JP7286068B2 - Endoscope Microwave Irradiator - Google Patents

Description

TECHNICAL FIELD The present invention relates to an endoscope microwave irradiation instrument for performing treatment such as hemostasis using microwaves using an endoscope.

2. Description of the Related Art Conventionally, an endoscopic forceps-type instrument for performing treatment such as hemostasis on living tissue using microwaves using an endoscope has been used. For example, a bipolar hemostatic forceps as a forceps-type treatment instrument has a pair of electrodes (forceps) arranged at the distal end of a sheath passed through a treatment instrument guide tube of an endoscope. It can be operated by the operation part. By supplying microwaves to the pair of forceps while gripping a living tissue such as a blood vessel, the tissue in the vicinity of the grip can be cauterized and coagulated to stop bleeding (for example, , see Patent Document 1).

In the technique described in Patent Document 1, a coaxial cable is used as means for supplying microwave energy to a pair of forceps. One of the pair of forceps pieces is connected to the high-voltage side terminal of the microwave power supply via the central conductor of the coaxial cable. The other of the pair of forceps pieces is connected to the ground terminal of the microwave power source via the outer conductor of the coaxial cable. An electric field of microwaves is formed between the pair of forceps pieces by transmitting the output of the microwave power source through the coaxial cable.

An inner connection pipe made of metal is fitted around the outer circumference of the exposed portion at the tip of the center conductor. The inner connection pipe and the central conductor are integrated by soldering. In addition, an outer connecting pipe made of metal is fitted inside the base cylinder portions of the pair of forceps pieces. The base tube portion and the outer connection pipe are integrated by welding or the like. Further, the outer connecting pipe is fitted around the outer periphery of the inner connecting pipe and integrated with the inner connecting pipe by laser welding or the like. Thereby, the central conductor is electrically connected to one of the pair of forceps pieces through the inner connecting pipe and the outer connecting pipe in sequence.

Japanese Patent No. 6267339

However, in the conventional forceps-type treatment instrument as disclosed in Patent Document 1, microwave loss occurs at the connecting portion between the central conductor and the inner connecting pipe, the connecting portion between the inner connecting pipe and the outer connecting pipe, and the like. There was a problem that arises.

The present invention has been made to solve such conventional problems, and is capable of reducing the loss of microwaves and efficiently cauterizing living tissue by irradiating microwaves. An object of the present invention is to provide a microscope microwave irradiation instrument.

In order to solve the above problems, an endoscopic microwave irradiation instrument according to the present invention includes a cable for energy transmission, a microwave irradiation section connected to the tip of the cable, and an outer sheath that houses the cable. wherein the cable has a central conductor, a tubular insulator surrounding the central conductor, and an outer conductor surrounding the tubular insulator. and the microwave irradiation unit includes a first movable arm connected to the central conductor, a second movable arm connected to the outer conductor, the first movable arm and the second movable arm and an insulating connection member that connects the two so that they can be insulated from each other and rotatably about a predetermined rotation axis at a location other than their distal ends; Both side holding members for holding from both sides in the axial direction, the coaxial cable is housed in the outer sheath so as to be displaceable in the axial direction, and the first movable arm is positioned closer to the coaxial than the rotating shaft. The first movable arm and the second movable arm are directly connected to the center conductor of the coaxial cable at the cable-side end thereof, and the first movable arm and the second movable arm move when the coaxial cable is displaced in the outer sheath in the axial direction, It is the structure which carries out opening-and-closing movement in the said front-end|tip side.

With this configuration, in the endoscopic microwave irradiation instrument according to the present invention, the first movable arm is directly connected to the central conductor of the coaxial cable. Efficient cauterization can be performed by irradiating the living tissue gripped by the second movable arm with microwaves.

Further, in the endoscopic microwave irradiation instrument according to the present invention, the first movable arm and the second movable arm may constitute forceps that can be opened and closed on the distal end side.

With this configuration, the endoscopic microwave irradiation instrument according to the present invention can realize bipolar hemostatic forceps with a simple configuration.

Further, in the endoscopic microwave irradiation instrument according to the present invention, the two-side holding member includes a pair of parallel arm portions that hold the insulating connecting member, and the proximal end portions of both parallel arm portions to the outer sheath. It may also have an annulus that secures together.

