JP2000262538A - Electric operative device using puncture electrode for high frequency - Google Patents

Abstract

PROBLEM TO BE SOLVED: To protect the treating section from being damaged, and also, provide a wide coagulation-cauterization range, in an electric operative device using a puncture electrode for high frequency. SOLUTION: On the side surface of a sheath 2, a plurality of puncture electrodes 16 which can freely project from/retract into a puncture electrode discharging port 7, are provided. Also, on the side surface section of the sheath 2, a surface electrode 3 of another polarity, which has a wider area than the puncture electrode 16, is disposed between the puncture electrodes 16. Also, a cooling baloon 6 for the cooling of a treating section, is disposed on the side surface section of the sheath 2. Then, a high frequency output is fed to the puncture electrodes 16 and the surface electrode 3.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an electrosurgical apparatus using a high-frequency puncture electrode, and more particularly, to a high-frequency puncture electrode that improves a puncture electrode to obtain a wide coagulation and cautery range and protects a mucosal surface. Related to the electrosurgical device that was used.

[0002]

2. Description of the Related Art An electrosurgical device performs a treatment such as incision and coagulation of a living tissue by flowing a high-frequency current, and an electrosurgical device using a puncture electrode is widely used.

For example, US Pat. No. 5,582,589,
In the specification, a sharp probe consisting of a radio frequency electrode and an insulating sleeve surrounding the radio frequency electrode is pierced into a patient's prostate by a handle means at hand, and a high-frequency current is applied.
A technique for monitoring the temperature of a portion near the urethral wall has been disclosed.

US Pat. No. 5,672,173 also has a primary antenna that penetrates tissue and a secondary antenna disposed laterally from the primary antenna, wherein the secondary antenna is a primary antenna. An abatement apparatus is disclosed that is less rigid than an antenna, has at least one radius of curvature, and is connected to an energy source. This device uses a high-frequency current between a puncture catheter and a puncture electrode discharged from the puncture catheter.

[0005]

By the way, the technology described in the above-mentioned US Pat. No. 5,582,589 is as follows.
When a high-frequency current is applied between the puncture electrodes, there is a problem that the coagulation and ablation range is limited to a narrow range near the puncture electrode. Even when a high-frequency current is applied between the puncture electrode and the counter electrode, the coagulation and ablation range does not change, and there is concern about burns on the counter electrode and the like.

Further, although a temperature sensor is provided, a cooling mechanism for the urethral wall is not provided, so that the obtained coagulation and ablation range is small at the same temperature.

On the other hand, the above US Pat. No. 5,672,173
The technique described in the specification has a problem that it is difficult to widen a coagulation ablation range because both electrodes are thin, though it is a bibolar type.

Accordingly, an object of the present invention is to provide an electrosurgical apparatus using a high-frequency puncture electrode which can protect a treatment portion from being damaged and can obtain a wide range of coagulation and ablation. is there.

[0009]

According to the first aspect of the present invention, there is provided a sheath, a puncture electrode provided on a side surface of the sheath so as to be freely protruded and retracted, and a puncture electrode provided on a side surface of the sheath. And an electrode of another polarity having an area larger than that of the puncture electrode, wherein a high-frequency output is supplied to the puncture electrode and the electrode of the other polarity.

According to the invention of claim 2, according to claim 1,
In the electrosurgical apparatus using the high-frequency puncturing electrode according to the above, the puncturing electrode is composed of a plurality of electrodes at the same potential.

Further, according to the invention of claim 3, according to claim 1,
In the electrosurgical apparatus using the high-frequency puncture electrode described in the above, a cooling balloon that covers the electrode of the other polarity to cool the treatment section, and a cooling water circulation channel that circulates cooling water to the cooling balloon. Are further provided.

In the electrosurgical apparatus using the high-frequency puncture electrode according to the first aspect, a puncture electrode is provided on the side surface of the sheath so as to be freely protruded and retracted, and the side surface portion of the sheath is larger than the puncture electrode. An electrode of another polarity having a large area is provided. Then, a high-frequency output is supplied to the puncture electrode and the electrode of the other polarity.

Further, in the electrosurgical apparatus using the high-frequency puncturing electrode according to the second aspect, the puncturing electrode is composed of a plurality of electrodes at the same potential.

