CN116710012A - Treatment tool for endoscope - Google Patents

Abstract

The treatment tool for an endoscope comprises: a sheath; a tube member extending within the sheath and having a first conduit; and a treatment unit connected to the distal end of the pipe member, the treatment unit including a second pipe communicating with the first pipe and a liquid feed port capable of feeding a fluid, and a third pipe having an opening area smaller than the opening area of the first pipe and the opening area of the second pipe being formed between the distal end of the pipe member and the liquid feed port.

Description

Treatment tool for endoscope

Technical Field

The present invention relates to a treatment tool for an endoscope.

Background

Conventionally, in endoscopic treatment such as an endoscopic submucosal dissection operation (Endoscopic Submucosal Dissection: hereinafter, sometimes simply referred to as ESD), an endoscopic treatment tool for dissection, such as a high-frequency knife, has been used. The treatment tool for an endoscope is configured to be capable of endoscopically incising and dissecting a living tissue such as a mucous membrane and submucosal layer, and to be capable of delivering a medical solution, physiological saline, or the like from a distal end portion liquid delivery hole.

In ESD surgery, a local injection needle for an endoscope is inserted into a channel formed in an insertion portion of the endoscope. The initial local injection is performed by delivering a drug solution, physiological saline, or the like in a state where a needle at the distal end portion is inserted into a lesion formed in the lumen of the digestive tract, and the lesion is inflated. Thereafter, the local injection needle for an endoscope is pulled out from the endoscope, and the high-frequency treatment tool for an endoscope is inserted. The periphery of the lesion is incised by a high-frequency treatment tool for an endoscope, and the exposed submucosa is peeled off to excise the lesion. In addition, in the operation, the drug solution, physiological saline, or the like injected into the submucosa leaks out with time, and as a result, the swollen lesion is atrophic. Therefore, the additional local injection is performed by appropriately feeding the liquid while pressing the liquid feeding port at the distal end portion against the submucosa.

As such an endoscope treatment tool, for example, a treatment tool for an endoscope described in patent document 1 is known. In the endoscopic treatment tool of patent document 1, a conductive spiral tube is disposed on the proximal side of a high-frequency knife, and the spiral tube functions as an electrode and a liquid feeding line.

Prior art literature

Patent literature

Patent document 1: chinese patent application publication No. 111202485A

Disclosure of Invention

Problems to be solved by the invention

In the endoscopic treatment tool of patent document 1, in addition to the conditions of the mucous membrane and the submucosa (thickness of the mucous membrane, softness of the surface, etc.), when the manner of attaching the liquid feeding hole to the mucous membrane and the submucosa is inappropriate or when the potential of the liquid such as physiological saline or a chemical liquid fed from the liquid feeding hole at the distal end is weak, the shape and the size may be uneven when the mucous membrane and the submucosa swell. As a result, the lesion is not formed into a desired bulge shape and size. In this case, since the local injection is performed with the high-frequency treatment tool and the local injection needle replaced every time the local injection is performed, the time for the operation becomes long. In order to solve such a problem, it is necessary to use a liquid-feeding pump having a high pressure or a high flow rate, or a liquid-feeding pump having a high pressure and a high flow rate. However, there is a problem that the size and price of the liquid feeding pump are also high.

In the treatment tool for an endoscope of patent document 1, a liquid feed hole is provided at the distal end of the high-frequency knife, and Kong Jiao of the liquid feed hole is small. Therefore, if the electric current is repeatedly applied in a state where blood and mucus enter the holes of the liquid feeding hole and adhere to the holes, the adhering substances are zoomed and fixed, and the liquid feeding line is blocked, so that the liquid medicine, the physiological saline, and the like cannot be fed forward. Therefore, when the blockage in the liquid feeding line cannot be removed, the high-frequency treatment tool needs to be replaced with a new one, and the operation time becomes long.

The present invention has been made in view of the above-described problems, and an object of the present invention is to provide a treatment tool for an endoscope, which can deliver a liquid such as a chemical solution or physiological saline from a distal end portion of the treatment tool with a strong potential without using a high-performance liquid delivery pump.

Solution for solving the problem

The treatment tool for an endoscope according to claim 1 of the present invention comprises: a sheath; a tube member extending within the sheath and having a first conduit; and a treatment unit connected to the distal end of the pipe member, the treatment unit including a second pipe communicating with the first pipe and a liquid feed port capable of feeding a fluid, and a third pipe having an opening area smaller than the opening area of the first pipe and the opening area of the second pipe being formed between the distal end of the pipe member and the liquid feed port.

In the above-described treatment tool for an endoscope, the distal end of the third tube may be located on a distal side from the proximal end of the treatment section.

In the above-described treatment tool for an endoscope, the distal end of the third tube may be located closer to the distal end of the second tube than the distal end of the third tube, and a stepped portion may be formed between the distal end of the third tube and the second tube.

In the above-described treatment tool for an endoscope, the stepped portion may be provided at a proximal end of the second tube.

In the above-described treatment tool for an endoscope, the third pipeline may be formed at a distal end of the tube member.

In the above-described treatment tool for an endoscope, the distal end of the tube member may be inserted into the second pipeline.

The endoscope treatment tool may include a tube having the third channel, and a distal end of the tube may be inserted into the second channel of the treatment unit.

In the above-described treatment tool for an endoscope, the third line may be formed on a proximal side of the second line of the treatment portion.

In the above-described treatment tool for an endoscope, an inclined surface may be formed between the proximal end of the third tube and the first tube.

