Endoscope system with electrodes
The endoscope system with a flexible and actively bendable tip and integrated recovery electrode addresses the challenge of treating lesions near the urethra by enabling precise curvature and safe, effective surgical procedures.
Patent Information
- Application Number
- JP2022001704
- Authority / Receiving Office
- JP · JP
- Patent Type
- Patents
- Current Assignee / Owner
- Filing Date
- 2022-01-07
- Publication Date
- 2025-01-24
- Estimated Expiration
- 2042-01-07
AI Technical Summary
Existing endoscopes with rigid tips struggle to treat lesions near the communication opening with the urethra due to their inability to bend at acute angles, causing difficulty in accessing and treating such areas and potentially causing discomfort to the subject.
An endoscope system with a flexible and actively bendable tip, equipped with a recovery electrode, allowing for precise curvature and treatment of lesions near the urethra by enabling the tip to be freely curved and facilitating the flow of current for surgical procedures.
The system allows for effective treatment of lesions near the urethra by enabling precise curvature of the endoscope tip, reducing subject discomfort, and improving operational efficiency and safety by integrating the recovery electrode, thus enhancing treatment efficacy and reducing the risk of burns.
Smart Images

Figure 0007621293000001 
Figure 0007621293000002 
Figure 0007621293000003
Abstract
Description
[Technical field]
[0001] The present invention relates to an electrode-equipped endoscope system that includes an insertion section that is inserted into a body cavity. [Background technology]
[0002] 2. Description of the Related Art Conventionally, endoscopes that use high-frequency current flowing from electrodes in an electrolyte solution environment to ablate or coagulate tissue within a subject have been widely used.
[0003] For example, Patent Document 1 discloses a cystoscope in which an elastic region having a lower bending rigidity than the tip rigid portion and the base rigid portion is provided between a tip rigid portion having an electrode provided at the tip of an electrode support portion inserted into a subject, and a base rigid portion connected to the base end of the electrode support portion. [Prior art documents] [Patent documents]
[0004] [Patent Document 1] International Publication No. 2020 / 136814 Summary of the Invention [Problem to be solved by the invention]
[0005] It is conceivable that a lesion occurs in the bladder near the opening to the urethra, and such a lesion is to be treated. In such a case, since the lesion is located near the opening to the urethra, it is necessary to perform the treatment with the tip of the cystoscope bent at an obtuse angle in the opposite direction to the direction in which the cystoscope entered the bladder, that is, with the tip of the cystoscope forming an acute angle. In the case of a so-called rigid cystoscope, which cannot be operated to bend the tip, it is difficult to treat such a lesion.
[0006] However, in the cystoscope of Patent Document 1, since the electrode support part has an elastic region, the tip rigid part having an electrode at the tip of the electrode support part can be deformed to a slight degree by contact with the inner wall of the bladder, but the electrode support part or tip rigid part cannot be bent significantly, and the above-mentioned problems cannot be solved.
[0007] The present invention has been made in consideration of the above circumstances, and its object is to provide an endoscopic system with electrodes used for treatments using external electrodes, in which the insertion portion inserted into the body cavity is configured to be freely bendable. [Means for solving the problem]
[0008] The electrode-equipped endoscopic system of the present invention is an electrode-equipped endoscopic system used for treatment using an external electrode, and comprises a corresponding electrode provided at the tip of an insertion section that is inserted into a body cavity, through which current flows from the external electrode, and a bending section provided at the tip.
