WO2018182101A1 - High-frequency knife for endoscopic submucosal dissection - Google Patents

Abstract

The present invention allows a double edge of a high-frequency knife, which has multiple electrodes formed in multiple steps at the tip thereof, to be easily hooked onto a tissue during tissue dissection, distributes a contact area to prevent the tissue from excessively concentrating at a tip electrode, and enables the knife to smoothly dissect a tissue without slipping at any location as the knife is easily hooked onto a lesion tissue layer.

Description

Endoscopic High Frequency Knife For Submucosal Incision

The present invention relates to a high frequency knife for endoscopic submucosal dissection, and to a high frequency knife integrally formed with a chemical injection needle for swelling mucosal tissue.

Endoscopic treatment Endoscopy is an important field in the treatment of gastrointestinal pain. The field of therapeutic endoscopy has been developed due to the miniaturization of electronic devices, the development of imaging technology, the development of therapeutic technology, and the skill of the physician.

Conventionally, the treatment of gastric cancer or colorectal cancer is dependent on a surgical operation method, but minimally invasive surgery has been possible as endoscopy is performed in parallel. Endoscopic Mucosal Resection (EMR) or Endoscopic Submucosal Dissection (ESD) among endoscopy-based surgical methods includes marking, incision, exfoliation, hemostasis, and water in the treatment instrument inserted through the working channel of the endoscope. Various types of tools are appropriately replaced depending on the purpose of treatment and the type of mucosa.

The treatment instrument enters the body through a tube that is inserted into the working channel of the endoscope. In general, a high frequency knife is a knife for cutting the mucous membrane of the tissue, a coagulator for hemostasis when bleeding during the mucosal resection, and a saline solution as a means of swelling the mucosal tissue to provide ease of ablation. Various kinds of treatment tools, such as a medicine injection needle (needle) for injecting the back is provided.

Endoscopic mucosal resection (EMR) is a treatment that started in the 80s in Japan with advanced endoscopy. Endoscopy is a tool for diagnosis, but here I have tried to treat early gastric cancer with an orgasm cap. It was hoped that small cancers attached to the mucous membrane could be cured with a lasso or cap and cut with an electric knife on the end of the endoscope. Endoscopic mucosal resection (EMR), however, is limited to a range of procedures because tumors larger than 2 cm in diameter can be accompanied by a sequelae caused by large cuts or perforation of the gastric wall.

To address this limitation, endoscopic submucosal dissection (ESD) was introduced. Endoscopic submucosal dissection (ESD) is an endoscopic technique that treats gastric cancer, as well as esophageal and colorectal cancer. Endoscopic submucosal dissection (ESD) is a surgical method that uses a high-frequency knife attached to the end of an endoscope to incise a tumor, such as a mass of cancer, attached to the mucous membrane and thinly detach it. In particular, unlike endoscopic mucosal resection (EMR), which cuts off the neck of a tumor, endoscopic submucosal dissection (ESD) is a mass of cancer at once, as the radiofrequency knife digs deeper into the cancer and mucous membranes and pulls out the mucous membranes little by little. It's a way to remove it.

Accordingly, using endoscopic submucosal dissection (ESD), large tumors can be removed theoretically as large as they are thin. In other words, using endoscopic submucosal dissection (ESD), unlike endoscopy mucosal resection (EMR), tumors whose tumor removal limits exceed 2 cm in diameter and 15 cm in diameter can be peeled off at once. In addition, endoscopic submucosal dissection (ESD) is performed in a sleep state without general anesthesia, and the operation time is about 40 minutes to about an hour, so the operation time is relatively short. In addition, they can be discharged three to four days after surgery and return to daily life almost immediately. As such, by performing endoscopic submucosal dissection (ESD), the diagnosis and treatment can be performed clinically, and the treatment rate of early gastric cancer, colorectal cancer, etc. can be increased, and the recovery period can be shortened.

The high frequency knife used for endoscopic submucosal dissection (ESD) is generally composed of an insulator fixed to the tip of an electrode, such as a high frequency knife disclosed in Korean Patent No. 0595803, in the process of cutting or cutting a lesion. It is configured to prevent damage to tissues or the body by the insulator even if it is connected to other tissues.

Looking at the process of endoscopic submucosal detachment with a conventional ESD knife as follows. Figure 1 is a schematic diagram for explaining the peeling process of endoscopic submucosal dissection (ESD). Referring to FIG. 1, the high-frequency knife entering the lesion tissue together with the endoscope marks the tissue region by slightly cauterizing the region of the lesion tissue. Thereafter, the drug injection needle penetrates into the lesion tissue and swells to facilitate ablation of the lesion tissue as the saline solution is injected into the lesion tissue. Thereafter, the high frequency knife invades at the marking point and starts to cut while rotating 360 degrees around the tissue at the applied high frequency. The high-frequency knife is thinly exfoliated the lesion tissue with the incision, wherein the high frequency applied to the knife is discontinuous so that the incision for cauterizing the tissue and the exfoliation for lifting the cauterized tissue are difficult to proceed simultaneously. More specifically, the high-frequency knife cuts tissue at the time when the high frequency is applied to the tip, and when the high frequency is not applied to the tip, the entire tissue is excised by alternately lifting the tissue using the structure of the knife tip. It is preferred to understand that.

In this process, the mucous membrane to be removed has a multi-layered structure, an uneven wrinkle shape, and may have a hardly deformed portion of blood vessels and fibrous tissues. Therefore, it is usually extremely difficult for the tip of the high-frequency knife to smoothly cut and peel simultaneously. The tip of the high-frequency knife generally has a predetermined length and has a dome-shaped round electrode shape that facilitates invasion and dissection of the tissue into the tissue, but smoothly lifts or hooks a thin layer of tissue that peels upward. It is inconvenient to make an incision while hooking.

In addition, when the high-frequency knife pulls the tissue, the tissue layer cut at the end of the knife is concentrated, and as the resistance is increased, it takes a long time to conduct electricity and causes burns on the incision surface. As described above, the conventional high-frequency knife for endoscopic submucosal dissection has a structural limitation that is not easy to proceed smoothly at the same time as the incision and detachment.

In addition, since the submucosal dissection is required to enter the periphery of the lesion tissue, marking, incision, exfoliation, hemostasis, washing, etc., it is important that the high-frequency knife is designed to perform such a treatment with a single insertion. Here, the tip structure of the high-frequency knife should be able to be peeled off as well as the cutting. Therefore, the needle for injecting water, hemostasis, saline, drugs, etc. into the high-frequency knife is preferably formed with the electrode to which the high frequency is applied, but the electrode and the needle are arranged at the tip so that the incision and peeling can be performed simultaneously. It is not easy to form the knife tip smoothly.

There is also a need to swell the lesion tissue prior to performing incisional detachment of submucosal dissection. To this end, the medical practitioner confirmed the location of the lesion with an endoscope, and then, a needle was inserted to inject the saline solution, the endoscope connected to the needle was removed from the body, and a high frequency knife was inserted to perform incisional peeling. That is, there is a problem in that the endoscope should be inserted alternately as the needle and the high-frequency knife are separated for chemical injection or tissue swelling during submucosal dissection.

The present invention is to provide a high-frequency knife having a tip structure in which the tip of the high-frequency knife for endoscopic submucosal dissection is penetrated into the tissue so that the tissue is dispersed contact without excessive concentration of the tissue at the knife end at the time of incision.

In addition, the present invention is to provide a high-frequency knife capable of cutting smoothly and easy cutting and peeling by forming a structure of the tip that is easy to hook (hooking) to the layer of lesion tissue.

