JPS6133927Y2 - - Google Patents

Description

[Detailed Description of the Invention] This invention relates to a resectoscope electrode used as a high-frequency cauterization forceps in a resectoscope.

This type of resectoscope is used to observe and treat an affected area within a body cavity when performing surgical treatment such as prostatectomy. The overall configuration of this resectoscope is shown in FIG. In FIG. 1, a resect scope 1 includes a scope 2 and a resect sheath 3 into which the scope 2 can be inserted and removed. This scope 2 consists of an eyepiece part 4 and a scope insertion part 5, and the resect sheath 3 is comprised of an operating handle 6 and a sheath insertion part 7. The scope 2 and the resect sheath 3 are connected to a connecting part 8 as described later.
are connected via. The sheath insertion section 7
The outer tube 9 is formed into a thin cylindrical shape from metal such as brass or stainless steel, and is formed into a cylindrical shape with an open bottom side from a heat-resistant insulating material such as epoxy resin or ceramic, and is attached to the tip of the outer tube 9. Tip insulating member 10
It is composed of. A scope insertion portion 5 and an electrode 12, which will be described later, are inserted into the internal passage of the outer tube 9.

Moreover, the operating handle portion 6 of the resect sheath 3
A fixed member 13 disposed at the rear end of the outer tube 9, a movable member 15 slidable along a guide shaft 14 protruding in the axial direction from behind the fixed member 13, and the fixed member 13 and the movable part. The rear end of the electrode 12 is removably fixed to the movable member 15, and the main body member 4
Grip 17 protruding from the bottom of 2 and movable member 15
The electrode 12 is configured to move toward the insulating member 10 at the distal end of the resect sheath 3 when a finger is placed on a finger hook 18 provided therein and the two are brought close to each other against the biasing force of the leaf spring 16. A water supply port 19 which can be opened and closed is provided in the main body member 42 and communicates with the inside of the outer tube 9 so that water for cleaning can be supplied to the internal passage.

The electrode 12 is disposed in the sheath insertion section 7 in parallel with the scope insertion section 5, and its tip electrode is formed into a loop shape, for example, and is configured to resect the affected area (prostate) while being heated with electricity. ing.

The tip insulating member 10 fixed to the tip of the sheath outer tube 9 prevents the loop at the tip of the electrode 12 from coming into contact with the metal sheath outer tube 9, thereby preventing accidents such as electric shock.

By the way, as a conventional method for attaching and fixing the distal end insulating member 10 to the distal end of the sheath outer tube 9, there is one shown in FIGS. 2 and 3. In the fixing method shown in FIG. 2, an insertion groove 20 is formed in the distal insulating member 10, and the distal end of the sheath outer tube 9 is inserted and fixed into the insertion groove 20. With this configuration, a wide gap can be created between the outer periphery of the scope insertion portion 5 and the inner periphery of the distal insulating member 10, so the diameter of the electrode 12 can be increased, and as a result, the resection operation can be performed easily and reliably. . Incidentally, the scope insertion portion 5 and the electrode 12 are maintained at a sliding blood pressure by a stabilizer 21.

However, this distal insulating member fixing structure has a disadvantage that the outer periphery of the distal insulating member 10 protrudes outward from the outer periphery of the sheath outer tube 9, making its diameter thicker and difficult to insert into the lumen.

In the fixing method shown in FIG. 3, an engaging step 22 is formed on the outer periphery of the distal insulating member 10, and the sheath outer tube 9 is inserted and fixed into the engaging step 22. In this configuration, contrary to the above, the diameter of the distal insulating member 10 is formed to be the same as the diameter of the sheath outer tube 9, and insertion into the lumen is easy.

However, with this fixed configuration, it is not possible to provide a wide gap between the outer periphery of the scope insertion part 5 and the inner periphery of the distal insulating member 10, so the diameter of the electrode 12 has to be reduced, resulting in poor operability of the electrode 12. However, there is the disadvantage that reliable excision treatment is difficult.