[0009] In the present invention, a user bends the distal end of the insertion section by operating the bending portion, and performs a procedure of resection or coagulation of a lesion using the external electrode. At this time, a current from the external electrode flows to the corresponding electrode and is collected. Effect of the Invention
[0010] According to the present invention, it is possible to provide an endoscope system with electrodes in which an insertion section to be inserted into a body cavity can be freely bent. [Brief description of the drawings]
[0011] [Figure 1] 1 is an external view of an electrode-equipped endoscope system according to a first embodiment of the present invention. [Diagram 2] 2 is a diagram showing a distal end surface of an imaging unit of the electrode-equipped endoscope system of the first embodiment. FIG. [Diagram 3] FIG. 3 is a cross-sectional view taken along line III-III in FIG. [Figure 4] 2 is a cross-sectional view showing a schematic configuration of an imaging device of the electrode-equipped endoscope system of the first embodiment. FIG. [Diagram 5] 1 is a perspective view for explaining a state in which a recovery electrode is provided on an active bending section of the electrode-equipped endoscope system of the first embodiment. FIG. [Figure 6] FIG. 6 is a cross-sectional view taken along line AA in FIG. 5. [Figure 7] 1 is a perspective view showing a high-frequency knife used in the electrode-equipped endoscope system of embodiment 1. FIG. [Figure 8] FIG. 2 is an exemplary diagram illustrating a treatment using the electrode-equipped endoscope system of the first embodiment. [Figure 9] 13 is a perspective view for explaining a state in which a recovery electrode is provided on the outer surface of a flexible section closer to the operation section than the active bending section in an electrode-equipped endoscope system according to a second embodiment. FIG. [Figure 10] 13 is a perspective view for explaining a state in which a recovery electrode is provided on the outer surface of a flexible section closer to the operation section than the active bending section in an electrode-equipped endoscope system of embodiment 3. FIG. [Figure 11] 13 is a perspective view for explaining a state in which a recovery electrode is provided on the outer surface of a flexible section closer to the operation section than the active bending section in an electrode-equipped endoscope system of embodiment 4. FIG. [Figure 12] 13 is a perspective view for explaining a state in which a recovery electrode is provided on the outer surface of a flexible section closer to the operation section than the active bending section in an electrode-equipped endoscope system of a fifth embodiment. FIG. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS
[0012] DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS An electrode-equipped endoscope system according to an embodiment of the present invention will be described in detail below with reference to the drawings.
[0013] (Embodiment 1) 1 is an external view of an endoscope system 10 with electrodes according to a first embodiment of the present invention. The endoscope system 10 with electrodes of this embodiment includes a soft, disposable endoscope, and is used when a procedure such as resection is performed using a so-called high-frequency knife in a state where the inside of the bladder is filled with an electrolyte solution such as physiological saline (electrolyte solution environment). For example, the endoscope system 10 with electrodes is for single use.
[0014] The electrode-equipped endoscope system 10 comprises an insertion section 14 that is inserted into the bladder of a subject, an operation section 20 that operates the insertion section 14, and a connector section 24 that is connected to a processor or the like (not shown). The insertion portion 14 is connected to the operating portion 20 via the folding portion 16 , and the connector portion 24 is connected to the operating portion 20 via a universal cord 25 .
[0015] The universal cord 25 is flexible and includes an electric line for transmitting an electric signal from the imaging means of the insertion portion 14 to the connector portion 24, a flow path through which the electrolyte solution passes, and the like.
[0016] The operation unit 20 has a grip portion 205, a button 210 that receives instructions from a user, and a bending knob 21 that operates the bending operation of the active bending unit 12, which will be described later.
[0017] The gripping portion 205 has a substantially cylindrical shape, and a channel inlet 22 for inserting a treatment tool such as the high-frequency knife into the bladder from the outside is provided near the folding portion 16. In addition, inside the gripping portion 205, a relay portion 40 is provided that connects an imaging unit 617 of the imaging portion 13 (described later) to the processor.
[0018] The insertion section 14 has a cylindrical shape with a small diameter and is configured to be freely bent. The insertion section 14 has, in order from the tip side, an imaging section 13, an active bending section 12, and a flexible section 11. The flexible section 11 is connected to the active bending section 12 via a connecting section 18.
[0019] The imaging section 13 has an imaging unit 617 including imaging means such as a CCD (Charge Coupled Device) or a CMOS (Complementary Metal Oxide Semiconductor), a circuit board for driving the imaging means, an observation optical system, etc., and a lens unit 62 consisting of a series of lenses (see FIG. 3). The imaging section 13 also has an irradiation and illumination optical system for irradiating light onto an observation target site in the bladder. An electric signal from the imaging unit 617 of the imaging section 13 is sent to the processor via the relay section 40 and the connector section 24.
[0020] The active bending section 12 can be actively bent. That is, the active bending section 12 can be freely bent in four directions in response to the operation of the bending knob 21. On the other hand, the flexible section 11 can be passively bent. That is, the flexible section 11 bends by contact with an object.
[0021] FIG. 2 is a diagram showing a distal end surface 131 of the imaging section 13 of the electrode-equipped endoscope system 10 according to the first embodiment, and FIG. 3 is a cross-sectional view taken along line III-III in FIG. The imaging unit 13 has a cylindrical shape and a diameter slightly larger than the active bending unit 12. A flange 70 is provided along the periphery of the imaging unit 13 on the end surface facing the active bending unit 12. The tip of the active bending unit 12 is fitted inside the flange 70.
[0022] A unit hole 71 penetrating in the axial direction is formed in the imaging section 13. The unit hole 71 opens in the approximate center of the circular tip surface 131, has a rectangular cross section, and the imaging device 15 is inserted into the unit hole 71.
