JP2008295905A - Monopolar type high frequency knife for endoscope - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a monopolar type high frequency knife for an endoscope, comprising separate high frequency electrodes for incision and hemostasis, capable of continuously performing incision and hemostasis, while having no risk of damaging a normal living body tissue even when the unnecessary one of the high frequency electrodes for incision and hemostasis gets in contact with it. <P>SOLUTION: The first and the second high frequency electrodes 8A and 8B of different wire diameter are disposed at 180° symmetric positions around the axial line of a flexible sheath 2. For conductive wires, a first conductive wire 5A continuous with the first high frequency electrode 8A, and a second conductive wire 5B continuous with the second high frequency electrode 8B are inserted into the flexible sheath 2 to be disposed in such a way that they are not electrically continuous with each other. <P>COPYRIGHT: (C)2009,JPO&INPIT

Description

  The present invention relates to a monopolar high-frequency knife for an endoscope.

  Endoscopic monopolar high-frequency knives generally have a living tissue that touches a high-frequency electrode through which a high-frequency current is passed, with a long and narrow high-frequency electrode arranged at the distal end portion that is guided into the body through the treatment instrument insertion channel of the endoscope. With Joule heat, an incision treatment is performed as if cutting with a knife.

However, such incision procedures often involve bleeding. Therefore, if the hemostasis treatment is performed with a coagulation forceps or the like other than the high frequency knife subsequent to the incision, the operation becomes extremely complicated. In such a case, an incision treatment and a hemostasis treatment can be continuously performed with one high-frequency knife (for example, Patent Document 1).
JP2007-44281

  However, in a configuration in which the front and back sides of the high-frequency electrode are formed with a narrow incision electrode and a wide hemostasis electrode, when a high-frequency current is applied to one of the front-side and back-side high-frequency electrodes, Since the high-frequency current flows, there is a possibility that the unnecessary high-frequency electrode may damage the living tissue when it accidentally touches the normal living tissue.

  Therefore, the present invention can continuously perform incision and hemostasis with separate high-frequency electrodes for incision and hemostasis, and the unnecessary high-frequency electrode is normal among the high-frequency electrodes for incision and hemostasis. An object of the present invention is to provide a monopolar high-frequency knife for an endoscope that does not cause damage to the living tissue even if the living tissue is touched.

  In order to achieve the above object, the monopolar high-frequency knife for endoscope according to the present invention has a high-frequency electrode made of a conductive wire material on the side surface near the distal end of the electrically insulating flexible sheath. In the monopolar type high-frequency knife for endoscope, in which a conductive wire that is exposed along the direction and is inserted and arranged in the flexible sheath is conductively connected to the high-frequency electrode, the wire diameter is different from the first high-frequency electrode. The second high-frequency electrode is disposed at a 180 ° symmetrical position about the axis of the flexible sheath, and as the conductive wire, a first conductive wire that conducts to the first high-frequency electrode and a second high-frequency electrode The second conductive wire that is conducted is inserted and arranged in the flexible sheath in a state in which the second conductive wires are not electrically conducted to each other.

  In addition, the flexible sheath may be inserted through the outer tube that is inserted into and removed from the treatment instrument insertion channel of the endoscope so as to be rotatable in the direction around the axis, and the flexible sheath has a plurality of penetrating lengths. It may be formed of a multi-lumen tube in which holes are formed, and the first and second conductive wires may be inserted through different through-holes of the multi-lumen tube.

  In addition, the first and second conductive wires are both formed of stranded wires, and one of the first and second high-frequency electrodes is a stranded wire core, and the other high-frequency electrode is The stranded wire may be used as it is, and the length of the high-frequency electrode having the larger wire diameter of the first and second high-frequency electrodes is shorter than the length of the high-frequency electrode having the smaller wire diameter. Also good.

  The first and second power cord connecting terminals for connecting the high-frequency power cord to the operating portion coupled to the proximal end of the flexible sheath are provided in a state where they are not electrically connected to each other. The conductive wire may be conductively connected to the first power cord connecting terminal and the second conductive wire may be conductively connected to the second power cord connecting terminal, or may be coupled to the proximal end of the flexible sheath. In addition, a power cord connection terminal for connecting the high frequency power cord to the operation unit may be arranged so as to be selectively conductively connected to only one of the first and second conductive wires.

