JP2003305054A - Electrosurgery apparatus - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To realize an electrosurgery apparatus free from useless power consumption. <P>SOLUTION: This electrosurgery apparatus is provided with a high frequency generating means for generating a high frequency current; a high frequency generation instructing means for instructing high frequency generation to the high frequency generating means; an active electrode for transmitting the high frequency current to organism tissue; a return electrode for recovering the high frequency current flowing from the active electrode to the organism tissue; an output power changing means for changing the output power of the high frequency generating means; and a control means for controlling the output power changing means. The control means controls the output power changing means to gradually increase the output power after the high frequency generation instructing means receives the instructions of the high frequency generation. <P>COPYRIGHT: (C)2004,JPO

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an electrosurgical device, and more particularly, to an electrosurgical device that electrically performs incision, excision, evaporation and the like of living tissue.

[0002]

2. Description of the Related Art Generally, a resectoscope device for electrosurgery is used for transurethral resection.
n: TUR) and transcervical resection:
Used for TCR), it is mainly equipped with an optical endoscope (also referred to as scope) that is an endoscope for observation and an electrode unit for excision of living tissue in an elongated hollow sheath that is inserted into a body cavity. It is a thing.

There are two types of resectoscope devices, one that can be treated in a non-conductive solution and the other that can be treated in a conductive solution.

When a prostatectomy or the like is performed using a type of resectoscope which can be processed in a non-conductive solution, it is a transparent liquid having an insulating property as a perfusate for expanding a narrow cavity D -Supplying sorbitol etc. to expand the cavity and insert the sheath of the resectoscope into the cavity. Then, a high-frequency current was applied to the treatment electrode of the electrode unit arranged in the distal end opening of the sheath while observing the surface of the lesion with a scope arranged in the sheath. The high-frequency current flows from the treatment electrode through the body tissue and flows through the counter electrode plate as an external electrode arranged outside the body. The operator treats the lesioned part by operating the treatment electrode to move the treatment electrode forward and backward.

When a resectoscope device of a type that can be treated in a conductive solution is used to perform treatment such as prostatectomy, physiological saline, which is a conductive liquid, is used as the perfusate. Then, for example, in the technique disclosed in Japanese Patent Laid-Open No. 2000-201146, in the vicinity of the distal end of an elongated hollow sheath to be inserted into a body cavity filled with a conductive liquid,
A structure is shown in which a return electrode is arranged and the high frequency current from the treatment electrode is collected through the return electrode.

In the case of a resectoscope device using a non-conductive solution, an electric current is concentrated in the vicinity of the metal in a patient in which a metal bolt or the like is implanted, which burns nearby living tissue, Since the electric current flows through the nerve, the patient's body moves reflexively, making it difficult for the operator to perform the procedure. Such a problem does not occur in a resectoscope device using a conductive solution.

[0007]

However, in any of the ejectoscope devices, the high frequency current is supplied by the operator at a certain time (at t0) as shown in FIG. 9 by a switch such as a foot switch. When turned on, the power supply is performed so that the power supply becomes a preset constant power value PP (Watt). FIG. 9 is a diagram for explaining a situation of power supply to the resectoscope device.

The constant power value PP is equal to or higher than the power value necessary for the treatment for cutting the living tissue, and in fact, a high power equal to or higher than the power required for the treatment is set as the output power.

When the output power is set to a high power value, the power supply circuit for that purpose must be a circuit corresponding to the high power, so that the device itself becomes expensive.

Further, if the temperature of the conductive solution is low, it takes time to evaporate the conductive solution around the treatment electrode. Therefore, in the case of a resectoscope device using a conductive solution, there is a problem that the time required for the treatment electrode to be treated differs depending on the temperature of the physiological saline solution supplied into the body cavity.

The present invention has been made in view of the above circumstances, and a main object of the present invention is to provide an electrosurgical apparatus which does not waste power consumption.

[0012]

The electrosurgical apparatus of the present invention comprises a high-frequency generating means for generating a high-frequency current, a high-frequency generating instruction means for instructing the high-frequency generating means to generate a high-frequency current, and the high-frequency current for living tissue. An active electrode for transmitting, a return current collecting means for collecting high frequency current flowing from the active electrode to the biological tissue, and a control means for controlling output power of the high frequency current transmitted from the active electrode to the biological tissue. And the control means is
After receiving the high frequency generation instruction from the high frequency generation instruction means, the output power is controlled to be gradually increased.

