JP2002301088A - Endoscopic treatment device - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an endoscopic treatment device capable of performing a treatment without replacement of a treatment tool having a different function inserted to, a tube of an endoscope and quickly performing a series of works from the enucleate of a diseased tissue to the hemostasis thereof. SOLUTION: This endoscopic treatment device endoscopically used to perform the enucleation, hemostasis, and coagulation of the tissue of a living body by carrying a high frequency current to the tissue comprises a lengthy probe 3 endoscopically insertable into the body and having a through-hole opened at the tip. An electrode knife part 11 is provided near the tip of the probe 3 so as to be protrudable from the tip of the probe 3, and capable of carrying high frequency current; a tip insulation part 13 larger in diameter than the knife part 11, which is provided at the tip of the knife part 11. A control device 7 has a high frequency power source for supplying the high frequency current to the knife part 11, a conduit for supplying an inert gas to the through-hole possessed by the probe 3, and a means for controlling the supply of high frequency current to the knife part.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention is used endoscopically to cut a living tissue or to stop or coagulate a treatment target site of a living body such as a bleeding part by applying a high-frequency current. The present invention relates to a treatment device for an endoscope.

[0002]

2. Description of the Related Art A high-frequency coagulation apparatus for an endoscope which stops hemostasis by supplying a high-frequency current to a bleeding part is disclosed in Japanese Patent Application Laid-Open No. 9-164149.
No. 6,009,036.

An apparatus disclosed in Japanese Patent Application Laid-Open No. Hei 9-164149, known as an argon beam coagulator, uses a gas supply for supplying an ionizable gas (an inert gas such as argon). Means, HF source, H
One element for conducting an HF current from the F source into the gas. This means that the HF current is caused to flow through the bleeding part using the gas injected toward the bleeding part by the gas supply means as a medium,
Thus, a wide range of hemostasis can be performed at once without contact.

On the other hand, a treatment apparatus for an endoscope in which a mucous membrane of an affected part is resected endoscopically is disclosed in Japanese Patent Application Laid-Open No. 8-299355. The treatment apparatus for an endoscope disclosed in this Japanese Patent Application Laid-Open No. 8-299355 discloses a needle-shaped high-frequency knife,
An electric insulating tip provided at the tip of the high-frequency knife and having a diameter larger than that of the high-frequency knife. According to this, because the incision is made while pressing the insulating part against the affected part,
During incision of the mucous membrane, penetration into deep tissue that should not be incised and unnecessary cauterization can be prevented.

[0005]

By the way, conventionally, when hemostasis is performed after incision of the mucous membrane, after the incision is made in the mucous membrane by a treatment device for an endoscope disclosed in Japanese Patent Application Laid-Open No. 8-299355, It has been replaced with another high-frequency coagulation device for endoscopes disclosed in Japanese Patent Application Laid-Open No. 9-164149.

In the case of this conventional technique, it is necessary to replace the treatment tool, which requires labor and time for replacement.
The burden on the surgeon and patient is large.

Further, when hemostasis is performed using a high-frequency coagulation device for an endoscope disclosed in Japanese Patent Application Laid-Open No. 9-164149, etc., when a mucous membrane comes into contact with the distal end of the device, the mucosa contacts the distal end of the probe. In such a case, the original treatment function cannot be sufficiently performed, and there is a disadvantage that it takes time and effort such as replacing the probe itself.

SUMMARY OF THE INVENTION The present invention has been made in view of the above-mentioned circumstances. It is an object of the present invention to replace a treatment tool having a different function in a treatment tool insertion hole of an endoscope and perform treatment. To provide an endoscope treatment device that can quickly perform a series of operations leading to resection and hemostasis,
An object of the present invention is to provide a treatment device for an endoscope which can prevent the mucous membrane from sticking to the electrode even when the mucous membrane of the affected part contacts the distal end of the device.

