Endoscopic treatment instruments

Abstract

We provide endoscopic treatment instruments. [Solution] An endoscopic treatment instrument comprising: a treatment member extending in a first direction, having an openable and closable treatment section and a support section at the tip that supports the base end of the treatment section; a cylindrical housing member extending in the first direction through which the treatment member is inserted; a flow path formed between the inner circumferential surface of the housing member and the treatment member, which allows liquid supplied from the base end of the housing member into the housing member to be discharged from the tip-side opening of the housing member; and a constricted portion of the flow path, wherein the constricted portion is provided on the tip side of the base end edge of the support section.

Description

Technical Field

[0001] The present invention relates to an endoscopic treatment instrument.

Background Art

[0002] In Patent Document 1, there is described an endoscopic treatment instrument including a treatment instrument body extending in a first direction with a tip portion configured to be openable and closable, an operation member provided on the proximal end side of the treatment instrument body for opening and closing the tip portion, and a cylindrical housing member that houses the treatment instrument body therein and has a through-hole through which a fluid can be supplied. The housing member and the treatment instrument body are configured to be relatively movable in the first direction so as to take a first state in which the treatment instrument body protrudes from a first opening on the tip end side of the housing member and a second state in which at least a part of the protruding range of the treatment instrument body in the first state is retracted to the proximal end side of the first opening.

Prior Art Documents

Patent Documents

[0003]

Patent Document 1

Summary of the Invention

Means for Solving the Problems

[0004] An endoscopic treatment instrument according to one embodiment of the technology of the present disclosure has a treatment portion that can be opened and closed and a support portion that supports the proximal end side of the treatment portion on the tip end side, a treatment member extending in a first direction, a cylindrical housing member extending in the first direction through which the treatment member is inserted, a flow path formed between the inner peripheral surface of the housing member and the treatment member for discharging a liquid supplied from the proximal end side of the housing member into the housing member from an opening on the tip end side of the housing member, and a constriction portion of the flow path. The constriction portion is provided on the tip end side of the proximal end edge of the support portion.

Brief Description of the Drawings

[0005] [Figure 1]Figure 1 is a schematic diagram showing the general configuration of a system including an endoscopic treatment instrument 1, which is one embodiment of the present invention. [Figure 2] Figure 2 is a perspective view showing the configuration of the treatment member 20. [Figure 3] Figure 3 is an exploded perspective view of a part of the treatment member 20. [Figure 4] Figure 4 is an enlarged perspective view showing the shaft support member 221. [Figure 5] Figure 5 is a perspective view of the shaft support member 221 from a different direction than in Figure 3. [Figure 6] Figure 6 is a schematic cross-sectional view showing a detailed configuration example of the operating unit 50. [Figure 7] Figure 7 is a schematic diagram showing the state when the operating unit 50 shown in Figure 6 is operated. [Figure 8] Figure 8 is a schematic diagram showing the containment member 30 and the treatment member 20 viewed from above. [Figure 9] Figure 9 is a schematic diagram showing the containment member 30 and the treatment member 20 viewed from below. [Figure 10] Figure 10 is a schematic diagram showing the containment member 30 and the treatment member 20 as viewed from the left side. [Figure 11] Figure 11 is a schematic diagram showing the containment member 30 and the treatment member 20 viewed from the right side. [Figure 12] Figure 12 is a schematic cross-sectional view taken along the line AA shown in Figure 10. [Figure 13] Figure 13 is a schematic cross-sectional view taken along the BB arrow shown in Figure 10. [Figure 14] Figure 14 is a schematic cross-sectional view taken along the CC arrow shown in Figure 10. [Figure 15] Figure 15 is a schematic cross-sectional view of the endoscopic treatment instrument 1 between the covering member 23E and the operating section 50. [Figure 16] Figure 16 is a schematic diagram of the endoscopic treatment instrument 1 viewed from the front. [Figure 17] Figure 17 is a schematic diagram of the first modified endoscopic instrument 1, viewed from the front. [Figure 18] Figure 18 is a schematic cross-sectional view of the annular portion 221C of the endoscopic treatment instrument 1 shown in Figure 17. [Figure 19] Figure 19 is a schematic cross-sectional view of the endoscopic treatment instrument 1 shown in Figure 17 at the position of the axial support member 221. [Figure 20] Figure 20 is a schematic diagram of a second modified example of the endoscopic treatment instrument 1, viewed from the front. [Figure 21] Figure 21 is a schematic diagram of a third modified example of the endoscopic treatment instrument 1, viewed from the front. [Modes for carrying out the invention]

[0006] Figure 1 is a schematic diagram showing the general configuration of a system including an endoscopic treatment instrument 1, which is one embodiment of the present invention. The system shown in Figure 1 comprises an endoscopic treatment instrument 1, a liquid supply device 100 for supplying liquid such as water or local injection solution, a supply pipe 101 connecting the endoscopic treatment instrument 1 and the liquid supply device 100, a high-frequency power supply 200, a cable 201 connecting the endoscopic treatment instrument 1 and the high-frequency power supply 200, a counter electrode 203 attached to the treatment target (e.g., the human body), and a cable 202 connecting the high-frequency power supply 200 and the counter electrode 203.

