JP4475991B2 - Endoscopic high-frequency incision tool - Google Patents

Endoscopic high-frequency incision tool Download PDF

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JP4475991B2
JP4475991B2 JP2004075535A JP2004075535A JP4475991B2 JP 4475991 B2 JP4475991 B2 JP 4475991B2 JP 2004075535 A JP2004075535 A JP 2004075535A JP 2004075535 A JP2004075535 A JP 2004075535A JP 4475991 B2 JP4475991 B2 JP 4475991B2
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bending operation
bending
flexible tube
distal end
frequency incision
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JP2005261521A (en
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真一 松野
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Hoya Corp
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Description

この発明は内視鏡用高周波切開具に関する。   The present invention relates to a high-frequency cutting tool for an endoscope.

内視鏡に用いられる高周波切開具においては、先端の高周波切開電極が用途に応じて各種の形状に形成されており、内視鏡的粘膜切除術を行うための高周波切開電極の場合は、内視鏡の処置具挿通チャンネルに挿脱自在な可撓管の先端から前方に向かって棒状に突出配置されている。   In a high-frequency incision tool used for an endoscope, a high-frequency incision electrode at the tip is formed in various shapes depending on the application. In the case of a high-frequency incision electrode for performing endoscopic mucosal resection, It protrudes and arrange | positions in the rod shape toward the front from the front-end | tip of the flexible tube which can be inserted or removed in the treatment tool penetration channel of an endoscope.

そして、そのような内視鏡用高周波切開具を内視鏡に内蔵されている処置具挿通チャンネルに通して粘膜切除を行う際には、棒状の高周波切開電極を粘膜面に沿って移動させる必要があり、そのためには、内視鏡の処置具挿通チャンネルの先端開口部内に配置された処置具起上片が用いられる（例えば、特許文献１、２）。
特開２００１−２１２０７８ 特開２００３−２１０３８９ Further, when performing such mucosal resection through such a high-frequency incision instrument for an endoscope through a treatment instrument insertion channel built in the endoscope, it is necessary to move the rod-shaped high-frequency incision electrode along the mucosal surface. For this purpose, a treatment instrument raising piece arranged in the distal end opening of the treatment instrument insertion channel of the endoscope is used (for example, Patent Documents 1 and 2).
JP2001-212078 JP2003-210389A

しかし、粘膜に触れる高周波切開電極は内視鏡の処置具挿通チャンネルの先端開口部からある程度以上の長さ突出した状態になっているので、その根元の位置にある処置具起上片を僅かに動作させただけでも高周波切開電極が大きく移動してしまい、細かい切開作業を正確に行うことができない。   However, since the high-frequency incision electrode that touches the mucous membrane protrudes from the distal end opening of the treatment instrument insertion channel of the endoscope to a certain length or more, slightly lift the treatment instrument raising piece at the base position. Even if it is operated, the high-frequency incision electrode moves greatly, and a fine incision operation cannot be performed accurately.

そこで本発明は、先端から突出する棒状の高周波切開電極を粘膜面に沿って術者の所望通りに移動させて細かい切開作業等でも正確に行うことができる内視鏡用高周波切開具を提供することを目的とする。   Therefore, the present invention provides a high-frequency incision tool for an endoscope that can accurately perform even a fine incision operation by moving a rod-shaped high-frequency incision electrode protruding from the distal end along a mucosal surface as desired by an operator. For the purpose.

上記の目的を達成するため、本発明の内視鏡用高周波切開具は、内視鏡に内蔵されている処置具挿通チャンネルに挿脱自在な可撓管の先端から前方に向かって、棒状の高周波切開電極が突出配置された内視鏡用高周波切開具において、所定方向に屈曲に自在な湾曲部を可撓管の先端近傍に形成して、湾曲部を牽引操作するための湾曲操作ワイヤを可撓管内に軸線方向に進退自在に挿通配置すると共に、可撓管の基端側に連結された操作部に、高周波電源コードを接続するための接続端子と、湾曲操作ワイヤを進退操作するための湾曲操作片とを配置したものである。   In order to achieve the above-mentioned object, the high-frequency incision tool for an endoscope of the present invention has a rod-like shape from the distal end of a flexible tube that can be inserted into and removed from a treatment instrument insertion channel built in the endoscope. In an endoscopic high-frequency incision tool in which a high-frequency incision electrode is protruded, a bending operation wire for pulling the bending portion is formed by forming a bending portion that can be bent in a predetermined direction in the vicinity of the distal end of the flexible tube. Inserted into the flexible tube so as to be movable back and forth in the axial direction, and connected to the operation portion connected to the proximal end side of the flexible tube to connect the high frequency power cord and the bending operation wire to advance and retract The bending operation piece is arranged.