With this configuration, in the endoscopic microwave irradiation instrument according to the present invention, the positions of the rotation shafts of the first movable arm and the second movable arm can be fixed with respect to the outer sheath by the both-side holding members and the insulating connecting member. can.

Further, in the endoscopic microwave irradiation instrument according to the present invention, the central conductor has an exposed portion exposed from the cylindrical insulator and the outer conductor by a predetermined length, and the first movable The arm is connected to the exposed portion of the central conductor at an end closer to the coaxial cable than the rotating shaft so as to be able to transmit an operating force to the exposed portion of the central conductor. The outer conductor may be connected to the outer conductor via a conductive pull wire at the end on the side so that the operating force can be transmitted.

With this configuration, in the endoscopic microwave irradiation device according to the present invention, when the coaxial cable is displaced in the axial direction within the outer sheath, the operating force is transmitted to the exposed portion of the central conductor and the pull wire connected to the outer conductor. As a result, the first movable arm and the second movable arm can be opened and closed at their distal end sides.

SUMMARY OF THE INVENTION The present invention provides an endoscopic microwave irradiation instrument capable of reducing the loss of microwaves and efficiently cauterizing living tissue by irradiating microwaves.

1 is a plan view showing the overall configuration of an endoscopic microwave irradiation instrument according to an embodiment of the present invention; FIG. FIG. 2 is a sectional view taken along the line II of FIG. 1; 1 is a perspective view showing a configuration of a microwave irradiating section of an endoscope microwave irradiating instrument according to an embodiment of the present invention; FIG. Fig. 2 is a plan view showing a connection structure between a forceps portion and a coaxial cable of the endoscopic microwave irradiation instrument according to the embodiment of the present invention; 1 is a schematic cross-sectional view showing the internal structure of a microwave irradiation section of a microwave irradiation instrument for an endoscope according to an embodiment of the present invention, where (a) shows a state in which the forceps section is open, and (b) shows the forceps; It shows that the part is closed. FIG. 4 is a perspective view showing a modification of the microwave irradiation section of the endoscope microwave irradiation instrument according to the embodiment of the present invention.

An embodiment of an endoscope microwave irradiation instrument 1 according to the present invention will be described below with reference to the drawings. Note that the dimensional ratio of each configuration on each drawing does not necessarily match the actual dimensional ratio.

As shown in FIG. 1, the endoscopic microwave irradiation instrument 1 of the present embodiment includes a coaxial cable 11 as a cable for energy transmission, an outer sheath 10 housing the coaxial cable 11, an operation section 20, and a coaxial cable. and a microwave irradiation unit 30 connected to the tip of the cable 11 . An operation section 20 is provided at the proximal end of the outer sheath 10 , and a microwave irradiation section 30 is provided at the distal end of the outer sheath 10 .

The outer sheath 10 is composed of a flexible hollow tube, and a tube made of insulating resin is used. The resin material forming the outer sheath 10 is not particularly limited as long as it is an electrically insulating material, and polyethylene, polypropylene, polyvinyl chloride, polyurethane, polyamide, polyester, polycarbonate, polyethersulfone, fluorine resin, and the like can be used.

As shown in FIG. 2, the coaxial cable 11 includes a central conductor 12, a cylindrical insulator 13 surrounding the central conductor 12, an outer conductor 14 surrounding the cylindrical insulator 13, and an outer conductor 14 for electrical insulation from other members. and an insulating coating portion 15 covering the outer conductor 14 are integrally provided. The coaxial cable 11 is inserted through the outer sheath 10 and accommodated in the outer sheath 10 so as to be displaceable in the axial direction.

A microwave connector 18 is connected to the proximal end 11a of the coaxial cable 11, and a microwave irradiation section 30 is connected to the distal end. The microwave irradiation unit 30 can be connected to a microwave power supply (not shown) via the connector 18 and the coaxial cable 11 . The frequency of microwaves used is, for example, 2450 MHz, which is higher than the frequency of high-frequency current (several hundred MHz) used in conventional high-frequency treatment instruments.

