CN100542475C - Air supply plant and endoscopic system - Google Patents
Air supply plant and endoscopic system Download PDFInfo
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- CN100542475C CN100542475C CNB2005800403321A CN200580040332A CN100542475C CN 100542475 C CN100542475 C CN 100542475C CN B2005800403321 A CNB2005800403321 A CN B2005800403321A CN 200580040332 A CN200580040332 A CN 200580040332A CN 100542475 C CN100542475 C CN 100542475C
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Abstract
The invention provides control method, plenum system and the endoscopic system of air supply plant, air supply plant.Air supply plant is connected with the aspirating pipeline of endoscope, carries gas via this aspirating pipeline to patient's body cavity, and this air supply plant has: the switching part that can switch between the state of carrying the state of gas to aspirating pipeline or stopping to supply gas; The time instrumentation portion of the time of supplying gas of instrumentation gas; And with the time instrumentation portion be electrically connected and control the control part of switching part, control part is being controlled to switching part after aspirating pipeline is carried the state of described gas, be transfused to supplying gas the time of time instrumentation portion, when the time of supplying gas by time institute of instrumentation portion instrumentation reached predefined setting-up time, control part carried out switching controls to become the state that stops to supply gas from state from described gas to aspirating pipeline that carry to switching part.
Description
Technical field
The present invention relates to be used for air supply plant that the gas observed in intraperitoneal and the tube chamber is supplied with via the aspirating pipeline of endoscope and the endoscopic system that comprises this plenum system in tube chamber.
Background technology
Carry out the operation of the insertion section of inserting endoscope in the tube chambers such as for example large intestine being treated into treatment sites in recent years.In this operation, the insertion section of endoscope is inserted in patient's the tube chambers such as large intestine.In addition, in order to ensure the purpose in the endoscope visual field and the purpose of guaranteeing to be used for the zone of manipulation utensil, via aspirating pipeline injecting gas in tube chamber of described endoscope.
Make tube chamber become swelling state by injecting gas in tube chamber.So, by inserting intraluminal endoscope, while can carry out the observation of into treatment sites, the affirmation of the preparation implement that inserts via the preparation implement passage of endoscope is handled etc.
In addition,, for example can replace in the past the air that uses, and use the carbon dioxide that organism is easy to absorb (below be expressed as carbon dioxide) as described gas.
When carrying out this operation, use to have the flexible endoscope (hereinafter referred to as flexible endoscope) that inserts intraluminal soft insertion section such as large intestine.This flexible endoscope is connected with light supply apparatus and camera control unit.In addition, in insertion section, operating portion and the general cable of flexible endoscope, be provided with and supply gas/the flow pipe road.This supplies gas/and the flow pipe road is supplied to the conduct of supplying with from air supply plant and carbon dioxide cylinder and observes carbon dioxide with gas in tube chamber.These flexible endoscopes, light supply apparatus, camera control unit, air supply plant and carbon dioxide cylinder have constituted endoscopic system.
Existing endoscopic system connects from the extended gases at high pressure of carbon dioxide cylinder with pipe at the input side of air supply plant, connects the distolateral of snorkel that tube chamber that base end side is connected with described light supply apparatus uses at the outlet side of this air supply plant.
Big enteral is for example inserted from patient's anus in the insertion section of the endoscope that operator will be connected with described light supply apparatus, makes described air supply plant become operating state under such state.Thus, with the carbon dioxide in the carbon dioxide cylinder via be arranged at the interface of supplying gas on the endoscope-use adapter that is connected with light supply apparatus, be arranged in the general cable and the operating portion of endoscope, insertion section in supply gas/supply with in the flow pipe Lu Erxiang tube chamber.
As this existing endoscopic system, a lot of schemes have been proposed.Disclosed endoscope-use air supply plant in 2000-No. 139827 communiques of TOHKEMY for example, snorkel on the outlet side of supplying gas that is connected in described air supply plant is connected with the pliers hole of endoscope, thereby carries gas in tube chamber or in the body cavity via the pliers pipeline (preparation implement pipeline) that is communicated with the described forceps channel of endoscope.
But described existing endoscopic system constitutes the interface of supplying gas via the endoscope that is connected in light supply apparatus, supplies gas/supply with carbon dioxide in the flow pipe road direction tube chamber.Therefore, the light supply apparatus that connected endoscope is supplied with carbon dioxide from air supply plant continuously, replace from supplying gas/air that conveying pump is supplied with to aspirating pipeline via the interface of supplying gas.
In addition, carried out stopping up when being arranged at the operation of the hole portion on the water button of supplying gas/send, in tube chamber, supplied with carbon dioxide at operator.In other words, do not stop up at operator under the state of hole portion of the water button of supplying gas/send, supply with in aspirating pipeline from air supply plant carbon dioxide during, to atmosphere, emit carbon dioxide continuously from hole portion.That is,, therefore there is uneconomic problem even after intraluminal observation or operation are finished, also continue to consume carbon dioxide in the carbon dioxide cylinder.
In addition, carry out the operation of tube chamber internal therapy, to also have in order reducing patient's wound not to be opened abdominal part and treated surgical operation under the peritoneoscope of processing (the following surgical operation that yet is expressed as) except using above-mentioned flexible endoscope.In this surgical operation, will for example be used for piercing through patient's abdominal part observing second trocar that is directed to endoceliac first trocar (trocar) and is used for preparation implement is directed to into treatment sites with endoscope.
In addition, in order to ensure the purpose in the visual field of endoscope and the purpose in zone of guaranteeing to be used for the operation of preparation implement, supply with pneumoperitoneum gas to intraperitoneal.Thus, the abdominal cavity is owing to pneumoperitoneum becomes swelling state with gas.Therefore, operator uses and to insert Intraabdominal endoscope via first trocar, can carry out the observation of the preparation implement that inserts to into treatment sites with via second trocar and processing etc.Here can use with gas as pneumoperitoneum in addition and for example be easy to the above-mentioned carbon dioxide that absorbed by organism.
The pneumoperitoneum device makes carbon dioxide by the mobile state of aspirating pipeline and the mobile intercepted state that makes the carbon dioxide by aspirating pipeline repeatedly.Particularly, control part detects Intraabdominal pressure by pressure transducer, and the abdominal cavity that monitors predefined patient set to press with actual abdominal cavity press poor, and regulate the flow of carbon dioxide according to this pressure differential.
For example, in 2000-No. 139827 communiques of TOHKEMY, disclose and be used for the endoscope-use air supply plant that in body cavitys such as stomach air supply is checked the state of affected part.Be connected and the end of extended connection tube with the connector of this endoscope-use air supply plant, be connected with the forceps channel inlet that is communicated to the preparation implement passage.On this endoscope-use air supply plant, be connected with and carry out remote-operated foot control.
Therefore, by this foot control or the discharge that is arranged on the endoscope-use air supply plant are carried out suitable operation with switch, can be from the connector air-out.This air is sent in the body cavity by connection tube, forceps channel inlet and preparation implement passage.
In recent years, as new trial,, for example also carry out treating in the tube chambers such as insertion section insertion large intestine with endoscope the operation of into treatment sites except inserting the Intraabdominal endoscope via first trocar.In this operation, determine into treatment sites, treat by the endoscope of abdominal cavity side and the endoscope of tube chamber side.
When carrying out this operation, for example constitute surgical system 100 under the peritoneoscope shown in Figure 51.Surgical system under this peritoneoscope 100 is carried out following explanation.Be inserted into the endoscope (not shown) of abdominal cavity side is connected with first camera control unit 103 with first light supply apparatus 101 among the figure via the trocar.In addition, the endoscope (not shown) with the insertion section that is inserted into tube chamber is connected with second camera control unit 104 with secondary light source device 102.
In addition, first carbon dioxide cylinder 107 is connected with pneumoperitoneum device 105.Pneumoperitoneum device 105 is supplied with carbon dioxide via the trocar to intraperitoneal.Via the endoscope-use carbon dioxide adjusting device of supplying with carbon dioxide in supplying gas in the insertion section that is arranged at endoscope/flow pipe road direction tube chamber
(Endoscopic CO2 Regulator: the following ECR that slightly is designated as) 106 are connected with second carbon dioxide cylinder 108.
Each device 101,102,103,104,105,106 also is electrically connected with for example ablation device (being also referred to as electric mes) 111 blood processor such as grade except moving the system controller 110 etc. of control.By constituting surgical system 100 under such peritoneoscope, thereby can supply with carbon dioxide to intraperitoneal, and can in tube chamber, supply with carbon dioxide by ECR 106 and treat by pneumoperitoneum device 105.In addition, each device is arranged in first go-cart 112, second go-cart 113 and the ECR go-cart 114 etc.
Be connected with secondary light source device 102 with pipe 115 from the extended tube chambers of ECR 106.The carbon dioxide of supplying with from ECR106 from secondary light source device 102 via the interface of supplying gas the light source adapter (not shown) that is arranged at endoscope (not shown), supply gas/supply with in the flow pipe road direction tube chamber.
In addition, surgical system 100 has under the peritoneoscope: observation monitor 117, centralized operation panel 118, centralized displaying panel 119, image recording structure 121,122, allotter 123, communication adapter 124, communication adapter 125, allotter 126, suction bottle 127, peripheral controls 128, communication cable 129a, 129b and the connection cord 130 of demonstration endoscopic images etc.
About surgical operation under this peritoneoscope, in " Japanese anesthesiology can the 46th time conference リ Off レ Star シ ヤ-コ-ス テ キ ス ト " paper that is entitled as " the Xiong Qiang Mirror Fu Qiang Mirror Ma De Ask Questions of section " that P36 to 43 put down in writing, put down in writing following viewpoint: " press in the abdominal cavity and may dynamically exert an influence to circulating under the situation about excessively raising or cause air embolism.Therefore; Except the inspection of blood pressure; Electrocardiogram; Pulse oximetry meter parameters such as (pulse oximeter) (below be also referred to as vital sign), also need suitably to set the higher limit that pneumoperitoneum presses and intraperitoneal is compressed into row observe. ".
In addition, in the paper that is entitled as " Shou Intraoperative Ma Xia the little Child Fu Qiang Mirror " of pediatric surgery VOL.26.no.8 1994-8, the preventing of high carbon dioxide mass formed by blood stasis during about pneumoperitoneum handled, record and " end expiratorycarbon dioxide is monitored; Under the state that concentration does not rise; Increase ventilation (breathing) number of times.In addition; Under the intrinsic pressure high situation in abdominal cavity; Even existence increases the situation that rate of ventilation also can't suppress end expiratorycarbon dioxide, temporarily interrupt pneumoperitoneum improvement with wait patient's state to operator (surgeon) request cooperation this moment. ".
In addition, " carbon dioxide thromboembolism disease takes place in the probability that exists pneumoperitoneum gas to enter in blood vessel from conduit (katheter); when in a large amount of carbon dioxide intravasations about recording in discovery and the processing of selecting carbon dioxide as the carbon dioxide thromboembolism under the situation of pneumoperitoneum gas.At this moment, partial pressure of carbon dioxide in endexpiratory gas reduces rapidly.If carbon dioxide thromboembolism disease has been taken place, immediately the pneumoperitoneum device is stopped, from the pneumoperitoneum loop carbon dioxide being discharged as far as possible.”。
In the past, the supervision of the device (anesthetic machine, respiratory organ and patient monitoring device etc.) of Anesthetist's management was undertaken by the Anesthetist.If the show value of these Biont informations takes place unusual, then, unusual to the operator report under the situation of needs according to Anesthetist's judgement, the patient is carried out various replies handle.On the other hand, the demonstration of the operation device (pneumoperitoneum device, electric mes etc.) of operator management monitors by operator or nurse, and reports this information to the Anesthetist, and the patient is carried out various processing.
Like this, management and supervision at various devices are shared under the situation of carrying out by the multidigit doctor, not should be noted that and from the demonstration of each device, to omit unusual, perhaps must be careful the unobstructed of reception and registration between Anesthetist and the operator, various replies are handled can not postponed.
Therefore, for example in 2001-No. 170008 communiques of TOHKEMY, proposed: in report patient's patients' such as partial pressure of carbon dioxide in endexpiratory gas the parameter of Biont information, taken place when unusual, can easily confirm the surgical system of patient's Biont information by the patient monitoring device.
But in the surgical system shown in Figure 51, supply gas and insert rigid endoscope to intraperitoneal in patient's body cavity inserts flexible endoscope and determines that into treatment sites is to treat in tube chamber.But do not consider that in this surgical system the counter-measure when unusual takes place for the parameter of Biont information as the report patient.
Summary of the invention
The present invention in view of the above problems, purpose is to provide control method, plenum system and the endoscopic system of more high performance air supply plant, air supply plant.
The invention provides a kind of air supply plant, this air supply plant is connected with the aspirating pipeline of endoscope, carry gas via this aspirating pipeline to patient's body cavity, it is characterized in that, described air supply plant has: switching part, and it can switch to described aspirating pipeline and carry the state of described gas or the state that stops to supply gas; Time instrumentation portion, the supplying gas the time of the described gas of its instrumentation; Control part, its with this time instrumentation portion be electrically connected, control described switching part; Flow measurement portion, its flow to the described gas carried in described aspirating pipeline is measured; And comparison operation portion, it is based on the instrumentation result from described flow measurement portion, time started of instrumentation of the described time of supplying gas of instrumentation portion is carried out calculation process to described time, described comparison operation portion uses the instrumentation result of described flow measurement portion to calculate the changes in flow rate amount of predetermined unit interval, and this result of calculation and preset threshold are compared, based on this comparative result to described time instrumentation portion time started of instrumentation of described movement time carry out calculation process, described control part becomes after described aspirating pipeline is carried the state of described gas it at the described switching part of control, described control part is transfused to described the supplying gas the time of described time instrumentation portion, when the described time of supplying gas by described time institute of instrumentation portion instrumentation reaches predefined setting-up time, described control part carries out switching controls to described switching part, so that from carrying the state of described gas to become the state that stops to supply gas to described aspirating pipeline, and, based on the instrumentation time started from the operation result of described comparison operation portion, described control part is transfused to described the supplying gas the time of described time instrumentation portion, when the described time of supplying gas by described time institute of instrumentation portion instrumentation reached predefined setting-up time, described control part carried out switching to from the state of supplying gas the control of the state that stops to supply gas to described switching part.
The present invention also provides a kind of endoscopic system, it is characterized in that, described endoscopic system possesses endoscope, this endoscope has the aspirating pipeline that can supply gas to patient's body cavity, and described endoscopic system possesses air supply plant, this air supply plant has: switching part, and it can switch to described aspirating pipeline and carry the state of described gas or the state that stops to supply gas; Time instrumentation portion, the supplying gas the time of the described gas of its instrumentation; Control part, its with this time instrumentation portion be electrically connected, control described switching part; Flow measurement portion, its flow to the described gas carried in described aspirating pipeline is measured; And comparison operation portion, it is based on the instrumentation result from described flow measurement portion, time started of instrumentation of the described time of supplying gas of instrumentation portion is carried out calculation process to described time, described comparison operation portion uses the instrumentation result of described flow measurement portion to calculate the changes in flow rate amount of predetermined unit interval, and this result of calculation and preset threshold are compared, based on this comparative result to described time instrumentation portion time started of instrumentation of described movement time carry out calculation process, described control part becomes after described aspirating pipeline is carried the state of described gas it at the described switching part of control, described control part is transfused to described the supplying gas the time of described time instrumentation portion, when the described time of supplying gas by described time institute of instrumentation portion instrumentation reaches predefined setting-up time, described control part carries out switching controls to described switching part, so that from carrying the state of described gas to become the state that stops to supply gas to described aspirating pipeline, and, based on the instrumentation time started from the operation result of described comparison operation portion, described control part is transfused to described the supplying gas the time of described time instrumentation portion, when the described time of supplying gas by described time institute of instrumentation portion instrumentation reached predefined setting-up time, described control part carried out switching to from the state of supplying gas the control of the state that stops to supply gas to described switching part.
Description of drawings
Fig. 1 is the figure of configuration example of the endoscopic system of the air supply plant of expression with first embodiment of the invention.
Fig. 2 is the front view of this air supply plant.
Fig. 3 is the rearview of this air supply plant.
Fig. 4 is the block diagram of the configuration example of this air supply plant inside of explanation.
Fig. 5 is the sequential chart of the effect of this air supply plant of explanation.
Fig. 6 is the flow chart of the control example of this air supply plant of expression.
Fig. 7 is the profile that the leak condition of the hole portion ejection carbon dioxide on the water button of supplying gas from being arranged at/send is described.
Fig. 8 is that explanation is stopped up the hole portion firmly be arranged on the water button of supplying gas/send and to the profile of the state of insertion section side transport of carbon dioxide.
Fig. 9 is the block diagram of configuration example of the air supply plant of explanation second embodiment of the invention.
Figure 10 is the sequential chart of the effect of this air supply plant of explanation.
Figure 11 is the flow chart of the control example of this air supply plant of expression.
Figure 12 is the rearview of the air supply plant of its variation 1.
Figure 13 is the block diagram of configuration example of the air supply plant inside of its variation 1 of explanation.
Figure 14 is the structure chart of configuration example that expression has the endoscopic system of this air supply plant.
Figure 15 is the rearview of the air supply plant of its variation 2.
Figure 16 is the block diagram of the configuration example of the inner and light supply apparatus of the air supply plant of its variation 2 of explanation.
Figure 17 is the block diagram of configuration example of the air supply plant of explanation third embodiment of the invention.
Figure 18 is the sequential chart of the effect of this air supply plant of explanation.
Figure 19 is the flow chart of the control example of this air supply plant of expression.
Figure 20 is the block diagram of configuration example of the air supply plant of explanation four embodiment of the invention.
Figure 21 is the flow chart of the control example of this air supply plant of expression.
Figure 22 is the sequential chart of the effect of this air supply plant of explanation.
Figure 23 is the block diagram of configuration example of the air supply plant of explanation fifth embodiment of the invention.
Figure 24 is the flow chart of the control example of this air supply plant of expression.
Figure 25 is the sequential chart of the effect of this air supply plant of explanation.
Figure 26 is the block diagram of configuration example of the air supply plant of explanation sixth embodiment of the invention.
Figure 27 is the flow chart of the control example of this air supply plant of expression.
Figure 28 is the chart of the voltage-discharge characteristic of its choke valve of expression.
Figure 29 is the sequential chart of the effect of this air supply plant of explanation.
