JP2001190563A - Cauter - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a cauter capable of enabling an operator to execute the operation with little pain and fatigue on both of the operator and a patient. SOLUTION: In this cauter including a cauterizing probe 1 having a heating means on its point part to cauterize a part to be operated in a body cavity, the probe 1 having the heating means on a point of a soft cable 5, a shaft 2 holding the probe 1 and keeping the attitude of the probe 1 in the operation, and a handle 13 for gripping this shaft 2 are provided, the probe 1 is held by the shaft 2 in a state that the point part having the heating means of the probe 1 forwardly projects from the point of the shaft 2, and a projecting length of the probe 1 is adjustable.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an ablation instrument having an ablation probe.

[0002]

2. Description of the Related Art Conventionally, a hard cautery which has a needle-like member capable of piercing a living tissue and which is heated to a deep part of the living tissue through the needle-like member to heat and necrotize the deep part of the living tissue. The probe is disclosed in JP-A-62-2137.
No. 49 is known.

[0003] On the other hand, there are various diseases as medical applications of treatment for heating and necrosis of living tissue. One example is treatment of a group of obstructive sleep apnea and snoring. In a treatment example of this disease, an ablation probe is orally inserted, and the excess tissue is reduced by heating and necrosis of the root of the tongue or the deep part of the soft palate.

[0004]

However, when a hard cautery probe is orally inserted and a treatment for reducing the excess tissue by heating and necrosis of the tongue base or the deep part of the soft palate is performed, the patient has a large opening. The athlete had to maintain a stable posture while the surgeon had to keep the cautery probe stable.

[0005] Such a treatment is painful to the patient and at the same time has a limited patience. For this reason, the treatment time depends on the patient's patience limit, and in some cases, a sufficient therapeutic effect may not be obtained. Similarly, it is difficult for the surgeon to keep the puncture depth or the like constant due to fatigue, and a stable effect may not be obtained.

[0006] The present invention has been made in view of the above circumstances, and an object of the present invention is to provide a cautery treatment tool which enables both an operator and a patient to perform a procedure with less pain and fatigue.

[0007]

SUMMARY OF THE INVENTION The present invention relates to a cautery treatment instrument having a cautery probe having a heat generating means at a distal end for treating an operation site in a body cavity, wherein the heat generating means is provided at a distal end of a flexible cable. Ablation probe, a shaft that holds the ablation probe, maintains the posture of the ablation probe during operation, and a handle portion that grips the shaft, and the tip of the ablation probe having heat generating means has a tip portion of the shaft. The ablation probe is held by the shaft in a state of protruding forward from the distal end, and a length of the ablation probe protruding is adjustable.

[0008]

DESCRIPTION OF THE PREFERRED EMBODIMENTS [First Embodiment] FIGS. 1 to 5
The cautery treatment device according to the first embodiment of the present invention will be described with reference to FIG. 1 is a sectional view of a cautery probe, FIG. 2 is an explanatory view of the entire cautery treatment tool, FIG. 3 is a perspective view of an inner tube and an outer tube constituting a shaft of the cautery treatment device, and FIG. FIG. 5 is an explanatory view of the unlocking state when the user slides the finger toward the user, and FIG. 5 is an explanatory view of using the cautery treatment tool.

(Construction) As shown in FIG. 2, the cautery treatment instrument includes a cautery probe 1 and a shaft 2 configured in a sheath shape. The cautery probe 1 is used by being inserted into the shaft 2.

As shown in FIG. 1, the cautery probe 1 has a puncture needle 6 fixed to a distal end of a coaxial cable 5.
The puncture needle 6 is formed to have a sharpened tip so that it can puncture a living tissue, and a heating element 7 is embedded inside the puncture needle 6. The heating element 7 is the cable 5
It is connected to the. As the heating element 7, various methods such as Joule heat by electric resistance, heat generation by high-frequency current, and heat generation by microwave can be considered.

The cable 5 is connected to a controller 8 as shown in FIG. The controller 8 includes a commercial power cord 9. The power supply ON / OFF operation is performed by a switch operation button 10 provided on a handle 13 described later.

As shown in FIG. 3, the shaft 2 is provided with an inner tube 1.
The outer tube 12 is shorter than the length of the inner tube 11. A handle 13 is fixed to a proximal end of the inner tube 11. The cautery probe 1 is configured to be retracted and inserted into the inner tube 11. A plurality of slits 14 are formed at the tip of the inner tube 11. Inner tube 1
The distal end of the cautery probe 1 has at least a puncture needle 6 of the cautery probe 1 having a wall thickness gradually increasing toward the distal end.
Is formed to take in the coaxial cable 5 up to the vicinity of (1).

