Treatment tool for endoscope

Abstract

The invention relates to a treatment tool for an endoscope. The purpose of the present invention is to satisfactorily perform local injection while maintaining tissue incision and dissection properties. This treatment tool for an endoscope is provided with: a sheath (9) having a first hole (921) open at the tip; an electrode (11) that passes through the first hole (921) and has a second hole (113) that opens at the tip; and a needle member (13) that is inserted through the second hole (113), the needle member (13) being capable of protruding from the tip of the second hole (113), and a fluid being injected into the tissue from a gap between the electrode (11) and the needle member (13).

Description

[0001] This application is a divisional application of the application filed on October 27, 2022, with application number 202211323241.0 and invention title "Determination Apparatus for Endoscope". Technical Field

[0002] This invention relates to endoscopic treatment instruments and methods. Background Technology

[0003] In the past, ESD (Endoscopic Submucosal Dissection) has used cutting and dissection instruments such as high-frequency knives, as well as instruments for local injection and hemostasis. (See, for example, Patent Documents 1-3).

[0004] Patent documents 1 and 2 describe an endoscopic treatment device capable of performing tissue cutting and local injection treatment.

[0005] Furthermore, in the case of local injection treatment, as shown in Patent Document 3, there is a known method of local injection into tissue by spraying liquid from the tip of an electrode used for cutting and peeling.

[0006] Existing technical documents

[0007] Patent documents

[0008] Patent Document 1: Chinese Invention Patent Application Publication No. 111202485

[0009] Patent Document 2: Japanese Patent Publication No. 2012-523863

[0010] Patent Document 3: Chinese Invention Patent Application Publication No. 108272503 Summary of the Invention

[0011] The problem the invention aims to solve

[0012] However, reliably injecting liquid into the tissue is difficult when liquid is simply ejected from the tip of the electrode. To reliably inject liquid into the tissue, it is necessary to inject the liquid directly into the tissue. However, the electrode shape needs to be suitable for cutting and dissecting; if it is designed for puncture into the tissue, it will affect the tissue's cutting and dissecting performance. Therefore, it is difficult to achieve a balance between cutting and dissecting performance and local injection performance.

[0013] The present invention was made in view of the above circumstances, and its object is to provide an endoscopic treatment instrument and treatment method that can perform local injection well while maintaining the tissue cutting and dissection performance.

[0014] Solution for solving the problem

[0015] To address the aforementioned problems and achieve the objective, the endoscopic treatment device of the present invention comprises: a sheath having a first hole open at a front end; an electrode passing through the first hole and having a second hole open at a front end; and a needle member passing through the second hole, the needle member being capable of protruding from the front end of the second hole to inject fluid into the tissue through the gap between the electrode and the needle member.

[0016] The treatment method of the present invention includes the following steps: inserting an endoscopic treatment instrument having a needle member protruding from the electrode into the body; forming a slit from the mucosal surface to the submucosa using the tip of the needle member protruding from the electrode; bulging the mucosal surface by injecting fluid from the electrode through the slit into the submucosa; and peeling off the submucosa while passing a high-frequency current through the electrode with the needle member housed at a position closer to the base end than the tip of the electrode.

[0017] The effects of the invention

[0018] According to the present invention, an endoscopic treatment instrument and treatment method are provided that can perform local injection effectively while maintaining the tissue cutting and dissection properties. Attached Figure Description

[0019] Figure 1 This is a diagram showing the endoscope system of Embodiment 1.

[0020] Figure 2 This is a diagram illustrating the structure of the insertion part of the treatment device.

[0021] Figure 3 This is a diagram illustrating the structure of the insertion part of the treatment device.

[0022] Figure 4 This is a diagram illustrating the structure of the insertion part of the treatment device.

[0023] Figure 5A This is a diagram illustrating an example of the shape of a protrusion.

[0024] Figure 5B This is a diagram illustrating an example of the shape of a protrusion.

[0025] Figure 5C This is a diagram illustrating an example of the shape of a protrusion.

[0026] Figure 6A This is a diagram showing an example of the shape of a flange.

[0027] Figure 6B This is a diagram showing an example of the shape of a flange.

[0028] Figure 6C This is a diagram showing an example of the shape of a flange.

[0029] Figure 6D This is a diagram showing an example of the shape of a flange.

[0030] Figure 7 It is a diagram illustrating the operation of endoscopic instruments.

[0031] Figure 8 It is a diagram illustrating the operation of endoscopic instruments.

[0032] Figure 9 It is a diagram illustrating the operation of endoscopic instruments.

[0033] Figure 10 It is a diagram illustrating the operation of endoscopic instruments.

[0034] Figure 11 This is a diagram illustrating an example of a structure without pipes.

[0035] Figure 12 This is a diagram showing a variation of implementation method 1.

[0036] Figure 13 This is a diagram showing a variation of implementation method 1.

[0037] Figure 14 This is a diagram illustrating the structure of the treatment device insertion section in Embodiment 2.

[0038] Figure 15 This is a diagram illustrating the structure of the treatment device insertion section in Embodiment 2.

[0039] Figure 16 This is a diagram illustrating the structure of the treatment device insertion section in Embodiment 2.

[0040] Figure 17 This is a diagram illustrating the structure of the treatment device insertion part in Embodiment 3.

[0041] Figure 18 This is a diagram illustrating the structure of the treatment device insertion part in Embodiment 3.

[0042] Figure 19 This is a diagram illustrating the structure of the treatment device insertion part in Embodiment 3.

[0043] Figure 20 This is a diagram illustrating the structure of the treatment device insertion part in Embodiment 4.

[0044] Figure 21 This is a diagram illustrating the structure of the treatment device insertion part in Embodiment 4.

[0045] Figure 22This is a diagram illustrating the structure of the treatment device insertion part in Embodiment 4.

[0046] Figure 23 This is a diagram showing a variation of embodiment 1 to 4.

[0047] Figure 24 This is a diagram showing a variation of embodiment 1 to 4, example 2.

[0048] Figure 25 This is a diagram showing variation 3 of embodiments 1 to 4.

[0049] Figure 26 This is a diagram showing variation 4 of embodiments 1 to 4.

[0050] Figure 27 This is a diagram showing variation 5 of embodiments 1 to 4.

[0051] Explanation of reference numerals in the attached figures

[0052] 1. Endoscope system; 2. Endoscope; 3. Display device; 4. Light source device; 5. Control device; 6. Endoscope treatment device; 7. 7A-7C, Treatment device insertion part; 8. Treatment device operating part; 9. 9B, Sheath; 10. 10A, 10C, First advance / retract mechanism; 11. 11B, 11D-11G, Blade; 12. Second advance / retract mechanism; 13. 13B, 13H, Needle component; 14. Wire; 15. 15A, 15C, Connecting component; 16. Inner tube; 21. Endoscope insertion part; 22. Endoscope operating part; 23. Universal cable; 24. Connector part; 81. Operating part body; 82. First sliding member; 83. Second sliding member; 91. Sheath body; 92. 92B. Front end component; 100. Power supply; 101. Communicating hole; 111. Blade body; 11 2. 112F, 112G, protrusions; 113, 113D, 113E, second hole; 131, needle component body; 132, flange; 151, connecting hole; 152, first connecting hole; 200, water supply source; 211, front end unit; 212, bend; 213, flexible tube; 221, operating component; 222, bending knob; 223, insertion port; 811, ring; 81 2. Water inlet; 821, ring; 822, plug; 921, 921B, first hole; 1321, through hole; 9211, large diameter section; 9212, small diameter section; 9213, first step section; 9214, receiving hole; 9215, second step section; CO, power cable; P1, P1C, flow path; SL, physiological saline; T1, target area; T2, marking mark; TU, pipe. Detailed Implementation

[0053] Hereinafter, embodiments for carrying out the present invention will be described with reference to the accompanying drawings. However, the present invention is not limited to the embodiments described below. Furthermore, in the accompanying drawings, the same reference numerals are used to denote the same parts.

