JP3132319B2 - Dipole electric scalpel - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a dipole electric scalpel. More specifically, the present invention provides a dipole capable of suppressing rotation and twisting of the conductive filaments during operation and preventing short-circuiting between the conductive filaments and dropping of the conductive filaments from the spacer. Regarding electric scalpel.

[0002]

2. Description of the Related Art An electrosurgical scalpel is an electrosurgical instrument utilizing high-frequency electric energy. Since an electric surgical instrument can be electrically incised without giving an electric shock to a living body, bleeding during surgery can be reduced. In recent years, it has been widely used. The electric scalpel uses the action of high-frequency electrical energy between the electrode of the scalpel and living tissue,
There are monopole electric scalpels and dipole electric scalpels. Monopole electric scalpels have the advantage of being excellent in cutting power of living tissue and having little bleeding when cutting, but since the required power is as high as about 500 W, the range of living tissue to be cut is wide, so It is not suitable for cutting the details of living tissue. On the other hand, the dipole electric scalpel can be operated with a low power requirement, and the range of the living tissue to be cut is narrow, so that it is suitable for cutting the details of the living tissue. The dipole electric scalpel has a first conductive filament and a second conductive filament slidable in the longitudinal direction in the lumen of the tube, and the first conductive filament using an insulating spacer. It is known that a loop is formed by connecting the tip of the strip to the tip of the second conductive filament (JP-A-2-291850, JP-A-4-4-2).
No. 41853, JP-A-4-325151). In such a dipole electric scalpel, the first conductive striatum and the second conductive striated body are slid in the lumen, and the first conductive striated body and the second conductive striated body are exposed from the distal end of the tube. When the conductive filament is housed in the lumen of the tube, the first and second conductive filaments exposed from the distal end of the tube rotate and twist, so that the first conductive filament is twisted. The short-circuit between the striatum and the second conductive striated body, and furthermore, since the striated body rotates in the hole of the spacer, the adhesive layer is broken and the conductive striated body falls off the spacer. there were.

[0003]

SUMMARY OF THE INVENTION The present invention suppresses the rotation and torsion of the first and second conductive filaments, short-circuits between the conductive filaments, and reduces the conductive filaments. An object of the present invention is to provide a dipole electric scalpel capable of preventing the spacer from falling off and performing a stable operation.

[0004]

Means for Solving the Problems The inventors of the present invention have made intensive studies to solve the above-mentioned problems, and as a result, provided a hole for fitting the tip of the conductive filament in the spacer, and It has been found that by providing a movable space for the conductive filament in the fitting hole of the hole, rotation and twist of the conductive filament can be suppressed, and the present invention has been completed based on this finding. That is, the present invention relates to [1] a dipole electric scalpel having a tube, a first conductive striated body, a second conductive striated body, a conductive striated body operating section, and a spacer; Has a lumen communicating from the proximal end to the distal end, and (2) the first conductive filament and the second conductive filament are slidable in the longitudinal direction within the lumen of the tube. (3) the first conductive filament and the second conductive filament are electrically inserted from the proximal end to the distal end of the tube and exposing the distal end from the distal end of the tube; (4) The conductive filament operating part is installed on the proximal end side of the tube, and is connected to the rear end of the first conductive filament and the rear end of the second conductive filament. And a mechanism for sliding the first and second conductive filaments in the longitudinal direction of the tube. (5) The spacer is It is those made of an electrically insulating material,
It has two holes for fitting the tip of the first conductive filament and the tip of the second conductive filament, and the fitting hole of the two holes has the conductive filament. A movable margin is provided, which is provided at the tip of the first conductive filament and the tip of the second conductive filament, and (6) the tip of the first conductive filament and the second conductive filament. A dipole electric scalpel is provided, which is fitted to a hole of the spacer and electrically connected to a distal end of the striatum. Further, as a preferred embodiment of the present invention, [2] The dipole according to [1], wherein a projection is provided at a portion located at a tip of the conductive filament and located at a movable margin when fitted into the hole of the spacer. [3] The dipole electric scalpel according to [2], wherein the protrusion is located in a direction in which there is no surrounding wall in the movable margin, and the tip of the conductive filament is fitted into the hole of the spacer. [4] The dipole electric scalpel according to any one of [1] to [3], wherein the holes of the spacer are perforated in parallel, and [5] The length of the hole is 20 to 80% of the length of the spacer. And the length of the movable margin is 80 to 20% of the length of the spacer.
[1] to [4].