In addition, the present invention is to provide a high-frequency knife that can be performed by subcutaneous mucosal detachment with a single insertion without having to insert a needle and electrode endoscope alternately integrated on the high-frequency knife catheter needle for drug injection.

In addition, the present invention is to provide a high-frequency knife having a structure capable of alternately discharging the needle and the high frequency electrode tip by a simple operation.

In order to achieve the above object, the present invention, in the high-frequency knife for endoscopic submucosal dissection detachment, is provided at the tip of the tube inserted into the body of the both ends of the tube portion and the electrode tip is energized when applying the high frequency to ablate the lesion tissue in the body The electrode tip includes: an electrode rod exposed from the tip of the tube and made of a conductor; A first electrode having a radius larger than that of the electrode rod at the tip of the electrode rod and having an upper surface raised in a dome shape; And a second electrode formed on the electrode rod spaced apart in parallel with the first electrode at a predetermined distance, wherein the electrode rod has a plurality of electrodes formed in multiple stages.

In another aspect, the present invention provides a high-frequency knife for endoscopic submucosal dissection, an electrode tip provided at the tip of the tube inserted into the body of the both ends of the tube portion and energized when the high frequency is applied to ablate lesion tissue in the body; Needles that invade submucosa of lesion tissue to introduce liquid for swelling tissue; And a handle for manipulating the electrode tip and the needle, wherein the handle includes a first handle part connected to the electrode tip to advance and retreat the electrode tip, and a second handle part connected to the needle to advance and advance the needle. And, including a gear portion for transmitting a force to the second handle portion in a direction opposite to the direction of the force applied to the first handle portion, it is possible to alternately expose the electrode tip or the needle only by the operation of the handle It is another feature.

In addition, the present invention is a high-frequency knife for endoscopic submucosal dissection detachment, the electrode tip is provided at the front end of the tube inserted into the body of the both ends of the tube portion and energized when applying the high frequency to ablate the lesion tissue in the body; Needles that invade submucosa of lesion tissue to introduce liquid for swelling tissue; And a handle for manipulating the electrode tip and the needle, wherein the handle includes a first handle part connected to the electrode tip to advance and retreat the electrode tip, and a second handle part connected to the needle to advance and advance the needle. And, including a wire portion for transmitting a force to the second handle portion in a direction opposite to the direction of the force applied to the first handle portion, it is possible to alternately expose the electrode tip or the needle only by the operation of the handle It is another feature.

The high frequency knife according to the present invention has a double blade structure in which a plurality of electrodes are formed in multiple stages at an electrode tip to which high frequency is applied. In this case, there is an advantage in hooking the tissue when the electrode tip performs exfoliation of the tissue. In addition, the electrode tip structure can prevent the unintentional increase in impedance around the electrode tip by dispersing the contact area so that tissue is not excessively concentrated on the tip electrode. Therefore, the structure of the electrode tip according to the present invention can be easily hooked to the layer of lesion tissue during the incision, as well as the tissue is not condensed at the end of the electrode tip so that the impedance is kept constant so that the tissue is dissected. The precision can be improved and the incision exfoliation process can be performed smoothly.

In addition, according to the present invention is provided with a structure in which the electrode to which the high frequency is applied and the needle for injecting the drug or saline are alternately exposed at the same position of the high frequency knife tip. Accordingly, there is an advantage in that the tip structure is formed so that the marking, cutting, peeling, and water-receiving functions can be performed with a single treatment device, but the needle does not interfere with the peeling of the tissue when dissecting the tissue through the electrode tip.

Figure 1 is a schematic diagram for explaining the peeling process of endoscopic submucosal dissection (ESD).

2 is a perspective view of a high frequency knife according to an embodiment of the present invention.

3 is an enlarged view of an electrode tip A type according to an embodiment of the present invention.

4 is an enlarged view of an electrode tip B type according to an embodiment of the present invention.

5 is an enlarged exploded view of the injection hole according to the embodiment of the present invention.

6 is an enlarged view of the treatment instrument according to the embodiment of the present invention.

7 is an enlarged exploded view of a fixed switch according to an embodiment of the present invention.

8 shows a handle of a high frequency knife according to another embodiment of the present invention.

9 is a view illustrating an operation of the high frequency knife according to the embodiment of FIG. 8.

10 shows a handle of a high frequency knife according to another embodiment of the present invention.

11 is a view illustrating an operation of the high frequency knife according to the embodiment of FIG. 10.

Hereinafter, with reference to the contents described in the accompanying drawings will be described in detail the present invention. However, the present invention is not limited or limited by the exemplary embodiments. Like reference numerals in the drawings denote members that perform substantially the same function.

The objects and effects of the present invention may be naturally understood or more apparent from the following description, and the objects and effects of the present invention are not limited only by the following description. In addition, in describing the present invention, when it is determined that the detailed description of the known technology related to the present invention may unnecessarily obscure the subject matter of the present invention, the detailed description thereof will be omitted.

2 is a perspective view of the high-frequency knife 1 according to the embodiment of the present invention. Referring to FIG. 2, the high frequency knife 1 may include an electrode tip 10, an injection hole 30, a handle 50, a power connection 70, a tube portion 80, and a needle 90 (FIG. 6). Can be.

In this embodiment, a power cable for applying a high frequency to the electrode tip 10 may be connected to the power supply connection 70. The power connection unit 70 may be formed to be movable between the handle 50 and the injection hole 30. In the conventional handpiece ESD knife, the power connection is fixedly formed in an area in which the jack for connecting the power is close to the handle for the operator to operate. In practice, if a medical practitioner connects an ESD knife to a power jack, the power cable may interfere with the operating radius of the handle, resulting in inconvenience. The power connection unit 70 according to the present embodiment is provided to be able to adjust the distance spaced from the handle 50 so as not to cause inconvenience in operation due to the power cable to be connected.

The form in which the power connector 70 is disposed is not limited to the above-described position, and the direction of the terminal provided for connecting the power connector 70 to the jack is also not limited to the direction toward the bottom as shown in FIG. can be changed. In addition, the power supply connection 70 may be connected to the needle (90, Figure 6) to control the movement of the needle (90, Figure 6) through the drive forward and backward. The related description will be described in detail in the description of FIG. 5.

The handle 50 may be divided into a first handle part 501 and a second handle part 503. In other words, the handle 50 may be provided as a second handle part 503 to be gripped by a thumb and a first handle part 501 to be gripped by a finger other than the thumb. The first handle part 501 is connected to the second handle part 503 so that relative movement is possible. If the first handle portion 501 is fixed, the second handle portion 503 may be slidingly driven, and if the second handle portion 503 is fixed, the first handle portion 501 may be slidingly driven.

In this case, in the present embodiment, the handle 50 may be formed with a hole 5031 cut along the circumference of the outer peripheral surface of the rear end of the second handle portion 503 to which the thumb is pressed. The handle 50 is generally configured to operate the first handle 501 or the second handle 503 by holding with one hand for precise manipulation. The thumb retreating the second handle portion 503 is not made in the vertical direction exactly from the first handle portion 501 in the structure of the hand. This is because the thumb extends in an arc when moving away from the rest of the fingers. In this embodiment, the structure in which the hole 5031 is cut along the circumference of the outer circumferential surface at the rear end of the second handle part 503 can alleviate the lateral tension applied by the thumb. That is, by distributing the lateral tension in the axial direction with respect to the moving axis of the first handle part 501, the lateral in-output force applied by the thumb is buffered, and more precise operation is possible. In addition, the pain due to the pressure applied to the thumb can be reduced from the user's point of view.

