JP2003033369A - Operation apparatus - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an operation apparatus that can make its operation easy and safe. SOLUTION: The operation apparatus 1 of this invention is equipped with an electrode 22, a hand-piece 2 provided with the electrode 22, a high-frequency electric current generation device 3 which supplies the electrode 22 with a high frequency electric current, an ultrasonic wave generation device 4 which supplies the electrode 22 with ultrasonic wave oscillations, and a means for control which controls a ratio of an output of a high-frequency electric current from the high-frequency wave generation device 3 to ultrasonic wave oscillations from the ultrasonic wave generation device 4. Thus, when each output is controlled, since it is not necessary to execute a control operation for each output separately, the apparatus allows an easy and safe operation thereof when medical operations are executed.

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, surgical devices such as electric scalpels and ultrasonic scalpels have been used in surgical operations.

The electric scalpel, when a high-frequency current is passed through a living body placed between the scalpel tip electrode and the counter electrode plate, causes incision and hemostasis while cauterizing living tissue due to electric power concentration generated at the tip of the scalpel tip electrode. It is performed and has an advantage that surgery with a small amount of bleeding can be performed.

Among the electric scalpels used in recent years, a high-frequency incision current mainly used for incising a tissue,
There is one that can selectively use a high frequency coagulation current mainly used for coagulation of tissues. In such a device,
Generally, a high-frequency current whose waveform is a pure sine wave is used as a high-frequency cutting current, and a high-frequency current whose waveform is a damped sine wave is used as a high-frequency coagulation current.

On the other hand, the ultrasonic scalpel is for crushing biological tissue by ultrasonic vibration supplied to a scalpel (horn). For example, a highly elastic blood vessel is left and the surrounding biological tissue is crushed. There is an advantage that the tissue can be selectively disrupted.

[0006] Some ultrasonic scalpels have a function of treating a surgical site with ultrasonic waves and at the same time sucking blood vessels and foreign substances in the surgical site. Such an ultrasonic scalpel is configured to crush the surgical site by ultrasonic vibration generated at the scalpel and constantly suck blood or foreign matter at the surgical site from the suction port provided at the scalpel. .

In recent years, there has been used a surgical device which is constructed so as to be capable of supplying both high-frequency current and ultrasonic vibration to one scalpel, thereby having both functions of an electric scalpel and an ultrasonic scalpel. There is.

[0008]

However, in the conventional surgical apparatus, it is necessary to separately adjust the output of the high frequency current and the output of the ultrasonic vibration for each output, which is complicated. Operation was required.

The present invention has been made in view of the above points, and an object of the present invention is to provide a surgical device which can be operated easily and safely.

[0010]

These objects are achieved by the present invention described in (1) to (7) below.

(1) Electrode part, handpiece to which the electrode part is attached, high-frequency current supply means for supplying high-frequency current to the electrode part, and ultrasonic vibration supply for supplying ultrasonic vibration to the electrode part A surgical device comprising: means and first adjusting means for adjusting a ratio of an output of a high frequency current and an output of an ultrasonic vibration.

(2) The surgical apparatus according to (1), further comprising holding means for holding the ratio of the output of the high frequency current adjusted by the first adjusting means and the output of the ultrasonic vibration constant. .

(3) The magnitude of the output of the high frequency current and the output of the ultrasonic vibration is adjusted while the ratio of the output of the high frequency current and the output of the ultrasonic vibration is kept constant by the holding means. The surgical device according to (2) above, which has a second adjusting means.

(4) The surgical apparatus according to (3), wherein the second adjusting means is configured so as to adjust the output of the high frequency current and the output of the ultrasonic vibration in a stepless manner.

(5) The high-frequency current supply means is configured to supply a high-frequency incision current and a high-frequency coagulation current, and the ultrasonic vibration supply means generates an ultrasonic vibration during cutting and an ultrasonic vibration during coagulation. The surgical device according to any one of (1) to (4) above, which is configured to be supplied.

(6) The first adjusting means can adjust the ratio between the output of the high frequency incision current and the output of the ultrasonic vibration during incision, and at the same time, outputs the high frequency coagulation current and the output of the ultrasonic vibration during coagulation. The surgical apparatus according to (5) above, which is configured to adjust the ratio of

(7) The second adjusting means can adjust the magnitude of the output of the high frequency incision current and the output of the ultrasonic vibration at the time of incision, and the output of the high frequency coagulation current and the output of the ultrasonic vibration during coagulation. The surgical apparatus according to (5) or (6) above, which is configured to be adjustable in size.

