1. Field of the Invention
The present invention relates to endoscopic surgical tools which are endoscopically inserted into a body.
2. Description of the Related Art
Endoscopic treatment tools such as a biopsy brush provided with synthetic fibers inserted between a stranded wire have been used conventionally in order to sample tissue from a body which is used for medical tests. When tissue is sampled with the biopsy brush above, tissue is often sampled by rotating the brush section with a rotary operation of a handle disposed at a proximal end of a wire.
However, tissue sampling target sites such as a bile duct have several narrow portions and a friction often exerts between tissue walls and the brush. If the rotary operation above is performed in this case, the wire that rotates though the brush section does not rotate due to the friction, so there is a possibility of breaking the wire upon exerting an excessive torsional load.
The present invention was conceived in view of the above-described circumstances and has as its objective the provision of an endoscopic surgical tool which can be operated safely even when a torsional load is exerted on a wire.
An endoscopic surgical tool according to a first aspect of the present invention is an endoscopic surgical tool which is inserted into a body endoscopically: the tool includes a wire, a surgical section disposed at a first end of the wire which is used for treatment in the body, an operation section disposed at a second end of the wire which moves in conjunction with the wire so as to rotate by a rotary operation; and the movement of the operating section in conjunction with the wire is released upon exerting more than a predetermined excessive torsional load on the wire.
The endoscopic surgical tool according to the present invention may further include a brittle section which is disposed in the operation section side of the wire and breaks with a smallest torsional load which may exerts on the wire, and the brittle section may break upon exerting more than the predetermined torsional load on the wire.
The operator section may include a first operating member in which the second end of the wire is fixed and a second operating member which is fixed to the first end of the wire.
The operator section may include a first operating member in which the second end of the wire is fixed; and a second operating member which is bonded by an adhesive on the first operating member; and the adhesion between the first operating member and the second operating member may be detached upon exerting more than the predetermined torsional load on the wire.
The operator section may include a first operating member in which the second end of the wire is fixed and a second operating member which is fixed on the first operating member; and the first operating member may include a strain relief portion provided with notches formed along the periphery direction intermittently, the strain relief portion may be ruptured upon exerting more than the predetermined torsional load on the wire.
The endoscopic surgical tool according to a second aspect of the present invention is an endoscopic surgical tool which is inserted into a body endoscopically: the tool includes a wire, a surgical section which is disposed on the first end of the wire and used for treatment in a body, a first operating member in which the second end of the wire is fixed, and a second operating member which is fixed at the first operating member and moves in conjunction with the wire so as to rotate by a rotary operation; and the movement of the second operating member in conjunction with the wire is released upon exerting more than a predetermined torsional load on the wire.
The endoscopic surgical tool according to the present invention may further include a holding member which is disposed between the first and second operating members and holds the first and second operating members by friction.
The endoscopic surgical tool according to the present invention may further include: a first engaging member which is disposed on the first operating member, and a second engaging member which is disposed on the second operating member which fixes the second operating member to the first operating member by engaging the first engaging member; and the engagement between the first and second engaging members may be released upon exerting more than the predetermined torsional load.
The first operating member may be a tube which includes a notch on its outer surface and the second end of the wire is inserted through the first operating member and exposed to the outside of the first operating member from the notch. In this case, when more than a second predetermined torsional load which is smaller than the predetermined torsional load is exerted to the wire, the second end portion may start to be drawn into the first operating member; and when more than the predetermined torsional load is exerted on the wire, the second end portion may be completely housed in the first operating member so as to stop the movement of the second operating member in conjunction with the wire.
The first embodiment of the present invention of the endoscopic treatment tool will be explained with reference to
Brush markers 8A and 8B made of stainless steel are disposed at both the front and rear portions of the surgical section 3 by caulking, respectively, so that the markers become guides to understand the position of the surgical section 3 when the endoscopic treatment tool 1 is operated under fluoroscopy.