The tube portion 80 defines an area of the tube starting at the tip of the injection port 30 and entering the body. The tube portion 80 is formed of a tube for receiving the electrode tip 10 and the tube 801 containing a conductor for conducting high frequency up to the tip 803 of the tube and a channel for delivering fluid transmitted from the inlet 30. The tip 803 may be configured.

A plurality of water inlets 8031 for discharging the fluid in the direction in which the tip 803 of the tube electrode tip 10 is exposed may be formed.

In the present embodiment, the water inlet 8031 formed at the tip 803 of the tube is of the incision function due to the bleeding of the carbonized cells and cells generated through friction with the electrode tip 10 at the time of incisional separation of the lesion tissue Liquid can be sprayed to prevent degradation and to ensure visibility. Through this, it is possible to induce a smooth incision of the high-frequency knife 1, it is possible to improve the ease of peeling.

The electrode tip 10 may be provided at the tip 803 of the tube inserted into the body of both ends of the tube portion 80 and energized when power is applied to ablate lesion tissue in the body. The electrode tip 10 may be in direct contact with the periphery of the lesion tissue to generate a marking for marking the incision region on the tissue, or may perform an incision and peeling operation for cutting the tissue. The electrode tip 10 according to the present exemplary embodiment may require a structure so that the tissue is not condensed when the tissue is incision, and even a hard or layered lesion tissue can be smoothly cut. The structure of the electrode tip 10 for cutting in the manner described above is limited in the state having a single electrode. In this embodiment, the structure of the tip is designed so that the cutting and the peeling operation can be performed smoothly by starting the electrode installed in multiple stages. Descriptions related to electrodes provided in multiple stages will be described in detail with reference to the following drawings.

3 is an enlarged view of an electrode tip 10 A type according to an embodiment of the present invention. FIG. 3A is a perspective view of an electrode tip 10 A type, and FIG. 3B is a cross-sectional view of the electrode tip 10 A type. 4 is an enlarged view of the electrode tip 10 B type according to another embodiment of the present invention. 4 (a) is a perspective view of the electrode tip 10 B type, (b) is a cross-sectional view of the electrode tip 10 B type. 3 and 4, it can be seen that the electrode tip 10 is a structure formed by extending outward from the tip 803 of the tube. The electrode tip 10 includes a component part of the first electrode 103 and the second electrode 105 formed in multiple stages on the electrode rod 101 and the electrode rod 101 without distinction of the type. Details related to the A type and the B type of the electrode tip 10 shown in FIGS. 3 and 4 will be described in detail in the following <Example 1> and <Example 2>.

The electrode rod 101 is exposed from the tip 803 of the tube and may be made of a conductor. In the present specification, the electrode rod 101 defines a column portion extending in the longitudinal direction of the knife 1 in the structure of the electrode tip 10.

Electrode tip 10 is formed in a multi-stage electrode 103, 105 to have a predetermined radius on the column-shaped electrode rod 101, in the present specification, in the structure of the electrode tip 10, on the electrode rod 101 The area | region of the knife which forms the double-electrode structure in was divided into the 1st electrode 103 and the 2nd electrode 105, and was defined.

The electrode rod 101 may cut the lesion tissue or the surrounding area when the high frequency is applied to have energy. The electrode rod 101 may be made of a conductor to cut the lesion or surrounding tissue even in the lateral movement of the high frequency knife 1.

The electrode rod 101 has a conductive region partitioned by a second electrode 105 to be described later, and lesion tissue is hooked to the conductive region between the partitioned first electrode 103 and the second electrode 105. The amount can be dispersed.

In the present embodiment, the conductive region formed between the first electrode 103 and the second electrode 105 may have an uneven surface of the mucous membrane where the lesion is formed, or the high frequency knife 1 may invade the deformed tissue whose strength is increased. When the cutting and peeling process is performed, the lesion tissue cut at the tip of the electrode tip 1 may be agglomerated to prevent a burn. In particular, the high-frequency knife 1 provided with the conductive region formed between the first electrode 103 and the second electrode 105 is not limited to the position where the tissue cut off during hooking is dispersed in the knife tissue so that the lesion tissue is cut. The incision process can be easily performed without slipping.

The electrode rod 101 has the second electrode 105 such that the separation distance between the second electrode 105 and the tip 803 of the tube is greater than the separation distance between the first electrode 103 and the second electrode 105. The first electrode 103 may be spaced apart in parallel. In particular, when the electrode rod 101 penetrates into the submucosal layer of a thin wall of the esophagus, the large intestine, etc., the tip 803 of the second electrode 105 and the tube for easily hooking the mucosal layer of the tissue. The separation distance between them can be increased. Accordingly, the aforementioned separation distance between the second electrode 105 and the tip 803 of the tube is greater than the separation distance between the first electrode 103 and the second electrode 105 at the height of the limited electrode rod 101. Can be formed.

In this embodiment, the length of the spaced apart electrode rod 101 between the first electrode 103 and the second electrode 105 may be 0.3mm to 0.5mm. More preferably, the length of the spaced apart electrode rod 101 between the first electrode 103 and the second electrode 105 may be 0.4 mm. In the organs of the stomach and the colon, the average thickness of the submucosal layer is about 2.0 mm to 2.8 mm, and when the submucosal layer is peeled off, when the blood vessels and fibrosis are observed, the mucosal layer is formed through instantaneous contact with the electrode rod 101 which transmits a high frequency current. Can cause tissue damage. Therefore, when the separation distance between the first electrode 103 and the second electrode 105 is formed to be 0.3mm to 0.5mm, it is possible to minimize the burn or damage of the tissue.

On the other hand, the separation distance between the second electrode 105 and the tip 803 of the tube may be designed in the range of 0.8mm to 1.0mm to have a range larger than the above-described separation distance. More preferably, the separation distance between the second electrode 105 and the tip 803 of the tube may be 0.9 mm.

The electrode rod 101 may be exposed to a length of 1.0 mm to 4.0 mm from the tip 803 of the tube. More preferably, the electrode rod 101 may be designed to have a height of 2 mm from the tip 803 of the tube.

In the present specification, an upper surface means an upper surface of an electrode, and a lower surface of an electrode means a lower surface that is a cross-section toward the tube 801.

The first electrode 103 may have a radius larger than that of the electrode rod 101 at the distal end of the electrode rod 101 and may be provided in a domed shape with an upper surface raised.

In the present embodiment, the first electrode 103 is formed in the shape of the upper surface is raised, it is generated according to the pressure in contact with the contact angle when the electrode tip 10 around the lesion tissue or lesion through this The markings can be of different sizes. In addition, the first electrode 103 may be easily cauterized in a tissue in a contact direction other than the direction in which the first electrode 103 is vertically contacted with the mucosa due to the structure of the upper surface raised in the dome shape.

Meanwhile, the upper surface of the first electrode 103 raised in the dome shape may be induced to be peeled in a curved shape along the upper surface without condensation of the lesion tissue in the process of peeling the submucosal layer of the lesion tissue.

A first insulator 1031 made of a ceramic material having a predetermined thickness may be coated on the edge of the first electrode 103. The first insulator 1031 blocks the high frequency so that the unintended contact of the side regions of the first electrode 103 does not cut the peripheral region.

The first electrode 103 may be designed with a diameter of 0.7 mm to 1.0 mm and a height of 0.3 mm to 0.5 mm. More preferably, the first electrode 103 may be designed with a diameter of 0.8 mm and a height of 0.4 mm.