The electrosurgical apparatus of the present invention comprises a high frequency generating means for generating a high frequency current, a high frequency generation instructing means for instructing the high frequency generating means to generate a high frequency, and an active electrode for transmitting the high frequency current to a living tissue. A resectoscope and a control means for controlling output power of the high-frequency current transmitted from the active electrode to the living tissue, the resectoscope returning at least one of a sheath and a scope of the resectoscope. The control means has a connection means to the high frequency generation means for use as a current recovery means, and the control means gradually increases the output power after receiving the high frequency generation instruction from the high frequency generation instruction means. To control.

[0014]

BEST MODE FOR CARRYING OUT THE INVENTION Embodiments of the present invention will be described below with reference to the drawings.

FIG. 1 is a diagram for explaining the configuration of an electrosurgical device using a resectoscope device.

FIG. 1 shows the use of a resectoscope device.
A state of performing a transurethral resection is shown. The resectoscope device includes a resectoscope 1 and a high frequency power supply device 2. A high frequency power supply device 2 for supplying a high frequency ablation current (hereinafter referred to as an active current) to a treatment electrode of an electrode unit to be described later and for collecting a return current (hereinafter referred to as a return current) is provided in the resectoscope 1. It is connected. The tip of the resectoscope 1 is inserted into the patient 3 transurethrally. The power supply from the high frequency power supply 2 to the treatment electrode is controlled by turning on and off the foot switch 4 connected to the high frequency power supply 2. When the foot switch 4 is turned on, a high frequency current from the high frequency power supply device 2 is supplied to the treatment electrode of the resectoscope 1 via the cable 5. Then, as will be described later, the return current is collected via the cable 6.

Further, in FIG. 1, a physiological saline having conductivity as a perfusate is supplied to the resectoscope 1 from a physiological saline pack 7 through a sterile tube 8 into a body cavity such as a bladder. A heater 9 is provided in the middle of the sterilization tube 8 so as to surround the outer circumference of the sterilization tube 8. The heater 9 heats the physiological saline solution to a set temperature by a temperature control means (not shown). The heater 9 is
It may be provided so as to surround the periphery of the physiological saline solution pack 7 as shown by a dotted line in FIG. Also, the heater 9
Is detachably attached to a sterile tube or the like.
After filling the body cavity with physiological saline, the surgeon inserts the Resectscope 1 into the body cavity and treats the surface of the body tissue to be incised, excised, etc. while observing the image of the endoscope for observation. The electrode is moved and the foot switch 4 is turned on to perform incision or the like.

Next, the structure of the resectoscope 1 will be described with reference to FIGS. 2, 3 and 4. FIG. 2 is a side view showing the configuration of the resectoscope 1. FIG. 3 is a perspective view for explaining the configuration of the treatment electrode. FIG. 4 is an assembly diagram for explaining the configuration of the resectoscope 1.

The resectoscope 1 is a hollow outer sheath 11 having a through hole, which is an outer tube, and a scope 12 which is also arranged in the through hole of the outer sheath 11.
And a handle portion 13 which is an operation portion, and an outer sheath 1
And an electrode unit 14 arranged in one through hole.

The outer sheath 11 is composed of, for example, a hollow insertion portion 21 which is inserted into the body cavity through the urethra, and a hand main body portion 22 provided at the rear end of the insertion portion 21,
The tip of the insertion portion 21 has an opening 28. Two fluid conduits 22 a and 22 b are provided on the side peripheral portion of the hand body portion 22. Specifically, the fluid conduit 22a has a cock 23 and a solution delivery cap 24 for delivering electrically conductive physiological saline or the like as a perfusion solution to the treatment portion. The fluid conduit 22b has a cock 25 and a drain mouthpiece 26 for discharging physiological saline or the like. A tube for liquid feeding is connected to the liquid supply mouthpiece 24 which is a tube connecting means, and a drainage mouthpiece 26 which is also a tube connecting means,
A tube for drainage is connected. Cock 23, 25
By moving the, it is possible to control the liquid supply and drainage.

