CN108523986B - High-frequency cutter with injection needle for endoscope - Google Patents

High-frequency cutter with injection needle for endoscope Download PDF

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Publication number
CN108523986B
CN108523986B CN201810588584.7A CN201810588584A CN108523986B CN 108523986 B CN108523986 B CN 108523986B CN 201810588584 A CN201810588584 A CN 201810588584A CN 108523986 B CN108523986 B CN 108523986B
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axial electrode
tube
handle
needle
needle tube
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CN108523986A (en
Inventor
张融南
周华珍
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Anrei Medical HZ Co Ltd
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Anrei Medical HZ Co Ltd
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical 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
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical 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
    • A61B18/14Probes or electrodes therefor
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12Surgical 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
    • A61B18/14Probes or electrodes therefor
    • A61B18/1492Probes or electrodes therefor having a flexible, catheter-like structure, e.g. for heart ablation
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00982Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body combined with or comprising means for visual or photographic inspections inside the body, e.g. endoscopes

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Plasma & Fusion (AREA)
  • General Health & Medical Sciences (AREA)
  • Otolaryngology (AREA)
  • Physics & Mathematics (AREA)
  • Veterinary Medicine (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Public Health (AREA)
  • Cardiology (AREA)
  • Surgical Instruments (AREA)
  • Infusion, Injection, And Reservoir Apparatuses (AREA)

Abstract

The invention relates to a high-frequency cutter with an injection needle for an endoscope, which comprises a vertical injection joint, a double finger ring, a handle, a connector, a sliding block, an outer sheath tube, a hollow tube, a needle tube, an axial electrode, an insulating head, a radial electrode, a spring hose and a steel rope, wherein the spring hose and the outer sheath tube are fixedly connected with the handle, the needle tube and the axial electrode are arranged in the spring hose, the vertical injection joint is arranged on the handle in a sliding manner, the connector is arranged on the double finger ring, the sliding block is arranged in the handle, the connector is in interference fit with the sliding block, the double finger ring is arranged on the handle in a sliding manner, the hollow tube is inserted in the sliding block, the needle tube penetrates through the hollow tube and is connected with the vertical injection joint to form a liquid channel, the distal end of the hollow tube is fixed with one end of the steel rope, and the other end of the steel rope is fixed with the axial electrode through an axial electrode connecting piece.