In the present specification, the height of the first electrode 103 defines the side wall of the column model and the region may be understood as the edge of the first electrode 103, so that the first insulator 1031 is coated on the region. Can be understood. On the other hand, when the diameter and height of the first electrode 103 is further increased, it is expected to shorten the time for cutting the tissue, but the area that the electrode and the tissue is in contact with the wider cutting amount increases the disadvantage Can cause. Accordingly, it may be noted that the range of diameter and height of the first electrode 103 of the high-frequency knife 1 according to the embodiment of the present invention may be limited because the risk of tissue puncture may be increased.

The second electrode 105 may be spaced apart from the first electrode 103 in parallel with the electrode rod 101 at a predetermined distance.

In the present embodiment, the first electrode 103 and the second electrode 105 may maintain a predetermined interval so as not to be in contact with each other. The second electrode 105 is positioned on the electrode rod 101 provided between the first electrode 103 positioned at the one end of the electrode tip 10 and the tip 803 of the tube, so that the region of the electrode rod 101 is positioned. Can be fractionated. Lower surfaces of the first electrode 103 and the second electrode 105 may be formed in parallel with each other.

Like the first electrode 103, the second electrode 105 may be coated with a ceramic insulator on the side edge thereof. In this embodiment, the ceramic insulator coated on the edge of the second electrode 105 is referred to as a second insulator 1051. The second insulator 1051 blocks the high frequency so that unintended contact of the side regions of the second electrode 105 does not incise the peripheral region.

The second electrode 105 may have the same diameter as that of the first electrode 103 and may be installed at a height lower than that of the first electrode 103. In this embodiment, the second electrode 105 may be designed to a height of 0.2mm to 0.4mm. More preferably, the second electrode 105 may be designed to a height of 0.3 mm. The diameter of the second electrode 105 may be designed to be the same as the diameter of the first electrode 103.

The electrode tip 10 according to the present exemplary embodiment may be divided into an A type embodiment and a B type embodiment according to the shape of the second electrode 105.

The second electrode 105 of the A type may be formed in a disk shape having a flat upper surface. In the present exemplary embodiment, unlike the first electrode 103, the second electrode 105 may be provided in a form in which the bending is not included in an upper surface of the second electrode 105. The second electrode 105 may have a flat upper surface and a lower surface, and may be provided in a cylindrical shape surrounding the electrode rod 101. A type electrode structure will be described in more detail in <Example 1> to be described later.

The second electrode 105 of the B type may be formed in a tapered shape having a diameter reduced in the direction of the upper surface. In this embodiment, the top surface of the second electrode 105 may be raised. The second electrode 105 may be formed in the shape of a taper 1053 in such a manner that an upper surface connected to the electrode rod 101 from the side on which the second insulator 1051 is coated is raised in the direction of the first electrode 103. have. The upper surface of the second electrode 105 may be symmetrical with respect to the central axis of the electrode rod 101. As the upper surface of the second electrode 105 has the shape of the taper 1053 as described above, only a portion of the first electrode 103 and the electrode rod 101 of the electrode tip 10 is invaded into the lesion tissue. When peeling is performed, the peeling of the lesion tissue may be prevented by peeling along the upper surface of the second electrode 105. The electrode structure of the B type will be described in more detail in <Example 2> to be described later.

5 is an enlarged exploded view of the injection hole 30 according to the embodiment of the present invention. Referring to FIG. 5, the injection hole 30 includes a first injection pipe 301, a second injection pipe 303, a rubber packing 305, a first sliding groove 307, and a second sliding groove 309. can do. The first injection tube 301 and the second injection tube 303 were divided into ordinal numbers as different liquid phases may be introduced. In addition, the first sliding groove 307 and the second sliding groove 309 were divided into ordinal numbers according to positions provided. On the other hand, the power supply connecting portion 70 capable of driving forward and backward at a position corresponding to the injection hole 30 may be provided.

The inlet 30 may deliver fluid to the tip 803 of the tube. The injection hole 30 may include a first injection pipe 301, a second injection pipe 303, a rubber packing 305, a first sliding groove 307, and a second sliding groove 309.

The first injection tube 301 may receive a saline solution for cleaning the lesion tissue and the surroundings.

In this embodiment, the first injection tube 301 may be injected with saline solution for the lesion area and the surrounding washing. The first injection pipe 301 may communicate with the first aqueduct 3013 penetrating the high-frequency knife 1 at the center to deliver a saline solution injected from the outside to the water inlet 8031 formed at the tip 803 of the tube. . The saline solution delivered to the water inlet 8031 may be cooled and washed while the upper surface of the first electrode 103 contacts the lesion tissue and is cauterized. The first injection pipe 301 may include a first stopper 3011 to prevent the backflow of the saline solution to be injected and to prevent the inflow of foreign substances from the outside. In particular, the first injection pipe 301 may be understood as a saline water injection pipe.

The first aqueduct 3013 defines a passage of fluid that communicates the first injection tube 301 and the tip 803 of the tube. The first aqueduct 3013 may receive the saline solution and transmit water to the tip 803 of the tube, and may discharge the saline solution through the water inlet 8031.

The second injection tube 303 may communicate with the needle 90 to receive the saline solution and the drug.

In the present embodiment, the second infusion tube 303 may be injected with saline and drugs. The second injection tube 303 communicates with the second water channel 3033 penetrating the high frequency knife 1 of the tube 801, and may transmit the saline solution and the drug injected from the outside to the needle 90. The saline solution and the drug delivered to the needle 90 are introduced from the needle 90 to the bottom of the lesion tissue and the tissue mucosa through the needle pit 901, through which the lesion tissue can prevent infection during invasion. In addition, the lesion tissue may be swollen in a form that is easily cut and exfoliated through the saline solution injected from the needle 90. The second injection tube 303 may include a second stopper 3031 to prevent the backflow of the drug to be injected and to prevent the inflow of foreign substances from the outside. In particular, the second infusion tube 303 may be understood as a saline and drug infusion tube in communication with the needle 90.

The second water channel 3033 defines a passage of the fluid communicating the second injection pipe 303 and the needle 90. The second aqueduct 3033 may receive the saline solution and the drug to be fed to the needle 90, and discharge the saline solution through the needle inlet 901 to swell the lesion and swell the lesion. In addition, the drug can be released to prevent infection of the lesion site.

 The inlet 30 may replace the treatment tool A including the electrode tip 10 or the needle 90 selectively exposed from the tip 803 of the tube through the retraction drive of the second inlet tube 303. have.

In the present embodiment, the injection hole 30 may be formed with a second sliding groove 309 so as to drive the second injection tube 303 forward and backward. The injection opening 30 may have a first sliding groove 307 formed at a position corresponding to the second sliding groove 309. The injection hole 30 may selectively expose the treatment tool A according to a user's needs due to the forward and backward driving of the second injection pipe 303.

Meanwhile, the second injection tube 303 may include a second spring 3035 and a second fixing rod 3037. The second injection tube 303 may expose the needle 90 connected to the second water channel 3033 to the outside of the front end 803 of the tube when driven forward. At this time, the second spring 3035 and the second fixing rod 3037 may be bound and fixed. On the other hand, the second injection pipe 303 may drive the needle 90 connected to the second aqueduct 3033 into the front end 803 of the tube when driven backward. At this time, the second spring 3035 and the second fixing rod 3037 may be coupled. To this end, the second fixing rod 3037 may be formed with a plurality of second spring grooves 30371. In addition, the second fixing rod 3037 and the fixing switch 40 may be detached due to the driving of the second injection tube 303. To this end, the second fixing rod 3037 may be formed with a second fixing rod groove. In the present embodiment, the second fixing rod groove means a groove formed in the second fixing rod 3037 to correspond to the position of the first fixing rod groove 30173 of the first fixing rod 3017.

