Endoscope treatment tool

Abstract

The present invention provides an endoscope treatment device that improves convenience. The endoscope treatment device (6) includes: a sheath (9) having a first hole (922) at its front end; and a cutting portion (11) that extends through the first hole (922) in a retractable manner and has a second hole (120) extending between the front end and the base end. The endoscope treatment device is configured to switch between a first mode in which fluid flows through the first hole (922) via the main flow path (M1) and a second mode in which fluid flows through the second hole (120) via the main flow path (M1) depending on the movement of the cutting portion (11).

Description

Technical Field

[0001] This invention relates to an endoscopic treatment device. Background Technology

[0002] There is a known endoscopic treatment device that has an insertion part that is inserted into a body cavity via an endoscope and uses a high-frequency current to cut open the part of the biological tissue that is to be treated (hereinafter referred to as the target part) (see, for example, Patent Document 1).

[0003] In the endoscopic treatment device described in Patent Document 1, the insertion part includes a sheath having a first hole at the front end that communicates with the inside and outside, and a cutting part that protrudes from the first hole to the outside of the sheath and cuts the target area by passing a high-frequency current. The cutting part has a second hole extending from the base end to the front end. Furthermore, this endoscopic treatment device is configured to switch between a first mode that allows fluid to flow into the body cavity through the gap between the inner surface of the first hole and the outer surface of the cutting part, and a second mode that allows fluid to flow into the body cavity through the second hole.

[0004] Existing technical documents

[0005] Patent documents

[0006] Patent Document 1: Chinese Invention Patent Application Publication No. 108272503 Summary of the Invention

[0007] The problem the invention aims to solve

[0008] However, in the endoscopic treatment device described in Patent Document 1, an independent first flow path and a second flow path are provided in the insertion section. The first flow path communicates with the first hole of the first and second holes, and is a flow path that allows liquid to flow into the first hole. The second flow path communicates with the second hole of the first and second holes, and is a flow path that allows liquid to flow into the second hole. Moreover, these two flow paths are connected to independent water supply sources. That is, because the structure of the operating part that allows liquid to flow into the first and second flow paths becomes more complex, the operation becomes cumbersome.

[0009] The present invention was made in view of the above circumstances, and its object is to provide an endoscopic treatment device that can improve convenience.

[0010] Solution for solving the problem

[0011] To address the aforementioned problems and achieve the objective, the endoscopic treatment device of the present invention includes: a sheath having a first hole at its front end; and a cutting portion extending through the first hole in a retractable manner, and having a second hole extending between the front end and the base end, the endoscopic treatment device being configured to switch between a first mode in which fluid flows through a main channel communicating with the first hole and a second mode in which fluid flows through the main channel communicating with the second hole, depending on the retraction of the cutting portion.

[0012] The effects of the invention

[0013] The endoscopic treatment device of the present invention improves convenience. Attached Figure Description

[0014] Figure 1 This is a diagram showing the endoscope system of Embodiment 1.

[0015] Figure 2 This is a diagram illustrating the structure of the insertion part of the treatment device.

[0016] Figure 3 This is a diagram illustrating the structure of the insertion part of the treatment device.

[0017] Figure 4 This is a diagram illustrating the structure of the insertion part of the treatment device.

[0018] Figure 5 This is a diagram illustrating the structure of the insertion part of the treatment device.

[0019] Figure 6 It is a diagram illustrating the operation of endoscopic instruments.

[0020] Figure 7 It is a diagram illustrating the operation of endoscopic instruments.

[0021] Figure 8 It is a diagram illustrating the operation of endoscopic instruments.

[0022] Figure 9 It is a diagram illustrating the operation of endoscopic instruments.

[0023] Figure 10 This is a diagram illustrating the structure of the treatment device insertion section in Embodiment 2.

[0024] Figure 11 This is a diagram illustrating the structure of the treatment device insertion section in Embodiment 2.

[0025] Figure 12 It is a diagram illustrating the operation of endoscopic instruments.

[0026] Figure 13 It is a diagram illustrating the operation of endoscopic instruments.

[0027] Figure 14 This is a diagram illustrating a variation of embodiment 2.

[0028] Figure 15 This is a diagram illustrating the structure of the treatment device insertion part in Embodiment 3.

[0029] Figure 16 This is a diagram illustrating the structure of the treatment device insertion part in Embodiment 3.

[0030] Figure 17 It is a diagram illustrating the operation of endoscopic instruments.

[0031] Figure 18 It is a diagram illustrating the operation of endoscopic instruments.

[0032] Figure 19 This is a diagram illustrating the structure of the treatment device insertion part in Embodiment 4.

[0033] Figure 20 This is a diagram illustrating the structure of the treatment device insertion part in Embodiment 4.

[0034] Figure 21 This is a diagram illustrating the structure of the treatment device insertion part in Embodiment 4.

[0035] Figure 22 This is a diagram illustrating the structure of the treatment device insertion part in Embodiment 4.

[0036] Figure 23 This is a diagram illustrating the structure of the treatment device insertion part in Embodiment 4.

[0037] Figure 24 It is a diagram illustrating the operation of endoscopic instruments.

[0038] Figure 25 It is a diagram illustrating the operation of endoscopic instruments.

[0039] Figure 26 This is a diagram illustrating the structure of the treatment device insertion section in Embodiment 5.

[0040] Figure 27 This is a diagram illustrating the structure of the treatment device insertion section in Embodiment 5.

[0041] Figure 28 This is a diagram illustrating the structure of the treatment device insertion section in Embodiment 5.

[0042] Figure 29 This is a diagram illustrating the structure of the treatment device insertion section in Embodiment 5.

[0043] Figure 30This is a diagram illustrating the structure of the treatment device insertion section in Embodiment 5.

[0044] Figure 31 This is a diagram illustrating the structure of the treatment device insertion section in Embodiment 5.

[0045] Figure 32 It is a diagram illustrating the operation of endoscopic instruments.

[0046] Figure 33 This is a diagram illustrating the movement of endoscopic instruments.

[0047] Figure 34 This is a diagram illustrating the structure of the treatment device insertion section in Embodiment 6.

[0048] Figure 35 This is a diagram illustrating the structure of the treatment device insertion section in Embodiment 6.

[0049] Figure 36 It is a diagram illustrating the operation of endoscopic instruments.

[0050] Figure 37 It is a diagram illustrating the operation of endoscopic instruments.

[0051] Figure 38 This is a diagram illustrating the structure of the treatment device insertion part in Embodiment 7.

[0052] Figure 39 This is a diagram illustrating the structure of the treatment device insertion part in Embodiment 7.

[0053] Figure 40 It is a diagram illustrating the operation of endoscopic instruments.

[0054] Figure 41 It is a diagram illustrating the operation of endoscopic instruments.

[0055] Figure 42 This is a diagram illustrating the structure of the treatment device insertion section in Embodiment 8.

[0056] Figure 43 This is a diagram illustrating the structure of the treatment device insertion section in Embodiment 8.

[0057] Figure 44 It is a diagram illustrating the operation of endoscopic instruments.

[0058] Figure 45 It is a diagram illustrating the operation of endoscopic instruments.

[0059] Figure 46A This is a diagram showing an example of the shape of the protrusion.

[0060] Figure 46BThis is a diagram showing an example of the shape of the protrusion.

[0061] Explanation of reference numerals in the attached figures

[0062] 1. Endoscopic system; 2. Endoscope; 3. Display device; 4. Light source device; 5. Control device; 6. Endoscopic treatment device; 7. 7A-7G, Treatment device insertion part; 8. Treatment device operating part; 9. 9A-9G, Sheath; 10. 10B, Cable; 11. 11A-11G, Cutting part; 12. 12A-12C, 12E, Knife; 13. 13A, 13C-13G, Connecting member; 14. Force application member; 15. Flow path switching member; 21. Endoscope insertion part; 22. Endoscope operating part; 23. Universal cable; 24. Connector part; 81 82. Main body of the operating part; 91. Sliding part; 92. Sheath body; 92. Front end component (92A-92G); 100. Power supply; 101. Through hole; 120. Second hole (120A-120G); 121. Blade body; 122. Protrusion (122A); 123. Blade hole (123A-123C, 123E); 130G1. First fitting hole; 130G2. Second fitting hole; 130G3. Storage hole; 130G4. Connecting hole; 131. Cylindrical part; 132. Rotation limiting part; 133. Fitting hole; 134. Connecting hole; 135. 137. 130F1, First connecting hole; 136, 138, 130F2, Second connecting hole; 139, Third connecting hole; 151, Support part; 152, Sealing part; 200, Water supply source; 211, Front end unit; 212, Bending part; 213, Flexible tube; 221, Operating component; 222, Bending knob; 223, Insertion port; 811, Ring; 812, Water inlet; 821, Ring; 822, Plug; 920, Bottom part; 921, Inner circumferential surface; 922, 922A~922C, 922G, First hole; 922G1, Hole body; 922G2, Auxiliary Auxiliary hole; 1211, abutment part; 1231, inflow hole; 1232, outflow hole; 1233, 1235, 1237, main body of the second hole; 1234, 1236, 1238, connecting hole; 9211, first wall part; 9212, second wall part; 9213, groove part; 9214, 9214F, third wall part; 9215, support part; 9216, 9216F, annular part; 9221, fourth wall part; 9222, fifth wall part; CO, power cord; M1, main flow path; SL, physiological saline; T1, target area; T2, marking mark; TU, tube. Detailed Implementation

[0063] Hereinafter, embodiments for carrying out the present invention will be described with reference to the accompanying drawings. However, the present invention is not limited to the embodiments described below. Furthermore, the same reference numerals are used to denote the same parts in the accompanying drawings.

[0064] (Implementation Method 1)

[0065] [Structure of the endoscopic system]

[0066] Figure 1 This is a diagram showing the endoscope system 1 according to embodiment 1.

[0067] Endoscopic system 1, used in the medical field, is a system that treats a part of biological tissue within a body cavity (hereinafter referred to as the target site) by applying high-frequency energy while simultaneously observing the body cavity. Furthermore, the treatments that can be performed by the endoscopic system 1 of this embodiment include coagulation (sealing) of the target site or incision of the target site. Figure 1 As shown, the endoscope system 1 includes an endoscope 2, a display device 3, a light source device 4, a control device 5, and an endoscope handling instrument 6.

[0068] A portion of endoscope 2 is inserted into the body cavity to capture an image of the subject reflected from within the cavity, and outputs the image signal generated by this capture. For example... Figure 1 As shown, the endoscope 2 includes an endoscope insertion part 21, an endoscope operation part 22, a universal cable 23, and a connector part 24.

[0069] At least a portion of the endoscope insertion section 21 is flexible and is the portion that is inserted into the body cavity. For example... Figure 1 As shown, the endoscope insertion part 21 includes a front end unit 211, a bending part 212, and a flexible tube 213.

[0070] The front end unit 211 is located at the front end of the endoscope insertion section 21. Although specific illustrations are omitted, the front end unit 211 includes an illumination optical system, a camera optical system, and a camera unit.

[0071] The illumination optical system is opposite to one end of the light guide (not shown) that is wound inside the endoscope insertion part 21, and the light transmitted by the light guide is irradiated into the body cavity from the front end of the endoscope insertion part 21.

[0072] The camera optical system acquires light (the image of the subject) that is incident on the body cavity from the illumination optical system and reflected from the body cavity, and images the light onto the imaging surface of the imaging element that constitutes the camera unit.

[0073] The camera unit is configured to include camera elements such as CCD (Charge Coupled Device) or CMOS (Complementary Metal Oxide Semiconductor), capture images of the subject imaged by the camera optical system, and output the image signal generated by the capture.

[0074] The bending portion 212 is connected to the base end side (endoscope operation section 22 side) of the front end unit 211. Although specific illustrations are omitted, the bending portion 212 has a structure formed by connecting multiple bending blocks, and is capable of bending.

[0075] The flexible tube 213 is connected to the base end side of the bend 212 (endoscope operation part 22 side), and is longitudinally elongated and flexible.

[0076] The endoscope operating section 22 is connected to the base portion of the endoscope insertion section 21. Furthermore, the endoscope operating section 22 receives various operations performed on the endoscope 2. For example... Figure 1 As shown, the endoscope operation section 22 is provided with multiple operation components 221, a bending knob 222 and an insertion port 223.

[0077] Multiple operating components 221 are composed of buttons and the like that accept various operations.

[0078] The bending knob 222 is configured to rotate according to user operation. Furthermore, by rotating the bending knob 222, a bending mechanism (not shown) such as a metal or resin wire disposed in the endoscope insertion part 21 is activated. As a result, the bending part 212 bends.

[0079] The insertion port 223 is connected to a conduit (not shown) extending from the front end of the endoscope insertion part 21 to the base side (endoscope operation part 22 side), and is an insertion port through which the endoscope treatment instrument 6, treatment instrument insertion part 7, etc., penetrates from the outside of the conduit.

[0080] The general cable 23 extends from the endoscope operation section 22 in a direction different from the extension direction of the endoscope insertion section 21, and is a cable equipped with the aforementioned light guide and signal line for transmitting the aforementioned image signal.

[0081] The connector 24 is located at the end of the universal cable 23 and is connected to the light source device 4 and the control device 5 in a detachable manner.

[0082] The display device 3 is an LCD (Liquid Crystal Display) or EL (Electroluminescence) display, etc., which displays a predetermined image under the control of the control device 5.

