WO2025115096A1 - Crushing tool and attachment for crushing tool - Google Patents

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

This disclosure relates to a crusher and an attachment for the crusher.

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 down on the stone, thereby breaking it up. Stone breaking with basket forceps is simple and low-cost. However, there are cases where the breaking power of stones using basket forceps is insufficient and the stone cannot be broken up completely.

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

U.S. Pat. No. 5,176,688 U.S. Pat. No. 9,168,099

However, the conventional basket forceps described in Patent Documents 1 and 2 may not be able to crush the stone depending on the position of the stone that is taken in. For example, when the stone is taken in at a position that is offset from 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.

In light of the above, the present disclosure aims to provide a crushing tool and an attachment for the crushing tool that can crush stones appropriately regardless of the location of the stones that have been introduced.

In order to solve the above problems, this disclosure proposes the following means.
The crushing tool of the 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 positioned radially outward from the tip surface of the tip member.

The crushing tool attachment according to the 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 slopes radially outward from the base end to the tip end.

The crushing tool according to the 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. 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.

The crushing tool and crushing tool attachment disclosed herein can crush stones effectively regardless of the location of the stones that are introduced.

1 is an overall view of an endoscopic treatment system according to a first embodiment. FIG. 2 is an overall view showing a crushing tool of the endoscope treatment system. FIG. FIG. 4 is a cross-sectional view of the tip of the crushing tool. FIG. 1 shows a bile duct to be treated. FIG. 1 shows the incorporation process. 4 is a cross-sectional view of the tip of the crushing tool in a crushing step. FIG. 4 is a cross-sectional view of the tip of the crushing tool in the crushing step. FIG. 4 is a cross-sectional view of the tip of the crushing tool in the crushing step. FIG. FIG. 13 is a diagram showing a conventional tip member (comparative example) that does not have a tapered portion. FIG. 13 is a perspective view of a tip portion of a modified example of the crushing tool. FIG. 11 is a perspective view of a tip portion of a crushing tool according to a second embodiment. FIG. 4 is a cross-sectional view of the tip of the crushing tool. FIG. 2 is a front view of the tip portion of the crushing tool as viewed from the tip side. FIG. 13 is a front view of a modified example of the tip portion of the crushing tool. FIG. 11 is a perspective view of a tip portion of a crushing tool according to a third embodiment. FIG. 4 is a cross-sectional view of the tip of the crushing tool. FIG. 13 is a perspective view of a tip portion of a modified example of the crushing tool. FIG. 11 is a cross-sectional view of the tip portion of the modified example. FIG. 11 is a perspective view of a tip portion of a crushing tool according to a third embodiment. FIG. 4 is a cross-sectional view of the tip of the crushing tool. FIG. 13 is a perspective view of an attachment according to a fifth embodiment. FIG. FIG. 1 is a perspective view of a conventional crushing tool. FIG. 13 is a perspective view of the attachment mounted on a conventional crushing tool.

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.

[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 when in use.

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

The insertion section 210 has a tip rigid section 211 provided at the tip, a bending section 212 provided at the base end side of the tip rigid section 211 that can be bent, and a flexible tube section 213 provided at 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 of the tip rigid section 211 in a state exposed to the outside.

The insertion section 210 is formed with a treatment tool channel 230 for inserting the crushing tool 100. The tip 230a of the treatment tool channel 230 opens on the side of the tip hard section 211. The base end of the treatment tool channel 230 extends to the operating section 220.

The treatment tool channel 230 has a lifting table 214 (see FIG. 6) at the distal end rigid portion 211. The proximal end of the lifting table 214 is rotatably supported by the distal end rigid portion 211. A lifting table operating wire (not shown) is fixed to the distal end of the lifting table 214 and extends to the proximal end side through the insertion portion 210.

The bending section 212 is configured to bend freely in the vertical and horizontal directions. The tip of the operating wire is fixed to the tip side of the bending section 212. The operating wire extends through the insertion section 210 to the operating section 220.

The base end of the operation section 220 is provided with a knob 223 for operating the operation wire and a switch 224 for operating the imaging unit 216, etc. The user can bend the bending section 212 in a desired direction by operating the knob 223.

The distal end of the operating section 220 is provided with a forceps port 222 that communicates with the treatment tool channel 230. 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.

