JP6829563B2 - Basket forceps - Google Patents

Description

The present invention relates to basket forceps that are inserted into a body cavity through an endoscope and used to collect and crush foreign substances such as stones in the body cavity.

The basket forceps are basically composed of an operation wire inserted into a tubular sheath and a plurality of elastic wires attached to the tips of the operation wires. The operating wire is configured to be able to move forward and backward in the axial direction of the sheath, and when the elastic wire is pushed out of the sheath by the operating wire, the plurality of elastic wires are configured to expand. Then, the expanded elastic wire forms a basket, and foreign matter such as stones is taken into the basket to be collected and crushed.

When operating the operation wire to push the elastic wire out of the sheath and take in stones, etc. inside the expanded elastic wire, a guide wire is provided to accurately control the traveling direction of the elastic wire. There is also a basket forceps. Examples of this include, for example:

Japanese Unexamined Patent Publication No. 2-1113353 Japanese Unexamined Patent Publication No. 2011-19937

In Patent Document 1, a tip is provided at the tip of an elastic wire (grip wire) to be expanded, and a guide wire to be inserted into the sheath is provided inside the elastic wire and from the base end to the tip of the tip. A basket forceps inserted through a through hole is disclosed.

In Patent Document 2, a tip tip is provided at the tip of the elastic wire to be expanded, and a guide wire for inserting the inside of the sheath or the inside of the endoscope is provided from the side of the tip tip toward the tip. The basket forceps inserted through the through hole are disclosed.

In the case of basket forceps as disclosed in Patent Document 1, when the elastic wire is expanded, the guide wire passing through the inside of the sheath and the through hole of the tip tip passes substantially in the center of the expanded elastic wire. As a result, the elastic wire extruded out of the sheath is surely guided by the guide wire, so that it is easy to operate the operation wire and insert the elastic wire to the target portion. However, since the guide wire passes through substantially the center of the expanded elastic wire, stones and the like easily interfere with the guide wire, and it is difficult to take the stones and the like inside the elastic wire. On the other hand, when a calculus or the like is taken inside the elastic wire, the guide wire is also gripped by the elastic wire together with the calculus or the like. Therefore, when collecting the calculus or the like, the guide wire must be pulled out together with the guide. There is also a problem that the treatment cannot be performed continuously with the wire indwelling.

On the other hand, in the case of basket forceps as disclosed in Patent Document 2, since the guide wire passes through the through hole provided from the side of the tip to the tip, the guide wire enters the inside of the expanded elastic wire. It is said to be difficult. Here, the guide wire is connected to the channel of the endoscope, the operation wire lumen provided in the sheath, or the guide wire lumen provided separately from the operation wire lumen in the sheath. It is said that there is. However, if the guide wire communicates directly into the endoscope channel, the guide wire does not communicate with the sheath, so if you try to push the sheath along the guide wire, the guide wire will bend and be used. There is a problem that it is difficult for a person's force to be transmitted to the tip of the sheath and it is difficult to push the sheath. In addition, the exposed guide wire may be caught by other members in the endoscope. On the other hand, in the case of a structure in which the guide wire is inserted into the operation wire lumen provided in the sheath, the guide wire is caught between the tip tip and the tip of the sheath when the elastic wire is housed in the sheath. There is a problem that the sheath cannot be inserted along the guide wire. On the other hand, in the case of a structure in which a guide wire lumen is provided separately from the operation wire lumen in the sheath, the diameter of the sheath is increased by the amount of the guide wire lumen provided, and the flexibility of the sheath is also reduced. There is a problem that it becomes difficult to insert into.

Therefore, in view of the above-mentioned problems, an object of the present invention is to provide a basket forceps that can be easily inserted into a target portion while preventing interference between the guide wire and the expanded elastic wire.

