Endoscopic needle scalpel

Abstract

To provide a needle-like scalpel for an endoscope, the scalpel making it possible to suitably perform marking and incision on a biological tissue.SOLUTION: A needle-like scalpel 1 for an endoscope comprises a needle-like treatment part 30 and a tube body (a stopper part 16). The stopper part 16 comprises: a proximal side compressed diameter part (a slit 16d) having a narrowed lumen 16k; a distal side compressed diameter part (a circular hole part 16e) on the distal side of the slit 16d; and an enlarged diameter part 16f. The needle-like treatment part 30 includes a part to be locked (a joint pipe 14) that is formed so as to have a diameter larger than those of surroundings and is housed in the enlarged diameter part 16f. By the joint pipe 14 abutting on the proximal side compressed diameter part (a peripheral wall of the slit 16d), the peripheral wall of the slit 16d restricts the position of the needle-like treatment part 30 at a first projection position. Also, by the joint pipe 14 abutting on a peripheral wall of the hole part 16e, the distal side compressed diameter part (the peripheral wall of the hole part 16e) restricts the position of the needle-like treatment part 30 at a second projection position.SELECTED DRAWING: Figure 3

Description

[Technical Field]

[0001] The present invention relates to a needle scalpel for an endoscope. [Background technology]

[0002] Endoscopic submucosal dissection (ESD) is a surgical procedure in which an endoscope is inserted into organs such as the stomach or intestines to treat the target area. During ESD, the target area, such as cancer, is marked while observing with the endoscope, and then a drug is injected into the submucosal layer to lift it up, after which procedures such as incision, dissection, resection, and hemostasis are performed. A high-frequency knife is known as a medical device used for marking and incision procedures. Such a high-frequency knife is described, for example, in Patent Document 1. The endoscopic treatment tool (high-frequency knife) described in Patent Document 1 is designed to quickly perform incision treatment and coagulation treatment by selectively using electrode parts with shapes suited to each treatment. For this purpose, Patent Document 1 describes an endoscopic treatment tool that is provided with a tubular first electrode part with an insertion hole formed therein and a rod-shaped second electrode part that is inserted into the insertion hole so as to be able to move forward and backward. In this endoscopic treatment tool, the second electrode part protrudes and retracts from the tip of the first electrode part, and is configured to be electrically connected to the first electrode part when retracted into the first electrode part.

[0003] According to the above configuration, the operating unit is moved toward the distal end to cause the rod-shaped second electrode unit to protrude from the distal end of the first electrode unit and contact the body tissue. In this state, a cutting current is passed through the second electrode unit to locally cauterize and incise the body tissue in contact with the second electrode unit. If bleeding occurs during such treatment, the application of the cutting current is stopped and the second electrode unit is retracted into the first electrode unit. This electrically connects the second electrode unit and the first electrode unit. When a coagulation current is passed through the first electrode unit via the second electrode unit, the distal end of the first electrode unit (including the second electrode unit) is pressed against the body tissue including the bleeding site, allowing for a coagulation treatment to be performed in which the bleeding site and the surrounding body tissue are cauterized to stop the bleeding.

[0004] A high-frequency knife that operates as described above has a long tube that is inserted into the body and an operating unit for operating the tube from outside the body. The high-frequency knife requires that the wire, which is inserted into the tube and has an electrode at its tip, be properly guided to the treatment site by operating the operating unit. [Prior art documents] [Patent documents]

[0005] [Patent Document 1] Japanese Patent Application Laid-Open No. 2006-326157 Summary of the Invention [Problem to be solved by the invention]

[0006] However, although Patent Document 1 discloses a technique for advancing and retracting a wire to cause an electrode (second electrode portion) to protrude or retract relative to another portion (first electrode portion), it is not easy to adjust the amount of protrusion to the marking position. The present invention has been made in view of the above points, and has as its object to provide an endoscopic needle scalpel that can suitably mark and incise biological tissue. [Means for solving the problem]

