WO2023027509A1

WO2023027509A1 - Tissue removal device

Info

Publication number: WO2023027509A1
Application number: PCT/KR2022/012669
Authority: WO
Inventors: 김희만
Original assignee: 연세대학교 원주산학협력단
Priority date: 2021-08-27
Filing date: 2022-08-24
Publication date: 2023-03-02

Abstract

A tissue removal device comprises: an insertion member that is inserted into the body; a first treatment member that is positioned inside the insertion member; a second treatment member that is positioned inside the insertion member; a body member that is coupled to the insertion member and is installed so that the first treatment member and the second treatment member pass therethrough; an operation unit that is rotatably coupled to the body member, is coupled to be movable along the longitudinal direction of the body member, receives one end of each of the first treatment member and the second treatment member, and selectively advances or retracts each of the first treatment member and the second treatment member; and a first handle member that is coupled to a portion of the body member where the operation unit is located.

Description

tissue removal device

The present invention relates to a tissue removal device that can be used in procedures to remove a portion of tissue inside the body.

Due to the development of endoscopic equipment and therapeutic endoscopy, tumors occurring in the esophagus, stomach, and large intestine among human digestive organs can be cured through endoscopic tumor resection if detected early.

Endoscopic tumor resection is performed when lesions such as polyps, adenomas, and early cancers without lymph node metastasis are found endoscopically. Endoscopic tumor resection includes endoscopic polypectomy for relatively small polyps, endoscopic mucosal resection for relatively large or flat polyps, and endoscopic submucosal dissection for large and flat polyps.

Endoscopic submucosal dissection resection uses an endoscope to confirm the lesion, and then energizes the area around the lesion using an incision, marks it, and injects physiological saline mixed with a hemostatic agent and dye into the submucosa to swell the mucosa. Thereafter, the marginal part of the early cancer is incised and the submucosal layer is incised to remove the early cancer part.

Endoscopic submucosal dissection resection uses a method of en bloc removal of cancer cells, reducing the possibility of uncertain resection where cancer cells may remain. However, endoscopic submucosal dissection has a disadvantage in that it takes a long time compared to other endoscopic polypectomy. Therefore, there are cases in which submucosal dissection and mucosal resection are used together to shorten the procedure time. When submucosal dissection and mucosal resection are used together, an incision knife and a snare are used as surgical instruments, respectively.

Conventional tissue removal devices capable of combining submucosal dissection and mucosal resection have an incision at the end of the snare, and there is a risk of perforation at an unintended site due to the incision during the snare resection procedure. Accordingly, the need for a tissue resection instrument capable of safely and quickly performing endoscopic submucosal dissection has emerged.

(Patent Document 1) KR Patent Registration No. 10-1585019 (2016.01.14)

An object of the present invention is to provide a tissue removal device that can be rapidly used in combination with submucosal dissection, mucosal resection, and various procedures.

Tissue removal device according to the spirit of the present invention is an insertion member that is inserted into the body; a first treatment member positioned inside the insertion member; a second treatment member positioned inside the insertion member; a third treatment member positioned inside the insertion member; a body member coupled to the insertion member and installed so that the first to third treatment members pass therethrough; rotatably coupled to the body member, movably coupled along the longitudinal direction of the body member, receiving ends of the first treatment member to third treatment member, and receiving the first treatment member to the third treatment member; an operating unit that selectively advances or retracts each; and a first handle member coupled to a portion of the body member where the manipulation unit is located.

Meanwhile, a first catching part is formed at an end of a portion of the first treatment member accommodated in the manipulation unit, and a second catching portion is formed at an end of a portion of the second treatment member accommodated in the manipulation unit. 3 A third hooking part is formed at an end of a portion of the treatment member accommodated in the operation unit, and when the operation unit is positioned adjacent to the first handle member, the operation unit is provided with the first hooking part to the third hooking part. When all of the hooking parts are retracted and the operation unit is moved in a direction away from the first handle member by an external force in a state in which it is positioned adjacent to the first handle member, the operation unit moves from the first hooking part to the first handle member. By advancing a selected one of the third hooking parts, the selected one of the first to third treatment members may be exposed from the insertion member to the outside.

Meanwhile, the body member includes an inner space accommodating the first to third hooking parts, and the operation unit is positioned to surround an outer portion of the body member and rotates and rotates with respect to the body member. a moving member that moves; a push member located in the inner space of the body member and selectively pushing the first to third hooking parts as they are rotated and moved together with the moving member; and a connecting member connecting the movable member and the push member and positioned to pass through the body member.

Meanwhile, the manipulation unit may further include one or more second handle members coupled to the moving member and allowing a part of the user's body to be inserted.

On the other hand, the moving member, the first rotating portion to which the second handle member is coupled; and a second rotation unit coupled to rotate with the first rotation unit.

On the other hand, the push member, the base portion; The shape of the vertical cross-section is made of a rail shape to prevent the first to third hooking parts from being separated from the base part, and in the process of rotating the base part in conjunction with the moving member, the first hooking part to the first hooking part to the third hooking part are prevented. To prevent interference with the third hooking part, the first hooking part to the third hooking part are made to penetrate along the movement trajectory, and any one selected from the first hooking part to the third hooking part is inserted into the insertion member A rail unit that advances to the side; And even if the base part is moved in a direction away from the first handle member by being drawn in from a part of the rail part toward the first handle member, by the rail part among the first hooking part to the third hooking part. It may include; a receiving part for maintaining a state in which the rest of the items that are not advanced are retracted toward the first handle member.

On the other hand, the body member, a plurality of first guide units for guiding the movement path of the connecting member so that the control unit is movable along the longitudinal direction of the body member; and a second guide unit connecting the plurality of first guide units and guiding a movement path of the connecting member so that the control unit is rotatable based on an axial direction of the body member.

Meanwhile, a power supply member installed to pass through the body member and supplying power to at least one of the first treatment member to the third treatment member may be further included.

