KR20180070501A - Medical snare apparatus - Google Patents

Abstract

The present invention relates to a medical snare device which comprises: a tube having a hole; a wire slidably installed along the hole of the tube; a cut-out part installed at one end of the wire and having a hook part which cuts out polyp by being inserted and tightened into one end portion of the tube; a forward/backward unit installed at the other end of the tube for advancing or retracting the wire along the hole of the tube; and a rotation unit rotating the hook part when the wire moves with respect to the tube. The snare device can rotate the hook part so that the hook part of the cut-out part can be inserted into portion where polyp protrudes, thereby maximizing efficiency in a procedure for removing the polyp.

Description

[0001] Medical snare apparatus [0002]

The present invention relates to a medical snare apparatus, and more particularly, to a medical snare apparatus used in an operation for removing a part of a tissue inside a body.

Generally, a polyp is a condition in which the intestinal mucosa is abnormally raised and protrudes into the intestine. In this case, polypectomy is performed.

A polypectomy is the complete resection of a polyp using a polypectomy tool, usually removing more than 5 mm of polyp.

Korean Patent Laid-Open Publication No. 10-2016-0035930 discloses an endoscopic snare device. The posted snare device is connected to an operating portion, a driving cord moving in the forward and backward directions by the operation of the operating portion, an electrical insulating tube through which the driving cord passes, and a driving cord, And an electrically conductive annular wire installed so that at least a part thereof is exposed to the outside of the tip of the electrically insulating tube and then moved backward so that at least a part thereof can be introduced into the electrically insulating tube.

This type of snare device is performed by using an annular electrically conductive wire together with an endoscope as a polyp region to be removed in the polypectomy. In order to rotate the annular wire according to the formation direction of the polyp, There is a problem that the entire device must be rotated. Such a problem is disadvantageous in that the posture of the practitioner is inconvenient and it is difficult to set the precise direction of the loop wire.

SUMMARY OF THE INVENTION It is an object of the present invention to provide a medical snare device which can be easily rotated in accordance with the direction of a polygon of a cut of a cutout.

In order to accomplish the above object, a medical snare apparatus according to the present invention comprises: a tube having a hollow; a wire slidably installed along the hollow of the tube; a wire installed at one end of the wire, A resection portion having a collar for cutting the polyp by being tightened; A forward / backward unit installed at the other end of the tube for advancing or retracting the wire along the hollow of the tube; And a rotation unit for rotating the ring when the wire moves with respect to the tube.

Wherein the forward / backward unit includes a first insertion portion into which a finger can be inserted, a guide portion extending from the first insertion portion and providing a movement path of the wire along the longitudinal direction and exposed to the outside, A body portion having an elongate frame; A second inserting portion for inserting a finger, a second inserting portion for connecting the second inserting portion and a third inserting portion, and an insertion port for inserting the elongate frame to be movable along the longitudinal direction of the elongate frame, And a handle portion having a movable frame that is engaged as far as possible.

According to an aspect of the present invention, the rotation unit includes a contact protrusion radially protruding from an outer circumferential surface of a wire adjacent to the ring, and the contact protrusion contacts the inside of the tube, A helical groove is formed so as to rotate the part.

Alternatively, the rotation unit may include a contact protrusion radially protruding from the outer circumferential surface of the wire adjacent to the ring, and the contact protrusion may contact the inside of the tube to rotate the ring when the wire is moved back and forth A spiral protrusion protruding in a helical shape is formed.

Alternatively, the rotation unit may include a contact protrusion radially protruding from an outer circumferential surface of the wire adjacent to the ring, and the contact protrusion may be in contact with the wire when the wire is moved back and forth, A helical spiral through-hole is formed.

Alternatively, the spinning unit may include a helical body coupled to an outer side of the wire so as to be able to move forward and backward in a travel path of a guide portion formed in the elongated frame, wherein a helical groove is formed on an outer circumferential surface of the wire, And a rotation selection operation unit installed in the extension frame and adjusting the rotation or straightening of the helical body by entering or releasing the rotary interference pin into the spiral groove of the helical body according to the operation of the operation lever.

