High-frequency treatment tool

Abstract

A high-frequency treatment tool is provided with: a sheath through which an operation wire is inserted in the direction of the longitudinal axis; a tip member provided at the tip of the sheath, the tip member having a lumen penetrating in the longitudinal axis direction; and an electrode that passes through the lumen and is capable of protruding from the tip member toward the tip side by the operation wire, in which a scraping part is provided on the inner peripheral surface of the tip member and within the range of the tip member in the longitudinal axis direction, the scraping part including a nipping part for nipping the biological tissue adhering to the electrode, the nip portion has a corner extending in a direction intersecting the longitudinal axis. The high-frequency treatment tool of the present invention can conveniently perform a cleaning operation of biological tissue adhering to the surface of an electrode in a state of being inserted into a body, and has a good cleaning effect.

Description

Technical Field

[0001] The present invention relates to a high-frequency treatment instrument. Background Art

[0002] High-frequency treatment instruments, such as high-frequency electrosurgical knives, are commonly used treatment instruments in endoscopic procedures such as endoscopic submucosal dissection (ESD). Such treatment instruments have an electrode at the distal end that can apply a high-frequency current. When the electrode is brought into contact with human tissue and current is applied to the electrode, operations with various functions such as tissue cutting, marking, and hemostasis can be performed.

[0003] However, during the treatment process, residues of thermally denatured or charred biological tissue will adhere to the surface of the electrode to form a biological tissue attachment (hereinafter referred to as "attachment"). If these attachments are not promptly cleaned from the electrode surface, it will affect the high-frequency current applied from the electrode to the tissue and reduce the performance of the treatment instrument.

[0004] Conventionally, the high-frequency treatment instrument is pulled out from the endoscopic channel, the surface of the electrode is cleaned outside the body, and after cleaning, it is inserted back into the body through the endoscopic channel to continue the treatment. However, this makes the treatment operation cumbersome and time-consuming.

[0006] Prior Art Documents Patent Documents Patent Document 1: International Publication No. WO2014 / 042039 Summary of the Invention Technical Problem to be Solved by the Invention

[0007] An object of the present invention is to provide a high-frequency treatment instrument that can conveniently clean the biological tissue attached to the surface of the electrode without being pulled out of the body, while ensuring a good cleaning effect. Technical Solution for Solving the Technical Problem

[0008] The high-frequency treatment instrument of the present invention includes: a sheath through which an operating wire penetrates in the direction of the longitudinal axis; a distal member having a lumen penetrating in the direction of the longitudinal axis, provided at the distal end of the sheath; an electrode penetrating the lumen, capable of protruding from the distal member toward the distal side through the operating wire, and a scraping portion is provided on the inner circumferential surface of the distal member and within the range of the distal member in the direction of the longitudinal axis, the scraping portion includes a biting portion that bites into the biological tissue attached to the electrode, and the biting portion has an edge extending in a direction crossing the longitudinal axis.

[0009] In addition, the high-frequency treatment instrument of the present invention includes: a sheath through which an operating wire penetrates in the direction of the longitudinal axis; a front-end member having a lumen penetrating in the direction of the longitudinal axis, provided at the front end of the sheath; an electrode penetrating the lumen and capable of protruding from the front-end member toward the front end side through the operating wire, and a scraping portion is provided on the inner peripheral surface of the front-end member and within the range of the front-end member in the direction of the longitudinal axis, the scraping portion includes a biting portion that bites into biological tissue attached to the electrode, and the biting portion has an edge extending in the direction of the longitudinal axis.

[0011] In the present invention, the biting portion may be circumferentially provided around the electrode on the front-end member. The biting portion may be provided at positions opposite to each other in a direction orthogonal to the longitudinal axis. In the present invention, the biting portion may form an acute angle with the edge as the tip.

[0012] In addition, the high-frequency treatment instrument of the present invention includes: a sheath through which an operating wire penetrates in the direction of the longitudinal axis; a front-end member having a lumen penetrating in the direction of the longitudinal axis, provided at the front end of the sheath; an electrode penetrating the lumen and capable of protruding from the front-end member toward the front end side through the operating wire, and a scraping portion is provided on the inner peripheral surface of the front-end member and within the range of the front-end member in the direction of the longitudinal axis, the scraping portion includes a biting portion that bites into biological tissue attached to the electrode.

[0013] In the present invention, the biting portion may be a brush circumferentially provided on at least a part of the inner peripheral surface of the front-end member. In addition, in the present invention, the biting portion may also be a cone or a thread circumferentially provided on at least a part of the inner peripheral surface of the front-end member.

[0014] In the present invention, a plurality of the biting portions may be provided on the inner peripheral surface of the front-end member in the direction of the longitudinal axis.

[0015] In the present invention, it may be that the front-end member has a fluid passage for discharging fluid toward the front end side, and in a cross-section orthogonal to the longitudinal axis, the biting portion and the fluid passage are offset from each other.

