JPH0554347B2 - - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION [Industrial Application Field] The present invention relates to a cautery and hemostasis device that is used endoscopically to cauterize and stop bleeding from a bleeding wound.

[Prior Art] In recent years, endoscopes that can perform diagnostic or therapeutic procedures inside a body cavity without requiring an incision from the body surface by inserting an elongated insertion section into the body cavity have become widely used. It is used. In addition to the viewing means, this endoscope is generally equipped with a hollow channel through which various treatment instruments are inserted. It has become possible to perform various medical treatments while observing the festival.

By the way, there are laser treatment devices that irradiate laser beams to coagulate blood as a means to remove tumors or the like in body cavities or to stop bleeding in wounds such as ulcers.
At present, there are problems in that laser beam irradiation requires skill and is expensive.

For this purpose, a cautery probe that can be inserted through the channel of the endoscope is used, and by energizing a heating coil installed at the distal end of the cautery probe, the bleeding area pressed against the cautery probe is coagulated. A device has been proposed.

However, with this heating coil type device,
Due to the low responsiveness of temperature rise during blood coagulation and temperature fall after hemostasis,
The problem is that the surrounding tissue other than the target area (wound) may be necrotized due to heat conduction to the surrounding tissue during the time until the probe coagulates or after the probe cools down. There is.

Therefore, Japanese Patent Application Laid-Open No. 58-69556 discloses a high-speed heat-generating ablation probe that uses a heat-generating element with good heating and cooling response as an ablation probe that can be inserted into the channel of an endoscope. There is.
This prior art device has a nozzle in the probe that emits a lavage fluid that is pumped through a catheter to clean blood from the wound and help locate bleeding sites that require coagulation.

[Problems to be Solved by the Invention] The conventional technology has a drawback in that when the probe tip is lower than the liquid level in the cleaning liquid tank, the cleaning liquid naturally flows out from the probe tip due to the siphon principle. In addition, this ensures that the probe tip is constantly cooled with cleaning fluid, which prevents the probe tip from rising in temperature when necessary and preventing the desired treatment. There were cases where the cleaning solution dripped and the floor around the probe became soaked with water.

It is an object of the present invention to solve the above-mentioned problems and to provide a cautery and hemostasis device that is safe and easy to use, and in which the liquid supply to the probe is reliably stopped by stopping the operation of the pump for supplying the cleaning liquid.

[Means for Solving the Problems] This invention provides an ablation probe at the tip of an elongated sheath that can be inserted into a treatment tool channel of an endoscope,
A heating element is disposed within the probe to make the tip surface of the probe a heat transfer section, a nozzle is disposed on the probe, a liquid passage for sending a cleaning liquid to the nozzle is disposed within the sheath, and a cleaning liquid is provided in the liquid passage. The cautery hemostasis device has a water channel system and a liquid feeding means, which includes a control valve that opens at a predetermined pressure or higher in the middle of the water channel system on the downstream side of the liquid feeding means.

[Function] This cautery hemostasis device uses a control valve installed in the waterway system downstream of the liquid feeding means to control the water level difference based on the siphon principle when the liquid feeding means, such as the liquid feeding pump, is not in operation. It does not open under pressure and no cleaning fluid is delivered to the probe.

[Example] Hereinafter, an example of the present invention will be described with reference to the drawings.

As shown in FIG. 1, the cautery hemostasis device 1 includes a power supply device 3 provided with an operation panel 2 on the front surface, and is removably connected to the power supply device 3 through an electrical connector 4, a liquid supply connector 4, and a liquid supply connector 5. A foot switch 9 is detachably attached to the power supply device 3 via a connector 8 provided on a cable 7, and a cleaning liquid tank 10 is detachably attached to the side of the power supply device 3. ing.