As shown by the dotted line 27 in FIG. 4, the inner sheath 31 is inserted through the rear opening of the main body portion 22 and placed in the insertion portion 21. Inner sheath 31
Is a hollow insertion part 3 that is inserted into the outer sheath 11.
2 and a hand body portion 33 provided at the rear end of the insertion portion 32
And a tip member 34 provided at the tip of the insertion portion 32 and made of an insulating member such as a hard resin member. The tip of the tip member 34 has an opening 35. As shown by the dotted line 36 in FIG. 4, the scope 12 is
It is inserted together with the electrode unit 14 through the opening on the rear side of the hand-held main body 33 and is arranged inside the inner sheath 31.

In some cases, the outer sheath 11 is not used and only the inner sheath 31 is attached.

The scope 12 is a slender elongated insertion tube 41 having a built-in observation optical system and inserted and arranged in the inner sheath 31, and a guide tube 42 through which the insertion tube 41 is inserted.
And a hand portion 43 disposed at the base end of the guide tube 42. An eyepiece portion 44 for visual observation by an operator is provided at the proximal end of the hand portion 43. A light guide connection portion 45 to which a light guide (not shown) that supplies illumination light for observation is connected to the observation site is provided on the side of the hand portion 43.

As shown in FIG. 3, the electrode unit 14 inserted through the inner sheath 31 is located at the distal end side and is a treatment electrode 61 which is a hard metal member, a bifurcated arm member 62, and this bifurcated arm. It is mainly configured by an elongated metal pipe 63 having a base end portion of the member 62 arranged at the tip end portion. The treatment electrode 41 is an elongated wire-shaped electrode.
The bifurcated arm member 62 is a bifurcated member having a portion substantially parallel to the insertion axis direction of the scope 12. Both ends of the treatment electrode 61 are connected to the tip of the bifurcated member. The treatment electrode 61 has an arc shape. Further, the treatment electrode 61 and the bifurcated arm member 62 are hook-shaped at the tip of the electrode unit 14 serving as an active electrode, and the plane including the arc-shaped treatment electrode 61 and the scope 12 are included.
The insertion axis has a predetermined angle.

The outer circumference of the metal pipe 63 is covered with an insulating tube (not shown), and the base end of the metal pipe 63 is exposed as an electrode connecting portion at the rear end of this insulating tube.

Electrode unit 14 which is an active electrode
Indicates that the treatment electrode 61 is the tip member 34 of the inner sheath 31.
The opening 35 is arranged inside the inner sheath 31 so as to be movable back and forth in the insertion direction of the inner sheath 31.

The proximal end portion of the metal pipe 63 having the treatment electrode 61 and the bifurcated arm member 62 provided on the distal end side is inserted into the insertion portion 32 of the inner sheath 31 and the proximal main body portion 33, and the proximal end surface of the proximal main body portion 33. Slider 4 which will be described later and extends from
It is fixed at 6.

The handle portion 13 is provided with a sheath connecting portion 47 which is detachably connected to the hand main body portion 33 of the inner sheath 31, and a projecting portion from the rear end surface of the sheath connecting portion 47 to the rear side so that the insertion tube 41 is provided. Is mainly formed of a guide tube 48 through which the guide tube 48 is inserted, and a substantially pipe-shaped slider 46 in which the guide tube 48 is slidably held.

The slider 46 is provided with an electrode fixing portion (not shown) serving as an electrical connection portion with the electrode connection portion at the rear end portion of the electrode unit 14, and a power supply cable 5 extending from the high frequency power supply device 2. A high frequency power supply connector 49 that is detachably connected and a ring-shaped thumb hook ring 50 on which the operator's thumb is put are provided.

Then, the slider 46 and the sheath connecting portion 47 are connected.
Are connected by an elastic member (not shown) such as a spring in a state in which a force is applied to separate them from each other.
That is, the slider 46 is always urged toward the eyepiece portion 44 by the elastic member.

