KR20220014413A - Multi-lumen medical dispensing device for combination of multiple treatment tools - Google Patents

Abstract

The present invention provides a medical ejection instrument in which a plurality of treatment tools are used in combination. The medical ejection instrument includes: a first treatment tool; a second treatment tool; a main body selectively ejecting the first treatment tool or the second treatment tool; and a tube part provided in the main body and extending in a predetermined length so that the first or second treatment tool that has entered is guided into the human body. The tube part includes: a single lumen tube accommodating the first treatment tool and the second treatment tool in a single cavity from a proximal portion, which extends from one end of the main body, to a first region; and a double lumen tube for separating and accommodating the first treatment tool and the second treatment tool in respective cavities from the first region to a second region that extends up to the position at which the plurality of treatment tools intersect in order to be ejected.

Description

Medical dispensing device of multi-lumen structure for the use of multiple treatment instruments in combination

The present invention relates to a medical discharge device used for procedures such as an endoscope, and more particularly, to a medical discharge device in which a plurality of treatment tools are used together on one device.

Recently, as social changes such as Western lifestyle and dietary changes progress, colon diseases are also increasing. With the rapid development of colonoscopy equipment and techniques, colonoscopy is increasing in quantity compared to the past. Although colonoscopy has become easier than before, it is still not a universal test that anyone can easily perform. In fact, although the number of doctors who perform colonoscopy is increasing, high-level skills are required to accurately diagnose and treat patients while performing examinations within a short time without causing pain to the patient.

The lesion tissue confirmed through colonoscopy should be differentiated between lesions requiring resection and lesions that do not. When performing lesion tissue resection, an appropriate method should be selected according to the characteristics of the polyp found, such as the location, size, shape, and number of the lesion.

A needle for drug injection, an ESD knife, a snare, a marker, a biopsy device, a hemostatic clip, etc. may be used as a necessary treatment tool for lesion tissue resection. Each of these treatment instruments was provided as a medical treatment instrument. When performing lesion tissue resection, there is a need for a medical discharge device that can selectively use the necessary treatment tools as the treatment tools used for the procedure vary.

In this regard, the present applicant has developed and applied for a high-frequency knife using a combination of an ESD knife and a needle treatment device and has been registered (Korean Patent No. 1830085, hereinafter abbreviated as 'Prior Patent 1'). Prior Patent 1 discloses a mechanism for alternately discharging two treatment instruments using a gear or a wire. However, in Prior Patent 1, due to the nature of the mechanism, when one treatment instrument is operated, the other treatment instrument is always driven in the opposite direction, so it is difficult to design the driving range for each treatment instrument.

To explain in more detail regarding the driving range, among medical instruments, the snare requires a driving range of 60 to 64 mm, and the knife and needle require a driving range of 14 to 17 mm. As in the above case, in order to use two treatment instruments with remarkably different driving ranges due to the characteristics of the treatment instruments, it is advantageous that one treatment instrument is designed to have an independent operation section and safety device. Accordingly, the present applicant developed and applied for a medical dispensing device (Korean Patent Application Laid-Open No. 10-2020-0053044, hereinafter abbreviated as 'Prior Patent 2') so that treatment devices with different driving ranges can be used in combination. Prior Patent 2 discloses a mechanism capable of independently manipulating two types of treatment instruments each having a different driving range.

Thereafter, the present applicant recognized that, unlike the theoretical kinematic design, a new problem occurred when the ejection mechanism, which used a plurality of treatment instruments in combination, was used in an actual procedure. 1 shows a problem that may occur when a conventional medical discharge device in which two types of treatment tools are used in combination is driven for an actual procedure.

Referring to FIG. 1 , it is assumed that the treatment tool is composed of two types of a needle 3 and an ESD knife 4 as the medical dispensing device of Prior Patent 2 and inserted into the large intestine 2 . When inserted into an internal organ, the tube 8 of the medical discharge device is curved as it progresses in the path of the tortuous large intestine 3 . As the tube 8 of the discharge mechanism is bent, the wire of the needle 3 and the wire of the ESD knife 4 are crossed or twisted in the tube, which is a plurality of treatment tools, and frictional force is increased. In FIG. 1 , the intersection of two types of treatment instrument wires was expressed as points T1 and T2. The conventional medical discharge device in which a plurality of treatment devices are used in combination has a problem in that the intended performance cannot be expressed due to the above-described problem when the endoscope is actually inserted. 1 (a) and (b) show this, due to the twist of T1 and T2, the needle 3 does not come out as much as the length (X1) to be originally discharged from the end of the tube 8, or the ESD knife ( There is a problem that 4) does not come out as much as the length (X2) that should be originally discharged.

Figure 2 shows the end of the tube 8 to be checked by a medical practitioner in an actual endoscope. Referring to FIG. 2 , the field of view of a medical worker is limited due to the nature of the endoscope, so the ESD knife 4 as a treatment tool must be accurately positioned at the center of the end of the tube 8 . As described above in FIG. 1 , if the ESD knife 4 or other treatment tool is not properly exposed to the end of the tube 8 , it may be difficult to grasp the field of view during the procedure and an inaccurate procedure may be performed.

The above-described problem is a problem that occurs when a plurality of treatment instruments are merged into one ejection mechanism, because two types of wires on a single lumen of the tube are configured to advance and retreat independently, respectively. However, in order to solve this problem, if the tube 8 itself is composed of 2-lumen and each treatment instrument is separated and guided, the flexibility of the tube 8 decreases, making it more difficult to control the insertion of a tortuous internal organ. have.

Accordingly, the present applicant devises an improved medical discharge device that implements a multi-lumen so that a plurality of treatment instruments are not twisted when the tube 8 is bent several times while securing the flexibility of the tube 8 similar to that of the prior art. became

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

An object of the present invention is to provide a medical discharge device that can be provided on a single handpiece with a heterogeneous treatment tool to be used together when excising lesion tissue such as a polyp.

The present invention is capable of manipulating a different type of treatment instrument that is not limited in the type of treatment tool only by one insertion, and by manipulating a manipulation module to fix some of the different treatment instruments, other treatment than the treatment instrument intended to be driven by careless manipulation An object of the present invention is to prevent unintentional discharging of the sphere and to provide a medical dispensing device capable of independently manipulating the treatment device.

According to the present invention, the tube is configured such that the wire of the dissimilar treatment instrument is not twisted while securing the flexibility of a single lumen during the treatment of a medical discharge device having a different type of treatment instrument, so that the dissimilar treatment instrument can be operated normally at the end of the tube. We want to provide a medical dispensing device.

In order to achieve the above object, the present invention provides a medical discharge device in which a plurality of treatment instruments are used in combination, comprising: a first treatment instrument; a second treatment device; a body for selectively discharging the first treatment instrument or the second treatment instrument; and a tube portion provided on the main body and extending to a predetermined length so that the penetrating first treatment instrument or the second treatment instrument is guided into the body, wherein the tube portion is formed from a proximal portion extending from an end of the main body. A single lumen tube for accommodating the first and second treatment instruments in a single hollow up to a first area, and a first treatment instrument from the first area to a second area until a plurality of treatment instruments are crossed for ejection; It is characterized in that it is composed of a double lumen tube for separately accommodating the second treatment instrument into each hollow.

