WO2016079788A1 - 内視鏡用エネルギ処置具及び内視鏡システム - Google Patents
内視鏡用エネルギ処置具及び内視鏡システム Download PDFInfo
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- WO2016079788A1 WO2016079788A1 PCT/JP2014/080357 JP2014080357W WO2016079788A1 WO 2016079788 A1 WO2016079788 A1 WO 2016079788A1 JP 2014080357 W JP2014080357 W JP 2014080357W WO 2016079788 A1 WO2016079788 A1 WO 2016079788A1
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- treatment instrument
- treatment
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- endoscope
- power
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B18/1482—Probes or electrodes therefor having a long rigid shaft for accessing the inner body transcutaneously in minimal invasive surgery, e.g. laparoscopy
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3476—Powered trocars, e.g. electrosurgical cutting, lasers, powered knives
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B18/1492—Probes or electrodes therefor having a flexible, catheter-like structure, e.g. for heart ablation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/70—Cleaning devices specially adapted for surgical instruments
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/012—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor
- A61B1/018—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor for receiving instruments
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B18/1442—Probes having pivoting end effectors, e.g. forceps
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
- A61B2018/00601—Cutting
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00964—Features of probes
- A61B2018/0097—Cleaning probe surfaces
- A61B2018/00976—Cleaning probe surfaces with scraping means
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/70—Cleaning devices specially adapted for surgical instruments
- A61B2090/701—Cleaning devices specially adapted for surgical instruments for flexible tubular instruments, e.g. endoscopes
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B2576/00—Medical imaging apparatus involving image processing or analysis
Definitions
- the present invention relates to an endoscope energy treatment tool and an endoscope system, and more particularly to an endoscope energy treatment tool that wirelessly supplies power to an energy treatment tool.
- Patent Document 1 discloses a high-frequency incision forceps that applies a high-frequency current to a living tissue as an energy treatment tool that is inserted into a body through a treatment instrument channel of a flexible endoscope.
- a cable that is electrically connected to a high-frequency power source is connected to a connection terminal provided in an operation unit.
- a counter electrode plate is installed on the body surface so as to face the high-frequency incision tool.
- the power supply device and the energy treatment tool are connected to each other through a cable.
- the energy treatment tool and the power supply device are connected by wire, the operation of the energy treatment tool becomes complicated due to the presence of the cable.
- Patent Literature 2 and Patent Literature 3 disclose devices that wirelessly supply power to an energy treatment device.
- Patent Document 2 and Patent Document 3 disclose an apparatus that wirelessly supplies electric power from a power transmission electrode provided in a trocar to a power reception electrode of a capacitive cordless surgical instrument inserted in the trocar through capacitive coupling. Yes.
- the treatment tool is frequently inserted into and removed from the treatment tool channel according to the content of the treatment.
- a treatment instrument such as a high-frequency incision forceps disclosed in Patent Literature 1 is inserted into the endoscope insertion portion so as to be able to advance and retreat.
- the treatment instrument channel of the flexible endoscope is as thin as several millimeters in diameter, and the treatment instrument channel and the treatment instrument are flexible and curved. Therefore, when the treatment tool is inserted and removed, tissue in the body attached to the distal end of the treatment tool at the time of treatment, body fluid such as blood, tissue sample to be grasped and collected from the body, and the like adhere to the inner surface of the treatment tool channel.
- body fluid such as blood, tissue sample to be grasped and collected from the body, and the like adhere to the inner surface of the treatment tool channel.
- the dielectric constant between the power transmission electrode and the power reception electrode that are capacitively coupled changes.
- the capacitance of the capacitor formed by the power transmission electrode and the power reception electrode changes with a change in the dielectric constant between the power transmission electrode and the power reception electrode. Therefore, the change in the dielectric constant may cause a decrease in the transmission efficiency of power to the treatment tool, a fluctuation in the design value of the transmission power, and the like, which is an obstacle to stable power supply.
- the present invention has been made in view of the above circumstances, and in an energy treatment tool of a wireless power feeding method, an energy treatment tool for an endoscope and an endoscope that can stably supply power to the treatment tool.
- the purpose is to provide a system.
- An energy treatment instrument for an endoscope is a flexible treatment instrument having a power reception unit that capacitively couples by facing a power transmission electrode disposed in a treatment instrument channel included in the endoscope.
- a cleaning section that is disposed so as to be in contact with the treatment instrument channel and that cleans the inside of the treatment instrument channel as the treatment instrument insertion section moves.
- An endoscope system is disposed along an energy treatment instrument for an endoscope according to the present invention, a treatment instrument channel having flexibility, and an outer peripheral surface of the treatment instrument channel. And an endoscope having a power transmission unit that generates an alternating electric field to be applied to the treatment instrument channel.
- the endoscope energy treatment tool and the endoscope system of the present invention it is possible to stably supply wireless power to the treatment tool via the endoscope apparatus.
- FIG. 1 is a diagram showing an overall configuration of an endoscope energy treatment device according to a first embodiment of the present invention.
- FIG. It is sectional drawing which shows the state by which the energy treatment tool for endoscopes which concerns on 1st embodiment of this invention was inserted in the endoscope insertion part. It is an equivalent circuit diagram of the endoscope system according to the first embodiment of the present invention.