なお、湾曲操作ワイヤを先端側に押し込む方向に湾曲操作片を付勢する付勢手段が設けられていてもよく、湾曲操作ワイヤを押し込む方向に湾曲操作片を移動させたときに湾曲操作片に当接して湾曲操作片の移動を規制する螺動ストッパが、湾曲操作片の進退方向に螺動するように操作部に配置されていてもよい。   An urging means for urging the bending operation piece in the direction of pushing the bending operation wire toward the distal end may be provided, and when the bending operation piece is moved in the direction of pushing the bending operation wire, A screw stopper that abuts and restricts the movement of the bending operation piece may be arranged on the operation unit so as to be screwed in the advancing and retreating direction of the bending operation piece.

その場合、湾曲操作ワイヤを先端側に押し込む方向に湾曲操作片を付勢する付勢手段が設けられていて、その付勢力によって湾曲操作片が螺動ストッパに当接するようにしてもよい。   In that case, biasing means for biasing the bending operation piece in the direction of pushing the bending operation wire toward the distal end side may be provided, and the bending operation piece may be brought into contact with the screw stopper by the biasing force.

また、湾曲部に、相対的に直交する方向に屈曲する第１の湾曲部と第２の湾曲部とが設けられていて、湾曲操作片として、第１の湾曲部を屈曲させる操作をするための第１の湾曲操作片と第２の湾曲部を屈曲させる操作をするための第２の湾曲操作片とが、操作部に互いに独立して進退自在に直列に配置されていてもよい。   Further, the bending portion is provided with a first bending portion and a second bending portion that are bent in a direction orthogonal to each other, and the bending operation piece is operated to bend the first bending portion. The first bending operation piece and the second bending operation piece for performing an operation of bending the second bending portion may be arranged in series in the operation portion so as to be movable forward and backward independently of each other.

また、第１の湾曲操作片と第２の湾曲操作片とが、接続端子を間に挟んでその前後に配置されていてもよい。   Moreover, the 1st bending operation piece and the 2nd bending operation piece may be arrange | positioned before and behind that on both sides of a connection terminal.

本発明によれば、所定方向に屈曲に自在な湾曲部を可撓管の先端近傍に形成して、湾曲部を牽引操作するための湾曲操作ワイヤを可撓管内に軸線方向に進退自在に挿通配置すると共に、可撓管の基端側に連結された操作部に、湾曲操作ワイヤを進退操作するための湾曲操作片を配置したことにより、高周波切開電極を可撓管の先端近くで小さく首振りさせることができるので、先端から突出する棒状の高周波切開電極を粘膜面に沿って術者の所望通りに移動させて細かい切開作業等でも正確に行うことができる。   According to the present invention, a bending portion that can be bent in a predetermined direction is formed in the vicinity of the distal end of the flexible tube, and a bending operation wire for pulling the bending portion is inserted into the flexible tube so as to be able to advance and retract in the axial direction. In addition, the bending operation piece for advancing and retreating the bending operation wire is disposed in the operation unit connected to the proximal end side of the flexible tube, so that the high-frequency incision electrode is made small near the distal end of the flexible tube. Since it can be swung, the rod-shaped high-frequency incision electrode projecting from the tip can be moved along the mucosal surface as desired by the operator and can be accurately performed even in a fine incision operation.

内視鏡に内蔵されている処置具挿通チャンネルに挿脱自在な可撓管の先端から前方に向かって、棒状の高周波切開電極が突出配置された内視鏡用高周波切開具において、所定方向に屈曲に自在な湾曲部を可撓管の先端近傍に形成して、湾曲部を牽引操作するための湾曲操作ワイヤを可撓管内に軸線方向に進退自在に挿通配置すると共に、可撓管の基端側に連結された操作部に、高周波電源コードを接続するための接続端子と、湾曲操作ワイヤを進退操作するための湾曲操作片とを配置する。   An endoscope high-frequency incision tool in which a rod-shaped high-frequency incision electrode is projected forward from the distal end of a flexible tube that can be inserted into and removed from a treatment instrument insertion channel built in an endoscope in a predetermined direction. A bending portion that can be bent is formed in the vicinity of the distal end of the flexible tube, and a bending operation wire for pulling the bending portion is inserted into the flexible tube so as to be able to advance and retract in the axial direction. A connection terminal for connecting a high-frequency power cord and a bending operation piece for advancing and retracting the bending operation wire are arranged on the operation unit coupled to the end side.

