JP2002306507A - Device for operation, and method for preventing attachment of foreign material for the same - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a device for operation equipped with a function for preventing the tissue from being burnt onto an electrode on the top of a scalpel. SOLUTION: In a system 1 for operation provided with a scalpel top electrode 26 to become an electrode part for supplying a high frequency current to the viable tissue for treating the viable tissue, a main body 40 of hand piece, to which the scalpel top electrode 26 is attached, a high frequency current supply part 50 for supplying the high frequency current to the scalpel top electrode 26, and a ultrasonic vibration supply part 10 for supplying ultrasonic vibrations to the scalpel top electrode 26, the scalpel top electrode 26 can be ultrasonically vibrated while the high frequency current is supplied to the scalpel top electrode 26. Thus, the viable tissue can be prevented from being burnt onto the scalpel top electrode 26.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a surgical apparatus having a function of cutting and coagulating a living tissue using a high-frequency current.

[0002]

2. Description of the Related Art Conventionally, in a surgical operation, a surgical device such as an electric scalpel that uses a high-frequency current when cutting or stopping a living tissue has been used.

An electric scalpel is a device that radiates a high-frequency current to the living tissue from the tip of a scalpel tip electrode, and performs incision and hemostasis of the living tissue and capillaries using Joule heat and arc discharge generated by the high-frequency current. .

FIG. 7 is a block diagram showing the overall configuration of a conventional electric scalpel device.

As shown in FIG. 7, the electric knife 70 has a counter electrode plate 73 and a knife tip electrode 74 each having a high-frequency output terminal of a high-frequency current supply unit 71 for generating a high-frequency current brought into contact with the body surface of a living body 72. To generate an arc discharge or Joule heat at the tip of the female tip electrode 74, and use the electric spark or heat generated at the distal end of the female tip electrode 74 to cut, cauterize, stop bleeding, coagulate blood, etc. Take action.

[0006] Since the electric scalpel has a hemostatic function and various other functions which are not provided by a metal scalpel generally used in the past, it has various functions such as general surgery and endoscopic surgery. Used in various fields.

[0007]

However, in the electric scalpel according to the prior art described above, the living tissue in contact with the scalpel tip electrode during use is scorched on the surface of the scalpel tip electrode by electric spark or heat generated from the scalpel tip electrode. Since the impedance increases due to the carbonized tissue, it becomes difficult for a current to flow from the scalpel tip electrode to the living body, thereby causing a problem in that the incision function and the hemostatic function of the scalpel tip electrode are reduced. Was.

Therefore, when performing an operation using such an electric scalpel, it is necessary to remove the carbonized living tissue attached to the tip of the scalpel electrode using sterilized sandpaper or the like. Was needed.

[0009] In view of the above problems, an object of the present invention is to provide a surgical apparatus having a function of preventing scorching of a living tissue to a scalpel electrode.

[0010]

This and other objects are achieved by the present invention which is defined below as (1) to (7).

(1) An electrode section for treating a living tissue using a high-frequency current, a handpiece body to which the electrode section is attached, high-frequency current supply means for supplying a high-frequency current to the electrode section, An ultrasonic vibration supply unit for supplying ultrasonic vibration to the electrode unit, wherein the electrode unit is configured to be capable of ultrasonic vibration while supplying a high-frequency current to the electrode unit. A surgical device characterized by the above-mentioned.

(2) The tip of the electrode portion is set at 220 cm to 2200 cm / sec by the ultrasonic vibration supplying means.
The surgical apparatus according to the above (1), which vibrates at a speed of:

(3) The tip of the electrode section is set at 1100 cm to 1800 c / sec by the ultrasonic vibration supply means.
The surgical apparatus according to the above (2), which vibrates at a speed of m.

(4) The ultrasonic vibration supply means has an ultrasonic vibration supply section provided on the handpiece body, and the electrode section is detachably connected to the ultrasonic vibration supply section. The surgical device according to any one of the above (1) to (3), which is a scalpel tip electrode.

