KR102614596B1 - Multi-lumen medical dispensing device for combination of multiple treatment tools - Google Patents

Abstract

The present invention provides a medical dispensing device in which a plurality of treatment tools are used in combination, comprising: a first treatment tool; Treatment District 2; a main body that selectively discharges the first treatment tool or the second treatment tool; and a tube portion provided in the main body and extending to a predetermined length to guide the penetrating first treatment tool or the second treatment tool into the body, wherein the tube part extends from a proximal part extending from an end of the main body. A single lumen tube receiving the first treatment tool and the second treatment tool in a single hollow up to one area, and the first treatment tool from the first area to a second area before the plurality of treatment tools are crossed for discharge. One feature is that it is composed of a double lumen tube that separately accommodates the second treatment tool in each hollow.

Description

Medical dispensing device with multi-lumen structure for combined use of multiple treatment devices {MULTI-LUMEN MEDICAL DISPENSING DEVICE FOR COMBINATION OF MULTIPLE TREATMENT TOOLS}

The present invention relates to a medical dispensing device used in procedures such as endoscopy, and particularly to a medical dispensing device in which a plurality of treatment tools are used together on one device.

Recently, as social changes such as Western lifestyle and dietary changes occur, colon diseases are increasing. As the development of colonoscopy equipment and techniques accelerates, the number of colonoscopy tests is increasing quantitatively compared to before. Although colonoscopy has become easier than before, it is still not a common test that anyone can easily perform. In fact, the number of doctors performing colonoscopy is increasing, but a high level of skill is required to provide accurate diagnosis and treatment while performing the test in a short time without causing pain to the patient.

Lesional tissue identified through colonoscopy must be differentiated between lesions that require resection and those that do not. When performing lesion tissue resection, an appropriate method must be selected according to the characteristics of the polyp discovered, such as the location, size, shape, and number of the lesion.

Equipment needed for lesion tissue resection may include needles for drug injection, ESD knives, snares, markers, biopsy devices, and hemostatic clips. These instruments were each provided as medical surgical instruments. When performing lesion tissue resection, as the treatment tools used in the procedure are diverse, there is a need for a medical discharge device that can selectively use the necessary treatment tools.

In this regard, the present applicant has developed, applied for, and registered (Korean Patent No. 1830085, hereinafter abbreviated as ‘Prior Patent 1’) a high-frequency knife combining an ESD knife and a needle treatment tool. Prior patent 1 discloses a mechanism that alternately discharges two treatment tools using gears or wires. However, prior patent 1 has the disadvantage that, due to the nature of the mechanism, when one treatment tool is operated, the other treatment tools are necessarily driven in the opposite direction, making it difficult to design the driving range for each treatment tool.

To explain the driving range in more detail, among medical treatment tools, snares require a driving range of 60 to 64 mm, and knives and needles require a driving range of 14 to 17 mm. As in the above case, in order to use two treatment tools together with significantly different operating ranges due to the characteristics of the treatment tools, it is advantageous to design one treatment tool so that there is an independent operation section and safety device. Accordingly, the present applicant developed and applied for a medical ejection device (Korean Patent Publication No. 10-2020-0053044, hereinafter abbreviated as ‘Prior Patent 2’) so that treatment structures with different driving ranges can be used together. Prior patent 2 discloses a mechanism that can independently manipulate two types of treatment tools, each having a different driving range.

Afterwards, the present applicant recognized that, contrary to the theoretical kinematic design, a new problem arises when a discharge device that uses a plurality of treatment tools is used in actual procedures. Figure 1 shows problems that may occur when a conventional medical ejection device using two types of treatment devices is operated for an actual procedure.

Referring to FIG. 1, it is assumed that the medical dispensing device of prior patent 2 consists of two types of treatment tools, a needle (3) and an ESD knife (4), and is inserted into the large intestine (2). When inserted into an internal organ, the tube 8 of the medical discharge device progresses along the tortuous path of the large intestine 3 and becomes curved. As the tube 8 of the discharge device is bent, the wires of the needles 3, which are a plurality of treatment tools, and the wires of the ESD knife 4 intersect or twist within the tube, and friction increases. In Figure 1, the intersection of two types of treatment wires is expressed as points T1 and T2. Conventional medical dispensing devices using a plurality of treatment tools have a problem in that the intended performance cannot be achieved due to the above-mentioned problems when actually inserting an endoscope. Figures 1 (a) and (b) show this. Due to the twisting of T1 and T2, the needle (3) does not come out as long as the original discharge length (X1) at the end of the tube (8), or the ESD knife ( A problem arises in which 4) does not reach the original length (X2) that should be discharged.

Figure 2 shows the end of the tube 8 that is seen by medical personnel in an actual endoscope. Referring to FIG. 2, the medical worker's field of view is limited due to the characteristics of the endoscope, so the ESD knife (4), which is a treatment tool, must be positioned exactly in the center of the end of the tube (8). As described above in FIG. 1, if the ESD knife 4 or other treatment tool is not properly exposed to the end of the tube 8, it may be difficult to see the field of view during the procedure and an inaccurate procedure may be performed.

The above-mentioned problem is a problem that arises when a plurality of treatment tools are merged into one discharge device, and this is because two types of wires are configured to advance and retract independently on a single lumen of the tube. However, in order to solve this problem, if the tube 8 itself is composed of 2 lumens and each treatment device is guided separately, the flexibility of the tube 8 may decrease, making it more difficult to control the insertion of tortuous internal organs. there is.

Accordingly, the present applicant designed an improved medical dispensing device that secures the flexibility of the tube 8 similar to the conventional one and implements multiple lumens to prevent the plurality of treatment tools from being twisted when the tube 8 is bent several times. It has been done.

Korean Patent No. 1830085 Korean Patent Publication No. 10-2020-0053044

The present invention seeks to provide a medical dispensing device in which heterogeneous treatment tools that must be used together when resecting lesional tissue such as polyps can be provided on a single handpiece.

The present invention can operate different types of treatment tools without restrictions with just one insertion, and fixes some of the different types of treatment tools by manipulating the operation module to provide treatment other than the treatment tool that is intended to be operated by careless operation. The aim is to provide a medical ejection device that prevents the sphere from being ejected unintentionally and allows the treatment tool to be operated independently.

The present invention configures the tube so that the wires of the heterogeneous treatment devices are not twisted while ensuring the flexibility of a single lumen when performing a procedure using a medical discharge device equipped with a heterogeneous treatment device, so that the heterogeneous treatment devices can operate normally at the end of the tube. We would like to provide a medical dispensing device.

In order to achieve the above object, the present invention provides a medical dispensing device using a plurality of treatment tools in combination, comprising: a first treatment tool; Treatment District 2; a main body that selectively discharges the first treatment tool or the second treatment tool; and a tube portion provided in the main body and extending to a predetermined length to guide the penetrating first treatment tool or the second treatment tool into the body, wherein the tube part extends from a proximal part extending from an end of the main body. A single lumen tube receiving the first treatment tool and the second treatment tool in a single hollow up to one area, and the first treatment tool from the first area to a second area before the plurality of treatment tools are crossed for discharge. One feature is that it is composed of a double lumen tube that separately accommodates the second treatment tool in each hollow.

Preferably, the tube portion may have a multi-lumen structure in which the double lumen tube penetrates the second region of the sheath provided as the single lumen tube, thereby changing the number of lumens in a specific region.

Preferably, the tube portion is a single lumen tube in which a treatment tool is discharged centrally through a single hollow in a third area from the second area where the double lumen tube is located to the end where the treatment tool is crossed and discharged. It can be configured.