図面を参照して本発明の実施例を説明する。
図１は、本発明の第１の実施例の内視鏡用高周波切開具の全体構成の側面断面図、図２はその先端部分の側面断面図であり、図示されていない内視鏡に内蔵されている処置具挿通チャンネルに挿脱自在な可撓管１は、例えばステンレス鋼線により形成された密着巻きコイルの外面に可撓性外皮を被覆して形成されている。 Embodiments of the present invention will be described with reference to the drawings.
FIG. 1 is a side sectional view of the overall configuration of an endoscope high-frequency incision instrument according to a first embodiment of the present invention, and FIG. 2 is a side sectional view of a distal end portion thereof. The flexible tube 1 that can be inserted into and removed from the treatment instrument insertion channel is formed by covering the outer surface of a tightly wound coil formed of, for example, a stainless steel wire with a flexible skin.

図２に示されるように、可撓管１の先端近傍部分には、例えば前後に並んで配置された一対の節輪をリベット等で回動自在に連結した構成の屈曲自在な湾曲部２が形成されている。ただし、湾曲部２はいわゆるマルチルーメンチューブ等で形成したものであってもよい。   As shown in FIG. 2, a flexible bending portion 2 having a configuration in which a pair of node rings arranged side by side, for example, is rotatably connected by a rivet or the like is provided at the vicinity of the distal end of the flexible tube 1. Is formed. However, the bending portion 2 may be formed of a so-called multi-lumen tube or the like.

可撓管１の最先端部には、電気絶縁性の材料からなる先端チップ４が取り付けられていて、導電性の材料によって棒状に形成された高周波切開電極３が、先端チップ４を貫通して可撓管１の最先端部の軸線位置に真っ直ぐに前方に突出する状態に配置されている。   A distal end tip 4 made of an electrically insulating material is attached to the most distal end portion of the flexible tube 1, and a high-frequency incision electrode 3 formed in a rod shape by a conductive material passes through the distal end tip 4. It arrange | positions in the state which protrudes ahead straightly at the axial line position of the front-end | tip part of the flexible tube 1. FIG.

５は、可撓管１内に全長にわたって挿通配置されて先端において高周波切開電極３に接続された導電線であり、この実施例においては導電線５の先端をそのまま延長して高周波切開電極３が形成されている。   Reference numeral 5 denotes a conductive wire inserted through the entire length of the flexible tube 1 and connected to the high-frequency incision electrode 3 at the tip. In this embodiment, the high-frequency incision electrode 3 is formed by extending the tip of the conductive wire 5 as it is. Is formed.

６は、可撓管１内において導電線５を被覆する絶縁被覆チューブであり、湾曲部２付近の部分は柔軟に屈曲することができるように外周面に螺旋溝が形成されて、腰折れを防止するためのコイル線がその螺旋溝に沿って巻き付けられている。   6 is an insulation-coated tube for covering the conductive wire 5 in the flexible tube 1, and a spiral groove is formed on the outer peripheral surface so that the portion in the vicinity of the curved portion 2 can be flexibly bent to prevent hip breakage. A coil wire is wound around the spiral groove.

湾曲部２より先端寄りの位置には、可撓管１内に軸線方向に進退自在に挿通配置された湾曲操作ワイヤ７の先端が連結されており、湾曲操作ワイヤ７を基端側から牽引することにより、湾曲部２が牽引量に対応する角度まで所定の方向に屈曲する。８は、可撓管１内において湾曲操作ワイヤ７を緩く挿通ガイドするガイドコイルである。   A distal end of the bending operation wire 7 inserted and disposed in the flexible tube 1 so as to be movable back and forth in the axial direction is connected to a position closer to the distal end than the bending portion 2, and the bending operation wire 7 is pulled from the proximal end side. Thus, the bending portion 2 bends in a predetermined direction to an angle corresponding to the pulling amount. Reference numeral 8 denotes a guide coil for gently guiding the bending operation wire 7 through the flexible tube 1.