An edge chip 9 is disposed at the front portion of the surgical section 3 so as to freely rotate relative to the wire 2. A through hole 9A where a guide wire which is described later is inserted is disposed at the edge chip 9.
The sheath 4 is a flexible tube formed of, for example, synthetic resin and a pipe-like index member 10 formed of stainless steel is fixed inside of and near the distal end thereof as shown in
The brush markers 8A, 8B or the index member 10 may be formed of materials such as tantalum which has a high level of visibility under fluoroscopy, instead of stainless steel.
Furthermore, a colored section 11 is disposed at a predetermined position of the main body 5 side of the sheath 4 as shown in
The sheath 4 is fixed by press-fitting at a distal end of the main body member 12. An inlet 14 for a contrast agent to be filled is disposed at the upper portion of the main body 5. The inlet 14 joins the through hole 12A as shown in
A connecting section 13 includes a connector 17 which is disposed at a rear end of the main body member 12, a fitting member 18 where the operator section 6 is engaged and a packing 19 disposed between the connector 17 and the fitting member 18. A through hole is provided in each member included in the connecting section 13 along their central axis.
The fitting member 18 is screw-fitted to an inside of the substantial pipe-like connecting member 17 so that it is structured to allow a movement within a predetermined area in an axial direction. A through hole 18A of the fitting member 18 is formed in a tapered shape in which the diameter increases gradually as it approaches a rear end so that it is structured to allow engagement of the operator section 6 as described later. The packing 19 is formed of elastic materials such as rubber.
The pipe 20 is formed of metal and an inserted rear end of the wire 2 (the second end portion) is fixed to the pipe 20 by brazing a filler metal 22 drained into the pipe 20. A proximal end of the pipe 20 is fixed to the handle 21 by welding.
The handle 21 is made of, for example, synthetic resin. By performing a rotary operation with the handle 21 around the axial line, the pipe 20 and the wire 2 integrated into the handle 21 move in conjunction with the handle 21 so as to rotate around the axial line.
The operator section 6 configured as above is inserted into the main body 5 as shown in
Furthermore, as shown in
The movement of the endoscopic treatment tool 1 when in use configured as above is described with reference to
First, an endoscope 100 is inserted into a body cavity of a patient with a conventional procedure. A distal end of the endoscope 100 is advanced in the vicinity of a duodenal papilla R1, and then a guide wire (not shown) is inserted into an instrument channel from a forceps port 101 of the endoscope 100.
The guide wire which is protruded from the distal end of the endoscope 100 is advanced into a bile duct R2 from the duodenal papilla R1 and detained under fluoroscopy. Next, the sheath 4 is advanced along the guide wire by inserting the rear end of the guide wire into the through hole 9A of the edge chip 9 and inserting it into the forceps port 101, at a position where the surgical section 3 of the endoscopic treatment tool 1 is housed in the sheath 4. For a smooth operation, the main body 5 is fixed to the endoscope 100 by the anchor 16 if necessary.
As shown in
When the wire 2 is fixed with respect to the sheath 4, extension and retraction of the wire 2 is controlled by advancing the handle 21 and the end portion 21A is fitted into the through hole 18A of the connecting section 13. When the wire 2 is fixed at a position where the wire 2 is further advanced with respect to the sheath 4, the fitting member 18 is screwed into the connector 17 so that the packing 19 is pressed by the fitting member 18, and deflects toward the through hole disposed on the packing 19. Therefore, extension and retraction of the wire 2 is controlled by the pipe 20 being sandwiched by the packing 19.
When tissue is harvested at a narrow cavity area such as intrahepatic bile duct, the surgical section 3 may become difficult to rotate due to friction between the surgical section 3 and an inner surface of, for example, a bile duct. At this time, if the handle 21 continues to be rotated, there may be a possibility of breaking the wire 2 by exerting an excessive torsional load than the predetermined amount.