[0016] In the present invention, a rod that can move forward and backward in the direction of the longitudinal axis may be provided inside the electrode.

[0017] In the present invention, it may be that the electrode has a first state and a second state. In the first state, the electrode protrudes from the front-end member and bends with a first radius of curvature. In the second state, the electrode is received in the inner cavity of the front-end member and bends with a second radius of curvature greater than the first radius of curvature. In the second state, a part of the electrode is pressed by the biting portion.

[0018] In the present invention, the electrode can rotate relative to the front-end member about the longitudinal axis. Effects of the invention

[0019] According to the high-frequency treatment instrument of the present invention, it is possible to conveniently perform the cleaning operation of biological tissue attached to the surface of the electrode in a state where it is inserted into the body, and at the same time, the cleaning effect is good. Description of the drawings

[0020] Figure 1 It is an overall schematic view of the high-frequency treatment instrument of the first embodiment. Figure 2A It is a perspective view of the vicinity of the front end of the insertion portion of the high-frequency treatment instrument of the first embodiment, omitting the illustration of the large-diameter portion of the electrode. Figure 2B It is a perspective view of the vicinity of the front end of the insertion portion of the high-frequency treatment instrument of the first embodiment, omitting the illustration of the front-end member and the large-diameter portion of the electrode. Figure 2C It is a view of the electrode, the front-end member, and the sheath cut along a plane passing through the longitudinal axis O, showing the scraping portion, and omitting the illustration of the large-diameter portion of the electrode. Figure 2D It is a perspective view of the scraping portion of the high-frequency treatment instrument of the first embodiment. Figure 3A It is a perspective view of the vicinity of the front end of the insertion portion of the high-frequency treatment instrument of the second embodiment, omitting the illustration of the large-diameter portion of the electrode. Figure 3B It is a perspective view of the vicinity of the front end of the insertion portion of the high-frequency treatment instrument of the second embodiment, omitting the illustration of the front-end member and the large-diameter portion of the electrode. Figure 3C It is a perspective view of the scraping portion of the high-frequency treatment instrument of the second embodiment. Figure 3D It is a schematic view of an alternative example of the scraping portion of the high-frequency treatment instrument of the second embodiment, which is a cross-sectional view of the biting portion perpendicular to the longitudinal axis O. Figure 4A It is a cross-sectional view of the vicinity of the front end of the insertion portion of the high-frequency treatment instrument of the third embodiment cut along a plane passing through the longitudinal axis O, omitting the illustration of the large-diameter portion of the electrode. Figure 4B It is Figure 4AEnlarged cross-sectional view of the middle T region. Figure 4C is Figure 4A Enlarged perspective view of the middle T region. Figure 5 It is a partial cross-sectional view of the front end vicinity of the insertion portion of the high-frequency treatment instrument of the fourth embodiment, cut by a plane passing through the longitudinal axis O. Figure 6 It is a schematic structural diagram of Modification 1. Figure 7 It is a schematic structural diagram of Modification 2. Figure 8 It is a schematic structural diagram of Modification 3. Figure 9 It is a schematic structural diagram of Modification 4. Figure 10 It is a schematic structural diagram of Modification 5. Figure 11A It is a schematic diagram when the electrode of Modification 6 is in the first state. Figure 11B It is a schematic diagram when the electrode of Modification 6 is in the second state. Figure 12 It is a schematic structural diagram of Modification 7. Specific embodiments

[0021] Next, the specific embodiments of the present invention will be described with reference to the accompanying drawings. It should be noted that the following specific embodiments and modifications are only for illustrative purposes of the present invention and are not used to limit the protection scope of the present invention. In addition, the dimensional ratios of the respective parts shown in the drawings have been appropriately enlarged or reduced according to the needs of the description, and the structures irrelevant to the key points to be described have been appropriately simplified or omitted. First embodiment

[0022] Figure 1 It is an overall schematic diagram of the high-frequency treatment instrument of the first embodiment of the present invention. The high-frequency treatment instrument 1 of the first embodiment is, for example, a high-frequency electrosurgical knife used for performing operations such as tissue cutting, and includes an insertion portion 10 and an operation portion 20. In Figure 1 this, the side facing the insertion portion 10 is called the front end side, and the side facing the operation portion 20 is called the base end side.

[0023] The insertion portion 10 is the part inserted into the patient's body through the endoscope channel, and includes a sheath 11, a front end member 12, an electrode 13, and an operation wire 14.

[0024] The sheath 11 is the main structure of the insertion portion 10, forms a long tubular shape that can be inserted into the endoscope channel, and has flexibility. The sheath 11 forms a channel inside along the direction of the longitudinal axis O for the operation wire 14 described later to pass through. At the same time, this channel can also form a part of the water supply path.

[0025] The front-end member 12 is provided at the front end of the sheath 11 and forms a substantially cylindrical shape. An inner cavity is formed inside the front-end member 12 along the direction of the longitudinal axis O. The inner cavity of the front-end member 12 communicates with the passage of the sheath 11, and the electrode 13 can pass through it.