- FIG. 1 is a diagram showing an overall configuration of an endoscope system 100 including an endoscope energy treatment tool 10 (hereinafter referred to as “energy treatment tool”) according to the present embodiment.
- energy treatment tool an endoscope energy treatment tool 10
- the endoscope system 100 includes a flexible endoscope device (hereinafter referred to as “endoscope device”) 30, an energy treatment instrument 10, and a counter electrode plate 50.
- the endoscope system 100 is configured to make physical contact with a conductor (via a capacitive coupling between a power transmission unit (described later) provided in the endoscope apparatus 30 and a power reception unit (described later) provided in the energy treatment instrument 10. Power is supplied to the energy treatment device 10 wirelessly without connection).
- the endoscope apparatus 30 includes an endoscope operation unit 31, an endoscope insertion unit 32, a power transmission unit 34, a control unit 35, a power supply unit 36, a foot switch 37, and a monitor 38.
- the side on which the endoscope operation unit 31 is provided (the operator's hand side) is referred to as the proximal end side, and the side on which the endoscope insertion unit 32 is provided. Will be referred to as the tip side.
- the endoscope operation unit 31 includes various switches and knobs for the operator to operate the endoscope, the operation of the endoscope insertion unit 32, and the like.
- the endoscope insertion portion 32 has a long shape with flexibility, and a proximal end portion is connected to the endoscope operation portion 31.
- a known endoscope observation device, an illumination device, and the like that acquire an in-vivo image are provided.
- the endoscope insertion portion 32 is provided with a treatment instrument channel 33 that is made of a resin tube or the like and has flexibility, into which the energy treatment instrument 10 and other known treatment instruments can be inserted.
- the treatment instrument channel 33 is formed along the endoscope insertion portion 32, one opening at the distal end surface of the endoscope insertion portion 32 (tip opening 331), and the other being the side portion 311 of the endoscope operation portion 31. Is open.
- FIG. 2 is a cross-sectional view showing the treatment instrument channel 33 portion of the endoscope insertion portion 32.
- the power transmission unit 34 is provided along the treatment instrument channel 33 in the endoscope insertion unit 32.
- the power transmission unit 34 includes a power transmission electrode 341 that generates an AC electric field according to the high-frequency power supplied from the power source unit 36, and an inductor (described later) connected in series to the power transmission electrode 341.
- the power transmission electrode 341 is, for example, a cylindrical electrode member having a length of about 15 cm provided to cover the treatment instrument channel 33 in the circumferential direction.
- the power transmission electrode 341 is provided in at least a part of a section from the opening of the side 311 of the endoscope operation unit 31 of the treatment instrument channel to the opening (tip opening 331) of the distal end surface of the endoscope insertion unit 32. .
- a conductor such as copper can be used.
- the treatment tool channel 33 which is a flexible tube, for example.
- a flexible power transmission electrode 341 can be manufactured by forming a metal film such as copper on the outer peripheral surface of the metal film by vapor deposition or plating.
- the power transmission electrode 341 is covered with an insulating resin and is not exposed on the inner peripheral surface 332 of the treatment instrument channel 33, and between the power transmission electrode 341 and the inner peripheral surface 332 of the treatment instrument channel 33, Insulating materials such as resins are present.
- the control unit 35 is connected to an endoscope operation unit 31.
- the control unit 35 transmits a signal for controlling the operation of each unit of the endoscope apparatus 30 to control the entire endoscope apparatus 30.
- the power supply unit 36 is connected to the control unit 35.
- power necessary for driving the endoscope device 30 and the like and power necessary for driving the energy treatment instrument 10 are supplied from the power supply unit 36 via the control unit 35.
- the foot switch 37 is connected to the power supply unit 36 and is provided for performing ON / OFF operation of energy output such as high-frequency power in the power supply unit 36. When the operator steps on the foot switch 37, the energy treatment instrument 10 is energized.
- the monitor 38 displays an image acquired by an endoscope observation device (not shown) provided at the distal end of the endoscope insertion portion 32.
- FIG. 3 is a diagram showing the overall configuration of the energy treatment device 10.
- the energy treatment tool 10 is used to treat a living tissue (treatment target site P1) of a patient P as shown in FIG.
- the energy treatment instrument 10 includes a treatment instrument insertion unit 11, a treatment unit 12, a treatment instrument operation unit 13, a power reception unit 14, and a cleaning unit 15.
- the treatment instrument insertion portion 11 is flexible enough to be inserted into the treatment instrument channel 33 and is formed in a long shape.
- the treatment portion 12 is provided at the distal end portion of the treatment instrument insertion portion 11.
- the treatment unit 12 for example, a known configuration that performs treatment on a living tissue (treatment target site P1) using electric power energy such as a high-frequency knife, forceps, and needle can be appropriately selected and employed.
- the treatment part 12 is a high frequency knife.
- the treatment instrument operation unit 13 is connected to the proximal end portion of the treatment instrument insertion unit 11. By operating the treatment instrument operation section 13, the treatment instrument insertion section 11 and the treatment section 12 can be advanced and retracted with respect to the treatment instrument channel 33.
- the power receiving unit 14 is provided in the treatment instrument insertion unit 11, has a power receiving electrode 141, and is connected to the treatment unit 12 by wiring (not shown).