Further, in the electrosurgical apparatus using the high-frequency puncture electrode according to the third aspect, the treatment portion is cooled by a cooling balloon that covers the electrode of the other polarity, and the cooling balloon has a cooling water reflux. The cooling water is circulated through the passage.

According to the first and second aspects of the invention, when the puncture electrode is inserted into the tissue and energized, the area of the puncture electrode and the electrode of the other polarity is sufficiently large, so that the coagulation ablation range is widened. .

According to the third aspect of the invention, when the puncture electrode is inserted into the tissue and the cooling balloon is energized while circulating the cooling water, the area of the puncture electrode and the electrode of the other polarity are large. Therefore, the range of coagulation and cauterization is widened, and the surface mucous membrane can be protected from burns by the cooling effect of the cooling water.

[0017]

Embodiments of the present invention will be described below with reference to the drawings.

First, a first embodiment of the present invention will be described with reference to FIG.

FIG. 1 (a) is an external view showing the entire puncture electrode assembly according to the present invention, FIG. 1 (b) is a view of the electrode portion viewed from the side, and FIG. 1 (c) is the urethra. FIG. 5 is a view showing a state in which a puncture electrode is discharged in the inside.

The puncture electrode assembly 1 has a sheath 2 having a closed distal end, and a surface electrode 3 is provided near the distal end of the sheath 2. Then, the insertion / removal direction of the puncture electrode assembly 1 in the vicinity of the surface electrode 3,
That is, in the directions of arrows A ₁ and A _{2 in} FIG.
A cooling water inlet 4 and a cooling water outlet 5 for the cooling balloon 6 are provided. Further, in the vicinity of the cooling balloon 6, a puncture electrode discharge hole 7 for discharging a puncture electrode 16 described later is provided.
However, for example, in FIG. 1A, it is provided at four places. In the puncture electrode assembly 1, a fixing balloon 8 is provided on a side opposite to the surface electrode 3.

The puncture electrode assembly 1 has an interior member 9 slidable within the sheath 2 as shown by arrows A ₁ and A ₂ in FIG. Then, through the interior member 9, the cooling water inlet connector 11, the cooling water outlet connector 12, the high frequency connector 13, the fixing balloon air supply port 1
4 is connected to the cooling water inlet 4, the cooling water outlet 5, the surface electrode 2, the puncture electrode 16 described below, and the fixing balloon 8.

The puncture electrode 16 is to be discharged from the puncture electrode discharge hole 7 and is provided to the puncture electrode discharge knob 9 of the interior member 9.
a, ie, the interior member 9 is
It is discharged by being slid in the arrow A ₁ direction (a). On the other hand, puncture electrode discharge knob 9a is pulled from the sheath 2 (which is slid in the arrow A ₂ direction), the puncture electrode 16
Is stored in the puncture electrode discharge hole 7.

In this case, the number of the puncture electrode discharge holes 7 and the number of the puncture electrodes 16 are two on each side, and four each. However, the numbers and positions are not limited thereto.

These four puncturing electrodes 16 are formed in arc shapes facing inward from both sides with the plane electrode 3 interposed therebetween, and the tips 16a are in a state where the electrodes are exposed, and the root side is insulated. It constitutes the coated insulating part 16b. The puncturing electrodes 16 are all electrodes of the same potential, and the surface electrode 3 is an electrode of another polarity.
High-frequency energy is supplied to the surface electrode 3 and the puncture electrode 16 via the high-frequency connector 13. The high frequency power supply may be a general electric knife.

The puncture electrode assembly 1 is configured so that the cooling water entered from the cooling water inlet connector 11 enters the cooling balloon 6 through the cooling water inlet 4 in order to circulate the cooling water. The cooling water flowing out of the cooling water outlet 5 flows out of the cooling water outlet connector 12. The device for circulating the cooling water may be constituted by a general pump or a circulating device. Further, the material of the cooling balloon 6 may be made of a material having no conductivity.

The fixing balloon 8 is for pressing the cooling balloon 6 against the urethral wall, and can be inflated by sending air from the fixing balloon air inlet 14.

