Treatment instrument for endoscope

Abstract

The treatment instrument for an endoscope includes a sheath, a tube member extending within the sheath and having a first tube, and a treatment portion connected to a distal end of the tube member and having a second tube communicating with the first tube and a liquid delivery port capable of delivering fluid, an opening area of a third tube formed between a distal end portion of the tube member and the liquid delivery port being smaller than opening areas of the first tube and the second tube.

Description

Technical Field

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

[0002] Previously, endoscopic instruments such as high-frequency knives were used for cutting and dissecting in endoscopic treatments such as endoscopic submucosal dissection (ESD). These endoscopic instruments are configured to cut and dissect biological tissues such as mucosa and submucosa through the endoscope, and to deliver medications, saline, etc., through a delivery port at the distal end.

[0003] In ESD (Extracorporeal Dissection) surgery, an endoscopic local injection needle is inserted into the channel formed in the insertion section of the endoscope. An initial local injection, such as medication or saline solution, is performed by injecting the needle at its tip into the lesion formed within the lumen of the digestive tract, causing the lesion to swell. Afterward, the endoscopic local injection needle is withdrawn from the endoscope, and an endoscopic high-frequency treatment instrument is inserted. Using the endoscopic high-frequency treatment instrument, the area around the lesion is incised, and the exposed submucosa is dissected to remove the lesion. Furthermore, during the procedure, the medication or saline solution injected into the submucosa leaks out over time, resulting in the swollen lesion shrinking. Therefore, additional local injections are performed by pressing the distal end of the injection port against the submucosa while appropriately injecting fluid.

[0004] As an endoscopic treatment device, for example, the endoscopic treatment device described in Patent Document 1 is known. In the endoscopic treatment device of Patent Document 1, a conductive spiral tube is arranged on the proximal side of the high-frequency knife, and the spiral tube functions as an electrode and a fluid delivery line.

[0005] Existing technical documents

[0006] Patent documents

[0007] Patent Document 1: Chinese Invention Patent Application Publication No. 111202485A Summary of the Invention

[0008] The problem the invention aims to solve

[0009] In the endoscopic treatment device of Patent Document 1, besides factors such as the condition of the mucosa and submucosa (mucosal thickness, surface softness, etc.), in cases where the fluid delivery port is not properly positioned against the mucosa and submucosa, or where the flow of saline solution, medication, etc., delivered from the distal delivery port is weak, the shape and size of the bulging mucosa and submucosa can sometimes be inconsistent. As a result, the lesion does not achieve the desired bulging shape and size. In such cases, the procedure time is prolonged because the high-frequency treatment device and local injection needle must be changed for each local injection. To solve this problem, a high-pressure or high-flow-rate fluid delivery pump, or a high-pressure and high-flow-rate fluid delivery pump, is needed. However, this results in the problem of large-scale fluid delivery pumps and high prices.

[0010] In the endoscopic treatment device of Patent Document 1, there is a fluid delivery hole at the tip of the high-frequency knife, but the hole is relatively small. Therefore, if electricity is repeatedly applied while blood or mucus has entered and adhered to the fluid delivery hole, the deposits will char and adhere, blocking the fluid delivery line and preventing the delivery of medications, saline, etc. Therefore, if the blockage in the fluid delivery line cannot be cleared, a new high-frequency treatment device needs to be used, thus prolonging the operation time.

[0011] The present invention was made in view of the following problem, and its object is to provide an endoscopic treatment device that can deliver liquids such as medications and saline solution from the distal end of the treatment device with a strong liquid force without using a high-performance liquid delivery pump.

[0012] Solution for solving the problem

[0013] The first technical solution of the present invention provides an endoscopic treatment device comprising: a sheath; a tubular member extending within the sheath and having a first conduit; and a treatment portion connected to the distal end of the tubular member, having a second conduit communicating with the first conduit and a fluid delivery port, wherein a third conduit with an opening area smaller than the opening area of ​​the first conduit and the opening area of ​​the second conduit is formed between the distal end of the tubular member and the fluid delivery port.

[0014] In the aforementioned endoscopic treatment device, the distal end of the third tubing may be located on the distal side compared to the proximal end of the treatment section.

[0015] In the aforementioned endoscopic treatment device, the distal end of the third conduit may be located closer to the distal end of the second conduit than the distal end of the second conduit, and a step portion may be formed between the distal end of the third conduit and the second conduit.

[0016] In the aforementioned endoscopic treatment device, the stepped portion may also be located at the proximal end of the second tubing.

[0017] In the aforementioned endoscopic treatment apparatus, the third conduit may also be formed at the distal end of the tubular component.

[0018] In the aforementioned endoscopic treatment apparatus, the distal end of the tubular component may also be inserted into the second tubing.

[0019] The aforementioned endoscopic treatment device may also include a cylinder having the third conduit, the distal end of which is inserted into the second conduit of the treatment unit.

[0020] In the aforementioned endoscopic treatment device, the third conduit may also be formed proximal to the second conduit of the treatment section.

[0021] In the aforementioned endoscopic treatment device, an inclined surface may be formed between the proximal end of the third tube and the first tube.

[0022] In the aforementioned endoscopic treatment device, the sheath may also have an insulating head at its distal end, which is heat-resistant and insulating, and the treatment part may be a high-frequency knife that penetrates the insulating head and is capable of moving forward and backward relative to the sheath.