Figure 30 is the block diagram of configuration example of the air supply plant of its variation 1 of explanation.
Figure 31 is the flow chart of control example of the air supply plant of its variation 1 of expression.
Figure 32 is the block diagram of configuration example of the air supply plant of its variation 2 of explanation.
Figure 33 is arranged on the profile of the throttle orifice (orifice) on its aspirating pipeline.
Figure 34 is the flow chart of control example of the air supply plant of its variation 2 of expression.
Figure 35 is the figure as the structure of surgical system under the peritoneoscope of the monitoring arrangement of external device (ED) and respiratory organ of illustrating of expression seventh embodiment of the invention.
Figure 36 is the figure that the structure of surgical system under the peritoneoscope with plenum system is described.
Figure 37 is the figure that is used to illustrate its centralized operation panel.
Figure 38 is the figure that is used to illustrate its centralized displaying panel.
Figure 39 is the structure chart of the internal structure of its air supply plant of expression.
Figure 40 is the figure that is used to illustrate the panel part of its air supply plant.
Figure 41 is the flow chart that is used to illustrate the control example of its air supply plant when abdominal cavity and tube chamber are supplied gas.
Figure 42 is the flow chart that is used to illustrate the control example that its partial pressure of carbon dioxide in endexpiratory gas is confirmed.
Figure 43 is the flow chart of control example that is used to illustrate the action of the setting pressure that reduces its abdominal cavity and tube chamber.
Figure 44 is the flow chart that is used to illustrate the control example of the restorative action of setting pressure that makes its abdominal cavity and tube chamber.
Figure 45 is its partial pressure of carbon dioxide in endexpiratory gas of expression, press in the abdominal cavity and the sequential chart of the relation that tube chamber is pressed.
Figure 46 is the figure of structure of surgical system under the peritoneoscope with plenum system of explanation the 8th embodiment of the present invention.
Figure 47 is used to the figure that illustrates that it send water tank.
Figure 48 is the structure chart of the internal structure of its water sending device of expression.
Figure 49 is the flow chart of control example that is used to illustrate the action of the setting pressure that reduces its abdominal cavity and tube chamber.
Figure 50 is the figure that is used to illustrate the warning picture on its panel that is shown in display floater.
Figure 51 be explanation except being inserted into Intraabdominal endoscope, the figure of surgical system under the existing peritoneoscope of operation of into treatment sites is treated in the insertion section of inserting endoscope in tube chambers such as large intestine.
The specific embodiment
Followingly embodiment of the present invention is described with reference to accompanying drawing.
(first embodiment)
Fig. 1 to Fig. 8 is about first embodiment of the invention, Fig. 1 is the figure of configuration example that expression has the endoscopic system of air supply plant, Fig. 2 is the front view of the air supply plant of Fig. 1, Fig. 3 is the rearview of the air supply plant of Fig. 1, Fig. 4 is the block diagram of configuration example of the air supply plant inside of key diagram 1, Fig. 5 is the sequential chart of the effect of explanation air supply plant, Fig. 6 is the flow chart of the control example of expression air supply plant, Fig. 7 is explanation supply gas from being arranged at/the send profile of leak condition of the hole portion ejection carbon dioxide on the water button, and Fig. 8 is that explanation is stopped up the hole portion that firmly is arranged on the water button of supplying gas/send and to the profile of the state of insertion section side transport of carbon dioxide.
The endoscopic system of present embodiment shown in Figure 1 is a surgical system under the tube chamber mirror (hereinafter referred to as surgery systems) 1.This surgery systems 1 constitutes mainly and comprises: endoscopic system 2, plenum system 3, system controller 4, the monitor 5 as display device, centralized displaying panel 6, centralized operation panel 7 and go-cart 8.
In addition, in the operating room of this surgery systems 1 of configuration, be provided with the operating-table 9 that allows patient 10 couch.
Be provided with on operating portion 25: the water button 25a that supplies gas/send, the preparation implement that attracts button 25b, makes the bending operation knob 27 of not shown bending section flexure operation and be communicated to not shown preparation implement passage are inserted port 28.Base end part at general cable 26 is provided with the adapter 26a of endoscope.
It is illuminating lamp (not shown) etc. that light supply apparatus 22 has lighting unit from illumination light to endoscope 21 that supply with.Loading and unloading freely connect the adapter 26a of endoscope with light source adapter on this light supply apparatus 22.
In addition, by the adapter 26a of endoscope is connected with light supply apparatus 22, and become light source adapter and the opposed configuration status of illuminating lamp.Therefore, the illumination light that penetrates from illuminating lamp is transmitted not shown optical fibers and is penetrated from the not shown illuminating window that is arranged at insertion section 24 leading sections.
In addition, endoscope's adapter 26a is provided with that adapter 26c is used in supplying gas of being communicated with upstream side aspirating pipeline 21a via the aspirating pipelines in the general cable 26.An end that on this supplies gas with adapter 26c, connects snorkel 33.The base end part of this snorkel 33 is connected with the air supply plant described later 31 of plenum system 3 and is supplied to gas.
In addition, not shown flow pipe extends and is connected with sending water tank from the described adapter 26a of endoscope.For example in sending water tank, store water as liquid.
The gas of carrying from plenum system 3 is by the interior aspirating pipeline of the aspirating pipeline (not shown) in the adapter 26a of endoscope and general cable 26, and is delivered to operating portion 25 via upstream side aspirating pipeline 21a (with reference to Fig. 7).In addition, this gas is sent from the water button 25a that supplies gas/send that is arranged at operating portion 25.And simultaneously, the gas of sending from plenum system 3 via the pipeline in the flow pipe (not shown) to sending water tank inside to pressurize.
Therefore, operate the water button 25a that supplies gas/send by operator and make upstream side aspirating pipeline 21a and downstream aspirating pipeline 21b described later become connected state (with reference to Fig. 8), spray from the nozzle of supplying gas on the not shown leading section that is arranged at insertion section 24 thereby make by gas of carrying to the flow pipe road of endoscope 21 or water.
On air supply plant 31, be provided with high-tension connector 31a and supply gas and use adapter 31c.Supplying gas with an end that connects snorkel 33 on the adapter 31c, the other end of this snorkel 33 is connected with adapter 26c with supplying gas of the adapter 26a of endoscope on being connected to described light supply apparatus 22.In addition, snorkel 33 is formed by silicon or Teflon (テ Off ロ Application) (registered trade mark).
From gas bomb 32 extended gases at high pressure with the pipe 34 be arranged at air supply plant 31 on high-tension connector 31a be connected.
4 pairs of surgery systems 1 integral body of system controller are unified control.On system controller 4, centralized displaying panel 6, centralized operation panel 7, light supply apparatus 22, CCU 23 and air supply plant 31 have been connected, so that can carry out two-way communication via not shown communication line.
Reception shows the endoscopic images of the subject that is obtained by endoscope 21 from the picture signal of CCU 23 outputs on the picture of monitor 5.On centralized displaying panel 6, be provided with the display frame of liquid crystal display etc.Centralized displaying panel 6 is connected with system controller 4.The endoscopic images that therefore can in display frame, show described subject, and operating state that can this endoscope's peripheral unit of centralized displaying under situation with endoscope's peripheral unit.
Promptly, centralized operation panel 7 is connected with system controller 4, therefore operator is by carrying out proper handling to the touch sensor portion that is shown in display part, can carry out the situation identical operations corresponding to the console switch of endoscope's peripheral unit shown with straightforward manipulation.Be that operator can remotely carry out the various operations of endoscope's peripheral unit or setting etc. on centralized operation panel 7.
Being equipped with peripheral unit in go-cart 8 is light supply apparatus 22, CCU 23, air supply plant 31, system controller 4, monitor 5, centralized displaying panel 6, centralized operation panel 7 and gas bomb 32 etc.
In addition, in the surgery systems 1 of present embodiment except endoscopic system 2, also can have operating the 2nd endoscopic system that constitutes by light supply apparatus 11, CCU 12, not shown rigid endoscope and endoscope-use video camera under the peritoneoscope that is used to carry out patient 10, and as electric mes device 13 of endoscope's peripheral unit etc.
The structure of above-mentioned air supply plant 31 is described to Fig. 4 below with reference to Fig. 2.
As shown in Figure 2, be provided with on and off switch 35, switch 50 and supply gas and use adapter 31c at the front surface downside of air supply plant 31.
On and off switch 35 is the console switchs of operation that are used to carry out the power supply of on/off air supply plant 31.Switch 50 is the console switchs that are used for supplying gas of air supply plant 31 carried out the operation of opening/closing switching.Supply gas with the end of adapter 31c connection from the snorkel 33 of the adapter 26a of endoscope.
In addition, the front surface upside at air supply plant 31 is provided with gas surplus display part 43.The carbon dioxide surplus that this gas surplus display part 43 shows in the gas bomb 32.
As shown in Figure 3, the back underside at air supply plant 31 is provided with high-tension connector 31a and power connector 36.On high-tension connector 31a, connect as mentioned above from gas bomb 32 extended gases at high pressure pipes 34.Power connector 36 connects the adapter that is used for to the not shown feed cable of air supply plant 31 power supplies.
In addition, be provided with time set operating portion 49 at the back side of air supply plant 31 upside.This time set operating portion 49 is to use timing function described later to set the console switch of the movement time of air supply plant 31.
For example, time set operating portion 49 is illustrated in figure 3 as the switch of " timing function is closed ", " 15min ", " 30min " Three Estate formula, can set any timing among the above-mentioned three by action bars 49a is slided.
In addition, " timing function is closed " is the pattern of not using timing function.In addition, " 15min " when time set operating portion 49 is not limited to carry out timing function and " 30min " for example corresponding to movement time (supplying gas the time) of 2 grades of the proficiency of the operator that uses air supply plant 31, also be not limited to these of scope in addition movement time, and can at random carry out the setting of exercises time.
In addition,, also be not limited thereto, for example also can use the switch of volume adjusting (volume) formula of the setting that can freely regulate movement time by rotary knob to constitute though time set operating portion 49 uses the switch of sliding type to constitute.
Below as shown in Figure 4, can carry out using the timing function of setting by time set operating portion 49 describing as the internal structure of the air supply plant 31 of the setting of movement time of the time of supplying gas.
As shown in Figure 4, air supply plant 31 have blood pressure lowering portion 40, as the switching part of switch unit promptly open and close valve 41, pressure instrumentation portion 42, gas surplus display part 43, drive division 44, as the tube chamber of control unit supply gas control part (hereinafter referred to as control part) 45, as informing unitary informing portion 48, time set operating portion 49 and switch 50.
On the high-tension connector 31a of air supply plant 31, connect from gas bomb 32 extended gases at high pressure pipes 34, use via these gases at high pressure and manage 34 carbon dioxide of supplying with from gas bomb 32.
In addition, connect aspirating pipeline 31b on high-tension connector 31a, this aspirating pipeline 31b is communicated with blood pressure lowering portion 40 and pressure instrumentation portion 42.In addition, aspirating pipeline 31b is via blood pressure lowering portion 40 with open and close valve and be communicated with adapter 31c with supplying gas.
42 pairs of pressure from the carbon dioxide of gas bomb 32 quilt gasification supplies of pressure instrumentation portion are measured, and measurement result is exported to gas surplus display part 43.This gas surplus display part 43 shows the carbon dioxide surplus in the gas bomb 32 as shown in Figure 2 based on the measurement result from pressure instrumentation portion 42.
The carbon dioxide blood pressure lowering that blood pressure lowering portion 40 will supply with via high-tension connector 31a is the pressure of regulation.
Open and close valve 41 and carry out on-off action based on driving signal from drive division 44 outputs.Thereby the flow of supplying gas to the outlet side that opens and closes valve 41 is regulated.The output that opens and closes valve 41 offers to supply gas via aspirating pipeline 31b uses adapter 31c.
Drive division 44 opens and closes the driving signal that valve 41 carries out on-off action based on generating from the control signal of control part 45 described later to be used to make.And drive division 44 is controlled the on-off action that opens and closes valve 41 by supplying with this driving signal.
Drive division 44, informing portion 48, time set operating portion 49 and switch 50 are electrically connected with control part 45.
Informing portion 48 for example is the speaker of sounding or in the display part either party, perhaps speaker and display part is combined.This informing portion 48 is passed through sound according to the control of control part 45, perhaps informs for example end movement time (halted state) of air supply plant 31 such as operator by demonstration.
Time set operating portion 49 will be by intervalometer 47 outputs as time instrumentation unitary formation time instrumentation portion to control part 45 of the setting signal of the movement time of setting as mentioned above.In addition, switch 50 will be used to control judgement control part 46 outputs to control part 45 of switching signal that the on/off of supplying gas of air supply plant 31 switches.
The action of 45 pairs of air supply plant 31 integral body of control part is controlled, and has the control part 46 of judgement and intervalometer 47.
Though not shown, intervalometer 47 has timer conter.This intervalometer 47 uses timer conters to based on counting the movement time (setting-up time) from the setting signal of time set operating portion 49, and the count value that will count (temporal information) is exported to judgement control part 46 simultaneously.
In addition, intervalometer 47 makes the count resets of timer conter by the control of judging control part 46.
To judging that control part 46 inputs are from the switching signal of switch 50 and the temporal information of coming self-timer 47.This judgement control part 46 is based on the program described later (with reference to Fig. 6) of being stored in not shown storage part, use the temporal information of self-timer 47, carry out informing portion 48 inform control, by drive division 44 open and close the open and close controlling of valve 41, the resetting of timer counter of carrying out in the intervalometer 47 controlled etc.
For example, when judging that control part 46 is transfused to switching signal from switch 50, its control drive division 44 becomes open mode so that open and close valve 41, begins the counting of the timer conter of intervalometer 47 simultaneously.
In addition, judge that the count value (temporal information) of 46 pairs of intervalometers of being supplied with 47 of control part and the movement time of being set by time set operating portion 49 (setting-up time) compare.In addition, when count value reaches this movement time, judge that control part 46 drives informing portions 48, thus by sound and (or) show and inform that to operator etc. the action of air supply plant 31 stops that controlling drive division 44 simultaneously so that open and close valve 41 becomes closed condition.
Thus, operator can utilize and import to intraluminal endoscope and observe, operation wait finish after, supplying gas of air supply plant 31 stopped in the predefined specified action time.Therefore, even the water button 25a that supplies gas/send is an open mode, the carbon dioxide that also can prevent to be stored in the gas bomb flows out constantly lavishly.
The action of supplying with carbon dioxide to tube chamber by the air supply plant 31 that is arranged in the surgery systems 1 that constitutes is as mentioned above described to Fig. 8 below with reference to Fig. 5.
In the air supply plant 31 that the surgery systems 1 of present embodiment is had, when energized, judge that control part 46 makes programming start shown in Figure 6.
As shown in Figure 6, judge the holding state (S1) that the processing of control part 46 by step S1 becomes air supply plant 31 can to supply gas.Judge the judgment processing of control part 46 by follow-up step S2, according to judge from the switching signal of aspirated switch (switch) 50 supplies this switch 50 whether be " connection " (S2).At this moment, by judging that control part 46 is judged as under the situation that switch 50 is not " connection " (when switching signal is " L level ": with reference to Fig. 5), make to handle and return step S1, standby is switched " on " up to switch 50.
When being judged as switch 50 for " connection " (when switching signal is " H level " :) with reference to Fig. 5, at moment tS shown in Figure 5, judge the processing of control part 46 by follow-up step S3, control drive division 44 opens and closes valve 41 (S3) to open.Like this, carbon dioxide is carried to tube chamber from the nozzle of supplying gas on the leading section that is positioned at insertion section 24.
At this moment, from supplying gas of air supply plant 31, arrive operating portion 25 via the aspirating pipeline in the aspirating pipeline (not shown) in snorkel 33, the adapter 26a of endoscope, the general cable 26 and upstream side aspirating pipeline 21a (with reference to Fig. 7) with the carbon dioxide of adapter 31c.Then, this carbon dioxide arrive be equipped with the water button 25a that supplies gas/send that is arranged at operating portion 25 the water button of supplying gas/send with cylinder (hereinafter referred to as supplying gas/send water vat) 25c.
Here, be under the situation of open state at the 25d of hole portion that is arranged at the water button 25a that supplies gas/send, as shown in Figure 7, carbon dioxide is pressed shown in arrow a among the figure, arrow b and the arrow c, becomes the leak condition to the outside ejection from the 25d of hole portion.
On the other hand, stopped up under the situation that is arranged at the 25d of hole portion on the water button 25a that supplies gas/send at finger as shown in Figure 8 by operator, the carbon dioxide that transports via upstream side aspirating pipeline 21a is shown in arrow a, arrow d and arrow e among the figure, not from the 25d of hole portion to external leaks, and via swan-neck 25e downstream side aspirating pipeline 21b supply with.Become thus and make carbon dioxide feed status in the tube chamber that carbon dioxide carries via nozzle in tube chamber.
In addition, label 21c is upstream side flow pipe road, and label 21d is flow pipe road, downstream, and label 25f is a check-valves, and label 25g, label 25h are liner, and label 25i is a spring.
In addition, under state shown in Figure 8, when the active force that overcomes spring 25i and the water button 25a that will supply gas/send when depressing ormal weight, move the position of check-valves 25f and liner 25g, 25h, becomes the state that upstream side flow pipe road 21c and flow pipe road, downstream 21d are communicated with.
Then, judge the judgment processing of control part 46 by follow-up step S5, compare to the count value (temporal information) of the intervalometer 47 supplied with from intervalometer 47 with by time set operating portion 49 predefined movement times (setting-up time TL shown in Figure 5), judge whether count value has reached this setting-up time (S5).
At this moment, judge that control part 46 does not reach under the situation of setting-up time TL being judged as count value, in the judgment processing of subsequent step S6, judge switch 50 whether be " disconnection " (S6).Judge that control part 46 does not return step S5 for making under the situation of " disconnection " to handle at switch 50, and change step S8 described later over to for making processing under the situation of " disconnection " at switch 50.
On the other hand, when in the judgment processing of step S5, be judged as count value when having reached described setting-up time, judge that control part 46 drives informing portion 48 at time tY shown in Figure 5, and by sound and (or) show to operator etc. and inform that the action of air supply plant 31 stops (S7).Thus, the air supply plant 31 of present embodiment can inform to operator etc. reached predefined setting-up time TL, supplying gas stops automatically.
