JP2011125652A - Electrosurgical instrument and electrosurgical appliance - Google Patents

Electrosurgical instrument and electrosurgical appliance Download PDF

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JP2011125652A
JP2011125652A JP2009299465A JP2009299465A JP2011125652A JP 2011125652 A JP2011125652 A JP 2011125652A JP 2009299465 A JP2009299465 A JP 2009299465A JP 2009299465 A JP2009299465 A JP 2009299465A JP 2011125652 A JP2011125652 A JP 2011125652A
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electrode knife
thermoelectric element
electrosurgical instrument
electrode
knife
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Yoshinobu Abe
可伸 安部
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<P>PROBLEM TO BE SOLVED: To provide a compact electrosurgical appliance, excellent in the operability, capable of accurately measuring and controlling the temperature of an electrode knife and the living tissue in the periphery. <P>SOLUTION: The medical electrosurgical appliance is for performing a high-frequency treatment to the target living tissue by feeding high-frequency currents to the metal electrode knife 1. The electrode knife is a first thermoelectric element 1 and a metal material different from the electrode knife is a second thermoelectric element 2a. The second thermoelectric element with an insulation layer on the surface is joined to the electrode knife as the first thermoelectric element to make a thermocouple. <P>COPYRIGHT: (C)2011,JPO&INPIT

Description

本発明は、患部に高周波電流を流して生体組織の熱凝固、焼灼、切開、切除、破壊、脱毛などを行う電気手術器に係り、特にコンパクトで操作性が良好で、かつ電極ナイフおよびその周辺の生体組織の温度を正確に計測し、かつ制御できる電気手術器に関する。  TECHNICAL FIELD The present invention relates to an electrosurgical instrument that conducts thermal coagulation, cauterization, incision, excision, destruction, hair removal, etc. of living tissue by flowing a high-frequency current to an affected area, and is particularly compact and has good operability and an electrode knife and its surrounding The present invention relates to an electrosurgical device that can accurately measure and control the temperature of a living tissue.

近年、電気手術器が、皮膚科、形成外科、耳鼻咽喉科、産婦人科、外科、整形外科、脳神経外科、美容外科、歯科などの外科的治療に幅広く利用されている。
電気手術器は、体内に挿入した金属製電極ナイフを通じて患部に高周波電流を流し、生体組織の水分子を振動・加熱させ、熱凝固、焼灼、脱毛、切開、切除、破壊などの処置を行うものである。
In recent years, electrosurgical instruments have been widely used in surgical treatments such as dermatology, plastic surgery, otolaryngology, obstetrics and gynecology, surgery, orthopedics, neurosurgery, cosmetic surgery, and dentistry.
An electrosurgical device applies high-frequency current to the affected area through a metal electrode knife inserted into the body, and vibrates and heats water molecules in living tissue to perform treatments such as thermal coagulation, cauterization, hair removal, incision, excision, and destruction. It is.

患部に高周波電流を流す際、弱い高周波電流を流した場合には、生体組織の昇温を細胞のたんぱく質が変性する程度に抑えることができる。このような処置は、組織の凝固や焼灼による止血、毛根の凝固による脱毛などの分野で用いられている。
一方、強い高周波電流を流した場合には、組織の水分を瞬時に気化させて細胞内で小規模な水蒸気爆発を発生させ、電極ナイフ周辺の細胞組織を吹き飛ばすことができる。このような処置は、出血を制限しながら切開や切除を行ったり、目的組織の破壊を行う際に用いられている。
When a high frequency current is applied to the affected area, if a weak high frequency current is applied, the temperature of the living tissue can be suppressed to such an extent that the protein of the cell is denatured. Such treatments are used in fields such as tissue coagulation and hemostasis by cauterization, and hair removal by hair root coagulation.
On the other hand, when a strong high-frequency current is applied, the moisture in the tissue is instantly vaporized to generate a small-scale water vapor explosion in the cell, and the cellular tissue around the electrode knife can be blown away. Such a treatment is used when performing incision or excision while restricting bleeding or destroying a target tissue.