[0007] The endoscopic needle scalpel of the present invention is an endoscopic needle scalpel that is inserted into a channel of an endoscope and used to mark and incise biological tissue, and includes a needle treatment section that has an electrode at its tip that is powered by a power supply wire and that performs treatment on biological tissue, and a tubular body having an inner cavity that can accommodate a part of the needle treatment section, and the tubular body has a proximal reduced diameter section where the inner cavity is narrowed, a distal reduced diameter section that is distal to the proximal reduced diameter section, and a distal reduced diameter section that is provided between the proximal reduced diameter section and the distal reduced diameter section, and the inner cavity is narrowed between the proximal reduced diameter section and the distal reduced diameter section. and an enlarged diameter portion having a diameter larger than the inner diameter of the proximal reduced diameter portion and the inner diameter of the distal reduced diameter portion, wherein the needle-shaped treatment portion is formed to have a diameter larger than the inner diameter of the proximal reduced diameter portion and the inner diameter of the distal reduced diameter portion, and has an engaged portion formed to have a diameter larger than the periphery and housed in the enlarged diameter portion, and when the power supply wire is retracted and the engaged portion abuts against the proximal reduced diameter portion, the proximal reduced diameter portion restricts the position of the needle-shaped treatment portion to a first protruding position, and when the power supply wire is advanced and the engaged portion abuts against the distal reduced diameter portion, the distal reduced diameter portion restricts the position of the needle-shaped treatment portion to a second protruding position. The engaged portion is a joint that joins the power supply wire and the electrode, and an opening that is connected to the expanded diameter portion and has a width larger than the width of the joint is formed on the outer peripheral surface of the tube, and the opening is formed only on one radial side of the tube, and the inner wall surface of the expanded diameter portion on the opposite radial side of the tube abuts against the joint so that the joint housed in the expanded diameter portion is positioned concentrically with the axis of the tube. It is characterized by: [Effects of the Invention]

[0008] The present invention can provide an endoscopic needle scalpel that can suitably mark and incise biological tissue. [Brief explanation of the drawings]

[0009] [Figure 1] 1 is a diagram showing the appearance of an endoscopic needle scalpel according to an embodiment of the present invention. FIG. [Figure 2] 2 is a diagram showing the state in which the needle scalpel for endoscope shown in FIG. 1 is inserted into an endoscope and used. FIG. [Figure 3] FIG. 2 is a schematic perspective view for explaining the structure of the distal end side of the endoscopic needle scalpel. [Figure 4] 4 is a vertical cross-sectional view of part IV in FIG. 1, showing the connection between the tube part and the cap. FIG. [Figure 5](a) shows a state in which the protruding length of the needle-like treatment part is relatively short, and (b) shows a state in which the protruding length of the needle-like treatment part is relatively long. [Figure 6] 1A is a plan view of the stopper portion, FIG. 1B is a bottom view of the stopper portion, and FIG. 1C is a front view of the stopper portion. [Figure 7] FIG. 1(a) is a diagram showing the state of the electrodes during marking, and FIG. 1(b) is a diagram showing the state of the electrodes during pre-cutting. [Figure 8] FIG. 10(a) is a diagram showing a state in which marking is being performed, and FIG. 10(b) is a diagram showing a state in which pre-cutting is being performed. DETAILED DESCRIPTION OF THE INVENTION

[0010] An endoscopic needle scalpel 1 according to one embodiment of the present invention will be described below. In the description of this embodiment, the same components or members will be designated by the same reference numerals, and some of the description may be omitted. The drawings shown in this embodiment are intended to explain the structure, function, and operation of the endoscopic needle scalpel 1 of the present invention, but do not define its specific shape. Therefore, the drawings do not necessarily accurately depict the dimensional ratios of the length, height, thickness, and other dimensions of the components that make up the endoscopic needle scalpel. In this document, the proximal side (base end side) refers to the side that is positioned closer to the surgeon during the procedure, and the distal side (tip end side) refers to the side that is positioned further away from the surgeon during the procedure.

[0011] <Summary> First, an overview of an endoscopic needle scalpel 1 according to this embodiment will be described mainly with reference to Fig. 1 to Fig. 3. Fig. 1 is a diagram showing the appearance of the endoscopic needle scalpel 1 according to this embodiment. Fig. 2 is a diagram showing the endoscopic needle scalpel 1 shown in Fig. 1 inserted into an endoscope 200 for use, and Fig. 3 is a schematic perspective view for explaining the structure of the distal end side of the endoscopic needle scalpel 1.

