JP2016214553A - Electrosurgical treatment device, control method of electrosurgical treatment device, and electrosurgical system - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a new and improved electrosurgical treatment device capable of preventing a field of view from being hindered during endoscope surgery by smoke, fatty components, droplets, etc. that are generated, a control method of the electrosurgical treatment device, and an electrosurgical system.SOLUTION: An electrosurgical treatment device includes an insertion part that has a treatment part to which electric power is supplied at the tip, a power control part for controlling the electric power supplied to the treatment part, a suction passage provided to the insertion part that has an opening on the tip side of the insertion part, and a suction part for sucking liquid through the suction passage.SELECTED DRAWING: Figure 1

Description

  The present disclosure relates to an electrosurgical treatment apparatus, an electrosurgical treatment apparatus control method, and an electrosurgical system.

  Conventionally, in the medical field or the like, as exemplified by laparoscopic surgery or the like, surgery using an endoscope (hereinafter, also simply referred to as “endoscopic surgery”) has been performed. In such endoscopic surgery, there is a case where a treatment apparatus is used in which a treatment section for treating a living tissue is provided at the distal end of an insertion section that is inserted into a body cavity. For example, as one aspect of a treatment apparatus for performing surgical treatment such as incision on a living tissue, for electrosurgical operation that electrically incises, sutures, and sinters the living tissue contacting the treatment portion by energizing the treatment portion Treatment devices are known.

  Patent Document 1 discloses a suction port that sucks smoke generated when a surgical procedure is performed on a living body, a deodorization filter unit that deodorizes and removes smoke sucked from the suction port, and a suction port and a deodorization filter. A surgical local exhaust system including a suction tube that communicates with a portion and can be disposed with a suction port facing a position where smoke is generated is disclosed. Such a local surgical exhaust system is intended to prevent gas generated during a surgical procedure on a living body from staying in an operating room.

  Further, in Patent Document 2, extraction is performed with a suction tube, a vacuum pump that applies a negative pressure to the suction tube, a vacuum regulator that adjusts the pressure in the suction tube, an electric scalpel device connected to the suction tube, and a suction tube. A lesion tissue extraction device is disclosed that includes a suction bottle that stores a lesion tissue, and a computer that controls a vacuum regulator and an electric knife device. In such a diseased tissue extraction device, the suction tube functions as an electric knife electrode, and the amount of lesion tissue extracted can be adjusted by adjusting the pressure of the vacuum regulator and adjusting the output of the electric knife device.

JP 2014-204901 A JP 2011-147719 A

  Endoscopic surgery is performed by operating an electrosurgical treatment device while visually recognizing an image of the endoscope, and thus it is necessary to secure a field of view safely. However, since the electrosurgical treatment device destroys living tissue by electricity, heat, ultrasonic waves, or the like, fine particles of smoke and fat are easily scattered around the surgical site. For this reason, the field of view is obstructed in the imaging of the endoscope, and it may be difficult to appropriately treat the affected area. The field of view can also be hindered when splashes of destroyed biological tissue adhere to the lens portion of the endoscope. Therefore, it is desired to ensure visibility during endoscopic surgery.

  Therefore, in the present disclosure, a new and improved electrosurgical treatment apparatus and electrosurgical treatment that can prevent the visual field during endoscopic surgery from being hindered by generated smoke, fat components, splashes, and the like. An apparatus control method and an electrosurgical system are proposed.

According to the present disclosure, an insertion portion having a treatment portion to which power is supplied at the tip;
A power control unit for controlling power supplied to the treatment unit;
A suction passage provided in the insertion portion and having an opening on a distal end side of the insertion portion;
A suction section for sucking fluid through the suction passage;
An electrosurgical treatment device is provided.

In addition, according to the present disclosure, detecting a power supply state to the treatment unit provided at the distal end of the insertion unit;
Controlling the operation of the suction part based on the supply of the electric power, and sucking the fluid from the opening on the distal end side of the insertion part;
An electrosurgical treatment device control method is provided.

Further, according to the present disclosure, the insertion portion having a treatment portion to which power is supplied at the tip,
A power control unit for controlling power supplied to the treatment unit;
A suction passage provided in the insertion portion and having an opening on the distal end side of the insertion portion;
A suction section for sucking fluid through the suction passage;
An analysis unit for analyzing the fluid sucked through the suction passage;
An electrosurgical system is provided.

  As described above, according to the present disclosure, it is possible to suppress the visual field at the time of endoscopic surgery from being hindered by generated smoke, a fat component, splashes, and the like. Note that the above effects are not necessarily limited, and any of the effects shown in the present specification, or other effects that can be grasped from the present specification, together with or in place of the above effects. May be played.

It is a mimetic diagram showing an example of composition of an electrosurgical system concerning an embodiment of this indication. It is a block diagram showing an example of composition of an electrosurgical system concerning the embodiment. It is a perspective view which shows the front-end | tip part of the insertion part which concerns on the same embodiment. It is a top view which shows the front-end | tip part of the insertion part which concerns on the same embodiment. It is a perspective view which shows the front-end | tip part of another insertion part which concerns on the same embodiment. It is a side view which shows the front-end | tip part of another insertion part which concerns on the same embodiment. It is explanatory drawing which shows an example of the analysis method of the attracted | sucked fluid. It is explanatory drawing which shows the spectrum for every component. It is explanatory drawing which shows a power control method. It is a flowchart which shows an example of the control processing of the suction control part which concerns on the same embodiment. It is a flowchart which shows another example of the control processing of the suction control part which concerns on the embodiment. It is a flowchart which shows an example of the control processing of the analysis process part which concerns on the same embodiment. It is a flowchart which shows an example of the control processing of the analysis process part which concerns on the same embodiment. It is explanatory drawing which shows the state of the visual field defect by scattering of smoke or a fat component.

  Hereinafter, preferred embodiments of the present disclosure will be described in detail with reference to the accompanying drawings. In addition, in this specification and drawing, about the component which has the substantially same function structure, duplication description is abbreviate | omitted by attaching | subjecting the same code | symbol.

