JP2000140118A - High frequency treatment implement - Google Patents

Abstract

PROBLEM TO BE SOLVED: To execute efficient treatment by small electric power by providing a balloon near the tip part of an inserting member, arranging plural electrodes on the outer surface of this balloon to constitute a bipolar-type electrode and expanding the balloon to place this electrode on a treating area in the body cavity to make high frequency current flow. SOLUTION: The part of the flexible sheath 2 of the tool 1 is introduced into the body cavity through the channel of an endoscope previously inserted into the body cavity in using the high frequency treating implement 1. The tip part of the sheath 2 is projected from the tip of the endoscope and the part of the balloon 3 is positioned at the constricted part of a tube-like internal organ. Then, at the time of expanding the balloon 3 by feeding fluid for expansion into the balloon 3 by a syringe fixed to a mouthpiece 24, the part of a high-frequency electrode 6 is pushed to be in contact with an affected part. At the time of energizing a high frequency current to the electrode 6 in this case, tissues in the neighborhood of the electrode 6 are denatured to expand the constricted part. Thus, high frequency treatment is surely and efficiently executed.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a high-frequency treatment device which is introduced into a body cavity through a channel of an endoscope, for example, and treats an affected part in the body with high frequency.

[0002]

2. Description of the Related Art In Japanese Utility Model Publication No. 61-7694,
2. Description of the Related Art There is known a high-frequency incision device that is inserted into a body cavity through a channel of an endoscope so as to incise tissue at a site in the body cavity with high frequency. In this high-frequency incision instrument, two holes are provided in a side wall of a distal end portion of a flexible tube to be inserted into a body cavity.
From the two holes, a part of the conductive wire inserted into the flexible tube is exposed to the outside, and the part of the conductive wire exposed by pushing and pulling the conductive wire with the hand operation unit is formed into an arc shape. Swell or shrink. And
After introducing the distal end of the flexible tube into the stenotic part of the tubular organ, surgery is performed to incise the stenotic part of the tubular organ by applying high frequency while swelling the conductive wire to release the stenosis. Is performed.

[0003]

[Problems to be Solved by the Invention]
In the high-frequency incision device disclosed in Japanese Utility Model Publication No. Sho 61-7694, when a treatment for releasing a stenotic part of a tubular organ is performed by this, a part of the conductive wire is pushed out to the side to be swollen and pressed against tissue. Although it is necessary, even if the conductive wire inserted into the long flexible tube is pushed, the force is not sufficiently transmitted to the exposed portion of the conductive wire. Further, depending on the shape of the conductive wire, the pressing action of the conductive wire against the affected part may be insufficient. In addition, since the conductive wire provided at the distal end of the flexible tube constitutes a monopolar electrode, there is no intention to treat since a current flows also to a tissue part which is not intended to be treated toward the extracorporeal electrode. There are circumstances in which the effect of the current path on the tissue part must be sufficiently considered.

(Object) The present invention has been made in view of the above-mentioned problems. The object of the present invention is to reliably press an electrode portion against a treatment site and to restrict a high-frequency current to a range required for treatment. It is an object of the present invention to provide a high-frequency treatment instrument that can efficiently treat a tissue by flowing the gas.

[0005]

According to the present invention, a balloon is provided near the distal end of an insertion member to be inserted into a body cavity, and a plurality of electrodes are arranged on the outer surface of the balloon to constitute a bipolar electrode. A high-frequency treatment instrument characterized in that the balloon is inflated and the bipolar electrode is pressed against a treatment target site in a body cavity to flow a high-frequency current.

[0006]

The electrode portion is reliably pressed against the affected part by the inflation of the balloon. In addition, since the bipolar type electrode is configured, the high-frequency current flows only in the vicinity of the plurality of electrodes in a limited manner, and the high-frequency current does not flow unnecessarily to the part of the tissue that is not intended to be treated.

[0007]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS [First Embodiment] A high-frequency treatment instrument for an endoscope according to a first embodiment of the present invention will be described with reference to FIGS.

(Structure) FIG. 1 shows the entire high-frequency treatment instrument 1. This high-frequency treatment instrument 1 has a flexible tube 2 as an insertion member to be inserted into a body cavity, and the flexible tube (catheter) 2 is an insertion member that can be inserted into a body cavity through a channel of an endoscope (not shown). It constitutes. An elastically inflatable balloon 3 is attached to the distal end of the flexible tube 2. As shown in FIG. 2, the outer surface of the balloon 3 is provided with the flexible tube 2.
Two electric wires 4 and 5 so as to run substantially parallel along the axis of
Is attached. The portions of the electric wires 4 and 5 exposed on the outer surface of the balloon 3 form high-frequency electrodes 6 and 7, respectively, and the pair of high-frequency electrodes 6 and 7 constitute a bipolar electrode 8. The surface of the balloon 3 in contact with the electric wires 4 and 5 is coated with a fluororesin,
The electric wires 4 and 5 are electrically insulated from each other.