[0012] The needle scalpel 1 for an endoscope according to this embodiment is inserted into a channel 210 of an endoscope 200 shown in FIG. 2 and used to mark and incise biological tissue (lesion 60, see FIG. 8). The endoscopic needle scalpel 1 comprises a needle treatment section 30 having an electrode 30a at its tip end that is powered by a power supply wire 11 and that performs treatment on biological tissue (lesion area 60), and a tubular body (stopper section 16) having an inner cavity 16k that can accommodate a portion of the needle treatment section 30 inside. The stopper portion 16 includes a proximal reduced diameter portion (slit 16d) where the inner cavity 16k is narrowed, a distal reduced diameter portion (circular hole portion 16e, see Figure 6(c)) located distal to the slit 16d, and an expanded diameter portion 16f provided between the slit 16d and the circular hole portion 16e, where the inner cavity 16g has a larger diameter than the slit 16d and the circular hole portion 16e. The needle-shaped treatment portion 30 is formed with a diameter larger than the inner diameter of the slit 16d and the inner diameter of the circular hole portion 16e, and has an engaged portion (connecting pipe 14) formed with a diameter larger than the surrounding area and accommodated in the expanded diameter portion 16f. When the power supply wire 11 is retracted, the joining pipe 14 abuts against the proximal reduced diameter portion (the peripheral wall of the slit 16d), and the peripheral wall of the slit 16d restricts the position of the needle-like treatment unit 30 to the first protruding position. When the power supply wire 11 is advanced, the joining pipe 14 abuts against the peripheral wall of the circular hole 16e, and the distal reduced diameter portion (the peripheral wall of the circular hole 16e) restricts the position of the needle-like treatment unit 30 to the second protruding position.

[0013] In this embodiment, "the bore 16k is narrowed" means that at least a part of the bore 16k in the circumferential direction is formed to be smaller in the radial direction than the adjacent part on the axially inner side of the stopper portion 16. As described above, the "proximal reduced diameter portion" is a concept that includes the slit 16d and the peripheral wall of the slit 16d that defines the slit 16d, and the "distal reduced diameter portion" is a concept that includes the circular hole portion 16e and the peripheral wall of the circular hole portion 16e that defines the circular hole portion 16e. In addition, the "inner diameter" of the proximal reduced diameter portion or the distal reduced diameter portion refers to the diameter of an imaginary circle tangent to the opposing inner wall surfaces when they are configured to include opposing inner wall surfaces.

[0014] According to the above configuration, the stopper portion 16 makes it easier to set the position of the needle-shaped treatment portion 30 to the first protrusion position and the second protrusion position, and marking and incision (pre-cutting) of biological tissue (lesion area 60) can be performed preferably by varying the amount of protrusion of the needle-shaped treatment portion 30.

[0015] [Overall configuration] As shown in Fig. 1, the endoscopic needle scalpel 1 includes an operation section 20, a needle treatment section 30, and a tube section 10 that connects the operation section 20 and the needle treatment section 30. Such an endoscopic needle scalpel 1 is inserted into a channel 210 of an endoscope 200 shown in Fig. 2 and is used to mark and incise biological tissue (lesion 60). As shown in Fig. 2, an objective lens 230 and a light guide 220 are formed on the endoscope 200.

[0016] A power feeder wire 11 (see FIG. 3) is inserted through the inner cavity of the tubular portion 10. The endoscopic needle scalpel 1 includes a needle-shaped treatment section 30 that is provided at the tip of the power feeder wire 11 and is supplied with power via the power feeder wire 11, the tubular portion 10 that houses the power feeder wire, and an operation section 20 that is provided on the proximal end side of the tubular portion 10 and operates the power feeder wire 11 and the needle-shaped treatment section 30 to move forward and backward. The above configuration will be explained below in order.

[0017] [Operation section] As shown in FIG. 1 , the operating unit 20 is a member that adjusts the projection length of the needle-shaped treatment unit 30 by operating the power supply wire 11 in the tube unit 10 to advance or retreat. The operating unit 20 includes a handle 22, a shaft 21, a slider 23, and a power plug 24. The handle 22 is a part that is held by an operator. The shaft 21 is cylindrical, and when the slider 23 is slid in the axial direction of the shaft 21, the power supply wire 11 slides toward the distal end or proximal end in accordance with the movement of the slider 23. The power plug 24 can be connected to a power cable (not shown) that is connected to an external power source, and when electricity is applied, a high-frequency current can be applied to the needle-shaped treatment unit 30 via the power supply wire 11.

[0018] 1 and 4, a cap 25 is provided at the distal end of the operating section 20. Fig. 4 is a longitudinal cross-sectional view of section IV in Fig. 1, showing the connection between the tube section 10 and the cap 25. The proximal end side of the tube section 10, which will be described later, is attached to the cap 25 of the operating section 20. Specifically, as shown in FIG. 4, the tip of cap 25 extends distally, and a receiving groove 25a is formed on the outer periphery of the tip of cap 25 to receive the proximal end of anti-break tube 10a. The cap 25 has a locking projection 25b that projects radially outward, and a ridge connection portion 25c that is made up of a plurality of ridges that extend in the circumferential direction and are spaced apart in the axial direction.