Description

High-frequency cutter with injection needle for endoscope
Technical Field
The present invention relates to an instrument for Endoscopic Submucosal Dissection (ESD) for the treatment of digestive tract polyps and early cancers, and in particular to a high frequency cutter with an injection needle for an endoscope for cutting and dissecting tissue.
Background
Electric knives for ESD are commonly used in the market, including needle knives, IT knives (with ceramic heads), hook knives, delta knives, flush knives (with Flush holes in the cutter head), and the like. Each knife has the respective characteristics: the rod-shaped electrode of the needle knife can be rapidly dotted for marking and cutting mucous membrane; the IT tool bit part is protected by a ceramic insulator, so that unnecessary parts are prevented from being cut when the mucous membrane layer is peeled off, and perforation and bleeding are prevented; the L-shaped cutter head of the hook cutter rotates to a proper angle, so that the edge of a focus can be cut rapidly; the three-petal radial electrode of the triangular knife is beneficial to marking points and burning bleeding points for hemostasis; the flushing hole is arranged in the cutter head of the Flush cutter, so that bleeding points can be flushed in the operation process to improve the visual field.
In the endoscopic submucosal dissection process, doctors are involved in various steps and instruments, such as injecting physiological saline with an injection needle to lift the focus part, cauterizing and marking the focus part with a needle knife or a triangle knife to mark and cut the edge along the mark, stripping the tissue with an IT knife (with a ceramic head) to cauterize and stop bleeding at the bleeding point, stopping bleeding by a hemostatic clamp, performing electric coagulation hemostasis by a thermal biopsy forceps, performing ligation cutting by an electric snare, and the like. In the operation process, doctors can change the instruments according to the operation requirement so as to meet the requirement of each step. Frequent instrument replacement is cumbersome and time-consuming, and is unfavorable for the operation of patients.
A high-frequency cutter with an injection needle for an endoscope of Anrui medical instruments (Hangzhou) limited company has the following patent number: CN201620034846.1 discloses a high frequency knife with an injection needle, the injection needle passes through a hollow IT knife, and the IT knife is extended and retracted by means of the movement of an outer sheath.
A combination high frequency cutter of japan Fuji corporation, patent number: jp_4870710_b2 discloses a combination high frequency knife, one implementation of which is that an injection needle is passed through a hollow IT knife.
The high-frequency knife with the injection needle disclosed in the above patent adopts the structure that the needle tube penetrates through the IT knife, so that the IT knife is hollow, but the hollow structure is poor in conductivity, low in cutting efficiency and inconvenient to use.
Disclosure of Invention
In order to solve the technical problems, the invention aims to provide the high-frequency cutter with the injection needle for the endoscope, which has high cutting efficiency, integrates the functions of the IT cutter and the injection needle, reduces the replacement of instruments, saves time and energy, and is more efficient and safer.
In order to achieve the above object, the present invention adopts the following technical scheme:
an injection needle-equipped high-frequency knife for an endoscope, a handle portion including a vertical injection joint, a double finger ring, a handle, a connector, a slider, an outer sheath tube and a hollow tube, and an insertion portion including a needle tube, an axial electrode, an insulating head, a radial electrode, a spring hose and a steel cord,
the spring hose and the outer sheath tube are fixedly connected with the handle, the outer sheath tube is sleeved outside the spring hose, the spring hose is further covered with an insulating layer, the needle tube and the axial electrode are both arranged in the spring hose,
the vertical injection joint is arranged on the handle in a sliding way, the connector for connecting a high-frequency power supply is arranged on the double finger ring, the sliding block is arranged in the handle, the connector is in interference fit with the sliding block, the double finger ring is arranged on the handle in a sliding way,
the hollow tube is inserted into the sliding block, the needle tube penetrates through the hollow tube and then is connected with the vertical injection joint to form a liquid channel, the needle tube is driven to extend out of or retract into the spring hose through the sliding of the vertical injection joint, the distal end of the hollow tube is fixed with one end of the steel rope, the other end of the steel rope is fixed with the axial electrode through the axial electrode connecting piece, and the axial electrode is driven to extend out of or retract into the spring hose through the sliding of the double finger rings;
the radial electrode is fixed at the far end of the axial electrode, and the radial electrode insulating head is in interference fit, so that the axial electrode is arranged in a square hole of the insulating head in a penetrating mode.
As a preferable scheme: the spring hose is internally provided with a double-cavity channel structure, and the needle tube and the axial electrode are arranged in different cavity channels.
As a preferable scheme: the insulation head is integrally formed into an arc surface, a notch is formed in one side of the insulation head, and the needle tube passes through the notch.
As a preferable scheme: the distal end of the spring hose is also provided with an insulating cap, the outer side of the needle tube is provided with a needle tube limiting tube, and when the needle tube is completely extended, the needle tube limiting tube is propped against the insulating cap.
As a preferable scheme: the side wall of the handle is provided with a first limiting hole and a second limiting hole at intervals, the vertical injection joint is provided with an elastic buckling strip, when the elastic buckling strip is clamped at the position of the first limiting hole, the needle tube is retracted, and when the elastic buckling strip is clamped at the position of the second limiting hole, the needle tube is extended.
As a preferable scheme: the double-finger ring is provided with a positioning screw rod in a rotating way through the threaded hole, and the positioning screw rod is rotated to enable the positioning screw rod to prop against the handle to fix the position of the double-finger ring so as to fix the position of the axial electrode.
As a preferable scheme: the axial electrode head is flat, the insulating head is provided with a square hole matched with the axial electrode head in shape, and the axial electrode is inserted into the square hole of the insulating head.
As a preferable scheme: one end of the handle is also provided with a thumb ring.
As a preferable scheme: the vertical injection joint is located between the double finger ring and the thumb ring.
As a preferable scheme: the double finger ring is arranged between the thumb ring and the vertical injection joint, a liquid channel and a through hole for a steel rope to pass through are arranged in the vertical direction at the center of the vertical injection joint, and the liquid channel and the through hole are mutually independent.
According to the invention, the needle tube and the axial electrode are independently controlled through the vertical injection joint and the double finger rings, so that the operation is more convenient, and the needle tube and the axial electrode are arranged in the spring hose in parallel, so that the conductivity of the axial electrode is better, and the cutting efficiency is higher.
The needle tube of the invention realizes the function of an injection needle; the axial electrode realizes the function of an IT knife; sterile water may be sprayed when the needle cannula is retracted. The doctor can perform corresponding operation according to the needs, not only can inject physiological saline to lift the focus part, but also can cut and strip mucous membrane tissues, and can wash bleeding points, thereby saving the time for replacing the instrument.
