JPS61162941A - Cauterizing hemostatic apparatus - Google Patents

Abstract

(57) [Summary] This bulletin contains application data before electronic filing, so abstract data is not recorded.

Description

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

[Technical background of the invention and its problems] In recent years, by inserting an elongated insertion section into a body cavity,
BACKGROUND OF THE INVENTION Endoscopes that can perform diagnostic or therapeutic procedures within body cavities without requiring incisions from the body surface are widely used. In addition to observation means, this endoscope is generally provided with a hollow channel through which various treatment instruments are inserted.
Various therapeutic treatments can be performed under the visual observation of the operator using treatment instruments that are inserted through the channel and are appropriate for symptoms within the body cavity.

By the way, there are laser treatment devices that irradiate laser beams to coagulate blood when a tumor or the like in a body cavity is removed or as a means to stop bleeding from wounds such as ulcers, but at present, only those skilled in laser beam irradiation, etc. There are problems in that it requires a lot of time and is expensive.

For this reason, a device has been proposed that uses an ablation probe that can be inserted through the channel of an endoscope and energizes a heating coil installed at the tip of the ablation probe to coagulate the bleeding area that is pressed against it. .

However, with this heating coil type device, the responsiveness of the rise in temperature when coagulating blood and the fall of temperature during hemostasis is low, so the time required for coagulation is low.
Alternatively, there is a problem that the surrounding tissues other than the target site (wound) may be necrotized due to heat conduction to the surrounding tissues during the time until the probe cools down after solidification.

Therefore, Japanese Patent Application Laid-Open No. 58-69556 and Japanese Patent Application No. 58-69556,
No. 9-192277 proposes a high-speed heat-generating ablation probe that uses a heat-generating element with good heating and cooling responsiveness as an ablation probe that can be inserted into and passed through the channel of an endoscope. In these prior art devices, a non-adhesive coating is applied to the outer periphery of the heat-generating ablation probe that directly contacts the tissue to prevent it from sticking to the tissue during hemostasis by ablation. By the way, in the device, the non-adhesive coating is applied to the outer periphery of a hollow cylindrical cap having a hemispherical (arc-shaped) tip, and after the cap is fitted to the main body fixed to the tip of the elongated sheath. , the ends except for the nozzle portion formed in the direction of the outer circumferential axis are fixed with solder.

However, as mentioned above, a groove-shaped nozzle is formed in the axial direction of the outer circumference of the cap and the main body, so it is necessary to prevent the solder from going around the nozzle part, which is difficult in terms of workability. .

Furthermore, if solder flows into the groove-shaped nozzle, the groove of the nozzle must be cut and formed using a file or the like.

Further, the non-adhesive coating applied to the outer periphery of the cap gradually falls off with repeated use, and the non-adhesive effect deteriorates until the non-adhesive effect disappears. Therefore, it is necessary to apply a new anti-stick coating before the anti-stick effect disappears. However, if this non-adhesive coating (e.g. Teflon coating) is applied while the cap is fixed to the probe body, the baking temperature will be 400°C or higher. There is a problem that the Zener diode may be destroyed or deteriorated. Therefore, it is necessary to separate the cap and the probe body each time a non-adhesive coating is applied to the outer periphery of the cap, and there is a problem in that workability is poor when fixing the probe body with solder as in the prior art device at the time of separation. Furthermore,
After applying a non-stick coating to the cap, there are the aforementioned difficulties in fitting and securing the cap to the probe body.

[Object of the Invention] The present invention has been made in view of these circumstances, and it is possible to fix the cap and the probe body, the outer periphery of which is coated with non-adhesive coating, by using an engaging means instead of fixing with solder. It is an object of the present invention to provide a cautery hemostasis device that facilitates the removal of the hemostatic device.

Another object of the present invention is to facilitate alignment of the nozzle portion of the cap and the nozzle portion of the probe body in the case where a groove-shaped nozzle is provided in the direction of the outer circumferential axis of the cap and the probe body. An object of the present invention is to provide a cautery hemostasis device according to the present invention.