[0019] The locking protrusion 25b is a portion that locks onto the anti-breakage tube 10a and is adjacent to the accommodating groove 25a on the distal side. The locking protrusion 25b is formed in a trapezoidal cross section, and its diameter decreases from the central portion toward the distal side. The outer diameter of the ridge connecting portion 25c is formed to be larger than the inner diameter of the sheath 12 (and the anti-break tube 10a) in its natural state.

[0020] [Tube section] Next, the tube portion 10 will be described mainly with reference to Fig. 4 in addition to Figs. 1 to 3. Fig. 4 is a cross-sectional view showing the connection portion between the tube portion 10 and the cap 25. In Fig. 4, the lead pipe and power supply wire 11 (not shown) are omitted. As shown in FIGS. 3 and 4, the tube portion 10 includes an insulating sheath 12 (shown by a two-dot chain line in FIG. 3) and a break-preventing tube 10a that covers the outer periphery of the proximal end of the sheath 12.

[0021] The sheath 12 is a member that covers and protects the power supply wire 11 and the stopper portion 16, which will be described later. The sheath 12 is long and flexible, and is inserted into a channel 210 shown in FIG. 2. The maximum diameter of the sheath 12 according to this embodiment is preferably in the range of 0.9 mm to 4.8 mm, and in this embodiment, the diameter is 2.6 mm, so that it can be inserted into a channel 210 with a diameter of 2.8 mm or more. The length of the sheath 12 is, for example, in the range of 1500 mm to 2500 mm, and in this embodiment, the length is 1650 mm.

[0022] The sheath 12 according to this embodiment is made of a resin material that is insulating, heat-resistant, flexible, and slippery. The resin material may be a single type of resin, a mixture of multiple types of resin, or a mixture of resin and other materials. More specifically, one or more flexible materials such as fluorine-based resins, polyolefin-based resins, polyamide-based resins, polyimide-based resins, polyurethane-based resins, and polycarbonate-based resins may be appropriately selected and used. The sheath 12 according to this embodiment is made of a perfluoroethylene-hexafluoropropylene copolymer (FEP). The proximal end of the sheath 12 is press-fitted into the distal end of the cap 25 and is attached in a state where it abuts against the distal end surface of the locking protrusion 25b beyond the protruding connecting portion 25c.

[0023] Specifically, the outer periphery of the portion of the sheath 12 press-fitted into the distal end of the cap 25 is covered by the coil spring 26. The inner diameter of the coil spring 26 in its natural state is smaller than the outer diameter of the distal end of the cap 25. Therefore, the sheath 12 press-fitted into the distal end of the cap 25 is tightly fixed to the protrusion connecting portion 25c by the elastic restoring force applied radially inward from the coil spring 26. Therefore, when a user moves the power supply wire 11 in the axial direction, the sheath 12 covering the outer periphery of the power supply wire 11 can be prevented from being dragged by the power supply wire 11 and moving by the force of the coil spring 26.

[0024] 4, the coil spring 26 is embedded in the breakage prevention tube 10a by thermal fusion, but the invention is not limited to this configuration. The breakage prevention tube 10a may be attached to the coil spring 26 and the cap 25 by its elastic restoring force. The distal end of the sheath 12 is bonded to the outer peripheral surface of a tube (stopper portion 16) described below with an adhesive (not shown).

[0025] The power supply wire 11 is a wire that slides freely back and forth in the axial direction within the lumen of the tube section 10 by operating the operating section 20, and also serves as an operating wire for moving the tip of the tube section 10 to a desired position. The outer diameter of the power supply wire 11 is preferably in the range of, for example, 0.25 mm or more and 1.0 mm or less. The tube portion 10 has at its tip a stopper portion 16 (described later) from which the needle-shaped treatment portion 30 projects and is accommodated.

[0026] [Needle treatment part] Next, the needle-shaped treatment portion 30 will be described mainly with reference to Fig. 5 in addition to Fig. 1 to Fig. 4. Fig. 5(a) shows a state in which the protruding length of the needle-shaped treatment portion 30 is relatively short, and Fig. 5(b) shows a state in which the protruding length of the needle-shaped treatment portion 30 is relatively long.

