JP5581062B2 - Endoscopic high-frequency treatment instrument - Google Patents

Endoscopic high-frequency treatment instrument Download PDF

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JP5581062B2
JP5581062B2 JP2010004828A JP2010004828A JP5581062B2 JP 5581062 B2 JP5581062 B2 JP 5581062B2 JP 2010004828 A JP2010004828 A JP 2010004828A JP 2010004828 A JP2010004828 A JP 2010004828A JP 5581062 B2 JP5581062 B2 JP 5581062B2
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electrode
tip
body block
flexible sheath
operation wire
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JP2011142995A (en
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幹治 遠藤
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Hoya Corp
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この発明は内視鏡用高周波処置具に関する。   The present invention relates to a high-frequency treatment instrument for an endoscope.

内視鏡を利用した粘膜切開剥離術（ＥＳＤ）等に用いられる内視鏡用高周波処置具には、切開処置用の先端突没電極と剥離処置用の側面固定電極とが、同じ可撓性シースの先端部分に配置されている。   In the endoscopic high-frequency treatment tool used for mucosal dissection and exfoliation (ESD) using an endoscope, the tip protrusion electrode for incision treatment and the side fixed electrode for exfoliation treatment have the same flexibility. It is arrange | positioned at the front-end | tip part of a sheath.

そのような内視鏡用高周波処置具には多くの場合、内視鏡の処置具挿通チャンネルに挿脱自在な可撓性シースの最先端部分に電気絶縁性の先端本体ブロックが取り付けられて、その先端本体ブロックの先端から前方に突没自在に先端突没電極が設けられている。   In such an endoscope high-frequency treatment instrument, in many cases, an electrically insulating tip body block is attached to the most distal portion of a flexible sheath that can be inserted into and removed from the endoscope treatment instrument insertion channel. A tip protrusion electrode is provided so as to freely protrude forward from the tip of the tip body block.

可撓性シース内には、先端突没電極を進退操作するための導電性の操作ワイヤが挿通配置され、側面固定電極は、先端本体ブロックの先端部分の一側面部から軸線と平行な細長い線状又は帯状に外面に露出する状態に固定的に設けられている（例えば、特許文献１）。   In the flexible sheath, a conductive operation wire for advancing and retracting the tip protrusion / retraction electrode is inserted and arranged, and the side surface fixing electrode is an elongated line parallel to the axis from one side surface portion of the tip portion of the tip body block. It is fixedly provided in a state of being exposed on the outer surface in the form of a strip or a band (for example, Patent Document 1).

特開２００８−２９６６７JP 2008-29667 A

生体組織の高周波焼灼処置を行う際には、処置対象ではない生体組織を誤って焼灼しないようにする必要がある。したがって、側面固定電極に高周波電流を通電して使用する際には、先端突出電極を先端本体ブロック内に完全に没入させ、先端突出電極を突出させて使用する際には、側面固定電極に高周波電流が通電されない状態にする必要がある。   When performing a high-frequency cauterization treatment of a living tissue, it is necessary to prevent accidental cauterization of a living tissue that is not a treatment target. Therefore, when a high-frequency current is applied to the side fixed electrode, the tip protruding electrode is completely immersed in the tip main body block, and when the tip protruding electrode is protruded, the high frequency current is applied to the side fixed electrode. It is necessary to make a state where no current is applied.

そこで、特許文献１に記載された発明においては、先端突没電極への導電部材として機能する操作ワイヤとは別に、側面固定電極への導電部材として機能する独立した導電線が可撓性シース内に配置され、先端突没電極への通電のための操作ワイヤと側面固定電極への通電のための導電線とが可撓性シース内に並列に配置されている。   Therefore, in the invention described in Patent Document 1, an independent conductive wire that functions as a conductive member for the side surface fixing electrode is provided in the flexible sheath, separately from the operation wire that functions as a conductive member for the tip protruding and retracting electrode. The operation wire for energizing the tip protruding electrode and the conductive wire for energizing the side fixed electrode are arranged in parallel in the flexible sheath.

しかし、そのような構成では、操作ワイヤの進退動作が導電線により阻害されて先端突没電極の突没動作が不調になったり、先端部分における電気絶縁が不確実になったりする問題が生じる。   However, in such a configuration, there is a problem that the operation of the operation wire is hindered by the conductive wire, and the operation of the projecting and retracting of the tip projecting electrode becomes unsatisfactory, or the electrical insulation at the distal end portion becomes uncertain.

そこで、操作ワイヤの進退動作に対応して、操作ワイヤの先端部分と側面固定電極とを電気的に接離させることで、一本の操作ワイヤを先端突没電極と側面固定電極の双方への導電部材として機能させることが考えられる。   Therefore, in response to the advance / retreat operation of the operation wire, the distal end portion of the operation wire and the side surface fixed electrode are electrically connected to and separated from each other, so that one operation wire can be connected to both the front end projecting electrode and the side surface fixed electrode. It can be considered to function as a conductive member.

