JP2012249807A - Treatment apparatus for therapy, and control method for the same - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a treatment apparatus for therapy capable of preventing overheating by heating chips even when a contact state between a living tissue and a heat transfer part in contact with the living tissue is not uniform.SOLUTION: The treatment apparatus for therapy that heats the heat transfer part by a plurality of heating chips discretely arranged at the heat transfer part, is adapted to apply predetermined constant power to each heating chip in a step S11; to acquire the temperature of each heating chip in a step S12; to set the heating chip slowest in temperature rise out of the plurality of heating chips as a reference chip in a step S13; to set, for each heating chip, a control parameter in controlling power to be supplied to the heating chip based on the temperature rise difference between the reference chip and the other heating chips in a step S14; and then to control each heating chip based on the set control parameter, thus allowing each heating chip to be controlled according to a heat load.

Description

  The present invention relates to a therapeutic treatment apparatus and a control method thereof.

  In general, therapeutic treatment apparatuses that treat living tissue using high-frequency energy or thermal energy are known. For example, Patent Document 1 discloses the following therapeutic treatment apparatus. That is, this therapeutic treatment apparatus has an openable / closable holding part that holds a biological tissue to be treated. A high-frequency electrode for applying a high-frequency voltage and a heat-generating chip for heating the high-frequency electrode are disposed at a portion of the holding unit that contacts the living tissue. The holding unit is provided with a cutter. In the use of such a therapeutic treatment apparatus, first, a living tissue is grasped by a holding part and a high frequency voltage is applied. Furthermore, the living tissue is anastomosed by heating the living tissue with the holding member. Moreover, it is also possible to excise in the state which joined the biological tissue edge part with the cutter with which the holding | maintenance part was equipped.

JP 2009-247893 A

  In the therapeutic treatment apparatus as described above, a configuration is considered in which a plurality of heat generating chips for heating the heat transfer portion that are in contact with a living tissue such as a high-frequency electrode are discretely arranged. In order to rapidly increase the temperature of the heat transfer section, a large amount of power is input to the heat generating chip. At this time, if the contact state between the living tissue and the heat transfer portion is uneven depending on the location, a temperature difference occurs between the portions that are not in contact with the living tissue and the portions that are not in contact with the living tissue. There is a risk of overheating the hot section. Such overheating may lead to a failure of the treatment apparatus such as a failure of the heat generating chip.

  Accordingly, an object of the present invention is to provide a therapeutic treatment apparatus that can prevent overheating by a heat generating chip even if the contact state between a living tissue and a heat transfer portion in contact with the living tissue is not uniform.

  In order to achieve the above object, one embodiment of the therapeutic treatment apparatus of the present invention is a therapeutic treatment apparatus for heating and treating a living tissue at a target temperature, and includes a first main surface and a second main surface that are front and back. Among the principal surfaces of the first and second surfaces, a heat transfer portion that contacts the living tissue and transfers heat to the living tissue, and the third and fourth main surfaces that constitute the front and back surfaces of the third principal surface. In the main surface of the heat transfer portion, the heat transfer portion is discretely arranged so as to be joined to the second main surface of the heat transfer portion, and electric power is supplied to the heat generating member formed on each of the fourth main surfaces. A plurality of heat generating chips that heat the heat transfer unit, a temperature acquisition unit that acquires the temperature of each of the heat generating members, a storage unit that stores the temperature, and the power that is input to the heat generating member. A control unit, wherein the control unit sets the temperature when the predetermined power is supplied to the heat generating member. The temperature rise of each of the heat generating members in a predetermined period is calculated based on the temperature stored in the storage unit and the temperature stored in the storage unit, and the temperature rise difference between each of the plurality of heat generating chips And determining each control parameter used for temperature control of the heat generating chip, and feedback controlling the power to be input to each of the plurality of heat generating chips based on the control parameter. To do.

  In addition, in order to achieve the above object, one aspect of the method for controlling the therapeutic treatment apparatus of the present invention is to heat the heat transfer portion where the heat generating chip is disposed by applying power to each heat generating member of the plurality of heat generating chips. A method for controlling a therapeutic treatment apparatus for treating a living tissue by heating the living tissue at a target temperature by the heat transfer unit, starting the heating by applying the electric power to the heating member, and starting the heating A temperature rise of each of the subsequent heat generating chips is acquired, a reference chip is selected from the plurality of heat generating chips based on the temperature increase, and a temperature comparison between the reference chip and each of the other heat generating chips is performed. The control parameters of each of the heat generating chips are set based on the control parameters, and the temperature of each of the heat generating chips is controlled based on the control parameters.

