JP2015009003A - Basket holding device - Google Patents

Abstract

PROBLEM TO BE SOLVED: To make it easy to take stones or the like different in size into a basket part.SOLUTION: A basket holding device 1 includes a flexible sheath 2, an operation wire 3 inserted into the sheath 2 so as to be movable back and forth, and a basket part 4 provided in a tip end of the operation wire 3. The basket part 4 is projected or retracted from the flexible sheath 2 to be contracted or expanded by moving the operation wire 3 forward and backward. Energization force displacement points different in energization force are set to intermediate portions from a rear end chip 7 to a tip end chip 6 in elastic wires 5a-5d. Curved energization force with no rotation in an axial direction of the basket part 4 is energized from the energization force displacement points to the rear end chip 7 side, and spiral-rotation energization force with rotation in the axial direction of the basket part is energized to the tip end chip 6 side of the energization force displacement points.

Description

  The present invention relates to a basket gripping tool that is inserted into a body cavity and collects and crushes foreign objects such as stones in the body cavity, and in particular, easily collects and crushes stones of different sizes. The present invention relates to a basket gripping tool that can be used.

  In general, in order to remove a bile duct stone or the like, a basket gripping tool that is inserted into a treatment instrument guide tube of an endoscope and protrudes from the distal end of the endoscope to collect or crush foreign matter is used. The basket gripping tool is provided with a basket-like basket portion at the tip of an operation wire inserted through the flexible sheath, and the basket portion can be inserted into the flexible sheath together with the operation wire. By moving the operation wire forward and backward by operating the operation unit connected to the basket, the basket portion protrudes and retracts from the distal end of the flexible sheath to take in stones into the basket portion, and pulls the operation wire to grasp the stones etc. Pull out. The following patent documents are mentioned as a document in which the technique regarding such a basket holding tool was described.

  The following Patent Document 1 includes a basket portion that is elastically spread by a plurality of elastic wires provided with a plurality of bending points, and each of the plurality of elastic wires is formed in a case where each of the elastic wires swells in the expanding direction. A basket technique provided with a means for changing or maintaining the angle is described, and Patent Document 2 describes a Dormia-type basket technique in which a plurality of elastic wires composed of stranded wires are spiral. .

JP-A-6-296617 Japanese Patent Laid-Open No. 10-127648

  In the basket gripping tool described in Patent Document 1 described above, when the basket portion is opened in a narrow lumen, the angle formed by adjacent wires constituting the basket portion becomes small, and even if they approach each other, one of them is separated from the other. The angle can be changed by pulling apart, and the shape of the basket portion can be maintained, and the technique described in Patent Document 2 is cut off compared to a single wire by using an elastic wire constituting the basket portion as a stranded wire. The area of the basket can be made elastic. However, the techniques described in these patent documents have a problem that it is difficult to capture a calculus or the like having a small diameter as compared with a basket diameter in a state where the basket is fully opened.

  In order to explain this problem, a use example using a basket gripping tool will be described with reference to FIGS. 5 and 6. For example, a procedure for capturing a calculus in a bile duct is shown in FIGS. 5 and 6A. As described above, the operation wire 3 is pulled, and the basket portion 4 at the distal end is pulled into the flexible sheath 2 and held in a contracted state, and can be applied to the channel of the endoscope 100 inserted into the duodenum 200. Inserting the flexible sheath 2 through the distal end of the endoscope 100 through the flexible sheath 2, inserting the distal end of the flexible sheath 2 into the bile duct 220 from the fatter papilla 210, and positioning the distal end in front of the calculus 230; Then, the operation wire 3 is pushed forward by the operation of the operation portion 10 at hand, and the basket portion 4 is moved by the elastic restoring force of the elastic wire by protruding the basket portion 4 from the tip of the flexible sheath 2 as shown in FIG. big From this state, as shown in FIG. 6 (c), the basket portion 4 is pulled, and a calculus is formed in the bulge from the gap between the elastic wires on the rear end side of the basket portion 4 from this state. The step of performing the operation of taking in 230, and as shown in FIG. 6 (d), the basket portion 4 is contracted by retracting the basket portion 4 by pulling the operation wire 3 after taking the stone into the bulge of the basket portion 4. There are a process of wrapping and capturing the calculus 230 inside, and a process of pulling the flexible sheath 2 toward the front while holding the calculus 230 in the basket 4 and pulling it out of the bile duct and taking it out of the body. If the size of the stone 230 is close to the diameter of the bile duct 220 as shown in the figure, the stone can be easily captured. However, if the stone 230 is smaller than the diameter of the bile duct 220, the stone falls off from the gap between the elastic wires. May, there is a problem that must be carried out capture operations again.