[Crushing tool 100]
FIG. 2 is an overall view showing the crushing tool 100. As shown in FIG.
The crushing tool 100 (also referred to as the endoscopic treatment tool 100) comprises a sheath 1, an operating wire 2 (see FIG. 4), a tip member 3, a basket 4, and an operating 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 is referred to as the "tip side (distal side) A1", and the side of the operating section 5 is referred to as the "base side (proximal side) A2".

FIG. 3 is a perspective view of the tip of the crushing tool 100. As shown in FIG.
The sheath 1 is a flexible, long member extending from a distal end 1a to a proximal end 1b. The sheath 1 has an outer diameter allowing it to be inserted into a treatment instrument channel 230 of an endoscope 200. As shown in Fig. 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. An operating wire 2 is inserted into an internal space (lumen) 1s of the sheath 1.

The operating wire 2 is a metal wire that is inserted through the internal space 1s of the sheath 1. The tip of the operating wire 2 is connected to the basket 4, and the base end of the operating wire 2 is connected to the operating section 5.

FIG. 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. A central axis O3 in the longitudinal direction A of the tip member 3 coincides with a 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.

The main body 31 is formed in a cylindrical shape and is attached to the tip 1a of the sheath. The internal space 3s of the main body 31 is connected to the internal space 1s of the sheath 1.

The tapered portion 32 is formed in a cone shape, and the length in the radial direction R decreases from the base end side A2 to the tip end side A1. A flat tip surface 33 is formed at the tip of the tapered portion 32. The tip surface 33 is a plane perpendicular to the longitudinal direction A of the crushing tool 100. Four wire guides 34 are formed in the tapered portion 32 along the circumferential direction C relative to the longitudinal direction A. Note that the tip 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.

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 provided inward in the radial direction R of the tip member 3.

The wire guide 34 has 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.

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

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 tip 42 side (distal side A1) than the tip 34a of the wire guide 34.

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 tip surface 33 is located closer to the tip tip 42 side (distal side A1) than the opening 36.

It is desirable that the length L1 in the radial direction R of the tip surface 33 of the tip member 3 is smaller than the inner diameter L2 at the tip of the main body 31. Furthermore, it is desirable that the maximum distance L3 from the opening 36 to the tip surface 33 is greater than the inner diameter L2 of the main body 31.

The basket 4 is formed into a basket shape by four basket wires 41. The tips of the four basket wires 41 are attached to a tip tip 42. The base ends of the four basket wires 41 are attached to a bundling portion 43 provided at the tip of the operating wire 2. The basket wires 41 are composed of a single wire or a stranded wire made of a material having high elasticity. For example, nickel-titanium alloy, stainless steel, stainless steel alloy, etc. can be used as the material of the basket wires 41.

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

As shown in FIG. 4, the basket wires 41 have multiple bends 41c formed between the tip 42 and the bundled portion 43. Note that each basket wire 41 does not necessarily have to have multiple bends 41c, and may be smoothly curved from the tip 42 to the bundled portion 43. The basket 4 is configured to expand in a basket-like shape in a natural state using the multiple basket wires 41.

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.

The first basket wire 411 and the third basket wire 413 are arranged on either side of the central axis O3. The second basket wire 412 and the fourth basket wire 414 are arranged on either side of the central axis O3.

The first basket wire 411 is guided by the first wire guide 341. The second basket wire 412 is guided by the second wire guide 342. The third basket wire 413 is guided by the third wire guide 343. The fourth basket wire 414 is guided by the fourth wire guide 344.

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.

The operating section 5 is provided on the base end side A2 of the sheath 1. The operating section 5 includes an operating section main body 51, a slider 53, and a guidewire port 54.

The tip of the operating unit body 51 is connected to the base end 1b of the sheath 1. The operating wire 2 extends from the base end 1b of the sheath 1. The operating wire 2 is fixed to the slider 53.

The liquid supply port 52 is provided in the operating unit body 51. The liquid supply port 52 is connected to the base end of the sheath 1 via a duct formed in the operating unit body 51. The liquid supplied from the liquid supply port 52 passes through the sheath 1 and is released from the tip member 3.

The slider 53 is attached to the operation unit 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 body 51, the operation wire 2 moves forward or backward.

