JP3402643B2 - Trocar - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION [0001] BACKGROUND OF THE INVENTION 1. Field of the Invention
Trocar used to remove the gall bladder
Related. [0002] 2. Description of the Related Art Generally, laparoscopic gall bladder removal surgery and the like are performed.
Trocars used for metal are stainless steel and other metal materials
And an outer tube provided outside the inner needle.
Of the inner needle protruding from the distal end of the mantle tube.
After piercing the abdominal wall of the patient, remove the inner needle from the mantle tube and use it.
I use it. [0003] The tip of such an inner needle of a trocar is
It is sharp and sharp, and its cross-section perpendicular to the axial direction is diamond-shaped.
It is formed into a shape or triangle, and the edge of the patient
The abdominal wall can be cut straight. Therefore,
If the inner needle of such a trocar is used repeatedly,
The edge part is worn and the sharpness is reduced.
There is a title. In order to solve such a problem,
In addition, an electrode is provided at the tip of the inner needle, and this electrode and the patient
High-frequency current between the mounted patient plate
Apply electricity and cut the patient's abdominal wall with Joule heat generated at the electrodes.
The trocar that was to be opened was actually opened 56-16600
No. 6 proposes this. [0005] SUMMARY OF THE INVENTION Such a trocar
Cuts the patient's body wall with Joule heat generated in the electrode section
As a result, a stable incision force can always be obtained
However, there was room for improvement as follows. That is,
The trocar has a distal end of the inner needle that penetrates the patient's body wall.
If contact with organs in the body cavity such as the liver or the wall of the body cavity is excessive
In such a case, Joule heat generated in the electrode part
There was concern that the cavity walls would be thermally damaged. [0006] The present invention has been made in view of such problems.
The purpose is to use the tip of an inner needle that has penetrated the patient's body wall.
Even if the end contacts the internal organs or the body cavity wall due to excessive force,
Heat damage to internal organs and body cavity walls
It is intended to provide a trocar without any. [0007] SUMMARY OF THE INVENTION A trocar of the present invention
Is an inner needle having a tip that can be inserted into the subject, and an inner needle
It has an insertion passage through which the needle can be inserted,
An outer tube capable of projecting the distal end of the inner needle from an end;
A first electrode provided at the tip of the needle, and a first electrode
A second electrode disposed on the hand side and provided on the inner needle;
The first electrode and the second electrode are independently processed.
Current supply means for supplying a current for placement;
The state of contact with the subject, the second electrode and the subject
Detection means for independently detecting the contact state with the body
When,By this detecting means, the first electrode or the
When it is detected that the second electrode and the subject are not in contact with each other
Is the first electrode or the first electrode
Control means for cutting off the respective currents supplied to the second electrode
Steps andIt has. [0008] According to the trocar of the present invention, the inner needle is removed from the outer tube.
When inserting the inner needle into the subject by projecting
The electrode contacts the subject, and then the second electrode contacts the subject.
A current for processing is flowing through each electrode.
The first electrode is in contact with the subject and the treatment by the first electrode is performed.
Then, the second electrode contacts the subject and is
Action is taken.During these procedures, each electrode and test
The state of contact with the body is detected. And the first electrode
When it is detected that the second electrode and the subject are not in contact with each other,
Each current supplied to the first electrode or the second electrode
Is disconnected. As a result, heat inside the body cavity and the body cavity wall
Damage is prevented. [0009] BRIEF DESCRIPTION OF THE DRAWINGS FIG. 1 is a block diagram showing a first to seventh embodiments of the present invention.
A description will be given with reference to FIGS. FIGS. 1 and 2 show a first embodiment of the present invention.
It is a figure, and 1 is a mantle tube in the figure. This mantle tube 1 is abdominal cavity
An insertion passage for inserting a medical instrument such as a mirror or forceps into a body cavity
The abdominal wall etc body wall(Subject)2 for forming
Made of a metal material such as stainless steel.
You. Reference numeral 3 denotes a freely insertable / removable inside the mantle tube 1.
The tip of the inner needle 3 has an abdominal wall or the like.
The needle-like portion 4 pierced into the body wall 2 protrudes from the distal end of the mantle tube 1.
It is provided out. The needle-like portion 4 has a cross section in the lateral direction.
It is formed in a rectangular shape such as a triangle, and each corner is
A strip-shaped electrode 5 is provided along the ridge line of the needle-shaped portion 4.
I have. The inner needle 3 is made of an insulating material except for the electrode 5.
I have. These electrodes 5 are connected to each other at the tip of the needle 4.
From the high frequency power supply 7 via the cable 6
The waves are energized. The high frequency power supply 7 has a patient's body.