According to the endoscopic treatment tool 1 of the present embodiment, a user can safely manipulate an extension and retraction movement and removal of the endoscopic treatment tool 1 by holding the wire 2 protruded from the rear portion of the main body 5 in case the wire 2 is broken, since the wire 2 is broken at a brittle portion 23 which has a least strength so as to release the movement of the wire 2 in conjunction to the operator section 6.
Furthermore, since the edge chip 9 where the guide wire is inserted is fitted so as to freely rotate with respect to the wire 2, the wire 2 can be smoothly operated without being twisted even the guide wire is meandered or twisted.
In the preceding embodiment, the brittle portion 23 is disposed by tempering. However, the method for forming the brittle portion is not limited thereto; it is also acceptable to provide the brittle section by other methods.
For example, as shown in an example of a modification in
Furthermore, in the above embodiment, the example in which the operator section includes the pipe 20 and the handle 21, and the wire 2 is fixed to the pipe 20 is described. However the structure of the present application is not limited thereto, for instance it is also acceptable if the operator section 6 does not include the pipe 20 and the rear end of the wire 2 is directly fixed to the handle 21.
Furthermore, predetermined amounts of torsional load in which the brittle portion 23 breaks can be adjusted freely by controlling the manufacturing method of the brittle portion 23. For example, when the wire 2 of the surgical section 3 is tempered in order to increase the fixability of fiber 7 at the surgical section 3, the brittle portion 23 can be manufactured in the way that the brittle portion 23 becomes more brittle than the surgical section 3 by increasing the degree of tempering the brittle portion 23. In this way, breaking the surgical section 3 by torsional load before the brittle portion 23 can be prevented so as to obtain the same effect of the present invention in the above embodiment.
The second embodiment of the present invention of the endoscopic treatment tool will be explained with reference to
In the following description, components that are the same as the first embodiment shall be provided with the same numeric symbol and redundant descriptions shall be omitted.
According to an endoscopic treatment tool 31 of the present embodiment, when the surgical section 3 looses its rotatability due to a friction force against the tissues around, for example, a biliary duct and an excessive torsional load is exerted by a rotary operation of the handle 21, the strain relief portion 34 of the pipe 33 is broken by cutting. Then the movement of the wire 2 in conjunction with the operator section 6 is released hence the torsional load exerted to the wire 2 is absorbed so that breakage of the wire 2 can be prevented.
The present embodiment describes an example of releasing the movement of the wire 2 in conjunction with the operator section 6 by providing the strain relief portion at the pipe 33, however the manufacturing method of the operator section 6 in order to release the movement of the wire 2 in conjunction with the operator section 6 when an excessive torsional load is exerted on the wire 2 is not limited thereto.
For instance, the pipe 33 and the handle 21 may be bonded by, for example, an adhesive without being fixed by welding. In this case, the amount and strength of an adhesive may be adjusted so as to detach the bonding between the pipe 33 and the handle 21 in order to release the movement of the operator section 6 in conjunction with the wire 2 when excessive torsional load is exerted on the wire 2.
Next, a third embodiment of the present invention will be explained with reference to
In the following description, components that are the same as the first embodiment shall be provided with the same numeric symbols and redundant descriptions shall be omitted.
A ring-shaped groove 44C is disposed along a periphery direction at a predetermined position of the insertion hole 44B. A holding member 45 such as an O-ring made of an elastic material such as rubber is disposed inside of the groove 44C.
When a handle 44 of the endoscopic treatment tool 41 is rotary operated, the handle 44, the pipe 43 and the wire 2 move in conjunction with each other and rotate with the friction force of the holding member 45 so as to rotate the surgical section 3 disposed at the edge of the wire 2, at a normal state where there is no friction between the surgical section 3 and tissue in the vicinity thereof.
