JPH08308851A - Electrosurgical device - Google Patents

Abstract

PURPOSE: To provide an electrosurgical device which according to treatment purposes controls high-frequency power, that is output from a high-frequency cauterization power supply device to a treatment tool, by detecting information on or changes in the high-frequency cauterization power supply device and in living tissue. CONSTITUTION: This electrosurgical device 5 comprises a power supply 6 for cauterization, a monopolar treatment tool 71, and a patient electrode 72. A high-frequency cauterization power supply device comprises an output circuit 62 so formed that high-frequency power amplified by a high-frequency power amplifying circuit 61 is output via three internal transformers; a relay circuit 63 via which the high-frequency power that is output from each internal transformer of the output circuit 62 is switched and supplied to a treatment tool 7; sensors 64 placed between the relay circuit 63 and each port 60a, 60b to detect living-body impedance or the like; an A/D converter 65 for converting signals output from the sensors 64; and a CPU 66 for controlling each circuit.

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 excising living tissue or stopping hemostasis using high frequency power.

[0002]

2. Description of the Related Art Conventionally, an electrosurgical apparatus has been used when performing an incision or coagulation hemostasis in a surgical operation or a medical operation. This electrosurgical device connects a high-frequency cautery power supply device (hereinafter referred to as a power source for cauterization) and a treatment tool, and outputs high-frequency power from the treatment tool to the treatment section to perform treatment. It was necessary to optimally control the output high frequency power. For this reason, in the monopolar mode, the leak current is indirectly detected by detecting and comparing the output current output from the electrosurgical high-frequency power supply with the feedback current that returns, or the output end and the feedback end of the high-frequency power supply are detected. The impedance between was detected. Further, in the bipolar mode, a temperature sensor is configured at the tip of the electrode to detect the temperature applied to the tissue surface.

However, even if the output current or output voltage output from the ablation power supply is controlled, the current density applied to the living tissue depends on the area of the treatment tool in contact with the treatment part of the patient, the characteristics of bioimpedance with respect to high frequency, and the like. , Or
Since the electric power changes, it is difficult to efficiently perform optimal ablation with high-frequency electric power or perform coagulation hemostasis.
Further, in an electrosurgical device in which a temperature sensor configured at the tip of a bipolar mode electrode detects a temperature rise in a treatment portion to control a coagulation state, the electrosurgical device itself outputs a noise level of a high-frequency current. However, since noise is mixed in the detection signal, the detection accuracy is affected and it is difficult to reliably control.

As shown in FIG. 10, a conventional electrosurgical apparatus 1 has been used.
Is composed of an ablation power supply 2 and a treatment tool 3.
The ablation power supply 2 includes a power supply circuit 22 for generating various voltages from the commercial power supply 4 through an insulating transformer 21, and various powers generated by the power supply circuit 22 such as cutting, mixing or coagulation. A signal generating circuit 23 and a waveform shaping circuit 24 which generate a signal which is a basis of a waveform signal of a high frequency output corresponding to the treatment, a high frequency power amplifier circuit 25 which amplifies the signal generated by the waveform shaping circuit 24 at a high frequency, A selection circuit 26 for selectively switching the supply destination of the high frequency power amplified by the high frequency power amplification circuit 25 to an output circuit of a bipolar mode or a monopolar mode, the selection circuit 26, the power supply circuit 22, the signal generation circuit 23, and a waveform. It is composed of a molding circuit 24 and a CPU 27 which is connected to the high frequency power amplifier circuit 25 and controls each circuit.

A monopolar output transformer 26a for monopolar mode and a bipolar output transformer 26b for bipolar mode are connected to the selection circuit 26. The monopolar port 20a, which is the output terminal of the monopolar output transformer 26a, is connected to the monopolar treatment instrument 31 corresponding to the monopolar mode and the patient electrode 32 for the return current, and the bipolar output transformer 26b. The bipolar port 20b which is the output end of the bipolar treatment tool 33 corresponding to the bipolar mode.
Are connected.

