JPS6171040A - Cauterization 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 [Technical Field of the Invention] The present invention relates to an ablation treatment device that is used endoscopically to cauterize and stop bleeding from a bleeding wound. This relates to cauterization treatment H''JJ in which blood, etc. from the wound is washed away.

[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. This endoscope is generally equipped with a hollow channel in the center of the observation means through which various treatment tools are inserted, and the operator visually observes the symptoms using the treatment tools that are passed through the channel. Various therapeutic procedures can be performed underneath.

By the way, if a tumor, etc. in a body cavity is removed, or if an ulcer, etc.
There is a laser treatment device that coagulates blood by irradiating a laser beam as a blood treatment method for a 1 m mouth, but at present it has problems such as requiring skill to irradiate the laser beam and high cost. There is.

For this reason, a device has been proposed that uses a cautery probe that can be inserted into the channel of an endoscope and energizes a heating coil placed inside the distal end of the cautery probe, thereby coagulating the pressed bleeding part.

However, with this heating coil type device, the responsiveness of the rise in temperature 11 when coagulating blood and the fall of temperature after hemostasis is low, so the time required for coagulation or the probe after coagulation is low. There is a problem in that during the time it takes for the wound to cool down, heat conduction to the surrounding tissue causes necrosis of the surrounding tissue other than the target area (wound).

Therefore, Japanese Unexamined Patent Publication 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 delivering a cleaning fluid that is pumped through the catheter to clean blood from the wound and make it easier for the instrument to locate bleeding sites that require coagulation.

However, in the prior art device, the specific configuration and shape of the nozzle for causing the cleaning liquid to flow along the outer circumferential axis of the probe is not disclosed. Further, this device has an electric system that supplies electricity to the ablation probe and a water channel system that pumps the cleaning liquid, but a separate structure for the two is not disclosed.

[Object of the Invention] The present invention has been made in view of these circumstances, and it is possible to clean the ablation probe by flowing the cleaning liquid under pressure through the water passage in the elongated sheath in a straight line along the axial direction of the outer circumference of the ablation probe. The liquid can be sent forward, making it easy to aim at the desired location, and the cleaning liquid being sent out does not go around the tip of the cautery probe, which presses against the wound to coagulate and transfers heat to the wound. The purpose of the present invention is to provide an ablation treatment device with a

[Summary of the Invention] In order to achieve the above object, the ablation treatment device according to the present invention has the following features:
A spiral nozzle that communicates with the liquid passage provided in the sheath is formed in the direction of the outer circumferential axis of the ablation probe, which is provided at the tip of an elongated sheath that can be inserted into the channel of the endoscope and has a heating element inside. The emission angle of the groove-shaped nozzle is set to 20 degrees or less, and the cleaning liquid discharged from the groove-shaped nozzle is configured to flow along the outer circumferential axis of the ablation probe and to be delivered in a straight line.

[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 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 connectors at the base of the sheath, and FIG. 5 is a sectional view of the electrical connectors.

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 6 detachably connected to the power supply box 3 through an electrical connector 4 and a water supply connector 5. It is comprised of a wattage 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 are inserted into the center of the treatment tool channel of the endoscope (not shown), and the ablation probe 1 at the tip
2, through which the ablation probe 12 is introduced into the body cavity.

Inside the sheath 11, a coaxial cable 13 is arranged to energize a heating element 14 formed in the axial direction, and a plurality of nozzles 15 formed on the outer periphery of the ablation probe 12 are arranged in the axial direction of the tip of the sheath 11. A water supply channel 16 is formed to forcefully feed the cleaning water. Then, the electrical connector 4 and water supply connector 5 on the base side of the ablation probe device 60 are connected to the power supply box 3, and the watt switch 9 also connects the connector 8 of the cable 7 to the power supply box 3. By turning on the main switch 3a and selecting and setting the heating amount and cleaning water supply amount setting buttons 2a and 2b provided on the operation panel 2, press the cleaning water supply side switch 9a of the foot switch 9. The water pump installed in the power supply box 3 is activated to direct the cleaning water in the cleaning water tank 10 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 to the affected area in the body cavity. By supplying water to wash away blood, etc. from the affected area, or by pressing the heating switch 9b side of the foot switch 9, electricity is applied to the heating element 14 in the ablation probe 12 at the tip via the coaxial cable 13 in the sheath 11 to maintain a predetermined temperature. It can be heated to.

