CN103415265A - Multi-procedural tool for endoscopic submucosal layer which operates plurality of modes in one device through a multi-procedure module - Google Patents
Multi-procedural tool for endoscopic submucosal layer which operates plurality of modes in one device through a multi-procedure module Download PDFInfo
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- CN103415265A CN103415265A CN2012800096963A CN201280009696A CN103415265A CN 103415265 A CN103415265 A CN 103415265A CN 2012800096963 A CN2012800096963 A CN 2012800096963A CN 201280009696 A CN201280009696 A CN 201280009696A CN 103415265 A CN103415265 A CN 103415265A
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/3203—Fluid jet cutting instruments
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3478—Endoscopic needles, e.g. for infusion
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00238—Type of minimally invasive operation
- A61B2017/00269—Type of minimally invasive operation endoscopic mucosal resection EMR
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00353—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery one mechanical instrument performing multiple functions, e.g. cutting and grasping
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B2018/1405—Electrodes having a specific shape
- A61B2018/1412—Blade
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
- A61B2090/3937—Visible markers
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
- A61B2090/3937—Visible markers
- A61B2090/395—Visible markers with marking agent for marking skin or other tissue
Abstract
The present invention relates to a multi-procedural tool for an endoscopic submucosal layer which operates a plurality of modes in one device through a multi-procedure module, and solves problems which exist in conventional surgical tools for the endoscopic submucosal layer, whereby a spray catheter which is generally a catheter for spraying a pigment, a knife for marking, a needle for injecting, an incision knife, a hemostasis and cleaning knife, and a delamination knife are alternately used during the operation, and also, it may take a long time to acquire the skills to use the above-described tools. Also, it may take a long time to replace the plurality of knives, and the purchase costs for the plurality of surgical tools is high. The multi-procedural tool for the endoscopic submucosal layer according to the present invention includes a control module, a tube module, and a multi-procedure module. Thus, a pigment spraying mode, a lesion marking mode, an injection mode, an incisionhemostasiscleaning mode, and a delamination mode may be operated under the control of one control mode. Also, a water spraying pressure may be adjusted to perform a minute incision operation, and simultaneously, all modes such as hemostatic incision and various injection shots may be operated through one manipulation. Thus, even a non-expert can easily acquire skills, and also, seriously bent sections can be medically operated on, and vertical incisions and turning incisions can be made. Furthermore, operating time and costs may be minimized.
Description
Technical field
The present invention relates to the excision of endoscope tela submucosa and use pertinent instruments, is for (the Endoscopic Submucosal Dissection of decollement under endoscopic mucosal; ESD) the new and improved version instrument of use.
Background technology
Therapeutic endoscopy field and the attention thereof the use endoscope carried out in digestive system diagnosis and treatment field.Development and the related doctor masterful technique of the therapeutic endoscopy operation of using the electronics endoscope is carried out by the development of the miniaturization of electronic device, image technology and by various working channels (Working Channel) after super mini imageing sensor (CCD, Charge Coupled Device) occurs Clinics and Practices technology have obtained very large development.
After endoscope came out, under the endoscopic mucosal that the former gastric cancer that need be undertaken by surgical operation and colorectal neoplasm operation also can be undertaken by the endoscope working channel, decollement (ESD) was treated.Under endoscopic mucosal, decollement is can carry out simultaneously clinical diagnosis and treatment by endoscopic inferior mucosa resection operation (Endoscopic Mucosal Resection), and the cure rate of its early gastric cancer and colorectal cancer etc. has also had significant raising.
(the Endoscopic Submucosal Dissection of decollement under above-mentioned endoscopic mucosal; ESD) or endoscopic mucosal resection operation (Endoscopic Mucosal Resection; EMR) the various instrument that the Therapeutic Method that passes through the importing working channel is used carries out.
The endoscope working channel importing flexible pipe connected by the therapeutic equipments fuselage imports body interior by treatment tool.Can in the process of using-system mucosa resection scalpel (Knife) or excision mucosa etc., inject hemostasis coagulating agent (Coagulator), or, for the easier resection operation that carries out injects tissue expander with saline solution and medicine etc., also can be used in and inject abluent and clean bleeding part etc. to guarantee the visual field.
The working channel be provided with by endoscope is treated rear taking-up after will a treatment tool importing, then imports another treatment tool and carry out next step treatment.
