KR20160032542A - Endoscopic instrument comprising conductive wire and tip - Google Patents

Abstract

The present invention relates to an endoscope instrument for forming a closed loop by providing an energizable wire and a finishing portion so as to facilitate and smooth removal of polyps and the like. A wire inserted into the tube to move up and down; A lasso to which one side of the wire is connected and which can be energized; And an end portion that is positioned at one end of the tube and has an opening capable of inserting and extracting the snare, and which can be energized. As a result, it is possible to form a closed loop that is energized at a desired time point by the operator, thereby enabling smooth and easy removal of tissues and the like to be removed by a practitioner such as a polyp.

Description

BACKGROUND OF THE INVENTION 1. Field of the Invention [0001] The present invention relates to an endoscopic instrument having a conductive wire and a finish,

The present invention relates to an endoscopic instrument. More specifically, the present invention relates to an endoscope apparatus for easily and smoothly removing a polyp or the like by forming a closed loop by providing a wire and a finishing portion which can be energized.

Previously, lesions such as colorectal tumors were difficult to treat due to technical constraints, but with the development of endoscopic therapy, related devices and devices emerged. In particular, it has been found desirable to remove polyps found by such devices. A polypectomy to remove polyps can reduce the risk of developing colon cancer, alleviate symptoms such as bleeding or obstruction, and prevent malignancy in advance.

Polypectomy is one of the basic and important therapeutic procedures that endoscopy practitioners usually perform in clinical practice. However, the length of the procedure time and the difficulty of the procedure vary depending on the size and position. If the lesion is large, it is difficult to perform a mass resection. Therefore, the resection is generally performed, which causes difficulties in complete resection.

In cases of complete resection, the incidence of complications and complications is high, and high local recurrence rate is seen. Therefore, if possible, it is advantageous to perform a resection rather than a partial resection for complete resection. An electrosurgical unit (ESU) and a snare are used for more effective polypectomy.

Conventionally, there is a snare that can be energized to match the characteristics of polyps of various shapes and sizes. Generally, such a snare is used as a device that completely unfolds, wrapping the polyp, slowly tightening, and capturing and cutting lesions. Generally, the endoscope is slowly retracted from the proximal portion of the polyp, and the polyp is caught. When the polyp head is very large and heading toward the anus, it is slowly opened and captured at the head of the polyp.

Also, a high-frequency power supply is applied to a snare having such an operating principle, and electric energy is delivered to the snare and concentrated at the trapping site. The high-frequency power supply supplies electrical energy to endoscope attachments such as lasso and incision, and provides high-frequency alternating current from 300 KHz to 3 MHz, which does not stimulate the nerves and muscles.

Heat generated by high frequency AC dehydrates and evaporates intracellular and extracellular water. At this time, the tissue is cut or solidified according to the sudden degree of heat generation and the applied voltage. Current is continuously or intermittently energized depending on the nature of the site to be treated.

Most of the high-frequency power supply devices intermittently apply a high current of 200 V or more to the tissues so that the heat generation in the tissues gradually proceeds. As a result, the inside and outside of the cells are gradually dried to dehydrate and inactivate the cells, thereby causing tissue coagulation. Such tissue coagulation can reduce the risk of hemorrhage immediately after the procedure and can be easily cleaved by a snare or the like.

When the tissue is intermittently energized, the time during which electricity flows into the tissue is called a duty cycle. The degree of coagulation and incision varies depending on the degree of the duty cycle. However, in spite of the fact that the degree of such a duty cycle can be controlled, when the polygon is clamped and energized in the past, the tube for receiving the lasso is generally formed of an insulator so that heat is not generated in a part of the lasso, A problem that can not be achieved occurs.

For example, U.S. Published Patent Application No. 2014-0222014 relates to a surgical instrument that is used to remove polyps in polypectomy, particularly a surgical instrument configured to facilitate adjustment of the loop size using a switch for beneficial lesion capture. The snare may be formed of wire and moved to the inside and outside of the tube to receive the snare so that the size of the snare can be adjusted. This type of snare can be used to remove polyps of various sizes, but when the captured polyps are tightened, some of the polyps on the end side of the tube are located in spaces between the wires forming the snare, Heat is not received properly. As a result, some of the polyps that have not been properly heated can not be cleaned completely.

