Endoscopic instruments

Abstract

This invention provides an endoscopic treatment device comprising: a resin sheath; a flow path forming member rotatably mounted on the front end of the sheath about its length axis; forceps blades supported by the flow path forming member in an openable and closable manner; a linkage mechanism connected to the forceps blades to open and close the forceps blades; an operating line extending along the length axis of the sheath; and a connecting member connecting the base arm of the linkage mechanism and the operating line. The flow path forming member has: a first fluid inlet through which the base arm of the linkage mechanism passes; and a notch forming a second fluid inlet as a gap between the flow path forming member and the front end cover of the sheath. When the forceps blades are closed, a portion of the linkage mechanism closes the first fluid inlet; when the forceps blades are open, a portion of the connecting member closes the first fluid inlet.

Description

Technical Field

[0001] This invention relates to an endoscopic treatment device. This application claims the benefit of U.S. Provisional Application No. 63 / 143141, filed January 29, 2021, the entire contents of which are incorporated herein by reference. Background Technology

[0002] In the past, endoscopic treatments such as ESD (endoscopic submucosal dissection) have used endoscopic instruments for cutting and dissecting, such as high-frequency knives, endoscopic instruments for local injection, and endoscopic instruments for hemostasis.

[0003] Japanese Patent Application Publication No. 2013-111308 and Chinese Patent Application Publication No. 205359621 disclose an endoscopic treatment device capable of performing multiple procedures, including tissue incision, dissection, local injection, and hemostasis. The high-frequency endoscopic treatment device described in Japanese Patent Application Publication No. 2013-111308 is capable of performing incision, dissection, and hemostasis. The high-frequency scalpel described in Chinese Patent Application Publication No. 205359621 is capable of performing incision, dissection, and local injection. Summary of the Invention

[0004] The first technical solution of the present invention provides an endoscopic treatment device comprising: a resin sheath; a flow path forming member rotatably mounted on the front end of the sheath about its length axis; forceps supported by the flow path forming member in an openable and closable manner; a linkage mechanism connected to the forceps to open and close the forceps; an operating line extending along the length axis of the sheath; and a connecting member connecting the base arm of the linkage mechanism and the operating line. The flow path forming member has: a first fluid delivery hole through which the base arm of the linkage mechanism passes; and a notch forming a second fluid delivery hole as a gap between the flow path forming member and the front end cover of the sheath. When the forceps are closed, a portion of the linkage mechanism closes the first fluid delivery hole, and when the forceps are opened, a portion of the connecting member closes the first fluid delivery hole. Attached Figure Description

[0005] Figure 1 This is an overall diagram of the endoscopic treatment system according to the first embodiment.

[0006] Figure 2 This is an overall diagram showing the treatment instruments of the endoscopic treatment system.

[0007] Figure 3 This is a cross-sectional view of the front end of the handling instrument with the pliers in the closed position.

[0008] Figure 4 This is a cross-sectional view of the front end of the pliers in the open position.

[0009] Figure 5 This is a three-dimensional view of the supporting components of the treatment device.

[0010] Figure 6 This is a diagram showing the connecting components of the treatment device.

[0011] Figure 7 This is a front view of the front end of the treatment device with the pliers in the closed position.

[0012] Figure 8 This is a front view of the front end of the handling instrument with the pliers in the open state.

[0013] Figure 9 It is a cross-sectional view of the front end of a modified processing tool equipped with pliers.

[0014] Figure 10 This is a front view of the front end of the processing device with this variant.

[0015] Figure 11 This is a diagram showing a modified example of the flow path forming component of the treatment device.

[0016] Figure 12 This is a diagram showing another variation of the flow path forming component.

[0017] Figure 13 This is a diagram showing another variation of the flow path forming component.

[0018] Figure 14 This is a diagram showing another variation of the flow path forming component.

[0019] Figure 15 This is a diagram showing the flow path forming components, which also include O-rings.

[0020] Figure 16 This diagram shows that it also includes the base arm of the O-ring.

