JPH10165361A - Treatment appliance for endoscope - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a treatment appliance with superior operativity and insertion performance and easily aim the affected part from the front despite of a simple structure. SOLUTION: In this treatment appliance, a flexible sheath 1 which is inserted in an treatment appliance insertion channel of an endoscope in such a state as forwarding/retreating freely is constituted of a coil pipe formed by winding a metal fine wire therearound. In this case, the tip part of the coil pipe or the outer surface part, is ground or formed by winding a metal fine wire, whose element wire diameter is finer than that of other parts, therearound so that it is formed into a bent free part 1a which is softer than the other part of the coil pipe and freely bent in an appropriate direction.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a treatment tool for an endoscope in which a flexible sheath inserted through a treatment tool insertion channel of the endoscope so as to be able to advance and retreat is formed by a coil pipe.

[0002]

2. Description of the Related Art In general, a treatment instrument for an endoscope has a structure in which a flexible sheath is formed by a coil pipe or the like tightly wound with a stainless steel thin wire, and a treatment piece is attached to the distal end thereof.

[0003]

When aiming the affected part with such a conventional treatment tool, the distal end portion of the flexible sheath 91 of the treatment tool is inserted into the endoscope 92 as shown in FIG. It projects straight from the channel 93 to the affected part. Therefore, accurate treatment cannot be performed on the affected part A or the like that cannot be positioned in front of the endoscope 92.

Therefore, if the sheath 91 is further protruded from the treatment instrument insertion channel 93 with the distal end of the treatment instrument pressed against the affected part, the sheath 91 bends and the direction of the tip is changed. Since the elasticity is strong, the bent portion jumps and the tip of the treatment tool is
It comes off the part and eventually returns to its original straight state.

In view of this, there is a device in which the distal end portion of the sheath 91 can be arbitrarily bent by remote control (Japanese Utility Model Publication No. 52-22146, Japanese Utility Model Application Laid-Open No. 1-119).
No. 621).

[0006] However, in such an endoscope treatment tool,
Since it is necessary to perform the treatment operation and the bending operation with the operation part of the treatment tool, the operability is very poor, and it is not easy to bring the tip into contact with the affected part from the front, and the treatment operation is performed in a very thin sheath. The operation wire and the operation wire for the bending operation are inserted side by side, so that the sheath is hardened and the insertion property to the treatment instrument insertion channel is deteriorated.

SUMMARY OF THE INVENTION It is an object of the present invention to provide a treatment tool for an endoscope which has good operability and penetrability and can easily aim at an affected part from the front with a simple structure.

[0008]

Means for Solving the Problems To achieve the above object, a treatment instrument for an endoscope according to the present invention comprises a flexible sheath which is inserted into a treatment instrument insertion channel of the endoscope so as to be able to advance and retreat. In a treatment tool for an endoscope formed by a coil pipe wound with a thin metal wire, a distal end portion of the coil pipe has an outer surface portion ground and a preload applied at the time of coil winding is removed. It is characterized by being formed in a bendable portion which is more flexible than other portions and can be bent in any direction.

Further, in the treatment tool for an endoscope of the present invention, the flexible sheath inserted in the treatment tool insertion channel of the endoscope so as to be able to advance and retreat is formed by a coil pipe wound with a thin metal wire. In the treatment instrument for an endoscope, a range of 5 to 30 mm of the distal end portion of the coil pipe is formed into a bendable portion which has an outer surface portion ground and is more flexible than other portions of the coil pipe and can be bent in any direction. It is characterized by being formed.

In the treatment instrument for an endoscope according to the present invention, the flexible sheath inserted into the treatment instrument insertion channel of the endoscope so as to be able to advance and retreat is formed by a coil pipe formed by winding a thin metal wire. In the treatment instrument for an endoscope, the distal end portion of the coil pipe is formed of a thin metal wire having a smaller element wire diameter than the other portions, and is more flexible than the other portions of the coil pipe and bendable in any direction. It is characterized in that it is formed in a free part.

