JP2012143276A - Microwave surgical instrument - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a surgical instrument which has a shape similar to that of a generally used surgical scalpel, can unfailingly seal a vascular system of a biological tissue when the tissue is incised or separated, causes no or little bleeding, and hardly causes damage of proximal tissues.SOLUTION: The microwave surgical instrument includes: a coaxial microwave transmitting section having a central conductor, an insulator and an external conductor; and a blade shaped flat on the front end of thereof. The blade includes a surgical blade having a wide central conductor directly connected to the central conductor, an insulator for covering the surgical blade except for its cutting edge, and an external conductor for covering the insulator. The cutting edge protrudes from the external conductor and the insulator, has a curved edge line, and is positioned on the center of ends of the external conductors on both the sides, and a distance between the edge line and the end of the external conductor is ≤2 mm. This surgical instrument is excellent in operability and incision function, and causes no or little bleeding.

Description

  The present invention relates to a microwave surgical instrument including a medical surgical blade.

  A surgical scalpel is formally called a scalpel or lancet, which is a knife-like device that cuts and detaches skin and organs with a blade without regard to hemostasis. As the energy device, only a high-frequency electric knife is put into practical use. This high frequency electric knife can cut the tissue while hemostasis due to the tissue destruction caused by the high voltage short circuit. However, due to the extremely high voltage, the surrounding tissue is also destroyed while the hemostatic ability is not sufficient. In addition, lymphatic vessel sealing is insufficient.

There was no energy device other than ultrasound that can be cut without bleeding from the tissue instead of high frequency, but we have developed a device with higher sealing ability and higher hemostasis capability than microwave and microwave.
Patent Document 1 describes a surgical instrument having a structure in which a knife blade that does not use energy that is originally used in surgery is placed close to a microwave energy device. In addition, the present inventors have applied for a patent for a device that is constituted by a blade, an insulator, and an external conductor that are directly connected to a central conductor of a coaxial cable for microwave transmission, with the blade tip exposed from the external conductor (Patent Document 2). .

Japanese Patent Laid-Open No. 60-24835 JP 2008-54925 A

  It has a shape similar to a commonly used surgical scalpel, and when incising or cutting the tissue, it securely seals the vascular system of the living tissue so that it does not bleed or only a small amount of bleeding. Provide a surgical device that is not easily damaged.

  As a result of intensive research to solve the above problems, the present inventors have adjusted the exposed width of the distal end portion of the surgical blade protruding from the outer conductor and the insulator, so that the living tissue can be microscopically treated during the incision operation. The present invention was completed by finding that the blade line of the surgical blade can be brought into contact with the living tissue immediately after applying the wave and sealing the vascular system.

That is, this invention consists of the following.
1. A medical surgical instrument including a coaxial microwave transmission portion including a central conductor, an insulator, and an outer conductor and a blade portion formed flat at the tip thereof, and the blade portion is directly connected to the center conductor. A surgical blade composed of a wide central conductor, an insulator that covers the surgical blade except for the blade tip, and an outer conductor that covers the insulator, the blade tip projecting from the external conductor and the insulator, A microwave surgical instrument in which the line is a curved line and is located in the center of the end portions of the outer conductors on both sides thereof, and the distance between the blade line and the outer conductor end portion is 2 mm or less.
2. 2. The microwave surgical instrument according to 1 above, wherein the distance between the blade line and the outer conductor end is 0.5 mm or more and 1.5 mm or less.
3. 3. The microwave surgical instrument according to 1 or 2 above, wherein the blade line of the surgical blade has a length for obtaining an accurate incision.
4). 4. The microwave surgical instrument according to 3 above, wherein the length of the blade line is 5 mm or greater and 45 mm or less.
5. 5. The microwave surgical instrument according to any one of the preceding items 1 to 4, wherein the coaxial microwave transmission section is a soft coaxial cable.

The surgical instrument of the present invention is a surgical instrument that excels in operability and incision function and does not bleed or hardly bleed. The surgical instrument of the present invention is a microwave surgical instrument that is close to the shape of a scalpel used in conventional surgery and can be used for both conventional cutting and pen-holding. It became possible to obtain a precise incision by making it possible to make it straight and long. At that time, the microwaves emitted around the blade line are applied to the biological tissue immediately before the biological tissue is incised, and the peripheral tissue vessel can be coagulated immediately before or simultaneously with the blade line coming into contact with the biological tissue. Has the effect of becoming a novice.
Furthermore, the surgical instrument of the present invention is a highly safe surgical instrument that can perform an incision operation with low power and does not damage adjacent tissue.

