KR100773587B1 - Electrode for coagulation - Google Patents

Abstract

The small-acting electrode according to the present invention extends from the blunt end to be inserted into the human body and is bent at a predetermined position, and includes a conductive electrode to which a high frequency current can be applied; Since it comprises an insulating member which is installed to surround the portion except the non-insulating part, which is a section from the end of the electrode, it is designed to safely and effectively cauterize the endometrium and to be inserted in the human body as it is designed in consideration of the human insertion path. In addition to cauterizing the endometrium, such electrodes can be used for various purposes in endometriosis, hemostasis in surgical sites, cauterization of inflammatory sites, and cauterization of other lesions.

Cauterization, electrode, high frequency, insulation member, non-insulation portion, insulation portion, endometrium

Description

Catalytic Electrode {ELECTRODE FOR COAGULATION}

1 to 4 are perspective views showing various examples of the endometrial small-function electrode according to the prior art,

5 is a perspective view showing a first embodiment of an endometrial small-acting electrode according to the present invention;

6A and 6B are side cross-sectional views showing portions A and B of FIG. 5 enlarged,

7 is a perspective view showing a second embodiment of the endometrial small-acting electrode according to the present invention;

8A, 9A, 8B, and 9B are enlarged side cross-sectional views of portions C and D of FIG. 7.

<Explanation of symbols on main parts of the drawings>

50 electrode 52 non-insulated part

52a: end 54: insulating member

56: handle 58: temperature sensor line

60: scale

The present invention relates to a small-acting electrode for treating menstrual hyperplasia, and particularly relates to a small-acting electrode capable of reducing pain of a patient even when inserted into a human body while simultaneously cauterizing the endometrium effectively.

In general, in menstrual hypermenorrhea due to uterine fibroids, uterine adenoma, or other diseases, or menstrual hyperplasia, which is usually a symptom of severe bleeding, the menstruation is intentionally made by ablation or coagulation of the endometrium. Treatment is given to keep it out or to make only a small amount of menstruation.

Even if such treatment is performed, the hormones of the woman are continuously secreted, so there is no risk of metabolic abnormalities. Therefore, a procedure in which the endometrium is cauterized when women who have had enough children or who do not plan to have children suffer from hypermenorrhea It is done a lot.

Basically, the inside of the uterine cavity is a balloon-like balloon, and by inserting a suitable apparatus to cauterize the endometrium as a whole, when heated to about 70 ℃, cauterization of the endometrium is completed.

At this time, the inner wall of the uterus is composed of two layers such as epidermal layer and myoepithelial layer. When cauterization proceeds, cauterization is performed not only at the epidermal layer but also at the epidermal layer where menstruation occurs. It is done.

More specifically, in order to cauterize the endometrium, a thin electrosurgical device, a microwave-applied surgical device, a balloon-type surgery device, a scalpel-type surgery device, and the like have been conventionally used.

First, the electrosurgical device is composed of a non-insulating part so that a high frequency can be generated at one end 1a formed bluntly with a thin thin linear electrode as shown in FIG. 1, while the insulating member 2b is connected to a part connected thereto. Is covered with an insulating portion, and the other end on the opposite side of the one end portion is composed of a connecting portion used by being fitted to a member such as a handle.

Of course, it is installed to be connected to the high frequency to the electrode, this electrosurgical device is designed to be used in other human body in addition to the endometrium.

However, the electrode of the electrosurgical device is formed with a thin and long straight line having an outer diameter of less than 2 mm and a length of 17 to 20 cm even though its end 1a is blunt, so that the position of the uterine cavity with respect to the vagina is in a straight line. Because it is not in the right angle, but at a right angle, it is difficult for a doctor to remotely operate outside the vagina during endometrial cauterization, and it is difficult for the electrode to contact the endometrium effectively, and furthermore, since the temperature is not controlled, it is actually used. Rarely.