Further, in the treatment tool for an endoscope of the present invention, the flexible sheath inserted through the treatment tool insertion channel of the endoscope so as to be able to advance and retreat is formed by a coil pipe formed by winding a thin metal wire. In the treatment instrument for an endoscope, a tip portion of the coil pipe is formed of a thin metal wire having a smaller element wire diameter than other portions, and a preload applied at the time of coil winding is removed, and another portion of the coil pipe is removed. It is characterized by being formed in a bendable portion that is more flexible and bendable in any direction.

The length of the bendable portion is 5 to 30 m.
m, and the bendable portion preferably has twice or more flexibility as compared with other portions of the coil pipe.

Further, the coil pipe may be wound with a gap in the bendable portion, and the coil pipe may be wound closely in other portions.

[0014]

Embodiments of the present invention will be described with reference to the drawings. FIG. 2 shows an endoscope biopsy forceps, which is one of the endoscope treatment tools. However, the present invention may be applied to endoscope treatment tools other than biopsy forceps.

The flexible sheath 1 which is removably inserted into the treatment instrument insertion channel of the endoscope is formed of, for example, a coil pipe formed by winding a stainless steel thin wire into a pipe with a constant diameter.

An operating portion 2 connected to the proximal end of the flexible sheath 1 has a slider 4 for operating the operating wire 3 which is inserted into the sheath 1 so as to be able to advance and retreat freely over its entire length.
It is slidably arranged.

At the distal end of the sheath 1, a pair of tissue collecting cups 5 and 5 as distal treatment pieces are attached so as to be openable and closable about a shaft 6, and the slider 4 is slidably operated on the operation unit 2 side. When the operation wire 3 is advanced and retracted, the tissue collection cups 5 and 5 open and close in a fan shape about the shaft 6.

FIG. 1 shows the vicinity of the distal end portion of the biopsy forceps. A pair of tissue sampling cups 5 and 5 are each formed in a hemispherical shape slightly elongated in the axial direction. , 5 together, the tip surface forms one spherical surface. A blade is formed at a ridgeline portion of the opening facing each other between the tissue collection cups 5 and 5.

The shaft 6 is mounted near the distal end of a distal end body 8 connected and fixed to the distal end of the sheath 1. The rear half (the right side in FIG. 1) of the distal end body 8 is formed in a cylindrical shape, The part is formed in the shape of a parallel arm whose center is cut by a slit.

Each of the tissue collection cups 5 and 5 is integrally formed with arms 9 and 9 extending rearward from an engagement position with the shaft 6, and has a pantograph-shaped link disposed in a slit portion of the distal end main body 8. Each arm 9 is connected to the mechanism 10.

The distal end of the operation wire 3 is connected and fixed to the rear end of the link mechanism 10, and when the operation wire 3 is pushed in from the operation section 2 side, the link mechanism 10 is operated, and FIG. , The tissue collection cups 5, 5 open fan-shaped about the axis 6.

In this state, when the operation wire 3 is pulled from the operation section 2 side, the tissue collection cups 5 and 5 are closed, and the biopsy tissue or the like of the diseased part A is collected in the tissue collection cups 5 and 5. Can be.

As shown in an enlarged view in FIG. 4, projections 11, 11 having forward-pointed tips are provided on the surfaces of the tip portions of the pair of tissue collection cups 5, 5, respectively.
Is protruded at a position inside the outer diameter.

FIG. 5 is a front view of the tissue collection cups 5, 5, and the projections 11, 11 are formed in an annular shape having a diameter of about half of the tissue collection cups 5, 5 when viewed from the front. Then, as shown in FIG.
In order not to protrude forward from the distal ends of the tissue collection cups 5, 5, they are located on substantially the same plane as the distal end positions of the tissue collection cups 5, 5.

As shown in FIG. 1, the distal end portion 1a of the flexible sheath 1 can be bent with a small force by grinding the outer surface portion of the flexible sheath 1 to reduce the cross-sectional area of the wire. I can do it.

A load (so-called preload) is applied to the flexible sheath 1 at the time of winding the coil in the direction of bringing adjacent wires into close contact with each other in order to strengthen the waist, but the preload is removed to bend. It's easier.

As a result, the distal end portion 1a of the flexible sheath 1
Is a bendable portion 1a which is twice as flexible as the other portions and is bendable in any direction. No operation wire is provided for remotely controlling the bending.

