JP2000287991A - End of hemostatic forceps for endoscope - Google Patents

Abstract

(57) [Problem] To provide a distal end portion of an endoscope hemostatic forceps capable of reliably preventing bleeding from a blood vessel passing near the center of a stem portion and resecting a polyp. A pair of grasping pieces (31) that are opened and closed in a beak shape by remote operation from a hand side, and a conductive needle (32) made of a conductive material disposed forward between the pair of grasping pieces (31). Then, a high-frequency current can be supplied to the conductive needle 32.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an endoscope which is used for insertion and removal of a treatment instrument insertion channel of an endoscope, and which can excise a polyp in a body cavity in a hemostatic state or perform hemostasis after the excision. It relates to the tip of a hemostat.

[0002]

2. Description of the Related Art Generally, an endoscope snare in which a wire loop through which a high-frequency current is applied is used for excision of a polyp using an endoscope is used. This is performed by passing a high-frequency current in a tightened state.

Further, by using a so-called hot biopsy in which a high-frequency current can be supplied to a forceps cup which is opened and closed like a beak, a high-frequency current is supplied by inserting a stem of a polyp between a pair of forceps cups. Done.

[0004]

However, in any case of the polypectomy described above, the stem of the polyp is cauterized and cut by Joule heat generated by the high-frequency current from the outer surface of the polyp. Inadequate coagulation of blood vessels passing near the center of the stomach could cause bleeding after resection.

Accordingly, an object of the present invention is to provide a distal end portion of an endoscope hemostatic forceps capable of reliably preventing bleeding from a blood vessel passing near the center of a stalk and removing a polyp. I do.

[0006]

In order to achieve the above object, a distal end portion of the endoscope hemostatic forceps of the present invention is provided with a pair of grasping pieces which are opened and closed in a beak shape by remote operation from a hand side,
A conductive needle made of a conductive material disposed forward between the pair of gripping pieces; and a high-frequency current can be supplied to the conductive needle.

[0007] The gripping piece may be a biopsy forceps cup. The gripping piece may be formed of a conductive material, and a high-frequency current may be applied to the gripping piece together with the conductive needle, or the gripping piece may be formed of a non-conductive material. You may.

[0008]

Embodiments of the present invention will be described with reference to the drawings. FIG. 2 shows the entire configuration of the endoscope hemostatic forceps, and a flexible operating sheath 1 inserted into and removed from a treatment tool insertion channel of an endoscope (not shown) includes a conductive operation wire. 2 is inserted and arranged over the entire length so as to be able to advance and retreat in the axial direction.

A distal end operating portion 3 is provided at the distal end of the sheath 1, and a pair of forceps cups 31 (grip pieces) that can be opened and closed like a beak are connected to a link mechanism driven by the advance and retreat operation of the operation wire 2. Between the pair of forceps cups 31,
A conductive needle 32 formed of a stainless steel material or the like is disposed forward.

An operating section 4 for moving the operating wire 2 forward and backward is connected to the proximal end of the sheath 1. The operating portion main body 41 to which the proximal end of the sheath 1 is connected is formed in an elongated rod shape, and a first finger hook 42 for engaging the operator's thumb is formed at the proximal end thereof. I have.

A slider 44 is slidably engaged with a slit 43 formed along the longitudinal direction of the operation section main body 41, and the index finger and the middle finger of the operator are engaged with the slider 44. A second finger hook 45 is formed.

A base end of the operation wire 2 passed through a reinforcing pipe member for preventing buckling is inserted into the conductive block member 46 arranged in the slit 43, and these also serve as high-frequency power supply connection terminals. It is fixed to the slider 44 by a manual screw 47.

As a result, when the slider 44 is advanced and retracted along the operation section main body 41 as shown by the arrow A, the operation wire 2 advances and retreats in the sheath 1 and the forceps cup 31 is opened and closed. By connecting the power cord 50, a high-frequency current can be supplied to the operation wire 2.

FIG. 1 shows a distal end portion of a sheath 1 of a hemostat. The sheath 1 is formed by, for example, coating a flexible electric insulating tube 1b on an outer surface of a tightly wound coil pipe 1a in which a stainless steel wire is wound with a constant diameter.

A slit 34 is formed in the longitudinal direction of the distal end body 33 made of conductive metal connected and fixed to the distal end of the sheath 1, and the conductive body is fixed in a state of being extended near the front end thereof. A pair of forceps cups 31 are rotatably supported by metal support pins 35.

The link mechanism 36 is formed in a so-called pantograph shape from a conductive metal material and is disposed in the slit 34. A link rod 37 made of a conductive metal connected to the rear end of the link mechanism 36 is connected to the distal end of the operation wire 2. Are fixedly connected.