このように電気手術器は、高周波電流の流し方により、様々な加熱方法や処置方法を行うことができることから、止血、脱毛、切開、ポリープやがんの切除・破壊など、様々な用途に用いられているが、これらの処置には微細な作業が要求されることから、コンパクトで操作性が良好な電極ナイフが求められていた。
また、電極ナイフに供給される高周波電流のエネルギーが不十分であったり過剰である場合には、生体組織に適切な処置ができなかったり、炭化や気泡が発生したり、必要以上の破壊が起こるといった問題が発生する。そのため、電極ナイフの温度計測および制御が可能な電気手術器が求められていた。
As described above, the electrosurgical device can be used in various applications such as hemostasis, hair removal, incision, polyp and cancer excision / destruction because various heating methods and treatment methods can be performed depending on the flow of high-frequency current. However, since these operations require fine work, a compact electrode knife with good operability has been demanded.
In addition, when the energy of the high-frequency current supplied to the electrode knife is insufficient or excessive, proper treatment cannot be performed on the living tissue, carbonization or bubbles are generated, or unnecessary destruction occurs. Such a problem occurs. Therefore, an electrosurgical device capable of measuring and controlling the temperature of the electrode knife has been demanded.

そこで、熱電対を電極ナイフに取り付けて電極ナイフの温度を計測し、その計測結果を高周波電流の供給量へフィードバックすることが考えられた。しかし、高周波電流供給下では、熱電対の検出温度信号に高周波ノイズが混入するため、正確な温度検出が行えないという問題があった。  Therefore, it has been considered to attach a thermocouple to the electrode knife, measure the temperature of the electrode knife, and feed back the measurement result to the supply amount of the high-frequency current. However, under high-frequency current supply, high-frequency noise is mixed in the detection temperature signal of the thermocouple, so that there is a problem that accurate temperature detection cannot be performed.

そこで、先端接続部をポリオレフィン系合成樹脂により被覆した熱電対を電極針先端に接着剤で固定した医療用電極針装置が提案されている(特許文献1)。
また、先端部を除く外周面に絶縁被覆を施した中空の外針と、外針に挿通される、先端部に温度センサを接着剤で固定した内針とを備え、外針に内針を介して高周波電流を供給するようにした温度センサ付き電極針装置が提案されている(特許文献2)。
特開2007−000237号公報 特開2007−000303号公報
In view of this, a medical electrode needle device has been proposed in which a thermocouple having a tip connection portion coated with a polyolefin-based synthetic resin is fixed to the tip of the electrode needle with an adhesive (Patent Document 1).
In addition, it has a hollow outer needle with an insulation coating on the outer peripheral surface excluding the tip, and an inner needle that is inserted through the outer needle and has a temperature sensor fixed to the tip with an adhesive. There has been proposed an electrode needle device with a temperature sensor that supplies a high-frequency current through the same (Patent Document 2).
JP 2007-000237 A JP 2007-000303 A

上述のように、特許文献1に示される医療用電極針装置を用いることにより、電極針の温度を計測することができた。しかし、この方法では、電極針に熱電対が接着固定されていることから、電極針がかさ高くなり、操作性が悪くなるという問題が発生した。また熱電対の接触状態によっては、電極針およびその周辺の生体組織の温度が正確に計測できないという問題が発生した。  As described above, the temperature of the electrode needle could be measured by using the medical electrode needle device disclosed in Patent Document 1. However, in this method, a thermocouple is bonded and fixed to the electrode needle, which causes a problem that the electrode needle becomes bulky and the operability is deteriorated. Further, depending on the contact state of the thermocouple, there has been a problem that the temperature of the electrode needle and the surrounding living tissue cannot be measured accurately.

また、特許文献2に示される電極針装置でも、特許文献1の電極針と同様に温度センサの設置により電極針がかさ高くなり、操作性が悪くなるという問題が発生した。また、温度センサの設置状態によっては、電極針およびその周辺の生体組織の温度が正確に計測できないという問題が発生した。  Further, in the electrode needle device shown in Patent Document 2, similarly to the electrode needle of Patent Document 1, the problem that the electrode needle becomes bulky due to the installation of the temperature sensor is deteriorated. Moreover, the problem that the temperature of an electrode needle | hook and its surrounding biological tissue cannot be measured correctly generate | occur | produced depending on the installation state of a temperature sensor.

