Treatment instrument

Abstract

A treatment tool includes a sheath, a forceps disposed at a distal end of the sheath so as to be opened and closed freely, a rod disposed at the distal end of the sheath so as to be protruded and withdrawn, the rod being able to pass a high-frequency current, an operation portion disposed at a proximal end of the sheath so as to advance and retract the rod, a receiving portion attached to the forceps, the rod having a rod main body and an abutting portion disposed at a distal end side of the rod main body, a length of the abutting portion in a radial direction being longer than a length of the rod main body in the radial direction, the receiving portion pushing the forceps in the radial direction by abutting of the abutting portion of the rod that is retracted.

Description

Technical Field

[0001] This invention relates to treatment apparatus. Background Technology

[0002] Previously, in endoscopic procedures such as ESD (endoscopic submucosal dissection), high-frequency knives and other endoscopic instruments were used for cutting and dissection. In the event of bleeding during the procedure, it was necessary to temporarily remove the endoscopic instruments used for cutting and dissection from the body cavity and replace them with endoscopic instruments used for hemostasis to perform endoscopic hemostasis.

[0003] Patent Document 1 describes a high-frequency knife capable of performing tissue cutting, dissection, and hemostasis. The high-frequency knife described in Patent Document 1 is also capable of performing hemostasis using hemostatic forceps.

[0004] Existing technical documents

[0005] Patent documents

[0006] Patent Document 1: International Publication No. 2019 / 206042 Summary of the Invention

[0007] The problem the invention aims to solve

[0008] However, the high-frequency knife described in Patent Document 1 independently performs the operations of cutting and peeling and hemostatic treatment, which is complicated due to the many switching operation steps.

[0009] In view of the above, the object of the present invention is to provide a treatment device that can perform incision, dissection and hemostasis, and the switching operation between the treatment device for incision and dissection and the hemostatic forceps for hemostasis is easy.

[0010] Solution for solving the problem

[0011] To address the aforementioned technical problems, the present invention proposes the following technical means.

[0012] The first embodiment of the present invention comprises: a sheath; pliers, which are slidably disposed at the front end of the sheath; a rod, which is disposed at the front end of the sheath and can be supplied with a high-frequency current; an operating part disposed at the base end of the sheath to move the rod forward and backward; and a receiving part mounted on the pliers; the rod has a rod body and an abutting part disposed at the front end of the rod body, the radial length of the abutting part being longer than the radial length of the rod body, and the receiving part pushing the pliers radially away due to abutting against the abutting part of the retracted rod.

[0013] The effects of the invention

[0014] The treatment device according to the present invention is capable of performing incision, dissection and hemostasis, and the switching operation between the treatment device for performing incision and dissection and the hemostatic forceps for performing hemostasis is easy. 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.

[0017] Figure 3 This is a side view of the front end of the treatment device.

[0018] Figure 4 This is a cross-sectional view of the front end of the treatment device.

[0019] Figure 5 This is a front view of the front end of the treatment device with the pliers in the closed position.

[0020] Figure 6 This is a front view of the front end of the treatment device with the pliers in the open position.

[0021] Figure 7 This is a side view of the electrode section and pliers in the area through which the second rod passes.

[0022] Figure 8 This is a side view of the front end of the instrument used to stop bleeding at the site of bleeding.

[0023] Figure 9 This is a side view of the front end of the instrument used to stop bleeding at the site of bleeding.

[0024] Figure 10 This is a side view showing a modified example of the rod of the treatment device.

[0025] Figure 11 This is a side view of the front end of the treatment device according to the second embodiment.

[0026] Figure 12 This is a cross-sectional view of the front end of the treatment device.

[0027] Figure 13 It is along Figure 11 Cross-sectional view of the XX line pressure tube, etc.

[0028] Figure 14 This is a side view of the front end of the treatment device with the electrode section retracted.

[0029] Figure 15 This is a front view of the front end of the treatment device with the pliers open.

[0030] Figure 16 This is a side view of the front end of the treatment device according to the third embodiment.

[0031] Figure 17 This is a cross-sectional view of the front end of the treatment device.

[0032] Figure 18 It is along Figure 16 Cross-sectional view of pliers, etc., for YY lines.

[0033] Figure 19 This is a cross-sectional view of the front end of the treatment device with the electrode section retracted.

[0034] Figure 20 This is a cross-sectional view of the front end of the treatment device according to the fourth embodiment.

[0035] Figure 21 This is a cross-sectional view of the front end of the treatment device with the electrode section retracted. Detailed Implementation

[0036] (First Implementation)

[0037] Reference Figures 1 to 9 The endoscopic treatment system 300 of the first embodiment of the present invention will be described. Figure 1 This is an overall view of the endoscopic treatment system 300 of this embodiment.

[0038] [Endoscopic Handling System 300]

[0039] 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.

[0040] [Endoscope 200]

[0041] The endoscope 200 is a known flexible endoscope, which includes an insertion part 202 that is inserted into the body from the tip and an operation part 207 installed at the base of the insertion part 202.

[0042] The insertion part 202 includes a camera part 203, a curved part 204, and a flexible part 205. Starting from the front end of the insertion part 202, the camera part 203, curved part 204, and flexible part 205 are arranged in that order. A channel 206 for inserting the treatment device 100 is provided inside the insertion part 202. The front end of the insertion part 202 has a front opening 206a of the channel 206.

[0043] The camera unit 203 is equipped with an imaging element such as a CCD or CMOS, and is capable of capturing images of the part being processed. When the processing device 100 protrudes from the front opening 206a of the channel 206, the camera unit 203 can capture images of the clamps 3 of the processing device 100.

