JP6130134B2 - Endoscopic treatment tool - Google Patents

Description

  The present invention relates to an endoscope treatment tool that is inserted into a treatment tool guide tube (channel) of an endoscope so as to be able to advance and retreat, and in particular, a rotational force from an operation unit in the treatment tool guide tube of the endoscope. The present invention relates to a treatment instrument for an endoscope that smoothly conveys to a treatment section and does not cause uneven rotation.

  In general, an endoscope treatment instrument is used by being inserted into a treatment instrument guide tube (channel) opened in a tube-like insertion portion constituting the endoscope. The treatment tool for endoscope inserts an operation wire, which is connected to a treatment portion consisting of a pair of treatment pieces such as a forceps cup at the tip, into a cylindrical sheath, and advances and retracts this operation wire. In general, the treatment section is driven to open and close at the distal end of the sheath by operation.

  The following patent documents can be cited as documents describing endoscope treatment tools according to the prior art. In Patent Document 1, a general link mechanism is used to open and close the treatment portion at the distal end, and a pair of support shafts are provided by a support shaft that traverses the slit (slot) of the distal end body provided at the distal end of the sheath. Supports the intermediate part of the forceps cup (treatment piece) in a freely rotatable manner, and connects the sheath side end of the forceps cup to one end of each link mechanism in a freely rotatable manner, and pushes in the operation wire. When the forceps cup is rotated about the shaft and the tips are separated from each other, the open state is established, and in the treatment instrument in which the tips are brought close to each other and closed by pulling the operation wire, the flexible shaft is covered. The end of the flexible shaft-like body is welded by the laser beam irradiation from the side at the contact portion between the fitted annular ring-shaped welding auxiliary ring and the edge of the receiving hole of the connected member. Connected to the connected member And it discloses a technique to prevent not adequate connection strength laser welding is performed incompletely obtained. Further, Patent Document 2 includes a connecting rod having a holding portion that rotatably holds one end of the operating wire with respect to the connecting rod, and the sheath and the operating wire that are generated when the distal end side of the sheath is rotated in the circumferential direction. A technique for facilitating the opening / closing operation of the treatment portion by facilitating the operation of the operation wire in the forward / backward direction by not transmitting the difference in rotational force to the connecting rod.

JP 2007-130421 A JP 2012-55367 A

  The endoscope treatment tool described in the above-mentioned patent document describes a technique for suitably performing laser welding of a treatment part to be opened and closed and a technique for easily opening and closing a treatment part. When the sheath is bent by being inserted into the opened treatment instrument guide tube (channel), a restoring force is exerted so that the operation wire and the contact coil return straight, and the treatment section in the treatment instrument for endoscope is operated. The sliding resistance between the tip support frame and the receiving frame and the sliding resistance between the channel inner wall of the endoscope and the treatment part increase, and the rotational force from the operation part is not smoothly transmitted to the treatment part, and uneven rotation is likely to occur. There was a problem.

  This will be described in detail with reference to the drawings. As shown in FIG. 4, a conventional endoscopic treatment tool includes a sheath 2 including a close coil 2b and an outer tube 2a, and an operation wire inserted through the sheath 2. 3 and a treatment section 6 including a pair of treatment pieces that are pivotally supported by a support shaft 12 and are pivotally displaced in an open state and a closed state, and the treatment section 6 is rotatably supported and connected to the sheath. A connection mechanism comprising a distal end support frame 30 and a receiving frame 31 is connected to the rear end of the operation wire 3 and the other end of the sheath 2. The treatment section 6 includes a pair of forceps cups 8 (treatment pieces), a support shaft 12 for supporting each forceps cup 8 on one axis, and a pair of slide shafts on each forceps cup 8. Can be rotated by 10 A pair of links 13 of the pivoted plates form, and a link support shaft 11 to one axis supporting said pair of links. The receiving frame 31 is disposed at a position where the contact coil 2b and the rear end of the tip support frame 30 are in contact with each other and is covered and attached by the tip portion of the outer tube 2a (the tip support frame 30 and the contact coil 2b). , The dimension L2 needs to be increased. Further, as shown in FIG. 5, when the sheath 2 is bent, a restoring force f that causes the operation wire 3 to return straight and a restoring force F that causes the contact coil 2b of the sheath 2 to return straight are generated.

