WO2023113397A1 - Tissue retraction apparatus for endoscope channel insertion - Google Patents

Tissue retraction apparatus for endoscope channel insertion Download PDF

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Publication number
WO2023113397A1
WO2023113397A1 PCT/KR2022/020108 KR2022020108W WO2023113397A1 WO 2023113397 A1 WO2023113397 A1 WO 2023113397A1 KR 2022020108 W KR2022020108 W KR 2022020108W WO 2023113397 A1 WO2023113397 A1 WO 2023113397A1
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Prior art keywords
weight
tissue
traction
endoscopic
endoscope
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PCT/KR2022/020108
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French (fr)
Korean (ko)
Inventor
김은선
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고려대학교 산학협력단
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Publication of WO2023113397A1 publication Critical patent/WO2023113397A1/en

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
    • A61B17/0218—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors for minimally invasive surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/02—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors
    • A61B17/0206—Surgical instruments, devices or methods, e.g. tourniquets for holding wounds open; Tractors with antagonistic arms as supports for retractor elements
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00238—Type of minimally invasive operation
    • A61B2017/00269—Type of minimally invasive operation endoscopic mucosal resection EMR
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00743—Type of operation; Specification of treatment sites
    • A61B2017/00818—Treatment of the gastro-intestinal system

