JP2002065692A - Electric operation apparatus - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an electric operation apparatus which conducts thermal coagulation of tissues by a high-frequency current, and doesn't make a high-frequency current flow by drying surrounding tissues of a part where electricity is turned on. SOLUTION: An operator holds the grip 50 of a handpiece 22 and inserts a cannula 52 into an operation part. By a high-frequency current flowed from the part of turning on electricity 74 at the end of the cannula 52, tissues around the part of turning on electricity 74 are coagulated thermally. The inside of the cannula 52, which is used as a circulation path 76 of moist liquid, is constituted to be hollow. A pump part of the apparatus body sends out a physiological saline solution as a, moist liquid, and this moist liquid is poured out of the grip 50 into the circulation path 76. The moist liquid is sent through the circulation path 76 and out of a discharge 78 set at the part of turning on electricity 74 and poured into tissues, and aridity of tissues is prevented.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an electrosurgical device for performing electrosurgery on tissue with high-frequency current.

[0002]

2. Description of the Related Art Electrosurgery is performed by an operator operating a handpiece constituting an electrosurgical instrument. The operator grips the grip provided on the base end side of the elongated handpiece, and abuts the current-carrying part provided on the distal end with the surgical site. The current-carrying portion is an electrode for flowing a high-frequency current through the living tissue, and electric surgery such as incision and coagulation of the portion is performed by heat generated by the high-frequency current from the current-carrying portion. FIG. 5 is a schematic cross-sectional view of a current-carrying portion at the tip of a handpiece of a conventional electrosurgical instrument. The outer shell of the power supply unit 2 is an electrode formed of metal, and is supplied with a high-frequency current from an electrosurgical instrument main unit connected to a grip (not shown). The inside of the current-carrying part 2 is formed hollow, and the temperature sensor 4 is disposed in the hollow part. In addition, the hollow portion continues from the grip portion, in which a pipe 6 is provided along the axis of the handpiece to form a double pipe structure. The outer space 8 and the inner space 10 of this double pipe are used for circulation of cooling water. For example, the cooling water supplied from the electrosurgical instrument main body reaches the distal end through the outer space 8 from the gripping part side. Then, the heat of the current-carrying portion is removed, and the heat-returning portion returns to the grip portion side via the inner space 10 and is discharged to the outside of the handpiece.

[0003] With this configuration, when the temperature of the energizing section 2 is detected to be higher than a predetermined limit by the temperature sensor 4, the electrosurgical instrument main body increases the flow rate of cooling water in the handpiece shaft. So that the temperature of the energizing section 2 is lowered. This prevents the temperature of the current-carrying part 2 from becoming unnecessarily high and prevents the tissue from being scorched on the current-carrying part 2.

[0004]

An electrosurgical device is used in an operation for heat coagulation and necrosis of, for example, a cancer tissue by heat generated by a current-carrying part. Here, in the conventional electrosurgical device, when the tissue around the energized portion is thermally coagulated, there is a problem in that the tissue dries at that portion, making it difficult for electric current to flow, and making coagulation outward more difficult.

SUMMARY OF THE INVENTION The present invention has been made to solve the above problems, and has as its object to provide an electrosurgical instrument capable of easily performing a wide range of heat coagulation surgery.

[0006]

According to the present invention, there is provided an electrosurgical device which is an electrode which is in contact with a tissue and which is energized by applying a high-frequency current to the tissue to perform electrosurgery on the tissue; Tissue wetting means for supplying a wetting liquid to the tissue in contact with the tissue.

According to the present invention, the wetting liquid is supplied to the tissue around the current-carrying portion which is thermally coagulated, and is prevented from drying even after the heat coagulation. As a result, the high-frequency current from
The thermal coagulation proceeds over a wide range without being disturbed by the heat-coagulated tissue and is transmitted to the outer tissue.

In another electrosurgical device according to the present invention,
The energization section is formed at the distal end, and a grip section to be gripped by an operator is formed at the proximal end side, and the tissue wetting means includes a supply source of the wetting liquid connected to the grip section, And a flow passage for guiding the wetting liquid to the tissue near the conducting section.

According to the present invention, the operator performs an operation using a basically elongated handpiece having a conducting portion formed at the distal end and a grip portion formed at the base end side. The wetting liquid is supplied to the handpiece from a supply source via, for example, a tube or the like. The source is connected to the flow passage at the grip located opposite the surgical site. The flow passage extends from the grip portion to the tip of the handpiece, and the wetting liquid supplied from the supply source reaches the operation tissue near the tip of the handpiece by the flow passage.