Preferably, the rotation selecting operation portion is provided with a retracting guide pipe which is formed so as to protrude from the elongated frame so as to have an interference guide hole communicating with the moving passage in a direction intersecting with the extending direction of the moving passage of the elongate frame, and; And a first spring installed between the rotary interference pin and the advancing and retreating guide tube for applying an elastic force in a direction in which the rotary interfering pin is retreated from the moving path, The rotary interference pin is provided so as to be rotatable while receiving the guide tube from outside, and the rotation path opposing to the rotation interference pin is formed to be variable in the distance from the advance / retreat guide pipe according to the rotation position, Or retracted.

The tube receiving groove may be formed at a distal end of the elongate frame so that the tube can be received in a seating state and communicate with the moving passage. The area for forming the tube receiving groove is smaller than the moving area of the moving frame A threaded portion having an outer diameter and formed with a thread on an outer circumferential surface thereof, a through hole through which the tube passes is formed at the center, and an inner circumferential surface A coupling cover having an inner circumferential ring portion protruding from a screw thread formed on the outer circumferential ring portion and having an outer circumferential ring portion extending in a direction parallel to the inner circumferential ring portion and having an inner diameter capable of receiving the extension frame; A retractable ring provided so as to be able to move forward and backward between the outer peripheral ring portion of the coupling cover and the operation lever; Wherein the advancing and retreating ring is provided between the outer peripheral ring portion of the engagement cover and the advancing / retreating ring so as to apply a rotational force to rotate the operation lever in the first direction, and applies a resilient force in a direction away from the engagement cover It is preferable to further include a spring.

The medical snare device of the present invention includes a rotation unit, so that the annulus can be rotated so that the annulus of the ablation portion can be inserted into the protruded portion of the polyp, so that the efficiency of the procedure for removing the polyp can be maximized.

1 is a perspective view showing a medical snare apparatus according to a first embodiment of the present invention,
FIG. 2 is an exploded perspective view of the medical snare apparatus of FIG. 1,
3 to 6 are views showing embodiments of a rotation unit formed at the tip of a tube of the medical snare apparatus according to the present invention,
7 is a perspective view showing a state of use of the medical snare apparatus according to the present invention,
FIG. 8 is a front view showing a medical snare apparatus in which a rotating unit is applied to a rear end of a tube according to another embodiment of the present invention,
9 is a sectional view of the medical snare apparatus of Fig. 8 in a state in which the operating lever is fixed to the fixed hook 192,
FIG. 10 is a bottom view showing a state in which the handle unit of the medical snare apparatus of FIG. 8 is partially advanced to a position where the operation lever is not rotated;
Fig. 11 is a bottom view showing a state in which the handle unit of the medical snare apparatus of Fig. 8 is advanced and the spiral body is advanced while being rotated;
Fig. 12 is a front view showing a state in which the operating lever of the medical snare apparatus of Fig. 8 is rotated and fixed to the interference release position,
13 is a bottom view of Fig.

Hereinafter, a medical snare apparatus according to a preferred embodiment of the present invention will be described in detail with reference to the accompanying drawings.

The medical snare device according to the present invention is for removing cells or polyps in the body such as organ or the like, and one embodiment thereof is shown in Fig. 1 to Fig.

In the present embodiment, the description will be made by taking as an example the ablation of a polyp in the intestines.

Referring to Figs. 1 to 7, a medical snare apparatus 1 according to the present invention includes a cutout portion 10, a forward / backward unit 50, and a rotation unit 30.

The cut-off portion 10 includes a tube 20 having a hollow 21, a wire 12 slidably installed along the hollow 21 of the tube 20, (11) for cutting the polyp by being pulled into one end of the polyphenol (20) and tightened.

The wire 12 is made of a metal having an elastic force.

The ring portion 11 should not undergo plastic deformation during insertion and withdrawal of the tube 20 into the hollow 21.

The ring 11 and the wire 12 are preferably formed of a conductor so that current can be supplied through the terminal 60 of the forward and backward unit described later and the polyp can be excised using a high frequency current.

The tube 20 may be made of synthetic resin having flexibility so that the tube 20 can easily move along an insertion path other than a straight line in the inside of the body.