Definitions

  • the present invention relates to a tissue traction device for inserting an endoscope channel, and more particularly, to an endoscope that is inserted into a lesion site in a human body through an endoscope channel and then connected to the lesion site using an endoscope clip to enable tissue traction at the lesion site. It relates to a tissue retraction device for channel insertion.
  • Gastrointestinal cancer gastric cancer, esophageal cancer, colorectal cancer, etc. refers to a malignant tumor that occurs in the gastrointestinal tract, and is a disease that grows very fast, invades and destroys normal gastrointestinal tissue, metastasizes to other parts, and leads to death.
  • Treatments for gastrointestinal cancer include radiation therapy, chemotherapy, and surgical treatment.
  • laparoscopic or endoscopic surgical treatment is possible, and the methods include open surgery, laparoscopic surgery in which a laparoscope is inserted through the hole after making several small holes in the stomach, and endoscopy.
  • ESD endoscopic submucosal dissection
  • Endoscopic submucosal dissection is a treatment that resects only the lesion site using an endoscope without open surgery, and is applied to local treatment of early gastric cancer, early esophageal cancer, early colorectal cancer, and adenoma.
  • Endoscopic submucosal dissection is a surgical method in which drugs are injected under the lesion area to inflate the lesion area and then incision is made using an endoscopic incision. It does not require general anesthesia and does not leave any surgical scars because it uses an endoscope. It has the advantage that the patient's recovery time is greatly shortened because the patient's cost is greatly reduced.
  • a clip used as an endoscopic treatment instrument as shown in Korean Patent Registration No. 10-1078544 is used.
  • Clips for endoscopic surgery are used for purposes such as ligating a bleeding site through an endoscope, suturing a fissure, or being used as a marking during mucosal resection.
  • tissue traction methods used clinically for endoscopic treatment have not been established, and several methods have been studied and reported in papers in the past, but all of them are difficult to implement in practice (damage to the mucous membrane of the gastrointestinal tract, high cost, interference with the operation of other endoscopic procedures etc.) is accompanied by difficulties in commercialization.
  • No. 10-1838553 filed and registered by the present applicant discloses tissue traction detachable from an endoscope clip for endoscopic submucosal dissection, which can facilitate the procedure by traction of gastrointestinal tissues in a desired direction during therapeutic endoscopic procedures such as endoscopic submucosal dissection A device is disclosed.
  • endoscopic submucosal dissection must be performed in a state where an endoscope channel is inserted through the mouth, esophagus, and anus, and it is difficult to insert a traction device for traction to the lesion site into the surgical site. Therefore, there is a need for an endoscopic tissue traction device that can be easily inserted into a lesion site in the human body through an endoscope channel.
  • An object of the present invention is to provide a tissue traction device for inserting an endoscopic channel that can be inserted into a lesion site in a human body through an endoscope channel as a device for traction of a lesion site in the course of performing endoscopic submucosal dissection.
  • the present invention is to provide a tissue traction device for inserting an endoscope channel that is attached to a tissue of a desired lesion site or connected to a surrounding area using an endoscope clip to assist in traction of the lesion site.
  • the present invention is to provide a tissue traction device for insertion of an endoscopic channel, which has a weight and a plurality of traction lines acting on its own weight in the direction of gravity, and is easy to operate when the tissue traction device is inserted into a lesion site in the human body through a channel. will be.
  • the present invention is to provide a tissue traction device for insertion of an endoscopic channel in which the weight of a weight can be adjusted and the weight can be adjusted and selected according to the thickness of the patient's stomach wall and the characteristics of the tissue at the lesion site.
  • a tissue traction device for inserting an endoscopic channel is a tissue traction device that can be inserted into a lesion in a human body through an endoscope channel, and includes a weight provided in a long column shape to be inserted into the endoscope channel; and a plurality of traction lines connected to the lesion site by an endoscope clip and connected to the weight so as to traction the tissue of the lesion site, wherein the plurality of traction lines are provided for connection with the tissue. It includes a traction line and a second traction line provided for connection with a peripheral part of the tissue.
  • the first towline is configured to tow the tissue by applying tension according to the weight of the weight in a state of being connected to the tissue, and depending on the position of the peripheral part to which the second towline is connected, the first towline Through this, the tension applied to the tissue can be controlled.
  • the traction line may include a traction thread connected to the weight and a circular ring-shaped traction ring provided at an end of the traction thread into which the endoscope clip is inserted.
  • the weight may include a cylindrical weight body having a weight head at one end, and the weight head may have a groove formed in a ring shape along an outer periphery so that the pulling yarn is wound.
  • the weight head is provided with a withdrawal groove formed along the central axis of the weight head so that the towing ring is withdrawn while the pulling thread is wound on the groove portion, and a plurality of connection grooves communicating between the withdrawal groove and the groove portion. can do.
  • the weight body may further include a weight that is detachably coupled to the weight head so that the weight of the weight can be adjusted.
  • the plurality of tow lines may be provided to have different colors.
  • the plurality of towing lines may have different lengths and at least one of diameters.
  • the weight may have a length of 10 mm to 20 mm, a weight of 1 g to 5 g, and a diameter of 2 mm to 5 mm.
  • the plurality of tow lines may be formed of silk sutures.
  • a tissue traction device for inserting an endoscopic channel that can be inserted into a lesion site in a human body through an endoscope channel is provided as a device for traction of a lesion site in the course of performing endoscopic submucosal dissection.
  • a tissue traction device for inserting an endoscope channel that is attached to a tissue of a desired lesion site using an endoscope clip or connected to a surrounding region to assist in traction of the lesion site.
  • the present invention has a weight and a plurality of traction lines for load acting in the direction of gravity, so that the tissue traction device can be easily operated when inserted into the lesion site in the human body through the channel.
  • Tissue traction for endoscopic channel insertion device is provided.
  • a tissue traction device for insertion of an endoscopic channel in which the weight of the weight can be adjusted and the weight can be adjusted and selected according to the thickness of the patient's stomach wall and the characteristics of the tissue at the lesion site.
  • FIG. 1 is a perspective view of a tissue traction device for endoscopic channel insertion according to an embodiment of the present invention.
  • FIG. 2 is a cross-sectional view of a tissue pulling device for endoscopic channel insertion according to an embodiment of the present invention.
  • FIG. 3 is a use state diagram showing a process of connecting a tissue traction device for insertion of an endoscopic channel according to an embodiment of the present invention to a lesion site.
  • FIG. 4 is a state diagram showing a state in which a tissue traction device for inserting an endoscopic channel according to an embodiment of the present invention is connected to a lesion site.
  • FIG. 5 is a front view of a tissue traction device for inserting an endoscopic channel according to another embodiment of the present invention.
  • FIG. 1 is a perspective view of a tissue traction device for endoscopic channel insertion according to an embodiment of the present invention.
  • FIG. 2 is a cross-sectional view of a tissue pulling device for endoscopic channel insertion according to an embodiment of the present invention.
  • FIG. 3 is a use state diagram showing a process of connecting a tissue traction device for insertion of an endoscopic channel according to an embodiment of the present invention to a lesion site.
  • FIG. 4 is a state diagram showing a state in which a tissue traction device for inserting an endoscopic channel according to an embodiment of the present invention is connected to a lesion site.
  • a tissue traction device 10 for inserting an endoscopic channel is a tissue traction device that can be inserted into a lesion site in the human body through an endoscope channel 20 .
  • the lesion site means, for example, an internal organ in which a tissue to be removed using an endoscopic incision by inserting an endoscopic channel is present.
  • the lesion site may be, for example, an internal organ of the human body, such as the stomach, large intestine, or esophagus, but is not limited thereto.
  • the tissue traction device 10 for inserting an endoscopic channel includes a weight 100 and a plurality of traction lines 200 connected to the weight 100 .
  • the weight 100 may be provided in a long column shape having a predetermined length (L) and cross-sectional area (D).
  • the weight 100 is configured to be inserted into the endoscope channel 20 .
  • the endoscope channel 20 may be a tubular channel provided in an endoscopic surgical tool that can be used for endoscopic surgery, such as a channel of a gastrointestinal endoscope.
  • the length (L) of the weight 100 is greater than the diameter of the weight 100 so that the weight 100 can be inserted through the endoscope channel 20 and tow the tissue by applying a tension higher than an appropriate level to the tissue. It may be provided several times to several tens of times longer.
  • the length (L) of the weight 100 may be formed to be approximately 10 mm to 20 mm, or more.
  • the length L of the weight 100 can be designed in consideration of the size of the lesion site and the body cavity around it, , it can be formed with a length of about 5 cm or less when the size of the space in the body cavity around the lesion is not wide.
  • the diameter D of the weight 100 may be designed to be smaller than the diameter of the endoscope channel 20 so that the weight 100 can be smoothly inserted into the lesion site through the endoscope channel 20 .
  • the diameter (D) of the weight 100 may be formed to be 2 mm to 5 mm, but is not necessarily limited thereto, and the weight depends on the diameter of the endoscope channel 20
  • the diameter D of the weight 100 may be designed to be less than 2 mm or greater than 5 mm.
  • the weight 100 is harmless to the human body, has excellent corrosion resistance, and may be made of a stainless steel material having a smooth surface, but is not necessarily limited thereto.
  • the weight 100 includes a weight body 100a to which a plurality of tow lines 200 are connected.
  • the weight body 100a may have a substantially cylindrical shape. Both end portions of the weight body 100a may be formed as tapered surfaces with edges processed.
  • the weight 100 includes a weight head 110 and a weight 120 .
  • the weight head 110 may be provided at one end of the weight 100 .
  • the weight head 110 may include a groove 111, a lead-out groove 112, and a plurality of connection grooves 113 for connection of the plurality of towing lines 200.
  • the groove 111 may be formed in a circular ring shape along the outer periphery of the weight head 110 .
  • the groove portion 111 is a groove configured to form an intaglio in the direction of the central axis of the weight 100 based on the cross-sectional area D of the weight 100.
  • the groove 111 may be provided to function as a snare for fixing the towing line 200 to the weight 100.
  • the groove 111 may be formed to have a width of 0.5 mm to 1 mm and a depth of 0.3 to 0.8 mm.
  • the drawing groove 112 may be hollow formed along the central axis of the weight head 110 from one end surface close to the groove portion 111 .
  • the drawing groove 112 may have a diameter of 0.4 mm to 0.8 mm.
  • the connecting groove 113 is a hollow formed to communicate between the drawing groove 112 and the groove portion 111 to facilitate the connection of the towing line 200, and may be provided in plurality on the outer circumferential surface of the groove portion 111. there is.
  • connection groove 113 In the illustrated example, two connection grooves 113 are connected to the lead-out groove 112, but three or more connection grooves 113 may be formed.
  • the connection groove 113 may have a diameter of 0.4 mm to 0.8 mm.
  • the weight 120 may allow the weight 100 to hang on the lesion site in the vertical direction with the weight head 110 positioned at the top by its own weight.
  • each traction line 200 may be connected to the weight 100 and the other end may be connected to the tissue 30 at the lesion site or to a surrounding area of the tissue 30 .
  • the towing line 200 may be connected to the lesion site by an endoscope clip to pull the tissue 30 of the lesion site.
  • the towline 200 may include a towline 210 and a tow hook 220 provided at an end of the towline 210 .
  • One end of the tow thread 210 may be connected to the weight 100 through a knot, or may be connected to the weight 100 through a lead-out groove 112 and a plurality of connection grooves 113.
  • the towing yarn 210 may be wound around the groove part 111, and in a state of being wound around the groove part 111, the take-out groove 112 through a plurality of connection grooves 113 communicating between the groove part 111 and the take-out groove 112. ) can be withdrawn to the outside.
  • the traction ring 220 may have a circular ring shape provided at the end of the traction thread 210 so that the endoscope clip is inserted.
  • the tow ring 220 may be attached to the lesion site by hooking an endoscope clip, and at this time, tension acting on the lesion site may be controlled by the weight 100 .
  • the towing ring 220 may have a diameter of approximately 5 mm to 10 mm.
  • the plurality of traction lines 200 may include a first traction line 201 and a second traction line 202 .
  • the first towing line 201 may be provided for connection with the tissue 30 to be towed.
  • the first traction line 201 may be configured to pull the tissue 30 by applying tension according to the weight of the weight 100 while connected to the tissue 30 .
  • the second traction line 202 may be provided for connection with a peripheral portion of the tissue 30 .
  • the tension applied to the tissue 30 through the first traction line 201 may be controlled according to the position of the peripheral part to which the second traction line 202 is connected.
  • the plurality of towing lines 200 may have different lengths L1 and L2 and at least one of diameters.
  • the lengths L1 and L2 of the towline 200 may be the shortest distance between the end of the tow hook of the towline 200 and the end of the weight 100 to which the towline 200 is connected. .
  • a plurality of towing lines 200 may be provided to have different colors. Accordingly, in the process of performing endoscopic submucosal dissection, it is possible to easily distinguish between the lengths L1 and L2 and the diameter of the traction line 200 .
  • the plurality of traction lines 200 may be formed of silk sutures such as black silk sutures so that they can be well attached to the lesion tissue through endoscopic clips.
  • the number of tow lines 200 connected to the weight 100 is two, but three or more tow lines 200 may be provided.
  • an endoscope is inserted into a lesion site inside a body tissue, such as the stomach, large intestine, or esophagus, and then the tissue traction device 10 is inserted into the lesion site through the endoscope channel 20 .
  • an endoscope clip may also be inserted into the lesion site through the endoscope channel.
  • the endoscopic clip With the endoscope clip inserted into the tow ring of one of the plurality of tow lines of the tissue traction device 10, the endoscopic clip is fixed to the surrounding area away from the tissue (lesion), and the tow line is suspended at the tissue portion, The other traction line is also suspended by the endoscope clip by inserting the endoscope clip into the tow hook and fixing it to the tissue part. It is attached to body tissue at a location remote from the location of the lesion.
  • the weight of the weight 100 is transmitted to the tissues and areas around the tissues through the plurality of traction lines, and the tissues are towed by the tension of the plurality of traction lines. It can remain partially exfoliated.
  • an operation such as excision of the exposed lesion may be performed using a surgical instrument. Accordingly, since the exposed state of the lesion is maintained by the tissue traction device 10, it is easy to observe the state of the lesion and it is possible to effectively excise the lesion.
  • the tissue traction device 10 can reduce the risk of perforation, lower the difficulty of the procedure, and reduce the operation time in the case of, for example, endoscopic submucosal dissection, thereby real clinical results. can be very useful in
  • FIG. 5 is a front view of a tissue traction device for inserting an endoscopic channel according to another embodiment of the present invention.
  • the weight body 120 may be coupled to the weight head 110 in a detachable manner (eg, screw coupling) so that the weight of the weight body 100a can be adjusted. Accordingly, the weight of the weight 120 coupled to the weight head 110 can be adjusted and selected according to the thickness of the stomach wall of the patient undergoing endoscopic submucosal dissection or the characteristics of the tissue at the lesion site.
  • a detachable manner eg, screw coupling

