JP6731759B2 - Medical clip and its locator - Google Patents

Description

The present invention relates to a medical clip that marks a lesion in a digestive tract and a position locator that specifies the marking position from outside the digestive organ.

Generally, the position of the lesion is confirmed visually and tactilely from the outside of the digestive organs during surgery to remove a tumor in the digestive organs such as the stomach or the large intestine, or other digestive organs that require excision surgery. If it is difficult to do so, insert an endoscope into the digestive organs in advance before surgery, and attach dyes or clips to the lesion or its vicinity (hereinafter, collectively referred to as lesion area). Marks are marked with, and at the time of surgery, lesions are visually or tactilely confirmed using the marks to determine the resection site.

However, this general method often fails to identify the lesion site during surgery. In such a case, insert the endoscope again to search for the lesion site, and confirm the position of the clip by visually observing the illumination light from the tip of the endoscope from outside the digestive organ or by fluoroscopy. The site of resection was determined by. In determining such a lesion site, the operation time becomes long, and there are problems such as an increased burden on the patient and hygiene.

As a technique for improving the drawbacks of the conventional technique, there is a technique (Patent Document 1) in which a clip attached near the lesion of the digestive organ and a light-emitting body are combined and the lesion is confirmed by observing the clip shining from outside the digestive organ. Since it is visible through the organ wall, it is difficult to confirm the position clearly.

In addition, an endoscope inserted into the digestive organ, a treatment tool outside the digestive organ inserted into the body cavity, and means for detecting the relative position of the endoscope and the treatment tool (for example, a permanent magnet and a magnetic field). There is a technology (Patent Document 2) in which a sensor is provided. This technique involves inserting the endoscope into the digestive organs immediately before the operation, and then performing the operation with the endoscope inserted, by inserting the endoscope again and illuminating light from the endoscope tip. Similar to the visual recognition method, there are problems that the operation time is long, the burden on the patient is significantly increased, and the visual field during the operation is deteriorated.

In addition, the steps of inserting the endoscope into the digestive system to search for lesions, attaching magnets to the searched lesion or its vicinity, and leaving the attached magnet as a marker for the lesion, remove the endoscope from the digestive system. There is a digestive organ lesion site identification system (Patent Document 3) that includes a step of extracting and a step of identifying a magnet attachment site from outside the digestive organ with a magnetic sensor, and using the identified magnet attachment site as a digestive organ lesion site.

When using a magnet and a magnetic sensor as in the above Patent Documents 2 and 3, the magnitude of the magnetic field measured by the magnetic sensor changes depending on the direction of the magnet and the direction of the magnetic sensor, and the position is accurately specified. Was difficult. The conventional method as described above has a problem that the position of the lesion site cannot be specified quickly and accurately.

Registered utility model No. 3027808 Patent No. 3321236 JP-A-2002-159508

In view of the above situation, the present invention can accurately identify a lesion site in digestive organ lesion excision surgery, can be performed rapidly without increasing the burden on the patient, and can improve the reliability of surgery. An object is to provide a medical clip and a position locator thereof.

To achieve the above object, the present invention provides a torus, a coil wound around the torus, a capacitor connected to both ends of the torus, and the torus, which is placed in the digestive organs of the human body. With respect to a medical clip having a clip body formed of an elastic member so as to be pierceable, a position locator for locating the position,
An oscillation circuit that oscillates including a resonance circuit constituted by the search coil, the variable capacitance capacitor, and the search coil,
Oscillation frequency varying means for varying the oscillation frequency of the resonant circuit by adjusting the capacitance of the variable capacitor,
An oscillation intensity measuring means for measuring the oscillation intensity of the oscillation circuit,
The resonance frequency of the resonance circuit formed by the coil and the capacitor included in the medical clip is measured to measure the oscillation intensity when the oscillation frequency of the oscillation circuit of the position locator is tuned, It is characterized by specifying the position. In the present invention, since the medical specifier measures the oscillation intensity in a state of being strongly electromagnetically coupled with the medical clip, it has extremely high sensitivity and can quickly and accurately specify the position of the medical clip. it can.

