JPH11114059A - Endoscope treatment tool - Google Patents

Abstract

(57) [Problem] To provide an endoscopic treatment tool capable of preventing and preventing bleeding after performing endoscopic treatment. A treatment member configured to perform treatment on a mucous membrane in a body cavity is configured to protrude and retract from a distal end of a sheath inserted into and removed from a treatment instrument insertion channel of an endoscope. In the mirror treatment tool, the sheath 11 is provided with an electrically insulating tube 11b covering the outer surface and a conductive member 11a disposed inside the tube.
A high-frequency electrode 21 electrically connected to the sheath 11 is provided so as to be exposed on the distal end surface of the sheath 11 so that a high-frequency current can be sent to the high-frequency electrode 21 via the conductive member 11 a of the sheath 11.

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 used through a treatment tool insertion channel of an endoscope.

[0002]

2. Description of the Related Art An endoscope injection tool used for injecting a drug solution or the like into a mucous membrane in a body cavity, a high-frequency snare for an endoscope used for removing a polyp formed on a mucosal surface, and the like are used in the body cavity. A treatment member such as an injection needle or a snare wire for performing treatment on the mucous membrane is configured to protrude and retract from a distal end of a sheath inserted into and removed from a treatment instrument insertion channel of the endoscope.

[0003]

When an injection is made into a mucous membrane in a body cavity, bleeding may occur from a hole after the needle is removed. Also, when a polyp is removed by a high-frequency snare, bleeding may occur from the cut end.

[0004] In such a case, when the blood vessel of the bleeding source is thick and the amount of bleeding is large, the bleeding itself is dangerous. It becomes difficult to continue the endoscopy.

Accordingly, an object of the present invention is to provide a treatment tool for an endoscope which can prevent and prevent bleeding after performing a transendoscopic treatment.

[0006]

In order to achieve the above-mentioned object, a treatment device for an endoscope according to the present invention comprises a treatment member for performing treatment on a mucous membrane in a body cavity, wherein the treatment member is inserted through the treatment device of the endoscope. In an endoscope treatment tool configured to protrude and retract from a distal end of a sheath inserted into and removed from a channel, the sheath includes an electrically insulating tube covering an outer surface and a conductive member disposed inside the tube. Along with the provision, the high-frequency electrode electrically connected to the conductive member is provided so as to be exposed on the distal end surface of the sheath, so that a high-frequency current can be sent to the high-frequency electrode through the conductive member of the sheath. Features.

The conductive member may be a close-wound coil pipe made of metal, and the outer peripheral surface may be covered with the electrically insulating tube. Further, the treatment member may be an injection needle, and the injection needle may be formed of a conductive material, and may be in electrical contact with the high-frequency electrode in a state of protruding from the distal end of the sheath. Good.

The treatment member may be a snare wire, and the conductive member and the snare wire may be electrically connected. An operating mechanism for performing an operation of projecting and retracting the treatment member from the distal end of the sheath is provided on a proximal end side of the sheath, and a connection terminal electrically connected to the conductive member is connected to the operating mechanism. May be arranged.

[0009]

Embodiments of the present invention will be described with reference to the drawings. 1 and 2 show an endoscope injection tool to which the present invention is applied. FIG. 1 shows a state where the injection needle 13 is protruded, and FIG. 2 shows a state where the injection needle 13 is retracted. I have.

Reference numeral 11 denotes a sheath which can be inserted into and removed from a treatment tool insertion channel of an endoscope (not shown). For example, a conductive metal wire such as a stainless steel wire is spirally tightly wound with a constant diameter. The outer surface of the thus formed coil pipe 11a is formed by coating a flexible electric insulating tube 11b such as a tetrafluoroethylene resin tube.

A high-frequency electrode 21 made of a conductive metal, such as stainless steel, is attached to the distal end of the sheath 11 so as to be exposed on the entire distal end surface of the sheath 11. The high-frequency electrode 21 is connected to the tip portion of the coil pipe 11a by silver brazing or soldering, and both members are electrically connected.

Inside the sheath 11, a liquid feed tube 12 made of an electrically insulating flexible tube such as a tetrafluoroethylene resin tube or the like is inserted so as to be able to advance and retreat in the axial direction.

An injection needle 13 made of, for example, stainless steel or the like is connected and fixed to the tip of the liquid sending tube 12. Therefore, by moving the liquid supply tube 12 in the sheath 11 in the axial direction, the injection needle 1
3 protrudes and retracts from the distal end of the sheath 11 through a needle passage hole 22 pierced through an axial position of the high-frequency electrode 21.