[0083] The light source device 4 emits illumination light. Moreover, the illumination light emitted from the light source device 4 passes through the connector part 24, the universal cable 23, the endoscope operation part 22, and the light guide and illumination optical system that are wound around the endoscope insertion part 21, and then shines into the body cavity from the front end of the endoscope insertion part 21.

[0084] The control device 5 is configured to include a CPU (Central Processing Unit) or FPGA (Field-Programmable Gate Array), etc., to comprehensively control the operation of the display device 3 and the light source device 4.

[0085] For example, the control device 5 performs predetermined processing on the image signal input from the aforementioned camera unit via the aforementioned signal line to generate an endoscopic image. Furthermore, the control device 5 controls the operation of the display device 3 so that the endoscopic image, etc., is displayed on the display device 3.

[0086] In addition, in this embodiment 1, the light source device 4 and the control device 5 are constructed independently, but they can also be integrated into a single housing.

[0087] [Structure of endoscopic treatment instruments]

[0088] Endoscopic instruments, such as those used in ESD (Endoscopic Submucosal Dissection), are examples of instruments used in this procedure. Figure 1 As shown, the endoscopic treatment device 6 includes a treatment device insertion part 7 and a treatment device operation part 8.

[0089] like Figure 1 As shown, the treatment device insertion part 7 is the part that protrudes from the front end of the endoscope insertion part 21 through the insertion port 223 and is inserted into the body cavity, which corresponds to the insertion part of the present invention.

[0090] Furthermore, the detailed structure of the treatment device insertion part 7 will be described later in the section on "Structure of the Treatment Device Insertion Part". Additionally, the term "front end" as used below refers to one end of the treatment device insertion part 7 in the insertion direction, and the term "base end" as used below refers to the other end of the treatment device insertion part 7 on the side opposite to the insertion direction.

[0091] The instrument operation unit 8 is connected to the base portion of the instrument insertion portion 7 (the base portion of the instrument insertion portion 7 in the insertion direction). Furthermore, the instrument operation unit 8 receives operations performed on the endoscopic instrument 6. For example... Figure 1 As shown, the operating part 8 of the treatment device includes an operating part body 81 and a sliding member 82.

[0092] The main body 81 of the operating part has an elongated shape and fixes the base portion of the sheath 9 (described later). The sheath 9 constitutes the insertion part 7 of the treatment device. Furthermore, as... Figure 1 As shown, a ring 811 for a surgeon or other operator to hook their fingers is provided at the base of the main body 81 of the operating unit. Furthermore, a water inlet 812 for connection to a pipe TU is provided on the main body 81 of the operating unit. Physiological saline solution is supplied from a water source 200, such as a pump, to the water inlet 812 via the pipe TU.

[0093] Here, saline solution is equivalent to the fluid of the present invention. Furthermore, the fluid used in the present invention is not limited to saline solution; other liquids, gases such as air, may also be used.

[0094] The sliding member 82 is mounted on the operating part body 81 in a manner that allows it to move along the length of the operating part body 81 according to operations performed by an operator such as a surgeon. For example... Figure 1 As shown, the slider 82 is provided with a pair of rings 821 for operators such as surgeons to hook their fingers. Furthermore, the slider 82 is provided with a plug 822 for connecting a power cord CO. The plug 822 is electrically connected to the power supply 100 via the power cord CO.

[0095] [Structure of the insertion part of the treatment device]

[0096] Figures 2-5 This diagram illustrates the structure of the treatment device insertion section 7. Specifically, Figure 2 This is a cross-sectional view obtained by cutting the front end portion of the treatment device insertion part 7 with a plane containing the central axis of the treatment device insertion part 7. Figure 3 It is the device insertion part 7 Figure 2 A cross-sectional view showing the location of line III-III. Figure 4 It is the device insertion part 7 Figure 2 A cross-sectional view showing the location of line IV-IV. Figure 5 It is the device insertion part 7 Figure 2 A cross-sectional view showing the location of the VV line.

[0097] like Figures 1-5 As shown, the insertion part 7 of the treatment device includes a sheath 9 and a wire 10. Figure 2 ) and the cut portion 11 ( Figure 2 ).

[0098] The sheath 9 is part of the outer surface of the insertion part 7 of the treatment device. For example... Figure 1 and Figure 2 As shown, the sheath 9 includes a sheath body 91 and a front end component 92.

[0099] The sheath body 91 is made of resin material or the like and is a cylindrical component with insulation and flexibility. Furthermore, the base portion of the sheath body 91 is fixed to the operating part body 81. Additionally, the sheath body 91 is connected to the water inlet 812.

[0100] The front end member 92 has a bottomed cylindrical shape, with the bottom portion 920 facing the front end side. Figure 2 The front end of the sheath body 91 is closed in a posture (left side). This front end member 92 can be made of an electrically insulating component made of ceramic, resin, rubber, or similar materials, or it can be made of a component with an insulating coating applied to the surface of a metal or similar material. Furthermore, the front end member 92 can be a single component or a combination of multiple components.

[0101] like Figure 2 and Figure 5 As shown, a first wall portion 9211 and a second wall portion 9212 are provided on the inner peripheral surface 921 of the front end member 92.

[0102] like Figure 2 and Figure 5 As shown, the first wall portion 9211 is a wall that protrudes from the inner peripheral surface 921 toward the central axis of the front end member 92 and extends along the central axis.

[0103] like Figure 2 and Figure 5 As shown, the second wall portion 9212 protrudes from the inner peripheral surface 921 toward the central axis of the front end member 92 and extends along the central axis to the wall of the bottom portion 920 of the front end member 92. Furthermore, as... Figure 2 and Figure 5 As shown, a groove 9213 extending along the entire length of the second wall portion 9212 is provided in the second wall portion 9212.

[0104] The sheath body 91 and the front end component 92 described above serve as the main path M1 of this invention. Figure 2 The main channel M1 supplies saline solution from water source 200 via pipe TU and water inlet 812.

[0105] In addition, such as Figures 2-4 As shown, a first hole 922 is provided in the bottom portion 920 of the front end member 92, which connects the bottom portion 920 and the front end of the front end member 92. The first hole 922 opens in both the bottom portion 920 and the front end of the front end member 92. The bottom portion 920 corresponds to the front end of the sheath of the present invention.

[0106] The first hole 922 has a circular cross-section and extends in a straight line along the central axis of the front end member 92. Here, as... Figure 2As shown, the inner diameter of the first hole 922 is set to be smaller than the inner diameter of the inner circumferential surface 921. Additionally, the first hole 922 may preferably be located on the central axis of the front end member 92.

[0107] The wire 10 is made of a conductive material such as metal and runs through the sheath 9. Furthermore, the base of the wire 10 is fixed to the slider 82. That is, the wire 10 moves forward and backward within the sheath 9 according to the operation performed by an operator such as a surgeon on the slider 82. In addition, the wire 10 is electrically connected to the plug 822.

[0108] The cutting section 11 is made of a conductive material such as metal and is fixed to the front end of the wire 10. Furthermore, the cutting section 11 passes through the first hole 922. That is, the cutting section 11 and the wire 10 move forward and backward within the sheath 9 (first hole 922) according to the operation of the slider 82 by an operator such as a surgeon. Furthermore, the front end of the cutting section 11 protrudes from the first hole 922 to the front end member 92. Moreover, a high-frequency current is supplied to the cutting section 11 from the power supply 100 via the power cord CO, the plug 822, and the wire 10 to cut the target area within the body cavity. Figures 2-5 As shown, the cutting portion 11 is equipped with a knife 12.

[0109] The blade 12 protrudes from the first hole 922 to the outside of the front end component 92, and is the part that cuts open the object part, such as... Figure 2 As shown, it is composed of a so-called hook-shaped blade. The blade 12 includes a blade body 121 and a protrusion 122.

[0110] The blade body 121 is located on the central axis of the front end member 92 and is composed of a cylindrical member extending in a straight line along this central axis. Here, as... Figure 2 and Figure 4 As shown, the outer diameter of the cutter body 121 is set to be smaller than the inner diameter of the first hole 922.

[0111] The protrusion 122 is located at the front end of the blade body 121, at approximately 90° to the blade body 121. Figure 2 The part that bends upwards from the center.

[0112] like Figure 2 As shown, the blade 12 described above has a blade hole 123 extending from the base end to the front end. The blade hole 123 is composed of an inlet hole 1231 and an outlet hole 1232.

[0113] The inflow hole 1231 is from the base end of the cutter body 121, in Figure 2 and Figure 5 The hole in the middle is an upper side hole extending toward the central axis of the blade body 121.

[0114] The outflow hole 1232 is located on the central axis of the blade body 121 and is a hole that extends in a straight line along the central axis. Moreover, the outflow hole 1232 communicates with the outside of the blade 12 on the front end side through the protrusion 122 and communicates with the inflow hole 1231 on the base end side.

[0115] Moreover, such as Figures 2-5 As shown, a connecting member 13 is provided on the base end side of the blade 12.

[0116] The connecting member 13 is a component that connects the knife 12 and the wire 10. The connecting member 13 includes a cylindrical portion 131 and a rotation limiting portion 132.

[0117] The cylindrical portion 131 is composed of a cylindrical member extending in a straight line along the central axis of the front end member 92. Here, as... Figure 5 As shown, the outer diameter of the cylindrical portion 131 is set to be slightly smaller than the separation dimension between the first wall portion 9211 and the second wall portion 9212 and larger than the inner diameter of the first hole 922. Additionally, the cylindrical portion 131 may preferably be located on the central axis of the front end member 92.

[0118] Moreover, such as Figure 2 As shown, a fitting hole 133 is provided in the cylindrical portion 131, and the fitting hole 133 extends from the end face of the front end to the base end. Figure 2 (Extending from the right side) the knife supply body 121 is fitted in. Furthermore, as... Figure 2 and Figure 5 As shown, a connecting hole 134 is provided in the cylindrical part 131. The connecting hole 134 extends from the outer peripheral surface of the cylindrical part 131 toward the central axis of the cylindrical part 131 and communicates with the inflow hole 1231.

[0119] The cutting hole 123, fitting hole 133, and connecting hole 134 described above open on the outer peripheral surface of the base end side of the cutting portion 11, which corresponds to the second hole 120 of the present invention. Figure 2 ).

[0120] like Figure 2 and Figure 5 As shown, the rotation limiting part 132 is a protrusion extending from the outer peripheral surface of the cylindrical part 131, which is inserted into the groove 9213. Furthermore, when the cutting part 11 moves in and out of the sheath 9 according to the operation of the sliding member 82 by an operator such as a surgeon, the rotation limiting part 132 is always inserted into the groove 9213. Moreover, the rotation limiting part 132 restricts the rotation of the blade 12 and the wire 10 around its central axis.

[0121] The second wall portion 9212 (groove portion 9213) and the rotation restriction portion 132 described above correspond to the rotation restriction structure of the present invention.

[0122] [Action of endoscopic handling instruments]

[0123] Next, the operation of the endoscopic treatment device 6 described above will be explained. For ease of explanation, the ESD procedure will be used as an example below.

[0124] Figures 6-9 This diagram illustrates the operation of the endoscopic handling instrument 6. Specifically, Figure 6 This is a diagram illustrating the ESD marking process. Figure 7 This is a diagram illustrating the local injection process for ESD. Figure 8 and Figure 9 Is with Figure 2 The corresponding sectional view.

[0125] First, the surgeon or other operator inserts the endoscope insertion part 21 into the body cavity, moving the tip of the endoscope insertion part 21 to the target site T1. Figure 6 )nearby.

[0126] Next, the surgeon or other operator performs a first operation, retracting the slider 82 towards the hand (ring 811 side). As a result, the protrusion 122 abuts against the front end member 92, so that only the protrusion 122 protrudes from the first hole 922 outside the front end member 92. Then, the surgeon or other operator inserts the instrument insertion part 7 from the insertion port 223 into the tubing within the endoscope insertion part 21, causing it to protrude from the front end of the endoscope insertion part 21.

[0127] Next, the surgical operator and other operators perform the marking process as shown below.

[0128] That is, while maintaining the state in which the protrusion 122 protrudes from the first hole 922 to the front end member 92 through the first operation performed on the slider 82, the operator operates the foot switch or other operating parts (not shown) to supply a high-frequency current from the power supply 100 to the blade 12. Then, as... Figure 6 As shown in (a), the surgeon or other operator presses the protrusion 122 against the biological tissue surrounding the target site T1. This cauterizes the biological tissue in contact with the protrusion 122. That is, as... Figure 6 (a) and Figure 6 As shown in (b), a marking mark T2 is formed at the burned area.

[0129] Then, the surgical operator and other operators repeat the above procedures multiple times, such as... Figure 6 As shown in (c), a number of marking marks T2 are formed to a degree that allows for the determination of the outer edge of the object region T1. Afterwards, the surgeon or other operator ends the process of supplying a high-frequency current from the power source 100 to the blade 12.

[0130] Next, the surgical operator and other operators perform the local injection procedure as shown below.