(5) The handpiece body has a hand switch for controlling the output of at least one of the high-frequency current supply means and the ultrasonic vibration supply means. The surgical device according to any one of (1) to (4).

(6) The surgical apparatus according to any one of (1) to (5), wherein only one of the high-frequency current supply means and the ultrasonic vibration supply means can be operated.

(7) Surgery characterized by preventing foreign matter from adhering to the scalpel tip electrode by ultrasonically oscillating the scalpel tip electrode of a surgical apparatus for treating a living tissue using a high-frequency current. For preventing foreign matter from adhering to equipment.

[0018]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS A preferred embodiment of the surgical apparatus according to the present invention will be described below with reference to the accompanying drawings.

FIG. 1 is a block diagram showing the overall configuration of a surgical apparatus according to the present invention. FIG. 2 is a sectional side view showing a handpiece body and a scalpel tip electrode of the surgical device of the present invention. FIG. 3 is a view of various scalpel tips connected to the distal end of the handpiece body of the surgical device of the present invention. It is a side view. FIG. 4 is a cross-sectional side view showing a modification of the handpiece body and the scalpel tip electrode of the surgical apparatus of the present invention.

Hereinafter, the surgical apparatus of the present invention will be described in detail. As shown in FIGS. 1 and 2, the surgical apparatus 1 of the present invention has a female tip electrode 26 serving as an electrode part for performing treatment on a living tissue using a high-frequency current, and the female tip electrode 26 is attached thereto. The handpiece body 40, a high-frequency current supply unit 50 serving as a high-frequency current supply unit that supplies a high-frequency current to the knife tip electrode 26, and a super-sonic unit that supplies an ultrasonic vibration to the knife tip electrode 26. And a sonic vibration supply unit 10. Further, a counter electrode plate 51 is connected to the high-frequency current supply unit 50.

As shown in FIG. 2, the handpiece main body 40 includes a cover 41 forming an outer shell of the handpiece main body 40, a hand switch 43 provided on the surface of the cover 41, and the female tip electrode 26. It has the ultrasonic vibration supply unit 10 that supplies ultrasonic vibration, and support units 42 a and 42 b that are provided inside the cover 41 and support the ultrasonic vibration supply unit 10.

The cover 41 is made of resin or the like, and has a small diameter so that a doctor using the surgical apparatus 1 can easily hold the cover.

The hand switch 43 is connected to the cover 4
1, a doctor using the surgical apparatus 1 can turn on / off the output of the high-frequency current supply unit 50 or the ultrasonic vibration supply unit 10 by finger. ing.

The hand switch 43 includes an electric output switch 44 for turning on / off the output from the high-frequency current supply unit 50 and an ultrasonic output switch for turning on / off the output from the ultrasonic vibration supply unit 10. 45.

As shown in FIG. 2, the electric output switch 44 includes an incision electric output switch 44a for turning on / off the output of a living tissue incision current from the high frequency current supply unit 50, and the high frequency current It is preferable to include a coagulation electric output switch 44b for turning on and off the output of the living tissue coagulation current from the supply unit 50.

Also, as described above, the hand switch 43
In the case where the electric output switch 44 is composed of the electric output switch 44a for incision and the electric output switch 44b for coagulation, as shown in FIG. Output switch 45
Are provided at positions facing each other on the cover 41, erroneous operation of the switch during the operation can be reduced.

The output from the high-frequency current supply unit 50 and the output from the ultrasonic vibration supply unit 10 can be turned on / off not only by the hand switch 43 but also by the foot switch 31.

As shown in FIG. 2, the ultrasonic vibration supply section 10 is located inside the handpiece main body 40, and is provided with an ultrasonic vibrator (vibration generating section) 2 provided on the base end side.
0 and a horn (vibration transmitting unit) 23 connected to the end face on the distal end side of the ultrasonic vibrator 20. The ultrasonic vibration supply unit 10 is connected to a handpiece body 4 described later.
0 are supported by the support portions 42a and 42b.

