JPS61164546A - Cauterizing treatment 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] [Industrial Application Field] The present invention relates to an ablation treatment device that is used endoscopically to cauterize and stop bleeding in a body cavity, and specifically relates to a watertight structure at the tip of the ablation probe. Regarding.

[Conventional technology]

In recent years, by inserting an elongated insertion section into the body cavity,
Endoscopes are widely used to perform diagnostic or therapeutic procedures inside body cavities without requiring incisions from the body surface.These endoscopes generally include various treatment instruments in addition to observation means. A hollow channel is provided through which the patient is inserted, and by inserting a treatment tool according to the symptoms of the affected area into this channel, various therapeutic procedures can be performed under the visual observation of the operator. Therefore, we used a cautery loop that can be inserted into the channel of an endoscope, and by energizing a heating coil installed at the distal end of the cautery loop, we coagulated the bleeding area that was pressed against it. Special R Showa 58-6955
Publication No. 6)

This prior art device includes a spring mounting portion 102 and a braided securing portion 6.
2, a small amount of epoxy is applied to form a seal 70 to prevent fluid from entering the cylindrical cavity 80. In addition, the watertight structure between the shell 40 and the main body 420 has not been described and is not taken into consideration. (Liquid may have entered the cylindrical cavity 80.) Also, although the space between the spring mounting portion 102 and the braided fixing portion 62 is made liquid-tight with epoxy, the epoxy seal does not allow pinholes to form. (Also, even if a pinhole occurs, it cannot be seen with the naked eye, so it is difficult to make it liquid-tight.)And if water enters the cylindrical cavity 80, it will cause damage inside the tip of the probe. There has been a problem in that short circuits, etc. occur within the probe tip, putting the patient in a dangerous situation.This invention was made to address these problems, and aims to prevent short circuits, etc. from occurring within the probe tip. The purpose is to provide a safe ablation treatment device.

[Means for Solving the Problems and Their Effects] The distal end 80 of the cautery glove in this device has a cylindrical main body 82 having a through hole 81 in the axial direction. A bottomed cylindrical cap portion #83 having thermal conductivity is provided. A heating element 85 is thermally connected to the inner bottom portion 84 of the cap member 83 . A heating element 8 is provided in the through hole 81 of the main body 820.
A power supply wire 86 for feeding 51C power is inserted through the power supply type s86, and this power supply type s86 is coated with insulation and has a conductor exposed portion 90 near the first heating element 85. And cap part #8
3 and the main body 820 and between the main body 82 and the insulating coating part 87, watertight members 88 and 89 are provided respectively, and the conductor exposed parts 9 of the heating element 85 and the power supply wire 86 are interposed.
Make 0 liquid tight.

〔Example〕

Hereinafter, the present invention will be described in detail with reference to the drawings.

Figures 2 to 6 show an embodiment of the present invention, and the ablation treatment device 1 includes a power supply box 3 with an operation panel 2 on the front, and an electrical connector 4 connected to the power supply box 3.
and a cautery door 6 which is detachably connected to the water supply connector 5; a seven-point switch 9 which is detachably attached to the power supply box 3 via a connector 8 provided on the cable 7; It consists of a cleaning water tank lO which is removably attached to the side VcN.

