JP2010246769A - Medical electrode instrument - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a medical electrode instrument, capable of stably measuring the potential at the surface of the heart that is beating, while maintaining the size of the potential-measurable range, and measuring the epicardial potential with minimum invasiveness. <P>SOLUTION: The medical electrode instrument 1 is insertable into an examinee through a trocar. It is provided with a wiring tube 16 for housing cables to transmit electric signals detected by an electrode array 9 comprising a plurality of electrodes which detect the potential to an electric signal analysis device separately for the respective electrodes, a suction tube 18 to connect more than one suction parts 12b to be sucked to an object to a suction device, an electrode substrate 51 on which the plurality of the electrodes are disposed, and the electric array 9, of which length along the axes of the wiring tube 16 and the suction tube 18 is longer than the inner diameter of the trocar. <P>COPYRIGHT: (C)2011,JPO&INPIT

Description

  The present invention relates to a medical electrode device including an electrode array used for epicardial electrocardiographic measurement.

  Atrial fibrillation is classified as arrhythmia, causing (1) palpitations as subjective symptoms, (2) heart function deterioration, (3) causing thromboembolism (causing cerebral infarction, etc.) . Examples of surgical treatment for such arrhythmia include catheter ablation treatment, which is a less invasive treatment method, and maze surgery, which is a highly invasive treatment method. it can.

  Catheter ablation treatment is a treatment method based on electrophysiological measurement technology. Specifically, in catheter ablation treatment, a dedicated catheter is inserted mainly from a thick blood vessel (femoral vein or femoral artery) at the base of the foot, and the heart of the catheter is seen through X-rays by fluoroscopy. To reach. An electrode for measuring the cardiac potential is provided at the distal end of the catheter, and the cardiac potential measurement is performed while the electrode is in contact with the inner wall of the heart.

  By this measurement, it is possible to determine whether or not the part in contact with the catheter at that time is an abnormal part such as a secondary conduction path. The operation of detecting this abnormal part is usually called “mapping”, and a map (map) showing the abnormal part in the heart is created by such mapping. After grasping the abnormal site by this mapping, a high-frequency current is applied to the electrode provided at the distal end of the catheter, and only a small area of heart tissue in contact with the distal end of the catheter is electrically cauterized. Kill the cells of the tissue.

  However, since catheter ablation treatment is performed under fluoroscopy, it has a problem of long-term X-ray exposure.

  On the other hand, the maize operation was devised by Cox et al. In 1991 and not only electrically isolated the left atrial posterior wall including all pulmonary veins, but also all macro reentry circuits that pivot around the anatomical barrier. A technique is adopted in which the atrial reentry is blocked and the maintenance of atrial fibrillation is prevented by cutting, further cutting the atrial muscle below a certain width and re-stitching.

  Thus, maze surgery is an invasive treatment performed under an open chest. However, in recent years, port treatment called minimally invasive maze surgery, which is performed using a dedicated surgical tool through a plurality of small holes, has begun to be performed. However, since this minimally invasive maze operation is not a treatment based on electrophysiological mapping information of a surgical target portion in a subject during the operation, there is a possibility that an unnecessary incision may be performed in some cases.

  That is, as problems of the minimally invasive maze operation, it can be mentioned that it is difficult to find an abnormal site and point treatment is difficult. This is due to the fact that a system for measuring local electrophysiological information during surgery has not been established.

  Note that the information provided by the mapping performed in the catheter ablation treatment is an intracardiac electrocardiogram, not epicardial measurement information. Therefore, the mapping performed in catheter ablation treatment cannot be applied to minimally invasive maze surgery. Here, as a technique regarding the measurement of the epicardial potential, for example, Patent Document 1 discloses the following technique.

  That is, Patent Document 1 discloses a method for fixing a cardiac electrode outside a patient's heart, the step of temporarily placing the electrode at a target position near the heart, and a plurality of different positions near the heart. And detecting an electrical signal on the electrode, analyzing a selected parameter from the electrical signals on the electrode detected at the plurality of different positions, and based on an analysis of the selected parameter. A method is disclosed comprising: determining a preferred position for attachment of a cardiac electrode from a plurality of different positions; and securing the cardiac electrode to a preferred position external to the patient's heart.

  According to the technique disclosed in Patent Document 1, the accuracy in placing electrodes on the epicardial surface for electronic mapping of the beating heart is improved.