Preferably, the tube unit may have a multi-lumen structure in which the double lumen tube is penetrated into the second region in the sheath provided as the single lumen tube to become a single sheath, but the number of lumens in a specific region is changed.

Preferably, the tube part is a single lumen tube in which any one treatment instrument is discharged through a single hollow in the third area, which is from the second area where the double lumen tube is located to the distal end where the treatment instrument is discharged. can be configured.

Preferably, the tube part has a single lumen structure in the first region, a double lumen structure in the second region, and a single lumen structure in a third region from the second region to the distal end where the treatment instrument is crossed, , it may be a multi-lumen structure in which the number of lumens is changed from 1 -> 2 -> 1 along the length in a single sheath.

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

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

Preferably, the tube unit is configured as a single lumen tube through which any one treatment instrument is discharged through a single hollow to the center in a third area that is from the second area to the distal end where the treatment instrument crosses, and the third area The single lumen tube of, has a length of 10 mm or more.

Preferably, the main body comprises: a handle portion having an independent operation section of the first treatment instrument or the second treatment instrument; It includes a gear unit driven by gear coupling with the handle unit in a predetermined section of the manipulation section of the handle section, and can independently operate a plurality of treatment tools in the manipulation section of the handle section.

Preferably, when the manipulation section of the first treatment instrument is a first driving range and the manipulation section of the second treatment instrument is a second driving range, the first driving range is greater than the second driving range, and the first driving range The second driving range may be included.

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

Preferably, the gear unit includes: a pinion gear gear-coupled to the handle unit; and a rack gear driven in the longitudinal direction by receiving the rotational force of the pinion gear and connected to the second treatment instrument, so that the second treatment instrument may advance and retreat according to a driving direction of the rack gear.

In addition, the present invention provides a medical dispensing device in which a plurality of treatment instruments are used in combination, comprising: a first treatment instrument that advances and retreats together with the following handle; a second treatment device that advances and retreats together with the following gear; a main body provided with a handle portion having an independent operation section of the first treatment instrument or the second treatment instrument, and a gear portion driven by gear engagement with the handle portion in a predetermined section among the operation sections of the handle portion; and a tube portion provided in the main body and extending to a predetermined length so that the penetrating first treatment instrument or the second treatment instrument is guided into the body, wherein the tube portion is a single sheath, but the number of lumens in a specific area It is another feature that is a multi-lumen structure that is changed.

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

Preferably, the tube portion comprises a single lumen tube for accommodating the first treatment instrument and the second treatment instrument in a single hollow from a proximal portion extending from an end of the body to a first area, and a plurality of treatment instruments from the first area. It may be composed of a double lumen tube that separates and accommodates the first treatment instrument and the second treatment instrument in a hollow space up to the second area until they are crossed for discharging.

In addition, the present invention provides a medical dispensing device in which a plurality of treatment instruments are used in combination, comprising: a tube unit inserted into the body; The first treatment instrument and the second treatment instrument are advanced and retreated by manipulation of the handle below; an operation module for controlling any one of the first treatment instrument and the second treatment instrument in a non-driven state; and a handle for driving a treatment instrument that is not in a non-driven state by the manipulation module and independently manipulating the first treatment instrument or the second treatment instrument, wherein the tube portion is a single sheath, but a lumen in a specific area Another feature is that it is a multi-lumen structure in which the number of is changed.

Preferably, the manipulation module includes: a fixing pin for fixing any one of the first treatment instrument and the second treatment instrument to maintain it in a non-driven state; and a fixing pin button for operating the fixing pin, wherein the fixing pin may be indirectly operated by the fixing pin button.

Preferably, the handle portion, a fixed handle; and an operation handle that moves relatively from the fixed handle and pushes or pulls the plurality of treatment instruments.

Preferably, the tube portion comprises a single lumen tube for accommodating the first treatment instrument and the second treatment instrument in a single hollow from a proximal portion extending from an end of the body to a first area, and a plurality of treatment instruments from the first area. It may be composed of a double lumen tube that separates and accommodates the first treatment instrument and the second treatment instrument in a hollow space up to the second area until they are crossed for discharging.

According to the present invention, the medical dispensing device may include two types of treatment instruments, and the two types of treatment instruments may be individually driven by securing independent operation sections. Therefore, when the medical discharge device of the present invention is used, the treatment time can be shortened, and the treatment can be performed more efficiently by minimizing the side effects from the procedure. In addition, according to the present invention, the operation handle can be driven with one hand, and only by adjusting the length of the operation handle, the driving range is significantly different from a treatment instrument (for example, a snare (drive range 600 to 64 mm) or a needle (drive range 14 to 17mm)) can be easily operated.

According to the present invention, the tube portion is provided in a multi-structure of 1 lumen -> 2 lumen -> 1 lumen, so that flexibility in the 1 lumen area is secured, kinking is prevented in the 2 lumen area, and selective dispensing of the treatment instrument in the last 1 lumen area is achieved. It is possible. The tube unit according to the present invention can guide the middle so that the double lumen tube is penetrated at an appropriate position of the tube to minimize the decrease in flexibility and prevent the dissimilar treatment instruments from being twisted. Accordingly, the present invention has the advantage that the intended performance can be expressed without twisting each of the plurality of treatment instrument wires even if the tube portion is bent several times according to the shape of the internal organ during the operation of different types of treatment instruments.

1 shows a problem that may occur when a conventional medical discharge device in which two types of treatment tools are used in combination is driven for an actual procedure.
Figure 2 shows the end of the medical discharge device tube to be checked by a medical worker in an actual endoscope.
3 shows a medical discharge device according to an embodiment of the present invention.
4 is a cross-sectional view of a tube portion according to an embodiment of the present invention.
5 shows a side view of a tube part according to an embodiment of the present invention.
6 shows an experimental example for configuring a multi-lumen tube portion according to an embodiment of the present invention.
7 shows an embodiment constituting the main body of the medical discharge device according to the embodiment of the present invention.
8 shows a driving state of the gear unit and the locking unit of the main body according to the embodiment of FIG. 7 .
9 shows a driving state of the medical discharge device according to the embodiment of FIG.
FIG. 10 is a view for explaining a driving range of the medical discharge device according to the embodiment of FIG. 7 .
11 shows another embodiment constituting the main body of the medical discharge device according to the embodiment of the present invention.
12 is a front view showing the first treatment instrument and the second treatment instrument are drawn into the tube portion of the medical discharge device according to the embodiment of FIG. 11 .
13 shows a state when the fixing pin and the fixing pin button of the medical discharge device according to the embodiment of FIG. 11 are raised.
14 shows a state in which the fixing pin is moved upward to drive the medical dispensing device.
15 shows a state when the fixing pin and the fixing pin button of the medical discharge device according to the embodiment of FIG. 11 go down.
16 shows a state in which the fixing pin of the medical discharge device according to the embodiment of FIG. 11 is moved downward.
17 is a diagram illustrating a state in which the first treatment tool is driven when the operation module of the medical discharge device according to the embodiment of FIG. 11 is raised.
18 is a diagram illustrating a state in which the second treatment tool is driven when the operation module of the medical discharge device according to the embodiment of FIG. 11 is lowered.