Then, judge control part 46 in the processing of time tY by subsequent step S8, control drive division 44 is so that switching valve 41 is closed condition (S8).Promptly stop air supply plant 31 supplying gas to tube chamber.
Thus, the air supply plant 31 of the present embodiment water button 25a that supplying gas/sending is under the situation of open mode (operator does not have to stop up the state of the 25d of hole portion of water button 25a of firmly supplying gas/send as shown in Figure 7), can prevent that carbon dioxide from flowing out constantly lavishly via this water button 25a that supplies gas/send.
Then, judgement control part 46 is exported the reset signal of the timer counter in the intervalometer 47 by the processing of subsequent step S9 to intervalometer 47, be reset to zero thereby control so that stop the counting of this intervalometer 47, makes to handle and returns described step S1 (S9).
Therefore, according to present embodiment, by carrying out above-mentioned control, thereby supplying gas of air supply plant 31 stopped automatically beginning from supplying gas through behind the predefined setting-up time TL.Therefore, the air supply plant 31 of present embodiment can prevent to forget the situation of closing switch after observation that utilizes the intraluminal endoscope 21 of importing to carry out and operation end, can prevent that the carbon dioxide that stores in gas bomb runs off lavishly constantly from the water button 25a that supplies gas/send simultaneously.
In addition, in the air supply plant 31 of present embodiment predefined setting-up time for example the operator when carrying out the large intestine splanchnoscopy proficiency and set, but being not limited to operator must finish observation, processing etc. in above-mentioned setting-up time TL.The present invention also improves this respect, and the example of such embodiment is described as follows.
(second embodiment)
Below second embodiment is described.
About second embodiment of the invention, Fig. 9 is the block diagram of the configuration example of explanation air supply plant to Fig. 9 to Figure 11, and Figure 10 is the sequential chart of the effect of explanation air supply plant, and Figure 11 is the flow chart of the control example of expression air supply plant.In addition, Fig. 9 gives identical label and step S numbering to Figure 11 pair of element identical with above-mentioned first embodiment and contents processing, and omits explanation, only different piece is described.
The structure of Fig. 1 in the overall structure of the surgery systems of present embodiment and first embodiment is basic identical, but is used for the structure difference of the air supply plant 31 of this surgery systems 1.
As shown in Figure 9, air supply plant 31 is basic identical with the structure of Fig. 4, still also has flow measurement portion 51, is arranged at comparison operation portion 52 and storage part 53 in the control part 45.
The flow of using the carbon dioxide of adapter 31c supply to supplying gas detects in flow measurement portion 51, and testing result is exported to comparison operation portion 52.
Flow threshold VL reads from storage part 53 in comparison operation portion 52, carries out calculation process so that be that the effusion meter measured value compares to this flow threshold VL of reading with from the testing result of flow measurement portion 51.Then, comparison operation portion 52 is with judgement control part 46 outputs of this comparative result to described control part 45.
That is, the comparison operation of comparison operation portion 52 is handled by what carry out effusion meter measured value and threshold value VL and is relatively judged whether operations such as observation by the water button 25a operation of supplying gas/send, thereby the counting of guiding intervalometer 47 begins regularly.
That is, judge that control part 46 is under the effusion meter measured value situation bigger than threshold value VL at the comparative result from comparison operation portion 52, be judged as the operations of not carrying out by the water button 25a operation of supplying gas/send such as observation, carry out the counting of the timer conter in the intervalometer 47.
On the other hand, described judgement control part 46 is judged as in the operations of carrying out by the water button 25a operation of supplying gas/send such as observation under the effusion meter measured value situation littler than threshold value VL, carries out the resetting of counting of the timer conter in the intervalometer 47.That is,, determine that the counting of intervalometer 47 begins regularly by making the count resets of intervalometer 47.
Thus, under the situation of the operations of not carrying out operating by the water button 25a that supplies gas/send such as observation, intervalometer 47 is counted, and under the situation of the operations of carrying out operating by the water button 25a that supplies gas/send such as observation, the counting of intervalometer 47 is reset on the other hand.Therefore, the counting that can automatically change the intervalometer 47 that setting-up time TL is counted begins regularly.
Thus, the air supply plant 31 of present embodiment can prevent to stop perioperative the supplying gas such as observation of carrying out by the water button 25a operation of supplying gas/send.In addition, by prolonging the movement time of whole air supply plant 31, even operation is not finished in setting-up time TL, supplying gas of air supply plant 31 can not stop yet.In addition, air supply plant 31 stops to supply gas after not carrying out having passed through setting-up time TL1 by the operations such as observation of the water button 25a operation of supplying gas/send forcibly.
In addition, in the present embodiment, setting-up time TL1 shown in Figure 10 for example can service time setting operation portion 49 set arbitrarily, for example be set at 5 minutes equal times.In addition, other structure of air supply plant 31 is identical with first embodiment.
The action of air supply plant 31 in the surgery systems 1 that is arranged at present embodiment being supplied with carbon dioxide to tube chamber below with reference to Figure 10 and Figure 11 describes.In addition, in Figure 10, shown the open and-shut mode that opens and closes valve 41, operator to the opening/closing state of push-botton operation, effusion meter measured value, flow threshold VL, reset signal and the intervalometer 47 of the water button 25a that supplies gas/send each regularly.
In the air supply plant 31 that the surgery systems 1 of present embodiment is had, when energized, judge that control part 46 startings are stored in the program shown in Figure 11 in the not shown storage part.
As shown in figure 11, the program of present embodiment in the program (with reference to Fig. 6) of first embodiment step S4 and step S5 between the judgment processing of step S20 and the processing of step S21 are set, and other processing sequence, contents processing are identical with first embodiment.
Therefore, judge control part 46 as shown in figure 11, identical with first embodiment, carry out the processing of step S3 by step S1, step S2, thereby at moment tS shown in Figure 10, control drive division 44 opens and closes valve 41 to open, and in tube chamber transport of carbon dioxide.Then, the processing by step S4 begins the counting of intervalometer 47.
Then, judge the judgment processing of control part 46 by new additional step S20 in the present embodiment, carry out calculation process, so that be that the effusion meter measured value compares (S20) to the flow threshold VL that reads from storage part 53 by comparison operation portion 52 with from the testing result of flow measurement portion 51.
At this moment, judge control part 46 in the comparative result from comparison operation portion 52, the effusion meter measured value is judged as the operations of not carrying out by the water button 25a operation of supplying gas/send such as observation than under the big situation of threshold value VL, the counting of intervalometer 47 is begun, and make processing change next step S5 over to.On the contrary, judgement control part 46, was judged as in the operations of carrying out by the water button 25a operation of supplying gas/send such as observation than threshold value VL hour at the effusion meter measured value, made to handle to change step S21 over to.
In the processing of this step S21, owing to be to judge that control part 46 is judged as the effusion meter measured value situation littler than threshold value VL by the judgment processing of step S20, therefore at time t1 shown in Figure 10 (time t2, time t3, time tY), the reset signal of the intervalometer in the intervalometer 47 counting to intervalometer 47 outputs, is stopped the counting of this intervalometer 47 and is reset to zero (S21).Judge that then control part 46 changes processing over to step S5.
Later processing is identical with first embodiment, carries out the count value of intervalometer 47 of step S5 and the comparison of setting-up time TL1 (with reference to Figure 10), carry out according to comparative result the judgment processing of step S6 or step S7 informing portion 48 inform control treatment.
In the processing of step S6 owing to be to judge that control part 46 is judged as the situation that count value does not reach setting-up time TL1, therefore judge switch 50 whether be " disconnection " (S6).Then, judging that control part 46 does not return step S20 for making under the situation of " disconnection " to handle at switch 50, is being to change processing over to step S8 under the situation of " disconnection ".
On the other hand, after having been undertaken informing control treatment by step S7 informing portion 48, judge that control part 46 is identical with first embodiment, in the processing of time tY shown in Figure 10 by step S8, control drive division 44 becomes closed condition (S8) so that open and close valve 41.
That is, after time t3 finally detected the operations of not carrying out by the water button 25a operation of supplying gas/send such as observation, begins to have passed through setting-up time TL1 (for example 5 minutes) from the time t4 that intervalometer 47 is reset thereupon, supplying gas of air supply plant 31 stopped.
Therefore, air supply plant 31 according to present embodiment, the counting that can automatically change the intervalometer 47 that setting-up time TL1 is counted begins regularly, thereby can prevent to supply gas to stop during the operations of carrying out operating by the water button 25a that supplies gas/send such as observation.In addition, air supply plant 31 is not finished even perform the operation in setting-up time TL by prolonging whole movement time, can not stop to supply gas yet.
In addition, after not carrying out having passed through setting-up time TL1 by the operations such as observation of the button 25a operation of supplying gas/send back to, the air supply plant 31 of present embodiment is forced to stop to supply gas, therefore identical with first embodiment, the carbon dioxide that can prevent to be stored in the gas bomb runs off lavishly constantly from the water button 25a that supplies gas/send.
In addition in the air supply plant 31 of present embodiment, during the water of supplying gas/sending, from the water button 25a that supplies gas/send leak during flow depend on the kind of endoscope 21.Therefore under identical flow threshold VL, may exist erroneous judgement disconnected.
Therefore disconnected in order to prevent this erroneous judgement, the air supply plant 31 of present embodiment also can be the structure shown in variation 1 described later and the variation 2.The variation 1 and the variation 2 of the air supply plant in the present embodiment 31 are described to Figure 16 below with reference to Figure 12.
Figure 12 and Figure 13 are used to illustrate variation 1, and Figure 12 is the rearview of the air supply plant of variation 1, and Figure 13 is the block diagram of the configuration example of the air supply plant inside of explanation variation 1.In addition, Figure 12 only describes different parts for the element labelling same numeral identical with above-mentioned each embodiment with Figure 13.
As Figure 12 and shown in Figure 13, the air supply plant 31 of variation 1 also is provided with flow threshold input part 54 on the basis of the structure of second embodiment.
This flow threshold input part 54 as shown in figure 12, be arranged at air supply plant 31 rear side time set operating portion 49 near.Flow threshold input part 54 is other 5 grade formula switch of level of for example 5 grades that can switch flow threshold and vary in size.Particularly, flow threshold input part 54 can be set 5 other flow thresholds of the arbitrary number of level in the grade by slide bar 54a.
For example, the rank of 5 grades is that " rank 1 " that vary in size set according to the kind of operable endoscope 21 in advance arrives the flow threshold of " rank 5 ", and " rank 1 " is the flow threshold of minima, and " rank 5 " is peaked flow threshold.
In addition, flow threshold input part 54 will be exported to storage part 53 by other flow threshold of level that operation is set.Then, other flow threshold of level of setting is stored in the storage part 53.
That is, the 52 employed flow threshold VL of comparison operation portion of second embodiment are the flow thresholds of being set by flow threshold input part 54.
In addition, flow threshold input part 54 also can be corresponding to employed endoscope 21 in the predetermined flow threshold scope, the variable resistance type switch that can set arbitrarily by the slide of control stick.
Other structure of air supply plant 31 is identical with above-mentioned each embodiment.
The air supply plant 31 of this variation is by moving with the essentially identical control method of second embodiment (program shown in Figure 11), but in the judgment processing of step S20, can use the flow threshold VL that sets by flow threshold input part 54 by comparison operation portion 52, carry out comparison judgment processing with the effusion meter measured value.Contents processing in addition is identical with contents processing among each step S shown in Figure 11.
Therefore according to the air supply plant 31 of this variation, effect except second embodiment, can also set flow threshold corresponding to employed endoscope 21, the erroneous judgement that the operation of water button 25a has or not so can prevent to supply gas/send is disconnected, can carry out stopping control corresponding to good the supplying gas of precision of the kind of endoscope 21.
Figure 14 is used to illustrate variation 2 to Figure 16, Figure 14 is the structure chart of configuration example of the endoscopic system of the air supply plant of expression with variation 2, Figure 15 is the rearview of the air supply plant of variation 2, and Figure 16 is the block diagram of the configuration example of the inner and light supply apparatus of the air supply plant of explanation variation 2.In addition, Figure 14 only describes different parts for the element labelling same numeral identical with above-mentioned each embodiment to Figure 16.
With relative corresponding to the situation of the flow threshold VL of endoscope 21 in the variation 1 via 54 inputs of flow threshold input part, the air supply plant 31 of this variation detects and takes out the flow threshold based on the kind of the endoscope 21 that connects from light supply apparatus 22, sets the flow threshold VL corresponding to endoscope 21.
As Figure 14 and shown in Figure 15, be provided with the adapter 31d that continues that is electrically connected, is used to communicate with light supply apparatus 22 in the rear side of the air supply plant 31 of this variation.Adapter (not shown) on an end that is connected in connection cord 55 on this connection adapter 31d.The other end of this connection cord 55 is connected with adapter 22a on being arranged at light supply apparatus 22.
Though do not illustrate, the endoscope 21 that is used for this variation has the ID signal generator of the ID signal of the kind that can send expression endoscope 21.When this ID signal generator is connected with light supply apparatus 22 via the adapter 26a of endoscope in endoscope 21, send the ID signal to light supply apparatus 22 sides.
Be provided with the 22A of kind portion of endoscope that receives the ID signal on the light supply apparatus 22 as shown in figure 16.The 22A of this kind portion of endoscope differentiates the kind of the endoscope 21 that is connected based on the described ID signal that is received.In addition, the not shown flow threshold table of the 22A of kind portion of endoscope use is determined the flow threshold based on the endoscope 21 that is determined, and the flow threshold that will determine sends to air supply plant 31 sides via connection cord 55.
The air supply plant 31 of this variation has and is connected the Department of Communication Force 56 that adapter 31d is electrically connected.This Department of Communication Force 56 via connection cord 55 be connected adapter 31d and receive the flow threshold that sends from light supply apparatus 22 sides, identical with variation 1, to storage part 53 outputs.
Thus, air supply plant 31 is obtained flow threshold corresponding to endoscope's 21 use traffic threshold value input parts 54 in variation 1, but in variation 2, only endoscope 21 is connected with light supply apparatus 22, just can automatically obtains flow threshold corresponding to the endoscope 21 that is connected.
Other structure of air supply plant 31 is identical with above-mentioned each embodiment.
In addition, the control method of the air supply plant 31 of this variation is identical with above-mentioned variation 1.
Therefore according to the air supply plant 31 of this variation, effect except above-mentioned variation 1, can also need not to carry out input operation and obtain flow threshold automatically, thereby can set flow threshold more easily corresponding to endoscope 21 corresponding to employed endoscope 21.
(the 3rd embodiment)
Below the 3rd embodiment is described.
About third embodiment of the invention, Fig. 7 is the block diagram of the configuration example of explanation air supply plant to Figure 17 to Figure 19, and Figure 18 is the sequential chart of the effect of explanation air supply plant, and Figure 19 is the flow chart of the control example of expression air supply plant.In addition, Figure 17, and only describes different parts for the element identical with above-mentioned each embodiment and contents processing labelling same numeral and step S numbering and omit explanation to Figure 18.
Be used for present embodiment surgery systems 1 air supply plant 31 as shown in figure 17, basic identical with the structure of Fig. 9 in second embodiment, and the comparison operation contents processing difference of comparison operation portion 52.
In addition, storage part 53 has been stored comparison operation portion 52 and has been compared calculation process required positive flow threshold RL and minus flow threshold-RL.
Promptly, the comparison operation of comparison operation portion 52 handle be by to the changes in flow rate amount of unit interval and flow threshold RL ,-RL compares, thereby precision is judged the processing that has or not by the operations such as observation of the water button 25a operation of supplying gas/send well, guides the counting of intervalometer 47 to begin regularly (zero hour) thus.
Promptly, judge that control part 46 is in the comparative result from comparison operation portion 52, the changes in flow rate amount specific discharge threshold value RL of unit interval ,-when RL (absolute value) is big, be judged as in the operations of carrying out by the water button 25a operation of supplying gas/send such as observation, carry out the resetting of timer conter in the intervalometer 47.That is,, and determine that the counting of intervalometer 47 begins regularly by count resets with intervalometer 47.
In addition as shown in figure 18, for example under the situation of the water button 25a that supplies gas/send of having supplied gas state of operation, action reduces the flow of supplying gas to the minus changes in flow rate amount of unit interval meaning by supplying gas.Therefore, the flow threshold that is used for comparing with this minus changes in flow rate amount becomes flow threshold-RL, judge control part 46 this flow threshold of use RL ,-absolute value of RL.
On the other hand, judge control part 46 the changes in flow rate amount specific discharge threshold value RL of unit interval ,-RL (absolute value) is when little (also existing null situation), be judged as the operations of not carrying out by the water button 25a operation of supplying gas/send such as observation, carry out the counting of the timer conter in the described intervalometer 47.
Thus, judge that control part 46 resets intervalometer 47 when carrying out the operations of operating by the water button 25a that supplies gas/send such as observation, when not carrying out the operations of operating by the water button 25a that supplies gas/send such as observation, carry out the counting of intervalometer 47 on the other hand, thereby the counting that can automatically change the intervalometer 47 that described setting-up time TL is counted begins regularly (zero hour).
Thus, air supply plant 31 can prevent to supply gas to stop during the operations of carrying out operating by the water button 25a that supplies gas/send such as observation.In addition, air supply plant 31 is by prolonging whole supplying gas movement time, thereby even do not finish operation in setting-up time TL, also can not stop to supply gas.
In addition, air supply plant 31 is not after carrying out having passed through setting-up time TL1 by the operations such as observation of the water button 25a operation of supplying gas/send, and pressure stops to supply gas.In addition, even the air supply plant of present embodiment 31 is obtained the flow threshold corresponding to the kind of endoscope 21 unlike the variation 1 of second embodiment and variation 2, also can precision judge the comparison judgment processing of control part 46 well.
In addition in the present embodiment, setting-up time TL1 shown in Figure 180 can be identical with above-mentioned second embodiment, and for example service time, setting operation portion 49 set arbitrarily, was set at 5 minutes equal times here.
Other structure of air supply plant 31 is identical with above-mentioned each embodiment.
The supply action of air supply plant 31 in the surgery systems 1 that is arranged at present embodiment being supplied with carbon dioxide to tube chamber below with reference to Figure 18 and Figure 19 describes.In addition, figure 18 illustrates the open and-shut mode that opens and closes valve 41, operator to the push-botton operation of the water button 25a that supplies gas/send, effusion meter measured value, the variable quantity of unit interval (changes in flow rate amount), flow threshold RL ,-the on/off state of RL, reset signal and intervalometer 47 each regularly.
