JPH05192348A - Endoscopic treating tool - Google Patents

Abstract

PURPOSE:To easily rotate a treating part on the top end even if a sheath inserting part is lengthy and curved in the course and perform a certain treating operation. CONSTITUTION:A holding part 3 is provided on the top end of a sheath 2, and an ultrasonic motor 15 is provided near the connecting part between the sheath top end part and the sheath rear end part, whereby the sheath top end part is rotated to the sheath rear end part. The holding part 3 is operated by the contraction and extension of a traction member 9 made of a shape memory alloy according to its temperature change. The current-carrying operations to the traction member 9 and the ultrasonic motor 15 are independently conducted by switches 13, 14 for operating a current-carrying control circuit 12 for independently carrying a current thereto.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a treatment instrument for an endoscope which is introduced endoscopically into a body cavity to perform treatments such as collection, grasping, and incision of living tissue.

[0002]

2. Description of the Related Art There is a procedure for transendoscopically introducing a treatment instrument into a body through a treatment instrument insertion channel of an endoscope and performing a predetermined treatment on a living tissue in the body. For example, a biopsy forceps is known as an endoscopic treatment tool of this type. A general biopsy forceps for an endoscope is provided with a biopsy forceps at the distal end of a long flexible sheath, and an operation wire inserted through the sheath at an operation part provided on the proximal side of the sheath. The push-pull operation is used to open and close the tip forceps.

Further, in the biopsy forceps disclosed in Japanese Utility Model Publication No. 52-40616, a biopsy forceps portion provided at the distal end of the sheath is rotatably provided, and an operation wire inserted through the sheath is operated by an operation portion on the proximal side. By pushing and pulling, the forceps part for biopsy is rotated.

[0004]

Generally, when a forceps is inserted into a body cavity through an endoscope, the tip forceps portion opens and closes in only one direction, and this direction is the direction of the tissue site to be sampled. Often does not fit.

For example, in the case of a ridge-like tissue site as shown in FIG. 5, when the opening and closing direction of the forceps coincides with the ridge direction as shown in FIG. It is difficult, and in this case, it is convenient to change the direction of the forceps so that the forceps are opened and closed in the direction orthogonal to the ridgeline direction as shown in FIG. The same applies to a protruding portion such as a polyp.

However, in a general conventional forceps for an endoscope, when the direction of the forceps is changed, the entire forceps device is twisted at the hand of the endoscope to change the direction of the distal forceps. I'm taking the way. However, in such an operating means, since the portion of the endoscope that is inserted in the treatment instrument insertion channel is considerably long, the resistance in the channel absorbs the operating rotational force on the hand side, The driving force could not be sufficiently transmitted to the forceps at the tip.
Therefore, in reality, the operation was almost impossible. Further, when the twisted force increases above a certain level, the accumulated force is transmitted to the forceps at once, and an unstable operation situation such as excessive rotation is likely to occur.

On the other hand, as shown in Japanese Utility Model Publication No. 52-40616, even in the mechanism in which the distal forceps portion is remotely rotated by pushing and pulling the operation wire, the sheath portion is long,
Moreover, it is difficult to reliably transmit an appropriate operating force to the tip forceps to be rotated due to the operation wire whose frictional resistance with the sheath is increased due to bending in the middle, for example, buckling. There are many.

The present invention has been made in view of the above-mentioned problems, and an object of the present invention is to provide a sheath insertion portion having a long length when a treatment is endoscopically inserted into a body cavity and a treatment is performed. An object of the present invention is to provide a treatment tool for an endoscope in which the distal treatment section can be easily rotated even if it is bent in the middle and a treatment operation can be reliably performed.

[0009]

SUMMARY OF THE INVENTION The present invention provides a treatment tool for an endoscope which is transendoscopically introduced into a body cavity to perform collection, grasping, incision and the like of living tissue, and a sheath distal end portion. A sheath divided into a sheath rear end portion, a treatment member provided at the distal end of the sheath distal end portion, and a sheath distal end portion provided near the connecting portion between the sheath distal end portion and the sheath rear end portion. A rotary drive means for rotating the rear end portion, an electric operation member made of a shape memory alloy arranged at the distal end portion of the sheath for operating the treatment member by operating by heat generated by energization, and driven by the electric operation member. And a power cord inserted through the sheath for supplying an electric current.