[0009]

In order to achieve the above object,
INDUSTRIAL APPLICABILITY The present invention can be used endoscopically.
In a treatment device for an endoscope that stops and coagulates blood, a long probe that can be inserted into a body transendoscopically and has a through hole that opens at the tip, and the probe that is provided near the tip of the probe, An electrode which can be protruded and retracted from the tip of the electrode, and which can supply a high-frequency current, provided at the tip of the electrode,
An electrical insulator having a diameter larger than that of the electrode, a high-frequency power supply for supplying a high-frequency current to the electrode, a means for supplying an inert gas to the through hole of the probe, and a means for supplying a high-frequency current to the electrode. And a control device having the same.

[0010] According to the present invention, there is provided a function of incising a single treatment tool and a function of stopping blood, so that it is not necessary to replace the treatment tool. In addition, the distance between the electrode tip of the probe and the mucous membrane is maintained by applying the electrical insulator provided at the electrode tip to the affected part. This prevents the mucous membrane from adhering to the electrode tip.

[0011]

DESCRIPTION OF THE PREFERRED EMBODIMENTS (First Embodiment) A first embodiment of the present invention will be described with reference to FIGS. The high-frequency coagulation apparatus for an endoscope according to the present embodiment is shown in FIG.
As shown in FIG. 1, a long probe (treatment probe main body) 3 that can be inserted into a treatment tool insertion hole 2 of an endoscope 1 (see FIG. 8) described later, and a hand-side operation unit 4 of the probe 3 A control device 7 to which the probe 3 is connected via the current supply cable 5 and the fluid supply tube 6; A foot switch 8 for an operator to operate the control device 7.

As shown in FIG. 2, the probe 3 includes an insertion portion 9, a high-frequency knife 13 inserted therein, and a conductive wire 21 for transmitting a high-frequency current from the control device 7 to the high-frequency knife 13. , And the near-side operation unit 4.

As shown in FIG. 3, the insertion portion 9 of the probe 3 comprises a resin tube 15 and a tip 10 attached to the tip of the resin tube 15. The tip 10 is connected via a ring-shaped intermediary tool 19. It is connected to the resin tube 15. The resin tube 15 is a so-called multi-lumen tube in which a relatively large-diameter pipe line 48 formed at the center and at least one or more relatively small-diameter pipe lines 16 provided around the pipe 48 are formed. It is. The resin tube 15 is desirably made of a material having excellent flexibility such as PTFE. Further, the outer diameter of the resin tube 15 is φ1.5 mm to φ6 mm, and particularly preferably φ2 mm to 3.5 mm.
The length of the resin tube 15 is longer than the entire length of the treatment instrument insertion hole 2 of the endoscope 1.

The pipe 4 having the larger diameter of the resin tube 15
The diameter of 8 is large enough to allow an appropriate amount of inert gas to flow even when the high-frequency knife 13 and the conductive wire 21 advance and retreat.

An operation wire 18 is inserted through the smaller diameter pipe 16, and one end of the operation wire 18 is adhesively fixed to the resin tube 15 at a tip end of the pipe 16. The other end of the operation wire 18 is a resin tube 15
5 and extends out from a slit 54 formed in the base end portion of the resin tube 15 as shown in FIG. The operation wire 18 can be advanced and retracted by performing a push-pull operation on the hand side.

As shown in FIG. 3, a plurality of rectangular slits (holes) 17 are provided in the distal end portion of the smaller diameter pipe 16 of the resin tube 15. By forming the slit 17 in this manner, when the operation wire 18 inserted into the small-diameter conduit 16 is pulled toward the hand, the tip of the resin tube 15 is drawn toward the hand, and the slit 17 is formed. The curved portion starts to curve. By utilizing this, the direction of the tip of the probe 3 can be freely adjusted (see FIG. 8).

The width of the slit 17 is 1 mm to 1 mm.
0 mm, and particularly desirably 3 mm to 6 mm. The interval between the slits 17 is 1 mm to 100 mm, particularly 2 mm
Desirably, it is about 5 mm. The number of slits 17 is not limited to the number shown in the figure.