[0054] (Implementation Method 1)

[0055] (Structure of an endoscope system)

[0056] Figure 1 This is a diagram showing the endoscope system 1 according to embodiment 1.

[0057] Endoscopic system 1, used in the medical field, is a system that treats a portion of biological tissue within a body cavity (hereinafter referred to as the target site) by applying high-frequency energy while simultaneously observing the body cavity. Furthermore, treatments that can be performed using the endoscopic system 1 of this embodiment include coagulation (sealing) of the target site or incision of the target site. Figure 1 As shown, the endoscope system 1 includes an endoscope 2, a display device 3, a light source device 4, a control device 5, and an endoscope handling device 6.

[0058] A portion of endoscope 2 is inserted into the body cavity to capture an image of the subject reflected from within the cavity, and the resulting image signal is output. For example... Figure 1 As shown, the endoscope 2 includes an endoscope insertion part 21, an endoscope operation part 22, a universal cable 23, and a connector part 24.

[0059] At least a portion of the endoscope insertion section 21 is flexible and is the portion that is inserted into the body cavity. For example... Figure 1 As shown, the endoscope insertion part 21 includes a front end unit 211, a bending part 212, and a flexible tube 213.

[0060] The front end unit 211 is located at the front end of the endoscope insertion section 21. Although specific illustrations are omitted, the front end unit 211 includes an illumination optical system, a camera optical system, and a camera unit.

[0061] The illumination optics system is positioned opposite one end of a light guide (not shown) that is wound around the endoscope insertion part 21, and the light transmitted by the light guide is directed from the front end of the endoscope insertion part 21 into the body cavity.

[0062] The camera optical system receives light (the image of the subject) that is incident on the body cavity from the illumination optical system and reflected from the body cavity, and images it onto the imaging surface of the camera element that constitutes the camera unit.

[0063] The camera unit is configured to include camera elements such as CCD (Charge Coupled Device) or CMOS (Complementary Metal Oxide Semiconductor), capture images of the subject imaged by the camera optical system, and output the image signal generated by the capture.

[0064] The bending portion 212 is connected to the base end side (endoscope operation section 22 side) of the front end unit 211. Although specific illustrations are omitted, the bending portion 212 has a structure formed by connecting multiple bending blocks, and is capable of bending.

[0065] The flexible tube 213 is connected to the base end side (endoscope operation part 22 side) of the bend 212, and is longitudinally elongated and flexible.

[0066] The endoscope operating section 22 is connected to the base portion of the endoscope insertion section 21. Furthermore, the endoscope operating section 22 receives various operations performed on the endoscope 2. For example... Figure 1 As shown, the endoscope operation section 22 is provided with multiple operation components 221, a bending knob 222 and an insertion port 223.

[0067] Multiple operating components 221 are composed of buttons and the like that accept various operations.

[0068] The bending knob 222 is configured to rotate according to user operation. Furthermore, by rotating the bending knob 222, a bending mechanism (not shown) such as a metal or resin wire disposed in the endoscope insertion part 21 is activated. As a result, the bending part 212 bends.

[0069] The insertion port 223 is connected to a conduit (not shown) extending from the front end of the endoscope insertion part 21 to the base side (endoscope operation part 22 side), and is an insertion port through which the endoscope treatment instrument 6 treatment instrument insertion part 7 and the like pass from the outside into the conduit.

[0070] The general cable 23 extends from the endoscope operation section 22 in a direction different from the extension direction of the endoscope insertion section 21, and is equipped with the aforementioned light guide and signal line for transmitting the aforementioned image signal.

[0071] The connector part 24 is located at the end of the universal cable 23 and is connected to the light source device 4 and the control device 5 in a detachable manner.

[0072] The display device 3 is an LCD (Liquid Crystal Display) or EL (Electroluminescence) display, etc., which displays a predetermined image under the control of the control device 5.

[0073] The light source device 4 emits illumination light. Moreover, the illumination light emitted from the light source device 4, after passing through the light guide wound around the connector part 24, the universal cable 23, the endoscope operation part 22, the endoscope insertion part 21, and the illumination optical system, irradiates the body cavity from the front end of the endoscope insertion part 21.

[0074] The control device 5 is configured to include a CPU (Central Processing Unit) or FPGA (Field-Programmable Gate Array), etc., to control the operation of the display device 3 and the light source device 4 in an overall manner.

[0075] For example, the control device 5 performs predetermined processing on the image signal input from the aforementioned camera unit via the aforementioned signal line to generate an endoscopic image. Furthermore, the control device 5 controls the operation of the display device 3, causing the endoscopic image, etc., to be displayed on the display device 3.

[0076] In addition, in this embodiment 1, the light source device 4 and the control device 5 are constructed independently of each other, but they can also be integrated into a single housing.

[0077] (Structure of endoscopic treatment instruments)

[0078] Endoscopic instruments 6 include, for example, instruments used in ESD (Endoscopic Submucosal Dissection). Figure 1 As shown, the endoscopic treatment device 6 includes a treatment device insertion part 7 and a treatment device operation part 8.

[0079] like Figure 1 As shown, the treatment device insertion part 7 is the part that protrudes from the front end of the endoscope insertion part 21 through the tube inside the endoscope insertion part 21 via the insertion port 223 and is inserted into the body cavity, which corresponds to the insertion part of the present invention.

[0080] Furthermore, the detailed structure of the treatment device insertion part 7 will be described later in the section on "Structure of the Treatment Device Insertion Part". Additionally, the term "front end" as used below refers to one end of the treatment device insertion part 7 in the insertion direction, and the term "base end" as used below refers to the other end of the treatment device insertion part 7 on the side opposite to the insertion direction.

[0081] The instrument operating section 8 is connected to the base portion of the instrument insertion section 7. Furthermore, the instrument operating section 8 receives operations performed on the endoscopic instrument 6. For example... Figure 1 As shown, the operating part 8 of the treatment device includes an operating part body 81, a first sliding member 82, and a second sliding member 83.

[0082] The main body 81 of the operating part has an elongated shape and is fixed to the base portion of the sheath 9, which constitutes the insertion part 7 of the treatment device (described later). Furthermore, as... Figure 1 As shown, a ring 811 for a surgeon or other operator to hook their fingers is provided at the base of the main body 81 of the operating unit. Furthermore, a water inlet 812 connected to a pipe TU is provided on the main body 81 of the operating unit. Physiological saline solution is supplied from a water source 200, such as a pump, to the water inlet 812 via the pipe TU.

[0083] Here, saline solution is equivalent to the fluid of the present invention. Furthermore, the fluid used in the present invention is not limited to saline solution; other liquids, gases such as air, may also be used.

[0084] The first sliding member 82 is mounted on the operating part body 81 in a manner that allows it to move along the length of the operating part body 81 according to the operation of an operator such as a surgeon. For example... Figure 1 As shown, the first slider 82 is provided with a pair of rings 821 for operators such as surgeons to hook their fingers. Furthermore, the first slider 82 is provided with a plug 822 for connection to a power cable CO. Moreover, the plug 822 is electrically connected to the power supply 100 via the power cable CO.

[0085] The second slider 83 is mounted on the operating unit body 81 in such a way that it can move along the length direction of the operating unit body 81 according to the operation of the operator or other operator. In addition, the second slider 83 can move along the length direction of the operating unit body 81 independently of the first slider 82.

