JP2000083962A - Coagulotomic device for electric operation apparatus - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a coagulotomic device for an electric operation apparatus capable of safely and surely coagulating and incising the biotissue. SOLUTION: A pair of electrodes 3, 4 come into contact with the biotissue 2 and high-frequency electric power is supplied via a monitor section 8 from a bipolar power source 9. The changing of the condition of the biotissue 2 is detected in this monitor section 8. When the sufficient coagulation is detected to be obtd. by the changing condition of the biotissue 2, the output of the bipolar power source 9 is stopped. After the output of the bipolar power source 9 is stopped by the monitor section 8, an incision knife 5 is driven by a drive section 7 according to the signal from this monitor section 8 to execute the incising.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an electrosurgical apparatus, and more particularly, to a coagulation and incision apparatus for an electrosurgical apparatus for performing treatment such as coagulation and incision of a living tissue using high frequency power.

[0002]

2. Description of the Related Art An electrosurgical apparatus performs a treatment such as excision and coagulation of a living tissue by flowing a high-frequency current through the living tissue.
It is used for general surgery and the like. Further, as an electrosurgical apparatus for coagulating and incising living tissue by endoscopic surgery, in particular, as a bipolar electrosurgical apparatus, for example, a bipolar coagulating incision forceps described in US Pat. No. 5,445,638 is known. ing.

[0003] The bipolar coagulating incision forceps described in US Patent No. 5,445,638 comprises two movable jaws as bipolar electrodes, sandwiches a living tissue between the two movable jaws, and removes the tissue. After coagulation, the incision scalpel is protruded into the movable jaw by operating the operation handle to cut the coagulated tissue.

[0004]

However, in this device, if the living tissue is not sufficiently coagulated by the bipolar electrode, there is a danger of bleeding at the time of incision with a dissecting knife. Therefore, the degree of coagulation of the tissue is determined by visual observation of the operator and empirical judgment of the operator. In addition, since the work is performed manually by the operator, there is a possibility of an erroneous operation such as erroneously operating the incision knife in a state where sufficient coagulation cannot be obtained.

In addition, Japanese Patent Application Laid-Open No. Hei 8-308885 and Japanese Patent Application No. 9-183748, which was an earlier application filed by the present applicant.
The publication describes an electrosurgical device that detects an output value from a high-frequency ablation power supply device or a change in a living tissue and controls the output based on the detected value.

The above-mentioned US Pat. No. 5,445,638, JP-A-8-308885, and Japanese Patent Application No. 9-183748.
In the issue, the living tissue is clamped by the bipolar electrode by operating the handle and cauterized, and then another lever is operated to move the cutting knife back and forth to separate the cauterized tissue. However,
In such a device, the operation of holding and releasing the biological tissue,
The operation of the incision scalpel must be performed separately. Therefore, the operation becomes complicated, and in addition, since the user has to look at the operation without looking at the screen for the operation, there is a problem in operability and safety.

The present invention has been made in view of the above circumstances, and has as its object to provide a coagulation and incision apparatus for an electrosurgical apparatus that can coagulate and incise a living tissue safely and reliably.

[0008]

That is, the present invention relates to an electrosurgical apparatus which coagulates or cuts a living tissue by supplying a high-frequency power from a high-frequency power supply to a treatment tool for performing a treatment in contact with the living tissue. Detecting means for detecting a change in the state of the living tissue in contact with the treatment instrument; and stopping the output of the high-frequency power supply device when the detecting means detects that sufficient coagulation of the living tissue has been obtained. And a driving unit for driving the treatment tool in accordance with a signal from the monitoring unit to perform an incision after the output of the high-frequency power supply is stopped by the monitoring unit. .

According to the present invention, high-frequency power is supplied from a high-frequency power supply to a treatment tool for performing a treatment in contact with a living tissue,
In the electrosurgical apparatus for coagulating or incising the living tissue, a change in the state of the living tissue coming into contact with the treatment tool is detected by a detecting unit. When the detection means detects that the living tissue has been sufficiently coagulated, the output of the high-frequency power supply is stopped by the monitoring means. After the output of the high-frequency power supply device is stopped by the monitoring means, the treatment tool is driven by the driving means in accordance with a signal from the monitoring means to make an incision.

[0010]

Embodiments of the present invention will be described below with reference to the drawings. FIG. 1 is a diagram showing a schematic configuration of a coagulation / incision device of an electrosurgical device according to a first embodiment of the present invention.

