JP2001314411A - Surgical operation system - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a surgical operation system with an easy operation that makes selection possible to enable treatment output from a hand piece held by an operator. SOLUTION: A plurality of hand pieces such as a scissors type hand piece 3A provided with a sensor 18A for detecting holding (grasping) of a handle 17A by the operator can be connected to the system. An oscillating circuit 21 that generates driving signal and sensor circuits 24A-24C that detect the held hand piece by an output signal of the sensor 18A are arranged on the system main body 2. The operator can continue treatment without changing switch by inputting output signal of the oscillating circuit 21 in the actually held hand piece to change a switch 22 via a selection circuit.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

The present invention relates to a surgical operation system having a plurality of handpieces.

[0002]

2. Description of the Related Art Conventionally, an ultrasonic scalpel device as described in Japanese Patent Application No. 11-269242 has been proposed as a surgical operation device replacing an electric scalpel or the like.
As such surgical devices have become widespread, the types of handpieces that can be used during surgery have increased. Therefore, if a plurality of handpieces suitable for an operation can be connected to one surgical apparatus, a plurality of handpieces are used while being switched in a single surgical operation.

In the conventional system, in order to switch between a plurality of handpieces, it was necessary to operate a switch on the front panel of the apparatus main body. Alternatively, a dedicated remote switch for switching handpieces was required.

[0004]

However, in the above-described method using the switch on the front panel,
Since the main unit is installed in a dirty area in the operating room,
The operator who is actually performing the operation cannot perform the operation, and needs to be operated by a nurse or the like, which may be complicated.

In the above-described switching method using the remote switch, switches operated by the operator are installed in an operating room in a clean area. There was a risk that it would be hindered.

(Object of the Invention) The present invention has been made in view of these circumstances, and enables a surgeon to actually perform a treatment output on a plurality of connected handpieces from a handpiece actually used by an operator. It is an object of the present invention to provide a surgical operation system with good operability, which is selectable so as to be as follows.

[0007]

A main body provided with a handpiece connecting portion for detachably connecting a plurality of handpieces, and a drive for supplying a driving signal to the handpiece connected to the handpiece connecting portion. In a surgical operation system provided with a means, a holding unit provided in each of the plurality of handpieces, a holding detection unit provided in each holding unit, and a detection signal from the holding detection unit, the handpiece connection unit Output switching means for switching the output of the drive signal, by providing a drive signal to the handpiece actually holding the holding unit, without the operator performing a switching operation, etc. The treatment can be performed with the held handpiece, and the operability can be improved.

[0008]

Embodiments of the present invention will be described below with reference to the drawings. (First Embodiment) FIGS. 1 to 7 relate to a first embodiment of a surgical operation system according to the present invention, and FIG. 1 is an overall configuration of an ultrasonic operation system according to the first embodiment of the present invention. FIG. 2 shows the internal configuration of the apparatus main body, FIG. 3 shows the configuration of the holding detecting means, FIG. 4 shows a hand piece portion provided with a holding detecting sensor, and FIG. 5 shows the holding detecting means. 6 shows a circuit configuration of a capacitance sensor circuit, FIG. 6 shows a processing content of an output port selection process, and FIG. 7 shows a configuration of a holding detection unit in a modified example.

An ultrasonic operation system 1 according to a first embodiment of the surgical operation system of the present invention shown in FIG. 1 has an ultrasonic operation apparatus main body (hereinafter simply referred to as an apparatus main body) 2 for generating a drive signal.
And a plurality of treatment tools detachably connected to the apparatus main body 2 such as a scissors-type handpiece 3A, a hook-type handpiece 3B, and a trocar-type handpiece 3C.
And a foot switch 4 for performing output ON / OFF operation
And a remote switch 5 for remote control.

In this embodiment, an ultrasonic surgical system for performing incision, coagulation and the like by ultrasonic waves is used. Each of the handpieces 3I (I = A, B, C) includes an ultrasonic vibrator therein as described later. Built-in. In addition, the apparatus main body 2 has a built-in oscillation circuit that performs ultrasonic vibration by applying a drive signal to each ultrasonic transducer.

An operation display panel 6, an operation panel 7, and the scissors-type handpiece 3 are provided on the front of the apparatus main body 2.
A, a connector plug 8 provided at the end of each cable 8 of the hook type handpiece 3B and the trocar type handpiece 3C
A, 8B, and 8C are detachably connected to connectors 9A, 9B, and 9C, respectively, and selection switches 10A and 10A provided on operation panel 7 for selecting connectors 9I.
B, 10C, a remote switch connector 11b to which a remote switch connector plug 11a (see FIG. 2) of the remote switch 5 is connected, and a speaker 12 for notifying a selection result by sound. The rear switch panel 13 has a foot switch connector 13 to which a foot switch plug 13a of the foot switch 4 is connected.
b (see FIG. 2).

Each handpiece 9I has an elongated sheath portion 14
I and an operating section (or gripping section) 15I formed at the rear end (base end) of the sheath section 14I.
An ultrasonic transducer 23 (represented by the scissors type handpiece 3A in FIG. 2) is built in I.

The scissors type handpiece 3A and the hook type handpiece 3B have operating units 15A and 15B, respectively.
The operator holds (grasps) the hand and treats the treatment sections 16A and 16A at the distal end.
Operation handles 17A and 17B are provided for opening and closing B and performing a treatment operation for treatment such as coagulation by ultrasonic waves. On the other hand, the trocar type handpiece 3C has a cylindrical gripper 1.
The structure is such that a treatment operation is performed by the treatment section 16C at the distal end while directly grasping 5C.

In this embodiment, each handpiece 9I is provided with a holding detection sensor 18I for detecting (or recognizing) a holding state. Specifically, the scissors-type handpiece 3A and the hook-type handpiece 3B are provided with sensors 18A and 18B as holding detecting means for recognizing the holding by the operation handles 17A and 17B. On the other hand, the trocar type handpiece 3C has the operation unit 15C.
A sensor 18C is provided on the outer peripheral surface of the cylindrical shape.

The handpiece 9I used by the operator
When the device is held and held, the device main body 2 detects (recognizes) it with the output of the sensor 18I and selects the handpiece 9I capable of outputting, so that the output operation can be performed by the foot switch 4. To improve operability. The remote switch 5 is provided with three selection switches 19A, 19B, and 19C for selecting the connectors 9A, 9B, and 9C.

FIG. 2 shows the internal configuration of the apparatus main body 2. An oscillation circuit 21 for generating a drive signal for ultrasonic vibration, and a drive signal generated by the oscillation circuit 21 are selectively supplied to three connectors (referred to as output ports) 9I. Switch 22 as switching means
Are provided.

The drive signal from the oscillation circuit 21 passes through the contact i turned on by the changeover switch 22 and from the connector 9I connected to the contact i to the handpiece 3I connected to the connector 9I to the drive line 27a in the cable 8. Is supplied through the controller and a drive signal is applied to the built-in ultrasonic vibrator 23, so that when the ON switch of the foot switch 4 is depressed, ultrasonic vibration occurs.

The ultrasonic vibration is transmitted to the treatment section 16I on the distal end side through an ultrasonic transmission member, and the treatment section 16I is applied to a target tissue so that treatments such as incision and coagulation can be performed.

A signal detection line 27b connected to the sensor 18I is also inserted into the cable 8, and a detection signal from the sensor 18I is input from the connector plug 8I to the sensor circuit 24I in the apparatus main body 2 via the connector 9I. It has become.

These sensor circuits 24A, 24B, 24C
Determines (recognizes) whether or not the handpiece 3I is held from the output signal of the sensor 18I and outputs it to the selection circuit 25.

The selection circuit 25 comprises sensor circuits 24A, 24
Based on the output signals of B and 24C, the contact i of the changeover switch 22 is selected so that a drive signal is output to the ultrasonic transducer 23 of the handpiece 3I provided with the sensor 18I determined to be in the holding state.

