TW201416053A - Endoscopic resection tool for tumors utilizing ultrasound - Google Patents

Abstract

An endoscopic resection tool includes an ultra-sound transmission rod and a scraper member connected therewith. The ultra-sound transmission rod has a front end and a rear end on which to provide an ultra-sound receiving terminal. The scraper member has a first end and a second end with which to connect the front end of the ultra-sound transmission rod. An ultra-sound adapter seat generates an ultra-sound wave converted from outer vibration to transmit to the ultra-sound receiving terminal, and to further transmit to the scraper member.

Description

Ultrasound tumor resection tool for endoscope

The present invention relates to an ultrasonic tumour resection tool for an endoscope; in particular, an endoscopic ultrasonic tumor resection tool is suitable for treating tumors of various shapes.

In general, various conventional urethral endoscopic tract urethral resectoscope mechanisms are widely used in bladder tumor resection. For example, the Republic of China Patent Publication No. 201103493 discloses a transurethral endoscopic bladder tumor resection mechanism, and the genus is a resection of a bladder tumor by electric cutting, and the aforementioned bladder tumor resection mechanism and the electrosurgical scraping tool are as follows: .

Figure 1 is an exploded perspective view of a conventional transurethral endoscopic bladder tumor resection mechanism, which is disclosed in Japanese Patent Publication No. 201103493. Referring to Figure 1, the conventional endoscopic tumor resection mechanism 1 is a long tubular tool that passes through the urethra of the human body and then enters the interior of the bladder. The endoscopic tumor resection mechanism 1 includes an endoscope base 10 and a reciprocating mechanism 11.

Referring again to FIG. 1, the endoscope base 10 has an endoscope window 101, and the inside of the bladder is viewed by the endoscope window 101. In addition, a tool assembly channel 102 is longitudinally extended on one side of the endoscope base 10, and the tool assembly channel 102 is for receiving an electric cutting tool 20, as shown in the lower position of FIG. The electric cutting tool 20 is used to perform electric scraping of the tumor tissue located on the inner surface of the bladder.

</ RTI> <RTIgt; </ RTI> <RTIgt; </ RTI> <RTIgt; </ RTI> <RTIgt; </ RTI> <RTIgt; </ RTI> <RTIgt; Referring to FIG. 2, the tool assembly channel 102 of the endoscope base 10 is coupled to the electric cutting tool 20 so that the electric cutting tool 20 can move relative to the tool combination channel 102 in a relatively reciprocating operation. In addition, one end of the electric cutting tool 20 is locked on The reciprocating mechanism 11 is configured such that the reciprocating mechanism 11 and the electric cutting tool 20 can perform synchronous reciprocating motion.

Referring again to FIG. 1, in addition to combining the cutting tool 20, the tool combination channel 102 of the endoscope base 10 can also be selected as an auxiliary conduit channel. The auxiliary catheter channel is used to directly pass through a ureteral catheter (not shown), so that the ureteral catheter enters the interior of the kidney via the bladder and ureter, and other parts of the ureteral catheter are not described in detail herein.

Referring again to FIGS. 1 and 2, the endoscope base 10 has a guide slider 103 coupled to the endoscope window 101. The reciprocating mechanism 11 is longitudinally reciprocable along the guiding slide 103. As shown in FIG. 2, one end of the electric cutting tool 20 is locked to the reciprocating mechanism 11 so that the reciprocating mechanism 11 and the electric cutting tool 20 can perform synchronous reciprocating motion.

Referring again to FIGS. 1 and 2, the reciprocating mechanism 11 has a C-shaped spring piece 111 coupled to the endoscope base 10, and the C-shaped spring piece 111 is used to provide a resilient pressure to the reciprocating mechanism 11. So that the reciprocating mechanism 11 is against the endoscope window 101. When the C-shaped spring piece 111 is pressed or released, the reciprocating mechanism 11 can be caused to move or reset.