  For this reason, the endoscope treatment tool according to the prior art has a linear shape from the receiving frame 31 to the support shaft for opening and closing the treatment portion 6 when inserted into the channel of the endoscope 100 as shown in FIG. The length L3 of the support frame 4 is long, and the tip support frame 4 and the treatment portion 6 are curved by this dimension L3. The sliding resistance is in contact with the channel inner wall of the endoscope, and the tip support frame 30 of the receiving frame 31 shown in FIG. There is a problem that the sliding resistance of the sliding surface increases in the dimension L2 in contact with the rotation, and the rotational force from the operation unit 7 is not smoothly transmitted to the treatment unit 6 and uneven rotation easily occurs. Further, the dimension L3 is linear, and since the distance L3 is long, it is difficult to insert the endoscope treatment tool in a state where the endoscope 100 is curved, There was also the risk of damaging the fiber and other internals.

  In view of such a problem, the present invention is intended to solve the above-described problems of the related art, and an endoscopic treatment tool capable of smoothly transmitting a rotational force from an operation unit to a treatment unit. The purpose is to provide.

  In order to achieve the above object, the present invention provides a flexible sheath that is passed through a treatment instrument guide tube of an endoscope, an operation wire that is inserted through the sheath, and a support shaft that is pivotally supported by the support shaft. A treatment portion including a pair of treatment pieces that are rotationally displaced between a state and a closed state, a connection mechanism that rotatably supports the treatment portion and is connected to the sheath, the rear end of the operation wire, and the rear end of the sheath A treatment instrument for an endoscope including an operation unit that moves the operation piece forward and backward to displace the treatment piece between the open state and the closed state, and the connection mechanism is formed in an annular shape. A tip support frame having a pair of arms extending from the base end portion and penetrating the support shaft at the tip, and provided with a key-like portion in which the annular rear end of the base end portion is bent inward, and a cylinder So that the tip of the ring engages the key-shaped portion of the tip support frame. By being configured by a receiving frame configured to fit the sheath tip to the rear end outer periphery with projecting toward the first feature.

  The present invention also provides a flexible sheath that is passed through the endoscope treatment instrument guide tube, an operation wire that is inserted through the sheath, and a support shaft that is pivotally supported by the support shaft to be in an open state and a closed state. A treatment section comprising a pair of pivoting treatment pieces, a coupling mechanism for pivotally supporting the treatment section and coupling with the sheath, coupled to the rear end of the operation wire and the rear end of the sheath, An endoscopic treatment tool including an operation unit that moves a treatment piece forward and backward to displace the treatment piece between the open state and the closed state, and the connection mechanism has an annular tip facing the outer circumferential direction. And a pair of arms extending from the annular base end portion and penetrating the support shaft to the tip end. Caulking the rear end of the ring toward the protrusion of the receiving frame By being configured by the tip support frame of Engineering shape as a second feature.

  The endoscope treatment tool according to the present invention has a connecting mechanism for connecting the distal end of the sheath and the rear end of the treatment portion extending through the support shaft that extends from the annular base end portion and rotatably supports the treatment portion. A distal end support frame provided with a key-like portion that has a ring-shaped rear end of the base end portion that bends inward, and a cylindrical distal end on the key-like portion of the distal end support frame. It is configured by a receiving frame that protrudes in the outer peripheral direction so as to be engaged and fits the sheath tip on the outer periphery of the rear end, or the annular tip protrudes in the outer peripheral direction and the sheath on the outer periphery of the rear end. A receiving frame having a shape that fits the tip, and a pair of arms that extend from the annular base end and pivotally support the treatment portion and penetrate the tip, and the annular rear end of the base end And a tip support frame having a shape that is caulked toward the protruding portion of the receiving frame. It can tell smoothly to the treatment portion of the rotational force from the operation to reduce the sliding resistance during the rotational operation unit.