[0131] That is, the surgeon or other operator performs a second operation to advance the slider 82. Thus, as... Figure 8 As shown, the blade 12 protrudes to its maximum length from the front end of the sheath 9 (front end member 92). In this state, the connecting member 13 abuts against the bottom portion 920 (the periphery of the opening) of the front end member 92. Thus, as Figure 8 As indicated by the "×" mark, the opening on the base side of the first hole 922 is closed by the connecting member 13. That is, the connecting member 13 corresponds to the third closing member of the present invention capable of closing the opening on the base side of the first hole 922. On the other hand, the connecting hole 134 is positioned offset from the position opposite to the first wall portion 9211. That is, the position of the connecting hole 134 is offset from the position of the first wall portion 9211 in the longitudinal axis direction of the sheath 9. Thus, the connecting hole 134 communicates with the main flow path M1.

[0132] Furthermore, while maintaining the state where the blade 12 protrudes to its maximum protrusion length from the front end of the sheath 9 due to the second operation performed on the slider 82, the operator operates the foot switch or other operating parts (not shown) to supply saline solution from the water supply source 200. Thus, the saline solution supplied from the water supply source 200... Figure 8 As indicated by the middle arrow, the saline solution SL, after flowing from the main flow path M1 through the connecting hole 134, inlet hole 1231, and outlet hole 1232, is ejected from the front end of the blade 12. This ejected saline solution SL is injected below the target area T1 under its water pressure. Figure 7 Therefore, the target site T1 is suspended from the underlying submucosa and other tissues.

[0133] Next, the surgeon and other operators will perform the incision procedure as shown below.

[0134] That is, while maintaining the second operation performed on the slider 82, which causes the blade 12 to protrude to its maximum protrusion length from the front end of the sheath 9 (front end member 92), the operator operates a foot switch or other operating unit (not shown) to supply a high-frequency current from the power supply 100 to the blade 12. Then, while confirming the marking mark T2, the operator moves the protrusion 122 around the target site T1 in a state of penetrating biological tissue, cutting the entire circumference of the target site T1. Afterwards, the target site T1 is removed by peeling off the submucosa or other parts of the mucosa containing the cut target site T1.

[0135] The ESD procedure is completed through the above steps. Additionally, during the cleaning of the surgical site, the surgeon or other operators perform the following operations within each step of the ESD procedure.

[0136] The surgeon or other operator sets the device to a state where only the protrusion 122 protrudes from the first hole 922 to the outside of the front end member 92 through a first operation on the slider 82; that is, the protrusion 122 protrudes from the first hole 921 while the blade body 111 is located within the first hole 922. In this state, as... Figure 5 and Figure 9 As shown, the connecting hole 134 is positioned opposite to the first wall portion 9211. That is, the position of the connecting hole 134 coincides with the position of the first wall portion 9211 along the longitudinal axis of the sheath 9. In this state, the first wall portion 9211 abuts against the outer peripheral surface (opening periphery) of the cylindrical portion 131, thereby... Figure 9 The "×" mark indicates that the connecting hole 134 (the opening on the base end side of the second hole 120) is closed by the first wall portion 9211. That is, the first wall portion 9211 corresponds to the first sealing member of the present invention, which is disposed within the sheath 9 and is capable of closing the opening on the base end side of the cut portion 11. On the other hand, the first hole 922 is released from the closure by the connecting member 13 and communicates with the main flow path M1.

[0137] Next, the surgical operator or other personnel operate the foot switch and other control mechanisms (illustrations omitted) to supply saline solution from the water supply source 200. Thus, the saline solution supplied from the water supply source 200... Figure 9 As indicated by the middle arrow, after flowing from the main flow path M1 through the first hole 922, the saline solution is ejected from the front end of the sheath 9 (front end member 92) and supplied to the surgical site within the body cavity. Here, the opening area between the inner circumferential surface of the first hole 922 and the outer circumferential surface of the blade body 121 is larger than the opening area of ​​the outflow hole 1232. Therefore, the surgical site is cleaned using saline solution ejected from the front end of the sheath 9 (front end member 92).

[0138] As described above, in this embodiment 1, the main flow path M1 can communicate with the first hole 922 and the second hole 120 respectively at the front end side (front end member 92) of the sheath 9. Furthermore, the configuration allows switching between a first mode and a second mode by moving the incision portion 11 forward and backward according to the operation of the slider 82 by an operator such as a surgeon. The first mode is set by moving the incision portion 11 towards the base end side of the sheath 9, and is a mode in which saline solution flows into the body cavity through communication between the main flow path M1 and the first hole 922. More specifically, the first mode is a state where the main flow path M1 is connected to the first hole 922 and the opening at the base end side of the incision portion 11 is closed by the first wall portion 9211. The second mode is set by moving the incision portion 11 towards the front end side of the sheath 9, and is a mode in which saline solution flows into the body cavity through communication between the main flow path M1 and the second hole 120. More specifically, the second mode is a state in which the main road M1 is connected to the second hole 120 and the opening on the base side of the first hole 922 is closed by the connecting member 13.

[0139] According to the above description of Embodiment 1, the following effects are achieved.

[0140] In the endoscopic treatment device 6 of this embodiment 1, the main flow path M1 can communicate with the first hole 922 and the second hole 120 respectively at the front end side (front end member 92) of the sheath 9. In other words, the flow path for supplying saline in the treatment device insertion part 7 consists of one flow path (main flow path M1) from the base end side to the front end side of the treatment device insertion part 7, and branches into two (the first hole 922 and the second hole 120) at the front end side (front end member 92) of the sheath 9.

[0141] Furthermore, in the endoscopic treatment device 6 of this embodiment 1, the surgeon or other operator can switch between the first mode and the second mode by performing a first operation and a second operation on the slider 82, which are simple operations. Therefore, in ESD, the local injection process and other processes can be performed using a single endoscopic treatment device 6 without changing the treatment device.

[0142] Therefore, the endoscopic treatment device 6 of this embodiment 1 can improve convenience.

[0143] Furthermore, in the endoscopic treatment device 6 of this embodiment 1, a rotation limiting structure (second wall portion 9212 (groove portion 9213) and rotation limiting portion 132) is provided between the cutting portion 11 and the sheath 9 to limit the rotation of the cutting portion 11 around its central axis. Therefore, as the blade 12, a so-called hook-shaped blade that needs to avoid this rotation around its central axis can be used.

[0144] (Implementation Method 2)

[0145] Next, this second embodiment will be described.

[0146] In the following description, the same reference numerals are used for structures that are the same as those in Embodiment 1 described above, and detailed descriptions of them are omitted or simplified.

[0147] In the endoscopic treatment device 6 of this embodiment 2, the structure of the front end portion of the treatment device insertion part 7 is different from that of the endoscopic treatment device 6 described in embodiment 1 above. Hereinafter, for ease of explanation, the treatment device insertion part of this embodiment 2 will be referred to as the treatment device insertion part 7A.

[0148] Figure 10 and Figure 11 This diagram illustrates the structure of the treatment device insertion section 7A in Embodiment 2. Specifically, Figure 10 Is with Figure 2The corresponding sectional view. Figure 11 It is the device insertion part 7A Figure 10 A cross-sectional view showing the position of the XI-XI line.

[0149] In the treatment device insertion section 7A, such as Figure 10 and Figure 11 As shown, the structures of the sheath 9 and the cutting portion 11 differ from those of the treatment device insertion portion 7 described in Embodiment 1 above. Hereinafter, for ease of explanation, the sheath and the cutting portion of this Embodiment 2 will be referred to as sheath 9A and cutting portion 11A, respectively.

[0150] In the 9A sheath, such as Figure 10 and Figure 11 As shown, the shape of the front end member 92 differs from that of the sheath 9 described in Embodiment 1 above. Hereinafter, for ease of explanation, the front end member of this Embodiment 2 will be referred to as front end member 92A.

[0151] Furthermore, the front-end component 92A can be composed of a single component or by combining multiple components.

[0152] In the front-end component 92A, such as Figure 10 and Figure 11 As shown, in contrast to the front end member 92 described in Embodiment 1 above, a third wall portion 9214 is provided instead of the first wall portion 9211 and the second wall portion 9212.

[0153] like Figure 10 and Figure 11 As shown, the third wall portion 9214 includes an annular portion 9216 and a pair of support portions 9215.

[0154] like Figure 10 and Figure 11 As shown, a pair of support portions 9215 protrude in a straight line from the inner peripheral surface 921 toward the central axis of the front end member 92A.

[0155] like Figure 11 As shown, the annular portion 9216 has an annular shape that is coaxial with the central axis of the front end member 92A, and its outer peripheral surface is connected to the protruding ends of a pair of support portions 9215.

[0156] Furthermore, in the front-end component 92A, such as Figure 10 As shown, the shape of the first hole 922 differs from that of the front end member 92 described in Embodiment 1 above. Hereinafter, for ease of explanation, the first hole of this Embodiment 2 will be referred to as the first hole 922A.

[0157] The first hole 922A has a circular cross-section and extends in a straight line along the central axis of the front end member 92A. Furthermore, as... Figure 10 As shown, the front end portion of the first hole 922A expands in diameter as it moves towards the front end. Here, the inner diameter of the base end portion of the first hole 922A is set to be smaller than the inner diameter of the inner circumferential surface 921. Furthermore, the inner diameter of the first hole 922A is set to be larger than the outer diameter of the blade body 121. Additionally, the first hole 922A may preferably be located on the central axis of the front end member 92A.

[0158] In the cut section 11A, as Figure 10 and Figure 11 As shown, the shapes of the blade 12 and the connecting member 13 are different from those of the cutting portion 11 described in Embodiment 1 above. Hereinafter, for ease of explanation, the blade and the connecting member of this Embodiment 2 will be referred to as blade 12A and connecting member 13A, respectively.

[0159] In the knife 12A, such as Figure 10 As shown, the shape of the protrusion 122 differs from that of the blade 12 described in Embodiment 1 above. Hereinafter, for ease of explanation, the protrusion of this Embodiment 2 will be referred to as protrusion 122A.

[0160] The protrusion 122A has a circular plate shape coaxial with the central axis of the blade body 121. Here, as... Figure 10 As shown, the outer diameter of the protrusion 122A is set to be smaller than the inner diameter of the front end portion of the first hole 922A.

[0161] Furthermore, in the knife 12A, such as Figure 10 As shown, the shape of the cutting hole 123 differs from that of the cutting knife 12 described in Embodiment 1 above. Hereinafter, for ease of explanation, the cutting hole of this Embodiment 2 will be referred to as cutting hole 123A.

[0162] like Figure 10 As shown, the cutting hole 123A is located on the central axis of the cutting body 121 and extends in a straight line from the base end of the cutting body 121 to the end face of the front end of the protrusion 122A along the central axis.

[0163] The connecting member 13A is composed of a cylindrical member extending linearly along the central axis of the front end member 92A. Here, the outer diameter of the connecting member 13A is set to be slightly smaller than the inner diameter of the annular portion 9216. Figure 11 And it is larger than the inner diameter of the portion on the base side of the first hole 922A. Furthermore, as... Figure 10 and Figure 11As shown, the connecting member 13A is provided with a first communicating hole 135 and a second communicating hole 136. Alternatively, the connecting member 13A may preferably be located on the central axis of the front end member 92A.

[0164] like Figure 10 As shown, the first connecting hole 135 extends linearly along the central axis from the front end of the connecting member 13A toward the base end. Furthermore, when the connecting member 13A is connected to the blade body 121, the first connecting hole 135 communicates with the blade hole 123A. Alternatively, the first connecting hole 135 may preferably be located on the central axis of the connecting member 13A.

[0165] The second connecting hole 136 is a cross-shaped hole that communicates with the first connecting hole 135 and with an opening on the outer peripheral surface of the connecting member 13A.

[0166] The cutting hole 123A, the first connecting hole 135, and the second connecting hole 136 described above open on the outer peripheral surface of the base end side of the cut portion 11A, which corresponds to the second hole 120A of the present invention. Figure 10 ).

[0167] Next, the operation of the endoscopic treatment device 6 in Embodiment 2 will be described. For ease of explanation, the ESD process will be used as an example, similar to Embodiment 1 described above.

[0168] Figure 12 and Figure 13 This diagram illustrates the operation of the endoscopic handling instrument 6. Specifically, Figure 12 and Figure 13 Is with Figure 10 The corresponding sectional view.

[0169] In this embodiment 2, the operator, such as a surgeon, performs the local injection procedure as shown below.

[0170] That is, the surgeon or other operator sets the blade 12A to its maximum protruding length from the sheath 9A (front end member 92A) through a second operation on the slider 82. In this state, the connecting member 13A abuts against the bottom portion 920 (opening periphery) of the front end member 92A. Thus, as... Figure 12 As indicated by the "×" mark, the opening on the base side of the first hole 922A is closed by the connecting member 13A. That is, the connecting member 13A corresponds to the third closing member of the present invention capable of closing the opening on the base side of the first hole 922A. Furthermore, the connecting member 13A is positioned further forward than the annular portion 9216. That is, the second connecting hole 136 is not closed by the inner circumferential surface of the annular portion 9216 and is connected to the main flow path M1.

[0171] Next, while maintaining the state where the blade 12A protrudes to its maximum length from the front end of the sheath 9A due to the second operation performed on the slider 82, the operator operates the foot switch or other operating parts (not shown) to supply saline solution from the water supply source 200. Thus, the saline solution supplied from the water supply source 200... Figure 12 As indicated by the middle arrow, the saline solution flows from the main flow path M1 through the first connecting hole 135, the second connecting hole 136, and the knife hole 123A, and then exits from the tip of the knife 12A. This exiting saline solution is injected below the target site T1. Thus, the target site T1 is suspended from the underlying submucosa and other tissues.