The second spring 3035 may fix the needle 90.

In the present embodiment, the second spring 3035 is to be engaged with the second spring groove 30371 formed at a position close to the handle 50 of the plurality of second spring grooves 30371 formed in the second fixing rod 3037. Can be. The second spring 3035 may be formed with a convex portion in the direction of the second spring groove 30371. The convex portion of the second spring 3035 is not limited in shape or size, and may include all shapes and sizes that may be engaged with the second spring groove 30371 to minimize the flow of the second fixing rod 3037. Can be. However, the convex portion of the second spring 3035 according to the present embodiment may be provided in a “∩” form. The second spring 3035 is the second spring groove 30371 while the convex portion is compressed when the user operates the second injection pipe 303 in a state where the second spring 3035 and the second spring groove 30371 are bound. ) Can be released. In summary, the second spring 3035 may be engaged with the second spring groove 30371 when the second injection pipe 303 moves to one end or the other end of the second sliding groove 309, and thus the needle ( 90) can be fixed.

The second fixing rod 3037 may be connected to the needle 90, and a plurality of fixing grooves may be formed to bind with the second spring 3035.

In the present embodiment, a plurality of second spring grooves 30371 formed in the second fixing rod 3037 may be formed, and the second spring grooves 30371 formed at the foremost end of the tube have a needle 90. The second spring 3035 is bound when the tissue is swelled in the exposed state from the 803, the needle 90 is drawn into the tip 803 of the tube by the pressure generated between the tissue and the needle 90 Can be prevented. In addition, the second spring groove 30371 formed at the rearmost portion has the second spring 3035 engaged when the needle 90 is introduced into the tip 803 of the tube, so that the needle 90 and the tube portion 80 are formed. ) Internal friction can be prevented.

Similarly, the power connection 70 may communicate with the electrode tip 10 to control the drive forward and backward of the electrode tip 10 through the drive forward and backward.

In the present embodiment, the power supply connection unit 70 may be connected to the first water channel 3013 to transmit the retraction drive to the electrode tip 10. A first sliding groove 307 may be formed in the injection hole 30 to drive the power connection unit 70 forward and backward. The power connection unit 70 may selectively expose the treatment tool A according to the needs of the user due to the forward and backward driving. In particular, the power connector 70 may be connected to the first spring 3015 and the first fixing rod 3017. The power connection unit 70 may expose the electrode tip 90 connected to the first water channel 3013 to the outside of the front end 803 of the tube when driven forward. At this time, the first spring 3015 and the first fixing rod 3017 may be bound and fixed. On the other hand, the power connector 70 may lead the electrode tip 10 connected to the first aqueduct 3013 into the tip 803 of the tube when driven backward. At this time, the first spring 3015 and the first fixing rod 3017 may be bound and fixed. To this end, the first fixing rod 3017 may be formed with a plurality of first spring grooves 30171. In addition, the first fixing rod 3017 and the fixed switch 40 may be detached due to the drive of the power connector 70. To this end, the first fixing rod 3017 may be formed with a first fixing groove (30173).

The first spring 3015 may fix the electrode tip 10.

In the present embodiment, the first spring 3015 is to be engaged with the first spring groove 30171 formed at a position close to the handle 50 of the plurality of first spring grooves 30171 formed in the first fixing rod 3017. Can be. The first spring 3015 may have a convex portion in the direction of the first spring groove 30171. The convex portion of the first spring 3015 is not limited in shape or size, and may include all shapes and sizes that can be coupled with the first spring groove 30171 to minimize the flow of the first fixing rod 3017. Can be. However, the convex portion of the first spring 3015 according to the present embodiment may be provided in a “∩” form. When the user manipulates the power connection unit 70 in a state where the first spring 3015 and the first spring groove 30171 are engaged, the first spring 3015 is compressed with the first spring groove 30171 while the convex portion is compressed. Binding can be released. In summary, the first spring 3015 may be engaged with the first spring groove 30171 when the power connector 70 moves to one end or the other end of the first sliding groove 307, and thereby the electrode tip 10. ) Can be fixed.

The first fixing rod 3017 may be connected to the electrode tip 10, and a plurality of fixing grooves may be formed to bind with the first spring 3015.

In the present embodiment, a plurality of first spring grooves 30171 formed in the first fixing rod 3017 may be formed, and the first spring grooves 30171 formed at the foremost electrodes may have an electrode tip 10 of the tube. When cutting and detaching the tissue in the state exposed from the tip 803, the first spring 3015 is bound, so that the electrode tip 10 is the tip 803 of the tube by the pressure generated between the tissue and the electrode tip 10. It is possible to prevent the phenomenon of entering into the inside. In addition, the first spring groove 30171 formed at the rearmost portion is engaged with the first spring 3015 when the electrode tip 10 is introduced into the tip 803 of the tube, so that the electrode tip 10 and the tube portion are formed. (80) Internal friction can be prevented.

The rubber packing 305 may seal the tip of the injection hole 30 to block the fluid flowing back from the other end of the tube portion 80 toward the first injection tube 301.

In the present embodiment, the fluid introduced through the inlet 30 may be delivered to the tip 803 or the needle 90 of the tube through the first channel 3013 and the second channel 3033. The delivered fluid may be discharged through the water inlet 8031 or the needle water inlet 901, and the discharged fluid may ride on the outer walls of the first water channel 3013 and the second water channel 3033 in the direction of the injection port 30. Can backflow. In particular, when the fluid is introduced into the power supply connecting portion 70 via the injection port 30 may cause a defect of the high-frequency knife (1) is necessary to prevent the device. Rubber packing 305 may be provided essentially to perform this role. In particular, the rubber packing 305 may be in contact with the other end of the tube due to the nature of the elastic material to prevent the gap that can be reverse flow of the fluid.

The rubber packing 305 may be formed with an axial through-hole through which the first aqueduct 3013 and the second aqueduct 3033 penetrate to guide the advance paths of the aqueducts 3013 and 3033.

In the present embodiment, the rubber packing 305 may be formed with a through hole for coupling the first channel 3013 and the second channel 3033. The rubber packing 305 may be fixed to the other end of the tube to guide the path so that the rubber packing 305 may move through the through hole during the driving of the first water channel 3013 and the second water channel 3033.

6 is an enlarged view of the treatment instrument A according to the embodiment of the present invention. Referring to FIG. 6, the treatment instrument A may be selectively exposed for the electrode tip 10 and the needle 90 to act.

The needle 90 may invade under the mucosa of the lesion tissue to introduce a liquid for swelling the tissue.

In general, the needle 90 may perform a preparation process for injecting a solution by invading the submucosal layer of the lesion before incisional separation of the lesion tissue. The needle 90 according to the present embodiment may be provided with a needle water inlet 901 at one end thereof to receive liquid from the injection hole 30. In particular, the needle 90 may be in communication with the second water channel 3033 to inject drugs and saline.

The needle drain 901 may inject the delivered liquid into the submucosal layer to swell the lesion site and the electrode tip 10 so as to easily contact each other. The needle channel 901 may inject a saline solution to swell the tissue before incision and inject a drug to prevent infection of the cells.

7 is an enlarged exploded view of the fixed switch 40 according to the embodiment of the present invention. Referring to FIG. 7, the fixed switch 40 may include a first holder 401 and a second holder. The fixed switch 40 may fix the electrode tip 10 or the needle 90. In detail, the fixed switch 40 may selectively fix one of the electrode tip 10 and the needle 90 as it is moved to one end or the other end by external pressure.