[0010] In another aspect of the electrosurgical instrument according to the present invention, a discharge port through which the wetting liquid is discharged is formed on a surface of the energizing section.

According to the present invention, the flow passage is formed inside the current-carrying portion, and the discharge port is provided at the end of the flow passage. The wetting liquid that has reached the current-carrying part via the flow passage is discharged from the discharge port on the surface to the tissue. The discharge port can be basically provided at an arbitrary position on the surface of the energizing section. That is, since the flow passage is not arranged on the surface of the current-carrying portion, the current-carrying portion and the tissue can be in good contact with each other, and the wetting liquid can be supplied to any location on the surface of the current-carrying portion.

In a preferred aspect of the present invention, the electrosurgical instrument is characterized in that a plurality of the discharge ports are formed along the periphery of the energizing section. According to this aspect, it becomes easy to effectively spread the wetting liquid to the entire tissue with which the current-carrying portion comes into contact.

According to another aspect of the present invention, there is provided an electrosurgical device, comprising: a temperature sensor for detecting a temperature of the current-carrying portion; and control means for controlling injection of the wetting liquid into the tissue based on an output of the temperature sensor. It has.

There is a correlation between the temperature of the current-carrying part and the drying of the tissue in the vicinity thereof. For example, it can be said that the higher the temperature, the faster the drying proceeds. According to the present invention, the control means controls the supply of the wetting liquid to the tissue based on the temperature of the current-carrying part detected by the temperature sensor, and suitably prevents the drying of the tissue due to the conduction of the high-frequency current.

According to still another aspect of the present invention, there is provided an electrosurgical device, comprising: impedance detecting means for detecting impedance of the tissue in the vicinity of the energizing portion; and the wetting liquid for the tissue based on an output of the impedance detecting means. And control means for controlling the injection of.

There is a correlation between the degree of desiccation of the tissue near the conducting part and the impedance of the tissue. For example, as the coagulation proceeds and the tissue dries, the impedance increases. According to the present invention, the impedance detecting means detects, for example, the impedance between the current-carrying part and the return electrode plate,
Monitor the impedance of the tissue near the conducting part. The control means controls the supply of the wetting liquid to the tissue based on the output of the impedance detection means, and suitably prevents the drying of the tissue due to the conduction of the high-frequency current.

In still another electrosurgical instrument according to the present invention, the control means determines the amount of high-frequency current supplied to the current-carrying part and the amount of wetting fluid injected into the tissue based on the output of the temperature sensor. It is characterized by controlling.

According to the present invention, the control unit controls the injection amount of the wetting liquid and the high-frequency current amount based on the detected temperature of the current-carrying unit.

In a preferred aspect of the present invention, the control means includes:
Based on the temperature of the current-carrying part reaching a predetermined upper limit temperature, the supply of current to the current-carrying part is stopped, and wetting liquid injection into the tissue is started. An electrosurgical device characterized in that the current supply is started and the injection of the wetting liquid is stopped based on reaching a lower limit temperature.

[0020] In the electrosurgical instrument according to the present invention, the tissue wetting means injects a conductive liquid as the wetting liquid into the tissue.

The wetting liquid prevents the drying of the tissue, thereby ensuring the conductivity of the high-frequency current from the conducting part to the tissue. ADVANTAGE OF THE INVENTION According to this invention, by making a wetting liquid itself electroconductive, better electroconductivity is ensured and it becomes possible to advance thermocoagulation over a wider range. For example, physiological saline can be used as the conductive wetting liquid.

[0022]

Next, embodiments of the present invention will be described with reference to the drawings.

FIG. 1 is a schematic diagram showing a schematic configuration of an electrosurgical instrument according to the present invention. This electrosurgical instrument is of a unipolar type, and has an apparatus main body 20, a handpiece 22 and a return electrode plate 24 connected thereto. Device body 20
Is configured to include a control unit 30, a high-frequency generation unit 32, a pump unit 34, a liquid reservoir 36, and a temperature display unit 38.

The handpiece 22 has a grasping portion 50 to be grasped by an operator, and a cannula 52 formed in a thin needle shape and punctured at an operation portion. An energization unit is provided at the tip of the cannula 52.