[0044] The bending portion 204 bends according to the operator's operation of the operating portion 207. The flexible portion 205 is a flexible tubular part.

[0045] The operating unit 207 is connected to the flexible unit 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 that causes the bending part 204 to bend. 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, etc.

[0046] [Treatment equipment 100]

[0047] Figure 2 This is an overall view showing the treatment device 100.

[0048] Treatment instrument 100 is a treatment instrument capable of performing incision, dissection, and hemostasis. Treatment instrument 100 comprises a sheath 1, a rod 2, forceps (forceps component) 3, and an operating line 4. Figure 4 (as shown) and operation section 5. In the following description, in the longitudinal direction A of the treatment device 100, the side inserted into the patient's body is referred to as the "front end side (A1)" and the side of operation section 5 is referred to as the "base end side (A2)".

[0049] The sheath 1 is flexible and insulating, and is an elongated member extending from the front end 1a to the base end 1b. The sheath 1 has an outer diameter for insertion into a channel 206 of the endoscope 200. Figure 1 As shown, with the sheath 1 inserted into the channel 206, the front end 1a of the sheath 1 can protrude from the front opening 206a of the channel 206 and be inserted into it. In addition, the edge of the front end of the sheath 1 can be rounded.

[0050] Figure 3 This is a side view of the front end of the handling device 100.

[0051] Rod 2 is a roughly cylindrical rod-shaped component made of a metal material such as stainless steel, and is configured to protrude into the front end 1a of the sheath 1. Rod 2 has a rod body 20, an electrode portion 21, and a stop portion 22 (shown in...). Figure 4 ).

[0052] Figure 4 This is a cross-sectional view of the front end of the treatment device 100.

[0053] The lever 2 can move along the length direction A and passes through the pliers 3. The central axis O2 of the lever 2 in the length direction A is approximately the same as the central axis O1 of the sheath 1 in the length direction A.

[0054] The rod body 20 is a cylindrical rod-shaped component made of stainless steel or other metal materials. An operating line 4 is installed at the base of the rod body 20. The operating line 4 is connected to the rod body 20 via a stop 22. The operating line 4 is connected to the operating part 5, and the rod body 20 supplies high-frequency current from the operating line 4 to the electrode part 21 and the forceps 3. The portion of the rod body 20 exposed at the front end of the forceps 3 and the electrode part 21 function as high-frequency electrodes, providing high-frequency current to living tissue, primarily used for cutting and dissection. However, depending on the situation, the portion of the rod body 20 exposed at the front end of the forceps 3 and the electrode part 21 can also be used for hemostasis.

[0055] Figure 5 This is a front view of the front end of the handling device 100 with the pliers 3 in the closed state.

[0056] The electrode portion 21 is a circular plate-shaped conductive member disposed at the front end of the rod body 20. In the front view viewed horizontally relative to the length direction A, the outer periphery of the electrode portion 21 forms a concentric circle with the outer periphery of the rod body 20. Figure 4 As shown, the length L1 of the electrode part 21 in the radial direction R perpendicular to the length direction A is greater than the length L2 of the rod body 20 in the radial direction R.

[0057] A stop 22 is provided on the outer periphery of the lever body 20 and the operating line 4, connecting the lever body 20 and the operating line 4. Furthermore, the stop 22 limits the length of the lever body 20 protruding from the front end of the pliers 3. As a result, the protrusion of the electrode portion 21 is also limited. Figure 4 As shown, the stop portion 22 restricts the amount of protrusion of the electrode portion 21 relative to the sheath 1 by engaging with the engagement portion 1c provided at the front end 1a of the sheath 1.

[0058] The forceps (forceps component) 3 is a conductive component made of stainless steel or other metal materials. Forceps 3 functions as a high-frequency electrode to deliver a high-frequency current to living tissue, primarily for hemostasis. Figure 4 As shown, the pliers 3 have a first clamping plate 31, a second clamping plate 32, and a connecting part 34.

[0059] The first clamp 31 and the second clamp 32 are connected at the connecting portion 34 on the base end side A2, and are configured to open and close freely toward the front end side A1. The connecting portion 34 is charged in such a way that it is intended to bring the first clamp 31 and the second clamp 32 into contact and close. The connecting portion 34 is housed inside the front end 1a of the sheath 1.

[0060] The first clamping plate 31 and the second clamping plate 32 are configured to be symmetrical with respect to the central axis O3 in the length direction A of the clamping plate 3. Figure 4 As shown, the central axis O3 of the pliers 3 in the length direction A is approximately the same as the central axis O1 of the sheath 1 in the length direction A.

[0061] The rod 2 passes through the connecting portion 34 where the first clamp 31 and the second clamp 32 are connected, and through the area surrounded by the first clamp 31 and the second clamp 32. In the following description, the area surrounded by the first clamp 31 and the second clamp 32 and through which the rod 2 passes is referred to as the "rod passage area E".

[0062] Figure 6 This is a front view of the front end of the treatment device with the pliers in the open position.

[0063] The first clamping plate 31 has a first concave bottom 311 disposed on the front end side A1, a first arc-shaped edge portion 312 disposed at a position opposite to the second clamping plate 32, and a first base end support portion 315 disposed on the base end side A2 of the first concave bottom 311 (shown in the figure). Figure 7 ).

[0064] The first concave bottom 311 forms a cup shape and opens towards the second clamping plate 32 in the opening and closing direction B of the clamps 3.

