JP2002248112A - Medical care equipment - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a medical care equipment which is excellent in its compactness and heat conductivity of a forefront processing section and is capable of easily performing coagulation and incision even in a small cavity. SOLUTION: The medical care equipment whose processing section 3 for coagulation and incision of tissues is attached to a tip of an insertion portion 2 to be inserted in a body cavity is characterized by a heat conductive member 13 housing a heating element 12 at the tip of the above insertion portion 2, and thermally connected to the heating element 12 being further protruded toward the forefront side than the above tip portion.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a medical device used for coagulation and incision of mucous membranes of internal organs and tissues, and coagulation of inferior turbinate mucosa on nasal mucosa as a surgical treatment for allergic rhinitis. It relates to a treatment tool.

[0002]

2. Description of the Related Art Conventionally, medical treatment tools for coagulating or incising internal organs such as respiratory organs and digestive organs by inserting into the body cavity of a living body, and surgical treatment for allergic rhinitis such as hay fever are known. 2. Description of the Related Art Medical treatment tools used for coagulation of the inferior turbinate mucous membrane to the nasal mucosa as a treatment method are known.

For example, Japanese Patent Application Laid-Open No. Hei 8-500025 discloses that a heating element made of a ferromagnetic material is provided at the distal end of an insertion portion to be inserted into a body cavity. A treatment instrument for heating and treating a treatment section is disclosed.

Japanese Patent Application Laid-Open No. H11-197158 discloses a cautery probe that can be inserted into an endoscope. The cautery probe has a cylindrical coagulation treatment portion at the distal end thereof, and a peripheral surface of the coagulation treatment portion. There is disclosed a treatment tool which presses and coagulates a tissue.

Further, Japanese Patent Application No. 11-296885 discloses a cautery probe used for coagulation of the inferior turbinate mucous membrane in the nasal mucosa, etc., wherein a heating element is provided inside a cap at the distal end, and a peripheral surface of the cap is provided. There is disclosed a treatment tool that presses a tissue against tissue to cauterize the mucous membrane.

[0006]

However, the device disclosed in Japanese Patent Application Laid-Open No. Hei 8-500025 energizes a heating element made of a ferromagnetic material with a high frequency to heat the treatment section by self-heating by the skin effect. However, there are problems in miniaturization of the distal end of the treatment section and electrical safety. Also, Japanese Patent Application Laid-Open
Japanese Patent Application Laid-Open No. 197158 discloses a structure in which a peripheral surface of a cylindrical coagulation treatment portion is pressed against tissue to coagulate, and a structure in which a local portion of the tissue cannot be incised.

[0007] Further, in Japanese Patent Application No. 11-296684, a heating element is provided inside a cap at the tip, but a part of the cap has a heat insulating structure.
Since it is impossible to uniformly generate heat on the peripheral surface of the cap, it is difficult to perform treatment in a narrow cavity such as treatment in a nasal cavity.

The present invention has been made in view of the above circumstances, and has as its object to reduce the size of the treatment section at the distal end and to excel in thermal conductivity, and to coagulate and dissect even in treatment in a narrow cavity. An object of the present invention is to provide a medical treatment tool that can easily perform a treatment.

[0009]

In order to achieve the above object, according to the present invention, there is provided a medical device having a treatment section for coagulating or incising tissue at a distal end of an insertion section to be inserted into a body cavity. In the treatment instrument, a heat treatment element may be provided at a distal end of the insertion portion, and a treatment portion may be provided that is thermally coupled to the heat generation element and includes a heat conductive member that protrudes further distally than the distal end. Features.

A second aspect of the present invention is characterized in that a cross-sectional area of the treatment section is smaller than a cross-sectional area of the insertion section.

According to a third aspect of the present invention, there is provided a medical treatment instrument having a treatment section for coagulating or incising tissue at a distal end of an insertion section to be inserted into a body cavity, wherein a heating element is built in the distal end of the insertion section. A treatment section thermally coupled to the heating element; and a treatment element fixing means for conducting heat of the heating element to a part of an outer peripheral surface of the treatment section. I do.

