JP3061745B2 - Insufflation device - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an insufflation device, and more particularly, to inflating the abdomen by injecting gas such as carbon dioxide into the body, and for performing endoscopic observation or treatment with an endoscope. The present invention relates to a pneumoperitoneum device having a feature in securing a visual field.

[0002]

2. Description of the Related Art In general, for example, when performing medical treatment in the abdominal cavity of a patient under endoscopic observation, a gas such as carbon dioxide is injected into the abdominal cavity to be treated conventionally to inflate the abdomen and perform the treatment. The observation field of view is secured so that the treatment process can be fully understood. For injecting gas into the abdominal cavity, a gas insufflation device that sends gas from a gas supply source such as a gas cylinder while controlling the pressure with a decompressor, an electromagnetic valve, a pressure sensor, etc., and maintains the inside of the abdominal cavity at a set pressure is used. used.

As such an insufflation device, for example, as disclosed in Japanese Patent Publication No. 2-14843 or US Pat. No. 5,152,745, the insufflation flow rate is measured and controlled to a flow rate value set by a user. There are those that send air.

Further, as shown in German Patent DE 37 18 417, a flow rate is detected at the time of stoppage, and the detected value is charged to a capacitor using an electric circuit to hold a voltage and used as an offset value to obtain an offset value. An insufflation device that separates a correction circuit for correcting a flow rate and an amplification circuit for amplifying a flow rate and holds an offset value to perform correction when air is being supplied to a contact provided in a pipeline is disclosed. Have been.

[0005]

However, for example, Japanese Patent Publication No. 2-14843 and US Pat.
In the insufflation apparatus that measures the air supply flow rate disclosed in Japanese Patent No. 745 and controls the air supply rate to a flow rate value set by a user to perform air supply, when the flow rate sensor drifts due to a temperature change or a temporal change, There is a problem that flow control cannot be performed correctly.

[0006] Further, in the insufflation device disclosed in the above-mentioned German Patent DE 37 18 417, which separates the correction circuit and the amplifier circuit and performs the correction while holding the offset value, not only the circuit configuration becomes complicated, but also In addition, it is necessary to provide a contact for detecting the gas flow in the gas pipeline, which causes a problem that the configuration of the entire apparatus becomes complicated.

SUMMARY OF THE INVENTION The present invention has been made in view of the above circumstances, and provides an insufflation device which can always and surely and safely control a set flow value to perform air supply with a simple configuration. It is intended to be.

[0008]

According to the present invention, there is provided an insufflation apparatus for injecting gas from a gas supply source into an abdominal cavity of a living body through an insufflation insert. A gas supply pipe leading to the insufflation insert, and a pipe switching means provided in the gas supply pipe, which repeats injecting and stopping injection of gas into the abdominal cavity of the living body by opening and closing operation. Controlling the flow switching means so as to repeat a flow measurement means for measuring a flow rate of the gas in the gas supply pipe and an injection of gas into the abdominal cavity of the living body and a stop of the injection. In addition, the first flow rate measured by the flow rate measuring means while the gas is being injected into the abdominal cavity, and the first flow rate measured by the flow rate measuring means while the injection of the gas into the abdominal cavity is stopped. And the second flow rate to be Interrupt, and having a control unit for repeating a function of calculating a value obtained by subtracting the second flow rate from the first flow rate as a true flow value.

[0009]

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

FIGS. 1 to 4 relate to an embodiment of the present invention. FIG. 1 is a configuration diagram showing a configuration of an insufflation device, FIG. 2 is a configuration diagram showing a configuration of a front panel of FIG. 1, and FIG. FIG. 4 is a flowchart for explaining the operation of the insufflation device of FIG. 1, and FIG.
FIG. 5 is a characteristic diagram showing output characteristics of the flow sensor of FIG.

(Structure) As shown in FIG. 1, the insufflation device 1 is provided with a connection base 2 for connecting a gas supply source, and the connection base 2 is connected to a single or a plurality of CO ₂ via a connection hose 3. A cylinder 4 as a gas supply source filled with (carbon dioxide) gas is connected. Further, the insufflation device 1 has an air supply base 5 for connecting an insufflation insert such as an insufflation needle or a trocar. The trocar 7 is connected.
The insufflation trocar 7 is inserted into the abdomen of the patient 8 to inject gas into the abdominal cavity.

Further, the insufflation device 1 is provided with a pinch valve 10 for closing / opening the suction tube 9. One end of the suction tube 9 is connected to the treatment trocar 11 which is inserted into the abdominal cavity of the patient 8 separately from the insufflation trocar 7, and the other end is connected to the wall suction device of the operating room via the pinch valve 10. (Not shown), and a pinch valve 10 controls suction of gas in the abdominal cavity.