[0026] The electrode 13 is provided at the foremost end of the insertion portion 10 in such a manner as to penetrate the inner cavity of the front-end member 12, and is used for performing treatment operations such as cutting tissues by high-frequency current. The electrode 13 includes a large-diameter portion 132 and an electrode main body 131 as the energized portion. Among them, according to the type of high-frequency treatment instrument, the large-diameter portion 132 can be insulated or energized.

[0027] The electrode main body 131 is formed in an elongated cylindrical shape, for example, formed of a conductive material such as metal, and its proximal end is connected to the front end of an operation wire 14 described later. By the pushing operation of the operation wire 14, the electrode 13 can protrude from the front-end member 12 toward the front end side.

[0028] The large-diameter portion 132 is formed at the front end of the electrode main body 131. The outer diameter of the large-diameter portion 132 is larger than the outer diameter of the electrode main body 131, and the outer diameter of the large-diameter portion 132 is larger than the inner diameter of the front-end member 12. When the electrode 13 is retracted by the pulling operation of the operation wire 14, the large-diameter portion 132 abuts against the front end of the front-end member 12. The large-diameter portion 132 can be made of an insulating material or coated with an insulating coating on its surface to prevent tissue perforation during energized treatment.

[0029] The operation wire 14 penetrates the passage of the sheath 11 along the direction of the longitudinal axis O. The front end of the operation wire 14 is connected to the proximal end of the electrode main body 131 of the electrode 13, and the proximal end of the operation wire 14 is connected to a sliding portion 23 in an operation portion 20 described later. The operation wire 14 is used to move the electrode 13 along the direction of the longitudinal axis O. As described later, the operation wire 14 can also rotate the electrode 13 relative to the sheath 11 and the front-end member 12 around the longitudinal axis O. The operation wire 14 is formed of a single metal wire or a stranded metal wire and constitutes a part of the current path for high-frequency current.

[0030] The operation portion 20 is used for an operator to operate the high-frequency treatment instrument 1, and includes a gripping portion 21, a sliding portion 23, a power supply interface 24, and a water supply interface 25.

[0031] The gripping portion 21 is made of, for example, a resin material and is the portion held by the operator when operating the high-frequency treatment instrument 1. A ring portion for placing the thumb is integrally formed at the proximal end of the gripping portion 21. The proximal end portion of the sheath 11 is connected to the front end of the gripping portion 21. The proximal end portion of the sheath 11 and the front end of the gripping portion 21 can be connected in such a way as to rotate relative to each other around the longitudinal axis O. A sliding groove 22 is formed in the gripping portion 21 along its length direction.

[0032] The sliding part 23 is arranged in the sliding groove 22 in such a way that it can slide along the sliding groove 22. The sliding part 23 is integrally formed with a finger-ring part for placing a finger, which is convenient for sliding operation. The proximal end of the operating wire 14 is fixed to the sliding part 23. Therefore, corresponding to the sliding of the sliding part 23, the operating wire 14 also moves along the direction of the longitudinal axis O, driving the electrode 13 to move along the direction of the longitudinal axis O.

[0033] The proximal end part of the sheath 11 and the front end of the holding part 21 can be connected in such a way that they can rotate relative to each other around the longitudinal axis O. Therefore, relative to the sheath 11, when the sliding part 23 and the holding part 21 are rotated together around the longitudinal axis O, the operating wire 14 rotates around the longitudinal axis O relative to the sheath 11, and can drive the electrode 13 to rotate around the longitudinal axis O together.

[0034] A power supply interface 24 is formed on the sliding part 23. The power supply interface 24 can be connected to an external power supply (not shown). The power supply interface 24 is electrically connected to the operating wire 14. The high-frequency current from the external power supply reaches the human tissue to be treated via the power supply interface 24, the operating wire 14, and the electrode 13, for performing a tissue cutting treatment operation.

[0035] A water supply interface 25 is further formed on the holding part 21. The water supply interface 25 can be connected to an external fluid supply device (not shown). The external fluid supply device can be, for example, a pump or a syringe, etc. The water supply interface 25 is communicated with the channel of the sheath 11. The external fluid supply device provides a fluid such as physiological saline, which is discharged toward the front end of the front end member 12 via the water supply interface 25, the channel of the sheath 11, and the inner cavity of the front end member 12, for performing operations such as wound irrigation.

[0036] Next, the scraping part 30 of the first embodiment will be described with reference to the drawings. The scraping part 30 is used to remove the attachments adhering to the electrode.

[0037] As Figure 1 shown, the scraping part 30 is fixedly arranged on the inner peripheral surface of the front end member 12, and, in the direction of the longitudinal axis O, the scraping part 30 is entirely within the range of the front end member 12. In particular, the scraping part 30 does not protrude from the front end member 12 toward the front end side.