The patient plate 9 installed on the wall 2 is a cable 8
Connected through. Further, the high frequency power supply 7
Measures the resistance between electrode 5 and patient plate 9
It has a resistance measurement circuit (not shown),
When the resistance between the shent plates 9 becomes infinite, the electrodes 5
The power supply to is stopped. And once
When the power stops, the power will not be supplied even if there is a resistance.
ing. The first embodiment of the present invention constructed as described above.
Then, the high frequency is passed through the electrode 5 provided at the corner of the needle-shaped portion 4.
When electricity is applied, the corners of the needles 4 generate heat due to high frequency.
Thus, the body wall 2 such as the abdominal wall is
Can be cut off. Therefore, in this embodiment, the needle-shaped portion
4 can prevent sharpness deterioration due to wear.
A stable cutting force can be obtained. Further, the present invention having the above-described structure
In one embodiment, the resistance between electrode 5 and patient plate 9 is
When the resistance becomes infinite, the power supply to the electrode 5 is stopped.
Even if the tip of the needle-shaped part 4 contacts an organ in the body cavity, the circumference of the organ is high.
The organ is exposed to high frequency without wave current
It doesn't hurt. In the first embodiment, the electrode 5 and the
Measuring the resistance between the shear plates 9 and energizing the electrodes 5
Was stopped, but as shown in FIG.
An electrode 10 is provided at the tip, and a resistance between the electrode 10 and the electrode 5 is provided.
May be measured. Next, a second embodiment of the present invention will be described with reference to FIGS.
This will be described with reference to FIG. In FIG. 4, 21 is an inner needle.
There is a triangular pyramid-shaped needle-like portion 22 at the tip of the inner needle 21.
Is provided. This needle-like portion 22 has a blunt portion 23 at the tip.
The electrodes 24 and 25 have an interval at the ridgeline.
And the inner needle 21 excluding the electrodes 24 and 25
Is an insulating material. These electrodes 24, 25
It is detected by the resistance measurement that it has reached the cavity, and the electrodes 24,
Stop energizing 25 and reset once energizing stops
Control unit 2 that controls so that it cannot be energized unless it is
6, the electrodes 24 and 25 are connected to the high-frequency power supply unit 27.
The high frequency power supply unit 27
Is applied. In the figure, reference numeral 28 denotes a mantle
Tube 29 is an airtight valve. The second embodiment of the present invention configured as described above
In the example, the electrodes 24 and 25 are spaced apart from each other on the ridge of the needle 22.
Since these electrodes 24 and 25 are
By energizing high frequency, the body wall 30 such as
The incision can be made by waves. Electrodes 24 and 25 are body
When the control unit 26 detects that it has reached the cavity,
The energization of the electrodes 24 and 25 stops. Therefore, acicular
Even if the corners of the part 22 are worn, the sharpness does not decrease.
And a stable sharpness can always be obtained. Also the needle
Since the distal end of the protruding portion 22 is the blunt portion 23, it comes into contact with organs in the body cavity
Touching will not harm internal organs. FIG. 7 shows a third embodiment of the present invention.
In the drawing, 31 is the inner needle of the trocar, and 32 is the tip of the inner needle 31.
It is a taper provided at the end. This taper 32 has a line
Electrodes 33 are provided along the ridgeline of the taper 32.
ing. This electrode 33 is provided at the base end of the inner needle 31.
It is electrically connected to the power cord mounting portion 34,
High-frequency current is supplied from the power cord attachment part 34
Swelling. The tip of the tapered portion 32 has an arc shape.
ing. The third embodiment of the present invention constructed as described above.
Then, the electrode 33 provided on the tapered portion 32 of the inner needle 31 has a high height.
By applying a high frequency current, body walls such as the abdominal wall
Can be dissected. Therefore, the inner needle 31
Regardless of the wear of the tip of the body, the body wall is always stable and sharp
Can be incised. In the third embodiment, the tip of the inner needle 31 is
An electrode 33 for high frequency was formed at the end portion.
As shown in FIG.
a and 34b may be provided. Also, as shown in FIG.
Is provided with a detection rod 35, and a switch 36 is
Is turned on and off to stop the power supply to the electrode 33.
May be. As another modified example, FIG.
Modifications as shown in FIG. Next, a fourth embodiment of the present invention will be described with reference to FIG.
This will be described with reference to FIG. 14 and 15
Reference numeral 51 denotes a trocar inner cylinder.
An electrode 53 connected to the oscillator power supply 52 is provided.
A spring 54 made of an insulating material is provided at a lower end of the electrode 53.
A switch member 55 is provided through the
At the lower end of the material 55, a knife 56 is provided. Soshi
The vibrators 57, 58 are provided on both sides of the switch member 55.
They are provided facing each other. A fourth embodiment of the present invention having the above-described structure.