In the above-described treatment tool for an endoscope, the sheath may have an insulating head at a distal end, the insulating head may have heat resistance and insulation properties, and the treatment portion may be a high-frequency knife penetrating through the insulating head and being capable of advancing and retreating with respect to the sheath.

The above-described treatment tool for an endoscope may further include: a cylinder having the third line; and a connector connecting the cylinder and the high-frequency blade, formed of a conductive material, and abutting the connector and the insulating head to position a protruding position where the high-frequency blade protrudes from the sheath.

In the above-described treatment tool for an endoscope, the treatment tool may further include a connector that connects the tube member and the high-frequency blade, and is formed of a conductive material, and the high-frequency blade may be positioned at a protruding position protruding from the sheath by the connector being in contact with the insulating head.

In the above-described treatment tool for an endoscope, the high-frequency knife may include: a distal end member having insulation properties, the distal end member being formed with the liquid feed port; and an energizing portion having conductivity and disposed at a proximal end portion of the distal end member, an outer edge portion of the energizing portion being exposed at a proximal side of the distal end member.

In the above-described treatment tool for an endoscope, the treatment portion may include a pair of forceps members and a shaft member provided with the pair of forceps members on a distal side, and the second pipe may be formed on the shaft member.

ADVANTAGEOUS EFFECTS OF INVENTION

With the above-described treatment tool for an endoscope, a liquid such as a chemical solution or physiological saline can be delivered from the distal end portion of the treatment portion with a strong potential of the liquid without using a high-performance liquid delivery pump.

The invention can prevent the long time of operation without changing a high-frequency treatment tool and a local injection needle to perform local injection every time of local injection. The invention can restrain the enlargement of the liquid sending pump and the price because the liquid sending pump with high pressure and high flow is not needed.

Drawings

Fig. 1 is an overall view of an endoscopic treatment tool according to a first embodiment of the present invention.

Fig. 2 is a partial cross-sectional view of a treatment tool for an endoscope according to a first embodiment of the present invention.

Fig. 3 is a cross-sectional view of a main part of an endoscope treatment tool according to a first embodiment of the present invention.

Fig. 4 is a cross-sectional view of a main part of a treatment tool for an endoscope according to a modification.

Fig. 5 is a cross-sectional view of a main part of an endoscope treatment tool according to a modification.

Fig. 6 is a cross-sectional view of a main part of an endoscope treatment tool according to a modification.

Fig. 7 is a cross-sectional view of a main part of an endoscope treatment tool according to a modification.

Fig. 8 is a cross-sectional view of a main part of a treatment tool for an endoscope according to a modification.

Fig. 9 is a view from line IX-IX of fig. 8.

Fig. 10 is an overall view of an endoscopic treatment tool according to a second embodiment of the present invention.

Fig. 11 is a cross-sectional view of a main part of an endoscope treatment tool according to a second embodiment of the present invention.

Fig. 12 is a cross-sectional view of a main part of an endoscope treatment tool according to a modification.

Fig. 13 is a cross-sectional view of a main part of an endoscope treatment tool according to a modification.

Fig. 14 is a cross-sectional view of a main part of an endoscope treatment tool according to a modification.

Fig. 15 is a cross-sectional view of a main part of a treatment tool for an endoscope according to a modification.

Detailed Description

(first embodiment)

A first embodiment of the treatment tool for an endoscope according to the present invention will be described below with reference to fig. 1 to 3. Fig. 1 is an overall view of an endoscopic treatment tool 1 according to the present embodiment. Fig. 2 is a cross-sectional view of a main part of the treatment tool 1 for an endoscope. In fig. 2, the distal end is illustrated in an enlarged manner compared to the proximal portion. The treatment tool 1 for an endoscope is inserted into a channel of an endoscope, not shown, and used. As shown in fig. 1, the treatment tool 1 for an endoscope has a treatment section 2 at a distal end and an operation section 4 at a proximal end.

The treatment tool 1 for an endoscope includes a sheath 10, an operation wire 3, and a high-frequency knife 2 (hereinafter, simply referred to as "knife"). An operation section 4 is provided at the proximal end of the flexible sheath 10. A knife 2 is arranged at the far end of the operation wire 3, and the operation wire 3 penetrates through the inside of the sheath 10. The knife 2 and the operation wire 3 are configured to be capable of advancing and retreating relative to the sheath 10 in accordance with the operation of the operation section 4. The knife 2 is configured to be capable of cutting tissue or the like by applying a high-frequency current through the operation unit 4 and the operation wire 3. A liquid feeding line is formed from the operation unit 4 side to the distal end of the blade 2 in the treatment tool 1 for an endoscope. The treatment tool 1 for an endoscope is configured to be capable of supplying liquid to a liquid supply line and supplying liquid from a distal end portion of the blade 2.

The operation wire 3 is made of a metal material having conductivity such as stainless steel. The first pipe 31 is formed over the entire length of the operation wire 3. The operation wire 3 is, for example, a closely wound coil. The operation wire 3 is covered with an insulating inner tube 6 over the entire length.

The sheath 10 is made of an electrically insulating material such as tetrafluoroethylene. The outer diameter of the sheath 10 is set to a size that can pass through a channel of an endoscope, not shown. The operation wire 3 penetrates the sheath 10. The operating wire 3 is capable of advancing and retracting in a direction along the length axis C of the sheath 10. The sheath 10 and the operation wire 3 constitute an insertion portion penetrating the channel of the endoscope.

