KR20210120227A - Polyp removal apparatus for endoscopic procedure - Google Patents

Abstract

The present invention relates to a polyp removal apparatus for an endoscopic procedure to enable direct access to a lower stem to simultaneously perform resection and suturing without going through an upper head of a polyp in a polyp removal procedure through an endoscope, thereby simplifying the procedure and reducing the difficulty and time of the procedure. The polyp removal apparatus includes: a manipulation unit moving a first wire and a second wire by an operator's hand; an extension unit embedding the first wire and the second wire; and a removal unit performing opening and closing operations of an upper jaw and a lower jaw in conjunction with movements of the first wire, and performing moving operations of a slider in the upper jaw in conjunction with movements of the second wire, wherein the slider of the upper jaw is provided with a cutter, and staples are placed on a slider's movement path.

Description

Polyp removal device for endoscopic procedures

The present invention relates to a polyp removal device for endoscopic procedures, and more particularly, by directly accessing the lower stalk without passing through the upper head of the polyp in a polyp removal procedure through an endoscope, excision and suturing are performed. It relates to a polyp removal device for an endoscopic procedure that can be performed at the same time, thereby reducing the difficulty and time of the procedure as well as a simple procedure.

In general, colon polyp refers to a condition in which the intestinal mucosa grows abnormally to become a lump and protrude to the inside of the intestine. In this case, polyp resection is performed.

Polypectomy refers to the complete excision of polyps larger than a certain size using a polypectomy tool, and polyps larger than 5 mm are usually removed. As a surgical instrument for performing a procedure upon removing such a polyp, a snare for excising the tissue after grabbing the tissue is employed.

Korean Patent Application Laid-Open No. 2018-0070501 discloses a medical snare device. Referring to FIG. 1 , a medical snare device 1 according to the prior art includes an excision unit 10 , a forward/backward unit 50 , and a rotation unit 30 , and the cutting unit 10 includes a wire 12 . It is installed at the end and is provided with a ring portion 11 for excising a polyp by being pulled into one end of the tube 20 and tightened.

Medical snare device having the above structure, as shown in FIG. 2, when the polyp is inserted into the ring, the polyp is excised by retracting the wire with respect to the tube so that the ring is inserted into the inside of the tube.

However, the snare method according to the prior art has a problem in that it is difficult to insert a protrusion tissue such as a polyp into the ring. In particular, in the case of a polyp with a large upper head, the ring with a limited diameter cannot pass through and the ring cannot access the lower stem, which often causes a lot of difficulties in the procedure.

In addition, if the thickness of the lower stem of the polyp is thicker than 1 cm, since the blood vessels in the stem are thick, a separate detachable snare is first inserted to prevent bleeding, and the lower part of the stem is tied up. The stem is excised, but since the detachable snare is not easy to operate, this method has a problem in that the procedure is complicated and takes a long time, so the preference is low.

The present invention has been devised to solve the above problems, and its purpose is to directly access the lower stem without going through the upper head of the polyp in a polyp removal procedure through an endoscope and perform excision and suturing at the same time, so a convenient procedure is Of course, there is provided a polyp removal device for endoscopic procedures that can reduce the difficulty of the procedure and the procedure time.

According to the present invention, a manipulation unit for moving the first wire and the second wire by the operator's hand; an extension part for embedding the first wire and the second wire; and a removal unit for performing an opening/closing operation of the upper and lower jaws in association with the movement of the first wire and performing a movement operation of the slider in the upper jaw in association with the movement of the second wire; It provides a polyp removal device, characterized in that the slider of the upper jaw is provided with a cutter, and a staple is disposed on the movement path of the slider.

Preferably, the operation unit, a first handler in which a slot of a long hole is formed along the longitudinal direction therein; a mover disposed in the slot and moving along the slot; an elastic member disposed in the slot to restore movement of the mover; a second handler coupled to the mover and coupled to the first handler so as to be slidable in the front-rear direction along the outer surface of the first handler in conjunction with the mover; and a dial provided on an outer surface of the first handler to rotate. Including, one end of the first wire is connected to the mover, and one end of the second wire is connected to the dial.