The intermediary tool 19 is bonded and fixed to the inner surface of the resin tube 15 at the distal end of the conduit 48. The intermediary device 19 is made of a relatively hard and heat-resistant material such as a ceramic, for example. A through hole 47 is provided in the center of the mediating tool 19. The diameter of the through hole 47 is large enough for the high-frequency knife 13 to advance and retreat, and to allow an appropriate amount of inert gas to flow.

A screw portion 22 is formed on the outer peripheral portion on the distal end side of the intermediary tool 19.
Is screwed. The tip 10 is made of a relatively hard and heat-resistant material such as ceramic. The outer diameter of the distal end tip 10 is φ1.5 mm to φ6 mm, and particularly preferably φ2 mm to φ3.5 mm.

A through hole 14 is provided at the center of the tip 10. The diameter of the through hole 14 is
Are large enough to advance and retreat, and to flow the inert gas.

A screw portion 22 is provided on the proximal inner surface of the distal tip 10. As a result, the distal tip 10 is fixedly attached to the intermediary tool 19, but is also detachable. The connection means between the tip 10 and the intermediary tool 19 may be of any type as long as it is detachable, and is not limited to the screw type.

The high-frequency knife 13 is composed of a knife section 11 as an electrode which can be protruded and retracted from the tip of the probe 3 and which can supply a high-frequency current, and a tip insulating section 12 as an electrical insulator provided at the tip of the knife section 11. Become. The knife unit 1
1 is made of a material having excellent conductivity, such as tungsten, stainless steel, and gold. In addition, the length of the knife portion 11 is 3 mm to 20 mm, and particularly preferably 5 mm to 10 mm. In addition, the knife portion 11 has the tip 10
The protrusion length at this time is from 1 mm to 7 mm, but is preferably from 2 mm to 5 mm.

The tip insulating section 12 attached to the tip of the knife section 11 has a diameter larger than the outer diameter of the knife section 11 as an electrode. Further, the distal end insulating portion 12 is made of a material having excellent electrical insulation properties and heat resistance, such as ceramics, for example. Further, the surface of the distal end insulating portion 12 is thinly coated with, for example, a fluorine coat or the like in order to prevent sticking of the mucous membrane.

A connecting pipe 20 is provided at the base end side of the knife portion 11.
The distal end of the conductive wire 21 is connected via the.
The connection pipe 20 is made of a material having excellent conductivity, such as stainless steel or gold.

As shown in FIG. 5, the hand-side operation section 4 includes a pipe-shaped main body 49, a base member (fluid supply connection means) 50, and a current-carrying connector (high-frequency supply connection means) 23. . The main body 49 has an internal conduit 51,
The inner diameter of the internal conduit 51 is large enough to allow the distal end portion of the base member 50 to pass therethrough.

Semi-circular projections 28 and 27 are provided on a part of the inner surface of the inner conduit 51 of the main body 49 and on the outer surface near the tip of the base member 50, respectively. As shown in FIG. 5, when the high-frequency knife 13 is most protruded, the protrusions 27 and 27 are positioned relative to each other.
Are located on the distal end side of the protrusion 28.
As a result, the projections 27 and 28 serve as stoppers that do not move unless the base member 50 is intentionally moved.

Thus, the high-frequency knife 13 can be fixed at the most protruding position. At this time, the convex portion 61 of the base member 50 has a role of sealing the open end of the main body 49. Therefore, the inside of the internal conduit 51 is kept airtight. Also, since the surfaces of the projections 27 and 28 are sufficiently smooth,
When the cap member 50 is intentionally moved, it can be moved relatively easily. Further, the shapes of the protrusions 27 and 28 are not limited to those shown in the drawings, and may be elliptical, trapezoidal, triangular, or the like. Further, the stopper mechanism is not limited to the protrusion mechanism, and may be a method of fixing with a screw or the like.

