Treatment instrument for endoscope

Abstract

Provided is an endoscope treatment tool in which a connector supplied with high-frequency current does not rotate and the connector and a wire connected to a high-frequency treatment device are properly connected. The endoscope treatment tool includes a sheath, a handle main body attached to a base end portion of the sheath, a wire disposed so as to be able to advance and retreat along a length axis direction of the handle main body and to be able to rotate around the length axis, a treatment portion connected to a front end of the wire and disposed on a front end side of the sheath, a rotation handle that is able to move relative to the handle main body and is connected to a base end portion of the wire, and a connector having a through passage through which the wire is able to advance and retreat and to rotate, the connector extending in a direction intersecting an advancing and retreating direction of the wire and having electrical conductivity.

Description

TECHNICAL FIELD

[0001] The present application relates to an endoscope treatment instrument.

[0002] This application claims priority from U.S. Provisional Patent Application No. 63 / 306,154 filed on February 3, 2022 in the United States, the contents of which are incorporated herein. BACKGROUND

[0003] In the past, in endoscope treatment, an endoscope treatment instrument including a hemostatic forceps that performs hemostasis by cauterizing a treatment target of bleeding, a high-frequency knife, and the like that passes a high-frequency current has been used. A wire connected to the high-frequency treatment instrument is supplied with a high-frequency current via an A wire (active wire) connected to a connector provided at an operation portion of the endoscope treatment instrument.

[0004] In a case where the high-frequency treatment instrument needs to be operated by rotation, the wire connected to the high-frequency treatment instrument is attached to the operation portion so as to be able to rotate around a length axis of the operation portion. In this case, when the wire is rotated in order to rotate the high-frequency treatment instrument, the connector attached to the wire also rotates, and thus the A wire is easily wound around the operation portion.

[0005] The endoscope treatment instrument described in Patent Document 1 is able to rotate the tip mechanism without rotating the connector around the length axis by rotating the handle to rotate only the wire.

[0006] Prior art documents

[0007] Patent documents

[0008] Patent Document 1: Japanese Patent Application Publication No. 2009-034388 SUMMARY

[0009] PROBLEMS TO BE SOLVED BY THE INVENTION

[0010] However, in the endoscope treatment instrument described in Patent Document 1, the power feeding plug and the wire are connected by a power passing portion having elasticity. The power passing portion having elasticity sometimes hinders the movement of the wire. Thus, in the endoscope treatment instrument described in Patent Document 1, the connection state of the power feeding plug and the wire is not necessarily optimal.

[0011] In view of the above, an object of the present application is to provide an endoscope treatment instrument in which a connector to which a high-frequency current is supplied does not rotate, and the connector and a wire connected to a high-frequency treatment instrument are properly connected.

[0012] MEANS FOR SOLVING THE PROBLEM

[0013] To solve the above problems, the present application proposes the following solutions.

[0014] The endoscope treatment instrument according to the first aspect of the present application includes: a sheath; a handle main body attached to a base end portion of the sheath; a wire configured to be able to advance and retreat along a length axis direction of the handle main body and to be able to rotate around the length axis; a treatment portion coupled to a front end of the wire and configured on a front end side of the sheath; a rotation handle movable with respect to the handle main body and coupled to a base end portion of the wire; and a connector having a through passage through which the wire is able to advance and retreat and to rotate, the connector extending in a direction intersecting with an advancing and retreating direction of the wire and having electrical conductivity.

[0015] Effects of the Invention

[0016] In the endoscope treatment instrument of the present application, the connector to which a high-frequency current is supplied does not rotate, and the connector and the wire coupled to the high-frequency treatment device are properly connected. BRIEF DESCRIPTION OF DRAWINGS

[0017] Figure 1 is a whole view of an endoscope treatment system including the endoscope treatment instrument according to the first embodiment.

[0018] Figure 2 is a whole view of the endoscope treatment instrument.

[0019] Figure 3 is a side view of an operation portion of the endoscope treatment instrument.

[0020] Figure 4 is a plan view of the operation portion.

[0021] Figure 5 is a sectional view of the operation portion.

[0022] Figure 6 is a view of a coupling portion of a connector of the operation portion.

[0023] Figure 7 is a sectional view of the operation portion along an X-X line of Figure 3 .

[0024] Figure 8 is a sectional view of a slider of the operation portion.

[0025] Figure 9 is a sectional view of the slider when a lower side of the operation portion is directed downward vertically.

[0026] Figure 10 is a sectional view of the slider when an upper side of the operation portion is directed downward vertically.

[0027] Figure 11 is a sectional view of the slider when the left side of the operation section is oriented downward vertically.

[0028] Figure 12 is a diagram showing a slit formed in a tube of an operation wire.

[0029] Figure 13 is a diagram showing a modification example of a through passage of the connector.

[0030] Figure 14 is a diagram showing an operation section of an endoscope treatment instrument according to a second embodiment.

[0031] Figure 15 is a sectional view of the operation section.

[0032] Figure 16 is a sectional view of a fixed slider of the operation section.

[0033] Figure 17 is a diagram showing an operation section of an endoscope treatment instrument according to a third embodiment.

[0034] Figure 18 is a sectional view of a handle body of the operation section.

[0035] Figure 19 is a diagram showing a modification example of a conductive member of the handle body.

[0036] Figure 20 is a diagram showing another modification example of the conductive member of the handle body.

[0037] Figure 21 is a sectional view of the connector along Y-Y of Figure 20

[0038] Figure 22 is a diagram showing a modification example of the operation section of the endoscope treatment instrument according to the first embodiment.

