Crushing tool and attachment for crushing tool

Abstract

This crushing tool comprises: a sheath; a tip member attached to a tip of the sheath; and a basket wire protruding from a tip of the tip member. The tip member has a wire guide for guiding the basket wire. The wire guide is disposed radially outward from a tip surface of the tip member.

Description

Crushing tools and crushing tool attachments

[0001] The present disclosure relates to a crusher and an attachment for the crusher.

[0002] Basket forceps (basket grasping forceps, basket-type grasping forceps) are used as lithotripsy tools to break up stones formed in the bile duct, etc. Basket forceps are formed into a basket shape using wire. The user places the stone into the basket forceps and closes the basket forceps to clamp the stone, thereby breaking it up. Stone breaking with basket forceps is simple and low-cost. However, stone breaking with basket forceps tends to lack the breaking force, and there are cases where the stone cannot be broken up completely.

[0003] Basket forceps with improved crushing power have been devised to crush stones appropriately. For example, Patent Documents 1 and 2 disclose basket forceps that crush stones using a crushing member other than a wire.

[0004] U.S. Patent No. 5,176,688 U.S. Patent No. 9,168,099

[0005] However, the conventional basket forceps described in Patent Documents 1 and 2 may not be able to crush a stone depending on the position of the stone. For example, when a stone is caught in a position that is off the central axis of the basket forceps, it is difficult to apply a crushing force evenly to the stone, making it difficult to crush the stone.

[0006] In consideration of the above circumstances, an object of the present disclosure is to provide a crushing tool and an attachment for the crushing tool that can crush stones suitably regardless of the position of the stones that have been taken in.

[0007] In order to solve the above problems, this disclosure proposes the following means: A crushing tool according to a first aspect of the present disclosure comprises a sheath, a tip member attached to the tip of the sheath, and a basket wire protruding from the tip of the tip member, the tip member having a wire guide that guides the basket wire, and the wire guide is disposed radially outward from the tip surface of the tip member.

[0008] A crushing tool attachment according to a second aspect of the present disclosure has a guide lumen through which a basket wire passes, and the guide lumen has an inclined surface that inclines radially outward from the base end to the tip end.

[0009] A crushing tool according to a third aspect of the present disclosure comprises a sheath, a tip member attached to the tip of the sheath, and a basket formed by a basket wire protruding from the tip of the tip member, and when a stone is captured by the basket and the basket wire is further pulled toward the base end of the sheath, the tip of the tip member is pressed against the stone.

[0010] According to the crushing tool and the attachment for the crushing tool of the present disclosure, stones can be crushed suitably regardless of the position of the trapped stone.

[0011] 1 is an overall view of an endoscopic treatment system according to a first embodiment; FIG. 1 is an overall view showing a crushing tool of the endoscopic treatment system; FIG. 2 is a perspective view of a tip portion of the crushing tool; FIG. 3 is a cross-sectional view of the tip portion of the crushing tool; FIG. 4 is a view showing a bile duct to be treated; FIG. 5 is a view showing a taking-in process; FIG. 6 is a cross-sectional view of the tip portion of the crushing tool in the crushing process; FIG. 7 is a cross-sectional view of the tip portion of the crushing tool in the crushing process; FIG. 8 is a view showing a conventional tip member (comparative example) without a tapered portion; FIG. 9 is a perspective view of a tip portion of a modified example of the crushing tool; FIG. 10 is a perspective view of a tip portion of a crushing tool according to a second embodiment; FIG. 11 is a cross-sectional view of the tip portion of the crushing tool; FIG. 12 is a front view of the tip portion of the crushing tool as seen from the tip side; FIG. 13 is a front view of a modified example of the tip portion of the crushing tool; FIG. 14 is a perspective view of a tip portion of a crushing tool according to a third embodiment; FIG. 15 is a cross-sectional view of the tip portion of the crushing tool; FIG. 16 is a perspective view of a tip portion of a modified example of the crushing tool; FIG. 17 is a cross-sectional view of the tip portion of the modified example; FIG. 18 is a perspective view of a crushing tool according to a third embodiment; FIG. 19 is a cross-sectional view of the tip portion of the crushing tool; FIG. 19 is a perspective view of a tip portion of a modified example of the crushing tool; FIG. 19 is a cross-sectional view of the tip portion of the modified example; FIG. 19 is a perspective view of a crushing tool according to a third embodiment; FIG. 19 is a cross-sectional view of the tip portion of the crushing tool; 1 is a perspective view of a conventional crushing tool and an attachment attached to the conventional crushing tool;

[0012] First Embodiment An endoscopic treatment system 300 including a crushing tool 100 according to a first embodiment of the present invention will be described with reference to FIGS. 1 to 10. FIG.