As shown in FIG. 5, a pipe 25 for flowing an inert gas is formed through the base member 50 so as to penetrate therethrough. Is provided. The current-carrying connector 23 is provided with a cover 24 and a connection terminal 26. Connection terminal 2
6 is located in the cover part 24 and is electrically connected to the conductive wire 21 via an L-shaped pipe 52. The L-shaped pipe 52 is made of a material having excellent conductivity such as stainless steel or gold. This allows the high-frequency knife 13 to move forward and backward by moving the base member 50 forward and backward.

Next, the operation of the high-frequency coagulation apparatus for an endoscope according to the present embodiment will be described with reference to FIGS. First, as shown in FIG. 6, physiological saline is injected into the connective tissue 30 between the mucous membrane 29 and the muscular layer 31 using a local injection needle (not shown), and the mucous membrane 29 is bulged. Also, in advance,
(P plate) is stretched outside the patient's body.

Next, at the incision 11 of the high-frequency knife 13,
After making a small incision 53 on the swollen mucous membrane 29, the tip insulating portion 12 of the high-frequency knife 13 is inserted under the mucous membrane 29.
By cutting off the mucous membrane 29 in this state, the mucous membrane 29 is incised while preventing power supply to the muscle layer 31.

Next, a description will be given of a hemostatic operation at a bleeding site during or after mucosal resection. As shown in FIG. 7, the high-frequency knife 13 is turned to the bleeding site while observing with the endoscope 1. High frequency knife 1
3 is made to protrude from the through hole 14 of the tip 10, and the tip insulating portion 12 of the high-frequency knife 13 is pressed against the bleeding site.

Next, discharge of an inert gas and high-frequency current supply are performed. As a result, a plasma reaction is caused between the knife portion 11 and a living tissue adjacent to the knife portion 11, and the bleeding site is cauterized to stop bleeding. At this time, the knife portion 11 as an electrode
, The knife portion 11 of the probe 10 does not contact the mucous membrane.

Further, by pulling the operation wire 18 by the operation on the hand side and bending the distal end portion of the insertion portion 9 as shown in FIG. 8, a narrow lumen which cannot bend the endoscope 1 is used. Even in an organ, the hemostasis can be performed by easily facing the distal end portion of the insertion portion 9 and the hemostasis site.

At this time, as shown in FIG. 9, when the insertion portion 55 of the endoscope 1 is covered with a conductor 32 and is connected to the control device 7 at hand, the endoscope 1 The insertion portion 55 is used in place of the electrode (P plate) on the human body side, and the current can be transferred within the human body as shown in FIG. This saves the labor of extending the electrode (P plate) on the human body side outside the patient's body.

Further, without coating the endoscope 1, FIG.
As shown in FIG.
4 and may be connected to the control device 7 via the connection tool 36 and the connection cord 37. At this time, the hand base 35 is inserted into the overtube 33 inserted in the body in advance.
The endoscope 1 is inserted and used.

Furthermore, since the tip 10 is replaceable, it can be replaced with various types of tips depending on the application and used properly. Hereinafter, some examples of the tip 10 will be described and described.

(1) The tip shown in FIG. 11 is a tip 10 having a closed tip, and a side port 37 is provided on a side surface of the tip 10. According to the distal tip 10, when performing hemostasis in a narrow luminal organ in which the endoscope 1 cannot be bent, the operation wire 18 does not need to be advanced or retracted, so that hemostasis can be performed more easily. The size of the side port 37 is large enough for the fluid to flow out. In addition, side mouth 3
The shape of 7 is not limited to that of FIG.

(2) The tip shown in FIG.
It has an electrode insertion hole 38 provided at the center of the 0 axis and a plurality of fluid insertion holes 39 provided on the side wall of the distal end tip 10.

According to the tip 10, as shown in FIG. 13, fluid and high-frequency current can be simultaneously passed in multiple directions, so that a wide range of hemostasis can be achieved at once. It is particularly effective for hemostasis of a concave affected part. In addition, the size of the electrode insertion hole 38 is such that the high-frequency knife 13 advances and retreats,
It is large enough for the fluid to escape. Fluid insertion hole 3
The size of 9 is large enough for the fluid to flow out. The number of fluid insertion holes 39 is not limited to those shown in FIGS. Further, the shape of the fluid insertion hole 39 is not limited to those shown in FIGS. 12 and 13, and may be elliptical, triangular, or square.

