WO2024062636A1

WO2024062636A1 - Electric scalpel

Info

Publication number: WO2024062636A1
Application number: PCT/JP2022/036534
Authority: WO
Inventors: 伸一山本; 光夫五十嵐
Original assignee: 株式会社コスミックエムイー; 伸一山本
Priority date: 2022-09-20
Filing date: 2022-09-29
Publication date: 2024-03-28
Also published as: JP2024044984A; JP7356767B1; JP2024044180A; JP7281033B1

Abstract

Provided is an electric scalpel used for laparoscopic or thoracoscopic surgery. For the purpose of reducing interference between shafts or between arms compared to prior art, the electric scalpel (10) comprises a main shaft (11) at least part of which is made of a flexible material and which is provided with an electrode (12) at one end (113) thereof, the one end (113) being inserted into the abdominal or thoracic cavity of a patient from outside the body of the patient.

Description

Electric scalpel

The present invention relates to an electric scalpel used in conjunction with a laparoscope or thoracoscope.

For surgeries such as bile pus removal, colectomy, ovarian empyema removal, and total hysterectomy, laparoscopic surgery (or laparoscopic surgery) is performed by inserting a laparoscope, which is a type of endoscope, into the abdominal cavity. ) is becoming popular. In laparoscopic surgery, an operator (for example, a surgeon) performs surgery using a plurality of surgical instruments while viewing an image of the abdominal cavity obtained by laparoscopy. Examples of surgical tools include electric scalpels (see Non-Patent Documents 1 to 3) and forceps. The tips of these surgical tools are inserted into the patient's abdominal cavity through a small hole in the abdomen.

Also, a robot that assists in laparoscopic surgery is known (see Non-Patent Document 4). This robot has multiple arms. A robotic hand that functions as an electric scalpel or forceps is attached to the tip of each arm. Each robotic hand is inserted into the abdominal cavity through a small hole made in the patient's abdomen. In the following, laparoscopic surgery that uses such a robot will also be referred to as robotic surgery.

Note that the surgical tools and robots described above are applicable not only to laparoscopic surgery but also to thoracoscopic surgery. In thoracoscopic surgery, a laparoscope, which is a type of endoscope, is inserted into the abdominal cavity to perform the surgery. However, in the following, laparoscopic surgery will be used as an example.

By the way, in the above-mentioned laparoscopic surgery, a laparoscope and a plurality of surgical instruments are inserted into the abdominal cavity. Furthermore, in a robot that supports laparoscopic surgery as described above, a laparoscope and a plurality of arms are inserted into the abdominal cavity.

The shafts of the surgical instruments used in laparoscopic surgery that are inserted into the abdominal cavity, and the arms of the robots used in robotic surgery, are both designed to be rigid. This is because there is a risk that the precision of laparoscopic surgery will decrease if the shafts and arms bend.

As a result, when attempting to move the distal end of each surgical instrument to a desired position, the shafts forming each surgical instrument may interfere with each other. Similarly, when trying to move the robot hand of each arm to a desired position, the arms may interfere with each other. In these cases, in order to continue the surgery, it is necessary to eliminate the above-mentioned interference by adjusting the mutual positions of the surgical instruments and the mutual positions of the arms. However, such work requires a lot of time and effort for the operator, and is one of the causes of prolonging the operation time.

An electric scalpel according to one aspect of the present invention has been developed in view of the above-mentioned problems, and its purpose is to reduce interference between shafts or arms in an electric scalpel used in laparoscopic surgery or thoracoscopic surgery. The aim is to make it less likely that this will occur.

The electric scalpel according to one aspect of the present invention is an electric scalpel used in combination with a laparoscope or a thoracoscope. In order to solve the above problems, the present electric scalpel has a main shaft whose one end is inserted into the abdominal cavity or thoracic cavity from outside the patient's body, and whose one end is provided with an electrode. At least a portion of the main shaft is made of a flexible material.

The electric scalpel according to one aspect of the present invention can make interference between shafts or arms less likely to occur than in the past in an electric scalpel used in laparoscopic surgery or thoracoscopic surgery.

FIG. 1 is a perspective view of an electric scalpel according to an embodiment of the present invention. FIG. 2 is a sectional view of a main shaft included in the electric scalpel shown in FIG. 1. FIG. FIG. 2 is a perspective view of an electrode and a grip part included in the electric scalpel shown in FIG. 1. FIG. FIG. 2 is a perspective view of a modified example of the grip included in the electric scalpel shown in FIG. 1; FIG. 2 is a schematic diagram of laparoscopic surgery in which the electric scalpel shown in FIG. 1 is used in combination with a laparoscope.