The inner tube 11 and the outer tube 12 are connected to the inner tube 11 while the coaxial cable 5 is pulled into the grip portion 15 of the inner tube 11 to a portion near the puncture needle 6 of the cautery probe 1.
By sliding 2 toward the front side, the grip portion 15 of the inner tube 11 is tightened by the outer tube 12 to reduce the inner diameter, and a chuck mechanism for tightening and fixing the coaxial cable 5 of the cauterization probe 1 is configured.

A projection 18 is formed on the outer periphery of the inner tube 11 so as to fit into and engage with a concave portion 17 formed on the inner surface of the outer tube 12. When the outer tube 12 is advanced with respect to the inner tube 11, when the grip portion 15 of the inner tube 11 is tightened by the outer tube 12, a locking mechanism is formed in which the protrusion 18 is fitted into and engaged with the recess 17. Is done.

FIG. 4 shows the ablation probe 1 by sliding the outer tube 12 toward the user, enlarging the inner diameter of the grip 15 of the inner tube 11.
Has been released.

(Operation) When using the above cautery treatment tool, the operator pulls the cable 5 into the inner tube 11 and fixes the cautery probe 1 to the shaft 2 as shown in FIG. While inserting, the puncture needle 6 and the distal end of the shaft 2 are inserted into the widely opened mouth of the patient. And
As shown in FIG. 5, the puncture needle 6 is inserted into a desired portion of the living tissue 19.
Puncture the tip of After puncturing the living tissue 19 with the puncture needle 6,
By pulling the outer tube 12 toward the user, the engagement between the inner tube 11 and the cable 5 is released, and only the shaft 2 is taken out of the mouth. In this state, the patient closes his mouth and makes the cable 5 lightly chewed. By supplying electric energy from the controller 8 to the heating element 7 to generate heat, the heating treatment of the living tissue 19 is started. Since the puncture needle 6 is punctured into the living tissue 19, treatment can be performed to a deep portion of the living tissue 19.

(Effect) After puncturing the living tissue 19 with the puncture needle 6, the patient can close his or her mouth almost.
Not painful. Therefore, a desired treatment time can be secured. On the other hand, since the surgeon can release his hand from the cautery treatment tool, there is no fatigue. In addition, it is possible to prevent a displacement or an error in the puncture depth due to an inadvertent operation, so that a stable therapeutic effect can be obtained.

[Second Embodiment] An ablation treatment tool according to a second embodiment of the present invention will be described with reference to FIGS. 6 is a cross-sectional view of the distal end portion of the cautery treatment tool, FIG. 7 is an explanatory view of the entire cautery treatment tool, and FIG. 8 is an explanatory view of the entire cautery treatment tool with the shaft deformed.

(Construction) Coaxial cable 5 of cautery probe 1
A heating element 7 is provided at the end of the heating element 7, and the heating element 7 is covered with a tip cap 21. The outer peripheral surface of the tip cap 21 is subjected to a coating treatment for preventing sticking. The coaxial cable 5 is sheathed in a sheath 20.
A shaft 22 is attached to the sheath 20, and the sheath 20 guided and held by the coaxial cable 5 is guided and held by the shaft 22. A fixed portion 24 is provided at the distal end of the shaft 22, and the fixed portion 24 holds a portion near the distal end of the cable 5. The sheath 20 is a tube made of a soft resin, for example, PTFE. The shaft 22 can be deformed (bent) by a predetermined external force given by hand, and can maintain its posture unless a predetermined external force is applied, for example, a metal (stainless steel, silver, gold, copper, etc.). It is formed from a material.

(Operation) If the sheath 20 is kept straight, when the surgeon guides the cautery probe 1 of the cautery treatment instrument to the affected part, the distal end of the cautery probe 1 cannot reach the lesion or the surgeon's view. In some cases. In such a case, the operator bends the shaft 22 with the force of the hand, for example, as shown in FIG.
Is changed to a desired shape as shown by.

(Effect) Since both the flexible cautery probe 1 and the shaft 22 holding it can be deformed into a desired shape and maintained in that shape, the distal end portion of the cautery treatment tool, such as a deep portion, can be used. Guidance is possible even in places where guidance is difficult, and stable treatment is possible. The surgeon does not need to perform the procedure in an unreasonable environment, and there is no fatigue.

In the configuration of the second embodiment, the shaft 22 may be formed by covering the outside of a metal with a resin. In this case, the risk of breakage is low even after repeated bending.

