JP2014023757A - Medical treatment device and control method of the same - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a medical treatment device that allows prevention of a breakdown due to wiring breakage.SOLUTION: A control part of a medical treatment device makes a control as follows. In a step S101, predetermined limited power Psave is supplied to a heat generating chip provided in a high frequency electrode. In a step S102, whether lapse time T is larger than suppression control time Tset or not is determined and the limited power Psave corresponding to the suppression control time Tset is supplied to the heat generating chip. In a step S103, a general feedback control is carried out. In a step S104, whether it is process termination time or not is determined and the feedback control in the step S103 is repeated until the process termination time. In comparison with the case in which supplied power is not maintained by limited power, a temperature rise in the high frequency electrode is suppressed in an initial stage of power supply and wiring breakage caused by a difference in the thermal expansion coefficient between a sealant and a wiring is prevented.

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 and closable holding portion that holds a biological tissue that is a treatment target. A high-frequency electrode for applying a high-frequency voltage is provided on a portion of the holding portion that contacts the living tissue. Further, the high frequency electrode is provided with a heat generating chip as an electrothermal conversion element for heating the high frequency electrode. The holding unit is provided with a cutter. In the use of such a therapeutic treatment apparatus, the holding unit first holds the living tissue. The holding unit applies a high-frequency voltage to the living tissue, and further heats the living tissue using a heat generating chip, thereby anastomosing the living tissue. 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

  Patent Document 1 discloses a configuration in which a plurality of small heat generating chips are discretely arranged on a high-frequency electrode. Wiring for supplying power to the heat generating chip is composed of an FPC board and a bonding wire (hereinafter referred to as a wire) by a wire bonding technique. Also, in order to efficiently transfer the heat generated in the heat generating chip to the high frequency electrode and to electrically insulate the heat generating chip and the wire, the heat generating chip and the wire of the high frequency electrode have low thermal conductivity and are insulated. The sealing agent which has property is provided. In such a configuration, a large amount of power is supplied to the heat generating chip in order to rapidly raise the high-frequency electrode to a high temperature. Since the thermal expansion coefficient and thermal conductivity of the sealant and the wiring such as wire are different, if a large amount of power is applied to the heat generating chip and the heat is generated suddenly, the wiring is due to the difference in deformation between the sealant and the wiring. May break and the therapeutic treatment device may break down.

  Therefore, an object of the present invention is to provide a therapeutic treatment apparatus and a control method thereof for preventing a failure due to a breakage of a wiring.

  In order to achieve the above object, according to one aspect of the present invention, a therapeutic treatment apparatus is a therapeutic treatment apparatus for heating and treating a living tissue, and a heat transfer unit that transfers heat to the living tissue. The electrothermal conversion element that is disposed in the heat transfer section and heats the heat transfer section when electric power is input, the wiring that is electrically connected to the electrothermal conversion element, the electrothermal conversion element, and the wiring An insulating material for covering, a power supply unit for supplying power to the electrothermal conversion element via the wiring, a first power for preheating at least the heat transfer unit, and the heat transfer unit for the treatment And a control unit that controls the power supply unit so as to supply the second heat larger than the first power to be heated to the electrothermal conversion element.

  In order to achieve the above object, according to one aspect of the present invention, there is provided a method for controlling a treatment apparatus for treatment comprising: an electrothermal conversion element to which a wiring is connected, wherein the wiring and the electrothermal conversion element are covered with an insulating material. A method of controlling a therapeutic treatment apparatus for heating a heat transfer unit by applying electric power to the electrothermal conversion element, and heating and treating a living tissue by the heat transfer unit, the temperature of the heat transfer unit Supplying a first electric power for preheating the heat transfer section to the electric heat exchange element until the temperature of the heat transfer section reaches the preheat temperature until the temperature reaches the preheat temperature. And supplying a second power larger than the first power to the electrothermal exchange element.

  Since the first electric power for preheating is applied to the electrothermal conversion element before the second electric power for treatment is applied, a treatment apparatus for treatment and a control method therefor that prevent a failure due to wiring breakage can be provided. .

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 generating chip | tip 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. Sectional drawing which shows the outline of the structural example of the wiring member which concerns on one Embodiment of this invention. The top view which shows the outline of structural examples, such as a 1st high frequency electrode, a heat generating chip, a wiring member, and various wiring which concern on one Embodiment of this invention. The block diagram which shows the structural example of the control apparatus which concerns on one Embodiment of this invention. The flowchart which shows an example of the process of the electric power control which concerns on one Embodiment of this invention. The figure which shows an example of the relationship between the input electric power to the heat generating chip | tip with respect to the elapsed time which concerns on one Embodiment of this invention, and the temperature of a high frequency electrode. The figure which shows another example of the relationship between the input electric power to the heat generating chip | tip with respect to the elapsed time which concerns on one Embodiment of this invention, and the temperature of a high frequency electrode. The figure which shows another example of the relationship between the input electric power to the heat generating chip | tip with respect to the elapsed time which concerns on one Embodiment of this invention, and the temperature of a high frequency electrode. The flowchart which shows another example of the process of the electric power control which concerns on one Embodiment of this invention. The flowchart which shows another example of the process of the electric power control 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 treatment of living tissue. This therapeutic treatment apparatus causes high-frequency energy and thermal energy to act on a living tissue. As shown in FIG. 1, the therapeutic treatment apparatus 300 includes an energy treatment tool 310, a control device 370, and a foot switch 380.