[Overview of electric scalpel]
In laparoscopic surgery (or laparoscopic surgery), which is performed by inserting a laparoscope, which is a type of endoscope, into the abdominal cavity, the operator (for example, the surgeon) views images of the abdominal cavity obtained by the laparoscope. While performing the surgery, multiple surgical instruments are used. The electric scalpel 10 is an electric scalpel suitable for use in conjunction with a laparoscope in such laparoscopic surgery. Note that the electric scalpel 10 can also be used in conjunction with a thoracoscope in thoracoscopic surgery (or thoracoscopic surgery) performed by inserting a thoracoscope, which is a form of an endoscope, into the thoracic cavity. In this embodiment, the electric scalpel 10 will be explained using laparoscopic surgery as an example.

In this embodiment, the electric scalpel 10 has a smoke evacuation function, a cleaning function, and a suction function. The smoke exhausting function is a function of exhausting at least one of intraperitoneal gas and mist. The washing function is a function of washing the inside of the abdominal cavity by discharging a washing liquid. The suction function is a function of suctioning the fluid present in the abdominal cavity.

Further, in this embodiment, the main shaft 11 of the electric scalpel 10 is connected to a grip 16 via a connector 15. An operator or surgical assistant in the vicinity of the patient can control the position of the electrode 12 within the abdominal cavity by controlling the grip 16. In addition, when using a robot to support laparoscopic surgery, the robot arm and robot hand R _H (see Figure 3) are inserted into the abdominal cavity, so the robot hand R _H is used to connect the electrodes in the abdominal cavity. It is also possible to control 12 positions.

[Configuration of electric scalpel]
The configuration of an electric scalpel 10 according to an embodiment of the present invention will be described with reference to FIGS. 1 to 3. FIG. 1 is a perspective view of the electric scalpel 10. FIG. 2 is a sectional view of the main shaft 11 included in the electric scalpel 10. Note that FIG. 2 is a cross-sectional view that is a cross section perpendicular to the central axis of the main shaft 11, and is a cross-sectional view taken along the line AA' shown in FIG. FIG. 3 is a perspective view of the electrode 12 and grip portion 13 included in the electric scalpel 10.

As shown in FIG. 1, the electric scalpel 10 includes a main shaft 11, an electrode 12, a grip part 13, a guide 14, a connector 15, a grip 16, a power supply cable 17, an exhaust pipe 18, a cleaning pipe 19, and a suction pipe 20. There is.

<Main shaft>
As shown in FIGS. 1 and 2, the main shaft 11 includes a main tube 111, a connecting member 112, wiring 115, and a covering 116.

(main tube)
The main tube 111 constituting the main portion of the main shaft 11 is a cylindrical and flexible tube. The material constituting the main tube 111 may be any flexible material, preferably a resin material. Examples of the resin material include vinyl chloride. However, the material constituting the main tube 111 is not limited to resin (eg, vinyl chloride), and can be appropriately selected from flexible materials.

Note that in this embodiment, the main tube 111 is a tube whose entire structure is flexible. However, in one aspect of the present invention, at least a portion of the main tube 111 only needs to have flexibility. When a part of the main tube 111 is made of a flexible material and the remaining part of the main tube 111 is made of a rigid material, a part of the section including the end 113 described below is made of a flexible material. It is preferable to use a material having the following properties. In this case, the length of the partial section can be determined as appropriate, but is preferably less than half the length of the main tube 111 (for example, 700 mm as described later). By configuring the main tube 111 in this way, the main tube 111 inserted into the abdominal cavity can have flexibility, while the majority of the main tube 111 located outside the body can be configured to be rigid. By providing flexibility to the entire main tube 111 or at least a portion thereof, the flexible portion of the main tube 111 can be bent. Therefore, the electric scalpel 10 can prevent the main tube 111 from being included in the field of view of the laparoscope when the operator places the electrode 12 in the abdominal cavity. Note that when a partial section of the main tube 111 including the end 113 is made flexible, the electrode 12 in the abdominal cavity is made more flexible than when the entire section of the main tube 111 is made flexible. The position of the patient can be easily adjusted from outside the abdominal cavity (i.e., outside the patient's body).

Note that when the partial section including the end portion 113 is made of a flexible material, the electric scalpel 10 is equipped with a bending adjustment mechanism that arbitrarily adjusts the degree of bending of the main tube 111 in the partial section. Preferably. An example of this bending adjustment mechanism is one that includes a wire and a winding mechanism that adjusts the tension of the wire. In this bending adjustment mechanism, the distal end of the wire is fixed near the end portion 113, and the midway section of the wire extends along the internal space of the main tube 111 (hereinafter referred to as the through hole _TH ). It's wired. Further, the proximal end of the wire is fixed to a winding mechanism, and the winding mechanism is fixed to a grip 16 described below. The winding mechanism may be a manual type that winds up the wire using a lever, or an automatic type that winds up the wire using a motor.

When the winding mechanism is not winding the wire, the main tube 111 maintains its original straight state. On the other hand, as the winding mechanism winds up the wire, the vicinity of the end 113 to which the distal end of the wire is fixed is pulled toward the grip 16. Therefore, a partial section of the main tube 111 made of a flexible material bends depending on the length of the wire wound up by the winding mechanism.