Special table 2007-509702 gazette

  By the way, epicardial potential measurement methods can be broadly classified into “single point measurement” and “multi-point measurement” from the viewpoint of the number of measurement points.

  In one-point measurement, although the invasiveness is low, it is difficult to measure the potential distribution in a certain region required for electrophysiological mapping because the area where the electrode can be installed is small.

  In multipoint measurement, electrodes such as sock-type electrodes, sheet-type electrodes, and silicon epicardial patch electrodes are used, but these are all supposed to be used under thoracotomy and are therefore invasive. Cannot be applied to low port treatment.

  Furthermore, as an issue common to both single-point measurement and multi-point measurement, the area of the adsorption part on the heart surface and the potential are measured to stably measure the heart surface potential against the beating heart. The difficulty of coexistence with the installation area of the electrode for this purpose can be mentioned. That is, there is a trade-off between stability and the size of the measurable area.

  The present invention has been made in view of the above circumstances, and achieves both stable measurement of the heart surface potential with respect to the beating heart and the size of the potential measurable region. An object of the present invention is to provide a medical electrode device that realizes minimally invasive epicardial electrocardiographic measurement.

To achieve the above object, a medical electrode device according to the first aspect of the present invention comprises:
A medical electrode device inserted into a subject through a trocar,
A wiring tube that houses cables for independently transmitting electrical signals detected by a plurality of electrodes that detect the potential of an object to an electrical signal analyzer;
A suction tube for connecting one or more suction portions for suction to the object to a suction device;
An electrode substrate on which a plurality of the electrodes are disposed;
It comprises a plurality of the electrodes arranged in a predetermined arrangement area on the electrode substrate, and the arrangement area is longer in the axial direction of the wiring tube and the suction tube than the inner diameter of the trocar An electrode array;
It comprises.

  According to the present invention, the measurement of the heart surface potential with respect to the beating heart stably and the size of the potential measurable region are compatible, and a minimally invasive epicardial cardiac potential measurement is realized. A medical electrode device can be provided.

The front view of the medical electrode instrument which concerns on the 1st Embodiment of this invention. The side view of the medical electrode device which concerns on the 1st Embodiment of this invention. The side view of the medical electrode device which concerns on the 1st Embodiment of this invention (The figure which shows the modification regarding the structure of an adsorption | suction part). The perspective view of the medical electrode instrument which concerns on the 1st Embodiment of this invention inserted in the trocar. The side view of the medical electrode device which concerns on the 2nd Embodiment of this invention. The side view of the medical electrode device which concerns on the 2nd Embodiment of this invention made to adsorb | suck to the heart surface (object). The side view of the medical electrode device which concerns on the modification of the 2nd Embodiment of this invention. The side view of the medical electrode device which concerns on the modification of the 2nd Embodiment of this invention made to adsorb | suck to the heart surface (object). Sectional drawing of the electrode which concerns on the modification of the 2nd Embodiment of this invention.

[First embodiment]
A medical electrode device according to a first embodiment of the present invention will be described below with reference to the drawings.

  FIG. 1 is a front view of a medical electrode device according to a first embodiment of the present invention. FIG. 2 is a side view of the same.

  The medical electrode device 1 includes a measurement unit, a wiring tube 16, a suction tube 18, and a holding unit 22. Here, the measurement part 21 has the electrode array 9, the support part 14, and the adsorption | suction part 12b.

  Although details will be described later, the medical electrode device 1 of the present invention is used by being inserted into a subject via a trocar (diameter 10 mm) for minimally invasive port treatment and further reaching the heart. . Accordingly, the measurement unit is configured to have a width of 9 mm and a total length of 24 mm as shown in FIG. 1 so that the measurement unit can be inserted into a trocar having a diameter of 10 mm. In the example shown in FIG. 3, the height is 7 mm.

  In the electrode array 9, 32 (8 × 4) Pt electrodes 12 a 1, 12 a 2,..., 12 a 31, 12 a 32 are arranged at an interval of 1.8 mm in the vertical and horizontal directions in the arrangement region 12 a of the electrode substrate 51. It is arranged to be vacant. Each of the Pt electrodes 12a1, 12a2,..., 12a31, 12a32 has a flat plate shape with a diameter of 0.5 mm. The shape of the Pt electrode is not particularly limited to a flat plate shape. It may be a protruding electrode. For example, it is hemispherical with a diameter of 0.5 mm. Moreover, it may be cylindrical. The electrode array 9 is in contact with the heart surface. The electrode array 9 is used to directly measure the electrocardiographic distribution in the contacted area.