The cautery plug 6 includes an elongated and flexible sheath 1.
1, a distal end 12 following the distal end of the sheath 11, and the electrical connector 4 and water supply connector 5 provided on the base side of the sheath 11, and the sheath 11 and its distal end 12 are connected to an endoscope (not shown). It can be inserted into the treatment instrument insertion channel of 5, and the distal end of the cauterizing poug is introduced into the body cavity through this channel. Inside the sheath 11, a coaxial goople 13 serving as a power supply wire is inserted through the axial center and a heating element 1 is disposed inside the distal end portion 12.
4, and this sheath 11
Coaxial Google 13 inside, cauterized Prug 12 on the outer axial direction
A water supply channel 16 for pumping cleaning water is formed into a plurality of holes 15 formed on the outer periphery. Then, the electrical connector 4 and water supply connector 5 on the base side of the ablation probe 6 are connected to the power supply box 3#'C, and the 7-point switch 9 is connected to the power supply box 3, and the connector 8 of the Google 7 is connected to the power supply box 3. 3, turn on the main switch 3a, and select and set the heating amount and cleaning water supply amount setting buttons 2a and 2b provided on the operation panel 2, and press the cleaning water supply side switch 9a of the 7-button switch 9. By doing so, the water pump installed in the power supply box 3 is activated to supply the clean water in the wash water tank/reservoir to the sheath 1.
1 through the water supply channel 16 to the /sole 15 of the tip 12 external station.
... to the affected area in the body cavity to wash away blood, etc. from the affected area, and by pressing the heating switch 9b side of the 7-way switch 9.
3, power is supplied to the heating element 14 in the tip portion 12 so that it can be heated to a predetermined temperature.

In addition, the power supply box 3 has a configuration in which an electric system for the cauterization power source and a water supply system for supplying cleaning water are installed in the same box. Safety is ensured by isolating the electrical system and water supply system by isolating them with an isolation chassis, and the system can be completed by separating and assembling each section separately and then assembling both. It also makes the manufacturing process easier.

The details of the distal end portion 12 of the cautery plug 6 are constructed as shown in FIGS. 3 and 4. That is, a main body 18 having a solid axial through hole 17 is subsequently fixed to the distal end of an elongated flexible sheath 111, for example, a defugin sheath, and the distal end is pushed onto the outer periphery of the main body 18 into a wound. A cap 19 is attached and fixed as a bottomed cylindrical cap member having a hemispherical surface (arc surface) #'C formed as a heat transfer surface 19a for cauterizing and coagulating the wound and having good heat transfer.

The through hole 17 has #! from its tip side. 1st to 3rd
Consisting of hole portions 17m, 17b, and 17c, the first and second holes are
A stepped portion 17d is provided at the trailing portion of the holes 17a and 17b. Further, the coaxial googly 13 has a core wire 13
a, an insulating coating 13b covering the entire core wire, and an outer R
It consists of a net-shaped shield M13c provided on the wire, and an insulating coating 13d that covers the entire shield wire, and on its tip side,
Parts of the insulating coatings 13b and 13d are removed, and the core wire 13a is exposed in the hole 17m, forming a part of the exposed conductor part 70. The shield Is13e is exposed in the hole 17c. The exposed shield wire 13c is twisted to form a joint portion 13e.

The main body 18 has a circumferential protrusion 18m protruding from its tip, and a plurality of pistons on the side circumference of the protrusion 18m, avoiding the nozzle 15.
A protruding portion 8b is provided at its proximal end portion, which is formed to have a small diameter and has a plurality of stepped portions at its outer portion, and is provided with a trailing portion 18a that follows the end portion of the sheath 11. A groove is provided on the outer periphery of the trailing portion 18c so as to be continuous with the nozzle 15, so that the nozzle 15 and the water supply channel 16 are communicated with each other. Also, subsequent part 1
A hole 18d is drilled in the hole 8e, and the tip of the connecting portion 13e of the shield wire is connected to the end of the connecting portion 13e. By positioning it in this hole 18d and soldering it with heat-resistant solder, resin-cored solder, or the like, the main body 18 and the shield @ 13c are electrically connected. The coaxial googly 13 is fixed by adhesive 66Vc at the end of the trailing portion 18c. In addition, hole 1
8d Instead of liquid, the third hole 17c may be filled with solder.

A Zener diode, for example, serving as the heat generating element 14 is soldered to the inside M (inner bottom portion) 71 of the cap 19 opposite to the hemispherical heat transfer surface 19m using solder 20 . In addition, the cap 9 is attached to the side circumference of the cap 19 on the main body 18.
A groove is formed at a position corresponding to the noil 15, and a hole is formed at a position corresponding to the pinot 18b.