[0010]

1 to 5 show a first embodiment of the present invention. In FIG. 1, reference numeral 1 denotes an endoscopic biopsy forceps that is inserted into a body cavity through a treatment tool insertion channel of an endoscope (not shown) to grasp a living tissue site in the body cavity or to collect the living tissue. The biopsy forceps 1 for an endoscope is provided with a grip portion 3 having cups 3a and 3b as treatment members at the distal end of a sheath 2, and an operating portion 4 connected to the proximal end of the sheath 2. The sheath 2 is formed of a coil in which metal wires are tightly wound. Further, the sheath 2 is divided into two in the axial direction at a position near the distal end side, and connecting rings 5 and 6 are respectively connected to the rear end of the sheath distal end 2a and the front end of the sheath rear end 2b. ing. The butt connection ends of the connection rings 5 and 6 are rotatably fitted and connected. A sealing packing 7 is inserted between the butt connection end faces.

A fixing member 8 is fixed inside the rear end portion of the sheath front end portion 2a, and one end of a pulling member 9 as an electric operating member made of a wire made of shape memory alloy (SMA) is fixed to the fixing member 8. It is installed. The shape-memory alloy traction member 9 has a characteristic that it expands and contracts in the longitudinal axis direction due to a temperature change, is elongated at room temperature, and contracts when heated.

The linear pulling member 9 is a sheath tip portion 2a.
And is connected to the grip portion 3. The grip portion 3 has a pair of cups 3a and 3b, and the pair of cups 3a and 3b are connected to the pulling member 9 via an opening / closing drive link mechanism (not shown). Then, the push-pull movement of the pulling member 9 due to the action as described later is converted into the opening / closing operation of the cups 3a, 3b by the link mechanism.

To one end and the other end of the pulling member 9, one ends of energizing lead wires 11a and 11b as power cords for supplying a driving current are respectively connected. The other ends of the current-carrying lead wires 11 a and 11 b are guided to the operation section 4 through the inside of the sheath 2 and connected to the power supply control circuit section 12 installed in the operation section 4. The energizing operation to the pulling member 9 through the energizing lead wires 11a and 11b is performed by the gripping operation switch 13 provided in the operating portion 4.
Done by

Further, in the middle of the sheath 2, a connecting portion between the sheath front end portion 2a and the sheath rear end portion 2b, that is, inside the connecting rings 5 and 6 in this embodiment, is shown in FIG. As described above, the small-sized ultrasonic motor 15 as a rotary drive element is provided, and the ultrasonic motor 15 constitutes a rotary drive means for rotating the sheath front end 2a with respect to the sheath rear end 2b. The stator 16 of the ultrasonic motor 15 is fixed to, for example, the connecting ring 6 on the sheath rear end 2b side, and the rotor 17 of the ultrasonic motor 15 is fixed to the connecting ring 5 on the sheath tip 2a side. The joint surface between the stator 16 and the rotor 17 is pressure-contacted by a spring or the like (not shown). Lead wires 18a, 18b for energizing the ultrasonic motor 15
Is guided to the operating portion 4 through the sheath rear end portion 2b and connected to the power supply control circuit portion 12 installed in the operating portion 4. The energization operation to the ultrasonic motor 15 through the energization lead wires 18a and 18b is performed by the rotary operation switch 14 provided in the operation unit 4.

The pulling member 9 and the ultrasonic motor 1
Although not shown in the drawing, insulation treatment is performed between 5 and the sheath 2 so that they are not electrically conductive with each other.

Next, the operation of the endoscopic biopsy forceps 1 will be described. First, the grip operation switch 1 in the biopsy forceps 1
3 is turned on, the power control circuit 12 leads 1
The traction member 9 is energized through 1a and 11b. The pulling member 9 is heated by Joule heat due to its own resistance, and contracts in the longitudinal direction according to the temperature. Due to the contraction of the pulling member 9 in the longitudinal direction, the opening / closing drive link mechanism (not shown) is pulled to close the cups 3a, 3b.

After the gripping operation, when the energization is stopped by the gripping operation switch 13, the pulling member 9 is cooled by natural heat dissipation. Since the pulling member 9 is a bidirectional shape memory alloy, the pulling member 9 returns to its original length as it is cooled, and the cups 3a and 3b of the grip portion 3 naturally return from the state of gripping the object to the open state. ..