[0021] Figure 17 This is a perspective view showing another variation of the flow path forming component. Detailed Implementation

[0022] (First Implementation)

[0023] Reference Figures 1 to 14 The endoscopic treatment system 300 of the first embodiment of the present invention is described. Figure 1 This is an overall view of the endoscopic treatment system 300 of this embodiment.

[0024] [Endoscopic Handling System 300]

[0025] like Figure 1 As shown, the endoscopic treatment system 300 includes an endoscope 200 and a treatment device 100C. The treatment device 100C is inserted into the endoscope 200 for use.

[0026] [Endoscope 200]

[0027] Endoscope 200 is a known flexible endoscope, including an insertion part 202 inserted into the body from the tip and an operating part 207 mounted on the base of the insertion part 202.

[0028] The insertion part 202 includes a camera part 203, a curved part 204, and a flexible part 205. The camera part 203, the curved part 204, and the flexible part 205 are arranged sequentially from the front end of the insertion part 202. A channel 206 for inserting the treatment device 100C is provided inside the insertion part 202. A front opening 206a of the channel 206 is provided at the front end of the insertion part 202.

[0029] The camera unit 203 is equipped with an imaging element such as a CCD or CMOS, and can capture images of the part that is being processed. The camera unit 203 can capture images of the rod 2 of the processing device 100C when it protrudes from the front opening 206a of the channel 206 of the processing device 100C.

[0030] The bending portion 204 bends as the operator operates the operating portion 207. The flexible portion 205 is a flexible tubular part.

[0031] The operating unit 207 is connected to the flexible part 205. The operating unit 207 includes a handle 208, an input unit 209, a base opening 206b of the channel 206, and a universal cable 210. The handle 208 is the part held by the operator. The input unit 209 receives operational input for bending the bending part 204. The universal cable 210 outputs images captured by the camera unit 203 to the outside. The universal cable 210 is connected to a display device such as a liquid crystal display via an image processing device equipped with a processor.

[0032] [Treatment Equipment 100C]

[0033] Figure 2 This is an overall diagram representing the treatment equipment 100C.

[0034] The treatment device (endoscopic treatment device) 100C includes a sheath 1C, forceps 6, support member 7, connecting member 9, operating line 4C, and operating part 5C. In the following description, the side of the treatment device 100C that is inserted into the patient's body along the length direction A is referred to as the "front end side A1", and the side of the operating part 5C is referred to as the "base end side A2".

[0035] The sheath 1C is flexible and insulating, and is a longitudinally elongated resin component extending from the front end 1a to the base end 1b. The sheath 1C has an outer diameter that allows insertion into the channel 206 of the endoscope 200, and is capable of moving in and out of the channel 206.

[0036] Figure 3 This is a cross-sectional view of the front end of the handling instrument 100C with the pliers 6 in the closed state.

[0037] The sheath 1C has a spiral sheath 15 and a cylindrical resin sheath 16 covering the outer surface of the spiral sheath 15. A front cover 17 is installed at the front end 1a of the sheath 1C.

[0038] The front cover 17 is a rigid cylindrical component made of metal or other materials. A concave engaging groove 17e is formed on the inner circumferential surface of the front cover 17 along the circumferential direction C.

[0039] The sheath 1C has a water supply pipe 18 extending along the length direction A. The water supply pipe 18 communicates with a front opening 17a formed in the front end cover 17. The front opening 17a opens at the front end side A1.

[0040] Figure 4 This is a cross-sectional view of the front end of the handling device 100C with the pliers 6 in the open position.

[0041] The pliers (handling unit) 6 is a pliers capable of being opened and closed. The pliers 6 is conductive and can also be used as a high-frequency knife. The pliers 6 has a pair of plier plates (first plier plate 61 and second plier plate 62) and a linkage mechanism 63. The linkage mechanism 63 and the operating line 4C constitute the operating components for operating the pliers 6.