In the air supply plant 31 that the surgery systems 1 of present embodiment is had, when energized, judge the program shown in Figure 19 of being stored in the not shown storage part of control part 46 startings.
As shown in figure 19, the program of present embodiment is provided with the processing of step S30, the judgment processing of step S31 and the processing of step S32, replace step S4 in the program (with reference to Figure 11) of second embodiment and the judgment processing of the step S20 between the step S5, the processing of step S21, and other processing sequence is identical with second embodiment with contents processing.
Therefore, judge control part 46 as shown in figure 19, identical with second embodiment, via step S1, step S2, by the processing of step S3, the moment tS control drive division 44 shown in Figure 19 opens and closes valve 41 to open.Like this, from the nozzle of supplying gas of the leading section that is positioned at insertion section 24 to the tube chamber transport of carbon dioxide.Then, the processing by step S4 begins the counting of intervalometer 47.
Then, judge the processing of control part 46 by new additional step S30 in the present embodiment, control ratio uses preceding effusion meter measured value of predefined setting-up time and current effusion meter measured value, the changes in flow rate amount (S30) of unit of account time (being equivalent to setting-up time) than operational part 52.
Then, judge the judgment processing of control part 46 by subsequent step S31, carry out calculation process with to the changes in flow rate amount of unit interval of in step S30, calculating and the described flow threshold RL that reads from storage part 53 by comparison operation portion 52 ,-RL (absolute value) compares (S31).
At this moment, judge that control part 46 is in the comparative result from comparison operation portion 52, the changes in flow rate amount specific discharge threshold value RL of unit interval ,-RL hour, be judged as in the operations of carrying out by the water button 25a operation of supplying gas/send such as observation, begin the counting of intervalometer 47 and change processing over to next step S5.On the other hand, judge control part 46 the changes in flow rate amount of unit interval than described flow threshold RL ,-when RL (absolute value) is big, be judged as the operations of not carrying out by the water button 25a operation of supplying gas/send such as observation, make to handle to change step S32 over to.
In the processing of step S32, judge that control part 46 is identical with the processing (with reference to Figure 11) of step S21 in second embodiment, in the reset signal of the timer counter of time t1 shown in Figure 180 (time t2, time t3, time tY) in intervalometer 47 output intervalometers 47.Then, judge that control part 46 stops the counting of intervalometer 47 and is reset to zero (S32), changes processing over to step S5.
Later processing is identical with first embodiment, carries out the count value of intervalometer 47 of step S5 and the comparison of setting-up time TL1 (with reference to Figure 18), carry out according to comparative result the judgment processing of step S6 or step S7 informing portion 48 inform control treatment.
In the processing of step S6, owing to be to be judged as the situation that count value does not reach setting-up time TL1, therefore judge control part 46 judge switch 50 whether be " disconnection " (S6), not returning step S30 for making under the situation of " disconnection " to handle at switch 50, is being to make under the situation of " disconnection " to handle to change step S8 over to.
On the other hand, after in step S7, having been undertaken informing control treatment, judge that control part 46 is identical with second embodiment, at time tY shown in Figure 180 by informing portion 48, by the processing of step S8, control drive division 44 is so that switching valve 41 is closed condition (S8).
That is, after time t3 finally detects the operations of not carrying out by the water button 25a operation of supplying gas/send such as observation, begins to have passed through setting-up time TL1 (for example 5 minutes) from the time t4 that intervalometer 47 is reset thereupon, stop to supply gas of air supply plant 31.
Therefore according to present embodiment, because can automatically change the counting of the intervalometer 47 that setting-up time TL1 is counted begins regularly, thereby during the operations of carrying out operating such as observation, can not stop to supply gas by the water button 25a that supplies gas/send, and by prolonging the movement time of whole air supply plant 31, even in setting-up time TL, do not finish operation, can not stop to supply gas of air supply plant 31 yet.
In addition, even without the operations of carrying out by the water button 25a operation of supplying gas/send such as observation, through also forcing to stop to supply gas behind the setting-up time TL1, therefore identical with second embodiment, can avoid being stored in carbon dioxide in the gas bomb 32 from described supplying gas/send water button 25a to run off constantly lavishly.
In addition, even the air supply plant of present embodiment 31 is obtained the flow threshold corresponding to the kind of endoscope 21 unlike the variation 1 of second embodiment and variation 2, also can precision judge the comparison judgment processing of control part 46 well.
In addition, in above-mentioned first to the 3rd embodiment, can realize: after the use that is being through with imports to the observation or operation of intraluminal flexible endoscope, can prevent that the inspection that is stored in the gas bomb 32 from being the air supply plant 31 that carbon dioxide consumes with being wasted with gas, and the surgery systems 1 with the endoscopic system 2 that comprises this air supply plant 31.
(the 4th embodiment)
Below the 4th embodiment is described.
About the 4th embodiment of the present invention, Figure 20 is the block diagram of the configuration example of explanation air supply plant to Figure 20 to Figure 22, and Figure 21 is the flow chart of the control example of expression air supply plant, and Figure 22 is the sequential chart of explanation air supply plant effect.In description of the present embodiment, omit explanation in addition, only different parts is described for the element labelling same numeral identical with above-mentioned each embodiment.
Below with reference to Figure 20 the formation of the air supply plant 31 of present embodiment is described.
As shown in figure 20, the air supply plant 31 of present embodiment have valve unit 60, as the test section 45A of detecting unit and as the tube chamber of the control unit control part (hereinafter referred to as control part) 45 of supplying gas.
On the high-tension connector 31a of air supply plant 31, connect from gas bomb 32 extended gases at high pressure pipes 34, supply with carbon dioxide with pipe 34 from gas bomb 32 via these gases at high pressure.In addition, connect aspirating pipeline 31b on high-tension connector 31a, this aspirating pipeline 31b is communicated with valve unit 60.
Reducing transformer 61 is the pressure of the carbon dioxide blood pressure lowering of supplying with via high-tension connector 31a for regulation.
The output of electromagnetic valve 62 is supplied with adapter 31c to supplying gas via flow transducer 63, aspirating pipeline 31b.
Whether test section 45A is taken into testing result, and detect the carbon dioxide that should carry based on this testing result in body cavity and leak from the water button 25a that supplies gas/send of endoscope 21, and testing result is offered control part 45.
For example test section 45A at first compares flow measurement value and pre-set threshold VL (with reference to Figure 22) as testing result from flow transducer 63.Then, test section 45A detects the carbon dioxide that should carry and leaks from the water button 25a that supplies gas/send of endoscope 21 in body cavity under the flow measurement value situation bigger than threshold value VL.And on the other hand, test section 45A detects the carbon dioxide that should carry and does not leak from the water button 25a that supplies gas/send of endoscope 21 in body cavity under the flow measurement value situation littler than threshold value VL.
Promptly, detect at test section 45A under the situation that the carbon dioxide that should insert in body cavity leaks from the water button 25a that supplies gas/send of endoscope 21, the water button 25a that supplies gas/send is open mode (operator not have obstruction firmly supply gas/send the state of the 25d of hole portion of water button 25a).On the other hand, detect under the situation that the carbon dioxide that should insert in body cavity do not leak from the water button 25a that supplies gas/send of endoscope 21 at test section 45A, the water button 25a that supplies gas/send is closed condition (operator stopped up and supplied gas/send the state of the 25d of hole portion of water button 25a).
The action of control part 45 by-pass valve control unit 60.Particularly, control part 45 is controlled the on-off action of electromagnetic valve 62 based on the testing result from test section 45A.In addition, be provided with not shown intervalometer at control part 45, control part 45 is obtained the time information from this intervalometer.
The supply action of air supply plant 31 in the surgery systems 1 that is arranged at formation like this being supplied with carbon dioxide below with reference to Figure 21, Figure 22, the Fig. 7 that uses in the first embodiment and Fig. 8 in tube chamber describes.
In the air supply plant 31 that the surgery systems 1 of this example is had, when energized, control part 45 startings program shown in Figure 21.
As shown in figure 21, control part 45 is controlled by the processing of step S40, so that open electromagnetic valve 62, and transport of carbon dioxide in body cavity (S40).
At this moment, from air supply plant 31 supply gas with the carbon dioxide of adapter 31c arrive via the aspirating pipeline in the aspirating pipeline (not shown) in snorkel 33, the adapter 26a of endoscope, the general cable 26 and upstream side aspirating pipeline 21a (with reference to Fig. 7) be equipped with the water button 25a that supplies gas/send that is arranged at operating portion 25 the water button of supplying gas/send with cylinder (hereinafter referred to as supplying gas/send water vat) 25c.
Here, when the 25d of hole portion that is arranged at the water button 25a that supplies gas/send was open state, carbon dioxide became the leak condition to the outside ejection from the 25d of hole portion shown in arrow a, arrow b, arrow c among the figure as shown in Figure 7.
On the other hand, stopped up under the situation of the 25d of hole portion that is arranged at the water button 25a that supplies gas/send at the finger that utilizes operator as shown in Figure 8, the carbon dioxide of carrying via upstream side aspirating pipeline 21a is shown in arrow a, arrow d, arrow e among the figure, can be from the 25d of hole portion to external leaks, and via swan-neck 25e downstream side aspirating pipeline 21b supply with.Become carbon dioxide feed status in the tube chamber that carbon dioxide carries via nozzle thus in tube chamber.
In addition, label 21c is upstream side flow pipe road, and label 21d is flow pipe road, downstream, and label 25f is a check-valves, and label 25g, label 25h are liner, and label 25i is a spring.
In addition, under state shown in Figure 8, when the active force that overcomes spring 25i and the water button 25a that will supply gas/send when depressing ormal weight, move the position of check-valves 25f and liner 25g, 25h, becomes the state that upstream side flow pipe road 21c and flow pipe road, downstream 21d are communicated with.
Then, control part 45 flow measurement value in this comparative result detects the carbon dioxide that should carry and leaks from the water button 25a that supplies gas/send of endoscope 21 than under the big situation of threshold value VL in body cavity.That is, to be judged as the water button 25a that supplies gas/send be open mode (operator does not have to stop up the state of the 25d of hole portion of water button 25a of firmly supplying gas/send as shown in Figure 7) to control part 45.
On the other hand, control part 45 flow measurement value in comparative result detects the carbon dioxide that should carry and does not leak from the water button 25a that supplies gas/send of endoscope 21 than under the little situation of threshold value VL in body cavity.That is, to be judged as the water button 25a that supplies gas/send be closed condition (operator stops up the state of the 25d of hole portion of the water button 25a that firmly supplies gas/send as shown in Figure 8) to control part 45.
By the judgment processing of step S41, can in the action of supplying gas of air supply plant 31, detect the open and-shut mode of the water button 25a that supplies gas/send like this.
Then, control part 45 is judged as the processing that changes step S42 under the situation that the water button 25a that supplies gas/send is open mode (state of not supplying gas) in the judgment processing by step S41.On the other hand, control part 45 is being judged as repeated execution of steps S41 under the situation that the water button 25a that supplies gas/send is closed condition (carrying out the state of the conveying of carbon dioxide).
In the processing of step S42, because the water button 25a that supplies gas/send is open mode (leak condition), so control part 45 controls to close electromagnetic valve 62 in order to prevent carbon dioxide from consuming with being wasted, stops to supply gas.Then, when having passed through predefined setting-up time, control part 45 is controlled behind setting-up time to open electromagnetic valve 62 by the processing of subsequent step S43, makes to handle and returns step S41.
The sequential chart of the on-off action of the flow measurement value of actual flow transducer 63 when carrying out above-mentioned control example, the on-off action of the water button 25a that supplies gas/send and electromagnetic valve 62 is shown in Figure 22.
As shown in figure 22, before moment t0, air supply plant 31 is by the processing of the step S40 of control part 45, and electromagnetic valve 62 is controlled as open mode, via supplying gas with adapter 31c to endoscope's 21 transport of carbon dioxide.
In addition, operator is removed finger at moment t0 from the 25d of hole portion of the water button 25a that supplies gas/send, makes this water button 25a that supplies gas/send become open mode.Therefore, the water button 25a that supplies gas/send becomes leak condition, and the flow of supplying gas of carbon dioxide is increased.
Like this, carry out the judgment processing of the step S41 of control part 45 at moment t1, bigger thereby test section 45A detects the flow measurement value than threshold value VL.That is, to be judged as the water button 25a that supplies gas/send be open mode to control part 45.
Then, control part 45 is controlled to close electromagnetic valve 62 by the processing of step S42 based on this testing result.Thus, the result that closes of electromagnetic valve 62 reduces the flow of supplying gas of carbon dioxide.
In the present embodiment, carry out the judgment processing of the control part 45 of step S41 at every section setting-up time.In addition, this setting-up time is represented the time from the moment t1 of Figure 22 to moment t2.This setting-up time for example can on centralized operation panel 7, be provided with can setting-up time operating portion, and use this operating portion to set arbitrarily.
After having passed through setting-up time then, promptly at moment t2, the processing of the step S43 by control part 45 is controlled opening electromagnetic valve 62, thereby the flow of supplying gas of carbon dioxide is increased.
At moment t3, carry out the judgment processing of the step S41 of control part 45 once more then, bigger thereby test section 45A detects the flow measurement value than threshold value VL.Also be judged as the water button 25a that supplies gas/send this moment is open mode.
Based on this testing result, control part 45 by the processing of step S43, is controlled to close electromagnetic valve 62 in the same manner then.At moment t3, the result that electromagnetic valve 62 cuts out reduces the flow of supplying gas of carbon dioxide thus.
The water button 25a that supplying gas like this/sending be open mode during in, carry out processing from step S41 to step S43.
Thus, the control part 45 water button 25a that supplying gas/sending is under the situation of open mode, carries out the open and close controlling of electromagnetic valve 62 of judgment processing, step S42 and the step S43 of step S41 at every section setting-up time and handles.Therefore can make the flow of supplying gas of the flow-rate ratio carbon dioxide in the past of supplying gas that leaks from the 25d of hole portion of the water button 25a that supplies gas/send little.
At moment t6, operator stops up the 25d of hole portion of the water button 25a that firmly supplies gas/send with finger, that is, make to supply gas/to send water button 25a be closed condition.Thereby the flow of supplying gas of carbon dioxide is reduced.
Like this, carry out the judgment processing of the step S41 of control part 45 at moment t7, littler thereby test section 45A detects the flow measurement value than threshold value VL.That is, to be judged as the water button 25a that supplies gas/send be closed condition to control part 45.Control part 45 was not closed electromagnetic valve 62 and was continued to supply with carbon dioxide this moment.
Therefore according to present embodiment, when operator when the 25d of hole portion of the water button 25a that supplies gas/send removes finger, the gas pushing quantity of carbon dioxide reduces, so can reduce the consumption of carbon dioxide.
(the 5th embodiment)
Below the 5th embodiment is described.
About fifth embodiment of the invention, Figure 23 is the block diagram of configuration example of the air supply plant of explanation the 5th embodiment to Figure 23 to Figure 25, and Figure 24 is the flow chart of the control example of expression air supply plant, and Figure 25 is the sequential chart of the effect of explanation air supply plant.In addition,, and omit explanation, only different parts is described for element identical and identical label and the step S numbering of contents processing labelling identical with the 4th embodiment with above-mentioned each embodiment.
The structure of Fig. 1 in the overall structure of the surgery systems of present embodiment and above-mentioned each embodiment is basic identical, and is used for the structure difference of the air supply plant 31 of this surgery systems 1.
As shown in figure 23, the structure of Figure 20 in air supply plant 31 and the 4th embodiment is basic identical, but have: have valve unit 60A, the connection tube 31D that is connected with suction pump 64 of suction pump 64 and connect the base end side of this connection tube 31D and be used for will be by suction pump 64 attractions gas to the air vent 31e of atmosphere discharge.
In valve unit 60A, suction pump 64 be configured to electromagnetic valve 62 and flow transducer 63 between aspirating pipeline 31b be communicated with.
Therefore, suction pump 64 is via aspirating pipeline and upstream side aspirating pipeline 21a (with reference to Fig. 7) in the aspirating pipeline (not shown) in aspirating pipeline 31b, snorkel 33, the adapter 26a of endoscope, general cable 26, is communicated with hole portion 25d (with reference to Fig. 7) of the water button 25a that supplies gas/send of operating portion 25.
When driving suction pump 64, in aspirating pipeline 31b, promptly via the gas in the 25d of hole portion (with reference to Fig. 7) the attraction atmosphere of the water button 25a that supplies gas/send that is communicated with this aspirating pipeline 31b.
Then, suction pump 64 is discharged via path upstream side aspirating pipeline 21a (with reference to Fig. 7) opposite when supplying gas, the aspirating pipeline in the general cable 26, aspirating pipeline (not shown), snorkel 33, aspirating pipeline 31b, suction pump 64 inside, connection tube 31D and the air vent 31e in the adapter 26a of endoscope the gas that attracts in atmosphere.
When suction pump 64 stops, when electromagnetic valve 62 is opened, test section 45A is that flow measurement value and pre-set threshold VL2 (with reference to Figure 25) compare to the testing result from flow transducer 63.Then, test section 45A detects the carbon dioxide that should carry and leaks (the water button 25a that supplies gas/send is an open mode) from the water button 25a that supplies gas/send of endoscope 21 when the flow measurement value is bigger than threshold value VL2 in body cavity.
On the other hand, when electromagnetic valve 62 close, when driving suction pump 64, test section 45A is that flow measurement value and pre-set threshold-VL1 (with reference to Figure 25) compare to the testing result from flow transducer 63.Then, when the flow measurement value than threshold value-VL1 hour, just detect from the water button 25a that supplies gas/send of endoscope 21 and attract gas (the water button 25a that supplies gas/send is an open mode) the atmosphere.
In addition, threshold value VL2 is identical with the 4th embodiment with threshold value-VL1, can set arbitrarily.
Other structure is identical with above-mentioned each embodiment.
The action of air supply plant 31 in the surgery systems 1 that is arranged at present embodiment being supplied with carbon dioxide to tube chamber below with reference to Figure 24 and Figure 25 describes.
In the air supply plant 31 that the surgery systems 1 of present embodiment is had, when energized, control part 45 startings are stored in the program shown in Figure 24 in the not shown storage part.
As shown in figure 24, control part 45 is controlled so that open electromagnetic valve 62 transport of carbon dioxide in body cavity by the processing of step S40.