Preferably, the tube portion is configured with a single lumen structure in the first region, a double lumen structure in the second region, and a single lumen structure in the third region from the second region to the end where the treatment tool is intersected and discharged. , It may be a multi-lumen structure in which the number of lumens along the length of the sheath changes from 1 to 2 to 1.

Preferably, the single lumen tube in the first region has a length of greater than 0 and less than or equal to 1300 mm from the proximal portion.

Preferably, the double lumen tube in the second region has a length of 1000 mm to 2300 mm or less.

Preferably, the tube portion is composed of a single lumen tube in which one treatment tool is discharged centrally with a single hollow in a third area from the second area to the end where the treatment tool is crossed and discharged, and the third area The single lumen tube has a length of 10 mm or more.

Preferably, the main body includes a handle portion having an independent manipulation section of the first treatment tool or the second treatment tool; It includes a gear unit driven by a gear combination with the handle unit in a predetermined section among the operation sections of the handle unit, and a plurality of treatment tools can be independently operated in the operation section of the handle unit.

Preferably, when the operation section of the first treatment tool is the first drive range and the operation section of the second treatment tool is the second drive range, the first drive range is larger than the second drive range, and the first drive range is The second driving range may be included in the above.

Preferably, the first treatment tool and the second treatment tool may be two treatment tools differently selected from the group consisting of a needle, knife, marker, endoscope, biopsy device, and hemostatic clip.

Preferably, the gear part includes a pinion gear gear-coupled with the handle part; and a rack gear that is driven in the longitudinal direction by receiving the rotational force of the pinion gear and to which the second treatment tool is connected, so that the second treatment tool can be advanced and retreated according to the driving direction of the rack gear.

In addition, the present invention provides a medical dispensing device in which a plurality of treatment tools are used in combination, comprising: a first treatment tool that advances and retreats together with the handle portion shown below; a second treatment tool that advances and retracts together with the lower gear unit; a main body provided with a handle unit having an independent operation section of the first treatment tool or the second treatment tool, and a gear unit driven by gear engagement with the handle unit in a predetermined section among the operation sections of the handle unit; and a tube part provided in the main body and extending to a predetermined length to guide the first treatment tool or the second treatment tool penetrated into the body, wherein the tube part is a multi-tube part in which the number of lumens is changed in a specific area. Another characteristic is that it has a lumen structure.

Preferably, one of the first treatment tools and the second treatment tool is locked in an independent operation section of the handle so that only the other treatment tool can be driven forward and backward.

Preferably, the tube portion includes a single lumen tube receiving the first treatment tool and the second treatment tool in a single hollow from the proximal part extending from the end of the main body to the first area, and a plurality of treatment tools from the first area. It may be composed of a double lumen tube that separately accommodates the first treatment tool and the second treatment tool in their respective hollows up to the second area before they intersect for discharge.

In addition, the present invention provides a medical dispensing device in which a plurality of treatment tools are used in combination, comprising: a tube portion inserted into the body; A first treatment tool and a second treatment tool that advance and retreat by manipulating the handle below; an operation module that controls either the first treatment tool or the second treatment tool to a non-driven state; and a handle part that drives a treatment tool that is not in a non-driven state by the operation module and independently manipulates the first treatment tool or the second treatment tool, wherein the tube part changes the number of lumens in a specific area. Another feature is that it has a multi-lumen structure.

Preferably, the manipulation module includes a fixing pin that fixes either the first treatment tool or the second treatment tool and maintains it in a non-driven state; and a fixation pin button for manipulating the fixation pin, wherein the fixation pin can be indirectly manipulated by the fixation pin button.

Preferably, the handle portion includes a fixed handle; And it may include an operation handle that moves relatively from the fixed handle and pushes or pulls the plurality of treatment tools.

Preferably, the tube portion includes a single lumen tube receiving the first treatment tool and the second treatment tool in a single hollow from the proximal part extending from the end of the main body to the first area, and a plurality of treatment tools from the first area. It may be composed of a double lumen tube that separately accommodates the first treatment tool and the second treatment tool in their respective hollows up to the second area before they intersect for discharge.

According to the present invention, the medical dispensing device can be equipped with two types of treatment tools, and the two types of treatment tools can be individually driven by securing independent operation sections. Therefore, when using the medical dispensing device of the present invention, the treatment time can be shortened, and side effects from the treatment process can be minimized, allowing the treatment to be performed more efficiently. In addition, according to the present invention, the operation handle can be driven with one hand, and treatment tools with significantly different driving ranges (for example, snares (driving range 600 to 64 mm) or needles (driving range 14 to 14 mm) can be operated by simply adjusting the length of the operating handle. 17mm)) can be easily operated.

According to the present invention, the tube part is provided in a multi-structure of 1 lumen -> 2 lumen -> 1 lumen to ensure flexibility in the 1 lumen area, prevent twisting in the 2 lumen area, and selectively discharge the treatment tool in the last 1 lumen area. possible. The tube part according to the present invention allows a double lumen tube to be inserted at an appropriate position in the tube to minimize reduction in flexibility and guide the middle of the tube to prevent dissimilar treatment tools from becoming twisted. Accordingly, the present invention has the advantage that the intended performance can be achieved without each of the plurality of treatment device wires being twisted even if the tube portion is bent several times according to the shape of the internal organ during the procedure of a heterogeneous treatment device.

Figure 1 shows problems that may occur when a conventional medical ejection device using two types of treatment devices is operated for an actual procedure.
Figure 2 shows the end of a medical discharge device tube that is checked by a medical worker in an actual endoscope.
Figure 3 shows a medical dispensing device according to an embodiment of the present invention.
Figure 4 shows a cross-sectional view of a tube portion according to an embodiment of the present invention.
Figure 5 shows a side view of the tube portion according to an embodiment of the present invention.
Figure 6 shows an experimental example for configuring a multi-lumen of the tube portion according to an embodiment of the present invention.
Figure 7 shows an example of configuring the main body of a medical discharge device according to an embodiment of the present invention.
Figure 8 shows the driving of the gear part and the locking part of the main body according to the embodiment of Figure 7.
Figure 9 shows the operation of the medical ejection device according to the embodiment of Figure 7.
Figure 10 is a diagram for explaining the driving range of the medical discharge device according to the embodiment of Figure 7.
Figure 11 shows another embodiment constituting the main body of a medical dispensing device according to an embodiment of the present invention.
Figure 12 shows a front view of the first treatment tool and the second treatment tool being inserted into the tube portion of the medical discharge device according to the embodiment of Figure 11.
FIG. 13 shows a state when the fixing pin and fixing pin button of the medical dispensing device according to the embodiment of FIG. 11 are raised.
Figure 14 shows the medical dispensing device being driven as the fixing pin is moved upward.
FIG. 15 shows a state when the fixing pin and fixing pin button of the medical dispensing device according to the embodiment of FIG. 11 are lowered.
Figure 16 shows the fixing pin of the medical discharge device according to the embodiment of Figure 11 having been completely moved downward.
FIG. 17 shows the first treatment device being driven when the operation module of the medical discharge device according to the embodiment of FIG. 11 is raised.
FIG. 18 shows the second treatment device being driven when the operation module of the medical dispensing device according to the embodiment of FIG. 11 is lowered.

Hereinafter, the present invention will be described in detail with reference to the accompanying drawings. However, the present invention is not limited or limited by the exemplary embodiments. The same reference numerals in each drawing indicate members that perform substantially the same function.