  The energy treatment tool 310 is a linear type surgical treatment tool for performing treatment by, for example, penetrating the abdominal wall. The energy treatment device 310 includes a handle 350, a shaft 340 attached to the handle 350, and a holding unit 320 provided at the tip of the shaft 340. The holding unit 320 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 of the living tissue. Hereinafter, for the sake of explanation, the holding portion 320 side is referred to as a distal end side, and the handle 350 side is referred to as a proximal end side. The handle 350 includes a plurality of operation knobs 352 for operating the holding unit 320. The handle 350 is provided with a non-volatile memory (not shown) that stores eigenvalues and the like related to the energy treatment tool 310. The shape of the energy treatment device 310 shown here is, of course, 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 350 is connected to the control device 370 via the cable 360. Here, the cable 360 and the control device 370 are connected by a connector 365, and this connection is detachable. That is, the therapeutic treatment apparatus 300 is configured such that the energy treatment tool 310 can be exchanged for each treatment. A foot switch 380 is connected to the control device 370. The foot switch 380 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 380, ON / OFF of the supply of energy from the control device 370 to the energy treatment tool 310 is switched.

  An example of the structure of the holding part 320 and the shaft 340 is shown in FIG. 2A shows a state in which the holding unit 320 is closed, and FIG. 2B shows a state in which the holding unit 320 is opened. The shaft 340 includes a cylindrical body 342 and a sheath 343. The cylindrical body 342 is fixed to the handle 350 at its proximal end. The sheath 343 is disposed on the outer periphery of the cylindrical body 342 so as to be slidable along the axial direction of the cylindrical body 342.

  A holding part 320 is disposed at the tip of the cylindrical body 342. The holding unit 320 includes a first holding member 322 and a second holding member 324. The base portion of the first holding member 322 is fixed to the distal end portion of the cylindrical body 342 of the shaft 340. On the other hand, the base portion of the second holding member 324 is rotatably supported by the support pin 346 at the distal end portion of the cylindrical body 342 of the shaft 340. Therefore, the second holding member 324 rotates around the axis of the support pin 346 and opens or closes with respect to the first holding member 322.

  In a state in which the holding part 320 is closed, the cross-sectional shape of the base part of the first holding member 322 and the base part of the second holding member 324 is circular. The second holding member 324 is biased by an elastic member 347 such as a leaf spring so as to open with respect to the first holding member 322. When the sheath 343 is slid to the distal end side with respect to the cylindrical body 342 and the base portion of the first holding member 322 and the base portion of the second holding member 324 are covered by the sheath 343, as shown in FIG. The first holding member 322 and the second holding member 324 are closed against the urging force of the elastic member 347. On the other hand, when the sheath 343 is slid to the proximal end side of the cylindrical body 342, the second holding member 324 is moved relative to the first holding member 322 by the urging force of the elastic member 347 as shown in FIG. open.

  The cylindrical body 342 includes a first high-frequency electrode energization line 162 connected to a first high-frequency electrode 110, which will be described later, and a second high-frequency electrode energization line 262 connected to the second high-frequency electrode 210. It is inserted. In addition, the cylindrical body 342 includes a pair of first heating chip energization lines 164 connected to a heating chip 140 which is a heating member described later, and a pair of second heating chip energizations connected to the heating chip 240. Line 264 is inserted.

  A drive rod 344 connected to one of the operation knobs 352 on the base end side is installed inside the cylinder 342 so as to be movable along the axial direction of the cylinder 342. On the distal end side of the drive rod 344, a thin plate-like cutter 345 having a blade formed on the distal end side is installed. When the operation knob 352 is operated, the cutter 345 is moved along the axial direction of the cylindrical body 342 via the drive rod 344. When the cutter 345 moves to the distal end side, the cutter 345 is accommodated in a first cutter guide groove 332 and a second cutter guide groove 334 described later formed in the holding portion 320.

  The holding unit 320 will be described with reference to FIG. As shown in FIG. 3, the first holding member 322 has a first cutter guide groove 332 for guiding the cutter 345 described above. The first holding member 322 is provided with a first high-frequency electrode 110 formed of, for example, a copper thin plate. The first high-frequency electrode 110 is configured to come into contact with a living tissue on one main surface (hereinafter referred to as a first main surface). Since the first high-frequency electrode 110 has the first cutter guide groove 332, the planar shape thereof is a U-shape as shown in FIG. As shown in FIG. 2, a first high-frequency electrode conducting line 162 is electrically connected to the second main surface that is opposite to the first main surface of the first high-frequency electrode 110. The first high-frequency electrode 110 is connected to the control device 370 via the first high-frequency electrode energization line 162 and the cable 360.