  Also, since the bile duct is always crushed, the basket part is pressed against the inner wall, and force is applied from the outside to the inside of the basket part, but the tip side swells and the rear end side is squeezed If the shape is long, the distance from the maximum diameter part of the basket part to the binding position of the wire on the rear end side is long, so the force against the inward force is weak, the basket part is crushed, and as a result, There was also a problem that it became more difficult to capture.

  In view of such problems, the present invention is intended to solve the above-described problems of the prior art, and an object of the present invention is to provide a basket gripping tool that can easily capture calculus having different sizes into a basket portion. .

  In order to achieve the above object, the present invention is provided with a long flexible sheath, an operation wire that is inserted into the flexible sheath so as to freely advance and retreat, and a distal end portion of the operation wire. A basket portion that forms a substantially bowl shape by binding the front end and the rear end of the elastic wire and accommodates and holds a collection object in the inside of the bowl shape; In the basket gripper that retracts and retracts elastically by retracting and retracting the basket portion from the distal end portion of the flexible sheath by advancing and retracting along the direction, the basket portion in the expanded state An urging force displacement point having a different urging force between the front end and the rear end is set on the plurality of elastic wires, and continuous rotation in the axial direction of the basket portion is performed between the urging force displacement point and the front end. The energizing force of the accompanying spiral times Is energized, the first feature that the biasing force of the curved without rotation with respect to the axial direction of the basket portion between until the urging force displacement point from the rear end is energized.

  In addition, the present invention provides a long flexible sheath, an operation wire that is inserted into the flexible sheath so as to be able to advance and retreat, and a plurality of elastic wires provided at the distal ends of the operation wires. A basket portion that forms a substantially bowl-like shape by binding the rear end and accommodates and holds a collection object in the substantially bowl-like shape; and the operation wire is advanced and retracted along the axial direction of the basket portion In the basket gripping tool that elastically contracts or expands by projecting and retracting the basket portion from the distal end portion of the flexible sheath by the operation, the basket portion in the expanded state includes the plurality of elastic wires. An urging force displacement point having a different urging force is set between the front end and the rear end, and a spiral turn with continuous rotation in the axial direction of the basket portion is performed between the urging force displacement point and the front end. Power is energized, after The energizing force of the spiral turn with a turning radius in the range of plus 25% to minus 25% of the maximum spiral turn radius due to the spiral turn with respect to the direction perpendicular to the axial direction of the basket portion between the biasing force displacement point and the biasing force displacement point. The second feature is that is energized.

  According to the third aspect of the present invention, in the basket gripping tool of the first or second feature, the biasing force displacement point of the elastic wire is set from the rear end to an intermediate portion of the tip. Alternatively, in the basket gripping tool of the third feature, the fourth feature is that the curve from the rear end to the biasing force displacement point is biased substantially linearly in a direction away from the basket portion axial direction, In the basket gripping tool having any one of the above characteristics, a fifth characteristic is that the basket portion is composed of at least three to eight elastic wires.

  In the basket gripping tool according to the present invention, biasing force displacement points having different biasing forces between the front end and the rear end are set on the plurality of elastic wires, and the rear end side of the biasing force displacement point is set with respect to the axial direction of the basket portion. The biasing force of the curve without the rotation is biased, and the biasing force of the spiral rotation with the rotation in the axial direction of the basket portion is biased to the tip side of the biasing force displacement point, whereby the biasing force displacement When the elastic wire is stored in the flexible sheath up to the vicinity of the biasing force displacement point, the stress when stored in the flexible sheath to the point becomes difficult to be transmitted to the distal end side. A small-diameter basket portion can be formed by each elastic wire, and small stones and the like can be easily taken in by using the small-diameter basket portion.

The figure for demonstrating the structure of the basket holding tool by one Embodiment of this invention. The figure for demonstrating operation | movement of the basket holding tool by this embodiment. The figure for demonstrating the structure of the basket holding tool by a prior art. The longitudinal cross-sectional view which shows the front-end | tip part of the basket holding tool by this embodiment, and the operation part by the side of a hand. The figure for demonstrating the usage method of a basket holding tool. The figure for demonstrating the usage method of a basket holding tool.

Hereinafter, an embodiment of a basket gripping tool according to the present invention will be described in detail with reference to the drawings.
A basket gripping tool 1 according to an embodiment of the present invention is used by being inserted into a treatment instrument insertion channel of an endoscope. As shown in FIG. A flexible sheath 2, an operation wire 3 that is inserted into the flexible sheath 2 so as to be able to advance and retract, and a distal end of the operation wire 3. And a basket portion 4 for holding a sinkable stone or the like.