By fitting the pin 18b into this hole, the cap 19 is removably fixed to the main body 18, and the main body 18 and the camp 19 are electrically connected.

The core wire 13m of the coaxial cable and the heating element 14 are electrically connected to each other by an electrically conductive member such as a power transmission coil 21 (a part of the exposed conductor portion 70). A glass tube serving as an insulating tube 22 is provided on the outer periphery of this power transmission coil 21 . An O-ring as a watertight member 60 is provided at the rear end of the insulating tube 22 and interposed between the outer periphery of the insulating sheath 13b (forming an insulating sheath) of the coaxial googly 13 and the first hole 17a. Being ignored.

A coil spring serving as the biasing member 23 is provided interposed between the watertight member 60 and the stepped portion 17d. Further, an annular member 61 is provided on the circumferential portion of the cap 19 in contact with a stepped portion 19b provided at the inner end of the cap 19. - An O-ring as a watertight member 62 is interposed between the outer circumference of the circumferential protrusion 18m of the main body 18 and the inner circumference of the cap 19, and the annular member 61 allows the watertight member 62 to close the circumferential protrusion 18m. It prevents it from coming off. In addition, the heating element 14 includes a shield $113c,
Body 1g, cap 19. For a common voltage (ground level) followed through solder 20°, core wire 13. A drive voltage is supplied via the conductor exposure @70.

The heating element 14 includes an insulating tube 22 and a watertight member 6.
The solder 2011 is biased by the biasing member 23 via the solder 2011 via the biasing member 23. This means that when the heating element 14 is heated, it is approximately 25
This is to prevent the solder joining the heating element 14 from melting and making the heating element 14 unstable since the temperature is around 0υ.

Also, the heating element 14 is soldered 2 by the biasing member 23.
As the coaxial cable 13 and the heating element 14 are energized and stabilized at 0° C., the power transmission coil 21 is used to connect the coaxial cable 13 and the heating element 14 as described above.

a cap 19 having a hemispherical heat transfer surface 19m at the tip;
has a non-adhesive coating 24 on its outer periphery to prevent the cap 19 from sticking to tissue, e.g. 7-71.
:1 coating (silver stone coating)
is applied. This is cap 19. The tip part 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 may not stick to the tissue or cause damage due to it. This prevents rebleeding. Also, since the non-adhesive coating 24 on the outer surface of the tip 12 is formed on a cap 19 that is separate from the main body 18, after applying the non-adhesive hood 24 to the cap 191C, the cap 19 is attached to the heating element 14. It is also assembled on the main body 18 side. Therefore, there is no risk of destroying or deteriorating the heating element 14, such as a Zener diode. However, in the past, the non-adhesive coating was applied after the hemispherical tip and the main body were joined, so the baking temperature of the non-adhesive coating was over 400°C, which caused the internal diode to be destroyed. There were problems such as deterioration or deterioration.

A plurality of holes 15 on the outer periphery of the tip portion 12 are formed in straight portions of the main body 18 and the cap 19. The /sole 15 is formed in a groove shape in the direction of the outer circumferential axis, and its rear end side is linearly connected to the water supply channel 16 formed in the sheath 11, and its exit side is a straight section. It rises in a gentle arc shape, and the output angle θ is 15 degrees to 16 degrees.
It is formed at the same time. Further, the distance from the nozzle output end to the tip of the prong tip 12 is set to be greater than or equal to the radius of curvature of the hemispherical heat transfer surface 19i. By forming the slits 15 like this 5, the cleaning water emitted from the slits 15 . Water can be fed in a straight line to the previous area, which makes it easy to target the area to be washed, and also prevents the fed washing water from going around the hemispherical heat transfer surface 19a.

