JPH10127658A - Bipolar coagulation element - Google Patents

Abstract

PROBLEM TO BE SOLVED: To prevent the deterioration of draining ability by forming the cross- sectional area of an insertion part main body to be smaller than the area of a circle formed by setting a longest chord in the cross-sectional shape of the insertion part main body to be a diameter in a bipolar solidifier with the insertion part main body for inserting into a celom through a channel. SOLUTION: This bipolar coagulation element 1 is provided with an insertion part 2 and a connector part 3 connected with its base tip part, and the main body 4 of the insertion part 2 is formed by covering two conductor electrodes 5 and 6 with electrically insulated external skins. In addition the connector part 3 is provided with two terminals 8 and 9 for being respectively continued with the electrodes 5 and 6 to be connected to a high frequency power source. In this case the cross sectional shape of the main body 4 is made an ellipse and the length of its longest chord in (the length of a long axis) D is made shorter than the channel diameter of an endoscope to which the solidifier is inserted. Thereby, at the time of sending draining liquid through the channel of the endoscope, a large gap is formed between with the channel to secure a large draining quantity.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a bipolar coagulant for an endoscope in which at least two conductive electrodes for passing a high-frequency current from a high-frequency power supply device are provided in an electrically insulating insertion body.

[0002]

2. Description of the Related Art In recent years, as endoscopes have become smaller in diameter, endoscopes have been used not only in the upper and lower digestive tracts but also in various parts such as the bladder, the kidneys, and the ventricles. It has been done. During observation, bleeding from the biopsy site or lesion site may obscure the observation field of view and hinder observation and procedural procedures. Endoscope observation. However, a large amount of bleeding from a biopsy site or a lesion site still obscures the visual field, which hinders the procedure. Therefore, it has been considered to actively stop bleeding by high-frequency coagulation without waiting for the bleeding to stop naturally.

[0003] Conventional high-frequency coagulation is predominantly monopolar, but monopolar high-frequency coagulation requires the installation and connection of a plate-shaped extracorporeal electrode on the surface of the patient's body. is there. Furthermore, when monopolar high-frequency coagulation is used in a ventricle, there is a concern about the effect on nerve cells. Therefore, in recent years, bipolar type coagulation has been increasingly used. In the conventional bipolar coagulant, the insertion portion main body is formed of an insulating jacket having a circular cross-section in a tube shape, and the insertion portion main body has a distal end protruding therefrom and at least two or more connected to the high frequency power supply device at the base end side. Conductor electrodes are provided, and a high-frequency current flows through these conductor electrodes.

[0004]

[Problems to be solved by the invention]

<Problems of the Prior Art> An endoscope used for the urinary tract or the ventricle has a small outer diameter, and the diameter of a channel provided for the endoscope is necessarily reduced. The conventional bipolar high-frequency coagulator has a circular cross-sectional shape of the insertion section main body that is the same as the channel of the endoscope, and when the insertion section of the bipolar high-frequency coagulator is inserted into the channel of the endoscope, the high-frequency coagulation occurs. Only a small annular clearance was formed between the outer periphery of the insertion part of the child and the inner periphery of the channel, and almost no perfusion was possible through the clearance. Therefore, there is a problem that the observation visual field becomes turbid due to bleeding while the high-frequency coagulation is inserted into the channel, and it becomes difficult to confirm the bleeding point.

[0005] Further, since the perfusion ability is reduced, after coagulation, the tissue is easily seized to the electrode, and the coagulation ability is reduced. On the contrary, when the electrode is seized to the tissue and peeled off,
There were circumstances such as bleeding again. In addition, when no perfusate is used, smoke may be generated at the time of coagulation, and the visual field may be obstructed.

As shown in Japanese Patent Publication No. 61-4260, it is conceivable to provide a fluid conduit in the coagulant itself. In this case, however, a gap is provided between a plurality of electrodes.
There is a drawback that a necessary and sufficient inner diameter cannot be secured, and the perfusion rate is extremely reduced, which is not practical.

<Object> The present invention has been made in view of the above-mentioned problems, and an object of the present invention is to provide a perfusion capability such as air supply / suction even when used by being inserted into a channel formed in an endoscope system. An object of the present invention is to provide a bipolar coagulant that does not lower the density and prevents seizure between an electrode and a tissue.