Note that such a bending adjustment mechanism can bend a partial section of the main tube 111 in one direction. Therefore, by providing a plurality of such bending adjustment mechanisms in the electric scalpel 10, a partial section of the main tube 111 can be bent in a plurality of directions.

The outer diameter of the main tube 111 may be determined as appropriate depending on the inner diameter of a trocar used to insert the electrode 12 of the electric scalpel 10 into the abdominal cavity in laparoscopic surgery. For example, when inserting the electric scalpel 10 into the abdominal cavity using a trocar with an inner diameter of 5 mm, the outer diameter of the main tube 111 is preferably about 4 mm. This is because in the case of the electric scalpel 10, a guide 14, which will be described later, is further provided outside the main tube 111, and the outer diameter of the guide 14 is required to be less than the inner diameter of the trocar (for example, 5 mm). When the guide 14 is omitted, the outer diameter of the main tube 111 can be appropriately set within a range of less than 5 mm.

The length of the main tube 111 is not limited and can be determined as appropriate. In this embodiment, the length of the main tube 111 is 700 mm. When using the electric scalpel 10 for laparoscopic surgery on adults, the length of the main tube 111 is preferably 600 mm or more and 1000 mm or less.

Note that one end of the main tube 111, which is the end closest to the electrode 12 described below, is referred to as end 113. In FIG. 1, end 113 is not visible as it is covered by a connecting member 112 described below. For that reason, in FIG. 1, the lead line indicated by the reference symbol 113 is shown with a dashed line. Additionally, the other end of the main tube 111 is located inside the grip body 161 of the grip 16 described below via a connector 15 described below. Note that hereinafter, the portion near the other end that is inserted into the connector 15 is referred to as the connection portion 114.

The other end of the main tube 111 described above is connected to the exhaust pipe 18, the cleaning pipe 19, and the suction pipe 20 through a connector that branches into three parts inside the grip body 161.

The connecting member 112 has a cylindrical shape and is made of a conductor. The connecting member 112 is fixed over the main tube 111 so as to cover the end portion 113. In this embodiment, the connecting member 112 is made of copper. Further, in this embodiment, the connecting member 112 is fixed to the main tube 111 by lending a portion thereof. However, the conductor constituting the connecting member 112, the length of the connecting member 112, and the method of fixing the connecting member 112 to the main tube 111 are not limited and can be determined as appropriate. Note that the conductor constituting the connection member 112 is preferably a highly conductive metal, and examples of such metals include aluminum and stainless steel in addition to the above-mentioned copper.

An electrode 12 is provided at an end 113 of the main tube 111 that is covered by the connecting member 112.

(wiring)
A wire 115 and a coating 116 are housed in the internal space of the main shaft 11 (see FIG. 2). The wire 115 and the coating 116 each pass through a through hole T _H from the other end located inside the grip body 161 to the end 113. Hereinafter, the internal space of the main tube 111 will be referred to as a through hole T _H.

The wiring 115 is a wiring for feeding high frequency current to the electrode 12. The tip of the wiring 115 is connected to a part of the electrode 12 so as to be electrically connected to the electrode 12.

The covering 116 is a resin coating layer that covers the outer surface of the wiring 115. The covering 116 prevents the wiring 115 from shorting with other members and protects the wiring 115.

(Example of modification of main shaft)
As described above, the main shaft 11 is configured by accommodating the wiring 115 and the covering 116 in the through hole _TH . However, as long as the main shaft 11 is at least partially made of a flexible material, accommodates the wiring 115, and includes the through hole _TH , any structure may be used. It's okay. For example, a modification of the main shaft 11 is a flexible columnar member, which is provided with a through hole for accommodating the wiring 115, an exhaust through hole, a suction through hole, and a cleaning through hole. It may be configured by a columnar member. Another modification of the main shaft 11 is configured to accommodate an exhaust subtube, a suction subtube, and a cleaning subtube in addition to the wiring 115 in the through hole _TH . Good too.

<Electrode>
As shown in FIG. 3, the electrode 12 is an electrode provided at the end 113 of the main tube 111 and covered by the connecting member 112. The electrode 12 is fixed to the connection member 112 so as to be electrically connected to the connection member 112. Further, one end of the wiring 115 is connected to the electrode 12 in a conductive state.

The diameter of the electrode 12 can be determined appropriately according to the inner diameter of the trocar. For example, if a trocar with an inner diameter of 8 mm is used, the electrode 12 should be less than 8 mm.

The electric scalpel 10 is a monopole type electric scalpel. Therefore, a single electrode made of a conductor is used as the electrode 12. In this embodiment, a spherical member made of aluminum is used as the electrode 12. That is, in this embodiment, the electrode 12 is a so-called ball-tip type electrode. In this embodiment, the diameter of the electrode 12 is 7 mm.