- the power receiving electrode 141 is a cylindrical electrode provided along the outer peripheral surface of the treatment instrument insertion portion 11, and is formed using a conductor such as copper, for example.
- the power receiving electrode 141 can be produced, for example, by forming a metal film on the outer peripheral surface of the treatment instrument insertion portion 11 similarly to the power transmitting electrode 341.
- the power receiving electrode 141 formed of a metal film has flexibility.
- the outer surface of the power receiving electrode 141 is covered with an insulating material such as a resin in order to ensure electrical insulation.
- FIG. 4 is a cross-sectional view showing a state where the energy treatment instrument 10 is inserted through the endoscope insertion portion 32.
- the power receiving electrode 141 and the treatment instrument channel 33 are connected.
- the provided power transmission electrode 341 is substantially opposed.
- the power receiving electrode 141 may be at a position where at least a part of the power receiving electrode 341 can face the treatment electrode 12 when the treatment portion 12 protrudes from the distal end opening 331 of the treatment instrument channel 33. Therefore, the power receiving electrode 141 may be provided at least at a part in the length direction of the treatment instrument insertion portion 11.
- the power transmission electrode 341 It is preferable that the power transmission electrode and the power reception electrode are configured so that the entire range in the longitudinal direction thereof always faces the power reception electrode 141. Therefore, the length of the power receiving electrode 141 in the axial direction is preferably longer by several centimeters than the length of the power transmitting electrode 341 in the axial direction.
- the cleaning unit 15 is provided on the outer periphery of the treatment instrument insertion unit 11.
- the cleaning unit 15 is provided on the tip side of the power receiving unit 14.
- the cleaning unit 15 is provided so as to protrude outward in the radial direction of the treatment instrument insertion portion 11 over the circumferential direction of the treatment instrument insertion portion 11.
- the protruding length of the cleaning unit 15 from the outer peripheral surface of the treatment instrument insertion unit 11 is such that when the cleaning unit 15 is disposed at a position facing the power transmission unit 34 by the advance / retreat operation of the treatment instrument insertion unit 11, At least the outer peripheral edge is set so as to come into contact with the inner peripheral surface 332 of the treatment instrument channel 33.
- the cleaning unit 15 is formed of an elastic member having an outer diameter equal to or larger than the inner diameter of the treatment instrument channel 33 and capable of being deformed into a shape along at least the inner diameter of the treatment instrument channel 33.
- the cleaning unit 15 may be formed integrally with the outer peripheral portion of the treatment instrument insertion portion 11 or may be formed by attaching another member to the outer periphery of the treatment instrument insertion portion 11.
- the cleaning unit 15 of the present embodiment is integrated with the outer peripheral portion of the treatment instrument insertion portion 11 by processing a part of resin such as polytetrafluoroethylene (PTFE) forming the treatment instrument insertion portion 11 into a convex shape. Is formed.
- PTFE polytetrafluoroethylene
- another member is attached to the outer periphery of the treatment instrument insertion portion 11 to form a cleaning portion, for example, another ring-shaped member made of a flexible material such as soft rubber or urethane sponge is used as the outer periphery of the treatment instrument insertion portion 11. It may be attached to the surface with an adhesive or the like.
- the counter electrode plate 50 is connected to the power supply unit 36 and is disposed so as to be attached to the body surface of the patient P or placed on the bed so as to contact the body surface of the patient P. Is done. That is, the energy treatment device 10 of the present embodiment is a monopolar type (monopolar type) that conducts treatment by energizing with the counter electrode 50 via the patient P when the treatment unit 12 contacts the treatment target site P1 of the patient P. ) Treatment tool.
- monopolar type monopolar type
- the operator inserts the energy treatment instrument 10 from the opening of the side part 311 of the endoscope operation part 31.
- the operator advances the treatment instrument insertion portion 11 relative to the treatment instrument channel 33 until the treatment section 12 protrudes from the distal end opening 331 of the treatment instrument channel 33.
- the cleaning unit 15 first approaches the power transmission unit 34 provided in the treatment instrument channel 33.
- the cleaning section 15 slides through the region of the inner peripheral surface 332 of the treatment instrument channel 33 where the power transmission electrode 341 is disposed.
- the cleaning unit 15 ensures that no foreign matter exists between the power reception unit 14 and the power transmission unit 34.
- FIG. 5 is an equivalent circuit diagram of the endoscope system 100 in a state where the power reception unit 14 and the power transmission unit 34 face each other.
- the power transmission electrode 341 and the power reception electrode 141 are disposed to face each other, so that the capacitor C1 is formed by capacitive coupling between these two electrodes.
- the power transmission unit 34 includes a power transmission electrode 341 and an inductor 342 connected in series with the power transmission electrode 341.
- the inductor 342 configures a capacitor C1 and an LC resonance circuit.
- the frequency of the high frequency power supplied from the power supply unit 36 can be set from about 100 kHz to about 100 MHz.
- the frequency of the high-frequency power is preferably selected from frequencies permitted for use by laws and regulations, for example, 13.56 MHz.
- the resonance frequency of the LC resonance circuit composed of the capacitor C1 and the inductor 342 of the power transmission unit 34 is configured to match the frequency of the high frequency power supplied from the power supply unit 36, so that the power transmission unit can efficiently receive power. Can be powered.