Therefore, the operator reduces the distance between the finger hook portion 51 and the ring 50 while holding the finger hook portion 51 of the sheath connecting portion 47 and the thumb hook ring 50 provided on the slider 46 by hand. The slider 46 with respect to the guide tube 48 by appropriately operating
2 toward the distal end, and the treatment electrode 6 of the electrode unit 14 is moved.
1 moves so as to project in the distal direction with respect to the insertion tube 41. In the state where no force is applied to the finger rest 51 and the ring 50, the treatment electrode 61 and the distal end of the insertion tube 41 are located at substantially the same position in the insertion direction of the scope 12. However, in the direction indicated by the arrow a in FIG.
When a force is applied to 1 and the ring 50 to reduce the distance, the insertion tube 41 does not move, but the processing electrode 61 moves in the direction indicated by the arrow b so as to project toward the distal end of the scope 12.

On the other hand, the high frequency power source connector 49 and the above-mentioned electrode fixing portion are electrically connected by, for example, a lead wire or the like. Therefore, by connecting the cable 5 from the high-frequency power supply device 2 to the high-frequency power supply connector 49, the treatment electrode 61 of the electrode unit 14 is brought into a conductive state, and the lesion can be treated. The resectoscope device can measure the leakage current by obtaining the difference between the current value supplied to the treatment electrode 61 and the current value of the return current.

FIG. 5 is a block diagram showing the structure of the high frequency power supply device.

As shown in FIG. 5, the high frequency power supply device 2 is
A control circuit 101 that receives a signal from the foot switch 4 to control power supply, a power supply circuit 102 that is controlled by the control circuit 101 to generate DC power, and a DC power from the power supply circuit 102 is switched to generate high-frequency power. A high-frequency generating circuit 103 that generates, a waveform circuit 104 that supplies a waveform signal of the high-frequency power that is controlled by the control circuit 101 and that is generated by the high-frequency generating circuit 103, and a high-frequency wave of the high-frequency power that the high-frequency generating circuit 103 generates. An output transformer circuit 105 that amplifies the voltage and is applied between the terminal for the treatment electrode 61 and the terminal for the return current to supply a high frequency current to the treatment electrode 61, and a current for detecting the high frequency current output from the output transformer circuit 105. Sensors 106a, 10
6b, a voltage sensor 106c that detects the voltage between the terminal for the treatment electrode 61 and the terminal for the return current, and the current value detected by the current sensors 106a and 106b and the voltage value detected by the voltage sensor 106c as A / The control circuit 101 includes a sensor signal processing circuit 107 for D conversion.
Is a power supply circuit 102 based on the digitized current data and voltage data from the sensor signal processing circuit 107.
The waveform circuit 104 and the output transformer circuit 105 are controlled.

The control circuit 101 includes an arithmetic unit such as a CPU (Central Processing Unit) and executes the control described later by a software program. The control circuit 1
01 may be realized by a hardware circuit that is not a software program.

Next, the means for collecting the return current in the above-described resectoscope device will be specifically described. In the present embodiment, the return current is collected without using a body electrode plate as in the related art, but there are several methods for collecting the return current, which will be described with reference to FIG. FIG. 6 is a side view for explaining the configuration of the reject scope 1 having a connector for connecting to the return current cable.

(1) When the return current is collected via the outer sheath As shown in FIG. 6, a cable current connector 71 for the return current is provided on the hand body portion 22 of the outer sheath 11.

Since the insertion portion 21 and the main body portion 22 of the outer sheath 11 are both conductive members such as metal, the current from the active electrode flows to the outer sheath 11 via the conductive liquid and is used for the return current. It flows to the connector 71 as an electrical connecting means to the cable 6. Therefore, the return current can be recovered to the return current cable 6 via the outer sheath 11.

When the return current is collected through the outer sheath, even if the body tissue is in contact with the outer sheath 11, the return current is collected through the metal member due to the difference in impedance.

(2) When the return current is collected through the inner sheath As shown in FIG. 6, the cable connector 72 for the return current shown by the dotted line may be provided in the main body portion 33 of the inner sheath 31 at hand. .

In this case, the insertion portion 3 of the inner sheath 31
Since 2 and the hand body 33 are both conductive members such as metal, the current from the active electrode flows to the inner sheath 31 via the conductive liquid and is electrically connected to the return current cable 6. Flows into the connector 72. Therefore, the return current can be recovered to the return current cable 6 via the inner sheath 31.