In the present embodiment, when the high frequency knife 1 is set as shown in FIG. 7, the fixed switch 40 may be drawn in a direction entering the drawing by pressure. In this case, the fixing switch 40 may fix the electrode tip 10 by fixing the second fixing rod 3037. Similarly, the fixed switch 40 may be drawn out in the direction from the drawing under the pressure in the opposite direction. In this case, the fixing switch 40 may fix the needle 90 by fixing the first fixing rod 3017.

The first holder 401 may fix the electrode tip 10.

In this embodiment, the first fixing rod 401 may be coupled to the first fixing rod groove 30173 formed in the first fixing rod 3017, and thereby the electrode tip 10 connected to the first fixing rod 3017. This can be fixed. That is, the first holder 401 may fix the electrode tip 10 to the inside of the tip 803 of the tube without fixing the electrode tip 10 to the outside of the tip 803 of the tube.

In addition to the above-described driving, the user may implement the drive of the second water pipe 303, and the needle 90 may be exposed to the outside of the tip of the tube as the second water pipe 303 moves forward. When the second water pipe 303 is moved to the front of the second sliding groove 309, the needle 90 may be fixed by binding the second spring 3035 and the second fixing rod 3037.

The second holder may fix the needle 90.

In the present embodiment, the second fixing rod may be bound to the second fixing rod groove formed in the second fixing rod 3037, and thus the needle 90 connected to the second fixing rod 3037 may be fixed. That is, the second holder may fix the needle 90 inside the tip 803 of the tube without fixing the needle 90 outside the tip 803 of the tube.

In addition to the above-described driving, the user can implement the drive forward and backward of the power connector 70, the electrode tip 10 may be exposed to the outside of the front end of the tube as the power connector 70 moves forward. When the power connector 70 is moved to the front of the first sliding groove 307, the first spring 3015 and the first fixing rod 3017 may be coupled to fix the electrode tip 10. In the present embodiment, the second fixing rod is defined as a structure formed for fixing the second fixing rod 3037 at a position symmetrical with the first fixing rod 401.

Hereinafter, the embodiment which modified and applied the structure of the electrode tip 10 which comprises the high frequency knife 1 is explained in full detail.

Example 1 Electrode Tip 10 A type

Referring again to FIG. 3, the electrode tip 10 type A may be designed to extend from the tip 803 of the tube to a length of 1.8 mm to 2.2 mm. More preferably, the electrode tip 10 type A may be designed to extend to a length of 2.0 mm from the tip 803 of the tube. In the electrode tip 10 type A, the separation distance between the first electrode 103 and the second electrode 105 may be smaller than the separation distance between the second electrode 105 and the tip 803 of the tube. In detail, the separation distance between the first electrode 103 and the second electrode 105 may be 0.3 mm to 0.5 mm, and the separation distance between the second electrode 105 and the tip 803 of the tube may be 0.8 mm to It may be formed to 1.0mm. More preferably, the separation distance between the first electrode 103 and the second electrode 105 may be 0.4 mm, and the separation distance between the second electrode 105 and the tip 803 of the tube may be 0.9 mm. have.

In addition, the electrode tip 10 A type may be designed with a height of the first electrode 103 is 0.3mm to 0.5mm. More preferably, the type A of the electrode tip 10 may be designed such that the height of the first electrode 103 is 0.4 mm. In the electrode tip 10 type A, the height of the second electrode 105 may be designed to be 0.2 mm to 0.4 mm. More preferably, in the electrode tip 10 type A, the height of the second electrode 105 may be designed to be 0.3 mm. As such, the electrode tip 10 A type may be designed to have a height of the first electrode 103 higher than that of the second electrode 105.

In addition, the electrode tip 10 type A may be designed such that the first electrode 103 and the second electrode 105 have the same diameter. In detail, the electrode tip 10 type A may have a diameter of 0.7 mm to 1.2 mm between the first electrode 103 and the second electrode 105. More preferably, the electrode tip 10 type A may be designed such that the diameter of the first electrode 103 and the second electrode 105 is 0.8 mm.

In the electrode tip 10 type A, side surfaces of the first electrode 103 and the second electrode 105 may be coated with the first insulator 1031 and the second insulator 1051.

In particular, the electrode tip 10 type A may be formed in a dome shape in which the upper surface of the first electrode 103 is raised, and the upper surface of the second electrode 105 may be provided in a flat shape without being raised. In addition, the second electrode 105 may have a side surface coated with the second insulator 1051 and the upper surface and the lower surface may be provided in a flat shape without being raised so that the electrode region may not be exposed to the side surface.

Example 2 Electrode Tip 10 B Type

Referring again to FIG. 4, the electrode tip 10 B type may be designed to extend from 1.8 mm to 2.2 mm in length from the tip 803 of the tube. The electrode tip 10 type B may be designed to extend 2.0 mm from the tip 803 of the tube. In the electrode tip 10 type B, the separation distance between the first electrode 103 and the second electrode 105 may be smaller than the separation distance between the second electrode 105 and the tip 803 of the tube. In detail, the separation distance between the first electrode 103 and the second electrode 105 may be 0.4 mm to 0.6 mm, and the separation distance between the second electrode 105 and the tip 803 of the tube may be 0.7 mm or more. 0.9 mm may be formed. More preferably, the separation distance between the first electrode 103 and the second electrode 105 may be 0.5 mm, and the separation distance between the second electrode 105 and the tip 803 of the tube may be 0.8 mm. have.

In addition, the electrode tip 10 B type may be designed such that the height of the first electrode 103 is 0.3 mm to 0.5 mm. More preferably, the type B of the electrode tip 10 may be designed such that the height of the first electrode 103 is 0.4 mm. In addition, in the electrode tip 10 A type, the height of the second electrode 105 may be designed to be 0.2 mm to 0.4 mm. More preferably, the type A of the electrode tip 10 may be designed to have a height of 0.3 mm for the second electrode 105. As described above, for the type B of the electrode tip 10, the height of the first electrode 103 may be greater than that of the second electrode 105. It can be designed higher than the height of 105.

 The electrode tip 10 type B may be designed such that the first electrode 103 and the second electrode 105 have the same diameter. In detail, the electrode tip 10 B type may have a diameter of 0.7 mm to 1.2 mm between the first electrode 103 and the second electrode 105. More preferably, the electrode tip 10 type B may have a diameter of 0.8 mm between the first electrode 103 and the second electrode 105.

In particular, the electrode tip 10 B type is formed in the shape of a dome in which the upper surface of the first electrode 103 is raised, and the upper surface of the second electrode 105 is symmetrically formed with respect to the electrode rod 101 as a central axis. The taper 1053 may be formed by being raised toward the first electrode 103. Therefore, the B type has a difference that the electrode region of the second electrode 105 may be exposed to the side, unlike the A type.

6 and 7, the electrode tip 10 to which high frequency is applied and the needle 90 for injecting saline for swelling of the lesion tissue are alternately exposed at the same position of the high frequency knife tip. Disclosed is a knife having a structure in which a fixed switch 40 is formed in one region of the handle 50.

The high frequency knife according to the embodiment of FIGS. 6 and 7 requires the user to push / pull the fixed switch 40 in order to alternately discharge the needle 90 and the electrode tip 10. 8 to 11 below, an embodiment of the high-frequency knife capable of alternately exposing the needle 90 and the electrode tip 10 only by the manipulation of the handle 50 without the additional manipulation requiring the user to use a separate switch. Explain.

8 shows a handle 50 of a high frequency knife in accordance with another embodiment of the present invention. The embodiment of FIG. 8 configures the gear portion 57 in the handle 50 so that the needle 90 and the electrode tip 10 can be alternately exposed by the drawing-in and drawing-out operation of the second handle portion 503. .