Drawings
Fig. 1 is a schematic cross-sectional structure of embodiment 1 of the present invention.
Fig. 2 is a schematic view of the structure of embodiment 1 of the present invention when the needle tube is extended.
Fig. 3 is a schematic view of the structure of embodiment 1 of the present invention when the needle tube is retracted and the IT knife is extended.
Fig. 4 is a schematic structural view of a vertical injection joint according to embodiment 1 of the present invention.
Fig. 5 is a schematic view of the structure of the handle of embodiment 1 of the present invention.
Fig. 6 is a schematic structural view of the insulating head of the present invention.
Fig. 7 is a schematic cross-sectional structure of embodiment 2 of the present invention.
Fig. 8 is a schematic structural view of a vertical injection joint according to embodiment 2 of the present invention.
Detailed Description
Embodiments of the present invention are described in detail below, examples of which are illustrated in the accompanying drawings, wherein like or similar reference numerals refer to like or similar elements or elements having like or similar functions throughout. The embodiments described below by referring to the drawings are illustrative and intended to explain the present invention and should not be construed as limiting the invention.
Example 1
An injection needle-equipped high-frequency knife for an endoscope, as shown in FIGS. 1 to 6, a handle portion including a vertical injection joint 12, a double finger ring 13, a handle 14, a connector 15, a slider 16, an outer sheath 17 and a hollow tube 18, and an insertion portion including a needle tube 1, an axial electrode 2, an insulating head 3, a radial electrode 4, a spring hose 6 and a steel cord 9,
the spring hose 6 and the outer sheath 17 are fixedly connected with the handle 14, the outer sheath 17 is sleeved outside the spring hose 6, the spring hose 6 is further covered with an insulating layer 7, the needle tube 1 and the axial electrode 2 are both arranged in the spring hose 6,
the vertical injection joint 12 is arranged on the handle 14 in a sliding way, a connector 15 for connecting a high-frequency power supply is arranged on the double-finger ring 13, the sliding block 16 is arranged in the handle 14, the connector 15 is in interference fit with the sliding block 16, the double-finger ring 13 is arranged on the handle 14 in a sliding way,
the hollow tube 18 is inserted into the sliding block 16, the needle tube 1 penetrates through the hollow tube 18 and is connected with the vertical injection joint 12 to form a liquid channel, the needle tube 1 is driven to extend out of or retract into the spring hose 6 through the sliding of the vertical injection joint 12, the distal end of the hollow tube 18 is fixed with one end of the steel rope 9, the other end of the steel rope 9 is fixed with the axial electrode 2 through the axial electrode connecting piece 10, and the axial electrode 2 is driven to extend out of or retract into the spring hose 6 through the sliding of the double finger ring 13;
the radial electrode 4 is fixed at the distal end of the axial electrode 2, and the insulating head 3 of the radial electrode 4 is in interference fit, so that the axial electrode 2 is penetrated in the square hole 3a of the insulating head 3. The insulating head 3 can be prevented from rotating, so that the needle tube 1 can pass by smoothly.
The spring hose 6 is internally provided with a double-cavity channel structure, and the needle tube 1 and the axial electrode 2 are arranged in different cavities.
The insulation head 3 is integrally formed into an arc surface, a notch 3b is formed in one side of the insulation head 3, and the needle tube 1 passes through the notch 3 b.
The distal end of the spring hose 6 is also provided with an insulating cap 5, the outer side of the needle tube 1 is provided with a needle tube limiting tube 8, and when the needle tube 1 is completely extended, the needle tube limiting tube 8 is propped against the insulating cap 5.
The side wall of the handle 14 is provided with a first limit hole 14a and a second limit hole 14b at intervals, the vertical injection joint 12 is provided with an elastic buckling strip 12a, when the elastic buckling strip 12a is clamped at the position of the first limit hole 14a, the needle tube 1 is retracted, and when the elastic buckling strip 12a is clamped at the position of the second limit hole 14b, the needle tube 1 is extended.
The needle tube 1 is a long hollow tube, and the needle tube 1 is connected with a vertical injection joint 12 of the handle part to form a liquid channel. The vertical injection adapter 12 is slidable on the handle 14 with the movement start and stop being limited by the holes 14a and 14b in the handle 14. The needle cannula 1 is retracted when the resilient catch 12a on the vertical injection joint 12 is in the position of the aperture 14a and the needle cannula 1 is extended when the resilient catch 12a is in the position of the aperture 14 b. When the needle tube 1 is extended, the needle tube limiting tube 8 is blocked by the insulating cap 5, so that the extension length of the needle tube 1 is precisely controlled. When the needle tube extends out, physiological saline can be injected to lift the focus part, and when the needle tube retracts, sterile water can be sprayed to wash out the bleeding point, so that the field of view of the endoscope is improved. The insulating layer 7 is coated outside the spring hose 6, and together with the insulating cap 5, prevents the metal part from being exposed, and plays an electric insulating role.
The positioning screw 19 is rotatably arranged on the double finger ring 13 through the opened threaded hole, and the positioning screw 19 is rotated to enable the positioning screw 19 to prop against the handle 14 to fix the position of the double finger ring 13 and further fix the position of the axial electrode 2.
The positioning screw 19 is screwed on the double finger ring 13, and the axial electrode 2 is prevented from moving back and forth by friction between the threaded column and the handle 14. When the positioning screw 19 is unscrewed, the double-finger ring 13 can drive the axial electrode 2 to move forwards and backwards, and when the positioning screw 19 is locked, the double-finger ring 13 cannot slide on the handle 14. Therefore, when the axial electrode 2 is needed, the positioning screw 19 is unscrewed, the axial electrode 2 can be controlled to move, when the axial electrode 2 is not needed, the axial electrode 2 can be retracted into the spring hose 6, the positioning screw 19 is screwed, the axial electrode 2 and the needle tube 1 can be prevented from extending simultaneously, and the operation safety is improved.
The head of the axial electrode 2 is flat, the insulating head 3 is provided with a square hole 3a matched with the head of the axial electrode 2 in shape, and the axial electrode 2 is inserted into the square hole 3a of the insulating head 3.
One end of the handle 14 is also provided with a thumb ring 11. The vertical injection joint 12 is located between the double finger ring 13 and the thumb ring 11
Examples
Example 2 differs from example 1 in that the positions of the vertical injection joint 12 and the double finger ring 13 are exchanged, and the double finger ring 13 is between the thumb ring 11 and the vertical injection joint 12, as shown in fig. 7 and 8. The vertical injection joint 12 is provided with a liquid passage 12c and a through hole 12b for passing the steel rope 9 in the vertical direction at the center position, the liquid passage 12c is sealed, and the liquid passage 12c and the through hole 12b are arranged independently of each other, so that the steel rope 9 can axially move therein.
It should be noted that the above embodiments are merely representative examples of the present invention. Many variations of the invention are possible. Any simple modification, equivalent variation and modification of the above embodiments according to the principles of the present invention should be considered to fall within the scope of the present invention.

