Endoscopic treatment tool

Abstract

This endoscopic treatment tool comprises: a shaft; an electrode located at the distal end of the shaft; a rod located at least partially within the electrode; and an elastic body for applying a preload such that the distal end of the rod is received closer to the proximal end than the distal end of the electrode.

Description

Technical field

[0001] The present invention relates to an endoscopic treatment device. It claims priority in provisional US patent application No. 63 / 564,938, filed on March 13, 2024, the contents of which are hereby incorporated by reference. State of the art

[0002] Traditionally, endoscopic treatments, such as endoscopic submucosal dissection (ESD), have used endoscopic treatment tools for incision and dissection, such as high-frequency knives, and endoscopic treatment tools for local injection, etc.

[0003] An endoscopic treatment tool described in patent document 1 comprises a rod that is movable forwards and backwards relative to an electrode and can perform incision and dissection treatments as well as local injection treatments. List of cited documents Patent document

[0004] Patent document 1: Japanese unexamined patent application, first publication no. 2024-091534 Summary of the invention: Technical problem

[0005] However, the endoscopic treatment tool described in patent document 1 requires that a surgeon consciously change the process of moving the electrode back and forth and the process of moving the rod back and forth depending on the treatment situation, and it is necessary to facilitate these processes.

[0006] In view of the above circumstances, it is an object of the present invention to provide an endoscopic treatment tool with an electrode and a rod that can be easily operated depending on the treatment situation, such as incision and dissection treatment and local injection treatment. Solution to the problem

[0007] To solve the above problems, the present invention proposes the following means.

[0008] An endoscopic treatment tool according to a first aspect of the present invention comprises: a shaft; an electrode arranged at a distal end side of the shaft; a rod arranged at least partially inside the electrode; and an elastic body that pre-tensions a distal end of the rod so that it is received in the electrode. Advantageous effects of the invention

[0009] The electrode and rod of the endoscopic treatment tool of the present invention can be easily operated depending on the treatment situation, such as incision and dissection treatment and local injection treatment. Brief description of the drawings [ Fig. 1] An overall view of an endoscopic treatment system of a first embodiment. [ Fig. 2] An overall view showing a treatment instrument of the endoscopic treatment system. [ Fig. 3] A perspective view of a distal end section of the treatment instrument. [ Fig. 4] A cross-sectional view of the distal end section of the treatment instrument. [ Fig. 5] As above. [ Fig. 6] A cross-sectional view of the distal end section of the treatment instrument when a rod is in a third position. [ Fig. 7] A cross-sectional view along the in Fig. 6 shown line X1-X1. [ Fig. 8] A cross-sectional view of a control element and a control section. [ Fig. 9] A diagram illustrating the operation of the treatment instrument. [ Fig. 10] As above. [ Fig. 11] As above. [ Fig. 12] As above. [ Fig. 13] A diagram showing the rod puncturing tissue. [ Fig. 14] A diagram showing a knife for delivering fluid into tissue. [ Fig. 15] A diagram showing a modified example of an elastic body. [ Fig. 16] A diagram showing a modified example of a lever. [ Fig. 17] A cross-sectional view along the in Fig. 16 shown line X2-X2. [ Fig. 18] A diagram showing a modified example of an operating section. [ Fig. 19] As above. [ Fig. 20] A diagram showing a modified example of a rod. [ Fig. 21] A diagram showing a modified example of a first connector of the treatment instrument. [ Fig. 22] A diagram showing another modified example of the first connector. [ Fig. 23] A diagram showing another modified example of the first connector. [ Fig. 24] A diagram showing another modified example of the first connector. [ Fig. 25] A diagram showing another modified example of the first connector. [ Fig. 26] A diagram showing a distal end section of a modified example of the treatment instrument. [ Fig. 27] A diagram illustrating the operation of a treatment instrument of a second embodiment. [ Fig. 28] As above. [ Fig. 29] As above. [ Fig. 30] As above. [ Fig. 31] A diagram illustrating the operation of a treatment instrument of a third embodiment. [ Fig. 32] As above. [ Fig. 33] A diagram showing a modified example of a first connector of the treatment instrument. [ Fig. 34] A diagram showing another modified example of the first connector. Description of the embodiments (First embodiment)

[0010] An endoscopic treatment system 300 according to a first embodiment of the present invention is described with reference to Fig. 1, Fig. 2, Fig. 3, Fig. 4, Fig. 5, Fig. 6, Fig. 7, Fig. 8, Fig. 9, Fig. 10, Fig. 11 to Fig. 12 described. Fig. Figure 1 is an overall view of the endoscopic treatment system 300 according to this embodiment. [Endoscopic Treatment System 300]

[0011] The endoscopic treatment system 300 includes, as described in Fig. Figure 1 shows an endoscope 200 and a treatment instrument 100. The treatment instrument 100 is used by inserting it into the endoscope 200. [Endoscope 200]

[0012] The endoscope 200 is a known flexible endoscope and comprises an insertion section 202 which is inserted into a body from a distal end, an operating section 207 which is attached to a proximal end of the insertion section 202, and a universal cable 210 which is attached to the operating section 207.

[0013] The insertion section 202 is a long, thin element that can be inserted into a lumen. The insertion section 202 has a distal end section 201, a bending section 204, and a flexible section 205. The distal end section 201, the bending section 204, and the flexible section 205 are connected in this order from the distal end. A channel 206 for inserting the treatment instrument 100 is provided inside the insertion section 202. The distal end section 201 is equipped with a distal end opening section 206a of the channel 206 and an imaging unit 203.

[0014] The imaging unit 203 comprises an imaging element such as a CCD or CMOS and is capable of capturing an image of a treatment site. The imaging unit 203 can capture an image of the distal end section of the treatment instrument 100 in a state where the treatment instrument 100 protrudes from the distal end opening section 206a of the channel 206. The bending section 204 bends according to an operator's action on the operating section 207. The flexible section 205 is a tubular section that exhibits flexibility.

[0015] The operating section 207 is connected to the flexible section 205. The operating section 207 has a handle 208, an input unit 209, and a proximal end opening section 206b of the channel 206. The handle 208 is a section held by the operator. The input unit 209 receives an operator input to perform a bending operation at the bending section 204.

[0016] The universal cable 210 connects the endoscope 200 to an external device. An imaging cable, a fiber optic cable, or similar, which outputs an imaging signal acquired by the imaging unit 203, is inserted into the universal cable 210. [Treatment instrument 100]

[0017] Fig. Figure 2 is an overall view showing the treatment instrument 100.

[0018] The treatment instrument (endoscopic treatment tool) 100 comprises an outer shaft 1, a blade 2, a rod 3, a control element 4 (see Fig. 4) and an operating section 5. In the following description, in the longitudinal direction (longitudinal axis direction, axial direction) A of the treatment instrument 100, the side that is inserted into the patient's body is referred to as the "distal end side (distal side) A1", and the side of the operating section 5 is referred to as the "proximal end side (proximal side) A2".