しかし、側面固定電極が、先端本体ブロックの先端部分の一側面部から軸線と平行な細長い線状又は帯状に外面に露出する状態に設けられている内視鏡用高周波処置具においては、側面固定電極を確実に固定するのが容易ではない（高周波焼灼時に高温になるので接着剤は剥離する）という問題もある。   However, in the endoscope high-frequency treatment instrument in which the side surface fixing electrode is provided on the outer surface in the form of an elongated line or strip parallel to the axis from one side surface of the distal end portion of the distal end main body block, the side surface fixing is performed. There is also a problem that it is not easy to securely fix the electrode (the adhesive peels off because of high temperature during high-frequency cauterization).

本発明は、一本の操作ワイヤだけで、先端突没電極と側面固定電極で同時に高周波焼灼が行われることがないように、両電極に高周波電流を通電させることができ、且つ、側面固定電極を確実な固定状態に組み付けることができる内視鏡用高周波処置具を提供することを目的とする。   In the present invention, a high-frequency current can be passed through both electrodes so that the high-frequency cauterization is not performed simultaneously with the tip protruding electrode and the side fixed electrode with only one operation wire, and the side fixed electrode An object of the present invention is to provide a high-frequency treatment instrument for an endoscope that can be assembled in a fixed state.

上記の目的を達成するため、本発明の内視鏡用高周波処置具は、内視鏡の処置具挿通チャンネルに挿脱自在な可撓性シースの最先端部分に取り付けられた電気絶縁性の先端本体ブロックと、先端本体ブロックの先端から前方に突没自在な先端突没電極と、可撓性シース内に軸線方向に進退自在に挿通配置されて可撓性シースの基端側からの操作により先端突没電極を先端本体ブロックから前方に突没させるための導電性の操作ワイヤと、先端本体ブロックの一側面部から軸線と平行な細長い線状又は帯状に外面に露出する状態に先端本体ブロック及び可撓性シースに対し固定的に取り付けられた側面固定電極とが設けられた内視鏡用高周波処置具において、先端突没電極と操作ワイヤとがその双方のどちらよりも径の大きな導電材からなる導電接続体で機械的及び電気的に接続され、先端本体ブロックの軸線位置には、先端突没電極は通過するが導電接続体は入り込めない径の先側細径孔と、その導電接続体が通過する径の後側太径孔とが直列に貫通形成され、側面固定電極の先端がＪ字状に曲げ戻されて、その曲げ戻された部分が先端本体ブロックに形成された電極保持溝内に嵌め込まれて保持され、側面固定電極の後側の部分が先端本体ブロックの後端位置付近において可撓性シース内に曲げ込まれた構成を備え、操作ワイヤが後方から前方に押し込み操作されたときは、導電接続体が先側細径孔の後端入口に後方から当接することにより、先端突没電極がそれ以上前方に突出しない状態になると共に、操作ワイヤと側面固定電極との間が電気的に遮断され、操作ワイヤが後方から牽引操作されたときは、導電接続体が側面固定電極の後側の部分に前方から当接することにより、先端突没電極が先端本体部内に没入してそれ以上後方に退避しない状態になると共に、操作ワイヤと側面固定電極との間が電気的に導通する、ものである。   In order to achieve the above object, an endoscopic high-frequency treatment instrument of the present invention is an electrically insulating tip attached to the most distal portion of a flexible sheath that can be removably inserted into a treatment instrument insertion channel of an endoscope. A main body block, a tip projecting / retracting electrode that can project forward and backward from the tip of the main body block, and an axially extending / retracting insertion through the flexible sheath so that it can be operated from the base end side of the flexible sheath. Conductive operation wire for projecting and retracting the tip projecting electrode forward from the tip body block, and the tip body block exposed from the one side of the tip body block to the outer surface in the form of an elongated line or strip parallel to the axis And a high-frequency treatment instrument for an endoscope provided with a side fixed electrode fixedly attached to a flexible sheath, and a conductive material having a larger diameter than both of the tip protruding electrode and the operation wire Led by The connecting body is mechanically and electrically connected, and at the axial line position of the tip body block, a tip side small-diameter hole having a diameter through which the tip protrusion electrode passes but cannot enter the conductive connector, and the conductive connector The rear large-diameter hole that passes through is formed in series, the tip of the side fixed electrode is bent back into a J shape, and the bent back portion is in the electrode holding groove formed in the tip body block The rear portion of the side fixed electrode is bent into the flexible sheath in the vicinity of the rear end position of the tip body block, and the operation wire is pushed from the rear to the front. When the conductive connecting member comes into contact with the rear end inlet of the front-side narrow hole from the rear side, the tip protrusion electrode does not protrude further forward and the gap between the operation wire and the side fixed electrode is Electrically shut off, operation wire is behind When the traction operation is performed, the conductive connecting member comes into contact with the rear portion of the side surface fixed electrode from the front, so that the tip protruding electrode is immersed in the tip main body portion and is not retracted further rearward. The operation wire and the side surface fixed electrode are electrically connected.

なお、側面固定電極が、先端本体ブロックの先端部分の一側面部のみから外面に露出するものであってもよく、電極保持溝が、先端本体ブロックの先端面にスリット状に形成されていてもよい。   The side surface fixing electrode may be exposed to the outer surface from only one side surface of the tip portion of the tip body block, and the electrode holding groove may be formed in a slit shape on the tip surface of the tip body block. Good.