[0042] A pair of clamping jaws (first clamping jaw 61 and second clamping jaw 62) are connected in a linkage mechanism 63 on the base end side A2, and are configured to open and close freely towards the front end side A1. The first clamping jaw 61 and the second clamping jaw 62 are configured symmetrically with respect to the central axis O6 of the length direction A of the clamps 6. Figure 4 As shown, the central axis O6 of the length direction A of the pliers 6 is approximately aligned with the central axis O1 of the length direction A of the sheath 1C.

[0043] The linkage mechanism 63 has a base arm 63a on its base end side. The base arm 63a is formed, for example, in a cylindrical shape. The base arm 63a can pass through the central hole 7a (described later) and move forward and backward along the length direction A. At the front end side A1 of the base arm 63a, there is an enlarged portion 63b that is radially larger than that of the base arm 63a. The enlarged portion 63b has an abutment surface 63c on the base end side A2 that can abut against the support member 7.

[0044] Figure 5 This is a three-dimensional view of the supporting component 7.

[0045] The support member 7 supports the clamps 6 in an openable and closable manner at the front end 1a of the sheath 1C. The support member 7 has a flow path forming member 70 and a bracket 72.

[0046] The flow path forming member 70 is formed as a circular plate capable of engaging with the engaging groove 17e of the front cover 17, and is supported on the front cover 17 in a manner that allows it to rotate around the central axis O1 of the sheath 1C. The flow path forming member 70 has a central hole (first liquid delivery hole, through hole) 7a extending along the length direction A and notches 7b recessed radially R on both sides of the central hole 7a. Figure 3 and Figure 4 As shown, the base arm 63a of the linkage mechanism 63 passes through the central hole 7a.

[0047] The notch 7b is formed by cutting off the outer peripheral surface of the flow path forming member 70 with two planes parallel to the axis of the central hole 7a. The notch 7b is disposed on both sides in a direction orthogonal to the opening and closing direction of the pliers 6.

[0048] The support 72 is a pair of plate-like members positioned on either side of the central axis O6 of the pliers 6. A through hole 73 is formed on the front end side A1 of the support 72. Figure 3 and Figure 4 As shown, the bracket 72 supports a pair of pliers (first pliers 61 and second pliers 62) so that they can rotate by means of a shaft member 74 that passes through the through hole 73.

[0049] The bracket 72 is fixed to the flow path forming member 70 at its base end, and is integral with the flow path forming member 70 and can rotate about the central axis O1 of the sheath 1C. The bracket 72 and the flow path forming member 70 can be constructed independently as long as they are integrally rotated, and can also be fixed by welding or bonding.

[0050] like Figure 5 As shown, the outer surface 75 of the support 72 and the notch 7b of the flow path forming member 70 form the same surface.

[0051] Figure 6 This is a diagram representing connecting component 9.

[0052] The connecting member 9 is a cylindrical component that connects the front end of the operating line 4C to the base arm 63a of the linkage mechanism 63 of the pliers 6. The front end of the operating line 4C and the base arm 63a of the linkage mechanism 63 are joined inside the connecting member 9 by brazing. A through hole 91 is formed in the connecting member 9 for inserting brazing filler metal for joining. The front end of the operating line 4C and the base arm 63a of the linkage mechanism 63 can also be fixed by welding or bonding.

[0053] The operating line 4C is the shaft of the water supply pipe 18 that passes through the sheath 1C and is conductive. The operating line 4C is made of metal raw materials such as stainless steel. The front end of the operating line 4C is connected to the clamp 6 by means of the connecting structure 9, and the base end of the operating line 4C is connected to the operating part 5C.

[0054] like Figure 3 As shown, when the operating line 4C is retracted, the clamps 6 are in a closed state, and the abutment surface (base end face) 63c of the expanded diameter portion 63b of the linkage mechanism 63 abuts against the front end of the flow path forming member 70, sealing the central hole 7a and thus preventing water from being supplied to the central hole 7a. Furthermore, the portion sealing the central hole 7a (the second sealing portion, the second member) is not limited to the abutment surface 63c; it can be any part of the linkage mechanism 63.

[0055] Figure 7 This is a front view of the front end of the treatment device 100C with the pliers 6 in the closed state.