The size and material of each component of the coaxial cable 11 are set so as to be able to pass through the treatment instrument guide tube of the endoscope and to efficiently transmit desired microwaves. For example, but not by way of limitation, the center conductor 12 is made of copper wire, copper-coated steel wire, iron wire, or the like, and has a diameter of 0.2-0.4 mm. The tubular insulator 13 has a diameter of 0.6 to 1.2 mm, for example. The outer conductor 14 is made of copper braided wire, for example, and has a thickness of 0.08 to 0.2 mm. The thickness of the insulating coating portion 15 is, for example, 0.05 to 0.1 mm.

The operating portion 20 includes a base 21 , a slider 22 and a tip cap 23 . The base 21 has a finger ring portion 21a and a guide portion 21b having a guide groove. The slider 22 is attached so as to be slidable forward and backward (left and right in FIG. 1) along the guide portion 21b of the base 21 . A tip cap 23 is attached to the tip (distal end) of the base 21 . Base 21, slider 22 and tip cap 23 are mainly made of insulating resin.

The distal end cap 23 has a substantially cylindrical space inside on the distal end side thereof, and the proximal end of the outer sheath 10 is inserted through a penetrating portion formed at the distal end of the distal end cap 23 .

The coaxial cable 11 is inserted through the outer sheath 10, and slides in the outer sheath 10 (in the direction along the axial direction) by sliding the slider 22 forward and backward (left and right in FIG. 1) with respect to the base 21 in the operation portion 20. slide movement) is possible. That is, the coaxial cable 11 functions as a power transmission member that transmits a sliding force for opening and closing the forceps portion 31 provided in the microwave irradiation portion 30 according to the operation of the operation portion 20 .

A proximal end portion of the coaxial cable 11 is pulled out from the operating portion 20, and a connector 18 is attached to the proximal end 11a. At the distal end of coaxial cable 11, center conductor 12 is electrically connected to first forceps piece (first movable arm) 31a, and outer conductor 14 is electrically connected to second forceps piece (second movable arm) 31b. It is connected. Microwaves generated by a microwave power supply connected to the connector 18 are sent through the coaxial cable 11 to the first forceps piece 31a and the second forceps piece 31b. That is, the coaxial cable 11 functions as an energy transmission member that transmits microwave energy.

As shown in FIGS. 3 to 5, the microwave irradiation section 30 includes a forceps section 31 composed of a first forceps piece 31a and a second forceps piece 31b, which are a pair of electrodes, and both side holding members made of insulating resin. 32 and an insulating spacer 33 as an insulating connecting member made of insulating resin.

The first forceps piece 31a and the second forceps piece 31b are made of a conductive member made of metal such as stainless steel. As shown in FIG. 3, tip convex teeth 31e are formed on the tip side of the grasping portions of the first forceps piece 31a and the second forceps piece 31b. A single tip longitudinal groove 31f is formed in a central portion of the tip convex tooth 31e along a direction (hereinafter also referred to as a vertical direction) substantially perpendicular to a rotation axis L (X-axis direction) described later. By providing the distal end longitudinal groove 31f in the distal convex tooth 31e, it is possible to prevent the body tissue gripped by the forceps portion 31 from slipping in the direction along the rotation axis L (hereinafter also referred to as the lateral direction). A stable grip can be realized.

The two-side holding member 32 includes a cylindrical annular portion 32c having a substantially cylindrical neck portion 32d (see FIG. 5) and a pair of parallel arm portions ( a first arm portion and a second arm portion) 32a and 32b. In the drawings, the X, Y and Z axes are perpendicular to each other.

As shown in FIG. 3, insulating spacers 33 and rotating shafts 34 such as metal pins for fixing the insulating spacers 33 are provided near the distal end portions of the first arm portion 32a and the second arm portion 32b. A recess 32e is provided for mounting the .

The insulating spacer 33 is held by a pair of parallel arm portions 32a and 32b from both sides in the direction of the axis (rotational axis L) of the rotating shaft portion 34, and the first forceps piece 31a and the second forceps piece 31b are held by the pair of parallel arm portions 32a and 32b. are connected so as to be insulated from each other and to be rotatable about the rotation axis L at the point . A through hole 33 b (see FIG. 5 ) having a substantially circular cross section is formed in the insulating spacer 33 as a mounting hole for the rotating shaft portion 34 .