(3) The tip 10 shown in FIG. 14 has a closed end, and a plurality of the side holes 37 are arranged in the axial direction. According to the tip 10, a high-frequency current can be passed in the axial direction for a long time, so that hemostasis over a wide area can be achieved at once. It is particularly effective for hemostasis of elongated hollow organs. The number of side holes 37 is not limited to that shown in FIG.

According to the present embodiment, a series of operations from resection of diseased tissue to hemostasis can be continuously performed without replacing a treatment tool having a different function in the treatment tool insertion hole (channel) 2 of the endoscope 1. The operation can be easily performed, and as a result, the operation time can be reduced.

Also, the tip insulating portion 12 of the high-frequency knife 13
Is pressed against the diseased part, so that the tip 1 of the probe 3
The distance between 0 and the mucous membrane 29 can be appropriately set apart. Therefore, it is possible to prevent a situation in which the mucous membrane 29 adheres to the distal end tip 10, making it difficult for the inert gas to flow, and making it impossible to uniformly stop bleeding around the bleeding part.

(Second Embodiment) A second embodiment of the present invention will be described with reference to FIGS. The high-frequency coagulation apparatus for an endoscope according to the present embodiment has a function of local hemostasis in addition to a function of incision and a function of wide-range hemostasis, and a rough configuration is the same as that of the first embodiment which was previously performed. Is the same.

The insertion portion 9 includes the tip 10 and the connecting tool 1.
9, the single lumen tube 56, the protection member 41
It is provided with. The tip 10 is made of a material having excellent conductivity, such as tungsten, stainless steel, or gold. The surface of the tip 10 is coated with a thin film of, for example, a fluororesin to prevent scorching. Further, the connection tool 19 is made of a material having excellent conductivity such as tungsten, stainless steel, and gold. The size of the through hole 47 of the connector 19 is smaller than the diameter of a projection 40 provided at the distal end of the knife portion 11 of the high-frequency knife 13 described later.

The single lumen tube 56 is
For example, it is made of a material having excellent flexibility such as PTFE. The protection member 41 is made of a relatively hard and heat-resistant material such as a ceramic. The protection member 41 is disposed so as to be cut between the high-frequency knife 13 and the tip 10 in the through hole 14 of the tip 10. The protection member 41 serves to protect the tip 10 from being melted by the plasma reaction during hemostasis.

At the tip of the knife portion 11 of the high-frequency knife 13, a disk-shaped projection 40 having a diameter larger than that of the knife portion 11 and smaller than the tip insulating portion 12 is provided. The protrusion 40 is made of a material having excellent conductivity, such as tungsten, stainless steel, and gold. The cross-sectional shape of the projection 40 is not limited to a circle, but may be an ellipse, a square, or a triangle.

As described above, the diameter of the protrusion 40 is
As shown in FIG. 16, when the high-frequency knife 13 is stored, the projection 40 is
It comes in contact with.

Next, the operation of the high-frequency coagulation apparatus for an endoscope according to this embodiment will be described. First, the method of making the incision is the same as in the case of the first embodiment described above. Since the diameter of the projection 40 is sufficiently smaller than the diameter of the distal end insulating portion 12, an unintended portion of the projection 40 is not cut at the time of cutting. Also, the method of stopping blood over a wide range is the same as in the first embodiment described above.

As for the local hemostasis method, as shown in FIG. 16, the distal tip 10 of the probe 3 is pressed against the bleeding site while observing with the endoscope 1. At this time, the high-frequency knife 13 is fully pulled in, and the projection 40 and the intermediate tool 19 are
Contact. Then, after pressing the tip 10 against the bleeding site, the controller 7 supplies an HF current.
Then, the supplied high-frequency current is transmitted in the order of the conductive wire 21 → the knife portion 11 → the protrusion 40 → the mediation tool 19 → the distal tip 10 to perform hemostasis by directly cauterizing the bleeding site. At this time, since the tip tip 10 is provided with a coating for preventing burning, the mucous membrane does not stick and does not block the through hole 14.