[0023] The electrode-equipped endoscope system 10 includes an imaging device 15 disposed within the insertion section 14 and the folding section 16. The imaging device 15 includes a lens unit 62 and an imaging unit 617, and the imaging unit 617 is connected to the relay section 40 via a cable unit 50.
[0024] FIG. 4 is a cross-sectional view that illustrates a schematic configuration of the imaging device 15 of the electrode-equipped endoscope system 10 according to the first embodiment. The imaging device 15 includes a housing tube 60, which houses a lens unit 62 and an imaging unit 617. The housing tube 60 is a rectangular tube, with one end being a circular hole 61 having a circular inner peripheral surface, and the other end being a rectangular hole 68 having a rectangular inner peripheral surface. The lens unit 62 is inserted into the circular hole 61, and the imaging unit 617 is inserted into the rectangular hole 68. A light-shielding mask 614 is provided between the lens unit 62 and the imaging unit 617.
[0025] The lens unit 62 has an observation window 132 and multiple imaging lenses 621. The observation window 132 is exposed at the tip surface 131, and the imaging lenses 621 are provided on the back side of the observation window 132. The observation window 132 and the multiple imaging lenses 621 are arranged on the same axis. The outer circumferential surfaces of the observation window 132 and the multiple imaging lenses 621 are covered and fixed by a lens frame 622.
[0026] The imaging unit 617 includes a filter 623 , an imaging element 611 , and an imaging substrate 612 . The filter 623 removes unnecessary light, such as infrared light, from the light incident on the imaging element 611. The light incident from the lens unit 62 is focused on the imaging element 611, and the imaging element 611 converts the optical image into an electrical signal. The imaging board 612 has a built-in driver circuit that controls the imaging element 611. The cable unit 50 is connected to the imaging board 612 from the other end side of the housing tube 60.
[0027] The cable unit 50 includes a plurality of cable wires 511 bundled by a cable tube 51. One end of the cable unit 50 is connected to an imaging board 612. The connection portion between the one end of the cable unit 50 and the imaging board 612 is potted with insulating resin 54.
[0028] The filter 623, the imaging element 611, the imaging board 612 and one end of the cable unit 50 are held by an insulating tube 535 in an assembled state.
[0029] The cable unit 50 extends outward from the other end of the housing tube 60. The other end of the cable unit 50 is connected to the relay section 40 through the active bending section 12 and the flexible section 11.
[0030] In the housing tube 60, at the end of the circular hole portion 61, a crenellated hole 619 is formed in the outer surface of each of the two opposing side walls. Also, at the end of the rectangular hole portion 68, a recess 682 is formed in the outer surface of one of the two side walls (see FIG. 4). The side wall in which the recess 682 and the crenellated hole 619 are formed is located closer to the outer circumferential surface of the imaging unit 13 than the other three side walls.
[0031] A cable hole 42 is formed in the active bending section 12 at a position corresponding to the unit hole 71 (see FIG. 3). The cable hole 42 is circular in cross section and passes through the active bending section 12 in the axial length direction. The cable hole 42 of the active bending section 12 communicates with the unit hole 71 of the imaging section 13, and a cable unit 50 is inserted into the cable hole 42. The cable unit 50 extends to the relay section 40 of the operation section 20 via the flexible section 11 and the folding section 16.
[0032] Although not shown, the active bending unit 12 has a bending mechanism in which a plurality of pieces, which are metal circular members, are connected in the axial direction. By operating the bending knob 21 of the operation unit 20, the user can control the bending of the bending mechanism and bend the active bending unit 12 in a predetermined direction. The entire outer periphery of the link is covered with a metal braid 122 made by weaving extremely fine metallic threads. Furthermore, the outside of the metal braid 122 is covered with an insulating resin material 121 (see FIG. 6).
[0033] 2, in the distal end surface 131 of the imaging unit 13, illumination windows 133 are provided on both sides of the observation window 132. The illumination hole 76 into which the light-emitting element 136 is inserted penetrates the imaging unit 13 in the axial direction. The illumination hole 76 is circular in cross section, and one end opens to the distal end surface 131, at which the illumination window 133 is provided. The illumination window 133 expands the irradiation angle of the illumination light emitted from the light-emitting element 136.
[0034] The insertion section 14 is formed with a bending wire hole for a bending wire 17 for bending the imaging section 13 (active bending section 12), which passes through the insertion section 14 in the axial direction. The bending wire hole consists of a bending wire hole 47 formed in the active bending section 12, and bending wire holes (not shown) formed in each of the flexible section 11 and the folding stopper section 16. For convenience, only the bending wire hole 47 will be described below.