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Abstract

A tissue retraction apparatus for endoscope channel insertion according to an embodiment of the present invention can be inserted into a lesion site in a human body via an endoscope channel, and comprises: a weight having a long columnar shape so as to be insertable into the endoscope channel; and a plurality of retraction wires which are connected to the lesion site by an endoscope clip and connected to the weight to pull tissue in the lesion site. The plurality of retraction wires include a first retraction wire provided in order to be connected to the tissue and a second retraction wire provided in order to be connected to a site near the tissue.

Description

내시경 채널 삽입용 조직 견인 장치Tissue traction device for endoscopic channel insertion
본 발명은 내시경 채널 삽입용 조직 견인 장치에 관한 것으로, 보다 상세하게는 내시경 채널을 통해 인체 내의 병변 부위로 삽입한 뒤 내시경 클립을 이용해 병변 부위에 연결하여 병변 부위의 조직을 견인할 수 있도록 하는 내시경 채널 삽입용 조직 견인 장치에 관한 것이다.The present invention relates to a tissue traction device for inserting an endoscope channel, and more particularly, to an endoscope that is inserted into a lesion site in a human body through an endoscope channel and then connected to the lesion site using an endoscope clip to enable tissue traction at the lesion site. It relates to a tissue retraction device for channel insertion.
위장관암 (위암, 식도암, 대장암 등)이란 위장관에 발생하는 악성 종양을 말하며, 성장속도가 매우 빨라 정상적인 위장관 조직을 침습하여 파괴하고 다른 부위로 전이하여 사망에 이르게 하는 질병이다. Gastrointestinal cancer (gastric cancer, esophageal cancer, colorectal cancer, etc.) refers to a malignant tumor that occurs in the gastrointestinal tract, and is a disease that grows very fast, invades and destroys normal gastrointestinal tissue, metastasizes to other parts, and leads to death.
위장관암의 치료법으로는 방사선치료, 항암화학요법 및 수술적 치료방법이 있다. 특히, 조기위장관암의 경우에는 복강경 혹은 내시경 수술적 치료가 가능한 경우가 있으며 그 방법으로는, 개복수술, 배에 조그마한 구멍을 여러 개 뚫은 뒤 구멍을 통해 복강경을 넣어서 수술하는 복강경수술 및 내시경을 입과 식도, 항문을 통해 삽입하여 병변 부위를 제거하는 내시경 점막하 박리술(ESD, endoscopic submucosal dissection)이 있다.Treatments for gastrointestinal cancer include radiation therapy, chemotherapy, and surgical treatment. In particular, in the case of early gastrointestinal cancer, there are cases where laparoscopic or endoscopic surgical treatment is possible, and the methods include open surgery, laparoscopic surgery in which a laparoscope is inserted through the hole after making several small holes in the stomach, and endoscopy. There is an endoscopic submucosal dissection (ESD) that removes the lesion by inserting it through the esophagus and anus.
내시경 점막하 박리술은 개복수술 없이 내시경을 이용하여 병변부위 만을 절제하는 치료법으로 조기 위암, 조기식도암, 조기대장암, 선종 등의 국소 치료에 적용되고 있다. 내시경 점막하 박리술은 병변 부위 아래 약물을 주입해 병변 부위를 부풀린 후 내시경 절개도를 이용하여 절개하는 수술법으로, 전신마취가 필요 없으며, 내시경을 이용하기 때문에 수술흉터가 전혀 남지 않으며, 개복하거나 배에 구멍을 뚫지 않아 환자의 회복시간이 매우 단축되어 환자의 부담 비용이 크게 절감된다는 장점이 있다.Endoscopic submucosal dissection is a treatment that resects only the lesion site using an endoscope without open surgery, and is applied to local treatment of early gastric cancer, early esophageal cancer, early colorectal cancer, and adenoma. Endoscopic submucosal dissection is a surgical method in which drugs are injected under the lesion area to inflate the lesion area and then incision is made using an endoscopic incision. It does not require general anesthesia and does not leave any surgical scars because it uses an endoscope. It has the advantage that the patient's recovery time is greatly shortened because the patient's cost is greatly reduced.
이러한 내시경 점막하 박리술을 시술할 때에는 한국등록특허 제10-1078544호에 도시된 바와 같은 내시경용 처치기구로 이용하는 클립이 사용되고 있다. 내시경 수술용 클립은 내시경에 의해 출혈 부위를 결찰하거나, 열창을 봉합하거나, 또는 점막절제 시의 마킹으로서 사용되는 등의 용도로 이용되고 있다. 한편, 내시경 치료를 위하여 임상에 쓰이는 조직 견인 방법은 확립되어 있지 않으며, 과거 몇몇 방법들이 연구되어 논문으로 보고되었으나, 모두 실제 실행의 어려움(위장관 장기의 점막 손상, 고비용, 다른 내시경 시술 기기 작동의 방해 등)이 동반되어 상용화에 어려움이 있다.When performing such an endoscopic submucosal dissection, a clip used as an endoscopic treatment instrument as shown in Korean Patent Registration No. 10-1078544 is used. Clips for endoscopic surgery are used for purposes such as ligating a bleeding site through an endoscope, suturing a fissure, or being used as a marking during mucosal resection. On the other hand, tissue traction methods used clinically for endoscopic treatment have not been established, and several methods have been studied and reported in papers in the past, but all of them are difficult to implement in practice (damage to the mucous membrane of the gastrointestinal tract, high cost, interference with the operation of other endoscopic procedures etc.) is accompanied by difficulties in commercialization.
본 출원인에 의해 출원되어 등록된 제10-1838553호에는 내시경점막하 박리술과 같은 치료 내시경 시술 중 위장관 조직을 원하는 방향으로 견인하여 시술을 용이하게 할 수 있는 내시경점막하 박리술을 위한 내시경 클립에 탈부착되는 조직 견인 장치가 개시되어 있다.No. 10-1838553 filed and registered by the present applicant discloses tissue traction detachable from an endoscope clip for endoscopic submucosal dissection, which can facilitate the procedure by traction of gastrointestinal tissues in a desired direction during therapeutic endoscopic procedures such as endoscopic submucosal dissection A device is disclosed.
그러나, 내시경 점막하 박리술은 내시경 채널이 입과 식도, 항문를 통해 삽입된 상태에서 진행되어야 하고, 병변 부위를 견인하기 위한 견인 기구를 수술 부위에 삽입하는데 어려움이 있다. 따라서 내시경 채널을 통해 인체 내 병변 부위로 용이하게 삽입 가능한 내시경용 조직 견인장치가 필요한 실정이다.However, endoscopic submucosal dissection must be performed in a state where an endoscope channel is inserted through the mouth, esophagus, and anus, and it is difficult to insert a traction device for traction to the lesion site into the surgical site. Therefore, there is a need for an endoscopic tissue traction device that can be easily inserted into a lesion site in the human body through an endoscope channel.
본 발명은 내시경 점막하 박리술을 수행하는 과정에서 병변 부위의 견인을 하기 위한 장치로, 내시경 채널을 통해 인체 내 병변 부위로 삽입 가능한 내시경 채널 삽입용 조직 견인 장치를 제공하기 위한 것이다.An object of the present invention is to provide a tissue traction device for inserting an endoscopic channel that can be inserted into a lesion site in a human body through an endoscope channel as a device for traction of a lesion site in the course of performing endoscopic submucosal dissection.
또한, 본 발명은 내시경 클립을 이용하여 원하는 병변 부위의 조직에 부착되거나 주변 부위에 연결되어, 병변 부위의 견인을 돕기 위한 내시경 채널 삽입용 조직 견인 장치를 제공하기 위한 것이다.In addition, the present invention is to provide a tissue traction device for inserting an endoscope channel that is attached to a tissue of a desired lesion site or connected to a surrounding area using an endoscope clip to assist in traction of the lesion site.
또한, 본 발명은 중력방향으로 자중이 작용하는 무게추 및 복수개의 견인선을 가져 조직 견인 장치가 채널을 통해 인체내 병변 부위로 삽입 시 조작이 용이한 내시경 채널 삽입용 조직 견인 장치를 제공하기 위한 것이다.In addition, the present invention is to provide a tissue traction device for insertion of an endoscopic channel, which has a weight and a plurality of traction lines acting on its own weight in the direction of gravity, and is easy to operate when the tissue traction device is inserted into a lesion site in the human body through a channel. will be.
또한, 본 발명은 무게추의 중량조절이 가능하여 환자의 위벽두께 및 병변 부위 조직의 특성에 따라 무게를 조절하여 선택할 수 있는 내시경 채널 삽입용 조직 견인 장치를 제공하기 위한 것이다.In addition, the present invention is to provide a tissue traction device for insertion of an endoscopic channel in which the weight of a weight can be adjusted and the weight can be adjusted and selected according to the thickness of the patient's stomach wall and the characteristics of the tissue at the lesion site.
본 발명의 실시예에 따른 내시경 채널 삽입용 조직 견인 장치는 내시경 채널을 통해 인체 내의 병변 부위로 삽입 가능한 조직 견인 장치로서, 상기 내시경 채널에 삽입 가능하도록 장형의 기둥 형상으로 마련되는 무게추; 및 내시경 클립에 의해 상기 병변 부위에 연결되어 상기 병변 부위의 조직을 견인하도록 상기 무게추에 연결되는 복수개의 견인선;을 포함하고, 상기 복수개의 견인선은 상기 조직과 연결을 위해 마련되는 제1 견인선과, 상기 조직의 주변 부위와 연결을 위해 마련되는 제2 견인선을 포함한다.A tissue traction device for inserting an endoscopic channel according to an embodiment of the present invention is a tissue traction device that can be inserted into a lesion in a human body through an endoscope channel, and includes a weight provided in a long column shape to be inserted into the endoscope channel; and a plurality of traction lines connected to the lesion site by an endoscope clip and connected to the weight so as to traction the tissue of the lesion site, wherein the plurality of traction lines are provided for connection with the tissue. It includes a traction line and a second traction line provided for connection with a peripheral part of the tissue.