[0056] When the clamps 6 are closed and the central hole 7a is sealed, the liquid supplied from the water supply line 18 is delivered to the front end side A1 only through the second liquid supply hole 19, which serves as the gap between the front opening 17a and the notch 7b of the front end cover 17. Therefore, it is possible to suppress the radial expansion of the water supply direction and deliver water forward in a generally straight and aesthetically pleasing manner.

[0057] like Figure 4 As shown, when the operating line 4C is advanced, the clamps 6 are in the open state, and the distal end of the connecting member 9 abuts against the base end of the flow path forming member 70, closing the central hole 7a and thus preventing water from being supplied to the central hole 7a. Furthermore, the portion closing the central hole 7a (the first closing portion, the first member) is not limited to the distal end of the connecting member 9; it can be any part of the connecting member 9.

[0058] Figure 8 This is a front view of the front end of the handling device 100C with the pliers 6 in the open state.

[0059] When the clamps 6 are in the open state and the central hole 7a is closed, the liquid supplied from the water supply pipe 18 is only delivered to the front end side A1 through the second liquid supply hole 19, which is the gap between the front opening 17a and the notch 7b of the front end cover 17. Therefore, it is possible to suppress the radial expansion of the water supply direction and deliver water forward in a generally straight and aesthetically pleasing manner.

[0060] like Figure 2 As shown, the operation unit 5C includes an operation unit body 51, a slider 52C, a power supply connector 53C, and a liquid supply port 54C.

[0061] The slider 52C is movable relative to the operating unit body 51 along the length direction A, and is mounted in a manner that allows it to rotate about an axis along the length direction A. The base 4b of the operating line 4C is mounted on the slider 52C. The operating line 4C moves forward or backward relative to the operating unit body 51 by the surgical operator. The operating line 4C rotates by the surgical operator about an axis along the length direction A.

[0062] The power connector 53C is fixed to the operating unit body 51. The power connector 53C can be connected to a high-frequency power supply device (not shown) and is connected to the base end of the operating line 4C. The power connector 53C can supply high-frequency current from the high-frequency power supply device to the clamp 6 via the operating line 4C.

[0063] Liquid supply port 54C is located on the main body 51 of the operating unit. Liquid supplied from liquid supply port 54C passes through water supply pipe 18 and is released from the front opening 17a of the sheath 1C.

[0064] [Instructions for using treatment device 100C]

[0065] Next, a procedure performed using the endoscopic system equipped with the treatment device 100C of this embodiment (method of using the endoscopic treatment system) will be described. Specifically, local injection, incision, dissection, and hemostasis procedures for lesions treated endoscopically, such as ESD (endoscopic submucosal dissection), will be described.

[0066] As part of the preparatory work, the surgeon uses known methods to identify the lesion. Specifically, the surgeon inserts the insertion part 202 of the endoscope 200 into the digestive tract (e.g., esophagus, stomach, duodenum, large intestine) and identifies the lesion while observing the images obtained by the imaging part 203 of the endoscope.

[0067] <Insertation Steps>

[0068] The surgeon inserts the treatment instrument 100C into the channel 206, causing the front end 1a of the sheath 1C to protrude from the front opening 206a of the insertion part 202. The surgeon advances the slider 52C of the operating part 5C relative to the operating part body 51, causing the forceps 6 to protrude.

[0069] <Cutting and peeling steps>

[0070] The surgeon performs incision and dissection. While a high-frequency current is applied, the surgeon moves a pair of closed forceps (first forceps 61 and second forceps 62) to incise the mucosa of the lesion. Furthermore, the surgeon advances the closed forceps (first forceps 61 and second forceps 62), lifts the incised mucosa of the lesion while a high-frequency current is applied, and simultaneously dissects the submucosa of the incised lesion.

[0071] like Figure 3 As shown, when a pair of clamps (first clamp 61 and second clamp 62) are closed, the central hole 7a of the flow path forming member 70 is closed by the linkage mechanism 63.

