KR200145990Y1 - Apparatus for abscission of endocervical columnar tissue using electrode - Google Patents

Apparatus for abscission of endocervical columnar tissue using electrode Download PDF

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KR200145990Y1
KR200145990Y1 KR2019960019840U KR19960019840U KR200145990Y1 KR 200145990 Y1 KR200145990 Y1 KR 200145990Y1 KR 2019960019840 U KR2019960019840 U KR 2019960019840U KR 19960019840 U KR19960019840 U KR 19960019840U KR 200145990 Y1 KR200145990 Y1 KR 200145990Y1
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electrorod
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/42—Gynaecological or obstetrical instruments or methods
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
    • A61B2017/320069—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic for ablating tissue
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/3209—Incision instruments
    • A61B2017/32096—Incision instruments for slowly cutting through tissue, e.g. stent like temporary implants having sharp edges
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/3209—Incision instruments
    • A61B17/3211—Surgical scalpels, knives; Accessories therefor
    • A61B2017/32113—Surgical scalpels, knives; Accessories therefor with extendable or retractable guard or blade
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/42—Gynaecological or obstetrical instruments or methods
    • A61B2017/4216—Operations on uterus, e.g. endometrium

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Abstract

본 고안은 일렉트로드(Electrode)를 이용한 자궁내경조직 절제기구에 관한 것으로, 자궁내경조직을 절제함에 있어서 값싸고 다루기 쉬우며 부분자궁적출술에 있어서 수술 후 남아있는 자궁경부조직의 암발생 우려가 없는 새로운 절재기구를 제시함으로서 종래 많은 장점에도 불구하고 부분자궁적출술이 널리 보급되지 못한 문제점을 해결할 목적으로 안출된 것이다.The present invention relates to an endometrial tissue ablation apparatus using an electrode, which is inexpensive, easy to handle in the removal of uterine cervical tissue, and a new method without the risk of cancer of the cervical tissue remaining after surgery in partial hysterectomy. By presenting an ablation apparatus, despite the many advantages in the past, partial uterine extraction was devised for the purpose of solving a problem that is not widely spread.

본 고안은 이와 같은 목적을 달성하기 위하여, 5-7mm범위의 직경을 갖는 일렉트로드(1)에 절연피복층(2)을 형성하고, 일렉트로드의 일단부에는 케이블 조인트(3)를 형성하며, 타단부에는 15-25mm범위의 외경을 갖는 환형 커터(4)를 부착한 구성으로 자궁내경조직 절제기구를 구성하여 자궁을 개복하여 자궁체부를 제거한후 자궁경부에 일렉트로드를 삽입하고 일렉트로닉 어뎁터로 부터의 고주파 또는 전기적 자극을 커터에 제공하여 자궁내경조직을 태워가면서 원통형으로 절제할 수 있도록 구성한 것을 특징으로 하는 일렉트로드를 이용한 자궁내경조직 절제기구를 제시한다.In order to achieve the above object, the present invention forms an insulating coating layer 2 on the electrode 1 having a diameter in the range of 5-7 mm, and forms a cable joint 3 at one end of the electrode. At the end, an annular cutter (4) having an outer diameter in the range of 15-25 mm was attached to the uterine endometrial tissue ablation apparatus, and the uterus was opened, the uterus was removed, and an electric rod was inserted into the cervix. The present invention proposes an endometrial tissue ablation apparatus using an electrorod, characterized by configured to provide a high-frequency or electrical stimulation to a cutter to burn the endometrial tissue in a cylindrical manner.

이상의 구성에 의해 용이하게 부분자궁적출술을 시행할 수 있고, 시술비용이 적게들며, 일렉트로드에 의한 고주파나 전기적 자극을 이용하여 절제부위를 태워버림으로 수술중 출혈을 줄일 수 있고, 암세포의 잔류가능성을 제거할 수 있게 된다.With the above configuration, partial uterine extraction can be easily performed, the procedure cost is low, and the bleeding can be reduced by burning the ablation site by using high frequency or electrical stimulation by the electrorod, and the possibility of cancer cells remaining Can be removed.

Description

일렉트로드(Electrode)를 이용한 자궁내경조직 절제기구Endometrial Tissue Ablation Apparatus Using Electrode

제1도는 본 고안의 기본 구성도.1 is a basic configuration of the present invention.