As shown in FIG. 2, the ultrasonic vibrator 20 includes a piezoelectric element 2 for converting the ultrasonic excitation power from the ultrasonic excitation power supply unit 60 into mechanical ultrasonic vibration.
1 and metal blocks 22a, 22 sandwiching the piezoelectric element 21
b. The metal block 22b is provided with a cable 30c for transmitting the current from the high-frequency current supply unit 50 to the female tip electrode 26. The piezoelectric element 21 includes the ultrasonic excitation power supply unit 60 Cables 30a and 30b for supplying the ultrasonic excitation power from are installed.

Although the electrosurgical ultrasonic vibrator 20 is used in the surgical apparatus 1 of the present embodiment, the present invention is not limited to this embodiment, and a magnetostrictive ultrasonic vibrator may be used. It is possible.

The horn 23 is made of a metal material having both mechanical strength and conductivity that can withstand ultrasonic vibration, that is, a titanium alloy, a stainless alloy, or the like. A function of amplifying the ultrasonic vibration and transmitting it to the female tip electrode 26; and a function of supplying the current supplied from the high-frequency current supply unit 50 to the metal block 22b of the ultrasonic vibrator 20 to the female tip electrode 26. Has the function of transmitting to

As shown in FIG. 2, the horn 23 has a base end connected to a distal end of the ultrasonic vibrator 20. The horn 23 is provided with a step 25 at a position corresponding to a node of vibration when the horn 23 undergoes ultrasonic resonance. As described above, since the horn 23 is provided with the step at the position of the node of the ultrasonic vibration, the ultrasonic vibration from the ultrasonic vibrator 20 is amplified by the horn 23 and the female tip electrode 26 To be transmitted to.

Further, in this embodiment, as shown in FIG. 2, the portion of the horn 23 from the step 25 to the tip side is designed to have a small diameter, and the handpiece body 4 formed by this is formed.
A hand switch 43 to be described later is mounted in the space inside 0. By using such a structure, the expansion of the outer diameter of the handpiece body 40 is suppressed.

The horn 23 has a female screw 27 at its tip. The female screw portion 27 is attached with a male screw portion 24 provided at the base end of a female tip electrode 26 described in detail later.

The ultrasonic vibrator 20 and the horn 23 are separately formed in this embodiment, and they are connected by a screw connection or the like (not shown). The present invention is not limited to this, and the metal block 22b of the ultrasonic vibrator 20 and the horn 23 may be integrally formed.

The support portions 42a and 42b are formed of O-rings made of rubber or the like, and are provided near the distal end and the proximal end of the cover 41. The positions of these support portions 42a and 42b are preferably provided at positions where the female tip electrode 26 becomes a node of vibration with small vibration displacement when the ultrasonic vibration is caused by the operation of the ultrasonic vibrator 20. .

The scalpel tip electrode 26 constitutes the electrode portion of the surgical apparatus 1 of the present invention, and has a mechanical strength and an electrical conductivity that can withstand ultrasonic vibrations similar to the horn 23. That is, it is formed of a titanium alloy, a stainless steel alloy, or the like. Then, as shown in FIGS. 3 (a) to 3 (d), a needle type (a), a knife type (b), a hook type (c) mainly used for incising a tissue or a hemostatic type is mainly used. Various shapes are used depending on the type of treatment, such as the ball mold (d) used. At the base end of the female tip electrode 26, there is provided a male screw part 24 to be connected to a female screw part 27 provided at the tip of the horn 23.

Hereinafter, a first operation example of the surgical apparatus 1 according to the present invention will be described in detail with reference to FIGS.

First, the operation when a high-frequency current is used when performing a treatment using the surgical apparatus 1 of the present invention will be described.

When the electric output switch 44 is pressed and turned on, the high-frequency current from the high-frequency current supply unit 50 passes through the cable 30c, the metal block 22b of the ultrasonic vibrator 20, and the horn 23. Is supplied to the female tip electrode 26. The current flowing from the female electrode 26 to the living body 2 flows to the return electrode plate 51 and returns to the high-frequency current supply unit 50.

When the pressing of the electric output switch 44 is released and turned off, the supply of the high-frequency current to the female tip electrode 26 is stopped.