A main panel 28 for selecting various waveforms and setting control values of various circuits is connected to the CPU 27, and various circuits are controlled via the CPU 27. ing. If an abnormality should occur, the operator is notified of the abnormality via the alarm circuit 29, and the CPU 27 stops the output.

As shown in FIG. 11, the characteristic of the high frequency power output from the ablation power supply 2 is that the value output from the output transformer which is an output circuit is, for example, 150 W or 300.
When set to W, due to the bioelectrical impedance, the bioelectrical impedance reaches the peak of the impedance characteristic of the output transformer in the vicinity of 300Ω, and changes so as to draw an attenuation curve with this peak value as a boundary. In this way, the impedance characteristic of the output transformer changes depending on the bioelectrical impedance, so that the sharpness of the treatment tool and the hemostatic performance become unstable. Therefore, when performing treatment using an electrosurgical device, the output power and output time to the treatment site have been set based on the operator's intuition and experience over the years based on the visual conditions of the treatment site.

To avoid this problem, Japanese Patent Publication No. 5-851
Japanese Patent Publication No. 77 discloses an electrosurgical instrument in which a high frequency output characteristic is flattened with respect to a biological impedance as shown in FIG.

[0009]

However, in the high frequency output characteristic shown in the above Japanese Patent Publication No. 5-85177, the high frequency output characteristic from the output circuit is fixed, and the vicinity of the maximum value indicated by the broken line of the high frequency output is deleted. Since it has a flat high-frequency output characteristic, the high-frequency output characteristic is not attenuated by the change in bioimpedance,
It is impossible to output the maximum output value set in the electrosurgical device. For this reason, it has not been suitable for a treatment requiring high output. In addition, it does not control the high-frequency output from the ablation power supply by detecting the bioimpedance, but only outputs the high-frequency power of a preset output value, so changes in the bioimpedance and the ablation power supply. It was not possible to deal with the difference in the impedance of the treatment tool connected to. Therefore, it was necessary to set the output time of the high frequency power based on the intuition and experience of the operator.

The present invention has been made in view of the above circumstances. For the purpose of treatment, the high frequency power output from the high frequency cautery power supply device to the treatment tool is detected by detecting the information or changes in the high frequency cautery power supply device and living tissue. It is an object of the present invention to provide an electrosurgical device that is controlled accordingly.

[0011]

An electrosurgical apparatus according to the present invention is an electrosurgical apparatus for excising or coagulating living tissue by supplying high-frequency power from a high-frequency ablation power supply device to a treatment tool that is in contact with the living tissue. Further, the high frequency cautery power supply device is provided with an output circuit having a plurality of transformers, and a detection means for detecting at least one of an output value from the high frequency cautery power supply device and a change in a living tissue.

[0012]

According to this structure, when high frequency power is supplied to the treatment tool to excise or coagulate the living tissue, the detecting means detects the bioimpedance, the output voltage, the output current, the capacitance, etc. The output from the transformer having the corresponding peak value of the output impedance is appropriately output from the output circuit to the treatment tool, and the treatment corresponding to the treatment purpose can be performed.

[0013]

DESCRIPTION OF THE PREFERRED EMBODIMENTS The present invention will be described below with reference to the drawings. 1 to 3 relate to a first embodiment of the present invention, FIG. 1 is an explanatory view showing a configuration of a main part of an electrosurgical apparatus, and FIG. 2 is an explanation showing output characteristics of an internal transformer arranged in an output circuit. 3 and 4 are characteristic diagrams of the high frequency output output from the output circuit.

As shown in FIG. 1, an electrosurgical device 5 includes a high frequency ablation power supply device (hereinafter referred to as ablation power supply) 6 and a treatment tool 7 such as the ablation power supply 6 for monopolar mode.
The monopolar treatment tool 71 is connected to the monopolar port 60a and the patient electrode 72 is connected to the counter electrode port 60b.