(3) When the return current is collected via the scope As shown in FIG. 6, a cable connector 73 for the return current shown by a dotted line may be provided at the hand portion 43 of the scope 12.

In this case, since the guide tube 42 of the scope 12, the sheath connecting portion 47, the guide tube 48, the slider 46 and the hand portion 43 are all conductive members such as metal, the current from the active electrode is the conductive liquid. Through scope 12
To the connector 73 as an electrical connecting means to the return current cable 6. Therefore, scope 1
The return current can be recovered to the return current cable 6 via 2.

As indicated by a dotted line 74, the scope 1
A connector may be provided in the light guide connection part 45 of FIG.

(4) When the return current is collected via the handle portion As shown in FIG. 6, the cable connector 75 for the return current shown by the dotted line is provided on the slider 46 of the handle portion 13 holding the active electrode. May be.

Inside the handle portion 13, the connector 75 is
The guide tube 48, which is a conductive member such as metal, is electrically connected, and the guide tube 48 is electrically connected to the outer sheath 11, the inner sheath 31, or the scope 12.

Therefore, the current from the active electrode flows through the outer sheath 11, the inner sheath 31 or the scope 12 to the handle portion 13, and the connector 75 as an electrical connecting means to the return current cable 6.
Through the return current cable 6. Therefore,
The return current can be recovered to the return current cable 6 via the handle portion 13.

(5) When the return current is recovered via the fluid conduit As shown in FIG. 6, the cable connector 76 for the return current shown by the dotted line is connected to the liquid delivery mouthpiece 24 provided on the outer sheath 11. It may be provided. The liquid delivery cap 24 is provided at the tip of the liquid delivery conduit provided in the outer sheath 11.

In this case, since the insertion portion 21, the main body portion 22 and the fluid conduit 22a are conductive members such as metal, the current from the active electrode flows to the fluid conduit 22a via the conductive liquid. , To the connector 76 as an electrical connecting means to the return current cable 6. Therefore,
The return current can be recovered to the return current cable 6 via the fluid conduit.

Although the connector 76 is provided on the liquid delivery mouthpiece 24 here, the connector 76 may be provided on the drainage mouthpiece 26.

Further, in the above description, a separate connector is provided on the liquid supply mouthpiece 24 or the drainage mouthpiece 26, but the liquid supply mouthpiece 24 or the drainage mouthpiece 26 is used as it is as the return current connector 76 without changing its shape. It may be used to recover the return current.

Incidentally, the above-mentioned connectors 71 to 76.
Is fixed to the inner sheath 31 or the like, but may be detachable from the inner sheath 31 or the like.

According to the above configuration, the return current can be recovered without disposing the return electrode in the vicinity of the sheath tip as in the conventional case, so that the structure of the resectoscope itself is simple and can be inserted. The diameter of the part does not become thick.

As a return current recovery method, as disclosed in the above-mentioned Japanese Patent Laid-Open No. 2000-201946, a return current recovery means is provided in the vicinity of the distal end of the elongated hollow sheath inserted into the body cavity. The return electrode may be arranged, and the high-frequency current from the treatment electrode may be collected via the return electrode.

When a treatment using a conductive solution is performed using the above-described resectoscope device having a connector for connecting to a return current cable, as shown in FIGS. The return current cable 6 may be connected to the connector provided on the sheath or the like.

Next, the output of the high frequency power supply 2 will be described.

FIG. 7 is a diagram showing how the output power of the high frequency power supply device changes with time when the operator turns on the foot switch 4. The vertical axis is the output power and the horizontal axis is the time axis. When the operator presses the foot switch 4 at a certain time, that is, at time t0, the control circuit 101 causes the power supply circuit 102, the waveform circuit 104, and the output transformer circuit 1 to operate.
05 is controlled to gradually increase the output power from the value of P0 which is 0 watt, as shown in FIG.

To increase the output power, the control circuit 1
01 controls the voltage value or current value of the power supply circuit 102, the waveform circuit 104, or the amplification degree of the output transformer circuit 105. As a result, the control circuit 101 can gradually increase the power as shown in FIG. 7.

