Surgery – Instruments – Heat application
Reexamination Certificate
1997-11-25
2001-04-24
Dvorak, Linda C. M. (Department: 3739)
Surgery
Instruments
Heat application
C606S013000, C606S016000
Reexamination Certificate
active
06221069
ABSTRACT:
FIELD OF THE INVENTION
The present invention relates to an apparatus for medical treatment and in particular to an apparatus for medical treatment which is miniaturized to such a size that it can be used together with an endoscope and is capable of incising the living tissue with less bleeding.
BACKGROUND OF THE INVENTION
Recently, incision of the living tissue using laser light and the like has been commonly conducted since it is excellent in hemostasis. If the laser light is used, emission of the laser light from the front end of an optical fiber is concentionally conducted while the front end of the optical fiber is separated from a target tissue. However, by the reason of high damages to the apparatus components, irradiation of the living tissue with the laser light emitted from the surface of a probe has recently been conducted while the probe is in contact with the living tissue after the laser light has transmitted through the optical fiber to the emission probe and been incident upon the emission probe disposed in front of the front end of the optical fiber.
The present inventor has developed various contact type probes and they have been widely used. In order to incise the tissue by using such a contact type probe, it is necessary to cause the probe to track an incision line on the surface of the tissue on one side thereof a plurality of times. When a fine blood vessel is cut, bleeding is less since the blood vessel where it is irradiated with the laser light will be solidified. However, when a blood vessel having a diameter of 1.5 mm or more is to be cut, it is usually necessary to preliminarily knot the blood vessel on both sides of the cut position with a suture to prevent bleeding.
As far as one light guide probe is used in such a manner, it is necessary to knot a large blood vessel on the both sides of the cutting position every time when the blood vessel is cut. This will hinder the ready and easy operation. Although a suture which is biocompatible to the living tissue in recovery after operation has been developed, it is necessary to remove the suture from the tissue after opening the body again if the concrescence between the suture and the living tissue is not complete. This removing operation is hard on the patient.
If an organ which is easy to bleed such as liver is to be cut it is necessary to gradually cut the organ along the same incision line many times in order to minimize bleeding. It takes a long time to conduct the operation, and attention should be paid.
In case in which one of an organ has been already incised and the other has not been incised yet, even if irradiation with laser light is conducted plural times when some organ is to be cut or incised, the tissue behind the tissue to be treated is inevitably slightly irradiated with laser light by accident. On the other hand, in case of the projecting tumor, it has been known that the tumor is cut from the neck thereof with an annular radio frequency snare which is disposed around the tumor. This operation is not excellent in hemostasis. If physiological saline is used, an electric shock is given to the tissue and burn may occur in the vicinity of the diseased portion so that the tissue is unwatedly damaged.
From this point of view, in order to conduct at proper and quick surgical operation, cutting and incision of the tissue should be conducted one time operation, the hemostasis should be high and only target tissue should be able to be cut or incised and incision is possible without knotting if the target tissue is a blood vessel.
Therefore, the present inventor has proposed an apparatus for treatment which has overcome these problems in Japanese Unexamined patent publication No. Hei 3-218742. The apparatus for treatment using the laser light irradiation has two light guide probes which faces each other. The laser light emitting portions of the two light guide probes can be in and out of contact with each other by the surgical operators actuation. The laser light is incident to respective light guide probes via respective laser light transmitting systems. A target tissue to be treated is disposed between the laser light emitting portions of the light guide probes.
However, since the two light guide probes are linked to each other at their base ends so that they are substantially V-shaped and the target tissue is to be tweezed with a tweezers in prior art, the width of the apparatus per se and the range of actuation of the apparatus can not be made small. The prior art apparatus is suitable for the treatment in an open position in laparotomy, but is not suitable for the application in which the apparatus is inserted into a body cavity together with an endoscope.
In the above-mentioned prior art, it is necessary to pay attention so that the light guide probe will not be contact with the tissue in the vicinity of a target position to be treated even after the incision is completed since the light guide probe per se generates heat on incision.
Although the laser light is mainly directed toward the target position to be treated, some of the laser light is slightly incident upon the tissue other than the tissue to be treated. Accordingly, there is the risk in which the tissue in the vicinity of the target position to be treated will be damaged.
Although the prior art is capable of conducting incision and bleeding stopping simultaneously, the prior art is not ideal since the temperatures optimal for the incision and solidification of the living tissue are different.
SUMMARY OF THE INVENTION
It is a main object of the present invention to ideally conduct incision and bleeding stopping by one time operation, to miniaturize the apparatus for treatment to such a size that it can be inserted into a body cavity as well as an opening position together with an endoscope and to substantially prevent a damage to the living tissue other than a target position to be treated.
In order to accomplish the above-mentioned object, the present invention provides an apparatus for medical treatment characterized in that said apparatus comprises:
an outer probe which is in form of hook;
an inner probe which faces said outer probe and is capable of being in and out of contact with said inner probe in a longitudinal direction by the operator's actuation; and
heating means for heating a target tissue to be treated which is disposed between said outer and inner probes.
Since the outer and inner two probes are brought into in and out of contact with each other by the operator's actuation in accordance with the present invention, treatment can be conducted without enlarging and opening the apparatus in a lateral direction. The apparatus can be miniaturized to such a size that it can be used together with an endoscope. Since incision of the target tissue to be treated is conducted by heating means for hiating the target tissue in interest while it is sandwiched between the hooked portions of two probes, incision and arresting of bleeding of the tissue can be achieved by one time operation.
Said heating means may be adapted to irradiate at least the inner probe of said outer and inner probe with laser light to cause said probe to generate heat.
Said heating means may be resistive heating means which is provided on one of said two probes.
Said heating means may comprise means for supplying said two probes serving as electrodes with a radio frequency current.
Said heating means may comprise means for causing one of said two probes to oscillate at ultrasonic frequency.
Said heating means may comprise for causing one of said two probe to serve as an antenna for emitting microwaves and in which the hook portion of said one probe is formed with a blade.
The surface of said outer or inner probe which faces a target tissue to be treated may have a function of cutting blade.
The present invention further provides an apparatus for medical treatment comprising;
an outer and inner hook probe, each comprising a hollow tubular member having a portion in the form of hook at the front end thereof;
said inner hook probe being inserted int
Dvorak Linda C. M.
Gibson Roy
McDermott & Will & Emery
S.L.T. Japan Co., Ltd.
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