JPH0464696B2 - - Google Patents

Description

[Detailed Description of the Invention] [Technical Field of the Invention] The present invention is capable of removing the internal glands of the enlarged prostate gland (prostatic hyperplasia) by detaching it from the external glands and removing it by transurethral insertion into the bladder. The present invention relates to an improvement of a resectoscope device as described above.

[Technical Background of the Invention and Problems Therewith] In recent years, endoscopes, which have an insertion section inserted into a body cavity and are capable of observing, diagnosing, and treating affected areas, have been widely used. This endoscope includes a resectoscope that is inserted into the bladder through the urethra and is configured to perform treatments such as prostate resection using a resection loop electrode device that applies high-frequency current.

In general, a resect scope consists of a hollow resect sheath that is inserted into the urethra, a slider that is detachably attached to the rear end of the resect sheath, and an observation scope (optical) that is detachably attached to the rear end of the slider. A loop electrode device for prostate resection can be inserted into the resect sheath and its rear end can be fixed to a slider, and by operating the slider, the tip of the loop electrode can be fixed to a slider. It is designed so that it can be plunged through the resect sheath.

However, when using a resect scope configured in this way to resect the intraprostatic glands by applying a high-frequency current to the loop electrode of the electrode device protruding from the tip of the resect sheath, it is difficult to completely remove the enlarged intraprostatic glands. The procedure is extremely difficult as it is dangerous to the human body, and the drawback is that some of the internal glands tend to remain, causing the prostate tissue to become enlarged again.

Therefore, as described in Japanese Utility Model Application Publication No. 59-93513, the present inventor installed a resectoscope in place of the above-mentioned electrodes, and under the direct vision of the resectoscope, the glands outside the prostate and the enlarged prostate gland were detected. We have developed a prostate dissection device that can be inserted between the prostate gland and the prostate gland to completely remove the internal glands by detaching them from the external glands. The prostate ablation device has a retractable coagulation electrode,
It is pressed against the spot where the bleeding has stopped to coagulate and stop the bleeding. Incidentally, it is anatomically more effective to use a loop electrode device to which a high-frequency current is applied, rather than to remove the intraprostatic gland using only the above-mentioned detachment device alone.

However, with conventional resectoscopes and dissection devices, it is necessary to replace the dissection device and loop electrode device each time necessary during surgery.
Moreover, these strippers and loop electrodes are attached to the distal end of the resectoscope, so each time they are replaced, the resectoscope, which is inserted into the bladder through the urethra, must be removed and replaced. It must then be inserted into the bladder again through the urethra.

[Objective of the Invention] The present invention has been made in view of these circumstances, and it is possible to simultaneously attach an ablation device and a resection loop electrode device to which a high-frequency current is applied to one resect scope, and to operate each of them independently. The prostatic glands can be inserted into the bladder through the urethra without having to be replaced during surgery, allowing for efficient and complete removal of the intraprostatic glands. It is an object of the present invention to provide a resectoscope device that can shorten surgical time and reduce the burden on a patient since there is no need to replace and reinstall the device.

[Summary of the Invention] In order to achieve the above object, a resectoscope device according to the present invention is provided with two sliders, one of which is equipped with a stripper and the other with an electrode device, and the stripper and the electrode device are connected to each other. Each can be slid independently.

[Embodiments of the Invention] Hereinafter, embodiments of the present invention will be described with reference to the drawings.

1 to 3 relate to one embodiment of the device of the present invention, in which FIG. 1 is a side view, FIG. 2 is an enlarged sectional view showing the distal end of the resect sheath, and FIG. 3 is the distal end of the sheath shown in FIG. 2. FIG.

In these figures, reference numeral 1 denotes a resectoscope device, in which an elongated sheath 3 to be inserted into the urethra is provided in front of a sheath body 2, and a connecting portion 4 is provided at the rear end of this sheath body 2 to connect the sheath. Two support shafts 5 and 6 are vertically protruded from the portion 4 in the rear axial direction, and a connecting portion 7 is fixed to the rear ends of the support shafts 5 and 6.
While inserting the scope insertion tube 8 from this connecting portion 7 into the sheath 3, the front connecting portion 4
two sliders 9 that slide independently in the axial direction along the support shafts 5 and 6, respectively, between the and the rear connecting portion 7;
10 are arranged. The sheath body 2 includes a water supply mouthpiece 1 for supplying irrigation fluid into the bladder and urethra.
1 and a pot 11a for adjusting water supply, and a finger hook 13 is provided protruding from the bottom. Further, a spring 1 is attached to the front connecting portion 4 and each slider 9, 10.
4 and 14 are constructed so that the sliders 9 and 10 return to contact with the rear connecting portion 7. A scope (rigid endoscope) 15 is inserted into the distal end of the sheath 3 through the scope insertion tube 8 from the rear of the connecting portion 7, so that the front of the distal end of the sheath 3 can be observed. This scope 15 has an eyepiece 16 at the rear, and a light guide fitting 17 to which a ride guide cable is connected to a light source device (not shown).

