JPS62122651A - Rotary incision type rejectoscope - 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 [Field of Industrial Application] The present invention relates to a rotary ablation type resectoscope having a structure in which an ablation electrode is rotationally driven.

[Prior Art] In recent years, endoscope devices that can diagnose and perform therapeutic treatments within body cavities without requiring incisions have been widely used.

For example, when the prostate is enlarged, a sheath through which an optical tube for observation and an electrode for ablation are inserted is inserted into the endoscopic device, and the ablation electrode is moved back and forth under observation with the optical tube. There is a resectoscope that can remove enlarged prostate glands.

The resectoscope that performs ablation by moving the ablation electrode back and forth is generally operated manually, which has low ablation efficiency and is inconvenient when other operations are performed at the same time.

For this reason, for example, in the resectoscope disclosed in German DE 331 325, the ablation electrode is rotationally driven by a rotational drive means to perform ablation.

Rotation by the rotary drive means in this manner is advantageous in that the resection efficiency can be improved compared to when manually moving back and forth, the resection operation becomes easier, and the resection treatment can be performed by a smaller number of people.

[Problems to be Solved by the Invention] However, in the conventional example described above, the structure of the rotationally driven electrode has not been clarified, so it cannot be actually constructed.

The present invention has been made in view of the above-mentioned points, and provides a rotary ablation type resectoscope that can safely and reliably transmit high-frequency current and that can easily perform the rotational ablation electrode tB2. The purpose is to provide.

[Means and effects for solving the problems] The present invention includes a gripping portion to which an optical viewing tube is attached and a rotation drive means built-in, and a gripping portion detachably attached to the gripping portion and a detachable portion to the sheath. The rotary ablation electrode is rotatably supported between the provided front body and the rotary ablation electrode is rotatably driven by the rotation driving means.

[Example] Hereinafter, the present invention will be specifically described with reference to the drawings.

1 to 11 relate to a first embodiment of the present invention, FIG. 1 shows the vicinity of the connection part to which the rotary ablation electrode part and the front main body part are attached in the first embodiment, and FIG. The resectoscope of the first embodiment is shown disassembled, and FIG. 3 shows the ring-shaped contact on the rotatably driven electrode mounting member side and the contact part on the stator side, and FIG. 4 shows the rear end surface of the rotating resection electrode part. FIG. 5 shows a sectional view of the gland A-0-A' in FIG. 4, FIG. ) shows the contact member with the rotary ablation electrode connected, FIG. 7 shows a cross section of the front part of FIG. 5, and FIG. 8 shows the rotary ablation electrode with the sheath attached. 9 shows the shape of the front body, FIG. 10 shows a cross section taken along the line c-c' in FIG. 9, and FIG. 11 shows a cross section taken along the line D-D' in FIG. 9. .

As shown in FIG. 2, the rotary ablation type resectoscope 1 of the first embodiment includes a resectoscope gripping part (rigid scope gripping part) 2 having a built-in rotation driving means, and the resectoscope gripping part (hereinafter referred to as "rigid scope gripping part"). , simply referred to as a grip section) 2 for observation, which is detachably attached to a portion near the upper end, and an insertion section 4 of the optical tube 3 in the grip section 2 to which the optical tube 3 is attached. A rotary excision electrode section 5 is attached coaxially and removably to the outer circumferential side of the rotary excision electrode section 5, and a rotary excision electrode section 5 is attached to the outside of the rotary excision electrode section 5 to rotatably support the rotary excision electrode section 5 while preventing it from coming off. By connecting a connector to the front main body part 6, the hollow sheath part 7 to which the front main body part 6 can be attached and detached, and the grip part 2, high frequency current can be supplied to the rotary ablation electrode part 5. It is comprised of a high frequency power supply section 8 and a control device section 9 that performs various controls.

The optical viewing tube 3 has a light guide cap 12 protruding from the side of an operating section 11 provided with a large diameter at the rear end of the insertion section 4, and a light guide cable is connected to the cap 12. Illumination light is supplied from the light source device 13, passes through the light guide inserted into the insertion section 4, and is emitted from the tip toward the object. However,
The object illuminated with this illumination light is imaged by an imaging optical system disposed at the tip of the insertion section 4, and the formed image is transferred to the operation section 11 side by an image transmission means such as a relay lens system. transmitted to,
After passing through the eyepiece lens in the eyepiece section, magnified observation can be performed from one side.

