JP2000287986A - Tool for surgical implement - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an implement for surgical operation which can improve operability by making it possible to operate instruction for work and control of output level by a finger. SOLUTION: When a jog dial 18 is rotated by the thumb of a hand gripping an operating part 4, output level of ultrasonic wave outputted from a tool for surgical operation is set. Then, when the jog dial 12 is pressed by the same thumb, the ultrasonic wave with a set output level is given to tissues of a living body from the apex of a probe 13 and the tissues of the living body is cut out with the heat of this ultrasonic wave. As described above, it is possible to operate instruction for work and control of output level by a finger.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a surgical tool for applying a medical treatment by applying energy to a living tissue.

[0002]

2. Description of the Related Art Conventionally, various surgical instruments driven by electric power are known. For example, an ultrasonic surgical apparatus for incising or coagulating a living tissue using ultrasonic vibration, or an ultrasonic surgical apparatus using high-frequency electric power. Monopolar (monopolar) and bipolar (bipolar) high-frequency treatment tools for incising and coagulating living tissue, heat scalpel device for incising living tissue using heat, and living tissue using ultrasonic vibration There is an ultrasonic suction device that pulverizes and aspirates a living tissue, and a resection device that pulverizes a living tissue using a rotating force of a drill or the like. Further, recently, a battery-type surgical instrument having improved operability by removing a power cable by loading a battery into an electrically-driven surgical instrument has been proposed. As an example of such a surgical tool, for example, in Japanese Patent Publication No. 2-43501, a drill for crushing a living tissue is provided at the tip of a probe, and a motor for supplying a rotational driving force to the drill and an electric power for the motor are provided. A cutting device having a configuration in which a battery to be supplied and a switch for operating the motor are provided in a grip portion is shown.

[0003]

However, in Japanese Patent Publication No. 2-43501 mentioned in the prior art, means for operating the energy output from the surgical tool is shown, but the energy output from the surgical tool is disclosed. There is no means for performing an output level adjustment operation for adjusting the output level of the device. In the configuration as it is, for example, the rotational driving force of the motor cannot be adjusted. In addition, if the means for performing the output level adjustment operation is simply added in addition to the means for performing the operation operation, the operation means for the operation operation and the operation means for the output level adjustment operation are separately provided, and the operation becomes complicated. Oops. Also,
Depending on the surgical tool, there is not only the operation of energy output, but also, for example, an operation of sandwiching a living tissue to output energy, and thus, if means for performing an operation other than the operation of energy output is added. , And the operation was complicated. The present invention has been made in view of the above circumstances, and performs an operation operation for operating energy output from a surgical instrument and an output level adjustment operation for adjusting an output level of output energy with one finger. By allowing the operator to grasp and operate the operating tool and the output level adjustment operation with one hand, and by retaining fingers for performing other operations except the operation operation and the output level operation. It is an object of the present invention to provide a surgical tool that improves operability.

[0004]

In order to achieve the above object, the present invention provides a treatment section which contacts or approaches a treatment target site which is a living tissue to apply energy to the treatment target site to perform a medical treatment; Operating means having an energy supply unit for outputting energy for driving the treatment unit, and a rotating unit capable of rotating operation, outputting rotation angle information of the rotating unit and pressing the rotating unit. Adjusting means for adjusting and controlling the energy supplied from the energy supply unit according to the rotation angle information; and operating means for operating and controlling the energy supply from the energy supply unit according to the pressing operation. It is characterized by that.

[0005]

Embodiments of the present invention will be described below with reference to the drawings. 1 to 3 relate to a first embodiment of the present invention, FIG. 1 is an explanatory view showing the entire configuration of a surgical instrument, FIG. 2 is an enlarged view around a jog dial of an operation unit, FIG.
FIG. 2 is a block diagram showing a configuration of an electric system.