In order to address these problems Korean Patent, disclose regulation No. 10-0943130: the treatment director can control the therapeutic equipments fuselage according to the demand for the treatment of; The flexible pipe that the endoscope working channel be connected with the therapeutic equipments fuselage imports; Above-mentioned treatment tool for the treatment of in and out of the therapeutic equipments hose; Above-mentioned treatment tool with control function be connected fetch control the endoscope that comprises the control tool mouth with excision under mucosa with the treatment mouth; Above-mentioned treatment tool imports to excise the scalpel of bio-tissue in the terminal for the treatment of flexible pipe; With the scalpel that is fixed on the treatment hose, write mutually the coagulating agent that carries out solidification treatment; In the injection that the treatment hose imports and exports, treat required pin; Inject the rinse bath of abluent; The tip that above-mentioned instrument is controlled mouth is connected with the treatment flexible pipe, and middle part is connected with control flume and controls fuselage; At the front end of controlling fuselage, be provided with the outstanding cleanout fluid inlet that can be convenient to inject cleanout fluid; The middle part of above-mentioned control fuselage is provided with controllable operation with sliding cutter;
Above-mentioned controller just is provided with the needle tray of controllable link infusion appliance and the treatment mouth of excision use under the endoscopic mucosal that forms after one's death.
In order to distinguish that accurately performing the operation is position and the big or small use injection pigment spray conduit (Spray catheter) that needs of pathological changes.The submucosal resection major part all needs Reusability pigment injection catheter, pathological changes labelling to inject with pin, cut with scalpel, hemostasis, cleaning function and stripping surgical knife with scalpel, pathological changes expansion, therefore needs repeatedly alternating treatment mouth repeatedly.So not only need a lot of time, and also have the too high problem of expense according to the treatment tool used.
And, want adapt to use also needs regular hour of original scalpel, more difficultly carry out crooked position or the vertically cutting at position, can not carry out the bent angle excision, the adjusting of scalpel length is difficulty comparatively also.Sometimes also can can't effectively exert oneself because of softness too, be difficult to carry out meticulous operation.
Summary of the invention
Need the problem solved
In order to reach the above object, the present invention is combined into a device by the control module of pigment jet mode, pathological changes marking mode, jet mode, cutting, hemostasis, cleaning mode, separation mode and operates under the control of controlling template.The pressure that adjustable water sprays, but the according to circumstances also pigment of injecting jet and medicine.When carrying out the precision excision, also can carry out high efficiency hemostasis processing.Non-expert also can be easily skilled the use scalpel, and can carry out bending, vertical cutting removes, and can carry out the bent angle excision.Compared with these what is more important, use endoscopic mucosal lower floor multiple function apparatus not only can shorten surgery cost, also surgery cost can be reduced to simultaneously minimized.
The approach of dealing with problems
In order to reach above purpose, the present invention is combined into a multifunction surgical template by various modes and operates.This multi-functional endoscope tela submucosa surgical unit is by controlling the required pigment jet mode of endoscopic mucosal menisectomy, the pathological changes marking mode, jet mode, cut mode, hemostasis, cleaning mode, the control template of separation mode, scope equipment and the multifunction surgical module that can be the place ahead terminal of the importing working channel be connected with control module provides the flexible pipe module of required electricity and water and for flexible pipe module the place ahead terminal endoscopic mucosal lower floor operative site, provide the pigment jet mode under the control of controlling template, the pathological changes marking mode, cutting, hemostasis, cleaning mode, the multifunction surgical template of separation mode forms.
The effect of invention
As mentioned above, the present invention is operating pigment jet mode, pathological changes labelling template, injection template, cutting, hemostasis, cleaning mode, separation mode under the control of controlling template, is reducing the required time of performing the operation in for a device.The pressure that adjustable water sprays, but the according to circumstances also pigment of injecting jet and medicine.When carrying out the precision excision, also can carry out high efficiency hemostasis processing.Non-expert also can be easily skilled the use scalpel, can carry out and can carry out bending, the vertically excision at position by circular blade and aciculiform blade, can carry out the highly difficult endoscopic mucosal lower floor operations such as bent angle excision.
