JPH1043197A - Electrode for electric operation - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an electrode for electric operation which prevents the undesired thermal damage in an indefinite current route and enables the improvement of the performance in all functions of abscission, solidification, transpiration, etc., and various applications. SOLUTION: The electrode holding member of the electrode for electric operation which treats the vital section in the celom by supplying a high-frequency current to this vital section is provided with a rear end electrode 16 and front end electrode 17 which are respectively looped. The distance between these two electrodes 16 and 17 is fixed or made movable. While the high-frequency current is passed between these electrodes 16 and 17, the treatment is executed by moving the plural electrodes 16, 17 in the state of maintaining the each other's positional relation of the entire part thereof or moving the individual electrodes.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an electrosurgical electrode used for high-frequency surgery on a living body part in a resectoscope device or the like.

[0002]

2. Description of the Related Art There is known a resectoscope device which is used for infertility treatment in a prostate and a bladder or infertility in obstetrics and gynecology, and resects the lesion by high frequency while observing the lesion. Generally, an optical viewing tube and an electrode rod are inserted into a sheath inserted into a body cavity.
When using this resectoscope device, the electrode rod is connected via a cable to the active electrode side of the electrosurgical power supply separately installed, and the patient electrode is connected to the neutral electrode side of the electrosurgical device. Connect. Then, a high-frequency current is applied between the electrode rod and the patient electrode, and the lesion is excised by the high-frequency current concentrated on the lesion of the patient through the electrode rod. Such a technique for resecting a lesion by an electric operation is represented by the technique described in Japanese Patent Publication No. Hei 4-2645. USP 4
No. 060087, which does not require a patient electrode to be stuck on the patient's body surface, and a method in which a high-frequency current is applied between two parallelly arranged loop electrodes (rod electrodes) to perform ablation has been proposed. I have.

[0003]

In the above-mentioned prior art, in the high-frequency ablation system represented by Japanese Patent Publication No. 4-2645, a high-frequency current output from an electrode rod placed in a body cavity of a human body is used. Diffuses in the human body and flows to the patient electrode attached to the body surface of the human body. However, since the path of the high-frequency current is long, the resistance value is high, and a high output must be applied. Moreover, the path of the high-frequency current flowing between the electrode rod placed in the body cavity of the human body and the patient electrode attached to the surface of the human body is not clear, and depending on the state of attachment of the patient electrode on the surface of the human body. It must be set so that the high-frequency current applied to ablate or coagulate the lesion does not cause current concentration in the path to the patient electrode or at the contact surface with the patient electrode. It was very troublesome.

[0004] In order to solve this problem, US Pat.
In P-4060087, although the patient electrode can be eliminated, there are the following disadvantages. That is, since the combination of the active electrode and the neutral electrode, each of which is composed of two loop electrodes fixed to the arm, is connected, the application and excision performance of the excision is extremely poor and inefficient. And with this method,
Since the distance between the two electrodes is also fixed, and the amount and range of the resected tissue are often limited, the resection performance is eventually inferior to that of the above-mentioned Japanese Patent Publication No. Hei 4-2645. There was a problem.

[0005] The present invention is an electrosurgical electrode that prevents unintentional burns in the unclear current path as described above, and improves performance in all functions such as ablation, coagulation, and transpiration and enables various applications. The purpose is to provide.

[0006]

SUMMARY OF THE INVENTION The present invention relates to an electrosurgical electrode for applying a high-frequency current to a living body part in a body cavity to electrically operate the living body part, and at least two or more electrodes mounted on an electrode holding member. A high-frequency current is passed between the electrode elements, and the distance between the electrode elements is selectable, and at least one of the electrode elements is movable with respect to the electrode holding member. It is something that was taken. According to the present invention, at least two or more electrode elements are arranged in the optical axis direction of the optical viewing tube, and the active output terminal and the neutral output terminal of the electrosurgical device can be exchanged for each electrode element without being unique. Can be connected to Further, the positional relationship between the tip electrode portions of the respective electrode elements can be made to be movable in one direction or in the other direction, so that it can be used as a scanner. In particular, if the positional relationship of the electrode element in the direction perpendicular to the optical axis of the optical viewing tube is changed, a treatment operation while observing can be easily performed. In addition to the loop electrode, it is also possible to perform evaporation in a bipolar manner by a combination of a roller electrode and a combination of a loop electrode and a roller electrode to make the loop electrode function as an active electrode, and to use the roller electrode as a patient electrode. By functioning as, electrosurgery can be performed with a shorter current path compared to the conventional monopolar procedure. In addition, by making the distance between each electrode element movable and the entire electrode set movable, an effective treatment can be performed according to the excision or coagulation performance, the size of the tumor, and the application site. The above operation contributes to the improvement of safety and the basic performance of the surgical electrode.

