JP7185217B2 - An end effector capable of turning gas into plasma and an endoscope equipped with the end effector - Google Patents

Description

The present invention relates to an end effector capable of turning gas into plasma and an endoscope equipped with the end effector.

Conventionally, a low-temperature plasma generator connected to a supply source of gas to be plasmatized is known (see, for example, Non-Patent Document 1). In addition to surface treatment, low-temperature plasma can provide effects such as sterilization, blood coagulation (hemostasis), and wound healing in the medical field. In particular, cold plasma is expected to be applied to hemostasis because it can coagulate blood in a short period of time without damaging tissue.

Mynavi Co., Ltd., “Development of an atmospheric pressure plasma device that can precisely control the temperature from -90 to +150 ° C, such as Tokyo Institute of Technology,” [online], [searched January 31, 2018], Internet <URL: https ://news.mynavi.jp/article/20111026-a080/>

SUMMARY OF THE INVENTION Accordingly, it is an object of the present invention to provide an improved hemostatic end effector capable of plasmatizing gas and an endoscope equipped with the end effector.

In one aspect of the present invention, an end effector of the present invention is an end effector capable of plasmatizing gas, the end effector has a housing structure having an internal space, the end effector includes the end a first hole for passing gas external to the end effector to the interior of the end effector, the first hole being located adjacent a distal end of the end effector; It comprises a first hole and means for plasmatizing said gas.

In one embodiment of the present invention, the means for plasmatizing the gas includes a first electrode and a second electrode different from the first electrode, and the gas is A plasma may be generated by an electrical discharge between the electrode and the second electrode.

In one embodiment of the invention, said first electrode may be a grounded electrode and said second electrode may be a high voltage electrode having a higher voltage than said first electrode.

In one embodiment of the invention, the plasmatized gas may be emitted from the first hole.

In one embodiment of the present invention, a second hole for discharging the plasmatized gas may be further provided, and the second hole may be a hole different from the first hole.

In one embodiment of the invention, the first electrode forms the housing structure of the end effector, and the first hole and the second hole are present on the first electrode. may

In one embodiment of the present invention, the second electrode may have a columnar shape and be arranged in the internal space.

An embodiment of the invention may further comprise means for guiding the gas to a position where it can be plasmatized.

In one embodiment of the invention, the means for directing the gas to a plasmatable location may be a pump.

In one embodiment of the invention, the gas may be a gas present in the body.

In one embodiment of the invention, the gas present in the body may be gas present in the abdominal cavity.

In one embodiment of the invention, the gas may be carbon dioxide.

In one embodiment of the invention, the end effector may not be directly or indirectly connected to the source of plasmatized gas.

In one embodiment of the invention, the first hole is provided on a side surface of the end effector, and the plasmatized gas is directed longitudinally through the end effector through the first hole. The end effector may further include a laser irradiator for pointing an irradiation position of the plasmatized gas.

In one embodiment of the present invention, further comprising a tapered hood covering the distal end of the end effector, the hood having holes in the tip portion of the hood for discharging the plasmatized gas. You may prepare.

In one aspect of the present invention, an endoscope of the present invention is an endoscope comprising an insertion section and an operation section connected to a proximal end of the insertion section, wherein the insertion section an end effector projectable from a distal end of the section, the insertion section being bendable to change the orientation of the tip section, the end effector having a housing structure having an interior space. and the end effector has a first hole for passing gas exiting the end effector into the interior space, the first hole adjacent a distal end of the end effector. and a means for plasmatizing the gas.

In one aspect of the invention, the system for intraperitoneal hemostasis of the subject invention may include an end effector as described above or an endoscope as described above.

In one embodiment of the invention, the system does not include an external gas supply.

According to the present invention, it is possible to provide an improved end effector capable of hemostasis and an endoscope with such an end effector capable of plasmatizing gas.

FIG. 1 shows a schematic diagram of an endoscope 10 with an end effector of the present invention. 2 is an enlarged perspective view of the distal end portion 11' of the insertion section 11. FIG. FIG. 3A is a cross-sectional view showing an example of the configuration of the end effector 100 of the present invention. FIG. 3B is a cross-sectional view showing an example of the configuration of pump 140 of the present invention. FIG. 3C is a cross-sectional view showing another example of the configuration of the end effector 100 of the present invention. FIG. 4A is a cross-sectional view showing an example of the configuration of the end effector 200 of the present invention. FIG. 4B is a cross-sectional view showing another example of the configuration of the end effector 200 of the present invention. FIG. 4C is a cross-sectional view showing another example of the configuration of the end effector 200 of the present invention. FIG. 5A is a cross-sectional view showing an example of the configuration of the end effector 300 of the present invention. FIG. 5B is a cross-sectional view showing another example of the configuration of the end effector 300 of the present invention. FIG. 5C is a cross-sectional view showing another example of the configuration of the end effector 300 of the present invention. FIG. 6A is a cross-sectional view showing an example of the configuration of the end effector 400 of the present invention. FIG. 6B is a cross-sectional view showing another example of the configuration of the end effector 400 of the present invention. FIG. 7 shows an example of the shape of the surface of the distal end of the end effector of the present invention.