本発明は上述のような従来技術の問題点などに鑑みてなされたものであり、その主たる目的は、コンパクトで操作性が良好で、電極ナイフおよびその周辺の生体組織の温度を正確に計測し、かつ制御できる電気手術器を提供することを目的とするものである。  The present invention has been made in view of the above-described problems of the prior art, and its main purpose is to be compact and easy to operate, and to accurately measure the temperature of the electrode knife and the surrounding living tissue. And it aims at providing the electrosurgical device which can be controlled.

上記した課題を解決するために、第一発明は、金属製電極ナイフに高周波電流を供給することによって対象となる生体組織に対して高周波処置を行うための医療用電気手術具であって、前記電極ナイフを第一熱電素子とし、前記電極ナイフとは異なる金属材料を第二熱電素子とし、前記第一熱電素子である電極ナイフに、表面に絶縁層を設けた前記第二熱電素子を接合して熱電対としたことを特徴とする電気手術具である。
第二発明は、前記電極ナイフがステンレス製またはチタン合金製であることを特徴とする請求項1に記載の電気手術具である。
In order to solve the above-mentioned problem, the first invention is a medical electrosurgical instrument for performing high-frequency treatment on a target biological tissue by supplying a high-frequency current to a metal electrode knife, The electrode knife is the first thermoelectric element, the metal material different from the electrode knife is the second thermoelectric element, and the second thermoelectric element having an insulating layer on the surface is joined to the electrode knife that is the first thermoelectric element. An electrosurgical instrument characterized by being a thermocouple.
The second invention is the electrosurgical instrument according to claim 1, wherein the electrode knife is made of stainless steel or titanium alloy.

第三発明は、前記第二熱電素子がステンレス製またはチタン合金製であることを特徴とする請求項1に記載の電気手術具である。
第四発明は、前記熱電対の温度計測手段が、高周波電流供給下において、単位時間毎に短時間の高周波電流供給停止時間を設け、前記高周波電流供給停止時間に前記熱電対で温度計測を行うものであることを特徴とした請求項1〜3に記載の電気手術具を用いた電気手術器。
The third invention is the electrosurgical instrument according to claim 1, wherein the second thermoelectric element is made of stainless steel or titanium alloy.
According to a fourth aspect of the present invention, the thermocouple temperature measuring means provides a short high-frequency current supply stop time per unit time under high-frequency current supply, and performs temperature measurement with the thermocouple during the high-frequency current supply stop time. An electrosurgical instrument using the electrosurgical instrument according to claim 1, wherein the electrosurgical instrument is used.

第五発明は、前記温度計測手段と、前記温度計測手段を用いて計測した温度計測結果を高周波発生装置の出力へとフィードバックすることによる前記電極ナイフの温度制御手段を有することを特徴とする、請求項1〜4に記載の電気手術具を用いた電気手術器である。  The fifth invention comprises the temperature measuring means, and the temperature control means of the electrode knife by feeding back the temperature measurement result measured using the temperature measuring means to the output of the high frequency generator, An electrosurgical instrument using the electrosurgical instrument according to claim 1.

請求項1に係る発明の電気手術具によれば、コンパクトで操作性が良好で、かつ電極ナイフおよびその周辺の生体組織の温度を正確に計測し、かつ制御できる電気手術具を容易に得ることができる。
請求項2に係る発明の電気手術具によれば、加工が容易で、耐久性が高く、金属アレルギーを起こしにくく、メンテナンスの容易な電気手術具を容易に得ることができる。
請求項3に係る発明の電気手術具によれば、加工が容易で、耐久性が高く、金属アレルギーを起こしにくく、メンテナンスの容易な電気手術具を容易に得ることができる。
According to the electrosurgical instrument of the invention of claim 1, it is possible to easily obtain an electrosurgical instrument that is compact and has good operability, and that can accurately measure and control the temperature of the electrode knife and its surrounding biological tissue. Can do.
According to the electrosurgical instrument of the invention according to claim 2, it is possible to easily obtain an electrosurgical instrument that is easy to process, has high durability, hardly causes metal allergy, and is easy to maintain.
According to the electrosurgical instrument of the invention according to claim 3, it is possible to easily obtain an electrosurgical instrument that is easy to process, highly durable, hardly causes metal allergy, and is easy to maintain.