  According to the present invention, the temperature rise of each heat generating chip is compared, and the control parameter of each heat generating chip is set according to the temperature increase, so that the contact state between the living tissue and the heat transfer section in contact therewith is not uniform. However, it is possible to provide a therapeutic treatment apparatus that can prevent overheating by the heat generating chip.

Schematic which shows the structural example of the treatment system for treatment which concerns on one Embodiment of this invention. It is the schematic of the cross section which shows the structural example of the shaft and holding | maintenance part of the energy treatment tool which concerns on one Embodiment of this invention, (A) is a figure which shows the state which the holding | maintenance part closed, (B) is a holding | maintenance part open. FIG. It is the schematic which shows the structural example of the 1st holding member of the holding part which concerns on one Embodiment of this invention, (A) is a top view, (B) is a longitudinal cross section which follows the 3B-3B line | wire shown to (A). The figure, (C) is a cross-sectional view which follows the 3C-3C line | wire shown to (A). The top view which shows the outline of the structural example of the heat-emitting chip which concerns on one Embodiment of this invention. It is a figure which shows the outline of the structural example of the heat generating chip | tip which concerns on one Embodiment of this invention, Comprising: Sectional drawing which follows the 4B-4B line | wire shown to FIG. 4A. The figure which shows the structural example of the energy source which concerns on one Embodiment of this invention. The figure for demonstrating the contact state of a 1st high frequency electrode and a biological tissue. The flowchart which shows an example of the temperature control process by the control part of the treatment apparatus for treatment which concerns on one Embodiment of this invention. The flowchart which shows an example of the heating prevention process by the control part which concerns on one Embodiment of this invention. The figure for demonstrating the temperature change of the heat-emitting chip which concerns on one Embodiment of this invention.

  An embodiment of the present invention will be described with reference to the drawings. The therapeutic treatment apparatus according to the present embodiment is an apparatus for use in the treatment of living tissue, and is an apparatus that causes high-frequency energy and thermal energy to act on the living tissue. As shown in FIG. 1, the therapeutic treatment device 210 includes an energy treatment tool 212, an energy source 214, and a foot switch 216.

  The energy treatment device 212 is a linear type surgical treatment device for performing treatment by penetrating the abdominal wall, for example. The energy treatment device 212 includes a handle 222, a shaft 224 attached to the handle 222, and a holding portion 226 provided at the tip of the shaft 224. The holding unit 226 can be opened and closed, and is a treatment unit that holds a living tissue to be treated and performs treatment such as coagulation and incision. Hereinafter, for the sake of explanation, the holding portion 226 side is referred to as a distal end side, and the handle 222 side is referred to as a proximal end side. The handle 222 includes a plurality of operation knobs 232 for operating the holding unit 226. Note that the shape of the energy treatment device 212 shown here is an example, and other shapes may be used as long as they have the same function. For example, the shape may be a forceps or the shaft may be curved.

  The handle 222 is connected to the energy source 214 via a cable 228. A foot switch 216 is connected to the energy source 214. The foot switch 216 operated with a foot may be replaced with a switch operated with a hand or other switches. When the operator operates the pedal of the foot switch 216, the supply of energy from the energy source 214 to the energy treatment tool 212 is switched ON / OFF.

  An example of the structure of the holding part 226 and the shaft 224 is shown in FIG. 2A shows a state where the holding portion 226 is closed, and FIG. 2B shows a state where the holding portion 226 is opened. The shaft 224 includes a cylindrical body 242 and a sheath 244. The cylindrical body 242 is fixed to the handle 222 at its proximal end. The sheath 244 is disposed on the outer periphery of the cylindrical body 242 so as to be slidable along the axial direction of the cylindrical body 242.

  A holding portion 226 is disposed at the distal end portion of the cylindrical body 242. The holding unit 226 includes a first holding member 260 and a second holding member 270. The base portion of the first holding member 260 is fixed to the distal end portion of the cylindrical body 242 of the shaft 224. On the other hand, the base of the second holding member 270 is rotatably supported by a support pin 256 at the tip of the cylindrical body 242 of the shaft 224. Accordingly, the second holding member 270 rotates around the axis of the support pin 256 and opens or closes with respect to the first holding member 260.