[0023] The endoscopic treatment device described above may also include: a cylindrical body having the third conduit; and a connector connecting the cylindrical body and the high-frequency blade, formed of a conductive material, which abuts against the insulating head to position the high-frequency blade from a protruding position protruding from the sheath.

[0024] The endoscopic treatment device described above may also include a connector that connects the tubular component and the high-frequency blade. The connector is made of a conductive material and abuts against the insulating head to position the high-frequency blade from a protruding position protruding from the sheath.

[0025] In the aforementioned endoscopic treatment device, the high-frequency knife may also have: a distal end member that is insulating and has the liquid delivery port formed thereon; and an energized part that is conductive and disposed at the proximal end of the distal end member, the outer edge of which is exposed on the proximal side of the distal end member.

[0026] In the aforementioned endoscopic treatment device, the treatment unit may have a pair of clamp members and a shaft member on the distal side of the pair of clamp members, with the second conduit formed in the shaft member.

[0027] The effects of the invention

[0028] Using the aforementioned endoscopic treatment device, medications, saline, and other liquids can be delivered from the distal end of the treatment section with a strong liquid flow without the need for a high-performance delivery pump.

[0029] This invention eliminates the need to change high-frequency treatment instruments and local injection needles for each local injection, thus reducing the duration of the procedure. Furthermore, this invention eliminates the need for high-pressure and high-flow-rate delivery pumps, thereby reducing the need for larger pumps and lowering costs. Attached Figure Description

[0030] Figure 1 This is an overall view of the endoscopic treatment device according to the first embodiment of the present invention.

[0031] Figure 2 This is a partial cross-sectional view of the endoscopic treatment device according to the first embodiment of the present invention.

[0032] Figure 3 This is a cross-sectional view of the main parts of the endoscopic treatment device according to the first embodiment of the present invention.

[0033] Figure 4 This is a cross-sectional view of the main parts of a modified endoscopic treatment device.

[0034] Figure 5 This is a cross-sectional view of the main parts of a modified endoscopic treatment device.

[0035] Figure 6 This is a cross-sectional view of the main parts of a modified endoscopic treatment device.

[0036] Figure 7 This is a cross-sectional view of the main parts of a modified endoscopic treatment device.

[0037] Figure 8 This is a cross-sectional view of the main parts of a modified endoscopic treatment device.

[0038] Figure 9 From Figure 8 The graph observed from the IX-IX line.

[0039] Figure 10 This is an overall view of the endoscopic treatment device according to the second embodiment of the present invention.

[0040] Figure 11 This is a cross-sectional view of the main part of the endoscopic treatment device according to the second embodiment of the present invention.

[0041] Figure 12 This is a cross-sectional view of the main parts of a modified endoscopic treatment device.

[0042] Figure 13This is a cross-sectional view of the main parts of a modified endoscopic treatment device.

[0043] Figure 14 This is a cross-sectional view of the main parts of a modified endoscopic treatment device.

[0044] Figure 15 This is a cross-sectional view of the main parts of a modified endoscopic treatment device. Detailed Implementation

[0045] (First Implementation)

[0046] The following is for reference Figures 1-3 The first embodiment of the endoscopic treatment device of the present invention will be described. Figure 1 This is an overall view of the endoscopic treatment device 1 of this embodiment. Figure 2 This is a cross-sectional view of the main parts of the endoscopic treatment device 1. Figure 2 The distal end is shown enlarged compared to the proximal portion. The endoscope is used by inserting the endoscope handling instrument 1 into the channel of the endoscope (not shown). Figure 1 As shown, the endoscope treatment device 1 has a treatment part 2 at the distal end and an operation part 4 at the proximal end.

[0047] The endoscopic treatment device 1 includes a sheath 10, an operating line 3, a high-frequency blade 2 (hereinafter referred to as "blade"), and an operating section 4. The operating section 4 is located at the proximal end of the flexible sheath 10. The blade 2 is located at the distal end of the operating line 3, which extends through the interior of the sheath 10. The blade 2 and the operating line 3 are configured to move forward and backward relative to the sheath 10 as the operating section 4 is operated. The blade 2 is configured to be energized with a high-frequency current via the operating section 4 and the operating line 3, enabling it to cut tissue, etc. A fluid delivery line is formed in the endoscopic treatment device 1 from the operating section 4 side to the distal end of the blade 2. The endoscopic treatment device 1 is configured to supply fluid to the fluid delivery line and deliver fluid from the distal end of the blade 2.

[0048] The operating wire 3 is made of a conductive metal material, such as stainless steel. A first conduit 31 is formed along the entire length of the operating wire 3. The operating wire 3 is, for example, a tightly wound coil. The operating wire 3 is covered by an insulating inner tube 6 along its entire length.

[0049] The sheath 10 is formed of an electrically insulating material, such as tetrafluoroethylene. The outer diameter of the sheath 10 is set to be large enough to pass through the channel of an endoscope (not shown). An operating line 3 passes through the sheath 10. The operating line 3 can move forward and backward in the direction along the length axis C of the sheath 10. The sheath 10 and the operating line 3 constitute an insertion portion that passes through the channel of the endoscope.