While gradually increasing the power, the control circuit 1
01 monitors whether or not a discharge has occurred at the treatment electrode 61. Specifically, when the output power is gradually increased from a low power value to a high power value, physiological saline or the like evaporates at a certain time point (t1) to generate vapor, and the treatment electrode 61.
The resistance value of increases and discharge starts. By this discharge,
The living tissue begins to be cut and can be resected. Therefore, when the control circuit 101 detects that the discharge has started, it stops increasing the output power and maintains the output power at a constant value of P1 watt which is the output power when the discharge is detected.

Once discharge has occurred, there is no need to increase the power further, so that the minimum power value P1 watt is sufficient. Therefore, it is possible to realize electrosurgery using the resectoscope device without wasteful power consumption.

FIG. 8 is a diagram showing how the output power of the high-frequency power supply device changes with time according to another example. The vertical axis is the output power and the horizontal axis is the time axis. When the operator presses the foot switch 4 at some time, that is, at time t0, the control circuit 101 causes the power supply circuit 102 and the waveform circuit 1 to operate.
04 and the output transformer circuit 105 to gradually increase the output power from the value of P0 which is 0 watt, as shown in FIG.

While gradually increasing the power, the control circuit 1
01 monitors whether or not a discharge has occurred at the treatment electrode 61. Specifically, when the output power is gradually increased from a low power value to a high power value, physiological saline or the like evaporates from a certain time point (t1) and vapor is generated, resulting in the treatment electrode 61.
The resistance value of increases and discharge starts.

When the control circuit 101 detects that the discharge has started, it does not increase the output power and outputs the output power from the output power P1 watt at the time of detecting the discharge to P1 watt.
It is lowered to a preset constant value P2 watt, which is a lower power value, and the constant value P2 is maintained.

For example, when the saline solution evaporates at an output power of 220 to 300 watts, the power is reduced thereafter. After discharging, it may be low power, for example, about 100 watts. This is because once discharge starts at the treatment electrode 61, heat is generated even though the power is low, so steam is continuously generated at a power of about 100 watts. That is, although the temperature of the treatment electrode 61 is raised by using the electric power of about 300 watts at first, the output electric power may be low thereafter.

Whether or not the discharge has started is determined by calculating the impedance based on the voltage value and the current value detected by the voltage sensor 106c and the current sensors 106a and 106b. For example, it is determined whether or not the output power is reduced to a constant value depending on whether or not the tissue resistance reaches a preset impedance, for example, 500 ohms.

Once the discharge is generated, it is not necessary to increase the electric power further, so that the electric power can be raised to the minimum electric power value P1. Therefore, using the Resectoscope device,
It is possible to realize electrosurgery without wasteful power consumption.

By the way, if the conductive solution is filled in the body cavity and the active electrode and the return electrode are kept in the normal state in the conductive solution, discharge is possible, so that output power is supplied. Good. However, if the conductive solution is not filled in the body cavity, or if the active electrode and the return electrode are not normally held in the conductive solution, discharge in an incomplete state occurs. .

Therefore, the conductive perfusate is sufficiently filled in the lesion area before the high-frequency current for discharging the active electrode is supplied, and the active electrode and the return electrode are normally filled in the conductive solution. The state of being held in the state is detected by the impedance measuring means, and the high frequency current is supplied to the active electrode based on the detection result.

Therefore, while outputting a predetermined small output power, the impedance is calculated and calculated based on the output signals of the voltage sensor and the current sensor, and when the impedance becomes equal to or less than a preset value, the high frequency current is changed. When the impedance is supplied and the impedance exceeds a preset value, the high frequency current is not supplied. If the preset value is, for example, 50 ohms or less, a high frequency current is supplied.

Specifically, the output power of a small power value, which is not 0 watt, is output as the value of P0 shown in FIGS. 7 and 8. In that state, when the foot switch 4 is turned on, the active electrode and the return electrode are normally held in the conductive solution where the conductive perfusate is sufficiently filled in the lesion. If it is in the state, the high frequency power is output so that the output value of the high frequency power gradually increases. With that small power value being output,
When the foot switch 4 is turned on, when the lesion area is sufficiently filled with the conductive perfusion solution, the active electrode and the return electrode are not normally held in the conductive solution. If so, the high frequency power is not output so that the output value of the high frequency power gradually increases.