Other objects, functions and effects of the present invention will become more apparent from the following description of embodiments with reference to the drawings.

[0019]

BEST MODE FOR CARRYING OUT THE INVENTION Preferred embodiments of the surgical apparatus of the present invention will be described below with reference to the accompanying drawings.

FIG. 1 is a block diagram showing the overall configuration of the surgical operating apparatus according to the present invention. FIG. 2 is a sectional view showing the configuration of the handpiece according to the surgical device of the present invention. Figure 3
5 is a timing chart of the operations of the high-frequency current generator, the ultrasonic vibration generator, the suction device, and the wash water supply device in the incision mode of the surgical device of the present invention. FIG. 4 is a timing chart of the operations of the high-frequency current generator, the ultrasonic vibration generator, the suction device, and the wash water supply device in the coagulation mode of the surgical device of the present invention. FIG. 5 is a timing chart of the operations of the high-frequency current generator, the ultrasonic vibration generator, the suction device, and the wash water supply device in the ultrasonic output mode of the surgical device of the present invention. FIG. 6 is a front view showing an adjustment panel provided in the control device for the surgical apparatus according to the present invention. In the present embodiment, the left side in FIG. 2 is the “tip”,
The right side will be described as "rear end".

As shown in FIG. 1, the surgical apparatus of the present invention includes a handpiece 2, a high-frequency current generator 3 as a high-frequency current supply means for supplying a high-frequency current to the handpiece 2, and a handpiece 2. An ultrasonic vibration generator (ultrasonic oscillator) 4 as ultrasonic vibration supply means for supplying ultrasonic vibration, a cleaning water supply device 5 for supplying cleaning water near the surgical site, and a liquid and particles near the surgical site. It has a suction device 6 as suction means for sucking, a control device 7 as control means for controlling each of these devices, a hand switch 25 connected to the control device 7, an adjustment panel 71 and a foot switch 8. .

The configuration of each element will be described in detail below. As shown in FIG. 2, the handpiece 2 includes a surgical unit 21.
And a casing 24 accommodating the surgical unit 21.

The surgical unit 21 is composed of an electrode portion 22 and an ultrasonic transducer 23 connected to the electrode portion 22 and supplying ultrasonic vibration to the electrode portion 22.

The electrode portion 22 is made of a material having resistance to ultrasonic vibrations such as titanium alloy or stainless steel, and has a function as a knife tip of an electric knife, that is, an electrode.
The ultrasonic scalpel is configured so that it can also have a function as a scalpel tip, that is, an ultrasonic horn. Further, the electrode portion 22 is connected to the high frequency current generator 3 by a conducting wire (not shown in FIG. 2). Further, the electrode portion 22 is
It is composed of a hollow tubular body, and a suction hole 221 for sucking a liquid such as blood or a foreign substance near the surgical site is provided therein.

The suction hole 221 penetrates from the front end to the rear end of the electrode portion 22 and is connected to the suction device 6 shown in FIG. 1 on the rear end side via a channel 231 described later.

The ultrasonic vibrator 23 is, for example, a bolt tightening ultrasonic vibrator, and is composed of a plurality of piezoelectric elements, electrodes, metal blocks located on both sides of these, and the like.

The electrode portion 22 is fixed to the tip of the ultrasonic oscillator 23, and the vibration of the ultrasonic oscillator 23 is transmitted to the electrode portion 22. Also, the ultrasonic transducer 2
On the central axis of 3, there is provided a flow path 231 for delivering the liquid or foreign matter sucked from the suction hole 221 of the electrode portion 22 to the suction device 6. In addition, this ultrasonic transducer 2
3 is connected to the ultrasonic vibration generator 4 by a conductor (not shown).

As shown in FIG. 2, the casing 24 is mainly composed of a casing main body 241, and a front end side cap 242 and a rear end side cap 244 located on the front end side and the rear end side of the casing main body 241. There is.

The casing body 241 is formed of a resin material into a substantially cylindrical shape, and the surgical unit 21 is housed therein. A hand switch 25 is provided on the casing body 241.

As shown in FIG. 2, the hand switch 25 is provided on the side of the casing body 241 on the tip side.