[0072] like Figure 7 As shown, when the pair of clamps (first clamp 61 and second clamp 62) are closed, the central hole (first liquid delivery hole) 7a is closed by the linkage mechanism 63. Therefore, the liquid supplied from the water supply line 18 is only delivered to the front end side A1 through the second liquid delivery hole 19, which serves as the gap between the front end cover 17 and the notch 7b.

[0073] Because the central hole (first liquid delivery hole) 7a is closed, the cross-sectional area of ​​the liquid delivery path becomes smaller, thus increasing the velocity of the delivered liquid. Furthermore, at the front end A1 of the second liquid delivery hole 19, the forceps 6 and the support 72 do not obstruct the flow of liquid, allowing it to be delivered straight forward. Therefore, cutting and dissection can be performed after the bleeding has been removed.

[0074] <Steps to stop bleeding>

[0075] In the event of bleeding during the incision and dissection process, the surgeon shall perform hemostasis. For example... Figure 4 As shown, the surgeon opens a pair of forceps (first forceps 61 and second forceps 62) by moving the slider 52C relative to the main body 51 of the operating part towards the front end A1. While pressing the pair of forceps (first forceps 61 and second forceps 62) in the open state, the surgeon stops the bleeding by cauterizing the bleeding point using a high-frequency current (hemostasis step).

[0076] like Figure 4 As shown, when a pair of clamps (first clamp 61 and second clamp 62) are opened, the central hole 7a of the flow path forming member 70 is closed by means of the linkage mechanism 63.

[0077] like Figure 8As shown, when the pair of clamps (first clamp 61 and second clamp 62) are opened, the central hole (first liquid delivery hole) 7a is closed by the linkage mechanism 63. Therefore, the liquid supplied from the water supply line 18 is only delivered to the front end side A1 through the second liquid delivery hole 19, which serves as the gap between the front end cover 17 and the notch 7b.

[0078] Because the central hole (first delivery hole) 7a is closed, the cross-sectional area of ​​the liquid flow path is reduced, thus increasing the velocity of the delivered liquid. Furthermore, at the front end A1 of the second delivery hole 19, the forceps 6 and the support 72 do not obstruct the flow of liquid, allowing it to be delivered straight forward. This makes the bleeding point more clearly defined.

[0079] When the mucous membrane is covered by blood or other fluids, the surgeon can supply fluid to the water supply line 18 to flush out the bleeding, making the bleeding site clearer and facilitating hemostasis.

[0080] like Figure 4 As shown, when a pair of clamps (first clamp 61 and second clamp 62) are opened, the central hole (first liquid delivery hole) 7a of the flow path forming member 70 is closed by the connecting structure 9.

[0081] like Figure 8 As shown, when the pair of clamps (first clamp 61 and second clamp 62) are opened, the central hole (first liquid delivery hole) 7a is closed by the connecting member 9. Therefore, the liquid supplied from the water supply line 18 is only delivered to the front end side A1 through the second liquid delivery hole 19, which serves as the gap between the front end cover 17 and the notch 7b.

[0082] Because the central hole 7a is closed, the cross-sectional area of ​​the liquid flow path decreases, thus increasing the velocity of the liquid. Furthermore, at the front end A1 of the second liquid delivery hole 19, the clamps 6 and the support 72 do not obstruct the flow of liquid, allowing it to be delivered straight forward. This enables reliable cleaning of the target area.

[0083] The treatment device 100C of this embodiment can perform multiple treatments such as local injection, incision, dissection, and hemostasis.

[0084] The treatment device 100C of this embodiment can deliver liquid supplied from the water supply line 18 straight forward from the front opening 17a, whether the pair of clamps (first clamp 61 and second clamp 62) are closed or open.

[0085] The first embodiment of the present invention has been described in detail above with reference to the accompanying drawings. However, the specific structure is not limited to this embodiment, and design changes that do not depart from the spirit of the present invention are also included. Furthermore, the constituent elements shown in the above embodiments and variations can be appropriately combined to form a configuration.