[0027] The needle-shaped treatment unit 30 is provided at the tip of the power supply wire 11, and a high-frequency current is passed through it. The power is passed through it by connecting a power cable (not shown) to a power plug 24 protruding from the operation unit 20 shown in FIG. The needle-shaped treatment portion 30 is a needle-shaped electrode that receives power, passes current through the treatment site, marks the area to be treated, and pre-cuts the marked treatment site. Note that "needle-shaped" here indicates a protrusion with a smaller diameter than the tubular portion 10, and may have other shapes, such as a spherical shape.

[0028] The state in which the needle treatment unit 30 has a short protrusion length, as shown in Fig. 5(a), is achieved by sliding the slider 23 in the operation unit 20 toward the handle 22 to retract the power supply wire 11. The state in which the needle treatment unit 30 has a long protrusion length, as shown in Fig. 5(b), is achieved by sliding the slider 23 toward the tube unit 10 to advance the power supply wire 11. The needle-shaped treatment portion 30 is used for marking the treatment site when the protruding length is short, and is used for pre-cutting the treatment site when the protruding length is long.

[0029] The power supply wire 11 is a member that transmits a force generated by an operation performed on the operation unit 20 to the needle treatment unit 30. The power supply wire 11 is also made of a strand of multiple metal wires, and also functions as a path for supplying high-frequency current to the needle treatment unit 30. Specifically, the power supply wire 11 is made of a strand of stainless steel. For convenience, the power supply wire 11 is shown in each drawing as having a circular cross section. In this embodiment, the power supply wire 11 advances or retreats within the tube portion 10 by sliding the slider 23 back and forth. As the power supply wire 11 advances or retreats, the length by which the needle-shaped treatment portion 30, which is in contact with the tip of the power supply wire 11, protrudes from the tube portion 10 changes. In other words, the operation portion 20 can change the protruding length of the needle-shaped treatment portion 30.

[0030] The joining pipe 14 is hollow, and the power supply wire 11 and the needle-shaped treatment section 30 (electrode 30a) are inserted into the hollow portion from opposite directions and welded to each other. The power supply wire 11 is connected to the electrode 30a by the joining pipe 14 to supply power.

[0031] The locked portion explained in the above summary is the joint portion (joining pipe 14) that joins the power supply wire 11 and the electrode 30a. According to the above configuration, the joining pipe 14 can function as both a locked portion that is locked by the stopper portion 16 and a joining portion that joins the power supply wire 11 and the electrode 30a.

[0032] In this embodiment, the joining pipe 14 is used as an example of the "engaged portion," but the present invention is not limited to this configuration as long as it is engaged with the proximal reduced diameter portion and the distal reduced diameter portion. For example, the "engaged portion" may be a portion of the power supply wire 11 that protrudes radially from the surrounding area, or a portion of the electrode 30a that protrudes radially from the surrounding area. Note that when the engaged portion is provided on the power supply wire 11, the power supply wire 11 is technically considered to belong to the needle-like treatment unit 30.

[0033] [Stopper part] Next, the stopper portion 16 will be described mainly with reference to Figures 6 and 7. Figure 6(a) is a plan view of the stopper portion 16, Figure 6(b) is a bottom view of the stopper portion 16, and Figure 6(c) is a front view of the stopper portion 16. Figure 7(a) is a diagram showing the state of the electrode 30a during marking, and Figure 7(b) is a diagram showing the state of the electrode 30a during pre-cutting. Note that the sheath 12 is not shown in Figure 7.

[0034] As shown in Figure 3, the proximal end side of the stopper portion 16 is housed in the distal end portion of the sheath 12. The stopper portion 16 according to this embodiment is made of insulating, heat-resistant ceramics and has a large diameter portion 16a and a small diameter portion 16b. The outer diameter of the large diameter portion 16a is approximately equal to the outer diameter of the sheath 12, and it is preferable that the boundary between the large diameter portion 16a and the sheath 12 is flush. The outer diameter of the small diameter portion 16b is not particularly limited as long as it can be housed in the sheath 12.

[0035] The small diameter portion 16b is formed with a lumen 16k capable of accommodating the joining pipe 14. A step 16c is formed on the inner peripheral surface of the small diameter portion 16b that forms the lumen 16k, and the power supply wire 11 is positioned and held by the step 16c and loosely inserted into the lumen 16k.

[0036] As shown in FIG. 6, an opening 16g is formed on the outer circumferential surface of the tube (stopper portion 16), which is connected to the expanded diameter portion 16f and has a width larger than that of the joint portion (joining pipe 14). In other words, the expanded diameter portion 16f of the lumen 16k communicates with the outside (the hollow space of the sheath 12 when the sheath 12 is attached) via the opening 16g in the radial direction relative to the central axis. According to the above configuration, it is possible to accommodate the joining pipe 14 from the outer peripheral surface of the stopper portion 16 into the expanded diameter portion 16f through the opening 16g.

