JP3716475B2 - Dipole electrosurgical instrument - Google Patents

Description

[0001]
BACKGROUND OF THE INVENTION
The present invention relates to a dipole electrosurgical treatment instrument. More specifically, the present invention is a dipole capable of suppressing the 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 spacers. The present invention relates to an electrosurgical treatment instrument.
[0002]
[Prior art]
An electrosurgical treatment instrument is a surgical instrument that uses high-frequency electrical energy, and since it can electrically incise a living tissue without damaging the living body and reduce bleeding during surgery, It has come to be used. The electrosurgical treatment instrument uses the action of high-frequency electrical energy between the electrode provided at the tip of the instrument and the living tissue, and the monopolar electrosurgical treatment instrument and the dipole electrosurgical treatment instrument are is there.
The monopolar electrosurgical treatment instrument has an advantage of excellent cutting force of living tissue and less bleeding when cut, but since the required power is as high as about 500 W, the range of living tissue to be cut is Wide and therefore not suitable for cutting the details of living tissue. On the other hand, the treatment instrument for dipole electrosurgical operation can be operated with low power requirements, 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 electrosurgical instrument has a first conductive filament and a second conductive filament that are slidable in the longitudinal direction in the lumen of the tube, and the first using an insulating spacer. Known is one in which the tip of the conductive filament and the tip of the second conductive filament are connected to form a loop (JP-A-2-291850, JP-A-4-241835, (Kaihei 4-325151).
In such a dipole electrosurgical treatment instrument, the first conductive filaments are exposed from the distal end of the tube by sliding the first conductive filaments and the second conductive filaments in the lumen. And when the second conductive filament is housed in the lumen of the tube, the first conductive filament and the second conductive filament exposed from the distal end of the tube rotate and twist. One conductive filament and the second conductive filament are short-circuited, and further, the conductive filament rotates in the spacer hole, so that the adhesive layer is destroyed and the conductive filament is removed from the spacer. There was a problem of dropping out.
[0003]
[Problems to be solved by the invention]
The present invention suppresses rotation and twisting of the first conductive filament and the second conductive filament, prevents short-circuiting between the conductive filaments and dropping of the conductive filament from the spacer, and stabilizes The present invention has been made for the purpose of providing a dipole electrosurgical treatment instrument that can be operated in this manner.
[0004]
[Means for Solving the Problems]
As a result of intensive studies to solve the above problems, the present inventors have provided a protrusion protruding in the direction perpendicular to the long axis of the conductive filament at the tip of the conductive filament, Rotating the conductive filament by providing a hole for inserting the conductive filament, and providing a margin for fixing the conductive filament at the tip of the hole and bonding the conductive filament In addition, the present inventors have found that twisting can be suppressed and falling off can be prevented, and the present invention has been completed based on this finding.
That is, the present invention is a dipole electrosurgical treatment instrument having a tube, a first conductive striatum, a second conductive striatum, a conductive striatum operating portion and a spacer,
(1) The tube has a lumen communicating from the proximal end to the distal end,
(2) The first conductive filament and the second conductive filament are inserted from the proximal end to the distal end of the tube so as to be slidable in the longitudinal direction within the lumen of the tube, and the distal end of the tube The tip of the conductive filament can be exposed from the end, and a projection protruding in a direction perpendicular to the long axis of the conductive filament is provided at the tip of the conductive filament. And
(3) The first conductive filament and the second conductive filament are electrically insulated,
(4) The conductive striated manipulator is installed on the proximal end side of the tube and connected to the rear end of the first conductive striated body and the rear end of the second conductive striated body. Having a mechanism for sliding the conductive linear body and the second conductive linear body in the tube long axis direction,
(5) The spacer is made of an electrical insulator and has two holes for fitting the first conductive filament and the second conductive filament, and the tips of the two holes. The side is provided with a margin for fixing the conductive filament, and the fixed margin comprises a wall surrounding the tip side of the hole, and a protrusion protruding in a direction perpendicular to the long axis of the conductive filament. By being sandwiched between the opposing fixed margin walls, rotation of the first conductive filament and the second conductive filament is prevented,
(6) Insert the first conductive filament and the second conductive filament into the hole of the spacer, and fix the protrusion at the tip of the conductive filament exposed from the tip of the hole. Provided is a dipole electrosurgical treatment instrument that is fitted and fixed by an adhesive, and the tip of the first conductive filament and the tip of the second conductive filament are electrically insulated and connected. Is.