According to the present embodiment, in addition to the effects of the above-described first embodiment, relatively vigorous bleeding (which is not good at argon beam coagulators) without changing the treatment tool is performed. ) Can also be supported.

(Example of Another Hemostatic Probe) Here, another example of another hemostatic probe of the bleeding part is shown. In the probe shown in FIG. 17, the probe 3 is constituted by using a spirally formed electrode 42 instead of the high-frequency knife 13. This probe 3
According to the method, as in the case of the first embodiment, a method of stopping blood by generating plasma in an inert gas is also possible, and at the same time, a hemostatic agent can be sprayed from a conduit in the probe 3. It is possible. At this time, since the electrode 42 is provided with the spiral groove 43 like a screw, it is possible to spray the hemostatic agent over a wide area by atomizing the fluid.

In the probe shown in FIG. 18, the probe 3 was constituted by using a high-frequency snare 44 instead of the high-frequency knife 13. According to the probe 3, a series of operations such as generating a plasma in an inert gas to stop blood bleeding as described in the first embodiment after excision of a lesion such as polypectomy with a high-frequency snare 44 are performed by a treatment tool. Can be done without replacing

FIG. 19 shows a tip 1 having an electrode through-hole 45 provided at the center in the axial direction and a plurality of fluid through-holes 46 provided therearound.
Probe 3 provided with 0. According to the probe 3, since the electrode 45 is always fixed at the center position, plasma can be uniformly generated around the electrode 45 around the electrode 45. This eliminates unevenness in the hemostatic state.

(Third Embodiment) A third embodiment of the present invention will be described with reference to FIGS. The present embodiment is an example using a bipolar high frequency in the probe having the function of local hemostasis in the above-described second embodiment and a method of manufacturing the same. These will be described below. Same as the second embodiment,
The description will focus on the different components.

As shown in FIGS. 20 and 21, the insertion portion 9 of the probe 3 has a distal tip 10 provided with an electrically insulating resin tube 15 and a conducting wire 59.
Are provided with two independent spiral electrodes 57 and 58. The helical electrode 57 is connected to a conducting wire 59 built in the resin tube 15, and the helical electrode 58 is connected to the intermediary tool 19 built in the tip 10. Therefore, the high-frequency knife 13 is pulled toward the base end, and the high-frequency knife 13 is applied to the intermediary tool 19 so that the spiral electrode 58 can be energized.

Here, the spiral electrodes 57 and 58 are formed on the outer surface of the tip chip 10 without any irregularities and on the same plane. The spiral electrodes 57 and 58 may be the same material or different materials as long as they are conductive materials.
In consideration of heat resistance, a material having a higher melting point, such as platinum, is preferable to a material such as silver or gold.

Next, a method of manufacturing the tip 10 will be described with reference to FIGS. First, FIG.
As shown in FIGS. 2 and 23, two spiral grooves 60 are previously formed on the outer surface of the distal end tip 10 (spiral groove forming step).

Next, as shown in FIG.
A material to be the spiral electrodes 57 and 58 is formed so as to completely cover the outer surface of No. 0 (coating forming process to be an electrode material).

Finally, as shown in FIG. 25, the outer surfaces of the distal end tip 10 covered with the materials to be the spiral electrodes 57 and 58 are uniformly polished or ground to separate the spiral electrodes 57 and 58 independently. (Spiral electrode exposure forming step).

The method of incising using the probe 3 of this embodiment is the same as that of the first embodiment described above. Further, the method for stopping hemostasis over a wide range is the same as in the case of the first embodiment.