The figure which shows the structure of the treatment part by 1st Embodiment of this invention. The figure which shows the structure of the treatment part by 2nd Embodiment of this invention. The figure for demonstrating the state which penetrated the treatment part by embodiment of this invention to the channel of the endoscope. The figure which shows the structure of the treatment part by a prior art. The figure which shows the curved state of the treatment part by a prior art. The figure for demonstrating the state which penetrated the treatment part by a prior art to the channel of the endoscope. The figure which shows the whole structure of the treatment tool for endoscopes which penetrated the treatment part. The figure for demonstrating the connection structure by 1st Embodiment.

Hereinafter, an embodiment of an endoscope treatment tool according to the present invention will be described in detail with reference to the drawings.
[First Embodiment]
As shown in FIG. 7, the overall structure of the endoscope treatment tool 1 according to the present embodiment is composed of a flexible sheath 2 including a close coil 2b and a cylindrical outer tube 2a (not shown in FIG. 7). , An operation wire 3 made of a flexible wire such as stainless steel inserted into the sheath 2, a tip support frame 4 connected to the tip of the sheath 2, and the tip support frame 4 And the operation part 7 provided on the proximal end side of the sheath 2 and the operation wire 3.

  The close contact coil 2b is formed of a close wound coil pipe such as a stainless steel wire, and an outer tube 2a which is an electrically insulating flexible tube such as a tetrafluoroethylene resin tube is covered on the outer peripheral surface. Has been. In addition, this sheath 2 may be comprised only with flexible tubes, such as resin, such as PEEK, polyethylene, a polyimide, without using a coil pipe.

  The operation unit 7 includes an operation unit main body 7a and a slider 7b slidably attached to the operation unit main body 7a. Although not shown, the operation portion main body 7a is formed with a groove in the axial direction over a predetermined length, and the slider 7b is fitted in the groove so as to be slidable in the axial direction. Further, the base end of the sheath 2 is fixed to the operation portion main body 7a, and the base end of the operation wire 3 inserted through the inside of the sheath 2 and the operation portion main body 7a is fixed to the slider 7b. The operation wire 3 can be advanced and retracted by operating the slider 7b in the axial direction with respect to the operation portion main body 7a. Although not shown, a high frequency current can be applied to the treatment section 6 via the operation wire 3 by connecting a high frequency power source to the slider 7b.

  As shown in FIGS. 1 and 8, the treatment portion 6 includes a pair of forceps cups 8 (treatment pieces) and a pair of arm portions 4 a of a connection mechanism described later on the rear end side of the pair of forceps cups 8. A support shaft 12 for supporting the shaft, a pair of plate-like links 13 pivotally supported on the forceps cup 8 by a pair of slide shafts 10, and a link support shaft 11 for supporting the pair of links 13 in one axis. The forceps cup 8 is pivotally supported by the support shaft 12 so that the substantially intermediate portion is rotatable, and the forceps cup 8 rotates about the support shaft 12 via the rod 18 by pushing out the operation wire 3. The tips of the forceps cups 8 are close to each other around the support shaft 12 through the rod 18 by pulling the operation wire 3 and opened in a closed state. . In this example, the plate-shaped link 13 is used. However, the present invention is not limited to this. For example, the link wires are connected so as to be divided into two forks, and the distal ends of the link wires are connected to the forceps cup 8. You may make it connect.

Now, in the endoscope treatment tool according to the present embodiment, as shown in FIGS. 1 and 8, the connection mechanism between the treatment portion 6 and the sheath 2 extends from the annular base end portion to rotate the treatment portion 6. A tip support frame 4 having a pair of arms 4a penetrating the support shaft 12 to be moved and supported at the tip, and provided with a key-like portion in which the annular rear end of the base end is bent inward, and a cylinder And a receiving frame 20 having a shape that protrudes in the outer peripheral direction so as to engage with the key-shaped portion of the front end support frame 4 and that fits the sheath 2 on the outer periphery of the rear end. With such a configuration, since the rear end of the front support frame 30 and the front end of the contact coil 2b are conventionally in contact with each other, the length L2 (FIG. 4) of the receiving frame 31 needs to be increased. On the other hand, the sliding dimension L1 between the receiving frame 20 and the distal end support frame 4 when the operation wire 3 is rotated by fitting and joining the close contact coil 2b to the outer peripheral surface of the receiving frame 20 is conventional. Compared to the sliding dimension L2 (FIG. 4) according to the technology, the length is reduced to about ¼.
Note that the key-shaped portion of the distal end support frame 4 according to the present embodiment has a rear end of the receiving frame 20 after the receiving frame 20 is inserted from the rear end side of the annular base end portion provided with a pair of arms 4a at the distal end. It is formed by inserting an annular member 4b fitted to the cylindrical inner wall of the tip support frame 4 from the side and fixing it by laser welding or the like.

