JPH09262244A - Resectoscope - Google Patents

Abstract

PROBLEM TO BE SOLVED: To effectively treat the transpiration and coagulation of the human tissue by applying a touch face on the electrode for the human tissue resection and turning on high frequency electricity focused to the part touching the human tissue thanks to a concave processed there to minimize touching face. SOLUTION: Within the sheath 3 formed in the resectoscope are arranged an inserter 4 and an electrode unit 17 made of a roller transpiration electrode. The unit 17 is composed of a thin rod 25, a Y shaped pair of arms 26a, 26b connected to the edge of the rod 25 by a wire 24 put closer to its center and a roller axis 27 held between the edges of arms 26a, 26b. The roller axis 27 has a roller 28 to rotate free made of a cylindrical metal having several ring like grooves (recessed parts) 33 on around. With this means a space to touch the human body is minimized and high frequency electricity is turned focused on there so as to effectively treat the transpiration and coagulation of the human tissue.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a resectoscope for performing excision and transpiration of the prostate, excision of lesions in body cavities and bleeding, coagulation and hemostasis under an endoscope.

[0002]

2. Description of the Related Art Generally, in a resectoscope, a scope (optical tube) which is an endoscope for observation and an electrode for excising a living tissue are inserted into a sheath to observe a lesion in a body cavity with the scope. On the other hand, the electrode is projected and retracted from the distal end opening of the sheath to the outside to burn the lesion.

Conventionally, for example, in Japanese Utility Model Publication No. 4-2645, an electrode formed in a loop shape with a thin wire is provided at the tip portion of an electrode rod as this type of resectoscope.
A structure is disclosed in which a high-frequency current is passed through the electrode to cut away the tissue.

DE 4242126C1 discloses a roller rotatably supported on a wire as an electrode of a resectoscope. Then, in a state in which the roller arranged in front of the endoscope is pressed against the living tissue, by moving the roller back and forth with respect to the endoscope, the roller is rolled on the living tissue, and further the roller is rolled on the living tissue. By applying a high-frequency current to the roller, treatment such as transpiration of the prostate and coagulation of a lesion area is performed.

Further, here, a large number of protrusions are provided on the roller, and when the roller is rolled on the living tissue, the protrusions are pierced into the tissue to give a therapeutic effect to the deep portion of the tissue, and the high-frequency current causes The efficiency of transpiration and coagulation of lesions is being improved.

[0006]

Since the tip shape of the electrode of the resectoscope disclosed in Japanese Utility Model Publication No. 4-2645 is formed in a loop shape with a thin wire, a living tissue is formed while a high frequency current is applied to the electrode. Although it is possible to excise it like shaving, there is a problem that it is difficult to operate the resectoscope for uniformly shaving a living tissue over a wide range.

Further, in order to stop the bleeding by applying an electrode formed in the shape of a loop with a thin wire to the bleeding part, or to accurately coagulate a wide area, it is necessary to accurately apply the thin loop to the bleeding part. There is also a problem that difficult operation of the resectoscope is required.

[0008] Further, recently, a surgical operation has been performed to treat benign prostatic hyperplasia, in which a high-output high-frequency current is passed through the prostate to evaporate at once and the prostate is reduced to improve the urination state. The shaped electrode has a problem that it is impossible to uniformly evaporate a wide range.

Further, in the technique of DE4242126C1, if a large number of protrusions provided on the roller are too high, the living tissue will be deeply vaporized or burnt in spots.
There is a problem that a wide area cannot be treated uniformly. Further, since the electric current is concentrated on the protrusions, the tips of the protrusions are deformed or worn by heat, and the treatment effect is deteriorated.

If the protrusion on the roller is too low, the roller body directly contacts the living tissue, so that the current is not concentrated on the protrusion and flows from the roller body to the living tissue, resulting in a problem of reduced therapeutic effect. .

The present invention has been made in view of the above circumstances, and an object thereof is to enable a high-frequency current to be intensively applied to a contact portion with a living tissue and to perform treatment such as evaporation of the living tissue or coagulation. An object of the present invention is to provide a resectoscope that can improve efficiency and can easily perform an operation for uniformly treating a wide range.