また、先端本体ブロックが可撓性シースの内周部に嵌め込まれた状態に固定されていて、側面固定電極が、可撓性シースに軸線方向に間隔をあけて形成された二つの電極通過孔の間においてのみ外面に露出し、電極保持溝が先端本体ブロックの外周部に形成されていて、側面固定電極の曲げ戻された先端部分が、二つの電極通過孔のうちの先側の電極通過孔を通って可撓性シースの内周面に沿う状態で電極保持溝内に嵌め込まれていてもよい。   Also, two electrode passage holes in which the tip body block is fixed in a state of being fitted into the inner peripheral portion of the flexible sheath, and the side surface fixing electrode is formed in the flexible sheath with an interval in the axial direction. The electrode holding groove is formed on the outer peripheral portion of the tip body block, and the tip portion of the side fixed electrode that is bent back is passed through the front electrode of the two electrode passage holes. It may be fitted into the electrode holding groove in a state along the inner peripheral surface of the flexible sheath through the hole.

本発明によれば、操作ワイヤが後方から前方に押し込み操作されたときは、導電接続体が先側細径孔の後端入口に後方から当接することにより、先端突没電極がそれ以上前方に突出しない状態になると共に、操作ワイヤと側面固定電極との間が電気的に遮断され、操作ワイヤが後方から牽引操作されたときは、導電接続体が側面固定電極の後側の部分に前方から当接することにより、先端突没電極が先端本体部内に没入してそれ以上後方に退避しない状態になると共に、操作ワイヤと側面固定電極との間が電気的に導通するので、一本の操作ワイヤだけで、先端突没電極と側面固定電極で同時に高周波焼灼が行われることがないように両電極に高周波電流を通電させることができ、且つ、側面固定電極の先端がＪ字状に曲げ戻されて、その曲げ戻された部分が先端本体ブロックに形成された電極保持溝内に嵌め込まれて保持され、側面固定電極の後側の部分が先端本体ブロックの後端位置付近において可撓性シース内に曲げ込まれていることにより、側面固定電極を確実な固定状態に組み付けることができる。   According to the present invention, when the operation wire is pushed forward from the rear, the conductive connector contacts the rear end inlet of the front-side narrow hole from the rear, so that the tip protruding electrode is further forward. When the operation wire and the side fixed electrode are electrically disconnected from each other, and the operation wire is pulled from the rear, the conductive connector is moved to the rear portion of the side fixed electrode from the front. By abutting, the tip protrusion electrode is immersed in the tip main body portion and is not retracted further rearward, and the operation wire and the side fixed electrode are electrically connected, so one operation wire The high-frequency current can be applied to both electrodes so that the high-frequency cauterization is not performed simultaneously on the tip protruding electrode and the side fixed electrode, and the tip of the side fixed electrode is bent back into a J shape. That song The returned portion is fitted and held in the electrode holding groove formed in the tip body block, and the rear portion of the side fixed electrode is bent into the flexible sheath near the rear end position of the tip body block. Therefore, the side surface fixing electrode can be assembled in a surely fixed state.

本発明の第１の実施例に係る内視鏡用高周波処置具の先端突没電極が突出した状態の側面断面図である。It is side surface sectional drawing of the state which the front-end | tip protrusion electrode of the high frequency treatment tool for endoscopes which concerns on 1st Example of this invention protruded. 本発明の第１の実施例に係る内視鏡用高周波処置具の先端突没電極が突出した状態の斜視図である。It is a perspective view in the state where the tip projection electrode of the high frequency treatment instrument for endoscopes concerning the 1st example of the present invention projected. 本発明の第１の実施例に係る内視鏡用高周波処置具の側面固定電極の単体斜視図である。It is a single-piece | unit perspective view of the side fixed electrode of the high frequency treatment tool for endoscopes which concerns on 1st Example of this invention. 本発明の第１の実施例に係る内視鏡用高周波処置具の先端突没電極が没入した状態の側面断面図である。It is side surface sectional drawing of the state which the tip protrusion electrode of the high frequency treatment tool for endoscopes which concerns on 1st Example of this invention was immersed. 本発明の第１の実施例に係る内視鏡用高周波処置具の先端突没電極が没入した状態の斜視図である。It is a perspective view in the state where the tip projection electrode of the high frequency treatment instrument for endoscopes concerning the 1st example of the present invention was immersed. 本発明の第２の実施例に係る内視鏡用高周波処置具の先端突没電極が突出した状態の側面断面図である。It is side surface sectional drawing of the state which the front-end | tip protrusion electrode of the high frequency treatment tool for endoscopes which concerns on 2nd Example of this invention protruded. 本発明の第２の実施例に係る内視鏡用高周波処置具の先端突没電極が突出した状態の斜視図である。It is a perspective view in the state where the tip projection electrode of the high frequency treatment instrument for endoscopes concerning the 2nd example of the present invention projected. 本発明の第２の実施例に係る内視鏡用高周波処置具の先端突没電極が没入した状態の側面断面図である。It is side surface sectional drawing of the state which the tip protrusion electrode of the high frequency treatment tool for endoscopes which concerns on 2nd Example of this invention was immersed. 本発明の第２の実施例に係る内視鏡用高周波処置具の先端突没電極が没入した状態の斜視図である。It is a perspective view in the state where the tip sunk electrode of the high frequency treatment instrument for endoscopes concerning the 2nd example of the present invention was immersed.