  As will be described in detail later, a plurality of heat generating chips 140 are arranged on the second main surface of the first high-frequency electrode 110 that does not contact the living tissue. Furthermore, a wiring member 150 is disposed on the second main surface for wiring to the heat generating chip 140. The first cover member 120 is disposed so as to cover the heat generating chip 140, the wiring including the wiring member 150, and the first high-frequency electrode 110. The first cover member 120 is made of, for example, resin. A gap between the first high-frequency electrode 110 at the base end and the first cover member 120 is filled with an end sealant 180. Insulating sealant 190 is enclosed in a space surrounded by first high-frequency electrode 110, first cover member 120, and end sealant 180. In FIG. 2, the first cover member 120, the end sealant 180, and the sealant 190 are not shown for simplification of the drawing. In this way, the first electrode portion 100 surrounded by the first high-frequency electrode 110 and the first cover member 120 is formed. The first electrode unit 100 is embedded and fixed in a first holding member body 326 having electrical insulation properties and heat insulation properties.

  As shown in FIG. 2, the second holding member 324 has a shape that is symmetric to the first holding member 322 and has the same structure as the first holding member 322. That is, a second cutter guide groove 334 is formed in the second holding member 324 at a position facing the first cutter guide groove 332. Further, the second holding member 324 is provided with a second high-frequency electrode 210 at a position facing the first high-frequency electrode 110. The second high-frequency electrode 210 is configured to come into contact with the living tissue on one main surface thereof. The second high-frequency electrode 210 is connected to the control device 370 via the second high-frequency electrode energization line 262 and the cable 360.

  Further, a heat generating chip 240 similar to the heat generating chip 140 is bonded to the surface of the second high-frequency electrode 210 that does not contact the living tissue. A second cover member similar to the first cover member 120 is provided so as to cover the heat generating chip 240, wiring including a wiring member for connection to the heat generating chip 240, and the second high-frequency electrode 210. Has been placed. Base end portions of the second high-frequency electrode 210 and the second cover member are filled with an end sealant. An insulating sealant is sealed in a space surrounded by the second high-frequency electrode 210, the second cover member, and the end sealant. In this way, the second electrode part 200 surrounded by the second high-frequency electrode 210 and the second cover member 220 is formed. The second electrode unit 200 is embedded and fixed in the second holding member main body 328.

  The first electrode unit 100 will be described in detail. The second electrode unit 200 has the same structure as that of the first electrode unit 100, and thus the description of the second electrode unit 200 is omitted. The heat generating chip 140 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. The heat generating chip 140 is formed using a substrate 141 formed of a high thermal conductivity material such as alumina nitride or alumina. On one surface of the main surface of the substrate 141, a resistance pattern 143 that is a Pt thin film for heat generation is formed. In addition, rectangular electrodes 145 are formed on the surface of the substrate 141 in the vicinity of the two short sides of the rectangle. Here, the electrode 145 is connected to each end of the resistance pattern 143. An insulating film 147 made of, for example, polyimide is formed on the surface of the substrate 141 including the resistance pattern 143 except for the portion where the electrode 145 is formed.

  A bonding metal layer 149 is formed on the entire back surface of the substrate 141. The electrode 145 and the bonding metal layer 149 are multilayer films made of, for example, Ti, Cu, Ni, and Au. The electrodes 145 and the bonding metal layer 149 have stable strength against soldering or the like. For example, the bonding metal layer 149 is provided so that the bonding is stable when the heating chip 140 is soldered to the first high-frequency electrode 110.

  The heat generating chip 140 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 110. Here, the heat generating chips 140 are fixed by soldering the surface of the bonding metal layer 149 and the second main surface of the first high-frequency electrode 110, respectively. A conductive paste may be used for this fixing. Note that the heating chip 240 fixed to the second high-frequency electrode 210 also has the same structure as the heating chip 140 described above.

  The wiring member 150 is, for example, a flexible printed board. A schematic cross-sectional view of the wiring member 150 is shown in FIG. As shown in this figure, a wiring pattern 152 made of, for example, copper is formed on a substrate 151 made of, for example, polyimide. The wiring pattern 152 is covered with an insulating film 153. However, a part of the wiring pattern 152 is not covered with the insulating film 153, and the exposed wiring pattern 152 functions as the electrode 154. The wiring member 150 is different in size and shape as necessary, but the basic structure is as described above. The wiring member 150 may be a foil-like or plate-like wiring member such as a glass epoxy substrate instead of the flexible substrate.