The accompanying drawing explanation
Fig. 1 is that the present invention uses the multifunction surgical template that various modes is combined in to the endoscopic mucosal lower floor multifunction surgical configuration of instrument key element perspective view that a device operates,
Fig. 2 is that the present invention uses the multifunction surgical template that various modes is combined in to the multifunction surgical configuration of instrument key element internal cross section figure of endoscopic mucosal lower floor that a device operates,
Fig. 3 is the perspective internal view of teflon hose (210), aciculiform blade drive wire (220), multistage support (230) composition,
Fig. 4 is that the present invention uses high-pressure injection pattern (232a) pigment propellant, water and normal saline to be sprayed to model's illustration of adjustment process by buret,
Fig. 5 presses jet mode (232b) pigment propellant, water and normal saline to be sprayed to model's illustration of adjustment process during the present invention uses by buret,
Fig. 6 is that the present invention uses low-pressure fuel injection pattern (232c) pigment propellant, water and normal saline to be sprayed to model's illustration of adjustment process by buret,
Before Fig. 7 endoscopic mucosal lower floor operation that to be the present invention undertaken by spherical blade, spray pigment at operative site and take to differentiate and be suspicious of as the position of cancer rill and the pigment jet mode model illustration of the injection pigment at normal position,
Model's illustration of cutting (=excision), hemostasis and the clean cut of diseased region, hemostasis, cleaning mode in Fig. 8 endoscopic mucosal lower floor operative site that to be the present invention undertaken by spherical blade,
Fig. 9 is the present invention peels off the separation mode of diseased region by the spherical blade of multifunction surgical template model's illustration,
Figure 10 is model's illustration that the present invention passes through the marking mode of aciculiform leaf marking diseased region,
Figure 11 is model's illustration that the present invention passes through the jet mode of aciculiform expansion blade pathological tissues,
Model's illustration of cutting (=excision), hemostasis and the clean cut of diseased region, hemostasis, cleaning mode in Figure 12 endoscopic mucosal lower floor operative site that to be the present invention undertaken by the aciculiform blade,
Figure 13 is that the present invention peels off model's illustration of the separation mode of diseased region by the aciculiform blade of multifunction surgical template.
The specific embodiment
Below for being attached with the explanation of illustration of the present invention.
Fig. 1 is that the present invention is combined in various modes by the multifunction surgical template perspective view of the endoscopic mucosal lower floor multifunction surgical configuration of instrument key element operated in a device, and it comprises controls template (100), flexible pipe template (200) and multifunction surgical template (300).
At first, introduce first above-mentioned control template (100).
The major function of above-mentioned control template (100) is to use for the operator provides to control when endoscopic mucosal lower floor performs the operation required pigment jet mode, pathological changes marking mode, jet mode, cutting, hemostasis, cleaning mode, separation mode.It comprises inlet (130), the first stopper (140), pulley stick (150), the second stopper (160) and the finger bracket (170) of stick fuselage (110), stick head (120), medicine and pigment.
Above-mentioned stick fuselage (110) is comprised of the yi word pattern pulley structure.
The head of its front end position stick, but at the inlet that a side of stick is provided with injection of medicine and pigment, be bias type.The place ahead of stick head is provided with the first obstruction device, pulley stick, the second obstruction device and finger bracket.
The pulley stick is positioned at the lead in track groove that the terminal of stick fuselage is provided with.
The front end that above-mentioned stick head (120) is positioned at the stick fuselage is connected the flexible pipe body has been fixed on the banquette of stick with the flexible pipe template, aciculiform blade drive wire is passed to the flexible pipe template and be connected on the pulley stick to perform the operation.
It is by the multilevel hierarchy contexture, and the flexible pipe template is fixed on banquette one side (121).
Said medicine and color enter inlet (130) and are positioned at the position that stick head surface one skew back line direction is outstanding, and the template of stick head part rises to such an extent that be the effect that according to circumstances needs to select to provide pigment propellant, normal saline or medicine etc.
It is mainly by liquid injection port, to supply with to the flexible pipe template after by any one in syringe or liquid supply valve goalkeeper pigment propellant, water or normal saline, filling.
The pigment propellant here is mainly used for being injected in endoscopic mucosal lower floor and prejudges that operative site uses when distinguishing cancerous cell and being suspicious of position and normal position.The injection of pigment propellant need in the situation that high pressure by spherical blade, spray.
Above-mentioned water refers to and carries out rapidly the required composition that plays injection effect and cleaning action of endoscopic mucosal lower floor resection operation for precision.
The Musclar layer that above-mentioned normal saline is mainly used for expanding endoscopic mucosal lower floor operative site is used during to tela submucosa.Thereby make Musclar layer to tela submucosa safer the carrying out of resection operation.
Above-mentioned the first obstruction device (140) is brought in the movement of controlling the place ahead pulley stick before being positioned at the stick head.
It is positioned at the front end of pulley stick lead in track groove ringwise.
Above-mentioned pulley stick (150) is positioned at the rear end of the first stopper, front end with aciculiform blade and drive wire, be connected with by the lead in track groove can before and after push-and-pull make the aciculiform blade in from the circle to the sheet outstanding forwards pass on strength or the aciculiform blade be built in to circular blade inside give rear and pass on strength.
Its fuselage is yi word pattern section handle shape, and the rear end of fuselage respectively has a handle up and down, and the handle front end of upper end is provided with conductivity section (151).
Conductivity section also is connected with aciculiform blade and drive wire.
The aciculiform blade drive wire that front end one side of above-mentioned pulley stick connects is by sliding before and after the lead in track groove.