Then, when the knife 56 is pressed against the body wall, the switch member
55 contacts the electrode 53 and the vibrators 57 and 58
The knife 56 vibrates in the direction of the arrow.
Can be. Therefore, the body wall is
The incision can be made by vibration. In the fourth embodiment, the knife 56 is
The body wall was cut by vibrating in the horizontal direction.
And the knife 56 is vibrated up and down as shown in FIG.
You may make it cut the body wall. Further, as shown in FIG.
You may make it cut a body wall using. Next, a sixth embodiment of the present invention will be described with reference to FIGS.
This will be described with reference to FIG. In FIG. 20, reference numeral 61 denotes a book
14 shows a trocar according to a sixth embodiment of the present invention,
As shown in FIG.
And an inner needle 63 removably inserted into the sleeve 62.
Have been. The mantle tube 62 extends through the body wall of the patient.
An insertion portion 64 to be inserted into a body cavity, and a base of the insertion portion 64
And a grip 65 provided at the end.
Is a transformer as an airtight valve to ensure airtightness in the body cavity.
A pet valve 66 is provided. On the other hand, the inner needle 63 is a rod-shaped inner needle
A wedge-shaped tip having a tip formed in an arc shape at the tip of the body 67
68, and a circular arc portion of the distal end portion 68
A plurality of electrodes 69 move back and forth in the radial direction of the tip arc
It is provided freely.These electrodes 69 are roughly classified
And the first electrode located on the distal end side and closer to the first electrode
And a second electrode located on the side.Note that the inner needle 63 is
It is formed of edge material. The electrodes 69 are shown in FIGS.
As shown, insulating springs 70 provided in the tip 68 are provided.
In the direction protruding radially from the tip of the inner needle 63
When pressed against the patient's body wall, the insulating spring 70
.. Retreats into the distal end portion 68 against the urging force of.
In contact with the current-carrying members 71.
Is supplied with electricity to the electrodes 69. this
Are connected via lead wires 72, respectively.
It is connected to a control unit 73 (see FIG. 20).
High from the power supply unit 74 connected to the control unit 73
Frequency current is supplied. In addition, the energizing part
The members 71 have a cylindrical shape with one end closed.
The insulating springs 70 are accommodated inside the cylindrical portion so as to be stretchable.
I have. The control unit 73 controls each of the electrodes 69.
The power supply is controlled by, for example,
Detects the value of the high-frequency current supplied to each electrode 69.
Then, each electrode 69 enters the abdominal cavity and biases the insulating spring 70.
The contact with the conducting member 71 is separated by the force and the high-frequency conduction stops.
It can be seen from the detection of the current that the power supply has stopped. And once each
When the power supply to the electrodes 69 is stopped, unless the electrodes are reset,
Each electrode 69 is controlled independently so as not to re-energize
It is configured as follows. In such a configuration, the tip of the mantle tube 62
Push the tip 68 of the inner needle 63 protruding from the end against the abdominal wall of the patient.
When hit, the electrode 6 provided at the tip 68 of the inner needle 63
9 ...SequentiallyInner needle 63 against the urging force of insulating springs 70.
Retreats into the tip 68 of theGoingThe tip 68 of the inner needle 63
Contact with the current-carrying members 71. And
When the poles 69 contact the energizing members 71, the power supply unit
74 via the control unit 73 and the conducting members 71.
Since a high-frequency current flows through the electrodes 69.
As described above, Joule heat generated in the electrodes 69.
The abdominal wall 75 can be incised. Also, as shown in FIG.
When the part 68 penetrates the abdominal wall 75 of the patient, the tip of the inner needle 63
Since the part 68 does not receive the resistance of the abdominal wall 75, the electrode 69
…ButSequentiallyThe tip of the inner needle 63 due to the urging force of the insulating spring 70.
Direction protruding from the end 68, that is,
Move in the directionGoing, The electrodes 69...
You. Then, the control unit 73 receives a signal from the power supply unit 74.
The current value of the high-frequency current supplied to the electrodes 69 is detected,
When it is found that the power supply to the electrodes 69 has stopped, the power supply
Do not re-energize sequentially from the stopped electrode 69
Perform control. Therefore, at this time, the patient
The distal end 68 of the inner needle 63 has excessive force as shown in FIG.
Control unit 73 even if it touches the organ 76 in the body cavity
Since the power supply to the electrodes 69 is stopped, the internal organs of the body cavity
76 is a thermal loss due to Joule heat generated in the electrodes 69.
You will not be hurt. In the sixth embodiment, the inner needle 63 is
A plurality of electrodes 69 provided on the tip 68 are insulated by an insulating spring.
70 project radially from the tip of the inner needle 63
26, but as shown in FIG.
A plurality of electrodes 69 provided on the insulated spring 70 are provided.