  The first high-frequency electrode 110, the heat generating chip 140 on the first high-frequency electrode 110, and electrical connections related to them will be described with reference to FIG. As shown in FIG. 6, the planar shape of the first high-frequency electrode 110 is U-shaped so as to form a first cutter guide groove 332.

  Six heating chips 140 are discretely arranged on the first high-frequency electrode 110. That is, three heat generating chips 140 are arranged in two rows symmetrically with the first cutter guide groove 332 sandwiched from the base end side toward the tip end side. The heat generating chips 140 arranged in one row are referred to as a first heat generating chip 1401, a second heat generating chip 1402, and a third heat generating chip 1403 in order from the base end side. Similarly, the heat generating chips arranged in the other row are referred to as a fourth heat generating chip 1404, a fifth heat generating chip 1405, and a sixth heat generating chip 1406 in order from the base end side.

  A wiring member 150 is disposed on the first high-frequency electrode 110 in order to connect each heat generating chip 140. The wiring member 150 is fixed using, for example, an adhesive resin. First, the wiring member 150 is disposed at the base end on the side where the first heat generating chip 1401 is disposed. This wiring member 150 is referred to as a first wiring member 1501. Similarly, a second wiring member 1502 is disposed at the proximal end of the first high-frequency electrode 110 on the side where the fourth heat generating chip 1404 is disposed.

  One of the pair of first heating chip energization lines 164 is electrically connected to the electrode 154 on the proximal end side of the first wiring member 1501. Similarly, the other end of the pair of first heating chip energization lines 164 is electrically connected to the electrode 154 on the proximal end side of the second wiring member 1502. The first high-frequency electrode conducting line 162 is electrically connected to the proximal end portion of the first high-frequency electrode 110.

  The electrode 154 on the distal end side of the first wiring member 1501 and the electrode 145 on the proximal end side of the first heating chip 1401 are electrically connected by a wire 156 by wire bonding. In this way, the first heat generating chip energization line 164 is electrically connected to the first heat generating chip 1401 via the first wiring member 1501. Similarly, the first heating chip energization line 164 is electrically connected to the fourth heating chip 1404 via the second wiring member 1502.

  A third wiring member 1503 is disposed between the first heat generating chip 1401 and the second heat generating chip 1402 on the first high-frequency electrode 110. The proximal electrode 154 of the third wiring member 1503 and the distal electrode 145 of the first heat generating chip 1401 are electrically connected by a wire 156 by wire bonding. Similarly, the electrode 154 on the distal end side of the third wiring member 1503 and the electrode 145 on the proximal end side of the second heat generating chip 1402 are electrically connected by a wire 156 by wire bonding. Thus, the first heat generating chip 1401 and the second heat generating chip 1402 are electrically connected in series.

  Similarly, a fourth wiring member 1504 is disposed between the second heat generating chip 1402 and the third heat generating chip 1403. The second heat generating chip 1402 and the third heat generating chip 1403 are electrically connected in series via the fourth wiring member 1504. A fifth wiring member 1505 is disposed between the third heat generating chip 1403 and the sixth heat generating chip 1406. The third heat generating chip 1403 and the sixth heat generating chip 1406 are electrically connected in series via the fifth wiring member 1505. Similarly, the sixth heat generating chip 1406 and the fifth heat generating chip 1405 are electrically connected in series via the sixth wiring member 1506. The fifth heat generating chip 1405 and the fourth heat generating chip 1404 are electrically connected in series via the seventh wiring member 1507. As described above, the six heat generating chips 140 are connected in series between the pair of first heat generating chip energization lines 164.

  Each heat generating chip 140 is connected to the control device 370 via a first heat generating chip energization line 164 and a cable 360. The control device 370 controls the power input to the heat generating chip 140. The current output from the control device 370 flows through each resistance pattern 143 of each heat generating chip 140. As a result, each resistance pattern 143 generates heat. When the resistance pattern 143 generates heat, the heat is transmitted to the first high-frequency electrode 110. The living tissue in contact with the first high-frequency electrode 110 is cauterized by this heat.

  The control device 370 will be described. As shown in FIG. 7, the control device 370 includes a control unit 371, a heat generating chip drive circuit 372, a temperature acquisition unit 373, a high frequency energy output circuit 374, a storage unit 375, an input unit 376, and a display unit 377. And a speaker 378. The control unit 371 is connected to each unit in the control device 370 and controls each unit of the control device 370. The high-frequency energy output circuit 374 is connected to the energy treatment device 310 and drives the first high-frequency electrode 110 and the second high-frequency electrode 210 of the energy treatment device 310 under the control of the control unit 371. That is, the high frequency energy output circuit 374 applies a high frequency voltage to the first high frequency electrode 110 and the second high frequency electrode 210 via the first high frequency electrode energization line 162 and the second high frequency electrode energization line 262. To do.