The ablation power source 6 has a high frequency for high frequency amplification of a waveform signal which is a basis of high frequency power generated by a waveform shaping circuit (not shown) located in the preceding stage and corresponding to various treatments such as incision, mixing or coagulation. A power amplifier circuit 61, an output circuit 62 formed to output the high frequency power amplified by the high frequency power amplifier circuit 61 via, for example, three internal transformers, and a high frequency output from the internal transformer of the output circuit 62. A relay circuit 63 for switching and supplying electric power to the treatment instrument 7, the relay circuit 63 and the ports 60a, 60
sensor 64, 64, which is a detecting means arranged between the ablation power source and the ablation power source to detect the output voltage, the output current, the return current, the capacitance of the living body, and the bioelectrical impedance. ． ．
And an A / D converter 65 for digitally converting the signal output from the sensor 64, and is connected to the A / D converter 65, the high frequency power amplifier circuit 61, and the relay circuit 63 to control each circuit. It is composed of a CPU 66.

As shown in FIG. 2, the three internal transformers provided in the output circuit 62 each have a maximum output value of high frequency power set to 150 W or 300 W, and when the bioimpedance value is in the range a, In the range b and the range c, three levels are set so that the output characteristic peaks.

A detection signal of the bioimpedance detected by the sensor 64 is input to the CPU 66 through the A / D converter 65, and an internal transformer for outputting high frequency power corresponding to the bioimpedance is selected from the output circuit 62. When the relay circuit 63 is switched and output to the treatment tool 71, or when various control of various waveforms and various control values of various circuits or an abnormality occurs, the abnormality is notified or the output is stopped via the notifying means. It is configured.

By configuring the electrosurgical device 5 as described above, when a treatment is performed using the electrosurgical device 5, the sensor 64 causes the output voltage from the cautery power source 6 and the bioimpedance which is a change in the living body. Set to detect and. Then, since the change in the bioelectrical impedance is always fed back to the CPU to be grasped, the CPU 66 constantly monitors the relay circuit 63.
The internal transformer of the output circuit 62 outputs the high-frequency power of the most appropriate value to the treatment instrument 71. As a result, even if the output characteristic of one transformer is attenuated as shown by the broken line as shown in FIG. 3, it is output from the output circuit having the three internal transformers having different output characteristics via the relay circuit. It is possible to output the maximum output value in a substantially flat state when the bioimpedance is in the range of 200Ω to 500Ω, for example, by controlling the high-frequency power that is generated by the CPU. As a result, it is possible to stably perform treatments such as excision and coagulation with high output.

The number of internal transformers provided in the output circuit 62 is not limited to three, but may be two or four or more. The internal transformers are selected and arranged in consideration of bioelectrical impedance. As shown in FIG. 4, the CPU 66 switches the relay circuit 63 to output a desired high frequency output of the internal transformer based on the bioimpedance detection signal detected by the sensor 64. In addition to setting the waveform to output high frequency power with emphasis on coagulation rather than the start of ablation, as shown in FIG. By setting the output waveform of high-frequency power that improves the hemostatic performance, it is possible to perform control according to the user's usage environment.

As described above, the CPU controls the use environment desired by the user by switching the relay circuit that connects the internal transformer of the output circuit that outputs the high frequency power and the treatment tool in accordance with the bioelectrical impedance detected by the sensor. be able to. By the way, conventionally, an electrosurgical device has a foot switch (hereinafter referred to as a foot switch), a surgical hand piece (hereinafter referred to as a hand piece) for output operation at hand, or a hand switch that only controls output at hand instead of a foot switch. While the switch section was in the ON state, the output was continuously output. Further, in the conventional electrosurgery performed under an endoscope and electrosurgery performed in the field of surgery, electrosurgery is performed with repetition of a relatively short output time. However, in some cases, the treatment may be performed by increasing the energization time. In addition, due to a failure of the electrosurgical device itself or a defect such as a poor connection between the cautery power supply and the treatment tool, the high frequency power may not completely flow from the treatment tool to the living body while the switch is in the ON state. there were. In this way, if high frequency power is continuously generated without being supplied with high frequency power to the treatment tool, heat may be generated inside the cautery power supply or a defect may occur, resulting in electrosurgery. It may deteriorate the durability of the device.