[0019] The outer sheath 1 is a long, tubular element extending from a distal end 1a to a proximal end 1b. The outer sheath 1 can be inserted into the channel 206 of the endoscope 200 and can be moved forwards and backwards through the channel 206. As shown in Fig. As shown in Figure 1, the distal end 1a of the outer shaft 1 can protrude from and retract from the distal end opening section 206a of the canal 206 while the outer shaft 1 is inserted into the canal 206.

[0020] Fig. Figure 3 is a perspective view of the distal end section of the treatment instrument 100. The outer shaft 1 has a tube 10 extending in the longitudinal direction A and a distal end element 11 provided at the distal end of the tube 10. Furthermore, the outer shaft 1 can be formed by molding the tube 10 and the distal end element 11 as a single piece.

[0021] Hose 10 is a long, tubular element with flexibility and insulating properties. Hose 10 is made of, for example, resin. The distal end element 11 is fitted into the interior of hose 10 and attached to it. Furthermore, the distal end element 11 can be bonded to hose 10 using an adhesive or similar substance.

[0022] The distal end element 11 is cylindrical. Furthermore, "cylindrical" includes not only a strictly cylindrical shape, but also a shape that closely approximates a cylindrical shape. The distal end element 11 preferably consists of an insulating material such as resin. A first through-hole 12 is formed in the distal end element 11.

[0023] The first through-hole 12 is a hole provided in the distal end element 11 and penetrates the distal end element 11 in the longitudinal direction A. The front end of the first through-hole 12 communicates with a distal end opening 12a formed in a distal end surface 14 of the distal end element 11. The proximal end of the first through-hole 12 communicates with an interior space 19 of the tube 10. The knife 2 is inserted through the first through-hole 12.

[0024] Fig. 4 and Fig. Figure 5 shows cross-sectional views of the distal end section of the treatment instrument 100. The blade (electrode, blade electrode) 2 is a rod-shaped metal element. Furthermore, "rod-shaped" includes not only a strictly round rod shape but also a shape that closely approximates a round rod shape. The blade 2 is made of a material such as stainless steel. The blade 2 is conductive and accepts a high-frequency current. The blade 2 has a blade body 20, a flange 21, and a first connector 22.

[0025] The blade 2 is inserted through the first through-hole 12 of the distal end element 11 of the outer shaft 1 along the longitudinal direction A and can project from the distal end opening 12a towards the distal end face A1 and retract. Furthermore, the blade 2 can be fixed in such a way that it cannot be moved forwards and backwards while projecting from the distal end opening 12a towards the distal end face A1.

[0026] A central axis O2 in the longitudinal direction A of the knife 2 preferably coincides with a central axis O1 in the longitudinal direction A of the outer shaft 1. Furthermore, "coincidence" includes not only exact matches but also approximate matches.

[0027] The knife body 20 is a rod-shaped metal element. The outer diameter of the knife body 20 is smaller than the inner diameter of the first through-hole 12. The knife body 20 can be moved forwards and backwards through the first through-hole 12 in the longitudinal direction A.

[0028] The flange (distal end section with increased diameter) 21 is a disc-shaped conductive element provided at the distal end of the knife body 20. A length D2 of the flange 21 in a radial direction R perpendicular to the longitudinal direction A is longer than a length D1 of the knife body 20 in the radial direction R. A flat proximal end surface 21b is formed on the proximal end face A2 of the flange 21. Furthermore, the flange 21 is not limited to a disc shape, but can be triangular or hook-shaped.

[0029] The cutter body 20 and the flange 21 have a first pipe 23 extending along the longitudinal direction A. The first pipe 23 communicates with a distal end opening 23a formed in the flange 21. The distal end opening 23a is an opening provided on the distal end face A1 of the flange 21.

[0030] The first connector (stop element) 22 is a cylindrically shaped metal element. Furthermore, "cylindrical" includes not only a strictly cylindrical shape but also a shape that closely approximates a cylindrical shape. The first connector 22 connects the knife body 20 and an inner tube 41. Specifically, the outer circumferential surface of the first connector 22 and the inner circumferential surface of the first connector 22 are joined to each other by welding or a similar process, and the outer circumferential surface of the first connector 22 and the inner circumferential surface of the inner tube 41 are joined to each other by welding or a similar process. The first connector 22 cannot be inserted through the first through-hole 12 in the longitudinal direction A. The first pipe 23 communicates with an interior space 43 formed in the inner tube 41.

[0031] The inner tube 41 is attached to the proximal end of the blade body 20 by the first connector 22. A high-frequency current is supplied to the blade 2 via the inner tube 41, which is connected to the operating section 5. When a high-frequency current is supplied to the blade 2 from the inner tube 41, the blade body 20 and the flange 21 act as active electrodes that deliver the high-frequency current to the biological tissue.

[0032] As in Fig. As shown in Figure 4, a distal end 22a of the first connector 22 or a distal end 41a of the inner tube 41 comes into contact with a proximal end surface 15 of the distal end element 11 when the knife 2 is moved forward relative to the outer shaft 1.

[0033] The knife 2 is positioned in a first position P1, which is the position on the most distal end face A1 when the distal end 22a of the first connector 22 comes into contact with the proximal end face 15 of the distal end element 11. Furthermore, the knife 2 can be positioned in the first position P1 when a slider 52 of the operating section 5, which will be described later, comes into contact with a distal stop 51s (see Figure 1). Fig. 8).

[0034] As in Fig. As shown in Figure 5, the proximal end face 21b of the flange 21 and the distal end face 14 of the distal end element 11 come into contact when the knife 2 is moved backward relative to the outer shaft 1. When the proximal end face 21b of the knife 2 and the distal end face 14 of the distal end element 11 come into contact, the knife 2 is positioned in a second position P2, which is the position on the most proximal end face A2. Furthermore, the knife 2 can be positioned in the second position P2 when the slide 52 of the operating section 5, described later, comes into contact with a proximal stop 51t (see Figure 5). Fig. 8).

[0035] Fig. Figure 6 is a cross-sectional view of the distal end section of the treatment instrument 100 when the rod 3 is in a third position P3.

[0036] The rod (solid needle) 3 is a rod-shaped element and is preferably made of a non-conductive material such as a resin or ceramic material, so as not to be electrically conductive contrary to the surgeon's intention, but it can also be made of a metal material. The rod 3 has a main body section 31, a distal end section 32, and a second connector 33.

[0037] The rod 3 is inserted through the first pipe 23 of the knife 2 along the longitudinal direction A and can protrude from the distal end opening 23a in the direction of the distal end side A1 and retract.

[0038] The main body section 31 and the distal end section 32 are long, round, rod-shaped elements. Furthermore, "round rod shape" includes not only a strictly round rod shape but also a shape that closely approximates a round rod shape. The outer diameter of the main body section 31 and the distal end section 32 is smaller than the inner diameter of the first pipe 23. The main body section 31 and the distal end section 32 are movable forwards and backwards through the first through-hole 12 in the longitudinal direction A. The distal end section 32 can be shaped such that the distal end face A1 is tapered.

[0039] The second connector 33 connects the rod 3 and an actuating wire 42. Specifically, the proximal end of the rod 3 and the distal end of the actuating wire 42 are fastened by welding or similar means. The second connector 33 cannot be inserted through the first pipe 23 in the longitudinal direction A.

