Treatment instrument

Abstract

The treatment device includes: a flexible sheath; a rod disposed at the front end of the sheath in a protruding manner, having a first electrode through which a high-frequency current is passed; a conductive second electrode disposed at the front end of the sheath in a deformable manner; and an operating part disposed at the base end of the sheath to move the rod forward and backward, wherein the second electrode is energized by contacting the first electrode of the rod, and the second electrode is deformed by contacting the first electrode of the rod.

Description

Technical Field

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

[0002] Previously, endoscopic procedures such as ESD (endoscopic submucosal dissection) used endoscopic instruments for cutting and dissecting, such as high-frequency knives. In cases of bleeding during surgery, these instruments needed to be temporarily removed from the body cavity and replaced with hemostatic instruments for endoscopic hemostasis.

[0003] Patent Document 1 discloses an endoscopic high-frequency treatment device capable of performing tissue incision, dissection, and hemostasis. The endoscopic high-frequency treatment device disclosed in Patent Document 1 can perform incision, dissection, and hemostasis without changing the treatment device.

[0004] Existing technical documents

[0005] Patent documents

[0006] Patent Document 1: Japanese Patent Application Publication No. 2013-111308 Summary of the Invention

[0007] The problem the invention aims to solve

[0008] However, the high-frequency treatment device for endoscopes described in Patent Document 1 cannot adjust the shape of the front end through which the high-frequency current is passed in during the treatment of cauterizing the bleeding site to stop bleeding, making it difficult to perform hemostasis treatment corresponding to the size of the bleeding site.

[0009] Based on the above, the object of the present invention is to provide a treatment device capable of performing incision, dissection and hemostasis, which can perform appropriate hemostasis corresponding to the size of the bleeding site.

[0010] Solution for solving the problem

[0011] To address the above problems, the present invention proposes the following solution.

[0012] The first technical solution of the present invention includes a treatment device comprising: a sheath having flexibility; a rod disposed at the front end of the sheath in a manner that allows it to protrude and be inserted, having a first electrode at the front end through which a high-frequency current is passed; a second electrode disposed at the front end of the sheath in a deformable manner and having conductivity; and an operating part disposed at the base end of the sheath, which causes the rod to move forward and backward, wherein the second electrode is energized by contacting the first electrode of the rod, and the second electrode is deformed by contacting the first electrode of the rod.

[0013] The effects of the invention

[0014] Using the treatment device of the present invention, it is possible to perform incision, dissection and hemostasis, and to perform appropriate hemostasis according to the size of the bleeding site. Attached Figure Description

[0015] Figure 1 This is an overall diagram of the endoscopic treatment system according to the first embodiment.

[0016] Figure 2 This is an overall diagram showing the treatment apparatus of the endoscopic treatment system according to the first embodiment.

[0017] Figure 3 This is a perspective view of the front end of the treatment device according to the first embodiment.

[0018] Figure 4 These are a front view and a sectional view along the length of the front end of the treatment device according to the first embodiment.

[0019] Figure 5 This is a front view and a cross-sectional view along the length of the front end of the treatment device of the first embodiment in the state of deformation of the second electrode.

[0020] Figure 6 This is a front view and a cross-sectional view along the length of the front end of the treatment device of the first embodiment in a state where the second electrode is further deformed.

[0021] Figure 7 This is a front view and a cross-sectional view along the length of the front end of the treatment device of the first embodiment, showing the second electrode in the state of maximum deformation.

[0022] Figure 8 This is a top view of the operating section of the treatment device according to the first embodiment.

[0023] Figure 9 The operation section of the first embodiment is along Figure 8 A cross-sectional view of the X-ray.

[0024] Figure 10 The operation section of the first embodiment is along Figure 9 A cross-sectional view of the Y-Y line.

[0025] Figure 11 The operation section of the first embodiment is along Figure 9 A cross-sectional view of the Y-Y line.

[0026] Figure 12 This is a diagram showing a first embodiment of a handling device in which the sliding member of the operating part of the first embodiment is fixed to the front end side.

[0027] Figure 13 This is a diagram showing a first embodiment of a treatment device in which the sliding member of the operating part of the first embodiment is fixed to the base end side.

[0028] Figure 14 This is a perspective view of the front end of the treatment device according to the second embodiment of the present invention.

[0029] Figure 15 This is a cross-sectional view along the length of the front end of the treatment device according to the second embodiment.

[0030] Figure 16 This is a cross-sectional view along the length of a modified example of the second electrode of the treatment device according to the second embodiment.

[0031] Figure 17 This is a cross-sectional view along the length of the front end of the treatment device according to the third embodiment of the present invention.

[0032] Figure 18 This is a cross-sectional view along the length of the front end of the treatment device according to the fourth embodiment of the present invention.

[0033] Figure 19 This is a cross-sectional view along the length of the treatment device of the fourth embodiment in the state of deformation of the second electrode.

[0034] Figure 20 These are a front view and a sectional view along the length of the front end of the treatment device according to the fifth embodiment of the present invention.

[0035] Figure 21 This is a cross-sectional view along the length of the front end of the treatment device in the fifth embodiment, with the second electrode in a state where deformation has begun.

[0036] Figure 22 This is a cross-sectional view along the length of the front end of the treatment device in the fifth embodiment, with the second electrode further deformed.

[0037] Figure 23 This is a perspective view of the second locking mechanism of the operating section of the treatment device according to the sixth embodiment of the present invention.

[0038] Figure 24 This is a diagram showing the operation section of the sixth embodiment, which uses the second locking mechanism of the sixth embodiment to fix the position of the slider to the front end side.

