JPS62207449A - Apparatus for incising living body tissue - 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 biological tissue resection device that can safely perform resection of a target tissue.

[Conventional technology]

In recent years, in order to diagnose the symptoms of an affected area within a body cavity or to remove a tumor or an overly enlarged area, it has become increasingly common to insert it through one oral cavity without making an incision, or to treat it by inserting it through a small puncture hole. Endoscopes that can do this are now widely used. The endoscope is also used as an observation means when operating a pukorg for ablation treatment.

By the way, as the ablation method mentioned above, high wave vibration is used.
There is something to do. For example, in the conventional example disclosed in U.S. Pat. This method uses a powerful ultrasonic beam to destroy the target tissue.

Furthermore, Japanese Patent Laid-Open No. 51-24092 also discloses that the target tissue is destroyed and removed using an ultrasonic beam.

Furthermore, in the conventional example disclosed in Japanese Patent Publication No. 47-39197, an elongated rod is vibrated at high frequency.

This is an excision procedure in which the distal end of the vibrated rod contacts the target biological tissue and excises it.

[Problem that the invention seeks to solve]

In the conventional technique, first, it takes time and effort to excise the target tissue, and the excised tissue cannot be accurately confirmed, making it difficult to accurately excise the tissue.

If the second button is used to cut the tissue by directly bringing the jid into contact with the tissue, it is very effective for cutting the visible part. However, when this cutting device cuts a region deeper than the visible surface, it becomes impossible to see the tip of the jid.

For this reason, it was necessary to check whether or not the target tissue was being excised by feeling the change in frequency during resection.
Accurate confirmation is not possible and unnecessary! There was a risk of removing other tissues in i'.

The present invention has been made in view of the above points, and an object of the present invention is to provide a biological tissue resection device that can safely perform resection of only the target tissue.

[Means for Solving the Problems] The living tissue resection device of the present invention is provided with means for detecting a change in the vibration frequency or amplitude of a vibrating resection jig that is vibrated at a high frequency, and detects a change signal exceeding an allowable value. The device is characterized by being equipped with a danger prevention means that warns or stops the cutting function.

[For production]

When the vibrating jig is vibrated at a high frequency to ablate living tissue, the vibration frequency or amplitude of the vibrating jid is detected, and if the vibration frequency or amplitude exceeds a permissible value, a warning is issued by the danger prevention means or the excitation of the photographing a 'y drive is stopped. Stop, etc.

〔Example〕

Hereinafter, the present invention will be specifically explained with reference to the drawings.

WXJ diagram shows the cutting device of the actual gun example.

@11 The tissue resection device 1 has a large-diameter grip portion 3 formed at the rear end side of an elongated guide tube 2, and a vibrator 4 as a vibration means is housed inside the grip portion 3.

The vibrating rod 5, which is elongated and passed through the guide tube 2, can be excited by the vibrator 4.

The vibrator 4 is a magnetostrictive vibrator 6 made of, for example, nickel, Alpha, or 7-elite. A coil 7 is wound around the coil 7, and a high frequency current is supplied to the coil 7 from an external high frequency oscillator 8.

It constitutes a transducer that excites the magnetostrictive vibrator 6 at high frequency.

Therefore, the magnetostrictive vibrator 6 has a vibration wJp rod 5 and a joint 9.
The buttons are connected to each other via the magnetostrictive vibrator 6, and vibrate reciprocally along its longitudinal direction along with the vibration of the magnetostrictive vibrator 6. The hollow part of the guide tube 2 outside the vibrating jid 5 is connected to a water supply tube 0 near the rear end of the guide tube 2, and water is supplied from the water supply means to the distal end side of the vibrating jid 5 through the cough water supply tube 10. It is now possible to do so. Therefore, the tissue fragments from when the affected area, such as the enlarged prostate, which is in contact with the tip of the vibrating jid 5 is excised, are removed together with the water that is sent into the area.

Through the hollow part of the vibrating rod 5 and the hollow part of a joint 9 communicating with the hollow part, and further through the suction tube 2 connected to the opening of the joint 9, suction can be removed to the suction means side. .