That is, while along with the lead in track groove, to aciculiform blade drive wire positive direction, applying power by the pulley stick, the aciculiform blade just can pass from spherical blade inside.At this moment use syringe or water pump to provide water to medicine and pigment inlet.Thereby the area of water narrow down gradually outstanding outside the aciculiform blade and circular blade between produce the injection that high pressure has completed water.
On the contrary, while along with the lead in track groove, to aciculiform blade drive wire, applying power by the pulley stick in the other direction, the aciculiform blade just can be retracted into built-in multistage support (230) buret of the inner formation of spherical blade.At this moment use syringe or water pump to provide water to medicine and pigment inlet.The area of water broadens gradually by the inside of circular blade, just can reduce to produce between aciculiform blade in interior plant buret and circular blade the injection of water.
Above-mentioned the second obstruction device (160) is brought in the movement of controlling the pulley stick slided backward after being positioned at the pulley stick.
The rear end that above-mentioned finger bracket (170) is positioned at the second obstruction device play a part two fingers that fixing operation person presss from both sides the pulley stick so that operation.
It is below the related description of flexible pipe template of the present invention (200).
Above-mentioned flexible pipe with control the template multifunction surgical template formed for the place ahead terminal that is connected in the working channel that imports the scope equipment electricity and water be provided.As shown in Figure 2, by teflon hose (210), aciculiform blade drive wire (220), multistage support (230), formed.
Above-mentioned teflon hose (210) is imported in the working channel of endoscope and image processing device, by working channel inside by aciculiform blade and spherical blade compatibility in the inner, erects the effect of supporting aciculiform blade and spherical blade for multistage of front end.
The politef material can play the effect of insulation when aciculiform blade and spherical blade acceptance power supply.
Above-mentioned teflon hose also can play the effect that scope guide groove instrument imports of being convenient in addition.
Its front end one side is connected with multistage support one side, and rear end one side is connected with the banquette of stick head.
Also can form a round tube, length is 140～190cm.
Above-mentioned aciculiform blade drive wire (220) is positioned at the inside of teflon hose, the front end terminal is connected with the aciculiform blade, the rear end terminal is connected with the conductivity section of pulley stick, receive pulley manipulation positive direction power and carry out mobile aciculiform blade with opposite direction power, pass on from the electricity of conductivity section conduction and carry out the electric weight supply with the aciculiform blade.
Below all by metals such as rustless steels, undertaken.
Aciculiform blade drive wire of the present invention (220) as shown in Figure 3, hind wing or rock and ensure the invariant position of teflon hose front end when a side of multistage support connecting portion is provided with multistage support and prevents from performing the operation.The drive wire pulley adnexa (221) in its East China directly is connected with the surface of teflon hose.
The hook (222) that the rear end of drive wire pulley adnexa of the present invention (221) forms hangs up on drive wire pulley adnexa when the aciculiform blade advances, at this moment the aciculiform blade will be given prominence to the outside 0.5mm～6mm of spherical blade.
Above-mentioned multistage support (230) is positioned at an end of teflon hose front end inboard, plays to support spherical blade and aciculiform blade the effect that utilizes high pressure or low pressure to regulate the injection of importing water.The support (231) outstanding by multi-stage type forms with buret (232).
Above-mentioned multi-stage type is given prominence under the state of support (231) with sealing and is installed in the teflon hose head to support spherical blade and aciculiform blade.
In order to seal the head that is arranged on teflon hose, need installation procedure multi-stage taper shape for lugs, be connected as a single entity with the circular blade of front end one side.
Above-mentioned buret (232) is more and more narrow to the amplitude at the position that combines with circular blade from introducing port, more and more narrow so that regulate high pressure, middle pressure, low pressure and spray at the contact surface that pigment propellant, water, saline solution are provided.
To the shape that narrows down gradually and be front wide and rear narrow with the circular blade binding site, inner introducing port is provided with the liquid entrance hole from inner introducing port, and aciculiform blade drive wire lateral direction penetrating is in central shaft, and the buret terminal is combined for one with circular blade.
Above-mentionedly check colors by buret that to carry out diagram content as shown in Fig. 4 and Fig. 5,6 that the adjusting of high pressure, middle pressure, low pressure sprays identical for plain propellant, water, normal saline etc.Refer to the adjusting of spraying by the process of high-pressure injection pattern (232a), middle pressure jet mode (232b), low-pressure fuel injection pattern (232c).
Above-mentioned high-pressure injection pattern (232a) be illustrated as Fig. 4.Aciculiform blade (320) is close to spherical blade (310) jet rear flank and makes the high pressure that area (A2) that the area (A1) that has buret (232) inner pigment propellant, water and normal saline arrives spherical blade jet (311) just can 15bar～20bar while narrowing down to 80～90% spray, the pattern of this pattern for using when diseased region sprays pigment propellant, water, normal saline.