A selection signal of a selection switch 10I provided on the operation panel 7 and a selection signal of a selection switch 19I provided on the remote switch 5 are also input to the selection circuit 25. 10I, 19I
Is operated, the changeover setting of the changeover switch 22 is performed so that the contact i designated for selection is turned on. Then, the drive signal is output to the ultrasonic transducer 23 in the corresponding handpiece 3I.

The apparatus body 2 has a built-in control circuit 26 for performing overall control. For example, when the foot switch 4 is operated, an operation signal is input to the control circuit 26, and the oscillation / oscillation of the oscillation circuit is performed. Stop (or turn on the oscillation output)
/ OFF). When an output value is set by operating the operation panel 7, the oscillation output of the oscillation circuit 21 is controlled so that the output value is set.

Further, the selection circuit 25 controls the changeover switch 2
When the switching of the contact i is performed, information about which contact i is turned on is transmitted from the selection circuit 25 to the control circuit 26, and the control circuit 26 receives the information or displays the information or the information on the operation display panel 6. The connector 9I (or port number) connected to the contact point i is visually displayed, or the speaker 12 is notified audibly.

Next, referring to FIG. 3, the details of the sensor 18A (the same applies to 18B and 18C) constituting the holding detecting means will be described. In this case, the holding detection method is configured to make a determination based on a change in capacitance.

The detector 30 constituting the sensor 18A
Are metal electrodes 31 arranged in parallel on an insulating plate,
The capacitor 31 is electrically connected to a capacitance sensor circuit 24A provided in the apparatus main body 2 via a signal line 27b from the two electrodes 31, 31.

When an operator's hand is attached between the two electrodes 31, 31, the capacitance between the two electrodes 31, 31 changes. This is detected (recognized) by the capacitance sensor circuit 24A, a selection signal is generated, and the contact point i of the changeover switch 22 is switched. The two electrodes 3
In the case of a handpiece (3A or 3B) with a handle as shown in FIG. 4 (A), the detection unit 30 formed by the components 1 and 31 is inside the fixed handle 32a or inside the movable handle 32b in the operation handle 17A or 17B. It is good to provide in.

In the case of a trocar type handpiece 3C as shown in FIG. 4B, two electrodes 31, 31 are preferably arranged at, for example, upper and lower positions of the handpiece grip 15C. In this way, the operator can use the handpiece 3
It is possible to prevent erroneous detection due to a change in capacitance due to a state other than holding C, for example, being placed on the patient's side.

Next, referring to FIG. 5, for example, a capacitance sensor circuit 24A
A detailed configuration example (the same applies to 24B and 24C) will be described.
The capacitance sensor circuit 24A includes an oscillation circuit 35, a Wheatstone bridge 36 to which the oscillation signal of the oscillation circuit 35 is applied, the detection unit 30 connected thereto, and a detection unit based on the output signal of the Wheatstone bridge 36. The comparator 37 includes a comparator 37 that obtains a signal for determining the detection state of the detector 30 and a filter 38 that obtains a binarized signal corresponding to the detection state from the output of the comparator 37.

The oscillation circuit 35 is constituted by, for example, an inverter (having a Schmitt circuit configuration) or the like, and generates a signal of several kHz to several hundred kHz. The oscillation output of the oscillation circuit 35 is applied to a Wheatstone bridge 36 in which four impedance elements including the detection unit 30 are connected in a bridge shape. More specifically, the oscillation output includes resistors R1, R
2 and a connection point between the capacitor C1 and one end of the detection unit 30.

The signal for detecting the potential (balance state) between the connection point between the resistor R1 and the other end of the detection unit 30 and the connection point between the resistor R1 and the capacitor C1 is supplied to the comparator 3
7 is input to the input terminal.

That is, one of the four impedance elements constituting the Wheatstone bridge 36 is replaced with the detection unit 30 including the two electrodes 31 provided on the handpiece 3I. By doing this, 2
The change of the capacitance component can be detected depending on the presence or absence of the operator's hand between the electrodes 31 and 31, and it is possible to recognize that the handpiece 3I is held by the operator.

For example, if the detection unit 30 is not in the holding state,
In this case, since the capacitance is small and the impedance is large, the potential on the detection unit 30 side is set higher than the potential on the capacitor C1 side, and the comparator output is set to “L”. When the holding unit 30 is held and the capacitance increases, the potential on the detecting unit 30 side becomes the capacitor C
The potential of the capacitor C1 or the resistances R1, R
2 is set.

In this case, since the signal is modulated by the oscillation output (AC output), the resistance R3 that passes a component lower than the oscillation frequency is used.
By passing through a filter 38 having a function as a low-pass filter composed of a capacitor C2 and an output signal, an output signal whose output changes from "L" to "H" according to the holding state can be obtained.

As described above, in the present embodiment, the connector plug 8I of each handpiece 3I is connected to the connector 9I of the apparatus main body 2 and the selection switch 1 on the operation panel 7 is set.
The operator can operate the selection switch 19I on the remote switch 5 to select one handpiece 3I to be used by the operator and perform an output operation with the foot switch 4 to perform surgery. In 3I,
A sensor 18I for holding detection is provided in a part held by the operator,
After confirming the output signal of the sensor 18I in the apparatus main body 2, it is possible to perform the operation by automatically switching the contact point i of the changeover switch 22 so that the ultrasonic drive signal is output to the held handpiece 3I. It is characterized by being able to do it.

The operation of the present embodiment thus configured will be described with reference to FIG. As shown in FIG. 1, one or a plurality of handpieces 3I used for treatment such as the Caesars type handpiece 3A are connected to the apparatus main body 2.

For example, as shown in FIG. 2, when the handpiece 3A is connected to the apparatus main body 2 and the operation handle 17A of the handpiece 3A is held, a detection signal corresponding to the holding state is sent from the sensor 18A to the sensor circuit. 24A.

The sensor circuit 24A sends a selection signal held by the handpiece 3A to the selection circuit 25 based on the detection signal, and the selection circuit 25
It is determined that the selection signal has been input from the sensor circuit 24A in A, 24B and 24C.

As a result, the selection circuit 25 is connected to the changeover switch 2
2 to a state where the output line of the oscillation circuit 21 is supplied to the connector 9A to which the held handpiece 3A is connected. That is, the contact a is selected. The result selected by the selection circuit 25 is
The information is transmitted to the control circuit 26, is displayed on the operation display panel 6, and is also notified by the speaker 12 (may be notified only by one of them).

In the above description, the handpiece 3A or the like is actually held and the automatic switching is performed by the output signal of the sensor circuit 24A.
It is also possible to make a determination by the selection circuit 25 based on the operation result of I or the operation result of the selection switch 19I in the remote switch 5, and to select the changeover switch 22 based on the result.

Although the general operation has been described above, the process of selecting an output port (connector 9I) in the apparatus main body 2 is as shown in FIG. The selection circuit 25 determines whether the selection switches 10A to 10C of the operation panel 7 have been pressed as shown in step S1 of FIG. 6, and if not, the selection switches 19A to 19A of the remote switch 5 in step S2.
It is determined whether 9C has been pressed. If not, it is determined whether a selection signal has been received by the sensor circuits 24A to 24C in step S3. If not, the process returns to step S1.

On the other hand, if it corresponds to the judgment of steps S1 to S3, the process proceeds to step S4, where the selection switches 10A to 10C of the operation panel 7, the selection switches 19A to 19C of the remote switch 5, or the selection signals by the sensor circuits 24A to 24C. Corresponding output port (connector 9
A to 9C), the selection control of the contact i of the changeover switch 22 is performed.

For example, when the selection switch 10A of the operation panel 7 is pressed in the judgment processing of step S1,
The signal is input to the selection circuit 25 and the changeover switch 22
A selection operation (switching operation) is performed such that the contact “a” is turned ON. If the selection switches 10A to 10
When the selection switch 19A of the remote switch 5 is pressed without operating C, the signal is input to the selection circuit 25 and the selection operation of the changeover switch 22 is performed.

Furthermore, if any of the above switches 10
A to 10C and 19A to 19C are not selected, and the sensor 18A as the holding recognition means provided in the handpiece 3I is not selected.
18C and a signal indicating that the handpiece 3I has been selected by the sensor circuits 24A to 24C incorporated in the apparatus main body 2, is input to the selection circuit 25, thereby performing the selection operation of the changeover switch 22.