INDUSTRIAL APPLICABILITY The medical clip and the position specifying device of the present invention can quickly and accurately specify the position of the medical clip, so that the reliability of surgery can be improved without increasing the burden on the patient.

Schematic configuration diagram showing an embodiment of a medical clip of the present invention Schematic external view showing an embodiment of the position locator of the present invention Functional explanatory drawing of the medical clip and position locator which concern on this invention The electromagnetic field resonance explanatory drawing which concerns on this invention

The medical clip and locator of the present invention are described below, but the present invention is not limited to these embodiments. First, the medical clip of the present invention will be described.

The medical clip according to the present invention is inserted into the digestive organ of a living body and attached inside the digestive organ as a mark of a lesion, and one of the important issues is to consider compatibility with the human body. Therefore, the medical clip of the present invention needs to be made of a member having an affinity for the human body. A coil, a capacitor, or the like having a poor affinity with the human body can be improved in affinity with the human body by surface-treating it with silicon or the like having a good affinity with the human body.

FIG. 1 is a schematic configuration diagram showing an embodiment of a medical clip 10 of the present invention. The medical clip 10 includes a clip body 11, an annular body (winding frame) 12, a coil 13, and a capacitor 14.

The clip body 11 is formed of an elastic member so that the circular ring body 12 can penetrate therethrough. The clip body 11 is such that when the annular body 12 is moved along the longitudinal direction of the clip body 11, the clip opening of the clip body 11 is opened and closed. When the annular body 12 is moved to the front of the clip body 11 (on the side of the clip mouth), the clip mouth of the clip body 11 is closed. On the other hand, when the annular body 12 is moved to the rear of the clip body 11 (the side opposite to the clip opening), the clip opening of the clip body 11 opens. It is preferable that the material of the clip body 11 has a high magnetic permeability and a low electrical conductivity.

As described above, the annular body (reel) 12 not only plays a role of opening and closing the nipping opening of the clip body 11 by its movement, but also serves as a reel of the coil 13. The coil 13 is electrically connected in parallel with the capacitor 14. The coil 13 and the capacitor 14 move integrally with the annular body 12. The material of the annular body (reel) 12 is preferably one having a high magnetic permeability and one having a low electric conductivity. The capacitor 14 is preferably an ultra-small capacitor such as a chip capacitor made of laminated ceramic. It is preferable that the torus (winding frame) 12, the coil 13, and the capacitor 14 are integrated and covered with an insulating resin or the like having an affinity for a living body. Further, in order for the medical clip 10 to pass through the forceps hole of the digestive organ endoscope, the dimension of the medical clip 10 on the plane perpendicular to the longitudinal direction when the clip body 11 is closed is 3 mm or less. Those are preferable.

Next, an embodiment of the position locator of the present invention will be described in detail based on the drawings.
FIG. 2 is a schematic external view showing an embodiment of the position specifying device of the present invention. The position identifying device 50 identifies the position from outside the digestive organ when the operation is performed, using the above-mentioned medical clip 10 attached in advance in the vicinity of the lesion in the digestive organ as a mark.

The locator 50 is a cylindrical circular tube 51 that can be inserted into the body from outside the body via a trocar, a search coil 52 wound around the tip of the tube 51, and a variable capacitance diode that forms a resonance circuit with the search coil 52. (Variable capacitance) 53, oscillation circuit 54 that oscillates including its resonance circuit, oscillation frequency changing means 55 that changes the frequency of the oscillation circuit, and oscillation intensity measuring means 56 that measures the oscillation intensity of the oscillation circuit. And

The material of the circular tube 51 is preferably one that has an affinity for living organisms, has low magnetic permeability, and has low electrical conductivity. The search coil 52 is obtained by directly winding a copper wire with an insulating coating around the tip portion of the circular tube 51, or by separately winding it around a winding frame and inserting or attaching it to the tip portion of the circular tube 51. When the search coil 52 wound directly on the circular tube 51 is used, it is preferable to insert a columnar ferrite having a high magnetic permeability and a low electric conductivity into the circular tube 51 in the search coil 52 portion. In the case of the search coil 52 separately wound around the winding frame, the material of the winding frame is preferably one having a high magnetic permeability and a low electrical conductivity such as ferrite. Further, it is preferable that the search coil 52 be covered with an insulating resin or the like having an affinity for a living body.

