JPH0614937B2 - Cautery hemostatic probe - Google Patents

Description

Description: TECHNICAL FIELD The present invention relates to an ablation and hemostasis probe probe used in a transoscope to ablate and hemostat a wound that is hemostasis.

[Problems to be Solved by Prior Art and Invention] In recent years, by inserting an elongated insertion portion into a body cavity,
2. Description of the Related Art Endoscopes are widely used which allow diagnosis or therapeutic treatment inside a body cavity without requiring an incision from the body surface. This endoscope is generally provided with a hollow channel through which various treatment tools are inserted in addition to the observation means, and the operator visually observes with a treatment tool according to the symptom in the body cavity inserted into this channel. Various therapeutic procedures can be performed below.

By the way, there is a laser treatment device that coagulates blood by irradiating a laser beam as a hemostatic means for excising a tumor etc. in a body cavity or for a wound such as an ulcer. In addition, there is a problem that the cost is high.

Therefore, using an ablation hemostatic probe that can be inserted into the channel of the endoscope, by energizing the heating coil installed in the distal end side of the ablation hemostatic probe, a device for coagulating the bleeding portion pressed against is proposed. ing.

However, in this heating coil type device, since the responsiveness of the rise of temperature when coagulating blood and the fall of the temperature after hemostasis are low, the time until coagulation is
Alternatively, there is a problem that the peripheral tissue other than the target site (wound) is necrotic due to heat conduction to the peripheral tissue during the time until the probe is cooled after coagulation.

Therefore, Japanese Patent Application Laid-Open No. 58-69556 proposes a device in which a cautery hemostatic probe capable of being inserted through a channel of an endoscope is incorporated with a Zener diode having good responsiveness for heating and cooling as a heating element. ing.

In this prior art example, since the Zener diode is used as the heating element and the one having the small heat capacity (small volume and mass) is used, the heating when the power supplied to the Zener diode is turned on and off is controlled. In addition, the thermal response of cooling is good, there are few defects that necrosis the surrounding tissue, and hemostasis can be performed only at a desired site, which is a convenient device.

However, in order to improve the thermal response of the Zener diode, the amount of electricity consumed per unit time for a device having a small heat capacity is very large, and the temperature rise is also very large. There is a problem that deterioration of characteristics is unavoidable in repeated use under severe conditions that greatly exceed the maximum rating. Therefore, if repeatedly used, the amount of heat generated changes due to the deterioration of the characteristics of the Zener diode, and when trying to stop the ablation with the amount of heat generated according to the target site, the actual amount of heat generated will deviate from the set value. There is a drawback that various treatments cannot be performed. Further, as the deterioration progresses, there is a risk of destruction during use, and there is a problem in reliability such as the necessity of interrupting the treatment procedure. In addition, a complicated electric circuit is required to control the amount of heat generated by the Zener diode as a heating element, and a member that holds the Zener diode to serve as a heat transfer unit and to form an outer shell as a probe is required. However, there is a problem that the structure becomes complicated and the number of constituent members increases.

[Object of the Invention] The present invention has been made in view of these circumstances, and has good heating and cooling responsiveness, resistance to electrical and thermal destruction, and little deterioration in characteristics, while controlling heat generation temperature. Can be set by the material composition of the heating element itself,
As a result, there is no need for complicated control electric circuits,
Moreover, it is an object of the present invention to provide a cautery hemostatic probe in which the probe body can be formed by the heating element itself and the number of parts and the number of assembling steps can be reduced.

[Means for Solving the Problems] In order to achieve the above object, the cautery hemostatic probe according to the present invention forms a probe main body with a positive temperature coefficient thermistor as a constant temperature heating element, and connects a sheath to the probe main body. A cable inserted through the sheath is electrically connected to the probe main body.

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

1 to 4 relate to an embodiment of the present invention. FIG. 1 is a sectional view showing an ablation hemostatic probe, FIG. 2 is a perspective view showing an overall configuration of an ablation hemostatic device, and FIG. FIG. 4 is a cross-sectional view taken along the line AA of FIG. 4, and FIG. 4 is a partially cutaway front view showing an electric and water supply connector of a sheath base portion.

As shown in FIG. 2, an ablation hemostatic device 1 is provided with a power source box 3 provided on the entire surface of a prepared panel 2, and an ablation hemostatic probe detachably connected to the power source box 3 by an electrical connector 4 and a water supply connector 5. Device 6 and the power supply box 3
The switch 7 includes a foot switch 9 which is detachably attached by a connector 8 provided on the cable 7, and a wash water tank 10 which is detachably attached to a side surface of the power supply box 3.

