JPH09313500A - Galvanosurgery device - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a galvanosurgery device which can prevent the pressure in a peritoneal cavity from rising to a dangerous level even in case the operator omits the measure to exhaust the gas from the cavity or in case the amount of exhausted gas is smaller than the amount of injection. SOLUTION: Argon gas as inert gas accommodated in a container 12 is supplied to a hand-piece 4 via an internal pipeline 14 and tube 23 functioning as a gas delivery line in a gas sending device 3, and the hand-piece 4 is inserted in the peritoneal cavity 6a of a patient through a trocar 5. To the internal pipeline, a solenoid proportional control valve 19 and a pressure gage 20 are connected, wherein the pressure gage 20 is to sense the pressure near the outlet of the internal pipeline 14. The pressure gage 20 measures the pressure corresponding to the intra-cavity pressure and sends the result to a control part 22, which monitors whether the given value lies over the threshold, and if yes, the valve 19 is closed to stop the argon gas being sent to the hand-piece 4, and thereby the pressure in the cavity 6a is precluded from rising to a dangerous level.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an electrosurgical device using an inert gas, and more specifically, it applies high frequency electric energy to a human body through a flow of a conductive inert gas to coagulate or stop hemostasis. is there.

[0002]

2. Description of the Related Art In recent years, by not inserting an incision and inserting an insertion portion through a trocar from a small puncture hole, the inside of the abdominal cavity or the like can be observed, and treatment can be performed by using a treatment tool as needed. Rigid endoscopes, such as laparoscopes, have become widely used.

When a polyp is excised with a treatment tool under the observation of a rigid endoscope, an electrosurgical device such as a treatment tool that coagulates or stops bleeding is used to stop bleeding. As this electrosurgical device, for example, as disclosed in Japanese Examined Patent Publication No. 6-4076, a jet of an inert gas is generated, the jet is guided to a target tissue such as an affected area, and a high frequency is applied to an ionized conductive passage in the gas jet. Electrosurgical devices may be used that provide hemostasis or coagulation by passing a drive signal. This electrosurgical device is described as using a jet of argon gas at 4 to 13 L / min.

[0004]

However, the above-mentioned prior art has the following drawbacks. When the electrosurgical device is used for surgery such as hemostasis under laparoscope, the abdominal cavity is filled with gas such as carbon dioxide gas injected for pneumoperitoneum, and yet to prevent atrophy in the abdominal cavity due to leakage. It is sealed.

If a conventional device is used in this situation, a pressure of 4 to 13 L / min is injected into the abdominal cavity, so that the pressure in the abdominal cavity increases, so that gas embolism should not occur. The operator used the device while opening the mouthpiece of the trocar inserted into the abdominal cavity and discharging the gas in the abdominal cavity to the outside of the abdominal cavity (atmosphere).

[0006] However, this method is not only very complicated, but the amount discharged from the abdominal cavity due to the shape of the mouthpiece of the trocar may be smaller than the amount injected, so that the abdominal cavity is constantly invaded. It was necessary to open the mouthpiece of the trocar, for example, by monitoring the pressure, and if this was not done, gas embolism might occur.

The present invention has been made in view of the above-mentioned points. In the unlikely event that the operator does not take a procedure for discharging gas in the abdominal cavity, or if the amount of gas discharged is smaller than the injection amount, the abdominal cavity It is an object of the present invention to provide an electrosurgical device capable of preventing the pressure of the device from rising to a dangerous value.

[0008]

In an electrosurgical apparatus for causing coagulation or hemostasis by applying high-frequency electric energy to a human body through a flow of an inert gas, the gas flow in a duct for supplying air is turned on / off. A control valve for turning it off, a pressure sensor for measuring the pressure near the outlet of the pipeline, and a gas flow O when the output value of the pressure sensor exceeds a threshold value.
By providing an air supply device having a control unit for controlling the control valve so as to be FF, measuring the pressure in the pipeline and stopping the air supply when the pressure exceeds a threshold value. Therefore, even if the operator does not take a procedure for discharging the gas in the abdominal cavity, or even if the amount of the gas discharged is smaller than the injection amount, the pressure in the abdominal cavity is prevented from rising to a dangerous value.

[0009]

BEST MODE FOR CARRYING OUT THE INVENTION Embodiments of the present invention will be specifically described below with reference to the drawings. (First Embodiment) FIGS. 1 and 2 relate to a first embodiment of the present invention. FIG. 1 shows an air supply device in an electrosurgical apparatus according to the first embodiment, and FIG. An explanatory view is shown.