[0038] As Figures 2A to 2D shown, the scraping part 30 is integrally formed in a substantially cylindrical shape, coaxial with the longitudinal axis O, and the thickness in the radial direction is substantially uniform. The outer diameter of the scraping part 30 is smaller than the inner diameter of the inner cavity of the front end member 12. The inner diameter of the scraping part 30 is slightly larger than the outer diameter of the electrode body 131 of the electrode 13, just enabling the electrode body 131 to pass through.

[0039] The scraping part 30 has four biting parts 31 on its front end side, which are arranged along the circumferential direction around the electrode body 131 on the inner circumferential surface of the front end member 12. The four biting parts 31 are respectively arranged at positions opposite to each other in the direction orthogonal to the longitudinal axis O. The biting part 31 is formed into a sharp tooth shape facing the front end side, and can bite into the attachment on the electrode 13. Specifically, an edge 311 extending in the direction crossing the longitudinal axis O is formed at the front end of each biting part 31. Preferably, the edge 311 extending in the direction crossing the longitudinal axis O is located at a position closer to the proximal end side than the front end of the front end member 12. The biting part 31 uses this edge 311 as the tip, forms an acute angle with the circumferential width gradually decreasing towards the front end side, and extends along the outer circumferential surface of the electrode body 131 towards the front end side.

[0040] Here, "fitting" includes not only the actual adhering situation, but also the situation where there is a small gap available for drainage. In addition, "crossing the longitudinal axis O" includes both the case perpendicular to the longitudinal axis O and the case not perpendicular to the longitudinal axis O. In the case not perpendicular to the longitudinal axis O, preferably, the edge 311 is inclined towards the proximal end side relative to the longitudinal axis O, but it can also be inclined towards the front end side relative to the longitudinal axis O.

[0041] At the same time, the adjacent biting parts 31 are recessed towards the proximal end side relatively, forming four accommodating parts 32. Since the scraping part 30 is formed only within the range of the front end member 12 in the direction of the longitudinal axis O, the accommodating part 32 is surrounded by the inner circumferential surface of the front end member 12, the outer circumferential surface of the electrode body 131 and the bottom at the proximal end side of the accommodating part 32, forming an accommodating space that opens only towards the front end side.

[0042] In the present embodiment, the scraping part 30 has four biting parts 31 and four accommodating parts 32, but the number of the biting parts 31 and the accommodating parts 32 is not limited to this, and an appropriate number can be set as needed.

[0043] When performing a scraping operation on the attachment on the electrode, by sliding the sliding part 23 of the operation part 20 along the sliding groove 22 towards the proximal end side, the electrode 13 is retracted towards the proximal end side from the state protruding from the front end member 12. At this time, on the one hand, the edge 311 of the biting part 31 bites into the attachment on the electrode body 131, cuts the attachment in a large area into small pieces, and reduces the adhesion of the attachment. This is particularly beneficial for removing stubborn attachments generated due to tissue burning and the like. On the other hand, as the electrode body 131 slides towards the proximal end side relative to the scraping part 30, the attachment is scraped off by the scraping part 30 that fits the outer circumferential surface of the electrode body 131.

[0044] At the same time, the fragments of the attached matter scraped off by the scraping portion 30 are captured by the housing portion 32. As described above, since the scraping portion 30 is formed only within the range of the front end member 12 in the direction of the longitudinal axis O, the housing portion 32 is surrounded by the inner peripheral surface of the front end member 12, the outer peripheral surface of the electrode body 131, and the bottom portion on the proximal end side of the housing portion 32 to form a housing space that opens only toward the front end side. Therefore, it is easy to capture the fragments of the attached matter. As a result, the possibility that the fragments of the attached matter scraped off by the scraping portion 30 fall on the treatment wound surface is reduced.

[0045] In addition, when scraping the attached matter on the electrode body 131, after the edge 311 of the biting portion 31 bites into the attached matter, the electrode 13 can also be rotated relative to the front end member 12 and the sheath 11. At this time, the electrode 13 rotates relative to the scraping portion 30 fixedly provided on the inner peripheral surface of the front end member 12, and the attached matter can also be removed in the circumferential direction. Second Embodiment

[0046] Next, Figures 3A to 3C the second embodiment of the present invention will be described. Compared with the first embodiment, the difference in the second embodiment is only the structure of the scraping portion 30A. For the same structures as those in the first embodiment, the same reference numerals are used, and the repeated description is omitted.

[0047] As Figures 3A to 3C shown, the entire scraping portion 30A is formed in a substantially cylindrical shape and is coaxial with the longitudinal axis O, and the thickness in the radial direction is substantially uniform. The outer diameter of the scraping portion 30A is smaller than the inner diameter of the inner cavity of the front end member 12 and is fixedly provided on the inner peripheral surface of the front end member 12. The inner diameter of the scraping portion 30A is slightly larger than the outer diameter of the electrode body 131 of the electrode 13, and the electrode body 131 can just pass through.

[0048] Similar to the first embodiment, in the direction of the longitudinal axis O, the entire scraping portion 30A is located within the range of the front end member 12. In particular, the scraping portion 30A does not protrude from the front end member 12 toward the front end side.