[0039] Figure 23 is a front view of the modification example.

[0040] Figure 24 is a right side view of the modification example.

[0041] Figure 25 is a left side view of the modification example.

[0042] Figure 26 is a plan view of the modification example.

[0043] Figure 27 is a bottom view of the modification example.

[0044] Figure 28 is a rear view of the modification example. ​

[0045] Reference Signs List

[0046] 300, endoscope treatment system; 200, endoscope; 100, 100B, 100C, treatment instrument for endoscope; 1, sheath; 2, operation wire; 3, support member; 4, forceps (forceps member); 4C, knife; 5, 5B, 5C, 5D, operation portion; 6, 6B, 6C, 6D, handle main body; 69, 69B, 69C, conductive member; 7, 7C, connector; 8, 8C, slider; 9, 9B, 9C, rotary handle; G, gap; G1, up-down gap; G2, left-right gap; CS1, up-down slider gap; CS2, left-right slider gap; CC1, up-down connector gap; CC2, left-right connector gap. DETAILED DESCRIPTION

[0047] (First Embodiment)

[0048] Reference Figures 1-13 An endoscope treatment system 300 provided with a treatment instrument for endoscope 100 of the first embodiment of the present application will be described with reference to the drawings. Figure 1 is a general view of the endoscope treatment system 300.

[0049] [Endoscope Treatment System 300]

[0050] As shown in Figure 1 , the endoscope treatment system 300 includes a treatment instrument for endoscope 100 and an endoscope 200. The treatment instrument for endoscope 100 is used by being inserted into the endoscope 200.

[0051] [Endoscope 200]

[0052] The endoscope 200 is a well-known flexible endoscope including an insertion portion 210 inserted into a body from a front end, an operation portion 220 installed to a base end of the insertion portion 210, and a general cable 230 installed to the operation portion 220.

[0053] The insertion portion 210 is an elongated longitudinal member capable of being inserted into a lumen. The insertion portion 210 has a front end portion 211, a curved portion 214, and a flexible portion 215. The front end portion 211, the curved portion 214, and the flexible portion 215 are connected in this order from a front end side. A passage 216 for insertion of the treatment instrument 100 is provided inside the insertion portion 210. A front end opening portion 212 of the passage 216 and an imaging portion 213 are provided in the front end portion 211.

[0054] The imaging portion 213 is provided with, for example, an imaging element such as a CCD, a CMOS, or the like, and is capable of imaging a site to be treated. The curved portion 214 is curved in accordance with an operation performed on the operation portion 220 by a user. The flexible portion 215 is a site of a tube shape having flexibility.

[0055] The operation section 220 is connected to the flexible section 215. The operation section 220 has a handle 221, an input section 222, and a forceps opening 223. The handle 221 is a member that is supported by the user. The input section 222 accepts an operation input for causing the bending section 214 to perform a bending action. The forceps opening 223 is a base end opening portion of the channel 216.

[0056] A general-purpose cable 230 connects the endoscope treatment instrument 100 and an external device. The general-purpose cable 230 has inserted therein a camera cable, an optical fiber cable, or the like that outputs a camera signal captured by the camera section 213 to the outside.

[0057] [Endoscope treatment instrument 100]

[0058] Figure 2 is a general view of the endoscope treatment instrument 100.

[0059] The endoscope treatment instrument 100 (also referred to as a treatment instrument 100) is a hemostatic forceps that cauterizes a lesion to perform hemostasis. The treatment instrument 100 includes a sheath 1, an operation wire 2 (refer to Figure 5 ), a support member 3, a forceps (forceps member) 4, and an operation section 5. In the following description, the side of the treatment instrument 100 that is inserted into the body of a patient in the lengthwise axis direction A will be referred to as a "distal end side Al", and the side of the operation section 5 will be referred to as a "base end side A2".

[0060] [Sheath 1]

[0061] The sheath 1 has flexibility and is a longitudinal coil sheath that extends from a distal end la to a base end lb. The sheath 1 has an outer diameter that can be inserted into the channel 216 of the endoscope 200. As shown in Figure 1 , in a state in which the sheath 1 is inserted into the channel 216, the distal end la of the sheath 1 can be protruded and retracted with respect to the distal end opening portion 212 of the channel 216. The sheath 1 can also have insulating properties.

[0062] The base end lb of the sheath 1 is joined to the operation section 5 in a manner that allows rotation about the lengthwise axis, using a joint portion 12 (refer to Figure 5 ).

[0063] [Operation wire 2]

[0064] The operation wire 2 penetrates the inside space of the sheath 1. The distal end of the operation wire 2 is connected to the forceps 4, and the base end of the operation wire 2 is connected to the operation section 5. The operation wire 2 is a wire 21 made of metal and a tube 22 made of metal that is provided to the base end portion of the wire 21 (refer to Figure 5 ). The wire 21 and the tube 22 are fixed together in a manner that does not allow relative movement, by chemical bonding such as adhesion, or mechanical bonding such as riveting.

[0065] [Support member 3]

[0066] The support member 3 is located at the front end 1a of the sheath 1, supporting the pliers 4 so that they can be opened and closed. The support member 3 may also have a linkage mechanism that converts the forward and backward movement of the operating line 2 into the opening and closing movement of the pliers 4.

[0067] [Pliers 4]

[0068] The forceps (forceps component) 4 is a component for grasping biological tissue. The forceps 4 is supported by the support component 3 so that it can be opened and closed toward the front end side A1. The forceps 4 is made of metal materials such as stainless steel and includes a first forceps plate 41 and a second forceps plate 42. The support component 3 and the forceps 4 constitute the "treatment section 110" for treating the affected area.

