WO2012115363A2

WO2012115363A2 - Multi-procedural tool for endoscopic submucosal layer which operates plurality of modes in one device through a multi-procedure module

Info

Publication number: WO2012115363A2
Application number: PCT/KR2012/000812
Authority: WO
Inventors: 정명준
Original assignee: 주식회사 세양메디칼
Priority date: 2011-02-22
Filing date: 2012-02-02
Publication date: 2012-08-30
Also published as: CN103415265A; KR101056698B1; WO2012115363A3

Abstract

The present invention relates to a multi-procedural tool for an endoscopic submucosal layer which operates a plurality of modes in one device through a multi-procedure module, and solves problems which exist in conventional surgical tools for the endoscopic submucosal layer, whereby a spray catheter which is generally a catheter for spraying a pigment, a knife for marking, a needle for injecting, an incision knife, a hemostasis and cleaning knife, and a delamination knife are alternately used during the operation, and also, it may take a long time to acquire the skills to use the above-described tools. Also, it may take a long time to replace the plurality of knives, and the purchase costs for the plurality of surgical tools is high. The multi-procedural tool for the endoscopic submucosal layer according to the present invention includes a control module, a tube module, and a multi-procedure module. Thus, a pigment spraying mode, a lesion marking mode, an injection mode, an incision·hemostasis·cleaning mode, and a delamination mode may be operated under the control of one control mode. Also, a water spraying pressure may be adjusted to perform a minute incision operation, and simultaneously, all modes such as hemostatic incision and various injection shots may be operated through one manipulation. Thus, even a non-expert can easily acquire skills, and also, seriously bent sections can be medically operated on, and vertical incisions and turning incisions can be made. Furthermore, operating time and costs may be minimized.

Description

Endoscopic submucosal multi-layer surgical instrument that operates multiple modes as a single device through a multi-surgery module

FIELD OF THE INVENTION The present invention relates to treatment instruments for endoscopic submucosal resection, and more particularly, to the provision of improved treatments for use in Endoscopic Submucosal Dissection (ESD).

Endoscopy treatment endoscopy is recognized as an important field in the medical field of the digestive system. In particular, treatment endoscopy using electronic endoscopy, that is, endoscopy treatment, is the miniaturization of electronic devices from the appearance of ultra-small solid state imaging devices (CCD). Thanks to the development of imaging technology, various diagnostics through the working channel, the development of treatment technology, and the skill of the physician's hand skills.

In the past, in the case of gastric cancer or colorectal cancer, endoscopic submucosal dissection (ESD) was performed through an instrument inserted through a working channel provided in the endoscope. By performing endoscopic mucosal resection, the diagnosis and treatment are performed clinically and the treatment rate of early gastric or colon cancer is increasing.

On the other hand, various types of treatment tools used for the treatment to be inserted through the working channel of the endoscope during Endoscopic Submucosal Dissection (ESD) or Endoscopic Mucosal Resection (EMR) are used. .

That is, the treatment tool is inserted into the body through a tube connected to the treatment body constituting the treatment instrument and inserted into a working channel provided in the endoscope, and is commonly used for cutting mucosal tissues. Coagulators used for hemostasis during bleeding during mucosal ablation, and needles necessary for injecting saline, drugs, etc. as a means to inflate tissue to provide ease of ablation. Various types of treatment tools are used, such as washer fluid (washing) operation for easy visibility due to bleeding.

Conventionally, a treatment tool is inserted into one treatment tool through a working channel provided in an endoscope, and one operation is performed. After the treatment tool is withdrawn, another treatment tool is inserted to perform a desired treatment. Has been made.

