JPH0324219B2 - - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION (Field of Industrial Application) The present invention relates to a resectoscope for performing transurethral electrical resection of benign prostatic hyperplasia, bladder cancer, and the like.

(Prior art) This type of resectoscope has an optical viewing tube and a rod-shaped electrode inserted into the working element sheath, and a loop (electrical conductor) is attached to the tip of the rod-shaped electrode, which is protruded from the tip of the sheath. I'm getting used to it. This resectoscope is used to perform transurethral electrical ablation on patients with benign prostatic hyperplasia or bladder cancer.After the patient is given lumbar anesthesia, the resectoscope is inserted into the urethra and the tip reaches the lesion. let Next, the lesion is directly viewed through the attached optical viewing tube, and the loop is brought close to the target enlarged prostate tissue and cancerous tissue under direct vision. Then, a high-frequency ablation current is applied to this loop to ablate the tissue. At the same time, sterilized water is run to wash the area, and the loop is applied to the bleeding point, and a coagulating high-frequency current is applied to the loop to stop the bleeding.

There are two main types of resectoscope loops: one for resection and one for coagulation. The excision loop consists of a thin wire with a diameter of approximately 0.3 mm.
On the other hand, the coagulation loop consists of a thick electric wire with a diameter of about 0.7 mm.

(Problems with the Prior Art) When a predetermined tissue is excised using a resection loop, the tissue may not be completely excised because the tissue has non-uniform hardness. In this case, resection has to be performed again, which increases the surgical time.

Furthermore, if there is an incompletely excised site, this will block the bleeding point, making it difficult to find the bleeding point, and causing a problem that coagulation cannot be performed reliably. Moreover, the cutting loop is not suitable for coagulation, and when it is used, it has the disadvantage that coagulation cannot be performed efficiently. There is also a method of coagulating the loop by replacing it with a thicker one, but it takes time to replace it, which increases the surgical time.

There is also a method of passing both a high-frequency current for ablation and a high-frequency current for coagulation through the resection loop to perform ablation and coagulation, but both methods tend to be incomplete.
Surgery requires skill.

(Technical problem to be solved) This invention enables reliable resection even if the tissue is hard.
Moreover, it is an object of the present invention to obtain a resectoscope loop that can reliably perform coagulation in a short time simply by switching the high-frequency current to coagulation.

(Structure of the Invention) The present invention provides a resectoscope loop that is attached to the tip of a rod-shaped electrode inserted into a working element sheath so as to be able to protrude and retract from the tip of the sheath.
The loop is a resectoscope loop made up of at least two resection electric wires, which are arranged close to each other in the same direction with an interval of 0.2 mm to 1.0 mm.

The present invention will be described below with reference to illustrative embodiments.

FIG. 1 is an overall schematic diagram of the resectoscope. This resectoscope has an optical viewing tube 2 and a rod-shaped electrode 3 inserted into a working element sheath 1, and two loops (electrical conductors) 4 and 5 are protruded from the sheath tip to the tip of the rod-shaped electrode 3. Immersively installed.

In addition, 6 in the figure is a slider, which is operated to cause the loops 4 and 5 to protrude and retract from the sheath tip with a predetermined stroke.

FIG. 2 shows an enlarged view of the tip of the resectoscope, and FIG. 3 shows an enlarged view of the two loops 4 and 5. At the tip of the rod-shaped electrode, a bifurcated wire (not shown) is covered with insulating members 7 and 8, and the loops 4 and 5 are disposed at the tip. each loop 4,5
consists of thin cutting wire. The thin resection electric wire herein refers to a wire with a diameter suitable for tissue resection, preferably 0.1 to 0.5 mm in diameter, particularly preferably 0.3 mm. Although this material is not particularly limited, it is generally made of nichrome. Furthermore, each loop 4, 5 is arranged close to each other. Here, arranging in close proximity in the same direction means a distance that allows tissue to be resected in one loop 4 and then continuously in the other loop 5, and that both loops 4 and 5 are used for coagulation. This refers to placing the devices at a distance that allows them to coagulate when high-frequency current is applied to the tissue to efficiently coagulate bleeding points. Specifically, the distance between both loops 4 and 5 is 0.2 to 1.0 mm, preferably
It is best to have a spacing of 0.6mm.

(Operation) The resectoscope having the above-described structure is inserted into the urethra, the tip reaches the lesion, and the lesion is viewed directly through the optical viewing tube 2. Loops 4 and 5 are brought close to the tissue to be ablated under direct vision, and a high-frequency current for ablation (usually 450 KHz) is passed through the loops 4 and 5. The high-frequency current is supplied by depressing a pedal and causing a high-frequency current generator (not shown) to flow. This resectoscope consists of double loops 4 and 5, so
Since the tissue is excised twice, even if the tissue has uneven hardness, the tissue can be reliably and completely excised in a short time. When the tissue is excised and washed with sterile water at the same time, the excised tissue and the blood that has come out from it are flushed into the bladder, keeping the field of vision clear and allowing the bleeding point to be seen clearly.

Next, the loops 4 and 5 are applied again to the bleeding point, and a coagulating high-frequency current (usually 450 KHz) is applied thereto to stop the bleeding. In this case, since both the loops 4 and 5 are close to each other, they jointly act on the bleeding point, and although the wire is thin, it is possible to obtain the same effect as when using a thick coagulating wire.

(Other Examples) The present invention is not limited to the above embodiments. For example, in addition to the configuration shown, another rod-shaped electrode may be provided, and a coagulation loop made of a thick electric wire may be attached to the tip of the electrode.

(Effects of the Invention) As explained above, according to the present invention, the same tissue is ablated twice, so the tissue can be completely ablated, and when coagulating, the high-frequency current for ablation is switched to the high-frequency current for coagulation by depressing the pedal. Just that is enough.
Therefore, the surgery can be performed accurately, the surgical time can be shortened, and the surgical effect can be improved.

[Brief explanation of the drawing]

Fig. 1 is an overall view of a resectoscope showing an embodiment of the present invention, Fig. 2 is an enlarged view of the tip of the resectoscope, and Fig. 3 is an enlarged view of the electric conductor of the resectoscope. FIG. DESCRIPTION OF SYMBOLS 1... Working element sheath, 2... Optical viewing tube, 3... Rod-shaped electrode, 4, 5... Loop (electric conductor), 6... Slider, 7, 8... Insulating member.

Claims (1)

[Claims] 1. A resect scope loop that is attached to the tip of a rod-shaped electrode inserted in a working element sheath so that it can be protruded and retracted from the tip of the sheath, and the loop consists of at least two resection electric wires, which are separated by 0.2 mm to 1.0 mm. Loops for resectoscopes that are arranged closely in the same direction at intervals of .