The purpose and effect of the present invention can be naturally understood or become clearer through the following description, and the purpose and effect of the present invention are not limited to the following description. Additionally, in describing the present invention, if it is determined that a detailed description of known techniques related to the present invention may unnecessarily obscure the gist of the present invention, the detailed description will be omitted.

Figure 3 shows a medical dispensing device according to an embodiment of the present invention. Referring to FIG. 3, the medical dispensing device 1 may include a main body 90, a first treatment tool 10, a second treatment tool 30, a handle part 50, and a tube part 80. there is.

The terms first treatment tool and second treatment tool defined in this specification refer to equipment used during medical procedures such as endoscopes and incisions. In this embodiment, the instrument may be a needle, knife, marker, endoscope, biopsy instrument, hemostatic clip, etc. In this embodiment, the first treatment tool 10 and the second treatment tool 30 may be two treatment tools differently selected from the group consisting of a needle, knife, marker, endoscope, biopsy device, and hemostatic clip.

For explanation of the driving range, in the embodiment where the first treatment tool 10 is a snare and the second treatment tool 30 is a needle, the snare is pulled in or out of the tube 80 to form a sufficient snare diameter. It has a wide range of characteristics. In general, the snare must be able to be manipulated with an advance/retract distance of about 60 to 64 mm by pushing or pulling the handle portion 50. On the other hand, the needle, which is the second treatment tool 30, is a treatment tool for washing or injecting a chemical solution by penetrating into the lesion tissue. The above needle has the characteristic of having a small operating range so that only the sharp end can be exposed, as if too much is exposed from the tube 80, it may unintentionally invade deeply into the lesion tissue or cause unnecessary wounds. In general, the needle must be able to move forward and backward at a distance of about 14 to 17 mm by pushing or pulling the handle 50.

The main body 90 can selectively discharge the first treatment tool 10 or the second treatment tool 30. The detailed structure of the main body 90 and the mechanism for driving each of the plurality of treatment tools will be explained through the embodiments of FIGS. 7 to 18.

The tube portion 80 is provided in the main body 90 and extends to a predetermined length to guide the penetrating first treatment tool 10 or the second treatment tool 30 into the body. In the case of colonoscopy, the organs that need to be accessed are long and complex. This makes it difficult to access the polyp with an endoscope or manipulate it for surgery. This becomes a factor that makes it difficult to insert and drive not only the endoscope but also a treatment tool such as the medical discharge device 1 according to this embodiment used in procedures using an endoscope.

As in this embodiment, when a metal wire that conducts current through a knife and a plastic tube that supplies the injection fluid are provided together on one discharge device as two types of treatment tools, the metal wire and the plastic tube are in the tube portion 80. There are cases where the operator's operation becomes stiff due to crossing or excessive friction, and the treatment tool is not discharged to the designed length. The tube portion 80 according to this embodiment may be composed of a single lumen tube 81 and a double lumen tube 83 in consideration of the above matters.

Figure 4 shows a cross-sectional view of the tube portion 80 according to an embodiment of the present invention. Figure 4(a) shows a cross-sectional view of the single lumen tube 81, and Figure 4(b) shows a cross-sectional view of the double lumen tube 83. Figure 5 shows a side view of the tube portion 80 according to an embodiment of the present invention.

Referring to Figures 4 and 5, the tube portion 80 according to this embodiment has a configuration in which the number of lumens varies from a portion of the extended length. Referring to (a) of FIG. 4, the single lumen tube 81 freely accommodates the first treatment tool 10 and the second treatment tool 30 therein. The single lumen tube 81 is constructed from the proximal region starting from the body 90 to a predetermined length. As an example, the single lumen tube 81 accommodates the metal wire 10 of the ESD knife and the plastic tube 30 of the needle through which the chemical solution is delivered as the first and second treatment tools in one lumen. The single lumen tube 81 has sufficient flexibility to be guided through complex internal organs. However, if the single lumen tube 81 is bent several times, the wire 10 and the plastic tube 30 are twisted or twisted, and in the process, excessive pressure or friction occurs with each other.

Accordingly, the tube portion 80 is composed of a double lumen tube 83 in the distal region of the length, and referring to Figure 4(b), the double lumen tube 83 has a first lumen 831 and a second lumen up and down. (833) can be formed.

The double lumen tube 83 receives the wire 10 in the first lumen 831 and the plastic tube 30 in the second lumen 833. The inner diameter of the lumen may change depending on the type of treatment device. The tube portion 80 is provided with a structure capable of guiding the treatment wire to be positioned without being twisted or twisted in the section of the single lumen tube 81 due to the double lumen tube 83 located at the distal portion.

3 and 5, the single lumen tube 81 provides a first treatment tool 10 and a second treatment tool 30 from the proximal part extending from the end of the main body 90 to the first area A1. Accommodates in a single hollow.

The double lumen tube 83 supplies the first treatment tool 10 and the second treatment tool 30 from the first area A1 to the second area A2 before the plurality of treatment tools intersect for discharge. Separately accommodated in the hollow of.

The tube portion 80 is a single hollow section from the second area A2, where the double lumen tube 83 is located, to the third area A3, which is the end where the treatment tools are crossed and discharged. It consists of a single lumen tube 81 that is discharged.

The first area (A1), the second area (A2), and the third area (A3) are all terms named to distinguish specific sections in the length of the tube portion 80. The first area (A1) can be understood as a proximal location, the second area (A2) as a distal location, and the third area (A3) as an end location.

The tube portion 80 has a multi-lumen structure in which a double lumen tube 83 is inserted into the second area A2 in the sheath provided as a single lumen tube 81, and the number of lumens is changed in a specific area. Referring to FIG. 5, since the double lumen tube 83, which is shorter in length than the single lumen tube 81, is penetrated, the number of lumens in a specific area of the single lumen tube 81 changes from 2 to 1.
Since it is difficult to construct the tube portion 80 by joining different types of tubes, such as the single lumen tube 81 and the double lumen tube 83, it is provided as a single lumen tube 81, but the double lumen tube 83 is provided in the second area. It is desirable to manufacture and provide it in a form that penetrates and inserts up to (A2). Accordingly, the third area A3 after the penetration of the double lumen tube 83 is naturally formed as an area of the single lumen tube 81 again.

In this embodiment, the tube portion 80 is composed of a single lumen structure in the first area (A1), a double lumen structure in the second area (A2), and a single lumen structure in the third area (A3), and has a length in the sheath. It has a multi-lumen structure in which the number of lumens changes from 1 to 2 to 1.

The single lumen tube 81 in the first area A1 has a length of more than 0 but less than 1300 mm from the proximal part. The double lumen tube 83 in the second area A2 has a length of 1000 mm to 2300 mm or less. The single lumen tube 81 in the third area A3 has a length of 10 mm or more.

In this embodiment, the medical discharge device 1 used in colonoscopy procedures is preferably designed so that the length of the tube portion 80 is 2300 mm or more. In Figure 5, the first treatment tool 10 is shown as an ESD knife, and the second treatment tool 30 is shown as a needle 30, and the ESD knife 10 and needle 30 intersect in the third area A3. It runs. Medical discharge devices with multiple treatment devices require a distance of at least 10 mm for cross-driving. In addition, after cross-driving, the distance D that must be advanced toward the center of the single circumference of the tube portion 80 is required to be at least 5 mm. Accordingly, the length of the third area A3 must be at least 15 mm. It is important that the single lumen tube 81 in the preferred first area A1 does not exceed a length of 1300 mm, and the double lumen tube 83 in the second area A2 has a length of 1300 mm over the entire length of the tube part 80. It is preferably designed by subtracting the length of the single lumen tube 81 in area 1 (A1) and the length of the third area (A3). The length section of the second area A2 can be designed to be 1000 mm to 2300 mm or less. The smaller the length, the more flexible the tube portion 80 is, so it is more preferable to select it in the range of 1000 mm to 1500 mm. Below, an experimental example will be described as the reason why the lengths of the single lumen tube 81 and the double lumen tube 83 were set as above.