On the other hand, when the rotary operation switch 14 is operated, an AC wave is supplied from the power supply control circuit 12 to the ultrasonic motor 15 through the lead wires 18a and 18b. here,
When the rotary operation switch 14 is continuously turned on, an AC wave continues to be supplied from the power supply control circuit 12, and the ultrasonic motor 15 continues to rotate during that time, but when the rotation angle of the ultrasonic motor 15 reaches 180 °, for example. The power supply to the ultrasonic motor 15 is automatically stopped, and the rotary operation switch 14 is newly added.
When is operated, this time, the ultrasonic motor 15 is controlled so as to rotate in the reverse direction so that the phase of the AC wave is shifted by 90 ° in the reverse direction so that the power is supplied. As a result, the grip portion 3 at the tip is rotated and the lead wires 11a, 11b, 18a, 1 in the sheath 2 are rotated.
8b is prevented from being unintentionally twisted.

Further, as shown in FIG. 4, the endoscope biopsy forceps 1 is projected into the body cavity through the treatment tool insertion channel of the endoscope 20 as shown in FIG. When collecting the polyp 22 of FIG. 4, if the opening and closing directions of the cups 3a and 3b of the grip portion 3 of the biopsy forceps 1 match the projecting direction of the polyp 22 as shown in FIG. 22 cannot be easily gripped. In this case, the operation section 4 of the biopsy forceps 1 under the observation of the endoscope 20.
The rotation operation switch 14 of the biopsy forceps 1 is rotated to rotate the grip portion 3 of the biopsy forceps 1 to remove the polyp 22 as shown in FIG.
To an angle that can be gripped from the side. After that, the grip operation switch 13 is operated to securely grip the polyp 22, and the polyp 22 is sampled.

Even in the case of the ridge-shaped tissue portion 23 as shown in FIG. 5, the opening / closing direction of the cups 3a, 3b of the grip portion 3 of the biopsy forceps 1 is the ridge as shown in FIG. If the directions do not match, it can be easily gripped by rotating the gripping portion 3 as shown in (B) so that the opening / closing direction of the cups 3a, 3b is a direction traversing the ridge.

6 and 7 show a second embodiment of the present invention. In the embodiment described above, the ultrasonic motor 15 is used to drive the sheath tip 2a of the sheath 2 to rotate, whereas in the embodiment, the electrostatic motor 25 is used for driving. Except for this, the other points are the same as those of the above-described embodiment. That is, the electrostatic motor 25
Has an electrostatic structure composed of an electrode 26 and a rotor 27, and the electrode 26 has a connection ring 6 on the sheath rear end 2b side.
The rotor 27 is fixed to the connecting ring 5 on the sheath distal end portion 2a side. Similarly, the electrostatic motor 25 is connected with lead wires 18a and 18b for energizing the electrostatic motor 25.

Even in the case of this embodiment, however, the electrostatic motor 25 is turned on by turning on the rotary operation switch 14.
Can be driven to rotate the grasping portion 3 of the biopsy forceps 1 and position it in an orientation suitable for this. Further, as described above, the reverse rotation may be controlled within a range of, for example, 180 ° or less.

In addition to these elements, as the rotary drive element, an electromagnetic motor 28 is used to rotationally drive the portion of the sheath 2 on the distal end side as in the third embodiment shown in FIGS. 8 and 9. Good. The main body of the electromagnetic motor 28 is fixed to the connecting ring 6 on the sheath rear end 2b side, and the actuator 29 is fixed to the connecting ring 5 on the sheath tip 2a side.

10 to 11 show a fourth embodiment of the present invention. This embodiment is a modified example of the rotation driving means in the endoscopic biopsy forceps 1, in which the rotation driving means 30 having a double-barrel structure is provided between the sheaths 2 partitioned in the front and rear.
Is provided. The rotation driving means 30 is composed of an inner cylinder 31 and an outer cylinder 32, and the outer cylinder 32 is composed of a pair of front and rear cylinder members 32a and 32b. A long slot 33 extending along the axial direction is formed in the peripheral portion of the rear tubular member 32b, and the first pin 3 protruding from the outer periphery of the inner barrel 31 is formed in the slot 33.
4 is inserted and engaged. Therefore, the tubular member 32b behind the outer barrel 32 and the inner barrel 31 are in an engaged state in which they move relatively only in the axial direction of the sheath 2.