A through-hole 32f through which the coaxial cable 11 passes is formed in the annular portion 32c and the neck portion 32d of the both-side holding member 32. As shown in FIG. The inner diameter of the through hole 32f is larger than the outer diameter of the outer conductor 14 of the coaxial cable 11, and the outer diameter of the annular portion 32c is substantially the same as the outer diameter of the outer sheath 10 so as to slide smoothly inside the endoscope. .

The annular portion 32c is adapted to integrally fix proximal portions of the parallel arm portions 32a, 32b to the distal end of the outer sheath 10. As shown in FIG. Alternatively, loop 32 c may be rotatably attached to the distal end of outer sheath 10 . In this case, the coaxial cable 11 can be rotated around its axis within the outer sheath 10 by rotating the operating portion 20 . That is, the coaxial cable 11 functions as a power transmission member that transmits a rotational force that rotates the forceps portion 31 around the sheath axis for posture adjustment.

As shown in FIG. 4, the coaxial cable 11 has a central conductor 12 exposed by a predetermined length, a cylindrical insulator 13 exposed by a predetermined length, and an outer conductor 14 exposed by a predetermined length in order from the distal end side. Only the length is exposed. That is, in the microwave irradiation section 30, the central conductor 12 has an exposed portion 12a exposed from the tubular insulator 13 and the outer conductor 14 by a predetermined length. The first forceps piece 31a is directly connected to the exposed portion 12a of the central conductor 12 at the end portion closer to the coaxial cable 11 than the rotation axis L so as to be able to transmit the operating force. Further, the second forceps piece 31b is connected to the outer conductor 14 via a conductive pull wire 14a at an end portion closer to the coaxial cable 11 than the rotation axis L so as to transmit an operating force. The pull wire 14a is made of a conductive material such as copper, iron, or stainless steel, and is electrically connected to the external conductor 14 by soldering or the like.

As the coaxial cable 11 slides, the sliding force is transmitted to the first forceps piece 31a and the second forceps piece 31b via the exposed portion 12a of the central conductor 12 and the pull wire 14a, thereby The forceps piece 31b can be opened and closed. The first forceps piece 31a and the second forceps piece 31b rotate toward each other with respect to the insulating spacer 33 about the rotation axis L, the forceps portion 31 is closed, and the affected part to be treated is gripped by the forceps pieces. It is possible to sandwich between parts. To open the forceps portion 31, the opposite operation is performed. That is, when the coaxial cable 11 is displaced in the axial direction within the outer sheath 10, the first forceps piece 31a and the second forceps piece 31b constituting the bipolar hemostatic forceps open and close at their distal ends.

A first forceps piece 31a and a second forceps piece 31b constituting the forceps portion 31 are rotatably supported by an insulating spacer 33 so as to be electrically insulated from each other so as to form a substantially X shape. It is arranged between the first arm portion 32a and the second arm portion 32b of the both side holding members 32 in the state.

As shown in FIG. 5, each of the first forceps piece 31a and the second forceps piece 31b has a shaft hole 31c having a substantially circular cross section formed in the intermediate portion thereof, and the center conductor 12 is exposed on the rear end side. A through hole 31g is formed for attaching the portion 12a or the pull wire 14a. The distal end of the exposed portion 12a of the central conductor 12 is connected to the through hole 31g of the first forceps piece 31a, and the distal end of the pull wire 14a is connected to the through hole 31g of the second forceps piece 31b.

The first forceps piece 31a is rotatably supported by the insulating spacer 33 by inserting the shaft portion 33a of the insulating spacer 33 into the shaft hole 31c. Similarly, the second forceps piece 31b is rotatably supported by the insulating spacer 33 by inserting the shaft portion (not shown) of the insulating spacer 33 into the shaft hole (not shown). Further, the distal end portions of the two shaft portions 33a of the insulating spacer 33 are fitted into the concave portions 32e of the first arm portion 32a and the second arm portion 32b of the both-side holding member 32, respectively. The rotating shaft portion 34 is inserted through the central through hole 33 b of the shaft portion 33 a of the insulating spacer 33 . Thereby, as shown in FIG. 1, the first forceps piece 31a and the second forceps piece 31b rotatably supported by the insulating spacer 33 are supported between the pair of parallel arm portions 32a and 32b.