[0086] The shape of the pliers 6 is not limited to the shape shown in the above embodiments. Figure 9 This is a cross-sectional view of a processing tool having pliers 6A, which is a variation of pliers 6. Figure 10 This is a front view of the surgical instrument equipped with forceps 6A. Forceps 6A has a pair of forceps plates (first forceps plate 61A and second forceps plate 62A) and a linkage mechanism 63. Forceps 6A has a protrusion 68 on the upper surface of the front end of the first forceps plate 61A, opposite to the side of the second forceps plate 62A, and a protrusion 69 on the lower surface of the front end of the second forceps plate 62A, opposite to the side of the first forceps plate 61A. The surgical operator can easily use the protrusions 68 and 69 to perform incision and dissection procedures.

[0087] Figure 11 This is a diagram showing a modified example of a flow path forming member 70D.

[0088] The flow path forming member 70D has a recess 76 on the front end side A1 of the central hole 7a, which allows the base end side of the enlarged diameter portion 63b to enter. Since the part that closes the central hole 7a (the second closing part, the second member) becomes the abutment surface 63c and the base end side of the enlarged diameter portion 63b, the central hole 7a can be closed more properly.

[0089] Figure 12 This is a diagram showing a modified example of a flow path forming member 70, namely, a flow path forming member 70E.

[0090] The central hole 7a of the flow path forming member 70E allows the base end of the expanded diameter portion 63b of the base end arm 63a to enter and engage with the entered expanded diameter portion 63b. The expanded diameter portion 63b of the base end arm 63a entering the central hole 7a becomes the part that closes the central hole 7a (second closing portion, second member). When the operating line 4C is pulled to its maximum extent, the base end of the expanded diameter portion 63b of the base end arm 63a can more properly close the central hole 7a by contacting only the front end of the inner circumferential surface of the central hole 7a of the flow path forming member 70G. When the operating line 4C is advanced, the expanded diameter portion 63b separates from the flow path forming member 70.

[0091] Figure 13 This is a diagram showing a modified example of a flow path forming member 70F.

[0092] The inner circumferential surface of the central hole 7a of the flow path forming member 70F is formed into a tapered shape that extends towards the front end side A1. The enlarged diameter portion 63b of the base arm 63a can more properly close the central hole 7a by contacting only the base end of the inner circumferential surface of the central hole 7a of the flow path forming member 70F.

[0093] Figure 14This is a diagram showing a modified example of a flow path forming member 70G.

[0094] The inner circumferential surface of the central hole 7a of the flow path forming member 70G is formed into a tapered shape that extends towards the base end side A2. When the operating line 4C is pulled to the maximum extent, the base end of the expanded diameter portion 63b of the base end arm 63a can more properly close the central hole 7a by contacting only the front end of the inner circumferential surface of the central hole 7a of the flow path forming member 70G. When the operating line 4C is advanced, the expanded diameter portion 63b separates from the flow path forming member 70.

[0095] Figure 15 This diagram shows a flow path forming member 70D that also includes an O-ring 8. The O-ring 8 is provided in the recess 76 and can engage with the enlarged diameter portion 63b of the base arm 63a. By engaging with the O-ring 8, the enlarged diameter portion 63b of the base arm 63a can more properly seal the central hole 7a. Preferably, silicone oil S is applied to the portion that engages with the O-ring 8.

[0096] Figure 16 This is a diagram showing the base arm 63a that also has an O-ring 8.

[0097] The O-ring 8 is inserted into the recess 65 formed on the outer periphery of the enlarged portion 63b. The enlarged portion 63b of the base arm 63a engages with the central hole 7a through the inserted O-ring 8, thereby more properly sealing the central hole 7a. Preferably, silicone oil S is pre-applied to the portion that engages with the O-ring 8.

[0098] Figure 17 This is a perspective view of a flow path forming member 70H, which is a modified example of the flow path forming member 70.