[0039] Figure 25 This is a diagram showing the operation section of the sixth embodiment, in which the position of the slider is fixed to the base end side using the second locking mechanism of the sixth embodiment. Detailed Implementation

[0040] (First Implementation)

[0041] Reference Figures 1 to 13 The endoscopic treatment system 300 of the first embodiment of the present invention is described. Figure 1 This is an overall view of the endoscopic treatment system 300 of this embodiment.

[0042] [Endoscopic Handling System 300]

[0043] like Figure 1 As shown, the endoscopic treatment system 300 includes an endoscope 200 and a treatment device 100. The treatment device 100 is inserted into the endoscope 200 for use.

[0044] [Endoscope 200]

[0045] The endoscope 200 is a known flexible endoscope, including an insertion part 202 inserted into the body from the tip and an operating part 207 mounted on the base of the insertion part 202.

[0046] The insertion part 202 includes a camera part 203, a curved part 204, and a flexible part 205. The camera part 203, the curved part 204, and the flexible part 205 are arranged sequentially from the front end of the insertion part 202. A channel 206 for inserting the treatment device 100 is provided inside the insertion part 202. A front opening 206a of the channel 206 is provided at the front end of the insertion part 202.

[0047] The camera unit 203 is equipped with an imaging element such as a CCD or CMOS, and can capture images of the part that is being processed. The camera unit 203 can capture images of the electrode part 3 of the processing device 100 when it protrudes from the front opening 206a of the channel 206.

[0048] The bending portion 204 bends as the operator operates the operating portion 207. The flexible portion 205 is a flexible tubular part.

[0049] The operating unit 207 is connected to the flexible part 205. The operating unit 207 includes a handle 208, an input unit 209, a base opening 206b of the channel 206, and a universal cable 210. The handle 208 is the part held by the operator. The input unit 209 receives operational input for bending the bending part 204. The universal cable 210 outputs images captured by the camera unit 203 to the outside. The universal cable 210 is connected to a display device such as a liquid crystal display via an image processing device equipped with a processor.

[0050] [Treatment equipment 100]

[0051] Figure 2 This is an overall drawing of the treatment device 100.

[0052] Treatment device 100 is a treatment device capable of performing incision, dissection, and hemostasis. Treatment device 100 includes a sheath 1, a rod 2, an electrode 3, and an operating line 4 (shown in the figure). Figure 4 (A1) and (A2) the operating part 5. In the following description, the side of the treatment device 100 that is inserted into the patient's body along the length direction A will be referred to as the "front end side (A1)" and the side of the operating part 5 will be referred to as the "base end side (A2)".

[0053] The sheath 1 is formed of an electrically insulating material such as tetrafluoroethylene, and is a flexible, longitudinally elongated member extending from the front end 1a to the base end 1b. The sheath 1 has an outer diameter capable of being inserted into the channel 206 of the endoscope 200. Figure 1 As shown, when the sheath 1 is inserted into the channel 206, the front end 1a of the sheath 1 can protrude into the channel 206 relative to the front opening 206a of the channel 206.

[0054] Figure 3 This is a perspective view of the front end of the treatment device 100.

[0055] Rod 2 is a roughly cylindrical component made of stainless steel or other metal material, and is disposed at the front end 1a of the sheath 1 in a manner that allows it to protrude and be embedded. Rod 2 has a rod body 20, a first electrode 21, and a stop 22.

[0056] Figure 4 These are the front view of the front end of the handling device 100 and the sectional view along the length direction A.

[0057] Rod 2 extends through electrode section 3 along length direction A in a manner that allows it to move forward and backward. The central axis O2 of rod 2 along length direction A is approximately aligned with the central axis O1 of sheath 1 along length direction A.

[0058] The rod body 20 is a cylindrical component made of metal raw materials such as stainless steel. An insulating coating 20a is applied to the front end of the rod body 20. The operating line 4 is mounted to the base end of the rod body 20 by means of a stop 22. The rod body 20 supplies high-frequency current from the operating line 4, which is connected to the operating part 5, to the first electrode 21.

[0059] The first electrode 21 is a circular conductive member located at the front end of the rod body 20. In a frontal view taken from a direction horizontal to the length direction A, the outer periphery of the first electrode 21 and the outer periphery of the rod body 20 are concentric circles. The radial length L1 of the first electrode 21, perpendicular to the length direction A, is longer than the radial length L2 of the rod body 20. The portion of the first electrode 21 and the rod body 20 exposed at the front end of the second electrode 32 functions as a high-frequency electrode for introducing high-frequency current into biological tissue, primarily for cutting and peeling procedures. However, depending on the situation, hemostasis can also be performed.

[0060] The first electrode 21 has a first hemostatic treatment surface S1 on its front end side A1, which is perpendicular to the length direction A. The first hemostatic treatment surface S1 is used for hemostasis when the first electrode 21 and the second electrode 32 are in contact. The first hemostatic treatment surface S1 can be formed as a plane or as a curved surface.

[0061] A stop 22 is provided on the outer periphery of the rod body 20 and the operating line 4, connecting the rod body 20 and the operating line 4. Furthermore, the stop 22 limits the length of the rod body 20 exposed from the front end of the second electrode 32. As a result, the amount of protrusion of the first electrode 21 is also limited. Figure 4 As shown, the stop member 22 restricts the amount of protrusion of the first electrode 21 by engaging with the electrode portion 3 provided at the front end 1a of the sheath 1.

