JPS5878655A - High frequency incision and cutting tool - Google Patents

Abstract

(57) [Summary] This bulletin contains application data before electronic filing, so abstract data is not recorded.

Description

DETAILED DESCRIPTION OF THE INVENTION The present invention relates to a frequency cutting tool that can be introduced into a body cavity and cut out m-ruts in the body cavity using a high-frequency current.

The conventional high-frequency cutting and cutting tool operates a wire electrode inserted into the V-sheath at an operating portion provided at the proximal end C of the sheath. When the operating section is housed in the sheath, the operating section main body is fixed so as not to rotate relative to the sheath and the wire electrode. For this reason, when the main body of the operating section is rotated, this rotation is transmitted to the tip via the wire electrode, and the half-moon loop at the tip of the wire electrode may become twisted and tangled more than shown in FIG. When entanglement occurs in this way, the tissue cannot be properly restrained, and even when the Takahato #1 current is applied, the tissue cannot be reliably cut, and the wire electrode and the tissue may become stuck.

The present invention was made in view of the above circumstances, and its purpose is to provide a high-frequency incision and resection j4 that can prevent wire electrodes from tangling and safely perform high-frequency incision and resection. be.

Hereinafter, one embodiment of the present invention will be described based on FIGS. 2 to 7.

Reference numeral 1 in FIG. 1 denotes an electrically insulating sheath, and a hollow base 2 is fitted and fixed at the proximal end of this sheath 1 on the proximal side, as shown in FIG.

The base 212 is provided with a guide W3, and a wire electrode 4 is inserted into the guide tube 3. Further, a fixture 5 is fixedly attached to the proximal end C of the wire electrode 4 as shown in FIG. Further, the fixture 5 is provided with a protruding rod part 7 for holding an operating member 26 which can be freely advanced and retracted, which will be described later, and a protruding part 8 is formed at the tip of the protruding rod 1.

A pipe 9 is rotatably fitted into and engaged with the protruding rod portion 1.

Further, a slider 12 having a through hole 11 is inserted into the distal end of the sheath 1 so as to be freely advanced and retractable, and the distal end side of the wire pole 4 is inserted through the through hole 11 of the slider 12. The tip side of the wire electrode 4 forms a half-moon-shaped loop 13 and is then bent and connected to the slider 12. Furthermore, a ring-shaped stopper 14 is fixedly attached within the distal end ζ of the sheath 1, located on the distal side of the slider I2.

An operating section main body 15 is attached to the base 2 of the top-distributed spoon 1. The operating section main body 15 has a disturbance 16 formed along the longitudinal direction of the sheath 1, and a chuck 11 for holding the cap 2 at the tip thereof. Further, the chuck 17 is opened and closed by a rotating ring 18 attached to its outer periphery. Then, the rotating ring 18 is turned to close the chuck 17 to rotatably hold the cap 2, and
Turn the rotary flJx8 to open the chuck 12, and the cap 2
You can release the hold. In other words, the chuck 17 is the sheath 1
The cap 2 is held rotatably without rattling.

Furthermore, as shown in FIGS. 6 and 7, a slide piece 21 is provided at the distal end of the operation section main body 15 and penetrates perpendicularly to the inner circumference of the rotating ring 18. Both ends touch the formed cam circumference #i22, and the rotating ring 18
When the sheath 1 is rotated as described above, it is displaced in a direction perpendicular to the longitudinal direction of the sheath 1.

Further, as shown in FIG. 7, the slide piece 2 has a small hole 23 and a large hole 24 arranged side by side along the sliding direction, and are opened so as to communicate with each other. Small hole 2S
has a small inner diameter corresponding to the outer diameter of the small diameter portion 25 of the cap 2, and the large hole 24 has a large inner diameter corresponding to the largest outer diameter of the cap 2. When the rotating ring 18 is rotated to close the chuck 11 and tighten the cap 2, the slide piece 21 is moved by the cam circumferential surface 22 as shown in FIG. By fitting and engaging, the cap 2 is prevented from coming off.

Furthermore, when the rotating ring 18 is loosened and the chuck 17 is loosened to release the fastening of the cap 2, the slide piece 21 is moved to the opposite side by the cam 1ia1 surface 22, the large hole 24 is moved to the center of the cap 2, and the large hole 24 is moved to the center of the cap 2. The cap 2 can be pulled out through the hole 24.

On the other hand, a slidable C2 operation member 26 is housed in the operation section main body 15 along its longitudinal direction. A holder 2r for holding the pipe 9 of the protruding rod portion 7 is attached to the operating member 26. The holder 27 is formed by fitting a piston body 29 into a cylinder body 28, and the piston body 29 is biased in one direction by a coil spring 30. Further, the piston body 29 is provided with an operation button 31 that protrudes in the biasing direction.

Furthermore, through holes 32 and 33 are formed in the cylinder body 28 and the piston body 29, respectively, and extend through the operating section body 15 in the longitudinal direction.