[0037] The opening 16g according to this embodiment is formed to have a width greater than the width of the joining pipe 14 and a length greater than the axial length of the joining pipe 14. The formation of the opening 16g allows the joining pipe 14 to be widely exposed to the outside. Therefore, with the joining pipe 14, the tip end of the power feeder wire 11, and the base end of the electrode 30a housed within the stopper portion 16, the user can easily weld the joining pipe 14 and the power feeder wire 11, and the joining pipe 14 and the electrode 30a, through the opening 16g. In particular, when the ceramic stopper portion 16 according to the present embodiment has higher rigidity than, for example, a resin material, it may be difficult to assemble the power supply wire 11 and the electrode 30a into the stopper portion 16 after welding them to the connecting pipe 14. Even in such a case, after the electrode 30a is passed through the circular hole 16e formed at the distal end of the stopper portion 16, welding can be performed through the opening 16g while the joining pipe 14 and the power supply wire 11 are butted together.

[0038] However, the present invention is not limited to this configuration, and the axial length of the opening 16g may be shorter than the length of the joining pipe 14. Even in this case, the joining pipe 14 can be stored in the expanded diameter portion 16f by passing the joining pipe 14 through the opening 16g at an angle within an imaginary plane connecting the center line of the stopper portion 16 and the center of the stopper portion 16. This configuration is suitable when there is no need to expose the joining pipe 14 to the stopper portion 16, because the joining pipe 14 and the power supply wire 11, and the joining pipe 14 and the electrode 30a are attached by adhesive or a fitting structure rather than by welding.

[0039] Furthermore, the opening 16g is formed up to the proximal end of the stopper portion 16. Because the opening 16g is formed in this manner, the user can easily route the power supply wire 11 through the opening 16g so that the power supply wire 11 extends from the expanded diameter portion 16f beyond the proximal end of the stopper portion 16.

[0040] 7, the axial movement range of the joining pipe 14 is defined by the enlarged diameter portion 16f of the stopper portion 16. In other words, the axial movement range of the electrode 30a joined to the joining pipe 14 is also equal to the movement range of the joining pipe 14. The state shown in FIG. 7(a) in which the joining pipe 14 is on the proximal side and abuts against the step portion 16c, and the electrode 30a slightly protrudes from the stopper portion 16, is the state during marking. The state shown in FIG. 7(b) in which the joint pipe 14 is on the distal side and abuts against the distal end face of the enlarged diameter portion 16f, and the electrode 30a protrudes largely from the stopper portion 16, is the pre-cut state.

[0041] 6, opening 16g is formed on only one radial side of the tubular body (stopper portion 16). An inner wall surface 16h of expanded diameter portion 16f on the opposite radial side of stopper portion 16 abuts against joining pipe 14 so that the joining portion (joining pipe 14) housed in expanded diameter portion 16f is positioned concentrically with the axis of stopper portion 16. In other words, the distance between the center of the expanded diameter portion 16f and the inner wall surface 16h is equal to the radius of the joining pipe 14 (including a substantially equal length to the extent of manufacturing tolerance). According to the above-described configuration, the joint pipe 14 housed through the opening 16g can be suitably centered, and the user can easily connect the power supply wire 11 and the electrode 30a to the joint pipe 14.

[0042] As shown in FIGS. 6(a) and 6(c), a protruding ridge 16i is formed on the edge of the opening 16g on the outer circumferential surface of the stopper portion 16, protruding radially outward from the surrounding area. Then, with adhesive applied to the outer periphery of the small diameter portion 16b of the stopper portion 16, the distal end portion of the sheath 12 is inserted into the small diameter portion 16b, thereby bonding the stopper portion 16 and the sheath 12 together.

[0043] According to the above configuration, when the sheath 12 is joined to the tubular body (stopper portion 16) using adhesive, the adhesive can be prevented from flowing into the opening 16g, and the adhesive can be prevented from affecting the relative movement of the needle-shaped treatment portion 30 with respect to the stopper portion 16.