[0008]

SUMMARY OF THE INVENTION The present invention relates to a bipolar coagulant having an insertion portion main body inserted into a body cavity through a channel formed in an endoscope system, wherein a cross-sectional area of the insertion portion main body is reduced. Characterized in that the shape is smaller than the area of a circle formed with the longest chord in the cross-sectional shape as a diameter.

[0009]

BEST MODE FOR CARRYING OUT THE INVENTION

<First Embodiment> A first embodiment of the present invention will be described with reference to FIGS.
An embodiment will be described. (Configuration) FIG. 1 shows the entire bipolar coagulant according to the first embodiment. The bipolar coagulant 1 has an insertion part 2 and a connector part 3 connected to a base end thereof. The insertion portion main body 4 of the insertion portion 2 is formed by an electrically insulating outer cover 7 that covers the two conductive wire electrodes 5 and 6. The connector portion 4 is provided with two terminals 8 and 9 which are electrically connected to each of the conductive wire electrodes 5 and 6 and are connected to a high-frequency power source (not shown).

FIG. 2 is an enlarged view of the distal end portion of the insertion section 2. At the tip of the insertion portion main body 4, protruding portions 5a and 6a that are respectively connected to the conductive wire electrodes 5 and 6 are provided to protrude forward.

FIG. 3 shows a cross section of the insertion section 2, and the cross section of the insertion section main body 4 is an ellipse.
When the longest chord length (major axis length) is indicated by D, D is smaller than a channel diameter of an endoscope 10 into which the bipolar coagulant 1 is inserted, which will be described later. The shaft length is less than D and is oblong. The broken line shown in FIG. 3 indicates a maximum circle S having a diameter D. Therefore, the cross-sectional area of the insertion portion 2 is smaller than the area of the maximum circle S having the diameter D.

As shown in FIG. 4, the endoscope 10 includes an operation section 11 and an insertion section 12, and the insertion section 12 includes a distal end bending section 13 and a flexible section 14. The endoscope 10 has a channel 15 formed from the operation section 11 to the insertion section 12. As shown in FIG. 5, the channel 15 has a perfect circular cross-sectional shape, and the channel diameter is longer than the longest chord length D in the insertion portion main body 4 of the bipolar coagulant 1 as described above. The base end of the channel 15 is connected to an opening 16 provided in the operation section 11 of the endoscope 10 as shown in FIG. 4, and the distal end of the channel 15 is connected to the insertion section 12 of the endoscope 10 as shown in FIG. Open at the tip. An observation window 17 is provided at the distal end surface of the insertion section 12 of the endoscope 10.
And an illumination window 18 are provided, and the operation unit 1 of the endoscope 10 is provided.
1 is provided with an eyepiece 19 and a bending operation knob 20.

The connecting portion A between the bending portion 13 and the flexible portion 14 in the insertion portion 12 of the endoscope 10 is configured as shown in FIG. That is, the distal bending portion 13 has a plurality of articulated tubes 21 (only two are shown) arranged in a row in the longitudinal axis direction, and adjacent ones are rotatably connected to each other. The group is covered with a skin tube 22. The flexible portion 14 has a spiral tube 23 formed by spirally winding a band material having elasticity, a mesh tube 24 in which a wire is knitted in a tube shape and fitted to the spiral tube 23, and the mesh tube 24 is covered. It is made of a soft synthetic resin or the like, and is covered with the same outer tube 22 as that of the curved end portion 13.

Further, one end faces of a connection pipe 25 having the same outer diameter as those formed by the spiral pipe 23 and the mesh pipe 24 of the flexible portion 14 are joined in abutting manner. A first foil 26 is coated on both outer peripheral surfaces of the joined portion of the above, and in this state, they are fixed by bonding or soldering. At the inner periphery of the connection pipe 25, the tip bending portion 13 is provided.
A coil pipe 28 which guides through a bending wire 27 for performing a bending operation is fixed by brazing. An end face of the node ring pipe 21 is joined to the other end face of the connection pipe 25 by abutting. Both outer peripheral faces of these joint portions are covered with a second foil 29, and in this state, adhesive or solder is applied. To secure them. For this reason, the articulating tube 21
Connection in a form in which the outer diameter of the connection portion between the cable and the connection pipe 25 is kept as small as possible. Although not shown, the spiral tube 2 is directly connected to the rear end face of the node ring tube 21 without using the connection tube 25.
3 and the end of the mesh tube 24 may be connected and fixed by abutting foil.