[0040] As in Fig. As shown in Figure 6, the second connector 33 of the rod 3 comes into contact with a proximal end 20b of the knife body 20 when the rod 3 is moved forward relative to the outer shaft 1. The distal end section 32 protrudes from the distal end opening 23a towards the distal end face A1. When the second connector 33 of the rod 3 comes into contact with the proximal end 20b of the knife body 20, the rod 3 is positioned in the third position P3, which is the position on the most distal end face A1.

[0041] Fig. 7 is a cross-sectional view along the in Fig. 6 shown line X1-X1.

[0042] The second connector 33 has a cross-section perpendicular to the longitudinal axis A, which is not circular but has a shape in which part of the circular shape is cut out (e.g., a D-shaped cut). That is, at least part of the transverse cross-section of the second connector 33 at the distal end section is formed by an outer surface 33s extending in a direction perpendicular to the longitudinal axis of the rod 3. The number of outer surfaces 33s is not limited to one; several can be provided. Furthermore, the shape in which part of a circular shape is cut out can be a shape with a concave outer surface. The outer surface 33s can also extend over the entire length of the second connector 33 from the distal end to the proximal end.With this configuration, the interior 43 of the inner hose 41 is connected to the first pipe 23, even when the second connector 33 comes into contact with the proximal end of the knife body 20, as in . Fig. Figure 6 shows that the shape of the second connector 33 is not limited to a circular shape, as long as it is a shape capable of forming a flow passage that establishes a connection between the interior 43 and the first pipe 23 when the second connector 33 comes into contact with the proximal end of the knife body 20. For example, the distal end section of the second connector 33 is not limited to a circular shape with a cut-out portion and may have a rectangular or elliptical shape.

[0043] Fig. Figure 8 is a cross-sectional view of the control element 4 and the control section 5.

[0044] The control element 4 has an inner tube 41 which is guided through the interior (pipe, lumen) 19 of the outer shaft 1, and an actuating wire 42 which is guided through the interior 43 of the inner tube 41.

[0045] The inner tube (first actuating element) 41 is a conductive wire that actuates the blade 2. The distal end of the inner tube 41 is connected to the blade 2 via the first connector 22. The proximal end of the inner tube 41 is connected to the slide 52 of the operating section 5. Furthermore, the inner tube 41 can be in any other form, as long as it is a hollow conductive tube, for example, a hollow metal coil.

[0046] The actuating wire (second control element) 42 is a wire that actuates the rod 3. The distal end of the actuating wire 42 is connected to the rod 3 by the second connector 33. The proximal end of the actuating wire 42 passes through a through-hole 41b provided at the proximal end of the inner tube 41 and is connected to a lever 56 of the control section 5. Furthermore, the actuating wire 42 can be in any other form, as long as it is an element capable of moving the rod 3 forwards and backwards.

[0047] Furthermore, the rod 3 and the actuating wire 42 can be formed in one piece. For example, the rod 3 and the actuating wire 42 can be a single wire or strand and can be processed such that the distal end section has a smaller diameter than the proximal end section.

[0048] The operating section (handle) 5 shows, as in Fig. Figure 2 shows a handle body 51, a slider 52, a power supply plug 53, a liquid dispensing port 54, a suction port 55, a lever 56 and an elastic body 57.

[0049] The distal end section of the handle body 51 is connected to the proximal end 1b of the outer shaft 1. The handle body 51 has an interior space 59 through which the inner tube 41 can be inserted. The inner tube 41 runs through the interior space 19 of the tube 10 and the interior space 59 of the handle body 51 and extends to the slide 52. The actuating wire 42 runs through the interior space 43 of the inner tube 41 and the interior space 59 of the handle body 51 and extends to the lever 56.

[0050] The slider (second slider) 52 is attached to the handle body 51 to be movable along the longitudinal direction A. The proximal end of the inner tube 41 is attached to the slider 52. When the surgeon moves the slider 52 forward and backward relative to the handle body 51, the inner tube 41 and the knife 2 move forward and backward.

[0051] The power supply connector 53 is attached to the slide 52. The power supply connector 53 can be connected to a high-frequency power supply device (not shown) and is connected to the proximal end section of the inner tube 41. The power supply connector 53 can supply a high-frequency current supplied by the high-frequency power supply device to the blade 2 via the inner tube 41. Furthermore, the power supply connector 53 can be attached to the handle body 51 instead of the slide 52.

[0052] The liquid dispensing port 54 is provided in the slide valve 52. The liquid dispensing port 54 is connected to the proximal end section of the inner tube 41 and is in communication with the interior 43. The liquid supplied from the liquid dispensing port 54 passes through a water dispensing flow passage WR (interior 43, first pipe 23) and is expelled from the distal end opening 23a. Alternatively, the liquid dispensing port 54 can be provided in the handle body 51 instead of the slide valve 52.

[0053] The suction port 55 is provided in the handle body 51. The suction port 55 is connected to the distal end section of the handle body 51 and is in communication with the interior 59. The suction port 55 can be connected to a pump device (not shown). By sucking on the suction port 55, the fluid drawn from the distal end opening 23a passes through the suction flow passage SR (interior 19, interior 59) and is drained from the body.

[0054] The lever (first slider) 56 is attached to the slider 52 to be movable along the longitudinal direction A. The proximal end of the actuating wire 42 is attached to the lever 56. When the surgeon moves the lever 56 forward and backward relative to the slider 52, the actuating wire 42 and the rod 3 move forward and backward.

[0055] The elastic body 57 is arranged between the handle body 51 and the lever 56, connecting them. The distal end of the elastic body 57 is attached to the handle body 51, and the proximal end is attached to the lever 56. The elastic body 57 is connected to the actuating wire 42 via the lever 56. The elastic body 57 biases the lever 56 towards the proximal end A2, so that a distal end 3a of the rod 3 is received within the interior 43 of the inner tube 41. That is, the distal end 3a of the rod 3 is located within the inner tube 41 while the elastic body 57 returns to its original shape. When the rod 3 is moved forward against the elastic force of the elastic body 57, the rod 3 is biased towards the proximal end A2 by the elastic body 57.Furthermore, the distal end 3a of the rod 3 is arranged on the proximal end side A2 in relation to the distal end of the outer shaft 1, while the elastic body 57 returns to an original shape.

[0056] Furthermore, the lever 56 can consist of two or more parts. For example, the lever 56 can consist of a first element connected to the actuating wire 42 and the elastic body 57, and a second element operated by the surgeon in a contact state. [Operation of the treatment instrument 100]

[0057] Next, the operation of treatment instrument 100 will be described. Fig. 9, Fig. 10, Fig. 11 to Fig. 12 are diagrams illustrating the operation of the treatment instrument 100.

[0058] As in Fig. As shown in Figure 9, the surgeon moves the slider 52 forward relative to the handle body 51, thus moving the knife 2 forward relative to the outer shaft 1. The knife 2 is positioned in the first position P1. Because the elastic body 57 biases the lever 56 toward the proximal end A2, the distal end 3a of the rod 3 remains in a position (fourth position P4) to be received in the interior 43 of the inner tube 41. At this point, the distal end 3a of the rod 3 is positioned on the proximal end A2 with respect to the distal end of the outer shaft 1.