[0007] Endoscopic instrument 1 is used by being inserted into the instrument insertion channel of an endoscope (not shown). In the following, when the endoscopic instrument 1 is inserted into the instrument insertion channel, the exit side of the instrument insertion channel will be referred to as the tip side, and the inlet side of the instrument insertion channel will be referred to as the proximal end side. The direction along the axis of the instrument insertion channel of the endoscope will be referred to as the axial direction. The axial direction constitutes the first direction. This axial direction is the same as the direction along the axis CL of the endoscopic instrument 1.

[0008] The endoscopic treatment instrument 1 comprises a treatment member 20 extending in the axial direction, having an openable and closable treatment section 21 and a support section 22 (see Figure 2) at its tip that supports the base end of the treatment section 21; a cylindrical housing member 30 extending in the axial direction through which the treatment member 20 is inserted; and an operating section 50 provided at the base end of the housing member 30 for opening and closing the treatment section 21.

[0009] The housing member 30 has flexibility and is inserted into the treatment tool channel of the endoscope.

[0010] The operation unit 50 includes a tip member 40 fixed to the proximal end of the housing member 30, a cable connection part 41 provided on the proximal end side of the tip member 40 and having a connection terminal 41A for making an electrical connection with the cable 201, a slider 42 provided on the proximal end side of the cable connection part 41, and a finger hook part 43 provided on the proximal end side of the slider 42. A liquid supply part 40Ah connected to the supply pipe 101 is provided on the tip member 40.

[0011] Figure 2 is a perspective view showing the configuration of the treatment member 20. Figure 3 is an exploded perspective view of a part of the treatment member 20.

[0012] As shown in Figure 2, the treatment member 20 includes a treatment part 21 provided on the distal end side, a support part 22 that supports the proximal end side of the treatment part 21, and a connection part 23 that connects the treatment part 21 and the operation unit 50.

[0013] The treatment part 21 has serrated concavo-convex parts 21a on the inside, and includes a pair of claw parts 21A and 21B that can be opened and closed around an opening and closing axis 21C extending in a direction perpendicular to the axial direction.

[0014] Figure 2 shows a forward direction Fr, which is the direction from the proximal end side to the distal end side of the endoscope treatment tool 1, and a rearward direction Rr, which is the opposite direction of the forward direction Fr. Figure 2 shows a right direction R, which is one of the opening and closing directions of the claw parts 21A and 21B, and a left direction L, which is the other of the opening and closing directions. Figure 2 shows an upward direction U, which is one of the directions perpendicular to the opening and closing directions of the claw parts 21A and 21B, and a downward direction D, which is the other of the perpendicular directions.

[0015] The forward direction Fr and the rearward direction Rr are collectively referred to as the front-rear direction. The front-rear direction is synonymous with the aforementioned axial direction. The right direction R and the left direction L are collectively referred to as the left-right direction. The upward direction U and the downward direction D are collectively referred to as the up-down direction. The front-rear direction, the left-right direction, and the up-down direction intersect each other.

[0016] As shown in Figure 3, the support section 22 includes a shaft support member 221 that supports the opening / closing shaft 21C of the treatment section 21, and a connecting member 222 that connects the shaft support member 221 and the connecting section 23. The shaft support member 221 has a roughly U-shape when viewed in the left-right direction. The connecting member 222 is cylindrical with its axis extending in the front-rear direction.

[0017] Figure 4 is a magnified perspective view of the shaft support member 221. Figure 5 is a perspective view of the shaft support member 221 from a different direction than that shown in Figure 4.

[0018] As shown in Figures 4 and 5, the shaft support member 221 comprises an upper shaft support portion 221A and a lower shaft support portion 221B that are arranged vertically and support the opening / closing shaft 21C at their tip ends, an annular portion 221C that is annular in the front-rear direction and provided on the base end side of the upper shaft support portion 221A and the lower shaft support portion 221B, and a cylindrical extension portion 221D that extends from around the opening on the base end side of the annular portion 221C toward the base end.

[0019] The upper shaft support portion 221A and the lower shaft support portion 221B each have thickness in the vertical direction and are composed of curved plate-like structures that curve away from the axis CL. The extended portion 221D is configured to have a smaller diameter than the annular portion 221C.

[0020] As shown in Figure 2, the base ends of the claw portions 21A and 21B are positioned and supported between the upper shaft support portion 221A and the lower shaft support portion 221B.

