WO2018182101A1 - Couteau haute fréquence pour dissection sous-muqueuse endoscopique - Google Patents

Couteau haute fréquence pour dissection sous-muqueuse endoscopique Download PDF

Info

Publication number
WO2018182101A1
WO2018182101A1 PCT/KR2017/008103 KR2017008103W WO2018182101A1 WO 2018182101 A1 WO2018182101 A1 WO 2018182101A1 KR 2017008103 W KR2017008103 W KR 2017008103W WO 2018182101 A1 WO2018182101 A1 WO 2018182101A1
Authority
WO
WIPO (PCT)
Prior art keywords
electrode
tip
needle
tube
handle
Prior art date
Application number
PCT/KR2017/008103
Other languages
English (en)
Korean (ko)
Inventor
조훈상
윤여웅
황지영
박홍준
Original Assignee
유펙스메드 주식회사
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by 유펙스메드 주식회사 filed Critical 유펙스메드 주식회사
Publication of WO2018182101A1 publication Critical patent/WO2018182101A1/fr

Links

Images

Classifications

    • 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
    • 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
    • A61B2018/00053—Mechanical features of the instrument of device
    • A61B2018/00107—Coatings on the energy applicator
    • 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
    • A61B2018/00982—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body combined with or comprising means for visual or photographic inspections inside the body, e.g. endoscopes
    • 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
    • A61B2018/1405—Electrodes having a specific shape
    • 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
    • A61B2018/1467—Probes or electrodes therefor using more than two electrodes on a single probe
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B2218/00—Details of surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2218/001—Details of surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body having means for irrigation and/or aspiration of substances to and/or from the surgical site
    • A61B2218/002—Irrigation
    • A61B2218/003—Irrigation using a spray or a foam