By the way, in the first tissue example of the present invention, as described below, when the vibrating jig 5 excises the resected tissue [1], the vibrating jig 5 safely performs the resection so as not to further ablate the muscle layer [3]. Means are provided to do so.

That is, at the rear end of the vibration jid 5 adjacent to the joint 9,
An annular recess or groove is formed on the outer periphery, and a C annular permanent magnet 15 is fitted and fixed therein, and the grip portion 3 is located at this outer periphery position.
A coil 16 is attached to the inner wall, and the change in the frequency of the vibration of the vibrating rod 5 can be detected by the sum of the signal outputs generated by the II coil 16.

Both ends of the coil [6] are connected to the input end of the frequency detection circuit [7], and the output end of this frequency detection circuit [17] is connected to the input end of the comparison circuit [8].

The frequency detection circuit 17 includes, for example, a waveform/shaping circuit, a counter circuit, and a D/Afl conversion circuit. However, at °C, the output of this D/A conversion circuit is the comparison circuit]8
A warning device 19 as a danger prevention means using LgD or the like, which is applied to one input terminal of the input terminal and compares it with a reference voltage applied to the other input terminal, and warns when the potential of the one input terminal becomes less than this reference voltage. It is possible to drive 5 (it has become. Furthermore,
O-rings 20 and 21 are interposed at the base side connection part of the guide tube 20 to prevent water from leaking to the outside. Further, an O-ring 22 is also interposed in the joint 9 portion adjacent to the connection portion of the suction tube 2.

The operation of the thus constructed embodiment will be described below.

After inserting an endoscope (not shown) and confirming the resection site, the endoscope is removed and the guide tube 2 in the first embodiment is inserted. (Incidentally, this may be done under observation with an endoscope.) Then, the high frequency oscillation: fc (f8) is turned on and a high frequency driving current is passed through the coil 7 of the exciter 4. Then, the magnetostrictive The vibrator 6 vibrates, and the connected vibrating rod 5 also vibrates in its longitudinal direction.
When it is advanced and applied to the prostate gland]1, the applied area is resected. This excised tissue piece passes through a hollow passage inside the imaging jid 5 and is expelled to the suction means side together with the water sent through the water supply tube 0.

By the way, when the above-mentioned vibration rad 5 is applied and ablated, the physical characteristics of the tissue (accordingly, the load changes, so the vibration frequency of the oscillation rod 5 changes, but the prostate) The load is small and the change in imaging frequency is small. Therefore, the output of the comparator circuit 18 is maintained at the G level, indicating whether it is functioning normally. When approaching the muscle layer 13, the load applied to the vibrating rod 5 increases, that is, the load changes, and the change in the frequency of the vibrating rod 5 increases.This change is detected by the frequency detection circuit 7, and layer 13
When it gets close enough to , the output exceeds the reference value as an allowable value, and the output of the comparator circuit]8 becomes the NO level, and the warning device]9 is activated to emit a buzzer sound or the LgDO point for warning. Become a light.

Therefore, the operator can prevent tissue from being removed and removed other than the tissue to be removed.

In the first embodiment described above, changes in vibration frequency were detected, but
In this case, differential changes in frequency are detected and allowed! When above μ, operate VcW@device]9 and the temperature is also good. In addition, it is also possible to operate the warning device 19 by detecting the change in the amplitude of the vibration using the above-mentioned frequency detection means. Through,
) It is good to detect the envelope and apply the detected wave to one input trend of the comparison circuit [8].

In addition, along with the operation of the above-mentioned warning device] 9, the high-frequency oscillation device 8
It is also possible to take risk prevention measures such as turning off the power source so that the high frequency output of the vibrator 4 is not supplied to the vibrator 4 side. In addition, as the above comparison circuit] 8, a window comparator is used to
The high-frequency vibration may be stopped when the level changes more greatly than the warning level. Incidentally, the above-mentioned tolerance value may be set according to the tissue to be excised. FIG. 2 shows a second embodiment of the present invention.