[0086] (Structure of the treatment device insertion section)

[0087] Figures 2-4 This diagram illustrates the structure of the treatment device insertion section 7. Specifically, Figures 2-4 This is a cross-sectional view obtained by cutting the front end portion of the treatment device insertion part 7 with a plane including the central axis of the treatment device insertion part 7. Furthermore, Figure 2 This is a diagram showing the device insertion section 7 set to the first state. Figure 3 This is a diagram showing the treatment device insertion section 7 set to the second state. Figure 4 This is a diagram showing the treatment device insertion section 7 set to the third state.

[0088] like Figures 1-4 As shown, the insertion part 7 of the treatment device includes a sheath 9 and a first advancing / retreating member 10. Figures 2-4 ), knife 11 ( Figures 2-4 ), 2nd advance / retreat component (line) 12 ( Figures 2-4 ) and needle component 13 ( Figures 2-4 ).

[0089] The sheath 9 is part of the outer surface of the insertion part 7 of the treatment device. For example... Figures 1-4 As shown, the sheath 9 includes a sheath body 91 and a front end component 92.

[0090] The sheath body 91 is made of resin material or the like and is a cylindrical component with insulation and flexibility. Furthermore, the base portion of the sheath body 91 is fixed to the operating part body 81.

[0091] The front end member 92 is composed of a generally cylindrical member. This front end member 92 can be made of an electrically insulating component made of ceramic, resin, rubber, or similar materials, or it can be made of a component with an insulating coating applied to the surface of a metal or similar material. Furthermore, the front end member 92 is fixed to the front end of the sheath body 91. More specifically, the front end member 92 is inserted into the front end of the sheath body 91, closing off that front end. Figures 2-4 As shown, the front end component 92 is provided with a first hole 921 that connects the inside and outside of the sheath 9.

[0092] The first hole 921 has a circular cross-section and is located on the central axis of the front end member 92, extending in a straight line along the central axis. Furthermore, the first hole 921 has a stepped shape in which the inner diameter of the front end portion is larger than the inner diameter of the base portion. Hereinafter, for ease of explanation, the portion of the first hole 921 with the larger inner diameter on the front end side will be referred to as the large-diameter portion 9211. Figures 2-4 The portion with a smaller inner diameter on the base side is described as small diameter portion 9212. Figures 2-4 Furthermore, the stepped portion between the large-diameter portion 9211 and the small-diameter portion 9212 is described as the first stepped portion 9213. Figures 2-4 ).

[0093] The front end of the first advancing / retracting member 10 is connected to the blade 11, and can advance and retract within the sheath body 91. It is a member that causes the blade 11 to advance and retract along the central axis of the sheath 9. Figures 2-4 As shown, the first advancing / retreating member 10 includes a pipe 14, a connecting member 15, and an inner pipe 16.

[0094] The tube 14, made of a conductive material such as metal, is located inside the sheath 9 and is a cylindrical, flexible coil extending along the central axis of the sheath 9. Furthermore, the base of the tube 14 is fixed to the first sliding member 82. That is, the tube 14 moves forward and backward within the sheath body 91 according to the operation of the first sliding member 82 by an operator such as a surgeon. In addition, the tube 14 is electrically connected to the plug 822. Furthermore, the tube 14 communicates with the water inlet 812.

[0095] Furthermore, if there is a means to conduct electricity between the plug 822 and the knife 11 using a metal wire or the like, then the metal tube 14 is not necessary.

[0096] The connecting member 15 connects the first advance / retractor member 10 and the blade 11. This connecting member 15 is made of a conductive material such as metal, is located inside the sheath 9, and has a cylindrical shape extending linearly along the central axis. Furthermore, as... Figures 2-4 As shown, the tube 14 is fixed to the base end of the connecting member 15 in a state of insertion into the base end side. Thus, the tube 14 communicates with the connecting member 15. That is, the connecting member 15 and the tube 14 move together within the sheath body 91 according to the operation of the first sliding member 82 by an operator such as a surgeon. On the other hand, the blade 11 is fixed to the front end side of the connecting member 15 in a state of insertion into the front end side. That is, the connecting member 15 is fixed to the outer peripheral surface of the base end of the blade 11, configured such that the blade 11, the tube 14, and the connecting member 15 advance together according to the operation of the first sliding member 82, and the front end of the connecting member 15 abuts against the front end member 92, thereby limiting the amount of protrusion of the blade 11 from the front end member 92.

[0097] The tube 14 and connecting member 15 described above correspond to the communicating hole 101 of the present invention. Figures 2-4 Furthermore, the connecting hole 101 serves as the flow path P1 of the present invention for the flow of physiological saline solution supplied from the water source 200 via the pipe TU and the water inlet 812. Figures 2-4 It can perform its functions.

[0098] The inner tube 16, made of resin or similar material, is an insulating and flexible cylindrical component, positioned to cover the outer circumferential surface of the tube 14 and the outer circumferential surface of the connecting member 15. Furthermore, the inner tube 16 prevents leakage of saline solution from the flow path P1. That is, the inner tube 16, along with the tube 14 and the connecting member 15, moves forward and backward within the sheath body 91 according to the operation performed by an operator such as a surgeon on the first sliding member 82.

[0099] The blade 11 corresponds to the electrode of the present invention. Physiological saline solution is injected into the target area via a slit formed at the target area using the needle member 13. Furthermore, the blade 11 is made of a conductive material such as metal and is fixed with its base portion inserted into the connecting member 15. That is, the blade 11, together with the first advance / retreat member 10, moves forward and backward within the sheath body 91 according to the operation performed by an operator such as a surgeon on the first sliding member 82. Furthermore, the blade 11 protrudes from the first hole 921 to the outside of the front end member 92. Moreover, a high-frequency current is supplied to the blade 11 from the power supply 100 via the power cable CO, plug 822, tube 14, and connecting member 15 to cut open the target area within the body cavity. Figures 2-4 As shown, the knife 11 includes a knife body 111 and a protrusion 112.

[0100] The blade body 111 is composed of a cylindrical member located on and extending along the central axis of the front end member 92. Here, as... Figures 2-4 As shown, the outer diameter of the blade body 111 is set to be slightly smaller than the inner diameter of the first hole 921.

[0101] A protrusion 112 is provided at the front end of the blade body 111 and has a circular plate shape coaxial with the central axis of the blade body 111. The protrusion 112 extends radially from the outer peripheral surface of the blade body 111, and the maximum radial width of the protrusion 112 is set to be larger than the inner diameter of the first hole 921. The maximum radial width of the protrusion 112 can also be set to be larger than the inner diameter of the small diameter portion 9212 and slightly smaller than the inner diameter of the large diameter portion 9211.

[0102] Figures 5A to 5C This is a diagram showing an example of the shape of the protrusion 112.

[0103] Here, the protrusion 112 does not necessarily have to be in the shape of a circular plate, such as Figures 5A to 5C As shown, it can also be hemispherical ( Figure 5A ), triangular shape ( Figure 5B The flange shape is not limited to this flange shape; it can also be a hook shape. Figure 5C ).

[0104] like Figures 2-4 As shown, the blade 11 described above is provided with a second hole 113, which is located on the central axis of the blade body 111 and extends from the base end of the blade 11 to the front end along the central axis. Moreover, the second hole 113 communicates with the flow path P1 by connecting the blade 11 to the first advance / retract member 10.

[0105] The second retraction member 12, for example, is a wire made of metal material, connected to the base end of the blade 11. It can retract relative to the first retraction member 10 within the communicating hole 101, and is a member that causes the needle member 13 to retract along the central axis of the sheath 9. Furthermore, the second retraction member 12 is fixed to the second sliding member 83. That is, the second retraction member 12 retracts within the communicating hole 101 according to the operation performed by an operator such as a surgeon on the second sliding member 83.