[0099] The flow path forming member 70H also has a side hole 7c communicating with the central hole 7a in the notch portion 7b. The side holes 7c are arranged on both sides of the axis separated from the central hole 7a. When the operating line 4C is retracted, the clamp 6 is in a closed state, and the abutting surface (base end face) 63c of the expanded diameter portion 63b of the linkage mechanism 63 abuts against the front end of the flow path forming member 70H, and the front end side A1 of the central hole 7a is closed. When the front end side A1 of the central hole 7a is closed, the fluid passing through the central hole 7a does not flow from the central hole 7a toward the front end side A1, but can flow out from the side hole 7c toward the second liquid delivery hole 19. Therefore, when the front end side A1 of the central hole 7a is closed, the flow rate of the fluid passing through the second liquid delivery hole 19 can be increased.

Claims

1. An endoscope treatment instrument, wherein the endoscope treatment instrument includes: a sheath made of resin; a flow path forming member installed to a front end portion of the sheath in a manner that is rotatable about a length axis of the sheath; a forceps blade supported by the flow path forming member in a manner that is openable and closable; a link mechanism linked to the forceps blade to open and close the forceps blade; an operation wire extending along the length axis of the sheath; and a link member linking a base end arm of the link mechanism and the operation wire, the flow path forming member has: a first liquid feeding hole through which the base end arm of the link mechanism is inserted; and a notch portion that forms a second liquid feeding hole as a gap between the flow path forming member and a front end cover of the sheath, a portion of the link mechanism closes the first liquid feeding hole when the forceps blade is closed, a portion of the link member closes the first liquid feeding hole when the forceps blade is opened, the base end arm of the link mechanism abuts against the flow path forming member when the forceps blade is closed, a distal end portion of the link member abuts against the flow path forming member when the forceps blade is opened.

2. The endoscope treatment instrument according to claim 1, wherein the base end arm of the link mechanism is retracted so that the base end arm abuts against the flow path forming member and the forceps blade is closed, the link member is advanced so that the distal end portion of the link member abuts against the flow path forming member and the forceps blade is opened.

3. An endoscope treatment instrument, wherein the endoscope treatment instrument includes: a sheath; a treatment portion provided on a front end side of the sheath; a flow path forming member provided on a front end portion of the sheath, having a through hole extending along a length axis of the sheath; an operation member inserted through the through hole, linked to the treatment portion; a first closing portion that closes a base end of the through hole while the operation member is advanced; and a second closing portion that closes a front end of the through hole while the operation member is retracted, the first closing portion closes the base end of the through hole by abutting against a base end face of the flow path forming member, the second closing portion closes the front end of the through hole by abutting against a front end face of the flow path forming member.

4. The endoscope treatment instrument according to claim 3, wherein the operation member is a link mechanism linked to the treatment portion and an operation wire extending along the length axis of the sheath.

5. The endoscope treatment instrument according to claim 4, wherein the endoscope treatment instrument further includes a link member linking a base end arm of the link mechanism and the operation wire, the link member includes the first closing portion.

6. The endoscope treatment instrument according to claim 5, wherein the flow path forming member has a notch portion that forms a second liquid feeding hole as a gap between the flow path forming member and a front end cover of the sheath.

7. The endoscope treatment instrument according to claim 6, wherein a side hole that communicates with the through hole is formed in the notch portion.

8. The treatment instrument according to claim 5, wherein the link mechanism includes the second closed portion.

9. The treatment instrument according to claim 5, wherein the through-hole of the flow path forming member is inserted with the proximal arm.

10. The treatment instrument according to claim 3, wherein the flow path forming member has a notch portion that forms a second liquid feeding hole as a gap between the flow path forming member and an inner peripheral surface of the sheath.

11. The treatment instrument according to claim 3, wherein the first closed portion and the second closed portion have an outer diameter that is larger than the through-hole and smaller than an inner diameter of the sheath.

12. The treatment instrument according to claim 5, wherein the treatment portion is a forceps, when the forceps is closed, the proximal arm of the link mechanism abuts against the flow path forming member, when the forceps is opened, a distal end portion of the link mechanism abuts against the flow path forming member.

13. The treatment instrument according to claim 5, wherein the treatment portion is a forceps, by retreating the proximal arm of the link mechanism, the proximal arm abuts against the flow path forming member and the forceps is closed, by advancing the link mechanism, a distal end portion of the link mechanism abuts against the flow path forming member and the forceps is opened.

Images