The present invention is attached to a tubular sheath that is inserted into a body cavity through an endoscope, an operating wire that is movably inserted into a lumen in the sheath, and the tip of the operating wire, and the tip of the sheath. In a basket forceps having a plurality of elastic wires that expand when extruded to the outside of the sheath and a tip that is attached to the tip of the elastic wire and has a through hole.
The sheath comprises a guide wire lumen having openings located spaced apart from the tip of the sheath to the proximal end side .
The problem was solved by a basket forceps characterized in that the base end side opening of the through hole and the guide wire lumen are located on the same axis .

According to the present invention, first, since the guide wire can be inserted into the through hole provided in the tip, the elastic wire forming the basket can be reliably guided by the guide wire. Further, since the sheath is provided with a guide wire lumen having openings located at a distance from the tip of the sheath on the proximal end side, the through hole of the tip tip and the guide wire inserted into the guide wire lumen are the sheath. It is easy to bend outward in the radial direction. Therefore, it is possible to prevent the guide wire from interfering with the expanded elastic wire. Further, since the guide wire lumen through which the guide wire passes is provided on the base end side of the sheath tip, the diameter of the sheath tip side can be reduced, so that the sheath tip side has high flexibility and the target portion. It can be a basket forceps that can be easily inserted into.

Further, if the opening is inclined from the tip side to the base end side, or the through hole penetrates from the side surface of the tip tip toward the tip, the guide wire is in the radial direction of the sheath. It is suitable because it is more easily curved to the outside.

A cross-sectional view along an axial direction showing a main part of the first embodiment of the present invention. The schematic diagram when the treatment is performed using the 1st Embodiment of this invention. The cross-sectional view along the axial direction which shows the state in which the elastic wire of 1st Embodiment of this invention is expanded. A cross-sectional view along an axial direction showing a main part of the second embodiment of the present invention. The figure which shows the reference example of this invention.

Hereinafter, embodiments of the present invention will be described with reference to FIGS. 1 to 5. However, the present invention is not limited to this embodiment.

The basket forceps 10 shown in FIG. 1 includes a tubular sheath 12, an operation wire 22 inserted into a lumen 14 in the sheath 12, and a plurality of pieces attached to the tip of the operation wire 22 via a fixing member 24. It includes an elastic wire 26 and a tip 28 attached to the tip of the elastic wire 26. The operation wire 22 and the elastic wire 26 are provided so as to be able to move forward and backward with respect to the sheath 12. The elastic wire 26 is configured to expand by itself when pushed out of the sheath 12 by the operating wire 22. As for the configuration of the base end side of the basket forceps 10 and the detailed configuration of the elastic wire 26, a known structure may be adopted, and since it is not the gist of the present invention, description thereof will be omitted.

The tip 28 of the tip of the basket forceps 10 is provided with a through hole 25. The through hole 25 is linear and includes a proximal end side opening 27 that opens to the proximal end side of the tip tip 28 and an distal end side opening 29 that opens to the distal end side. Further, the sheath 12 includes a guide wire lumen 16, and the openings 17 thereof are located on the proximal end side of the tip of the sheath 12 with a predetermined interval. The base end side opening 27 of the through hole 25 and the guide wire lumen 16 are located on the same axis. Although not illustrated, the guide wire lumen 16 is also open on the proximal end side so that the guide wire 30 (see FIG. 2) penetrates, and the operation wire 22 is in the middle of the sheath 12. The elastic wire 26 may be configured to communicate with the lumen 14 in the sheath 12 through which the elastic wire 26 is inserted. The diameters of the through hole 25 and the guide wire lumen 16 are large enough to allow the guide wire 30 (see FIG. 2) to loosely fit and move forward and backward, as will be described later.

As shown in FIG. 2, the basket forceps 10 are inserted into the body cavity through the endoscope 40, for example, into the bile duct 50. At this time, first, the guide wire 30 is inserted into the bile duct 50, and the basket forceps 10 are inserted into the bile duct along the guide wire 30 through which the through hole 25 (see FIG. 1) of the tip tip 28 and the guide wire lumen 16 of the sheath 12 are inserted. It is inserted near the gallstone 52, which is a stone in 50. As described above, in the basket forceps 10, since the guide wire 30 is inserted into the through hole 25 of the tip tip 28, the sheath 12 and the elastic wire 26 can be reliably guided by the guide wire 30.

