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WO2018216134A1 - Système de marquage - Google Patents

Système de marquage Download PDF

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Publication number
WO2018216134A1
WO2018216134A1 PCT/JP2017/019353 JP2017019353W WO2018216134A1 WO 2018216134 A1 WO2018216134 A1 WO 2018216134A1 JP 2017019353 W JP2017019353 W JP 2017019353W WO 2018216134 A1 WO2018216134 A1 WO 2018216134A1
Authority
WO
WIPO (PCT)
Prior art keywords
marking
magnet
contact
marking system
contact portion
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/JP2017/019353
Other languages
English (en)
Japanese (ja)
Inventor
高橋　慎治
孝侑 畠中
拓也 奥村
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Olympus Corp
Original Assignee
Olympus Corp
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Olympus Corp filed Critical Olympus Corp
Priority to PCT/JP2017/019353 priority Critical patent/WO2018216134A1/fr
Publication of WO2018216134A1 publication Critical patent/WO2018216134A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
    • A61B1/012—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor
    • A61B1/018—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor characterised by internal passages or accessories therefor for receiving instruments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges

Definitions

  • the present invention relates to a marking system for marking a predetermined position of a body tissue.
  • EMR endoscopic mucosal resection
  • ESD endoscopic submucosal dissection
  • the above-mentioned method of pricking with the inking or endoscopic forceps cannot accurately indicate the position on the mucosa side to the abdominal side.
  • the range of ink that can be dyed is increased.
  • the indicated range varies depending on the operator's sense.
  • the indicated range may vary between when the specific position is protruded and after the protrusion is released. There is a problem.
  • the present invention has been made in view of such a problem, and an object of the present invention is to provide a marking system capable of suitably performing marking on a specific position of a luminal organ.
  • the present invention provides a long portion having flexibility, a first device having a first contact portion provided at a distal end portion of the elongated portion, an elongated insertion portion, and a distal end portion of the insertion portion.
  • a second device having a second contact portion, and a marking portion provided on at least one of the first device and the second device and configured to be able to mark tissue, the first contact portion and the One of the second contact portions includes a magnet or an electromagnet, the other includes any one of a magnet, an electromagnet, and a ferromagnetic material, and at least one of the first contact portion and the second contact portion via a direction changing portion.
  • the marking system is connected to the long part or the insertion part, and is configured to change the orientation of the first contact part or the second contact part connected to the direction changing part.
  • the marking unit may be provided in the second device, or may be provided in both the first device and the second device.
  • the marking part may contain a marking material.
  • the marking part may have an electrode part.
  • the first contact portion and the second contact portion include a magnet or an electromagnet, and are configured such that the center position of the marking by the marking portion provided in the first device coincides with the center axis of the magnet or electromagnet.
  • the second device may be configured such that a center position of the marking by the marking portion provided in the second device coincides with a center axis of the magnet or the electromagnet.
  • the direction changing portion may be configured to be able to bend or bend in all directions away from the longitudinal axis, with the longitudinal portion or the insertion portion as a center.
  • the direction changing unit may include one or more joints having one or more degrees of freedom.
  • marking can be suitably performed on a specific position of a luminal organ.
  • FIG. 1 is a diagram schematically showing a marking system 1 of the present embodiment. As shown in FIG. 1, the marking system 1 includes a first device 10 and a second device 50.
  • the first device 10 is introduced into a luminal organ such as the digestive tract.
  • the first device 10 includes a flexible long portion 11, a first contact portion 20 provided at a distal end portion of the long portion 11, and a grip portion 30 provided at a proximal end portion of the long portion 11. And.
  • a resin tube (sheath) or the like can be used as the long portion 11, for example, a resin tube (sheath) or the like can be used.
  • FIG. 2 is an enlarged view showing the first contact portion 20.
  • the first contact portion 20 includes a columnar magnet (magnetic member) 21 and a first marking portion 22 provided on the tip surface of the magnet 21.
  • the magnetic axis (line connecting the S pole and the N pole) Mx1 of the magnet 21 coincides with the cylindrical central axis of the magnet 21 (hereinafter, the “magnetic axis Mx1” may be referred to as “central axis Mx1”). is there).
  • the first marking portion 22 is configured to contain a marking material such as a pigment or a dye that can adhere to the tissue.
  • a marking material having high biocompatibility is preferable. For example, carbon powder can be used.
  • the first marking portion 22 may be configured by directly applying a marking material to the tip surface of the magnet 21, or may be configured by arranging a sponge or the like on the tip surface of the magnet 21 to absorb the marking material. .
  • the first marking portion 22 may be configured by disposing a seal-like marking material that can be peeled off when it is no longer needed on the tip surface of the magnet 21.
  • the shape of the first marking portion 22 when viewed in the direction of the central axis Mx1 of the magnet 21 can be set as appropriate, but the center position of the shape coincides with the central axis Mx1.