[0012]

Means for Solving the Problems A scope, a sheath for inserting the scope into a body cavity, an electrode for excising living tissue protruding from the tip opening of the sheath to the outside, and an electric current flowing through the electrode. In the resectoscope having an electrode energizing means, the electrode is provided with a surface contact portion that makes a substantially surface contact with a biological tissue, and the surface contact portion is provided with a recessed portion that reduces a contact area with the biological tissue. It is a characteristic resectoscope. And, by reducing the contact area with the living tissue by the recessed portion of the surface contact portion of the electrode, the high-frequency current is intensively flown to evaporate the living tissue and enhance the efficiency of treatment such as coagulation, and a wide range. The operation for uniform treatment can be easily performed.

[0013]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS Hereinafter, a first embodiment of the present invention will be described with reference to FIGS. FIG. 1 shows a schematic configuration of the entire resectoscope according to the present embodiment. The resectoscope is provided with a scope 1, a working element 2 and a sheath 3.

Further, the scope 1 has an elongated insertion portion 4 and
A proximal end portion 5 connected to the proximal end portion of the insertion portion 4 is provided. Then, an eyepiece 6 is provided at the proximal end 5,
A light guide connection portion 7 is provided.

The distal end of the cylindrical member 8 is connected to the proximal end of the sheath 3. A water supply port 9 for injecting a liquid is projected from the outer peripheral surface of the cylindrical member 8. Further, the working element 2 is provided at the base end of the cylindrical member 8.
The connecting member 10 is attached.

Further, the working element 2 comprises a front unit 11 connected to the base end of the cylindrical member 8 and an insulating member, and a slider 12 which can be operated back and forth in the axial direction.
And an elongated guide tube 13 for guiding the sliding movement of the slider 12. Here, the connecting member 10 has an insertion hole 10a for the guide tube 13 and an electrode insertion hole 1
0b are formed. The distal end side of the guide tube 13 is inserted into the insertion hole 10a of the connecting member 10, passes through the cylindrical member 8, and extends to a portion near the distal end opening 3a of the sheath 3.

Further, a scope fixing member 14 is provided at the base end of the guide tube 13. And scope 1
The insertion portion 4 is inserted into the guide tube 13 through the scope fixing member 14 and extends to a portion near the distal end opening portion 3a of the sheath 3.

The front unit 11 of the working element 2 has a finger-hanging member 1 fixed to the connecting member 10.
5 are provided. The finger hook member 15 and the slider 1
A substantially U-shaped leaf spring member 16 is provided between the two. The spring force of the leaf spring member 16 biases the slider 12 in a direction away from the finger hook member 15.

Further, the slider 12 is provided with a fixed portion 18 of an electrode unit 17 for excising a living tissue, a power cord connection base 19, and a finger hook ring 20. Here, the fixed portion 18 of the electrode unit 17 and the power cord connection base 19 are connected by a lead wire 21. Further, the power cord connection base 19 is connected to the high frequency power source 22 and the tip end of an active cord 23 having a base end attached thereto.

In addition to the insertion portion 4 of the scope 1, an electrode unit 17 composed of a roller type evaporation electrode is disposed in the sheath 3 as shown in FIG. The electrode unit 17 has a slender shaft portion 25 by a metal wire 24 arranged at the shaft center, bifurcated arms 26a and 26b connected to the tip of the shaft portion 25, and a bifurcated arm. Two
A roller shaft portion 27 that connects the tips of the 6a and 26b is formed. A substantially cylindrical metal roller (conductive rotating body) 28 is rotatably attached to the roller shaft portion 27. In this case, the roller 28 is the metal wire 24.
The roller shaft 27 can be rotated while always in contact with the roller shaft 27 and is always electrically connected to the roller shaft 27.

Further, the metal wire 24 is covered and insulated from both sides of the roller shaft portion 27 to the vicinity of the proximal portion by an insulating tube 29 made of an insulating material such as Teflon.
In addition, a connection portion 30 where the metal wire 24 is exposed is provided at an end portion of the electrode unit 17 on the proximal side.