Definitions

  • the present invention relates to a high frequency knife for endoscopic submucosal dissection, and to a high frequency knife integrally formed with a chemical injection needle for swelling mucosal tissue.
  • Endoscopic treatment Endoscopy is an important field in the treatment of gastrointestinal pain.
  • the field of therapeutic endoscopy has been developed due to the miniaturization of electronic devices, the development of imaging technology, the development of therapeutic technology, and the skill of the physician.
  • Endoscopic Mucosal Resection EMR
  • ESD Endoscopic Submucosal Dissection
  • endoscopy-based surgical methods includes marking, incision, exfoliation, hemostasis, and water in the treatment instrument inserted through the working channel of the endoscope.
  • Various types of tools are appropriately replaced depending on the purpose of treatment and the type of mucosa.
  • the treatment instrument enters the body through a tube that is inserted into the working channel of the endoscope.
  • a high frequency knife is a knife for cutting the mucous membrane of the tissue, a coagulator for hemostasis when bleeding during the mucosal resection, and a saline solution as a means of swelling the mucosal tissue to provide ease of ablation.
  • Various kinds of treatment tools such as a medicine injection needle (needle) for injecting the back is provided.
  • Endoscopic mucosal resection is a treatment that started in the 80s in Japan with advanced endoscopy. Endoscopy is a tool for diagnosis, but here I have tried to treat early gastric cancer with an orgasm cap. It was hoped that small cancers attached to the mucous membrane could be cured with a lasso or cap and cut with an electric knife on the end of the endoscope. Endoscopic mucosal resection (EMR), however, is limited to a range of procedures because tumors larger than 2 cm in diameter can be accompanied by a sequelae caused by large cuts or perforation of the gastric wall.
  • Endoscopic submucosal dissection is an endoscopic technique that treats gastric cancer, as well as esophageal and colorectal cancer.
  • Endoscopic submucosal dissection is a surgical method that uses a high-frequency knife attached to the end of an endoscope to incise a tumor, such as a mass of cancer, attached to the mucous membrane and thinly detach it.
  • ESD endoscopic submucosal dissection
  • ESD endoscopic submucosal dissection
  • EMR endoscopy mucosal resection
  • tumors whose tumor removal limits exceed 2 cm in diameter and 15 cm in diameter can be peeled off at once.
  • endoscopic submucosal dissection (ESD) is performed in a sleep state without general anesthesia, and the operation time is about 40 minutes to about an hour, so the operation time is relatively short. In addition, they can be discharged three to four days after surgery and return to daily life almost immediately.
  • ESD endoscopic submucosal dissection
  • the high frequency knife used for endoscopic submucosal dissection is generally composed of an insulator fixed to the tip of an electrode, such as a high frequency knife disclosed in Korean Patent No. 0595803, in the process of cutting or cutting a lesion. It is configured to prevent damage to tissues or the body by the insulator even if it is connected to other tissues.
  • FIG. 1 is a schematic diagram for explaining the peeling process of endoscopic submucosal dissection (ESD).
  • ESD endoscopic submucosal dissection
  • the high-frequency knife is thinly exfoliated the lesion tissue with the incision, wherein the high frequency applied to the knife is discontinuous so that the incision for cauterizing the tissue and the exfoliation for lifting the cauterized tissue are difficult to proceed simultaneously. More specifically, the high-frequency knife cuts tissue at the time when the high frequency is applied to the tip, and when the high frequency is not applied to the tip, the entire tissue is excised by alternately lifting the tissue using the structure of the knife tip. It is preferred to understand that.
  • the mucous membrane to be removed has a multi-layered structure, an uneven wrinkle shape, and may have a hardly deformed portion of blood vessels and fibrous tissues. Therefore, it is usually extremely difficult for the tip of the high-frequency knife to smoothly cut and peel simultaneously.
  • the tip of the high-frequency knife generally has a predetermined length and has a dome-shaped round electrode shape that facilitates invasion and dissection of the tissue into the tissue, but smoothly lifts or hooks a thin layer of tissue that peels upward. It is inconvenient to make an incision while hooking.
  • the conventional high-frequency knife for endoscopic submucosal dissection has a structural limitation that is not easy to proceed smoothly at the same time as the incision and detachment.
  • the high-frequency knife is designed to perform such a treatment with a single insertion.
  • the tip structure of the high-frequency knife should be able to be peeled off as well as the cutting. Therefore, the needle for injecting water, hemostasis, saline, drugs, etc. into the high-frequency knife is preferably formed with the electrode to which the high frequency is applied, but the electrode and the needle are arranged at the tip so that the incision and peeling can be performed simultaneously. It is not easy to form the knife tip smoothly.
  • the present invention is to provide a high-frequency knife having a tip structure in which the tip of the high-frequency knife for endoscopic submucosal dissection is penetrated into the tissue so that the tissue is dispersed contact without excessive concentration of the tissue at the knife end at the time of incision.
  • the present invention is to provide a high-frequency knife capable of cutting smoothly and easy cutting and peeling by forming a structure of the tip that is easy to hook (hooking) to the layer of lesion tissue.
  • the present invention is to provide a high-frequency knife that can be performed by subcutaneous mucosal detachment with a single insertion without having to insert a needle and electrode endoscope alternately integrated on the high-frequency knife catheter needle for drug injection.
  • the present invention is to provide a high-frequency knife having a structure capable of alternately discharging the needle and the high frequency electrode tip by a simple operation.
  • the present invention in the high-frequency knife for endoscopic submucosal dissection detachment, is provided at the tip of the tube inserted into the body of the both ends of the tube portion and the electrode tip is energized when applying the high frequency to ablate the lesion tissue in the body
  • the electrode tip includes: an electrode rod exposed from the tip of the tube and made of a conductor; A first electrode having a radius larger than that of the electrode rod at the tip of the electrode rod and having an upper surface raised in a dome shape; And a second electrode formed on the electrode rod spaced apart in parallel with the first electrode at a predetermined distance, wherein the electrode rod has a plurality of electrodes formed in multiple stages.
  • the present invention provides a high-frequency knife for endoscopic submucosal dissection, an electrode tip provided at the tip of the tube inserted into the body of the both ends of the tube portion and energized when the high frequency is applied to ablate lesion tissue in the body; Needles that invade submucosa of lesion tissue to introduce liquid for swelling tissue; And a handle for manipulating the electrode tip and the needle, wherein the handle includes a first handle part connected to the electrode tip to advance and retreat the electrode tip, and a second handle part connected to the needle to advance and advance the needle. And, including a gear portion for transmitting a force to the second handle portion in a direction opposite to the direction of the force applied to the first handle portion, it is possible to alternately expose the electrode tip or the needle only by the operation of the handle It is another feature.
  • the present invention is a high-frequency knife for endoscopic submucosal dissection detachment
  • the electrode tip is provided at the front end of the tube inserted into the body of the both ends of the tube portion and energized when applying the high frequency to ablate the lesion tissue in the body; Needles that invade submucosa of lesion tissue to introduce liquid for swelling tissue;
  • a handle for manipulating the electrode tip and the needle wherein the handle includes a first handle part connected to the electrode tip to advance and retreat the electrode tip, and a second handle part connected to the needle to advance and advance the needle.
  • the handle includes a first handle part connected to the electrode tip to advance and retreat the electrode tip, and a second handle part connected to the needle to advance and advance the needle.
  • the handle including a wire portion for transmitting a force to the second handle portion in a direction opposite to the direction of the force applied to the first handle portion, it is possible to alternately expose the electrode tip or the needle only by the operation of the handle It is another feature.
  • the high frequency knife according to the present invention has a double blade structure in which a plurality of electrodes are formed in multiple stages at an electrode tip to which high frequency is applied.