When the surgical section 3 looses the ability to rotate such as by entering into a narrow cavity, a torsional load is exerted by a rotary operation of the handle 44. When an excessive torsional load is applied, the handle 44 rotates free by releasing the movement of the pipe 43 due to the friction of the holding member 45 so that an excessive torsional load will not be applied to the wire 2. Hence the wire 2 is prevented from being damaged.
According to the endoscopic treatment tool 41 of the present embodiment, the movement of the sheath 4 in conjunction with the wire 2 is released by releasing the friction generated by the holding member 45 which holds the pipe 43 and the handle 44. Since breakage of the wire 2 can be prevented without damaging the wire 2 or the operator section 42, an andoscopic treatment tool which is safely operated continuously even when an excessive torsional load is transiently exerted on the wire 2.
Next, a forth embodiment of an endoscopic treatment tool 51 of the present invention will be explained with reference to
In the following description, components that are the same as the first embodiment shall be provided with the same numeric symbols and redundant descriptions shall be omitted.
When the handle 54 of the endoscopic treatment tool 51 is rotated, the second engaging member 54C of the handle and the first engaging member 53A of the pipe 53 are engaged so that the pipe 53 and the wire 2 fixed on the pipe 53 are rotated in conjunction with the handle 54.
When the surgical section 3 looses its rotatability by, for example, entering into a narrow cavity, a torsional load is exerted by the rotary operation of the handle 54. When an excessive torsional load is exerted, the movement of the handle 54 in conjunction with the pipe 53 is released by rotating the second engaging member 54C over the first engaging member 53A. Consequently, the handle 54 freely rotates so as to release the torsional load exerted on the wire 2. Thus a breakage of the wire 2 can be prevented.
According to the endoscopic treatment tool 51 of the present embodiment, the breakage of the wire can be prevented without damaging the wire and operator section as per the endoscopic treatment tool 41 described above. Furthermore, a torsional load exerted on the wire 2 is easily released by releasing the movement of the handle 54 in conjunction with the pipe 53, hence an endoscopic treatment tool which can be operated more safely can be constructed.
According to the present embodiment, the example of the structure where both the first engaging member 53A and the second engaging member 54C are protruded is described, however the structure is not limited thereto, instead, one of them may be grooved so as to engage the first engaging member 53A and the second engaging member 54C.
Next, a fifth embodiment of the present invention is described with reference to
In the following description, components that are the same as the first embodiment shall be provided with the same numeric symbols and redundant descriptions shall be omitted.
A movement of an endoscopic treatment tool 61 when in use is described. First, the surgical section 3 housed inside of the sheath 4 is made to advance into the bile duct R2 by the same procedure as shown in
When the surgical section 3 looses its rotatability due to being in a narrow cavity and so on, more than a predetermined value (the second predetermined value) of torsional load is exerted to the wire 2, the rear end 2A of the wire 2 stats to be drawn into the pipe 63 by bending the rear end 2A of the wire 2 as shown in
According to the endoscopic treatment tool 61 of the present embodiment, even when the rear end 2A of the wire 2 is contained in the pipe 63, a repeated rotary operation is possible by protruding the rear end 2A from the notch 63A by rotating the handle 64 in an opposite direction. Therefore, the breakage of the wire can be prevented without damaging the wire and the operator section as per the endoscopic treatment tools 41 and 51 described above.
While preferred embodiments of the invention have been described and illustrated above, it should be understood that these are exemplary of the invention and are not to be considered as limiting. Additions, omissions, substitutions, and other modifications can be made without departing from the spirit or scope of the invention.
For instance, in the embodiment above, the surgical tools in which the distal end of the surgical section is a brush are given as examples; the invention is not limited thereto. For instance, the surgical section may be a conventionally known basket 65 which is formed by twisting a plurality of wires as an example of a modification shown in
Furthermore, the target tissue and organs are not limited in the bile duct as described above; the present invention can be applied in any organ even where rotation of the surgical section may be difficult.
Accordingly, the invention is not to be considered as being limited by the foregoing description, and is only limited by the scope of the appended claims.
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