As used herein, the term "distal" refers to the portion further from the user (operator) and the term "proximal" refers to the portion closer to the user. As used herein, "about" refers to within ±10% of the number that follows.

BEST MODE FOR CARRYING OUT THE INVENTION Hereinafter, embodiments of the present invention will be described with reference to the drawings. The same reference numerals are used for the same components throughout the specification.

FIG. 1 shows a schematic diagram of an example of an endoscope 10 equipped with the end effector of the present invention.

The endoscope 10 includes an insertion section 11 , an operation section 12 connected to the proximal end of the insertion section 11 , and a supply source 13 connected to the operation section 12 .

Source 13 is for supplying feed. The supply source 13 is interconnected to the operating portion 12, as shown in FIG. There may be one source or multiple sources. The feed supplied from source 13 can be any other than the gas that is plasmatized. For example, it may be illumination light that illuminates the treatment site or the periphery of the examination site, a laser light source for guiding the irradiation position of plasma emitted from the end effector, or cleaning or endoscopic treatment of the treatment site. It may be cooling water for cooling a mirror or the like.

The operation section 12 is for operating the insertion section 11 and devices built into the insertion section 11 . As shown in FIG. 1, the operating section 12 is interconnected with a supply source 13 and configured to be able to control the amount of material supplied from the operating section 12 .

The insertion portion 11 is a portion that is inserted into the body. The insertion section 11 is controlled by the operation section 12 and is configured to be able to bend so as to change the direction of the insertion section 11 according to an input on the operation section 12 . The insertion section 11 includes an end effector 100 protruding from a distal end 11 ′ of the insertion section 11 . The size of the diameter of the insertion portion 11 may be any size. It is preferable to be as small as possible so that it can operate even in a small space (for example, inside the intestines or digestive organs). For example, if the endoscope 10 is a large intestine endoscope, the length is about 13 mm, but the present invention is not limited to this. Also, the diameter of the end effector can be of any size. It is preferable to be as small as possible so that it can operate even in a small space (for example, inside the intestines or digestive organs). For example, when the end effector is provided in the forceps channel of an endoscope for large intestine, it is about 3 mm, but the invention is not limited to this.

2 is an enlarged perspective view of the distal end portion 11' of the insertion section 11. FIG.

The insertion portion 11 includes a forceps channel through which the end effector 100 can optionally protrude from the open end of the forceps channel on the distal end 11 ′ of the insertion portion 11 . is configured to For example, it protrudes when the end effector treats a treatment site, and is housed in the insertion section 11 when the endoscope 10 itself is moved.

The external shape of the end effector 100 may be any cylindrical body. In the embodiment shown in FIG. 2, it is cylindrical, but the invention is not so limited.

Devices built into the insertion section 11 may include, in addition to the end effector 100, an imaging unit (such as a camera lens) and an illumination device (such as a light), for example. The number of devices built into the insertion portion 11 may be one or plural. Furthermore, a nozzle for discharging the supply from the supply 13 may be provided in the insert 11 .

(1) First Embodiment of End Effector FIG. 3A is a cross-sectional view showing an example of the configuration of the end effector 100 of the present invention.

The end effector 100 has a housing structure with an internal space. In the example shown in FIG. 3A, the end effector 100 has an inflow hole 110 for passing gas existing outside the end effector 100, and a gas entering the internal space from the outside of the end effector 100 through the inflow hole 110 to plasma. As a means for doing so, a first electrode 120a and a second electrode 120b, and a discharge hole 130 for discharging plasmatized gas are provided. An inlet hole 110 is located adjacent the distal end of the end effector. Adjacent location here refers to any location on the distal end side of the end effector where the end effector is inserted into the body during use.