Meanwhile, a movement limiting member installed outside the body member to limit a movement range of the manipulation unit may be further included.

Meanwhile, a power supply member installed inside the movement limiting member and supplying power to at least one of the first treatment member to the third treatment member may be further included.

Meanwhile, the first handle member may be rotatably coupled to the body member.

Meanwhile, a portion of the first treatment member protruding from the insertion member may be formed of a cutting blade.

Meanwhile, a portion of the second treatment member protruding from the insertion member may be configured as a snare in the shape of a closed curve.

Meanwhile, a portion of the third treatment member protruding from the insertion member may be configured as a nozzle for injecting a liquid medicine into a tissue inside the body.

Meanwhile, a chemical solution supply member installed to penetrate the body member and communicating with the third treatment member to supply a chemical solution to the third treatment member may be further included.

Since the tissue removal device according to an embodiment of the present invention can selectively use a plurality of treatment members, the tissue removal operation time can be shortened compared to the case where a plurality of treatment members are separately provided.

In the tissue removal device according to an embodiment of the present invention, since each treatment member is independently operated, it is possible to prevent unexpected accidents during the procedure and allow the user to safely use the treatment member.

1 is a plan view of a tissue removal device according to an embodiment of the present invention.

2 is a cross-sectional view of the tissue removal device of FIG. 1;

3 is a perspective view illustrating an excerpt of an operating unit.

4 is a cross-sectional perspective view of the operation unit of FIG. 3;

5 is a perspective view illustrating a portion adjacent to a portion where an operation unit is moved in a body member;

6 to 10 are views illustrating the operation of the tissue removal device.

6 is a view showing a state in which the first treatment member is advanced in the tissue removal device.

Figure 7 is a cross-sectional view of the tissue removal device of Figure 6;

8 is a view showing a state in which the second treatment member is advanced in the tissue removal device.

Figure 9 is a cross-sectional view of the tissue removal device of Figure 8;

10 is a view showing a state in which the third treatment member is advanced in the tissue removal device.

11 is a diagram showing a modified example of the operating unit.

The embodiments described in this specification and the configurations shown in the drawings are only one preferred example of the disclosed invention, and there may be various modifications that can replace the embodiments and drawings in this specification at the time of filing of the present application.

The same reference numerals or numerals presented in each drawing in this specification indicate parts or components that perform substantially the same function. It may be exaggerated for a clear description of the shape and size of elements in the drawings.

Terms used in this specification are used to describe the embodiments, and are not intended to limit and/or limit the disclosed invention. Singular expressions include plural expressions unless the context clearly dictates otherwise. In this specification, terms such as "include" or "have" are intended to indicate that there is a feature, number, step, operation, component, part, or combination thereof described in the specification, but one or more other features It does not preclude in advance the existence or addition of numbers, steps, operations, components, parts, or combinations thereof.

Terms including ordinal numbers such as "first" and "second" used herein may be used to describe various components, but the components are not limited by the terms, and the terms are one It is used only for the purpose of distinguishing a component from other components. For example, a first element may be termed a second element, and similarly, a second element may be termed a first element, without departing from the scope of the present invention.

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

1 is a plan view of a tissue removal device according to an embodiment of the present invention, FIG. 2 is a cross-sectional view of the tissue removal device of FIG. 1, FIG. 3 is a perspective view of an operating unit, and FIG. 5 is a cross-sectional perspective view of the control unit, and FIG. 5 is a perspective view of a part adjacent to a part to which the control unit is moved in the body member.

1 to 5, the tissue removal device 100 according to an embodiment of the present invention includes an insertion member 110, a first treatment member 121, a second treatment member 122, and a body member 130. ), an operating unit 150 and a first handle member 140.

Insertion member 110 is inserted into the body. The insertion member 110 for this may be a tube made of a soft material, but is not limited thereto. The free end of the insertion member 110 may have a size and shape through which the first treatment member 121 and the second treatment member 122, which will be described later, can enter and exit.

The first treatment member 121 is located inside the insertion member 110 . The first treatment member 121 may be installed to move forward and backward inside the body member 130 to be described later. Here, the forward direction of the first treatment member 121 is the direction in which the first treatment member 121 moves to be exposed to the outside from the insertion member 110, and the backward direction of the first treatment member 121 moves toward the operation unit 150 to be described later. is the direction to be

A portion of the first treatment member 121 protruding from the insertion member 110 may be formed as a cutting blade 121b. The cutting blade 121b may be used in submucosal dissection resection. The cutting blade 121b is applied with high-frequency power, and may mark a region around a lesion tissue or cut a mucous membrane or submucosa.

The second treatment member 122 is positioned inside the insertion member 110 . The second treatment member 122 may be installed to move forward and backward inside the body member 130 to be described later. A portion of the second treatment member 122 that protrudes from the insertion member 110 may be configured as a noose 122b in the shape of a closed curve.

The snare 122b may be used in mucosal resection. The snare 122b receives high-frequency power, captures the protruding lesion tissue exposed to the outside from the insertion member 110, and then is inserted into the insertion member 110 again to remove the lesion tissue.

Each of the first treatment member 121 and the second treatment member 122 as described above may be spaced apart from each other by a predetermined distance. Accordingly, it is possible to prevent the first treatment member 121 and the second treatment member 122 from interfering with each other while moving forward and backward.

Meanwhile, although not shown in the drawing, the first treatment member 121 and the second treatment member 122 of the tissue removal device 100 according to an embodiment of the present invention include a snare 122b, a cutting blade 121b, and In addition to the nozzle 123b, it may be possible to apply various instruments required for the procedure.

The tissue removal device 100 according to an embodiment of the present invention includes a first treatment member 121 and a second treatment member 122, so that a user can perform multiple tumor resections simultaneously.

The body member 130 is coupled to the insertion member 110 and installed so that the first treatment member 121 and the second treatment member 122 pass therethrough. The shape of the body member 130 may be, for example, a cylindrical shape, but is not limited thereto. The insertion member 110 described above may be coupled to the front end of the body member 130, and the first handle member 140 to be described later may be coupled to the rear end of the body member 130.