The through-holes 32 and 33 are aligned with each other by pushing the piston body 29 through the operation button 3117-, and are locked so that the protruding rod portion 2 can be inserted thereinto. In addition, the protrusion 1
5, the piston body 29 moves as shown in FIG. 5 and presses the protruding rod portion 1 against one side of the through hole 32. Thus, the protruding rod portion 1 is rotatably held by the holder 27 via the pipe 9, and is prevented from coming off the holder 27. Further, by moving the operating member 2C, the wire electrode 4 can be moved forward and backward along the sheath 1.

The wire electrode 4 is electrically connected to a socket (not shown) provided on the operating member 26 via a holder 27, and a cord (not shown) is connected to the socket, so that it is electrically connected to the frequency generation St. It is now connected.

Next, a method of using the above-mentioned high-frequency cutting and cutting tool will be explained.

First, the sheath 1 is inserted into the body cavity through an insertion channel through an endoscope that has been previously inserted into the body cavity. When the operation member 26 is advanced relative to the operation section main body 15, the wire electrode 4 is also advanced, and the distal end of the wire electrode 4 protrudes from the distal end of the sheath 1. However, when the operation member 26 is advanced further, the slider 12 moves forward toward the stopper 14. The wire electrode 4 continues to move forward and forms a half-moon-shaped loop 13''Ik- at the tip.
is applied to the target area, such as a polyp.

After confirming this state with an endoscope, the operating member 26 is retreated with respect to the operating section main body 15, the loop 13 is closed, and the wire electrode 4 is drawn into the sheath 1, and the loop of the polyp is tied up. While cutting, a high frequency current is passed through the wire electrode 4 to cut it.

On the other hand, since the operating section main body 15 is rotatable with respect to the sheath 1 and the wire electrode 4, even if the operating section main body 15 is twisted during operation, the twisting is not transmitted to the sheath 1 and the wire electrode 4. Therefore, the rotation of the operating part main body 15 is transmitted to the loop 13 at the tip through the wire pole 4, so that when binding a polyp, the polyp will not be tied up properly as shown in FIG. 1, or it will not stick to the polyp.

FIG. 8 shows another embodiment of the invention.

In this embodiment, the pipe 9 is not provided on the protruding rod portion 1,
A fixture 5 and a wire electrode 4 are rotatably connected. That is, the ring 41 is fitted and fixed to the base end of the wire electrode 4, and this ring 41 is fitted into the flange hole 42 of the fixture 5 so as to be rotatable, and the ring 41 is engaged with the collar 43. This prevents it from coming off.

FIG. 89 shows still another embodiment of the present invention.

In this embodiment, the tip C of the wire electrode 4 or part 1;
The installation is fixed, and the distal end C of the sheath 1: the formed side hole 51
．． A part of the wire electrode 4 is protruded to the side from 52 to form a knife 53 that protrudes and retracts. The other configurations are the same.

When the wire electrode 4 is moved forward, the knife 53 is pushed out to the side as shown in FIG.

Further, by pulling the wire tip 4, the knife 53 can be made smaller. Note that this is suitable, for example, when incising the papilla of the duodenum.

As explained above, the present invention does not transmit the twist of the operation part main body to the tip side of the wire electrode, so the tip part C2 does not get tangled, and therefore, the target area can be incised and removed easily and safely. be able to.

[Brief explanation of the drawing]

mx diagram is an explanatory diagram showing the conventional disadvantages, FIG. 2 is a side view showing an embodiment of the present invention, FIG. 3 is a side sectional view with the operation unit body removed, and FIG. 4 is the same wire electrode. 185 is a sectional view of the holding device, FIG. 6 is a side sectional view of the operating section, FIG. 7 is a vertical rear view of the base, and FIG. 8 is a sectional view of another embodiment. A sectional view showing the fixture, and FIG. 9 is a side sectional view showing still another embodiment. DESCRIPTION OF SYMBOLS 1...Sheath, 4...Wire electrode, 1...Protruding rod part, 9...Pipe, 15...Operation part main body, 17...
-Chuck, 26...operating member. 1. Indication of the case Patent application No. 6234 No. 1, 1988 2. Title of the invention: High-frequency incision and excision odor 3 , Relationship to the case of the person making the amendment Patent applicant (037) + 1. None) Director General of the Japan Patent Office Shima 1) Haruki Tono1, Indication of the case Patent Application No. 176234/19883, Person making the amendment Relationship with the case Patent applicant (037) Orinno Mosu Optical Industry Co., Ltd. 4. Agent 6, drawing to be amended 7, content of amendment, drawing 9, Figure 4 will be amended as shown in the attached sheet.

Claims (1)

[Claims] A sheath having electrical insulation properties, an operating section main body provided at the proximal end of the sheath, and a wire electrode that is inserted into the sheath so as to be freely advanced and retractable and whose shape changes according to the operation of the operating section main body. A high-frequency incision and resection tool, characterized in that the main body of the operating section is rotatable relative to the sheath and the wire electrode, respectively.