An insulating head 8 is inserted into a distal opening of the sheath 10. The insulating head 8 is fixed to the distal end portion of the sheath 10 by an adhesive or the like, not shown. The insulating head 8 is formed of a material having heat resistance and insulation properties, such as ceramic or resin. The insulating head 8 has a through hole 82, and the through hole 82 communicates with the internal space of the sheath 10 and is open at a remote position. A stepped portion 83 formed by expanding the opening of the through hole 82 is formed on the distal side of the through hole 82 of the insulating head 8. Has a recess 84 recessed from the distal end face of the insulating head 8 toward the proximal side. The outer diameter of the proximal portion of the insulating head 8 is sized to be insertable into the distal end of the sheath 10. The distal end portion of the insulating head 8 is formed with a large diameter portion 85 having a larger diameter than the proximal portion. The outer diameter of the large diameter portion 85 is substantially equal to the outer diameter of the sheath 10. The outer peripheral portion of the large diameter portion 85 on the distal side has a curved surface.

As shown in fig. 2, the operation portion 4 is provided at the proximal portion of the sheath 10. The operation section 4 includes an operation body 43 and a slider 44. The slider 44 is provided slidably along the longitudinal axis C with respect to the operation body 43. By the operation of advancing and retreating the slider 44 with respect to the operation body 43, the operation of advancing and retreating the knife 2 with respect to the sheath 10 can be performed.

The operation body 43 is fixed to the proximal end portion of the sheath 10. A slit 431 is formed in the operation body 43 along the longitudinal axis C. The slider 44 is slidable along the slit 431 with respect to the operation body 43. The proximal end of the operation body 43 has a ring 432 for hooking.

The slider 44 is provided with a hooking ring 442. The slider 44 has an electrical connector 42. The electric connector 42 is electrically connected to a high-frequency power supply device, not shown. The proximal end of the operation wire 3 is electrically connected to the electrical connector 42.

Fig. 3 is a cross-sectional view of the distal end of slider 44 along length axis C. The slider 44 is formed with an insertion hole 441 for the operation wire 3. A proximal end portion of the operation wire 3 is inserted into the insertion hole 441, and a proximal end portion of the operation wire 3 is fixed. Specifically, a pair of protruding portions 443 for fixing the operation wire 3 are formed in the insertion hole 441. The projection 443 projects from the inner surface of the insertion hole 441 in a direction orthogonal to the longitudinal axis C. The convex portion 443 is a substantially cylindrical protrusion. The convex portions 443 protrude to such an extent that the outer peripheral surface of the proximal end portion of the operation wire 3 inserted into the insertion hole 441 contacts the pair of convex portions 443.

As shown in fig. 3, the slider 44 is provided with a liquid feeding pipe head 41. Although not shown, the liquid feeding tube head 41 is configured to be detachable from a liquid feeding member such as a syringe or a liquid feeding tube extended from a liquid feeding pump. The liquid feeding pipe head 41 has an injection port 411. An injection passage 412 communicating with the liquid feeding tube head 41 and the insertion hole 441 is formed in the slider 44. An opening 33 for injecting liquid is formed at the proximal end of the operation wire 3. The opening 33 is an opening communicating with the inside and outside of the operation wire 3. At a position where the insertion hole 441 and the opening 33 are opposed, the operation wire 3 is fixed with respect to the insertion hole 441. As a result, the liquid feed line 31 is connected to the operation line 3 from the liquid feed port 411. An O-ring 444 is attached to each of the projections 443. The O-ring 444 keeps the operation wire 3 and the boss 443 watertight. When the liquid is circulated from the liquid feeding pipe head 41, the O-ring 444 prevents the liquid from leaking from the gap between the operation wire 3 and the projection 443.

As shown in fig. 2, a cylinder 5 is fixed to the distal end of the operation wire 3. The cylinder 5 is a cylindrical member having conductivity, such as stainless steel. The cylinder 5 is formed with a third conduit 53 along the length axis C. The opening area of the third pipe 53 is smaller than the opening area of the first pipe 31 of the operation wire 3. The proximal end of the barrel 5 and the distal end of the operating wire 3 are fixed together by a weld 11. The distal end of the operation wire 3, the proximal end of the cylinder 5, and the welded portion 11 are covered with the distal end of the inner tube 6. As a result, the first pipe 31 and the third pipe 52 are connected watertight. A spiral groove 54 is formed in the outer peripheral surface of the intermediate portion of the tubular body 5 in the longitudinal axis C direction.

The knife 2 is an electrode member. As shown in fig. 2, the knife 2 is connected to the distal end of the operating wire 3 by means of a cylinder 5 and a connector 7. The blade 2 is made of a material having conductivity, such as stainless steel. The knife 2 is a tubular member extending along a length axis C. That is, the knife 2 is a tubular electrode formed with the second tube 22 along the length axis C. The knife 2 has a large diameter portion 24 and a small diameter portion 25. The large diameter portion 24 is located at the distal end of the blade 2. The small diameter portion 25 is located in a region from the proximal end of the large diameter portion 24 to the proximal end 23 of the blade 2. A second conduit 22 extending along the longitudinal axis C is formed inside the knife 2. A second conduit 22 extends from the proximal end to the distal end of the blade 2, opening at the proximal and distal ends of the blade 2. The opening at the distal end of the knife 2 is a liquid feed 21 for delivering liquid. The liquid feed port 21 opens at the large diameter portion 24. The large diameter portion 24 is thicker in the radial direction than the small diameter portion 25.