[0059] As in Fig. As shown in Figure 10, the surgeon moves the lever 56 forward relative to the slider 52, causing the rod 3 to move forward relative to the knife 2. The knife 2 is positioned in the third position P3, and the distal end section 32 protrudes from the distal end opening 23a toward the distal end face A1. When the surgeon releases the lever 56, the lever 56 moves toward the proximal end face A2 due to the elastic force of the elastic body 57. As a result, the distal end 3a of the rod 3 returns, as shown in Figure 10. Fig. 9 shown, back to the fourth position P4 to be received in the interior 43 of the inner tube 41.

[0060] As in Fig. As shown in Figure 11, the surgeon moves the slider 52 backward relative to the handle body 51, causing the knife 2 to move backward relative to the outer shaft 1. The knife 2 is positioned in the second position P2. As the elastic body 57 biases the lever 56 toward the proximal end A2, the distal end 3a of the rod 3 moves into the fourth position P4 to be received in the interior 43 of the inner tube 41. At this point, the distal end 3a of the rod 3 is positioned on the proximal end A2 with respect to the distal end of the outer shaft 1.

[0061] As in Fig. As shown in Figure 12, the surgeon moves the lever 56 forward relative to the slider 52, causing the rod 3 to move forward relative to the knife 2. The knife 2 is positioned in the third position P3, and the distal end section 32 protrudes from the distal end opening 23a toward the distal end face A1. When the surgeon releases the lever 56, the lever 56 moves toward the proximal end face A2 due to the elastic force of the elastic body 57. As a result, the distal end 3a of the rod 3 moves, as shown in Figure 12. Fig. 11 shown, into the fourth position P4, in order to be received in the interior 43 of the inner tube 41. [Procedure for using the endoscopic treatment system 300]

[0062] Next, a method using the endoscopic treatment system 300 of this embodiment (a method for using the endoscopic treatment system 300) is described. In particular, the local injection treatment as well as the incision and dissection treatment of a lesion during an endoscopic procedure, such as endoscopic submucosal dissection (ESD), are described.

[0063] As a preparatory step, the surgeon identifies the lesion using a known procedure. Specifically, the surgeon inserts the insertion section 202 of the endoscope 200 into the digestive tract (for example, the esophagus, stomach, duodenum, or colon) and identifies the lesion while viewing images obtained from the imaging unit 203 of the endoscope. <Einführschritt>

[0064] The surgeon inserts the treatment instrument 100 into the channel 206, so that the distal end 1a of the outer shaft 1 protrudes from the distal end opening section 206a of the insertion section 202. <markierungsschritt>

[0065] As in Fig. As shown in Figure 11, the surgeon moves the slider 52 backward relative to the handle body 51 so that the knife 2 is positioned in the second position P2. The flange 21, which projects from the distal end face 14 of the distal end element 11, is used to cauterize and mark the biological tissue surrounding the lesion. <punktionsschritt>

[0066] Fig. Figure 13 is a diagram showing rod 3 puncturing the tissue.

[0067] As in Fig. As shown in Figure 10, the surgeon moves the slider 52 forward relative to the handle body 51 so that the distal end of the knife 2 is in the first position P1. The surgeon then moves the lever 56 forward relative to the slider 52 so that the distal end of the rod 3 is in the third position P3. The surgeon uses the rod 3 to puncture and penetrate the site on the lesion where a fluid for local injection (local injection fluid) is to be injected. <Lokaler Injektionsschritt>

[0068] Fig. Figure 14 is a diagram showing knife 2, which releases fluid into the tissue.

[0069] As in Fig. 9 or Fig. As shown in Figure 11, the rod 3 moves backward to the fourth position P4 when the surgeon releases the lever 56. Accordingly, the water delivery flow passage WR (interior 43, first tube 23) is largely ensured. The surgeon inserts the distal end (including the distal end opening 23a) of the knife 2 through the hole formed by puncturing with the rod 3 into the submucosa or delivers fluid (local injection fluid) from the fluid delivery port 54 into the tissue while maintaining contact with the tissue surface. The fluid (local injection fluid) is expelled from the distal end opening 23a and injected into the tissue. <Inzisions- und Dissektionsschritt>

[0070] Next, the surgeon performs the incision and dissection procedure. As in Fig. As shown in Figure 9, the surgeon advances the knife 2 and moves the flange 21 to incise the mucosa of the lesion while applying a radiofrequency current. The surgeon then advances the knife 2, lifts the mucosa of the incised lesion to expose the submucosa, and dissects the submucosa of the incised lesion while applying radiofrequency current.

[0071] The surgeon continues the above-described procedures (treatments) as needed, finally excises the lesion and completes the ESD procedure.

[0072] According to the treatment instrument 100 of this embodiment, the knife 2 and the rod 3 can be easily operated depending on the treatment situation, such as incision and dissection treatment and local injection treatment. The surgeon does not need to operate the lever 56 in reverse, and when the surgeon releases the lever 56, the rod 3 is automatically received in the interior 43 of the inner tube 41, thus simplifying the procedure. Furthermore, it is possible to prevent the surgeon from unintentionally operating the knife 2 with the rod 3 protruding.

[0073] Although the first embodiment of the present invention has been described in detail above with reference to the drawings, the specific configuration is not limited to this embodiment, and design modifications and the like are also included within the scope of the present invention. Furthermore, the components shown in the embodiments and modified examples can be configured in combination in a suitable manner. (Modified Example 1)

[0074] Fig. Figure 15 is a diagram showing an elastic body 57A, which is a modified example of the elastic body 57. The distal end of the elastic body 57A is attached to the lever 56, and the proximal end of the elastic body 57A is attached to the handle body 51. As the lever 56 moves forward relative to the handle body 51, a restoring force (elastic force) acts on the elastic body 57A, causing it to deform and move the lever 56 toward the proximal end face A2. As with the elastic body 57, the elastic body 57A biases the lever 56 toward the proximal end face A2, so that the distal end 3a of the rod 3 is received in the first tube 23 of the knife 2.That is, as with the elastic body 57, the distal end 3a of the rod 3 is located inside the inner tube 41, while the elastic body 57A returns to its original shape, and when the rod 3 is moved forward against the elastic force of the elastic body 57A, the rod 3 is biased by the elastic body 57 towards the proximal end A2. Furthermore, the distal end 3a of the rod 3 is positioned on the proximal end A2 with respect to the distal end of the outer shaft 1, while the elastic body 57A returns to its original shape. (Modified Example 2)

[0075] Fig. Figure 16 is a diagram showing a lever 56A, which is a modified example of the lever 56. Fig. 17 is a cross-sectional view along the in Fig. The lever 56A is attached to the outer circumferential section of the handle body 51 in place of the slide 52 and is mounted to the handle body 51 to be movable along the longitudinal direction A. A hollow tube 58 is provided in the interior 59 of the handle body 51. The tube 58 connects the inner tube 41 and the slide 52. The actuating wire 42 is inserted through the tube 58 and connected to the lever 56A. The elastic body 57 is inserted through the tube 58 and connects the handle body 51 and the lever 56A. Because the lever 56A is located in a position separate from the slide 52, the surgeon can operate the lever 56A independently of the slide 52. That is, the lever 56A does not move even when the slider 52 is moved along the longitudinal direction A, and the slider 52 does not move even when the lever 56A is moved along the longitudinal direction A. (Modified Example 3)