As shown in FIG. 1, the inert gas electrosurgical apparatus 1 according to the first embodiment of the present invention applies a high frequency drive signal (also referred to as a high frequency signal) for applying an inert gas to living tissue by ionizing or the like. A high-frequency generator 2 for generating, an air-supplying device 3 for supplying an inert gas, a high-frequency generator 2 and an air-supplying device 3 are connected to discharge a jet flow of the inert gas from a nozzle at the tip and Inert gas is ionized by a high-frequency drive signal guided by a needle-shaped electrode placed in the body, and high-frequency electrical energy is applied to the living tissue to be treated through this ionized passage to generate a high-frequency signal, and a treatment action such as coagulation or hemostasis is performed. And the handpiece 4 for performing.

The handpiece 4 is inserted into the abdominal cavity 6a of the human body 6 via the trocar 5. Also, the handpiece 4
In order to observe the treatment by the laparoscope 7 the trocar 8
It is inserted into the abdominal cavity 6a of the human body 6 via.

An electrode is inserted into the handpiece 4, one end of a high frequency electric cable 9 is connected to an electrode connecting portion at a rear end of the electrode, and the other end of the high frequency electric cable 9 is connected to the high frequency generator 2. Thus, the high frequency signal can be supplied to the high frequency electrode side of the handpiece 4.

Further, one end of an electric cable for return is connected to the high frequency generator 2, and this electric cable is connected to a patient plate (not shown) which contacts the human body 6 in a wide area.

A cylinder 12 filled with compressed argon gas as an inert gas is connected to a mouthpiece on the gas supply source side of the air supply device 3, that is, a high pressure mouthpiece 11 via a high pressure hose 13. Inside the air supply device 3, the high pressure base 11
Is connected to the upstream end of the internal pipe line 14, and the argon gas is supplied to the downstream side of the internal pipe line 14 via the internal pipe line 14.

This internal line 14 which functions as an air supply line
A primary pressure reducer 16 for reducing pressure, a secondary pressure reducer 17 for further reducing pressure, a flow rate sensor 18 for detecting the flow rate, and an electromagnetic proportional control for electromagnetically controlling the opening / closing of the valve on the way from the upstream side to the downstream side of A valve 19 and a pressure sensor 20 for detecting pressure are sequentially arranged, and a connection mouthpiece 21 is provided at the downstream end near the pressure sensor 20. That is, the pressure sensor 20 detects the pressure in the internal pipeline 14 near the outlet of the internal pipeline.

Further, the flow rate sensor 18 and the electromagnetic proportional control valve 1
9, the pressure sensor 20 is electrically connected to the control unit 22,
The flow rate detected by the flow rate sensor 18 is input to the control unit 22, and the pressure detected by the pressure sensor 20 is input to the control unit 22. Further, the opening / closing operation of the electromagnetic proportional control valve 19 is controlled by the control unit 22 depending on whether the pressure value detected by the pressure sensor 20 is equal to or more than a preset threshold value.

That is, the control section 22 controls the electromagnetic proportional control valve 19 to be in the open state when it is less than the threshold value and to be in the closed state when it is more than the threshold value. As a result, the flow of argon gas in the internal conduit 14 is turned on / off.

One end of the tube 23 is connected to the connection mouthpiece 21, and the other end is connected to a mouthpiece at the rear end of the air supply line provided in the handpiece 4. A foot switch 24 is connected to the control unit 22 via a signal line 25.

On the other hand, one end of a light guide cable 26 is connected to the light guide mouthpiece of the laparoscope 7, and the other end of the light guide cable 26 is connected to a light source device (not shown). Then, the illumination light generated by the light source device is transmitted by the light guide cable 26 and supplied to the light guide inside the laparoscope 7. This light guide is inserted through the rigid insertion portion, transmits the supplied illumination light, and emits from the light guide tip surface attached to the illumination window on the tip surface of the insertion portion to illuminate the target tissue side such as the affected area. .

An observation window is also formed on the distal end surface of the insertion portion, and an objective lens for forming an image is attached to the observation window to form an optical image of the target tissue. The optical image is transmitted to the eyepiece side at the rear end side of the insertion section by the relay lens system inserted through the insertion section.

A TV camera 27 having a built-in image pickup device is connected to this eyepiece, and a signal cable 28 extending from the TV camera 27 is connected to a camera control unit (not shown) and photoelectrically converted by the image pickup device. Performs signal processing on the image pickup signal to generate a standard video signal,
An image formed on the image sensor is displayed on a monitor (not shown).