The outer peripheral surface of the insulating tube 29 is covered with a metal pipe 31 from the vicinity of the end portion on the proximal side to the vicinity of the distal end portion, so that the rigidity of the electrode unit 17 is enhanced. In the vicinity of the tip of the metal pipe 31, there are forked arms 26a, 2
Bifurcated arms 32a and 32b having the same shape as 6b are provided. And these two-forked arm portions 32a, 32b
The rigidity of the bifurcated arms 26a and 26b is also improved.

The roller 28 of the electrode unit 17 is arranged near the tip opening 3a of the sheath 3.
Further, the base end portion of the shaft portion 25 is movably inserted into the electrode insertion hole 10b of the connecting member 10. The connecting portion 30 of the electrode unit 17 is mechanically fixed to the fixing portion 18 of the slider 12 and is electrically connected thereto. As a result, the electrode unit 17 is assembled to the working element 2. Then, by sliding the slider 12, the roller 28 at the tip of the electrode unit 17 can be projected and retracted from the tip opening 3a of the sheath 3 to the outside while the high frequency current is being supplied.

Further, a plurality of rollers are provided on the outer peripheral surface of the roller 28 of the electrode unit 17, as shown in FIG.
Two ring-shaped grooves (recessed portions) 33 are provided. Then, the roller 28 is formed by these three ring-shaped grooves 33.
Means for reducing the contact area with the living tissue is formed.

Next, the operation of the above configuration will be described.
When using the resectoscope, first, the sheath 3 is inserted into the treatment target site in the body cavity of the patient. And scope 1
The observation of the treatment target portion in the body cavity by means of and the treatment of the treatment target portion such as the lesion in the body cavity by the working element 2 are performed.

The treatment by the working element 2 is performed as follows. That is, by moving the slider 12 forward with the thumb of one hand of the operator hooked on the finger hook ring 20 and the remaining fingers hooked on the finger hook member 15, the electrode unit 17 also moves forward and the roller 28 moves the sheath 3 to the sheath 3. It can be made to project to the outside from the tip opening 3a. Then, while observing the treatment target site in the body cavity by the scope 1, the roller 28 is brought into contact with the living tissue of the treatment target site. In this state, by sliding the slider 12, the roller 28 is rolled on the living tissue of the treatment target site, and a high-frequency current is passed to the roller 28 while rolling the roller 28 on the living tissue to evaporate the prostate or A treatment such as coagulation of the lesion is performed.

Further, during the operation of applying a high-frequency current to the roller 28, only the tip portion of the projection 33a other than the three ring-shaped grooves 33 formed on the outer peripheral surface of the roller 28 of the electrode unit 17 is brought into contact with the living tissue. Ring groove 33
It is possible to reduce the area of the contact portion between the roller 28 and the living tissue as compared with a smooth roller in which the roller is not formed.
Therefore, a high-frequency current can be intensively applied to the tip portion of the protrusion 33a other than the three ring-shaped grooves 33 formed on the outer peripheral surface of the roller 28, so that evaporation of living tissue or
The efficiency of treatment such as coagulation can be increased.

Therefore, the following effects are obtained with the above-mentioned structure. That is, by rolling the roller 28 on the living tissue and applying a high-frequency current to the roller 28,
Since it is possible to perform treatments such as transpiration of the prostate and coagulation of lesions, the operation of uniformly treating a wide range can be easily performed.

Furthermore, since three ring-shaped grooves 33 are provided on the outer peripheral surface of the roller 28 of the electrode unit 17, the contact portion between the roller 28 of the electrode unit 17 and the living tissue is a protrusion 33a other than the ring-shaped groove 33. Only the tip part of. Therefore, the contact area with the living tissue can be made smaller than that of a roller having a smooth outer peripheral surface.
Three ring-shaped grooves 33 formed on the outer peripheral surface of the roller 28
A high-frequency current can be intensively applied to the tip portion of the protrusion 33a other than the above, and the efficiency of treatment such as evaporation of living tissue and coagulation can be improved.

In this embodiment, the electrode unit 17
Although the structure in which the three ring-shaped grooves 33 are provided on the outer peripheral surface of the roller 28 of No. 3 is shown, one or a plurality of ring-shaped grooves 33 other than three are formed on the outer peripheral surface of the roller 28 of the electrode unit 17.
May be provided.