According to a fourth aspect of the present invention, the heating element fixing means of the third aspect includes a fixing member built in the treatment section and thermally coupled to the heating element, and fixing the fixing member to an inner peripheral surface of the treatment section. And a pressing member that is brought into close contact with the second member.

According to the first and second aspects of the present invention, the insertion portion of the medical treatment instrument is inserted into the body cavity via the trocar penetrating the abdominal wall. In this state, when the heating element is energized, the heating element generates heat. Since the heat of the heat generating element is transferred to the treatment section made of a heat conducting member, the treatment section is heated to a temperature at which the tissue is coagulated and incised.

According to the configuration of the third and fourth aspects, the heat of the heating element can be uniformly conducted to a part of the outer peripheral surface of the treatment section in the treatment section, so that the treatment element is as narrow as the treatment in the nasal cavity. Can be treated in the cavity.

[0015]

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

FIGS. 1 and 2 show a first embodiment. FIG. 1 is a side view showing an entire hook probe as a medical treatment tool, and FIG. 2 is a vertical sectional side view of a tip side of the hook probe.

As shown in FIG. 1, the hook probe 1 is
An insertion section 2 inserted into a body cavity via a trocar punctured in the abdominal wall, a treatment section 3 provided at a distal end of the insertion section 2,
A handle 4 is provided at the proximal end of the insertion section and is an operation section that the operator grasps when holding the hook probe 1.

As shown in FIG. 2, the insertion portion 2 is formed of an elongated and hard sheath 5, a coaxial cable 6 is inserted inside the sheath 5, and a water supply conduit is provided around the outer periphery of the coaxial cable 6. 7 are provided. A metallic nozzle component 8 is fitted into the distal end portion of the sheath 5, and an insertion hole 9 through which the coaxial cable 6 is inserted and a nozzle 10 communicating with the water supply pipe 7 are directed obliquely forward into the nozzle component 8. The opening is provided.

The diameter of the insertion hole 9 of the nozzle component 8 is increased at the tip end, and a heating element 12 made of, for example, a thin-film resistance element is provided in the hollow portion 11. 6a is electrically connected by soldering or the like.

A base cylindrical portion 14 of a heat conducting member 13 constituting the treatment section 3 is fitted around the outer periphery of the nozzle constituting member 8 including the heating element 12. The heat conductive member 13 is formed of a material having excellent heat conductivity, for example, copper or brass. The surface of the heat conductive member 13 is plated, and further coated with Teflon (registered trademark) to prevent adhesion to tissue. Inside the hollow portion 11 of the heat conducting member 13, a fixing portion 15 made of a material having the same excellent thermal conductivity, for example, copper or brass, is incorporated, and the fixing portion 15 and the heating element 12 are mechanically coupled. Or they are joined by heat compound or soldering. Further, the fixing portion 15
The heat-generating element 12 is fixedly connected to the heat-conducting member 13 by mechanical connection, heat compounding, or soldering.

A further inclined surface 13a is provided on the distal end side of the heat conducting member 13 so that the sectional area gradually decreases toward the distal end side.
, A substantially L-shaped hook portion 16 is provided so as to protrude integrally therewith. The hook portion 16 has a circular or square cross section, is formed to have a smaller cross-sectional area than the sheath 5, and has a blade portion 17 formed inside the hook portion 16. Then, the site where the tissue has adhered is peeled off by the hook portion 16 or the blade portion 1 is removed.
The incision can be made at 7.

An electric contact 18 for connecting to the coaxial cable 6 is provided on a side of the handle 4, and is connected to a power supply (not shown) via a cable (not shown) having a connector. At the rear end of the handle 4, a connection base 19 communicating with the water supply pipe 7 is provided. The connection base 19 is connected to a water supply source (not shown) via a tube (not shown). The connection base 19 is provided with a valve 20 for adjusting the amount of water supply, and the valve 20 is provided with an operation button 21 for an operator to operate.

Next, the operation of the first embodiment will be described.

With the electric contacts 18 provided on the handle 4 connected to a power source and the connection base 19 connected to a water supply source,
The handle 4 of the hook probe 1 is grasped, and the insertion section 2 is inserted into the body cavity through a trocar penetrating the abdominal wall. In this state, the heating element 12 is connected via the coaxial cable 6.
When power is supplied to the heating element 12, the heating element 12 generates heat. Heating element 12
Is transferred to the heat conducting member 13 via the fixing portion 15, so that the heat conducting member 13 is heated to a temperature at which the tissue is coagulated and cut.