The description will be made in the following order.
<1. Detailed Description of Background Technology>
<2. Example of overall configuration of electrosurgical system>
[2.1. Electrosurgical instrument]
(2.1.1. Basic configuration)
(2.1.2. Suction passage)
[2.2. Suction device]
[2.3. Analysis equipment]
(2.3.1. Fluid treatment part)
(2.3.2. Analysis processing unit)
(2.3.3. Display processing unit)
(2.3.4. Warning processing section)
(2.3.5. Collection tank)
[2.4. Power control device]
[2.5. Display device]
<3. Example of control processing>
[3.1. Example of suction control processing]
(3.1.1. First example)
(3.1.2. Second example)
[3.2. Example of display processing and warning processing]
[3.3. Example of power control processing]

<1. Detailed Description of Background Technology>
First, the background art of the present disclosure will be described in detail.
In recent years, an electrosurgical treatment instrument (hereinafter, also simply referred to as “treatment instrument”) called a monopolar, bipolar, or thunderbeat that electrically incises, sutures, or sinters a living tissue. An electrosurgical treatment device (hereinafter, also simply referred to as “treatment device”) provided is known. The treatment instrument is also called an energy device. According to such a treatment apparatus, incision, suturing, and sintering can be performed simultaneously. The treatment apparatus is often used for endoscopic surgery performed while visually recognizing a captured image of an endoscope.

  The treatment device destroys a living tissue by electricity, heat, ultrasonic waves, or the like, and there are cases where fine particles of smoke and fat are scattered around the surgical site and obstruct the field of view. In addition, visual field defects may occur due to the destruction of the splashes of living tissue attached to the lens at the distal end of the endoscope. FIG. 14 is an explanatory diagram showing a state in which the field of view during endoscopic surgery is hindered. Both the upper and lower figures in FIG. 14 show a state where the treatment tool 10 is treating the diseased cell C. The upper diagram in FIG. 14 shows a state with good visibility, and the lower diagram in FIG. 14 shows a state with poor visibility.

  As described above, when smoke or a fat component is generated in the vicinity of the surgical site, the view through the captured image of the endoscope is hindered, and it is difficult to perform an appropriate treatment on the diseased cell C. As a result, for example, there is a possibility that some of the diseased cells C that must be removed remain, or conversely, normal cells may be excessively removed beyond the range that must be removed. Further, in a state of poor visibility, it is difficult to accurately perform stitching and sintering by the treatment device.

  In addition, there is a possibility that diseased cells such as cancer cells may metastasize to other places due to splashes of living tissue scattered around the surgical site. On the other hand, it is conceivable to use a ventilation device to forcibly ventilate the air in the surgical site to ensure visibility. However, if air is sent into the body cavity by the ventilator, the internal organs are dried, or bacteria attached to the ventilator itself or the filter of the ventilator enter the body, causing infections and complications. There is a risk. When air containing moisture is sent into the body cavity in order to suppress the drying of the internal organs, the lens of the endoscope becomes cloudy, resulting in poor visibility.

  Also, in endoscopic surgery, in order to confirm the validity of a surgical result at a cell level that cannot be seen, wait for the result of a post-operative biopsy, or perform a biopsy by interrupting the operation during the operation. There is a need. After all, endoscopic surgery is a technique that strongly depends on the field of view of the doctor who performs the surgery, and the quality of the field of view can greatly affect the success or failure of the surgery.

  From the above background, the electrosurgical system according to the present disclosure removes smoke and oil particles that obstruct the field of view during endoscopic surgery, and maintains a good field of view. In addition, the electrosurgical system according to the present disclosure suppresses the transfer of diseased cells and the occurrence of infectious diseases by appropriately removing smoke and droplets generated when a biological tissue is destroyed by a treatment device.

<2. Example of overall configuration of electrosurgical system>
First, an example of the entire configuration of the electrosurgical system according to the embodiment of the present disclosure will be described. FIG. 1 is a schematic diagram showing an electrosurgical system 100 according to the present embodiment. FIG. 2 is a block diagram showing the configuration of the electrosurgical system 100 divided into functions. The electrosurgical system 100 includes an electrosurgical treatment instrument 110, a power control device (power control unit) 200, a suction device (suction unit) 300, an analysis device (analysis unit) 400, and a display device (display unit) 500. With. Among these, the electrosurgical treatment instrument 110 and the suction device 300 constitute an electrosurgical treatment apparatus.

[2.1. Electrosurgical instrument]
(2.1.1. Basic configuration)
The treatment instrument 110 includes an insertion portion 112 that can be inserted into a body cavity, and an operation portion 114 that is connected to the insertion portion 112 and that is operated by a user. The insertion portion 112 has a cylindrical sheath 120 extending in the longitudinal direction of the insertion portion 112, and treatment portions 130 a and 130 b for performing treatment on the affected area are provided at the distal end portion of the sheath 120.

  The operation unit 114 includes a main body 115 to which a rear end portion of the sheath 120 is fixed, a locking portion 116 that is provided at the rear end of the main body 115 and into which a user's finger is inserted, and is connected to the main body 115 and is connected to the main body 115. And a handle 118 capable of moving back and forth in the longitudinal direction. On both sides of the handle 118, there are provided through holes into which the user's fingers are inserted. In the treatment instrument 110 of the present embodiment, when the handle 118 of the operation unit 114 is slid relatively rearward by the user, the two treatment units 130a and 130b provided at the distal end portion of the sheath 120 are close to each other, Operates to pinch the affected area.

  A suction tube 150 is connected to the treatment instrument 110 at the position of the operation unit 114. The other end of the suction tube 150 is connected to the suction device 300. In addition, an electrical cable 104 is connected to the treatment instrument 110 at the position of the operation unit 114. The other end of the electric cable 104 is connected to the power control device 200. The electric cable 104 may be connected to the power control apparatus 200 using a connector provided on the other end side. Electric power can be supplied to the two treatment portions 130 a and 130 b provided at the distal end portion of the sheath 120 via the electric cable 104. Further, when the user slides the handle 118 rearward, an electric signal is output to the power control device 200 via the electric cable 104.