One output terminal of the high-frequency generator 32 is connected to the handpiece 22 via the power line 60, and the other output terminal is connected to the return electrode plate 24. The high-frequency generator 32 generates a high-frequency voltage, and the high-frequency voltage is applied between the current-carrying part of the handpiece 22 and the return electrode plate 24. As a result, a high-frequency current is supplied from the current-carrying part to the tissue of the operative part, and an electric operation is performed. This device exclusively inserts the current-carrying part into the surgical tissue such as cancer tissue in the living body, and heat-coagulates the surgical tissue by the heat generated by the high-frequency current.
Used for necrotic uses.

The pump section 34 sends out the physiological saline prepared in the liquid reservoir 36 to the handpiece 22 through the tube 62.

The control unit 30 controls the operation of the high frequency generator 32 and the pump unit 34. As will be described later, a temperature sensor is provided in the conducting portion of the handpiece 22, and an output signal thereof is input to the control unit 30 via the signal line 64. The control unit 30 detects the temperature T of the tissue around the energization unit based on the output of the temperature sensor. The control unit 30 displays the detected temperature T on the temperature display unit 38, and can control the amount of high-frequency current and the amount of physiological saline supplied to the tissue based on the temperature.

FIG. 2 is a schematic sectional view of the handpiece 22. The cannula 52 has a structure in which the elongated needle-like electrode 70 is covered with an insulating coating 72. The electrode 70 at the distal end of the cannula 52 is exposed without being covered with the insulating coating 72, and this portion becomes a current-carrying portion 74 that can be in electrical contact with the operative tissue.

The electrode 70 has a hollow structure and the tube 62
The physiological saline injected into the grip portion 50 from the
The inside is guided to the current supply unit 74 as a flow passage 76. Micropores are formed in the electrode walls constituting the current supply unit 74. These pores function as a discharge port 78 for discharging the physiological saline guided to the power supply unit 74 by the flow passage 76 to the tissue near the power supply unit 74. For example, a plurality of discharge ports 78 can be provided dispersedly in the circumferential direction and the axial direction of the conducting section 74.

The temperature sensor 80
Are used to measure the temperature around the conducting section 74. The temperature sensor 80 is molded with a sealing member 82 such as a silicone resin to prevent direct contact with physiological saline. Thereby, the temperature sensor 80
Is hardly affected by the temperature of the physiological saline, and the temperature of the tissue around the current-carrying unit 74 can be accurately measured.

The output of the temperature sensor 80 is transmitted to the control unit 30 via a signal line 64. The signal line 64 is guided toward the grip 50 through the inside of the electrode 70 which is a flow path 76, pulled out from the grip 50, and connected to the controller 30.

In the grip 50, the high-frequency generator 3
Power lines 60 from 2 are connected to electrodes 70. One end of a plug portion 90 made of an insulating material is connected to an end of the electrode 70 on the grip portion 50 side. The plug portion 90 is formed hollow and communicates with the hollow of the electrode 70. The opposite end of the plug part 90 protrudes from the side of the grip part 50, and the tube 62 from the pump part 34 is connected to this protruding part 92. As a result, the flow passage 76 in the electrode 70 is
4 is connected.

The plug portion 90 is provided with a hole 94 for drawing out the signal line 64 from the flow passage 76. Signal line 6
4 and the power line 60 can be bundled into one cable 96 and connected to the apparatus main body 20.

FIG. 3 is a schematic control flow chart of the present apparatus. At the start of use of the apparatus, the user can set or change the heating target range by the power supply unit 74 as needed by operating the operation panel of the apparatus main body 20. Thereby, the upper limit temperature T _MAX and the lower limit temperature T _{MIN of the} heating control are set in the control unit 30 (S100). The control unit 30 determines an initial value I ₀ of the high-frequency current I according to the set heating target range (S105). Control unit 30
Is, for example, the intermediate temperature of the heating target range (T _MAX +
The initial current value I ₀ is adjusted according to T _MIN ) / 2.