Hereinafter, the present invention will be described in detail with reference to the drawings. FIG. 1 is a partial cross-sectional view of the dipole electric scalpel of the present invention. The dipole electric scalpel of the present invention is formed by a tube 1, a first conductive filament 2, a second conductive filament 3, a conductive filament operating part 4, and a spacer 5. The tube has a lumen 8 communicating from a proximal end 6 to a distal end 7, into which a conductive filament or the like is inserted. There is no particular limitation on the material of the tube, and metals such as stainless steel or plastics such as polyethylene, polypropylene, polyvinyl chloride, polyurethane, polyamide, polyester, polycarbonate, polyether sulfone can be used. A material having an appropriate elastic modulus can be selected accordingly. In the dipole electric scalpel of the present invention, the first conductive striated body and the second conductive striated body are longer than the tube, and can be slid in the longitudinal direction within the lumen of the tube near the tube. It is inserted from the distal end to the distal end, and the tip is exposed from the distal end of the tube. Further, the first conductive filament and the second conductive filament are electrically insulated from each other. There is no particular limitation on the method of electrically insulating the two conductive filaments from each other. For example, when the tube is an electrical insulator, as shown in FIG.
The first conductive wire and the second conductive wire are inserted and fixed, and one conductive wire is inserted through the resin tube, and the other conductive wire is inserted into the tube lumen. The strip can be insulated. When the tube is made of a conductive material such as a metal, the tube can be treated in the same manner as an electrically insulating tube by coating the inner surface of the tube with an insulating material. Alternatively, when the tube is made of a conductive material, by inserting the first conductive filament and the second conductive filament respectively into the resin tube, or by using a resin tube having two lumens The two conductive filaments can be electrically insulated from each other by inserting the conductive filaments into the respective lumens or by providing an insulating coating layer on the surface of the conductive filaments. it can. In the dipole electric scalpel of the present invention, the material of the first conductive striatum and the second conductive striatum,
Any conductive material can be used without particular limitation. Examples of such a conductive material include gold, silver,
Examples thereof include simple metals such as platinum, nickel, iron, aluminum, tin, and zinc, and alloys such as stainless steel and nichrome. The structure of the conductive wire may be either a single wire or a stranded wire, and the stranded wire includes a single wire and a coil surrounding the core wire. The outer diameter of the conductive striatum can be arbitrarily selected depending on the surgical site, but is usually 0.1 to 1 mm, preferably 0.2 to 1 mm.
A 0.6 mm one is used. By making the inner diameter of the resin tube through which the conductive wire is inserted larger than the outer diameter of the conductive wire, the conductive wire can be slid in the long axis direction in the lumen. The material of the resin tube through which the conductive filament is inserted is not particularly limited, and examples thereof include polyethylene, polypropylene, and polytetrafluoroethylene.

The dipole electric scalpel of the present invention is provided at the proximal end side of the tube and is connected to the rear end of the first conductive filament and the rear end of the second conductive filament. A conductive wire operating unit 4 having a mechanism for sliding the conductive wire and the second conductive wire in the longitudinal direction of the tube is provided. By operating the conductive filament operating section, the conductive filament can be slid in the tube lumen, and the conductive filament exposed at the distal end can be housed or exposed in the lumen. .
The structure of the conductive filament operating section can be used without any particular limitation as long as the two conductor filaments can be slid in the longitudinal direction in the tube lumen. Lever 10 movable in the longitudinal direction as shown in FIG.
And a moving member that moves in the long axis direction in conjunction therewith, or a rotating member and a moving member that moves in the long axis direction in conjunction with the rotation of the rotating member May be provided. The rear end of the first conductive filament and the rear end of the second conductive filament are further connected to the high-frequency current generator 13 through the terminal 11 and the cord 12. In the dipole electric scalpel of the present invention, the distal end of the first conductive filament and the distal end of the second conductive filament exposed from the distal end of the tube are fitted into the holes of the spacer 5, respectively. Electrically insulated via a loop 1 between the spacer and the distal end of the tube.
5 is formed. At the time of the treatment, first, the exposed portion of the distal end of the conductive striatum from the distal end of the tube is enlarged by operating the conductive striated body operation section, and a large loop is formed. Next, the loop is placed around the affected part to be resected, such as a polyp, and is slid in the direction in which the conductive striatum is housed in the tube lumen. Upon activation, the affected area is excised with electrical energy. The spacer used for the dipole electric scalpel of the present invention is made of an electric insulator, and has two holes for fitting the tip of the first conductive filament and the tip of the second conductive filament. In addition, there is a movable allowance for the conductive linear body in the fitting holes of these holes. FIG. 2 is a perspective view of one embodiment of a spacer used for the dipole electric knife of the present invention. In this figure, for easy understanding, the invisible portions of the hole 16 and the movable margin 17 are indicated by dotted lines. 3 is a four-view drawing of one embodiment of the spacer used in the dipole electric knife of the present invention shown in FIG. 2, FIG. 3 (a) is a front view, FIG. 3 (b) is a plan view, FIG.
3C is a bottom view, and FIG. 3D is a side view. FIG.
4A is a cross-sectional view of one embodiment of a spacer used for the dipole electric knife of the present invention shown in FIG. 4A, FIG. 4A is a cross-sectional view taken along line AA of FIG. 3B, and FIG. It is sectional drawing of the AA of FIG.3 (b) in the state which fitted the striatum.