Therefore, the hook portion 16 of the heat conducting member 13
Thus, the site where the tissue has adhered can be peeled or incised. At this time, since the hook portion 16 is substantially L-shaped, has a small cross-sectional area, and is provided with the blade portion 17 on the inner side, peeling and incision can be performed in the details of the tissue. At this time, the water can be sent from the nozzle 10 toward the treatment site of the tissue by sending the water from the water sending pipe 7. Further, since the surface of the heat conductive member 13 is coated with Teflon, it can be prevented from adhering to tissue.

3 and 4 show a second embodiment. FIG. 3 (a) is a side view showing the whole of a spatula probe as a medical treatment tool, and FIG. 3 (b) is a plan view of a treatment section. FIG. 4 is a vertical sectional side view of the distal end side of the spatula probe, and the same components as those in the first embodiment are denoted by the same reference numerals and description thereof is omitted.

In this embodiment, the structure of the treatment section 3 is different from that of the first embodiment, and the heat conducting member 22 is formed of a material having excellent heat conductivity, for example, copper or brass, and the surface is plated. It is coated with Teflon to further prevent adhesion to tissue.

The heat conducting member 22 has an elliptical shape in a plan view and a downward arcuate spatula shape in a side sectional view. Therefore, the cross-sectional area of the heat conductive member 22 is formed to be smaller than that of the sheath 5, and a blade portion 23 is formed at the distal end.

According to the present embodiment, since the heat conducting member 22 has a spatula shape, it is suitable for tissue separation.
The shape is not limited to a spatula shape and may be a straight needle shape or a curved needle shape.

FIG. 5 is a longitudinal sectional side view of the tip side of a hook probe showing a third embodiment, and the same components as those in the first embodiment are denoted by the same reference numerals and description thereof is omitted.

In this embodiment, a substantially L-shaped hook 16 is formed at the tip of the heat conducting member 13 and the hook 1
The hook member 16 is prevented from deformation and breakage by fixing a reinforcing member 23 to the outside of the hook 6. By applying Teflon coating also on the surface of the reinforcing member 23, adhesion to tissue can be prevented.

FIGS. 6 and 7 show a fourth embodiment, FIG. 6 is a side view showing an entire hook probe as a medical treatment tool, and FIG. 7 is a longitudinal sectional side view of the tip side of the hook probe. The same components as those in the first embodiment are denoted by the same reference numerals, and description thereof is omitted.

In this embodiment, the outer sheath 24 is detachably fitted to the outside of the sheath 5 to form a double sheath structure, and the distal end of the outer sheath 24 is basically provided with the first embodiment. A heat conducting member 25 similar to that described above is provided integrally. A substantially L-shaped hook portion 26 is integrally provided at an end of the heat conducting member 25 via an inclined surface 25a so as to gradually decrease in cross-sectional area toward the end. The hook 26 has a circular or square cross section.
The cross-sectional area is smaller than the sheath 5 and the hook 2
6, a blade portion 27 is formed. Then, the site where the tissue has adhered can be peeled off or incised by the hook portion 26.

The proximal end of the outer sheath 24 extends to the handle 4, and a fixing portion 28 for fixing the outer sheath 24 is provided at the distal end of the handle 4. Therefore, when a part of the heat conducting member 25 is deformed or damaged, it can be easily replaced with a new one together with the outer sheath 24, and the replacement operation is easy.

8 to 10 show a fifth embodiment, FIG. 8 is a side view showing the entirety of an ablation probe as a medical treatment instrument, FIG. 9 is a vertical side view of the tip side of the ablation probe, and FIG.
FIG. 3 is an exploded perspective view of a pressing mechanism. This embodiment is an ablation probe suitable for nasal mucosa coagulation and ablation as a treatment for hay fever in which pollen adheres to the nasal mucosa and causes an allergic reaction.