[0005]
DETAILED DESCRIPTION OF THE INVENTION
Hereinafter, the present invention will be described in detail with reference to the drawings.
FIG. 1 is a partial cross-sectional view of a dipole electrosurgical treatment instrument of the present invention. The dipole electrosurgical treatment instrument of the present invention is formed of a tube 1, a first conductive filament 2, a second conductive filament 3, a conductive filament operating section 4 and a spacer 5. The tube has a lumen 8 that communicates from the proximal end 6 to the distal end 7, and a conductive filament is inserted into the lumen. The material of the tube is not particularly limited, and metals such as stainless steel, or plastics such as polyethylene, polypropylene, polyvinyl chloride, polyurethane, polyamide, polyester, polycarbonate, and polyethersulfone can be used. Accordingly, one having an appropriate elastic modulus can be selected.
In the dipole electrosurgical treatment instrument of the present invention, the first conductive filament and the second conductive filament are longer in length than the tube, and can be slid in the longitudinal direction within the lumen of the tube. It is inserted from the proximal end of the tube 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. 1, a resin tube 9 is provided in the tube lumen. The first conductive wire and the second conductive wire are inserted through the resin tube, one conductive wire is inserted into 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 metal, it can be handled 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, the resin tube having two lumens is used by inserting the first conductive filament and the second conductive filament into the resin tube, respectively. The two conductive filaments are electrically insulated from each other by inserting the conductive filaments through the respective lumens or by providing an insulating film layer on the surface of the conductive filaments. Can do.
[0006]
In the dipole electrosurgical treatment instrument of the present invention, the material of the first conductive filament and the second conductive filament can be used without particular limitation as long as it is a conductive material. Examples of the property material include simple metals such as gold, silver, platinum, nickel, iron, aluminum, tin, and zinc, and alloys such as stainless steel and nichrome. The structure of the conductive filament may be either a single wire or a stranded wire, and the stranded wire includes a core wire composed of 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 0.6 mm. By making the inner diameter of the resin tube through which the conductive filament is inserted larger than the outer diameter of the conductive filament, the conductive filament can be slidable in the long axis direction in the lumen. There is no restriction | limiting in particular in the material of the resin tube which penetrates a conductive filament, For example, polyethylene, a polypropylene, polytetrafluoroethylene etc. can be mentioned.
The dipole electrosurgical treatment instrument of the present invention is installed on the proximal end side of the tube, connected to the rear end of the first conductive filament and the rear end of the second conductive filament, A conductive linear body operation unit 4 having a mechanism for sliding the conductive linear body and the second conductive linear body in the tube major axis direction is provided. By sliding the conductive striatum within the tube lumen by operating the conductive striatum manipulator, the conductive striatum exposed at the distal end is exposed from the lumen or stored in the lumen. Can do. The structure of the conductive linear body operation unit can be used without particular limitation as long as it can slide the two conductive linear bodies in the long axis direction within the tube lumen. For example, FIG. And a lever 10 that can move in the long axis direction and a moving member that moves in the long axis direction in conjunction with the lever 10 or a rotating member and a rotation of the rotating member. And a moving member that moves in the major axis direction in conjunction with the movement. 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.