Next, as shown in FIG. 2, the microwave application type surgical device has a blunt end 2a formed to have a blunt electrode 2 and a controller connected thereto to apply microwaves to the electrode 2. It consists of a handle (4) included.

Of course, the electrode 2 is composed of a non-insulating part so as to generate a microwave only in a partial section from its end 2a, and the other part is composed of an insulating part.

However, the microwave application type surgical device as described above is difficult to be inserted into a limited human body such as the vagina and uterine cavity because the electrode 2 is thick in structure, so that the pain of the patient can be increased, and furthermore, it is formed in a straight shape. Therefore, because it does not form a shape similar to the lumen of the uterus is a problem that can give a uterus when the uterine cavity is inserted.

Next, the balloon-type surgical device is inserted into the uterine cavity by inserting the air balloon 14 to the end of the hollow catheter 12, as shown in Figure 3a and 3b, and then the high temperature saline of about 90 ℃ When injected into the balloon 14 through the catheter 12, the balloon 14 is inflated and in contact with the endometrium A. In this state, as the hot saline circulates, the endometrium A is heated. Cauterization occurs.

Of course, separate equipment is provided so that the saline can be circulated through the catheter 12.

However, the balloon-type surgical device as described above may burst the balloon 14 during the operation of circulating high temperature saline in the state in which the balloon 14 is inflated, in this case is directly connected to a medical accident may be dangerous to the patient There is this.

Next, as shown in FIG. 4, the fan type surgery machine includes a hollow guide member 22, a fan blade 24 inserted into a contracted shape inside the guide member 22, and a handle 26 connected thereto. It further comprises a control unit (not shown) for applying a high frequency to the fan 24.

At this time, the guide member 22 is pushed into the uterine cavity through the cervix through the vagina, and then the fan blade 24 is inserted into the contracted shape in the guide member 22 and pushed into the guide member 22. Protruding to the end of (22), the endometrium is in contact with the end and the fan-shaped flesh of the fan blade 24 while the fan blade 24 is extended, cauterization proceeds while high frequency is applied in this state.

However, since the end of the scalp type 24 also has a sharp end of the scalp 24 may cause injury to the cervix, a medical accident may be dangerous in the patient, carbon dioxide gas to solve this problem There is a problem in that the pressure to continue to measure while inserting, the shape is complicated, there is a problem that the manufacturing cost is also high.

The present invention has been made to solve the above problems of the prior art, it is easy to insert into the human body as well as to provide a small-acting electrode that can be used safely and simply as well as not damaging the human organs during the procedure The purpose is.

The small-acting electrode according to the present invention for solving the above problems is formed by extending from a blunt end so as to be inserted into the human body and bent at a predetermined position, to which a high frequency current can be applied; And an insulating member installed to surround a portion of the electrode except for the non-insulating portion, which is a partial section.

Hereinafter, embodiments of the present invention will be described in detail with reference to the accompanying drawings.

5 is a perspective view showing a first embodiment of the cervical small-acting electrode according to the present invention, Figures 6a and 6b is an enlarged side cross-sectional view of the portion A and B of FIG.

The first embodiment of the endometrial action electrode according to the present invention is an electrode 50 and end 52a formed to be bent at a predetermined position from the blunt end 52a as shown in FIGS. 5, 6A, and 6B. The insulating member 54 is installed to wrap from a point away from the predetermined distance from the non-insulating part 52 and the insulating part, and is made of a handle 56 connected to the electrode 50 can be caught by the operator, A separate device for applying a high frequency to the electrode 50 is connected and installed, and a temperature sensor line 58 for measuring the temperature of the electrode 50 is embedded to control the input current according to the temperature of the electrode 50. Do it.

In more detail, the electrode 50 is made of a conductive material capable of transmitting high frequency, such as stainless (or similar metal), and the end 52a does not injure the uterine lining even if the end 52a contacts the endometrium. To prevent puncture medical accidents, hemispheres are welded to the ends of the hollow shaft so as to form blunt, and an angle of 60 ° or less from a predetermined position from the end 52a considering the position of the abdomen so that the uterus is almost vertical from the vagina. To bend.