As shown in FIG. 8, the cautery probe 31
It has a hollow outer sheath 32 formed of a hard metal, a synthetic resin material, or the like, and a flexible inner sheath 33 is provided inside the outer sheath 32. Outer sheath 32
An operation unit 34 is provided at the near side of the control unit. The outer sheath 32 has a bent portion 3 in the middle so as not to interfere with the endoscope and to be easily inserted into the nasal cavity to approach the target site.
5 are provided.

A treatment section 36 is provided at the distal end of the outer sheath 32. The treatment section 36 is configured as shown in FIGS. That is, a material with excellent thermal conductivity,
For example, the treatment section main body 37 formed of copper or brass has a cylindrical shape with a closed top end and an open base end. A connection member 39 is provided at the opening of the base end via a seal member 38. ing. A serrated retaining portion 40 is provided at the base end of the connecting member 39.
Press-fit.

Further, a cable insertion hole 41 is provided in the axis of the connection member 39, and a coaxial cable 42 is inserted into the cable insertion hole 41. This coaxial cable 4
Reference numeral 2 extends through the inner sheath 33 to the operation section 34 and is connected to a cable 43 connected to the operation section 34.

A heating element 44 composed of, for example, a thin-film resistance element is electrically connected to the conductor 42a at the end of the coaxial cable 42 by soldering or the like. This heating element 44
Is pressed and fixed to a fixing member 46 made of a material having excellent thermal conductivity, for example, copper or brass, by a pressing mechanism 45 as a heating element fixing means.
7 is tightly fixed to the inner peripheral surface.

The pressing mechanism 45 has a substantially semicircular pressing member 4.
The pressing member 47 is provided with an inclined surface 47a having a downward slope toward the front end side. On the lower surface at the base end of the pressure receiving member 48, an inclined surface 48 having an upward slope toward the base end side.
a is provided. The inclined surfaces 47a and 48a are in surface contact with each other at the same inclination angle,
Is pressed forward, the pressure receiving member 48 moves in the direction of the fixing member 46 while the inclined surfaces 47a and 48a slide.

The fixing member 46 which comes into contact with the pressure receiving member 48
Has a flat surface 49 having a holding hole 49a for holding the front end of the heating element 44 at the front end, and an opening 50 at the rear end side of the flat surface 49. ing. Then, the pressure receiving member 48 is placed on the flat surface 49.
Of the coaxial cable 42 faces the opening 50 of the fixing member 46.

Therefore, when the pressing member 47 is pressed forward, the inclined surfaces 47a and 48a slide and the pressing member 4
8 moves in the direction of the fixing member 46 and presses the flat surface 49 of the fixing member 46 with the lower surface of the pressing receiving member 48.
The fixing member 46 is in close contact with the inner surface of the treatment section main body 37. Since the heat of the heating element 44 is efficiently transferred to the treatment section main body 37 via the fixing member 46 by the close contact between the fixing member 46 holding the heating element 44 and the treatment section main body 37, the treatment section main body 3
7 can be uniformly heated.

The cautery probe 31 configured as described above
For example, the nasal mucosa can be coagulated and cauterized by inserting the nasal cavity into the nasal cavity and pressing the outer peripheral surface of the treatment section body 37 against the nasal mucosa. That is, it can be used for coagulation of the inferior turbinate mucous membrane to the nasal mucosa as a surgical treatment for allergic rhinitis such as hay fever.

According to each of the above embodiments, the following configuration is obtained.

(Supplementary Note 1) In a medical treatment tool provided with a treatment section for coagulating or incising tissue at a distal end of an insertion section to be inserted into a body cavity, a heating element is incorporated at the distal end of the insertion section. A medical treatment tool, further comprising: a treatment portion thermally coupled to a heating element and including a heat conductive member protruding further distally than the distal end.

(Supplementary note 2) The medical treatment tool according to supplementary note 1, wherein a cross-sectional area of the treatment section is smaller than a cross-sectional area of the insertion section.

(Supplementary Note 3) The medical treatment tool according to Supplementary Note 1, wherein the treatment section has a hook portion having a substantially L shape.

(Supplementary Note 4) The medical treatment instrument according to Supplementary Note 1, wherein the treatment section has a spatula shape.

(Supplementary note 5) The medical treatment tool according to Supplementary note 1, wherein the heating element is fixed to the heat conducting member through a fixing portion.