In this embodiment, the case where the electric output switch for incision 44a is turned on and the case where the electric output switch for coagulation 44b is turned on are described without distinction. Electrical output switch 44
When a is turned on, a high frequency current for incision is supplied to the knife tip electrode 26 when the electric output switch for coagulation 44b is turned on.

In this embodiment, the high-frequency current supply unit 50, the cable 30c, the ultrasonic vibration supply unit 10, the female tip electrode 26, the counter electrode plate 51, the cable 30e, the high-frequency current supply unit 50 Current flows through a series of closed loop circuits.

Next, the operation in the case of using ultrasonic vibration when performing a treatment using the surgical apparatus 1 of the present invention will be described.

When the ultrasonic output switch 45 is pressed and turned on, the ultrasonic excitation power from the ultrasonic excitation power supply section 60 is supplied to the piezoelectric element 21 through the cables 30a and 30b. The ultrasonic excitation power supply unit 60 includes circuits such as an excitation signal generation circuit and an amplification circuit, and the ultrasonic excitation power is generated through these circuits.

When the ultrasonic excitation power from the ultrasonic excitation power supply section 60 is supplied to the piezoelectric element 21, the piezoelectric element 21 expands and contracts by the supplied ultrasonic excitation power, and a mechanical ultrasonic wave is generated. Generates vibration. This mechanical ultrasonic vibration is applied to the female tip electrode 26 through the horn 23.
Is transmitted to the tip.

When operating the surgical apparatus 1 of the present invention, it is preferable to ultrasonically vibrate the tip of the knife tip electrode 26 at a speed of 220 cm to 2200 cm per second. When vibrated, adhesion of tissue to the distal end of the knife electrode 26 is reduced. Then, the tip of the female tip electrode 26 is set at 1100 per second.
When the ultrasonic vibration is performed so that the speed becomes 1 cm to 1800 cm, the adhesion of the tissue to the tip of the knife tip electrode 26 is almost eliminated.

Here, the velocity V [m / s] of the tip of the knife tip electrode 26 is determined by changing the vibration frequency of the ultrasonic wave to be used to N [H
z], the vibration amplitude (Peak to
If the peak value is R [m], it is represented by the following equation (1). V = πRN (1)

Then, the tip of the knife tip electrode 26 is
In order to vibrate at a speed of 0 to 2200 [cm / s], for example, when the female tip electrode 26 is vibrated by an ultrasonic wave of 23 [kHz], the vibration amplitude is set to about 30 to 300 [μ].
m].

Similarly to the electric output switch 44, the ultrasonic output switch 45 is turned on when pressed and turned off when released, and the ultrasonic vibration to the female tip electrode 26 is caused by the operation. The supply is controlled.

The first operation example of the surgical apparatus according to the present invention has been described above. In this example, the high-frequency current supply unit 50 is used.
The ultrasonic vibrator 20 is turned on and off only by the hand switch 43.

By turning on the ultrasonic output switch 45 while the electric output switch 44 is on, the high-frequency current supply section 50 and the ultrasonic vibrator 20 can be operated simultaneously. A high-frequency current is supplied to the knife tip electrode 26, and the knife tip electrode 26 can be ultrasonically vibrated while functioning as an electric knife.

When only one of the electric output switch 44 and the ultrasonic output switch 45 is turned on, only one of the high-frequency current supply unit 50 and the ultrasonic vibrator 20 is operated. can do.

Note that these controls can be performed by combining the hand switch 43 with the controls in a second operation example and a third operation example described later.

Next, a second operation example of the surgical apparatus according to the present invention will be described with reference to FIG. FIG. 5 is a time chart showing a second operation example of the operation of the high-frequency current supply unit and the ultrasonic vibration supply unit of the surgical device of the present invention.

Hereinafter, the second operation example will be described focusing on differences from the above-described first operation example. The description of the same items as in the first operation example is omitted.