In order to solve such a problem, Korean Patent Publication No. 10-0943130, the treatment body for the operation control necessary for the operator treatment; A treatment tube connected to the treatment body and inserted into the working channel of the endoscope; A treatment tool for entering and exiting from the end of the treatment tube to perform a treatment operation; In an endoscope submucosal resection treatment tool comprising a frame control tool provided on the treatment body to be connected to the treatment tool and control means;

The treatment tool includes a knife which performs a function of cutting the biological tissue while entering and exiting the treatment tube end; A core regulator fixed to the end of the treatment tube and configured to perform coagulation treatment in cooperation with a knife; A needle for injecting drugs necessary for treatment while entering and exiting the end of the treatment tube; And a washer hole for injecting washer fluid; The tool control tool includes a control body provided with a control hole so that the control means can be connected to the center having a connector for connecting the treatment tube at the tip; A washer liquid inlet formed to protrude to inject the washer liquid into the side of the control body; A knife slider coupled to control the knife at an intermediate position of the control body; An endoscopic submucosal resection instrument consisting of a needle hole formed to connect the injector to control the needle behind the control body has been presented.

However, this requires the use of a spray catheter for pigmentation in order to determine the exact location and size of the lesion. Subcutaneous mucosal resection is mainly performed by pigment catheter, lesion marking knife, and lesion expansion. Considering the need to alternately use injection needles, incision knife, hemostatic and cleansing functions, and peeling knives, it takes a long time to replace a plurality of treatment tools, and a lot of costs associated with the provision of a plurality of surgical instruments. there was.

In addition, conventional knives take a long time to be skilled, severe bending and vertical ablation are difficult, it is impossible to bend and cut, difficult to adjust the length of the knife, too flexible, effective force is not transmitted sometimes, fine operation There was a difficult problem.

In order to achieve the above object, in the present invention, the pigment spraying mode, lesion marking mode, injection mode, phosphate, hemostasis, washing mode, peeling mode can be operated by one device under the control of the control module, and water injection pressure Depending on the situation, it is possible to disperse pigments or inject the drug, and to perform detailed resection or resection with increased hemostasis, and even non-experts can easily use the knife, and severe bending, vertical ablation, and bending ablation can be performed. First of all, the purpose of the present invention is to provide a multi-surgical instrument for endoscopic submucosal layer that operates as a single device through a multi-procedure module that can minimize procedure time and cost.

In order to achieve the above object, the endoscopic submucosal multi-surgery apparatus for operating a plurality of modes according to the present invention as one device through a multi-surgery module

A control module for controlling the operation of the pigment spray mode, the lesion marking mode, the injection mode, the eclampsia, hemostasis and washing mode, and the exfoliation mode required by the operator for endoscopy submucosa,

A tube module which is connected to a control module and inserted into a working channel provided in the endoscope, and supplies electricity and water to a multi-procedure module formed at an end in all directions;

It is located at the end of the tube module in all directions to move the pigment spray mode, lesion marking mode, injection mode, ecsiosis, hemostasis, washing mode, and peeling mode to one device under the control module. This is accomplished by being composed of a multi-procedure module.

As described above, in the present invention, the pigment spraying mode, lesion marking mode, injection mode, phosphate, hemostasis, washing mode, and peeling mode can be operated by one device under the control of the control module, thereby reducing the procedure time. It is possible to control the spray pressure of water, and to apply pigment spraying or drug injection depending on the situation, to perform fine resection or resection with increased hemostasis, and even non-experts can easily master knives, and use ball blades and needle blades. Through severe bends, vertical ablation site, and can be removed by cutting, there is a good effect to implement a high-end endoscopic submucosal procedure.

1 is a perspective view showing the components of the endoscopic submucosal multi-layer surgical instrument for operating a plurality of modes according to the present invention as a single device through a multi-operative module,

Figure 2 is an internal cross-sectional view showing the components of the endoscopic submucosal multi-layer surgical instrument for operating a plurality of modes according to the present invention as a single device through a multi-operative module,

Figure 3 is an internal perspective view showing the configuration of the Teflon tube 210, the needle blade driving wire 220, the multi-stage support 230 according to the present invention,

Figure 4 is an embodiment showing the process of controlled spraying the pigment spray, water, physiological saline in the high-pressure injection mode (232a) through the orifice tube according to the present invention,

Figure 5 is an embodiment showing the process of controlled spraying the pigment spray, water, physiological saline in the medium pressure injection mode (232b) through the orifice tube according to the present invention,