  The heat generating chip drive circuit 372 is connected to the energy treatment tool 310 and drives each heat generating chip 140 and heat generating chip 240 of the energy treatment tool 310 under the control of the control unit 371. That is, the heat generating chip driving circuit 372 controls the heat generating chip 140 and the heat generating chip 240 for heating via the first heat generating chip conductive line 164 and the second heat generating chip conductive line 264 under the control of the control unit 371. Power is supplied to each of the resistance patterns 143.

  The temperature acquisition unit 373 has a function of acquiring the resistance value of each resistance pattern 143 of the heat generating chip 140 and the heat generating chip 240 based on the voltage applied to the heat generating chip 140 and the heat generating chip 240 and the current flowing at that time. The resistance value of the resistance pattern 143 changes according to the temperature of the resistance pattern 143. Therefore, the relationship between the temperature and resistance value of the resistance pattern 143 is acquired in advance, and the relationship is stored in the storage unit 375 in advance. Based on the resistance value of the resistance pattern 143, the temperature acquisition unit 373 acquires the temperature of the resistance pattern 143 using the relationship between the temperature of the resistance pattern 143 and the resistance value. Here, the temperature of the first high-frequency electrode 110 and the second high-frequency electrode 210 can be regarded as the temperature of the resistance pattern 143 or can be obtained from the temperature of the resistance pattern 143. The temperature acquisition unit 373 outputs the acquired temperatures of the first high-frequency electrode 110 and the second high-frequency electrode 210 to the control unit 371. Since the temperature is acquired based on the resistance value of the resistance pattern 143, it is not necessary to provide a separate temperature sensor on the first high-frequency electrode 110, which is advantageous for downsizing the first electrode unit 100.

  Note that the above temperature acquisition method is an example, and the present invention is not limited to this. For example, the temperature acquisition unit 373 acquires the temperatures of the first high-frequency electrode 110 and the second high-frequency electrode 210 based on the outputs of the temperature sensors provided in the first high-frequency electrode 110 and the second high-frequency electrode 210. May be. For example, a thermocouple can be used as the temperature sensor. Since it is not based on the resistance value of the resistance pattern 143, it is advantageous to use a temperature sensor in that it is not necessary to have a relationship between the temperature of the resistance pattern 143 and the resistance value.

  The control unit 371 stores the temperatures of the first high-frequency electrode 110 and the second high-frequency electrode 210 acquired from the temperature acquisition unit 373 in the storage unit 375, and appropriately reads them as necessary. The control unit 371 calculates the power to be input to the heat generating chip 140 and the heat generating chip 240 using the temperatures of the first high frequency electrode 110 and the second high frequency electrode 210. The control unit 371 controls the heat generating chip driving circuit 372 to input the calculated power to the heat generating chip 140 and the heat generating chip 240.

  A foot switch (SW) 380 is connected to the control unit 371, and ON from which the treatment by the energy treatment instrument 310 is performed and OFF from which the treatment is stopped are input from the foot switch 380. The input unit 376 inputs various settings of the control unit 371. The display unit 377 displays various settings of the control unit 371. The storage unit 375 stores various data necessary for the operation of the control device 370. The speaker 378 outputs an alarm sound or the like.

  Next, the operation of the medical treatment apparatus 300 according to this embodiment will be described. The surgeon operates the input unit of the control device 370 in advance to set the output conditions of the therapeutic treatment device 300, for example, the set power of the high frequency energy output, the target temperature of the heat energy output, the heating time, and the like. In the therapeutic treatment apparatus 300, each value may be set individually, or a set of setting values corresponding to the surgical procedure may be selected. In this embodiment, the target temperature is T_target.

  The holding part 320 and the shaft 340 of the energy treatment tool 310 are inserted into the abdominal cavity through the abdominal wall, for example. The operator operates the operation knob 352 to open and close the holding unit 320, and grasps the living tissue to be treated by the first holding member 322 and the second holding member 324. At this time, the first main surface of the first high-frequency electrode 110 provided on the first holding member 322, and the first main surface of the second high-frequency electrode 210 provided on the second holding member 324 In addition, the living tissue to be treated comes into contact.

  When the operator grasps the biological tissue to be treated by the holding unit 320, the operator operates the foot switch 380. When the foot switch 380 is switched to ON, the first high-frequency electrode 110 and the second high-frequency electrode 210 are preset from the control device 370 via the first high-frequency electrode energization line 162 passing through the cable 360. High frequency power is supplied. 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 control device 370 supplies power to each of the heat generating chips 140 and the heat generating chips 240 so that the temperature of the first high frequency electrode 110 and the second high frequency electrode 210 becomes the target temperature. Supply. Here, the target temperature is 200 ° C., for example. At this time, the current flows from the control device 370 through the resistance pattern 143 of each heat generating chip 140 via the cable 360 and the first heat generating chip conducting line 164. The resistance pattern 143 of each heat generating chip 140 generates heat by current. The heat generated in the resistance pattern 143 is transmitted to the first high-frequency electrode 110 through the substrate 141 and the bonding metal layer 149. As a result, the temperature of the first high-frequency electrode 110 increases. Similarly, power is supplied from the control device 370 to the heat generating chip 240 via the cable 360 and the second heat generating chip energization line 264, and the heat generating chip 240 generates heat. Due to the heat generated in the heat generating chip 240, the temperature of the second high-frequency electrode 210 rises.