In the flexible tube 2, a distal end portion 9 located on the distal end side of the balloon 3 is tapered. The cross-sectional shape of the flexible tube 2 is as shown in FIG. 3, and the flexible tube 2 is formed by an integrated multi-lumen tube having a plurality of conduits 11, 12, 13, and 14. ing. 1st pipeline 1
Reference numeral 1 denotes a large semicircular shape, and the first conduit 11 penetrates to the distal end of the flexible tube 2. The second to fourth conduits 12, 13, 14 are arranged on the first conduit 11 side by side. The fourth conduit 14 leading to the balloon 3 is located between the second conduit 12 and the third conduit 13 for individually passing the electric wires 4 and 5 respectively.

The fourth conduit 14 communicates with the inside of the balloon 3 through a communication hole 16 as shown in FIG. In addition, the second conduit 12 and the third conduit 13 are opened to outside from a drawing hole 18 provided near the base end side of the balloon 3. The distal ends of the wires 4 and 5 are connected and fixed to the flexible tube 2 near the distal end side of the balloon 3. Each electric wire 4,
The proximal end portion 5 is drawn into the corresponding second pipe line 12 and third pipe line 13 by corresponding inlet holes 18. The electric wires 4 and 5 are arranged so as to be electrically insulated from each other.

At the base end of the flexible tube 2, a main body 20 is provided.
A plug 21 is attached to the main body 20 via a conducting wire 22. Furthermore, the main body 20
Are fitted with tubes 23 and 24 via tubes 25 and 26, respectively. The conductive wire 22 has two conductive wires (not shown) therein, and the connecting wires 27 and 28 provided on the plug 21 via the conductive wires.
Are connected individually. This plug 21
Is connected to a high-frequency power supply (not shown), the connection pins 27,
28 is electrically connected to the high frequency power supply.

The ferrules 23 and 24 communicate with the corresponding conduits 11 and 14 via the tubes 25 and 26, respectively. A luer taper is formed in the openings of the bases 23 and 24, and a syringe (not shown) is attached to the bases 23 and 24.

(Operation) When using the high-frequency treatment instrument 1, a portion of the flexible sheath 2 of the high-frequency treatment instrument 1 inserted into a body cavity in advance, for example, through a channel of an endoscope (not shown) is introduced into the body cavity. . At this time, the balloon 3 is kept deflated. Further, since the balloon 3 is in a contracted state, the electric wires 4 and 5 do not protrude strongly.

Next, the distal end portion of the flexible sheath 2 is protruded from the distal end of the endoscope, and the balloon 3 is positioned at the stenosis of the tubular organ. Then, an inflation fluid is sent into the balloon 3 by a syringe attached to the base 24, and the balloon 3 is inflated as shown in FIGS. Then, the stenosis portion is expanded by the inflated balloon 3. As a result, the high-frequency electrodes 6 and 7 are pressed against and contact the affected area. In this state, when a high-frequency current is applied to the high-frequency electrodes 6 and 7, the high-frequency current flows from the high-frequency electrode 6 to the high-frequency electrode 7 (or from the high-frequency electrode 7 to the high-frequency electrode 6). Metamorphosis results in dilation of the stenosis.

The flexible tube 2 is connected to the base 23.
Can be used as a catheter for feeding a liquid through the conduit 11 by attaching a syringe (not shown). (Effect) As described above, since the high-frequency electrodes 6 and 7 are pressed against the diseased part, reliable and efficient high-frequency treatment can be performed.

[Second Embodiment] A high-frequency treatment instrument for an endoscope according to a second embodiment of the present invention will be described with reference to FIG. However, components having the same configuration as that of the first embodiment are denoted by the same reference numerals, and detailed description thereof will be omitted.

(Structure) The high-frequency treatment device according to the second embodiment differs from the first embodiment in the structure of the bipolar electrode formed on the outer surface of the balloon 3, as shown in FIG. That is, the bipolar electrode 30 is
1 and 32 are made of elastic wires, and these electrodes 3
An electrically insulative wire 33 that expands and contracts with 1, 32 is braided or braided to form a mesh structure, and is attached to substantially the entire outer periphery of the balloon 3. One electrode 31 is divided into a plurality of electrode portions 31a, 31b,..., And the other electrode 32 is also divided into a plurality of electrode portions 32a, 32b.
b, 32c,... And electrode 3
0 from the front end side of the electrode portions 32a, 31a, 32b, 31
are arranged in the order of b,. The surface of the balloon 3 with which the electrode portions 31a, 31b, 32a, 32b, 32c are in contact is coated with a fluororesin. The electrode portions 31a and 31b of the one electrode 31 are connected to the conducting wire 35.
Are connected to each other by the electrode portion 32 of the other electrode 32
a, 32b and 32c are connected to each other by another conducting wire 36. The conducting wires 35 and 36 are drawn into the corresponding second conduit 12 and third conduit 13 by the lead-in holes 18 in the same manner as in the above-described embodiment. Then, they are individually connected to the connection pins 27 and 28 of the plug 21, respectively.