[0172] Furthermore, since the marking and cutting processes are the same as in Embodiment 1 described above, their descriptions are omitted.

[0173] In addition, during the various procedures of ESD, when cleaning the surgical site, the surgeon and other operators perform the following operations.

[0174] The surgeon or other operator sets the slider 82 to a state where only the protrusion 122A protrudes from the first hole 922A beyond the front end member 92A through a first operation. In this state, as... Figure 11 and Figure 13 As shown, the connecting member 13A is inserted into the annular portion 9216, and the second communicating hole 136 is positioned opposite the inner circumferential surface of the annular portion 9216. That is, the inner circumferential surface of the annular portion 9216 abuts against the outer circumferential surface (the periphery of the opening) of the connecting member 13A. Thus, as... Figure 13 The "×" mark indicates that the second connecting hole 136 (the opening on the base end side of the second hole 120A) is closed by the inner circumferential surface of the annular portion 9216. That is, the annular portion 9216 corresponds to the first sealing member of the present invention, which is disposed within the sheath 9A and is capable of closing the opening on the base end side of the cut portion 11A. On the other hand, the first hole 922A is released from the closure by the connecting member 13A and communicates with the main flow path M1.

[0175] Next, while maintaining the state where the protrusion 122A protrudes from the first hole 922A beyond the front end member 92A through the first operation performed on the slider 82, the operator operates the foot switch or other operating parts (not shown) to supply saline solution from the water supply source 200. Thus, the saline solution supplied from the water supply source 200... Figure 13As indicated by the middle arrow, after flowing from the main flow path M1 through the first hole 922A, the saline solution is ejected from the front end of the sheath 9A and supplied to the surgical site within the body cavity. Here, the opening area between the inner circumferential surface of the first hole 922A and the outer circumferential surface of the blade body 121 is larger than the opening area of ​​the blade hole 123A. Therefore, the surgical site is cleaned using saline solution ejected from the front end of the sheath 9A (front end member 92A).

[0176] As described above, in this second embodiment, similarly to the first embodiment, the main flow path M1 can communicate with the first hole 922A and the second hole 120A at the front end side (front end member 92A) of the sheath 9A. Furthermore, the configuration allows switching between a first mode and a second mode by moving the incision portion 11A forward and backward according to the operation of the slider 82 by an operator such as a surgeon. The first mode is set by moving the incision portion 11A towards the base end side of the sheath 9A, and is a mode in which saline solution flows into the body cavity through communication between the main flow path M1 and the first hole 922A. More specifically, the first mode is a state where the main flow path M1 is connected to the first hole 922A and the opening at the base end side of the incision portion 11A is closed by the annular portion 9216. The second mode is set by moving the incision portion 11A towards the front end side of the sheath 9A, and is a mode in which saline solution flows into the body cavity through communication between the main flow path M1 and the second hole 120A. More specifically, the second mode is a state in which the main path M1 is connected to the second hole 120A and the opening on the base side of the first hole 922A is closed by the connecting member 13A.

[0177] When the treatment device insertion part 7A of Embodiment 2 described above is used, the same effect as that of Embodiment 1 is achieved.

[0178] (A variation of Implementation Method 2)

[0179] Figure 14 This is a diagram illustrating a variation of embodiment 2. Specifically, Figure 14 Is with Figure 10 The corresponding sectional view.

[0180] In the above-described embodiment 2, it can also be achieved by... Figure 14 The shape shown constitutes the shape of the front end side portion of the first hole 922A. Specifically, Figure 14 The portion of the front end side of the first hole 922A shown in this modified example extends in a straight line toward the front end along the central axis of the front end member 92A after the diameter is expanded toward the front end.

[0181] (Implementation Method 3)

[0182] Next, this third embodiment will be described.

[0183] In the following description, the same reference numerals are used for structures that are the same as those in Embodiment 1 described above, and detailed descriptions of them are omitted or simplified.

[0184] In the endoscopic treatment device 6 of this embodiment 3, the structure of the front end portion of the treatment device insertion part 7 differs from that of the endoscopic treatment device 6 described in embodiment 1 above. Hereinafter, for ease of explanation, the treatment device insertion part of this embodiment 3 will be referred to as the treatment device insertion part 7B.

[0185] Figure 15 and Figure 16 This diagram illustrates the structure of the treatment device insertion section 7B in Embodiment 3. Specifically, Figure 15 Is with Figure 2 The corresponding sectional view. Figure 16 It is the device insertion part 7B. Figure 15 A cross-sectional view showing the position of the XVI-XVI line.

[0186] In the treatment device insertion section 7B, such as Figure 15 and Figure 16 As shown, the structures of the sheath 9, the wire 10, and the cutting portion 11 differ from those of the treatment device insertion portion 7 described in Embodiment 1 above. Hereinafter, for ease of explanation, the sheath, wire, and cutting portion of this Embodiment 3 will be referred to as sheath 9B, wire 10B, and cutting portion 11B, respectively.

[0187] In sheath 9B, such as Figure 15 and Figure 16 As shown, the shape of the front end member 92 differs from that of the sheath 9 described in Embodiment 1 above. Hereinafter, for ease of explanation, the front end member of this Embodiment 3 will be referred to as front end member 92B.

[0188] Furthermore, the front-end component 92B can be composed of a single component or by combining multiple components.

[0189] In the front-end component 92B, such as Figure 15 As shown, the first wall portion 9211 and the second wall portion 9212 are omitted compared to the front end member 92 described in Embodiment 1 above.

[0190] Furthermore, in the front-end component 92B, such as Figure 15 and Figure 16 As shown, the shape of the first hole 922 differs from that of the front end member 92 described in Embodiment 1 above. Hereinafter, for ease of explanation, the first hole of this Embodiment 3 will be referred to as the first hole 922B.

[0191] The first hole 922B has a circular cross-section and extends in a straight line along the central axis of the front end member 92B. Furthermore, as... Figure 15 As shown, the front end portion of the first hole 922B expands in diameter towards the front end. Here, the inner diameter of the base end portion of the first hole 922B is set smaller than the inner diameter of the inner circumferential surface 921. Furthermore, the inner diameter of the front end portion of the first hole 922B is set larger than the outer diameter of the protrusion 122A. Also, the inner diameter of the first hole 922B is set larger than the outer diameter of the blade body 121. Additionally, the first hole 922B may preferably be located on the central axis of the front end member 92B.

[0192] Furthermore, a fifth wall portion 9222 is provided on the inner surface of the first hole 922B. Figure 15 ) and a pair of fourth wall sections 9221 ( Figure 15 , Figure 16 ).

[0193] like Figure 15 and Figure 16 As shown, a pair of fourth wall portions 9221 are located on the inner surface of the first hole 922B. Figure 15 and Figure 16 The middle section consists of walls that protrude toward the central axis of the first hole 922B from opposite parts in the vertical direction. Here, the separation dimension between the protruding ends of the pair of fourth wall portions 9221 is set to be slightly larger than the outer diameter of the blade body 121.

[0194] The fifth wall portion 9222 is an annular wall coaxial with the central axis of the first hole 922B. Here, the inner diameter of the fifth wall portion 9222 is set to be slightly larger than the outer diameter of the blade body 121.

[0195] In online 10B, such as Figure 15 As shown, the shape of the line 10B differs from that of the line 10 described in Embodiment 1 above; it has a cylindrical shape. Furthermore, the through hole 101 within the line 10B communicates with the water inlet 812. Moreover, the through hole 101 functions as the main flow path M1 of the present invention, through which physiological saline solution supplied from the water source 200 flows via the pipe TU and the water inlet 812.

[0196] In the cut section 11B, as Figure 15 and Figure 16 As shown, compared to the cutting portion 11 described in Embodiment 1 above, the connecting member 13 is omitted and the shape of the blade 12 is different. Hereinafter, for ease of explanation, the blade of this Embodiment 3 will be referred to as blade 12B.

[0197] like Figure 15As shown, the blade 12B has the same external shape as the blade 12A described in Embodiment 2 above. That is, the blade 12B includes a blade body 121 and a protrusion 122A. Moreover, the blade body 121 is directly connected to the line 10B. In addition, in this Embodiment 3, an annular abutment portion 1211 is provided on the base end side of the outer peripheral surface of the blade body 121. This abutment portion 1211 protrudes from the outer peripheral surface and extends throughout the entire circumference centered on the central axis of the blade body 121.

[0198] Furthermore, in the knife 12B, such as Figure 15 As shown, the shape of the cutting hole 123A differs from that of the cutting knife 12A described in Embodiment 2 above. Hereinafter, for ease of explanation, the cutting hole in Embodiment 3 will be referred to as cutting hole 123B.

[0199] The tool hole 123B includes the second hole body 1233 ( Figure 15 ) and connecting holes 1234 ( Figure 15 , Figure 16 ).

[0200] like Figure 15 As shown, the second hole body 1233 is located on the central axis of the blade body 121, and extends in a straight line from the base end of the blade body 121 to the end face of the front end of the protrusion 122A along the central axis. Moreover, when the blade body 121 is connected to the line 10B, the second hole body 1233 communicates with the through hole 101.

[0201] The connecting hole 1234 is an I-shaped hole located approximately at the center of the length of the blade body 121, communicating with the second hole body 1233, and... Figure 15 and Figure 16 It extends along the vertical direction (radial direction of the blade body 121) and opens on the outer peripheral surface of the blade body 121.

[0202] The above-described hole 123B corresponds to the second hole 120B of the present invention. Figure 15 ).

[0203] Next, the operation of the endoscopic treatment device 6 in Embodiment 3 will be described. For ease of explanation, the ESD process will be used as an example, similar to Embodiment 1 described above.

[0204] Figure 17 and Figure 18 This diagram illustrates the operation of the endoscopic handling instrument 6. Specifically, Figure 17 and Figure 18 Is with Figure 15 The corresponding sectional view.

[0205] In this embodiment 3, the operator, such as a surgeon, performs the local injection procedure as shown below.

[0206] That is, the surgeon or other operator sets the blade 12B to its maximum protruding length from the front end of the sheath 9B (front end member 92B) through a second operation on the slider 82. In this state, the abutment portion 1211 abuts against the bottom portion 920 (opening periphery portion) of the front end member 92B. Thus, the movement of the blade 12B towards the front end is restricted. Furthermore, the connecting hole 1234 is positioned opposite to a pair of fourth wall portions 9221. In this state, the pair of fourth wall portions 9221 abut against the outer peripheral surface (opening periphery portion) of the blade body 121, thereby... Figure 17 The "×" mark indicates that the flow path between the first hole 922B and the connecting hole 1234 is blocked by a pair of fourth wall portions 9221.

[0207] Next, while maintaining the state where the blade 12B protrudes to its maximum protrusion length from the front end of the sheath 9B through the second operation performed on the slider 82, the operator operates the foot switch or other operating parts (not shown) to supply saline solution from the water supply source 200. Thus, the saline solution supplied from the water supply source 200... Figure 17 As indicated by the middle arrow, the saline solution flows from the main flow path M1 through the flow path via the orifice 123B and is ejected from the tip of the blade 12B. This ejected saline solution is injected below the target site T1 under its water pressure. Thus, the target site T1 is suspended from the underlying submucosa and other tissues.

[0208] Furthermore, since the marking and cutting processes are the same as in Embodiment 1 described above, their descriptions are omitted.

[0209] In addition, during the various procedures of ESD, when cleaning the surgical site, the surgeon and other operators perform the following operations.

[0210] The surgeon or other operator sets the slider 82 to a state where only the protrusion 122A protrudes from the first hole 922B to the outside of the front end member 92B through a first operation. In this state, as... Figure 18 As shown, the connecting hole 1234 is positioned offset from the position opposite to the pair of fourth wall portions 9221. Thus, the connecting hole 1234 communicates with the first hole 922B.

[0211] Next, while maintaining the state where the protrusion 122A protrudes from the first hole 922B to the front end member 92B through the first operation performed on the slider 82, the operator operates the foot switch or other operating parts (not shown) to supply saline solution from the water supply source 200. Thus, the saline solution supplied from the water supply source 200... Figure 18As indicated by the middle arrow, the saline solution flows from the main flow path M1 through the flow path via the blade hole 123B and is ejected from the front end of the blade 12B. Furthermore, it flows from the main flow path M1 through the flow path via the blade hole 123B, the connecting hole 1234, and the first hole 922B and is ejected from the front end of the sheath 9B, supplying the surgical site. Here, the saline solution that has flowed through the main flow path M1 is ejected from both the blade hole 123B and the first hole 922B. Therefore, the surgical site is cleaned using the saline solution ejected from both the blade hole 123B and the first hole 922B.

[0212] As described above, in this third embodiment, similarly to the first embodiment, the main flow path M1 can communicate with the first hole 922B and the second hole 120B at the front end side (front end member 92B) of the sheath 9B. Furthermore, the configuration allows switching between a first mode and a second mode by moving the incision portion 11B forward and backward according to the operation of the slider 82 by an operator such as a surgeon. The first mode is set by moving the incision portion 11B towards the base end side of the sheath 9B, and is a mode in which saline solution flows into the body cavity through communication between the main flow path M1 and the first hole 922B and the second hole 120B. The second mode is set by moving the incision portion 11B towards the front end side of the sheath 9B, and is a mode in which saline solution flows into the body cavity through communication between the main flow path M1 and the second hole 120B.