This second embodiment does not include the magnet 5 and the coil 16 that constitute the vibration frequency detection means in the above-mentioned tlX embodiment. ℃, but the structure is actually similar to the one shown in FIG. It is connected to the ablation high frequency oscillation 9cas via the section 31.

The calibration high frequency oscillator [32] is connected to this control B
3] to a reflected wave amplitude detection circuit 33, and this reflected wave amplitude detection circuit 33 is connected to a warning device J9 via a comparison circuit 18.

The high-frequency current device for ablation [8] sends a high-frequency current for ablation in pulses as shown in FIG. 3 (&).

During the pause period of this pulse, as shown in FIG. The amplitude detection circuit 33 takes in the signal. The reflected wave amplitude detection circuit 33 captures the reflected wave as shown in FIG.
If the value is other than @), a warning will be issued.

(Alternatively, the high frequency oscillation current for cutting may be cut off at ℃.) This second practical example has the advantage that safety can be confirmed without providing the permanent magnet 5, the coil 16, etc.

FIG. 4 shows an Ia3 woven implementation of the present invention.

This third practical example can be used in combination with an endoscope.

That is, in this third embodiment, the guide tube 4 is provided with a channel 42 through which a resection device can be inserted, and a channel 44 through which an observation endoscope 43 can be inserted. Channel 44 into which [1143 is inserted]
An O-ring 45 is interposed near the rear end of the housing to prevent water from leaking. Note that the magnet [5] is fixed to the outer station of the vibration-rad 5.

Further, the vibrating rod 5 is formed integrally with the joint 9 in FIG. 1.

The rest of the configuration is the same as that of the first example.

According to this third case, the resection can be performed under constant observation using the endoscope 43, so the resection can be performed more safely. Note that it is clear that the second embodiment can also be used as a means for safely excision in this @33 entrapment.

In addition, the water supply channel or suction channel is connected to the resection device channel 4.
Alternatively, the endoscope channel 44 can be used without using the inside of the vibrating rod 5. Therefore, the vibrating rod 5 is not limited to a hollow tubular member, but may be a solid rod-like member.

The magnetostrictive vibrator 5 of the vibrator 4 can reduce the loss of eddy current by making the plate-like members laminated.Also, it is possible to reduce the loss of eddy current by making it a closed loop instead of a bar-shaped open loop. Also, it is not limited to the one that utilizes the magnetostrictive phenomenon, and for example, a permanent magnet may be placed inside the coil 7 to vibrate at a high frequency.Furthermore, the piezoelectric vibrator You can also use

Note that the present invention is not limited to the prostate gland and the like as the resected tissue, and by making it possible to variably set the reference potential of the comparison circuit 18 depending on the resected tissue, a wide range of biological tissues can be safely resected.

[Effects of the Invention J As described above, according to the present invention, when a tissue other than the target tissue to be excised is approached and ablated, a warning is issued by a change in vibration frequency or amplitude, and the risk of stopping the ablation is prevented. Because the means are provided.

Only the target tissue to be removed can be safely removed.

[Brief explanation of drawings]

FIG. 1 is a sectional view showing the first embodiment of the present invention, FIG. 2 and W2B relate to the second embodiment of the invention, FIG. 2 is a schematic configuration diagram showing the second practical example, and FIG. The figure is a timing chart diagram for explaining the operation of the second example of the web, and FIG. 4 is a sectional view showing the third example of the web of the present invention.

Claims (1)

[Claims] A living tissue resection device that excites a vibrator with high frequency from a high-frequency oscillation means and makes it possible to excise tissue that comes into contact with the tip of the vibrating rod by high-frequency vibration of an elongated vibrating rod connected to the vibrator. a means for detecting the amplitude or frequency of the vibrating rod, a means for comparing whether the detected amplitude or frequency is within a permissible value, and a means for issuing a warning based on the output of the comparing means; A biological tissue resection device characterized in that it is provided with a danger prevention means for stopping the excitation of the biological tissue.