상기 제1 견인선은 상기 조직과 연결된 상태에서 상기 무게추의 자중에 따른 장력을 가하여 상기 조직을 견인하도록 구성되고, 상기 제2 견인선이 연결되는 상기 주변 부위의 위치에 따라 상기 제1 견인선을 통해 상기 조직에 가해지는 장력이 제어될 수 있다. The first towline is configured to tow the tissue by applying tension according to the weight of the weight in a state of being connected to the tissue, and depending on the position of the peripheral part to which the second towline is connected, the first towline Through this, the tension applied to the tissue can be controlled.
상기 견인선은 상기 무게추에 연결되는 견인사와, 상기 내시경 클립이 삽입되도록 상기 견인사의 단부에 마련되는 원형 고리 형상의 견인 고리를 포함할 수 있다.The traction line may include a traction thread connected to the weight and a circular ring-shaped traction ring provided at an end of the traction thread into which the endoscope clip is inserted.
상기 무게추는 일단에 무게추 헤드를 구비하는 원기둥 형상의 무게추 본체를 포함하고, 상기 무게추 헤드는 상기 견인사가 감기도록 외주연을 따라 고리 형태로 형성되는 홈부를 구비할 수 있다.The weight may include a cylindrical weight body having a weight head at one end, and the weight head may have a groove formed in a ring shape along an outer periphery so that the pulling yarn is wound.
상기 무게추 헤드는 상기 견인사가 상기 홈부에 감긴 상태에서 상기 견인 고리가 인출되도록 상기 무게추 헤드의 중심축을 따라 형성되는 인출홈과, 상기 인출홈과 상기 홈부 사이에 연통되는 복수개의 연결홈을 구비할 수 있다.The weight head is provided with a withdrawal groove formed along the central axis of the weight head so that the towing ring is withdrawn while the pulling thread is wound on the groove portion, and a plurality of connection grooves communicating between the withdrawal groove and the groove portion. can do.
상기 무게추 본체는 상기 무게추의 중량 조절이 가능하도록 상기 무게추 헤드에 착탈식으로 결합되는 중량추를 더 포함할 수 있다.The weight body may further include a weight that is detachably coupled to the weight head so that the weight of the weight can be adjusted.
상기 복수개의 견인선은 서로 다른 색상을 가지도록 마련될 수 있다.The plurality of tow lines may be provided to have different colors.
상기 복수개의 견인선은 길이 및 직경 중의 적어도 하나가 상이할 수 있다.The plurality of towing lines may have different lengths and at least one of diameters.
상기 무게추는 10 mm 내지 20 mm의 길이, 1 g 내지 5 g의 무게, 및 2 mm 내지 5 mm의 직경을 가질 수 있다.The weight may have a length of 10 mm to 20 mm, a weight of 1 g to 5 g, and a diameter of 2 mm to 5 mm.
상기 복수개의 견인선은 실크 봉합사로 형성될 수 있다.The plurality of tow lines may be formed of silk sutures.
본 발명의 실시예에 의하면, 내시경 점막하 박리술을 수행하는 과정에서 병변 부위의 견인을 하기 위한 장치로, 내시경 채널을 통해 인체 내 병변 부위로 삽입 가능한 내시경 채널 삽입용 조직 견인 장치가 제공된다.According to an embodiment of the present invention, a tissue traction device for inserting an endoscopic channel that can be inserted into a lesion site in a human body through an endoscope channel is provided as a device for traction of a lesion site in the course of performing endoscopic submucosal dissection.
또한, 본 발명의 실시예에 의하면, 내시경 클립을 이용하여 원하는 병변 부위의 조직에 부착되거나 주변 부위에 연결되어 병변 부위의 견인을 돕기 위한 내시경 채널 삽입용 조직 견인 장치가 제공된다.In addition, according to an embodiment of the present invention, there is provided a tissue traction device for inserting an endoscope channel that is attached to a tissue of a desired lesion site using an endoscope clip or connected to a surrounding region to assist in traction of the lesion site.
또한, 본 발명의 실시예에 의하면, 중력방향으로 하중이 작용하는 무게추 및 복수개의 견인선을 가져 조직 견인 장치가 채널을 통해 인체내 병변 부위로 삽입 시 조작이 용이한 내시경 채널 삽입용 조직 견인 장치가 제공된다.In addition, according to an embodiment of the present invention, it has a weight and a plurality of traction lines for load acting in the direction of gravity, so that the tissue traction device can be easily operated when inserted into the lesion site in the human body through the channel. Tissue traction for endoscopic channel insertion device is provided.
또한, 본 발명의 실시예에 의하면, 무게추의 중량조절이 가능하여 환자의 위벽두께 및 병변 부위 조직의 특성에 따라 무게를 조절하여 선택할 수 있는 내시경 채널 삽입용 조직 견인 장치가 제공된다.In addition, according to an embodiment of the present invention, a tissue traction device for insertion of an endoscopic channel is provided in which the weight of the weight can be adjusted and the weight can be adjusted and selected according to the thickness of the patient's stomach wall and the characteristics of the tissue at the lesion site.
도 1은 본 발명의 실시예에 따른 내시경 채널 삽입용 조직 견인 장치의 사시도이다.1 is a perspective view of a tissue traction device for endoscopic channel insertion according to an embodiment of the present invention.
도 2는 본 발명의 실시예에 따른 내시경 채널 삽입용 조직 견인 장치의 단면도이다.2 is a cross-sectional view of a tissue pulling device for endoscopic channel insertion according to an embodiment of the present invention.
도 3은 본 발명의 실시예에 따른 내시경 채널 삽입용 조직 견인 장치를 병변 부위에 연결하는 과정을 나타낸 사용 상태도이다.3 is a use state diagram showing a process of connecting a tissue traction device for insertion of an endoscopic channel according to an embodiment of the present invention to a lesion site.
도 4는 본 발명의 실시예에 따른 내시경 채널 삽입용 조직 견인 장치가 병변 부위에 연결된 상태를 나타낸 사용 상태도이다.4 is a state diagram showing a state in which a tissue traction device for inserting an endoscopic channel according to an embodiment of the present invention is connected to a lesion site.
도 5는 본 발명의 다른 실시예에 따른 내시경 채널 삽입용 조직 견인 장치의 정면도이다.5 is a front view of a tissue traction device for inserting an endoscopic channel according to another embodiment of the present invention.
본 발명의 이점 및/또는 특징, 그리고 그것들을 달성하는 방법은 첨부되는 도면과 함께 상세하게 후술되어 있는 실시예들을 참조하면 명확해질 것이다. 그러나, 본 발명은 이하에서 개시되는 실시예들에 한정되는 것이 아니라 서로 다른 다양한 형태로 구현될 것이며, 단지 본 실시예들은 본 발명의 개시가 완전하도록 하며, 본 발명이 속하는 기술분야에서 통상의 지식을 가진 자에게 발명의 범주를 완전하게 알려주기 위해 제공되는 것이며, 본 발명은 청구항의 범주에 의해 정의될 뿐이다. 명세서 전체에 걸쳐 동일 참조 부호는 동일 구성요소를 지칭한다. 이하에서는 첨부된 도면을 참조하여 본 발명의 실시예들을 상세히 설명하기로 한다.Advantages and/or features of the present invention, and methods of achieving them, will become apparent with reference to the following detailed description of the embodiments taken in conjunction with the accompanying drawings. However, the present invention is not limited to the embodiments disclosed below and will be implemented in various forms different from each other, only these embodiments make the disclosure of the present invention complete, and common knowledge in the art to which the present invention pertains. It is provided to completely inform the person who has the scope of the invention, and the present invention is only defined by the scope of the claims. Like reference numbers designate like elements throughout the specification. Hereinafter, embodiments of the present invention will be described in detail with reference to the accompanying drawings.
도 1은 본 발명의 실시예에 따른 내시경 채널 삽입용 조직 견인 장치의 사시도이다.1 is a perspective view of a tissue traction device for endoscopic channel insertion according to an embodiment of the present invention.
도 2는 본 발명의 실시예에 따른 내시경 채널 삽입용 조직 견인 장치의 단면도이다.2 is a cross-sectional view of a tissue pulling device for endoscopic channel insertion according to an embodiment of the present invention.
도 3은 본 발명의 실시예에 따른 내시경 채널 삽입용 조직 견인 장치를 병변 부위에 연결하는 과정을 나타낸 사용 상태도이다.3 is a use state diagram showing a process of connecting a tissue traction device for insertion of an endoscopic channel according to an embodiment of the present invention to a lesion site.
도 4는 본 발명의 실시예에 따른 내시경 채널 삽입용 조직 견인 장치가 병변 부위에 연결된 상태를 나타낸 사용 상태도이다.4 is a state diagram showing a state in which a tissue traction device for inserting an endoscopic channel according to an embodiment of the present invention is connected to a lesion site.
도 1 내지 도 4를 참조하면, 본 발명의 실시예에 따른 내시경 채널 삽입용 조직 견인 장치(10)는 내시경 채널(20)을 통해 인체 내의 병변 부위로 삽입 가능한 조직 견인 장치이다.Referring to FIGS. 1 to 4 , a tissue traction device 10 for inserting an endoscopic channel according to an embodiment of the present invention is a tissue traction device that can be inserted into a lesion site in the human body through an endoscope channel 20 .