By the situation of pulley stick along the direction application of force of aciculiform blade drive wire, the aciculiform blade just can protrude from the jet of spherical blade along the lead in track groove.
At this moment need to use syringe or water pump to be medicine and pigment inlet injected water, make to exist area (A2) that the area (A1) of buret (232) inner pigment propellant, water and normal saline arrives spherical blade jet (311) while narrowing down to 80～90%, protrude between outside aciculiform blade and spherical blade and just can use high pressure to spray water.
Above-mentioned middle pressure jet mode (232b) as shown in Figure 5, after allowing the boundary position (232-1) of aciculiform blade rear end and buret and circular blade be located on same line, between the jet (311) that makes aciculiform blade (320) and spherical blade (310), forming under the state of a two layer of space, make to exist the pigment propellant in buret, area (A3) when the area of water and normal saline (A1) arrives the two layer of space formed between aciculiform blade (320) and spherical blade (310) jet (311) narrows down to the pattern of spraying to compress into row in 8bar～14bar after 50～79%, can use during at diseased region injection water or normal saline at needs.
Along the lead in track groove, apply the situation of opposite force by the direction of pulley stick and aciculiform blade drive wire, the position of aciculiform blade and buret and spherical blade boundary position are same straight line.
At this moment need to use syringe or water pump to be medicine and pigment inlet injected water, make to exist area (A3) that the area (A1) of buret (232) inner pigment propellant, water and normal saline arrives the two layer of space formed between aciculiform blade (320) and spherical blade (310) jet (311) while narrowing down to 50～79%, during the jet at the aciculiform blade by spherical blade just can 8bar～14bar, compress into row and spray water.
Above-mentioned low-pressure fuel injection pattern (232c) as shown in Figure 6, after allowing the boundary position (232-1) of aciculiform blade rear end and buret and circular blade be located on same line, make spherical blade form inner space (310a), when the area (A1) that has pigment propellant, water, normal saline in buret arrives the area reducing to 20 of the inner space of spherical blade～49%, then with the low-voltage of 2bar～7bar, diseased region water or normal saline are carried out to cleaning operation.
Along the lead in track groove, apply the situation of opposite force by the direction of pulley stick and aciculiform blade drive wire, the head position of aciculiform blade and buret and spherical blade boundary position are same straight line.
At this moment need to use syringe or water pump to be medicine and pigment inlet injected water, while making to exist the area of pigment propellant, water and normal saline in buret to arrive the area reducing to 20 of the two layer of space formed between aciculiform blade and spherical blade jet～49%, water just can carry out low-pressure fuel injection by the jet at spherical blade behind the inner space of aciculiform blade.
It is below the related description of multifunction surgical template of the present invention (300).
Above-mentioned multifunction surgical template (300) is positioned at the anterior terminal of flexible pipe pattern, when endoscopic mucosal lower floor operative site, plays pigment jet mode, pathological changes marking mode, jet mode, cutting, hemostasis, cleaning mode, separation mode are combined into to the effect that a device operates under the regulation and control of controlling template.It is comprised of spherical blade (310) and aciculiform blade (320).
Above-mentioned spherical blade (310) is a spherical blade, with multistage outstanding support front end, being one and being connected, is to drive separately pigment jet mode, cutting, hemostasis, cleaning mode, separation mode in the operation of endoscopic mucosal lower floor under the regulation and control of controlling template.
As shown in the figure, its front end is spherical in shape, and rear end is connected as one in a tubular form and with the front end of multistage outstanding support.The aciculiform blade is built in its inside and can freely travels to and fro between its inside.
Above-mentioned aciculiform blade (320) just can protrude from the outside of spherical blade when being activated the line positive direction and applying power, while being activated on the contrary the reciprocal application of force of line, just can interiorly ensconce in spherical blade, while carrying out the operation of endoscopic mucosal lower floor, drive pathological changes marking mode, jet mode, cutting, hemostasis, cleaning mode, separation mode under the regulation and control of controlling template.
Its terminal that is aciculiform (=spire sheet) (320) leading section is connected with the control template with the jet that debouches the spherical blade of opening.
When the water of the buret that passes through multistage support here was built in spherical blade inside at the aciculiform blade, hydraulic pressure was lower, and at this moment water can be along the jet ejection of aciculiform blade surface from spherical blade; When the aciculiform blade protruded from spherical blade, the aciculiform blade gets lodged in the spherical blade jet made its area reducing increase pressure to carry out high-pressure injection.
