JP2007037845A - Heat generation treating apparatus - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a heat generation treating apparatus by which a desired treatment effect is obtained by properly controlling output to each heat generation element and where a heat generation element having primary electrical resistivity very different from a reference resistivity is incorporated to a treatment instrument to be usable. <P>SOLUTION: The heat generation treating apparatus 1 is provided with: a coagulotomy implement 2 where one or more heat generation elements 21 are provided at a heat generation treatment part 7; an applied current detection part 31 and an applied voltage detection part 32; a control calculation part 33 for calculating the resistivity or temperature of the heat generation elements 21; an output setting part 35 which performs setting for controlling the heat generation elements 21; an output control part 36 which controls output to the heat generation elements 21; a plurality of identifiers 10 expressing characteristic information of the heat generation elements 21; an identifier information obtaining part 41 for obtaining characteristic information expressed by the plurality of identifiers 10; an information discrimination part 46 for discriminating the characteristic of the heat generation elements 21; and a control state correction part 47 for correcting control of heat generation by the output control part 36. <P>COPYRIGHT: (C)2007,JPO&INPIT

Description

  The present invention relates to a fever treatment device, and more particularly, to a fever treatment device that performs treatment by applying heat to a living tissue.

  Generally, a fever treatment device is used when performing treatment such as incision, coagulation, and hemostasis of an affected part in a surgical operation or an internal medicine operation. This exothermic treatment device has a treatment part provided with a heating element that is a heating part for heating the affected part, and by giving heat to the affected part the heat generated by the heating element of this treatment part, incision and coagulation, Treatment such as hemostasis can be performed.

  Such an exothermic treatment device is proposed in, for example, Japanese Patent Application Laid-Open No. 2004-160191. In the heat treatment device described in this publication, an identifier (electric resistance element) indicating initial characteristic information for each heat generating element is provided in each treatment tool, and when the treatment tool is connected, the resistance value of the identifier read from the identifier is set. Based on this, initial electrical resistance value data at room temperature is obtained for each heating element.

  The heat treatment device described in the above publication divides the corresponding heat generation elements into groups based on the acquired initial electrical resistance value data of the heat generation elements, and performs output control for each heat generation element. The grouping of the heating elements based on the initial electrical resistance value data is set within the range of the initial electrical resistance value ± 0.5Ω, and an error of 1.0Ω at the maximum occurs in the grouped heating elements. For this reason, it is difficult for the heat treatment apparatus described in the above publication to perform appropriate output control for each of the heat generating elements, and as a result, a desired treatment effect may not be obtained.

  In general, it is difficult to produce all the heating elements uniformly, and the initial electric resistance value of the heating elements may vary. In such a case, when the conventional heat treatment device is used by incorporating a heat generating element having an initial electric resistance value far from the reference resistance value into the treatment section, the initial electric resistance value of the heat generating element is within a grouping range. Therefore, proper output control to the corresponding heating element cannot be performed. For this reason, the conventional heat treatment device cannot incorporate a heat generating element having an initial electric resistance value far from the reference resistance value into the treatment tool, so that the yield of the heat generating elements is reduced accordingly. It was.

In addition, although it is not an exothermic treatment apparatus, USP 5,400,267 gazette is proposed as a medical apparatus which cauterizes a biological tissue, for example. In the medical device described in this publication, a memory storing instrument impedance information as identification information of a treatment instrument is provided in each treatment instrument to control a high-frequency current supplied to the treatment unit. However, since the medical device described in the above publication performs output control only by instrument impedance information, it cannot perform output control with high accuracy.
JP 2004-160191 A USP 5,400,267

  The conventional heat treatment device acquires initial electric resistance value data at room temperature of the heat generating element as initial characteristic information for each heat generating element when the treatment tool is connected, and is based on the acquired initial electric resistance value data. The heating elements are grouped and output control is performed for each heating element.

  However, in the conventional heat treatment apparatus, an error of 1.0Ω at the maximum is generated in the heat generating elements to be grouped. Therefore, it is difficult to perform appropriate output control for each heat generating element, and a desired treatment effect is obtained. There is a fear of not being. In addition, since the conventional heat treatment apparatus cannot incorporate a heating element having an initial electrical resistance value far from the reference resistance value into the treatment tool, there is a problem that the yield of the heating elements is reduced accordingly. It was.

  The present invention has been made in view of the above circumstances. A heating element having an initial electrical resistance value far from a reference resistance value is obtained by performing appropriate output control for each heating element to obtain a desired treatment effect. An object of the present invention is to provide an exothermic treatment device that can be used by being incorporated in a treatment instrument.

  In order to solve the above problems, a heat treatment apparatus according to one aspect of the present invention includes a treatment tool in which one or more heat generation means for generating heat to be applied to a living tissue are provided in a treatment section, and is applied to the heat generation means. Applied current detection means for detecting the applied current value, applied voltage detection means for detecting the voltage value applied to the heat generation means, and the heat generation means using the detection results of the applied current detection means and the applied voltage detection means. Based on the calculation means for calculating the resistance value or temperature, the output setting means for setting for controlling the heat generating means, the calculation result by the calculating means and the setting of the output setting means, to the heat generating means Output control means for controlling the output of the plurality of identifiers representing the characteristic information of the heat generating means, or the memory means storing the characteristic information of the heat generating means, the characteristic information represented by the plurality of identifiers, or the previous Characteristic information acquisition means for acquiring characteristic information stored in the memory means, characteristic determination means for determining the characteristic of the heat generating means based on the characteristic information acquired by the characteristic information acquisition means, and determination of the characteristic determination means Control state correcting means for correcting heat generation control by the output control means based on the result.

  The heat treatment device of the present invention is used by incorporating a heat generation element having an initial electric resistance value far from the reference resistance value into a treatment tool, by performing appropriate output control for each heat generation element to obtain a desired treatment effect. There is an effect that can be done.

  Embodiments of the present invention will be described below with reference to the drawings.