As shown in FIG. 1, a surgical instrument 1, which is a battery-type ultrasonic coagulation and incision apparatus that performs coagulation and incision on a treatment target site by ultrasonic waves using a built-in battery as a power source, is inserted into a body cavity or the like. An elongated insertion portion 2, a rotation knob 3 provided at a base end of the insertion portion 2, and rotating the outer periphery to rotate the insertion portion 2; and a rotation knob 3 at a base end side of the insertion portion 2. Is rotatably connected via the rotation knob 3,
An operation unit 4 for grasping and operating the surgical instrument 1 and an ultrasonic transducer 11 provided in the operation unit 4 and generating ultrasonic waves
A horn 12 formed in a substantially tapered shape and connected to the front end of the ultrasonic vibrator 11 in the operation unit 4 for amplifying the amplitude of the ultrasonic wave emitted from the ultrasonic vibrator 11
And a probe 13 that is connected to the front end of the horn 12, penetrates through the insertion portion 2, protrudes forward from the tip of the insertion portion 2, and transmits ultrasonic waves to the protruding portion. Jaw 1 provided rotatably facing each other
4, a drive rod (not shown) that is inserted into the insertion section 2 and the operation section 4 and moves the jaw 14 by moving forward and backward, and provided on the operation section 4. The jaw 14 is moved by moving the drive rod back and forth.
A driving circuit 16 provided in the operation unit 4 for driving the ultrasonic vibrator 11;
The drive circuit 1 is provided in the operation unit 4 and has at least
And a battery 17 which is a power supply for supplying power to the power supply 6, and adjusts an output level of the drive circuit 16 by rotating the battery 17.
Also, a jog dial 18 for operating the output of the drive circuit 16 by pressing it into the operation unit 4, and an LED (light emitting diode) provided on the operation unit 4 for displaying the output level set by the jog dial 18. (A diode).

A compliant member (not shown) made of, for example, Teflon (registered trademark) may be provided at a contact portion between the protrusion at the tip of the probe 13 and the jaw 14.

As shown in FIG. 2, the lever 15 is disposed at a position where the lever 15 can be operated with the index finger or the middle finger when the operation part 4 is gripped.
Is disposed at a position where, for example, the thumb can be operated when the operation unit 4 is gripped, and the display device 19 is located at a position slightly above and forward of the jog dial, for example, when the operation unit 4 is gripped. Are located in This allows
The operation unit 4 can be gripped and the lever 15 and the jog dial can be operated with one hand.

As shown in FIG. 3, the jog dial 1
Reference numeral 8 denotes an encoder 18a that detects the rotation angle of the jog dial 18 and provides the rotation angle information to the drive circuit 16 and the display device 19, and a switch 18b that detects and presses the jog dial 18 to open and close. It is provided with.

The drive circuit 16 includes a drive signal oscillating circuit 16a for oscillating a signal for driving the ultrasonic vibrator 11 to operate in accordance with the state of the switch 18b of the jog dial 18, and a rotation from the encoder 18a. A drive signal amplifying circuit 16b is provided which adjusts the output level of the signal obtained by the drive signal oscillating circuit 16a according to the angle information and supplies the signal to the ultrasonic vibrator 11.

Next, the operation of the embodiment will be described. First, the insertion section 2 is inserted into the body via a trocar tube (not shown), and a tissue at a treatment target site to be subjected to a coagulation treatment or an incision treatment is sandwiched between the protrusion of the probe 13 at the tip of the insertion section 2 and the jaw 14. At this time, the lever 1 of the operation unit 4
5 is rotated by pulling the index finger or the middle finger, for example, toward the hand side, so that a drive rod (not shown) inserted through the insertion portion 2 advances and retreats in the axial direction, and the jaws 14 are closed.
The tissue is sandwiched between the jaws 14. Note that lever 1
The jaw 14 is adjusted to a desired opening angle by the rotation angle at the time of rotating the 5.

Next, while holding the tissue sandwiched between the jaws 14 by pulling the lever 15 toward the user, the jog dial 18 is for example gripped by the hand of the hand holding the operation unit 4.
Is rotated by the encoder 18a, the rotation angle of the jog dial 18 is detected by the encoder 18a.
The rotation angle information obtained in step (a) is supplied to the drive signal amplification circuit 16b, and the drive signal amplification circuit 16
The gain of b is adjusted, the output level of the drive signal supplied from the drive circuit 16 to the ultrasonic transducer is adjusted to a desired output level, and the output level of the ultrasonic vibration supplied from the tip of the probe 13 to the tissue is adjusted to the desired level. Adjusted to the level. At this time, the operator can set the output level to a desired level by rotating the jog dial 18 while checking the value of the output level displayed on the display device 19.