Figure 6 is an embodiment showing the process of controlled spraying the pigment spray, water, physiological saline in the low pressure injection mode (232c) through the orifice tube according to the present invention,

7 is a diagram illustrating a pigment spray mode in which a pigment is sprayed to distinguish a suspected site from a suspected area, such as a cancer mass, by spraying a pigment onto the pre-endoscopic submucosal layer procedure through a ball blade according to the present invention. Example,

Figure 8 shows the ecchymosis, hemostasis, rinsing mode of the census (= ablation), hemostasis, and cleaning the lesion site of the endoscopic submucosal layer through the ball blade according to the present invention In one embodiment,

Figure 9 is an embodiment showing a peeling mode for peeling the lesion site through the ball blade of the multi-surgery module according to the present invention,

Figure 10 is an embodiment showing a marking mode for marking around the lesion through the needle blade according to the invention,

Figure 11 is an embodiment showing the injection mode inflating the lesion tissue through the needle blade according to the present invention,

FIG. 12 is a view illustrating the incisor hemostasis, hemostasis, and lavage modes in which the lesions of the endoscopic submucosal layer are treated with needle blades (= ablation), bleeding, and washed through the needle blades according to the present invention. In one embodiment,

Figure 13 is an embodiment showing a peeling mode for peeling the lesion site through the needle blade of the multi-surgery module according to the present invention.

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

1 is a perspective view showing the components of the endoscopic submucosal multi-layer surgical instrument for operating a plurality of modes according to the present invention as a single device through a multi-surgery module, which is a control module 100, a tube module 200, the multi-surgery module 300.

First, the control module 100 will be described.

The control module 100 is to serve to control the operation of the pigment spray mode, lesion marking mode, injection mode, pre-eclampsia, hemostasis, washing mode, peeling mode, peeling mode required for the subendoscopic submucosal procedure , It is composed of the handle body 110, the handle head portion 120, the drug / pigment inlet 130, the first stopper 140, the slide handle 150, the second stopper 160, finger support 170 do.

The handle body 110 has a straight slide structure.

It is composed of a handle head portion at the front end, the drug, pigment inlet is formed in a diagonal direction on one side of the handle head portion, the first stopper, the slide handle, the second stopper, the finger support portion is configured in front of the handle head portion, respectively.

Then, the guide rail groove is formed in the middle portion of the handle body, the slide handle is formed thereon.

The handle head portion 120 is located at the front end of the handle body is connected to the tube module is fixed and connected to the tube body to the handle step, while connecting and operating the needle blade driving wire passing through the tube module toward the slide handle. Play a role.

It consists of a multi-stage layered structure, fixing the tube module on one side 121.

The drug and pigment inlet 130 is projected diagonally on one side of the surface around the handle head portion serves to select and supply any one of a variety of situations, such as dye spray, physiological saline, drugs to the handle head module.

It is filled with a syringe or a liquid supply pump to any one of the pigment spray, water, saline, and then supplied to the tube module through the liquid inlet.

Here, the pigment dispersant refers to a pigment that is sprayed to distinguish the suspected site from the suspected site such as a dark mass by spraying the pigment on the anticipated subsidiary submucosal layer. The pigment spreader must be sprayed through the ball blade because it must be sprayed with a strong injection pressure.

The water is used for the role of injection and cleaning for the detailed and rapid procedure during the endoscopic submucosal resection.

The physiological saline is used to inflate the submucosal layer from the myocardium at the endoscopic submucosal layer. This makes it safe and easy to remove the procedure from the root layer to the submucosa.

The first stopper 140 is positioned at the front end of the handle head part to control the movement of the slide handle slid forward.

It consists of an annular band shape and is located at the tip of the guide rail groove of the slide handle.

The slide handle 150 is located at the rear end of the first stopper, and the needle blade driving wire is connected to one end of the slide handle 150 so as to slide forward and backward through the guide rail groove to transmit the force in the forward direction to protrude the needle blade out of the ball blade. Or needle blade to transfer the force in the reverse direction to be embedded into the ball blade.

It is made of a straight slice handle shape, the handle ringer is formed up and down one by one in the rear end of the body, the electrical conducting portion 151 is formed at the tip of the upper handle ringer.