[0021] The support portion 22 further includes a connecting member 222 that connects the shaft support member 221 and the connecting portion 23, as shown in Figure 3. The connecting member 222 is configured as a cylindrical shape extending in the front-rear direction. The extended portion 221D of the shaft support member 221 is inserted through the connecting member 222 from the tip side, and the connecting member 222 and the extended portion 221D are fixed inside the connecting member 222.

[0022] The connecting portion 23 comprises a pair of link rods 23A, the tip of which is supported by the claw portion 21A and the claw portion 21B respectively; an operating wire 23C extending from the operating portion 50 to the base end of the link rod 23A; and a cylindrical member 23B that internally supports the tip of the operating wire 23C. The pair of link rods 23A protrude from the support portion 22 towards the base end, passing through the annular portion 221C, the extended portion 221D, and the connecting member 222 from between the upper shaft support portion 221A and the lower shaft support portion 221B. The link rods 23A are inserted into the cylindrical member 23B and fixed to the tip surface of the operating wire 23C inside the cylindrical member 23B.

[0023] As shown in Figure 2, the connecting portion 23 includes a coil sleeve 23D made of a tightly wound coil provided on the base end of the link rod 23A, a cylindrical member 23B, and the outer circumference of the operating wire 23C, and a covering member 23E that covers the tip end of the coil sleeve 23D. The tip of the coil sleeve 23D is fixed inside the connecting member 222. The base end of the coil sleeve 23D is fixed inside the tip member 40 shown in Figure 1. When the operating wire 23C moves in the front-rear direction, the link mechanism of the pair of link rods 23A is activated, and the claw portions 21A and 21B are opened and closed.

[0024] As shown in Figure 5, a gap is formed between the left and right ends of the upper shaft support portion 221A and the left and right ends of the lower shaft support portion 221B to prevent interference between the base ends of the claw portions 21A and 21B and the link rod 23A when the claw portions 21A and 21B are opened and closed.

[0025] As shown in Figures 4 and 5, the annular portion 221C is provided with a groove 221E that extends in the front-rear direction in a portion of the circumferential direction.

[0026] Figure 6 is a schematic cross-sectional view showing a detailed configuration example of the operating section 50. The tip member 40 is cylindrical and is fixed to the housing member 30 at its tip, so that the inside of the housing member 30 and the inside of the tip member 40 are in communication.

[0027] A connector member 40A is provided inside the tip member 40, fixed to the tip member 40. The connector member 40A has a roughly T-shaped cross-section and has a first straight portion extending in the vertical direction and a second straight portion extending from approximately the center of the first straight portion in the vertical direction toward the tip. The second straight portion is provided with a through hole that penetrates from front to back, and this through hole communicates with the interior of the housing member 30 at the tip side and with the interior of the tip member 40 at the base end side. Inside the lower part of the through hole in the first straight portion of the connector member 40A, there is a liquid supply section 40Ah, which is composed of a hole that connects this through hole to the outside. When liquid is discharged from the liquid supply device 100 with the supply pipe 101 connected to the liquid supply section 40Ah, this liquid is supplied to the housing member 30 via the through hole in the connector member 40A. The tip member 40 and the connector member 40A constitute a liquid supply section that supplies liquid to the housing member 30 from the base end side.

[0028] Inside the tip member 40, there is an O-ring 40C, which serves as a sealing member and is provided on the base end side of the connector member 40A, and a flanged cylindrical connector member 40D, which is provided on the base end side of the O-ring 40C. The O-ring 40C is sandwiched between the inner wall of the tip member 40 and the outer surface of the base end side of the connector member 40A. Inside the tip side of the connector member 40D, a cylindrical member 40a extending toward the tip side is fixed. The cylindrical member 40a extends into the interior of the connector member 40A.

[0029] Of the connection portion 23 of the treatment member 20, the operating wire 23C and the coil sleeve 23D have their base ends located inside the tip member 40. The coil sleeve 23D extends from the position of the connecting member 222 to the tip end of the connector member 40A. The operating wire 23C extends further towards the base end than the base end of the coil sleeve 23D, passing through the inside of the cylindrical member 40a and extending further towards the base end than the connector member 40D. The connector member 40D is configured to be movable relative to the tip member 40 and the connector member 40A in the front-rear direction.

[0030] An O-ring 40E is provided on the inner circumference of the connector member 40D between it and the operating wire 23C, acting as a sealing member. The O-rings 40C and 40E are positioned on the proximal end side of the internal space of the connector member 40A into which liquid flows from the liquid supply section 40Ah. The O-rings 40C and 40E firmly prevent the liquid supplied to the inside of the connector member 40A from moving into the space on the proximal end side of the connector member 40A in the tip member 40. Inside the connector member 40D, a fixing member 40F is provided on the proximal end side of the O-ring 40E to fix the O-ring 40E in place.

[0031] The cable connection portion 41 is composed of a cylindrical member through which an operating wire 23C extending from the connector member 40D toward its base end is inserted, and its tip is supported by the base end of the connector member 40D. The cable connection portion 41 and the connector member 40D are connected so as not to move relative to each other in the front-rear direction, but so as to be able to rotate relative to each other around the axis CL. The connection terminal 41A is electrically connected to the operating wire 23C inserted through the cable connection portion 41.