  In a state where the holding portion 226 is closed, the cross-sectional shape of the base portion of the first holding member 260 and the base portion of the second holding member 270 is circular. The second holding member 270 is urged by an elastic member 258 such as a leaf spring so as to open with respect to the first holding member 260. When the sheath 244 is slid to the distal end side with respect to the cylindrical body 242, and the base portion of the first holding member 260 and the base portion of the second holding member 270 are covered by the sheath 244, as shown in FIG. The first holding member 260 and the second holding member 270 are closed against the urging force of the elastic member 258. On the other hand, when the sheath 244 is slid to the proximal end side of the cylindrical body 242, as shown in FIG. 2B, the second holding member 270 with respect to the first holding member 260 is applied by the urging force of the elastic member 258. Will open.

The cylindrical body 242 includes a high-frequency electrode energization line 268 connected to a first high-frequency electrode 266 or a second high-frequency electrode 276, which will be described later, and a heat-generating chip energization line 281 connected to the heat-generating chip 100 that is a heat-generating member. And are inserted.
A drive rod 252 connected to one of the operation knobs 232 on the proximal end side is disposed in the cylinder 242 so as to be movable along the axial direction of the cylinder 242. On the distal end side of the drive rod 252, a thin plate-like cutter 254 having a blade formed on the distal end side is disposed. When the operation knob 232 is operated, the cutter 254 is moved along the axial direction of the cylindrical body 242 via the drive rod 252. When the cutter 254 moves to the front end side, the cutter 254 is accommodated in cutter guide grooves 264 and 274 described later formed in the holding portion 226.

  The first holding member 260 has a first holding member main body 262, and the second holding member 270 has a second holding member main body 272. As shown in FIG. 3, a cutter guide groove 264 for guiding the cutter 254 described above is formed in the first holding member main body 262. The first holding member main body 262 is provided with a recess, in which a first high-frequency electrode 266 made of, for example, a copper thin plate is disposed. Since the first high-frequency electrode 266 has the cutter guide groove 264, the planar shape thereof is substantially U-shaped as shown in FIG.

As will be described in detail later, a plurality of heat generating chips 100 are bonded to the surface of the first high-frequency electrode 266 on the first holding member main body 262 side. A sealing film 360 is formed by applying a sealing agent made of, for example, silicone so as to cover the heating chip 100, the wiring to the heating chip 100, and the first high-frequency electrode 266.
As shown in FIG. 2, a high-frequency electrode conducting line 268 is electrically connected to the first high-frequency electrode 266. The first high-frequency electrode 266 is connected to the cable 228 via the high-frequency electrode conducting line 268.

  The second holding member 270 has a shape that is symmetrical to the first holding member 260. That is, the cutter guide groove 274 is formed in the second holding member 270 at a position facing the cutter guide groove 264. The second holding member body 272 is provided with a second high-frequency electrode 276 at a position facing the first high-frequency electrode 266. The second high-frequency electrode 276 is connected to the cable 228 via a high-frequency electrode conducting line 268.

When the holding unit 226 in the closed state grips the living tissue, the gripped living tissue comes into contact with the first high-frequency electrode 266 and the second high-frequency electrode 276.
The first holding member main body 262 and the second holding member main body 272 further have a mechanism for heat generation in order to cauterize the living tissue in contact with the first high-frequency electrode 266 and the second high-frequency electrode 276. The heat generating mechanism provided in the first holding member main body 262 and the heat generating mechanism provided in the second holding member main body 272 have the same form. Here, the heat generation mechanism formed in the first holding member main body 262 will be described as an example.

  First, the heat generating chip 100 constituting the heat generating mechanism will be described with reference to FIGS. 4A and 4B. Here, FIG. 4A is a top view, and FIG. 4B is a cross-sectional view taken along line 4B-4B shown in FIG. 4A. As shown in FIGS. 4A and 4B, the heat generating chip 100 is formed using an alumina substrate 111. A resistance pattern 113 that is a Pt thin film for heat generation is formed on one surface of the main surface of the substrate 111. In addition, rectangular electrodes 115 are formed on the surface of the substrate 111 in the vicinity of the two short sides of the rectangle. Here, the electrode 115 is connected to each end of the resistance pattern 113. An insulating film 117 made of, for example, polyimide is formed on the surface of the substrate 111 including on the resistance pattern 113 except for a portion where the electrode 115 is formed.