The housing 57 of the position locator 50 contains a variable capacitance diode 53, an oscillating circuit 54, an oscillating frequency varying means 55, and an oscillating intensity measuring means 56, and an oscillating intensity indicator 58 is provided on the surface thereof. It is attached and connected to the circular pipe 51. The wiring from the search coil 52 is guided to the housing 57 through the inside of the circular pipe 51. In the present embodiment, only the search coil 52 is attached to the circular tube 51, but the variable capacitance diode 53 may be built in the circular tube 51. Further, the oscillation circuit 54, the oscillation frequency varying means 55, and the oscillation intensity measuring means 56 may be built in the circular tube 51. Further, the connection between the circular tube 51 and the housing 57 may be via a flexible cable or the like.

FIG. 3 is a functional explanatory view explaining the functions of the medical clip 10 and the position locator 50 according to the present invention. The variable capacitance diode 53 acts as a capacitor when a voltage is applied in the reverse direction of the diode, and the capacitance of the capacitor can be varied according to the magnitude of the applied voltage, that is, an electronic variable capacitance capacitor. The electronic variable capacitor may be a mechanical variable capacitor. The variable capacitance diode 53 is electrically connected to the search coil 52 provided in the circular tube 51 so as to form a resonance circuit.

The oscillation circuit 54 is electrically connected to a resonance circuit formed by the search coil 52 and the variable capacitance diode 53, and oscillates at a resonance frequency of the resonance circuit, that is, an oscillation frequency determined by the search coil 52 and the variable capacitance diode 53. To do. Specifically, a Hartley oscillator circuit, a Colpitts oscillator circuit, or another oscillator circuit can be used. The oscillation frequency oscillated by the self-excited oscillation circuit 61 can be changed by the applied voltage applied to the variable capacitance diode 53. As will be described later, the search coil 52 and the variable capacitance diode 53 are preferably connected via a coupling capacitor C1 (see FIG. 3).

The oscillation frequency changing means 55 has a function of changing the applied voltage applied to the variable capacitance diode 53, that is, a changing function of changing the oscillation frequency of the oscillation circuit 54, and the medical clip 10 has the oscillation frequency of the oscillation circuit 54. It has a tuning function of matching the resonance frequency of the resonance circuit formed by the coil 13 and the capacitor 14, that is, tuning.

The variable mechanism and the tuning function of the oscillation frequency changing means 55 may be manually performed or may be automatically controlled using an electronic automatic control circuit. In this case, specifically, the oscillation frequency varying means 55 is a DC variable power source, and it is preferable to connect the oscillation frequency varying means 55 to the variable capacitance diode 53 via the high resistance resistor element R as shown in FIG. Further, it is preferable that the search coil 52 be connected to the variable capacitance diode 53 via the coupling capacitor C1 so that the direct current component does not flow in the search coil 52. The capacitance of the coupling capacitor C1 is preferably sufficiently larger than the capacitance of the variable capacitance diode 53. Even when a mechanical variable capacitor is used instead of the variable diode 53, the above-mentioned variable function and tuning function can be easily realized by manual or automatic control.

The oscillation intensity measuring means 56 has a measurement function of measuring the oscillation intensity of the oscillation circuit 54 and a display function of outputting a display signal representing the measured oscillation intensity to the oscillation intensity display 58 to display the oscillation intensity. The measuring function of the oscillation intensity measuring means 56 may directly measure the intensity of the oscillation circuit 54 as an alternating current via a coupling capacitor C2 as shown in FIG. You may measure it. In this case, it is preferable that the capacitance of the coupling capacitor C2 be sufficiently smaller than the capacitance of the variable capacitance diode 53.