[0032] The finger rest portion 43 is supported inside the cable connection portion 41 at its base end. The cable connection portion 41 and the finger rest portion 43 are connected so as not to move relative to each other in the front-rear direction, and so as to be rotatable relative to each other about the axis CL.

[0033] The slider 42 is provided on the outer circumference of the cable connection portion 41 and the finger rest portion 43, straddling them, and is configured to be movable in the front-rear direction relative to the cable connection portion 41 and the finger rest portion 43. The slider 42 and the cable connection portion 41 are connected so as to be rotatable relative to each other around the axis CL. The slider 42 and the finger rest portion 43 are connected so as not to be rotatable relative to each other around the axis CL. The operating wire 23C, inserted through the cable connection portion 41 from the tip side, is inserted into the inside of the finger rest portion 43 and fixed to the wire fixing portion 42A of the slider 42 in the cavity 43A inside the finger rest portion 43.

[0034] The endoscopic treatment instrument 1 is configured to be able to assume two states: a protruding state in which the treatment section 21 protrudes from the tip-side opening 30h of the housing member 30, and a retracted state in which the entire protruding range of the treatment section 21 from the tip-side opening 30h in the protruding state is retracted to the proximal end side of the tip-side opening 30h. In the protruding state, the treatment section 21 protrudes from the tip-side opening 30h to the extent that it can be opened to its maximum extent. Figure 6 shows the retracted state.

[0035] When using the endoscopic treatment instrument 1, in the retracted state shown in Figure 6, for example, while maintaining the front-to-back position of the finger rest 43, the tip member 40 is moved toward the base end. As a result of this operation, as shown in Figure 7, the tip member 40, connector member 40A, and O-ring 40C move toward the base end relative to the cylindrical member 40a, connector member 40D, and cable connection part 41. Consequently, although the front-to-back position of the treatment member 20 remains unchanged, the tip of the housing member 30 moves toward the base end, resulting in a protruding state.

[0036] In this protruding state, moving the slider 42 in the forward and backward direction relative to the cable connection part 41 and the finger rest part 43 causes the operating wire 23C to move in the forward and backward direction. The movement of the operating wire 23C opens and closes the treatment part 21, allowing the submucosal layer and other tissues to be grasped and energized, thereby enabling the excision of the lesion.

[0037] The physician opens and closes the treatment section 21 using the operating section 50, and after excising the lesion with the treatment section 21, moves, for example, the housing member 30 and the tip member 40 toward the tip, and houses the entire treatment section 21 in the housing member 30. After that, the physician withdraws the endoscopic treatment instrument 1 from the endoscope. Procedures such as ESD (Endoscopic Submucosal Dissection) are performed by following these steps.

[0038] In the above-described protruding state, when the finger rest portion 43 is rotated around the axis CL, the slider 42 rotates together with the finger rest portion 43, and the operating wire 23C fixed to the wire fixing portion 42A of the slider 42 rotates. When the operating wire 23C rotates, the link rod 23A fixed to it also rotates. Therefore, the orientation of the treatment portion 21 can be flexibly changed by rotating it in the protruding state.

[0039] The cable connection section 41 is rotatable relative to the connector member 40D, the slider 42, and the finger rest 43. Therefore, for example, when performing a rotational operation to rotate the finger rest 43 while gripping the tip member 40, it is possible to prevent the cable connection section 41 from following this rotation. Since the cable 201 is connected to the cable connection section 41, the cable 201 does not need to rotate as the cable connection section 41 does not rotate, allowing for efficient treatment using the endoscopic treatment instrument 1.

[0040] Furthermore, even if you want to change the position of the cable 201, the cable connection part 41 can rotate relative to the connector member 40D, so the position of the cable 201 can be changed while maintaining the position of the tip member 40.

[0041] Figure 8 is a schematic diagram of the containment member 30 and treatment member 20 viewed from above. Figure 9 is a schematic diagram of the containment member 30 and treatment member 20 viewed from below. Figure 10 is a schematic diagram of the containment member 30 and treatment member 20 viewed from the left. Figure 11 is a schematic diagram of the containment member 30 and treatment member 20 viewed from the right. In Figures 8 to 11, the containment member 30 is shown in cross-section.

[0042] As shown in Figures 8 to 11, a flow path SP is formed between the inner circumferential surface 30s of the containment member 30 and the treatment member 20, allowing the liquid supplied to the interior of the containment member 30 from the base end side of the containment member 30 by the tip member 40 to be discharged from the tip side opening 30h of the containment member 30.

