JPH0426092Y2 - - Google Patents

Description

[Detailed Description of the Invention] [Industrial Application Field] The present invention relates to a high-frequency endoscope device that has a wide observation range and has high electrical safety.

[Prior Art] In recent years, it has become possible to observe organs within a body cavity by inserting an elongated insertion section into a body cavity, and to perform various therapeutic procedures as needed using a treatment instrument inserted into a treatment instrument channel. Endoscopy devices are widely used.

The endoscopic device includes a high-frequency endoscope device for resecting the prostate, the uterine cavity, the ureter, the kidney, and the like. For example, as shown in Japanese Utility Model Application No. 60-149616, one of these high-frequency endoscope devices is inserted into the bladder through the urethra and is used to treat the prostate gland by applying high-frequency current to the resection electrode. There is a resectoscope device that is configured to perform treatments such as resection.

In general, a resect scope device includes a hollow resect sheath that is inserted into the urethra, a handle section that has a slider that is detachably attached to the rear end of the resect sheath, and a handle section that is detachably attached to the rear end of the handle section. It consists of an observation scope (optical viewing tube) with a bifurcated tip and a loop-shaped electrode for prostate resection, which can be protruded and retracted from the tip of the resect sheath.

The distal end of the resect sheath is formed of an insulating member called a beak in order to come into contact with the loop electrode.

FIG. 6 shows the distal end of a conventional resectoscope device, and FIG. 7 shows an arthroscopic image of the conventional resectoscope device inserted into the urethra.

A beak 57 made of an insulating material is formed at the distal end of the sheath 52. A scope 55 and an electrode 56 are inserted into the sheath 52. A loop-shaped cutout 5 is provided at the tip of the electrode.
6a is provided.

In addition, in FIG. 7, numeral 61 indicates the inside of the bladder cavity, and 5
7a indicates the opening of the beak 57.

[Problems to be solved by the invention] By the way, the conventional beak 57 is required to have insulation properties, heat resistance, and strength, and is made of an opaque material such as glass fiber-containing epoxy resin. There was a problem.

That is, as shown in FIG. 6, the normally loop-shaped cutting section 56a is housed within the beak 57 to ensure electrical safety, and the insulation between the cutting section 56a and the tip of the scope 55 is maintained. In order to ensure that the distance l1 between the resection portion 56a and the scope 55 is
is sufficiently maintained. Therefore, scope 55
is arranged so as to be stored sufficiently deep from the tip of the beak 57. Therefore, if the beak 57 is formed of an opaque material, the periphery of the field of view of the scope 55 is
Therefore, no matter how wide the angle of view of the objective lens system of the scope 55 is, the range θ1 of the urethra that can be observed is limited by the beak 57. Therefore, it was not possible to reliably select the resection range, and there was a risk that tissue that should not be resected would be resected.

On the other hand, in order to widen the observation range θ1, it is necessary to widen the field of view of the scope 55 and bring the scope 55 closer to the tip of the beak 57.
As described above, the insulation between the cut portion 56a and the tip of the scope 55 is significantly reduced, resulting in a problem that electrical safety cannot be ensured.

The above-mentioned problems are not limited to the resectoscope, but also apply to other high-frequency endoscope devices for resecting the intrauterine cavity, ureter, renal pelvis, and the like.

[Purpose of the invention] The present invention was made in view of the above circumstances, and aims to maintain a sufficient distance between the electrode and the tip of the scope.
The purpose of the present invention is to provide a high-frequency endoscope device that has high electrical safety, and can widen the observation range by widening the scope, making it possible to reliably select, for example, the resection range. .

[Means for Solving the Problems] The high-frequency endoscope device of the present invention includes an elongated, hollow sheath that is inserted into a body cavity, and a sheath that is inserted through the sheath to ablate tissue within the body cavity using high frequency waves. or an electrode comprising a coagulating electrode, an operating section capable of operating the electrode from outside the body, and an optical viewing tube inserted into the sheath and having an optical system capable of observing the inside of a body cavity, at least at the distal end of the sheath. The portion is made of a transparent insulating material.

