JP2000245744A - Electric surgical machine - Google Patents

Abstract

PROBLEM TO BE SOLVED: To improve the operability by reducing the difference in delay time of the start of operation caused by the difference in treatment tools, and reducing the difference in operation sense. SOLUTION: High frequency generated in a waveform generating circuit 33 is amplified by a variable amplifier circuit 34 capable of controlling its amplification ratio by a control circuit 32, and transmitted to a high frequency cauterizing treatment tool 3 through a boosting circuit 35 and the like, a part to be treated is heated, and the surgical removal operation and the like is started after the delay time necessary for the impedance of the part to be treated to increase to a predetermined value. The control circuit 32 controls the constant current on the basis of constant target current in accordance with a current value and the like obtained by an output current measuring circuit 37 and the like during this delay time. On this occasion, the difference in delay time is reduced by switching the target current value by a treatment tool selecting switch 12b corresponding to the kind of high frequency cauterizing treatment tool 3, whereby the difference in operation sense can be reduced, and the operability can be improved.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an electrosurgical apparatus for performing medical treatment such as ablation or coagulation on living tissue using a high-frequency current.

[0002]

2. Description of the Related Art Conventionally, there has been known an electrosurgical apparatus for performing a procedure such as excision or coagulation on a living tissue or the like using a high-frequency current. Such an electrosurgical apparatus generally includes a high-frequency ablation power supply device that generates a high-frequency current, and a high-frequency ablation treatment tool including an active electrode that contacts a treatment target site of a patient and performs a medical treatment with the high-frequency current. It is configured. As a type of the high-frequency ablation treatment instrument, a monopolar treatment instrument and a bipolar treatment instrument are known. The monopolar treatment device is connected to one output terminal of the high-frequency ablation power supply device, and is connected to the active electrode portion to be brought into contact with the treatment target portion of the patient, and the other output terminal is connected to the body surface other than the treatment target portion of the patient. And a return electrode portion which is brought into surface contact with the device. Then, high-frequency power is generated by the high-frequency ablation power source device, the high-frequency current flows intensively into the living tissue by bringing the active electrode into contact with the treatment target site, and the high-frequency current is dispersed and collected from the return electrode. Medical treatments such as tissue resection and coagulation can be performed. In addition, the bipolar treatment tool does not have a return electrode, and the active electrode portion is connected to both output terminals of the high-frequency ablation power supply device. Further, there are various types of electrode shapes of the active electrode portion depending on the application. For example, a loop-shaped loop electrode as shown in FIG.
A band-shaped band electrode as shown in FIG. 11B and a roller-shaped roller electrode as shown in FIG.

Generally, the output power of an electrosurgical device is
The characteristics shown in FIG. 12 are shown with respect to the load impedance which is the impedance of the living tissue. That is, when the load impedance is within a predetermined range from the rated load impedance, the rated output power required to perform the treatment on the treatment target site is obtained, and when the load impedance is smaller or larger than this range, the output power is And the output power required to perform the treatment on the treatment target site cannot be obtained. Since the living tissue before the supply of the high-frequency power to the active electrode section is started contains a large amount of water, the load impedance is small and the rated output power cannot be obtained.

When the supply of high-frequency power to the active electrode portion is started, the moisture generated in the living tissue by the heat generated in the living tissue by the high-frequency power and the heat transmitted from the active electrode portion to the living tissue by the high-frequency power. Decrease, tissue degeneration occurs, and the load impedance increases over time, as shown in FIG. Then, the voltage drop due to the load impedance increases, and the output voltage of the electrosurgical apparatus increases. When the output voltage reaches a predetermined voltage VE, an arc discharge starts from the active electrode portion to the living tissue, and an action such as an excision action on the living tissue starts due to the arc discharge. In addition, the action on living tissue is
By modulating the waveform of the high-frequency current as well as the ablation action, a coagulation action can be performed, and thereby hemostasis can be performed. The curves a, b, c in the figure
Indicates differences in characteristics due to differences in the electrode shape, size, volume, material, and the like of the active electrode.

[0005] As described above, the electrosurgical apparatus generally has a problem in that a delay occurs from the start of the output of electric power to the start of the resection / coagulation action on the treatment target site. Therefore, if the output current is increased to accelerate the degeneration of the living tissue, the load impedance increases quickly, but there is a problem that excessive power is output after the load impedance reaches a required value. Was.

Therefore, for example, in Japanese Patent Publication No. 2542058, by controlling the output current to increase for a predetermined time after the start of power output, during a period in which the load impedance is small immediately after the start of power output, There is shown a means capable of outputting an increased electric power to accelerate tissue degeneration and outputting an appropriate electric power after a predetermined time.
Thereby, the delay time from the start of the output of the electric power to the start of the excision / coagulation action is reduced.

[0007]

However, on the other hand,
As shown in FIG. 13, the delay time until the excision / coagulation action starts differs depending on the shape and material of the active electrode constituting the high-frequency ablation instrument, such as the size and volume. For example, a loop electrode shown in FIG.
The electrode shape such as the volume is different between the band electrode shown in FIG. 11B and the roller electrode shown in FIG. 11C, and a difference occurs in the delay time until the excision / coagulation action starts. Then, depending on the electrode shape etc. of the active electrode used,
There is a problem that the operation feeling is different and the operability is poor.
The present invention has been made in view of the above circumstances, and reduces the difference in the delay time of the action start due to the difference in the treatment tool,
An object of the present invention is to provide an electrosurgical apparatus that improves operability by reducing a difference in operation feeling.