Preferably, a first ring into which the operator's finger can be inserted is coupled to the rear of the first handler, and a second ring and a second ring into which the operator's finger can be inserted are coupled to the outer surface of the second handler. characterized by being

Preferably, the extension part is characterized in that the first wire and the second wire are embedded in a tube made of a flexible material.

Preferably, the removal unit includes: a housing connected to the extension unit and housing a driving link connected to the first wire; an upper jaw connected to the driving link and having a slider connected to the second wire; and a lower jaw connected to the driving link and disposed to face the upper jaw; It is characterized in that it includes.

Preferably, the upper jaw and the lower jaw are characterized in that the gap between them is constricted or opened by the contraction and relaxation of the driving link, which link movement about the axis of rotation according to the forward and backward movement of the first wire.

Preferably, a plurality of staples are embedded in the upper jaw in a row along the longitudinal direction, a slider movable in a linear direction along the rail is provided at the rear end thereof, and a cutter is provided at the lower portion of the slider, the slider The cutter provided at the lower part of the slider cuts the lower stem of the polyp sandwiched between the upper and lower jaws while moving according to the forward and backward linear movement of the slider, and the upper part of the staple embedded in the upper jaw is located on the movement path of the slider. It is characterized in that the lower part of the slider presses the upper part of the staple according to the front and rear linear movement of the slider and discharges the staple to the outside of the upper jaw, thereby sealing the stem of the polyp that has been excised.

According to the present invention, in a polyp removal procedure through an endoscope, it is possible to directly access the lower stem without going through the upper head of the polyp to perform excision and suturing at the same time, thereby reducing the difficulty and time of the procedure as well as a simple procedure. there is

In particular, it can be operated without being limited by the size of the head of the polyp, and even for a polyp that is expected to bleed, excision and suturing are performed simultaneously in a single procedure, thereby reducing the risk of bleeding.

1 is a perspective view showing a medical snare device according to the prior art.
FIG. 2 is a view for explaining a polyp resection process using the medical snare device according to FIG. 1 .
3 is a perspective view illustrating an apparatus for removing polyps for endoscopic procedures according to an embodiment of the present invention.
4 is a view for explaining an operating state of the manipulation unit according to an embodiment of the present invention.
5 is a view for explaining an operating state of the removal unit according to an embodiment of the present invention.
6 is a view for explaining the structure of the upper and lower jaws according to an embodiment of the present invention.
7 is a view for explaining the operating state of the upper jaw according to an embodiment of the present invention.
8 is a view for explaining a polyp removal process by a manipulation unit according to an embodiment of the present invention.

Since the present invention can have various changes and can have various embodiments, specific embodiments are illustrated in the drawings and described in detail in the detailed description. However, this is not intended to limit the present invention to specific embodiments, and it should be understood to include all modifications, equivalents and substitutes included in the spirit and scope of the present invention. In describing each figure, like reference numerals have been used for like elements.

Terms such as first, second, A, and B may be used to describe various elements, but the elements should not be limited by the terms. The above terms are used only for the purpose of distinguishing one component from another. For example, without departing from the scope of the present invention, a first component may be referred to as a second component, and similarly, a second component may also be referred to as a first component. and/or includes a combination of a plurality of related listed items or any of a plurality of related listed items.

When a component is referred to as being “connected” or “connected” to another component, it is understood that the other component may be directly connected or connected to the other component, but other components may exist in between. it should be On the other hand, when it is mentioned that a certain element is "directly connected" or "directly connected" to another element, it should be understood that the other element does not exist in the middle.

The terms used in the present application are only used to describe specific embodiments, and are not intended to limit the present invention. The singular expression includes the plural expression unless the context clearly dictates otherwise. In the present application, terms such as “comprise” or “have” are intended to designate that a feature, number, step, operation, component, part, or combination thereof described in the specification exists, but one or more other features It should be understood that this does not preclude the existence or addition of numbers, steps, operations, components, parts, or combinations thereof.