A first electrode 120a forms a housing structure for the end effector 100, and a second electrode 120b has a columnar shape that extends to near a discharge hole 130 present on the distal end of the end effector 100. provided at the tip of the conductor. For example, the first electrode 120a is a grounded electrode and the second electrode 120b is a high voltage electrode having a higher voltage than the first electrode 120a. When a voltage is applied between the first electrode 120a and the second electrode 120b by a power source (not shown), discharge occurs between the first electrode 120a and the second electrode 120b. Accordingly, gas entering through inlet 110 travels through the interior space of end effector 100 to around the distal end of end effector 100 and passes between first electrode 120a and second electrode 120b. Plasma is generated around the emission hole 130 by the discharge and emitted from the emission hole 130 . As a result, plasmatized gas is ejected from the discharge hole 130, and blood coagulation and sterilization effects are brought about by irradiating an irradiation target (for example, a bleeding site) with the plasmatized gas. The flow rate of gas in the end effector towards the discharge is greater than 0 to about 15 L/min, 0.01 L/min, or about 0.1 to about 3 L/min, preferably about 1 to about 3 L/min. and most preferably from about 2 to about 3 L/min. The greater the flow rate of the gas in the end effector toward the discharge section, the more effectively the affected area is treated with the plasmatized gas. It should be noted that the inflow hole 110 and the discharge hole 130 have any shape as long as the gas to be plasmatized can pass through. For example, the shape of the inlet hole 110 and the outlet hole 130 may be circular, square, or polygonal. The opening area of the inflow hole 110 is about 0.03 to about 4 mm ² , more preferably about 0.8 mm ² . If the size of the inflow hole 110 is too small, a load may be applied to take gas into the end effector. Although the number of inflow holes 110 is one in the example shown in FIG. 3A, the present invention is not limited to this. The number of inflow holes 110 is an arbitrary number equal to or greater than 1, and when there are a plurality of inflow holes, the opening area of the inflow holes may be the total area of each of the plurality of inflow holes.

Furthermore, the end effector 100 may include means for guiding the gas entering the interior of the housing from the inflow hole 110 to a position where it can be turned into plasma. This means is, for example, a pump 140 capable of generating an airflow around the discharge hole 130 where the electrical discharge occurs. The pump 140 is configured to guide the gas entering from the inflow hole 110 toward the discharge hole 130 when installed in the internal space of the end effector 100 as shown in FIG. 3A. The pump 140 generates an airflow from the outside of the end effector 100 to the inside through the inflow hole 110 , and the pump 140 guides the gas entering through the inflow hole 110 to around the discharge hole 130 . In this way, the end effector 100 having the pump 140 makes it possible to efficiently and continuously guide the gas to be plasmatized into the interior of the end effector 100, and eventually to generate the plasma of the gas to be plasmatized. efficient conversion. It should be noted that pump 140 can be any type of pump that an end effector can be equipped with. Examples of the pump 140 include a piezoelectric pump, a piston pump, and an impeller pump that can be made compact and lightweight, but the present invention is not limited to these. The flow rate of the pump 140 built into the end effector 100 is, for example, greater than 0 to about 1.0 L/min. The higher the gas flow rate through the pump 140, the more effectively the affected area is treated with the plasmatized gas. A plurality of pumps 140 may be provided according to the required flow rate.

FIG. 3B is a cross-sectional view showing an example of the configuration of pump 140 of the present invention. In the example shown in FIG. 3B, the pump 140 includes a pump chamber 141, an air supply port 142, an exhaust port 143, a diaphragm 144 vibrated by a piezoelectric element (not shown), an air supply valve 145, and an exhaust valve. 146. The air supply port 142 is provided on the inflow hole 110 side for taking in external gas into the end effector. The exhaust port 143 is provided on the side where the gas is turned into plasma. The pump chamber 141 is connected to an air supply port 142 and also connected to an exhaust port 143 . A diaphragm 144 is arranged in the pump chamber 141 . The air supply valve 145 is a check valve, which allows the pump 140 to supply gas from the air supply port 142 to the pump chamber 141 , but the gas does not flow from the pump chamber 141 to the air supply port 142 . It is configured so that it cannot be exhausted. The exhaust valve 146 is also a check valve, which allows the pump 140 to exhaust gas from the pump chamber 142 to the exhaust port 143, but does not supply the gas from the exhaust port 143 to the pump chamber 141. configured so that it cannot. The driving of the piezoelectric element causes the diaphragm 144 to vibrate, thereby causing the pump chamber 141 to alternate between a negative pressure state and a positive pressure state. When the pump chamber 141 is in a negative pressure state, the air supply valve 145 is opened and the gas from the air supply port 141 is sucked into the pump chamber 141 . Since the exhaust valve 146 is closed at this time, the gas in the pump chamber is not exhausted to the exhaust port 143 . When the pump chamber 141 is in a positive pressure state, the exhaust valve 146 is opened and gas existing in the pump chamber 141 is exhausted to the exhaust port 143 . At this time, since the air supply valve 145 is closed, the gas existing in the pump chamber 141 is not exhausted to the air supply port 142 .

3A and 3B, the pump 140 is installed in the internal space of the end effector 100, but the place where the pump 140 is installed is outside the end effector 100 (for example, the end effector 100 around the inlet hole 110 on the outer surface of the .

In addition, the end effector 100 may contain a liquid or a A foreign matter shielding means for preventing foreign matter from entering the discharge portion may be provided. Examples of foreign matter shielding means include a water stop filter made of PTFE or the like that allows gas to pass through but does not allow liquid to pass therethrough, and a foreign matter removing filter having a porous or mesh structure that removes foreign matter contained in liquid or gas. Not limited. By providing the end effector 100 with such a foreign matter shielding means, it is possible to reduce the possibility of causing problems due to foreign matter entering the discharge section. In addition, in the present invention, the foreign matter shielding means is not limited to a pump having a filter mechanism. The foreign matter shielding means may be any means as long as it prevents liquid or foreign matter from entering the discharge section.

