JPS62211054A - Apparatus for incising tissue of living body - Google Patents

Abstract

(57) [Summary] This bulletin contains application data before electronic filing, so abstract data is not recorded.

Description

DETAILED DESCRIPTION OF THE INVENTION [Industrial Field of Application] The present invention relates to a biological tissue resection device for resecting tissue within a living body while visually confirming it with an optical viewing tube.

[Prior art]

In recent years, urinary endoscopes such as cystourethroscopes and resectoscopes have come to be widely used for observation, diagnosis, and treatment of urinary system diseases. In order to remove the affected tissue while visually checking the affected area using such a urinary endoscope,
For example, using a resectoscope disclosed in Japanese Patent Application Laid-Open No. 58-81029, the affected tissue is cauterized and resected with high-frequency current.

[Problem that the invention seeks to solve]

In conventional technology, when ablation is performed using high-frequency current,
Cauterization causes biological tissue to degenerate and whiten, making it difficult to determine the area to be cauterized and resected, and there is a risk that normal tissue may also be excised. Furthermore, if the cutting tool accidentally comes into contact with muscle tissue, there is a risk that the patient will cause a reflex action, resulting in perforation or the like, resulting in serious accidents such as excessive bleeding.

The present invention was made with attention to these problems, and there is less risk of erroneous resection (i.e., there is less risk of erroneous resection (i.e., there is no difference between the affected tissue and the normal 'rJl' during resection).
It is an object of the present invention to provide a living tissue resection device that allows collars to be easily identified.

[Means for solving problems]

This device has a guide hole 3 for insertion of a treatment instrument in an optical viewing tube 4, and a resection tool 2 that applies ultrasonic vibrations to living tissue is inserted into this guide hole 3. 5
c, 5d.

[For production]

In this device, a cutting tool 2 that applies ultrasonic vibrations to tissue is inserted into an optical viewing tube 4, and the cutting tool 2 is inserted into living tissue while observing through the optical viewing tube 4.
, 6d are placed on the living tissue, vibrations are transmitted by the ultrasonic vibrator at the rear end to the cutting blades 6c and 5d, causing the living tissue to be excised.

〔Example〕

The present invention will be explained based on illustrated embodiments.

FIG. 1 shows a biological tissue resection device according to an embodiment of the present invention. It consists of an optical viewing tube 4 having a hole 3 therein.

As shown in FIG. 2, the cutting tool 2 is composed of a grip part 5 containing an ultrasonic vibration device, a cutting member 6 inserted into the guide hole 3 of the optical viewing tube 4, and a power supply part (not shown). There is. As shown in detail in FIG. 3, the gripping portion 5 is for housing a bottomed cylindrical cup-shaped exterior member 8 for housing the ultrasonic transducer 7 and a hole 79 located in front of the transducer 7. A male threaded fiber 8a is formed on the outer periphery of the open end of the outer member 8, and both ends of the female thread 8a are open, so that both members 8 and 10 are integrated. It looks like this.

A cutting member mounting portion of the horn 9 extends from the small diameter opening 10b of the exterior member 10, and a circumferential groove portion 10c is formed on the inner periphery of the opening portion 10b, and the horn 9 is inserted into the circumferential groove portion 10C. An O-ring 11 is fitted for airtightness.

In the interior space of the exterior member 8, a Langevin-type ultrasonic transducer 7 with screw fastening is supported by an O-ring 12° 13, and one electrode 14 of the transducer 7 is connected to a lead wire 15. The other electrode 16 is led out of the exterior member 8 as a connection cable 18 via a lead wire 17, and is connected to an ultrasonic power source (not shown).

On the other hand, the ultrasonic transducer 7 housed within the exterior member 10
The front horn 9 has its small-diameter tip extending outward from the small-diameter opening 10b, and has a connecting hole 9a bored in the tip and a male thread 9b formed on its outer periphery. In this connection hole 9a, a base 6a of a long axis-shaped cutting member 6 is provided.
is fitted, and after bringing the flange portion 6b formed near the base of the cutting member 6 into close contact with the end face of the small diameter tip of the horn 9, the cutting member 6 is removed by tightening the ring nut 19 onto the male thread 9b. Fixed. A hoe-shaped cutting blade 6c is provided at the tip of the cutting member 6, as shown in side and plan views in FIGS. 4 and 5.

Further, the cutting member 6 is detachably attached to the horn 9 of the ultrasonic transducer 7 via the ring nut 19.

The cutting member 6 of the cutting tool 2 is inserted into the treatment tool insertion guide hole 3 of the optical viewing tube 4 as shown in FIG. That is, in the optical viewing tube 4, the base of a rigid cylindrical insertion part 20 is fixed to a main body part 21, and the main body part 21 is provided with a light guide cap 22, and this cap 22 is equipped with a light source (not shown). Illumination light from the device is incident and transmitted to light guides 23, 24 (see FIG. 7) within the insertion section 20. Also, a pipe 25 forming the guide hole 3
passes through the main body 21, and a rubber cap 26 is attached to the opening at the outer end to maintain airtightness with the cutting tool 2.