Next, the operation of the puncture electrode assembly 1 configured as described above will be described.

When the puncture electrode assembly 1 is inserted into the urethra 18 of the patient, as shown in FIG.
As shown in FIGS. 1A and 1B, the puncture electrode 16
Is stored in the puncture electrode discharge hole 7 and the cooling balloon 6
The fixing balloon 8 is in a contracted state.

After the puncture electrode assembly 1 is inserted into the urethra 18 up to the treatment site, cooling water is circulated and the cooling balloon 6 is inflated. That is, the cooling water entered from the cooling water inlet connector 11 enters the cooling balloon 6 from the cooling water inlet 4, and the cooling balloon 6 is expanded. The cooling water also flows from the cooling water outlet 5 through the cooling water outlet connector 12.

Here, conductive water such as physiological saline is used as the cooling water. Thereafter, air is supplied by a syringe from the fixing balloon air supply port 14, and the fixing balloon 8 is inflated. As a result, the cooling balloon 6 moves the urethral mucosa 19
And is fixed in the urethra 18.

Next, the interior member 9 by puncturing electrode discharge knob 9a is pushed in the arrow A ₁ direction of FIG. 1 (a), piercing electrode 16 is punctured within the prostate. At this time, the insulative portion 16b coated with the insulative material forms the urethral mucosa 1
When the puncture is performed to enter the inside of the urethral mucosa 19
Can prevent damage.

When a high-frequency current is supplied from a high-frequency power supply (not shown) connected to the high-frequency connector 13 in a state where the four puncturing electrodes 16 are punctured in the treatment section,
An electric current flows between the puncture electrode 16 and the surface electrode 3, and the coagulation region 20 around the portion between the tip portion 16 a of the puncture electrode 16 and the surface electrode 3 is coagulated and cauterized.

As described above, according to the first embodiment,
By using the surface electrode 3 that can be punctured and has a larger area than the area 16, the coagulation / cauterization range can be expanded as compared with the case where a current is passed between the two needle electrodes. Further, the cooling effect of the cooling water flowing through the cooling balloon 6 and the inside of the prostate can be coagulated without damaging the urethral mucosa 19 by the insulating portion 16b.
You can cauterize.

Further, by the method of fixing the inside of the urethra 18 by the fixing balloon 8, the outer diameter at the time of insertion can be made small and a stable treatment state can be created.

Also, since it is a bipolar type, a counter electrode on the body surface is not required, and there is no fear of burns on the counter electrode or other parts.

In the first embodiment described above, the material of the cooling balloon 6 is not required to be conductive. However, the present invention is not limited to this, and the cooling balloon 6 may be formed of a conductive material. In this case, as the conductive material, for example, a mixture of silicon rubber and carbon is used as a cooling balloon.

Further, by embedding a mesh-like metal net in the cooling balloon itself, the cooling balloon itself can be used as an electrode.

Next, a second embodiment of the present invention will be described.

FIG. 2 is a perspective view showing a main part of a puncture electrode assembly according to a second embodiment of the present invention.

In the embodiments described below, the same parts as those in the above-described first embodiment are denoted by the same reference numerals, and description thereof will be omitted.

The second embodiment is different from the first embodiment in that the position of the puncture electrode discharge hole 7 is different. That is, in FIG. 2, the puncture electrode discharge hole 7 is provided not on the side of the surface electrode 3 but on the side near the cooling water outlet 5 and closer to the puncture electrode discharge knob 9a than the cooling balloon 6. I have.

When the puncture electrode discharge knob 9a is pushed, a substantially linear puncture electrode 16 is discharged from the puncture electrode discharge hole 7. Puncture electrode 16
Is composed of a tip portion 16a with exposed electrodes and an insulating portion 16b coated with an insulating coating.

The operation of the puncture electrode assembly according to the second embodiment is the same as that of the above-described first embodiment, and a description thereof will be omitted.

As described above, according to the second embodiment,
The same effects as those of the first embodiment can be obtained. By changing the arrangement of the puncture electrode, a puncture electrode assembly suitable for the treatment site can be made.

Next, a third embodiment of the present invention will be described.

FIG. 3 is a perspective view showing a configuration of a main part of a puncture electrode assembly according to the third embodiment.

