1. Field of the Invention
The present invention relates to a treatment instrument for treating body tissue.
This application claims priority from Japanese Patent Application No. 2009-026583 filed on Feb. 6, 2009, the content of which is incorporated herein by reference.
2. Description of Related Art
Conventionally, as treatment instruments for conducting treatment of body tissue, there are known to be lithotriptic baskets that tightly bind and crush calculi with wire, and high-frequency treatment instruments that grasp body tissue and that perform cautery incisions and the like with wire capable of carrying high-frequency current.
As examples of such treatment instruments, there is, for example, the endoscopic treatment instrument recorded in Patent Document 1 which is provided with a wire capable of carrying high-frequency current. This endoscopic treatment instrument is provided with a manipulation wire that passes through a sheath, a connecting pipe that is provided on the distal end side of this manipulation wire, and a loop wire (wire) of which both ends are inserted into and fixed to this connecting pipe.
According to the endoscopic treatment instrument recorded in Patent Document 1, it is possible to securely grasp body tissue with this loop wire (wire), and excise body tissue such as polyps and the like.
Patent Document 1: Japanese Unexamined Patent Application, First Publication No. 2000-271146.
However, with the endoscopic treatment instrument recorded in Patent Document 1, both ends of the wire are inserted together into and fixed to the connecting pipe. Consequently, there is the problem that it is necessary to configure the inner diameter of the connecting pipe to be at least twice the outer diameter of the wire, and that it is difficult to reduce the diameter of the connecting pipe. Moreover, when the connecting pipe that bulges in the radial direction relative to the wire undergoes sliding movement relative to that sheath, sliding resistance occurs. Consequently, there is the problem that the tractive force and pressing force that are required to operate the manipulation wire are large.
The present invention was made in light of the foregoing circumstances, and its object is to offer a treatment instrument that enables reduced diameter.
In order to solve the aforementioned problems, the present invention is provided with the following structure.
The treatment instrument of the present invention is provided with: a flexible wire that has a first end part and a second end part, and that has a treatment part at an intermediate part for conducting treatment within a body cavity; small-diameter parts where at least a portion of the outer circumferential face of the wire has a smaller diameter or is denuded relative to the rest; a bundled part where the wire is bundled so as to at least include the small-diameter parts; and a manipulation wire that is connected to the bundled part.
According to the present invention, a small-diameter part of the wire has a portion where the diameter is smaller than that of the other portion of the wire. Accordingly, the bundled part where the wire is bundled so as to include the small-diameter parts is more compact than in the case where the same number of wires is bundled without inclusion of small-diameter parts. Accordingly, it is possible to reduce the maximum external diameter of the connecting part of the bundled part and the manipulation wire, and create a treatment instrument of smaller diameter.
With respect to the treatment instrument of the present invention, it is preferable that the small-diameter parts be provided at least at the first end part or the second end part.
In this case, as the small-diameter parts are provided at the end parts, it is possible to impart a larger diameter than the small-diameter parts to the intermediate part that serves to conduct treatment within the body cavity.
It is also preferable that the treatment instrument of the present invention has a connecting tube into which at least the small-diameter parts and the manipulation wire are inserted, and in which they are fixed.
In this case, as the small-diameter parts and manipulation wire are together inserted into and fixed to a connecting tube, the respective external faces of the small-diameter parts and the manipulation wire are supported on the inner circumferential face of the connecting tube. Accordingly, fixation can be conducted simply and reliably compared to the case where the respective end parts of the small-diameter parts and the manipulation wire are joined together.
The treatment instrument of the present invention is provided with: a flexible wire that has a first end part and a second end part, and that has a treatment part at an intermediate part for conducting treatment within a body cavity; a small-diameter part where at least a portion of the outer circumferential face of the first end part has a smaller diameter or is denuded relative to the outer circumferential face of the intermediate part of the wire; and a bundled part where the wire is curved or folded back, and the small-diameter part is fixed to the outer circumferential face of the wire. The length from the treatment part to the second end part is longer than the length from the treatment part to the first end part.