Meanwhile, when the user does not use the tissue removal device 100 according to an embodiment of the present invention, a portion of the first treatment member 121 remains accommodated in the insertion member 110, and the remaining portion of the first treatment member 121 remains accommodated in the body. A state accommodated in the member 130 can be maintained. The second treatment member 122 may also be located in the same position as the first treatment member 121 .

The manipulation unit 150 is rotatably coupled to the body member 130 and movably coupled along the longitudinal direction of the body member 130 . Also, the manipulation unit 150 accommodates one end of the first treatment member 121 and the second treatment member 122, and selectively separates the first treatment member 121 and the second treatment member 122, respectively. advance or retreat

The user manipulates the manipulation unit 150 to expose one of the first treatment member 121 and the second treatment member 122 to the outside of the insertion member 110, and selects a treatment member to perform treatment. can be used for A detailed description of the operation unit 150 for this purpose will be described later.

The first handle member 140 is coupled to a portion of the body member 130 where the manipulation unit 150 is located. A user may use the tissue removal device 100 by manipulating the manipulation unit 150 relative to the first handle member 140 . For example, a user may use the tissue removal device 100 by inserting a thumb into the first handle member 140 and gripping the manipulation unit 150 with an index finger and a middle finger, but is not limited thereto.

Meanwhile, the first handle member 140 may be rotatably coupled to the body member 130 . A user may grip the control unit 150 and the first handle member 140 using his or her fingers, and the first handle member 140 may naturally rotate while the control unit 150 rotates. Accordingly, a user can conveniently use the tissue removal device 100 according to an embodiment of the present invention.

As described above, in the tissue removal apparatus 100 according to an embodiment of the present invention, the user can manipulate the manipulation unit 150 to select an instrument to be used for the procedure. That is, since the tissue removal device 100 according to an embodiment of the present invention can selectively use a plurality of treatment members in one device, the tissue removal operation time is reduced compared to the case where a plurality of treatment members are separately provided. can be shortened

To explain the tissue removal device 100 according to an embodiment of the present invention for this purpose in more detail, a first hooking portion ( 121a) may be formed, and a second hooking portion 122a may be formed at an end of a portion of the second treatment member 122 accommodated in the manipulation unit 150.

When the operation unit 150 is positioned adjacent to the first handle member 140, the operation unit 150 is capable of retracting both the first hooking part 121a and the second hooking part 122a. can At this time, one end of both the first treatment member 121 and the second treatment member 122 is accommodated in the insertion member 110 and is not exposed to the outside.

Conversely, when the operation unit 150 is moved in a direction away from the first handle member 140 by an external force in a state in which it is located adjacent to the first handle member 140, the operation unit 150 advances the selected one of the first hooking part 121a and the second hooking part 122a so that the selected one of the first treatment member 121 and the second treatment member 122 is the insertion member ( 110) to be exposed to the outside. A user may use the treatment member exposed to the outside for a procedure.

Meanwhile, although not shown in the drawing, a constant amount of frictional force may be maintained between the body member 130 and the first treatment member 121 and the second treatment member 122 described above. Accordingly, while the first treatment member 121 and the second treatment member 122 are selectively advanced and retracted by the manipulation unit 150, the first treatment member 121 and the second treatment member 122 is not moved by gravity or inertia, and can be accurately moved only by manipulation of the manipulation unit 150.

Hereinafter, the manipulation unit 150 that allows a selected one of the first treatment member 121 and the second treatment member 122 to be exposed to the outside will be described in detail. Prior to describing the manipulation unit 150, the aforementioned body member 130 includes an inner space 133 accommodating the first hooking part 121a and the second hooking part 122a.

The manipulation unit 150 may include, for example, a moving member 151, a pushing member 154, and a connecting member 153.

The movable member 151 is positioned to surround a portion of the outside of the body member 130 and can be rotated and moved with respect to the body member 130 . The shape of the moving member 151 may be, for example, a pipe shape.

The inner diameter of the movable member 151 may correspond to the outer diameter of the body member 130 . The movable member 151 is installed so as to come into close contact with the circumferential surface of the body member 130 and may be moved along the longitudinal direction of the body member 130 or rotated based on the axial direction of the body member 130 .

The push member 154 is located in the inner space 133 of the body member 130. The shape of the push member 154 may be, for example, a piston shape. As the push member 154 rotates and moves in conjunction with the movable member 151, it can selectively push the first clasp 121a and the second clasp 122a. A detailed description of the push member 154 will be described later.

The connection member 153 connects the movable member 151 and the push member 154 and may be positioned to pass through the body member 130 . The connection member 153 may have a cylindrical shape.

The connecting member 153, the pushing member 154, and the moving member 151 may be coupled to each other after being manufactured. Alternatively, the connection member 153, the push member 154, and the moving member 151 may be integrally manufactured, but is not limited thereto.

The aforementioned push member 154 may include, for example, a base part 154a, a rail part 154b, and a receiving part 154c.

The base portion 154a may have a shape that can be accommodated in the inner space 133 of the body member 130 .

The rail part 154b may have a vertical cross-section formed in a rail shape to prevent the first and second hooking

parts

121a and 122a from being separated from the base part 154a. In more detail, the rail portion 154b may include, for example, a first space portion K and a second space portion M. The first space portion K may have a size corresponding to that of the first catching portion 121a to the second catching portion 122a.

Meanwhile, taking the first treatment member 121 among the first treatment member 121 and the second treatment member 122 as an example, the first locking portion 121a of the first treatment member 121 is a cutting blade. (121b) and may be connected with a metal wire, the second space portion (M) may be made of a size corresponding to the diameter of the metal wire. Accordingly, it is possible to prevent the first treatment member 121 from being separated from the rail part 154b.