FIG. 3C is a cross-sectional view showing another example of the configuration of the end effector 100 of the present invention.

The end effector 100′ shown in FIG. 3C further includes second means for guiding the gas entering the interior of the housing from the inflow hole 110 to a position where plasma can be generated, and a partition plate 150 instead of the pump 140. obtain. The partition plate 150 is configured to be impervious to gas, so that the gas entering from the inflow hole 110 can be efficiently supplied to the pump 140'.

Pump 140' can be any type of pump. Examples of pump 140' include, but are not limited to, rotary pumps, piston pumps, and impeller pumps. The flow rate of pump 140' is, for example, greater than 0 to about 15 L/min, 0.01 L/min, or about 0.1 to about 3 L/min, preferably about 1 to about 3 L/min, and most Preferably, about 2 to about 3 L/min. The higher the flow rate of gas through pump 140', the more effectively the plasmatized gas treats the affected area. A plurality of pumps 140' may be provided according to the required flow rate.

In addition, the second means, for example, transfers the plasmatized gas from an environment outside the end effector 100 (for example, inside the human body) to another environment outside the endoscope 10 (for example, outside the human body). A pump 140 ′ through which airflow can be generated around the discharge hole 130 of the end effector 100 . In the example shown in FIG. 3C, the end effector 100 pumps gas that is plasmatized into the pump 140' from the gap between the end effector 100 and the distal end 11' of the insertion section 11 or the interior space of the end effector 100. and a second pass 142 to allow the gas to be plasmatized around the discharge hole 130 from the pump 140'. In the example shown in FIG. 3C , a path 141 ′ for supplying gas entering from the gap between the end effector 100 and the distal end portion 11 ′ of the insertion section 11 to the pump 140 ′, and the inside of the end effector 100 A path 141 ″ for supplying gas from the space to the pump 140 ′ joins to form a first path 141 . In addition, in the example shown in FIG. 3C, the second path 142 passes through the second electrode 120b and extends to the discharge section, but the present invention is not limited to this. The second path 142 can extend anywhere so long as it is capable of supplying gas to be plasmatized around the discharge holes 130 from the pump 140'. For example, the second path 142 may be configured to penetrate to the distal end side surface of the partition plate 150 of the surfaces other than the distal end surface of the second electrode 120b. good.

Pump 140 ′ is disposed outside end effector 100 as shown in FIG. The pump 140 ′ generates an airflow from around the inflow hole 110 to around the discharge hole 130 through the first path 141 and the second path 142 , and the pump 140 ′ pushes the gas around the inflow hole 110 to around the discharge hole 130 . Induce. The path formed by the first path 141, the pump 140', and the second path 142 includes auxiliary means (for example, a device capable of analyzing gas components, a support gas that promotes plasma generation, etc.). supply source, a gas supply source specialized for a particular treatment) may be provided, a connection with such ancillary means may be provided, and another environment outside the endoscope 10 may be provided. There are no openings or connections to external gas sources for gas below (e.g., outside the human body) so that external gas does not intervene in the first and second paths 141 and 142. good too.

Examples of devices capable of analyzing gas components include gas chromatography, mass spectrometers, electrochemical measurement devices, and odor analyzers, but the present invention is not limited to these. An example of the support gas is argon gas, which has the effect of increasing the plasma temperature, but the present invention is not limited to this. In addition, as gases specialized for specific treatments, for example, xenon gas that enables phototherapy by increasing the emission of visible light, helium that enables treatment with high-energy ions and UV rays that are generated secondarily gas, but the invention is not so limited.

By analyzing the components of the gas, for example, the desired concentration and purity can be detected when reusing the gas in the body as a gas for generating plasma, or when secondary gases are used. It is possible to detect the mixing ratio of secondary gases, check the plasma state, the presence or absence of disease, and the plasma irradiation state. Based on the results, it is possible to adjust the amount of gas supplied from a support gas supply source that promotes plasma generation or from a gas supply source that is specialized for a specific treatment.

By providing the end effector 100 with a pump 140' capable of circulating the gas inside the body, swelling of the abdomen can be suppressed and the flow rate of the gas can be freely adjusted. In the past, the clinician had to be aware of the degree of expansion of the abdomen (intra-abdominal cavity) when performing tissue treatment because the gas was introduced into the body from outside the body. Since the invention circulates and uses the gas inside the body, it reduces the need to be conscious of such expansion of the abdomen (intra-abdominal cavity). The degree of freedom in adjusting the flow rate of the gas greatly affects the effect of treatment of tissue such as an affected area using the plasma gas. is advantageous because it leads to an increase in the effect (eg, hemostatic effect) of the treatment of