More specifically, in the embodiment of Figure 8, the high-frequency knife is provided at the tip of the tube 801 is inserted into the body of the both ends of the tube portion 80 and the electrode tip is energized when applying the high frequency to ablate the lesion tissue in the body 10; Needle 90 for invading under the mucosa of lesion tissue to introduce liquid for swelling tissue; And a handle 50 for manipulating the electrode tip 10 and the needle 90.

In this embodiment, the handle 50 is connected to the electrode tip 10, the first handle portion 501 for advancing and retracting the electrode tip 10, and the agent 90 is connected to the needle 90 to advance and retreat the needle 90 The second handle part 503 and the gear part 57 which transmits a force to the 2nd handle part 503 in the direction opposite to the direction of the force applied to the 1st handle part 501 may be included. According to the present exemplary embodiment, the electrode tip 10 or the needle 90 may be alternately exposed by only the manipulation of the handle 50 by the gear part 57.

The handle 50 may be coupled to the outer circumferential surface of the body of the second handle 503 such that the first handle 501 is slidably movable. In this embodiment, as shown in Figure 8, the second handle portion 503 may be formed integrally on the high-frequency knife body. The first handle part 501 may be fitted to the outside of the cylindrical body of the second handle part 503 and may be slidably moved forward and backward of the body of the second handle part 503. In this embodiment, the second handle portion 503 to which the user inserts the thumb is fixed integrally with the knife body, and the first handle portion 501 to which the user inserts the index finger and the ring finger is relatively moved. Done.

Here, the first handle portion 501 may include a holder 5011 protruding in the direction of the second handle portion 503 on the inner side. The first handle 501 may be provided with a first rack gear 571 to be described later on one surface of the inner side and a holder 5011 on the other surface of the inner side. The holder 5011 may be understood as a stopper with a spring and the elastic force of the spring is directed toward the body of the second handle portion 503.

The second handle portion 503 may be formed with one or more cut holes 5031 for fixing the holder 5011 in the longitudinal direction on the outer peripheral surface of the body. When the first handle 501 is slid, the holder 5011 may be fixed to a region in which the cut hole 5031 is formed. The high frequency knife according to the present embodiment discharges the electrode tip 10 or the needle 90 alternately, and the handle fixing by the holder 5011 is for fixing the discharged electrode tip 10 or the needle 90. .

The gear unit 57 may include a first rack gear 571, a second rack gear 573, and a pinion gear 575.

The first rack gear 571 is fixedly coupled to the first handle portion 501. The first rack gear 571 may be formed in the body length direction of the first handle part 501.

The second rack gear 573 may be provided in the second handle part 503. The second handle part 503 is formed with a 'b' shaped cavity inside the body, the second rack gear 573 and the pinion gear 575 may be provided in the cavity. That is, the second rack gear 573 may be located inside the second handle 557 and may be coupled to the sliding space in the longitudinal direction of the second handle 557 in the cavity space.

The pinion gear 575 is fixedly coupled on the cavity of the second handle portion 503 and is toothed between the first rack gear 571 and the second rack gear 573. In the present embodiment, when the first handle 501 is moved in the longitudinal direction of the knife with respect to the fixed second handle 503, the first handle 501 of the first handle 501 by the first rack gear 571 The pinion gear 573 rotates in the movement direction, and the rotational force of the pinion gear 573 moves the second rack gear 573 in the direction opposite to the first rack gear 571.

9 is a view illustrating an operation of the high frequency knife according to the embodiment of FIG. 8. Referring to FIG. 9, the first rack gear 571 and the second rack gear 573 may be complementarily moved by the movement of the first handle part 501. In this case, the first handle part 501 is connected to the electrode tip 10 through the electrode tip connection line 801a, and the second handle part 503 is connected to the needle 90 through the needle connection line 801b. Pay attention. As a result, when the first rack gear 571 and the second rack gear 573 are complementarily driven, the needle 90 retreats when the electrode tip 10 moves forward, and when the needle 90 moves forward, the electrode Tip 10 is retracted. Accordingly, it can be understood that the electrode tip 10 or the needle 90 can be selectively exposed to the tip end of the high-frequency knife only by the manipulation of the first handle part 501 of the user.

10 shows a handle 50 of a high frequency knife in accordance with another embodiment of the present invention. FIG. 10 is a high frequency knife configured to alternately expose the electrode tip 10 or the needle 90 only by the operation of the handle 50 as in the embodiment of FIG. 8. FIG. 10 is a different embodiment from FIG. 8 and uses the configuration of the wire portion 59 instead of the gear portion 57 on the handle 50.

Referring to Figure 10, the high-frequency knife is provided at the tip of the tube 801 is inserted into the body of the both ends of the tube portion 80, the electrode tip (10) is energized when the application of the high frequency to excise the lesion tissue in the body; Needle 90 for invading under the mucosa of lesion tissue to introduce liquid for swelling tissue; And a handle 50 for manipulating the electrode tip 10 and the needle 90, and the handle 50 is connected to the electrode tip 10 so as to advance and retract the electrode tip 10. And a second handle portion 503 connected to the needle 90 to advance and retract the needle 90, and to the second handle portion 503 in a direction opposite to the direction of the force applied to the first handle portion 501. Including a wire portion 59 for transmitting a force, it is possible to alternately expose the electrode tip 10 or the needle 90 only by the operation of the handle 50.

The wire portion 59 may include a rigid wire 593 inserted into the wire tube 591.

In the present embodiment, the second handle portion 503 may be formed with a 'shaped wire tube 591 curved in the rear end direction of the knife. Referring to FIG. 10, the second handle part 503 is integrally formed with the high frequency knife body. As shown in the internal sectional view of the second handle portion 503, the wire tube 591 has two rows of pipes running parallel to each other along the longitudinal direction of the knife body and bent in the rear end direction of the knife. Has a tilted 'shape.

An electrode tip connecting line 801a is inserted into one side of the wire tube 591, and a needle connecting line 801b is penetrated into the other side thereof. In this case, the rigid wire 593 is connected to the rear end of the electrode tip connecting line 801a and the rear end of the needle connecting line 801b, respectively, and is inserted into the wire tube 591.

11 is a view illustrating an operation of the high frequency knife according to the embodiment of FIG. 10.

Both ends of the rigid wire 593 are fixedly coupled to the electrode tip connecting line 801a and the needle connecting line 801b, respectively. Therefore, when the first handle part 501 is advanced in the tip direction of the knife, the electrode tip connection line 801a connected to the first handle part 501 is advanced, and a rigid wire fixedly connected to the rear end of the electrode tip connection line 801a is formed. 593 is dragged toward the tip of the knife. In this case, it is noted that the rigid wire 593 is 'bending through the' shaped wire tube 591 so that the other end is fixedly coupled to the needle connecting line 801b. Therefore, when one end of the rigid wire 593 advances along the electrode tip connecting line 801a, the other end of the rigid wire 593 retreats to pull the needle connecting line 801b toward the rear end of the knife. In the above principle, the user may selectively expose the electrode tip 10 or the needle 90 even by operating only the first handle 501.

Although the present invention has been described in detail through the representative embodiments above, it will be understood by those skilled in the art that various modifications can be made without departing from the scope of the present invention with respect to the above-described embodiments. will be. Therefore, the scope of the present invention should not be limited to the embodiments described, but should be defined by all changes or modifications derived from the claims and the equivalent concepts as well as the following claims.