[Summary of the Invention] To achieve the above object, the cautery hemostasis device according to the present invention has the following features:
An ablation probe body that can be inserted into a channel of an endoscope and is provided at the tip of an elongated sheath and has a heating element inside; a hollow cylindrical cap that has a non-adhesive coating on its outer circumferential surface and an rflg tip; A removable engaging portion is provided at the probe body, and the cap is engaged and fixed to the probe body by engagement of the engaging portion.

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

1 to 5 relate to the first embodiment of the device of the present invention,
Figure 1 is a sectional view showing the ablation probe, Figure 2 is a perspective view showing the overall configuration of the device, Figure 3 is a sectional view taken along line A-A in Figure 1, and Figure 4 is the electrical and water supply connector at the base of the sheath. FIG. 5 is a partially cutaway front view showing the electrical connector, and FIG. 5 is a sectional view of the electrical connector.

As shown in FIG. 2, the ablation treatment device 1 includes a power supply box 3 provided with an operation panel 2 on the front, and an ablation probe device detachably connected to the power supply box 3 through an electrical connector 4 and a water supply connector 5. 6, a foot switch detachably attached to the power supply box 3 via a connector 8 provided on the cable 7, and a cleaning water tank 10 detachably attached to the side of the power supply box 3.

The ablation probe device 6 includes an elongated and flexible sheath 11, an ablation probe 12 connected to the tip of the sheath 11, and the electrical connector 4 and water supply connector 5 provided on the base side of the sheath 11. The sheath 11 and the cautery probe 12 at its tip can be inserted into a treatment tool channel of an endoscope (not shown), and the cautery probe 1-b 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 to energize a heating element 14 installed inside the ablation probe 12 at the tip, and the outer circumferential axis of the coaxial cable 13 inside the sheath 11 In this direction, a water supply channel 16 is formed for pumping cleaning water to a plurality of nozzles 15 formed on the outer periphery of the ablation probe 12. and,
The electric connector 4 and the water supply connector 5 on the base side of the ablation probe device 6 are connected to the power supply box 3, and the foot switch 9 is also connected to the connector 8 of the cable 7 to the power supply box 3. Main switch 3
a, and with the heating amount and cleaning water supply amount setting buttons 2a and 2b provided on the operation panel 2 selected and set, press the cleaning water supply side switch 9a of the foot switch 9.
By pressing , the water pump installed in the power supply box 3 is activated, and the cleaning water in the cleaning water tank 10 is passed through the water supply channel 16 in the sheath 11 and from the nozzle 15 on the outer periphery of the ablation probe 12 at the tip. By sending water toward the affected area in the body cavity to wash away blood, etc., or by pressing the heating switch 9b side of the foot switch 9, the heating element 14 in the ablation probe 12 at the tip is transmitted via the coaxial cable 13 in the sheath 11. It can be heated to a predetermined temperature by energizing it.

In addition, the power supply box 3 has a configuration in which the electric system for the cauterization power source and the water supply system for the water supply for washing water are housed in the same box, so for example, the top and bottom or left and right sides of the box 3 can be isolated. The manufacturing process is such that safety is ensured by separating the electrical system and water supply system in a separate chassis, and the manufacturing process can be completed by separately assembling each prefecture and then assembling both. It's also easy.