[0062] The electrode part 3 is located at the front end 1a of the sheath 1. The electrode part 3 has a support member 31 and a second electrode 32.

[0063] The support member 31 is formed from metallic raw materials such as stainless steel or insulating raw materials such as ceramic. The support member 31 is fixed to the front end 1a of the sheath 1 and serves to support the second electrode 32. The support member 31 is fixed to the front end 1a of the sheath 1 by welding, adhesive, or other means. The support member 31 has a through hole 31a through which the rod 2 passes. The support member 31 is formed from a raw material harder than the second electrode 32, allowing the second electrode to easily deform radially under the retraction of the first electrode, preventing it from moving inward into the sheath 1.

[0064] The second electrode 32 is a hollow component with conductivity and elasticity, formed of, for example, conductive silicone rubber. The second electrode 32 is fixed to the front end of the support member 31 by welding, adhesive, or the like. The second electrode 32 has a through hole 32b through which the rod 2 passes.

[0065] like Figure 4 As shown, the second electrode 32 is formed into a hemispherical shape without external force. Specifically, the second electrode 32 is formed into a hemispherical shape with a convex front end A1 without external force. In this embodiment, the convex front end 32a, which protrudes most towards the front end A1, is located near the central axis O3 in the length direction A of the second electrode 32.

[0066] The through hole 32b opens at the convex front end 32a, which protrudes most towards the front end side A1. The protrusion of the second electrode 32 towards the front end side A1 increases as it approaches the through hole 32b. The through hole 32b is formed along the central axis O3 in the length direction A of the second electrode 32.

[0067] The radial length L3 of the through hole 32b is longer than the radial length L2 of the rod body 20. Therefore, the rod body 20 can move forward and backward along the length direction A in the through hole 32b. In the following description, moving the rod 2 towards the front end side A1 is called "forward", and moving the rod 2 towards the base end side A2 is called "backward".

[0068] Figure 5 These are a front view and a cross-sectional view along the length direction A of the treatment device 100 with the second electrode 32 deformed. The radial length L1 of the first electrode 21 is longer than the radial length L3 of the through hole 32b. Therefore, when the first electrode 21 retracts, it contacts the front end 32a of the second electrode 32. The second electrode 32 deforms upon contact with the first electrode 21. When the first electrode 21 advances and separates from the second electrode 32, the second electrode 32 returns to its original shape. In the following description, the original shape of the second electrode 32 will also be referred to as the "initial shape" of the second electrode 32.

[0069] An insulating coating 20a is applied to the front end of the rod body 20, so that even if the front end of the rod body 20, through which a high-frequency current is applied, comes into contact with the second electrode 32, no current flows from the rod body 20 to the second electrode 32. On the other hand, when the first electrode 21 and the second electrode 32, through which a high-frequency current is applied, come into contact, a high-frequency current flows from the first electrode 21 to the second electrode 32. In this state, the second electrode 32 functions as a high-frequency electrode that applies a high-frequency current to biological tissue, primarily for hemostasis.

[0070] like Figure 5 As shown, the second electrode 32 is deformed by being pressed by the retracted first electrode 21. Specifically, the curvature of the front end 32a of the deformed second electrode 32 is smaller compared to the initial shape. As a result, a second hemostatic treatment surface S2 with a smaller curvature is formed on the front end side A1.

[0071] The first hemostatic treatment surface S1 and the second hemostatic treatment surface S2 form a hemostatic treatment surface S that facilitates hemostasis treatment of bleeding sites positioned face-up in the longitudinal direction A. The hemostatic treatment surface S is preferably formed as a generally coplanar plane or curved surface.

[0072] Figure 6 This is a front view and a cross-sectional view along the length direction A of the treatment device 100 in a further deformed state of the second electrode 32. The second hemostatic treatment surface S2 increases in size as the contacting first electrode 21 retracts.

[0073] Figure 7These are a front view and a cross-sectional view along the length direction A of the treatment device 100 with the second electrode 32 at its maximum deformation. In the front view, viewed from a direction horizontal to the length direction A, the second electrode 32 is deformed to its maximum radial length compared to the radial length of the sheath 1. The second hemostatic treatment surface S2 has its minimum curvature and its maximum area when it is at its maximum retraction from the first electrode 21.

[0074] The operating line 4 is made of stainless steel or other metal raw materials and runs through the internal space 10 of the sheath 1. The front end of the operating line 4 is connected to the rod 2, and the base end of the operating line 4 is connected to the operating part 5.

[0075] Figure 8 This is a top view of the operating unit 5.

[0076] The operating unit 5 includes an operating unit body 51, a sliding member 52, a power supply connector 53, and a locking mechanism 54.

[0077] The front end of the operating part body 51 is connected to the base end 1b of the sheath 1. The operating part body 51 has an internal space 50 through which the operating line 4 can pass. The operating line 4 extends to the slider 52 through the internal space 10 of the sheath 1 and the internal space 50 of the operating part body 51.

[0078] The slider 52 is mounted to the operating unit body 51 in a manner that allows it to move along the length direction A relative to the operating unit body 51. The base end of the slider 52 is connected to the operating line 4. The operator moves the slider 52 forward and backward relative to the operating unit body 51, thereby moving the operating line 4 and the rod 2 forward and backward relative to the sheath 1. A power connector 53 is fixed to the slider 52.

[0079] The power connector 53 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 4. The power connector 53 can supply high-frequency current from the high-frequency power supply device to the first electrode 21 via the operating line 4 and the rod body 20.

[0080] Figure 9 It is along the operation unit 5 Figure 8 A cross-sectional view of the X-ray.

