Treatment tool and treatment system for endoscope

Abstract

The utility model provides a treatment instrument and a treatment system for an endoscope. This treatment tool for an endoscope is provided with: a sheath having a longitudinal axis; an electrode, at least a portion of which protrudes from the distal end portion of the sheath toward the distal end side; and a tube which is supported by the distal end of the sheath and has a suction line penetrating in the longitudinal direction of the longitudinal axis, the distal end opening of the suction line being located at the distal end of the sheath, and the proximal end opening of the suction line being open to the outside of the sheath at a position between the distal end and the proximal end of the sheath.

Description

Technical Field

[0001] This utility model relates to endoscopic treatment devices and treatment systems. Background Technology

[0002] In the past, endoscopic procedures such as ESD (endoscopic submucosal dissection) have used high-frequency knives and other endoscopic instruments for cutting and dissecting, as well as for hemostasis.

[0003] When using endoscopic instruments to achieve hemostasis, the surgeon determines the site of hemostasis by administering fluid. When hemostasis is performed after the site has been determined, it is desirable that there be no electrolyte-rich fluid surrounding the site. Therefore, the surgeon aspirates fluid from the tissue surrounding the target tissue before performing hemostasis. Endoscopic instruments with aspiration functions are described in Patent Documents 1 and 2.

[0004] Existing technical documents

[0005] Patent documents

[0006] Patent Document 1: U.S. Patent Application Publication No. 2007 / 0038213

[0007] Patent Document 2: Japanese Patent Application Publication No. 2009-233269 Utility Model Content

[0008] Problems to be solved by utility models

[0009] However, since the endoscopic treatment instruments described in Patent Documents 1 and 2 have suction channels along the entire length of the sheath, increasing the suction efficiency requires increasing the diameter of the channels, thus increasing the outer diameter of the sheath along its entire length. If the outer diameter of the sheath increases along its entire length, there is a possibility that the suction performance of the endoscope will decrease.

[0010] In view of the above, the purpose of this utility model is to provide an endoscope treatment device that can perform suction from the front end of the sheath without significantly reducing the suction performance of the endoscope.

[0011] Solution for solving the problem

[0012] To solve the above-mentioned technical problems, the present invention proposes the following technical solution.

[0013] The first technical solution of this utility model discloses an endoscopic treatment device, characterized in that the endoscopic treatment device comprises: a sheath having a length axis; an electrode, at least a portion of which protrudes from the front end of the sheath toward the front end side; and a tube supported at the front end of the sheath, which internally includes a suction tube extending along the length axis, the front end opening of the suction tube being located at the front end of the sheath, and the base end opening of the suction tube opening toward the outside of the sheath at a position between the front end and the base end of the sheath.

[0014] The second technical solution of this utility model is an endoscope treatment device according to the first technical solution of the endoscope treatment device, characterized in that the tube covers at least a portion of the outer peripheral surface of the front end of the sheath, and the suction tube is formed between the front end of the sheath and the tube.

[0015] The endoscope treatment device of the third technical solution of this utility model is based on the endoscope treatment device of the first technical solution, characterized in that the sheath includes an outer tube extending along the length direction and an insulating front end member installed at the front end of the outer tube, and the front end of the tube is fixed to the sheath by the front end member.

[0016] The endoscopic treatment device of the fourth technical solution of this utility model is based on the endoscopic treatment device of the third technical solution, characterized in that the front end member has a suction hole extending along the length direction, and the suction hole is connected to the suction tube through the front end opening.

[0017] The fifth technical solution of this utility model is an endoscope treatment device according to the first technical solution of the endoscope treatment device, characterized in that the outer diameter of the sheath is smaller than the outer diameter of the tube and larger than the outer diameter of the electrode.

[0018] The sixth technical solution of this utility model is an endoscope treatment device according to the third technical solution of the endoscope treatment device, characterized in that the front end member has: a first part that protrudes from the front end of the outer tube; and a second part that is inserted into the outer tube, the front end of the tube being fixed to the first part.

[0019] The seventh technical solution of this utility model is an endoscope treatment device according to the third technical solution of the endoscope treatment device, characterized in that the length of the front end member from the front end to the base end is 10mm to 20mm.

[0020] The endoscopic treatment device of the eighth technical solution of this utility model is based on the endoscopic treatment device of the third technical solution, characterized in that the front end member has: a first part that protrudes from the front end of the outer tube; and a second part that is inserted into the outer tube, wherein the front end opening of the suction tube is formed in the first part.

[0021] The endoscopic treatment device of the ninth technical solution of this utility model is based on the endoscopic treatment device of the fourth technical solution, characterized in that the inner circumferential surface of the suction hole is located radially inward than the inner circumferential surface of the tube.

[0022] The tenth technical solution of this utility model is an endoscope treatment device according to the third technical solution of the endoscope treatment device, characterized in that a wire member that can move freely along the length direction is provided inside the sheath, the endoscope treatment device has a connector connecting the base end of the electrode and the wire member, the front end of the electrode is flange-shaped, and the position of the opening of the base end of the tube is located at a position closer to the front end of the connector than when the front end of the electrode is abutted against the front end member.

[0023] The endoscopic treatment device of the eleventh technical solution of this utility model is based on the endoscopic treatment device of the eighth technical solution, characterized in that a side hole is formed on the side of the first part of the front end member, and the side hole is connected to the suction tube.

[0024] The treatment system of the twelfth technical solution of this utility model is characterized in that the treatment system includes: an endoscope having a suction channel; and a treatment device arranged to move freely in and out of the suction channel, the treatment device having a tube arranged to protrude and retract freely relative to the front end of the suction channel, the tube containing a suction tube inside, the base opening of the suction tube being located inside the suction channel.

[0025] The processing system of the thirteenth technical solution of this utility model is based on the processing system of the twelfth technical solution, characterized in that, when the front opening of the suction tube protrudes relative to the front end of the endoscope, the base opening of the suction tube is located in the suction channel in the curved part of the endoscope.

[0026] The fourteenth technical solution of this utility model is based on the twelfth technical solution, characterized in that the length of the tube from the front end to the base end is shorter than the length of the curved portion of the endoscope along its length axis.