  A bonding metal layer 119 is formed on the entire back surface of the substrate 111. The electrode 115 and the bonding metal layer 119 are multilayer films made of, for example, Ti, Cu, Ni, and Au. These electrodes 115 and bonding metal layer 119 have stable strength against soldering or the like. The bonding metal layer 119 is provided so that the bonding is stable when the heat generating chip 100 is soldered to the first high-frequency electrode 266, for example.

  The heat generating chip 100 is disposed on the surface (second main surface) opposite to the surface (first main surface) in contact with the living tissue of the first high-frequency electrode 266 and the second high-frequency electrode 276. . Here, the heat generating chip 100 is fixed by soldering the surface of the bonding metal layer 119 and the second main surface of the first high-frequency electrode 266 or the second high-frequency electrode 276, respectively.

  The case of the first high-frequency electrode 266 will be described as an example with reference to FIG. Six heating chips 100 are discretely arranged on the first high-frequency electrode 266. That is, three heat generating chips 100 are arranged in two rows symmetrically across the cutter guide groove 264 from the base end side to the tip end side.

A pair of heat generating chip energization lines 281 are connected to the pair of electrodes 115 of the heat generating chip 100, respectively. In this way, each heat generating chip 100 is connected to the energy source 214 via the heat generating chip energization line 281 and the cable 228. The energy source 214 individually controls the power supplied to each heat generating chip 100.
On the first high-frequency electrode 266, a sealing agent made of silicone, for example, is applied so as to cover the heat generating chip 100 and the heat generating chip energization line 281, and a sealing film 360 is formed as shown in FIG. ing.

  The current output from the energy source 214 flows through the resistance patterns 113 of the six heat generating chips 100. As a result, each resistance pattern 113 generates heat. When the resistance pattern 113 generates heat, the heat is transmitted to the first high-frequency electrode 266. The living tissue in contact with the first high-frequency electrode 266 is cauterized by this heat.

  In order to efficiently transmit the heat generated in the heat generating chip 100 to the first high-frequency electrode 266, the sealing film 360 and the surrounding first holding member main body 262 have the heat of the first high-frequency electrode 266 and the substrate 111. It is preferable to have a thermal conductivity lower than the conductivity. Since the thermal conductivity of the sealing film 360 and the first holding member body 262 is low, thermal conduction with less loss is realized.

  As shown in FIG. 5, the energy source 214 includes a control unit 180, a high-frequency energy output circuit 181, a heat generating chip drive circuit 182, an input unit 185, a display unit 186, a storage unit 187, and a speaker. 188 is disposed. The control unit 180 is connected to each unit in the energy source 214 and controls each unit of the energy source 214. The high frequency energy output circuit 181 is connected to the energy treatment instrument 212 and drives the first high frequency electrode 266 and the second high frequency electrode 276 of the energy treatment instrument 212 under the control of the control unit 180. That is, the high-frequency energy output circuit 181 applies a high-frequency voltage to the first high-frequency electrode 266 and the second high-frequency electrode 276 via the high-frequency electrode conducting line 268.

  The heat generating chip drive circuit 182 is connected to the energy treatment tool 212 and drives each heat generating chip 100 of the energy treatment tool 212 under the control of the control unit 180. That is, the heat generating chip driving circuit 182 supplies power to each resistance pattern 113 of the heat generating chip 100 for heating via the heat generating chip energization line 281 under the control of the control unit 180. Here, the heat generating chip drive circuit 182 can individually change the amount of power supplied to each heat generating chip 100.

  The heat generating chip drive circuit 182 has a function of acquiring the resistance value of each resistance pattern 113 of the heat generating chip 100 based on the voltage applied to the heat generating chip 100 and the current flowing at that time. The resistance value of the resistance pattern 113 changes according to the temperature of the resistance pattern 113. Therefore, the relationship between the temperature of the resistance pattern 113 and the resistance value is acquired in advance, and the relationship is stored in the storage unit 187 in advance. The heat generating chip driving circuit 182 acquires the temperature of the resistance pattern 113 based on the resistance value of the resistance pattern 113 using the relationship between the temperature of the resistance pattern 113 and the resistance value. The heat generating chip drive circuit 182 outputs the acquired temperature of the resistance pattern 113 to the control unit 180. The control unit 180 stores the temperature of the resistance pattern 113 acquired from the heat generating chip driving circuit 182 in the storage unit 187, and appropriately reads it as necessary.