[0008]

In order to achieve the above object, the present invention provides a medical treatment for a treatment target site by applying electric energy to the treatment target site by contacting the treatment target site. An electrosurgical apparatus capable of selectively connecting a plurality of types of active electrodes, comprising: a power supply including constant current control means for maintaining a current value of a current supplied to the active electrodes at a given target current value; Target current value selecting means for selecting the target current value according to the type of active electrode connected to the power supply among a plurality of types of active electrodes.

[0009]

Embodiments of the present invention will be described below with reference to the drawings.

(First Embodiment) FIGS. 1 to 5 relate to a first embodiment of the present invention. FIG. 1 is an explanatory view showing the overall configuration of an electrosurgical apparatus, and FIG. 2 is an operation panel. FIG. 3 is a block diagram showing a configuration of a high-frequency ablation power supply device, FIG. 4 is a block diagram showing a configuration of a control circuit, and FIG. 5 is an explanatory diagram showing characteristics of output power with respect to load impedance.

As shown in FIG. 1, an electrosurgical apparatus 1 according to the present embodiment contacts a patient 2 to apply high-frequency power,
Induction cautery treatment device 3 for performing ablation and coagulation treatment on treatment target site 2a, and induction cautery power supply device 4 for generating high frequency power to be supplied to this induction cauterization treatment device 3
Is connected to this high-frequency ablation power supply 4 with a cable,
It has a foot switch 5 for instructing output of high-frequency power. The high-frequency ablation power supply 4 includes:
It has two output terminals 11 a and 11 b for outputting power to be supplied to the high-frequency ablation treatment tool 3, and an operation panel 12 for performing operations such as operation setting of the high-frequency ablation power supply device 4.

The high-frequency cautery treatment instrument 3 has an active electrode portion 21 having an electrode 21a for performing a treatment in contact with a treatment target portion 2a, and extends from the active electrode portion 21, and the other end is electrically connected to the output terminal 11a. A cable 22 that is electrically connected;
A return electrode portion 23 that comes into surface contact with the body surface 2b other than the treatment target site 2a of the patient 2, and extends from the return electrode portion 23;
The other end has a cable 24 connected to the output terminal 11b. That is, in the example of the present embodiment, the high-frequency ablation treatment tool 3 is a monopolar treatment tool.

The foot switch 5 is, for example, an ablation switch 5 for instructing generation of a high frequency ablation power.
a, and a coagulation switch 5b for instructing generation of high-frequency power for coagulation.

The foot switch 5 is not limited to a foot switch, but may be any means capable of instructing the high-frequency ablation power supply 4 to generate high frequency. For example, a switch may be provided on the active electrode section 21 or the like. . Operation panel 1
Part or all of 2 may be provided not only fixedly to the housing of the high-frequency ablation power supply 4, but also via a cable, may be provided on the foot switch 5, or may be provided on the active electrode unit. 21 may be provided.

As shown in FIG. 2, the operation panel 12
Is a display unit 12a on which the type of electrode shape of the electrode 21a of the active electrode unit 21 of the connectable high-frequency cautery treatment instrument 3 is described.
And an electrode 21a having an electrode shape described on the display section 12a.
And a treatment tool selection switch 12b for selecting the high frequency ablation treatment tool 3 having the above. In the example of the figure, as the electrode shape, "loop electrode" and "band electrode"
And “roller electrode” can be selected. In addition, not only the shape of the electrode but also other indications indicating the type of the electrode 21a and other indications indicating the type of the high-frequency ablation instrument 3 may be written on the display unit 12a. The treatment tool selection switch 12b is not limited to a rotary switch as shown in the figure, and may be, for example, a push button switch or another switch. Further, for example, a lamp 1 for displaying a selected electrode shape or the like.
2c may be provided near the display unit 12a.

As shown in FIG. 3, the inside of the high-frequency ablation power supply 4 converts a power supplied from a commercial power supply or the like into a power supply circuit 31 for supplying power to each part of the high-frequency ablation power supply 4. A control circuit 32 for controlling each part of the high-frequency ablation power supply 4, a waveform generation circuit 33 controlled by the control circuit 32 to generate a high frequency of a waveform used for treatment, and a waveform obtained by the waveform generation circuit 33 A variable amplifying circuit 34 for amplifying the high frequency in accordance with an amplification factor instructed by the control circuit 32, a boosting circuit 35 for boosting the high frequency obtained by the variable amplifying circuit 34 and outputting the boosted high frequency to the output terminals 11a and 11b; The output terminal 1
An output voltage measurement circuit 36 and an output current measurement circuit 37 for measuring high-frequency output voltages and output currents output to 1a and 11b, respectively, and an output voltage value signal and an output current measurement circuit obtained by these output voltage measurement circuits 36 The output current value signal obtained at 37 is A / D converted and supplied to the control circuit 32 by A / D conversion circuits 36a and 37a.