여기서, 병변 부위란 예를 들어, 내시경 채널을 삽입하여 내시경 절개도를 이용하여 제거하고자 하는 조직이 존재하는 체내 기관을 의미한다. 병변 부위는 예를 들어, 위, 대장, 식도 등과 같은 인체의 내부 기관일 수 있으나, 이에 한정되는 것은 아니다.Here, the lesion site means, for example, an internal organ in which a tissue to be removed using an endoscopic incision by inserting an endoscopic channel is present. The lesion site may be, for example, an internal organ of the human body, such as the stomach, large intestine, or esophagus, but is not limited thereto.
내시경 채널 삽입용 조직 견인 장치(10)는 무게추(100) 및 무게추(100)에 연결되는 복수개의 견인선(200)을 포함한다.The tissue traction device 10 for inserting an endoscopic channel includes a weight 100 and a plurality of traction lines 200 connected to the weight 100 .
무게추(100)는 소정의 길이(L) 및 단면적(D)을 가지는 장형의 기둥 형상으로 마련될 수 있다.The weight 100 may be provided in a long column shape having a predetermined length (L) and cross-sectional area (D).
무게추(100)는 내시경 채널(20)에 삽입 가능하도록 구성된다. 내시경 채널(20)은 위장관 내시경의 채널과 같이 내시경 수술에 사용될 수 있는 내시경 수술 도구에 마련된 관형의 채널일 수 있다. The weight 100 is configured to be inserted into the endoscope channel 20 . The endoscope channel 20 may be a tubular channel provided in an endoscopic surgical tool that can be used for endoscopic surgery, such as a channel of a gastrointestinal endoscope.
내시경 채널(20)을 통해 무게추(100)가 삽입 가능하면서도 조직에 적정 수준 이상의 장력을 가하여 조직을 견인할 수 있도록, 무게추(100)의 길이(L)는 무게추(100)의 직경 보다 수배 내지 수십배 이상 길게 마련될 수 있다.The length (L) of the weight 100 is greater than the diameter of the weight 100 so that the weight 100 can be inserted through the endoscope channel 20 and tow the tissue by applying a tension higher than an appropriate level to the tissue. It may be provided several times to several tens of times longer.
무게추(100)의 직경(D)이 수 mm 로 설계되는 경우, 무게추(100)의 길이(L)는 대략 10 mm 내지 20 mm, 혹은 그 이상의 길이로 형성될 수 있다. When the diameter (D) of the weight 100 is designed to be several mm, the length (L) of the weight 100 may be formed to be approximately 10 mm to 20 mm, or more.
무게추(100)는 병변 부위에 연결되어 대략 수직 방향으로 매달린 상태로 조직을 견인하게 되므로, 무게추(100)의 길이(L)는 병변 부위와 그 주변의 체강 크기를 고려하여 설계될 수 있으며, 병변 부위 주변의 체강의 공간 크기가 넓지 않은 경우 대략 5 cm 이하의 길이로 형성될 수 있다.Since the weight 100 is connected to the lesion site and pulls the tissue in a suspended state in a substantially vertical direction, the length L of the weight 100 can be designed in consideration of the size of the lesion site and the body cavity around it, , it can be formed with a length of about 5 cm or less when the size of the space in the body cavity around the lesion is not wide.
내시경 채널(20)을 통해 무게추(100)가 원활하게 병변 부위로 삽입될 수 있도록, 무게추(100)의 직경(D)은 내시경 채널(20)의 직경 보다 작게 설계될 수 있다.The diameter D of the weight 100 may be designed to be smaller than the diameter of the endoscope channel 20 so that the weight 100 can be smoothly inserted into the lesion site through the endoscope channel 20 .
통상적인 내시경 채널(20)의 직경을 고려하여 무게추(100)의 직경(D)은 2 mm 내지 5 mm로 형성될 수 있으나, 반드시 이에 한정되지 않고, 내시경 채널(20)의 직경에 따라 무게추(100)의 직경(D)이 2 mm 미만 또는 5 mm를 초과하여 설계될 수도 있다.Considering the diameter of the conventional endoscope channel 20, the diameter (D) of the weight 100 may be formed to be 2 mm to 5 mm, but is not necessarily limited thereto, and the weight depends on the diameter of the endoscope channel 20 The diameter D of the weight 100 may be designed to be less than 2 mm or greater than 5 mm.
무게추(100)는 인체에 무해하면서 내식성이 우수하며, 매끄러운 표면을 가지는 스테인레스 스틸 재질로 이루어질 수 있으나, 반드시 이에 한정하는 것은 아니다.The weight 100 is harmless to the human body, has excellent corrosion resistance, and may be made of a stainless steel material having a smooth surface, but is not necessarily limited thereto.
무게추(100)는 복수개의 견인선(200)이 연결되어 있는 무게추 본체(100a)를 포함한다.The weight 100 includes a weight body 100a to which a plurality of tow lines 200 are connected.
무게추 본체(100a)는 대략 원기둥 형상을 가질 수 있다. 무게추 본체(100a)의 양측 단부는 모서리가 가공된 테이퍼면으로 형성될 수 있다.The weight body 100a may have a substantially cylindrical shape. Both end portions of the weight body 100a may be formed as tapered surfaces with edges processed.
무게추(100)는 무게추 헤드(110) 및 중량추(120)를 포함한다. 무게추 헤드(110)는 무게추(100)의 일측 단부에 마련될 수 있다.The weight 100 includes a weight head 110 and a weight 120 . The weight head 110 may be provided at one end of the weight 100 .
무게추 헤드(110)는 복수개의 견인선(200)의 연결을 위하여, 홈부(111), 인출홈(112) 및 복수개의 연결홈(113)을 구비할 수 있다.The weight head 110 may include a groove 111, a lead-out groove 112, and a plurality of connection grooves 113 for connection of the plurality of towing lines 200.
홈부(111)는 무게추 헤드(110)의 외주연을 따라 원형의 고리 형태로 형성될 수 있다. The groove 111 may be formed in a circular ring shape along the outer periphery of the weight head 110 .
홈부(111)는 무게추(100)의 단면적(D)를 기준으로 무게추(100)의 중심축 방향으로 음각을 형성할 수 있도록 구성된 홈이다. 홈부(111)는 견인선(200)을 무게추(100)에 고정하기 위한 올가미의 기능을 하도록 마련될 수 있다.The groove portion 111 is a groove configured to form an intaglio in the direction of the central axis of the weight 100 based on the cross-sectional area D of the weight 100. The groove 111 may be provided to function as a snare for fixing the towing line 200 to the weight 100.
홈부(111)는 0.5 mm 내지 1 mm의 폭으로 형성되고, 0.3 내지 0.8 mm 깊이로 형성될 수 있다.The groove 111 may be formed to have a width of 0.5 mm to 1 mm and a depth of 0.3 to 0.8 mm.
인출홈(112)은 홈부(111)를 기준으로 가까운 일단면으로부터 무게추 헤드(110)의 중심축을 따라 형성되는 중공일 수 있다. 인출홈(112)은 0.4 mm 내지 0.8 mm 직경으로 형성될 수 있다.The drawing groove 112 may be hollow formed along the central axis of the weight head 110 from one end surface close to the groove portion 111 . The drawing groove 112 may have a diameter of 0.4 mm to 0.8 mm.
연결홈(113)은 견인선(200)의 연결을 용이하게 하기 위하여 인출홈(112)과 홈부(111) 사이에 연통될 수 있도록 형성되는 중공으로, 홈부(111)의 외주면에 복수개 구비될 수 있다.The connecting groove 113 is a hollow formed to communicate between the drawing groove 112 and the groove portion 111 to facilitate the connection of the towing line 200, and may be provided in plurality on the outer circumferential surface of the groove portion 111. there is.
도시된 예에서는 2개의 연결홈(113)이 인출홈(112)에 연결되어 있으나, 3개 이상의 연결홈(113)이 형성될 수도 있다. 연결홈(113)은 0.4 mm 내지 0.8 mm 직경으로 형성될 수 있다.In the illustrated example, two connection grooves 113 are connected to the lead-out groove 112, but three or more connection grooves 113 may be formed. The connection groove 113 may have a diameter of 0.4 mm to 0.8 mm.
중량추(120)는 자중에 의해 무게추 헤드(110)가 상부에 위치한 상태로 무게추(100)가 상하 방향으로 병변 부위에 매달리도록 할 수 있다.The weight 120 may allow the weight 100 to hang on the lesion site in the vertical direction with the weight head 110 positioned at the top by its own weight.
각 견인선(200)의 일단은 무게추(100)에 연결되고 타단은 병변 부위의 조직(30) 또는 조직(30)의 주변 부위에 연결될 수 있다. One end of each traction line 200 may be connected to the weight 100 and the other end may be connected to the tissue 30 at the lesion site or to a surrounding area of the tissue 30 .
견인선(200)은 내시경 클립에 의해 병변 부위에 연결되어 병변 부위의 조직(30)을 견인하도록 할 수 있다.The towing line 200 may be connected to the lesion site by an endoscope clip to pull the tissue 30 of the lesion site.
견인선(200)은 견인사(210)와, 견인사(210)의 단부에 마련되는 견인고리(220)를 포함할 수 있다.The towline 200 may include a towline 210 and a tow hook 220 provided at an end of the towline 210 .
견인사(210)의 일단은 무게추(100)에 매듭으로 연결되거나, 무게추(100)에 마련된 인출홈(112)과 복수개의 연결홈(113)을 통해 연결될 수 있다.One end of the tow thread 210 may be connected to the weight 100 through a knot, or may be connected to the weight 100 through a lead-out groove 112 and a plurality of connection grooves 113.
견인사(210)는 홈부(111)에 감길 수 있으며, 홈부(111)에 감긴 상태에서 홈부(111)와 인출홈(112) 사이에 연통되는 복수개의 연결홈(113)을 통해 인출홈(112)을 따라 외부로 인출될 수 있다.The towing yarn 210 may be wound around the groove part 111, and in a state of being wound around the groove part 111, the take-out groove 112 through a plurality of connection grooves 113 communicating between the groove part 111 and the take-out groove 112. ) can be withdrawn to the outside.
