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WO2014061505A1 - Outil de traitement pour endoscope - Google Patents

Outil de traitement pour endoscope Download PDF

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Publication number
WO2014061505A1
WO2014061505A1 PCT/JP2013/077345 JP2013077345W WO2014061505A1 WO 2014061505 A1 WO2014061505 A1 WO 2014061505A1 JP 2013077345 W JP2013077345 W JP 2013077345W WO 2014061505 A1 WO2014061505 A1 WO 2014061505A1
Authority
WO
WIPO (PCT)
Prior art keywords
treatment
operation member
contact portion
endoscope
treatment tool
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/JP2013/077345
Other languages
English (en)
Japanese (ja)
Inventor
鈴木　啓太
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Olympus Medical Systems Corp
Original Assignee
Olympus Medical Systems Corp
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Olympus Medical Systems Corp filed Critical Olympus Medical Systems Corp
Publication of WO2014061505A1 publication Critical patent/WO2014061505A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B10/00—Instruments for taking body samples for diagnostic purposes; Other methods or instruments for diagnosis, e.g. for vaccination diagnosis, sex determination or ovulation-period determination; Throat striking implements
    • A61B10/02—Instruments for taking cell samples or for biopsy
    • A61B10/06—Biopsy forceps, e.g. with cup-shaped jaws
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B10/00—Instruments for taking body samples for diagnostic purposes; Other methods or instruments for diagnosis, e.g. for vaccination diagnosis, sex determination or ovulation-period determination; Throat striking implements
    • A61B10/02—Instruments for taking cell samples or for biopsy
    • A61B10/04—Endoscopic instruments, e.g. catheter-type instruments
    • A61B2010/045—Needles
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/00234—Surgical instruments, devices or methods for minimally invasive surgery
    • A61B2017/00353—Surgical instruments, devices or methods for minimally invasive surgery one mechanical instrument performing multiple functions, e.g. cutting and grasping
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B2017/2901—Details of shaft
    • A61B2017/2902—Details of shaft characterized by features of the actuating rod