図１に示されるように、可撓管１の基端側には、湾曲部２の屈曲操作を行うための操作部１０が設けられており、可撓管１の基端に連結された操作部本体１１の手元側端部には、操作者の第１指を通すことができる固定指掛け１２が取り付けられている。操作部本体１１は、加工と組み立ての都合から数個の部品をつなぎ合わせて、略真っ直ぐな棒状に形成されている。   As shown in FIG. 1, an operation unit 10 for performing a bending operation of the bending portion 2 is provided on the proximal end side of the flexible tube 1, and an operation connected to the proximal end of the flexible tube 1. A fixed finger hook 12 through which an operator's first finger can be passed is attached to the hand side end of the body 11. The operation unit main body 11 is formed in a substantially straight rod shape by connecting several parts for convenience of processing and assembly.

操作部本体１１の中間部分には、図示されていない高周波電源コードが接続される接続端子１３が、導電線５の基端に電気的に導通する状態に側方に向けて突設されていて、導電線５を介して高周波切開電極３に高周波電流を通電することができる。   A connection terminal 13 to which a high-frequency power cord (not shown) is connected is provided at the intermediate portion of the operation unit main body 11 so as to project sideways so as to be electrically connected to the proximal end of the conductive wire 5. A high-frequency current can be applied to the high-frequency incision electrode 3 through the conductive wire 5.

また、湾曲部２を屈曲させる操作を行うための湾曲操作片１４が操作部本体１１に軸線方向に進退自在に取り付けられている。この湾曲操作片１４は、牽引のみの操作になるので鍔状の指掛け突起が一か所だけに形成されている。   Further, a bending operation piece 14 for performing an operation of bending the bending portion 2 is attached to the operation portion main body 11 so as to be able to advance and retract in the axial direction. Since this bending operation piece 14 is an operation of only pulling, a hook-like finger hooking projection is formed only at one place.

湾曲操作片１４にビス止め連結されたワイヤ連結部材１５には、可撓管１内から真っ直ぐに操作部本体１１内に引き出された湾曲操作ワイヤ７の基端部分が半田付け等により連結固定されている。   The proximal end portion of the bending operation wire 7 drawn straight out from the flexible tube 1 into the operation portion main body 11 is connected and fixed to the wire connection member 15 that is screwed to the bending operation piece 14 by soldering or the like. ing.

また、湾曲操作片１４と操作部本体１１の段部との間に配置された圧縮コイルスプリング１６によって、湾曲操作ワイヤ７を常に先側に向かって押し込む方向に湾曲操作片１４が付勢されている。   Further, the bending operation piece 14 is urged in a direction in which the bending operation wire 7 is always pushed toward the front side by the compression coil spring 16 disposed between the bending operation piece 14 and the step portion of the operation unit main body 11. Yes.

その結果、矢印Ｘで示されるように、圧縮コイルスプリング１６の付勢力に抗して湾曲操作ワイヤ７を手元側に牽引する方向に、湾曲操作片１４を操作部本体１１に沿って移動操作すると、矢印ｘで示されるように、湾曲部２が湾曲操作ワイヤ７の牽引量に対応する角度だけ屈曲する。   As a result, as shown by the arrow X, when the bending operation piece 14 is moved and operated along the operation portion main body 11 in the direction of pulling the bending operation wire 7 toward the hand against the urging force of the compression coil spring 16. As shown by the arrow x, the bending portion 2 bends by an angle corresponding to the pulling amount of the bending operation wire 7.

その時の湾曲操作片１４の状態が操作部１０の上半部に図示されており、湾曲操作片１４から手を放せば、下半部に実線で図示されているように、湾曲操作片１４が圧縮コイルスプリング１６の付勢力により元の待機状態に戻されて、湾曲部２が元の真っ直ぐなニュートラル状態に戻る。   The state of the bending operation piece 14 at that time is shown in the upper half of the operation unit 10, and if the hand is released from the bending operation piece 14, the bending operation piece 14 is shown in the lower half as shown by a solid line. The urging force of the compression coil spring 16 returns to the original standby state, and the bending portion 2 returns to the original straight neutral state.