  According to the present invention, as the high-frequency electrode, the first and second high-frequency electrodes having different wire diameters are arranged at 180 ° symmetrical positions around the axis of the flexible sheath, and the first conductive wire is used as the first conductive wire. By inserting the first conductive wire conducting to the high-frequency electrode and the second conductive wire conducting to the second high-frequency electrode into the flexible sheath in a state where they are not electrically connected to each other. Incision treatment and hemostasis treatment can be performed continuously with separate high frequency electrodes for incision and hemostasis, and the unnecessary high frequency electrode of the incision and hemostasis high frequency electrodes touches normal living tissue. However, there is no risk of damaging the living tissue.

  A high-frequency electrode made of a conductive wire is exposed on the side surface in the vicinity of the distal end of the electrically insulating flexible sheath along the longitudinal direction of the flexible sheath, and a conductive wire inserted into the flexible sheath is provided. In a monopolar type high-frequency knife for endoscope that is conductively connected to a high-frequency electrode, the first and second high-frequency electrodes having different wire diameters are arranged at 180 ° symmetrical positions about the axis of the flexible sheath as the high-frequency electrode. As a conductive wire, the first conductive wire that conducts to the first high-frequency electrode and the second conductive wire that conducts to the second high-frequency electrode are not electrically connected to each other. It was inserted into the flexible sheath.

Embodiments of the present invention will be described below with reference to the drawings.
FIG. 3 shows the overall configuration of the endoscope monopolar high-frequency knife according to the first embodiment of the present invention. Reference numeral 1 denotes an outer tube that is inserted into and removed from a treatment instrument insertion channel of an endoscope (not shown). For example, it is formed of an electrically insulating flexible tube such as a tetrafluoroethylene resin tube.

  In the outer tube 1, a flexible sheath 2 is disposed so as to be loosely inserted over the entire length so as to be rotatable about an axis. The distal end of the flexible sheath 2 protrudes from the distal end of the outer tube 1 by about 1 to several centimeters. In addition, the protrusion length does not change.

  As shown also in FIG. 2 illustrating the II-II cross section, the flexible sheath 2 is formed of a multi-lumen tube in which a plurality of (here, two) through holes 3A and 3B are formed in parallel over the entire length. In each of the through holes 3A and 3B, flexible conductive wires 5A and 5B made of, for example, a stranded wire obtained by twisting a plurality of fine stainless steel wires are inserted and arranged over the entire length.

  Two sets of small holes 6A and 6B, which communicate with the through holes 3A and 3B, are formed in the side surface of the distal end portion of the flexible sheath 2 protruding from the distal end of the outer tube 1, and the first group The small holes 6A are formed in a state where each small hole 6A communicates with the first through-hole 3A at an interval in the front-rear direction (that is, a direction parallel to the axis of the flexible sheath 2). They are formed at 180 ° symmetrical positions around the axis of the flexible sheath 2 with respect to the first set of small holes 6 </ b> A so as to communicate with the second through-holes 3 </ b> B at intervals in the front-rear direction.

  Between the first pair of small holes 6A, as shown in FIG. 1, the first high-frequency electrode 8A made of a conductive wire is exposed on the outer surface of the flexible sheath 2 along the longitudinal direction. As shown in FIG. 1, the second high-frequency electrode 8 </ b> B made of a conductive wire is disposed on the outer surface of the flexible sheath 2 along the longitudinal direction between the second pair of small holes 6 </ b> B. Has been.

  The first high-frequency electrode 8A arranged in this way is formed by extending only the core wire of the first conductive wire 5A made of a stranded wire and pulling it back into the flexible sheath 2, and the second high-frequency electrode 8A is formed. The electrode 8B is formed by extending the tip portion of the second conductive wire 5B as it is and pulling back only the core wire into the flexible sheath 2.

  As a result, the first high-frequency electrode 8A having a thin wire diameter is suitable for incision for incising a living tissue, and the second high-frequency electrode 8B having a large wire diameter is suitable for hemostasis for coagulating the living tissue. The high-frequency electrode 8A and the second high-frequency electrode 8B are arranged in parallel at a 180 ° symmetrical position about the axis of the flexible sheath 2 in a state physically and electrically separated from each other.