Experimental example. Operation test of single lumen and multi-lumen section of tube section

Figure 6 shows an experimental example for configuring a multi-lumen of the tube portion 80 according to an embodiment of the present invention. The test conditions were the most severe within the scope within which the endoscope can operate. The experimental model is wrapped 3.5 turns with a radius of 20 cm (2.5 turns for camouflage) and the distal end is rotated 180 degrees with a radius of 3 cm to evaluate the driveability of the device.

The operation of the knife and needle at the end of the tube section was checked based on a movement of approximately 50 mm from the mechanism section. First, in the case where the entire tube part was composed of a single lumen tube and the case where the entire tube part was composed of a double lumen tube, the driving resistance and whether driving defects occurred according to the length of the tube, which is the size of the tube, were checked. The quantity tested for each condition was 20.

[Table 1]

The outer diameter of the wire, which was the first treatment tool, was 0.43 mm, and the outer diameter of the tube, which was the second treatment tool, was 1.03 mm. When using these multiple treatment devices, when a single lumen tube was constructed, operation failure occurred at both the 1600 mm length for gastrointestinal endoscopy and the 2300 mm length for colonoscopy.

In experiments with single lumen tubes, there was no significant reduction in wire and tube driving resistance even when the inner diameter of the tube was expanded to 1.5 to 1.7 mm. Therefore, it is understandable that when multiple treatment devices are used together with a single lumen tube, it is difficult to solve the problem in terms of both inner diameter and length conditions. In particular, the single lumen tube had a defect rate exceeding 50% in the 2300mm test.

In the case of the double lumen tube, no drive failure occurred when the inner diameter was expanded beyond 0.55 mm and 1.1 mm, respectively. However, even in the case of the double lumen tube, it was confirmed that some defects occurred in the 2300mm driving test. In addition, although it is difficult to experiment with data, if the entire tube portion 80 is composed of a double lumen tube, flexibility is drastically reduced, making it difficult to insert the endoscope and control it to the target position. In addition, the use of a multi-lumen catheter is necessary for colonoscopy procedures of 2300 mm or more, but partial operation failure occurs in small internal diameter conditions of 0.5 mm or 1.05 mm.

Therefore, in this experiment, it was confirmed that if only a single lumen tube or a double lumen tube is used, even numerical or design optimization is insufficient to achieve sufficient performance of the product when implementing heterogeneous treatment equipment. As a result, The need for a combination of single lumen tubes and double lumen tubes was recognized.

Therefore, in this experimental example, a single lumen tube and a double lumen tube were additionally combined to test drive failure at different length ratios.

Results of an experimental example. Poor driving section in the multi-lumen section

[Table 2]

[Table 2] shows the results of an experiment that identified drive failure sections for different length ratios by combining single lumen tubes and double lumen tubes. A single lumen tube corresponds to the conditions of ‘Tube 2’, and a multi-lumen tube corresponds to the conditions of ‘Tube 1’. The inner diameter of the single lumen tube was fixed at 1.8 mm, and the inner diameter of the multi-lumen tube was fixed at 0.55 mm and 1.1 mm, respectively.

Referring to [Table 2], as a result of the experiment, a drive failure occurred when the length of the single lumen tube exceeded 1600mm. The point at which a defect occurs is when the single lumen tube has a length of 1600mm and the double lumen tube has a length of 700mm. In summary, when the single lumen tube 81 is constructed up to a length of 1300 mm based on the proximal part of the tube portion 80 starting from the main body 90, and the double lumen tube 83 is constructed in the subsequent section, driving failure occurs. This does not occur. In other words, the first area A1 is preferably set to a section of 1300 mm or less, and the second area A2 is preferably set to a section of 1000 mm or more.

Based on the above experimental example, it is possible to understand the design of the above-described tube portion 80 and the reason for setting the first, second, and third areas (A1, A2, and A3). According to this embodiment, a tube containing a plurality of treatment tools is inserted into the long and complex organ of the large intestine, so that the intersection and discharge drive of the treatment tools with the intended performance at the end can operate normally even if the tube portion 80 is bent several times. You can. Below, various embodiments of the main body 90 that discharges a plurality of treatment tools are disclosed.

Figure 7 shows an embodiment of the main body 90 of the medical discharge device 1 according to an embodiment of the present invention. Referring to FIG. 7, the medical dispensing device 1 includes a main body 90, a first treatment tool 10, a second treatment tool 30, a handle part 50, a gear part 60, and a power connection part 70. ), and may include a tube portion 80. Hereinafter, the tube portion 80 may be applied to the embodiments of FIGS. 1 to 6 , and thus redundant reference will be omitted.

Referring to FIG. 7, the main body 90 refers to a catheter main body 90 having a predetermined length. The main body 90 has a handle portion 50 at the rear end through which medical workers can independently manipulate each treatment tool. The main body 90 is provided with a power connection unit 70 for applying high frequency waves at the proximal part. A tube 80 that is inserted into the body is provided at the front end of the main body 90. The medical dispensing device 1 according to this embodiment accommodates a first treatment tool 10 and a second treatment tool 30 in a tube 80.

The independent manipulation section in this embodiment can be understood as a sliding section of the handle portion 50 that can independently manipulate the first treatment tool 10 or the second treatment tool 30. Preferably, the independent manipulation section can be linked to the treatment tool that requires a large driving range among the two treatment tools. As an example, in this embodiment, the first treatment tool 10 (snare), which requires a larger driving range among the two treatment tools, has an independent operating section. Accordingly, the second treatment tool 30 is fixed when the first treatment tool 10 is operated, and the driving range of the first treatment tool 10 can be easily designed through the length of the main body 90. In order to implement a mechanism with an independent manipulation section, the medical dispensing device 1 according to this embodiment may include a locking portion 40 that locks another treatment tool.

The power connector 70 may be connected to a jack that supplies power to the first treatment tool 10. According to this embodiment, the other end of the wire that drives the first treatment tool 10 is fixed to the power connection unit 70. The power connector 70 may supply power to the first treatment device 10 through a wire.

The mechanisms of the handle portion 50 and the gear portion 60 will be described with reference to FIG. 7 .

The handle portion 50 has an independent manipulation section of the first treatment tool 10 or the second treatment tool 30. In the prior art literature, various discharging mechanisms using an ESD knife and needle were proposed. The conventional literature generally consisted of a plurality of operating means (handles) to respectively operate a plurality of treatment tools. That is, the first handle for advancing and retracting the ESD knife and the second handle for advancing and retracting the needle were configured in parallel to enable independent operation of a plurality of treatment tools. However, from the perspective of a medical practitioner who operates the discharge device with one hand while looking at the endoscope, having separate handles for each treatment device has the problem of making precise surgical work more difficult.

Accordingly, the handle unit 50 according to this embodiment is configured so that both the first treatment tool 10 and the second treatment tool 30 can be driven from the handle unit 50, so that a single treatment tool can be operated. It was designed to be identical to the environment, taking user convenience into consideration. In addition, the handle portion 50 according to this embodiment has the feature of being configured to selectively discharge the first treatment tool 10 and the second treatment tool 30 with only one sliding operation.