The control circuit 32 is composed of, for example, hardware, such as a microprocessor 32a, and a storage element (not shown) for storing a program to be executed by the microprocessor 32a. The control circuit 32 includes a signal supplied from the foot switch 5, a signal supplied from the treatment tool selection switch 12b, the output voltage measurement circuit 36, and the output current measurement circuit 3.
7, a control signal instructing a waveform generated by the waveform generating circuit 33 to the waveform generating circuit 33 in accordance with signals provided via A / D conversion circuits 36a and 37a, and the variable amplifying circuit 34 And a control signal for instructing the variable amplification circuit 34 via the D / A conversion circuit 34a.

The waveform generating circuit 33 includes, for example, a high frequency generating circuit 33a for generating a high frequency and the control circuit 32
And a modulation signal generation circuit 33b for generating a signal of a waveform for ablation, a signal of a waveform for coagulation, and the like, and a high frequency obtained by the high frequency generation circuit 33a is obtained by the modulation signal generation circuit 33b. Modulation circuit 33 that modulates with a signal
c.

The booster circuit 35 includes, for example, a booster transformer 35a that inputs the high frequency obtained by the variable amplifier circuit 34 from the primary side and outputs the high frequency boosted from the secondary side. . At this time, this step-up transformer 3
A capacitor connected in series to the secondary side of 5a and removing a DC component may be provided. Further, a capacitor for parallel resonance may be provided on the primary side of the step-up transformer 35a.

As shown in FIG. 4, the control circuit 32
Functionally, a control signal is supplied to the waveform generation circuit 33 in response to an instruction signal from the foot switch 5, and a high frequency of a waveform corresponding to the content of treatment such as excision or coagulation is output from the waveform generation circuit 33. The output voltage measurement circuit 36 controls the waveform control circuit 41 for controlling the waveform generation circuit 33.
And a load impedance calculating unit 42 that receives the output voltage value signal and the output current value signal obtained from the output current measurement circuit 37 via the A / D conversion circuits 36a and 37a to calculate the load impedance, An output power calculation unit 43 that receives the output voltage value signal and the output current value signal obtained from the voltage measurement circuit 36 and the output current measurement circuit 37 via the A / D conversion circuits 36a and 37a, respectively, and calculates the output power. And the output voltage measuring circuit 36
, Through the A / D conversion circuit 36a, an output voltage value signal is input, and a constant voltage for obtaining an amplification factor signal for controlling the variable amplification circuit 34 to maintain the output voltage from the high-frequency ablation power supply 4 constant. A control unit 44 and the output power calculation unit 4
A constant power control unit 45 that receives the output power value signal obtained in Step 3 and obtains an amplification signal for controlling the variable amplification circuit 34 so as to maintain the output power from the high-frequency ablation power supply 4 constant; An output current value signal is input from the output current measurement circuit 37 via an A / D conversion circuit 37a, and amplification for controlling the variable amplification circuit 34 to keep the output current from the high frequency ablation power supply 4 constant. A constant current control unit 46 for obtaining a rate signal and a load impedance signal obtained by the load impedance calculation unit 42 are input, and an amplification factor signal obtained by the constant voltage control unit 44 according to the load impedance range. And one of the gain signal obtained by the constant power control unit 45 and the gain signal obtained by the constant current control unit 46 is selectively passed, and the passed gain signal is transmitted to the D / A conversion And is configured with a control characteristic selection unit 47 via the road 34a gives to the variable amplifier circuit 34.

The load impedance calculator 42 calculates a load impedance by dividing the output voltage signal and the output current signal, for example.

The output power calculator 43 calculates the output power by, for example, multiplying the output voltage value signal by the output current value signal.

The constant voltage control section 44 includes a target voltage value storage section 44a for storing a target voltage value to be kept constant, a voltage value comparison section 44b for detecting a difference between the output voltage value and the target voltage value, It has a gain adjusting section 44c for adjusting the gain applied to the variable amplifier circuit 34 according to the output of the voltage value comparing section 44b.

The constant power control unit 45 detects a difference between an output voltage value obtained by the output power calculation unit and a target power value storage unit 45a for storing a target power value to be kept constant. Power value comparing section 45b and the variable amplifying circuit 34 according to the output of the power value comparing section 45b.
It has an amplification rate adjusting section 45c for adjusting the amplification rate applied to the power supply.

The constant current control section 46 stores, for example, three target current value storage sections 51a and 51 for storing target current values to be kept constant corresponding to a plurality of types of electrode shapes and the like.
b, 51c, and the target current value storage units 51a, 51b, 51c according to the state of the treatment tool selection switch 12b.
And a current value comparing section for detecting a difference between the output current value and a target current value obtained by passing through the target current value selecting section 52. 53, and an amplification factor adjusting unit 54 for adjusting the amplification factor applied to the variable amplification circuit 34 in accordance with the output of the current value comparison unit 53.

For example, when the value of the load impedance obtained by the load impedance calculator 42 falls within a predetermined range from the rated load impedance, the control characteristic selector 47 obtains the value by the constant power controller 45. When the load signal is passed and the load impedance value is smaller than a predetermined range, the gain signal obtained by the constant current controller 46 is passed and when the load impedance value is larger than a predetermined range. Is designed to allow the amplification factor signal obtained by the constant voltage control section 44 to pass therethrough.

