JPS6133926Y2 - - Google Patents

Description

[Detailed description of the invention] [Technical field of the invention] This invention relates to a resectoscope that is inserted directly into the bladder from the urethra to perform treatment while visually checking the affected area (prostate). It is possible to completely remove the internal glands by inserting a stripper between the external prostate gland and the enlarged internal gland, and to separate the internal glands from the external glands.Moreover, the stripper can slide smoothly. This invention relates to a resectoscope prostate dissection device that allows appropriate treatment to be performed.

[Technical background of the invention and its problems] In recent years, endoscopes have been widely used for observing, diagnosing, and treating affected areas by inserting an insertion section into a body cavity. Conventionally, such an endoscope includes a resectoscope that is inserted into the bladder through the urethra and is configured to perform a treatment such as resection of the prostate gland using an electrode to which a high-frequency current is applied. This resect scope consists of a scope, an electrode, a resect sheath into which the scope and electrode are inserted, a grip protruding from the rear and lower part of the resect sheath, and a movable member that fixes the rear end of the electrode and is provided with a finger rest. , the finger of one hand is inserted into the grip of the resect sheath and the finger hook of the movable member, the grip movable member is slid, the two are brought close to each other, and the electrode is moved forward and backward within the resect sheath.

With conventional resectoscopes, when an enlarged intraprostatic gland is removed, electricity is applied to the protruding electrode extending from the tip of the resect sheath while looking directly through the scope. It is difficult to remove 100% of the enlarged intraprostatic glands as it poses a danger to the human body.
The disadvantage was that the remaining prostate gland enlarged again.

For this purpose, a detachment element is provided in a protruding shape or in a protrusive manner at the tip of the resect sheath, and this detachment element is inserted between the extraprostatic gland and the enlarged intraprostatic gland to detach the internal gland from the external gland. A resectoscope has been proposed. This resectoscope is constructed as shown in FIG. Reference numeral 1 denotes a resect sheath to be inserted into the urethra, and a water intake port 3 communicating with the inside of the sheath 1 is formed in a grip 2 formed at the base of the sheath 1. Reference numeral 4 denotes a scope, and this scope 4 has a light source connection part 5, and is further attached with an insertion part 6 that is inserted into the sheath 1 almost to the distal end, and an eyepiece part 4.
The front of the distal end of the sheath 1 can be viewed directly from a. Reference numeral 7 denotes a sliding body, which is provided with a finger hook 8 and is supported by a guide 9 provided between the eyepiece part 4a and the sheath 1 base so as to be movable back and forth. Connect the other end to the moving body 7 with the sheath 1
A spring 10 attached to the base side normally urges the eyepiece 4a to move backward toward the eyepiece 4a on the hand side. The sliding body 7 is designed such that the base of the spindle 11a of the peeling element 11 inserted into the sheath 1 can be removably fixed using a fixing member 12.
By moving the sliding body 7 forward, the separator, electrodes, etc. can be projected forward from the distal end of the sheath 1.

2 and 3 show an example of the distal end of the resectoscope shown in FIG.
The distal end swollen portion 1a is formed generally in the shape of a gutter so that it can slide on the inner wall surface of the lower half, and its distal end portion is formed in a tapered tongue shape. The support shaft 11a of this stripper 11 is formed of a rod-shaped member, and the base end of this member is removably attached to the slider 7 with the fixing member 12, as described in FIG. It is configured so that it can protrude forward from within the bulge portion 1a.

In a resectoscope configured like this,
When fixing the base end of the stripper 11 to the slider 7 with the fixing member 12, the distance l between the scope guide tube 7a of the slider 7 and the support shaft 11a of the stripper 11 on the slider side.
It is necessary to take a wide range of

However, with conventional resectoscopes,
The spindle 11a of the stripper 11 is made of a hard member and is formed more linearly than the distal end of the stripper 11. It is not possible to increase the distance l on the sliding body side. For this reason, the peeler 11
There was a problem that the peeling element 11 could not be securely fixed to the sliding body 7 and the peeling element 11 could not be slid smoothly.

[Purpose of the invention] In view of the above-mentioned points, the present invention enables the peeler to slide smoothly, and also provides a fixing member for the peeler on the sliding body, and it is possible to connect the scope guide tube of the sliding body and the peeler. It is an object of the present invention to provide a prostate dissection device for a resectoscope, which can widen the interval on the sliding body side and securely fix the dissecting element to the sliding body.