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

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

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

<Step S2: Insertion process>
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 to project the basket 4 of the crushing tool 100 from the tip 230a, and inserts the basket 4 of the crushing tool 100 into the bile duct B from the opening of the papilla PA while keeping the basket 4 closed. 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.

<Step S3: Importing step>
FIG. 6 is a diagram showing the capture process.
The surgeon opens the basket 4 and takes the stone S into the basket 4. Specifically, the stone S is taken into the basket 4 through the basket wires 41 and captured. At this time, the stone S is in a position away from the tip surface 33, and the basket 4 holds the stone S with a force that does not crush it.

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

The four wire guides 34 are separated by walls 35 provided on the inside of the tip 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.

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 tip surface 33 of the tip member 3. As a result, the stone S is less likely to slip off the tip surface 33. As a result, the surgeon can pinch the stone S between the basket wire 41 on the tip side A1 and the tip surface 33 on the base end side A2, and crush the stone S with a small amount of force.

FIG. 10 is a diagram showing a conventional tip member P (comparative example) that does not have a tapered portion 32. As shown in FIG.
The conventional tip member P has a cylindrical shape that does not have the tapered portion 32 and the wire guide 34 (wall 35). Therefore, when the basket 4 is pulled toward the base end side A2, the direction D in which the four basket wires 41 are pulled is unlikely to be the same. In addition, the conventional tip member P does not have the wall 35. Therefore, it is not possible to restrict 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 wire 411 moves beyond the central axis O3 to the opposite side in the radial direction R.

The crushing tool 100 according to this embodiment can crush the calculus S appropriately regardless of the position of the calculus S taken into the basket 4.

The first embodiment of the present invention has been described above in detail with reference to the drawings, but the specific configuration is not limited to this embodiment, and design modifications and the like that do not deviate from the gist of the present invention are also included. In addition, the components shown in the above-mentioned embodiment and modified examples can be configured in appropriate combinations.

(Variation 1)
FIG. 11 is a perspective view of the tip of a crushing tool 100A which is a modified example of the crushing tool 100. As shown in FIG.
Compared to the crushing tool 100, the crushing tool 100A includes a tip member 3A which is a modified example 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 disposed inward in the radial direction R from 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 provided from the tip surface 33 toward the opening 36.

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, the same components as those already described will be denoted by the same reference numerals, and duplicated description will be omitted.

FIG. 12 is a perspective view of the tip of the crushing tool 100B.
The crushing tool 100B 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 100B includes a sheath 1, a manipulation wire 2, a distal end member 3B, a basket 4, and a manipulation section 5.

FIG. 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. A central axis O3 in the longitudinal direction A of the tip member 3B coincides with a 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.

FIG. 14 is a front view of the tip portion of the crushing tool 100B as viewed from the tip side A1.
The tip portion 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 the four protrusions 37. A slit 38 is formed in the tip surface 33B.

The slits 38 pass through the central axis O3 of the tip member 3 and extend in the radial direction R. The slits 38 are connected to the tip of the wire guide 34. As shown in FIG. 15, in a front view from the tip side A1 in the longitudinal direction A, the slits 38 and the tip of the wire guide 34 may be arranged alternately along the circumferential direction C.

The crushing tool 100B according to this embodiment has a slit 38 formed in the tip surface 33B, so the stone S is less likely to slip off the tip surface 33B.

The second embodiment of the present invention has been described above in detail with reference to the drawings, but the specific configuration is not limited to this embodiment, and design modifications and the like that do not deviate from the gist of the present invention are also included. In addition, the components shown in the above-mentioned embodiment and modified examples can be configured in appropriate combinations.

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

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, the same components as those already described will be denoted by the same reference numerals, and duplicated description will be omitted.

FIG. 16 is a perspective view of the tip 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 manipulation wire 2, a distal end member 3C, a basket 4, and a manipulation section 5.

FIG. 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. A central axis O3 in the longitudinal direction A of the tip member 3C coincides with a 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.

The main body 31C is formed in a cylindrical shape and is attached to the tip 1a of the sheath. The internal space 3s of the main body 31C is connected to 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.

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.

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 wire 41 is advanced or retreated, the basket wire 41 is guided by the inclined wall 35C.