  • the first marking portion 22 is provided on the entire tip surface of the columnar magnet 21.
  • the second device 50 is provided at a rigid and elongated insertion part 51 having no flexibility, a second contact part 60 provided at a distal end part of the insertion part 51, and a proximal end part of the insertion part 51. And a grip 70.
  • the insertion part 51 the thing similar to the well-known treatment tool etc. which are used for the various procedures performed under a laparoscope, for example can be used.
  • FIG. 3 is an enlarged view showing the second contact portion 60.
  • the second contact portion 60 includes a columnar magnet 61, a second marking portion 62 provided on the distal end surface of the magnet 61, and a wire (direction changing portion) that connects the proximal end portion of the magnet 61 and the insertion portion 51. 63.
  • the magnet 61 and the second marking portion 62 have the same configuration as the magnet 21 and the first marking portion 22 described above, respectively.
  • the magnetic axis Mx2 of the magnet 61 coincides with the cylindrical central axis of the magnet 61 (hereinafter, the “magnetic axis Mx2” may be referred to as “central axis Mx2”), and the direction of the central axis of the magnet 61
  • the magnetic pole on the tip side of the magnet 61 is different from the magnetic pole on the tip side of the magnet 21.
  • the magnet 61 is attached to the second device 20 so that the magnetic pole on the tip side is an N pole.
  • Both ends of the wire 63 are attached to the magnet 61 and the insertion portion 51 so as to coincide with the central axis Mx2 of the magnet 61 when the wire 63 is linear, and the insertion portion 51 and the magnet 61 are connected.
  • the wire 63 can be bent in all directions away from the longitudinal axis X1 of the insertion portion 51. By bending, the direction of the central axis Mx2 of the magnet 61 is separated from the longitudinal axis X1 with the longitudinal axis X1 as the center. It is configured to be changeable in all directions.
  • the wire 63 either a single wire or a stranded wire can be used. However, a stranded wire is more preferable because it is more flexible and more easily bent than a single wire having the same diameter.
  • the user makes a hole in the body wall such as the abdominal wall of the patient, inserts a trocar or the like through the hole, and places it in the body wall. Treatment such as insufflation is performed as necessary to establish an environment in which the laparoscope and the second device 50 can be inserted into the patient's body. Further, a flexible endoscope is inserted from the patient's mouth or the like, and the distal end portion of the endoscope is moved to the vicinity of the treatment target site.
  • the marking position is first determined in the stomach.
  • the user inserts the first device 10 into the treatment instrument channel of the endoscope by inserting the distal end side of the first device 10 into the opening provided in the operation unit of the endoscope.
  • the user advances the first device 10 in the treatment instrument channel and causes the first contact portion 20 to protrude from the treatment instrument channel opened at the distal end of the endoscope 100 as shown in FIG.
  • the first device 10 may be inserted through the treatment instrument channel before inserting the endoscope into the patient.
  • a user who operates the endoscope 100 and the first device 10 is referred to as a “first operator”.
  • the first operator confirms the treatment target portion Ls with the endoscope 100 and determines a position for marking. Thereafter, as shown in FIG. 5, the first operator adjusts the position of the endoscope 100 and then advances the first device 10 to contact the tissue Ts at the position where marking is performed. By this operation, the first marking portion 22 comes into contact with the tissue Ts, the marking material adheres to the tissue Ts, and marking is performed on the tissue surface inside the stomach. Even after the marking is performed, the first operator confirms that the marking has been applied to the user operating the second device 50 while maintaining the state in which the first marking portion 22 is in contact with the tissue Ts. Tell. In the following description, the user who operates the second device 50 is referred to as “second operator”.
  • the second operator inserts the second device 50 into a trocar or the like, and advances the second device 50 toward the stomach while observing the abdominal cavity with the laparoscope 150.
  • the laparoscope 150 may be operated by a person other than the second operator, such as a scopist.
  • the tip of the second device 50 enters the magnetic field of the magnet 21 provided in the first contact portion 20, the magnet 61 of the second contact portion 60 is attracted to the magnet 21 as shown in FIG. 6.
  • the wire 63 can be bent in all directions away from the longitudinal axis X ⁇ b> 1 of the insertion portion 51, so that the movement of the magnet 61 being attracted to the magnet 21 is not hindered.
  • the second contact portion 60 can change the direction based on the magnetic force generated between the magnet 61 and the magnet 21.
  • the second operator further advances the second device 50 while maintaining the state where the magnet 61 is attracted to the magnet 21. Then, as shown in FIG. 7, the magnet 61 opposes the stomach wall Gw so that the center axis Mx2 of the magnet 61 and the center axis Mx1 of the magnet 21 coincide with each other. As a result, the second marking portion 62 contacts the outer surface of the stomach, and marking is performed on the outer surface of the tissue Ts.
  • the 1st contact part 20 and the 2nd contact part 60 are pulled apart, and the same procedure is repeated. If necessary, the first device 10 and the second device 50 may be removed from the body, and the first marking part 22 and the second marking part 62 may be replenished with a marking material.
  • the marking system 1 of the present embodiment by combining with a hollow organ observation means such as a soft endoscope and a body cavity observation means such as a laparoscope, the wall of the hollow organ is sandwiched. At the same position, marking can be easily performed on the inside and outside of the hollow organ.