The abdominal cavity 6a of the human body 6 is filled with carbon dioxide gas through a trocar 8 or the like by an insufflation device (not shown), and the abdominal cavity 6a is set in a state suitable for observation or treatment of the abdominal cavity. It

In the present embodiment, in the vicinity of the connection base 21,
That is, the pressure corresponding to the pressure in the body cavity 6a where the tip opening of the handpiece 4 is exposed is detected (measured) by detecting the pressure of the argon gas flowing in the vicinity of the outlet of the internal conduit 14, and the pressure is measured. When the preset pressure threshold value is exceeded, a mechanism is provided to stop the supply of argon gas to the handpiece 4 side and prevent the pressure in the abdominal cavity 6a from rising to a dangerous value. It is characterized by

Specifically, the output of the pressure sensor 20 for detecting the pressure of the argon gas in the internal conduit 14 near the base 21 is input to the control unit 22 and stored in advance in the pressure information storage unit 22a in the control unit 22. The threshold value is compared with the threshold value, and when the threshold value is exceeded, the controller 22 controls the electromagnetic proportional control valve 19 to stop the air supply. Then, when the pressure value reaches the set pressure value or less, the electromagnetic proportional control valve 19 is controlled to open again.

Further, when the control unit 22 exceeds the threshold value and stops air supply, the control unit 22 sends a control signal to the buzzer 29 as a warning device to perform a warning operation.
I try to let the surgeon know about it.

When the pressure of the argon gas detected by the pressure sensor 20 is equal to or lower than the threshold value and the hemostasis or the like is performed, the electromagnetic proportional control valve 19 measures the hemostasis or the like detected by the flow sensor 18. The control unit 22 proportionally controls the valve opening / closing amount of the electromagnetic proportional control valve 19 so that the set flow rate is suitable for.

In this state, the argon gas is supplied to the handpiece 4 side at a constant flow rate, is fed to the tip side of the handpiece 4 through the air feeding conduit provided around the high frequency electrode, and is opened at the tip. The flow becomes a jet flow from the nozzle, and is radiated (discharged) to the side of the living tissue to be treated.

At this time, the tip side of the high-frequency electrode arranged near the center of the nozzle is shaped like a needle, the jet of argon gas is ionized by the high-frequency signal, and the ionized argon having a conductive state is formed. The high-frequency signal current flows to the living tissue side of the treatment target through the gas jet portion,
Treatments such as coagulation or hemostasis are performed. The high-frequency signal current that has passed through the tissue to be treated returns to the high-frequency generator 2 via the patient plate that is in contact with the patient over a wide area.

Next, the operation of the present embodiment will be described. The high-pressure argon gas in the cylinder 12 is decompressed by the primary decompressor 16 to about 3 kgf / (square cm), and the decompressed argon gas is decompressed by the secondary decompressor 17 at about 50 mmHg.
The pressure is reduced. Here, when the foot switch 24 is pressed, air supply is started, and the supplied argon gas is flow rate sensor 18
The flow rate is measured by the control unit 22, this value is taken into the control unit 22, a comparison process with the set flow rate value is performed, and the flow rate is controlled by the electromagnetic proportional control valve 19. Then, turn on a foot switch or the like (not shown) connected to the high frequency generator 2.
By doing so, a high-frequency signal is output to the high-frequency electrode side, and the biological tissue (in this case, organ tissue in the abdominal cavity) can be treated such as hemostasis.

In this case, the flow rate of the argon gas is 0 to 15
When the stop signal is sent to the solenoid proportional control valve 19 while being controlled during L / min and the stop control is performed by the control unit 22,
The electromagnetic proportional control valve 19 is closed to reduce the flow rate to 0 L / mi.
set to n. The pressure sensor 20 measures the pressure in the vicinity of the base 21 of the internal conduit 14, and this value is taken into the control unit 22. The control unit 22 compares this pressure value with a predetermined threshold value, and when the measured pressure value exceeds the threshold value, the air supply is stopped.

Next, the operation leading to the air supply stop will be described with reference to FIG. FIG. 2A shows the pressure sensor 20.
2B, the pressure in the abdominal cavity 6a, the air supply control ON / OFF (air supply / stop), and the buzzer 29 in FIG. 2C.
7 is a graph showing a time series relationship of ON / OFF of the warning by.

In this embodiment, the abdominal pressure is set to 15 mmHg and the patient is insufflated by an insufflation device (not shown). On the other hand, the threshold value in the air supply device 3 is set by a setting knob (not shown) and stored in the pressure information storage unit 22a of the control unit 22.