</ RTI> <RTIgt; </ RTI> <RTIgt; </ RTI> <RTIgt; </ RTI> <RTIgt; </ RTI> <RTIgt; </ RTI> <RTIgt; </ RTI> <RTIgt; Referring to Figures 2 and 3, the cutting tool 20 has a first end and a second end, wherein the first end includes an electrically conductive guide wire 201 and the second end includes an electrode 202. The electric cutting wire 201 is used to electrically cut the bladder tumor, and the electrode 202 is electrically connected to the reciprocating mechanism 11 to supply an appropriate current through the electric cutting wire 201.

Referring to FIG. 2 again, when the C-shaped spring piece 111 is pressed, the reciprocating mechanism 11 and the electric cutting tool 20 can be driven to move relatively forward, as shown by the direction of the left arrow in FIG. 2; When the C-shaped spring piece 111 is used, the reciprocating mechanism 11 and the electric cutting tool 20 can be moved relatively backward, as shown in FIG. The direction of the right arrow is shown.

In the above, FIG. 4 is a side view showing the state of use of a surgical resection of a bladder tumor using a transurethral endoscopic bladder tumor resection mechanism, which is disclosed in Japanese Patent Publication No. 201103493. Referring to FIG. 4, the electric cutting wire 201 of the electric cutting tool 20 can cut a tumor 4 along a surface 3 of the bladder wall. During the tumor resection operation, the electric cutting wire 201 of the electric cutting tool 20 can enter the side of the tumor 4 along the surface 3 of the bladder wall, as shown by the direction of the left arrow in FIG. 4; When the electric cutting wire 201 of the cutting tool 20 is against one side of the tumor 4, the electric cutting wire 201 of the electric cutting tool 20 is energized, and the tumor 4 is electrically burned along the surface 3 of the bladder wall. As shown by the direction of the right arrow in Fig. 4, a muscle layer 31 is left.

Referring to FIG. 4 again, when the electric cutting wire 201 of the electric cutting tool 20 abuts and scrapes the tumor 4, the operator must manually operate the electric cutting wire 201 to perform the electric shaving operation. And the tumor should be scraped off step by step. However, the operator manually manipulates the curable guidewire 201 via the endoscope window 101 (shown in FIG. 4), which may be due to the operator's inability to accurately control the electrosurgical scraping depth of the curable guidewire 201. Or, due to energization, the bladder wall surface 3 and the muscle layer 31 are subjected to current stimulation contraction, causing the preset scraping depth to change, and causing accidental scraping of the epidermal layer and the muscle layer 31 or the peritoneal layer 34 of the bladder wall surface 3, and The internal space of the posterior abdominal cavity 32, or the internal space of the peritoneal cavity 33, thereby increasing the risk of surgery of the patient, for example, cutting the blood vessel of the posterior abdominal cavity 33 to cause internal bleeding or the cells of the tumor 4 diffusing into the peritoneal cavity 33. internal. Alternatively, during an endoscopic bladder tumor resection procedure, the operator may accidentally scratch the epidermal layer and the muscle layer 31 or the peritoneal layer 34 of the bladder wall surface 3 due to the above-mentioned inadvertent operation.

In addition, Fig. 5 discloses a perspective view of another conventional electrosurgical endoscopic bladder tumor resection mechanism in which the electrosurgical tool is located at the portion of the electrically guided guide wire, which is in contrast to the publication No. 201103493. Referring to FIG. 5, in order to reduce the risk of surgery, in addition to providing the electric cutting wire 201, the cutting tool body 20 further includes a supplement. The safety guard 203 is provided, and the auxiliary safety guard 203 is spaced apart from one side of the electric cutting guide 201. The auxiliary safety guard 203 is used to limit the tumor scraping depth of the electrically flexible guide wire 201. However, conventional endoscopic bladder tumor resection surgery still has a certain degree of surgical risk by electrosurgical scraping. The above-mentioned publication No. 201103493 is only a reference to the technical background of the present invention and the state of the art is not limited to the scope of the present invention.