The specific position of the opening 17 (see FIG. 1) is determined according to the site where the basket forceps are used, and the farther the position is from the tip of the sheath 12, the more the guide is when the sheath 12 is pushed. Since the wire 30 is easily bent, it is preferable to provide the wire 30 at a position near the tip of the sheath 12. For example, when basket forceps are used for the bile duct, the opening 17 (see FIG. 1) should be located within a range of about 15 cm from the tip of the sheath 12. Basically, as shown in the figure, the opening 17 (see FIG. 1) is located at a portion (intrabody cavity insertion part 18) that comes out of the endoscope 40 and is inserted into the body cavity during surgery. .. When the opening 17 is located in the sheath 12 of the portion protruding from the proximal end side of the endoscope 40 to the outside of the endoscope, the guide wire 30 moves in the channel for the treatment instrument of the endoscope 40. Since it is the same as inserting, the opening 17 is an endoscope located in the channel for the treatment instrument of the endoscope 40 at the time of surgery even if it is the farthest from the tip of the sheath 12. It needs to be located at the mirror communication part 19.

With this configuration, the through hole 25 (see FIG. 1) of the tip tip 28 and the guide wire 30 inserted into the guide wire lumen 16 can be easily curved outward in the radial direction of the sheath 12, and the tip of the sheath 12 can be easily curved. Since the diameter of the side, particularly the portion beyond the opening 17 of the guide wire lumen 16, can be reduced, the basket forceps 10 have high flexibility on the tip side of the sheath 12 and can be easily inserted into the target portion. be able to.

After the basket forceps 10 are inserted to an appropriate position in the body cavity to remove and crush stones and the like, the operation wire 22 is pushed toward the tip of the sheath 12 by the operation of the user and is connected to the operation wire 22. The elastic wire 26 is pushed out of the sheath 12. As shown in FIG. 3, the elastic wire 26 extruded to the outside of the sheath 12 expands each of the plurality of wires by its self-expanding function. At this time, as described above, since the guide wire 30 tends to bend outward in the radial direction of the sheath 12, it is possible to prevent the guide wire 30 from interfering with the expanded elastic wire 26. Therefore, it is easy to take in stones and the like inside the elastic wire 26, and it is possible to prevent the problem that the guide wire 30 is gripped by the elastic wire 26 together with the stones and the like. Is easy to do continuously.

As in the case of the opening 17a of the guide wire lumen 16 shown in FIG. 4, if the guide wire lumen 16 is inclined from the tip end side toward the proximal end side, the opening 17a is radially outside of the sheath 12. Since the guide wire 30 (see FIG. 3) is more likely to bend outward in the radial direction of the sheath 12, the basket forceps 10a can be formed. As a result, the effect of preventing interference between the guide wire 30 and the expanded elastic wire 26 (see FIG. 3) can be further enhanced.

As described above, according to the present invention, it is possible to provide a basket forceps that can be easily inserted into a target site while preventing interference between the guide wire and the expanded elastic wire.

10, 10a, 10b Basket forceps 12 Sheath 14 lumen 16 Guide wire lumen 17 Opening 22 Operating wire 25 Through hole 26 Elastic wire 28 Tip tip 40 Endoscope

Claims (3)

It is attached to a tubular sheath that is inserted into the body cavity through an endoscope, an operation wire that is movably inserted into a lumen in the sheath, and the tip of the operation wire, and is attached to the outside of the sheath from the tip of the sheath. In a basket forceps having a plurality of elastic wires that expand when extruded and a tip that is attached to the tip of the elastic wire and has a through hole.
The sheath comprises a guide wire lumen having openings located spaced apart from the tip of the sheath to the proximal end side .
The base end side opening of the through hole and the guide wire lumen are located on the same axis .
Basket forceps. The basket forceps according to claim 1, wherein the opening is inclined from the distal end side toward the proximal end side. The basket forceps according to claim 1 or 2, wherein the through hole penetrates from the side surface of the tip to the tip.

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