Thus, from supplying gas of air supply plant 31 with the carbon dioxide of adapter 31c, via aspirating pipeline and the upstream side aspirating pipeline 21a (with reference to Fig. 7) in the aspirating pipeline (not shown) in snorkel 33, the adapter 26a of endoscope, general cable 26, arrive to be equipped with and be arranged at supplying gas on the operating portion 25/the send water vat 25c that supplies gas/send of water button 25a.
At this moment, control part 45 is in the judgment processing of step S44, and the testing result that test section 45A is carried out from flow transducer 63 is the comparison of flow measurement value and pre-set threshold VL2 (with reference to Figure 25).
On the other hand, under the flow measurement value situation bigger than threshold value VL2, control part 45 is judged as the carbon dioxide that should carry and leaks from the water button 25a that supplies gas/send of endoscope 21 in body cavity.That is, to be judged as the water button 25a that supplies gas/send be open mode to control part 45.Being judged as the water button 25a that supplies gas/send is under the situation of open mode, and control part 45 makes to handle and changes step S45 over to.
When control part 45 begins to attract, gas in the atmosphere is attracted from hole portion 25d (with reference to Fig. 7) of the water button 25a that supplies gas/send, via the aspirating pipeline in upstream side aspirating pipeline 21a (with reference to Fig. 7), the general cable 26, aspirating pipeline (not shown), snorkel 33 and the aspirating pipeline 31b in the adapter 26a of endoscope, arrive suction pump 64.The gas that arrives suction pump 64 is discharged to atmosphere via connection tube 31D and air vent 31e.
At this moment, control part 45 is in the judgment processing of step S47, and making test section 45A is that flow measurement value and pre-set threshold-VL1 (with reference to Figure 25) compare (rightabout flows when supply gas with carbon dioxide in negative sign "-" expression gas edge) to the testing result from flow transducer 63.
On the other hand, under the situation of flow measurement value bigger than threshold value-VL1 (flow of the mobile gas of rightabout is little when supply gas with carbon dioxide in the edge), the gas that control part 45 is judged as in the atmosphere is attracted from the water button 25a that supplies gas/send.That is, to be judged as the water button 25a that supplies gas/send be closed condition to control part 45.Being judged as the water button 25a that supplies gas/send is under the situation of closed condition, and control part 45 stops suction pump 64 in step S48, change the processing of step S40 over to, begins supplying gas of carbon dioxide once more.
The sequential chart of on-off action of on-off action, the electromagnetic valve 62 in the air supply plant 31 and suction pump 64 of representing the water button 25a that supplies gas/send that flow measurement value, the operator of actual flow transducer 63 when carrying out above-mentioned control example carry out is shown in Figure 25.
Before moment t0 shown in Figure 25, operator is with pointing the 25d of hole portion that stops up the water button 25a that firmly supplies gas/send, and the water button 25a that promptly supplies gas/send is a closed condition.In addition, control part 45 is controlled by the processing of step S40, so as to open electromagnetic valve 62, transport of carbon dioxide in body cavity.
Then, control part 45 carries out the judgment processing of step S44, but because the flow measurement value is littler than threshold value VL2, and 25a is opened can't to detect the water button of supplying gas/send, the judgment processing that repeats step S44 is up to moment t0.
At moment t0, operator is removed finger from the 25d of hole portion of the water button 25a that supplies gas/send, that is, make to supply gas/send water button 25a to become open mode.Thus, become the state of carbon dioxide from the 25d of the hole portion leakage of the water button 25a that supplies gas/send, the flow of supplying gas of carbon dioxide increases.
At moment t1, carry out the judgment processing of the step S44 of control part 45 like this, bigger thereby test section 45A detects the flow measurement value than threshold value VL2.That is, to be judged as the water button 25a that supplies gas/send be open mode to control part 45.
Then, based on this testing result, control part 45 is closed electromagnetic valve 62 by the processing of step S45, controls to drive suction pump 64 by the processing of step S46.Thereby stop to supply with carbon dioxide at moment t1, make suction pump 64 begin to attract gas in the atmosphere.Its result, the flow of supplying gas reverse when supplying gas with carbon dioxide increases.
Then, control part 45 carries out the judgment processing of step S47, but because the flow measurement value is littler than threshold value-VL1, has closed and can't detect the water button 25a that supplies gas/send, and the judgment processing that repeats step S47 is up to moment t2.
At moment t2, operator stops up the 25d of hole portion of the water button 25a that firmly supplies gas/send with finger, that is, make to supply gas/to send water button 25a be closed condition.Make suction pump 64 can't attract gas in the atmosphere thus, make that the reverse flow of supplying gas reduces when supplying gas with carbon dioxide.
Like this, carry out the judgment processing of the step S47 of control part 45 at moment t3, bigger thereby test section 45A detects the flow measurement value than threshold value-VL1.That is, to be judged as the water button 25a that supplies gas/send be closed condition to control part 45.
Based on this testing result, control part 45 stops suction pump 64 by the processing of step S48 then, controls to open electromagnetic valve 62 by the processing of step S40.Thus, make suction pump 64 stop to attract gas in the atmosphere, begin the supply of carbon dioxide once more.
Therefore according to present embodiment, when the 25d of hole portion of the water button 25a that supplies gas/send has removed finger, do not carry out supplying gas of carbon dioxide, thereby can reduce the consumption of carbon dioxide at operator.
(the 6th embodiment)
Below the 6th embodiment is described.
Figure 26 to Figure 29 about sixth embodiment of the invention, Figure 26 is the block diagram of the configuration example of explanation air supply plant, Figure 27 is the flow chart of the control example of expression air supply plant, Figure 28 is the chart of voltage-discharge characteristic of the choke valve of expression Figure 26, and Figure 29 is the sequential chart of the effect of explanation air supply plant.In addition, for element labelling same numeral identical and omission explanation, and only different parts is described with above-mentioned each embodiment.
The structure of Fig. 1 in the overall structure of the surgery systems of present embodiment and above-mentioned each embodiment is basic identical.The air supply plant 31 that is used for this surgery systems 1 has internal structure and the 4th, the different valve unit 60B of the 5th embodiment as shown in figure 26.
That is, control part 45 is controlled to change the voltage of control signal, regulates the throttle opening of choke valve 66, thereby can regulate the flow of supplying gas of the carbon dioxide of supply.
The characteristic of choke valve 66 is the magnitude of voltage of control signal with the transverse axis as shown in figure 28, is flow value with the longitudinal axis, has following characteristic: flow value is F1 during magnitude of voltage P1, becomes the big flow value F2 of specific discharge value F1 than the big magnitude of voltage P2 of magnitude of voltage P1 the time.
In the present embodiment, identical with the 5th embodiment, carry out the flow measurement value of flow transducer 63 and the comparison of two threshold value VLL, VLH by test section 45A, thereby detect the open and-shut mode of the water button of supplying gas/send.In addition, in the present embodiment, two threshold value VLL, VLH for corresponding respectively to the threshold value of flow value F1, F2, satisfy VLH as shown in figure 28〉relation of VLL.
At this moment, threshold value VLH is used to judge that the water button 25a that supplies gas/send is the threshold value of open mode, and threshold value VLL is used to judge that the water button 25a that supplies gas/send is the threshold value of closed condition.
In addition, in the present embodiment, the throttling operating state when throttling operating state (hereinafter referred to as the F1 state) the when operating state of choke valve 66 comprises flow value F1 for example and flow value F2
(hereinafter referred to as the F2 state) these two kinds of throttling operating states.
In addition, these two states of F1, F2 are not limited to these flow values, and can set arbitrarily.About two threshold value VLH, VLL, also can set arbitrarily in the same manner in addition with the 5th embodiment.
Other structure and above-mentioned each embodiment are basic identical.
The action of air supply plant 31 in the surgery systems 1 that is arranged at present embodiment being supplied with carbon dioxide to tube chamber below with reference to Figure 27 and Figure 29 describes.
In the air supply plant 31 that the surgery systems 1 of present embodiment is had, when energized, control part 45 startings are stored in the program shown in Figure 27 in the not shown storage part.
As shown in figure 27, control part 45 is controlled so that choke valve 66 becomes the state of F2 by the processing of step S49, opens throttling transport of carbon dioxide in body cavity.
At this moment, from supplying gas of air supply plant 31 with the carbon dioxide of adapter 31c, via aspirating pipeline and the upstream side aspirating pipeline 21a (with reference to Fig. 7) in the aspirating pipeline (not shown) in snorkel 33, the adapter 26a of endoscope, general cable 26, be arranged at supplying gas on the operating portion 25/the send water vat 25c that supplies gas/send of water button 25a and arrive to be equipped with.
Then, control part 45 is in the judgment processing of step S50, and utilizing test section 45A is that flow measurement value and pre-set threshold VLH, VLL (with reference to Figure 28 and Figure 29) compare to the testing result from flow transducer 63.
Then, control part 45 flow measurement value in this comparative result detects the carbon dioxide that should supply gas and leaks from the water button 25a that supplies gas/send of endoscope 21 than under the big situation of threshold value VLH in body cavity, and promptly being judged as the water button 25a that supplies gas/send is open mode.
On the other hand, control part 45 in this comparative result the flow measurement value than under the little situation of threshold value VLL, detect the carbon dioxide that should supply gas and do not leak from the water button 25a that supplies gas/send of endoscope 21 in body cavity, promptly being judged as the water button 25a that supplies gas/send is closed condition.
Like this, by the judgment processing of step S50, in the action of supplying gas of air supply plant 31, detect the open and-shut mode of the water button 25a that supplies gas/send.
Then, it is under the situation of open mode (state of not supplying gas) that control part 45 is judged as the water button 25a that supplies gas/send in the judgment processing by step S50, changes the processing of step S51 over to.And on the other hand, control part 45 is being judged as under the situation that the water button 25a that supplies gas/send is closed condition (carrying out the state of supplying gas of carbon dioxide), changes the processing of step S52 over to.
In the processing of step S51, because the water button 25a that supplies gas/send is open mode (leak condition), so control part 45 consumes in order to prevent carbon dioxide with being wasted, and the state that choke valve 66 is controlled to be F1 is with the reduction flow of supplying gas.Control part 45 makes to handle and returns step S50 then.
On the other hand, in the processing of step S52, owing to be to carry out the state of supplying gas of carbon dioxide (the water button 25a that supplies gas/send is a closed condition), so control part 45 is controlled to be the F2 state with the increase flow of supplying gas with choke valve 66.Control part 45 makes to handle and returns step S50 then.
The sequential chart of the throttling action of the flow measurement value of actual flow transducer 63 when carrying out this control example, the on-off action of the water button 25a that supplies gas/send and choke valve 66 is shown in Figure 29.
As shown in figure 29, before moment t0, air supply plant 31 is by the processing of the step S49 of control part 45, and choke valve 66 is controlled as the F2 state, via supplying gas with adapter 31c to endoscope's 21 transport of carbon dioxide.
In addition, operator is removed finger and is made this water button 25a that supplies gas/send become open mode from the 25d of hole portion of the water button 25a that supplies gas/send at moment t0.Therefore, the water button 25a that supplies gas/send becomes leak condition, and the flow of supplying gas of carbon dioxide is increased.
Like this at moment t1, carry out the judgment processing of step S50 by control part 45, bigger thereby test section 45A detects the flow measurement value than threshold value VLH.That is, to be judged as the water button 25a that supplies gas/send be open mode to control part 45.
Then, based on this testing result, control part 45 is controlled to be the F1 state by the processing of step S51 with choke valve 66.Thereby the flow of supplying gas at moment t1 carbon dioxide reduces.
At moment t2, operator stops up the 25d of hole portion of the water button 25a that firmly supplies gas/send with finger.That is, to make the water button 25a that supplies gas/send be closed condition to operator.Thereby the flow of supplying gas of carbon dioxide reduces.
Like this, carry out the judgment processing of step S50 by control part 45 at moment t3, littler thereby test section 45A detects the flow measurement value than threshold value VLL.That is, to be judged as the water button 25a that supplies gas/send be closed condition to control part 45.
Then, based on this testing result, control part 45 is controlled to be the F2 state by the processing of step S52 with choke valve 66.Thereby the flow of supplying gas of carbon dioxide increases.
Therefore according to present embodiment, when operator when the 25d of hole portion of the water button 25a that supplies gas/send has removed finger, the flow of supplying gas of carbon dioxide reduces, so can reduce the consumption of carbon dioxide.
In addition, the air supply plant in the present embodiment 31 also constitutes shown in variation 1 and the variation 2 as described later like that.The variation 1 and the variation 2 of the air supply plant 31 of present embodiment are described to Figure 34 with reference to Figure 30.
Figure 30 and Figure 31 are used to illustrate variation 1, Figure 30 is the block diagram of configuration example of the air supply plant of explanation variation 1, Figure 31 is the flow chart of the control example of expression air supply plant, Figure 32 is used to illustrate variation 2 to Figure 34, Figure 32 is the block diagram of configuration example of the air supply plant of explanation variation 2, Figure 33 is the profile that is arranged at the throttle orifice in the aspirating pipeline of Figure 32, and Figure 34 is the flow chart of the control example of expression air supply plant.
As shown in figure 30, the air supply plant 31 of variation 1 has and is provided with the valve unit 60C that first, second electromagnetic valve 62a, 62b substitute the choke valve 66 in the present embodiment.
In valve unit 60C, first, second electromagnetic valve 62a, 62b are identical with choke valve 66, based on from the control signal of control part 45 output and controlled on-off action.In addition, the second electromagnetic valve 62b is configured to the first electromagnetic valve 62a arranged side by side at aspirating pipeline 31b.
When the first electromagnetic valve 62a moves under open mode, have and to come the characteristic of transport of carbon dioxide with big flow value Fa, and when the second electromagnetic valve 62b moves, have the characteristic of coming transport of carbon dioxide with rill value Fb under open mode.
That is, in this variation, the F1 state of above-mentioned choke valve 66 is to make the flow of supplying gas become the state of flow value Fb by closing the first electromagnetic valve 62a and opening the second electromagnetic valve 62b.
In addition, in this variation, the F2 state of above-mentioned choke valve 66 is to make the flow of supplying gas become the state of (flow value Fa+ flow value Fb) by opening the first electromagnetic valve 62a and the second electromagnetic valve 62b.
Can obtain the effect identical thus with the choke valve 66 of present embodiment.
The air supply plant 31 of this variation is by moving with the essentially identical control method of the air supply plant of present embodiment (program shown in Figure 27), but as shown in figure 31, the contents processing difference of step S53, step S55 and step S56.
That is, the control part 45 of this variation is controlled by the processing of step S53, so that make first, second electromagnetic valve 62a, 62b all open and become the F2 state, transport of carbon dioxide in body cavity.
Then, control part 45 is in the step S54 that carries out the judgment processing identical with step S50 (with reference to Figure 27), and utilizing test section 45A is that flow measurement value and pre-set threshold VLH, VLL (with reference to Figure 28 and Figure 29) compare to the testing result from flow transducer 63.Thereby control part 45 is identical with present embodiment, can detect the open and-shut mode of the water button 25a that supplies gas/send.
Then, it is under the situation of open mode (leak condition) that control part 45 is judged as the water button 25a that supplies gas/send in the judgment processing by step S54, changes the processing of step S55 over to.And on the other hand, control part 45 is being judged as under the situation that the water button 25a that supplies gas/send is closed condition (state that does not have leakage), changes the processing of step S56 over to.
In the processing of step S55, water button 25a is open mode (leak condition) owing to supply gas/send, so control part 45 consumes in order to prevent carbon dioxide with being wasted, control to close the first electromagnetic valve 62a and to open the second electromagnetic valve 62b, make the flow of supplying gas become the state that rill value Fb is F1 (the F1 state of the choke valve 66 of present embodiment), the flow of supplying gas is reduced.Then, control part 45 makes to handle and returns step S54.
On the other hand, in the processing of step S56, owing to be to carry out the state of supplying gas of carbon dioxide (the water button 25a that supplies gas/send is a closed condition), therefore control part 45 is controlled so that first, second electromagnetic valve 62a, 62b are opened and is made the flow of supplying gas become the state (the F2 state of the choke valve 66 in the present embodiment) of (flow value Fa+ flow value Fb), and the flow of supplying gas is increased.Then, control part 45 makes to handle and returns step S54.Obtain and essentially identical effect of present embodiment and effect thus.
Therefore according to variation 1, use first, second electromagnetic valve 62a, 62b even do not use choke valve 66, also can obtain and choke valve 66 essentially identical effect and effects, thus air supply plant that can constituent ratio present embodiment air supply plant 31 more at a low price.
The air supply plant 31 of variation 2 shown in figure 32, it has the valve unit 60D that is provided with electromagnetic valve 62 and substitutes the choke valve 66 of present embodiment as the throttle orifice 67 of flow regulating part.
In valve unit 60D, identical with variation 1 when electromagnetic valve 62 moves under open mode have the characteristic that can come transport of carbon dioxide with big flow value Fa.In addition, throttle orifice 67 is arranged to electromagnetic valve 62 arranged side by side at aspirating pipeline 31b.
Therefore only by closing electromagnetic valve 62, can make the flow of supplying gas become flow value Fb, become the F1 state of the choke valve 66 of present embodiment.
Only by opening electromagnetic valve 62, can make the flow of supplying gas become (flow value Fa+ flow value Fb) in addition, become the F2 state of the choke valve 66 of present embodiment.
In addition, by being set, connecting pipeline (aspirating pipeline 31b) that throttle orifice 67 forms is communicated with adapter 31c with supplying gas all the time, therefore snorkel 33 not with this situation about being connected of supplying gas with adapter 31c under, cause carbon dioxide to leak into the atmosphere with adapter 31c from supplying gas.But in variation 2, be provided with not shown check-valves on supplying gas with adapter 31c, this check-valves blocks the pipeline of supplying gas with in the adapter 31c under the situation that does not connect snorkel 33, prevents the leakage of carbon dioxide.
Can obtain the effect identical by said structure with the choke valve 66 of present embodiment.
The air supply plant 31 of variation 2 is according to moving with the essentially identical control method of the air supply plant of present embodiment (program shown in Figure 27), and the contents processing difference of step S58 and S59 as shown in figure 34.