FIG. 7 shows a flexible sheath 30 used when the endoscope 10 is transurethrally inserted into the urinary tract. The flexible sheath 30 has a sheath insertion portion 31 formed of a tightly wound metal coil, a base 32 provided at a base end of the sheath insertion portion 31, and an endoscope 10 provided in the base 32 in a watertight state. A rubber cap 33 having a possible insertion hole (not shown), and a front base 34 connected and fixed to the distal end of the sheath insertion portion 31 with a binder. An eave portion 35 having a blunt tip is formed in the front base 34. Since the sheath insertion portion 31 and the front base 34 are made of metal, they are not easily crushed even if they are thin, and can be reliably connected because they are made of metal. For this reason, there is no danger of falling off during use, and the operator can use it with confidence.

FIG. 8 shows a perfusion sheath 40 used when inserting the endoscope 10 into a ventricle. This perfusion sheath 40
Is a double tube structure of an outer tube 41 and an inner tube 42. The outer tube 41 includes an insertion tube portion 43 and a fixing portion 44, and an O-ring-shaped seal member 45 is provided on the inner periphery of the fixing portion 44. Further, a screw hole 46 is provided in the fixing portion 44 so as to penetrate in the radial direction, and a fixing screw (screw) 47 is screwed into the screw hole 46. This fixing screw 4
7 has a blunt portion 48 at the tip, and the blunt portion 48 is
To fix the inner tube 42 to the outer tube 41. The inner tube 42 is provided with the sealing member 45.
A cylindrical portion 51 having a diameter that can be inserted in a watertight state and a flange portion 52 provided at an outer end of the cylindrical portion 51.
An insertion port 53 for inserting the insertion portion 12 of the endoscope 10 is formed at an outer end of the inner tube 42 provided with the tube 2.

When the endoscope system uses not only the channel of the endoscope itself but also a perfusion system and a rigid endoscope having no channel, for example, the perfusion sheath and the rigid endoscope are used. The bipolar coagulant may be inserted into the clearance between the two and used.

(Operation) FIG. 4 shows the channel 1 of the endoscope 10.
5 shows a state when the bipolar coagulant 1 is inserted.
FIG. 5 shows a state when the bipolar coagulant 1 is inserted into the channel 15 of the endoscope 10 as viewed from the distal end of the endoscope.
The operator inserts the insertion portion 2 of the bipolar coagulant 1 into the channel 15 in a state in which the perfusate is supplied through the channel 15 of the endoscope 10. Because of the ellipse, a clearance 62 is formed which is considerably larger than the clearance 61 between the maximum circle S having the longest chord length D as the diameter and the inner peripheral surface of the channel 15. While the surgeon is performing the high-frequency treatment, the state in which the perfusion solution is sent and sucked from the clearance 62 can be maintained.

Therefore, a case will be described in which the intraventricular treatment is performed using the perfusion sheath 40 shown in FIG. First, as shown in FIG. 9, the perfusion sheath 32 is punctured into the ventricle 65, and the insertion section 12 of the endoscope 10 is inserted into the ventricle 65 through the perfusion sheath 32. At this time, ventricle 6
The pressure in the inner tube 5 is controlled by the insertion port 5 for the endoscope of the inner tube 42 provided on the distal and proximal ends of the outer tube 41 of the perfusion sheath 40.
It is determined by the difference between the height of the head and the head, ie, the head difference h.

After moving the inner tube 42 in the longitudinal direction with respect to the outer tube 41 and adjusting the head difference h, the fixing screw 47 is screwed in, and the blunt portion 48 of the fixing screw 47 is inserted into the cylindrical portion of the inner tube 42. The inner tube 42 is fixed by pressing the inner tube 43. In other words, the insertion port 5 for the endoscope on the distal end and the proximal end side of the perfusion sheath 40.
The head difference h is obtained by arbitrarily changing the length between
Can be adjusted. As a result, the pressure in the ventricle 65 can be controlled, so that the operator can operate the endoscope with confidence even for a child whose cranial fusion has not been completed.