[0076] Fig. 18 and Fig. Figure 19 shows an operating section 5A, which is a modified example of operating section 5. Operating section 5A includes the shaft slide 50, the handle body 51, the power supply connector 53, the liquid dispensing port 54, the suction port 55, the lever 56A, and the elastic body 57. The power supply connector 53, the liquid dispensing port 54, and the suction port 55 are not shown. The shaft slide 50 is connected to the proximal end 1b of the outer shaft 1 and is movable forwards and backwards relative to the handle body 51. The proximal end 41d of the inner tube 41 is attached to the handle body 51 such that it is not movable forwards or backwards. The surgeon moves the shaft slider 50 forwards and backwards relative to the handle body 51, so that the outer shaft 1 can be moved forwards and backwards relative to the knife 2.Furthermore, the inner tube 41 can be moved forwards and backwards together with the outer shaft 1. (Modified Example 4)

[0077] Fig. Figure 20 is a diagram showing a rod 3A, which is a modified example of rod 3. When the surgeon releases the lever 56, rod 3A moves into a position where its distal end 3a is received in the first tube 23 of the knife 2. In this case, the distal end 3a of rod 3A can be positioned between the distal end and the proximal end of the distal end element 11 in the longitudinal axis direction A. (Modified Example 5)

[0078] Fig. Figure 21 is a diagram showing a first connector 22A, which is a modified example of the first connector 22. In the embodiment described above, the distal end 41a of the inner tube 41, which is attached to the first connector 22, is exposed towards the distal end 22a of the first connector 22 and can come into contact with the proximal end face 15 of the distal end element 11. On the other hand, the Fig. The first connector 22A shown in Figure 21 has a step 22s on its outer surface that engages with the distal end 41a of the inner tube 41. The distal end 41a of the inner tube 41 is not exposed towards the distal end 22a of the first connector 22A. The distal end 22a of the first connector 22A is reliably positioned by contacting the proximal end surface 15 of the distal end element 11. The distal end 41a of the inner tube 41 can be easily connected to the step 22s of the first connector 22A, thus facilitating assembly. (Modified Example 6)

[0079] Fig. Figure 22 is a diagram showing a first connector 22B, which is a modified example of the first connector 22. The first connector 22B has a projection 22b that extends radially inward on the inner surface at the proximal end face, and the knife body 20 is attached by welding or similar means, with the knife body 20 in contact with the projection 22b. The projection 22b of the first connector 22B is located on the proximal end face A2 with respect to the proximal end 20b of the knife body 20. An inclined surface (chamfered surface) 22c is formed on the proximal end face A2 of the projection 22b to make contact with the second connector 33. The inclined surface 22c is formed in a tapered shape, the diameter of which decreases from the proximal end face A2 to the distal end face A1.Therefore, the rod 3 can be smoothly inserted into the knife body 20 without its distal end 3a becoming entangled with the first connector 22B when the lever 56 is moved forward relative to the slide 52 while the distal end 3a of the rod 3 is inside the interior 43. As the rod 3 is moved forward relative to the inner tube 41 (knife body 20), the second connector 33 of the rod 3 and the inclined surface 22c of the first connector 22B come into contact. With the second connector 33 of the rod 3 and the first connector 22B in contact, the rod 3 is positioned in the third position P3, which is the position on its most distal end face A1. Furthermore, the projection 22b may have a reduced diameter shape. Even if the second connector 33 and the first connector 22B come into contact with each other, the interior 43 of the inner hose 41 is connected to the first pipe 23.The shape of the second connector 33 is not restricted, as long as it is a shape capable of forming a flow passage that establishes a connection between the interior 43 and the first pipe 23 when the first connector 22B and the second connector 33 come into contact. For example, the distal end section of the second connector 33 is not limited to a circular shape with a cut-out portion and may have a rectangular or elliptical shape. Furthermore, if the second connector 33 does not have these flow-passage-forming shapes, a slot may be formed on the chamfered surface 22c, which can become a flow passage when the first connector 22B and the second connector 33 come into contact.

[0080] Fig. Figure 23 is a diagram showing a first connector 22Ba, which is a modified example of the first connector 22B. The first connector 22Ba has a projection 22p extending radially outward on the outer surface of the distal end face A1 of the first connector 22Ba, and the outer surface of the proximal end face of the first connector 22Ba is covered by a distal end section 41s of the inner tube 41. The distal end 41a of the inner tube 41 is attached to the projection 22p in a contact condition by welding or the like. Therefore, the distal end 41a of the inner tube 41 is not exposed toward the distal end 22a of the first connector 22Ba. According to this configuration, the distal end 22a of the first connector 22Ba is reliably positioned by contact with the proximal end face 15 of the distal end element 11.The distal end 41a of the inner tube 41 can be easily connected to the step 22s of the first connector 22Ba, thus facilitating assembly. Even when the second connector 33 and the first connector 22Ba come into contact, the interior 43 of the inner tube 41 remains connected to the first pipe 23. The shape of the second connector 33 is not restricted, as long as it is a shape capable of forming a flow passage that establishes a connection between the interior 43 and the first pipe 23 when the first connector 22Ba and the second connector 33 come into contact. For example, the distal end section of the second connector 33 is not limited to a circular shape with a cutout and can be rectangular or elliptical.Furthermore, if the second connector 33 does not have these flow-transmitting shapes, a slot may be formed on the chamfered surface 22c which can become a flow passage when the first connector 22Ba and the second connector 33 come into contact with each other.

[0081] Fig. Figure 24 is a diagram showing a first connector 22Bb, which is a modified example of the first connector 22B. A second connector 33B is a connector that has a larger outer diameter than the second connector 33. The inclined surface 22c of the first connector 22Bb extends outwards in the radial direction R compared to the inclined surface 22c of the first connector 22B.