Therefore, the duty cycle is determined according to the nature of the part to be operated by the practitioner, and the size of the snare is adjusted, so that the wire is not applied to a part of the polyp in the clamping operation.

On the other hand, there are various points to be noted when energizing electricity. If the tofu of the polyp with electrical conduction touches the opposite normal barrier, the normal barrier may be energized and perforation may occur. Korean Patent Laid-Open Publication No. 2014-0097813 provides a medical snare device capable of easily wrapping a polyp and adjusting a direction of a snare even in a difficult-to-treat area. By using such a snare device, it is possible to easily adjust the snare, and more delicate procedures are possible. However, even in such a case, the tube for accommodating the snare is formed of an insulator, so that there is a limit in completely removing the polyp as in the conventional technique.

Therefore, there is a need for a lasso which is advantageous for completely eliminating polyps and a medical device equipped with the lasers. It is necessary to provide an apparatus which can smoothly flow current to a snare portion surrounding a captured polygon and uniformly apply heat. Further, there is a need for a device in which the high-frequency power supply device is configured so that solidification and cutting according to the set current intensity and duty cycle can be performed more efficiently.

US 2014-0222014 A KR 2014-0097813 A

SUMMARY OF THE INVENTION The present invention has been made to solve the above problems.

More specifically, it is an object of the present invention to provide an endoscope apparatus of the type in which polyps are completely removed.

It is also an object of the present invention to provide an endoscope apparatus which allows a practitioner to easily operate a current to flow smoothly in a noose portion surrounding a captured polyp.

It is also an object of the present invention to provide an endoscopic instrument that is constructed such that the high-frequency power supply apparatus can more effectively perform coagulation and cutting according to a set current intensity and a duty cycle.

According to an aspect of the present invention, A wire 200 inserted into the tube 300 to move up and down; A snare 210 to which one side of the wire 200 is connected and is energized; And an end portion (100) disposed at one end of the tube (300) and provided with an opening capable of inserting and extracting the snare (210) and being energized.

When the snare 210 is energized, it is preferable that the finishing unit 100 is energized so that the snare 210 and the finishing unit 100, which are energized, form a closed loop.

It is preferable that a switch 620 for energizing the snare 210 and the finishing unit 100 is located at the other end of the tube 300.

The first grip portion 510 and the second grip portion 610 are located at the other end of the tube 300 and the relative movement between the first grip portion 510 and the second grip portion 610 The wire 200 moves up and down.

The nail 210 is pre-stressed and inserted into the tube 300. When the wire 200 moves toward the one end of the tube 300, A loop protruding from the opening of the finishing unit 100 and having a width greater than that of the tube 300 is formed and when the wire 200 moves toward the other end of the tube 300, (Not shown).

The endoscope apparatus according to one embodiment of the present invention further includes an adjusting unit 430. The adjusting unit 430 rotates the wire 200 and moves the wire 200 according to the rotation of the wire 200 It is preferable that the snare 210 be rotated.

In addition, the finishing unit 100 according to an embodiment of the present invention may include a current-carrying unit 120; And an insulation part 110 performing an insulation function with respect to the conductive part 120. [

Also, an endoscope apparatus in which the light emitting unit 11 and the camera 12 are positioned at one end of the tube 300 according to an embodiment of the present invention is provided.

According to the present invention, since not only the wire but also the finishing portion are energized, it is possible to form a closed loop in which the operator is energized at a desired time. Through this, it is possible to smoothly and easily remove tissues and the like to be removed by a practitioner such as a polyp.

In addition, whether or not a closed loop in which the energization has been performed can be effectively performed by a single switch operation on the side of a practitioner.

Further, it is easy to place a closed loop formed in a tissue or the like to be removed after the closed loop is formed by providing a separate control unit.

In addition, the finishing portion is provided with a separate insulating portion, so that the phenomenon of energizing up to an unnecessary portion of the user can be effectively prevented.

In addition, due to the structure capable of forming a closed loop, it is advantageous to complete removal of the polyp, thereby effectively preventing post-procedure complications.