This idea was made in view of the above points, and consists of a scope, electrodes, and a resect sheath into which the scope and electrodes are inserted. In a resect scope in which the inner periphery of the distal insulating member fixed to the distal end of the resect sheath protrudes inwardly from the inner periphery of the resect sheath, the upper part of the electrode is extended at least over the range of movement of the electrode over the distal insulating member. By crushing it into a flat shape to form a stepped part and making the cross-sectional area of this part the same as that of other parts, the gap between the outer periphery of the scope insertion part and the inner periphery of the tip insulating member is narrower than other parts. Even in cases where the electrode is moved forward and backward, the electrode can be smoothly moved forward and backward without reducing the diameter of the electrode, and the diameter of the electrode can be made thicker to provide rigidity, and as a result, the operability of advancing and retracting the electrode can be improved. It is an object of the present invention to provide a resectoscope that allows resection operations to be performed easily and reliably.

This invention will be specifically explained below with reference to the drawings. 4 to 6 show an embodiment of this invention. Fig. 4 is a sectional view showing the structure of the tip of the resectoscope of this invention, Fig. 5 is a front view showing the overall structure of the electrode, and Fig. 6 is A--A in Fig. 5.
It is a sectional view taken along the line A'. In these figures, the number 3
Reference numeral 1 denotes a sheath outer tube, and a distal insulating member 33 having an engaging stepped portion 32 on the outer periphery is inserted and fixed at the distal end, and the outer diameter of the distal insulating member 33 is set to the sheath outer tube 3
1, the inner circumference of the tip insulating member 33 protrudes inward from the inner circumference of the sheath outer tube 31. Therefore, this tip insulating member 33
The gap between the inner circumference and the outer circumference of the scope insertion section 34 is narrower than the gap between the other sheath outer tubes 31 and the scope insertion section 34. Also, the scope insertion section 34
The electrode 35 is slidably held by a stabilizer 36, and the electrode 35 moves back and forth within the sheath outer tube 31. In the electrode 35, the periphery of the conductive wire 43 is covered with an insulating tube 37, and the outer periphery of the electrode 35 is further covered with an outer tube 38, and the insulating tube 37 is exposed from the outer tube 38 at a part of the tip. An electrode loop 39 protrudes from the tip, and a connecting member 40 is further connected to the rear end. The electrode 35 is connected to the outer tube 38 and the insulating tube 3 in order to retract its inner protruding surface within the range of movement relative to the distal insulating member 33.
The upper part of each of the parts 7 is pressed into a flat shape to form a stepped part 41. The cross-sectional area of this stepped portion 41 is
The cross-sectional area of the other portions of the electrode 35 is the same. Incidentally, the conductive wire 43 at the stepped portion 41 may also be formed into a flat shape.

In such a configuration, when the inner periphery of the tip insulating member 33 protrudes inward and the gap with the outer periphery of the scope insertion portion 34 is narrower than in other parts, the electrode 35 that advances and retreats over this part is It can be retracted without reducing the diameter, provides the necessary rigidity, and improves operability.

As described above, this invention includes forming a step by flattening the upper part of the electrode at least over the range of advancement and retraction of the electrode on the tip insulating member, and also changing the cross-sectional area of this part and the cross-section of other parts. By making the area the same, even if the gap between the outer periphery of the scope insertion part and the inner periphery of the tip insulating member is narrower than others, the electrode can move smoothly forward and backward without reducing the diameter of the electrode. Further, the electrode can be fully formed with a large diameter to provide rigidity, and as a result, the operability of advancing and retracting the electrode can be improved, and the excision treatment operation can be performed easily and reliably.

[Brief explanation of drawings]

Fig. 1 is a front view showing an example of a resect scope in which this invention is implemented, Figs. 2 and 3 are sectional views showing the tip structure of a conventional resect scope, and Figs. Showing an example of the idea,
FIG. 4 is a sectional view showing the configuration of the distal end of the resectoscope, FIG. 5 is a front view showing the entire electrode, and FIG. 6 is an enlarged sectional view taken along line A-A' in FIG. 31... Sheath outer tube, 33... Tip insulating member,
34... Scope insertion part, 35... Electrode, 41...
...Step part of the electrode.

Claims (1)

[Scope of utility model registration request] It consists of a scope, an electrode, and a resect sheath into which the scope and electrode are inserted. A resect scope whose inner periphery protrudes inward from the inner periphery of a resect sheath, characterized in that a stepped portion is formed on the electrode at least over a range in which the electrode extends and retreats over the tip insulating member.