したがって、可撓管１の先端部分を内視鏡の処置具挿通チャンネルの先端から突出させてから、指先で湾曲操作片１４を進退操作するだけで高周波切開電極３が可撓管１の先端近傍の湾曲部２を中心に回動するので、高周波切開電極３の先端部分を粘膜面に沿って細かく移動させて、術者の所望通りの粘膜切開作業を正確に行うことができる。   Accordingly, the high-frequency incision electrode 3 can be moved in the vicinity of the distal end of the flexible tube 1 simply by causing the distal end portion of the flexible tube 1 to protrude from the distal end of the treatment instrument insertion channel of the endoscope and then moving the bending operation piece 14 forward and backward with the fingertip. Thus, the distal end portion of the high-frequency incision electrode 3 can be finely moved along the mucosal surface, and the mucosal dissection work desired by the operator can be performed accurately.

図３は、本発明の第２の実施例の内視鏡用高周波切開具の全体構成を示す側面断面図、図４はその先端部分の平面断面図であり、この実施例においては、湾曲部２として、相対的に直交する方向に屈曲する第１の湾曲部２Ａと第２の湾曲部２Ｂとが設けられている。   FIG. 3 is a side sectional view showing the entire configuration of the endoscope high-frequency incision instrument according to the second embodiment of the present invention, and FIG. 4 is a plan sectional view of the distal end portion thereof. 2, a first bending portion 2 </ b> A and a second bending portion 2 </ b> B that are bent in a direction orthogonal to each other are provided.

図４に示されるように、第１の湾曲部２Ａは複数個（例えば５〜１０個程度）の節輪をリベット等で回動自在に順に連結して構成されており、第２の湾曲部２Ｂは、第１の実施例の湾曲部２と同様の単一点屈曲構造であって、第１の湾曲部２Ａの最先端部に配置されている。   As shown in FIG. 4, the first bending portion 2 </ b> A is configured by sequentially connecting a plurality of (for example, about 5 to 10) node rings rotatably with rivets or the like. Reference numeral 2B denotes a single-point bending structure similar to that of the bending portion 2 of the first embodiment, and is disposed at the most distal end portion of the first bending portion 2A.

そして、第１の湾曲部２Ａの先端部分には第１の湾曲操作ワイヤ７Ａの先端が連結され、第２の湾曲部２Ｂの先端部分には第２の湾曲操作ワイヤ７Ｂの先端が連結されている。８Ａは第１の湾曲操作ワイヤ７Ａのガイドコイル、８Ｂは第２の湾曲操作ワイヤ７Ｂのガイドコイルである。   The distal end portion of the first bending operation wire 7A is connected to the distal end portion of the first bending portion 2A, and the distal end portion of the second bending operation wire 7B is connected to the distal end portion of the second bending portion 2B. Yes. 8A is a guide coil of the first bending operation wire 7A, and 8B is a guide coil of the second bending operation wire 7B.

図３に示されるように、操作部１０には、湾曲操作片として、第１の湾曲操作片１４Ａと第２の湾曲操作片１４Ｂとが互いに独立して前後方向に進退自在に直列に配置されており、接続端子１３より先側に配置された第１の湾曲操作片１４Ａは第１の実施例の湾曲操作片１４と同じ構成である。   As shown in FIG. 3, in the operation unit 10, a first bending operation piece 14 </ b> A and a second bending operation piece 14 </ b> B are arranged in series as the bending operation pieces so as to be able to advance and retreat in the front-rear direction independently of each other. The first bending operation piece 14A disposed on the front side of the connection terminal 13 has the same configuration as the bending operation piece 14 of the first embodiment.

そして、第１の湾曲操作片１４Ａにビス止め連結された第１のワイヤ連結部材１５Ａには、可撓管１内から真っ直ぐに操作部本体１１内に引き出された第１の湾曲操作ワイヤ７Ａの基端部分が連結固定されて、第１の圧縮コイルスプリング１６Ａによって、第１の湾曲操作ワイヤ７Ａを常に先側に向かって押し込む方向に第１の湾曲操作片１４Ａが付勢されている。   Then, the first wire connecting member 15A screwed to the first bending operation piece 14A is connected to the first bending operation wire 7A drawn straight from the flexible tube 1 into the operation portion main body 11. The base end portion is connected and fixed, and the first bending operation piece 14A is urged by the first compression coil spring 16A in a direction in which the first bending operation wire 7A is always pushed toward the front side.