견인 고리(220)는 내시경 클립이 삽입되도록 견인사(210)의 단부에 마련되는 원형 고리 형상일 수 있다.The traction ring 220 may have a circular ring shape provided at the end of the traction thread 210 so that the endoscope clip is inserted.
견인고리(220)는 내시경 클립을 걸어 병변 부위에 부착될 수 있으며 이때, 무게추(100)에 의해 병변 부위에 작용하는 장력이 제어될 수 있다. 견인고리(220)의 직경은 대략 5 mm 내지 10 mm로 형성될 수 있다.The tow ring 220 may be attached to the lesion site by hooking an endoscope clip, and at this time, tension acting on the lesion site may be controlled by the weight 100 . The towing ring 220 may have a diameter of approximately 5 mm to 10 mm.
복수개의 견인선(200)은 제1 견인선(201) 및 제2 견인선(202)를 포함할 수 있다.The plurality of traction lines 200 may include a first traction line 201 and a second traction line 202 .
제1 견인선(201)은 견인될 조직(30)과 연결을 위해 마련될 수 있다.The first towing line 201 may be provided for connection with the tissue 30 to be towed.
제1 견인선(201)은 조직(30)과 연결된 상태에서 무게추(100)의 자중에 따른 장력을 가하여 조직(30)을 견인하도록 구성될 수 있다.The first traction line 201 may be configured to pull the tissue 30 by applying tension according to the weight of the weight 100 while connected to the tissue 30 .
제2 견인선(202)은 조직(30)의 주변 부위와 연결을 위해 마련될 수 있다.The second traction line 202 may be provided for connection with a peripheral portion of the tissue 30 .
제2 견인선(202)은 연결되는 주변 부위의 위치에 따라 제1 견인선(201)을 통해 조직(30)에 가해지는 장력이 제어될 수 있다. The tension applied to the tissue 30 through the first traction line 201 may be controlled according to the position of the peripheral part to which the second traction line 202 is connected.
복수개의 견인선(200)은 길이(L1, L2) 및 직경 중의 적어도 하나가 상이할 수 있다. 본 명세서에서 견인선(200)의 길이(L1, L2)는 견인선(200)의 견인고리의 단부와, 견인선(200)이 연결되는 무게추(100)의 단부 사이의 최단 거리일 수 있다.The plurality of towing lines 200 may have different lengths L1 and L2 and at least one of diameters. In this specification, the lengths L1 and L2 of the towline 200 may be the shortest distance between the end of the tow hook of the towline 200 and the end of the weight 100 to which the towline 200 is connected. .
복수개의 견인선(200)은 서로 다른 색상을 가지도록 마련될 수 있다. 이에 의해, 내시경 점막하 박리술을 수행하는 과정에서, 견인선(200)의 길이(L1,L2) 및 직경의 차이를 쉽게 구분할 수 있다.A plurality of towing lines 200 may be provided to have different colors. Accordingly, in the process of performing endoscopic submucosal dissection, it is possible to easily distinguish between the lengths L1 and L2 and the diameter of the traction line 200 .
복수개의 견인선(200)은 내시경 클립을 통해 병변 조직에 잘 부착될 수 있도록 블랙 실크 봉합사와 같은 실크 봉합사로 형성될 수 있다.The plurality of traction lines 200 may be formed of silk sutures such as black silk sutures so that they can be well attached to the lesion tissue through endoscopic clips.
도시된 예에서는 무게추(100)에 연결되는 견인선(200)의 개수가 2개이나, 3개 이상의 견인선(200)이 마련될 수도 있다.In the illustrated example, the number of tow lines 200 connected to the weight 100 is two, but three or more tow lines 200 may be provided.
이하에서, 상술한 바와 같은 본 발명의 실시예에 따른 조직 견인 장치의 사용 방법에 대해 설명한다. 먼저, 위, 대장, 식도 등 신체 조직 내부의 병변 부위에 내시경을 삽입한 다음, 내시경 채널(20)을 통해 조직 견인 장치(10)를 병변 부위로 삽입한다. 이때, 조직 견인 장치(10)에 이어서 내시경 클립 또한 내시경 채널을 통해 병변 부위로 삽입할 수 있다.Hereinafter, a method of using the tissue retraction device according to an embodiment of the present invention as described above will be described. First, an endoscope is inserted into a lesion site inside a body tissue, such as the stomach, large intestine, or esophagus, and then the tissue traction device 10 is inserted into the lesion site through the endoscope channel 20 . At this time, following the tissue traction device 10, an endoscope clip may also be inserted into the lesion site through the endoscope channel.
조직 견인 장치(10)의 복수개의 견인선 중 하나의 견인선의 견인고리에 내시경 클립을 삽입한 상태에서 조직(병변)으로부터 이격된 주변 부위에 내시경 클립을 고정하여 견인선을 조직 부변 부위에 매달고, 다른 하나의 견인선 역시 견인고리에 내시경 클립을 삽입하여 조직 부분에 고정함으로써 내시경 클립에 의해 매달리도록 한다. 병변의 위치에서 이격되는 위치의 신체 조직에 부착된다.With the endoscope clip inserted into the tow ring of one of the plurality of tow lines of the tissue traction device 10, the endoscopic clip is fixed to the surrounding area away from the tissue (lesion), and the tow line is suspended at the tissue portion, The other traction line is also suspended by the endoscope clip by inserting the endoscope clip into the tow hook and fixing it to the tissue part. It is attached to body tissue at a location remote from the location of the lesion.
이와 같이 복수개의 견인선이 조직과 조직 주변 부위에 매달림에 따라 무게추(100)의 자중이 복수개의 견인선을 통해 조직과 조직 주변 부위로 전달되고, 복수개의 견인선의 장력에 의해 조직이 견인되어 부분적으로 박리된 상태로 유지될 수 있다.In this way, as the plurality of traction lines are suspended from the tissue and surrounding areas, the weight of the weight 100 is transmitted to the tissues and areas around the tissues through the plurality of traction lines, and the tissues are towed by the tension of the plurality of traction lines. It can remain partially exfoliated.
조직의 견인에 따라 점막이 노출되면, 수술용 기구를 이용하여 노출된 병변을 절제하는 등의 수술을 수행할 수 있다. 이에 따라 조직 견인 장치(10)에 의해 병변의 노출 상태가 유지되기 때문에, 병변의 상태를 관찰하기가 용이하며, 병변을 효과적으로 절제할 수 있게 된다.When the mucous membrane is exposed due to tissue traction, an operation such as excision of the exposed lesion may be performed using a surgical instrument. Accordingly, since the exposed state of the lesion is maintained by the tissue traction device 10, it is easy to observe the state of the lesion and it is possible to effectively excise the lesion.
상술한 바와 같은 본 발명의 실시예에 따른 조직 견인 장치(10)는 예를 들어 내시경점막하 박리술을 시행하는 경우 등에 있어 천공의 위험을 줄이고, 시술의 난이도를 낮출 수 있으며, 시술시간이 줄어들어 실제 임상에서 매우 유용하게 활용이 가능하다.As described above, the tissue traction device 10 according to the embodiment of the present invention can reduce the risk of perforation, lower the difficulty of the procedure, and reduce the operation time in the case of, for example, endoscopic submucosal dissection, thereby real clinical results. can be very useful in
도 5는 본 발명의 다른 실시예에 따른 내시경 채널 삽입용 조직 견인 장치의 정면도이다.5 is a front view of a tissue traction device for inserting an endoscopic channel according to another embodiment of the present invention.
중량추(120)는 무게추 본체(100a)는 무게추(100)의 중량 조절이 가능하도록 무게추 헤드(110)에 착탈식(예를 들어, 나사 결합)으로 결합될 수 있다. 이에 의해, 내시경 점막하 박리술을 시행하는 환자의 위벽두께 또는 병변 부위 조직의 특성에 따라 무게추 헤드(110)에 결합되는 중량추(120)의 무게를 조절하여 선택할 수 있다.The weight body 120 may be coupled to the weight head 110 in a detachable manner (eg, screw coupling) so that the weight of the weight body 100a can be adjusted. Accordingly, the weight of the weight 120 coupled to the weight head 110 can be adjusted and selected according to the thickness of the stomach wall of the patient undergoing endoscopic submucosal dissection or the characteristics of the tissue at the lesion site.
지금까지 본 발명에 따른 구체적인 실시예에 관하여 설명하였으나, 본 발명의 범위에서 벗어나지 않는 한도 내에서는 여러 가지 변형이 가능함은 물론이다. 그러므로, 본 발명의 범위는 설명된 실시예에 국한되어 정해져서는 안 되며, 후술하는 청구범위뿐 아니라 이와 균등한 것들에 의해 정해져야 한다. 이상과 같이 본 발명은 비록 한정된 실시예와 도면에 의해 설명되었으나, 본 발명은 상기의 실시예에 한정되는 것은 아니며, 이는 본 발명이 속하는 분야에서 통상의 지식을 가진 자라면 이러한 기재로부터 다양한 수정 및 변형이 가능하다. 따라서, 본 발명 사상은 아래에 기재된 청구범위에 의해서만 파악되어야 하고, 이의 균등 또는 등가적 변형 모두는 본 발명 사상의 범주에 속한다고 할 것이다.Although specific embodiments according to the present invention have been described so far, various modifications are possible without departing from the scope of the present invention. Therefore, the scope of the present invention should not be limited to the described embodiments and should not be defined, but should be defined by not only the following claims but also those equivalent thereto. As described above, the present invention has been described by the limited embodiments and drawings, but the present invention is not limited to the above embodiments, and those skilled in the art in the field to which the present invention belongs can make various modifications and transformation is possible Therefore, the spirit of the present invention should be grasped only by the claims described below, and all equivalent or equivalent modifications thereof will be said to belong to the scope of the spirit of the present invention.