[0082] The inclined surface 22c of the first connector 22Bb has a length (outer diameter) in the radial direction R that is longer than the outer diameter of the cutter body 20, and can come into sufficient contact with the second connector 33B. That is, the second connector 33B comes into contact with the inclined surface 22c of the first connector 22Bb and does not come into contact with the cutter body 20. In this configuration as well, the distal end 22a of the first connector 22Bb is reliably positioned by contact with the proximal end surface 15 of the distal end element 11. Even if the second connector 33B and the first connector 22Bb come into contact with each other, the interior 43 of the inner tube 41 is in communication with the first pipe 23.The shape of the second connector 33B is not restricted, as long as it is a shape capable of forming a flow passage that establishes a connection between the interior 43 and the first pipe 23 when the first connector 22Bb and the second connector 33B come into contact. For example, the distal end section of the second connector 33B is not limited to a circular shape with a cut-out portion and may be rectangular or elliptical. Furthermore, if the second connector 33B does not have these flow-passage-forming shapes, a slot may be formed on the chamfered surface 22c, which may become a flow passage when the first connector 22Bb and the second connector 33B come into contact. (Modified Example 7)

[0083] Fig. Figure 25 is a diagram showing a first connector 22C, which is a modified example of the first connector 22. The first connector 22C has an inclined conduit 22d located on the proximal end face A2 with respect to the proximal end 20b of the knife body 20. The inclined conduit 22d is a conduit through which the rod 3 is inserted. The inner circumferential surface of the inclined conduit 22d is formed in a tapered shape, the diameter of which decreases from the proximal end face A2 to the distal end face A1. Therefore, the rod 3 can be inserted smoothly into the knife body 20 without the distal end 3a of the rod 3 becoming entangled in the first connector 22C when the lever 56 is moved forward relative to the slide 52, while the distal end 3a of the rod 3 is located within the interior 43.When the rod 3 is moved forward relative to the inner tube 41 (knife body 20), the second connector 33 of the rod 3 and the inner circumferential surface of the inclined pipe 22d of the first connector 22C come into contact. When the second connector 33 comes into contact with the inner circumferential surface of the inclined pipe 22d, the second connector 33 is located inside the inclined pipe 22d. Furthermore, at least a portion of the transverse cross-section of the second connector 33 at the distal end section is the outer surface 33s, which extends in a direction perpendicular to the longitudinal axis of the rod 3, as shown in [reference]. Fig. Figure 7 shows that the interior space 43 of the inner tube 41 is more reliably connected to the first pipe 23, even when the second connector 33 and the first connector 22C come into contact with each other. The shape of the second connector 33 is not restricted, as long as it is a shape capable of forming a flow passage that establishes a connection between the interior space 43 and the first pipe 23 when the first connector 22C and the second connector 33 come into contact with each other. For example, the distal end section of the second connector 33 is not limited to a circular shape with a cutout and can be rectangular or elliptical.Furthermore, if the second connector 33 does not have these flow-transmitting shapes, a slot may be formed on the inner circumferential surface of the inclined pipe 22d, which can become a flow passage when the first connector 22C and the second connector 33 come into contact with each other. (Modified Example 8)

[0084] Fig. Figure 26 is a diagram showing a distal end section of a treatment instrument 100A, which is a modified example of the treatment instrument 100. The treatment instrument 100A further comprises an insulating element 7. The insulating element 7 is a non-conductive element such as a resin or ceramic material. The insulating element 7 is provided at the distal end of the knife body 20. The insulating element 7 has a through-hole 71 extending in the longitudinal axis direction A. The through-hole 71 communicates with the first tube 23. The distal end section 32 of the rod 3 can pass through the first tube 23 and the through-hole 71 and protrude from the through-hole 71 toward the distal end A1. (Second embodiment)

[0085] A treatment instrument 100B according to a second embodiment of the present invention is described with reference to Fig. 27, Fig. 28, Fig. 29 to Fig. 30 described. In the following description, the same components as those already described are identified with the same reference symbols, and their descriptions are omitted.

[0086] Fig. 27, Fig. 28, Fig. 29 to Fig. 30 are diagrams illustrating the operation of the treatment instrument 100B.

[0087] The treatment instrument (endoscopic treatment tool) 100B comprises the outer shaft 1, the blade 2, the rod 3, the control element 4 and an operating section 5B.

[0088] The operating section (handle) 5B comprises the handle body 51, the slider 52, the power supply connector 53, the liquid dispensing port 54, the suction port 55, the lever 56 and an elastic body 57B.

[0089] The elastic body 57B is located between the slide 52 and the lever 56 and connects the slide 52 and the lever 56. The distal end of the elastic body 57B is attached to the slide 52, and the proximal end of the elastic body 57B is attached to the lever 56. The elastic body 57B is connected to the actuating wire 42 via the lever 56. The elastic body 57B biases the lever 56 towards its proximal end A2, so that the distal end 3a of the rod 3 is received in the interior 43 of the inner tube 41. That is, as with the elastic body 57, the distal end 3a of the rod 3 is located inside the inner tube 41, while the elastic body 57B returns to an original shape, and when the rod 3 is moved forward against the elastic force of the elastic body 57B, the rod 3 is pre-tensioned by the elastic body 57 towards the proximal end A2.Furthermore, the distal end 3a of the rod 3 is arranged on the proximal end side A2 in relation to the distal end of the outer shaft 1, while the elastic body 57B returns to an original shape.

[0090] As in Fig. As shown in Figure 27, the surgeon moves the slider 52 forward relative to the handle body 51, thus moving the knife 2 forward relative to the outer shaft 1. The knife 2 is positioned in the first position P1. Since the elastic body 57B biases the lever 56 towards the proximal end A2, the distal end 3a of the rod 3 remains in the fourth position P4, in order to be received in the interior 43 of the inner tube 41. At this point, the distal end 3a of the rod 3 is positioned on the proximal end A2 with respect to the distal end of the outer shaft 1.

[0091] When the slide 52 is moved forward relative to the handle body 51, the lever 56 engages with a first receiving surface 52a formed at the proximal end of the slide 52 and is moved forward together with the slide 52 while being pressed by the first receiving surface 52a. Therefore, the relative positional relationship between the knife 2 and the rod 3 in the longitudinal axis direction A is maintained.

[0092] As in Fig. As shown in Figure 28, the surgeon moves the lever 56 forward relative to the slider 52, causing the rod 3 to move forward relative to the knife 2. The rod 3 is positioned in the third position P3, and the distal end section 32 protrudes from the distal end opening 23a toward the distal end face A1. When the surgeon releases the lever 56, the lever 56 moves toward the proximal end face A2 due to the elastic force of the elastic body 57B. As a result, the distal end 3a of the rod 3 moves, as shown in Figure 28. Fig. 27 shown, into the fourth position P4, in order to be received in the interior 43 of the inner hose 41.

[0093] As in Fig. As shown in Figure 29, the surgeon moves the slider 52 backward relative to the handle body 51, causing the knife 2 to move backward relative to the outer shaft 1. The knife 2 is positioned in the second position P2. As the elastic body 57B biases the lever 56 toward the proximal end A2, the distal end 3a of the rod 3 moves into the fourth position P4 to be received in the interior 43 of the inner tube 41. At this point, the distal end 3a of the rod 3 is positioned on the proximal end A2 with respect to the distal end of the outer shaft 1.

[0094] When the slide 52 is moved backwards relative to the handle body 51, the lever 56 is moved backwards together with the slide 52 while being pressed by the elastic body 57B, which in turn is pressed by a second receiving surface 52b formed on the slide 52. Therefore, the relative positional relationship between the knife 2 and the rod 3 in the longitudinal axis direction A is maintained.

[0095] As in Fig. As shown in Figure 30, the surgeon moves the lever 56 forward relative to the slider 52, causing the rod 3 to move forward relative to the knife 2. The rod 3 is positioned in the third position P3, and the distal end section 32 protrudes from the distal end opening 23a toward the distal end face A1. When the surgeon releases the lever 56, the lever 56 moves toward the proximal end face A2 due to the elastic force of the elastic body 57B. As a result, the distal end 3a of the rod 3 moves, as shown in Figure 30. Fig. 29 shown, into the fourth position P4, in order to be received in the interior 43 of the inner hose 41.