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

Objects and effects of the present invention can be naturally understood or made clearer by the following description, and the objects and effects of the present invention are not limited only by the following description. In addition, in the description of the present invention, if it is determined that a detailed description of a known technology related to the present invention may unnecessarily obscure the gist of the present invention, the detailed description thereof will be omitted.

3 shows a medical discharge device according to an embodiment of the present invention. Referring to FIG. 3 , the medical discharge device 1 may include a body 90 , a first treatment instrument 10 , a second treatment instrument 30 , a handle unit 50 , and a tube unit 80 . have.

The terms of the first treatment instrument and the second treatment instrument defined herein refer to instruments used in medical procedures such as endoscopy and incision. In this embodiment, the treatment instrument may be a needle, a knife, a marker, an endoscope, a biopsy instrument, a hemostatic clip, or the like. In this embodiment, the first treatment instrument 10 and the second treatment instrument 30 may be two treatment instruments selected differently from the group consisting of a needle, a knife, a marker, an endoscope, a biopsy instrument, and a hemostatic clip.

For explanation of the driving range, in the embodiment, when the first treatment instrument 10 is a snare and the second treatment instrument 30 is a needle, the snare is drawn in or drawn out from the tube 80 to form a sufficient snare diameter. It has a large range. In general, the snare must be able to be operated with a forward and backward distance of about 60 to 64 mm by pushing or pulling the handle portion 50 . On the other hand, the needle, which is the second treatment instrument 30, is a treatment instrument for washing or injecting a chemical solution by penetrating into the lesion tissue. If the needle is exposed too much from the tube 80, it may inadvertently invade deeply into the lesion tissue or cause unnecessary wounds, so that only the sharp end of the needle is exposed. In general, the needle must be able to be operated with a forward and backward distance of about 14 to 17 mm by pushing or pulling the handle portion 50 .

The main body 90 may selectively discharge the first treatment instrument 10 or the second treatment instrument 30 . As a detailed configuration of the main body 90 , a mechanism for respectively driving a plurality of treatment instruments will be described with reference to the embodiments of FIGS. 7 to 18 .

The tube part 80 is provided in the main body 90, and is formed to extend to a predetermined length so that the penetrating first treatment instrument 10 or the second treatment instrument 30 is guided into the body. In the case of colonoscopy, the shape of the organ to be approached is located in a long and complex shape. This causes difficulties in accessing the polyp with an endoscope or manipulating it for surgery. This becomes a factor that makes it difficult to insert and drive not only the endoscope, but also a treatment instrument such as the medical discharge device 1 according to the present embodiment used for a procedure using the endoscope.

As in this embodiment, when a metal wire that conducts current with a knife and a plastic tube for supplying an injection solution are provided together on one discharge device as two types of treatment tools, the metal wire and the plastic tube in the tube part 80 are Crossed or excessively rubbed, the operator's operation becomes stiff, and there are cases in which the treatment instrument is not discharged as much as the designed length. The tube part 80 according to this embodiment may be composed of a single lumen tube 81 and a double lumen tube 83 in consideration of the above.

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

4 and 5, the tube portion 80 according to the present embodiment has a configuration in which the number of lumens varies from a portion of the elongated length. Referring to FIG. 4A , the single lumen tube 81 freely accommodates the first treatment instrument 10 and the second treatment instrument 30 therein. The single lumen tube 81 is configured to a predetermined length from the region of the proximal portion starting from the body 90 . The single lumen tube 81 is accommodated in one lumen using the metal wire 10 of the ESD knife and the plastic tube 30 of the needle to which the chemical solution is delivered as the first and second treatment instruments as an example. The single lumen tube 81 is flexible enough to guide complex internal organs. However, when the single lumen tube 81 is bent several times, the wire 10 and the plastic tube 30 are twisted or twisted, and in the process, excessive pressure or friction is generated with each other.

Thus, the tube portion 80 consists of a double lumen tube 83 in the distal region of its length and with reference to FIG. (833) may be formed.

The double lumen tube 83 accommodates the wire 10 in the first lumen 831 and the plastic tube 30 in the second lumen 833 . The inner diameter of the lumen may be changed according to the type of treatment device. The tube portion 80 is provided in a structure capable of guiding the treatment instrument wire without twisting or twisting in the section of the single lumen tube 81 due to the double lumen tube 83 located at the distal portion.

3 and 5, the single lumen tube 81 connects the first treatment instrument 10 and the second treatment instrument 30 from the proximal portion extending from the end of the body 90 to the first area A1. Accommodates as a single hollow.

The double lumen tube 83 transports the first treatment instrument 10 and the second treatment instrument 30 from the first area A1 to the second area A2 until a plurality of treatment instruments are crossed for ejection, respectively. Separated into the hollow of the house.

The tube part 80 is a single hollow in the third area A3 from the second area A2 where the double lumen tube 83 is located to the distal end where the treatment instrument is crossed and discharged. Consists of a single lumen tube 81 to be discharged.

The first area A1 , the second area A2 , and the third area A3 are all terms named to distinguish a specific section in the length of the tube part 80 . It may be understood that the first area A1 is a location of the proximal portion, the second area A2 is a location of the distal portion, and the third area A3 is a location of the end portion.

The tube portion 80 has a multi-lumen structure in which the double lumen tube 83 is penetrated into the second area A2 in the sheath provided as a single lumen tube 81 to become a single sheath, but the number of lumens in a specific area is changed. have Since it is difficult to configure the tube portion 80 by bonding heterogeneous tubes of the single lumen tube 81 and the double lumen tube 83 , it is provided as a single lumen tube 81 , but the double lumen tube 83 is provided in the second region. It is preferable to be manufactured and provided in the form of penetrating and inserting up to (A2). Accordingly, the third area A3 after penetration of the double lumen tube 83 is naturally formed as the area of the single lumen tube 81 again.

In the present embodiment, the tube portion 80 has a single lumen structure in the first area A1, a double lumen structure in the second area A2, and a single lumen structure in the third area A3, so that a single sheath It has a multi-lumen structure in which the number of lumens is changed from 1 -> 2 -> 1 along the length.