The details of the ablation probe 12 on the distal end side of the ablation probe device 6 are constructed as shown in FIGS. 1 and 3. That is, a main body 18 having a solid axial through hole 17 is connected and fixed to the distal end of an elongated flexible sheath 111, for example, a Teflon sheath, and the distal end is pressed against the wound on the outer periphery of the main body 18. As a heat transfer surface 19a for cauterizing and coagulating the wound, a hollow cylindrical cap 19 formed in a hemispherical surface (arc surface) and having good heat transfer is removably engaged and fixed. A concave portion 17a connected to the through hole 17 is formed on the distal end side of the main body 18, in which the distal end of the coaxial cable 13 inserted from the sheath 11 side is located, and the inner wall of the cap 19 facing the hemispherical heat transfer surface 19a is located. solder 20
For example, a Zener diode as the heating element 14 is joined at the heating element 14, and the tip of the core wire 13a of the coaxial cable 13 and the heating element 14 are electrically connected through the power transmission coil 21. Further, the heating element 14 is urged toward the soldering 20 side by a coil spring 23 whose one end is brought into contact with the inner wall of the recess 17 of the main body 18 via an insulating tube 22 such as a glass tube and an O-ring 22a. This is because when the heat generating element 14 is heated, the temperature reaches about 250°C, so the solder joining the heat generating element 14 starts to melt, and the heat generating element 14
This is to prevent instability. Also, in this way, the heating element 14 is fixed to the half date 2 by the coil spring 23.
Since the core wire 13a of the coaxial cable 13 is stabilized by being biased towards the 0 side, the connection between the core wire 13a of the coaxial cable 13 and the heating element 14 is performed by the power transmission coil 21 as described above. Furthermore, the O-ring 22a is for sealing water that enters from the sheath 11 side through the coaxial cable 13. The cap 19, which has a hemispherical heating surface 19a at its tip, is coated with a non-adhesive coating 24 such as a Teflon coating (Silverstone coating) on its outer periphery to prevent the cap 19 from sticking to tissue. . This is cap 19. The cauterization probe 12 is heated by the heat generated by the inner thigh heating element 14, and cauterizes and coagulates the bleeding part of the wound to stop the bleeding, and because it comes into direct contact with the tissue, it does not stick to the tissue or cause damage due to the cauterization probe 12. This prevents rebleeding. Furthermore, since the non-adhesive coating 24 on the outer peripheral surface of the ablation probe 12 is formed on a cap 19 that is separate from the main body 18, after applying the non-adhesive coating 24 to the cap 19, one cap is attached to the heating element 14. It is also assembled on the main body 18 side. Therefore, there is no risk of damaging or deteriorating the heating element 14, such as a Zener diode. However, in the past, the non-adhesive coating was performed after the hemispherical tip and the main body were joined, so the baking temperature of the non-adhesive coating was over 400 degrees Celsius, which destroyed the internal diode. There were problems such as deterioration.

On the other hand, the outer wire 13b of the coaxial cable 13 is twisted at the tip side to form a twisted part 13G, and this twisted part 13c
is connected to the main body 18 with solder 18b filled in a fixing hole 18a formed at the rear of the main body 18.

A plurality of nozzles 15 on the outer periphery of the ablation probe 12 are formed in a straight portion of the main body 18 and one cap. This nozzle 15... is formed into a groove shape by aligning a groove 15a and a slit 15b provided in the direction of the outer circumferential axis, and the rear end side communicates linearly with a water supply channel 16 formed in the sheath 11. On the other hand, the output side rises in a gentle arc shape from the direct part, and the output angle θ is 15
It is formed at a temperature of 16 degrees to 16 degrees. Also, the nozzle exit end
The distance to the tip of -112 is set to be greater than or equal to the radius of curvature of the hemispherical heat transfer surface 19a of P0-112.

By forming the nozzles 15 in this way, the cleaning water emitted from the nozzles 15 flows linearly along the outer circumferential axis direction of the ablation probe 12, and linearly flows forward of the probe 12. This makes it easy to target the area to be cleaned, and prevents the supplied cleaning water from going around the hemispherical heat transfer surface 19a.