[0096] According to the treatment instrument 100B of this embodiment, the knife 2 and the rod 3 can be easily operated depending on the treatment situation, such as incision and dissection treatment and local injection treatment. The surgeon does not need to operate the lever 56 backwards, and when the surgeon releases the lever 56, the rod 3 is automatically retracted into the interior 43 of the inner tube 41, thus simplifying the procedure. Furthermore, it is possible to prevent the surgeon from unintentionally operating the knife 2 with the rod 3 protruding. Since the knife 2 and the rod 3 are movable forwards and backwards in the longitudinal axis direction A, the stroke of the lever 56 relative to the slide 52 can be reduced.

[0097] Although the second embodiment of the present invention has been described in detail above with reference to the drawings, the specific configuration is not limited to this embodiment, and design modifications and the like are also included within the scope of the present invention. Furthermore, the components shown in the embodiments and modified examples can be configured in combination in a suitable manner. (Third embodiment)

[0098] A treatment instrument 100C according to a third embodiment of the present invention is described with reference to Fig. 31 and Fig. 32 described. In the following description, the same components as those already described are designated with the same reference symbols, and their descriptions are omitted.

[0099] Fig. 31 and Fig. 32 are diagrams illustrating the operation of the treatment instrument 100C.

[0100] The treatment instrument (endoscopic treatment tool) 100C comprises the outer shaft 1, the knife 2, the rod 3, the control element 4, an operating section 5C and the elastic body 6.

[0101] The knife 2 is similar to the first embodiment and comprises the knife body 20, the flange 21, and the first connector 22. The knife body 20 and the flange 21 have the first pipe 23 extending along the longitudinal direction A. The first connector (stop element) 22 connects the knife body 20 and the inner tube 41. The first connector 22 cannot be inserted through the first through-hole 12 in the longitudinal direction A. The first pipe 23 is in communication with the interior space 43 formed in the inner tube 41.

[0102] The rod 3 is similar to that of the first embodiment and comprises the main body section 31, the distal end section 32, and the second connector 33. The rod 3 is inserted through the first tube 23 of the knife 2 along the longitudinal direction A and can project from the distal end opening 23a towards the distal end face A1 and retract. The second connector 33 connects the rod 3 and the actuating wire 42. The second connector 33 cannot be inserted through the first tube 23 in the longitudinal direction A.

[0103] The operating section 5C comprises the handle body 51, the slider 52, the power supply connector 53, the liquid dispensing port 54, the suction port 55, and the lever 56. The operating section 5C does not have an elastic body.

[0104] The elastic body 6 is located in the interior 43 of the inner tube 41 and is arranged between the proximal end 20b of the knife body 20 and the second connector 33 in the longitudinal axis direction A. The elastic body 6 pre-tensions the rod 3 towards the proximal end A2, so that the distal end 3a of the rod 3 is received in the interior 43 of the inner tube 41. That is, as in the first embodiment, the distal end 3a of the rod 3 is located inside the inner tube 41 while the elastic body 6 returns to its original shape, and when the rod 3 is moved forward against the elastic force of the elastic body 6, the rod 3 is pre-tensioned by the elastic body 6 towards the proximal end A2. Furthermore, the distal end 3a of the rod 3 is arranged on the proximal end side A2 in relation to the distal end of the outer shaft 1, while the elastic body 6 returns to an original shape.

[0105] As in Fig. As shown in Figure 31, the surgeon moves the slider 52 forward relative to the handle body 51, thus moving the knife 2 forward relative to the outer shaft 1. The knife 2 is positioned in the first position P1. As the elastic body 6 biases the second connector 33 toward the proximal end A2, the distal end 3a of the rod 3 moves into the fourth position P4 to be received in the interior 43 of the inner tube 41. At this point, the distal end 3a of the rod 3 is positioned on the proximal end A2 with respect to the distal end of the outer shaft 1.

[0106] When the slide 52 is moved forward relative to the handle body 51, the lever 56 engages with the first receiving surface 52a, which is formed at the proximal end of the slide 52, and is moved forward together with the slide 52 while being pressed by the first receiving surface 52a. Therefore, the relative positional relationship between the knife 2 and the rod 3 in the longitudinal axis direction A is maintained.

[0107] As in Fig. As shown in Figure 32, the surgeon moves the lever 56 forward relative to the slider 52, causing the rod 3 to move forward relative to the knife 2. The knife 2 is positioned in the third position P3, and the distal end section 32 protrudes from the distal end opening 23a toward the distal end face A1. When the surgeon releases the lever 56, the rod 3 moves toward the proximal end face A2 due to the elastic force of the elastic body 6. Consequently, the distal end 3a of the rod 3 moves, as shown in Figure 32. Fig. 31 shown, into the fourth position P4, in order to be received in the interior 43 of the inner tube 41.

[0108] According to the treatment instrument 100C of this embodiment, the blade 2 and the rod 3 can be easily operated depending on the treatment situation, such as incision and dissection treatment and local injection treatment. Furthermore, it is possible to prevent the surgeon from unintentionally operating the blade 2 with the rod 3 protruding. Compared to a case in which the elastic body 57 is provided in the operating section 5, the treatment instrument 100C is less susceptible to the influence of the curved shape of the insertion section 202 of the endoscope 200 with regard to the stroke of the rod 3, and the penetration depth of the rod 3 into the tissue can be easily controlled.

[0109] Although the third embodiment of the present invention has been described in detail above with reference to the drawings, the specific configuration is not limited to this embodiment, and design modifications and the like are also included within the scope of the present invention. Furthermore, the components shown in the embodiments and modified examples described above can be configured in combination in a suitable manner. (Modified Example 3-1)

[0110] Fig. Figure 33 is a diagram showing a first connector 22E, which is a modified example of the first connector 22. The first connector 22E has a reduced-diameter section 22b located on the proximal end face A2 with respect to the proximal end 20b of the knife body 20. The elastic body 6 is located in the interior 43 of the inner tube 41 and is positioned between the first connector 22E and the second connector 33 in the longitudinal axis direction A. (Modified Example 3-1)

[0111] Fig. Figure 34 is a diagram showing a first connector 22D, which is a modified example of the first connector 22. The first connector 22D has a guide tube 22g extending towards the proximal end face A2. The guide tube 22g is a tube that accommodates the elastic body 6. The elastic body 6, accommodated in the guide tube 22g, is guided by the guide tube 22g and can expand and contract smoothly, so that the distal end 3a of the rod 3 does not become entangled in the wire of the elastic body 6. Furthermore, a portion of the second connector 33 can enter the guide tube 22g of the first connector 22D, while the elastic body 6 returns to its original shape. Furthermore, the distal end of the actuating wire 42 can enter the guide tube 22g of the first connector 22D, while the elastic body 6 returns to its original shape.According to this configuration, the rod 3 can be operated smoothly relative to the knife body 20, as the first connector 22D and the second connector 33 are less likely to get caught. (Further modifications)