  The first high-frequency electrode 8A is electrically connected to the first conductive wire 5A, the second high-frequency electrode 8B is electrically connected to the second conductive wire 5B, and the first conductive wire 5A The second conductive wire 5B is inserted and arranged in the flexible sheath 2 in a state where the second conductive wire 5B is not electrically connected to each other.

  As shown in FIG. 3, the operation unit 10 is connected to the proximal end of the flexible sheath 2. The proximal end of the flexible sheath 2 is fixedly connected to the distal end of the operation unit main body 11, and a ring-shaped finger hook 12 is formed at the opposite end (hand side end) of the operation unit main body 11. .

  13 is a grip ring that is attached to the front portion of the operation unit main body 11 so as to be relatively rotatable around the axis with respect to the operation unit main body 11 (but not to move in the axial direction). The proximal end of the outer tube 1 is fixedly connected to the distal end portion. Reference numeral 9 denotes a bend preventing tube fitted near the proximal end of the outer tube 1 in order to prevent the vicinity of the proximal end of the outer tube 1 and the flexible sheath 2 from being bent suddenly and broken.

  With such a configuration, when the operator grips the grip ring 13 with the fingertip and rotates the operation portion main body 11 about the axis as indicated by the arrow A, the flexible sheath 2 is formed in the outer tube 1. As the arrow B shows, the first and second high-frequency electrodes 8A and 8B rotate around the axis together with the distal end of the flexible sheath 2 as the arrow B rotates. The direction can be moved.

  The wire fixing plate 14 formed of an electrical insulating material is fixedly disposed in a slit formed in the operation unit main body 11, and the base ends of the first conductive wire 5A and the second conductive wire 5B are between each other. Opened and fixed to the wire fixing plate 14. Reference numeral 15 denotes a cover cylinder for restricting the wire fixing plate 14 from being detached from the slit.

  Then, the first and second power cord connecting terminals 20A and 20B for individually connecting high-frequency power cords not shown are screwed into the wire fixing plate 14 so as not to be electrically connected to each other, and the cover cylinder 15 The first power cord connecting terminal 20A is electrically connected to the first conductive wire 5A, and the second power cord connecting terminal 20B is electrically connected to the second conductive wire 5B.

  Therefore, of the first high-frequency electrode 8A and the second high-frequency electrode 8B arranged so as not to be electrically connected to each other, the first high-frequency electrode 8A is a high-frequency power source connected to the first power cord connecting terminal 20A. The second high-frequency electrode 8B is connected to the cord, and is connected to the high-frequency power cord connected to the second power cord connecting terminal 20B.

  When the endoscope monopolar type high-frequency knife of the embodiment having the above-described configuration is used, first, the first high-frequency power cord (not shown) is connected to the first power cord connection terminal 20A, and the first incision is made. The incision treatment of the living tissue is performed with the high frequency electrode 8A. In this case, since no high-frequency current flows through the second high-frequency electrode 8B, there is no possibility of damaging the living tissue even if the second high-frequency electrode 8B touches the surrounding normal tissue.

  When bleeding occurs due to the incision procedure using the first high-frequency electrode 8A, the high-frequency power cord is connected to the second power cord connection terminal 20B, and then the second high-frequency electrode 8B for hemostasis is used. A hemostatic treatment can be performed, and in this case, since no high-frequency current flows through the first high-frequency electrode 8A, there is a risk that even if the first high-frequency electrode 8A touches the surrounding normal tissue, the living tissue may be damaged. Absent.

  FIG. 4 shows the distal end portion of the monopolar high-frequency knife for endoscope according to the second embodiment of the present invention, wherein the second high-frequency electrode 8B for hemostasis is shorter than the first high-frequency electrode 8A for incision. Is formed. By configuring in this way, it is easy to perform hemostasis treatment for only the necessary site.

  5 and 6 show the operation part 10 of the monopolar type high-frequency knife for endoscope according to the third embodiment of the present invention, and the power cord connecting terminal 20 is rotatable about the rotation support shaft 21. FIG. Only one conductive end 22 is urged from the outside toward the inside by the compression coil spring 23.