Therefore, the endoscope treatment tool according to the present embodiment is compared with the linear dimension L3 from the sheath side end portion of the distal end support frame 4 to the support shaft 12 for opening and closing the treatment portion 6 shown in FIG. The treatment portion can be shortened as shown by a dimension L4, the sliding dimension (L1) between the receiving frame 20 and the distal end support frame 4 when the operation wire 3 is rotated, and the sheath side end of the distal end support frame 4. By reducing the linear dimension (L4) (rigid portion) to the support shaft 12 for opening and closing 6, the rotational force from the operation unit 7 can be smoothly transmitted to the treatment unit 6.
Further, since the dimension L3 of the rigid portion can be made much shorter than that of the conventional example, it can be easily inserted into and removed from the endoscope channel.

[Second Embodiment]
In the above-described embodiment, as the connection mechanism between the treatment section 6 and the sheath 2 and the close contact coil 5, the distal end support frame 4 provided with a key-shaped portion in which an annular rear end is bent inward, and the distal end is the distal end. Although the example which uses the receiving frame 20 of the shape which protrudes in an outer peripheral direction so that it may engage with the said key-shaped part of the support frame 4 and fits the sheath 2 to a rear-end outer periphery was demonstrated, this invention is this connection mechanism. For example, as shown in FIG. 2, a receiving frame 20 having a shape in which an annular tip protrudes toward the outer periphery and the sheath 2 is fitted to the outer periphery of the rear end, and an annular base end A pair of arms 4a extending through the support shaft 12 that pivotally supports the treatment portion 6 and penetrating at the tip thereof, and the annular rear end of the base end portion is crimped toward the protruding portion of the receiving frame 20 You may comprise by the front-end | tip support frame 4 of a shape.

  In the endoscope treatment tool according to the second embodiment, the sliding portion between the receiving frame 20 and the tip support frame 4 when the operation wire 3 is rotated by the above-described caulking structure is deleted. Compared with the structure of the first embodiment, the rotational force from the operation unit 7 can be transmitted to the treatment unit 6 more smoothly.

2 Sheath 2a Outer tube 2b Adhesion coil 3 Operation wires 4, 30 Tip support frame 4a Arm part 6 Treatment part 8 Forceps cup 12 Support shaft 20, 31 Receiving frame 30 Tip support frame 100 Endoscope

Claims (1)

A pair of a flexible sheath that is passed through the treatment instrument guide tube of the endoscope, an operation wire that is inserted through the sheath, and a support shaft that is pivotally displaced between an open state and a closed state. A treatment portion including a treatment piece; a connection mechanism that rotatably supports the treatment portion and is connected to the sheath; and is connected to the rear end of the operation wire and the rear end of the sheath; An endoscopic treatment tool including an operation unit that displaces the treatment piece between the open state and the closed state,
The coupling mechanism has a pair of arms extending from an annular base end portion and penetrating the support shaft at the tip, and a key-like portion in which the annular rear end of the base end portion bends inward. A provided tip support frame, and a receiving frame having a shape in which a cylindrical tip protrudes in the outer peripheral direction so as to engage with the key-shaped portion of the tip support frame and the sheath tip is fitted to the outer periphery of the rear end. Configure
An annular member is fitted to a cylindrical inner wall on the rear end side of the protruding portion of the receiving frame and on the rear end side of the proximal end portion of the distal end support frame, and the annular member is the distal end support frame. An endoscope treatment tool characterized by being fixed to the endoscope.

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