[0049] The scraping portion 30A has four biting portions 31A on the front end side, which are arranged along the circumferential direction on the inner peripheral surface of the front end member 12 so as to surround the electrode body 131. The four biting portions 31A are respectively arranged at positions opposite to each other in the direction orthogonal to the longitudinal axis O. The biting portion 31A is in a fan shape that is separated from each other in the circumferential direction in a cross section orthogonal to the longitudinal axis O. And each of the biting portions 31A is formed in a columnar shape that extends toward the front end side along the direction of the longitudinal axis O and extends toward the front end side while adhering to the outer peripheral surface of the electrode body 131.

[0050] On both circumferential ends of each biting portion 31 on the side closer to the electrode main body 131, edges 311A extending in the direction of the longitudinal axis O are respectively formed. The four biting portions 31 formed in the scraping portion 30A altogether have 8 edges 311A. Preferably, the edges 311A extending in the direction of the longitudinal axis O are located on the proximal side with respect to the front end of the front end member 12. By means of the edges 311A, the biting portion 31A can bite into the attachment on the electrode main body 131. Alternatively, as Figure 3D shown, the biting portion 31A may also form an acute angle with the edge 311A as the tip to obtain a good biting effect.

[0051] Between adjacent biting portions 31A, four accommodating portions 32A extending in the direction of the longitudinal axis O are formed. Since the scraping portion 30A is formed only within the range of the front end member 12 in the direction of the longitudinal axis O, the accommodating portion 32A is surrounded by the inner circumferential surface of the front end member 12, the outer circumferential surface of the electrode main body 131, and the bottom on the proximal side of the accommodating portion 32A, forming an accommodating space that opens only to the front end side.

[0052] In the present embodiment, the scraping portion 30A has four biting portions 31A and four accommodating portions 32A, but the numbers of the biting portions 31A and the accommodating portions 32A are not limited thereto, and an appropriate number can be set as needed.

[0053] When performing a scraping operation on the attachment on the electrode, by sliding the sliding portion 23 of the operation portion 20 along the sliding groove 22 toward the proximal side, the electrode 13 is retracted toward the proximal side from the state of protruding from the front end member 12. At this time, on the one hand, the edge 311A of the biting portion 31A bites into the attachment on the electrode main body 131, cutting the attachment that forms a large contiguous area into small pieces, reducing the adhesion of the attachment. This is particularly advantageous for removing stubborn attachments generated due to tissue charring or the like. On the other hand, as the electrode main body 131 slides toward the proximal side relative to the scraping portion 30A, the attachment is scraped off by the scraping portion 30A that is in contact with the outer circumferential surface of the electrode main body 131.

[0054] At the same time, the attachment fragments scraped off by the scraping portion 30A are captured by the accommodating portion 32A. As described above, since the scraping portion 30A is formed only within the range of the front end member 12 in the direction of the longitudinal axis O, the accommodating portion 32A is surrounded by the inner circumferential surface of the front end member 12, the outer circumferential surface of the electrode main body 131, and the bottom on the proximal side of the accommodating portion 32A, forming an accommodating space that opens only to the front end side, which is convenient for capturing the attachment fragments. Therefore, the possibility of the attachment fragments scraped off by the scraping portion 30A falling on the treatment wound surface is reduced.

[0055] In addition, when scraping the attachment on the electrode body 131, after the edge 311A of the biting portion 31A bites into the attachment, the electrode 13 can also be rotated relative to the front-end member 12 and the sheath 11. At this time, the electrode 13 rotates relative to the scraping portion 30A fixedly provided on the inner peripheral surface of the front-end member 12, and the attachment can also be removed in the circumferential direction. Third Embodiment

[0056] Next, Figures 4A to 4C , the third embodiment of the present invention will be described. Compared with the first embodiment, the difference in the third embodiment of the present invention lies in the different structures of the front-end member 12B and the scraping portion 30B. For the same structures as those in the first embodiment, the same reference numerals are used, and repeated descriptions are omitted.

[0057] As Figures 4A to 4C shown, a stepped portion 122B is formed on the inner peripheral surface of the front-end member 12B. The stepped portion 122B divides the inner peripheral surface of the front-end member 12B into a large-diameter portion 121B on the front-end side and a small-diameter portion 123B on the base-end side. The inner diameter of the large-diameter portion 121B is larger than that of the small-diameter portion 123B. The inner diameter of the small-diameter portion 123B is slightly larger than the outer diameter of the electrode body 131, just allowing the electrode body 131 to pass through.

[0058] A scraping portion 30B is provided in the large-diameter portion 121B. The scraping portion 30B includes an annular base portion 31B1 and a biting portion 31B2 implanted in the annular base portion 31B1.

[0059] The annular base portion 31B1 is fixedly provided on the inner peripheral surface of the large-diameter portion 121B by riveting, bonding, welding, or the like, and is the base for fixing the biting portion 32B2.