The small diameter portion 25 penetrates through the through hole 82 of the insulating head 8. The outer diameter of the small diameter portion 25 is smaller than the inner diameter of the recess 84 of the through hole 82 of the insulating head 8 on the far side from the step 83. The opening area of the concave portion 84 is larger than the area of the large diameter portion 24 in the direction orthogonal to the longitudinal axis C. The blade 2 is inserted into the insulating head 8 so as to be capable of moving forward and backward with respect to the insulating head 8. When the knife 2 retreats, the large diameter portion 24 enters the concave portion 84.

The distal end of the barrel 5 is inserted into the second conduit 22 of the knife 2. The cartridge 5 and the knife 2 are connected by means of a connector 7. The connector 7 is formed of a metal material having conductivity, such as stainless steel. The connector 7 is formed with a through hole 72 penetrating along the longitudinal axis C. A spiral groove 71 is formed in the inner peripheral surface of the through hole 72 at the proximal end portion of the connector 7. The inner peripheral surface of the distal end 721 of the through hole 72 of the connector 7 has an opening size into which the small diameter portion 25 of the blade 2, which will be described later, can be inserted. A proximal end portion of the blade 2 is inserted into the distal end portion 721 of the through-hole 72, and the blade 2 and the connector 7 are fixed.

The cylindrical body 5 is inserted into the through-hole 72 from the proximal side of the connector 7, and is screwed by the screw grooves 54, 71. The distal end portion of the cylinder 5 protrudes to a position on the distal side from the distal end of the connector 7. In a state where the connector 7 and the cylinder 5 are screwed together, the proximal end 23 of the blade 2 is inserted into the distal end 721 of the through hole 72. In this example, the connector 7 and the cylinder 5 are fixed by screw threads, but the method of joining the connector and the cylinder is not limited to screw-coupling. For example, the connector and the cylinder may be joined by an adhesive or welding.

The blade 2 is connected to the electrical connector 42 via the connector 7, the cylinder 5, the welded portion 11, and the operation wire 3. As a result, the blade 2 is energized from the high-frequency power supply device connected to the electrical connector 42 through the operation wire 3, the welding portion 11, the connector 7, and the cylinder 5.

As shown in fig. 2, the opening area of the third pipe 53 of the cylinder 5 is smaller than the opening areas of the first pipe 31 of the operation wire 3 and the second pipe 22 of the knife 2. Thus, the flow path of the liquid from the operation line 3 to the liquid feed port 21 of the knife 2 is once narrowed in the third pipe 53. As a result, the liquid supplied to the first pipe 31 of the operation line 3 passes through the third pipe 53, and the hydraulic pressure increases. The liquid with increased hydraulic pressure is fed from the liquid feed port 21 of the knife 2 through the second pipe 22. As a result, even if the liquid pressure of the liquid supplied to the first pipe 31 is low, the potential of the liquid in the second pipe 22 can be increased, and the liquid can be supplied from the liquid supply port 21 in a state in which the potential of the liquid is increased.

Next, the operation of the treatment tool 1 for an endoscope will be described. For example, a user, such as an operator, inserts his or her finger into the ring 432 of the operation body 31 and the ring 442 of the slider 44, and slides the slider 44 with respect to the operation body 43 in a direction along the longitudinal axis C with one hand to operate the treatment instrument 1 for an endoscope.

The operation wire 3 is moved to the distal side with respect to the sheath 10 by an operation of moving the slider 44 to the distal side with respect to the operation body 43. With this, the blade 2 protrudes to a position on the far side from the insulating head 8. At this time, when the slider 44 is pushed in to the distal side, as shown in fig. 2, the distal end surface 74 of the connector 7 abuts against the proximal end 81 of the insulating head 8. As a result, the blade 2 protrudes to the maximum protruding position. That is, the connector 7 abuts against the insulating head 8, thereby positioning the protruding position of the blade 2. The state in which the connector 7 abuts against the insulating head 8 and the blade 2 protrudes to the most distal side is referred to as a protruding state.

In the protruding state, the distal portion of the small diameter portion 25 of the blade 2 can be protruded to a position on the distal side from the sheath 10 through the through hole 82 of the insulating head 8. A liquid such as normal saline is supplied from the inlet 411 of the liquid feed pipe head 41 to the first pipe 31. The liquid is transported from the liquid feed port 21 to the distal side through the first pipe 31 of the operation wire 3, the third pipe 53 of the cylinder 5, and the second pipe 22 of the knife 2.

By moving the slider 44 proximally relative to the operation body 43, the operation wire 3 is retracted proximally relative to the sheath 10. As a result, the large diameter portion 24 is in contact with the recess 84 of the insulating head 8. As a result, the small diameter portion 25 of the knife 2 is accommodated in the inner space 10S of the sheath 10, and the operation wire 3 is accommodated in the proximal position.

Next, the operation of the endoscope processing tool 1 according to the present embodiment will be described.

The distal portion of the sheath 10 of the treatment tool 1 for an endoscope is protruded from the channel of the endoscope, and the knife 2 is opposed to a lesion mucous membrane portion which is a treatment target portion in a body cavity, for example.