[0027] The fifteenth technical solution of this utility model, based on the twelfth technical solution, is characterized in that, when the front opening of the suction tube protrudes relative to the front end of the endoscope, the base opening of the suction tube and the suction channel are connected within the suction channel in the curved portion of the endoscope.

[0028] The treatment system of the sixteenth technical solution of this utility model is based on the treatment system of the twelfth technical solution, characterized in that the endoscope has a tapered part at the front end of the suction channel, with the inner diameter narrowing towards the front end.

[0029] The seventeenth technical solution of this utility model discloses an endoscopic treatment device, characterized in that the endoscopic treatment device comprises: a sheath having a length axis, the sheath being a multi-lumen tube; and an electrode, wherein the sheath internally includes a suction tube extending along the length axis and a blade tube through which the electrode can be inserted in an advancing and retracting manner, at least a portion of the electrode protruding from the front end of the blade tube toward the front end side, the front opening of the suction tube being located at the front end of the sheath, and the base opening of the suction tube opening toward the outside of the sheath at a position between the front end and the base end of the sheath.

[0030] Effects of the utility model

[0031] The endoscope treatment device of this invention can perform suction from the front end of the sheath without significantly reducing the suction performance of the endoscope. Attached Figure Description

[0032] Figure 1 This is an overall diagram of the endoscopic treatment system according to the first embodiment.

[0033] Figure 2 This is an overall diagram showing the treatment instruments of the endoscopic treatment system.

[0034] Figure 3 This is a three-dimensional view of the front opening of the endoscope channel in the endoscopic treatment system.

[0035] Figure 4 This is a three-dimensional view of the front end of the treatment device.

[0036] Figure 5 This is a diagram showing the front end of the treatment device when the tip of the knife is in the second position.

[0037] Figure 6 It is along Figure 5 A cross-sectional view along line X1-X1.

[0038] Figure 7 It is along Figure 5 A cross-sectional view along line X2-X2.

[0039] Figure 8 This is a diagram showing the front end of the treatment device when the tip of the knife is in the first position.

[0040] Figure 9 This is a cross-sectional view of the front end of the treatment device.

[0041] Figure 10 This is a diagram showing a modified example of the suction hole.

[0042] Figure 11 This is a diagram showing other variations of the suction hole.

[0043] Figure 12 This is a diagram showing a variation of the knife.

[0044] Figure 13 This is a cross-sectional view of a modified example of the treatment device.

[0045] Figure 14 This is a cross-sectional view of a modified example of this channel.

[0046] Figure 15 This is a perspective view of the front end of the treatment device according to the second embodiment.

[0047] Figure 16 This is a cross-sectional view of the front end of the processing instrument when the tip of the knife is in the second position.

[0048] Figure 17 This is a cross-sectional view of the front end of the treatment device when the tip of the knife is in the first position.

[0049] Figure 18 This is a perspective view of the front end of the treatment device according to the third embodiment.

[0050] Figure 19 This is a cross-sectional view of the front end of the treatment device.

[0051] Explanation of reference numerals in the attached figures

[0052] 300. Endoscope treatment system; 200. Endoscope; 206, 206A. Channel; 206a. Front opening; 206b. Base opening (forceps jaw); 206t. Conical part; 209c. Suction button; 100, 100B, 100C. Treatment instrument (endoscope treatment instrument); 1, 1B, 1C. Sheath; 1a. Front end; 1b. Base end; 10, 10B. Outer tube; 11, 11B. Front end component; 12, 12B. Through hole; 12a. First opening; 12C. Knife tube; 13, 13A, 13B. Suction port; 13a, 13Aa. Front opening (suction opening); 13Ba. Side opening (suction opening); 13C. Suction tube; 13Ca. Front opening; 14. Front face; 15. First part 16. Second part; 18. Expanded diameter section; 19. Internal space (pipeline, cavity); 2. Suction tube (suction tube component); 21. Front opening; 22, 22C. Base opening; 23. Internal space, suction tube; 24. Second tube; 3, 3A, 3B. Knife (electrode); 30, 30A, 30B. Knife body; 31, 31B. Flange (front diameter expansion section); 32, 32B. Connector (connecting component); 33. First tube; 33a. Front opening; 4, 4B. Operating line; 43. Third tube; 44. Coil shaft; 5. Operating part; 51. Operating part body; 52. Sliding part; 53. Power supply connector; 54. Liquid supply port; 6. Sharp component (rod); 61. Sharp part; SR. Suction flow path; WR. Liquid delivery flow path. Detailed Implementation

[0053] (First Implementation)

[0054] For the endoscopic treatment system 300 of the first embodiment of this utility model, refer to... Figures 1 to 9 Please provide an explanation. Figure 1 This is an overall view of the endoscopic treatment system 300 of this embodiment.

[0055] [Endoscopic Handling System 300]

[0056] like Figure 1 As shown, the endoscopic treatment system 300 includes an endoscope 200 and a treatment device 100. The treatment device 100 is inserted into the endoscope 200 for use.

[0057] [Endoscope 200]

[0058] The endoscope 200 is a known flexible endoscope, which includes an insertion part 202 that is inserted into the body from the tip and an operation part 207 installed at the base of the insertion part 202.

[0059] The insertion part 202 includes a camera part 203, a curved part 204, and a flexible part 205. Starting from the front end of the insertion part 202, the camera part 203, the curved part 204, and the flexible part 205 are sequentially arranged. Inside the insertion part 202, there is a channel 206 for inserting the treatment device 100. At the front end of the insertion part 202, there is a front opening 206a of the channel 206.

[0060] The camera unit 203 is equipped with an imaging element such as a CCD or CMOS, and is capable of capturing images of the part to be processed. When the processing device 100 protrudes from the front opening 206a of the channel 206, the camera unit 203 can capture images of the blade 3 of the processing device 100.

[0061] The bending portion 204 bends according to the operator's operation of the operating portion 207. The flexible portion 205 is a flexible tubular part.

[0062] The operating unit 207 is connected to the flexible unit 205. The operating unit 207 has a handle 208, an input unit 209, a base opening (pliers jaw) 206b of the channel 206, and a universal cable 210. The handle 208 is the part held by the operator.