  1 to 25 relate to the first embodiment of the present invention, FIG. 1 is a device configuration diagram showing the overall configuration of the heat treatment device, FIG. 2 is a front view of the device main body of FIG. 1, and FIG. FIG. 4 is an explanatory view showing a surgical forceps as a coagulation / incision treatment instrument, FIG. 5 is a schematic perspective view from the horizontal side of the heat treatment section of FIG. 4, and FIG. 7 is a schematic perspective view of the heat treatment section 5 from the top surface vertical direction, FIG. 7 is a top sectional view of the heat treatment section of FIG. 4 from the top surface vertical direction, and FIG. 8 is a side view of the heat treatment section of FIG. 9 is a circuit block diagram of the heat treatment apparatus of FIG. 1, FIG. 10 is an external perspective view of tweezers as a coagulation / incision treatment instrument, and FIG. 11 is an external side view of the tweezers of FIG. 12 is an external side view showing an endoscopic surgical forceps as a coagulation / incision treatment tool, and FIG. 13 is detachable from the apparatus main body. FIG. 14 shows a heating element initial resistance value identification table showing initial characteristics of the heating element, and FIG. 15 shows a temperature resistance characteristic (temperature resistance characteristic slope) of the heating element. FIG. 16 shows a heating element characteristic identification (slope) table showing the temperature resistance characteristic (temperature resistance characteristic intercept) of the heating element, and FIG. 17 shows a resistance value with respect to the temperature of the heating element. The first graph, FIG. 18 is a second graph showing the resistance value with respect to the temperature of the heating element, FIG. 19 is a flowchart showing the calibration operation, FIG. 20 is a flowchart of the discrimination process performed by the information discrimination unit, FIG. FIG. 22 is a flow chart of resistance characteristic determination processing for a heating element, FIG. 22 is a device configuration diagram showing the overall configuration of a heat treatment apparatus according to a modified example, and FIG. 23 shows surgical forceps as the coagulation / cutting treatment instrument of FIG. FIG. 24 is an explanatory view showing tweezers as the coagulation / incision treatment instrument in FIG. 22, and FIG. 25 is an explanatory view showing endoscopic surgical forceps as the coagulation / incision treatment instrument in FIG. .

  As shown in FIG. 1, the exothermic treatment apparatus 1 according to the first embodiment detachably connects a coagulation / incision treatment instrument 2 as a treatment instrument containing a heating element to be described later and the coagulation / incision treatment instrument 2. The apparatus main body 3 is configured to supply power to the heat generating element of the incision treatment instrument 2 to control driving. The apparatus body 3 can be connected to a foot switch 6.

  The coagulation / incision treatment instrument 2 is configured to detachably connect a main body connection connector 5 provided at a proximal end portion of an extending connection cable 4 to the apparatus main body 3. The coagulation / incision treatment instrument 2 has a treatment section 9 including a heat treatment section 7 having a plurality of heat generating elements 21 and an elastic receiving section 8 that can be separated from the heat treatment section 7. And this treatment part 9 grasps a living tissue and performs predetermined treatment.

  The heat treatment section 7 and the elastic receiving section 8 of the treatment section 9 grasp the living tissue, and when the heat treatment section 7 generates heat by energization from the apparatus main body 3, the heat treatment section 7 supplies heat energy to the grasped living tissue to coagulate the tissue. An incision or coagulation procedure is performed. Further, the number of the heat generating elements 21 varies depending on the type of treatment tool according to the purpose of treatment, and accordingly, an identifier 10 described later is built in the main body connector 5 (see FIG. 9).

  As shown in FIGS. 2 and 3, the apparatus main body 3 has a front panel 3a and a back panel 3b. As shown in FIG. 2, the front panel 3a includes a connector receiving portion 52 to which the main body connector 5 of the coagulation / cutting instrument 2 can be detachably connected. Further, the front panel 3a includes a power switch 50 for turning on / off the power and an LED 51 that is lit when the power is turned on. Further, the front panel 3a has various switches and display LEDs described below for setting control contents such as energy supply to the heat treatment section 7 of the coagulation / cutting instrument 2 and switching conditions.

The front panel 3a shifts to a section 1 setting switch 55 for shifting to the control content setting state for the output section 1, a section 2 setting switch 56 for shifting to the control content setting state for the output section 2, and a control content setting state for the output section 3. A section 3 setting switch 57 and a joule setting switch 58 for shifting to the joule control value setting state are provided.
Further, the front panel 3a includes a power setting switch 59 for shifting to the power control value setting state, a power setting value display LED 60 for displaying the power setting value, a power setting value DOWN switch 61 for changing the power setting value, and a power setting value UP switch. 62, a voltage setting switch 63 for shifting to a voltage control value setting state, a voltage setting value display LED 64 for displaying a voltage setting value, a voltage setting value DOWN switch 65 and a voltage setting value UP switch 66 for changing the voltage setting value, current control Current setting switch 67 that shifts to the value setting state, current setting value display LED 68 that displays the current setting value, current setting value DOWN switch 69 and current setting value UP switch 70 that change the current setting value, transition to the temperature control value setting state Temperature setting switch 71 to perform, temperature setting value display LED 72 to display the temperature setting value, temperature setting value A temperature setting value DOWN switch 73 and a temperature setting value UP switch 74 to be changed, a Joule setting value display LED 75 for displaying the Joule setting value, and a Joule setting value DOWN switch 76 and a Joule setting value UP switch 77 for changing the Joule setting value are provided. Have.

Further, the front panel 3a includes a limit temperature set value display LED 78 for displaying a set value of a limit temperature at which the section control ends or shifts to the next section control, a limit temperature set value DOWN switch 79 for changing the limit temperature set value, and a limit temperature. A set value UP switch 80, a section control time setting display LED 81 for setting the time of each control section, that is, an output time, a section control time DOWN switch 82 and a section control time UP switch 83 for changing the section control time are provided. .
Further, the front panel 3a instructs the first output sequence switch 84 to designate only the section 1 as the output sequence, and instructs the section 2 to be performed after the section 1 output (section 1 → section 2). Output sequence switch 85, instructing the output sequence to be performed after section 1 output, section 2 and section 3 (section 1 → section 2 → section 3), output by third output sequence switch 86 and joule control A joule control switch 87 for instructing The switches 84 to 87 and the setting information transmission unit 38 constitute a control selection instruction unit.