[Function] According to the present invention, observation of a wide range is possible through the tip of the sheath formed of a transparent insulating material.

[Example] Hereinafter, an example of the present invention will be described with reference to the drawings.

1 to 3 relate to the first embodiment of the present invention, in which FIG. 1 is a sectional view of the distal end of the resectoscope device, and FIG. 2 is a mirror view when the resectoscope device is inserted into the urethra. FIG. 3 is a side view of the resectoscope device.

As shown in FIG. 3, the resect scope device 1 of this embodiment has an elongated sheath insertion portion 2a that is inserted into the urethra and a sheath body 2b that connects the insertion portion 2a to the front (resect). sheath 2
a (resect) handle 4 connected to the rear end of the sheath body 2b; an observation scope (optical viewing tube) 5 inserted into the sheath 2 from behind the handle 4; It is constructed by combining an electrode 6 inserted into the inside of the electrode 6.

As shown in FIG. 1, the insertion section 2 of the sheath 2
a has insulation, heat resistance, and strength at the tip;
In addition, insulating beaks 7 made of a transparent insulating material, for example, transparent ceramics (for example, transparent alumina ceramics Al ₂ O ₃ ) are continuously provided. Incidentally, the sheath insertion portion 2a may be integrally formed of transparent ceramic similar to the beak 7.

The sheath main body 2b has a water supply port 8 with a socket 8a for supplying irrigation fluid into the bladder through the sheath 2, and also has a fitting opening 3 into which the handle connection part 9 of the handle 4 is fitted, and this handle For example, an attachment/detachment button 10 is provided for engaging and disconnecting a click mechanism for fixing the connecting portion 9 within the fitting opening 3.

The handle 4 has an insertion section 13, which is composed of a scope guide pipe 11 inserted through the insertion section 5a of the scope 5 and an electrode guide pipe 12 through which the electrode 6 is inserted, connected in front of the handle connection section 9, This insertion portion 13 is adapted to be inserted into the sheath 2. In addition, the handle connection portion 9
A guide shaft 14 is provided to protrude in the rear axial direction, and a scope connecting portion 15 is fixed to the rear end of the guide shaft 14. On the other hand, a slider 16 that slides in the axial direction along the guide shaft 14 is disposed between the front handle connection part 9 and the rear scope connection part 15.
For example, it is biased by a spring 18 installed between it and the front handle connection part 9 to return to contact with the rear scope connection part 15. Although the spring 18 is an arcuate plate spring in the illustrated example, it may be a coil spring or may not include a spring. Further, the handle connecting portion 9 includes:
Finger rests 19a and 19b are provided on the top and bottom in a protruding manner.
Further, the bottom rear portion of the slider 16 is bulged downward, and a thumb ring 20 is attached to this bulge.

The slider 16 has an electrode fixing part 17 into which the rear end of the electrode 5 is inserted from the front and fixed detachably.
A connector 21 is provided in a protruding manner to supply a high frequency current from a high frequency ablation power source (not shown) to the connected electrode 6. The outer periphery of this connector 21 is covered with an insulating cover 21b fixed by a nut 21a. An electrode 6 fixed to the slider 16 and protruding forward
protrudes forward through an insertion hole formed in the handle connecting portion 9 and an electrode guide pipe 12 protruding forward from the handle connecting portion 9.

Further, the scope connecting portion 15 of the handle 4
The scope 5 can be detachably inserted and connected, and the connected scope 5 can be
It is inserted into the scope guide pipe 11 extending from the front connecting part 9 to the rear scope connecting part 15, and projects forward from this pipe 11. In the illustrated example, the rear extending portion of the scope guide pipe 11 also serves as the guide shaft 14, but it may be constructed separately from this guide shaft.