In the third embodiment shown in FIG. 3, a channel 22 is provided inside the puncture electrode assembly 1 in addition to the configuration of the above-described first embodiment. Further, an observation window 23 is formed at the center of the surface electrode 3.

In such a configuration, when confirming the position of the treatment site, it is possible to confirm using the channel 23 and the observation window 23 using a side-view scope or an ultrasonic probe. This also allows the puncture electrode 16
Can be easily confirmed when the puncture is performed. Other operation methods are the same as those in the first embodiment.

As described above, according to the third embodiment,
In addition to the effects of the first embodiment, there is an advantage that a treatment site and a puncture position can be easily confirmed.

In the third embodiment, when at least a sideoscope is inserted into the channel 23, the cooling balloon 6 is made of a transparent member.

Next, a fourth embodiment of the present invention will be described.

FIG. 4 is an external view showing the configuration of the fourth embodiment.

Referring to FIG. 4, a thermocouple 25 is attached to the surface of the cooling balloon 6 in the puncture electrode assembly 1 '. The signal of the thermocouple 25 is output to the temperature sensor connector 27 of the therapeutic device main body 26.

The treatment machine main body 26 has a cooling water circulation function and a high frequency output unit, and is connected to a temperature sensor connector 27, a cooling water inlet connector 28, a cooling water outlet connector 29, and a high frequency connector 30. The setting part of the treatment machine main body 19 includes a sensor temperature setting part 31, a high-frequency output setting part 3,
2. A cooling water temperature setting unit 33 and a cooling water flow rate setting unit 34 are provided, and each setting and display is performed. Further, the treatment machine main body 26 is provided with a high-frequency output switch 35 for turning on and off a high-frequency wave and a cooling system switch 36 for turning on and off the cooling water circulation.

FIG. 5 is a block diagram showing an electrical configuration of the treatment machine main body 26 shown in FIG.

Referring to FIG. 5, a pump 41 for supplying cooling water to the cooling balloon 6 of the puncture electrode assembly 1 '.
And a temperature controller 42 for adjusting the sensor temperature are connected to the cooling system adjustment unit 43. The output of the cooling system adjustment unit 43 is output to a control unit 44 that issues commands to various functions.
Supplied to

The control section 44 includes a temperature measuring section 45 for measuring the temperature of the thermocouple 45, a high-frequency output section 46 for outputting a high frequency to the puncture electrode 16 and the surface electrode 3, and a setting for setting various parameters. The part 47 is connected.

In such a configuration, the treatment machine main body 26
Thereby, the cooling water inlet connector 28, the cooling water outlet connector 29, the high-frequency connector 30, and the temperature sensor connector 27 are connected, and predetermined setting values are set. The sensor temperature is set as an allowable temperature value of the mucosal surface.

The method of inserting and fixing the puncture electrode assembly 1 'is the same as that of the first embodiment.

When the cooling system switch 36 of the treatment machine main body 26 is turned on, the cooling water flows from the cooling water inlet connector 11 to the cooling water inlet 4, the cooling balloon 6, the cooling water at the set water temperature and flow rate. The water reaches the cooling water outlet connector 12 via the water outlet 5 and is returned. Then, when the high frequency output switch 35 is turned on, a high frequency is output at the set output value, and the puncture electrode 16 and the surface electrode 3 that have been ejected coagulate / cauterize the treatment portion. However, it cannot be turned on when the cooling water is not circulating.

When the temperature of the thermocouple 25 exceeds the sensor temperature set in advance by the setting section 47 during the high frequency output, the high frequency output is stopped. Then, when the temperature of the thermocouple 25 falls below the sensor temperature, the output is started again.

As described above, in the fourth embodiment, in addition to the above-described first embodiment, the temperature of the mucous membrane surface is constantly monitored, and when the temperature exceeds the allowable value, the temperature is automatically monitored. Since the output can be stopped, damage to the mucous membrane can be further prevented.

In the above-described embodiment, the puncture electrode assembly is fixed in the lumen by providing the fixing balloon and inflating the balloon. However, the present invention is not limited to this. For example, in the case of a small lumen, the puncture electrode assembly can be fixed only by inflating the cooling balloon, so that the fixing balloon is not required in this case. Therefore, the presence or absence of the fixation balloon may be determined according to the thickness of the lumen.