その結果、矢印Ｙで示されるように、第１の圧縮コイルスプリング１６Ａの付勢力に抗して第１の湾曲操作ワイヤ７Ａを手元側に牽引する方向に第１の湾曲操作片１４Ａを操作部本体１１に沿って移動操作すると、矢印ｙで示されるように、第１の湾曲部２Ａが第１の湾曲操作ワイヤ７Ａの牽引量に対応する角度だけ屈曲する。   As a result, as shown by the arrow Y, the first bending operation piece 14A is moved in the direction of pulling the first bending operation wire 7A toward the hand against the biasing force of the first compression coil spring 16A. When the moving operation is performed along the main body 11, the first bending portion 2A bends by an angle corresponding to the pulling amount of the first bending operation wire 7A as indicated by an arrow y.

そして、この実施例においては、第１の湾曲操作片１４Ａの先端側に隣接して、第１の圧縮コイルスプリング１６Ａによって第１の湾曲操作片１４Ａがニュートラル状態になる方向に戻されるのを規制する円筒状の螺動湾曲ストッパ１７が配置されている。   In this embodiment, the first bending operation piece 14A is prevented from being returned to the neutral state by the first compression coil spring 16A adjacent to the distal end side of the first bending operation piece 14A. A cylindrical screw bending stopper 17 is disposed.

螺動湾曲ストッパ１７は、その内周部に形成された雌ネジ部が操作部本体１１の先端付近の外周部に形成された雄ネジ部と螺合しており、軸線周りに回転操作することにより操作部本体１１の軸線方向に移動（螺動）する。   The screw bending stopper 17 has a female screw portion formed on an inner peripheral portion thereof engaged with a male screw portion formed on an outer peripheral portion in the vicinity of the tip of the operation portion main body 11, and is rotated around an axis. As a result, the operating unit body 11 is moved (screwed) in the axial direction.

その結果、第１の湾曲操作片１４Ａを牽引操作した状態から螺動湾曲ストッパ１７を回転させて、図５の上半部に矢印Ｂで示されるように、螺動湾曲ストッパ１７を手元側方向に移動させれば、第１の圧縮コイルスプリング１６Ａの付勢力によって戻される第１の湾曲操作片１４Ａの静止位置（即ち、第１の湾曲部２Ａの屈曲状態）を無段階に調整することができ、螺動湾曲ストッパ１７から手を放せばその時点の調整状態が維持される。   As a result, the screw bending stopper 17 is rotated from the state in which the first bending operation piece 14A is pulled, and the screw bending stopper 17 is moved in the proximal direction as indicated by an arrow B in the upper half of FIG. If it is moved to, the stationary position of the first bending operation piece 14A returned by the urging force of the first compression coil spring 16A (that is, the bent state of the first bending portion 2A) can be adjusted steplessly. If the hand is released from the screw bending stopper 17, the adjustment state at that time is maintained.

また、第１の湾曲操作片１４Ａから手を放して螺動湾曲ストッパ１７だけを回転操作することによっても、第１の湾曲操作片１４Ａが軸線方向に微動して第１の湾曲部２Ａの屈曲角が調整されて、その状態で静止させることができる。   Also, by releasing the first bending operation piece 14A and rotating only the screw bending stopper 17, the first bending operation piece 14A is finely moved in the axial direction to bend the first bending portion 2A. The corners are adjusted and can be kept stationary in that state.

したがって、第１の湾曲部２Ａを容易な操作で最適の屈曲状態に安定して維持することができ、その他の操作を行う際に湾曲状態を手で保持する必要がないので、一連の操作を円滑に行うことができる。   Therefore, the first bending portion 2A can be stably maintained in an optimal bending state by an easy operation, and it is not necessary to hold the bending state by hand when performing other operations. It can be done smoothly.

図３に戻って、接続端子１３より後方位置に軸線方向に進退自在に配置された第２の湾曲操作片１４Ｂには、第２のワイヤ連結部材１５Ｂがビス止め連結されていて、そこに可撓管１内から真っ直ぐに操作部本体１１内に引き出された第２の湾曲操作ワイヤ７Ｂの基端部分が連結固定されて、第２の圧縮コイルスプリング１６Ｂによって、第２の湾曲操作ワイヤ７Ｂを常に先側に向かって押し込む方向に第２の湾曲操作片１４Ｂが付勢されている。   Returning to FIG. 3, the second wire connecting member 15 </ b> B is screwed and connected to the second bending operation piece 14 </ b> B which is disposed at a position rearward of the connection terminal 13 so as to be movable back and forth in the axial direction. The proximal end portion of the second bending operation wire 7B drawn straight out from the flexible tube 1 into the operation portion main body 11 is connected and fixed, and the second bending operation wire 7B is connected by the second compression coil spring 16B. The second bending operation piece 14B is always urged in the direction of pushing toward the front side.