Further, although the present embodiment discloses the electrode unit 17 to be assembled in the resectoscope,
The same roller 28 may be provided in a surgical electric treatment instrument that uses the electrode unit 17 alone without being attached to the resectoscope.

FIG. 4 shows a second embodiment of the present invention. This is because the conductive coating layer 41 plated with gold is formed on the inner peripheral surface of the roller 28 of the electrode unit 17 of the first embodiment, and the metal wire 2
Similarly, a conductive coating layer 42 plated with gold is formed on the outer peripheral surface of the roller shaft portion 27 in FIG.

As a result, the roller 2 of the electrode unit 17 is
Since it is possible to prevent an oxide film from being formed between the contact surface between the roller shaft portion 27 and the metal wire 24,
The resistance of electrical contact can be reduced.

The conductive coating layers 41 and 42 are not limited to gold plating, and an oxide film is prevented from being formed between the contact surface between the roller 28 of the electrode unit 17 and the roller shaft portion 27 of the metal wire 24. It may be another conductive metal or a conductive coating layer made of another conductive material.

FIG. 5 shows a third embodiment of the present invention. This is a roller 28 of the electrode unit 17 of the first embodiment provided with a roller 51 made of pure titanium or a titanium alloy.

As a result, it is possible to prevent the living tissue H from adhering to the roller 28 of the electrode unit 17 during energization. The outer peripheral surface of the roller 28 of the electrode unit 17 according to the first embodiment may be coated with titanium to prevent the biological tissue H from adhering thereto.

6 to 8 show a fourth embodiment of the present invention. This is one in which four ring-shaped grooves (recessed portions) 61 having a corrugated right and left are provided on the outer peripheral surface of the roller 28 of the electrode unit 17 of the first embodiment.

As a result, the electrode unit 1 is placed on the living tissue.
When the roller 28 of No. 7 is energized while rolling, the portion of the living tissue that is evaporated or coagulated by contact with the roller 28 is not a straight line but has a wavy shape, so that the treatment can be performed more uniformly and evenly.

Here, when the linear ring-shaped groove 33 is provided on the outer peripheral surface of the roller 28 of the electrode unit 17 as in the first embodiment, the roller 28 of the roller 28 is initially formed after the start of the treatment. Since only the tips of the protrusions 33a between the ring-shaped grooves 33 come into contact with the living tissue, the current density increases,
Not only the transpiration effect but also the incision effect of the living tissue occurs. Therefore, in this case, as the treatment progresses, as shown in FIG.
As shown in FIG. 3, the protrusions 33a between the ring-shaped grooves 33 of the roller 28 sink into the living tissue, the living tissue enters the ring-shaped grooves 33, and even the groove wall surface of the ring-shaped grooves 33 of the roller 28 is reached. Since the living tissue comes into contact, the contact area of the roller 28 with the living tissue increases, and as a result, the current density decreases as shown by the characteristic curve A in FIG. 8 and the transpiration effect may decrease.

On the other hand, in this embodiment, the roller 2
The ring-shaped groove 61 on the outer peripheral surface of No. 8 is formed in a corrugated shape that undulates to the left and right.
The contact portion between the and the biological tissue moves in the axial direction of the roller 28 as the roller 28 rotates. Therefore, in the present embodiment, it is possible to make it difficult for the protrusions 66a between the ring-shaped grooves 66 of the roller 28 to sink into the living tissue even if the treatment progresses, so that the roller 28 as shown in FIG. 7B. It is possible to always hold only the tip portion of the protrusion 66a between the ring-shaped grooves 66 in a state of being brought into contact with the living tissue, reduce the contact area of the roller 28 with the living tissue, and increase the current density. As shown by the characteristic curve B in No. 8, a stable transpiration effect can be obtained.

In the present embodiment, the electrode unit 17
Four corrugated ring-shaped grooves 61 on the outer peripheral surface of the roller 28 of
Although the configuration in which the electrode is provided is shown, the roller 2 of the electrode unit 17 is
A plurality of corrugated ring-shaped grooves 33 other than one or four may be provided on the outer peripheral surface of 8.

FIG. 9 shows a fifth embodiment of the present invention. As in the first embodiment, three circumferential ring-shaped grooves (recessed portions) 33 are formed on the surface of the roller 28 of the electrode unit 17 of the first embodiment (see FIGS. 1 to 3). A plurality of axial grooves (concave portions) that are provided and extend in the axial direction intersecting the three ring-shaped grooves 33
71 is provided.

