Incision instrument, incision apparatus, and organ incision method

Abstract

The incision instrument of the present invention includes: a substantially rod-shaped electrode that has one end and the other end; a cable that has one end that is electrically connected to the electrode; and a connecting portion that is provided at the other end of the cable and is connectable to a high frequency power supply.

1 . An incision instrument comprising: 
 a substantially rod-shaped electrode that has one end and the other end;    a cable that has one end that is electrically connected to the electrode; and    a connecting portion that is provided at the other end of the cable and is connectable to a high frequency power supply.    
   
   
       2 . The incision instrument according to  claim 1 , wherein the cable is covered by an insulating tube that provides electrical insulation.  
   
   
       3 . An incision apparatus comprising: 
 a puncture needle in which is formed a lumen that extends from a proximal end to a distal end of the puncture needle;    an incision instrument that includes a substantially rod-shaped electrode that has one end and the other end, a cable that has one end that is electrically connected to the electrode, and a connecting portion that is provided at the other end of the cable and is connectable to a high frequency power supply, and in which at least the electrode is inserted into the lumen from the distal end of the puncture needle; and    a pusher that is inserted into the lumen from the proximal end of the puncture needle and that is adapted to push the electrode of the incision instrument out from the distal end of the puncture needle.    
   
   
       4 . An incision apparatus comprising: 
 a flexible sheath;    a flexible puncture needle in which is formed a lumen that extends from a proximal end to a distal end of the puncture needle, and that is inserted into the sheath and is adapted to retractably protrude from a distal end of the sheath;    an incision instrument that includes a substantially rod-shaped electrode that has one end and the other end, a cable that has one end that is electrically connected to the electrode, and a connecting portion that is provided at the other end of the cable and is connectable to a high frequency power supply, and in which at least the other end of the cable is inserted into the lumen from the distal end of the puncture needle; and    a pusher that is inserted into the lumen from the proximal end of the puncture needle and whose distal end is engaged by the other end of the cable of the incision instrument, and that is adapted to push the other end of the cable out from the distal end of the puncture needle.    
   
   
       5 . A method of making an incision in an organ comprising: 
 piercing, by a puncture needle, an abdominal wall and an organ that is to be incised;    disposing, via the puncture needle, a substantially rod-shaped electrode inside the organ, and disposing the other end of a cable whose one end is electrically connected to the electrode outside a body through the organ and the abdominal wall;    performing insufflation using a conduit that has been introduced into an abdominal cavity so as to form a space between the abdominal wall and the organ;    pulling the cable towards the other end side so that the electrode that is connected to the one end of the cable is placed in contact with an incision position of the organ, and the incision position of the organ is pulled into the space that is formed between the abdominal wall and the organ; and    supplying power to the cable so that an incision is made by the electrode at the incision position of the organ.    
   
   
       6 . The method of making an incision in an organ according to  claim 5 , wherein a lumen is formed in the puncture needle, and the method comprises: 
 inserting at least the electrode into the lumen and retaining the other end of the cable at the proximal end of the puncture needle;    piercing the puncture needle so as to penetrate as far as the interior portion of the organ from the body exterior via the abdominal wall; and    pushing the electrode out from the distal end of the puncture needle so that the electrode is disposed inside the organ, and the other end of the cable is disposed outside the body through the organ and the abdominal wall.    
   
   
       7 . The method of making an incision according to  claim 6 , comprising: introducing an observation apparatus through a natural orifice into an interior portion of the organ.  
   
   
       8 . The method of making an incision in an organ according to  claim 5 , wherein the inserting of the puncture needle includes making the puncture needle, which has been introduced through the natural orifice of the body into the interior portion of the organ, penetrate as far as the body exterior from the interior portion of the organ via the abdominal wall, and the positioning of the other end of the cable outside the body includes pushing the other end of the cable, which is accommodated inside the lumen that is formed in the puncture needle, out from the distal end of the puncture needle so that the other end of the cable is forwarded to the body exterior from the interior portion of the organ.  
   
   
       9 . The method of making an incision in an organ according to  claim 8 , wherein the positioning of the electrode in the interior portion of the organ includes: 
 after sending forward the other end of the cable to the body exterior from the distal end of the puncture needle in whose lumen the other end of the cable and the electrode have been accommodated, pulling back the distal end of the puncture needle into the interior portion of the organ while the electrode is still accommodated inside the lumen; and    after pulling the puncture needle into the interior portion of the organ, pulling out the accommodated electrode from the lumen.    
   
   
       10 . The method of making an incision in an organ according to  claim 8 , comprising introducing an observation apparatus is through the natural orifice into the interior portion of the organ.  
   
   
       11 . The method of making an incision in an organ according to  claim 10 , comprising: 
 introducing an endoscope provided with the observation apparatus through the natural orifice;    introducing the puncture needle from a channel in the endoscope into the interior portion of the organ; and    making the puncture needle penetrate as far as the body exterior via the abdominal wall.    
   
   
       12 . The method of making an incision in an organ according to  claim 5 , comprising placing a side surface portion of the electrode in contact with the incision position of the organ.  
   
   
       13 . The method of making an incision in an organ according to  claim 5 , wherein the organ is a stomach.  
   
   
       14 . The method of making an incision in an organ according to  claim 13 , wherein an incision is made in a front wall of the stomach as the incision position.  
   
   
       15 . The method of making an incision in an organ according to  claim 5 , wherein the insufflation of the abdominal cavity is performed by causing an insufflation needle to penetrate the abdominal wall from the body exterior.  
   
   
       16 . The method of making an incision in an organ according to  claim 5 , wherein the insufflation of the abdominal cavity is performed by inserting an insufflation needle through a natural orifice into the interior portion of the organ and then causing the insufflation needle to penetrate the organ.  
   
   
       17 . The method of making an incision in an organ according to  claim 5 , further comprising: 
 introducing a conduit into the interior portion of the organ through a natural orifice of a body; and    supplying a gas using the conduit into the interior portion of the organ so as to inflate the organ, and wherein the making of the puncture needle to penetrate includes making the puncture needle penetrate the organ that has been inflated by the supplied gas and the abdominal wall.    
   
   
       18 . The method of making an incision in an organ according to  claim 5 , wherein the pulling of the cable towards the other end side includes: 
 fixing the other end side of the cable to a fixing instrument that is mounted on a surface of the abdominal wall so that a length between the fixed position of the abdominal wall and the electrode is held substantially constant; and    moving, by using the insufflation, the position on the abdominal wall that is in the vicinity of the fixing instrument relatively to the organ so that the cable is pulled towards the other end side.    
   
   
       19 . The method of making an incision in an organ according to  claim 5 , wherein the pulling of the cable to the other end side includes dragging the cable.