[0065] The first arc-shaped edge portion 312 is the opening edge of the first concave bottom 311, forming an arc shape. The first arc-shaped edge portion 312 has a first front end recess 313 and a first serrated portion 314. The first front end recess 313 is a recess provided on the front end side. The width direction C is perpendicular to the length direction A and the opening / closing direction B, and the first serrated portion 314 is a serrated protrusion and recess provided on both sides of the width direction C.

[0066] The first base support portion (bearing portion) 315 extends in the length direction A and supports the first concave bottom 311 at the front end side A1. When the first clamp 31 and the second clamp 32 are in the closed state, the first base support portion 315 is positioned closer to the central axis O3 than the first concave bottom 311.

[0067] The second clamping plate 32 has a second concave bottom 321 disposed on the front end side A1, a second arcuate edge portion 322 disposed at a position opposite to the first clamping plate 31, and a second base end support portion 325 disposed on the base end side A2 of the second concave bottom 321 (shown in...). Figure 7 ).

[0068] The second concave bottom 321 forms a cup shape and opens towards the first clamp plate 31 in the opening and closing direction B of the clamp 3.

[0069] The second arc-shaped edge portion 322 is the opening edge of the second concave bottom 321, forming an arc shape. The second arc-shaped edge portion 322 has a second front end recess 323 and a second serrated portion 324. The second front end recess 323 is a recess provided on the front end side. The second serrated portion 324 is a serrated protrusion and recess provided on both sides in the width direction C.

[0070] The second base end support (bearing portion) 325 extends along the length direction A and supports the second concave bottom 321 at the front end side A1. When the first clamp 31 and the second clamp 32 are in the closed state, the second base end support 325 is positioned closer to the central axis O3 than the second concave bottom 321.

[0071] In the closed state with the first clamp 31 and the second clamp 32 closed, such as Figure 3 As shown, the first serrated portion 314 and the second serrated portion 324 engage.

[0072] In the closed state with the first clamp 31 and the second clamp 32 closed, such as Figure 4 and Figure 5 As shown, the first front end recess 313 and the second front end recess 323 do not contact each other to form a through hole 33. On the other hand, except for the portion forming the through hole 33, the first arc-shaped edge portion 312 and the second arc-shaped edge portion 322 abut against each other.

[0073] like Figure 5 As shown, in the front view viewed from a direction horizontal relative to the length direction A, the through hole 33 forms a circle centered on the central axis O3. Figure 4 As shown, the length L3 of the through hole 33 in the radial direction R is greater than the length L1 of the electrode part 21 in the radial direction R. Therefore, the rod body 20 and the electrode part 21 can move forward and backward along the length direction A of the through hole 33. In the following description, the movement of the rod 2 toward the front end side A1 is referred to as "forward", and the movement toward the base end side A2 is referred to as "backward".

[0074] In the closed state with the first clamp 31 and the second clamp 32 closed, such as Figure 4 As shown, the length L4 of the rod passage region E, which is surrounded by the first concave bottom 311 and the second concave bottom 321, in the radial direction is greater than the length L1 of the electrode portion 21 in the radial direction. In the following description, the rod passage region E surrounded by the first concave bottom 311 and the second concave bottom 321 is referred to as the "first rod passage region E1".

[0075] Since the length L4 is greater than the length L1, in the closed state where the first clamp 31 and the second clamp 32 are closed, the rod body 20 and the electrode part 21 can move forward and backward along the length direction A in the first rod passage area E1.

[0076] In the closed state with the first clamp 31 and the second clamp 32 closed, such as Figure 4 As shown, the length L5 of the rod passage region E surrounded by the first base end support 315 and the second base end support 325 in the radial direction is greater than the length L2 of the rod body 20 in the radial direction, but less than the length L1 of the electrode part 21 in the radial direction. In the following description, the rod passage region E surrounded by the first base end support 315 and the second base end support 325 is referred to as the "second rod passage region E2".

[0077] Since length L5 is greater than length L2, the rod body 20 can move forward and backward along the length direction A in the second rod passage area E2 when the first clamp 31 and the second clamp 32 are closed. On the other hand, since length L5 is less than length L1, if the electrode part 21 is to move forward and backward along the length direction A in the second rod passage area E2, the electrode part 21 will come into contact with at least one of the first base end support part 315 and the second base end support part 325.

[0078] It should be noted that the length L5 of the second rod passing through the region E2 in the radial direction is the shortest length between the first base support 315 and the second base support 325 when the first clamp 31 and the second clamp 32 are in the closed state. When the electrode part 21 passes through the second rod passing through the region E2, it will contact at least one of the first base support 315 and the second base support 325.

[0079] When the electrode section 21 is energized, a high-frequency current is applied to the first clamp 31 when the electrode section 21 contacts the first base support section 315. Additionally, when the electrode section 21 is energized, a high-frequency current is applied to the second clamp 32 when the electrode section 21 contacts the second base support section 325.

[0080] Of course, it is also possible that after the electrode part 21 contacts the first base end support part 315 and the second base end support part 325 in a non-energized state, the electrode part 21 is energized to supply high-frequency current to the first clamp 31 and the second clamp 32.

[0081] The first clamp 31 and the second clamp 32 have an insulating coating on their outer surfaces on the side opposite to the rod passage area E. Specifically, the portion of the first clamp 31 other than the first concave bottom 311 and the first arcuate edge 312, and the portion of the second clamp 32 other than the second concave bottom 321 and the second arcuate edge 322, are provided with an insulating coating. According to this configuration, the possibility of accidental tissue burns can be reduced when the clamps 3 are energized.

[0082] Figure 7 This is a side view of the electrode section 21 and the clamps 3 passing through the area E2 via the second rod.