Definitions

  • the present invention relates to an endoscope treatment tool, and more particularly, to an endoscope treatment tool including a plurality of operation members for operating a treatment portion.
  • Patent Literature 1 describes an endoscope treatment tool including a treatment unit including a pair of forceps members that are opened and closed.
  • An operation member such as an operation wire is connected to the pair of forceps members via a link mechanism.
  • the forceps member opens when the operation member is advanced toward the treatment portion, and the forceps member closes when the operation member is retracted.
  • an operation member of an endoscope treatment tool a hard rod, a flexible operation wire, or the like is known.
  • an operation wire is operated to be inserted into a forceps channel that has been bent or meandered.
  • a member Generally used as a member.
  • the operation wire is not easily deformed with respect to the pulling operation and can transmit the force appropriately to the treatment section.
  • the operation wire may not be able to transmit force appropriately to the treatment section depending on the pushing operation for moving forward. Therefore, for example, in a state where a large amount of tissue exists around the treatment portion, the force cannot be sufficiently transmitted. As a result, it is not easy or impossible to open the pair of forceps members against the tissue, and a desired treatment may be difficult.
  • the present invention has been made in view of such a problem, and can easily transmit the amount of operation force to the treatment section when the operation member is moved forward or backward, thereby facilitating operation.
  • An object of the present invention is to provide an endoscopic treatment tool.
  • An endoscope treatment tool is a treatment for performing a predetermined treatment in a living body, which is attached to a flexible long insertion portion and a distal end portion of the insertion portion.
  • a first operating member that is connected to the treatment section and moves the treatment section by moving backward with respect to the insertion section; and the treatment section having higher compression resistance than the first operation member
  • a second operation member that is connected to the insertion portion and moves the treatment portion by moving forward with respect to the insertion portion; and is attached to a proximal end portion of the insertion portion and operates the first operation member and the second operation member
  • the operation portion includes a first contact portion that contacts the first operation member, and the second operation member. And a second abutting portion that abuts.
  • the first contact portion and the second contact portion may be provided on the same slider.
  • the first contact portion and the second contact portion are configured such that when the first contact portion contacts the first operation member, the second operation member and the second contact portion are not in contact with each other.
  • the first operation member and the first contact portion are in a non-contact state. Thus, only the second operation member may be operated.
  • the second operation member may be an operation coil made of a metal strand.
  • the first operation member may be inserted through the operation coil.
  • the endoscope treatment tool can easily transmit the operation force amount to the treatment portion both when the operation member is moved forward and when the operation member is moved backward. Can be provided.
  • FIG. 1 is a diagram showing an overall configuration of an endoscope treatment tool according to a first embodiment of the present invention. It is a figure which shows the treatment part and its periphery of the treatment tool for endoscopes which concern on 1st embodiment of this invention in a partial cross section. It is sectional drawing which shows the operation part in the treatment tool for endoscopes which concerns on 2nd embodiment of this invention. It is a figure which shows the other example of the treatment part in the treatment tool for endoscopes which concerns on 1st embodiment of this invention. It is a figure which shows 1 operation
  • FIG. 1 is a diagram illustrating an overall configuration of an endoscope treatment tool 1 according to the present embodiment.
  • the biopsy needle (endoscopic treatment tool) 1 includes a long flexible insertion portion 10, a treatment portion 20, and an operation portion 50.
  • the treatment portion 20 is provided at the distal end portion of the insertion portion 10.
  • the operation unit 50 is attached to the proximal end portion of the needle tube 10.
  • the insertion portion 10 is formed in a flexible tubular shape having a lumen, and a coil, a resin, or the like can be used as a material.
  • FIG. 2 is a diagram showing a partial cross section of the treatment section 20 and its periphery.
  • the treatment portion 20 includes a pair of forceps members 21 that can be opened and closed, and a cover member 22.
  • a forceps member 21 is attached to the cover member 22.
  • the pair of forceps members 21 are rotatably attached to a rotation shaft 23 fixed to the cover member 22.
  • the cover member 22 is fixed to the distal end portion of the insertion portion 10.
  • the operating member 30 for operating the treatment section is inserted into the inner cavity of the insertion section 10 so as to be able to advance and retreat with respect to the insertion section 10.
  • the operation member 30 includes an operation wire 31 (first operation member), an operation coil 32 (second operation member), and a connection member 33.
  • An operation wire 31 is inserted through the operation coil 32.
  • the distal ends of the operation wire 31 and the operation coil 32 are fixed to the connection member 33.
  • the operation wire 31 is a known wire formed by stranding a strand made of metal or the like, or a single wire.
  • the operation wire 31 is equivalent to a wire used for operating a treatment portion in a general endoscope treatment tool.
  • the operation coil 32 has a known configuration in which metal strands are closely wound in a spiral shape, and has an inner diameter larger than the outer diameter of the operation wire 31.
  • the connecting member 33 is made of metal or the like.
  • the connection member 33 has a cylindrical fixing portion 33A on the proximal end side.