According to the present invention, as the small-diameter part is bundled and fixed to the outer circumferential face of the wire, it is possible to reduce its maximum external diameter compared to the case where a conventional first end part that is not of small diameter is fixed to the outer circumferential face of the wire.
With respect to the treatment instrument of the present invention, it is also acceptable for the small-diameter parts to be tapered so that diameter narrows in a tapered form.
In this case, as the external diameter of the wire in the tapered portion gradually changes, a bump in the outer circumferential face of the wire is eliminated. Consequently, it is possible to prevent damage resulting from wire breakage or the like due to catching of this bump on an object or the like.
In addition, with respect to the treatment instrument of the present invention, it is preferable that the wire have electrical conductivity, and that it be further provided with conductive members that are electrically connected to the aforementioned wire and that serve to supply high-frequency current.
In this case, it is possible to conduct high-frequency current from the conductive members via the wire to a target object that contacts the wire.
Moreover, with respect to the treatment instrument of the present invention, it is preferable that the manipulation wire have electrical conductivity.
The configuration can be simplified in this case, because it is possible to conduct high-frequency current to the wire and to manipulate the wire by means of the manipulation wire.
With respect to the treatment instrument of the present invention, it is also preferable that the treatment part be a snare wire that tightly binds body tissue and performs cautery cutting.
In this case, the small-diameter part has a smaller diameter relative to the snare loop part in the snare wire that contacts body tissue in order to tightly bind the body tissue. Accordingly, it is possible to reduce the diameter of the bundled part regardless of the thickness of the snare loop part.
It is also acceptable for the treatment instrument of the present invention to have a plurality of the wires, and for the treatment part to be provided with a basket that contacts the body tissue at three or more separate points relative to a substance within the body cavity, and that captures the substance within the body cavity.
According to the treatment instrument of the present invention, small-diameter parts are provided at portions of the wires. Consequently, with respect to a bundled part where the wires are bundled so as to include more than one small-diameter part, it is possible to reduce maximum external diameter. It is also possible to reduce the diameter of the treatment instrument provided with the wires.
A treatment instrument of a first embodiment of the present invention is described below with reference to
A manipulation wire 5 that is composed of flexible metallic wire and that is respectively connected to the treatment part 3 and manipulation part 4 runs through the interior of the sheath 2.
With respect to the manipulation part 4, one may appropriately adopt a configuration of a conventional manipulation part of a treatment instrument. For example, one may adopt a manipulation part provided with a manipulation body 45 into which the manipulation wire 5 is inserted so as to be capable of freely moving forward or backward and which extends in the axial direction, a slider 41 that is capable of freely moving forward or backward relative to the manipulation body 45 and that serves to conduct forward/backward operation of the manipulation wire 5 relative to the sheath 2, and a supply electrode 46 that is provided in this slider 41 and that serves to connect the manipulation wire 5 to an external high-frequency power supply device (not illustrated in the drawings). High-frequency current can be carried from the high-frequency power supply device to the supply electrode 46, manipulation wire 5, and a wire 50 which are conductive members that have electrical conductivity.
With respect to this type of manipulation part 4, in order to optimally conduct forward and backward operation of the slider 41 relative to the manipulation body 45, it is preferable to provide finger grips 42, 43, and 44 that may be gripped by the fingers of the operator.
Furthermore, a bundled part 55 where the wire 50 is bundled is configured by the first end part 51, second end part 52, and connecting tube 54. In addition, a distal end 5b of the manipulation wire 5 inserts into the connecting tube 54 so as to face the first end part 51 and second end part 52.
The wire 50 and manipulation wire 5 are both inserted into the connecting tube 54, and are fixed thereto by, for example, brazing. With respect to the method of connecting the manipulation wire 5 and the wire 50, so long as it is a method that uses the connecting tube 54, an appropriate method other than brazing may be adopted such as welding, soldering, or caulking.