その結果、図５に矢印Ｘで示されるように、第２の圧縮コイルスプリング１６Ｂの付勢力に抗して第２の湾曲操作ワイヤ７Ｂを手元側に牽引する方向に第２の湾曲操作片１４Ｂを操作部本体１１に沿って移動操作すると、第２の湾曲部２Ｂが第２の湾曲操作ワイヤ７Ｂの牽引量に対応する角度だけ、第１の湾曲部２Ａと直交する方向に屈曲する（図示せず）。   As a result, as shown by an arrow X in FIG. 5, the second bending operation piece 14B is pulled in the direction of pulling the second bending operation wire 7B toward the proximal side against the urging force of the second compression coil spring 16B. Is moved along the operation portion main body 11, the second bending portion 2B bends in a direction orthogonal to the first bending portion 2A by an angle corresponding to the pulling amount of the second bending operation wire 7B (see FIG. Not shown).

したがって、第２の実施例の内視鏡用高周波切開具においては、可撓管１の先端部分を内視鏡の処置具挿通チャンネルの先端から突出させてから、第１の湾曲部２Ａを好ましい任意の屈曲状態に静止させ、その屈曲方向と直交する方向に第２の湾曲部２Ｂを任意に屈曲させることにより、高周波切開電極３の先端部分を粘膜面に沿って細かく移動させて、術者の所望通りの粘膜切開作業を正確に行うことができる。   Therefore, in the endoscope high-frequency incision instrument of the second embodiment, the first bending portion 2A is preferable after the distal end portion of the flexible tube 1 protrudes from the distal end of the treatment instrument insertion channel of the endoscope. The operator is allowed to stand still in an arbitrary bending state, and the second bending portion 2B is arbitrarily bent in a direction perpendicular to the bending direction, whereby the distal end portion of the high-frequency incision electrode 3 is finely moved along the mucosal surface. The desired mucosal dissection work can be performed accurately.

なお、本発明は上記実施例に限定されるものではなく、例えば湾曲部２の構造そのものはどの様なものであっても差し支えなく、第１の湾曲部２Ａと第２の湾曲部２Ｂが設けられる場合には、どのような構造のものを組み合わせても差し支えない。また、湾曲操作片１４，１４Ａ，１４Ｂと接続端子１３との位置関係はどのように設定しても差し支えなく、接続端子１３が操作部１０に配置されていなくてもよい。   Note that the present invention is not limited to the above-described embodiment. For example, the bending portion 2 may have any structure, and the first bending portion 2A and the second bending portion 2B are provided. If possible, any structure may be combined. Further, the positional relationship between the bending operation pieces 14, 14 </ b> A, 14 </ b> B and the connection terminal 13 may be set in any way, and the connection terminal 13 may not be disposed in the operation unit 10.

本発明の第１の実施例の内視鏡用高周波切開具の全体構成を示す側面断面図である。It is side surface sectional drawing which shows the whole structure of the high frequency incision tool for endoscopes of the 1st Example of this invention. 本発明の第１の実施例の内視鏡用高周波切開具の先端部分の側面断面図である。It is side surface sectional drawing of the front-end | tip part of the high frequency incision tool for endoscopes of 1st Example of this invention. 本発明の第２の実施例の内視鏡用高周波切開具の全体構成を示す側面断面図である。It is side surface sectional drawing which shows the whole structure of the high frequency incision tool for endoscopes of the 2nd Example of this invention. 本発明の第２の実施例の内視鏡用高周波切開具の先端部分の平面断面図である。It is plane sectional drawing of the front-end | tip part of the high frequency incision tool for endoscopes of the 2nd Example of this invention. 本発明の第２の実施例の内視鏡用高周波切開具の螺動湾曲ストッパと第２の湾曲操作片を動作させた状態の側面断面図である。It is side surface sectional drawing of the state which operated the screw bending stopper and 2nd bending operation piece of the high frequency incision tool for endoscopes of the 2nd Example of this invention.