The handle portion 50 may include a fixing handle 501 and an operating handle 503. For convenience of explanation, the terms for handles are classified into fixed handle and operating handle. However, both fixed handle 501 and operating handle 503 represent a configuration of a handle that can be operated with one hand. Referring to FIG. 2, the fixing handle 501 may be formed at the rear end of the main body 90.

The fixing handle 501 accommodates the user's thumb, and the operating handle 503 accommodates fingers other than the user's thumb. The fixed handle 501 refers to a fixed configuration that does not move among the configurations of the handle portion 50 that the user operates with his or her hand. If the handle that accommodates the thumb is slidably driven, the medical dispensing device 1 is provided. If so, the fixation handle 501 and the operation handle 503 of FIG. 2 may be opposite to each other.

The operating handle 503 is relatively moved from the fixed handle 501 and is configured to push or pull the first treatment tool 10. The operation handle 503 may be partially formed with teeth 5031 that are gear-coupled with the gear unit 60 on the inside.

The teeth 5031 are formed in the longitudinal direction along which the operation handle 503 slides. The teeth 5031 drive the gear unit 60, which will be described later. Referring to FIG. 2, note that the teeth 5031 are not formed throughout the entire length of the operation handle 503 inside the operation handle 503. The operation handle 503 has a section in which teeth 5031 are not formed at the rear end of the inner length. The reason why the teeth 5031 are partially formed on the operation handle 503 as described above is to prevent the teeth 5031 from engaging with the gear portion 60 in a predetermined section during the sliding section of the operation handle 503. As the teeth 5031 do not engage with the gear unit 60 in a predetermined section of the sliding section of the operation handle 503, there is an area in which the gear unit 60 is not driven, and the operation handle 503 is independent. An operation section is formed.

The teeth 5031 are a component that drives the gear unit 60, and the length of the teeth 5031 actually determines the driving range that can advance and retreat the second treatment tool 30 connected to the gear unit 60. . Therefore, in this embodiment where the second treatment tool 30 is a needle with a driving range of about 14 to 17 mm, the teeth 5031 formed on the operation handle 503 can be formed to have a corresponding length of 14 to 17 mm. there is.

The gear unit 60 may be driven by gear engagement with the handle unit 50 in a predetermined section among the operation sections of the handle unit 50. The gear unit 60 may include a pinion gear 61, a rack gear 63, and a cylinder 65.

The pinion gear 61 may be gear-coupled with the handle portion 50.

According to this embodiment, the pinion gear 61 can be rotated from the section in which the teeth 5031 are partially formed among the operation sections of the handle portion 50. The pinion gear 61 serves to transmit the rotational motion rotated by the external force of the handle portion 50 to the rack gear 63 as a horizontal motion. The pinion gear 61 is fixedly coupled to the main body 90 so as to be rotatable. In this embodiment, the pinion gear 61 may be fixedly coupled to a position spaced apart from the fixing handle 501 by at least the length of the teeth 5031 formed on the operation handle 503. Therefore, the operation handle 503 with teeth 5031 formed rearward of the pinion gear 61 can be retracted, and in the process of the operation handle 503 being retracted, the teeth 5031 engage with the pinion gear 61 and rotate. do.

The rack gear 63 is driven in the longitudinal direction by receiving the rotational force of the pinion gear 61, and the second treatment tool 30 is connected to the second treatment tool 30 according to the driving direction of the rack gear 63. may be pushed back. The pinion gear 61 engages with the teeth 5031 and rotates while the operation handle 503 is retracted. When the pinion gear 61 rotates, the rack gear 63 coupled to the other side of the pinion gear 61 receives a rotational force and is driven forward or backward inside the main body 90. The length of the rack gear 63 may be formed to a length corresponding to the teeth 5031.

The cylinder 65 refers to an area where the front end of the rack gear 63 is extended, and the second treatment tool 30 is connected to the rack cylinder 65. When the rack gear 63 advances or retracts together with the cylinder 65, the second treatment tool 30 connected through the cylinder 65 may also advance or retract. That is, the second treatment tool 30 is not directly connected to the handle unit 50, but can be operated indirectly through the gear unit 60 by manipulating the handle unit 50.

The locking unit 40 may be further included in the medical dispensing device 1 to fix the movement of the rack gear 63 in the independent manipulation section of the handle unit 50.

The locking portion 40 may be formed in the main body 90. The locking unit 40 locks and secures either the first treatment tool 10 or the second treatment tool 30 in an independent manipulation section of the handle unit 50. The locking unit 40 can be maintained in a locked state when the gear unit 60 is not driven, and can be maintained in an open state in a predetermined section where the gear unit 60 is gear-engaged among the operation sections of the handle unit 50. . In this embodiment, the locking part 40 may be provided as a cantilever with a free end. The locking portion 40 may have a stopper structure for hooking formed at an end of the free end. The locking part 40 can be pressed by the sliding operation of the handle part 50, and the stopper for hooking can lock the treatment tool by pressing the gear part 60.

The rack gear 63 or the cylinder 65 may have one or more locking grooves 41 and 43 that can be engaged with the locking portion 40 formed on the surface that comes into contact with the main body 90. The first locking groove 41 may be formed at the position of the operation handle 503 where the teeth 5031 of the rack gear 63 engage with the pinion gear 51.

The second locking groove 43 may be formed at a location spaced apart from the first locking groove 41 by the length of the operation handle 503. Accordingly, the second locking groove 43 may be provided on the cylinder 65 from which the rack gear 53 extends. In Figure 2, when the operation handle 503 is advanced forward, the operation handle 503 presses the locking part 40 and is fastened to the first locking groove 41, and the operation handle 503 is continuously pressed to the area where the operation handle 503 is continuously pressed. The rack gear 63 is fixed while moving forward. However, when the operation handle 503 advances further and the rear end of the operation handle 503 passes the first locking groove 41, the pressure of the locking portion 40 is released and the locking of the rack gear 63 is released. You can. Accordingly, the second locking groove 43 functions to fix the rack gear 63 even if the operation handle 503 is advanced beyond the first locking groove 41.

Figure 8 shows the operation of the gear part 60 and the locking part 40 of the main body according to the embodiment of Figure 7. The driving mechanism of the gear unit 60, the locking unit 40, and the handle unit 50 will be described with reference to FIG. 8.

Referring to the picture at the top, when the user moves the operation handle 503 forward, the operation handle 503 applies pressure to the locking portion 40 formed in the section facing the main body 90. The operation handle 503 presses the locking part 40, and the locking part 40 is hooked to the locking grooves 41 and 43, so that the gear part 60 is fixed and does not move. Since the gear unit 60 is fixed, the second treatment tool 30 does not advance or retreat, and the first treatment tool 10 is discharged out of the tube 80.

Referring to the picture at the bottom, when the user retracts the operation handle 503, the pressure applied to the locking portion 40 formed in the section where the operation handle 503 faces the main body 90 is released. As the operation handle 503 is pushed back, the pressed locking part 40 is released from the locking grooves 41 and 43, and the gear part 60 becomes drivable. The operation handle 503 is retracted, and the teeth 5031 formed on the operation handle 503 and the pinion gear 61 are tooth-coupled to enable the second treatment tool 30 to be discharged.

FIG. 9 shows the operation of the medical ejection device 1 according to the embodiment of FIG. 7.

Referring to the upper picture of FIG. 9, the handle unit 50 is formed by the user holding the fixing handle 501 with the thumb, holding the operation handle 503 with the fingers other than the thumb, and applying pressure to the first treatment tool. It is configured so that (10) can be advanced or retreated. When the user advances the operation handle 503 toward the front end of the main body 90, the operation handle 503 applies pressure to the locking portion 40 that maintains the gear portion 60 in a locked state. The operation handle 503 that advances while applying pressure to the locking unit 40 discharges the first treatment tool 10 out of the tube 80. The section in which the locking unit 40 maintains locking can be understood as an independent operation section of the handle unit 50.