Its inner composition of aciculiform blade of the present invention is extremely solid, not easy to wear, thawing, and material is extremely light, and its purity is more than 99.00%.Proportion (20) 2.6986, melting point (℃) 660.2, specific heat (100) (cal/g) 0.226, latent heat (cal/g) 96.4, conductivity degree (%) 69.94, resistance temperature is 0.00429 aluminium material or to adopt purity be that aluminium ingot (Ingot) more than 99% is raw material, after in 670～690 temperature range, aluminum being dissolved, add therein 1.0～2.0wt% calcium powder (Capowder) thickening agent and after 5～10 minutes, add again the MgH of 0.5～2.5wt% with the 600rpm stirring
2, TiH
2Foaming agent stirs producing foamed aluminium material after 2～3 minutes with 1,000rpm.
Being below the present invention has been combined in a plurality of patterns by the multifunction surgical template explanation of the detailed operation of the endoscopic mucosal multifunction surgical instrument regulated and controled in a device.
[pigment jet mode]
As shown in Figure 7, this pattern is for distinguishing the cancer rill and being suspicious of position and carrying out when pigment sprays with normal position the pattern of using before the operation of endoscopic mucosal lower floor.
At first, the pulley stick of controlling template is pulled back, make the aciculiform blade built-in in spherical blade.
Then, use syringe or liquid supply pump that pigment agent is injected from liquid injection port.
Next, the teflon hose by the flexible pipe template transmits the pigment propellant to import to multistage outstanding internal stent.
Finally, built-in in spherical blade at the aciculiform blade, under the state that the spherical blade jet opens wide, pigment agent is sprayed by the jet of aciculiform blade surface at spherical blade.
[pathological changes marking mode]
As shown in figure 10, the pattern of this pattern for using when pathological changes makes marks on every side.
At first, push the pulley stick of controlling template to the place ahead, make the aciculiform blade protrude from spherical blade; Then under the state of the pulley stick being pushed to the place ahead, power to the aciculiform blade by conductivity section.
Finally, by charged aciculiform blade, carry out labelling at the tissue point point around pathological changes.
[jet mode]
As shown in figure 11, this pattern is a pattern of using while being used for expanding pathological tissues.
At first, push the pulley stick of controlling template to the place ahead, make the aciculiform blade protrude from spherical blade.
Then, under the state of the pulley stick being pushed to the place ahead, use syringe or liquid supply pump that normal saline is injected from liquid injection port.
Next, the teflon hose by the flexible pipe template transmits normal saline to import to multistage outstanding internal stent.
Finally, the aciculiform blade is protruding under the state of spherical blade, the aciculiform blade gets lodged under the state that the jet of spherical blade diminishes the area of jet and imports normal saline, and the entrance of at this moment making by the aciculiform blade provides normal saline to expand pathological changes with high voltage style.
[cutting, hemostasis, the cleaning mode that are undertaken by spherical blade]
As shown in Figure 8, this pattern is mainly the pattern of (=excision), hemostasis, clean treatment of by spherical blade, diseased region being cut in the operation of endoscopic mucosal lower floor.
At first, the pulley stick of controlling template is pulled back, make the aciculiform blade built-in in spherical blade.
Then, to the aciculiform blade, power the pulley stick being pushed away under rearward state by conductivity section.
At this moment, by the aciculiform blade, conduct the current on spherical blade.
Next, by the spherical blade with electric current, excise pathological changes tissue on every side, the operation of stopping blooding simultaneously.
Again next, use syringe to the liquid injection port injected water the pulley stick being pushed away under rearward state.
Again next, teflon hose by the flexible pipe template imports water, under the state of spherical blade inside, importing normal saline under the state that the jet of spherical blade is opened the aciculiform blade is built-in, at this moment spherical blade just can be with low pressure to supplying normal saline to clean the blood flowed out around pathological changes.
Finally, to excision and with the pathological tissues injection water stopped blooding, carry out cleaning operation.
[cutting, hemostasis, the cleaning mode that are undertaken by the aciculiform blade]
As shown in figure 12, this pattern is mainly the pattern of (=excision), hemostasis, clean treatment of by the aciculiform blade, diseased region being cut in the operation of endoscopic mucosal lower floor.
At first, push the pulley stick of controlling template to the place ahead, make the aciculiform blade protrude from spherical blade.
Then, under the state of the pulley stick being pushed to the place ahead, power to the aciculiform blade by conductivity section.
Next, by the spherical blade with electric current, excise pathological changes tissue on every side, the operation of stopping blooding simultaneously.
Again next, under the state of the pulley stick being pushed to the place ahead, use syringe to the liquid injection port injected water.
Again next, teflon hose by the flexible pipe template imports water, at the aciculiform blade, protrude under the state of spherical blade and import normal saline under the state that the jet of spherical blade is opened, at this moment spherical blade just can be with low pressure to supplying normal saline to clean the blood flowed out around pathological changes.