[0063] The input unit 209 includes an angle knob 209a, an air / liquid delivery button 209b, and a suction button 209c. The angle knob 209a receives input for bending the bending section 204. The air / liquid delivery button 209b inputs the operation of supplying air / liquid through the front opening 206a. The suction button 209c inputs the suction operation for suction through the front opening 206a; pressing the suction button 209c initiates suction within the channel.

[0064] The universal cable 210 outputs images captured by the camera unit 203 to the outside. The universal cable 210 is connected to a display device such as an LCD via an image processing device equipped with a processor. In addition, the endoscope 200 is connected to the suction pump 400 via the universal cable 210, and suction within the channel 206 is started by pressing the suction button 209c.

[0065] [Treatment equipment 100]

[0066] Figure 2 This is an overall drawing of the treatment device 100.

[0067] Treatment instruments (endoscopic treatment instruments, high-frequency treatment instruments) 100 include a sheath 1, a suction tube 2, a knife 3, and an operating line 4 (see reference). Figure 5 ) and operating part 5. In the following description, the side of the treatment device 100 that faces into the patient's body in the length direction A is referred to as "the front end side (distal side) A1", and the side of the operating part 5 is referred to as "the base side (proximal side) A2".

[0068] Figure 3 This is a three-dimensional view of the front opening 206a of channel 206.

[0069] The sheath 1 is a longitudinally elongated tubular member extending from the front end 1a along the length direction A to the base end 1b, where the length direction A is along the length axis. The sheath 1 can be inserted into the channel 206 of the endoscope 200 and can move in and out of the channel 206. With the sheath 1 inserted into the channel 206, the front end 1a of the sheath 1 can protrude and sink relative to the front opening 206a of the channel 206.

[0070] Figure 4 This is a perspective view of the front end of the treatment device 100.

[0071] The sheath 1 has an outer tube 10 extending along the length direction A and a front end member 11 provided at the front end of the outer tube 10. In addition, the sheath 1 can be formed by integrally molding the outer tube 10 and the front end member 11, or it can be made of the same raw material.

[0072] Figure 5 This is a diagram showing the front end of the treatment device 100 when the front end of the knife 3 is in the second position P2.

[0073] The sheath 1 is inserted into the internal space 23 of the suction tube 2 (hereinafter also referred to as "suction tube 23"). A portion of the knife 3 is inserted into the internal space 19 of the sheath 1. That is, the outer diameter of the sheath 1 is smaller than the outer diameter of the suction tube 2 and larger than the outer diameter of the knife 3.

[0074] The outer tube 10 is a longitudinally elongated tubular member with flexibility and insulation. The outer tube 10 is formed, for example, from resin. In this embodiment, the internal space 19 of the outer tube 10 is a portion of the space into which the knife 3 can be inserted.

[0075] Figure 6 It is along Figure 5 A cross-sectional view along line X1-X1. Figure 7 It is along Figure 5 A cross-sectional view along line X2-X2. The front end member 11 is formed in a cylindrical shape. Furthermore, "cylindrical" includes not only a strictly cylindrical shape but also a shape close to a cylinder. The front end member 11 is preferably formed of an insulating material such as resin. The length of the front end member 11 from the front end to the base end is, for example, 10 mm to 20 mm. Figure 4 As shown, a through hole 12 and a suction hole 13 are formed in the front end member 11. The through hole 12 and the suction hole 13 are not directly connected. The front end member 11 has a first part 15 and a second part 16.

[0076] The first part 15 is located at the front end side A1 of the front end member 11 and is formed in the shape of a circular plate. Furthermore, "circular plate" includes not only a strictly circular shape but also a shape close to a circular plate. At least a portion of the first part 15 protrudes from the outer tube 10 toward the front end side A1. Figure 4 As shown, the first part 15 has a front end face 14 on the front end side A1. At least a portion of the first part 15 is inserted into the suction tube 2 and is fitted and fixed with the front end opening 21 of the suction tube 2. The first part 15 protrudes from the front end of the suction tube 2 toward the front end side A1. The outer diameter of the first part 15 is larger than the outer diameter of the outer tube 10.

[0077] The second part 16 is located at the base end A2 of the front end member 11 and is formed in a cylindrical shape. Furthermore, "cylindrical shape" includes not only a strictly cylindrical shape but also a shape close to a cylinder. The second part 16 is located at the base end A2 of the first part 15. The second part 16 is inserted into the outer tube 10 and is fixed by fitting into the front end opening of the outer tube 10. For example, the second part 16 of the front end member 11 and the outer tube 10 can also be joined by pressing a self-tapping screw provided on the front end member 11 into the outer tube 10. Alternatively, the second part 16 of the front end member 11 and the outer tube 10 can also be joined by adhesive bonding.

[0078] A through hole 12 is provided in the first part 15 and the second part 16 of the front end member 11, and is a hole that penetrates the front end member 11 along the length direction A. The front end of the through hole 12 communicates with the first opening 12a formed on the front end face 14 of the front end member 11. The base end of the through hole 12 communicates with the internal space 19 of the outer tube 10.

[0079] A suction hole 13 is provided in the first part 15 of the front end member 11, and is a hole that penetrates the first part 15 of the front end member 11 along the length direction A, forming at least a part of the suction flow path SR. Three suction holes 13 are formed in the first part 15 of the front end member 11. The three suction holes 13 are respectively connected to three front openings 13a formed in the front end face 14 of the front end member 11. The base end of the suction hole 13 is connected to the suction passage 23 of the suction tube 2. The inner circumferential surface 13s of the suction hole 13 is located radially inside the inner circumferential surface 2s of the suction tube 2.

[0080] The front opening 13a of the suction hole 13 is arranged radially separate from the first opening 12a of the through hole 12. The three front openings 13a are evenly arranged along the circumferential direction C relative to the length direction A. The front openings 13a are formed into an elongated hole shape along the circumferential direction C.

[0081] The suction tube (suction conduit component) 2 is formed in a cylindrical shape. Furthermore, "cylindrical shape" includes not only a strictly cylindrical shape but also a shape close to a cylinder. The suction tube 2 has a suction conduit 23 forming at least a portion of the suction flow path SR. The suction conduit 23 is a conduit extending along the length direction A. The suction tube 2 covers the entire circumference of the outer tube 10 along the circumferential direction C at least a portion of the outer peripheral surface of the front end portion 1a of the sheath 1. The suction flow path SR of the suction conduit 23 is formed between the outer peripheral surface of at least a portion of the front end portion 1a of the sheath 1 and the inner peripheral surface of the suction tube 2.