When the output level is set to a desired output level, when the jog dial 18 is pushed in the direction of the rotation axis of the jog dial 18, that is, when the jog dial 18 is pushed into the operation section 4, this operation is detected. The opened / closed state of the switch 18b is changed by the drive signal oscillation circuit 16
a, and a drive signal oscillation circuit 16a receiving power supply from the battery 17 operates to output a drive signal. The drive signal is amplified by a drive signal amplification circuit 16b having a gain corresponding to the output level. , To the ultrasonic transducer 11. Then, the ultrasonic transducer 11 to which the drive signal is given oscillates an ultrasonic wave, the ultrasonic wave is amplified by the horn 12, and the probe 13
It is transmitted to the protruding part at the three tips. And this probe 1
The living tissue sandwiched between the protrusion 3 and the jaw 14 is:
Heated by the heat generated by the ultrasonic vibration, a coagulation treatment or an incision treatment is performed on a living tissue including a blood vessel.

As described above, according to the present embodiment, not only can the operation of the output of the ultrasonic energy from the surgical instrument 1 be instructed, but also the output level of the ultrasonic energy output from the surgical instrument 1 can be controlled. Settings can be adjusted.
In addition, the output operation operation and the output level adjustment operation are both performed by the same operation means, ie, the jog dial 18, and these operations can be performed by one finger, and the operability is excellent. The grip of the operation unit 4 and the operation of the jog dial 18 can be performed with one hand. In addition, since fingers other than the finger that operates the jog dial 18 of the hand holding the operation unit 4 are reserved, the lever 15 can be operated with these retained fingers. Since the other hand that holds the operation unit 4 is reserved, it is possible to operate the rotary knob 3 and perform operations other than the operation tool 1 with the retained hand. Therefore, according to the present embodiment, it is possible to perform an operation for operating the energy output from the surgical tool 1 and an output level adjustment operation for adjusting the output level of the output energy with one finger. In addition, it is possible to perform the operation of holding the surgical instrument 1 with one hand, and to perform the operation of adjusting the output level with one hand, and to hold the finger for performing other operations except the operation operation and the output level operation. The effect that the property is improved is obtained.

Further, since the output can be started after the output level is set to a desired level, a period during which the output level is unstable until the output level reaches the desired level is short. Therefore, the period from when the operation instruction is given to when the desired output level is obtained is short, and the followability is good. Also,
After the output level is set to a desired level, an operation for maintaining the output level setting is not required, so that the output level is stably maintained. ◎ Note that the present invention is not limited to only the above-described embodiment,
Various modifications can be made without departing from the spirit of the invention. For example, a surgical tool is not limited to an ultrasonic coagulation and incision apparatus, but may be an ultrasonic suction apparatus, a monopolar or piperboard high-frequency surgical tool, or a thermal tool that is electrically driven and performs operation instructions and output level adjustment. A female device or the like may be used. Further, for example, the surgical tool is not limited to the one in which a battery is built in the main body of the surgical tool, and the one that receives power supply from the outside is also within the scope of the present invention. By incorporating the battery in the main body of the surgical instrument, operability including portability is improved.

In general, a battery-type surgical instrument having a built-in battery is excellent in portability, and is expected to be used for medical activities in a highly urgent situation such as a disaster area or a battlefield. . However, battery-operated surgical tools have the disadvantage that when the battery is discharged and the capacity becomes insufficient, it takes time to replace the battery, or when the battery for replacement is not secured, it cannot be used continuously. And hindered use in highly urgent situations. Therefore, an example of a portable surgical tool that can be used continuously even when the battery is discharged and the capacity is insufficient or without the battery will be described with reference to FIGS. 4 to 6.

As shown in FIG. 4, a surgical instrument 51, which is a battery-type ultrasonic scalpel, has an insertion portion 52 for insertion into a body cavity or the like.
A grip 53, which is connected to the proximal end of the insertion portion 52 and grips the surgical instrument 51, and covers the insertion portion 52, and the proximal end is detachably fitted to the outer periphery of the distal end of the grip 53. A mating sheath 52a, a handle 61 that is, for example, detachably attached to, for example, a proximal end side of the grip 53, and that is manually rotated and provided in the grip 53,
An induction electromotive power generator 62 that generates electric power by rotating the handle 61, a battery 63 that is provided in the grip 53 and stores the electric power generated by the power generator 62, A driving circuit 64 for receiving a power supply from the battery 63 and generating a driving signal for generating ultrasonic waves;
And a horn provided in the grip 53 and amplifying the amplitude of the ultrasonic wave emitted from the ultrasonic vibrator, provided in the grip 53. 66, a probe 67 that is provided to pass through the inside of the insertion portion 52, and transmits an ultrasonic wave output from the horn 66 to the tip of the insertion portion 52, and is integrally formed at the tip of the probe 67, The insertion part 52
And a switch 69 provided on the grip 53 for operating the output of ultrasonic waves.