A syringe or a liquid feeding tube, not shown, is attached to the inlet 411 of the liquid feeding tube head 41. The user presses the knife 2 against the mucous membrane of the lesion, and supplies the physiological saline stored in the syringe or the liquid-feeding pump to the first tube 31 of the operation wire 3. In this case, the blade 2 may be in a protruding state or in a housed state. The normal saline is sent to the remote side from the liquid sending port 21 through the liquid sending pipeline. In the treatment instrument 1 for an endoscope, the liquid supplied to the first tube 31 passes through the third tube 53, then passes through the second tube 22, and is sent from the liquid sending port 21. The third pipeline 52 has a smaller opening area than the first pipeline 31. Therefore, the liquid supplied to the first pipe 31 passes through the third pipe 53, so that the potential of the liquid becomes strong. Thus, the liquid can be fed from the liquid feed port 21 in a state where the potential of the liquid is strong. As a result, the liquid is supplied in a state where the liquid supply port 21 is pressed against the mucous membrane and submucosal layer of the lesion, and the lesion is inflated.

Then, a high-frequency current is supplied to the blade 2 through the electric connector 42, the operation wire 3, and the connector 7 from a high-frequency power supply device, not shown, connected to the electric connector 42 of the operation unit 4.

Next, for example, when the knife 2 is moved in a lateral direction orthogonal to the longitudinal axis C, the mucous membrane (tissue) in contact with the knife 2 is incised. After the lesion mucous membrane portion is completely incised in the circumferential direction, the knife 2 is brought into contact with an incision formed by incising the periphery of the lesion mucous membrane portion, and the lesion mucous membrane portion is entirely resected and peeled off.

When incision of mucous membrane and treatment of coagulating bleeding point are performed, body fluid such as mucus and blood may enter the second tube 22 of the knife 2 from the fluid feed port 21 due to capillary phenomenon or the like. In this case, mucus and blood adhering to the second line 22 may be burned by the heat of the high-temperature knife 2 due to the incision and separation by the knife 2. The liquid feeding line of the second line 22 is narrowed by the scorching of mucus and blood in the second line 22, and thus, it is difficult to feed liquid. Then, the liquid is fed through the third pipe 53 in a state in which the potential of the liquid is increased, and the adhering matter burned in the second pipe 22 is removed. As described above, the liquid in which the momentum of the liquid is enhanced in the third pipe 53 is sent from the liquid feed port 21 through the second pipe 22. As a result, the adhering matter burned in the second pipe 22 is peeled off from the inner peripheral surface of the second pipe 22 by the liquid pressure and discharged from the liquid feed port 21.

As described above, in the treatment tool 1 for an endoscope according to the present embodiment, the third line 53 is provided between the first line 31 and the liquid feeding port 21. The opening area of the third pipe 53 is smaller than the opening areas of the first pipe 31 and the second pipe 22. As a result, the liquid supplied to the first pipe 31 passes through the third pipe 53, and the potential of the liquid can be increased, so that the liquid can be supplied from the liquid supply port 21 in a state in which the potential of the liquid is increased. With the treatment tool 1 for an endoscope, even if the output of the syringe or the liquid feeding pump that supplies the liquid to the first line 31 is small, the liquid can be fed from the liquid feeding port 21 in a state in which the potential of the liquid is enhanced.

In the treatment device 1 for an endoscope according to the present embodiment, the third pipe 53 having a smaller opening area than the first pipe 31 and the second pipe 22 is provided between the distal end portion of the operation wire 3 and the liquid feeding port 21, so that the saline and the chemical liquid can be fed from the liquid feeding port 21 in a state where the potential of the liquid is strong without using a high-performance liquid feeding pump. As a result, local injection operation for swelling the lesion by feeding liquid to the mucosa and submucosa is facilitated, and the treatment tool does not need to be replaced, thereby shortening the operation time.

In the treatment tool 1 for an endoscope, the liquid is sent from the third line 53 in a state where the potential of the liquid is strong, whereby the adhering matter burned in the second line 22 can be easily removed. Thus, the second pipe 22 can be prevented from being clogged with the attached matter.

The manner of providing the third pipe 53 is not limited to the above example. The treatment tool for an endoscope may be, for example, a modified example shown in fig. 4 to 9. In the following description, the same parts as those in the first embodiment are denoted by the same reference numerals, and the description thereof is omitted, and only the differences will be described.

The example shown in fig. 4 is an example in which the structures of the operation wire 3A, the connector 7A, and the cylinder 5A are different from those of the first embodiment. The operation wire 3A is a flexible tube made of a conductive material. In the case where the operation wire 3A is a tube, the inner tube 6 is not necessarily constructed since the first pipe 31 of the operation wire 3A can be kept in a watertight state. In the first embodiment, an example is shown in which the cylinder 5 partially protrudes to a position closer to the position side than the connector 7 and is connected to the operation wire 3. However, the third pipe 53A may be located between the distal end of the operation wire 3 and the liquid feed port 21. For example, as shown in fig. 4, the tubular body 5A may be fitted into the proximal end portion of the second channel 22 of the knife 2A, so that the third channel 53A having a smaller opening area than the first channel 31 and the second channel 22 may be disposed.

In the first embodiment, an example is shown in which the tubular body 5 is fixed to the operation wire 3, the proximal end portions of the connector 7 and the blade 2 are fixed, and the connector 7 and the tubular body 5 are screwed together to connect the tubular body and the blade 2. The manner of connecting the operation wire 3 and the blade 2 by the connector 7 is not limited to this example. For example, as shown in fig. 4, the distal end of the operation wire 3A and the proximal end of the blade 2A may be fixed by penetrating the through hole 72 of the connector 7A. In this configuration example, the operation wire 3A and the blade 2A can be energized by being in contact with the connector 7A. In this case, as shown in fig. 4, the inner tube 6 of the first embodiment may not be provided. According to this configuration, as in the first embodiment, the liquid can be supplied from the liquid supply port 21 in a state in which the potential of the liquid is increased by increasing the liquid pressure of the liquid in the third pipe 53A.