In addition, the rail part 154b prevents interference with the first hooking part 121a and the second hooking part 122a while the base part 154a is rotated in conjunction with the moving member 151. It may be made to penetrate along the movement trajectory of the first catching part 121a and the second catching part 122a. At this time, the shape of the rail part 154b when viewed from the axial direction of the base part 154a may be a torus shape. When the rail part 154b is formed as described above, the base part 154a can be naturally rotated together with the moving member 151 .

The rail part 154b as described above may advance a selected one of the first catching part 121a and the second catching part 122a toward the insertion member 110 .

The accommodating portion 154c is formed to be retracted from a portion of the rail portion 154b toward the first handle member 140 . Even if the base part 154a is moved in a direction away from the first handle member 140, the accommodating part 154c is the rail part among the first hooking part 121a and the second hooking part 122a. The remainder that is not advanced by (154b) may be maintained in a retracted state toward the first handle member 140.

The above-described first treatment member 121 and second treatment member 122 may be positioned every 180 degrees around the imaginary central axis of the base portion 154a, but is not limited thereto.

When the user wants to move the first treatment member 121 forward, the user rotates the moving member 151 by a certain angle so that the second treatment member 122 is located at a position corresponding to the accommodating portion 154c. .

When the user moves the movable member 151 toward the insertion member 110, the first treatment member 121 may be moved forward by the rail portion 154b. At this time, since the second treatment member 122 maintains a certain amount of frictional force with the body member 130, it can maintain its current position while being accommodated in the accommodating portion 154c.

Then, when the user moves the movable member 151 toward the first handle member 140, the first treatment member 121 may be retreated to the location where the second treatment member 122 is located.

On the other hand, if the above-described body member 130 is described in more detail, the body member 130 may include a plurality of first guide parts 131 and second guide parts 132 as an example.

The first guide part 131 may guide the movement path of the connecting member 153 so that the manipulation unit 150 can move along the longitudinal direction of the body member 130 . The number of first guide parts 131 may be two (131A, 131B). The first guide portion 131 may be penetrated in a slit shape along the longitudinal direction of the body member 130 .

As the connection member 153 rectilinearly reciprocates by either one of the two

first guide members

131A and 131B, the first treatment member 121 and the second treatment member 122 are selectively moved forward and backward. can To this end, the two first guide parts 131 may be positioned parallel to each other and may be positioned at an angle of 180 degrees with respect to a virtual central axis of the body member 130, but is not limited thereto.

The second guide part 132 connects the plurality of first guide parts 131 . The second guide part 132 may connect one end of the plurality of first guide parts 131 to each other so that the plurality of first guide parts 131 communicate with each other.

The second guide part 132 may guide the moving path of the connection member 153 so that the control unit 150 can rotate based on the axial direction of the body member 130 . Like the first guide part 131, the second guide part 132 may also penetrate a part of the body member 130 in a slit shape. The second guide portion 132 may be formed at 180 degrees along the radial direction of the body member 130, but is not limited thereto.

The connecting member 153 of the operation unit 150 connects the moving member 151 and the push member 154 to the first guide part 131 and the second guide part 132 included in the body member 130. ) can be moved along.

When the user rotates the control unit 150, the connecting member 153 moves along the second guide part 132, and when the user advances or retreats the control unit 150, the connecting member 153 moves along the first guide part. Move along (131). The linear movement distance of the manipulation unit 150 may be limited by the length of the first guide part 131 , and the rotation angle of the manipulation unit 150 may be limited by the length of the second guide part 132 .

Meanwhile, the manipulation unit 150 may further include one or more second handle members 152 .

The second handle member 152 is coupled to the movable member 151 and allows a part of the user's body to be inserted. The second handle member 152 may be two, and the second handle member 152 may be positioned opposite to each other with the moving member 151 interposed therebetween.

The second handle member 152 may have a ring shape, but is not limited thereto. The second handle member 152 may allow the user to stably grip the movable member 151 while manipulating the control unit 150 without missing it.

The second handle member 152 may be integrally formed with the moving member 151 . Alternatively, it may be possible that the second handle member 152 is made detachable from the movable member 151 .

Meanwhile, referring to the gripping method of the tissue removal device 100 according to an embodiment of the present invention described above, the user inserts his or her thumb into the first handle member 140 and inserts two of the remaining fingers into the second handle member 140. It can be inserted into the handle member 152.

In the tissue removal device 100 according to an embodiment of the present invention, the first treatment member 121 and the second treatment member 122 are formed by relative movement of the second handle member 152 with respect to the first handle member 140. ) can be implemented.

Meanwhile, the tissue removal device 100 according to an embodiment of the present invention may further include a power supply member 160 .

The power supply member 160 is installed to pass through the body member 130 and may supply power to one or more of the first treatment member 121 and the second treatment member 122 . When both the first treatment member 121 and the second treatment member 122 of the first treatment member 121 and the second treatment member 122 need to receive power and operate, the power supply member 160A; 160B) may be two. In this case, one power supply member 160A may be connected to the first treatment member 121 and the other power supply member 160B may be connected to the second treatment member 122 .

The power supply member 160 may receive power from a wall power source (not shown) or a battery and supply high-frequency current to one or more of the first treatment member 121 and the second treatment member 122 .

Meanwhile, the tissue removal device 100 according to an embodiment of the present invention may further include a movement limiting member 170 .

The movement limiting member 170 may be installed outside the body member 130 to limit the movement range of the manipulation unit 150 . The movement limiting member 170 may be formed in a bar shape and may be installed perpendicular to the longitudinal direction of the body member 130 . The movement limiting member 170 may protrude from a portion of the circumference of the body member 130, but is not limited thereto.

The movement limiting member 170 may be integrally formed with the body member 130 . The movement limiting member 170 may prevent the manipulation unit 150 from excessively moving toward the tube. The shape of the movement limiting member 170 for this purpose may be formed in various forms such as a ring shape and a protrusion shape, for example.