Urges to protrude axially from the tip of the inner needle 63
May be. According to such a configuration, the same as in the sixth embodiment is obtained.
In this way, it is possible to prevent thermal damage to the organ 76 in the body cavity
At the same time, the projection direction of the electrodes 69 is the insertion direction of the inner needle 63.
, The electrodes 69 are caught in the abdominal wall 75
Make sure the incision in the abdominal wall 75 is secure
be able to. Also, the insulating spring 70 is eliminated, and the electrode 69
To the tip 68 of the inner needle 63, and the control unit 73
The high-frequency power supply is detected when power supply to each electrode 69 is stopped.
Is performed when the value is lower than the set value.
Once stopped, the power is not re-energized unless reset.
May be implemented. Next, a seventh embodiment of the present invention will be described with reference to FIG.
Will be explained. 27, reference numeral 80 denotes a seventh embodiment of the present invention.
5 illustrates an inner needle of a trocar according to an example. This inner needle 80
Has a triangular cross-section at the tip of the rod-shaped inner needle body 81.
Or a diamond-shaped tapered portion 82 is provided.
, Each edge of the tapered portion 82 has a first electrode 83a.
Are provided along the ridgeline of the edge portion.
I have.The first electrodes 83a and the second electrodes 83b
The positional relationship is such that the tip side is the first electrode 83a.
83a are closer to the second electrodes 83b.
You.Note that the inner needle 81 is formed of an insulating material. The first electrode 83a... And the second electrode
83b are connected to the control unit 85 via the power cord 84.
Connected to the control unit 85.
High frequency current is supplied from the high frequency power supply 86
I have. The control unit 85 includes a high frequency power supply 86
From the first electrode 83a to the second electrode 83b.
.. And the second electrode 83a.
When no high-frequency current is flowing through the electrodes 83b, the inner needle
The tip (taper 82) of 81 has penetrated the patient's body wall
To the first electrode 83a and the second electrode 83b.
So that the power supply to each electrode is stopped independently and the power supply to the electrodes
Stop the power once and do not turn on the power again unless reset.
It is configured to perform such control. According to such a configuration, the tip of the inner needle 81
While the tapered portion 82 is penetrating the body wall of the patient,
Plate attached to the body surface of the person
) And the first electrodes 83a are infinite.
High-frequency power supply 86
Control the high-frequency current flowing through the first electrodes 83a.
The tip of the inner needle 81 is affected by the
It is possible to detect that the person has penetrated the body wall. Soshi
To detect that the tip of the inner needle 81 has penetrated the body wall of the patient.
If known, the control unit 85 controls the high frequency power supply 86
To cut off the power supply line between
.. Are turned off. this
When the second electrodes 83b are in contact with the body wall,
It is energized. Further penetration into the body wall,
The poles 83b are in the same state as the first electrodes 83a, and are in a state of stopping electricity supply.
The distal end of the inner needle 81 penetrating the patient's body wall
Even if the body contacts the organs in the body cavity too much due to Joule heat
Thermal damage to organs in the body cavity can be prevented. In the seventh embodiment, the inner needle 81 is
A first electrode 83a and a second electrode 83b are provided on the tapered portion 82.
Although provided along the ridgeline of the edge portion, as shown in FIG.
Only the second electrodes 83b are provided on the tapered portion 82 of the inner needle 81.
May be. According to such a configuration, the tip of the tapered portion 82
Since there is no electrode on the end side, the inner needle 8 penetrating the body wall of the patient
Even if the tip of 1 is too vibrant and contacts internal organs of the body cavity,
No thermal damage occurs. An eighth embodiment of the present invention will be described with reference to FIG.
I will tell. In the drawings, the same parts as in the first embodiment
The same reference numerals are given and the detailed description is omitted. Reference numeral 90 denotes a high-frequency generation circuit for generating a high-frequency voltage.
The output of the high frequency generation circuit 90 is
Is supplied to the primary winding of the transformer 92 via the. Electricity system
The control unit 91 sends a signal from the high-frequency generation circuit 90 to the transformer 92.
This is for controlling energization, and is used to control a shutoff circuit 97 described later.
Respond to commands. At one end of the secondary winding of the transformer 92, the inner needle 3
Each electrode 5 at the tip of is electrically connected via cable 93
Is done. The other end of the secondary winding of the transformer 92 is connected to the patient's body wall.
2 is connected to the cable 94
Are electrically connected via That is, the transformer 92
The high frequency voltage generated in the secondary winding is applied to each electrode 5 and the patient.
The voltage is applied to between the plate 9. A cable is connected from one end of the secondary winding of the transformer 92.
Current detector 95 in the current path to the sensor 93 (and the electrode 5).