At this time, the electrode 50 has an outer diameter of 2 to 8 mm, the length is preferably configured to be thin and long to 15 to 30 cm.

That is, when the outer diameter of the electrode 50 is less than 2mm, the diameter is too thin compared to the length of the entire electrode 50 is flexible, it is difficult to effectively adjust the electrode 50 outside the vagina, and the When the outer diameter exceeds 8mm, the external diameter of the electrode 50 is preferably limited in the above-mentioned range because the pain to the patient as the insertion through the cervix is large, the length of the electrode 50 is also the average human body In consideration of the structure and the length of insertion is preferably limited in the above-mentioned range.

Next, the insulating member 54 is covered on a portion of the outer surface of the electrode 50 to be cauterized by high frequency only at one end of the electrode 50, the insulating member 54 is the end of the electrode ( 52a) is installed from a point 1 to 6 cm away, as a result of the non-insulation unit 52 to ensure a length of 1 to 6 cm.

At this time, even if the insulating member 54 is installed on the outer circumferential surface of the electrode 50, it is preferable to reduce the foreign matter even if the electrode 50 is inserted into the cervix so that a step is not formed with the non-insulating part 52. On the outer circumferential surface of the electrode 50, only the tip portion where the insulating member 54 is installed is polished to form an inclined groove 52h, or all the portions on which the insulating member 54 is to be installed are polished, and then the insulating member 54 to cover the outer circumferential surface of the electrode 50.

Of course, the electrode 50 may be configured to be bent at the boundary between the non-insulating portion 52 and the insulating member 54, even if bent in any of the non-insulating portion 52 and the insulating member 54 It's okay.

Next, the temperature sensor line 58 is installed to be inserted into the electrode 50 as the hollow shaft is formed therein, and is installed to be inserted up to the end 52a of the electrode to adjust the temperature of the non-insulating part 52 side. The measurement and, accordingly, control the generation of high frequency by adjusting the current input to the electrode 50.

At this time, the temperature sensor line 58 is to control the temperature to prevent excessive cauterization in the non-insulated portion 52, but the cauterization degree is determined by the high frequency applied basically, but the patient Since the tissue characteristics are different, it is preferable to control the temperature in consideration of this. Furthermore, in order to prevent excessive cauterization or carbonization of the endometrium, impedance control is automatically performed according to the impedance measurement value of the endometrium. More desirable.

In addition, the length of the electrode 52 is indicated by a scale 60 from the end 52a of the electrode so as to identify the degree of insertion of the electrode 50 into the cervix.

Usually, as cauterization proceeds in the endometrium during the cauterization procedure, gas is generated in the tissue and the tissue is whitened, and it is often difficult to identify the boundary of the endometrium by ultrasound. In this case, the electrode 50 is excessively It is necessary to check in real time the length of the electrode 50 inserted into the vagina and the uterine cavity through the scale 60 in order to prevent a medical accident that is inserted into the uterine wall by mistake.

Of course, the general size of the uterine cavity is approximately determined, but it is dangerous to insert the electrode 50 to exceed the size excessively, even if the size of the uterine cavity can be increased due to uterine fibroids, adenomyosis, etc. in advance Predicting the size of the uterine cavity through ultrasound diagnosis, it is necessary to insert the electrode only within the range of the size, in this case, the insertion length of the electrode 50 is adjusted through the scale (60).

Looking at the operation of the present invention configured as described above are as follows.

First, the electrode is inserted into the surgical site as the active electrode, while the inactive electrode in the form of a ground pad is attached to the outside of the human body to allow current to flow through each other.