When the output port is selected, the result of the port selected by the display means of the operation display panel 6 and the sound of the speaker 12 is notified to the operator as shown in step S5. Then, the process returns to step S1. As described above, it is possible to configure the holding detecting means only by providing two electrodes on the handpiece, and without operating the selection switch 10I of the operation panel 7 or the selection switch 19I of the remote switch 5, a plurality of hand beads 3A can be formed. 3C, it is possible to automatically recognize and use which handpiece 3I is held by the operator, and the operability is greatly improved.

In the above-described example, as the holding detecting means,
Although the sensor 18I and the capacitance sensor circuit 24I were used, as another method, as shown in FIG.
For example, an infrared sensor 39 is used as the detection unit 30 of the sensor 18I provided in the
0 may be used.

The infrared sensor 39 is an infrared light emitting element that emits infrared light, and an infrared light detecting element (such as an infrared detecting phototransistor or an infrared detecting photodiode) that is disposed near the infrared light emitting element and detects infrared light from the infrared light emitting element. The setting is made such that the amount of infrared light received by the infrared detecting element greatly changes depending on the presence or absence of holding.

The output signal from the infrared detecting element is sent to the infrared sensor circuit 40, and the infrared sensor circuit 4
The holding state is determined with 0. Further, the result of the port selection may be notified from the speaker 12 by voice synthesized in the apparatus main body 2.

This embodiment has the following effects. The output of the sensor 18I for holding detection provided on the handpiece 3I can automatically select the treatment output from the actually held handpiece 3I, so that the operator can hold the hand without holding the switching operation. The treatment can be performed with the piece 3I, and the usability can be improved. That is,
Operability can be greatly improved. In addition, since the switching operation is performed, the treatment is not interrupted, and a smooth treatment can be performed.

(Second Embodiment) Next, a second embodiment of the present invention will be described with reference to FIGS. FIG. 8 shows the tip of the scissors type handpiece 3A ',
In the present embodiment, the treatment section 16A at the distal end of the sheath section 14A
LED 41A is provided in the vicinity of. That is, this scissors-type handpiece 3A 'is the same as the scissors-type handpiece 3A described in the first embodiment,
The structure is such that an LED 41A is provided in the vicinity of the treatment section 16A at the distal end of a. The hook type hand bead 3B 'shown in FIG. 9 also has a structure in which an LED 41B is provided near the treatment section 16B.

FIG. 9 is a view for explaining the overall configuration of an ultrasonic operation system 51 according to the second embodiment. This ultrasonic operation system 51 includes an apparatus main body 52, a handpiece 3A ',
3B ', foot switch 4, and remote switch 5'
And an endoscope 53 for observing the operation site.

The apparatus main body 52 in the present embodiment is the first
In the apparatus main body 2 of the embodiment, an LED 54A is provided near the selection switches 10A to 10C of the operation panel 7.
To 54C.

In this embodiment, the cable 8 'is
In the cable 8 according to the first embodiment, L
The signal line connected to the ED 41I is inserted, and the device main body 52 is connected via the connector plug 8I and the connector 9I.
Connected to a control circuit 26 (see FIG. 2).

The remote switch 5 'according to the present embodiment is the same as the remote switch 5 according to the first embodiment, except that an LED 55 is provided near each selection switch 19I.
I is provided. The other configuration is the same as that of the first embodiment. The same components as those of the first embodiment are denoted by the same reference numerals, and description thereof will be omitted.

Next, the operation of the present embodiment will be described. One of the plurality of handpieces 3A'3B 'is selected by the remote switch 5' or the holding detection means according to the first embodiment, and the selected hand bead 3I 'when used, for example, a scissors type handpiece. When 3A is selected, the LED 41A provided near the tip of the 3A emits light, and the operator can easily determine which handpiece 3A 'can be output during treatment under the observation of the endoscope 53. Can be recognized.

The selection result is obtained by emitting an LED 55I provided near the selection switch 19I of the remote switch 5 'or emitting an LED 54I provided near the selection switch 10I on the operation panel 7 of the apparatus main body 52. They also make announcements.

As described above, according to the present embodiment, even in the operation under the endoscope 53, it is possible for the operator to recognize the selected handpiece 3I 'without taking his eyes off the image of the endoscope 53. And the operability is improved. The other effects are the same as those of the first embodiment.

(Third Embodiment) Next, a third embodiment of the present invention will be described with reference to FIGS.

As shown in FIG. 10, in the third embodiment (under the endoscope) of the high frequency / ultrasonic surgical system 61 of the present invention, a patient 63 lying on an operating table 62 is shown.
For P, a return electrode plate 64 is laid between the operating table 62 and the patient 63.

The electrode of the counter electrode plate 64 is connected to a high frequency output generator 65 by a cable. Patient 63
A rigid endoscope 66, a scissor-type handpiece 6
7. Rod-shaped handpiece 68, hook-shaped handpiece 69
Are inserted through a sheath (not shown).

At the rear end of the rigid endoscope 66, a TV camera head 71 having a built-in image pickup device is attached. The TV camera 71 is connected to a camera control unit (CCU) 72, and performs signal processing for the image pickup device. To do. Then, the standard video signal generated by the CCU 72 is output to the TV monitor 73 so that the endoscope image captured by the image sensor can be displayed on the display surface of the TV monitor 73.

The scissor-type handpiece 67, the rod-shaped handpiece 68, and the hook-type handpiece 69 are connected to a high-frequency output generator 65 and an ultrasonic output generator 75 via an output switching unit 74 for switching output. ing.

The high frequency output generator 65 and the ultrasonic output generator 75 are
6 and 77, to turn on / off the output of high frequency and ultrasonic
It can be turned off.

The output switching unit 74 is, for example, 3
A hand switch 79 having two ports a, b, and c and having a port a selection switch 78a, a port b selection switch 78b, and a port c selection switch 78c for selecting the ports a, b, and c is connected.

The ultrasonic connector of the scissor type handpiece 67 is connected to the ultrasonic output connector 81a of the output switching unit 74, and the A code (active code) is connected to the high frequency output connector 82a.

The ultrasonic connector of the rod-shaped handpiece 68 is the ultrasonic output connector 81b of the output switching unit 74.
A code is connected to the high frequency output connector 82
b. The ultrasonic connector of the hook type handpiece 69 is connected to the ultrasonic output connector 81c of the output switching unit 74, and the A code is connected to the high frequency output connector 82c.

The output switching unit 74 is provided with a port a selection display 83a, a port b selection display 83b, and a port c selection display 83c.

As shown in FIG. 11A, a scissor-type handpiece 67 has a probe 85a and a vibrator section 8 at the rear end.
6a, a handle portion 87a is provided at the rear end of the vibrator portion 86a. By operating the handle portion 87a, the movable one side of the grip portion 88a at the tip of the probe is rotated to perform treatment. The part can be grasped.

As shown in FIG. 11B, the rod-shaped handpiece 68 comprises a probe 85b and a vibrator 86b. The probe 85b has a hollow structure, and its tube is suctioned through a suction tube 89. Connected to device 90. As shown in FIG.
Reference numeral 9 denotes a probe 85c and a vibrator 86c, and a hook 87c is provided at the tip of the probe 85c.

Next, the operation of the present embodiment will be described. The surgeon inserts the rigid endoscope 66, the scissor-type handpiece 67, the rod-shaped handpiece 68, and the hook-type handpiece 69 into the body of the patient 63, and attaches the distal end of each handpiece to the image of the rigid endoscope 66. Observe by That is, an image observed by the rigid endoscope 66 is captured by the TV camera head 71, converted into a video signal standardized by the CCU 72, and displayed on the TV monitor 73.

While viewing the image on the TV monitor 73, the surgeon moves the scissor-type handpiece 67 from each of the handpieces 67 to 69 to a desired position in the surgical site. The operator presses the port c selection switch 78c of the hand switch 79, and sets the energy output port of the output switching unit 74 to c.