[0060] The biting portion 31B2 forms a brush fixed to the annular base portion 31B1 in a radial direction along the circumferential direction, extends from the annular base portion 31B1 toward the electrode body 131 in the radial direction, and the end abuts or almost abuts against the electrode body 131. The biting portion 31B2 has sufficient strength to bite into (penetrate) the attachment on the electrode. The material of the biting portion 31B2 can be resin or metal. The biting portion 31B2 does not necessarily need to be formed in the entire circumference along the circumferential direction of the large-diameter portion 121B, and the biting portion 31B2 can also be formed only in at least a part of the circumferential direction.

[0061] In the inner cavity of the front-end member 12B, a receiving space 32B is formed between the biting portion 31B2 and the stepped portion 122B.

[0062] In addition, the stepped portion 122B of the front-end member 12B can function as a second scraping portion 33B.

[0063] When scraping the attachment on the electrode, by sliding the sliding part 23 of the operation part 20 along the sliding groove 22 toward the proximal end side, the electrode 13 is retracted toward the proximal end side from the state of protruding from the front end member 12B. At this time, on the one hand, the biting part 31B2 bites into the attachment on the electrode body 131, cuts the attachment that forms a large area into small pieces, and reduces the adhesion of the attachment. This is particularly advantageous for removing stubborn attachments generated due to tissue burning or the like. On the other hand, as the electrode body 131 slides toward the proximal end side relative to the scraping part 30B, the attachment is scraped by the biting part 31B2 (scraping part 30B) and the step part 122B (second scraping part 33B).

[0064] At the same time, the attachment fragments scraped by the biting part 31B2 and the step part 122B are captured by the receiving part 32B. Since the biting part 31B2 and the step part 122B are formed within the range of the front end member 12B in the direction of the length axis O, the receiving part 32B is surrounded by the inner peripheral surface of the front end member 12B, the outer peripheral surface of the electrode body 131, the biting part 31B2 and the step part 122B, forming a relatively closed receiving space, which is convenient for capturing the attachment fragments. Therefore, the possibility of the scraped attachment fragments falling on the treatment wound surface is reduced. Fourth Embodiment

[0065] Next, in combination with Figure 5 , the fourth embodiment of the present invention will be described. Compared with the third embodiment, the difference in the fourth embodiment of the present invention lies only in the structure of the scraping part 30C. For the same structures as those in the third embodiment, the same reference numerals are marked and the repeated description is omitted.

[0066] As Figure 5 shown, the scraping part 30C of this embodiment does not have an annular base part, but directly forms the biting part 31C on the inner peripheral surface of the large-diameter part 121B of the front end member 12B. Each biting part 31C is composed of an elongated cone and extends from the inner peripheral surface of the large-diameter part 121B toward the electrode body 131.

[0067] Viewed from the direction of the length axis O, the biting parts 31C are arranged along the circumferential direction and extend radially from the inner peripheral surface of the large-diameter part 121B toward the electrode body 131. However, the biting parts 31C do not necessarily have to be formed over the entire circumference along the circumferential direction of the large-diameter part 121B, and may also be formed only on at least a part of the circumferential direction.

[0068] In the inner cavity of the front end member 12B, a receiving space 32C is formed between the biting part 31C and the step part 122B.

[0069] In addition, the step part 122B of the front end member 12B can function as the second scraping part 33C.

[0070] When performing a scraping operation on the attachments on the electrode, the sliding portion 23 of the operating portion 20 is slid toward the base end side along the sliding groove 22, so that the electrode 13 is retracted from the state of protruding from the front end member 12B toward the base end side. At this time, on the one hand, the biting portion 31C bites into the attachments on the electrode body 131, breaking the attachments that are connected into a large area into small pieces, thereby reducing the adhesion of the attachments. This is particularly useful for removing stubborn attachments generated by tissue burns, etc. On the other hand, as the electrode body 131 slides toward the base end side relative to the scraping portion 30C, the attachments are scraped off by the biting portion 31C (scraping portion 30C) and the step portion 122B (second scraping portion 33C).

[0071] At the same time, the attachment fragments scraped off by the biting portion 31C and the step portion 122B are captured by the receiving portion 32C. As mentioned above, since the biting portion 31C and the step portion 122B are formed within the range of the front end member 12B in the direction of the length axis O, the receiving portion 32C is surrounded by the inner peripheral surface of the front end member 12B, the outer peripheral surface of the electrode body 131, the biting portion 31C and the step portion 122B, forming a relatively closed receiving space, which is convenient for capturing the attachment fragments. Therefore, the possibility of the scraped attachment fragments falling on the treated wound surface is reduced. Modification 1

[0072] In the third embodiment, one scraping portion 30B is provided along the direction of the longitudinal axis O. However, a plurality of scraping portions 30B may be provided along the direction of the longitudinal axis O. Figure 6 As shown, in this modification, two scraping parts 30B1 and 30B2 are provided in the direction along the longitudinal axis O to enhance the scraping effect of the attached matter. At this time, the space between the scraping parts 30B1 and 30B2 can also become a receiving space 32B. Modification 2