  The two treatment units 130a and 130b are provided with a first electrode and a second electrode, respectively. The first electrode and the second electrode are provided at positions of the two treatment portions 130a and 130b facing each other, and can contact the living tissue. When the two treatment units 130a and 130b come close to each other by the operation of the handle 118 by the user, a high-frequency current is supplied to the first electrode and the second electrode provided in the two treatment units 130a and 130b. Thereby, when the user slides the handle 118 to the rear end side, the two treatment parts 130a and 130b are brought close to each other while the high frequency current is applied to the first electrode and the second electrode, and the affected part is electrically An incision is made.

  Note that the treatment instrument 110 in a mode in which the two treatment units 130a and 130b are close to each other and incises the affected part is merely an example, and the treatment instrument 110 that can be used in the technique according to the present embodiment is not limited to this example. That is, the treatment instrument 110 may be of a monopolar type, a bipolar type, or other types as long as it electrically treats the affected area.

(2.1.2. Suction passage)
3 and 4 are a perspective view and a top view showing the distal end portion of the treatment instrument 110. FIG. The sheath 120 of the insertion portion 112 of the treatment instrument 110 is provided with a suction passage 125 having a suction opening 125a at the distal end portion. The suction passage 125 is a passage when the suction device 300 sucks a fluid including smoke, a fat component, and splashes from the body cavity with air. In the present embodiment, the suction passage 125 is provided in the sheath 120 along the longitudinal direction. The rear end side of the suction passage 125 communicates with the suction pipe 150 at the position of the operation unit 114. The suction passage 125 is disposed from the suction opening 125a to the vicinity of the operation unit 114, and has a moderately reduced diameter. The suction passage 125 is configured with a shape and material that do not interfere with the operation.

  A part or all of the suction passage 125 may also serve as an arrangement space for electric wiring that guides electric power to the first electrode and the second electrode of the two treatment portions 130a and 130b. Thereby, the suction passage 125 can be provided without changing the appearance and diameter of the sheath 120. At that time, the electrical wiring may be covered with an insulating sheet or the like. Thereby, it is possible to prevent a fluid such as smoke, a fat component, or a droplet sucked through the suction passage 125 from adhering to the electric wiring and causing a short circuit or the like. As shown in FIGS. 5 and 6, the suction passage may be provided by attaching a suction tube 140 to the outer peripheral portion of the sheath 120. In this case, the suction opening 140 a on the distal end side of the suction tube 140 is disposed in the vicinity of the treatment portions 130 a and 130 b on the distal end side of the sheath 120.

  A suction tube 150 that communicates with the suction passage 125 connects the treatment instrument 110 and the analyzer 400. The suction pipe 150 guides air, smoke, splashes, and the like sucked from the suction opening 125 a of the suction passage 125 to the analyzer 400. A suction tube 160 is also connected between the analyzer 400 and the suction device 300. Therefore, during operation of the suction device 300, air or the like in the body cavity is sucked through the suction passage 125 and the suction tubes 150 and 160.

[2.2. Suction device]
The suction device 300 sucks fluid such as air, smoke, and droplets at the distal end of the treatment instrument 110 via the suction passage 125 and the suction pipes 150 and 160. The suction device 300 is connected to the power control device 200 and the analysis device 400 by communication cables 108 and 109, and information can be transmitted and received between the devices. The suction device 300 includes a vacuum pump 310 and a suction control unit 320. The vacuum pump 310 is an example of a device that generates a suction force, and may be replaced with another device as long as the device can generate the suction force. The suction controller 320 controls the output of the vacuum pump 310. The suction device 300 is connected to the power control device 200 via the communication cable 108. Thereby, the suction control unit 320 can detect the energization state of the treatment instrument 110 by the power control device 200.

  The suction control unit 320 may operate the vacuum pump 310 in accordance with a period in which power is supplied to the treatment instrument 110 by the power control device 200. As a result, the vacuum pump 310 can be stopped in a non-energized state of the treatment instrument 110, that is, in a state where no smoke or splashes can occur in the body cavity. Therefore, the power cost can be suppressed and the tip of the treatment instrument 110 can be prevented from adsorbing to the living tissue.

  When operating the vacuum pump 310 according to the energization period to the treatment instrument 110, the output of the vacuum pump 310 may be changed according to the energization amount. When the affected part is treated by the treatment instrument 110, the larger the amount of power supplied, the more likely smoke or splashes are generated due to the destruction of the living tissue. Therefore, it is preferable that the suction control unit 320 controls the vacuum pump 310 so that the output of the vacuum pump 310 increases as the energization amount increases.

  In addition, the suction control unit 320 may stop the operation of the vacuum pump 310 and interrupt the suction when a preset time has elapsed after the start of energization of the treatment instrument 110. Thereby, while the treatment with respect to the living tissue is interrupted, the vacuum pump 310 can be stopped to reduce the power cost.

  In addition, the suction control unit 320, after starting the energization of the treatment instrument 110, based on the analysis result by the analysis device 400 described later, when the suctioned air or the like does not include a specific foreign matter, the vacuum pump 310 The operation may be stopped and the suction may be interrupted. Thereby, while an appropriate measure is being performed, the vacuum pump 310 can be stopped to reduce the power cost.

[2.3. Analysis equipment]
The analyzer 400 analyzes components contained in the sucked air and smoke. For example, the analysis device 400 analyzes a fluid such as aspirated air and detects fat, cells, and water content contained in the air. The analysis result is used to determine the state of the affected area and to determine the status of treatment for the affected area. The analysis apparatus 400 includes a fluid treatment unit 430, an analysis processing unit 440, a display processing unit 450, and a warning processing unit 460.