The movement limiting member 170 as described above can prevent the first locking part 121a of the first treatment member 121 from strongly colliding with the rear end of the receiving part 154c when the operation unit 150 moves forward. It may be desirable to be located at a specific location on member 130 .

Meanwhile, the aforementioned first power supply member 160 and second power supply member 160 may be provided on the outer circumferential surface of the body member 130 separately from the movement limiting member 170 .

Alternatively, the power supply member 160 may be installed inside the movement limiting member 170 . In this case, the number of movement limiting members 170 may be the same as the number of power supply members 160 . When there are two power supply members 160, there may also be two movement limiting members 170, but is not limited thereto.

Since the power supply member 160 is installed inside the movement limiting member 170, the structure of the tissue removal device 100 according to an embodiment of the present invention can be simplified.

Hereinafter, the operation process of the tissue removal apparatus 100 according to an embodiment of the present invention will be described with reference to the drawings.

FIG. 6 is a view showing a state in which the first treatment member is advanced from the tissue removal device, and FIG. 7 is a cross-sectional view of the tissue removal device of FIG. 6 .

Referring to FIGS. 6 and 7 , in a state where the manipulation unit 150 of the tissue removal device 100 according to an embodiment of the present invention is positioned as shown in FIG. 2 , the user moves the manipulation unit 150 at a specific angle. It can be rotated and then moved forward. At this time, the connecting member 153 may be advanced along one of the first guide parts 131A among the plurality of first guide parts 131 .

Thereafter, the first hooking part 121a is moved forward by the rail part 154b, and the second hooking part 122a is received in the receiving part 154c and can continue to maintain its retracted current position. Accordingly, the first treatment member 121 is exposed to the outside from the insertion member 110, and the user can perform a procedure using the first treatment member 121.

After the user finishes using the first treatment member 121 , the user may withdraw the manipulation unit 150 . At this time, as shown in FIG. 2 , both the first hooking part 121a and the second hooking part 122a may be retracted by the rail part 154b.

FIG. 8 is a view showing a state in which the second treatment member is advanced from the tissue removal device, and FIG. 9 is a cross-sectional view of the tissue removal device of FIG. 8 .

Referring to FIGS. 8 and 9 , in a state where the manipulation unit 150 of the tissue removal device 100 according to an embodiment of the present invention is positioned as shown in FIG. 2 , the user moves the manipulation unit 150 at a specific angle. It can be rotated and then moved forward. At this time, the connecting member 153 moves by a predetermined distance along the second guide part 132, and is different from the first guide part 131A mentioned in the description of FIG. 7 among the plurality of first guide parts 131. It may advance along any one of the other first guide parts 131B.

Thereafter, the second hooking part 122a moves forward by the rail part 154b, and the first hooking part 121a can continue to maintain its retracted current position while being accommodated in the receiving part 154c. Accordingly, the second treatment member 122 is exposed to the outside from the insertion member 110, and the user may perform a procedure using the second treatment member 122.

After the user finishes using the second treatment member 122, the user withdraws the operation unit 150. At this time, as shown in FIG. 2 , both the first hooking part 121a and the second hooking part 122a may be retracted by the rail part 154b.

11 is a diagram showing a modified example of the operating unit.

Referring to FIG. 11 , the moving member 251 included in the manipulation unit 150 may include a first rotating part 251a and a second rotating part 251b as a modified example.

The first rotating part 251a may be coupled to the second handle member 152 .

The second rotating part 251b may be rotatably coupled to the first rotating part 251a. The second rotation unit 251b and the first rotation unit 251a may rotate relative to each other on a coaxial line.

For this, the coupling structure of the first rotation unit 251a and the second rotation unit 251b includes a locking jaw (not shown) and a locking groove (not shown) at the part where the first rotation unit 251a and the second rotation unit 251b come into contact with each other. It may be formed, but is not limited thereto, and any structure may be used as long as the first rotation unit 251a and the second rotation unit 251b can rotate relative to each other.

In the manipulation unit 150 as described above, even if the first rotation unit 251a is not rotated and only the second rotation unit 251b is rotated, the connecting member 153 can be moved along the second guide unit 132 . That is, the user may rotate and operate the second rotation unit 251b with the other hand while holding the first handle member 140 and the second handle member 152 with one hand.

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

1 to 5 , a tissue removal device 100 according to an embodiment of the present invention includes an insertion member 110, a first treatment member 121, a second treatment member 122, and a third treatment member. 123, a body member 130, an operating unit 150 and a first handle member 140.

Insertion member 110 is inserted into the body. The insertion member 110 for this may be a tube made of a soft material, but is not limited thereto. The free end of the insertion member 110 may have a size and shape through which the first treatment member 121, the second treatment member 122, and the third treatment member 123, which will be described later, can enter and exit.

The third treatment member 123 is located inside the insertion member 110 . The third treatment member 123 may be installed to move forward and backward inside the body member 130 to be described later. A portion of the third treatment member 123 protruding from the insertion member 110 may be configured as a nozzle 123b for injecting a chemical solution into a tissue inside the body.

Each of the first treatment member 121 to the third treatment member 123 as described above may be spaced apart from each other by a predetermined distance. Accordingly, it is possible to prevent the first treatment member 121 to the third treatment member 123 from interfering with each other while moving forward and backward.

Meanwhile, although not shown in the drawing, the first treatment member 121 to the third treatment member 123 of the tissue removal device 100 according to an embodiment of the present invention include a snare 122b, a cutting blade 121b, and In addition to the nozzle 123b, it may be possible to apply various instruments required for the procedure.

The tissue removal device 100 according to an embodiment of the present invention includes a first treatment member 121, a second treatment member 122, and a third treatment member 123, so that a user can simultaneously perform multiple tumor resections. can make it possible

The body member 130 is coupled to the insertion member 110 and installed so that the first treatment member 121 to the third treatment member 123 pass therethrough. The shape of the body member 130 may be, for example, a cylindrical shape, but is not limited thereto. The insertion member 110 described above may be coupled to the front end of the body member 130, and the first handle member 140 to be described later may be coupled to the rear end of the body member 130.