[0007]

BEST MODE FOR CARRYING OUT THE INVENTION

(First Embodiment) A first embodiment of the present invention will be described with reference to FIGS. FIG. 1 schematically shows a system configuration of the electrosurgical apparatus. In FIG.
Is the main body of the apparatus. This apparatus body 1 has a commercial power supply 2
The power supply circuit 4 is connected to the insulation transformer 3 which is electrically connected to the power supply. The power supply circuit 4 is connected to a high frequency generation circuit 5 and a waveform generation circuit 6 therefor. High frequency generator 5
The operation of the waveform generating circuit 6 is controlled by the control device 7. The high frequency output from the high frequency generator 5 is amplified by the high frequency amplifier 8 and output through the output circuit 9. An output terminal of the output circuit 9 is connected to an electrode 11 for electrosurgery, which will be described later, via a cable 10 so that a high-frequency current is supplied to the electrode 11 for electrosurgery.

The electrosurgical electrode 11 is inserted, for example, into a sheath 12 of a resectoscope device as shown in FIG. An optical viewing tube (not shown) including a light guide for illuminating the anterior surgical field is attached to the sheath 12, and the optical viewing tube can illuminate and observe an operating field in a body cavity.

[0009] As shown in FIG.
Is constituted by mounting a plurality of electrode elements on an electrically insulating electrode holding member 15 inserted into the sheath 12. Each electrode element here is a pair of loop electrodes,
It comprises a rear electrode 16 and a front electrode 17. The tip electrode 17 is supported on the electrode holding member 15 so as to be able to advance and retreat. In this embodiment, the rear end electrode 16 and the front end electrode 17 are used.
Are movable with respect to the electrode holding member 15 and are movable in the optical axis direction of an optical viewing tube (not shown). Also,
The electrodes 16 and 17 are pushed or pulled together or individually by an operating mechanism (not shown) on the rear end side of the sheath 12,
The electrode holding member 15 can be moved forward and backward by sliding. Note that the rear end electrode 16 may be fixedly provided on the electrode holding member 15. The distance between the electrodes 16 and 17 is selectable, at least one of the tip electrodes 17 is movable, and the whole of the plurality of electrodes 16 and 17 is moved while maintaining the mutual positional relationship between the electrodes. And the individual electrodes 16 and 17 can be individually moved.

As shown in FIG. 2, both the front end portions of the rear end electrode 16 and the front end electrode 17 are bent in the same direction with respect to the base end portion, so that, as shown in FIG. The loop-shaped tip electrode portions 16a and 17a are formed. The height positions of the lower ends of these tip electrode portions 16a and 17a are the same, and
a and 17a are formed in the same shape which overlaps when viewed from the front as shown in FIG.

A stopper 18 is provided at the tip of the electrode holding member 15 and contacts the tip electrode 17 when the tip electrode 17 is retracted. This stopper 18
When the tip electrode 17 is retracted to the final rear end, the tip electrode 17 hits and maintains a small distance between the tip electrode 17 and the rear electrode 16 so that the rear electrode 16 and the tip electrode 17 do not come into direct contact. To be regulated.

Here, the rear end electrode 16 is used as a neutral electrode (collection electrode), and the front end electrode 17 is used as an active electrode (treatment active electrode). That is, through the cable 10, the rear end electrode 16 is connected to the neutral output terminal 9 a in the output circuit 9 of the device main body 1.
Reference numeral 7 is connected to an active output terminal 9b of the output circuit 9 of the apparatus main body 1.

A high frequency is applied between the two rear-end electrodes 16 and the front-end electrode 17. At this time, high-frequency waves having different waveforms are applied independently or in combination according to treatments such as incision, mixing, and coagulation. This makes it possible to perform appropriate treatment according to the condition of the lesion, incision performance, coagulation performance, and mixed incision performance.

For example, when used as a resectoscope device, the sheath 12 is guided into a body cavity as shown in FIG. 1, and as shown in FIG. The electrode 17 is exposed, and the tip of each loop is brought into contact with the living body part of the body cavity organ 20 to be treated.
Then, the distal electrode 17 is moved in the optical axis direction of the optical viewing tube while applying a high frequency having a waveform corresponding to the treatment to the rear electrode 16 and the distal electrode 17, thereby treating a portion that comes into contact with the distal electrode 17. Can be.