  The analysis apparatus 400 includes a storage unit (not shown) that stores programs executed by the analysis processing unit 440, the display processing unit 450, and the warning processing unit 460, and the calculation results of each processing unit. The analysis device 400 is connected to the power control device 200 and the suction device 300 by communication cables 105 and 109, and can transmit and receive information to and from each device. Further, the display device 500 is connected to the analysis device 400 via the communication cable 106.

(2.3.1. Fluid treatment part)
The fluid treatment unit 430 is a part that performs a predetermined treatment on the aspirated fluid such as air and enables analysis of components such as the air. The fluid treatment unit 430 may be configured to allow the sucked air or the like to pass through a detection tube filled with a reagent for detecting a specific component and analyze the component concentration of the specific component based on the color change of the detection tube. Good. For example, by using a detection tube filled with a probe reagent such as an organic small molecule fluorescent probe, the analysis processing unit 440 can determine whether cancer cells are contained in the aspirated air or the like.

  Further, by using a detection tube filled with a probe reagent such as a pancreatic fluid leakage detection optical probe, the analysis processing unit 440 can determine the presence or absence of pancreatic fluid leakage. Pancreatic fluid leakage is known to significantly worsen the prognosis of surgery, and the success rate of surgery can be improved by monitoring such pancreatic fluid leakage. In this case, a plurality of detection tubes filled with different reagents depending on the component to be detected may be provided. Further, each reagent or the like may be directly sprayed instead of filling the detection tube.

  Further, when a medicine used for photodynamic diagnosis or photodynamic therapy is used during the operation, the fluid treatment unit 430 irradiates the aspirated air or the like with excitation light, and the fluorescence condition or It is good also as a structure which can observe the light emission condition. For example, when a drug that emits light from specific cells such as a tumor is used, the analysis processing unit 440 determines the presence or absence of the cell to which the drug is attached by observing the fluorescence state in the fluid treatment unit 430. can do. And when fluorescence is seen in the sucked air, it becomes possible to determine that the excision position by the treatment instrument 110 is too close to the affected part or has not been excised.

  The fluid treatment unit 430 may be configured to irradiate the sucked air or the like with infrared light and detect the spectrum of transmitted light. If it is the fluid treatment unit 430, the analysis processing unit 440 determines the molecular structure of the component contained in the sucked air or the like by infrared spectroscopy, and the moisture, fat content contained in the sucked air or the like, Alternatively, the protein contained in the cell can be discriminated.

  7 and 8 are diagrams for explaining component analysis by infrared spectroscopy. As shown in FIG. 7, in infrared spectroscopy, a measurement object is irradiated with infrared light having a predetermined spectrum, and the spectrum of transmitted light is measured and analyzed, whereby the difference in molecular structure of the component to be measured is analyzed. Determine. Infrared spectroscopy can be measured in a non-contact manner with respect to the measurement object, and the measurement object may be powder or liquid. FIG. 8 shows near-infrared spectra of water, lipids, and proteins. The vertical axis indicates the absorbance, and the higher the absorbance, the greater the extent to which light of that wavelength is absorbed. As described above, since the wavelength range of light to be absorbed differs depending on water, lipid, and protein, the analysis processing unit 440 observes the spectrum of transmitted light, so that the analysis processing unit 440 includes components and component amounts contained in the sucked air and the like. Can be analyzed.

  Originally, it is difficult to analyze the method of observing fluorescence and luminescence in a bright environment in the operating room. However, in the electrosurgical system 100 of this embodiment, the fluid treatment unit 430 in the analyzer 400 is used. Further, by allowing the sucked air or the like to pass therethrough, measurement in a dark surrounding becomes possible.

(2.3.2. Analysis processing unit)
The analysis processing unit 440 identifies a component in the fluid such as aspirated air based on the measurement result and the observation result in the fluid treatment unit 430. As described above, the analysis processing unit 440 identifies specific disease cells such as tumors and cancer cells, and foreign substances such as pancreatic juice in addition to moisture, lipids, and proteins contained in the sucked air and the like according to the method employed. . In addition, the analysis processing unit 440 may determine the amount of such moisture and lipid.

  When the amount of moisture contained in air or the like is large, it can be said that the amount of smoke due to the destruction of the living tissue is large and visibility is likely to be poor. This may be because the amount of power supplied to the first electrode and the second electrode of the treatment instrument 110 is too large. Similarly, even when the amount of lipid or protein contained in the sucked air or the like is large, it can be said that it is in a state where visibility is likely to be poor. This may also be caused by the amount of power supplied to the first electrode and the second electrode of the treatment instrument 110 being too large. Therefore, in this case, it is desirable to reduce the amount of power supplied to the treatment instrument 110 by the power control device 200.

  Further, in the photodynamic diagnosis or photodynamic treatment, when a lot of fluorescence is observed in the aspirated air or the like, it can be determined that the aspirated air or the like contains a tumor. This may be because the excision position is too close to the tumor or the tumor has not been completely excised. Similarly, even when cancer cells or other foreign substances are contained in the sucked air or the like, it is conceivable that the excision position is too close to the foreign substances or the foreign substances have not been completely excised. Therefore, in this case, it is desirable to notify the doctor who is performing surgery using the display device 500 or a warning device (not shown).

  Furthermore, even when pancreatic fluid leakage is common, the doctor or the like can take measures to prevent complications by notifying the doctor or the like with the display device 500 or a warning device.

  Therefore, the analysis processing unit 440 may determine the display content by the display device 500 based on the analysis result and output a display command to the display processing unit 450. Further, the analysis processing unit 440 may determine whether or not a warning operation is necessary based on the analysis result, and may output a warning command to the warning processing unit 460.

  Further, the analysis processing unit 440 determines whether the energization amount to the first electrode and the second electrode of the treatment instrument 110 is within an appropriate range based on the analysis result, and increases or decreases the power intensity in the power control device 200. Command may be output. The supply power may be reduced when the amount of the fat component or other foreign component contained in the sucked air or the like is large, and the supply power may be increased when the amount of the fat component or the like is too small.