Meanwhile, when the user does not use the tissue removal device 100 according to an embodiment of the present invention, a portion of the first treatment member 121 remains accommodated in the insertion member 110, and the remaining portion of the first treatment member 121 remains accommodated in the body. A state accommodated in the member 130 can be maintained. The second treatment member 122 and the third treatment member 123 may also be located in the same position as the first treatment member 121 .

The manipulation unit 150 is rotatably coupled to the body member 130 and movably coupled along the longitudinal direction of the body member 130 . In addition, the manipulation unit 150 accommodates one end of the first treatment member 121 to the third treatment member 123, and selectively moves each of the first treatment member 121 to the third treatment member 123. advance or retreat

The user manipulates the manipulation unit 150 to expose any one of the first treatment member 121 to the third treatment member 123 to the outside of the insertion member 110, and selects a treatment member to perform treatment. can be used for A detailed description of the operation unit 150 for this purpose will be described later.

To explain the tissue removal device 100 according to an embodiment of the present invention for this purpose in more detail, a first hooking portion ( 121a) may be formed, and a second hooking portion 122a may be formed at an end of a portion of the second treatment member 122 accommodated in the manipulation unit 150. Also, a third hooking part (not shown) may be formed at an end of a portion of the third treatment member 123 accommodated in the manipulation unit 150 .

When the manipulation unit 150 is positioned adjacent to the first handle member 140, the manipulation unit 150 may retract all of the first catching portion 121a to the third catching portion. At this time, one end of all of the first treatment member 121 to the third treatment member 123 is accommodated in the insertion member 110 and is not exposed to the outside.

Conversely, when the operation unit 150 is moved in a direction away from the first handle member 140 by an external force in a state in which it is located adjacent to the first handle member 140, the operation unit 150 advances the selected one of the first hooking part 121a to the third hooking part so that the selected one of the first treatment member 121 to the third treatment member 123 is removed from the insertion member 110 exposed to the outside. A user may use the treatment member exposed to the outside for a procedure.

Meanwhile, although not shown in the drawings, a constant amount of frictional force may be maintained between the body member 130 and the aforementioned first treatment member 121, second treatment member 122, and third treatment member 123. . Accordingly, while the first treatment member 121, the second treatment member 122, and the third treatment member 123 are selectively advanced and retracted by the operation unit 150, the first treatment member 121 , The second treatment member 122 and the third treatment member 123 are not moved by gravity or inertia, and can be accurately moved only by manipulation of the manipulation unit 150.

Hereinafter, the operation unit 150 that allows the selected one of the first treatment member 121 to the third treatment member 123 to be exposed to the outside will be described in detail. Meanwhile, the aforementioned body member 130 includes an inner space 133 accommodating the first catching part 121a to the third catching part.

The push member 154 is located in the inner space 133 of the body member 130. The shape of the push member 154 may be, for example, a piston shape. As the push member 154 rotates and moves in conjunction with the movable member 151, the first catching portion 121a to the third catching portion may be selectively pushed. A detailed description of the push member 154 will be described later.

The rail part 154b may have a vertical cross-section formed in a rail shape to prevent the first hooking part 121a to the third hooking part from being separated from the base part 154a. In more detail, the rail portion 154b may include, for example, a first space portion K and a second space portion M. The first space portion K may have a size corresponding to that of the first catching portion 121a to the second catching portion 122a.

Meanwhile, taking the first treatment member 121 among the first treatment member 121 to the third treatment member 123 as an example, the first hooking portion 121a of the first treatment member 121 is a cutting blade. (121b) and may be connected with a metal wire, the second space portion (M) may be made of a size corresponding to the diameter of the metal wire. Accordingly, it is possible to prevent the first treatment member 121 from being separated from the rail part 154b.

In addition, the rail part 154b prevents interference with the first hooking part 121a to the third hooking part while the base part 154a is rotated in conjunction with the moving member 151. It may be formed to penetrate along the movement trajectory of the first hooking part 121a to the third hooking part. At this time, the shape of the rail part 154b when viewed from the axial direction of the base part 154a may be a torus shape. When the rail part 154b is formed as described above, the base part 154a can be naturally rotated together with the moving member 151 .

The rail part 154b as described above may advance any selected one of the first hooking part 121a to the third hooking part toward the insertion member 110 side.

The accommodating portion 154c is formed to be retracted from a portion of the rail portion 154b toward the first handle member 140 . Even when the base part 154a is moved in a direction away from the first handle member 140, the accommodating part 154c is the rail part 154b among the first hooking part 121a to the third hooking part. The rest of the items that are not advanced by the may be maintained in a retracted state toward the first handle member 140.

The aforementioned first treatment member 121 to third treatment member 123 may be positioned every 120 degrees around the virtual central axis of the base portion 154a. At this time, there may be two accommodating parts 154c. Each of the two accommodating parts 154c may be formed at an angle of 120 degrees around the imaginary central axis of the base part 154a, but is not limited thereto.

When the user wants to move the first treatment member 121 forward, the user rotates the moving member 151 by a certain angle so that the second treatment member 122 and the third treatment member 123 are two accommodating parts ( 154c) to be located at a position corresponding to each.

When the user moves the movable member 151 toward the insertion member 110, the first treatment member 121 may be moved forward by the rail portion 154b. At this time, since the second treatment member 122 and the third treatment member 123 maintain a constant frictional force with the body member 130, they can maintain their current positions while being accommodated in the accommodating portion 154c.

Then, when the user moves the movable member 151 toward the first handle member 140, the first treatment member 121 retreats to the position where the second treatment member 122 and the third treatment member 123 are located. It can be.

The first guide part 131 may guide the movement path of the connecting member 153 so that the manipulation unit 150 can move along the longitudinal direction of the body member 130 . The number of first guide parts 131 may be three (131A, 131B, 131C). The first guide portion 131 may be penetrated in a slit shape along the longitudinal direction of the body member 130 .