- an impedance matching circuit is provided in the endoscope apparatus 30 or the power supply unit 36 to perform matching between the output impedance of the power supply unit and the input impedance of the circuit shown in FIG. 5, and power from the power supply unit to the circuit shown in FIG. The input efficiency may be increased.
- the energy treatment device 10 is replaced so as to sequentially use the optimum treatment device according to the content of the treatment.
- bodily fluids or tissues attached to the treatment section 12 or the treatment instrument insertion section 11 may adhere to the inner surface of the treatment instrument channel 33 as foreign substances.
- the attached state of the foreign substance adheres to the range where the power transmission unit 34 is provided on the inner peripheral surface 332 of the treatment instrument channel 33, the attached state of the foreign substance (attached area, attached amount, and attached substance type).
- the capacitance of the capacitor C1 formed when the power transmitting unit 34 and the power receiving unit 14 face each other varies.
- a newly inserted energy treatment tool (hereinafter referred to as “exchange energy treatment tool”) is also provided with a cleaning unit. Therefore, when the replacement energy treatment device is inserted into the treatment device channel 33, the cleaning unit 15 provided in the replacement energy treatment device 10A is provided by the power transmission unit 34 as shown in FIG. The foreign matter X is pushed out and removed from the inner peripheral surface 332 in the specified range. Thereafter, the power reception unit 14 and the power transmission unit 34 of the exchange energy treatment instrument 10A face each other to establish the capacitor C1.
- the endoscope system 100 even when the foreign substance X adheres to the inner peripheral surface 332 of the treatment instrument channel 33 when the energy treatment instrument 10 that has been used is removed, the attached foreign substance X is subsequently inserted.
- the cleaning unit 15 of the exchange energy treatment tool 10A is removed from the range where at least the power transmission unit 34 is provided. Therefore, even when the energy treatment tool is frequently replaced during the treatment, a state in which no foreign matter is always present is ensured between the power transmission unit 34 and the power reception unit 14, and the power transmission unit 34 and the power transmission unit 34 viewed from the power source unit 36.
- the fluctuation of the impedance of the circuit including the power reception unit 14 can be suppressed, the fluctuation of the transmission power to the energy treatment tool 10 due to the impedance fluctuation can be suppressed, and the endoscope apparatus 30 can transfer to the energy treatment tool 10. Stable wireless power feeding is possible.
- the cleaning unit 15 As described above, according to the endoscope system 100 of the present embodiment provided with the energy treatment device 10, by providing the cleaning unit 15, it is possible to always perform stable wireless power feeding. Moreover, since it is not necessary to connect electric wirings, such as a cable, for the electric power supply to the energy treatment tool 10, the operativity of an energy treatment tool improves. Further, since the cleaning unit 15 is disposed on the distal end side with respect to the power receiving unit 14, when the energy treatment device 10 is inserted into the treatment device channel 33, the cleaning unit 15 must be placed before the power receiving unit 14 faces the power transmission unit 34. Slides in contact with the inner peripheral surface 332 of the treatment instrument channel 33 in the vicinity of the power transmission section 34.
- the cleaning unit 15 is not limited to the configuration provided over the entire circumference of the outer peripheral surface of the treatment instrument insertion unit 11.
- FIG. 8 to FIG. 11 show modifications of the energy treatment device having different cleaning unit configurations.
- FIGS. 8 to 11 are views showing modifications of the cleaning unit of the first embodiment, and are cross-sectional views orthogonal to the axis of the treatment instrument insertion unit 11.
- a brush-type cleaning unit 15 ⁇ / b> B is provided in which a plurality of elongated resin protrusions 151 projecting radially outward from the outer peripheral surface of the treatment instrument insertion unit 11 are arranged in the circumferential direction of the treatment instrument insertion unit 11. .
- the cleaning part such as a thin plate-like valve body extending in the circumferential direction and radially outward of the treatment instrument insertion part 11 is brought into contact with and slides on the inner peripheral surface 332 of the treatment instrument channel 33. Any possible configuration can be used without particular limitation.
- a belt-like convex portion constituting the cleaning portion 15 ⁇ / b> C is provided so as to be spirally wound around the outer peripheral surface of the treatment instrument insertion portion 11.
- three ring-shaped cleaning portions 15 ⁇ / b> D are provided side by side with a gap in the major axis direction of the treatment instrument insertion portion 11.
- the cleaning unit 15E of the modified example shown in FIG. 11 has a plurality of convex portions that are spaced in the circumferential direction of the treatment instrument inserting unit 11, and this is similar to the modified example shown in FIG. Three rows are provided at intervals in the long axis direction.
- the cleaning unit may be configured by appropriately combining the configurations of the above-described modified examples.
- the configuration in which the power transmission electrode 341 and the power reception electrode 141 are covered with an insulating resin is exemplified.
- capacitive coupling is possible if the insulation between the power transmission electrode 341 and the power reception electrode 141 is maintained when the power transmission electrode 341 and the power reception electrode 141 are opposed to each other. Therefore, at least one surface of the power transmission electrode and the power reception electrode may be covered with an insulating material.
- the inductor 342 is arranged in the power transmission unit 34, but the arrangement location is not limited to this.
- the inductor 342 is arranged so as to be connected to the power reception electrode 141 of the power reception unit 14, and the capacitor C1.