This state is displayed on the port c selection display 83c of the output switching unit 74. When incising the peritoneum of the patient 63 at the initial stage of the operation, the surgeon operates the foot switch 76 by hooking the peritoneum on the hook portion 87c of the hook type handpiece 69.

The signal of the foot switch 76 is transmitted to the high frequency output generator 65, and the high frequency energy is input to the high frequency input connector (not shown) of the output switching unit 74. Since the port c selection switch 78c is selected, the high-frequency energy input to the high-frequency input connector receives the probe 85 via the high-frequency output connector 82c.
c. The high frequency energy flows through the peritoneum into the return electrode 64, and the energy returns to the high frequency output generator 65. The peritoneum is incised by the high-frequency energy passing through the peritoneum.

If the output can be low, the operator operates the foot switch 77. The signal of the foot switch 77 is transmitted to the ultrasonic output generator 75, and the ultrasonic energy is input to an ultrasonic input connector (not shown) of the output switching unit 74. Port c selection switch 78c
Is selected, the ultrasonic energy input to the ultrasonic input connector is transmitted to the probe 85c via the ultrasonic output connector 81c, and the peritoneum is incised.

That is, the surgeon can use the hook type handpiece 69.
The incision output can be switched by stepping on the foot switches 77 and 76. Further, when the operation proceeds and a blood vessel in the body is processed, the operator operates the port a selection switch 78a of the hand switch 79 and sets the energy output of the output switching unit 74 to the port a.

In this case, the port c selection display 83c turns off and the port a selection display 83a turns on. The operator operates the handle portion 87a of the scissor-type handpiece 67,
The blood vessel is sandwiched between the grips 88a. Here, when the operator steps on the foot switch 77, the signal of the foot switch 77 is transmitted to the ultrasonic output generator 75, and the ultrasonic energy is input to the ultrasonic input connector (not shown) of the output switching unit 74.

Since the output port a is selected, the ultrasonic energy input to the ultrasonic input connector is transmitted to the grip portion 88a of the scissor-type handpiece 67 via the ultrasonic output connector 81a. Therefore, it is possible to cut while coagulating the blood vessel sandwiched between the grip portions 88a.

In this procedure, if it becomes necessary to cut another tissue, the surgeon operates the foot switch 76 while holding the tissue to be cut between the tissues and pressing the tip of the handpiece 67. As a result, high-frequency energy is transmitted from the high-frequency output generator 75 to the grip portion 88a of the scissor-type handpiece 67, and the grip portion 88
It is also possible to incise the tissue that has been in contact with a.

Further, when the surgeon reaches the malignant tissue and removes the tissue, the energy output of the output switching unit 74 is set to the port b by operating the port b selection switch 78b of the hand switch 79. . In this case, when the surgeon presses the tip of the rod-shaped handpiece 68 against the malignant tissue and depresses the foot switch 77, the ultrasonic energy is generated from the ultrasonic output generator 75 by the probe 8.
5b, the malignant tissue is destroyed and emulsified.

Since the suction tube 89 and the suction device 90 are attached to the probe 85b, the emulsified malignant tissue is suctioned by the suction device 90 via the suction tube 89 and removed from the operation site. At this time, when bleeding occurs from the surrounding tissue, the surgeon applies the tip of the probe 85b to the bleeding part, and by stepping on the foot switch 76, the high-frequency energy is transmitted to the probe 85b, and the bleeding part is stopped. You.

This embodiment has the following effects. In the present embodiment, when performing various treatments in one operation, it is possible to easily select and use the optimal probe shape, which has a great effect on shortening the operation time.

(Fourth Embodiment) Next, a fourth embodiment of the present invention will be described with reference to FIGS. Note that the same parts as those in the third embodiment are denoted by the same reference numerals, and description thereof will be omitted. As shown in FIG. 12, the output switching unit main body 91 has a (first) extension unit 92 or further has a (second) extension unit 93
12 and 13 can be detachably connected (in FIGS. 12 and 13, the additional unit 9 is attached to the output switching unit main body 91).
2 is shown connected.)

The output switching unit main body 91 includes a port a ultrasonic output connector 94a, a port a high frequency output connector 9
5a, port a selection switch 96a, port b ultrasonic output connector 94b, port b high frequency output connector 95
b, port b selection switch 96b is provided on the operation panel.

As shown in FIG. 13, on the right side of the output switching unit main body 91, an ultrasonic connection plug 111, a high frequency connection plug 112, and a control plug 110 are provided. As shown in FIG. 12 and FIG.
Has a port c ultrasonic output connector 94c, a port c high frequency output connector 95c, and a port c selection switch 96c on the front panel.

The extension unit 93 includes a port d ultrasonic output connector 94 d and a port d high frequency output connector 9.
A 5d, port d selection switch 96d is provided on the front panel.

As shown in FIG. 13, the left side of the extension unit 92 has an ultrasonic connector 114, a high frequency connector 115, and a control connector 113.
The output switching unit 91 and the extension unit 92 are detachably connected by a detachment mechanism (not shown). At this time, the “ultrasonic connection plug 111 and the ultrasonic connection connector 114” are used.
"High-frequency connection plug 112 and high-frequency connection connector 11
5 "is located at a position where the" control plug 110 and control connector 113 "are automatically connected.

Further, on the right side of the extension unit 92, an ultrasonic connection plug 97, a high-frequency connection plug 98, and a control plug 99 are disposed, and the extension unit 93 of the extension unit 93 shown in FIG. It has a structure that can be connected to the ultrasonic connector 100, the high-frequency connector 101, and the control connector 102.

As shown in FIG. 13, an ultrasonic output generator 75 is connected to the ultrasonic input connector 103 of the output switching unit main body 91.
Is connected to a high-frequency output generator 65.

The ultrasonic input connector 103 is connected to a port-a switching relay 120, a port-b switching relay 121, and an extension unit relay 122, respectively. Similarly, the high frequency input connector 104 is also connected to the port a switching relay 1
20, port b switching relay 121, extension relay 122
It is connected to the. The port a switching relay 120 is connected to the port a ultrasonic output connector 94a and the port a high frequency output connector 95a.

The port b switching relay 121 includes a port b ultrasonic output connector 94b and a port b output connector 95b.
It is connected to the. The extension unit relay 122 is connected to the ultrasonic connection plug 111 and the high frequency connection plug 112. A control circuit 105 is built in the output switching unit main body 91, and the control circuit 105 is connected to a control bus 106.

Each control line of the port a switching relay 120, the port b switching relay 121, and the extension unit relay 122 is connected to the control bus 106. The port a selection switch 96a and the port b selection switch 96b provided on the front panel are also connected to the control bus 106. The control bus 106 includes the control plug 1
10 is also connected.

A control bus 107 is connected to the control connector 113 of the extension unit 92.
The extension unit 92 includes a port c switching relay 123,
An extension unit relay 124 is built in. The ultrasonic connector 114 is connected to the port c switching relay 123 and the extension unit relay 124. Similarly, the high-frequency connector 115 has a port c switching relay 123.
And an extension unit relay 124.

The relay 123 is further connected to a port c ultrasonic output connector 94c and a port c high frequency output connector 95c. Further, the extension unit relay 124
Are connected to an ultrasonic connection plug 97 and a high-frequency connection plug 98. The control lines of the port c switching relay 123 and the extension unit relay 124 are connected to the control bus 107. The port c selection switch 96c and the control plug 99 are further connected to the control bus 107.

Next, the operation of the present embodiment will be described. Third
In a case where three handpieces are used as in the case of the third embodiment, an additional unit 92 is connected to the output switching unit 91. Thereby, the ultrasonic connection plug 111 is connected to the ultrasonic connection connector 114 and the high-frequency connection plug 112
Is connected to the high-frequency connection connector 115, and the control plug 110 is connected to the control connector 113.

When the control plug 110 and the control connector 113 are connected, the information is transmitted to the control circuit 1.
The control circuit 105 turns on the extension unit relay 122. On the other hand, since nothing is connected to the control plug 99, the control circuit 105
Keeps the extension unit relay 124 turned off. A scissor-type handpiece 67 is connected to the port a, a rod-shaped handpiece 68 is connected to the port b, and a hook-type handpiece 69 is connected to the port c.