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

In this embodiment, it is preferable that the medical discharge device 1 used for colonoscopy is designed to have a length of the tube portion 80 of 2300 mm or more. In FIG. 5 , the first treatment instrument 10 is illustrated as an ESD knife, and the second treatment instrument 30 is illustrated as a needle 30 , and the ESD knife 10 and the needle 30 intersect in the third area A3. drive A medical dispensing device having a plurality of treatment devices requires at least 10 mm as a distance for cross driving. In addition, after the cross drive, the distance D to be advanced toward the center of the end circumference of the tube portion 80 is required at least 5 mm. Accordingly, the length of the third area A3 must be at least 15 mm. It is important that the preferred single lumen tube 81 of the first area A1 does not exceed a length of 1300 mm, and the double lumen tube 83 of the second area A2 is the first in the entire length of the tube portion 80 . It is preferable to design by subtracting the length of the single lumen tube 81 and the third area (A3) of the first area (A1). The length section of the second region A2 may be designed to be 1000 mm to 2300 mm or less, and as the length is smaller, the flexibility of the tube part 80 is secured, so it is more preferably selected in a length range of 1000 mm to 1500 mm. Hereinafter, an experimental example will be described for the reason for setting the lengths of the single lumen tube 81 and the double rubel tube 83 as described above.

experimental example. Driving test of single lumen and multi-lumen sections of the tube section

6 shows an experimental example for configuring the multi-lumen of the tube portion 80 according to an embodiment of the present invention. The most severe test conditions were applied in the range in which the endoscope can be driven. In the experimental model, 3.5 turns (2.5 turns for camouflage) are wound with a radius of 20 cm, and the distal end is rotated 180 degrees with a radius of 3 cm to evaluate the drivability of the device.

Based on the movement of about 50 mm from the mechanical part, it was checked whether the knife and the needle were driven at the end of the tube part. First, in the case where the entire tube part was composed of a single lumen tube and the case where the entire tube part was composed of a double lumen tube, it was checked whether driving resistance and driving failure by length, which are the dimensions of the tube, occurred. The number of tests per condition is 20.

[Table 1]

The outer diameter of the wire serving as the first treatment instrument was 0.43 mm, and the outer diameter of the tube serving as the second treatment instrument was 1.03 mm. When using such a plurality of treatment instruments, when a single lumen tube is configured, driving failure occurred in both the length of 1600 mm for the gastroscope and 2300 mm for the colonoscope.

In the experiment of single lumen tube, even if the inner diameter of the tube was expanded to 1.5~1.7 mm, there was no significant reduction in wire and tube driving resistance. Therefore, it can be understood that when a plurality of treatment instruments are used together with a single lumen tube, it is difficult to solve the problem in both the condition of the inner diameter and the condition of the length. In particular, the single lumen tube exceeded 50% in the test of 2300 mm.

In the case of the double lumen tube, when the inner diameter was expanded to 0.55 mm and 1.1 mm or more, respectively, no driving failure occurred. However, it was confirmed that some defects occurred in the 2300mm driving test even in the case of the double lumen tube. In addition, although it is difficult to experiment with data, when the entire tube portion 80 is formed of a double lumen tube, flexibility is rapidly reduced, and there is a problem in that it is difficult to insert the endoscope and control the target position. In addition, the use of a multi-lumen catheter is required in the treatment conditions of 2300 mm or more, which is an endoscope for the colon, but driving failure occurs partially in the conditions of small inner diameters of 0.5 mm and 1.05 mm.

Therefore, in this experiment, if only one single lumen tube or a double lumen tube is used, it was confirmed that there was a lack of sufficient performance of the product to be expressed even with numerical or design optimization when implementing heterogeneous treatment instruments. The need for a combination of single lumen tubes and double lumen tubes was recognized.

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

Results of experimental examples. Poor driving section of multi-lumen section

[Table 2]

[Table 2] shows the experimental results of determining the driving failure section by different length ratios by combining the single lumen tube and the double lumen tube. The single lumen tube corresponds to the condition of ‘Tube 2’, and the multi-lumen tube corresponds to the condition of ‘Tube 1’. The inner diameter of the single lumen tube was fixed to 1.8 mm, and the inner diameter of the multi-lumen tube was fixed to 0.55 mm and 1.1 mm, respectively.

Referring to [Table 2], as a result of the experiment, when the length of the single lumen tube became 1600 mm or more, driving failure occurred. The point of failure is when a single lumen tube has a length of 1600 mm and a double lumen tube has a length of 700 mm. In summary, it is composed of a single lumen tube 81 up to a length of 1300 mm based on the proximal portion of the tube portion 80 starting from the body 90, and when configuring the double lumen tube 83 in the subsequent section, driving failure This does not happen. In other words, it is preferable that the first area A1 is set to a section of 1300 mm or less, and the second area A2 is set to a section of 1000 mm or more.

Based on the above experimental example, it is possible to understand the reason for the design of the tube part 80 and the setting of the first, second, and third areas A1, A2, and A3. According to this embodiment, the tube through which a plurality of treatment instruments has penetrated is inserted into the long and complicated organ of the large intestine, so that even if the tube portion 80 is bent several times, the intersection and ejection drive of the treatment instrument with the intended performance at the end will operate normally. can Hereinafter, various embodiments of the body 90 for discharging a plurality of treatment instruments are disclosed.

7 shows an embodiment constituting the main body 90 of the medical discharge device 1 according to the embodiment of the present invention. Referring to FIG. 7 , the medical discharge device 1 includes a main body 90 , a first treatment instrument 10 , a second treatment instrument 30 , a handle unit 50 , a gear unit 60 , and a power connection unit 70 . ), and may include a tube portion 80 . Hereinafter, for the tube portion 80, the above-described embodiments of FIGS. 1 to 6 can be applied, and thus, redundant reference is omitted.

Referring to FIG. 7 , the body 90 refers to the catheter body 90 having a predetermined length. The main body 90 is configured with a handle portion 50 at the rear end of which a medical worker independently manipulates each treatment tool. The main body 90 is formed with a power connector 70 for applying a high frequency to the proximal portion. A tube 80 to be inserted into the body is provided at the front end of the body 90 . In the medical discharge device 1 according to the present embodiment, the first treatment instrument 10 and the second treatment instrument 30 are accommodated in the tube 80 .

The independent operation section in the present embodiment may be understood as a sliding section of the handle unit 50 capable of independently manipulating the first treatment instrument 10 or the second treatment instrument 30 . Preferably, the independent operation section can be linked to a treatment instrument requiring a large driving range among the two treatment instruments. As an example, in this embodiment, the first treatment instrument 10 (snare) requiring a large driving range among the two treatment instruments has an independent operation section. Accordingly, when the first treatment instrument 10 is manipulated, the second treatment instrument 30 is fixed, and the driving range of the first treatment instrument 10 can be easily designed through the length of the main body 90 . In order to implement a mechanism having an independent operation section, the medical discharge device 1 according to the present embodiment may include a locking unit 40 for locking other treatment devices.

The power connector 70 may be connected to a jack for supplying power to the first treatment device 10 . According to the present embodiment, the other end of the wire for driving the first treatment instrument 10 is fixed to the power connection unit 70 . The power connection unit 70 may supply power to the first treatment instrument 10 through a wire.

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

The handle portion 50 has an independent operation section of the first treatment instrument 10 or the second treatment instrument 30 . As a prior art, various ejection mechanisms using a combination of an ESD knife and a needle have been proposed. In the prior art, a plurality of operating means (handles) are generally configured to operate a plurality of treatment instruments, respectively. That is, the first handle for moving the ESD knife forward and backward and the second handle for operating the needle forward and backward are configured in parallel to enable independent operation of a plurality of treatment instruments. However, from the point of view of a medical operator who operates the ejection device with only one hand while looking at the endoscope, the fact that a handle for operating each treatment tool is separately constituted has a problem that makes precise operation more difficult.