Further, the hand switch 25 is provided with an incision mode switch 251, a coagulation mode switch 252 and an ultrasonic output mode switch 253. When the incision mode switch 251 is pressed, an incision mode, that is, a high frequency current. And ultrasonic vibration are used to select a mode in which incision or crushing of biological tissue is mainly performed, and when the coagulation mode switch 252 is pressed, the coagulation mode,
That is, a mode for mainly coagulating blood or living tissue using high-frequency current and ultrasonic vibration is selected. Further, when the ultrasonic output mode switch 253 is pressed, a mode in which the tissue is crushed and sucked only by ultrasonic vibration is selected. The incision mode switch 2
Any one of 51, coagulation mode switch 252 and ultrasonic output mode switch 253 is selected. Each of these switches is connected to the controller 7 by a conductor (not shown in FIG. 2).

The foot switch 8 (see FIG. 1) connected to the controller 7 has the same functions as the incision mode switch 251, the coagulation mode switch 252 and the ultrasonic output mode switch 253 provided in the hand switch 25. There are three types of switches having

The foot switch 8 and the hand switch 2
5 when the switches in the same mode are simultaneously pressed, for example, when the incision mode switch provided on the foot switch 8 and the incision mode switch 251 provided on the hand switch 25 are simultaneously pressed, The operation of the switch is also effective.

On the other hand, when the switches of the foot switch 8 and the hand switch 25 in different modes are simultaneously pressed, for example, the incision mode switch 251 of the hand switch 25 and the coagulation mode switch of the foot switch 8 are simultaneously pressed. In this case, the operation of the hand switch 25 is valid and the operation of the foot switch 8 is invalid. However, not limited to this, in this case, the operation of the hand switch 25 may be invalidated and the operation of the foot switch 8 may be validated.

Further, the casing body 241 is provided with a cleaning water supply pipe 26 which is disposed along the outer peripheral surface of the casing body 241 and supplies cleaning water to the tip of the electrode portion 22. The rear end side of the cleaning water supply pipe 26 is shown in FIG.
It is connected to the washing water supply device 5 shown in FIG.

The cleaning water supply device 5 is configured to be able to change the supply amount of cleaning water according to the type or condition of the high frequency current supplied to the electrode portion 22 under the control of the control means 7.

As shown in FIG. 2, the tip cap 242 is provided so as to cover the outer periphery of the electrode portion 22. The tip end cap 242 is provided with a connecting portion 243 to which the tip end of the wash water supply pipe 26 is connected. Also,
A cleaning water supply passage 27 is formed between the tip end cap 242 and the electrode portion 22. Then, the cleaning water supplied from the cleaning water supply pipe 26 is supplied to the tip portion of the electrode portion 22 through the cleaning water supply passage 27.

The high frequency current generator 3 comprises a handpiece 2
Is connected to the electrode section 22 and is configured to be able to selectively supply the high frequency incision current and the high frequency coagulation current to the electrode section 22. Here, the high-frequency incision current is a high-frequency current whose waveform is represented by a pure sine wave, and is preferably used when incising or crushing a tissue. The high-frequency coagulation current is a high-frequency current whose waveform is represented by an attenuated sine wave, and is preferably used when coagulating tissue.

The ultrasonic vibration generator 4 includes the handpiece 2
Ultrasonic oscillator 23, which is connected to the ultrasonic vibrator 23 and is preferably used when a high-frequency incision current is supplied from the high-frequency current generator 3, and is suitably used when a high-frequency coagulation current is supplied. The ultrasonic vibration during coagulation and the ultrasonic vibration that is preferably used when the tissue is crushed by only the ultrasonic output are selectively supplied. Here, the ultrasonic vibration at the time of incision, the ultrasonic vibration at the time of coagulation, and the ultrasonic vibration can be ultrasonic vibrations of three different magnitudes having different amplitudes, for example. Further, the vibration speed of the tip of the electrode portion 22 when the ultrasonic vibration during incision and the ultrasonic vibration during coagulation is applied is 220 [cm / s] to 2200 [c].
m / s] is preferable. The ultrasonic vibration supply means in the present invention includes the ultrasonic vibration generator 4 and the ultrasonic vibrator 23.

The suction device 6 is connected to a suction hole 221 provided in the electrode portion 22, and the suction of the suction device 6 sucks liquid or foreign matter near the surgical site from the tip of the electrode portion 22.