However, the electric scalpel 10 may be a bipolar electric scalpel, and in that case, the electrode 12 may be composed of a pair of electrodes. Further, the conductor constituting the electrode 12 is not limited to aluminum, and can be appropriately selected from among conductors. Further, the shape of the electrode 12 is not limited to a spherical shape. Other shapes of the electrode 12 may be an L-shape, a spatula shape, or the like.

The electrode 12 is provided with one cleaning suction port 121 and a plurality of exhaust ports 122 (see FIG. 3).

(Washing and suction port)
The irrigation and suction port 121 is a through-hole provided so as to pass through the center of the spherical electrode 12 and penetrate the electrode 12. Of the pair of openings of the irrigation and suction port 121, the opening closest to the connecting member 112 is connected to the end 113 of the main tube 111 inside the connecting member 112. As shown in Fig. 3, the electrode 12 is fixed to the end 113 so that the through-hole constituting the irrigation and suction port 121 is parallel to the central axis of the main tube 111.

The cleaning suction port 121 configured in this manner can discharge the cleaning liquid supplied using the cleaning pipe and the main tube 111 in a direction along the central axis of the main tube 111, and can also discharge the cleaning liquid supplied using the cleaning pipe and the main tube 111. 20 can be used to aspirate the fluid present in the abdominal cavity.

(exhaust port)
The exhaust port 122 is composed of a plurality of through holes provided isotropically so as to surround the cleaning suction port 121.

Of the pair of openings of each through-hole configuring the exhaust port 122, the opening on the side closer to the connecting member 112 is provided so as to surround the opening on the side closer to the connecting member 112 of the cleaning suction port 121. Of the pair of openings of each through-hole constituting the exhaust port 122 , the opening on the side closer to the connecting member 112 is connected to the end 113 of the main tube 111 .

Of the pair of openings in each through-hole configuring the exhaust port 122, the opening on the side far from the connecting member 112 is provided so that the normal line of each opening intersects with the central axis of the main tube 111, as shown in FIG. ing.

The exhaust port 122 configured in this manner can exhaust at least one of the gases and mist that may be generated when the electric scalpel 10 cuts, dissects, or stops bleeding in the abdominal cavity at the exact location where the gases and/or mist are generated. Therefore, the electric scalpel 10 can exhaust at least one of the gases and mist described above more efficiently than conventional methods.

<Grip part>
As shown in FIG. 3, the grip part 13 is a cylindrical member fixed to a part of the side surface of the cylindrical connecting member 112. In this embodiment, the cross-sectional shape of the grip portion 13 is elliptical. However, the shape of the cross section of the grip part 13 is not limited to an ellipse, and can be determined as appropriate.

The end portion 113 is connected such that its axial direction (the normal direction to the bottom surface of the end portion 113) is approximately parallel to the direction of the central axis of the connecting member 112 (that is, the direction of the central axis of the main tube 111). It is fixed to the side surface of member 112. Therefore, when the connecting member 112 is fixed to the main tube 111 so that the connecting member 112 covers the end 113, the grip portion 13 is provided so as to protrude from the main shaft 11 near the end 113. There is. Further, the grip portion 13 has a cylindrical shape and is in contact with the upper portion of the grip portion 112 .

Furthermore, it is preferable that the gripping portion 13 is made of a conductor, like the connecting member 112. In this embodiment, the gripping portion 13 is made of copper, like the connecting member 112. In this embodiment, the gripping portion 13 is integrally molded with the connecting member 112. Therefore, the gripping portion 13 is electrically conductive with the connecting member 112, and by extension, is also electrically conductive with the electrode 12. In this way, it is preferable that the gripping portion 13 is electrically conductive with the electrode 12.

(How to use the grip)
When using a robot to support laparoscopic surgery, the robot arm and robot hand _RH are inserted into the abdominal cavity. Here, as shown in FIG. 3, a robot hand _RH having a pair of claws Cr is used. The operator of the robot, which is one aspect of the operator, operates the robot to open the pair of claws Cr while inserting the pair of claws Cr into the internal space of the gripping part 13. As a result, in the internal space of the gripping part 13, the robot hand _RH can hold the gripping part 13 using the pair of claws Cr. Therefore, the operator can hold the electrode 12 via the grip part 13 fixed to the pair of claws Cr, and can also control the position of the electrode 12 in the abdominal cavity using the robot hand _RH . . Buzzing can also be performed by using a robot hand _RH that can supply high-frequency current to the pair of claws Cr.

<Guide>
As shown in FIG. 1, the guide 14 is a cylindrical pipe whose length is shorter than the main shaft 11. In this embodiment, the length of the guide 14 is 400 mm. When using the electric scalpel 10 for laparoscopic surgery on adults, the length of the guide 14 is preferably 300 mm or more and 500 mm or less.