In FIG. 1, the coagulation / incision device 1 of the electrosurgical device has electrodes 3 and 4 at its distal end to form a pair of movable jaws for holding a living tissue 2 therebetween. The electrodes 3 and 4 are opened and closed by an operation handle (not shown) on the hand side. The electrodes 3 and 4 can be operated so as to be able to protrude and retract, and are provided at the distal end of the insertion section 6 together with the cutting knife 5 that advances and retreats between the electrodes 3 and 4.

The incision knife 5 is electrically connected to a drive unit 7 for driving the incision knife 5 forward and backward through an insertion portion 6. In addition, the electrodes 3 and 4 pass through the insertion portion 6,
It is electrically connected to a bipolar power supply 9 for generating high-frequency power via a monitoring unit 8. Further, the driving unit 7 and the monitoring unit 8 are electrically or mechanically connected.

In such a configuration, the living tissue 2 is held between the electrodes 3 and 4 by operating a handle (not shown). A high frequency current is supplied to the electrodes 3 and 4 from the bipolar power supply 9 via the monitoring unit 8 and the insertion unit 6. As a result, a high-frequency current flows intensively in the living tissue 2 sandwiched between the electrodes 3 and 4, and cauterization and coagulation are performed.

At this time, the monitoring unit 8 detects and monitors the state of the above-described high-frequency ablation, that is, a change in the state of the living tissue 2. The change in the state of the living tissue 2 by the monitoring unit 8 is, for example, as described in the above-mentioned Japanese Patent Application Laid-Open No. 8-3088851, by detecting a change in the state of the electric energy flowing through the electrodes 3 and 4, and detecting the detected data. The biological information of the biological tissue may be obtained based on the information. Further, as described in Japanese Patent Application No. 9-183748, a method of detecting a change in the state of a living tissue by detecting an output value from the bipolar power supply 9 may be used.

In this way, the monitoring unit 8 controls the living tissue 2
When it is detected that sufficient coagulation has been obtained due to the change in the situation, the output of the bipolar power supply 9 is stopped, and the coagulation of the living tissue 2 is stopped. At the same time, signals and information are transmitted from the monitoring unit 8 to the driving unit 7, and the driving unit 7 drives the incision knife 5. Thus, the incision operation is started after the completion of the coagulation.

As described above, according to the first embodiment, the incision by the incision scalpel 5 can be performed by detecting the end of coagulation by the monitoring unit 8 irrespective of the visual observation of the operator. FIG.
FIG. 4 is a diagram showing a schematic configuration of a coagulation / incision device of an electrosurgical device according to a second embodiment of the present invention. In the embodiment described below, the same parts as those in the above-described first embodiment are denoted by the same reference numerals, and description thereof will be omitted.

In FIG. 2, a fixed electrode 12 fixed to the insertion portion 6 for holding the living tissue 2 and a reciprocating movement from the insertion portion 6 are provided at the distal end of the coagulation / incision device 11 of the electrosurgical device. Drive electrode 13 is provided. And
The configuration of the coagulation / incision device 11 after the insertion unit 6 includes a driving unit 7,
It has a monitoring unit 8 and a bipolar power supply 9 and is the same as the first embodiment described above, so that the description is omitted.

In such a configuration, first, a high-frequency current intensively flows through the living tissue 2 sandwiched between the fixed electrode 12 and the driving electrode 13 to perform cauterization and coagulation. When the monitoring unit 8 detects that sufficient coagulation has been obtained due to a change in the state of the living tissue 2, the output of the bipolar power supply 9 is stopped, and the coagulation of the living tissue 2 is stopped. At the same time, signals and information are transmitted from the monitoring unit 8 to the driving unit 7, and the driving unit 13 moves the driving electrode 13 in the forward and backward directions (left and right directions in FIG. 2). Thereby, the pressing force on the living tissue 2 is changed, and the living tissue 2 is incised.

As described above, according to the second embodiment,
The incision can be made without using an incision knife by detecting the end of coagulation by the monitoring unit 8 irrespective of the operator's visual observation or the like. FIG. 3 is a diagram showing a schematic configuration of a coagulation / incision device of an electrosurgical device according to a third embodiment of the present invention.

In FIG. 3, electrodes 16 and 17 for holding the living tissue 2 are provided in the insertion portion 6 at the distal end of the coagulation / incision device 15 of the electrosurgical device so as to be openable and closable. The configuration of the coagulation / incision device 15 after the insertion section 6 includes the drive section 7, the monitoring section 8, and the bipolar power supply 9, and is the same as in the first and second embodiments described above. Omitted.