A cylinder pressure sensor 13 provided inside the insufflation device 1 is connected to the connection base 2, and a first pressure reducer 15 is connected via a high-pressure pipe 14. The first pressure reducer 15 is connected to a second pressure reducer 18 via an internal pipe 16 and a closing valve 17. These first and second decompressors 15 and 18 constitute decompression means.

The pressure of the cylinder detected by the cylinder pressure sensor 13 is displayed on the front panel 19 of the insufflation apparatus 1 so that the operator can recognize the remaining gas in the cylinder 4. Approximately 5-6 Mpa of CO ₂ sealed in the cylinder 4
The gas can be reduced in pressure to about 3 kgf / cm ² in the first pressure reducer 15 and can be reduced to about 80 mmHg in the second pressure reducer 18 via the internal pipe 16.

The first decompressor 15 is provided with a safety valve 20. In the case where the decompression value exceeds a predetermined pressure due to a failure, excessive pressure is not applied to the second decompressor 18 and gas is released to the atmosphere. Is to be released.

The internal pipe 21 for introducing CO ₂ gas from the second decompressor 18 to the downstream side is provided with a plurality of pipe switching means via a joint 23 via a flow sensor 22 (flow measuring means). It is connected to a manifold valve 24.
The manifold valve 24 includes a first valve 25, a second valve 26, and
Third valve 27, fourth valve 28, fifth valve 2
Nine valves are integrally arranged.

The first valve 25 and the second valve 2
6, the inlet sides of the third valve 27 have different orifice diameters for controlling the flow rate, and have the instantaneous flow rate values of 16 L / min, 2 L / min, and 8 L / min, respectively.

The manifold valve 2 communicating with the joint 23
4 are connected to each other as a line upstream of the first valve 25, the second valve 26, and the third valve 27, and are connected to each other. A switch 31 is connected to the internal conduit 30 via a connection tube 32 and a joint 33.

Downstream of the third valve 27 is an internal line 3
4 and is connected to the upstream side of the fourth valve 28, and furthermore, the internal conduit 34 is connected to the joint 35 and the connection tube 3
6 are connected to two pressure sensors 37 and 38. The downstream pipe 39 of the fifth valve 29 is open to the atmosphere.

The downstream side of the first valve 25, the second valve 26, and the fourth valve 28 and the upstream side of the fifth valve 29 communicate with each other through an internal pipe 40 connected to each valve and assembled. The internal conduit 40 is connected to the air supply base 5 via a joint 41 and a connection tube 42.

The closing valve 17, the first to fifth valves 25 to 29 of the manifold valve 24, the flow sensor 22, the pressure switch 31, and the pressure sensors 37 and 38 are all provided in the insufflation device 1. It is electrically connected to a control unit 43 that performs operation control. Further, the control unit 43 is connected to a front panel 19 including a switch for giving an operation instruction of the apparatus.

The measuring range of the pressure sensor 37 is 0 to 52 mm
Hg and the pressure sensor 38 are 0 to 82 mmHg.

An operation changeover switch 45 is electrically connected to the control unit 43. The operation changeover switch 45 is composed of three ON / OFF switches, and eight operation states can be set by a combination of these ON / OFF switches.

Next, the configuration of the front panel 19 will be described. As shown in FIG. 2, the front panel 19 includes a plurality of display units and a plurality of key input units in addition to a power switch 49 for turning on / off the power of the apparatus.
Pombe pressure display bar LED50, peritoneal pressure display bar LED51, flow rate display bar LED52, and abdominal pressure value LED for numerical display using two-color LEDs that enable analog display
53, a flow rate LED 54 and an integrated flow rate LED 55. The key input unit includes an air supply switch 60 for instructing various operations, a stop switch 61, an abdominal pressure setting up switch 62, an abdominal pressure setting down switch 63, a flow setting up switch 64, a flow setting down switch 65, and a flow mode setting. It comprises a (high) switch 66, a flow mode setting (variable) switch 67, a flow mode setting (low) switch 68, and a reset switch 69.

(Operation) First, the pressure sensor offset operation will be described below.

The operation switch 45 is switched to select the pressure sensor offset correction value acquisition mode, and the power is turned on.

When the abdominal pressure setting up switch 62 is pressed in a state where nothing is connected to the air supply base 5, the pressure sensors 37, 3
8 were captured 32 times at 30 msec intervals,
The average of these is taken as the pressure sensor offset correction value.

The pressure sensor offset correction value is recorded in an EEPROM (not shown) inside the control unit 43. This operation is performed at the time of shipment from the factory, and cannot be operated by a normal user.