As shown in FIG. 1, the grip part 2 to which the optical viewing tube 3 is detachably attached has a built-in motor 15 as a rotation driving means at the lower part of the portion through which the optical viewing tube 3 is inserted.

The rotation axis of this motor 15 is coaxial with the optical viewing tube 3,
A timing belt 19 is passed between the electrode mounting member 18 which is rotatably supported by bearings 16 and 17 on the outer circumferential side, and the electrode mounting member 18 is rotationally driven by rotating the motor 15. It is possible to do so.

Incidentally, the rotation start and rotation of the motor 15 can be operated by a push button switch 21 at the front of the motor 15.

The electrode mounting member 18 is formed of an insulating material into a substantially cylindrical shape, and is interposed between the outer periphery of the front part in the axial direction and the rear end, which is tapered in step shape, between the electrode mounting member 18 and the outer periphery side member. It is rotatably supported by bearings 16 and 17.

For example, two holes in the electrode mounting member 18 facing each other at an angle of 1804 are provided with through holes in the axial direction, and the high frequency electrode conductors 22 and 22 are inserted into the insulated tube, and the rear end is attached to the outer periphery of the electrode mounting member 18. Hardened cylindrical member 18
It is connected to a concentric ring-shaped contact 23 via an L-shaped metal fitting cap attached to -. (In addition, in Fig. 1, the optical viewing tube 3
It is not shown as a plane passing through the central axis of the body, but as a cross-section cut out at an angle of 90 degrees, and therefore only one hemipelium 22 is shown. ) At this contact point 23, as shown in FIG. 3, for example, a contact point 24a at the tip of a single-shaped electrode 24 fixed to the stator of the gripping part 2 contacts the inner surface of the concentric ring, and a contact point 24a on the stator side contacts the inner surface of the concentric ring. On the other hand, the high frequency current is transmitted to the contact 23 on the rotor side which is rotationally driven. This electrode 24 is connected to the high frequency power supply unit 8 via a lead wire.

The front end of each high-frequency electrode conductor 22 is exposed from the covering tube and serves as a connection contact 22a held by a holder 25, and is shaped to protrude forward within the recess at the front end of the electrode mounting member 18.

Thus, the connection part 26 at the rear end of the rotary ablation electrode part 5 can be connected to the electrode 22a.

That is, as shown in FIG. 1, FIG. 4, or FIG. 5, the connection portions 26 on the side of the rotary ablation electrode portion 5 are provided at two symmetrical positions on the substantially ring-shaped or cylindrical insulating mounting member 27. A disc-shaped insulating contact holding member 2 is placed inside the through hole.
8.28, the rear ends of the two excision wires 29.29 are held on these contact holding members 28.28, and the contact members 3o are electrically connected to the rear ends of each excision wire 29 by soldering or the like (
and fixed to the contact holding member 28). Incidentally, the thick solid line in FIG. 5 indicates the outer shape of the rear end portion of the rotary ablation electrode section 5.

As shown in FIG. 6(a), each of the contact members 30 is formed into a substantially mouth shape inside the cylindrical recess of the mounting member 27, and its tip is narrower than the outer diameter of the high frequency current contact 22a. The high frequency current contact 22a is formed into a loop shape.
By inserting it toward the end, the tip expands as shown in FIG. 6(b), and the high-frequency current contact 22a is pinched to establish electrical and mechanical connections. .

In other words, the high frequency current can be transmitted to the contact member 30, 30 on the rotary ablation type electrode section 5 side via the contacts 22a, 22a on the gripping section 2 side, and when the electrode mounting member 18 on the gripping section 2 side is rotated, In both cases, the rotating excision electrode section 5 side is also rotationally driven. Note that by connecting at two points facing each other at an angle of 180° in this manner, high frequency transmission can be performed more reliably than when only one piece is used. Further, rotational motion can also be transmitted smoothly.

Note that the mounting member 27 and the contact holding member 28 inside thereof
As shown in FIG. 5, a ring-shaped recess is provided between the two and a watertight O-ring 32 is interposed therebetween. Also, the above (
A ring-shaped recess is also provided between the q member 27 and the electrode mounting member 18 on its outer periphery, and a watertight O-ring 33 is interposed therebetween.