In view of the above, the present invention has been made in order to solve the above problems, and provides an endoscopic ultrasonic tumor resection tool for improving the surgical risk of a conventional transurethral endoscopic bladder tumor resection mechanism, and can be used for other suitable organ tumors.

The main object of the present invention is to provide an ultrasonic mirror tumor removal tool for an endoscope, which is provided with an ultrasonic scraper in an endoscopic tumor resection mechanism, and the ultrasonic scraper provides a resection function and a hemostasis function at different ultrasonic frequencies. In order to achieve the purpose of reducing the risk of surgery for patients.

In order to achieve the above object, an ultrasonic mirror tumor removal tool for an endoscope according to a preferred embodiment of the present invention includes: a supersonic waveguide rod having a front end of the guide rod and a rear end of the guide rod, the rear end of the guide rod is provided with an adapter end; and a scraper having a first end and a second end, the second end Combined with the front end of the guide rod; wherein a joint is used to transmit external vibration to the adapter end of the ultrasonic waveguide rod to generate ultrasonic vibration, and the ultrasonic wave is transmitted to the front end of the guide rod of the ultrasonic waveguide rod The scraper is on.

The doctor blade of the preferred embodiment of the invention comprises a doctor body.

In the preferred embodiment of the invention, the doctor body is a downwardly bent body portion.

The doctor blade of the preferred embodiment of the invention comprises a crossbar.

In the preferred embodiment of the invention, the crossbar is selected from a left crossbar or a rightward crossbar.

In a preferred embodiment of the invention, the scraper is assembled in a reverse rotation assembly to an endoscopic tumor resection mechanism.

The ultrasonic waveguide rod of the preferred embodiment of the invention comprises an outer protective layer.

In the preferred embodiment of the invention, the connector holder is disposed on an endoscopic tumor resection mechanism.

In the preferred embodiment of the invention, the connector housing outputs ultrasonic waves for providing a scraping tissue function.

In the preferred embodiment of the invention, the connector housing outputs ultrasonic waves for providing tissue hemostasis.

In order to fully understand the present invention, the preferred embodiments of the present invention are described in detail below and are not intended to limit the invention.

The ultrasonic tumor resection tool of the endoscope of the preferred embodiment of the present invention can be applied to various technical fields of endoscopic tumor resection, for example, it can be applied to various bladder tumor resection [scraping] operations, but it is not used for The scope of application of the ultrasonic tumor resection tool of the present invention is limited.

Figure 6 is an exploded side elevational view of the ultrasonic tumor resection tool of the preferred embodiment of the present invention and its endoscopic tumor resection mechanism; Figure 7 is a view showing an ultrasonic tumour resection tool and an endoscope thereof according to a preferred embodiment of the present invention. A combined side view of the tumor resection mechanism corresponding to the exploded view of FIG. 6; FIG. 8 is a combined side view showing the reciprocating motion of the endoscopic ultrasonic tumor resection tool of the preferred embodiment of the present invention, which corresponds to the 7 is a side view; FIG. 9 is a view showing the ultrasonic mirror removal tool of the endoscope in the preferred embodiment of the present invention.

Referring to Figures 6, 7 and 8, the preferred embodiment of the present invention uses an internal view. The scope tumor resection mechanism 1 includes an endoscope seat 10 and a reciprocation mechanism 11. The endoscope base 10 has an endoscope window 101 and uses the endoscope window 101 to view the inside of a body or an organ. In addition, a tool combination channel 102 is longitudinally extended on one side of the endoscope base 10, and the tool combination channel 102 is used to accommodate an ultrasonic surgical tool 5, as shown in the lower position of FIG. The ultrasonic surgical tool 5 scrapes the tumor tissue located on the surface of the internal tissue with ultrasonic energy.