That is,,, close electromagnetic valve in order to prevent carbon dioxide from consuming by the processing of step S58 when the judgment processing of control part 45 by step S57 is judged as the water button 25a that supplies gas/send when being open mode (leak condition) with being wasted.Form the connecting pipeline through throttle orifice 67 thus, control part 45 flow-control of will supplying gas is the state (the F1 state of the choke valve 66 in the present embodiment) of rill value Fb, and the flow of supplying gas is reduced.Then, control part 45 makes to handle and returns step S57.
On the other hand, control part 45 is judged as the water button 25a that supplies gas/send when being closed condition (do not have leak state) in the judgment processing by step S57, opens electromagnetic valve 62 by the processing of step S59.Flow-control will increase the flow of supplying gas for the state (the F2 state of the choke valve 66 in the present embodiment) of (flow value Fa+ flow value Fb) thereby the connecting pipeline of formation process throttle orifice 67, control part 45 will be supplied gas.Then, control part 45 makes to handle and returns step S57.Thereby can obtain and essentially identical effect of present embodiment and effect.
Therefore according to variation 2, use electromagnetic valve 62 and throttle orifice 67, also can obtain identical effect and effect even do not use choke valve 66, thus air supply plant air supply plant 31 more at a low price that can the constituent ratio present embodiment.In addition compared with above-mentioned variation 1 simpler and low price.
In addition, can realize in above-mentioned the 4th to the 6th embodiment: the inspection that can prevent to be stored in the gas bomb 32 is control method, the air supply plant 31 of the air supply plant 31 that consumes of carbon dioxide and the surgery systems 1 with the endoscopic system 2 that comprises air supply plant 31 with gas with being wasted.
(the 7th embodiment)
With reference to the accompanying drawings the 7th embodiment of the present invention is described.In addition, for structure tag same numeral that in above-mentioned each embodiment, has illustrated and omission explanation, and serve as main describing only with different structures, effect, effect.
Figure 35 to Figure 40 about the 7th embodiment of the present invention, Figure 35 is the figure that expression illustrates the structure of surgical system under the peritoneoscope that external device (ED) is monitoring arrangement and respiratory organ, Figure 36 is the figure that the structure of surgical system under the peritoneoscope with plenum system is described, Figure 37 is the figure that is used to illustrate the centralized operation panel, Figure 38 is the figure that is used to illustrate the centralized displaying panel, Figure 39 is the structure chart of internal structure of expression air supply plant, and Figure 40 is the figure that is used to illustrate the panel part of air supply plant.In the present embodiment, the structure identical with above-mentioned each embodiment used identical label and omitted its explanation.
As shown in figure 35, under the peritoneoscope of present embodiment in the surgical operation, prepare surgical system 70 under the peritoneoscope, as the monitoring arrangement (being also referred to as the patient monitoring device) 200 and the respiratory organ (artificial ventilator) 300 of external equipment.
The patient 10 who lies on the operating-table 9 utilizes breathing mask 301 to cover the oral cavity.Breathing mask 301 is connected to the other end of the exhaust tube 303 that an end is connected with respiratory organ 300.Exhaust tube 303 exhalation sensor 302 is installed midway.
On this exhalation sensor 302, be electrically connected with from monitor apparatus 200 extended signal cables 201.
Here monitoring arrangement 200 is carried out simple declaration.
In the present embodiment, by the exhalation sensor 302 in the exhaust tube 303 that is equipped on respiratory organ 300, gas concentration lwevel in the expiration of patient's 10 discharges is measured, the information signal of this gas concentration lwevel is offered the control part 204 of monitoring arrangement 200.Control part 204 calculates partial pressure of carbon dioxide in endexpiratory gas according to the gas concentration lwevel in the expiration of patient's 10 discharges, and its value of calculation is shown on the multiparameter monitor 202.
Also will narrate in the back in addition, the system controller 4 of surgical system 70 is electrically connected under the control part 204 of monitoring arrangement 200 and the peritoneoscope.
After this, will be elaborated to surgical system 70 under the peritoneoscope of the present invention below.
As shown in figure 36, surgical system under the peritoneoscope of present embodiment (being designated hereinafter simply as surgical system) 1 constitutes to have: the first endoscopic system 2a, the second endoscopic system 2b and plenum system 4a, and have: system controller 4, monitor 5, centralized displaying panel (being designated hereinafter simply as display floater) 6, centralized operation panel (being designated hereinafter simply as guidance panel) 7 and go-cart 8 as display device.
On electric mes device 13, be connected with electric mes 13a as surgical instrument.First trocar 14 is that endoscope described later is imported to the Intraabdominal trocar.Second trocar 15 is that the preparation implements such as electric mes 13a that will carry out cutting tissue or processing import to the Intraabdominal trocar.The 3rd trocar 16 is that the pneumoperitoneum that is used for supplying with from the air supply plant described later 31 that constitutes plenum system 4a imports to the Intraabdominal trocar with promptly for example identical with above-mentioned each embodiment carbon dioxide of gas.In addition, also carbon dioxide can be imported to intraperitoneal from first trocar 14 or second trocar 15.
The first endoscopic system 2a constitutes mainly and comprises: for example insertion section as first endoscope is rigid rigid endoscope 20, first light supply apparatus 11, first camera control unit (being designated hereinafter simply as a CCU) 12 and endoscope-use video camera 20b.
The insertion section of rigid endoscope 20 (not shown) is inserted and is led in first trocar 14, is disposed at intraperitoneal.In the insertion section, have by the relay lens (not shown) that transmits shot object image and wait the viewing optical system that constitutes and by the lamp optical system of formations such as photoconduction (not shown).Base end part in the insertion section is provided with the 20a of eyepiece portion that the optical image that is transmitted by viewing optical system is observed.Loading and unloading freely are equipped with endoscope-use video camera 20b on the 20a of eyepiece portion.Has imaging apparatus (not shown) in the inside of endoscope-use video camera 20b.
First light supply apparatus 11 is supplied with illumination light to rigid endoscope 20.The one CCU 12 will image on the imaging apparatus of endoscope-use video camera 20b, be picture signal through the electrical signal conversion of opto-electronic conversion, for example with this picture signal to monitor 5 and 6 outputs of centralized displaying panel.Thus, the endoscopic images that on the picture of monitor 5 or centralized displaying panel 6, shows the subject that is obtained by rigid endoscope 20.
In addition, rigid endoscope 20 and first light supply apparatus 11 are by being connected from the extended optical cable 39b of the sidepiece of rigid endoscope 20.The one CCU 12 is connected by shooting cable 37a with endoscope-use video camera 20b.
The second endoscopic system 2b constitutes mainly and comprises: have second endoscope 21, secondary light source device 22 and second camera control unit (being designated hereinafter simply as the 2nd CCU) 23 that is inserted into intraluminal soft insertion section 24 such as large intestine.
The 2nd CCU 23 will imaging on the imaging apparatus on the not shown leading section of the insertion section 24 that is arranged at second endoscope 21, be picture signal through the electrical signal conversion of opto-electronic conversion, for example to monitor 5 or centralized displaying panel 6 these picture signals of output.According to this picture signal, on the picture of monitor 5 or centralized displaying panel 6, show the endoscopic images of the subject that obtains by second endoscope 21.In addition, label 39 is to be arranged at the cable that electric connector 36b on the light source adapter 36a and the 2nd CCU 23 are electrically connected.
On air supply plant 31, be provided with: supply with interface (hereinafter referred to as first interface) 41a with as second tube chamber of supplying with interface as first abdominal cavity of supplying with interface and supply with interface (hereinafter referred to as second interface) 41b.Being connected with first pipe on the first interface 41a is the end of abdominal cavity with pipe 45a, and this abdominal cavity is connected with the 3rd trocar 16 with the other end of managing 45a.
Being connected with second pipe on the second interface 41b is the end of tube chamber with pipe 45b, and this tube chamber is connected with second endoscope 21 with the other end of managing 45b.Tube chamber is connected to the interface 39a of the adapter 37 that is connected with the preparation implement access portal portion of second endoscope 21 with the other end of pipe 45b.
That is, manage 45b, adapter 37 from the carbon dioxide of air supply plant 31 via tube chamber usefulness, and pass through the preparation implement passage of second endoscope 21, supply in the tube chamber.In addition, air supply plant 31 is connected with pipe 34 by gases at high pressure with gas bomb 32.
Secondary light source device 22 as second air supply plant is supplied with illumination light to second endoscope 21.Loading and unloading freely connect light source adapter 36a on this secondary light source device 22.By light source adapter 36a is connected with secondary light source device 22, illumination light transmits in not shown optical fibers and illuminating window from the not shown leading section that is arranged at insertion section 24 penetrates.
In addition, in secondary light source device 22, be built-in with not shown for example compressor, it constitutes air feed part as being used for carrying the pressure controlled unit of supplying gas of the regulation of air via the general cable 26 and the insertion section 24 of second endoscope 21 in patient 10 body cavity.
4 pairs of surgical system 70 integral body of system controller are unified control.On system controller 4, connecting centralized displaying panel 6, centralized operation panel 7, electric mes device 13, light supply apparatus 11,22, CCU 12,23 and air supply plant 31 etc., making them can carry out two-way communication as endoscope's peripheral unit via not shown communication line.
On the picture of monitor 5, receive from the picture signal of a CCU 12 or the 2nd CCU 23 outputs, show endoscopic images by the taken subject of rigid endoscope 20 or second endoscope 21.
On centralized displaying panel 6, be provided with display frames such as liquid crystal display.By centralized displaying panel 6 is connected with system controller 4, thereby can in display frame, carry out the centralized displaying of the operating state of the endoscopic images of described subject and endoscope's peripheral unit.
In go-cart 8, be equipped with electric mes device 13, light supply apparatus 11,22, CCU 12,23, air supply plant 31, system controller 4, centralized displaying panel 6, centralized operation panel 7 and gas bomb 32 etc. as peripheral unit.
Here based on Figure 37 the configuration example of guidance panel 7 is described.
As shown in figure 37, on guidance panel 7, be provided with: be used to regulate the abdominal cavity usefulness of air supply plant 31 or the setting operation button 7a of the pneumoperitoneum flow that tube chamber is used; Be used to regulate the action button 7b of the output valve of electric mes device (high-frequency combustion device) 12; Be used to regulate the action button 7c of the tone of CCU (TV video camera) 12,23; Be used to indicate and show the action button 7d of switching being shown in image information on the monitor 5; Be used to indicate the video recording of VTR or the action button 7e that video recording stops; And be used for action button 7f that the light quantity of first light supply apparatus 11 and secondary light source device 22 is regulated.
Based on Figure 38 an example of the display frame of display floater 6 is described below.
As shown in figure 38, in the display frame of display floater 6, be the setting and the operating state of the function of air supply plant 31, electric mes device 13 etc. in the last demonstration of separately viewing area 6A (6a, 6b), 6c, 6d, 6e about the equipment that system controller 4 communicates control respectively for example.In addition, viewing area 6A shows setting, the operating state about air supply plant 31, and the display tube cavity pressure shows that 6a, intra-abdominal pressure show 6b, the demonstration of carbon dioxide surplus and flow demonstration etc.
Based on Figure 39 the structure of air supply plant 31 is described below.
As shown in figure 39, in air supply plant 31, mainly be provided with: supply with pressure sensor 81, reducing transformer 82, first electro-pneumatic proportional valve 83, second electro-pneumatic proportional valve 84, first electromagnetic valve 85, second electromagnetic valve 86, as first pressure regulating unit and as the first relief valve 87a of first pressure regulating part, as second pressure regulating unit and as the second relief valve 87b of second pressure regulating part, as first detecting unit and as first pressure transducer 88 of first test section, as second detecting unit and as second pressure transducer 89 of second test section, first flow pick off 90, second flow transducer 91, and control part 45.In addition, on air supply plant 31, except interface 41a, 41b, also be provided with high voltage interface 93, setting operation portion 95 and display part 96.In addition, first electro-pneumatic proportional valve 83 and constitute first i.e. first air feed part in unit of supplying gas as first electromagnetic valve 85 of first opening/closing unit, second electro-pneumatic proportional valve 84 and second electromagnetic valve 86 constitute second i.e. second air feed part in unit of supplying gas.
Be divided into two branches from the outlet side of importing the reducing transformer 82 of carbon dioxide via high voltage interface 93, one of them branch is that the order polyphone connects first electro-pneumatic proportional valve 83, first electromagnetic valve 85, first pressure transducer 88, first flow pick off 90, first pipeline that the first interface 41a and abdominal cavity constitute with pipe 45a is the abdominal cavity stream, and another branch is that the order polyphone connects second electro-pneumatic proportional valve 84, second electromagnetic valve 86, second pressure transducer 89, second flow transducer 91, second pipeline that the second interface 41b and tube chamber constitute with pipe 45b is the tube chamber stream.
On high voltage interface 93, connect gases at high pressure with managing 34.Gases at high pressure are connected with the carbon dioxide cylinder (being designated hereinafter simply as gas bomb) 32 of the outside that is positioned at air supply plant 31 with pipe 34.
Setting operation portion 95 and display part 96 constitute panel part 97.Supply with 81 pairs of pressure of pressure sensor and measure, and this measurement result is exported to control part 45 from the carbon dioxide of gas bomb 32 supplies.Reducing transformer 82 is the pressure of the carbon dioxide blood pressure lowering of supplying with in air supply plant 31 through gasification and via high voltage interface 93 for regulation.
First electro-pneumatic proportional valve 83 is based on the control signal from control part 45 output, will press i.e. 0 to 80mmHg the scope of first pressure that be adjusted to roughly by supplying gas of the carbon dioxide after pick off 82 blood pressure lowerings.On the other hand, second electro-pneumatic proportional valve 84 will be adjusted to second pressure by the pressure of supplying gas of the carbon dioxide after reducing transformer 82 blood pressure lowerings and promptly be roughly 0 to 500mmHg scope based on the control signal from control part 45 outputs.
First electromagnetic valve 85 and second electromagnetic valve 86 carry out on-off action based on the control signal of exporting from control part 45.The abdominal cavity of the outlet side of 88 pairs first electro-pneumatic proportional valves 83 of first pressure transducer is measured with the stream internal pressure, and its measurement result is exported to control part 45.Control part 45 is based on calculating Intraabdominal force value from the measurement result of this first pressure transducer 88.
In addition, the tube chamber of the outlet side of 89 pairs second electro-pneumatic proportional valves 84 of second pressure transducer is exported its measurement result with measuring in the stream to control part 45.Control part 45 is based on calculating intraluminal force value from the measurement result of this second pressure transducer 89.
First flow pick off 90 and 91 pairs of flows that supply to the carbon dioxide of interface 41a, 41b of second flow transducer are measured, and its measurement result is exported to control part 45.
That is, the carbon dioxide of supplying with from gas bomb 32 by reducing transformer 82 by blood pressure lowering after, the control signal based on from control part 45 outputs supplies to intraperitoneal via the abdominal cavity with stream, and supplies in the tube chamber with stream via tube chamber.
In addition, when the measured value of first pressure transducer 88 had surpassed the intra-abdominal pressure setting value, the first relief valve 87a of outlet side that is arranged at first flow pick off 90 was based on becoming open mode from the control signal of control part 45.That is, by opening the first relief valve 87a, Intraabdominal carbon dioxide is released in the atmosphere, and intra-abdominal pressure is carried out reduction regulation.
In addition, the second relief valve 87b that is arranged at the outlet side of second flow transducer 91 also is the measured value when second pressure transducer 89 when having surpassed tube chamber internal pressure setting value, based on becoming open mode from the signal of control part 45.Like this tube chamber internal pressure is carried out reduction regulation.
In addition, control part 45 is connected with the system controller 4 of outside, and various detection information signals, various control signals etc. are offered system controller 4.In addition, the content of the end-expiratory carbon dioxide of discharging based on patient 10 from exhalation sensor 301, this system controller 4 is supplied to the information signal of the partial pressure of carbon dioxide in endexpiratory gas of being calculated by monitoring arrangement 200.
Based on Figure 40 the panel part 97 of air supply plant 31 is described below.
As shown in figure 40, a side of air supply plant 31 is provided with the panel part 97 with setting operation portion 95 and display part 96.
On panel part 97, be provided with on and off switch 71, the start button 72 of supplying gas, the stop button 73 of supplying gas, intra-abdominal pressure as setting operation portion 95 is set button 74a, 74b and the abdominal cavity side gas flow of supplying gas is set button 75a, 75b, the tube chamber side gas flow of supplying gas is set button 81a, 81b, abdominal cavity mode selector switch 82a, tube chamber mode selector switch 83a, gas surplus display part 76 as display part 96, intra-abdominal pressure display part 77a, 77b, abdominal cavity effluent amount display part 78a, 78b, the gas gross display part 79 of supplying gas, tube chamber effluent amount display part 80a, 80b, abdominal cavity pattern display part 82b, and tube chamber pattern display part 83b etc.
In addition, when intraperitoneal is supplied with carbon dioxide, when existing when unusual, make the i.e. bright lamp of the first alarm display part 84a as the unitary first alarm portion of first alert notification by control part 45.In addition, when in tube chamber, supplying with carbon dioxide, when existing when unusual, make the i.e. bright lamp of the second alarm display part 84b as the unitary second alarm portion of second alert notification by control part 45.In addition, when generation in intraperitoneal and the tube chamber was unusual, control part 45 made each alarm display part 84a, the bright lamp of 84b, and not shown alarm buzzer is piped.
On and off switch 71 is the switches that are used for the main power source of air supply plant 31 is switched to on-state or off-state.The start button 72 of supplying gas is to be used to indicate beginning to supply with the button of carbon dioxide to the abdominal cavity side.The stop button 73 of supplying gas is to be used to indicate the switch that stops to supply with to the abdominal cavity side carbon dioxide.
Intra-abdominal pressure sets button 74a and the gas flow of supplying gas is set button 75a, 81a by push-botton operation, and each setting value is slowly changed to the direction that improves.On the other hand, intra-abdominal pressure sets button 74b and the gas flow of supplying gas is set button 75b, 81b by push-botton operation, and each setting value is slowly changed to the direction that reduces.
On gas surplus display part 76, show the carbon dioxide surplus in the gas bomb 32.The measurement result that on intra-abdominal pressure display part 77a, shows the abdominal cavity pressure of measuring by first pressure transducer 88.On the other hand, on intra-abdominal pressure display part 77b, show the setting pressure of for example intra-abdominal pressure setting button 74a, 74b being carried out push-botton operation and setting.