The guide 14 is configured such that its inner diameter slightly exceeds the outer diameter of the main tube 111. Further, the guide 14 is configured such that its outer diameter is smaller than the inner diameter (for example, 5 mm) of the trocar.

The guide 14 is made of a material that is less flexible than the flexible material that makes up at least a portion of the main shaft 11 (main tube 111 in this embodiment). In this embodiment, a polycarbonate pipe with a thickness of 2.0 mm is used as the guide 14. However, the pipe constituting the guide 14 is not limited to this, and any pipe that exhibits lower flexibility than the main tube 111 can be used as appropriate. In addition to the above-mentioned polycarbonate, silicone, ethylene propylene rubber, and stainless steel may be used.

The guide 14 configured in this manner exhibits lower flexibility than the main tube 111, and hardly bends against forces that may occur during surgery.

In the electric scalpel 10, the guide 14 is arranged so that its inner surface surrounds the outer surface of the main tube 111. That is, the main tube 111 penetrates the inner space of the guide 14. Therefore, the guide 14 slides with its inner surface along the outer surface of the main tube 111 in the direction of arrow B shown in FIG. 1 (direction of the central axis of the main tube 111).

Note that in this embodiment, a simple pipe is used as the guide 14. Therefore, the length of the guide 14 is constant. However, in one aspect of the present invention, a pipe that is expandable and has a variable length can also be used. Further, in this case, one end of the extensible guide 14, which is closer to the connector 15, may be fixed to the main tube 111. In that case, by moving one end of the extensible guide 14 that is far from the connector 15 in a direction closer to the electrode 12, the flexible main tube 111 It is also possible to prevent it from bending.

With this configuration, when an operator or surgical assistant positioned near the patient wishes to move the electrode 12 inside the abdominal cavity, the operator can cover a longer section of the main tube 111 with the guide 14. If the guide 14 is designed so that its length when fully extended is approximately the same as the length of the main tube 111, it is possible to cover almost the entire section of the main tube 111 with the guide 14. Therefore, an operator or surgical assistant positioned near the patient can move one end of the main shaft to the desired position with greater precision.

<Connector>
The connector 15 is a member for connecting the main shaft 11 to a grip 16, which will be described later. As shown in FIG. 1, the connector 15 includes a spindle holding section 151 and a rotation knob 152.

The main shaft holding portion 151 is a member molded into a cylindrical shape. There are no limitations on the material that constitutes the main shaft holding portion 151. This material may be, for example, a resin material or a metal material.

The connecting portion 114 of the main tube 111 is inserted and fixed into the through hole of the main shaft holding portion 151.

The main shaft 11 and the grip 16 can be connected by fitting the grip 16 into the main shaft holding portion 151. Therefore, the main shaft of a conventional straight shaft, which has a connector common to the connector 15 used in this embodiment, can be connected to the grip 16 and used.

The wiring 115 accommodated in the through hole _TH is connected at the spindle holding portion 151 to a power supply cable accommodated in a grip body 161 of the grip 16, which will be described later.

The rotation knob 152 is a tubular member attached to the main shaft holding portion 151 so as to be rotatable around the axis. By rotating the rotation knob 152, the direction of the main shaft 11 can be adjusted.

From a sanitary standpoint, among the members constituting the electric scalpel 10, the assembly of the main shaft 11, electrode 12, grip portion 13, guide 14, and connector 15 should be a disposable type that can be thrown away after each surgery. is preferred.

<Grip>
As shown in FIG. 1, the grip 16 includes a grip main body 161, a high output button 162, a low output button 163, a cleaning button 164, and a suction button 165.

The grip main body 161 is a member that the surgeon or surgical assistant grips when operating the electric scalpel 10. The grip main body 161 is a cylindrical member. The material constituting the grip body 161 is not limited. This material may be, for example, a resin material or a metal material. Furthermore, the shape of the grip main body 161 is not limited to a cylindrical shape, and can be determined as appropriate. A grip 16A, which is a modified example of the grip 16, will be described later with reference to FIG. 4.

The power supply cable 17, exhaust pipe 18, cleaning pipe 19, and suction pipe 20 are inserted into the internal space of the grip body 161. As described above, the power supply cable 17 is connected to the wiring 115, and the exhaust pipe 18, cleaning pipe 19, and suction pipe 20 are connected to the main tube 111 via a connector that branches into three. The exhaust pipe 18 is an example of an exhaust pipe.

When the electric scalpel 10 is used, (1) the power supply cable 17 is connected to the power supply unit of the electric scalpel 10, (2) the exhaust pipe 18 is connected to an exhaust port (e.g., an exhaust port of an insufflation device) provided in the operating room, (3) the cleaning pipe 19 is connected to a cleaning liquid supply port provided in the operating room, and (4) the suction pipe 20 is connected to a liquid suction port provided in the operating room.

The grip body 161, a high output button 162, a low output button 163, a cleaning button 164, and a suction button 165 are provided on the outer surface of the grip body 161.