- An LC resonance circuit including may be formed. Further, even when the inductor 342 does not exist, that is, when the LC resonance circuit including the capacitor C1 is not formed, substantially the same effect as the above-described example can be exhibited.
- FIG. 12 is a view showing a part of the energy treatment device 210 according to the present embodiment in a partial cross section.
- FIG. 13 is a schematic diagram showing how the energy treatment device 210 is used.
- the energy treatment device 210 according to the present embodiment is different from the first embodiment in the configuration of the cleaning unit 215. That is, as shown in FIG. 12, the cleaning unit 215 is provided on the entire outer peripheral surface of the treatment instrument insertion unit 11 and the surface on which the power receiving electrode 141 is provided, and covers the entire power receiving electrode 141. Yes.
- the cleaning unit 215 is configured by mounting a cylindrical member made of a soft resin having an area substantially equal to that of the power receiving electrode 141 on the treatment instrument insertion unit 11 so as to cover the power receiving electrode 141.
- the cleaning unit 215 is provided so as to cover the surface of the power receiving electrode 141, when the power receiving electrode 141 is arranged at a position facing the power transmitting electrode 341 as shown in FIG.
- the cleaning unit 215 exists between the power transmission electrode 341 and no gap exists. As a result, it is possible to prevent foreign matter from adhering between the power receiving electrode 141 and the power transmitting electrode 341 after the foreign matter X is removed from the inner peripheral surface 332 of the treatment instrument channel 33.
- the cleaning unit is formed by thickening the resin covering the power receiving electrode 141 out of the resin constituting the treatment instrument insertion unit 11 so as to protrude radially outward. And may be formed integrally.
- the capacitance of the capacitor C1 formed by the power transmission electrode 341 and the power reception electrode 141 can be increased.
- the capacitance of the capacitor C1 increases, it becomes less susceptible to variations in parasitic capacitance that may occur in the wiring path including the treatment section 12 during treatment, and more stable power transmission becomes possible.
- the voltage generated in the capacitor C1 can be reduced, it is easier to ensure the insulation of the device.
- PTFE polytetrafluoroethylene
- FIG. 14 shows a cross-sectional view of a modification of the present embodiment.
- the power receiving electrode 141A has a spiral shape. That is, the power receiving electrode 141 ⁇ / b> A is formed by winding a thin flat and strip-shaped conductor in a spiral shape with a diameter substantially equal to the diameter of the outer periphery of the treatment instrument insertion portion 11.
- the cleaning unit 215A is provided by winding a thin flat plate-like insulating flexible resin similar to the power receiving electrode 141A in a spiral shape so as to cover the entire power receiving electrode 141A.
- the same effects as those of the second embodiment are achieved. Furthermore, when the power receiving electrode 141A and the cleaning unit 215A are spiral, as in this modification, the power receiving electrode 141A and the cleaning unit 215A can easily follow the curvature of the treatment instrument insertion unit 11. As a result, the treatment instrument insertion portion 11 and the endoscope insertion portion 32 into which the treatment instrument insertion portion 11 has been inserted are not hindered and can be suitably operated.
- the power receiving electrode 141A and the cleaning unit 215A as in this modification, even if there is a foreign object, the power receiving electrode in the gap in the cleaning unit 215A, that is, the inner peripheral surface 332 of the treatment instrument channel 33, 141A is taken in a portion where the power supply electrode 141A is not provided, and foreign matter can be prevented from adhering between the power reception electrode 141A and the power transmission electrode 341.
- the cleaning unit 215 of this embodiment does not necessarily need to cover the entire surface of the power receiving electrode 141A, and may have a shape that covers at least the outer periphery including the tip of the power receiving electrode 141A.
- FIG. 15 is a partial cross-sectional view showing the energy treatment device 310 according to the present embodiment.
- the cleaning unit 315 of the energy treatment instrument 310 includes the cleaning unit 15 of the first embodiment and the cleaning unit 215 of the second embodiment in the axial direction of the treatment instrument insertion unit 11.
- the cleaning parts 15 and 215 are arranged at the two positions on the outer peripheral part and the front end side of the power receiving electrode 141, so that the foreign matter X can be more reliably removed, and the wireless power feeding performance is further stabilized. Can be achieved.
- FIG. 16 is a partial cross-sectional view showing a state where the energy treatment device 410 is inserted into the treatment device channel 33.
- FIG. 17 is a diagram illustrating an overall configuration of the endoscope system 101 including the energy treatment tool 410. As shown in FIG. 17, the endoscope system 101 includes an endoscope apparatus 430 and an energy treatment tool 410.
- the energy treatment tool 410 is a bipolar (dipole type) treatment tool. As shown in FIG. 16, the energy treatment tool 410 includes forceps having a pair of forceps pieces 412 ⁇ / b> A and 412 ⁇ / b> B as the treatment portion 412.
- the endoscope apparatus 430 includes two power transmission electrodes, a first power transmission electrode 4341 and a second power transmission electrode 4342, in the power transmission unit 434.
- the power receiving unit 414 of the energy treatment device 410 includes two power receiving electrodes, a first power receiving electrode 4141 and a second power receiving electrode 4142.
- the first power receiving electrode 4141 and the first power transmission electrode 4341 substantially opposes
- the 2nd power receiving electrode 4142 and the 2nd power transmission electrode 4342 substantially oppose.