[0081] The locking mechanism 54 fixes the protruding position of the rod 2 by fixing the position of the slider 52 in the longitudinal direction A. The locking mechanism 54 has an engaging groove 55 and a movable engaging part 56.

[0082] like Figure 8 and Figure 9As shown, the engaging groove 55 has multiple grooves 55a formed in the operating part body 51. Each groove 55a has a width direction B perpendicular to the length direction A as its depth direction and opens into the interior space 50 side of the operating part body 51. Multiple grooves 55a are arranged in the length direction A.

[0083] like Figure 9 As shown, the movable engaging portion 56 is mounted on the slider 52. The movable engaging portion 56 is elastic and can move between a first position P1 as the initial position and a deformed second position P2. In the front view viewed from the width direction B perpendicular to the length direction A, the movable engaging portion 56 is formed in an L-shape and has a pressing portion 56a protruding relative to the slider 52.

[0084] Figure 10 It is along the operation unit 5 Figure 9 A cross-sectional view of the Y-Y line.

[0085] Figure 10 The movable engaging portion 56 shown is in a state without external force, positioned at the first position P1 as its initial position. The movable engaging portion 56 has a protrusion 56b protruding along the width direction B. When the movable engaging portion 56 is in the first position P1, the protrusion 56b engages with any of the plurality of slots 55a. As a result, the position of the slider 52 in the length direction A is fixed.

[0086] Figure 11 It is along the operation unit 5 Figure 9 A cross-sectional view of the Y-Y line.

[0087] Figure 11 The movable engaging portion 56 shown is pushed by the surgical operator toward the pressing portion 56a towards the slider 52, and positioned in the second position P2. When the movable engaging portion 56 is in the second position P2, the protrusion 56b does not engage with any of the plurality of slots 55a. As a result, the position of the slider 52 in the longitudinal direction A is not fixed.

[0088] The surgeon pushes the pressing part 56a closer to the slider 52, causing the movable engaging part 56 to move to the second position P2. After releasing the engagement between the groove 55a and the protrusion 56b (unlocking mechanism 54), the surgeon changes the position of the slider 52 in the longitudinal direction A.

[0089] After the surgeon changes the position of the slider 52 along its length A, the force applied to the pressing part 56a is released, causing the movable engaging part 56 to return to the first position P1. The groove 55a and the protrusion 56b engage, and the position of the slider 52 along its length A is fixed again.

[0090] Figure 12This is a diagram showing the handling device 100 with the sliding member 52 fixed to the front end side.

[0091] With the first electrode 21 protruding relative to the second electrode 32, the protruding and recessed position of the rod 2 is fixed. The surgeon can easily use the first electrode 21, which is fixed in the protruding state, to perform incision and dissection procedures.

[0092] Figure 13 This is a diagram showing a treatment device 100 with the sliding member 52 fixed to the base end side.

[0093] With the first electrode 21 in contact with the second electrode 32, the protruding insertion position of the rod 2 is fixed. The surgeon can easily perform hemostasis using the hemostasis treatment surface S formed by the first electrode 21 and the second electrode 32. Because the protruding insertion position of the rod 2 is fixed, the size of the hemostasis treatment surface S is maintained.

[0094] [How to use the Endoscopic Treatment System 300]

[0095] Next, the operation performed using the endoscopic treatment system 300 of this embodiment (the method of using the endoscopic treatment system 300) will be described. Specifically, the incision, dissection, and hemostasis of the lesion in endoscopic treatments such as ESD (endoscopic submucosal dissection) will be described.

[0096] As a preparatory step, the surgeon uses known methods to locate the lesion and cause it to swell. Specifically, the surgeon inserts the insertion part 202 of the endoscope 200 into the digestive tract (e.g., esophagus, stomach, duodenum, large intestine) and locates the lesion while observing images obtained by the imaging part 203 of the endoscope. Next, the surgeon inserts a known submucosal injection needle through the channel 206 of the insertion part 202 and injects a local injection fluid (local injection solution) using the submucosal injection needle, causing the lesion to swell. After injecting the local injection solution, the submucosal injection needle is withdrawn from the channel 206.

[0097] The surgeon inserts the treatment instrument 100 into the channel 206, causing the front end 1a of the sheath 1 to protrude from the front opening 206a of the insertion part 202. The surgeon then advances the slider 52 of the operating part 5 relative to the main body 51 of the operating part, causing the rod 2 to protrude.

[0098] The surgeon advances lever 2, and with a high-frequency current applied, moves the first electrode 21 to cut the mucosa of the lesion. Furthermore, the surgeon advances lever 2, and with a high-frequency current applied, lifts the cut mucosa of the lesion to expose the submucosa, while simultaneously peeling away the cut submucosa of the lesion.

[0099] Bleeding is often associated with incision and dissection procedures. In cases of bleeding, the surgeon performs hemostasis. Hemostasis involves cauterizing the ulcerated area after the lesion has been removed, or cauterizing the bleeding site from the incision or dissection procedure to stop the bleeding.

[0100] The surgeon retracts rod 2, bringing the first electrode 21 into contact with the second electrode 32. The surgeon adjusts the size of the hemostasis treatment surface S according to the hemostasis target. In cases where the target is large, such as... Figure 7 As shown, the rod 2 is retracted until the second hemostatic treatment surface S2 becomes the largest. The size of the hemostatic treatment surface S, formed by the first hemostatic treatment surface S1 and the second hemostatic treatment surface S2, is adjusted in multiple stages according to the hemostatic object.