[0013] [Endoscopic Treatment System 300] Fig. 1 is an overall view of an endoscopic treatment system 300. As shown in Fig. 1, the endoscopic treatment system 300 includes a crushing tool 100 and an endoscope 200. The crushing tool 100 is inserted into the endoscope 200 for use.

[0014] [Endoscope 200] The endoscope 200 is a known side-viewing flexible endoscope, and includes a long insertion section 210 and an operation section 220 provided at the base end of the insertion section 210. Note that the endoscope 200 may also be a direct-viewing flexible endoscope.

[0015] The insertion section 210 has a tip rigid section 211 provided at the tip, a bending section 212 that can be bent and is provided on the base end side of the tip rigid section 211, and a flexible tube section 213 that is provided on the base end side of the bending section 212. An imaging unit 216 having a light guide 215 and a CCD is provided on the side surface of the tip rigid section 211 in a state that it is exposed to the outside.

[0016] The insertion section 210 is formed with a treatment instrument channel 230 for inserting the crushing tool 100. A distal end 230a of the treatment instrument channel 230 opens on the side surface of the distal hard section 211. A proximal end of the treatment instrument channel 230 extends to the operation section 220.

[0017] An elevator 214 (see FIG. 6 ) is provided on the distal end hard portion 211 of the treatment instrument channel 230. The proximal end of the elevator 214 is rotatably supported by the distal end hard portion 211. An elevator operating wire (not shown) fixed to the distal end of the elevator 214 extends through the insertion section 210 toward the proximal end.

[0018] The bending portion 212 is configured to be bendable in the vertical and horizontal directions. The tip of a control wire is fixed to the tip side of the bending portion 212. The control wire extends through the insertion portion 210 to the control portion 220.

[0019] A knob 223 for operating the operating wire and a switch 224 for operating the imaging unit 216, etc., are provided on the proximal end side of the operation section 220. The user can bend the bending section 212 in a desired direction by operating the knob 223.

[0020] A forceps port 222 communicating with the treatment tool channel 230 is provided on the distal end side of the operation section 220. The user can insert the crushing tool 100 through the forceps port 222. A forceps plug 225 is attached to the forceps port 222 to prevent leakage of bodily fluids.

[0021] [Crushing Tool 100] Figure 2 is an overall view showing the crushing tool 100. The crushing tool 100 (also referred to as an endoscopic treatment tool 100) comprises a sheath 1, a manipulation wire 2 (see Figure 4), a tip member 3, a basket 4, and an operation section 5. In the following description, in the longitudinal direction A of the crushing tool 100, the side that is inserted into the patient's body will be referred to as the "tip side (distal side) A1," and the side that faces the operation section 5 will be referred to as the "base side (proximal side) A2."

[0022] Figure 3 is a perspective view of the distal end of the crushing tool 100. The sheath 1 is a flexible, long member extending from the distal end 1a to the proximal end 1b. The sheath 1 has an outer diameter that allows it to be inserted into the treatment instrument channel 230 of the endoscope 200. As shown in Figure 1, when the sheath 1 is inserted into the treatment instrument channel 230, the distal end 1a of the sheath 1 can protrude and retract from a distal end opening 230a of the treatment instrument channel 230. A control wire 2 is inserted into the internal space (lumen) 1s of the sheath 1.

[0023] The operation wire 2 is a metal wire that is inserted through the internal space 1s of the sheath 1. The distal end of the operation wire 2 is connected to the basket 4, and the proximal end of the operation wire 2 is connected to the operation unit 5.

[0024] 4 is a cross-sectional view of the tip of the crushing tool 100. The tip member 3 is attached to the tip 1a of the sheath 1. The tip member 3 is made of a metal such as stainless steel. The central axis O3 in the longitudinal direction A of the tip member 3 coincides with the central axis O1 in the longitudinal direction A of the sheath 1. The tip member 3 has a main body 31, a tapered portion 32, and a wire guide 34.

[0025] The main body 31 is formed in a cylindrical shape and is attached to the distal end 1a of the sheath 1. The internal space 3s of the main body 31 communicates with the internal space 1s of the sheath 1.

[0026] The tapered portion 32 is formed in a conical shape, and its length in the radial direction R decreases from the base end side A2 to the tip end side A1. A flat tip end surface 33 is formed at the tip of the tapered portion 32. The tip end surface 33 is a plane perpendicular to the longitudinal direction A of the crushing tool 100. Four wire guides 34 are formed on the tapered portion 32 along the circumferential direction C relative to the longitudinal direction A. Note that the tip end surface 33 does not necessarily have to be a plane perpendicular to the longitudinal direction A of the crushing tool 100, and may be, for example, a curved surface that is convex toward the tip end side A1.