[0050] An insulating head 8 is inserted into the distal opening of the sheath 10. The insulating head 8 is fixed to the distal end of the sheath 10 using an adhesive (not shown). The insulating head 8 is formed of a heat-resistant and insulating material such as ceramic or resin. A through hole 82 is formed in the insulating head 8, which communicates with the internal space of the sheath 10 and is distally open. A stepped portion 83, formed by enlarging the opening of the through hole 82, is formed on the distal side of the insulating head 8. A recess 84 is formed that is recessed from the distal end of the insulating head 8 towards the proximal end. The outer diameter of the proximal portion of the insulating head 8 is large enough to be inserted into the distal end of the sheath 10. A large-diameter portion 85, which is larger than the proximal portion, is formed at the distal end of the insulating head 8. The outer diameter of the large-diameter portion 85 is approximately equal to the outer diameter of the sheath 10. The outer periphery of the large-diameter portion 85 on the distal side has a curved surface.

[0051] like Figure 2 As shown, the operating part 4 is located near the sheath 10. The operating part 4 includes an operating body 43 and a slider 44. The slider 44 is configured to slide relative to the operating body 43 along the length axis C. By moving the slider 44 forward and backward relative to the operating body 43, operations such as moving the blade 2 forward and backward relative to the sheath 10 can be performed.

[0052] The operating body 43 is fixed to the proximal end of the sheath 10. A slit 431 is formed in the operating body 43 along its length axis C. The slider 44 is able to slide relative to the operating body 43 along the slit 431. A hook ring 432 is provided at the proximal end of the operating body 43.

[0053] The slider 44 is provided with a hook-shaped ring 442. The slider 44 has an electrical connector 42. The electrical connector 42 is electrically connected to a high-frequency power supply device (not shown). The proximal end of the operating line 3 is electrically connected to the electrical connector 42.

[0054] Figure 3 This is a cross-sectional view along the length axis C of the distal end of the slider 44. The slider 44 has an insertion hole 441 for the operating line 3. The proximal end of the operating line 3 is inserted into the insertion hole 441 and fixed therein. Specifically, a pair of protrusions 443 for fixing the operating line 3 are formed within the insertion hole 441. The protrusions 443 protrude from the inner surface of the insertion hole 441 in a direction orthogonal to the length axis C. The protrusions 443 are generally cylindrical in shape. The protrusions 443 protrude to the extent that the outer peripheral surface of the proximal end of the operating line 3 inserted into the insertion hole 441 contacts the pair of protrusions 443.

[0055] like Figure 3As shown, a liquid delivery head 41 is provided on the sliding member 44. Although not shown in the figure, the liquid delivery head 41 is configured to allow for the attachment and removal of a liquid delivery component such as a syringe or a liquid delivery tube extending from a liquid delivery pump. The liquid delivery head 41 has an injection port 411. An injection passage 412 communicating between the liquid delivery head 41 and the insertion hole 441 is formed on the sliding member 44. An opening 33 for injecting liquid is formed at the proximal end of the operating line 3. The opening 33 is an opening communicating with the inside and outside of the operating line 3. The operating line 3 is fixed relative to the insertion hole 441 at the position opposite to the insertion hole 441 and the opening 33. As a result, a first conduit 31 is connected from the liquid delivery port 411 to the operating line 3. O-rings 444 are installed on each protrusion 443. The O-rings 444 maintain a watertight seal between the operating line 3 and the protrusions 443. When liquid flows from the liquid delivery head 41, the O-ring 444 is used to prevent liquid from leaking from the gap between the operating line 3 and the protrusion 443.

[0056] like Figure 2 As shown, a cylinder 5 is fixed to the distal end of the operating line 3. The cylinder 5 is a conductive cylindrical component, such as stainless steel. A third conduit 53 is formed on the cylinder 5 along its length axis C. The opening area of ​​the third conduit 53 is smaller than the opening area of ​​the first conduit 31 of the operating line 3. The proximal end of the cylinder 5 and the distal end of the operating line 3 are fixed together by a weld 11. The distal end of the operating line 3, the proximal end of the cylinder 5, and the weld 11 are covered by the distal end of the inner tube 6. As a result, the first conduit 31 and the third conduit 53 are watertightly connected. A spiral groove 54 is formed on the outer circumferential surface of the middle part of the cylinder 5 in the direction of the length axis C.

[0057] Knife 2 is an electrode component. For example... Figure 2 As shown, the blade 2 is connected to the distal end of the operating line 3 via the cylinder 5 and connector 7. The blade 2 is formed of a conductive material, such as stainless steel. The blade 2 is a tubular component extending along the length axis C. That is, the blade 2 is a tubular electrode with a second conduit 22 formed along the length axis C. The blade 2 has a large-diameter portion 24 and a small-diameter portion 25. The large-diameter portion 24 is located at the distal end of the blade 2. The small-diameter portion 25 is located in the region from the proximal end of the large-diameter portion 24 to the proximal end 23 of the blade 2. The second conduit 22, extending along the length axis C, is formed inside the blade 2. The second conduit 22 extends from the proximal end to the distal end of the blade 2 and opens at both the proximal and distal ends. The opening at the distal end of the blade 2 is a liquid delivery port 21. The liquid delivery port 21 opens in the large-diameter portion 24. The large-diameter portion 24 is radially thicker than the small-diameter portion 25.

[0058] The small-diameter portion 25 penetrates the through hole 82 of the insulating head 8. The outer diameter of the small-diameter portion 25 is smaller than the inner diameter of the recess 84 on the distal side of the through hole 82 of the insulating head 8, which is further from the stepped portion 83. In a direction orthogonal to the length axis C, the opening area of ​​the recess 84 is larger than the area of ​​the large-diameter portion 24. The blade 2 penetrates the insulating head 8 in a manner that allows it to move forward and backward relative to the insulating head 8. When the blade 2 retracts, the large-diameter portion 24 enters the recess 84.