  The exothermic treatment apparatus 1 is capable of “constant voltage control”, “constant current control”, “constant temperature control”, “constant power control”, and “constant heat amount control (joule control)”. The constant voltage control, the constant current control, and the constant power control are control contents for applying a constant voltage, current, and power to the heating element 21, respectively. The constant temperature control is a control in which a current and a voltage are applied so that the temperature of the heat generating element 21 is constant, and the constant heat control is the amount of heat applied to the heat generating element 21 from the start of output to an arbitrary set value (consumption). The control is such that the output is stopped when the amount of heat is reached.

The output sequence has, for example, three types of control of only one step, control of up to two steps, control of up to three steps. The exothermic treatment apparatus 1 can select any one, and can perform any one of “constant voltage control”, “constant current control”, “constant temperature control”, and “constant power control” in each control section. . Note that the “constant heat amount control” has no concept of the section control described above, and stops output when the amount of heat applied to the heating element 21 reaches an arbitrary set value.
In the output sequence, the condition for stopping the output or switching the control is time or a predetermined temperature (limit temperature) in the heating element 21, and these values are set before output.

  In addition, regarding the control switching based on the heating element temperature (limit temperature), in the present embodiment, the control is switched when even one of the plurality of heating elements exceeds the limit temperature. A method that can select either “method of switching control contents when at least one limit temperature is exceeded” or “method of switching control contents when all of the heating elements exceed the limit temperature”, for example, limit temperature switching condition selection A switch may be provided.

  Still further, the front panel 3a includes a status display LED 54 that displays the status of the apparatus main body 3, an output display LED 53 that indicates that the heating element 21 of the coagulation / cutting instrument 2 is energized, and the coagulation / cutting instrument 2 There are treatment instrument abnormality display LEDs 89 to 92 that are turned on when there is an abnormality, a power supply abnormality display LED 88 that is turned on when there is an abnormality in the internal circuit, and a buzzer (not shown) that generates a warning sound. On the other hand, as shown in FIG. 3, the back panel 3 b includes a foot switch connector receiving portion 93 and a power inlet 94. The apparatus main body 3 can be connected to, for example, a coagulation / incision treatment instrument 2 having a maximum of four heating elements.

As shown in FIG. 4, the coagulation / incision treatment instrument 2 is, for example, a surgical forceps 100, and includes the treatment part 9 having the heat treatment part 7 and the elastic receiving part 8 as described above. The handle portion 20 is configured to perform an opening / closing operation for grasping the tissue. The connection cable 4 extends from the proximal end side of the handle portion 20.
As shown in FIGS. 5 and 6, the heat treatment section 7 of the coagulation / incision treatment instrument 2 (surgical forceps 100) can transfer heat to a plurality of heat generating elements 21, for example, the same three heat generating elements 21 a, 21 b, and 21 c. The heat transfer plates 22 are connected to each other in a possible manner.

Next, the detailed structure of the treatment part 9 having the heat treatment part 7 and the elastic receiving part 8 will be described.
As shown in FIGS. 7 and 8, the heat treatment section 7 has a heat generating element 21 (21a to 21c) built in the heat treatment section body 7a. Here, the heating element 21 as a heating means is a thin plate resistor formed on a ceramic plate, for example. One end of each of the lead wires 23 (23a, 23b, 23c) for energizing these heating elements 21 (21a to 21c) is connected, and the other end of these lead wires 23 is inserted through the connection cable 4. The main body connector 5 is connected to a connector terminal (not shown).

  As described above, the heat generating elements 21 (21a to 21c) are coupled to the heat transfer plate 22 so as to be able to transfer heat, and the heat generated by the heat generating elements 21 (21a to 21c) is transferred to the heat transfer plate 22. To be communicated to. In the configuration shown in FIG. 7, the heat generating element 21 (heat generating portion) and the heat transfer plate 22 (treatment portion) are separated from each other, but the heat generating treatment in which these heat generating portions and the treatment portion are integrally formed. Part. Further, the integrally formed heat treatment portion may be a heat resistant metal body (for example, nichrome wire).

  On the other hand, as shown in FIG. 8, the elastic receiving portion 8 includes an elastic member 24 having a saw blade portion 24 a capable of grasping a living tissue between the elastic transfer portion 22 and the heat transfer plate 22 of the heat treatment portion 7. 8a. In the coagulation / incision treatment instrument 2, the elastic receiving portion 8 is closed with respect to the heat treatment portion 7 by closing the handle portion 20, and the heat transfer plate 22 of the heat treatment portion 7 and the saw blade portion 24 a of the elastic reception portion 8. Thus, the living tissue is elastically grasped. In the coagulation / incision treatment instrument 2, the living tissue sandwiched between the heat transfer plate 22 and the elastic member 24 is coagulated / incised or coagulated by the heat of the heat transfer plate 22. In addition, the shape of the heat generation treatment part 7 and the elastic receiving part 8 which comprise the treatment part 9 is not limited to the above-mentioned thing.

Next, the apparatus main body 3 will be described with reference to the block diagram of FIG.
In the apparatus main body 3, drive power for causing the heat generating element 21 to generate heat is output-controlled by the output control unit 36.
The applied current detection unit 31 of the apparatus main body 3 is an applied current detection unit that detects a current value applied to the heating element 21. The applied voltage detection unit 32 is applied voltage detection means, and detects a voltage value applied to the heating element 21. The control calculation unit 33 as the calculation means uses the results of the applied current detection unit 31 and the applied voltage detection unit 32 to perform a calculation necessary for the predetermined control instructed from the control selection switching unit 39, and generates a heating element. In other words, the power supply status and the state of the heating element 21, specifically, the temperature (resistance value and heat consumption) are calculated.

In addition, the control calculation part 33 can perform temperature measurement using the resistance value of the heat generating element 21 changing with a temperature change. That is, the control calculation unit 33 measures the resistance value of the heating element 21 by measuring the current value flowing through the heating element 21 and the voltage value applied to the heating element 21 that change as the resistance value of the heating element 21 changes as a resistance value detection function. It is possible to detect and calculate the temperature of the heating element 21 from the detected resistance value.
9 is various switches such as the section 1 setting switch 55 provided on the front panel 3a, and various display LEDs provided on the front panel 3a are used as the display unit 44. Yes.