以下、図面を参照して本発明の実施例を説明する。
図１と図２は、本発明の第１の実施例に係る内視鏡用高周波処置具の先端部付近を示す側面断面図と斜視図である。 Embodiments of the present invention will be described below with reference to the drawings.
FIG. 1 and FIG. 2 are a side sectional view and a perspective view showing the vicinity of the distal end portion of the high-frequency treatment instrument for endoscope according to the first embodiment of the present invention.

１は、図示されていない内視鏡の処置具挿通チャンネルに挿脱自在な電気絶縁性の可撓性シースである。可撓性シース１は、例えば四フッ化エチレン樹脂チューブ等からなり、その外径サイズは例えば２ｍｍ程度で、全長は例えば１〜２ｍ程度である。   Reference numeral 1 denotes an electrically insulating flexible sheath that can be inserted into and removed from a treatment instrument insertion channel of an endoscope (not shown). The flexible sheath 1 is made of, for example, a tetrafluoroethylene resin tube or the like, and has an outer diameter size of, for example, about 2 mm and a total length of, for example, about 1-2 m.

可撓性シース１の最先端部分には、外径サイズが可撓性シース１と同程度の略円柱状に形成された先端本体ブロック１０が連結固定されている。先端本体ブロック１０は、例えばセラミックス等のような電気絶縁性の材料で形成されており、後端部付近が可撓性シース１の先端部分内に差し込み固定されている。   A distal end main body block 10 formed in a substantially cylindrical shape having an outer diameter size similar to that of the flexible sheath 1 is connected and fixed to the most distal end portion of the flexible sheath 1. The distal end main body block 10 is made of an electrically insulating material such as ceramics, and the vicinity of the rear end portion is inserted and fixed in the distal end portion of the flexible sheath 1.

先端本体ブロック１０には、先端本体ブロック１０の先端から前方に突没自在な先端突没電極２と、先端本体ブロック１０の一側面部から軸線と平行な細長い帯状に外面に露出する側面固定電極３とが取り付けられている。       The tip body block 10 includes a tip projecting electrode 2 that can project forward from the tip of the tip body block 10, and a side fixed electrode that is exposed from one side surface of the tip body block 10 to an outer surface in the form of an elongated strip parallel to the axis. 3 is attached.

先端突没電極２と側面固定電極３は共に、例えばステンレス鋼等のような導電金属製であり、先端突没電極２は直径が一定の丸棒状に形成され、側面固定電極３は一定幅で一定肉厚の板材又は帯材を折り曲げた状態に形成されている。   The tip protruding electrode 2 and the side fixed electrode 3 are both made of a conductive metal such as stainless steel, for example, the tip protruding electrode 2 is formed in a round bar shape having a constant diameter, and the side fixed electrode 3 has a constant width. It is formed in the state which bent the board | plate material or strip | belt material of fixed thickness.

可撓性シース１内には、先端突没電極２を先端本体ブロック１０から前方に突没させるための導電性の操作ワイヤ４が、軸線方向に進退自在に挿通配置されている。操作ワイヤ４を可撓性シース１の基端側から進退操作することにより、先端突没電極２を先端本体ブロック１０の先端面１０ａから前方に突没させることができる。操作ワイヤ４には、電気絶縁性の絶縁被覆チューブ４１が全長にわたって被覆されている。   In the flexible sheath 1, a conductive operation wire 4 for projecting and retracting the tip projecting electrode 2 forward from the tip body block 10 is inserted and disposed so as to be movable forward and backward in the axial direction. By operating the operation wire 4 forward and backward from the proximal end side of the flexible sheath 1, the distal end projecting electrode 2 can project forward from the distal end surface 10 a of the distal end main body block 10. The operation wire 4 is covered with an electrically insulating insulating tube 41 over its entire length.

操作ワイヤ４と先端突没電極２とは、短円柱状の導電金属材からなる導電接続体５で機械的及び電気的に一体的に接続されている。先端突没電極２と操作ワイヤ４とを比較すると操作ワイヤ４の方が外径が大きく、導電接続体５は先端突没電極２及び操作ワイヤ４のどちらよりも大きな外径サイズに形成されている。   The operation wire 4 and the tip protruding electrode 2 are mechanically and electrically connected integrally by a conductive connection body 5 made of a short cylindrical conductive metal material. When the tip protrusion electrode 2 and the operation wire 4 are compared, the operation wire 4 has a larger outer diameter, and the conductive connector 5 is formed to have a larger outer diameter than both the tip protrusion electrode 2 and the operation wire 4. Yes.