When the electric output switch 44 is turned on, the high-frequency current supply unit 5 is turned on in the same manner as in the first operation example.
0 supplies a high-frequency current to the knife tip electrode 26.
On the other hand, in the second operation example, unlike the first operation example, simultaneously with the supply of the high-frequency current, the ultrasonic vibrator 20 intermittently generates the ultrasonic vibration with respect to the female electrode 26. Supply.

Specifically, as shown in the time chart of FIG. 5, the ultrasonic vibrator 20 performs ultrasonic vibration for a certain period of time while the high-frequency current is supplied from the high-frequency current supply unit 50. It is supplied to the female tip electrode 26. After a certain period of time from the start of the supply of the ultrasonic vibration,
The ultrasonic vibrator 20 stops supplying ultrasonic vibration to the knife tip electrode 26 for a certain time. Then, after a lapse of a predetermined time from the stop of the supply of the ultrasonic vibration, the ultrasonic vibrator 20 supplies the ultrasonic vibration to the knife tip electrode 26 again for a predetermined time.

The operation of the high-frequency current supply unit 50 and the ultrasonic vibrator 20 is controlled by the electric output switch 4.
4 is released and is continued until it is turned off in the same manner as in the first operation example.

In this embodiment, it is necessary to control the high-frequency current supply unit 50 and the ultrasonic vibrator 20 by a control unit (not shown) using a computer or the like.

In this embodiment, the knife tip electrode 2
6 is continuously supplied from the high-frequency current supply unit 50 to the female electrode 2.
6 is supplied intermittently from the ultrasonic transducer 20. This is to prevent excessive heating and metal fatigue of the ultrasonic vibrator 20 and the horn 23 which may occur when the ultrasonic vibration from the ultrasonic vibrator 20 is continuously performed. While the high-frequency current supply unit 50 continuously supplies the high-frequency current to the knife tip electrode 26, the ultrasonic vibration is continuously applied from the ultrasonic vibrator 20 to the knife tip electrode 26. Of course, it is also possible to supply them.

Next, a third operation example of the surgical apparatus 1 of the present invention will be described with reference to FIG.

FIG. 6 is a time chart showing a third operation example of the operation of the high-frequency current supply unit and the ultrasonic vibration supply unit of the surgical apparatus according to the present invention.

Hereinafter, the third operation example will be described focusing on differences from the first and second operation examples described above. The description of the same items as in the first operation example and the second operation example is omitted.

When the electric output switch 44 is turned on, the high-frequency current supply unit 50 operates as shown in FIG.
A high-frequency current is supplied to the knife tip electrode 26 for a certain time. After a lapse of a predetermined time from the start of the supply of the high-frequency current, the high-frequency current supply unit 50
The supply of high frequency current to is stopped.

On the other hand, at the same time when the supply of the high-frequency current is stopped, the ultrasonic vibrator 20 supplies ultrasonic vibration to the knife tip electrode 26 for a certain time. After a lapse of a predetermined time from the start of the supply of the ultrasonic vibration, the ultrasonic vibrator 20
Stops the supply of ultrasonic vibration to the knife tip electrode 26.

Further, at the same time when the supply of the ultrasonic vibration is stopped, the high-frequency current supply unit 50 supplies a high-frequency current to the knife tip electrode 26 for a certain time.

Then, the operations of the high-frequency current supply unit 50 and the ultrasonic vibrator 20 are continued until the pressing of the electric output switch 44 is released and turned off similarly to the first and second operation examples. I do.

In this embodiment, similarly to the second operation example, it is necessary to control the high-frequency current supply unit 50 and the ultrasonic vibrator 20 by a control unit (not shown) using a computer or the like. There is.

In this embodiment, as described above,
The high-frequency current supply unit 50 and the ultrasonic vibrator 20
Are alternately operated, but the present invention is not limited to this embodiment, and it is also possible to operate the ultrasonic transducer 20 for a predetermined time before and after the operation of the high-frequency current supply unit 50.

In this embodiment, when incising and coagulating tissue using a high-frequency current, a monopolar type electric electrode having one electrode as an electrode portion provided on the handpiece body and the other electrode as a counter electrode plate. I explained as a female,
The present invention is not limited to this embodiment, and the present invention can be applied to a bipolar-type electric scalpel in which both electrodes are provided on the handpiece body.