[0027] The wire guides 34 are grooves that extend along the longitudinal direction A on the outer periphery of the tapered portion 32. The four wire guides 34 are arranged at different positions in the circumferential direction C of the tapered portion 32. The four wire guides 34 are arranged outward in the radial direction R with respect to the central axis O3. The four wire guides 34 are separated by walls 35 that are provided inward in the radial direction R of the tip member 3.

[0028] The wire guide 34 includes a first wire guide 341, a second wire guide 342, a third wire guide 343, and a fourth wire guide 344. The first wire guide 341, the second wire guide 342, the third wire guide 343, and the fourth wire guide 344 are arranged at equal intervals along the circumferential direction C.

[0029] The first wire guide 341 and the third wire guide 343 are disposed on either side of the central axis O3. The second wire guide 342 and the fourth wire guide 344 are disposed on either side of the central axis O3.

[0030] The tip 34a of the wire guide 34 is located on the side surface 32s of the tapered portion 32. Therefore, the wire guide 34 does not extend to the tip surface 33. In other words, the tip surface 33 is located closer to the tip chip 42 (distal side A1) than the tip 34a of the wire guide 34.

[0031] The base end 34b of the wire guide 34 extends to the main body 31. An opening (wire insertion portion, guide lumen) 36 that communicates with the internal space 3s of the main body 31 is formed between the main body 31 and the wire guide 34. The distal end surface 33 is located closer to the distal tip 42 side (distal side A1) than the opening 36.

[0032] The length L1 of the distal end surface 33 of the distal end member 3 in the radial direction R is preferably smaller than the inner diameter L2 at the distal end of the main body 31. Furthermore, the maximum distance L3 from the opening 36 to the distal end surface 33 is preferably greater than the inner diameter L2 of the main body 31.

[0033] The basket 4 is formed into a basket shape by four basket wires 41. The distal ends of the four basket wires 41 are attached to a distal tip 42. The proximal ends of the four basket wires 41 are attached to a bundling portion 43 provided at the distal end of the operating wire 2. The basket wires 41 are composed of solid wires or stranded wires made of a highly elastic material. Examples of materials that can be used for the basket wires 41 include nickel-titanium alloys, stainless steel, and stainless steel alloys.

[0034] The basket wires 41 protrude from the internal space 3s of the main body 31 to the distal end side A1 through the opening 36. The basket wires 41 protruding from the opening 36 to the distal end side A1 are guided in the forward and backward directions by the wire guide 34.

[0035] 4, the basket wires 41 have a plurality of bent portions 41c formed between the distal tip 42 and the bundled portion 43. Note that each basket wire 41 does not necessarily have to have a plurality of bent portions 41c, and may be smoothly curved from the distal tip 42 to the bundled portion 43. The basket 4 is configured so that the plurality of basket wires 41 expands into a basket shape in a natural state.

[0036] The basket wires 41 include a first basket wire 411, a second basket wire 412, a third basket wire 413, and a fourth basket wire 414. The first basket wire 411, the second basket wire 412, the third basket wire 413, and the fourth basket wire 414 are arranged at equal intervals along the circumferential direction C.

[0037] The first basket wires 411 and the third basket wires 413 are arranged on both sides of the central axis O3. The second basket wires 412 and the fourth basket wires 414 are arranged on both sides of the central axis O3.

[0038] First basket wire 411 is guided by first wire guide 341. Second basket wire 412 is guided by second wire guide 342. Third basket wire 413 is guided by third wire guide 343. Fourth basket wire 414 is guided by fourth wire guide 344.

[0039] The number of basket wires 41 is not limited to four, and may be, for example, three, five, or six. The number of wire guides 34 is changed according to the number of basket wires 41.

[0040] The operation section 5 is provided on the proximal end side A2 of the sheath 1. The operation section 5 includes an operation section main body 51, a slider 53, and a guidewire port 54.

[0041] The distal end of the operation portion main body 51 is connected to the proximal end 1b of the sheath 1. The operation wire 2 extends from the proximal end 1b of the sheath 1. The operation wire 2 is fixed to a slider 53.

[0042] The liquid supply port 52 is provided in the operation portion main body 51. The liquid supply port 52 is connected to the proximal end of the sheath 1 via a conduit formed in the operation portion main body 51. The liquid supplied from the liquid supply port 52 passes through the sheath 1 and is released from the tip member 3.