先端本体ブロック１０の軸線位置には、先側細径孔１１と後側太径孔１２とが直列に貫通形成されている。先側細径孔１１は、先端突没電極２が軸線方向に通過自在であるが導電接続体５の外径よりは細くて導電接続体５が入り込めない径に形成され、後側太径孔１２は、導電接続体５が軸線方向に通過自在な径に形成されている。   A front side small diameter hole 11 and a rear side large diameter hole 12 are formed in series at the axial position of the distal end main body block 10. The front-side narrow hole 11 is formed to have a diameter that allows the front-end protruding electrode 2 to pass through in the axial direction but is narrower than the outer diameter of the conductive connector 5 so that the conductive connector 5 cannot enter. The hole 12 is formed to have a diameter through which the conductive connector 5 can pass in the axial direction.

その結果、先側細径孔１１の後端の後側太径孔１２側から先側細径孔１１への入口部分の段部１３が、導電接続体５が後側太径孔１２内を前方に向かって移動した時のストッパになっており、導電接続体５が段部１３に当接することにより、先端突没電極２が先端本体ブロック１０の先端面１０ａからそれ以上突出しないように規制される。   As a result, the stepped portion 13 of the entrance portion from the rear large diameter hole 12 side to the front small diameter hole 11 at the rear end of the front small diameter hole 11 causes the conductive connector 5 to pass through the rear large diameter hole 12. This is a stopper when moving forward, and the conductive connecting body 5 is in contact with the step portion 13 so that the tip protruding electrode 2 is prevented from protruding further from the tip surface 10 a of the tip body block 10. Is done.

側面固定電極３は、単体の状態が図３に示されるように、一定幅の帯状部材の先端がＪ字状に曲げ戻されて（先端曲げ戻し部３１）、後端部が略９０°程度に小さく折り曲げられている（後端折り曲げ部３２）。   As shown in FIG. 3, the side surface fixed electrode 3 has a band-shaped member having a constant width bent at the front end in a J-shape (front end return portion 31), and the rear end portion is approximately 90 °. (Back end bent portion 32).

図１及び図２に示されるように、側面固定電極３は、先端本体ブロック１０の一側面のみに軸線と平行方向に細長く形成された電極位置決め溝１５内にピッタリと嵌め込まれて、その部分で外面に露出している。   As shown in FIGS. 1 and 2, the side surface fixing electrode 3 is fitted into an electrode positioning groove 15 that is elongated in a direction parallel to the axis on only one side surface of the tip body block 10. Exposed on the outside.

側面固定電極３の先端曲げ戻し部３１は、先端本体ブロック１０の先端面１０ａから先端本体ブロック１０内に潜って形成されたスリット状の電極保持溝１４内に嵌め込まれて保持されている。   The tip bending return portion 31 of the side fixed electrode 3 is fitted and held in a slit-like electrode holding groove 14 formed in the tip body block 10 from the tip surface 10 a of the tip body block 10.

側面固定電極３の後端折り曲げ部３２は、先端本体ブロック１０の後端面１０ｂに係合する状態に、内方の可撓性シース１内に曲げ込まれている。また、側面固定電極３の後端近傍部分は可撓性シース１の内側に潜っていて、可撓性シース１で外方から押さえられた状態になっている。   The rear end bent portion 32 of the side surface fixed electrode 3 is bent into the inner flexible sheath 1 so as to engage with the rear end surface 10 b of the distal end main body block 10. Further, the portion near the rear end of the side surface fixed electrode 3 is dive inside the flexible sheath 1 and is pressed from the outside by the flexible sheath 1.

このようにして、側面固定電極３は、幅方向には電極位置決め溝１５で押さえられ、前後方向には先端曲げ戻し部３１と後端折り曲げ部３２が先端本体ブロック１０に当接している。   In this way, the side fixed electrode 3 is pressed by the electrode positioning groove 15 in the width direction, and the front end bending return portion 31 and the rear end bending portion 32 are in contact with the front end main body block 10 in the front-rear direction.

そして、先端本体ブロック１０からの剥離方向には、前側において先端曲げ戻し部３１が電極保持溝１４に嵌め込まれ、後端側の部分が可撓性シース１で押さえられている。このようにして、側面固定電極３は先端本体ブロック１０に確実に固定された状態になっている。   In the peeling direction from the distal end main body block 10, the distal end bending return portion 31 is fitted into the electrode holding groove 14 on the front side, and the rear end side portion is pressed by the flexible sheath 1. In this way, the side surface fixing electrode 3 is in a state of being securely fixed to the tip body block 10.

このように構成された内視鏡用高周波処置具は、図１及び図２に示されるように、操作ワイヤ４が後方から前方に押し込み操作されたときは、先端突没電極２が先端本体ブロック１０の先端面１０ａから前方に突出する。   As shown in FIGS. 1 and 2, the endoscope high-frequency treatment instrument configured as described above has the distal end projecting electrode 2 arranged at the distal end body block when the operation wire 4 is pushed forward from the rear. 10 protrudes forward from the tip surface 10a.