The control device 7 usually includes a microcomputer (CPU), and the high frequency current generator 3, the ultrasonic vibration generator 4, the wash water supply device 5, and the suction device 6 are provided.
Take overall control of. The control means in the present invention includes the control device 7, the hand switch 25 connected to the control device 7, the foot switch 8, and an adjustment panel 71 described later.

The operation of the surgical operating apparatus according to the present invention will be described below. When the incision mode switch 251 of the hand switch 25 (or the foot switch 8) is pressed, the incision mode is selected, and the control device 7 controls the high frequency current as shown in the time chart of FIG. The generator 3 and the ultrasonic vibration generator 4 output high-frequency incision current and ultrasonic vibration during incision, respectively. Further, the wash water supply device 5 supplies the wash water in synchronization with these outputs. At this time, suction by the suction device 6 is always performed regardless of whether or not the incision mode switch 251 is pressed. Further, the supply amount of cleaning water in this case is set independently of the ultrasonic output mode described later, and in the present embodiment, a smaller amount of cleaning water is supplied to the tip of the electrode portion 22 than in the ultrasonic output mode. Is being supplied.

From this state, the incision mode switch 251
When the pressing is released, the incision mode is released, and as shown in FIG. 3, the output of the high-frequency incision current and the ultrasonic vibration during incision and the supply of cleaning water are stopped by the control of the control device 7.

When the coagulation mode switch 252 of the hand switch 25 (or foot switch 8) is pressed, the coagulation mode is selected, and the control device 7 controls the time chart of FIG. So that the high-frequency current generator 3 and the ultrasonic vibration generator 4
Outputs high-frequency coagulation current and ultrasonic vibration during coagulation, respectively. In addition, the suction device 6 stops the suction that has been performed until then in synchronization with these outputs. When the coagulation mode is selected, the cleaning water supply device 5
Regardless of whether or not the incision mode switch 251 is pressed, the supply of cleaning water is always stopped.

From this state, the solidification mode switch 252
When the pressure is released, the coagulation mode is released, and as shown in FIG. 4, the output of the high-frequency coagulation current and the ultrasonic vibration during coagulation is stopped by the control of the controller 7. Further, the suction by the suction device 6 is restarted.

When the ultrasonic output mode switch 253 of the hand switch 25 (or foot switch 8) is pressed, the ultrasonic output mode is selected, and the control means 7 controls the time chart of FIG. As shown, the ultrasonic vibration generator 4 outputs ultrasonic vibrations. Further, the wash water supply device 5 supplies the wash water in synchronization with these outputs. At this time, suction by the suction device 6 is always performed regardless of whether or not the ultrasonic output mode switch 253 is pressed. Further, the supply amount of cleaning water in this case is set independently of the cutting mode, and in the present embodiment, a larger amount of cleaning water is supplied to the tip of the electrode section 22 than in the cutting mode. It is like this.

From this state, when the pressing of the ultrasonic output mode switch 253 is released, the ultrasonic output mode is released, and as shown in FIG. 5, the output of the ultrasonic vibration and the cleaning are controlled by the control device 7. The water supply is turned off.

As described above, in this embodiment, the ultrasonic vibration during cutting and the ultrasonic vibration during coagulation suitable for the respective outputs of the high-frequency incision current and the high-frequency coagulation current from the high-frequency current generator 3 are used. Is configured to supply. Therefore, when switching the type of the high frequency current, it is not necessary to perform the switching operation of the ultrasonic vibration according to the type of the current, and the high frequency current and the ultrasonic vibration can be changed by one operation of the hand switch 25 or the foot switch 8. Both modes can be easily switched.

Further, in the present embodiment, when the coagulation mode, that is, the mode in which the blood or the biological tissue is coagulated by using the high frequency coagulation current is selected, the suction by the suction device 6 is stopped. There is. Therefore, coagulation is completed without sucking and removing the coagulated tissue.

Further, in the present embodiment, when the coagulation mode is selected, the supply of cleaning water by the cleaning water supply device 5 is stopped.

Therefore, when the high-frequency coagulation current is supplied, the coagulation function of the high-frequency coagulation current is not impaired due to the decrease in the current density due to the washing water.

Not limited to the above-described embodiment, when the coagulation mode is selected, the cleaning water of a flow rate set separately from the incision mode and the ultrasonic output mode is supplied to the tip of the electrode section 22. It is also possible to In that case, carbonization of the coagulation site can be suppressed by supplying cleaning water to such an extent that the coagulation function of the high frequency coagulation current is not significantly deteriorated. Further, by supplying the cleaning water, the adhesion of the tissue to the tip of the electrode portion 22 can be suppressed.