  • the electrode tip structure can prevent the unintentional increase in impedance around the electrode tip by dispersing the contact area so that tissue is not excessively concentrated on the tip electrode. Therefore, the structure of the electrode tip according to the present invention can be easily hooked to the layer of lesion tissue during the incision, as well as the tissue is not condensed at the end of the electrode tip so that the impedance is kept constant so that the tissue is dissected. The precision can be improved and the incision exfoliation process can be performed smoothly.
  • the present invention is provided with a structure in which the electrode to which the high frequency is applied and the needle for injecting the drug or saline are alternately exposed at the same position of the high frequency knife tip. Accordingly, there is an advantage in that the tip structure is formed so that the marking, cutting, peeling, and water-receiving functions can be performed with a single treatment device, but the needle does not interfere with the peeling of the tissue when dissecting the tissue through the electrode tip.
  • FIG 1 is a schematic diagram for explaining the peeling process of endoscopic submucosal dissection (ESD).
  • FIG. 2 is a perspective view of a high frequency knife according to an embodiment of the present invention.
  • FIG 3 is an enlarged view of an electrode tip A type according to an embodiment of the present invention.
  • FIG 4 is an enlarged view of an electrode tip B type according to an embodiment of the present invention.
  • FIG 5 is an enlarged exploded view of the injection hole according to the embodiment of the present invention.
  • FIG. 6 is an enlarged view of the treatment instrument according to the embodiment of the present invention.
  • FIG. 7 is an enlarged exploded view of a fixed switch according to an embodiment of the present invention.
  • FIG. 8 shows a handle of a high frequency knife according to another embodiment of the present invention.
  • FIG. 9 is a view illustrating an operation of the high frequency knife according to the embodiment of FIG. 8.
  • FIG. 10 shows a handle of a high frequency knife according to another embodiment of the present invention.
  • FIG. 11 is a view illustrating an operation of the high frequency knife according to the embodiment of FIG. 10.
  • the high frequency knife 1 may include an electrode tip 10, an injection hole 30, a handle 50, a power connection 70, a tube portion 80, and a needle 90 (FIG. 6). Can be.
  • a power cable for applying a high frequency to the electrode tip 10 may be connected to the power supply connection 70.
  • the power connection unit 70 may be formed to be movable between the handle 50 and the injection hole 30.
  • the power connection is fixedly formed in an area in which the jack for connecting the power is close to the handle for the operator to operate.
  • the power cable may interfere with the operating radius of the handle, resulting in inconvenience.
  • the power connection unit 70 according to the present embodiment is provided to be able to adjust the distance spaced from the handle 50 so as not to cause inconvenience in operation due to the power cable to be connected.
  • the form in which the power connector 70 is disposed is not limited to the above-described position, and the direction of the terminal provided for connecting the power connector 70 to the jack is also not limited to the direction toward the bottom as shown in FIG. can be changed.
  • the power supply connection 70 may be connected to the needle (90, Figure 6) to control the movement of the needle (90, Figure 6) through the drive forward and backward. The related description will be described in detail in the description of FIG. 5.
  • the handle 50 may be divided into a first handle part 501 and a second handle part 503.
  • the handle 50 may be provided as a second handle part 503 to be gripped by a thumb and a first handle part 501 to be gripped by a finger other than the thumb.
  • the first handle part 501 is connected to the second handle part 503 so that relative movement is possible. If the first handle portion 501 is fixed, the second handle portion 503 may be slidingly driven, and if the second handle portion 503 is fixed, the first handle portion 501 may be slidingly driven.
  • the handle 50 may be formed with a hole 5031 cut along the circumference of the outer peripheral surface of the rear end of the second handle portion 503 to which the thumb is pressed.
  • the handle 50 is generally configured to operate the first handle 501 or the second handle 503 by holding with one hand for precise manipulation.
  • the thumb retreating the second handle portion 503 is not made in the vertical direction exactly from the first handle portion 501 in the structure of the hand. This is because the thumb extends in an arc when moving away from the rest of the fingers.
  • the structure in which the hole 5031 is cut along the circumference of the outer circumferential surface at the rear end of the second handle part 503 can alleviate the lateral tension applied by the thumb.
  • the lateral in-output force applied by the thumb is buffered, and more precise operation is possible.
  • the pain due to the pressure applied to the thumb can be reduced from the user's point of view.
  • the tube portion 80 defines an area of the tube starting at the tip of the injection port 30 and entering the body.
  • the tube portion 80 is formed of a tube for receiving the electrode tip 10 and the tube 801 containing a conductor for conducting high frequency up to the tip 803 of the tube and a channel for delivering fluid transmitted from the inlet 30.
  • the tip 803 may be configured.
  • a plurality of water inlets 8031 for discharging the fluid in the direction in which the tip 803 of the tube electrode tip 10 is exposed may be formed.
  • the water inlet 8031 formed at the tip 803 of the tube is of the incision function due to the bleeding of the carbonized cells and cells generated through friction with the electrode tip 10 at the time of incisional separation of the lesion tissue Liquid can be sprayed to prevent degradation and to ensure visibility. Through this, it is possible to induce a smooth incision of the high-frequency knife 1, it is possible to improve the ease of peeling.
  • the electrode tip 10 may be provided at the tip 803 of the tube inserted into the body of both ends of the tube portion 80 and energized when power is applied to ablate lesion tissue in the body.
  • the electrode tip 10 may be in direct contact with the periphery of the lesion tissue to generate a marking for marking the incision region on the tissue, or may perform an incision and peeling operation for cutting the tissue.
  • the electrode tip 10 according to the present exemplary embodiment may require a structure so that the tissue is not condensed when the tissue is incision, and even a hard or layered lesion tissue can be smoothly cut.
  • the structure of the electrode tip 10 for cutting in the manner described above is limited in the state having a single electrode. In this embodiment, the structure of the tip is designed so that the cutting and the peeling operation can be performed smoothly by starting the electrode installed in multiple stages. Descriptions related to electrodes provided in multiple stages will be described in detail with reference to the following drawings.
  • FIG. 3 is an enlarged view of an electrode tip 10 A type according to an embodiment of the present invention.
  • FIG. 3A is a perspective view of an electrode tip 10 A type
  • FIG. 3B is a cross-sectional view of the electrode tip 10 A type
  • 4 is an enlarged view of the electrode tip 10 B type according to another embodiment of the present invention.
  • 4 (a) is a perspective view of the electrode tip 10 B type
  • (b) is a cross-sectional view of the electrode tip 10 B type. 3 and 4
  • the electrode tip 10 is a structure formed by extending outward from the tip 803 of the tube.
  • the electrode tip 10 includes a component part of the first electrode 103 and the second electrode 105 formed in multiple stages on the electrode rod 101 and the electrode rod 101 without distinction of the type. Details related to the A type and the B type of the electrode tip 10 shown in FIGS. 3 and 4 will be described in detail in the following ⁇ Example 1> and ⁇ Example 2>.
  • the electrode rod 101 is exposed from the tip 803 of the tube and may be made of a conductor.
  • the electrode rod 101 defines a column portion extending in the longitudinal direction of the knife 1 in the structure of the electrode tip 10.
  • Electrode tip 10 is formed in a multi-stage electrode 103, 105 to have a predetermined radius on the column-shaped electrode rod 101, in the present specification, in the structure of the electrode tip 10, on the electrode rod 101
  • region of the knife which forms the double-electrode structure in was divided into the 1st electrode 103 and the 2nd electrode 105, and was defined.
  • the electrode rod 101 may cut the lesion tissue or the surrounding area when the high frequency is applied to have energy.
  • the electrode rod 101 may be made of a conductor to cut the lesion or surrounding tissue even in the lateral movement of the high frequency knife 1.
  • the electrode rod 101 has a conductive region partitioned by a second electrode 105 to be described later, and lesion tissue is hooked to the conductive region between the partitioned first electrode 103 and the second electrode 105.
  • the amount can be dispersed.
  • the conductive region formed between the first electrode 103 and the second electrode 105 may have an uneven surface of the mucous membrane where the lesion is formed, or the high frequency knife 1 may invade the deformed tissue whose strength is increased.