そして、後側太径孔１２内に位置する導電接続体５が先側細径孔１１の後端入口の段部１３に後方から当接することにより、先端突没電極２がそれ以上前方に突出しない状態になる。その状態では、導電接続体５が後側太径孔１２内に潜っていて側面固定電極３と接触しないので、操作ワイヤ４と側面固定電極３との間は電気的に遮断される。   Then, the conductive connector 5 located in the rear large-diameter hole 12 comes into contact with the step 13 at the rear end entrance of the front small-diameter hole 11 from the rear, so that the tip protruding electrode 2 protrudes further forward. It will be in a state that does not. In this state, since the conductive connecting body 5 is submerged in the rear large-diameter hole 12 and does not contact the side fixed electrode 3, the operation wire 4 and the side fixed electrode 3 are electrically disconnected.

したがって、操作ワイヤ４が高周波電源と接続された状態にされると、先端突没電極２のみに高周波電流が通電され、側面固定電極３には通電されないので、先端本体ブロック１０から前方に突出した先端突没電極２により粘膜切開処置等を安全に行うことができる。   Therefore, when the operation wire 4 is connected to the high-frequency power source, only the high-frequency current is supplied to the tip protruding electrode 2 and not the side fixed electrode 3, so that it protrudes forward from the tip main body block 10. Mucosal dissection treatment or the like can be performed safely by the tip protrusion electrode 2.

次いで、図４及び図５に示されるように、操作ワイヤ４が後方から牽引操作されると、先端突没電極２が先側細径孔１１内に引き込まれ、後側太径孔１２内で後退する導電接続体５が先端本体ブロック１０の後端位置において側面固定電極３の後端折り曲げ部３２に前方から当接する。   Next, as shown in FIGS. 4 and 5, when the operation wire 4 is pulled from behind, the tip protruding electrode 2 is drawn into the front side small diameter hole 11, and within the rear side large diameter hole 12. The retracting conductive connector 5 abuts the rear end bent portion 32 of the side surface fixed electrode 3 from the front at the rear end position of the front end main body block 10.

それによって、先端突没電極２が、先端本体ブロック１０内に没入した状態でそれ以上後方に退避しない状態になると共に、導電接続体５を介して操作ワイヤ４と側面固定電極３との間が電気的に導通し、側面固定電極３に高周波電流が通電される状態になる。このようにして、後端折り曲げ部３２が、先端突没電極２の後退を規制するストッパと側面固定電極３への通電接点とを兼用している。   As a result, the tip protrusion electrode 2 is in a state where it is immersed in the tip body block 10 and is not retracted further back, and the gap between the operation wire 4 and the side surface fixed electrode 3 is interposed via the conductive connector 5. It becomes electrically conductive, and the side surface fixed electrode 3 is in a state where a high-frequency current is passed. In this way, the rear end bent portion 32 serves both as a stopper for restricting the retraction of the front end projecting electrode 2 and the energizing contact to the side surface fixed electrode 3.

なお、先端突没電極２にも高周波電流が通電されるが、先端突没電極２は先端本体ブロック１０内に没入しているので高周波処置機能は発揮されない。したがって、側面固定電極３のみで高周波焼灼を行いながら、粘膜剥離処置等を安全に行うことができる。   Although a high-frequency current is also applied to the tip sunk electrode 2, the tip sunk electrode 2 is immersed in the tip body block 10, so that the high frequency treatment function is not exhibited. Accordingly, it is possible to safely perform the mucosal detachment treatment while performing high-frequency cauterization only with the side surface fixing electrode 3.

図６及び図７は、本発明の第２の実施例に係る内視鏡用高周波処置具を示しており、可撓性シース１が、内視鏡の処置具挿通チャンネルに挿脱される長い本体シース１Ａと、その本体シース１Ａの先端に軸線周り方向に回転自在に接続された短い先端シース１Ｂとで形成されている。６は、操作ワイヤ４のガタつき防止等のために本体シース１Ａに固定的に内挿された内挿チューブである。   6 and 7 show an endoscope high-frequency treatment instrument according to a second embodiment of the present invention, in which the flexible sheath 1 is inserted into and removed from the endoscope treatment instrument insertion channel. The main body sheath 1A is formed of a main body sheath 1A and a short front end sheath 1B connected to the front end of the main body sheath 1A so as to be rotatable around the axis. Reference numeral 6 denotes an insertion tube that is fixedly inserted into the main body sheath 1A in order to prevent the operation wire 4 from rattling.

この実施例では、先端本体ブロック１０全体が先端シース１Ｂの内周部に嵌め込まれた状態に固定されている。そして、導電ワイヤからなる線状の側面固定電極３が、先端シース１Ｂに軸線方向に間隔をあけて形成された二つの電極通過孔８，９の間においてのみ外面に露出する状態に構成されている。   In this embodiment, the entire distal body block 10 is fixed in a state where it is fitted into the inner periphery of the distal sheath 1B. And the linear side surface fixed electrode 3 which consists of a conductive wire is comprised in the state exposed to an outer surface only between the two electrode passage holes 8 and 9 formed in the front-end | tip sheath 1B at intervals in the axial direction. Yes.