[0043] The slider 53 is attached to the operation unit main body 51 so as to be movable along the longitudinal direction A. The base end of the operation wire 2 is fixed to the slider 53. When the user moves the slider 53 forward or backward relative to the operation unit main body 51, the operation wire 2 moves forward or backward.

[0044] The guidewire port 54 is an opening through which a guidewire can be inserted.

[0045] [Operation of the Endoscopic Treatment System 300] Next, the operation of the endoscopic treatment system 300 according to this embodiment will be described. Specifically, the procedure for crushing a stone S formed in the bile duct B will be described. Fig. 5 is a diagram showing the bile duct B as a treatment target.

[0046] <Step S1: Endoscope Insertion Process> The surgeon inserts the insertion section 210 of the endoscope 200 into the patient's lumen through a natural orifice such as the mouth. The surgeon bends the bending section 212 by operating the operation section 220 as necessary. The surgeon inserts the rigid tip section 211 of the endoscope 200 up to the duodenum DU. The surgeon positions the rigid tip section 211 in a position that faces the opening PA1 of the papilla PA.

[0047] <Step S2: Insertion Step> The surgeon inserts the crushing tool 100 into the bile duct B from the opening PA1 of the papilla PA. Specifically, the surgeon inserts the crushing tool 100 into the treatment tool channel 230 of the endoscope 200, causing the basket 4 of the crushing tool 100 to protrude from the tip portion 230a, and, with the basket 4 kept closed, inserts the basket 4 of the crushing tool 100 into the bile duct B from the opening of the papilla PA. The surgeon may place a guide wire in the bile duct B and insert the basket 4 of the crushing tool 100 into the bile duct B along the guide wire.

[0048] <Step S3: Capture Step> Figure 6 shows the capture step. The surgeon opens the basket 4 and captures the stone S into the basket 4. Specifically, the stone S is captured and taken into the basket 4 through the basket wires 41. At this time, the stone S is positioned away from the tip surface 33, and the basket 4 holds the stone S with a force that does not crush it.

[0049] <Step S4: Crushing Process> Figures 7 to 9 are cross-sectional views of the tip of the crushing tool 100 during the crushing process. As shown in Figure 7, the stone S is assumed to be captured at a position offset from the central axis O3 and on the third basket wire 413 side of the central axis O3. As shown in Figure 8, the surgeon operates the slider 53 of the operation unit 5 to retract the operation wire 2 and pull the basket 4 toward the base end side A2. Because the wire guide 34 guides the pulled basket wires 41, the direction D in which the four basket wires 41 are retracted tends to be the same. As a result, as the four basket wires 41 are retracted, the stone S approaches the central axis O3.

[0050] The four wire guides 34 are separated by walls 35 provided inside the distal end member 3 in the radial direction R. The walls 35 restrict the basket wires 41 from moving beyond the central axis O3 to the opposite side in the radial direction R. As a result, as the four basket wires 41 are retracted, the stone S is prevented from moving away from the central axis O3.

[0051] As shown in Figure 9, with the stone S captured by the basket 4, the surgeon further pulls the basket wire 41 toward the base end side A2. As the stone S approaches the central axis O3, it is firmly pressed against the distal end surface 33 of the distal end member 3. This makes it difficult for the stone S to slip off the distal end surface 33. This allows the surgeon to pinch the stone S between the basket wire 41 on the distal end side A1 and the distal end surface 33 on the base end side A2, allowing the stone S to be crushed with a small amount of force.

[0052] FIG. 10 is a diagram showing a conventional distal end member P (comparison example) that does not have a tapered portion 32. The conventional distal end member P has a cylindrical shape that does not have a tapered portion 32 or a wire guide 34 (wall 35). Therefore, when the basket 4 is pulled toward the base end side A2, the four basket wires 41 are unlikely to be pulled in the same direction D. Furthermore, the conventional distal end member P does not have a wall 35. Therefore, it is not possible to prevent the basket wires 41 from moving beyond the central axis O3 to the opposite side in the radial direction R. In FIG. 10, the first basket wires 411 have moved beyond the central axis O3 to the opposite side in the radial direction R.

[0053] According to the crushing tool 100 of this embodiment, the calculus S can be crushed suitably regardless of the position of the calculus S taken into the basket 4.

[0054] Although the first embodiment of the present invention has been described above in detail with reference to the drawings, the specific configuration is not limited to this embodiment and includes design modifications within the scope of the present invention. Furthermore, the components shown in the above-described embodiment and modifications can be configured by appropriately combining them.