Next, the operation of the present embodiment will be described. First, in using the electrosurgical apparatus 1, the cables 22 and 24 of the high-frequency ablation instrument 3 are connected to the output terminals 11a and 11b of the high-frequency ablation power supply 4, and the type of the connected high-frequency ablation instrument 3 is treated. The selection is made with the tool selection switch 12b, and the return electrode unit 23 is brought into surface contact with the body surface 2b other than the treatment target site 2a of the patient 2. Here, by selecting the type of the high-frequency ablation treatment tool 3 with the treatment tool selection switch 12b, the target current value selection unit 52 becomes the target current value storage unit corresponding to each of the plurality of types of the high-frequency ablation treatment tool 3. Of the target current values supplied from 51a, 51b, and 51c, the target current value corresponding to the type of the selected high-frequency ablation treatment tool 3 is passed and supplied to the current value comparison unit 53.

Next, in order to cut or coagulate the treatment target portion 2a of the patient, the electrode 21a of the active electrode section 21 is brought into contact with the treatment target portion 2a, and the cutout switch 5a or the coagulation switch 5b of the foot switch 5 is operated. Manipulate. Then, the waveform control unit 41 of the control circuit 32
A control signal is output to the control unit 3 so as to output a high frequency of a waveform for ablation or a waveform for coagulation. Then, the waveform generating circuit 33 generates a high frequency of a waveform for ablation or a waveform for coagulation according to the given control signal, and the high frequency is
It is amplified by the variable amplifier circuit 34, boosted by the booster circuit 35, and given to the high-frequency cautery treatment instrument 3 via the output terminals 11a and 11b. Then, a high-frequency current is applied to the treatment target portion 2a in contact with the electrode 21a, and the treatment target portion 2a is heated by the high-frequency current, and the treatment target portion 2a is heated by the electrode 21a heated by the high-frequency current. At this time, the current from the electrode 21a of the active electrode unit 21 intensively flows into the treatment target site 2a, and the current flowing into the treatment target site 2a returns to the body surface 2b other than the treatment target site 2a. Since it is dispersed and collected by the electrode unit 23, energy given to the living tissue other than the treatment target site 2a is suppressed. Further, by forming the feedback electrode section 23 larger than the electrode 21a of the active electrode section 21, heat generation of the feedback electrode section 23 is suppressed.

When the high-frequency current is applied to the high-frequency cautery treatment tool 3, the load impedance of the living tissue at the target site 2 a is small and the load impedance of the heated target site 2 a reaches a predetermined value. Resection
No coagulation action occurs.

When high-frequency power is output from the high-frequency ablation power supply 4, the high-frequency output voltage and output current are measured by the output voltage measurement circuit 36 and the output current measurement circuit 37, respectively, and the obtained output voltage value signal is obtained. And the output current value signal are supplied to the control circuit 32 via A / D conversion circuits 36a and 37a, respectively. Then, the constant voltage control unit 44 compares the given output voltage value with the target voltage value, and outputs an amplification factor signal adjusted to maintain the output voltage value at the target voltage value. Further, the output power calculation unit 43 calculates an output power value from the given output voltage value and output current value, and the constant power control unit 45 compares the output power value with the target power value and outputs the output power value. Output the amplification factor signal adjusted to maintain the target power value. Further, the constant current control unit 46
Compares a given output current value with a target current value and outputs an amplification signal that is adjusted to maintain the output current value at the target current value. Further, the load impedance calculation unit 42
The load impedance is calculated from the given output voltage value signal and output current value signal, and the control characteristic selecting unit 47 is controlled according to the range of the load impedance. here,
When the load impedance is smaller than the predetermined range,
The control characteristic selection unit 47 allows the gain signal obtained by the constant current control unit 46 to pass therethrough, and the gain signal is supplied to the variable amplifier circuit 34 via the D / A conversion circuit 34a. The circuit 34 adjusts the high frequency amplification factor according to the applied amplification factor signal.

That is, as shown in FIG. 5, when the load impedance is smaller than a predetermined range, the output high frequency is controlled with a constant current. Here, the characteristic curves α, β, and γ in the constant current control region in the figure show the difference in characteristics due to the difference in the target current value selected by the treatment tool selection switch 12b according to the type of the high-frequency ablation treatment tool 3. I have. That is, the electrode 21a of the high-frequency cautery treatment instrument 3 has a small electrode 2 like a loop electrode.
In the case of 1a, the current density flowing through the electrode 21a is large, and the heating of the electrode 21a is fast, so that a small target current value is selected, and a control characteristic indicated by, for example, a characteristic curve α in the figure is obtained. When the electrode 21a is a large electrode 21a like a roller electrode, the current density flowing through the electrode 21a is small and the heating of the electrode 21a is slow, so that a large target current value is selected. The control characteristic indicated by γ is obtained. Thus, the difference in the amount of heating of the treatment target portion 2a due to the difference in the type of the electrode 21a of the high-frequency cautery treatment tool 3 is reduced, and the difference in the speed of increase in the load impedance of the treatment target portion 2a is reduced.