  • the center of the first marking portion 22 and the center axis of the magnet 21 coincide with each other, and in the second contact portion 60, the center of the second marking portion 62 and the center axis of the magnet 61 are aligned. Match. Accordingly, the pair of markings applied to the inside and outside of the luminal organ are formed so that the positions of the centers coincide. Therefore, a pair of markings can be performed in a state of being aligned with high accuracy.
  • the magnet 21 and the magnet 61 generate a magnetic force between the first contact portion 20 and the second contact portion 60, The second contact portion 60 is attracted to the first contact portion 20. Therefore, the second operator can easily recognize that the first contact portion 20 is located on the extension line in the direction in which the second contact portion 60 faces, even if it cannot be directly visually recognized. As a result, by simply operating the second device 50 so that the second contact portion 60 approaches the first contact portion 20, a pair of markings can be performed easily and with high accuracy, and complicated or skilled operations can be performed. unnecessary.
  • FIGS. 1 The difference between the marking system of the present embodiment and the marking system 1 of the first embodiment is the configuration of the tip portions of the first device and the second device.
  • the same components as those already described are denoted by the same reference numerals, and a common description is omitted.
  • FIG. 8 shows the marking system 201 of this embodiment.
  • the marking system 201 includes a first device 210 and a second device 250.
  • the first device 210 includes a long portion 11, a first contact portion 220 provided on the distal end side of the long portion 11, a grip portion 230 provided on the proximal end side of the long portion 11, and a long portion. 11 and a first marking portion 240 inserted through the grip portion 230.
  • FIG. 9 is an enlarged cross-sectional view of the distal end portion of the first device 210 and shows a state in which the first marking portion 240 is inserted.
  • the magnet 221 of the first contact portion 220 is formed in a cylindrical shape and has a through hole 221a extending in the axial direction.
  • the outer surface of the magnet 221 is entirely covered with an insulating material including the inner peripheral surface of the through hole 221a. Thereby, the insulating coating layer 222 is provided on the surface of the magnet 221.
  • the center axis of the through-hole 221a, the center axis of the cylindrical shape of the magnet 221 and the longitudinal axis of the long portion 11 in the linear shape coincide with each other, but this is essential in the present invention. Absent.
  • the grip portion 230 is formed in a cylindrical shape having an internal space, and the long portion 11 and the grip portion 230 are connected so that the internal space of the long portion 11 and the internal space of the grip portion 230 communicate with each other. Yes.
  • the first marking portion 240 includes a rod-shaped electrode portion 241 provided at the distal end portion, an operation portion 242 provided at the proximal end portion, and a wiring portion 243 provided between the electrode portion 241 and the operation portion 242. It has.
  • the electrode part 241 has a dimension capable of moving forward and backward in the through hole 221a, and the electrode part 241 can be protruded from the through hole 221a by moving the first marking part 240 inserted through the long part 11 forward. it can.
  • the operation unit 242 includes a plug 245 configured to be connectable to an external power source, and a switch 246.
  • the wiring part 243 extends into the operation part 242 and is electrically connected to the plug 245. Therefore, power can be supplied to the electrode 241 through the wiring portion 243 by connecting an external power source to the plug 245. The presence or absence of power supply can be switched by operating the switch 246.
  • the second device 250 includes an insertion portion 51, a second contact portion 260 provided at the distal end portion of the insertion portion 51, and a grip portion 270 provided at the proximal end portion of the insertion portion 51.
  • tip part of the 2nd device 250 is shown in a partial cross section.
  • the second contact portion 260 includes a magnet 261, an electrode portion (second marking portion) 263 inserted through the magnet 261, and a direction changing portion 265 that connects the magnet 261 and the insertion portion 51.
  • the magnet 261 is formed in a cylindrical shape like the magnet 221, and has a through hole 261 a and an insulating coating layer 262.
  • dimensions such as the outer diameter and the inner diameter of the through hole 261a are the same as or substantially the same as those of the magnet 221.
  • the electrode portion 263 is formed in a rod shape, and the base end portion is fixed to the direction changing portion 265 by welding or the like.
  • the direction changing part 265 includes a first ring 265 a to which the electrode part 263 is fixed and a second ring 265 b to be fixed to the insertion part 51. Both the first ring 265a and the second ring 265b are formed of a conductor such as metal. As shown in FIG. 10, the first ring 265 a is fixed to the base end surface of the magnet 261 with an adhesive 266 in a state where the electrode portion 263 is inserted into the through hole 261 a so as not to contact the magnet 261. The protruding length of the electrode part 263 at this time is preferably such that it does not penetrate the wall of the target luminal organ. A wiring (not shown) is connected to the second ring 265b, and the wiring extends through the insertion portion 51 to the grip portion 270.
  • the first ring 265a is connected so as not to be separated from the second ring 265b because a part of the first ring 265a is disposed so as to pass through the ring of the second ring 265a and has a closed ring shape.