[0069] [Operations Section 5]

[0070] Figure 3 This is a side view of the operating unit 5. Figure 4 This is a top view of the operating unit 5.

[0071] An operating part (handle) 5 is located on the base end side A2 of the sheath 1. The operating part 5 includes a handle body 6, a connector 7, a slider 8, and a rotary handle 9. In this embodiment, the connector 7 is mounted on the slider 8.

[0072] In the following description of the operation section 5, the direction in which the connector 7 is located relative to the handle body 6 is designated as the upper side B1 in the vertical direction B, and the side in the vertical direction B opposite to the upper side B1 is designated as the lower side B2. Furthermore, the direction perpendicular to the length axis direction A and the vertical direction B is designated as the width direction C or the left-right direction C. The direction to the right when viewing the base side A2 from the front end side A1 is designated as the right side C1 in the width direction C, and the direction to the left is designated as the left side C2 in the width direction C.

[0073] Figure 5 This is a cross-sectional view of the operating section 5.

[0074] The handle body 6 has an internal space 6s through which the operation cable 2 passes. The operation cable 2 extends to the slider 8 through the internal space 6s of the sheath 1 and the internal space 1s of the handle body 6. Figure 4 As shown, the handle body 6 has a body slit 61 extending along the length axis direction A. The body slit 61 communicates with the internal space 6s.

[0075] The handle body 6 has a thumb ring 62 on the base side A2. The surgeon can support the handle body 6 by inserting their thumb through the thumb ring 62.

[0076] The connector 7 is capable of being connected to a high-frequency power supply device not shown, and is electrically and physically connected to the base end portion of the operation wire 2. The connector 7 is capable of supplying a high-frequency current supplied from the high-frequency power supply device to the pliers 4 via the operation wire 2.

[0077] The connector 7 is supported by the slide member 8, and is formed in a substantially cylindrical shape extending in the extension direction D. The extension direction D is a direction intersecting the length axis direction A which is the advancing and retreating direction of the operation wire 2, and in the present embodiment, is a direction orthogonal to the length axis direction A. The connector 7 has a joint portion 71, a power feeding plug 74, and a reduced diameter portion 75.

[0078] Figure 6 is a view showing the joint portion 71 of the connector 7.

[0079] The joint portion 71 is formed in a substantially cylindrical shape, and is provided at the inner side DI which is one side in the extension direction D. The joint portion 71 is joined to the operation wire 2 by penetrating the main body slit 61 of the handle main body 6. The joint portion 71 has a penetration passage 72 and a slit 73.

[0080] Figure 7 is a cross-sectional view of the operation portion 5 along the X-X line of Figure 3 .

[0081] The penetration passage 72 is a through-hole formed in the length axis direction A along the operation wire 2, and the tube 22 provided at the base end portion of the operation wire 2 penetrates the penetration passage 72 in a manner capable of advancing and retreating. A gap G is provided between the inner peripheral surface of the penetration passage 72 and the operation wire 2. The gap G in the up and down direction B is referred to as "up and down gap Gl", and the gap G in the left and right direction C is referred to as "left and right gap G2".

[0082] The slit 73 is a slit extending from the penetration passage 72 to the end portion of the inner side DI. The slit 73 is continuously formed from the front end side Al in the length axis direction A to the base end side A2.

[0083] The power feeding plug 74 is a plug provided at the outer side DO which is the other side in the extension direction D, and is for connecting an A-wire (active wire).

[0084] The reduced diameter portion 75 is an intermediate portion in the extension direction D, and is provided between the penetration passage 72 and the power feeding plug 74. The outer diameter of the reduced diameter portion 75 is smaller than the outer diameter of the joint portion 71 and the outer diameter of the power feeding plug 74.

[0085] Figure 8 is a cross-sectional view of the slide member 8.

[0086] The slider 8 is attached so as to be able to advance and retreat along the body slit 61 of the handle main body 6. The slider 8 is able to advance and retreat with respect to the handle main body 6 along the length axis direction A but is not able to rotate around the length axis. The base end portion of the operation wire 2 is connected to the slider 8. The operation wire 2 is advanced and retreated by the surgical operator relatively advancing and retreating the slider 8 with respect to the handle main body 6.

[0087] The slider 8 is attached so as to be able to advance and retreat with respect to the handle main body 6. Therefore, as shown in Figure 8 , the slider 8 has a gap (hereafter also referred to as "up-down slider gap CS1") in the up-down direction B between the slider 8 and the handle main body 6. Further, as shown in Figure 7 , the slider 8 has a gap (hereafter also referred to as "left-right slider gap CS2") in the left-right direction C between the slider 8 and the handle main body 6.

[0088] The slider 8 has an operation wire support portion 81 that supports the operation wire 2, a connector support portion 84 that supports the connector 7, and a double ring 87 that is provided on both sides in the up-down direction B.

[0089] The operation wire support portion 81 supports the base end portion of the operation wire 2. The operation wire support portion 81 has a first through-hole 82 that penetrates along the length axis direction A and a connecting member 83 that is attached to the base end opening 82a of the first through-hole 82.

[0090] The connecting member 83 is a member that is fixed to the base end of the operation wire 2 and has a claw portion (snap fitting member) 83a that has elasticity on the base end side A2. The connecting member 83 is fixed to the base end of the operation wire 2, for example, by adhesion, press-in fixing, or the like. The claw portion 83a engages with the edge of the base end opening 82a of the first through-hole 82. The operation wire 2 (tube 22) is attached to the slider 8 by the claw portion 83a so as to be unable to advance and retreat with respect to the slider 8 along the length axis direction A but able to rotate around the length axis.