(Effect) Even if the insertion part 2 of the bipolar coagulant 1 is inserted into the channel 15 in a state where the perfusate is fed through the channel 15 of the endoscope 10, the insertion part 2 of the bipolar coagulation 1 Because the cross-sectional shape of
The largest circle S whose diameter is the longest chord length D and channel 1
A clearance 62 is formed which is considerably larger than the clearance 61 between the inner peripheral surface 5 and the inner peripheral surface. Therefore, a state in which the perfusion solution is sent from the clearance 62 can be sufficiently maintained even while the operator performs the high-frequency treatment. As a result, since the perfusion solution can be sent from the clearance 62, turbidity of the visual field due to bleeding can be suppressed until the hemostasis by the high-frequency coagulation is completed. In addition, since there is perfusion during coagulation, it is possible to suppress burn-in of tissue to the conductive wire electrode.

<Second Embodiment> A second embodiment of the present invention will be described with reference to FIG. FIG. 10 is a cross-sectional view of the insertion part of the bipolar coagulant in the middle. (Construction) Bipolar coagulant 71 according to the second embodiment
The cross section of the insertion portion main body 72 of the insertion portion has a substantially polygonal shape, for example, a rectangular shape, more specifically, a substantially square shape as shown in FIG. 10, and is located at four vertices of the square shape. The conductive wire electrode 73 is provided at each of the corners. That is, the insertion portion main body 72 is provided with four conductive wire electrodes 73. And 2 on the diagonal of the square
The books are electrically connected to each other, and are electrically connected to the two terminals 8 and 9 provided in the connector section 3 described above. The distal end of each conductive wire electrode 73 is a protruding portion that projects forward from the distal end of the insertion portion main body 72 (not shown). Also in this case, when the cross-sectional shape of the insertion portion main body 72 indicates the longest chord length in a direction corresponding to the diagonal line by D, the D is an endoscope 1 for inserting the bipolar coagulant 71 described later.
The length is smaller than the channel diameter of zero. The broken line shown in FIG. 10 indicates a maximum circle S having a diameter D. Therefore, the cross-sectional area of the insertion portion main body 72 is smaller than the area of the maximum circle S having the diameter D.

(Operation) This is the same as the first embodiment. (Effect) Since there are many conductive wire electrodes 73, high-frequency solidification can be performed reliably.

<Third Embodiment> A third embodiment of the present invention will be described with reference to FIG. FIG. 11 is a cross-sectional view of the insertion part of the bipolar coagulant. (Configuration) Bipolar coagulant 81 according to the third embodiment
As in the first embodiment, there are two conductive electrodes 82, and an electric power having a substantially uniform thickness concentrically with the conductive electrodes 82 around each conductive electrode 82 so as to surround the conductive electrodes 82. The electrically insulating outer skin layer 83 is formed. Further, each of the concentric insulating skin layers 83 is integrally connected to the insulating skin layer 83 by a bridge portion 84 made of the same material or insulating resin to form an insertion portion main body 85. Therefore, the insertion portion main body 85
As shown in FIG. 11, the cross-sectional shape of each of them has a generally eyeglass-like shape as a whole, in which ring-shaped insulating skin layers 83 at both ends thereof are connected by thin bridge portions 84.

In this case as well, when the cross-sectional shape of the insertion portion main body 85 is the longest chord length indicated by D, D is smaller than the channel diameter of the endoscope 10 into which the bipolar coagulant 81 is inserted. The broken line indicated by 11 is a maximum circle S having a diameter of D.
Is shown. Therefore, the cross-sectional area of the insertion portion main body 85 is considerably smaller than the area of the maximum circle S having the diameter D.

(Operation) This is the same as the first embodiment. (Effects) Same as in the first embodiment. A sufficient gap can be formed between the inner peripheral surface of the endoscope channel and the outer periphery of the insertion portion main body 85.

<Fourth Embodiment> A fourth embodiment of the present invention will be described with reference to FIG. FIG. 12 is a cross-sectional view in the middle of the insertion part of the bipolar coagulation. (Configuration) Bipolar coagulant 91 according to the fourth embodiment
As in the first embodiment, two conductive electrodes 92 are provided, and around the individual conductive electrodes 92 so as to surround the conductive electrodes 92, an electric power having a substantially uniform thickness is formed concentrically with the conductive electrodes 92. An electrically insulating skin layer 93 is formed. Further, the concentric insulating skin layers 93 are joined together and integrally formed,
Alternatively, the insertion portion main body 94 is configured by being integrally connected by fusion or adhesion. Therefore, as shown in FIG. 12, the cross-sectional shape of the insertion portion main body 94 has a so-called daruma shape in which both ring-shaped insulating outer layers 93 are connected.