When the operator performs blood vessel processing with the scissor-type handpiece 67, the operator operates the port a selection switch 96a of the output switching unit 91. The signal of the port a selection switch 96a is transmitted to the control circuit 105, and the control circuit 105 turns on the port a switching relay 120. As a result, transmission of an ultrasonic output and a high-frequency output to the scissor-type handpiece 67 connected to the port a becomes possible.

Next, when removing the malignant tissue with the rod-shaped handpiece 68, the operator operates the port b selection switch 96b of the output switching unit 91. The signal of the port b selection switch 96b is transmitted to the control circuit 105, and the control circuit 105 turns off the port a switching relay 120 and turns on the port b switching relay 121. Thereby, the ultrasonic output and the high-frequency output can be transmitted to the rod-shaped handpiece 68 connected to the port b. The same applies when selecting port c.

When the surgeon is planning to use only two types of handpieces, the extension unit 92 is removed from the output switching unit 91. When the connection between the control plug 110 and the control connector 113 is disconnected, the control circuit 105 turns off the extension unit relay 122. Therefore, the surgeon performs an operation by attaching an arbitrary handpiece to the port a and the port b. A plurality of extension units can be added to the extension unit 92. In this case, the operation of the
Since this is almost the same as the case of adding 2, the description is omitted.

This embodiment has the following effects. According to the present embodiment, it is possible to arbitrarily set the number of ports of the output switching unit to which the handpiece is connected, so that appropriate arrangement can be performed even in a limited operation space.

That is, according to the third and fourth embodiments, the energy output can be selectively supplied to the target handpiece without pulling out the plurality of handpieces from the operative site during the operation. It is possible to greatly increase the efficiency.

(Fifth Embodiment) Next, a fifth embodiment of the present invention will be described with reference to FIGS.
The purpose of this embodiment is to look away from the treatment unit,
An object of the present invention is to provide an endoscopic surgical operation system in which a plurality of types of handpieces can be easily and reliably selected and switched for use. The background is as follows.

In Japanese Patent Application Laid-Open No. 2000-271135,
By connecting the connector expansion unit between the ultrasonic treatment handpiece and the ultrasonic surgical apparatus, the ultrasonic output from one apparatus (ultrasonic surgical apparatus) can be selectively applied to a plurality of handpieces. Means for switching are disclosed.

With the above configuration, when performing surgery,
When using multiple handpieces, it is not necessary to replace the ultrasonic surgical device and handpiece each time the handpiece used is changed.
It became possible by switching the handpiece used.

The switching means can be switched by a selection switch or a hand switch attached to the connector expansion unit. However, JP
In the conventional example of 000-271135, it was only possible to confirm which handpiece was selected by actually outputting it.

The means for checking whether the selected switch and the handpiece correspond to each other needs to check whether the cable connecting the handpiece and the ultrasonic surgical apparatus is actually connected. Was. For this reason, the operator using the handpiece has to transfer his / her gaze from the tissue to the device every time the handpiece is switched from the living tissue to be treated. An object of the present embodiment is to eliminate the above-mentioned drawbacks.

Since the present embodiment is similar to the first embodiment, the same components as those in the first embodiment are denoted by the same reference numerals and description thereof will be omitted. The surgical operation system 1B according to the present embodiment is different from the system 1 shown in FIG.
And an endoscope device 129.

That is, the endoscope apparatus 129 is an optical endoscope (abbreviated as a scope) 130 for performing an endoscopic examination, and a camera mounted on the scope 130 and having a built-in image pickup device for obtaining an endoscope image. A head 131, a light source device 133 for supplying illumination light to the scope 130 via a light guide cable 132, and a camera connected to the camera head 131 via a signal cable 134 to perform signal processing on an image sensor and generate a video signal A control unit (abbreviated as CCU) 135 is connected to the CCU 135,
And a monitor 136 for displaying an endoscope image.
The CU 135 is connected to the apparatus main body 2B by a communication cable 137.

FIG. 15 is a view mainly showing C in the endoscope apparatus 129.
The configuration of a part of the CU 135 and the apparatus main body 2B is shown. The light source device 133 has a built-in light source lamp 138, the illumination light of which is condensed and transmitted through a light guide cable 132, and further passes through a light guide 140 inserted through an insertion portion 139 in the scope 130, and has a distal end surface. Is emitted from. The illuminated subject such as the affected part is formed by the objective lens 141, and the optical image is transmitted to the rear side through the relay lens system 142. Then, an image is formed on an image sensor 144 incorporated in the camera head 131 mounted on the eyepiece 143.

The signal photoelectrically converted by the image pickup device 144 is input to an analog processing circuit 148 in the CCU 135 via a signal cable 134, subjected to analog processing such as amplification and color separation, and then digitally converted by an A / D conversion circuit 149. Converted to a signal.

Further, the digital processing circuit 150 performs processing such as white balance processing and the like, and inputs the processed data to the character superposition circuit 151. The digital video signal output from the character superimposition circuit 151 is output to a D / A conversion circuit 152.
, And is converted to a standard video signal through a post-processing circuit 153 and output to a monitor 136.

Further, a CPU 154 is provided in the CCU 135 so that, for example, the digital processing circuit 150 in the CCU 135 can be controlled.

The CPU 154 is provided with a character generation circuit 155, which generates a character according to the control signal of the CPU 154 and outputs the generated character to the character superposition circuit 151. The CPU 154 is connected to a CPU 26A constituting the control circuit 26 via a connector 157 provided on the apparatus main body 2 by a communication cable 137 having one end connected to the connector 156, and can transmit and receive information.

The apparatus main body 2B is different from the apparatus main body 2 shown in FIG. 2 in that a type identification resistor Ri provided on each handpiece 3I and the like (the handpiece 3A is connected to the connector 9A in FIG. The resistance is provided with a resistance detection (type identification) circuit 161 for detecting the resistance value of Ra) and detecting the type.

The three input terminals of the resistance detection circuit 161 are connected to the type identification resistance Ri connected to the contact of the connector 8I via the contacts of the connectors 9A to 9C. That is, the resistance detection circuit 161 is connected to the connector 9
Handpieces 3I connected to A, 9B and 9C respectively
The resistance value is detected in accordance with the type of.

The resistance value detected by the resistance detection circuit 161 is input to the CPU 26A, and the CPU 26A reads the look-up table (LUT) 1 in which identification information is written in advance.
With reference to the information from 62, the type of the detected resistance value is identified. Instead of detecting the resistance value, the reference voltage may be divided by a known resistance value and a type identification resistor Ri, and the type may be identified based on the divided voltage value.

In the case of FIG. 15, it is identified that a Caesar type handpiece 3A is connected to the connector 9A (port A). The CPU 26A stores the identified handpiece type information and information on the port number to which the handpiece is connected in a register or the like in the CPU 26A.

The selection switch 10 of the apparatus body 2B
When an instruction to select a handpiece 3I to be used is given by the remote switch 5 or the remote switch 5, information on the port I to which the handpiece 3I is connected is transmitted to the control circuit 26.
Is input to the CPU 26A. When the selection instruction of the handpiece 3I is thus issued, the CPU 26A sends the handpiece type information indicating the type of the handpiece 3I and the information of the port number stored in the register or the like to the CPU 154, as shown in FIG. The handpiece type information and the port number can be displayed on the display surface of the monitor 136.

When the operator holds the handpiece 3I to be used in place of the selection instruction by the selection switch 10I or the like, the information of the port I to which the handpiece 3I is connected is detected by the sensor circuit 24I and the control is performed. The signal is sent to the CPU 26A of the circuit 26.

Also in this case, the CPU 26A sends the handpiece type information and the port number information to the CPU 154, and displays the handpiece type information and the port number on the display surface of the monitor 136.

As described in the first embodiment, when the handpiece 3I is held, the changeover switch 22 is set to a state where a drive signal can be output to the selected port I via the selection circuit 25. The contact i is switched.