  • the distal end portion of the operation wire 31 is fixed to the connection member 33 by bonding, soldering, brazing, or the like while being inserted into the lumen of the fixing portion 33A.
  • the operation coil 32 and the fixing portion 33A are integrally formed by joining the inner surface of the operation coil 32 and the outer peripheral surface of the fixing portion 33A in a state where the fixing portion 33A is inserted into the lumen of the distal end portion of the operation coil 32. It is fixed.
  • the operation coil 32 and the fixing portion 33A are joined by means such as adhesion, soldering, or brazing.
  • connection member 33 and the proximal end side of the pair of forceps members 21 are connected via a link member 34. Accordingly, when the operation member 30 is advanced and retracted with respect to the insertion portion 10, the pair of forceps members 21 rotate around the rotation shaft 23, and the treatment portion 20 functions as a forceps that can be opened and closed.
  • the operation unit 50 includes an operation unit main body 51 and a slider 52, and the basic configuration thereof is known.
  • the operation portion main body 51 is fixed to the proximal end portion of the insertion portion 10.
  • the slider 52 is attached to be slidable in the longitudinal direction of the operation section main body 51.
  • the operation wire 31 extending through the insertion portion 10 and the proximal end portion of the operation coil 32 protrude into the internal space of the operation portion main body 51 and are fixed to the slider 52. Therefore, the operation member 30 can be moved forward and backward with respect to the insertion portion 10 by sliding the slider 52 with respect to the operation portion main body 51.
  • the user first introduces an endoscope (not shown) into the patient's body and moves the distal end portion of the endoscope to the vicinity of the target tissue to be treated.
  • the user inserts the endoscope treatment tool 1 into the forceps channel of the endoscope from the treatment portion 20 side, and causes the treatment portion 20 to protrude from the distal end opening of the forceps channel.
  • the user opens the pair of forceps members 21 by moving the slider 52 of the operation unit 50 forward while confirming the target tissue in the visual field of the endoscope.
  • the user arranges the pair of forceps members 21 such that a part of the target tissue is positioned between the pair of forceps members 21.
  • the pair of forceps members 21 are closed and the target tissue is grasped.
  • the operation coil 32 having more excellent compression resistance among the operation members 30 mainly transmits the operation force amount to the treatment section 20.
  • the operation wire 31 having higher tensile resistance mainly transmits the operation force amount to the treatment section 20.
  • the operation member 30 that transmits the operation force amount to the treatment unit 20 is operated in addition to the operation wire 31 that is generally used in a flexible endoscope treatment tool.
  • An operation coil 32 having higher compression resistance than the wire 31 is provided. For this reason, it is possible to suitably transmit the amount of operation force to the treatment unit 20 both when the operation member 30 is moved forward and when the operation member 30 is moved backward, and an endoscope treatment tool that can be easily operated can be provided. .
  • FIG. 3 is a cross-sectional view showing the operation unit 70 of the endoscope treatment tool 61 according to the present embodiment. Similar to the first embodiment, the operation unit 70 includes an operation unit main body 71 and a slider 72. However, the operation wire 31 extending through the insertion portion 10 and the proximal end portion of the operation coil 32 are not fixed to the slider 72.
  • the proximal end portion 32A of the operation coil 32 is located on the distal end side with respect to the slider 72.
  • the operation coil 32 can be advanced while the end surface (second contact portion) 72A on the distal end side of the slider 72 is in contact with the base end portion 32A of the operation coil 32.
  • the operation wire 31 extends through the through hole 73 formed in the slider 72 to the proximal end side than the slider 72.
  • a disc-shaped diameter-expanding member 74 is attached to the proximal end portion 31 ⁇ / b> A of the operation wire 31.
  • the diameter of the base end portion 31 ⁇ / b> A of the operation wire 31 is enlarged, and the diameter-expanding member 74 cannot enter the through hole 73. Therefore, when the slider 72 is retracted, the end surface (first contact portion) 72B on the base end side of the slider 72 can be brought into contact with the diameter-expanding member 74 of the operation wire 31 and the operation wire 31 can be pulled.
  • the amount of operation force is suitably treated both when the operation member is advanced and when the operation member is moved backward. Can be transmitted to the part.
  • the slider 72 when the slider 72 is retracted, the slider 72 and the operation coil 32 are not in contact with each other, and only the operation wire 31 is pulled.
  • the slider 71 moves forward, the slider 72 and the operation wire 31 are not in contact with each other, and only the operation coil 32 is pressed. That is, when pulling and pressing the operation member, the slider 72 contacts only a member capable of suitably transmitting the force in each operation. As a result, there is no loss of force transmission due to contact with the other operation member, and the operation force can be more suitably transmitted to the treatment section.
  • the configuration of the treatment section is not limited to the above-described forceps.
  • other examples of the treatment unit will be described.
  • the treatment section 80 shown in FIG. 4 is a biopsy needle provided with a puncture section 81 and a collection member 82.
  • the puncture portion 81 is sharply formed at the tip and is punctured into the tissue.
  • the sampling member 82 is rotatably attached to the puncture portion 81.
  • the distal end side of the collection member 82 is formed in a cup shape so as to accommodate the tissue, and the proximal end portion 82 ⁇ / b> A of the collection member 82 is connected to the operation member 30 via the link 83.