The example shown in fig. 5 is an example in which the structures of the operation wire 3B, the connector 7B, the cylinder 5B, the insulating head 8B, and the proximal end portion of the blade 2B are different from those of the first embodiment. The structures of the operation wire 3B, the connector 7B, and the cylinder 5B are the same as those of the modification shown in fig. 4. The proximal end 26 of the blade 2B has a larger diameter than the small diameter portion 25. A step 27 is formed between the small diameter portion 25 and the proximal end portion 26. The proximal end 26 has a thickness greater than the thickness of the small diameter portion 25 in a direction orthogonal to the longitudinal axis C. The second pipe 22 at the proximal end 26 has a receiving portion for the tubular body 5B. The proximal end 26 has a slightly larger opening area than the other region of the second conduit 22, and is configured to allow the tubular body 5B to be fitted therein.

A recess 821 recessed toward the distal side is formed at the proximal end of the insulating head 8B. The recess 821 has a larger opening size than the through hole 82 of the insulating head 8, and a stepped portion 822 is formed. In the example shown in fig. 5, when the blade 2B is pushed out, the stepped portion 27 of the proximal end 26 of the blade 2B abuts against the stepped portion 822 of the recess 821 of the insulating head 8B. As a result, the position where the knife 2 protrudes to the greatest extent with respect to the sheath 10 is positioned. The treatment instrument of the modification example shown in fig. 5 can deliver the liquid from the liquid delivery port 21 in a state in which the potential of the liquid is enhanced in the third line 53B, as in the first embodiment.

The connector 7 and the cylinder 5 shown in the first embodiment are not necessarily constructed. As in the example shown in fig. 6, the second line 22 and the third line 53C may be formed continuously in the knife 2C. The knife 2C has a third channel 53C having a smaller opening area than the second channel 22 and the first channel 31 of the operation wire 3 on the proximal end side of the second channel 22. In this case, the proximal end portion of the blade 2 and the distal end portion of the operation wire 3 may be fixed together by the welding portion 11. The treatment device according to the modification example shown in fig. 6 can deliver the liquid from the liquid delivery port 21 in a state in which the potential of the liquid is enhanced in the third line 53C, as in the first embodiment.

In the example shown in fig. 7, the third pipe 53D is integrally formed with the blade 2D as in the modification shown in fig. 6. The third pipeline 53D is similar to the modification shown in fig. 6. An inclined surface 29 is formed between the proximal end of the third conduit 53D and the proximal end of the knife 2D. The inclined surface 29 is a wedge-shaped inclined surface having a diameter reduced from the proximal end of the knife 2D toward the proximal end of the third conduit 53D. With this configuration, the liquid is smoothly fed from the first pipe 31 to the third pipe 53D, and the pressure loss can be reduced. The treatment instrument of the modification example shown in fig. 7 can deliver the liquid from the liquid delivery port 21 in a state in which the potential of the liquid is enhanced in the third line 53D, as in the first embodiment.

In the first embodiment, the example in which the first pipe 31 is provided inside the operation wire 3 is shown, but the first pipe 31 may be provided independently of the operation wire. The first pipeline and the third pipeline are not limited to one pipeline respectively. As in the example shown in fig. 8 and 9, a plurality of liquid feeding pipes 9 may be provided independently of the operation wire 3. In the modification shown in fig. 8 and 9, three liquid feeding pipes 9 are arranged around the operation wire 3. The distal end of the operation wire 3 is fixed with the connector 7E. The proximal end of the blade 2E is fixed to the connector 7E. As a result, the blade 2E is energized via the operation wire 3 and the connector 7E. A connection pipe 73 is formed in the connector 7E. The connection lines 73 are formed in the same number as the number of liquid feed tubes 9. The proximal end of each connecting pipe 73 is connected to each liquid feeding pipe 9. The connection pipe 73 opens at three places separately in the circumferential direction of the connector 7E at the proximal end of the connector 7E, and is inclined toward the distal end of the connector 7E. The three connecting lines 73 merge at the distal end of the connector 7E. The third pipe 53E is formed on the far side of the junction of the three liquid sending pipes 9. The third line 53E is formed at the connection portion between the connector 7E and the slit 2E. The opening area of the third pipe 53E is smaller than the opening area of the joining portion of the connecting pipe 73. According to this configuration, as in the first embodiment, the diameter of the liquid feeding line is reduced in the third line 53E, and liquid can be fed from the liquid feeding port 21 of the knife 2E in a state in which the potential of the liquid is enhanced.

(second embodiment)

The endoscope treatment tool 1F according to the second embodiment will be described with reference to fig. 10 to 12. The treatment tool for an endoscope is not limited to a high-frequency knife, and can be applied to a treatment tool for an endoscope having functions of feeding a liquid and supplying electricity. As shown in fig. 10, the endoscope treatment tool 1F of the present embodiment is an example in which the treatment portion is forceps 2F. The structure of the operation unit 4, the sheath 10, the operation wire 3, and the inner tube 6 is the same as that of the first embodiment.

