JPH10155798A - 内視鏡用ホットバイオプシー鉗子 - Google Patents
内視鏡用ホットバイオプシー鉗子Info
- Publication number
- JPH10155798A JPH10155798A JP8323918A JP32391896A JPH10155798A JP H10155798 A JPH10155798 A JP H10155798A JP 8323918 A JP8323918 A JP 8323918A JP 32391896 A JP32391896 A JP 32391896A JP H10155798 A JPH10155798 A JP H10155798A
- Authority
- JP
- Japan
- Prior art keywords
- forceps
- cup
- endoscope
- blood vessel
- clamp
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Granted
Links
Landscapes
- Surgical Instruments (AREA)
Abstract
等を容易かつ確実に挟んで止血することができる内視鏡
用ホットバイオプシー鉗子を提供すること。 【解決手段】高周波電源2に接続されて手元側からの遠
隔操作によって開閉駆動される一対の鉗子カップ17を
先端部分に有し、内視鏡1の鉗子チャンネル1aに挿通
して使用される内視鏡用ホットバイオプシー鉗子におい
て、上記鉗子カップ17の最大開き角を中心軸線に対し
て10°ないし30°にした。
Description
子の鉗子カップに処置用の高周波電流を通電できるよう
にした内視鏡用ホットバイオプシー鉗子に関する。
操作により作動するリンク機構によって開閉駆動される
一対の鉗子カップを先端部分に有し、内視鏡の鉗子チャ
ンネルに挿通して使用される。
ような生検鉗子の鉗子カップに高周波電流を通電するこ
とにより、生検組織採取の際に傷つけられる粘膜組織を
焼灼して、出血を防止できるようにしたものである。
には、導電性ワイヤによってループ状に形成されたいわ
ゆる高周波スネアが用いられるが、高周波電流による焼
灼が不十分な状態で切除が行われた場合等には、断端か
ら出血する場合がある。
プ切除後の断端では血管が数ミリメートル飛び出してい
て、そのような部分からの出血を経内視鏡的に止血する
場合に、ホットバイオプシー鉗子が用いられる。
101の断端に血管100の切り口が突出した状態を示
しており、開かれた状態のホットバイオプシー鉗子の鉗
子カップ90を先端側から見た状態である。
0で血管100の突出部を挟んで、その鉗子カップ90
に高周波電流を流せば、血管100の切り口部分を閉じ
た状態で焼灼、凝固して、止血をすることができる。
や、高周波電極を押し当てるようにしたもの等もある
が、出血部位が血液で覆われていると正確な止血処置は
非常に困難であり、血管100を摘んで焼灼することが
できる内視鏡用ホットバイオプシー鉗子は非常に安全か
つ確実に止血を行うことができる。
の鉗子カップは一般に90°ないし100°程度まで開
く。すると、図12に略示されるように、鉗子カップ9
0で血管100を摘んだときに、鉗子カップ90の閉じ
方向に血管100に加わる力Fに対して、血管100を
鉗子カップ90の間から押し出す方向に加わる力f(f
=F.tanθ)が、f≧Fと非常に大きい。そのた
め、血管100が鉗子カップ90の間から滑り出して、
うまく摘めない場合が多い。
た後の出血部位の血管等を容易かつ確実に挟んで止血す
ることができる内視鏡用ホットバイオプシー鉗子を提供
することを目的とする。
め、本発明の内視鏡用ホットバイオプシー鉗子は、高周
波電源に接続されて手元側からの遠隔操作によって開閉
駆動される一対の鉗子カップを先端部分に有し、内視鏡
の鉗子チャンネルに挿通して使用される内視鏡用ホット
バイオプシー鉗子において、上記鉗子カップの最大開き
角を中心軸線に対して10°ないし30°にしたことを
特徴とする。
開き幅を2mmないし3mmの範囲にするとよく、さら
に、上記鉗子カップの縁部に、歯状の凹凸が形成されて
いてもよい。
面が、0.1mm〜0.5mmの幅を有しているとよ
い。
態を説明する。図2は、内視鏡1を通じてホットバイオ
プシー鉗子10が使用される状態を示しており、ホット
バイオプシー鉗子10の可撓性のあるシャフト部10a
が内視鏡1の鉗子チャンネル1aに挿通され、ホットバ
イオプシー鉗子10の先端部10bで患者200の体内
