JPH05285150A - Water jet operating device - Google Patents

Abstract

PURPOSE:To provide the water jet operating device which can prevent the collision of a sucked waste liquid against a jet stream, can prevent the influence, of the negative pressure at the time of suction on the jet stream and enables the sure and rapid operation of a desired section by the jet stream. CONSTITUTION:This device has a water jet catheter 2 which is provided with a flow passage 5 for passing high-pressure fluid and an injection nozzle 6 at its front end and a catheter 3 for sucking the waste liquid which is juxtaposed as a separate body with this water jet catheter, has a suction port 7 at its front end and is positioned with this suction port 7 in the same position as the position of this injection nozzle 6 or in front thereof.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a water jet surgical apparatus for injecting a high-pressure fluid from an injection nozzle to perform incision, excision, cleaning, etc.

[0002]

2. Description of the Related Art A water jet surgical apparatus for performing operations such as incision and excision of living tissue by jetting pressure of high-pressure fluid is known, for example, from Japanese Patent Laid-Open No. 1-313047. This consists of a suction pipe protruding from the handpiece body and a water jet injection pipe concentrically provided inside the suction pipe. The injection nozzle at the tip of this injection pipe is It is provided slightly inside the suction port.

When high-pressure fluid is sent from the water jet jet pipe, the high-pressure fluid is jetted from the jet nozzle at the tip of the jet pipe toward the surgical site. on the other hand,
The fluid jetted to the surgical site and the fluid around it are sucked from the suction port of the suction pipe and discharged.

[0004]

However, in the water jet surgical apparatus configured as described above, the jet nozzle at the tip of the jet pipe is provided slightly inside the suction port at the tip of the suction pipe. Therefore, the jet flow emitted from the jet nozzle collides with the drainage sucked into the suction port. Therefore, there is a problem that the injection pressure drops and the cutting force of the jet flow decreases. Further, due to the negative pressure generated in the suction pipe at the time of sucking the drainage, a force is applied to the jet flow emitted from the jet nozzle in the direction of expanding the jet flow, which also causes a problem that the cutting force of the jet flow is reduced.

The present invention has been made in view of the above circumstances, and an object of the present invention is not to drop the injection pressure even if the drainage is sucked while the high-pressure fluid is injected from the injection nozzle. It is an object of the present invention to provide a water jet operation device that can operate a target site reliably and quickly by a jet flow.

[0006]

In order to achieve the above object, the present invention provides a water jet catheter having a flow passage through which a high-pressure fluid is passed and having a jet nozzle at its tip, and a separate body from this water jet catheter. And a suction port is provided at the tip end portion, and a drainage suction catheter having the suction port at the same position as or in front of the injection nozzle is provided.

[0007]

When the high-pressure fluid is sent from the water jet catheter, the high-pressure fluid is jetted from the jet nozzle to the surgical site of the living tissue, while the fluid jetted to the surgical site and its surrounding fluid are separate from the water jet catheter. It is possible to prevent the sucked drainage liquid from being sucked and discharged from the suction port of the drainage suction catheter, and to prevent negative pressure during suction from affecting the jet jet flow. Prevents jet pressure drop.

[0008]

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

1 to 4 show a first embodiment. Reference numeral 1 denotes the entire water jet surgical apparatus, which is composed of a water jet catheter 2 and a drainage suction catheter 3. Water jet catheter 2
And the drainage suction catheter 3 are separate bodies, and are connected in parallel by a plurality of catheter bands 4 as shown in FIG.

The water jet catheter 2 is shown in FIG.
Is a pipe or tube provided with a flow path 5 for passing a high-pressure fluid, as indicated by a dotted line. In order to increase the flow velocity, the tip of the flow path 5 is formed to have a smaller diameter than the root side, and forms the injection nozzle 6.

The drainage suction catheter 3 is a hollow pipe or tube, and a suction port 7 is provided at the tip of the hollow pipe or tube. A tissue piece generated by an incision is formed in the suction port 7 in the drainage suction catheter 2. A mesh-shaped filter 8 is detachably attached so as not to be clogged. That is, the filter 8 can be removed and used.

Further, the water jet catheter 2
As shown in FIG. 2, the drainage suction catheter 3 has the tip of the drainage suction catheter 3, that is, the suction port 7 is at the tip of the water jet catheter 2, that is, at the same position (a) or front (b) as the jet nozzle 6. Therefore, even if the water jet surgical apparatus 1 is upright with respect to the affected area, the drainage can be surely sucked.