  The biological tissue in contact with the first high-frequency electrode 110 or the second high-frequency electrode 210 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 352 to move the cutter 345 and cut the living tissue. The treatment of the living tissue is thus completed.

  The heating treatment using the heat generating chip 140 and the first high-frequency electrode 110 and the heat generating chip 240 and the second high-frequency electrode 210 will be described in more detail. The temperature control of the first electrode unit 100 and the second electrode unit 200 in the control unit 371 will be described with reference to the flowchart shown in FIG. Since the first electrode unit 100 and the second electrode unit 200 have the same configuration, the first electrode unit 100 will be described as an example. The second electrode unit 200 may be controlled separately similarly to the first electrode unit 100. Further, with reference to the electric power supplied to the heat generating chip 140 of the first electrode part, the same electric power as the electric power supplied to the heat generating chip 140 of the first electrode part is also supplied to the heat generating chip 240 of the second electrode part 200. It can be controlled to be charged.

  In step S <b> 101, the control unit 371 controls the heat generating chip driving circuit to input a predetermined limited power Psave into the heat generating chip 140 provided in the first high-frequency electrode 110. Here, it is assumed that the limit power Psave is smaller than the maximum power Pmax input to the heat generating chip 140. When the limited power Psave is input to the heat generating chip 140, the temperature acquisition unit 373 acquires the temperature of the first high-frequency electrode 110 based on the resistance value of the resistance pattern 143 of the heat generating chip 140.

  In step S102, the control unit 371 determines whether or not the elapsed time T is longer than a predetermined suppression control time Tset. When it is determined that the elapsed time T is not greater than the suppression control time Tset, the process returns to step S101. On the other hand, when it is determined that the elapsed time T is greater than the suppression control time Tset, the process proceeds to step S103. That is, the limited power Psave is input to the heat generating chip 140 for the suppression control time Tset. Here, the suppression control time Tset is a short time that does not significantly affect the temperature increase of the first high-frequency electrode 110 related to the treatment on the living tissue, for example, 0.5 seconds.

In step S103, the control unit 371 performs feedback control. For example, the following general feedback control is performed. In the feedback control, the control unit 371 determines the power P to be input to the heat generating chip 140 provided in the first high frequency electrode 110 based on the temperature Temp of the first high frequency electrode 110 acquired from the temperature acquisition unit 373. To do. Here, the power P is obtained by the following formula (1), for example.
P = C1 × dTemp / dt + C2 × (T_target-Temp) + Pnow (1)
Here, C1 and C2 are predetermined control gains, and T_target is the target temperature of the first high-frequency electrode 110. The current temperature Temp of the first high-frequency electrode 110 is calculated based on, for example, the resistance value of the resistance pattern of the heat generating chip 140. Pnow is the current input power. The control unit 371 causes the heat generating chip driving circuit 372 to input power P to the heat generating chip 140. Thereafter, the process proceeds to step S104. Note that the method of determining the power P is not limited to the above formula (1), and various formulas used for feedback control can be used.

  In step S104, the control unit 371 determines whether it is the treatment end time. When it is determined that it is not the end time, the process returns to step S103. That is, the feedback control in step S103 is repeated until the treatment end time. On the other hand, when it is determined in step S104 that the end time is reached, the process ends. Here, the end time of the treatment is determined in advance for each treatment, for example.

  With the above control, the relationship between the input power and the high-frequency electrode temperature with respect to the elapsed time is as shown in a schematic diagram shown in FIG. Here, FIG. 9A shows the relationship of the input power with respect to the elapsed time, and FIG. 9B shows the relationship of the temperature of the first high-frequency electrode 110 with respect to the elapsed time. The relationship according to the present embodiment is represented by a solid line in FIGS. 9 (a) and 9 (b).

  As shown in FIGS. 9A and 9B, the input power is first increased to the limit power Psave. The time T0 during which the power rises to the limit power Psave is extremely short, but is shown in an enlarged manner in FIG. 9 for easy understanding. Thereafter, the input power is maintained at the limit power Psave only during the suppression control time Tset. Subsequently, feedback control is performed. That is, for example, the input power rises to the maximum power Pmax at the beginning of the feedback control, and then decreases according to the temperature rise of the first high-frequency electrode 110.

  The limit power Psave and the suppression control time Tset that is the application time thereof can be arbitrarily changed. However, the limit power Psave and the suppression control time Tset are set to such a degree that the temperature increase of the first high-frequency electrode 110 related to the treatment on the living tissue is not greatly affected.