As a result, the roller 2 of the electrode unit 17 is
Since the contact area between 8 and the living tissue can be made smaller than that of the roller 28 having only the ring-shaped groove 33 in the circumferential direction as in the first embodiment, the high frequency current is made to flow more intensively when energized. Therefore, it is possible to further enhance the efficiency of treatment such as transpiration and coagulation of biological tissue and enhance the therapeutic effect.

FIG. 10 shows a sixth embodiment of the present invention. This is provided with a plurality of spiral grooves (concave portions) 81 on the outer peripheral surface of the roller 28 of the electrode unit 17 of the first embodiment (see FIGS. 1 to 3).

As a result, the electrode unit 1 is placed on the living tissue.
When the roller 28 of No. 7 is energized while rolling, as in the fourth embodiment (see FIG. 6), the biological tissue portion that is evaporated or coagulated by contact with the roller 28 is not a straight line but has a wavy shape. Since it is formed, evaporation or coagulation can be performed more uniformly.

FIG. 11 shows a seventh embodiment of the present invention. This is one in which a plurality of circular holes (concave portions) 91 are provided on the surface of the roller 28 of the electrode unit 17 of the first embodiment (see FIGS. 1 to 3).

As a result, the electrode unit 1 is placed on the living tissue.
When the roller 28 of No. 7 is energized while rolling, the contact area between the outer peripheral surface of the roller 28 and the biological tissue can be reduced by the circular holes 91 in the outer peripheral surface of the roller 28. A high-frequency current can be intensively applied to a portion other than the circular hole 91, and the efficiency of treatment such as evaporation and coagulation of living tissue can be improved.

Further, in this embodiment, the contact portion between the outer peripheral surface of the roller 28 and the biological tissue other than the circular holes 91 is in contact with the biological tissue as the roller 28 rotates.
It moves in the axial direction according to the position of. Therefore, in the present embodiment, it is possible to make it difficult for the portions other than the circular holes 91 on the outer peripheral surface of the roller 28 to sink into the biological tissue even if the treatment progresses. It is possible to always hold only the portion of the above in a state of making substantially surface contact with the living tissue, and like the fourth embodiment (see FIG. 6),
The contact area of the roller 28 with the living tissue is reduced, the current density is increased, and a stable transpiration effect is obtained.

Further, FIGS. 12A to 12C show an eighth embodiment of the present invention. This embodiment is the first
7 to 7, a U-shaped electrode 101 having a substantially U-shaped cross section is provided in place of the electrode unit 17 composed of the roller type evaporation electrode. The U-shaped electrode 101 is provided with an electrode body 102 of a predetermined length along the axial direction of the sheath 3 (see FIG. 1) of the resectoscope.

On the outer peripheral surface of the electrode body 102, a plurality of linear grooves (concave portions) 1 for reducing the contact area with the living tissue are formed.
03 is provided. Each linear groove 103 is shown in FIG.
As shown in (B), it extends along the axial direction of the sheath 3 of the resectoscope.

Therefore, the above configuration has the following effects. That is, in the present embodiment, the U-shaped electrode 1
Since the plurality of linear grooves 103 for reducing the contact area with the living tissue are provided on the outer peripheral surface of the electrode body 102 of No. 01, the contact portion between the electrode body 102 of the U-shaped electrode 101 and the living tissue is shown in FIG. ), Only the portion other than the linear groove 103 is formed. Therefore, the electrode body 10 of the U-shaped electrode 101, which does not have the linear groove 103 and has a smooth outer peripheral surface, is formed.
Since the contact area with the living tissue can be made smaller than that of 2, the high-frequency current can be concentratedly applied to the portion other than the linear groove 103 formed on the outer peripheral surface of the electrode body 102 of the U-shaped electrode 101. Therefore, it is possible to enhance the efficiency of treatment such as evaporation and coagulation of living tissue.