Specifically, the end 52a of the electrode is inserted into the uterine cavity through the vagina and the cervix, and then the non-insulation part 52 is placed inside the uterine cavity, and is in contact with the uterine wall, while looking at the scale 60 To adjust the insertion length of the electrode 50.

At this time, the cauterization of the endometrium proceeds while flowing a high frequency of 20 to 60 W to the electrode 50 through the control unit, and at the same time, if the operator reciprocates back and forth, left and right while holding the handle 56, the electrode 50 is reciprocated in the uterine cavity in the front, rear, left and right movements and cauterization is made over the entire area of the endometrium.

Of course, the reciprocating speed of the electrode 50 is adjusted in proportion to the high frequency flowing through the electrode 50. For example, when a high frequency of 50 W flows through the electrode 50, the electrode 50 is relatively While reciprocating at a high speed, when a high frequency of 30 W flows through the electrode 50, the electrode 50 is reciprocated at a relatively slow speed.

At this time, the temperature sensor line 58 measures the temperature of the non-insulation unit 52 side, and controls the current supplied to the electrode 50 according to the temperature, but basically the cauterization degree according to the high frequency applied However, since the tissue characteristics of the endometrium vary from patient to patient, the operator needs to appropriately adjust the generation of high frequency according to the temperature measured by the temperature sensor line 50, and further, the high frequency automatically according to the impedance measurement value of the endometrium. Impedance control, which regulates the development, is also made to prevent excessive cauterization or carbonization of the endometrium.

 Such cauterization proceeds while looking inside the uterine cavity through the ultrasound imaging apparatus. As cauterization proceeds, gas is generated in the tissues of the endometrium and whitening occurs, so it is difficult to determine the boundary of the endometrium even when the uterine cavity is seen through the ultrasound.

Therefore, the operator adjusts the insertion length of the electrode while watching the scale 60 in addition to the ultrasound imaging apparatus, and the procedure is performed according to the operator's hand sense.

7 is a perspective view showing a second embodiment of the endometrial action electrode according to the present invention, Figures 8a and 9a and 8b and 9b is an enlarged side cross-sectional view of portion C and D of FIG.

The second embodiment of the endometrial insufficiency electrode according to the present invention is composed of one bi-polar electrode which is configured to insulate the active electrode and the inactive electrode from each other and to make a separate electrical connection, FIG. 7 9B, the sheath 152 constituting one end portion and the hollow internal electrode 154 inserted therein constitute an active electrode and are coaxially positioned with the sheath 152 and at the same time. A hollow external electrode installed on the outside to surround the 156 is configured to form an inactive electrode, the temperature sensor line 158 for measuring the temperature of the electrode as well as a separate device for applying a high frequency is connected to the electrode ) Is embedded to control the input current according to the temperature of the electrode.

More specifically, the sheath 152 and the inner electrode 154 is made of a conductive material that can transmit high frequency, such as stainless (or similar metal), but do not hurt even if the end (152a) is in contact with the endometrium In addition, hemispheres are welded to the ends of the hollow shaft to form a blunt formation to prevent medical accidents that penetrate the uterine wall.

In this case, the non-isolated portion is configured to be cauterized by the high frequency in the section including the sheath 154 from the end 152a, but the sheath 154 from the end 152a is 1 to 6 cm.

Next, the external electrode 156 is also made of a conductive material capable of transmitting high frequency, such as stainless steel, and has a ring-shaped ring insulating material such that the sheath 152 and the external electrode 156 can be insulated in the axial direction. A 160 is installed between the sheath 152 and the external electrode 156, the inner shell 162 of the hollow shaft shape is formed so that the inner electrode 154 and the outer electrode 156 can be insulated from each other. It is provided between the 154 and the external electrode 156.

In addition, in order to form a portion of the tip of the external electrode 156 along with the sheath 152 as a non-insulating part, the hollow shaft-shaped outer shell insulating material 164 is separated from the tip of the external electrode 156 by a predetermined distance. It is installed so as to surround, which constitutes a portion of the outer electrode 156 as a non-insulating portion, the current transmitted to the human body through the inner electrode 154 and the sheath 152 again to the front end of the outer electrode 156 It is to be configured to flow through.