  • the lesion tissue cut at the tip of the electrode tip 1 may be agglomerated to prevent a burn.
  • the high-frequency knife 1 provided with the conductive region formed between the first electrode 103 and the second electrode 105 is not limited to the position where the tissue cut off during hooking is dispersed in the knife tissue so that the lesion tissue is cut. The incision process can be easily performed without slipping.
  • the electrode rod 101 has the second electrode 105 such that the separation distance between the second electrode 105 and the tip 803 of the tube is greater than the separation distance between the first electrode 103 and the second electrode 105.
  • the first electrode 103 may be spaced apart in parallel.
  • the tip 803 of the second electrode 105 and the tube for easily hooking the mucosal layer of the tissue.
  • the separation distance between them can be increased. Accordingly, the aforementioned separation distance between the second electrode 105 and the tip 803 of the tube is greater than the separation distance between the first electrode 103 and the second electrode 105 at the height of the limited electrode rod 101. Can be formed.
  • the length of the spaced apart electrode rod 101 between the first electrode 103 and the second electrode 105 may be 0.3mm to 0.5mm. More preferably, the length of the spaced apart electrode rod 101 between the first electrode 103 and the second electrode 105 may be 0.4 mm.
  • the average thickness of the submucosal layer is about 2.0 mm to 2.8 mm, and when the submucosal layer is peeled off, when the blood vessels and fibrosis are observed, the mucosal layer is formed through instantaneous contact with the electrode rod 101 which transmits a high frequency current. Can cause tissue damage. Therefore, when the separation distance between the first electrode 103 and the second electrode 105 is formed to be 0.3mm to 0.5mm, it is possible to minimize the burn or damage of the tissue.
  • the separation distance between the second electrode 105 and the tip 803 of the tube may be designed in the range of 0.8mm to 1.0mm to have a range larger than the above-described separation distance. More preferably, the separation distance between the second electrode 105 and the tip 803 of the tube may be 0.9 mm.
  • the electrode rod 101 may be exposed to a length of 1.0 mm to 4.0 mm from the tip 803 of the tube. More preferably, the electrode rod 101 may be designed to have a height of 2 mm from the tip 803 of the tube.
  • an upper surface means an upper surface of an electrode
  • a lower surface of an electrode means a lower surface that is a cross-section toward the tube 801.
  • the first electrode 103 may have a radius larger than that of the electrode rod 101 at the distal end of the electrode rod 101 and may be provided in a domed shape with an upper surface raised.
  • the first electrode 103 is formed in the shape of the upper surface is raised, it is generated according to the pressure in contact with the contact angle when the electrode tip 10 around the lesion tissue or lesion through this
  • the markings can be of different sizes.
  • the first electrode 103 may be easily cauterized in a tissue in a contact direction other than the direction in which the first electrode 103 is vertically contacted with the mucosa due to the structure of the upper surface raised in the dome shape.
  • the upper surface of the first electrode 103 raised in the dome shape may be induced to be peeled in a curved shape along the upper surface without condensation of the lesion tissue in the process of peeling the submucosal layer of the lesion tissue.
  • a first insulator 1031 made of a ceramic material having a predetermined thickness may be coated on the edge of the first electrode 103.
  • the first insulator 1031 blocks the high frequency so that the unintended contact of the side regions of the first electrode 103 does not cut the peripheral region.
  • the first electrode 103 may be designed with a diameter of 0.7 mm to 1.0 mm and a height of 0.3 mm to 0.5 mm. More preferably, the first electrode 103 may be designed with a diameter of 0.8 mm and a height of 0.4 mm.
  • the height of the first electrode 103 defines the side wall of the column model and the region may be understood as the edge of the first electrode 103, so that the first insulator 1031 is coated on the region. Can be understood.
  • the diameter and height of the first electrode 103 is further increased, it is expected to shorten the time for cutting the tissue, but the area that the electrode and the tissue is in contact with the wider cutting amount increases the disadvantage Can cause. Accordingly, it may be noted that the range of diameter and height of the first electrode 103 of the high-frequency knife 1 according to the embodiment of the present invention may be limited because the risk of tissue puncture may be increased.
  • the second electrode 105 may be spaced apart from the first electrode 103 in parallel with the electrode rod 101 at a predetermined distance.
  • the first electrode 103 and the second electrode 105 may maintain a predetermined interval so as not to be in contact with each other.
  • the second electrode 105 is positioned on the electrode rod 101 provided between the first electrode 103 positioned at the one end of the electrode tip 10 and the tip 803 of the tube, so that the region of the electrode rod 101 is positioned. Can be fractionated. Lower surfaces of the first electrode 103 and the second electrode 105 may be formed in parallel with each other.
  • the second electrode 105 may be coated with a ceramic insulator on the side edge thereof.
  • the ceramic insulator coated on the edge of the second electrode 105 is referred to as a second insulator 1051.
  • the second insulator 1051 blocks the high frequency so that unintended contact of the side regions of the second electrode 105 does not incise the peripheral region.
  • the second electrode 105 may have the same diameter as that of the first electrode 103 and may be installed at a height lower than that of the first electrode 103.
  • the second electrode 105 may be designed to a height of 0.2mm to 0.4mm. More preferably, the second electrode 105 may be designed to a height of 0.3 mm.
  • the diameter of the second electrode 105 may be designed to be the same as the diameter of the first electrode 103.
  • the electrode tip 10 according to the present exemplary embodiment may be divided into an A type embodiment and a B type embodiment according to the shape of the second electrode 105.
  • the second electrode 105 of the A type may be formed in a disk shape having a flat upper surface.
  • the second electrode 105 may be provided in a form in which the bending is not included in an upper surface of the second electrode 105.
  • the second electrode 105 may have a flat upper surface and a lower surface, and may be provided in a cylindrical shape surrounding the electrode rod 101.
  • a type electrode structure will be described in more detail in ⁇ Example 1> to be described later.
  • the second electrode 105 of the B type may be formed in a tapered shape having a diameter reduced in the direction of the upper surface.
  • the top surface of the second electrode 105 may be raised.
  • the second electrode 105 may be formed in the shape of a taper 1053 in such a manner that an upper surface connected to the electrode rod 101 from the side on which the second insulator 1051 is coated is raised in the direction of the first electrode 103. have.
  • the upper surface of the second electrode 105 may be symmetrical with respect to the central axis of the electrode rod 101.
  • the upper surface of the second electrode 105 has the shape of the taper 1053 as described above, only a portion of the first electrode 103 and the electrode rod 101 of the electrode tip 10 is invaded into the lesion tissue. When peeling is performed, the peeling of the lesion tissue may be prevented by peeling along the upper surface of the second electrode 105.
  • the electrode structure of the B type will be described in more detail in ⁇ Example 2> to be described later.
  • the injection hole 30 includes a first injection pipe 301, a second injection pipe 303, a rubber packing 305, a first sliding groove 307, and a second sliding groove 309. can do.
  • the first injection tube 301 and the second injection tube 303 were divided into ordinal numbers as different liquid phases may be introduced.
  • the first sliding groove 307 and the second sliding groove 309 were divided into ordinal numbers according to positions provided.
  • the power supply connecting portion 70 capable of driving forward and backward at a position corresponding to the injection hole 30 may be provided.
  • the inlet 30 may deliver fluid to the tip 803 of the tube.
  • the injection hole 30 may include a first injection pipe 301, a second injection pipe 303, a rubber packing 305, a first sliding groove 307, and a second sliding groove 309.
  • the first injection tube 301 may receive a saline solution for cleaning the lesion tissue and the surroundings.
  • the first injection tube 301 may be injected with saline solution for the lesion area and the surrounding washing.
  • the first injection pipe 301 may communicate with the first aqueduct 3013 penetrating the high-frequency knife 1 at the center to deliver a saline solution injected from the outside to the water inlet 8031 formed at the tip 803 of the tube. .