The cautery hemostatic probe device 6 includes an elongated flexible sheath 11, an ablation hemostatic probe 12 connected to the distal end of the sheath 11, the electrical connector 4 and a water supply connector 5 provided on the base side of the sheath 11. The sheath 11 and the ablation hemostatic probe 12 at the tip thereof can be inserted into a treatment tool channel of an endoscope (not shown), and the ablation hemostatic probe 12 is introduced into the body cavity through this channel. A coaxial cable 13 is inserted into the sheath 11 at the center in the axial direction so that the cautery hemostatic probe 12 at the tip is energized via the electrodes 14a and 14b, and the coaxial cable 13 in the sheath 11 is also provided.
A water supply passage 16 for pressure-feeding the wash water to the nozzle 15 formed in the ablation hemostatic probe 12 is formed in the outer peripheral axial direction. Then, the electrical connector 4 and the water supply connector 5 on the base side of the cautery hemostatic probe device 6 are connected to the power supply box 3
And the foot switch 9 also connects the connector 8 of the cable 7 thereof to the power supply box 3,
While turning on the main switch 3a, the operation panel 2
By pressing the wash water feed side switch 9a side of the foot switch 9 in a state where, for example, the heating amount and the wash water feed amount setting buttons 2a and 2b provided in the
By operating the water pump provided in the power supply box 3, the washing water in the washing water tank 10 is sent from the nozzle 15 of the ablation hemostatic probe 12 at the tip toward the affected area in the body cavity through the water passage 16 in the sheath 11. Wash away the blood etc. of the affected area,
By pressing the heating switch 9a side of the foot switch 9, the ablation hemostatic probe 12 at the tip is energized via the coaxial cable 13 in the sheath 11 so that the probe 12 can be heated to a predetermined temperature.

Details of the cautery hemostatic probe 12 on the distal end side of the cautery hemostatic probe device 6 are configured as shown in FIGS. 1 and 3. That is, the cautery hemostatic probe main body 17 connected and fixed to the tip of the elongated flexible sheath 11, for example, a Teflon sheath, has a positive temperature coefficient thermistor (Positive Temperature Coe) as a constant temperature heating element.
(ficient Thermoistr-semiconductor ceramics) itself is processed into a cylindrical shape having a hemispherical end. Electrodes 14a and 14b are attached to the inner peripheral surface and the outer peripheral surface of the cylindrical probe body 17, respectively. The core wire 13a of the coaxial cable 13 inserted into the sheath 11 is connected to the electrode 14a and the outer wire 13b is connected to the outer wire 13b. It is electrically connected to the electrode 14b. The central axial through hole of the ablation hemostatic probe main body 17 formed in this cylindrical shape forms the nozzle 15 communicating with the water supply passage 16 formed in the sheath 11, so that water can be supplied toward the affected part in the body cavity. ing. Further, a non-adhesive coating 1 for preventing the tissue from sticking to the outermost periphery of the cautery hemostatic probe body 17
8 has been given. This is because the probe body 17
It causes heat by its own heat generation, cauterizes and coagulates the bleeding part of the wound, and is in direct contact with the tissue.Therefore, it is necessary to prevent sticking to the tissue and re-bleeding due to it. Because there is.