Referring to FIG. 8, the tool combination channel 102 of the endoscope base 10 is coupled to the ultrasonic surgical tool 5 so that the ultrasonic surgical tool 5 can move relative to the tool combination channel 102 in a relatively reciprocating operation. In addition, one end of the ultrasonic surgical tool 5 is locked to the reciprocating mechanism 11 so that the reciprocating mechanism 11 and the ultrasonic surgical tool 5 perform synchronous reciprocating motion with respect to the tool combination passage 102.

Referring again to FIGS. 6, 7, and 8, the endoscope base 10 has a guide slider 103 coupled to the endoscope window 101. Between the endoscope base 10 and the endoscope window 101, the reciprocating mechanism 11 can be longitudinally reciprocated along the guiding slide 103. As shown in FIGS. 7 and 8, one end of the ultrasonic surgical tool 5 is locked to the reciprocating mechanism 11 so that the reciprocating mechanism 11 and the ultrasonic surgical tool 5 are synchronously reciprocated relative to the guiding slide 103.

Referring to FIGS. 6, 7, and 8, the reciprocating mechanism 11 has a C-shaped spring piece 111 connected to the endoscope base 10, and the C-shaped spring piece 111 is used to provide a resilient pressure to the reciprocating The mechanism 11 is such that the reciprocating mechanism 11 abuts against the endoscope window 101. When the C-shaped spring piece 111 is pressed or released, the reciprocating mechanism 11 can be caused to move or reset. In addition, the endoscope tumor resection mechanism 1 has a joint 112, and the joint 112 is disposed on the rear side of the reciprocating mechanism 11 for transmitting ultrasonic waves generated by vibration to the ultrasonic surgical tool 5.

Referring again to Figures 6, 7, and 8, in the positional configuration, the connector block 112 is located on one side of the endoscope window 101, or is configured in other suitable positions. The input ultrasound of the connector block 112 can be adjusted according to the surgical needs, and is suitable for providing a scraping tissue function or tissue hemostasis function.

Referring to Figures 7 and 9, the ultrasonic surgical tool 5 of the preferred embodiment of the present invention is an elongated strip tool comprising at least one ultra-sound transmission rod 50 and a scraper. [scraper member] 51. The ultrasonic waveguide rod 50 and the doctor blade 51 are combined into an integrated surgical tool, for example, an integrally formed tool, but it is not intended to limit the scope of the present invention. The ultrasonic surgical tool 5 adjusts its length according to actual needs, that is, the length specification of the ultrasonic surgical tool 5 is adjusted according to the length specification of the tool combination channel 102 of the endoscope tumor resection mechanism 1.

Referring to FIGS. 7 and 9, the ultrasonic waveguide rod 50 has a front end of the guide rod (not shown) and a rear end of the guide rod (not shown), which are respectively on the front side of the ultrasonic waveguide rod 50 and Back side. An adapter end 501 is disposed at the rear end of the guide rod, and the adapter end 501 is coupled to the joint base 112 of the reciprocating mechanism 11. In addition, the ultrasonic waveguide rod 50 includes an outer insulator 502, and the outer protective layer 502 is coated on the outer surface of the ultrasonic waveguide rod 50, as shown in FIG.

Referring to Figures 7 and 9, the doctor blade 51 has a first end (not shown) and a second end (not shown). The second end of the scraper 51 is coupled to the leading end of the guide shaft of the ultrasonic waveguide rod 50. During the surgical operation, the connector 112 is used to output appropriate energy to the adapter end 501 of the ultrasonic waveguide rod 50, and then the transducer 501 of the ultrasonic waveguide rod 50 converts energy into ultrasonic waves, and then conducts the On the scraper 51.

Referring again to FIGS. 7 and 9, for example, the connector 112 transmits an external [machine] vibration to the adapter end 501 of the ultrasonic waveguide rod 50 to generate ultrasonic vibration, and then the super The front end of the guide rod of the sound waveguide rod 50 is the ultrasonic wave Conducted to the scraper 51.