  FIG. 9 is an explanatory diagram showing the relationship between the power supplied to the treatment instrument 110, the detected amount of fat components, and the detected amounts of moisture and other components. The detected amount of the fat component, moisture and other components changes according to the power supplied to the treatment instrument 110. As shown by A in FIG. 9, the smoke-like fine foreign substance component is ejected relatively slowly as the supply power increases. In addition, as shown by B in FIG. 9, fat components such as fat components that are more likely to obstruct visibility are apt to be ejected rapidly when exceeding a certain power value as the supply power increases. .

  The analysis processing unit 440 outputs an instruction signal for increasing / decreasing the supplied power to the power control apparatus 200 so that the detected amount of moisture and other components other than the fat component falls within a preset appropriate range. At that time, the analysis processing unit 440 instructs to increase / decrease the supply power so that the detected amount of the fat component that tends to hinder the visibility does not exceed the preset fat component limit value. Thereby, in endoscopic surgery using the treatment instrument 110, treatments such as incision, suturing, and sintering can be appropriately performed on the affected part.

  The appropriate range of the detected amount of moisture and other components and the limit value of the fat component are set to appropriate values according to the surgical procedure, the patient's physique, and the like. That is, the limit value of the fat component may exceed the proper range of the detected amount of moisture and other components, or may be within the proper range.

(2.3.3. Display processing unit)
The display processing unit 450 displays analysis result information on the display device 500 in accordance with a display command from the analysis processing unit 440. In particular, when diseased cells such as tumors and cancer cells are contained in the sucked air or the like, or when the amount of water, lipids, proteins, or pancreatic juice is large, this is displayed on the display device 500. Note that the display processing unit 450 may display information other than these pieces of information on the display device 500.

(2.3.4. Warning processing section)
The warning processing unit 460 operates a warning device (not shown) in accordance with a warning command from the analysis processing unit 440. For example, the warning processing unit 460 activates the warning device when diseased cells such as tumors or cancer cells are included in the sucked air or the like, or when the amount of water, lipid, protein, or pancreatic juice is large. . Examples of the warning device include a warning sound and a warning lamp, but other warning devices may be used.

(2.3.5. Collection tank)
In the present embodiment, the analyzer 400 includes a collection tank 410 and a filter 420. The suction pipes 150 and 160 are both connected to the gas phase portion at the top of the collection tank 410. Therefore, even if the sucked air or the like contains splashes, the splashes are collected in the collection tank 410. Further, the filter 420 is provided in the collection tank 410 at a connection position of the suction pipe 160 that communicates with the suction device 300. Therefore, moisture and fat components contained in the sucked air and the like are collected by the filter 420. Thereby, it becomes difficult for fat components and splashes to enter the vacuum pump 310, and the vacuum pump 310 is easily kept clean.

  In the electrosurgical system 100 of the present embodiment, the analyzer 400 is provided between the treatment instrument 110 and the suction device 300, but the suction device 300 is provided between the treatment instrument 110 and the analyzer 400. The analysis device 400 may be placed on the downstream side of the suction device 300.

[2.4. Power control device]
The power control apparatus 200 performs energization control to the first electrode and the second electrode provided in the treatment unit 130 of the treatment instrument 110. Thereby, an electrical incision etc. with respect to an affected part is attained. When the handle 118 of the treatment instrument 110 is operated by a doctor or the like and the two treatment units 130a and 130b are brought closer to each other, the power control device 200 is applied to the first electrode and the second electrode of the two treatment units 130a and 130b. On the other hand, a high frequency current may be supplied. As a result, power is not supplied to the first electrode and the second electrode while the affected area is not treated, and the power cost can be reduced.

  The power control device 200 is connected to the suction device 300 and the analysis device 400 by communication cables 105 and 108, and information can be transmitted and received between the devices. Further, the power control device 200 may increase or decrease the power supplied to the first electrode and the second electrode based on the increase / decrease command of the supply power from the analysis device 400. As described above, the analyzer 400 determines that the supplied power is too large when the smoke or fat component in the sucked air is large, and outputs an instruction signal to the power control device 200 to reduce the power. To do. In addition, when the smoke or fat component in the sucked air is small, the analysis device 400 determines that the supplied power is too small and outputs an instruction signal to the power control device 200 to increase the power. The power control apparatus 200 controls the supplied power according to the instruction signal.

[2.5. Display device]
The display device 500 displays the analysis result of the sucked air or the like according to the instruction signal from the display processing unit 450. In addition to the analysis result, the display device 500 may display on / off of the power supplied to the treatment instrument 110, the amount of power, the presence / absence of the operation of the vacuum pump 310, and the magnitude of the output. Further, the display device 500 may display a warning in accordance with an instruction signal from the warning processing unit 460. The display device 500 may be a known display device typified by a liquid crystal display.

<3. Example of control processing>
The configuration example of the electrosurgical system according to the present embodiment has been described above. Next, an example of control processing in the electrosurgical system will be described.

[3.1. Example of suction control processing]
First, an example of suction control processing using the vacuum pump 310 by the suction control unit 320 will be described.

(3.1.1. First example)
FIG. 10 is a flowchart illustrating a first example of the suction control process. First, in step S10, the suction control unit 320 determines whether or not energization is started for the first electrode and the second electrode of the treatment instrument 110. The suction control unit 320 can determine whether or not energization is started by reading the energization state of the power control device 200. When energization to the first electrode and the second electrode is not started (S10: No), the suction control unit 320 repeats the determination in step S10 without starting suction.

  On the other hand, when energization to the first electrode and the second electrode is started (S10: Yes), the suction control unit 320 operates the vacuum pump 310 in step S14 to detect air or splashes in the body cavity. Start aspiration. At this time, the suction control unit 320 resets the timer counter and measures the elapsed time from the start of suction.

  Next, in step S18, the suction control unit 320 determines whether or not the timer value has exceeded a predetermined time set in advance. The predetermined time can be set to an appropriate value in consideration of the time required for one treatment when, for example, treatment such as incision, suture, or sintering is performed on the affected part. For example, the predetermined time can be a value within a range of 3 to 10 seconds.