At this time, a high-frequency current is applied to a portion between the rear end electrode 16 and the tip electrode 17, and the current path is a specified short portion between the rear end electrode 16 and the tip electrode 17. And a clear place limited to the vicinity of a lesion inside the human body. For this reason, as in the conventional case described above, when a high-frequency current flows toward the patient (extracorporeal) electrode, a situation may occur in which a current concentrates on the path to the patient electrode or on the contact surface with the patient electrode. Absent. Also,
Since the high-frequency treatment can be performed in the specified and short current path, the treatment efficiency is improved without impairing the performance of ablation, coagulation, transpiration, and the like. Moreover, since the loss of the high-frequency current is small, it is not necessary to apply an output higher than necessary. Therefore, safety is remarkably improved.

(Second Embodiment) Referring to FIGS. 4 and 5, a second embodiment of the present invention will be described. In this embodiment, the shape of the rear electrode 16 and the front electrode 17 in the electrosurgical electrode 11 in the configuration of the first embodiment is formed in a circular loop shape, and further, the front electrode portion 16a of the rear electrode 16 is formed. The length is the tip electrode portion 17a of the tip electrode 17.
It is shorter.

As described above, the tip lengths of the electrodes 16 and 17 are differently combined to provide directionality when performing a procedure such as excision. That is, by providing a difference in length between the rear end electrode 16 and the front end electrode 17, as shown in FIG. The electrode 17 is pulled toward the hand and cut off in the pulling direction to give directionality.

As in the case of the electrodes described above, the output waveform of the high-frequency current and the distance between the electrodes are made variable, thereby
Desired performance can be realized in accordance with different lesions, excision quality, and coagulation quality. Also, the rear end electrode 16 and the front end electrode 1
Since the loop shape of 7 is made circular, treatment performance can be improved.

(Third Embodiment) A third embodiment of the present invention will be described with reference to FIG. This embodiment is different from the second embodiment in that the length of the distal electrode portion 16a of the rear electrode 16 in the surgical electrode 11 is longer than the distal electrode portion 17a of the distal electrode 17. is there. According to this, when excision of a lesion in the living body 20 such as an organ in a body cavity as shown in FIG. 6, the tip electrode 17 can be pushed out and excision in the pushing direction.

(Fourth Embodiment) A fourth embodiment of the present invention will be described with reference to FIG. This embodiment is different from the operation method in which a lesion is removed, and is a surgical operation method in which high-frequency current is applied by a roller electrode to rapidly evaporate water in cell tissue in a wide range and explosively evaporate. That is, in a form similar to that of the above-described embodiment, the front electrode 21 and the rear electrode 23 are provided on the electrically insulating electrode holding member 15. A cylindrical roller electrode 22 is provided at the tip of the tip electrode 21, and a cylindrical roller electrode 24 is provided at the tip of the rear electrode 23. Each of the roller electrodes 22, 24 is made of a conductive material. Each of the roller electrodes 22 and 24 rolls on the living body 20 when the tip electrode 21 and the rear end electrode 23 are moved back and forth while contacting the living body 20.

Then, the roller electrodes 22 and 24 are inserted into the body cavity, contact the roller electrodes 22 and 24 on the living body 20, apply a high-frequency current between the roller electrodes 22 and 24, and concentrate the high-frequency current on the living body portion therebetween. Let it evaporate. On this occasion,
If the distance between the roller electrodes 22 and 24 is changed and the output current is a plurality of incision, mixing, coagulation, and discharge hemostatic waveforms, desired quality can be achieved in accordance with the transpiration and coagulation sites.

In this case as well, the risk of burns due to unintended current concentration is avoided, and an electrode for evaporation in a clear current path at a short distance is realized by combining a plurality of electrodes. In addition, any one of the roller electrodes 22 and 24 can be freely selected to output a waveform current such as incision, mixing, coagulation, or the like, or both may be output.

(Fifth Embodiment) A fifth embodiment of the present invention will be described with reference to FIG. In this embodiment, the rear end electrode 25 is a loop-shaped electrode, and the front end electrode 26 is provided with a cylindrical roller electrode 27 at the front end in the same configuration as the above embodiment.

