JP2004275641A - High-frequency scalpel for endoscope - Google Patents

Abstract

An object of the present invention is to provide a high-frequency scalpel for an endoscope capable of easily and safely removing a mucous membrane in a body through a treatment tool insertion channel of the endoscope.
A high-frequency electrode (2) is gradually moved away from an extension line (X) of an axis of a flexible sheath (1) from a base end side to a distal end side by a springy material, and the flexible sheath (1) near the tip end. It is formed by a single bending rod having a shape bent toward the extension line X of the axis, and when the high-frequency electrode is moved in the direction of being drawn into the distal end of the flexible sheath, the distal end is moved along the axis of the flexible sheath. The high-frequency electrode is elastically deformed so as to approach the extension of.
[Selection diagram] Fig. 1

Description

[0001]
TECHNICAL FIELD OF THE INVENTION
The present invention relates to a high-frequency scalpel for an endoscope used through a treatment tool insertion channel of an endoscope.
[0002]
[Prior art]
In general, a high-frequency scalpel for an endoscope is configured such that a rod-shaped high-frequency electrode disposed at a distal end portion of a flexible sheath having electrical insulation properties is moved from the proximal end side of the flexible sheath to the distal end of the flexible sheath. It is configured to be able to be protruded and retracted from inside (for example, Patent Document 1).
[0003]
[Patent Document 1]
JP-A-2002-153484
[0004]
[Problems to be solved by the invention]
2. Description of the Related Art In recent years, endoscopic procedures for performing surgery without laparotomy using an endoscope have been widely performed, and endoscopic mucosal resection (EMR) for removing mucosal tissue having early cancer or the like has also been performed. Is being done. In such a mucosal resection, it is necessary to resect the mucosal tissue so as not to pierce the submucosal body wall.
[0005]
However, with a structure in which a rod-shaped high-frequency electrode is simply protruded and retracted from the distal end of a flexible sheath, such as a conventional high-frequency scalpel for an endoscope, it is difficult to finely adjust the resection range. In order to prevent the body wall from being perforated, a very high level of technique is required, and it has been difficult to perform it widely and generally.
[0006]
Accordingly, an object of the present invention is to provide a high-frequency scalpel for an endoscope that can easily and safely cut off mucous tissue in a body through a treatment tool insertion channel of the endoscope.
[0007]
[Means for Solving the Problems]
In order to achieve the above object, a high-frequency scalpel for an endoscope according to the present invention operates a high-frequency electrode disposed at a distal end portion of a flexible sheath having electrical insulation by operating the high-frequency electrode from the proximal end side of the flexible sheath. In a high-frequency scalpel for an endoscope configured to be able to protrude and retract from within the distal end of the flexible sheath, the high-frequency electrode can be moved from the proximal end to the distal end by a springy material. It is formed by a single bending rod having a shape gradually bent away from the extension of the axis of the flexible sheath toward the extension of the axis of the flexible sheath near the distal end, and the high-frequency electrode is formed inside the distal end of the flexible sheath. The high-frequency electrode is elastically deformed so that when it moves in the direction in which the high-frequency electrode is drawn, the tip approaches the extension of the axis of the flexible sheath.
[0008]
When the high-frequency electrode moves in the direction of being drawn into the distal end of the flexible sheath, the distal end of the high-frequency electrode approaches the extension of the axis of the flexible sheath, and then moves beyond the extension of the axis. Thus, a higher resection function can be obtained by moving in a direction away from the extension of the axis.
[0009]
Further, the cross-sectional shape of a portion closer to the distal end than the bent portion of the high-frequency electrode may be formed in a substantially triangular shape having an apex angle on a side closer to the flexible sheath, and the distal end opening of the flexible sheath may be formed. A guide groove for guiding the high-frequency electrode may be formed in the inner peripheral surface portion of the first member so as to regulate the direction of the high-frequency electrode.
[0010]
BEST MODE FOR CARRYING OUT THE INVENTION
An embodiment of the present invention will be described with reference to the drawings.
FIG. 2 shows the entire configuration of a high-frequency scalpel for an endoscope, and a flexible sheath 1 inserted into and removed from a treatment tool insertion channel of an endoscope (not shown) includes, for example, an ethylene tetrafluoride resin tube or the like. It is formed by such an electrically insulating flexible tube.
[0011]
A high-frequency electrode 2 made of a conductive material having a high spring property such as a nickel-titanium-based superelastic alloy material is protruded and retracted into the distal end of the flexible sheath 1 at the distal end of the flexible sheath 1. Are located in
[0012]
In the flexible sheath 1, an operation wire 3 that is operated to advance and retreat in the axial direction from an operation unit 10 arranged on the proximal end side is inserted and arranged over the entire length. The operation wire 3 is formed of a conductive material such as a stainless steel wire or a superelastic alloy wire, and also serves as a conductive wire for high-frequency current to the high-frequency electrode 2.
[0013]
A first finger hook 11a is provided at the rear end of the operation unit main body 11 to which the base end of the flexible sheath 1 is connected, at the operation unit 10 provided at the base end (hand side) of the flexible sheath 1. The second finger hook 12 is slidably engaged with a slit portion which is attached and formed in an intermediate portion of the operation portion main body 11. Reference numeral 13 denotes a power supply socket for connecting a high-frequency power supply cord (not shown), which is electrically connected to the operation wire 3.
[0014]
With such a configuration, by operating the second finger rest 12 forward and backward, the operation wire 3 advances and retracts in the axial direction within the flexible sheath 1, and a high-frequency power cord (not shown) is connected to the power socket 13. A high-frequency current can be supplied to the high-frequency electrode 2 via the operation wire 3.
[0015]
Since the movement of the flexible sheath 1 and the operation wire 3 in the axial direction is relative to each other, if the operation portion main body 11 is moved forward and backward so that the second finger hook 12 does not move, The flexible sheath 1 can be moved back and forth in the axial direction without moving the operation wire 3 and the high-frequency electrode 2 at the tip thereof.