[Description of the code]

1: high frequency knife 10: electrode tip

101: electrode rod 103: first electrode

1031: first insulator 105: second electrode

1051: second insulator 1053: taper

30: injection hole 301: first injection tube

3011: first plug 3013: first aqueduct

3015: first spring 3017: first fixing rod

30171: First spring groove 30173: Ash 1 fixing groove

303: second injection tube 3031: second plug

3033: second aqueduct 3035: second spring

3037: second fixing bar 3071: second spring groove

305: rubber packing 307: first sliding groove

309: second sliding groove 40: fixed switch

401: first fixing table 50: handle

501: first handle 5011: holder

503: second handle portion 5031: cut hole

70: power connection portion 80: tube portion

801: tube 801a: electrode tip connecting line

801b: needle connecting line 803: end of the tube

8031: Sewage 90: Needle

901: Needle Aqueduct A: Treatment Tool

57: gear portion 571: first rack gear

573: second rack gear 575: pinion gear

59: wire part 591: wire tube

593: rigid wire

The high frequency knife according to the present invention has a double blade structure in which a plurality of electrodes are formed in multiple stages at an electrode tip to which high frequency is applied. In addition, according to the present invention is provided with a structure in which the electrode to which the high frequency is applied and the needle for injecting the drug or saline are alternately exposed at the same position of the high frequency knife tip. Accordingly, the medical workers can smoothly hook and incision of the tissue during the operation of the submucosal dissection detachment, can perform marking, incision, exfoliation, water transfer, etc. as a single treatment instrument can be usefully used high frequency knife according to the present invention have.

Claims (25)

In the radiofrequency knife for endoscopic submucosal dissection, An electrode tip provided at the tip of the tube inserted into the body of both ends of the tube portion and energized upon application of high frequency to ablate lesion tissue in the body, The electrode tip is, An electrode rod exposed from the tip of the tube and made of a conductor; A first electrode having a radius larger than that of the electrode rod at the tip of the electrode rod and having an upper surface raised in a dome shape; And A second electrode formed on the electrode rod spaced in parallel with the first electrode at a predetermined distance; A high frequency knife, characterized in that a plurality of electrodes formed in the electrode rod (rod) in multiple stages. The method of claim 1, The electrode rod (rod), A conductive region is partitioned by the second electrode, A high-frequency knife, characterized in that the amount of hooking lesion tissue is dispersed in the conductive region between the partitioned first electrode and the second electrode. The method of claim 1, The electrode rod (rod), The high frequency electrode is characterized in that the second electrode is spaced apart in parallel with the first electrode so that the separation distance between the second electrode and the front end of the tube is greater than the separation distance between the first electrode and the second electrode. knife. The method of claim 1, The electrode rod (rod), High frequency knife, characterized in that exposed from the tip of the tube in a length of 1.0mm to 4.0mm. The method of claim 1, The first electrode, A high frequency knife, characterized in that the ceramic insulator is coated on the side edge of the upper surface. The method of claim 1, The first electrode, High frequency knife, characterized in that designed with a diameter of 0.7mm to 1.2mm and a height of 0.3mm to 0.5mm. The method of claim 1, The second electrode, High frequency knife characterized in that the ceramic insulator is coated on the side edge. The method of claim 1, The second electrode, A high-frequency knife having a diameter equal to the diameter of the first electrode and designed to be lower than the first electrode. The method of claim 1, The second electrode, A high frequency knife, wherein the upper surface is formed into a flat disk shape. The method of claim 1, The second electrode, A high frequency knife, characterized in that formed in a tapered shape in which the diameter is reduced in the direction of the upper surface. The method of claim 1, And a needle for infiltrating the mucosa of the lesion tissue to introduce a liquid for swelling the tissue. The method of claim 11, Further comprising an inlet for delivering a fluid to the tip of the tube, The inlet is, A first injection tube communicating with the tip of the tube and receiving saline for washing the lesion tissue and the surrounding area; And And a second injection tube communicating with the needle to receive the saline solution and the drug. The method of claim 12, The inlet is, And a treatment instrument including the electrode tip or the needle, which is selectively exposed from the tip of the tube, through a forward and backward drive of the second infusion tube. The method of claim 12, The inlet, The high frequency knife further comprises a rubber packing for sealing the front end of the injection hole to block the fluid flowing back toward the first injection tube from the other end of the tube portion. The method of claim 14, The rubber packing, A high-frequency knife, characterized in that the through-hole in the axial direction through which the aqueduct of the first injection pipe and the second injection pipe is introduced to guide the advancing path of the aqueduct. The method of claim 11, Further comprising a power connection for supplying power, The power connection unit, High frequency knife in communication with the electrode tip, it is possible to control the drive forward and backward of the electrode tip through the drive forward and backward. The method of claim 12, The inlet, A first spring for fixing the electrode tip; And And a second spring for securing the needle. The method of claim 17, The inlet, A first fixing rod connected to the electrode tip and having a plurality of fixing grooves formed therein for binding with the first spring; And And a second fixing bar connected to the needle and having a plurality of fixing grooves formed thereon, the second fixing rod being coupled to the second spring. The method of claim 11, A fixing switch for fixing the electrode tip or the needle, The fixed switch, A first holder for fixing the electrode tip; And A second fixture for fixing the needle, A high-frequency knife, characterized in that for selectively fixing one of the electrode tip and the needle as it is moved to one end or the other end by external pressure. The method of claim 1, The tip of the tube, High frequency knife characterized in that a plurality of water outlets for discharging the fluid in the direction in which the electrode tip is exposed. In the radiofrequency knife for endoscopic submucosal dissection, An electrode tip provided at the front end of the tube inserted into the body of both ends of the tube part and energized upon application of high frequency to ablate lesion tissue in the body; Needles that invade submucosa of lesion tissue to introduce liquid for swelling tissue; And A handle for manipulating the electrode tip and the needle, The handle is, A first handle part connected to the electrode tip to advance and retreat the electrode tip, a second handle part connected to the needle to advance and retreat the needle, and the first handle part to be opposite to the direction of the force applied to the first handle part; Including the gear part which transmits a force to 2 handle parts, The high frequency knife, characterized in that the electrode tip or the needle can be exposed alternately only by the operation of the handle. The method of claim 21, The gear unit, A first rack gear fixedly coupled to the first handle part; A second rack gear provided to allow sliding movement inside the second handle part; And And a pinion gear toothedly coupled between the first rack gear and the second rack gear. The method of claim 21, The handle is, The first handle portion is coupled to the outer peripheral surface of the body of the second handle portion to enable the sliding movement, The first handle portion, The inner surface is provided with a holder protruding in the direction of the second handle portion, The second handle portion is a high-frequency knife, characterized in that formed on the outer circumferential surface of the body at least one cut hole for binding the holder in the longitudinal direction. In the radiofrequency knife for endoscopic submucosal dissection, An electrode tip provided at the front end of the tube inserted into the body of both ends of the tube part and energized upon application of high frequency to ablate lesion tissue in the body; Needles that invade submucosa of lesion tissue to introduce liquid for swelling tissue; And A handle for manipulating the electrode tip and the needle, The handle is, A first handle part connected to the electrode tip to advance and retreat the electrode tip, a second handle part connected to the needle to advance and retreat the needle, and the first handle part to be opposite to the direction of the force applied to the first handle part; Including the wire part which transmits a force to 2 handle parts, The high frequency knife, characterized in that the electrode tip or the needle can be exposed alternately only by the operation of the handle. The method of claim 24, The second handle portion, A 'shaped wire tube is formed which curves in the direction of the rear end of the knife, The wire part, And a rigid wire inserted into the wire tube and connected to a rear end of an electrode tip connection line to which the electrode tip is connected and to a rear end of a needle connection line to which the needle is connected.

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