The material of the spacer used in the dipole electric knife of the present invention is not particularly limited, and an electric insulating material having appropriate strength, heat resistance and workability can be used. For example, alumina, ceramics such as zirconia, polybenzimidazole,
Heat-resistant plastics such as polyether sulfone can be used. The size of the spacer used for the dipole electric knife of the present invention is not particularly limited, and can be selected according to the outer diameter of the conductive striatum, etc., and the diameter is usually 0.5 to 5 mm, preferably, The length is usually 0.5 to 5 mm, preferably 1 to 3 mm. The spacer used for the dipole electric scalpel of the present invention is provided with two holes for fitting the conductive filaments. Preferably, the two holes have a columnar inner surface to which the tip of the first conductive filament and the tip of the second conductive filament can be fitted, respectively, and are preferably substantially parallel. Preferably, the inner diameter of the hole is slightly larger than the outer diameter of the conductive filament so that the conductive filament can fit. The length of the hole in the spacer is
It is preferably 20 to 80% of the length of the spacer (FIG. 4), and more preferably 40 to 70% of the length of the spacer. The hole of the spacer is usually penetrated, but may be a non-penetrated hole having a hole bottom. There is no particular limitation on the method of fixing the conductive linear body fitted in the hole of the spacer, and for example, it is fixed by ordinary bonding. As shown in FIG. 4 (c), the end of the conductive filament that penetrates the hole of the spacer is crushed and widened to form a fitting 14, and the filament is prevented from coming off by being hooked on the edge of the hole of the spacer. I can do it. The spacer used in the dipole electric knife of the present invention is provided with a movable allowance. The movable margin consists of a wall surrounding the fitting hole of the hole, and the conductive striated body can move in the bending direction of the loop formed by the conductive striated body, that is, in the back-to-back direction. , For example, in a direction perpendicular to the bending direction of the loop. An example of a method of processing a movable margin will be described for the columnar spacer of the embodiment shown in FIGS. In the axial direction of the cylindrical spacer material, two holes 16 slightly larger than the outer diameter of the conductive filament are formed.
Next, for a fixed length portion on the fitting opening side of the hole, a space having a width substantially equal to the diameter of the hole of the spacer is cut in the circumferential direction from the hole to form the movable margin 17. it can. In the spacer used in the dipole electric scalpel of the present invention, the width of the movable margin is slightly larger than the outer diameter of the conductive filament, and is approximately equal to the diameter of the hole for fitting the conductive filament. preferable. The length of the movable margin is 20 to 80% of the length of the spacer, preferably 30%.
Desirably, it is 60%.