1 is a schematic perspective view of an endoscope instrument according to the present invention. Hereinafter, the upper side of Fig. 1 to be held by the operator will be referred to as the operator side, and the lower side of Fig. 1 where the tissue to be removed and the like to be removed will be described as the operation side.
2A and 2B are perspective views of the operating side of an endoscope instrument according to the present invention, wherein FIG. 2A shows an endoscope instrument in a general atmospheric condition before the snare protrudes outwardly from the dead end, FIG. 2B is a cross- In other words, an endoscopic instrument of a situation in which I work.
Fig. 3 is a conceptual view of the operation side of the endoscope instrument according to the present invention, and is a view for explaining an energization method.
Fig. 4 shows another embodiment of the endoscope apparatus according to the present invention, in which an endoscope apparatus to which other applications such as a light emitting unit, a lens, and the like are applied together is shown.

Hereinafter, the present invention will be described in more detail with reference to the drawings.

In the following, "practitioner" means a person who operates the endoscope apparatus according to the present invention. It will generally be a doctor. The term "subject" means a person to be treated and having a tissue to be removed such as a polyp by the endoscope apparatus according to the present invention. It will generally be a patient.

In the following description, a polyp is described as an example, but the present invention is not limited thereto. Any tissue or portion may be removed by the endoscopic instrument.

The overall configuration of an endoscope instrument according to the present invention will be described with reference to Fig.

The endoscope instrument according to the present invention includes a first gripper 510, a second gripper 610, and a switch 620 on the side of a practitioner to be held by a practitioner.

The practitioner can operate the switch 620 while holding one finger on the first gripper 510 while holding the other finger on the second gripper 610. At the same time, 610 and the switch 620 may be referred to as an operation unit 600 together.

The switch 620 is connected to the finish 100 and the wire 200 via a flexible wire (not shown). Specifically, to the conductive portion 120 of the finishing portion 100, which will be described later in detail. Accordingly, when the practitioner operates the switch 620, the noises 210 and the current-carrying unit 120 are energized through the wire 200. [

On the other hand, a rigid body 400 is provided to support the operation of the operator and the operation of the operator.

And the second grip portion 610 is connected to the wire 200 on the inner side of the body 400. The wire 200 is moved up and down by the relative movement between the first gripper 510 and the second gripper 610 while the snare 210 provided at one end of the wire 200 also moves up and down .

On the other hand, a control unit 430 is disposed at one end of the body 400 to enable the operator to rotate the body 400. The control unit 430 is connected to the wire 200 so that when the control unit 430 rotates, the wire 200 rotates and the snare 210 provided at one end of the wire 200 also rotates.

A tube 300 is provided at one end of the body 400. And is inserted into the subject from the portion of the tube 300, so that it is generally flexible.

The wire 200 passes through the tube 300 so as to freely move. The wire 200 is also generally flexible.

It goes without saying that the length of the tube 300 is not limited.

At one end of the tube 300, a finishing portion 100 is provided.

The finishing portion 100 need not be flexible and is preferably rigid so as to support the nose 210.

An end portion of the finishing portion 100 is provided with an opening so that the snare 210 protrudes outward through the opening by the operation of the operator.

The finishing portion 100 according to the present invention is characterized in that the energizing portion is energized. The energizing portion includes an insulating portion 120 for performing an insulating function between the conductive portion 120 and a portion where energization is not required, such as the tube 300, (110).

The snare 210 is connected to one end of the wire 200. Thus, when the wire 200 moves up and down, the noose 210 also moves up and down. When the wire 200 rotates, the noose 210 also rotates.

Referring to FIGS. 2A and 2B, the operation of the finishing unit 100 and the other noose 210 will be described in detail.

FIG. 2A shows the state before the operation by the operator, that is, a general atmospheric condition.

The snare 210 is pre-stressed and inserted into the tube 300 in a state of being fabricated. That is, the force to be widened to the outside is blocked by the tube 300 and the finishing unit 100 or the like.

When a practitioner moves the wire 210 to the work side by relatively moving the first gripper 510 and the second gripper 610, the snare 210 attached to the wire 210 passes through the opening of the stopper 100 Respectively.