Further, by performing suction in the coagulation mode, it is possible to coagulate while crushing and removing the tissue.

In the surgical apparatus of this embodiment, the controller 7 is provided with the ratio of the output of the high frequency current and the output of the ultrasonic vibration output when the incision mode and the coagulation mode are selected. It is configured to be adjustable by the adjustment panel 71.

The configuration will be described below. The adjustment panel 71 has a substantially cylindrical shape as shown in FIG.
An output ratio adjusting knob 72 and an output adjusting knob 73 which are rotated by an operator's hand are provided.

The output ratio adjusting knob 72 functions as a "first adjusting means" for adjusting the ratio between the output magnitude of the high frequency current and the output magnitude of the ultrasonic vibration, and is adjusted by the output ratio adjusting knob 72. It has a function as "holding means" for holding the output ratio thus set.

Around the output ratio adjusting knob 72, the value of the ratio between the output power from the high frequency current generator and the output power from the ultrasonic vibration generator expressed by the following equation (1) is graduated. ing. Output ratio = output of high frequency current [W] / output of ultrasonic vibration [W] (1)

Then, by rotating the output ratio adjusting knob 72, the output ratio control device which is interlocked with the rotation axis of the output ratio adjusting knob 72 is operated, so that the output of the high frequency current and the output of the ultrasonic vibration are combined. The ratio can be adjusted.
When the output ratio of the output ratio adjusting knob 72 is set to 0, only ultrasonic vibration is output, and when set to ∞ (infinity), only high frequency current is output. There is.

Further, the output ratio adjusting knob 72 is constructed so that the position at the time when the rotation is stopped is held, so that the value of the output ratio at that position is held.

On the other hand, the output adjusting knob 73 simultaneously adjusts the output of the high frequency current and the output of the ultrasonic vibration while maintaining the output ratio adjusted by the output ratio adjusting knob 72. It has a function as "means".

That is, in this embodiment, the output of ultrasonic vibration as an absolute output (reference output) is graduated around the output adjusting knob 73. Then, by rotating the output adjusting knob 73, the output control device that operates in conjunction with the rotation axis of the output adjusting knob 73 is operated, and the high-frequency current is maintained while the output ratio adjusted by the output ratio adjusting knob 72 is maintained. And the output of ultrasonic vibration are adjusted together. In the present embodiment, the output is adjusted based on the output of the ultrasonic vibration, but the present invention is not limited to this. The output is adjusted based on the output of the high-frequency current, the output of the high-frequency current and the ultrasonic vibration. The output may be adjusted on the basis of the total output of the output and the output.

Further, in the present embodiment, the output ratio and the magnitude of the output are stepless (continuous) by the rotation of each knob.
Since it is configured so that it can be adjusted to, it is possible to easily perform fine adjustment of each output. However, the present invention is not limited to this embodiment, and a configuration in which each output is adjusted stepwise, or a configuration in which a display unit such as a liquid crystal panel is provided and the output is adjusted by inputting a numerical value or the like into the display unit good.

Further, in this embodiment, the output of the high frequency current and the output of ultrasonic vibration are adjusted by the output ratio adjusting knob 72.
The output adjusting knob 73 and the output adjusting knob 73 are used for adjustment. In addition to these two adjusting knobs, an adjusting means such as a switch for adjusting the output of the high frequency current and the output of the ultrasonic vibration is provided. Is preferred.

When such adjusting means is provided, the control device 7 is configured to calculate the output ratio based on the value of each output adjusted by the adjusting means, and based on the calculated output ratio. It is preferable that the output ratio adjusting knob 72 and the output adjusting knob 73 are rotationally displaced to predetermined positions.

Since one adjustment panel 71 is provided for each of the incision mode and the coagulation mode, an appropriate output ratio can be set for each mode and an output of an appropriate size can be set. Treatment can be performed. However, the present invention is not limited to this embodiment, and it is also possible to share one adjustment panel in the incision mode and the coagulation mode.

Further, in the present embodiment, the output ratio is determined from the output power from the high frequency current generator and the output power from the ultrasonic vibration generator 4, but the output power used in this embodiment is Besides, the output ratio may be determined based on the output current or output voltage from the high-frequency current generator 3, the output voltage from the ultrasonic vibration generator 4, the vibration amplitude of ultrasonic vibration at the tip of the electrode portion 22, or the like. It is possible.