The electrical connector 4 and water supply connector 5 on the base side of the cautery plug 6 are constructed as shown in FIGS. 5 and 6. That is, at the rear end of the sheath 11, the water supply tube succeeding member 2 is attached.
5 is followed by an electric connector 4 at the rear end of this succeeding member 25, and a water supply tube 26 is followed by a side part of the succeeding member 25, and the electrical system and waterway system are separated at this part. , the coaxial goople 13 and the water supply channel 16 are inserted into the sheath 11, respectively. The subsequent member 250 main body 27
has a through hole 28 in the central axis direction, through which the coaxial goggle 13 extending from the sheath 11 side is inserted, and extends in the direction of the electrical connector 4 at the rear. Further, this main body 27 has a trailing cap 29 having a tapered outer periphery protruding forward, and the rear end of the sheath 11 is fitted into this cap 291C. A male thread is formed on the rear outer periphery of the metal 29 of the main body 270, and a retaining ring 30 having a tapered depression restraining ring 30a is screwed onto the inner periphery of the male thread, and the sheath 11 is fitted into the base 29. The rear end is pressed and fixed by a taper depression ring of 30 m. In addition, a ring is fitted on the base side of the 7-seat 11 in an annular fitting groove 30b formed between the T-push-down restraining ring 30 & provided on the inner circumference of the retaining ring 30 and the inner circumferential surface of the retaining ring 30. The rear end of the anti-bending tool 31 is fitted and fixed. A recess 32 connected to the through hole 281'C is formed on the rear end side of the following main body 27. A female thread is formed on the inner circumference of the recess 32, and an electrical connector 4 having a male thread at the tip is screwed into the recess 32 for subsequent connection. . Furthermore, this trailing portion main body 27 is provided with a two-stage recessed portion 33 on the side thereof which communicates with the through hole 28#c. A female thread is formed on the inner periphery of the inner small-diameter recess 33m of this recess 33, and the end of the joint 34 which follows the end of the water supply tube 26 is screwed into a male thread having a rounded bottom. 7 joints 34a protruding from the outer periphery of this joint 34
An O-ring serving as a watertight member 35 is interposed between the outer large-diameter recess 33b and the bottom surface of the outer large-diameter recess 33b to ensure watertightness. In this way, the water supply tube 26 is connected to the rear main body 2 through the joint 34.
7, and between the outer periphery of the coaxial googly 13 inserted into this through hole 28 and the inner periphery of the through hole 28 is a water supply channel 16 m, and this trailing portion main body 27#C is fitted and connected to the It communicates with the water supply channel 16 of the sheath 11. A female thread is formed on the inner periphery of the recess 32 of the succeeding section main body 27, and a presser screw 36 having a coaxial goggle through hole 36& is screwed therein, and the tip of the presser screw 36 and the axial through hole 28 are screwed together. Alternatively, an O-ring as a watertight member 65 is interposed between the external station of the coaxial group 13 and the watertight member 65 is pressed by the retaining screw 36 to make watertight between the water supply channel 16a side and the rear electrical connector 4 side. As a result, the electrical system and waterway system are separated.

The water supply tube 26 and the joint 34 are tapered.
It is subsequently fixed with screws 37. Moreover, inside this water supply tube 26, a coil 26 is installed along the entire length of the tube.
1 is inserted, and a connector 5 is provided on the rear end side. The connector 5 has a plug 38 and this plug 3.
8 and a cap screw 39 screwed into the hole. plug 3
The end of the water supply tube 26 is fixed to the connector 5 by the 0 part 38& provided at the end of the water supply tube 8 and the inner rmy-bar part of the cap screw 39.

A coaxial goggle 13 is partially extended into the electrical connector 4 following the rear end of the trailing portion main body 270,
This Google 13 is connected to the contact via a variable resistor 41 in addition to a fixed resistor 40. In this way, the variable resistor 41
The reason for this is that it is necessary to ensure that a constant current flows regardless of variations in the Zener voltage of the Zener diode used as the heating element 14, or variations in the resistance value of the Google 13, etc. This variable resistor 41 facilitates the adjustment and improves workability. Note that the coogle 13 is located in the recess 3.
There is enough slack within 2.