Therefore, in order to eliminate such a problem, as shown in FIG. 6, in the electrosurgical apparatus 5a, the handpiece 81 is used.
Alternatively, on / off of the foot switch 82 or a switch such as a hand switch (not shown) is detected by the switch detection unit 84 via the connection unit 83, and this switch detection unit 84
The signal detected in step 6 is transmitted to the CPU 66, and the sensor 64 of the above-described embodiment monitors the change in bioelectrical impedance to detect whether or not high-frequency power output from the treatment instrument is started.

That is, in the electrosurgical apparatus of this embodiment, when the start of the output of the high frequency power is detected, at least one of the time preset in the apparatus main body and the time later set on the main panel is detected. However, the continuous output time is measured. Then, for example, as shown in the setting tables of FIG. 7 and FIG. 8, visual indication is made at each elapsed time using an LED or the like as a notification means, or a buzzer is sounded to notify the operator, output is stopped, and output is allowed again. It is set so as to carry out the operation such as. The elapsed time is measured by a microprocessor, a counter element or a timer element.

For example, if the treatment tool is broken,
When the foot switch is turned on, high-frequency current does not flow to the human body, and only the ablation power supply is in continuous output. At this time, the switch detection unit 84 confirms that the switch is on, but since the sensor 64 does not detect the change in the bioelectrical impedance due to the high-frequency power acting on the biomedical tissue, after 30 seconds have elapsed, the LE is not activated.
Make D blink. Then, each time a predetermined time elapses, the process moves to a new step and a predetermined operation is executed. By this, while notifying the user of an abnormal condition,
It is possible to prevent destruction of the cautery power supply due to heat and deterioration of durability.

Further, not only the ON / OFF signal of the output switch can be detected, but whether the high frequency current is actually applied to the living tissue can be detected by the change of the living body impedance. It is also possible to measure the time after the current actually flows.

The operation shown in the setting table is set in advance in the machine body, and depending on the operator's preference,
The elapsed time and change of notification means can be arbitrarily set.

Further, as shown in FIG. 9, for example, threshold values from level 1 to level 4 are set in accordance with bioimpedance values d, e, f, g. Then, during the electrosurgery, when the bioelectrical impedance reaches a preset threshold value, the sensor 64 detects this, and the detection signal is transmitted to the CPU 66 so that the ablation power source 6 automatically operates. By stopping the high frequency output to the treatment tool, it becomes possible to set the coagulation quality or the ablation quality desired by the user.

Further, since the user can select and set the level according to the application site in surgery, the procedure, the treatment tool, etc., it is possible to obtain coagulation quality and resection quality with good reproducibility at all times. It is not necessary to perform cut-and-try in order to set the output suitable for each surgery performed by the conventional electrosurgical device, and it is possible to shorten the surgery time and improve the efficiency.

The value detected by the sensor is not limited to the bioimpedance, and may be the capacitance of the living body, the output power or the output current. Further, although the electrosurgical device using the monopolar mode treatment tool has been described, the treatment tool may be a bipolar mode treatment tool.

[Additional Notes] 1. In an electrosurgical device for excising or coagulating living tissue by supplying high-frequency power to a treatment instrument brought into contact with living tissue from the high-frequency ablation power supply device, the high-frequency ablation power supply device has an output circuit having a plurality of transformers, and the high frequency An electrosurgical device provided with a detection means for detecting at least one of an output value from a cauterization power supply device and a change in a living tissue.

2. The electrosurgical device according to appendix 1, wherein high frequency power is output from the high frequency ablation power supply device to a monopolar mode including a patient electrode and a monopolar treatment instrument.