Finally, it is needless to say that the present invention is not limited to the above-described embodiments, and various changes and improvements can be made within the scope described in the claims.

[0073]

As described above, according to the present invention, the distal end of the female tip electrode for transmitting high-frequency current to the living tissue is configured to vibrate ultrasonically. A surgical device having a function of preventing scorching of tissue is realized.

[Brief description of the drawings]

FIG. 1 is a block diagram showing the overall configuration of a surgical apparatus according to the present invention.

FIG. 2 is a sectional side view showing a handpiece main body and a scalpel tip electrode of the surgical apparatus of the present invention.

FIG. 3 is a side view of various scalpel electrodes connected to the distal end of the handpiece body of the surgical device of the present invention.

FIG. 4 is a cross-sectional side view showing a modification of the handpiece body and the knife tip electrode of the surgical apparatus of the present invention.

FIG. 5 is a time chart showing a second operation example of the operation of the high-frequency current supply unit and the ultrasonic vibration supply unit of the surgical apparatus of the present invention.

FIG. 6 is a time chart showing a third operation example of the operation of the high-frequency current supply unit and the ultrasonic vibration supply unit of the surgical apparatus of the present invention.

FIG. 7 is a block diagram showing a configuration of a conventional electric knife.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 Surgical apparatus 2 Living body 10 Ultrasonic vibration supply part 20 Ultrasonic vibrator 21 Piezoelectric element 22a, 22b Metal block 23 Horn 24 Male thread part 25 Step part 26 Female tip electrode 27 Female thread part 30a-30e Cable 31 Foot switch 40 Handpiece main body 41 Cover 42a, 42b Supporting part 43 Hand switch 44 Electric output switch 44a Electric output switch for incision 44b Electric output switch for coagulation 45 Ultrasonic output switch 50 High frequency current supply unit 51 Counter electrode plate 60 Ultrasonic excitation power supply unit 70 Electric scalpel 71 High-frequency current supply unit 72 Living body 73 Counter electrode plate 74 Female tip electrode

 ────────────────────────────────────────────────── ─── Continued on the front page (72) Inventor Shigeo Kimura 6-22-1, Mury, Mitaka-shi, Tokyo Aloka F-term (reference) 4C060 FF04 JJ11 KK03 KK10 KK14

Claims (7)

[Claims] 1. An electrode unit for treating a living tissue using a high-frequency current, a handpiece body to which the electrode unit is attached, a high-frequency current supply unit for supplying a high-frequency current to the electrode unit, and the electrode And an ultrasonic vibration supply unit for supplying ultrasonic vibration to the unit, wherein the electrode unit is configured to be capable of ultrasonic vibration while supplying a high-frequency current to the electrode unit. Characteristic surgical device. 2. The surgical apparatus according to claim 1, wherein the tip of the electrode unit vibrates at a speed of 220 cm to 2200 cm per second by the ultrasonic vibration supply unit. 3. The surgical apparatus according to claim 2, wherein the tip of the electrode unit vibrates at a speed of 1100 cm to 1800 cm per second by the ultrasonic vibration supply unit. 4. The ultrasonic vibration supply unit includes an ultrasonic vibration supply unit provided on the handpiece main body, and the electrode unit is detachably connected to the ultrasonic vibration supply unit. 2. A female tip electrode.
4. The surgical device according to any one of claims 3 to 3. 5. The handpiece body according to claim 1, further comprising: a hand switch for controlling an output of at least one of the high-frequency current supply unit and the ultrasonic vibration supply unit. The surgical device according to any one of claims 4 to 7. 6. The surgical apparatus according to claim 1, wherein only one of the high-frequency current supply unit and the ultrasonic vibration supply unit can be operated. 7. A surgical apparatus, wherein a scalpel tip electrode of a surgical apparatus for treating a living tissue using a high-frequency current is ultrasonically vibrated to prevent foreign matter from adhering to the scalpel tip electrode. A method for preventing foreign matter from adhering to the device.