One of the caps and the main body 18 are removably engaged with each other by an engaging portion. That is, the cap 19 and the main body 18
For example, an engagement hole 51 and a pin insertion hole 52 are formed in three equal parts at a circular position on the outer periphery of the area other than the nozzle 15, and a pin with a protrusion 53a is formed in the pin insertion hole 52. 53
is implanted to project a protrusion 53a, and the protrusion 53a is engaged with the engagement hole 51 of the cap 19 fitted to the outer periphery of the main body 18, thereby removably fitting and fixing the cap 19 to the main body 18. There is. Therefore, in this configuration, by fitting the cap 19 to the main body 18 and engaging the protrusion 53a of the bottle 53 to the engagement hole 51 of the cap 19, the slit 15b of the cap 19 forming the nozzle 15 and the main body 19 are connected. The groove portion 15a is aligned.

Further, an O-ring 54 is interposed between the tip of the main body 18 and the cap 19 for watertightness, and this O-ring 54 is an annular O-ring holding member with one end in contact with the cap 19 side. It is pressed against the main body 18 side at 55. This O-ring pressing member 55 is used to hold the O-ring when fixing the cap 19.
It also serves as an O-ring guide for inserting the ring 54 into the cap 19 side and fitting the tip of the main body 18 into the cap 19.

The electrical connector 4 and water supply connector 5 on the base side of the ablation probe device 6 are constructed as shown in FIGS. 4 and 5. That is, a water supply tube connection member 25 is connected to the sheath 11v&end, an electrical connector 4 is connected to the rear end of this connection member 25, and a water supply tube 26 is connected to the side of the connection member 25. The electrical system and the waterway system are separated at this part, and each coaxial cable 13 is inserted into the sheath 11.
and the water supply channel 16 are inserted therethrough. Further, a coil 26a is installed inside the water supply tube 26, and the water supply tube 26 is equipped with a coil 26a.
6 has improved breakage prevention and bending resistance. The main body 27 of the connecting member 25 has a through hole 28 in the direction of the central axis, through which the coaxial cable 13 extending from the sheath 11 side passes through, and extends toward the electrical connector 4 at the rear. Further, this main body 27 has a connecting cap 29 having a tapered outer periphery protruding forward, and the rear end of the sheath 11 is fitted into this cap 29. A male thread is formed on the rear outer periphery of the base 29 of the main body 7, and a retaining ring 30 having a tapered downward restraining ring 30a on the inner periphery is screwed into the male thread.
The rear end of the sheath 11 fitted with the tapered downward restraining ring 30a
It is fixed by pressing. Further, there is an annular fitting groove 30b between the tapered retaining ring 30a provided on the inner circumference of the retaining ring 30 and the inner circumferential surface of the retaining ring 30, and an annular fitting groove 30b is provided on the base side of the sheath 11 in this groove 30b. The rear end of the anti-bending tube 31 is fitted and fixed. A recess 32 connected to the through hole 28 is formed on the rear end side of the connecting portion main body 27, and this recess 32
A female thread is formed on the inner periphery of the electrical connector 4, and an electrical connector 4 having a male thread at the tip is screwed together for connection. Furthermore, this connecting portion main body 27 has a two-stage recessed portion 3 in the side portion that communicates with the through hole 28.
3, a female thread is formed on the inner periphery of the inner small-diameter recess 33a of this recess 33, and a joint 34 having a male thread of the water supply tube 26 is screwed into the joint 34. Outer large diameter recess 33b
An O-ring 35 is interposed between the base and the bottom to ensure watertightness.

In this way, the water supply tube 26 communicates with the through hole 28 of the connection part main body 27 via the joint 34, and this n through hole 28
The outer periphery of the coaxial cable 13 inserted inside and the through hole 2
8 inner periphery is the water supply channel 16a, and this connection part main body 27
It communicates with the water supply channel 16 of the sheath 11 which is fitted and connected to the sheath 11. A female thread is formed on the inner periphery of the recess 32 of the connecting portion main body 27, and a retaining screw 36 having a coaxial cable through hole 36a is screwed into the retaining screw 36.
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 with a retaining screw 36 to connect the water supply channel 16a side and the rear electrical connector 4 side. The electrical system and waterway system are separated to ensure watertightness.