[0106] The needle component 13 is a solid component used to create a slit in the target area (tissue), and can move in and out within the second hole 113. For example... Figures 2-4 As shown, the needle component 13 includes a needle component body 131 and a flange portion 132.

[0107] The needle component body 131 is located inside the second hole 113 and is composed of a cylindrical component extending linearly along the central axis of the second hole 113. Furthermore, the outer diameter of the front end portion of the needle component body 131 decreases towards the front end, forming a needle tip. Additionally, the needle component 13 is designed to move freely in a direction orthogonal to the direction in which the protrusion 112 extends.

[0108] Figures 6A to 6D This is a diagram showing an example of the shape of the flange 132. Specifically, Figures 6A to 6D Is Figure 4 The cross-sectional view is formed by cutting along the A-A line, showing the connecting member 15 and the flange 132. Additionally, in Figures 6A to 6D For ease of explanation, tube 14 is illustrated with a double-dotted line.

[0109] A flange 132 is provided at the base end of the needle member body 131 and is fixed to the front end portion of the second advance / retract member 12. Furthermore, the flange 132 is disposed within the connecting member 15 to limit the travel distance of the needle member 13's advance / retract movement. Specifically, the flange 132 is configured within the connecting member 15 such that it abuts against the base end of the blade body 111 when moving towards the front end, and abuts against the front end of the tube 14 when moving towards the base end. Additionally, the abutment location of the flange 132 when moving to the front end is not limited to the base end of the blade body 111. Alternatively, a structure can be adopted in which a protrusion or step is provided radially inward on the blade body 111 near the base end, and the flange 132 abuts against this step when moving to the front end. Again, the abutment location of the flange 132 when moving to the base end is not limited to the front end of the tube 14. Alternatively, a structure can be adopted in which a protrusion or step is provided radially inward on the front end of the tube 14, and the flange portion 132 abuts against this step when moved to the base end side. Furthermore, the flange portion 132 can be configured, for example, as... Figures 6A to 6D The shape shown does not block the flow path P1, maintaining the connection between the flow path P1 and the second hole 113.

[0110] For example, such as Figure 6A As shown, the flange 132 has a cross shape: extending from the central axis of the needle component body 131 towards... Figure 6A The components protrude in the vertical, horizontal, and other directions, and each protruding end can slide on the inner circumferential surface of the connecting member 15.

[0111] In addition, for example, such as Figure 6B As shown, the flange portion 132 has the shape of the letter I: extending from the central axis of the needle component body 131 towards... Figure 6A The protrusions extend in the left and right directions, and each protruding end can slide on the inner circumferential surface of the connecting member 15.

[0112] And, for example, such as Figure 6C As shown, the flange portion 132 is formed into a semi-circular shape with its center aligned with the central axis of the needle member body 131. Furthermore, the arcuate portion of the outer edge of the flange portion 132 can slide on the inner circumferential surface of the connecting member 15.

[0113] In addition, for example, such as Figure 6D As shown, the flange portion 132 is formed into a circular shape with its center aligned with the central axis of the needle member body 131, and has a plurality of through holes 1321 extending along the central axis. Furthermore, the arcuate portion of the outer edge of the flange portion 132 is capable of sliding on the inner circumferential surface of the connecting member 15.

[0114] Furthermore, the flange portion 132 can be integrally formed with the needle component body 131, or the flange portion 132 and the needle component body 131 can be formed independently and fixed to each other by bonding or the like. Additionally, the flange portion 132 can be integrally formed with the thread 12, or the flange portion 132 and the thread 12 can be formed independently and fixed to each other by bonding or the like.

[0115] The knife 11 and needle component 13 described above are constructed in a way that prevents them from communicating with each other.

[0116] For example, an insulating coating is applied to at least one of the inner circumferential surface of the second hole 113 and the surface of the needle member 13.

[0117] In addition, for example, the needle component 13 is made of a material that is electrically insulating.

[0118] (Action of endoscopic instruments)

[0119] Next, the operation of the endoscopic treatment device 6 described above will be explained. For ease of explanation, the ESD procedure will be used as an example below.

[0120] Figures 7-10 This diagram illustrates the operation of the endoscopic handling instrument 6. Specifically, Figure 7 This is a diagram illustrating the marking process in ESD. Figures 8-10 This is a diagram illustrating the local injection process in ESD.

[0121] First, the surgeon or other operator inserts the endoscope insertion part 21 into the body cavity, moving the tip of the endoscope insertion part 21 to the target site T1. Figure 7 )nearby.

[0122] Next, the surgeon or other operator performs a first retraction operation by pulling the first slider 82 forward (towards the ring 811). As a result, the instrument insertion portion 7 is in a state where the protrusion 112 is located within the large-diameter portion 9211, the base end of the protrusion 112 abuts against the first stepped portion 9213, and only the protrusion 112 protrudes from the first hole 921 to the outside of the front end member 92; that is, the protrusion 112 protrudes from the first hole 921 and the blade body 111 is located within the first hole 921 (corresponding to the second embodiment of the present invention). Furthermore, the surgeon or other operator performs a second retraction operation by pulling the second slider 83 forward (towards the ring 811). As a result, the instrument insertion portion 7 is in a state where the flange portion 132 abuts against the front end of the tube 14, and the front end of the needle member 13 is located within the second hole 113 (corresponding to the fourth embodiment of the present invention). Alternatively, when the protrusion 112 is located within the large-diameter portion 9211, the base end of the protrusion 112 abuts against the first step portion 9213 and the protrusion 112 is completely contained within the large-diameter portion 9211, or the axial dimension of the large-diameter portion 9211 at the front end of the front end member 92 is the same as the axial dimension of the protrusion 112, and the front end of the protrusion 112 is coplanar with the front end surface of the front end member.

[0123] Figure 11 This diagram illustrates an example of a structure without pipe 14. Specifically, Figure 11 Is with Figure 2 The corresponding sectional view.

[0124] In addition, such as Figure 11 As shown, without the tube 14, a structure can be provided instead of the tube 14, in which the inner diameter of the base end of the connecting member 15 is smaller than the maximum width of the flange 132, so that the flange 132 abuts against the base end of the connecting member 15 during the second retraction operation.

[0125] As described above, based on the first retraction operation performed on the first slider 82 and the second retraction operation performed on the second slider 83, the treatment device insertion part 7 becomes... Figure 2 The first state is shown. Then, the surgeon or other operator inserts the first-state treatment instrument insertion part 7 through the insertion port 223 into the tubing within the endoscope insertion part 21, causing it to protrude from the front end of the endoscope insertion part 21. Furthermore, even if the blade 11 protrudes slightly from the front end member 92, the operation of inserting the first-state treatment instrument insertion part 7 through the insertion port 223 into the tubing within the endoscope insertion part 21 will not cause any problems.

[0126] Next, the surgical operator and other operators perform the marking process as shown below.

[0127] That is, while maintaining the first state of the instrument insertion part 7 by performing a first retraction operation on the first slider 82 and a second retraction operation on the second slider 83, the operator operates the foot switch or other operating parts (not shown) to supply a high-frequency current from the power supply 100 to the blade 11. Then, as... Figure 7 As shown in (a), the surgeon or other operator presses the protrusion 112 against the surrounding biological tissue (mucosal surface) of the target site T1. This cauterizes the biological tissue in contact with the protrusion 112. That is, as... Figure 7 (a) or Figure 7 As shown in (b), a marking mark T2 is formed at the burned area.