As shown in FIG. 5, the driving circuit 64
A power supply circuit 64a for performing, for example, voltage conversion or voltage stabilization on the power supplied from the battery 63 and supplying power to each part of the drive circuit 64;
Drive signal generating circuit 64 for generating a drive signal for driving
b. The drive circuit 64 is operated by operating the switch 69.

The generator 62 shown in FIG. 4 is not limited to an induction electromotive type generator, but may be a generator 71 having a configuration as shown in FIG. 6, for example. Generator 71 shown in FIG.
Is configured to include a heat generation source 71a that generates heat by rotating the handle 61, and a heat-electric converter 71b that converts heat generated by the heat generation source 71a into electricity.

Next, the operation of the surgical instrument 51 will be described. When the handle 61 is rotated, the rotational kinetic power is generated by the generator 6.
2 converts the electric energy into electric energy.

Next, for example, the hook 68 is brought into contact with the living tissue so as to be hooked so as to suppress bleeding from the living tissue as a treatment target site, and the switch 69 is operated.
Then, the drive circuit 6 receiving the power supply from the battery 63
4 drives the ultrasonic vibrator 65, and the ultrasonic vibrator 65
The ultrasonic wave emitted from the horn 66 is amplified by the horn 66 and transmitted to the hook 68 through the probe 67, and the heat generated in the hook 68 by the ultrasonic vibration causes the hook 68 to emit heat.
The living tissue is excised while the bleeding from the living tissue contacting is suppressed.

If the capacity of the battery 63 is insufficient, the handle 61 is rotated again to charge the battery 63, and the surgical tool 51 is continuously used. The handle 61 is not only operated by the operator of the surgical tool 51, but also
For example, like a surgeon, a nurse or the like whose hands are sterilized may be operated. Further, the turning radius of the handle 61 may be made large so that the handle 61 can be operated with a light force. Also,
By reducing the turning radius of the handle 61, portability may be improved.

According to the portable surgical instrument described above with reference to FIGS. 4 to 6, the effect is obtained that the battery can be continuously used even if the battery is discharged and the capacity is insufficient or the battery is not used. Can be The surgical tool 51 is an ultrasonic scalpel as an example of the surgical tool, but is not limited to this, and the surgical tool may be any portable and electrically driven surgical tool. For example, a scissors (scissors) type Ultrasonic coagulation and incision device, ultrasonic suction device, monopolar and bipolar high-frequency treatment tools, heat scalpel, and the like may be used.

By the way, in recent years, a probe equipped with an ultrasonic transducer for transmitting and receiving an ultrasonic beam at its tip is inserted into the body, and the ultrasonic wave is reflected on a boundary surface of a biological tissue having a different acoustic impedance. Ultrasonic observation apparatuses that image echo signals obtained from reflected waves, display the obtained ultrasonic images on a display device, and observe an affected part are widely used. In such an ultrasonic observation apparatus, as shown in, for example, Japanese Utility Model Application No. 56-150721, a trocar having an insertion hole for guiding a probe into a body is punctured into a body wall, and the trocar is inserted through the trocar. Then, the probe is inserted into the body, and the affected part is ultrasonically observed. However, when a probe is introduced into the body via a trocar as shown in Japanese Utility Model Application No. 56-150721,
While observing the affected part with this probe, other treatment tools and endoscopes cannot be introduced into the body through this trocar. In order to introduce the trocar into the body, another trocar is punctured into the body wall to introduce a treatment tool, an endoscope, or the like into the body, thereby invading the patient. Therefore, an example of an ultrasonic observation apparatus that enables a minimally invasive treatment or examination by introducing another treatment tool, an endoscope, or the like into a body through a trocar used for ultrasonic observation is illustrated. 7 and FIG.