  • the magnet 261 can change the direction of the central axis in almost all directions away from the axis X1 of the insertion portion 51.
  • the central axis of the magnet 261 and the position of the tip of the electrode part 263 coincide.
  • the grip portion 270 is configured to be connectable to an external power source, and includes a plug 271 electrically connected to the above-described wiring and a switch 272.
  • the functions of the plug 271 and the switch 272 are the same as those of the plug 245 and the switch 246, respectively. Therefore, when an external power source is connected to the plug 271 and the switch 272 is turned on, power can be supplied to the electrode portion 263 through the plug 271, the wiring, and the direction changing portion 265.
  • the first operator When marking the inside of the luminal organ using the marking system 201, the first operator inserts the first marking part 240 into the long part 11 from the grip part 230. When the first surgeon operates the switch 246 to supply electric power to the electrode unit 241 with the electrode unit 241 protruding from the through-hole 221a, the tissue of the luminal organ with which the electrode unit 241 contacts changes in quality. Marking is applied.
  • the operation of the second device 250 is substantially the same as that of the second device 50 of the first embodiment.
  • the second operator operates the switch 272 to supply power to the electrode unit 263.
  • the tissue of the luminal organ with which the electrode portion 263 comes into contact is degenerated and marked.
  • a pair of markings can be performed simply and with high accuracy, similarly to the marking system 1 of the first embodiment. Further, since the first marking portion and the second marking portion are configured to have electrodes, no marking material is required. Therefore, it is not necessary to replenish the marking material during the marking operation, and the operation can be simplified.
  • the magnets 221 and 261 are covered with the insulating coating layers 222 and 262, respectively, it is possible to prevent the current density from being reduced due to energization of the magnets and to perform the marking by the electrode portions 241 and 263. .
  • the mode of tissue alteration by the electrode is not particularly limited as long as it is discriminable from the surrounding tissue that is not marked.
  • marking may be performed by supplying a high-frequency current to the electrode and cauterizing the tissue, or marking may be performed by solidifying the tissue by increasing the temperature of the electrode by supplying power.
  • a stopper for limiting the protruding amount of the first marking portion 240 to a predetermined value or less may be provided. If it does in this way, it can control suitably that marking by the 1st marking part penetrates a hollow organ.
  • a wiring protruding from the insertion portion 51 may be directly connected to the electrode portion 263.
  • the material of the insulating coating layer is preferably a highly biocompatible material such as a fluorine-based resin or titanium oxide.
  • an insulating coating layer may be provided in a region excluding the tip of the electrode portion. In this embodiment, the insulating coating layer is not essential and may not be provided.
  • FIG. 11 shows a marking system 301 of this embodiment.
  • the marking system 201 includes a first device 310 and a second device 250.
  • the first device 310 includes the long part 11, the first contact part 320, and the grip part 30.
  • the first device 310 has the same configuration as the first device 10 of the first embodiment except that the first marking unit 22 is not provided.
  • the second device 250 is the same as in the second embodiment.
  • the marking system 301 is suitable for performing marking with a margin on the treatment target site on the abdominal cavity side.
  • the first surgeon forms a marking Mk around the treatment target site Ls located in the luminal organ using the high-frequency knife 110 protruding from the endoscope 100.
  • the first operator replaces the high-frequency knife 110 with the first device 310 and causes the magnet 21 to protrude from the endoscope 100. And as shown in FIG. 13, the magnet 21 is made to contact the structure
  • the second contact portion 260 of the second device 250 is attracted to the magnet 21, and FIG. As shown, the central axis of the first contact part 320 and the central axis of the second contact part 260 coincide.
  • the marking Mk2 is located outside the lumen organ at a position with a margin with respect to the marking Mk formed by the high-frequency knife 110. It is formed.
  • the second surgeon can perform the treatment by taking a sufficient distance from the treatment target site Ls by excising the tissue based on the marking Mk2 formed by the electrode part 263 that is the second marking part.
  • the position indicated by the first contact unit 320 from the inside of the luminal organ is simply and highly accurate outside the luminal organ. Can be marked.
  • the second surgeon can reliably perform the treatment using the marking Mk2 as an index even if the treatment target site Ls cannot be visually recognized directly.
  • the marking system 301 of the present embodiment can be suitably used when the marking position is different between the inside and the outside of the luminal organ.
  • the marking portion provided in the first device has a configuration that can not be marked even when it comes into contact with the tissue like the electrode portion 263, the first device includes the marking portion. Marking similar to the above-described marking Mk2 can be performed by not energizing when the contact portion is brought into contact with the luminal organ.
  • a direction change part is not restricted to what was mentioned above.
  • a known ball joint 306 shown in FIG. 17, a known ball chain 302 shown in FIG. 18, or a chain (not shown) in which three or more annular members are connected can be used as the direction changing portion.
  • These direction change parts are the examples comprised so that it could bend or bend