[0083] When electrode 21 passes through the second rod passage area E2, it contacts the first base end support 315 and the second base end support 325, pushing the first base end support 315 and the second base end support 325 radially outward. Electrode 21 acts as an "abutment" for the first base end support 315 and the second base end support 325 when passing through the second rod passage area E2. As a result, the first clamp 31 and the second clamp 32 change from a closed state to an open state.

[0084] like Figure 8 As shown, the operating line 4 is a wire made of stainless steel or other metal material, which passes through the internal space of the sheath 1 for 1 second. Figure 4 As shown, the front end of the operation line 4 is connected to the stop part 22, and the base end of the operation line 4 is connected to the operation part 5.

[0085] like Figure 1 and Figure 2 As shown, the operation unit 5 has an operation unit body 51, a slider 52 and a power supply connector 53.

[0086] 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 through which the operating line 4 can be inserted. The operating line 4 extends to the slider 52 through the internal space of the sheath 1 and the internal space of the operating part body 51.

[0087] The slider 52 is mounted 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 operating line 4 is connected to the slider 52. The surgeon moves the operating line 4 and the rod 2 relative to the sheath 1 by moving the slider 52 forward and backward relative to the operating unit body 51. A power connector 53 is fixed to the slider 52.

[0088] The power connector 52 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 to the electrode section 21 and the clamp 3 via the operating line 4 and the rod 2.

[0089] [How to use the Endoscopic Treatment System 300]

[0090] Next, the operation of the endoscopic treatment system 300 using this embodiment (method of using the endoscopic treatment system 300) will be described. Specifically, the incision, dissection, and hemostasis of the lesion site during endoscopic treatments such as ESD (endoscopic submucosal dissection) will be described.

[0091] As a preparatory step, the surgeon identifies the lesion using known methods, causing it to bulge. Specifically, the surgeon inserts the insertion portion 202 of an endoscope 200 into the digestive tract (e.g., esophagus, stomach, duodenum, large intestine) and identifies the lesion while observing images obtained through the imaging portion 203 of the endoscope. Next, the surgeon inserts a known submucosal injection needle through the channel 206 of the insertion portion 202 and injects a local injection fluid (local injection solution) through the needle, causing the lesion to swell and bulge. After injecting the local injection solution, the submucosal injection needle is removed from the channel 206.

[0092] 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 assistant advances the slider 52 of the operating part 5 relative to the operating part body 51, causing the rod 2 to protrude.

[0093] The surgeon advances lever 2 and moves electrode 21 to cut the mucosa of the lesion while a high-frequency current is applied. Additionally, while advancing lever 2 and applying a high-frequency current, the surgeon lifts the cut mucosa of the lesion to expose the submucosa and simultaneously peels away the cut submucosa.

[0094] Bleeding is often an inevitable consequence of incision and dissection procedures. In cases of bleeding, the surgeon performs hemostasis. Hemostasis involves cauterizing the ulcerated area after dissection of the lesion or the bleeding site (T) from the incision or dissection procedure to stop the bleeding.

[0095] Figure 8 This is a side view of the front end of a treatment device 100 used to stop bleeding at a bleeding site.

[0096] The surgeon retracts electrode 21 to the second rod passage area E2, bringing electrode 21 into contact with the first base support 315 and the second base support 325. Electrode 21 pushes the first base support 315 and the second base support 325 radially outward. As a result, the first clamp 31 and the second clamp 32 change from a closed state to an open state. The further electrode 21 is retracted, the wider the first clamp 31 and the second clamp 32 open. The surgeon and assistant rotate the operating part 5 clockwise or counterclockwise relative to the length direction A, or move the sheath 1 forward or backward, adjusting the position of the clamps 3 in the open state to grasp the living tissue at the bleeding site.

[0097] Figure 9 This is a side view of the front end of a treatment device 100 used to stop bleeding at a bleeding site.

[0098] The surgeon advances the electrode to the first rod passage area E1, causing the electrode portion 21 to separate from the first base support portion 315 and the second base support portion 325. As a result, the first clamp 31 and the second clamp 32 transition from an open state to a closed state. The first clamp 31 and the second clamp 32 hold the living tissue.

[0099] The forceps 3 has a first serrated portion 314 and a second serrated portion 324. Therefore, when the surgeon uses the first serrated portion 314 and the second serrated portion 324 to grasp the living tissue, the living tissue is difficult to detach from the forceps 3. As a result, the surgeon can effectively grasp the bleeding site T between the first concave bottom 311 and the second concave bottom 321.

[0100] With the first and second clamps in contact with the rod 2, the surgeon applies a high-frequency current to the rod 2. This action (treatment) applies a high-frequency current to the first arc-shaped edge 312 and the second arc-shaped edge 322 that are in contact with the living tissue, cauterizing the bleeding site T. Alternatively, depending on the situation, after properly clamping the bleeding site T between the first concave bottom 311 and the second concave bottom 321, the electrode 21 can be further advanced to contact the bleeding site T, cauterizing the bleeding site T with its tip. The surgeon continues the above actions (treatments) as needed, ultimately removing the lesion and ending the ESD procedure.

[0101] The treatment device 100 according to this embodiment can perform incision, dissection, and hemostasis treatments, and the switching operation between the rod 2 for incision and dissection treatments and the forceps 3 for hemostasis treatments is easy. The surgeon can switch between the rod 2 for incision and dissection treatments and the forceps 3 for hemostasis treatments simply by moving the rod 2 forward and backward.

[0102] The first embodiment of the present invention has been described in detail above with reference to the accompanying drawings. However, the specific features are not limited to this embodiment and also include design changes that do not depart from the main concept of the present invention. In addition, the feature elements shown in the foregoing embodiments and variations can be appropriately combined.