[0055] (Variation 1) Figure 11 is a perspective view of the tip of a crushing tool 100A, which is a variation of the crushing tool 100. Compared to the crushing tool 100, the crushing tool 100A includes a tip member 3A, which is a variation of the tip member 3. An opening 33h is formed in the tip surface 33 of the tip member 3A. The opening 33h communicates with the internal space 3s of the main body 31. The opening is located more inward in the radial direction R than the tip 34a of the wire guide 34. Note that the opening 33h does not necessarily need to communicate with the internal space 3s of the main body 31, and may be a bottomed hole extending from the tip surface 33 toward the opening 36.

[0056] Second Embodiment A crushing tool 100B according to a second embodiment of the present invention will be described with reference to Fig. 12 to Fig. 14. In the following description, components common to those already described will be assigned the same reference numerals, and duplicated description will be omitted.

[0057] 12 is a perspective view of the distal end of the crushing tool 100B. The crushing tool 100B is used together with an endoscope 200 as an endoscopic treatment system, similar to the crushing tool 100 of the first embodiment. The crushing tool 100B includes a sheath 1, a control wire 2, a distal end member 3B, a basket 4, and a control section 5.

[0058] 13 is a cross-sectional view of the tip of the crushing tool 100B. The tip member 3B is attached to the tip 1a of the sheath 1. The tip member 3B is made of a metal such as stainless steel. The central axis O3 in the longitudinal direction A of the tip member 3B coincides with the central axis O1 in the longitudinal direction A of the sheath 1. The tip member 3B has a main body 31, a tip portion 32B, and four wire guides 34.

[0059] 14 is a front view of the tip of the crushing tool 100B as viewed from the tip side A1. The tip 32B has four protrusions 37. The wire guides 34 and the protrusions 37 are arranged alternately along the circumferential direction C. A curved or flat tip surface 33B is formed at the tip of each of the four protrusions 37. A slit 38 is formed in the tip surface 33B.

[0060] The slits 38 pass through the central axis O3 of the distal end member 3 and extend in the radial direction R. The slits 38 are continuous with the distal ends of the wire guides 34. As shown in Fig. 15 , in a front view seen from the distal end side A1 in the longitudinal direction A, the slits 38 and the distal ends of the wire guides 34 may be arranged alternately along the circumferential direction C.

[0061] According to the crushing tool 100B of this embodiment, the slits 38 are formed in the tip end surface 33B, so that the calculus S is less likely to slip off from the tip end surface 33B.

[0062] Although the second embodiment of the present invention has been described above in detail with reference to the drawings, the specific configuration is not limited to this embodiment and includes design modifications within the scope of the present invention. Furthermore, the components shown in the above embodiment and modified examples can be configured by appropriately combining them.

[0063] In the above embodiment, the number of the protrusions 37 having the distal end surface 33B is four, but the number of the protrusions 37 is not limited to this. From the viewpoint of fixing the stone S, it is desirable that the number of the protrusions 37 be at least three or more.

[0064] (Third embodiment) A crushing tool 100C according to a third embodiment of the present invention will be described with reference to Fig. 16 and Fig. 17. In the following description, components common to those already described will be assigned the same reference numerals and redundant description will be omitted.

[0065] 16 is a perspective view of the distal end of the crushing tool 100C. The crushing tool 100C is used as an endoscopic treatment system together with an endoscope 200, similar to the crushing tool 100 of the first embodiment. The crushing tool 100C includes a sheath 1, a control wire 2, a distal end member 3C, a basket 4, and a control section 5.

[0066] 17 is a cross-sectional view of the tip of the crushing tool 100C. The tip member 3C is attached to the tip 1a of the sheath 1. The tip member 3C is made of a metal such as stainless steel. The central axis O3 in the longitudinal direction A of the tip member 3C coincides with the central axis O1 in the longitudinal direction A of the sheath 1. The tip member 3C has a main body 31C, a tapered portion 32, and a wire guide 34C.

[0067] The main body 31C is formed in a cylindrical shape and is attached to the distal end 1a of the sheath 1. The internal space 3s of the main body 31C is in communication with the internal space 1s of the sheath 1. Four wire guides 34C are formed in the main body 31C along the circumferential direction C relative to the longitudinal direction A.

[0068] The wire guides 34C are grooves that extend along the longitudinal direction A on the outer periphery of the main body 31C. The four wire guides 34C are arranged at different positions in the circumferential direction C of the main body 31C. The four wire guides 34C are arranged outward in the radial direction R with respect to the central axis O3. The four wire guides 34C are separated by inclined walls 35C provided inward in the radial direction R of the tip member 3C.

[0069] The inclined wall (inclined surface) 35C is a surface that inclines outward in the radial direction R as it moves from the base end to the tip end of the tip member 3C. When the basket wires 41 are advanced or retreated, the basket wires 41 are guided by the inclined wall 35C.