On abdominal cavity effluent amount display part 78a, show the measurement result of measuring by first flow pick off 90.On the other hand, on abdominal cavity effluent amount display part 78b, show the abdominal cavity side is supplied gas that gas flow sets that button 75a, 75b carry out push-botton operation and the setting flow set.On the gas gross display part 79 of supplying gas, show by control part 45 based on the measured value of first flow pick off 90 and the gas gross of supplying gas that computing is obtained.
On tube chamber effluent amount display part 80a, show the measurement result of measuring by second flow transducer 91.On the other hand, on tube chamber effluent amount display part 80b, show the tube chamber side is supplied gas that gas flow sets that button 81a, 81b carry out push-botton operation and the setting flow set.
Identical, when having operated tube chamber mode selector switch 83a, the bright lamp of tube chamber pattern display part 83b, with the selection operation while of this tube chamber pattern, abdominal cavity pattern display part 82b turns off the light.The setting of the gas flow of supplying gas of the setting of intra-abdominal pressure in addition,, abdominal cavity side and tube chamber side etc. also can be undertaken by centralized operation panel 7.
In addition, also can on centralized displaying panel 6, show by operator in advance from specified one or more value the value of intra-abdominal pressure display part 77a, 77b, each flow display part 78a, 78b, 80a, 80b, gas gross display part 79 demonstrations of supplying gas.
The action of the surgical system 70 of the present embodiment that constitutes is as mentioned above described to Figure 45 based on Figure 41.
Figure 41 is the flow chart that is used to illustrate the control example of air supply plant when abdominal cavity and tube chamber are supplied gas, Figure 42 is the flow chart of control example that is used to illustrate the affirmation of partial pressure of carbon dioxide in endexpiratory gas, Figure 43 is the flow chart that is used to illustrate the control example of the action that the setting that reduces abdominal cavity and tube chamber is pressed, Figure 44 is used to illustrate the flow chart of the setting of abdominal cavity and tube chamber being pressed the control example of restorative action, and Figure 45 is the expression partial pressure of carbon dioxide in endexpiratory gas, press in the abdominal cavity and the sequential chart of the relation that tube chamber is pressed.
At first the action of carrying out usually from the air supply plant 31 of the surgical system 70 of present embodiment begins to describe.
At first doctor or nurse connect the on and off switch 71 of air supply plant shown in Figure 40 31, intra-abdominal pressure is set button 74a, 74b, the gas flow of supplying gas set button 75a, 81a and the gas flow of supplying gas and set button 75b, 81b and operate, the supply flow rate of the carbon dioxide of set the internal pressure of abdominal cavity and tube chamber, supplying with to abdominal cavity and tube chamber.
In addition, Intraabdominal pressure for example is set at 8 to 15mmHg by doctor or nurse.On the other hand, intraluminal pressure is by air supply plant 31, and setting flow and the abdominal cavity set corresponding to the tube chamber side is supplied gas gas flow setting button 81a, 81b carry out push-botton operation are intrinsic pressure, are set to for example 10mmHg.
When the on and off switch 71 of air supply plant 31 was switched on, control part 45 carried out the control based on the order of each step S (S) shown in the flow chart of Figure 41.At this moment, first electromagnetic valve 85 and second electromagnetic valve 86 are closed condition.
In addition, as shown in figure 41, when the on and off switch 71 of air supply plant 31 was switched on, control part 45 carried out the affirmation (S60) of partial pressure of carbon dioxide in endexpiratory gas, judged whether to be abdominal cavity pattern (S61).About the affirmation of this partial pressure of carbon dioxide in endexpiratory gas, the processing of being undertaken based on the flow chart of Figure 42 by control part 45.The back will describe in detail it.
At first the action to the air supply plant in the abdominal cavity pattern 31 describes.
Particularly, at first control part 45 utilizes first pressure transducer 88 to detect actual intra-abdominal pressure (S62), shows intra-abdominal pressure on intra-abdominal pressure display part 77a.Simultaneously, according to being shown in intrinsic pressure poor in setting value on the intra-abdominal pressure display part 77b and abdominal cavity, determine the pressure of supplying gas of first electro-pneumatic proportional valve 83.
At this moment, control part 45 is provided by supplying with the measurement result that pressure sensor 81 and first flow pick off 90 are measured, and judges the intrinsic pressure setting value (S63) that whether reaches in abdominal cavity.Then, on gas surplus display part 76, show the gas surplus, on intra-abdominal pressure display part 77a, show intra-abdominal pressure, on abdominal cavity effluent amount display part 78a, show flow, on the gas gross display part 79 of supplying gas, show the total amount of the gas of obtaining by computing of supplying gas.
Be judged as intra-abdominal pressure and do not reach the control part 45 of set pressing and open first electromagnetic valve 85 (S64), open first electro-pneumatic proportional valve 83 (S65),, change step S60 once more over to closing first electromagnetic valve 85 (S66) through after the stipulated time.Air supply plant 31 repeats above-mentioned control action and presses until the abdominal cavity of setting.
Like this, the carbon dioxide of in air supply plant 31, supplying with from gas bomb 32, be depressurized to the pressure of regulation by the reducing transformer 82 and first electro-pneumatic proportional valve 83, and be adjusted to the flow of regulation, send into intraperitoneal with the pipe 45a and the 3rd trocar 16 by first electromagnetic valve 85 and via the first interface 41a, abdominal cavity.
In addition, as mentioned above, intra-abdominal pressure for example is set at 8 to 15mmHg by doctor or nurse.In the present embodiment, establish the intra-abdominal pressure that doctor or nurse set and for example be 10mmHg.In addition, the intra-abdominal pressure of the patient 10 during the operation beginning is to press (10mmHg) little pressure than setting, and is promptly basic identical with atmospheric pressure.Therefore, when common operation began, air supply plant 31 was judged as intra-abdominal pressure and does not reach setting pressure (10mmHg).
In step S63, be judged as the control part 45 that intra-abdominal pressure reached setting value (10mmHg) and change the step S71 that judges whether to the tube chamber pattern over to.
That is, in the control that press in the abdominal cavity, be the abdominal cavity pattern as long as be judged as, then repeatedly carry out carbon dioxide state that flows and the mobile state that blocks carbon dioxide.In addition, during near intra-abdominal pressure reaches setting value shown on intra-abdominal pressure display part 77b setting, become and stop the state of supplying gas to the abdominal cavity.
Thus, the pressure by regulation forms the space at intraperitoneal, and operator is observed into treatment sites by being disposed at the rigid endoscope 20 of first trocar 14, handles etc. by be inserted into Intraabdominal electric mes 13a via second trocar 15 simultaneously.In addition, compare under the high situation of the setting value that shows on the intra-abdominal pressure display part 77b in the measurement result from first pressure transducer 88 that is input to control part 45, control part 45 is to first relief valve 87a output control signal.Thus, make the first relief valve 87a become open mode, Intraabdominal carbon dioxide is released in the atmosphere, make the intra-abdominal pressure blood pressure lowering.
Action to the air supply plant in the tube chamber pattern 31 describes below.
When in step S61, being judged as when not being the abdominal cavity pattern, perhaps in step S63, be judged as the abdominal cavity and press to have reached and set when pressing, judge whether to be tube chamber pattern (S71).In this step S71, control part 45 is judged as when not being the tube chamber pattern, changes step S60 once more over to.
On the other hand, be judged as is that the control part 45 of tube chamber pattern utilizes second pressure transducer 89 to detect actual tube chamber internal pressure (S72), setting flow and the abdominal cavity set corresponding to the tube chamber side is supplied gas gas flow setting button 81a, 81b carry out push-botton operation are intrinsic pressure, determine the pressure of supplying gas of second electro-pneumatic proportional valve 84.
At this moment, control part 45 is supplied with by supplying with the measurement result that the pressure sensor 81 and second flow transducer 91 are measured, judged the intrinsic pressure setting value (S73) that whether reached of tube chamber.Identical with the abdominal cavity pattern, on gas surplus display part 76, show the gas surplus, on tube chamber effluent amount display part 80a, show flow, on the gas gross display part 79 of supplying gas, show the total amount of the gas of obtaining by computing of supplying gas.
Be judged as the tube chamber internal pressure and do not reach the control part 45 of set pressing and open second electromagnetic valve 86 (S74), open second electro-pneumatic proportional valve 84 (S75), close second electromagnetic valve 86 (S76), change step S60 once more over to through after the stipulated time.The control action that air supply plant 31 repeats from step S60 to step S76 is pressed until the tube chamber that becomes setting.
In addition, as mentioned above, setting flow and the abdominal cavity set are intrinsic pressure corresponding to doctor or nurse supply gas to the tube chamber side that gas flow sets that button 81a, 81b carry out push-botton operation, and the tube chamber internal pressure is set at for example 10mmHg.The tube chamber internal pressure of patient 10 when in addition, operation begins presses (10mmHg) little, promptly basic identical with atmospheric pressure than setting.Therefore when common operation began, air supply plant 31 was judged as the tube chamber internal pressure and does not reach setting pressure (10mmHg).
The carbon dioxide of supplying with in air supply plant 31 from gas bomb 32 is the pressure of regulation by blood pressure lowering by the reducing transformer 82 and second electro-pneumatic proportional valve 84, and be adjusted to the flow of regulation, send in the tube chamber with the pipe 45b and second endoscope 21 by second electromagnetic valve 86 and via the second interface 41b, tube chamber.
In step S73, be judged as the control part 45 that the tube chamber internal pressure reached setting value (10mmHg) and change step S60 over to.
That is, identical with the abdominal cavity pattern, in the control that tube chamber is pressed, be the tube chamber pattern as long as be judged as, then repeat carbon dioxide state that flows and the mobile state that blocks carbon dioxide.Then, when the tube chamber internal pressure reaches near the setting value (10mmHg) setting, become and stop the state of supplying gas to tube chamber.
Therefore, when be the tube chamber pattern during, use the carbon dioxide of pipe 34 supply in air supply plant 31 via gases at high pressure from gas bomb 32, by reducing transformer 82 and 84 blood pressure lowerings of second electro-pneumatic proportional valve is the pressure of regulation, and the flow with regulation passes through second electromagnetic valve 86, is sent in the tube chamber with managing the 45b and second endoscope 21 via second flow transducer 91, the second interface 41b, tube chamber.
When the state of supplying gas, to the measurement result of control part 45 inputs by supply pressure sensor 81 and second flow transducer, 91 mensuration to tube chamber.Thus, on gas surplus display part 76, show the gas surplus, on tube chamber effluent amount display part 80a, show flow, on the gas gross display part 79 of supplying gas, show the total amount of the gas of obtaining by computing of supplying gas.
When during tube chamber supply carbon dioxide, first pressure transducer 88 and second pressure transducer 89 detect intraperitoneal and intraluminal pressure always, are in the state that is monitored by control part 45.Here, when comparing the force value that rises to regulation with setting value at intra-abdominal pressure in tube chamber is supplied gas process when above, control part 45 is closed second electromagnetic valve 86 and second electro-pneumatic proportional valve 84, is stopped to supply gas to tube chamber, and makes the second relief valve 87b become open mode.Thus, making the second relief valve 87b is open mode, intraluminal carbon dioxide is released in the atmosphere, and the tube chamber internal drop is depressed near the setting value.
Use Figure 42 to press to expression partial pressure of carbon dioxide in endexpiratory gas, the abdominal cavity of the flow chart of Figure 44 and Figure 45 below and the sequential chart of each force value of tube chamber pressure, the action that air supply plant 31 carries out during to the affirmation of the partial pressure of carbon dioxide in endexpiratory gas in carrying out step S60 shown in Figure 41 describes.
At first via the value of calculation of 4 pairs of control parts of system controller, 45 inputs from the partial pressure of carbon dioxide in endexpiratory gas of monitoring arrangement 200.Then, whether little than threshold value control part 45 carry out force value the judgement (S81) of the partial pressure of carbon dioxide in endexpiratory gas of input shown in Figure 42.
In addition, the threshold value of the patient's 10 of present embodiment partial pressure of carbon dioxide in endexpiratory gas is made as partial pressure of carbon dioxide in endexpiratory gas and for example is the value of 5mmHg.
The value that is judged as partial pressure of carbon dioxide in endexpiratory gas in step S81 is a control part 45 more than the 5mmHg in threshold value, finishes the affirmation of partial pressure of carbon dioxide in endexpiratory gas, changes step S61 shown in Figure 41 over to.
On the other hand, the value that is judged as partial pressure of carbon dioxide in endexpiratory gas in step S81 is the control part 45 of 5mmHg less than threshold value, reduces the abdominal cavity and sets pressure (S82), reduces the tube chamber setting and presses (S83).Then, through after the stipulated time, control part 45 judges that whether value from the partial pressure of carbon dioxide in endexpiratory gas of system controller 4 inputs is than threshold value (5mmHg) big (S84).
For example in the present embodiment, the abdominal cavity set to be pressed to be reset to and is set half the value (5mmHg) of pressing (10mmHg) value in step S82.In addition, even Intraabdominal force value is set as setting value (5mmHg) again, but behind the process official hour, the value of partial pressure of carbon dioxide in endexpiratory gas does not reach 5mmHg when above, further resets so that the value (2.5mmHg) of pressing to half of setup pressure value (5mmHg) is again set in the abdominal cavity.
Identical, tube chamber set to press the setting that is reset in the present embodiment to press half the value (5mmHg) of (10mmHg) value in step S83.In addition, even tube chamber internal pressure value is for setting value (5mmHg) again, through after the stipulated time, when the value of partial pressure of carbon dioxide in endexpiratory gas does not reach 5mmHg when above, further reset so that tube chamber is set the value (2.5mmHg) of pressing to half of setup pressure value (5mmHg) again.
Being judged as from the partial pressure of carbon dioxide in endexpiratory gas of system controller 4 input in step S84 is control part 45 threshold value (5mmHg) more than, the abdominal cavity is set press return to initial setting value promptly (S85) by the value (10mmHg) of operator setting.Then,, make tube chamber set pressure and return to initial tube chamber setting pressure value (10mmHg) (S86), finish the affirmation of partial pressure of carbon dioxide in endexpiratory gas, change step S61 shown in Figure 41 over to according to the relation between setting flow of setting by operator and the abdominal cavity pressure.
Below use Figure 43 the action more specifically of above-mentioned air supply plant 31 to be described to Figure 45.
In addition, in the following description, the action that the setting of the reduction abdominal cavity of step S82 shown in Figure 42 is pressed is suitable to the action of step S94 with the step S91 of Figure 43.In addition, the reduction tube chamber of the step S83 of Figure 42 is set the action of pressure with suitable to the action of step S98 from the step S95 of Figure 43.In addition, restorative action is pressed in the step S85 shown in Figure 42 abdominal cavity is set, and is suitable to the action of step S106 with the step S101 of Figure 44.In addition, restorative action is pressed in the step S86 of Figure 42 tube chamber is set, and is suitable to the action of step S111 with the step S107 of Figure 44.
For example at moment t0 shown in Figure 45, based on the end expiratorycarbon dioxide by exhalation sensor 301 detected patients 10, the value of the partial pressure of carbon dioxide in endexpiratory gas that is calculated by monitoring arrangement 200 is lower than threshold value (5mmHg).At this moment, control part 45 changes the abdominal cavity and sets pressure (S91) as shown in figure 43, opens the first relief valve 87a (S92), closes the first relief valve 87a (S93) through after the stipulated time.As mentioned above, the abdominal cavity of the change value of set pressing becomes half the value (5mmHg) that pressure value (10mmHg) is set in before changing abdominal cavity.
Then, control part 45 receives the measurement result of being measured by first pressure transducer 88 and first flow pick off 90, judges the intrinsic pressure setting pressure again (S94) that whether reached in abdominal cavity.That is, the first relief valve 87a repeat on-off action up to the abdominal cavity intrinsic pressure reach again to set press (5mmHg).Thus, be fed into Intraabdominal carbon dioxide and be discharged to the outside during for open mode at the first relief valve 87a.That is, the abdominal cavity is pressed not reach again and is set when pressing in step S94, and control part 45 changes step S92 once more over to.
For example at the moment of Figure 45 t1, control part 45 is judged as intrinsic pressure having reached in abdominal cavity and sets when pressing (5mmHg) again, and the change tube chamber is set and pressed (S95).As mentioned above, the tube chamber of the change value of set pressing be half a value (5mmHg) of tube chamber setting pressure value (10mmHg) before changing.
For example at the moment of Figure 45 t2, when being judged as that tube chamber is intrinsic pressure to have reached setting value (5mmHg), control part 45 changes step S84 shown in Figure 42 over to.In addition, as mentioned above, the value that the tube chamber of change set to be pressed be half a value (5mmHg) of tube chamber setting pressure value (10mmHg) before changing.
Then, whether big than threshold value control part 45 carry out partial pressure of carbon dioxide in endexpiratory gas the judgement of step S84.For example at moment t3 shown in Figure 45, according to the end expiratorycarbon dioxide from exhalation sensor 301 inputs, it is bigger than threshold value (5mmHg) that monitoring arrangement 200 calculates the resulting value of partial pressure of carbon dioxide in endexpiratory gas.At this moment, import the signal calculated of partial pressure of carbon dioxide in endexpiratory gas via 4 pairs of control parts of system controller 45.Then, control part 45 returns to initial abdominal cavity setting pressure as shown in figure 44 and promptly sets pressure (10mmHg) (S101) by the abdominal cavity that operator is set.
Then, control part 45 is closed second electromagnetic valve 86 (S102) in order to improve Intraabdominal pressure, opens first electromagnetic valve 85 (S103), opens first electro-pneumatic proportional valve 83 (S104).Thus, the carbon dioxide that supplies in the air supply plant 31 from gas bomb 32 is the pressure of regulation by reducing transformer 82 and 83 blood pressure lowerings of first electro-pneumatic proportional valve, and be adjusted to the flow of regulation, send into intraperitoneal with the pipe 45a and the 3rd trocar 16 by first electromagnetic valve 85 and via the first interface 41a, abdominal cavity.Then, control part 45 is being closed first electromagnetic valve 85 (S105) through after the stipulated time.
Then control part 45 is supplied with by supplying with the measurement result that pressure sensor 81 and first flow pick off 90 are measured, control part 45 judges that intrinsic pressure whether having reached in abdominal cavity set pressure (10mmHg) (S106).Like this, repeat the action of step S103 to step S106, being supplied gas in the abdominal cavity reaches setting pressure (10mmHg) until internal pressure.Then, be judged as the intrinsic pressure control part 45 of setting pressure (10mmHg) that reached in abdominal cavity and change step S107 over to.Like this, stop to supply gas, for example shown in the moment t4 of Figure 45 Intraabdominal pressure is kept certain to the abdominal cavity.