Further, like the pump 140, at least one of the pump 140', the first path 141, and the second path 142 is provided with foreign matter shielding means (for example, a filter mechanism) so that, for example, the inflow hole 110 It is possible to remove liquids and foreign substances that have entered together with the gas before they reach the discharge section. Further, by configuring the pump 140' to operate intermittently, the gas passing through the second path 142 is pulsed to provide a steady flow of gas and a pulsed flow of gas to the discharge. It is possible to provide Further, high-density plasma may be generated by matching the peak time of the pulsed gas and the peak time of the applied voltage. As a result, the hemostatic effect can be enhanced, power consumption can be reduced, and useless electrode consumption and temperature rise can be avoided. Any power source capable of supplying power such that the discharge power peaks in time with the peaks of the pulsed gas may be used. For example, a power supply with two independently controllable power generators may be used. One of the two power generators always generates a low voltage and high current, and the other power generator generates a high voltage in accordance with the peak of the pulse gas, thereby adjusting the timing of the peak of the pulse gas. Together, a peak discharge power is achieved. However, the invention is not so limited.

Although the embodiment shown in FIG. 3C describes an example in which the end effector 100' includes only the pump 140', the present invention is not limited to this. End effector 100 ′ may include both pump 140 ′ and pump 140 instead of partition plate 150 . Also, in the embodiment shown in FIG. 3C, the example in which the paths 141 ′ and 141 ″ join together to form the first path 141 has been described, but the present invention is not limited to this. The first path 141 may be a path with only path 141' or a path with only path 141''. Also, the gap between the end effector 100 and the distal end portion 11' of the insertion portion 11 may be a naturally open space, or may have a shape that will be described later with reference to FIG. This gap may be created by having

Also, although not shown, gas and/or liquid entering from the inflow hole 110 is leaked to the outside through a hole through which the end effector 100 or the end effector 100' passes at the proximal end of the insertion portion 11. A sealing mechanism may be provided to prevent This can prevent the gas and/or liquid entering from the inflow hole 110 from flowing into the operation section 12 . The sealing mechanism can be any mechanism. Examples include rubber packing, O-rings, mechanical seals, etc., but the present invention is not limited to these.

In the present invention, the generation of plasma gas may be continuous discharge in which discharge is always performed, or pulse discharge in which discharge is performed intermittently. In the case of pulse discharge, when the discharge is ON, plasma gas is generated and treatment such as hemostasis of the affected area is performed, and when the discharge is OFF, plasma is not generated, but the discharged gas causes blood to be disturbed. can be removed. By doing so, it becomes possible to perform treatment such as hemostasis more efficiently while improving the visibility of the camera of the endoscope.

An example of the environment external to the end effector 100 and the environment external to the end effector 100' is within the human body, and more specifically within the human peritoneal cavity (e.g., within the stomach, within the intestines), but not limited thereto. not. The external environment of the end effector 100 can be, for example, the body of any animal (eg, pig, mouse). That is, the plasmatized gas is gas existing in the body, more specifically gas existing in the abdominal cavity, but is not limited thereto. The plasmatized gas can be, for example, gas present in any animal (eg, pig, mouse). Since the end effector 100 of the present invention uses the gas existing in the body as the gas to be plasmatized, it is possible to simplify the device and reduce the cost without the need for another gas supply source.

In embodiments in which end effector 100 and end effector 100' are used intraperitoneally, the gas that is plasmatized may preferably be carbon dioxide. This is because carbon dioxide has high bioabsorbability and is easily absorbed into the blood unlike oxygen and the like, so it is possible to reduce the risk of forming a thrombus or the like. In addition, the applicant noted that carbon dioxide is nonflammable, and when carbon dioxide is used for plasma generation, gas ignition accidents do not occur during surgery. It has been found to be suitable for lower hemostasis. Also, the temperature of the plasmatized gas is preferably low (ie, about 50° C. to about 150° C.). This is because cold plasma does not cause thermal damage to the tissue being treated and therefore can reduce post-operative patient burden. It should be noted that the higher the temperature of the gas, the more effective the hemostatic effect, but the longer the recovery period. Therefore, the temperature of the gas should preferably be set in consideration of the degree of hemostasis and the recovery period.

Note that the end effector 100 and the end effector 100' of the present embodiment are not directly or indirectly connected to a supply source of plasmatized gas existing outside the body. As used herein, a gas source that exists outside the body of the subject whose hemostasis is to be achieved is referred to as an "external gas source." In preferred embodiments, the end effector of the present invention does not have an external gas supply and is not connected to an external gas supply.