Then, the needle blade driving wire is connected to the electric conduction portion.

The slide handle is connected to the needle blade driving wire on one side of the front end and slides back and forth through the guide rail groove.

That is, when the force in the forward direction enters the needle blade driving wire through the slide handle along the guide rail groove, the needle blade protrudes outward through the ball blade.

At this time, when water is supplied to the drug inlet with a syringe or a water pump, the water receiving area is narrowed and high pressure water is injected between the needle blade and the ball blade protruding to the outside.

On the contrary, when the force in the backward direction enters the needle blade driving wire through the slide handle along the guide rail groove, the needle blade passes through the ball blade and is embedded in the orifice tube of the multistage support member 230.

In this case, when water is supplied to the drug dye inlet by a syringe or a water pump, the water receiving area is widened, and the water spray is weakly injected between the needle blade and the ball blade embedded in the orifice tube through the inside of the ball blade.

The second stopper 160 is positioned at the rear end of the slide handle to control the movement of the slide handle slid backward.

The finger support part 170 is positioned at the rear end of the second stopper, and serves to support the forward and backward movement of two fingers inserted in the slide handle by placing the finger of the operator.

Next, the tube module 200 according to the present invention will be described.

The tube module is connected to the control module is inserted into the working channel provided in the endoscope, and serves to supply electricity and water toward the multi-surgery module formed at the front end, as shown in Figure 2, Teflon tube 210, a needle blade driving wire 220, and a multi-stage support 230.

The Teflon tube 210 is inserted into a working channel provided in the endoscope, accommodates a needle blade driving wire through the inside, and a multi-stage support is milled on one side of the tip to support the needle blade and the ball blade.

It is made of Teflon material serves to insulate the needle blade and the ball blade when the electric supply.

In addition, the Teflon tube serves to smoothly insert the instrument into the endoscope channel in addition to the insulation.

The front end is connected to one side of the multi-stage support, the rear end is configured to be connected to the step of the handle head portion.

Then, one long catheter (circular tube) is formed, the length is formed of 140 ~ 190cm.

The needle blade driving wire 220 is located inside the Teflon tube, the front end is connected to the needle blade, the rear end is connected to the electrical conduction portion of the slide handle receives the forward and backward forces of the slide handle It moves the needle blade, and receives electricity from the electric conduction unit to supply electricity to the needle blade.

It consists of metals, such as stainless steel.

In addition, the needle blade driving wire 220 according to the present invention, as shown in Figure 3, the multi-stage support at one side of the multi-stage support connecting portion during the procedure, do not be shaken or shaken, so as to be fixed to the Teflon tube tip, A sliding wire slide member 221 is formed in surface contact with the surface of the Teflon tube.

In the present invention, the hook bar 222 is formed at the rear end of the wire slide member 221 so that the hook bar is caught by the wire slide member when the needle blade is advanced, and the needle blade is 0.5 mm to 6 mm outside the ball blade. Is configured to protrude.

The multi-stage support 230 is located at one end of the inner side of the Teflon tube, and supports the ball blade and the needle blade, and serves to control and spray the introduced water at high pressure and low pressure.

It is composed of a multi-stage supporting protrusion 231, the orifice tube 232.

The multi-stage support protrusion 231 serves to support the ball blade and the needle blade while being sealed to the head of the Tbronn tube.

It is made of a multi-stage tapered protrusion to be installed to be sealed to the head of the Tbronn tube, the ball blade is integrally connected to one side of the tip.

The orifice tube 232 has a shape that becomes narrower from the inner inlet to the ball blade coupling portion to induce a narrowing of the receiving area of the pigment spraying agent, water, and physiological saline to be controlled and injected at high pressure, medium pressure, and low pressure. Play a role.

It is formed in the shape of the left light right narrower from the inner inlet to the ball blade coupling portion, the liquid inlet hole is formed through the inner inlet, the needle blade driving wire is formed in the transverse direction of the center axis, Ball blade is formed integrally coupled to the end of the piece pipe.