  If the timer value does not exceed the predetermined time (S18: No), the suction control unit 320 repeats the determination in step S18 until the timer value exceeds the predetermined time. On the other hand, when the timer value exceeds the predetermined time (S18: Yes), the suction control unit 320 proceeds to step S22, stops the vacuum pump 310, and stops the suction of air and droplets in the body cavity. Thereafter, the process returns to step S10 again, and the processing of each step is repeated according to the procedure described so far.

  According to the suction control process according to the first example described above, smoke, fat components, and droplets generated by the destruction of the living tissue are sucked while a doctor or the like is performing a treatment on the affected part, and in the vicinity of the distal end of the treatment instrument 110. Scattering is suppressed. Thereby, the visual field defect while a doctor or the like is performing treatment for the affected part during endoscopic surgery is improved. Therefore, it can contribute to the improvement of the success rate of endoscopic surgery. Further, in the suction control process according to the first example, the vacuum pump 310 is stopped while there is no possibility of generating smoke or splashes, so that the power cost can be reduced.

(3.1.2. Second example)
FIG. 11 is a flowchart illustrating a second example of the suction control process. First, in step S30, the suction control unit 320 determines whether or not energization is started for the first electrode and the second electrode of the treatment instrument 110 in step S30. The suction control unit 320 can determine whether or not energization is started by reading the energization state of the power control device 200. When energization to the first electrode and the second electrode is not started (S30: No), the suction control unit 320 repeats the determination in step S30 without starting suction.

  On the other hand, when energization to the first electrode and the second electrode is started (S30: Yes), the suction control unit 320 operates the vacuum pump 310 in step S34 to detect air or splashes in the body cavity. Start aspiration. Next, in step S38, the suction control unit 320 reads the analysis result of the air sucked by the suction device 300, and determines whether or not a predetermined foreign matter is included in the sucked air or the like. The predetermined foreign matter is, for example, a tumor, a cancer cell, pancreatic juice, or the like, and the analyzer 400 observes whether or not the feature amount of these foreign matters appears, thereby removing the foreign matter in the sucked air or the like. Can be identified.

  When the predetermined foreign matter is contained in the sucked air or the like (S38: Yes), the suction control unit 320 repeats the determination in step S38 until no foreign matter is contained. On the other hand, when the predetermined foreign matter is not included in the sucked air or the like (S38: No), the suction control unit 320 proceeds to step S42, stops the vacuum pump 310, and the air or droplets in the body cavity. Stop aspiration. Thereafter, the process returns to step S30 again, and the processing of each step is repeated according to the procedure described so far.

According to the suction control process according to the second example described above, when a doctor or the like starts treatment on the affected part with a good visibility, the smoke, fat components, and splashes generated are sucked and the tip of the treatment instrument 110 is drawn. Scattering in the vicinity is suppressed. Thereby, the visual field defect while a doctor or the like is performing treatment for the affected part during endoscopic surgery is improved. Therefore, it can contribute to the improvement of the success rate of endoscopic surgery. In the suction control process according to the second example, when a predetermined foreign object is not found in the air or the like sucked after that, the vacuum pump 310 is stopped. Electric power cost can be reduced while preventing incision and the like.
[3.2. Example of display processing and warning processing]
Next, an example of display processing and warning processing by the analysis processing unit 440 will be described.
FIG. 12 is a flowchart illustrating an example of display processing and warning processing according to the present embodiment. First, the analysis processing unit 440 determines whether or not the suction device 300 is sucking air or the like from the body cavity. If the suction is not being performed (S50: No), the analysis processing unit 440 repeats the determination in step S50 as it is because it cannot analyze the sucked air or the like.

  On the other hand, when air or the like is sucked from the body cavity by the suction device 300 (S50: Yes), the analysis processing unit 440 proceeds to step S54, and the analysis processing unit 440 analyzes the sucked air and the like. The analysis process may be, for example, an analysis using a detector tube filled with a reagent for detecting a specific component, or an analysis using a method using a fluorescent reagent or a photodynamic method using infrared spectroscopy. May be. The electrosurgical system according to this embodiment can take out air or the like from the body cavity and perform component analysis without interrupting the operation.

  Next, the analysis processing unit 440 proceeds to step S58, and determines whether or not foreign substances to be warned are included in the sucked air or the like based on the analysis result. When a predetermined foreign matter is contained in the sucked air or the like (S58: Yes), the analysis processing unit 440 proceeds to step S66 and outputs an instruction signal to the warning processing unit 460 to operate the warning device. . Thereby, a warning sound is generated or a warning lamp is turned on.

  On the other hand, when the predetermined foreign matter is not included in the sucked air or the like (S58: No), or after outputting the instruction signal to the warning processing unit 460 in step S66, the analysis processing unit 440 In step S62, an instruction signal is output to the display processing unit 450, and the display content on the display device 500 is updated. Thereby, the display of the analysis result of the sucked air, the warning display, etc. are updated. After updating the display contents, the process returns to step S50 again, and the processing of each step is repeated according to the procedure described so far.

  According to the above display process and warning process, it is possible to notify whether or not an appropriate treatment is being performed on the affected part by the treatment instrument 110 during the operation without interrupting the endoscopic operation. Thereby, endoscopic surgery can be advanced while correcting the positions of the treatment parts 130a and 130b with respect to the affected part. Alternatively, all diseased cells can be removed in endoscopic surgery. Therefore, it can contribute to the improvement of the success rate of endoscopic surgery.

[3.3. Example of power control processing]
Next, an example of a power control process for controlling the power supplied to the treatment instrument 110 by the analysis processing unit 440 will be described.
FIG. 13 is a flowchart illustrating an example of the power control process according to the present embodiment. First, the analysis processing unit 440 analyzes the sucked air or the like when air or the like is sucked from the body cavity, similarly to steps S50 and S54 shown in FIG.