Finally, to excision and with the pathological tissues injection water stopped blooding, carry out cleaning operation.
[separation mode]
This pattern is for peeling off the pattern of diseased region by the multifunction surgical template.This pattern can be divided into the separation mode undertaken by spherical blade and as shown in figure 13 the separation mode that the aciculiform blade carries out that passes through as shown in Figure 9.
[separation mode 1. undertaken by spherical blade]
At first, the pulley stick of controlling template is pulled back, make the aciculiform blade built-in in spherical blade.
Then, the pulley stick is being pushed away under rearward state and by spherical blade, diseased region peeled off.
When being more suitable for needing peeling off of hemostasis to perform the operation for contact is larger, this pattern uses.
[separation mode 2. undertaken by the aciculiform blade]
At first, push the pulley stick of controlling template to the place ahead, make the aciculiform blade protrude from spherical blade.
Then, under the state of the pulley stick being pushed to the place ahead, by the aciculiform blade, diseased region is peeled off.When being more suitable for performing the operation for peeling off of careful precision, this pattern uses.
Claims (6)
1. one kind is combined into by a plurality of patterns the endoscopic mucosal lower floor multifunction surgical instrument that a device regulates and controls, it is characterized in that, described endoscopic mucosal lower floor multifunction surgical instrument can be simultaneously operate controlling template (100), flexible pipe template (200), multifunction surgical template (300), and described control template is pigment jet mode, pathological changes marking mode, jet mode, cutting, hemostasis, cleaning mode and the separation mode that the endoscopic mucosal operation needs; The scope working channel that described flexible pipe template is connected with the stick template provides water and electricity for the multifunction surgical template of the place ahead terminal; Described multifunction surgical template can be handled pigment jet mode, pathological changes marking mode, jet mode, cutting, hemostasis, cleaning mode, the separation mode of the endoscopic mucosal lower floor operative site of flexible pipe template the place ahead terminal simultaneously under the control of controlling template (100).
2. endoscopic mucosal according to claim 1 lower floor multifunction surgical instrument, is characterized in that, described control template (100) has the stick fuselage (110) that can form yi word pattern pulley stick simultaneously; The stick front fuselage is connected the inner stick head (120) that aciculiform blade drive wire is imported to pulley stick side with the teflon hose on being fixed on banquette; The flexible pipe stencil-chosen that passes through that stick head surface one skew back line direction is outstanding is supplied pigment propellant, water, the medicine of normal saline and the inlet (130) of pigment; Be positioned at the first obstruction device (140) that the control pulley stick of stick head front end moves forward; Front portion one side of the first obstruction device rear end and aciculiform blade be connected the lead in track groove control before and after the aciculiform blade protrude from or be built in spherical blade inside with to aciculiform blade positive direction or carry out the pulley stick (150) of the application of force in the other direction; Be positioned at pulley stick rear end and control the second obstruction device (160) that the pulley stick moves backward; The energy support operation personnel of the second obstruction device rear end finger so as to hold that the finger bracket (170) of two fingers of pulley stick operates a plurality of patterns are combined into to the endoscopic mucosal lower floor multifunction surgical instrument that a device regulates and controls.
3. endoscopic mucosal according to claim 1 lower floor multifunction surgical instrument, it is characterized in that, described flexible pipe template (200) refers to have and can be simultaneously the multistage support of front end one side seal of the aciculiform blade drive wire that inserts scope working channel inside be supported to the teflon hose (210) of aciculiform blade and spherical blade; With the aciculiform blade of teflon hose inside terminals, be connected, the rear end terminal with the conductivity section of pulley stick, be connected the power of the pulley stick being advanced or retreating convey to the aciculiform blade from a conducting part by the aciculiform blade drive wire (220) of conduction of current to the aciculiform blade; What be positioned at that teflon hose front end one side supports that spherical blade and aciculiform blade will pour that multistage support (230) that water sprays with high pressure by buret operates into is combined into a plurality of patterns the endoscopic mucosal lower floor multifunction surgical instrument that a device regulates and controls.
4. endoscopic mucosal according to claim 1 lower floor multifunction surgical instrument, it is characterized in that, described multistage support (230) refers to have and can to sealing, be arranged on the support spherical blade of teflon hose head and the outstanding support (231) of multi-stage type of aciculiform blade simultaneously; What while by inner entrance, supplying pigment propellant, water, normal saline to the front wide and rear narrow form of the connecting portion of spherical blade, can operate by the buret (232) that the adjusting of high, medium and low voltage is sprayed is combined into a plurality of patterns the endoscopic mucosal lower floor multifunction surgical instrument that a device regulates and controls.