Is provided. This current detector 95 is
The current flowing to the secondary side is detected. This detection result is
96. The CPU 96 detects the detection result of the current detector 95.
Is compared with a predetermined set value.
When the result becomes lower than the set value, a power supply stop command is issued. This
Is supplied to the shut-off circuit 97 and the alarm circuit 98.
Sent. The cutoff circuit 97 stops power supply from the CPU 96.
In response to the command, the action of shutting off the power supply to the power control unit 91
To The alarm circuit 98 is operated by the CPU
A visual or audible warning by light or sound in response to
Emit. The operation will be described. When the high frequency generation circuit 90 operates, each electrode
High frequency voltage is applied between 5 and patient plate 9
Is done. The needle portion 4 of the inner needle 3 is connected to the patient's body wall (for example,
When the abdominal wall 2 is touched, the transformer 92 2
A closed circuit is formed on the next side, and a high density
High frequency current flows. As a result, the puncture point is burned out
It is. Therefore, even if the needle portion 4 is worn out,
In addition, sufficient sharpness is ensured and always stable incision force
Obtainable. When the needle portion 4 of the inner needle 3 penetrates the body wall 2, each
The resistance between the pole 5 and the patient plate 9 increases.
As a result, the secondary current of the transformer 92 decreases. This secondary side
The current decrease is detected by the current detector 95 and the CPU 96.
The interruption circuit 97 and the alarm circuit 98 respond to the detection.
I do. That is, while the high-frequency current is cut off,
Is issued. Therefore, the tip of the needle-like portion 4 is located inside the body cavity.
Even if it touches a container, high-frequency current will not flow through that container.
Therefore, it is possible to avoid damage to the storage. Moreover, an alarm is issued
The surgeon can quickly confirm that the body wall 2 has been pierced.
It can detect and improve safety. In addition, re-insertion
Can be performed by the operator's manual reset operation.
You. In the eighth embodiment, the power control unit 9
1 only turned on or off the current, but the body wall 2
The remaining insertion thickness in the current detector 95 as the detected current value
Based on the detected thickness.
Even if a configuration for adjusting the amount of power supplied to the power control unit 91 is added
Good. In this case, as the thickness of the remaining insertion decreases,
Wave currents decrease, minimizing the effect on living organisms
be able to. The ninth embodiment of the present invention will be described with reference to FIG.
I will tell. Here, instead of the inner needle 3 in the eighth embodiment,
The inner needle 100 is used. Eighth implementation for other configurations
Same as the example. The inner needle 100 is located at the tip of a rod-shaped inner needle body 101.
At the end, a tapered section with a triangular cross section (corresponding to needle 4) 10
With 2. Each edge of the tapered portion 102 has a ridge
An electrode 103 is provided along each line. The inner needle body 101 is made of a metal material such as stainless steel.
And the inside of each electrode 103 is masked.
Fluorine resin insulation coating 104 on the entire surface of needle 101
Has been given. This insulating coating 104 allows the inner needle
Insulate the surface of 101 except for each electrode 103
I have. Change the state of the insulating coating 104 along the line BB
FIG. 31 shows a cross section and FIG. 31 shows a cross section taken along line CC.
32. For the material of the insulating coating 104,
Materials that can be insulated, such as ceramics and silicon resin
Anything is fine. The operation and effects are the same as in the eighth embodiment.
The same. In the ninth embodiment, the inner needle body
The insertion part 101a of 101 is not necessarily
For example, a structure covered with an insulating tube may be used.
It is good also as a result. As shown in FIG. 33, the tapered portion 102
A concave portion 101b is formed on the surface of the
And apply an insulating coating 104 on it in a buried state.
It is good also as a result. In this case, the insulating coating 104
Since each electrode 103 does not protrude from the electrode 103,
Can be reliably contacted. Further, at the tip of the inner needle body 101,
The streamlined curved surface portion 105 shown in FIG.
Formed, and two metal wires (wires) 106
And replace the metal wire 106 with the electrode 103
It is good also as a structure used. Curved surface 105 viewed from below
FIG. 35 shows this. The curved surface portion 105 has a metal wire 106
The insulating coating 104 is applied to the parts except for. Referring to FIG. 36, a tenth embodiment of the present invention will be described.
explain. Here, instead of the inner needle 3 in the eighth embodiment,
The inner needle 110 is used. For other configurations, refer to
It is the same as the embodiment. 36 shows the upper side of the inner needle 110.
The part is partially cut away. The inner needle 110 is made of a ceramic or a plus tip.
At the tip of the rod-shaped inner needle body 111 made of insulating material such as
The surface has a triangular taper (corresponding to the needle 4) 112
You. Along each edge of the tapered portion 112, along the ridgeline
Each of the electrodes 113 is provided in a buried state. Each electrode 113 has an inner needle as shown in FIG.