[0082] Figure 8 This is a diagram showing the front end of the treatment device 100 when the front end of the knife 3 is in the first position P1.

[0083] The front opening 21 of the suction tube 2 is located at the front end 1a of the sheath 1. The front opening 21 of the suction tube 2 is fitted and fixed to the first part 15. For example, the first part 15 of the front end member 11 and the suction tube 2 can also be joined by adhesive.

[0084] The first part 15 of the front end component 11 is connected to the suction tube 2 at a position that is closer to the front end side A1 and to the outer side of the radial direction R than the connection position between the second part 16 and the outer tube 10.

[0085] The fitting diameter D4 of the suction tube 2 and the first part 15 is larger than the fitting diameter D3 of the outer tube 10 and the second part 16 (D4 > D3). The fitting diameter D4 of the suction tube 2 and the first part 15 is smaller than the maximum outer diameter D5 of the front end member 11 (D5 > D4).

[0086] The base opening 22 of the suction tube 2 opens outward from the sheath 1 at a position between the front end and the base end. For example... Figure 5 As shown, when the surgeon observes the images captured by the camera unit 203 while performing aspiration and hemostasis using the scalpel 3, the tip opening 21 of the aspiration tube 2 protrudes from the tip opening 206a of the channel 206, and the protrusion length L1 of the tip of the scalpel 3 protruding from the tip opening 206a of the channel 206 is 5 mm to 10 mm. At this time, the base opening 22 of the aspiration tube 2 is disposed inside the channel 206 of the endoscope 200. For example, the base opening 22 of the aspiration tube 2 can also be disposed inside the channel 206 in the curved portion 204 of the endoscope 200. The length L2 of the aspiration tube 2 is shorter than the length of the curved portion 204 of the endoscope 200 along its length axis, for example, by 10 mm to 20 mm. If the aspiration tube 2 is too long, it is easy to bend longitudinally; therefore, the length L2 of the aspiration tube 2 is preferably 20 mm or less.

[0087] like Figure 5As shown, the suction tube 23 is connected to the suction port 13 via a front opening 21 at the front end side A1. Furthermore, the suction tube 23 is connected to the channel 206 via a base opening 22 at the base end side A2. That is, the suction port 13, the suction tube 23, and the channel 206 form the suction flow path SR. The front opening 13a is the suction opening of the suction flow path SR. Liquid suctioned from the front opening 13a is discharged out of the body through the suction flow path SR (suction port 13, suction tube 23, channel 206). From the viewpoint of suction efficiency, it is preferable that the gap between the front opening 206a of the channel 206 and the suction tube 2 is small.

[0088] Furthermore, the connection between the first part 15 and the suction tube 2 is not limited to the connection made by the above-described fitting. The first part 15 and the suction tube 2 can be connected as long as the suction hole 13 and the suction tube 23 are connected.

[0089] The blade (electrode) 3 is made of metal and is a slender component. The blade 3 is formed from materials such as stainless steel. The blade 3 is conductive and is energized with a high-frequency current. The blade 3 has a blade body 30, a flange 31, and a connector 32.

[0090] The blade 3 penetrates the through hole 12 of the front end member 11 of the sheath 1 along the length direction A, and can freely protrude and retract towards the front end side A1 relative to the first opening 12a. Alternatively, the blade 3 can be fixed in a state where it protrudes from the first opening 12a towards the front end side A1 and cannot move forward or backward.

[0091] The central axis O3 of the blade 3 along the length direction A is preferably aligned with the central axis O1 of the sheath 1 along the length direction A. In addition, "aligned" includes not only strictly aligned shapes but also roughly aligned shapes.

[0092] The blade body 30 is a metal rod-shaped component. The outer diameter of the blade body 30 is smaller than the inner diameter of the through hole 12. The blade body 30 can move forward and backward along the length direction A within the through hole 12 and the first opening 12a.

[0093] The flange (expanded diameter portion at the front end) 31 is a flange-shaped conductive member provided at the front end of the blade body 30. In the front view viewed along the length direction A, the outer periphery of the flange 31 and the outer periphery of the blade body 30 are concentrically formed. The length D2 of the flange 31 in the radial direction R perpendicular to the length direction A is longer than the length D1 of the blade body 30 in the radial direction R. The flange 31 cannot penetrate the through hole 12 and the first opening 12a. A planar base end face 31b is formed on the base end side A2 of the flange 31. In addition, the flange 31 is not limited to a circular plate shape, but can also be triangular or hook-shaped. Furthermore, an insulating resin member can be fixed to the front end of the blade 3.

[0094] like Figure 5As shown, if the blade 3 is advanced relative to the sheath 1, the front end of the connector 32 contacts the front end member 11 (second part 16). Through the contact between the front end of the connector 32 and the front end member 11, the front end of the blade 3 is positioned at the second position P2, which is the position closest to the front end side A1.

[0095] like Figure 8 As shown, if the blade 3 is moved backward relative to the sheath 1, the base end face 31b of the flange 31 contacts the front end member 11 (first part 15). Through the contact between the base end face 31b of the flange 31 and the front end member 11, the front end of the blade 3 is positioned at the first position P1, which is the position closest to the base end side A2.

[0096] Figure 9 This is a cross-sectional view of the front end of the handling device 100.

[0097] like Figure 9 As shown, the blade body 30 and flange 31 have a first conduit 33 extending along the length direction A. The first conduit 33 communicates with a front opening 33a formed in the flange 31. The front opening 33a is an opening provided on the front end side A1 of the flange 31.

[0098] The connector (connector component) 32 is a cylindrical metal component. Furthermore, "cylindrical" includes not only a strictly cylindrical shape but also a shape that approximates a cylinder. The connector 32 connects the blade body 30 and the operating line 4.

[0099] like Figure 9 As shown, when the front end of the blade 3 is positioned at the first position P1, the base opening 22 of the suction tube 2 is located at a position A1 closer to the front end than the base end 32p of the connector 32. Therefore, longitudinal bending of the suction tube 2 can be prevented.

