JPH024293B2 - - Google Patents

Description

[Detailed Description of the Invention] [Industrial Application Field] The present invention relates to an ablation treatment device that is used endoscopically to cauterize and stop bleeding in a body cavity, and specifically relates to a watertight structure at the tip of an ablation probe. Regarding.

[Conventional technology]

2. Description of the Related Art In recent years, endoscopes have been widely used that allow diagnosis or treatment within a body cavity by inserting an elongated insertion portion into the body cavity without requiring an incision from the body surface. This endoscope is generally equipped with a hollow channel through which various treatment instruments other than the observation means are inserted. Various therapeutic treatments can now be performed under visual observation. Therefore, a device (Japanese Unexamined Patent Application Publication No. 1983-1981) that uses a cautery probe that can be inserted through the channel of an endoscope and energizes a heating coil installed at the tip of the cautery probe to coagulate the bleeding area that has been pressed against it. -69556) has been proposed.

This prior art device applies a small amount of epoxy between the spring mount 102 and the braided fixation 62 to form a seal 70 to prevent fluid from entering the cylindrical cavity 80. In addition, the shell 40 and the main body 42
The watertight structure between them is not mentioned at all and is not considered.

[Problem that the invention seeks to solve]

In the conventional technology, the space between the shell 40 and the main body 42 is not made liquid-tight, and liquid enters into the cylindrical cavity 80. Furthermore, the space between the spring mounting part 102 and the braided fixing part 62 is made liquid-tight with epoxy.
Epoxy seals tend to have pinholes, or even if pinholes do occur, they cannot be seen with the naked eye, making it difficult to ensure liquid tightness. and,
If water enters the cylindrical cavity 80, shoots will occur within the tip of the probe and the probe will lose its heating function, so the operator must remove the probe from the scope and replace it with a new probe. There were problems in that it was troublesome to have to insert the tube, and it also caused a lot of pain to the patient. The present invention was made in view of these problems, and an object of the present invention is to provide an ablation treatment device in which failures such as shoots do not occur within the tip of the probe.

[Means for solving problems and their effects]

FIG. 1 is a diagram illustrating the present invention.

The distal end portion 80 of the ablation probe in this invention has a cylindrical body 82 having a through hole 81 in the axial direction.
A bottomed cylindrical cap member 83 having thermal conductivity is provided to cover the outer peripheral surface of the main body 82. A heating element 85 is thermally connected to the inner bottom 84 of the cap member 83. An O-ring 86 is interposed between the cap member 83 and the main body 82, and comes into contact with a stepped portion 87 provided near the inner bottom 84 of the cap member 83, thereby pushing the O-ring 86 in the axial direction. An annular member 88 is provided which compresses the heating element 85 to make it liquid-tight.

〔Example〕

Embodiments of the present invention will be described below with reference to the drawings.

FIGS. 2 to 6 show an embodiment of the present invention, and the ablation treatment device 1 has an operation panel 2 on the front.
A power supply box 3 equipped with a
an ablation probe 6 which is detachably connected to the electrical connector 4 and a water supply connector 5; a foot switch 9 which is detachably attached to the power supply box 3 via a connector 8 provided on the cable 7; and a side surface of the power supply box 3. The washing water tank 10 is detachably attached to the washing water tank 10.

The ablation probe 6 includes an elongated and flexible sheath 11, a distal end 12 connected to the distal end of the sheath 11, and the electrical connector 4 and water supply connector 5 provided on the base side of the sheath 11. , the sheath 11 and its distal end 12 can be inserted into a treatment instrument insertion channel of an endoscope (not shown),
The tip of the ablation probe is introduced into the body cavity through this channel. Inside the sheath 11 is a coaxial cable 1 as a power supply wire.
A coaxial cable 13 is inserted through the axial center of the sheath 11 to supply power to a heating element 14 disposed inside the distal end portion 12, and a plurality of coaxial cables 13 formed on the outer periphery of the ablation probe 12 are connected to the outer periphery of the coaxial cable 13 in the sheath 11 in the axial direction. A water supply channel 16 for forcefully feeding cleaning water to the nozzles 15 is formed. Then, the electric connector 4 and the water supply connector 5 on the base side of the ablation probe 6 are connected to the power supply box 3, and the foot switch 9 also connects the connector 8 of the cable 7 to the power supply box 3, and the main power supply of the power supply box 3 is connected. At the same time as turning on the switch 3a, the heating amount and washing water amount setting button 2a provided on the operation panel 2,
2b is selected and set, by pressing the wash water supply side switch 9a of the foot switch 9, the water pump installed in the power supply box 3 is operated to supply the wash water in the wash water tank 10 into the sheath 11. The nozzle 15 on the outer periphery of the tip portion 12 via the water supply channel 16
The sheath 11 is flushed from ... towards the affected area in the body cavity to wash away blood, etc. from the affected area, or by pressing the heating switch 9b side of the foot switch 9.
Power is supplied to the heating element 14 inside the tip 12 through the coaxial cable 13 inside, so that it can be heated to a predetermined temperature.