As shown in the partial plan sectional view of FIG. 3, the conductive needle 32 is provided with a support pin 3 in a hole formed on the base end side.
5 is supported by a support pin 35, and the end of the arm 32a formed by bending to the side is connected to the tip main body 33.
Is fixed by caulking in the hole 33a formed therein to prevent rotation.

As a result, while the conductive needle 32 is fixed to the tip body 33, the tip body 33 and the link mechanism 3 are fixed.
The operation wire 2 is electrically connected to the operation wire 2 through the connection wire 6 and the like.

Further, since the pair of forceps cups 31 are also formed of a conductive stainless steel material or the like, the high-frequency current applied to the operation wire 2 reaches the forceps cup 31 as well. Note that no high-frequency current flows on the outer surface of the sheath 1 covered with the electrically insulating tube 1b.

FIG. 4 shows a state in which the polyp 100 is cut off at the stem by passing the endoscope hemostatic forceps of this embodiment through a treatment tool insertion channel (not shown) of the endoscope. The conductive needle 32 is pierced into the stem of the polyp 100, and the stem of the polyp 100 is strongly sandwiched between the pair of forceps cups 31 while applying a high-frequency current.

Then, the portion of the stem of the polyp 100 sandwiched between the forceps cups 31 is cut while being cauterized by Joule heat generated by the high-frequency current. that time,
Blood vessel 10 passing through the central part of the stem of polyp 100
By puncturing the conductive needle 32 in the vicinity of 1, the surrounding portion is coagulated with protein and bleeding is prevented.

The forceps cup 31 may be formed of an electrically insulating material. In this case, the stem of the polyp 100 is mechanically cut, but no bleeding occurs because the blood vessel 101 is coagulated by the conductive needle 32.

FIGS. 5 and 6 show a state in which hemostasis is performed by using the endoscope hemostatic forceps of the above embodiment when bleeding is occurring from that part after the polyp is cut. In such a case, first, as shown in FIG.
The blood vessel 101 after the polyp is excised is punctured with a conductive needle 32, and the portion is sandwiched between a pair of forceps cups 31 and a high-frequency current is applied to the conductive needle 32 as shown in FIG. 101 is coagulated to stop bleeding.

It is preferable that the frequency and intensity of the high-frequency current to be used are appropriately adjusted so that the most appropriate coagulation state can be obtained.

[0025]

According to the present invention, a high-frequency current is supplied by puncturing a blood vessel in the stem of a polyp with a conductive needle made of a conductive material provided between a pair of gripping pieces opened and closed by remote control. By doing so, blood vessels passing around the center of the polyp can be coagulated to prevent bleeding, so that the polyp can be safely removed or hemostasis can be performed after the removal.

[Brief description of the drawings]

FIG. 1 is a side sectional view of a distal end portion of a distal end portion of an endoscope hemostatic forceps according to an embodiment of the present invention.

FIG. 2 is a partial side sectional view showing the entire configuration of the endoscope hemostatic forceps according to the embodiment of the present invention.

FIG. 3 is a partial plan sectional view of a distal end portion of the endoscope hemostatic forceps according to the embodiment of the present invention.

FIG. 4 is a schematic diagram showing a state of a polypectomy procedure using the endoscope hemostatic forceps according to the embodiment of the present invention.

FIG. 5 is a schematic view showing a state of hemostasis treatment after polyp resection by the endoscope hemostatic forceps according to the embodiment of the present invention.

FIG. 6 is a schematic diagram showing a state of hemostasis treatment after polyp resection with the endoscope hemostatic forceps according to the embodiment of the present invention.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 Sheath 1b Electrically insulating tube 2 Operation wire 31 Forceps cup 32 Conductive needle 47 Manual screw (connection terminal) 50 High frequency power cord

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Claims (4)

[Claims] 1. A pair of gripping pieces which are opened and closed like a beak by remote control from a hand side, and a conductive needle made of a conductive material disposed forward between the pair of gripping pieces. ,
A distal end portion of the endoscope hemostatic forceps, wherein a high-frequency current can be supplied to the conductive needle. 2. The end portion of the hemostatic forceps for an endoscope according to claim 1, wherein the gripping piece is a biopsy forceps cup. 3. The endoscope according to claim 1, wherein the holding piece is formed of a conductive material, and a high-frequency current is supplied to the holding piece together with the conductive needle. 4. A distal end portion of an endoscope hemostatic forceps according to claim 1, wherein said gripping piece is formed of a non-conductive material.