As described above, in the present embodiment, when the handpiece 3I is selected or held, a drive signal can be output to the port I to which the handpiece 3I is connected as described in the first embodiment. The output line is switched as described above, and the type of the handpiece 3I and the port I
Is displayed on the monitor 136.

Then, while observing the endoscope image, the surgeon can move the eye to the apparatus main body 2B side and check the type of the selected or held handpiece 3I without confirming the selected handpiece or the like. It can be confirmed on the monitor 136 screen. In other words, in this case, even when a plurality of types of handpieces are used, the selected or held handpiece can be confirmed without fail, and the operability is improved.

The main operation of the present embodiment will be briefly described below. When performing a surgical operation under endoscopic observation, FIG.
As shown in FIG. 4, while preparing the endoscope apparatus 129, C
The communication cable 137 of the CU 135 is connected to the device main body 2B.

A plurality of or a single handpiece to be used in the surgical operation is connected to the apparatus main body 2B. For example, when the Caesar type handpiece 3A is connected to the port A (connector 9A) of the apparatus main body 2B as shown in FIG. 15, the resistance value of the type identification resistor Ra provided on the connector 8A is detected by the resistance detection circuit 161 and the CPU 26
Sent to A. The CPU 26A identifies that the Caesar type handpiece 3A is connected to the port A by referring to the identification information written in the LUT 162, and stores it in a register or the like therein.

When the hook type handpiece 3B is connected to the connector 9B, it is identified that the hook type handpiece 3B is connected to the port B, and the information is stored.

Then, the scope 130 and the handpiece 3
A or the like is inserted into the patient's abdomen via a trocar (not shown), and the affected part is observed. The endoscope image of the affected part is displayed on the monitor 13.
6, the operator observes the endoscopic image, and holds the Caesar-type handpiece 3A, for example, for use in surgery, and holds the handpiece 3A as described in the first embodiment. Detection signal corresponding to the sensor circuit 2
4A.

The sensor circuit 24A sends a selection signal held by the handpiece 3A to the selection circuit 25 based on the detection signal, and the selection circuit 25
It is determined that the selection signal has been input from the sensor circuit 24A in A, 24B and 24C.

As a result, the selection circuit 25 operates
A switching control signal is sent to the connector 2 so that the output line of the oscillation circuit 21 is connected to the connector 9A to which the held handpiece 3A is connected. The result selected by the selection circuit 25 is transmitted to the CPU 26A of the control circuit 26, displayed on the operation display panel 6, and notified by the speaker 12.

The result selected by the selection circuit 25 is C
When input to the PU 26A, the CPU 26A sends the selected handpiece type information and port number information to the CPU 154 of the CCU 135 via the communication cable 137.

CPU 154 generates character information corresponding to the transmitted information in character generation circuit 155, outputs the character information to character superposition circuit 151, and superposes the character information on the endoscope image. The video signal in which the character information is superimposed on the endoscope image is output to the monitor 136,
6 together with an endoscope image as shown in FIG.
The held handpiece type information and port number information are displayed.

In FIG. 16, for example, HP-1 is displayed as the handpiece type information, and port A is displayed as the port number.

Therefore, the operator can check the type of the held handpiece 3A and the output port thereof without moving the eyes while observing the endoscopic image displayed on the monitor 136. it can.

After the confirmation, the foot switch 4
, The ultrasonic wave is output from the tip of the selected handpiece 3A, and a treatment such as an incision can be performed.

When the treatment with the Caesar type handpiece 3A is stopped by holding the hook type handpiece 3B, the output line is switched to the handpiece 3B, and the monitor 136 displays the type of the handpiece. Information (for example, HP-2) and a port number (port B) are displayed.

When the trocar type handpiece 3C is held, the same display is performed.

Instead of holding the handpiece 3A, the user operates the selection switch 10I on the operation panel 7 or selects the selection switch 19 on the remote switch 5.
When I is operated, the changeover switch 22 is switched by the selection circuit 25. In this case as well, the selected handpiece type information and the port number are displayed on the monitor 136.

According to the present embodiment, when performing a surgical operation with an ultrasonic treatment tool while observing an endoscope image, the type of the ultrasonic treatment tool connected to each port is identified and the endoscope is used. Since the images are simultaneously displayed on the monitor screen displaying the mirror image, the type of the ultrasonic treatment instrument connected to each port can be confirmed without shifting the line of sight in the observation direction, and an environment in which surgery can be easily performed can be provided.

Further, in the present embodiment, it is possible to select and set a state in which treatment can be performed with the handpiece simply by holding the handpiece to be used. Thus, the treatment can be performed without removing the line of sight from the treated tissue. Also, there is an effect that the operator can select a handpiece in a clean area by himself.

In the above configuration, two types of character information can be displayed, but at least one type may be displayed. However, by displaying two pieces of information, when a port number is displayed, for example, when two handpieces of the same type are used, it is useful to confirm which handpiece is selected.

(Sixth Embodiment) Next, a sixth embodiment of the present invention will be described with reference to FIGS. The high frequency (under the endoscope) of the sixth embodiment shown in FIG.
The ultrasonic surgical system 161 is similar to the high frequency / ultrasonic surgical system 61 of the third embodiment of FIG.

This high frequency / ultrasonic surgical operation system 1
At 61, a patient 16 lying on an operating table 162
A counter electrode plate 164 is laid on 3.

The counter electrode plate 164 is connected to the high frequency output generator 165 by a cable. Patient 163
A rigid endoscope 166, a scissor-type handpiece 167A, a rod-shaped handpiece 167B, and a hook-type handpiece 167C are inserted into the abdomen through a sheath (not shown).

The scissors-type handpiece 167A, the rod-shaped handpiece 167B, and the hook-type handpiece 167C have almost the same structure as that described with reference to FIGS. 11A, 11B, and 11C. A treatment by a sound wave and a treatment by a high-frequency electric signal can be performed. In the present embodiment, the holding detection sensors 185a and 185, which will be described later, are further described.
b and 185c are provided respectively.

At the rear end of the rigid endoscope 166, a TV camera head 171 having a built-in image sensor is attached.
The camera 171 is connected to the CCU 172 and performs signal processing on the image sensor. And CCU
The standard video signal generated in 172 is transmitted to the TV monitor 173
And the endoscope image picked up by the image pickup device can be displayed on the display surface of the TV monitor 173.

The scissors-type handpiece 167A, the bar-shaped handpiece 167B, and the hook-type handpiece 167C are connected to an output switching unit 174 for switching the output.
75.

The high-frequency output generator 165 and the ultrasonic output generator 175 are connected to foot switches 176 and 177, respectively, so that high-frequency and ultrasonic output can be turned on / off.

The output switching unit 174 has, for example, three ports a, b, and c, and port selection switches 178a, 178b, and 17 for selecting the ports a, b, and c.
8c is connected to the remote switch 179.

The three ports a, b, and c are respectively composed of ultrasonic ports 181a, 181b, 181c and high-frequency ports 182a, 182b, 182c. The handpieces 167A, 167B, 167C are connected to these ports, respectively.

More specifically, the scissor-type handpiece 167
The A ultrasonic connector is connected to the ultrasonic output connector 181a of the output switching unit 174, and the A code (active code) is connected to the high frequency output connector 182a.
It is connected to the.

The ultrasonic connector of the rod-shaped handpiece 167B is the ultrasonic output connector 1 of the output switching unit 174.
The A code is connected to the high frequency output connector 182b. Hook type handpiece 1
The 67C ultrasonic connector is an output switching unit
The A code is connected to the high frequency output connector 182c.

The output switching unit 174 is the holding detection device 1
86, the generator 165 or 17
The drive output line 5 is switched to the port i to which the handpiece 167I is connected.

The output switching unit 174 is provided with selection display sections 183a, 183b, 183c for displaying the selection states of the ports a, b, c, respectively. In the present embodiment, handpieces 167A, 167
B and 167C are respectively provided with holding detection sensors 185a, 185b and 185c for detecting (or recognizing) the holding state.