(Operation) In this embodiment, when the balloon 3 is contracted, the electrodes 31 and 32 and the insulating wire 33 are attached to the outer peripheral surface of the balloon 3 in a state of being contracted by the elasticity thereof. When the balloon 3 is inflated, the electrodes 31 and 32 also spread and are pressed against the affected part. When electricity is supplied in this state, the electrode 31 is moved to the electrode 32 (or the electrode 3
2 to the electrode 31), the tissue near each of the electrodes 31, 32 is denatured, and the stenosis is expanded.

(Effect) An electrode 3 is provided around the entire periphery of the balloon 3.
Since the bipolar electrodes 1 and 32 are provided to form the bipolar electrode, the denaturation of the tissue and the release of the stenotic portion are completed by a single energization. [Third Embodiment] With reference to FIG. 7, a high-frequency treatment instrument for an endoscope according to a third embodiment of the present invention will be described. However, the same components as those in the first and second embodiments are denoted by the same reference numerals, and the detailed description thereof is omitted.

(Structure) As shown in FIG. 7, the high-frequency treatment instrument for an endoscope according to the third embodiment has a bipolar electrode 40 formed on the outer surface of the balloon 3 in comparison with the first and second embodiments. different. That is, the bipolar electrode 40 is provided such that the electrodes 41 and 42 are wound around the outer periphery of the balloon 3 in two spirals. These electrodes 41, 42
Is formed by, for example, metal deposition or adhesion of a conductive elastic body. Further, the electrodes 41 and 42 may be made of a conductive resin.

Each of the electrodes 41, 42 has a conducting wire 43, 4 connected thereto.
4 are respectively connected, and the electric wires 43 and 44 are individually connected to the pins 27 and 28 of the plug 21 similarly to the above-described embodiment.

(Operation) In this embodiment, when the balloon 3 is inflated, the electrodes 41 and 42 are pressed against the affected part. When electricity is supplied in this state, a current flows from the electrode 41 to the electrode 42 (or from the electrode 42 to the electrode 41),
The tissue near each of the electrodes 41 and 42 is denatured, and the stenosis is expanded.

(Effects) The electrodes 41, 4 are arranged all around the balloon 3.
2 to form the bipolar electrode 40, the denaturation of the tissue and the release of the stenosis are completed by a single energization. Further, since the electrodes 41 and 42 are directly attached to the surface of the balloon 3 and the electrodes 41 and 42 are flexible, the electrodes 4 and 42 are applied to the tissue according to the shape of the affected part when the balloon 3 is inflated.
1, 42 can be reliably pressed.

<Supplementary Notes> A balloon is provided near the distal end of the insertion member inserted into the body cavity, a plurality of electrodes are arranged on the outer surface of the balloon to form a bipolar electrode, and the balloon is inflated to form the bipolar electrode inside the body cavity. A high-frequency treatment instrument characterized in that a high-frequency current is caused to flow by being pressed against a treatment target site. 2. An electrode constituting a bipolar electrode is constituted by a plurality of electrodes arranged on the outer surface of the balloon so as to travel substantially parallel along the direction of the insertion portion, wherein a first electrode is provided.
A high-frequency treatment device according to the item. 3. 2. The high-frequency device according to claim 1, wherein the bipolar electrode has a mesh structure formed by a conductive electrode wire having elasticity on the outer surface of the balloon and an electrically insulating wire having elasticity. Treatment tools. 4. 2. The high-frequency treatment instrument according to claim 1, wherein the bipolar electrode is constituted by a plurality of spirally arranged electrodes on the outer surface of the balloon.

[0025]

As described above, according to the present invention, a procedure such as release of a stenosis can be reliably performed by inflating a balloon and pressing an electrode of a bipolar electrode against an affected part to energize it. . In addition, since the bipolar type electrode is used, the path of the high-frequency current is limited to the vicinity of the affected part, so that adverse effects on a tissue part not intended for treatment can be eliminated.
In addition, efficient treatment can be performed with less electric power than monopolar.

[Brief description of the drawings]

FIG. 1 is a side view of a high-frequency treatment device according to a first embodiment.

FIG. 2 is a perspective view of the distal end of the high-frequency treatment instrument.

FIG. 3 is a cross-sectional view of a portion along the line AA in FIG.

FIG. 4 is a cross-sectional view of a portion along the line BB in FIG. 1;

FIG. 5 is a vertical cross-sectional view of the insertion member of the high-frequency treatment tool taken along line CC in FIG. 3;

FIG. 6 is a side view of a distal end portion of the high-frequency treatment tool according to the second embodiment.

FIG. 7 is a side view of a distal end portion of the high-frequency treatment device according to the third embodiment.

[Explanation of symbols]

DESCRIPTION OF SYMBOLS 1 ... High frequency treatment tool, 2 ... Flexible tube, 3 ... Balloon, 4, 5 ... Electric wire, 6, 7 ... High frequency electrode, 8 ... Bipolar electrode.

Claims (1)

[Claims] A balloon is provided near the distal end of an insertion member to be inserted into a body cavity, a plurality of electrodes are arranged on an outer surface of the balloon to form a bipolar electrode, and the balloon is inflated to form the bipolar electrode. A high-frequency treatment instrument wherein an electrode is pressed against a treatment target site in a body cavity to flow a high-frequency current.