JP3174096B2 - Surgical surgery device - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a surgical apparatus which is used as an ultrasonic scalpel and an electric scalpel while also using a handpiece.

[0002]

2. Description of the Related Art An ultrasonic scalpel as a surgical operating device is
Recently, it is widely used for liver resection and brain surgery. Generally, this kind of ultrasonic scalpel has an ultrasonic vibrator and an ultrasonic probe, and oscillates the ultrasonic vibrator to crush or emulsify tissue by ultrasonic vibration transmitted through the ultrasonic probe. On the other hand, the crushed or emulsified tissue is removed by suction.
When this type of ultrasonic scalpel is used in a surgical operation, highly elastic tissues such as blood vessels and nerve tissues are not excised, and other tissues are crushed. A fluid such as saline is supplied to the resection site to moisten the tissue and suppress heat generation due to crushing. The crushed tissue is removed by suction together with the liquid.

[0003] If a surgical apparatus of this kind is used, thick blood vessels are preserved, so that a safe operation with little bleeding can be performed. However, since the capillaries are resected, it is necessary to cope with bleeding therefrom using a hemostatic means such as an electric scalpel. The way to use these two instruments is
Since it is cumbersome to change instruments, a surgical instrument having both functions of performing an electrosurgical current from a handpiece of an ultrasonic knife to the tip of an ultrasonic probe to perform hemostatic treatment has been considered.

[0004] Ultrasonic scalpels have been widely applied to surgical operations such as liver resection and brain surgery. However, the handpiece used depends on the application site and method of the operation.
For example, a handpiece having a powerful output or a small handpiece useful for a small operation is selectively used.

[0005] On the other hand, since it is necessary to supply electric energy to each of the handpieces on the driving device side, means for detecting the type of handpiece being used is provided (US Pat. No. 4,768,496; D
E3427517C).

[0006]

The following problems occur when the apparatus is provided with the function of an electric scalpel added to the ultrasonic scalpel. 2. Description of the Related Art Conventionally, a drive unit of an ultrasonic transducer in a handpiece has been electrically insulated.

However, this type of ultrasonic scalpel handpiece is provided with a means for supplying a liquid and a means for sucking tissue crushed at the tip of the handpiece. The means for supplying the liquid is such that one end of a water supply tube is connected to a pump provided in a device for sending out the liquid, and the other end of the water supply tube is connected to a handpiece. The means for suctioning the crushed tissue at the tip of the handpiece is connected to a suction device provided with a suction bottle at the other end of the suction tube having one end connected to the handpiece.

Each tube in the liquid feeding means and the suction means is provided with a countermeasure against water leakage. However, because of the presence of liquid in each tube,
The handpiece and each means are electrically connected through the liquid. For this reason, when outputting an electric scalpel signal from the tip of the ultrasonic scalpel to hemostatically coagulate the tissue, there is a possibility that a high-frequency current, which is an electric scalpel signal, flows to another portion such as the apparatus main body through the above-described path.

On the other hand, the means for discriminating the handpiece, when an identification element is provided in the connector and the connector is connected to the apparatus main body, is connected to a drive circuit of the apparatus main body. There is a risk that it will flow out.

[0010] If the high-frequency current for hemostasis leaks to a portion other than the hemostasis site, the hemostasis is not sufficiently performed, and the operation cannot proceed safely. Leakage of current to other parts causes noise and causes malfunction.

SUMMARY OF THE INVENTION The present invention has been made in view of the above-mentioned problems, and an object of the present invention is to provide a surgical apparatus which secures safety by blocking current leakage from a handpiece. is there.

[0012]

According to the present invention, there is provided a handpiece having an ultrasonic vibrator for performing ultrasonic vibration and treating a living body with the ultrasonic vibration of the ultrasonic vibrator. A main body having an exterior housing ultrasonic driving means for supplying a driving signal to the ultrasonic vibrator, a pipe connected to the handpiece, and for perfusing a treatment fluid; and A perfusion control means for controlling the fluid to be perfused, an electric scalpel means connected to the handpiece and supplying a high-frequency current for treatment, and electrically insulating the perfusion control means from the main body. An insulating member for fixedly interrupting the electric current of the electrosurgical unit from the conduit.