When the living tissue of the heated treatment target site 2a is denatured due to a decrease in water content, the load impedance increases, and the load impedance falls within a predetermined range from the rated load impedance. Then, the output voltage increases, and the excision or coagulation action starts on the treatment target portion 2a. When the load impedance becomes a value within a predetermined range, the control characteristic selection unit 47 that has obtained the load impedance value calculated by the load impedance calculation unit 42 passes the amplification factor signal obtained by the constant power control unit 45, The signal is supplied to the variable amplifier circuit 34 via the D / A conversion circuit 34a. That is, as shown in FIG. 5, when the load impedance is within the predetermined range, the output high frequency is controlled at a constant power.

When the load impedance becomes larger than the predetermined range, the control characteristic selector 47 obtains the load impedance value calculated by the load impedance calculator 42.
Passes the gain signal obtained by the constant voltage control unit 44 and supplies it to the variable amplifier circuit 34 via the D / A conversion circuit 34a. That is, as shown in FIG. 5, when the load impedance is larger than the predetermined range, the output high frequency is controlled at a constant voltage.

As described above, according to the present embodiment, when the load impedance of the treatment target portion 2a is smaller than the predetermined range, the output high frequency is controlled by the constant current,
At this time, the output high frequency is controlled at a constant current so as to maintain a different target current value in accordance with the shape of the electrode 21a of the active electrode portion 21 of the high-frequency cautery treatment tool 3. As a result, the difference in the delay time from the time when the foot switch 5 is operated to the time when the excision / coagulation action starts is reduced, and the difference in operation feeling due to the difference in the delay time is reduced, thereby improving the operability. Can be In addition, when the load impedance of the treatment target portion 2a is within a predetermined range in which the excision and coagulation action can be given to the treatment target portion 2a, the output high frequency is controlled at a constant power. This stabilizes the high-frequency energy applied to the treatment target site 2a for providing the resection / coagulation action, and improves operability. Further, when the load impedance of the treatment target portion 2a is larger than the predetermined range, the output high frequency is controlled at a constant voltage, so that the output power is prevented from becoming excessive, and the arc discharge can be stably generated. it can.

The selection item selected by the treatment tool selection switch 12b is not limited to information indicating the type of electrode shape, but may be, for example, information indicating the size or volume of the electrode, or indicating the material of the electrode. It may be information. At this time,
In general, information on the size, volume and material of the electrode is correlated with the delay time from the start of heating to the start of ablation / coagulation, and it is possible to select the target current value from this information. is there. For example, when using the same voltage,
The delay time can be adjusted by changing the target current value. This allows for incisions,
The time to coagulation can be selected or variable. The selection item selected by the treatment tool selection switch 12b is information corresponding to a name that can identify information such as an electrode shape, an electrode size, a volume, and a material, and that can identify an electrode type such as an electrode model number. There may be. In addition to controlling the high-frequency waveform and controlling the current value according to the operation of the excision switch 5a and the coagulation switch 5b of the foot switch 5, that is, according to the operation of excision or coagulation. Is also good.

FIG. 6 relates to a first modification of the first embodiment and is an explanatory view showing the configuration of a high-frequency ablation instrument. In this modification, the same components as those in the first embodiment are denoted by the same reference numerals, and description thereof is omitted. As in the present modified example shown in FIG. 6, instead of the monopolar high-frequency ablation instrument 3 of the first embodiment (see FIG. 1), a bipolar high-frequency ablation instrument 3a is connected to the high-frequency ablation power supply device 4. It may be connected and used. The high-frequency treatment instrument 3a includes, for example, an active electrode unit 7 including two electrodes 71a and 71b that are in contact with a treatment target portion 2a of the patient 2.
1 and cables 72a and 72b for electrically connecting the electrodes 71a and 71b to the output terminals 11a and 11b of the high-frequency ablation power supply 4, respectively. As described in the present modification, the high-frequency ablation instrument constituting the electrosurgical apparatus 1 may be a monopolar type or a bipolar type.

FIG. 7 is a block diagram showing a configuration of a control circuit according to a second modification of the first embodiment. In addition,
In the present modified example, the same reference numerals are given to portions configured substantially the same as in the first embodiment, and description thereof will be omitted. Also, the points different from the first embodiment will be mainly described.

This modified example has the same function as that of the first embodiment, and shows an example of the mounting form of the control circuit 32 described with reference to FIG. As shown in FIG. 7, in the control circuit 32 of the present modification, the waveform control unit 41
The amplification factor adjustment unit 44c, the amplification factor adjustment unit 45c, the amplification factor adjustment unit 54, and the control characteristic selection unit 47 are configured by the microprocessor 32a. The load impedance calculation unit 42 (see FIG. 4) is a hardware circuit having a similar role.
The output power calculation unit 43 (see FIG. 4) is a hardware circuit having a similar role.
02, and the voltage value comparison unit 44b (see FIG. 4)
Voltage value comparison circuit 1 which is a hardware circuit having a similar role.
12, a target voltage value storage unit 44a (see FIG. 4).
Is a trimmer 111 which is a hardware circuit having a similar role.
And the power value comparison unit 45b (see FIG. 4) is a hardware circuit having a similar role.
The target power value storage unit 45a (see FIG. 4)
The current value comparing section 53 (see FIG. 4) is constituted by a trimmer 121 which is a hardware circuit having a similar role, and is constituted by a current value comparing circuit 133 which is a hardware circuit having a similar role. 51a, 51b, 51c (FIG. 4)
) Is composed of trimmers 131a, 131b, and 131c, which are hardware circuits having the same role. The target current value selection unit 52 (see FIG. 4) is a hardware circuit having the same role. 132. Also, from the output of the hardware circuit whose output signal is not supplied to the microprocessor 32a, the A / D conversion circuit is appropriately deleted, and the output signal is output to the microprocessor 32a.
An A / D conversion circuit is appropriately inserted in the output of the hardware circuit directly supplied to a. The output voltage measuring circuit 36, the output current measuring circuit 37, the load impedance measuring circuit 101, the output power measuring circuit 102, the trimmer 1
11, voltage value comparison circuit 112, trimmer 121, power value comparison circuit 122, trimmers 131a, 131b, 131c,
Of course, the output signal of each circuit of the current value comparison circuit 133 may be a signal of a voltage corresponding to the output value of each circuit.