請求項4に係る発明の電気手術具によれば、電極ナイフに供給される高周波電流のノイズの影響を受けずに、電極ナイフおよびその周辺の生体組織の温度を正確に計測することができる。
請求項5に係る発明の電気手術器によれば、電極ナイフおよびその周辺の生体組織の温度を正確に計測し、かつ制御できることにより、様々な組織の様々な処置に適用可能な電気手術器を容易に得ることができる。
According to the electrosurgical instrument of the invention of claim 4, the temperature of the electrode knife and its surrounding living tissue can be accurately measured without being affected by the noise of the high-frequency current supplied to the electrode knife.
According to the electrosurgical device of the invention according to claim 5, the electrosurgical device applicable to various treatments of various tissues can be obtained by accurately measuring and controlling the temperature of the electrode knife and the surrounding biological tissue. Can be easily obtained.

上記より、以下に本願発明に係る加熱装置の作用効果を列挙する。
第一の効果は、コンパクトであることである。
第二の効果は、操作性が良好であることである。
第三の効果は、加工が容易であることである。
第四の効果は、耐久性が高いことである。
第五の効果は、金属アレルギーを起こしにくいことである。
From the above, the effects of the heating device according to the present invention will be listed below.
The first effect is compactness.
The second effect is that the operability is good.
The third effect is that processing is easy.
The fourth effect is high durability.
The fifth effect is that it is difficult to cause metal allergy.

第六の効果は、メンテナンスが容易であることである。
第七の効果は、処置時の電極ナイフおよびその周辺の生体組織の温度を正確に把握できることである。
第八の効果は、処置時の電極ナイフおよびその周辺の生体組織の温度を容易にコントロールできることである。
第九の効果は、様々な生体組織に適用可能であることである。
第十の効果は、様々な処置に適用可能であることである。
The sixth effect is that maintenance is easy.
The seventh effect is that the temperature of the electrode knife and its surrounding living tissue at the time of treatment can be accurately grasped.
The eighth effect is that the temperature of the electrode knife during treatment and the surrounding living tissue can be easily controlled.
The ninth effect is that it can be applied to various biological tissues.
The tenth effect is that it can be applied to various treatments.

以下、図面を参照しながら、本発明の実施の形態を詳しく説明する。
図1は、本発明に係る電気手術具の構成を説明するための模式図である。この図において、1は電極ナイフ(第一熱電素子)、2は第二熱電素子に表面絶縁層を設けたもの、2aは第二熱電素子、2bは表面絶縁層、3は電極ナイフと第二熱電素子の接合点、4は生体組織、5は対極板、11は電圧計、12は高周波電源、13は高周波電流、14は温度計測結果の高周波電源へのフィードバックである。
Hereinafter, embodiments of the present invention will be described in detail with reference to the drawings.
FIG. 1 is a schematic diagram for explaining the configuration of an electrosurgical instrument according to the present invention. In this figure, 1 is an electrode knife (first thermoelectric element), 2 is a second thermoelectric element provided with a surface insulating layer, 2a is a second thermoelectric element, 2b is a surface insulating layer, 3 is an electrode knife and second Junction points of thermoelectric elements, 4 is a living tissue, 5 is a counter electrode, 11 is a voltmeter, 12 is a high frequency power source, 13 is a high frequency current, and 14 is a feedback of the temperature measurement result to the high frequency power source.

本発明の電気手術具は、第一熱電素子として機能する金属製電極ナイフに、金属製電極ナイフとは異なる金属材料を第二熱電素子として接合し、熱電対としたことを特徴としており、電極ナイフが電極ナイフとしての機能を果たしつつ、電極ナイフおよびその周辺の生体組織の温度を正確に計測するための熱電対としても機能することができる。  The electrosurgical instrument of the present invention is characterized in that a metal material different from a metal electrode knife is joined to a metal electrode knife functioning as a first thermoelectric element as a second thermoelectric element to form a thermocouple. While the knife functions as an electrode knife, it can also function as a thermocouple for accurately measuring the temperature of the electrode knife and surrounding living tissue.