With respect to the method of formation of the small-diameter parts 51a and 52a, one may adopt a method where the outer circumferential face of the wire is pared away by centerless taper processing, a method where the end parts of the wire 50 are immersed in a chemical solution to corrode the end parts of the wire 50, and so on. Moreover, although not illustrated in the drawings, it is also possible to form an inclined end face and form the taper by cutting the wire 50 at the first end part 51 or second end part 52 at an angle that is inclined relative to the axial line of the wire 50.
Operations during use of the treatment instrument 1 of the present embodiment having the configuration described above are described with reference to
First, the user inserts a prescribed endoscope into a body cavity of a patient from a natural orifice such as the anus or mouth. In the present embodiment, the endoscope is provided with a guide means capable of guiding the treatment instrument 1 along the endoscope, such as a treatment instrument channel through which the treatment instrument 1 is capable of freely passing with forward or backward movement, and an imaging mechanism capable of imaging the body tissue that is the object of treatment, such as a solid-state imaging device or a fiberscope.
The user guides the distal end of the endoscope to a prescribed position within the body cavity of the patient, and confirms the body tissue that is the object of treatment within the visual field of the imaging mechanism. Next, the user passes the treatment instrument 1 along, for example, the aforementioned treatment instrument channel, and directs it to the interior of the body cavity of the patient through the treatment instrument channel.
Next, the user causes sliding movement of the slider 41 of the manipulation part 4 (see
The wire 50 that projects from the distal end 2a of the sheath 2 restores itself to an open state due to its own elasticity, and becomes approximately annular in shape. The user adjusts the position of the wire 50 so that the wire 50 is placed around the polyp P.
When this is done, the wire 50 and the connecting tube 54 that are fixed to the distal end of the manipulation wire 5 are moved so as to be stored within a lumen 21 of the sheath 2. At this time, as the polyp P is enclosed by the wire 50, the wire 50 contacts the outer face of the polyp P. Furthermore, when the wire 50 is pulled back into the lumen 21 of the sheath 2, the polyp P contacts the distal end 2a of the sheath 2. In this state, the polyp P is tightly bind by both the wire 50 and the sheath 2.
Next, the user causes high-frequency current to be conducted to the treatment part 3 through the supply electrode 46. The high-frequency current is conducted to the supply electrode 46, manipulation wire 5, and wire 50 which are conductive members having electrical conductivity. A description is omitted with respect to other conductive members that serve to electrically connect the respective supply electrode 46, manipulation wire 5, and wire 50. At a contact portion T of the wire 50 and the polyp P, Joule heat is generated by the high-frequency current, whereupon a cautery incision of body tissue is made at the contact portion T, and the polyp P is excised.
When the polyp P is excised, the polyp P is taken out of the body after excision using a known tissue recovery device that is not illustrated in the drawings, the treatment instrument 1 is withdrawn from the interior of the body cavity, and the treatment sequence is terminated.
With respect to conventional treatment instruments, it was required to reduce the external diameter of the sheath, but it was difficult to reduce diameter, because the maximum external diameter of the member that includes the wire, connecting tube and manipulation wire, and that moves backward and forward through the interior of the sheath is determined by the external diameter of the end part of the wire and the external diameter of the connecting tube. As a result, previously, the connecting tube would slide against the lumen of the sheath at the connecting portion of the wire and the manipulation wire, and resistance would be large when the operator manipulated the manipulation part.
According to the treatment instrument 1 of the present embodiment, a bundled part 55 is configured by bundling and inserting the first end part 51 and second end part 52 which are small-diameter parts into the interior of the connecting tube 54. The total diameter of the first end part 51 and second end part 52 is configured to be more than two times smaller than the diameter of the intermediate part 53. Consequently, the inner diameter of the connecting tube is smaller than the inner diameter of a conventional connecting tube. As a result, even in the case where the thickness of the tube wall of the connecting tube is made the same in order to ensure the strength of the connecting tube, the external diameter of the connecting tube is reduced. Accordingly, with respect to the treatment instrument 1 of the present embodiment, it is possible to optimally conduct forward/backward operation of the treatment part 3 and the manipulation wire 5 within the sheath 2, because the sliding resistance between the lumen 21 and the connecting tube 54 can be reduced in comparison to conventional configurations.