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. In addition to ensuring safety by isolating the electrical system and water supply system by separating them in a separate chassis, each prefecture is separated and assembled, and then both are assembled. The manufacturing process has also been made 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, a main body 18 having a solid shaft-direction penetration 7L17 is connected and fixed to the distal end of an elongated flexible sheath 119, for example, a Teflon sheath, and the distal end of the main body 18 is pressed against a wound on the outer periphery of the main body 18, and the distal end of the main body 18 is pressed against the wound. Heat transfer surface 19a that cauterizes and solidifies
It is constructed by attaching and fixing one hollow cylindrical cap having a hemispherical surface (arc surface) and having good heat transfer.

The main body 18 has a recess 1 connected to the channel hole 17 on the tip side.
7a is formed and the tip of the coaxial cable 13 inserted from the sheath 11 side is located, and the inner wall facing the hemispherical heat transfer surface 1.98 of the cap 19 is soldered 20 to form a heating element 14, for example. A Zener diode is connected, and the tip of the coaxial cable 13 and the heating element 14 are electrically connected by a power transmission coil 21. Further, the heating element 14 is urged toward the soldering 20 side by a 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 heating element 14 from becoming unstable due to melting of the solder joining the heating element 14, since the heating element 14 reaches a temperature of about 250°C when heated. be. In addition, since the coil spring 23 biases the heating element 14 toward the soldering 20 side and stabilizes it, the connection between the coaxial cable 13 and the heating element 14 is made using the power transmission coil 21 as described above. Is going.

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. Also, since the non-adhesive coating 24 on the outer surface of the ablation probe 12 is formed on a cap 19 that is separate from the main body 18, the non-adhesive coating 24 on the outer surface of the ablation probe 12 is
After applying the non-stick coating 24 to the cap 19
ill (=1) is added to the side of the heating cord 14 and the main body 18.Therefore, there is no risk of destroying or deteriorating the heating element 141, for example, a Zener diode.However, conventionally, the hemispherical tip and the main body are joined together. Since the structure was such that the non-adhesive coating was applied after the coating was applied, there was a problem that the baking temperature of the non-adhesive coating was 400° C. or higher, which caused the internal diode to be destroyed or deteriorated.

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 groove shape in the direction of the outer circumferential axis, and the rear end side is linearly connected to the water supply channel 16 formed in the sheath 11, while the output side is directly connected to the water supply channel 16 formed in the sheath 11. It rises in a gentle arc shape, and the Tagawa angle θ is 15.
It is formed at a temperature of 16 degrees 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 120. By forming the nozzles 15 in this way, the cleaning water emitted from the nozzles 15 can be transferred to the cauterization probe 1.
2. The probe 12 is caused to flow linearly along the outer circumferential axis direction.
Water can be fed straight forward, 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 1.9a. Incidentally, the main body 18 is formed with a heat dissipation groove No. 1a for cooling.

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 duplex connection member 25 is connected to the rear end of the sheath 11, 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 water channel system are separated at this location, and the coaxial cable 13 and water water channel 16 are inserted into the sheath 11, respectively. The main body 27 of the connecting member 250 has a through hole 28 in the central axis direction, through which the coaxial cable 13 extending from the sheath 11 side passes and extends in the direction of the rear electrical connector 4.

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 spout 29 of the main body 7, and a retaining ring 30 having a tapered retaining ring 30a on the inner periphery is screwed into the male thread, and the sheath is fitted into the base 29. The rear end of 11 is pressed and fixed by a tapered presser ring 30a. Further, an annular fitting groove 30b is provided 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 the retaining ring 30 has an annular fitting groove 30b.
The rear end of a folded duplex 31, which is provided on the base side of the sheath 11, is fitted and fixed therein.