Turning on / off the energization of the high-frequency current to the energizing section 74
The turning off is performed by the operator operating the energizing switch. For example, a foot switch (not shown in FIG. 1) can be used as the energizing switch. When the operator depresses the foot switch, the operation is turned on and the energization is started. When the operator stops pressing the foot switch, the operation is turned off and the energization is stopped. Is done. When the energizing switch is turned on (S110), the control unit 3
0 controls the high-frequency generator 32 to supply the high-frequency current of the set current value I to the conduction unit 74 (S11).
5). Incidentally, at the time when the energization is started, the set value of the current is an initial current value I _0. Further, the control unit 30 controls the driving / stopping of the pump unit 34 according to the pump control state set based on the tissue temperature T described later (S12).
0). When the pump control state is set to “drive”, the pump unit 34 is driven to supply the physiological saline from the liquid reservoir 36 to the handpiece 22 at a predetermined flow rate. Conversely, when the pump control state is set to “stop”, the pump unit 34 is stopped and the liquid reservoir 36 is stopped.
Then, the supply of the physiological saline to the handpiece 22 is stopped. At the start of the operation of the device, the pump control state is set to "stop".

The controller 30 monitors the temperature T of the tissue around the power supply 74 based on the output from the temperature sensor 80.
If the temperature T is lower than the lower limit temperature T _MIN (S12
5) The set value of the high-frequency current I is increased by a predetermined amount (S
130) After setting "stop" in the pump control state (S135), the process returns to step S110.

On the other hand, in step S125, the temperature T
Is higher than the lower limit temperature, the process proceeds to step S140. In step S140, the temperature T becomes the upper limit temperature T _MAX
If so, the set value of the high-frequency current I is reduced by a predetermined amount (S145), and "drive" is set in the pump control state (S150), and the process returns to step S110.

If the temperature T is between the lower limit temperature T _MIN and the upper limit temperature T _MAX (S140), the process returns to step S110 with the high-frequency current I and the pump control state set as they are.

In step S110, if the energizing switch is still on, the control unit 30 controls the high frequency generating unit 32 so that the high frequency current I given as the set value at that time is supplied to the energizing unit 74. (S11
5) In addition, drive / stop of the pump unit 34 is controlled according to the pump control state set at that time (S12).
0). On the other hand, if the energizing switch is in the off state, the control unit 30 stops the high frequency generation unit 32 and the pump unit 34,
The supply of the high-frequency current and the physiological saline to the power supply unit 74 is stopped (S155, S160).

According to the above control, when the temperature T of the tissue around the power supply 74 exceeds a predetermined upper limit, the high-frequency current is reduced to lower the temperature, and the physiological saline is supplied to the power supply 74. By injecting into surrounding tissue, drying of the tissue is prevented and high-frequency current flows over a wide range, so that thermal coagulation of the tissue proceeds over a wide range. On the other hand, when the temperature T of the tissue in the vicinity of the conducting unit 74 falls below a predetermined lower limit, the high-frequency current is increased, and the injection of the physiological saline is stopped to avoid cooling of the tissue due to the injection. As a result, the temperature of the tissue is increased, and the progress of thermal coagulation is achieved.

In the above control loop, when it is detected that the temperature T is lower than the lower limit temperature T _MIN , the supply of the physiological saline is stopped, and when it is detected that the temperature T is higher than the upper limit temperature T _MAX. , The supply of physiological saline was started. Instead, every time the temperature T is detected to be lower than the lower limit temperature T _MIN , the supply amount of the physiological saline is decreased by a predetermined amount, and it is detected that the temperature T is higher than the upper limit temperature T _MAX. Each time it is performed, the supply amount of the physiological saline may be increased by a predetermined amount.

In the above-described embodiment, the temperature sensor 80 is provided in the energizing section 74, and the degree of drying of the tissue is detected based on the temperature of the tissue in the vicinity of the energizing section 74 obtained by this.
It controlled the volume of saline injected. on the other hand,
The degree of desiccation of the tissue can also be detected by the electrical impedance of the tissue. That is, it is detected that the drying of the tissue has progressed because the impedance has increased. For example, the control unit 30 includes the power supply unit 74 and the return electrode plate 2.
4 is obtained from the high-frequency generator 32, and the impedance is detected. For example, a predetermined upper limit value R _MAX and a lower limit value R _MIN are set for the impedance,
These can be used in place of the above-mentioned upper limit temperature T _MAX and lower limit temperature T _MIN to control the injection amount of the physiological saline so as to prevent the drying of the tissue in the vicinity of the power supply unit 74. In this case, the temperature sensor 80 can be omitted.