The forward / backward unit 50 is installed at the other end of the tube 20 to advance or retract the wire 12 along the hollow 21 of the tube 20.

The forward and backward unit 50 is provided on the opposite side of the side where the ring 11 of the tube 20 is exposed to move the wire 12 back and forth along the hollow 21 of the tube 20, Is inserted into the hollow (21) of the tube (20) or can be drawn out.

This forward and backward unit 50 has a body portion 51 coupled to the end of the tube 20 and a handle portion 55 connected to the end of the wire 12 and moving along the body portion 51 .

The body 51 includes a first insertion portion 52 to which a finger can be inserted, an extension frame 53 extending from the first insertion portion 52 and formed with a guide portion 53a along the longitudinal direction, And a coupling cover 54 for coupling the tube 20 and the end of the tube 53 to each other.

The first insertion portion 52 is formed in a ring shape so that the finger can be inserted into the first insertion portion 52. The operator inserts the body portion 51 into the first insertion portion 52 in the forward and backward directions with respect to the handle portion 55 .

The guide portion 53a formed in the elongated frame 53 in the longitudinal direction is drawn in the longitudinal direction of the elongate frame 53 and is exposed to the outside and the wire 12 of the resected portion 10 moves inside And has a structure having a moving passage.

The handle portion 55 is coupled to the elongated frame 53 so as to be movable along the longitudinal direction of the elongate frame 53.

The handle portion 55 includes second and third inserting portions 56 and 57 for inserting fingers and a second inserting portion 56 for connecting the second inserting portion 56 and the second inserting portion 57, A terminal 60 provided on the moving frame 58 for supplying a current to the ring 11 of the cutout portion 10 and an outer peripheral surface of the terminal 60 And a terminal case 61 surrounding the terminal case 61.

 The terminal 60 may be connected to the end of the wire 12 to supply electricity to the annulus 11 of the cutout 10.

The second and third insertion portions 56 and 57 are formed in a ring shape so that the fingers can be inserted so that the operator inserts the finger into the second and third insertion portions 56 and 57, 58 in the forward and backward directions.

The rotary unit 30 is installed at one end of the tube 20 adjacent to the ring 11 and rotates the ring 11 as the wire 12 moves relative to the tube 20. [

The rotation unit 30 is formed on the end side of the tube 20 and the wire 12 adjacent to the ring 11 so as to rotate the ring 11 about the end of the tube 20, FIG. 3 shows an embodiment of the present invention.

Referring to FIG. 3, the rotating unit 30 has a contact protrusion 31 radially projecting from the wire 12 adjacent to the ring 11.

The rotation unit 30 is provided with an end portion of the tube 20 in a spiral shape so as to guide the contact projection 31 when the wire 12 moves forward and rearward and to rotate the ring portion 11, And a contact projection guide portion 32 formed in the twisted tube 20 so as to extend in a spiral manner.

The contact projection guide portion 32 may have a non-circular cross section.

The contact projection guide portion 32 may be formed so as to have a structure in which the end portion of the tube 20 is pressed at both sides to collapse the hollow into a non-circular shape, and then this portion is spirally twisted.

4, the contact projection guide portion 32 is provided with a contact protrusion 31 protruding in the radial direction on the outer peripheral surface of the wire 12 adjacent to the ring portion 11 so as to rotate the ring portion 11 The spiral groove 32a may be formed on the inner circumferential surface of the tube 20 on the side of the end of the tube 20. [

5, the contact projection guide portion 32 is formed of the spiral projection 32b for guiding the contact projection 31 on the inner peripheral surface on the end side of the tube 20, And may be formed of a helical threaded through hole 32c on the side adjacent to the hook 11 of the contact projection guide 32 as shown.

The operation of the medical snare apparatus according to the present invention constructed as described above will be described as follows.

The medical snare apparatus 1 according to the present invention is a medical snare apparatus 1 according to the present invention in which a practitioner inserts a finger into the first to third insertion portions 52, 56 and 57 and inserts the tube 20 inside the body So that the annulus 11 of the cutout 10 is close to the cylinder 100 to be cut out. The handle portion 55 of the forward / backward unit 50 is moved back and forth with respect to the body portion 51 to rotate the collar portion 11 so as to be smoothly inserted into the polyp.