When the control circuit 32 is mounted as in the present modification, the processing of the control circuit 32 can be performed faster than when the functions constituting the control circuit 32 are all mounted, for example, by the microprocessor 32a. There is.

(Second Embodiment) FIGS. 8 to 10 relate to a second embodiment of the present invention. FIG. 8 is an explanatory diagram showing the configuration of an operation panel, and FIG. 9 shows the configuration of a control circuit. FIG. 10 is a block diagram illustrating the operation procedure. Note that, in the present embodiment, the same reference numerals are given to portions configured substantially the same as in the first embodiment, and description thereof will be omitted. Also, the points different from the first embodiment will be mainly described.

As shown in FIG. 8, in this embodiment, an operation panel 201 is provided in place of the operation panel 12 (see FIG. 2) of the first embodiment. In the operation panel 201, the display unit 12a that displays the selection items selected by the treatment tool selection switch 12b includes, in addition to the selection items indicating the type of the high-frequency ablation treatment tool 3 such as the electrode shape, the high-frequency ablation such as the electrode shape. The selection item 202 includes, for example, “automatic electrode selection” for selecting an operation mode for automatically selecting the type of the treatment tool 3.

As shown in FIG. 9, in the present embodiment, a control circuit 211 is provided instead of the control circuit 32 (see FIG. 4) of the first embodiment. In the control circuit 211, the treatment instrument automatic selection unit 2 is provided in the middle of a signal given from the treatment instrument selection switch 12b to the constant current control unit 46.
21 is inserted.

The treatment instrument automatic selection unit 221 includes, for example, a load impedance storage unit 231 for storing the load impedance calculated by the load impedance calculation unit 42 when the foot switch 5 is operated, and a load impedance storage unit 231. Is compared with the respective impedance values when the electrodes of each of the high-frequency cautery treatment tools 3 are short-circuited to the return electrode unit 23, and for example, the high-frequency ablation treatment tool 3 having the closest impedance is selected. An impedance comparison unit 232 for obtaining a treatment tool selection signal, and a constant current control unit 46 which selectively passes the treatment tool selection signal from the treatment tool selection switch 12b and the treatment tool selection signal obtained by the impedance comparison unit 232.
And a treatment tool selection signal selection unit 233 to be given to the patient. When the selection item 202 is selected by the treatment tool selection switch 12b, the treatment tool selection signal selection unit 233 allows the treatment tool selection signal obtained by the impedance comparison unit 232 to pass therethrough, and other than the selection item 202. When selected, a treatment tool selection signal from the treatment tool selection switch 12b is passed.

Next, the operation of the present embodiment will be described. In the present embodiment, points different from the first embodiment will be mainly described. Prior to the case, the selection item 202 is selected with the treatment tool selection switch 12b, and as shown in FIG.
The electrode 21a of the active electrode 21 of the high-frequency ablation instrument 3 is brought into contact with a predetermined position of the return electrode 23, and for example, the excision switch 5a of the foot switch 5 is operated. Then, by operating the excision switch 5a, a high-frequency current is output from the high-frequency ablation power supply device 4 to the high-frequency ablation treatment tool 3, and
The impedance at the time of short-circuiting the high-frequency cautery treatment tool 3 is calculated by the load impedance calculation unit 42 and stored in the impedance storage unit 231. At this time, if the electrode shape of the electrode 21a is small, for example, a loop electrode, a small impedance value is calculated, and if the electrode shape is large, for example, a roller electrode, a large impedance value is calculated. Then, a treatment tool selection signal for selecting the high-frequency cautery treatment tool 3 having the short-circuit impedance closest to the short-circuit impedance value stored in the impedance storage unit 231 is obtained by the impedance comparison unit 232, and the treatment tool selection signal is , Treatment instrument selection signal selection unit 23
3 and is given to the target current value selection unit 52. Other operations are the same as those of the first embodiment. The operation when the item other than the selection item 202 is selected by the treatment tool selection switch 12b is the same as that of the first embodiment.

In the high-frequency cautery treatment instrument 3, the feedback electrode section 23 may be formed of a high impedance, for example, a conductive rubber so that the load impedance calculating section 42 or the like can easily obtain the impedance at the time of short circuit. When the selection item 202 is selected by the treatment tool selection switch 12b, the output voltage may be controlled to be lower than usual in order to prevent an overcurrent.