Moreover, it is also possible to compact the interstice of the lumen 21 and connecting tube 54, and further reduce the diameter of the sheath 2.
In the present embodiment, the intermediate part 53 has a larger diameter than the small-diameter parts 51a and 52a. This is because it is necessary to have a thickness that suitably inhibits the wire 50 from excessively cutting into body tissue or the like and severing the body tissue when the intermediate part 53 tightly binds the body tissue. With respect to the wire 50 of the present embodiment, the small-diameter parts 51a and 52a are provided so as to avoid the region where contact is made with body tissue when the body tissue is tightly bind. Accordingly, body tissue such as the polyp P can be cut while cauterizing by applying high-frequency current. Consequently, the wire 50 of the present embodiment is able to combine the performance of a snare wire and reduced sheath diameter in the manner described above.
(Variation 1)
A variation of the wire 50 is described below with reference to
The drawings show a wire 250 of the present variation.
As shown in
As shown in
As shown in
In the present variation, when the first end part 251 and second end part 252 are inserted into the connecting tube 54, the element that regulates the inner diameter of the connecting tube 54 is the outer diameter of the manipulation wire 5. Accordingly, with respect to the present variation, it is possible to establish the inner diameter of the connecting tube 54 at the minimum inner diameter that satisfies the form that is required by the manipulation wire 5 when the treatment part 3 is moved forward or backward. Consequently, the present variation enables minimization of the inner diameter and external diameter of the connecting tube 54. Accordingly, the present variation enables the diameter of the sheath to be reduced like the treatment instrument 1 described above.
(Variation 2)
A variation of the wire 50 is described below with reference to
These drawings show a wire 350 of the present variation.
As shown in
As shown in
As the diameter of the bundled part can be reduced in the manner described above even with the aforementioned shape, it is possible to obtain the same effect as the treatment instrument 1 described above.
Next, a treatment instrument of a second embodiment of the present invention is described with reference to
The treatment instrument of the present embodiment is not provided with the manipulation wire 5, and is provided with a wire 450 instead of the wire 50.
Next, a treatment instrument of a third embodiment of the present invention is described with reference to
As shown in
This type of basket configuration may be suitably employed, for example, for lithotriptic baskets that serve to crush gallstones and the like, stone extraction baskets that serve to recover gallstones and the like, or basket-type microsnares that serve to crush blood clots and the like.
With respect to such baskets having bundled parts including one or more small-diameter parts, multiple wires are bundled together, with the result that it is possible to reduce the maximum external diameter of the portions where the wires are bundled in comparison to conventional baskets where the bundled portions are of large diameter.
Next, a treatment instrument of a fourth embodiment of the present invention is described with reference to
For example,
A basket configuration similar to that of the third embodiment is obtainable with this type of configuration as well. By bundling multiple wires in the same way as the third embodiment, it is possible to reduce the maximum external diameter of the portions where the wires are bundled in comparison to conventional baskets where the bundled portions are of large diameter.
In the present embodiment, it is also possible to adopt configurations where the orientation of the bumps that occur in the small-diameter parts are changed, in a manner similar to the positional relations shown in
Next, a treatment instrument of a fifth embodiment of the present invention is described with reference to
For example,
A basket configuration similar to that of the third embodiment is obtained with this type of configuration as well. By bundling multiple wires in the same way as the third embodiment, it is possible to reduce the maximum external diameter of the portions where the wires are bundled in comparison to conventional baskets where the bundled portions are of large diameter.
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 present invention. 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.
Number | Date | Country | Kind |
---|---|---|---|
2009-026583 | Feb 2009 | JP | national |
Number | Date | Country | |
---|---|---|---|
Parent | PCT/JP2010/050889 | Jan 2010 | US |
Child | 12851700 | US |