  For comparison, the relationship between the input power and the electrode temperature with respect to the elapsed time when the power is not maintained at the limit power and the feedback control is performed from the beginning is shown by one-dot chain lines in FIGS. Compared with the comparative example shown by the alternate long and short dash line in these drawings, according to the present embodiment shown by the solid line, the temperature increase of the first high-frequency electrode 110 in the initial stage of power-on is suppressed.

  According to the present embodiment, the encapsulant 190, the wire 156, and the like are preheated before feedback control by application of the limit power Psave. By this preheating, the temperature difference between the sealant 190 and the wire 156 becomes smaller than when there is no preheat, and the breakage of the wire 156 caused by the difference in thermal expansion coefficient between the sealant 190 and the wire 156 is prevented. Thus, the failure of the energy treatment tool 310 is prevented. Note that the present embodiment is effective not only for the wires 156 but also for other wirings such as the wiring pattern 152 of the wiring member 150 and the like.

  In the above example, the limit power Psave is used to acquire the temperature of the first high-frequency electrode 110 immediately after the start of control. However, the present invention is not limited to this, and in order to acquire the temperature of the first high-frequency electrode 110, first, a predetermined power value P0 is applied only for a predetermined period T1 to acquire the resistance value of the resistance pattern 143 of the heating chip 140. Also good. That is, the relationship between the input power and the electrode temperature with respect to the elapsed time may be as shown in FIG. 10 or FIG. 11, for example. At the beginning of the control, a predetermined power P0 is applied for a predetermined period T1, and the resistance value of the resistance pattern 143 is acquired. Based on this resistance value, the temperature of the first high-frequency electrode 110 is acquired. Immediately thereafter, the limit power Psave is applied only during the suppression control time Tset. Thereafter, feedback control is performed. Here, the predetermined power P0 applied to obtain the electrode temperature may be larger than the limit power Psave as shown in FIG. 10, or may be larger than the limit power Psave as shown in FIG. It may be small.

  In the present embodiment, the limited power Psave is applied for a predetermined time Tset. However, the present invention is not limited to this. For example, the temperature of the first high-frequency electrode 110 may be acquired, and the control may proceed to feedback control when the temperature of the first high-frequency electrode 110 reaches a predetermined preheating temperature. That is, as shown in FIG. 12, in step S151, the control unit 371 applies the limited power. In step S152, the control unit 371 determines whether or not the temperature of the first high-frequency electrode 110 is equal to or higher than a predetermined preheating temperature. When it is not equal to or higher than the preheating temperature, the process returns to step S151, and when it is equal to or higher than the preheating temperature, the process proceeds to step S153. In step S153, the control unit 371 performs feedback control. In step S154, the control unit 371 determines whether it is the treatment end time. When it is determined that it is not the end time, the process returns to step S153, and when it is determined that the end time is reached, the process ends. If it does in this way, failure of energy treatment tool 310 is prevented by setting preheating temperature to the temperature which prevents fracture of wire 156 grade. That is, the period during which the limit power is applied may be defined by time or temperature.

  Moreover, when performing the heating treatment a plurality of times using the same energy treatment tool 310, the power suppression control to which the limit power Psave before the feedback control is applied may be performed each time the heating treatment is performed. It may not be performed in the second and subsequent heating treatments. For example, a process when the power suppression control is not performed in the second and subsequent heating treatments will be described with reference to a flowchart shown in FIG.

  In step S201, the control unit 371 applies a limited power. In step S202, the control unit 371 determines whether or not the elapsed time T is greater than a predetermined suppression control time Tset. When it is determined that the elapsed time T is not greater than the suppression control time Tset, the process returns to step S201. On the other hand, when it is determined that the elapsed time T is greater than the suppression control time Tset, the process proceeds to step S203.

  In step S203, the control unit 371 performs feedback control. In step S204, the control unit 371 determines whether it is the treatment end time. If it is determined that it is not the end time, the process returns to step S203. On the other hand, when it is determined that the end time is reached, the process proceeds to step S205.

  In step S205, the control unit 371 determines whether the treatment has been started again. When it is determined that the process has not been started, the process repeats step S205. When it is determined that the treatment has been started again, the process proceeds to step S206. In step S206, the control unit 371 determines whether or not a predetermined time has elapsed since the end of the previous treatment. When it is determined that the predetermined time has elapsed, the process returns to step S201. That is, the limit power is applied and then feedback control is performed. On the other hand, when it is determined in step S206 that the predetermined time has not elapsed, the process returns to step S203. That is, feedback control is performed without applying the limit power.

  In this example, when the next treatment is started within a predetermined time after the end of the previous treatment, since there is residual heat, it is not necessary to apply the limit power, and thus the feedback control is started. When the next treatment is not started within a predetermined time after the end of the previous treatment, it is considered that the first electrode unit 100 and the second electrode unit 200 are cooled, and therefore, the application is started from application of the limit power. In this way, treatment time can be shortened by omitting application of unnecessary limiting power.