[0100] The connector 32 has a second conduit 34 extending along the length direction A. The second conduit 34 communicates with the first conduit 33 and the third conduit 43 formed on the operating line 4. The second conduit 34 is formed in a tapered shape that narrows from the base end side A2 toward the front end side A1.

[0101] An operating line 4 is mounted at the base of connector 32. High-frequency current is supplied to the blade 3 via the operating line 4, which is connected to the operating unit 5. When high-frequency current is supplied to the blade 3 from the operating line 4, the blade body 30 and flange 31 function as active electrodes that output high-frequency current to biological tissue.

[0102] The operating line 4 is a wire component that penetrates the internal space (pipeline, cavity) 19 of the outer tube 10 of the sheath 1. The operating line 4 is the wire component that operates the blade 3. The operating line 4 has a coil shaft 44. The front end of the operating line 4 is connected to the connector 32 of the blade 3, and the base end of the operating line 4 is connected to the sliding member 52 of the operating part 5. In addition, the operating line 4 can also be in other forms as long as it is a hollow shaft.

[0103] The coil shaft 44 is a hollow coil wire component made of metal. The coil shaft 44 is formed from materials such as stainless steel. A third conduit 43 is formed inside the coil shaft 44. The third conduit 43 is connected to the base end of the second conduit 34. The first conduit 33, the second conduit 34, and the third conduit 43 form a liquid delivery flow path WR. Fluid supplied from the liquid supply port 54 is discharged from the front opening 33a through the liquid delivery flow path WR (third conduit 43, second conduit 34, and first conduit 33).

[0104] The coil shaft 44 may also have its outer periphery covered by a heat-shrink tubing or the like. By covering the outer periphery of the coil shaft 44 with heat-shrink tubing, liquid is less likely to leak from the third conduit 43.

[0105] like Figure 1 and Figure 2 As shown, the operation unit 5 has an operation unit body 51, a slider 52, a power supply connector 53, and a liquid supply port 54.

[0106] The front end of the operating part body 51 is connected to the base end 1b of the sheath 1 (the base end of the outer tube 10). The operating part body 51 has an internal space through which the operating line 4 can pass. The operating line 4 extends to the slider 52 through the internal space 19 of the outer tube 10 and the internal space of the operating part body 51.

[0107] The slider 52 is mounted in a manner that allows it to move along the length direction A relative to the operating part body 51. The base of the operating line 4 is connected to the slider 52. The surgical operator moves the operating line 4 and the blade 3 forward and backward relative to the operating part body 51 by moving the slider 52 forward and backward.

[0108] The power connector 53 is fixed to the slider 52. The power connector 53 can be connected to a high-frequency power supply device (not shown) via a conductive wire to the base end of the operation line 4. The power connector 53 can supply high-frequency current from the high-frequency power supply device to the blade 3 via the operation line 4. Alternatively, the power connector 53 may be fixed to the operating part body 51 instead of the slider 52.

[0109] A liquid supply port 54 is provided on the sliding member 52. The liquid supply port 54 is connected to the base end of the third pipe 43 via a pipe formed in the sliding member 52. Figure 9 As shown, the liquid supplied from the liquid supply port 54 is discharged from the front opening 33a through the liquid delivery flow path WR (third pipe 43, second pipe 34, first pipe 33). Alternatively, the liquid supply port 54 may be provided on the main body of the operating part 51 instead of on the sliding member 52.

[0110] Based on the above structure, the treatment device 100 achieves the effect of performing suction from the front end of the sheath 1 without significantly reducing the suction performance of the endoscope 200. In other words, the endoscope treatment system 300 can balance the suction efficiency of the endoscope 200's channel 206 and the suction efficiency of the treatment device 100's suction tube 2.

[0111] [How to use the Endoscopic Treatment System 300]

[0112] The operation of the endoscopic treatment system 300 according to this embodiment (method of using the endoscopic treatment system 300) will be described below. Specifically, the local injection and incision / dissection procedures for lesions during endoscopic treatments such as ESD (endoscopic submucosal dissection) will be described.

[0113] As a preparatory step, the surgeon identifies the lesion using known methods. Specifically, the surgeon inserts the insertion part 202 of the endoscope 200 into the digestive tract (e.g., esophagus, stomach, duodenum, large intestine) and identifies the lesion while observing images obtained through the imaging part 203 of the endoscope.

[0114] <Insertation Steps>

[0115] The surgical operator inserts the treatment instrument 100 into the channel 206, so that the front end 1a of the sheath 1 protrudes from the front opening 206a of the insertion part 202.

[0116] <Marking Steps>

[0117] like Figure 8 As shown, the surgeon moves the slider 52 of the operating part 5 back relative to the operating part body 51, positioning the tip of the blade 3 in the first position P1. The front end of the flange 31, protruding from the front end face 14 of the front end member 11, is used to cauterize the biological tissue surrounding the lesion to apply a mark.

[0118] <Local Injection Procedure>

[0119] like Figure 5 As shown, the surgeon advances the slider 52 of the operating part 5 relative to the main body 51 of the operating part, positioning the tip of the blade 3 in the second position P2. With the tip opening 33a of the blade 3 inserted into the submucosa, the surgeon delivers fluid (local injection solution) through the fluid supply port 54. The fluid (local injection solution) is released from the tip opening 33a through the fluid delivery path WR (third line 43, second line 34, first line 33).

[0120] <Cutting and peeling steps>

[0121] Next, the surgeon performs the incision and dissection procedure. While advancing the blade 3 and applying a high-frequency current, the surgeon moves the flange 31 to incise the mucosa of the lesion. Furthermore, while advancing the blade 3 and applying the high-frequency current, the surgeon lifts the incised mucosa of the lesion to expose the submucosa, and simultaneously dissects the submucosa of the incised lesion.

[0122] <Steps to stop bleeding>

[0123] In the event of bleeding during the incision and dissection procedure, the surgeon performs hemostasis. The surgeon delivers fluid through the fluid supply port 54 to clean the area around the hemostasis point to confirm its location. Next, the surgeon aspirates electrolyte fluid from the surgical site for reliable hemostasis. The surgeon presses the aspiration button 209c and performs aspiration through the endoscope 200 via the front opening 206a (first step). Then, aspiration is performed through the aspiration tubing 23 of the treatment device 100 (second step). As a result, the fluid aspirated from the front opening 13a is drained from the body through the aspiration flow path SR (aspiration port 13, aspiration tubing 23, channel 206). The surgeon can also bring the front opening of the aspiration flow path SR into contact with the fluid for efficient aspiration.