  Here, the electrical signals detected by the Pt electrodes 12a1, 12a2,..., 12a31, 12a32 are independent electrical signals. Therefore, the Pt electrodes 12a1, 12a2,..., 12a31, 12a32 are wired so that electric signals can be output independently. Each electric signal is input to a “multi-channel electrocardiogram analysis system (for example, EPWorkMate, manufactured by EPMed Systems; 1 kHz)”.

  The arrangement interval of the Pt electrodes 12a1, 12a2,..., 12a31, 12a32 is not limited to the above-described example, and the calculation accuracy when the potential at the position where no electrode is provided is calculated by interpolation calculation can withstand practical use. Of course, any arrangement interval within the range may be used.

  The suction portion 12b is connected to a suction device (not shown) via a suction tube 18. The suction unit 12b, the suction tube 18 and the suction device (not shown) constitute a suction system. In this suction system, the suction portion 12b generates a suction force according to the air pressure (for example, set to a vacuum state) adjusted by a suction device (not shown).

  For example, when the inside of the suction tube 18 is set to a vacuum state by a suction device (not shown), the contact pressure to the heart surface of the suction portion 12b coincides with the suction force by the vacuum, and this suction force is within the contact surface. It is almost uniform and constant.

  In addition, as shown in FIG. 1, it is preferable that the adsorption | suction part 12b is provided so that the circumference | surroundings of the electrode array 9 may be enclosed from four corners. However, the suction part 12b may be provided in any form as long as it can be stably suctioned to the suction object.

  FIG. 3 is a diagram illustrating a modified example related to the configuration of the suction unit 12b. Of course, as shown in the figure, the suction portion 12b may be composed of at least one suction port 103 and a wall portion 101. The wall 101 is disposed so as to surround the electrode array 9. In this case, the Pt electrodes 12a1, 12a2,..., 12a31, 12a32 constituting the electrode array 9 are disposed in the vicinity of the surface having the maximum cross-sectional area of the support portion 14 as shown in FIG. ing.

  Incidentally, as shown in FIG. 3, the suction port 103 in the suction portion 12 b is disposed so as to surround the electrode array 9 from a plurality of locations in a region surrounded by the wall portion 101. However, the suction port may be provided in any form as long as it can be stably adsorbed to the object to be adsorbed. For example, you may arrange | position at the peripheral part of the area | region enclosed by the wall part. Or you may arrange | position at the edge part of the area | region enclosed by the wall part.

  As a result, the space including the electrode array 9 surrounded by the wall portion 101 can be evacuated by the suction force.

  The wall portion 101 is formed so as to protrude from the support portion 14 side toward the heart surface contact side of the electrode array 9. The height of the wall 101 may be a height that can form a sealed space surrounded by the wall 101 and the heart surface when the electrode array 9 contacts the heart surface by the suction force of the suction system. More preferably, the height slightly protrudes from the electrode array 9 toward the heart surface contact side.

  Here, when a surface virtually including a contact portion of each electrode of the electrode array 9 with the heart surface is defined as a measurement surface, the measurement surface may be configured in a curved surface shape. Furthermore, you may comprise in the curved surface shape where the center position in a longitudinal direction is dented most deeply. Specifically, the shape matches the curvature of the heart surface. Specifically, the electrode array 9 is formed to have a curved surface shape as shown in FIG. In other words, the electrode array 9 is shaped so as to exhibit a curved shape in which each electrode is in close contact with the potential measurement target site on the heart surface without gap as much as possible. Thereby, the measurement accuracy of the potential measurement is improved.

  In addition, about this measurement surface, it is also possible to form the electrode substrate 51 of the electrode array 9 in a curved surface, for example, and to comprise in a curved surface. Alternatively, the height of the protruding electrode can be set so that the measurement surface is curved.

  The wall portion 101 includes at least one pair of wall portions facing each other. The at least one pair of wall portions is a curved wall portion 101 having the lowest height at the central portion. The curved wall 101 is formed on the longest side of the wall surrounding the electrode array 9. Thus, when the electrode array 9 comes into contact with the occluding surface, it becomes easier to form a sealed space surrounded by the wall portion 101 and the occluding surface. Furthermore, the curved shape of the wall portion 101 is more preferably configured to match the curvature of the heart surface. That is, it is more preferable that the curved surface shape along the electrode array 9 is formed in a shape in which the vicinity of the center is deepest recessed.