[0070] The tip 34a of the wire guide 34C is located on the side surface 32s of the tapered portion 32. Therefore, the wire guide 34C does not extend to the tip surface 33. In other words, the tip surface 33 is located closer to the tip chip 42 (distal side A1) than the tip 34a of the wire guide 34C.

[0071] The base end 34b of the wire guide 34C extends to the main body 31C. The main body 31C has an opening (wire insertion portion, guide lumen) 36 that communicates with the internal space 3s of the main body 31. The distal end surface 33 is located closer to the distal tip 42 (distal side A1) than the opening 36.

[0072] It is desirable that the length L1 in the radial direction R of the tip surface 33 of the tip member 3C is smaller than the inner diameter L2 at the tip of the main body 31C.

[0073] The number of basket wires 41 is not limited to four, and may be, for example, three, five, or six. The number of wire guides 34C is changed according to the number of basket wires 41.

[0074] According to the crushing tool 100C of this embodiment, the wire guide 34C has an inclined wall 35C, which makes it easier to insert the basket wires 41 and reduces the opening and closing force of the basket 4. In addition, the force transmitted from the operation unit 5 to the stone S is increased. Furthermore, if the exposed position of the basket wires 41 is on the outer side in the radial direction R, the basket wires 41 are more likely to follow the stone S when holding it. Therefore, the length of the tapered portion 32 in the longitudinal direction A can be shortened. As a result, the endoscope insertion performance is improved, and stability when the tip surface 33 is abutted against the stone S is also improved.

[0075] Although the third embodiment of the present invention has been described above in detail with reference to the drawings, the specific configuration is not limited to this embodiment and includes design modifications within the scope of the present invention. Furthermore, the components shown in the above embodiment and modifications can be configured by appropriately combining them.

[0076] 18 is a perspective view of the distal end of a crushing tool 100D, which is a modification of the crushing tool 100C. The crushing tool 100D includes a sheath 1, a manipulation wire 2, a distal end member 3D, a basket 4, and a manipulation section 5.

[0077] 19 is a cross-sectional view of the tip of the crushing tool 100D. Compared to the tip member 3C, the tip member 3D has a wire guide 34D instead of the wire guide 34C. The tip member 3D has a main body 31C, a tapered portion 32, and the wire guide 34D.

[0078] The wire guides 34D are grooves that extend along the longitudinal direction A on the outer peripheries of the main body 31C and the tapered portion 32. The four wire guides 34D are arranged at different positions in the circumferential direction C of the main body 31C. The four wire guides 34D are arranged outward in the radial direction R with respect to the central axis O3. The four wire guides 34D are separated by inclined walls 35C provided inward in the radial direction R of the tip member 3C.

[0079] The tip 34a of the wire guide 34D extends to the tip surface 33 of the tapered portion 32. The tip 34a of the wire guide 34D is disposed on the periphery of the tip surface 33.

[0080] (Fourth embodiment) A crushing tool 100E according to a fourth embodiment of the present invention will be described with reference to Fig. 20 and Fig. 21. In the following description, components common to those already described will be assigned the same reference numerals and redundant description will be omitted.

[0081] 20 is a perspective view of the distal end of the crushing tool 100E. The crushing tool 100E is used as an endoscopic treatment system together with an endoscope 200, similar to the crushing tool 100 of the first embodiment. The crushing tool 100E includes a sheath 1, a control wire 2, a distal end member 3E, a basket 4, and a control section 5.

[0082] 21 is a cross-sectional view of the tip of the crushing tool 100E. The tip member 3E is attached to the tip 1a of the sheath 1. The tip member 3E is made of metal such as stainless steel. The central axis O3 in the longitudinal direction A of the tip member 3E coincides with the central axis O1 in the longitudinal direction A of the sheath 1. The tip member 3E has a main body 31, a tapered portion 32, and a wire guide 34E.

[0083] The wire guides 34E are grooves that extend along the longitudinal direction A on the outer periphery of the tapered portion 32. The four wire guides 34E are arranged at different positions in the circumferential direction C of the main body 31. The four wire guides 34E are arranged outward in the radial direction R with respect to the central axis O3. The four wire guides 34E are separated by inclined walls 35C provided inward in the radial direction R of the tip member 3E.

[0084] The tip 34a of the wire guide 34E is located on the side surface 32s of the tapered portion 32. Therefore, the wire guide 34E does not extend to the tip surface 33. In other words, the tip surface 33 is located closer to the tip chip 42 (distal side A1) than the tip 34a of the wire guide 34E.