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 tip 42 side (distal side A1) than the tip 34a of the wire guide 34C.

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 tip surface 33 is located closer to the tip tip 42 side (distal side A1) than the opening 36.

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.

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.

In the crushing tool 100C according to this embodiment, the wire guide 34C has an inclined wall 35C, which makes it easier for the basket wire 41 to be inserted, and reduces the opening and closing force of the basket 4. In addition, the force transmitted from the operating unit 5 to the stone S is greater. Also, if the position at which the basket wire 41 is exposed is on the outside in the radial direction R, the basket wire 41 is more likely to follow the stone S when holding it. Therefore, the length of the longitudinal direction A of the tapered portion 32 can be shortened. As a result, the endoscope insertion performance is improved, and stability is also improved when the tip surface 33 is abutted against the stone S.

The third embodiment of the present invention has been described above in detail with reference to the drawings, but the specific configuration is not limited to this embodiment, and design modifications and the like that do not deviate from the gist of the present invention are also included. In addition, the components shown in the above-mentioned embodiment and modified examples can be configured in appropriate combinations.

(Modification)
18 is a perspective view of the distal end of a crushing tool 100D which is a modified example of the crushing tool 100C. The crushing tool 100D includes a sheath 1, an operating wire 2, a distal end member 3D, a basket 4, and an operating section 5.

FIG. 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.

The wire guides 34D are grooves that extend along the longitudinal direction A on the outer periphery 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.

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 positioned on the periphery of the tip surface 33.

(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, the same components as those already described will be denoted by the same reference numerals, and duplicated description will be omitted.

FIG. 20 is a perspective view of the tip 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 manipulation wire 2, a tip member 3E, a basket 4, and a manipulation section 5.

FIG. 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 a metal such as stainless steel. A central axis O3 in the longitudinal direction A of the tip member 3E coincides with a 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.

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.

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 tip 42 side (distal side A1) than the tip 34a of the wire guide 34E.

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 tip surface 33 is located closer to the tip tip 42 side (distal side A1) than the opening 36.

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

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.

In the crushing tool 100E according to this embodiment, the wire guide 34E has an inclined wall 35C, which makes it easier for the basket wire 41 to be inserted, and reduces the opening and closing force of the basket 4. In addition, the force transmitted from the operating unit 5 to the stone S is greater. Also, if the position at which the basket wire 41 is exposed is on the outside in the radial direction R, the basket wire 41 is more likely to follow the stone S when holding it. Therefore, the length of the longitudinal direction A of the tapered portion 32 can be shortened. As a result, the endoscope insertion performance is improved, and stability is also improved when the tip surface 33 is abutted against the stone S.

The fourth embodiment of the present invention has been described above in detail with reference to the drawings, but the specific configuration is not limited to this embodiment, and design modifications and the like that do not deviate from the gist of the present invention are also included. In addition, the components shown in the above-mentioned embodiment and modified examples can be configured in appropriate combinations.

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.

Fifth Embodiment
An attachment 3F according to a fifth embodiment of the present invention will be described with reference to Fig. 22 to Fig. 25. In the following description, components common to those already described will be given the same reference numerals and duplicated description will be omitted.

FIG. 22 is a perspective view of the 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 a metal such as stainless steel. The attachment 3F has a tapered portion 32 and a detachable portion 39.

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. The end of the base end side A1 of the detachable portion 39 is provided with a plurality of engaging protrusions 39p that protrude inward in the radial direction R.

The wire guide 34F is a groove that extends 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 radially outward in the radial direction R with respect to the central axis O3.

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.

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.

FIG. 23 is a cross-sectional view of the 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 base end to the tip end.

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.

Figure 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 can be attached and detached by fitting (including snap-fitting) to the tip member P of the conventional crushing tool Q. For example, as shown in Figure 24, the main body 31 of the tip member P of the crushing tool Q is provided with a plurality of engaging recesses 31r. As shown in Figure 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, whereby the detachable part 39 is attached 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 by adhesive tape.