[0091] The connector support portion 84 supports the connector 7. The connector support portion 84 has a second through-hole 85 that penetrates along the up-down direction B and a plug protector portion 86 that is formed on the upper side B1 of the second through-hole 85 in a cylindrical shape.

[0092] The second through-hole 85 is a through-hole through which the reduced diameter portion 75 of the connector 7 penetrates. As shown in Figure 8 , the length of the second through-hole 85 in the up-down direction B is shorter than the length of the reduced diameter portion 75 in the up-down direction B. Therefore, the connector 7 has a gap (hereafter also referred to as "up-down connector gap CC1") in the up-down direction B between the connector 7 and the slider 8.

[0093] As shown in Figure 7As shown, the length of the second through hole 85 in the left-right direction C is longer than the length of the reduced diameter portion 75 of the connector 7 in the left-right direction C. Furthermore, the length of the main body slit 61 of the handle body 6 in the left-right direction C is longer than the length of the connecting portion 71 of the connector 7 in the left-right direction C. Therefore, the connector 7 has a gap in the left-right direction C between itself and the handle body 6 and the slider 8 (hereinafter referred to as "left-right connector gap CC2").

[0094] Figure 9 This is a cross-sectional view of the slider 8 when the lower side B2 of the operating part 5 faces the vertical lower side.

[0095] When the lower side B2 of the operating part 5 faces the vertical downward side (gravity direction), the connector 7, due to the upper and lower connector gap CC1, therefore... Figure 9 The connector 7 moves downwards to B2 relative to the handle body 6. The gap between the upper and lower connectors CC1 is larger than the gap between the upper and lower connectors G1. Therefore, the through-path 72 of the connector 7 contacts the operating line 2 on the upper side B1 in a manner that allows it to conduct electricity. That is, in the radial direction R (refer to...) of the connector 7 towards the operating line 2... Figure 6 When the first direction (lower side B2, inner side DI) of the through passage 72 moves, the through passage 72 contacts the operating line 2 in a way that allows it to be energized in the second direction (upper side B1, outer side DO) on the side opposite to the first direction.

[0096] The sliding member 8 of the support connector 7 has an upper and lower sliding member gap CS1, therefore, as Figure 9 The slider 8 moves downwards to B2 relative to the handle body 6. As a result, the connector 7, supported by the slider 8, also moves downwards to B2 relative to the handle body 6. Considering the gap CS1 between the upper and lower sliders, if the sum of the gaps CC1 between the upper and lower connectors and CS1 is greater than the upper and lower gap G1, then the through-path 72 of the connector 7 will contact the operating line 2 at the upper B1 in a manner that allows it to conduct electricity. For example, if the gap CC1 between the upper and lower connectors is zero, then the gap CS1 between the upper and lower sliders only needs to be greater than the upper and lower gap G1.

[0097] Figure 10 This is a cross-sectional view of the slider 8 when the upper side B1 of the operating part 5 faces the vertically downward side.

[0098] When the upper side B1 of the operating part 5 faces the vertically downward side, the connector 7, due to the upper and lower connector gap CC1, therefore... Figure 10 The connector 7 moves upward to the upper side B1 relative to the handle body 6. The gap between the upper and lower connectors CC1 is larger than the gap between the upper and lower connectors G1. Therefore, the through-path 72 of the connector 7 contacts the operating line 2 on the lower side B2 in a manner that allows it to conduct electricity. That is, in the radial direction R (refer to...) of the connector 7 towards the operating line 2... Figure 6When the second direction (upper side Bl, outer side DO) on the handle main body 6 is moved, the through passage 72 on the first direction (lower side B2, inner side DI) on the opposite side of the second direction is in contact with the operation wire 2 in a manner that electricity can pass therethrough.

[0099] The slide 8 that supports the connector 7 moves to the upper side Bl with respect to the handle main body 6 as shown in FIG. 8A because of the upper and lower slide gap CS1. As a result, the connector 7 that is supported by the slide 8 also moves to the upper side Bl with respect to the handle main body 6. In consideration of the upper and lower slide gap CS1, if the total of the upper and lower connector gap CC1 and the upper and lower slide gap CS1 is larger than the upper and lower gap Gl, the through passage 72 of the connector 7 is in contact with the operation wire 2 in a manner that electricity can pass therethrough on the lower side B2. For example, in the case where the upper and lower connector gap CC1 is zero, the upper and lower slide gap CS1 can be larger than the upper and lower gap Gl. Figure 10

[0100] Figure 11 FIG. 9 is a cross-sectional view of the slide 8 when the left side C2 of the operation section 5 is oriented to the vertical lower side.