It is a figure which shows the one aspect | mode of a microwave surgical instrument. It is a figure which shows the microwave irradiation simulation of this invention surgical instrument whose distance of an edge line and an external conductor is 2 mm. A part of the blade cannot be covered by the microwave irradiation part even in the air and in the condition of sea water imitating the living tissue. It is a figure which shows the microwave irradiation simulation of this invention surgical instrument whose distance of an edge line and an external conductor is 1 mm. The blade is covered with the microwave irradiation part in the air and in the condition of seawater imitating the living tissue. A mesenteric movement in a dog, a female cutting the vein, and a photo after cutting several seconds later show that the vessel has been disconnected without bleeding.

  The microwave surgical instrument of the present invention is a microwave surgical instrument having a shape similar to that of a surgical scalpel that has been conventionally used in surgery, and relates to a surgical instrument that does not bleed or requires only a small amount even when bleeding.

  The microwave surgical instrument according to the present invention includes a coaxial microwave transmission portion including a central conductor, an insulator, and an outer conductor, and a blade portion that is formed flat at the tip thereof. In the present invention, a microwave of 900 to 6000 MHz can be used equally. Preferably, it is 2450 ± 50 MHz.

A blade portion is provided at the tip of the microwave transmission portion. The blade has a flat shape, a surgical blade made of a wide central conductor directly connected to the central conductor of the microwave transmission unit, an insulator that covers the surgical blade except for the tip of the blade, and the insulator An outer conductor is provided. The blade line of the surgical blade is a curve, and both end portions of the outer conductor are positioned at approximately equal distances on both sides, and the distance between the blade line and the outer conductor end portion is 2 mm or less. The distal end portion of the surgical blade protrudes from the outer conductor and the insulator.
The blade portion has a function of cutting a living tissue, a function of applying a microwave immediately before cutting, and a function of coagulating a living tissue immediately before or simultaneously with cutting.

  The surgical blade is a center conductor that is wider than the center conductor of the coaxial structure and is formed into a blade, and the tip (blade edge) protrudes from the insulator and the external conductor. At this time, if the distance between the blade line and the outer conductor end (exposed blade) is 2 mm or less, the blade line enters the microwave irradiation region with the power used for normal treatment, and before the blade contacts the living tissue. Microwaves are applied to the living tissue, and the living tissue can be coagulated immediately before or simultaneously with the incision, so that bleeding can be minimized.

  The blade line is a curved line and is located at the center of the end of the outer conductor on both sides. That is, the edge line is a curved line, and the ends of the outer conductors on both sides thereof are also preferably curved, and the distance from the edge line to the outer conductor ends on both sides is substantially equidistant. In this structure, it is a feature of the present invention that the distance between the blade line and the outer conductor end is 2 mm or less.

As shown in the microwave simulation of the surgical instrument of the present invention, when the distance between the blade line and the external conductor exceeds 2 mm, the range in which the microwaves fly from the blade tip to the external conductor covers the blade line. When it is applied to the tissue, coagulation does not occur in the vicinity of the blade line having an incision function, and the function of the microwave that can coagulate with a small electric power is impaired. On the other hand, if the distance between the blade line and the outer conductor is 2 mm or less, the microwave can cover and hide the blade line (FIG. 3), and the periphery of the blade line that hits the tissue is coagulated and hemostatic by the microwave. Bleeding is suppressed.
In the simulation, the surgical instrument having the structure shown on the left in FIG. 3 was used to irradiate microwaves in the sea and in seawater simulating the living tissue, and analyzed by a high-frequency simulator. (Equipment used: HFSS (high-frequency three-dimensional electromagnetic field simulator), coaxial cable: outer diameter 8 mm, microwave frequency: 2.45 GHz, output: 1 W)

  This proximity structure between the blade line and the outer conductor allows the length of the vertically long blade to be formed, and allows the shape of a conventional knife blade to be formed instead of as a needle. And it was made possible to spread the wound by moving the incision object part horizontally. In addition, a hemostatic effect can be expected by pinpointing the tip at a bleeding point, and it can cope with hemostasis associated with incision.

The surgical instrument of the present invention has a structure in which the tip portions of the center conductor and the outer conductor are flattened to form a blade portion, and the center conductor is exposed as a tip portion (blade edge) of 2 mm or less along the tip edge. That is, the blade line portion having an incision function, the exposed blade portion that strongly emits microwaves, and the portion to which the microwaves are directed are close to each other (2 mm or less), and the tissue is hemostatically coagulated simultaneously with the incision.
In addition, it is impossible to spread the incision straight by moving the blade with a needle-shaped coagulation core such as the needle tip. To widen the incision, the blade line of the surgical blade must have a certain length. However, the present invention has been able to provide a surgical blade that can expand the incision with less bleeding by setting the distance between the blade line and the outer conductor to 2 mm or less. With this structure of the present invention, a knife having a blade length exceeding 15 mm could be developed.