[0085] The base end 34b of the wire guide 34E extends to the main body 31. An opening (wire insertion portion, guide lumen) 36 that communicates with the internal space 3s of the main body 31 is formed between the main body 31 and the wire guide 34E. The distal end surface 33 is located closer to the distal tip 42 side (distal side A1) than the opening 36.

[0086] It is desirable that the length L1 in the radial direction R of the tip surface 33 of the tip member 3E be smaller than the inner diameter L2 of the tip of the main body 31.

[0087] The number of basket wires 41 is not limited to four, and may be, for example, three, five, or six. The number of wire guides 34E is changed according to the number of basket wires 41.

[0088] According to the crushing tool 100E of this embodiment, the wire guide 34E has an inclined wall 35C, which makes it easier to insert the basket wires 41 and reduces the opening and closing force of the basket 4. Also, the force transmitted from the operation unit 5 to the stone S is increased. Furthermore, if the exposed position of the basket wires 41 is on the outer side in the radial direction R, the basket wires 41 are more likely to follow the stone S when holding it. Therefore, the length of the tapered portion 32 in the longitudinal direction A can be shortened. As a result, the endoscope insertion performance is improved, and stability when the tip surface 33 is abutted against the stone S is also improved.

[0089] Although the fourth embodiment of the present invention has been described above in detail with reference to the drawings, the specific configuration is not limited to this embodiment and includes design modifications within the scope of the present invention. Furthermore, the components shown in the above-described embodiment and modifications can be configured by appropriately combining them.

[0090] In the above embodiment, the wire guides 34, 34C, 34D, and 34E are grooves. However, the form of the wire guides is not limited to this. The wire guides are not limited to grooves and may be guide lumens, at least a portion of which is formed in a tubular shape.

[0091] Fifth Embodiment An attachment 3F according to a fifth embodiment of the present invention will be described with reference to Figures 22 to 25. In the following description, components that are common to those already described will be assigned the same reference numerals, and duplicate descriptions will be omitted.

[0092] Fig. 22 is a perspective view of an attachment 3F. The attachment 3F is a member that can be attached to a conventional crushing tool Q as shown in Fig. 24. The attachment 3F is made of metal such as stainless steel. The attachment 3F has a tapered portion 32 and a detachable portion 39.

[0093] The detachable portion 39 is formed in a cylindrical shape, and four wire guides 34F are formed along the circumferential direction C relative to the longitudinal direction A. A plurality of engaging protrusions 39p that protrude inward in the radial direction R are provided at the end of the base end side A1 of the detachable portion 39.

[0094] The wire guides 34F are grooves that extend along the longitudinal direction A on the outer periphery of the detachable portion 39. The four wire guides 34F are arranged at different positions in the circumferential direction C of the detachable portion 39. The four wire guides 34F are arranged outward in the radial direction R with respect to the central axis O3.

[0095] The tip 34a of the wire guide 34F is located on the side surface 32s of the tapered portion 32. Therefore, the wire guide 34F does not extend to the tip surface 33. In other words, the tip surface 33 is located on the distal side A1 of the tip 34a of the wire guide 34F.

[0096] The base end 34b of the wire guide 34F extends to the base end of the detachable portion 39. In other words, the wire guide 34F is a slit.

[0097] 23 is a cross-sectional view of an attachment 3F. The wire guide 34F has a guide lumen 36F that communicates with the internal space 3s of the detachable portion 39. The guide lumen 36F has an inclined surface 35C that inclines outward in the radial direction R from the proximal end to the distal end.

[0098] The number of basket wires 41 is not limited to four, and may be, for example, three, five, or six. The number of wire guides 34F is changed according to the number of basket wires 41.

[0099] Fig. 25 is a perspective view of an attachment 3F attached to the tip member P of a conventional crushing tool Q. The detachable part 39 is detachable from the tip member P of the conventional crushing tool Q by fitting (including snap-fitting). For example, as shown in Fig. 24, a plurality of engaging recesses 31r are provided on the main body 31 of the tip member P of the crushing tool Q. As shown in Fig. 25, the engaging protrusions 39p of the detachable part 39 and the engaging recesses 31r of the tip member P of the crushing tool Q are connected by snap-fitting, thereby attaching the detachable part 39 to the tip member P. Note that the method of attaching the detachable part 39 is not limited to fitting. For example, the detachable part 39 may be fixed to the tip member P with adhesive tape.

[0100] When the detachable portion 39 is attached to the distal end member P, the internal space 3s of the detachable portion 39 communicates with the internal space 1s of the sheath 1. When the detachable portion 39 is attached to the distal end member P, the distal end surface 33 is located closer to the distal tip 42 (distal side A1) than the distal end 34a of the wire guide 34F. Furthermore, when the detachable portion 39 is attached to the distal end member P, the basket wires 41 are inserted through slits in the wire guide 34F, and when the basket wires 41 are advanced or retreated, the basket wires 41 are guided by the inclined surface 35C.