符号の説明Explanation of symbols

１ 可撓管
２，２Ａ，２Ｂ 湾曲部
３ 高周波切開電極
７，７Ａ，７Ｂ 湾曲操作ワイヤ
１０ 操作部
１１ 操作部本体
１３ 接続端子
１４，１４Ａ，１４Ｂ 湾曲操作片
１６，１６Ａ，１６Ｂ 圧縮コイルスプリング（付勢手段）
１７ 螺動湾曲ストッパ DESCRIPTION OF SYMBOLS 1 Flexible tube 2, 2A, 2B Bending part 3 High frequency incision electrode 7, 7A, 7B Bending operation wire 10 Operation part 11 Operation part main body 13 Connection terminal 14, 14A, 14B Bending operation piece 16, 16A, 16B Compression coil spring ( Energizing means)
17 Screw curved stopper

Claims (4)

内視鏡に内蔵されている処置具挿通チャンネルに挿脱自在な可撓管の先端から前方に向かって、棒状の高周波切開電極が突出配置された内視鏡用高周波切開具において、
相対的に直交する方向に屈曲自在な第１と第２の湾曲部が上記可撓管の先端近傍に形成されて、上記第１と第２の湾曲部を個々に牽引操作するための第１と第２の湾曲操作ワイヤが上記可撓管内に軸線方向に進退自在に挿通配置されると共に、上記可撓管の基端側に連結された操作部に、高周波電源コードを接続するための接続端子と、上記第１と第２の湾曲操作ワイヤを個別に手動で進退操作するための第１と第２の湾曲操作片が互いに独立して進退自在に直列に配置され、
上記第１と第２の湾曲操作片が、上記接続端子を間に挟んでその前方と後方とに分かれて配置されて、上記第１と第２の湾曲操作片のうち上記接続端子より前方に位置する上記第１の湾曲操作片のみを任意の位置から移動しないように規制することができるストッパが、上記操作部に設けられていることを特徴とする内視鏡用高周波切開具。 In a high-frequency incision tool for an endoscope in which a rod-shaped high-frequency incision electrode protrudes forward from the distal end of a flexible tube that can be inserted into and removed from a treatment instrument insertion channel built in an endoscope.
First and second bending portions that can be bent in directions that are relatively perpendicular to each other are formed in the vicinity of the distal end of the flexible tube, and a first for individually pulling the first and second bending portions . When the second bending operation wire is inserted and arranged to freely advance and retreat in the axial direction to the flexible tube Rutotomoni, the operation section on the base end side is connected to the flexible tube connection for connecting a high frequency power supply cord A terminal and first and second bending operation pieces for manually advancing and retracting the first and second bending operation wires individually are arranged in series so as to be independently movable forward and backward .
The first and second bending operation pieces are arranged in front and rear with the connection terminal interposed therebetween, and the first and second bending operation pieces are more forward than the connection terminal. A high-frequency incision tool for an endoscope , wherein a stopper capable of restricting only the first bending operation piece located so as not to move from an arbitrary position is provided in the operation portion . 上記第１の湾曲操作ワイヤを先端側に押し込む方向に上記第１の湾曲操作片を付勢する付勢手段が設けられている請求項１記載の内視鏡用高周波切開具。 The high-frequency incision tool for an endoscope according to claim 1, further comprising a biasing unit that biases the first bending operation piece in a direction in which the first bending operation wire is pushed toward a distal end side. 上記ストッパが、上記第１の湾曲操作ワイヤを押し込む方向に上記第１の湾曲操作片を移動させたときに上記第１の湾曲操作片に当接して上記第１の湾曲操作片の移動を規制する螺動ストッパであり、上記第１の湾曲操作片の進退方向に螺動するように上記操作部に配置されている請求項２記載の内視鏡用高周波切開具。 Said stopper, restricts the movement of the first bending operation wire in a direction to push the said first bending operation member to the first bending operation member when moving in contact with the first bending operation piece to a threadedly stopper endoscopic high-frequency surgical tool of claim 2, wherein disposed in the operation portion so as to threadedly advancing and retracting direction of the first bending operation member. 上記付勢手段の付勢力によって、上記第１の湾曲操作片が上記螺動ストッパに当接する請求項３記載の内視鏡用高周波切開具。 By the biasing force of the superscript SL Zeite stage, endoscopic high-frequency surgical tool of claim 3, wherein said first bending operation member abuts on the threadedly stopper.
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