- FIG. 18 is an equivalent circuit diagram of the endoscope system 101 in a state where the power reception unit 414 and the power transmission unit 434 face each other.
- the first power receiving electrode 4141 is connected to one (first forceps piece 412A) of the forceps pieces of the treatment portion 412 by wiring.
- the second power receiving electrode 4142 is connected to the other of the treatment sections 412 (second forceps piece 412B).
- the first power transmission electrode 4341 and the first power reception electrode 4141 constitute a first capacitor C2
- the second power transmission electrode 4342 and the second power reception electrode 4142 constitute a second capacitor C3.
- the cleaning unit 15 of this embodiment is provided on the outer peripheral portion of the insertion portion of the energy treatment tool 410.
- the cleaning unit 15 is not limited to the shape and arrangement shown in FIG. 16, and the same configuration as that of each of the other embodiments described above can be applied.
- stable power feeding can be realized as in the above-described embodiments.
- the present invention can also be suitably applied to an endoscope system including a bipolar treatment instrument.
- the treatment instrument channel 33 may be formed so that the diameter of the channel of the portion 333 where the power transmission electrode 341 is disposed is reduced. If comprised in this way, the cleaning part 15 can be made to contact with the treatment tool channel 33 only in the part 333 in which the power transmission part 34 is arrange
- an endoscope energy treatment tool and an endoscope system capable of supplying power more stably and wirelessly to a treatment tool.
- Energy treatment tool for endoscope 10A Exchange energy treatment tool (energy treatment tool for endoscope) 11 treatment instrument insertion parts 30, 430 Endoscope device (endoscope) 33, 333 Treatment instrument channel 12, 412 Treatment unit 14, 414 Power receiving unit 15, 15B, 15C, 15D, 15E, 215, 315, 515 Cleaning unit 34, 434 Power transmission unit 341 Power transmission electrode
Abstract
Description
以下、本発明の第一実施形態について、図1から図5を参照して説明する。
図1は、本実施形態に係る内視鏡用エネルギ処置具10(以下、「エネルギ処置具」と称する。)を備える内視鏡システム100の全体構成を示す図である。
内視鏡挿入部32には、樹脂チューブなどで構成され可撓性を有し、エネルギ処置具10やその他の公知の処置具が挿入可能な処置具チャンネル33が設けられている。処置具チャンネル33は、内視鏡挿入部32に沿って形成され、一方が内視鏡挿入部32の先端面に開口し(先端開口331)、他方が内視鏡操作部31の側部311に開口している。
送電電極341は、処置具チャンネル33を周方向に覆うように設けられた例えば、長さ15cm程度の円筒状の電極部材である。送電電極341は、処置具チャンネルの内視鏡操作部31の側部311の開口から内視鏡挿入部32の先端面の開口(先端開口331)までの区間の少なくとも一部に設けられている。送電電極341の材料としては、例えば、銅などの導体を用いることができる。尚、送電電極341を、可撓性を有する内視鏡挿入部32に設ける場合は、送電電極も可撓性を有することが必要となるが、例えば、可撓性チューブである処置具チャンネル33の外周面に、蒸着法又はめっき法により、銅等の金属膜を成膜することで、可撓性を有する送電電極341を作製することができる。
送電電極341は絶縁性の樹脂で覆われており、処置具チャンネル33の内周面332には露出しておらず、送電電極341と処置具チャンネル33の内周面332との間には、樹脂等の絶縁性材料が存在している。
電源部36は、制御部35に接続されている。内視鏡システム100においては、内視鏡装置30の駆動等に必要な電力、およびエネルギ処置具10の駆動に必要な電力が、電源部36から制御部35を介して供給される。
フットスイッチ37は、電源部36と接続され、電源部36における高周波電力等のエネルギ出力のON/OFF操作を行うために設けられている。操作者がフットスイッチ37を踏むと、エネルギ処置具10への通電が行われる。なお、本実施形態ではフットスイッチを採用しているが、エネルギ処置具への通電のON/OFF操作が可能であれば、いかなるスイッチを用いてもかまわない。
モニタ38には、内視鏡挿入部32の先端に設けた内視鏡用観察装置(不図示)で取得した画像が表示される。
