Treatment tool for endoscope

Abstract

The invention provides a treatment tool for an endoscope. This treatment tool for an endoscope is provided with: a sheath; an electrode disposed on the tip side of the sheath; a rod, at least a part of which is disposed within the electrode; and an elastic body which applies force in a manner that the front end of the rod is accommodated in the electrode.

Description

Technical Field

[0001] This application claims the benefit of U.S. Provisional Application No. 63 / 564,938, filed on March 13, 2024, the entire contents of which are incorporated herein by reference. Background Art

[0002] Conventionally, in endoscopic treatments such as ESD (endoscopic submucosal dissection), endoscopic treatment instruments for incision and dissection, such as a high-frequency knife, and endoscopic treatment instruments for local injection have been used.

[0003] The endoscopic treatment instrument described in Patent Document 1 includes a rod that is freely movable relative to an electrode, and is capable of performing incision and dissection treatment and local injection treatment.

[0004] Prior art literature

[0005] Patent Literature

[0006] Patent Document 1: Japanese Patent Application Laid-Open No. 2024-091534 Summary of the Invention

[0007] Problems to be solved by the invention

[0008] However, the endoscopic treatment instrument described in Patent Document 1 requires the operator to intentionally change the electrode advance / retract operation and the rod advance / retract operation according to the treatment scenario, and these operations need to be facilitated.

[0009] In view of the above circumstances, an object of the present invention is to provide an endoscopic treatment instrument comprising an electrode and a rod that is easy to operate in accordance with treatment scenarios such as incision and dissection treatment and local injection treatment.

[0010] Solutions for solving problems

[0011] In order to solve the above problems, the present invention proposes the following solutions.

[0012] An endoscopic treatment instrument according to a first aspect of the present invention includes: a sheath; an electrode disposed at a distal end of the sheath; a rod at least partially disposed within the electrode; and an elastic body for applying force so that the distal end of the rod is accommodated within the electrode.

[0013] Effects of the Invention

[0014] The electrodes and the shaft of the endoscopic treatment instrument of the present invention are easy to operate in accordance with treatment scenarios such as incision and peeling treatment and local injection treatment. BRIEF DESCRIPTION OF THE DRAWINGS

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

[0016] Figure 2 This is an overall view showing a treatment instrument of the endoscope treatment system.

[0017] Figure 3 This is a perspective view of the distal end portion of the treatment instrument.

[0018] Figure 4 It is a cross-sectional view of the distal end portion of the treatment instrument.

[0019] Figure 5 It is a cross-sectional view of the distal end portion of the treatment instrument.

[0020] Figure 6 is a cross-sectional view of the front end portion of the treatment instrument with the rod in the third position.

[0021] Figure 7 It is along Figure 6 A cross-sectional view taken along line X1-X1 is shown.

[0022] Figure 8 It is a cross-sectional view of the operating member and the operating portion.

[0023] Figure 9 It is a diagram for explaining the operation of the treatment tool.

[0024] Figure 10 It is a diagram for explaining the operation of the treatment tool.

[0025] Figure 11 It is a diagram for explaining the operation of the treatment tool.

[0026] Figure 12 It is a diagram for explaining the operation of the treatment tool.

[0027] Figure 13 is a diagram showing the rod piercing tissue.

[0028] Figure 14 This figure shows a knife that delivers fluid into tissue.

[0029] Figure 15 It is a diagram showing a modified example of the elastic body.

[0030] Figure 16 It is a diagram showing a modified example of the control lever.

[0031] Figure 17 It is along Figure 16 A cross-sectional view taken along the X2-X2 line is shown.

[0032] Figure 18 It is a diagram showing a modified example of the operation unit.

[0033] Figure 19 It is a diagram showing a modified example of the operation unit.

[0034] Figure 20 It is a diagram showing a modified example of the rod.

[0035] Figure 21 It is a diagram showing a modified example of the first connector of the treatment instrument.

[0036] Figure 22 It is a diagram showing another modified example of the first connector.

[0037] Figure 23 It is a diagram showing another modified example of the first connector.

[0038] Figure 24 It is a diagram showing another modified example of the first connector.

[0039] Figure 25 It is a diagram showing another modified example of the first connector.

[0040] Figure 26 It is a diagram showing the distal end portion of a modified example of the treatment instrument.

[0041] Figure 27 It is a diagram for explaining the operation of the treatment instrument according to the second embodiment.

[0042] Figure 28 It is a diagram for explaining the operation of the treatment instrument according to the second embodiment.

[0043] Figure 29 It is a diagram for explaining the operation of the treatment instrument according to the second embodiment.

[0044] Figure 30 It is a diagram for explaining the operation of the treatment instrument according to the second embodiment.

[0045] Figure 31 It is a diagram for explaining the operation of the treatment instrument according to the third embodiment.

[0046] Figure 32 It is a diagram for explaining the operation of the treatment instrument according to the third embodiment.

[0047] Figure 33 It is a diagram showing a modified example of the first connector of the treatment instrument.

[0048] Figure 34 It is a diagram showing another modified example of the first connector.

[0049] Description of Reference Numerals

[0050] 300. Endoscope treatment system; 200. Endoscope; 100. 100A. 100B. 100C. Treatment instrument (treatment instrument for endoscope); 1. Outer sheath; 10. Tube; 11. Front end member; 12. First through hole; 12a. Front end opening; 14. Front end face; 15. Base end face; 19. Internal space (pipeline, lumen); 2. Blade (electrode, blade electrode); 20. Blade body; 21. Flange (front end enlarged diameter portion); 21b. Base end face; 22. 22A. 22B. 22Ba. 22Bb. 22C. 22D. 22E. First connector (abutment member); 23. First pipeline; 23a. Front end opening; 3. 3A. Rod (solid needle); 3a. Front end; 31. Main body; 32. Front end ; 33. Second connector; 4. Operating member; 41. Inner tube (first operating member); 42. Operating wire (second operating member); 43. Internal space; 5. 5A, 5B, 5C. Operating portion (handle); 50. Sheath slider; 51. Handle body; 51s. Front end stopper; 51t. Base end stopper; 52. Slider (second slider); 53. Power supply plug; 54. Liquid delivery port; 55. Suction port; 56. 56A. Control lever (first slider); 57. 57A, 57B. Elastic body; 58. Tube; 59. Internal space; 6. Elastic body; 7. Insulating member; P1. First position; P2. Second position; P3. Third position; P4. Fourth position; SR. Suction flow path; WR. Liquid delivery flow path. DETAILED DESCRIPTION

[0051] (First embodiment)

[0052] Reference Figures 1 to 12 An endoscope treatment system 300 according to a first embodiment of the present invention will be described. Figure 1 It is an overall diagram of the endoscope treatment system 300 according to this embodiment.

[0053] [Endoscope treatment system 300]

[0054] like Figure 1 As shown, the endoscope treatment system 300 includes an endoscope 200 and a treatment instrument 100. The treatment instrument 100 is inserted into the endoscope 200 for use.