According to the present embodiment described above, the following effects can be obtained in addition to the effects of the first embodiment. In the present embodiment, the type of the high-frequency ablation instrument 3 can be automatically detected. Therefore, when there are many types of the high-frequency ablation treatment tools 3 to be selected, the burden on the operator to select the type of the high-frequency ablation treatment tools 3 is reduced, and the operability is improved.

The present invention is not limited to the above-described embodiment, but can be variously modified without departing from the gist of the invention.

[Supplementary Notes] (Additional Item 1-1) A plurality of types of active electrodes for performing a medical treatment on the treatment target site by applying electrical energy to the treatment target site by contacting the treatment target site. An electrosurgical apparatus capable of selectively connecting a plurality of types of active electrodes, the power source including a constant current control unit that maintains a current value of a current supplied to the active electrode at a given target current value. An electrosurgical apparatus comprising: a target current value selecting unit that selects the target current value according to a type of an active electrode connected to the power supply.

(Supplementary Item 1-2) The electrosurgical apparatus according to Supplementary Item 1-1, wherein input means for instructing the type of the medical treatment, and type of the medical treatment instructed from the input means Means for controlling the electric current in accordance with the following.

(Additional Item 1-3) The electrosurgical apparatus according to additional item 1-1, wherein the target current value selecting means is set in advance corresponding to each of the plurality of types of active electrodes. An electrosurgical apparatus, wherein the target current value is selected from a plurality of current values.

(Additional Item 1-4) In the electrosurgical apparatus according to additional item 1-1, the medical treatment includes a resection procedure for the treatment target site.

(Additional Item 1-5) In the electrosurgical apparatus according to Additional Item 1-1, the medical treatment includes a coagulation treatment for the treatment target site.

(Additional Item 1-6) In the electrosurgical apparatus according to additional item 1-6, the coagulation treatment includes a hemostatic treatment for the treatment target site.

(Additional Item 1-7) In the electrosurgical apparatus according to Additional Item 1-1, the active electrode includes a loop electrode in which the electrode is formed in a loop shape.

(Additional Item 1-8) In the electrosurgical apparatus according to additional item 1-1, the active electrode includes a band electrode in which the electrode is formed in a band shape.

(Additional Item 1-9) In the electrosurgical apparatus according to Additional Item 1-1, the active electrode includes a roller electrode having an electrode formed in a roller shape.

(Additional Item 1-10) The electrosurgical apparatus according to Additional Item 1-1, further comprising: input means for instructing the target current value selecting means with information indicating the type of the active electrode. Was.

(Additional Item 1-11) In the electrosurgical apparatus according to additional item 1-10, the information indicating the type of the active electrode includes information indicating a shape of the active electrode.

(Additional Item 1-12) In the electrosurgical apparatus according to additional item 1-10, the information indicating the type of the active electrode includes information indicating the size of the active electrode. (Additional Item 1-13) In the electrosurgical apparatus according to Additional Item 1-10, the information indicating the type of the active electrode includes information indicating a material of the active electrode.

(Additional Item 1-14) In the electrosurgical apparatus according to Additional Item 1-10, the information indicating the type of the active electrode includes information indicating a volume of the active electrode.

(Additional Item 1-15) In the electrosurgical apparatus according to additional item 1-10, the information indicating the type of the active electrode is information corresponding to a name that can identify the type of the active electrode. including.

(Additional Item 1-16) In the electrosurgical apparatus according to additional item 1-2, the means for controlling the current controls a current value.

(Additional Item 1-17) In the electrosurgical apparatus according to additional item 1-2, the means for controlling the current controls a waveform of the current.

(Additional Item 1-18) The electrosurgical apparatus according to Additional Item 1-1, further comprising voltage value measuring means for measuring a voltage value of the current.

(Additional Item 1-19) The electrosurgical apparatus according to Additional Item 1-1, further comprising current value measuring means for measuring a current value of the current.

(Supplementary Item 1-20) The electrosurgical apparatus according to Supplementary Item 1-1, further comprising power value measuring means for measuring a power value of the current.

(Supplementary Note 1-21) The electrosurgical apparatus according to Supplementary Note 1-1, further comprising impedance measuring means for measuring an impedance value of the treatment target site.

(Additional Item 1-22) The electrosurgical apparatus according to additional item 1-21, wherein the constant current control means comprises:
The current is controlled when the impedance value obtained by the impedance measuring means is smaller than a predetermined value.

(Additional Item 1-23) In the electrosurgical apparatus according to Additional Item 1-1, the power supply includes a constant voltage control unit that maintains a voltage value of the current constant.

(Additional Item 1-24) The electrosurgical apparatus according to Additional Item 1-1, wherein the power supply includes a constant power control unit for maintaining a constant power value of the current.

(Additional Item 1-25) The electrosurgical apparatus according to Additional Item 1-10, wherein the time required for the medical treatment is adjusted by operating the input means.

(Additional Item 1-26) The electrosurgical apparatus according to Additional Item 1-10, wherein the delay time when the medical treatment starts after the current starts flowing by operating the input means. Adjusted.

(Additional Item 2-1) The electrosurgical apparatus according to additional items 1-1 to 1-3, wherein the type of the active electrode is detected to control the target current value selecting means. An electrode type detecting means was provided.