[0016]
1 and 3 show a distal end portion of a high-frequency scalpel for an endoscope. FIG. 1 is a plan sectional view, and FIG. 3 is a side sectional view. The base end of the high-frequency electrode 2 is connected and fixed to the tip of the operation wire 3 via a connection pipe 4 by, for example, brazing.
[0017]
As shown in FIG. 1, the high-frequency electrode 2 gradually moves away from the extension X of the axis of the flexible sheath 1 from the base end to the tip end, and the axis X of the flexible sheath 1 near the tip. Is formed only by a single bending rod having a shape bent toward the extension of the line.
[0018]
In the natural state where the high-frequency electrode 2 is not elastically deformed, as shown in FIG. 1, the leading end of the portion 2 a closer to the tip than the bent portion is in contact with the extension line X of the axis of the flexible sheath 1. It is arranged in such a state that it is laterally deviated to the extent that there is an interval therebetween.
[0019]
The cross-sectional shape of the portion 2a closer to the tip than the bent portion of the high-frequency electrode 2 is formed in a triangular shape having an apex near the tip of the flexible sheath 1 as shown in FIG. Have been.
[0020]
However, the shape does not need to be a triangular shape in a strict sense. If the shape has a ridgeline on the side near the distal end of the flexible sheath 1, the current density to the mucosal tissue that touches it is increased. The excision ability can be enhanced.
[0021]
As shown in FIG. 4, the high-frequency scalpel for an endoscope according to the embodiment configured as described above is operated by pulling the operation wire 3 from the operation unit 10 side as indicated by an arrow A (or by operating the operation wire 3). By pushing the flexible sheath 1 without moving it, the high-frequency electrode 2 gradually moves in the direction of being drawn into the flexible sheath 1, and accordingly, the high-frequency electrode 2 elastically deforms and its tip is indicated by an arrow B. Approach the extension line X of the axis of the flexible sheath 1.
[0022]
When the high-frequency electrode 2 further moves in the direction of being drawn into the tip of the flexible sheath 1, the tip of the high-frequency electrode 2 moves beyond the extension X of the axis of the flexible sheath 1 and extends from the extension X of the axis. Move away from you. As a result, the high-frequency electrode 2 can be largely moved at the front position of the distal end of the flexible sheath 1, and an excellent excision function can be obtained.
[0023]
As shown in FIG. 5 and FIG. 6 showing a VI-VI cross section thereof, a guide groove 5 for guiding the high-frequency electrode 2 is formed in the inner peripheral surface of the distal end opening of the flexible sheath 1. In addition, the direction of the high-frequency electrode 2 can be regulated so that the direction of the high-frequency electrode 2 does not rotate unexpectedly.
[0024]
7 to 10 schematically show a state of mucosal resection (EMR) using the high-frequency scalpel for endoscope of the above embodiment. First, the high-frequency scalpel for endoscope is passed through the treatment instrument insertion channel of the endoscope. Then, as shown in FIG. 7, the high-frequency electrode 2 is made to face the mucosal tissue 100 in a state of being directed substantially parallel to the mucosal surface.
[0025]
Then, as shown by an arrow C in FIG. 8, the flexible sheath 1 is pushed in so as not to move the operation wire 3 from the operation unit 10 side, and at the same time, a high-frequency current is supplied to the high-frequency electrode 2. The portion 2a closer to the tip than the bent portion of the high-frequency electrode 2 moves as shown by arrow D so as to pierce the mucosal tissue 100 from the side.
[0026]
Therefore, if the procedure is terminated by itself, the drilling procedure for the mucosal tissue 100 can be easily performed. However, when performing the mucosal resection, the entire high-frequency scalpel (or the internal scalpel) as shown by the arrow E in FIG. By pulling the entire endoscope toward the hand, the mucosal tissue 100 is excised by the portion 2a closer to the tip than the bent portion of the high-frequency electrode 2. FIG. 10 shows a state of such a mucosal tissue 100 viewed from the side.
[0027]
In this manner, by using the high-frequency scalpel for an endoscope of the present invention, the mucosal tissue 100 in the body can be resected so as not to be perforated.
[0028]
【The invention's effect】
According to the present invention, the high-frequency electrode is gradually moved away from the extension of the axis of the flexible sheath from the proximal side to the distal side by the springy material, and the axis of the flexible sheath near the distal end. The high-frequency electrode is formed by a single bending rod having a shape bent toward the extension line, so that the high-frequency electrode is prevented from moving, and the flexible sheath is moved to the front side. Moves in a direction approaching the extension of the axis of the flexible sheath 2 and pierces the mucosal tissue, and then moves the entire high-frequency scalpel for endoscope to easily and safely remove the mucosal tissue in the body. It can be resected as follows.
[Brief description of the drawings]
FIG. 1 is a plan sectional view of a distal end portion of a high-frequency scalpel for an endoscope according to an embodiment of the present invention.
FIG. 2 is a plan view showing the overall configuration of a high-frequency scalpel for an endoscope according to an embodiment of the present invention.
FIG. 3 is a side sectional view of a distal end portion of the high-frequency scalpel for an endoscope according to the embodiment of the present invention.
FIG. 4 is a plan sectional view of the distal end portion of the high-frequency scalpel for an endoscope according to the embodiment of the present invention in an operating state.
FIG. 5 is a cross-sectional plan view of a modification of the operating state of the distal end portion of the high-frequency scalpel for an endoscope according to the embodiment of the present invention.
6 is a sectional view of the high-frequency knife for an endoscope according to the embodiment of the present invention, taken along line VI-VI in FIG. 5;
FIG. 7 is a perspective view of a distal end portion of the high-frequency scalpel for an endoscope in use according to the embodiment of the present invention.
FIG. 8 is a plan view of a distal end portion of the high-frequency scalpel for an endoscope in use according to the embodiment of the present invention.
FIG. 9 is a plan view of the distal end portion of the high-frequency scalpel for an endoscope according to the embodiment of the present invention in use.
FIG. 10 is a side view showing the state of the mucosal tissue after the treatment with the high-frequency scalpel for an endoscope according to the embodiment of the present invention.
[Explanation of symbols]
DESCRIPTION OF SYMBOLS 1 Flexible sheath 2 High frequency electrode 2a Part nearer to the tip than bent part 3 Operation wire 10 Operation part X Extension of axis of flexible sheath