As shown in FIG. 7 and FIG. 8, the ultrasonic observation apparatus 101 is provided at two places, for example, on the upper surface of the casing 102 and can be placed in the body. A handle 104 that can be gripped and the housing 102
A control circuit 105 provided in the housing, and controlling each part of the ultrasonic observation apparatus 101; an ultrasonic vibrator 106 provided in the housing 102 and controlled by the control circuit 105 to transmit and receive ultrasonic waves; An ultrasonic transmission window 107 that is provided on the outer surface of the housing 102 and that comes into contact with or approaches a living tissue that is an observation target site, and that allows the ultrasonic transducer 106 to transmit ultrasonic waves transmitted to and received from the living tissue; The control circuit 105 is provided, for example, on the top surface of the housing 102.
A display device 108 such as an LCD (Liquid Crystal Display) that displays an ultrasonic image or the like under the control of the control circuit 10
5, a battery 109 for supplying power to the ultrasonic vibrator 106 and the display device 108, and a lid 110 that is detachably provided on the housing 102 and is used to replace the battery 109. .

The control circuit 105 is implemented in hardware, for example, by mounting a microprocessor and a storage element storing a program to be executed by the microprocessor. Further, the control circuit 105
Functionally, for example, means (not shown) for generating a signal for driving the ultrasonic vibrator 106 and an echo signal that the ultrasonic vibrator 106 receives and outputs ultrasonic waves are input, and this echo signal A sound ray signal corresponding to a so-called sound ray from the time when an ultrasonic beam is transmitted from the ultrasonic transducer 106 to be reflected by a living tissue and returns to the ultrasonic transducer 106 after performing a detection process, an amplification process, and the like. Not shown means for obtaining the sound ray signal, and a not shown means for outputting a video signal containing an ultrasonic image obtained by converting the data contained in the sound ray signal into data of a rectangular coordinate system from, for example, a polar coordinate system,
A means (not shown) for driving the display device 108 to render the video signal on the display device 108, a means (not shown) for detecting the remaining capacity of the battery 109, and the remaining capacity of the battery 109 are transmitted to the display device 108. The display device 108 is provided with a unit (not shown) for driving the display device 108 for drawing.

Next, the operation of the ultrasonic observation apparatus 101 will be described. First, a trocar (not shown) is punctured into the body wall, and the ultrasonic observation apparatus 101 is inserted into the body while grasping the handle 104 with the forceps 103, and the ultrasonic transmission window 1 is inserted into the observation target site.
The ultrasonic observation device 101 is placed at a position where the device 07 contacts or approaches. In the example of FIG. 7, the ultrasonic observation apparatus 101 sets the common bile duct 125, which is a part after the confluence of the intrahepatic bile duct 122 coming out of the liver 121 and the gallbladder duct 124 coming out of the gall bladder 123, as the observation target part. The state where it is detained is shown.

Then, the ultrasonic wave transmitted from the ultrasonic vibrator 106 driven by the control circuit 105 is irradiated through the ultrasonic transmission window 107 to the site to be observed, and the boundary of the living tissue having the different ultrasonic impedance. And is received by the ultrasonic transducer 106 via the ultrasonic transmission window 107. Then, the control circuit 105 that inputs the echo signal output from the ultrasonic transducer 106 provides a video signal including an ultrasonic image to the display device 108, and the display device 108
Draw an ultrasound image. Then, the ultrasonic image displayed on the display device 108 is observed by inserting an endoscope (not shown) into the body. The movement of the observation target part by the ultrasonic observation apparatus 101 is performed by operating the forceps 103 from outside the body.
3 is performed by gripping the handle 104 and moving the ultrasonic observation apparatus 101.

The ultrasonic observation apparatus 101 includes a battery 109
And the control circuit 105 and the ultrasonic vibrator 106
And the display device 108 operate with the power supplied from the battery 109, so that a cable for supplying power from the outside is unnecessary. Therefore, after the ultrasonic observation apparatus 101 is placed in the body, the trocar used to introduce the ultrasonic observation apparatus 101 into the body is released, and this trocar can be used to remove other treatment tools, endoscopes, and the like. Used to introduce to

As described above, the ultrasonic observation apparatus 10
According to 1, there is an effect that a minimally invasive treatment or examination can be performed by enabling other treatment tools, endoscopes, and the like to be introduced into the body via a trocar used for ultrasonic observation. .

The ultrasonic observation apparatus 101 has a configuration in which an ultrasonic image, which is output information from the ultrasonic observation apparatus 101, is observed with, for example, an endoscope. A communication unit for transmitting information to the outside of the body by data communication using, for example, radio waves, visible light, infrared light, or the like may be provided in the ultrasonic observation apparatus.