By the way, as shown in the cross section of FIG. 7, the resection wires 29 and 29 extend at an angle of 180° to the outer periphery of a pipe 35 provided with a hollow portion 34 through which the insertion portion 4 of the optical viewing tube 3 is inserted. Small diameter wire holding pipes 37.3 in two opposing locations
7 is covered with insulating tubes 38 and 38, respectively, and inserted therethrough.

The distal ends of these cutting wires 29, 29 are formed into a U-shape or a semicircular loop shape, as shown in FIG. 8, and both cutting wires 29, 29 are connected to each other. Therefore, in the normal state attached to the sheath part 7, the resection wire 29
．． As shown in FIG. 8, the distal end loop portion 29 extends to the openings of the three insulating beaks at the distal end portion of the sheath portion 7.

Therefore, the gap between the loop portion and the beak 39 is approximately 0.
At about 1al111, the tissue piece taken inside the loop portion is separated by this slight gap between the rotated loop portion and the beak 39. Furthermore, Beak 3
The opening side edge extends straight in the optical axis direction in the horizontal direction of the field of view of the optical viewing tube 3.

By the way, the rotary ablation electrode section 5 has a connection section 2 at its rear end.
6 is the electrode mounting member 1 near the upper part of the front end of the grip part 2
By fitting the contacts 22a, 22a of 8 into the protruding recesses, it can be connected to the electrode mounting member 18 as shown in FIG. The attachment/detachment mechanism (with respect to the main body) is a screw that is screwed into the screw (1.1) to prevent the rotational ablation electrode 5 from being manipulated and to allow it to pivot freely.

As shown in FIG. 1 or FIG. 9, the front body portion 6 has a substantially ring-shaped handle on the inner periphery of its rear end with a tilt screw (to be screwed into the male screw 41 on the grip portion 2 side). ”
42, and a sheath attachment/detachment member 43 formed on the front side of this attachment part 42, and a fitting taper part 4/I is formed on the front side of this sheath name part 43, The outer periphery of the front side of this fitting taper portion 714 is shaped like a 7-papered hole to fit into the sheath portion 7. Positioning pins 45 and locking pins 46 and 46 (not shown in FIGS. 10 and 11) are provided on the outer periphery of the sheath attachment/detachment member 43, respectively, and project radially outward in the direction CJ.

Further, at the rear end of the sheath attachment/detachment member 43, there is a screw (for example, at an angle of 180°) for positioning the grip portion 2 in the rotational direction.
Guide pins 47, 47 are provided so as to be able to engage in pin engagement recesses 48, 48 of the gripping portion 2.

A ring-shaped recess is provided on the inner circumferential side of the sheath attaching/detachable member 43, and a watertight O-ring 49 is accommodated therein, and the rotary excision electrode section 5 attached to the grip section 2 is connected to the inner circumferential side of the sheath attachment/detachment member 43. This is to prevent moisture from getting in between. Note that the rotational excision electrode section 5 is stopped from being handled by this front main body section 6 and is rotated.
The front end of the electrode member 18, both of which are rotationally driven, smoothly abuts the inner surface of the rear end of the front main body 6, and is configured to be rotationally driven without wobbling back and forth.

The front main body part 6 is attached to the grip part 2 by screwing,
Furthermore, a connecting portion 50 formed at the rear end of the hollow sheath portion 7
The head fixing pin 45 is inserted as a guide and engaged with the locking pins 46, 46 so that it can be detachably attached to the sheath portion 7. Furthermore, the rear end side of the sheath part 7 is provided with a irrigant fitting (and a ferrule). In addition, in addition to the above-mentioned O-rings as a watertight means are installed at the connections of each part in -H. I'm just asking.

= 12- Note that turning on and off of the high frequency current can be controlled using a foot switch or other means.

When placed in the rotary ablation type resect cove 1 of the first embodiment configured in this way, the rotary ablation electrode part 5 can be attached from the front of the grip part 2. In this case, by removing the rear end of the rotary ablation electrode part 5, the contact members 30 and 30 in the member 27 are inserted into the recesses facing the contacts 22a and 22a on the grip part 2 side. , the opening-shaped contact member 30.30 inside the handle member 27 is connected to the protruding contact 22.
a, 22a are electrically and mechanically connected while being pressed together.

Furthermore, after the rotational ablation electrode part 5 is installed, the front main body part 6 can be fixed by engaging the guide pins 47, 47 of the front main body part 6 into the recesses 49,49 of the gripping part 2 and screwing them.
When the front main body part 6 is attached, the rotary excision electrode part 5 is prevented from being removed and is rotatably supported.