  • the treatment section 80 is inserted into the channel when housed in the outer sheath 85 (insertion section) in order to prevent the puncture section 81 from damaging the channel inner wall of the endoscope, and the outer sheath 85 is used when performing a biopsy. Protruding from.
  • the puncture unit 81 is punctured into an organ or the like from which a tissue is collected. Thereafter, when the operation member 30 is advanced, the sampling member 82 rotates around the rotation shaft 84 and protrudes from the outer peripheral surface of the puncture portion 81 as shown in FIG. When the operating member 30 is retracted in this state, a part of the tissue is scraped off from the organ or the like by the sampling member 82 and is stored in the cup-shaped space on the distal end side, and the sampling member 82 is stored in the puncture portion 81. Is done.
  • the operation of causing the sampling member 82 to protrude from the outer peripheral surface of the puncture unit 81 requires a large amount of force because a large amount of tissue exists around the puncture unit 81 punctured into an organ or the like.
  • the operation member 30 includes the operation coil 32 having excellent compression resistance, the amount of operation force for advancing the operation member is suitably transmitted to the treatment section, and the tissue sampling procedure can be suitably performed. .
  • the treatment unit 90 shown in FIG. 6 is also a biopsy needle provided with a puncture unit and a collection member, similar to the treatment unit 80 described above. It is comprised so that it may protrude from the outer peripheral surface of 81. FIG.
  • the connection mode between the operation member and the sampling member the correspondence between the advance / retreat of the operation member and the operation of the sampling member can be set as appropriate.
  • the treatment section 100 shown in FIG. 7 is configured as a so-called known umbrella-shaped biopsy instrument including an inner blade portion 101 provided with a puncture portion 101A and an outer blade portion 105 through which the inner blade portion 101 is inserted.
  • the inner blade portion 101 has a sharp puncture portion 101A on the distal end side, and has an inner blade 102 on the proximal end side with respect to the puncture portion 101A.
  • the inner blade 102 is formed in a circumferential shape centered on the axis of the puncture needle 101A and has an inner blade 102 facing the proximal end side.
  • the outer blade portion 105 is attached to the distal end portion of the coil sheath 110 through which the operation member 30 is inserted, and has an outer blade 106.
  • the outer blade 106 is formed in a circumferential shape that is substantially concentric with the inner blade 102 and has a larger diameter than the inner blade 102, and faces the distal end side.
  • the base end portion 101 ⁇ / b> B of the inner blade portion 101 is connected to the operation member 30, and can advance and retreat with respect to the outer blade portion 105.
  • the shape of the base end portion 101B is the same as that of the connecting member 33, but the shape of the base end portion is not particularly limited.
  • the operation member 30 has the operation coil 32 having excellent compression resistance. Therefore, the amount of operating force for moving the operating member forward can be suitably transmitted to the inner blade portion 101 against the above-described pushing force. As a result, it is possible to suitably perform breakthrough of a stenosis site where a relatively large amount of force is required.
  • the treatment section 110 shown in FIG. 8 is a so-called known guillotine-type biopsy needle including a needle tube 111 having a puncture portion 111A and a separation portion 112 accommodated in the needle tube 111.
  • a collection hole 113 for collecting a tissue is provided on the side surface of the needle tube 111.
  • the separation part 112 has a cutting blade 114 facing the proximal end side, and is connected to the operation member 30.
  • the separation part in order to cut out the tissue appropriately, the separation part may be advanced and retracted several times. At this time, if the tissue protrudes into the lumen of the needle tube, it may become an obstacle when the separation portion is advanced.
  • the operation force amount is suitably transmitted to the separation unit 112 by the operation member 30 including the operation coil 32, and the separation unit 112. The forward operation can be suitably performed.
  • the operation member in the present embodiment can suitably transmit both the forward and backward operation force amounts to the treatment section. For this reason, it is particularly suitable when combined with a treatment section that requires a relatively large force for forward operation. Therefore, it is natural that the configuration of the treatment portion in the endoscope treatment tool according to the present invention is not limited to the above-described forceps, various biopsy needles, and biopsy tools.
  • the operation wire that is the first operation member is inserted into the operation coil that is the second operation member.
  • the arrangement mode of the first operation member and the second operation member is not limited to this, and for example, the first operation member and the second operation member may be arranged so as to run in parallel. In this case, since it is not necessary to secure a space for passing the operation wire through the lumen of the operation coil, the inner diameter of the operation coil can be reduced.
  • the first operating member and the second operating member do not necessarily have to be operated with a common slider.
  • the first operating member and the second operating member may be attached to separate sliders and may be operated independently.
  • the connection member is not essential for the operation member in the present embodiment. Therefore, the first operation member and the second operation member may be directly connected to the treatment section.
  • the endoscope treatment tool can easily transmit the operation force amount to the treatment portion both when the operation member is moved forward and when the operation member is moved backward. Can be provided.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Molecular Biology (AREA)
  • Pathology (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Biodiversity & Conservation Biology (AREA)
  • Medical Informatics (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)
  • Endoscopes (AREA)