Further, the temperature limit detection unit 34 of the apparatus main body 3 is a predetermined temperature detection unit, and after the calculation result regarding the temperature of the control calculation unit 33 reaches the “temperature limit value” set by the setting information transmission unit 38, A signal for “control switching” or “stop control” is output to the control selection switching unit 39. The time measuring unit 40 is a time measuring unit, and outputs the elapsed time information to the control selection switching unit 39 after the output time reaches a predetermined time arbitrarily set by the operation unit 42. The setting information transmission unit 38 outputs the setting information input by the operation unit 42 to the output setting unit 35 and the temperature limit detection unit 34.
In addition, an output set value adjustment unit 45 is provided between the output setting unit 35 and the output control unit 36 to eliminate the protruding voltage at the start of output to the heating element 21 and stabilize the output control. The output set value adjusting unit 45 performs control of “increasing gradually to a predetermined control set value gradually during a predetermined time after the start of output”. The control set value is a set value set by operating the control sections 1 to 3 setting switches 55 to 57.

  In the present embodiment, the control set value is raised smoothly by the output set value adjustment unit 45. However, the method of raising the control set value may be changed stepwise in other words, The control set value may be a predetermined function.

  The output setting unit 35 as an output setting means obtains a set value from the setting information of the setting information transmission unit 38 and the control selection switching unit 39 and the temperature resistance characteristic (heating element resistance value Y) information from the control state correction unit 47. calculate. The control selection switching unit 39 as the control selection unit outputs the control selection information and the control switching information to the control calculation unit 33 and the output setting unit 35, thereby controlling the control output unit via the control calculation unit 33 and the output setting unit 35. The output control unit 36 is controlled.

  The output control unit 36 serving as an output control unit controls the current or voltage so that the calculation result of the control calculation unit 33 matches the set value of the output setting unit 35. In the present embodiment, the setting information transmission unit 38, the control selection switching unit 39, and the time measurement unit 40 are provided in the CPU 37, but may be provided outside the CPU 37.

  In addition, for example, a coagulation / cutting instrument having a maximum of four heating elements 21 can be connected to the apparatus main body 3, and in this case, an applied current detection unit 31 for four channels corresponding to each of the heating elements 21. The applied voltage detection unit 32, the control calculation unit 33, the temperature limit detection unit 34, the output setting unit 35, and the output control unit 36 function.

  The apparatus main body 3 has an identifier information acquisition unit 41 as characteristic information acquisition means. The identifier information acquisition unit 41 detects information on the identifier 10 provided in the main body connector 5. This identifier 10 is, for example, an electric resistance element. In the present embodiment, the identifier 10 is provided with four types of identifiers A10a, B10b, C10c, and D10d.

  Information of “type of treatment instrument” is assigned to the identifier A10a. The identifier B10b is assigned information of “electric resistance value (initial resistance value) of the heating element at an arbitrary temperature” as initial characteristic data of the heating element 21. As the temperature resistance characteristic data of the heat generating element 21, information of “gradient of characteristics regarding the temperature and resistance value of the heat generating element” is assigned to the identifier C10c. As the temperature resistance characteristic data of the heating element 21, information of “intercept of characteristics regarding the temperature and resistance value of the heating element” is assigned to the identifier D10d. Details of the information held by these identifiers 10 (identifiers A to D) will be described later.

  The identifier information acquisition unit 41 outputs information of the detected identifier 10 (identifiers A to D) to an information determination unit 46 as a characteristic determination unit. Based on information from the identifier 10 (identifiers A to D), the information determination unit 46 determines the type of treatment tool (the number of heating elements), the initial resistance value and the temperature resistance of each heating element incorporated in the treatment tool. The characteristic inclination and intercept data are discriminated, and the discriminated data is output to the control state correction unit 47 as control state correction means.

The control state correction unit 47 calculates the heating element resistance value Y based on the following equation 1 as a temperature resistance characteristic by processing the data from the information determination unit 46 for each heating element.
Heating element resistance value Y = heating element initial resistance value Rint × (slope A × temperature X + intercept B) (Equation 1)
The control state correction unit 47 outputs data of the heating element resistance value Y calculated for each heating element to the output setting unit 35 and corrects the installation value set by the output setting unit 35. As described above, the output setting unit 35 calculates a setting value from the setting information of the setting information transmission unit 38 and the control selection switching unit 39 and the temperature resistance characteristic (heating element resistance value Y) information from the control state correction unit 47. To do.
The apparatus main body 3 configured as described above supplies power to the heating element 21 of the coagulation / incision treatment instrument 2 to perform coagulation / incision or coagulation treatment of a living tissue.

The coagulation / incision treatment instrument 2 is a surgical forceps 100. Examples of the coagulation / incision treatment instrument 2 include tweezers and endoscopic surgical forceps described below.
As shown in FIGS. 10 and 11, the tweezers 101 is configured to detachably connect the main body connection connector 5 b provided at the proximal end portion of the extending connection cable 4 b to the apparatus main body 3. In the tweezers 101, two forceps arms 103a and 103b extend from the forceps main body 102, and one of the two forceps arms 103a and 103b has one heating element 21 built in at the tip. The treatment section 9b includes a treatment section 9b including a treatment section 7b and an elastic receiving section 8b that can be separated from the heat treatment section 7b. The treatment section 9b grasps a living tissue and performs a predetermined treatment. It has become.

A finger grip 104 is provided in the middle of the forceps arms 103a and 103b to help the operator hold and operate the tweezers 101. In the tweezers 101, when the operator grips the finger grip 104, the heat treatment portion 7b and the elastic receiving portion 8b of the treatment portion 9b can grasp the living tissue.
The tweezers 101 is configured to supply heat energy to the grasped living tissue to perform coagulation incision or coagulation treatment of the tissue when the heat generation treatment portion 7b generates heat by energization from the apparatus main body 3.