At this moment t4,, set to the initial tube chamber of control part 45 inputs from system controller 4 and press (10mmHg) (S107) when stopping when intraperitoneal is supplied gas.Then, control part 45 is pressed based on the setting of being imported, and in order to improve intraluminal pressure, opens second electromagnetic valve 86 (S108), opens second electro-pneumatic proportional valve 84 (S109), closes second electromagnetic valve (S110) through after the stipulated time.Thus, the carbon dioxide that supplies in the air supply plant 31 from gas bomb 32 is the pressure of regulation by reducing transformer 82 and 84 blood pressure lowerings of second electro-pneumatic proportional valve, and be adjusted to the flow of regulation, send in the tube chamber with the pipe 45b and second endoscope 21 by second electromagnetic valve 86 and via the second interface 41b, tube chamber.
Then control part 45 is supplied with the measurement result of being measured by second pressure transducer 89 and second flow transducer 91.Then, control part 45 judges that intrinsic pressure whether having reached of tube chamber set to press (10mmHg) (S111).Like this, repeat the action of step S108 to step S111, tube chamber is supplied gas reaches setting pressure (10mmHg) until internal pressure.Then, be judged as intrinsic pressure having reached of tube chamber and set control part 45 finishing control of pressing (10mmHg).Like this, for example shown in Figure 45 at moment t5, stop to supply gas to tube chamber, tube chamber keeps setting pressure (10mmHg).
As mentioned above, the end expiratorycarbon dioxide that utilizes the exhalation sensor 301 of respiratory organ 300 from the expiration that patient 10 is discharged, to detect, according to the partial pressure of carbon dioxide in endexpiratory gas of being calculated by monitor 200,31 pairs of abdominal cavities of air supply plant and tube chamber carry out blood pressure lowering or boost.
The air supply plant 31 of present embodiment is under the low situation of patient 10 partial pressure of carbon dioxide in endexpiratory gas, at first discharge Intraabdominal carbon dioxide as shown in figure 45, the pressure (being 5mmHg here) that is adjusted to setting is again pressed in the abdominal cavity, then discharge intraluminal carbon dioxide until reaching the pressure of setting again (being 5mmHg here).Thus, it is too narrow and small that the zone in the abdominal cavity that undergos surgery can not become, so operator can continue to carry out the processing of affected part.Therefore, operator is followed the low state of patient 10 partial pressure of carbon dioxide in endexpiratory gas, can carry out emergency processing to the affected part in the operation, and interim the interruption is performed the operation.
In addition, in the present embodiment, illustrated that to initial abdominal cavity and tube chamber each set the action compress into a blood pressure lowering of row, but according to the low state of patient 10 partial pressure of carbon dioxide in endexpiratory gas, plenum system 4a carries out the blood pressure lowering action of the internal pressure of interim abdominal cavity and tube chamber.
Above result is, according to the plenum system 4a of present embodiment, can suppress the pneumoperitoneum the supplied with surplus supply with gas in patient 10 intraperitoneal and tube chamber.
In addition, in the present embodiment, for abdominal cavity and tube chamber being carried out blood pressure lowering or boosting, the threshold value of the partial pressure of carbon dioxide in endexpiratory gas that control part 45 is judged is identical value, but control part 45 also can be judged two threshold values respectively, promptly abdominal cavity and tube chamber is carried out the first threshold of blood pressure lowering and second threshold value that abdominal cavity and tube chamber are boosted.
(the 8th embodiment)
Followingly eighth embodiment of the invention is described with reference to accompanying drawing.In addition, omitting explanation for the structure tag same numeral that has illustrated in above-mentioned each embodiment, serves as main describing with different structures, effect, effect only.
Figure 46 is the figure of the structure of surgical system under the peritoneoscope with plenum system that relates to of explanation present embodiment, and Figure 47 is used to illustrate the figure that send water tank, and Figure 48 is the structure chart of the internal structure of expression air supply plant.
As shown in figure 46, under the peritoneoscope of present embodiment in the surgical system 70, the tube chamber that an end is connected with air supply plant 31 is connected with the water tank 32a that send on being arranged at go-cart 8 with the other end of pipe 45b.
That is, from the carbon dioxide of air supply plant 31 via tube chamber with pipe 45b, send water tank 32a, supply gas flow pipe 36A and light source adapter 36a, by the plenum duct in the general cable 26, in tube chamber, supply with.
The light source adapter 36a of second endoscope 21 also is connected with secondary light source device 22.That is, in tube chamber, supply with via the general cable 26 and the insertion section 24 of second endoscope 21 from light source adapter 36a from the air of the not shown compressor of secondary light source device 22.In addition, the compressor of this secondary light source device 22 is controlled by system controller 4, is controlled as usually not driving.
Particularly, when supplying with carbon dioxide from air supply plant 31 in tube chamber, system controller 4 stops the driving of the compressor of secondary light source device 22.That is, the air of the compressor of secondary light source device 22 is not controlled to by system controller 4 and supplies with in tube chamber simultaneously with the supplying gas of carbon dioxide of air supply plant 31.
Therefore, in tube chamber, send in the process of carbon dioxide,, also do not drive the compressor of secondary light source device 22 even the user has operated the water button 25a that supplies gas/send of second endoscope 21 at air supply plant 31.
Here the water tank 32a that send shown in Figure 47 is described.
As shown in figure 47, in sending water tank 32a, store liquid such as distilled water.Send water tank 32a to be communicated with the peristome of the tube chamber of supplying gas flow pipe 36A and being connected that is connected with secondary light source device 22 with pipe 45b pipe end separately with air supply plant 31 in case inside.In addition, in the flow pipe 36A that supplies gas, insert and be connected with snorkel 36B and the flow pipe 36C that is branched off into the Y font.Snorkel 36B one end is connected with secondary light source device 22, and the other end branches into two branches, is connected with light source adapter 36a with sending water tank 32a.Flow pipe one end immerses in the liquid that send in the water tank 32a, and the other end is connected with light source adapter 36a.
By operating the water button 25a that supplies gas/send of second endoscope 21, will be from the carbon dioxide of air supply plant 31 or from the air of secondary light source device 22 with send the distilled water in the water tank 32a optionally in tube chamber, to supply with from the front end of the insertion section 24 of second endoscope 21.Particularly, when having selected to send water among the water button 25a that supplying gas/sending, snorkel 36B becomes by the structure of obturation in operating portion 25 inside of second endoscope 21.
By in sending water tank 32a, supply with from the carbon dioxide of air supply plant 31 or from the air of secondary light source device 22, the pressure that send in the water tank 32a is risen, send distilled water in the water tank 32a to be pushed and flow in the flow pipe 36C, and supply with in tube chamber from insertion section 24 front ends of second endoscope 21 via light source adapter 36a, general cable 26.In addition, when having selected to supply gas among the water button 25a that supplying gas/sending, flow pipe 36C in the inside of the operating portion 25 of second endoscope 21 by obturation.
Be fed into send in the water tank 32a from the carbon dioxide of air supply plant 31 or from the air of secondary light source device 22, flow in the snorkel 36B by sending water tank 32a, supply with in tube chamber from insertion section 24 front ends of second endoscope 21.In addition, the water button 25a that supplies gas/send of second endoscope 21 is operated by operator.
In addition, as shown in figure 48, system controller 4 is identical with the 7th embodiment, is electrically connected with the control part 45 and the monitoring arrangement 200 of air supply plant 31.Therefore, the end expiratorycarbon dioxide that system controller 4 detects according to the exhalation sensor 301 of the respiratory organ 300 that is transfused to is supplied with the detection signal of the partial pressure of carbon dioxide in endexpiratory gas that monitoring arrangements 200 calculate to control part 45.In addition, system controller 4 is electrically connected with secondary light source device 22.
The flow chart that below uses Figure 49 describes the action of the plenum system 4a of the present embodiment that constitutes as mentioned above.
In addition, the step S91 of Figure 49 is to step S98, is illustrated in the flow chart of Figure 43 of the 7th embodiment, therefore omits its explanation.In the present embodiment, after step S98, control part 45 is supplied with the driven compressor request signal (S99) of secondary light source device 22 to system controller 4.
Then, the system controller 4 that receives control signal from control part 45 makes the compressor start of secondary light source device 22, and shows alarm picture 6B shown in Figure 50 on the panel of display floater 6.In this alarm picture 6B, show " will in tube chamber, supply gas to switch to and carry out supplying gas of air " such alert message shown in Figure 50 by light supply apparatus.
Thus, operator can be supplied with the air of authorized pressure from the compressor of secondary light source device 22 based on the predetermined operation of the water button 25a that supplies gas/send of second endoscope 21 in tube chamber.
Above result is, the plenum system 4a of present embodiment when patient 10 partial pressure of carbon dioxide in endexpiratory gas is threshold value when following, can stop to supply with carbon dioxide to tube chamber except the effect of above-mentioned each embodiment, and by air supply, and prevent the operation interruption.
In addition, in the 7th, the 8th embodiment, plenum system 4a can carry out blood pressure lowering or pressurization to the internal pressure of abdominal cavity and tube chamber based on the variation from for example arterial blood oxygen saturation capacity of monitoring arrangement 200, blood flow etc.In addition, also can change the internal pressure of coming corresponding to it and carry out blood pressure lowering or pressurization for the combination of these Biont informations to abdominal cavity and tube chamber.
The the 7th, the 8th embodiment according to the above description, the parameter that can be implemented in the Biont information of knowing the patient have taken place when unusual, can alleviate the plenum system 4a of doctor and nurse's burden (doctor and nurse can successfully handle).
In addition, the invention is not restricted to above-mentioned embodiment, can in the scope of the main idea that does not break away from invention, implement various distortion.
Claims (6)
1, a kind of air supply plant, this air supply plant is connected with the aspirating pipeline of endoscope, carries gas via this aspirating pipeline to patient's body cavity, it is characterized in that described air supply plant has:
Switching part, it can switch to described aspirating pipeline and carry the state of described gas or the state that stops to supply gas;
Time instrumentation portion, the supplying gas the time of the described gas of its instrumentation;
Control part, its with this time instrumentation portion be electrically connected, control described switching part;
Flow measurement portion, its flow to the described gas carried in described aspirating pipeline is measured; And
Comparison operation portion, it is based on the instrumentation result from described flow measurement portion, and time started of instrumentation of the described time of supplying gas of instrumentation portion is carried out calculation process to described time,
Described comparison operation portion uses the instrumentation result of described flow measurement portion to calculate the changes in flow rate amount of predetermined unit interval, and this result of calculation and preset threshold are compared, based on this comparative result to described time instrumentation portion time started of instrumentation of described movement time carry out calculation process
Described control part becomes after described aspirating pipeline is carried the state of described gas it at the described switching part of control, described control part is transfused to described the supplying gas the time of described time instrumentation portion, when the described time of supplying gas by described time institute of instrumentation portion instrumentation reaches predefined setting-up time, described control part carries out switching controls to described switching part, so that from carrying the state of described gas to become the state that stops to supply gas to described aspirating pipeline, and, based on the instrumentation time started from the operation result of described comparison operation portion, described control part is transfused to described the supplying gas the time of described time instrumentation portion, when the described time of supplying gas by described time institute of instrumentation portion instrumentation reached predefined setting-up time, described control part carried out switching to from the state of supplying gas the control of the state that stops to supply gas to described switching part.
2, air supply plant according to claim 1 is characterized in that, described air supply plant also has the time setting part that can freely set described setting-up time.
3, air supply plant according to claim 1 and 2 is characterized in that, described switching part also has informing portion, and this informing portion is used to inform that described air feed part switches to the halted state of supplying gas from the state of supplying gas,
Described control part is controlled, and when reaching predefined setting-up time with box lunch by described time of supplying gas of described time institute of instrumentation portion instrumentation, uses described informing portion to inform.
4, a kind of endoscopic system is characterized in that, described endoscopic system possesses endoscope, and this endoscope has the aspirating pipeline that can supply gas to patient's body cavity,
And described endoscopic system possesses air supply plant, and this air supply plant has:
Switching part, it can switch to described aspirating pipeline and carry the state of described gas or the state that stops to supply gas;
Time instrumentation portion, the supplying gas the time of the described gas of its instrumentation;
Control part, its with this time instrumentation portion be electrically connected, control described switching part;
Flow measurement portion, its flow to the described gas carried in described aspirating pipeline is measured; And
Comparison operation portion, it is based on the instrumentation result from described flow measurement portion, and time started of instrumentation of the described time of supplying gas of instrumentation portion is carried out calculation process to described time,
Described comparison operation portion uses the instrumentation result of described flow measurement portion to calculate the changes in flow rate amount of predetermined unit interval, and this result of calculation and preset threshold are compared, based on this comparative result to described time instrumentation portion time started of instrumentation of described movement time carry out calculation process
Described control part becomes after described aspirating pipeline is carried the state of described gas it at the described switching part of control, described control part is transfused to described the supplying gas the time of described time instrumentation portion, when the described time of supplying gas by described time institute of instrumentation portion instrumentation reaches predefined setting-up time, described control part carries out switching controls to described switching part, so that from carrying the state of described gas to become the state that stops to supply gas to described aspirating pipeline, and, based on the instrumentation time started from the operation result of described comparison operation portion, described control part is transfused to described the supplying gas the time of described time instrumentation portion, when the described time of supplying gas by described time institute of instrumentation portion instrumentation reached predefined setting-up time, described control part carried out switching to from the state of supplying gas the control of the state that stops to supply gas to described switching part.
5, endoscopic system according to claim 4 is characterized in that, described air supply plant also has the time setting part that can freely set described setting-up time.
6, according to claim 4 or 5 described endoscopic systems, it is characterized in that described switching part also has informing portion, this informing portion is used to inform that described air feed part switches to the halted state of supplying gas from the state of supplying gas,
Described control part is controlled, and when reaching predefined setting-up time with box lunch by described time of supplying gas of described time institute of instrumentation portion instrumentation, uses described informing portion to inform.
Applications Claiming Priority (4)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| JP363368/2004 | 2004-12-15 | ||
| JP2004363368A JP2006167122A (en) | 2004-12-15 | 2004-12-15 | Air supply system |
| JP115963/2005 | 2005-04-13 | ||
| JP115962/2005 | 2005-04-13 |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CN101065049A CN101065049A (en) | 2007-10-31 |
| CN100542475C true CN100542475C (en) | 2009-09-23 |
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| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CNB2005800403321A Expired - Fee Related CN100542475C (en) | 2004-12-15 | 2005-12-08 | Air supply plant and endoscopic system |
Country Status (2)
| Country | Link |
|---|---|
| JP (1) | JP2006167122A (en) |
| CN (1) | CN100542475C (en) |
Families Citing this family (20)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| JP4810623B2 (en) * | 2009-08-07 | 2011-11-09 | オリンパスメディカルシステムズ株式会社 | Medical system |
| US20130253368A1 (en) | 2010-12-08 | 2013-09-26 | Chandrakanth Are | Portable laparoscope system |
| ES2363550B2 (en) * | 2011-03-31 | 2012-02-24 | Nicolas Anthony Costovici | SYSTEM FOR INSUFLATION OF HEATED GAS IN PATIENTS |
| WO2013099507A1 (en) * | 2011-12-28 | 2013-07-04 | オリンパスメディカルシステムズ株式会社 | Body cavity internal pressure adjustment device and endoscope system |
| JP5959309B2 (en) * | 2012-05-23 | 2016-08-02 | オリンパス株式会社 | Endoscope line switching device |
| CN102871730B (en) * | 2012-08-07 | 2014-12-31 | 李兆申 | Gas supply device for digestive endoscope |
| CN102949244B (en) * | 2012-09-18 | 2015-07-08 | 李兆申 | Carbon dioxide collecting and conveying device for gastrointestinal endoscopy |
| JP5882190B2 (en) * | 2012-12-27 | 2016-03-09 | 九州クリエートメディック株式会社 | Gas injection equipment |
| JP6132657B2 (en) * | 2013-05-14 | 2017-05-24 | オリンパス株式会社 | Air supply device |
| CN105813537B (en) * | 2013-12-26 | 2018-04-10 | 奥林巴斯株式会社 | pneumoperitoneum device |
| KR101584935B1 (en) * | 2015-03-11 | 2016-01-13 | 이상엽 | Co_2 injection apparatus and co_2 injection amount control method for endoscope |
| EP3691511A4 (en) * | 2017-10-06 | 2021-06-02 | Endomaster Pte Ltd | An endoscope system |
| CN110495849A (en) * | 2018-05-18 | 2019-11-26 | 重庆金山医疗器械有限公司 | The aqueous vapor transportation system of endoscope |
| CN110495848A (en) * | 2018-05-18 | 2019-11-26 | 重庆金山医疗器械有限公司 | Endoscope aqueous vapor feed system |
| CN113677253A (en) * | 2019-04-16 | 2021-11-19 | 奥林巴斯株式会社 | Endoscope system |
| CN111388031B (en) * | 2019-06-28 | 2021-08-10 | 深圳迈瑞生物医疗电子股份有限公司 | Pneumoperitoneum machine and endoscope equipment |
| EP3782528B1 (en) * | 2019-08-23 | 2023-04-19 | Chang Gul Hong | Fluid supply device for endoscope |
| CN110711024B (en) * | 2019-09-30 | 2024-05-17 | 首都医科大学附属北京同仁医院 | Foot-controlled gas flow rate device for controlling gas supply device and jet stripping system |
| CN112674698A (en) * | 2020-12-25 | 2021-04-20 | 湖南瑞邦医疗科技发展有限公司 | Auxiliary cleaning device for endoscope catheter |
| CN112754394B (en) * | 2020-12-31 | 2023-08-15 | 上海澳华内镜股份有限公司 | Operating system, control method and endoscope |
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| JP3250744B2 (en) * | 1992-06-17 | 2002-01-28 | 長野計器株式会社 | Gas ventilation device and its abnormality determination device |
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| JP3250744B2 (en) * | 1992-06-17 | 2002-01-28 | 長野計器株式会社 | Gas ventilation device and its abnormality determination device |
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| Publication number | Publication date |
|---|---|
| JP2006167122A (en) | 2006-06-29 |
| CN101065049A (en) | 2007-10-31 |
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