  As shown in FIG. 4, the basket gripping tool 1 includes an operation unit 10 connected to the proximal end of the flexible sheath 2, and the operation unit 10 includes a substantially cylindrical operation unit main body 11, An operation pipe 12 that is inserted into the cylinder of the operation unit main body 11 so as to be able to advance and retreat is provided, and a water supply port 13 protrudes on the outer peripheral surface of the operation unit main body 11 in a direction substantially orthogonal to the center line direction of the operation pipe 12. The inner end of the water supply port 13 is in communication with the in-cylinder space of the operation unit main body 11. An injection (not shown) or the like can be attached to the water supply port 13 to supply liquid into the flexible sheath 2, and the proximal end portion of the operation wire 3 is fixed to the distal end portion of the operation pipe 12. The operation wire 3 can be advanced and retracted, and the proximal end portion of the operation pipe 12 extends to the rear end side, protrudes outward from the operation portion main body 11, and the grip portion 14 is connected to the rear end side. .

The basket portion 4 is formed by twisting and / or curving a plurality of elastic wires 5a to 5d (four in this embodiment) made of stranded wires and each elastic wire 5a to 5d into a predetermined shape as will be described later. The front end chip 6 and the rear end chip 7 are formed to bind the front end and the rear end. In this application, the straight broken line extending from the rear end tip 7 to the front end tip 6 shown in FIG. 1 is called a basket portion axis, and the basket portion axis is not rotated with respect to the basket portion axis. A transition that changes the distance (dimension) of the ball (for example, minimum distance−maximum distance−minimum distance) is referred to as “curving”, and the “curving” accompanied by rotation with respect to the axis of the basket portion is referred to as “spiral turn”. ”And“ spiral times ”are referred to as urging force displacement points.
The bundling of the plurality of elastic wires 5a to 5d and the rear end may be performed by brazing or laser welding without using the front end tip and the rear end tip.

  The elastic wires 5a and 5c are, as shown in FIG. 1 (a), between the front end tip 6 and the rear end tip 7 in the opened state of the basket portion (without rotation about the basket portion axis). Curved to form an urging force displacement point at the center position (L1≈L2) and bulge outward to a dimension L3 so as to form a vertex b1 or b3 having the maximum diameter, and from the position of the vertex b1 or b3 to the tip 6 The bulge is contracted while spiraling toward the side, and is self-biased so as to be symmetric with respect to the basket portion axis.

  Similarly, the elastic wires 5b and 5d are curved between the front end tip 6 and the rear end tip 7 (with no rotation around the basket portion axis) to form a biasing force displacement point at the center position b2. Alternatively, it bulges outward to form a dimension L3 so as to form b4, and shrinks the bulge while spirally turning from the position of the apex b2 or b4 toward the tip 6 to be symmetrical with respect to the basket part axis. It is formed to be energized. In addition, the code | symbol c4, c2 in a figure is a vertex of the spiral turning toward the front-end | tip tip 6 from the position of the vertex b2 or b4, and the code | symbol d shows the spiral radius.

  Thus, in the basket portion 4 according to the present embodiment, when the elastic wires 5a and 5c are from the rear end tip 7 to the center position of the elastic wire length, the curve from the rear end tip 7 to the biasing force displacement point is shown in FIG. As shown in the figure seen from the tip side shown in FIG. 2, it is substantially linear in a direction away from the basket portion axial direction, and includes a rotational component centered on the basket portion axis from the center position to the tip tip 6. The curved portion from the rear end tip 7 of the elastic wires 5a and 5c to the central position of the elastic wire length is self-biased so as to face each other with the axis of the basket portion being axisymmetric, and the elastic wires 5b and 5d are similarly As shown in FIGS. 1 (b) and 1 (d), the elastic wires 5a to 5d are arranged every 90 degrees in the open state as shown in FIGS. 1 (b) and (d). Self biasing to a position with a configured gentle curve that curves without rotating relative to the basket portion axis, are and arranged such pair of elastic wire becomes axisymmetric.

  Furthermore, when the basket portion 4 is viewed from the tip direction of the opened elastic wires 5a to 5d, the biasing force displacement of each elastic wire 5a to 5d from the rear end tip 7 is shown in FIG. An approximately D-shaped straight portion is formed between the points. 1 (C) and 1 (D) show a state rotated 45 degrees from the state shown in FIGS. 1 (A) and 1 (B).