In addition, the power supply box 3 has a configuration in which an electric system for the cauterization power source and a water supply system for supplying cleaning water are installed in the same box. Safety is ensured by isolating the electrical system and water supply system by separating them with an isolation chassis, and it can be completed by separating and assembling each section separately and then assembling both. This also makes the manufacturing process easier.

The details of the tip 12 of the ablation probe 6 are constructed as shown in FIGS. 3 and 4. That is, a main body 18 having a through hole 17 extending in the central axis direction is connected and fixed to the tip of an elongated flexible sheath 11, for example, a Teflon sheath, and the main body 18
A hemispherical surface (arc surface) is formed on the outer periphery of the heat transfer surface 19a, the tip of which is pressed against the wound and cauterizes and solidifies the wound.
A cap 19, which is a bottomed cylindrical cap member with good heat transfer, is mounted and fixed thereon.

The through hole 17 consists of first to third hole portions 17a, 17b, and 17c from its tip side,
A step portion 17d is provided at the connection portion between the first and second hole portions 17a and 17b. The coaxial cable 13 is composed of a core wire 13a, an insulating sheath 13b that covers the entire core wire, a net-shaped shield wire 13c provided on the outer periphery of the core wire, and an insulating sheath 13d that covers the entire seed wire. Insulating coatings 13b and 13d are partially removed, and hole 17a is removed.
In this case, the core wire 13a is exposed and forms a part of the conductor exposed portion 70. The shield wire 13c is exposed in the hole 17c. The exposed shield 13c is twisted to form a joint portion 13e.

The main body 18 has a circumferential projection 18a at its tip.
A plurality of pins 18b are bored in the side periphery of the pins 18b, avoiding the nozzle 15, and the base end thereof is formed to have a small diameter and has a plurality of steps on the outer periphery. Connection part 18 that connects to the end of sheath 11
c is provided. On the outer periphery of the connecting portion 18c,
A groove is provided continuously with the nozzle 15, and communicates the nozzle 15 with the water supply channel 16. Further, a hole 18d is bored in the connecting portion 18c, and the tip of the connecting portion 13e of the shield wire is positioned in this hole 18d,
For example, by soldering with heat-resistant solder, resin-cored solder, etc., the main body 18 and the shield wire 13c can be connected to each other.
is becoming conductive. The coaxial cable 13 is adhesively fixed at the end of the connecting portion 18c with an adhesive 66. Note that not only the hole 18d but also the third hole 17c may be filled with solder.

The heating element 1 is attached to the inner wall (inner bottom) 71 of the cap 19 facing the hemispherical heat transfer surface 19a with solder 20.
For example, Zener diodes as 4 are soldered together. Furthermore, a groove is formed on the side circumference of the cap 19 at a position corresponding to the nozzle 15 when the cap 19 is placed over the main body 18, and a hole is formed at a position corresponding to the pin 18b. By fitting the pin 18b into this hole, the cap 19 is removably fixed to the main body 18, and the main body 18 and the cap 19 are electrically connected.

The core wire 13a of the coaxial cable and the heating element 14 are electrically connected by an electrically conductive member such as the power transmission coil 21 (a part of the conductor exposed portion 70). A glass tube serving as an insulating tube 22 is provided on the outer periphery of this power transmission coil 21 . An O-ring as a watertight member 60 is provided at the rear end of the insulating tube 22 and interposed between the outer periphery of the insulating sheath 13b (forming the insulating sheath) of the coaxial cable 13 and the first hole 17a. ing. A coil spring serving as the biasing member 23 is provided interposed between the watertight member 60 and the stepped portion 17d. Further, an annular member 61 is provided on the inner circumferential portion of the cap 19 so as to abut against a stepped portion 19b provided on the tip side of the inner circumference of the cap 19. On the other hand, the outer periphery of the circumferential projection 18a of the main body 18 and the cap 1
An O-ring as a watertight member 62 is interposed between the inner circumference of the ring 9 and the annular member 61 to prevent the watertight member 62 from coming off the circumferential projection 18a. The heating element 14 includes a shield wire 13c, a main body 18, a cap 19, and a solder 2.
A driving voltage is supplied through the core wire 13 and the conductor exposed portion 70 to a common voltage (ground level) connected through the conductor.