FIG. 13 shows a ninth embodiment of the present invention. In this embodiment, a plurality of linear grooves 10 formed on the outer peripheral surface of the electrode body 102 of the U-shaped electrode 101 of the eighth embodiment (see FIGS. 12A to 12C).
Instead of 3, a plurality of corrugated grooves (recessed portions) 111 that meander in a substantially corrugated shape are provided as shown in FIG.

Therefore, in this embodiment, the U-shaped electrode 10 is used.
Since the plurality of corrugated grooves 111 are provided on the outer peripheral surface of the one electrode body 102, the contact portion between the electrode body 102 of the U-shaped electrode 101 and the biological tissue is only the portion other than the corrugated groove 111. Therefore, as in the eighth embodiment, the contact area of the electrode body 102 of the U-shaped electrode 101 with the living tissue can be reduced, so that the electrode body 1 of the U-shaped electrode 101 can be reduced.
A high-frequency current can be intensively applied to a portion other than the corrugated groove 111 formed on the outer peripheral surface of 02, and the efficiency of treatment such as evaporation and coagulation of biological tissue can be improved.

Further, in the present embodiment, in particular, a plurality of corrugated grooves 111 on the outer peripheral surface of the electrode body 102 of the U-shaped electrode 101.
Is formed in a substantially wavy shape, the contact portion between the outer peripheral surface of the electrode main body 102 and the biological tissue is moved along with the movement of the U-shaped electrode 101 along the axial direction of the sheath 3 to form each wavy groove. The U-shaped electrode 101 can be moved along 111 in a direction substantially orthogonal to the forward / backward movement direction.
Therefore, in the present embodiment, it is possible to make it difficult for the biological tissue to enter the respective corrugated grooves 111 even if the treatment progresses. Therefore, only the portion of the outer peripheral surface of the electrode body 102 other than the corrugated groove 111 contacts the biological tissue. The U-shaped electrode 101 can be held in a constant state, the contact area with the biological tissue in the U-shaped electrode 101 can be reduced, the current density can be increased, and a stable evaporation effect can be obtained.

FIG. 14 shows a tenth embodiment of the present invention. In this embodiment, instead of the plurality of corrugated grooves 111 formed on the outer peripheral surface of the electrode body 102 of the U-shaped electrode 101 of the ninth embodiment (see FIG. 13), FIG.
A plurality of circular holes (recessed portions) 121 are provided as shown in FIG.

Therefore, in this embodiment, the U-shaped electrode 10 is used.
Since a plurality of circular holes 121 are provided on the outer peripheral surface of the first electrode body 102, the contact portion between the electrode body 102 of the U-shaped electrode 101 and the living tissue is only the portion other than the circular hole 121. Therefore, as in the ninth embodiment, the contact area of the electrode body 102 of the U-shaped electrode 101 with the living tissue can be reduced, so that the electrode body 1 of the U-shaped electrode 101 can be reduced.
A high-frequency current can be intensively applied to a portion other than the circular hole 121 formed on the outer peripheral surface of 02, and the efficiency of treatment such as evaporation of living tissue or coagulation can be improved.

Further, the U-shaped electrode 10 is also used in this embodiment.
Along with the operation of moving 1 in the axial direction of the sheath 3, the contact portion between the outer peripheral surface of the electrode body 102 and the biological tissue is moved by the circular hole 121 in a direction different from the moving direction of the U-shaped electrode 101. Therefore, even if the treatment progresses, it is possible to make it difficult for the living tissue to enter the circular holes 121. Therefore, only the portion of the outer peripheral surface of the electrode body 102 other than the circular hole 121 can be kept in contact with the living tissue at all times, and the contact area of the U-shaped electrode 101 with the living tissue is reduced to reduce the current density. The stable evaporation effect is obtained.

Note that the present invention is not limited to the above-described embodiment, and it goes without saying that various modifications can be made without departing from the spirit of the present invention. Next, other characteristic technical matters of the present application will be additionally described as follows.

(Additional Item 1) A scope, a sheath for inserting the scope into a body cavity, an electrode for tissue excision projecting and retracting from a distal end opening portion of the sheath, and a base end portion of the scope for removing the tissue. In a resectoscope having an electrode energizing means for energizing an electrode, near the tip of the electrode, in a substantially cylindrical shape,
Moreover, a resectoscope characterized in that a metal rotating body having at least one groove is provided on the circumferential surface thereof.