の患部の処置が行われる。
板3が接触させてあり、ホットバイオプシー鉗子10の
手元側に設けられた操作部10cと高周波電源装置2と
の間、及び患者電極板3と高周波電源装置2との間は、
各々電気コード4,5によって接続されている。6は、
内視鏡1を患者電極板3と同電位にさせるためのアース
用コードである。
ており、操作部10cに配置されたスライダー11を移
動操作することにより、シャフト部10a内に進退自在
に通された操作ワイヤが軸線方向に移動して、先端部1
0bに設けられた鉗子カップが開閉する。
スライダー11に設けられていて、操作ワイヤを介して
先端部10bの鉗子カップと電気的につながっている。
したがって、高周波電源装置2から先端部10bの鉗子
カップに対して高周波電流が供給される。
端部10bを示している。13は、シャフト部10aを
全長にわたって構成する密巻きコイルパイプであり、そ
の外周面には、電気絶縁性の外皮チューブ14が被覆さ
れている。15は操作ワイヤである。
アーム状に形成されたリンク機構支持部16aと、コイ
ルパイプ13の先端に連結される筒状部16bとからな
っている。
は、一対の鉗子カップ17が支軸18によって回転自在
に支持されていて、その鉗子カップ17を開閉駆動する
ためのリンク機構19が、リンク機構支持部16a内に
配置されている。
に挿通された操作ワイヤ15の先端は、リンク機構19
に連結されたワイヤつなぎ20に固着されており、操作
ワイヤ15が進退操作されると、リンク機構19がパン
タグラフ状に作動して鉗子カップ17が開閉される。
17の縁部には、複数の溝17aが適宜の間隔をあけて
軸線と直角の方向に形成されていて、それによって、鉗
子カップ17の縁部が鰐口の歯状に形成されている。
た状態を示しており、鉗子カップ17の先端の最大開き
幅Wは2mmないし3mmに形成され、中心軸線に対す
る鉗子カップ17の最大開き角θは10°ないし30°
に設定されている。
まれた状態を略示しており、鉗子カップ17の閉じ方向
に血管100に加わる力をFとすると、f=F.tan
θの力が、血管100を鉗子カップ17の間から押し出
す方向に加わる。血管100が一対の鉗子カップ17の
間から滑りださないようにするためには、fが小さい方
がよい。
15°の各々の場合の、鉗子カップ17が血管100を
押圧する力Fと血管100を押し出そうとする力fを図
示したものである。
00を押し出そうとする力が大きいので、鉗子カップ1
7で血管100を摘む際に血管100が鉗子カップ17
の間から滑り出しやすい。
り、血管100を押し出そうとする力が血管100を押
圧する力の58%と半分程度に減少する。そして、いっ
たん鉗子カップ17で血管100を押圧すれば、図7に
示されるように、血管100は鉗子カップ17によって
θ=20°程度になるまで押し潰される。
・Fになり、血管100を押し出そうとする力は押圧力
の3分の1程度まで減少する。したがって、血管100
が鉗子カップ17の間から滑り出さない。
り、血管100を押し出そうとする力は押圧力の4分の
1近くまで減少して、血管100を鉗子カップ17の間
に確実に把持することができる。
17の最大開き角θは30°以下に設定するのがよい。
ただし、θを余り小さくすると、必要な開き幅を得るの
に鉗子カップ17の長さが長くなりすぎる等の不利な面
が出てくるので、θは10°以上とするのがよい。
01の断端から突出した血管100を、鉗子カップ17
で摘もうとする際の状態を示しており、一対の鉗子カッ
プ17の最大開き幅Wが3mmのもので、直径1mm程
度の血管100を摘もうとする場合を例示している。
が3mmを越えないようにすると、ポリープが切除され
た後の茎部101を鉗子カップ17で挟んでしまうこと
が殆どなくなり、また、鉗子カップ17と血管100と
の間に隙間があき過ぎないので、血管100を容易に把
持することができる。
17で把持したら、鉗子カップ17に高周波電流を流す
ことによって、血管100の切り口部分を焼灼凝固して
止血を行うことができる。
挟み込むように狙う際には、開いた鉗子カップ17と血
管100との間に、ある程度の隙間が必要である。隙間
が小さすぎると、血管17を摘むのが困難になる。
Wは2mm以上に設定するのがよく、3mmに設定すれ
ば、直径が2mm程度の血管100まで容易に摘むこと
ができる。
形態の内視鏡用ホットバイオプシー鉗子を示しており、
鉗子カップ17の先側部分の太さを細く形成したもので
ある。図10の平面部分断面図に示されるように、鉗子
カップ17の縁部の噛み合わせ面17bは、例えば0.