[0101] In the main view, viewed from a direction horizontal to the length direction A, the second electrode 32 is deformed to be larger than the sheath 1 in the radial direction R. Therefore, even when the hemostasis target is large, the surgeon can increase the hemostasis treatment area S and properly perform hemostasis.

[0102] The surgeon presses the hemostatic treatment surface S onto the bleeding ulcer or mucosa to achieve hemostasis, and applies a high-frequency current to the rod 2 for cauterization. Because the locking mechanism 54 of the operating unit 5 fixes the protruding position of the rod 2, the surgeon can perform hemostasis while maintaining the size of the hemostatic treatment surface S. Therefore, it is possible to properly prevent cauterization of areas where hemostasis is not necessary.

[0103] The surgeon continues the above actions (treatments) as needed, and finally removes the lesion, ending the ESD procedure.

[0104] The treatment instrument 100 of this embodiment can perform incision, dissection, and hemostasis, and can perform appropriate hemostasis according to the size of the bleeding site. The surgeon can easily perform hemostasis without using specialized hemostasis instruments. The surgeon can reliably cauterize the bleeding site using the hemostasis treatment surface S, which can be adjusted in multiple stages according to the bleeding target.

[0105] The first embodiment of the present invention has been described in detail above with reference to the accompanying drawings. However, the specific structure is not limited to this embodiment, and design changes that do not depart from the spirit of the present invention are also included. Furthermore, the constituent elements shown in the above embodiments and variations can be appropriately combined to form a configuration.

[0106] (Variation 1-1)

[0107] In the above embodiment, the endoscope 200 is a flexible endoscope. The treatment device 100 can also be used together with a rigid endoscope as an endoscopic treatment system.

[0108] (Variations 1-2)

[0109] In the above embodiment, an insulating coating 20a is applied to the front end of the rod body 20, so that no current is supplied from the rod 2 to the second electrode 32 when the first electrode 21 is not in contact with the second electrode 32. However, the insulation state between the rod body 20 and the second electrode 32 is not limited to this. Alternatively, the insulating coating 20a may not be applied to the rod body 20, but the insulating coating may be applied to the inner peripheral surface of the through hole 32b of the second electrode 32.

[0110] (Variations 1-3)

[0111] In the above embodiment, the rod 2 passes through the second electrode 32. However, the configuration of the rod 2 and the second electrode 32 is not limited to this. If the retracted rod 2 can deform the second electrode 32, the rod 2 may not pass through the second electrode 32.

[0112] (Second Implementation)

[0113] Reference Figures 14-15 The processing device 100B according to the second embodiment of the present invention will be described. In the following description, the same reference numerals will be used for structures that are common to the structures already described, and repeated descriptions will be omitted.

[0114] [Treatment Equipment 100B]

[0115] The treatment device 100B, like the treatment device 100 of the first embodiment, is used together with the endoscope 200 as an endoscopic treatment system. The treatment device 100B is a treatment device capable of performing incision, dissection, and hemostasis. The treatment device 100B includes a sheath 1, a rod 2, an electrode 3B, an operating line 4, and an operating part 5.

[0116] Figure 14 This is a perspective view of the front end of the treatment device 100B.

[0117] Electrode 3B is located at the front end 1a of sheath 1. Electrode 3B has a support member 31 and a second electrode 32B.

[0118] Figure 15 It is a cross-sectional view along the length direction A of the front end of the handling device 100B.

[0119] The second electrode 32B is a solid component with conductivity and elasticity. The second electrode 32B is fixed to the front end of the support component 31 by welding, adhesive, etc. The second electrode 32B has a slit 33B and a through hole 32b through which the rod 2 passes.

[0120] like Figure 15As shown, the second electrode 32B is formed into a hemispherical shape when there is no external force. Specifically, the second electrode 32B is formed into a hemispherical shape with a convex front end A1 when there is no external force. In this embodiment, the convex front end 32a that protrudes most towards the front end A1 is located near the central axis O3 in the length direction A of the second electrode 32B.

[0121] like Figure 14 As shown, slit 33B is a cut-out located inside the second electrode 32B. Slit 33B is formed around the central axis O3 in the longitudinal direction A of the second electrode 32B, within the entire circumference of the circumference C.

[0122] like Figure 15 As shown, slit 33B is an isosceles triangle with its apex A1 in a cross-section along the length direction A. Slit 33B opens at the base end A2 of the second electrode 32B. An internal space 34B, divided by slit 33B, is formed inside the second electrode 32B.

[0123] Like the second electrode 32 of the first embodiment, the second electrode 32B is deformed by being pressed by the retracted first electrode 21. Compared to the second electrode 32 of the first embodiment, the second electrode 32B has an internal space 34B formed by the slit 33B at its base end A2, making the base end A2 portion of the second electrode 32B more flexible. Therefore, the base end side of the second electrode 32B is more easily deformable compared to the second electrode 32 of the first embodiment. Furthermore, the second electrode 32B is more likely to widen radially R when pressed from the front end side. Because the second electrode 32B is more easily deformable radially R, it is easier for the surgical operator to adjust the size of the hemostasis treatment surface S.

[0124] The treatment instrument 100B of this embodiment can perform incision, dissection, and hemostasis, and can perform appropriate hemostasis according to the size of the bleeding site. The surgeon can easily perform hemostasis without using specialized hemostasis instruments. The surgeon can reliably cauterize the bleeding site using the hemostasis treatment surface S, which can be adjusted in multiple stages according to the bleeding target.