제2도는 본 고안의 다른 실시례도.2 is another embodiment of the present invention.

제3도는 본 고안의 사용상태도.3 is a state of use of the present invention.

* 도면의 주요부분에 대한 부호의 설명* Explanation of symbols for main parts of the drawings

1 : 일렉트로드 2 : 피복 절연층1: Electrode 2: Cover insulation layer

3 : 케이블조인트 4 : 커터3: cable joint 4: cutter

4a : 연결간 4b : 연결간지지체4a: Between Connections 4b: Between Connections

본 고안은 일렉트로드(Electrode)를 이용한 자궁내경조직 절제기구에 관한 것으로서, 보다 상세히는 경복부 부분자궁적출술을 시행한 후 자궁경부의 편평원주 상피결합부를 포함하는 이형대와 자궁내경관의 원주상피세포층을 원통형으로 용이하게 제거 할 수 있도록 고안된 수술기구에 관한 것이다.The present invention relates to an endometrial tissue resection apparatus using an electrode, and more particularly, a columnar epithelial cell layer of a dysplasia including an squamous columnar epithelial junction of the uterine cervix and an endometrial canal after performing a partial abdominal hysterectomy. It relates to a surgical instrument designed to be easily removed in a cylindrical shape.

여성의 생식기관은 외음부를 시작으로 질부와, 자궁경부와, 난관으로 이어지는 자궁 강부 및 자궁체부를 포함하여 이루어지는바, 여성이 자궁근종, 자궁내막증, 자궁선증, 골반내염증 질환, 난소종양에 걸린 경우에는 자궁적출술의 적응증이 되기도 한다.The female reproductive organs include the vagina, the vagina, the cervix, the uterine cavity and the uterine body leading to the fallopian tube. The woman has uterine fibroids, endometriosis, uterine adenosis, pelvic inflammatory disease, and ovarian tumor. In some cases, hysterectomy may be an indication.

자궁적출술은 자궁전체를 제거하는 전자궁적출술과, 자궁경부를 일부 남겨놓고 자궁을 제거하는 부분자궁 적출술로 구분되어 실시되고 있는데, 부분자궁 적출술은 남아있는 자궁경부에서 암이 발생할 수 있다는 우려 때문에 전자궁적출술이 불가능한 경우, 예를 들면 폐쇄된 더글라스와, 골반염증이나 자궁내막증등으로 해부학적 구조가 변형된 경우 및 전자궁 적출술법이 보급되지 않아서 어쩔 수 없이 부분자궁적출술을 할 수 밖에 없는 경우를 제외하고는 시행되고 있지 않고 있다.Hysterectomy is divided into two groups: uterine extraction, which removes the entire uterus, and partial uterine extraction, which removes the uterus, leaving only part of the uterus. Partial uterine extraction is performed because of the concern that cancer may develop in the remaining cervix. Except in cases where this is impossible, for example, in closed Douglas, pelvic inflammatory disease or endometriosis, and anatomical deformity, and because the hysterectomy is not prevalent, partial hysterectomy is inevitable. Is not being implemented.

그러나 부분자궁적출술에 대한 이와 같은 우려는 편평원주상피결합부(squamocolumnar junction)를 포함하여 내자궁경 상피(endocervical columnar cell)를 제거하게 되면 수술 후 자궁경부암의 예방이 충분하다는 것이 입증되고 있고, 자궁 경부를 남겨두는 부분적출술은 부부간 성생활에 있어 성감을 저하시키지 않고 여성들에게 자궁의 일부조직을 갖고 있다는 심리적 안정감을 주는 장점을 갖고 있으나 지금까지 이와 같은 장점을 도외시하고 자궁경부까지 제거하는 전자궁적출술이 일반적으로 시행되고 있는 실정이다.However, such concerns about partial hysterectomy have demonstrated that the removal of endocervical columnar cells, including squamocolumnar junctions, is sufficient to prevent cervical cancer after surgery. Partial extraction, which leaves the body, has the advantage of giving women the psychological stability of having some tissues of the uterus without degrading their sexual sensation, but so far, uterine extraction, which ignores these advantages and removes the cervix, is common The situation is being implemented.