[Supplementary Note] (Supplementary item 1-1) A treatment unit that performs a medical treatment by contacting or approaching a treatment target site which is a living tissue and giving energy to the treatment target site, and an energy for driving the treatment unit. An operation unit having an energy supply unit for outputting, a rotation unit capable of rotating operation, outputting rotation angle information of the rotation unit, and pressing the rotation unit, and the rotation angle information An operation means for adjusting and controlling the energy supplied from the energy supply unit in accordance with the operation, and an operation means for operating and controlling the energy supply from the energy supply unit in accordance with the pressing operation. Utensils.

(Supplementary item 1-2) The surgical tool according to additional item 1-1, further comprising a battery that supplies at least electric power for driving the energy supply unit.

(Additional Item 1-3) In the surgical instrument according to Additional Item 1-1, the energy applied to the treatment target site includes at least one of ultrasonic vibration and heat.

(Additional Item 1-4) In the surgical instrument according to Additional Item 1-1, the energy applied to the treatment target site includes a high frequency.

(Additional Item 1-5) In the surgical instrument according to Additional Item 1-1, the energy applied to the treatment target site includes a mechanical kinetic force such as a rotational kinetic force.

(Supplementary Note 1-6) In the surgical instrument according to Supplementary Note 1-1, the medical treatment includes an incision / resection procedure for the treatment target site.

(Additional Item 1-7) In the surgical instrument according to Additional Item 1-1, the medical treatment includes a coagulation / hemostatic treatment for the treatment target site.

(Additional Item 1-8) In the surgical instrument according to Additional Item 1-1, the medical treatment includes a crushing treatment for the treatment target site.

(Additional Item 1-9) The surgical instrument according to Additional Item 1-1, wherein the operation means includes a jog dial type switch.

(Additional Item 1-10) In the surgical instrument according to Additional Item 1-1, the adjusting means adjusts the magnitude of energy output from the energy supply unit.

(Additional Item 1-11) The surgical instrument according to Additional Item 1-10, further comprising a display means for displaying the magnitude of the energy.

(Supplementary item 1-12) The surgical instrument according to Supplementary item 1-1, further comprising other operating means not used for controlling the energy output from the energy supply unit.

(Additional Item 1-13) In the surgical instrument according to Additional Item 1-1, the operating means can be operated with one finger.

(Supplementary item 1-14) The surgical instrument according to Supplementary item 1-13, wherein the surgical instrument can be gripped by a hand constituting the finger.

(Supplementary Item 2-1) In a surgical instrument which is driven by electric power supplied from a built-in battery and gives energy to a treatment target site to perform a medical treatment on the treatment target site, a surgical instrument for charging the battery is provided. A surgical instrument comprising power generation means for generating electric power.

(Supplementary Item 2-2) The surgical instrument according to Additional Item 2-1 wherein the power generating means converts the applied rotational kinetic force into electric power.

(Supplementary note 2-3) The surgical instrument according to Supplementary note 2-2, further comprising a handle that generates the rotational movement force by human power.

(Additional Item 2-4) The handle was provided so as to be detachably attached.

(Additional Item 2-4) In the surgical instrument according to Additional Item 2-1, the energy applied to the treatment target site includes at least one of ultrasonic vibration and heat.

(Additional Item 2-5) In the surgical instrument according to Additional Item 2-1, the energy applied to the treatment target site includes a high frequency.

(Additional Item 2-6) In the surgical instrument according to Additional Item 2-1, the energy applied to the treatment target site includes a mechanical kinetic force such as a rotational kinetic force.

(Additional Item 2-7) In the surgical instrument according to Additional Item 2-1, the medical treatment includes an incision / resection procedure for the treatment target site.

(Additional Item 2-8) In the surgical instrument according to Additional Item 2-1, the medical treatment includes a coagulation / hemostatic treatment for the treatment target site.

(Additional Item 2-9) In the surgical instrument according to Additional Item 2-1, the medical treatment includes a crushing treatment for the treatment target site.

(Additional Item 2-10) The surgical instrument according to Additional Item 2-1 is suitable for being carried.

(Supplementary item 3-1) In an ultrasonic diagnostic apparatus that obtains a video signal including an ultrasonic image from an echo signal due to a reflected wave of an ultrasonic wave transmitted toward a living tissue or the like, an ultrasonic wave transmitting / receiving ultrasonic wave An ultrasonic vibrator, control means for controlling the ultrasonic vibrator to obtain the video signal, a battery for supplying power to at least the ultrasonic vibrator and the control means, and at least the ultrasonic vibrator and the control An ultrasonic observation apparatus comprising: a housing having means and the battery, and having a size that can be placed in a body.