[0101] According to the attachment 3F of this embodiment, by attaching it to a conventional crushing tool Q, the conventional crushing tool Q can be used as a crushing tool 100F having the same functions as the crushing tool 100 of the first embodiment, etc.

[0102] Although the fifth embodiment of the present invention has been described above in detail with reference to the drawings, the specific configuration is not limited to this embodiment and includes design modifications within the scope of the present invention. Furthermore, the components shown in the above-described embodiment and modifications can be configured by appropriately combining them.

[0103] The present invention can be applied to an endoscopic treatment tool having a basket wire.

[0104] 300 Endoscopic treatment system 200 Endoscope 100, 100A, 100B, 100C, 100D, 100E, 100F Crushing tool (endoscopic treatment tool) 1 Sheath 1s Internal space (lumen) 2 Operating wire 3, 3A, 3B, 3C Distal end member 3F Attachment 3s Internal space 31, 31C Main body 32 Tapered portion 32B Distal end portion 33, 33B Distal end surface 33h Opening 34, 34C, 34F Wire guide 341 First wire guide 342 Second wire guide 343 Third wire guide 344 Fourth wire guide 35 Wall 35C Inclined wall (inclined surface) 36 Opening (wire insertion portion) 37 Projection portion 38 Slit 39 Detachable portion 4 Basket 41 Basket wire 411 First basket wire 412 Second basket wire 413 Third basket wire 414 Fourth basket wire 42 Distal tip 43 Bundling section 5 Operation section 51 Operation section main body 52 Liquid supply port 53 Slider 54 Guidewire port A Longitudinal direction A1 Distal side (distal side) A2 Base end side (proximal side) B Bile duct C Circumferential direction R Radial direction S Stone

Claims

1. A crusher comprising a sheath, a tip member attached to the tip of the sheath, and a basket wire protruding from the tip of the tip member, wherein the tip member has a wire guide for guiding the basket wire, and the wire guide is disposed radially outside the tip surface of the tip member.

2. The crusher according to claim 1, wherein a plurality of the wire guides are arranged at different positions in the circumferential direction of the tip member.

3. The crusher according to claim 1, wherein the wire guides are separated by a wall provided inward in the radial direction of the tip member.

4. The crusher according to claim 1, wherein the wire guide has an inclined surface that inclines outward in the radial direction from the base end to the tip of the tip member.

5. The crusher according to claim 1, wherein the tip member has a tapered portion that tapers toward the tip of the tip member, and the tip of the wire guide is provided on the tapered portion.

6. The crusher according to claim 1, wherein the tip surface of the tip member is flat.

7. The crusher according to claim 1, wherein the tip surface of the tip member is a curved surface that protrudes from the base end to the tip of the tip member.

8. The crusher according to claim 1, wherein the tip surface of the tip member has at least three or more protrusions, and the protrusions and the tips of the wire guides are arranged alternately along the circumferential direction of the tip member.

9. The crusher according to claim 1, wherein an opening is formed in the tip surface of the tip member, and the opening is disposed radially inside the tip of the wire guide.

10. The crusher according to claim 1, wherein an opening is formed in the tip surface of the tip member, and the tip surface of the tip member is located on the distal side of the opening.

11. The crusher according to claim 1, wherein a slit extending in the radial direction and passing through the central axis of the tip member is formed in the tip surface of the tip member, and the slit and the tips of the wire guides are arranged alternately along the circumferential direction of the tip member.

12. The crusher according to claim 1, wherein a slit extending in the radial direction and passing through the central axis of the tip member is formed in the tip surface of the tip member, and the slit is continuous with the tips of the wire guides.

13. The wire guide has a guide lumen, and the crusher according to claim 1.

14. The tip member has a cylindrical main body portion and a tapered portion whose diameter decreases toward the tip of the tip member, and the length in the radial direction of the tip surface of the tip member is smaller than the inner diameter of the main body portion. The crusher according to claim 9.

15. The maximum distance from the opening to the tip surface is larger than the inner diameter of the main body portion, and the crusher according to claim 14.

16. It has a guide lumen through which a basket wire passes, and the guide lumen has an inclined surface that inclines radially outward from the proximal end toward the distal end. Attachment for crusher.

17. A sheath, a tip member attached to the tip of the sheath, and a basket formed by basket wires protruding from the tip of the tip member. When the basket wire is further pulled toward the proximal end side of the sheath with the stone captured by the basket, the tip of the tip member is pressed against the stone. Crusher.

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