[0035] The bending wire holes 47 are circular in cross section, and four bending wire holes 47 are formed near the outer circumferential surface of the active bending section 12. The bending wire holes 47 are formed at equal intervals in the circumferential direction of the active bending section 12. One end of the bending wire holes 47 opens on the end surface of the active bending section 12 on the imaging section 13 side.
[0036] In addition, in the imaging section 13, a recess 77 is formed on the end face on the active bending section 12 side at a position corresponding to the one end of each bending wire hole 47. Each recess 77 is circular in cross section and has a larger diameter than the bending wire hole 47.
[0037] A bending wire 17 is inserted into each bending wire hole 47. One end of the bending wire 17 protrudes into the corresponding recess 77 through the one end of the bending wire hole 47. The one end of the bending wire 17 is fixed in the recess 77 by soldering, crimping, or the like. The other end of the bending wire 17 is connected to the bending knob 21 of the operation unit 20 through the bending wire hole. When a user operates the bending knob 21, the bending wire 17 bends the active bending unit 12.
[0038] 3, a communication hole 712 that communicates with the unit hole 71 is formed on the outer circumferential surface of the imaging unit 13 at a position that corresponds in the radial direction to the recess 682 of the housing tube 60. The communication hole 712 is circular in cross section, and a screw thread is formed on the inner circumferential surface. A fixing screw 69 is screwed into the communication hole 712. The fixing screw 69 is pressed against the housing tube 60, thereby fixing the position of the housing tube 60 in the unit hole 71.
[0039] The insertion section 14 is formed with a channel that passes through the insertion section 14 in the axial direction and through which the high-frequency knife passes when inserted from the channel inlet 22. The channels include a channel 78 formed in the imaging section 13, a channel 48 formed in the active bending section 12, and a channel (not shown) formed in the flexible section 11.
[0040] One end of the channel 78 is expanded to form a forceps port 142, and opens near the observation window 132 at the tip surface 131. The other end of the channel 78 communicates with one end of the channel 48 via a channel pipe 781 (see FIG. 3).
[0041] That is, the channel pipe 781 is provided across the imaging section 13 and the active bending section 12. One end of the channel pipe 781 is fitted inside the channel 78, and the other end of the channel pipe 781 is fitted inside the channel .
[0042] In the electrode-equipped endoscope system 10 of the first embodiment, a recovery electrode 19 (counter electrode) that recovers the current flowing from the high-frequency knife via an electrolyte solution is provided in the active bending section 12. That is, the recovery electrode 19 is provided integrally with the insertion section 14. FIG. 5 is a perspective view illustrating a state in which a recovery electrode 19 is provided on the active bending section 12 of the electrode-equipped endoscope system 10 of the first embodiment, and FIG. 6 is a cross-sectional view taken along line AA in FIG.
[0043] The recovery electrode 19 is made of a conductive metal such as stainless steel and has a cylindrical shape. The recovery electrode 19 has an outer diameter substantially equal to that of the active bending section 12, and is fitted into a recess provided on the outer circumferential surface of the active bending section 12 so that the axis of the recovery electrode 19 coincides with that of the active bending section 12. The outer circumferential surface of the recovery electrode 19 is flush with the resin material 121 of the active bending section 12 so as not to interfere with the insertion of the electrode-equipped endoscope system 10 into the bladder. The recovery electrode 19 is also insulated from the metal blade 122.
[0044] A connection line 191 is connected to the inner peripheral surface of the recovery electrode 19. The connection line 191 extends through the flexible portion 11 and the folded portion 16, and electrically connects the recovery electrode 19 to the high frequency power supply device. For example, the connection line 191 may be configured to pass through the curved wire hole 47.
[0045] The flexible section 11 is configured to have different hardness depending on the position in the axial direction. The flexible section 11 is configured such that one end on the active bending section 12 side is bendable, and the hardness of the other portion except for the one end is higher than that of the one end. Specifically, considering that a human bladder is assumed to be a sphere with a diameter of 10 cm, and a male urethra is said to be 20 cm, the hardness of the 30 cm portion on the operation section 20 side of the flexible section 11 having a dimension of 40 cm in the axial direction may be made higher. That is, in the flexible section 11, 3 / 4 of the portion on the operation section 20 side has a higher hardness than the remaining 1 / 4. In addition, it is preferable to configure the boundary between these two portions so that the hardness changes gradually rather than stepwise.