The spacer used in the dipole electric scalpel of the present invention is provided with a movable margin so that the conductive filament can be slid to expose or store the tip of the conductive filament from the distal end of the tube. In addition, since the conductive linear body fitted to the spacer can be bent and deformed in the bending direction of the loop at the movable portion, the rotation and twist of the conductive linear body can be prevented. The conductive filament used for the dipole electric scalpel of the present invention is preferably provided with a projection 18 near the tip. The projection is provided so as to be positioned at a movable portion of the spacer when the conductive filament is fitted in the hole of the spacer. When the conductive filament is fitted into the hole of the spacer, it is preferable that the projection be positioned in a direction in which there is no surrounding wall in the movable space as shown in FIGS. 2 and 4B. By providing the projection at this position, the rotation of the conductive filament in the positional relationship with the spacer can be more completely prevented, and the destruction of the bonding portion and the short circuit due to the twist can be prevented. The shape of the spacer used for the dipole electric scalpel of the present invention is not limited to a columnar shape, and any shape can be selected according to a surgical site or the like. FIG. 5 is a perspective view of another embodiment of the spacer used in the dipole electric scalpel of the present invention. In this figure, the holes 16 and the movable
The invisible part of is displayed with a dotted line. FIG. 5 (a) shows a shell-type spacer, in which a hole is not penetrated. FIG. 5B shows a spherical spacer, and FIG. 5C shows a dish-shaped spacer. FIG. 5 (d)
Is a columnar spacer in which a partition between two movable margins is removed and a movable margin is integrated. Further, the spacer shown in FIG. 5 may be flat like an elliptical columnar spacer. The effect of the present invention can also be obtained by such a spacer. In the conventional dipole electric scalpel, in a state where the conductive filament is exposed from the lumen and forms a loop, the conductive filament is bent and deformed in the vicinity of the fitting port, and the state having the distortion is generated. When the conductive filament was stored in the lumen, the conductive filament rotated and twisted as the loop became smaller. In the dipole electric scalpel of the present invention, since the movable margin (wall portion) is provided at one of the fitting openings of the spacer, the conductive filament is movable when the conductive filament forms a loop. It moves within the margin and the bending near the fitting opening is reduced, whereby the distortion of the conductive filament is reduced, rotation and torsion are suppressed, and no short circuit or falling off occurs. Furthermore, if the width of the movable margin is set to be substantially the same as the outer diameter of the conductive filament, and if a projection is provided on the surface of the part that moves within the movable margin of the conductive filament, the conductive filament rotates. Even if a force is applied, the projections hit the wall of the movable margin and inhibit rotation of the conductive filament. Therefore, distortion of the conductive filament is small, rotation and torsion are suppressed, and short circuit and dropout do not occur.

[0009]

The dipole electric scalpel of the present invention provides a movable space in the fitting hole of the hole of the spacer to reduce the bending of the conductive striated body, so that the tip of the conductive striated body is exposed and stored. In this case, the rotation and twist are suppressed, and a stable operation can be performed without causing a short circuit of the conductive filament or dropping from the spacer.

[Brief description of the drawings]

FIG. 1 is a partial cross-sectional view of a dipole electric scalpel of the present invention.

FIG. 2 is a perspective view of one embodiment of a spacer used in the dipole electric scalpel of the present invention.

FIG. 3 is a four-sided view of a spacer used in the dipole electric knife shown in FIG. 2;

FIG. 4 is a sectional view of a spacer used in the dipole electric knife shown in FIG. 2;

FIG. 5 is a perspective view of another embodiment of the spacer used in the dipole electric knife of the present invention.

[Explanation of symbols]

 REFERENCE SIGNS LIST 1 tube 2 first conductive striated body 3 second conductive striated body 4 conductive striated body operating section 5 spacer 6 proximal end 7 distal end 8 lumen 9 resin tube 10 lever 11 terminal 12 cord 13 high frequency current Generator 14 Stopper 15 Loop 16 Hole 17 Movable 18 Projection

──────────────────────────────────────────────────続 き Continued on front page (58) Field surveyed (Int. Cl. ⁷ , DB name) A61B 18/00-18/28

Claims (1)

(57) [Claims] 1. A dipole electric scalpel having a tube, a first conductive striated body, a second conductive striated body, a conductive striated manipulator, and a spacer, wherein (1) the tube is a proximal end (2) the first conductive filament and the second conductive filament are slidable in a longitudinal direction within the lumen of the tube, and the proximal end of the tube is slidable in the longitudinal direction. And a distal end of the tube is exposed from the distal end of the tube, and (3) the first conductive filament and the second conductive filament are electrically insulated. (4) The conductive filament operating section is disposed on the proximal end side of the tube, and is connected to the rear end of the first conductive filament and the rear end of the second conductive filament, It has a mechanism for sliding the conductive filament and the second conductive filament in the longitudinal direction of the tube. (5) The spacer is an electric insulator. And it becomes one,
It has two holes for fitting the tip of the first conductive filament and the tip of the second conductive filament, and the fitting hole of the two holes has the conductive filament. A movable margin is provided, which is provided at the tip of the first conductive filament and the tip of the second conductive filament, and (6) the tip of the first conductive filament and the second conductive filament. A dipole electric scalpel, wherein the distal end of the striatum is fitted into the hole of the spacer and is electrically insulated and connected.