  Thus, for example, the first high-frequency electrode 110 and the second high-frequency electrode 210 function as a heat transfer unit that transfers heat to the living tissue. For example, the heat generating chip 140 and the heat generating chip 240 are disposed in the heat transfer unit and function as an electrothermal conversion element that heats the heat transfer unit when power is supplied. For example, the wire 156 and the wiring pattern 152 function as wiring that is electrically connected to the electrothermal conversion element. For example, the sealing agent 190 functions as an insulating material that covers the electrothermal conversion element and the wiring. For example, the heat generating chip drive circuit 372 functions as a power supply unit that supplies power to the electrothermal conversion element via the wiring. For example, the control unit 371 generates at least a first power for preheating the heat transfer unit and a second power larger than the first power for heating the heat transfer unit for the treatment. It functions as a control unit that controls the power supply unit so as to be supplied to the conversion element. For example, the temperature acquisition unit 373 functions as a temperature acquisition unit that acquires the temperature of the heat transfer unit based on the resistance value of the electrical resistance pattern when the first power is supplied.

  DESCRIPTION OF SYMBOLS 100 ... 1st electrode part, 110 ... 1st high frequency electrode, 120 ... 1st cover member, 140 ... Heat generating chip, 141 ... Substrate, 143 ... Resistance pattern, 145 ... Electrode, 147 ... Insulating film, 149 ... Bonding Metal layer, 150 ... Wiring member, 151 ... Substrate, 152 ... Wiring pattern, 153 ... Insulating film, 154 ... Electrode, 156 ... Wire, 162 ... First conductive line for high frequency electrode, 164 ... For the first heating chip Energizing line, 180 ... end sealant, 190 ... sealant, 200 ... second electrode part, 210 ... second high frequency electrode, 220 ... second cover member, 240 ... heating chip, 262 ... second ,..., Second heat generating chip energization line, 300... Treatment device, 310... Energy treatment device, 320 .. holding part, 322... First holding member, 324. Holding member, 326 ... first holding member main body, 328 ... second holding member main body, 332 ... first cutter guide groove, 334 ... second cutter guide groove, 340 ... shaft, 342 ... cylindrical body, 343 ... Sheath, 344 ... drive rod, 345 ... cutter, 346 ... support pin, 347 ... elastic member, 350 ... handle, 352 ... control knob, 360 ... cable, 365 ... connector, 370 ... control device, 371 ... control unit, 372 ... Heat generating chip drive circuit, 373 ... temperature acquisition unit, 374 ... high frequency energy output circuit, 375 ... storage unit, 376 ... input unit, 377 ... display unit, 378 ... speaker, 380 ... foot switch.

Claims (6)

A therapeutic treatment apparatus for heating and treating living tissue,
A heat transfer section for transferring heat to the living tissue;
An electrothermal conversion element that is disposed in the heat transfer unit and heats the heat transfer unit by applying electric power;
A wiring electrically connected to the electrothermal conversion element;
An insulating material covering the electrothermal conversion element and the wiring;
A power supply unit for supplying power to the electrothermal transducer through the wiring;
At least a first power for preheating the heat transfer unit and a second power larger than the first power for heating the heat transfer unit for the treatment are supplied to the electrothermal conversion element. A control unit for controlling the power supply unit;
A therapeutic treatment apparatus comprising: The electrothermal conversion element includes an electric resistance pattern,
A temperature acquisition unit that acquires a temperature of the heat transfer unit based on a resistance value of the electrical resistance pattern when the first power is supplied;
The therapeutic treatment device according to claim 1.   The treatment apparatus according to claim 2, wherein the control unit causes the power supply unit to supply the second power when the temperature is equal to or higher than a predetermined preheating temperature.   When the control unit supplies power again after completing the supply of the second power to the electric heat exchange element, after the supply of the second power to the electric heat exchange element is completed. It is determined whether or not the elapsed time is within a predetermined time, and when the elapsed time is within the predetermined time, the second power is supplied without supplying the first power to the electrothermal exchange element. The therapeutic treatment device according to any one of claims 1 to 3. A heat transfer part is heated by applying electric power to the electrothermal conversion element to which the wiring is connected and the wiring and the electrothermal conversion element are covered with an insulating material. A method of controlling a therapeutic treatment apparatus for heating and treating tissue,
Supplying first electric power for preheating the heat transfer section to the electrothermal exchange element until the temperature of the heat transfer section reaches a predetermined preheating temperature;
When the temperature of the heat transfer unit reaches the preheating temperature, supplying second electric power larger than the first electric power to the electric heat exchange element for the treatment;
A control method for a therapeutic treatment apparatus comprising:   When supplying electric power again after finishing supplying the second electric power to the electric heat exchange element, an elapsed time after completing supplying the second electric power to the electric heat exchange element is a predetermined time. It is determined whether the second power is supplied to the electrothermal exchange element without supplying the first power when the elapsed time is within the predetermined time. A control method for the therapeutic treatment device described.

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