Claims (4)

The high-frequency electrode disposed at the distal end of the flexible sheath having electrical insulation properties can be protruded and retracted from the distal end of the flexible sheath by an operation from the proximal end side of the flexible sheath. In the configured high-frequency scalpel for endoscope,
The high-frequency electrode is gradually moved away from the extension of the axis of the flexible sheath as it goes from the proximal end to the distal end by a springy material, and the extension of the axis of the flexible sheath near the distal end. The high-frequency electrode is formed by a single bending rod having a shape bent toward the end, and when the high-frequency electrode moves in a direction of being drawn into the distal end of the flexible sheath, the distal end is extended along the axis of the flexible sheath. A high-frequency scalpel for an endoscope, wherein the high-frequency electrode is elastically deformed so as to approach the endoscope. When the high-frequency electrode moves in a direction to be drawn into the distal end of the flexible sheath, the distal end of the high-frequency electrode approaches an extension of the axis of the flexible sheath, and then extends the axis. The high-frequency scalpel for an endoscope according to claim 1, wherein the scalpel moves in a direction beyond the line and away from an extension of the axis. 3. The endoscope according to claim 1, wherein a cross-sectional shape of a portion of the high-frequency electrode closer to the tip than the bent portion is formed in a substantially triangular shape having an apex on a side closer to the flexible sheath. For high frequency scalpel. 4. The endoscope according to claim 1, wherein a guide groove for guiding the high-frequency electrode is formed in an inner peripheral surface portion of the distal end opening of the flexible sheath so as to regulate the direction of the high-frequency electrode. High frequency knife for mirror.

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