(Additional Item 2) The resectoscope according to Additional Item 1, wherein the metallic rotating body is rotatable while being electrically connected to the electrode energizing means.

(Additional Item 3) A scope, an electrode operator, a sheath for inserting the scope, and a hand portion are connected and fixed to the electrode operator, pass through the inside of the sheath, and the tip projects from the tip end opening of the sheath. In a resectoscope consisting of a submerged electrode, the tip of the electrode consists of a substantially cylindrical metal,
The rotating body for treating the affected area is provided so as to be rotatable while electrically contacting the conductive wire in the electrode, and one or more grooves are provided on the outer peripheral surface of the rotating body. Reject scope.

(Additional Item 4) In an electric treatment instrument for surgical operation, a rotating body made of a substantially cylindrical metal is provided at a distal end of the treatment instrument so as to rotate while electrically contacting a conductive wire in the treatment instrument. At the same time, one or a plurality of grooves are provided on the outer peripheral surface of the rotating body.

(Operations of Additional Items 3 and 4) One or more grooves are provided on the outer surface of the rotating body of the electrode, and when a high-frequency current is passed while pressing the rotating body against the tissue, the contact portion between the rotating body and the tissue. However, I tried to make it as many areas as possible with a small area.

(Additional Item 5) In the electrode for a resectoscope, a rotating body made of a substantially cylindrical metal is provided at the tip of the electrode so as to rotate while electrically contacting a conductive wire inside the electrode, and An electrode for a resectoscope in which a conductive coating layer is provided on the inner surface of the rotating body and / or the outer peripheral surface of the conductive wire at the portion where the rotating body and the conductive wire contact each other.

(Supplementary Note 6) In an electric treatment instrument for surgical treatment, a rotating body made of a substantially cylindrical metal is provided at the tip of the treatment instrument so as to rotate while electrically contacting a conductive wire inside the treatment instrument. In addition, the electric treatment instrument is provided with a conductive coating layer on the inner surface of the rotating body and / or the outer peripheral surface of the conductive wire at the portion where the rotating body and the conductive wire contact each other.

(Operations of Supplementary Items 5 and 6) A conductive coating layer is provided on the inner circumference of the hole through which the wire of the rotating body is inserted and / or the outer circumference of the wire to prevent the formation of an oxide film, and a conductive coating layer is provided on the contact portion. The electric resistance of was reduced to facilitate the flow of current.

(Additional Item 7) In the electrode for a resectoscope, a substantially cylindrical rotating body is provided at the tip of the electrode so as to rotate while electrically contacting an internal conductive wire, and the rotating body as a whole or An electrode for a resectoscope in which at least an outer peripheral surface of a rotating body is made of titanium or a titanium alloy.

(Supplementary Note 8) In an electric treatment instrument for surgical treatment, a substantially cylindrical rotating body is provided at the distal end of the treatment instrument so as to rotate while electrically contacting an internal conductive wire, and the rotating body is rotated. An electric treatment instrument in which the entire body or at least the outer peripheral surface of the rotating body is made of titanium or a titanium alloy.

(Operations of Supplementary Items 7 and 8) The rotating body is made of a material (titanium or the like) for preventing the tissue from scorching and adhering so that the electric current can always flow stably from the rotating body to the tissue. (Additional Item 9) A scope, a sheath for inserting the scope into a body cavity, an electrode for excision of living tissue protruding from the distal end opening of the sheath to the outside, and an electrode energizing means for energizing the electrode. In a resectoscope having, a substantially cylindrical conductive rotating body is provided in a contact portion with the biological tissue in the electrode, and a contact area with the biological tissue is reduced on an outer peripheral surface of the conductive rotating body. A resectoscope characterized by having means.

(Additional Item 10) In an electrosurgical power source and a roller-type evaporation electrode connected to the electrosurgical power source, one or more grooves are formed in the roller electrode, and the shape of the groove is meandering instead of cylindrical. Alternatively, an electrosurgical electrode characterized by forming a cylindrical hole so that the electrode does not easily drip into a living body.