In the past, pressurized gas was typically delivered to the end effector and the gas turned into plasma. However, the present invention is clearly different from such prior art, and in the end effector 100 of the present embodiment, the plasmatized gas can be provided to the internal space of the end effector 100 only through the inflow hole 110 . In this way, the end effector 100 of the present embodiment plasmatizes gas existing in the body (for example, intestinal carbon dioxide) without using a plasmatized gas supply source, thereby stopping bleeding in the abdominal cavity. can be achieved. With such a configuration, there is no need to provide a separate gas supply source, and the overall configuration of the endoscope can be simplified and the cost can be reduced. In addition, since the gas that exists inside the body is used, it is possible to prevent foreign matter from entering the body when using gas from outside the body. It is also possible to suppress the risk of generating

The end effector of the present invention reduces the amount of gas supplied from an external gas supply source and circulates and uses the gas present in the human body, thereby suppressing swelling of the abdomen and increasing the flow rate of the gas. can be earned, suppressing fluctuations in the pneumoperitoneum pressure in the body, thereby reducing the burden on the patient. In addition, since a tube for introducing extracorporeal gas can be dispensed with, the diameter of the endoscope can be further reduced, which alleviates the patient's burden and pain. In addition, the use of extracorporeal gas can be reduced, thus reducing or eliminating the amount of gas that must be expelled from the body after the procedure, thereby simplifying or eliminating the need to dispose of the exhaled gas. It is possible. Furthermore, it is also possible to reduce the risk of secondary infection due to mists contained in gases outside the body.

(2) Second Embodiment of End Effector FIG. 4A is a cross-sectional view showing an example of the configuration of the end effector 200 of the present invention.

The end effector 200 has a housing structure with a small internal space. In the example shown in FIG. 4A, the end effector 200 has an inflow hole 110' for passing gas existing outside the end effector 200, and a gas entering the internal space from the outside of the end effector 200 through the inflow hole 110'. A first electrode 120a and a second electrode 120b are provided as means for generating plasma. In the example shown in FIG. 4A, the first electrode 120a forms the housing structure of the end effector 100 and the second electrode 120b has an annular shape to create a small interior space for the end effector 200. . For example, the first electrode 120a is a grounded electrode and the second electrode 120b is a high voltage electrode having a higher voltage than the first electrode 120a. In this embodiment, a voltage is applied between the first electrode 120a and the second electrode 120b by a power source (not shown) so as to generate a pulse discharge between the first electrode 120a and the second electrode 120b. do. Because of the pulse discharge that repeats ON/OFF of the discharge, the gas in the body is taken into the inflow hole 110' when the discharge is OFF, and the gas existing inside the inflow hole 110' becomes hot when the discharge is ON. , is turned into plasma and ejected from the inflow hole 110'. This is because the gas around the inflow hole 110' expands once electric discharge occurs, and when the temperature drops, the gas around the inflow hole 110' enters the inflow hole 110'. Since the gas is turned into plasma and ejected from the inflow hole 110 ′, this embodiment utilizes the properties of the gas. It is possible to eject gas more vigorously. Note that in the present embodiment, the flow rate of the gas plasmatized by the discharge between the first electrode 120a and the second electrode 120b is more than 0 to about 0.5 L/min. However, the invention is not so limited.

It should be noted that the end effector 200 of this embodiment is also not directly or indirectly connected to an external gas supply source, like the end effector 100 of the first embodiment. That is, in the end effector 200 of the present embodiment, the plasmatized gas is provided to the small internal space of the end effector 200 only through the inflow hole 110'. Thus, in the end effector 200 of the present embodiment, treatment such as hemostasis can be safely performed by using, for example, intestinal carbon dioxide without using an extracorporeal supply source of gas to be plasmatized. At the same time, it is possible to achieve simplification of the configuration of the entire endoscope.

FIG. 4B is a cross-sectional view showing another example of the configuration of the end effector 200 of the present invention.

The end effector 200′ shown in FIG. 4B further includes a space for retaining the gas to be plasmatized, and the space for retaining the gas to be plasmatized is the outside of the end effector 200′ and the inlet hole. 110'. By providing such a space in the end effector 200', the gas for generating the plasma gas can be stored in this space, so that plasmatized gas can be continuously generated.

FIG. 4C is a cross-sectional view showing another example of the configuration of the end effector 200 of the present invention.

The end effector 200'' shown in FIG. 4C has a first electrode 120a and a second electrode 120b layered configuration around the inlet hole 110'. With such a configuration, it is possible to generate and eject plasmatized gas even when there is no stream of gas to be plasmatized. It is also possible to achieve a more intense burst of plasmatized gas with a very small stream of plasmatized gas.

(3) Other configuration 1 of the end effector
FIG. 5A is a cross-sectional view showing an example of the configuration of the end effector 300 of the present invention.

When low-temperature plasma is generated, the area around the discharge hole 130 may become hot, so the end effector needs to be configured so that the affected area will not be burned by the high-temperature portion.