First, at time t0, the measurement value of the sensor 20 is equal to the pressure value of the abdominal cavity 6a. At time t1, the foot switch 24 is pressed and air supply is started. The air supply is started by increasing the flow rate from 0 to a predetermined value (set value) by the electromagnetic proportional control valve 19 as described above. When the air supply is started, a flow occurs in the internal conduit 14, and the measured value of the pressure sensor 20 increases by ΔP in the figure.

The increase in the measured value is (a) the internal pipeline 1
It is known that it is determined by the resistance value of the flow from the mounting portion of the pressure sensor 20 of No. 4 to the outlet of the conduit of the handpiece 4 and (b) the flow rate value. In the case of this embodiment, the flow rate is 15 L
In the case of / min, the case of ΔP = 25 mmHg is shown. The operator injects argon gas into the abdominal cavity 6a so that the pressure in the abdominal cavity 6a rises and does not reach a dangerous pressure.
The cock (not shown) such as the trocar 8 inserted into the mouth is opened to discharge the gas in the abdominal cavity 6a to adjust the pressure (section t1 to t2).

However, if this procedure is not taken or the amount of gas discharged is smaller than the amount injected, the intraperitoneal 6
The pressure of “a” rises and rises toward the unsafe pressure value side, and accordingly, the measurement value measured by the pressure sensor 20 that measures the pressure near the outlet of the internal conduit 14 also rises. Time t3 shows this state. Pressure setting of 6a in the abdominal cavity is 15m
It is mHg, and there is no influence on the patient up to 20 mmHg as a reference value. ΔP = 25mm for this 20mmHg
45 mmHg to which Hg is added is used as a threshold for stopping the air supply in the pressure sensor 20 during the air supply.

At time t3, since the measured value of the pressure sensor 20 has reached this threshold value, the control unit 22 outputs a signal to the electromagnetic proportional control valve 19 to set the flow rate to 0 L / min, and at the same time a warning is issued. A signal is also sent to the buzzer 29 as a device to activate the buzzer 29 and an LED (not shown) to give a warning to the operator. Pressure sensor 2 when air supply stops
A measured value of 0 equals abdominal pressure 6a. When the warning is issued, the operator notices that the pressure in the abdominal cavity 6a has risen,
The pressure in the abdominal cavity 6a is released.

As a result, when the pressure in the abdominal cavity 6a falls to the set value of 15 mmHg, the warning is ended and the state where the air can be supplied is restored again (time t4). At time t5 after this time t4, the inert gas electrosurgical apparatus 1 is activated again,
The surgery can be continued.

The present embodiment has the following effects. As described above, in the present embodiment, it is considered that the pressure in the abdominal cavity 6a is dangerous even if the operator does not take a procedure for expelling the gas in the abdominal cavity 6a, or if the amount of the discharged gas is smaller than the injection amount. Since the air supply is stopped when the reference value is sufficiently lower than the predetermined value, it is possible to reliably prevent the pressure from exceeding the reference value and reaching a dangerous pressure value.

Although the threshold value for stopping the air supply and starting the warning is directly input in the present embodiment, the pressure set value in the abdominal cavity 6a is input to determine the flow rate and the conduit resistance. The threshold value may be automatically set by adding the calculated ΔP thereto.

If the decompression value of the secondary decompressor 17 is set to a low pressure of about 20 to 30 mmHg, the rate of increase of the pressure in the abdominal cavity 6a becomes slower, and a safer device is provided. If the allowable value of 30 mmHg is set to 30 mmHg, the pressure becomes equal to the depressurized value when 30 mmHg is reached, and the air supply is naturally stopped. In this case, it is necessary to reduce the conduit resistance to the tip of the handpiece 4 so as not to drop the flow rate.

Further, although the handpiece type device is shown in the present embodiment, if the same configuration is applied to an endoscope, it can be applied to treatment of the digestive tract.

(Second Embodiment) FIGS. 3 to 6 relate to a second embodiment of the present invention. FIG. 3 shows an air supply device portion in the second embodiment, and FIG. 4 shows a handpiece. 5 shows a cross section taken along line AA of FIG. 4, and FIG. 6 shows a structure of a handpiece of a modification example with respect to FIG.

The air supply device 3'shown in FIG. 3 is different from the air supply device 3 in FIG. 1 in that an internal suction pipe line 30 is further provided, and a base 31 at one end of the internal suction pipe line 30 is shown via a tube 32. Not connected to an external suction source. A flow rate sensor 33 and a flow rate adjusting valve 34 using an electromagnetic proportional control valve are provided in this order from the mouthpiece 31 side of the internal suction pipeline 30, and reach a mouthpiece 35 provided at the other end.