  Next, in step S70, the analysis processing unit 440 determines whether or not the detected amount of moisture and other components obtained from the analysis result of the sucked air or the like is in an appropriate range. If the detected amount of moisture and other components is in an appropriate range (S70: Yes), the process proceeds to step S78 as it is. On the other hand, when the detected amount of moisture and other components is not in the appropriate range (S70: No), the analysis processing unit 440 proceeds to step S72 and outputs an intensity control signal to the power control apparatus 200.

  Specifically, the analysis processing unit 440 outputs an intensity control signal so as to increase the supply power if the detected amount of moisture and other components is in a shortage range. In addition, the analysis processing unit 440 outputs an intensity control signal so as to reduce the supply power if the detected amount of moisture and other components is in an excessive range. When increasing or decreasing the supply power to the treatment instrument 110, the supply power may be adjusted at a predetermined increase / decrease rate, or the supply power is adjusted at a predetermined increase / decrease range. Also good. After outputting the intensity control signal, the process proceeds to step S78.

  In step S78, the analysis processing unit 440 determines whether or not the detected amount of the fat component obtained from the analysis result of the sucked air or the like exceeds the limit value. If the detected amount of the fat component does not exceed the limit value (S78: No), the analysis processing unit 440 returns to step S50 again. On the other hand, when the detected amount of the fat component exceeds the limit value (S78: Yes), the analysis processing unit 440 outputs an intensity control signal so as to reduce the supply power in step S82.

  When reducing the supply power to the treatment instrument 110, the supply power may be reduced at a predetermined increase / decrease rate, or the supply power may be reduced within a predetermined reduction range. Also good. After outputting the intensity control signal, the process returns to step S50 again. Thereafter, the analysis processing unit 440 repeatedly performs the processing of each step according to the procedure described so far.

  According to the above power control processing, in endoscopic surgery using an electrosurgical treatment device, treatment is performed so that fat components, moisture, and other components are within an appropriate range based on the analysis result of aspirated air or the like. The power supply to the instrument is automatically adjusted. Thereby, a visual field can be kept favorable, without performing manual adjustment of the electric power supplied by a doctor or the like. Therefore, it can contribute to the improvement of the success rate of endoscopic surgery.

  The electrosurgical system 100 according to the present disclosure described above includes the suction device 300 that sucks air or the like from the vicinity of the distal end side of the treatment instrument 110 during endoscopic surgery. Thereby, in endoscopic surgery, smoke, splashes and the like generated by destruction of living tissue are discharged from the body cavity, and the visibility can be maintained well. Moreover, the possibility that the droplets containing the diseased cells may be transferred to other places is reduced. Therefore, it can contribute to the improvement of the success rate of endoscopic surgery.

  Further, in the electrosurgical system 100 according to the present disclosure, when the supply of power to the treatment instrument 110 is started, suction by the suction device 300 is started. Further, the suction device 300 stops the suction after a predetermined time has elapsed or when a predetermined foreign matter is not included in the sucked air or the like. Therefore, the treatment of the affected area by the treatment units 130a and 130b can be started with the visibility maintained well, and the suction device 300 is stopped when the possibility of generation of smoke, splashes, etc. is reduced and the power is reduced. Cost can be reduced.

  In addition, in the electrosurgical system 100 according to the present disclosure, when a predetermined foreign object is detected from aspirated air or the like, a warning or display to that effect is given. Thereby, a doctor etc. can grasp | ascertain and adjust the present treatment condition, without interrupting endoscopic surgery. Therefore, it can contribute to the improvement of the success rate of endoscopic surgery.

  Furthermore, in the electrosurgical system 100 according to the present disclosure, the amount of power supplied to the treatment instrument 110 is increased or decreased according to the detected amount of the fat component contained in the sucked air or the like, or the detected amount of moisture or other components. The Thereby, it is suppressed that the visual field of endoscopic surgery is obstructed, and it can contribute to the improvement of the success rate of endoscopic surgery.

  The preferred embodiments of the present disclosure have been described in detail above with reference to the accompanying drawings, but the technical scope of the present disclosure is not limited to such examples. It is obvious that a person having ordinary knowledge in the technical field of the present disclosure can come up with various changes or modifications within the scope of the technical idea described in the claims. Of course, it is understood that it belongs to the technical scope of the present disclosure.

  For example, in the above embodiment, the display device 500 is connected to the analysis device 400, but the present disclosure is not limited to such an example. The display device 500 may be connected to the suction device 300.

  In addition, some of the functions of the suction device 300, the analysis device 400, and the power control device 200 may be provided in another device. Furthermore, any two or all three of the suction device 300, the analysis device 400, and the power control device 200 may be integrated as one device.

  In the above-described embodiment, the display device 500 is a monitor such as a liquid crystal panel, but may be an optical display unit such as an indicator lamp.

  Further, the effects described in the present specification are merely illustrative or exemplary and are not limited. That is, the technology according to the present disclosure can exhibit other effects that are apparent to those skilled in the art from the description of the present specification in addition to or instead of the above effects.