Unless defined otherwise, all terms used herein, including technical and scientific terms, have the same meaning as commonly understood by one of ordinary skill in the art to which this invention belongs. Terms such as those defined in commonly used dictionaries should be interpreted as having a meaning consistent with the meaning in the context of the related art, and should not be interpreted in an ideal or excessively formal meaning unless explicitly defined in the present application. does not

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

3 is a perspective view illustrating an apparatus for removing polyps for endoscopic procedures according to an embodiment of the present invention.

Referring to FIG. 3 , the polyp removal device for endoscopic surgery according to an embodiment of the present invention can be used to remove colonic polyps that protrude into the inside of the intestine due to abnormal growth of the intestinal mucosa, and in particular, the instrument through the endoscope. It is suitable for endoscopic procedures to remove colon polyps by inserting them. However, the polyp removal device for endoscopic surgery according to an embodiment of the present invention does not have a structure specialized only for endoscopic surgery, and it is possible to apply not only to endoscopic surgery but also to general abdominal surgery using laparoscopy by adjusting the overall length. can be understood

An apparatus for removing polyps for endoscopic surgery according to an embodiment of the present invention includes a manipulation unit 100 operated by the operator's hand, an extension unit 200 connected to the manipulation unit 100 to extend the length, and the extension unit It may be configured to include a removal unit 300 that is connected to the 200 and operates according to the operation of the operation unit 100 to remove the polyp.

The operator holds the manipulation unit 100 by hand and handles it through various movements to perform a surgical action. The handling movement of the manipulation unit 100 is transmitted to the remote removal unit 300 by the extension unit 200 , and the removal unit 300 entering the large intestine is transmitted through the extension unit 200 . It has a structure that operates according to the handling movement of the manipulation unit 100 .

For example, the operator may perform a surgical action of pushing and pulling the first wire 210 through the handling of the operation unit 100, and accordingly, the operation unit 100 opens and closes the upper jaw 310 and the lower jaw 320. This operation of the upper jaw 310 and the lower jaw 320 will soon function as a polyp capture operation.

As another example, the operator may push and pull the second wire 220 through the handling of the operation unit 100 , and accordingly, the operation unit 100 may move the slider 311 in the upper jaw 310 . In this case, the movement of the slider 311 will function as a polyp excision and suturing operation soon.

Hereinafter, the polyp removal device for endoscopic surgery according to an embodiment of the present invention will be described focusing on the polyp capture operation and the polyp excision and suturing operation described above, but the present invention is not limited thereto. Additional operations such as controlling the movement of the snare added by the stylus or applying a high-frequency current for excision or suturing to the upper jaw 310 and the lower jaw 320 may also be performed by the manipulation unit 100 .

First, FIG. 4 is a view for explaining an operating state of a manipulation unit according to an embodiment of the present invention.

The manipulation unit 100 includes a first handler 110 , a second handler 120 , and a dial 130 . Hereinafter, for convenience of description, the direction in which the first ring 111 is coupled to the first handler 110 is defined as the rear, and the opposite direction is defined as the front, which is equally applied to the claims.

The first handler 110 as a whole has the shape of a column extending in the longitudinal direction. A slot 112 of a long hole is formed in the interior of the first handler 110 in the longitudinal direction. The slot 112 is formed to pass through the inside of the first handler 110 , and a mover 121 is disposed in the slot 112 , and an elastic member 113 is provided on the mover 121 in the slot 112 . ) is arranged to restore the movement of the mover 121 .

A first ring 111 is coupled to the rear of the first handler 110 . The first ring 111 is formed in a ring shape, and the operator's finger is inserted thereinto. The first ring 111 is shown and described as a ring shape in the drawings and the above description, but is not limited thereto, and may be formed in various shapes and may be provided integrally with the first handler 110 .