The ablation probe device 4 includes an elongated and flexible sheath 11, an ablation probe 12 connected to the distal end of the sheath 11, and the electrical connector 4 and liquid delivery connector 5 provided on the base side of the sheath 11. The sheath 11 and the ablation probe 12 at its tip can be inserted into a treatment tool channel of an endoscope (not shown), and the ablation probe 12 is introduced into the body cavity through this channel. A coaxial cable is inserted into the sheath 11 at the center in the axial direction to energize a heating element installed inside the cautery probe 12 at the tip, and a coaxial cable is inserted into the sheath 11 in the axial direction around the outer circumference of the coaxial cable. A liquid passage (not shown) is formed for pressure-feeding a cleaning liquid to a plurality of nozzles (not shown) formed on the outer periphery of the ablation probe 12 . Then, the electric connector 4 and the liquid feeding connector 5 on the base side of the ablation probe device 6 are connected to the power supply device 3, and the foot switch 9 also connects the connector 8 of the cable 7 to the power supply device 3. At the same time, turn on the main cable 3a, and press the heating amount and cleaning liquid feeding amount setting buttons 2a and 2b provided on the operation panel 2.
is selected and set, by pressing the cleaning liquid supply side switch 9a of the foot switch 9,
The liquid pump installed in the power supply device 3 is activated to send the cleaning liquid in the cleaning liquid tank 10 through the liquid passage in the sheath 11 from the nozzle on the outer periphery of the ablation probe 12 at the tip toward the affected area in the body cavity, thereby discharging the blood in the affected area. etc., or heat switch 9b of foot switch 9.
By pressing the side, electricity can be applied to the heating element in the ablation probe 12 at the tip via the coaxial cable in the sheath 11 to heat it to a predetermined temperature.

The inside of the power supply device 3 is constructed as shown in FIG. That is, the power supply device 3
An intermediate chassis (not shown) is disposed in the plane direction of the inner and lower parts, and is divided into an upper chamber (not shown) and a lower chamber 13b (not shown), and the upper chamber is connected to various circuits for supplying electricity to a heating element installed in the ablation probe 12. An electrical system is provided, and a water channel system 16 is provided in the lower chamber 13b for pumping cleaning water to the nozzle formed in the ablation probe 12. An assembly hole is formed in the intermediate shear, and the pump device 18 is assembled into this assembly hole. Said waterway system 1
6 includes a water tube 19 that supplies the cleaning water from the cleaning liquid tank 10 to the pump device 8, and a liquid feeding path 20 that passes the cleaning water pressurized and pumped by the water pump device 18. It is connected to the lower chamber 13b side of the water pump device 18. A recess 21 is formed in the side surface of the box 13 on the lower chamber 13b side, and a connector 22 to which the water tube 19 is connected is attached to a wall plate 21a forming the recess 21. Further, a water shielding plate 23 having a U-shaped cross section is attached to the front side of the intermediate chassis 14, and the water shielding plate 23 forms a liquid feeding path outlet chamber which is separated from the upper chamber in the box 13. 24, a water supply channel 20 is led out from the lower chamber 13b into this discharge chamber 24, and a water supply plug 2 is attached to the box front plate 25.
Connected to 6.

On the other hand, a bracket 27 is attached to the side surface of the box 13 having the concave portion 21, and the hanging piece 28 of the cleaning water tank 10 is hung on this bracket 27 so that the cleaning liquid tank 10 can be detachably suspended. . The cleaning water tank 10 has an outlet 29 and a liquid feeding tube 30 from the outlet 29.
is led out, and at the other end of this liquid feeding tube 30,
A base portion 31 that connects to the connector 22 is formed.

Check valves 40 and 4 are connected between the inlet and the outlet of the pump 18.
1 is provided to regulate the flow of the cleaning liquid. A pressure detector 42 is provided in the liquid feeding path 20, the output of which is input to a control circuit 43, and a control valve 44 is further provided in the liquid feeding path 20.

As shown in FIG. 3 and FIG. 4, the control valve 44 is provided with a spring 45 inside to bias the valve body 46 toward the inlet portion.

As shown in FIG. 5, the connector 22 has main bodies 22a and 22b of the connector 22 and a connecting tube 22c provided therein, and a packing 50 is attached to the connecting tube 22c. Base part 31
, a fitting tube 51 and a connecting cap 52 are provided, a packing 53 is attached to the connecting port 52, and a control structure similar to that shown in FIGS. 3 and 4 is installed inside the fitting tube 51. A valve 54 is provided. Furthermore, the liquid feeding tube 30 has an internal tube 30a, and this internal tube is connected to the fitting tube 51.