[0055] [Endoscope 200]

[0056] The endoscope 200 is a well-known flexible endoscope and includes an insertion portion 202 inserted into the body from the distal end, an operation portion 207 attached to the proximal end of the insertion portion 202 , and a universal cable 210 attached to the operation portion 207 .

[0057] The insertion section 202 is a slender, longitudinal member capable of being inserted into a lumen. The insertion section 202 includes a distal end 201, a curved portion 204, and a flexible portion 205. The distal end 201, curved portion 204, and flexible portion 205 are connected in sequence from the distal end. A channel 206 is provided within the insertion section 202 for inserting the treatment instrument 100. The distal end 201 is provided with a distal opening 206a of the channel 206 and the imaging unit 203.

[0058] The imaging unit 203 includes an imaging element such as a CCD or CMOS, and is capable of capturing images of the area being treated. The imaging unit 203 can capture the distal end of the treatment instrument 100 while it is protruding from the distal end opening 206a of the channel 206. The bending portion 204 bends in response to an operator's manipulation of the operating portion 207. The soft portion 205 is a flexible, tubular portion.

[0059] The operation section 207 is connected to the flexible section 205. The operation section 207 includes a handle 208, an input section 209, and the proximal opening 206b of the channel 206. The handle 208 is gripped by the operator. The input section 209 receives an operation input for bending the bending section 204.

[0060] The universal cable 210 connects the endoscope 200 to an external device. An imaging cable, an optical fiber cable, or the like that outputs an imaging signal captured by the imaging unit 203 to the outside is inserted into the universal cable 210 .

[0061] [Disposal device 100]

[0062] Figure 2 1 is an overall view showing the treatment instrument 100 .

[0063] The treatment instrument (treatment instrument for endoscope) 100 includes an outer sheath 1, a knife 2, a rod 3, and an operating member 4 (see Figure 4 ) and the operating portion 5. In the following description, the side of the treatment instrument 100 in the longitudinal direction (longitudinal axis direction, axial direction) A that is inserted into the patient's body is referred to as the "front end side (distal side) A1", and the operating portion 5 side is referred to as the "base end side (proximal side) A2".

[0064] The outer sheath 1 is a longitudinally long tubular member extending from a front end 1a to a base end 1b. The outer sheath 1 can be inserted into the channel 206 of the endoscope 200 and can move forward and backward in the channel 206. Figure 1 As shown, in a state where the outer sheath 1 is inserted into the passage 206 , the front end 1 a of the outer sheath 1 can protrude from and retract into the front end opening 206 a of the passage 206 .

[0065] Figure 3 It is a perspective view of the distal end portion of the treatment instrument 100 .

[0066] The outer sheath 1 includes a tube 10 extending in the longitudinal direction A and a front end member 11 provided at the front end of the tube 10 . Alternatively, the outer sheath 1 may be formed by integrally molding the tube 10 and the front end member 11 .

[0067] The tube 10 is a flexible and insulating long tubular member. The tube 10 is formed of, for example, resin. The front end member 11 is fitted inside the tube 10. Alternatively, the front end member 11 may be bonded to the tube 10 using an adhesive or the like.

[0068] The front end member 11 is formed into a cylindrical shape. Note that "cylindrical shape" includes shapes that are close to a cylindrical shape in addition to a strict cylindrical shape. The front end member 11 is preferably formed of an insulating material such as resin. A first through hole 12 is formed in the front end member 11.

[0069] The first through hole 12 is provided in the front end member 11 and is a hole that penetrates the front end member 11 in the longitudinal direction A.

[0070] The front end of the first through hole 12 communicates with a front end opening 12 a formed in the front end surface 14 of the front end member 11 .

[0071] The base end of the first through hole 12 communicates with the internal space 19 of the tube 10. The blade 2 passes through the first through hole 12.

[0072] Figure 4 and Figure 5 It is a cross-sectional view of the distal end portion of the treatment instrument 100 .

[0073] The blade (electrode, blade electrode) 2 is a metal, round rod-shaped member. "Round rod-shaped" encompasses shapes close to a round rod, not just a strict round rod shape. The blade 2 is made of a material such as stainless steel. It is electrically conductive and is passed through a high-frequency current. The blade 2 includes a blade body 20, a flange 21, and a first connector 22.

[0074] The blade 2 passes through the first through hole 12 of the front end member 11 of the outer sheath 1 along the longitudinal direction A, and can protrude toward the front end side A1 relative to the front end opening 12a and can be retracted. In addition, the blade 2 can also be fixed in a state of protruding toward the front end side A1 relative to the front end opening 12a so as to be unable to advance or retreat.

[0075] The central axis O2 of the blade 2 in the longitudinal direction A preferably coincides with the central axis O1 of the outer sheath 1 in the longitudinal direction A. In addition, "coincides" includes not only a strictly coincident state but also a substantially coincident state.

[0076] The blade body 20 is a round rod-shaped member made of metal. The outer diameter of the blade body 20 is smaller than the inner diameter of the first through hole 12. The blade body 20 can move forward and backward along the longitudinal direction A in the first through hole 12.

[0077] The flange (front end expanded diameter portion) 21 is a disc-shaped conductive member provided at the front end of the blade body 20. The flange 21 has a length D2 in a radial direction R perpendicular to the longitudinal direction A that is longer than the length D1 in the radial direction R of the blade body 20. A flat base end surface 21b is formed on the base end side A2 of the flange 21. The flange 21 is not limited to a disc-shaped shape and may also have a triangular or hook-shaped shape.

[0078] The blade body 20 and the flange 21 include a first conduit 23 extending along the longitudinal direction A. The first conduit 23 communicates with a front end opening 23a formed in the flange 21. The front end opening 23a is an opening provided on the front end side A1 of the flange 21.

[0079] The first connector (abutting member) 22 is a cylindrical member made of metal. In addition, "cylindrical" includes shapes close to cylindrical shapes in addition to a strict cylindrical shape. The first connector 22 connects the knife body 20 and the inner tube 41. Specifically, the outer peripheral surface of the knife body 20 and the inner peripheral surface of the first connector 22 are fixed by welding or the like, and the outer peripheral surface of the first connector 22 and the inner peripheral surface of the inner tube 41 are fixed by welding or the like. The first connector 22 cannot penetrate the first through hole 12 along the longitudinal direction A. The first pipeline 23 is connected to the internal space 43 formed in the inner tube 41.

[0080] An inner tube 41 is attached to the proximal end of the blade body 20 via the first connector 22. A high-frequency current is supplied to the blade 2 via the inner tube 41, which is connected to the operating portion 5. When the high-frequency current is supplied to the blade 2 from the inner tube 41, the blade body 20 and the flange 21 function as active electrodes that output the high-frequency current to living tissue.

[0081] like Figure 4 As shown in FIG. 1 , when the knife 2 is advanced relative to the outer sheath 1, the front end 22a of the first connector 22 or the front end 41a of the inner tube 41 contacts the base end surface 15 of the front end member 11. The front end 22a of the first connector 22 contacts the base end surface 15 of the front end member 11, thereby positioning the knife 2 at the position closest to the front end side A1, that is, the first position P1. Alternatively, the knife 2 may be positioned at the first position P1 by means of the sliding member 52 and the front end stopper 51s (see FIG. 1 ) of the operating portion 5 described later. Figure 8 ) contacts, whereby the knife 2 is positioned at the first position P1.