Referring to the middle picture of FIG. 9, when the user retracts the operation handle 503, the first treatment tool 10 is partially retracted inside the tube 80. When the operation handle 503 gradually retracts to the point where the teeth 5031 come into contact with the pinion gear 61, the user detects this through the checking unit 20. Beyond the independent operation section up to this point, when the operation handle 503 is further retracted, the locking portion 40 is discharged from the first locking groove 41 and the rack gear 63 is released. At the same time, the pinion gear 61 begins to rotate.

Referring to the bottom picture of FIG. 9, you can see the operation when the operation handle 503 is retracted after passing the independent operation section. The rack gear 63 is unlocked, and the pinion gear 61 is rotated counterclockwise. As the pinion gear 61 rotates, the rack gear 63 advances toward the front end of the main body 90. As the rack gear 63 advances, the second treatment tool 30 is discharged out of the tube 80.

The driving range of the first treatment tool 10 and the second treatment tool 30 according to this embodiment is that the operation section of the first treatment tool 10 is the first driving range, and the operation range of the second treatment tool 30 is When the section is the second driving range, the first driving range is larger than the second driving range, and the second driving range may be included in the first driving range.

Referring to FIG. 9, the driving range in which the first treatment tool 10 is independently moved by the user physically manipulating the operation handle 503 can be expressed as a length D1. Additionally, the driving range in which the second treatment tool 30 is moved by the user physically manipulating the operation handle 503 can be expressed as the length D2. In the section D2 in which the second treatment tool 30 is moved, not only the second treatment tool 30 but also the first treatment tool 10 is operated. Accordingly, the first driving range, which is the length at which the operating handle 503 operates the first treatment tool 10, may be D1+D2. The second driving range, which is the length at which the operation handle 503 operates the second treatment tool 30, may be D2. In summary, the first driving range, which is the length in which the first treatment tool 10 is manipulated, is larger than the second driving range, which is the length in which the second treatment tool 30 is manipulated, and the first driving range is greater than the second driving range. It will be included.

FIG. 10 is a diagram for explaining the driving range of the medical ejection device 1 according to the embodiment of FIG. 7. In more detail, Figure 10 explains the driving range of the teeth 5031 and the gear unit 60 according to an embodiment of the present invention. In FIG. 10, the section where the teeth 5031 are formed within the operation handle 503 can be indicated as R1. As described above, the length of the teeth 5031 determines the driving range of the second treatment tool 30. The section for manipulating the advance and retreat of the second treatment tool 30 is R1, and R1 can be designed to have a length suitable for the driving range of the second treatment tool 30.

Meanwhile, when the pinion gear 61 is driven in the R1 section, it corresponds to a space where the operation handle 503 can be retracted, and the tooth length of the rack gear 63 that engages in the R1 section is represented by the R2 section.

In summary, the length of the section R1 where the sawtooth 5031 is formed and the section R2 through which the second treatment tool 30 advances are approximately the same. When the user manipulates the length of R1, the second treatment tool 30 is discharged as much as R2. When the length at which the user physically manipulates the operation handle 503 is R1, the second treatment tool 30 moves by the length R2, which is equal to the length of R1. The medical dispensing device 1 according to this embodiment physically manipulates the operation handle 5031 through the mechanism of the gear part 60 and the teeth 5031 formed in a predetermined section of the handle part 50 as described above. Implements a mechanism that can independently discharge two types of treatment tools. In addition, even if the treatment tools have different driving ranges, the design can be easily changed without changing the mechanism due to the length of the teeth 5031 and the length of the main body 90. Therefore, the medical ejection device 1 according to this embodiment can discharge a plurality of treatment tools regardless of the type of treatment tool.

Figure 11 shows another embodiment of the main body 90 of the medical discharge device 1 according to an embodiment of the present invention. In this embodiment, one treatment tool is fixed to the main body 90 through the configuration of the operation module 100 and other treatment tools are driven independently, so that different types of treatment tools are used together in a form without a gear mechanism. .

Referring to FIG. 11, the first treatment tool 10 and the second treatment tool 30 are locked by a fixing pin 105 in an independent manipulation section of the handle portion 50. Only other treatment tools can be driven forward and backward. The independent manipulation section expressed in this embodiment can be understood as a sliding section of the handle portion 50 that can independently manipulate the first treatment tool 10 or the second treatment tool 30. Preferably, the independent operating section can be linked to the treatment tool that requires a large driving range among the two treatment tools. In this embodiment, it is assumed that the first treatment tool 10, which requires a large driving range, has an independent operation section, and the second treatment tool 30 has an independent operating range within the driving range of the first treatment tool 10. It is exemplified as having a driving range.

The handle unit 50 can manipulate the first treatment tool 10 or the second treatment tool 30 having an independent manipulation section. In the prior literature, various discharging mechanisms using a combination of an ESD knife and needle were proposed, and the prior literature generally consisted of a plurality of operating means (handles) to respectively operate a plurality of treatment tools. That is, the first handle for advancing and retracting the ESD knife and the second handle for advancing and retracting the needle were configured in parallel to enable independent operation of a plurality of treatment tools. However, from the perspective of a medical practitioner who operates the discharge device with one hand while looking at the endoscope, having separate handles for each treatment device has the problem of making precise surgical work more difficult.

Accordingly, in this embodiment, the handle unit 50 is configured to be able to drive both the first treatment tool 10 and the second treatment tool 30, and is designed to be the same as the operating environment for operating one treatment tool, so that the user Convenience was considered. In addition, the handle portion 50 according to this embodiment has the feature of being configured to selectively discharge the first treatment tool 10 or the second treatment tool 30 with only one sliding operation.

The first cylinder 600 is provided in the main body 90 and refers to an extended area connecting the handle portion 50 and the second treatment tool 30, and the first cylinder 600 is an operation handle 503. The second treatment device 30 can be moved forward or backward by being driven together during the forward and backward movement. That is, the second treatment tool 30 is not directly connected to the handle 50, but can be operated indirectly through the first cylinder 600 by manipulating the handle 50. The first cylinder 600 extends from the second treatment device 30 to the operation handle 503, and is partially empty in the area where the operation module 100 is located. This is a structure that enables movement of the manipulation module 100. This will be described in detail in Figure 3 below.

The second cylinder 610 is provided within the main body 90 and refers to an extended area connecting the handle portion 50 and the first treatment tool 10. The second cylinder 610 is driven on a similar principle to the first cylinder 600 when the operation handle 503 is driven forward and backward to advance or retreat the first treatment tool 10. That is, the first treatment tool 10 is not directly connected to the handle 50, but can be operated indirectly through the second cylinder 610 by manipulating the handle 50.

The power connection unit 70 may be connected to a power cable for applying high frequencies to the first treatment tool 10. According to this embodiment, the other end of the first treatment tool 10 is fixed to the power connection unit 70 to supply power. Note that the power connection portion 70 is formed to enable sliding movement. A conventional handpiece medical dispensing device is configured so that the jack to which the power is connected is fixedly coupled to an area close to the handle that the operator operates. In conventional handpiece medical dispensing devices, it was common for the power cable to interfere with the operating radius of the handle when a medical worker connected the power jack to the high-frequency knife at the surgical site. As in the past, when the power connection part where the jack is connected to the handpiece medical discharge device is fixedly formed, the power cable interferes with the operation of the delicate high-frequency knife or distorts the center of gravity, making the procedure difficult. The power connection unit 70 according to the embodiment is configured to allow adjustment of the distance from the handle unit 50 in consideration of the above matters, and there is no inconvenience in operation due to the power cable connected to the power connection unit 70. Avoid causing it.