The base side of the ablation hemostatic probe device 6 is configured as shown in FIG. That is, the water supply tube connection member 25 is connected to the rear end of the sheath 11, and the water supply tube 26 is connected to the side portion of the connection member 25. The electric system and the water channel system are separated at this portion, and the sheath and the sheath are respectively separated. The coaxial cable 13 and the water supply passage 16 are inserted into the inside 11. The main body 27 of the connecting member 25 has a through hole 28 in the central axis direction and penetrates the coaxial cable 13 extending from the wrinkle sheath 11 side and extends toward the rear electrical connector 4. Further, the main body 27 has a connection mouthpiece 29 having a tapered outer periphery protruding forward, and the rear end of the sheath 11 is fitted into the mouthpiece 29. A male screw is formed on the rear outer periphery of the base 29 of the main body 7, and a tapered pressing ring 3 is formed on the inner periphery of the male screw portion.
A retaining ring 30 having a diameter 0a is screwed and the rear end of the sheath 11 fitted to the mouthpiece 29 is pressed and fixed by a tapered retaining ring 30a. Further, an annular fitting groove 30b is provided between the tapered pressing ring 30a provided on the inner periphery of the retaining ring 30 and the inner peripheral surface of the retaining ring 30, and the sheath 1 is provided in this groove 30b.
The rear end of the bend-preventing tube 31 that is externally mounted on the base side of 1 is fitted and fixed. On the rear end side of the connecting portion main body 27, a recess 32 is formed which is continuous with the through hole 28. A female screw is formed on the inner periphery of the recess 32, and the electrical connector 4 having a male screw at the tip is screwed and connected. Furthermore, this connection body 2
7 has a two-step recess 33 communicating with the through hole 28 on its side, and a female screw is formed on the inner periphery of the inner small-diameter recess 33a of the recess 33 to screw a joint 34 having a male screw of the water supply tube 26. At the same time, an O-ring 35 is interposed between the flange 34a protruding on the outer periphery of the joint 34 and the bottom surface of the outer large-diameter recess 33b to achieve watertightness. In this way, the water supply tube 26 communicates with the through hole 28 of the connecting portion main body 27 via the joint 34, and the outer periphery of the coaxial cable 13 inserted into the through hole 28 and the through hole 2
The water supply passage 16a is formed between the inner periphery of the connection body 8 and
The water passage 16 of the sheath 11 fitted and connected to Further, a female screw is formed on the inner periphery of the recess 32 of the connecting portion main body 27 and a cap screw 36 having a coaxial cable through hole 36a is screwed therein.
An O-ring 37 is interposed between the tip and the axial through hole 28 or the outer periphery of the coaxial cable 13, and the O-ring 37 is pressed by a cap screw 36 to connect the water supply channel 16a side and the rear electrical connector 4 side. The electrical system and the water channel system are separated to achieve water tightness.

The water supply tube 26 and the joint 34 are connected and fixed by a taper screw 37. The connector 5 provided on the rear end side of the water supply tube 26 has a socket 38 with a lock mechanism and can be detachably connected to a water supply plug 39 of the power supply box 3.

With such a configuration, the cautery hemostatic probe main body 17 is formed by the positive temperature-related thermistor itself which is a semiconductor ceramic, and therefore, no other constituent member that forms the outer shell of the main body is required, and the material composition of the cautery The temperature can be set arbitrarily. For example, if the Kyurie temperature is set to 200 ° C., the electric resistance of the thermistor which has reached 200 ° C. will rapidly increase and the current will be limited to 200 ° C.

FIG. 5 shows a second embodiment of the ablation probe of the present invention. In this embodiment, the electrodes 14a, 14b of the positive temperature thermistor as the probe body 17 are arranged at the front and rear ends, while the sheath 11 of the sheath 11 is provided. A plurality of nozzles 15 communicating with the water supply passage 16 are formed in the outer peripheral axial direction of the probe main body 17. Then, the core wire 13 of the coaxial cable 13 is attached to the tip side electrode 14a.
a is inserted into the center axis direction 17a of the probe main body 17 and connected, and the rear end portion of the center axis direction hole 17a is provided with the water supply channel 16a.
The washing water is blocked by an insulating cap 40 so as not to enter the hole 17a.

[Effects of the Invention] As described above, according to the present invention, the heating and cooling responsiveness is good, the resistance to electrical and thermal destruction is strong, and the deterioration of the characteristics is small. It can be set according to its own material composition, and as a result, a complicated control electric circuit is unnecessary, and further, the probe main body can be formed by the heating element itself, and the number of parts and the number of assembly steps can be reduced.

[Brief description of drawings]

1 to 4 relate to the first embodiment of the present invention.
1 is a sectional view showing an ablation probe, FIG. 2 is a perspective view showing the entire structure of the apparatus, FIG. 3 is a sectional view taken along the line AA of FIG. 1, and FIG. 4 is a sheath base electrical and water supply connector. FIG. 5 is a partially cutaway front view, and FIG. 5 is a sectional view showing a second embodiment of the probe of the present invention. 11 ... Sheath, 12 ... Cautery hemostatic probe 13 ... Coaxial cable, 14a, 14b ... Electrode 15 ... Nozzle, 16 ... Water supply channel 17 ... Probe body 18 ... Non-adhesive coating

Claims (1)

[Claims] 1. A probe main body is formed by a positive temperature coefficient thermistor as a constant temperature heating element, and a sheath is connected to the probe main body, while a non-adhesive coating is applied to the outer periphery of the probe main body and the probe main body is inserted into the sheath. A cautery hemostatic probe, wherein a cable is electrically connected to the probe body.