The rear end side of the connecting portion main body 27 is formed with four parts 32 that are connected to the through hole 28, and a female thread is formed on the inner periphery of the four part 32, and an electrical connector 4 having a male thread at the tip is screwed and connected. Furthermore, this connecting portion main body 27 has a two-step four part 33 on the side that communicates with the through hole 28, and this four part 33
A female thread is formed on the inner periphery of the four inner small diameter portions 33a, and a joint 34 having a male thread of the water supply tube 26 is screwed into the inner periphery of the four inner small diameter portions 33a. O ring 3 between
5 is installed to ensure watertightness.゛As shown in this □, the water supply tube 26 communicates with the through hole 28G, -' of the connection part main body 27 via the joint 34, and the outer periphery of the coaxial cable 13 inserted into this through hole 28 and the inner periphery of the through hole 28. A water supply channel 16a is formed between the connecting portion main body 27 and communicates with the water supply channel 16 of the sheath 11 which is fitted and connected to the connecting portion main body 27. Further, a female thread is formed on the inner periphery of the deep part of the recess 32 of the connection portion main body 27, and a presser screw 36 having a coaxial cable through hole 36a is screwed therein. An O-ring 37 is interposed between the outer periphery of the coaxial cable 13 and the O-ring 37 is held by a screw 36.
The electric system and the waterway system are separated by pressing the waterway 16a side and the rear electrical connector 4 side watertightly.

The water supply tube 26 and the joint 34 are connected and fixed by a tapered screw 37. Also, this water supply...
The nefter 5 (provided on the rear end side of the plug 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 is due to variations in the Zener voltage of the Zener diode as the heating element 14, or due to the cable 1.
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.
11 facilitates the adjustment and improves workability.

[Advantageous Effects of the Invention 1] As explained above, according to the present invention, the cleaning liquid that is force-fed through the water passage in the elongated sheath is flowed in a straight line along the axial direction of the outer circumference of the ablation probe, and the liquid is sent to the front of the ablation probe. This makes it easy to aim at the area to be cleaned, and there is also an effect that the cleaning liquid sent out does not go around the tip of the cautery probe which presses against the wound to be coagulated and transfers heat to the wound.

[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, and FIG. 5 is a sectional view of the electrical connector. 6... Cauterization probe 11... Sheath 12...
Cautery probe 14... Heating element 15... Nozzle 16... Water supply procedure correction
Written by Mr. Manabu Shiga, Chief of the Patrol Agency, December 27, 1981.
(Sumi 1. Indication of Matter A'1 1987 Special Revised Application No. 192277 2. Title of the invention: Cautery therapy device d 3. Relationship between the person making the amendment and the case Special i! [Applicant's office: Shibuya 1, Tokyo Habagaya 2-43-2
Name (037) Olympus Optical Industry Co., Ltd. 71 Representative Satoshi Shimoyama Department 4, Agent 5, Date of amendment order (voluntary) 6, Subject of amendment 121 Scope of request for correction 7, Contents of amendment As shown in the attached sheet 1. The scope of claims is amended as follows. [A cautery probe is provided at the tip of a slender sheath that can be inserted into the treatment instrument channel of the endoscope at equal length, and a heating element is disposed within the probe to use the probe tip surface as a heat transfer section. A liquid passage extending from the base side to the probe is provided, and a groove-shaped nozzle communicating with the liquid passage is formed in the direction of the outer circumferential axis of the ablation probe, in which the cleaning liquid discharged from the groove-shaped nozzle is disposed along the outer circumferential axis of the ablation probe. The exit angle of the nozzle is set to 2 so that the liquid flows in a straight line.
An ablation treatment device characterized by having a temperature of 0 degrees or less. "that's all

Claims (1)

[Claims] A cautery probe is provided at the tip of an elongated sheath through which a treatment tool channel of an endoscope can be inserted, and a heating element is disposed within this probe to use the tip surface of the probe as a heat transfer portion.
A liquid passage extending from the base side to the probe is provided in the sheath, and a groove-shaped nozzle communicating with the liquid passage is formed in the axial direction of the outer circumference of the ablation probe, wherein the cleaning liquid discharged from the groove-shaped nozzle is applied to the outer circumference of the ablation probe. The exit angle of the nozzle is set at 20° so that the liquid flows along the axial direction and is delivered in a straight line.
A cautery treatment device characterized in that the temperature is less than 100%.