The manipulation module 100 may include a fixing shaft 101, a fixing pin button 103, and a fixing pin 105, and may be used for either the first treatment tool 10 or the second treatment tool 30. It can be controlled in driving state. In more detail, the fixing pin 105 of the manipulation module 100 fixes and locks some of the first to third treatment tools 10 to 11, thereby allowing the unlocked treatment tools to be driven. The fixing pin 105 can fix either the first treatment tool 10 or the second treatment tool 30 and maintain it in a non-driving state. The fixing pin button 103 can manipulate the fixing pin 105. In more detail, the fixing pin button 103 can indirectly manipulate the fixing pin 105.

In an embodiment of the present invention, the manipulation module 100 can move up and down, and among the manipulation modules 100, the fixing pin 105 that directly controls the treatment tool is fixed based on the fixing axis 101. ) can be moved within a range that does not deviate from the range. The fixing pin 105 is located inside the main body 90 and can be indirectly manipulated using the fixing pin button 103 provided on the outside of the main body 90 instead of direct manipulation. The fixing pin 105 can be moved by the fixing pin button 103 to fix some of the treatment tools at the corresponding position.

FIG. 12 shows a front view of the first treatment tool 10 and the second treatment tool 30 being inserted into the tube portion 80 of the medical discharge device 1 according to the embodiment of FIG. 11. Figure 12 shows two different types of treatment tools used in the medical dispensing device according to an embodiment of the present invention, where the first treatment tool 10 consists of a snare and the second treatment tool 30 consists of a needle.

The cross section of the tube portion 80 in FIG. 12 is a view of the second area A2 where the double lumen tube 83 described above is located. In the second area A2, the first treatment tool 10 and the second treatment tool 30 may be separately provided in each lumen. The double lumen tube 83 forms a first lumen 801 and a second lumen 803 divided into upper and lower parts. Inside the tube 80, the first lumen 801 provided above is provided with a second treatment tool 30, and the first lumen 801 provided below is provided with a first treatment tool 10. By providing the two treatment tools separately, a specific treatment tool does not affect the other treatment tools and can be guided to prevent mutual twisting or intersection even when the tube portion 80 is bent.

FIG. 13 shows a state when the fixing pin 105 and the fixing pin button 103 of the medical dispensing device according to the embodiment of FIG. 11 are raised.

The fixing pin 105 can move up and down based on the fixing axis 101, and some treatment tools are locked depending on the position of the fixing pin 105, so that the treatment tools can be driven independently. The fixing pin 105 and the fixing shaft 101 may be located between the first treatment tool 10 and the second treatment tool 30 inside the tube 90. The fixing pin 105 can move up and down around the fixing axis 101 without deviating from the fixing axis 101. The fixing pin 105 may be in the form of a cylindrical or prismatic pillar, and the horizontal length (diameter) of both ends of the fixing pin 105 may be longer than the horizontal length (diameter) of the pillar portion, so that it may have a shape similar to a sword. Due to the shape of the fixing pin 105, the end of the fixing pin 105 may be caught on the fixing shaft 101 when moving up and down, thereby limiting the movement range of the fixing pin 105.

The fixing pin 105 can be operated through the fixing pin button 103. The user of the present invention can operate the fixing pin 105 by manipulating the fixing pin button 103 located outside the main body 90 instead of directly manipulating the fixing pin 105 located inside the main body 90. . The fixing pin button 103 can move the fixing pin 105 by contacting the distal end surface of the fixing pin 105 and pushing or pressing the fixing pin 105. When manipulating the fixing pin 105, the fixing pin button 103 is located on the same vertical line as the fixing pin 105, and can be slidably moved together with the control handle 503 at the tip of the control handle 503.

Figure 13 shows the state when the fixing pin 105 and the fixing pin button 103 are raised, and Figure 14 shows the state when the fixing pin 105 and the fixing pin button 103 are raised and driven by the operation handle 503. It shows what it looks like.

Referring to FIG. 13, when the user lifts the fixing pin button 103 upward, the lower end of the fixing pin button 103 moves upward and is coupled to the second cylinder 610. In addition, the lower end of the fixing pin button 103 touches the lower surface of the fixing pin 105, and the lower end of the fixing pin 105 is pushed upward to the fixing shaft 101. The fixing pin button 103 is inserted into the second cylinder 610 so that the inside of the main body 90 is connected from the first treatment tool 10 to the operation handle 503. On the other hand, the upper part of the fixing pin 105, that is, the first cylinder 600, may be partially empty because it is not coupled to the fixing pin button 103.

Referring to FIG. 14, the fixing pin 105 is moved upward, and the fixing pin 105 is inserted into a part of the first cylinder 600 to form the first cylinder 600 and the second treatment tool 30. Controls the driving of . Additionally, since the upper end of the fixing pin button 103 is raised and leaves the main body 90, the first cylinder 600 is not coupled to the fixing pin button 103, leaving a portion of the first cylinder 600 empty. Accordingly, since the driving force is not transmitted from the operating handle 503 to which the user applies driving force to the first cylinder 600, the second treatment tool 30 connected to the first cylinder 600 is not driven. On the other hand, the second cylinder 610 has a fixing pin button 103 coupled to the empty portion, and does not have a fixing pin 105 to control operation, so it can be driven together when the operation handle 503 advances and retreats.

FIG. 15 shows a state when the fixing pin 105 and the fixing pin button 103 of the medical dispensing device according to the embodiment of FIG. 11 are lowered. FIG. 16 shows the fixing pin 105 of the medical discharge device according to the embodiment of FIG. 11 having been completely moved downward.

When the user pushes down the fixing pin button 103, the upper part of the fixing pin button 103 lowers the upper surface of the fixing pin 105 to the fixing shaft 101 and is coupled to the first cylinder 600. By inserting the fixing pin button 103, the inside of the main body 90 is connected from the second treatment tool 30 to the operation handle 503, but the lower part of the fixing pin 105, that is, the second cylinder 610, is partially may be empty.

Figure 16 shows the fixing pin 105 moved downward. The fixing pin 105 is inserted into a part of the second cylinder 610 to control the operation of the second cylinder 610 and the first treatment tool 10. do. Additionally, since the lower end of the fixing pin button 103 descends and leaves the main body 90, the second cylinder 610 is not coupled to the fixing pin button 103, leaving a portion of the second cylinder 610 empty. Accordingly, the first treatment tool 10 is not driven, and the second treatment tool 30 can be driven together with the first cylinder 600 when the operation handle 503 advances and retreats.

FIG. 17 shows the first treatment tool 10 being driven when the operation module 100 of the medical discharge device 1 according to the embodiment of FIG. 11 is raised. As shown at the top, the operation module 100, that is, the fixing pin 105, is raised, so the first cylinder 600 and the second treatment device 30 are locked, and the fixing pin button 103 is locked in the second cylinder. Combined with (610). After manipulating the fixing pin 105, the user can manipulate the handle portion 50, more preferably the manipulation handle 503, as shown at the bottom of FIG. 4. The user grasps the fixing handle 501 of the handle 50 with his thumb, grips the operation handle 503 with his fingers other than the thumb, and then applies pressure to advance and retract the first treatment device 10 to move the tube 80. ) can be discharged outside. The user can physically manipulate the operation handle 503 to operate the first treatment tool 10 in the range D1, which is an independent manipulation section of the first treatment tool 10. At this time, since the second treatment tool 30 is locked to the fixing pin 105, the second treatment tool 30 is not driven when the user advances the operation handle 503 toward the front end of the main body 90. In the embodiment of the present invention, the first treatment device 10 is a snare, so D1 can be driven at 600 to 64 mm.