The high-power button 162 and the low-power button 163 relate to the function of the electric scalpel 10, which, among the multiple functions it has, is to cut, ablate, and stop bleeding as an electric scalpel. When the high-power button 162 is pressed, a high-frequency current capable of cutting and ablat- ing tissue is supplied to the electrode 12 via the power supply cable 17 and the wiring 115. When the low-power button 163 is pressed, a high-frequency current capable of stopping bleeding is supplied to the electrode 12 via the power supply cable 17 and the wiring 115.

The cleaning button 164 is related to a cleaning function among the multiple functions that the electric scalpel 10 has. When the cleaning button 164 is pressed, cleaning liquid is discharged from the cleaning suction port 121 of the electrode 12 via the cleaning pipe 19 and the through hole _TH .

The suction button 165 relates to a suction function among the plurality of functions that the electric scalpel 10 has. By pressing the suction button 165, the liquid present in the abdominal cavity can be suctioned from the cleaning suction port 121 of the electrode 12 via the suction pipe 20 and the through hole _TH .

Although not shown in FIG. 1, the grip main body 161 may be provided with an opening/closing mechanism for controlling exhaust from the exhaust pipe 18 and a button or dial for controlling this opening/closing mechanism.

In this embodiment, the above-mentioned opening/closing mechanism is preferably a valve that completely opens or completely closes the inner cavity of the exhaust pipe 18. However, the present invention is not limited to this, and the above-mentioned opening/closing mechanism may be, for example, a valve.

(Example of modified grip)
A grip 16A, which is a modified example of the grip 16, will be described with reference to FIG. FIG. 4 is a perspective view of the grip 16A.

As shown in FIG. 4, the grip 16A includes a grip main body 161A, a high output button 162A, a low output button 163A, a cleaning button 164A, and a suction button 165A. Each of the grip body 161A, high output button 162A, low output button 163A, cleaning button 164A, and suction button 165A is the grip body 161, high output button 162, and low output button 163 of the grip 16, respectively. , a cleaning button 164, and a suction button 165. The grip 16A is based on the grip 16, and employs a grip main body 161A that has been transformed into a pistol shape, and has a high output button 162A, a low output button 163A, a cleaning button 164A, and a suction button 165A shaped like a pistol. This can be obtained by optimizing the grip body 161A of the mold.

In the grip 16A, a high output button 162 and a low output button 163 are provided at positions corresponding to the pistol trigger. Furthermore, in the grip 16A, a cleaning button 164A and a suction button 165A are provided at positions corresponding to the hammer of the pistol.

Note that the main shaft 11 and the grip 16A can also be connected to the grip 16A by fitting the grip 16A into the main shaft holding portion 151 of the connector 15 corresponding to the grip 16.

(Modified example of electric scalpel function)
In this embodiment, the electric scalpel 10 has an exhaust function, a cleaning function, and a suction function in addition to the functions of cutting, ablating, and hemostasis the tissue in the abdominal cavity as described above as an electric scalpel. There is. However, in one embodiment of the electric scalpel 10, at least one of the exhaust function, the cleaning function, and the suction function may be omitted. In one embodiment of the electric scalpel 10, when at least one of the exhaust function, cleaning function, and suction function is omitted, a pipe corresponding to the function to be omitted among the exhaust pipe 18, cleaning pipe 19, and suction pipe 20 described above is used. May be omitted. Thereby, the electric scalpel 10 can be made smaller and lighter.

[Example of using electric scalpel]
An example of how the electric scalpel 10 is used will be described with reference to FIG. 5. FIG. 5 is a schematic diagram of laparoscopic surgery in which the electric scalpel 10 is used in combination with the laparoscope L.

As shown in FIG. 5, in such laparoscopic surgery, the laparoscope L has an imaging element provided at its tip inserted into the abdominal cavity _CA of the patient P via the trocar Tr1. A moving image of the inside of the abdominal cavity _CA taken by the imaging device is displayed on a monitor M placed in the operating room. The operator or surgical assistant performs the laparoscopic surgery while referring to the moving image of the inside of the abdominal cavity _CA displayed on the monitor M.

Further, in such laparoscopic surgery, a plurality of surgical instruments are inserted into the abdominal cavity _CA together with the laparoscope L. Here, an electric scalpel 10 and forceps F are used as a plurality of surgical instruments. In the electric scalpel 10, an electrode 12 provided at an end 113 of a main tube 111 is inserted into the abdominal cavity _CA via a trocar Tr2. The scissors provided at the tip of the forceps F are inserted into the abdominal cavity _CA via the trocar Tr3.

The trocar Tr3 is connected via an air supply pipe PL1 to an air supply port _{P1 of the insufflation device DP} . Also, the trocar Tr1 is connected via a suction pipe PL2 to a suction port P2 of the insufflation device _DP .