The heating element 14 is biased toward the solder 20 by a biasing member 23 via an insulating tube 22 and a watertight member 60. This is because when the heat generating element 14 is heated, the temperature reaches about 250°C, so the solder bonding the heat generating element 14 begins to melt, and the heat generating element 1
This is to prevent 4 from becoming unstable.
In addition, since the heating element 14 is biased toward the solder 20 side by the biasing member 23 to stabilize it, the connection between the coaxial cable 13 and the heating element 14 is made by the power transmission coil 21 as described above. I'm going.

The cap 19, which has a hemispherical heat transfer surface 19a at its tip, is coated with a non-adhesive coating 24, such as Teflon coating (Silverstone coating), on its outer periphery to prevent the cap 19 from sticking to tissue. this is,
The cap 19 and the tip 12 are equipped with an internal heating element 14.
It is heated by the heat generated by the wound to cauterize and coagulate the bleeding part of the wound to stop the bleeding, and because it comes into direct contact with the tissue, it prevents sticking to the tissue and the resulting rebleeding. Moreover, the non-adhesive coating 24 on the outer peripheral surface of the tip portion 12 is applied to the main body 1.
Since the cap 19 is formed separately from the heat generating element 14 and the main body 1, after applying the non-adhesive coating 24 to the cap 19, the cap 19 is attached to the heating element 14 and the main body 1.
It is to be assembled on the 8th side. Therefore, there is no risk of destroying or deteriorating the heating element 14, such as a Zener diode. However, in the past, the structure was such that a non-adhesive coating was applied after the hemispherical tip and the main body were joined, so the baking temperature of the non-adhesive coating was over 400°C, which destroyed the internal diode. Or, as it deteriorated, problems arose.

A plurality of nozzles 15 on the outer periphery of the tip portion 12...
are formed on the straight portions of the main body 18 and the cap 19. This nozzle 15... is formed in a groove shape in the direction of the outer circumferential axis, and the rear end side is provided with the sheath 11.
While it communicates linearly with a water supply channel 16 formed inside, its output side rises in a gentle arc shape from the straight part, and the output angle θ is formed at 15 degrees to 16 degrees. In addition, the probe tip 1 at the nozzle exit end
The distance between the two tips is set to be greater than the radius of curvature of the hemispherical heat transfer surface 19a. By forming the nozzles 15 in this way, the nozzles 1
The cleaning water emitted from the tip 12 is caused to flow in a straight line along the outer peripheral axis direction of the tip 12, so that the water can be sent straight forward to the front of the tip 12, thereby directing the water to the area to be cleaned. Sniping is easy, and it is also possible to prevent the supplied cleaning water from going around the hemispherical heat transfer surface 19a.

The electrical connector 4 and water supply connector 5 on the base side of the ablation probe 6 are constructed as shown in FIGS. 5 and 6. That is, a water supply tube connection member 25 is connected to the rear end of the sheath 11, an electrical connector 4 is connected to the rear end of this connection member 25, and a water supply tube 26 is connected to the side of the connection member 25. The electrical system and the water channel system are separated at this location, and the coaxial cable 13 and water water channel 16 are inserted into the sheath 11, respectively. The main body 27 of the connecting member 25 has a through hole 28 in the central axis direction, through which the coaxial cable 13 extending from the sheath 11 is inserted, and extends toward the rear electrical connector 4.
Further, this main body 27 has a connecting cap 29 having a tapered outer periphery protruding forward, and the rear end of the sheath 11 is fitted into this cap 29. A male thread is formed on the rear outer periphery of the base 29 of the main body 27, and a tapered presser ring 30a is formed on the inner periphery of the male thread.
A retaining ring 30 having
It is pressed and fixed by 0a. Also, retaining ring 30
An annular fitting groove 30 formed between a tapered presser ring 30a provided on the inner circumference of the stopper ring 30 and an inner circumferential surface of the stopper ring 30.
The rear end of a bending tube 31, which is externally mounted on the base side of the sheath 11, is fitted and fixed into the inside of the tube. A recess 32 connected to the through hole 28 is formed on the rear end side of the connection body 27, and a female thread is formed on the inner periphery of the recess 32, and an electrical connector 4 having a male thread at the tip is screwed and connected. . Further, this connecting portion main body 27 is provided with a two-stage recessed portion 33 on the side thereof which communicates with the through hole 28 . A female thread is formed on the inner periphery of the inner small-diameter recess 33a of this recess 33, and is screwed into a male thread formed on the outer periphery of the end of a joint 34 connected to the end of the water supply tube 26. A flange 34 protruding from the outer periphery of this joint 34
A watertight member 3 is placed between the bottom surface of the outer large-diameter recess 33b and
An O-ring (No. 5) is installed to ensure watertightness. In this way, the water supply tube 26 is connected to the joint 3.
4 to the through hole 28 of the connecting portion main body 27, and the space between the outer periphery of the coaxial cable 13 inserted into the through hole 28 and the inner periphery of the through hole 28 is defined as a water supply channel 16a, and this connecting portion main body It communicates with the water supply channel 16 of the sheath 11 which is fitted and connected to the sheath 27 .
Further, a female thread is formed on the inner periphery of the inner periphery of the recess 32 of the connecting portion main body 27, and a coaxial cable through hole 36a is formed.
A presser screw 36 is screwed together, and an O-ring as a watertight member 65 is interposed between the tip of the presser screw 36 and the axial through hole 28 or the outer circumference of the coaxial cable 13 to seal the watertight member 65. The electrical system and the water channel system are separated by pressing with a retaining screw 36 to ensure watertight contact with the rear electrical connector 4 side on the water supply channel 16a side.