[Summary of the invention] The resectoscope prostate ablation device of this invention is
The spindle of the peeler is provided with a flexible portion or a crank-shaped bent portion so that the peeler can be easily and reliably fixed to the sliding body.

[Embodiments of the invention] Hereinafter, embodiments of the invention will be described based on the drawings.

Fig. 4 is a longitudinal sectional view showing the resectoscope according to the present invention, Fig. 5 is a perspective view showing the external appearance of the stripper shown in Fig. 4, and Fig. 6 is an enlarged view of the tip of the resectoscope shown in Fig. 4. FIG. 7 is a front view of FIG. 6.

As shown in FIG.
is composed of a scope 15, a handle 16 into which the scope 15 can be inserted and removed, and a sheath 17 which is detachably attached to the handle 16. The scope 15 is composed of an eyepiece section 18 and a scope insertion section 19a, and the scope 15 and the handle 16 are detachably connected via a connecting section 20 provided on the handle 16. The handle 16 is connected to the connecting portion 20 and the front fixing member 21.
are connected by a guide 22, and a sliding body 23 is slidably attached to the guide 22, and
The scope guide tube 19 is inserted into the sliding body 23, and the stripping element 2 is attached to the sliding body 23 by a fixing member 24.
The base of the support shaft 33 of No. 5 is fixed. A finger hook 26 is attached to the sliding body 23, and the sliding body 23 and the fixing member 21 are connected by a leaf spring 27. Further, the handle 16 and the sheath 17 are detachably connected to each other by a connecting portion 28 provided on the sheath 17. The sheath 17 has a connecting portion 2 with the handle 16.
8, a sheath body 29, and a sheath insertion part 30, and the sheath insertion part 30 has an outer tube 31 made of metal such as brass or stainless steel, and an outer tube 31 made of an insulating material such as epoxy resin or ceramic. tube 31
and a bulging tip portion 31a attached to the tip of the tube. A scope guide tube 19 is inserted into the internal passage of the outer tube 31 through the sheath body 29 and the connecting portion 28, and a separator 25 is inserted in parallel to the scope guide tube 19. As shown in FIG. 5, this peeler 25 has, for example, a tongue-shaped peeler body 32 formed at its tip, and a support shaft 33 for supporting the peeler body 32 is connected to this peeler body 32. Further, a rod-shaped flexible portion 34 is connected to the support shaft 33, and a peeler base portion 35 is connected to the rear end of this flexible portion 34. As shown in FIG.
The handle 1 is inserted through the through hole 21a provided in the handle 1.
6 side, and a peeler base 35 is fixed to the sliding body 23 by a fixing member 24. Therefore, the peeling element 25 can be bent at the sheath body 29 portion and inserted through the through hole 21a of the fixing member 21 disposed at a predetermined position. The distance between the guide tube 19 and the separator 25 on the handle 16 side can be increased.

In such a configuration, when the sliding body 23 on the handle 16 side is located on the eyepiece 18 side due to the biasing force of the spring 27, as shown in FIG.
The separator main body 32 is housed inside the bulging tip 31a of the outer tube 31. When the slider 23 is moved toward the sheath body 29 against the urging force of the spring 27, the peeler body 32 is removed from the bulging tip of the outer tube 31, as shown in FIGS. 6 and 7. It is in a state where it protrudes outward from 31a. In this state, the scope insertion section 19a is
The enlarged intraprostatic gland can be separated from the external gland using the detacher main body 32 while observing the prostate through the detacher main body 32.

FIG. 8 shows a second embodiment of the present invention of a peeler, in which instead of the support shaft provided with the flexible portion 34 shown in FIG.
The separator main body 32 is connected to a support shaft 36 having a crank-shaped bent portion 36a. and,
If this bending portion 36a is made to pass through the fixing member 21 of the handle 16 shown in FIG. 4, connected and fixed to the sliding body 23, and configured to move back and forth together with the sliding body 23, the same effect as in the case of FIG. 5 can be obtained. is obtained. Note that in this case, the support shaft 36 is made of a hard member.

In both the strippers shown in FIGS. 5 and 8, the stripper main body 32 is formed generally in the shape of a gutter, and its tip is formed in the shape of a tongue. The separator main body may be formed with such a shape as a slit so that the underside of the separator main body can be observed.

FIG. 9 shows a third embodiment of the present invention of a peeler, in which a peeler main body 37 is provided with a slit 38 for observation in the longitudinal direction of the peeler 25 approximately in the center, and the slit 38 is passed through the bottom of the main body 37. It is configured so that the sides can be observed.