(Supplementary Note 3-2) The ultrasonic observation apparatus according to Supplementary Note 3-1 further comprising a display unit provided on the housing and supplied with power from the battery to project the video signal.

(Additional Item 3-3) The ultrasonic observation apparatus according to additional item 3-1 wherein the control means includes a microprocessor.

(Additional Item 3-4) The ultrasonic observation apparatus according to Additional Item 3-1, wherein a handle for gripping the housing is provided.

(Additional Item 3-5) The ultrasonic observation apparatus according to Additional Item 3-4, wherein the casing is moved by gripping the handle with forceps or the like and operating the forceps or the like.

(Additional Item 3-6) The ultrasonic observation apparatus according to additional item 3-2, wherein the display means includes a liquid crystal display device.

[0063]

As described above, according to the present invention,
It is possible to perform an operation for operating the energy output from the surgical tool and an output level adjusting operation for adjusting the output level of the output energy with one finger, and to grasp the surgical tool, operate the apparatus, and output the level. The adjustment operation can be performed with one hand, and fingers for performing other operations except the operation operation and the output level operation are reserved,
The effect that operability is improved is obtained.

[Brief description of the drawings]

FIGS. 1 to 3 relate to a first embodiment of the present invention, and FIG. 1 is an explanatory view showing an entire configuration of a surgical instrument.

FIG. 2 is an enlarged view around a jog dial of an operation unit.

FIG. 3 is a block diagram showing a configuration of an electric system.

FIG. 4 to FIG. 6 are referred to in the description of a portable surgical tool which can be continuously used even when the battery is discharged and the capacity is insufficient or without the battery, and FIG. Explanatory diagram showing the configuration

FIG. 5 is a block diagram showing a configuration of an electric system of the surgical instrument.

FIG. 6 is a block diagram showing a configuration of a generator different from the generator shown in FIG. 5;

FIG. 7 and FIG. 8 enable minimally invasive treatment or examination by enabling other treatment tools, endoscopes and the like to be introduced into the body via a trocar used for ultrasonic observation. Reference is made to the description of the ultrasonic observation apparatus, and FIG. 7 is an explanatory view showing the appearance of the ultrasonic observation apparatus.

FIG. 8 is an explanatory diagram mainly showing an internal configuration of the ultrasonic observation apparatus.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 ... Surgical tool 11 ... Ultrasonic vibrator 16 ... Drive circuit 16a ... Drive signal oscillation circuit 16b ... Drive signal amplifier circuit 17 ... Battery 18 ... Jog dial 18a ... Encoder 18b ... Switch

 ──────────────────────────────────────────────────続 き Continuing on the front page (72) Inventor Shinji Hatta 2-43-2 Hatagaya, Shibuya-ku, Tokyo Inside Olympus Optical Industrial Co., Ltd. (72) Inventor Masaru Karasawa 2-34-2 Hatagaya, Shibuya-ku, Tokyo No. Olympus Optical Co., Ltd. (72) Katsumi Sasaki Inventor 2-43-2 Hatagaya, Shibuya-ku, Tokyo (72) Inventor Takeo Takei 2-43-2 Hatagaya, Shibuya-ku, Tokyo No. Within Olympus Optical Kogyo Co., Ltd. (72) Inventor Takeaki Nakamura 2-43-2 Hatagaya, Shibuya-ku, Tokyo Within Olympus Optical Kogyo Co., Ltd. (72) Yoshinao Daiaki 2-43, Hatagaya, Shibuya-ku, Tokyo No. 2 F-term in Olympus Optical Co., Ltd. (reference) 4C060 EE06 FF38 JJ17 JJ25 KK03 KK04 KK09 KK10 KK23 KK47 LL09

Claims (2)

[Claims] 1. A treatment section for contacting or approaching a treatment target site which is a living tissue to apply energy to the treatment target site to perform a medical treatment, an energy supply section for outputting energy for driving the treatment section, An operating means having a rotating portion capable of moving operation, outputting rotation angle information of the rotating portion and pressing the rotating portion; and operating means from the energy supply portion according to the rotating angle information. A surgical instrument comprising: an adjusting unit that adjusts and controls supplied energy; and an operating unit that controls the operation of energy supply from the energy supply unit in response to the pressing operation. 2. The surgical tool according to claim 1, further comprising a battery for supplying at least electric power for driving the energy supply unit.