[0082] like Figure 5 As shown in FIG. 1 , when the blade 2 is retracted relative to the outer sheath 1, the base end surface 21b of the flange 21 contacts the front end surface 14 of the front end member 11. The base end surface 21b of the blade 2 contacts the front end surface 14 of the front end member 11, so that the blade 2 is positioned at the position closest to the base end side A2, that is, the second position P2. Alternatively, the blade 2 may be positioned at the second position P2 by means of the slider 52 and the base end stopper 51t (see FIG. 1 ) of the operating portion 5 described later. Figure 8 ) contacts, whereby the knife 2 is positioned at the second position P2.

[0083] Figure 6 3 is a cross-sectional view of the distal end portion of the treatment instrument 100 with the rod 3 at the third position P3.

[0084] The rod (solid needle) 3 is a rod-shaped member, preferably made of a non-conductive material such as resin or ceramic to prevent the operator from passing electricity against their will, but may also be made of metal. The rod 3 has a main body 31, a distal end 32, and a second connector 33.

[0085] The rod 3 penetrates the first conduit 23 of the blade 2 along the longitudinal direction A, and can protrude toward the front end side A1 relative to the front end opening 23 a and can be retracted.

[0086] The main body 31 and the front end 32 are elongated, round rod-shaped members. The term "round rod-shaped" encompasses shapes that approximate a round rod, in addition to a strict round rod shape. The outer diameters of the main body 31 and the front end 32 are smaller than the inner diameter of the first conduit 23. The main body 31 and the front end 32 are capable of advancing and retracting along the longitudinal direction A within the first conduit 23. The front end side A1 of the front end 32 may also be tapered.

[0087] The second connector 33 connects the rod 3 and the operating wire 42. Specifically, the base end of the rod 3 and the distal end of the operating wire 42 are fixed by welding, etc. The second connector 33 cannot penetrate the first conduit 23 in the longitudinal direction A.

[0088] like Figure 6 As shown, when the rod 3 is advanced relative to the outer sheath 1, the second connector 33 of the rod 3 contacts the base end 20b of the blade body 20. The front end portion 32 protrudes further toward the front end A1 than the front end opening 23a. The contact between the second connector 33 of the rod 3 and the base end 20b of the blade body 20 positions the rod 3 at the third position P3, which is the position closest to the front end A1.

[0089] Figure 7 It is along Figure 6 A cross-sectional view taken along line X1-X1 is shown.

[0090] The cross section of the second connector 33 perpendicular to the longitudinal axis direction A is not a circular shape, but a shape formed by partially missing a circular shape (for example, a D-shaped cut shape). That is, with respect to the cross section of at least the front end portion of the second connector 33, at least a portion of the outer shape of the second connector 33 is formed by an outer surface 33s extending in a direction perpendicular to the longitudinal axis of the rod 3. The outer surface 33s is not limited to one, but may be multiple. In addition, the shape formed by partially missing a circular shape may also be a shape having a concave outer surface. In addition, the outer surface 33s may also be formed over the entire length from the front end to the base end of the second connector 33. According to this structure, as Figure 6As shown, even when the second connector 33 abuts the proximal end of the blade body 20, the internal space 43 of the inner tube 41 communicates with the first conduit 23. Furthermore, the shape of the second connector 33 is not limited to this, as long as it forms a flow path connecting the internal space 43 and the first conduit 23 when the second connector 33 abuts the proximal end of the blade body 20. For example, the distal end of the second connector 33 is not limited to a circular shape with a partially cutout portion; it may also be a rectangular or oval shape.

[0091] Figure 8 It is a cross-sectional view of the operating member 4 and the operating portion 5 .

[0092] The operating member 4 includes an inner tube 41 that passes through the internal space (tube, lumen) 19 of the outer sheath 1 and an operating wire 42 that passes through the internal space 43 of the inner tube 41 .

[0093] The inner tube (first operating member) 41 is a conductive tube used to operate the blade 2. The distal end of the inner tube 41 is connected to the blade 2 via the first connector 22. The proximal end of the inner tube 41 is connected to the slider 52 of the operating portion 5. Furthermore, the inner tube 41 may be in any other form, such as a hollow metal coil, as long as it is a hollow conductive tube.

[0094] The operating wire (second operating member) 42 is a wire member for operating the rod 3. The distal end of the operating wire 42 is connected to the rod 3 via the second connector 33. The proximal end of the operating wire 42 is connected to the control rod 56 of the operating unit 5 through a through-hole 41b provided at the proximal end of the inner tube 41. The operating wire 42 may have any other configuration as long as it enables the rod 3 to advance and retract.

[0095] Alternatively, the rod 3 and the operating wire 42 may be formed integrally. For example, the rod 3 and the operating wire 42 may be a single wire or a twisted wire, and the rod 3 and the operating wire 42 may be processed so that the diameter of the distal end portion is smaller than the diameter of the proximal end portion.

[0096] like Figure 2 As shown, the operating portion (handle) 5 includes a handle body 51 , a slider 52 , a power supply plug 53 , a liquid supply port 54 , a suction port 55 , a lever 56 , and an elastic body 57 .

[0097] The distal end of the handle body 51 is connected to the proximal end 1b of the outer sheath 1. The handle body 51 has an internal space 59 through which the inner tube 41 can pass. The inner tube 41 extends to the slider 52 through the internal space 19 of the tube 10 and the internal space 59 of the handle body 51. The operating wire 42 extends to the control rod 56 through the internal space 43 of the inner tube 41 and the internal space 59 of the handle body 51.

[0098] A slider (second slider) 52 is attached to the handle body 51 so as to be movable relative to the handle body 51 in the longitudinal direction A. The base end of the inner tube 41 is attached to the slider 52. When the operator advances or retracts the slider 52 relative to the handle body 51, the inner tube 41 and the blade 2 advance or retract.

[0099] The power plug 53 is fixed to the slider 52. The power plug 53 can be connected to a high-frequency power supply device (not shown) and is connected to the proximal end of the inner tube 41. The power plug 53 can supply high-frequency current supplied by the high-frequency power supply device to the blade 2 via the inner tube 41. Alternatively, the power plug 53 can be fixed to the handle body 51 instead of the slider 52.

[0100] The liquid supply port 54 is provided on the slider 52. The liquid supply port 54 is connected to the base end of the inner tube 41 and communicates with the internal space 43. Liquid supplied from the liquid supply port 54 passes through the liquid supply flow path WR (internal space 43, first conduit 23) and is discharged from the distal end opening 23a. Alternatively, the liquid supply port 54 may be provided on the handle body 51 instead of the slider 52.

[0101] A suction port 55 is provided on the handle body 51. The suction port 55 is connected to the front end of the handle body 51 and communicates with the internal space 59. The suction port 55 can be connected to a pump device (not shown). By suctioning through the suction port 55, the liquid sucked from the front end opening 12a is discharged outside the body through the suction flow path SR (internal space 19, internal space 59).