  A foot switch (SW) 216 is connected to the control unit 180, and ON from which the treatment by the energy treatment tool 212 is performed and OFF from which the treatment is stopped are input from the foot switch 216. The input unit 185 inputs various settings of the control unit 180. The display unit 186 displays various settings of the control unit 180. The storage unit 187 stores various data necessary for the operation of the energy source 214. The speaker 188 outputs an alarm sound or the like.

  Thus, for example, the first high-frequency electrode 266 or the second high-frequency electrode 276 functions as a heat transfer unit that transfers heat to the living tissue, for example, the resistance pattern 113 functions as a heat generating member, for example, the heat generating chip 100 , Discretely arranged in the heat transfer unit, and function as a plurality of heat generating chips that are formed on the heat transfer unit and heat the heat transfer unit by supplying power to the heat generating member. For example, the resistance pattern 113 and the heat generating chip drive circuit 182 include , Function as a temperature acquisition unit that acquires the temperature of the heat generation member, for example, the storage unit 187 functions as a storage unit that stores the temperature, for example, the control unit 180 as a control unit that controls the power to be input to the heat generation member Function.

  Next, the operation of the therapeutic treatment apparatus 210 according to this embodiment will be described. The surgeon operates the input unit of the energy source 214 in advance to set the output conditions of the therapeutic treatment device 210, for example, the set power of the high frequency energy output, the target temperature of the thermal energy output, the heating time, and the like. Each value may be set individually, or may be configured to select a set of setting values according to the technique.

  The holding part 226 and the shaft 224 of the energy treatment tool 212 are inserted into the abdominal cavity through the abdominal wall, for example. The surgeon operates the operation knob 232 to open and close the holding portion 226, and grips the living tissue to be treated by the first holding member 260 and the second holding member 270. At this time, the first main surface of both the first high-frequency electrode 266 provided on the first holding member 260 and the second high-frequency electrode 276 provided on the second holding member 270 is to be treated. Living tissue is in contact.

  When the operator grasps the biological tissue to be treated by the holding unit 226, the operator operates the foot switch 216. When the foot switch 216 is switched ON, high-frequency power having a preset set power is supplied from the energy source 214 to the first high-frequency electrode 266 and the second high-frequency electrode 276 via the cable 228. The supplied power is, for example, about 20W to 80W. As a result, the living tissue generates heat and the tissue is cauterized. By this cauterization, the tissue is denatured and solidified.

  Next, after stopping the output of the high frequency energy, the energy source 214 supplies power to the heat generating chip 100 so that the temperature of the first high frequency electrode 266 becomes the target temperature as will be described in detail later. Here, target temperature is 100 to 300 degreeC, for example. At this time, the current flows from the heat generating chip drive circuit 182 of the energy source 214 through the resistance pattern 113 of each heat generating chip 100 via the cable 228 and the heat generating chip conducting line 281. The resistance pattern 113 of each heat generating chip 100 generates heat by current.

The heat generated in the resistance pattern 113 is transferred to the first high-frequency electrode 266 through the substrate 111 and the bonding metal layer 119. As a result, the temperature of the first high-frequency electrode 266 increases. Similarly, the temperature of the second high-frequency electrode 276 also rises due to heat generated by the current flowing through each heat-generating chip 100 disposed on the second high-frequency electrode 276. The biological tissue in contact with the first main surface of the first high-frequency electrode 266 or the second high-frequency electrode 276 is further cauterized and further solidified by these heats.
When the living tissue is solidified by heating, the output of thermal energy is stopped. Finally, the operator operates the operation knob 232 to move the cutter 254 and cut the living tissue. The treatment of the living tissue is thus completed.

  The temperature control by the heat generating chip drive circuit 182 of the energy source 214 according to this embodiment will be described in detail. Here, the temperature control of the first high-frequency electrode 266 will be described as an example, but the temperature control of the second high-frequency electrode 276 is the same. In the present embodiment, control is performed so as to prevent the heating of the first high-frequency electrode 266 by the heating chip 100 from being overheated.