Referring to FIG. 9 again, the doctor blade 51 of the preferred embodiment of the present invention includes a doctor body 510 and a cross bar 511. The doctor body 510 is located between the first end and the second end of the scraper 51. Further, the cross bar 511 is provided between the first end and the second end of the scraper 51. The scraper body 510 is a downwardly bent body portion such that the scraper body 510 avoids obstructing the inspection line of sight of the endoscope window 101, and the crossbar 511 can be selected from a left crossbar (as shown in FIG. 9). Or a right crossbar.

For example, Fig. 10 is a side elevational view showing the operation of the bladder tumor resection operation of the ultrasonic tumor resection tool of the endoscope according to the preferred embodiment of the present invention, which corresponds to the top view of Fig. 9. Referring to FIG. 10, the blade 51 of the ultrasonic surgical tool 5 can scrape a tumor 4 along a surface 3 of the bladder wall, and the tumor 4 is located below the surface 3 of the bladder wall. When performing a tumor resection operation, the crossbar 511 of the scraper 51 can enter the inner side of the tumor 4 along the bladder wall surface 3, as indicated by the leftward arrow direction of Fig. 10; when the scraper 51 is transverse When the rod 511 is against the inside of the tumor 4, the output ultrasonic energy of the scraper 51 cuts off the tissue of the tumor 4. The doctor blade 51 is moved outward along the bladder wall surface 3 to scrape the tumor 4 from the bladder wall surface 3, as indicated by the direction of the right arrow in Fig. 10, and a muscle layer 31 is left. In addition, after scraping the tumor 4, the scraper 51 outputs appropriate ultrasonic energy to the wound of the muscle layer 31 for tissue hemostasis treatment. After the tumor resection operation is completed, the scraper 51 can be moved outward as indicated by the direction of the right arrow in Fig. 10 to exit the ultrasonic surgical tool 5.

For example, Figure 11 is a schematic side view showing another embodiment of the ultrasound tumor resection tool of the endoscope according to the preferred embodiment of the present invention for performing a bladder tumor resection operation. Referring to FIG. 11, the scraper 51 is assembled in the reverse direction of the tool assembly passage 102 of the endoscopic tumor resection mechanism 1. The scraper 51 can progressively scrape a tumor 4 along a bladder wall surface 3, and the tumor 4 is located above the bladder wall surface 3. The transverse direction of the scraper 51 when performing a tumor scraping operation The rod 511 can enter the inner side of the tumor 4 along the bladder wall surface 3; when the cross rod 511 of the scraper 51 is against the inner side of the tumor 4, the output ultrasonic energy of the scraper 51 cuts off the tissue of the tumor 4. In order to gradually scrape the tumor 4 from the surface 3 of the bladder wall and leave a muscle layer 31.

12A and 12B are views showing a side view of the ultrasonic tumor resection tool of the endoscope according to another preferred embodiment of the present invention, which corresponds to the scraper portion of Fig. 9. Referring to FIGS. 12A and 12B, in addition to the cross-sectional shape of the crossbar 511 of the scraper 51, the cross-bar 511 of the scraper 51 has a first cutting edge [left side] and a The second cutting edge [right side] consists of two curved surfaces for scraping the tissue. As shown in Fig. 12B, the cross bar 511 of the scraper 51 has a concave portion between the first cutting edge and the second cutting edge.

The foregoing preferred embodiments are merely illustrative of the invention and the technical features thereof, and the techniques of the embodiments can be carried out with various substantial equivalent modifications and/or alternatives; therefore, the scope of the invention is subject to the appended claims. The scope defined by the scope shall prevail.