Further, the control unit 22 'in the present embodiment.
In the control unit 22 of FIG. 1, a flow rate sensor 33,
The flow control valve 34 is connected to the control unit 22 '.
Controls the opening / closing amount of the flow rate adjusting valve 34 according to the flow rate detected by the flow rate sensor 33. The base 35 is the suction tube 3
It is connected via 6 to the handpiece 4 ′. Next, the handpiece 4'will be described with reference to FIG.

A high frequency electrode 37 is provided on the handpiece 4'along the central axis O, and the high frequency electrode 37 is connected to the high frequency electric cable 9 at the rear end of the handpiece 4 '.
The high frequency electric cable 9 is connected to the high frequency generator 2 described in FIG.

An air supply conduit 38 is formed by an inner cylindrical pipe coaxial with the central axis O. The air supply conduit 38 is connected to a tube 23 having one end connected to a connection mouthpiece at the rear end of the handpiece 4 '. Communicate. The other end of the tube 23 is connected to the mouthpiece 21 of the air feeding device 3 '.

An outer cylindrical pipe coaxial with the central axis O is provided outside the air supply conduit 38, and a suction conduit 39 is provided between the inner cylindrical pipe and the outer cylindrical pipe. The conduit 39 communicates with the suction tube 36, one end of which is connected to the connection mouthpiece at the rear end of the handpiece 4 '. The other end of the suction tube 36 is connected to the base 35.

As shown in FIG. 5 showing the cross section taken along the line AA in FIG. 4, the suction pipe 39 has an area of the suction pipe represented by reference numeral 39S and an area of the air supply pipe 38 indicated by reference numeral 38S. It is set to be larger. The air supply conduit 38 and the suction conduit 39 are openings that are opened at the tip surface 41 of the handpiece 4 '(that is, on the same surface).

In the present embodiment, when the pressure detected by the pressure sensor 20 becomes equal to or higher than the threshold value, the air supply is stopped as in the first embodiment. Further, when the pressure detected by the pressure sensor 20 exceeds a set value set lower than the threshold value, the control unit 22 'is electromagnetically proportional so as to reduce the air supply amount in proportion to the exceeded value. Control valve 19
The valve opening / closing amount of is controlled, and if it falls below this set value,
The flow rate adjusting valve 34 is controlled so as to reduce the suction amount in proportion to the value that has fallen below.

That is, in the first embodiment, the argon gas is sent to the inside of the body cavity 6a through the handpiece 4, and when the threshold value is exceeded, the argon gas is supplied to the handpiece 4 side. Whereas the mechanism to stop is formed,
In the present embodiment, a handpiece 4'having a suction conduit 39 adjacent to the opening of the air supply conduit 38 at the tip and having a suction port opened on the outside thereof is connected to the handpiece 4 ',
An air supply / suction unit provided with an air supply line system for supplying air and a suction line system for suctioning is provided, and when the pressure detected by the pressure sensor 20 becomes equal to or higher than a threshold value, the first embodiment is performed. The feature is that air supply is stopped in the same manner as the form, and when the threshold value is not exceeded, the air supply rate and suction rate are controlled according to the deviation from the set value lower than the threshold value. Has become. Other configurations are the same as those in FIG. 1, and the same components are designated by the same reference numerals and the description thereof will be omitted.

Next, the operation of the present embodiment will be described. When the foot switch 24 is stepped on, first, the pressure sensor 20 measures the pressure in the abdominal cavity 6a and stores it in the pressure information storage unit 22a of the control unit 22 '. Next, while operating the electromagnetic proportional control valve 19 and the flow rate adjusting valve 34, the high frequency current is applied to the high frequency electrode 3
7 is added. Here, the control method will be described with reference to FIG.

The control unit 22 'monitors the value of the pressure sensor 20 and adjusts the electromagnetic proportional control valve 19 and the flow rate so that the pressure rise value during air supply is maintained at the set value corresponding to ΔP in FIG. Control valve 34.

When the measured value of the pressure sensor 20 exceeds 40 mmHg, the air supply amount is reduced in proportion to the exceeded value to 40 mHg.
When it is lower than mHg, the suction amount is reduced in proportion to the lowering amount. The air supply amount and the suction amount are measured using the flow rate sensors 18 and 33. By controlling in this way, the pressure in the abdominal cavity 6a can be maintained at a value (20 mmHg) corresponding to the measurement value detected by the pressure sensor 20 in a normal use state.

If the suction function is lowered for some reason and the measured value exceeds the threshold value of 45 mmHg as shown in FIG. 2, the air supply is stopped as in the first embodiment.
Issues a warning. In this case, the suction does not stop.