[0213] When the treatment device insertion part 7B of Embodiment 3 described above is used, it also achieves the same effect as Embodiment 1 described above.

[0214] (Implementation Method 4)

[0215] Next, this embodiment 4 will be described.

[0216] In the following description, the same reference numerals are used for structures that are the same as those in Embodiment 1 described above, and detailed descriptions of them are omitted or simplified.

[0217] In the endoscopic treatment device 6 of this embodiment 4, the structure of the front end portion of the treatment device insertion part 7 is different from that of the endoscopic treatment device 6 described in embodiment 1 above. Hereinafter, for ease of explanation, the treatment device insertion part of this embodiment 4 will be referred to as the treatment device insertion part 7C.

[0218] Figures 19-23 This is a diagram illustrating the structure of the treatment device insertion part 7C in Embodiment 4. Specifically, Figure 19 Is with Figure 2 The corresponding sectional view. Figure 20 It is the insertion part of the treatment device 7C Figure 19 A cross-sectional view showing the location of the XX-XX line. Figure 21 It is the insertion part of the treatment device 7C Figure 19 A cross-sectional view showing the location of the XXI-XXI line. Figure 22 It is the insertion part of the treatment device 7C Figure 19 A cross-sectional view showing the location of line XXII-XXII. Figure 23 It is the insertion part of the treatment device 7C Figure 19 A cross-sectional view showing the location of line XXIII-XXIII.

[0219] In the treatment device insertion section 7C, such as Figures 19-23 As shown, the structures of the sheath 9 and the cutting portion 11 differ from those of the treatment device insertion portion 7 described in Embodiment 1 above. Hereinafter, for ease of explanation, the sheath and the cutting portion of this Embodiment 4 will be referred to as sheath 9C and cutting portion 11C, respectively.

[0220] In the 9C sheath, such as Figures 19-23 As shown, the shape of the front end member 92 differs from that of the sheath 9 described in Embodiment 1 above. Hereinafter, for ease of explanation, the front end member of this Embodiment 4 will be referred to as front end member 92C.

[0221] Furthermore, the 92C front-end component can be composed of a single part or by combining multiple parts.

[0222] In the front-end component 92C, such as Figure 19 As shown, the first wall portion 9211 is omitted compared to the front end member 92 described in Embodiment 1 above.

[0223] Furthermore, in the front-end component 92C, such as Figure 19 and Figure 20 As shown, the shape of the first hole 922 differs from that of the front end member 92 described in Embodiment 1 above. Hereinafter, for ease of explanation, the first hole of this Embodiment 4 will be referred to as the first hole 922C.

[0224] The first hole 922C is relative to the first hole 922 described in Embodiment 1 above. Figure 19 and Figure 20 The shape of the upper side is different. Specifically, the upper side of the first hole 922C has a predetermined gap with the cutter body 121, and the first hole 922C (the inner circumferential surface of the front end member 92C) extends radially and communicates with the main channel M1.

[0225] In the cut section 11C, as Figures 19-23As shown, the shapes of the blade 12 and the connecting member 13 are different from those of the cutting portion 11 described in Embodiment 1 above. Hereinafter, for ease of explanation, the blade and the connecting member of this Embodiment 4 will be referred to as blade 12C and connecting member 13C, respectively.

[0226] like Figure 19 As shown, the blade 12C has the same external shape as the blade 12A described in Embodiment 2 above. That is, the blade 12C includes a blade body 121 and a protrusion 122A.

[0227] Furthermore, in the knife 12C, such as Figure 19 As shown, the shape of the cutting hole 123A differs from that of the cutting knife 12A described in Embodiment 2 above. Hereinafter, for ease of explanation, the cutting hole of Embodiment 4 will be referred to as cutting hole 123C.

[0228] The tool hole 123C includes the second hole body 1235 ( Figure 19 , Figure 20 ) and connecting hole 1236 ( Figure 19 , Figure 21 ).

[0229] like Figure 19 As shown, the second hole body 1235 extends in a straight line from the end face of the front end side of the protrusion 122A toward the base end side along the central axis of the blade body 121. Alternatively, the second hole body 1235 may preferably be located on the central axis of the blade body 121.

[0230] like Figure 19 and Figure 21 As shown, the connecting hole 1236 is connected to a portion of the base end side of the second hole body 1233, and... Figure 19 and Figure 21 The center extends to the outer peripheral surface of the blade body 121 and opens on the outer peripheral surface of the blade body 121.

[0231] The cutting hole 123C described above opens on the outer peripheral surface of the base end side of the cutting portion 11C, which corresponds to the second hole 120C of the present invention. Figure 19 ).

[0232] In connecting member 13C, such as Figure 19 , Figures 21-23 As shown, the connecting hole 134 is omitted compared to the connecting member 13 described in Embodiment 1 above. Furthermore, in Figure 19 , Figures 21-23 For ease of explanation, the illustration of the fitting hole 133 is omitted.

[0233] Next, the operation of the endoscopic treatment device 6 in Embodiment 4 will be described. For ease of explanation, the ESD process will be used as an example, similar to Embodiment 1 described above.

[0234] Figure 24 and Figure 25 This diagram illustrates the operation of the endoscopic handling instrument 6. Specifically, Figure 24 and Figure 25 Is with Figure 19 The corresponding sectional view.

[0235] In this embodiment 4, the operator, such as a surgeon, performs the local injection procedure as shown below.

[0236] That is, the surgeon or other operator sets the device to a state where only the protrusion 122A protrudes from the first hole 922C to the outside of the front end member 92C through a first operation on the slider 82; that is, the protrusion 122A protrudes from the first hole 922C while the blade body 121 is located within the first hole 922C. In this state, as... Figure 24 As shown, the connecting hole 1236 is positioned at a point separated from the inner surface of the first hole 922C, creating a gap. Thus, the connecting hole 1236 communicates with the main flow path M1 through this gap. On the other hand, as... Figure 24 As indicated by the "×" mark, since the protrusion 122A abuts against the front end of the sheath 9C (front end member 92C), the front end side of the first hole 922C is closed by the protrusion 122A. That is, the protrusion 122A is equivalent to the second closing member of the present invention, which is capable of closing the opening on the front end side of the first hole 922C.

[0237] Next, while maintaining the state where the protrusion 122A protrudes from the first hole 922C to the front end member 92C through the first operation performed on the slider 82, the operator operates the foot switch or other operating parts (not shown) to supply saline solution from the water supply source 200. Thus, the saline solution supplied from the water supply source 200... Figure 24 As indicated by the middle arrow, the saline solution flows from the main flow path M1 through the connecting hole 1236 and the second hole body 1235, and is ejected from the tip of the blade 12C. This ejected saline solution is injected below the target site T1 under its water pressure. Thus, the target site T1 is suspended from the underlying submucosa and other tissues.

[0238] Furthermore, since the marking and cutting processes are the same as in Embodiment 1 described above, their descriptions are omitted.

[0239] In addition, during the various procedures of ESD, when cleaning the surgical site, the surgeon and other operators perform the following operations.

[0240] The surgeon or other operator sets the blade 12C to its maximum protrusion length from the front end of the sheath 9C by performing a second operation on the slider 82. In this state, such as... Figure 25 As shown, the connecting hole 1236 is positioned abutting against the inner surface of the first hole 922C. Thus, as... Figure 25 As indicated by the "×" mark, the flow path between the connecting hole 1236 and the main flow path M1 is blocked by the inner surface of the first hole 922C. That is, the inner surface of the first hole 922C corresponds to the first sealing member of the present invention, which is disposed within the sheath 9C and is capable of closing the opening at the base end side of the cut-out portion 11C. On the other hand, in this state, since the protrusion 122A separates from the front end of the sheath 9C (front end member 92C), the front end side of the first hole 922C is released from the closure provided by the protrusion 122A.

[0241] Next, while maintaining the state where the blade 12C protrudes to its maximum protrusion length from the front end of the sheath 9C due to the second operation performed on the slider 82, the operator operates the foot switch and other operating parts (not shown) to supply saline solution from the water supply source 200. Thus, the saline solution supplied from the water supply source 200... Figure 25 As indicated by the middle arrow, the saline solution flows from the main flow path M1 through the first hole 922C and is then ejected from the front end of the sheath 9C to supply the surgical site. Here, the opening area between the inner circumferential surface of the first hole 922C and the outer circumferential surface of the blade body 121 is larger than the opening area of ​​the second hole body 1235. Therefore, the surgical site is cleaned using saline solution ejected from the front end of the sheath 9C (front end member 92C).

[0242] As described above, in this embodiment 4, similar to embodiment 1, the main flow path M1 can communicate with the first hole 922C and the second hole 120C at the front end side (front end member 92C) of the sheath 9C. Furthermore, the configuration allows switching between a first mode and a second mode by moving the incision portion 11C forward and backward according to the operation performed by an operator such as a surgeon on the slider 82. The first mode, set by moving the incision portion 11C towards the front end side of the sheath 9C, is a mode in which saline solution flows into the body cavity through communication between the main flow path M1 and the first hole 922C. More specifically, the first mode is a state where the main flow path M1 is connected to the first hole 922C and the opening at the base end of the incision portion 11C is closed by the inner surface of the first hole 922C. The second mode is set by moving the cutting portion 11C toward the base end of the sheath 9C, and is a mode in which saline solution flows into the body cavity through the main flow path M1 and the second hole 120C. More specifically, the second mode is a state in which the main flow path M1 is connected to the second hole 120C and the opening at the front end of the first hole 922C is closed by the protrusion 122A.

[0243] When the treatment device insertion part 7C of Embodiment 4 described above is used, it also achieves the same effect as Embodiment 1 described above.

[0244] (Implementation Method 5)

[0245] Next, this embodiment 5 will be described.

[0246] In the following description, the same reference numerals are used for structures that are the same as those in Embodiment 1 described above, and detailed descriptions of them are omitted or simplified.

[0247] In the endoscopic treatment device 6 of this embodiment 5, the structure of the front end portion of the treatment device insertion part 7 differs from that of the endoscopic treatment device 6 described in embodiment 1 above. Hereinafter, for ease of explanation, the treatment device insertion part of this embodiment 5 will be referred to as the treatment device insertion part 7D.

[0248] Figures 26-31 This is a diagram illustrating the structure of the treatment device insertion section 7D in Embodiment 5. Specifically, Figure 26 Is with Figure 2 The corresponding sectional view. Figure 27 It is the insertion part of the treatment device 7D Figure 26 A cross-sectional view showing the location of the XXVII-XXVII line. Figure 28 It is the insertion part of the treatment device 7D Figure 26 A cross-sectional view showing the location of the XXVIII-XXVIII line. Figure 29 It is the insertion part of the treatment device 7D Figure 26 A cross-sectional view showing the location of the XXIX-XXIX line. Figure 30 It is the insertion part of the treatment device 7D Figure 26 A cross-sectional view showing the location of the XXX-XXX line. Figure 31 It is the insertion part of the treatment device 7D Figure 26 A cross-sectional view showing the location of the XXXI-XXXI line.

[0249] In the treatment device insertion section 7D, such as Figures 26-31 As shown, the structures of the sheath 9 and the cutting portion 11 differ from those of the treatment device insertion portion 7 described in Embodiment 1 above. Hereinafter, for ease of explanation, the sheath and the cutting portion of this Embodiment 5 will be referred to as sheath 9D and cutting portion 11D, respectively.

[0250] In the 9D sheath, such as Figures 26-31 As shown, the shape of the front end member 92 differs from that of the sheath 9 described in Embodiment 1 above. Hereinafter, for ease of explanation, the front end member of this Embodiment 5 will be referred to as front end member 92D.

[0251] Furthermore, the 92D front-end component can be composed of a single part or by combining multiple parts.

[0252] In the front-end component 92D, such as Figure 26 and Figure 31 As shown, in contrast to the front end member 92 described in Embodiment 1, a third wall portion 9214, as described in Embodiment 2, is provided instead of the first wall portion 9211 and the second wall portion 9212. Furthermore, in this Embodiment 5, as... Figure 31 As shown, a wire 10 passes through the annular portion 9216 that constitutes the third wall portion 9214.

[0253] In the cut section 11D, as Figures 26-30 As shown, compared to the cutting portion 11 described in Embodiment 1 above, the blade 12A described in Embodiment 2 above is used instead of the blade 12, and the shape of the connecting member 13 is different. Hereinafter, for ease of explanation, the connecting member of this Embodiment 5 will be referred to as connecting member 13D.

[0254] The connecting member 13D is composed of a cylindrical member extending linearly along the central axis of the front end member 92D. Here, the outer diameter of the connecting member 13D is set to be slightly smaller than the inner diameter of the first hole 922 and larger than the inner diameter of the annular portion 9216. Furthermore, as... Figure 26 , Figure 28 and Figure 29 As shown, the connecting member 13D is provided with a first connecting hole 137, a second connecting hole 138, and a pair of third connecting holes 139. Alternatively, the connecting member 13D may preferably be located on the central axis of the front end member 92D.

[0255] like Figure 26 As shown, the first connecting hole 137 extends linearly from the front end of the connecting member 13D toward the base end along the central axis of the connecting member 13D. Furthermore, when the connecting member 13D is connected to the blade body 121, the first connecting hole 137 communicates with the blade hole 123A. Alternatively, the first connecting hole 137 may preferably be located on the central axis of the connecting member 13D.