The catheters 2 and 3 are detachably connected to the high withstand pressure tube 11 and the drainage tube 12 by using detachable connectors 9 and 10. Further, the high pressure tube 11 and the drainage tube 12 are connected to the control device 13 shown in FIG.

That is, the high pressure resistant tube 11 is connected to the pressurizing pump 1 via the first pressure gauge 14 provided in the controller 13.
It is connected to 5. Also, the drainage suction tube 12 is the second
Is connected to the suction pump 17 via the pressure gauge 16.

The controller 18 provided in the controller 13 sets the outputs of the pressurizing pump 15 and the suction pump 17, displays the outputs of the first and second pressure gauges 14 and 16, and operates the limit switch 19. This is an integrated control circuit that sets a value and performs an operation of stopping the pressurizing pump 15 when the pressure in the flow path 5 to the water jet catheter 2 rises abnormally.

Next, the operation of the water jet surgical operation apparatus 1 configured as described above will be described. The water jet operation apparatus 1 is used for an abdominal surgery and a transabdominal operation in which an abdominal incision is introduced into the abdominal cavity. Figure 4
The procedure for transabdominal surgery is shown in Fig. 5, but it is also used for open surgery.

For the affected tissue 20 such as liver and adhesion tissue,
The water jet surgical device 1, the endoscope 22 and the grasping forceps 23 are guided through the mantle tube 21 inserted into the abdominal cavity transabdominally for treatment. A portion of the affected tissue 20 to be incised is spread by using the grasping forceps 23, and the water jet surgical apparatus 1 is opposed to the portion.

The portion incised by the jet jet 24 jetted from the jet nozzle 6 of the water jet catheter 2 becomes an incision wound 25. The foam generated on the surface of the incision 25 and the drainage collected in the incision 25 are sucked out of the abdominal cavity through the filter 8 from the suction port 7 by the suction catheter 2. This operation is performed while observing with the endoscope 22.

As described above, in the water jet surgical operation apparatus 1 according to the first embodiment, the water jet catheter 2 and the drainage suction catheter 3 are separately provided side by side,
Moreover, since the suction port 7 is located at the same position as or in front of the injection nozzle 6, the flow path of the jet jet flow 24 and the flow path of the drainage liquid are completely separated from each other, and the jet jet flow 24 and the discharged drainage liquid collide and are discharged. Diffusion of the jet jet 24 due to negative pressure during liquid suction does not occur. Therefore, the drainage can be sucked without reducing the incision force of the jet jet flow 24.

FIGS. 5A and 5B show the second embodiment.
In this embodiment, the water jet catheter 2 and the drainage suction catheter 3 are provided at the distal end thereof with a catheter band 27 in which a splash prevention cap 26 is integrated.
The splash prevention cap 26 is formed of a transparent resin and does not obstruct the field of view in the vicinity of the incision wound 25 during surgery.
Further, it is possible to prevent the jet jet 24 hitting the surface of the incision wound 25 from scattering and adhering to the observation window of the endoscope 22 in particular, so that it is possible to save the labor of cleaning the observation window during the operation.

FIG. 6 shows a third embodiment. In this embodiment, a first electromagnetic valve 29 is provided between the suction pump 17 of the control device 13 and a liquid jet bag 28 for containing jet water and containing physiological saline, Ringer's solution, and the like.
The second solenoid valve 31 is provided between the drainage tank 30 and the drainage tank 30, and the controller 18 controls the opening and closing of the first and second solenoid valves 29 and 31.

Normally, when sucking and removing the drainage, the first electromagnetic valve 29 is closed and the second electromagnetic valve 31 is opened. When the drainage suction flow path is clogged, the first solenoid valve 2
9 is opened, the second solenoid valve 31 is closed, and the suction pump 17
Operate in the opposite direction to when drainage was removed. At this time, since the liquid in the jet jet liquid bag 28 can be made to flow into the drainage suction flow path, the meat pieces or the like causing the clogging can be swept away and eliminated.

7 and 8 show a fourth embodiment. In this embodiment, as shown in FIG. 7A, a bent pipe 32 bent in an L-shape is projected from the tip of the water jet catheter 2, and the injection nozzle 3 is provided at the tip of the bent pipe 32.
3 is provided. In FIG. 2B, a tip member 35 having a flow path 34 bent in an L shape is provided at the tip of the water jet catheter 2, and an injection nozzle 36 is provided at the tip of the flow path 34. In the case of (b), a mark 37 such as a protrusion is provided on the tip member 35 so that the direction of the injection nozzle 36 can be seen.