  In a state where the entire surface of the first high-frequency electrode 266 is in contact with the living tissue, the heat conduction state of the first high-frequency electrode 266 is uniform. However, for example, as shown in FIG. 6, when the living tissue 900 is in non-uniform contact with the first high-frequency electrode 266, the heat conduction state becomes non-uniform. Here, FIG. 6 shows a positional relationship between the living tissue 900 and the first high-frequency electrode 266, and FIG. 6A is a perspective view seen from the living tissue 900 side, and FIG. These are represented by the plan view seen from the living tissue 900 side. In FIG. 6, regarding the six heat generating chips 100, the first heat generating chip 100-1, the second heat generating chip 100-2, the third heat generating chip 100-3, the fourth heat generating chip 100-4, and the first heat generating chip 100-1, respectively. 5 heating chips 100-5 and sixth heating chip 100-6.

  In the case shown in FIG. 6, the first heat generating chip 100-1, the second heat generating chip 100-2, the third heat generating chip 100-3, the fifth heat generating chip 100-5, and the sixth heat generating chip 100 are used. The biological tissue 900 is in contact with the first high-frequency electrode 266 at the position corresponding to −6, but the biological tissue 900 is in contact with the first high-frequency electrode 266 at the position corresponding to the fourth heating chip 100-4. Not.

  Usually, since it is necessary to heat the living tissue 900 in a short time, a large amount of electric power is instantaneously applied to the heat generating chip 100. At this time, as shown in FIG. 6, when there is a part that is not in contact with the living tissue 900 in a part of the first high-frequency electrode 266, the heat conduction condition is different from the other part in the part that is not in contact. For this reason, in the part which is not contacting the biological tissue 900 of the 1st high frequency electrode 266, temperature rises rapidly and there exists a possibility of overheating. As a result, the heat generating chip 100 (the fourth heat generating chip 100-4 in the example shown in FIG. 6) arranged in a portion not in contact with the living tissue 900 may fail. Further, even when the first high-frequency electrode 266 is not in contact with the living tissue 900, the same thing can occur for all the heat generating chips 100.

  In this embodiment, in order to prevent the overheating as described above, an overheating preventing process is performed when starting the heating. An example of processing according to the present embodiment will be described with reference to flowcharts shown in FIGS.

In step S1, the control unit 180 of the energy source 214 performs an overheating prevention process. An example of this overheating prevention process will be described with reference to the flowchart shown in FIG.
In step S11, the control unit 180 instructs the heat generating chip drive circuit 182 to apply a predetermined constant power to the resistance pattern 113 of each heat generating chip 100 for a predetermined time ΔT. Here, the predetermined constant power is, for example, 10 W, and the predetermined time ΔT is, for example, about 0.5 seconds to 1 second.

  In step S <b> 12, the control unit 180 acquires the temperature of each heat generating chip 100 after the predetermined time from the heat generating chip driving circuit 182. Here, the heat generating chip driving circuit 182 measures the resistance value of each resistance pattern 113 and calculates the temperature of each heat generating chip 100 based on the resistance value. The control unit 180 stores the acquired temperature of each heat generating chip 100 in the storage unit 187.

  In step S <b> 13, the control unit 180 reads the temperature of each heat generating chip 100 stored in the storage unit 187, compares the temperature of each heat generating chip 100, and has the lowest temperature among those heat generating chips 100, that is, the highest temperature rise. The slow heating chip 100 is selected as the reference chip. Here, as the reference chip, the heat generating chip 100 disposed at a position corresponding to a portion where the living tissue 900 and the first high-frequency electrode 266 are in contact is selected. This is because, at the position where the living tissue 900 and the first high-frequency electrode 266 are in contact with each other, the heat load is large and the temperature does not easily rise. For example, in the example shown in FIG. 6, the second heat generating chip 100-2 is selected. On the other hand, since the heat generating chip 100 disposed at a position corresponding to a portion where the living tissue 900 and the first high-frequency electrode 266 are not in contact has a small thermal load, the temperature rising speed is increased. For example, in the example shown in FIG. 6, the fourth heat generating chip 100 corresponds to this.

  FIG. 9 shows how the temperature rises over time between the temperature 152 of the second heat generating chip 100-2 and the temperature 154 of the fourth heat generating chip 100-4 set as the reference chip in the example shown in FIG. This is shown schematically. As shown in this figure, the temperature 152 of the second heat generating chip 100 and the temperature 154 of the fourth heat generating chip 100 differ by a temperature difference Th after a predetermined time ΔT has elapsed from the start of heating.