  • the direction changing unit may include one or more joints with one degree of freedom. If the direction changing portion has only one degree of freedom, the second marking portion may not be sufficiently changed in direction in relation to the generated magnetic force. By rotating around the axis, the positional relationship with the magnetic force can be adjusted, and the direction can be suitably changed. 19, FIG. 20, and FIG. 21 show an example of the direction changing unit having one degree of freedom, two degrees of freedom, and three degrees of freedom, respectively.
  • the direction changing part may be configured to include a joint structure with two degrees of freedom having two orthogonal rotation axes.
  • the magnet M1a and the magnet M2a may have different dimensions in the radial direction or in the direction perpendicular to the axis, as shown in FIG.
  • the first device since the first device is often introduced into the hollow organ via the channel of the endoscope, it is preferable to reduce the size of the magnet M1a.
  • the magnet M1c and the magnet M2c may be formed in a conical shape or a pyramid shape. In this case, since the tip side of the magnet becomes small, there is an advantage that it is easy to observe the contact state between the marking portion and the tissue.
  • the marking material is used while maintaining the advantage of easily observing the contact state between the marking portion and the tissue. Marking can also be suitably performed.
  • the magnet M1e and the magnet M2e may be formed in a frustum shape and a cylindrical shape.
  • the magnet M1f and the magnet M2f may be fitted to each other.
  • the shape fitted to each other there is an example in which one is spherical and the other is a dish-like shape having the same concave surface as the spherical surface, like a magnet M1g and a magnet M2g shown in FIG.
  • the two magnets can be prevented from shifting in the extending direction of the tissue after facing each other with the tissue interposed therebetween.
  • the magnet M1h and the magnet M2h may be spherical.
  • the shapes are in point contact with each other, the first contact portion and the second contact portion can be stabilized when the two magnets face each other across the tissue.
  • Spherical magnets are difficult to attach to the insertion part or the long part.
  • FIG. 29 when the magnet M1i and the magnet M2i are formed in a hemispherical shape, easy attachment to the insertion part and the long part and stable contact are achieved. Both can be achieved.
  • the two magnets can be attracted so that their center axes coincide with each other.
  • the dimension of the magnet M2j in the radial direction is smaller than that of the magnet M1j, it becomes difficult for the central axes to coincide with each other when they are pulled. Therefore, the dimension in the radial direction of the magnet M2j is preferably equal to or greater than the magnet M1j.
  • both a 1st contact part and a 2nd contact part are equipped with a magnet.
  • the accuracy of alignment may be slightly reduced, the same effect can be obtained if a magnetic force is generated between the first contact portion and the second contact portion.
  • Only one of them may have a magnet, and the other may be a ferromagnetic body that generates a magnetic force that attracts the tissue with the magnet interposed therebetween.
  • the magnet provided in a 1st contact part or a 2nd contact part may be an electromagnet instead of a permanent magnet. In this case, since the first contact portion and the second contact portion after marking can be easily separated by stopping the power supply, it is suitable for the case where marking is performed at a number of locations.
  • the structure provided with the needle tube 305 as shown in FIG. 31 as another structure of a marking part can also be used.
  • the tissue can be marked by connecting a supply unit (not shown) containing the marking material to the needle tube 305, inserting the needle tube 305 into the tissue, and injecting the marking material into the tissue.
  • the supply unit does not necessarily have to be located outside the body, and may be disposed inside the insertion unit or the long unit, for example.
  • the marking portion since the marking portion is not energized, the magnet 221 is not provided with an insulating coating layer.
  • the configuration of the marking portion does not need to be the same between the first device and the second device, and may be different.
  • the first device may include a direction changing unit.
  • a direction changing unit since the direction of the first contact portion can be changed to a direction different from the axis of the insertion portion protruding from the endoscope, it is effective when the internal space of the hollow organ is narrow. If the operation range of the direction change part is too wide, or if the force required for operation (operation force) is too small, it may not be easy to maintain the contact state between the first contact part and the tissue, It is preferable that the operating range and the operating force are appropriately adjusted. In the case where a target site that can be optically observed only from the outside of the luminal organ is excised from the inside of the luminal organ, only the first device may include the direction changing unit.
  • the insertion part of the second device is not necessarily rigid, and may be flexible like the long part. Such a configuration is effective when the location to be marked is in a position where it is difficult to access the hard insertion portion.
  • a flexible endoscope having the second device inserted through the treatment instrument channel is inserted into the abdominal cavity from a trocar or the like, and the second device may be introduced to a location to be marked while observing the abdominal cavity with the endoscope. .
  • the marking system of the present invention may be used with both the first device and the second device inserted into the body cavity.
  • the first device is introduced into the thoracic cavity
  • the second device is introduced into the abdominal cavity
  • marking is performed on both sides of the diaphragm.
  • the present invention can be suitably applied to marking procedures in the body.