Here, the values of the flow rate sensors 18 and 33 are compared, and if the difference exceeds 5 L / min, there is a possibility that one of the conduits is clogged or disconnected, and this is warned. You can Next, the operation of the handpiece 4'will be described with reference to FIG.

Since the handpiece 4'has a larger cross-sectional area of the suction conduit 39 than the air supply conduit 38, the flow velocity through the conduit (in normal use) is slower in the suction conduit 39. . Therefore, the gas flow discharged from the air supply conduit 38 is blown to the target tissue side such as the affected area without being sucked into the suction conduit 39, and the coagulation or hemostasis treatment is hardly affected by the suction. You can

As described above, according to the present embodiment,
Since the inert gas electrosurgical device has a suction function, it is not necessary for the operator to open the trocar cock, which improves the efficiency of the operation and increases the abdominal pressure due to the operator forgetting to open the trocar cock. Safety can be improved because it can be prevented. Further, since the flow velocity of the suction pipe line is set to be slower than the flow velocity of the air supply pipe line, the turbulence of the gas flow to be sent can be reduced.

In FIG. 4, the suction pipe 39 of the handpiece 4'forms a suction port having the same structure as the air supply pipe 38, which opens on the same end face. However, as shown in FIG. The opening 43 may be provided on the side surface of the to form the suction port.

By thus forming the suction port on the side surface of the handpiece 4 ', the influence on the flow of the argon gas can be further reduced. Further, by providing a liquid trap and a filter in the suction tube 36, it is possible to remove the liquid and smoke sucked from the affected area or the like, and prevent malfunction of the flow rate sensor 33 and the flow rate adjusting valve 34 due to contamination.

In FIG. 3, although the gas pressure in the internal conduit 14 communicating with the air conduit 38 of the handpiece 4'is detected to control the gas supply and suction, the suction conduit 39 is used. May be configured to detect the pressure of the gas in the internal suction pipe line 30 communicating with the air supply and suction, or to detect the pressure of each gas and control the air supply and the suction, respectively. May be.

(Third Embodiment) FIG. 7 shows a third embodiment of the present invention.
The handpiece 50 in the embodiment of FIG. The handpiece 50 according to the present embodiment has, for example, the structure of the handpiece 4 according to the first embodiment in which the relief valve 52 is provided in the air supply conduit 51.

A grasping portion 53, which is grasped by an operator on the rear end side of the handpiece 50, is provided with a hole communicating with the inner air supply conduit 51, and a movable member 54 forming a relief valve 52 in this hole.
A disc-shaped member 56 provided with an exhaust port 55 communicating with the outside air.
3, a coil-shaped spring 57 is interposed between the movable member 54 and the disc-shaped member 56, and the spring 57 urges the movable member 54 to elastically press inward. ing. In this state, the air supply line 51 and the exhaust port 55 are blocked by the movable member 54 in the fitted state.

The pressure on the side of the air supply line 51 is, for example,
When the pressure exceeds 30 mmHg, the movable member 54 is moved to the outside against the bias of the spring 57, and the air supply line 51 and the exhaust port 55 are moved.
And the relief valve 52 that automatically exhausts gas from the exhaust port 55 is formed. That is, the operating pressure of the relief valve 52 is set to 30 mmHg.

The air supply conduit 51 is formed by a circular tube concentrically surrounding the high frequency electrode 58 arranged along the central axis of the handpiece 50. Next, the operation of the present embodiment will be described.

During the procedure in which the handpiece 50 is used in the inert gas electrosurgical device 1 of the first embodiment, for example, a pressure increase in the abdominal cavity occurs as described in the operation of the first embodiment. , 30 mmHg, the relief valve 52
Automatically discharges the gas.

Therefore, according to the present embodiment, it is possible to realize an inexpensive structure which does not require an electric control section.

Although the handpiece 50 having the air supply conduit 51 has been described with reference to FIG. 7, the handpiece 4'having the air supply conduit 38 and the suction conduit 39 as shown in FIG.
The relief valve 5 so as to communicate with the air supply line 38.
2 can also be formed. In this case, the gas is automatically discharged by the relief valve 52 even if the air supply stop function when the threshold value is exceeded, which is described in the second embodiment, should be automatically discharged by the relief valve 52. It is possible to realize a safer device.

In addition, the relief valve 52 is connected to the air supply system portion (internal pipe line 14 and tube 2) after the rear end of the handpiece 7.
It may be provided in 3). For example, the tube 23 may be connected to the mouthpiece at the rear end of the handpiece 4 in FIG. 1 via an adapter provided with a relief valve 52.