処置部12は、処置具挿入部11の先端部に設けられている。処置部12としては、例えば、高周波ナイフ、鉗子、針など、電力エネルギを用いて生体組織(処置対象部位P1)に対して処置を行う公知の構成を適宜選択して採用することができる。本実施形態では、処置部12は高周波ナイフである。
本実施形態において、クリーニング部15は、処置具挿入部11の周方向にわたって処置具挿入部11の径方向外側に突出するように設けられている。クリーニング部15の処置具挿入部11の外周面からの突出長さは、処置具挿入部11の進退動作によりクリーニング部15が送電部34と対向する位置に配置されたときに、クリーニング部15の少なくとも外周縁部が処置具チャンネル33の内周面332と接触するように設定される。つまり、クリーニング部15は、処置具チャンネル33の内径以上の外径を持ち、少なくとも処置具チャンネル33の内径に沿う形状に変形可能な弾性部材で構成される。
まず、操作者は、内視鏡操作部31の側部311の開口からエネルギ処置具10を挿入する。操作者は、処置具チャンネル33の先端開口331から処置部12が突出するまで、処置具チャンネル33に対して処置具挿入部11を前進させる。このとき、まずクリーニング部15が処置具チャンネル33内に設けられた送電部34に近付く。処置具挿入部11の前進に伴い、処置具チャンネル33の内周面332のうちの送電電極341が配置されている領域をクリーニング部15が摺動して通過する。これにより、仮に、送電電極341付近の処置具チャンネル33の内周面332に埃等の異物が付着していた場合でも、異物はクリーニング部15により先端側へ押し出される。
先端開口33aから処置部12が突出すると、図4に示すように、受電部14と送電部34とが、絶縁性材料を挟んで対向する。このとき、クリーニング部15により受電部14と送電部34との間には異物が存在しない状態が確保されている。
また、エネルギ処置具10には、給電のためにケーブル等の電気配線を接続する必要がないため、エネルギ処置具の操作性が向上する。
さらに、クリーニング部15が受電部14よりも先端側に配置されているため、エネルギ処置具10を処置具チャンネル33に挿入すると、受電部14が送電部34と対向する前に、必ずクリーニング部15が送電部34近傍の処置具チャンネル33の内周面332と接触しながら摺動する。したがって、処置に伴い電源部36から送電部に高周波電力を供給する前に、送電部34と受電部14との間の異物を確実に除去できる。すなわち、操作者は、エネルギ処置具10を挿入するだけで処置具チャンネル33内の送電電極341付近の異物を、クリーニング部15により自動的に除去することが可能であり、異物を除去するための特別な作業等が必要ない。これにより内視鏡システム100の使用性を向上させることができる。
この他、図示は省略するが、処置具挿入部11の周方向且つ径方向外側に延びる薄い平板状の弁体からなるクリーニング部等、処置具チャンネル33の内周面332に当接して摺動可能な構成であれば特に制限なく採用可能である。
図10に示す変形例では、リング状のクリーニング部15Dが、処置具挿入部11の長軸方向に間隔を有して3つ並べて設けられている。
図11に示す変形例のクリーニング部15Eは、処置具挿入部11の周方向に間隔を有する複数の凸部を有し、これを図10に示す変形例と同様に、処置具挿入部11の長軸方向に間隔を有して3列設けている。図11に示す変形例では、処置具挿入部11の周方向における凸部の間隔の位相を長軸方向の各列でずらすと、クリーニング部15E全体として処置具チャンネルの内周面全体と接触するため好ましい。図9、図10及び図11に示す変形例では、処置具挿入部11の長軸方向のクリーニング部の長さが増すため、挿入時の異物除去の効果を大きく、かつ、クリーニング部が処置具挿入部11の外周面に一定の間隔を持つか、複数に分割されて配置されているためクリーニング部の長さが増した場合であっても処置具挿入部11の可撓性を妨げることがない。この他、上述した変形例の構成を適宜組み合わせてクリーニング部が構成されてもよい。
本発明の第二実施形態について、図12及び図13を参照して説明する。以下に説明する実施形態において、上述した第1実施形態に係るエネルギ処置具の構成要素と機能あるいは構造の点において同様である構成要素には、上記実施形態と同一符号が付されており、上記実施形態と重複する説明は省略される。
また、高誘電材料を用いてクリーニング部を構成すると、送電電極341と、受電電極141とで形成されるキャパシタC1の容量を増加させることができる。キャパシタC1の容量が増加すると、処置に際して処置部12を含む配線経路で発生する可能性のある寄生容量の変動の影響を受けにくくなり、より安定した電力伝送が可能となる。また、キャパシタC1に発生する電圧を下げることができるため、装置の絶縁性の確保がより容易になる。高誘電材料としては、例えば、比誘電率がεr=2.1であるポリテトラフルオロエチレン(PTFE)などのフッ素樹脂、比誘電率がεr=3~4であるシリコンゴム、比誘電率がεr=6~7であるフッ素ゴム等が挙げられる。
第三実施形態について、図15を参照して説明する。図15は、本実施形態に係るエネルギ処置具310を示す部分断面図である。エネルギ処置具310のクリーニング部315は、第一実施形態のクリーニング部15と第二実施形態のクリーニング部215とを処置具挿入部11の軸線方向に有する。このように、受電電極141の外周部及び先端側の二箇所にクリーニング部15、215が配置されることにより、より確実に異物Xを除去することが可能であり、無線給電性能の更なる安定を図ることができる。
上述した各実施形態はいずれもモノポーラ処置具を備える内視鏡システムであったが、本実施形態はバイポーラ処置具を備える内視鏡システムである。本発明の第四実施形態に係るエネルギ処置具410について図16及び図17を参照して説明する。図16は、エネルギ処置具410を処置具チャンネル33に挿入した状態を示す部分断面図である。図17は、エネルギ処置具410を備える内視鏡システム101の全体構成を示す図である。図17に示すように、内視鏡システム101は、内視鏡装置430と、エネルギ処置具410とを備える。
図16に示すように、処置具チャンネル33の先端開口331から処置部412が突出する位置まで処置具挿入部11が処置具チャンネル33に挿入されると、第一受電電極4141と第一送電電極4341とが略対向し、かつ第二受電電極4142と第二送電電極4342とが略対向する。
10A 交換エネルギ処置具(内視鏡用エネルギ処置具)
11 処置具挿入部
30、430 内視鏡装置(内視鏡)
33、333 処置具チャンネル
12、412 処置部
14、414 受電部
15、15B、15C、15D、15E、215、315、515 クリーニング部
34、434 送電部
341 送電電極
Claims (8)
- 内視鏡が備える処置具チャンネルに配された送電電極に対向することで容量結合する受電部を有する可撓性の処置具挿入部と、
前記処置具挿入部の先端側に配置され、前記受電部からの電力を用いてエネルギによる処置を行う処置部と、