Claims (10)

  1. 내시경 채널을 통해 인체 내의 병변 부위로 삽입 가능한 조직 견인 장치로서,A tissue traction device that can be inserted into a lesion site in the human body through an endoscope channel, comprising:
    상기 내시경 채널에 삽입 가능하도록 장형의 기둥 형상으로 마련되는 무게추; 및a weight provided in a long column shape to be inserted into the endoscope channel; and
    내시경 클립에 의해 상기 병변 부위에 연결되어 상기 병변 부위의 조직을 견인하도록 상기 무게추에 연결되는 복수개의 견인선을 포함하고,It includes a plurality of traction lines connected to the lesion site by an endoscope clip and connected to the weight so as to traction the tissue of the lesion site,
    상기 복수개의 견인선은 상기 조직과 연결을 위해 마련되는 제1 견인선과, 상기 조직의 주변 부위와 연결을 위해 마련되는 제2 견인선을 포함하는,The plurality of traction lines include a first traction line provided for connection with the tissue and a second traction line provided for connection with a peripheral portion of the tissue.
    내시경 채널 삽입용 조직 견인 장치.Tissue retraction device for endoscopic channel insertion.
  2. 청구항 1에 있어서,The method of claim 1,
    상기 제1 견인선은 상기 조직과 연결된 상태에서 상기 무게추의 자중에 따른 장력을 가하여 상기 조직을 견인하도록 구성되고,The first traction line is configured to tow the tissue by applying tension according to the weight of the weight in a state connected to the tissue,
    상기 제2 견인선이 연결되는 상기 주변 부위의 위치에 따라 상기 제1 견인선을 통해 상기 조직에 가해지는 장력이 제어되는,The tension applied to the tissue through the first traction line is controlled according to the location of the peripheral area to which the second traction line is connected.
    내시경 채널 삽입용 조직 견인 장치.Tissue retraction device for endoscopic channel insertion.
  3. 청구항 1에 있어서,The method of claim 1,
    상기 견인선은 상기 무게추에 연결되는 견인사와, 상기 내시경 클립이 삽입되도록 상기 견인사의 단부에 마련되는 원형 고리 형상의 견인 고리를 포함하는, 내시경 채널 삽입용 조직 견인 장치.The traction line includes a traction thread connected to the weight and a circular ring-shaped traction ring provided at an end of the traction thread so that the endoscope clip is inserted.
  4. 청구항 3에 있어서,The method of claim 3,
    상기 무게추는 일단에 무게추 헤드를 구비하는 원기둥 형상의 무게추 본체를 포함하고,The weight includes a cylindrical weight body having a weight head at one end,
    상기 무게추 헤드는 상기 견인사가 감기도록 외주연을 따라 고리 형태로 형성되는 홈부를 구비하는, 내시경 채널 삽입용 조직 견인 기기.The weight head has a groove formed in a ring shape along an outer periphery so that the pulling thread is wound, and a tissue pulling device for endoscopic channel insertion.
  5. 청구항 4에 있어서,The method of claim 4,
    상기 무게추 헤드는 상기 견인사가 상기 홈부에 감긴 상태에서 상기 견인 고리가 인출되도록 상기 무게추 헤드의 중심축을 따라 형성되는 인출홈과, 상기 인출홈과 상기 홈부 사이에 연통되는 복수개의 연결홈을 구비하는, 내시경 채널 삽입용 조직 견인 장치.The weight head is provided with a withdrawal groove formed along the central axis of the weight head so that the towing ring is withdrawn while the pulling thread is wound on the groove portion, and a plurality of connection grooves communicating between the withdrawal groove and the groove portion. A tissue traction device for endoscopic channel insertion.
  6. 청구항 4에 있어서,The method of claim 4,
    상기 무게추 본체는 상기 무게추의 중량 조절이 가능하도록 상기 무게추 헤드에 착탈식으로 결합되는 중량추를 더 포함하는, 내시경 채널 삽입용 조직 견인 장치.The weight body further comprises a weight that is detachably coupled to the weight head so that the weight of the weight can be adjusted.
  7. 청구항 1에 있어서,The method of claim 1,
    상기 복수개의 견인선은 서로 다른 색상을 가지도록 마련되는, 내시경 채널 삽입용 조직 견인 장치.The plurality of traction lines are provided to have different colors, tissue traction device for endoscopic channel insertion.
  8. 청구항 1에 있어서,The method of claim 1,
    상기 복수개의 견인선은 길이 및 직경 중의 적어도 하나가 상이한, 내시경 채널 삽입용 조직 견인 장치.The plurality of traction lines are different in at least one of length and diameter, tissue traction device for endoscopic channel insertion.
  9. 청구항 1에 있어서,The method of claim 1,
    상기 무게추는 10 mm 내지 20 mm의 길이, 1 g 내지 5 g의 무게, 및 2 mm 내지 5 mm의 직경을 가지는, 내시경 채널 삽입용 조직 견인 장치.The weight has a length of 10 mm to 20 mm, a weight of 1 g to 5 g, and a diameter of 2 mm to 5 mm.
  10. 청구항 1에 있어서,The method of claim 1,
    상기 복수개의 견인선은 실크 봉합사로 형성되는, 내시경 채널 삽입용 조직 견인 장치.The plurality of traction lines are formed of silk sutures, tissue traction device for endoscopic channel insertion.
PCT/KR2022/020108 2021-12-15 2022-12-12 Tissue retraction apparatus for endoscope channel insertion WO2023113397A1 (en)