The resectoscope 1 can be assembled into a usable state by attaching it to the sheath part 7 and attaching the optical viewing tube 3 to the sheath part 7.

In this state, the high frequency current of the high frequency power supply unit 8 is transmitted through the contact 24a of the gripping unit 2 on the stator side.
a and the concentric ring-shaped contact 23 are in contact with each other so as to pinch the contact 24a from both sides, so that even if the concentric ring-shaped contact 23 is rotationally driven, this contact state is maintained. .

Therefore, the contact 2 that contacts this stator side contact 24a
3, the high frequency current passes through the two high frequency electrode conductors 22.2.
2, and further through the contact member 30.30 of the rotary ablation electrode part 5 that pinches the contacts 22a, 22a on the front end side.
It is transmitted to the cutting wire 29.29 side. As a result, a high-frequency current can be passed through the two excision wires and the tissue portions that come into contact with the two tips to the ground electrode side that contacts the outer surface of the living body (not shown) over a wide area.

Therefore, when the switch 21 of the grip section 2 is pressed, the motor 15 rotates, and the rotary ablation electrode section 5 is rotated around the outer periphery of the optical viewing tube 3 together with the electrode mounting member 18 via the timing belt 19. Ru. In this case, the optical viewing tube 3
Under observation, the U-shaped tip Q of resection wire A729.29;! , i to the resection site, it is possible to separate the piece of tissue sandwiched between the three beaks when the U-shaped portion is resected and rotated.

According to this first embodiment, the rotary ablation electrode part 5 does not come off during rotation, stable rotational movement can be obtained, and the rotary ablation electrode part 5 can be easily replaced. Furthermore, the high-frequency current path is completely insulated and safe even if the rotary ablation electrode part 5 or the grip part 2 is wet. J: Since there are two contact points and the holding bases 25 and 25 for rotation transmission at 180' symmetry in the connection part between the rotary ablation electrode part 5 and the grip part 2, compared to the case where high frequency transmission is performed using one contact point, It becomes more reliable, and transmission of rotational interlocking becomes easier.

FIG. 12 shows the surrounding area of a rotary ablation electrode according to a second embodiment of the present invention.

In this second embodiment, a front body portion 51 and a rotary ablation electrode portion 52 rotatably supported on the front body portion 51 are integrated.

That is, a presser member 51 that protrudes inward in the radial direction is fixed to the rear end side of the front main body part 51 with screws 53 or the like at a position slightly apart from the inner surface 51a of the front main body part 51. The rotating cutting electrode part 5 is located between the holding member 51a and the holding member 54.
The rotary ablation electrode part 52 is integrated in a state in which the two protrusions 52a are sandwiched therebetween, and the rotary ablation electrode part 52 is rotatable.

The rest is the same as the first embodiment.

In this second embodiment, the rotary ablation electrode part 52 and the grip part 2 are inserted with their rotational positions aligned, and the screws of the front main body part 51 are tightened and fixed. Other operations are similar to those in the first embodiment.

Further, this second embodiment has almost the same effects as the first embodiment, but since the front main body portion 51 and the rotary ablation electrode portion 52 are integrated, the operation of attaching and detaching the electrode is facilitated.

FIG. 13 shows the attachment/detachment mechanism of the front main body in the third embodiment of the present invention.

In this third embodiment, the method of attaching and detaching the front main body part 61 and the grip part 62 is different. That is, the attachment/detachment part between the front body part 61 and the grip part 62 is the same as the mechanism for removing the front body part 61 to the sheath part side, and a locking pin 63 and a positioning pin 64 are provided on the front body part 61 side. It is. Furthermore, the gripping portion 62 is connected to the locking pin 6.
3 guide groove 65 and positioning pin 64 guide F! 46
6 is provided on the front end side of the gripping part 62, and this gripping part 6
A slide pin 6 fixed to a grip part 62 is attached to the outer circumferential side of 2.
A locking ring 69 is provided which is biased (toward this slide pin 67 side) by a spring 68 using 7 as a guide.

The locking ring 69 is also provided with a locking claw 71 that locks the locking pin 63 when the locking pin 63 is inserted into the guide groove 65.

Other aspects are substantially the same as the first embodiment.