[Third Embodiment] A cautery treatment tool according to a third embodiment of the present invention will be described with reference to FIGS.

(Configuration) This embodiment is a modified example of the shaft 22 in the configuration of the second embodiment. The shaft 22 here is formed of a continuous body in which a plurality of bridge members 31 are connected in a line. Each piece member 31 is connected by a connecting member 32.

As shown in FIG. 11, the connecting member 32 is provided with spherical balls 33 at both ends, and each ball 33 is engaged with the inside of a hole 34 formed at the end of the connecting piece member 31 in a state of being tightly fitted. Is held. When an external force is applied to the shaft 22 by hand, the ball 33 becomes the piece member 3 fitted with the ball 33.
Sliding within the one hole 34, the shaft 22 can be deformed into any shape.

(Operation and Effect) The same operation and effect can be obtained as in the second embodiment.

[Fourth Embodiment] A cautery treatment device according to a fourth embodiment of the present invention will be described with reference to FIGS.

The cautery treatment device of the present embodiment has a shaft 4
1 is configured as a bendable portion 42. The bendable portion 42 forms a large number of cuts 45 in the pipe material 43 while leaving the connecting portion 44, and deforms the connecting portion 44 by applying an external force to bend and deform as a whole. A wire 46 is inserted into the bendable portion 42 so as to be able to advance and retreat toward one side to be bent, and the tip of the wire 46 is fixed to the tip of the bendable portion 42. The proximal end of the wire 46 is wound around an angle knob 47 provided on the handle 13. By rotating the angle knob 47, the wire 46 is pulled, and the bendable portion 42 can be controlled to an arbitrary curved shape. FIG. 13 shows a straight state, and FIG. 14 shows a state in which the bendable portion 42 is bent.

In the cautery treatment device of the present embodiment, the bendable portion 42 can be bent into an arbitrary shape by pulling the wire 46 to apply an external force to the bendable portion 42.
Can be used similarly to the embodiment.

[Fifth Embodiment] An ablation instrument according to a fifth embodiment of the present invention will be described with reference to FIGS.

(Configuration) In this embodiment, the configuration of the puncture needle 6 and the heating element 7 in the cautery probe 1 of the cautery treatment tool according to the first embodiment is changed. The puncture needle 6 includes a needle-like member 51 and a pipe-like member 52. The needle-like member 51 provided at the tip of the pipe-like member 52 is made of a member having low thermal conductivity, for example, a resin member such as polysulfone. On the other hand, the pipe-shaped member 52 is made of a member having a high thermal conductivity, for example, a metal such as aluminum or ceramics.

(Operation) When the cautery treatment tool is used in the same manner as in the first embodiment, when heat is generated, a conventional configuration is used, or in the first embodiment, as shown in FIG. Although an ablation range 55 is shown, according to this configuration, since the heat conduction in the lateral direction is significantly better, an ablation range 56 as shown in FIG. 16B is shown.

(Effect) In general, many lesions 57 of this kind show development in a horizontal direction at a certain depth. Therefore, in the cauterization range 55 of FIG. 16A, there is a risk of cauterizing even normal tissue, but according to the present configuration, the risk is low.

[Modification of Fifth Embodiment] As shown in FIG. 17, the puncture needle 6 is formed as a single piece, and the thickness of the rear peripheral wall is significantly smaller than the thickness A of the front. With this configuration, the same operation and effect as those of the fifth embodiment can be obtained.

The puncture needle 6 and the heating element 7 may be configured as shown in FIGS. 18 to 20, respectively. FIG. 18 shows a light emitting portion 61 made of a nichrome wire, tungsten, or the like embedded in a transparent member instead of the heating element.
The light emitted from the light emitting section 61 heats only the metal side wall of the puncture needle 6 intensively. In addition, if the material of the puncture needle 6 covering the light emitting unit 61 is also transparent, it is possible to heat with far infrared rays, and it is possible to heat a deep part of the living tissue.

In the apparatus shown in FIG. 19, the heating element 7 is provided so as to retreat from the tip, and a mesh means 62 having a capillary structure is provided on the tip side of the heating element 7, and the mesh means 62 is impregnated with a working liquid. The heat generated by the heat generating element 7 vaporizes the working liquid in the mesh means 62, and the vapor flows to the tip heating section, where it condenses and radiates heat at the tip. The liquefied working liquid returns to the heating element 7 side due to capillary action in the mesh means 62. Heat can be efficiently heated by the heat absorption and heat dissipation. In addition, a flexible configuration can be obtained, and the insertability is improved.