[0059] The distal end of the cylinder 5 is inserted into the second conduit 22 of the blade 2. The cylinder 5 and the blade 2 are connected by a connector 7. The connector 7 is formed of a conductive metal material, such as stainless steel. The connector 7 has a through hole 72 extending along its length axis C. A spiral groove 71 is formed on the inner circumferential surface of the through hole 72 at the proximal end of the connector 7. The inner circumferential surface of the distal end 721 of the through hole 72 of the connector 7 has an opening size that allows the small-diameter portion 25 of the blade 2 (described later) to be inserted. The proximal end of the blade 2 is inserted into the distal end 721 of the through hole 72, and the blade 2 and the connector 7 are fixed together.

[0060] The cylindrical body 5 is inserted into the through hole 72 from the proximal side of the connector 7 and is threaded together using their helical grooves 54 and 71. The distal end of the cylindrical body 5 protrudes to a position further distal than the distal end of the connector 7. With the connector 7 and the cylindrical body 5 threaded together, the proximal end 23 of the blade 2 is inserted into the distal end 721 of the through hole 72. This example shows an instance where the connector 7 and the cylindrical body 5 are fixed by threads, but the method of joining the connector and the cylindrical body is not limited to threaded connection. For example, the connector and the cylindrical body can also be joined by adhesive or welding.

[0061] The blade 2 is connected to the electrical connector 42 via the connector 7, the cylinder 5, the welding part 11, and the operating line 3. As a result, the blade 2 is energized from the high-frequency power supply connected to the electrical connector 42 through the operating line 3, the welding part 11, the connector 7, and the cylinder 5.

[0062] like Figure 2 As shown, the opening area of ​​the third conduit 53 of the cylinder 5 is smaller than the opening area of ​​the first conduit 31 of the operating line 3 and the second conduit 22 of the blade 2. Therefore, the flow path of the liquid from the operating line 3 to the liquid inlet 21 of the blade 2 is temporarily narrowed in the third conduit 53. As a result, the liquid supplied to the first conduit 31 of the operating line 3 passes through the third conduit 53, thereby increasing the hydraulic pressure. The liquid with increased hydraulic pressure is conveyed from the liquid inlet 21 of the blade 2 through the second conduit 22. Consequently, even if the hydraulic pressure of the liquid supplied to the first conduit 31 is low, the momentum of the liquid in the second conduit 22 can be increased, allowing liquid to be delivered from the liquid inlet 21 in a state with enhanced momentum.

[0063] Next, the operation of the endoscopic treatment device 1 will be explained. For example, a user, such as a surgeon, inserts their fingers into the ring 432 of the operating body 31 and the ring 442 of the slider 44, and operates the endoscopic treatment device 1 by sliding the slider 44 relative to the operating body 43 in the direction along the length axis C with one hand.

[0064] By moving the slider 44 distally relative to the operating body 43, the operating line 3 is moved distally relative to the sheath 10. Consequently, the blade 2 protrudes to a position distal to the insulating head 8. At this time, when the slider 44 is pushed distally, as... Figure 2 As shown, the distal end face 74 of connector 7 abuts against the proximal end 81 of insulating head 8. As a result, blade 2 protrudes to its maximum protrusion position. That is, the protrusion position of blade 2 is positioned by connector 7 abutting against insulating head 8. The state in which connector 7 abuts against insulating head 8 and blade 2 protrudes to its farthest side is called the protrusion state.

[0065] In the protruding state, the distal portion of the small-diameter section 25 of the blade 2 can protrude through the through hole 82 of the insulating head 8 to a position further distal than the sheath 10. Physiological saline or other liquids are supplied to the first conduit 31 from the injection port 411 of the liquid delivery head 41. The liquid is transported to the distal side from the liquid delivery port 21 through the first conduit 31 of the operating line 3, the third conduit 53 of the cylinder 5, and the second conduit 22 of the blade 2.

[0066] By moving the slider 44 towards the proximal side relative to the operating body 43, the operating line 3 is retracted towards the proximal side relative to the sheath 10. As a result, the large-diameter portion 24 abuts against the recess 84 of the insulating head 8. As a result, the device is positioned in a retracted state where the small-diameter portion 25 of the blade 2 is housed within the internal space 10S of the sheath 10, and the operating line 3 is housed proximal to the proximal side.

[0067] Next, the operation of the endoscopic treatment device 1 of this embodiment will be described.

[0068] The distal portion of the sheath 10 of the endoscope treatment instrument 1 protrudes from the endoscope channel, for example, so that the blade 2 is positioned opposite the lesion mucosa portion within the body cavity that is the site of treatment.

[0069] A syringe or delivery tube (not shown) is installed at the injection port 411 of the delivery tube head 41. The user presses the blade 2 against the mucosa near the lesion and supplies saline solution contained in the syringe or delivery pump to the first tubing 31 of the operating line 3. At this time, the blade 2 can be either protruding or retracted. Saline solution is delivered distally from the delivery port 21 via the delivery tube. In the endoscopic treatment device 1, the fluid supplied to the first tubing 31 is delivered from the delivery port 21 after passing through the third tubing 53 and then through the second tubing 22. The opening area of ​​the third tubing 53 is smaller than that of the first tubing 31. Therefore, the fluid supplied to the first tubing 31 passes through the third tubing 53, thereby increasing the force of the fluid. Thus, fluid can be delivered from the delivery port 21 with a stronger force. As a result, when the delivery port 21 is pressed against the mucosa and submucosa of the lesion, the lesion swells.