This invention is not limited to the above-described embodiments, but can be modified extensively. That is, the watertight member 62 may be provided interposed between the main body 18 excluding the /seal 15 and the inner bottom portion 71 and the cap 190.

In addition, the watertight part #60 excludes the exposed conductor part 70 of the coaxial googly 13 (the main body 18 and the insulating coating part of the coaxial googly 13).
13b to 13d). At any rate, at least the heating element 14 and the conductor exposed portion 7
It is only necessary that the parts to which the drive voltage is applied with respect to a common potential such as 0 (shield wire 13c, main body 18, cap 19, solder 20, etc.) can be made watertight. However, it goes without saying that there is no problem even if the parts to which the common potential is applied are made watertight. Further, the power supply wire does not need to be the coaxial Google 13, but two wires are prepared for the common voltage and the drive voltage, and two through holes 17 are prepared in the main body 18, respectively, as in the above embodiment. It may be sealed to make it watertight. In addition, the main body 18
．． Cap 19. Instead of using the solder 20 for the common potential, another electric wire is inserted into the main body 18 to connect the heating element 14.
A common potential may be supplied to both.

[Effect of the Invention J As described above, according to the present invention, the heat generating element and the exposed conductor part in the tip of the glove can be reliably made liquid-tight, so short circuits etc. do not occur, and it is safe.

[Brief explanation of the drawing]

FIG. 1 is a diagram illustrating the present invention. Figures 2 to I
Figure IE6 shows an example of this invention, Figure 2 is a perspective view showing the overall configuration of the device, Figure 3 is a cross-sectional view showing the tip side of the cauterizing poogle, and Figure 4 is Figure 3. N-IT in
5 is a partially cutaway front view showing the electrical and water supply connectors at the base of the cautery glove, and FIG. 6 is a sectional view of the electrical connectors. l...Ablation treatment device, 6...Ablation plug, 12°80--Tip part, 13-Coaxial coogle, 14.85...
・Heating element, 17.81-・Through hole, 18.82-・Body, 19...Cap, 60, 62, 88.89・
・・Watertight member-70, 90・-Conductor exposed part, 71.84
... Inner bottom part, 83 - Cap member, 86 - Power supply wire, 87 - Insulation coating part. Proceedings No. 5245 (spontaneous) 1985 Patent Application No. 5245 2, Name of Invention Cauterization Treatment Device 3, As per the appendix for amendment (1) Page 3, lines 15 to 16 of the clear filing There was a problem in which the patient was in danger. Correct j as follows. ``Since the probe loses its ability to generate heat, the operator has to remove the probe from the scope and reinsert a new probe, which is cumbersome.
There was a problem in that it caused more pain to the patient. ” (2) Amend ``Safe, no failures'' on page 3, line 18 of Light 11m to ``No failures will occur.'' (3) Correct "1 press, etc. hit" on page 7, line 12 of the specification pt to "hit". (4) [ in the 5th line of page 18 of Book 11 of Akira does not occur and it is safe. " is corrected to "No failure occurs." Patent applicant Olympus Optical Industry Co., Ltd. Ni'mata C

Claims (1)

[Claims] In an ablation treatment device that supplies electricity to a heating element provided in the tip of an ablation probe that has an elongated sheath that can be inserted into a treatment tool channel of an endoscope, generates heat, and uses this heat to cauterize and stop bleeding at a bleeding site. The distal end of the ablation probe includes a cylindrical body having a through hole in the axial direction, a cylindrical cap member with a bottom that is external to this body and has heat conductivity, and a heat conductive cap member on the inner bottom of the cap member. a heating element connected to the main body; an insulated power supply wire that is inserted through a through hole of the main body to feed power to the heating element and has an exposed conductor portion in the vicinity of the heating element; the cap member and the main body; An ablation treatment device comprising a watertight member interposed between the main body and the insulating coating of the power supply wire.