[0073] In the fourth embodiment, one scraping portion 30C is provided along the direction of the longitudinal axis O. However, a plurality of scraping portions 30C may be provided along the direction of the longitudinal axis O. Figure 7 As shown, in this modification, two scraping parts 30C1 and 30C2 are provided in the direction along the longitudinal axis O to enhance the scraping effect of the attached matter. At this time, the space between the scraping parts 30C1 and 30C2 can also become a receiving space 32C. Modification 3

[0074] In the fourth embodiment and the second modification, the front end member 12B has a large diameter portion 121B, a step portion 122B and a small diameter portion 123B. In contrast, in this modification, the front end member 12 has an inner peripheral surface that is straight in the direction of the longitudinal axis O, and one or more scraping portions are provided on the inner peripheral surface of the front end member 12 along the direction of the longitudinal axis O. For example Figure 8As shown, five scraping portions 30C are provided on the inner circumferential surface of the front-end member 12 along the direction of the longitudinal axis O. At this time, accommodation spaces 32C can be formed between adjacent scraping portions 30C. Modification Example 4

[0075] In each of the foregoing embodiments, the electrode 13 is a solid electrode composed of an electrode body 131 and a large-diameter portion 132. In contrast, as Figure 9 shown, in the electrode 13A in this modification example, an electrode channel 133 is formed in the electrode body 131 and the large-diameter portion 132 along the direction of the longitudinal axis. The electrode channel 133 forms an opening on the front end surface of the large-diameter portion 132. A slender rod 134 is disposed in the electrode channel 133. The rod 134 can be advanced and retracted freely along the direction of the longitudinal axis from the opening of the electrode channel 133 by the operation of an operation wire (not shown), for example, for performing a local puncture operation. In addition, this modification example is provided with the scraping portion and the biting portion described in each of the foregoing embodiments for removing the attachments adhering to the electrode body 131. Modification Example 5

[0076] In each of the foregoing embodiments, the inner cavities of the front-end members 12 and 12B form part of the water supply passage. However, since scraping portions are provided in the inner cavities of the front-end members 12 and 12B, the water supply efficiency is adversely affected due to the narrow water supply passage.

[0077] In this modification example, as Figure 10 shown, in addition to the inner cavity through which the electrode 13 passes, the front-end member 12C separately has a fluid passage 124 that discharges fluid toward the front end side. The fluid passage 124 communicates with the passage of the sheath 11 on the proximal end side of the front-end member 12C and opens on the front end surface of the front-end member 12C.

[0078] In the direction orthogonal to the longitudinal axis O, the water supply passage 124 is provided radially outside the inner cavity having the biting portion 30C. Therefore, in a cross section orthogonal to the longitudinal axis O, the biting portion 30C and the fluid passage 124 are offset from each other.

[0079] When performing a wound cleaning operation, a fluid such as physiological saline is injected from the water supply interface 25 of the operation unit 20, flows into the fluid passage 124 of the front-end member through the passage of the sheath 11, and finally is discharged forward from the front end opening of the fluid passage 124. Since the biting portion and the fluid passage 124 are offset from each other in a cross section orthogonal to the longitudinal axis O, the fluid is not blocked by the biting portion, and the wound cleaning operation can be performed smoothly. Modification Example 6

[0080] In the foregoing embodiments, the electrodes 13 and 13A are rigid and straight columns. In contrast, the electrode 13B of this modification has a certain elasticity and flexibility, and has a bent shape in a natural state without external force. Such a bent-shaped electrode is convenient for operations in specific situations such as cutting operations at specific narrow parts in the human body cavity.

[0081] As Figure 11A shown, in the natural state where the electrode 13B protrudes from the front-end member 12, the electrode 13B is in a first state bent with a first radius of curvature R1. When the bent-shaped electrode 13B performs an operation of cutting tissue, usually the inner side of the bend abuts against the tissue. Therefore, as Figure 11A shown, it is easier for attachments to adhere to the inner side of the bend.

[0082] The high-frequency treatment instrument of this modification has a scraping part of any one of the foregoing embodiments and modifications.

[0083] When performing a scraping operation on the attachments on the electrode 13B, first, the electrode 13B is retracted toward the proximal end side from the natural state where it protrudes from the front-end member 12, so that the electrode body of the electrode 13B is received in the inner cavity of the front-end member 12. At this time, the attachments on the electrode 13B, especially the attachments on the inner side of the bend that are subjected to a greater pressing force, are scraped off by the scraping part 30C.

[0084] As Figure 11B shown, after the elastic and flexible electrode 13B is received in the inner cavity of the front-end member 12, due to being pressed by the inner peripheral surface of the front-end member 12, the electrode 13 changes from the first state bent with the first radius of curvature R1 to the second state bent with the second radius of curvature R2. Since the electrode 13B is pressed by the inner peripheral surface of the front-end member 12 and becomes straighter, the second radius of curvature R2 is greater than the first radius of curvature R1.