Accordingly, in the handle unit 50 according to the present embodiment, both the first treatment instrument 10 and the second treatment instrument 30 are configured to be drivable by the handle unit 50, thereby operating a single treatment instrument. The user's convenience was taken into consideration by designing the same as the environment. In addition, the handle unit 50 according to the present embodiment has a feature configured to selectively discharge the first treatment instrument 10 and the second treatment instrument 30 only by one sliding operation.

The handle unit 50 may include a fixed handle 501 and an operation handle 503 . For convenience of explanation, the terms of the handle are classified into a fixed handle and an operation handle, but the fixed handle 501 and the operation handle 503 both represent the configuration of a handle that is operated with one hand. Referring to FIG. 2 , the fixing handle 501 may be formed at the rear end of the body 90 .

The fixing handle 501 accommodates the user's thumb, and the operation handle 503 accommodates other fingers except the user's thumb. The fixed handle 501 refers to a structure that is fixed without moving among the components of the handle portion 50 that is manipulated by the user's hand. If so, the fixing handle 501 and the operation handle 503 of FIG. 2 may be opposite to each other.

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

The teeth 5031 are formed in the longitudinal direction in which the operation handle 503 slides. The teeth 5031 drive the gear unit 60, which will be described later. Referring to FIG. 2 , it is noted that the teeth 5031 are not formed in the entire section of the operation handle 503 along the length on the inside of the operation handle 503 . The operation handle 503 has a section in which the teeth 5031 are not formed at the rear end of the inner longitudinal surface. The reason that the teeth 5031 are partially formed on the operation handle 503 as described above is to prevent the teeth 5031 from meshing with the gear unit 60 in a predetermined section of the sliding section of the operation handle 503 . In a predetermined section of the sliding section of the manipulation handle 503 , the teeth 5031 do not mesh with the gear unit 60 , so that a region in which the gear unit 60 is not driven exists, and the control handle 503 is independent of the control handle 503 . An operation section is formed.

The teeth 5031 are a configuration for driving the gear unit 60, and the length at which the teeth 5031 is formed actually determines the driving range that can advance and retreat the second treatment instrument 30 connected to the gear unit 60. . Therefore, in the present embodiment where the second treatment tool 30 is a needle having a driving range of about 14 to 17 mm, the teeth 5031 formed on the manipulation handle 503 may be formed with a length of 14 to 17 mm corresponding thereto. have.

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

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

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

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

The cylinder 65 refers to an area in which the front end of the rack gear 63 extends, and the second treatment instrument 30 is connected to the rack cylinder 65 . When the rack gear 63 advances or retreats together with the cylinder 65 , the second treatment instrument 30 connected through the cylinder 65 may also advance or retreat. That is, the second treatment instrument 30 is not directly connected to the handle unit 50 , but may be indirectly manipulated through the gear unit 60 by manipulating the handle unit 50 .

The locking unit 40 may be further included in the medical discharge mechanism 1 to fix the movement of the rack gear 63 in an independent operation section of the handle unit 50 .

The locking part 40 may be formed in the body 90 . The locking unit 40 locks and fixes either the first treatment instrument 10 or the second treatment instrument 30 in an independent operation section of the handle unit 50 . The locking unit 40 can be maintained in a locked state when the gear unit 60 is not driven, and maintained in an open state in a predetermined section in which the gear unit 60 and the gear are engaged in the operation section of the handle section 50 . . In this embodiment, the locking unit 40 may be provided as a cantilever having a free end. The locking part 40 may be formed with a stop structure for hooking at the end of the free end. The locking unit 40 is pressurized by the sliding operation of the handle unit 50 so that the stopper for hooking presses the gear unit 60 to lock the treatment instrument.

The rack gear 63 or the cylinder 65 may have one or more locking grooves 41 and 43 that can be fastened to the locking part 40 on a surface that comes into contact with the body 90 . The first locking groove 41 may be formed at a position of the operation handle 503 in which the teeth 5031 in the rack gear 63 mesh with the pinion gear 51 .

The second locking groove 43 may be formed at a position spaced apart from the first locking groove 41 by the length of the manipulation handle 503 . Accordingly, the second locking groove 43 may be provided on the cylinder 65 in which the rack gear 53 is extended. In FIG. 2 , when the operation handle 503 is advanced forward, the operation handle 503 presses the locking part 40 to be fastened to the first locking groove 41 , until the operation handle 503 is continuously pressed to an area where it is pressed. While moving forward, the rack gear 63 is fixed. However, when the operation handle 503 advances further and the rear end of the operation handle 503 passes through the first locking groove 41, the pressure of the locking unit 40 is released and the locking of the rack gear 63 is released. can Accordingly, the second locking groove 43 functions to fix the rack gear 63 even if the operation handle 503 is advanced beyond the first locking groove 41 .

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

Referring to the upper figure, when the user advances the manipulation handle 503 , the manipulation handle 503 applies pressure to the locking part 40 formed in the section that comes into contact with the body 90 . The operation handle 503 presses the locking part 40, the locking part 40 is hooked to the locking grooves 41 and 43, and the gear part 60 is fixed and does not move. Since the gear unit 60 is fixed, the second treatment instrument 30 does not advance and retreat, and the first treatment instrument 10 is discharged out of the tube 80 .

Referring to the lower figure, when the user retracts the manipulation handle 503 , the pressure applied to the locking part 40 formed in the section where the manipulation handle 503 comes into contact with the body 90 is released. The locking part 40 pressed while the operation handle 503 is pushed back is separated from the locking grooves 41 and 43, and the gear part 60 is in a drivable state. The operation handle 503 is retracted, and the teeth 5031 and the pinion gear 61 formed on the operation handle 503 are toothed, so that the second treatment instrument 30 can be discharged.

9 shows a driving state of the medical discharge device 1 according to the embodiment of FIG.

Referring to the upper figure of FIG. 9 , in the handle part 50 , the user grips the fixed handle 501 with a thumb, grips the manipulation handle 503 with a finger other than the thumb, and then applies pressure to the first treatment tool. (10) is configured to advance and retreat. When the user advances the operation handle 503 in the front end direction of the main body 90 , the operation handle 503 applies pressure to the locking unit 40 that holds the gear unit 60 in a locked state. The operation handle 503 advanced while applying pressure to the locking unit 40 discharges the first treatment instrument 10 out of the tube 80 . A section in which the locking unit 40 maintains locking may be understood as an independent operation section of the handle unit 50 .

9 , when the user retracts the operation handle 503 , the first treatment instrument 10 is partially retracted to the inside of the tube 80 . When the operation handle 503 is gradually retracted, and the teeth 5031 are retracted to a point where they come into contact with the pinion gear 61 , the user senses this through the checking unit 20 . Beyond the independent operation section up to here, when the operation handle 503 is further tightened, the locking part 40 is discharged from the first locking groove 41 to release the fixing of the rack gear 63 . At the same time, the pinion gear 61 starts to rotate.