In FIG. 20, the puncture needle 6 is constituted by a ceramic heater. According to this configuration, it is possible to heat a deeper portion by far infrared rays.

<Supplementary Note> 1. A cautery treatment instrument including a cautery probe having a heat generating means at a distal end for treating an operation site in a body cavity, comprising: a cautery probe having a heat generating means at a distal end of a flexible cable;
A shaft for holding the cautery probe and maintaining the posture of the cautery probe during operation, and a handle for gripping the shaft, a tip having a heating means of the cautery probe protruding forward from the tip of the shaft. A cautery treatment instrument, wherein the cautery probe is held by the shaft in the retracted state, and the protruding length of the cautery probe is adjustable.

2. The shaft has a sheath shape, and the cable of the cauterizing probe is inserted into the shaft so as to be able to advance and retreat, and the cauterizing probe is fixed to the shaft at a position where the protruding length from the tip of the shaft is adjusted. The cautery treatment device according to claim 1, wherein the device is capable of being cauterized.

3. The cautery treatment device according to claim 1 or 2, wherein the shaft is detachable from the cautery probe.

[0041]

As described above, according to the present invention, the patient can close the mouth almost without suffering. Therefore, a desired treatment time can be secured.

On the other hand, the surgeon can release his hand,
It is possible to prevent displacement, puncture depth error due to careless operation without fatigue, and to obtain a stable therapeutic effect.

[Brief description of the drawings]

FIG. 1 is a cross-sectional view of an ablation probe of an ablation treatment tool according to a first embodiment of the present invention.

FIG. 2 is an explanatory view of the entire cautery treatment tool.

FIG. 3 is a perspective view of an inner tube and an outer tube constituting a shaft of the cautery treatment instrument.

FIG. 4 is an explanatory view of a state in which fixing is released when an outer tube is slid toward an inner tube with respect to an inner tube of a shaft of the cautery treatment instrument.

FIG. 5 is an explanatory view when the cautery treatment tool is used.

FIG. 6 is a sectional view of a distal end portion of a cautery treatment device according to a second embodiment of the present invention.

FIG. 7 is an explanatory view of the entire cautery treatment tool.

FIG. 8 is an explanatory view of a state in which the cautery treatment instrument shaft is deformed.

FIG. 9 is a cross-sectional view of a distal end portion of a cautery treatment device according to a third embodiment of the present invention.

FIG. 10 is a side view of a shaft of the cautery treatment tool.

FIG. 11 is a longitudinal sectional view of a shaft of the cautery treatment instrument.

FIG. 12 is a longitudinal sectional view of the shaft when the cautery treatment device is deformed.

FIG. 13 is an explanatory view of an entire cautery treatment device according to a fourth embodiment of the present invention.

FIG. 14 is an explanatory view of a state in which the shaft of the entire cautery treatment tool is deformed.

FIG. 15 is a longitudinal sectional view of a portion of a puncture needle and a heating element in a cautery probe of a cautery treatment device according to a fifth embodiment.

FIG. 16 is an explanatory diagram of an operation in a use state of the cauterization probe.

FIG. 17 is a longitudinal sectional view of a distal end portion showing a modification of the cauterization probe.

FIG. 18 is a vertical cross-sectional view of a distal end portion showing a modification of the ablation probe.

FIG. 19 is a longitudinal sectional view of a distal end portion showing a modification of the cauterization probe.

FIG. 20 is a longitudinal sectional view of a distal end portion showing a modification of the cauterization probe.

[Explanation of symbols]

1 ... cautery probe, 2 ... shaft, 5 ... coaxial cable,
6 puncture needle, 7 heating element, 13 handle.

 ──────────────────────────────────────────────────続 き Continued on the front page (72) Inventor Hinako Ichihara 2-43-2 Hatagaya, Shibuya-ku, Tokyo Inside Olympus Optical Industrial Co., Ltd. (72) Inventor Akihisa Ogawa 2-43-2 Hatagaya, Shibuya-ku, Tokyo No. Olympus Optical Co., Ltd. F-term (reference) 4C060 JJ29 KK02 KK04 KK09 KK20 KK47

Claims (1)

[Claims] 1. A cautery treatment instrument having a cautery probe having a heat generating means at a distal end for treating an operation site in a body cavity, comprising: a cautery probe having a heat generating means at a distal end of a flexible cable; A shaft that holds the posture of the ablation probe during operation, and a handle portion that grips the shaft, in a state in which a tip portion having a heating means of the ablation probe protrudes forward from the tip of the shaft. An ablation treatment tool, wherein the ablation probe is held by the shaft, and a protruding length of the ablation probe is adjustable.