  As shown in FIG. 12, the endoscopic surgical forceps 110 is configured to detachably connect a main body connector 5c provided at a proximal end portion of an extending connection cable 4c to the apparatus main body 3. . The forceps 110 for endoscopic surgery has a sheath portion 111 extending from a forceps main body 102c, and a heat treatment portion 7c having two heat generating elements 21 built in the distal end of the sheath portion 111, and the heat treatment. The treatment portion 9c is composed of a movable jaw 112 that can be separated from the portion 7c. The treatment portion 9c grips a living tissue and performs a predetermined treatment. The movable jaw 112 is rotatably attached to the heat treatment portion 7c by a pivot shaft 113. The endoscopic surgical forceps 110 includes a fixed handle 114a formed integrally with the forceps main body 102c and a movable handle 114b rotatable with respect to the forceps main body 102c.

  The endoscopic surgical forceps 110 rotates the movable handle 114b with respect to the fixed handle 114a, whereby the movable jaw 112 rotates about the pivot shaft 113 toward the heat treatment portion 7c. The exothermic treatment part 7b and the elastic receiving part 8b can grip the living tissue. The endoscopic surgical forceps 110 supplies heat energy to the grasped biological tissue when the heat treatment portion 7c generates heat by energization from the apparatus body 3, and performs coagulation incision or coagulation treatment of the tissue. ing.

  As described above, the coagulation / incision treatment instrument 2 includes the surgical forceps 100 having three heating elements, the tweezers 101 having one, and the endoscopic surgical forceps 110 having two. In addition, the coagulation / incision treatment tool 2 may be a trowel or knife instead of forceps. In this embodiment, a forceps is used as a representative example.

As described above, information on “type of treatment instrument” is assigned to the identifier A10a.
As shown in FIG. 13, the identifier A10a of the coagulation / incision treatment instrument 2 has a resistance of 10KΩ in the case of the tweezers 101, a resistance of 20KΩ in the case of the endoscopic surgical forceps 110, and the like. In this case, it has an electric resistance of 30 KΩ.

  As described above, the identifier B10b is assigned information of “electric resistance value (initial resistance value) at an arbitrary temperature of the heating element”. As shown in FIG. 14, the identifier B10b of the coagulation / incision treatment instrument 2 has electric resistances divided into three groups within a range of ± 0.5Ω with respect to the set values R1, R2, R3 in the apparatus body 3, for example. Yes. Specifically, the identifier B10b has a resistance of 10 KΩ when it is within a range of ± 0.5Ω with respect to the set value R1, and 20 KΩ when it is within a range of ± 0.5Ω with respect to the set value R2. When the resistance is within a range of ± 0.5Ω with respect to the set value R3, the resistance is 30KΩ.

  Furthermore, as described above, the identifier “C10c” is assigned information of “the gradient of the characteristics relating to the temperature and the resistance value of the heating element”. As shown in FIG. 15, the identifier C10c of the coagulation / incision treatment instrument 2 has electric resistances divided into three groups within a range of ± a with respect to the set values A1, A2, A3 in the apparatus main body 3, for example. Specifically, when the identifier C10c is within a range of ± a with respect to the setting value A1, a resistance of 10KΩ is set, and when it is within the range of ± a with respect to the setting value A2, a resistance of 20KΩ is set. When the value A3 is within a range of ± a, the resistance is 30 KΩ.

  Further, as described above, the identifier “D10d” is assigned information of “intercept of characteristics relating to temperature and resistance value of the heating element”. As shown in FIG. 16, the identifier D10d of the coagulation / incision treatment instrument 2 has electrical resistances divided into three groups within a range of ± b with respect to the set values B1, B2, and B3 in the apparatus main body 3, for example. Specifically, when the identifier D10d is within a range of ± b with respect to the set value B1, a resistor of 10 KΩ is set, and when within the range of ± b with respect to the set value B2, a resistor of 20 KΩ is set. When it is within the range of ± b with respect to the value B3, it has a resistance of 30 KΩ.

  In the present embodiment, by acquiring information of the identifier 10 (identifiers A to D), the information is divided into three groups such as identification group numbers 1 to 3 according to “type of treatment instrument” as shown in FIG. The identifier 10 (identifiers A to D) of the coagulation / incision instrument 2 connected is recognized as to which information in the identification groups 1 to 3 and the heating elements 21 (21a to 21c) are identified based on the information. Appropriate output control is performed. The reason for grouping is to reduce control errors due to variations in various parameters.

The operation of the heat treatment apparatus 1 configured as described above will be described.
For example, as shown in FIG. 1, the operator connects the surgical forceps 100 as the coagulation / incision treatment tool 2 to the apparatus main body 3. Next, the operator sets initial conditions such as control contents, output values, and control switching conditions for each control section after the apparatus body 3 is powered on. After setting the initial conditions, the operator puts the treated tissue in the treatment section 9 of the coagulation / incision treatment instrument 2 and performs a treatment by pressing the foot switch 6.

At this time, the heating element 21 has heating element characteristics (initial resistance value, temperature resistance characteristics) as shown in FIGS. 17 and 18, for example.
As shown in FIG. 17, in the heat generating element 21, when the electric resistance value at the initial temperature T1 ° C. is an initial resistance value, variations in R1Ω, R2Ω, and R3Ω may occur in the initial resistance value. For this reason, the heating element 21 has different temperature resistance characteristics (heating element resistance value Y) R4 at the temperature T2 ° C. even if the gradient of the electrical resistance value with respect to the temperature is the same.

  Further, as shown in FIG. 18, the heating element 21 may have a different slope of the electric resistance value with respect to the temperature. In this case, even if the heating element 21 has the same initial resistance value R1 at the initial temperature T1 ° C., the temperature resistance characteristics (heating element resistance value Y) R5 at the temperature T2 ° C. are different. Although not shown, the heating element 21 may have different initial resistance intercepts.

  For the above-described reason, even if the apparatus main body 3 performs control so that each heating element 21 (21a to 21c) has the same temperature setting value, an error occurs in the heating temperature difference due to each heating element. In this embodiment, in addition to the information of “type of treatment tool” and “electric resistance value (initial resistance value) of the heating element at an arbitrary temperature”, “gradient of characteristics regarding the temperature and resistance value of the heating element”, “ By using the information of “intercept of characteristics relating to temperature and resistance value of the heating element”, the output control of the heating element is performed with higher accuracy.