Therefore, discharge in an incomplete state does not occur.

As described above with reference to FIGS. 7 and 8, in the present embodiment, the output power supplied to the treatment electrode is gradually increased, and when discharge at the treatment electrode is detected, discharge detection is performed. Output power at time or a predetermined value of power lower than the output power at the time of discharge detection is maintained. Therefore, as compared with the related art, it is possible to discharge the battery with a minimum required low power without generating a high power, and thus unnecessary power is not needed. As a result, the power supply capacity can be small, and the cost can be reduced.

Further, when the output power is increased, the point of time when the discharge starts varies depending on the temperature of the conductive solution. Therefore, it takes time only to evaporate the conductive solution around the treatment electrode, and unnecessary power is required. Therefore, the conductive solution supplied into the body cavity is heated.

As shown in FIG. 1, the heater 9 is provided in the middle of the sterilization tube 8 and has a temperature of 36 in the body.
The physiological saline is heated from 40 to 40 degrees. Even if warmed up before the operation, the temperature of the physiological saline solution will drop to room temperature, for example, 25 degrees Celsius over time. Warmed saline causes faster evaporation around the treatment electrode as compared to unwarmed saline. As a result, less electricity is required for evaporation.

Further, a hemostatic agent is mixed with physiological saline. This is to stop the bleeding of the incised body tissue while treating the living tissue with the Resectoscope.

As described above, according to the above configuration, it is possible to realize the electrosurgical device without unnecessary power consumption. Further, since the means for heating the conductive solution is provided, there is no difference in the time until the treatment electrode can be treated. Furthermore, even if the operator turns on the foot while the lesion is not filled with the conductive solution that is the perfusate, the treatment electrode does not discharge in an incomplete state.

From the configuration described above, the configuration shown in the following appendix is characteristic.

[Additional Notes] (1) High frequency generating means for generating a high frequency current, high frequency generation instructing means for instructing the high frequency generating means to generate a high frequency, active electrodes for transmitting the high frequency current to living tissue, and An electrosurgical apparatus comprising: a return current collecting unit that collects a high-frequency current that has flowed from an active electrode to a living tissue; and a control unit that controls an output power of the high-frequency current transmitted from the active electrode to the living tissue. The electrosurgical device, wherein the control means controls to gradually increase the output power after receiving the high frequency generation instruction from the high frequency generation instruction means.

(2) High-frequency generating means for generating high-frequency current, high-frequency generation instructing means for instructing the high-frequency generating means to generate high-frequency, and a resectoscope having an active electrode for transmitting the high-frequency current to living tissue, In the electrosurgical device including a control unit that controls output power of the high-frequency current transmitted from the active electrode to the living tissue, the resectoscope returns at least one of a sheath and a scope of the resectoscope. The control means has a connection means to the high frequency generation means for use as a current recovery means, and the control means gradually increases the output power after receiving the high frequency generation instruction from the high frequency generation instruction means. An electrosurgical device characterized by being controlled as follows.

(3) The control means controls the output power to be maintained at a constant value when a predetermined condition is met after gradually increasing the output power. (1) or the electrosurgical device according to the additional item (2).

(4) The control means, when the output power is gradually increased and then a predetermined condition is satisfied, is a value lower than the value of the output power when the predetermined condition is satisfied. The electrosurgical device according to the additional item (1) or the additional item (2), wherein the output power is controlled so as to be reduced and maintained at a constant value.

(5) Further, there is provided a heating means for heating the conductive solution in contact with the active electrode and the return current collecting means in the body cavity. The electrosurgical device according to any one of 4).

(6) Further, it has a solution evaporation detecting means for detecting the evaporation of the conductive solution, and the control means determines whether or not the predetermined condition is satisfied based on the detection result of the solution evaporation detecting means. The electrosurgical device according to the additional item (3), the additional item (4), or the additional item (5), wherein

(7) The solution evaporation detecting means detects the impedance between the active electrode and the return current collecting means, and the control means determines the predetermined value depending on whether or not the impedance is below a predetermined value. The electrosurgical device according to the additional item (6), wherein it is determined whether or not the condition is satisfied.