  When the electrode array 9 side of the measuring unit 21 is brought into contact with the heart surface and the inside of the suction tube 18 is set to a vacuum state by a suction device (not shown), it is surrounded by the wall portion 101 connected by the suction port 103. The space is also in a vacuum state. Then, a suction force acts on the heart surface toward the electrode array 9 side so that the heart surface and the electrode array 9 are in close contact with each other. Since the wall portion 101 is provided on the suction portion 12b, the suction force is substantially uniform and more constant within the contact surface. Then, the heart surface conforms to the shape of the electrode array 9 so that the heart storage surface and the electrode array 9 are stably brought into close contact with each other. Furthermore, since the electrodes of the electrode array 9 are projecting electrodes, the contact pressure per unit area of the electrode tip is increased, and the electrodes can be reliably and stably brought into contact with the heart surface.

  Moreover, the contact pressure to the heart surface of the medical electrode device 1 is maintained constant by the suction system, and the medical electrode device 1 is fixed to the surface of the beating heart. As a result, by placing the medical electrode device 1 after adsorbing it to the heart surface, the medical electrode device 1 follows the movement of the pulsation while being fixed to the surface of the heart, and has a highly accurate epicardial electrocardiographic measurement without unevenness. Is possible.

  Here, the suction force of the suction portion 12b is set to, for example, about 1.4 kgf in consideration of the weight of the medical electrode device, the non-slip property with respect to the epicardium under the heartbeat, and the like. Thereby, the electrode array 9 adheres appropriately to the heart surface.

  In addition, it is preferable that the suction force can be set independently for each of the plurality of suction portions 12b.

  By the way, the electrode substrate 51 of the electrode array 9 is made of, for example, a hard resin. However, it goes without saying that the material constituting the electrode substrate 51 is not limited to this.

  The support portion 14 is a member that supports the electrode array 9. Cables connected to the respective Pt electrodes 12a1, 12a2,... 12a31, 12a32 constituting the electrode array 9 are bundled and accommodated in the wiring tube 16 via the support portion 14.

  The wiring tube 16 bundles and stores cables for independently inputting electric signals from the Pt electrodes 12a1, 12a2,..., 12a31, 12a32 to a multi-channel ECG recording system (not shown).

  The suction tube 18 is a tube that connects the suction portion 12b and a suction pump (not shown).

  The holding part 22 is a member for holding with, for example, a manipulator or forceps. The measuring unit 21 can be moved by holding the holding unit 22. In addition, the electrode array 9 can be installed at a desired position on the heart surface. In order to facilitate movement and installation, for example, a manipulator or forceps may be connected. For the connection, for example, fitting or screwing can be used.

  By the way, the medical electrode device 1 according to the first embodiment of the present invention is used by being inserted into a subject via a trocar for port treatment. That is, the medical electrode device 1 according to the first embodiment is a device used for minimally invasive epicardial electrocardiogram measurement.

  Here, the arrangement region 12a of the Pt electrodes 12a1, 12a2,..., 12a31, 12a32 constituting the electrode array 9 in the electrode substrate 51 has a length in the axial direction of the wiring tube 16 and the suction tube 18. Longer than the inner diameter.

  Further, in the measuring section 21, the lengths in the axial direction of the wiring tube 16 and the suction tube 18 are longer than the inner diameter of the trocar.

  FIG. 4 is a perspective view of the medical electrode device 1 inserted into the trocar. As shown in the figure, the medical electrode device 1 is inserted into a subject through a trocar 100 and used. In the example shown in FIG. 4, the inner diameter of the trocar 100 is 10 mm in diameter.

  An instrument that is inserted into a small-diameter trocar for minimally invasive port treatment is considered to be difficult to perform multipoint measurement because the size of the electrode installation area is limited (conventional) All the techniques are for single point measurement).

  In view of such circumstances, in the medical electrode device 1 according to the first embodiment of the present invention, as shown in FIG. 3, the plane 12A ′ and the axial direction S of the wiring tube 16 when not bent are Adopt a structure that is almost parallel. The plane 12A ′ is a plane on which the electrode array 9 is assumed to be a plane instead of the curved surface as described above for convenience of explanation.

  In other words, the electrode array 9 is provided so as to face the inner diameter surface of the insertion hole in the trocar 100 when the medical electrode device 1 is inserted into the trocar 100.