[0102] A control rod (first slider) 56 is attached to the slider 52 so as to be movable relative to the slider 52 in the longitudinal direction A. The base end of the operating wire 42 is attached to the control rod 56. When the operator advances or retracts the control rod 56 relative to the slider 52, the operating wire 42 and the rod 3 advance or retract.

[0103] The elastic body 57 is located between the handle body 51 and the control rod 56, connecting the two. The front end of the elastic body 57 is attached to the handle body 51, and the base end of the elastic body 57 is attached to the control rod 56. The elastic body 57 is connected to the operating wire 42 via the control rod 56. The elastic body 57 biases the control rod 56 toward the proximal end A2, causing the front end 3a of the rod 3 to be retracted into the internal space 43 of the inner tube 41. Specifically, when the elastic body 57 returns to its original shape, the front end 3a of the rod 3 is located within the inner tube 41. When the rod 3 is advanced, overcoming the elastic force of the elastic body 57, the rod 3 is biased toward the proximal end A2 by the elastic body 57. Furthermore, when the elastic body 57 returns to its original shape, the front end 3a of the rod 3 is located closer to the proximal end A2 than the front end of the outer sheath 1. Alternatively, the elastic body 57 biases the rod 3 so that the front end is retracted closer to the proximal end than the front end of the blade 2.

[0104] Furthermore, the control rod 56 may be composed of two or more members. For example, the control rod 56 may be composed of a first member connected to the operation wire 42 and the elastic body 57 and a second member that is touched and operated by the operator.

[0105] [Operation of Treatment Instrument 100]

[0106] Next, the operation of the treatment instrument 100 will be described. Figures 9 to 12 It is a diagram for explaining the operation of the treatment instrument 100 .

[0107] like Figure 9 As shown, the surgeon advances the slider 52 relative to the handle body 51, thereby advancing the blade 2 relative to the outer sheath 1. The blade 2 is positioned at the first position P1. Because the elastic member 57 biases the control rod 56 toward the proximal end A2, the rod 3 remains in a position (fourth position P4) where its distal end 3a is housed within the interior space 43 of the inner tube 41. At this point, the distal end 3a of the rod 3 is positioned closer to the proximal end A2 than the distal end of the outer sheath 1.

[0108] like Figure 10 As shown, the operator advances the control rod 56 relative to the slider 52 to advance the rod 3 relative to the knife 2. The rod 3 is positioned at the third position P3, with its front end 32 protruding toward the front end side A1 beyond the front end opening 23a. When the operator releases his hand from the control rod 56, the control rod 56 moves toward the base end side A2 due to the elastic force of the elastic body 57. As a result, Figure 9 As shown, the rod 3 returns to the fourth position P4 where the front end 3 a thereof is accommodated in the internal space 43 of the inner tube 41 .

[0109] like Figure 11 As shown, the surgeon retracts the slider 52 relative to the handle body 51, thereby retracting the blade 2 relative to the outer sheath 1. The blade 2 is positioned at the second position P2. The elastic member 57 applies a force to the control rod 56 toward the proximal end A2, causing the rod 3 to move to the fourth position P4, where its distal end 3a is housed within the interior space 43 of the inner tube 41. At this point, the distal end 3a of the rod 3 is positioned closer to the proximal end A2 than the distal end of the outer sheath 1.

[0110] like Figure 12 As shown, the operator advances the control rod 56 relative to the slider 52 to advance the rod 3 relative to the knife 2. The rod 3 is positioned at the third position P3, with its front end 32 protruding toward the front end side A1 beyond the front end opening 23a. When the operator releases his hand from the control rod 56, the control rod 56 moves toward the base end side A2 due to the elastic force of the elastic body 57. As a result, Figure 11 As shown, the rod 3 moves to the fourth position P4 where the front end 3 a thereof is accommodated in the internal space 43 of the inner tube 41 .

[0111] [How to use the endoscope treatment system 300]

[0112] Next, surgical procedures (method of using the endoscopic treatment system 300 ) using the present embodiment will be described. Specifically, local injection and incision and dissection of lesions in endoscopic treatments such as ESD (endoscopic submucosal dissection) will be described.

[0113] As a preparatory operation, the operator identifies the lesion using a known method. Specifically, the operator inserts the insertion portion 202 of the endoscope 200 into the digestive tract (e.g., esophagus, stomach, duodenum, large intestine) and identifies the lesion while observing the image obtained by the imaging portion 203 of the endoscope.

[0114] <Insert Step>

[0115] The operator inserts the treatment instrument 100 into the channel 206 so that the distal end 1 a of the outer sheath 1 protrudes from the distal end opening 206 a of the insertion portion 202 .

[0116] <Marking Step>

[0117] like Figure 11 As shown, the operator moves the slider 52 back relative to the handle body 51 and places the knife 2 at the second position P2. The flange 21 protruding from the distal end surface 14 of the distal end member 11 is used to cauterize the surrounding tissue of the lesion to mark the area.

[0118] <Piercing Steps>

[0119] Figure 13 It is a diagram showing the rod 3 puncturing tissue.

[0120] like Figure 10 As shown, the operator advances the slider 52 relative to the handle body 51, placing the knife 2 in the first position P1. Furthermore, the operator advances the control lever 56 relative to the slider 52, placing the rod 3 in the third position P3. The operator uses the rod 3 to puncture and penetrate the lesion into the area where the local injection liquid (local injection solution) is to be injected.

[0121] <Local Allocation Step>

[0122] Figure 14 This is a diagram showing a blade 2 for delivering liquid into tissue.

[0123] like Figure 9 or Figure 11As shown, the operator releases the control lever 56, causing the rod 3 to retract and move to the fourth position P4. This ensures a wide liquid supply path WR (internal space 43, first conduit 23). The operator inserts the tip of the scalpel 2 (including the tip opening 23a) through the hole punctured by the rod 3 into the submucosal layer or in contact with the tissue surface, and then delivers liquid (local injection solution) into the tissue through the liquid supply port 54. The liquid (local injection solution) is discharged from the tip opening 23a and injected into the tissue.

[0124] <Cutting and Peeling Step>

[0125] Next, the surgeon performs incision and dissection. Figure 9 As shown, the operator moves the flange 21 while advancing the blade 2 and applying high-frequency current, thereby incising the mucosa of the lesion. Furthermore, while advancing the blade 2 and applying high-frequency current, the operator lifts the mucosa of the incised lesion to expose the submucosal layer, thereby peeling off the submucosal layer of the incised lesion.

[0126] The operator continues the above-mentioned operations (treatments) as needed, and finally removes the lesion, thereby completing the ESD operation.

[0127] The treatment instrument 100 of this embodiment facilitates operation of the blade 2 and rod 3 for treatment scenarios such as incision and dissection and local injection. The operator does not need to retract the control lever 56; when the operator releases the control lever 56, the rod 3 automatically retracts into the interior space 43 of the inner tube 41, simplifying the surgical procedure. Furthermore, the operator is prevented from inadvertently operating the blade 2 with the rod 3 protruding.