3 to 7, a contact protrusion 31 radially protruding from the wire 12 is formed on the end of the tube 20 in a helical contact projection guide portion (32).

The movement of the contact projection 31 along the contact projection guide portion 32 is achieved by relatively moving the wire 12 with respect to the tube 20 by the forward / backward unit 50 as described above.

When the polygon 100 is inserted into the collar 11 by the above operation, the wire 12 is retracted with respect to the tube 20 so that the collar 11 is inserted into the tube 20, Abstain.

The medical snare apparatus 1 can rotate the ring unit 11 in accordance with the position of the cylinder 100 by the rotation unit 30 formed on the tube 20 and the wire 12, , It is possible to easily perform resection of the polyps without twisting the hand.

Meanwhile, unlike the illustrated example, the rotation unit can be installed at the other end of the tube 20, and an example thereof will be described with reference to FIGS. 8 to 13. FIG. The same reference numerals denote the same elements as those in the drawings.

The rotation unit 130 includes a helical body 140 and a rotation selection operation unit 170.

Unlike the method in which the guide portion 153a of the elongated frame 153 is previously exposed on the front surface, the movement path 153b through which the wire 12 and the helical body 210, which will be described later, Structure was applied.

The movable frame 58 may be coupled to the wire 12 or the helical body 210 in an interlocking manner through the opening of the guide portion 153a exposed on the bottom surface of the elongate frame 153. [

A tube receiving groove 155 is formed at the distal end of the elongate frame 153 so as to be able to receive the tube 20 in a seated state and communicate with the moving passage 153b. Region has a structure in which a threaded portion 156 having an outer diameter smaller than that of the region in which the moving frame 58 moves but having a thread formed on the outer circumferential surface thereof.

The helical body 140 is coupled to the outer side of the wire 12 so as to be able to move back and forth within the moving path 153b of the guide portion 153a formed in the elongated frame 153, Is formed in a predetermined region along the longitudinal direction.

The end of the wire 120 in the moving path 153b of the elongated frame 163 or the helical body 140 may be coupled to the moving frame 58 in a rotatable manner.

The rotation selection operation portion 170 is provided on the extension frame 153 and is configured to move the rotation interference pin 172 to be described later into or from the spiral groove 142 of the helical body 140 in accordance with the rotation operation of the operation lever 180 So that the rotation or straightening of the hull 140 can be adjusted.

The rotation selection operation portion 170 includes a forward movement guide pipe 174, a rotation interference pin 172, a first spring 176, and an operation lever 180.

The advancing / retreating guide pipe 174 is provided with an interference guide hole 174a communicating with the moving passage 153b in the direction intersecting the extending direction of the moving path 153b of the elongated frame 153 and accommodating the rotating interference pin 172 And is formed so as to protrude in the direction in which the outer diameter of the extension frame 153 extends.

The rotation interference pin 172 has a forward and backward body portion 172a having an outer diameter capable of advancing and retreating in the interference guide hole 174a and having a semicircular end rounded portion 172a and an interference guide hole 172b at the distal end of the forward and backward body portion 172a. And a head portion 172b formed to have an outer diameter larger than that of the head portion 174a.

The first spring 176 urges the rotation interference pin 172 to apply the elastic force in the direction in which the rotation interference pin 172 is retracted from the movement path 153b, that is, And the inner bottom of the advancing / retreating guide tube 174. The head 172a of the forward /

The operation lever 180 is provided on the elongated frame 153 to receive the advancing / retreating guide tube 174 from the outside on the hinge 182 provided on the elongated frame 153 along the direction orthogonal to the extending direction of the elongate frame 153 And a rotation path 184 opposed to the rotation interference pin 172 is formed so that a distance between the rotation path 184 and the advancing / retreating guide pipe 174 is variable, (153b). ≪ / RTI >

That is, the position denoted by reference symbol a in the rotation path denoted by reference numeral 184 in FIG. 13 is a position where the rotating interference pin 172 is interfered with to enter the moving path 153b, and the position denoted by reference symbol b is a rotating interference The pin 172 is retracted from the movement passage 153b to be in a position to cancel the interference of the helical body 140. [

The coupling cover 154 is formed to have a bell-shaped outer shape having a through hole 154a at the center thereof for receiving the tube 20 therethrough.