[0070] Next, a high-frequency power supply device (not shown) connected to the electrical connector 42 of the operation unit 4 is energized to the knife 2 via the electrical connector 42, the operation line 3, and the connector 7.

[0071] Next, for example, as the blade 2 moves in a transverse direction orthogonal to the length axis C, the mucosa (tissue) in contact with the blade 2 is cut. After the diseased mucosa portion is completely cut in the circumferential direction, the blade 2 is brought against the incision formed around the diseased mucosa portion, and the entire diseased mucosa portion is removed and peeled off.

[0072] During mucosal incision and coagulation of bleeding points, due to capillary action, bodily fluids such as mucus and blood may sometimes enter the second conduit 22 of the blade 2 from the inlet 21. In this case, the incision and peeling performed with the blade 2 may cause the mucus and blood adhering to the second conduit 22 to char under the heat of the blade 2. The charring of the mucus and blood in the second conduit 22 narrows the fluid delivery path, making fluid delivery difficult. Therefore, fluid is delivered through the third conduit 53 with enhanced fluid momentum to remove the charred adhering material in the second conduit 22. As described above, the fluid with enhanced fluid momentum in the third conduit 53 is transported through the second conduit 22 from the inlet 21. As a result, the charred adhering material in the second conduit 22 is peeled off from the inner circumferential surface of the second conduit 22 under the action of fluid pressure and discharged from the inlet 21.

[0073] As explained above, the endoscopic treatment device 1 of this embodiment has a third conduit 53 between the first conduit 31 and the delivery port 21. The opening area of ​​the third conduit 53 is smaller than the opening area of ​​the first conduit 31 and the second conduit 22. As a result, the liquid supplied to the first conduit 31 passes through the third conduit 53, thereby increasing the liquid's momentum, and allowing the liquid to be delivered from the delivery port 21 in a state with enhanced liquid momentum. Using the endoscopic treatment device 1, even if the output of the syringe or delivery pump supplying liquid to the first conduit 31 is small, liquid can still be delivered from the delivery port 21 in a state with enhanced liquid momentum.

[0074] The endoscopic treatment device 1 of this embodiment, by providing a third conduit 53 with a smaller opening area compared to the first conduit 31 and the second conduit 22 between the distal end of the operating line 3 and the delivery port 21, allows for the delivery of saline or medication with a strong liquid flow from the delivery port 21 without the need for a high-performance delivery pump. As a result, local injection operations that cause swelling of the lesion by delivering fluid to the mucosa and submucosa become easier, eliminating the need to change treatment devices and shortening the operation time.

[0075] By using the endoscopic treatment device 1, liquid is delivered from the third line 53 with a strong liquid flow, making it easy to remove charred deposits from the second line 22. This prevents the second line 22 from becoming clogged with deposits.

[0076] The configuration of the third conduit 53 is not limited to the examples described above. Endoscopic instruments could also be, for example, [other types of instruments]. Figures 4-9 The modified example shown is as follows. In the following description, the same reference numerals are used for the same parts as in the first embodiment, and their descriptions are omitted; only the differences are described.

[0077] Figure 4 The example shown differs from the first embodiment in the structure of the operating line 3A, connector 7A, and cylinder 5A. The operating line 3A is a flexible tube made of conductive material. Since the first conduit 31 of the operating line 3A can be kept watertight, the inner tube 6 is not necessary. In the first embodiment, an example is shown where the cylinder 5 partially protrudes closer to the position of the connector 7 and connects to the operating line 3. However, the third conduit 53A only needs to be located between the distal end of the operating line 3 and the liquid inlet 21. For example, it could also be as follows... Figure 4 As shown, by embedding the cylinder 5A into the proximal end of the second conduit 22 of the blade 2A, a third conduit 53A with a smaller opening area compared to the first conduit 31 and the second conduit 22 is configured.

[0078] In the first embodiment, an example is shown where the cylinder 5 is fixed to the operating line 3, the connector 7 and the proximal end of the blade 2 are fixed, and the connector 7 and the cylinder 5 are threaded together, thus connecting the cylinder and the blade 2. The configuration of connecting the operating line 3 and the blade 2 using the connector 7 is not limited to this example. For example, it can also be done as follows... Figure 4 As shown, the distal end of the operating line 3A and the proximal end of the blade 2A are fixed by passing through the through hole 72 of the connector 7A. In this structural example, the operating line 3A and the blade 2A can abut against the connector 7A to conduct electricity. In this case, it is also possible to... Figure 4 As shown, the inner tube 6 of the first embodiment is not provided. According to this structure, similar to the first embodiment, the hydraulic pressure of the liquid in the third pipeline 53A can be increased to deliver liquid from the delivery port 21 in a state with enhanced liquid momentum.