通常、高周波電流供給下での温度計測は、熱電対の検出温度信号に高周波ノイズが混入し、正確に行うことができない。しかし、本発明で示したように、高周波電流供給時に、単位時間毎に短時間の高周波電流供給停止時間を設け、その間に電極ナイフとしても機能している熱電対で温度計測を行えば、高周波電流のノイズの影響を受けずに電極ナイフおよびその周辺の生体組織の温度を計測することが可能となる。  Normally, temperature measurement under high-frequency current supply cannot be performed accurately because high-frequency noise is mixed in the temperature signal detected by the thermocouple. However, as shown in the present invention, when high-frequency current is supplied, if a short-time high-frequency current supply stop time is provided for each unit time, and temperature measurement is performed with a thermocouple that also functions as an electrode knife, It is possible to measure the temperature of the electrode knife and the surrounding living tissue without being affected by the noise of the current.

高周波電流の供給停止時間は、1000msごとに1〜50ms程度を、1〜100回程度で良いが、この範囲に限定するものではない。このように短い停止時間を複数回設定することにより、一回の停止時間を短くすることができ、かつ1秒間に複数回の計測を行うことができることから、高周波電流による生体組織の加熱には影響を与えず、正確な温度計測を行うことができる。
尚、電極ナイフと第二熱電素子を接合する際には、接合点を電極ナイフが生体組織に当接する部分に出来る限り近づけて設定することが望ましい。それにより、計測温度と生体組織に当接している部分の電極ナイフの温度と処置対象である生体組織の温度がほぼ等しくなり、処置時の生体組織の温度を把握することが可能となる。
また、温度計測結果を高周波発生装置の出力へとフィードバックし、制御する機構を設けることにより、電極ナイフおよびその周辺の生体組織を要求温度に制御することができる。
The supply stop time of the high-frequency current may be about 1 to 50 ms every 1000 ms, but about 1 to 100 times, but is not limited to this range. By setting such a short stop time a plurality of times, one stop time can be shortened and a plurality of measurements can be performed per second. Accurate temperature measurement can be performed without affecting.
When joining the electrode knife and the second thermoelectric element, it is desirable to set the joining point as close as possible to the portion where the electrode knife contacts the living tissue. As a result, the measured temperature and the temperature of the electrode knife in contact with the living tissue are substantially equal to the temperature of the living tissue to be treated, and the temperature of the living tissue at the time of treatment can be grasped.
In addition, by providing a mechanism for feeding back and controlling the temperature measurement result to the output of the high-frequency generator, the electrode knife and the surrounding biological tissue can be controlled to the required temperature.

本発明の電気手術具は、第二熱電素子の表面に絶縁層を設けたことを特徴としている。この表面絶縁層は、電極ナイフと第二熱電素子の間でショートが発生することを防ぐとともに、第二熱電素子の表面を保護したり、金属アレルギーをおこしにくくする機能も担っている。
表面絶縁層の設置は、絶縁樹脂塗料を塗布したり、絶縁樹脂フィルムやチューブで被覆することによって容易に達成できる。尚、絶縁樹脂材料としては、フッ素、ポリイミド、ポリオレフィン系樹脂などが挙げられるが、これらに限定するものではない。また、表面絶縁層の設置は、電極ナイフへの第二熱電素子の接合前/後いずれでもよい。
接合は溶接などの手段で容易に行うことができるが、とくにこの方法に限定するものではない。また、接合部には表面絶縁層を設けても設けなくてもよい。
The electrosurgical instrument of the present invention is characterized in that an insulating layer is provided on the surface of the second thermoelectric element. This surface insulating layer has a function of preventing the occurrence of a short circuit between the electrode knife and the second thermoelectric element, protecting the surface of the second thermoelectric element, and preventing metal allergy.
The installation of the surface insulating layer can be easily achieved by applying an insulating resin paint or coating with an insulating resin film or a tube. Examples of the insulating resin material include fluorine, polyimide, and polyolefin resin, but are not limited thereto. Further, the surface insulating layer may be installed either before or after the second thermoelectric element is joined to the electrode knife.
Joining can be easily performed by means such as welding, but is not particularly limited to this method. Further, a surface insulating layer may or may not be provided at the joint.

