Treatment instrument for endoscope and lymph node removing method

Abstract

A treatment instrument for endoscope of the present invention includes a puncture needle having a barb. A lymph node removing method of the present invention includes: an insertion step, wherein an endoscope has an insertable insertion portion which is inserted into an esophagus or a trachea being a lumen inside the body of a subject; the step of inserting a distal end portion arranged at the tip of the insertion portion of the endoscope into the lumen; a confirmation step of confirming the position of a mediastinal lymph node by performing ultrasound scanning using an ultrasound transducer arranged at the distal end portion; an anchoring step of placing an anchoring device which has been inserted through a channel inside the insertion portion of the endoscope, on the mediastinal lymph node by performing the ultrasound scanning; a incision step of cutting a wall of the lumen to make a fistula; and a drawing-in step of drawing the mediastinal lymph node into the lumen with the anchoring device.

1 . A treatment instrument for endoscope comprising a puncture needle having a barb. 
   
   
       2 . The treatment instrument for endoscope according to  claim 1 , further comprising a barb protecting mechanism which disables the operation of the barb. 
   
   
       3 . The treatment instrument for endoscope according to  claim 2 , wherein the barb protecting mechanism includes a barb protecting member or a barb protecting portion. 
   
   
       4 . The treatment instrument for endoscope according to  claim 3 , wherein the barb protecting member is a tube body which contains the puncture needle. 
   
   
       5 . The treatment instrument for endoscope according to  claim 3 , wherein the barb protecting member is a fitted body to be fitted with the barb. 
   
   
       6 . The treatment instrument for endoscope according to  claim 3 , wherein the barb protecting portion is capable of containing the barb inside the puncture needle. 
   
   
       7 . The treatment instrument for endoscope according to  claim 1 , wherein at least a part of the treatment instrument for endoscope has a ultrasound reflection part. 
   
   
       8 . The treatment instrument for endoscope according to  claim 1 , further comprising a sheath which the puncture needle can be put into or taken out of. 
   
   
       9 . The treatment instrument for endoscope according to  claim 2 , further comprising a sheath which the puncture needle and the barb protecting member can be put into or taken out of. 
   
   
       10 . The treatment instrument for endoscope according to  claim 8 , wherein a member having a cutting function can be put into and taken out of the sheath. 
   
   
       11 . The treatment instrument for endoscope according to  claim 10 , wherein the member having the cutting function is a ring-shaped high-frequency snare, and the puncture needle is arranged within the ring of the high-frequency snare. 
   
   
       12 . The treatment instrument for endoscope according to  claim 8 , wherein the member having the cutting function is a high-frequency output portion capable of performing electrification onto the circumference part of the sheath. 
   
   
       13 . A lymph node removing method comprising the steps of:
 an insertion step, wherein an endoscope has an insertable insertion portion which is inserted into an esophagus or a trachea being a lumen inside the body of a subject; the step of inserting a distal end portion arranged at the tip of the insertion portion of the endoscope into the lumen;   a confirmation step of confirming the position of a lymph node by performing ultrasound scanning using an ultrasound transducer arranged at the distal end portion of the endoscope;   an anchoring step of placing an anchoring device which has been inserted through a channel inside the insertion portion, on the lymph node by performing the ultrasound scanning;   an incision step of cutting a wall of the lumen to make a fistula; and   a drawing-in step of drawing the lymph node into the lumen with the anchoring device.   
   
   
       14 . The lymph node removing method according to  claim 13 , wherein the anchoring device is a treatment instrument for endoscope which includes a puncture needle having a barb. 
   
   
       15 . The lymph node removing method according to  claim 14 , wherein the treatment instrument for endoscope comprises a barb protecting mechanism which disables the operation of the barb. 
   
   
       16 . The lymph node removing method according to  claim 13 , further comprising a fistula closing step of closing the fistula after the drawing-in step. 
   
   
       17 . The lymph node removing method according to  claim 16 , further comprising a closing device placing step of placing a fistula closing device on the luminal wall after the confirmation step and before the anchoring step; wherein
 the fistula closing step is performed with the use of the fistula closing device.   
   
   
       18 . The lymph node removing method according to  claim 13 , further comprising a separation step of separating the lymph node from a surrounding tissue after the drawing-in step. 
   
   
       19 . A lymph node removing method comprising the steps of:
 an insertion step, wherein an endoscope has an insertable insertion portion which is inserted into an esophagus or a trachea being a lumen inside the body of a subject; the step of inserting a distal end portion arranged at the tip of the insertion portion of the endoscope into the lumen;   a confirmation step of confirming the position of the lymph node by performing ultrasound scanning using an ultrasound transducer arranged at the distal end portion of the endoscope;   an anchoring step of placing an anchoring device which has been inserted through a channel inside the insertion portion, on the lymph node by performing the ultrasound scanning;   an incision step of cutting a wall of the lumen to make a fistula; and   an insertion-into-mediastinum step of inserting the distal end portion of the endoscope from the fistula into a mediastinum using the anchoring device as a guide;   a separation step of separating the lymph node from a surrounding tissue under observation on an endoscopic image picked up by an image pickup device arranged at the distal end portion of the endoscope; and   a drawing-in step of drawing the lymph node into the lumen.   
   
   
       20 . The lymph node removing method according to  claim 19 , wherein the anchoring device is a treatment instrument for endoscope which includes a puncture needle having a barb. 
   
   
       21 . The lymph node removing method according to  claim 19 , wherein the anchoring device is a treatment instrument for endoscope which includes a guide wire provided with a puncture needle having a barb at a distal end portion of a wire. 
   
   
       22 . The lymph node removing method according to  claim 20 , wherein the treatment instrument for endoscope comprises a barb protecting mechanism which disables the operation of the barb. 
   
   
       23 . The lymph node removing method according to  claim 19 , further comprising a fistula closing step of closing the fistula after the drawing-in step. 
   
   
       24 . The lymph node removing method according to  claim 23 , further comprising a closing device placing step of placing a fistula closing device on the luminal wall after the confirmation step and before the anchoring step; wherein
 the fistula closing step is performed with the use of the fistula closing device.