[0079] Figure 5 The example shown is one where the structure of the proximal end of the operating line 3B, connector 7B, cylinder 5B, insulating head 8B, and blade 2B differs from that of the first embodiment. The structure of the operating line 3B, connector 7B, and cylinder 5B differs from that of the first embodiment. Figure 4 The variant shown is the same. The proximal end 26 of the blade 2B has a larger diameter than the small diameter portion 25. A stepped portion 27 is formed between the small diameter portion 25 and the proximal end 26. In a direction orthogonal to the length axis C, the thickness of the proximal end 26 is greater than the thickness of the small diameter portion 25. A receiving portion for the cylinder 5B is formed in the second conduit 22 of the proximal end 26. In the proximal end 26, the opening area of ​​the second conduit 22 is slightly larger than the opening area of ​​other areas, configured to allow the cylinder 5B to be embedded.

[0080] A recess 821 is formed at the proximal end of the insulating head 8B, recessed towards the distal side. The recess 821 has a larger opening size than the through hole 82 of the insulating head 8, and forms a stepped portion 822. Figure 5 In the example shown, when the blade 2B is pushed out, the stepped portion 27 of the proximal end 26 of the blade 2B abuts against the stepped portion 822 of the recess 821 of the insulating head 8B. As a result, the blade 2 is positioned at its maximum protrusion relative to the sheath 10. Figure 5 The treatment device shown in the modified example is also capable of delivering liquid from the liquid inlet 21 in a state where the momentum of the liquid is enhanced in the third pipeline 53B, just like in the first embodiment.

[0081] The connector 7 and the cylinder 5 shown in the first embodiment are not essential structures. Alternatively, they can be like... Figure 6As shown in the example, a second conduit 22 and a third conduit 53C are continuously formed on the blade 2C. The blade 2C has a third conduit 53C with a smaller opening area compared to the second conduit 22 and the first conduit 31 of the operating line 3 on the proximal end side of the second conduit 22. In this case, the proximal end of the blade 2 and the distal end of the operating line 3 can also be fixed together by the welding part 11. Figure 6 The treatment device shown in the modified example can deliver liquid from the liquid inlet 21 in the same manner as the first embodiment, with the liquid momentum enhanced in the third pipeline 53C.

[0082] exist Figure 7 In the example shown, with Figure 6 Similarly, in the variant shown, the third conduit 53D is integrally formed on the blade 2D. The shape of the third conduit 53D is the same as... Figure 6 The modified example shown is the same. An inclined surface 29 is formed between the proximal end of the third conduit 53D and the proximal end of the blade 2D. The inclined surface 29 is a wedge-shaped inclined surface that narrows from the proximal end of the blade 2D toward the proximal end of the third conduit 53D. With this structure, liquid can be smoothly delivered from the first conduit 31 to the third conduit 53D, and pressure loss can be reduced. Figure 7 The treatment device shown in the modified example is also able to deliver liquid from the liquid inlet 21 in a state in which the momentum of the liquid is enhanced in the third pipeline 53D, just like the first embodiment.

[0083] In the first embodiment, an example is shown where a first conduit 31 is located inside the operating line 3, but it is also possible for the first conduit 31 to be provided independently of the operating line. The first conduit and the third conduit are not each limited to a single conduit. Alternatively, it can be like... Figure 8 and Figure 9 As shown in the example, multiple delivery tubes 9 are set independently relative to operation line 3. Figure 8 and Figure 9In the modified example shown, three delivery tubes 9 are arranged around the operating line 3. The distal end of the operating line 3 is fixed to the connector 7E. The proximal end of the blade 2E is fixed to the connector 7E. As a result, the blade 2E is energized by means of the operating line 3 and the connector 7E. A connecting tube 73 is formed within the connector 7E. The connecting tubes 73 are formed in the same number as the delivery tubes 9. The proximal end of each connecting tube 73 is connected to each delivery tube 9. The connecting tubes 73 have three openings in the circumferential direction of the connector 7E at the proximal end of the connector 7E, inclined towards the distal end of the connector 7E. The three connecting tubes 73 merge at the distal end of the connector 7E. A third tube 53E is formed on the distal side of the merging portion of the three delivery tubes 9. The third tube 53E is formed at the connection between the connector 7E and the blade 2E. The opening area of ​​the third tube 53E is smaller than the opening area of ​​the merging portion of the connecting tubes 73. According to this structure, the diameter of the liquid delivery line is reduced in the third line 53E, just like in the first embodiment, so that liquid can be delivered from the liquid delivery port 21 of the blade 2E in a state with enhanced liquid momentum.

[0084] (Second Implementation)

[0085] Reference Figures 10-12 The endoscopic treatment device 1F according to the second embodiment is described. The endoscopic treatment device is not limited to a high-frequency ablation device; it can be applied to endoscopic treatment devices with functions of fluid delivery and electrical conduction. For example... Figure 10 As shown, the endoscopic treatment device 1F of this embodiment is an example where the treatment part is forceps 2F. The structure of the operating part 4, the sheath 10, the operating line 3, and the inner tube 6 is the same as in the first embodiment.

[0086] The pliers 2F have a pair of plier members 211, 212, a pair of connecting rod members 213, 214, multiple rotating shafts 216, 217, 218, a shaft member 215, a cover 228, and a stop 227. The pliers 2F have a known linkage mechanism. The cover 228 and the stop 227 are integrally formed. A through hole 229 extending along the length axis C is formed in the stop 227. A second conduit 22F is formed inside the shaft member 215. The proximal end of the shaft member 215 is fixed to the distal end of the operating line 3. A cylinder 5F is inserted into the proximal end of the second conduit 22F. A third conduit 53F of the cylinder 5F is disposed on the distal side of the first conduit 31 of the operating line 3, and a second conduit 22F is formed on the distal side of the third conduit 53F.