本発明では、金属製電極ナイフの材料をステンレス製またはチタン合金製であることを特徴としている。また、第二熱電素子の材料がステンレス製またはチタン合金製であることを特徴としている。電極ナイフと第二熱電素子を熱電対として機能させるためには両者の材料が異なっている必要があることから、電極ナイフがステンレス製である場合には第二金属はチタン合金製、電極ナイフがチタン合金製である場合には第二金属はステンレス製である必要がある。もしくは両金属の合金配合比率を、熱電対として機能する程度に変える必要がある。  The present invention is characterized in that the material of the metal electrode knife is made of stainless steel or titanium alloy. Further, the second thermoelectric element is made of stainless steel or titanium alloy. In order for the electrode knife and the second thermoelectric element to function as a thermocouple, both materials need to be different. Therefore, when the electrode knife is made of stainless steel, the second metal is made of a titanium alloy, and the electrode knife is made of When it is made of a titanium alloy, the second metal needs to be made of stainless steel. Or it is necessary to change the alloy compounding ratio of both metals so that it functions as a thermocouple.

ステンレスおよびチタン合金は、加工が容易で、耐久性が高く、金属アレルギーを起こしにくいことから、近年、生体用金属として多く用いられている。また、ステンレス、チタン合金ともに耐食性が高いことから、電極ナイフ表面に生体組織が付着しても腐食しにくいほか、洗浄剤を使用することもでき、メンテナンス性の良好な電気手術器を得ることができる。  Stainless steel and titanium alloys have been widely used in recent years because they are easy to process, have high durability, and are less susceptible to metal allergies. In addition, since both stainless steel and titanium alloy have high corrosion resistance, it is difficult to corrode even if biological tissue adheres to the surface of the electrode knife, and it is possible to use a cleaning agent to obtain an electrosurgical device with good maintainability. it can.

金属製電極ナイフの形状については、図2(a)〜(j)に示したように、処置方法に合わせて様々なものが考えられる。針状やナイフ状の電極ナイフでは、患部を切り取ったり破壊するなどの処置を行うことができる。フック状の電極ナイフでは、患部を引っ掻いたり、切り取ったり破壊するなどの処置を行うことができる。柔軟なループ状の電極ナイフは、患部を縛って焼き切るなどの処置を行うことができる。剛性のあるループ状の電極ナイフでは、患部をそぎ切るなどの処置を行うことができる。また、筒状の電極ナイフでは、施術後に筒の内部から洗浄液や消毒液などの薬液を注入することもできる。これらの他にも、針状のものの先端に絶縁体のセラミックスチップを取り付け、針の先端が組織に不必要な傷をつけることを防止したものなどもある。また、第二熱電素子が操作の邪魔になることを防ぐために、図2(k)に示したように、第二熱電素子を電極ナイフに巻きつけたり、電極ナイフに設けた溝に収納してもよい。本発明の電極ナイフにおいては、その形状や使用方法は特に限定されるものではない。
尚、電極ナイフの根元などの、生体組織の処置にかかわりのない部分には絶縁処置を施してもよい。
About the shape of metal electrode knives, various things can be considered according to the treatment method, as shown in FIGS. With a needle-like or knife-like electrode knife, it is possible to perform treatments such as cutting or destroying the affected area. With the hook-shaped electrode knife, it is possible to perform treatments such as scratching, cutting off or destroying the affected area. A flexible loop-shaped electrode knife can be used to perform treatment such as tying the affected area and burning it out. With a rigid loop-shaped electrode knife, it is possible to perform a treatment such as scraping the affected area. In the case of a cylindrical electrode knife, a chemical solution such as a cleaning solution or a disinfecting solution can be injected from the inside of the tube after the treatment. In addition to these, an insulating ceramic chip is attached to the tip of a needle-like material to prevent the tip of the needle from causing unnecessary damage to the tissue. Further, in order to prevent the second thermoelectric element from interfering with the operation, as shown in FIG. 2 (k), the second thermoelectric element may be wound around the electrode knife or stored in the groove provided in the electrode knife. Good. In the electrode knife of this invention, the shape and usage method are not specifically limited.
Insulating treatments may be applied to portions that are not involved in the treatment of living tissue, such as the base of the electrode knife.