[0085] Since the inner side of the bend of the electrode 13B is subjected to a greater pressing force from the inner peripheral surface of the front-end member 12, the attachments on the inner side of the bend are more easily removed by the scraping part 30C. After the electrode 13B is received in the inner cavity of the front-end member 12, the operation part 20 is rotated relative to the sheath 11, so that the operation wire 14 drives the electrode 13 to rotate around the longitudinal axis O relative to the front-end member 12. In this way, the attachments on the entire circumference of the electrode 13B can be cleaned well. Modification 7

[0086] In the fourth embodiment and Modifications 2 and 3, the scraping part 30C (biting part 31C) is formed of a cone. In this modification, as Figure 12As shown, the scraping portion 30D may also be a thread spirally provided on the inner peripheral surface of the front end members 12 and 12B. The scraping portion 30D may be an intermittent thread or a continuous thread. In addition, in order to enhance the water supply function, a fluid passage 124 as shown in Figure 10 may be provided in the front end member.

[0087] The above describes the embodiments and variations of the present invention. It should be emphasized that the above embodiments and variations are for illustrative purposes of the present invention. The protection scope of the present invention may include structures equivalent to the embodiments and variations, and may also include structures formed by combining the structural elements in the embodiments and variations whenever possible.

Claims

1. A high-frequency treatment instrument, characterized in that, Comprising: A sheath having an operating wire passing therethrough in the direction of the longitudinal axis; A front end member having a lumen passing therethrough in the direction of the longitudinal axis and provided at the front end of the sheath; An electrode passing through the lumen and capable of protruding from the front end member toward the front end side through the operating wire, A scraping portion is provided on the inner circumferential surface of the front end member within the range of the front end member in the direction of the longitudinal axis. The scraping portion includes a biting portion that bites into the biological tissue attached to the electrode, and the biting portion has an edge extending in a direction intersecting the longitudinal axis.

2. A high-frequency treatment instrument, characterized in that, Comprising: A sheath having an operating wire passing therethrough in the direction of the longitudinal axis; A front end member having a lumen passing therethrough in the direction of the longitudinal axis and provided at the front end of the sheath; An electrode passing through the lumen and capable of protruding from the front end member toward the front end side through the operating wire, A scraping portion is provided on the inner circumferential surface of the front end member within the range of the front end member in the direction of the longitudinal axis. The scraping portion includes a biting portion that bites into the biological tissue attached to the electrode, and the biting portion has an edge extending in the direction of the longitudinal axis.

3. The high-frequency treatment instrument according to claim 1 or 2, wherein The biting portion is circumferentially provided around the electrode on the front end member.

4. The high-frequency treatment instrument according to claim 3, wherein The biting portion is provided at positions opposite to each other in a direction orthogonal to the longitudinal axis.

5. The high-frequency treatment instrument according to claim 1 or 2, wherein The biting portion forms an acute angle with the edge as the tip.

6. A high-frequency treatment instrument, characterized in that, Comprising: A sheath having an operating wire passing therethrough in the direction of the longitudinal axis; A front end member having a lumen passing therethrough in the direction of the longitudinal axis and provided at the front end of the sheath; An electrode passing through the lumen and capable of protruding from the front end member toward the front end side through the operating wire, A scraping portion is provided on the inner circumferential surface of the front end member within the range of the front end member in the direction of the longitudinal axis. The scraping portion includes a biting portion that bites into the biological tissue attached to the electrode.

7. The high-frequency treatment instrument according to claim 6, wherein The biting portion is a brush circumferentially provided on at least a part of the inner circumferential surface of the front end member.

8. The high-frequency treatment instrument according to claim 6, wherein The biting portion is a cone or a thread circumferentially provided on at least a part of the inner circumferential surface of the front end member.

9. The high-frequency treatment instrument according to any one of claims 6 to 8, wherein A plurality of the biting portions are provided on the inner circumferential surface of the front end member in the direction of the longitudinal axis.

10. The high-frequency treatment instrument according to any one of claims 1, 2, 6 to 8, wherein The front end member has a fluid passage for discharging fluid toward the front end side, In a cross-section orthogonal to the longitudinal axis, the biting portion and the fluid passage are offset from each other.

11. The high-frequency treatment instrument according to any one of claims 1, 2, 6 to 8, wherein A rod that can move forward and backward along the direction of the longitudinal axis is provided inside the electrode.

12. The high-frequency treatment instrument according to any one of claims 1, 2, 6 to 8, wherein the electrode has a first state and a second state, in the first state, the electrode protrudes from the front end member and bends with a first radius of curvature, in the second state, the electrode is housed in the inner cavity of the front end member and bends with a second radius of curvature greater than the first radius of curvature, in the second state, a part of the electrode is pressed by the biting portion.

13. The high-frequency treatment instrument according to claim 12, wherein the electrode can rotate relative to the front end member about the longitudinal axis.

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