The tip of the conductive rod 114, which is approximately the same length as the main body 111 and is conductive
An end is integrally formed in an anchor shape. Meanwhile, the inner needle body
An insertion passage 115 is formed in the axis of 111, and the insertion passage
The shaft 114 is inserted into the passage 115 from the tip side.
Thus, each electrode 113 is attached. The base of the inner needle body 111 has a cable 93
A connection recess 116 is formed, and the bottom of the connection recess 116 is formed.
The insertion passage 117 is formed perpendicular to the insertion passage 115 from the surface.
It is. The connection recess 116 and the insertion passage 115 are
The plug 118 is inserted. This pin plug 118
As shown in Fig. 38, a slot notched along the axial direction
Along with the tip 118a at the tip,
It has a slit 118b at the base end that is notched
So that the slit 118a reaches the insertion passage 115
It has become. A cable is inserted into the slit 118b of the pin plug 118.
Bull 93 is connected. The shaft rod 114 is narrow at a position corresponding to the insertion passage 117.
It has a diameter portion 114a, and the pin plug 118 fits into the insertion hole 117.
When it is inserted, the slit 118a of the pin plug 118
4 to hold the small diameter portion 114a. This pinch
As a result, the pin plug 118 and the shaft 114 are
The cable 93 and each electrode 113 are brought into conduction. The operation and effect are the same as those of the eighth embodiment.
You. In the tenth embodiment, the shafts 114 and 114 are used.
And the pin plug 118 were inserted through the inner needle body 111,
When the main body 111 is formed of resin, each electrode 113, shaft
Insert the rod 114 and pin plug 118 into the mold for the inner needle body.
The so-called inserter where the resin is poured after the initial setting
The molding may be adopted. An eleventh embodiment of the present invention will be described with reference to FIG.
explain. Here, instead of the inner needle 3 in the eighth embodiment,
The inner needle 120 is used. For other configurations, refer to
It is the same as the embodiment. FIG. 39 shows the upper side of the inner needle 110.
The part is partially cut away. The inner needle 120 is made of a ceramic or a plus tip.
The tip of the rod-shaped inner needle body 121 made of an insulating material such as
It has a linear curved portion 122. Two pieces of gold
Attachment wire (wire) 123 is attached to the cross by brazing
The metal wire 123 is used as an electrode. At the intersection of each metal wire 123, the tip of the shaft 124 is
Connected. The shaft 124 is made of a metal material such as stainless steel.
And is insert molded into the shaft core of the inner needle body 121.
You. At the base end of the inner needle body 111, a connection recess for the cable 93 is provided.
A portion 126 is formed, and the pin plug 12
5 is provided. This pin plug 125 is made of stainless steel
Metal material that is connected to the shaft 124
Insert molding is performed on the inner needle main body 121 together with 124. Pi
The plug 125 has a notched slot along the axial direction.
A slot 125a is formed, and a cable is inserted into the slit 125b.
Is connected. That is, the cable 93 and the electrode
Each metal wire 123 with the pin plug 125 and shaft
The conductive state is established via the rod 124. The operation and effect are the same as those of the eighth embodiment.
You. Next, as a twelfth embodiment of the present invention, a supersonic
Wave type trocar, so-called ultrasonic inner needle
The arrangement will be described with reference to FIGS. 40 and 41. The ultrasonic inner needle device is an ultrasonic aspirator.
The roller suction probe 131 and an ultrasonic vibrator
Drive, which is a drive means for controlling movement and drive stop
Device 132, suction bin, suction pump, water tank, and
Suction and water supply device with a pump for water supply and water supply (not shown)
And The suction probe 131 is an ultrasonic vibrator (not shown).
Probe body 133 with a built-in
The ultrasonic suction tube 134 protruding from the
Have. The ultrasonic suction tube 134 is connected to a body cavity (eg, abdomen).
It has an elongated shape that can be inserted into the
Highly efficient metal
The probe is inserted and guided to the rear end side of the probe body 133. Step
A flexible suction line 135 is connected to the rear end of the lobe body 133.
The ultrasonic suction tube 13 is connected to the suction line 135.
4 is connected and communicated. At the tip of the ultrasonic suction tube 134, a blunt conical portion 13
4a is formed, and an opening 134b is formed in the conical portion 134a.
Is done. That is, the opening 134b is in communication with the suction line 135.
Through the suction line 135 and through the suction water supply
Via the suction bin of the device (not shown)
Connected to the The ultrasonic wave is emitted from the ultrasonic transducer in the probe body 133.
The ultrasonic vibration is transmitted to the ultrasonic suction tube 134.
You. The conical portion 134a of the ultrasonic suction tube 134 is brought into contact with the body wall.
Thus, the ultrasonic vibration is transmitted to the body wall. An ultrasonic suction tube is provided at the front end of the probe body 133.