Referring to the lower figure of FIG. 9 , it can be seen that the operation when the operation handle 503 is retracted past the independent operation section. The rack gear 63 is unlocked, and the pinion gear 61 is rotated counterclockwise. With the rotation of the pinion gear 61 , the rack gear 63 advances in the front end direction of the main body 90 . As the rack gear 63 advances, the second treatment instrument 30 is discharged out of the tube 80 .

As for the driving ranges of the first treatment instrument 10 and the second treatment instrument 30 according to the present embodiment, the operation section of the first treatment instrument 10 is the first driving range and the operation of the second treatment instrument 30 . When the section is the second driving range, the first driving range may be greater than the second driving range, and the second driving range may be included in the first driving range.

Referring to FIG. 9 , the driving range in which the user physically manipulates the manipulation handle 503 to independently move the first treatment tool 10 may be represented by the length of D1. In addition, the driving range in which the user moves the second treatment instrument 30 by physically manipulating the manipulation handle 503 may be represented by the length of D2. In the section D2 in which the second treatment instrument 30 is moved, not only the second treatment instrument 30 but also the first treatment instrument 10 are operated together. Accordingly, the first driving range, which is the length in which the manipulation handle 503 manipulates the first treatment instrument 10, may be D1+D2. The second driving range, which is the length in which the manipulation handle 503 manipulates the second treatment instrument 30 , may be D2. In summary, the first driving range, which is the length in which the first treatment instrument 10 is operated, is larger than the second driving range, which is the length in which the second treatment instrument 30 is operated, and the first driving range is the second driving range. will include

FIG. 10 is a view for explaining a driving range of the medical discharge device 1 according to the embodiment of FIG. 7 . In more detail, Figure 10 describes the driving range of the teeth 5031 and the gear unit 60 according to an embodiment of the present invention. In FIG. 10 , a section in which the teeth 5031 are formed in the manipulation handle 503 may be represented by R1. As described above, the length of the teeth 5031 determines the driving range of the second treatment instrument 30 . The section for manipulating the advance and retreat of the second treatment instrument 30 is R1 , and R1 may be designed to have a length suitable for the driving range of the second treatment instrument 30 .

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

In summary, the length of the section R1 in which the teeth 5031 is formed and the section R2 in which the second treatment instrument 30 advances are approximately the same. When the user manipulates the length of R1, the second treatment instrument 30 is discharged by R2. When the length at which the user physically manipulates the manipulation handle 503 is R1, the second treatment instrument 30 moves by the length of R2 equal to the length of R1. The medical discharge mechanism 1 according to this embodiment physically manipulates the manipulation handle 5031 through the mechanism of the teeth 5031 and the gear unit 60 formed in a predetermined section of the handle unit 50 as described above. It implements a mechanism capable of independently dispensing two types of treatment instruments. In addition, even with treatment instruments having different driving ranges from each other, it is possible to easily change the design without changing the mechanism by the length of the teeth 5031 and the length of the body 90 . Accordingly, the medical discharge device 1 according to the present embodiment can discharge a plurality of treatment instruments regardless of the type of treatment instruments.

11 shows another embodiment constituting the main body 90 of the medical discharge device 1 according to the embodiment of the present invention. In this embodiment, as one treatment instrument is fixed to the main body 90 through the configuration of the manipulation module 100 and the other treatment instrument is independently driven, different treatment instruments are used together in a form without a mechanism of a gear. .

Referring to FIG. 11 , the first treatment instrument 10 and the second treatment instrument 30 are locked by a fixing pin 105 in an independent operation section of the handle unit 50 . Only other treatment devices can be driven forward and backward. The independent operation section expressed in this embodiment may be understood as a sliding section of the handle unit 50 capable of independently manipulating the first treatment instrument 10 or the second treatment instrument 30 . Preferably, the independent operation section can be linked to a treatment instrument requiring a large driving range among the two treatment instruments. In this embodiment, it is assumed that the first treatment instrument 10 requiring a large driving range has an independent operation section, and the second treatment instrument 30 is independent within the driving range of the first treatment instrument 10 . It is exemplified as having a driving range.

The handle unit 50 may operate the first treatment instrument 10 or the second treatment instrument 30 having an independent operation section. In the prior art, various ejection mechanisms using a combination of an ESD knife and a needle have been proposed. In the prior art, a plurality of operating means (handles) are generally configured to operate a plurality of treatment instruments, respectively. That is, the first handle for operating the ESD knife forward and backward and the second handle for operating the needle forward and backward are configured in parallel to enable independent operation of a plurality of treatment instruments. However, from the point of view of a medical operator who operates the ejection device with only one hand while looking at the endoscope, the fact that a handle for operating each treatment tool is separately constituted has a problem that makes precise operation more difficult.

Accordingly, in the present embodiment, the handle unit 50 is configured to be capable of driving both the first treatment instrument 10 and the second treatment instrument 30, so that the user of convenience was considered. In addition, the handle unit 50 according to the present embodiment has a feature configured to selectively discharge the first treatment instrument 10 or the second treatment instrument 30 only by one sliding operation.

The first cylinder 600 is provided in the main body 90 and refers to an extended region connecting the handle portion 50 and the second treatment instrument 30 , and the first cylinder 600 is the operation handle 503 . It is driven together during the forward and backward driving of the second treatment instrument 30 to advance or retreat. That is, the second treatment instrument 30 is not directly connected to the handle unit 50 , but may be indirectly manipulated through the first cylinder 600 by manipulating the handle unit 50 . The first cylinder 600 extends from the second treatment instrument 30 to the manipulation handle 503 and is partially empty in the region where the manipulation module 100 is located. This is a structure that enables movement of the manipulation module 100 . This will be described in detail below with reference to FIG. 3 .

The second cylinder 610 is provided in the body 90 and refers to an extended region connecting the handle 50 and the first treatment instrument 10 . The second cylinder 610 may be driven together when the operation handle 503 is driven forward or backward on a similar principle to the first cylinder 600 to advance or retreat the first treatment instrument 10 . That is, the first treatment instrument 10 is not directly connected to the handle unit 50 , but may be indirectly manipulated through the second cylinder 610 by manipulating the handle unit 50 .

The power connector 70 may be connected to a power cable for applying a high frequency to the first treatment device 10 . According to the present embodiment, the other end of the first treatment instrument 10 is fixed to the power connector 70 to supply power. Note that the power connector 70 is formed to be slidably movable. The conventional handpiece medical dispensing mechanism is configured to be fixedly coupled to a region adjacent to the handle operated by the operator in which the jack for connecting the power source is operated. In the conventional handpiece medical dispensing device, when a medical worker connects the power jack to a high-frequency knife at the operation site, it is common that the power cable interferes with the working radius of the handle. When the power connection part to which the jack is coupled to the handpiece medical discharge device is fixedly formed as in the prior art, the power cable interferes with the manipulation of the delicate high-frequency knife or distorts the center of gravity, making the procedure difficult. The power connection unit 70 according to the embodiment is configured to be able to adjust the distance apart from the handle unit 50 in consideration of the above, and inconvenience in operation due to the power cable connected to the power connection unit 70 is reduced. so as not to cause

The manipulation module 100 may include a fixed shaft 101 , a fixed pin button 103 and a fixed pin 105 , and use either the first treatment instrument 10 or the second treatment instrument 30 . It can be controlled by driving state. In more detail, the fixing pin 105 of the manipulation module 100 fixes and locks a portion of the first treatment instrument 10 to the third treatment instrument 11 so that the unlocked treatment instrument can be driven. The fixing pin 105 may fix any one of the first treatment instrument 10 and the second treatment instrument 30 to maintain it in a non-driven state. The fixing pin button 103 may operate the fixing pin 105 , and in more detail, the fixing pin 105 may be indirectly operated by the fixing pin button 103 .