The following configurations also belong to the technical scope of the present disclosure.
(1) an insertion portion having a treatment portion to which power is supplied at the tip;
A power control unit for controlling power supplied to the treatment unit;
A suction passage provided in the insertion portion and having an opening on a distal end side of the insertion portion;
A suction section for sucking fluid through the suction passage;
An electrosurgical treatment device comprising:
(2) comprising a suction control unit for controlling the output of the suction unit;
The electrosurgical treatment device according to (1), wherein the suction control unit controls an output of the suction unit based on the electric power supplied to the treatment unit.
(3) A suction control unit for controlling the output of the suction unit is provided,
The electrosurgical treatment device according to (1) or (2), wherein the suction control unit starts the operation of the suction unit when the supply of the electric power to the treatment unit is started.
(4) A suction control unit for controlling the output of the suction unit is provided,
The electrosurgery according to any one of (1) to (3), wherein the suction control unit controls an output of the suction unit based on an analysis result of the fluid sucked through the suction passage. Treatment device.
(5) The electrosurgical treatment device according to (4), wherein the suction control unit stops the suction unit based on the analysis result when the predetermined fluid is not included in the fluid.
(6) A suction control unit for controlling the output of the suction unit is provided,
The electrosurgical treatment device according to any one of (1) to (5), wherein the suction control unit stops suction when a preset time has elapsed after the start of suction.
(7) Any one of (1) to (6), wherein the power control unit controls power supplied to the treatment unit based on an analysis result of the fluid sucked through the suction passage. An electrosurgical treatment device according to 1.
(8) The electrosurgical treatment device according to any one of (1) to (7), wherein the suction passage also serves as an arrangement space for electric wiring that guides the electric power to the treatment portion.
(9) The electrosurgical treatment device according to any one of (1) to (7), wherein the suction passage is a suction tube attached to the insertion portion.
(10) detecting the supply state of power to the treatment section provided at the distal end of the insertion section;
Controlling the operation of the suction part based on the supply of the electric power, and sucking the fluid from the opening on the distal end side of the insertion part;
An electrosurgical treatment device control method comprising:
(11) an insertion portion having a treatment portion to which power is supplied at the tip;
A power control unit for controlling power supplied to the treatment unit;
A suction passage provided in the insertion portion and having an opening on the distal end side of the insertion portion;
A suction section for sucking fluid through the suction passage;
An analysis unit for analyzing the fluid sucked through the suction passage;
An electrosurgical system comprising:
(12) A suction control unit that controls the output of the suction unit is provided,
The electrosurgical system according to (11), wherein the suction control unit controls an output of the suction unit based on an analysis result by the analysis unit.
(13) The electrosurgical system according to (11) or (12), wherein the analysis unit detects an oil component of the aspirated fluid.
(14) The electrosurgical system according to any one of (11) to (13), wherein the analysis unit detects a diseased cell of the fluid to be aspirated.
(15) The electrosurgical system according to any one of (11) to (14), further including a display unit that displays an analysis result by the analysis unit.
(16) The electrosurgical system according to any one of (11) to (15), further including a warning processing unit that issues a warning when an abnormality is found in the analysis result of the analysis unit.
(17) The electrosurgical system according to (16), wherein the warning processing unit issues a warning when a predetermined foreign object is detected as a result of analysis by the analysis unit.

100 electrosurgical system 110 electrosurgical treatment instrument (treatment instrument)
DESCRIPTION OF SYMBOLS 112 Insertion part 114 Operation part 120 Sheath 125 Suction passage 125a Suction opening 130a, 130b Treatment part 140 Suction pipe 140a Suction opening 150,160 Suction pipe 200 Power control apparatus (power control part)
300 Suction device (suction part)
310 Vacuum pump 320 Suction controller 400 Analyzer (analyzer)
430 Fluid treatment unit 440 Analysis processing unit 450 Display processing unit 460 Warning processing unit 500 Display device (display unit)

Claims (17)

An insertion portion having a treatment portion to which power is supplied at the tip;
A suction passage provided in the insertion portion and having an opening on a distal end side of the insertion portion;
A suction section for sucking fluid through the suction passage;
An electrosurgical treatment device comprising: A suction control unit for controlling the output of the suction unit;
The electrosurgical treatment device according to claim 1, wherein the suction control unit controls an output of the suction unit based on the electric power supplied to the treatment unit. A suction control unit for controlling the output of the suction unit;
The electrosurgical treatment device according to claim 1, wherein the suction control unit starts the operation of the suction unit when the supply of the electric power to the treatment unit is started. A suction control unit for controlling the output of the suction unit;
The electrosurgical treatment device according to claim 1, wherein the suction control unit controls an output of the suction unit based on an analysis result of the fluid sucked through the suction passage.   The electrosurgical treatment device according to claim 4, wherein the suction control unit stops the suction unit based on the analysis result when the fluid does not contain a predetermined foreign matter. A suction control unit for controlling the output of the suction unit;
The electrosurgical treatment device according to claim 1, wherein the suction control unit stops suction when a preset time has elapsed after the start of suction. A power control unit for controlling power supplied to the treatment unit;
The electrosurgical treatment device according to claim 1, wherein the power control unit controls power supplied to the treatment unit based on an analysis result of the fluid sucked through the suction passage.   The electrosurgical treatment device according to claim 1, wherein the suction passage also serves as an arrangement space for electric wiring that guides the electric power to the treatment portion.   The electrosurgical treatment device according to claim 1, wherein the suction passage is a suction tube attached to the insertion portion. Detecting the state of power supply to the treatment section provided at the distal end of the insertion section;
Controlling the operation of the suction part based on the supply of the electric power, and sucking the fluid from the opening on the distal end side of the insertion part;
An electrosurgical treatment device control method comprising: An insertion portion having a treatment portion to which power is supplied at the tip;
A power control unit for controlling power supplied to the treatment unit;
A suction passage provided in the insertion portion and having an opening on the distal end side of the insertion portion;
A suction section for sucking fluid through the suction passage;
An analysis unit for analyzing the fluid sucked through the suction passage;
An electrosurgical system comprising: A suction control unit for controlling the output of the suction unit;
The electrosurgical system according to claim 11, wherein the suction control unit controls an output of the suction unit based on an analysis result by the analysis unit.   The electrosurgical system according to claim 11, wherein the analysis unit detects an oil component of the fluid to be aspirated.   The electrosurgical system according to claim 11, wherein the analysis unit detects a diseased cell of the fluid to be aspirated.   The electrosurgical system according to claim 11, further comprising a display unit that displays an analysis result by the analysis unit.   The electrosurgical system according to claim 11, further comprising a warning processing unit that issues a warning when an abnormality is found in the analysis result of the analysis unit. The electrosurgical system according to claim 16, wherein the warning processing unit issues a warning when a predetermined foreign object is detected as a result of analysis by the analysis unit.

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