A sheath 136 having a diameter larger than the diameter of 134 is connected. this
The sheath 136 can be inserted through the trocar mantle tube 140 described later.
With an external diameter and accommodates an ultrasonic suction tube 134 inside
By doing so, the water supply pipe can be
A path 136a is formed. The tip of the sheath 136 absorbs ultrasonic waves.
It has a tapered shape with the conical portion 134a of the drawing tube 134,
The water outlet 136b is secured. This water outlet 136b is
Connected to a water supply base 137 connected to the side of the
It is. The water supply nozzle 137 is connected to the suction water supply device (shown in FIG.
No water supply port of the suction water supply device through the water supply tank
Connected to the amplifier. In other words, the water pump operates.
Then, water comes out from the distal end of the sheath 136. A pressure sensor is provided on the outer peripheral surface of the distal end of the sheath 136.
138 are mounted. This pressure sensor 138 is connected to the sheath 13
6 When the body touches the wall,
Know. The driving device 132 generates a high-frequency current.
To excite the ultrasonic transducer of the suction probe 131
Drive circuit for generating ultrasonic waves from the ultrasonic vibrator
132a and the drive circuit 132a according to the output of the pressure sensor 138.
A drive control circuit 132b for controlling driving. Drive control
Circuit 132b is a circuit in which pressure sensor 138 senses pressure from the body wall.
When it runs out, the operation of the drive circuit 132a is stopped and suction
The excitation of the ultrasonic transducer of the probe 131 is stopped. The operation will be described. The operator operates the suction probe of the ultrasonic inner needle device.
The insufficiency was caused by attaching the valve 131 to the trocar mantle tube 140.
Puncture body wall 141 of the patient. Pressure sensor at the end of sheath 136
When the body wall 141 is pressed against the
The drive control circuit 132b responds to the pressure detection signal of
132a works. As a result, the supersonic
The wave oscillator is excited. Ultrasonic vibration generated from ultrasonic transducer
Is transmitted to the body wall 141 by the ultrasonic suction tube 134, and the body wall 1
41 gradually emulsifies. The emulsified tissue is placed in an ultrasonic suction tube 1
34 to the suction bottle of the suction water supply device (not shown)
It is sucked. At this time, it passes through the water supply conduit 136a of the sheath 136.
Then, water is supplied to the emulsifying tissue. This water supply
Promotes the suction of emulsified tissue and
The tubing 134 is cooled. The insertion of the trocar mantle tube 140 continues, and the pressure
When the mounting position of the sensor 138 passes through the body wall 141, the pressure
The sensor 138 no longer detects pressure, and the drive control circuit
The operation of the drive circuit 132a stops in response to 132b. The result
As a result, before the trocar mantle tube 140 reaches the
The excitation of the wave oscillator stops, and the ultrasonic
Transmission of ultrasonic vibration to 1 stops. Thus, the trocar mantle tube 14 is placed in the abdominal cavity.
When 0 is inserted, the ultrasonic suction operation automatically stops.
Therefore, the internal organ 142 is damaged at the tip of the trocar mantle tube 140.
It's safe without being kicked. [0085] As described above, the present invention,Patient's body
The tip of the inner needle that has penetrated the wall
Even if it touches the cavity wall,Joule fever on internal organs and cavity walls
Can provide a trocar without thermal damage
You.