5. endoscopic mucosal according to claim 4 lower floor multifunction surgical instrument, it is characterized in that, described multi-stage type is given prominence to support (241) and is referred to have and can be simultaneously the jet (311) of aciculiform blade (320) being close to spherical blade (310) be located to area (A2) that the area (A1) of buret (232) inner pigment propellant, water and normal saline arrives spherical blade jet (311) while narrowing down to 80～90%, the high-pressure injection pattern (232a) of spraying with the high pressure of 15bar～20bar; The connecting portion (232-1) of aciculiform blade rearward end and buret and spherical blade is located on same line, make to form between the jet (311) of aciculiform blade (320) and spherical blade (310) space of a bilayer, the area (A3) while making to exist the area (A1) of pigment propellant, water and normal saline in buret to arrive the two layer of space formed between aciculiform blade (320) and spherical blade (310) jet (311) narrows down to after 50～79% in 8bar～14bar, to compress into the pressure jet mode (232b) of row injection; The connecting portion (232-1) of aciculiform blade rearward end and buret and spherical blade is located on same line, make spherical blade form inner space (310a), when the area (A1) that has pigment propellant, water, normal saline in buret arrives the area reducing to 20 of the inner space of spherical blade～49%, more a plurality of patterns are combined into to the endoscopic mucosal lower floor multifunction surgical instrument that a device regulates and controls with what the low-pressure fuel injection pattern (232c) that the low pressure of 2bar～7bar is sprayed operated.
6. endoscopic mucosal according to claim 1 lower floor multifunction surgical instrument, it is characterized in that, described multifunction surgical template (300) refers to and can be simultaneously the front end of spherical spherical blade and the outstanding support of multi-stage type be connected as a single entity, at the spherical blade (310) of drive pigment jet mode, cutting, hemostasis, cleaning mode, separation mode during at endoscopic mucosal lower floor operative site under the regulation and control of controlling template; During the positive direction application of force that is subject to by aciculiform blade drive wire, the aciculiform blade protrudes from spherical blade, while being subject to the reverse application of force on the contrary, the needlework blade just can be recovered to spherical blade inside, what inner membrance tela submucosa operative site drove that the aciculiform blade (320) of pathological changes marking mode, jet mode, cutting, hemostasis, cleaning mode, separation mode operates, a plurality of patterns is combined into to the endoscopic mucosal lower floor multifunction surgical instrument that a device regulates and controls under the regulation and control of controlling template.
Applications Claiming Priority (3)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| KR10-2011-0015719 | 2011-02-22 | ||
| KR1020110015719A KR101056698B1 (en) | 2011-02-22 | 2011-02-22 | The apparatus of multi administer medicine in esd |
| PCT/KR2012/000812 WO2012115363A2 (en) | 2011-02-22 | 2012-02-02 | Multi-procedural tool for endoscopic submucosal layer which operates plurality of modes in one device through a multi-procedure module |
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| CN103415265A true CN103415265A (en) | 2013-11-27 |
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| Application Number | Title | Priority Date | Filing Date |
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| CN2012800096963A Pending CN103415265A (en) | 2011-02-22 | 2012-02-02 | Multi-procedural tool for endoscopic submucosal layer which operates plurality of modes in one device through a multi-procedure module |
Country Status (3)
| Country | Link |
|---|---|
| KR (1) | KR101056698B1 (en) |
| CN (1) | CN103415265A (en) |
| WO (1) | WO2012115363A2 (en) |
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| WO2017024930A1 (en) * | 2015-08-10 | 2017-02-16 | 王国华 | Mucosa staining system |
| CN111658128A (en) * | 2020-07-08 | 2020-09-15 | 安瑞医疗器械(杭州)有限公司 | Multifunctional high-frequency cutter |
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| KR101328473B1 (en) | 2013-06-04 | 2013-11-13 | 정명준 | The apparatus of smart administer medicine in esd |
| KR101525579B1 (en) * | 2013-09-06 | 2015-06-04 | 가톨릭관동대학교산학협력단 | Dissection device for tissue |
| KR101585019B1 (en) | 2015-06-30 | 2016-01-14 | 순천향대학교 산학협력단 | Apparatus for Endoscopic Submucosal Dissection |
| CN109620356B (en) * | 2018-12-14 | 2024-03-29 | 张建国 | Transverse folding stripping knife |
| KR102229796B1 (en) * | 2020-09-23 | 2021-03-19 | 김창보 | Endoscopic injector having an electrode and method for using the same |
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Also Published As
| Publication number | Publication date |
|---|---|
| WO2012115363A2 (en) | 2012-08-30 |
| WO2012115363A3 (en) | 2012-10-18 |
| KR101056698B1 (en) | 2011-08-12 |
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