(8) Further, it has a conductive solution detecting means for detecting the presence of a conductive solution between the active electrode and the return current collecting means, and the control means has the conductive solution detecting means. The additional item (1) to the additional item (7), wherein when the presence of the conductive solution between the active electrode and the return current collecting means is detected, the increase of the output power is started. The electrosurgical device according to any one of 1) to 5).

(9) In the conductive solution detecting means, the conductive solution exists between the active electrode and the return current collecting means based on the impedance between the active electrode and the return current collecting means. The electrosurgical device according to the additional item (8), characterized in that:

The present invention is not limited to the above-described embodiments, and various changes and modifications can be made without departing from the spirit of the present invention.

[0088]

As described above, according to the present invention,
It is possible to realize an electrosurgical device without wasteful power consumption.

[Brief description of drawings]

FIG. 1 is a diagram for explaining a configuration of an electrosurgical apparatus using a resectoscope apparatus according to an embodiment of the present invention.

FIG. 2 is a side view showing the configuration of the resectoscope according to the embodiment of the present invention.

FIG. 3 is a perspective view for explaining a configuration of an electrode according to the embodiment of the present invention.

FIG. 4 is an assembly diagram for explaining the configuration of the resectoscope according to the embodiment of the present invention.

FIG. 5 is a block diagram showing a configuration of a high frequency power supply device according to an embodiment of the present invention.

FIG. 6 is a side view showing the configuration of a resectoscope having a connector for connecting to a return current cable according to the embodiment of the present invention.

FIG. 7 is a diagram showing how the output power of the high-frequency power supply device according to the embodiment of the present invention changes with time.

FIG. 8 is a diagram showing a state of another example of the temporal change of the output power of the high frequency power supply device according to the embodiment of the present invention.

FIG. 9 is a diagram for explaining a situation of power supply to a conventional detect scope device.

[Explanation of symbols]

1 ... Reject scope 2 High frequency power supply 3 ... Patient 4 ... Foot switch 5, 6 ... Cable 7 ... Saline solution pack 8 ... Sterilization tube 9 ... Heating means 11 ... Outer sheath 12 ... Scope 13 ... Handle part 14 ... Electrode unit 31 ... Inner sheath 61 ... Treatment electrode 71, 72, 73, 74, 75, 76 ... Connector

   ─────────────────────────────────────────────────── ─── Continued front page    (72) Inventor Shinji Hatta             2-43 Hatagaya, Shibuya-ku, Tokyo Ori             Inside Npus Optical Industry Co., Ltd. (72) Inventor Kenji Harano             2-43 Hatagaya, Shibuya-ku, Tokyo Ori             Inside Npus Optical Industry Co., Ltd. (72) Inventor Shuichi Kimura             2-43 Hatagaya, Shibuya-ku, Tokyo Ori             Inside Npus Optical Industry Co., Ltd. (72) Inventor Takeaki Nakamura             2-43 Hatagaya, Shibuya-ku, Tokyo Ori             Inside Npus Optical Industry Co., Ltd. F-term (reference) 4C060 KK03 KK06 KK17 MM27

Claims (2)

[Claims] 1. A high frequency generating means for generating a high frequency current, a high frequency generation instructing means for instructing the high frequency generating means to generate a high frequency, an active electrode for transmitting the high frequency current to a living tissue, and a living tissue from the active electrode. A return current collecting means for collecting the high-frequency current that has flowed into the living body, and a control means for controlling the output power of the high-frequency current transmitted from the active electrode to the living tissue. An electrosurgical device characterized by controlling the output power to gradually increase after receiving the instruction to generate the high frequency from the high frequency generation instruction means. 2. A high-frequency generating means for generating a high-frequency current, a high-frequency generation instructing means for instructing the high-frequency generating means to generate a high-frequency current, a resectoscope having an active electrode for transmitting the high-frequency current to a living tissue, In the electrosurgical device including a control unit that controls the output power of the high-frequency current transmitted from the active electrode to the living tissue, the resectoscope has a return current at least one of the sheath and the scope of the resectoscope. It has connection means to the high frequency generation means for use as a recovery means, and the control means gradually increases the output power after receiving the high frequency generation instruction from the high frequency generation instruction means. An electrosurgical device characterized by being controlled to.