Next, the operation of this embodiment will be explained based on the drawings.

After the heat treatment is completed, when the liquid supply switch 9a is pressed, the pump 18 is activated, and the cleaning liquid is supplied from the cleaning liquid tank 10 into the pump through the internal tube 30a in the liquid supply tube 30, the mouthpiece 31, the connector 22, and the water tube 19. be attracted. At this time, the inside of the cleaning liquid tank 10 leaks to the atmosphere through the gap between the liquid feeding tube 30 and the internal tube 30a, the notch (not shown) of the fitting tube 51, and the opening 60 of the connector body 22a, and the cleaning liquid is sucked out. Even if it is, the inside of the tank 10 will not become negative pressure.

The cleaning liquid sucked into the pump 18 is sent to the water supply flag 26 through a check valve 41 provided in the liquid supply path 20, a pressure detection channel 42, and a control valve 44. control valve 4
4, since pressurized cleaning liquid is sent from the pump 18, as shown in FIG. 4, the spring 45 and the valve body 46 are retracted by the pressure, allowing the cleaning liquid to pass through. Similarly, the spring 55 of the control valve 54 provided in the mouthpiece 31 is retracted by pressure, allowing the cleaning liquid to pass through.

In addition, the pressure detector 42 is activated when the left side of the cleaning liquid reaches a predetermined level or higher, and outputs a signal to the control circuit 43.
The control circuit 43 stops the operation of the pump 18 and the like to ensure safety.

In the cautery hemostasis device of this embodiment, the control valve 44 is provided in the middle of the liquid supply path, so when the pump 18 is not operating, the cleaning liquid does not drip from the tip of the probe, which prevents heating failure of the probe. , the area around the device will not get dirty. Furthermore, in this embodiment, a control valve 54 is also provided in the mouthpiece 31 of the tube 30 protruding from the tank 10, so when the mouthpiece 31 is removed from the connector 22, the control valve 54 closes and the cleaning liquid is released. There is no chance of any cleaning liquid getting around the device.

Note that the embodiments of the present invention are not limited to the embodiments described above, and the control valve may be provided at other positions in the waterway system, and the structure of the valve may be such that it opens at a certain pressure or higher. If so, its structure does not matter.

It is also conceivable to provide a solenoid valve that opens in conjunction with the operation of the pump as a control valve, but this would make the device complicated and heavy, which is not desirable.

[Effects of the Invention] According to the present invention, when sending washing water to the probe of a cautery hemostasis device, the washing water delivery hand is reliably stopped by stopping the operation of the liquid delivery pump, thereby eliminating unnecessary liquid delivery.
Eliminates dirt from washing water on equipment. This enables safe and reliable ablation treatment.

[Brief explanation of the drawing]

FIG. 1 is an overall view showing an embodiment of the present invention;
Figure 2 is a sectional view of an embodiment of the present invention, Figure 3, Figure 4 are sectional views of a control valve used in an embodiment of the invention, and Figure 5 is a sectional view of a control valve used in an embodiment of the invention. It is a sectional view of a cleaning water tank and a connector part used in the control valve used. DESCRIPTION OF SYMBOLS 1... Cautery hemostatic device, 11... Sheath, 12... Probe, 16... Water channel system, 18... Pump (water supply means),
20...Liquid feeding path, 44...Control valve.

Claims (1)

[Scope of Claims] 1. An ablation probe having a nozzle inside is provided at the tip of an elongated sheath that can be inserted into a treatment instrument channel of an endoscope, and a heating element is disposed within this probe, and a liquid path leading to the nozzle is provided. In the cautery hemostasis device, which has a waterway system communicating with the liquid passage, and a liquid feeding means for supplying a cleaning liquid to the waterway system, a predetermined portion is placed in the middle of the waterway system on the downstream side of the liquid feeding means. A cautery hemostasis device characterized by being provided with a control valve that opens under pressure.