As the connection member 153 is linearly reciprocated by any one of the three

first guide members

131A, 131B, and 131C, the first treatment member 121, the second treatment member 122, and the third treatment member (123) can be selectively advanced and retracted. To this end, the three first guide parts 131 may be positioned parallel to each other and may be positioned at an angle of 120 degrees with respect to the imaginary central axis of the body member 130, but is not limited thereto.

The second guide part 132 may guide the moving path of the connection member 153 so that the control unit 150 can rotate based on the axial direction of the body member 130 . Like the first guide part 131, the second guide part 132 may also penetrate a part of the body member 130 in a slit shape. The second guide portion 132 may be formed at 240 degrees along the radial direction of the body member 130, but is not limited thereto.

In the tissue removal device 100 according to an embodiment of the present invention, the first treatment member 121 and the second treatment member 122 are formed by the relative movement of the second handle member 152 with respect to the first handle member 140. ) and advancement and retraction of the third treatment member 123 can be implemented.

The power supply member 160 is installed to pass through the body member 130 and may supply power to one or more of the first treatment member 121 to the third treatment member 123 . When the first treatment member 121 and the second treatment member 122 of the first treatment member 121 to the third treatment member 123 need to receive power and operate, the

power supply members

160A and 160B ) can be two. In this case, one power supply member 160A may be connected to the first treatment member 121 and the other power supply member 160B may be connected to the second treatment member 122 .

The power supply member 160 may receive power from a wall power source (not shown) or a battery and supply high-frequency current to one or more of the first treatment member 121 to the third treatment member 123 .

Meanwhile, the tissue removal device 100 according to an embodiment of the present invention may further include a chemical solution supply member 180 .

The chemical solution supply member 180 is installed to pass through the body member 130 and communicates with the third treatment member 123 to supply a chemical solution to the third treatment member 123 . The chemical solution supply member 180 may receive the chemical solution from a storage tank (not shown) and supply the chemical solution to the third treatment member 123 . Alternatively, it may be possible to supply the chemical solution to the third treatment member 123 after the chemical solution is stored in the chemical solution supply member 180 itself.

After that, the first hooking part 121a is advanced by the rail part 154b, and the second hooking part 122a and the third hooking part can be accommodated in the accommodating part 154c and continue to maintain the retracted current position. Accordingly, the first treatment member 121 is exposed to the outside from the insertion member 110, and the user can perform a procedure using the first treatment member 121.

After the user finishes using the first treatment member 121 , the user may withdraw the manipulation unit 150 . At this time, as shown in FIG. 2 , all of the first catching part 121a, the second catching part 122a, and the third catching part (not shown) may be retracted by the rail part 154b.

Thereafter, the second hooking part 122a moves forward by the rail part 154b, and the first hooking part 121a and the third hooking part can continue to maintain their retracted current positions while being accommodated in the receiving part 154c. Accordingly, the second treatment member 122 is exposed to the outside from the insertion member 110, and the user may perform a procedure using the second treatment member 122.

After the user finishes using the second treatment member 122, the user withdraws the operation unit 150. At this time, as shown in FIG. 2 , all of the first catching part 121a, the second catching part 122a, and the third catching part (not shown) may be retracted by the rail part 154b.

Referring to FIG. 10 , the user manipulates the manipulation unit 150 and the third treatment member 123 is exposed from the insertion member 110 to the outside. A case where the user intends to use the third treatment member 123 may also be performed by a process similar to that described above, and thus a detailed description thereof will be omitted.

11 is a diagram showing a modified example of the operating unit.

Referring to FIG. 11 , the moving member 251 included in the manipulation unit 150 may include a first rotation unit 251a and a second rotation unit 251b as a modified example.

The first rotating part 251a may be coupled to the second handle member 152 .

In the above, the configuration and characteristics of the present invention have been described based on the embodiments of the present invention, but the present invention is not limited thereto, and various changes or modifications can be made within the spirit and scope of the present invention. It is obvious to those of ordinary skill in the art, and thus such changes or modifications are within the scope of the appended claims.

The present invention is implemented as a tissue removal device that can be used in combination with submucosal dissection resection, mucosal resection, and various procedures, but can be applied to various industrial fields within the range of taking the same configuration as in the present invention.

Claims

Insertion member to be inserted into the body;

a first treatment member positioned inside the insertion member;

a second treatment member positioned inside the insertion member;

a body member coupled to the insertion member and installed so that the first treatment member and the second treatment member pass therethrough;

rotatably coupled to the body member, movably coupled along the longitudinal direction of the body member, receiving end portions of the first treatment member and the second treatment member, and comprising the first treatment member and the second treatment member. an operating unit that selectively advances or retracts each of the treatment members; and

and a first handle member coupled to a portion of the body member where the manipulation unit is located.
According to claim 1,

A first hooking portion is formed at an end of a portion of the first treatment member accommodated in the operation unit,

A second hooking part is formed at an end of a portion of the second treatment member accommodated in the operation unit,

When the operating unit is positioned adjacent to the first handle member, the operating unit retracts both the first engaging portion and the second engaging portion;

When the operation unit is moved in a direction away from the first handle member by an external force in a state in which it is located adjacent to the first handle member, the operation unit may be selected from among the first hook member and the second hook member. A tissue removal device for exposing a selected one of the first treatment member and the second treatment member to the outside from the insertion member by advancing one.
According to claim 2,

The body member includes an inner space accommodating the first holding portion and the second holding portion,

The control unit is

a movable member positioned to surround a portion of the exterior of the body member and rotated and moved with respect to the body member;

a push member located in the inner space of the body member and selectively pushing the first and second hooking parts as they are rotated and moved together with the moving member; and

Tissue removal device comprising: a connecting member connecting the movable member and the push member and positioned to pass through the body member.
According to claim 3,

The control unit is

and at least one second handle member coupled to the movable member and allowing a user's body part to be inserted therein.
According to claim 4,