In the local hemostasis method, the tip 10 of the probe 3 is pressed against the bleeding site while observing with the endoscope 1. At this time, the high-frequency knife 13 is fully pulled in, and the projection 40 and the connection pipe 19 are kept in contact. After pressing the tip 10 against the bleeding site, the controller 7 supplies a coagulation current. Then, the supplied high-frequency current is transmitted in the order of the conductive wire 21 → the knife portion 11 → the protrusion 40 → the mediator 19 → the spiral electrode 58, and passes through the pressed bleeding site, and the spiral electrode 57 → the conducting wire 59 to the supply source. Return, and perform hemostasis by directly cauterizing the bleeding site.

The effects of the present embodiment have the following effects in addition to the effects of the above-described second embodiment.

First, since the hemostatic high-frequency electrodes (spiral electrodes) 57 and 58 provided on the outer surface of the distal end tip 10 are bipolar electrodes, a treatment on the human body side (P plate) is not required and the treatment can be performed easily. I can do it.

Further, since the spiral electrodes 57 and 58 are formed on the outer surface of the distal tip 10 without any irregularities on the same surface, the outer surface of the distal tip 10 is flat, and the treatment tool insertion hole 2 of the endoscope 1 is provided. The inside can be smoothly inserted.

Further, after the spiral groove 60 is provided, the spiral electrodes 57 and 58 are formed.
The widths of 7 and 58 can be formed uniformly with high precision, and uniform high-frequency solidification ability can be exhibited.

The present invention is not limited to the above embodiments, but can be applied to other embodiments.

According to the above description, the following items and items obtained by arbitrarily combining the items listed below can be obtained.

1. In a high-frequency coagulation device for an endoscope that can be used endoscopically and stops and coagulates a treatment target site by flowing a high-frequency current to a treatment target site of a living body, it can be inserted into the body transendoscopically, A long probe having a through-hole opening at the tip, an electrode provided near the tip of the probe and capable of conducting a high-frequency current, and an electricity provided at the tip of the electrode and having a larger diameter than the electrode. An insulator,
A high frequency power supply for supplying high frequency power to the electrode, and a control unit having means for supplying an inert gas to the through hole of the probe and means for supplying a high frequency current to the electrode. A high-frequency coagulation device for an endoscope, comprising:

2. 3. The probe according to claim 1, wherein the probe has an attachment mechanism for detachably attaching the distal end tip and the resin tube.

3. In the first aspect, the electrode can be freely protruded and retracted at the probe tip, and the protruding amount is 1 mm to
It is characterized by being set to 7 mm.

4. 3. The probe according to claim 3, wherein the probe has a fixing mechanism for fixing the electrode at a position where the electrode protrudes most.

[0072]

As described above, according to the present invention, by having both the incision function and the coagulation function, the diseased tissue can be replaced without changing the treatment tool having a different function into the treatment tool insertion hole of the endoscope. A series of operations from resection to hemostasis can be performed, and as a result, the procedure becomes simpler and the procedure time can be shortened. In addition, pressing the electrical insulator provided at the tip of the electrode against the tissue ensures that the tip of the probe of the argon beam coagulator and the tissue are kept at an appropriate distance. Does not cause the problem that the tissue is scorched and adhered to the electrode and the inert gas stops flowing. As a result, the tissue can be coagulated without impairing the original function during the procedure, and maintenance of the treatment device is not required. Connect.

[Brief description of the drawings]

FIG. 1 is a schematic explanatory view of a high-frequency coagulation device for an endoscope according to a first embodiment of the present invention.

FIG. 2 is a perspective view of the vicinity of a distal end of a probe of the high-frequency coagulation device for an endoscope according to the first embodiment.

FIG. 3 is a longitudinal sectional view of the vicinity of a distal end of a probe of the high-frequency coagulation apparatus for an endoscope according to the first embodiment.

FIG. 4 is a perspective view of a proximal portion of a probe of the high-frequency coagulation apparatus for an endoscope according to the first embodiment.

FIG. 5 is a longitudinal sectional view of a proximal portion of a probe of the high-frequency coagulation apparatus for an endoscope according to the first embodiment.

FIG. 6 is an explanatory diagram of the operation of the high-frequency coagulation device for an endoscope according to the first embodiment.