1mm〜0.5mmの幅の平坦な面を有していて、摘ま
れる血管100を切断しないようになっている。
れるものではなく、例えば鉗子カップ17には必ずしも
溝17aを設けなくてもよく、使用目的等によっては、
鉗子カップ17の縁部を鋭利に形成してもよい。
角を中心軸線に対して10°ないし30°にしたことに
より、ポリープを高周波切除した後の出血部位等におい
て、一対の鉗子カップの間に血管を挟んだ時に、血管が
鉗子カップの間から滑り出し難いので、出血元の血管を
容易且つ確実に摘んで止血することができる。
幅を2mmないし3mmとすることにより、ポリープの
茎部に引っ掛かることなく鉗子カップで出血元の血管等
をより容易かつ確実に血管を摘むことができる。
イオプシー鉗子の鉗子カップが開いた状態の先端部分の
側面部分断面図である。
イオプシー鉗子が使用されるシステムの全体略示図であ
る。
イオプシー鉗子の全体外観図である。
イオプシー鉗子の鉗子カップが閉じた状態の先端部分の
側面部分断面図である。
めの鉗子カップ部の略示図である。
めの線図である。
めの血管の略示断面図である。
めの被処置部の断面図である。
イオプシー鉗子の先端部分の側面部分断面図である。
バイオプシー鉗子の先端部分の平面部分断面図である。
作を説明するための被処置部の断面図である。
能を説明するための線図である。
Claims (4)
- 【請求項1】高周波電源に接続されて手元側からの遠隔
操作によって開閉駆動される一対の鉗子カップを先端部
分に有し、内視鏡の鉗子チャンネルに挿通して使用され
る内視鏡用ホットバイオプシー鉗子において、 上記鉗子カップの最大開き角を中心軸線に対して10°
ないし30°にしたことを特徴とする内視鏡用ホットバ
イオプシー鉗子。 - 【請求項2】上記一対の鉗子カップの先端の最大開き幅
が2mmないし3mmである請求項1記載の内視鏡用ホ
ットバイオプシー鉗子。 - 【請求項3】上記鉗子カップの縁部に、歯状の凹凸が形
成されている請求項1又は2記載の内視鏡用ホットバイ
オプシー鉗子。 - 【請求項4】上記鉗子カップの縁部の噛み合わせ面が、
0.1mm〜0.5mmの幅を有している請求項1、2
又は3記載の内視鏡用ホットバイオプシー鉗子。
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
JP32391896A JP3836551B2 (ja) | 1996-12-04 | 1996-12-04 | 内視鏡用ホットバイオプシー鉗子 |
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
JP32391896A JP3836551B2 (ja) | 1996-12-04 | 1996-12-04 | 内視鏡用ホットバイオプシー鉗子 |
Publications (2)
Publication Number | Publication Date |
---|---|
JPH10155798A true JPH10155798A (ja) | 1998-06-16 |
JP3836551B2 JP3836551B2 (ja) | 2006-10-25 |
Family
ID=18160084
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
JP32391896A Expired - Fee Related JP3836551B2 (ja) | 1996-12-04 | 1996-12-04 | 内視鏡用ホットバイオプシー鉗子 |
Country Status (1)
Country | Link |
---|---|
JP (1) | JP3836551B2 (ja) |
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