[0101] When the left side C2 of the operation section 5 is oriented to the vertical lower side, the connector 7 moves to the left side C2 with respect to the handle main body 6 as shown in FIG. 10A because of the left and right connector gap CC2. The left and right connector gap CC2 is larger than the left and right gap G2. Therefore, the through passage 72 of the connector 7 is in contact with the operation wire 2 in a manner that electricity can pass therethrough on the right side Cl. That is, when the first direction (left side C2) on the radial direction R (refer to FIG. 1) of the connector 7 with respect to the operation wire 2 is moved, the through passage 72 on the second direction (right side Cl) on the opposite side of the first direction is in contact with the operation wire 2 in a manner that electricity can pass therethrough. Figure 11 Figure 6

[0102] The slide 8 that supports the connector 7 moves to the left side C2 with respect to the handle main body 6 as shown in FIG. 10A because of the left and right slide gap CS2. As a result, the connector 7 that is supported by the slide 8 also moves to the left side C2 with respect to the handle main body 6. In consideration of the left and right slide gap CS2, if the total of the left and right connector gap CC2 and the left and right slide gap CS2 is larger than the left and right gap G2, the through passage 72 of the connector 7 is in contact with the operation wire 2 in a manner that electricity can pass therethrough on the right side Cl. For example, in the case where the left and right connector gap CC2 is zero, the left and right slide gap CS2 can be larger than the left and right gap G2. Figure 11 The case where the right side Cl of the operation section 5 is oriented to the vertical lower side (direction of gravity) is also the same, and the through passage 72 of the connector 7 is in contact with the operation wire 2 in a manner that electricity can pass therethrough on the left side C2. That is, when the second direction (left side C2) on the radial direction R (refer to FIG. 1) of the connector 7 with respect to the operation wire 2 is moved, the through passage 72 on the first direction (right side Cl) on the opposite side of the second direction is in contact with the operation wire 2 in a manner that electricity can pass therethrough.

[0103] Figure 6 ​​​​When the second direction (right C1) on the through passage 72 is moved, the through passage 72 contacts the operating line 2 in a manner that enables it to be energized in the first direction (left C2) on the side opposite to the second direction.

[0104] The same applies to the case where the direction perpendicular to the length axis A of the operating section 5, and excluding the vertical direction B and the left-right direction C, is towards the vertically downward side, in the radial direction R of the connector 7 towards the operating line 2 (refer to...). Figure 6 When the connector 7 moves in the first direction, the through-pass 72 contacts the operating line 2 in a energized manner in the second direction on the side opposite to the first direction. In the radial direction R (refer to...) of the connector 7 towards the operating line 2... Figure 6 When the operating part 5 is moved in the second direction, the through passage 72 contacts the operating line 2 in the first direction in a manner that enables it to be energized. That is, regardless of which direction the operating part 5 is tilted, a portion of the through passage 72 is always in contact with the operating line 2 in a manner that enables it to be energized.

[0105] like Figure 5 As shown, the rotary handle 9 is located in the handle body 6 at a position A1 closer to the front end than the slider 8. The rotary handle 9 cannot move forward or backward along the length axis A relative to the handle body 6, but it can rotate about the length axis. The rotary handle 9 has a sheath support portion 91 for supporting the sheath 1, a rotational connection portion 92 connected to the handle body 6 in a manner that allows rotation about the length axis, a through hole 93 for the operation line 2 to pass through, and a line drive portion 94 for rotating and driving the operation line 2.

[0106] The rotating connection 92 is a recessed portion that is recessed from the base end side A2 of the rotating handle 9 toward the front end side A1. The rotating connection 92 is mounted on the front end 6a of the handle body 6 in a manner that allows it to rotate about its length axis.

[0107] The through hole 93 is a through hole formed along the rotation axis of the rotary handle 9. The operating line 2 can move forward and backward along the length axis direction A inside the through hole 93 and can rotate around the length axis.

[0108] like Figure 5 As shown, the wire drive portion 94 is a protrusion that extends radially inward from the inner circumference of the through hole 93. The wire drive portion 94 is formed on both sides, separated by the rotation axis of the rotating handle.

[0109] Figure 12 This is a diagram showing the slit 23 formed in tube 22.

[0110] The wire driving portion 94 is engaged with the slit 23 formed in the tube 22. The slit 23 is a recess extending along the length axis direction A. The slit 23 is formed on both sides with the wire 21 interposed therebetween. The tube 22 is able to advance and retreat along the length axis direction A with respect to the wire driving portion 94 of the rotation handle 9, but is not able to rotate around the length axis with respect to the wire driving portion 94 of the rotation handle 9. When the rotation handle 9 is turned around the length axis, the wire driving portion 94 turns the operation wire 2 around the length axis by turning the slit 23 around the length axis.

[0111] The length of the length axis direction A of the slit 23 is longer than the advanceable and retreatable length of the length axis direction A of the slider 8. Therefore, even in the case where the operation wire 2 is advanced and retreated in accordance with the advance and retreat of the slider 8, the wire driving portion 94 is positioned inside the slit 23, and thus the wire driving portion 94 can maintain a state in which the operation wire 2 can be turned and driven.

[0112] [Method of using endoscope treatment system 300]

[0113] Next, a surgery performed using the endoscope treatment system 300 of the present embodiment (method of using endoscope treatment system 300) will be described. Specifically, an incision and dissection treatment and a hemostasis treatment of a lesion portion in an endoscopic treatment such as ESD (endoscopic submucosal dissection) will be described.

[0114] In the incision and dissection treatment, bleeding often occurs. In the case of bleeding, the surgery operator performs a hemostasis treatment. The hemostasis treatment is a treatment in which a cauterization is performed on an ulcer portion after the lesion portion is dissectioned, or a bleeding site that bleeds during the incision and dissection treatment.

[0115] The surgery operator turns the rotation handle 9 to turn the operation wire 2 and the forceps 4, so that the forceps 4 are disposed at an appropriate treatment position. Even in the case where the rotation handle 9 is turned, the connector 7 is not turned, and thus the A wire (active wire) connected to the connector 7 is not entangled with the operation portion 5.

