JPS6144502B2 - - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION The present invention relates to a high-frequency cutting tool that cuts and removes a target site within a body cavity using high-frequency current.

Conventionally, a high-frequency ablation tool has been used to remove polyps within body cavities. This high frequency cutting tool is
An operating wire is passed through a flexible sheath that is inserted through the endoscope's insertion channel, and a loop-shaped tip electrode is attached to the tip of the operating wire. It is necessary to position the polyp. In reality, it is rather rare that the tip electrode is positioned in the correct direction relative to the polyp, and it is usually necessary to twist the operating wire on the proximal side and transmit the rotation to the tip electrode to rotate it.

However, since the operating wire is flexible, its rotational force is not directly transmitted to the tip electrode, and twisting occurs along the way. Therefore,
The tip electrode does not turn smoothly as expected. In other words,
It may rotate behind the rotation of the hand control unit, or
Even if the rotation operation on the hand control unit side is stopped, the tip electrode may still be rotating. Even if an attempt was made to place the tip electrode at a position where it could be easily applied to the polyp, it was not possible to do so easily and was a very difficult task.

The present invention has been made in view of the above-mentioned circumstances, and its purpose is to provide a high-frequency cutting tool that can easily apply a loop-shaped tip electrode to a target site within a body cavity.

Embodiments of the present invention will be described below based on the drawings.

1 in FIG. 1 is a sheath of a high-frequency cutting tool 2,
This is constructed of electrically insulating material so that it can be inserted into the insertion channel 4 of the endoscope 3. An operating wire 5 made of a conductive material is inserted into the inside of the sheath 1 so as to be freely advanced and retracted, and this operating wire 5 can be moved forward and backward by an operating rod 7 of a hand-side operating section 6. There is.

Further, as shown in FIG. 2, a tip electrode 9 formed by forming a conductive wire 8 into a loop shape is attached to the tip of the operating wire 5 so as to be rotatable about the axial direction of the sheath 1. That is, the tip electrode 9
The conductive wire 8 is connected at both ends with a pipe 10, and the pipe 10 is inserted and fixed into a cylindrical member 11. Furthermore, the cylindrical member 11
A cylindrical retainer 12 attached to the tip of the operating wire 5 is rotatably fitted into the rear end of the operating wire 5.

The tip electrode 9 is provided so as to be able to protrude and retract into the tip of the sheath 1, so that when it is pushed out from the tip of the sheath 1, it expands, and when it is pulled into the sheath 1, it is closed.

Next, a case will be described in which, for example, a polyp 13 in a body cavity is removed using the high-frequency cutting tool 2.

First, in the proximal operating section 6, the operating wire 5 is pulled using the operating rod 7, and the tip electrode 9 is drawn into the sheath 1. Then, the endoscope 3 introduced into the body cavity
The sheath 1 of the high-frequency resection instrument 2 in the above state is inserted into the insertion channel 4 of the body cavity and protruded into the body cavity. Next, the operating wire 5 is pushed in by operating the proximal operating unit 6, the tip electrode 9 is protruded, and the tip electrode 9 is brought close to the polyp 13 at the target site by moving the sheath 1 back and forth and bending the endoscope 3. . At this time, if the loop surface of the tip electrode 9 is perpendicular to the polyp 13 as shown in FIG. 3, the tip electrode 9 can be applied to the polyp 13 by simply moving it in the direction of the arrow. However, when they are in the parallel state as shown in FIG. 4, when they are moved in the direction of the arrow, they move in the order shown in FIG. 5 a, b, and c. That is, the side part of the conductive wire 8 hits the tip surface of the head of the polyp 13 and slides on the tip surface, and the tip electrode 9 rotates in the direction of the arrow as shown in FIG. 5b and as shown in FIG. 5c. condition, and the polyp 13 becomes infected.

After the tip electrode 9 is applied to the polyp 13 in this manner, the neck of the polyp 13 is contracted by pulling the operating wire 5 on the proximal side. Then, a high-frequency current is applied to perform high-frequency cutting on the neck. Thus, the polyp 13 can be removed.

Note that FIG. 6 shows another embodiment of the present invention. This is a cylindrical stopper 15 inside the distal end of the sheath 14.
At the same time, a slider 16 is provided on the proximal side of the stopper 15 so as to be able to move forward and backward and rotate freely.One end of a conductive wire 18 constituting the tip electrode 17 is fixed to this slider 16, and a conductive wire 18 is fixed to the slider 16. The other end of the magnetic wire 18 passes through the slider 16 and is rotatably attached to the tip of the operating wire 19. That is, a cylindrical member 20 is attached and fixed to the tip of the operating wire 19, and a retainer 21 for the conductive wire 18 is rotatably housed within the cylindrical member 20. Further, a locking piece 22 is attached to the middle of the conductive wire 18, so that when the conductive wire 18 is pulled in by the operation wire 19, it hits the slider 16 and is pulled in as one piece.

Therefore, as shown in FIG.
When pushed in, the slider 16 hits the stopper 15 and the loop can be expanded by letting out only one end of the conductive wire 18. moreover,
Since this tip electrode 17 can freely rotate, it can be easily applied to the polyp 13 as in the above embodiment.

As explained above, the high frequency cutting tool of the present invention has
Since it is attached to the tip of the operating wire so as to be rotatable around the axial direction of the sheath, no matter which direction the tip electrode is oriented with respect to the target site, it will automatically change to that direction. Therefore, unlike conventional devices that require rotation from the hand side, the device can be easily and quickly applied to the target area.

[Brief explanation of the drawing]

FIG. 1 is a perspective view showing an embodiment of the present invention;
Figure 2 is a side sectional view of the tip, Figures 3 and 4 are perspective views of the embodiment in use, and Figures 5a, b, and c are front views of the embodiment in use. 6 are side sectional views of the distal end of another embodiment of the present invention. 1...Sheath, 2...High frequency cutting tool, 3...Endoscope, 5...Operation wire, 6...Proximal side operation unit,
8... Conductive wire, 9... Tip electrode, 13...
Polyp, 14... sheath, 17... tip electrode,
18... Conductive wire, 19... Operation wire.

Claims (1)

[Claims] 1 A sheath having electrical insulation properties, an operating wire that is inserted into the sheath so as to be freely advanced and retracted and can be operated forward and backward from the proximal side of the sheath, and a control wire that is attached to the tip of the operating wire so as to be rotatable about the axial direction of the sheath. 1. A high-frequency cutting tool, characterized in that it is made by forming a conductive wire into a loop shape and is equipped with a tip electrode that can be protruded and retracted from the tip of the sheath.