[0256] The second connecting hole 138 is an I-shaped hole located approximately at the center of the length of the connecting member 13D, communicating with the first connecting hole 137, and... Figure 26 and Figure 29 It extends along the vertical direction (radial direction of the connecting member 13D) and has an opening on the outer peripheral surface of the connecting member 13D.

[0257] The cutting hole 123A, the first connecting hole 137, and the second connecting hole 138 described above open on the outer peripheral surface of the base end side of the cut portion 11D, which corresponds to the second hole 120D of the present invention. Figure 26 ).

[0258] like Figure 28 As shown, a pair of third connecting holes 139 are holes located on both sides of the first connecting hole 137, extending in a straight line from the front end to the base end of the connecting member 13D along the central axis of the connecting member 13D. Furthermore, the pair of third connecting holes 139 are not connected to the first connecting hole 137 or the second connecting hole 138.

[0259] Next, the operation of the endoscopic treatment device 6 in Embodiment 5 will be described. For ease of explanation, the ESD process will be used as an example, similar to Embodiment 1 described above.

[0260] Figure 32 and Figure 33 This diagram illustrates the operation of the endoscopic handling instrument 6. Specifically, Figure 32 and Figure 33 Is with Figure 26 The corresponding sectional view.

[0261] In this embodiment 5, the operator, such as a surgeon, performs the local injection procedure as shown below.

[0262] That is, the surgeon or other operator sets the device to a state where only the protrusion 122A protrudes from the first hole 922 to the outside of the front end member 92D through a first operation on the slider 82, i.e., the protrusion 122A protrudes from the first hole 922 while the blade body 121 is located within the first hole 922. In this state, as... Figure 32 As shown, the front end of the connecting member 13D is inserted into the first hole 922, and its base end abuts against the end face of the front end of the annular portion 9216. In this state, the front end of the connecting member 13D is inserted into the first hole 922, and a pair of third connecting holes 139 are closed by the annular portion 9216, thereby achieving the desired effect. Figure 32 The "×" mark indicates that the flow path between the first hole 922 and the main flow path M1 is blocked by the connecting member 13D. That is, the connecting member 13D corresponds to the third sealing member of the present invention, capable of closing the opening on the base side of the first hole 922. Furthermore, as... Figure 32 As indicated by the "×" mark, the flow path between the pair of third connecting holes 139 and the main flow path M1 is blocked by the annular portion 9216. On the other hand, the second connecting hole 138 is positioned offset from the inner surface of the first hole 922. Thus, the second connecting hole 138 is connected to the main flow path M1.

[0263] Next, while maintaining the state where the protrusion 122A protrudes from the first hole 922 to the front end member 92D due to the first operation performed on the slider 82, the operator operates the foot switch or other operating parts (not shown) to supply saline solution from the water supply source 200. Thus, the saline solution supplied from the water supply source 200... Figure 32 As indicated by the middle arrow, the saline solution flows from the main flow path M1 through the second connecting hole 138, the first connecting hole 137, and the knife hole 123A, and is ejected from the tip of the knife 12A. This ejected saline solution is injected below the target site T1 under its water pressure. Thus, the target site T1 is suspended from the underlying submucosa and other tissues.

[0264] Furthermore, since the marking and cutting processes are the same as in Embodiment 1 described above, their descriptions are omitted.

[0265] In addition, during the various procedures of ESD, when cleaning the surgical site, the surgeon and other operators perform the following operations.

[0266] The surgeon or other operator sets the blade 12A to its maximum protrusion length from the front end of the sheath 9D by performing a second operation on the slider 82. In this state, such as... Figure 33 As shown, the base end of the connecting member 13D separates from the annular portion 9216. Furthermore, the first hole 922 communicates with the main flow path M1 via a pair of third connecting holes 139. On the other hand, the second connecting hole 138 is positioned opposite the inner surface of the first hole 922. In this state, the inner surface of the first hole 922 abuts against the outer peripheral surface (opening periphery) of the connecting member 13D, thereby... Figure 33 The "×" mark indicates that the flow path between the second connecting hole 138 and the main flow path M1 is blocked by the inner surface of the first hole 922. That is, the inner surface of the first hole 922 corresponds to the first sealing member of the present invention, which is disposed within the sheath 9D and is capable of closing the opening on the base end side of the cut portion 11D.

[0267] Next, while maintaining the state where the blade 12A protrudes to its maximum protrusion length from the front end of the sheath 9D due to the second operation performed on the slider 82, the operator operates the foot switch or other operating parts (not shown) to supply saline solution from the water supply source 200. Thus, the saline solution supplied from the water supply source 200... Figure 33 As indicated by the middle arrow, the saline solution flows from the main flow path M1 through the third connecting hole 139 and the first hole 922, and is then ejected from the front end of the sheath 9D to supply the surgical site. Here, the opening area between the inner circumferential surface of the first hole 922 and the outer circumferential surface of the blade body 121 is larger than the opening area of ​​the blade hole 123A. Therefore, the surgical site is cleaned using saline solution ejected from the front end of the sheath 9D (front end member 92D).

[0268] As described above, in this embodiment 5, similar to embodiment 1, the main flow path M1 can communicate with the first hole 922 and the second hole 120D at the front end side (front end member 92D) of the sheath 9D. Furthermore, the configuration allows switching between a first mode and a second mode by moving the incision portion 11D forward and backward according to the operation performed by an operator such as a surgeon on the slider 82. The first mode is set by moving the incision portion 11D towards the front end side of the sheath 9D, and is a mode in which saline solution flows into the body cavity through communication between the main flow path M1 and the first hole 922. More specifically, the first mode is a state where the main flow path M1 communicates with the first hole 922 and the opening at the base end side of the incision portion 11D is closed by the inner surface of the first hole 922. The second mode is set by moving the incision portion 11D towards the base end side of the sheath 9D, and is a mode in which saline solution flows into the body cavity through communication between the main flow path M1 and the second hole 120D. More specifically, the second mode is a state in which the main road M1 is connected to the second hole 120D and the opening on the base side of the first hole 922 is closed by the connecting member 13D.

[0269] When the treatment device insertion part 7D of Embodiment 5 described above is used, it also achieves the same effect as Embodiment 1 described above.

[0270] (Implementation Method 6)

[0271] Next, this embodiment 6 will be described.

[0272] In the following description, the same reference numerals are used for structures that are the same as those in Embodiment 1 described above, and detailed descriptions of them are omitted or simplified.

[0273] In the endoscopic treatment device 6 of this embodiment 6, the structure of the front end portion of the treatment device insertion part 7 differs from that of the endoscopic treatment device 6 described in embodiment 1 above. Hereinafter, for ease of explanation, the treatment device insertion part of this embodiment 6 will be referred to as the treatment device insertion part 7E.

[0274] Figure 34 and Figure 35 This diagram illustrates the structure of the treatment device insertion section 7E in Embodiment 6. Specifically, Figure 34 Is with Figure 2 The corresponding sectional view. Figure 35 It is the device insertion part 7E. Figure 34 A cross-sectional view showing the location of the XXXV-XXXV line.

[0275] In the treatment device insertion section 7E, such as Figure 34 and Figure 35As shown, the structures of the sheath 9 and the cutting portion 11 differ from those of the treatment device insertion portion 7 described in Embodiment 1 above. Hereinafter, for ease of explanation, the sheath and the cutting portion of this Embodiment 6 will be referred to as sheath 9E and cutting portion 11E, respectively.

[0276] In the 9E sheath, such as Figure 34 and Figure 35 As shown, the shape of the front end member 92 differs from that of the sheath 9 described in Embodiment 1 above. Hereinafter, for ease of explanation, the front end member of this Embodiment 6 will be referred to as front end member 92E.

[0277] Furthermore, the front-end component 92E can be composed of a single component or by combining multiple components.

[0278] In the front-end component 92E, such as Figure 34 and Figure 35 As shown, in contrast to the front end member 92 described in Embodiment 1 above, a third wall portion 9214 described in Embodiment 2 above is provided instead of the first wall portion 9211 and the second wall portion 9212.

[0279] In the cut section 11E, as Figure 34 and Figure 35 As shown, the shapes of the blade 12 and the connecting member 13 are different from those of the cutting portion 11 described in Embodiment 1 above. Hereinafter, for ease of explanation, the blade and the connecting member of this Embodiment 6 will be referred to as blade 12E and connecting member 13E, respectively.

[0280] like Figure 34 As shown, the blade 12E has the same external shape as the blade 12A described in Embodiment 2 above. That is, the blade 12E includes a blade body 121 and a protrusion 122A. In addition, in this Embodiment 6, the outer diameter of the blade body 121 is set to be slightly smaller than the inner diameter of the annular portion 9216. Moreover, the blade body 121 extends through the annular portion 9216.

[0281] Furthermore, in the knife 12E, such as Figure 34 As shown, the shape of the cutting hole 123A differs from that of the cutting knife 12A described in Embodiment 2 above. Hereinafter, for ease of explanation, the cutting hole of this Embodiment 6 will be referred to as cutting hole 123E.

[0282] The tool hole 123E includes the second hole body 1237 ( Figure 34 ) and connecting hole 1238 ( Figure 34 , Figure 35 ).

[0283] like Figure 34As shown, the second hole body 1237 extends in a straight line from the end face of the front end side of the protrusion 122A toward the base end side along the central axis of the blade body 121. Alternatively, the second hole body 1237 may preferably be located on the central axis of the blade body 121.

[0284] like Figure 34 and Figure 35 As shown, the connecting hole 1238 is a cross-shaped hole that is partially connected to the base end side of the second hole body 1237 and opens on the outer peripheral surface of the knife body 121.

[0285] The cutting hole 123E described above opens on the outer peripheral surface of the base end side of the cutting portion 11E, which corresponds to the second hole 120E of the present invention. Figure 34 ).

[0286] The connecting member 13E is located on the central axis of the front end member 92E and is composed of a cylindrical member extending in a straight line along the central axis. Here, the outer diameter of the connecting member 13E is set to be larger than the inner diameter of the annular portion 9216.

[0287] Next, the operation of the endoscopic treatment device 6 of this embodiment 6 will be described. For ease of explanation, the ESD process will be used as an example, similar to that of Embodiment 1 described above.

[0288] Figure 36 and Figure 37 This diagram illustrates the operation of the endoscopic handling instrument 6. Specifically, Figure 36 and Figure 37 Is with Figure 34 The corresponding sectional view.

[0289] In this embodiment 6, the operator, such as a surgeon, performs the local injection procedure as shown below.

[0290] That is, the operator, such as a surgeon, sets the slider 82 to a state where only the protrusion 122A protrudes from the first hole 922 to the front end member 92E through a first operation. In this state, as... Figure 36 As shown, the connecting hole 1238 is positioned offset from the inner circumferential surface of the annular portion 9216. Therefore, the connecting hole 1238 connects to the main flow path M1. On the other hand, as... Figure 36 As indicated by the "×" mark, the protrusion 122A abuts against the front end of the sheath 9E (front end member 92E), thus closing the front end side of the first hole 922. That is, the protrusion 122A corresponds to the second sealing member of the present invention, which is capable of closing the opening on the front end side of the first hole 922.

[0291] Next, while maintaining the state achieved by the first operation on the slider 82, where only the protrusion 122A protrudes from the first hole 922 to the front end member 92E (i.e., the protrusion 122A protrudes from the first hole 922 and the blade body 121 is located within the first hole 922), the operator operates the foot switch or other operating parts (not shown) to supply saline solution from the water supply source 200. Thus, the saline solution supplied from the water supply source 200... Figure 36 As indicated by the middle arrow, the saline solution flows from the main flow path M1 through the connecting hole 1238 and the second hole body 1237, and is ejected from the tip of the blade 12E. This ejected saline solution is injected below the target site T1 under its water pressure. Thus, the target site T1 is suspended from the underlying submucosa and other tissues.

[0292] Furthermore, since the marking and cutting processes are the same as in Embodiment 1 described above, their descriptions are omitted.

[0293] In addition, during the various procedures of ESD, when cleaning the surgical site, the surgeon and other operators perform the following operations.

[0294] The surgeon or other operator sets the blade 12E to its maximum protrusion length from the front end of the sheath 9E through a second operation on the slider 82. In this state, the front end of the connecting member 13E abuts against the end face of the base end side of the annular portion 9216. Furthermore, as... Figure 37 As shown, the connecting hole 1238 is positioned opposite the inner circumferential surface of the annular portion 9216. In this state, the inner circumferential surface of the annular portion 9216 abuts against the outer circumferential surface (the periphery of the opening) of the blade body 121, thereby... Figure 37 The flow path between the connecting hole 1238 and the main flow path M1, indicated by the "×" mark, is blocked by the annular portion 9216. That is, the annular portion 9216 corresponds to the first sealing member of the present invention, which is disposed within the sheath 9E and is capable of closing the opening at the base end of the cut portion 11E. On the other hand, the front end side of the first hole 922 is released from the closure provided by the protrusion 122A.

[0295] Next, while maintaining the state where the blade 12E protrudes to its maximum length from the front end of the sheath 9E due to the second operation performed on the slider 82, the operator operates the foot switch or other operating parts (not shown) to supply saline solution from the water supply source 200. Thus, the saline solution supplied from the water supply source 200... Figure 37As indicated by the middle arrow, the saline solution flows from the main flow path M1 through the first hole 922 and is then ejected from the front end of the sheath 9E to supply the surgical site. Here, the opening area between the inner circumferential surface of the first hole 922 and the outer circumferential surface of the blade body 121 is larger than the opening area of ​​the second hole body 1237. Therefore, the surgical site is cleaned using saline solution ejected from the front end of the sheath 9E (front end member 92E).