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Abstract

L'invention concerne un système de marquage comprenant : un premier dispositif ayant une partie allongée flexible et une première partie contact disposée au niveau de l'extrémité avant de la partie allongée ; et un second dispositif ayant une partie insertion effilée et une seconde partie contact disposée au niveau de l'extrémité avant de la partie insertion ; et une partie marquage disposée sur le premier dispositif et/ou le second dispositif et configurée pour être capable de marquer un tissu. L'une de la première partie de contact et de la seconde partie de contact comprend un aimant ou un électroaimant, et l'autre comprend l'un quelconque d'un aimant, d'un électroaimant et d'un ferroaimant. La première partie contact et/ou la seconde partie contact sont reliées à la partie allongée ou à la partie insertion par l'intermédiaire d'une partie de changement de direction de telle sorte que l'orientation de la première partie contact ou de la seconde partie contact reliée à la partie changement de direction peut être modifiée.
PCT/JP2017/019353 2017-05-24 2017-05-24 Système de marquage Ceased WO2018216134A1 (fr)

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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN118512165A (zh) * 2024-05-28 2024-08-20 四川大学华西医院 用于肺结节切除术中的磁性套环与电极针头组合定位系统

Citations (3)

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JP2006263073A (ja) * 2005-03-23 2006-10-05 Olympus Medical Systems Corp 磁性体留置具の探知及び把持装置
JP2010036024A (ja) * 2008-07-31 2010-02-18 Olympus Medical Systems Corp 内視鏡用縫合器
WO2015056693A1 (fr) * 2013-10-15 2015-04-23 オリンパスメディカルシステムズ株式会社 Dispositif médical

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JP2006263073A (ja) * 2005-03-23 2006-10-05 Olympus Medical Systems Corp 磁性体留置具の探知及び把持装置
JP2010036024A (ja) * 2008-07-31 2010-02-18 Olympus Medical Systems Corp 内視鏡用縫合器
WO2015056693A1 (fr) * 2013-10-15 2015-04-23 オリンパスメディカルシステムズ株式会社 Dispositif médical

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN118512165A (zh) * 2024-05-28 2024-08-20 四川大学华西医院 用于肺结节切除术中的磁性套环与电极针头组合定位系统

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