[0103] (Variation Example 1-1)

[0104] In the above embodiment, the endoscope 200 is a flexible endoscope. The treatment device 100 can also be used with a rigid endoscope. In this case, the sheath 1 may not be flexible.

[0105] (Variations 1-2)

[0106] In the above embodiment, the electrode portion 21 acts as an "abutment portion" against the first base end support portion 315 and the second base end support portion 325 when passing through the second rod passage area E2. However, the form of the abutment portion that pushes the first base end support portion 315 and the second base end support portion 325 radially outward is not limited to this. The rod 2 may also have an abutment portion that is separate from the electrode portion 21.

[0107] Figure 10 This is a side view of rod 2A, which is a variation of rod 2.

[0108] The rod 2A has a rod body 20, an electrode portion 21, a stop portion 22, and an abutment portion 23. The abutment portion 23 is provided on the base end side A2 of the electrode portion 21. The length of the abutment portion 23 in the radial direction R is greater than the length L5. In addition, the abutment portion forms a conical shape in which the length in the radial direction R increases towards the front end side A1. The surgeon retracts the abutment portion 23 to the second rod passage area E2, so that the abutment portion 23 contacts the first base end support portion 315 and the second base end support portion 325. The abutment portion 23 pushes the first base end support portion 315 and the second base end support portion 325 outward in the radial direction R. Since the abutment portion 23 has the aforementioned conical shape, the first clamp 31 and the second clamp 32 can smoothly transition from the closed state to the open state.

[0109] (Second Implementation)

[0110] Reference Figures 11 to 15 The treatment device 100B according to the second embodiment of the present invention will be described. In the following description, the same symbols are used for structures that are common to those already described, and repeated descriptions are omitted.

[0111] [Treatment Equipment 100B]

[0112] Figure 11 This is a side view of the front end of the handling device 100B.

[0113] Similar to the treatment device 100 of the first embodiment, the treatment device 100B is used together with the endoscope 200 as an endoscope system. The treatment device 100B is capable of performing incision, dissection, and hemostasis procedures. The treatment device 100B includes a sheath 1B, a rod 2, forceps (forceps member) 3B, and an operating line 4 (shown in…). Figure 12 ), operating part 5, pressure tube 6 and spring 7.

[0114] Except for the recess 12 on the outer periphery of the front end 1a, the sheath 1B is the same component as the sheath 1 in the first embodiment. The recess 12 is formed along the circumference of the sheath 1B.

[0115] Figure 12 This is a cross-sectional view of the front end of the treatment device 100B.

[0116] The forceps (forceps component) 3B is made of conductive metal and functions as a high-frequency electrode to pass high-frequency current to living tissue. The forceps 3 has a first clamping plate 31, a second clamping plate 32, and a connecting part 34B.

[0117] The first clamp 31 and the second clamp 32 are connected at the connecting portion 34B on the base end side A2, and are configured to open and close freely toward the front end side A1. The connecting portion 34B is charged in such a manner that the first clamp 31 and the second clamp 32 are to be in the open state. The connecting portion 34B is housed inside the front end 1a of the sheath 1B.

[0118] The crimp tube (sleeve) 6 is a tubular member that is slidably disposed at the front end 1a of the sheath 1. On the inner circumferential surface of the base end side of the crimp tube 6, a protrusion 66 is formed along the circumferential direction to engage with the recess 12 of the sheath 1B. The central axis O6 of the crimp tube 6 in the length direction A is substantially aligned with the central axis O1 of the sheath 1 in the length direction A.

[0119] The clamping tube 6 is a component that houses the clamps 3B and keeps them in a closed state. For example... Figure 12 As shown, the base end A2 of the pliers 3B is housed within the internal space 6s of the pressure tube 6.

[0120] Figure 13 It is along Figure 11 Cross-sectional view of the pressure tube 6 of the XX line.

[0121] The pressure tube 6 has a front end wall 63 that separates the internal space 6s and the external space of the pressure tube 6 on the front end side A1. The front end wall (bearing part) 63 has a rod through hole 60, a first clamp through hole 61 and a second clamp through hole 62.

[0122] In the front view viewed from a direction horizontal relative to the length direction A, the rod through-hole 60 is formed as a circle centered on the central axis O6. The length L6 of the rod through-hole 60 in the radial direction R is greater than the length L2 of the rod body 20 in the radial direction R, but less than the length L1 of the electrode part 21 in the radial direction R. Therefore, the rod body 20 can move forward and backward along the length direction A in the rod through-hole 60. On the other hand, the electrode part 21 cannot pass through the rod through-hole 60.

[0123] The first clamping plate through hole 61 is a through hole through which the first clamping plate 31 passes. The second clamping plate through hole 62 is a through hole through which the second clamping plate 32 passes. The first clamping plate through hole 61 and the second clamping plate through hole 62 are arranged on both sides of the central axis O6 in the opening and closing direction B.

[0124] Spring 7 is a compression spring housed in the recess 12 of the sheath 1B, which exerts a restoring force on the compression tube 6 towards the front end. For example... Figure 12As shown, the spring 7 moves the pressure tube 6 toward the foremost side A1. This causes the edge of the first clamping plate through hole 61 to move the first clamping plate 31 toward the closing direction, and the edge of the second clamping plate through hole 62 to move the second clamping plate 32 toward the closing direction. As a result, the pressure tube 6, moving toward the foremost side A1 by the spring 7, overcomes the force that the clamps 3B attempt to open, keeping the clamps 3B in a closed state.