  The basket gripping tool 1 configured in this way is a flexible sheath that pulls the operation wire 3 from the opened state of the basket portion 4 shown in FIG. 1 (a) to bring the elastic wires 5a to 5d to the vicinity of the biasing force displacement point. 2, the elastic wires 5a to 5d are accommodated in the flexible sheath 2 by about half as shown in FIG. 2 (a). The elastic wires 5a to 5d thus accommodated are described above. The biasing force is not easily transmitted to the projecting portion (b1 to b4 to the tip 6) due to the biasing of only the curve (without the axial rotation). As shown in FIG. 2 (a), a small-diameter Dormia basket portion 40 is formed while leaving the spiral of the projecting portion from the displacement point to the tip, and the operation wire 3 is further placed in the flexible sheath 2. When pulled in, as shown in (b) Further modified so that the outer diameter reduced in diameter. The size of the small-diameter Dormia-type basket portion 40 roughly corresponds to the symbol d shown in FIG.

  The stepwise deformation principle of the basket portion of the basket gripping tool according to this embodiment will be described. First, as shown in FIG. 3 (a), the basket gripping tool according to the prior art is formed by spirally rotating four elastic wires 50a to 50d under the same conditions. The elastic wires 50a to 50d are self-biased so as to bulge outward so as to form one apex at the center position (L1≈L2) while spirally rotating between the front end tip 6 and the rear end tip 7. It arrange | positions so that it may become line symmetry centering on a basket part axis line. As shown in FIG. 3 (b) when the elastic wires 5a to 5d in this state are viewed from the distal direction, the elastic wires 50a to 50d are formed so as to spiral in an elliptical shape, and the operation wire 3 is pulled to be flexible. 3 (c), the elastic wires 50a to 50d are each reduced in diameter from the rear end tip 7 to the front end tip 6 under the same conditions, as shown in FIG. On the other hand, as shown in FIG. 2A, the basket gripping tool 1 according to the present embodiment is a portion in which only the curvature of the elastic wires 5a to 5d is biased (the portion from the rear end tip 7 to the biasing force displacement point). ) Is stored in the flexible sheath 2, since the stress due to the storage is not easily transmitted to the distal end side, the distal end side is difficult to reduce in diameter, and the basket portion 40 having a small diameter is formed by the urging force by the spiraling on the distal end side. Can do. In other words, in the basket portion 4 according to the present embodiment, the curved portion housed in the flexible sheath 2 of the elastic wires 5a to 5d is crushed due to a loose curve, but the tip side where the spiral is urged is originally attached. The basket portion 40 having a small diameter can be formed by the force, and smaller stones can be easily captured by the elastic wires 5a to 5d that are gradually reduced in diameter.

  As described above, the conventional Dormia-type basket gripping tool has the same spiral shape of the plurality of elastic wires 50a to 50d, so that the basket portion 4 is front-facing (direction from the tip 6 side toward the tip 7). When viewed from the top, the elliptical elastic wires 50a to 50d are arranged at an angular interval of 90 degrees in the direction around the tip 6 and, as a result, have a point-symmetric relationship with the tip 6 as the center of symmetry. Therefore, when the elastic sheath 50 is drawn into the flexible sheath 2, all the elastic wires 50 a to 50 d contract under the same conditions regardless of the storage amount in the flexible sheath 2, whereas the basket according to the present embodiment. Since the gripper is curved substantially along the basket part axis without spiraling the deformation of the rear end tip 7 side of the elastic wires 5a to 50d, the size of the basket part is increased as described above. For example, when capturing a relatively large-diameter calculus, the basket portion is captured by a large-diameter basket portion in which all the elastic wires 5a to 5d shown in FIG. Small-diameter basket in which the basket portion is housed in the sheath from the rear end tip 7 of the elastic wires 5a to 5d shown in FIG. The stone can be captured by the portion 40.

  In addition, as described above, since the bile duct is always crushed, the basket portion is pressed against the inner wall, and a force is applied from the outside to the inside of the basket portion. Although it is difficult to sufficiently open the bile duct because it is small, the basket gripping tool according to the present embodiment includes the elastic wires 5a to 5d having a relatively large maximum warp (relatively large elastic restoring force). The bile duct is sufficiently opened by the elastic restoring force of the elastic wire, and the gallstone can be captured while the basket portion is reduced in diameter.