More than twice the flexibility means that less than half the force is required to apply the force in the direction perpendicular to the axial direction and to deflect the same amount. Note that if the degree of flexibility can be obtained without removing the preload, the preload need not be removed.

The overall length of the sheath 1 is, for example, 1 to 2 m, and the length of the bendable portion 1a is, for example, 5 m, as described later.
It is about 30 mm. The portion of the flexible sheath 1 other than the bendable portion 1a is not ground, and is not ground when the coil is wound.
The preload of about 0 to 150 g is still applied.

In the bendable portion 1a of this embodiment, the coil is stretched in the axial direction so that a gap is provided between adjacent strands. However, it is not always necessary to leave a gap. The portions of the flexible sheath 1 other than the bendable portion 1a remain tightly wound.

When using the endoscope treatment tool of the embodiment configured as described above, the distal end portion of the treatment tool is protruded from the treatment tool insertion channel of the endoscope, and the tissue collection cups 5, 5 are removed. Press against the affected area.

As shown in FIG. 3, even when the target A can be aimed only at an oblique direction, the protrusion 11 can bite into the mucous membrane in the body cavity and fix the positions of the tissue collection cups 5, 5.

When the sheath 1 is further extruded from such a state, as shown in FIG. 6, the bendable portion 1a is spontaneously supported by the shaft 6 of the tissue collection cups 5, 5 pressed close to the affected part A. The endoscope 20 is bent smoothly and swells with the outlet 22 of the treatment instrument insertion channel 21 of the endoscope 20 as a fulcrum, and the tissue collection cups 5 and 5 come into contact with the diseased part A from a direction close to the front. At this time, P is the force with which the affected part A is pushed in the axial direction of the distal end main body 8.

The bendable portion 1a has a high flexibility and has a straight line restoring property to be straightened in a natural state. Therefore, when the bendable portion 1a is bent as shown in FIG. 6, a force Q in a direction perpendicular to the axial direction acts on the tissue sampling cups 5,5.

As a result, the combined force F of P and Q is applied to the affected area A.
Acts, the tissue collection cups 5, 5 are strongly pressed against the affected area A, and when the treatment tool is a biopsy forceps, the biopsy tissue of the affected area A can be accurately sampled. Even when the tool is of a type other than the biopsy forceps, the treatment can be accurately performed on the affected part A.

The length of the bendable portion 1a acting as described above is preferably about 30 mm or less in the case of a gastrointestinal endoscopic treatment instrument. If it is too long, it will not bend to an appropriate size in a narrow body cavity, and it will be uncomfortable. A length of about 5 mm is required as a minimum.

FIG. 7 shows a second embodiment of the treatment tool for an endoscope according to the present invention, in which a bendable portion 1a is formed by a coil having a smaller element wire diameter than other portions of the flexible sheath 1. It is formed with a pipe.

In order to form such a bendable portion 1a seamlessly at the distal end portion of the flexible sheath 1, for example, as shown in FIG. 8, a stainless steel wire 1c serving as a wire forming a coil pipe is used. The diameter may be changed halfway. It is preferable to remove the preload of the bendable portion 1a.

However, if the flexibility of the other portion of the flexible sheath 1 can be obtained twice or more without removing the preload, the preload need not be removed.

As a result, the bendable portion 1a can have the same flexibility and straight line restorability as in the first embodiment.
It works in the same way as in the first embodiment. In this embodiment, the bendable portion 1a is tightly wound, but a gap may be provided between adjacent strands of the coil pipe as in the first embodiment.

The present invention is not limited to the above embodiment. For example, when the tumor at the portion where the tissue is to be collected is hard, or when the tissue collection cup 5 is in a slippery use environment, the protrusion may be used. 11 is used to protrude forward from the tissue collection cup 5 so that the tissue collection cup 5
Can be securely fixed to the affected part.

Further, the protrusion 11 provided on the outer surface of the tissue collection cup 5 may be formed in a square shape as shown in FIG. 9, and as shown in FIG. A plurality of protrusions 11 may be provided.