The water supply tube 26 and joint 34 are
It is connected and fixed with a tapered screw 37. or,
A coil 26a is inserted into the water supply tube 26 over almost its entire length, and a connector 5 is provided on the rear end side. The connector 5 consists of a plug 38 and a cap screw 39 screwed into the plug 38. The end of the water supply tube 26 is fixed to the connector 5 by the opening 38a provided at the end of the plug 38 and the tapered inner circumference of the cap screw 39.

On the other hand, a coaxial cable 13 is extended inside the electrical connector 4 connected to the rear end of the connection body 27, and this cable 13 is connected to a contact via a variable resistor 41 in addition to a fixed resistor 40. ing. The variable resistor 41 is inserted in this way so that a constant current flows regardless of variations in the Zener voltage of the Zener diode as the heating element 14, or variations in the resistance value of the cable 13, etc. This is because the variable resistor 41 facilitates the adjustment and improves work efficiency. Note that the cable 13 is sufficiently slackened within the recess 32.

This invention is not limited to the above-mentioned embodiments,
Various changes are possible. That is, the watertight member 62 is
It is sufficient that it is provided interposed between the main body 18 excluding the nozzle 15 and the inner bottom part 71 and the cap 19. In addition, the watertight member 60 includes the main body 18 of the coaxial cable 13 excluding the exposed conductor portion 70 and the coaxial cable 1
It is sufficient that the insulating coating parts (13b to 13d) of No. 3 are interposed therebetween. In any case, at least the common potential of the heating element 14 and the exposed conductor 70 (shield wire 13c, main body 18, cap 19,
It is only necessary to ensure that the portion to which the driving voltage is applied (solder 20, etc.) can be made watertight. However, it goes without saying that there is no problem even if the parts to which the common potential is applied are made watertight. In addition, the power supply wire does not need to be the coaxial cable 13; two wires are prepared for the common voltage and the drive voltage, and two through holes 17 are provided in the main body 18.
Each of these may be prepared and made watertight as in the above-mentioned embodiments. In addition, the main body 18, cap 1
9. Do not use the solder 20 for common potential.
Another electric wire is inserted into the main body 18, and the heating element 14
A common potential may be supplied to both.

〔Effect of the invention〕

As described above, according to the present invention, the heating element and the exposed conductor portion within the tip of the probe can be reliably made liquid-tight, so that failures such as shoots do not occur.

[Brief explanation of drawings]

FIG. 1 is a diagram illustrating the present invention. 2 to 6 show an embodiment of the present invention, FIG. 2 is a perspective view showing the overall structure of the device, and FIG.
The figure is a sectional view showing the distal end side of the ablation probe, Figure 4 is a cross-sectional view taken from Figure 3, Figure 5 is a partially cutaway front view showing the electrical and water supply connectors at the base of the ablation probe, and Figure 6 is the electrical connector. FIG. 1...Ablation treatment device, 6...Ablation probe, 1
2,80...Tip, 13...Coaxial cable, 1
4,85...Heating element, 17...Through hole, 18,
82...Main body, 19...Cap, 60, 62...
...Watertight member, 70...Conductor exposed portion, 71, 84...
...Inner bottom, 83... Cap member, 86... O-ring, 87... Step portion, 88... Annular member.

Claims (1)

[Claims] 1. In an ablation treatment device that generates heat by supplying power to a heating element provided in the tip of an ablation probe having an elongated sheath that can be inserted into a channel for a treatment instrument of an endoscope, etc., and cauterizes and stops bleeding at a bleeding site with this heat, The distal end of the ablation probe includes a cylindrical body having a through hole in the axial direction, a bottomed cylindrical cap member that is externally covered with the body and has thermal conductivity.
A heating element heat-conductively connected to the inner bottom of the cap member, an O-ring provided between the cap member and the main body, and a step portion provided near the inner bottom of the cap member are in contact with each other. An ablation treatment device comprising an annular member that compresses the O-ring in the axial direction.