電極ナイフとしてステンレス針を用い、これに表面にフッ素樹脂塗料を塗布したチタンワイヤーを接合し、図2(a)に示す電気手術具を作成した。この電気手術具に1000msごとに、20ms×5回の供給停止時間を設け、この停止時間に熱電対の温度を計測し、計測結果をフィードバックしながら高周波電流を供給し、電極ナイフの温度計測および制御が可能な電気手術器を作成した。  A stainless needle was used as an electrode knife, and a titanium wire having a fluororesin coating applied on the surface was joined to the electrode knife to produce an electrosurgical instrument shown in FIG. This electrosurgical instrument is provided with a supply stop time of 20 ms × 5 times every 1000 ms, the temperature of the thermocouple is measured during this stop time, a high-frequency current is supplied while feeding back the measurement result, and the temperature measurement of the electrode knife and A controllable electrosurgical device was created.

電極ナイフとしてステンレスナイフを用い、これに表面をテフロンチューブで被覆したチタンワイヤーを接合し、図2(b)に示す電気手術具を作成した。この電気手術具に1000msごとに、20ms×5回の供給停止時間を設け、この停止時間に熱電対の温度を計測し、計測結果をフィードバックしながら高周波電流を供給し、電極ナイフの温度計測および制御が可能な電気手術器を作成した。  A stainless steel knife was used as an electrode knife, and a titanium wire whose surface was covered with a Teflon tube was joined thereto to produce an electrosurgical instrument shown in FIG. This electrosurgical instrument is provided with a supply stop time of 20 ms × 5 times every 1000 ms, the temperature of the thermocouple is measured during this stop time, a high-frequency current is supplied while feeding back the measurement result, and the temperature measurement of the electrode knife and A controllable electrosurgical device was created.

電極ナイフとしてチタンナイフを用い、これに表面にポリイミド塗料を塗布したステンレス針を接合し、図2(c)に示す電気手術具を作成した。この電気手術具に1000msごとに、20ms×5回の供給停止時間を設け、この停止時間に熱電対の温度を計測し、計測結果をフィードバックしながら高周波電流を供給し、電極ナイフの温度計測および制御が可能な電気手術器を作成した。  A titanium knife was used as an electrode knife, and a stainless needle with a polyimide coating applied to the surface was joined to the electrode knife, thereby producing an electrosurgical instrument shown in FIG. This electrosurgical instrument is provided with a supply stop time of 20 ms × 5 times every 1000 ms, the temperature of the thermocouple is measured during this stop time, a high-frequency current is supplied while feeding back the measurement result, and the temperature measurement of the electrode knife and A controllable electrosurgical device was created.

(比較例1)
電極ナイフとしてステンレス針を用い、これに接着剤を用いて熱電対を張り付け、電気手術具を作成した。この電気手術具に高周波電流を供給し、電気手術器を作成した。
(比較例2)
電極ナイフとしてチタンナイフを用い、これに接着剤を用いて熱電対を張り付け、電気手術具を作成した。この電気手術具に高周波電流を供給し、電気手術器を作成した。
(Comparative Example 1)
A stainless needle was used as an electrode knife, and an electrosurgical instrument was prepared by attaching a thermocouple thereto using an adhesive. A high frequency current was supplied to the electrosurgical instrument to create an electrosurgical device.
(Comparative Example 2)
A titanium knife was used as an electrode knife, and an electrosurgical instrument was prepared by attaching a thermocouple to the titanium knife using an adhesive. A high frequency current was supplied to the electrosurgical instrument to create an electrosurgical device.

実施例1〜3および比較例1〜2の電気手術器を用いて、鶏肉の切除を行った。実施例1〜3は、電気手術器の操作性、患部の温度計測とも良好であり、目的通りの切除を行うことができた。比較例1〜2の電気手術器では、熱電対により電極ナイフがかさ高くなったために操作性が悪化し、微細な切除を行うことができなかった。また、高周波のノイズにより患部の温度計測を行うことができなかった。また、電極ナイフの温度制御ができなかったため、切除した肉片には部分的に炭化が生じた。  Using the electrosurgical devices of Examples 1 to 3 and Comparative Examples 1 and 2, chicken was excised. In Examples 1 to 3, the operability of the electrosurgical device and the temperature measurement of the affected area were good, and the excision as intended could be performed. In the electrosurgical devices of Comparative Examples 1 and 2, since the electrode knife became bulky due to the thermocouple, the operability deteriorated and fine excision could not be performed. Also, the temperature of the affected area could not be measured due to high frequency noise. In addition, since the temperature of the electrode knife could not be controlled, the cut meat pieces were partially carbonized.