Next, the tweezers 101 will be described as an example. One heating element 21 included in the tweezers 101 has an initial resistance value (R1 + 0.2Ω), a temperature resistance characteristic slope of A2 + c (c <a), and a temperature resistance characteristic intercept of B3-d (d <b). Suppose that
In this case, the treatment tool identification is “1” because the treatment tool is the tweezers 101. Therefore, the identifier A10a is 10 KΩ. The heating element initial resistance value identification is in the range of (R1 ± 0.5Ω) because the initial resistance value of the heating element 21 is (R1 + 0.2Ω), and the identification group number is “1”. Therefore, the identifier B10b is 10KΩ.

  The heater element characteristic identification (inclination) is in the range of A2 ± a because the inclination of the heater element 21 is A2 + c (c <a), and the identification group number is “2”. Therefore, the identifier C10c is 20KΩ. The heating element characteristic identification (intercept) is in the range of B3 ± b because the intercept of the heating element 21 is B3-d (d <b), and the identification group number is “3”. Therefore, the identifier D10d is 30 KΩ.

  As described above, the heating elements 21 are grouped, and the resistance values of the identifiers 10 (identifiers A to D) are set. The tweezers 101 has only one heat generating element 21 and is grouped for one heat generating element 21. However, when there are a plurality of heat generating elements 21, grouping is performed for each heat generating element. The resistance value of each identifier 10 (identifiers A to D) is set. That is, the identifier 10 (identifiers A to D) is incorporated as a set according to the number of heating elements.

In the following description, the operation of the apparatus main body 3 of the heat treatment apparatus 1 will be mainly described.
The apparatus main body 3 is activated when the coagulation / incision treatment instrument 2 is connected and the power switch 50 is turned on. When the coagulation / incision treatment tool 2 is connected, the apparatus main body 3 executes a calibration process as shown in the flowchart of FIG.

In step S <b> 1, the identifier information acquisition unit 41 acquires information on the identifier 10 (identifiers A to D) and outputs the information to the information determination unit 46. In step 2, the information discriminating unit 46, based on the received information from the identifier 10 (identifiers A to D), the type of treatment tool (the number of heating elements), and each heating element built in the treatment tool. The initial resistance value, the slope of the temperature resistance characteristic, and the intercept data are determined. The information discriminating unit 46 outputs the discriminated data to the control state correcting unit 47. In step S <b> 3, the control state correction unit 47 calculates the heating element resistance value Y based on Equation 1 as a temperature resistance characteristic by performing arithmetic processing on the data from the information determination unit 46 for each heating element.
The control state correction unit 47 outputs the calculated heating element resistance value Y to the output setting unit 35 as temperature characteristic information, and corrects the setting value set by the output setting unit 35.

At this time, the determination process performed by the information determination unit 46 follows the flowchart shown in FIG.
In step S11, the information determining unit 46 determines the type of the treatment tool based on the information of the identifier A10a. In step S12, the information determining unit 46 determines the resistance characteristic for each heating element based on the identifiers B10b to D10d. The resistance characteristic determination process for the heat generating element 21 follows the flowchart shown in FIG.

In step S21, the information determination unit 46 determines the initial resistance value based on the information of the identifier B10b. In step S22, the information determination unit 46 determines the temperature resistance characteristic (inclination) based on the information of the identifier C10c. In step S23, the information determination unit 46 determines the temperature resistance characteristic (intercept) based on the information of the identifier D10d.
Specifically, when the coagulation / incision instrument 2 is the tweezers 101, the identifier 10 (identifiers A to D) is 10KΩ for the identifier A10a, 10KΩ for the identifier B10b, 20KΩ for the identifier C10c, and 30KΩ for the identifier D10d as described above. It is.

  Since the identifier A10a is 10KΩ, the identifier information acquisition unit 41 identifies the identification group number “1” from the treatment instrument identification table of FIG. 13, and the identifier B10b is 10KΩ, so the identifier group is identified from the heating element initial resistance value identification table of FIG. Since the identifier C10c is 20KΩ, the identification group number “2” is identified from the heating element characteristic identification (slope) table, and the identifier group number “1” is identified from the heating element characteristic identification (intercept) table because the identifier D10d is 30KΩ. 3 ”is output to the information determination unit 46.

  Based on the information from the identifier information acquisition unit 41, the information determination unit 46 determines that the treatment tool is the tweezers 101 and that the heat generating element 21 built in the tweezers 101 is one. In addition, the information determination unit 46 has an initial resistance value (R1 ± 0.5Ω), a heating element characteristic identification (slope) A2 ± a, and a heating element characteristic identification (intercept) B3 ± b. Is determined. In addition, the information discrimination | determination part 46 performs the said discrimination | determination process for every heat generating element, when there exist multiple heat generating elements 21. FIG. The information determination unit 46 outputs the data determined for each of the heating elements to the control state correction unit 47.

  As described above, the control state correction unit 47 calculates the heating element resistance value Y based on Equation 1 as the temperature resistance characteristic by calculating the data from the information determination unit 46 for each heating element, and calculates the calculated heating element. The resistance value Y is output to the output setting unit 35 as temperature characteristic information, and the setting value set by the output setting unit 35 is corrected.

  The output setting unit 35 calculates a setting value from the setting information of the setting information transmission unit 38 and the control selection switching unit 39 and the temperature resistance characteristic (heating element resistance value Y) information from the control state correction unit 47, and calculates The set value is output to the output control unit 36.

  When such calibration processing is completed, output control to the heating element 21 is performed by pressing the foot switch 6. The output control unit 36 controls the output to the heating element 21 by controlling the current or voltage so that the calculation result of the control calculation unit 33 matches the set value of the output setting unit 35 for each heating element. At this time, the output set value adjustment unit 45 performs a control of “increasing gradually to a predetermined control set value gradually during a predetermined time after the start of output”.