[0124] Next, the surgeon presses down on the blade body 30 and flange 31 while applying a high-frequency current to cauterize the bleeding point to stop the bleeding (third step). At this time, since there is no electrolyte solution at the surgical site, the surgeon can quickly achieve hemostasis. The surgeon can also bring the blade 3 into contact with liquid to effectively achieve hemostasis.

[0125] Since the surgeon can use the same instrument 100 to perform hemostasis and aspiration, there is no need to change instruments or perform procedures such as aspirating blood through the endoscope 200 channel 206 after removing the instrument. Furthermore, the surgeon can perform the second and third steps simultaneously.

[0126] The surgeon continues the above actions (treatments) as needed, and finally removes the lesion, ending the ESD procedure.

[0127] According to the treatment device 100 of this embodiment, aspiration can be performed from the front end of the sheath 1 without significantly reducing the aspiration performance of the endoscope 200. In other words, the endoscope treatment system 300 can balance the aspiration efficiency of the endoscope 200's channel 206 and the aspiration efficiency of the treatment device 100's suction tube 2. Therefore, the treatment device 100 can also perform aspiration treatment utilizing the aspiration function of the endoscope 200, depending on the situation. Since the treatment device 100 can perform both aspiration treatment and hemostasis, the surgeon can immediately locate and stop the hemostasis point after aspirating and recovering fluid accumulated at the surgical site.

[0128] The first embodiment of this utility model has been described in detail above with reference to the accompanying drawings. However, the specific structure is not limited to this embodiment and may include design changes that do not exceed the scope of the spirit of this utility model. In addition, the constituent elements shown in the above embodiments and variations can be appropriately combined to form the present invention.

[0129] (Variation Example 1)

[0130] Figure 10 This is a diagram showing a modified example of suction hole 13A.

[0131] Six suction holes 13A are formed in the first part 15 of the front end member 11. Each of the six suction holes 13A communicates with six front openings 13Aa formed on the front end face 14 of the front end member 11. The base of each suction hole 13A communicates with the internal space 19 of the outer tube 10. The six front openings 13Aa are arranged equally along the circumferential direction C relative to the length direction A. The front openings 13Aa are formed to be circular when viewed from the length direction A. Furthermore, the suction holes 13A are symmetrically arranged with respect to the central axis along the length direction A of the front end member 11, but they can also be arranged asymmetrically with respect to the central axis along the length direction A.

[0132] (Variation Example 2)

[0133] Figure 11 This is a diagram showing a modified example of suction hole 13B.

[0134] The suction port 13B is a side hole formed on the side of the first portion 15 of the front end member 11. The suction port 13B communicates with the side opening 13Ba formed on the side of the front end member 11. The suction port 13B communicates with the internal space 19 of the outer tube 10. The surgeon can aspirate fluid accumulated at the surgical site through the suction port 13B formed on the side. Alternatively, the front end member 11 may have only the suction port 13B and not the suction port 13B.

[0135] (Variation Example 3)

[0136] Figure 12 This is a diagram showing knife 3A as a variant of knife 3.

[0137] The blade 3A does not have a fluid delivery path WR and therefore does not have a fluid delivery function. Even without a fluid delivery function, hemostasis and aspiration can still be performed appropriately. Since the fluid delivery path WR can be omitted from the blade 3A, connector 32, and operating line 4, the diameter of the sheath 1 can be reduced, thereby improving the aspiration efficiency of the aspiration path SR.

[0138] (Variation Example 4)

[0139] Figure 13 This is a cross-sectional view of treatment device 100A, which is a variation of treatment device 100.

[0140] The treatment device 100A also includes a sharp member (rod) 6. The sharp member 6 is a rod-shaped member formed of resin, metal, or the like. The sharp member 6 extends through the fluid delivery path WR of the blade 3 in a retractable manner. The sharp member 6 protrudes and retracts freely relative to the front opening 33a of the blade 3. A sharp point 61 is formed at the front end of the sharp member 6. The surgeon can easily insert the blade 3 into the local injection site by puncturing the local injection site (local injection solution) with the sharp point 61 of the sharp member 6 at the lesion site. When the sharp member 6 is retracted to its maximum extent, the front end of the sharp member 6 is located between the front end and the base end of the front member 11. Alternatively, when the sharp member 6 is retracted to its maximum extent, the front end of the sharp member 6 may be located between the base end of the front member 11 and the base opening 30b of the blade body 30. When the sharp member 6 is advanced, it is positioned at its most forward position A1 by contacting the stop 6s provided on the sharp member 6 with the conical second conduit 34. Alternatively, when the sharp member 6 is advanced to its maximum extent, the amount of protrusion of the sharp member 6 from the front end of the blade 3 is shorter than the total length of the suction tube 2. In this case, local injection and suction can be performed efficiently.

[0141] (Variation Example 5)

[0142] Figure 14 This is a cross-sectional view of channel 206A, which is a variation of channel 206.

[0143] Channel 206A has a tapered portion 206t formed in a conical shape. The tapered portion 206t is formed at the front end of channel 206A, and its inner diameter becomes narrower towards the front opening 206a. The tapered portion 206t is preferably located within the sliding range of the suction tube 2. The length L3 of the tapered portion 206t in the longitudinal direction A is, for example, 10 mm to 15 mm. Since the gap between the front opening 206a of channel 206A and the suction tube 2 is reduced, the suction efficiency of channel 206A is improved. Alternatively, winglets or the like can be provided on the endoscope 200 to fill the gap between the front opening 206a of channel 206A and the suction tube 2.

[0144] (Second Implementation)

[0145] Reference Figures 15 to 17 The processing device 100B according to the second embodiment of this utility model will be described below. In the following description, structures that are the same as those already described will be labeled with the same reference numerals and repeated descriptions will be omitted.

[0146] Figure 15 This is a perspective view of the front end of the treatment device 100B.

[0147] The treatment device (endoscopic treatment device, high-frequency treatment device) 100B is equipped with a sheath 1B, a suction tube 2, a knife 3B, an operating line 4B, and an operating part 5.