In the normal operation, when the value of the pressure sensor is obtained, a correct pressure value is calculated by subtracting the offset correction value recorded from the obtained value.

If the pressure sensor offset correction value is out of the normal error range of each pressure sensor (for example, ± 2.02 mmHg for the pressure sensor 37 and ± 3.65 mmHg for the pressure sensor 38), the pressure sensor fails. It is determined that the power supply is operating, and using the LEDs 53 and 54, for example, “E
r "and" 07 "are displayed to notify the user of the failure.

Next, the insufflation device 1 configured as described above
The operation of will be described.

After turning on the power switch 49 and turning on the power of the insufflation apparatus 1, a flow mode setting (high) switch 66, a flow mode setting (variable) switch 67, and a flow mode setting (low) are set.
The switch 68, the flow rate setting up switch 64, and the flow rate setting down switch 65 are pressed to set the flow rate. Further, the abdominal pressure setting up switch 62 and the abdominal pressure setting down switch 63
Set the peritoneal pressure according to. Then, the air supply switch 6
Pressing 0 starts the air supply operation.

The air supply operation will be described in detail. As described above, the user sets the abdominal pressure by the abdominal pressure setting up switch 62 and the abdominal pressure setting down switch 63 in step S1 of FIG. (High) switch 66,
The flow rate is set by a flow rate mode setting (variable) switch 67, a flow rate mode setting (low) switch 68, a flow rate setting up switch 64, and a flow rate setting down switch 65.

Then, after the air supply switch 60 is pressed,
At the start of the air supply operation in step S2, first, the closing valve 17 is opened, and at the same time, the third valve 27 is opened, and the first decompressor 15 and the second decompressor 1
The CO ₂ gas flows at a flow rate indicated by the point A in FIG. 4 through the pipe 8 and fills the pipes of the internal pipe 34 and the connection tube 36 corresponding to the intermediate tank of the manifold valve 24.

After the gas has been charged, the third valve 27 is closed and the fourth valve 28 is opened in step S3, so that the CO ₂ gas in the internal conduit 34 is removed from the internal conduit 4.
0, the connection tube 42, the pneumoperitoneum tube 6, and the pneumoperitoneum needle are sequentially injected into the abdominal cavity of the patient 8.

With the operation of injecting the CO ₂ gas into the abdominal cavity,
The pressure in the internal pipe 34 corresponding to the intermediate tank gradually decreases, and the pressure drop characteristic at this time is determined by the pressure sensor 37.
And 38.

The measurement ranges of the pressure sensors 37 and 38 are 0 to 52 mmHg and 0 to 82 mmHg, respectively. The pressure values are obtained from the two pressure sensors 37 and 38 as follows.

(1) First, a pressure value is obtained from the output of the pressure sensor 38. If the pressure value is 43 mmHg or more, this value is used as the pressure value (for example, when measuring the line pressure during air supply).

(2) When the value of the sensor 38 is smaller than 43 mmHg, the value is compared with the value of the sensor 37, and when the difference between the two exceeds the error range, it is determined that one of the failures has occurred and the operation is stopped to stop the patient. To ensure safety.

(3) If the output difference between the pressure sensors 37 and 38 is within the error range and is 43 mmHg or less,
The value of the sensor 37 having a narrow measurement range and high accuracy is acquired as a pressure value.

Then, the pressure in the abdominal cavity is calculated by the control unit 43 in step S4 based on the measurement data in step S3. This is referred to as a drop pressure measurement, and the pressure in the abdominal cavity can be obtained from the pressure drop curve. This corresponds to the pressure measurement section in section B in FIG. Here, the outputs of the pressure sensors 37 and 38 are input to the control unit 43, where they are converted from voltage values to pressure.

Next, at the point C in FIG. 4 where the flow of gas has disappeared in step S5, the value of the flow sensor 22 is read, and this value is set as the flow sensor offset value. This value is within the normal error range of the flow sensor 22 (for example, ± 1.
If the flow rate exceeds 6 L / min), the controller 43 determines that the flow rate sensor has failed and stops all operations.

Subsequently, in step S6, the gas is sent into the abdominal cavity, and as shown in the next section D in FIG. 4, the flow rate is detected by the flow rate sensor 22 provided on the pipeline at this time. Then, in step S7, the control unit 43 obtains the difference between the output signal of the flow sensor 22 and the flow sensor offset value measured at the point C, and sets this value as a true instantaneous flow value. This is done on software.

From these measured values and set values, the control unit 43
Determines the pipeline and the open time in step S8, closes each valve at point E in FIG. 4 after the elapse of the open time, and returns to step S3.