[0125] Figure 14 This is a side view of the front end of the treatment device 100B with the electrode section 21 retracted.

[0126] If the surgeon retracts rod 2, electrode 21 will contact the front end wall 63. Electrode 21 acts as an "abutment" against the front end wall 63 as it passes through rod through hole 60. If the surgeon retracts rod 2 further, spring 7 will be compressed against the restoring force. As a result, pressure tube 6 moves relative to sheath 1B toward base end side A2. It should be noted that the part of pressure tube 6 in contact with electrode 21 is not limited to the front end wall 63, but can be any part of pressure tube 6.

[0127] Figure 15 This is the front view of the treatment device 100B with the pliers 3B in the open state.

[0128] If the clamping tube 6 moves relative to the sheath 1B toward the base end A2, the contact portion between the edge of the first clamp through hole 61 and the first clamp 31 will move toward the base end. Additionally, the contact portion between the edge of the second clamp through hole 62 and the second clamp 32 will move toward the base end. As a result, the first clamp 31 and the second clamp 32 change from a closed state to an open state.

[0129] Similar to the first embodiment, the first clamp 31 and the second clamp 32 can be opened by the surgeon retracting the lever 2. Similarly, similar to the first embodiment, the first clamp 31 and the second clamp 32 can be closed by the surgeon advancing the lever 2. Using the treatment instrument 100B, the surgeon can perform incision, dissection, and hemostasis procedures in the same manner as in the first embodiment.

[0130] According to the treatment instrument 100B of this embodiment, incision, dissection, and hemostasis can be performed, and the switching operation between the rod 2 for incision and dissection and the forceps 3B for hemostasis is easy. The surgeon only needs to move the rod 2 forward and backward to switch between the rod 2 for incision and dissection and the forceps 3B for hemostasis.

[0131] The second embodiment of the present invention has been described in detail above with reference to the accompanying drawings. However, the specific features are not limited to this embodiment and also include design changes that do not exceed the scope of the main concept of the present invention. In addition, the feature elements shown in the foregoing embodiments and variations can be appropriately combined.

[0132] (Third Implementation)

[0133] Reference Figures 16 to 19 The treatment apparatus 100C according to the third embodiment of the present invention will be described. In the following description, the same symbols are used for structures that are common to those already described, and repeated descriptions are omitted.

[0134] [Treatment Equipment 100C]

[0135] Figure 16 This is a side view of the front end of the handling device 100C.

[0136] Similar to the treatment device 100 of the first embodiment, the treatment device 100C is used together with the endoscope 200 as an endoscope system. The treatment device 100C is a treatment device capable of performing incision, dissection, and hemostasis. The treatment device 100C includes a sheath 1, a rod 2, forceps (forceps member) 3C, an operating line 4, an operating part 5, a clamping tube 6, and a leaf spring 7C.

[0137] Figure 17 This is a side view of the front end of the handling device 100C.

[0138] The forceps (forceps component) 3C is made of conductive metal and functions as a high-frequency electrode to conduct high-frequency current to living tissue. The forceps 3C has a first clamping plate 31C, a second clamping plate 32C, and a connecting part 34C.

[0139] Figure 18 It is along Figure 16 Cross-sectional view of pliers, etc., for YY lines.

[0140] The first clamp 31C and the second clamp 32C are connected at a connecting portion 34C located on the base end side A2, and are configured to open and close freely toward the front end side A1. The connecting portion 34C rotatably connects the first clamp 31C and the second clamp 32C. The base end side of the connecting portion 34C is housed inside the front end 1a of the sheath 1.

[0141] The first clamping plate 31C has a first concave bottom 311C, a first arcuate edge portion 312C disposed at a position opposite to the second clamping plate 32C, and a first convex engagement portion 316 disposed on the inner peripheral surface of the first concave bottom 311C.

[0142] Except for the first concave bottom 311C which is formed from the front end of the first clamp 31C to the base end, the first concave bottom 311C is the same component as the first concave bottom 311 in the first embodiment.

[0143] The first arc-shaped edge portion 312C is the opening edge of the first concave bottom portion 311C, and is the same component as the first arc-shaped edge portion 312 in the first embodiment.

[0144] The first convex engagement portion 316 is a convex member disposed on the inner circumferential surface of the first concave bottom 311C opposite to the second clamping piece 32C, and is disposed on the front end side compared to the connecting portion 34C. The first convex engagement portion 316 has a first engagement surface (receiving portion) 317 that engages with the electrode portion 21. In the closed state with the first clamping piece 31C and the second clamping piece 32C closed, the first engagement surface 317 is inclined relative to the central axis O3 in the length direction A of the clamp 3C, and the base end side A2 is closer to the central axis O3 than the front end side A1.

[0145] The second clamp 32C has a second concave bottom 321C, a second arcuate edge portion 322C disposed at a position opposite to the first clamp 31C, and a second convex engagement portion 326 disposed on the inner peripheral surface of the second concave bottom 321C.

[0146] Except for the second concave bottom 321C which is formed from the front end of the second clamp 32C to the base end, the second concave bottom 321C is the same component as the second concave bottom 321 in the first embodiment.

[0147] The second arc-shaped edge portion 322C is the opening edge of the second concave bottom portion 321C, and is the same component as the second arc-shaped edge portion 322 in the first embodiment.

[0148] The second convex engagement portion 326 is a convex member disposed on the inner circumferential surface of the second concave bottom 321C opposite to the first clamp 31C, and is disposed on the front end side compared to the connecting portion 34C. The second convex engagement portion 326 has a second engagement surface 327 that engages with the electrode portion 21. In the closed state with the first clamp 31C and the second clamp 32C closed, the second engagement surface 327 (receiving portion) is inclined relative to the central axis O3 in the length direction A of the clamp 3C, and the base end side A2 is closer to the central axis O3 than the front end side A1.

[0149] like Figure 17 As shown, the first convex joint 316 and the second convex joint 326 are arranged on both sides with a central axis O3 between them. The shortest length L7 between the first convex joint 316 and the second convex joint 326 is greater than the length L2 of the rod body 20 in the radial direction R, but less than the length L1 of the electrode part 21 in the radial direction R. Therefore, the rod body 20 can move back and forth between the first convex joint 316 and the second convex joint 326 along the length direction A. On the other hand, the electrode part 21 engages with the first convex joint 316 and the second convex joint 326 when passing between them.

[0150] like Figures 16 to 18 As shown, the leaf spring 7C has a first leaf spring 71 and a second leaf spring 72.

[0151] The first leaf spring 71 is mounted on the sheath 1 and the first clamp 31C. The first leaf spring 71 is mounted so that it is in a planar state when the first clamp 31C and the second clamp 32C are closed. Therefore, the first leaf spring 71 applies a force to the first clamp 31C through a restoring force, causing the first clamp 31C to be in a closed state.

[0152] The second leaf spring 72 is mounted on the sheath 1 and the second clamp 32C. The second leaf spring 72 is mounted so that it is in a planar state when the first clamp 31C and the second clamp 32C are closed. Therefore, the second leaf spring 72 applies a restoring force to the second clamp 32C, causing the second clamp 32C to be in a closed state.

[0153] Figure 19 This is a cross-sectional view of the front end of the treatment device 100C with the electrode section 21 retracted.

[0154] If the surgeon retracts rod 2, electrode 21 engages with the first engagement surface 317 and the second engagement surface 327. If the surgeon retracts rod 2 further, electrode 21 pushes the first convex engagement portion 316 and the second convex engagement portion 326 outwards in a radial direction R. When engaging with the first engagement surface 317 and the second engagement surface 327, electrode 21 acts as an "abutment" for the first convex engagement portion 316 and the second convex engagement portion 326. As a result, the first clamp 31C and the second clamp 32C overcome the restoring force of the leaf spring 7 and change from a closed state to an open state.

[0155] If the surgeon moves the rod 2 backward, causing the electrode part 21 to separate from the first engagement surface 317 and the second engagement surface 327, the first clamp 31C and the second clamp 32C will change from the open state to the closed state due to the restoring force of the leaf spring 7C.

[0156] Similar to the first embodiment, the surgeon can open the first clamp 31C and the second clamp 32C by retracting the lever 2. Similarly, also similar to the first embodiment, the surgeon can close the first clamp 31C and the second clamp 32C by advancing the lever 2. Using the treatment instrument 100, the surgeon can perform incision, dissection, and hemostasis procedures in the same manner as in the first embodiment.

[0157] The treatment instrument 100C according to this embodiment can perform incision, dissection, and hemostasis, and the switching operation between the rod 2 for incision and dissection and the forceps 3C for hemostasis is easy. The surgeon only needs to move the rod 2 forward and backward to switch between the rod 2 for incision and dissection and the forceps 3C for hemostasis.

[0158] The third embodiment of the present invention has been described in detail above with reference to the accompanying drawings. However, the specific features are not limited to this embodiment and also include design changes that do not exceed the scope of the main concept of the present invention. In addition, the feature elements shown in the foregoing embodiments and variations can be appropriately combined.

[0159] (Fourth Implementation)

[0160] Reference Figures 20 to 21 The treatment device 100D according to the fourth embodiment of the present invention will be described. In the following description, the same symbols are used for structures that are common to those already described, and repeated descriptions are omitted.

[0161] [Treatment Equipment 100D]

[0162] Figure 20 This is a cross-sectional view of the front end of the treatment device 100D.

[0163] Similar to the treatment device 100 of the first embodiment, the treatment device 100D is used together with the endoscope 200 as an endoscope system. The treatment device 100D is a treatment device capable of performing incision, dissection, and hemostasis. The treatment device 100D includes a sheath 1D, a rod 2, forceps (forceps member) 3B, an operating line 4, an operating part 5, and a tube 6D.

[0164] Except for the slit 13 on the outer periphery of the front end 1a, the sheath 1D is the same component as the sheath 1 in the first embodiment. The slit 13 is formed along the length direction A and extends from the inner space 1s of the sheath 1D to the outer space.

[0165] The tube (sleeve) 6D has a tube body 64 and a tube fixing member 65. The tube body 64 is cylindrical and can accommodate the pliers 3B in a closed state. The base end 64b of the tube body 64 is fitted into the outer periphery of the front end 1a of the sheath 1D.

[0166] The tube fixing member 65 is a member that connects the base end 64b of the tube body 64 and the operating line 4. The tube fixing member 65 is configured through the slit 13, so that the tube body 64 located outside the sheath 1D and the operating line 4 located inside the sheath 1D can be connected.

[0167] Figure 21 This is a cross-sectional view of the front end of the treatment device 100D with the electrode section retracted.

[0168] If the surgeon retracts lever 2, the tube fixing member 65 and tube body 64 connected to the operating line 4 will also retract. The connecting part 34B of forceps 3B stores force in a manner intended to open the first clamp plate 31B and the second clamp plate 32B. Therefore, if the tube body 64 retracts relative to forceps 3B, the first clamp plate 31B and the second clamp plate 32B will change from a closed state to an open state.

[0169] If the surgeon moves the lever 2 forward, the tube body 64 will accommodate the forceps 3B, and the first forceps 31 and the second forceps 32 will change from the open state to the closed state.

[0170] Similar to the first embodiment, the surgeon can open the first clamp 31 and the second clamp 32 by retracting the lever 2. Similarly, also similar to the first embodiment, the surgeon can close the first clamp 31 and the second clamp 32 by advancing the lever 2. The surgeon can perform incision, dissection, and hemostasis procedures using the treatment instrument 100D in the same manner as in the first embodiment.

[0171] According to the treatment instrument 100D of this embodiment, incision, dissection, and hemostasis can be performed, and the switching operation between the rod 2 for incision and dissection and the forceps 3B for hemostasis is easy. The surgeon only needs to move the rod 2 forward and backward to switch between the rod 2 for incision and dissection and the forceps 3B for hemostasis.

[0172] The fourth embodiment of the present invention has been described in detail above with reference to the accompanying drawings. However, the specific features are not limited to this embodiment and also include design changes that do not exceed the scope of the main concept of the present invention. In addition, the feature elements shown in the foregoing embodiments and variations can be appropriately combined.

[0173] Industrial availability

[0174] This invention can be applied to treatment devices used for hemostasis.

[0175] Explanation of reference numerals in the attached figures

[0176] 300. Endoscopic treatment system; 200. Endoscope; 100, 100B, 100C, 100D. Treatment instrument; 1, 1B, 1D. Sheath; 2, 2A. Rod; 20. Rod body; 21. Electrode part; 22. Stop part; 23. Abutment part; 3, 3B, 3C. Pliers (pliers component); 31, 31B, 31C. First clamping piece; 32, 32B, 32C. Second clamping piece; 33. Through hole; 34, 34B, 34C. Connecting part; 315. First base support part ( 317. First mating surface (bearing part); 325. Second base end support (bearing part); 327. Second mating surface (bearing part); 4. Operating line; 5. Operating part; 51. Operating part body; 52. Sliding member; 53. Power supply connector; 6. Pressure tube (sleeve); 60. Rod through hole; 61. First clamp through hole; 62. Second clamp through hole; 63. Front end wall (bearing part); 6D. Tube; 64. Tube body; 65. Tube fixing member; 7. Spring; 7C. Leaf spring.

Claims

1. A treatment device, wherein, have: jacket; Pliers are provided at the front end of the sheath and can be opened and closed freely. The lever is recessed into the front end of the pliers and can be supplied with high-frequency current. An operating part is provided at the base end of the sheath to move the rod forward and backward; The rod has a rod body and an abutment portion disposed on the front end side of the rod body. The radial length of the abutment portion is longer than the radial length of the rod body. The processing device has a receiving part, and as the rod retracts, the abutting part abuts against the receiving part. The pliers transition from a closed state to an open state by bringing the abutting portion of the rod into contact with the bearing portion.

2. The treatment apparatus as claimed in claim 1, wherein, The pliers have a first clamping plate and a second clamping plate. The rod is capable of moving forward and backward within the area enclosed by the first and second clamps. The rod passage area has a first rod passage area on the front end side and a second rod passage area on the base end side. When the abutting portion is located in the area through which the second rod passes, the abutting portion contacts at least one of the first clamp and the second clamp, which serve as the bearing portion.

3. The treatment apparatus as described in claim 2, wherein, A sleeve is provided that can accommodate at least a portion of the pliers in their closed state. The sleeve is connected to the base end of the rod and moves in conjunction with the rod's forward and backward movements.

4. The treatment apparatus as claimed in claim 1, wherein, A sleeve having at least a portion of the pliers in a closed state. The sleeve is slidably disposed at the front end of the sheath. The bearing portion is formed in part of the sleeve.

5. The treatment apparatus as claimed in claim 1, wherein, The pliers have a first clamping plate and a second clamping plate. The rod passes through the area enclosed by the first clamp and the second clamp. The first clamping piece has a first engagement surface on its inner circumferential surface opposite to the second clamping piece. The second clamping piece has a second engagement surface on its inner circumferential surface opposite to the first clamping piece. The bearing portion comprises the first mating surface and the second mating surface.

6. The treatment device as claimed in any one of claims 1 to 4, wherein, When the pliers are closed, they form a through hole through which the rod can pass toward the front end.

7. The treatment device as claimed in any one of claims 1 to 4, wherein, The abutting part is an electrode disposed at the front end of the rod.

8. The treatment apparatus as described in claim 2 or 3, wherein, The first clamp and the second clamp have an insulating coating on their outer surfaces opposite to the rod passage area.

9. The treatment apparatus as claimed in claim 1, wherein, The pliers are made of a conductive material and are energized by contacting the abutment portion.

10. The treatment apparatus as claimed in claim 1, wherein, The pliers include a first clamping plate and a second clamping plate. The bearing portion is a part of the base end side of the first clamp and a part of the base end side of the second clamp.

11. The treatment apparatus as claimed in claim 1, wherein, It has a sleeve capable of accommodating a portion of the pliers. The bearing portion is a protrusion that extends inward toward the inside of the sleeve. The abutting part abuts against the bearing part as the rod retracts, thereby causing the sleeve to retract relative to the pliers, and the pliers to transition from a closed state to an open state.

12. The treatment apparatus of claim 1, wherein The pliers have a first clamping plate, a second clamping plate, and a connecting part that rotatably connects the first clamping plate and the second clamping plate. The first clamp has a first convex engaging member extending convexly on its inner side opposite to the second clamp. The second clamp has a convexly extending second convex engaging member on its inner side opposite to the first clamp. The first convex engaging member and the second convex engaging member include the bearing portion.

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