As a result, the heat treatment apparatus 1 can individually control the output of the treatment tool to be connected for each heat generating element 21 according to the temperature resistance characteristics (initial resistance value, inclination, intercept).
Therefore, the heat treatment apparatus 1 performs appropriate output control for each heat generating element to obtain a desired treatment effect, and incorporates the heat generating element 21 having an initial electric resistance value far from the reference resistance value into the treatment tool. Can be used.

  In the heat treatment apparatus 1 of this embodiment, the data of the heating element resistance value Y calculated by the control state correction unit 47 for each heating element is output to the output setting unit 35 and set by the output setting unit 35. Although the present invention is configured to correct the installation value, the present invention is not limited to this, and the control state correction unit 47 may correct the output control unit 36 or the control calculation unit 33.

  Moreover, although the heat treatment apparatus 1 of the present embodiment uses the initial resistance value of the heat generating element, the slope of the temperature resistance characteristic, and the intercept data as data determined by the information determining unit 46, the present invention is not limited to this. As the initial resistance value and temperature resistance characteristic data of the heating element, numerical data representing deviation from an arbitrary reference value or data such as percentage display may be used.

The coagulation / incision treatment instrument may be configured by providing the treatment instrument and the connection cable separately.
As shown in FIG. 22, the fever treatment device 1B can be selectively connected to any one of the surgical forceps 100B, the tweezers 101B, and the endoscopic surgical forceps 110B as the coagulation / cutting treatment instrument 2B. A connection cable 120 is provided. The connector 120a at one end of the connection cable 120 can be detachably connected to the connector receiving portion 52 of the apparatus body 3, and the connector 120a at the other end is used for surgical forceps 100B, tweezers 101B, and endoscopic surgery. It can be detachably connected to connector receiving portions 121A, 121B, 121C provided on the body portion of the forceps 110B.

  As shown in FIG. 23, the surgical forceps 100B is provided with a connector receiving portion 121A at the rear end of the handle portion 20 which is a trunk portion. An identifier 10 (identifiers A to D) similar to that described in the first embodiment is provided in the connector receiving portion 121A. Further, as shown in FIG. 24, the tweezers 101B is provided with a connector receiving portion 121B at the rear end of the forceps main body 102 that is the body portion. An identifier 10 (identifiers A to D) is provided in the connector receiving portion 121B.

Furthermore, as shown in FIG. 25, the endoscopic surgical forceps 110B is provided with a connector receiving portion 121C at the rear end of the forceps main body 102c, which is a body portion. An identifier 10 (identifiers A to D) is provided in the connector receiving portion 121C.
Therefore, in the heat treatment apparatus 1B, the connector 120a of the connection cable 120 is connected to the surgical forceps 100B, tweezers 101B, and the connector receiving parts 121A, 121B, and 121C of the endoscopic surgical forceps 110B as the coagulation / cutting instrument 2B. The information from the identifier 10 (identifiers A to D) built in the corresponding treatment instrument is connected by selectively connecting to any one of them and connecting the connector 120b to the connector receiving portion 52 of the apparatus main body 3. The main body 3 can acquire.

  Thereby, even if the treatment instrument main body and the connection cable are separated, the heat treatment apparatus 1B can identify the treatment instrument by the power source (apparatus main body 3), and prepare a connection cable for each treatment instrument. There is no need to reduce the cost by using a common connection cable.

26 and FIG. 27 relate to the second embodiment of the present invention, FIG. 26 is a circuit block diagram of the heat treatment apparatus of the second embodiment, and FIG. 27 is an example of stored information stored in the memory unit of FIG. FIG.
The first embodiment is configured such that an identifier is provided in the treatment instrument, and the heating elements of the treatment instrument connected to the apparatus main body are individually output-controlled according to the temperature resistance characteristics based on information read from the identifier. However, in the second embodiment, the treatment instrument is provided with a memory unit, and the heating elements of the treatment instrument connected to the apparatus main body are individually controlled in accordance with the temperature resistance characteristics based on the information read from the memory unit. To be configured. Since the other configuration is the same as that of the first embodiment, the description thereof will be omitted, and the same components will be described with the same reference numerals.

  As shown in FIG. 26, the heat treatment apparatus 1C according to the second embodiment includes a coagulation / cutting instrument having a memory 131 as a readable / writable memory means instead of the identifier 10 (identifiers A to D). 2C and an apparatus main body 3C provided with a memory information acquisition unit 132 as characteristic information acquisition means.

  In the memory unit 131, for example, “treatment instrument identification information”, “heating element initial resistance value information”, and “temperature resistance characteristic information (tilt and intercept)” as shown in FIG. 27 can be read and written. In the “initial resistance value information” shown in FIG. 27, since there are three heating elements, a heater pattern of 3 channels (CH) is described as an initial resistance value at room temperature (25 ° C.). In addition, “temperature resistance characteristic information (inclination and intercept)” shown in FIG. 27 describes inclination and intercept information in the heater pattern of the three channels (CH).

  Accordingly, the heat treatment apparatus 1C generates heat similarly to the first embodiment by connecting the main body connector 5C to the connector receiving section 52C of the apparatus main body 3C and reading the information in the memory section 131 into the memory information acquisition section 132. The output can be individually controlled for each element 21 according to its temperature resistance characteristics (initial resistance value, slope, intercept).

As a result, in addition to obtaining the same effect as the first embodiment, the heat treatment apparatus 1C can use a larger amount of information than the identifier 10 (identifiers A to D) by using the memory unit 131. Output control can be performed for each heating element with high accuracy. Further, the heat treatment apparatus 1C uses one memory unit 131, so that it is not necessary to provide the identifier 10 according to the number of heat generating elements, and the size can be reduced accordingly.
It should be noted that embodiments configured by partially combining the above-described embodiments and the like also belong to the present invention.