  The surgical instrument of the present invention has an incision function because the tip of the blade protrudes from the insulator and the external conductor. The distance between the blade line and the outer conductor of the microwave surgical instrument of the present invention is preferably 0.5 mm or more and 2 mm or less. The distance between the blade line and the outer conductor is more preferably 0.5 to 1.7 mm, still more preferably 0.5 to 1.5 mm, and still more preferably 0.8 to 1.2 mm.

  The blade line is a curved line in the same manner as a normal female blade line. The incision of the living tissue is facilitated by the curve. The length of the blade line is not particularly limited as long as it is possible to spread the wound by moving the incision target site horizontally, and is preferably a length for obtaining an accurate incision, but preferably 5 to 45 mm. is there. More preferably, it is 20-30 mm.

  The material of the blade may be a general conductor. For example, it is made of copper alloy such as gold or silver plated copper, gold or silver plated brass, or phosphor bronze.

  The blade portion is flat and extends long in front of the microwave transmission portion, and has a width approximately equal to the diameter of the microwave transmission portion. A preferred blade length is 5 to 45 mm. More preferably, it is 20-30 mm. The preferred width is 3 to 15 mm, more preferably 5 to 12 mm.

  The surgical instrument of the present invention includes a coaxial microwave transmission section including a central conductor, an insulator, and an outer conductor. The cross section of the coaxial microwave transmission section is substantially circular. In direct surgery, such as a laparotomy, the microwave transmission section is preferably covered with a holder made of an insulator so that the practitioner can hold it. The microwave transmission part inserted in the holder is about 10 to 20 cm, preferably about 12 to 16 cm. The coaxial microwave transmission section is preferably a coaxial cable, and the coaxial cable is connected to a microwave generator and supplied with microwaves. The surgical instrument of the present invention can be inserted into an endoscope and / or a catheter because the microwave transmission section is a soft coaxial cable.

  The coaxial cable used in the present invention includes a conductor center electrode made of phosphor bronze, an insulating shield tube made of Teflon (registered trademark) covering the center electrode, and an outer conductor (conductor) made of brass, for example. The earth pipe. The outside of the coaxial cable may be covered with a shield holder (also referred to as a guide tube). The shield holder is preferably made of a non-conductive member [for example, a non-magnetic coil such as Teflon (registered trademark) or phosphor bronze].

  The microwave surgical instrument of the present invention enables incision with little power and almost no bleeding, and is excellent in safety. The power used in the present invention is 5W to 80W, preferably 20W to 60W. More preferably, it is 40W-50W. If it is higher than 80 W, the surrounding tissue may be damaged. If it is less than 5 W, the function as a surgical blade and the hemostatic effect are not sufficient.

  As described above, the microwave surgical instrument of the present invention can be moved horizontally to spread the incision with little or no bleeding. Furthermore, incision is possible with a small electric power. Therefore, in the surgical treatment field in the medical field, the surgical instrument is extremely excellent in safety and operability.

1 Central conductor (surgical blade)
2 Insulator 3 Outer conductor

Claims (5)

  A medical surgical instrument including a coaxial microwave transmission portion including a central conductor, an insulator, and an outer conductor and a blade portion formed flat at the tip thereof, and the blade portion is directly connected to the center conductor. A surgical blade composed of a wide central conductor, an insulator that covers the surgical blade except for the blade tip, and an outer conductor that covers the insulator, the blade tip projecting from the external conductor and the insulator, A microwave surgical instrument in which the line is a curved line and is located in the center of the end portions of the outer conductors on both sides thereof, and the distance between the blade line and the outer conductor end portion is 2 mm or less.   The microwave surgical instrument according to claim 1, wherein the distance between the blade line and the outer conductor end is 0.5 mm or more and 1.5 mm or less.   The microwave surgical instrument according to claim 1 or 2, wherein the blade line of the surgical blade has a length for obtaining an accurate incision.   The microwave surgical instrument according to claim 3, wherein the length of the blade line is 5 mm or more and 45 mm or less.   The microwave surgical instrument according to any one of claims 1 to 4, wherein the coaxial microwave transmission section is a soft coaxial cable.