1‧‧‧Endoscopic tumor resection mechanism

10‧‧‧Endoscope base

101‧‧‧Endoscope window

102‧‧‧Tool combination channel

103‧‧‧Guide slider

11‧‧‧Reciprocal institutions

111‧‧‧C type spring piece

112‧‧‧ connector seat

20‧‧‧Electric cutting tool

201‧‧‧Electric cutting guide wire

202‧‧‧electrode

203‧‧‧Auxiliary safety guards

3‧‧‧Bone wall surface

31‧‧‧ muscle layer

32‧‧‧After the abdominal cavity

33‧‧‧peritoneal cavity

34‧‧‧ peritoneal layer

4‧‧‧ tumor

5‧‧‧Ultrasonic surgery tools

50‧‧‧Supersonic waveguide rod

501‧‧‧Transfer

502‧‧‧ outer protective layer

51‧‧‧Scraper

510‧‧‧ scraper body

511‧‧‧cross bar

Figure 1: An exploded side view of a conventional transurethral endoscopic bladder tumor resection mechanism.

Figure 2: A side view of a combined reciprocating motion of a transurethral endoscopic bladder tumor resection mechanism.

Figure 3: A perspective view of a conventional transurethral endoscopic bladder tumor resection mechanism with an electric cutting tool located at the position of the electric guide wire.

Figure 4: A side view of a surgical resection of a bladder tumor using a transurethral endoscopic bladder tumor resection mechanism.

Figure 5: A perspective view of another conventional transurethral endoscopic bladder tumor resection tool located at the site of the electric guide wire.

Figure 6 is an exploded side view of a supersonic tumor resection tool of the preferred embodiment of the present invention and an endoscopic tumor resection mechanism.

Figure 7 is a side elevational view of a combination of a supersonic tumor resection tool of the preferred embodiment of the invention and an endoscopic tumor resection mechanism.

Figure 8 is a side elevational view of the combined reciprocating motion of the endoscopic ultrasonographic tumor resection tool of the preferred embodiment of the present invention.

Fig. 9 is a view showing the supersonic tumor resection tool of the endoscope according to the preferred embodiment of the present invention located above the blade portion.

Fig. 10 is a side elevational view showing the operation of the bladder tumor resection operation by the ultrasonic tumor removal tool of the endoscope of the preferred embodiment of the present invention.

Figure 11 is a side elevational view showing the operation of the bladder tumor resection operation by the ultrasonic tumor removal tool of the endoscope of the preferred embodiment of the present invention.

12A and 12B are views showing a side view of the ultrasonic tumor removal tool of the endoscope in another preferred embodiment of the present invention.

5‧‧‧Ultrasonic surgery tools

502‧‧‧ outer protective layer

51‧‧‧Scraper

510‧‧‧ scraper body

511‧‧‧cross bar

Claims (10)

An ultrasonic mirror tumor removal tool for an endoscope, comprising: an ultrasonic waveguide rod having a front end of a guide rod and a rear end of a guide rod, the rear end of the guide rod is provided with an adapter end; and a scraper having a first end and a second end, the second end is coupled to the front end of the guide rod; wherein a joint is used to transmit external vibration to the transfer end of the ultrasonic waveguide rod to generate ultrasonic vibration, and then The leading end of the guide rod of the ultrasonic waveguide rod transmits the ultrasonic wave to the scraping blade. The ultrasonic tumor removal tool of claim 1, wherein the doctor blade comprises a doctor blade body. The ultrasonic tumor removal tool according to claim 2, wherein the blade body is a downwardly bent body portion. The ultrasonic tumor resection tool of claim 1, wherein the scraper comprises a crossbar. The ultrasonic tumor resection tool of claim 4, wherein the crossbar is selected from a left crossbar or a rightward crossbar. The ultrasonic tumor resection tool according to claim 1, wherein the scraper is assembled in a reverse rotation and assembled in an endoscopic tumor resection mechanism. The ultrasonic tumor removal tool of claim 1, wherein the ultrasonic waveguide rod comprises an outer protective layer. The ultrasonic tumor removal tool according to claim 1, wherein the connector is disposed on an endoscopic tumor resection mechanism. The ultrasonic tumor resection tool according to claim 1, wherein the connector outputs ultrasonic waves for providing a scraping tissue function. The ultrasonic tumor resection tool according to claim 1, wherein the connector outputs ultrasonic waves for providing tissue hemostasis function.