そして、側面固定電極３の先端曲げ戻し部３１を嵌め込んで保持するための電極位置決め溝１５′が先端本体ブロック１０の外周部に形成されて、側面固定電極３の先端曲げ戻し部３１が、二つの電極通過孔８，９のうちの先側の電極通過孔８を通って先端シース１Ｂの内周面に沿う状態で電極保持溝１５′内に嵌め込まれ、外側から先端シース１Ｂで押さえられてそこに固定されている。   An electrode positioning groove 15 ′ for fitting and holding the tip bending return portion 31 of the side surface fixed electrode 3 is formed on the outer peripheral portion of the tip body block 10, and the tip bending return portion 31 of the side surface fixing electrode 3 is It is fitted into the electrode holding groove 15 'through the front electrode passage hole 8 of the two electrode passage holes 8, 9 and along the inner peripheral surface of the distal sheath 1B, and is held by the distal sheath 1B from the outside. Is fixed there.

後側の電極通過孔９を通って先端シース１Ｂ内に導入された側面固定電極３の後端折り曲げ部３２′は、第１の実施例と同様に、先端本体ブロック１０の後端面１０ｂより僅かに後方位置において可撓性シース１内に曲げ込まれている。   The rear end bent portion 32 ′ of the side surface fixed electrode 3 introduced into the front end sheath 1 </ b> B through the rear electrode passage hole 9 is slightly smaller than the rear end surface 10 b of the front end main body block 10 as in the first embodiment. And bent into the flexible sheath 1 at the rear position.

そして、側面固定電極３を形成する導電ワイヤの延長部分は操作ワイヤ４に沿って先端シース１Ｂの後端部の後側に隣接する位置で操作ワイヤ４の周囲に巻き付けられている。３３が、その巻き付け部である。その導電ワイヤと操作ワイヤ４との間は、絶縁被覆チューブ４１により電気的に絶縁されている。   The extended portion of the conductive wire forming the side fixed electrode 3 is wound around the operation wire 4 along the operation wire 4 at a position adjacent to the rear side of the rear end portion of the distal sheath 1B. 33 is the winding part. The conductive wire and the operation wire 4 are electrically insulated by an insulation coating tube 41.

このように構成された実施例の内視鏡用高周波処置具は、図６、図７に示されるように、操作ワイヤ４が後方から前方に押し込み操作されたとき、及び図８、図９に示されるように、操作ワイヤ４が後方から牽引操作されたときの何れの場合も、前述の第１の実施例と同様に動作し（側面固定電極３の後端折り曲げ部３２′が、先端突没電極２の後退ストッパと側面固定電極３への通電接点とを兼用している）、さらに操作ワイヤ４を基端側から軸線周り方向に回転操作することにより、側面固定電極３の向きを任意に変えることもできる。   As shown in FIGS. 6 and 7, the high-frequency treatment instrument for an endoscope according to the embodiment configured as described above is shown in FIGS. 8 and 9 when the operation wire 4 is pushed forward from the rear, and FIGS. 8 and 9. As shown, the operation wire 4 is operated in the same manner as in the first embodiment when the operation wire 4 is pulled from behind (the rear end bent portion 32 ′ of the side surface fixing electrode 3 is The retracting stopper of the submerged electrode 2 is also used as a contact point for contact with the side fixed electrode 3), and the operation wire 4 is rotated from the base end side in the direction around the axis so that the direction of the side fixed electrode 3 can be arbitrarily set. It can also be changed to

１ 可撓性シース
２ 先端突没電極
３ 側面固定電極
４ 操作ワイヤ
５ 導電接続体
８，９ 電極通過孔
１０ 先端本体ブロック
１０ａ 先端面
１０ｂ 後端面
１１ 先側細径孔
１２ 後側太径孔
１３ 段部
１４ 電極保持溝
１５，１５′ 電極位置決め溝
３１ 先端曲げ戻し部
３２，３２′ 後端折り曲げ部
DESCRIPTION OF SYMBOLS 1 Flexible sheath 2 Tip protrusion electrode 3 Side surface fixed electrode 4 Operation wire 5 Conductive connection body 8, 9 Electrode passage hole 10 Tip body block 10a Tip surface 10b Rear end surface 11 Front side small diameter hole 12 Rear side large diameter hole 13 Step 14 Electrode holding groove 15, 15 ′ Electrode positioning groove 31 Bend at front end 32, 32 ′ Bend at rear end

Claims (4)