[0087] Linkage members 213 and 214 are connected to the distal end of shaft member 215 via proximal rotation shaft 218. Distal rotation shaft 216 passes through a pair of clamp members 211 and 212 and connects to cover 228. A through hole 216F is formed in the distal rotation shaft 216, extending along the length axis C. The opening area of ​​through hole 216F is equal to the opening area of ​​the second conduit 22F inside shaft member 215, and through hole 216F functions as an extension of the second conduit 22F. Therefore, the distal end of through hole 216F functions as a liquid delivery port 21F.

[0088] In the insulating head 8F, an enlarged diameter portion 823 is formed at the middle of the length axis C of the through hole 82. A stop member 227 is housed in the enlarged diameter portion 823. The stop member 227 limits the range of movement of the cover 228 relative to the length axis C of the insulating head 8F.

[0089] When the operating line 3 moves forward or backward relative to the sheath 10, the shaft member 215 moves forward or backward relative to the cover 228. A pair of clamp members 211, 212 are rotatably connected to the cover 228 via a remote rotating shaft 216. The result is that, Figure 11 As shown, as the operating line 3 advances, the proximal rotating shaft 218 approaches the distal rotating shaft 216, and a pair of clamping members 211, 212 open. In this state, liquid is supplied through the liquid delivery head 41, as in the first embodiment. Liquid is delivered from the distal end of the shaft member 215 through the first conduit 31, the third conduit 53F, and the second conduit 22F. The liquid delivered from the distal end of the shaft member 215 is delivered to the distal side through the liquid delivery port 21F provided at the distal end of the through hole 216F of the distal rotating shaft 216, between the opened pair of clamping members 211, 212. When the operating line 3 is retracted, the proximal rotating shaft 218 moves towards the proximal side and away from the distal rotating shaft 216, as... Figure 10 As shown, a pair of clamp components 211 and 212 are closed.

[0090] The endoscope treatment device 1F using the second embodiment, like the first embodiment, is able to deliver liquid from the delivery port 21F in a state where the momentum of the liquid is enhanced in the third conduit 53F.

[0091] The cylindrical body in this embodiment is not limited to the structure described above. For example, it could also be... Figure 12 and Figure 13 The pattern of the variant example shown. In Figure 12 In the example shown, the cylinder 5F is located at the distal end of the shaft member 215. Figure 12 In the example shown, the third conduit 53F is located on the distal end side of the shaft member 215. The distal end of the cylinder 5F protrudes to a position further distal than the distal end of the shaft member 215.

[0092] according to Figure 12 The modified example shown, similar to the second embodiment, involves supplying liquid to the distal side via a liquid delivery port 21F provided at the distal end of the through hole 216F through a liquid delivery port 21F located between the open pair of clamp members 211 and 212, with the liquid momentum enhanced in the third conduit 53F. By providing the third conduit 53F at the distal end of the shaft member 215, liquid can be supplied with enhanced liquid momentum at the distal portion of the device.

[0093] Figure 13 The variation shown is a cylinder with a 5H ratio. Figure 12 The example shown is a modified cylinder with a length of 5F. For example... Figure 13 As shown, the elongated cylinder 5H can also protrude to the vicinity of the distal rotation shaft 216. In this case, when the pair of clamping members 211, 212 are open, the distal end of the cylinder 5H protrudes to a position further distal than the distal rotation shaft 216. As a result, liquid can be delivered with enhanced liquid momentum at a more distal position while the pair of clamping members 211, 212 are open. Figure 13 The modified example shown can deliver liquid from the liquid outlet 21H in a state where the liquid momentum is enhanced in the third pipeline 53H, just like the second embodiment.

[0094] In the above embodiments, examples of high-frequency knives 2A to 2E are shown as endoscopic treatment devices, but endoscopic treatment devices are not limited to the examples described above. For example, they could also be... Figure 14 and Figure 15 The endoscopic instruments illustrated. Figure 14 and Figure 15In the high-frequency processing apparatus 2G shown, the structure of the distal end differs from that of the high-frequency blades 2A to 2E described above. The large-diameter portion 24G of the high-frequency processing apparatus 2G has a distal end member 244 and an energized portion 241. The distal end member 244 is disposed at the distal end of the large-diameter portion 24G. The distal end member 244 is formed, for example, from an insulating spherical member such as zirconium oxide or ceramic. The energized portion 241 is provided at the proximal end of the distal end member 244. The energized portion 241 is formed, for example, from a conductive metal material such as stainless steel, and has an annular proximal end 242 and a cylindrical portion 243. The cylindrical portion 243 protrudes from the proximal end 242 toward the distal side. The cylindrical portion 243 is inserted into the distal end member 244 and fixed. The distal end of the small-diameter portion 25G is inserted into the cylindrical portion 243 and fixed. The outer periphery (outer edge) 245 of the proximal end 242 of the energized section 241 is exposed along the outer peripheral surface of the proximal end of the distal end member 244. The energized section 241 is energized with a high-frequency current via the operating line 3G, connector 7G, and small-diameter section 25G. When energized, the outer periphery 245 of the proximal end 242 of the energized section 241 is configured to contact tissues, etc., and thus be able to cut tissues, etc. The cylinder 5G is inserted into the proximal end of the small-diameter section 25G. Liquid that has passed through the first conduit 31 is transported in a state where the liquid momentum is enhanced in the third conduit 53G, and is transported from the delivery port 21 via the second conduit 22G.