(Problem to be Solved by Appendix 10)
Conventionally, the grooved or gear-shaped electrode of the roller reduces the contact area with the living body in order to increase the current density, but as a result of the increased current density, not only the transpiration effect but also the incision effect occurs. As a result, the electrode dipped into the tissue and the tissue came into contact with the groove of the electrode, resulting in a decrease in the current density and a decrease in the transpiration effect.

(Purpose of Supplementary Note 10) Efficient electrosurgery. (Additional Item 11) The electrosurgical electrode, wherein the electrode has a U-shape having a certain thickness, and a groove is provided in a patient contact portion of the U-shaped electrode.

(Problem to be Solved by Appendix 11)
In the case of the conventional band electrode without a groove, since the contact area between the patient and the electrode portion is large, the high frequency current density is lowered and the cauterization performance is lowered. (Purpose of Supplementary Note 11) An electrode for electrosurgery with high cauterization efficiency.

[0074]

EFFECTS OF THE INVENTION According to the present invention, the electrode is provided with the surface contact portion that makes substantially surface contact with the living tissue, and the surface contact portion is provided with the recessed portion for reducing the contact area with the living tissue. By reducing the contact area between the
A high-frequency current can be concentratedly applied to the surface contact portion having a small contact area to improve the efficiency of treatment such as evaporation of living tissue and coagulation, and the operation of uniformly treating a wide range can be easily performed. .

[Brief description of drawings]

FIG. 1 is a vertical cross-sectional view showing a schematic configuration of an entire resectoscope according to a first embodiment of the present invention.

FIG. 2 is a perspective view showing a structure of an electrode unit of the resectoscope according to the first embodiment.

FIG. 3 is a perspective view showing a roller of the electrode unit of the resectoscope according to the first embodiment.

FIG. 4 is a vertical cross-sectional view showing a main configuration of an electrode unit of a detect scope according to a second embodiment of the present invention.

FIG. 5 is a vertical cross-sectional view showing a main part configuration of an electrode unit of a detect scope according to a third embodiment of the present invention.

FIG. 6 is a front view showing the main configuration of an electrode unit of a detect scope according to a fourth embodiment of the present invention.

FIG. 7 is an explanatory diagram for explaining the operation of the resectoscope according to the fourth embodiment.

FIG. 8 is a characteristic diagram showing operating characteristics of the detect scope according to the fourth embodiment.

FIG. 9 is a perspective view showing a main configuration of an electrode unit of a detect scope according to a fifth embodiment of the present invention.

FIG. 10 is a perspective view showing a configuration of a main part of an electrode unit of a detect scope according to a sixth embodiment of the present invention.

FIG. 11 is a perspective view showing a main configuration of an electrode unit of a detect scope according to a seventh embodiment of the present invention.

FIG. 12 shows an eighth embodiment of the present invention,
(A) is a perspective view showing a main part configuration of a U-shaped electrode of a resectoscope, (B) is a plan view of the same, and (C) is a longitudinal sectional view showing a contact part between the U-shaped electrode and a biological tissue.

FIG. 13 is a plan view showing a configuration of a main part of a U-shaped electrode of a detect scope according to a ninth embodiment of the invention.

FIG. 14 is a plan view showing a main configuration of a U-shaped electrode of a detect scope according to a tenth embodiment of the invention.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 Scope 3 Sheath 3a Tip opening 17 Electrode unit 19 Power cord connection mouthpiece (electrode energizing means) 28 Roller (surface contact part) 33, 61 Ring groove (concave part) 71 Axial groove (concave part) 81 Spiral groove (Concave part) 91, 121 Circular hole (concave part) 101 U-shaped electrode 103 Linear groove (concave part) 111 Corrugated groove (concave part)

 ─────────────────────────────────────────────────── ─── Continuation of front page (72) Inventor Hideto Yoshimine 2-43-2 Hatagaya, Shibuya-ku, Tokyo Inside Olympus Optical Co., Ltd.

Claims (1)

[Claims] 1. A scope, a sheath for inserting the scope into a body cavity, an electrode for excision of living tissue projecting outward from the distal end opening of the sheath, and an electrode energizing means for energizing the electrode. In the resectoscope having, the electrode is provided with a surface contact portion that makes a substantially surface contact with biological tissue,
A resectoscope, characterized in that a concave portion for reducing a contact area with the living tissue is provided in the surface contact portion.