[0044] 6(a) and 6(b), a protrusion 16j is formed on the outer peripheral surface of the tube (stopper portion 16) on the radially opposite side of the side where the protruding ridges 16i are formed, protruding radially outward from the periphery. The protrusion amount of the protrusion 16j and the protruding amount of the protruding ridges 16i are equal (including approximately equal due to differences in manufacturing tolerances). Specifically, the protruding ridge 16i is formed with the same width as the width of the protruding portion 16j, and the length and position in the axial direction of the stopper portion 16 are the same as the length and position of the protruding portion 16j. According to the above configuration, the ridge 16i and the protrusion 16j can prevent the adhesive contained between the sheath 12 and the tubular body (stopper portion 16) from being contained unevenly to one side in the radial direction. That is, in the circumferential direction of the stopper portion 16, the adhesive applied to the outer periphery of the stopper portion 16 can be left in at least two regions separated by the ridge 16i and the protrusion 16j.

[0045] [About the procedure] Next, a part of the submucosal dissection procedure will be explained mainly with reference to Figures 8(a) and 8(b). Figure 8(a) shows the state where marking is being performed, and Figure 8(b) shows the state where pre-cutting is being performed.

[0046] First, as shown in Fig. 8(a), an endoscope 200 is inserted into the body, and a plurality of marks 61 are made (marked) around a lesion 60 to indicate the area to be cut out using an endoscopic needle scalpel 1 inserted through the endoscope 200. This marking is performed using the endoscopic needle scalpel 1 in the state shown in Fig. 5(a) and Fig. 7(a).

[0047] Next, a drug is injected into the submucosal layer to lift the lesion 60. Then, as shown in Figure 8(b), the mucosa around the lesion 60 is cut (pre-cut) using the endoscopic needle scalpel 1 so as to pass outside the marks 61. This pre-cut is performed using the endoscopic needle scalpel 1 in the state shown in Figures 5(b) and 7(b).

[0048] After the pre-cutting, the lesion 60 is excised using a knife (not shown) passed through the endoscope 200, the lesion 60 is removed, and bleeding is stopped, completing the procedure. Then, a pathological examination or the like is performed on the excised lesion 60.

[0049] The various components of the endoscopic needle scalpel 1 of the present invention do not necessarily have to exist independently. It is acceptable for multiple components to be formed as a single member, for one component to be formed from multiple members, for one component to be part of another component, or for part of one component to overlap with part of another component, etc.

[0050] The above embodiment encompasses the following technical ideas. (1) A needle-shaped scalpel for an endoscope is inserted into a channel of an endoscope and used to mark and incise biological tissue, a needle-shaped treatment unit having an electrode at its tip end to which power is supplied by a power supply wire, and performing treatment on living tissue; a tubular body having an inner cavity capable of accommodating a part of the needle-shaped treatment portion therein; The tubular body includes a proximal reduced diameter portion where the lumen is narrowed, a distal reduced diameter portion located distal to the proximal reduced diameter portion, and an expanded diameter portion provided between the proximal reduced diameter portion and the distal reduced diameter portion, the lumen having a larger diameter than the proximal reduced diameter portion and the distal reduced diameter portion, the needle-shaped treatment portion has a diameter larger than the inner diameter of the proximal reduced diameter portion and the inner diameter of the distal reduced diameter portion, and has a locked portion formed with a diameter larger than the surrounding area and accommodated in the enlarged diameter portion; When the power supply wire is retracted and the locked portion abuts against the proximal reduced diameter portion, the proximal reduced diameter portion limits the position of the needle-like treatment portion to a first protruding position, a distal reduced diameter portion configured to restrict the position of the needle treatment portion to a second protruding position when the power supply wire advances and the locked portion abuts against the distal reduced diameter portion; (2) The needle scalpel for an endoscope according to (1), wherein the locked portion is a joint portion that joins the power supply wire and the electrode. (3) The needle scalpel for an endoscope according to (2), wherein an opening is formed on the outer peripheral surface of the tubular body, the opening being connected to the enlarged diameter portion and having a width greater than the width of the joint portion. (4) the opening is formed on only one radial side of the pipe body, The inner wall surface of the enlarged diameter portion on the opposite radial side of the tubular body abuts against the joint portion so that the joint portion housed in the enlarged diameter portion is positioned concentrically with the axis of the tubular body. (3) A needle scalpel for an endoscope as described above. (5) a sheath bonded to the outer peripheral surface of the tubular body by an adhesive; The needle scalpel for endoscopes according to (3) or (4), wherein a protruding ridge that protrudes radially outward from the periphery is formed on the edge of the opening on the outer circumferential surface of the tubular body. (6) a protrusion formed on the outer peripheral surface of the tube body on the opposite side in the radial direction from the side on which the protruding line is formed, the protrusion protruding radially outward from the periphery, The needle scalpel for an endoscope according to (5), wherein the protruding portion and the protruding muscle have the same protruding amount. [Explanation of symbols]