Then, as shown in FIG.
If it is used so as to jet jet toward the suction port 7 of the suction catheter 3 by 3, it is possible to suction and remove a larger amount of drainage, and it is also effective when making an incision in a narrow space.

FIG. 9 shows a fifth embodiment. In this embodiment, as shown in (a), the water jet catheter 2 and the drainage suction catheter 3 are passed through the outer tube 38,
The water jet catheter 2 and the drainage suction catheter 3 are the same as those in the first embodiment. Mantle 38 and both catheters 2, 3
May be fixed or removable.

(B) is a structure in which the water jet catheter 2 and the suction catheter outer tube 39 are passed through the outer tube 38 and integrated in parallel with each other. The drainage suction catheter is inserted into the suction catheter outer tube 38. 3 is detachably threaded. The catheter outer tube 39 and the outer tube 38 are fixed, but the water jet catheter 2 and the outer tube 38 may be fixed or detachable.

According to this embodiment, the catheter band 4
Can be integrated more easily than the first embodiment using. Also,
In the use state shown in FIG. 4, the water jet surgical operation apparatus 1 is easy to operate because there is no protrusion that is caught when the water jet surgical operation apparatus 1 is passed through the outer tube 21.

FIG. 10 shows a sixth embodiment. As shown in (a), the endoscope outer tube 4 is inserted into the outer tube 40 through which the water jet catheter 2 and the drainage suction catheter 3 are inserted.
1 is fixed, and an endoscope 43 having a small diameter for observing an affected tissue 42 shown in (b) is inserted into the endoscope outer tube 41. According to this embodiment, the endoscope 43
Since the incision 44 can be viewed from the front, the incision surface condition such as the incision depth can be known more accurately.

FIG. 11 shows a seventh embodiment. (A) is
A high-frequency electrode 47 for inserting a water jet catheter 2 and a drainage suction catheter 3 and a high-frequency electrode outer tube 46 fixed to an outer tube 45 inserted therein is inserted into a high-frequency electrode 47 for hemostasis and incision. Further, (b) shows that the water jet catheter 2 and the high frequency electrode 47 are fixed or detachable inside the high frequency electrode outer tube 46.
The high frequency electrode outer tube 46 may be used as a drainage suction catheter. According to this embodiment, there is an effect that hemostasis and the like on the incision surface can be performed from the front. Although not shown, the outer tube or the drainage suction catheter itself may have a high-frequency electrode function.

FIG. 12 shows an eighth embodiment. (A) is
A splash prevention cap 48 surrounding the jet nozzle 6 is detachably attached to the tip of the water jet catheter 2. The splash prevention cap 48 is made of transparent resin so as not to obstruct the field of view. In (b), the tip end portion 48a of the splash prevention cap 48 is narrowed in a tapered shape, which is more preferable from the viewpoint of securing the field of view.

FIG. 13 shows a ninth embodiment. The water jet catheter 2 is detachably inserted into an outer tube 50 to which a drainage suction catheter 3 is fixed. A fitting portion 50b having a diameter larger than that of the insertion portion 50a is provided at the proximal end portion of the outer tube 50, and the proximal end portion 51 of the water jet catheter 2 is fitted into the opening portion 50b.

An annular groove 52 is provided on the outer peripheral surface of the base end portion 51 of the water jet catheter 2, and the annular groove 5
A seal ring 53, which keeps the space between the outer tube 50 and the water jet catheter 2 airtight and seals the insufflation gas so as not to leak, is fitted to the unit 2. Further, a taper hole 54 is provided on the outer peripheral surface of the base end portion 51 of the water jet catheter 2, and a fixing screw 55 screwed from the outer peripheral wall of the fitting portion 50b of the outer tube 50 is engaged with the taper hole 54. The water jet catheter 2 is fixed so as not to come off from the outer tube 50 during use.

The distal end portion of the drainage suction catheter 3 is formed so that its end face is rounded so as not to damage the organ even when it comes into contact with the organ, and a suction tube 56 is provided at the proximal end portion. It is connected. Further, a high pressure resistant tube 58 is connected to the proximal end portion 51 of the water jet catheter 2 via a detachable connector 57.