[0046] 7 is a perspective view showing the high-frequency knife 200 used in the electrode-equipped endoscope system 10 of Embodiment 1. The high-frequency knife 200 is connected to a high-frequency power supply device. The high-frequency knife 200 includes a long, hose-shaped tube 202, a support part 204 that is provided inside one end of the tube 202 and has a diameter smaller than the inner diameter of the tube 202, and a round-rod electrode 201 (external electrode) that is provided on the support part 204 and protrudes outward through an opening on one end side of the tube 202. The high-frequency knife 200 can be freely curved. The round-rod electrode 201 is provided on the front side of the support part 204, and a coated conductive wire (not shown) that connects the round-rod electrode 201 to a high-frequency power supply device is connected to the back side of the support part 204. A gap 203 is formed between the tube 202, the support part 204, and the conductive wire.
[0047] An electrolyte solution is supplied into the bladder 300 through the gap 203. When the bladder 300 is filled with the electrolyte solution 400, the high-frequency knife 200 is inserted into the bladder 300 through the channel of the electrode-equipped endoscope system 10. When a high-frequency current is output from the high-frequency power supply device, the tissue of the subject in contact with the round rod-shaped electrode 201 generates heat, and the tissue is excised or coagulated by the heat. This is not a limitation, and the electrolyte solution may be configured to be supplied through a channel of the electrode-equipped endoscope system 10.
[0048] The operation of the electrode-equipped endoscope system 10 according to the first embodiment having the above-mentioned configuration will be described. 8 is an exemplary diagram for explaining a treatment using the electrode-equipped endoscope system 10 of the first embodiment. For example, the practitioner inserts the electrode-equipped endoscope system 10 into the bladder 300 through the urethra 500 of a subject (male). At this time, the active bending section 12 and a part of the flexible section 11 are inserted into the bladder 300. Next, the practitioner inserts the high-frequency knife 200 into the channel from the channel inlet 22, and inserts it up to the imaging section 13 of the electrode-equipped endoscope system 10. For example, an electrolyte solution is supplied from the high-frequency knife 200 into the bladder 300, and a treatment such as TUR (transurethral resection) is performed in a state in which the bladder 300 is filled with the electrolyte solution 400.
[0049] When a high-frequency current is output from the high-frequency power supply device to the high-frequency knife 200, the high-frequency current flows among the round-rod electrode 201 of the high-frequency knife 200, the electrolyte solution 400, and the recovery electrode 19. That is, the current from the round-rod electrode 201 is recovered by the recovery electrode 19 via the electrolyte solution 400. At this time, the tissue of the subject in contact with the round-rod electrode 201 generates heat, so that the tissue, which is the diseased area, can be excised, etc.
[0050] Here, as shown in FIG. 8, a case can be assumed in which a lesion 600 to be treated is located in the vicinity of the opening of the urethra 500 in the bladder 300. When the lesion 600 occurs in a region close to the opening of the urethra 500, the treatment needs to be performed with the tip of the insertion part 14 greatly bent in the opposite direction to the direction of entry of the insertion part 14 into the bladder 300. Therefore, in the case of a so-called rigid cystoscope, the tip of which cannot be bent, it is difficult to treat the lesion 600 near the urethra 500. Furthermore, since the shape of the human urethra 500 is not linear, if a rigid cystoscope that is linear and cannot be bent is used, the subject will feel great pain when the electrode-equipped endoscope system 10 (insertion part 14) passes through the urethra 500.
[0051] In contrast, the electrode-equipped endoscope system 10 of embodiment 1 can freely bend the tip portion of the insertion section 14 including the active bending section 12, and one end of the flexible section 11 on the active bending section 12 side can also be bent.
[0052] Therefore, even if a lesion 600 occurs in the bladder 300 near the opening to the urethra 500, in the electrode-equipped endoscopic system 10 of embodiment 1, the active bending section 12 can be bent so that the tip portion of the insertion section 14 is bent at an obtuse angle to form an acute angle, i.e., the tip surface 131 of the imaging section 13 can be directed toward the lesion 600.
[0053] Thereafter, the practitioner pushes out the high-frequency knife 200 from the forceps opening 142 of the distal end surface 131, brings it close to the lesion 600, and applies the rod-shaped electrode 201 to the lesion 600. This causes a treatment to remove or coagulate the lesion by using a current from the rod-shaped electrode 201. The current from the rod-shaped electrode 201 is also collected by the collection electrode 19 via the electrolyte solution 400. Therefore, the lesion 600 near the urethra 500 can also be appropriately treated.
[0054] Furthermore, since the active bending section 12 (the tip portion of the insertion section 14) and one end of the flexible section 11 on the active bending section 12 side can be bent, when the electrode-equipped endoscopic system 10 (insertion section 14) passes through the urethra 500, the active bending section 12 and the flexible section 11 can be deformed to fit the shape of the urethra 500, thereby reducing the subject's pain.