In this case, even if the outer shell insulating material 164 is installed on the outer circumferential surface of the outer electrode 156, it is preferable to reduce the foreign matter even if the electrode is inserted into the cervix so that a step is not generated in the connecting portion. The inclined groove 156h by forming only the tip portion on which the outer shell insulating material 164 is to be covered on the outer circumferential surface of the outer surface, or grinding all the portions on which the outer shell insulating material 164 is to be installed, and then the outer shell insulating material 164. Is covered on the outer circumferential surface of the external electrode 156.

In this case, the sheath 152, the inner electrode 154, the outer electrode 156 and a variety of insulating materials (160, 162, 164) constitutes one electrode, such an electrode is located in front of the abdomen so that the uterus is almost perpendicular to the vagina In consideration, it is preferable to bend at an angle of 60 ° or less from the end 152a at a predetermined position, and the outer diameter thereof is 2 to 8 mm, and the length thereof is preferably configured to be thin and long to 15 to 30 cm.

Of course, the electrode may be bent at any one of the sheath 152, the exposed portion of the external electrode 156, the outer shell insulating material 164.

Next, the temperature sensor line 158 is installed to be inserted into the inner electrode 154 as the hollow electrode is formed therein, and is installed to be inserted up to the end 152a of the inner electrode so that the sheath 152 is a non-insulating part. The side temperature is measured, and accordingly, the generation of high frequency is controlled by adjusting the current input to the electrode.

At this time, the temperature sensor line 158 is to control the temperature to prevent excessive cauterization in the sheath 152, but the cauterization degree is determined by the high frequency applied basically, the tissue of the endometrium for each patient Since the characteristics are different, it is desirable to control the temperature in consideration of this. Furthermore, in order to prevent excessive cauterization or carbonization of the endometrium, the impedance control for automatically adjusting the generation of high frequency is also performed according to the impedance measurement value of the endometrium. More preferably.

In addition, in order to identify the degree of insertion of the electrode into the cervix, the envelope insulation 54 may be marked with a scale (not shown) from the end 152a.

Looking at the assembly process of the second embodiment of the small-acting electrode as described above, the temperature sensor line 158 is inserted into the inner electrode 156, and then the endothelial insulating material 162 on the outer peripheral surface of the inner electrode 156, The outer electrode 154 and the outer shell insulating material 164 are sequentially covered, and the inner shell insulating material 162 is covered so that the tip of the inner electrode 152 is exposed to a predetermined length or more, and the front end of the outer electrode 154 is covered. The outer shell insulating material 164 is covered so as to partially expose the ring insulating material 164, and the ring insulating material 150 is fitted on the inner skin insulating material 162 so as to contact the tip of the outer electrode 154.

Next, the sheath 152 is fitted to the outer periphery of the inner electrode 154, and as shown in FIGS. 8A and 8B, the assembled parts of the sheath 152 and the ring insulation are formed with grooves and threads. Although it may be configured to be connected only in the axial direction by forming a back, as shown in FIGS. 9A and 9B, the sheath 152 is also radially in addition to the axial direction so as to completely engage the outer circumferential surface of the inner electrode 154. It may be configured to be connected, the hemispherical end is welded and fixed to the front end of the sheath 152 and the internal electrode 154.

The second embodiment of the endometrial small-acting electrode as described above also exhibits the same effects and effects as the first embodiment of the endometrial small-acting electrode mentioned above, and the sheath 152 and the external electrode 156 during surgery. When a current is supplied in a state where the front end portion is inserted into the human body, high frequency is generated through the end 152a and the sheath 152 through the internal electrode 154, and the current delivered to the human body is the external electrode ( Since only the electrode is inserted into the human body because it is transmitted through the front end portion of 156, it can be used simply because it does not need to attach a ground pad, which is a separate inactive electrode.

