JPS62127046A - Prostate release device of rejectoscope 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] [Industrial Application Field] The present invention is capable of removing the internal line of the enlarged prostate gland (prostatic hyperplasia) by detaching it from the external gland and removing it by transurethral insertion into the bladder. The present invention relates to a resectoscope device, and more particularly, to an improvement of a resectoscope device capable of immediately stopping bleeding in the event of bleeding during ablation of the intraprostatic gland.

[Problems to be solved by conventional techniques and inventions] In recent years,
Insert the insertion tube into the body cavity and observe the affected area.

Endoscopes are widely used for diagnostic and therapeutic procedures. This endoscope includes a lepictoscope that is inserted into the bladder through the urethra and is configured to perform treatments such as prostate resection using a resection loop electrode device that applies high-frequency current.

In general, a resectoscope consists of a hollow resect sheath that is inserted into the urethra, a handle that has a slider that is detachably attached to the proximal end of the resect sheath, and a handle that is detachably attached from the rear end of the handle. A loop electrode device for prostate resection is inserted into the resect sheath and its rear end can be fixed to a slider, and by operating the slider, This allows the tip of the loop electrode to be pushed out and retracted from the lepictosheath.

However, when using a resect scope configured in this manner to resect the prostatic gland by passing a high-frequency current through the loop electrode of the electrocution device protruding from the tip of the resect sheath, the treatment procedure is to completely remove the enlarged prostatic gland. This is extremely difficult as it is dangerous to the human body, and has the disadvantage that a portion of the internal cord tends to remain, causing the prostate tissue to become enlarged again.

Furthermore, the resectoscope having the above configuration has a problem in that there is no means to stop bleeding caused by ablation, and the ablation surgery cannot be safely performed in a short time, causing pain to the patient.

Therefore, in Utility Model Application No. 59-93513, Japanese Patent Application No. 51-193303, and Utility Model Application No. 58-97415, the present applicant has proposed that the resect scope is replaceably fitted with the electrode device, We have proposed a prostate avulsion device that can be inserted between an extraprostatic gland and an enlarged prostatic internal gland under direct vision of a scope to separate the internal gland from the external gland and completely remove the internal gland. Bleeding may occur when the internal wire is inserted between the external gland and the internal gland and removed from the external gland, so in Utility Model Application No. 59-93513, a high-frequency electrode is placed at the tip of the tubular coagulation guide. Established, patent application 1986-193
In No. 303, a loop-shaped high-frequency electrode is provided, and in Utility Model Application No. 58-97415, a high-frequency electrode is embedded at or near the tip surface of the stripper at the tip of the stripper, and a high-frequency current is applied to the electrode during the bleeding. It is applied to the bleeding area to coagulate and stop the bleeding.

However, with devices that heat using high-frequency current, the high-frequency DC current may stimulate the nerves of the thigh muscles during hemostasis, causing rapid thigh reflex movements (TUR reflexes), and high-frequency leakage current may cause urethral There is a risk of causing burns.

In addition, in the above method, there is no means to detect the temperature, so there is a risk that the temperature of the heating part will rise more than necessary, and in order to control the temperature, a temperature detection means and a temperature control circuit are required. The structure becomes complicated.

[Object of the invention] The present invention has been made in view of these circumstances.
U R reflex does not occur, and leakage currents such as high-frequency currents are eliminated to prevent heat generation in the urethra, etc., and if bleeding occurs during ablation of the prostatic gland, the ablation device can be used as a hemostasis probe. The bleeding can be stopped immediately by the stripper itself without replacing the bleeding area, the stripper can be formed by the heating element itself, the structure is simple, the temperature can be controlled by the heating element itself, and there is a temperature control circuit. It is an object of the present invention to provide a prostate dissection device that does not require a resectoscope device.

[Means and operations for solving the problems] To achieve the above object, the prostatic ablation device of the lectoscope device according to the present invention is provided at the tip and inserted between the extraprostatic gland and the internal line to remove the internal line. At least a portion of the peeling element peeled off from the external gland is a positive temperature coefficient thermistor (
Posi-tive temperature co
eHicient thermistor; hereinafter referred to as PTC
Abbreviated as element. ), and the PTC is formed at the time of hemostasis.
The element is energized to generate heat, and a stripper is pressed against the bleeding site to coagulate and stop the bleeding.

[Embodiments of the invention] Hereinafter, the present invention will be described in detail with reference to the drawings.

1 to 5 relate to one embodiment of the present invention, in which FIG. 1 is an explanatory diagram showing a partially cutaway resectoscope device, FIG. 2 is a perspective view of the distal end of the resectoscope device, and FIG. 3 is a sectional view of FIG. 2, FIG. 4 is a front view of FIG. 2, and FIG. 5 is a sectional view of the separator.

In these figures, numeral 1 is a lectoscope device;
A sheath body 3 in which an elongated sheath 2 to be inserted into the urethra is connected to the front, and a connecting part 4 that is inserted and connected to the rear part of this sheath body 3 are placed on the right, and a support shaft extends from the connecting part 4 in the rear axial direction. 5
A connecting part 6 is fixed to the rear end of the support shaft 5 by protruding from the connecting part 6, and a scope insertion part 7 is provided which communicates with the inside of the sheath 2 from the connecting part 6. A slider 8 that slides in the axial direction along the support shaft 5 is disposed between the connecting portions 6 of The handle part 10 is biased to return, and the scope (rigid endoscope) is inserted from the rear of the connecting part 6 through the scope insertion part 7 to the distal end of the sheath 2, and is capable of observing the front of the distal end of the sheath 2. ) 11. The sheath main body 3 has a water supply spout 12 with a cock for supplying irrigation fluid into the bladder and urethra, and a finger hook 13. The slider 8 also has a finger hook 1 at the lower part diagonally rearward thereof.
4 is installed protrudingly. On the other hand, the scope 11 has an eyepiece 15 at the rear, and a light guide base 1 to which a light guide cable is connected to a light source device (not shown).
6.