The display function of the oscillation intensity measuring means 56 is to visually or audibly display the oscillation intensity measured by the above-mentioned measurement function on the oscillation intensity display 58. The oscillation intensity indicator 58 is specifically a 7-segment LED indicator, and the display function of the oscillation intensity measuring means 56 visually displays the oscillation intensity as a numerical value. The oscillation intensity indicator 58 may be a blinking LED lamp, another visual indicator, or an audible indicator by a warning sound such as a buzzer. Further, the oscillation intensity measuring means 56 may include means for communicating with an external device.

The variable function and tuning function of the oscillation frequency changing means 55 and the measuring function and display function of the oscillation intensity measuring means 56 described above are configured by individual ICs such as an analog-digital converter, ROM, RAM, MPU, and digital-analog converter. Alternatively, it may be configured by a one-chip microcomputer in which these functions are integrated.

Next, the electromagnetic coupling action of the position locator 50 and the medical clip 10 will be described. When the locator 50 is brought close to the medical clip 10, the electric field coupling action via the floating capacitor formed by the locator 50 and the medical clip 10, the search coil 52 of the oscillation circuit 54 provided in the locator 50. The magnetic field generated from the electromagnetic induction action that causes an electromotive force in the coil 13 provided in the medical clip 10, and the resonance circuit provided in the position locator 50 and the resonance circuit provided in the medical clip 10 are electromagnetic fields. Electromagnetic field resonance action occurs in which mutual energy is exchanged. The medical clip and the position locator of the present invention positively utilize the electromagnetic field resonance method having a large electromagnetic coupling action.

The electromagnetic field resonance method can be roughly classified into an electric field resonance method that resonates via an electric field like an electric field coupling method and a magnetic field resonance method that resonates via a magnetic field like an electromagnetic induction method. In this embodiment, the magnetic field resonance method is used, but as another embodiment, the electric field resonance method may be used.

FIG. 4 is an electromagnetic field resonance explanatory view for explaining the electromagnetic field resonance action. This is an oscillation when the oscillation frequency of the oscillating circuit 54 is swept by the oscillation frequency varying means 55 of the locator 50 by using the distance between the locator 50 and the medical clip 10 as a parameter (M1, M2, M3). It is a graph of intensity. The distance between the position locator 50 and the medical clip 10 is M1>M2>M3, and fo is the resonance frequency of the resonance circuit included in the medical clip 10.

From the graph of FIG. 4, the electromagnetic energy generated by the oscillation circuit of the position locator 50 is resonantly absorbed at the resonance frequency of the resonance circuit of the medical clip 10, resulting in a sharp dip in the oscillation intensity of the oscillation circuit of the position locator 50. You can see that it is happening. Therefore, if the oscillation frequency of the oscillation circuit 54 of the position locator 50 is matched with the frequency of the resonance circuit of the medical clip 10, that is, tuned, and the oscillation intensity is measured by the oscillation intensity measuring means 56, the medical clip is obtained. Since it is possible to quickly and accurately identify the position of the patient, it is possible to improve the reliability of the operation without increasing the burden on the patient.

10 Medical Clip 11 Clip Body 12 Torus (Reel)
13 Coil 14 Capacitor 50 Positioning Device 51 Circular Tube 52 Search Coil 53 Variable Capacitance Diode 57 Housing 58 Oscillation Strength Indicator

Claims (1)

A toric body, a coil wound around the toric body, a capacitor connected to both ends of the toric body, and a clip body formed of an elastic member that allows the circular body to penetrate, which is placed in the digestive organs of the human body. A position locator for locating the position of a medical clip comprising:
An oscillation circuit that oscillates including a resonance circuit configured by a search coil and a variable capacitor,
Oscillation frequency varying means for varying the oscillation frequency of the resonant circuit by adjusting the capacitance of the variable capacitor,
An oscillation intensity measuring means for measuring the oscillation intensity of the oscillation circuit,
The resonance frequency of the resonance circuit formed by the coil and the capacitor included in the medical clip is measured to measure the oscillation intensity when the oscillation frequency of the oscillation circuit of the position locator is tuned, Position locator characterized by locating a position

Images