The exposed portion 12a of the central conductor 12 and the pull wire 14a connected to the outer conductor 14 need to be insulated from each other at locations that may come into contact with each other when the forceps portion 31 is opened and closed. For example, as shown in FIG. 5, the exposed portion 12a and the pull wire 14a are covered with insulating tubes 16 and 17, respectively. The resin material forming the insulating tubes 16 and 17 is not particularly limited, but polyethylene, polypropylene, polyvinyl chloride, polyurethane, polyamide, polyester, polycarbonate, polyethersulfone, fluororesin, and the like can be used, for example. Alternatively, instead of insulating tubes 16 and 17, exposed portion 12a and pull wire 14a may be coated with an insulating coating film. The material of the insulating coating film is not particularly limited, but for example, fluorine resin, polyimide resin, ceramics, or the like can be used.

FIG. 6 shows a modification of the microwave irradiation section 30 of the endoscope microwave irradiation instrument 1 according to this embodiment. As shown in FIG. 6, the holding portions of the first forceps piece 31a and the second forceps piece 31b are formed with a plurality of laterally extending mountain teeth 31d arranged in parallel in the vertical direction. By providing the first forceps piece 31a and the second forceps piece 31b with a plurality of (four in this example) toothed teeth 31d, it is possible to prevent the internal tissue gripped by the forceps portion 31 from slipping through in the vertical direction.

Next, the operation of the endoscope microwave irradiation instrument 1 will be described.

As shown in FIG. 5B, the endoscopic microwave irradiation instrument 1 is inserted into a treatment instrument guide tube (not shown) of the endoscope with the forceps portion 31 of the microwave irradiation portion 30 closed. be. When the microwave irradiation section 30 reaches the vicinity of the living tissue to be treated in the body, the slider 22 is slid toward the outer sheath 10 (to the left in FIG. 1) along the guide section 21b of the base 21 of the operation section 20. Then, the coaxial cable 11 is slid to the distal end side within the outer sheath 10 . At this time, due to the elasticity of the exposed portion 12a of the central conductor 12 of the coaxial cable 11 and the pull wire 14a, the first forceps piece 31a and the second forceps piece 31b are opened in a substantially V shape with the rotation shaft portion 34 as a fulcrum. (See FIG. 5(a)).

Next, the slider 22 is slid toward the finger ring portion 21a (to the right in FIG. 1) to slide the coaxial cable 11 within the outer sheath 10 to the proximal end side. At this time, the exposed portion 12a of the central conductor 12 of the coaxial cable 11 and the pull wire 14a are drawn toward the outer sheath 10, so that the first forceps piece 31a and the second forceps piece 31b are closed with the rotation shaft portion 34 as a fulcrum. trying to move to By this operation, the target living tissue is temporarily grasped by the first forceps piece 31a and the second forceps piece 31b.

In this state, by turning on the microwave power supply and supplying microwaves, the first forceps piece 31a electrically connected to the central conductor 12 and the second forceps piece electrically connected to the outer conductor 14 are generated. 31b, the living tissue gripped by the first forceps piece 31a and the second forceps piece 31b is irradiated with the microwaves to cauterize and coagulate the living tissue to stop bleeding. Since microwaves are more likely to propagate through living tissue than through air, microwave energy can be effectively applied to the target living tissue.

When the hemostasis treatment is completed, the microwave power supply is turned off to stop the supply of microwaves, the slider 22 is slid toward the outer sheath 10 (to the left in FIG. 1), and the first forceps piece 31a and the second forceps piece 31a are moved. The forceps piece 31b is opened to release the gripped living tissue. After that, the first forceps piece 31a and the second forceps piece 31b are pulled out from the treatment instrument guide tube of the endoscope in a closed state to complete a series of operations (treatment).

As described above, in the endoscopic microwave irradiation instrument 1 according to the present embodiment, since the first forceps piece 31a is directly connected to the central conductor 12 of the coaxial cable 11, microwave loss is reduced. Therefore, the biological tissue gripped by the first forceps piece 31a and the second forceps piece 31b can be efficiently cauterized by microwave irradiation.