[0043]

According to the present invention, the outer surface of the distal end portion of the coil pipe forming the flexible sheath is ground and the preload applied when the coil is wound is removed, or the flexible sheath is formed. By winding a thin metal wire having a smaller element wire diameter than the other portions and removing the preload, the sheath is formed at the distal end portion as a bendable portion that is more flexible than the other portion and can be bent in any direction. When the distal end of the tool protrudes from the treatment tool insertion channel of the endoscope and is pressed against the affected part, and the flexible shaft is further pushed out, the bendable part is in a natural state with the distal end pressed against the affected part as a fulcrum. To bend smoothly and change the direction of the distal end portion so that it can be brought into contact with the affected part from the front.

Therefore, the affected part can be easily aimed at the affected part from the front with a simple structure having good operability, and a bending operation wire or the like is not required.

[Brief description of the drawings]

FIG. 1 is a side sectional view of a distal end portion of an endoscope treatment tool according to a first embodiment of the present invention.

FIG. 2 is an overall side view of the treatment tool for an endoscope according to the first embodiment of the present invention.

FIG. 3 is a side view of a distal end portion of the treatment tool for an endoscope according to the first embodiment of the present invention in a used state.

FIG. 4 is a partially enlarged side sectional view of a distal end portion of the endoscope treatment tool according to the first embodiment of the present invention.

FIG. 5 is an enlarged front view of a distal end portion of the treatment tool for an endoscope according to the first embodiment of the present invention.

FIG. 6 is a side view of a distal end portion of the endoscope treatment tool according to the first embodiment of the present invention in a used state.

FIG. 7 is a side view of a distal end portion of an endoscope treatment tool according to a second embodiment of the present invention.

FIG. 8 is a partial side view of a strand forming a sheath of the endoscope treatment tool according to the second embodiment of the present invention.

FIG. 9 is a partially enlarged perspective view of a modification of the tissue sampling cup according to the embodiment of the present invention.

FIG. 10 is a partially enlarged perspective view of a modification of the tissue sampling cup according to the embodiment of the present invention.

FIG. 11 is a side view of a distal end portion of a conventional endoscope treatment tool in a used state.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 Flexible sheath 1a Flexible part 21 Treatment tool insertion channel

Claims (7)

[Claims] 1. A treatment instrument for an endoscope, wherein a flexible sheath inserted into a treatment instrument insertion channel of an endoscope so as to be able to advance and retreat is formed by a coil pipe wound with a thin metal wire. The tip portion is formed into a bendable portion that is more flexible and can bend in any direction than the other portions of the coil pipe, with the outer surface portion ground and the preload applied during coil winding removed. An endoscope treatment tool characterized by the following. 2. A treatment instrument for an endoscope, wherein a flexible sheath inserted into a treatment instrument insertion channel of the endoscope so as to be able to advance and retreat is formed by a coil pipe wound with a thin metal wire. The range of 5 to 30 mm at the tip is
An endoscope treatment tool, wherein an outer surface portion is ground to form a bendable portion that is more flexible and bendable in an arbitrary direction than other portions of the coil pipe. 3. A treatment tool for an endoscope, wherein a flexible sheath inserted into a treatment tool insertion channel of the endoscope so as to be able to advance and retreat is formed by a coil pipe wound with a thin metal wire. The distal end portion is formed of a thin metal wire having a smaller element wire diameter than the other portion, and is formed as a bendable portion that is more flexible and can be bent in any direction than the other portion of the coil pipe. Endoscope treatment tool. 4. A treatment tool for an endoscope, wherein a flexible sheath inserted into a treatment tool insertion channel of the endoscope so as to be able to advance and retreat is formed by a coil pipe wound with a thin metal wire. The distal end portion is formed of a thin metal wire having a smaller element wire diameter than the other portions, and the preload applied at the time of coil winding is removed, so that the bending is more flexible than the other portions of the coil pipe and can be freely bent in any direction. An endoscope treatment tool formed on a free part. 5. The endoscope treatment tool according to claim 1, wherein the length of the bendable portion is in the range of 5 to 30 mm. 6. The flexible part according to claim 1, wherein said flexible part has twice or more flexibility as compared with other parts of said coil pipe.
6. The treatment tool for an endoscope according to 2, 3, 4 or 5. 7. The coil pipe is wound with a gap in the bendable portion, and the coil pipe is wound tightly in other portions.
7. The treatment tool for an endoscope according to 4, 5, or 6.