[0043] The flow path SP has a different cross-sectional area perpendicular to the front-to-back direction at each position in the front-to-back direction of the housing member 30. In the range from the base end to the tip end of the housing member 30, this cross-sectional area is larger because the diameter of the structure housed in the housing member 30 is small. As a result, it becomes possible to smoothly flow the liquid from the base end to the tip end.

[0044] A large structure such as a shaft support member 221 or a connecting member 222 is provided at the tip of the housing member 30. As a result, the cross-sectional area of ​​the flow path SP tends to be smaller at the tip of the housing member 30.

[0045] In this embodiment, the cross-sectional area of ​​the flow path SP is minimized at the position of the annular portion 221C in the front-rear direction. Figure 12 is a schematic cross-sectional view taken along the arrow AA shown in Figure 10. As shown in Figure 12, at the position of the annular portion 221C, the flow path SP is the sum of the gap SP1 between the outer circumferential surface 221Cs of the annular portion 221C excluding the groove 221E and the inner circumferential surface 30s of the housing member 30, and the gap SP2 between the groove 221E and the inner circumferential surface 30s.

[0046] The gap SP1 is the minimum distance that allows the treatment member 20 and the containment member 30 to move relative to each other in the front-rear direction, and is so small that fluid cannot substantially pass through it. Therefore, at the position of the annular portion 221C, the gap SP2 can be considered as the flow path SP.

[0047] Figure 13 is a schematic cross-sectional view taken along the arrow BB shown in Figure 10. As shown in Figure 13, in the portion where the connecting member 222 and the covering member 23E overlap, the flow path SP consists of a gap SP3 between the outer circumferential surface 23Es of the covering member 23E and the inner circumferential surface 30s of the housing member 30. The cross-sectional area of ​​the gap SP3 is, for example, 4.7 times the cross-sectional area of ​​the gap SP2 in Figure 12. When viewed in the front-rear direction, most of this gap SP3 is covered by the annular portion 221C shown in Figure 12.

[0048] Figure 14 is a schematic cross-sectional view taken along the CC arrow shown in Figure 10. As shown in Figure 14, in the portion of the covering member 23E closer to the base end than the connecting member 222, the flow path SP consists of a gap SP4 between the outer circumferential surface 23Es of the covering member 23E and the inner circumferential surface 30s of the housing member 30. The cross-sectional area of ​​the gap SP4 is, for example, 10.4 times the cross-sectional area of ​​the gap SP2 in Figure 12. When viewed in the front-rear direction, most of this gap SP4 is covered by the annular portion 221C shown in Figure 12.

[0049] Figure 15 is a schematic cross-sectional view of the endoscopic treatment instrument 1 on the proximal end side of the covering member 23E. As shown in Figure 15, in the portion between the covering member 23E and the operating section 50, the flow path SP consists of a gap SP5 between the outer circumferential surface 23Ds of the coil sleeve 23D and the inner circumferential surface 30s of the housing member 30. The cross-sectional area of ​​the gap SP5 is, for example, 13.2 times the cross-sectional area of ​​the gap SP2 in Figure 12. When viewed in the front-rear direction, most of this gap SP5 is covered by the annular portion 221C shown in Figure 12.

[0050] Furthermore, beyond the annular portion 221C, a space exists between the lower shaft support portion 221B and the upper shaft support portion 221A, and the treatment portion 21 has a flattened shape, so the cross-sectional area of ​​the flow path SP is larger than the gap SP2.

[0051] Thus, in the endoscopic treatment instrument 1, the flow path SP is narrowest at the position of the annular portion 221C, and the outer surface 221Cs and groove 221E of the annular portion 221C constitute the narrowed portion of the flow path SP.

[0052] The liquid supplied to the containment member 30 from the base end passes through the gap SP5 shown in Figure 15, the gap SP4 shown in Figure 14, and the gap SP3 shown in Figure 13, in that order, and reaches the gap SP2 shown in Figure 12. Since the cross-sectional area of ​​gap SP2 is the smallest, the liquid is compressed in the narrow space of gap SP2 before being released towards the tip. Therefore, the liquid discharge pressure can be increased at the position of the annular portion 221C.

[0053] In the case of an endoscopic treatment instrument 1, which has an openable and closable treatment section 21, the proportion of the treatment section 21 to the inner cross-sectional area of ​​the housing member 30 becomes smaller when viewed in the front-to-back direction, so the flow path SP becomes larger around the treatment section 21. In addition, claw sections 21A and 21B and a shaft support member 221 that pivotally supports them so that they can be opened and closed are required, making the tip side longer. Therefore, the further the position where the flow path SP is narrowed is from the tip, the longer the distance the liquid discharged from that position travels before exiting the tip side opening 30h, making it difficult to increase the liquid discharge pressure even when the flow path SP is narrowed. According to this embodiment, since the flow path SP is narrowed by the annular section 221C, the liquid discharge pressure can be increased.