FIG. 10 shows a fourth embodiment of the stripper according to the present invention, in which two slits 40 for observation are provided in the stripper main body 39 in the longitudinal direction of the stripper 25, substantially parallel to each other. In this case, in order to prevent the strength of the stripper main body 39 from decreasing due to the provision of the slit 40, the width b on the base side of the slit 40 is made narrower than the width a on the distal end side of the stripper. This makes it possible to prevent the peeler main body 39 from bending or the like. Incidentally, it is generally possible to provide a plurality of slits 40. However, when there is only one slit as shown in FIG. 9, the widths a and b may be approximately equal.

11 and 12 show a fifth embodiment of the peeler according to the present invention. For example, a peeler main body 42 provided with a slit 41 for observation is fixed to the upper or lower surface of a support shaft 43, and A coagulation guide 46 having an electrode 45 at its tip inside an insertion hole 44 provided in a shaft 43
The separator main body 42
The base end of the support shaft 43 is connected to the sliding body 23 shown in FIG.
As shown in FIG. 2, the stripper main body 42 can protrude from the outer tube bulging tip 31a, while the coagulation guide 4
6 can be made to protrude forward by operating the resectoscope on the proximal side. In this case, the coagulation guide 4
The base end on the proximal side of 6 is a fixing member 21 shown in FIG.
It is connected to a movable part (not shown) and can move forward and backward within the support shaft 43 by operating the movable part. With this configuration, bleeding from the ablation site can be appropriately coagulated and stopped using the electrode 45 provided at the tip of the coagulation guide 46 while observing it through the scope insertion part 19a, so that the visual field due to bleeding can be stopped. There is no turbidity and the internal glands can be removed safely and smoothly.

In addition, in FIGS. 9 to 12, a slit is provided in the separator body as a means for observing the lower side of the separator body, but the separator body 32 shown in FIGS.
The separator body may be formed of a transparent member so that the lower side of the separator body can be seen through.

[Effects of the invention] As described above, according to the invention, a flexible part or a crank-shaped bent part is provided on the support shaft of the stripper disposed in parallel with the scope guide tube, and the rear end is fixed to the sliding body. Therefore, when providing a fixing member for the stripping element on the sliding body, the distance between the scope guide tube and the peeling element on the sliding body side can be widened, and the separating element can be easily and reliably fixed to the sliding body. be able to. This has the effect that the separator can be slid smoothly, the outer diameter of the sheath can be made thinner, and appropriate treatment can be performed.

[Brief explanation of the drawing]

Figure 1 is an overall view of the resectoscope, Figure 2 is a perspective view showing an example of the distal end of a conventional resectoscope's prostatic dissection device, Figure 3 is a front view of Figure 2, and Figure 4 is a book. A sectional view showing an embodiment of the resectoscope prostate ablation device according to the invention, FIG. 5 is a perspective view showing the appearance of the ablation device of FIG. 4, and FIG.
FIG. 7 is a front view of FIG. 6, FIG. 8 is a perspective view of the second embodiment of the separator, and FIG. 9 is the third embodiment. FIG. 10 is a plan view showing the fourth embodiment, FIG. 11 is a perspective view showing the fifth embodiment, and FIG.
FIG. 2 is a front view of the separator shown in FIG. 11 inserted into the sheath. 4...Resect scope, 15...Scope,
16...Handle, 17...Sheath, 19a...
Scope insertion section, 19...Scope guide tube, 21
...Fixing member, 21a...Through hole, 22...Guide, 23...Sliding body, 24...Fixing member, 25...
...Separator, 27...Plate spring, 28...Connection part, 2
9...Sheath body, 30...Sheath insertion part, 31
...Outer tube, 31a...Bulging tip, 32, 37,
39, 42... Stripper main body, 33, 36, 43...
... Support shaft, 34 ... Soft part, 35 ... Peeler base,
36a...Crank-shaped folded portion, 38, 40, 41...
...slit, 44...insertion hole, 45...electrode, 4
6...Coagulation conductor.

Claims (1)

[Scope of utility model registration request] A resectoscope comprising a scope, a stripper, and a sheath into which the scope and the stripper are inserted, and a sliding part that fixes the rear end of the stripper and moves the stripper back and forth. A flexible part or a crank-shaped bent part is provided on the shaft part that supports the main body and moves it back and forth, and the rear end is connected and fixed to the sliding part, and the distance between the scope insertion part and the peeling element on the sliding part side is widened. A resectoscope prostate dissection device characterized in that it is configured to remove the prostate.