[0125] The second embodiment of the present invention has been described in detail above with reference to the accompanying drawings. However, the specific structure is not limited to this embodiment, and design changes that do not depart from the spirit of the present invention are also included. Furthermore, the constituent elements shown in the above embodiments and variations can be appropriately combined to form a configuration.

[0126] (Variation Example 2-1)

[0127] In the above embodiment, the slit 33B is an isosceles triangle with the front end side A1 as the apex in the cross section along the length direction A. However, the form of the second electrode 32B having the slit 33B is not limited to this. Figure 16 The treatment device 100C shown is a cross-sectional view along the length direction A of the second electrode 32C, which is a modified example of the second electrode 32B. The second electrode 32C has a slit 33C instead of the slit 33B.

[0128] The slit 33C is a cut located inside the second electrode 32C. The slit 33C is formed around the central axis O3 in the longitudinal direction A of the second electrode 32C, within the entire circumference of the circumferential direction C.

[0129] Slit 33C is a rectangular cut in cross-section along the length direction A. Slit 33C opens at the base end A2 of the second electrode 32C. An internal space 34C, divided by slit 33C, is formed inside the second electrode 32C. Slit 33C is easier to process than slit 33B.

[0130] (Third Implementation)

[0131] Reference Figure 17 The processing device 100D according to the third embodiment of the present invention will be described. In the following description, the same reference numerals will be used for structures that are common to the structures already described, and repeated descriptions will be omitted.

[0132] [Treatment Equipment 100D]

[0133] The treatment device 100D, like the treatment device 100 of the first embodiment, is used together with the endoscope 200 as an endoscopic treatment system. The treatment device 100D is a treatment device capable of performing incision, dissection, and hemostasis. The treatment device 100D includes a sheath 1, a rod 2, an electrode part 3D, an operating line 4, and an operating part 5.

[0134] Figure 17 It is a cross-sectional view along the length direction A of the front end of the handling device 100D.

[0135] The electrode portion 3D is located at the front end 1a of the sheath 1. The electrode portion 3D has a support member 31 and a second electrode 32D.

[0136] The second electrode 32D is a hollow component with conductivity and elasticity. An internal space 34D is formed inside the second electrode 32D. The second electrode 32D is fixed to the front end of the support component 31 by welding, adhesive, etc. The second electrode 32D has a through hole 32b for the rod 2 to pass through.

[0137] The internal space 34D is formed into a cylindrical shape with the central axis O3 along the length direction A of the second electrode 32C as the central axis. The radial length L4 of the internal space 34D is longer than the radial length L1 of the first electrode 21.

[0138] The through hole 32b is formed at a position A1 closer to the front end than the internal space 34D. For example... Figure 17 As shown, the rod body 20 penetrates the internal space 34D and the through hole 32b.

[0139] The second electrode 32D, like the second electrode 32 in the first embodiment, is deformed by being pressed by the retracted first electrode 21. Compared to the second electrode 32 in the first embodiment, the second electrode 32D is a hollow component with an internal space 34D, and is therefore more flexible. Therefore, compared to the second electrode 32 in the first embodiment, the second electrode 32D allows for easier retraction of the rod 2. This makes it easier for the surgical operator to adjust the size of the hemostasis treatment surface S.

[0140] The treatment instrument 100D of this embodiment can perform incision, dissection, and hemostasis, and can perform appropriate hemostasis according to the size of the bleeding site. The surgeon can easily perform hemostasis without using specialized hemostasis instruments. The surgeon can reliably cauterize the bleeding site using the hemostasis treatment surface S, which can be adjusted in multiple stages according to the bleeding target.

[0141] The third embodiment of the present invention has been described in detail above with reference to the accompanying drawings. However, the specific structure is not limited to this embodiment, and design changes that do not depart from the spirit of the present invention are also included. Furthermore, the constituent elements shown in the above embodiments and variations can be appropriately combined to form a configuration.

[0142] (Variation 3-1)

[0143] In the above embodiment, the internal space 34D of the second electrode 32D, which is a hollow component, is formed in a cylindrical shape. However, the shape of the internal space 34D is not limited to this. The internal space 34D may also be, for example, a hemispherical shape similar to that of the second electrode 32D.

[0144] (Fourth Implementation)

[0145] Reference Figures 18-19 The processing device 100E according to the fourth embodiment of the present invention will be described. In the following description, the same reference numerals will be used for structures that are common to the structures already described, and repeated descriptions will be omitted.

[0146] [Treatment Equipment 100E]

[0147] The treatment device 100E, like the treatment device 100 of the first embodiment, is used together with the endoscope 200 as an endoscopic treatment system. The treatment device 100E is a treatment device capable of performing incision, dissection, and hemostasis. The treatment device 100E includes a sheath 1, a rod 2, an electrode 3E, an operating line 4, and an operating part 5.

[0148] Figure 18 It is a cross-sectional view of the front end of the handling device 100E along the length direction A.

[0149] The electrode section 3E is located at the front end 1a of the sheath 1. The electrode section 3E has a support member 31, a second electrode 32, and a reinforcing electrode 36.

[0150] The reinforcing electrode 36 is formed of a conductive metal material, such as stainless steel, and is harder than the second electrode 32. The reinforcing electrode 36 is located at the front end of the second electrode 32 and on the inner circumferential surface of the through hole 32b of the second electrode 32. The second electrode 32 and the reinforcing electrode 36 are connected by welding, adhesive, or the like.