In this case as well, the cross-sectional shape of the insertion portion main body 94 is represented by D, where D is the longest chord length, and D is smaller than the channel diameter of the endoscope 10 into which the bipolar coagulant 91 is inserted. A dashed line indicated by 12 indicates a maximum circle S having a diameter of D.
Is shown. Therefore, the cross-sectional area of the insertion portion main body 85 is considerably smaller than the area of the maximum circle S having the diameter D.

(Operation) This is the same as the first embodiment. (Effect) Single conductor electrode 92 covered with insulating skin layer 93
By fusing or bonding them together, the insertion portion main body 94 can be easily assembled. For this reason, it is possible to reduce the assembly cost and manufacture it at low cost.

[Supplementary Notes] In a bipolar coagulant having an insertion portion main body to be inserted into a body cavity through a channel formed in an endoscope, the cross-sectional shape of the insertion portion main body is the diameter of the longest chord in the cross-sectional shape of the insertion portion main body. A bipolar coagulant having a shape smaller than an area of a circle formed as a solid. 2. 2. The bipolar coagulant according to claim 1, wherein the cross section of the insertion portion main body has an elliptical (elliptical) shape. 3. 2. The bipolar coagulant according to claim 1, wherein the insertion section body has a substantially polygonal cross-sectional shape. 4. 2. The bipolar coagulant according to claim 1, wherein the cross-sectional shape of the insertion portion main body is a substantially rectangular shape. 5. 2. The bipolar coagulant according to claim 1, wherein the electrically insulated outer covering covering each conductive wire electrode is connected by a bridge. 6. 2. The bipolar coagulant according to claim 1, wherein the bipolar coagulator has a shape in which an electrically insulating outer covering covering each conductive wire electrode is applied and connected.

[0031]

As described above, according to the present invention, a considerably large clearance can be formed between the channel of the endoscope and the inner peripheral surface of the channel even when the channel is used. Even during the treatment, the perfusion ability is not reduced, and burn-in between the electrode and the tissue can be prevented. The surgeon can perform the procedure with peace of mind. In addition, since it can be implemented with a simple configuration, it can be easily manufactured and the manufacturing cost can be reduced.

[Brief description of the drawings]

FIG. 1 is an explanatory view showing an entire bipolar coagulant according to a first embodiment.

FIG. 2 is an enlarged perspective view showing a distal end portion of an insertion portion of the bipolar coagulant according to the first embodiment.

FIG. 3 is a transverse cross-sectional view of an intermediate portion in an insertion portion of the bipolar coagulant according to the first embodiment.

FIG. 4 is a side view in a state where the bipolar coagulant according to the first embodiment is inserted into an endoscope.

FIG. 5 is a front view of the distal end of the insertion section when the bipolar coagulant according to the first embodiment is inserted into the endoscope.

FIG. 6 is a vertical cross-sectional view of a connecting portion between the distal bending portion and the flexible portion in the insertion portion of the endoscope.

FIG. 7 is a side view of a soft sheath used when the endoscope is transurethrally inserted into the urinary tract.

FIG. 8 is a longitudinal sectional view of a perfusion sheath used when inserting the endoscope into a ventricle.

FIG. 9 is an explanatory view when the endoscope is inserted into a ventricle using the perfusion sheath.

FIG. 10 is a transverse cross-sectional view of a bipolar coagulator according to a second embodiment in the middle of an insertion portion.

FIG. 11 is a transverse cross-sectional view of a bipolar coagulator according to a third embodiment in the middle of an insertion portion.

FIG. 12 is a transverse cross-sectional view of a bipolar coagulator according to a fourth embodiment in the middle of an insertion portion.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 ... Bipolar coagulant 2 ... Insertion part 4 ... Insertion part main body 5 ... Lead wire electrode 6 ... Lead wire electrode 7 ... Electrical insulation outer skin 8 ... Terminal 9 ... Terminal 10 ... Endoscope 15 ... Channel D ... Longest chord length (long) Shaft length) S: Maximum circle

Claims (1)

[Claims] 1. A bipolar coagulant having an insertion portion main body inserted into a body cavity through a channel formed in an endoscope system, wherein the insertion portion main body has the longest cross-sectional shape in the cross-section shape of the insertion portion main body. A bipolar coagulator characterized in that it has a shape smaller than the area of a circle formed with the length of a chord as a diameter.