In the third embodiment configured in this way, when the front main body part 61 is attached to the grip part 62, if the positioning pin 64 is pushed into the guide groove 66, the locking pin 63 pushes down the locking ring 69. is inserted and fixed with the locking claw 71. On the other hand, when removing the front main body 17 part 61, the locking claws 71 are released by pushing down the six locking rings, and the front main body 17 can be pulled out.

In the third embodiment, which operates in this manner, the front main body portion 61 can be attached and detached with one touch, making the operation easy.

The one-touch attachment/detachment mechanism of the front main body portion 61 is not limited to the embodiments.

In addition, in the above embodiment, the motor 1 as the rotational drive means
5 is built into the grip part 2, and the other end of a flexible rotation transmission shaft, one end of which is connected to the rotation shaft of an external rotation drive means, is connected to the rotation shaft of this motor. Anything is fine.

[Effects of the Invention] As described above, according to the present invention, the number of electrodes that are coaxial with the optical viewing tube and rotationally driven by the rotational drive means at the outer circumferential position is provided in the grip part incorporating the rotational drive means. 18 = A front main body part in which a rotary excision electrode part to be attached to the front side of the electrode attachment means is detachably attached to the grip part, and a detachable part to the sheath part is installed. Since the rotating cutting electrode part is rotatably supported by being sandwiched between the parts, the rotating cutting electrode part can be reliably rotated, and the rotating cutting electrode part can be easily attached and detached.
Since the high frequency current is transmitted using two contacts, the transmission can be performed reliably. moreover,
Since watertight means are provided at the connection parts of each member, electrical leakage can be prevented and safety can be ensured.

[Brief explanation of drawings]

1 to 11 relate to a first embodiment of the present invention, FIG. 1 is a cross-sectional view showing the vicinity of the connection part to which the rotary ablation electrode part and the front body part are attached in the first embodiment, and FIG. 2 is the first
Third side view showing an exploded view of the excavator of the embodiment.
The figure is a sectional view showing the ring-shaped contact on the rotationally driven electrode mounting member side and the contact part on the data side. A sectional view taken along the line 8-0-A' in the figure, FIG. 6(a) is a sectional view showing the contact member in a state where the rotary ablation electrode part is not connected, and FIG. 6(b) is a sectional view showing the contact member in a state where the rotary ablation electrode part is not connected. A sectional view showing the contact member in a connected state, FIG. 7 is a sectional view of the front part of the rotary ablation electrode, and FIG. 8 shows the vicinity of the tip of the rotary ablation electrode with the sheath attached. 9 is a sectional view showing the shape of the front main body, FIG. 10 is a sectional view taken along the line CC' in FIG. 9, FIG. 11 is a sectional view taken along the line D-D' in FIG. 9, and FIG. The figure is a sectional view showing the vicinity of the connection part of the front body part in the second embodiment of the present invention, and FIG. FIG. 3 is a sectional view showing the vicinity of the front end. DESCRIPTION OF SYMBOLS 1...Resect scope 2...Gripping part 3...Optical viewing tube 5...Rotating ablation electrode part 6...Front main body part 7...Sheath part
8... High frequency power supply unit 15... Motor
18... Electrode mounting member 19... Timing belt 21... Switch 22... High frequency 'ffi polar conductor 22a, 23... Contact 2/l... Electrode 25.
...Holding stand 27...Mounting member 28...Electrode mounting member 29...Resection wire 30...Contact member Day 2, Title of the invention: Rotating resection type resectoscope 3
(Relationship with the case of the person making the amendment Representative of the patent applicant ° Satoshi Shimoyama Dept. 5, Date of amendment order (spontaneous)) 1. In the fourth line of page 4 of the middle box of the specification, "...Fig. 5 ”
I will correct it to "...Figure 5 is". 2. In the second line of page 11 of the statement box, there is a message that says ``is on the front side...''
" will be corrected to "Front side...". 3. Delete "This is the front body..." on the 7th to 11th lines of page 12 in the details. 4. Delete "Also, each of the above-mentioned parts..." from lines 18 to 20 on page 12 of the statement box.

Claims (1)

[Scope of Claims] A rotary ablation type resectoscope in which a high-frequency current is applied to the front side of the ablation electrode and the ablation electrode is rotationally driven, wherein the sheath is attached to a gripping portion having a built-in rotational drive means. A front main body having a detachable part can be detachably attached to the grip part,
A rotary ablation type resectoscope, characterized in that a rotary ablation electrode is sandwiched between the grip part and the front main body, and means for rotatably attaching the rotary ablation electrode to the grip part is formed.