However, on the outer peripheral surface near the rear end of the injection needle 13, a flange 13a having a diameter that cannot pass through the needle passage hole 22 is formed so as to protrude. As shown in FIG. When the injection needle 13 comes into contact with the back surface of the high-frequency electrode 21, the injection needle 13 projects from the distal end surface of the high-frequency electrode 21 by a predetermined length and cannot project any more.

On the other end side (rear end side) of an inner cylinder 14 made of electrically insulating plastic connected to the base end of the liquid feed tube 12, a liquid injection mouth 15 to which a syringe or the like can be connected is formed. I have. The inner cylinder 14 is axially movable in an outer cylinder 16 made of an electrically insulating material connected to the proximal end of the sheath 11.

The O mounted on the inner peripheral side of the outer cylinder 16
The relative positioning between the inner and outer cylinders 14 and 16 is performed by engaging the ring 17 with one of the click grooves 18 and 19 formed at two places on the outer peripheral surface of the inner cylinder 14.

In the state shown in FIG. 1, the O-ring 17 is engaged with the second click groove 19, and the injection needle 13 projects by a predetermined length on the distal end side. It is done in.

In the state shown in FIG. 2, the O-ring 17 is engaged with the first click groove 18, the injection needle 13 is housed in the sheath 11, and the endoscope is inserted into the treatment instrument insertion channel of the endoscope. Insertion and removal are performed in this state.

A connection terminal 20 connected to a high-frequency power cord (not shown) protrudes from a side surface of the outer cylinder 16. The connection terminal 20 is screwed into the outer cylinder 16 and the bottom surface is in contact with the coil pipe 11a.

Therefore, a high-frequency current can be sent from the connection terminal 20 to the high-frequency electrode 21 via the coil pipe 11a. When the injection needle 13 protrudes, high-frequency current also flows through the injection needle 13 that contacts the high-frequency electrode 21. However, the outer surface of the sheath 11 is an electrically insulating tube 1
There is no leakage of current because it is covered with 1b.

When using the endoscope injection device according to the embodiment configured as described above, first, as shown in FIG. 3, the mucosa 100 in the body cavity is transendoscopically injected. Needle 1
3 is punctured to perform a drug solution injection or the like.

Then, before removing the injection needle 13 from the mucous membrane 100, a high-frequency current is applied while the high-frequency electrode 21 provided at the tip of the sheath 11 is in contact with the mucous membrane 100. Then, as shown in FIG. 4, the mucous membrane surface in contact with the high-frequency electrode 21 is cauterized and coagulated by Joule heat. 1
Reference numeral 01 denotes the coagulation portion, and the portion in contact with the injection needle 13 is also coagulated.

In this manner, the mucous membrane 100 around the needle hole into which the injection needle 13 has been punctured and its entrance is coagulated.
As shown in FIG. 5, bleeding does not occur even after removing the injection needle 13 from the mucous membrane 100, and bleeding can be prevented and prevented.

FIGS. 6 and 7 show a high-frequency snare for an endoscope to which the present invention is applied. FIG. 6 is a side cross-sectional view of the distal end portion, and FIG. 7 is a side cross-sectional view of the operation portion. It is.

As shown in FIG. 6, a snare wire 32 made of a conductive elastic wire is connected to a distal end of a conductive operation wire 31 that is inserted through the sheath 11 so as to be able to advance and retreat in the axial direction.

The snare wire 32 swells in a loop shape by its own elasticity in a natural state, and when it is pulled into the sheath 11 by the operation wire 31, it is elastically deformed and narrows as shown by a two-dot chain line in FIG.

The operation section main body 34 shown in FIG. 7 is formed of an electrically insulating plastic, and has an annular first finger hook 35 for engaging the operator's thumb at its proximal end. Is formed.

A slider 36 having a second finger hook 37 for engaging the forefinger and the middle finger is formed in a slit 36 formed in the operation section main body 34 in a longitudinally elongated shape.
8 is slidably fitted, and the base end of the operation wire 31 is fixed to the slider 38.

Therefore, the slider 38 is connected to the slit 3
The operation wire 31 can be advanced and retracted by sliding operation along 6, so that the snare wire 32 can be put in and out of the distal end of the sheath 11.

A cylindrical connection tube 39 made of a conductive metal is fixedly disposed in the operation portion main body 34 at a position surrounding the operation wire 31. The base end of the coil pipe 11a is connected and fixed to the connection tube 39, and the connection terminal 20 is
The operation unit main body 34 is fitted in the side wall of the connection cylinder 39.
From the side.