[0054] Figure 16 is a schematic diagram of the endoscopic treatment instrument 1 viewed from the front. As shown in Figure 16, the liquid is discharged from gap SP2, but no other components overlap gap SP2. Therefore, the liquid discharged from gap SP2 travels along groove 221E toward the tip and is then forcefully discharged from the tip-side opening 30h. In this way, by narrowing the flow path SP, which was originally configured as an annular shape, into a non-annular region, such as gaps SP3, SP4, and SP5, the liquid discharge pressure can be increased.

[0055] Figure 17 is a schematic diagram of the first modified endoscopic instrument 1 viewed from the front. Figure 18 is a schematic cross-sectional view of the endoscopic instrument 1 at the position of the annular portion 221C shown in Figure 17. Figure 19 is a schematic cross-sectional view of the endoscopic instrument 1 at the position of the axial support member 221 shown in Figure 17.

[0056] In the modified example shown in Figure 17, a groove 221F extending in the front-rear direction is provided on the outer circumferential surface 221As of the upper shaft support portion 221A, and a groove 221F extending in the front-rear direction is provided on the outer circumferential surface 221Bs of the lower shaft support portion 221B. As shown in Figure 18, the groove 221F is also provided on the annular portion 221C. In the modified example shown in Figure 17, the gap between the outer circumferential surface of the shaft support member 221 (outer circumferential surface 221Cs of the annular portion 221C, outer circumferential surface 221As of the upper shaft support portion 221A, and outer circumferential surface 221Bs of the lower shaft support portion 221B) and the inner circumferential surface 30s of the housing member 30 is the minimum distance necessary for the treatment member 20 and the housing member 30 to move relative to each other in the front-rear direction. Therefore, when viewed in the front-to-back direction, most of the gaps SP3, SP4, and SP5 are covered by the annular portion 221C, the upper shaft support portion 221A, and the lower shaft support portion 221B.

[0057] Since a groove 221F is formed in the shaft support member 221, liquid can pass through the gap SP6 between this groove 221F and the inner circumferential surface 30s. Therefore, the gap SP6 constitutes the flow path SP, and the cross-sectional area of ​​the gap SP6 is the smallest. In the endoscopic treatment instrument 1 shown in Figure 17, the flow path SP is narrowest at the positions of the annular portion 221C, the upper shaft support portion 221A, and the lower shaft support portion 221B, and the outer circumferential surface 221Cs of the annular portion 221C, the outer circumferential surface 221As of the upper shaft support portion 221A, the outer circumferential surface 221Bs of the lower shaft support portion 221B, and the groove 221F constitute the narrowed portion of the flow path SP.

[0058] The liquid supplied to the containment member 30 from the base end passes through the gap SP5 shown in Figure 15, the gap SP4 shown in Figure 14, and the gap SP3 shown in Figure 13, in that order, and reaches the gap SP6 shown in Figures 18 and 19. Since the cross-sectional area of ​​gap SP6 is the smallest, the liquid is compressed in the narrow space of gap SP6 before being released towards the tip. Therefore, the liquid discharge pressure can be increased.

[0059] As shown in Figure 17, the liquid is discharged from the gap SP6, but no other components overlap the gap SP6. Therefore, the liquid discharged from the gap SP6 travels along the groove 221F towards the tip and is then forcefully discharged from the tip-side opening 30h. In this way, even with the configuration shown in Figure 17, the liquid discharge pressure can be increased.

[0060] Figure 20 is a schematic diagram of a second modified example of the endoscopic treatment instrument 1, viewed from the front. In the example shown in Figure 20, the cross-section of the annular portion 221C is such that the groove 221E in Figure 12 is filled in. Also, in the example shown in Figure 20, the gap between the outer circumferential surface of the shaft support member 221 (outer circumferential surface 221Cs of the annular portion 221C, outer circumferential surface 221As of the upper shaft support portion 221A, and outer circumferential surface 221Bs of the lower shaft support portion 221B) and the inner circumferential surface 30s of the housing member 30 is the minimum distance necessary for the treatment member 20 and the housing member 30 to move relative to each other in the front-rear direction. Furthermore, a hole 221G is formed in the shaft support member 221, extending from the base end surface of the annular portion 221C to the tip surfaces of the upper shaft support portion 221A and the lower shaft support portion 221B. In this modified example, the outer circumferential surface of the shaft support member 221 and the hole 221G constitute the narrowed portion of the flow path SP. Even with this configuration, it is possible to increase the liquid discharge pressure.

[0061] Furthermore, according to the configuration shown in Figures 17 and 20, the position where the cross-sectional area of ​​the flow path SP is minimized can be placed at the tip of the shaft support member 221. This allows for a higher liquid discharge pressure. In addition, since only the treatment section 21 is present in the path through which the liquid discharged from the hole 221G passes, the possibility of the liquid hitting an obstacle and losing pressure is reduced, thereby increasing the discharge pressure.

