JPS61168344A - 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 hemostasis device that is used transendoscopically to cauterize and stop bleeding from a bleeding wound, and in particular to The present invention relates to a cautery and hemostasis device that makes it easy to target the affected area by irradiating light and attaching a sniping marker to the cautery probe.

[Technical background of the invention and its problems 1 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 the observation means, this endoscope is generally equipped with a hollow channel through which various treatment instruments are inserted, and the operator can perform visual observation using the treatment instruments according to the symptoms inside the body cavity inserted through this channel. Various therapeutic procedures can be performed underneath.

By the way, there are laser treatment devices that irradiate laser beams to coagulate blood as a means to stop the bleeding of wounds such as those removed from tumors or ulcers in body cavities, but at present, the laser beam irradiation requires skill. However, there are also problems in that the cost is high.

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 after hemostasis is low, so the time required for coagulation,
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 Laid-Open No. 58-69556 discloses a high-speed heat-generating ablation probe that can be inserted into the channel of an endoscope and uses a heat-generating element with good heating and cooling response. There is. This prior art device is
The probe is equipped with a nozzle and has the function of discharging a cleaning fluid that is pumped through the catheter to clean blood from the wound and make it easier to find bleeding sites that require coagulation.

However, all of the conventional cautery hemostasis devices, including the one described in JP-A-58-69556, are used transendoscopically, and have a fine endoscope insertion section. The ablation probe is inserted into the body cavity through the endoscope, and is projected forward from the tip of the endoscope to press the tip of the ablation probe against the bleeding area to stop the bleeding. Since there is a parallax between the observation window of the endoscope and the observation window of the endoscope, aiming the tip of the ablation probe at the affected area must rely on the operator's intuition and requires a high degree of skill.

[Objective of the Invention 1] The present invention has been made in view of these circumstances, and is a method of emitting visible light from the tip of an ablation probe in the axial direction to illuminate the body cavity wall that is in front of the tip of the ablation probe in the axial direction, thereby marking a marker. To provide a cautery and hemostasis device that can be attached to a bleeding area, and can therefore easily and reliably aim the tip of a cautery probe at the bleeding area by aligning the marker with the bleeding area, and can quickly perform hemostasis treatment. It is intended to.

[Summary of the Invention] In order to achieve the above object, the cautery hemostasis device according to the present invention has the following features:
An ablation probe is provided at the tip of an elongated sheath that can be inserted into the treatment instrument channel of the endoscope, and a fiber for transmitting visible light is installed inside the sheath or the ablation probe, and the fiber is used to transmit visible light to the tip of the ablation probe. A marker exit window is provided to emit the visible light axially forward, and a marker is attached to the body cavity wall located axially forward of the ablation probe using the emitted visible light.

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

1 to 3 relate to the first 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 a sectional view taken along the line A--A in FIG. 1.

As shown in FIG. 2, the cautery hemostasis device 1 includes a power supply box 3 provided with an operation panel 2 on the front, and an ablation probe device 6 detachably connected to the power supply box 3 through an electrical connector 4 and a water supply connector 5. , a foot switch 9 which is detachably attached to the power supply box 3 via a connector 8 provided on the cable 7, and a cleaning water tank 10 which is 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 ablation probe 12 at its tip can be inserted into a treatment instrument channel of an endoscope (not shown), and the ablation probe 12 is introduced into the body cavity through this channel.

A coaxial cable 13 is inserted into the sheath 11 in the axial direction to energize a heating element 14 installed inside the cautery tip 0-112. A water supply channel 16 is formed in the direction of the outer circumferential axis to forcefully feed cleaning water to a plurality of nozzles 15 formed on the outer circumference of the ablation probe 12 . and,
The electrical connector 4 and water supply connector 5 on the base side of this ablation probe device 6 are connected to the power supply box 3, and the foot switch 9 also connects the connector 8 of its cable 7 to the power supply box 3, and the main power supply of the power supply box 3 is connected to the power supply box 3. switch 3
a, and with the heating m1 and wash water flow rate setting buttons 2a and 2b provided on the operation panel 2 selected and set, turn on the wash water feed 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 rest cavity to wash away blood, etc., or by pressing the heating switch 9b side of the foot switch 9, the heating element in the ablation probe 12 at the tip is heated via the coaxial cable 13 in the sheath 11. 14 and 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 separating them using an isolation chassis, and the manufacturing process can be completed by separating and assembling each prefecture and then assembling both. It also makes the process easier.