As shown in an enlarged view in FIG. 7, the cross section of the insertion portion 20 is a pipe 2 with a treatment instrument insertion guide hole 3 formed therein.
5, an image guide 27, and a light guide 23, 24 are inserted through it, and these members are fixed in place by a filling member 28. and optical viewing tube 4
The eyepiece 29 allows the patient to observe the affected area.

In order to excise a diseased part using the living tissue resection device 1 configured as described above, the insertion section 20 is inserted into the living body with an insertion aid (not shown) attached to the entrance of the living body. Then, while observing the affected area through the eyepiece 29 of the optical viewing tube 4, insert the resection blade 6c at the tip of the resection tool 2 along the two-dot chain line in FIG. Position it at the tip of the affected tissue to be resected as shown in . When the ultrasonic vibrator 7 is energized in this state, the ultrasonic vibration generated in the vibrator 7 is intensified by the horn 9, and this intensified ultrasonic vibration is transmitted to the cutting blade 6C via the cutting member 6.

If the cutting tool 2 is pulled toward the user while maintaining this vibration state, the affected tissue can be removed by the cutting blade 6c as shown by the solid line in FIG. 8.

At this time, since degeneration and whitening of 'fLJim does not occur during resection with the resection blade 6C, normal tissue and diseased tissue can be clearly distinguished, and erroneous resection is prevented.

The shape of the cutting blade 6C in the above embodiment may be a spatula shape like the cutting blade 6d shown in FIGS. 9 and 10. Further, as shown in FIG. 11, if a ring-shaped resin ring 30 made of a low-friction material such as tetrafluoroethylene resin is attached to the vibrating part of the cutting member 6 of the cutting tool 2, the treatment can be performed. The friction with the tool insertion guide hole 3 can be reduced and the efficiency of ultrasonic vibration can be improved.

Furthermore, the same effect can be achieved even if the resin ring 30 is fixed inside the guide hole 3.

Further, the insertion portion 20 may additionally be provided with a guide hole through which a treatment tool other than the cutting tool 2, such as forceps, is inserted.

Further, the cutting member 6 may be fixed to the tip of the horn 9 by means of brazing or the like, and by doing so, the loss of ultrasonic transmission is further reduced.

[Effects of the Invention] As described above, according to the present invention, since the affected tissue in the living body is excised by the cutting blade to which ultrasonic vibrations are applied, there is no degeneration and whitening of the tissue, and the resection range can be easily determined by the job, and errors can be avoided. Excision can be prevented.

Furthermore, even if the cutting blade comes into contact with muscle tissue during cutting, a high-frequency current will not flow as in the conventional case, so serious accidents such as perforation can be prevented.

[Brief explanation of drawings]

FIG. 1 is a side view of a living tissue resection device showing an embodiment of the present invention, FIG. 2 is a side view of the resection tool shown in FIG. 1, and FIG. FIG. 4 is a side view of the cutting blade shown in FIG. 2, FIG. 5 is a plan view of the cutting blade shown in FIG. 4, and FIG. 1. The figures are a side view of the optical viewing tube shown in FIG. 1, FIG. 7 is an enlarged sectional view taken along line A-A in FIG. 6, and FIG. FIG. 9 is a side view showing the state of the resection blade that excises the affected tissue with the device; FIG. 9 is a sectional view showing another example of the resection blade according to the present invention; FIG. 10 is a plane view of the resection blade shown in FIG. 9 above. 11 are side views showing a modification of the cutting member in the cutting device of the present invention. 1... Living tissue resection device 2... Cutting tool 3... Guide hole 4... Optical viewing tube 6... Cutting members 6c, 6d... - Cutting blade 7... Ultrasonic vibrator 9... Horn 30... Resin ring

Claims (6)

[Claims] (1) In a living tissue resection device comprising an optical viewing tube having a guide hole for insertion of a treatment instrument, and a cutting tool that is inserted through the guide hole of the optical viewing tube and applies ultrasonic vibration to the tissue, the tip of the cutting tool is A biological tissue resection device characterized by having a resection blade in the section. (2) The resection tool includes an ultrasonic vibrating device consisting of a Langevin type ultrasonic vibrator and a horn, and a shaft to which vibrations from the ultrasonic vibrating device are transmitted and which is inserted into the guide hole of the optical viewing tube. 2. The living tissue resection device according to claim 1, further comprising a cutting member having a cutting edge and a cutting blade formed at the distal end thereof. (3) The living tissue resection device according to claim 1, wherein the resection blade has a hoe-shaped shape. (4) The living tissue resection device according to claim 1, wherein the resection blade has a spatula shape. (5) The living tissue resection device according to claim 1, wherein the optical viewing tube has a guide hole through which a treatment tool such as forceps other than the resection tool is inserted. (6) The living tissue resection device according to claim 1, wherein a low-friction resin ring is formed at the vibration node of the shaft of the resection tool.