The second handler 120 is coupled to the mover 121 in the first handler 110, and interlocks with the mover 121 sliding in the front-rear direction along the slot 112 to protect the outer surface of the first handler 110. Accordingly, it is coupled to the first handler 110 so as to be slidable in the front-rear direction. At this time, one end of the first wire 210 is connected to the mover 121 , the first wire 210 is disposed through the center of the elastic member 113 , and the other end is embedded in the extension part 200 . will become

Both ends of the elastic member 113 are fixed between the mover 121 and the slot 112 so that the movement of the mover 121 is restored.

At this time, the second ring 122 and the third ring 123 are coupled to the outer surface of the second handler 120 . Like the first ring 111, the second ring 122 and the third ring 123 are formed in a ring shape so that the operator's finger can be inserted. The second ring 122 and the third ring 123 are also shown and described in a ring shape in the drawings and the above description, but are not limited to the shape, and can be formed in various shapes and are integral with the second handler 120 . can be provided as

Therefore, the operator can insert his finger into the first ring 111 of the first handler 110 and the second ring 122 and the third ring 123 of the second handler 120, and the first ring (111) and the second handler 120 with respect to the first handler 110 by applying a force to the second ring 122 and the third ring 123 forward (in Fig. 4 (a)) or backward (Fig. 4). By moving in the (b)) direction, it will be possible to move the first wire 210 in the front-rear direction.

The operation of pushing and pulling the first wire 210 through the handling of the operator's operation unit 100 is performed in the upper jaw 310 and the lower jaw 320 of the removal unit 300 through the first wire 210. It will be delivered and will function as a trapping action for the polyp.

Meanwhile, a dial 130 that rotates in forward and reverse directions is provided on the rear outer surface of the second handler 120 . One end of the second wire 220 is connected to and wound on an inner bobbin (not shown) of the dial 130, the second wire 220 is disposed through the second handler 120, and the other end is It is to be embedded in the extension (200).

Accordingly, the operator will be able to move the second wire 220 in the front-rear direction by turning the dial 130 in the forward or reverse direction with his/her finger.

The operation of pushing and pulling the second wire 220 through the handling of the operator's operation unit 100 is the slider 311 in the upper jaw 310 of the removal unit 300 through the second wire 210. It will be delivered and function as an excision and suturing operation of the polyp.

Meanwhile, the extension part 200 has a front distal end connected to the manipulation unit 100 and a rear distal end connected to the removal unit 300 . The extension part 200 is made of a tube 230 that is a flexible tube having a bending property, and the first wire 210 and the second wire 220 described above are embedded inside the tube 230 .

When the extension 200 is manufactured as a tool for open surgery, it is advantageous to have a relatively short length, so the tube 230 may be made of a rigid tube that does not bend. In contrast, when manufactured as a tool for endoscopic surgery Since it should have a long length and a thin diameter, it is preferable that the tube be made of a flexible material having a bending property.

5 is a view for explaining an operating state of the removal unit according to an embodiment of the present invention.

Referring to FIG. 5 , the removal unit 300 includes a housing 330 , a driving link 340 , an upper jaw 310 , and a lower jaw 320 .

The housing 330 is connected to the front end of the tube 230 and serves as a case in which the driving link 340 is embedded, and the first wire 210 and the second wire 220 extending from the tube 230 . ) are arranged to enable connection to the drive link 340 and the upper jaw 310, respectively.

The upper jaw 310 and the lower jaw 320 are connected to the driving link 340 , and the driving link 340 is connected to the other end of the first wire 210 . The upper jaw 310 and the lower jaw 320 are made to be closed or widened by the driving link 340, which link movement about the rotation shaft 341 according to the front and rear movement of the first wire 210. .