The forceps 2F includes a pair of forceps members 211, 212, a pair of link members 213, 214, a plurality of rotation shafts 216, 217, 218, a shaft member 215, a cover 228, and a stopper 227. The pliers 2F have a known link mechanism. The cap 228 and the stopper 227 are integrally formed. The stopper 227 has a through hole 229 penetrating along the longitudinal axis C. A second pipe 22F is formed inside the shaft member 215. The proximal end of the shaft member 215 is fixed to the distal end of the operation wire 3. A cylinder 5F is inserted into the proximal end of the second pipe 22F. A third pipe 53F of the tubular body 5F is disposed on the distal side of the first pipe 31 of the operation wire 3, and a second pipe 22F is formed on the distal side of the third pipe 53F.

The link members 213, 214 are coupled to the distal end of the shaft member 215 by a proximal rotation shaft 218. The distal rotation shaft 216 penetrates the pair of forceps members 211 and 212 and is connected to the cap 228. A through hole 216F penetrating along the longitudinal axis C is formed in the distal rotary shaft 216. The opening area of the through hole 216F is equal to the opening area of the second pipe 22F inside the shaft member 215, and the through hole 216F functions as an extension pipe of the second pipe 22F. Therefore, the distal end of the through hole 216F functions as the liquid feed port 21F.

In the insulating head 8F, an enlarged diameter portion 823 is formed in an intermediate portion of the through hole 82 in the longitudinal axis C direction. The stopper 227 is accommodated in the enlarged diameter portion 823. The stopper 227 restricts the movement range of the cap 228 with respect to the longitudinal axis C direction of the insulating head 8F.

When advancing and retreating the operation wire 3 relative to the sheath 10, the shaft member 215 advances and retreats relative to the cover 228. The pair of forceps members 211 and 212 are rotatably coupled to the cover 228 by a remote rotation shaft 216. As a result, as shown in fig. 11, as the operation wire 3 advances, the proximal rotation shaft 218 approaches the distal rotation shaft 216, and the pair of forceps members 211 and 212 opens. In this state, the liquid is supplied through the liquid feed pipe head 41 as in the first embodiment. Liquid is delivered from the distal end of shaft member 215 through first tubing 31, third tubing 53F, and second tubing 22F. The liquid fed from the distal end of the shaft member 215 is fed distally from between the opened pair of forceps members 211 and 212 through the liquid feed port 21F provided at the distal end of the through hole 216F of the distal rotation shaft 216. When the manipulation wire 3 is retracted, the proximal rotation shaft 218 moves proximally and away from the distal rotation shaft 216, and as shown in fig. 10, the pair of forceps members 211 and 212 is closed.

With the treatment tool 1F for an endoscope of the second embodiment, the liquid can be delivered from the liquid delivery port 21F in a state in which the potential of the liquid is enhanced in the third line 53F, as in the first embodiment.

The cylinder of the present embodiment is not limited to the above-described configuration. For example, the modification examples shown in fig. 12 and 13 may be employed. In the example shown in fig. 12, the cylinder 5F is provided at the distal end of the shaft member 215. In the example shown in fig. 12, the third pipe 53F is located on the distal end side of the shaft member 215. The distal end of the cylinder 5F protrudes to a position on the distal side from the distal end of the shaft member 215.

According to the modification shown in fig. 12, as in the second embodiment, liquid is fed to the distal side from between the opened pair of forceps members 211 and 212 through the liquid feed port 21F provided at the distal end of the through hole 216F in a state where the momentum of the liquid is enhanced in the third pipe 53F. By providing the third pipe 53F at the distal end of the shaft member 215, the liquid can be fed in a state where the potential of the liquid is enhanced in the distal portion of the device.

The modification shown in fig. 13 is an example in which the cylindrical body 5G is longer than the cylindrical body 5F of the modification shown in fig. 12. As shown in fig. 13, the long cylindrical body 5G may be protruded to the vicinity of the distal rotation shaft 216. In this case, when the pair of forceps members 211, 212 is opened, the distal end of the cylinder 5G protrudes to a position on the distal side from the distal rotation shaft 216. As a result, the pair of forceps members 211 and 212 can be opened to feed the liquid with the potential of the liquid increased on the farther side. According to the modification shown in fig. 13, liquid can be supplied from the liquid supply port 21G in a state in which the potential of the liquid is enhanced in the third pipe 53G, as in the second embodiment.

In the above-described embodiment, the high-frequency blades 2A to 2E are shown as an example of the treatment tool for an endoscope, but the treatment tool for an endoscope is not limited to the above-described example. For example, the treatment tool for an endoscope illustrated in fig. 14 and 15 may be used. In the high-frequency treatment instrument 2G shown in fig. 14 and 15, the configuration of the distal end portion is different from the above-described high-frequency cutters 2A to 2E. The large diameter portion 24G of the high frequency treatment tool 2G has a distal end member 244 and an energizing portion 241. Distal end member 244 is disposed at the distal end of large diameter portion 24G. The distal end member 244 is formed of an insulating spherical member such as zirconia or ceramic. The energizing portion 241 is provided at the proximal end of the distal member 244. The current-carrying portion 241 is formed of a conductive metal material such as stainless steel, for example, and has an annular proximal end portion 242 and a cylindrical portion 243. The cylindrical portion 243 protrudes distally from the proximal end 242. The cylindrical portion 243 is inserted into the distal end member 244 and fixed. The distal end of the small diameter portion 25G is inserted into the tubular portion 243 and fixed. An outer peripheral edge (outer edge portion) 245 of the proximal end portion 242 of the current-carrying portion 241 is exposed along an outer peripheral surface of the proximal end portion of the distal end member 244. The high-frequency current is supplied to the current supply portion 241 via the operation wire 3G, the connector 7G, and the small diameter portion 25G. When energized, the outer peripheral edge 245 of the proximal end 242 of the energizing part 241 is configured to come into contact with tissue or the like, and can cut the tissue or the like. The cylinder 5G is inserted into the proximal end of the small diameter portion 25G. The liquid having passed through the first pipe 31 is supplied in a state in which the momentum of the liquid is enhanced in the third pipe 53G, and is supplied from the liquid supply port 21 through the second pipe 22G.