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, the main body 18 having a solid axial through hole 17 is connected and fixed to the distal end of an elongated flexible sheath 119, 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 having a hemispherical surface (arc surface) and having good heat transfer is attached and fixed. The main body 18 has a recess 17 connected to the volume adjustment hole 17 on the distal end side.
a is formed and the tip of the core wire 13a of the coaxial cable 13 inserted from the sheath 11 side is located, and the inner wall opposite the hemispherical heat transfer surface 19a of the cap 19 is soldered 20.
For example, a Zener diode as the heating element 14 is joined at the heating element 14, and the tip of the coaxial cable core wire 13a 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. This is to prevent the heat generating element 14 from becoming unstable due to melting of the solder joining the heat generating element 14, since the temperature of the heat generating element 14 reaches approximately 250° C. when heated. Also, like this, coil spring 2
3, the heating element 14 is biased toward the soldering 20 side to stabilize it, and the coaxial cable core wire 13a and the heating element 1
4 is connected by the power transmission coil 21 as described above. Furthermore, the outer wire 13b of the coaxial cable 13 is electrically connected to the rear part of the main body.

a cap 19 having a hemispherical heat transfer surface 19a at the tip;
A non-adhesive coating 24 such as a Teflon coating (Silverstone coating) is applied to the outer periphery of the cap 19 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-stick coating 24 to the cap 19
is assembled to the heating element 14 and the main body 18 side. Therefore, there is no risk of destroying or deteriorating the heating element 149, such as a Zener diode. However, in the past, the structure was such that non-adhesive coating was performed after joining the hemispherical tip and the main body, so the baking temperature of the non-adhesive coating was over 400°C, which destroyed the internal diode. There were problems such as deterioration.

A plurality of nozzles 15 on the outer periphery of the ablation probe 12 are formed in straight portions of the main body 18 and the cap 19. This nozzle 15... is formed in a spiral shape in the direction of the outer circumferential axis, and the rear end side communicates linearly with the water supply channel 16 formed in the sheath 11, while the output side is gently sloped from the direct part. It rises in an arc shape, and the output angle θ is 15
It is formed at 1ff to 16 degrees. Further, the distance from the nozzle output end to the tip of the probe 12 is set to be greater than or equal to the radius of curvature of the hemispherical heat transfer surface 19a of the probe 12. By forming the nozzle 15 in this way,
The cleaning water emitted from the nozzles 15 is caused to flow linearly along the outer circumferential axis direction of the ablation probe 12.
2. Water can be sent in a straight line forward, which makes it easy to aim at the area to be washed, and also prevents the delivered washing water from going around the hemispherical heat transfer surface 19a. Note that the main body 18 is formed with heat radiation grooves 18a for cooling.

One or more fibers 25 for transmitting visible light are inserted into the sheath 11, the probe body 18, and one cap from the proximal side. This fiber 2
5 is buried in a groove 26 formed in the direction of the outer circumferential axis of the coaxial cable 13 as shown in FIG.
Alternatively, it is arranged along the inside of the water passage 16. In addition, the fiber 25 is inserted into a groove 27 formed in the axial direction of the inner wall of the through hole 17 and the recess 17a so as to communicate with the groove 26 in the sheath 11, for example. . Furthermore, the fiber 25 is inserted into the insertion hole 28 in the four-fold tube 19, which is formed so as to communicate with the recess 17a of the main body. And the aforementioned Gi 1! The insertion hole 28 of the knob 19 (the cautery probe 12 is placed in the center of the tip)
It communicates with a marker exit window 29 formed in the axial direction. The output end of the fiber 25 faces the two marker output windows, and the visible light transmitted through the fiber 25 is output from the center of the tip of the ablation probe 12 forward in the axial direction as a marker. The visible light is used as a marker by a helium-neon laser.

An argon laser or the like is used. The proximal side of the fiber 25 is connected to a light source device (not shown).

In this configuration, before pressing the ablation probe 12 against the bleeding site in the body cavity, visible light is emitted axially forward from the marker exit window 29 to illuminate the affected area against which the tip of the ablation probe 12 is pressed, thereby attaching a marker. Buryo cautery probe 12
By setting the position and moving the ablation probe 12 forward in the axial direction in this state, the tip of the probe 12 can be accurately pressed against a predetermined bleeding site.

FIG. 4 shows a second embodiment of the ablation probe of the present invention.

In this embodiment, a visible light transmission fiber 25 is sheathed into a sheath 11.
A heating coil 31 is inserted as a heating element of the ablation probe 12 in the central axis direction of the ablation probe 12, and a lead wire 32 inserted from the proximal side is connected thereto. Therefore, visible light as a marker is emitted from the tip of the ablation probe 12 forward in the central axis direction.
As in the first embodiment, the ablation probe 1 can be easily and accurately
2 Tips can be aimed at the affected area.

[Effects of the Invention] As explained above, according to the present invention, it is possible to emit visible light in the axial direction from the tip of the ablation probe to illuminate the body cavity wall that is in front of the tip of the ablation probe in the axial direction to attach a marker. Therefore, by aligning this marker with the bleeding area, the tip of the ablation probe can be easily and reliably aimed at the bleeding area, and furthermore, the bleeding can be stopped quickly.

[Brief explanation of the drawing]

1 to 3 relate to the first 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, Fig. 3 is a sectional view taken along line A-A in Fig. 1, and Fig. 4 is a second embodiment of the present invention. FIG. 11... Sheath 12... Cauterization prow 114.
...Heating element 25...Fiber 29...Marker exit window

Claims (1)

[Claims] An ablation probe is provided at the tip of an elongated sheath that can be inserted into the treatment instrument channel of the endoscope, and a fiber for transmitting visible light is installed inside the sheath or the ablation probe, and the fiber is used to transmit visible light to the tip of the ablation probe. What is claimed is: 1. A cautery and hemostasis device characterized by being provided with a marker exit window that emits visible light axially forward.