Specifically, the scissor-type handpiece 167
A has a sensor 185a on the operation handle portion, and a sensor 185a on the outer peripheral surface of the grip portion held by the operator on the rod-shaped handpiece 167B and the hook type handpiece 167C.
b, 185c. Each sensor 185a-185
The output of c is input to the holding detection device 186, and the holding detection device 186 transmits to the output switching unit 174 a signal for selecting the handpiece whose holding has been detected. Then, the held handpiece is brought into a usable state.

The output switching unit 174 is connected to the CPU 187 in the CCU 172 by a communication cable. The output switching unit 174 transmits to the CPU 187 the information on the port i of the handpiece 167I held by the holding / detecting device 186 to the CPU 187. . CPU 187 is C
By controlling the character actor generating means and the like of the CU 172, the port i selected and used is displayed so as to be superimposed on the endoscope image displayed on the monitor 173.

As described above, handpieces 167A-16
7C has substantially the same structure as that described with reference to FIGS. 11A to 11C, but for example, a scissor-type handpiece 167.
The schematic structure of A is as shown in FIG.

An operation unit 190 provided with an operation handle 189 protruding therein accommodates an ultrasonic vibrator 191 that vibrates ultrasonically. The ultrasonic vibrator 191 is connected to the ultrasonic vibrator 191 via an ultrasonic drive line 192. An ultrasonic drive signal is applied. Then, the ultrasonic vibration of the ultrasonic vibrator 191 vibrates the fixed blade 194 a of the treatment section 194 at the distal end thereof via the ultrasonic transmission rod 193.

The movable blade of the treatment section 194 is
By performing an operation of gripping and opening and closing 9, the operation is transmitted to the distal end side via the operation wire 195, and the movable blade rotates around the fulcrum. Then, ultrasonic waves are applied to the tissue gripped by the fixed blade 194a and the movable blade so that the tissue can be cut off or the like. Further, the ultrasonic transmission rod 193 is electrically connected to the high frequency output line 196,
A high-frequency current can be applied to the ultrasonic transmission rod 193. Then, high-frequency treatment can be performed on the tissue via the fixed blade 194a.

The operation handle 189 has a sensor 18.
5a is attached, and the sensor 185a is connected to the holding / detecting device 186 via a sensor line 197. Other configurations are the same as those described in the third embodiment and those described in the fifth embodiment.

This embodiment is different from the third embodiment in that the port i of the handpiece 167I which is further held is provided.
Is displayed on the monitor 173.

Next, the operation of the present embodiment will be briefly described. Each device is connected as shown in FIG. Then, the operator inserts the rigid endoscope 166, the scissor-type handpiece 167A, the rod-shaped handpiece 167B, and the hook-type handpiece 167C into the body of the patient 163, and inserts the distal end of each handpiece into the rigid endoscope 166. To be able to observe. That is, an image observed by the rigid endoscope 166 is captured by the TV camera head 171 and is output by the CCU 172.
Is converted to a standardized video signal by the TV monitor 173.
Is displayed on the display surface of.

The operator grasps (holds) the scissor-type handpiece 167A from each of the handpieces 167A to 167C in order to move the scissor-type handpiece 167A to a desired position in the operation section while viewing the image on the TV monitor 173. ).

Then, the output state of the sensor 185a is changed by the gripping, and the holding detecting device 186 detects that the sensor 185a of the scissor-type handpiece 167A is gripped. Then, a corresponding detection signal is output to the output switching unit 174.

Then, the output switching unit 174 sets the drive output lines of the generators 165 and 175 to a state where the drive output lines of the generators 165 and 175 are electrically connected to the port a to which the scissor type handpiece 167A is connected, and turns on the selection display section 183a to turn on the port a. Indicates that is selected.

Therefore, in this state, the foot switch 176
Alternatively, when the 177 is operated, the generator 165 is operated.
Alternatively, the drive output of 175 can be output to the handpiece 167A connected to the port a.

The signal detected by the holding / detecting device 186 is output to the CP of the CCU 172 via the output switching unit 174.
It is sent to U187. The CPU 187 generates character information of the detected port a, and displays the port a on the monitor 173 as shown in FIG. Therefore, the operator switches the eyes to the output switching unit 1 while observing the endoscope image.
It is possible to confirm that the port a to which the handpiece 167A is connected is selected without moving to the 74 side and confirming that the port a is selected. The same operation is performed when another handpiece 167B or 167C is gripped.

[0166] In the above description, the case of gripping is described, but the remote switch 179 may be operated. For example, when the port selection switch 178a is pressed, the output line is switched and the port a is displayed as in the case where the handpiece 167A is held.

Therefore, this embodiment has a plurality of handpieces 167A to 167C in addition to the effects of the third embodiment.
Of the remote switch 17
9 or the recognition by the holding / detecting device 186, the selected result is sent to the CCU 172, and the information of the port is displayed on the screen of the TV monitor 173 in the endoscopic image in a superimposed manner. Thus, the surgeon can recognize the handpiece to be used without moving his eyes from the observation state of the endoscope image. It should be noted that the present invention also includes embodiments and the like configured by partially combining the above-described embodiments.

[Supplementary Notes] In a surgical operation system provided with a main body portion provided with a handpiece connection portion for detachably connecting a plurality of handpieces, and a driving unit for supplying a drive signal to the handpiece connected to the handpiece connection portion, A holding unit provided in each of the plurality of handpieces, a holding detection unit provided in each holding unit, and switching of the output of the drive signal to the handpiece connection unit based on a detection signal of the holding detection unit. A surgical operation system, comprising: output switching means. 2. In Supplementary Note 1, in the surgical operation system, the plurality of handpieces each include an ultrasonic vibrator, and the driving unit provided in the main body unit outputs an ultrasonic driving signal for driving the ultrasonic vibrator. It is an ultrasonic surgery system.

3. In a surgical operation system in which a plurality of handpieces are connected to one driving device so as to be connectable, and one of the handpieces can be selected for treatment.
A drive device for generating treatment energy, switching means provided in the drive device for activating one of the plurality of handpieces, output control means for controlling the output of treatment energy, and each handpiece And a switching unit based on a signal from the holding detection unit for detecting a held handpiece, and output from the handpiece held by the operator by the output control unit. Surgical system characterized by things.

4. In Supplementary Note 3, the holding detecting means detects a change in capacitance, the handpiece has at least two metal electrodes, and the driving device has a detecting means for detecting a change in capacitance between the electrodes. is there. 5. In Supplementary Note 3, the holding detecting means detects a change in infrared light, the handpiece includes an infrared sensor, and the driving device includes a detecting means for detecting a change in a signal from the infrared sensor. 6. In Appendix 3, a light emitting element is provided at the tip of the handpiece, and the light emitting element at the tip of the selected handpiece emits light.

[0171] 7. In a surgical operation system provided with a main body portion provided with a handpiece connection portion for detachably connecting a plurality of handpieces, and a driving unit for supplying a drive signal to the handpiece connected to the handpiece connection portion, Holding parts provided in each of the plurality of hand pieces,
A surgical operation system comprising: a holding detection unit provided in each holding unit; and a display unit for displaying a detection result of the holding detection unit.

8. In a surgical operation system provided with a main body portion provided with a handpiece connecting portion for detachably connecting a plurality of handpieces, and a driving step for supplying a driving signal to the handpiece connected to the handpiece connecting portion. A surgical operation system comprising: a selection unit for selecting the plurality of handpieces; and an output switching unit for switching the output of the drive signal based on a detection signal of the selection unit.