[0051] 1 Endoscopic needle scalpel 10 Tube section 10a Anti-break tube 11 Power supply wire 12 Sheath 14 Joint pipe (retained part, joint part) 16 Stopper part (tube body) 16a Large diameter section 16b Small diameter section 16c Step 16d Slit (proximal narrowing part) 16e Circular hole (distal narrowed portion) 16f Expanded diameter part 16g opening 16h Inner wall surface 16i protrusion 16j Projection 16k lumen 20 Control section 21 Shaft 22 Handle 23 Slider 24 power plug 25 Cap 25a Receiving groove 25b Locking protrusion 25c Ridge connection 26 Coil spring 30 Needle treatment area 30a electrode 60 Lesion (biological tissue) 61 marks 200 Endoscope 210 channels

Claims

1. A needle-shaped scalpel for an endoscope is inserted into a channel of an endoscope and used to mark and incise biological tissue, a needle-shaped treatment unit having an electrode at its tip end to which power is supplied by a power supply wire, and performing treatment on living tissue; a tubular body having an inner cavity capable of accommodating a part of the needle-shaped treatment portion therein; The tubular body includes a proximal reduced diameter portion where the lumen is narrowed, a distal reduced diameter portion located distal to the proximal reduced diameter portion, and an expanded diameter portion provided between the proximal reduced diameter portion and the distal reduced diameter portion, the lumen having a larger diameter than the proximal reduced diameter portion and the distal reduced diameter portion, the needle-shaped treatment portion has a diameter larger than the inner diameter of the proximal reduced diameter portion and the inner diameter of the distal reduced diameter portion, and has a locked portion formed with a diameter larger than the surrounding area and accommodated in the enlarged diameter portion; the power supply wire is retracted and the locked portion abuts against the proximal reduced diameter portion, whereby the proximal reduced diameter portion limits the position of the needle-like treatment portion to a first protruding position; When the power supply wire advances and the locked portion abuts against the distal reduced diameter portion, the distal reduced diameter portion limits the position of the needle-like treatment portion to a second protruding position, the engaged portion is a joining portion that joins the power supply wire and the electrode, an opening is formed on the outer circumferential surface of the pipe body, the opening being connected to the expanded diameter portion and having a width larger than a width of the joint portion; the opening is formed on only one radial side of the pipe body, The inner wall surface of the enlarged diameter portion on the opposite radial side of the tubular body abuts against the joint portion so that the joint portion housed in the enlarged diameter portion is positioned concentrically with the axis of the tubular body.

2. A needle-shaped scalpel for an endoscope that is inserted into a channel of an endoscope and used to mark and incise biological tissue, a needle-shaped treatment unit having an electrode at its tip end to which power is supplied by a power supply wire, and performing treatment on living tissue; a tubular body having an inner cavity capable of accommodating a part of the needle-shaped treatment portion therein; The tubular body includes a proximal reduced diameter portion where the lumen is narrowed, a distal reduced diameter portion located distal to the proximal reduced diameter portion, and an expanded diameter portion provided between the proximal reduced diameter portion and the distal reduced diameter portion, the lumen having a larger diameter than the proximal reduced diameter portion and the distal reduced diameter portion, the needle-shaped treatment portion has a diameter larger than the inner diameter of the proximal reduced diameter portion and the inner diameter of the distal reduced diameter portion, and has a locked portion formed with a diameter larger than the surrounding area and accommodated in the enlarged diameter portion; the power supply wire is retracted and the locked portion abuts against the proximal reduced diameter portion, whereby the proximal reduced diameter portion limits the position of the needle-like treatment portion to a first protruding position; When the power supply wire advances and the locked portion abuts against the distal reduced diameter portion, the distal reduced diameter portion limits the position of the needle-like treatment portion to a second protruding position, the engaged portion is a joining portion that joins the power supply wire and the electrode, an opening is formed on the outer circumferential surface of the pipe body, the opening being connected to the expanded diameter portion and having a width larger than a width of the joint portion; a sheath bonded to the outer peripheral surface of the tubular body by an adhesive; A needle scalpel for an endoscope has a protruding ridge formed on the edge of the opening on the outer peripheral surface of the tubular body, protruding radially outward from the periphery.

3. a protrusion formed on the outer peripheral surface of the tube body on the opposite side in the radial direction from the side on which the protruding line is formed, the protrusion protruding radially outward from the periphery, 3. The needle scalpel for endoscope use according to claim 2, wherein the protruding portion and the protruding ridge are equal in protruding amount.

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