In the embodiment of the present invention, the manipulation module 100 can move up and down, and the fixing pin 105 that directly controls the treatment tool among the manipulation module 100 is the fixed shaft 101 with respect to the fixed shaft 101 . ) can be moved within a range that does not deviate from The fixing pin 105 is located inside the main body 90 and can be indirectly operated by the fixing pin button 103 provided on the outside of the main body 90 instead of direct manipulation. The fixing pin 105 is moved by the fixing pin button 103 so that some of the treatment instruments at the corresponding position may be fixed.

12 is a front view showing the first treatment instrument 10 and the second treatment instrument 30 are inserted into the tube portion 80 of the medical discharge device 1 according to the embodiment of FIG. 11 . 12 shows two different types of treatment tools in the medical discharge device according to an embodiment of the present invention, wherein the first treatment instrument 10 is a snare and the second treatment instrument 30 is composed of a needle.

The cross section of the tube part 80 in FIG. 12 is a view at the position of the second area A2 in which the above-described double lumen tube 83 is located. In the second area A2 , the first treatment instrument 10 and the second treatment instrument 30 may be separately provided in each lumen. The double lumen tube 83 forms a first lumen 801 and a second lumen 803 divided up and down. The second treatment instrument 30 is provided in the first lumen 801 provided above the tube 80, and the first treatment instrument 10 is provided in the first lumen 801 provided below. Since the two treatment instruments are provided separately, a specific treatment instrument can be guided so that it does not affect other treatment instruments and does not twist or cross each other even when the tube part 80 is curved.

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

The fixing pin 105 can move up and down based on the fixing shaft 101 , and depending on the position of the fixing pin 105 , some treatment instruments are locked, so that the treatment instruments can be driven independently. The fixing pin 105 and the fixing shaft 101 may be positioned between the first treatment instrument 10 and the second treatment instrument 30 inside the tube 90 . The fixing pin 105 can move up and down in a range that does not deviate from the fixing shaft 101 with the fixing shaft 101 as the center. The fixing pin 105 may be in the form of a column or a prismatic column, and the horizontal length (diameter) of both ends of the fixing pin 105 may be longer than the horizontal length (diameter) of the pillar portion and may have a shape similar to a 工. Due to the shape characteristics of the fixing pin 105, the end of the fixing pin 105 is caught on the fixing shaft 101 when the fixing pin 105 moves up and down, so the range of movement of the fixing pin 105 may be limited.

The fixing pin 105 may be operated through the fixing pin button 103 . The user of the present invention can operate the fixing pin 105 by manipulating the fixing pin button 103 located outside the main body 90 instead of directly operating the fixing pin 105 located inside the main body 90 . . The fixing pin button 103 can move the fixing pin 105 by pushing or pressing the fixing pin 105 in contact with the distal end surface of the fixing pin 105 . The fixing pin button 103 is positioned on the same vertical line as the fixing pin 105 when operating the fixing pin 105 , and is slidable together with the operation handle 503 at the tip of the operation handle 503 .

13 is a view when the fixing pin 105 and the fixing pin button 103 are raised, and FIG. 14 is driven by the operation handle 503 when the fixing pin 105 and the fixing pin button 103 are raised. shows how to become

Referring to FIG. 13 , when the user raises the fixing pin button 103 upward, the lower end of the fixing pin button 103 moves upward and is coupled to the second cylinder 610 . In addition, the lower end of the fixing pin button 103 comes into contact with the lower end of the fixing pin 105 , and pushes the lower end of the fixing pin 105 upward to the fixing shaft 101 . The fixing pin button 103 is inserted into the second cylinder 610 so that the inside of the main body 90 is connected from the first treatment instrument 10 to the operation handle 503 . On the other hand, the upper portion of the fixing pin 105 , that is, the first cylinder 600 is not coupled to the fixing pin button 103 , so that a part thereof may be empty.

Referring to FIG. 14 , as the fixing pin 105 is moved upward, the fixing pin 105 is inserted into a part of the first cylinder 600 , and the first cylinder 600 and the second treatment instrument 30 . drive control of In addition, since the upper end of the fixing pin button 103 is lifted out of the main body 90 , the first cylinder 600 is not coupled to the fixing pin button 103 so that a part of the first cylinder 600 is empty. Accordingly, since the driving force is not transmitted from the manipulation handle 503 to which the user applies the driving force to the first cylinder 600 , the second treatment instrument 30 connected to the first cylinder 600 is not driven. On the other hand, since the second cylinder 610 has a fixed pin button 103 coupled to the empty portion and there is no fixed pin 105 for controlling the driving, it can be driven together when the operation handle 503 moves forward or backward.

FIG. 15 shows a state when the fixing pin 105 and the fixing pin button 103 of the medical discharge device according to the embodiment of FIG. 11 go down. 16 shows a state in which the fixing pin 105 of the medical discharge device according to the embodiment of FIG. 11 has been moved downward.

When the user lowers the fixing pin button 103 , the upper end of the fixing pin button 103 lowers the upper surface of the fixing pin 105 to the fixing shaft 101 , and is coupled to the first cylinder 600 . With the insertion of the fixing pin button 103, the inside of the main body 90 is connected from the second treatment instrument 30 to the operation handle 503, but the lower side of the fixing pin 105, that is, the second cylinder 610, is partially may be empty.

16 shows a state in which the fixing pin 105 is moved downward, and the fixing pin 105 is inserted into a part of the second cylinder 610 to control the driving of the second cylinder 610 and the first treatment instrument 10 . do. In addition, since the lower end of the fixing pin button 103 descends to leave the body 90 , the second cylinder 610 is not coupled to the fixing pin button 103 , so that a part of the second cylinder 610 is empty. Accordingly, the first treatment instrument 10 is not driven, and the second treatment instrument 30 may be driven together with the first cylinder 600 when the operation handle 503 moves forward and backward.

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

18 shows a state in which the second treatment tool 30 is driven when the operation module 100 of the medical discharge device 1 according to the embodiment of FIG. 11 is lowered.

Referring to FIG. 18 , since the manipulation module 100 , that is, the fixing pin 105 is moved downward, the first treatment instrument 10 provided in the second lumen 803 is locked. The user may lower the fixing pin 105 down as shown in the figure shown at the top, and manipulate the handle 50 as shown in the figure shown at the bottom. When the user grips the fixing handle 501 with a thumb and applies pressure to the operation handle 503 with a finger other than the thumb, the second treatment instrument 30 advances and retreats and is discharged out of the tube 80, The locked first treatment instrument 10 is not driven. The user may physically manipulate the manipulation handle 503 to manipulate the second treatment instrument 30 in the range D2, which is an independent manipulation section of the second treatment instrument 30 . In the embodiment of the present invention, since the second treatment instrument 30 is a needle, D2 may be driven in a range of 14 to 17 mm.