FIG. 4 is a schematic sectional view of a cannula portion according to another embodiment. In this configuration, the handpiece has a plurality of electrodes 200. The cannula 202, for example, with the electrode 200 housed in an insulating tube 204,
A puncture is made into the surgical site where a thermocoagulation operation is performed. When the current is supplied, the distal end of the electrode 200 is deployed from the tube 204 into the tissue, and the distal end becomes the current supply unit 74.

Each of the electrodes 200 is hollow like the electrode 70, and the inside is formed as a passage 76 for physiological saline. Physiological saline injected into the flow passage 76 from the rear end of the handpiece is discharged to the tissue from a discharge port 78 provided at the distal end of the electrode 200. In the figure, a temperature sensor 80 is disposed at the tip of each electrode 200, and its output is
The signal is transmitted to the control unit 30 by the signal line 64 passed through the inside of the control unit 6.

[0045]

According to the present invention, since the wetting liquid is supplied to the tissue around the current-carrying part, the tissue around the current-carrying part, which tends to become high-temperature due to the concentration of the high-frequency current and easily dry, is prevented. . By preventing the desiccation, the high-frequency current is transmitted to a wide range of tissues, and the effect of the operation by the heat coagulation of the electrosurgical device of the present invention can be exerted on a wider range.

[Brief description of the drawings]

FIG. 1 is a schematic diagram showing a schematic configuration of an electrosurgical instrument according to the present invention.

FIG. 2 is a schematic sectional view of a handpiece.

FIG. 3 is a schematic control flowchart of the present apparatus.

FIG. 4 is a schematic sectional view of a cannula portion according to another embodiment.

FIG. 5 is a schematic cross-sectional view of a current-carrying portion at the tip of a handpiece of a conventional electrosurgical instrument.

[Explanation of symbols]

20 main body, 22 handpiece, 24 counter electrode,
30 control part, 32 high frequency generation part, 34 pump part, 3
6 liquid reservoir, 38 temperature display, 50 gripper, 5
2,202 cannula, 70,200 electrode, 72
Insulation coating, 74 conducting part, 76 flow passage, 78 discharge port, 80 temperature sensor.

 ────────────────────────────────────────────────── ─── Continuing on the front page (72) Inventor Shigeo Kimura 6-22-1, Mure, Mitaka-shi, Tokyo Aloka F-term (reference) 4C060 KK04 KK09 KK13

Claims (9)

[Claims] 1. An electrode which is in contact with a tissue, an energizing section for applying a high-frequency current to the tissue to perform electrosurgery on the tissue, and a tissue wetting for supplying a wetting liquid to the tissue in contact with the energizing section. An electrosurgical device comprising: means. 2. The electrosurgical instrument according to claim 1, wherein the energizing portion is formed at a distal end, and a grip portion gripped by an operator is formed at a proximal end side, and the tissue wetting means is provided at the grip portion. An electrosurgical device, comprising: a connected supply source of the wetting liquid; and a flow passage that guides the wetting liquid from the grip portion to the tissue near the energizing portion. 3. The electrosurgical device according to claim 2, wherein a discharge port through which the wetting liquid is discharged is formed on a surface of the current-carrying portion. 4. The electrosurgical device according to claim 3, wherein a plurality of the discharge ports are formed along a periphery of the current-carrying portion. 5. The electrosurgical instrument according to claim 1, wherein a temperature sensor for detecting a temperature of the power supply unit, and the wetting of the tissue based on an output of the temperature sensor. An electrosurgical device comprising: control means for controlling liquid injection. 6. The electrosurgical instrument according to claim 1, wherein impedance detecting means for detecting an impedance of the tissue near the current-carrying portion, and an output of the impedance detecting means. Control means for controlling the injection of the wetting fluid into the tissue. 7. The electrosurgical instrument according to claim 5, wherein the control means controls the amount of high-frequency current supplied to the energizing unit and the amount of wetting fluid injected into the tissue based on the output of the temperature sensor. An electrosurgical device characterized by the following. 8. The electrosurgical device according to claim 7, wherein the control unit stops supplying current to the energizing unit based on the fact that the temperature of the energizing unit has reached a predetermined upper limit temperature, and Starting the wetting liquid injection into the tissue, while starting the current supply and stopping the wetting liquid injection based on the fact that the temperature of the current-carrying unit has reached a predetermined lower limit temperature, And an electrosurgical instrument. 9. The electric surgical instrument according to claim 1, wherein the tissue wetting means injects a conductive liquid as the wetting liquid into the tissue. Surgical instrument.