Control spraying of the pigment spray agent, water, physiological saline to high pressure, medium pressure, low pressure through the orifice tube as shown in Figures 4 to 5, 6, high pressure injection mode (232a), medium pressure injection mode (232b) It means that the controlled injection through the process of the low pressure injection mode (232c).

As shown in FIG. 4, the high-pressure spraying mode 232a is in close contact with the needle blade 320 of the ball blade 310 to the injection port side 311, and the dye spray agent, water, and physiology contained in the orifice tube 232. It is a mode to induce the waterway area (A1) of the saline solution to be narrowed to the waterway area (A2) by 80 to 90% as it goes toward the ball blade injection port side (311), and to spray at a high pressure of 15 bar to 20 bar. This mode is used to apply water and saline solution.

The needle blade is protruded outwardly through the injection hole of the ball blade when the force in the forward direction enters the needle blade driving wire through the slide handle along the guide rail groove.

At this time, when water is supplied to the drug injector with a syringe or a water pump, the water channel area A1 of the pigment dispersant, water, and saline contained in the orifice tube 232 increases from 80 to 80 toward the ballblade jetting port side 311. High pressure water is injected between the needle blade and the ball blade projecting to the outside by narrowing the channel area A2 by 90%.

In the medium pressure injection mode 232b, as shown in FIG. 5, the needle blade 320 and the ball blade (by placing the rear end portion of the needle blade in the same line in the boundary portion 232-1 of the orifice tube and the ball blade) In the state in which the spacing space is formed between the injection holes 311 of 310, the channel areas A1 of the pigment spray agent, water, and saline contained in the orifice tube are the needle blade 320 and the ball blade 310. Induced to be narrowed to 50 ~ 79% of the channel area (A3) toward the separation space of the injection hole 311 of the injection mode at a medium pressure of 8bar ~ 14bar, which is used when injecting water and physiological saline to the lesion site Mode.

This is because when the force in the backward direction enters the needle blade driving wire through the slide handle along the guide rail groove, the needle blade is positioned in line with the boundary between the orifice tube and the ball blade.

At this time, when the water is supplied to the drug dye inlet by a syringe or a water pump, the waterway area A1 of the dye dispersant, water, and saline contained in the orifice tube 232 is the needle blade 320 and the ball blade 310. The narrower the waterway area (A3) by 50-79% toward the separation space of the injection hole 311 of the through the needle blade is injected from the injection port of the ball blade of 8bar ~ 14bar medium pressure.

In the low pressure injection mode 232c, as shown in FIG. 6, the head portion of the needle blade is positioned in the same line as the boundary portion 232-1 of the orifice tube and the ball blade, so that the ball blade internal space 310a is formed. Induced to form, the channel area (A1) of the pigment spray agent, water, and saline solution contained in the orifice tube is narrowed to 20 to 49% toward the inner space of the ballblade, so that the pressure is reduced to 2 bar to 7 bar. This is a mode for spraying, and is used for washing the lesion area with water or physiological saline.

When the force in the backward direction enters the needle blade driving wire through the slide handle along the guide rail groove, the head portion of the needle blade is positioned in line with the boundary between the orifice tube and the ball blade.

At this time, if water is supplied to the drug inlet by using a syringe or a water pump, the waterway area of the pigment spray agent, water, and saline solution contained in the orifice tube is 20 to 49% as it goes to the space of the injection hole of the needle blade and the ball blade. After narrowing, low pressure water is injected from the ballblading nozzle through the inner space of the needle blade.

Next, the multi-surgery module 300 according to the present invention will be described.

The multi-surgery module 300 is located at the front end of the tube module in the endoscopic submucosal layer treatment site pigmentation mode, lesion marking mode, injection mode, gynecology, hemostasis, washing mode, peeling mode of the control module It serves to operate as a single device under control, which is composed of a ball blade 310, a needle blade 320.

The ball blade 310 is composed of a ball-shaped blade, is integrally connected to the tip of the multi-stage support projection, and under the control of the control module, the pigment spray mode, ecchymosis, hemostasis alone during the endoscopic submucosa procedure It plays a role of driving the cleaning mode and the peeling mode.

As shown in Figure, the front end is made of a ball shape, the rear end is made of a pipe shape, it is connected integrally with the front end of the multi-stage support projection.

Then, the needle blade is configured to be built in and out.

The needle blade 320 protrudes outward from the ball blade by receiving the force in the forward direction from the needle blade driving wire, and receives the force in the backward direction from the needle blade driving wire to be embedded in the ball blade to endoscope under the control of the control module. It acts to drive the lesion marking mode, injection mode, ecsiography, hemostasis, washing mode, and exfoliation mode during the submucosal layer.

It is made of a needle (= thin blade) shape 320, the front end is moved back and forth at the ball blade injection opening is connected to the control module.

Here, when the water passing through the orifice tube of the multi-stage support is embedded in the ball blade, the pressure is lowered so that water is injected through the surface of the needle blade, and the water is injected through the ball blade injection hole. When the needle blade protrudes outward, the needle blade narrows the injection hole of the ball blade so as to increase the pressure so as to be injected at a high pressure.

In addition, the needle blade according to the present invention is durable, hard to wear, rust-free, light material, with a purity of 99.00% or more, specific gravity (20) 2.6986, melting point (℃) 660.2, specific heat (100) ( cal / g) 0.226, latent heat (cal / g) 96.4, electrical conductivity (%) 69.94, electrical resistance temperature coefficient of 0.00429, or made of aluminum ingots with a purity of 99% or more from 670 ~ after dissolving the aluminum in a temperature range of 690, and then to a thickener powder of Ca added in a 1.0 ~ 2.0wt% with respect to the dissolved aluminum was stirred for 5 ~ 10 minutes at 600rpm, MgH _2, 0.5 ~ 2.5wt the TiH ₂ blowing agent It is made of foamed aluminum material which is foamed by adding 2% by stirring at 1,000rpm for 2-3 minutes.

Hereinafter, a detailed operation process of an endoscopic submucosal multi-layer surgical instrument for operating a plurality of modes according to the present invention through a multi-operative module will be described.

[Color Spray Mode]

As shown in FIG. 7, the present invention relates to a mode in which a pigment is sprayed to distinguish a suspected site from a suspected area such as a cancer mass by spraying a pigment on the surgical site before the subendoscopic submucosal layer procedure.

First, pull the slide handle of the control module in the reverse direction so that the needle blade is built into the ball blade.

Subsequently, the colorant is introduced into the liquid inlet through a syringe or a liquid supply pump.

Subsequently, the pigment dispersant is delivered through the Tevron tube of the tube module and flows into the multi-stage supporting protrusion of the orifice principle.

Subsequently, the needle blade is embedded in the ball blade, and in the state where the ball blade injection port is opened, the dye is injected through the injection hole of the ball blade along the surface circumference of the needle blade.

[Lesion marking mode]

This relates to the mode of marking around the lesion, as shown in FIG. 10.

First, the slide handle of the control module is pushed in the forward direction to protrude the needle blade out of the ball blade. Then, while the handle is pushed in the forward direction, electricity is supplied to the needle blade through the electric conduction unit.

Subsequently, lightly touches the tissues around the lesions through the needle blades in which electricity flows to learn and mark the tissues as dots.

[Injection Mode]

This relates to a mode of inflating the lesion tissue, as shown in FIG.

First, by pushing the slide handle of the control module in the forward direction, the needle blade protrudes out of the ball blade.

Subsequently, while the slide handle of the control module is pushed in the forward direction, physiological saline is supplied to the liquid inlet through a syringe or a liquid pump.

Subsequently, the physiological saline is delivered through the Tevron tube of the tube module, and is introduced into the multi-stage supporting protrusion of the orifice principle.

Subsequently, the needle blade protrudes out of the ball blade, and the physiological saline flows in the state in which the injection hole of the ball blade is narrowed by the needle blade. Unlocked

[Inc. Hemostasis, Cleaning Mode through Ball Blade]

As shown in FIG. 8, the present invention relates to a mode in which the lesion area of the endoscopic submucosal procedure site is moved (= ablation), bleeded, and washed through the ball blade blade.

First, push the slide handle of the control module in the reverse direction, so that the needle blade is built into the ball blade.

Subsequently, while the slide handle of the control module is pushed in the reverse direction, electricity is supplied to the needle blade through the electric conduction unit.

At this time, electricity flows through the ball blade through the needle blade.

Subsequently, hemostasis is simultaneously performed while excision of the tissue around the lesion through the flowing ballsblade blade.

Subsequently, while the slide handle of the control module is pushed in the reverse direction, water is supplied to the liquid inlet through the syringe.

Subsequently, water is introduced through the Tevron tube of the tube module, and then the needle blade is in the state of being embedded inside the ball blade, and the physiological saline is introduced while the nozzle of the ball blade is open, and the ball blade flows to the lesion. To eliminate blood, supply saline at low pressure.

Subsequently, the dissected and hemostatic lesion tissue is sprayed with water to clean.

[Incence, Hemostasis, and Cleaning Mode through Needle Blades]

As shown in FIG. 12, the present invention relates to a mode of incising (= ablation), bleeding, and rinsing a lesion site of a subendoscopic submucosal procedure site through a needle blade.

Subsequently, while the slide handle of the control module is pushed in the forward direction, electricity is supplied to the needle blade through the electric conduction unit.

Subsequently, hemostasis is simultaneously performed while excision of the tissue around the lesion through the flowing needleblade.

Subsequently, while the slide handle of the control module is pushed in the forward direction, water is supplied to the liquid inlet through the syringe.

Subsequently, water is introduced through the Tevron tube of the tube module, and then the needle blade is protruded out of the ball blade, and the physiological saline is introduced while the nozzle of the ball blade is open, and the lesion is introduced into the lesion through the ball blade. To get rid of the flowing blood, saline is supplied at low pressure.

[Release Mode]

This relates to a mode of peeling the lesion site through the multi-surgery module. As shown in FIG. 9, a peeling mode through a ball blade and a peeling mode through a needle blade as shown in FIG. 13. Divided.

[One. Peeling Mode through Ball Blade]

Subsequently, in the state in which the slide handle of the control module is pulled in the backward direction, the lesion portion is peeled off only through the ball blade. This mode has a large contact area to peel off and is suitable for peeling further containing hemostatic properties.

[2. Peeling Mode through Needle Blade]

First, the slide handle of the control module is pushed in the forward direction so that the needle blade protrudes out of the ball blade.

Subsequently, in the state in which the slide handle of the control module is pushed in the forward direction, the lesion part is separated only through the needle blade. This mode is suitable for fine and precise procedures.

Claims

The control module 100 for controlling the operation of the pigment spray mode, the lesion marking mode, the injection mode, the ecstasis, hemostasis and washing mode, and the exfoliation mode, which are necessary for the endoscopic submucosal procedure,

The tube module 200 is connected to the handle module and inserted into the working channel provided in the endoscope, and supplies electricity and water to the multi-procedure module formed at the front end.

One device under the control of the control module 100 to be located at the forward end of the tube module to the pigmented spray mode, lesion marking mode, injection mode, phosphate, hemostasis, washing mode, peeling mode toward the endoscopic submucosal layer Endoscopic submucosal multi-layer surgical instrument for operating a plurality of modes, characterized in that it consists of a multi-surgery module 300 to operate as a device through a multi-surgery module.
The method of claim 1, wherein the control module 100

Handle body 110 made of a straight slice handle shape,

The handle head portion 120, which is located at the front end of the handle body and connected to the teflon tube of the tube module, is fixed to the step and supports the needle blade driving wire formed inside the tube to the slide handle, and one side of the surface around the handle head portion. Protruding obliquely to the drug and pigment inlet 130 to supply any one selected from the pigment spray, water, physiological saline to the tube module,

A first stopper 140 positioned at the front end of the handle head to control the movement of the slide handle slid in all directions;

Located at the rear end of the first stopper, the needle blade driving wire is connected to one side of the tip and slides back and forth through the guide rail groove to transmit the force in the forward direction to protrude the needle blade out of the ball blade or the needle blade is a ball blade. Slide handle 150 for transmitting the force in the reverse direction to be embedded therein,

A second stopper 160 positioned at a rear end of the slide handle to control movement of the slide handle slid backward;

Located in the rear end of the second stopper, a plurality of modes of operation as a device through a multi-surgery module, characterized in that it consists of a finger support portion 170 to support two fingers inserted into the slide handle by placing the fingers of the operator A surgical instrument for endoscopic submucosal layer.
The method of claim 1, wherein the tube module 200

A teflon tube 210 inserted into a working channel provided in the endoscope, accommodating a needle blade driving wire therein, and a multi-stage supporter being milled at one end thereof to support the needle blade and the ball blade;

It is connected to the needle blade at the inner end of the Teflon tube, and the rear end is connected to the electric conduction part of the slide handle to receive the forward and backward forces of the slide handle to the needle blade, and transfer electricity from the electric conduction part. Needle blade driving wire 220 to receive and deliver to the needle blade,

Located in one side of the Teflon tube tip, while supporting the ball blade and the needle blade, multi-stage multi-surgery module characterized in that it comprises a multi-stage support 230 for high-pressure spraying the introduced water into the orifice tube Endoscopic submucosal multi-function instrument to operate as a single device.
The method of claim 1, wherein the multi-stage support 230

A multi-stage support protrusion 231 which is installed while being sealed to the head of the Tbronn tube and supports the ball blade and the needle blade;

Consists of an orifice tube 232 that controls the injection of high pressure, medium pressure and low pressure by narrowing the receiving area of the pigment spraying agent, water and physiological saline, which is formed in a shape that becomes narrower from the inner inlet to the ball blade coupling part. Endoscopic submucosal multi-layer surgical instrument for operating a plurality of modes characterized in that the multi-operation module as a device.
The method of claim 4, wherein the multi-stage support protrusion 241 is

The needle blade 320 is brought into close contact with the injection hole side 311 of the ball blade 310 so that the channel area A1 of the pigment spray agent, water, and physiological saline contained in the orifice tube 232 is the ball blade injection hole side 311. High pressure injection mode (232a) to induce to narrow the channel area (A2) by 80 to 90% toward the high pressure of 15bar ~ 20bar,

The rear end of the needle blade is positioned in the same line at the boundary portion 232-1 of the orifice tube and the ball blade, leading to the formation of a space between the needle blade 320 and the injection hole 311 of the ball blade 310. In the state, the channel area A1 of the pigment spraying agent, water, and physiological saline contained in the orifice tube is 50 to 79% as far as the space between the injection holes 311 of the needle blade 320 and the ball blade 310. Medium pressure injection mode (232b) to induce to narrow the channel area (A3) to inject at a medium pressure of 8bar ~ 14bar,

Pigment spray agent and water contained in the orifice tube in a state where the head portion of the needle blade is placed in the same line in the boundary portion 232-1 of the orifice tube and the ball blade to induce the ballblade inner space 310a to be formed. , A plurality of physiological saline channel area (A1), a plurality of low pressure injection mode (232c) to induce to be narrowed to 20 ~ 49% as the inner space inside the ball blade to spray at a low pressure of 2bar ~ 7bar Endoscopic submucosal multi-layer surgical instrument that operates two modes as one device through a multi-surgery module.
According to claim 1, the multi-surgery module 300

It consists of a ball-shaped blade and is integrally connected to the tip of the multi-stage supporting protrusion, and under the control of the control module, the pigment dispensing mode, ecsiography, hemostasis, washing mode, and peeling mode can be performed at the time of endoscopic submucosal treatment. Ball blade 310 to drive,

Receives forward force from the needle blade driving wire and protrudes to the outside of the ball blade, and receives force in the backward direction from the needle blade driving wire and embeds it into the ball blade to control the lesion during endoscopic submucosal treatment under the control module. Endoscopic hardening mucosa to operate a plurality of modes of operation as a single device through a multi-surgery module, characterized in that it consists of a needle blade 320 for driving the marking mode, the injection mode, jeonjeon, hemostatic, washing mode, peeling mode Floor multi treatment equipment.