[0128] Then, the surgical operator and other operators repeat the above procedures multiple times, such as... Figure 7 As shown in (c), a number of marking marks T2 are formed to a degree that allows for the grasping of the outer edge of the object region T1. Afterwards, the surgeon or other operator ends the process of supplying a high-frequency current from the power source 100 to the blade 11.

[0129] Next, the surgical operator and other operators perform the local injection procedure as shown below.

[0130] That is, the surgeon or other operator performs a first forward movement by pushing in the first slider 82. As a result, the instrument insertion portion 7 is positioned such that the front end of the connecting member 15 abuts against the base end of the front end member 92, and the blade 11 protrudes from the front end of the sheath 9 by its maximum protrusion length (corresponding to the first embodiment of the present invention). Furthermore, the surgeon or other operator performs a second forward movement by pushing in the second slider 83. As a result, the instrument insertion portion 7 is positioned such that the flange portion 132 abuts against the base end of the blade body 111, and the needle member 13 protrudes from the front end of the blade 11 by its maximum protrusion length (e.g., 1 mm) (corresponding to the third embodiment of the present invention).

[0131] As described above, based on the first forward operation performed on the first slider 82 and the second forward operation performed on the second slider 83, the treatment device insertion part 7 becomes... Figure 3 The second state is shown. Moreover, in the second state, the operator or other operator inserts the tip of the needle component 13 into the biological tissue surrounding the target site T1, thereby forming a slit in the biological tissue from the mucosal surface to the submucosa.

[0132] Furthermore, while maintaining the second state of the instrument insertion part 7 by performing a first forward operation on the first slider 82 and a second forward operation on the second slider 83, the operator operates a foot switch or other operating unit (not shown) to supply saline solution from the water supply source 200. As a result, the saline solution supplied from the water supply source 200 flows through the flow path P1 to the second hole 113 and is then ejected from the tip of the blade 11. This ejected saline solution SL is injected into the submucosa below the target area T1. Figure 8 Therefore, the target area T1 (mucosal surface) bulges (rises) from the underlying submucosa and other tissues.

[0133] In addition, when injecting physiological saline SL below the target site T1, consider the following two methods.

[0134] The first method is as follows Figure 9 As shown, this is a method of injecting physiological saline SL into the area below the target site T1 while the tip of the needle component 13 is inserted into the biological tissue.

[0135] The second method is as follows Figure 10 As shown, this is a method of injecting physiological saline SL into the area below the target site T1 while the protrusion 112 and the front end of the needle component 13 are inserted into the biological tissue together.

[0136] Next, the surgeon and other operators will perform the incision procedure as shown below.

[0137] That is, the operator, such as the surgeon, performs a first forward movement on the first slider 82 while simultaneously performing a second backward movement on the second slider 83. During the first forward movement of the first slider 82, as described above, the instrument insertion portion 7 is positioned such that the blade 11 protrudes to its maximum length from the front end of the sheath 9. Furthermore, during the second backward movement of the second slider 83, as described above, the instrument insertion portion 7 is positioned such that the front end of the needle member 13 is located within the second hole 113.

[0138] As described above, based on the first forward operation performed on the first slider 82 and the second backward operation performed on the second slider 83, the treatment device insertion part 7 becomes... Figure 4 The third state is shown.

[0139] Furthermore, while maintaining the third state of the instrument insertion part 7 by performing a first forward operation on the first slider 82 and a second backward operation on the second slider 83, the operator operates the foot switch or other operating parts (not shown) to supply a high-frequency current from the power supply 100 to the blade 11. Then, while confirming the marking mark T2, the operator moves the protrusion 112 around the target site T1 in a state of penetrating biological tissue, cutting the entire circumference of the target site T1.

[0140] Subsequently, while maintaining the third state, the mucosal layer containing the object portion T1, which has been cut through the entire circumference, is removed by peeling off the submucosa. Since the third state is such that the tip of the needle member 13 is located inside the second hole 13, the cutting and peeling performance of the blade 11 is not affected.

[0141] The ESD process is completed through the above steps.

[0142] As described above, the needle member 13 of this embodiment 1 can move from a position where it is housed inside the blade 11 at the front end to a position where it protrudes from the second hole 113.

[0143] Hereinafter, the treatment device insertion part 7C, which is the structure of Embodiment 4 described later, will be used as an example. Figure 12 and Figure 13 A variation of Embodiment 1 will be described. Furthermore, the detailed structure of the treatment device insertion part 7C (flow path P1C, first advance / retract member 10C, and connecting member 15C) will be described in Embodiment 4, which will be described later.

[0144] In this embodiment 1, an example is shown where the needle member 13 is made of an electrically insulating material, but this is not a limitation. For example, the needle member 13 may also be made of an electrically conductive material such as metal. When the needle member 13 is made of an electrically conductive material, the outer edge (outer peripheral surface) of the flange portion 132 is always in contact with the connecting member 15C, so the needle member 13 can be energized by means of the connecting member 15C without depending on the amount of protrusion of the self-blade body 111. Furthermore, the method of energizing the needle member 13 is not limited to this, and it may also be configured such that by applying an insulating coating to the outer edge (outer peripheral surface) of the flange portion 132 or the inner peripheral surface of the connecting hole 152, the base end of the blade body 111 contacts the flange portion 132 when the needle member 13 protrudes to its maximum extent from the blade body 111, thereby energizing it.

[0145] When cutting tissue using the needle component 13, while retracting the tip of the blade 11 (protrusion 112) to a position abutting the tip of the sheath 9, the front end of the needle component 13 is moved to a position protruding from the tip of the blade 11. For example... Figure 12As shown, with the tip of the needle member 13 protruding from the tip of the blade 11, the flange 132 can also abut against a portion of the blade 11. In this state, the tip of the needle member 13 can be used to cut tissue. Furthermore, the tip of the needle member 13 can be alternately inserted into the tissue for local injection and tissue cutting. Also, tissue cutting using the needle member 13 and tissue cutting using the blade 11 can be alternately repeated. For example, after cutting the tissue using the needle member 13, as... Figure 13 As shown, tissue cutting is performed using the knife 11 with the needle member 13 housed inside the blade 11 and the tip of the blade 11 positioned distal to the sheath 9 and the tip of the needle member 13. The order of cutting using the needle member 13 and cutting using the blade 11 can be appropriately interchanged. Furthermore, tissue cutting includes not only mucosal incision and removal but also submucosal dissection.

[0146] According to the above description of Embodiment 1, the following effects are achieved.

[0147] In the endoscopic treatment device 6 of this embodiment 1, the treatment device insertion part 7 includes a needle member 13 for forming a slit in biological tissue within a body cavity and a knife 11 for injecting physiological saline into the biological tissue through the slit.

[0148] Therefore, in the endoscopic treatment device 6 of this embodiment 1, local injection can be performed well through the incision.

[0149] In particular, in the endoscopic treatment device 6 of this embodiment 1, during ESD, the treatment device does not need to be changed during the local injection process and other processes; the local injection process and other processes can be performed separately using the single endoscopic treatment device 6. Therefore, convenience can be improved.

[0150] Furthermore, in the endoscopic treatment device 6 of this embodiment 1, the needle member 13 is a solid member. Therefore, compared with a structure in which the needle member 13 has a hole for local injection, the needle member 13 does not bend longitudinally, and the lifespan of the treatment device insertion part 7 can be extended.

[0151] Furthermore, in the endoscopic treatment device 6 of this embodiment 1, a needle member 13 and a second advance / retract member 12 are disposed in the second hole 113 and the connecting hole 101. Therefore, the first advance / retract member 10, the blade 11, the second advance / retract member 12 and the needle member 13 can be compactly assembled, thereby reducing the diameter of the treatment device insertion portion 7.

[0152] (Implementation Method 2)

[0153] Next, this embodiment 2 will be described.

[0154] In the following description, the same reference numerals are used for structures that are the same as those in Embodiment 1 described above, and detailed descriptions of them are omitted or simplified.

[0155] In the endoscopic treatment device 6 of this embodiment 2, the structure of the front end portion of the treatment device insertion part 7 is different from that of the endoscopic treatment device 6 described in embodiment 1 above. Hereinafter, for ease of explanation, the treatment device insertion part of this embodiment 2 will be referred to as the treatment device insertion part 7A.

[0156] Figures 14-16 This diagram illustrates the structure of the treatment device insertion section 7A in Embodiment 2. Specifically, Figure 14 Is with Figure 2 The corresponding sectional view is a diagram showing the treatment device insertion section 7A set to the first state. Figure 15 Is with Figure 3 The corresponding sectional view is a diagram showing the treatment device insertion part 7A set to the second state. Figure 16 Is with Figure 4 The corresponding sectional view is a diagram showing the treatment device insertion part 7A set to the third state.

[0157] In the treatment device insertion section 7A, such as Figures 14-16 As shown, the difference lies in the fact that the length of the connecting member 15 is extended in the longitudinal direction, compared to the treatment device insertion part 7 described in Embodiment 1 above. Hereinafter, for ease of explanation, the first retracting member and the connecting member of this Embodiment 2 will be referred to as the first retracting member 10A and the connecting member 15A, respectively.

[0158] Furthermore, in this embodiment 2, based on the first retraction operation performed on the first slider 82 and the second retraction operation performed on the second slider 83, the treatment device insertion part 7A becomes the first state shown below.

[0159] Specifically, based on the first retraction operation performed on the first slider 82, such as Figure 14 As shown, the device insertion portion 7A, like in Embodiment 1 described above, has a protrusion 112 located within the large-diameter portion 9211, with the base end of the protrusion 112 abutting against the first step portion 9213, and only the protrusion 112 protruding from the first hole 921 to the front end member 92. Furthermore, according to the second retraction operation performed on the second slider 83, the device insertion portion 7A becomes such that the flange portion 132 abuts against the front end of the tube 14, and the needle member 13 is entirely located within the connecting member 15A.

[0160] Furthermore, in this embodiment 2, based on the first forward operation performed on the first slider 82 and the second forward operation performed on the second slider 83, the treatment device insertion part 7A becomes the second state shown below.

[0161] Specifically, based on the first forward operation performed on the first slider 82, such as Figure 15 As shown, the device insertion portion 7A, like in Embodiment 1, has its front end of the connecting member 15A abutting against the base end of the front end member 92, and the blade 11 protruding from the front end of the sheath 9 by its maximum protrusion length. Furthermore, according to the second forward operation performed on the second slider 83, the device insertion portion 7A, like in Embodiment 1, has its flange portion 132 abutting against the base end of the blade body 111, and the needle member 13 protruding from the front end of the blade 11 by its maximum protrusion length.

[0162] Furthermore, in this embodiment 2, based on the first forward operation performed on the first slider 82 and the second backward operation performed on the second slider 83, the treatment device insertion part 7A becomes the third state as shown below.

[0163] Specifically, based on the first forward operation performed on the first slider 82, such as Figure 16 As shown, the device insertion portion 7A is positioned such that the front end of the connecting member 15A abuts against the base end of the front end member 92, and the blade 11 protrudes from the front end of the sheath 9 by its maximum protrusion length. Furthermore, according to the second retraction operation performed on the second slider 83, the device insertion portion 7A is positioned such that the flange portion 132 abuts against the front end of the tube 14, and the needle member 13 is entirely located within the connecting member 15A.

[0164] Furthermore, since the operation of the endoscope treatment device 6 in Embodiment 2 is the same as that in Embodiment 1 described above, the description is omitted.

[0165] As described above, the needle member 13 of this embodiment 2 can move from a position where the front end is housed inside the first advance / retreat member 10A to a position where it protrudes from the second hole 113.

[0166] When the treatment device insertion part 7A of Embodiment 2 described above is used, the same effect as that of Embodiment 1 is achieved.

[0167] Furthermore, in the treatment device insertion part 7A of this embodiment 2, the second advance / retreat member 12 advances or retracts the needle member 13 from a position where the needle member 13 is located at a position closer to the base end than the second hole 113 to a position where the front end of the needle member 13 protrudes from the second hole 113 toward the front end.

[0168] Therefore, if physiological saline is supplied from the water source 200 while the needle member 13 is positioned entirely within the connecting member 15A using the second retraction operation performed on the second slider 83, surgical site cleaning can be performed as shown in each step of the ESD procedure.

[0169] That is, when the needle component 13 is entirely located within the connecting member 15A, compared to when the needle component body 131 is located within the second hole 113, the flow path area of ​​the saline solution flowing through the second hole 113 is larger. Therefore, if saline solution is supplied from the water source 200 while the needle component 13 is entirely located within the connecting member 15A using the second retraction operation of the second slider 83, the water pressure of the saline solution ejected from the tip of the blade 11 will be relatively low. In other words, the surgical site can be cleaned by supplying the saline solution to the surgical site.

[0170] (Implementation Method 3)

[0171] Next, this embodiment 3 will be described.

[0172] In the following description, the same reference numerals are used for structures that are the same as those in Embodiment 2 described above, and detailed descriptions of them are omitted or simplified.

[0173] In the endoscopic treatment device 6 of this embodiment 3, the structure of the front end portion of the treatment device insertion part 7A differs from that of the endoscopic treatment device 6 described in embodiment 2 above. Hereinafter, for ease of explanation, the treatment device insertion part of this embodiment 3 will be referred to as the treatment device insertion part 7B.

[0174] Figures 17-19 This diagram illustrates the structure of the treatment device insertion section 7B in Embodiment 3. Specifically, Figure 17 Is with Figure 14 The corresponding sectional view is a diagram showing the treatment device insertion part 7B set to the first state. Figure 18 Is with Figure 15 The corresponding sectional view is a diagram showing the treatment device insertion part 7B set to the second state. Figure 19 Is with Figure 16 The corresponding sectional view is a diagram showing the treatment device insertion part 7B set to the third state.

[0175] In the treatment device insertion section 7B, such as Figures 17-19 As shown, the difference lies in the fact that the lengths of the blade 11 and the needle member 13 are shortened in the longitudinal direction, compared to the treatment device insertion portion 7A described in Embodiment 2 above. Hereinafter, for ease of explanation, the blade and needle member of this Embodiment 3 will be referred to as blade 11B and needle member 13B, respectively.

[0176] Furthermore, in the treatment device insertion section 7B, such as Figures 17-19 As shown, the shape of the front end member 92 of the sheath 9 differs from that of the treatment device insertion part 7A described in Embodiment 2 above. Hereinafter, for ease of explanation, the sheath and the front end member of this Embodiment 3 will be referred to as sheath 9B and front end member 92B, respectively.

[0177] In the front-end component 92B, such as Figures 17-19 As shown, the shape of the first hole 921 differs from that of the front end member 92 described in Embodiment 2 above. Hereinafter, for ease of explanation, the first hole of this Embodiment 3 will be referred to as the first hole 921B.

[0178] like Figures 17-19 As shown, the first hole 921B includes a large diameter portion 9211 and a small diameter portion 9212, which are the same as those in the first hole 921 described in Embodiment 2 above, as well as a receiving hole 9214.

[0179] The receiving hole 9214 is located on the base end side of the smaller diameter portion 9212. The inner diameter of the receiving hole 9214 is set to be larger than the inner diameter of the smaller diameter portion 9212 and slightly larger than the outer diameter of the connecting member 15A. Hereinafter, for ease of explanation, the step portion between the smaller diameter portion 9212 and the receiving hole 9214 will be referred to as the second step portion 9215. In addition, the total length in the longitudinal direction of the blade 11B and the needle member 13B is shorter than that of the blade 11 and the needle member 13 described in Embodiment 2 above by an amount corresponding to the total length in the longitudinal direction of the receiving hole 9214.

[0180] Furthermore, in this embodiment 3, based on the first retraction operation performed on the first slider 82 and the second retraction operation performed on the second slider 83, the treatment device insertion part 7B becomes the first state shown below.

[0181] Specifically, based on the first retraction operation performed on the first slider 82, such as Figure 17 As shown, the device insertion portion 7B, similar to Embodiment 2 described above, has a protrusion 112 located within the large-diameter portion 9211, with the base end of the protrusion 112 abutting against the first stepped portion 9213, and only the protrusion 112 protruding from the first hole 921B to the front end member 92B. At this time, the connecting member 15A is located closer to the base end than the receiving hole 9214. Furthermore, according to the second retraction operation performed on the second sliding member 83, the device insertion portion 7B becomes such that the flange portion 132 abuts against the front end of the tube 14, and the needle member 13B is entirely located within the connecting member 15A.

[0182] Furthermore, in this embodiment 3, based on the first forward operation performed on the first slider 82 and the second forward operation performed on the second slider 83, the treatment device insertion part 7B becomes the second state as shown below.

[0183] Specifically, based on the first forward operation performed on the first slider 82, such as Figure 18 As shown, the treatment device insertion portion 7B is positioned such that the front end of the connecting member 15A is located within the receiving hole 9214, the front end of the connecting member 15A abuts against the second step portion 9215, and the blade 11B protrudes from the front end of the sheath 9B by its maximum protrusion length. Furthermore, according to the second forward operation performed on the second slider 83, the treatment device insertion portion 7B, similar to Embodiment 2 described above, is positioned such that the flange portion 132 abuts against the base end of the blade body 111, and the needle member 13B protrudes from the front end of the blade 11B by its maximum protrusion length (e.g., 1 mm).

[0184] Furthermore, in this embodiment 3, based on the first forward operation performed on the first slider 82 and the second backward operation performed on the second slider 83, the treatment device insertion part 7B becomes the third state shown below.

[0185] Specifically, based on the first forward operation performed on the first slider 82, such as Figure 19 As shown, the device insertion portion 7B, as described above, has its front end of the connecting member 15A located within the receiving hole 9214, the front end of the connecting member 15A abutting against the second step portion 9215, and the blade 11B protruding to its maximum protruding length from the front end of the sheath 9B. Furthermore, according to the second retraction operation performed on the second slider 83, the device insertion portion 7B, as described above, has its flange portion 132 abutting against the front end of the tube 14, and the needle member 13B entirely located within the connecting member 15A.

[0186] Furthermore, since the operation of the endoscope treatment device 6 in Embodiment 3 is the same as that in Embodiment 2 described above, the description is omitted.

[0187] When the treatment device insertion part 7B of Embodiment 3 described above is used, it also achieves the same effect as Embodiment 2 described above.

[0188] Furthermore, in the instrument insertion portion 7B of this embodiment 3, compared with the instrument insertion portion 7A described in embodiment 2 above, the overall length of the blade 11B and the needle member 13B in the longitudinal direction is shortened. Therefore, when the instrument insertion portion 7B is inserted from the insertion port 223 into the tubing within the endoscope insertion portion 21, it is easy to bend the instrument insertion portion 7B into a shape along the tubing, thereby improving the insertion performance.

[0189] (Implementation Method 4)

[0190] Next, this implementation method 4 will be described.

[0191] In the following description, the same reference numerals are used for structures that are the same as those in Embodiment 1 described above, and detailed descriptions of them are omitted or simplified.

[0192] In the endoscopic treatment device 6 of this embodiment 4, the structure of the front end portion of the treatment device insertion part 7 is different from that of the endoscopic treatment device 6 described in embodiment 1 above. Hereinafter, for ease of explanation, the treatment device insertion part of this embodiment 4 will be referred to as the treatment device insertion part 7C.

[0193] Figures 20-22 This is a diagram illustrating the structure of the treatment device insertion part 7C in Embodiment 4. Specifically, Figure 20 Is with Figure 2 The corresponding sectional view is a diagram showing the treatment device insertion part 7C set to the first state. Figure 21 Is with Figure 3 The corresponding sectional view is a diagram showing the treatment device insertion part 7C set to the second state. Figure 22 Is with Figure 4 The corresponding sectional view is a diagram showing the treatment device insertion part 7C set to the third state.

[0194] In the treatment device insertion section 7C, such as Figures 20-22 As shown, compared to the treatment device insertion part 7 described in Embodiment 1 above, the inner tube 16 is omitted, the flow path P1 for the flow of physiological saline is different, and the shape of the connecting member 15 is different. Hereinafter, for ease of explanation, the flow path, the first retraction member, and the connecting member of this Embodiment 4 will be referred to as flow path P1C, first retraction member 10C, and connecting member 15C, respectively.

[0195] In this embodiment 4, the sheath body 91 is connected to the water inlet 812. That is, the inner circumferential surface of the sheath body 91 and the outer circumferential surface of the pipe 14 and the outer circumferential surface of the connecting member 15C function as the flow path P1C of the present invention for the flow of physiological saline solution supplied from the water source 200 via the pipe TU and the water inlet 812.

[0196] like Figures 20-22 As shown, a connecting hole 151 is provided on the outer peripheral surface of the connecting member 15C, which passes through the inside and outside of the connecting member 15C.

[0197] Furthermore, the first connecting hole 152 of the present invention, which is connected to the second hole 113, is located within the connecting member 15C. Figures 20-22 Furthermore, the connecting hole 151 corresponds to the second connecting hole of the present invention, which connects the flow path P1C and the first connecting hole 152.

[0198] Furthermore, since the operation of the endoscopic treatment device 6 in this embodiment 4 is relative to that in embodiment 1, it only involves the flow path of physiological saline within the device insertion portion 7C (see...). Figure 20 and Figure 21 The arrows shown are different, so the explanation is omitted.

[0199] When the treatment device insertion part 7C of Embodiment 4 described above is used, it also achieves the same effect as Embodiment 1 described above.

[0200] Furthermore, in the treatment device insertion part 7C of this embodiment 4, since the inner tube 16 can be omitted, the structure of the treatment device insertion part 7C can be simplified, and the diameter of the treatment device insertion part 7C can be reduced.

[0201] (Other implementation methods)

[0202] This concludes the description of the methods for implementing the present invention, but the present invention should not be limited to the embodiments 1 to 4 described above.

[0203] In embodiments 1 to 4 described above, the shape of the protrusion 112 is not limited to the shape described in embodiments 1 to 4, and other shapes may also be used. For example, the blades 11 and 11B may be constructed from so-called hook blades.

[0204] In the above embodiments 1 to 4, the blades 11 and 11B are configured to be able to move forward and backward, but they are not limited to this. The blades 11 and 11B may also be configured to be unable to move forward or backward. That is, the blades 11 and 11B may also be configured to always be in any of the following states (1) and (2).

[0205] (1) The blades 11 and 11B always remain in a state where the front end of the sheaths 9 and 9B protrudes to its maximum length (e.g., Figure 2 (state).