Claims (6)

1. A high frequency knife with injection needle for endoscope, a handle part and an insertion part, which is characterized in that: the handle part comprises a vertical injection joint (12), a double finger ring (13), a handle (14), a connector (15), a sliding block (16), an outer sheath tube (17) and a hollow tube (18), the insertion part comprises a needle tube (1), an axial electrode (2), an insulating head (3), a radial electrode (4), a spring hose (6) and a steel rope (9),
the spring hose (6) and the outer sheath tube (17) are fixedly connected with the handle (14), the outer sheath tube (17) is sleeved outside the spring hose (6), the spring hose (6) is further coated with an insulating layer (7), the needle tube (1) and the axial electrode (2) are arranged in the spring hose (6),
the vertical injection joint (12) is arranged on the handle (14) in a sliding way, a connector (15) for connecting a high-frequency power supply is arranged on the double-finger ring (13), the sliding block (16) is arranged in the handle (14), the connector (15) is in interference fit with the sliding block (16), the double-finger ring (13) is arranged on the handle (14) in a sliding way,
the hollow tube (18) is inserted into the sliding block (16), the needle tube (1) penetrates through the hollow tube (18) and then is connected with the vertical injection joint (12) to form a liquid channel, the needle tube (1) is driven to extend out of or retract into the spring hose (6) through the sliding of the vertical injection joint (12), the distal end of the hollow tube (18) is fixed with one end of the steel rope (9), the other end of the steel rope (9) is fixed with the axial electrode (2) through the axial electrode connecting piece (10), and the axial electrode (2) is driven to extend out of or retract into the spring hose (6) through the sliding of the double finger rings (13);
the radial electrode (4) is fixed at the far end of the axial electrode (2), and the insulating head (3) of the radial electrode (4) is in interference fit, so that the axial electrode (2) is arranged in the square hole (3 a) of the insulating head (3) in a penetrating way;
the spring hose (6) is internally provided with a double-cavity channel structure, and the needle tube (1) and the axial electrode (2) are arranged in different cavity channels;
the head of the axial electrode (2) is flat, the insulating head (3) is provided with a square hole (3 a) matched with the head of the axial electrode (2), and the axial electrode (2) is inserted into the square hole (3 a) of the insulating head (3);
the side wall of the handle (14) is provided with a first limiting hole (14 a) and a second limiting hole (14 b) at intervals, the vertical injection joint (12) is provided with an elastic buckling strip (12 a), when the elastic buckling strip (12 a) is clamped at the position of the first limiting hole (14 a), the needle tube (1) is retracted, and when the elastic buckling strip (12 a) is clamped at the position of the second limiting hole (14 b), the needle tube (1) is extended;
the double-finger ring (13) is provided with a positioning screw (19) through the rotation of the offered threaded hole, the positioning screw (19) is rotated to enable the positioning screw (19) to prop against the handle (14) to fix the position of the double-finger ring (13) and further fix the position of the axial electrode (2), when the positioning screw (19) is unscrewed, the double-finger ring (13) drives the axial electrode (2) to move back and forth, when the axial electrode (2) is needed, the positioning screw (19) is unscrewed, the axial electrode (2) is controlled to move, when the axial electrode (2) is not needed, the axial electrode (2) is retracted into the spring hose (6), the positioning screw (19) is screwed, and the axial electrode (2) is ensured not to extend out of the needle tube (1) simultaneously.
2. A high-frequency knife with an injection needle for an endoscope according to claim 1, wherein: the insulation head (3) is integrally formed into an arc surface shape, a notch (3 b) is formed in one side of the insulation head (3), and the needle tube (1) passes through the notch (3 b).
3. A high-frequency knife with an injection needle for an endoscope according to claim 1, wherein: the distal end of the spring hose (6) is also provided with an insulating cap (5), the outer side of the needle tube (1) is provided with a needle tube limiting tube (8), and when the needle tube (1) is completely extended, the needle tube limiting tube (8) is propped against the insulating cap (5).
4. A high-frequency knife with an injection needle for an endoscope according to claim 1, wherein: one end of the handle (14) is also provided with a thumb ring (11).
5. A high-frequency knife with an injection needle for an endoscope according to claim 1, wherein: the vertical injection joint (12) is located between the double finger ring (13) and the thumb ring (11).
6. A high-frequency knife with an injection needle for an endoscope according to claim 1, wherein: the double finger ring (13) is arranged between the thumb ring (11) and the vertical injection joint (12), a liquid channel (12 c) and a through hole (12 b) for a steel rope (9) to pass through are arranged in the vertical direction at the center of the vertical injection joint (12), and the liquid channel (12 c) and the through hole (12 b) are mutually independent.
CN201810588584.7A 2018-06-08 2018-06-08 High-frequency cutter with injection needle for endoscope Active CN108523986B (en)