In the third embodiment, similarly to the above-described second embodiment, the living tissue 2 sandwiched by the electrodes 16 and 17 is first applied to the living tissue 2 without using a cutting knife. Cauterization and coagulation are performed. Here, when the monitoring unit 8 detects that sufficient coagulation has been obtained due to a change in the state of the living tissue 2, the output of the bipolar power supply 9 is stopped, and the coagulation of the living tissue 2 is stopped. And the monitoring unit 8
Then, signals and information are transmitted to the driving unit 7, and the pressing force of the electrodes 16 and 17 on the living tissue 2 is changed by the driving unit 7, and the living tissue 2 is incised.

As described above, according to the third embodiment,
The end of coagulation can be detected by the monitoring unit 8 and the coagulation and incision can be performed by the electrodes 16 and 17 irrespective of the operator's visual observation.

Next, as a fourth embodiment of the present invention, an example in which a water supply channel is provided in a coagulation / incision device of an electrosurgical device will be described. In the above-described first to third embodiments, the coagulation / incision device of the electrosurgical device includes:
No particular washing action is performed on the living tissue after completion of coagulation and incision. In the embodiment described below, an example will be described in which washing is performed after work such as coagulation and incision of living tissue is completed.

FIGS. 4A and 4B show a fourth embodiment of the present invention.
It is the figure which showed the schematic structure of the coagulation incision apparatus of the electrosurgery apparatus which concerns on embodiment. In FIG. 4 (a), the coagulation / cutting device 20 of the electrosurgical device is provided with a water supply mouthpiece 22 for supplying water from a water supply channel 26 described later to the handle 21. An insertion portion 24 is attached to the handle 21 via a main body 23, and a fixed electrode 25 having a circular cross section as shown in FIG. ing. A water supply channel 26 is provided on the inner wall of the insertion portion 24, and flows out through the center of the fixed electrode 25 during water supply.

The coagulation / incision device 20 is connected to the driving unit 7, the monitoring unit 8 and the power supply 9 'via a cord.
The configuration is the same as that of the above-described first to third embodiments, and a description thereof will be omitted.

In such a configuration, for example, a hemostatic operation of a living tissue (not shown) is performed by the fixed electrode 25 for hemostasis. Then, when the monitoring unit 8 detects that the hemostatic work has been completed due to a change in the state of the living tissue, the output of the power supply 9 'is stopped. At the same time, the water outlet 22
Then, water supply to the living tissue is started from the water supply channel 26 via the main body 23.

[0027] Thus, the bleeding point can be easily checked because the lesion can be washed and the blood at the bleeding site can be washed. FIGS. 5A and 5B are diagrams showing a schematic configuration of a coagulation / incision device of an electrosurgical device according to a fifth embodiment of the present invention.

In the coagulation and incision device of the electrosurgical device shown in FIGS. 5 (a) and 5 (b),
A fixing portion 28 having an annular cross section is provided. A spatula-shaped electrode 28a is formed on a part of the fixing portion 28 so as to protrude as an incision electrode. Also, the insertion portion 24
A water supply channel 26 is provided on the inner wall of the.

The other configuration is the same as that of the above-described fourth embodiment, and the description is omitted. In such a configuration, an incision operation of a living tissue (not shown) is performed by the incision electrode 28a. When the monitoring section 8 detects that the cutting operation has been completed, the output of the power supply 9 'is stopped. At the same time, the main body 2
Water supply to the living tissue from the water supply channel 26 via 3 is started.

[0030] Thus, the bleeding point can be easily checked because the lesion can be washed and the blood at the bleeding site can be washed. FIGS. 6A and 6B are diagrams showing a schematic configuration of a coagulation / incision device of an electrosurgical device according to a sixth embodiment of the present invention.

In the coagulation and incision device of the electrosurgical device shown in FIGS. 6 (a) and 6 (b),
A fixing portion 30 having a circular cross section is provided. Spatula-shaped electrodes 30a, 30b, 30c, and 30d are formed as protruding electrodes at a plurality of locations, for example, four locations, of the fixing portion 30 as incision electrodes. A water supply channel 26 is provided on the inner wall of the insertion section 24.

The other configuration is the same as that of the above-described fourth embodiment, and the description is omitted. In such a configuration, a cutting operation of a living tissue (not shown) is performed by the cutting electrodes 30a to 30d. And the monitoring unit 8
When it is detected that the cutting operation has been completed, the output of the power supply 9 'is stopped. At the same time, water supply from the water supply port 22 to the living tissue from the water supply channel 26 via the main body 23 is started.