Then, a high-frequency current is applied between the loop-shaped rear end electrode 25 and the roller electrode 27, and the high-frequency current is concentrated in a portion therebetween to evaporate. At this time, since the area of the roller electrode 27 in contact with the living body is larger than that of the rear end electrode 25, the current is concentrated at the rear end electrode 25, the tissue is excised smoothly, and the patient electrode is removed at the roller electrode 27. With the same effect as above, the current is safely collected without cauterization. Then, the combination of the loop-shaped rear end electrode 25 and the roller electrode 27 forms the two electrodes 25 and 2.
If the distance between the radiators 7 is variable and the output current is a plurality of incision, mixing, coagulation and discharge hemostatic waveforms, a desired quality can be achieved in accordance with the transpiration and coagulation quality. Further, by preparing a plurality of output current waveforms, it is possible to stop hemostasis from a pinpoint at the rear end electrode 25 to a surface of the roller electrode 27 over a wide area. Also in this case, the risk of burn due to unintended current concentration is avoided, and a combination of a plurality of electrodes realizes ablation and transpiration electrodes in a clear current path at a short distance.

[Supplementary Notes] An electrosurgical electrode for applying a high-frequency current to a living body site in a body cavity to treat the living body site, wherein at least 2
It has one or more electrodes, a high-frequency current is passed between the electrodes, and the distance between the electrodes can be fixed or movable, and the plurality of electrodes as a whole maintain the positional relationship between the electrodes. An electrode for electrosurgery, wherein the electrode can be moved as it is or individual electrodes can be moved. 2. The electrosurgical electrode according to claim 1, wherein the electrodes have different radial lengths in a combination of loop electrodes. 3. The electrode according to claim 1, wherein the electrode is a roller electrode. 4. The electrosurgical electrode according to claim 1, wherein the electrode is a combination of a roller electrode and a loop electrode. 5. The high-frequency current is ablation waveform output, coagulation waveform output,
2. The electrosurgical apparatus or the resectoscope apparatus according to claim 1, wherein a plurality of output waveforms such as a mixed waveform output and a discharge coagulation waveform are applied independently or in combination.

[0026]

As described above, according to the present invention, a patient electrode to be attached to the external surface is unnecessary, and a high-frequency current is applied only to a short portion specified only between electrodes near a lesion. . As a result, a clear current path is formed, and there is no current concentration at an unintended location, thereby enhancing safety. In addition, since the distance between the plurality of electrodes is selectable, the cut-out tissue is clogged between the electrodes, and the output current fluctuates due to the individual variation of the current-carrying tissue cells between the electrodes, which is specific to the human body. It is possible to solve the problems that the quality of coagulation or the like cannot be kept constant and that it is not possible to cope with all of the differences in lesion tissues such as large lesions, small lesions, and flat wide lesions. Further, the present invention can cope with various types of output high-frequency currents even if there are a plurality of types, and has excellent effects such as improvement in safety and speed of operation.

[Brief description of the drawings]

FIG. 1 is an explanatory view schematically showing a system configuration of an electrosurgical apparatus according to a first embodiment.

FIG. 2 is a side view of the vicinity of a distal end of a surgical electrode of the electrosurgical apparatus.

FIG. 3 is a front view of the vicinity of a distal end of a surgical electrode of the electrosurgical apparatus.

FIG. 4 is an explanatory diagram of a use state of a surgical electrode according to a second embodiment.

FIG. 5 is an explanatory view of a use state of a surgical electrode of the electrosurgical apparatus according to the second embodiment.

FIG. 6 is a side view of the vicinity of a distal end of a surgical electrode according to a third embodiment.

FIG. 7 is a side view of the vicinity of a distal end of a surgical electrode according to a fourth embodiment.

FIG. 8 is a side view of the vicinity of a distal end of a surgical electrode according to a fifth embodiment.

[Explanation of symbols]

 Description of Reference Numerals 5 ... High frequency generation circuit 9 ... Output circuit 11 ... Electrosurgical electrode 15 ... Electrode holding member 16 ... Back end electrode 17 ... End electrode 20 ... Internal body organ 21 ... End electrode 22 ... Roller electrode 24 ... Roller electrode 23 Electrode 25: Rear electrode 27: Roller electrode

Claims (1)

[Claims] An electrosurgical electrode for electrically operating a living body part by supplying a high-frequency current to the living body part in a body cavity, comprising at least two or more electrode elements mounted on an electrode holding member, High-frequency current is passed between the electrode elements,
An electrode for electrosurgery, wherein a distance between the electrode elements is selectable, and at least one of the electrode elements is movable with respect to the electrode holding member.