  • the saline solution delivered to the water inlet 8031 may be cooled and washed while the upper surface of the first electrode 103 contacts the lesion tissue and is cauterized.
  • the first injection pipe 301 may include a first stopper 3011 to prevent the backflow of the saline solution to be injected and to prevent the inflow of foreign substances from the outside.
  • the first injection pipe 301 may be understood as a saline water injection pipe.
  • the first aqueduct 3013 defines a passage of fluid that communicates the first injection tube 301 and the tip 803 of the tube.
  • the first aqueduct 3013 may receive the saline solution and transmit water to the tip 803 of the tube, and may discharge the saline solution through the water inlet 8031.
  • the second injection tube 303 may communicate with the needle 90 to receive the saline solution and the drug.
  • the second infusion tube 303 may be injected with saline and drugs.
  • the second injection tube 303 communicates with the second water channel 3033 penetrating the high frequency knife 1 of the tube 801, and may transmit the saline solution and the drug injected from the outside to the needle 90.
  • the saline solution and the drug delivered to the needle 90 are introduced from the needle 90 to the bottom of the lesion tissue and the tissue mucosa through the needle pit 901, through which the lesion tissue can prevent infection during invasion.
  • the lesion tissue may be swollen in a form that is easily cut and exfoliated through the saline solution injected from the needle 90.
  • the second injection tube 303 may include a second stopper 3031 to prevent the backflow of the drug to be injected and to prevent the inflow of foreign substances from the outside.
  • the second infusion tube 303 may be understood as a saline and drug infusion tube in communication with the needle 90.
  • the second water channel 3033 defines a passage of the fluid communicating the second injection pipe 303 and the needle 90.
  • the second aqueduct 3033 may receive the saline solution and the drug to be fed to the needle 90, and discharge the saline solution through the needle inlet 901 to swell the lesion and swell the lesion.
  • the drug can be released to prevent infection of the lesion site.
  • the inlet 30 may replace the treatment tool A including the electrode tip 10 or the needle 90 selectively exposed from the tip 803 of the tube through the retraction drive of the second inlet tube 303. have.
  • the injection hole 30 may be formed with a second sliding groove 309 so as to drive the second injection tube 303 forward and backward.
  • the injection opening 30 may have a first sliding groove 307 formed at a position corresponding to the second sliding groove 309.
  • the injection hole 30 may selectively expose the treatment tool A according to a user's needs due to the forward and backward driving of the second injection pipe 303.
  • the second injection tube 303 may include a second spring 3035 and a second fixing rod 3037.
  • the second injection tube 303 may expose the needle 90 connected to the second water channel 3033 to the outside of the front end 803 of the tube when driven forward.
  • the second spring 3035 and the second fixing rod 3037 may be bound and fixed.
  • the second injection pipe 303 may drive the needle 90 connected to the second aqueduct 3033 into the front end 803 of the tube when driven backward.
  • the second spring 3035 and the second fixing rod 3037 may be coupled.
  • the second fixing rod 3037 may be formed with a plurality of second spring grooves 30371.
  • the second fixing rod 3037 and the fixing switch 40 may be detached due to the driving of the second injection tube 303.
  • the second fixing rod 3037 may be formed with a second fixing rod groove.
  • the second fixing rod groove means a groove formed in the second fixing rod 3037 to correspond to the position of the first fixing rod groove 30173 of the first fixing rod 3017.
  • the second spring 3035 may fix the needle 90.
  • the second spring 3035 is to be engaged with the second spring groove 30371 formed at a position close to the handle 50 of the plurality of second spring grooves 30371 formed in the second fixing rod 3037.
  • the second spring 3035 may be formed with a convex portion in the direction of the second spring groove 30371.
  • the convex portion of the second spring 3035 is not limited in shape or size, and may include all shapes and sizes that may be engaged with the second spring groove 30371 to minimize the flow of the second fixing rod 3037.
  • the convex portion of the second spring 3035 according to the present embodiment may be provided in a “ ⁇ ” form.
  • the second spring 3035 is the second spring groove 30371 while the convex portion is compressed when the user operates the second injection pipe 303 in a state where the second spring 3035 and the second spring groove 30371 are bound. ) Can be released.
  • the second spring 3035 may be engaged with the second spring groove 30371 when the second injection pipe 303 moves to one end or the other end of the second sliding groove 309, and thus the needle ( 90) can be fixed.
  • the second fixing rod 3037 may be connected to the needle 90, and a plurality of fixing grooves may be formed to bind with the second spring 3035.
  • a plurality of second spring grooves 30371 formed in the second fixing rod 3037 may be formed, and the second spring grooves 30371 formed at the foremost end of the tube have a needle 90.
  • the second spring 3035 is bound when the tissue is swelled in the exposed state from the 803, the needle 90 is drawn into the tip 803 of the tube by the pressure generated between the tissue and the needle 90 Can be prevented.
  • the second spring groove 30371 formed at the rearmost portion has the second spring 3035 engaged when the needle 90 is introduced into the tip 803 of the tube, so that the needle 90 and the tube portion 80 are formed. ) Internal friction can be prevented.
  • the power connection 70 may communicate with the electrode tip 10 to control the drive forward and backward of the electrode tip 10 through the drive forward and backward.
  • the power supply connection unit 70 may be connected to the first water channel 3013 to transmit the retraction drive to the electrode tip 10.
  • a first sliding groove 307 may be formed in the injection hole 30 to drive the power connection unit 70 forward and backward.
  • the power connection unit 70 may selectively expose the treatment tool A according to the needs of the user due to the forward and backward driving.
  • the power connector 70 may be connected to the first spring 3015 and the first fixing rod 3017.
  • the power connection unit 70 may expose the electrode tip 90 connected to the first water channel 3013 to the outside of the front end 803 of the tube when driven forward. At this time, the first spring 3015 and the first fixing rod 3017 may be bound and fixed.
  • the power connector 70 may lead the electrode tip 10 connected to the first aqueduct 3013 into the tip 803 of the tube when driven backward.
  • the first spring 3015 and the first fixing rod 3017 may be bound and fixed.
  • the first fixing rod 3017 may be formed with a plurality of first spring grooves 30171.
  • the first fixing rod 3017 and the fixed switch 40 may be detached due to the drive of the power connector 70.
  • the first fixing rod 3017 may be formed with a first fixing groove (30173).
  • the first spring 3015 may fix the electrode tip 10.
  • the first spring 3015 is to be engaged with the first spring groove 30171 formed at a position close to the handle 50 of the plurality of first spring grooves 30171 formed in the first fixing rod 3017.
  • the first spring 3015 may have a convex portion in the direction of the first spring groove 30171.
  • the convex portion of the first spring 3015 is not limited in shape or size, and may include all shapes and sizes that can be coupled with the first spring groove 30171 to minimize the flow of the first fixing rod 3017.
  • the convex portion of the first spring 3015 according to the present embodiment may be provided in a “ ⁇ ” form.
  • the first spring 3015 When the user manipulates the power connection unit 70 in a state where the first spring 3015 and the first spring groove 30171 are engaged, the first spring 3015 is compressed with the first spring groove 30171 while the convex portion is compressed. Binding can be released.
  • the first spring 3015 may be engaged with the first spring groove 30171 when the power connector 70 moves to one end or the other end of the first sliding groove 307, and thereby the electrode tip 10. ) Can be fixed.
  • the first fixing rod 3017 may be connected to the electrode tip 10, and a plurality of fixing grooves may be formed to bind with the first spring 3015.
  • a plurality of first spring grooves 30171 formed in the first fixing rod 3017 may be formed, and the first spring grooves 30171 formed at the foremost electrodes may have an electrode tip 10 of the tube.
  • the first spring 3015 is bound, so that the electrode tip 10 is the tip 803 of the tube by the pressure generated between the tissue and the electrode tip 10. It is possible to prevent the phenomenon of entering into the inside.
  • the first spring groove 30171 formed at the rearmost portion is engaged with the first spring 3015 when the electrode tip 10 is introduced into the tip 803 of the tube, so that the electrode tip 10 and the tube portion are formed. (80) Internal friction can be prevented.
  • the rubber packing 305 may seal the tip of the injection hole 30 to block the fluid flowing back from the other end of the tube portion 80 toward the first injection tube 301.