Finally, it goes without saying that the present invention is not limited to the embodiments described above, and various modifications and improvements can be made within the scope described in the claims.

[0068]

As described above, the surgical apparatus of the present invention is configured so that each output can be adjusted based on the ratio of the output of the high frequency current to the output of the ultrasonic vibration. Therefore, when adjusting each output, it is not necessary to separately perform the adjusting operation for each output, and thus the operation during surgery can be performed easily and safely.

Further, when both outputs are adjusted while maintaining the ratio of the output of the high frequency current and the output of the ultrasonic vibration, both outputs can always be adjusted with an appropriate output ratio. it can.

[Brief description of drawings]

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

FIG. 2 is a cross-sectional view showing the configuration of a handpiece according to the surgical device of the present invention.

FIG. 3 is a timing chart of the operations of the high-frequency current generator, the ultrasonic vibration generator, the suction device, and the wash water supply device in the incision mode of the surgical device of the present invention.

FIG. 4 is a timing chart of the operations of the high-frequency current generator, the ultrasonic vibration generator, the suction device, and the wash water supply device in the coagulation mode of the surgical device of the present invention.

FIG. 5 is a timing chart of operations of the high-frequency current generator, the ultrasonic vibration generator, the suction device, and the wash water supply device in the ultrasonic output mode of the surgical apparatus of the present invention.

FIG. 6 is a front view showing an adjustment panel provided in the control device for the surgical apparatus according to the present invention.

[Explanation of symbols]

1 Surgical device 2 handpiece 21 Surgery unit 22 Electrode part 221 suction hole 23 Ultrasonic transducer 231 flow path 24 casing 241 casing body 242 Tip cap 243 connection 244 Rear end cap 25 hand switch 251 Incision Mode Switch 252 Coagulation mode switch 253 Ultrasonic output mode switch 26 Wash water supply pipe 27 Wash water supply channel 3 High frequency current generator 4 Ultrasonic vibration generator 5 Wash water supply device 6 suction device 7 Control device 71 Adjustment panel 72 Output ratio adjustment knob 73 Output control knob 8 foot switch

   ─────────────────────────────────────────────────── ─── Continued front page    (72) Inventor Shigeo Kimura             6-22-1, Mure, Mitaka City, Tokyo Aloka             Within the corporation F-term (reference) 4C060 JJ24 JJ25 KK03 KK04 KK05                       KK09 KK13 KK23 MM24

Claims (7)

[Claims] 1. An electrode part, a handpiece to which the electrode part is attached, a high-frequency current supplying means for supplying a high-frequency current to the electrode part, and an ultrasonic vibration supplying means for supplying an ultrasonic vibration to the electrode part. And a first adjusting means for adjusting a ratio of a high frequency current output and an ultrasonic vibration output. 2. The surgical apparatus according to claim 1, further comprising holding means for holding the ratio of the output of the high frequency current adjusted by the first adjusting means and the output of the ultrasonic vibration constant. 3. The magnitude of the output of the high frequency current and the output of the ultrasonic vibration is adjusted while the ratio of the output of the high frequency current and the output of the ultrasonic vibration is held constant by the holding means. The surgical device according to claim 2, comprising a second adjusting means. 4. The surgical apparatus according to claim 3, wherein the second adjusting means is configured to adjust the output of the high frequency current and the output of the ultrasonic vibration in a stepless manner. 5. The high-frequency current supply means is configured to supply a high-frequency incision current and a high-frequency coagulation current, and the ultrasonic vibration supply means supplies an incision ultrasonic vibration and a coagulation ultrasonic vibration. The surgical device according to any one of claims 1 to 4, which is configured to be capable of performing. 6. The first adjusting means is capable of adjusting the ratio of the output of the high frequency incision current and the output of the ultrasonic vibration during incision, and the output of the high frequency coagulation current and the output of the ultrasonic vibration during coagulation. The surgical device of claim 5, wherein the surgical device is configured to adjust the ratio. 7. The second adjusting means can adjust the output of the high frequency incision current and the output of the ultrasonic vibration during incision, and the output of the high frequency coagulation current and the output of the ultrasonic vibration during coagulation. 7. The surgical device of claim 5 or 6 configured to adjust height.