[0013]

According to the above construction, even in a surgical apparatus which uses the same handpiece as the ultrasonic scalpel and the electric scalpel, the high-frequency current of the electric scalpel flows only to the tissue part where hemostasis is stopped, and the ultrasonic vibrator of the handpiece is used. Do not flow into the device that drives the

[0014]

1 and 2 show a first embodiment of the present invention. In FIG. 1, reference numeral 1 denotes a handpiece having a built-in ultrasonic transducer, and a selected ultrasonic probe 2 is connected to the handpiece 1. The ultrasonic probe 2 transmits the ultrasonic vibration generated by the ultrasonic vibrator of the handpiece 1 to the tissue of the operation site. A water supply tube 3 and a suction tube 4 for perfusing a liquid are connected to the handpiece 1.

On the other hand, an oscillation circuit 7, a water supply means 8, a pinch valve 9 for turning on and off a suction operation, and the like are provided inside a drive device 5 of the ultrasonic knife, centering on a control circuit 6. I have. The oscillation circuit 7 is an insulating transformer 10
Supplies oscillation driving power to the insulated handpiece 1.

The water supply means 8 includes a motor 11 and a pump 13 connected to the motor 11 via a coupling 12. The pump 13 comprises a roller pump 8a which is squeezed in the water supply tube 3. Then, the physiological saline in the liquid container 14 is sent to the handpiece 1 through the water supply tube 3.

The pinch valve 9 is connected to the solenoid 15 and opens and closes by crushing or opening the middle of the suction tube 4 to control the suction operation. The suction tube 4 is connected to a suction device 17 via a suction bin 16. The tissue or liquid sucked through the suction tube 4 is stored in the suction bottle 16.

The ultrasonic probe 2 of the handpiece 1 is also used as an electric scalpel. Power supply 18 for this electric knife means
Are connected to the ultrasonic probe 2 of the handpiece 1 and the return electrode plate 19 via the current supply lines 18a and 18b, respectively. The output of the electric scalpel is on / off controlled by a switch 20 provided on the handpiece 1, for example.

The power cord 21 of the handpiece 1 has a connector 22 for connecting to the driving device 5.
The connector 22 is connected to the device body 5 of the drive device 5 as described later.
The connector is mounted on the connector receiver 23 provided at a.

As shown by hatching in FIG. 1, the water supply means 8, the pinch valve 9 and the connector 22 are connected to the device main body 5a of the drive device 5 via an electrically insulating member 25 such as plastic or bake. And they are electrically insulated from the electrical circuit of the drive 5. Further, the main bodies of the coupling 12 and the connector 22 are also formed of an electrically insulating material. In this way, the handpiece 1 and the driving device 5 are electrically insulated from each other to constitute an insulating means for interrupting a high-frequency current from the electric scalpel means.

FIG. 2 shows a schematic configuration of a means for determining the type of the handpiece 1, and FIG. 2 shows a detailed configuration of the determination means. In FIG. 2, reference numerals 1a, 1b, and 1c denote examples of various handpieces 1, which respectively show a strong handpiece 1a, a small handpiece 1b, and a bent handpiece 1c. Each handpiece 1a, 1
b, 1c are connected to the connector receiver 2 of the drive device 5.
3 is connected.

The driving device 5 including the oscillating circuit 7 includes a determination unit 27. The discriminating means 27 includes the driving device 5
The type of the handpiece 1 connected to the connector receiver 23 is determined, and the driving power and the frequency suitable for the handpiece 1 are controlled to be supplied.

FIG. 3 shows details of the discrimination circuit portion. In the connector 22 of each handpiece 1, discriminating elements 30a, 30b,..., Which are identified for each handpiece 1, for example, resistors having different values are provided. Drive device 26
Is connected via a transformer 31 for insulation from the control circuit 6 to an element circuit 32 for detecting, for example, a resistance value as element detecting means. The result of the resistance detection circuit 32 is sent to the control circuit 6, and the output power and frequency of the oscillation circuit 7 are set to appropriate values.