[0296] As described above, in this embodiment 6, similar to embodiment 1, the main flow path M1 can communicate with the first hole 922 and the second hole 120E at the front end side (front end member 92E) of the sheath 9E. Furthermore, the configuration allows switching between a first mode and a second mode by moving the incision portion 11E forward and backward according to the operation of the slider 82 by an operator such as a surgeon. The first mode is set by moving the incision portion 11E towards the front end side of the sheath 9E, and is a mode in which saline solution flows into the body cavity through communication between the main flow path M1 and the first hole 922. More specifically, the first mode is a state where the main flow path M1 is connected to the first hole 922 and the opening at the base end side of the incision portion 11E is closed by the annular portion 9216. The second mode is set by moving the incision portion 11E towards the base end side of the sheath 9E, and is a mode in which saline solution flows into the body cavity through communication between the main flow path M1 and the second hole 120E. More specifically, the second mode is a state in which the main road M1 is connected to the second hole 120E and the opening on the front end side of the first hole 922 is closed by the protrusion 122A.

[0297] When the treatment device insertion part 7E of Embodiment 6 described above is used, it also achieves the same effect as Embodiment 1 described above.

[0298] (Implementation Method 7)

[0299] Next, this embodiment 7 will be described.

[0300] In the following description, the same reference numerals are used for structures that are the same as those in Embodiment 1 described above, and detailed descriptions of them are omitted or simplified.

[0301] In the endoscopic treatment device 6 of this embodiment 7, the structure of the front end portion of the treatment device insertion part 7 differs from that of the endoscopic treatment device 6 described in embodiment 1 above. Hereinafter, for ease of explanation, the treatment device insertion part of this embodiment 7 will be referred to as the treatment device insertion part 7F.

[0302] Figure 38 and Figure 39 This is a diagram illustrating the structure of the treatment device insertion section 7F in Embodiment 7. Specifically, Figure 38 Is with Figure 2 The corresponding sectional view. Figure 39It is the device insertion part 7E. Figure 38 A cross-sectional view showing the location of the XXXIX-XXXIX line.

[0303] In the treatment device insertion section 7F, such as Figure 38 and Figure 39 As shown, the structures of the sheath 9 and the cutting portion 11 differ from those of the treatment device insertion portion 7 described in Embodiment 1 above. Hereinafter, for ease of explanation, the sheath and the cutting portion of this Embodiment 7 will be referred to as sheath 9F and cutting portion 11F, respectively.

[0304] In the 9F sheath, such as Figure 38 and Figure 39 As shown, the shape of the front end member 92 differs from that of the sheath 9 described in Embodiment 1 above. Hereinafter, for ease of explanation, the front end member of this Embodiment 7 will be referred to as front end member 92F.

[0305] Furthermore, the front-end component 92F can be composed of a single component or by combining multiple components.

[0306] In the front-end component 92F, such as Figure 38 and Figure 39 As shown, in contrast to the front end member 92 described in Embodiment 1 above, a third wall portion 9214F, which is substantially the same as the third wall portion 9214 described in Embodiment 2 above, is provided instead of the first wall portion 9211 and the second wall portion 9212.

[0307] In the third wall portion 9214, as Figure 38 and Figure 39 As shown, the shape of the inner circumferential surface of the annular portion 9216 differs from that of the third wall portion 9214 described in Embodiment 2 above. Hereinafter, for ease of explanation, the annular portion of this Embodiment 7 will be referred to as annular portion 9216F.

[0308] like Figure 38 and Figure 39 As shown, the inner circumferential surface of the annular portion 9216F has a truncated conical shape in which the inner diameter decreases as it moves toward the front end.

[0309] In the cut section 11F, as Figure 38 and Figure 39 As shown, compared to the cutting portion 11 described in Embodiment 1 above, the blade 12A described in Embodiment 2 above is used instead of the blade 12, and the shape of the connecting member 13 is different. Hereinafter, for ease of explanation, the connecting member of this Embodiment 7 will be referred to as connecting member 13F.

[0310] The connecting member 13F extends along the central axis of the front end member 92F and has a truncated conical shape that is approximately the same as the inner circumferential surface of the annular portion 9216F. Furthermore, as... Figure 38 and Figure 39 As shown, the connecting member 13F is provided with a first connecting hole 130F1 and a second connecting hole 130F2. In addition, the connecting member 13F may preferably be located on the central axis of the front end member 92F.

[0311] like Figure 38 As shown, the first connecting hole 130F1 extends linearly from the front end of the connecting member 13F toward the base end along the central axis of the connecting member 13F. Furthermore, when the connecting member 13F is connected to the blade body 121, the first connecting hole 130F1 communicates with the blade hole 123A. Alternatively, the first connecting hole 130F1 may preferably be located on the central axis of the connecting member 13F.

[0312] like Figure 38 and Figure 39 As shown, the second connecting hole 130F2 is a cross-shaped hole located approximately at the center of the length of the connecting member 13F, communicating with the first connecting hole 130F1, and opening on the outer peripheral surface of the connecting member 13F.

[0313] The cutting hole 123A, the first connecting hole 130F1, and the second connecting hole 130F2 described above communicate with the opening formed on the outer peripheral surface of the base end side of the cutting portion 11F, which corresponds to the second hole 120F of the present invention. Figure 38 ).

[0314] Next, the operation of the endoscopic treatment device 6 in Embodiment 7 will be described. For ease of explanation, the ESD process will be used as an example, similar to Embodiment 1 described above.

[0315] Figure 40 and Figure 41 This diagram illustrates the operation of the endoscopic handling instrument 6. Specifically, Figure 40 and Figure 41 Is with Figure 38 The corresponding sectional view.

[0316] In this embodiment 7, the operator, such as a surgeon, performs the local injection procedure as shown below.

[0317] That is, the operator, such as a surgeon, sets the slider 82 to a state where only the protrusion 122A protrudes from the first hole 922 to the front end member 92F through a first operation. In this state, as... Figure 40As shown, the connecting member 13F is positioned at a point where it separates from the base end side from the inner circumference of the annular portion 9216F. Thus, the second connecting hole 130F2 communicates with the main flow path M1. On the other hand, as... Figure 40 As indicated by the "×" mark, the protrusion 122A abuts against the front end of the sheath 9F (front end member 92F), thus closing the front end side of the first hole 922. That is, the protrusion 122A corresponds to the second sealing member of the present invention, which is capable of closing the opening on the front end side of the first hole 922.

[0318] Next, while maintaining the state where the protrusion 122A protrudes from the first hole 922 to the front end member 92F due to the first operation performed on the slider 82, the operator operates the foot switch or other operating parts (not shown) to supply saline solution from the water supply source 200. Thus, the saline solution supplied from the water supply source 200... Figure 40 As indicated by the middle arrow, the saline solution flows from the main flow path M1 through the second connecting hole 130F2, the first connecting hole 130F1, and the knife hole 123A, and is ejected from the tip of the knife 12A. This ejected saline solution is injected below the target site T1 under its water pressure. Thus, the target site T1 is suspended from the underlying submucosa and other tissues.

[0319] Furthermore, since the marking and cutting processes are the same as in Embodiment 1 described above, their descriptions are omitted.

[0320] In addition, during the various procedures of ESD, when cleaning the surgical site, the surgeon and other operators perform the following operations.

[0321] The surgeon or other operator sets the blade 12A to its maximum protrusion length from the front end of the sheath 9F by performing a second operation on the slider 82. In this state, such as... Figure 41 As shown, the connecting member 13F abuts against the inner circumferential surface of the annular portion 9216F. In this state, the inner circumferential surface of the annular portion 9216F abuts against the outer circumferential surface (the periphery of the opening) of the connecting member 13F, thereby... Figure 41 The flow path between the second connecting hole 130F2 and the main flow path M1, indicated by the "×" arrow, is blocked by the annular portion 9216F. That is, the annular portion 9216 is equivalent to the first sealing member of the present invention, which is disposed within the sheath 9F and is capable of closing the opening at the base end of the cut portion 11F. On the other hand, the front end side of the first hole 922 is released from the closure provided by the protrusion 122A.

[0322] Next, while maintaining the state where the blade 12A protrudes to its maximum protrusion length from the front end of the sheath 9F due to the second operation performed on the slider 82, the operator operates the foot switch and other operating parts (not shown) to supply saline solution from the water supply source 200. Thus, the saline solution supplied from the water supply source 200... Figure 41 As indicated by the middle arrow, the saline solution flows from the main flow path M1 through the first hole 922 and is then ejected from the front end of the sheath 9F to supply the surgical site. Here, the opening area between the inner circumferential surface of the first hole 922 and the outer circumferential surface of the blade body 121 is larger than the opening area of ​​the blade hole 123A. Therefore, the surgical site is cleaned using saline solution ejected from the front end of the sheath 9F (front end member 92F).

[0323] As described above, in this embodiment 7, similar to embodiment 1, the main flow path M1 can communicate with the first hole 922 and the second hole 120F respectively at the front end side (front end member 92F) of the sheath 9F. Furthermore, it is configured such that the incision portion 11F can be moved forward or backward according to the operation of the slider 82 by an operator such as a surgeon, thereby allowing switching between a first mode and a second mode. The first mode is set by moving the incision portion 11F towards the front end side of the sheath 9F, and is a mode in which saline solution flows into the body cavity through communication between the main flow path M1 and the first hole 922. More specifically, the first mode is a state where the main flow path M1 communicates with the first hole 922 and the opening at the base end side of the incision portion 11F is closed by the annular portion 9216F. The second mode is set by moving the incision portion 11F towards the base end side of the sheath 9F, and is a mode in which saline solution flows into the body cavity through communication between the main flow path M1 and the second hole 120F. More specifically, the second mode is a state in which the main path M1 is connected to the second hole 120F and the opening on the front end side of the first hole 922 is closed by the protrusion 122A.

[0324] When the treatment device insertion part 7F of Embodiment 7 described above is used, the same effect as that of Embodiment 1 is achieved.

[0325] In particular, since the inner circumferential surface of the annular portion 9216 and the connecting member 13F are truncated conical in shape, the leakage of saline solution into the second hole 120F can be suppressed in the first mode.

[0326] (Implementation Method 8)

[0327] Next, this embodiment 8 will be described.

[0328] In the following description, the same reference numerals are used for structures that are the same as those in Embodiment 1 described above, and detailed descriptions of them are omitted or simplified.

[0329] In the endoscopic treatment device 6 of this embodiment 8, the structure of the front end portion of the treatment device insertion part 7 is different from that of the endoscopic treatment device 6 described in embodiment 1 above. Hereinafter, for ease of explanation, the treatment device insertion part of this embodiment 8 will be referred to as the treatment device insertion part 7G.

[0330] Figure 42 and Figure 43 This diagram illustrates the structure of the treatment device insertion section 7G in Embodiment 8. Specifically, Figure 42 Is with Figure 2 The corresponding sectional view. Figure 43 It is the insertion part of the treatment device 7G Figure 42 A cross-sectional view showing the location of the XXXXIII-XXXXIII line.

[0331] In the treatment device insertion section 7G, such as Figure 42 and Figure 43 As shown, compared to the treatment device insertion part 7 described in Embodiment 1 above, the wire 10B described in Embodiment 3 above is used instead of the wire 10, and the structures of the sheath 9 and the cutting part 11 are different. Hereinafter, for ease of explanation, the sheath and the cutting part of this Embodiment 8 will be referred to as sheath 9G and cutting part 11G, respectively.

[0332] In the 9G case, such as Figure 42 and Figure 43 As shown, the shape of the front end member 92 differs from that of the sheath 9 described in Embodiment 1 above. Hereinafter, for ease of explanation, the front end member of this Embodiment 8 will be referred to as front end member 92G.

[0333] Furthermore, the 92G front-end component can be composed of a single component or by combining multiple components.

[0334] In the front-end component 92G, such as Figure 42 As shown, the first wall portion 9211 and the second wall portion 9212 are omitted compared to the front end member 92 described in Embodiment 1 above.

[0335] Furthermore, in the front-end component 92G, such as Figure 42 As shown, the shape of the first hole 922 differs from that of the front end member 92 described in Embodiment 1 above. Hereinafter, for ease of explanation, the first hole of this Embodiment 8 will be referred to as the first hole 922G.

[0336] like Figure 42 As shown, the first hole 922G includes a hole body 922G1 and an auxiliary hole 922G2.

[0337] The hole body 922G1 has a circular cross-section and extends linearly along the central axis of the front end member 92G. Here, the inner diameter of the hole body 922G1 is set to be smaller than the outer diameter of the protrusion 122A and larger than the outer diameter of the tool body 121. Alternatively, the hole body 922G1 may preferably be located on the central axis of the front end member 92G.

[0338] like Figure 42 As shown, the auxiliary hole 922G2 is a radially extending portion of the hole body 922G1, and extends in a straight line along the central axis of the front end member 92G, just like the hole body 922G1.