[0033] Thus, the bleeding point can be easily confirmed because the lesion can be washed and the blood at the bleeding site can be washed. Further, according to the fourth to sixth embodiments described above, the cauterization site at the electrode, the bleeding point can be reliably confirmed,
An efficient and reliable therapeutic effect can be obtained.

Furthermore, in the fourth to sixth embodiments, a water supply channel is provided at the center of the annular electrode or the fixed portion to supply water, but the present invention is not limited to this. You may make it provide a water supply channel.

According to the above embodiment of the present invention,
The following configuration can be obtained. (1) In an electrosurgical apparatus that coagulates or incises the living tissue by supplying high-frequency power from a high-frequency power supply to a treatment tool that performs treatment by contacting the living tissue, the living tissue that contacts the treatment tool Monitoring means for stopping the output of the high-frequency power supply device when the living tissue obtains sufficient coagulation based on the change in the situation, and after the output of the high-frequency power supply device is stopped by the monitoring means, the monitoring means A driving means for driving the treatment tool in accordance with a signal from the device to perform incision.

(2) The monitoring means has a detecting means for detecting a change in the state of the living tissue in contact with the treatment instrument, and the monitoring means can obtain a sufficient coagulation of the living tissue by the detecting means. The coagulation / incision device of the electrosurgical device according to the above (1), wherein the output of the high-frequency power supply device is stopped when the power is detected.

(3) The electrosurgical apparatus according to (3), wherein the treatment tool has at least a pair of electrodes that sandwich the living tissue and allow a high-frequency current to flow through the living tissue. apparatus.

(4) The coagulation and incision apparatus for an electrosurgical apparatus according to (3), wherein the treatment tool has an incision means for incising the living tissue in accordance with an output of the driving means.

(5) The coagulation and incision device for an electrosurgical device according to (4), wherein the incision means is constituted by an electric scalpel. (6) The electrosurgical apparatus according to (4), wherein the incision means includes the pair of electrodes for incising the living tissue by changing a pressing force on the living tissue. Coagulation and incision device.

[0040]

As described above, according to the present invention, it is possible to provide a coagulation and incision apparatus for an electrosurgical apparatus which can safely and reliably coagulate and incise a living tissue.

[Brief description of the drawings]

FIG. 1 is a diagram showing a schematic configuration of a coagulation / incision device of an electrosurgical device according to a first embodiment of the present invention.

FIG. 2 is a diagram showing a schematic configuration of a coagulation / incision device of an electrosurgical device according to a second embodiment of the present invention.

FIG. 3 is a diagram showing a schematic configuration of a coagulation and incision device of an electrosurgical device according to a third embodiment of the present invention.

FIG. 4 is a diagram showing a schematic configuration of a coagulation and incision device of an electrosurgical device according to a fourth embodiment of the present invention.

FIG. 5 is a diagram showing a schematic configuration of a coagulation and incision device of an electrosurgical device according to a fifth embodiment of the present invention.

FIG. 6 is a diagram showing a schematic configuration of a coagulation / incision device of an electrosurgical device according to a sixth embodiment of the present invention.

[Explanation of symbols]

 1, 11, 15 Coagulation and incision device of electrosurgical device, 2 living tissue, 3, 4, 16, 17 electrodes, 5 incision scalpel, 6 insertion unit, 7 driving unit, 8 monitoring unit, 9 bipolar power supply, 12 fixed electrode, 13 Drive electrode.

Claims (3)

[Claims] 1. An electrosurgical apparatus for coagulating or incising a living tissue by supplying high-frequency power from a high-frequency power supply to a treatment tool for performing a treatment in contact with a living tissue, wherein the treatment tool is brought into contact with the treatment tool. Detecting means for detecting a change in the state of the living tissue; monitoring means for stopping the output of the high-frequency power supply device when the detecting means detects that sufficient coagulation of the living tissue has been obtained; and And a driving means for driving the treatment tool in accordance with a signal from the monitoring means to perform an incision after the output of the high-frequency power supply is stopped. 2. The coagulation and incision device for an electrosurgical device according to claim 1, wherein the treatment tool has at least a pair of electrodes that sandwich the living tissue and allow a high-frequency current to flow through the living tissue. 3. The coagulation and incision device for an electrosurgical device according to claim 2, wherein the treatment tool has an incision means for incising the living tissue in accordance with an output of the driving means.