The scope 5 includes a main body 5b and a main body 5b.
an elongated insertion portion 5a continuous to the front of the main body 5b; a light guide connector 5c provided on the main body 5b;
Eyepiece 5d provided at the rear end of the main body 5b
It is composed of. Within this scope 5,
A light guide fiber (not shown) whose base end is connected to the light guide connector 5c and guides illumination light to the tip of the insertion section 5a, and an objective lens system (not shown) provided at the tip of the insertion section 5a. An image transmission optical system (not shown) is provided to transmit a formed observation image to the eyepiece 5d.

The electrode 6 has a shaft portion 2 inserted into the sheath 2.
2a, a forked part 22b that is bifurcated into two at the tip side of the shaft part 22a, and the tip of this forked part 22b is bent downward to be substantially perpendicular to the shaft part 22a to form an arcuate loop. Excision part (tip electrode) 22c
It is composed of. The cutout portion 22c includes:
A high frequency current is supplied from a power source (not shown) via the connector 21 of the handle 4 or the electrode fixing part 17.
End portion 2 of shaft portion 22a fixed to electrode fixing portion 17
2d, and is further supplied through the inner core of the shaft portion 22a or forked portion 22b, which is coated with insulation. Then, by operating the slider 16 of the handle 4 back and forth under the eyepiece 5d of the scope 5, the resection portion 22c is made to protrude from the beak 7, and any affected area ( It is now possible to selectively resect or incise the prostate gland, etc., or to stop bleeding in bleeding areas.

FIG. 2 shows the resectoscope device 1 of this embodiment.
This shows an arthroscopic image taken with a scope 5 when the urethra is inserted into the urethra. In the figure, reference numeral 61 indicates the inside of the bladder cavity, 62 indicates the spermatozoa, 63 indicates the inner wall of the prostate, and 7a indicates the opening of the beak 7.

In the present embodiment configured as described above, as shown in FIG. Even if the angle of view θ2 of the objective lens system of the scope 5 is widened,
Since the beak 7 is transparent, the periphery of the field of view is not eclipsed by the beak 7, as shown in FIG.
The position of the spermatozoa 62 of the urethra, etc. can be observed through the beak 7. Therefore, the resection range can be easily selected, the operation is easy, and safety can be improved.

4 and 5 relate to a second embodiment of the present invention, FIG. 4 is a side view showing the insertion part of the resectoscope device, and FIG. 5 is a sectional view of the distal end of the resectoscope device. .

This embodiment differs from the first embodiment in the sheath portion, and the sheath in this embodiment includes an inner sheath 24 that supplies irrigation fluid into the bladder, and an outer sheath 25 that discharges irrigation fluid to the outside of the body. It is made up of.

As shown in FIG. 4, the distal end of the insertion portion 24a of the inner sheath 24 is made of an insulating material that has insulation properties, heat resistance, strength, and is transparent, such as transparent ceramics (for example, transparent alumina ceramics Al _{2 ).}
Insulating beaks 7 made of O ₃ ) are arranged in series.
Incidentally, the insertion portion 24a of the inner sheath 24 may be formed integrally with the same transparent ceramic as the beak 7. The inner sheath main body 24b connected to the rear end of the insertion portion 24a has a water supply port 8 with a socket 8a for supplying irrigation fluid into the bladder through the inner sheath 24.
At the same time, it has a connecting part 27 that can be fitted into the fitting opening 26 of the outer sheath 25 on the insertion part side, and a handle connecting part 9 of the handle 4 on the proximal side.
A fitting opening 3 into which the handle connecting portion 9 is fitted, and an attachment/detachment button 10 for engaging and disengaging, for example, a click mechanism for fixing the handle connecting portion 9 within the fitting opening 3 are provided. As shown in FIG. 4, the insertion portion 13 of the handle 4 having the scope guide pipe 11 and the electrode guide pipe 12 can be inserted into the inner sheath 24, as in the first embodiment. Inside the sheath 24, the scope insertion part 5a and the electrode 6 are placed.
As shown in FIG. 5, it is possible to arrange the electrode 6 in a positional relationship that provides a sufficient insulating distance between the cutout part 22c and the tip of the insertion part 5a of the scope 5.