[0339] In the cut section 11G, such as Figure 42 and Figure 43 As shown, compared to the cutting portion 11 described in Embodiment 1 above, the blade 12A described in Embodiment 2 above is used instead of the blade 12, and the shape of the connecting member 13 is different. Hereinafter, for ease of explanation, the connecting member of this Embodiment 8 will be referred to as connecting member 13G.

[0340] The connecting member 13G is composed of a cylindrical member extending linearly along the central axis of the front end member 92G. Here, the outer diameter of the connecting member 13G is set to be larger than the inner diameter of the hole body 922G1 and smaller than the inner diameter of the front end member 92G. Furthermore, as... Figure 42 and Figure 43 As shown, the connecting member 13G is provided with a first fitting hole 130G1, a second fitting hole 130G2, a receiving hole 130G3, and a communicating hole 130G4. In addition, the connecting member 13G may preferably be located on the central axis of the front end member 92G.

[0341] The first fitting hole 130G1 is a circular hole extending in a straight line from the front end of the connecting member 15 toward the base end along the central axis of the connecting member 13G. Furthermore, the blade body 121 is fixed in the first fitting hole 130G1 in an inserted state. Alternatively, the first fitting hole 130G1 may preferably be located on the central axis of the connecting member 13G.

[0342] The second fitting hole 130G2 is a circular hole extending in a straight line from the base end of the connecting member 13G toward the front end side along the central axis of the connecting member 13G. Furthermore, the wire 10B is fixed to the second fitting hole 130G2 in an inserted state. Alternatively, the second fitting hole 130G2 may preferably be located on the central axis of the connecting member 13G.

[0343] The receiving hole 130G3 is a circular hole extending linearly from the front end side of the connecting member 13G toward the base end side along the central axis of the connecting member 13G, and communicates with the first fitting hole 130G1 and the second fitting hole 130G2. Here, the inner diameter of the receiving hole 130G3 is set to be larger than the inner diameters of the first fitting hole 130G1 and the second fitting hole 130G2. Furthermore, when the blade 12A and the wire 10B are connected using the connecting member 13G, the main flow path M1 communicates with the blade hole 123A via the receiving hole 130G3. That is, the blade hole 123A and the receiving hole 130G3 correspond to the second hole 120G of the present invention. Figure 42 Alternatively, the receiving hole 130G3 may preferably be located on the central axis of the connecting member 13G.

[0344] like Figure 42 As shown, the connecting hole 130G4 is an elongated hole that extends from the outer peripheral surface of the connecting member 13G to the receiving hole 130G3 and along the length axis of the connecting member 13G.

[0345] Moreover, in this embodiment 8, such as Figure 42 and Figure 43 As shown, the connecting member 13G described above is equipped with a force-applying member 14 and a flow path switching member 15.

[0346] like Figure 42 and Figure 43 As shown, the force-applying member 14 is composed of a helical spring and is disposed within the receiving hole 130G3. Moreover, one end of the force-applying member 14 abuts against or is fixed to the support portion 151 constituting the flow path switching member 15, and the other end abuts against or is fixed to the periphery of the second fitting hole 130G2. Furthermore, the force-applying member 14 applies force to the flow path switching member 15 toward the front end side.

[0347] The flow path switching component 15 is a component that switches the flow path of physiological saline flowing through the main flow path M1. For example... Figure 42 and Figure 43 As shown, the flow path switching component 15 includes a support portion 151 and a closing portion 152.

[0348] The support portion 151 is inserted into the receiving hole 130G3 through the connecting hole 130G4 and has a pin shape configured in a posture orthogonal to and located on the central axis of the connecting member 13G.

[0349] The closing portion 152 is fixed to one end of the support portion 151 located outside the connecting member 13G, and has a plate shape extending along the central axis of the connecting member 13G. The closing portion 152 is set to be sized to close the connecting hole 130G4.

[0350] Next, the operation of the endoscopic treatment device 6 in Embodiment 8 will be described. For ease of explanation, the ESD process will be used as an example, similar to Embodiment 1 described above.

[0351] Figure 44 and Figure 45 This diagram illustrates the operation of the endoscopic handling instrument 6. Specifically, Figure 44 and Figure 45 Is with Figure 42 The corresponding sectional view.

[0352] In this embodiment 8, the operator, such as a surgeon, performs the local injection procedure as shown below.

[0353] That is, the operator, such as a surgeon, sets the slider 82 to a state where only the protrusion 122A protrudes from the first hole 922G to the outside of the front end member 92G through a first operation. In this state, as... Figure 44 As shown, the connecting member 13G is positioned closer to the base end than the front end member 92G. Furthermore, the flow path switching member 15 moves relative to the connecting member 13G towards the front end under the force of the force-applying member 14. In this state, the closing portion 152 abuts against the outer peripheral surface (opening periphery) of the connecting member 13G, thereby closing the connecting hole 130G4.

[0354] Next, while maintaining the state where the protrusion 122A protrudes from the first hole 922G beyond the front end member 92G through the first operation performed on the slider 82, the operator operates the foot switch or other operating parts (not shown) to supply saline solution from the water supply source 200. Thus, the saline solution supplied from the water supply source 200... Figure 44 As indicated by the middle arrow, the saline solution flows from the main flow path M1 through the receiving hole 130G3 and the blade hole 123A, and then exits from the tip of the blade 12A. This exiting saline solution is injected below the target site T1 under its water pressure. Thus, the target site T1 is suspended from the underlying submucosa and other tissues.

[0355] Furthermore, since the marking and cutting processes are the same as in Embodiment 1 described above, their descriptions are omitted.

[0356] In addition, during the various procedures of ESD, when cleaning the surgical site, the surgeon and other operators perform the following operations.

[0357] The surgeon or other operator sets the blade 12A to its maximum protrusion length from the sheath 9G by performing a second operation on the slider 82. During this second operation, the connecting member 13G enters the front member 92G from the base end side. Meanwhile, the flow path switching member 15 engages with the base end of the front member 92G and moves relative to the connecting member 13G towards the base end side, overcoming the force of the force-applying member 14. Thus, as... Figure 45 As shown, the connecting hole 130G4 is released from the closure by the closing part 152.

[0358] Next, while maintaining the state where the blade 12A protrudes to its maximum length from the front end of the sheath 9G due to the second operation performed on the slider 82, the operator operates the foot switch or other operating parts (not shown) to supply saline solution from the water supply source 200. Thus, the saline solution supplied from the water supply source 200... Figure 45 As indicated by the middle arrow, after flowing from the main flow path M1 through the receiving hole 130G3 and the blade hole 123A, it is ejected from the front end of the blade 12A. Furthermore, after flowing from the main flow path M1 through the receiving hole 130G3, the connecting hole 130G4, the front end member 9G, and the auxiliary hole 922G2, it is ejected from the front end of the sheath 9G and supplied to the surgical site. Here, the saline solution flowing through the main flow path M1 is ejected from both the blade hole 123A and the auxiliary hole 922G2. Therefore, the surgical site is cleaned using the saline solution ejected from both the blade hole 123A and the auxiliary hole 922G2.

[0359] As described above, in this embodiment 8, similarly to embodiment 1, the main flow path M1 can communicate with the first hole 922G and the second hole 120G at the front end side (front end member 92G) of the sheath 9G. Furthermore, the configuration allows switching between a first mode and a second mode by moving the incision portion 11G forward and backward according to the operation of the slider 82 by an operator such as a surgeon. The first mode is a mode in which saline solution flows into the body cavity through the communication of the main flow path M1 with the first hole 922G and the second hole 120G. The second mode is a mode in which saline solution flows into the body cavity through the communication of the main flow path M1 with the second hole 120G.

[0360] When using the treatment device insertion part 7G of Embodiment 8 described above, the same effect as that of Embodiment 1 can be achieved.

[0361] (Other implementation methods)

[0362] This concludes the description of methods for implementing the present invention, but the present invention should not be limited to the embodiments 1 to 8 described above.

[0363] In embodiments 1 to 8 described above, surgical site cleaning is performed in mode 1, and local injection is performed in mode 2, but the procedure is not limited to this. For example, surgical site cleaning can be performed in both modes 1 and 2.

[0364] In all of the embodiments 1 to 8 described above, the rotation limiting structure of the present invention (second wall portion 9212 (groove portion 9213) and rotation limiting portion 132) may also be used.

[0365] In the embodiments 1 to 8 described above, the shape of the protrusion 122 (122A) is not limited to the shape described in embodiments 1 to 8, and other shapes may also be used.

[0366] Figure 46A and Figure 46B This is a diagram showing an example of the shape of the protrusion 122 (122A).

[0367] Specifically, the protrusion 122 (122A) can be as follows: Figure 46A or Figure 46B The image shown is hemispherical ( Figure 46A ), triangular shape ( Figure 46B It can be a flange shape, or a needle shape without the flange shape.

Claims

1. An endoscopic treatment device, wherein, The endoscopic handling apparatus includes: Sheath, having a first hole at the front end; and The cutting portion extends through the first hole in a retractable manner and has a second hole extending between the front end and the base end. With the front end of the cutting portion protruding from the front end of the sheath, it is possible to supply electricity to the cutting portion. The endoscopic treatment device is configured to switch between a first mode, in which fluid flows through a main channel within the sheath and into the first port, and a second mode, in which fluid flows through a main channel and into the second port, depending on the movement of the incision.

2. The endoscopic treatment device according to claim 1, wherein, The first mode is set by moving the cut portion toward the front end of the sheath. The second mode is set by moving the cut portion toward the base end of the sheath.

3. The endoscopic treatment device according to claim 2, wherein, The second hole opens on the outer peripheral surface of the base end side of the cut portion. The sheath includes a first sealing member disposed within the sheath, capable of closing the opening on the base end side of the cut portion. The first mode is a state in which the main flow path is connected to the first hole and the opening on the base end side of the cut portion is closed by the first sealing member.

4. The endoscopic treatment device according to claim 2, wherein, The cut portion includes a second sealing member capable of closing the opening at the front end of the first hole. The second mode is a state in which the main flow path is connected to the second hole and the opening on the front end side of the first hole is closed by the second sealing member.

5. The endoscopic treatment device according to claim 2, wherein, The second hole opens on the outer peripheral surface of the base end side of the cut portion. The sheath includes a first sealing member disposed within the sheath, capable of closing the opening on the base end side of the cut portion. The cut portion includes a second sealing member capable of closing the opening at the front end of the first hole. The first mode is a state in which the main flow path is connected to the first hole and the opening on the base end side of the cut portion is closed by the first sealing member. The second mode is a state in which the main flow path is connected to the second hole and the opening on the front end side of the first hole is closed by the second sealing member.

6. The endoscopic treatment device according to claim 2, wherein, The endoscopic device also features: A wire, which runs through the sheath; and A connecting member that connects the cut portion and the line. The connecting member includes a third sealing member capable of closing the opening at the base end of the first hole. The second mode is a state in which the opening on the base end side of the first hole is closed by the third sealing member.

7. The endoscopic treatment device according to claim 2, wherein, The second hole opens on the outer peripheral surface of the base end side of the cut portion. The sheath includes a first sealing member disposed within the sheath, capable of closing the opening on the base end side of the cut portion. The endoscopic handling device also has: A wire, which runs through the sheath; and A connecting member that connects the cut portion and the line. The connecting member includes a third sealing member capable of closing the opening at the base end of the first hole. The first mode is a state in which the main flow path is connected to the first hole and the opening on the base end side of the cut portion is closed by the first sealing member. The second mode is a state in which the main flow path is connected to the second hole and the opening on the base end side of the first hole is closed by the third sealing member.

8. The endoscopic treatment device according to claim 1, wherein, A rotation limiting structure is provided between the cut portion and the sheath, which restricts the rotation of the cut portion around its central axis.

9. The endoscopic treatment device according to claim 1, wherein, The first mode is set by moving the cut portion toward the base end of the sheath. The second mode is set by moving the cut portion toward the front end of the sheath.

10. The endoscopic treatment device according to claim 9, wherein, The second hole opens on the outer peripheral surface of the base end side of the cut portion. The sheath includes a first sealing member disposed within the sheath, capable of closing the opening on the base end side of the cut portion. The first mode is a state in which the main flow path is connected to the first hole and the opening on the base end side of the cut portion is closed by the first sealing member.

11. The endoscopic treatment device according to claim 9, wherein, The endoscopic device also features: A wire, which runs through the sheath; and A connecting member that connects the cut portion and the line. The connecting member includes a second sealing member capable of closing the opening at the base end of the first hole. The second mode is a state in which the main flow path is connected to the second hole and the opening on the base end side of the first hole is closed by the second sealing member.

12. The endoscopic treatment device according to claim 9, wherein, The second hole opens on the outer peripheral surface of the base end side of the cut portion. The sheath includes a first sealing member disposed within the sheath, capable of closing the opening on the base end side of the cut portion. The endoscopic handling device also has: A wire, which runs through the sheath; and A connecting member, which can move freely forward and backward relative to the first closing member, connects the cut portion and the line. The connecting member includes a second sealing member capable of closing the opening at the base end of the first hole. The first mode is a state in which the main flow path is connected to the first hole and the opening on the base end side of the cut portion is closed by the first sealing member. The second mode is a state in which the main flow path is connected to the second hole and the opening on the base end side of the first hole is closed by the second sealing member.

13. The endoscopic treatment device according to claim 1, wherein, The first mode allows fluid to flow through the main flow path connected to the first hole and the main flow path connected to the second hole.

Images