(Fourth Embodiment) FIG. 8 shows a fourth embodiment of the present invention.
The vicinity of the grip portion of the handpiece 60 in the embodiment is shown. In the present embodiment, for example, instead of the handpiece 4 in the first embodiment, the handpiece 60 shown in FIG.
To form an inert gas electrosurgical device.

A pressure sensor 62 and a valve 63 are provided in the air supply line 61 at the grip portion of the handpiece 60, for example, and are connected to the control unit 22 of FIG. 1 via signal lines 64 and 65, respectively. .

The pressure sensor 62 detects (measures) the pressure of the gas in the air supply conduit 61 from the pressure intake port 66 and transmits the measured value to the control unit 22. The control unit 22 compares the measured value with a set value and controls the opening / closing of the valve 63 according to the comparison result.

The valve 63 is provided so that the gas inlet 67 communicates with the central axis O side of the handpiece 60 and the outlet 68 communicates with the opposite side to the outside, and is controlled by the controller 22 via the signal line 65. It This valve 63 is Redwood
A Fluistor microvalve manufactured by Microsystems can be used for miniaturization.

Next, the operation of this embodiment will be described. When the pressure in the abdominal cavity is set to 15 mmHg, the control unit 22 compares the measured value of the pressure sensor 62 with this set value,
When the measured value of the pressure sensor 62 exceeds the set value of 10 mmHg, that is, when it reaches 25 mmHg, the valve 63 is opened and the pressure in the abdominal cavity is discharged to the atmosphere.

According to the present embodiment, the threshold value at the start of discharge can be changed according to the change in the set value of the abdominal pressure, so that a safer device can be realized. is there.

If a pressure measurement port is provided at the tip of the handpiece and the port and the pressure intake port 66 are connected by a conduit, the pressure in the abdominal cavity can be measured directly. Therefore, it is possible to eliminate the influence of the pressure increase of the handpiece pipe line due to the gas flow and to bring the threshold value close to the set value (for example, 20 mmHg is set as the threshold value for the set value of 15 mmHg). Accurate control is possible.

In the first embodiment, for example, the air supply device 3 has been described as connected to the handpiece 4 via the tube 23. However, the air supply device 3 in FIG. An arrangement including the air supply line of the handpiece 4 may be used as the air supply device. This can be applied to other embodiments.

Also in FIG. 3, the one including the air supply device 3 ', the tube 23, the air supply line of the handpiece 4', the suction tube 36, and the suction line 39 of the handpiece 4'is also included. It may be an air supply device.

Note that, for example, in the second embodiment,
If the pressure detected by the pressure sensor 20 is less than the threshold value, a device that controls the suction amount according to the amount of deviation from the set value also belongs to the present invention. That is, the air supply amount may be maintained at a value suitable for treatment such as hemostasis, and may be maintained at the set value by controlling the suction amount on the suction side. It should be noted that embodiments and the like configured by combining the above-described embodiments and the like in a partial manner also belong to the present invention.

[Additional Notes] 1. In an electrosurgical device for causing coagulation or hemostasis by applying high-frequency electric energy to a human body through a flow of an inert gas, a control valve for turning on / off a gas flow in a duct for supplying air, and a pipe. A pressure sensor for measuring the pressure near the passage outlet, and a control unit for controlling the control valve to turn off the gas flow when the output value of the pressure sensor exceeds a threshold value, An electrosurgical device comprising an air supply device having a.

(Effect of Supplementary Note 1) Even if the operator does not take measures for discharging the gas in the abdominal cavity, or the amount of gas discharged is smaller than the injection amount, the pressure in the abdominal cavity rises to a dangerous value. Can be prevented.

2. The electrosurgical device according to appendix 1, wherein the threshold value changes in association with a set value. 3. The electrosurgical device according to appendix 1, wherein the final reduced pressure value of the air supply device is 30 mmHg or less. 4. The electrosurgical device according to appendix 1, wherein a relief valve is provided in the conduit and the relief valve operates when the threshold value is exceeded.

5. Appendix 4 wherein the relief valve is provided in a handpiece of an electrosurgical device
An electrosurgical device according to claim 1. 6. The electrosurgical device according to appendix 5, wherein the pressure sensor is provided in the conduit of the handpiece. 7. In an electrosurgical device that applies high-frequency electrical energy to the human body through the flow of an inert gas to coagulate or stop bleeding, an air supply conduit for supplying air and a suction conduit for performing suction,
Electricity characterized by providing an air supply device having a pressure sensor provided in the air supply line or the suction line, and a control unit for controlling the air supply flow rate and the suction flow rate according to the output value of the pressure sensor. Surgical equipment.