  • the fluid introduced through the inlet 30 may be delivered to the tip 803 or the needle 90 of the tube through the first channel 3013 and the second channel 3033.
  • the delivered fluid may be discharged through the water inlet 8031 or the needle water inlet 901, and the discharged fluid may ride on the outer walls of the first water channel 3013 and the second water channel 3033 in the direction of the injection port 30.
  • Rubber packing 305 may be provided essentially to perform this role. In particular, the rubber packing 305 may be in contact with the other end of the tube due to the nature of the elastic material to prevent the gap that can be reverse flow of the fluid.
  • the rubber packing 305 may be formed with an axial through-hole through which the first aqueduct 3013 and the second aqueduct 3033 penetrate to guide the advance paths of the aqueducts 3013 and 3033.
  • the rubber packing 305 may be formed with a through hole for coupling the first channel 3013 and the second channel 3033.
  • the rubber packing 305 may be fixed to the other end of the tube to guide the path so that the rubber packing 305 may move through the through hole during the driving of the first water channel 3013 and the second water channel 3033.
  • FIG. 6 is an enlarged view of the treatment instrument A according to the embodiment of the present invention.
  • the treatment instrument A may be selectively exposed for the electrode tip 10 and the needle 90 to act.
  • the needle 90 may invade under the mucosa of the lesion tissue to introduce a liquid for swelling the tissue.
  • the needle 90 may perform a preparation process for injecting a solution by invading the submucosal layer of the lesion before incisional separation of the lesion tissue.
  • the needle 90 according to the present embodiment may be provided with a needle water inlet 901 at one end thereof to receive liquid from the injection hole 30.
  • the needle 90 may be in communication with the second water channel 3033 to inject drugs and saline.
  • the needle drain 901 may inject the delivered liquid into the submucosal layer to swell the lesion site and the electrode tip 10 so as to easily contact each other.
  • the needle channel 901 may inject a saline solution to swell the tissue before incision and inject a drug to prevent infection of the cells.
  • the fixed switch 40 may include a first holder 401 and a second holder.
  • the fixed switch 40 may fix the electrode tip 10 or the needle 90.
  • the fixed switch 40 may selectively fix one of the electrode tip 10 and the needle 90 as it is moved to one end or the other end by external pressure.
  • the fixed switch 40 when the high frequency knife 1 is set as shown in FIG. 7, the fixed switch 40 may be drawn in a direction entering the drawing by pressure. In this case, the fixing switch 40 may fix the electrode tip 10 by fixing the second fixing rod 3037. Similarly, the fixed switch 40 may be drawn out in the direction from the drawing under the pressure in the opposite direction. In this case, the fixing switch 40 may fix the needle 90 by fixing the first fixing rod 3017.
  • the first holder 401 may fix the electrode tip 10.
  • the first fixing rod 401 may be coupled to the first fixing rod groove 30173 formed in the first fixing rod 3017, and thereby the electrode tip 10 connected to the first fixing rod 3017. This can be fixed. That is, the first holder 401 may fix the electrode tip 10 to the inside of the tip 803 of the tube without fixing the electrode tip 10 to the outside of the tip 803 of the tube.
  • the user may implement the drive of the second water pipe 303, and the needle 90 may be exposed to the outside of the tip of the tube as the second water pipe 303 moves forward.
  • the needle 90 may be fixed by binding the second spring 3035 and the second fixing rod 3037.
  • the second holder may fix the needle 90.
  • the second fixing rod may be bound to the second fixing rod groove formed in the second fixing rod 3037, and thus the needle 90 connected to the second fixing rod 3037 may be fixed. That is, the second holder may fix the needle 90 inside the tip 803 of the tube without fixing the needle 90 outside the tip 803 of the tube.
  • the user can implement the drive forward and backward of the power connector 70, the electrode tip 10 may be exposed to the outside of the front end of the tube as the power connector 70 moves forward.
  • the first spring 3015 and the first fixing rod 3017 may be coupled to fix the electrode tip 10.
  • the second fixing rod is defined as a structure formed for fixing the second fixing rod 3037 at a position symmetrical with the first fixing rod 401.
  • the electrode tip 10 type A may be designed to extend from the tip 803 of the tube to a length of 1.8 mm to 2.2 mm. More preferably, the electrode tip 10 type A may be designed to extend to a length of 2.0 mm from the tip 803 of the tube.
  • the separation distance between the first electrode 103 and the second electrode 105 may be smaller than the separation distance between the second electrode 105 and the tip 803 of the tube.
  • the separation distance between the first electrode 103 and the second electrode 105 may be 0.3 mm to 0.5 mm, and the separation distance between the second electrode 105 and the tip 803 of the tube may be 0.8 mm to It may be formed to 1.0mm. More preferably, the separation distance between the first electrode 103 and the second electrode 105 may be 0.4 mm, and the separation distance between the second electrode 105 and the tip 803 of the tube may be 0.9 mm. have.
  • the electrode tip 10 A type may be designed with a height of the first electrode 103 is 0.3mm to 0.5mm. More preferably, the type A of the electrode tip 10 may be designed such that the height of the first electrode 103 is 0.4 mm. In the electrode tip 10 type A, the height of the second electrode 105 may be designed to be 0.2 mm to 0.4 mm. More preferably, in the electrode tip 10 type A, the height of the second electrode 105 may be designed to be 0.3 mm. As such, the electrode tip 10 A type may be designed to have a height of the first electrode 103 higher than that of the second electrode 105.
  • the electrode tip 10 type A may be designed such that the first electrode 103 and the second electrode 105 have the same diameter.
  • the electrode tip 10 type A may have a diameter of 0.7 mm to 1.2 mm between the first electrode 103 and the second electrode 105. More preferably, the electrode tip 10 type A may be designed such that the diameter of the first electrode 103 and the second electrode 105 is 0.8 mm.
  • side surfaces of the first electrode 103 and the second electrode 105 may be coated with the first insulator 1031 and the second insulator 1051.
  • the electrode tip 10 type A may be formed in a dome shape in which the upper surface of the first electrode 103 is raised, and the upper surface of the second electrode 105 may be provided in a flat shape without being raised.
  • the second electrode 105 may have a side surface coated with the second insulator 1051 and the upper surface and the lower surface may be provided in a flat shape without being raised so that the electrode region may not be exposed to the side surface.
  • the electrode tip 10 B type may be designed to extend from 1.8 mm to 2.2 mm in length from the tip 803 of the tube.
  • the electrode tip 10 type B may be designed to extend 2.0 mm from the tip 803 of the tube.
  • the separation distance between the first electrode 103 and the second electrode 105 may be smaller than the separation distance between the second electrode 105 and the tip 803 of the tube.
  • the separation distance between the first electrode 103 and the second electrode 105 may be 0.4 mm to 0.6 mm, and the separation distance between the second electrode 105 and the tip 803 of the tube may be 0.7 mm or more.
  • 0.9 mm may be formed. More preferably, the separation distance between the first electrode 103 and the second electrode 105 may be 0.5 mm, and the separation distance between the second electrode 105 and the tip 803 of the tube may be 0.8 mm. have.
  • the electrode tip 10 B type may be designed such that the height of the first electrode 103 is 0.3 mm to 0.5 mm. More preferably, the type B of the electrode tip 10 may be designed such that the height of the first electrode 103 is 0.4 mm.
  • the height of the second electrode 105 may be designed to be 0.2 mm to 0.4 mm. More preferably, the type A of the electrode tip 10 may be designed to have a height of 0.3 mm for the second electrode 105. As described above, for the type B of the electrode tip 10, the height of the first electrode 103 may be greater than that of the second electrode 105. It can be designed higher than the height of 105.
  • the electrode tip 10 type B may be designed such that the first electrode 103 and the second electrode 105 have the same diameter.
  • the electrode tip 10 B type may have a diameter of 0.7 mm to 1.2 mm between the first electrode 103 and the second electrode 105. More preferably, the electrode tip 10 type B may have a diameter of 0.8 mm between the first electrode 103 and the second electrode 105.
  • the electrode tip 10 B type is formed in the shape of a dome in which the upper surface of the first electrode 103 is raised, and the upper surface of the second electrode 105 is symmetrically formed with respect to the electrode rod 101 as a central axis.
  • the taper 1053 may be formed by being raised toward the first electrode 103. Therefore, the B type has a difference that the electrode region of the second electrode 105 may be exposed to the side, unlike the A type.