[0128] The first embodiment of the present invention has been described in detail with reference to the accompanying drawings, but the specific structure is not limited to this embodiment and includes design changes within the scope of the present invention. In addition, the components shown in the embodiment and the modified example can be appropriately combined to form the structure.

[0129] (Variation 1)

[0130] Figure 151 is a diagram showing an elastic body 57A as a modified example of the elastic body 57. The front end of the elastic body 57A is attached to the control rod 56, and the base end of the elastic body 57A is attached to the handle body 51. When the control rod 56 moves forward relative to the handle body 51, as the elastic body 57A deforms, a restoring force (elastic force) acts on the elastic body 57A, causing the control rod 56 to move toward the base end side A2. The elastic body 57A, like the elastic body 57, applies force to the control rod 56 toward the base end side A2 so that the front end 3a of the rod 3 is accommodated in the internal space 43 of the inner tube 41. That is, like the elastic body 57, when the elastic body 57A returns to its original shape, the front end 3a of the rod 3 is located inside the inner tube 41. When the rod 3 moves forward by overcoming the elastic force of the elastic body 57A, the rod 3 is applied force by the elastic body 57 in the direction toward the base end side A2. In addition, when the elastic body 57A has returned to its original shape, the distal end 3 a of the rod 3 is located closer to the proximal end side A2 than the distal end of the outer sheath 1 .

[0131] (Variation 2)

[0132] Figure 16 1 and 2 are diagrams showing a control lever 56A as a modified example of the control lever 56 . Figure 17 It is along Figure 16 The cross-sectional view along the X2-X2 line is shown. The control rod 56A is not mounted on the slider 52 but on the outer periphery of the handle body 51, and is mounted on the handle body 51 in a manner that it can move relative to the handle body 51 along the longitudinal direction A. A hollow tube 58 is provided in the internal space 59 of the handle body 51. The tube 58 connects the inner tube 41 and the slider 52. The operating wire 42 passes through the tube 58 and is connected to the control rod 56A. The elastic body 57 is sheathed on the tube 58 to connect the handle body 51 and the control rod 56A. Since the control rod 56A is arranged in a position separated from the slider 52, the surgical operator can operate the control rod 56A independently of the slider 52. That is, even if the slider 52 is moved along the longitudinal direction A, the control rod 56A does not move, and even if the control rod 56A is moved along the longitudinal direction A, the slider 52 does not move.

[0133] (Variation 3)

[0134] Figure 18 and Figure 191 is a diagram showing an operating portion 5A as a modified example of the operating portion 5. The operating portion 5A includes a sheath slider 50, a handle body 51, a power supply plug 53, a liquid supply port 54, a suction port 55, a control rod 56A, and an elastic body 57. In addition, the power supply plug 53, the liquid supply port 54, and the suction port 55 are omitted from the illustration. The sheath slider 50 is connected to the base end 1b of the outer sheath 1 and can move forward and backward relative to the handle body 51. The base end 41d of the inner tube 41 is mounted on the handle body 51 in a manner that cannot move forward and backward. The surgical operator can move the outer sheath 1 forward and backward relative to the knife 2 by moving the sheath slider 50 forward and backward relative to the handle body 51. In addition, the inner tube 41 can also move forward and backward in conjunction with the outer sheath 1.

[0135] (Variation 4)

[0136] Figure 20 This figure shows a rod 3A as a modified example of the rod 3. When the operator releases his hand from the control lever 56, the rod 3A moves to a position where the distal end 3a is housed in the first conduit 23 of the blade 2. In this case, the distal end 3a of the rod 3A may be located between the distal end and the proximal end of the distal end member 11 in the longitudinal axis direction A.

[0137] (Variant 5)

[0138] Figure 21 1 is a diagram showing a first connector 22A as a modified example of the first connector 22. In the above embodiment, the front end 41a of the inner tube 41 attached to the first connector 22 is exposed at the front end 22a of the first connector 22 and can contact the base end surface 15 of the front end member 11. On the other hand, Figure 21 The first connector 22A shown has a step 22s on its outer circumference that engages with the front end 41a of the inner tube 41. The front end 41a of the inner tube 41 is not exposed at the front end 22a of the first connector 22. The front end 22a of the first connector 22A abuts against the proximal end surface 15 of the front end member 11, thereby securely positioning the connector. This makes it easy to connect the front end 41a of the inner tube 41 to the step 22s of the first connector 22A, facilitating assembly.

[0139] (Variant 6)

[0140] Figure 222 is a diagram showing a first connector 22B as a modified example of the first connector 22. A protrusion 22b extending radially inward is provided on the inner surface of the base end side of the first connector 22B, and the knife body 20 is fixed by welding or the like while in contact with the protrusion 22b. The protrusion 22b of the first connector 22B is located closer to the base end side A2 than the base end 20b of the knife body 20. A slope (tapered surface) 22c is formed on the base end side A2 of the protrusion 22b so as to contact the second connector 33. The slope 22c is formed into a tapered shape that decreases in diameter from the base end side A2 toward the front end side A1. Therefore, when the control rod 56 is advanced relative to the slide 52 with the front end 3a of the rod 3 located within the internal space 43, the front end 3a of the rod 3 will not get stuck on the first connector 22B, and the rod 3 can be smoothly inserted into the knife body 20. When the rod 3 is advanced relative to the inner tube 41 (the blade body 20), the second connector 33 of the rod 3 contacts the inclined surface 22c of the first connector 22B. The contact between the second connector 33 and the first connector 22B positions the rod 3 at the third position P3, the position closest to the distal end A1. Furthermore, the protrusion 22b may have a tapered shape. Even when the second connector 33 and the first connector 22B are in contact, the internal space 43 of the inner tube 41 is connected to the first conduit 23. The shape of the second connector 33 is not limited, as long as it forms a flow path connecting the internal space 43 and the first conduit 23 when the first connector 22B and the second connector 33 abut. For example, the distal end of the second connector 33 is not limited to a circular shape with a partially cutout portion; it may also be a rectangular or rounded shape. Furthermore, if the second connector 33 does not have these shapes that can form a flow path, a slit may be formed on the tapered surface 22c to form a flow path when the first connector 22B and the second connector 33 abut.

[0141] Figure 23This figure shows a first connector 22Ba, a modified example of the first connector 22B. The first connector 22Ba has a radially outwardly extending protrusion 22p on the outer surface of the distal end side A1 of the first connector 22Ba. The outer surface of the proximal end side of the first connector 22Ba is covered by the distal end portion 41s of the inner tube 41. The distal end 41a of the inner tube 41 is fixed by welding or other means while abutting against the protrusion 22p. Therefore, the distal end 41a of the inner tube 41 does not protrude from the distal end 22a of the first connector 22Ba. This structure allows the distal end 22a of the first connector 22Ba to abut against the proximal end surface 15 of the distal end member 11, ensuring reliable positioning. This makes it easy to connect the distal end 41a of the inner tube 41 to the step 22s of the first connector 22Ba, simplifying assembly. Even when the second connector 33 and the first connector 22Ba are in contact, the internal space 43 of the inner tube 41 remains connected to the first conduit 23. The shape of the second connector 33 is not limited, as long as it forms a flow path connecting the internal space 43 and the first conduit 23 when the first connector 22Ba and the second connector 33 abut. For example, the tip of the second connector 33 is not limited to a circular shape with a partially cutout portion; it may also be rectangular or rounded. Furthermore, if the second connector 33 does not have these shapes that form a flow path, a slit may be formed in the tapered surface 22c to form a flow path when the first connector 22Ba and the second connector 33 abut.

[0142] Figure 242 is a diagram showing a first connector 22Bb as a modified example of the first connector 22B. The second connector 33B is a connector having a larger outer diameter than the second connector 33B. The inclined surface 22c of the first connector 22Bb extends to the outside of the radial direction R compared to the inclined surface 22c of the first connector 22B. The length (outer diameter) of the inclined surface 22c of the first connector 22Bb in the radial direction R is longer than the outer diameter of the knife body 20, and can fully contact the second connector 33B. That is, the second connector 33B abuts the inclined surface 22c of the first connector 22Bb and does not abut the knife body 20. In this structure, the front end 22a of the first connector 22Bb abuts the base end surface 15 of the front end member 11 and is reliably positioned. Even when the second connector 33B and the first connector 22Bb are in contact, the internal space 43 of the inner tube 41 is connected to the first pipeline 23. The shape of the second connector 33B is not limited, as long as it forms a flow path connecting the internal space 43 and the first conduit 23 when the first connector 22Bb and the second connector 33B abut. For example, the tip of the second connector 33B is not limited to a circular shape with a partially cutout portion; it may also be rectangular or rounded. Furthermore, if the second connector 33B does not have these shapes that can form a flow path, a slit may be formed on the tapered surface 22c to form a flow path when the first connector 22Bb and the second connector 33B abut.

[0143] (Variant 7)

[0144] Figure 25 2 is a diagram showing a first connector 22C as a modified example of the first connector 22. The first connector 22C has an inclined conduit 22d located at a position closer to the base end side A2 than the base end 20b of the knife body 20. The inclined conduit 22d is a conduit for the rod 3 to pass through. The inner peripheral surface of the inclined conduit 22d is formed into a tapered shape that decreases in diameter from the base end side A2 toward the front end side A1. Therefore, when the control rod 56 is advanced relative to the sliding member 52 in a state where the front end 3a of the rod 3 is located in the internal space 43, the front end 3a of the rod 3 will not be stuck on the first connector 22C and the rod 3 can be smoothly inserted into the knife body 20. When the rod 3 is advanced relative to the inner tube 41 (knife body 20), the second connector 33 of the rod 3 contacts the inner peripheral surface of the inclined conduit 22d of the first connector 22C. When the second connector 33 contacts the inner peripheral surface of the inclined conduit 22d, the second connector 33 is located inside the inclined conduit 22d. In addition, as Figure 7As shown, regarding a cross-section of at least the front end portion of the second connector 33, at least a portion of the outer shape of the second connector 33 is an outer surface 33s extending in a direction perpendicular to the longitudinal axis of the rod 3. Therefore, even when the second connector 33 and the first connector 22C are in contact, the internal space 43 of the inner tube 41 is more reliably connected to the first conduit 23. The shape of the second connector 33 is not limited, as long as it forms a flow path connecting the internal space 43 and the first conduit 23 when the first connector 22C and the second connector 33 abut. For example, the front end portion of the second connector 33 is not limited to a circular shape with a partially cutout portion; it can also be rectangular or rounded. Furthermore, if the second connector 33 does not have these shapes that can form a flow path, a slit can be formed on the inner circumferential surface of the inclined conduit 22d to form a flow path when the first connector 22C and the second connector 33 abut.

[0145] (Variation 8)

[0146] Figure 26 This figure shows the distal end of a treatment instrument 100A, which is a modified example of the treatment instrument 100. The treatment instrument 100A further includes an insulating member 7. The insulating member 7 is a non-conductive member such as a resin or ceramic material. The insulating member 7 is provided at the distal end of the blade body 20. The insulating member 7 has a through-hole 71 extending therethrough along the longitudinal axis direction A. The through-hole 71 communicates with the first conduit 23. The distal end 32 of the rod 3 extends through the first conduit 23 and the through-hole 71, and can protrude from the through-hole 71 toward the distal end side A1.

[0147] (Second embodiment)

[0148] Reference Figures 27 to 30 A treatment instrument 100B according to a second embodiment of the present invention will be described. In the following description, the same components as those already described are denoted by the same reference numerals, and duplicate descriptions will be omitted.

[0149] Figures 27 to 30 It is a diagram for explaining the operation of the treatment instrument 100B.

[0150] The treatment instrument (treatment instrument for endoscope) 100B includes an outer sheath 1, a blade 2, a shaft 3, an operation member 4, and an operation portion 5B.

[0151] The operating portion (handle) 5B includes a handle body 51 , a slider 52 , a power supply plug 53 , a liquid supply port 54 , a suction port 55 , a lever 56 , and an elastic body 57B.

[0152] The elastic body 57B is located between the slider 52 and the control rod 56, connecting the slider 52 and the control rod 56. The distal end of the elastic body 57B is attached to the slider 52, and the proximal end of the elastic body 57B is attached to the control rod 56. The elastic body 57B is connected to the operating wire 42 via the control rod 56. The elastic body 57B biases the control rod 56 toward the proximal end A2, causing the distal end 3a of the rod 3 to be retracted into the internal space 43 of the inner tube 41. In other words, similar to the elastic body 57, when the elastic body 57B returns to its original shape, the distal end 3a of the rod 3 is located within the inner tube 41. When the rod 3 is advanced against the elastic force of the elastic body 57B, the elastic body 57 biases the rod 3 toward the proximal end A2. Furthermore, when the elastic body 57B returns to its original shape, the distal end 3a of the rod 3 is located closer to the proximal end A2 than the distal end of the outer sheath 1.

[0153] like Figure 27 As shown, the operator advances the slider 52 relative to the handle body 51, thereby advancing the blade 2 relative to the outer sheath 1. The blade 2 is positioned at the first position P1. Because the elastic body 57B biases the control rod 56 toward the proximal end A2, the rod 3 is maintained at the fourth position P4, with its distal end 3a housed within the interior space 43 of the inner tube 41. At this point, the distal end 3a of the rod 3 is positioned closer to the proximal end A2 than the distal end of the outer sheath 1.

[0154] When the slider 52 moves forward relative to the handle body 51, the control rod 56 engages with the first receiving surface 52a formed at the base end of the slider 52 and moves forward together with the slider 52 while being pressed by the first receiving surface 52a. Therefore, the relative positional relationship between the knife 2 and the rod 3 in the longitudinal axis direction A can be maintained.

[0155] like Figure 28 As shown, the operator advances the control rod 56 relative to the slider 52 to advance the rod 3 relative to the knife 2. The rod 3 is positioned at the third position P3, with its front end 32 protruding toward the front end side A1 beyond the front end opening 23a. When the operator releases his hand from the control rod 56, the control rod 56 moves toward the base end side A2 due to the elastic force of the elastic body 57B. As a result, as shown in FIG. Figure 27 As shown, the rod 3 moves to the fourth position P4 where the front end 3 a thereof is accommodated in the internal space 43 of the inner tube 41 .

[0156] like Figure 29 As shown, the surgeon retracts the slider 52 relative to the handle body 51, thereby retracting the blade 2 relative to the outer sheath 1. The blade 2 is positioned at the second position P2. The elastic body 57B applies force to the control rod 56 toward the proximal end A2, causing the rod 3 to move to the fourth position P4, where its distal end 3a is housed within the interior space 43 of the inner tube 41. At this point, the distal end 3a of the rod 3 is positioned closer to the proximal end A2 than the distal end of the outer sheath 1.

[0157] When the slider 52 moves backward relative to the handle body 51, the control rod 56 moves backward together with the slider 52 while being pressed by the elastic body 57B pressed by the second receiving surface 52b formed on the slider 52. Therefore, the relative positional relationship between the knife 2 and the rod 3 in the longitudinal axis direction A can be maintained.

[0158] like Figure 30 As shown, the operator advances the control rod 56 relative to the slider 52 to advance the rod 3 relative to the knife 2. The rod 3 is positioned at the third position P3, with its front end 32 protruding toward the front end side A1 beyond the front end opening 23a. When the operator releases his hand from the control rod 56, the control rod 56 moves toward the base end side A2 due to the elastic force of the elastic body 57B. As a result, as shown in FIG. Figure 29 As shown, the rod 3 moves to the fourth position P4 where the front end 3 a thereof is accommodated in the internal space 43 of the inner tube 41 .

[0159] According to the treatment instrument 100B of this embodiment, the blade 2 and rod 3 are easily operated for treatment scenarios such as incision and dissection and local injection. The operator does not need to retract the control lever 56; when the operator releases the control lever 56, the rod 3 automatically retracts into the internal space 43 of the inner tube 41, thereby simplifying the surgical procedure. Furthermore, the operator is prevented from inadvertently operating the blade 2 while the rod 3 is protruding. Since the blade 2 and rod 3 can move forward and backward relative to each other in the longitudinal axis direction A, the stroke of the control lever 56 relative to the slider 52 can be reduced.

[0160] The second embodiment of the present invention has been described in detail with reference to the accompanying drawings, but the specific structure is not limited to this embodiment and includes design changes within the scope of the present invention. In addition, the components shown in the above embodiment and the modified example can also be appropriately combined to form a structure.

[0161] (Third embodiment)

[0162] Reference Figures 31 to 32 A treatment instrument 100C according to a third embodiment of the present invention will be described. In the following description, the same components as those already described are denoted by the same reference numerals, and duplicate descriptions will be omitted.

[0163] Figures 31 to 32 It is a diagram for explaining the operation of the treatment instrument 100C.

[0164] The treatment instrument (treatment instrument for endoscope) 100C includes an outer sheath 1 , a blade 2 , a rod 3 , an operation member 4 , an operation portion 5C, and an elastic body 6 .

[0165] The blade 2 is similar to the first embodiment and includes a blade body 20, a flange 21, and a first connector 22. The blade body 20 and the flange 21 have a first conduit 23 extending along the longitudinal direction A. The first connector (abutment member) 22 connects the blade body 20 and the inner tube 41. The first connector 22 cannot penetrate the first through-hole 12 along the longitudinal direction A. The first conduit 23 communicates with an internal space 43 formed in the inner tube 41.

[0166] The rod 3, similar to the first embodiment, comprises a main body 31, a distal end 32, and a second connector 33. The rod 3 extends through the first conduit 23 of the blade 2 along the longitudinal direction A, and is capable of protruding toward the distal end A1 relative to the distal end opening 23a and retracting therein. The second connector 33 connects the rod 3 to the operating wire 42. The second connector 33 does not extend through the first conduit 23 along the longitudinal direction A.

[0167] The operation portion 5C includes a handle body 51, a slider 52, a power supply plug 53, a liquid supply port 54, a suction port 55, and a lever 56. The operation portion 5C does not include an elastic body.

[0168] The elastic body 6 is located in the internal space 43 of the inner tube 41, and is located between the base end 20b of the blade body 20 and the second connector 33 in the longitudinal axis direction A. The elastic body 6 applies force to the rod 3 toward the base end side A2 so that the front end 3a of the rod 3 is accommodated in the internal space 43 of the inner tube 41. That is, similar to the first embodiment, when the elastic body 6 returns to its original shape, the front end 3a of the rod 3 is located inside the inner tube 41. When the rod 3 is advanced by overcoming the elastic force of the elastic body 6, the rod 3 is urged toward the base end side A2 by the elastic body 6. In addition, when the elastic body 6 returns to its original shape, the front end 3a of the rod 3 is located closer to the base end side A2 than the front end of the outer sheath 1.

[0169] like Figure 31 As shown, the surgeon advances the slider 52 relative to the handle body 51, thereby advancing the blade 2 relative to the outer sheath 1. The blade 2 is positioned at the first position P1. The elastic body 6 applies a force toward the proximal end A2 to the second connector 33, causing the rod 3 to move to the fourth position P4, where its distal end 3a is housed within the interior space 43 of the inner tube 41. At this point, the distal end 3a of the rod 3 is positioned closer to the proximal end A2 than the distal end of the outer sheath 1.

[0170] When the slider 52 moves forward relative to the handle body 51, the control rod 56 engages with the first receiving surface 52a formed at the base end of the slider 52 and moves forward together with the slider 52 while being pressed by the first receiving surface 52a. Therefore, the relative positional relationship between the knife 2 and the rod 3 in the longitudinal axis direction A can be maintained.

[0171] like Figure 32As shown, the operator advances the control lever 56 relative to the slider 52 to advance the rod 3 relative to the knife 2. The rod 3 is positioned at the third position P3, with its front end 32 protruding toward the front end side A1 beyond the front end opening 23a. When the operator releases his hand from the control lever 56, the rod 3 moves toward the base end side A2 due to the elastic force of the elastic body 6. As a result, Figure 31 As shown, the rod 3 moves to the fourth position P4 where the front end 3 a thereof is accommodated in the internal space 43 of the inner tube 41 .

[0172] The treatment instrument 100C of this embodiment facilitates operation of the blade 2 and rod 3, depending on the treatment scenario, such as incision and dissection and local injection. Furthermore, it prevents the operator from inadvertently operating the blade 2 while the rod 3 is protruding. Compared to a treatment instrument 100C having an elastic member 57 in the operating portion 5, the stroke of the rod 3 is less affected by the curved shape of the insertion portion 202 of the endoscope 200, making it easier to control the amount of tissue penetration by the rod 3.

[0173] The third embodiment of the present invention has been described in detail with reference to the accompanying drawings, but the specific structure is not limited to this embodiment and includes design changes within the scope of the present invention. In addition, the components shown in the above embodiments and modifications can also be appropriately combined to form the present invention.

[0174] (Variation 3-1)

[0175] Figure 33 This figure shows a first connector 22E as a modified example of the first connector 22. The first connector 22E has a reduced diameter portion 22b located closer to the proximal end side A2 than the proximal end 20b of the blade body 20. The elastic body 6 is located in the internal space 43 of the inner tube 41, and is positioned between the first connector 22E and the second connector 33 in the longitudinal axis direction A.

[0176] (Variation 3-1)

[0177] Figure 342 is a diagram showing a first connector 22D as a modified example of the first connector 22. The first connector 22D has a guide conduit 22g extending toward the base end side A2. The guide conduit 22g is a conduit for accommodating the elastomer 6. The elastomer 6 accommodated in the guide conduit 22g is guided by the guide conduit 22g, and the front end 3a of the rod 3 will not be hooked on the wire of the elastomer 6, and can be smoothly extended and retracted. In addition, it is also possible that when the elastomer 6 is restored, a part of the second connector 33 enters the guide conduit 22g of the first connector 22D. In addition, it is also possible that when the elastomer 6 is restored, the front end of the operating wire 42 enters the guide conduit 22g of the first connector 22D. According to this structure, since the first connector 22D and the second connector 33 are not easily stuck, the rod 3 can be smoothly operated relative to the knife body 20.

[0178] Industrial applicability

[0179] The present invention can be applied to an endoscope treatment instrument having a liquid feeding function, and the like.

Claims

1. An endoscope treatment instrument, wherein: The endoscope treatment instrument comprises: jacket; an electrode disposed on the front end side of the sheath; a rod, the front end of which is capable of protruding and retracting relative to the electrode; as well as The elastic body applies force so that the distal end of the rod is accommodated at a position closer to the proximal end side than the distal end of the electrode.

2. The endoscopic treatment instrument according to claim 1, wherein: The endoscopic treatment instrument further comprises: a handle body, which is provided at the base end portion of the sheath; a wire member connected to the base end portion of the rod; and a first slide, which operates the lever, The elastic body is connected to the wire member via the first sliding piece.

3. The endoscopic treatment instrument according to claim 1, wherein The endoscopic treatment instrument further comprises: an inner tube extending within the sheath; a first connector connecting the electrode and the inner tube; a wire member extending within the inner tube; as well as a second connector connecting the rod and the wire member, This endoscopic treatment instrument is configured such that the amount of protrusion of the rod from the electrode is restricted by the abutment between the second connector and the first connector.

4. The endoscopic treatment instrument according to claim 1, wherein The endoscopic treatment instrument further comprises: a handle body, which is provided at the base end portion of the sheath; a wire member connected to the base end portion of the rod; and a first sliding member connected to the wire member, The elastic body is located between the first sliding member and the handle body.

5. The endoscopic treatment instrument according to claim 4, wherein The endoscopic treatment instrument further comprises: an inner tube extending within the sheath; and a second sliding member connected to the base end portion of the inner tube, The first slide member can move forward and backward relative to the second slide member.

6. The endoscopic treatment instrument according to claim 1, wherein The endoscopic treatment instrument further comprises: a handle body provided at the base end portion of the sheath; and a first slide, which operates the lever, The elastic body is located between the first sliding member and the handle body.

7. The endoscopic treatment instrument according to claim 6, wherein: The endoscopic treatment instrument further comprises a second slider for operating the electrode. The first slide member can move forward and backward relative to the second slide member.

8. The endoscopic treatment instrument according to claim 5, wherein This endoscopic treatment instrument is configured such that, when the second slider is moved forward to the maximum extent and the first slider is not moved forward, the distal end of the rod does not protrude from the distal end of the electrode but is housed in the inner tube.

9. The endoscopic treatment instrument according to claim 7, wherein: The endoscopic treatment instrument further includes an inner tube extending within the sheath and connected to the electrode. This endoscopic treatment instrument is configured such that, when the second slider is moved forward to the maximum extent and the first slider is not moved forward, the distal end of the rod does not protrude from the distal end of the electrode but is housed in the inner tube.

10. The endoscopic treatment instrument according to claim 1, wherein When the front end of the rod protrudes from the front end of the electrode, the elastic body is elastically deformed. When the distal end of the rod is housed in the electrode, the elastic body returns to its original shape.

11. The endoscopic treatment instrument according to claim 10, wherein: When the elastic body returns to its original shape, the distal end of the rod is housed in the electrode, and the distal end of the rod is located closer to the proximal end than the distal end of the sheath.

12. The endoscopic treatment instrument according to claim 1, wherein When the elastic body returns to its original shape, the distal end of the rod is positioned closer to the proximal end than the distal end of the electrode that has retracted to the maximum extent.

13. The endoscopic treatment instrument according to claim 1, wherein The endoscopic treatment instrument further comprises: an inner tube extending within the sheath; a first connector connecting the electrode and the inner tube; a wire member extending within the inner tube; as well as a second connector connecting the rod and the wire member, The elastic body is disposed between the first connector and the second connector.

14. The endoscopic treatment instrument according to claim 1, wherein The endoscopic treatment instrument further comprises: a handle body provided at the base end portion of the sheath; a wire member connected to the base end portion of the rod; an inner tube extending within the sheath; a first slider connected to the wire member; and a second sliding member connected to the inner tube, The elastic body is located between the first sliding member and the second sliding member.

15. The endoscopic treatment instrument according to claim 14, wherein The first sliding member is engaged with the second sliding member and moves along the longitudinal axis together with the second sliding member.

16. The endoscopic treatment instrument according to claim 3, wherein The elastic body is disposed between the first connector and the second connector.

17. The endoscopic treatment instrument according to claim 1, wherein When the front end of the rod protrudes from the front end of the electrode, the elastic body is elastically deformed. When the distal end of the rod is stored closer to the proximal end than the distal end of the electrode, the elastic body returns to its original shape.

18. An endoscope treatment instrument, wherein: The endoscope treatment instrument comprises: jacket; an electrode disposed on the front end side of the sheath; a rod arranged to be movable forward and backward relative to the electrode; and An elastic body urges the distal end of the rod to move to a position closer to the proximal end than the distal end of the sheath.

19. The endoscopic treatment instrument according to claim 18, wherein The endoscopic treatment instrument further comprises: a handle body, which is provided at the base end portion of the sheath; a wire member connected to the base end portion of the rod; and a first slide, which operates the lever, The elastic body is connected to the wire member via the first sliding piece.

20. The endoscopic treatment instrument according to claim 18, wherein The endoscopic treatment instrument further comprises: an inner tube extending within the sheath; a first connector connecting the electrode and the inner tube; a wire member extending within the inner tube; as well as a second connector connecting the rod and the wire member, This endoscopic treatment instrument is configured such that the amount of protrusion of the rod from the electrode is restricted by the abutment between the second connector and the first connector.

21. An endoscope treatment instrument, wherein: The endoscope treatment instrument comprises: Tube; an electrode connected to the front end of the tube; and a rod, at least a portion of which is disposed within said electrode, This endoscopic treatment instrument is configured such that the rod is urged toward the proximal end of the tube in a state in which the distal end of the rod protrudes from the distal end of the electrode.

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