  The members of the elastic wires 5a to 5d and the operation wire 3 may be made of different materials, but the present invention is not limited to this. For example, at least one elastic wire among the plurality of elastic wires 5a to 5d is used. It is good also as a structure which passes along the rear end chip | tip 7 and extends to the hand side, makes it an operation wire, arranges elastic wires other than the extended elastic wire in the extended elastic wire, and fixes to the rear end chip | tip 7. The flexible sheath 2 may be a metal close-wound coil in the case where the flexible sheath 2 is gripped strongly, for example, by crushing a calculus. Further, in the present embodiment, an example in which four elastic wires are used has been described. However, the present invention is not limited to this, and may be configured by at least three to eight or more. Good. Further, the example in which the displacement point of the urging force of the elastic wire is provided in the intermediate portion of the elastic wire has been described. However, the size of the small-diameter basket portion is increased by providing the displacement portion further from the intermediate portion to the rear end tip 7 side. It can also be.

  Further, in the above-described embodiment, the elastic wires 5a to 5d are bent to the middle portion of the elastic wire as shown in FIG. 1 (a), and thus have a straight portion as shown in FIG. 1 (b). Although an example of forming a substantially D-shape has been described, the present invention is not limited to this, and the straight D-shaped straight portion is curved inward or outward, that is, from the tip 6 to the displacement portion. It may be slightly spiraled inwardly or outwardly, and the degree of spiraling inwardly or outwardly is preferably within 25% of the approximate D-shaped width. That is, the basket gripping tool according to the present invention is a plus of the maximum spiral turn radius by the spiral turn on the tip end 6 side with respect to the direction orthogonal to the axial direction of the basket portion 4 from the rear end tip 7 to the biasing force displacement point. A spiral energizing force with rotation in the range of 25% to minus 25% may be applied.

  In this embodiment, the urging force displacement point for changing the urging force of “bending” and “spiral rotation” is formed at one vertex at the central position (L1≈L2) of the basket. However, the present invention is not limited to this. If L1 <L2, the front end side of the basket becomes large, and if L1> L2, the rear end side of the basket becomes large, so that it can be set according to the purpose of use.

DESCRIPTION OF SYMBOLS 1 Basket gripping tool 2 Flexible sheath 3 Operation wire 4 Basket part 5a-5d, 50a-50d Elastic wire 6 Front-end tip 7 Rear-end tip 10 Operation part 11 Operation part main body 12 Operation pipe 13 Water supply port 14 Grasping part 100 Internal view Mirror 200 Duodenum 210 Fater papilla 220 Bile duct 230 Stone

Claims (5)

An elongated flexible sheath;
An operation wire that is inserted into the flexible sheath so as to freely advance and retract;
A basket portion that is provided at the distal end portion of the operation wire, forms a substantially bowl shape by bundling the tip and rear ends of a plurality of elastic wires, and accommodates and holds the collection target in the inside of the substantially bowl shape. And
In the basket gripping tool that elastically contracts or expands by causing the basket portion to protrude and retract from the distal end portion of the flexible sheath by advancing and retracting the operation wire along the axial direction of the basket portion,
The basket portion in the expanded state sets a biasing force displacement point having a different biasing force between the front end and the rear end in the plurality of elastic wires, and the basket between the biasing force displacement point and the front end. An energizing force of spiral rotation with continuous rotation in the axial direction of the portion is energized, and a curve is applied without rotation in the axial direction of the basket portion between the rear end and the displacement point of the energizing force. A basket gripping tool, wherein a force is biased. An elongated flexible sheath;
An operation wire that is inserted into the flexible sheath so as to freely advance and retract;
A basket portion that is provided at the distal end portion of the operation wire, forms a substantially bowl shape by bundling the tip and rear ends of a plurality of elastic wires, and accommodates and holds the collection target in the inside of the substantially bowl shape. And
In the basket gripping tool that elastically contracts or expands by causing the basket portion to protrude and retract from the distal end portion of the flexible sheath by advancing and retracting the operation wire along the axial direction of the basket portion,
In the basket portion in the expanded state, the plurality of elastic wires set urging force displacement points having different urging forces between the front end and the rear end, and the basket between the urging force displacement point and the front end. The urging force of the spiral rotation with continuous rotation with respect to the axial direction of the portion is urged, and due to the spiral rotation with respect to the direction orthogonal to the axial direction of the basket portion between the rear end and the urging force displacement point. A basket gripping tool in which a biasing force of a spiral having a turning radius in a range of plus 25% to minus 25% of a maximum spiral radius is biased.   The basket gripping tool according to claim 1 or 2, wherein an urging force displacement point of the elastic wire is set from the rear end to an intermediate portion of the tip.   The basket gripping tool according to claim 1 or 3, wherein the curve from the rear end to the biasing force displacement point is biased substantially linearly in a direction away from the basket portion axial direction. The basket gripping tool according to any one of claims 1 to 4, wherein the basket portion is composed of at least three to eight elastic wires.

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