(Purpose of Supplementary Note 7) Since the operator does not need to open the trocar cock, the efficiency of the operation can be improved, and the surgeon can prevent an increase in the abdominal cavity due to forgetting to open the trocar cock. To provide an electrosurgical device that can also be enhanced. (Operation of Supplementary Note 7) The pressure in the air supply line is measured, and the air supply flow rate and the suction flow rate are controlled so as not to exceed the threshold value. (Effect of Supplementary Note 7) Since the operator does not have to open the cock of the trocar, the efficiency of the operation can be improved. Further, it is possible to prevent an increase in abdominal pressure caused by forgetting to open the cock of the trocar of the operator, so that the safety is enhanced.

8. 8. The electrosurgical device according to appendix 7, wherein the flow velocity of the suction pipe line is set to be slower than that of the air supply pipe line. (Effect of Supplementary Note 8) In addition to the effect of Supplementary Note 7, since the flow velocity of the suction pipe line is set to be slower than that of the air supply pipe line, turbulence of the gas flow to be supplied can be reduced.

9. The electrosurgical device according to appendix 7, wherein the control unit, when the measured value of the pressure sensor exceeds a threshold value, reduces the air supply flow rate in accordance with the exceeded amount. 10. The electrosurgical device according to appendix 7, wherein, when the measurement value of the pressure sensor falls below a threshold value, the control unit reduces the suction flow rate in accordance with the fallen amount. 11. The electrosurgical device according to appendix 7, wherein a handpiece connected to the electrosurgical device is provided with an air supply conduit and a suction conduit.

12. 12. The electrosurgical device according to appendix 11, wherein the human body side openings of the air supply line and the suction line are close to each other. 13. 13. The electrosurgical device according to appendix 12, wherein the openings of the air supply line and the suction line are arranged on the same plane. 14． The electrosurgical device according to appendix 11, wherein the suction duct cross-sectional area is larger than the air supply duct cross-sectional area.

[0087]

As described above, according to the present invention, in an electrosurgical apparatus for causing coagulation or hemostasis by causing high frequency electric energy to act on a human body through a flow of an inert gas,
The control valve for turning on / off the flow of gas in the pipeline for supplying air, the pressure sensor for measuring the pressure near the outlet of the pipeline, and the output value of the pressure sensor exceeded the threshold value. In this case, since an air supply device having a control unit for controlling the control valve so as to turn off the gas flow is provided, when the pressure in the pipe is measured and the threshold value is exceeded, By stopping the air supply to the patient, the pressure inside the abdominal cavity can reach a dangerous value even if the operator does not take measures to expel the gas inside the abdominal cavity or if the amount of gas expelled is less than the amount injected. It is possible to prevent rising.

[Brief description of drawings]

FIG. 1 is a configuration diagram showing an inert gas electrosurgical device according to a first embodiment of the present invention.

FIG. 2 is an operation explanatory diagram of FIG. 1;

FIG. 3 is a configuration diagram showing an air feeding device portion according to a second embodiment of the present invention.

FIG. 4 is a cross-sectional view showing the structure of the handpiece.

FIG. 5 is a sectional view taken along line AA of FIG. 4;

FIG. 6 is a cross-sectional view showing a structure of a distal end side of a handpiece of a modified example.

FIG. 7 is a sectional view showing a handpiece according to a third embodiment of the present invention.

FIG. 8 is a cross-sectional view showing the vicinity of a grip portion of a handpiece according to a fourth embodiment of the present invention.

[Explanation of symbols]

 1 ... Inert gas electrosurgical device 2 ... High frequency generator 3 ... Air supply device 4 ... Handpiece 5, 8 ... Trocar 6 ... Human body 7 ... Laparoscope 9 ... High frequency electric cable 11 ... High pressure mouthpiece 12 ... Cylinder 13 ... High pressure hose 14 ... Internal pipeline 16,17 ... Pressure reducer 18 ... Flow rate sensor 19 ... Electromagnetic proportional control valve 20 ... Pressure sensor 21 ... Connection mouthpiece 22 ... Control section 22a ... Pressure information storage section 23 ... Tube 24 ... Foot switch 28 ... Signal Cable 29 ... Buzzer

Claims (1)

[Claims] 1. An electrosurgical apparatus for coagulating or stopping bleeding by applying high-frequency electric energy to a human body through the flow of an inert gas, for turning on / off the flow of gas in a duct for supplying air. A control valve, a pressure sensor for measuring the pressure in the vicinity of the outlet of the conduit, and controlling the control valve so that the gas flow is turned off when the output value of the pressure sensor exceeds a threshold value. An electrosurgical device comprising an air supply device having such a control unit.