When the engaging cover 154 is separated from the engaging cover 154, an inner ring portion 154b protruding from the inner circumferential surface so as to be screwed with the threaded portion 156 concentrically with respect to the through hole 154a, And an outer circumferential ring portion 154c having an inner diameter that is spaced apart along the direction in which the inner diameter extends and which extends in a direction parallel to the inner ring portion 154b and can receive the extension frame 153. [

The advancing / retracting ring 186 is provided so as to be movable along the extending frame 153 between the outer circumferential ring portion 154c of the engaging cover 154 and the operating lever 180.

The second spring 188 urges the outer peripheral ring portion 154c of the engaging cover 154 and the retracting ring 154c of the engagement cover 154 to apply a rotational force to rotate the operation lever 180 in the first direction, 186 so as to apply an elastic force to the retractable ring 186 in a direction away from the engaging cover 154.

The fixed hook 192 is engaged with the fitting groove 180a formed in the operating lever 180 when the operating lever 180 is turned clockwise in the direction in which the advancing / retreating ring 186 approaches the engaging cover 154 And is formed on the elongated frame 153 so as to fix the rotational position of the lever 180.

9, when the movable frame 58 is retracted by a predetermined length in a state where the operation lever 180 is fixed to the fixed hook 192, restoration interference The projection 58b interferes with the inclined groove 180c formed at the corresponding position of the operation lever 180 to cause the operation lever 180 to rotate to the initial position.

The operation lever 180 is rotated in the initial rotation position where the rotation interference pin 172 is interfered with the spiral groove 142 of the helical body 140 by interfering with the advancing / retreating ring 186 when no external force is applied And the rotation interference pin 172 is rotated to a position where it can interfere with the helical groove 142 of the helical body 140 when the advancing / retreating ring 186 is rotated by an external force in a direction approaching the coupling cover 154 So that it can be retracted.

Therefore, when the moving frame 58 is moved to the extended frame 153 to the position shown in FIG. 10 until the helical body 140 is interfered with the rotating interference pin 172, the hook portion 11 When the moving frame 58 is further advanced by turning the ring 11 in the ideal state as it is projected from the tube 20, the helical body 140 is rotated by interfering with the rotating interference pin 172, When the operation lever 180 is rotated clockwise and fixed to the extension frame 153 when it is determined that the operation lever 180 is rotated in accordance with the position of the object polygon to be removed, the movable frame 58 is retracted with respect to the extension frame 153 The ring 11 enters the tube 20 in a straight line, and a desired excision process is performed.

In a state where the external force is not applied to the operation lever 180, the helical body 140 is not interfered with, and the external force is applied to the operation lever 180 to rotate the helical body 140 Of course).

10: Cutting section 12: Wire
20: tube 30, 130: rotating unit
50: forward / backward unit 140: helical body
172: rotation interference pin 174: retractable guide tube
176: First spring 180: Operation lever
188: Second spring

Claims (11)