An end effector 300 shown in FIG. 5A is provided with a covering member 150 so as to cover the surface of the end effector 100 of the first embodiment. The covering member 150 may be made of any material as long as it has low thermal conductivity (has heat insulating properties) to the extent that the high temperature in the vicinity of the discharge hole can be reduced to a temperature that does not cause burns to the affected area. obtain. In one embodiment, the material of the covering member 150 is polytetrafluoroethylene or fluororesin, but the present invention is not limited to this. For example, when the covering member 150 is made of fluororesin so that the end effector 300 is treated with Teflon (registered trademark), and when the surface shape of the end effector 300 has irregularities (for example, dice-shaped irregularities), Since it is possible to prevent tissue such as an affected part from sticking to the end effector 300, providing such a covering member 150 or making the covering member 150 have an uneven surface shape is significant. By making the surface of the covering member 150 uneven, it is possible to further obtain the above effect. Also, the covering member 150 may be a molded solid member or a coated thin film. By providing the covering member 150, even if the high-temperature portion around the discharge hole 130 comes into contact with the affected area, the heat of the high-temperature portion is not transmitted to the affected area, so that the affected area will not be burned.

FIG. 5B is a cross-sectional view showing another example of the configuration of the end effector 300 of the present invention.

The end effector 300' shown in FIG. 5B is provided with a hood 160 to completely cover the side surfaces around the distal end of the end effector 100 of the first embodiment. The distal and proximal ends of hood 160 are both open ended and configured to allow the proximal end of hood 160 to be attached to the distal end of end effector 300'. The means of attaching the hood to the end effector can be any means. In one embodiment, the inner surface of the hood 160 is provided with a ring-like projection along the inner surface for stopping the sliding movement during attachment, but the present invention is not limited thereto. By providing such a hood 160, the hot area around the discharge hole 130 will not come into contact with the affected area and therefore the affected area will not be burned. Further, by providing the hood 160, it becomes possible to guide the region irradiated with the plasma gas. Furthermore, by making the hood 160 of a translucent material, it becomes possible to visually recognize the irradiation direction of the plasma gas.

FIG. 5C is a cross-sectional view showing another example of the configuration of the end effector 300 of the present invention.

The end effector 300'' shown in FIG. 5C is a tapered version of the hood 160' shown in FIG. 5B, tapering from the proximal end to the distal end of the hood 160'. . Thanks to such a hood 160', the hot area around the discharge hole 130 does not come into contact with the affected area and therefore the affected area does not get burned. Further, since the distal end portion of the hood 160' is tapered, the irradiation range of the discharged plasma gas is narrowed down, and the function of guiding the irradiation position of the gas more accurately is exhibited. Furthermore, by physically pressing the distal end of the hood 160' against the affected area, the plasma gas can be applied only to the affected area that requires irradiation. Although not shown in FIGS. 5B and 5C, the hoods 160 and 160' are provided with holes for discharging the gas filled inside the hoods 160 and 160' to the outside when the distal ends of the hoods 160 and 160' are pressed against the affected area. 160, 160' may be provided.

(4) Another configuration 2 of the end effector
FIG. 6A is a cross-sectional view showing an example of the configuration of the end effector 400 of the present invention.

Conventionally, when the discharge hole 130 is provided on the surface of the distal end of the end effector, as in the end effector 100 and the end effector 200, when the image of the camera provided in the endoscope is viewed, it is plasmatized. However, there is a problem that the gas irradiation position is hidden behind the distal end of the end effector, making it difficult to see.

The end effector 400 of the present invention includes a first electrode 120a and a second electrode 120b as means for plasmatizing gas, an emission hole 130 for emitting plasmatized gas, and an insulator 170. Prepare. As shown in FIG. 6A, the discharge holes 130 are positioned so as to be able to discharge plasmatized gas laterally with respect to the longitudinal direction of the end effector 400 . By ejecting the plasmatized gas to the side of the end effector, the irradiation position of the plasmatized gas can be visually recognized without being hidden behind the end effector 400 .

FIG. 6B is a cross-sectional view showing another example of the configuration of the end effector 400 of the present invention.

The end effector 400' shown in FIG. 6B is an end effector 400 with a laser illuminator. By pointing the irradiation position of the plasmatized gas using the laser irradiated from the laser irradiator, it is possible to more easily recognize the irradiation position of the plasmatized gas.

In addition, as shown in FIG. 6B(a), the laser irradiated from the laser irradiator is irradiated from the laser irradiator provided on the inner surface of the distal end portion of the end effector 400′. It may be emitted from the end effector 400 ′, or as shown in FIG. ' may be ejected from.

6A and 6B, the laser irradiator has been described as the member for indicating the irradiation position of the plasma gas. A rod-shaped member connected to the distal end portion 11′ of the portion 11 and arranged at the plasma gas irradiation position may be used, or a ring provided at the distal end portion of the rod-shaped member may be used. It may be a rod-shaped member with a ring whose center indicates the irradiation position of the plasma gas. By irradiating the plasma gas while applying the distal end of the rod-shaped member or the rod-shaped member with the ring to the affected area, the center of the ring of the distal end of the rod-shaped member and the rod-shaped member with the ring is irradiated with the plasma gas. Acts as a positioning guide. This makes it possible to visually recognize the irradiation position of the plasmatized gas. In addition, by bringing the distal end of the rod-shaped member and the ring of the rod-shaped member with the ring into physical contact with the bleeding site, it is possible to perform hemostasis while the bleeding site is pressed.