[0206] (2) The blades 11 and 11B always remain in a state where only the protrusions 112 protrude from the first holes 921 and 921B to the front end members 92 and 92B (e.g. Figure 3 (state).

[0207] Figure 23 This is a diagram showing a variation of embodiment 1 to 4.

[0208] In this variation example 1, as Figure 23 As shown, the shape of the second hole 113 described in embodiments 1 to 4 above differs. Hereinafter, for ease of explanation, the blade and the second hole in this modified example 1 will be referred to as blade 11D and second hole 113D, respectively. Furthermore, Figure 23This is a cross-sectional view obtained by cutting the blade 11D along the central axis of the blade 11D in this modified example 1.

[0209] like Figure 23 As shown, the edge portion of the front end of the second hole 113D is chamfered in a straight line in cross-section. Because the second hole 113D is formed in this way, when the needle members 13 and 13B protruding from the second hole 113D towards the front end are pulled towards the base end, the needle members 13 and 13B will not get caught on the edge portion of the front end of the second hole 113D. Therefore, the second forward operation and the second backward operation can be performed smoothly.

[0210] Figure 24 This is a diagram showing a variation 2 of embodiments 1 to 4.

[0211] In this variation example 2, as Figure 24 As shown, the shape of the second hole 113 described in embodiments 1 to 4 above differs. Hereinafter, for ease of explanation, the blade and the second hole in this modified example 2 will be referred to as blade 11E and second hole 113E, respectively. Furthermore, Figure 24 This is a cross-sectional view obtained by cutting the knife 11E with a cutting plane along the central axis of the knife 11E in this modified example 2.

[0212] like Figure 24 As shown, the edge of the front end of the second hole 113E is chamfered in a curved shape in cross-section. Because the second hole 113E is formed in this way, when the needle members 13 and 13B protruding from the second hole 113E towards the front end are pulled towards the base end, the needle members 13 and 13B will not get caught on the edge of the front end of the second hole 113E. Therefore, the second forward operation and the second backward operation can be performed smoothly.

[0213] Figure 25 This is a diagram showing a variation of embodiment 1 to 4, specifically example 3.

[0214] In this variation example 3, as Figure 25 As shown, the shapes of the protrusions 112 described in embodiments 1 to 4 above differ. Hereinafter, for ease of explanation, the blade and the protrusion in this modified example 3 will be referred to as blade 11F and protrusion 112F, respectively. Furthermore, Figure 25 This is a cross-sectional view obtained by cutting the knife 11F with a cutting plane along the central axis of the knife 11F in this modified example 3.

[0215] like Figure 25 As shown, the outer periphery of the front end of the protrusion 112F is chamfered in a straight line in cross-section. Because the protrusion 112F is formed in this way, it appears as if... Figure 10 As described in the text, the protrusion 112F can be inserted smoothly into the biological tissue.

[0216] Figure 26 This is a diagram showing a variation of embodiment 1 to 4, specifically example 4.

[0217] In this variation example 4, as Figure 26 As shown, the shapes of the protrusions 112 described in embodiments 1 to 4 above differ. Hereinafter, for ease of explanation, the blade and the protrusion in this modified example 4 will be referred to as blade 11G and protrusion 112G, respectively. Furthermore, Figure 26 This is a cross-sectional view obtained by cutting the knife 11G with a cutting plane along the central axis of the knife 11G in this modified example 4.

[0218] like Figure 26 As shown, the outer periphery of the front end of the protrusion 112G is chamfered in a curved shape in cross-section. Because the protrusion 112G is formed in this way, it appears as if... Figure 10 As described, the protrusion 112G can be inserted smoothly into the biological tissue.

[0219] Figure 27 This is a diagram showing a variation 5 of embodiments 1 to 4.

[0220] like Figure 27 As shown, in this modified example 5, the shapes of the needle members 13 and 13B described in embodiments 1 to 4 above are different. Hereinafter, for ease of explanation, the needle member of this modified example 5 will be referred to as needle member 13H. Furthermore, Figure 27 This is a cross-sectional view obtained by cutting the needle member 13H along the central axis of the needle member 13H in this modified example 5.

[0221] The outer diameter of the front end portion of the needle member 13H increases as it moves towards the front end, and then gradually decreases as it moves further towards the front end. Because the needle member 13H is formed in this way, similar to the variations 1-2 described above, when the needle member 13H, which protrudes from the second hole 113 towards the front end, is pulled towards the base end, it will not get stuck on the edge portion of the front end of the second hole 113. Therefore, the second forward operation and the second backward operation can be performed smoothly.

Claims

1. An endoscopic treatment device, wherein, The endoscopic device has the following features: jacket; The front end component is fixed to the front end of the sheath and has insulation properties; An electrode that can be moved in and out freely through the front end component and has an opening at the front end; as well as The needle component, which can move freely through the electrode, is solid. The tip of the needle component can protrude from the electrode. There is a flow path inside the electrode.

2. The endoscopic treatment device according to claim 1, wherein, The endoscopic treatment device includes: a tube that can move in and out inside the sheath; and a connecting member connected to the front end of the tube, the connecting member being fixed to the outer peripheral surface of the electrode.

3. The endoscopic treatment device according to claim 2, wherein, The needle component has: a needle component body that can penetrate the electrode; and a flange portion that cannot penetrate the electrode. The endoscopic treatment device also has a wire that extends from the flange toward the interior of the tube and is capable of moving forward and backward relative to the tube.

4. The endoscopic treatment device according to claim 2, wherein, The endoscopic treatment device further comprises: an operating body fixed to the base portion of the sheath; and a first sliding member connected to the base portion of the tube. The first sliding member is mounted on the operating part body in a manner that allows it to move along the length direction of the operating part body. The electrode and the tube move together within the sheath according to the movement of the first sliding member. The electrode is able to protrude from the front end member, and the electrode is configured such that by advancing the first slider relative to the main body of the operating part, the protrusion of the electrode from the front end member becomes the maximum, and the front end of the connecting member abuts against the base end of the front end member.

5. The endoscopic treatment device according to claim 4, wherein, The needle component has: a needle component body that can penetrate the electrode; and a flange portion that cannot penetrate the electrode. The endoscopic instrument also includes a wire extending from the flange toward the interior of the tube and capable of moving forward and backward relative to the tube. The endoscopic treatment device also includes a second sliding member connected to the base end of the wire. The endoscopic treatment device is configured such that the needle member protrudes from the front end of the electrode by advancing the second slider, and is configured such that the needle member is housed at a position closer to the base end side than the front end of the electrode by retracting the second slider.

6. The endoscopic treatment device according to claim 1, wherein, The needle component can move forward and backward between a position where its front end is housed inside the electrode and a position where its front end protrudes from the front end of the electrode.

7. The endoscopic treatment device according to claim 2, wherein, The needle component can move back and forth between a position where its front end is housed inside the connecting member and a position where its front end protrudes from the front end of the electrode.

8. The endoscopic treatment device according to claim 2, wherein, The needle component can move back and forth between a position where its front end is housed inside the tube and a position where its front end protrudes from the front end of the electrode.

9. The endoscopic treatment device according to claim 2, wherein, The needle component is positioned so that it protrudes from the front end of the electrode relative to the electrode and is retracted to a position where it is housed inside the tube.

10. The endoscopic treatment device according to claim 1, wherein, The needle component is positioned so that it protrudes from the front end of the electrode relative to the electrode at a position that is further back towards the base end of the sheath than the front end of the electrode.

11. The endoscopic treatment device according to claim 1, wherein, Fluid is injected into the tissue from the electrode with the tip of the needle component positioned closer to the base of the sheath than the tip of the electrode.

Images