In step S <b> 14, the control unit 180 sets control parameters for each of the heat generating chips 100 based on the temperature of the reference chip and the temperatures of the other heat generating chips 100. More specifically, the control parameter is set so that the temperature increase rate of the heat generating chip 100 other than the reference chip approaches the temperature increase rate of the reference chip. For example, the maximum power Pmax input to the heat generating chip 100 described later is reduced. For example, according to the following equation (1), the value is set lower than the reference value Pmax0 of the maximum power by an amount proportional to the temperature difference Th between the reference chip after the elapse of a predetermined time ΔT and the heat generating chip 100 of interest.
Pmax = Pmax0−a · Th (1)
Here, a is a proportionality constant.

Further, a proportional gain G, which will be described later, is reduced by an amount corresponding to the temperature difference Th from the reference gain G0 according to the following equation (2).
G = G0−b · Th (2)
Here, b is a proportionality constant. Proportional constants a and b are set in advance as appropriate values and stored in the storage unit 187.

  As described above, in the overheating prevention process, the maximum power Pmax and the proportional gain G, which are control parameters, are calculated for each heat generating chip 100. The maximum power Pmax and the proportional gain G of each heat generating chip 100 are set as the return value of the overheating prevention process.

Returning to the flowchart shown in FIG. 7, the description of the temperature control processing by the control unit 180 will be continued.
In step S <b> 2, the control unit 180 measures the resistance value of each resistance pattern 113 from the heat generating chip driving circuit 182 and acquires the temperature T of each heat generating chip 100 calculated based on the resistance value.

In step S3, control unit 180 calculates electric power P1 to be input to each resistance pattern used for feedback control according to the following equation (3).
P1 = P + G × (Tset−T) / P (3)
Here, G is a proportional gain calculated in the overheating prevention process, and Tset is a target temperature of the first high-frequency electrode 266.

  In step S4, the control unit 180 determines whether or not each calculated power P1 is larger than the corresponding maximum power Pmax calculated in the overheating prevention process. For the heat generating chip 100 in which the power P1 is greater than the maximum power Pmax, the control unit 180 moves the process to step S5. In step S5, the control unit 180 sets the input power P to the corresponding heat generating chip 100 to the maximum power Pmax, and moves the process to step S7.

  On the other hand, when the power P1 is equal to or less than the maximum power Pmax in the determination in step S4, the control unit 180 moves the process to step S6. In step S6, the control unit 180 sets the input power P to the corresponding heat generating chip 100 to the power P1 calculated in step S3, and moves the process to step S7.

In step S <b> 7, the control unit 180 outputs a command to the heat generating chip driving circuit 182 to input each set input power P to each of the heat generating chips 100. This input electric power P may be larger than the electric power applied to the heat generating chip 100 in the overheating preventing process.
In step S8, the control unit 180 determines whether or not the elapsed time has reached the treatment time top and has reached the treatment end time. If it is not the end time, the control unit 180 returns the process to step S <b> 2 and continues to supply power to each heat generating chip 100. On the other hand, if the end time is reached, the process ends.

  As described above, the electric power supplied to each heat generating chip 100 is controlled according to the temperature rise of the heat generating chip 100, that is, according to the thermal load derived from the contact state between the living tissue 900 and the first high-frequency electrode 266. . As a result, it is possible to increase the temperature of the first high-frequency electrode 266 in a short time in order to bring the living tissue to the target temperature in a short time, while excessively increasing the temperature of the portion not in contact with the living tissue. Heating can be prevented.

  When the reference value Pmax0 of the maximum power is used as the maximum power Pmax and the reference gain G0 is used as the proportional gain G without adjusting the control parameter by the overheat prevention control, for example, the temperature 159 indicated by a broken line in FIG. In addition, in a situation where the temperature rises beyond the limit temperature Tb of the heat generating chip 100, according to the present embodiment, control can be performed so as not to exceed the limit temperature Tb, for example, the temperature 154.

  In the description of the present embodiment, one reference chip is selected in the overheating prevention process. However, it is not limited to this. You may comprise so that a control parameter may be set using a some reference | standard. Also, without selecting a reference chip, the relationship between the temperature rise of the heat generating chip and the control parameter is prepared in advance in the storage unit 187 as a table, and the control parameter is determined based on this table and the measured temperature rise. You may make it set. Similarly, the relationship between the temperature rise of the heat generating chip and the control parameter may be held as a function, and the control parameter may be calculated based on the measured temperature rise.

  In the description of the present embodiment, an example is shown in which both the maximum power Pmax and the proportional gain G, which are control parameters, are changed according to the temperature difference Th, but either the maximum power Pmax or the proportional gain G is shown. May be changed. Of course, the above formulas (1), (2), and (3) are merely examples, and other relational formulas may be used, such as introducing higher-order formulas.