[0062] In the explanation so far, the flow path SP is narrowed by bringing the outer surface of the shaft support member 221 closer to the inner surface 30s of the housing member 30, and by providing grooves 221E, grooves 221F, or holes 221G in the shaft support member 221, but the explanation is not limited to this.

[0063] For example, in the connecting member 222, the diameter of the portion exposed from the covering member 23E and the portion covered by the covering member 23E may be increased, and the distance between the outer circumferential surface and the inner circumferential surface 30s of that portion may be set to the minimum value that allows the treatment member 20 to move. Then, a groove may be provided on the outer circumferential surface of that portion, or a hole that penetrates that portion in the front-to-back direction may be provided to form a narrowed portion of the flow path SP.

[0064] Alternatively, the treatment section 21 may be enlarged to create a narrowed section of the flow path SP. An example of this configuration will be explained with reference to Figure 21.

[0065] Figure 21 is a schematic diagram of a third modified example of the endoscopic treatment instrument 1, viewed from the front. In the example in Figure 21, the cross-section of the annular portion 221C is the same as in Figure 12, but with the groove 221E filled in and the outer diameter further reduced. Also, the distance between the outer circumferential surface of the shaft support member 221 and the inner circumferential surface 30s of the housing member 30 is the same as the distance between the maximum diameter portion of the covering member 23E and the inner circumferential surface 30s. Therefore, when viewed from the front, the gap SP3 is visible, as shown in Figure 21.

[0066] In the example shown in Figure 21, the claw portion 21A includes an overlapping portion 21Aa that overlaps with the gap SP3 when viewed from the front, and the claw portion 21B includes an overlapping portion 21Ba that overlaps with the gap SP3 when viewed from the front. The flow path SP formed by the gap SP3 is partially closed by the overlapping portions 21Aa and 21Ba, and the flow path SP is narrowest (the cross-sectional area is smallest) at the positions of the overlapping portions 21Aa and 21Ba. In this way, the liquid delivery pressure can also be increased by making the treatment portion 21 larger and forming a narrowed portion of the flow path SP with the overlapping portions 21Aa and 21Ba.

[0067] As explained above, this specification contains at least the following information:

[0068] (1) A treatment member having an openable and closable treatment section and a support section at the tip that supports the base end of the treatment section, extending in a first direction, A cylindrical housing member extending in the first direction through which the above-mentioned treatment member is inserted, A flow path is formed between the inner circumferential surface of the housing member and the treatment member, which allows the liquid supplied to the interior of the housing member from the base end side of the housing member to be discharged from the tip end opening of the housing member, The above flow path includes a constricted portion, The above-mentioned stenosis is provided on the tip side of the proximal end edge of the above-mentioned support portion, and is an endoscopic treatment instrument.

[0069] (2) (1) Endoscopic treatment instrument as described above, The above-mentioned stenosis is formed by the above-mentioned support portion, and is an endoscopic treatment instrument.

[0070] (3) (2) Endoscopic treatment instrument as described above, An operating part for opening and closing the above-mentioned treatment section is provided on the base end side, The above treatment member has a connecting portion that connects the above treatment portion and the above operating portion. The support portion comprises an axial support member that supports the opening and closing shaft of the treatment portion, and a connecting member that connects the axial support member and the connecting portion, wherein the support portion is an endoscopic treatment instrument.

[0071] (4) (3) Endoscopic treatment instrument as described above, The above-mentioned narrowed portion is formed by the above-mentioned axial support member, and is an endoscopic treatment instrument.

[0072] (5) (4) Endoscopic treatment instrument, The shaft support member has an outer circumferential surface that faces the inner circumferential surface of the housing member. The shaft support member described above is provided with a hole or groove extending in the first direction, The shaft support member, when viewed from the tip side in the first direction, partially covers the flow path on the base end side of the shaft support member. An endoscopic treatment instrument in which the constricted portion is formed by the outer circumferential surface of the shaft support member and the hole or groove.

[0073] (6) (5) Endoscopic treatment instrument as described above, The shaft support member comprises shaft support portions arranged in a direction intersecting the opening and closing direction of the treatment portion and supporting the opening and closing shaft of the treatment portion, and an annular portion provided at the base end of the shaft support portion. An endoscopic treatment instrument having the above-mentioned hole or groove in the annular portion.

[0074] (7) (5) Endoscopic treatment instrument as described above, The shaft support member comprises shaft support portions arranged in a direction intersecting the opening and closing direction of the treatment portion and supporting the opening and closing shaft of the treatment portion, and an annular portion provided at the base end of the shaft support portion. An endoscopic treatment instrument having the above-mentioned hole or groove provided in the shaft support portion.

[0075] (8) (3) Endoscopic treatment instrument as described above, The above-mentioned narrowed portion is an endoscopic treatment instrument formed by the above-mentioned connecting member.

[0076] (9) (1) Endoscopic treatment instrument as described above, The above-mentioned stenosis portion is an endoscopic treatment instrument composed of the above-mentioned treatment portion.