On the other hand, the outer sheath 25 has an insertion portion 25a formed of transparent ceramic or plastic.
and an outer sheath body 25b having a fitting opening 26 connected to the rear end of the insertion portion 25a. The distal end of the insertion portion 25a is provided with a diaphragm 28 formed such that the inner periphery of the distal end comes into contact with the outer periphery of the inner sheath 24, and a large number of small holes 29 for suctioning the irrigation fluid. Further, the outer sheath main body 25b has a drain port 30 with a pot 30a for discharging the irrigation fluid from the inside of the bladder through the outer sheath 25 and out of the body, and also fixes the connecting portion 27 of the inner sheath 24 in the fitting port 26. For example, a rotating ring 31 for engaging and disengaging a cam groove is provided. When the inner sheath 24 is attached to the outer sheath 25, a gap is created between the outer sheath 25 and the inner sheath 24 except for the aperture 28, as shown in FIG.
This gap functions as a drainage passage. That is, as shown by the arrow in FIG. 5, the irrigation fluid is supplied from the water supply port 8 through the inner sheath 24 into the bladder, and is supplied to the outer sheath 25 from the small hole 29 formed at the distal end of the outer sheath 25. and the inner sheath 24, and is discharged from the drain port 30 through this gap.

According to this embodiment, the inner wall of the urethra can be observed over a wide range through the transparent beak 7 of the inner sheath 24 and the transparent insertion portion 25a of the outer sheath 25, and the irrigation fluid is supplied from the inner sheath 24. Since water can be drained from the outer sheath 25 and perfusion can be performed continuously, a clear visual field can be obtained at all times.

Other configurations, operations, and effects are the same as those in the first embodiment.

The present invention is not limited to the above-mentioned embodiments, and the present invention is not limited to a resectoscope that is inserted into the urethra to remove the prostate. Similarly, other high-frequency endoscopic devices for resecting the cavity, the inside of the ureter, the inside of the kidney, etc., can be applied to each of the above embodiments by forming the entire beak or sheath insertion part from a transparent insulating material such as transparent ceramic. A similar effect can be obtained.

[Effect of the invention] As explained above, according to the invention, at least the tip of the sheath is formed of a transparent insulating material, and a wide field of view can be observed through the tip of the transparent sheath, so that the electrode and the scope can be easily observed. This has the effect that a sufficient distance between the distal ends can be maintained, electrical safety can be increased, and the observation range can be widened by widening the angle of the scope, so that, for example, the selection of the resection range can be performed reliably.

[Brief explanation of the drawing]

Figures 1 to 3 relate to the first embodiment of the present invention, in which Figure 1 is a sectional view of the distal end of the resectoscope device, and Figure 2 is a mirror view when the resectoscope device is inserted into the urethra. FIG. 3 is a side view of the resectoscope device, FIGS. 4 and 5 relate to the second embodiment of the present invention, and FIG. 4 shows the inserted part of the resectoscope device. 5 is a sectional view of the distal end of the resectoscope device, FIG. 6 is a sectional view of the distal end of the conventional resectoscope device, and FIG. 7 is a sectional view of the conventional resectoscope device inserted into the urethra. It is an explanatory view showing an arthroscopic image at the time of insertion. 1... resect scope device, 2... sheath,
2a...Sheath insertion part, 4...Handle, 5...
Scope, 5a... Insertion section, 6... Electrode, 7...
Beak, 22a...resection part.

Claims (1)

[Scope of utility model registration request] An elongated and hollow sheath inserted into a body cavity, an electrode inserted into the sheath and used to ablate or coagulate tissue in the body cavity using high frequency waves, an operating section capable of operating the electrode from outside the body, and the sheath. A high-frequency endoscope device equipped with an optical viewing tube that is inserted into a body cavity and has an optical system that allows observation of the inside of a body cavity, characterized in that at least a distal end portion of the sheath is formed of a transparent insulating material. Endoscope equipment.