The front tubular member 32a of the outer barrel 32 is fitted to the front end of the inner barrel 31.
The peripheral portion of 2a is formed with a spiral slot 35 which is oblique with respect to the axis thereof. A second pin 36 protruding from the outer circumference of the inner cylinder 31 is inserted into and engaged with the slot 35. Therefore, when the inner cylinder 31 moves in the axial direction, the outer cylinder 32
The tubular member 32b at the rear of the is rotatable.

The front cylinder member 32a of the outer cylinder 32 is connected to the rear end of the sheath front end 2a, and the rear cylinder member 32b is connected to the front end of the sheath rear end 2b. A rotation drive wire 37 is connected to the inner cylinder 31 and extends through the sheath 2 to the proximal end portion thereof. It should be noted that the lead wires 11a and 11b for energization connected to the pulling member 9 are inserted through the inner holes of the rotation driving means 30 and the sheath rear end portion 2b of the double-tube structure, and extend to the operation portion 4. There is.

Then, when the rotary drive wire 37 provided in the coil sheath 10 is pushed and pulled by the operating portion 4 on the hand side, the inner cylinder 31 moves forward and backward. As a result, the cylindrical member 32 in front of the outer cylinder 32 connected to the sheath distal end portion 2a.
By rotating a, the grip portion 3 at the tip is driven to rotate. Also,
By electrically heating the pulling member 9 through the lead wires 11a and 11b extending in the sheath 2, the gripping operation of the gripping portion 3 can be performed.

12 to 15 show a fifth embodiment of the present invention. This example captures stones in the body cavity
The mechanism of the above-described embodiment is applied to the basket forceps 40 to be removed. That is, the wire basket 41 is provided as a capturing portion provided at the tip of the sheath 2. Then, as shown in FIGS. 13 to 14, the sheath 2
When the traction member 9 made of a shape memory alloy disposed inside the sheath distal end portion 2a is energized, the wire basket 41 is pushed out from the distal end of the sheath 2 by the expansion and contraction of the traction member 9, and the ultrasonic motor 15 The sheath 2a together with the wire basket 41
Is rotated, and the intracavitary stone 42 is taken into the opened wire basket 41.

The basket forceps 40 of this type is inserted into the body cavity, and the wire basket 4 is inserted until the calculus 42 is present.
Even if 1 is brought and the wire basket 41 is advanced and retracted as it is, the calculus 42 hits the wire of the wire basket 41 as shown in FIG. 15 (A), and therefore the calculus 42 is present between the wires. It may not be possible to get in and it may be impossible to capture.

In such a case, the rotary operation switch 14 provided on the operation portion 4 is operated to allow the calculus 42 to insert the wire basket 41 at the tip between the wires as shown in FIG. 15B. The calculus 42 is taken into the wire basket 41 by rotating it to the position or by advancing and retracting the basket forceps 40 while rotating the calculus 42, and the calculus 42 is removed outside the body as it is to remove the calculus 42.

16 to 18 show a sixth embodiment applied to a high-frequency snare 50 for cutting a polyp or the like in a body cavity by inserting it through a treatment tool insertion channel of an endoscope, and from the distal end of its sheath 2. The means for advancing and retracting the snare wire 51 as a processing member and rotating it is the same as that of any of the first to fourth embodiments described above. The snare wire 51 is projected and retracted from the distal end of the sheath 2 by the pulling member 9 made of a shape memory alloy, and the ultrasonic motor 1
The sheath distal end portion 2a is rotated by 5 or the like to be rotated. The pulling member 9 is attached to the inside of the sheath distal end portion 2a via a fixture 52. The snare wire 51 and the pulling member 9 are also electrically connected to each other, and the lead wire 53 allows the snare wire 51 and the pulling member 9 to be simultaneously energized. The sheath 2 is made of Teflon or the like.

When this high-frequency snare 50 is inserted into a body cavity through an endoscope, there are cases where the wire portion of the treatment snare wire 51 coincides with the protruding direction of the polyp 54 and cannot be taken into the loop.

Therefore, in this high frequency snare 50, as shown in FIG.
When the snare wire 51 protruding from the distal end of the sheath 2 is brought close to the polyp 54 as shown by 7, when the polyp 54 cannot be caught by the snare wire 51, the rotary operation switch provided on the operation unit 4 is provided. 14 is operated to rotate the tip so that the snare wire 51 is caught by the polyp 54. The snare wire 51 changes the direction of the loop portion and is caught by the polyp 54. Then, when the operation switch 13 of the operation unit 4 is operated, the snare wire 51 is retracted into the sheath 2 and a high-frequency current is passed through the wire, so that the polyp 54 can be cut off.