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

On the other hand, a coaxial cable 13 is extended inside the electrical connector 4 connected to the rear end of the connection body 27, and this cable 13 is connected to a contact via a variable resistor 41 in addition to a fixed resistor 40. ing. The reason why the variable resistor 41 is inserted in this way is due to variations in the Zener voltage of the Zener diode serving as the heating element 14, or due to variations in the Zener voltage of the cable 13.
This is because it is necessary to adjust so that a constant current flows regardless of the variation in the resistance value of the variable resistor 41.
This facilitates the adjustment and improves workability.

FIG. 6 shows a second embodiment of the engaging portion between the cap and the main body of the device of the present invention. In this embodiment, a protrusion 61 is integrally provided on the outer periphery of the main body 18, and the protrusion 61 is engaged with an engagement hole 62 formed in the cap 19.

FIG. 7 shows a third embodiment of the engaging portion between the cap and the main body of the device of the present invention. In this example, cap 1
A protrusion 63 is integrally provided on the inner circumference of the cap 18, and an engagement hole 64 is formed on the outer circumference of the main body 18 opposite to the protrusion 63. It is designed to be engaged with.

Although not shown in the drawings, the engaging portion may be configured such that a female thread is formed on the inner periphery of the cap and a male thread is formed on the outer periphery of the main body, and the cap is screwed and fixed. In this case, the thread is formed so that the slit of the gap and the groove of the main body match to form a nozzle part when fixed. Furthermore, the engaging portion may be used in various ways other than those described in E.

[Effects of the Invention] As explained above, according to the present invention, the cap whose outer periphery is coated with a non-adhesive coating and the probe body can be fixed by the engaging means without using solder, thereby facilitating the fixing work. effective.

[Brief explanation of the drawing]

1 to 5 relate to one embodiment of the device of the present invention, FIG. 1 is a sectional view showing the ablation probe, FIG. 2 is a perspective view showing the overall configuration of the device, and FIG. 3 is the same as that shown in FIG. A-A line sectional view,
Fig. 4 is a partially cutaway front view showing the electrical and water supply connector at the base of the sheath, Fig. 5 is a cross-sectional view of the electrical connector, and Figs. 6 and 7 show the second and third embodiments of the device of the present invention. FIG. 3 is a cross-sectional view of the cap and main body with the internal structure omitted. 11... Sheath 12... Cauterization probe 14
... Heating element 18 ... Cap 19 ... Main body 51 ... Engagement element 52 ... Pin insertion hole
53...Pin 61...Protrusion 62...
Engagement hole 63...Protrusion 64...Engagement hole agent Patent attorney Susumu Ito Figure 5 Figure 4I Figure 6 Figure 7 Procedures fj7j-E (spontaneous) December 24, 1985 1 , Incident Display 1985 Patent Application No. 2700 2
, Title of the invention: Cautery hemostasis device 3, Relationship to the person making the amendment Patent applicant address: 2-43-2 Hatagaya, Shibuya-ku, Tokyo Name (037) Olympus Optical Industry Co., Ltd. Representative Toshibe Shimoyama 4. Agent 5. Date of amendment order (voluntary)

Claims (4)

[Claims] (1) An ablation probe is provided at the tip of a slender sheath through which a channel for a treatment instrument of an endoscope can be inserted, and a heating element is disposed within the probe to use the probe tip surface as a heat transfer section. A probe having a non-adhesive coating applied to the outer periphery of the probe to prevent it from sticking to tissue, the probe comprising a main body and a hollow cylindrical cap having a non-adhesive coating applied to the outer periphery and a closed tip,
A cautery and hemostasis device characterized in that both are removably engaged and fixed by an engagement means. (2) The cautery and hemostasis device according to claim 1, wherein the engagement means is configured by providing an engagement hole in the cap and a protrusion integrally or separately in the main body. (3) The cautery and hemostasis device according to claim 1, wherein the engagement means includes a protrusion on the cap and an engagement hole on the main body. (4) The cautery and hemostasis device according to claim 1, wherein the engaging means is a screw provided on the cap and the main body.