[0095] In the above embodiments, an example of using physiological saline is shown, but the fluid is not limited to this and may also be a drug solution, etc.

[0096] Using the endoscopic treatment device 1 described above, liquid can be delivered from the delivery port 21 with enhanced liquid momentum in the third tubing 53. Therefore, even if the delivery component connected to the delivery tube head 41 of the operation unit 4 is a low-pressure or low-flow syringe, a low-performance delivery pump, etc., liquid can be delivered from the delivery port 21 with a strong liquid momentum. Consequently, local injection operations can be performed without changing the high-frequency knife and local injection needle, thus shortening the treatment time.

[0097] Because liquid can be delivered from the delivery port 21 with enhanced liquid momentum, even when blood or mucous membranes enter the second conduit 22 of the knife 2, the delivery of fluid can remove objects that have adhered and burned due to repeated electrostatic discharge. As a result, it is possible to prevent the delivery conduit from being blocked by burnt deposits.

[0098] The foregoing has described various embodiments of the present invention, but the scope of protection of the present invention is not limited to the above embodiments. Various changes can be made to the combination of constituent elements of each embodiment, or various modifications can be applied to or deleted from each constituent element, without departing from the spirit of the present invention. The present invention is not limited by the foregoing description, but only by the scope of the appended claims.

[0099] Industrial availability

[0100] This provides an endoscopic treatment device that can deliver liquids such as medications and saline solution from the distal end of the device with a strong liquid force without using a high-performance delivery pump.

[0101] Explanation of reference numerals in the attached figures

[0102] 1. 1A. Endoscopic treatment instrument; 2. High-frequency knife (treatment section); 2F. Forceps (treatment section); 3. Operating line (tube component); 5. Cylinder; 7. Connector; 10. Sheath; 411. Injection port (supply port); 31. First tubing; 22. Second tubing; 53. Third tubing; 21. Liquid delivery port.

Claims

1. An endoscopic treatment device, wherein, The endoscopic handling apparatus includes: jacket; A tubular component, extending freely within the sheath, having a first conduit; and The treatment section, connected to the distal end of the tubular component, has a second conduit and a liquid inlet for conveying fluid; the treatment section is conductive. The treatment unit has a third conduit located between the liquid inlet and the distal end of the tubular component. The first pipeline and the second pipeline are connected via the third pipeline. The opening area of ​​the third pipe is smaller than the opening area of ​​the first pipe and the opening area of ​​the second pipe. The distal end of the third conduit is located inside the second conduit.

2. The endoscopic treatment device according to claim 1, wherein, The distal end of the third conduit is located on the distal side compared to the proximal end of the second conduit.

3. The endoscopic treatment device according to claim 1, wherein, The distal end of the third conduit is located closer to the distal end than the distal end of the second conduit. A stepped portion is formed between the distal end of the third conduit and the second conduit.

4. The endoscopic treatment device according to claim 3, wherein, The stepped portion is located at the proximal end of the second pipeline.

5. The endoscopic treatment device according to claim 1, wherein, The third conduit is connected to the distal end of the pipe component.

6. The endoscopic treatment device according to claim 5, wherein, The third conduit, connected to the distal end of the tubular member, is inserted into the second conduit.

7. The endoscopic treatment device according to claim 1, wherein, The endoscopic treatment device includes a cylinder having the third tubing. The distal end of the cylinder is inserted into the second pipeline of the treatment unit.

8. The endoscopic treatment device according to claim 1, wherein, The third conduit is formed on the proximal side of the second conduit in the treatment unit.

9. The endoscopic treatment device according to claim 1, wherein, An inclined surface is formed between the proximal end of the third conduit and the first conduit.

10. The endoscopic treatment device according to claim 1, wherein, The sheath has an insulating head at the distal end, which is heat-resistant and insulating. The processing part is a high-frequency knife that penetrates the insulating head and can move forward and backward relative to the sheath.

11. The endoscopic treatment device according to claim 10, wherein, The endoscopic handling apparatus also includes: A cylindrical body having the third conduit; and The connector, which connects the cylinder and the high-frequency blade, is made of a conductive material. The high-frequency knife is positioned at the protruding position of the sheath by abutting the connector and the insulating head.

12. The endoscopic treatment device according to claim 10, wherein, The endoscopic procedure also includes a connector that connects the tubular component and the high-frequency blade, and is made of a conductive material. The high-frequency knife is positioned at the protruding position of the sheath by abutting the connector and the insulating head.

13. The endoscopic treatment device according to claim 10, wherein, The high-frequency knife has the following characteristics: The distal end member, which is insulating, has the liquid inlet formed thereon; and An electrically conductive portion is disposed at the proximal end of the distal end member, the outer edge of which is exposed on the proximal side of the distal end member.

14. The endoscopic treatment device according to claim 1, wherein, The treatment unit has a pair of clamp components and a shaft component on the distal side of the pair of clamp components. The second conduit is formed on the shaft member.

15. The endoscopic treatment device according to claim 1, wherein, The processing part is a knife, and has a large-diameter portion located at the distal end of the knife and a small-diameter portion located in a region closer to the proximal end of the knife than the large-diameter portion. The second conduit extends from the proximal end of the blade to the distal end, and the liquid delivery port opens at the large diameter portion.

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