[0055] Furthermore, in the electrode-equipped endoscope system 10 of the first embodiment, the imaging device 15 can be collected by removing the fixing screw 69, pushing the recess 682 toward the tip side of the imaging unit 13 using a tool to expose the crab-eye holes 619, and hooking and pulling the crab-eye jig into the two crab-eye holes 619. This makes it possible to reduce environmental pollution and resource waste.
[0056] As described above, in the electrode-equipped endoscope system 10 of embodiment 1, the recovery electrode 19 is provided integrally with the insertion section 14, so there is no need to provide a separate counter electrode for recovering current from the rod-shaped electrode 201. This reduces costs and prevents burns due to poor contact that may occur when using a counter electrode.
[0057] As described above, the electrode-equipped endoscope system 10 of embodiment 1 is a flexible cystoscope for single-use, so that the recovery electrode 19 does not become dirty or have poor contact due to multiple uses, and the recovery electrode 19 does not deteriorate due to cleaning of the electrode-equipped endoscope system 10.
[0058] Furthermore, as described above, in the electrode-equipped endoscope system 10 of embodiment 1, the recovery electrode 19 has a cylindrical shape, so there is no directional restriction in recovering current from the high-frequency knife 200 via the electrolyte solution, thereby improving operability.
[0059] As described above, the flexible section 11 is configured such that the hardness of the other parts, except for the one end on the imaging section 13 side, is higher than that of the one end. Therefore, the electrode-equipped endoscope system 10 of the first embodiment can easily transmit force to the imaging section 13 of the electrode-equipped endoscope system 10 during operations such as twisting, thereby improving the operability of the electrode-equipped endoscope system 10.
[0060] In the above, an example has been described in which the recovery electrode 19 is made of a conductive metal, has a cylindrical shape, and is fitted onto the outer circumferential surface of the active bending section 12. However, the shape of the recovery electrode 19 is not limited to a cylindrical shape. For example, the recovery electrode 19 may be pad-shaped and provided on a part of the outer circumferential surface of the active bending section 12. Furthermore, the recovery electrode 19 is not limited to being made of a conductive metal, and may be made of conductive fiber.
[0061] In the above, the case where the recovery electrode 19 is provided in the active bending section 12 has been described as an example, but the present invention is not limited to this. The recovery electrode 19 may be provided on the tip side of the active bending section 12, or on the operation section 20 side of the active bending section 12, for example, on the connecting section 18. The recovery electrode 19 is placed in an electrolyte solution environment, but if it is too close to the tip surface 131, there is a risk that the current from the high-frequency knife 200 will not pass through the lesion and will flow directly to the recovery electrode 19. Therefore, it is more preferable to provide the recovery electrode on the operation section 20 side of the active bending section 12 than on the tip side of the active bending section 12.
[0062] (Embodiment 2) FIG. 9 is a perspective view illustrating a state in which a recovery electrode 19A (counter electrode) is provided on the outer surface of the flexible section 11 closer to the operation section 20 than the active bending section 12 in the electrode-equipped endoscope system 10 according to the second embodiment. 。
[0063] In the electrode-equipped endoscope system 10 of the second embodiment, the recovery electrode 19A is formed of, for example, a mesh-shaped conductive metal material and has a cylindrical shape. Flexible part 11 Approximately equal to the outer diameter of Flexible part 11 So that the axis of the Flexible part 11 The outer circumferential surface of the recovery electrode 19A is Flexible part 11 It is almost flush with the
[0064] Similar to the first embodiment, a connection wire 191 is connected to the inner circumferential surface of the recovery electrode 19A, electrically connecting the recovery electrode 19A to a high frequency power supply device (see FIG. 6).
[0065] As described above, in the electrode-equipped endoscope system 10 of embodiment 2, the recovery electrode 19A is made of a mesh-shaped conductive metal material, so that when the active bending section 12 performs a bending operation, the hindrance caused by the recovery electrode 19A is reduced, and the active bending section 12 can be easily bent.
[0066] Other configurations of the electrode-equipped endoscope system 10 of embodiment 2 are the same as those of the electrode-equipped endoscope system 10 of embodiment 1, and parts similar to those of embodiment 1 are given the same symbols and detailed descriptions are omitted.