  As a result, the conductive end portion 22 of the power cord connecting terminal 20 comes into contact with one head of the conductive wire holding screws 16A and 16B, and the power cord connecting terminal 20 is connected to the first and second conductive wires 5A and 5B. Only one of them can be selectively connected.

  Therefore, when performing an incision treatment, the power cord connection terminal 20 is used in a state of being electrically connected to the first conductive wire 5A as shown in FIG. 5, and when performing hemostasis treatment, it is shown in FIG. Thus, the power cord connecting terminal 20 can be rotated around the rotation support shaft 21 so that the power cord connecting terminal 20 can be brought into conduction with the second conductive wire 5B. There is no need to insert or remove the terminal 20. Other configurations are the same as those of the first embodiment, and the same operational effects as those of the first embodiment can be obtained.

It is a perspective view of the front-end | tip part of the monopolar type | mold high frequency knife for endoscopes of the 1st Example of this invention. It is II-II sectional drawing in FIG. 3 of the 1st Example of this invention. It is side surface sectional drawing which shows the whole structure of the monopolar type | mold high frequency knife for endoscopes of the 1st Example of this invention. It is a perspective view of the front-end | tip part of the monopolar type | mold high frequency knife for endoscopes of the 2nd Example of this invention. It is side surface sectional drawing of the state which performs the incision treatment of the operation part of the monopolar type | mold high frequency knife for endoscopes of the 3rd Example of this invention. It is side surface sectional drawing of the state which performs the hemostatic treatment of the operation part of the monopolar type | mold high frequency knife for endoscopes of the 3rd Example of this invention.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Outer tube 2 Flexible sheath 3A, 3B Through-hole 5A, 5B Conductive wire 6A, 6B Small hole 8A, 8B High frequency electrode 10 Operation part 20, 20A, 20B Power supply cord connection terminal

Claims (7)

A conductive wire in which a high-frequency electrode made of a conductive wire is exposed and arranged along the longitudinal direction of the flexible sheath on the side surface near the distal end of the electrically insulating flexible sheath, and is inserted into the flexible sheath. In the monopolar high-frequency knife for endoscope that is conductively connected to the high-frequency electrode,
As the high-frequency electrode, first and second high-frequency electrodes having different wire diameters are arranged at 180 ° symmetrical positions around the axis of the flexible sheath, and the first high-frequency electrode is used as the conductive wire. The first conductive wire that conducts to the second high-frequency electrode and the second conductive wire that conducts to the second high-frequency electrode are inserted into the flexible sheath so that they are not electrically connected to each other. A monopolar high-frequency knife for endoscopes.   2. The monopolar high-frequency knife for an endoscope according to claim 1, wherein the flexible sheath is inserted and disposed so as to be rotatable in a direction around an axis line in an outer tube inserted into and removed from a treatment instrument insertion channel of the endoscope.   The flexible sheath is formed of a multi-lumen tube in which a plurality of through-holes are formed over the entire length, and the first and second conductive wires are inserted into different through-holes of the multi-lumen tube. The monopolar high-frequency knife for endoscopes according to claim 1 or 2.   The first and second conductive wires are both formed of stranded wires, and the core wire of the stranded wire is used as one of the first and second high-frequency electrodes, and the other high-frequency electrode is used as the other high-frequency electrode. The monopolar high-frequency knife for an endoscope according to claim 1, 2, or 3, wherein the stranded wire is used as it is.   5. The length of a high-frequency electrode having a larger wire diameter of the first and second high-frequency electrodes is shorter than a length of a high-frequency electrode having a smaller wire diameter. Monopolar type high frequency knife for endoscope.   A first and second power cord connection terminals for connecting a high-frequency power cord to the operating portion coupled to the proximal end of the flexible sheath are provided in a state where they are not electrically connected to each other, and the first The conductive wire is electrically connected to the first power cord connecting terminal, and the second conductive wire is conductively connected to the second power cord connecting terminal. Monopolar type high frequency knife for endoscope.   A power cord connection terminal for connecting a high-frequency power cord to the operation section coupled to the proximal end of the flexible sheath can be selectively connected to only one of the first and second conductive wires. The monopolar type high-frequency knife for an endoscope according to any one of claims 1 to 5, which is disposed on the endoscope.

Images