Abstract

L'invention concerne un outil de traitement pour un endoscope, qui comprend : une partie d'introduction souple allongée ; une partie de traitement qui est fixée à une extrémité distale de la partie d'introduction ; un premier élément d'actionnement qui est relié à la partie de traitement et actionne la partie de traitement en se déplaçant vers l'arrière par rapport à la partie d'introduction ; un second élément d'actionnement qui est relié à la partie de traitement avec une résistance à la compression supérieure à celle du premier élément d'actionnement et actionne la partie de traitement en se déplaçant vers l'avant par rapport à la partie d'introduction ; une partie d'actionnement qui est fixée à une extrémité de base de la partie d'introduction et qui est conçue pour actionner le premier élément d'actionnement et le second élément d'actionnement.
PCT/JP2013/077345 2012-10-18 2013-10-08 Outil de traitement pour endoscope Ceased WO2014061505A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US201261715539P 2012-10-18 2012-10-18
US61/715,539 2012-10-18

Publications (1)

Publication Number Publication Date
WO2014061505A1 true WO2014061505A1 (fr) 2014-04-24

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ID=50488074

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Application Number Title Priority Date Filing Date
PCT/JP2013/077345 Ceased WO2014061505A1 (fr) 2012-10-18 2013-10-08 Outil de traitement pour endoscope

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WO (1) WO2014061505A1 (fr)

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
IT201800006731A1 (it) * 2018-06-27 2019-12-27 Dispositivo di prelievo di campioni di tessuto biologico
JP2020137949A (ja) * 2019-03-01 2020-09-03 国立研究開発法人国立がん研究センター 生検針
EP4294280A4 (fr) * 2021-02-16 2024-10-02 Simoff, Michael J. Dispositif de forceps inverse

Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPH08164141A (ja) * 1994-12-13 1996-06-25 Olympus Optical Co Ltd 処置具
JP2011177231A (ja) * 2010-02-26 2011-09-15 Patentstra Co Ltd 医療用コイル構造体と、その製造方法、並びに医療用コイル構造体を形成して成る医療用内視鏡と、医療用処置具と、超音波診断医療用カテーテルと、光干渉診断医療用カテーテル

Patent Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPH08164141A (ja) * 1994-12-13 1996-06-25 Olympus Optical Co Ltd 処置具
JP2011177231A (ja) * 2010-02-26 2011-09-15 Patentstra Co Ltd 医療用コイル構造体と、その製造方法、並びに医療用コイル構造体を形成して成る医療用内視鏡と、医療用処置具と、超音波診断医療用カテーテルと、光干渉診断医療用カテーテル

Cited By (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
IT201800006731A1 (it) * 2018-06-27 2019-12-27 Dispositivo di prelievo di campioni di tessuto biologico
WO2020003198A1 (fr) * 2018-06-27 2020-01-02 Euromedical S.R.L. Dispositif pour prélever des échantillons de tissu biologique
US11986172B2 (en) 2018-06-27 2024-05-21 Euromedical S.R.L. Device for collecting samples of biological tissue
JP2020137949A (ja) * 2019-03-01 2020-09-03 国立研究開発法人国立がん研究センター 生検針
JP7263055B2 (ja) 2019-03-01 2023-04-24 株式会社ナカニシ 生検針
EP4294280A4 (fr) * 2021-02-16 2024-10-02 Simoff, Michael J. Dispositif de forceps inverse

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