(Additional Item 2-2) The electrosurgical apparatus according to Additional Item 2-1 wherein the feedback electrode, which is an electrode paired with the active electrode, and the active electrode and the feedback electrode are short-circuited. Short-circuit impedance detecting means for detecting an impedance value at the time of the activation, and the active electrode type detecting means detects the type of the active electrode based on the impedance value detected by the short-circuit impedance detecting means.

(Additional Item 2-3) In the electrosurgical apparatus according to additional item 2-2, the return electrode is formed of conductive rubber.

(Additional Item 2-4) The electrosurgical apparatus according to Additional Item 2-1, wherein a pair of electrodes provided in the active electrode and an impedance value when the pair of electrodes are short-circuited. And a short-circuit impedance detecting means for detecting
The active electrode type detection means detects the type of the active electrode based on the impedance value detected by the short-circuit impedance detection means.

(Additional item 3-1) Electricity capable of connecting a plurality of types of treatment tools for performing a medical treatment on the treatment target site by applying electric energy to the treatment target site by contacting the treatment target site. In a surgical operating apparatus, a current value selecting means for selecting an arbitrary one of a plurality of current values, and a constant for maintaining a current value of an output current at the current value selected by the current value selecting means. An electrosurgical device comprising a current source.

(Additional Item 3-2) The electrosurgical apparatus according to additional item 3-1 wherein the current value selecting means is configured to determine a type of the treatment tool to be connected among the plurality of types of the treatment tool. Accordingly, one current value is selected from the plurality of current values.

(Additional Item 3-3) The electrosurgical apparatus according to Additional Item 3-1 wherein the two electrodes provided on the treatment tool are in contact with the treatment target site and the two electrodes are brought into contact with each other. And a contact resistance measuring means for measuring a contact resistance value at the time of contact, wherein the current value selecting means selects one current value from the plurality of current values according to the contact resistance value.

[0080]

As described above, according to the present invention,
The effect of improving the operability can be obtained by reducing the difference in the operation start delay time due to the difference in the treatment tool and the difference in the operation feeling.

[Brief description of the drawings]

FIG. 1 to FIG. 5 relate to a first embodiment of the present invention, and FIG. 1 is an explanatory view showing an overall configuration of an electrosurgical apparatus.

FIG. 2 is an explanatory diagram showing a configuration of an operation panel.

FIG. 3 is a block diagram showing a configuration of a high-frequency ablation power supply device.

FIG. 4 is a block diagram illustrating a configuration of a control circuit.

FIG. 5 is an explanatory diagram showing characteristics of output power with respect to load impedance.

FIG. 6 is an explanatory view showing a configuration of a high-frequency ablation instrument according to a first modification of the first embodiment.

FIG. 7 is a block diagram showing a configuration of a control circuit according to a second modification of the first embodiment;

FIGS. 8 to 10 relate to a second embodiment of the present invention, and FIG. 8 is an explanatory diagram showing a configuration of an operation panel.

FIG. 9 is a block diagram illustrating a configuration of a control circuit.

FIG. 10 is an explanatory diagram for explaining an operation procedure.

11 to 13 are referred to in the description of the prior art, FIG. 11 is an explanatory diagram showing the shape of an electrode, FIG. 11 (A) is an explanatory diagram showing the shape of a loop electrode, and FIG. Explanatory diagram showing the shape, (C) is an explanatory diagram showing the shape of the roller electrode

FIG. 12 is an explanatory diagram showing characteristics of output power with respect to load impedance.

FIG. 13 is an explanatory diagram showing characteristics of load impedance and output voltage with time.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 ... Electrosurgical apparatus 3, 3a ... High frequency cautery treatment tool 4 ... High frequency cautery power supply device 5 ... Foot switch 5a ... Resection switch 5b ... Coagulation switch 12b ... Treatment tool selection switch 21 ... Active electrode part 21a ... Electrode 32 ... Control circuit 33: Waveform generation circuit 34: Variable amplifier circuit 36: Output voltage measurement circuit 37: Output current measurement circuit 41: Waveform control unit 46: Constant current control unit 71: Active electrode unit 71a, 71b: Electrode

 ──────────────────────────────────────────────────続 き Continuing on the front page (72) Inventor Masahide Oyama 2-43-2 Hatagaya, Shibuya-ku, Tokyo Inside Olympus Optical Co., Ltd. (72) Inventor Kenji Harano 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optical Co., Ltd. F-term (reference) 4C060 KK03 KK04 KK09 KK10 KK15 KK17 KK23 KK30 KK47

Claims (3)

[Claims] An electric device capable of selectively connecting a plurality of types of active electrodes for performing a medical treatment on the treatment target site by applying electrical energy to the treatment target site by contacting the treatment target site. In the surgical apparatus, a power supply including a constant current control unit that maintains a current value of a current supplied to the active electrode at a given target current value; and an active power supply connected to the power supply among the plurality of types of active electrodes. An electrosurgical apparatus comprising: target current value selection means for selecting the target current value according to the type of an electrode. 2. The electrosurgical apparatus according to claim 1, wherein input means for indicating a type of the medical treatment, and the current is controlled in accordance with the type of the medical treatment specified by the input means. And an electrosurgical apparatus. 3. The electrosurgical apparatus according to claim 1, wherein said target current value selecting means is selected from a plurality of current values set in advance corresponding to each of said plurality of types of active electrodes. An electrosurgical apparatus, wherein the target current value is selected.