  • the electrode tip 10 to which high frequency is applied and the needle 90 for injecting saline for swelling of the lesion tissue are alternately exposed at the same position of the high frequency knife tip.
  • a knife having a structure in which a fixed switch 40 is formed in one region of the handle 50.
  • the high frequency knife according to the embodiment of FIGS. 6 and 7 requires the user to push / pull the fixed switch 40 in order to alternately discharge the needle 90 and the electrode tip 10.
  • 8 to 11 an embodiment of the high-frequency knife capable of alternately exposing the needle 90 and the electrode tip 10 only by the manipulation of the handle 50 without the additional manipulation requiring the user to use a separate switch.
  • FIG. 8 shows a handle 50 of a high frequency knife in accordance with another embodiment of the present invention.
  • the embodiment of FIG. 8 configures the gear portion 57 in the handle 50 so that the needle 90 and the electrode tip 10 can be alternately exposed by the drawing-in and drawing-out operation of the second handle portion 503. .
  • the high-frequency knife is provided at the tip of the tube 801 is inserted into the body of the both ends of the tube portion 80 and the electrode tip is energized when applying the high frequency to ablate the lesion tissue in the body 10; Needle 90 for invading under the mucosa of lesion tissue to introduce liquid for swelling tissue; And a handle 50 for manipulating the electrode tip 10 and the needle 90.
  • the handle 50 is connected to the electrode tip 10, the first handle portion 501 for advancing and retracting the electrode tip 10, and the agent 90 is connected to the needle 90 to advance and retreat the needle 90
  • the second handle part 503 and the gear part 57 which transmits a force to the 2nd handle part 503 in the direction opposite to the direction of the force applied to the 1st handle part 501 may be included.
  • the electrode tip 10 or the needle 90 may be alternately exposed by only the manipulation of the handle 50 by the gear part 57.
  • the handle 50 may be coupled to the outer circumferential surface of the body of the second handle 503 such that the first handle 501 is slidably movable.
  • the second handle portion 503 may be formed integrally on the high-frequency knife body.
  • the first handle part 501 may be fitted to the outside of the cylindrical body of the second handle part 503 and may be slidably moved forward and backward of the body of the second handle part 503.
  • the second handle portion 503 to which the user inserts the thumb is fixed integrally with the knife body, and the first handle portion 501 to which the user inserts the index finger and the ring finger is relatively moved. Done.
  • the first handle portion 501 may include a holder 5011 protruding in the direction of the second handle portion 503 on the inner side.
  • the first handle 501 may be provided with a first rack gear 571 to be described later on one surface of the inner side and a holder 5011 on the other surface of the inner side.
  • the holder 5011 may be understood as a stopper with a spring and the elastic force of the spring is directed toward the body of the second handle portion 503.
  • the second handle portion 503 may be formed with one or more cut holes 5031 for fixing the holder 5011 in the longitudinal direction on the outer peripheral surface of the body.
  • the holder 5011 may be fixed to a region in which the cut hole 5031 is formed.
  • the high frequency knife according to the present embodiment discharges the electrode tip 10 or the needle 90 alternately, and the handle fixing by the holder 5011 is for fixing the discharged electrode tip 10 or the needle 90. .
  • the gear unit 57 may include a first rack gear 571, a second rack gear 573, and a pinion gear 575.
  • the first rack gear 571 is fixedly coupled to the first handle portion 501.
  • the first rack gear 571 may be formed in the body length direction of the first handle part 501.
  • the second rack gear 573 may be provided in the second handle part 503.
  • the second handle part 503 is formed with a 'b' shaped cavity inside the body, the second rack gear 573 and the pinion gear 575 may be provided in the cavity. That is, the second rack gear 573 may be located inside the second handle 557 and may be coupled to the sliding space in the longitudinal direction of the second handle 557 in the cavity space.
  • the pinion gear 575 is fixedly coupled on the cavity of the second handle portion 503 and is toothed between the first rack gear 571 and the second rack gear 573.
  • first rack gear 571 the first rack gear 571 of the first handle 501 by the first rack gear 571
  • the pinion gear 573 rotates in the movement direction, and the rotational force of the pinion gear 573 moves the second rack gear 573 in the direction opposite to the first rack gear 571.
  • the first rack gear 571 and the second rack gear 573 may be complementarily moved by the movement of the first handle part 501.
  • the first handle part 501 is connected to the electrode tip 10 through the electrode tip connection line 801a
  • the second handle part 503 is connected to the needle 90 through the needle connection line 801b.
  • the needle 90 retreats when the electrode tip 10 moves forward, and when the needle 90 moves forward, the electrode Tip 10 is retracted. Accordingly, it can be understood that the electrode tip 10 or the needle 90 can be selectively exposed to the tip end of the high-frequency knife only by the manipulation of the first handle part 501 of the user.
  • FIG. 10 shows a handle 50 of a high frequency knife in accordance with another embodiment of the present invention.
  • FIG. 10 is a high frequency knife configured to alternately expose the electrode tip 10 or the needle 90 only by the operation of the handle 50 as in the embodiment of FIG. 8.
  • FIG. 10 is a different embodiment from FIG. 8 and uses the configuration of the wire portion 59 instead of the gear portion 57 on the handle 50.
  • the high-frequency knife is provided at the tip of the tube 801 is inserted into the body of the both ends of the tube portion 80, the electrode tip (10) is energized when the application of the high frequency to excise the lesion tissue in the body; Needle 90 for invading under the mucosa of lesion tissue to introduce liquid for swelling tissue; And a handle 50 for manipulating the electrode tip 10 and the needle 90, and the handle 50 is connected to the electrode tip 10 so as to advance and retract the electrode tip 10. And a second handle portion 503 connected to the needle 90 to advance and retract the needle 90, and to the second handle portion 503 in a direction opposite to the direction of the force applied to the first handle portion 501. Including a wire portion 59 for transmitting a force, it is possible to alternately expose the electrode tip 10 or the needle 90 only by the operation of the handle 50.
  • the wire portion 59 may include a rigid wire 593 inserted into the wire tube 591.
  • the second handle portion 503 may be formed with a 'shaped wire tube 591 curved in the rear end direction of the knife.
  • the second handle part 503 is integrally formed with the high frequency knife body.
  • the wire tube 591 has two rows of pipes running parallel to each other along the longitudinal direction of the knife body and bent in the rear end direction of the knife. Has a tilted 'shape.
  • An electrode tip connecting line 801a is inserted into one side of the wire tube 591, and a needle connecting line 801b is penetrated into the other side thereof.
  • the rigid wire 593 is connected to the rear end of the electrode tip connecting line 801a and the rear end of the needle connecting line 801b, respectively, and is inserted into the wire tube 591.
  • FIG. 11 is a view illustrating an operation of the high frequency knife according to the embodiment of FIG. 10.
  • Both ends of the rigid wire 593 are fixedly coupled to the electrode tip connecting line 801a and the needle connecting line 801b, respectively. Therefore, when the first handle part 501 is advanced in the tip direction of the knife, the electrode tip connection line 801a connected to the first handle part 501 is advanced, and a rigid wire fixedly connected to the rear end of the electrode tip connection line 801a is formed. 593 is dragged toward the tip of the knife. In this case, it is noted that the rigid wire 593 is 'bending through the' shaped wire tube 591 so that the other end is fixedly coupled to the needle connecting line 801b.
  • the user may selectively expose the electrode tip 10 or the needle 90 even by operating only the first handle 501.
  • electrode rod 103 first electrode
  • injection hole 301 first injection tube
  • first fixing table 50 handle
  • first handle 5011 holder
  • gear portion 571 first rack gear
  • the high frequency knife according to the present invention has a double blade structure in which a plurality of electrodes are formed in multiple stages at an electrode tip to which high frequency is applied.
  • the present invention is provided with a structure in which the electrode to which the high frequency is applied and the needle for injecting the drug or saline are alternately exposed at the same position of the high frequency knife tip. Accordingly, the medical workers can smoothly hook and incision of the tissue during the operation of the submucosal dissection detachment, can perform marking, incision, exfoliation, water transfer, etc. as a single treatment instrument can be usefully used high frequency knife according to the present invention have.