  By adopting such a structure, the medical electrode device 1 according to the first embodiment of the present invention can perform multipoint measurement while performing minimally invasive epicardial electrocardiogram measurement.

  Hereinafter, one usage example of the medical electrode device 1 according to the present embodiment will be described.

  The medical electrode device 1 is inserted into the subject via the trocar 100 for port treatment to reach the heart, and the electrode array 9 is brought into contact with the epicardium. Here, the electrical signals detected by the Pt electrodes 12a1, 12a2,..., 12a31, 12a32 constituting the electrode array 9 are independently input to a multi-channel electrocardiogram analysis system (not shown).

  Then, for ASCII data exported from a multi-channel electrocardiogram analysis system (not shown), for example, a program created with MALTAB (R2008a) is used, and cubic spline interpolation is used to measure the epicardial action potential. Then, local electrophysiological mapping is performed. In this way, local action potentials in the epicardium can be imaged with temporal changes.

  As described above, according to the first embodiment of the present invention, both the stable measurement of the potential of the heart surface with respect to the beating heart and the size of the potential measurable region are compatible. In addition, a medical electrode device that realizes minimally invasive epicardial electrocardiographic measurement can be provided.

  Specifically, the medical electrode device 1 according to the first embodiment of the present invention is a compact size that can be inserted into a trocar for minimally invasive port treatment, while performing multipoint measurement of epicardial cardiac potential. Furthermore, since the contact pressure of the electrode array 9 to the heart surface is kept constant by the suction system including the adsorbing portion 12b, the medical electrode device 1 follows the pulsation of the heart, and as a result, the epicardial cardiac potential In this measurement, unevenness does not occur, and stable and good measurement accuracy can be obtained despite the heartbeat. Further, since the Pt electrodes are regularly arranged, the accuracy of measurement of the epicardial electrocardiographic distribution in the measurement target region is high.

  That is, the medical electrode device according to the first embodiment of the present invention is a medical electrode device that realizes a function expected for an intraoperative electrophysiological measurement device in arrhythmic surgery.

[Second Embodiment]
Next, a second embodiment of the present invention will be described.

  FIG. 5 is a side view of a medical electrode device according to a second embodiment of the present invention. FIG. 6 is a view showing a state in which the medical electrode device according to the second embodiment of the present invention is brought into contact with the surface of the heart and is adsorbed on the surface by the suction system. The medical electrode instrument according to the first embodiment is different in that the electrode substrate 51 of the electrode array is formed of an elastic member.

  The electrode substrate 51 may be made of flexible silicon rubber, fluorine rubber, urethane rubber, thermoplastic elastomer, or the like. Electrodes 53 are disposed on the electrode substrate 51, and these electrodes 53 constitute an electrode array 9.

  The electrode array 9 is supported by the support portion 14. The electrode 53 is, for example, a protruding electrode. However, the electrode 53 is not limited to the protruding electrode, and may be an electrode having another shape.

  When a surface virtually including a contact portion of each electrode 53 of the electrode array 9 with the heart surface is a measurement surface, the measurement surface may be formed in a curved surface shape. The wall portion 101 is disposed so as to surround the periphery of the electrode array 9. The suction port 103 is disposed in the peripheral portion of the region surrounded by the wall portion 101. The suction port 103 constitutes a suction part 12 b together with the wall part 101. The electrode array 9, the suction part 12 b, and the support part 14 constitute a measurement part 21.

  When the inside of the suction tube 18 is set to a vacuum state by a suction device (not shown), the suction portion 12b has a suction force according to the air pressure (for example, set to a vacuum state) adjusted by the suction device (not shown). Arise. As shown in FIG. 6, when the measurement unit 21 is brought into contact with the heart surface 111, the measurement unit 21 is brought into close contact with and fixed on the heart surface 111 by the adsorption force of the adsorption unit 12 b.

  The electrode substrate 51 of the electrode array 9 is made of a flexible material. As a result, the electrode array 9 is deformed in accordance with the shape of the heart surface 111 due to the stress when the measurement unit 21 comes into close contact with the heart surface 111. That is, the measurement surface (following measurement surface 121 shown in FIG. 6) that virtually includes a contact portion of each electrode 53 of the electrode array 9 with the heart surface 111 matches the shape of the heart surface 111. Deform. As described above, the measurement surface follows the heart surface, so that the electrode 53 reliably contacts the heart surface 111. Since the follow-up measurement surface 121 is deformed on the electrode array 9 side by contact with the heart surface 111, deformation of the heart itself can be suppressed. Therefore, since the load on the heart itself is reduced, the epicardial electrocardiogram can be measured with little adverse effect on the heart by the medical electrode device 1.