The moving member,

a first rotation unit coupled to the second handle member; and

Tissue removal device comprising a; second rotation unit coupled to be rotatably coupled to the first rotation unit.
According to claim 3,

The push member,

base part;

The shape of the vertical section is made in the shape of a rail so that the first and second hooking parts are prevented from being separated from the base part, and the first hooking part and the first hooking part and the base part are rotated together with the moving member. To prevent interference of the second catching portion, the first catching portion and the second catching portion are passed through along the movement trajectory, and a selected one of the first catching portion and the second catching portion is directed toward the insertion member. a rail unit that advances; and

Even if the base part is moved in a direction away from the first handle member because it is formed to be retracted from a part of the rail part toward the first handle member, the rail part of the first hooking part and the second hooking part advances by the rail part. Tissue removal device comprising a; accommodating portion for maintaining a state in which the remainder is not retracted toward the first handle member.
According to claim 3,

The body member,

a plurality of first guide units for guiding a moving path of the connecting member so that the control unit is movable along the longitudinal direction of the body member; and

and a second guide unit connecting the plurality of first guide units and guiding a movement path of the connection member so that the manipulation unit is rotatable relative to an axial direction of the body member.
According to claim 1,

and a power supply member installed to pass through the body member and supplying power to at least one of the first treatment member and the second treatment member.
According to claim 1,

and a movement limiting member installed outside the body member to limit a movement range of the manipulation unit.
According to claim 9,

and a power supply member installed inside the movement limiting member and supplying power to at least one of the first treatment member and the second treatment member.
According to claim 1,

The first handle member tissue removal device is rotatably coupled to the body member.
According to claim 1,

The tissue removal device of claim 1 , wherein a portion protruding from the insertion member in the first treatment member is a cutting blade.
According to claim 1,

The tissue removal device of claim 1 , wherein a portion of the second treatment member protruding from the insertion member is formed of a snare having a closed curve shape.
Insertion member to be inserted into the body;

a first treatment member positioned inside the insertion member;

a second treatment member positioned inside the insertion member;

a third treatment member positioned inside the insertion member;

a body member coupled to the insertion member and installed so that the first to third treatment members pass therethrough;

rotatably coupled to the body member, movably coupled along the longitudinal direction of the body member, receiving end portions of the first treatment member to third treatment member, and receiving the first treatment member to third treatment member; an operating unit that selectively advances or retracts each; and

and a first handle member coupled to a portion of the body member where the manipulation unit is located.
According to claim 14,

A first hooking portion is formed at an end of a portion of the first treatment member accommodated in the operation unit,

A second hooking part is formed at an end of a portion of the second treatment member accommodated in the operation unit,

A third hooking portion is formed at an end of a portion of the third treatment member accommodated in the operation unit,

When the operating unit is positioned adjacent to the first handle member, the operating unit retracts both the first to the third engaging portions;

When the operation unit is moved in a direction away from the first handle member by an external force in a state in which it is located adjacent to the first handle member, the operation unit may be selected from among the first hooking part to the third hooking part. A tissue removal device for exposing selected one of the first to third treatment members from the insertion member by advancing one of them.
According to claim 15,

The body member includes an inner space accommodating the first to third holding parts,

The control unit is

a movable member positioned to surround a portion of the exterior of the body member and rotated and moved with respect to the body member;

a push member located in the inner space of the body member and selectively pushing the first to third hooking parts as they are rotated and moved together with the moving member; and

Tissue removal device comprising: a connecting member connecting the movable member and the push member and positioned to pass through the body member.
According to claim 16,

The control unit is

and at least one second handle member coupled to the movable member and allowing a user's body part to be inserted therein.
According to claim 17,

The moving member,

a first rotation unit coupled to the second handle member; and

Tissue removal device comprising a; second rotation unit coupled to be rotatably coupled to the first rotation unit.
According to claim 16,

The push member,

base part;

The shape of the vertical cross-section is made of a rail shape to prevent the first to third hooking parts from being separated from the base part, and in the process of rotating the base part in conjunction with the moving member, the first hooking part to the first hooking part to the third hooking part are prevented. To prevent interference with the third hooking part, the first hooking part to the third hooking part are made to penetrate along the movement trajectory, and any one selected from the first hooking part to the third hooking part is inserted into the insertion member A rail unit that advances to the side; and

Even if the base part is moved in a direction away from the first handle member because it is formed to be retracted from a part of the rail part toward the first grip member, the rail part among the first hooking part to the third hooking part moves forward. Tissue removal device comprising a; accommodating portion to keep the remaining things are retracted toward the first handle member.
According to claim 16,

The body member,

a plurality of first guide units for guiding a moving path of the connecting member so that the control unit is movable along the longitudinal direction of the body member; and

and a second guide unit connecting the plurality of first guide units and guiding a movement path of the connecting member so that the manipulation unit is rotatable based on an axial direction of the body member.
According to claim 14,

and a power supply member installed to pass through the body member and supplying power to at least one of the first to third treatment members.
According to claim 14,

and a movement limiting member installed outside the body member to limit a movement range of the manipulation unit.
According to claim 22,

and a power supply member installed inside the movement limiting member and supplying power to at least one of the first treatment member and the second treatment member.
According to claim 14,

The first handle member tissue removal device is rotatably coupled to the body member.
According to claim 14,

The tissue removal device of claim 1 , wherein a portion protruding from the insertion member in the first treatment member is a cutting blade.
According to claim 14,

The tissue removal device of claim 1 , wherein a portion of the second treatment member protruding from the insertion member is formed of a noose having a shape of a closed curve.
According to claim 14,

The tissue removal device of claim 1 , wherein the portion protruding from the insertion member of the third treatment member is formed of a nozzle for injecting a chemical solution into a tissue inside the body.
According to claim 14,

and a chemical solution supply member installed to penetrate the body member and communicating with the third treatment member to supply a chemical solution to the third treatment member.