In the above embodiment, the example in which the fluid is physiological saline is shown, but the fluid is not limited to this, and may be a chemical solution or the like.

With the treatment tool 1 for an endoscope, the liquid can be delivered from the liquid delivery port 21 in a state in which the potential of the liquid is enhanced in the third line 53. Therefore, even if the liquid feeding member connected to the liquid feeding pipe head 41 of the operation portion 4 is a low-pressure or low-flow syringe, a low-performance liquid feeding pump, or the like, the liquid can be fed from the liquid feeding port 21 in a state where the potential of the liquid is strong. Thus, the treatment time can be reduced without changing the high-frequency knife and the local injection needle to perform the local injection operation.

Since the liquid can be fed from the liquid feed port 21 in a state in which the potential of the liquid is enhanced, when blood or mucous membrane enters the second channel 22 of the knife 2, the objects adhering to and burning by repeated energization can be removed by feeding the fluid. As a result, clogging of the liquid feed line by the burnt deposit can be suppressed.

While the embodiments of the present invention have been described above, the protective scope of the present invention is not limited to the above embodiments, and various modifications may be made to the combination of the constituent elements of the embodiments or the addition or deletion of the constituent elements without departing from the gist of the present invention. The invention is not to be limited by the foregoing description but is only limited by the scope of the appended claims.

Industrial applicability

Provided is a treatment tool for an endoscope, which can deliver a liquid such as a chemical solution or physiological saline from a distal end of the treatment tool with a strong potential of the liquid without using a high-performance liquid delivery pump.

Description of the reference numerals

1. 1A, a treatment tool for an endoscope; 2. a high frequency knife (treatment section); 2F, forceps (treatment section); 3. an operation wire (pipe member); 5. a cylinder; 7. a connector; 10. a sheath; 411. an inlet (supply port); 31. a first pipeline; 22. a second pipeline; 53. a third pipeline; 21. a liquid feeding port.

Claims (14)

1. A treatment tool for an endoscope, wherein,

the treatment tool for an endoscope comprises:

a sheath;

a tube member extending within the sheath and having a first conduit; and

a treatment section connected to a distal end of the tube member, the treatment section having a second pipeline communicating with the first pipeline and a liquid feed port capable of feeding a fluid,

a third pipe having an opening area smaller than the opening area of the first pipe and the opening area of the second pipe is formed between the distal end portion of the pipe member and the liquid feeding port.

2. The treatment tool for an endoscope according to claim 1, wherein,

the distal end of the third tube is located on a distal side from the proximal end of the treatment portion.

3. The treatment tool for an endoscope according to claim 1, wherein,

the distal end of the third pipeline is located closer to the position side than the distal end of the second pipeline, and a step portion is formed between the distal end of the third pipeline and the second pipeline.

4. The treatment tool for an endoscope according to claim 3, wherein,

the step part is arranged at the proximal end of the second pipeline.

5. The treatment tool for an endoscope according to claim 1, wherein,

the third conduit is formed at a distal end of the tube member.

6. The treatment tool for an endoscope according to claim 5, wherein,

the distal end of the tube member is inserted into the second conduit.

7. The treatment tool for an endoscope according to claim 1, wherein,

the treatment device for endoscope comprises a cylinder body with the third pipeline,

the distal end of the barrel is inserted into the second conduit of the disposal portion.

8. The treatment tool for an endoscope according to claim 1, wherein,

the third line is formed on a proximal side of the second line of the treatment portion.

9. The treatment tool for an endoscope according to claim 1, wherein,

an inclined surface is formed between the proximal end of the third conduit and the first conduit.

10. The treatment tool for an endoscope according to claim 1, wherein,

the sheath has an insulating head at the distal end, the insulating head having heat resistance and insulation,

the treatment portion is a high-frequency knife penetrating through the insulating head and capable of advancing and retreating relative to the sheath.

11. The endoscopic treatment instrument according to claim 10, wherein,

the treatment tool for an endoscope further comprises:

a cylinder having the third line; and

a connector connecting the cylinder and the high-frequency blade, formed of a conductive material,

the high-frequency blade is positioned at a protruding position protruding from the sheath by abutting the connector and the insulating head.

12. The endoscopic treatment instrument according to claim 10, wherein,

the endoscopic treatment tool further includes a connector connecting the tube member and the high-frequency blade, formed of a conductive material,

the high-frequency blade is positioned at a protruding position protruding from the sheath by abutting the connector and the insulating head.

13. The endoscopic treatment instrument according to claim 10, wherein,

the high-frequency cutter comprises:

a distal end member having insulation properties, the distal end member being formed with the liquid feed port; and

and an energizing portion having conductivity and disposed at a proximal end portion of the distal end member, an outer edge portion of the energizing portion being exposed at a proximal side of the distal end member.

14. The treatment tool for an endoscope according to claim 1, wherein,

the treatment portion has a pair of forceps members and a shaft member provided with the pair of forceps members on a distal side,

the second pipe is formed in the shaft member.