FIG. 7 is an explanatory diagram of the operation of the high-frequency coagulation device for an endoscope according to the first embodiment.

FIG. 8 is an explanatory diagram of the operation of the high-frequency coagulation device for an endoscope according to the first embodiment.

FIG. 9 is an operation explanatory view of a modification of the high-frequency coagulation device for an endoscope according to the first embodiment.

FIG. 10 is an operation explanatory view of another modification of the high-frequency coagulation device for an endoscope according to the first embodiment.

FIG. 11 is a perspective view of a usage state of a modification of the distal end tip of the high-frequency coagulation device for an endoscope according to the first embodiment.

FIG. 12 is an explanatory view of another modification of the distal end tip of the high-frequency coagulation device for an endoscope according to the first embodiment.

FIG. 13 is an operation explanatory view of another modification of the distal end tip of the high-frequency coagulation device for an endoscope according to the first embodiment.

FIG. 14 is an operation explanatory view of another modification of the distal end tip of the high-frequency coagulation device for an endoscope according to the first embodiment.

FIG. 15 is a longitudinal sectional view of the vicinity of a distal end of a probe of the high-frequency coagulation apparatus for an endoscope according to the second embodiment.

FIG. 16 is a vertical cross-sectional view of the probe of the high-frequency coagulation apparatus for an endoscope according to the second embodiment in the use state near the distal end thereof.

FIG. 17 is a longitudinal sectional view showing the vicinity of a distal end portion of another example of the hemostatic probe.

FIG. 18 is a vertical cross-sectional view showing the vicinity of the distal end of another example of the hemostatic probe.

FIG. 19 is a vertical cross-sectional view of the vicinity of a distal end showing still another example of the hemostatic probe.

FIG. 20 is a side view of the distal end of the probe according to the third embodiment of the present invention.

FIG. 21 is a longitudinal sectional view of a distal end portion of a probe according to a third embodiment of the present invention.

FIG. 22 is an explanatory diagram of a procedure of a method of manufacturing a tip in a probe according to a third embodiment of the present invention.

FIG. 23 is an explanatory diagram of a method of manufacturing a tip in a probe according to a third embodiment of the present invention.

FIG. 24 is an explanatory view of a procedure of a method of manufacturing a tip in a probe according to a third embodiment of the present invention.

FIG. 25 is an explanatory diagram of a procedure of a method of manufacturing a tip in a probe according to a third embodiment of the present invention.

[Explanation of symbols]

DESCRIPTION OF SYMBOLS 1 ... Endoscope, 2 ... Treatment tool insertion hole, 3 ... Probe, 4 ... Hand side operation part, 5 ... Electrification cable, 6 ... Fluid supply tube, 7 ... Control device, 9 ... Insertion part, 10 ... Tip, 1
DESCRIPTION OF SYMBOLS 1 ... Knife part, 12 ... Insulated tip part, 13 ... High frequency knife, 23 ... Power supply connector, 26 ... Connection terminal, 48 ... Pipe line, 49 ... Main body, 50 ... Base member.

 ────────────────────────────────────────────────── ─── Continuing on the front page (72) Inventor Kou Kimura 2-43-2 Hatagaya, Shibuya-ku, Tokyo F-term in Olympus Optical Co., Ltd. 4C060 FF10 FF19 KK03 KK04 KK05 KK06 KK09 KK10 KK13 KK17 KK20 4C061 GG15

Claims (1)

[Claims] 1. A treatment apparatus for an endoscope which can be used endoscopically and incises, stops, and coagulates a treatment target site by flowing a high-frequency current to a treatment target site in a living body. A long probe that can be inserted into the body and has a through hole that opens at the tip, and an electrode that is provided near the tip of the probe and that can protrude and sink from the tip of the probe and that can pass a high-frequency current, An electrical insulator provided at the tip of the electrode, having a larger diameter than the electrode; a high-frequency power supply for supplying a high-frequency current to the electrode; a means for supplying an inert gas to the through hole of the probe; and the electrode And a control device having means for supplying a high-frequency current to the endoscope.