[0148] Figure 16 This is a cross-sectional view of the front end of the handling device 100B when the front end of the knife 3B is in the second position P2. Figure 17 This is a cross-sectional view of the front end of the treatment device 100B when the tip of the knife 3B is in the first position P1. The sheath 1B has an outer tube 10B extending along the length direction A and a front end member 11B provided at the front end of the outer tube 10B. Alternatively, the sheath 1B may be formed integrally by the outer tube 10B and the front end member 11B.

[0149] The outer tube 10B is a longitudinally elongated tubular member with flexibility and insulation. The outer tube 10B is formed, for example, from resin. In this embodiment, the internal space 19 of the outer tube 10B is the space through which the blade 3B passes and is at least a portion of the liquid delivery path WR.

[0150] The outer tube 10B has an enlarged diameter section 18 located on the base end side A2, closer to the base end opening 22 of the suction tube 2. The enlarged diameter section 18 is the portion whose outer diameter increases from the front end side A1 toward the base end side A2. The outer diameter of the portion of the outer tube 10B closer to the base end side A2 than the enlarged diameter section 18 is larger. As a result, the cross-sectional area of ​​the internal space 19 within the outer tube 10B can be increased, thus improving the efficiency of liquid delivery.

[0151] The front end member 11B is formed with the same shape as the front end member 11 in the first embodiment. A through hole 12B and a suction hole 13 are formed in the front end member 11B.

[0152] A through hole 12B is provided on the front end member 11B and is a hole that penetrates the front end member 11B along the length direction A. The front end of the through hole 12B communicates with a first opening 12a and a liquid delivery groove 12e formed on the front end face 14 of the front end member 11B. The first opening 12a and the liquid delivery groove 12e are connected. Alternatively, the first opening 12a and the liquid delivery groove 12e may not be connected. The base end of the through hole 12B communicates with the internal space 19 of the outer tube 10B.

[0153] In this embodiment, the through hole 12B forms at least a portion of the liquid delivery path WR. Liquid passing through the through hole 12B is discharged from the liquid delivery tank 12e at least.

[0154] The blade (electrode) 3B has a blade body 30B, a flange 31B, and a connector 32B. The blade 3B passes through a through hole 12B of the front end member 11B of the sheath 1B along the length direction A, and can protrude and retract freely toward the front end side A1 relative to the first opening 12a.

[0155] The blade body 30B is a metal rod-shaped component. The outer diameter of the blade body 30B is smaller than the inner diameter of the through hole 12B. The blade body 30B can move forward and backward along the length direction A within the through hole 12B and the first opening 12a. The blade body 30B cannot penetrate the liquid delivery groove 12e.

[0156] The flange (front end expansion section) 31B is a circular plate-shaped conductive component located at the front end of the blade body 30A. The flange 31B cannot penetrate the through hole 12B, the first opening 12a, and the liquid delivery groove 12e.

[0157] The blade body 30B and flange 31B do not have a first conduit 33 extending along the length direction A.

[0158] Compared to the connector 32 of the first embodiment, the connector (connector component) 32B also has a notch 32b on its outer peripheral surface that forms at least a portion of the liquid delivery path WR. When the blade 3B is positioned in the first position P1, the space formed by the notch 32b communicates with the through hole 12B to form the liquid delivery path WR.

[0159] Operating line 4B is a line component that penetrates the internal space (pipeline, cavity) 19 of the outer tube 10 of the sheath 1B. Operating line 4B is, for example, a solid line component. Operating line 4B does not have a third pipeline 43.

[0160] The liquid supply port 54 is connected to the base end of the internal space 19 of the outer tube 10 via a conduit formed in the sliding member 52. For example... Figure 16As shown, the liquid supplied from the liquid supply port 54 is discharged from the liquid delivery tank 12e through the liquid delivery flow path WR (internal space 19, through hole 12B). Even when the blade 3B is positioned in the first position P1, the liquid delivery tank 12e is not blocked by the flange 31B, and the liquid supplied to the through hole 12B is discharged from the liquid delivery tank 12e.

[0161] The treatment device 100B according to this embodiment, like the treatment device 100 of the first embodiment, achieves the effect of enabling aspiration from the front end of the sheath 1B without significantly reducing the aspiration performance of the endoscope 200. In other words, it can balance the aspiration efficiency of the endoscope 200's channel 206 and the aspiration efficiency of the treatment device 100B's aspiration tube 2. Therefore, the treatment device 100B can also perform aspiration treatment using the aspiration function of the endoscope 200, depending on the situation. Since the treatment device 100B can perform both aspiration treatment and hemostasis, the surgeon can immediately determine the hemostasis point and perform hemostasis after aspirating and recovering fluid accumulated at the surgical site.

[0162] The second embodiment of this utility model has been described in detail above with reference to the accompanying drawings. However, the specific structure is not limited to this embodiment and may include design changes that do not exceed the scope of the spirit of this utility model. In addition, the constituent elements shown in the above embodiments and variations can be appropriately combined to form the present invention.

[0163] (Third Implementation)

[0164] Reference Figures 18 to 19 The processing device 100C according to the third embodiment of this utility model will be described below. In the following description, structures that are the same as those already described will be labeled with the same reference numerals and repeated descriptions will be omitted.

[0165] Figure 18 This is a perspective view of the front end of the treatment device 100C. Figure 19 This is a cross-sectional view of the front end of the treatment device 100C. The treatment device (endoscopic treatment device, high-frequency treatment device) 100C includes a sheath 1C, a blade 3, an operating line 4, and an operating section 5.

[0166] The sheath 1C is a longitudinally elongated tubular member extending from the front end 1a along the length direction A to the base end 1b, where the length direction A is along the length axis. The sheath 1C can be inserted into the channel 206 of the endoscope 200 and can move in and out of the channel 206. The sheath 1C is a multi-lumen tube. The sheath 1C has a knife passage 12C through which a knife can be inserted and withdrawn, and a suction passage 13C that forms at least part of the suction flow path SR.

[0167] The front opening 13Ca of the suction tubing 13C is located at the front end of the sheath 1C. The base opening 22C of the suction tubing 13C opens outward from the sheath 1C at a position between the front end and the base end. The base opening 22C of the suction tubing 13C is formed by cutting off at least one lumen of the multi-lumen tube.