[0112] Fig. Figure 35 is a diagram showing an elastic body 57C, which is a modification of the elastic body 57B. The elastic body 57C is formed by making the distal end of the lever 56 spring-like. In other words, the elastic body 57C and the lever 56 are formed as a single piece. The lever 56 and the elastic body 57C have the same effect as the lever 56 and the elastic body 57B, which are separate components. A configuration in which several parts are formed as a single piece, such as the elastic body 57B and the lever 56, can be applied to all embodiments and modifications. Commercial applicability

[0113] The present invention can be applied to an endoscopic treatment tool with a water delivery function. Explanation of symbols 300 Endoscopic Treatment System 200 Endoscope 100, 100A, 100B, 100C Treatment instrument (Endoscopic treatment tool) 1 Outer shaft 10 hoses 11 Distal end element 12 First through hole 12a Distal end opening 14 Distal end surface 15 Proximal end face 19 Interior (Piping, Lumen) 2 knives (electrode, knife electrode) 20 knife bodies 21 Flange (Distal end section with increased diameter) 21b Proximal end face 22, 22A, 22B, 22Ba, 22Bb, 22C, 22D, 22E First connector (stop element) 23 First pipeline 23a Distal end opening 3, 3A Rod (Solid Needle) 3a Distal end 31 Main body section 32 Distal end section 33 Second connector 4 Control element 41 Inner hose (First control element) 42 Actuating wire (Second operating element) 43 Interior 5, 5A, 5B, 5C Control section (handle) 50 shaft slides 51 handle bodies 51s Distal stop 51t Proximal stop 52 slides (Second slide) 53 power supply plugs 54 Liquid dispensing connection 55 Suction port 56, 56A Lever (First slider) 57, 57A, 57B Elastic body 58 pipe 59 Interior 6 Elastic body 7 Insulating element P1 First Position P2 Second Position P3 Third Position P4 Fourth position SR Suction Flow Passage WR Water Discharge Flow Passage QUOTES INCLUDED IN THE DESCRIPTION

[0000] This list of documents cited by the applicant was automatically generated and is included solely for the reader's convenience. The list is not part of the German patent or utility model application. The DPMA accepts no liability for any errors or omissions. Cited patent literature

[0000] US 63 / 564,938

[0001] JP 2024-091534

[0004] < / punktionsschritt> < / markierungsschritt>

Claims

Endoscopic treatment instrument comprising: a shaft; an electrode arranged at a distal end of the shaft; a rod arranged at least partially within the electrode; and an elastic body pre-tensioning a distal end of the rod so that it is received in the electrode. Endoscopic treatment tool according to claim 1, further comprising: a handle body provided in a proximal end section of the shaft; a wire connected to a proximal end section of the rod; and a first slider actuating the rod, wherein the elastic body is connected to the wire via the first slider. Endoscopic treatment tool according to claim 1, further comprising: an inner tube extending into the shaft; a first connector connecting the electrode and the inner tube; a wire extending into the inner tube; and a second connector connecting the rod and the wire, wherein the second connector comes into contact with the first connector to limit the extent of the rod protruding from the electrode. Endoscopic treatment tool according to claim 1, further comprising: a handle body provided in a proximal end section of the shaft; a wire connected to a proximal end section of the rod; and a first slide connected to the wire, wherein the elastic body is arranged between the first slide and the handle body. Endoscopic treatment instrument according to claim 4, further comprising: an inner tube extending into the shaft; and a second slider connected to a proximal end section of the inner tube, wherein the second slider is operable to be moved forwards and backwards relative to the first slider. Endoscopic treatment tool according to claim 1, further comprising: a handle body provided in a proximal end section of the shaft; and a first slider actuating the rod, wherein the elastic body is arranged between the first slider and the handle body. Endoscopic treatment tool according to claim 6, further comprising: a second slider that actuates the electrode, wherein the second slider is operable in such a way that it can be moved forwards and backwards relative to the first slider. Endoscopic treatment tool according to claim 5, wherein a distal end of the rod is received in the inner tube so as not to protrude from a distal end of the electrode, while the second slider is moved forward to the maximum extent and the first slider is not moved forward. Endoscopic treatment tool according to claim 7, further comprising: an inner tube extending into the shaft and connected to the electrode, wherein a distal end of the rod does not protrude from a distal end of the electrode and is received in the inner tube, while the second slider is moved forward to the maximum extent and the first slider is not moved forward. Endoscopic treatment tool according to claim 1, wherein the elastic body is elastically deformed when a distal end of the rod protrudes from a distal end of the electrode, and wherein the elastic body returns to an original shape when a distal end of the rod is received in the electrode. Endoscopic treatment tool according to claim 10, wherein a distal end of the rod is received in the electrode and a distal end of the rod is arranged proximal relative to a distal end of the shaft, while the elastic body returns to an original shape. Endoscopic treatment tool according to claim 1, wherein a distal end of the rod is arranged on a proximal end side in relation to a distal end of the electrode being moved backwards to the maximum extent, while the elastic body returns to an original shape. Endoscopic treatment tool according to claim 1, further comprising: an inner tube extending into the shaft; a first connector connecting the electrode and the inner tube; a wire extending into the inner tube; and a second connector connecting the rod and the wire, wherein the elastic body is arranged between the first connector and the second connector. Endoscopic treatment instrument according to claim 1, further comprising: a handle body provided in a proximal end section of the shaft; a wire connected to a proximal end section of the rod; an inner tube extending into the shaft; a first slide connected to the wire; and a second slide connected to the inner tube, wherein the elastic body is arranged between the first slide and the second slide. Endoscopic treatment tool according to claim 14, wherein the first slider engages with the second slider and is moved forward along a longitudinal axis together with the second slider. Endoscopic treatment tool according to claim 3, wherein the elastic body is arranged between the first connector and the second connector. Endoscopic treatment tool according to claim 1, wherein the elastic body deforms elastically when the distal end of the rod protrudes from the distal end of the electrode, and the elastic body returns to an original shape when the distal end of the rod is retracted proximally beyond the distal end of the electrode. Endoscopic treatment instrument comprising: a shaft; an electrode arranged at a distal end of the shaft; a rod arranged to be movable forwards and backwards relative to the electrode; and an elastic body pre-tensioning a distal end of the rod to move beyond a distal end of the shaft in the direction of a proximal end. Endoscopic treatment tool according to claim 18, further comprising: a handle body provided in a proximal end section of the shaft; a wire connected to a proximal end section of the rod; and a first slider actuating the rod, wherein the elastic body is connected to the wire via the first slider. Endoscopic treatment tool according to claim 18, further comprising: an inner tube extending into the shaft; a first connector connecting the electrode and the inner tube; a wire extending into the inner tube; and a second connector connecting the rod and the wire, wherein the second connector comes into contact with the first connector to limit the extent of the rod protruding from the electrode. Endoscopic treatment instrument comprising: a tube; an electrode connected to a distal end of the tube; a rod located at least partially within the electrode; and an elastic body that biases the rod towards a proximal end of the tube, while a distal end of the rod extends from a distal end of the electrode.

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