内視鏡の処置具挿通チャンネルに挿脱自在な可撓性シースの最先端部分に取り付けられた電気絶縁性の先端本体ブロックと、
上記先端本体ブロックの先端から前方に突没自在な先端突没電極と、
上記可撓性シース内に軸線方向に進退自在に挿通配置されて上記可撓性シースの基端側からの操作により上記先端突没電極を上記先端本体ブロックから前方に突没させるための導電性の操作ワイヤと、
上記先端本体ブロックの一側面部から軸線と平行な細長い線状又は帯状に外面に露出する状態に上記先端本体ブロック及び上記可撓性シースに対し固定的に取り付けられた側面固定電極とが設けられた内視鏡用高周波処置具において、
上記先端突没電極と上記操作ワイヤとがその双方のどちらよりも径の大きな導電材からなる導電接続体で機械的及び電気的に接続され、
上記先端本体ブロックの軸線位置には、上記先端突没電極は通過するが上記導電接続体は入り込めない径の先側細径孔と、その導電接続体が通過する径の後側太径孔とが直列に貫通形成され、
上記側面固定電極の先端がＪ字状に曲げ戻されて、その曲げ戻された部分が上記先端本体ブロックに形成された電極保持溝内に嵌め込まれて保持され、上記側面固定電極の後側の部分が上記先端本体ブロックの後端位置付近において上記可撓性シース内に曲げ込まれた構成を備え、
上記操作ワイヤが後方から前方に押し込み操作されたときは、上記導電接続体が上記先側細径孔の後端入口に後方から当接することにより、上記先端突没電極がそれ以上前方に突出しない状態になると共に、上記操作ワイヤと上記側面固定電極との間が電気的に遮断され、
上記操作ワイヤが後方から牽引操作されたときは、上記導電接続体が上記側面固定電極の後側の部分に前方から当接することにより、上記先端突没電極が上記先端本体部内に没入してそれ以上後方に退避しない状態になると共に、上記操作ワイヤと上記側面固定電極との間が電気的に導通する、
ことを特徴とする内視鏡用高周波処置具。 An electrically insulating tip body block attached to the most distal portion of the flexible sheath that can be inserted into and removed from the treatment instrument insertion channel of the endoscope;
A tip protruding electrode that can be protruded forward from the tip of the tip body block;
Conductiveness inserted in the flexible sheath so as to be capable of moving forward and backward in the axial direction, and for causing the tip protruding electrode to protrude forward from the tip main body block by an operation from the proximal end side of the flexible sheath. Operation wire,
A side surface fixing electrode fixedly attached to the front end body block and the flexible sheath is provided in a state of being exposed on the outer surface in the form of an elongated line or strip parallel to the axis from one side surface portion of the front end body block. In a high-frequency treatment instrument for endoscopes,
The tip protruding electrode and the operation wire are mechanically and electrically connected with a conductive connecting member made of a conductive material having a diameter larger than both of them,
At the axial position of the tip main body block, a front narrow hole having a diameter through which the tip projecting electrode passes but a conductive connector cannot enter, and a rear large hole having a diameter through which the conductive connector passes. And is formed through in series,
The tip of the side fixed electrode is bent back into a J shape, and the bent back portion is fitted and held in an electrode holding groove formed in the tip body block, and the rear side of the side fixed electrode is A portion is bent into the flexible sheath in the vicinity of the rear end position of the tip body block;
When the operation wire is pushed forward from the rear, the conductive connector contacts the rear end inlet of the front-side narrow hole from the rear, so that the tip protruding electrode does not protrude further forward. With the state, the operation wire and the side fixed electrode are electrically disconnected,
When the operation wire is pulled from behind, the conductive connector contacts the rear portion of the side surface fixing electrode from the front, so that the tip protruding electrode is inserted into the tip main body portion. As well as being in a state where it does not retract backward, the operation wire and the side surface fixing electrode are electrically connected.
An endoscopic high-frequency treatment instrument characterized by the above. 上記側面固定電極が、上記先端本体ブロックの先端部分の一側面部のみから外面に露出する請求項１記載の内視鏡用高周波処置具。   The high-frequency treatment instrument for an endoscope according to claim 1, wherein the side surface fixing electrode is exposed to the outer surface from only one side surface portion of the distal end portion of the distal end body block. 上記電極保持溝が、上記先端本体ブロックの先端面にスリット状に形成されている請求項１又は２記載の内視鏡用高周波処置具。   The high-frequency treatment instrument for endoscope according to claim 1 or 2, wherein the electrode holding groove is formed in a slit shape on a distal end surface of the distal end main body block. 上記先端本体ブロックが上記可撓性シースの内周部に嵌め込まれた状態に固定されていて、上記側面固定電極が、上記可撓性シースに軸線方向に間隔をあけて形成された二つの電極通過孔の間においてのみ外面に露出し、上記電極保持溝が上記先端本体ブロックの外周部に形成されていて、上記側面固定電極の曲げ戻された先端部分が、上記二つの電極通過孔のうちの先側の電極通過孔を通って上記可撓性シースの内周面に沿う状態で上記電極保持溝内に嵌め込まれている請求項１又は２記載の内視鏡用高周波処置具。   Two electrodes in which the tip body block is fixed in a state of being fitted into the inner peripheral portion of the flexible sheath, and the side surface fixing electrode is formed on the flexible sheath with an interval in the axial direction. It is exposed to the outer surface only between the passage holes, the electrode holding groove is formed on the outer peripheral portion of the tip body block, and the bent back tip portion of the side surface fixing electrode is the one of the two electrode passage holes. The high-frequency treatment instrument for endoscope according to claim 1 or 2, which is fitted in the electrode holding groove in a state along the inner peripheral surface of the flexible sheath through the electrode passing hole on the front side of the endoscope.
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