[0007]
In the dipole electrosurgical treatment instrument of the present invention, the tip of the first conductive filament and the tip of the second conductive filament exposed from the distal end of the tube have two holes in the spacer 5. And are electrically insulated from each other through a spacer to form a loop 14 between the spacer and the distal end of the tube. At the time of treatment, first, the exposed portion from the distal end of the tube at the tip of the conductive striatum is enlarged by the operation of the conductive striatum manipulating unit to form a large loop. Next, the loop is arranged around the affected part to be excised such as a polyp, the conductive striate is slid in the direction to be accommodated in the tube lumen, and the loop is reduced to tighten around the affected part, thereby When activated, the affected area is excised with electrical energy.
The spacer used for the dipole electrosurgical treatment instrument of the present invention is made of an electrical insulator, and has two holes for inserting the tip of the first conductive filament and the second conductive filament. Furthermore, it has a margin for fixing the conductive filaments on the tip side of these holes. FIG. 2 is a perspective view of one embodiment of a spacer and a distal end portion of a conductive striatum used in the treatment instrument for dipole electrosurgery of the present invention. In this figure, in order to make an understanding easy, the part which cannot be visually observed of the hole 15, the fixing margin 16, and the conductive filament 17 is displayed with a dotted line. The spacer has two holes 15 into which the first conductive linear body and the second conductive linear body are inserted, and a fixing margin 16 for the conductive linear body is provided on the tip side of the hole. . A protrusion 18 protruding in a direction perpendicular to the long axis of the conductive filament is provided at the tip of the conductive filament. 3 is a four-sided view of a spacer used in the treatment instrument for dipole electrosurgical operation of the present invention shown in FIG. 2, FIG. 3 (a) is a front view, FIG. 3 (b) is a plan view, and FIG. ) Is a bottom view, and FIG. 3D is a side view. 4 (a) is a cross-sectional view of the spacer used in the dipole electrosurgical instrument of the present invention, taken along the line AA in FIG. 3 (b), and FIG. It is sectional drawing of the part corresponded to the AA line of FIG.3 (b) in the state which carried out.
[0008]
In the dipole electrosurgical treatment instrument of the present invention, there is no particular limitation on the method of providing the protrusion at the tip of the conductive filament, and the protrusion can be provided by any known method. For example, the projection can be provided by welding or bonding a projection portion made of a metal that is the same or different from the conductive filament to the conductive filament. Further, the protrusion can be provided by adhering a protrusion made of plastic to the conductive filament. Or the front-end | tip part of an electroconductive filament can be processed by plastic processing etc., and a processus | protrusion can be formed. Furthermore, it can be set as a protrusion by bending the front-end | tip of an electroconductive wire.
In the dipole electrosurgical treatment instrument of the present invention, there is no particular limitation on the method of inserting the conductive filament into the hole of the spacer. For example, the rear end of the conductive filament having a protrusion at the tip is provided. By fitting into the hole and pulling the conductive filament through the hole of the spacer, the protrusion at the tip can be fitted to the fixed part. Alternatively, it is possible to fit the protrusions fixedly after fitting the tips of the conductive filaments without the projections into the holes of the spacers and providing the projections at the tips.
The material of the spacer used in the dipole electrosurgical treatment instrument of the present invention is not particularly limited, and an electrically insulating material having appropriate strength, heat resistance, and workability can be used. Examples of such an electrical insulating material include ceramics such as alumina and zirconia, and heat-resistant plastics such as polybenzimidazole and polyethersulfone. The size of the spacer used in the dipole electrosurgical treatment instrument of the present invention is not particularly limited and can be selected according to the outer diameter of the conductive striatum, but the diameter of the circle or the major axis of the ellipse is usually Is 0.5 to 5 mm, preferably 1 to 3 mm, and the length is usually 0.5 to 5 mm, preferably 1 to 3 mm.
[0009]
The spacer used for the dipole electrosurgical instrument of the present invention is provided with two holes 15 for inserting the conductive filaments. The two holes preferably have columnar inner surfaces into which the first conductive filaments and the second conductive filaments can be fitted, respectively, and are generally parallel. The inner diameter of the hole is preferably slightly larger than the outer diameter of the conductive filament so that the conductive filament can be fitted therein.