は、本発明の電気手術器を説明するための模式図である。These are the schematic diagrams for demonstrating the electrosurgical device of this invention. (a)〜(j)は、本発明の電気手術具の一実施例を示す断面図、(k)は本発明の電気手術具の一実施例を示す正面図である。(A)-(j) is sectional drawing which shows one Example of the electrosurgical tool of this invention, (k) is a front view which shows one Example of the electrosurgical tool of this invention.

1 電極ナイフ(第一熱電素子)
2 第二熱電素子に表面絶縁層を設けたもの
2a 第二熱電素子
2b 表面絶縁層
3 接合部
4 生体組織
5 対極板
11 電圧計
12 高周波発生装置
13 高周波電流
14 温度計測結果の高周波電源へのフィードバック
1 Electrode knife (first thermoelectric element)
2 2nd thermoelectric element provided with a surface insulating layer 2a 2nd thermoelectric element 2b surface insulating layer 3 joint 4 biological tissue 5 counter electrode 11 voltmeter 12 high frequency generator 13 high frequency current 14 feedback

Claims (5)

金属製電極ナイフに高周波電流を供給することによって対象となる生体組織に対して高周波処置を行うための医療用電気手術具であって、
前記電極ナイフを第一熱電素子とし、
前記電極ナイフとは異なる金属材料を第二熱電素子とし、
前記第一熱電素子である電極ナイフに、表面に絶縁層を設けた前記第二熱電素子を接合して熱電対としたことを特徴とする電気手術具。
A medical electrosurgical instrument for performing high frequency treatment on a target biological tissue by supplying a high frequency current to a metal electrode knife,
The electrode knife as a first thermoelectric element,
A metal material different from the electrode knife is a second thermoelectric element,
An electrosurgical instrument characterized in that an electrode knife as the first thermoelectric element is joined to the second thermoelectric element having an insulating layer on the surface to form a thermocouple.
前記電極ナイフがステンレス製またはチタン合金製であることを特徴とする請求項1に記載の電気手術具。  The electrosurgical instrument according to claim 1, wherein the electrode knife is made of stainless steel or titanium alloy. 前記第二熱電素子がステンレス製またはチタン合金製であることを特徴とする請求項1に記載の電気手術具。  The electrosurgical instrument according to claim 1, wherein the second thermoelectric element is made of stainless steel or titanium alloy. 前記熱電対の温度計測手段が、高周波電流供給下において、単位時間毎に短時間の高周波電流供給停止時間を設け、
前記高周波電流供給停止時間に前記熱電対で温度計測を行うものであることを特徴とした請求項1〜3に記載の電気手術具を用いた電気手術器。
The thermocouple temperature measuring means provides a short high-frequency current supply stop time per unit time under a high-frequency current supply,
The electrosurgical instrument using the electrosurgical instrument according to claim 1, wherein temperature measurement is performed with the thermocouple during the high-frequency current supply stop time.
前記温度計測手段と、
前記温度計測手段を用いて計測した温度計測結果を、高周波発生装置の出力へとフィードバックすることによる前記電極ナイフの温度制御手段を有することを特徴とする、請求項1〜4に記載の電気手術具を用いた電気手術器。
The temperature measuring means;
5. The electrosurgery according to claim 1, further comprising temperature control means for the electrode knife by feeding back a temperature measurement result measured using the temperature measurement means to an output of a high frequency generator. Electrosurgical device using tools.
JP2009299465A 2009-12-21 2009-12-21 Electrosurgical instrument and electrosurgical appliance Pending JP2011125652A (en)

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Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPH07289556A (en) * 1994-04-25 1995-11-07 Inter Noba Kk Hot chip guide wire and hot chip catheter
JPH07289557A (en) * 1994-04-25 1995-11-07 Inter Noba Kk Heating treatment method of constricted part of blood vessel and local heating type catheter therefor

Patent Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPH07289556A (en) * 1994-04-25 1995-11-07 Inter Noba Kk Hot chip guide wire and hot chip catheter
JPH07289557A (en) * 1994-04-25 1995-11-07 Inter Noba Kk Heating treatment method of constricted part of blood vessel and local heating type catheter therefor

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