(Supplementary Note 6) In a medical treatment tool provided with a treatment section for coagulating or incising tissue at the distal end of an insertion section to be inserted into a body cavity, a heating element is built in the distal end of the insertion section, Providing a treatment section thermally coupled to the heating element,
A medical treatment tool, wherein the treatment section is provided with heating element fixing means for conducting heat of the heating element to a part of an outer peripheral surface of the treatment section.

(Supplementary Note 7) The heating element fixing means includes a fixing member built in the treatment section and thermally coupled to the heating element, and a pressing member for bringing the fixing member into close contact with an inner peripheral surface of the treatment section. 7. The medical treatment device according to attachment 6, wherein the medical treatment device comprises:

(Supplementary note 8) The medical treatment tool according to supplementary note 7, wherein the pressing member has an inclined surface that gradually presses the fixing member by pressing.

[0053]

As described above, according to the present invention, there is provided a heat conducting element having a built-in heating element at the distal end of the insertion portion, thermally connected to the heating element, and projecting further distally from the distal end. A treatment section comprising: Therefore, the treatment section at the distal end is excellent in miniaturization and thermal conductivity, and can easily perform coagulation and incision treatment even in treatment in a narrow cavity.

Further, according to the present invention, a heat treatment element is built in the distal end portion of the insertion portion, and a treatment section thermally coupled to the heat treatment element is provided, and the heat of the heat treatment element is applied to the treatment section. A heat-generating element fixing means for conducting heat is provided on a part of the outer peripheral surface. Therefore, the heating element and the treatment section can be in close contact with each other, and the heat of the heating element is efficiently transferred to the treatment section, so that the outer peripheral surface of the treatment section can be uniformly heated. Therefore, it can be used for inferior turbinate mucosa coagulation to the nasal mucosa as a surgical treatment for allergic rhinitis such as hay fever.

[Brief description of the drawings]

FIG. 1 is a side view showing a first embodiment of the present invention and showing an entire hook probe.

FIG. 2 is a vertical side view of the tip side of the hook probe of the embodiment.

3A and 3B show a second embodiment of the present invention, wherein FIG. 3A is a side view showing the entire hook probe, and FIG. 3B is a plan view of a treatment section.

FIG. 4 is a vertical side view of the tip side of the hook probe of the embodiment.

FIG. 5 shows a third embodiment of the present invention and is a longitudinal sectional side view of a tip side of a hook probe.

FIG. 6 is a side view showing a fourth embodiment of the present invention and showing an entire hook probe.

FIG. 7 is a vertical sectional side view of the tip side of the hook probe of the embodiment.

FIG. 8 is a side view showing a fifth embodiment of the present invention and showing the entirety of an ablation probe.

FIG. 9 is a vertical side view of the distal end side of the ablation probe of the embodiment.

FIG. 10 is an exploded perspective view of the pressing mechanism of the embodiment.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 ... Hook probe 2 ... Insertion part 3 ... Treatment part 12 ... Heating element 13 ... Heat conduction member

Claims (4)

[Claims] 1. A medical treatment tool having a treatment section for coagulating or incising tissue at a distal end of an insertion section to be inserted into a body cavity, wherein a heating element is incorporated at the distal end of the insertion section. A medical treatment instrument comprising: a treatment portion made of a heat conductive member thermally coupled to the distal end and further projecting toward the distal end side from the distal end portion. 2. The medical treatment tool according to claim 1, wherein a cross-sectional area of the treatment section is smaller than a cross-sectional area of the insertion section. 3. A medical treatment tool provided with a treatment section for coagulating or incising tissue at a distal end of an insertion portion to be inserted into a body cavity, wherein a heating element is incorporated at the distal end of the insertion portion, A treatment section thermally connected to the element, and a heating element fixing means for conducting heat of the heating element to a part of an outer peripheral surface of the treatment section in the treatment section; Treatment tools. 4. A fixing member embedded in the treatment section and thermally coupled to the heating element, wherein the heating element fixing means includes:
4. The medical treatment tool according to claim 3, further comprising a pressing member for bringing the fixing member into close contact with an inner peripheral surface of the treatment section.