When the detachable part 39 is attached to the tip member P, the internal space 3s of the detachable part 39 communicates with the internal space 1s of the sheath 1. When the detachable part 39 is attached to the tip member P, the tip surface 33 is located closer to the tip tip 42 side (distal side A1) than the tip 34a of the wire guide 34F. In addition, when the detachable part 39 is attached to the tip member P, the basket wire 41 is inserted through the slit of the wire guide 34F, and when the basket wire 41 is advanced or retreated, the basket wire 41 is guided by the inclined surface 35C.

The attachment 3F according to this embodiment can be attached to a conventional crushing tool Q, allowing the conventional crushing tool Q to be used as a crushing tool 100F having the same functions as the crushing tool 100 of the first embodiment, etc.

The fifth embodiment of the present invention has been described above in detail with reference to the drawings, but the specific configuration is not limited to this embodiment, and includes design modifications and the like that do not deviate from the gist of the present invention. In addition, the components shown in the above-mentioned embodiments and modified examples can be configured in appropriate combinations.

The present invention can be applied to endoscopic treatment tools that have basket wires.

300 Endoscope treatment system 200 Endoscope 100, 100A, 100B, 100C, 100D, 100E, 100F Crusher (endoscopic treatment tool)
1 Sheath 1s Internal space (lumen)
2 Operation wire 3, 3A, 3B, 3C Tip member 3F Attachment 3s Internal space 31, 31C Main body 32 Tapered portion 32B Tip portion 33, 33B Tip 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 Protrusion 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 Tip tip 43 Bundling portion 5 Operation portion 51 Operation portion main body 52 Liquid supply port 53 Slider 54 Guidewire port A Longitudinal direction A1 Tip side (distal side)
A2 base end side (proximal side)
B Bile duct C Circumferential direction R Radial direction S Stone

Claims (17)

A sheath,
a tip member attached to a tip of the sheath;
A basket wire protruding from the tip of the tip member;
Equipped with
The tip member has a wire guide that guides the basket wire,
The wire guide is disposed radially outward from the distal end surface of the distal end member.
Crushing tools. The wire guide is disposed at a plurality of different positions in the circumferential direction of the tip member.
A crushing tool according to claim 1. The wire guide is separated by a wall provided radially inward of the tip member.
A crushing tool according to claim 1. The wire guide has an inclined surface that inclines radially outward from the base end to the tip end of the tip member.
A crushing tool according to claim 1. The tip member has a tapered portion that reduces in diameter toward the tip of the tip member,
A tip of the wire guide is provided on the tapered portion.
A crushing tool according to claim 1. The tip surface of the tip member is flat.
A crushing tool according to claim 1. The tip surface of the tip member is a curved surface that is convex from the base end to the tip of the tip member.
A crushing tool according to claim 1. The tip surface of the tip member has at least three or more protrusions,
The protrusions and the tips of the wire guides are alternately arranged along the circumferential direction of the tip member.
A crushing tool according to claim 1. An opening is formed in the tip surface of the tip member,
The opening is disposed radially inward from a tip of the wire guide.
A crushing tool according to claim 1. An opening is formed in the tip surface of the tip member,
The distal end surface of the distal end member is located distal to the opening.
The crushing tool according to claim 1. A slit extending in a radial direction through a central axis of the tip member is provided on a tip surface of the tip member,
The slits and the tips of the wire guides are alternately arranged in the circumferential direction of the tip member.
A crushing tool according to claim 1. A slit extending in a radial direction through a central axis of the tip member is provided on a tip surface of the tip member,
The slit is connected to the tip of the wire guide.
A crushing tool according to claim 1. The wire guide has a guide lumen.
A crushing tool according to claim 1. The tip member has a cylindrical main body portion and a tapered portion that reduces in diameter toward the tip of the tip member,
The length of the tip surface of the tip member in the radial direction is smaller than the inner diameter of the main body portion.
A crushing tool according to claim 9. The maximum distance from the opening to the tip surface is greater than the inner diameter of the body portion.
A crushing tool according to claim 14. A guide lumen through which the basket wire passes is provided.
The guide lumen has an inclined surface that inclines radially outward from the proximal end to the distal end.
Crushing tool attachment. A sheath,
A tip member attached to the tip of the sheath;
a basket formed by a basket wire protruding from the tip of the tip member;
Equipped with
When the basket wire is further pulled toward the base end of the sheath in a state where the stone is captured by the basket, the tip of the tip member is pressed against the stone.
Crushing tools.

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