  Hereinafter, a modification of the medical electrode device according to the second embodiment will be described.

  FIG. 7 is a side view of a medical electrode device according to a modification of the second embodiment of the present invention. FIG. 8 is a view showing a state in which the medical electrode device according to the second embodiment of the present invention is brought into contact with the heart surface 111 and is adsorbed on the surface by the suction system. In the medical electrode instrument according to this modification, the height (length) of the electrode 53 changes due to the stress when the measurement unit 21 comes into close contact with the heart surface 111. Specifically, the electrode 53 has the following structure. FIG. 9 is a cross-sectional view of the electrode 53 in this modification.

  That is, the electrode 53 is a protruding electrode as shown in FIG. 7, and when the measuring unit 21 is closely attached and fixed on the heart surface 111 by the adsorption force of the adsorption unit 12b, the electrode 53 is caused by stress from the heart. As shown in FIG. 8, the height of each changes according to the shape of the heart surface.

  As shown in FIG. 9, the electrode 53 includes an electrode base end portion 53a, an electrode tip end portion 53b, an elastic member 53c, and a stopper portion 53d.

  The electrode distal end portion 53b is pressed by the elastic member 53c accommodated in the electrode proximal end portion 53a. Therefore, when the electrode tip 53 b comes into contact with the heart surface 111, each electrode tip 53 b expands and contracts so as to follow the follow-up measurement surface 121. As a result, the measurement unit 21 comes into close contact with the heart surface 111.

  Specifically, the elastic member 53c is, for example, a spring member or gas. The height of the entire electrode 53 changes due to the stress applied to the electrode tip 53b by the elastic member 53c.

  The stopper portion 53d is provided between the electrode base end portion 53a and the electrode tip end portion 53b. As a result, the electrode distal end portion 53b does not fall out of the electrode proximal end portion 53a. The electrode base end portion 53 a is installed on the electrode substrate 51.

  The configuration of the electrode 53 is not limited to the configuration illustrated in FIG. 9, and any configuration may be used as long as the total length (height) of the electrode 53 varies individually due to the stress applied to the electrode tip portion 53 b by the elastic member 53 c.

  As described above, according to the second embodiment, it is possible to provide a medical electrode device having the following effects in addition to the same effects as the medical electrode device according to the first embodiment. it can.

  That is, according to the medical electrode device according to the second embodiment, the same effect as the medical electrode device according to the first embodiment can be obtained, and the follow-up measurement surface 121 matches the shape of the heart surface 111. Therefore, the epicardial electrocardiogram can be measured with higher accuracy and stability.

  Further, according to the above-described modification, since the height of the protruding electrode 53 changes for each electrode, the follow-up measurement surface 121 deforms more closely with the shape of the heart surface 111. For this reason, the certainty of the contact to the heart surface 111 of an electrode increases.

  As mentioned above, although this invention was demonstrated based on 1st Embodiment and 2nd Embodiment of this invention, this invention is not limited to embodiment mentioned above, In the range of the summary of this invention, Of course, various modifications and applications are possible.

  For example, the following modifications can be given as modifications of the medical electrode device according to the first embodiment and the second embodiment.

[Modification]
A movable part for moving the measurement part may be provided between the measurement part 21 and the wiring tube 16 and the suction tube 18. Specifically, a movable part having a mechanical and / or electrical drive mechanism is provided between the measurement part and the wiring tube 16 and the suction tube 18 so that the measurement part can be moved in a desired direction. May be. This movable part may be provided in the holding part 22.

  Further, the above-described embodiments include inventions at various stages, and various inventions can be extracted by appropriately combining a plurality of disclosed constituent elements. For example, even if some constituent requirements are deleted from all the constituent requirements shown in the embodiment, the problem described in the column of the problem to be solved by the invention can be solved and described in the column of the effect of the invention. When an effect is obtained, a configuration from which this configuration requirement is deleted can be extracted as an invention.

  Each numerical value given in the above-described embodiment is merely an example, and it is needless to say that the numerical value is not limited thereto.