前記受電部から前記処置部までの間の前記処置具挿入部に前記処置具チャンネルと接触可能に配置され、前記処置具挿入部の移動に伴って前記処置具チャンネル内をクリーニングするクリーニング部と、
を備える内視鏡用エネルギ処置具。 - 前記クリーニング部は、前記処置具挿入部に対して間隔をあけて巻きつけられている
請求項1に記載の内視鏡用エネルギ処置具。 - 前記クリーニング部は、複数配置される
請求項1又は請求項2に記載の内視鏡用エネルギ処置具。 - 前記クリーニング部は、前記受電部の少なくとも先端部を被覆するように配置される
請求項1から請求項3のいずれか一項に記載の内視鏡用エネルギ処置具。 - 前記クリーニング部は、前記受電部と相似形状を有し、前記受電部を被覆する箇所に配置される
請求項4に記載の内視鏡用エネルギ処置具。 - 前記クリーニング部は、高誘電材料で構成される
請求項1から請求項5のいずれか1項に記載の内視鏡用エネルギ処置具。 - 前記クリーニング部は、前記受電部上と、前記受電部より前記処置具挿入部の先端側と、に配置される
請求項1から請求項6のいずれか一項に記載の内視鏡用エネルギ処置具。 - 請求項1から請求項7のいずれか1項に記載の内視鏡用エネルギ処置具と、
可撓性を有する処置具チャンネル、及び前記処置具チャンネルの外周面に沿って配設され前記処置具チャンネル内に印加する交流電界を発生する送電部を有する内視鏡と、
を備える内視鏡システム。
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DE112014007042.4T DE112014007042T5 (de) | 2014-11-17 | 2014-11-17 | Endoskopisches Energiebehandlungsinstrument und endoskopisches System |
JP2016559709A JP6347851B2 (ja) | 2014-11-17 | 2014-11-17 | 内視鏡用エネルギ処置具及び内視鏡システム |
CN201480083358.3A CN106999232A (zh) | 2014-11-17 | 2014-11-17 | 内窥镜用能量处置器具和内窥镜系统 |
PCT/JP2014/080357 WO2016079788A1 (ja) | 2014-11-17 | 2014-11-17 | 内視鏡用エネルギ処置具及び内視鏡システム |
US15/496,079 US20170224412A1 (en) | 2014-11-17 | 2017-04-25 | Endoscopic energy treatment instrument and endoscopic system |
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JPH07194610A (ja) * | 1993-12-28 | 1995-08-01 | Olympus Optical Co Ltd | 医療器具 |
JPH1199158A (ja) * | 1997-06-30 | 1999-04-13 | Ethicon Endo Surgery Inc | 静電的に連結した電気式外科手術用トロカール |
JPH11128241A (ja) * | 1997-06-30 | 1999-05-18 | Ethicon Endo Surgery Inc | 静電結合型コードレス電気式外科手術用器具 |
JP2002523131A (ja) * | 1998-08-20 | 2002-07-30 | ノバファーム リサーチ (オーストラリア) プロプライアタリー リミティッド | 内視鏡洗浄装置 |
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JP4468747B2 (ja) * | 2004-06-24 | 2010-05-26 | オリンパス株式会社 | 内視鏡洗滌消毒装置 |
EP3109739B1 (en) * | 2011-06-08 | 2022-08-03 | Scramoge Technology Limited | Electronic device, wireless power receiving apparatus, and display apparatus |
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2014
- 2014-11-17 JP JP2016559709A patent/JP6347851B2/ja active Active
- 2014-11-17 CN CN201480083358.3A patent/CN106999232A/zh active Pending
- 2014-11-17 WO PCT/JP2014/080357 patent/WO2016079788A1/ja active Application Filing
- 2014-11-17 DE DE112014007042.4T patent/DE112014007042T5/de not_active Withdrawn
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Patent Citations (4)
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JPH07194610A (ja) * | 1993-12-28 | 1995-08-01 | Olympus Optical Co Ltd | 医療器具 |
JPH1199158A (ja) * | 1997-06-30 | 1999-04-13 | Ethicon Endo Surgery Inc | 静電的に連結した電気式外科手術用トロカール |
JPH11128241A (ja) * | 1997-06-30 | 1999-05-18 | Ethicon Endo Surgery Inc | 静電結合型コードレス電気式外科手術用器具 |
JP2002523131A (ja) * | 1998-08-20 | 2002-07-30 | ノバファーム リサーチ (オーストラリア) プロプライアタリー リミティッド | 内視鏡洗浄装置 |
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JP2020508797A (ja) * | 2017-03-09 | 2020-03-26 | シーエスエー メディカル, インコーポレイテッド | 凍結療法システムのためのカテーテルスリーブ |
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JPWO2016079788A1 (ja) | 2017-08-24 |
DE112014007042T5 (de) | 2017-08-10 |
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