Next, the operation of the surgical operation apparatus will be described. By the control circuit 6, the oscillation circuit 7, the water supply means 8, and the pinch valve 9 operate so that the handpiece 1 functions as an ultrasonic scalpel. In addition, handpiece 1
By operating the upper switch 20, it functions as an electric scalpel.

When the handpiece 1 is made to function as an electric scalpel, high-frequency current flows into the tissue from the tip of the ultrasonic probe 2 and returns to the return electrode plate 19. Is full of liquid and tends to flow out through the liquid in these tubes 3 and 4 to other parts.

However, since the portions to which these tubes 3 and 4 are attached are insulated from the driving device 5 via the above-described insulating member 25, the high-frequency current does not flow into the driving device 5. Further, since it is coupled to the oscillation circuit 7 by the insulating transformer 10, it does not flow from this portion. That is, the high-frequency current for hemostasis flows into all tissues.

As described above, even when the ultrasonic scalpel handpiece 1 functions as an electric scalpel, a reliable and safe hemostatic operation can be performed. In addition, malfunctions due to high-frequency current flowing into the control circuit 6 and the like can be prevented, which is safe. Also, in the unlikely event that the water supply tube 3 or the suction tube 4 is cracked at the portion of the pump 13 or the pinch valve 9 and the liquid leaks out, the pump 13 and the pinch valve 9 are insulated from other portions. Therefore, the high-frequency current does not flow out to other parts, and safety is maintained.

When a high-frequency current of an electric scalpel is to be placed on the handpiece 1, the signal is output from the insulating transformer 10 for output.
, But it is cut off by the transformer 10. Further, the signal tends to flow toward the element detection circuit 32 due to stray capacitance coupling generated between the signal line and the discrimination element 30 in the connector 22, but is also cut off by the transformer 31. Therefore, the high-frequency current is prevented from flowing toward the oscillation circuit 7 and the handpiece determining means.

As described above, the detection of the handpiece 1 is insulated and detected, so that a high-frequency current does not flow, hemostasis is reliably and safely performed, and malfunction due to noise in the determination operation is less likely to occur. .

The above-described means based on the insulation method can be applied not only to the determination of the handpiece 1 but also to the detection of the on / off state of the hand switch 20 provided on the handpiece 1. Further, the above determination can also be used to detect whether or not the handpiece 1 has been connected.
Further, in the embodiment, the discriminating elements 30a, 30b,... Are resistors, but may be other passive elements, for example, capacitors or coils, or active elements such as diodes.

The matching between the handpiece and the driving device is performed by the output transformer. However, there is a method in which the wiring in the connector differs depending on the handpiece so that the matching is performed by selecting the tap of the transformer.

[0032]

According to the above invention, since the high-frequency current of the electric scalpel flows only to the portion to be treated, it is possible to reliably perform treatment such as hemostasis and to ensure safety.

[Brief description of the drawings]

FIG. 1 is an explanatory diagram of a schematic configuration of a surgical operation apparatus according to an embodiment of the present invention.

FIG. 2 is an explanatory view of a schematic configuration of a handpiece determining means of the surgical operating apparatus according to the embodiment of the present invention.

FIG. 3 is an explanatory diagram of a detailed configuration of a handpiece determining unit of the surgical operating apparatus according to the embodiment of the present invention.

[Explanation of symbols]

DESCRIPTION OF SYMBOLS 1 ... Handpiece, 2 ... Ultrasonic probe, 3 ... Water supply tube, 4 ... Suction tube, 5 ... Drive device, 6 ... Control circuit, 7 ... Oscillation circuit, 8 ... Water supply means, 10 ... Insulation transformer, 25 ... Insulation member .

Claims (1)

(57) [Claims] Claims: 1. An ultrasonic vibrator for performing ultrasonic vibration,
A handpiece for treating a living body by ultrasonic vibration of the ultrasonic vibrator, a main body having an exterior housing ultrasonic driving means for supplying a drive signal to the ultrasonic vibrator, and connected to the handpiece; A conduit for perfusing a treatment fluid, a perfusion control means for controlling the fluid perfusing the conduit, an electric scalpel means connected to the handpiece and supplying a high-frequency current for treatment, An insulating member that electrically insulates and fixes the perfusion control means with respect to the main body and cuts off current from the conduit to the electric scalpel means. apparatus.