[0116] The surgery operator passes a high-frequency current to the operation wire 2. Regardless of which of the directions perpendicular to the length axis direction A of the operation portion 5 is directed downward, at least a part of the through passage 72 is in contact with the operation wire 2 in a manner that enables the passage of the current. Therefore, regardless of the posture of the operation portion 5, a high-frequency current is passed from the connector 7 to the operation wire 2, and the forceps 4 can cauterize the bleeding site.

[0117] The surgery operator continues the above-described operation (treatment) as needed, and finally resects the lesion portion, and ends the ESD surgery.

[0118] The treatment instrument 100 for an endoscope according to the present embodiment is not rotated by the connector 7 to which the high-frequency current is supplied, and the A-wire (active wire) connected to the connector 7 is not wound around the operation section 5. Further, the connector 7 and the operation wire 2 are properly connected regardless of the posture of the operation section 5.

[0119] The first embodiment of the present application has been described in detail above with reference to the drawings, but the specific structure is not limited to this embodiment, and design changes and the like within a range not departing from the gist of the present application are also included. Further, the constituent elements shown in the above-described embodiments and modified examples can be appropriately combined to constitute.

[0120] In the above-described embodiment, the treatment section 110 is a hemostatic forceps that cauterizes a lesion to perform hemostasis, but the type of the treatment section is not limited thereto. The treatment instrument can be a high-frequency treatment device to which a high-frequency current is passed, and for example, can be a high-frequency knife.

[0121] Figure 13 FIG. 7 is a view showing a through passage 72A as a modification of the through passage 72.

[0122] The through passage 72A has a rib 72c that protrudes from the inner peripheral surface toward the inside of the radial direction R. The rib 72c extends along the length axis direction A. By adjusting the size of the rib 72c, it is possible to adjust the contact area of the through passage 72A with the operation wire 2.

[0123] (Second Embodiment)

[0124] Reference Figures 14-16 A treatment instrument 100B for an endoscope according to the second embodiment of the present application will be described. In the following description, the same reference numerals are assigned to structures common to the already described members, and repeated description is omitted.

[0125] [Treatment instrument 100B for an endoscope]

[0126] The treatment instrument 100B (also referred to as the treatment instrument 100B) is a hemostatic forceps that cauterizes a lesion to perform hemostasis. The treatment instrument 100B includes a sheath 1, an operation wire 2, a support member 3, a forceps (forceps member) 4, and an operation section 5B.

[0127] Figure 14 FIG. 8 is a view showing the operation section 5B.

[0128] The operation section 5B is provided on the proximal end side A2 of the sheath 1. The operation section 5B includes a handle main body 6B, a connector 7, and a rotary handle 9B. In the present embodiment, the connector 7 is attached to the handle main body 6B.

[0129] Figure 15 FIG. 9 is a cross-sectional view of the operation section 5B.

[0130] The handle main body 6B has a cylindrical portion 63, a fixed slide 64, and a rotary handle support portion 65. The cylindrical portion 63 is formed in a substantially cylindrical shape, and has an internal space 6s in which the operation wire 2 is to be inserted. The joint portion 12 that joins the base end 1b of the sheath 1 so as to be rotatable about the length axis is housed in the cylindrical portion 63.

[0131] The fixed slide 64 has the same shape as the slide 8 of the first embodiment. The fixed slide 64 is formed integrally with the cylindrical portion 63, and is a part of the handle main body 6B. Therefore, unlike the slide 8 of the first embodiment, the fixed slide 64 is not able to advance and retreat in the length axis direction A.

[0132] Figure 16 is a sectional view of the fixed slide 64.

[0133] The fixed slide 64 has the same connector support portion 84 as the slide 8 of the first embodiment. The connector 7 has an up-down connector gap CC1 in the up-down direction B between the connector 7 and the fixed slide 64. Further, the connector 7 has a left-right connector gap CC2 in the left-right direction C between the connector 7 and the fixed slide 64.

[0134] As with the first embodiment, the up-down connector gap CC1 is larger than the up-down gap Gl. Further, the left-right connector gap CC2 is larger than the left-right gap G2. Therefore, when the connector 7 is moved in a first direction in the radial direction R (refer to Figure 6 ) of the operation wire 2, the through passage 72 contacts the operation wire 2 in a second direction on the side opposite the first direction in a manner that allows electric conduction. When the connector 7 is moved in a second direction in the radial direction R (refer to Figure 6 ) of the operation wire 2, the through passage 72 contacts the operation wire 2 in the first direction in a manner that allows electric conduction.

[0135] The rotary handle support portion 65 is provided on the base end side A2 of the fixed slide 64, and supports the rotary handle 9B so as to be able to advance and retreat in the length axis direction A and to be rotatable about the length axis.

[0136] The rotary handle 9B is supported by the rotary handle support portion 65 of the handle main body 6B. The rotary handle 9B is able to advance and retreat in the length axis direction A and to be rotatable about the length axis with respect to the handle main body 6B.

[0137] The base end of the operation wire 2 is fixed to the rotary handle 9B. The base end of the operation wire 2 is fixed to the rotary handle 9B by chemical bonding such as adhesion, or mechanical bonding such as riveting. The operation wire 2 is advanced and retreated by advancing and retreating the rotary handle 9B in the length axis direction A. The operation wire 2 is rotated by rotating the rotary handle 9B about the length axis.

[0138] The treatment instrument 100B for an endoscope according to the present embodiment is not rotated by the connector 7 to which the high-frequency current is supplied, and the A-wire (active wire) connected to the connector 7 is not wound around the operation section 5B. Further, the connector 7 and the operation wire 2 are properly connected regardless of the posture of the operation section 5B.