Landscapes

  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Biomedical Technology (AREA)
  • Otolaryngology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Plasma & Fusion (AREA)
  • Physics & Mathematics (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Abstract

La présente invention permet à un double bord d'un couteau haute fréquence, qui a de multiples électrodes formées en de multiples étapes au niveau de son extrémité, d'être facilement accroché sur un tissu pendant la dissection de tissu, distribue une zone de contact pour empêcher le tissu de se concentrer excessivement au niveau d'une électrode de pointe, et permet au couteau de disséquer sans à-coups un tissu sans glisser à n'importe quel emplacement lorsque le couteau est facilement accroché sur une couche de tissu de lésion.
PCT/KR2017/008103 2017-03-29 2017-07-27 Couteau haute fréquence pour dissection sous-muqueuse endoscopique WO2018182101A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
KR10-2017-0039982 2017-03-29
KR1020170039982A KR101764386B1 (ko) 2017-03-29 2017-03-29 내시경 점막하 절개박리를 위한 고주파 나이프

Publications (1)

Publication Number Publication Date
WO2018182101A1 true WO2018182101A1 (fr) 2018-10-04

Family

ID=59655642

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/KR2017/008103 WO2018182101A1 (fr) 2017-03-29 2017-07-27 Couteau haute fréquence pour dissection sous-muqueuse endoscopique

Country Status (2)

Country Link
KR (1) KR101764386B1 (fr)
WO (1) WO2018182101A1 (fr)

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN110169819A (zh) * 2019-05-31 2019-08-27 江苏美安医药股份有限公司 射频导管转动式出针系统

Families Citing this family (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
KR101764386B1 (ko) * 2017-03-29 2017-08-03 유펙스메드 주식회사 내시경 점막하 절개박리를 위한 고주파 나이프
KR102028413B1 (ko) 2017-11-28 2019-10-04 주식회사 청우메디칼 다중 전극 구조의 공진형 수술 장치
KR102028411B1 (ko) 2017-11-29 2019-10-04 주식회사 청우메디칼 응고와 절제 공정의 자동 수행을 위한 가변 출력 구조의 공진형 수술 장치
CN108814711A (zh) * 2018-08-14 2018-11-16 浙江创想医学科技有限公司 一种新型黏膜切开刀
KR102234752B1 (ko) 2019-04-05 2021-04-02 인제대학교 산학협력단 내시경 점막하 박리 절제술을 위한 가위형 나이프
KR102336100B1 (ko) * 2019-07-10 2021-12-08 유펙스메드 주식회사 복수의 처치구 병용이 가능한 의료용 토출 기구
CN112803218B (zh) * 2021-01-08 2022-07-05 绵阳铂洋科技有限公司 一种用于电缆焊接的冷焊机
KR102679901B1 (ko) 2023-10-31 2024-06-28 황지영 양극성 전극을 사용하는 복합 전기 수술기

Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2007151615A (ja) * 2005-11-30 2007-06-21 Jms Co Ltd 生体用縫合具
JP2007531603A (ja) * 2004-03-31 2007-11-08 ウィルソン−クック・メディカル・インコーポレーテッド 医療装置用の調整可能ハンドル
KR100943130B1 (ko) * 2009-09-15 2010-02-18 주식회사 파인메딕스 내시경 점막하 절제용 처치구
KR101328473B1 (ko) * 2013-06-04 2013-11-13 정명준 3중 가변형 내시경하 점막하층 스마트 속시술기구
JP2014501551A (ja) * 2010-10-28 2014-01-23 クック メディカル テクノロジーズ エルエルシー アブレーションデバイス
KR101764386B1 (ko) * 2017-03-29 2017-08-03 유펙스메드 주식회사 내시경 점막하 절개박리를 위한 고주파 나이프

Family Cites Families (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP4109092B2 (ja) 2002-11-21 2008-06-25 オリンパス株式会社 高周波ナイフ
JP4315725B2 (ja) 2003-04-17 2009-08-19 オリンパス株式会社 高周波ナイフ

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2007531603A (ja) * 2004-03-31 2007-11-08 ウィルソン−クック・メディカル・インコーポレーテッド 医療装置用の調整可能ハンドル
JP2007151615A (ja) * 2005-11-30 2007-06-21 Jms Co Ltd 生体用縫合具
KR100943130B1 (ko) * 2009-09-15 2010-02-18 주식회사 파인메딕스 내시경 점막하 절제용 처치구
JP2014501551A (ja) * 2010-10-28 2014-01-23 クック メディカル テクノロジーズ エルエルシー アブレーションデバイス
KR101328473B1 (ko) * 2013-06-04 2013-11-13 정명준 3중 가변형 내시경하 점막하층 스마트 속시술기구
KR101764386B1 (ko) * 2017-03-29 2017-08-03 유펙스메드 주식회사 내시경 점막하 절개박리를 위한 고주파 나이프

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN110169819A (zh) * 2019-05-31 2019-08-27 江苏美安医药股份有限公司 射频导管转动式出针系统

Also Published As

Publication number Publication date
KR101764386B1 (ko) 2017-08-03

Similar Documents

Publication Publication Date Title
WO2018182101A1 (fr) Couteau haute fréquence pour dissection sous-muqueuse endoscopique
JP5336377B2 (ja) 内視鏡と共に使用するフード部材
US6210416B1 (en) Coaxial needle and severing snare
US5158561A (en) Monopolar polypectomy snare with coagulation electrode
AU2007238753B2 (en) Apparatus and methods for endoscopic resection of tissue
KR101830085B1 (ko) 복수개의 처치구 병용이 가능한 내시경 점막하 절개박리를 위한 고주파 나이프
EP1884214B1 (fr) Équipement de traitement électrochirurgical
JPH08299355A (ja) 高周波ナイフ
JP2004167081A (ja) 高周波ナイフ
CN205359621U (zh) 一种内窥镜用带注射针的高频刀具
WO2012115363A2 (fr) Outil multi-procédure pour la couche sous-muqueuse endoscopique qui exécute une pluralité de modes dans un dispositif par l'intermédiaire d'un module multi-procédure
CN105395251A (zh) 一种内镜用高频电刀
WO2022007732A1 (fr) Outil haute fréquence ayant de multiples fonctions
JP2001178740A (ja) 内視鏡治療装置
WO2022007733A1 (fr) Dispositif de coupe haute fréquence multifonctionnel pour endoscope
WO2016104971A1 (fr) Instrument d'injecteur pour opération endoscopique
US20110245829A1 (en) Endoscopic high-frequency treatment instrument
JP2024084788A (ja) 内視鏡用処置具
JP4965416B2 (ja) 高周波処置具
JPH119610A (ja) 内視鏡用焼灼具
KR20190020601A (ko) 복수개의 처치구 병용이 가능한 내시경 점막하 절개박리를 위한 고주파 나이프
KR102234752B1 (ko) 내시경 점막하 박리 절제술을 위한 가위형 나이프
KR20060028845A (ko) 내시경점막절제시술기구
KR20130062490A (ko) 가변 절개부를 구비한 고주파나이프
CN212234668U (zh) 一种内窥镜用切开刀

Legal Events

Date Code Title Description
121 Ep: the epo has been informed by wipo that ep was designated in this application

Ref document number: 17903059

Country of ref document: EP

Kind code of ref document: A1

NENP Non-entry into the national phase

Ref country code: DE

122 Ep: pct application non-entry in european phase

Ref document number: 17903059

Country of ref document: EP

Kind code of ref document: A1