Therefore, the same effect as that of the first embodiment can be obtained. Furthermore, by loosening the fixing screw 55,
The water jet catheter 2 can be removed from the mantle tube 50, and by washing the inside of the drainage suction catheter 3 inside the mantle tube 50, it is possible to wash away all the tissue debris and the like, which is more hygienic. Is. Further, when the water jet catheter 2 is damaged, the outer tube 50 and the drainage suction catheter 3 are not replaced, but the whole is replaced.
Is economical because it can be reused.

FIG. 14 shows a tenth embodiment. Basically, it is the same as the ninth embodiment, and the same components are given the same numbers and their explanations are omitted. The water jet catheter 2 is eccentrically inserted into the outer tube 50 in a detachable manner.

Therefore, the inside of the outer tube 50 is divided by the water jet catheter 2 into the injection passage 59a and the suction passage 59b, and the suction passage 59b.
A suction tube 56 is connected through a drainage suction pipe 60 connected to the fitting portion 50b of the outer tube 50.

With this configuration, therefore, the same effect as that of the ninth embodiment can be obtained. further,
When used in a laparoscopy, the mantle tube 50 makes a pendulum motion. Therefore, if the mantle tube 50 and the water jet catheter 2 are concentrically fitted, a part of the suction passage 59b is exposed on the water surface and sucked. Although there is a problem that the pressure decreases, the suction pressure can be prevented from decreasing by eccentricizing the water jet catheter 2 with respect to the outer tube 50.

[0038]

As described above, according to the present invention, a high-pressure fluid is sent from a water jet catheter and jetted to the surgical site of living tissue, while the fluid jetted to the surgical site and the fluid around it are water. Since the drainage suction catheter, which is separate from the jet catheter, is sucked and discharged from the suction port, the suctioned drainage can be prevented from colliding with the jet jet. Further, there is an effect that the negative pressure at the time of suction is prevented from affecting the jet jet, and the jet pressure does not drop, so that the jet can operate the target site reliably and quickly.

[Brief description of drawings]

FIG. 1 is an exploded perspective view of a water jet surgical apparatus according to a first embodiment of the present invention.

FIG. 2 is a plan view of the water jet surgical apparatus according to the embodiment.

FIG. 3 is a configuration diagram of a control device of the same embodiment.

FIG. 4 is a perspective view showing a usage state of the embodiment.

5A and 5B are a plan view and a perspective view of a distal end portion of a water jet surgical apparatus according to a second embodiment of the present invention.

FIG. 6 is a configuration diagram of a control device according to a third embodiment of the present invention.

FIG. 7 is a side view of the distal end portion of the water jet catheter according to the fourth embodiment of the present invention.

FIG. 8 is a perspective view of the use example of the embodiment.

FIG. 9 is a perspective view of a distal end portion of a water jet surgery device according to a fifth embodiment of the present invention.

FIG. 10 is a perspective view of a distal end portion of a water jet surgical apparatus according to a sixth embodiment of the present invention and a view showing a field of view of an endoscope.

FIG. 11 is a perspective view of a distal end portion of a water jet surgery device according to a seventh embodiment of the present invention.

FIG. 12 is a perspective view of a distal end portion of a water jet surgery device according to an eighth embodiment of the present invention.

13A and 13B show a water jet surgical operation apparatus according to a ninth embodiment of the present invention, wherein FIG. 13A is a longitudinal side view and FIG. 13B is a front view.

14A and 14B show a water jet surgical operation apparatus according to a tenth embodiment of the present invention, wherein FIG. 14A is a longitudinal side view and FIG. 14B is a front view.

[Explanation of symbols]

DESCRIPTION OF SYMBOLS 1 ... Water jet surgical device, 2 ... Water jet catheter, 3 ... Drainage suction catheter, 5 ... Flow path, 6 ... Injection nozzle, 7 ... Suction port.

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[Procedure amendment]

[Submission date] May 7, 1992

[Procedure Amendment 1]

[Document name to be amended] Statement

[Correction target item name] 0031

[Correction method] Change

[Correction content]

FIG. 13 shows a ninth embodiment. The water jet catheter 2 is detachably inserted into an outer tube 50 to which a drainage suction catheter 3 is fixed. A fitting portion 50b having a diameter larger than that of the insertion portion 50a is provided at the base end portion of the outer tube 50, and the base end portion 51 of the water jet catheter 2 is fitted into the fitting portion 50b.

Claims (1)

[Claims] 1. A water jet catheter having a flow passage for passing a high-pressure fluid and having a jet nozzle at its tip, and a water jet catheter provided separately from the water jet catheter and having a suction port at its tip, and this suction port. And a catheter for drainage suction which is placed at the same position as or in front of the injection nozzle.