The spacer used in the dipole electrosurgical treatment instrument of the present invention is provided with a fixing margin 16 on the distal end side of the hole. The fixing margin consists of a wall surrounding the mouth on the tip side of the hole, and when the conductive filament is inserted into the hole of the spacer, as shown in FIG. 2 and FIG. By fixing the projection provided at the tip in a direction perpendicular to the long axis of the conductive filament, it is positioned in the direction without the surrounding wall in the margin, so that the projection is sandwiched between opposing walls in parallel. Therefore, free rotation of the conductive filament is prevented.
An example of the processing method of a fixed margin is demonstrated about the elliptical columnar spacer of the aspect shown to FIGS. Two holes 15 that are slightly larger than the outer diameter of the conductive filaments are drilled in the axial direction of the elliptical spacer material. Next, a fixed margin 16 can be formed by cutting a space having a width approximately the same as the diameter of the hole of the spacer in the constant length portion on the tip side of the hole by cutting the hole in the circumferential direction.
In the dipole electrosurgical treatment instrument of the present invention, it is preferable that the width of the protrusion provided at the distal end portion of the conductive filament is slightly smaller than the width of the fixing margin. By reducing the difference between the width of the protrusion and the width of the fixing margin, the conductive linear body does not rotate freely, so that the conductive linear body can be stably held to prevent the occurrence of twisting, It is possible to prevent short circuit due to breakage or twisting. In addition, even if the bonded portion is broken, the tip of the conductive filament does not pass through the hole due to the projection, so that the conductive filament does not fall off the spacer.
[0010]
In the treatment instrument for a dipole electrosurgical device of the present invention, the conductive striatum is fixed by bonding with an adhesive at the fixing position of the spacer. The conductive linear body is restrained from free rotation by a protrusion protruding in a direction perpendicular to the long axis of the conductive linear body at the tip, but by fixing with an adhesive, the long axis direction This can prevent the rotation of the lens and prevent the rotation more reliably. The adhesive used is not particularly limited as long as it is electrically insulating, but a three-dimensional cross-linking adhesive such as an epoxy resin-based adhesive, a polyisocyanate-based adhesive, or a cross-linking acrylic adhesive is preferably used. be able to.
Fig.5 (a) is sectional drawing which shows the one aspect | mode of the fixing to the spacer of the conductive filament body by an adhesive agent. In this figure, a conductive wire is inserted into the hole of the spacer shown in FIG. 2, and the protrusion 18 at the tip of the conductive wire 17 is fixed and fitted with an adhesive 19 and adhered. The agent completely fills the fixing margin. FIG.5 (b) is sectional drawing which shows the other aspect of the fixation to the spacer of the conductive filament body by an adhesive agent. In this figure, the adhesive 19 completely fills the fixing margin, and further solidifies by forming a spherically raised portion on the upper part of the spacer, thereby forming a smooth curved surface so that the spacer can be inserted into the body cavity. Making it easy.
The shape of the spacer used in the treatment instrument for a dipole electrosurgical device of the present invention is not limited to an elliptical column shape, and an arbitrary shape can be selected according to the surgical site. FIG. 6 is a perspective view of another embodiment of the spacer used in the dipole electrosurgical treatment instrument of the present invention. In this figure, in order to make an understanding easy, the part which cannot see the hole 15 and the fixing margin 16 is displayed with a dotted line. FIG. 6A is a cylindrical spacer, FIG. 6B is a bullet spacer, FIG. 6C is a spherical spacer, and FIG. 6D is an umbrella spacer. . FIG. 6E shows a cylindrical spacer in which a partition between two fixing margins is deleted and the fixing margins are integrated. The effects of the present invention can also be obtained with these spacers.