FIG. 7 shows an example of the cross-sectional shape of the distal end of the end effector of the present invention. The cross-sectional shape of the distal end of the end effector of the present invention is preferably circular to match the shape of the circular forceps channel in order to prevent contamination by extracorporeal gas or foreign matter. Not limited. The cross-sectional shape of the end effector of the present invention is non-circular as shown in FIG. It may be a partial circle obtained by scraping off a portion, or a partial circle obtained by hollowing out a small circle). Since the end effector has such a non-circular shape, a gap is created between the circular forceps channel and the end effector, and gas that has accumulated in the body can be extracted through the gap.

It should be noted that the end effector of the present invention described with reference to FIGS. A cleaning mode may be implemented. In the cleaning mode, the end effector has, for example, a mechanism that allows high-pressure gas to flow to the discharge section, a mechanism that allows gas near the discharge section to be sucked together with dirt, or a mechanism that cleans the cleaning water coming out of the nozzle. It can be implemented in the end effector by providing a mechanism that can be aspirated with. As a result, it is possible to remove dirt accumulated in the discharge section, and thus to continuously generate stable plasma.

Although the present invention has been illustrated using the preferred embodiment of the invention as described above, the invention should not be construed as being limited to this embodiment. It is understood that the invention is to be construed in scope only by the claims. It is understood that a person skilled in the art can implement an equivalent range from the description of specific preferred embodiments of the present invention based on the description of the present invention and common technical knowledge.

INDUSTRIAL APPLICABILITY The present invention is useful for providing an improved hemostatic end effector capable of converting gas into plasma, an endoscope equipped with the end effector, and the like.

REFERENCE SIGNS LIST 10 endoscope 100 end effector 110 inflow port 120a first electrode 120b second electrode 130 discharge port 140 pump

Claims (15)

Gas can be turned into plasmaand is capable of hemostasisan end effector,
The end effector has a housing structure with an internal space,
The end effector is
provided so as to protrude from the distal end of the insertion section of the endoscope,
in the body gas existing outside the end effectorthrough the holea first hole for passing directly through the interior of the end effector, the first hole being located adjacent a distal end of the end effector;
means for plasmatizing the gas; and
with
The end effector further comprising a second hole for releasing the plasmatized gas, the second hole being a hole different from the first hole. The means for plasmatizing the gas includes a first electrode and a second electrode different from the first electrode,
The end effector of claim 1, wherein the gas is plasmatized by an electrical discharge between the first electrode and the second electrode. 3. The end effector of claim 2, wherein the first electrode is a grounded electrode and the second electrode is a high voltage electrode having a higher voltage than the first electrode. 4. The end effector of claim 3 , wherein the first electrode forms the housing structure of the end effector, the first hole and the second hole overlying the first electrode. . The end effector according to claim 4 , wherein the second electrode has a columnar shape and is arranged in the internal space. gas that enters the housing through the first hole Up to the position where plasma can be generatedinvitationClaim 1- further comprising means for guiding5The end effector according to any one of . 7. The end effector of Claim 6 , wherein the means for directing the gas to a plasmatable location is a pump. The end effector according to any one of claims 1 to 7 , wherein the gas is a gas existing inside the body. 9. The end effector of claim 8 , wherein the gas present in the body is gas present in the abdominal cavity. An end effector according to any preceding claim, wherein the gas is carbon dioxide . the second hole is provided on a side surface of the end effector;
The plasmatized gas is emitted obliquely with respect to the longitudinal direction of the end effector through the second hole,
The end effector according to any one of claims 1 to 10 , further comprising a laser irradiator for indicating an irradiation position of the plasmatized gas. 12. The hood according to any one of claims 1 to 11 , further comprising a tapered hood covering the distal end of the end effector, the hood comprising a hole in a tip portion of the hood for releasing the plasmatized gas. or the end effector according to item 1. An endoscope comprising an insertion section and an operation section connected to a proximal end of the insertion section,
the insertion section includes an end effector protruding from a distal end of the insertion section;
The insertion section is capable of bending so as to change the orientation of the distal end section,
The end effector has a housing structure with an internal space,
The end effector is
a first hole for allowing gas existing outside the end effector to pass directly into the internal space, the first hole being provided adjacent to the distal end of the end effector; , the first hole, and
and means for plasmatizing the gas,
The endoscope further comprising a second hole for releasing the plasmatized gas, wherein the second hole is a hole different from the first hole. A system for intraperitoneal hemostasis in a subject, comprising the end effector of any one of claims 1-12 or the endoscope of claim 13 . exist outside the body Claims that do not include an external gas supply14The system described in .

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