[Appendix]
(Additional item 1)
A treatment instrument provided with one or more heat generating means for generating heat to be applied to a living tissue in a treatment part;
Applied current detecting means for detecting a current value applied to the heat generating means;
Applied voltage detecting means for detecting a voltage value applied to the heat generating means;
Calculation means for calculating the resistance value or temperature of the heating means using the detection results of the applied current detection means and the applied voltage detection means,
Output setting means for performing settings for controlling the heat generating means;
Output control means for controlling the output to the heat generating means based on the calculation result by the calculating means and the setting of the output setting means;
A plurality of identifiers representing the characteristic information of the heat generating means, or memory means storing the characteristic information of the heat generating means;
Characteristic information represented by the plurality of identifiers, or characteristic information acquisition means for acquiring characteristic information stored in the memory means;
Based on the characteristic information acquired by the characteristic information acquisition means, characteristic determination means for determining the characteristics of the heat generating means,
Control state correction means for correcting heat generation control by the output control means based on the determination result of the characteristic determination means;
An exothermic treatment device characterized by comprising:

(Appendix 2)
The heat treatment apparatus according to claim 1, wherein the plurality of identifiers or the memory means are provided at predetermined positions of the treatment instrument.

(Additional Item 3)
The heat treatment apparatus according to claim 1, wherein the treatment tool includes the plurality of identifiers or the memory unit in any one of a body part, a handle operation part, and a connector part.

(Appendix 4)
The heat treatment apparatus according to any one of Additional Items 1 to 3, wherein the control correction unit corrects at least one operation of the output control unit, the output setting unit, and the calculation unit. .

(Appendix 5)
The characteristic information of the heating means includes electrical resistance value data at an arbitrary temperature of the heating means, inclination data of electrical resistance values with respect to the temperature of the heating means, intercept data of electrical resistance values with respect to the temperature of the heating means, and the heating means. The heat treatment apparatus according to any one of Additional Items 1 to 4, wherein the heat treatment apparatus is at least one of variation data with respect to the initial electrical resistance value.

  The heat treatment device of the present invention is used by incorporating a heat generation element having an initial electric resistance value far from the reference resistance value into a treatment tool, by performing appropriate output control for each heat generation element to obtain a desired treatment effect. Because it can, it is suitable for surgical operations for incision and coagulation.

It is an apparatus block diagram which shows the whole structure of a fever treatment apparatus. It is a front view of the apparatus main body of FIG. It is a rear view of the apparatus main body of FIG. It is explanatory drawing which shows the surgical forceps which is a coagulation incision treatment tool. FIG. 5 is a schematic perspective view of a side surface of the heat treatment section of FIG. 4 from the horizontal direction. It is a schematic perspective view from the upper surface perpendicular direction of the heat-generation treatment part of FIG. FIG. 5 is a top cross-sectional view of the heat treatment portion of FIG. 4 from the top surface vertical direction. It is side surface sectional drawing from the side surface horizontal direction of the heat treatment part of FIG. FIG. 2 is a circuit block diagram of the heat treatment device of FIG. 1. It is an external appearance perspective view of tweezers which is a coagulation incision treatment tool. It is an external appearance side view of the tweezers of FIG. It is an external appearance side view which shows the forceps for endoscopic surgery which is a coagulation incision treatment tool. It is a treatment tool identification table | surface which shows the kind of treatment tool detachably connected to an apparatus main body. It is a heating element initial resistance value identification table showing initial characteristics of the heating element. It is a heat generating element characteristic identification (slope) table | surface which shows the temperature resistance characteristic (temperature resistance characteristic inclination) of a heat generating element. It is a heat generating element characteristic identification (intercept) table | surface which shows the temperature resistance characteristic (temperature resistance characteristic intercept) of a heat generating element. It is a 1st graph which shows the resistance value with respect to the temperature of a heat generating element. It is a 2nd graph which shows the resistance value with respect to the temperature of a heat generating element. It is a flowchart which shows a calibration operation | movement. It is a flowchart of the discrimination | determination process which an information discrimination | determination part performs. It is a flowchart of the resistance characteristic discrimination | determination process with respect to a heat generating element. It is an apparatus block diagram which shows the whole structure of the exothermic treatment apparatus of a modification. It is explanatory drawing which shows the surgical forceps which is a coagulation incision treatment tool of FIG. It is explanatory drawing which shows the tweezers which is a coagulation incision treatment tool of FIG. It is explanatory drawing which shows the forceps for endoscopic surgery which is the coagulation incision treatment tool of FIG. It is a circuit block diagram of the heat treatment apparatus of Example 2. It is a figure which shows an example of the memory | storage information memorize | stored in the memory part of FIG.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 Exothermic treatment apparatus 2 Coagulation incision treatment tool 9 Treatment part 10 Identifier 21 Heating element 31 Applied current detection part 32 Applied voltage detection part 33 Control calculating part 35 Output setting part 36 Output control part 39 Control selection switching part 41 Identifier information acquisition part 46 Information discriminating unit 47 Control state correcting unit

Claims (3)

A treatment instrument provided with one or more heat generating means for generating heat to be applied to a living tissue in a treatment part;
Applied current detecting means for detecting a current value applied to the heat generating means;
Applied voltage detecting means for detecting a voltage value applied to the heat generating means;
Calculation means for calculating the resistance value or temperature of the heating means using the detection results of the applied current detection means and the applied voltage detection means,
Output setting means for performing settings for controlling the heat generating means;
Output control means for controlling the output to the heat generating means based on the calculation result by the calculating means and the setting of the output setting means;
A plurality of identifiers representing the characteristic information of the heat generating means, or memory means storing the characteristic information of the heat generating means;
Characteristic information represented by the plurality of identifiers, or characteristic information acquisition means for acquiring characteristic information stored in the memory means;
Based on the characteristic information acquired by the characteristic information acquisition means, characteristic determination means for determining the characteristics of the heat generating means,
Control state correction means for correcting heat generation control by the output control means based on the determination result of the characteristic determination means;
An exothermic treatment device characterized by comprising:   The heat treatment apparatus according to claim 1, wherein the control correction unit corrects at least one operation of the output control unit, the output setting unit, and the calculation unit. The characteristic information of the heating means includes electrical resistance value data at an arbitrary temperature of the heating means, inclination data of electrical resistance values with respect to the temperature of the heating means, intercept data of electrical resistance values with respect to the temperature of the heating means, and the heating means. The heat treatment apparatus according to claim 1, wherein the heat treatment apparatus is at least one of variation data with respect to the initial electric resistance value.

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