[0139] In addition, in the case where the sheath 1 is made of a material having electrical conductivity, the sheath 1 can be extended to the position of the connector 7 so as to contact the connector 7 and the sheath 1, instead of the operation wire 2, to electrically connect the connector 7 and the sheath 1.

[0140] The second embodiment of the present application has been described in detail above with reference to the drawings, but the specific structure is not limited to this embodiment, and design changes and the like within the scope of the gist of the present application are included. Further, the constituent elements shown in the above-described embodiments and modified examples can be appropriately combined to constitute.

[0141] (Third Embodiment)

[0142] Reference Figures 17-21 A treatment instrument 100C for an endoscope according to the third embodiment of the present application will be described. In the following description, the same reference numerals are assigned to structures common to the already described members, and repeated description is omitted.

[0143] [Treatment instrument 100C for an endoscope]

[0144] The treatment instrument 100C for an endoscope (also referred to as a treatment instrument 100C) is a high-frequency knife. The treatment instrument 100C includes a sheath 1, an operation wire 2, a knife 4C, and an operation section 5C.

[0145] Figure 17 is a view showing the operation section 5C.

[0146] The operation section 5C is provided at the proximal end side A2 of the sheath 1. The operation section 5C includes a handle main body 6C, a connector 7C, a slide 8C, and a rotation handle 9C. In the present embodiment, the connector 7C is attached to the handle main body 6C.

[0147] Figure 18 is a cross-sectional view of the handle main body 6C.

[0148] The handle main body 6C has a cylindrical portion 63, a rotation handle support portion 65C, and a connector support portion 66.

[0149] The rotation handle support portion 65C is provided at the proximal end side A2 of the handle main body 6C, and supports the rotation handle 9C so as not to be able to advance and retreat in the length axis direction A but to be able to turn around the length axis.

[0150] The connector support portion 66 supports the connector 7C. The connector support portion 66 has a third through hole 67 through which the connector 7C passes in the vertical direction B, a cylindrical plug protection portion 68 formed on the upper side B1 of the third through hole 67, and a conductive member 69.

[0151] The conductive member 69 is formed into a generally cylindrical shape using a conductive material. The conductive member 69 is a component that electrically and physically connects the operating line 2 and the connector 7C, and is disposed between the operating line 2 and the connector 7C. The conductive member 69 is arranged such that its central axis O is along the length axis direction A. Furthermore, the conductive member 69 is supported in a manner that allows it to rotate about its central axis O.

[0152] The conductive member 69 has a pressing area 69a that directly presses against the tube 22 of the operating line 2. The pressing area 69a is curved, but it can also be flat. The conductive member 69 is formed in a generally cylindrical shape, and the pressing area 69a is shaped to facilitate contact with the operating line 2. Therefore, even if the operating line 2 rotates about its length axis, the connector 7C and the operating line 2 are properly connected.

[0153] Connector 7C can be connected to a high-frequency power supply device (not shown), and is electrically and physically connected to the base end of the operating line 2 via the conductive member 69. Connector 7C can supply high-frequency current from the high-frequency power supply device to the blade 4C via the operating line 2.

[0154] The connector 7C is supported by the connector support 66 of the handle body 6C and is formed into a generally cylindrical shape extending along the extension direction D. The extension direction D is a direction that intersects the length axis direction A, which is the forward and backward direction of the operation line 2, and in this embodiment, it is a direction orthogonal to the length axis direction A. The connector 7C has a connecting part 71C and a power plug 74.

[0155] The connecting portion 71C is formed in a generally cylindrical shape and is provided on the inner side DI of one side in the extending direction D. The connecting portion 71C passes through the third through hole 67 and contacts the conductive member 69 at the end 76 of the inner side DI.

[0156] The power plug 74 is a plug located on the outer side DO on the other side as the extension direction D, for connecting the A wire (active wire).

[0157] The rotary handle 9C is supported by the rotary handle support 65C of the handle body 6C. The rotary handle 9C cannot move forward or backward along the length axis A relative to the handle body 6C, but it can rotate around the length axis.

[0158] The rotary handle 9C has a slit-shaped slider support that supports the slider 8C so that it can move forward and backward along the length axis direction A.

[0159] The slider 8C is attached so as to be able to advance and retreat along the slider support portion of the rotary handle 9C. The slider 8C is able to advance and retreat along the length axis direction A with respect to the rotary handle 9C but is not able to rotate around the length axis. The base end portion of the operation wire 2 is connected to the slider 8C. The operation wire 2 is advanced and retreated by the surgical operator relatively advancing and retreating the slider 8C with respect to the handle main body 6C.

[0160] With the treatment instrument 100C for an endoscope according to the present embodiment, the connector 7C to which the high-frequency current is supplied does not rotate, and the A wire (active wire) connected to the connector 7C does not become entangled with the operation portion 5C. Furthermore, the connector 7C and the operation wire 2 are properly connected regardless of the posture of the operation portion 5C.

[0161] The third embodiment of the present application has been described in detail above with reference to the drawings, but the specific structure is not limited to this embodiment and includes design changes and the like within a range not departing from the gist of the present application. Furthermore, the constituent elements shown in the above-described embodiments and modified examples can be appropriately combined.

[0162] (Modified example)

[0163] In the above-described embodiment, the conductive member 69 is a cylindrical member, but the shape of the conductive member is not limited to this. Figure 19 is a view showing a conductive member 69B that is a modified example of the conductive member 69. The conductive member 69B is a coil spring formed of metal and is wound around the outer peripheral portion of the operation wire 2. The conductive member 69B has elasticity, and the connector 7C and the operation wire 2 are properly connected even when the connector 7C is advanced and retreated in the extension direction D.