9. A plurality of handpieces each emitting a predetermined energy, a drive signal generating means for issuing a drive signal for driving the plurality of handpieces, and an output destination of the drive signal to any of the plurality of handpieces Output switching means for switching, a selection signal generating means provided in each of the plurality of handpieces, which issues a selection signal indicating that any of the plurality of handpieces has been selected, and home,
Notifying means for notifying information related to the handpiece provided with the selection signal generating means for emitting the selection signal,
Switching control means for controlling the switching means to switch an output destination of the drive signal to a handpiece provided with a selection signal generating means for emitting the selection signal among the plurality of handpieces. An energy surgery system, comprising:

9-1. In the energy surgery system according to Supplementary Note 9, the selection signal generating unit is provided in each of the plurality of handpieces, which detects that the holding units of the plurality of handpieces are held when the holding units are held. Holding detection means, when the holding detection means detects that the holding unit is held, outputs a selection signal to the switching control means, holding detection means provided in each of the plurality of hand pieces, Consists of

9-2. In the energy surgery system according to Supplementary Note 9, imaging means for imaging a predetermined observation region, signal processing means for generating a predetermined video signal based on an imaging signal imaged by the imaging means, and a video signal from the signal processing means A display unit for displaying a predetermined observation image based on the display unit, and information related to a handpiece provided with a selection signal generating unit that emits the selection signal on the observation image displayed on the display unit. Means. 9-3. In the energy surgery systems of Supplementary Notes 9, 9-1 and 9-2, the notifying unit notifies the operating state of the handpiece.

10. A plurality of handpieces each emitting a predetermined energy; a drive signal generating means for generating a drive signal for driving the plurality of handpieces; a drive signal generating means for any one of the plurality of handpieces; Output switching means for switching the output destination of the signal, holding portions provided in each of the plurality of handpieces, and when the holding portion is held, detecting that the holding portion has been held and detecting a predetermined holding detection signal. The drive signal is supplied to the handpiece provided with the holding detection unit that emits the holding detection signal among the plurality of handpieces. And an output switching means for controlling the switching means so as to switch the output destination.

10-1. The energy surgery system according to attachment 10, further comprising a notification unit that notifies information related to the handpiece provided with the holding detection unit that emits the holding detection signal among the plurality of handpieces. 10-2. In the energy surgery system according to Supplementary Notes 10 and 10-1, the energy surgery system includes an imaging unit configured to image a predetermined observation region, and a signal processing unit configured to generate a predetermined video signal based on an imaging signal captured by the imaging unit. Display means for displaying a predetermined observation image based on a video signal from the signal processing means; and selection signal generation means for emitting the selection signal for the observation image displayed on the display means. And superimposing means for superimposing information related to the handpiece.

10-3. In the energy surgery system according to Supplementary Note 10, the driving signal generation unit supplies a high-frequency output driving signal to the handpiece and supplies an ultrasonic output driving signal to the handpiece. And a switching means for switching between a drive signal from the high-frequency output means and a drive signal from the ultrasonic output means.

(11) Energy generating means for generating predetermined energy based on a driving signal generated by predetermined driving signal generating means, a handpiece main body including the energy generating means, a holding section provided on the handpiece main body, and the holding section includes: A holding detection unit provided in the handpiece main body, which detects the holding and issues a predetermined holding detection signal when held, and when the holding detection unit emits the holding detection signal. And a drive signal input means for receiving a drive signal from the predetermined drive signal generation means and sending the drive signal to the energy generation means. 11-1. In the energy surgery system according to attachment 11,
There is further provided a notifying unit for notifying that the holding unit is being held when the holding detection preliminary stage issues the holding detection signal.

[0180]

As described above, according to the present invention, there are provided a main body having a handpiece connecting portion for detachably connecting a plurality of handpieces, and a handpiece connected to the handpiece connecting portion. In a surgical operation system provided with a driving unit that supplies a driving signal, a holding unit provided in each of the plurality of handpieces, a holding detection unit provided in each holding unit, and a detection signal of the holding detection unit. ,
Output switching means for switching the output of the drive signal to the handpiece connection part, so that the operator outputs a drive signal to the handpiece actually held by the holding part, The treatment can be performed with the held handpiece without performing any operation or the like, and the operability can be improved.

[Brief description of the drawings]

FIG. 1 is a diagram showing an overall configuration of an ultrasonic operation system according to a first embodiment of the present invention.

FIG. 2 is a block diagram showing an internal configuration of an apparatus main body.

FIG. 3 is a diagram illustrating a configuration of a holding detection unit.

FIG. 4 is a perspective view showing a handpiece portion provided with a holding detection sensor.

FIG. 5 is a circuit diagram showing a circuit configuration of a capacitance sensor circuit constituting the holding detection means.

FIG. 6 is a flowchart showing processing contents of an output port selection processing.

FIG. 7 is a diagram illustrating a configuration of a holding detection unit according to a modification.

FIG. 8 is a perspective view showing a distal end portion of the scissors type handpiece.

FIG. 9 is a diagram showing an overall configuration of an ultrasonic operation system according to a second embodiment of the present invention.

FIG. 10 is a diagram showing an overall configuration of a surgical operation system according to a third embodiment of the present invention.

FIG. 11 is a view showing various hand pieces.

FIG. 12 is a diagram showing a main part of a surgical operation system according to a fourth embodiment of the present invention.

FIG. 13 is a diagram showing a configuration of an output switching unit main body and an extension unit of FIG. 13;

FIG. 14 is a diagram showing an overall configuration of a surgical operation system according to a fifth embodiment of the present invention.

FIG. 15 is a block diagram showing an internal configuration of a camera control unit and the like.

FIG. 16 is a view showing a state where port information and the like are displayed on a monitor.

FIG. 17 is a diagram showing an overall configuration of a surgical operation system according to a sixth embodiment of the present invention.

FIG. 18 is a diagram showing a schematic configuration of a scissor-type handpiece.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 ... Ultrasonic surgery system 2 ... Device main body 3A ... Scissors type handpiece 3B ... Hook type handpiece 3C ... Trocar type handpiece 4 ... Foot switch 5 ... Remote switch 6 ... Operation table panel 7 ... Operation panel 8 ... Cable 8A- 8C ... Connector plug 9A-9C ... Connector 10A-10C ... Selection switch 6A ... Selection switch 8 ... Selection button 12 ... Speaker 18A-18C ... Sensor 21,35 ... Oscillation circuit 22 ... Changeover switch 24A-24C ... Sensor circuit 25 ... Selection Circuit 26 Control circuit 30 Detector 31 Electrode 32a Movable handle 32b Fixed handle 36 Wheatstone bridge 37 Comparator 38 Filter

 ──────────────────────────────────────────────────続 き Continuing on the front page (72) Inventor ▲ Taka ▼ Hiroyuki 2-43-2 Hatagaya, Shibuya-ku, Tokyo Inside Olympus Optical Industrial Co., Ltd. (72) Inventor Makoto Miyawaki 2-43 Hatagaya, Shibuya-ku, Tokyo No. 2 Inside Olympus Optical Kogyo Co., Ltd. (72) Keiji Shioda Inventor 2-43-2 Hatagaya, Shibuya-ku, Tokyo (72) Inventor Takashi Ozaki 2-43 Hatagaya, Shibuya-ku, Tokyo No. 2 Inside Olympus Optical Co., Ltd. (72) Inventor Takeaki Nakamura 2-43-2, Hatagaya, Shibuya-ku, Tokyo F-term inside Olympus Optical Co., Ltd. (Reference) 4C060 JJ11 JJ17 JJ25 KK01 KK03 KK04 KK15 KK15 KK22

Claims (3)

[Claims] 1. A main body having a handpiece connecting portion for detachably connecting a plurality of handpieces, and a driving means for supplying a driving signal to the handpiece connected to the handpiece connecting portion. In the surgical operation system, a holding unit provided in each of the plurality of handpieces, holding detection means provided in each holding unit, and the driving unit with respect to the handpiece connection unit based on a detection signal of the holding detection unit. A surgical operation system, comprising: output switching means for switching an output of a signal. 2. A main body having a handpiece connecting portion for detachably connecting a plurality of handpieces, and a driving means for supplying a driving signal to the handpiece connected to the handpiece connecting portion. A surgical operation system, comprising: a holding unit provided in each of the plurality of handpieces; a holding detection unit provided in each holding unit; and a display unit displaying a detection result of the holding detection unit. And surgical system. 3. A main body having a handpiece connecting portion for detachably connecting a plurality of handpieces, and a driving step for supplying a driving signal to the handpiece connected to the handpiece connecting portion. A surgical operation system, comprising: selecting means for selecting the plurality of handpieces; and output switching means for switching the output of the drive signal based on a detection signal of the selecting means. Surgery system.