    DESCRIPTION OF SYMBOLS 1 ... Medical electrode instrument, 9 ... Electrode array, 12b ... Adsorption part, 12A '... Plane, 12a ... (Electrode) arrangement | positioning area, 14 ... Support part, 16 ... Wiring tube, 18 ... Suction tube, 21 ... Measuring unit 22 ... Holding unit 51 ... Electrode substrate 53 ... Electrode 53a ... Electrode base end part 53b ... Electrode tip part 53c ... Elastic member 53d ... Stopper part 100 ... Trocar 101 ... Wall part 103 ... suction port, 111 ... heart surface, 121 ... follow-up measurement surface.

Claims (24)

A medical electrode device inserted into a subject through a trocar,
A wiring tube that houses cables for independently transmitting electrical signals detected by a plurality of electrodes that detect the potential of an object to an electrical signal analyzer;
A suction tube for connecting one or more suction portions for suction to the object to a suction device;
An electrode substrate on which a plurality of the electrodes are disposed;
It comprises a plurality of the electrodes arranged in a predetermined arrangement area on the electrode substrate, and the arrangement area is longer in the axial direction of the wiring tube and the suction tube than the inner diameter of the trocar An electrode array;
A medical electrode device comprising: A measurement unit is configured together with the electrode array and the adsorption unit, and includes a support unit that supports the electrode array and the adsorption unit
2. The medical electrode device according to claim 1, wherein the measuring section has a length in the axial direction of the wiring tube and the suction tube that is longer than an inner diameter of the trocar.   The medical electrode device according to claim 2, wherein the plurality of electrodes constituting the electrode array are arranged in the vicinity of a surface having a maximum cross-sectional area of the support portion.   The surface on which the plurality of electrodes constituting the electrode array are disposed is opposed to an inner diameter surface of an insertion hole in the trocar when the medical electrode device is inserted into the trocar. The medical electrode apparatus as described in any one of these.   The surface on which the plurality of electrodes constituting the electrode array are disposed is substantially parallel to the axial direction of the wiring tube and the axial direction of the suction tube. Medical electrode device according to one of the above.   The medical electrode device according to claim 1, wherein the plurality of electrodes constituting the electrode array are regularly arranged at predetermined intervals.   The medical electrode device according to claim 6, wherein the plurality of electrodes constituting the electrode array are arranged in a matrix.   The medical electrode device according to claim 1, wherein the plurality of electrodes constituting the electrode array are projecting electrodes. The adsorption part is
At least one suction port;
A wall surrounding the electrode array;
The medical electrode device according to claim 1, comprising:   The medical electrode device according to claim 9, wherein the suction port is disposed so as to surround the electrode array from a plurality of locations.   The medical electrode device according to claim 9, wherein the suction port is disposed at a peripheral edge portion in a region surrounded by the wall portion.   The medical electrode device according to claim 9, wherein the suction port is disposed at an end portion in a region surrounded by the wall portion. The wall comprises at least a pair of walls surrounding the electrode array;
The medical electrode device according to claim 9, wherein the at least one pair of wall portions are curved wall portions having a curved shape having a lowest central portion.   The medical electrode device according to claim 13, wherein the curved wall portion is formed on a longest side among the sides constituting the arrangement region.   The medical electrode device according to claim 1, wherein the suction portion is independently connected to a suction device by the suction tube.   The medical electrode device according to claim 1, wherein a plurality of the suction portions are provided, and each suction portion can individually set a suction force.   The medical electrode device according to claim 1, further comprising a holding unit that holds the measurement unit.   The medical electrode device according to claim 1, wherein a measurement surface formed by contact portions of the plurality of electrodes with the object has a curved surface shape.   The medical electrode device according to claim 18, wherein the measurement surface has a curved shape in which a central position in the longitudinal direction is recessed most deeply.   The medical electrode device according to claim 18, wherein the measurement surface has a shape that matches a curvature of a heart surface.   The medical electrode device according to claim 18, wherein the measurement surface is formed in a curved shape by the shape of the electrode substrate.   The medical electrode device according to claim 18, wherein the measurement surface is a follow-up measurement surface that is deformed into a shape that matches a shape of the surface of the object by contact with the object.   23. The medical electrode device according to claim 22, wherein the follow-up measurement surface is deformed into a shape that matches a shape of the object surface when each of the electrode substrates is deformed.   23. The medical electrode device according to claim 22, wherein the follow-up measurement surface is deformed into a shape that matches the shape of the surface of the object as the height of each of the electrodes changes.

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