이와 같은 장점에도 불구하고 부분자궁적출술이 널리 보급되지 못한 것은 그동안 부분자궁적출술에 있어서 수술 후 남아있는 자궁경부조직의 암발생우려와 아울러 이를 복강경하에서 실시할 경우 고도의 수술기술을 요하고 수술기구가 값 비싸며 다루기 힘든 문제점 때문이라고 할 수 있다.Despite these advantages, partial uterine extraction has not been widely used.In the past, uterine cervical tissues may cause cancer of the uterine cervix. This is because of the expensive and unwieldy problems.

한편, 외과수술분야에서 절제도구로 일렉트로드를 이용한 수술기구가 폭넓게 이용되고 있고, 본 고안과 관련된 자궁경부관련 절제시술에서도 일렉트로드를 이용한 시술기구, 예를 들면, 국제특허공개공보 95/20922호에 제시된 바와 같은 일렉트로드 자궁경부시술기구가 공지되고 있다.On the other hand, surgical instruments using an electric rod as a resection tool in the field of surgical surgery is widely used, and surgical instruments using an electric rod in the cervical related ablation procedure related to the present invention, for example, International Patent Publication No. 95/20922 Electroloaded cervical procedures such as those shown in the art are known.

이것은 봉의 단부에 스톱암을 형성한 후 봉의 단부와 스톱암을 와이어 일렉트로드로 연결한 구성의 것으로 봉의 단부를 자궁경부에 넣고 봉을 축으로 하여 회전시키면 일렉트로드에 접촉된 부분이 절제되면서 질입구를 원추형태로 절제하도록 된 것으로 자궁경부의 절제자체는 불가능하고 자궁경부절제후 시행되는 질의 디자인에 이용될 수 있는 것이다.The stop arm is formed at the end of the rod, and the end of the rod and the stop arm are connected by wire electrods. The end of the rod is inserted into the cervix and the rod is rotated about the axis. The resection of the cervix is impossible, and the resection of the cervix is not possible and can be used for the design of the vagina that is performed after cervical resection.

본 고안은 일반수술기술을 익힌 자라면 누구나 쉽게 부분자궁적출술에서의 자궁경부절제술을 시행할 수 있는 수술기구를 제공하고, 일렉트로드를 이용함으로서 수술중 출혈을 줄이고, 암세포의 잔류가능성을 제거하는데 유용한 수술기구를 제공하도록 할 목적으로 안출된 것이다.The present invention provides a surgical instrument that can be easily performed by anyone who has undergone general surgical technique to perform cervical resection in partial hysterectomy, and it is useful for reducing bleeding during surgery and eliminating the possibility of cancer cells by using an electrorod. It is intended to provide surgical instruments.

이를 위하여, 본 고안은 5-7mm범위의 직경을 갖는 일렉트로드(1)에 절연피복층(2)을 형성하고, 일렉트로드의 일단부에는 케이블 조인트(3)를 형성하며, 타단부에는 15-25mm범위의 외경을 갖는 환형 커터(4)를 부착한 구성의 자궁내경조직 절제기구를 제시한다.To this end, the present invention forms an insulating coating layer (2) on the electrode (1) having a diameter in the range of 5-7mm, a cable joint (3) at one end of the electrode, 15-25mm at the other end An endometrial tissue ablation apparatus with an annular cutter 4 having an outer diameter in the range is presented.

상기에서 케이블 조인트는 일렉트로닉 어뎁터로 부터의 고주파 또는 전기를 커터에 제공하기 위한 것이며, 절연피복층은 시술자가 고주파 또는 전기의 영향을 받지 않게 하기 위한 것이다.In the above, the cable joint is to provide the cutter with high frequency or electricity from the electronic adapter, and the insulating coating layer is for preventing the operator from being affected by the high frequency or electricity.

커터(4)는 안테나를 일체로 형성한 것으로 일렉트로닉 어뎁터(5)로 부터의 약 4,000,000Hz의 고주파 또는 전기적 자극이 안테나에 인가됨으로서 접촉부위의 세포를 태워 자궁내경조직을 원통형으로 절취하게 된다.The cutter 4 is formed integrally with the antenna, and high frequency or electrical stimulation of about 4,000,000 Hz from the electronic adapter 5 is applied to the antenna to burn the cells at the contact site and cut the uterine internal tissue into a cylindrical shape.