A branch point _PB is provided in the middle of the suction pipe PL2 by inserting a Y-shaped connector. An exhaust pipe 18 of the electric scalpel 10 is connected to the branch point _PB . Therefore, in this usage example, the suction port P2 of the pneumoperitoneum device D _P is used to exhaust not only the trocar Tr1 but also the cleaning suction port 121 of the electrode 12.

Note that the pneumoperitoneum device D _P adjusts the amount of air supplied and the amount of suction so that the pressure inside the abdominal cavity _CA becomes a preset pressure. Therefore, in this usage example, even when exhaust is exhausted from the cleaning suction port 121 of the electrode 12 in addition to exhaust from the trocar Tr1, the pressure inside the abdominal cavity _CA is maintained at a preset pressure. be able to.

Furthermore, in laparoscopic surgery, after placing the electrode 12 of the electric scalpel 10 at a desired position within the abdominal cavity _CA , the guide 14 is slid toward the connection portion 114 of the main tube 111 (see FIG. 1). At this time, the guide 14 is retracted from the inside of the abdominal cavity _CA. Then, the portion of the main tube 111 that is not covered by the guide 14 can be bent. This makes it possible to bend the portion of the main tube 111 that is not covered by the guide 14 and move it freely within the abdominal cavity _CA , thereby ensuring that the main tube 111 is included in the field of view of the laparoscope L. It can be prevented.

In addition, when moving the electrode 12 of the electric scalpel 10, the guide 14 can be slid toward the end 113 of the main tube 111, thereby eliminating the flexibility of the portion of the main tube 111 covered by the guide 14, i.e., the vicinity of the end 113 of the main tube 111. This makes the main tube 111 behave as if it were a rigid shaft with no flexibility, allowing the surgeon or surgical assistant to easily move the electrode 12 to the desired position.

The present invention is not limited to the embodiments described above, and various modifications can be made within the scope of the claims, and embodiments obtained by appropriately combining technical means disclosed in different embodiments. are also included within the technical scope of the present invention.

〔summary〕
The electric scalpel according to the first aspect of the present invention is an electric scalpel used in combination with a laparoscope or a thoracoscope. The electric scalpel includes a main shaft whose one end is inserted into the abdominal cavity or thoracic cavity from outside the patient's body, the main shaft having an electrode provided at the one end, and at least a part of the main shaft , made of a flexible material.

According to the above configuration, since at least a portion of the main shaft is made of a flexible material, interference between the shafts is less likely to occur compared to a conventional electric scalpel equipped with a rigid shaft. Can be done.

Furthermore, in robotic surgery, when an operator uses an electric scalpel, the operator can hold the electric scalpel using, for example, a robot hand that functions as forceps. Therefore, since it is not necessary to separately prepare a robot arm to which the present electric scalpel is attached, it is possible to suppress the number of robot arms inserted into the abdominal cavity in robotic surgery or the frequency of replacing the robot arms. Therefore, this electric scalpel can make interference between the arms less likely to occur than before even in robotic surgery.

Note that when the operator is not using the electric scalpel, the operator can place the electric scalpel at any location within the abdominal cavity. As mentioned above, this electric scalpel has the secondary effect of increasing the degree of freedom when placing it in the abdominal cavity, since at least a portion of the main shaft is made of a flexible material. play.

Further, in the electric scalpel according to the second aspect of the present invention, in addition to the configuration of the electric scalpel according to the first aspect described above, a grip portion protruding from the main shaft is provided near the one end. A configuration is adopted.

According to the above configuration, when using the electric scalpel in robotic surgery, the operator can easily hold the electric scalpel using the robot hand that functions as forceps.

Furthermore, in the electric scalpel according to the third aspect of the present invention, in addition to the configuration of the electric scalpel according to the second aspect described above, the gripping part is made of a conductor, and the electrode and the gripping part This means that the structure is conductive.

According to the above configuration, buzzing can be performed by using a robot hand capable of supplying high-frequency current as the robot hand that holds the electric scalpel.

Further, in the electric scalpel according to the fourth aspect of the present invention, in addition to the configuration of the electric scalpel according to any one of the first to third aspects described above, the length is shorter than the main shaft. The guide further includes a cylindrical guide whose inner surface slides along the outer surface of the main shaft, the guide being more flexible than the flexible material forming at least a portion of the main shaft. A structure is adopted in which the material is made of a material with a low

According to the above configuration, the flexibility of the main shaft can be temporarily reduced by sliding the guide toward one end of the main shaft. Therefore, an operator or surgical assistant located near the patient can easily move one end of the main shaft to a desired position.

Further, in the electric scalpel according to the fifth aspect of the present invention, in addition to the configuration of the electric scalpel according to any one of the first to fourth aspects described above, the main shaft includes a A configuration is adopted in which the through hole is connected from one end to the other end, and the other end is provided with a through hole connected to an exhaust pipe.