According to the above embodiment of the present invention,
The following configuration can be obtained.

That is, (1) a sheath, a plurality of puncturing electrodes which can be protruded and retracted from the sheath and have the same electric potential, and an electrode of another polarity which is provided on the surface of the sheath and has a sufficiently larger area than the puncturing electrode. And a cooling balloon that can be extended and contracted to cover the electrode of the other polarity on the sheath surface, and a cooling water circulation channel that circulates cooling water to the cooling balloon,
A high-frequency electrosurgical device using a puncture electrode, comprising:

(2) The high-frequency electrosurgical apparatus using the puncture electrode according to (1), wherein the puncture electrode is at least partially coated with an insulating coating.

(3) The high-frequency electrosurgical device using a puncture electrode according to (1), wherein the cooling balloon has a temperature sensor on a surface thereof.

(4) An operation apparatus for a high-frequency hand using a puncture electrode according to (1), further comprising a balloon for fixing the sheath.

(5) The high-frequency device using the puncture electrode according to (1), further comprising a channel provided in the sheath and an observation window observable from the channel. Electric surgery equipment.

(6) A sheath, a plurality of puncturing electrodes which can be protruded and retracted into the sheath and have the same electric potential, and an electrode of another polarity provided on the surface of the sheath and having a sufficiently larger area than the puncturing electrode. A high-frequency puncturing electrode device having a telescopic cooling balloon that covers the other-polarity electrode on the sheath surface, a temperature sensor provided on the surface of the cooling balloon, and a connection to the high-frequency puncturing electrode device A high-frequency coagulation ablation device, comprising: a control device capable of controlling a high-frequency output when the temperature of the temperature sensor exceeds a preset temperature.

[0071]

As described above, according to the present invention, an electrosurgical apparatus using a high-frequency puncture electrode capable of protecting a treatment portion from being damaged and obtaining a wide range of coagulation and cauterization. And the specific effect that the surface mucous membrane of the treatment portion can be protected is obtained.

[Brief description of the drawings]

FIG. 1 is a view for explaining a first embodiment of the present invention, in which (a) is an external view showing an entire puncture electrode assembly according to the present invention, and (b) is a side view of an electrode portion. Figure,
(C) is a diagram showing a state in which a puncture electrode is discharged in the urethra.

FIG. 2 is a perspective view showing a main part of a puncture electrode assembly according to a second embodiment of the present invention.

FIG. 3 is a perspective view showing a configuration of a main part of a puncture electrode assembly according to a third embodiment of the present invention.

FIG. 4 is an external view showing a configuration of a fourth embodiment of the present invention.

FIG. 5 is a block diagram showing an electrical configuration of the treatment machine main body 26 shown in FIG.

[Explanation of symbols]

 1 puncture electrode assembly, 2 sheath, 3 face electrode, 4 cooling water inlet, 5 cooling water outlet, 6 cooling balloon, 7 puncture electrode discharge port, 8 fixing balloon, 9 interior member, 9a puncture electrode discharge knob, 11 cooling Water inlet connector, 12 cooling water outlet connector, 13 high frequency connector, 14 balloon air inlet for fixation, 16 puncture electrode, 16a tip, 16b insulating part, 18 urethra, 19 urethral mucosa, 20 coagulation area, 22 channel, 23 observation Window.

Claims (3)

[Claims] 1. A sheath, a puncture electrode provided on a side surface of the sheath so as to be freely protruded and retracted, and an electrode of another polarity provided on a side surface of the sheath and having a larger area than the puncture electrode. An electrosurgical apparatus using a high-frequency puncture electrode, comprising: supplying a high-frequency output to the puncture electrode and an electrode of another polarity. 2. The electrosurgical apparatus according to claim 1, wherein the puncture electrode comprises a plurality of electrodes at the same potential. 3. The apparatus according to claim 1, further comprising a cooling balloon for covering the electrode of the other polarity to cool the treatment section, and a cooling water circulation channel for circulating cooling water to the cooling balloon. An electrosurgical device using the high-frequency puncture electrode according to 1.