제1도는 일렉트로드와 일체로 결합된 형태의 커터를 도시한 것이며,제2도는 커터를 일렉트로드의 단부로 부터 연결간(4a)에 의해 내측으로 4cm범위로 돌출시키고 연결간지지체(4b)가 일렉트로드의 단부에서 나사결합되도록 한 구조를 보인 것이다.FIG. 1 shows a cutter of a type integrally coupled with an electric rod, and FIG. 2 shows the cutter projecting inwardly in the range of 4 cm from the end of the electric rod by the connecting rod 4a, and the supporting member 4b is connected. It shows a structure that is screwed at the end of the electrode.

이와 같은 구성에 의한 자궁내경조직 절제기구의 시술과정을 제3도에 의하여 설명하면 다음과 같다.Referring to FIG. 3, the procedure of the endometrial tissue resection apparatus is described as follows.

먼저, 개복을 행한 상태에서 병소가 되는 자궁체부(10)를 제거하고 자궁경부(11)로부터 일렉트로드의 케이불조인트 부를 삽입하여 이를 질(12)밖으로 노출시킨 상태에서 일렉트로닉 어뎁터에 접속된 케이불(6)을 조인트에 연결하고, 어뎁터 스위치(통상의 경우 풋스위치를 사용함)를 작동시켜 커터를 가열시킨 후 일렉트로드를 서서히 질 밖으로 뽑아내면 조직이 태워지면서 자궁경부내강조직을 원통형으로 절제하는 방법으로 진행된다.First, the uterus body 10 which becomes the lesion in the state of opening the abdomen is removed, and the keibull 6 connected to the electronic adapter in the state in which the cavities of the electric rod are inserted from the cervix 11 and exposed to the outside of the vagina 12. ) Is connected to the joint, the adapter switch (usually the foot switch is used), the cutter is heated, and the elector rod is slowly pulled out of the vagina, the tissue is burned and the cervical lumen is cut into a cylinder. do.

C1은 자궁체부의 절취선이며, C2는 본 고안에 의하여 절취하는 절취선을 표시한 것이다.C1 is a perforated line of the uterine body part, and C2 represents a perforated line to be cut by the present invention.

한편 제2도에 의한 절제기구의 경우에는 커터를 제거한 상태에서 일렉트로드만 질에 삽입한 후 개복부에서 커터를 결합한 상태에서 상기에서 설명한 방법과 동일한 방법으로 진행된다.On the other hand, in the case of the ablation apparatus according to FIG. 2, only the electrode is inserted into the vagina with the cutter removed, and then the same procedure as described above is performed in the state where the cutter is coupled at the open portion.

통상의 경우 절제할 자궁경부의 길이는 4cm범위내가 됨으로 제2도에 도시한 바와 같은 절제기구의 경우 일렉트로드의 단부로부터 내측으로 4cm보다 약간 크게 돌출 시킴으로서 절제된 환부가 커터 지지체 내부에 채워진 상태로 배출된다.In general, the length of the cervix to be resected is within the range of 4 cm. In the case of an ablation apparatus as shown in FIG. 2, the resection of the cervix is slightly larger than 4 cm inwardly from the end of the electric rod, so that the excised lesion is filled in the cutter support. do.

자궁경부의 내경직경은 5-7mm범위임으로 일렉트로드의 직경을 5-7mm범위에서 적절한 직경을 선택함으로서 일렉트로드가 자궁경부에 꼭 끼워진 상태로 절제가 이루어지고, 자궁경부의 내경이 가이드역활을 함으로서 절제범위를 벗어나지 않는 정확한 절제가 가능하며, 절제부위를 태워가면서 절제함으로 절제과정에서 출혈의 발생이 적고 절제부위에 존재할지도 모르는 암세포를 태워버리므로 암세포가 잔존할 가능성이 상대적으로 적어지게 된다.The internal diameter of the cervix is in the range of 5-7mm, so by selecting the appropriate diameter in the range of 5-7mm, the ablation is performed with the electrod fitted tightly to the cervix, and the internal diameter of the cervix acts as a guide. Accurate resection is possible without departing from the range, and by removing the burned ablation site, less bleeding occurs in the ablation process and burns the cancer cells that may be present in the ablation site, so the chance of remaining cancer cells becomes relatively small.