Although the biopsy forceps, the basket forceps, and the high-frequency snare have been described in the above-mentioned embodiments, the present invention is not limited to this, and a treatment tool capable of being actuated by driving a shape memory alloy wire rod, For example, it may be applied to a papillotomy knife, a hot tip, and other treatment tools.

[0035]

As described above, according to the treatment instrument for an endoscope of the present invention, since the rotation driving means for rotating the distal end portion of the sheath with respect to the rear end portion of the sheath is provided, it can be used endoscopically. When grasping and collecting living tissue such as polyps or removing calculi by introducing it into the body cavity, no matter what position the treatment part protruding into the body cavity is, the operation on the operator's side Since it can be changed more easily, reliable treatment can be performed quickly. Further, since the electric operation member of the treatment member is provided at the distal end portion of the sheath, the operation portion at the distal end can be reliably operated even if the sheath has a long sheath.

[Brief description of drawings]

FIG. 1 is a side view of a partially broken endoscopic biopsy forceps showing a first embodiment of the present invention.

2A and 2B also show a biopsy forceps for an endoscope according to the first embodiment, where FIG. 2A is a sectional view of a grip drive unit and a rotation drive unit, and FIG. 2B is a perspective view of the rotation drive unit.

3 (A), (B), and (C) are explanatory views of a state in which a lesion part is sampled with the endoscopic biopsy forceps of the first embodiment, respectively.

FIG. 4 is an explanatory view of a use state in which the endoscope biopsy forceps of the first embodiment is also inserted into the endoscope.

5 (A) and 5 (B) are explanatory views of a biopsy state of the endoscopic biopsy forceps of the first embodiment. FIG.

FIG. 6 is a cross-sectional view of a grip drive unit and a rotation drive unit in the endoscopic biopsy forceps according to the second embodiment of the present invention.

FIG. 7 is a perspective view of an electrostatic motor of the second embodiment.

FIG. 8 is a cross-sectional view of a grip drive unit and a rotation drive unit in an endoscopic biopsy forceps according to a third embodiment of the present invention.

FIG. 9 is a perspective view of an electromagnetic motor according to the third embodiment.

FIG. 10 is a cross-sectional view of a grasping drive unit and a rotation drive mechanism unit in an endoscopic biopsy forceps according to a fourth embodiment of the present invention.

FIG. 11 is a perspective view of a rotary drive mechanism portion according to the fourth embodiment.

FIG. 12 is a side view of a partially broken endoscope basket forceps showing a fifth embodiment of the present invention.

FIG. 13 is an explanatory view of the usage state of the basket forceps according to the fifth embodiment as seen from the side.

FIG. 14 is an explanatory view of the usage state of the basket forceps according to the fifth embodiment as seen from the side.

15 (A) and 15 (B) are explanatory views of the operating state when the usage state of the basket forceps in the fifth embodiment is also seen from the front.

FIG. 16 is a side view of a partially broken endoscope high frequency snare according to a sixth embodiment of the present invention.

FIG. 17 is an explanatory diagram of a usage state of the high frequency snare according to the sixth embodiment.

FIG. 18 is a side view of the vicinity of the tip of the high frequency snare according to the sixth embodiment.

[Explanation of symbols]

1 ... Biopsy forceps, 2 ... Sheath, 2a ... Sheath tip part, 2b
... sheath rear end part, 3 ... grip part, 9 ... traction member, 12 ... power supply control circuit, 13 ... grip operation switch, 14 ... rotation operation switch, 15 ... ultrasonic motor.

Claims (1)

[Claims] 1. A treatment instrument for an endoscope, which is transendoscopically introduced into a body cavity to perform treatments such as collection, grasping, and incision of living tissue, which is divided into a sheath distal end portion and a sheath rear end portion. With a sheath
A treatment member provided at the distal end of the sheath distal end, and a rotation driving means provided near the connecting portion between the sheath distal end and the sheath rear end for rotating the sheath distal end with respect to the sheath rear end. An electric operating member made of a shape memory alloy which is disposed at the distal end of the sheath and operates by heat generated by energization to operate the treatment member; and the electric operating member which is inserted into the sheath for supplying a drive current to the electric operating member. A treatment instrument for an endoscope comprising a power cord.