FIG. 18 shows the second treatment tool 30 being driven when the manipulation module 100 of the medical discharge device 1 according to the embodiment of FIG. 11 is lowered.

Referring to FIG. 18, since the manipulation module 100, that is, the fixing pin 105, is moved downward, the first treatment tool 10 provided in the second lumen 803 is locked. The user can pull down the fixing pin 105 as shown at the top and manipulate the handle portion 50 as shown at the bottom. When the user holds the fixing handle 501 with the thumb and holds the operation handle 503 with fingers other than the thumb and applies pressure, the second treatment tool 30 is advanced and retracted and discharged out of the tube 80. The locked first treatment device 10 is not driven. The user can physically manipulate the operation handle 503 to operate the second treatment tool 30 in the range D2, which is an independent manipulation section of the second treatment tool 30. In the embodiment of the present invention, the second treatment tool 30 is a needle, so D2 can be driven in the range of 14 to 17 mm.

Although the present invention has been described in detail through representative embodiments above, those skilled in the art will understand that various modifications can be made to the above-described embodiments without departing from the scope of the present invention. will be. Therefore, the scope of rights of the present invention should not be limited to the described embodiments, but should be determined not only by the claims described later, but also by all changes or modified forms derived from the claims and the concept of equivalents.

1: Medical dispensing device
2: Captain
3: Needle
4: ESD knife
8: tube
80: tube part
81: Single lumen tube
83: Double lumen tube
810: Single lumen
831: first lumen
833: second lumen
10: First treatment area
30: Second treatment area
40: Locking part
41: 1st locking groove
43: Second locking groove
50: handle part
501: Fixed handle
503: Operation knob
5031: sawtooth
60: Gear part
61: pinion gear
63: rack gear
65: cylinder
600: first cylinder
610: second cylinder
70: Power connection
90: body
100: operation module
101: fixed axis
103: fixing pin button
105: fixing pin

Claims (18)

In a medical dispensing device in which a plurality of treatment tools are used in combination,
1st treatment area;
Treatment District 2;
an operation module that controls either the first treatment tool or the second treatment tool to a non-driven state;
a handle unit that drives a treatment tool that is not in a non-driven state by the operation module and independently operates the first treatment tool or the second treatment tool;
a main body that selectively discharges the first treatment tool or the second treatment tool by manipulating the handle; and
A tube portion provided in the main body and extending to a predetermined length to guide the penetrating first treatment tool or the second treatment tool into the body,
The tube part,
a single lumen tube receiving the first treatment tool and the second treatment tool in a single hollow from a proximal portion extending from an end of the main body to a first region;
It consists of a double lumen tube that separately accommodates the first treatment tool and the second treatment tool in their respective hollows from the first area to the second area before the plurality of treatment tools intersect for discharge,
A medical dispensing device, characterized in that the tube part has a multi-lumen structure in which the number of lumens is changed in a specific area of the tube.
According to claim 1,
The tube part,
Medical discharge, characterized in that the double lumen tube, which is shorter in length than the single lumen tube, is inserted into the second area of the sheath provided as the single lumen tube, and has a multi-lumen structure in which the number of lumens is changed in a specific area of the tube. machine.
According to claim 1,
The tube part,
Medical discharge, characterized in that it is composed of a single lumen tube in which one treatment tool is discharged centrally through a single hollow in a third area from the second area where the double lumen tube is located to the end where the treatment tool is crossed and discharged. machine.
According to claim 1,
The tube part,
It is composed of a single lumen structure in the first region, a double lumen structure in the second region, and a single lumen structure in the third region from the second region to the end where the treatment tool is intersected and discharged,
A medical dispensing device characterized by a multi-lumen structure in which the number of lumens along the length changes from 1 to 2 to 1.
According to claim 1,
The single lumen tube in the first region is,
A medical dispensing device characterized in that it has a length of more than 0 and less than or equal to 1300 mm from the proximal part.
According to claim 1,
The double lumen tube in the second region is,
A medical ejection device characterized in that it has a length of 1000 mm to 2300 mm or less.
According to claim 1,
The tube part,
In the third area from the second area to the end where the treatment tools are crossed and discharged, it is composed of a single hollow tube with a single lumen through which one treatment tool is discharged to the center,
The single lumen tube in the third region is,
A medical dispensing device characterized by having a length of 10 mm or more.
According to claim 1,
The main body is,
a handle portion having an independent manipulation section of the first treatment tool or the second treatment tool;
A gear unit driven by coupling the handle unit with a gear in a predetermined section among the operation sections of the handle unit,
A medical dispensing device, characterized in that a plurality of treatment tools can be independently operated in the operation section of the handle.
According to claim 1,
When the operation section of the first treatment tool is the first drive range and the operation section of the second treatment tool is the second drive range,
The first driving range is greater than the second driving range,
A medical dispensing device, characterized in that the second driving range is included in the first driving range.
According to claim 1,
The first treatment tool and the second treatment tool,
A medical dispensing device comprising two treatment tools differently selected from the group consisting of needles, knives, markers, endoscopes, biopsy devices, and hemostatic clips.
According to claim 8,
The gear part,
a pinion gear gear-coupled with the handle portion; and
Including a rack gear that is driven in the longitudinal direction by receiving a rotational force of the pinion gear and to which the second treatment tool is connected,
A medical dispensing device, characterized in that the second treatment tool advances and retreats according to the driving direction of the rack gear.
In a medical dispensing device in which a plurality of treatment tools are used in combination,
A first treatment tool that advances and retreats together with the handle portion below;
a second treatment tool that advances and retracts together with the lower gear unit;
a main body provided with a handle unit having an independent operation section of the first treatment tool or the second treatment tool, and a gear unit driven by gear engagement with the handle unit in a predetermined section among the operation sections of the handle unit; and
A tube portion provided in the main body and extending to a predetermined length to guide the penetrating first treatment tool or the second treatment tool into the body,
The tube part,
A medical dispensing device characterized in that it has a multi-lumen structure in which a double lumen tube shorter than the single lumen tube is inserted into a second area of a sheath provided as a single lumen tube, and the number of lumens is changed in a specific area of the tube.
According to claim 12,
The first treatment tool and the second treatment tool,
A medical dispensing device, characterized in that one treatment tool is locked in the independent manipulation section of the handle and only the other treatment tool is driven forward and backward.
According to claim 12,
The tube part,
a single lumen tube receiving the first treatment tool and the second treatment tool in a single hollow from a proximal portion extending from an end of the main body to a first region;
Medical discharge, characterized in that it is composed of a double lumen tube that separately accommodates the first treatment tool and the second treatment tool in each hollow from the first area to the second area before the plurality of treatment tools are crossed for discharge. machine.

delete According to claim 1,
The operation module is,
a fixing pin that secures either the first treatment tool or the second treatment tool and maintains it in a non-driving state; and
Includes a fixing pin button for manipulating the fixing pin,
A medical dispensing device, characterized in that the fixing pin is indirectly manipulated by the fixing pin button.
According to claim 1,
The handle part,
fixed handle; and
A medical dispensing device comprising an operation handle that moves relatively from the fixed handle and pushes or pulls the plurality of treatment tools. delete