That is, as shown in (a) of Figure 5, the upper jaw 310 and the lower jaw 320 are fixed to the mover 121 through the first wire 210, and the mover 121 is an elastic member ( 113), the upper jaw 310 and the lower jaw 320 maintain a closed state. At this time, if the operator moves the second handler 120 forward while the operator puts his finger in the second ring 122 and the third ring 123, the mover 121 in the second handler 120 interlocks. As it moves forward, the first wire 210 is pushed forward and the driving link 340 is contracted to open the upper jaw 310 and the lower jaw 320 .

The lower stem of the polyp is positioned between the gapped upper jaw 310 and the lower jaw 320 to prepare for the capture of the polyp.

Then, as shown in Figure 5 (b), the operator in a state in which the lower stem of the polyp is located between the upper jaw 310 and the lower jaw 320, the second ring 122 and the third ring 123 ), the mover 121 in the second handler 120 interlocks and moves backward by the restoring force of the elastic member 113, and the first wire 210 is pushed backward and the driving link 340 ) to relax the upper jaw 310 and the lower jaw 320 are closed.

The closed upper jaw 310 and lower jaw 320 tightly capture the lower stem of the polyp.

6 is a view for explaining the structure of the upper and lower jaws according to an embodiment of the present invention.

Referring to (a) of FIG. 6, when viewed from the side, a plurality of staples 314 are built in a row along the longitudinal direction of the jaw in the upper jaw 310, and a rail 313 is installed at the rear end of the jaw. A slider 311 capable of moving in a linear direction is provided along the slider 311 , and a cutter 312 is provided at a lower portion of the slider 311 . In addition, (b) of FIG. 6 has shown the lower jaw 320. As shown in FIG.

Here, the other end of the second wire 220 is connected to the slider 311 in the upper jaw 310, and when the operator rotates the dial 130 of the operation unit 100 in the forward direction, the second wire 220 The slider 311 is pushed and the slider 311 moves forward in the upper jaw 310. When the dial 130 is rotated in the reverse direction, the slider 311 is pulled by the second wire 220 and the upper jaw ( 310), the slider 311 moves backward. This linear movement of the slider 311 will be guided by the rail 313 .

At this time, the sharp cutter 312 provided at the bottom of the slider 311 moves according to the forward and backward linear movement of the slider 311 and cuts the lower stem of the polyp sandwiched between the upper jaw 310 and the lower jaw 320 . will be isolated.

7 is a view for explaining the operating state of the upper jaw according to an embodiment of the present invention.

Referring to FIG. 7 , the forward and backward linear movement of the slider 311 described with reference to FIG. 6 performs not only the cutting operation of the cutter 312 but also the sealing operation of the resected and remaining polyp stem.

As shown in (a) of FIG. 7 , the upper portion of the staple 314 embedded in the upper jaw 310 is positioned on the movement path of the slider 311 . Therefore, as shown in (b) of FIG. 7 , when the slider 311 located in front of the upper jaw 310 is pulled and linearly moved to the rear of the upper jaw 310, the lower portion of the slider 311 is stapled 314. ) passes while pressing the upper portion downward to discharge the staple 314 out of the upper jaw 310 . The end of the staple 314 discharged in this way is bent by the opposite lower jaw 320 while being inserted into the lower stem of the polyp sandwiched between the upper jaw 310 and the lower jaw 320, and the stem portion of the remaining polyp is sutured. it will be done

Therefore, the operator can move the slider 311 of the upper jaw 310 only by rotating the dial 130 of the manipulation unit 100 , and the linear movement of the slider 311 is the cutting operation of the cutter 312 . It is to make it possible to simultaneously perform the sealing operation through the discharge of the staple 314 together with.

8 is a view for explaining a polyp removal process by a manipulation unit according to an embodiment of the present invention.

Now, a procedure of the polyp removal device for endoscopic surgery having the above-described configuration will be described with reference to FIG. 8 .

First, as shown in (a) of Figure 8, the operator spreads the upper jaw 310 and the lower jaw 320 in a state where the removal unit 300 inserted into the body through the endoscope is positioned on the lower stem of the polyp. After firmly capturing the lower stem of the polyp, the upper jaw 310 and the lower jaw 320 are closed again. Such a capture operation may be performed by manipulating the manipulation unit 100 that moves the first wire 210 .