[0067] (Embodiment 3) FIG. 10 is a perspective view illustrating a state in which a recovery electrode 19B (counter electrode) is provided on the outer surface of the flexible section 11 closer to the operation section 20 than the active bending section 12 in the electrode-equipped endoscope system 10 according to the third embodiment. 。
[0068] In the electrode-equipped endoscope system 10 of the third embodiment, the recovery electrode 19B is formed, for example, from a mesh-shaped conductive metal material, and has a cylindrical portion 193B having a cylindrical shape and a plurality of protrusions 192B protruding from the outer circumferential surface of the cylindrical portion 193B. The cylindrical portion 193B has an outer diameter of Flexible part 11 Approximately equal to the outer diameter of Flexible part 11 So that the axis of the Flexible part 11 The outer circumferential surface of the cylindrical portion 193B is Flexible part 11 The inner peripheral surface of the recovery electrode 19B is substantially flush with the outer peripheral surface of the recovery electrode 19, as in the first embodiment. B A connection line 191 (see FIG. 6) is connected to electrically connect the high frequency power supply device.
[0069] The plurality of protrusions 192B are made of a conductive metal such as stainless steel, and are arranged in rows at equal intervals in the circumferential direction of the cylindrical portion 193B. For example, the protrusions 192B are arranged in two rows, and each row is formed on the cylindrical portion 193B ( Flexible part 11 ) are arranged side by side at a predetermined interval in the axial direction.
[0070] As described above, in the electrode-equipped endoscope system 10 of embodiment 3, the cylindrical portion 193B of the recovery electrode 19B is made of a mesh-shaped conductive metal material, so that when the active bending section 12 performs a bending operation, interference from the recovery electrode 19B (cylindrical portion 193B) is reduced, and the active bending section 12 can be easily bent.
[0071] In addition, since a plurality of protrusions 192B are provided on the outer circumferential surface of the cylindrical portion 193B, a gap is formed between the inner wall of the bladder 300 and the cylindrical portion 193B when the recovery electrode 19B comes into contact with the inner wall of the bladder 300. Therefore, the electrolyte solution 400 can move through the gap, and the electrolyte solution 400 and the recovery electrode 19B are reliably in contact with each other.
[0072] Other configurations of the electrode-equipped endoscope system 10 of embodiment 3 are the same as those of the electrode-equipped endoscope system 10 of embodiment 1, and parts similar to those of embodiment 1 are given the same symbols and detailed descriptions are omitted.
[0073] (Embodiment 4) FIG. 11 is a perspective view illustrating a state in which a recovery electrode 19C (counter electrode) is provided on the outer surface of the flexible section 11 closer to the operation section 20 than the active bending section 12 in the electrode-equipped endoscope system 10 according to the fourth embodiment. 。
[0074] In the electrode-equipped endoscope system 10 of the fourth embodiment, the recovery electrode 19C has a plurality of ring parts 192C made of a conductive metal material such as stainless steel. In the fourth embodiment, the recovery electrode 19C is described by taking as an example a case where the recovery electrode 19C is made of three ring parts 192C, but is not limited to this.
[0075] The plurality of ring portions 192C include Flexible part 11 When the imaging section 13 has a diameter of 5 mm, the dimension of each ring portion 192C in the axial direction is, for example, 1 mm, and the ratio of the ring portion 192C to the interval between the ring portions 192C is, for example, 1:1 to 1:3.
[0076] Each ring portion 192C has an outer diameter Flexible part 11 Approximately equal to the outer diameter of Flexible part 11 So that the axis of the Flexible part 11 The outer circumferential surface of each ring portion 192C is Flexible part 11 The inner circumferential surface of each ring portion 192C is substantially flush with the outer circumferential surface of the ring portion 192C, and a connection wire 191 (see FIG. 6) that electrically connects the recovery electrode 19C and the high frequency power supply device is connected to the inner circumferential surface of each ring portion 192C, as in the first embodiment.
[0077] As described above, in the electrode-equipped endoscope system 10 of embodiment 4, the recovery electrode 19C is made up of multiple ring portions 192C, so that when the active bending section 12 performs a bending operation, the hindrance caused by the recovery electrode 19C is reduced, and the active bending section 12 can be easily bent.
[0078] The electrode-equipped endoscope system 10 of the fourth embodiment is not limited to the above description. For example, each ring portion 192C may be formed from a net-shaped conductive metal material and may have a plurality of protrusions 192B (see FIG. 10).
[0079] Other configurations of the electrode-equipped endoscope system 10 of embodiment 4 are the same as those of the electrode-equipped endoscope system 10 of embodiment 1, and parts similar to those of embodiment 1 are given the same symbols and detailed descriptions are omitted.