A cutter having a hollow tube, a wire slidably installed along the hollow of the tube, and a cutter installed at one end of the wire, the cutter being inserted into one end of the tube to cut out the polyp;
A forward / backward unit installed at the other end of the tube for advancing or retracting the wire along the hollow of the tube;
And a rotation unit for rotating the ring when the wire moves with respect to the tube. The apparatus of claim 1, wherein the forward /
A first inserting portion to which a finger is inserted; an extension frame extending from the first inserting portion and provided with a guiding portion exposed to the outside, providing a moving path of the wire along the length direction; ;
A second inserting portion for inserting a finger, a second inserting portion for connecting the second inserting portion and a third inserting portion, and an insertion port for inserting the elongate frame to be movable along the longitudinal direction of the elongate frame, And a handle portion having a movable frame that is engaged as far as possible. The method according to claim 1,
The rotating unit is installed adjacent to one end of the tube
And a contact protrusion protruding in a radial direction from the wire adjacent to the annular portion, wherein one end of the tube is twisted in a helical shape so as to guide the contact protrusion when the wire is moved forward and backward to rotate the annular portion, And the formed hollow forms a helical contact projection guide portion. The method according to claim 1,
The rotation unit includes a contact protrusion radially protruding from an outer circumferential surface of a wire adjacent to the annular portion. The contact protrusion contacts the inside of the tube to allow the annular portion to rotate when the wire is moved back and forth. And a groove is formed on the surface of the snare device. The method according to claim 1,
The rotation unit includes a contact protrusion radially protruding from an outer circumferential surface of a wire adjacent to the ring, and the contact protrusion contacts the inside of the tube to form a spiral shape so as to rotate the ring when the wire is moved forward and backward. And a protruding spiral projection is formed on the inner surface of the snare device. The method according to claim 1,
Wherein the rotation unit includes a contact protrusion radially protruding from an outer circumferential surface of a wire adjacent to the ring, and the contact protrusion contacts the ring when the wire is moved back and forth, And a helical threading hole is formed in the helical threading hole. 3. The apparatus according to claim 2, wherein the rotating unit
A helical body coupled to an outer side of the wire so as to be able to move forward and backward in a travel path of a guide portion formed in the elongated frame, the helical groove extending along a longitudinal direction on an outer circumferential surface;
And a rotation selection operating part provided in the elongated frame and adapted to adjust the rotation or rectilinear movement of the helical body by entering or releasing the rotary interference pin into the helical groove of the helical body according to the operation of the operating lever. Snare device. The apparatus as claimed in claim 7, wherein the rotation selection operation unit
A retractable guide pipe communicating with the movement passage in a direction intersecting the extending direction of the movement passage of the elongate frame and protruding from the elongated frame to have an interference guide hole for receiving the rotation interference pin;
And a first spring installed between the rotary interference pin and the advancing / retreating guide tube to apply an elastic force in a direction in which the rotary interfering pin is retreated from the moving path,
Wherein the operation lever is provided so as to be rotatable while receiving the advancing / retreating guide tube from the outside with respect to the hinge, and the rotation path opposing the rotation interference pin is spaced apart from the advancing / retreating guide pipe And the rotation interference pin is formed to be inserted or retracted into the movement passage. [9] The apparatus of claim 8, wherein a tube receiving groove is formed at the distal end of the elongate frame to receive the tube in a seated state and communicate with the moving passage, And a threaded portion having an outer diameter smaller than that of the outer circumferential surface,
An inner ring protruding from the inner circumferential surface of the inner circumferential surface so as to be screwed with the threaded portion concentrically with respect to the through hole and protruding from the inner circumferential ring portion, A coupling cover having a circumferential ring portion spaced apart from the inner circumferential ring portion and extending in a direction parallel to the inner circumferential ring portion and having an inner diameter capable of receiving the extending frame;
A retractable ring provided so as to be able to move forward and backward between the outer peripheral ring portion of the coupling cover and the operation lever;
Wherein the advancing and retreating ring is provided between the outer peripheral ring portion of the engagement cover and the advancing / retreating ring so as to apply a rotational force to rotate the operation lever in the first direction, and applies a resilient force in a direction away from the engagement cover Further comprising: a spring that urges the snare to be in contact with the snare. 10. The apparatus according to claim 9, further comprising a guide groove formed in the extension frame so as to securely engage the retractable ring with the fitting groove formed in the operation lever when the operation lever is rotated in the direction approaching the engagement cover, And a fixed hook formed on the outer peripheral surface of the fixed snare. 11. The apparatus according to claim 10, wherein the operating lever interferes with the advancing / retreating ring in a state in which no external force is applied to maintain an initial rotational position at which the rotating interference pin can interfere with the helical groove of the helical body, Wherein the rotation interference pin is configured to be retracted to a position where the rotation interference pin can not interfere with the helical groove of the helical body when rotated by an external force in a direction approaching the coupling cover.

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