[0151] Figure 19 This is a cross-sectional view along the length direction A of the treatment device 100E in a state where the second electrode 32 is deformed by the retracted first electrode 21. The second electrode 32, like the second electrode 32 in the first embodiment, is deformed by being pressed by the retracted first electrode 21. Since a reinforcing electrode 36 is provided at the front end of the second electrode 32E, the second electrode 32 is deformed by being pressed by the reinforcing electrode 36, which is in contact with the retracted first electrode 21. A second hemostatic treatment surface S2 is formed on the front end side A1 of the second electrode 32E.

[0152] Because the stiffer reinforcing electrode 36 is located at the front end of the second electrode 32 and on the inner circumferential surface of the through hole 32b of the second electrode 32, the force of the first electrode 21 pushing into the second electrode 32 becomes more uniform. Therefore, the deformed second electrode 32 easily becomes symmetrical about the central axis O3 when viewed from the length direction A, making it easier for the surgeon to adjust the size of the hemostasis treatment surface S.

[0153] When the first electrode 21 and the second electrode 32, through which a high-frequency current is applied, come into contact with each other via the reinforcing electrode 36, a high-frequency current is applied from the first electrode 21 to the second electrode 32.

[0154] The treatment instrument 100E of this embodiment can perform incision, dissection, and hemostasis, and can perform appropriate hemostasis according to the size of the bleeding site. The surgeon can easily perform hemostasis without using specialized hemostasis instruments. The surgeon can reliably cauterize the bleeding site using the hemostasis treatment surface S, which can be adjusted in multiple stages according to the bleeding target.

[0155] The fourth embodiment of the present invention has been described in detail above with reference to the accompanying drawings. However, the specific structure is not limited to this embodiment, and design changes that do not depart from the spirit of the present invention are also included. Furthermore, the constituent elements shown in the above embodiments and variations can be appropriately combined to form a configuration.

[0156] (Fifth Implementation)

[0157] Reference Figures 20-22 The fifth embodiment of the treatment device 100F of the present invention will be described. In the following description, the same reference numerals will be used for structures that are common to the structures already described, and repeated descriptions will be omitted.

[0158] [Treatment Equipment 100F]

[0159] The treatment device 100F, like the treatment device 100 of the first embodiment, is used together with the endoscope 200 as an endoscopic treatment system. The treatment device 100F is a treatment device capable of performing incision, dissection, and hemostasis. The treatment device 100F includes a sheath 1, a rod 2, an electrode 3F, an operating line 4, and an operating part 5.

[0160] Figure 20 It is a front view of the front end of the handling device 100F and a sectional view along the length direction A.

[0161] An electrode portion 3F is located at the front end 1a of the sheath 1. The electrode portion 3F has a support member 31 and a second electrode 32F. A rod 2 passes through the second electrode 32F along the central axis of the second electrode 32F.

[0162] The second electrode 32F is a conical helical spring (truncated cone spiral spring) formed from a conductive metal material such as stainless steel. The second electrode 32F is formed into a cone shape with the outer diameter decreasing from the base end side to the front end side. When viewed from the main view along the length direction A, the second electrodes 32F form a spiral shape in which the second electrodes 32F do not overlap. The second electrode 32F may also be formed from conductive rubber.

[0163] Figure 21 This is a cross-sectional view along the length direction A of the front end of the treatment device 100F in the state where the second electrode 32F begins to deform. The second electrode 32F, like the second electrode 32 in the first embodiment, is compressed by being pressed by the retracted first electrode 21. A second hemostatic treatment surface S2 is formed on the front end side A1 of the second electrode 32F.

[0164] Figure 22 This is a cross-sectional view along the length direction A of the front end of the treatment device 100F in a state where the second electrode 32F is further deformed. Figure 22The second electrode 32F shown is in a state of maximum compression along the length direction A. When viewed from the main view along the length direction A, the second electrode 32F has a non-overlapping spiral shape. Therefore, when the second electrode 32F is in a state of maximum compression along the length direction A, the second hemostasis treatment surface S2 becomes approximately planar, suitable as a surface for performing hemostasis treatment.

[0165] When the first electrode 21 and the second electrode 32F are in contact, a high-frequency current is supplied from the first electrode 21 to the second electrode 32F.

[0166] The treatment instrument 100F of this embodiment can perform incision, dissection, and hemostasis, and can perform appropriate hemostasis according to the size of the bleeding site. The surgeon can easily perform hemostasis without using specialized hemostasis instruments. The surgeon can reliably cauterize the bleeding site using the hemostasis treatment surface S, which can be adjusted in multiple stages according to the bleeding object.

[0167] The fifth embodiment of the present invention has been described in detail above with reference to the accompanying drawings. However, the specific structure is not limited to this embodiment, and design changes that do not depart from the spirit of the present invention are also included. Furthermore, the constituent elements shown in the above embodiments and variations can be appropriately combined to form a configuration.

[0168] (Sixth Implementation Method)

[0169] Reference Figures 23-25 The treatment apparatus 100G according to the sixth embodiment of the present invention will be described. In the following description, the same reference numerals will be used for structures that are common to the structures already described, and repeated descriptions will be omitted.

[0170] [Disposal equipment 100G]

[0171] The treatment device 100G (not shown) is similar to the treatment device 100 of the first embodiment, and is used together with the endoscope 200 as an endoscopic treatment system. The treatment device 100G is a treatment device capable of performing incision, dissection, and hemostasis. The treatment device 100G includes a sheath 1, a rod 2, an electrode part 3, an operating line 4, and an operating part 5G.

[0172] The operation unit 5G has an operation unit body 51, a sliding member 52, a power supply connector 53, a locking mechanism 54, and a second locking mechanism 57.