Therefore, the connecting cylinder 39 and the coil pipe 1
The connection terminal 20 and the high-frequency electrode 21 are electrically connected via 1a, and a high-frequency power cord can be connected to the connection terminal 20 to transmit a high-frequency current to the high-frequency electrode 21 at the tip.

A leaf spring 40 made of a conductive spring material attached to the inner surface of the connection tube 39 is in contact with the surface of the operation wire 31, and is connected to the connection terminal 20 via the connection tube 39 and the leaf spring 40. The wire 31 is electrically conductive.

The operation wire 31 can move in the axial direction while being in contact with the leaf spring 40. Therefore, the high-frequency current can be passed through the snare wire 32 at the tip at an arbitrary timing irrespective of the state of expansion and contraction.

When using the high-frequency snare for an endoscope of the embodiment configured as described above, first, the polyp is cut off with the snare wire 32 in the same manner as a normal high-frequency snare for an endoscope.

After the snare wire 32 is housed in the sheath 11, the sheath 11 is slightly fed out to press the high-frequency electrode 21 against the cut surface of the polyp of the mucous membrane, and a high-frequency current flows to cauterize and coagulate the cut surface. Thus, it is possible to prevent and prevent bleeding from the cut surface of the polyp.

[0036]

According to the present invention, a high-frequency current can be sent to the high-frequency electrode exposed on the distal end surface of the sheath through the sheath, so that a normal treatment tool for an endoscope can be used. After performing the treatment, the sheath tip can be continuously pressed against the treated mucosa in the body cavity to perform cauterization and coagulation with a high-frequency current, so that bleeding after endoscopic treatment is performed. Prevention and prevention can be easily performed, and high safety can be ensured.

[Brief description of the drawings]

FIG. 1 is a side sectional view of an endoscope injection tool to which the present invention is applied, in a state where an injection needle is projected.

FIG. 2 is a side cross-sectional view of the endoscope injection tool to which the present invention is applied, in a state where an injection needle is retracted.

FIG. 3 is a schematic view showing a use state of the endoscope injection tool to which the present invention is applied.

FIG. 4 is a schematic view showing a use state of an endoscope injection tool to which the present invention is applied.

FIG. 5 is a schematic diagram showing a state of a treatment target portion after using an endoscope injection tool to which the present invention is applied.

FIG. 6 is a side sectional view of a distal end portion of a high-frequency snare for an endoscope to which the present invention is applied.

FIG. 7 is a side sectional view of an operation portion of the high-frequency snare for an endoscope to which the present invention is applied.

[Explanation of symbols]

 Reference Signs List 11 sheath 11a coil pipe 11b electric insulating tube 13 injection needle 20 connection terminal 21 high-frequency electrode 32 snare wire

Claims (7)

[Claims] 1. A treatment for an endoscope in which a treatment member for performing treatment on a mucous membrane in a body cavity is configured to protrude and retract from a distal end of a sheath inserted into and removed from a treatment instrument insertion channel of the endoscope. In the device, the sheath is provided with an electrically insulating tube covering the outer surface and a conductive member disposed inside the sheath, and a high-frequency electrode electrically connected to the conductive member is provided on the distal end surface of the sheath. A treatment tool for an endoscope, wherein the treatment tool for an endoscope is provided so as to be exposed so that a high-frequency current can be sent to the high-frequency electrode via a conductive member of the sheath. 2. The treatment tool for an endoscope according to claim 1, wherein the conductive member is a tightly wound coil pipe made of metal, and the outer peripheral surface of the conductive member is covered with the electrically insulating tube. 3. The treatment instrument for an endoscope according to claim 1, wherein the treatment member is an injection needle. 4. The endoscope treatment tool according to claim 3, wherein the injection needle is formed of a conductive material, and is in electrical contact with the high-frequency electrode when protruding from the distal end of the sheath. 5. The endoscope treatment instrument according to claim 1, wherein the treatment member is a snare wire. 6. The treatment tool for an endoscope according to claim 5, wherein the conductive member and the snare wire are electrically connected. 7. An operating mechanism for performing an operation of pushing and retracting the treatment member from the distal end of the sheath is provided on a proximal end side of the sheath, and a connection terminal electrically connected to the conductive member is provided. The treatment tool for an endoscope according to any one of claims 1 to 6, wherein the treatment tool is disposed on the operation mechanism.