[0077] (10) (9) Endoscopic treatment instrument as described above, The above treatment area includes the nail portion, The claw portion has an overlapping portion that overlaps with the flow path on the base end side of the claw portion when viewed from the tip side in the first direction, An endoscopic treatment instrument in which the aforementioned overlapping portion constitutes the aforementioned stenosis.

[0078] (11) An endoscopic treatment instrument described in any one of (1) to (10), An endoscopic instrument in which the cross-sectional area of ​​the flow path in the constricted portion is smaller than the cross-sectional area of ​​the flow path outside the constricted portion. [Explanation of Symbols]

[0079] 1 Endoscopic treatment instruments 20 Treatment components 21 Treatment Department 21C Opening / Closing Shaft 21A,21B Claw part 21Aa, 21Ba superimposed area 21a Serrated uneven surface 22 Support part 23 Connection part 23A Link Rod 23B Cylindrical member 23C Operating Wire 23D Coil Sleeve 23E Covering material 221As, 221Bs, 221Cs outer surface 30 Containing member 30h Tip side opening 30s Inner surface 40 Tip member 40A Connector Components 40Ah liquid supply section 40C, 40E O-rings 40D Connector component 40F Fixing Member 41A Connection terminal 41 Cable connection section 42 Slider 42A Wire fixing section 43 Finger rest 43A Cavity 50 Control section 100 Liquid supply device 101 Supply pipe 200 High frequency power supply 201,202 Cables 203 Counter electrode 221 Axle support member 221A Upper shaft support part 221B Lower shaft support part 221C Annular section 221D Extension 221E,221F Groove 221G hole 222 Connecting member SP1, SP2, SP3, SP4, SP5, SP6 gap

Claims

1. A treatment member having an openable and closable treatment section and a support section at the tip that supports the base end of the treatment section, extending in a first direction, A cylindrical housing member extending in the first direction through which the treatment member is inserted, A flow path is formed between the inner circumferential surface of the containment member and the treatment member, which allows the liquid supplied to the interior of the containment member from the base end side of the containment member to be discharged from the tip end opening of the containment member, The flow path includes a constricted portion, The aforementioned stenosis is provided on the tip side of the proximal end edge of the support portion, in the endoscopic treatment instrument.

2. An endoscopic treatment instrument according to claim 1, The stenotic portion is formed by the support portion, and the instrument is an endoscopic treatment device.

3. An endoscopic treatment instrument according to claim 2, An operating part for opening and closing the aforementioned treatment section is provided on the base end side, The treatment member has a connecting portion that connects the treatment portion and the operating portion. The support portion comprises an axial support member that supports the opening and closing shaft of the treatment portion, and a connecting member that connects the axial support member and the connecting portion, wherein the support portion is an endoscopic treatment instrument.

4. An endoscopic treatment instrument according to claim 3, The aforementioned narrowed portion is formed by the aforementioned axial support member, and is an endoscopic treatment instrument.

5. An endoscopic treatment instrument according to claim 4, The shaft support member has an outer circumferential surface that faces the inner circumferential surface of the housing member, The shaft support member is provided with a hole or groove extending in the first direction, The shaft support member partially covers the flow path on the base end side of the shaft support member when viewed from the tip side in the first direction, An endoscopic treatment instrument in which the constricted portion is formed by the outer circumferential surface of the shaft support member and the hole or groove.

6. An endoscopic treatment instrument according to claim 5, The shaft support member comprises shaft support portions arranged in a direction intersecting the opening and closing direction of the treatment portion and supporting the opening and closing shaft of the treatment portion, and an annular portion provided at the base end of the shaft support portions. An endoscopic treatment instrument having the aforementioned hole or groove in the annular portion.

7. An endoscopic treatment instrument according to claim 5, The shaft support member comprises shaft support portions arranged in a direction intersecting the opening and closing direction of the treatment portion and supporting the opening and closing shaft of the treatment portion, and an annular portion provided at the base end of the shaft support portions. An endoscopic treatment instrument having the aforementioned hole or groove provided in the shaft support portion.

8. An endoscopic treatment instrument according to claim 3, The aforementioned narrowed portion is an endoscopic treatment instrument formed by the aforementioned connecting member.

9. An endoscopic treatment instrument according to claim 1, The stenotic portion is formed by the treatment portion, and is an endoscopic treatment instrument.

10. An endoscopic treatment instrument according to claim 9, The treatment portion includes the nail portion, The claw portion has an overlapping portion that overlaps with the flow path on the base end side of the claw portion when viewed from the tip side in the first direction, An endoscopic treatment instrument in which the constricted portion is formed by the superimposed portion.

11. An endoscopic treatment instrument according to any one of claims 1 to 10, An endoscopic instrument wherein the cross-sectional area of ​​the flow path in the constricted portion is smaller than the cross-sectional area of ​​the flow path outside the constricted portion.

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