The slide 9 has a cord connector 12 to which a cord is connected for supplying high-frequency current, and an electrode attachment/detachment part 19 for connecting and fixing the conductive shaft 18a of the excision electrode device 18. The inserted elongated conductive shaft 18a is inserted and fixed by tightening the detachable part 19. The ablation electrode 18 of this embodiment has a conductive shaft 1
Although the cutting loop electrode 18a provided at the tip of the cutting loop electrode 8b is formed in an annular shape, it may be in a normal shape, for example, a semicircle. On the other hand, the slider 10
Peeler attachment/detachment part 2 that connects and fixes the elongated shaft 20a of
1, and a shaft 20a inserted from the front into a connection hole (not shown) is inserted and fixed by tightening the attachment/detachment part 21. Both the cutting electrode device 18 and the stripping device 20 are inserted into the sheath 3 through the sheath body 2, and include a loop electrode 18b and a stripping device 20b disposed at the tips of the shafts 18a and 20a, respectively.
is positioned within the tip of the sheath 3, and by sliding the slider 9 forward, the loop electrode 18b protrudes from the beak 3a at the tip of the sheath 3, and the slider 10
By sliding the peeler 20b forward, the peeler 20b is made to protrude from the beak 3a. Further, the stripper 20b of the stripper 20 is formed so as to be able to slide inside the annular loop electrode 18b.

In such a configuration, by independently sliding the sliders 9 and 10, the loop electrode 18b or the stripper 20 can be removed from the tip of the sheath 3 when necessary.
This can be treated by protruding b. Note that the loop electrode 18b is used not only for resection of intraprostatic glands, but also for
It is also used for coagulation and hemostasis by pressing against the bleeding site. Therefore, even if bleeding occurs during surgery, hemostatic treatment can be performed immediately, so the amount of bleeding can be kept to a minimum and safe treatment can be performed.

As explained above, according to the present invention, it is possible to simultaneously attach the ablation device and the ablation loop electrode device to which a high-frequency current is applied to one resect scope, and to perform the plunge and retract operations of each independently. It can be selectively used while being inserted into the bladder through the urethra without having to be replaced during surgery, and the intraprostatic glands can be efficiently and completely removed, and there is no need to replace and reinstall the ablation device and loop electrode device. This has the effect of shortening the surgical time.

[Brief explanation of the drawing]

1 to 3 relate to one embodiment of the device of the present invention, in which FIG. 1 is a side view, FIG. 2 is an enlarged sectional view showing the distal end of the resect sheath, and FIG. 3 is the distal end of the sheath shown in FIG. 2. FIG. 2... Sheath body, 3... Sheath, 5, 6...
Support shaft, 7... Connection section, 9, 10... Slider, 1
5... Scope, 18... Ablation electrode device, 20...
Peeler.

Claims (1)

[Claims] 1. An elongated hollow sheath connected to the front of the sheath body and inserted into the urethra, and a support shaft connected to the rear of the sheath body in the axial direction, and inserted into the sheath. A resectoscope comprising: a connecting part having an insertion part into which a scope is inserted; and a slider disposed between the rear of the sheath body and the connecting part and slidable in the axial direction along a support shaft, the slider Two sliders are provided, each of which is slidable independently in the axial direction, and a stripper having a stripper at the tip of an elongated shaft to be inserted into the sheath can be attached to one of the sliders, and a stripper to the other slider. , an electrode device having a cutting loop electrode and through which a high-frequency current is applied can be attached to the tip of an elongated conductive shaft inserted into the sheath, and the shaft of the stripper and the conductive shaft of the electrode device can be attached. A resect scope device, characterized in that the scope is disposed between them, and the peeler and the electrode device are each independently slidable so as to protrude and retract from the distal end of the sheath.