[0173] Figure 23 This is a perspective view of the second locking mechanism 57 of the 5G operating unit.

[0174] The second locking mechanism 57 is a component that can be attached to and detached from the main body 51 of the operating part. The second locking mechanism 57 is U-shaped. Barb portions 57a are formed at both ends of the second locking mechanism 57.

[0175] Figure 24 This diagram shows the operation part 5G on the front end side A1, which uses the second locking mechanism 57 to fix the position of the slider 52. Figure 25 This diagram illustrates the operation section 5G, which uses a second locking mechanism 57 to fix the position of the slider 52 to the base end side A2. When the second locking mechanism 57 is installed on the operation section body 51, the barb portion 57a ​​engages with the operation section body 51 and is fixed relative to the operation section body 51. Therefore, the second locking mechanism 57 restricts the forward and backward movement of the slider 52 by being installed on the operation section body 51.

[0176] By using the second locking mechanism 57 to fix the position of the slider 52, the protruding and recessed position of the rod 2 is more reliably fixed in the state where the first electrode 21 protrudes relative to the second electrode 32. The surgeon can easily perform incision and dissection procedures using the first electrode 21 fixed in the protruding state.

[0177] The 100G instrument of this embodiment can perform incision, dissection, and hemostasis, and can perform appropriate hemostasis according to the size of the bleeding site. The surgeon can easily perform hemostasis without using specialized hemostasis instruments. The surgeon can reliably cauterize the bleeding site using the hemostasis treatment surface S, which can be adjusted in multiple stages according to the bleeding target.

[0178] The sixth embodiment of the present invention has been described in detail above with reference to the accompanying drawings. However, the specific structure is not limited to this embodiment, and design changes that do not depart from the spirit of the present invention are also included. Furthermore, the constituent elements shown in the above embodiments and variations can be appropriately combined to form a configuration.

[0179] Industrial availability

[0180] This invention can be applied to instruments used in hemostasis procedures.

[0181] Explanation of reference numerals in the attached figures

[0182] 300. Endoscopic treatment system; 200. Endoscope; 100, 100B, 100C, 100D, 100E, 100F, 100G. Treatment device; 1. Sheath; 2. Rod; 20. Rod body; 20a. Insulating coating; 21. First electrode; 22. Stop; 3, 3B, 3D, 3E, 3F. Electrode part; 31. Support member; 31b. Through hole; 32, 32B, 32C, 32D, 32F. Second electrode; 32a. Front end; 32b. Through hole; 33B, 33C. Slit; 34B, 34C, 34D. Internal space; 36. Reinforcing electrode; 4. Operating line; 5. 5G. Operating part; 51. Operating part body; 52. Sliding part; 54. Locking mechanism; 57. Second locking mechanism.

Claims

1. A treatment device, wherein, The treatment apparatus includes: The sheath is flexible; A rod that can move forward and backward relative to the sheath, and has a first electrode at its front end that can carry a high-frequency current. The second electrode, located at the front end of the sheath, is conductive; and An operating part, located at the base end of the sheath, causes the rod to move forward and backward. The rod passes through the second electrode. The second electrode is energized by contacting the first electrode of the rod. By moving the rod forward and backward, it is possible to switch between a state where the first electrode and the second electrode are in contact with each other and a state where they are separated. The second electrode is deformed by pressing it with the first electrode.

2. The treatment apparatus according to claim 1, wherein, While the first electrode is pressing down on the second electrode, causing the second electrode to deform, the first electrode moves forward, thereby separating the first electrode from the second electrode and restoring the second electrode to its original shape.

3. The treatment apparatus according to claim 1, wherein, The second electrode has a through hole through which the rod passes.

4. The treatment apparatus according to claim 3, wherein, In the radial direction of the through hole, the first electrode has a dimension longer than the length of the through hole. By retracting the first electrode relative to the sheath. Thus, the first electrode presses against the second electrode, and, It can deform the radial length of the second electrode to be greater than the radial length of the sheath.

5. The treatment apparatus according to claim 1, wherein, The second electrode is an elastic member.

6. The treatment apparatus according to claim 1, wherein, The second electrode is formed in a hemispherical shape.

7. The treatment apparatus according to claim 1, wherein, The first electrode forms a first hemostasis treatment surface on its front end side that contacts the object to be hemostatically treated. The second electrode forms a second hemostasis surface that is substantially coplanar with the first hemostasis surface. The second hemostatic treatment surface increases in size as the first electrode in contact with it retracts.

8. The treatment apparatus according to claim 1, wherein, The operating unit has a locking mechanism that fixes the forward and backward position of the rod.

9. The treatment apparatus according to claim 1, wherein, The second electrode has a slit extending from the base end toward the front end.

10. The treatment apparatus according to claim 1, wherein, The treatment device has a conductive reinforcing electrode located at the front end of the second electrode and formed of a raw material that is harder than the second electrode.

11. The treatment apparatus according to claim 1, wherein, At least a portion of the outer peripheral surface of the rod or at least a portion of the inner peripheral surface of the through hole through which the rod passes of the second electrode has an insulating coating.

12. The treatment apparatus according to claim 1, wherein, A support member is provided between the front end of the sheath and the base end of the second electrode, the support member being formed of a raw material harder than the second electrode.

13. The treatment apparatus according to claim 1, wherein, In a state where the second electrode is not deformed, the second electrode is disposed within a projection plane of the sheath.

14. The treatment tool according to claim 1, wherein, In a state where the second electrode is deformed, a part of the second electrode is disposed outside a projection of the sheath.

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