[0164] (Modified example)

[0165] In the above-described embodiment, the conductive member 69 is a cylindrical member, but the shape of the conductive member is not limited to this. Figure 20 is a view showing a conductive member 69C that is a modified example of the conductive member 69. The conductive member 69C is formed integrally with the connector 7C and is a recess provided to the end portion 76 on the inner side DI of the connector 7C. Figure 21 is a cross-sectional view of the connector 7C along the Y-Y of Figure 20 of (A), the conductive member 69C can also be a recess whose cross section perpendicular to the length axis direction A is polygonal. As shown in Figure 21 of (B), the conductive member 69C can also be a recess whose cross section perpendicular to the length axis direction A is a circular arc shape following the outer peripheral surface of the operation wire 2. Figure 21 of (B), the conductive member 69C can also be a recess whose cross section perpendicular to the length axis direction A is a circular arc shape following the outer peripheral surface of the operation wire 2.

[0166] (Modified example)

[0167] In the above-described embodiment, the conductive member 69 is a cylindrical member, but the shape of the conductive member is not limited to this.Figure 22 FIG. 5 is a diagram showing an operation section 5D that is a modification of the operation section 5 of the treatment instrument 100 for an endoscope according to the first embodiment. Figure 23 FIG. 6 is a front view of the operation section 5D. Figure 24 FIG. 7 is a right view of the operation section 5D. Figure 25 FIG. 8 is a left view of the operation section 5D. Figure 26 FIG. 9 is a plan view of the operation section 5D. Figure 27 FIG. 10 is a bottom view of the operation section 5D. Figure 28 FIG. 11 is a rear view of the operation section 5D.

[0168] The operation section 5D includes a handle main body 6D, a connector 7, a slider 8D, and a rotary handle (not shown). In the operation section 5D, the connector 7 is attached to the slider 8D. The handle main body 6D is formed in a substantially cylindrical shape, and has a grip 62D at the base end. The grip 62D is formed in a cylindrical shape having a tapered portion in the outer peripheral portion. The slider 8D is attached to the outer peripheral portion of the handle main body 6D in a manner capable of advancing and retreating in the length axis direction A.

Claims

1. An endoscopic treatment device, wherein, The endoscopic handling apparatus includes: jacket; The handle body is mounted on the base end of the sheath; The line is configured to be able to move forward and backward relative to the handle body along the length axis of the sheath and to rotate about the length axis. A processing unit, which is connected to the front end of the line, is disposed on the front end side of the sheath; A rotating handle, rotatable relative to the handle body about the length axis of the line, is connected to the base end of the line; and A connector that extends in a direction intersecting the forward and backward directions of the wire and is conductive. The handle body has a conductive member that contacts the wire and electrically connects the wire and the connector; the conductive member is a spring.

2. The endoscopic treatment device according to claim 1, wherein, The connector has a through passage through which the wire can pass in a forward, backward, and rotatable manner. At least a portion of the through-path is configured to be in contact with the wire in a manner that allows it to be electrically energized.

3. The endoscopic treatment device according to claim 2, wherein, The through-passage of the connector has a gap between it and the wire. As the connector moves in a first direction radially toward the wire, the through passage contacts the wire in a second direction on the side opposite to the first direction.

4. The endoscopic treatment device according to claim 3, wherein, As the connector moves in the second direction, the through passage contacts the wire in the first direction.

5. The endoscopic treatment device according to claim 2, wherein, The endoscopic instrument also includes a slider that is capable of moving forward and backward relative to the handle body along the length axis. The connector is mounted on the sliding member. The rotary handle is rotatable relative to the handle body about the length axis. The base end of the line is connected to the slider.

6. The endoscopic treatment device according to claim 5, wherein, The rotary handle is located in the handle body at a position closer to the front end than the slider.

7. The endoscopic treatment device according to claim 6, wherein, The endoscopic instrument has a tube that can move forward and backward along the length axis relative to the rotating handle, but cannot rotate about the length axis. The base end of the tube and the base end of the wire are fixed. The tube is supported such that it can rotate about the length axis relative to the sliding member, but cannot move forward or backward relative to the length axis.

8. The endoscopic treatment device according to claim 5, wherein, The rotary handle has a wire drive portion, which is a protrusion that engages with a slit formed at the base end of the wire for rotating the wire.

9. The endoscopic treatment device according to claim 5, wherein, The connector has a gap between itself and the slider. The gap is larger than the gap between the through passage and the line.

10. The endoscopic treatment device according to claim 5, wherein, The slider has a gap between itself and the handle body. The gap is larger than the gap between the through passage and the line.

11. The endoscopic treatment device according to claim 2, wherein, The connector is mounted on the handle body. The rotary handle is capable of moving forward and backward along the length axis relative to the handle body and can rotate around the length axis. The base end of the line is connected to the rotating handle.

12. The endoscopic treatment device according to claim 11, wherein, The rotating handle is located at the base end of the handle body.

13. The endoscopic treatment device according to claim 11, wherein, The connector has a gap between itself and the handle body. The gap is larger than the gap between the through passage and the line.

14. The endoscopic treatment device according to claim 1, wherein, The endoscopic instrument also includes a slider that is capable of moving forward and backward relative to the rotating handle along the length axis. The connector is mounted on the handle body. The rotary handle cannot move forward or backward along the length axis relative to the handle body, but it can rotate around the length axis. The base end of the line is connected to the slider.

15. The endoscopic treatment device according to claim 14, wherein, The rotating handle is located at the base end of the handle body.

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