In this way, a series of operation cycles of measurement and air supply are repeated, and the abdominal cavity pressure is maintained at the set pressure while controlling the flow rate to the set value.

(Effect) As described above, according to the insufflation device 1, the flow offset correction is always performed during the operation of the device, thereby preventing erroneous measurement due to deviation of the flow sensor over time and temperature change. Can perform safe insufflation. At the same time, a failure of the flow sensor can be easily found.

Further, since the sensor is corrected on the software in the control unit 43, the offset can be corrected more easily than hardware (for example, adjustment of a variable resistor).

[Appendix] (Appendix 1) In an insufflation device for reducing the pressure of a gas from a gas supply source and injecting the gas into the abdominal cavity of a living body through an insufflation tool, the insufflation gas is supplied from the gas supply source. A gas supply pipe leading to an insertion tool, a plurality of pipe switching means for switching a flow state of the gas supply pipe, a flow measurement means for measuring a flow rate of the gas in the gas supply pipe, and the flow rate Control means for controlling the plurality of pipeline switching means, based on the control, the control means controlling the plurality of pipeline switching means, calculating a flow rate offset value of the flow rate measurement means, the flow rate offset An insufflation device wherein the flow rate is corrected based on a value.

(Supplementary Item 2) In a pneumoperitoneum method of reducing the pressure of a gas from a gas supply source and injecting the gas into the abdominal cavity of a living body via a pneumoperitoneum insertion tool, the pneumoperitoneum is inserted from the gas supply source. A pressure measuring step of measuring a pressure of a gas supply pipe leading to a tool, a flow measurement step of measuring a flow rate of the gas in the gas supply pipe, and switching a flow state of the gas supply pipe based on the flow rate. And a control step of controlling the flow state of the gas supply pipeline, calculating a flow rate offset value of the flow rate measurement step, and correcting the flow rate based on the flow rate offset value. Insufflation method characterized by the following.

[0050]

As described above, according to the insufflation device of the present invention, the control means controls the plurality of conduit switching means,
Since the flow rate offset value of the flow rate measuring means is calculated and the flow rate is corrected based on the flow rate offset value, it is possible to always reliably and safely control the set flow value to perform air supply with a simple configuration. There is.

[Brief description of the drawings]

FIG. 1 is a configuration diagram showing a configuration of an insufflation device according to an embodiment of the present invention;

FIG. 2 is a configuration diagram showing a configuration of a front panel of FIG. 1;

FIG. 3 is a flowchart illustrating the operation of the insufflation device of FIG. 1;

FIG. 4 is a characteristic diagram showing output characteristics of the flow sensor of FIG. 1;

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 ... Insufflation device 4 ... Cylinder 6 ... Insufflation tube 7 ... Insufflation trocar 15 ... 1st decompression device 17 ... Closing valve 18 ... 2nd decompression device 19 ... Front panel 22 ... Flow sensor 24 ... Manifold valve 31 ... pressure switches 37, 38 ... pressure sensors 43 ... control unit 45 ... operation changeover switches

Continuation of the front page (72) Inventor Masahide Oyama 2-43-2 Hatagaya, Shibuya-ku, Tokyo Inside O-Limpus Optical Industry Co., Ltd. (72) Inventor Kenji 2-43-2 Hatagaya, Shibuya-ku, Tokyo O-limpus Optics (56) References JP-A-5-208016 (JP, A) JP-A-4-208818 (JP, A) JP-A-63-40821 (JP, A) JP-A-6-178780 (JP, A) , A) JP-A-3-53128 (JP, A) WO 94/17370 (WO, A1) (58) Fields investigated (Int. Cl. ⁷ , DB name) A61B 17/00-18/28 G01F 1 / 00-1/90

Claims (1)

(57) [Claims] 1. An insufflation device for injecting gas from a gas supply source into an abdominal cavity of a living body via an insufflation insert, wherein a gas supply pipe extending from the gas supply source to the insufflation insert. And a gas supply pipe, and the living body is opened and closed by an opening and closing operation.
The injection of gas into the abdominal cavity and the stop of the injection.
Return line switching means; flow rate measuring means for measuring the flow rate of the gas in the gas supply line; and the line switching so as to repeat injection of gas into the abdominal cavity of the living body and stop injection. While switching the means, while injecting gas into the abdominal cavity,
A first flow rate measured by the flow rate measuring means,
While the injection of gas into the abdominal cavity is stopped, the flow rate measurement is performed.
Sequentially taking the second flow rate measured by the means,
The value obtained by subtracting the second flow rate from the first flow rate is true.
And a control unit that repeats a function of calculating a flow rate value of the insufflation.