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KR1020210179477A KR20230090585A (en) 2021-12-15 2021-12-15 Apparatus for traction of tissue capable of insertion through endoscope channel

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Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20060149135A1 (en) * 2003-07-02 2006-07-06 Adrian Paz Virtual ports devices and method
JP5771602B2 (en) * 2010-04-06 2015-09-02 日立化成株式会社 Polymer molded body for pulling biological tissue, medical pulling member and medical puller using the same
KR101838553B1 (en) * 2017-07-20 2018-03-14 고려대학교 산학협력단 Tissue traction instrument using magnet attached for endoscopic submucosal dissection
KR20180065437A (en) * 2016-12-08 2018-06-18 박성재 Retractor for fixing endoscope
JP2020508773A (en) * 2017-03-01 2020-03-26 ユニヴェルシテ・リブレ・ドゥ・ブリュッセル Equipment for shearing tissue

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20060149135A1 (en) * 2003-07-02 2006-07-06 Adrian Paz Virtual ports devices and method
JP5771602B2 (en) * 2010-04-06 2015-09-02 日立化成株式会社 Polymer molded body for pulling biological tissue, medical pulling member and medical puller using the same
KR20180065437A (en) * 2016-12-08 2018-06-18 박성재 Retractor for fixing endoscope
JP2020508773A (en) * 2017-03-01 2020-03-26 ユニヴェルシテ・リブレ・ドゥ・ブリュッセル Equipment for shearing tissue
KR101838553B1 (en) * 2017-07-20 2018-03-14 고려대학교 산학협력단 Tissue traction instrument using magnet attached for endoscopic submucosal dissection

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