이상에서 설명한 바와 같이 본 고안에 의한 일렉트로드(Electrode)를 이용한 자궁내경조직 절제기구는 편평원주상피결합부(squamocolumnar junction)를 포함하여 내자궁경 상피(endocervical columnar cell)를 제거한 상태에서 부분자궁적출술이 이루어져 수술 후 자궁경부암의 발생이 적고, 자궁 경부를 남겨둠으로서 부부간 성생활에 있어 성감을 저하시키지 않고 여성들에게 자궁의 일부조직을 갖고 있다는 심리적 안정감을 주는 부분자궁적출술을 용이하게 행할 수 있고, 시술비용이 적게들며, 일렉트로드에 의한 고주파나 전기적 자극을 이용함으로서 수술중 출혈을 줄이고, 암세포의 잔류가능성을 제거하는데 매우 유용한 수술기구이다.As described above, the uterine endoscopic tissue ablation apparatus using an electrode according to the present invention includes partial squamous cell extraction in a state in which the endocervical columnar cell is removed, including a squamocolumnar junction. After the operation, cervical cancer is less likely to occur, and by leaving the cervix, it is possible to easily perform partial uterine extraction that gives women the psychological stability that they have some tissues of the uterus without degrading sexuality in the marital sex. It is a very useful surgical instrument for reducing the bleeding during surgery and eliminating the possibility of cancer cells by using high frequency and electrical stimulation by the electrorod.

Claims (2)

일렉트로드를 이용하여 자궁내경을 원통형으로 절제하는 자궁내경조직 절제기구를 구성함에 있어서, 5-7mm범위의 직경을 갖는 일렉트로드(1)에 절연피복층(2)을 형성하고, 일렉트로드의 일단부에는 케이블 조인트(3)를 형성하며, 타단부에는 15-25mm범위의 외경을 갖는 환형 커터(4)를 부착한 구성으로 하여 자궁을 개복하여 자궁체부를 제거한후 일렉트로드의 케이블 조인트부를 자궁경부로 삽입하여 질 외부로 노출시킨 상태에서 일렉트로닉 어뎁터를 결합하여 고주파 또는 전기적 자극을 커터에 제공하고 일렉트로드를 질 밖으로 뽑아줌으로서 자궁내경조직을 태워가면서 원통형으로 절제할 수 있도록 구성한 것을 특징으로 하는 일렉트로드를 이용한 자궁내경조직 절제기구.In constructing an endometrial tissue ablation apparatus for cylindrically cutting the endometrium by using an electrorod, an insulating coating layer 2 is formed on an electrorod 1 having a diameter in the range of 5-7 mm, and one end of the electrorod The cable joint 3 is formed at the other end, and an annular cutter 4 having an outer diameter in the range of 15-25 mm is attached to the other end, and the uterus is opened to remove the uterine body and then the cable joint of the electric rod is inserted into the cervix. The electronic rod is characterized by combining the electronic adapter in the state exposed to the outside of the vagina to provide a high frequency or electrical stimulus to the cutter and pulling the electrorod out of the vagina to burn the uterine cervical tissue and to remove the cylindrical rod. Uterine internal tissue resection apparatus. 제1항에 있어서, 커터(4)를 일렉트로드(1)의 단부로 부터 연결간(4a)에 의해 내측으로 4cm범위로 돌출시키고 연결간지지체(4b)가 일렉트로드의 단부에서 나사결합되도록 구성한 것을 특징으로 하는 일렉트로드를 이용한 자궁내경조직 절제기구.2. The cutter (4) according to claim 1, wherein the cutter (4) projects from the end of the electric rod (1) inwardly by the connecting rod (4a) in a range of 4 cm and the inter-connection support member (4b) is screwed at the end of the electric rod. Uterine internal tissue resection apparatus using an electrorod, characterized in that.
KR2019960019840U 1996-06-27 1996-06-27 Apparatus for abscission of endocervical columnar tissue using electrode KR200145990Y1 (en)

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