3. The electrosurgical device according to appendix 1, wherein high-frequency power is output from the high-frequency ablation power supply in a bipolar mode including a bipolar treatment tool.

4. The electrosurgical device according to appendix 1, wherein the detection means is means for detecting bioelectrical impedance. 5. The electrosurgical device according to appendix 1, wherein the detection means is means for measuring the electrostatic capacitance of the human body.

6. 6. The electrosurgical device according to appendix 1, wherein the detecting means is means for measuring the voltage output from the high frequency ablation power supply. 7. The electrosurgical device according to appendix 1, wherein the detection means is means for measuring the current output from the high frequency ablation power supply. The electrosurgical device according to appendix 1, wherein a change in the living tissue is detected by the detection means, and the high-frequency output value from the transformer of the output circuit is changed according to the detection result.

9. 10. The electrosurgical device according to appendix 1, which detects a change in the biological tissue by the detection means and stops the output from the cautery power supply when the change in the biological tissue exceeds a preset value or a preset value. 2. The output switch for turning on / off the supply of high-frequency power to the treatment instrument is a foot switch or a hand operation switch, and the detection circuit for detecting that these output switches are turned on / off is provided in appendix 1. Electrosurgical device 11. The electrosurgical device according to any one of appendices 4 to 7 and 10, wherein the start of the high frequency output is detected by the detection circuit and the detection means, and the output time of the high frequency power is measured.

12. 13. The electrosurgical device according to appendix 11, which measures the output time of the high-frequency power and, when a preset time elapses, notifies the operator of at least one of auditory phonogram or visual display and performs a predetermined operation. 13. The electrosurgical device according to appendix 12, wherein the output time is measured by a microcontroller.

14. 13. The electrosurgical device according to appendix 12, wherein the output time is measured by a counter element or a timer element.

[0037]

As described above, according to the present invention, the information or changes in the high frequency cautery power supply device and the living tissue are detected, and the high frequency power output from the high frequency cautery power supply device to the treatment tool is adjusted according to the purpose of the treatment. It is possible to provide an electrosurgical device that is controlled by the above method.

[Brief description of drawings]

1 to 3 relate to a first embodiment of the present invention,
FIG. 1 is an explanatory diagram showing a configuration of a main part of an electrosurgical apparatus.

FIG. 2 is an explanatory diagram showing output characteristics of an internal transformer arranged in an output circuit.

FIG. 3 is a characteristic diagram of a high frequency output output from the output circuit.

FIG. 4 is another characteristic diagram of the high frequency output output from the output circuit.

FIG. 5 is another characteristic diagram of the high frequency output output from the output circuit.

FIG. 6 is a treatment tool of an electrosurgical device, a foot switch, and a CP.
Diagram showing the relationship with U

7 and 8 are related to a safety management setting table of the main body of the electrosurgical apparatus, and FIG. 7 shows No. 1 of the safety management setting table.

FIG. 8 shows the second part of the safety management setting table.

FIG. 9 is a diagram showing a relationship between bioelectrical impedance and a threshold value.

10 to 12 are related to a conventional example, and FIG.
Reference numeral 0 is an explanatory view showing a schematic configuration of the electrosurgical device

FIG. 11 is a diagram showing a relationship between bioelectrical impedance and high frequency output.

FIG. 12 is a diagram showing a high-frequency output that is flat with respect to bioimpedance by deleting the vicinity of the maximum value.

[Explanation of symbols]

 5 ... Electrosurgical device 6 ... Induction cauterization power supply device 7 ... Treatment tool 62 ... Output circuit 64 ... Sensor (detection means)

Claims (1)

[Claims] 1. An electrosurgical device for excising or coagulating biological tissue by supplying high-frequency power from a high-frequency ablation power supply device to a treatment tool in contact with the biological tissue, wherein the high-frequency ablation power supply device has a plurality of transformers. An electrosurgical device comprising: a circuit; and a detection unit that detects at least one of an output value from the high-frequency ablation power supply device and a change in living tissue.