According to the above configuration, gas and mist existing in the abdominal cavity can be exhausted from one end of the main shaft by connecting the exhaust mechanism to the other end of the through hole. This means that when treating an affected area using this electric scalpel, an exhaust port can be provided in close proximity to the affected area. Therefore, the laparoscope or thoracoscope can efficiently exhaust gas and mist that may be generated in the affected area, and can prevent these gases and mist from filling the abdominal cavity. It is possible to take images of the inside of the chest cavity.

Note that an example of the above-mentioned exhaust mechanism is an exhaust line installed in an operating room. Furthermore, if the operating room is not equipped with an exhaust line, a pump such as a vacuum pump can also be used as the exhaust mechanism.

Further, in the electric scalpel according to the sixth aspect of the present invention, a configuration is adopted in the electric scalpel according to the fifth aspect described above, further comprising an opening/closing mechanism for controlling exhaust of the exhaust pipe. ing.

According to the above configuration, the opening/closing mechanism can control the exhaust from the exhaust pipe. Therefore, the operator who is located near the patient can adjust the exhaust timing by himself/herself without asking a surgical assistant. Therefore, this electric scalpel is suitable for laparoscopic surgery and thoracoscopic surgery that are not robotic surgery.

Further, in the electric scalpel according to the seventh aspect of the present invention, in the electric scalpel according to the sixth aspect described above, the opening/closing mechanism controls complete opening or complete closing of the inner cavity of the exhaust pipe. A valve configuration is adopted.

According to the above configuration, intraperitoneal gas and mist can be exhausted when necessary. Therefore, the amount of gas (mainly CO ₂ ) used for pneumoperitoneum can be reduced, contributing to cost reduction.

In addition, the electric scalpel according to the eighth aspect of the present invention has the same configuration as the electric scalpel according to any one of the fifth to seventh aspects described above, and the other end is further connected to a cleaning pipe that supplies cleaning liquid and a suction pipe that sucks up liquid.

According to the above configuration, the electric scalpel can be provided with a cleaning function and a suction function. Therefore, the number of surgical instruments inserted into the abdominal cavity, the number of arms, and the frequency of replacing arms can be reduced.

Further, in the electric scalpel according to the ninth aspect of the present invention, in addition to the configuration of the electric scalpel according to any one of the first to eighth aspects described above, the one end of the main shaft A part of the section including the main shaft is made of a material having higher flexibility than other sections of the main shaft, and further includes a bending adjustment mechanism that arbitrarily adjusts the bending of the part of the main shaft. has been done.

According to the above configuration, the operator can arbitrarily bend a partial section including one end of the main portion using the bending adjustment mechanism. Therefore, this electric scalpel can further improve the accuracy when moving one end of the main shaft to a desired position.

10 Electric scalpel 11 Main shaft 111 Main tube 112 Connection member 113 End (one end)
114 Connection part (between main shaft 11 and connector 15)
115 Wiring 116 Covering T _H through hole 12 Electrode 13 Gripping part 14 Guide 15 Connector 151 Spindle holding part 152 Rotation knob 16 Grip 161 Grip body 162 High output button 163 Low output button 164 Cleaning button 165 Suction button 17 Power supply cable 18 Exhaust pipe 19 Cleaning pipe 20 Suction pipe

Claims

An electric scalpel used in conjunction with a laparoscope or thoracoscope,
A main shaft with one end inserted into the abdominal cavity or thoracic cavity from outside the patient's body, the main shaft having an electrode provided at the one end,
At least a portion of the main shaft is made of a flexible material.
An electric scalpel characterized by:
A gripping portion protruding from the main shaft is provided near the one end.
The electric scalpel according to claim 1, characterized in that:
The gripping portion is made of a conductor,
The electrode and the gripping portion are electrically connected;
The electric scalpel according to claim 2, characterized in that:
further comprising a cylindrical guide having a length shorter than the main shaft, the guide having an inner surface sliding along an outer surface of the main shaft,
The guide is made of a material that is less flexible than the flexible material that constitutes at least a portion of the main shaft.
The electric scalpel according to any one of claims 1 to 3, characterized in that:
The main shaft is provided with a through hole that connects from the one end to the other end, and the other end is connected to an exhaust pipe.
The electric scalpel according to any one of claims 1 to 3, characterized in that:
further comprising an opening/closing mechanism for controlling exhaust of the exhaust pipe;
The electric scalpel according to claim 5, characterized in that:
The opening and closing mechanism is a valve that completely opens or completely closes the inner cavity of the exhaust pipe.
The electric scalpel according to claim 6 .
The other end includes a cleaning liquid pipe that supplies cleaning liquid;
It is further connected to a suction pipe that sucks liquid,
The electric scalpel according to claim 5, characterized in that:
A partial section of the main shaft including the one end is made of a material having higher flexibility than other sections of the main shaft,
further comprising a bending adjustment mechanism that arbitrarily adjusts the bending of the partial section;
The electric scalpel according to any one of claims 1 to 3, characterized in that: