and 40), and has a substantially cylindrical shape on the other surface side. It has the recessed part 136d recessed in the annular | circular shape with which the metal washer (washer member) 139 is fitted (refer FIG. 35).

  On one surface of the insulating spacer 136, as shown in FIG. 40, a guide groove 136c having a substantially arc shape is formed at a position substantially corresponding to the protrusion 131h of the first electrode 131a. The guide groove 136c is for defining the rotation angle range of the first electrode 131a and thus the opening angle of the cup 131 by loosely fitting the protrusion 131h of the first electrode 131a (FIG. 41, FIG. 41). (See FIG. 42). When the same protrusion as the protrusion 131h of the first electrode 131a is formed on the second electrode 131b, the same guide groove 136c as the corresponding guide groove 136c is formed on the other surface of the insulating spacer 136. A groove is provided.

  As shown in FIG. 35, the first electrode 131a is rotatably supported by the insulating spacer 136 by inserting the shaft portion 136b of the insulating spacer 136 into the through hole 131c. The second electrode 131b is rotatably supported by the insulating spacer 136 by inserting a metal washer 139 into the through hole 131c and fitting the metal washer 139 into the recess 136d of the insulating spacer 136. A substantially cylindrical king pin 137 is inserted into the through hole 136b of the insulating spacer 136 and the central through hole of the metal washer 139, one end of the king pin 137 is inserted into the through hole 132e of the arm portion 132a, and the insulating spacer 136 of the metal washer 139. The first electrode 131a and the second electrode 131b that are rotatably supported by the insulating spacer 136 are fitted into the pair of arm portions 132a and 132b by fitting and fixing the tip portion opposite to the through hole 132f of the arm portion 132b. Supported in between.

  As shown in FIG. 35, the tip end portion of the pin portion 133b of the return electrode 133 inserted through the through hole 132g formed in the arm portion 132b of the resin casing 132 is placed in the through hole 132f of the arm portion 132b. The protruding and exposed state where the tip of the metal washer 139 fitted in the through hole 132f of the arm part 132b and the exposed part near the tip of the pin part 133b are electrically connected by laser welding or the like The connection is fixed with. As a result, the second electrode 131b is kept electrically connected to the return electrode 133 via the washer 139 regardless of its rotation.

  As shown in FIGS. 27, 36 and 37, the power transmission mechanism between the distal end of the drive wire 13 and the first electrode 131a and the second electrode 131b constituting the cup 131 is a metal metal member. 119, a spring insulation member 115, a pair of straight lines 117a and 117b, and a pipe 118.

  The bush metal member 119 is a substantially cylindrical member formed of a conductive metal, and has a hole 119a for inserting the distal end of the drive wire 13 on the proximal end side thereof. The distal end of the drive wire 13 is inserted into 119a, and is connected and fixed in an electrically conductive state by laser welding or the like.

  The bush insulation member 115 is a substantially cylindrical member formed of an insulating resin, and has a relatively large-diameter hole 115d on the proximal end side and a relatively long hole 115d extending from the distal end side to the hole 115d. Has a small diameter hole 115b. Moreover, the bush insulation member 115 has a recess 115a having a bottom surface 115c. The recessed part 115a of the insulative insulating member 115 is a part for arranging and fixing the straight line 117a, and the hole 115b of the insulative insulating member 115 is a hole for inserting and fixing the straight line 117b.

  The straight lines 117a and 117b are each formed from a single wire made of a conductive metal such as stainless steel. On the proximal end side of the straight line 117b, the pipe 118 is connected and fixed by laser welding or the like in a state of being inserted into the hole 115b of the spring insulating member 115, and the portion where the pipe 118 is fixed is the hole of the spring insulating member 115. 115d. The bush insulation member 115 is inserted into the bush metal member 119 from the distal end side, and is adhered and fixed to the bush metal member 119 with an adhesive. The proximal end side of the straight line 117a is disposed along the recessed portion 115a of the contact insulating member 115, and the metallic contact member 119 is in a state where the proximal end surface of the straight line 117a is in contact with the bottom surface 115c of the recessed portion 115a. Are connected and fixed in an electrically conductive state by laser welding or the like. Thereby, the straight line 117a is electrically connected to the drive wire 13 via the metal metal member 119. On the other hand, since the straight insulation member 115 is interposed in the straight line 117b, it is in a state of being insulated from the joint metal member 119.

  As shown in FIG. 27, the distal end of the straight line 117a is attached to a hole 131g (see FIG. 38) formed near the proximal end of the first electrode 131a. The distal end is attached to a hole 131g (see FIG. 38) formed near the proximal end of the second electrode 131b. The straight line 117b is insulated and coated with a resin such as polytetrafluoroethylene (PTFE) except for a portion electrically connected to the second electrode 131b.

  When the slider 22 is slid to the distal end side with respect to the base 21, the drive wire 13 is slid to the distal end side, and the straight straight line 117a and the true straight line 117a and A sliding force is transmitted to the straight line 117b, the first electrode 131a is rotated in a direction away from the second electrode 131b via the straight line 117a, and the second electrode 131b is rotated from the first electrode 131a via the straight line 117b. The cup 131 can be opened by being rotated in the direction of separation. At this time, as shown in FIG. 42, the opening angle of the cup 131 is defined by the protrusion 131h formed on the first electrode 131a and the guide groove 136c formed on the insulating spacer 136. The same opening angle can always be set.

  On the other hand, when the slider 22 is slid to the proximal end side with respect to the base 21, the drive wire 113 is slid to the proximal end side along with this, and the straight line 117a is passed through the jumper metal member 119 and the jumper insulating member 115. Then, the sliding force is transmitted to the straight line 117b, the first electrode 131a is rotated in the direction approaching the second electrode 131b via the straight line 117a, and the second electrode 131b is turned to the first electrode via the straight line 117b. The cup 131 can be closed by being rotated in the direction approaching 131a.

  When the operation portion 2 including the base 21 and the slider 22 is rotated around the axis of the sheath portion 1 (outer sheath 11), the drive wire 13 is rotated accordingly, and the metal metal member 119 and the bush insulation member 115 are rotated. , The rotational force (torque) is evenly transmitted to the first electrode 131a and the second electrode 131b via the straight line 117a and the straight line 117b, and the resin wax 132 rotates with respect to the fixing bracket 135, so that the cup 131 is desired. It can be adjusted to the posture (rotational position).

  As described above, the rotation operation force for rotating the electrode and the slide operation force for opening and closing the electrode by the operation unit are transmitted via the drive wire and the contact member composed of at least the contact metal member and the contact insulating member. Furthermore, it is transmitted to the first electrode via the first wire member and to the second electrode via the second wire member.

  According to the third embodiment described above, the first electrode 131a, which is one of the high-frequency electrodes constituting the cup 131, is not shown in the figure via the straight line 117a, the jumper metal member 119, the drive wire 13, and the electric wire 24a. The second electrode 131b, which is electrically connected to one pole of the high frequency power supply device and is the other high frequency electrode, is a metal washer 139, a return electrode 133, a C ring 134, a fixture 135, an electric wire 14, a sleeve pipe 25, and an SK pipe. 26, is electrically connected to the other pole of the high-frequency power supply device (not shown) via the electric wire 24b. Transmission of power for opening and closing the cup 31 and rotation about its axis is performed by the drive wire 13, and the electric wire 14 and the drive wire 13 are separated by the inner sheath 12. Does not interfere with sliding or rotating motion. Accordingly, it is possible to improve the responsiveness of the rotating operation of the cup 31 (following performance of the electrode rotation with respect to the rotating operation in the operating portion) and the responsiveness of the sliding operation, and the change in the responsiveness due to the curved state of the sheath is reduced. High operability can be realized.

  In the first embodiment described above, the side plate portions 33a and 33b of the return electrode 33 are exposed to the outside, and part of the fixing bracket 35 is also exposed to the outside. Therefore, the side plate portions 33a and 33b, There is a risk that the fixing bracket 35 may come into contact with the tissue in the body. In the third embodiment, the pin portion 133b is not exposed to the outside through the inside (through hole 132g) of the arm portion 132b and fixed. Since the entire metal fitting 135 is completely buried in the outer sheath 11, the pin portion 133 b and the fixing metal fitting 135 are completely prevented from touching the body tissue.

  Further, as described with reference to FIG. 37, the bush insulating member 115 is bonded and fixed to the bush metal member 119, and the end surface of the straight line 117a on the base end side is the bottom surface of the recessed portion 115a of the bush insulating member 115. Since the straight line 117a is welded and fixed to the bush metal member 119 while being in contact with 115c, the hook insulator member 115 is securely fixed to the bush metal member 119, and stable performance is realized over a long period of time. can do. In addition, the number of parts can be reduced as compared with the first embodiment described above, and the cost can be reduced.

  Further, as best shown in FIG. 38, the gripping portions of the electrodes 131a and 131b are provided with a plurality of chevron teeth 131d extending in the lateral direction, so that the longitudinal direction in a state in which the body tissue is gripped. In addition to being able to suppress slipping through, the tip vertical tooth 131e is provided with the tip longitudinal groove 131f, so that slipping in the lateral direction while gripping the body tissue can be suppressed, and stable gripping can be achieved. Can be realized.

  In addition, since the pin portion 133b of the return electrode 133 is electrically connected to the second electrode 131b via the metal washer 139, it does not hinder the rotation of the second electrode 131b when the cup 131 is opened and closed. The electrical conduction state can be kept stable.

  Next, a fourth embodiment obtained by improving a part of the above-described third embodiment will be described with reference to FIGS. Note that the same components as those in the third embodiment described above are denoted by the same reference numerals, and description thereof is omitted.

  In the third embodiment described above, as described with reference to FIG. 38 and FIG. 39, the first electrode 131a and the second electrode 131b include a plurality ( For example, there are three protrusions 131d formed in parallel, a tip convex portion 131e is formed, and a tip vertical groove 131f is formed in the central portion of the tip convex portion 131e along the vertical direction. Using. On the other hand, in the fourth embodiment, a plurality of (for example, four) convex teeth (convex portions) 231c are regularly arranged in a staggered manner on the grip portions on the distal ends of the first electrode 231a and the second electrode 231b. (Alternately).

  The state where the living tissue 300 is grasped by the first electrode 231a and the second electrode 231b is schematically shown in FIGS. The convex teeth 231c of the first electrode 231a are located in the portion between the convex teeth 231c of the second electrode 231b. Similarly, the convex teeth 231c of the second electrode 231b are the portions between the convex teeth 231c of the first electrode 231a. Since an appropriate gap is formed between the respective convex teeth 231c, when the biological tissue 300 is grasped by the first electrode 231a and the second electrode 231b, the biological tissue 300 has an edge of each convex tooth 231c. Therefore, the living tissue 300 can be more reliably prevented from slipping in the lateral direction and the longitudinal direction, and the gripping property can be improved. In addition, by arranging the convex teeth 231c regularly in a staggered manner, the first electrode 231a and the second electrode 231b can have the same configuration, and the first electrode 231a and the second electrode 231b Compared with the case where it is set as a different structure, manufacturing cost can be reduced.

  The embodiment described above is described for facilitating the understanding of the present invention, and is not described for limiting the present invention. Therefore, each element disclosed in the embodiment described above is intended to include all design changes and equivalents belonging to the technical scope of the present invention.

1 ... sheath part,
11: outer sheath,
12 ... Inner sheath,
13 ... Drive wire,
14 ... Electric wire,
15 ... jumpsuit insulation member,
16 ... Tsunagi washer,
17a, 17b ... straight line,
18 ... pipe,
19 ... jumpsuit metal member,
2 ... operation part,
21 ... Base,
22 ... Slider,
23 ... tip cap,
24 ... Plug,
24a, 24b ... electric wires,
25 ... Sleeve pipe,
26 ... SK pipe,
3 ... forceps part,
31, 131 ... Cup,
31a, 31b, 131a, 131b, 231a, 231b ... electrodes,
32, 132 ... resin wax,
32a, 32b, 132a, 132b ... arm part,
32c, 132c ... neck,
32d, 132d ... annular groove,
32e, 32f ... through holes,
132g ... through hole 33,133 ... return electrode,
33a, 33b ... side plate,
133b ... Pin part 33c, 133c ... Slip ring part,
33d ... projection,
33e, 33f ... through hole,
34, 134 ... C-ring,
35, 135 ... fixing bracket,
36, 136 ... insulating spacers,
37,137 ... Kingpin,
39,139 ... Metal washer.

  41 ... Coil spring

Claims (8)

An outer sheath,
An operating portion provided at a proximal end of the outer sheath;
A substantially cylindrical conductive fixing member attached to the distal end of the outer sheath;
An electrode support member having a pair of opposing arm portions projecting toward the base end portion and the distal end side, the base end portion being attached to the fixing member so as to be rotatable around an axis of the fixing member; ,
A first electrode and a second electrode rotatably supported by the arm portions of the electrode support member in a state of being electrically insulated from each other;
An insulating inner sheath inserted through the outer sheath;
A conductive drive wire inserted through the inner sheath for transmitting a rotation operation force and a slide operation force by the operation unit;
A jumper member composed of a jumper metal member and a jumper insulation member attached to the distal end of the drive wire;
One end thereof is attached to the metallic metal member and the other end is attached to the first electrode, and a conductive first wire member that conducts the drive wire and the first electrode;
A second wire member having one end attached to the jumper insulating member and the other end attached to the second electrode;
Regardless of the rotation of the electrode support member with respect to the fixing member and the rotation of the second electrode with respect to the electrode support member, the electrodes abut against each of the fixing member and the second electrode to electrically conduct them. A return electrode attached to the support member;
An endoscopic high-frequency treatment instrument comprising: an electric wire inserted between the outer sheath and the inner sheath and having a distal end connected to the fixing member. The base end portion of the electrode support member has a substantially cylindrical neck portion, and the neck portion has an annular groove recessed from the outside,
A C ring member is rotatably fitted in the annular groove,
The high-frequency treatment instrument for endoscope according to claim 1, wherein the neck portion into which the C-ring member is loosely fitted is inserted into the fixing member, and the C-ring member is attached to the fixing member. The return electrode has a substantially annular ring portion that contacts the C ring member,
The high-frequency treatment instrument for endoscope according to claim 2, wherein a protrusion formed on one of the C-ring member and the ring portion is brought into conduction with each other by making point contact with the other. The electrode support member has a fitting groove on each outer side of the arm portion,
The high-frequency treatment instrument for endoscope according to claim 3, wherein the return electrode has a pair of side plate portions that are erected on the ring portion and are respectively fitted in the fitting grooves.   One of the side plate portions of the return electrode is electrically connected to the second electrode via a conductive, substantially annular washer member interposed rotatably around the rotation axis of the second electrode. The high-frequency treatment instrument for an endoscope according to claim 4, wherein: The operation unit is
A tip cap having a substantially cylindrical space into which the proximal end side of the outer sheath is inserted;
A substantially cylindrical conductive sleeve pipe attached in the substantially cylindrical space of the tip cap;
A small-diameter tip tube portion inserted into the proximal end portion of the outer sheath to which the outer sheath is attached and the proximal end of the electric wire is electrically connected, and a through hole through which the inner sheath is inserted A conductive SK pipe rotatably inserted in the sleeve pipe;
The sleeve pipe is inserted into the distal end side of the sleeve pipe, the distal end of the sleeve pipe is fixed to the sleeve pipe, and the proximal end of the sleeve pipe is in pressure contact with the stepped surface of the distal end cylinder portion of the SK pipe. The high-frequency treatment instrument for endoscope according to claim 1, further comprising: a conductive coil spring provided on the endoscope. The electrode support member has a through hole extending from the base end portion to the bearing portion of the second electrode on one inner side of the arm portion,
The return electrode is a substantially annular ring portion that contacts the C-ring member, and is erected on the ring portion. The return electrode passes through the through hole and is exposed at the bearing portion of the second electrode. The high-frequency treatment instrument for endoscope according to claim 1, further comprising a pin portion electrically connected to the endoscope. The jumper metal member is formed in a substantially cylindrical shape, and is welded and fixed to the distal end of the drive wire,
The jumpsuit insulating member is inserted into the jumper member metal from the distal end side,
The jumpsuit insulating member has a recessed portion in which the vicinity of the other end of the first wire member is disposed,
The first wire member is welded and fixed to the metal metal member in a state where the other end of the first wire member is in contact with the bottom surface of the recessed portion, and is connected to the drive wire via the metal metal member. The high-frequency treatment instrument for endoscope according to claim 1, wherein the high-frequency treatment tool for endoscope is electrically connected.

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