[0168] While the surgeon observes the images captured by the camera unit 203 and performs aspiration and hemostasis procedures using the scalpel 3, the tip opening 13Ca of the aspiration tubing 13C protrudes relative to the tip opening 206a, and the protrusion length L1 of the tip of the scalpel 3 from the tip opening 206a of the channel 206 is 5mm to 10mm. At this time, the base opening 22C of the aspiration tubing 13C is positioned inside the channel 206 in the bend 204 of the endoscope 200.

[0169] Similar to the first embodiment, a positioning member (front end member) 12d is provided at the front end of the knife tube 12C to position the knife 3 at the first position P1 and the second position P2.

[0170] Similar to the first embodiment, the connector (connecting member) 32 connects the blade body 30 and the operating line 4. When the blade 3 is advanced relative to the sheath 1C, the front end of the connector 32 contacts the positioning member 12d. Through this contact, the front end of the blade 3 is positioned at a second position P2, which is the position closest to the front end A1. When the blade 3 is retracted relative to the sheath 1C, the base end face 31b of the flange 31 contacts the positioning member 12d. Through this contact, the front end of the blade 3 is positioned at a first position P1, which is the position closest to the base end A2.

[0171] The treatment device 100C according to this embodiment, like the treatment device 100 of the first embodiment, achieves the effect of enabling aspiration from the front end of the sheath 1C without significantly reducing the aspiration performance of the endoscope 200. In other words, it can balance the aspiration efficiency of the endoscope 200's channel 206 and the aspiration efficiency of the treatment device 100C's aspiration tubing 13C. Therefore, the treatment device 100C can also perform aspiration treatment using the aspiration function of the endoscope 200, depending on the situation. Since the treatment device 100C can perform both aspiration treatment and hemostasis, the surgical operator can immediately determine the hemostasis point and perform hemostasis after aspirating and recovering fluid accumulated at the surgical site.

[0172] The third embodiment of this utility model has been described in detail above with reference to the accompanying drawings. However, the specific structure is not limited to this embodiment and includes design changes that do not depart from the scope of the spirit of this utility model. In addition, the constituent elements shown in the above embodiments and variations can be appropriately combined to form the present invention.

[0173] Industrial availability

[0174] This invention can be applied to endoscopic treatment devices with hemostatic function, etc.

Claims

1. An endoscopic treatment device, characterized in that, The endoscopic apparatus includes: Sheath, which has a length axis; An electrode, at least a portion of which protrudes from the front end of the sheath toward the front end side; as well as A tube, supported at the front end of the sheath, contains internally a suction tube extending along the length axis. The front opening of the suction tube is located at the front end of the sheath. The base opening of the suction tube opens outward from the sheath at a position between the front end and the base end of the sheath.

2. The endoscopic treatment device according to claim 1, characterized in that, The tube covers at least a portion of the outer peripheral surface of the front end of the sheath. The suction line is formed between the front end of the sheath and the tube.

3. The endoscopic treatment device according to claim 1, characterized in that, The sheath includes an outer tube extending along the length direction and an insulating front end member mounted on the front end of the outer tube. The front end of the tube is fixed to the sheath by the front end component.

4. The endoscopic treatment device according to claim 3, characterized in that, The front end component has a suction hole extending along the length direction. The suction port is connected to the suction tube via the front opening.

5. The endoscopic treatment device according to claim 1, characterized in that, The outer diameter of the sheath is smaller than the outer diameter of the tube but larger than the outer diameter of the electrode.

6. The endoscopic treatment device according to claim 3, characterized in that, The front-end component has: The first part protrudes from the front end of the outer tube; and The second part is inserted inside the outer tube. The front end of the tube is fixed to the first part.

7. The endoscopic treatment device according to claim 3, characterized in that, The length of the front end component from the front end to the base end is 10mm to 20mm.

8. The endoscopic treatment device according to claim 3, characterized in that, The front-end component has: The first part protrudes from the front end of the outer tube; and The second part is inserted inside the outer tube. The front opening of the suction tube is formed in the first portion.

9. The endoscopic treatment device according to claim 4, characterized in that, The inner circumferential surface of the suction hole is located radially inward than the inner circumferential surface of the tube.

10. The endoscopic treatment device according to claim 3, characterized in that, The sheath has internal linear members that can move freely along its length. The endoscopic treatment device has a connector for connecting the base of the electrode and the wire member. The front end of the electrode is flange-shaped. The base opening of the tube is located at a position closer to the front end of the connector than when the front end of the electrode is abutted against the front end member.

11. The endoscopic treatment device according to claim 8, characterized in that, A side hole is formed on the side of the first part of the front end member, and the side hole is connected to the suction tube.

12. A treatment system, characterized in that, The disposal system includes: An endoscope having a suction channel; and The treatment device is configured to move freely within the suction channel. The treatment device has a tube configured to protrude freely from and retract into the front end of the suction channel. The tube contains a suction channel inside. The base opening of the suction tube is located inside the suction channel.

13. The treatment system according to claim 12, characterized in that, With the front opening of the suction tubing protruding relative to the front end of the endoscope, the base opening of the suction tubing is located within the suction channel in the bend of the endoscope.

14. The treatment system according to claim 12, characterized in that, The length of the tube from the front end to the base end is shorter than the length of the curved portion of the endoscope along its length axis.

15. The treatment system according to claim 12, characterized in that, With the front opening of the suction tubing protruding relative to the front end of the endoscope, the base opening of the suction tubing and the suction channel are connected within the suction channel of the curved portion of the endoscope.

16. The treatment system according to claim 12, characterized in that, The endoscope has a tapered section at the front end of the suction channel, which narrows towards the front.

17. An endoscopic treatment device, characterized in that, The endoscopic apparatus includes: A sheath having a length axis, the sheath being a multi-lumen tube; and electrode, The sheath contains internally a suction tube extending along the length axis and a blade tube through which the electrode can be moved forward and backward. At least a portion of the electrode protrudes from the front end of the knife tube toward the front end side. The front opening of the suction tube is located at the front end of the sheath. The base opening of the suction tube opens outward from the sheath at a position between the front end and the base end of the sheath.

Images