Various embodiments of the endometrial small-acting electrode as described above can be usefully used not only for endometrial cauterization, but also for difficult endometriosis, coagulation in case of difficulty in hemostasis in general laparoscopic surgery, coagulation of inflammatory sites, and cauterization of other lesions. .

In the above, the present invention has been described in detail by taking an endometrial small-acting electrode as an example based on the embodiments of the present invention and the accompanying drawings, but the scope of the present invention is not limited by the above embodiments and the drawings, and the present invention. The scope of will be limited only by the contents described in the claims below.

The present invention configured as described above has the advantage that the end of the electrode is formed blunt, even if it is in contact with the inner wall of the uterus to reduce the risk of medical accidents that hurt or puncture.

In addition, the present invention is designed in consideration of the position of the uterus with respect to the vagina, because the non-insulated portion, which generates ultrasonic waves at a point away from the end of the electrode is formed to be bent at a set angle with respect to the other portion, the non-insulated portion in the uterine cavity Not only is it easy to contact, there is an advantage that it is easy to operate over the entire area while reciprocating linear motion.

In addition, the present invention is to install a temperature sensor inside the hollow electrode to control the high frequency in accordance with the temperature of the non-insulated portion in which ultrasonic waves are generated in the electrode, so that even if the cervical tissue of the patient exhibits different characteristics, the procedure is made accordingly. There is an advantage to increase the safety and satisfaction of the procedure.

In addition, since the present invention displays a scale indicating the length from the end of the electrode, even in a situation where it is difficult to observe by ultrasound during the cauterization procedure, the procedure can be performed while checking the insertion degree of the electrode through the scale, so that the wound on the uterine wall There is an advantage that can be prevented from coming out, or puncture.

In addition, since the present invention comprises the active electrode and the inactive electrode as one electrode, it is possible to use the electrode more easily by inserting the electrode into the human body without attaching a ground pad to the outside of the human body.

Claims (10)

A conductive electrode extending from the blunt end to be inserted into the human body and bent at a predetermined position, the conductive electrode capable of applying a high frequency current; And an insulating member installed to surround a portion of the electrode other than the non-insulating portion, which is a part of the electrode, from the end of the electrode. The method of claim 1, The electrode is composed of an active electrode (Passive electrode) and the active electrode (Passive electrode) is installed to be insulated from other parts even if exposed from the non-insulated portion, the active electrode and the inactive electrode is a separate electrical connection Small action electrode comprising a. The method of claim 2, The active electrode includes a relatively short hollow sheath and a relatively long hollow inner electrode installed therein, and the inactive electrode includes a hollow outer electrode installed to enclose the inner electrode coaxially with the sheath. An actuation electrode, characterized in that. The method of claim 3, wherein Between the active electrode and the inactive electrode, a ring insulating material for insulating the sheath and the external electrode in the axial direction, an inner skin insulating material for insulating the internal electrode and the external electrode, and installed so as to expose only a partial section of the tip of the external electrode Small action electrode characterized in that it further comprises a shell insulation material. The method of claim 1, And said electrode is bent at an angle of greater than 0 ° and less than 60 °. The method of claim 1, And said electrode is a hollow electrode, and a temperature sensor is installed therein for measuring the temperature of said non-insulating part. The method of claim 1, The outer diameter of the electrode is a small-acting electrode, characterized in that 2 ~ 8 mm. The method of claim 1, The non-insulating part has a length of 1 to 6 cm, and the electrode has a length of 15 to 30 cm. The method of claim 1, The electrode is a small-acting electrode, characterized in that the outer surface on which the insulating member is to be installed is polished so that no step occurs even if the insulating member is installed. The method according to any one of claims 1 to 9, The insulating member is a short-acting electrode, characterized in that the length is marked by a scale from the end of the electrode.

Images