A peeler 17 is attached to the resect scope 5A in combination. This peeler 17 is
A peeling element 19 is arranged at the tip of an elongated shaft 18, which is inserted from the front, the rear part of the shaft 18 is inserted into a connection hole (not shown) of the slider 8, and is fixed by tightening the detachable part 20. There is. And this peeling 2117 is
Slider 8 to connecting portion 4. Sheath 2 via sheath body 3
The separator 19 is positioned within the distal end of the sheath 2, and can be projected from the beak 2a at the distal end of the sheath 2 by sliding the slider 8 forward.

The peeling element 19 includes a PTC element 21 whose entire body is approximately gutter-shaped and whose distal end is shaped like a tapered tongue, and electrodes 22a attached to the inner and outer circumferential surfaces of the PTC element 21, respectively. , 22b, and an insulating coating 23 provided to cover the PTC element 21 and the electrodes 22a, 22b. The insulating coating 23 may be formed by coating with Teflon or the like which does not adhere to tissues within the body cavity.

The P 1'C element 21 is a thermistor with positive resistance-temperature characteristics, and the PTC element itself has an automatic temperature control function, and is used as a constant temperature heating element in the present invention. Furthermore, by changing the material composition of the PTC element 21, the PTC element 21 can be heated to a temperature suitable for hemostasis.

Inside the shaft 18 of the peeler 17, a lead wire 24, such as a coaxial cable, is wired in the axial direction and electrically connected to the electrodes 22a, 22b of the PTC element 21. The side is electrically connected to wiring installed inside the slider 8. Further, the slider 8 is provided with a connector 25 to which a cable 27 of a power source 26 is connected. This power supply 2
6 is connected to a foot switch 29 via a cable 28.

In such a configuration, the slider 8 is slid forward under direct vision through the scope 11 to cause the stripper 19 to protrude from the beak 2a at the tip of the sheath 2, and the stripper 19 is inserted between the extraprostatic gland and the internal line. The internal wire is inserted and removed from the external gland, but if bleeding occurs during this removal, the remover 19 is pressed against the bleeding location and the foot switch 29 of the power source 26 is pressed to remove the remover 19. PT within
The C element 21 is energized to generate heat, which is then conducted to the bleeding site to coagulate and stop the bleeding.

By using the PTC element 21 as a heating element, the tissue can be heated at a constant temperature suitable for coagulation and hemostasis without using a temperature control circuit.

In this embodiment, the peeler 19 is formed of the PTC element 21, but only the tip of the peeler 19 may be formed of the PTC element, or the peeler 19 is formed of a thermally conductive material.
9 may be formed and the PTC element may be embedded therein.

In addition, in the present invention, a resectoscope device.

The configuration and shape of the peeler are not limited to those shown in the drawings, and various other configurations may be used.

[Effects of the Invention] As explained above, according to the present invention, the TUR reflex does not occur, there is almost no leakage current such as high-frequency current, it is possible to prevent the generation of heat in the urethra, etc., and to remove the prostatic gland. If bleeding occurs in the area, the bleeding site can be immediately stopped by the abrasion itself without replacing the hemostasis probe with a hemostasis probe.

Furthermore, the PTC element itself as a constant temperature heating element can form a peeling element, and the structure is simple.

Furthermore, the PTC element itself can control the temperature, and as a result, a temperature control circuit is not required.

[Brief explanation of drawings]

1 to 5 relate to one embodiment of the present invention, in which FIG. 1 is an explanatory diagram showing a resectoscope device with a part cut away, FIG. 2 is a perspective view of the distal end of the resectoscope device, and FIG. 3 is a sectional view of FIG. 2, FIG. 4 is a front view of FIG. 2, and FIG. 5 is a sectional view of the separator. 1...Resectoscope device 2...Sheath 3...Sheath body 8...Slider 10...Handle part 11...Scope
17...Peeler 18...Shaft 19...
Stripper 21...PTC element

Claims (2)

[Claims] (1) A sheath body having an elongated hollow sheath that is inserted into the urethra, a handle portion having a slider that is connected to the sheath body and slides in the axial direction, and a sheath body that is inserted into the sheath through the handle portion or the sheath body. It is used in combination with a resect scope device consisting of a scope, the proximal shaft of which is fixed to the slider, which is inserted into the distal end of the sheath through the handle section or the sheath body, and the stripper is protruded from the distal end of the sheath by the slider. 1. A prostatic ablation device for removing the prostate, characterized in that at least a part of the ablating element for ablating the intraprostatic glands from the external glands is formed of a positive temperature coefficient thermistor as a constant temperature heating element that generates heat by electrical means. Zectoscope device prostate dissection device. (2) The prostate ablation device for a resectoscope apparatus according to claim 1, wherein the outer surface of the ablation element is coated with a material to which tissue does not adhere.