In a conventional dipole electrosurgical treatment instrument, in a state where the conductive striatum is exposed from the lumen and forms a loop, the conductive striate is distorted in the vicinity of the fitting entrance and has this distortion. When the conductive filament was stored in the lumen in a state, the conductive filament was rotated and twisted as the loop became smaller. In the treatment instrument for a dipole electrosurgical device of the present invention, a fixing margin is provided on the distal end side of the hole of the spacer, and the projection is projected in a direction perpendicular to the long axis of the conductive filament body. Since the rotation of the conductive striatum is prevented, even if a force for rotating the conductive striatum is applied, the protrusion portion hits the wall portion of the movable margin to suppress the rotation of the conductive striatum. Therefore, the distortion of the conductive wire body is small, rotation and twisting are suppressed, and no short circuit and dropout occur.
[0011]
【The invention's effect】
The dipole electrosurgical treatment instrument of the present invention is provided with a fixing margin on the tip end side of the hole of the spacer, and prevents the rotation of the conductive wire rod by the protrusion provided on the conductive wire rod. Twist is suppressed during storage, and a stable operation can be performed without causing a short circuit of the conductive filaments or dropping out of the spacers.
[Brief description of the drawings]
FIG. 1 is a partial cross-sectional view of a dipole electrosurgical treatment instrument of the present invention.
FIG. 2 is a perspective view of one embodiment of a spacer and a distal end portion of a conductive striatum used in the dipole electrosurgical treatment instrument of the present invention.
FIG. 3 is a four-side view of the spacer shown in FIG. 2;
FIG. 4 is a cross-sectional view of a spacer used in the dipole electrosurgical treatment instrument of the present invention and a distal end portion of a conductive filament.
FIG. 5 is a cross-sectional view showing a manner of fixing a conductive filament to a spacer.
FIG. 6 is a perspective view of another embodiment of the spacer used in the dipole electrosurgical treatment instrument of the present invention.
[Explanation of symbols]
DESCRIPTION OF SYMBOLS 1 Tube 2 1st conductive filament 3 Second conductive filament 4 Conductive filament operation part 5 Spacer 6 Proximal end 7 Distal end 8 Lumen 9 Resin tube 10 Lever 11 Terminal 12 Cord 13 High frequency current Generating device 14 Loop 15 Hole 16 Fixing margin 17 Conductive filament 18 Protrusion 19 Adhesive

Claims (1)

A dipole electrosurgical treatment instrument having a tube, a first conductive striatum, a second conductive striatum, a conductive striatum manipulator, and a spacer,
(1) The tube has a lumen communicating from the proximal end to the distal end,
(2) The first conductive filament and the second conductive filament are inserted from the proximal end to the distal end of the tube so as to be slidable in the longitudinal direction within the lumen of the tube, and the distal end of the tube The tip of the conductive filament can be exposed from the end, and a projection protruding in a direction perpendicular to the long axis of the conductive filament is provided at the tip of the conductive filament. And
(3) The first conductive filament and the second conductive filament are electrically insulated,
(4) The conductive striated manipulator is installed on the proximal end side of the tube and connected to the rear end of the first conductive striated body and the rear end of the second conductive striated body. Having a mechanism for sliding the conductive linear body and the second conductive linear body in the tube long axis direction,
(5) The spacer is made of an electrical insulator and has two holes for fitting the first conductive filament and the second conductive filament, and the tips of the two holes. The side is provided with a margin for fixing the conductive filament, and the fixed margin comprises a wall surrounding the tip side of the hole, and a protrusion protruding in a direction perpendicular to the long axis of the conductive filament. By being sandwiched between the opposing fixed margin walls, rotation of the first conductive filament and the second conductive filament is prevented,
(6) Insert the first conductive filament and the second conductive filament into the hole of the spacer, and fix the protrusion at the tip of the conductive filament exposed from the tip of the hole. It fitted adhered and fixed by adhesive, the first conductive striatum tip and the tip of the second conductive striatum electrically insulated linked with that dipole electrosurgical treatment instrument.

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