At this time, the prestressed alumina 210 spreads outwardly and forms a shape as shown in FIG. 2B. That is, a loop having a width d larger than the width of the tube 300 is formed.

The operator moves the endoscope apparatus such that a tissue such as a polyp is positioned inside the snare 210 in a state as shown in FIG. 2B. When the direction of the snare 210 is not aligned with the direction of the polygon to be removed, the control unit 430 may be operated to change the direction.

 When a polyp or the like to be removed is placed inside the snare 210, the operator operates the switch 620 to energize the snare 210 and the conductive part 120 of the finishing unit 100.

If only the alumina 210 is energized as in the prior art, energization is not performed at the gap below the alumina 210, which is inevitably generated in the process of spreading the alumina 210 to the outside, so that a complete closed loop can not be formed. The removal process can not be smooth. However, according to the present invention, not only the snare 210 but also the energizing part 120 of the finishing unit 100 is energized, so that the above-mentioned gap is energized. As a result of the energization up to the gap portion as described above, it is possible to expect a more preferable polyp removal effect according to the intermittent energization method and duty cycle setting conventionally used.

3, when the switch 620 is operated, the current flows in the direction A through the wire, passes through the snare 210, and returns in the direction B. In this case, since the current- . It is possible to stably prevent the electric current to the portion that does not need to be energized by the insulating portion (110).

When the removal operation is completed, the operator relatively moves the first gripper 510 and the second gripper 610 to move the wire 210 to the operator side, and the noose 210 attached to the wire 210 moves to the finisher 100, and is inserted inward to return to the shape shown in FIG. 2A.

4 is another embodiment of the present invention.

The endoscope apparatus according to the present invention may include all the endoscope apparatuses, but a separate light emitting unit 11 and camera 12 may be disposed at the end thereof.

While the present invention has been described with reference to exemplary embodiments thereof, it will be understood by those of ordinary skill in the art that various changes in form and details may be made therein without departing from the spirit and scope of the present invention as defined by the following claims. It will be appreciated that embodiments are possible. Accordingly, the scope of protection of the present invention should be determined by the claims.

10: Endoscopic tube
11:
12: Camera
100:
110:
120:
200: wire
210: Noose
300: tube
400: body
510: first grip section
600:
610:
620: Switch

Claims (8)

A tube 300;
A wire 200 inserted into the tube 300 to move up and down;
A snare 210 to which one side of the wire 200 is connected and is energized; And
And a finishing portion 100 disposed at one end of the tube 300 and having an opening capable of inserting and extracting the snare 210,
Endoscopic instrument.
The method according to claim 1,
When the current is applied to the snare 210, the finishing unit 100 is energized and the closed snare 210 and the finishing unit 100 form a closed loop,
Endoscopic instrument.
3. The method of claim 2,
A switch 620 for energizing the noose 210 and the finishing unit 100 is disposed at the other end of the tube 300,
Endoscopic instrument.
The method of claim 3,
The first gripper 510 and the second gripper 610 are located at the other end of the tube 300 and the relative movement of the first gripper 510 and the second gripper 610 The wire 200 moves up and down,
Endoscopic instrument.
5. The method of claim 4,
The snare 210 is pre-stressed and inserted into the tube 300,
When the wire 200 moves toward the one end of the tube 300, the wire 200 protrudes from the opening of the finishing unit 100 to form a loop having a width greater than the width of the tube 300 and,
The wire 200 is inserted into the opening of the finishing portion 100 of the wire 200 when the wire 200 moves toward the other end of the tube 300,
Endoscopic instrument.
6. The method according to any one of claims 1 to 5,
The endoscopic instrument further includes an adjuster 430,
The control unit 430 rotates the wire 200 and rotates the nose 210 according to the rotation of the wire 200. [
Endoscopic instrument.
6. The method according to any one of claims 1 to 5,
The finishing unit 100 includes:
A current-carrying unit 120 capable of conducting current; And
And an insulation part (110) performing an insulation function with respect to the conductive part (120).
Endoscopic instrument.
6. The method according to any one of claims 1 to 5,
Wherein the light emitting part (11) and the camera (12) are located at the one end of the tube (300)
Endoscopic instrument.

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