Next, as shown in (b) of Figure 8, the operator rotates the dial 130 to operate the operation of pulling the second wire 220, and accordingly, the cutter 312 of the upper jaw 310 is As the slider 311 is moved, the stem of the polyp is excised, and at the same time, the operation of suturing the stem portion of the polyp remaining after being excised is performed together with the staples 314 .

A polyp that has been excised and sutured at the same time is shown in FIG. 8(c). It can be seen that a part of the head and stem of the polyp has been removed by the resection operation, and the stem portion of the polyp remaining after the resection is sutured with staples 314 . At this time, a portion of the head and stem of the resected polyp may be picked up by the closing operation of the upper jaw 310 and the lower jaw 320 and discharged into the body.

As described above, the best embodiment has been disclosed in the drawings and the specification. Although specific terms are used herein, they are used only for the purpose of describing the present invention and are not used to limit the meaning or the scope of the present invention described in the claims. Therefore, those skilled in the art will understand that various modifications and equivalent other embodiments are possible therefrom. Therefore, the true technical protection scope of the present invention should be determined by the technical spirit of the appended claims.

100: control unit 110: first handler
111: first ring 112: slot
120: second handler 121: mover
122: second ring 123: third ring
200: extension 210: first wire
220: second wire 230: tube
300: removal part 310: upper jaw
311: slider 312: cutter
313: rail 314: staple
320: lower jaw 330: housing
340: drive link 341: rotation shaft

Claims (7)

a manipulation unit for moving the first wire and the second wire by the operator's hand;
an extension part for embedding the first wire and the second wire; and
a removal unit for performing an opening/closing operation of the upper and lower jaws in association with the movement of the first wire and performing a movement operation of the slider in the upper jaw in association with the movement of the second wire; includes,
A polyp removal device, characterized in that a cutter is provided on the slider of the upper jaw, and a staple is disposed on the movement path of the slider.
The method of claim 1,
The operation unit,
A first handler in which a slot of a long hole is formed along the longitudinal direction therein;
a mover disposed in the slot and moving along the slot;
an elastic member disposed in the slot to restore movement of the mover;
a second handler coupled to the mover and coupled to the first handler so as to be slidable in the front-rear direction along the outer surface of the first handler in conjunction with the mover; and
a dial provided on an outer surface of the first handler to rotate; includes,
One end of the first wire is connected to the mover, and one end of the second wire is connected to the dial.
3. The method of claim 2,
A first ring into which the operator's finger can be inserted is coupled to the rear of the first handler,
Polyp removal device, characterized in that the second ring and the second ring into which the operator's finger can be inserted is coupled to the outer surface of the second handler.
The method of claim 1,
and the extension portion embeds the first wire and the second wire in a tube made of a flexible material.
The method of claim 1,
The removal unit,
a housing connected to the extension and having a driving link connected to the first wire;
an upper jaw connected to the driving link and having a slider connected to the second wire; and
a lower jaw connected to the drive link and disposed to face the upper jaw; Polyps removal device comprising a.
6. The method of claim 5,
The upper jaw and the lower jaw are polyp removal device, characterized in that the gap between them by the contraction and relaxation of the drive link link movement about the axis of rotation according to the front and rear movement of the first wire.
6. The method of claim 5,
A plurality of staples are embedded in the upper jaw in a row along the longitudinal direction, a slider movable in a straight direction along the rail is provided at the rear end thereof, and a cutter is provided at the lower part of the slider,
The cutter provided at the lower part of the slider cuts the lower stem of the polyp sandwiched between the upper and lower jaws while moving according to the forward and backward linear movement of the slider,
The upper part of the staple embedded in the upper jaw is located on the movement path of the slider, and as the slider moves forward and backward, the lower part of the slider presses the upper part of the staple and discharges the staple to the outside of the upper jaw. Polyp removal device, characterized in that the suture.

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