[0080] (Embodiment 5) FIG. 12 is a perspective view illustrating a state in which a recovery electrode 19D (counter electrode) is provided on the outer surface of the flexible section 11 closer to the operation section 20 than the active bending section 12 in the electrode-equipped endoscope system 10 according to the fifth embodiment. 。
[0081] In the electrode-equipped endoscope system 10 of the fifth embodiment, the recovery electrode 19D is made of a conductive metal such as stainless steel and has a spiral shape. Flexible part 11 Approximately equal to the outer diameter of Flexible part 11 So that the axis of the Flexible part 11The outer circumferential surface of the recovery electrode 19D is Flexible part 11 The recovery electrode 19D has an inner circumferential surface that is substantially flush with the outer circumferential surface of the recovery electrode 19. D A connection line 191 (see FIG. 6) is connected to electrically connect the high frequency power supply device.
[0082] As described above, in the electrode-equipped endoscope system 10 of embodiment 5, the recovery electrode 19D has a spiral shape, so that when the active bending section 12 performs a bending operation, the hindrance caused by the recovery electrode 19D is reduced, the active bending section 12 can bend easily, and the stress applied to the recovery electrode 19D is distributed, thereby reducing the risk of disconnection / breakage.
[0083] The electrode-equipped endoscope system 10 of the fifth embodiment is not limited to the above description, and the recovery electrode 19D may be formed from a net-shaped conductive metal material.
[0084] Other configurations of the electrode-equipped endoscope system 10 of embodiment 5 are the same as those of the electrode-equipped endoscope system 10 of embodiment 1, and parts similar to those of embodiment 1 are given the same symbols and detailed descriptions are omitted.
[0085] The technical features (constituent elements) described in the first to fifth embodiments can be combined with each other, and by combining them, new technical features can be formed. The embodiments disclosed herein are illustrative in all respects and should not be considered as limiting. The scope of the present invention is defined by the claims, not by the above meaning, and is intended to include all modifications within the scope and meaning equivalent to the claims. [Explanation of symbols]
[0086] 10 Endoscope system with electrodes 11 Flexible part 12 Active bending section 13 Imaging unit 14 Insertion section 18 Connecting part 19, 19A, 19B, 19C, 19D Recovery electrodes 20 Control section 131 Tip surface 142 Forceps mouth 192B Protrusion 192C Ring section 200 High Frequency Knife 201 Round rod electrode 300 Bladder 400 electrolyte solution 500 Urethra 600 Lesions
Claims
1. An electrode-equipped endoscope system for use in treatment using external electrodes, a counter electrode provided at a tip of an insertion part to be inserted into a body cavity and through which a current flows from the external electrode; A curved portion provided at the tip portion; a forceps port provided on a distal end surface of the insertion portion through which the external electrode passes; An operation unit for operating the bending operation of the bending portion, An endoscope system with electrodes, wherein the corresponding electrode is provided closer to the operation section than the tip surface.
2. The external electrodes are used within the bladder in an electrolyte solution environment; 2. The electrode-equipped endoscope system according to claim 1, wherein a current from the external electrode flows to the corresponding electrode via the electrolyte solution.
3. An endoscopic system with electrodes as described in claim 1 or 2, wherein the corresponding electrode is provided on the outer peripheral surface of the insertion portion at the curved portion, or on the tip side of the curved portion or on the operating portion side of the curved portion.
4. The electrode-equipped endoscope system according to claim 1 , wherein the counter electrode is cylindrical and fitted onto an outer circumferential surface of the insertion portion.
5. The counter electrode includes a plurality of ring members; The electrode-equipped endoscope system according to claim 1 , wherein the plurality of ring members are fitted onto an outer circumferential surface of the insertion portion at predetermined intervals in the longitudinal direction of the insertion portion.
6. 6. An endoscope system with an electrode according to claim 4, wherein the counter electrode is in a net shape.
7. The electrode-equipped endoscope system according to claim 4 , wherein the corresponding electrode includes a plurality of protrusions.
8. The electrode-equipped endoscope system according to claim 1 , wherein the counter electrode has a spiral shape.
9. The electrode-equipped endoscope system according to claim 3 , wherein the flexible section provided closer to the operation section than the bending section has a hardness higher than that of the end section except for the end section on the bending section side.
10. 10. An electrode-equipped endoscope system according to claim 1, which is disposable.
11. A single-use electrode-equipped endoscope system according to any one of claims 1 to 10.
12. The insertion portion is inserted into the bladder, 12. The electrode-equipped endoscope system according to claim 1, wherein the bending portion is bent so that a tip surface of the insertion portion faces a lesion portion near an opening in the bladder that communicates with the urethra.
Citation Information
Patent Citations
Insertion part of endoscope
JP1999262470A
Endoscope
JP2001221957A
Electric treatment instrument
JP2005261698A
Methods and apparatus for electrosurgical ventriculostomy
US20030088245A1
Flexible tube for endoscope, endoscope type medical device, and methods for producing these
WO2019013243A1