Although the present invention has been described in detail through representative embodiments above, those of ordinary skill in the art to which the present invention pertains will understand that various modifications are possible within the limits without departing from the scope of the present invention with respect to the above-described embodiments. will be. Therefore, the scope of the present invention should not be limited to the described embodiments, but should be defined by all changes or modifications derived from the claims and equivalent concepts as well as the claims to be described later.

1: Medical dispensing device
2: Captain
3: Needle
4: ESD Knife
8: tube
80: tube part
81: single lumen tube
83: double lumen tube
810: single lumen
831: first lumen
833: second lumen
10: first treatment device
30: 2nd treatment device
40: locking unit
41: first locking home
43: second locking home
50: handle part
501: fixed handle
503: operation knob
5031: tooth
60: gear unit
61: pinion gear
63: rack gear
65: cylinder
600: first cylinder
610: second cylinder
70: power connection
90: body
100: operation module
101: fixed shaft
103: push pin button
105: fixing pin

Claims (18)

In the medical dispensing device in which a plurality of treatment instruments are used together,
first treatment device;
a second treatment device;
a body for selectively discharging the first treatment instrument or the second treatment instrument; and
It is provided on the main body, and includes a tube portion extending to a predetermined length so that the penetrating the first treatment instrument or the second treatment instrument is guided into the body,
The tube part,
a single lumen tube to receive the first and second instruments in a single hollow from a proximal portion extending from an end of the body to a first region;
Medical dispensing, characterized in that it consists of a double lumen tube for separately accommodating the first treatment instrument and the second treatment instrument from the first area to a second area until a plurality of treatment instruments are crossed for discharge Instrument.
The method of claim 1,
The tube part,
In the sheath provided as the single lumen tube, the double lumen tube is penetrated into the second region to become a single sheath, but it has a multi-lumen structure in which the number of lumens in a specific region is changed.
The method of claim 1,
The tube part,
Medical discharge, characterized in that it consists of a single lumen tube in which any one treatment instrument is discharged to the center in a single hollow in the third area, which is from the second area where the double lumen tube is located to the distal end where the treatment instruments are discharged Instrument.
The method of claim 1,
The tube part,
a single lumen structure in the first region, a double lumen structure in the second region, and a single lumen structure in a third region from the second region to the distal end where the treatment instrument is crossed,
Medical dispensing device, characterized in that it has a multi-lumen structure in which the number of lumens along the length in a single sheath is changed from 1 -> 2 -> 1.
The method of claim 1,
The single lumen tube of the first region,
Medical dispensing device, characterized in that it has a length of more than 0 and 1300 mm or less from the proximal part.
The method of claim 1,
The double lumen tube of the second area,
Medical dispensing device, characterized in that it has a length of 1000mm to 2300mm or less.
The method of claim 1,
The tube part,
In the third region, which is from the second region to the distal end where the treatment instrument is discharged, it is composed of a single lumen tube through which one treatment instrument is discharged through a single hollow to the center,
The single lumen tube of the third region,
Medical discharge device, characterized in that it has a length of 10mm or more.
The method of claim 1,
The body is
a handle portion having an independent operation section of the first treatment instrument or the second treatment instrument;
It includes a gear part driven by gear coupling with the handle part in a predetermined section of the manipulation section of the handle part,
Medical dispensing device, characterized in that it can independently operate a plurality of treatment instruments in the operation section of the handle portion.
The method of claim 1,
When the operation section of the first treatment instrument is a first driving range, and the manipulation section of the second treatment instrument is a second driving range,
The first driving range is greater than the second driving range,
Medical dispensing device, characterized in that the second driving range is included in the first driving range.
The method of claim 1,
The first treatment instrument and the second treatment instrument are
A medical dispensing device, characterized in that it is two different treatment tools selected from the group consisting of a needle, a knife, a marker, an endoscope, a biopsy device, and a hemostatic clip.
The method of claim 1,
The gear unit,
a pinion gear gear-coupled to the handle; and
Including a rack gear driven in the longitudinal direction by receiving the rotational force of the pinion gear and connected to the second treatment tool,
Medical dispensing device, characterized in that the second treatment tool advances and retreats according to the driving direction of the rack gear.
In the medical dispensing device in which a plurality of treatment instruments are used together,
The first treatment tool that advances and retreats together with the following handle;
a second treatment device that advances and retreats together with the following gear;
a main body provided with a handle portion having an independent operation section of the first treatment instrument or the second treatment instrument, and a gear portion driven by gear engagement with the handle portion in a predetermined section among the operation sections of the handle portion; and
It is provided on the main body, and includes a tube portion extending to a predetermined length so that the penetrating the first treatment instrument or the second treatment instrument is guided into the body,
The tube part,
A medical discharge device, characterized in that it has a single sheath but a multi-lumen structure in which the number of lumens is changed in a specific area.
13. The method of claim 12,
The first treatment instrument and the second treatment instrument are
Medical dispensing device, characterized in that one treatment instrument is locked in the independent operation section of the handle portion and only the other treatment instrument is driven forward and backward.
13. The method of claim 12,
The tube part,
a single lumen tube to receive the first and second instruments in a single hollow from a proximal portion extending from an end of the body to a first region;
Medical dispensing, characterized in that it consists of a double lumen tube for separately accommodating the first treatment instrument and the second treatment instrument from the first area to a second area until a plurality of treatment instruments are crossed for discharge Instrument.

In the medical dispensing device in which a plurality of treatment instruments are used together,
a tube portion to be inserted into the body;
The first treatment instrument and the second treatment instrument are advanced and retreated by manipulation of the handle below;
an operation module for controlling any one of the first treatment instrument and the second treatment instrument in a non-driven state; and
and a handle for driving a treatment instrument that is not in a non-driven state by the manipulation module and independently manipulating the first treatment instrument or the second treatment instrument,
The tube part,
A medical discharge device, characterized in that it has a single sheath but a multi-lumen structure in which the number of lumens is changed in a specific area.
15. The method of claim 14,
The operation module is
a fixing pin for fixing any one of the first treatment instrument and the second treatment instrument to maintain it in a non-driven state; and
It includes a fixing pin button for operating the fixing pin,
The fixing pin is a medical dispensing device, characterized in that indirectly operated by the fixing pin button.
15. The method of claim 14,
The handle portion,
fixed handle; and
Medical dispensing device, characterized in that it moves relatively from the fixed handle and comprises a manipulation handle for pushing or pulling the plurality of treatment instruments.
15. The method of claim 14,
The tube part,
a single lumen tube to receive the first and second instruments in a single hollow from a proximal portion extending from an end of the body to a first region;
Medical dispensing, characterized in that it consists of a double lumen tube for separately accommodating the first treatment instrument and the second treatment instrument from the first area to a second area until a plurality of treatment instruments are crossed for discharge Instrument.

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