  Note that the present invention is not limited to the above-described embodiment as it is, and can be embodied by modifying the constituent elements without departing from the scope of the invention in the implementation stage. In addition, various inventions can be formed by appropriately combining a plurality of components disclosed in the embodiment. For example, even if some constituent elements are deleted from all the constituent elements shown in the embodiment, the problem described in the column of problems to be solved by the invention can be solved and the effect of the invention can be obtained. The configuration in which this component is deleted can also be extracted as an invention.

  DESCRIPTION OF SYMBOLS 100 ... Heat generating chip, 111 ... Substrate, 113 ... Resistance pattern, 115 ... Electrode, 117 ... Insulating film, 119 ... Metal layer for joining, 152 ... Temperature of 2nd heat generating chip, 154 ... Temperature of 4th heat generating chip, 161: heating chip energization line, 180: control unit, 181 ... high frequency energy output circuit, 182 ... heating chip drive circuit, 185 ... input unit, 186 ... display unit, 187 ... storage unit, 188 ... speaker, 210 ... for treatment Treatment device 212 ... Energy treatment tool 214 ... Energy source 216 ... Foot switch 222 ... Handle 224 ... Shaft 226 ... Holding part 228 ... Cable 232 ... Operating knob 242 ... Cylinder 244 ... Sheath 252 ... Drive rod, 254 ... Cutter, 256 ... Support pin, 258 ... Elastic member, 260 ... First holding member, 262 ... First Holding member main body, 264, 274 ... cutter guide groove, 266 ... first high frequency electrode, 268 ... high frequency electrode conducting line, 270 ... second holding member, 272 ... second holding member main body, 276 ... second High-frequency electrode, 281... Heating chip energization line, 360... Sealing film, 900.

Claims (5)

A therapeutic treatment device for heating and treating a living tissue at a target temperature,
Of the first main surface and the second main surface forming the front and back, a heat transfer section that contacts the living tissue on the first main surface and transfers heat to the living tissue;
Out of the third main surface and the fourth main surface forming the front and back, the third main surface is discretely arranged in the heat transfer section so as to be joined to the second main surface of the heat transfer section, A plurality of heat generating chips for heating the heat transfer section by applying power to the heat generating member formed on each of the fourth main surfaces;
A temperature acquisition unit for acquiring the temperature of each of the heating members;
A storage unit for storing the temperature;
A control unit for controlling the electric power to be input to the heat generating member;
Comprising
The controller is
Storing the temperature when the predetermined power is supplied to the heat generating member in the storage unit;
Based on the temperature stored in the storage unit, the temperature rise of each of the heat generating members in a predetermined period is calculated,
Based on the difference in temperature rise between each of the plurality of heating chips, determine each control parameter used for temperature control of the heating chip,
Based on each of the control parameters, feedback control of the power to be input to each of the plurality of heat generating chips,
A therapeutic treatment device. In determining the control parameter, the control unit,
Based on the temperature rise, a reference chip is selected from the plurality of heat generating chips,
By comparing the temperature increase of the reference chip and the temperature increase of each of the other heat generating chips among the plurality of heat generating chips, a control parameter used for temperature control of each of the other heat generating chips is determined.
The therapeutic treatment device according to claim 1.   The therapeutic parameter according to claim 1, wherein the control parameter is a maximum power value input to each of the heat generating chips and / or a proportional gain related to each of the heat generating chips in the feedback control. Treatment device.   3. The therapeutic treatment apparatus according to claim 2, wherein the control unit selects the heat generating chip having the slowest temperature rise from the start of heating to the time when a predetermined time elapses as the reference chip. A therapeutic treatment apparatus that heats a heat transfer portion in which the heat generating chip is arranged by applying electric power to each heat generating member of the plurality of heat generating chips, and heats and treats a living tissue at a target temperature by the heat transfer portion. Control method,
Applying the electric power to the heating member to start the heating,
Obtaining the temperature rise of each of the heating tips after starting the heating;
A reference chip is selected from the plurality of heating chips based on the temperature rise,
Based on a comparison of the temperature between the reference chip and each of the other heat generating chips, the control parameters of each of the heat generating chips are set,
Controlling the temperature of each of the heat generating chips based on the control parameter;
A method for controlling a therapeutic treatment apparatus.

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