In addition, in the endoscopic microwave irradiation instrument 1 according to the present embodiment, the first forceps piece 31a is directly connected to the central conductor 12 of the coaxial cable 11, so a bipolar hemostatic forceps with a simple configuration can be realized. . The present invention is not limited to bipolar hemostatic forceps, but can also be applied to a bipolar knife or the like having a first movable arm and a second movable arm that serve as a pair of electrodes that can be opened and closed. It can also be applied to a forceps-type treatment instrument having a forceps piece that does not have a handle.

Further, in the endoscopic microwave irradiation instrument 1 according to the present embodiment, the exposed portion 12a of the central conductor 12 and the pull wire 14a connected to the outer conductor 14 are insulated from each other by insulating tubes 16, 17 and the like. , the first forceps piece 31a and the second forceps piece 31b are insulated from each other by an insulating spacer 33 in the vicinity of the rotation axis L. As shown in FIG. As a result, the endoscopic microwave irradiation instrument 1 according to the present embodiment concentrates the microwaves on the distal ends of the first forceps piece 31a and the second forceps piece 31b, and the first forceps piece 31a and the second forceps piece 31b Efficient cauterization can be performed on the living tissue gripped by the pieces 31b.

Further, in the endoscopic microwave irradiation instrument 1 according to the present embodiment, the position of the rotation axis L of the first forceps piece 31a and the second forceps piece 31b is adjusted with respect to the outer sheath 10 by the both-side holding members 32 and the insulating spacers 33. can be fixed.

Further, in the endoscopic microwave irradiation instrument 1 according to the present embodiment, when the coaxial cable 11 is displaced in the axial direction within the outer sheath 10, the exposed portion 12a of the central conductor 12 and the pull wire 14a connected to the outer conductor 14 are displaced. By transmitting the operating force to and, the first forceps piece 31a and the second forceps piece 31b can be opened and closed at their distal end sides.

1 Endoscope Microwave Irradiator 10 Outer Sheath 11 Coaxial Cable 12 Central Conductor 12a Exposed Portion 13 Cylindrical Insulator 14 Outer Conductor 14a Pull Wire 15 Insulating Coating Part 16, 17 Insulating Tube 30 Microwave Irradiating Part 31 Forceps Part 31a First forceps piece 31b second forceps piece 32 holding members 32a, 32b parallel arm portion 32c annular portion 33 insulating spacer 34 rotation shaft portion

Claims (3)

An endoscopic microwave irradiation instrument comprising a cable for energy transmission, a microwave irradiation section connected to the tip of the cable, and an outer sheath housing the cable,
wherein the cable comprises a coaxial cable having a central conductor, a tubular insulator surrounding the central conductor, and an outer conductor surrounding the tubular insulator;
The microwave irradiator includes a first movable arm connected to the central conductor, a second movable arm connected to the outer conductor, and the first movable arm and the second movable arm other than their distal ends. an insulating connecting member that is insulated from each other at a point and is rotatably connected about a predetermined rotating shaft; and holding members on both sides,
the coaxial cable is housed in the outer sheath so as to be displaceable in the axial direction;
The central conductor has an exposed portion exposed by a predetermined length from the tubular insulator and the outer conductor,
the first movable arm is electrically connected to the exposed portion of the central conductor of the coaxial cable so as to be able to directly transmit an operating force at an end on the coaxial cable side of the rotating shaft;
The second movable arm is electrically connected to the external conductor via a conductive pull wire so as to be able to transmit an operating force at an end on the coaxial cable side of the rotating shaft,
The microwave irradiation instrument for an endoscope, wherein the first movable arm and the second movable arm open and close at the distal end side when the coaxial cable is displaced in the axial direction within the outer sheath. 2. The endoscope microwave irradiation instrument according to claim 1, wherein said first movable arm and said second movable arm constitute forceps that can be opened and closed at said distal end side. The both-sides holding member has a pair of parallel arm portions that hold the insulating connecting member, and an annular portion that integrally fixes base end portions of both parallel arm portions to the outer sheath. The microwave irradiation instrument for an endoscope according to claim 1 or 2.

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