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Publication number Priority date Publication date Assignee Title
CN107693110B (en) * 2017-09-30 2020-09-04 四川大学华西医院 Mucous membrane stripper under endoscope
CN109394335B (en) * 2018-12-06 2024-03-19 江苏安特尔医疗科技有限公司 High-frequency composite electric knife
CN110123415A (en) * 2019-04-23 2019-08-16 齐从虎 A kind of endoscopic hemostasis removing integrated knife
CN110236669B (en) * 2019-05-28 2021-01-01 安瑞医疗器械(杭州)有限公司 Linkage structure of endoscope apparatus

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CN105395251A (en) * 2015-12-15 2016-03-16 安瑞医疗器械(杭州)有限公司 High-frequency electrotome for endoscope
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CN205359621U (en) * 2016-01-14 2016-07-06 安瑞医疗器械(杭州)有限公司 Endoscope is with high frequency cutter of taking syringe needle
CN209032622U (en) * 2018-06-08 2019-06-28 安瑞医疗器械(杭州)有限公司 A kind of high-frequency knife of the endoscope-use with injection needle

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Publication number Priority date Publication date Assignee Title
CN102379739A (en) * 2011-08-31 2012-03-21 南京微创医学科技有限公司 Winding prevention type multifunctional high-frequency scalpel of endoscope
CN102579129A (en) * 2012-03-28 2012-07-18 刘枫 High-frequency incision knife with accurate fixed-length knife bit for endoscope
CN105395251A (en) * 2015-12-15 2016-03-16 安瑞医疗器械(杭州)有限公司 High-frequency electrotome for endoscope
CN105434038A (en) * 2015-12-15 2016-03-30 安瑞医疗器械(杭州)有限公司 Multifunctional high-frequency tool for endoscope
CN205359621U (en) * 2016-01-14 2016-07-06 安瑞医疗器械(杭州)有限公司 Endoscope is with high frequency cutter of taking syringe needle
CN209032622U (en) * 2018-06-08 2019-06-28 安瑞医疗器械(杭州)有限公司 A kind of high-frequency knife of the endoscope-use with injection needle

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