BRIEF DESCRIPTION OF THE DRAWINGS FIG. 1 is a view showing an inner needle of a trocar according to a first embodiment of the present invention. FIG. 2 is a schematic configuration diagram of a trocar according to the first embodiment of the present invention. FIG. 3 is a view showing a modified example of the trocar according to the first embodiment of the present invention. FIG. 4 is a schematic configuration diagram of a trocar according to a second embodiment of the present invention. FIG. 5 is a perspective view showing a distal end portion of an inner needle of a trocar according to a second embodiment of the present invention. FIG. 6 is a diagram illustrating the operation of a trocar according to a second embodiment of the present invention. FIG. 7 is a view showing an inner needle of a trocar according to a third embodiment of the present invention. FIG. 8 is an explanatory diagram of an operation of a trocar according to a third embodiment of the present invention. FIG. 9 is a view showing a modified example of the trocar according to the third embodiment of the present invention. FIG. 10 is a view showing a modified example of the trocar according to the third embodiment of the present invention. FIG. 11 is a view showing a modified example of the trocar according to the third embodiment of the present invention. FIG. 12 is a view showing a modified example of the trocar according to the third embodiment of the present invention. FIG. 13 is a view showing a modified example of the trocar according to the third embodiment of the present invention. FIG. 14 is an external view of a trocar according to a fourth embodiment of the present invention. FIG. 15 is a view showing the internal structure of a trocar according to a fourth embodiment of the present invention. FIG. 16 is a view showing the tip of a trocar according to a fourth embodiment of the present invention. FIG. 17 is a view showing a modified example of the trocar according to the fourth embodiment of the present invention. FIG. 18 is a view showing a modified example of the trocar according to the fourth embodiment of the present invention. FIG. 19 is a schematic configuration diagram of a trocar according to a fifth embodiment of the present invention. FIG. 20 is a schematic configuration diagram of a trocar according to a sixth embodiment of the present invention. FIG. 21 is a sectional view showing the internal structure of the distal end of the inner needle shown in FIG. 20; FIG. 22 is a sectional view taken along the line AA of FIG. 21; FIG. 23 is an explanatory view of the operation of the trocar shown in FIG. 20; FIG. 24 is an explanatory diagram of the operation of the trocar shown in FIG. 20; FIG. 25 is a diagram illustrating the operation of the trocar shown in FIG. 20; FIG. 26 is a sectional view showing a modification of FIG. 21; FIG. 27 is a view showing an inner needle of a trocar according to a seventh embodiment of the present invention. FIG. 28 is a diagram showing a modification of FIG. 27; FIG. 29 is an overall configuration diagram of an eighth embodiment of the present invention. FIG. 30 is a configuration diagram of an inner needle according to a ninth embodiment of the present invention. FIG. 31 is a sectional view taken along the line BB of FIG. 30; FIG. 32 is a sectional view taken along the line CC of FIG. 30; FIG. 33 is a view showing a modification of the insulating coating in FIG. 30; FIG. 34 is a view showing a modification of the inner needle shape of FIG. 30; FIG. 35 is a view of the configuration in FIG. 34 viewed from below. FIG. 36 is a configuration diagram of an inner needle according to a tenth embodiment of the present invention. FIG. 37 is a configuration diagram of an electrode and a shaft in FIG. 36; FIG. 38 is a configuration diagram of a pin plug in FIG. 36. FIG. 39 is a configuration diagram of an inner needle according to an eleventh embodiment of the present invention. FIG. 40 is a configuration diagram of a twelfth embodiment of the present invention. FIG. 41 is a diagram illustrating the operation of the twelfth embodiment. [Description of References] 1,28 ... Mantle, 3, 21, 31 ... Inner needle, 4, 22 ...
Needle-shaped part, 5, 24, 25, 33 ... electrode, 7, 27 ... high frequency power supply, 9 ... patient plate, 62 ... mantle tube, 63 ... inner needle, 69 ... electrode, 70 ... insulating spring, 71 ...
Energizing member, 73: control unit, 74: power supply unit,
80 ... inner needle, 83a, 83b ... electrode, 85 ... control unit, 86 ... high frequency power supply.

──────────────────────────────────────────────────続 き Continuing on the front page (72) Inventor Minoru Tsuruta 2-43-2 Hatagaya, Shibuya-ku, Tokyo Inside Olympus Optical Co., Ltd. (72) Inventor Shiro Bito 2-43-2 Hatagaya, Shibuya-ku, Tokyo No. O-Limpus Optical Co., Ltd. (72) Inventor Akio Nakata 2-43-2 Hatagaya, Shibuya-ku, Tokyo In-line Olympus Optical Co., Ltd. (72) Inventor Tsuruo Hatori 2-43-2, Hatagaya, Shibuya-ku, Tokyo No. O-Limpus Optical Co., Ltd. (72) Inventor Nobuhiko Washizuka 2-43-2 Hatagaya, Shibuya-ku, Tokyo O-limpus Optical Co., Ltd. (72) Inventor Yasuhiko Omagari 2-43-2, Hatagaya, Shibuya-ku, Tokyo No. 72 Olympus Optical Co., Ltd. Inventor Shinichi Nishigaki 2-43-2 Hatagaya, Shibuya-ku, Tokyo Within the Industrial Co., Ltd. (72) Inventor Kenji Yoshino 2-43-2 Hatagaya, Shibuya-ku, Tokyo O-limpus Optical Industrial Co., Ltd. (72) Inventor Keisuke Saito 2-43-2 Hatagaya, Shibuya-ku, Tokyo O-Limpus Optics (72) Inventor Yasuo Goto 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optical Co., Ltd. (56) References JP-A-4-44739 (JP, A) JP-A-6-42 7367 (JP, A) Japanese Utility Model Showa 56-166006 (JP, U) Table 6-511175 (JP, A) Table 8-508176 (JP, A) (58) Fields surveyed (Int. Cl. ⁷ , DB name) A61B 17/00 A61B 18/00

Claims (1)

(57) Claims 1. An inner needle having a distal end portion that can be inserted into a subject, an insertion passage through which the inner needle can be inserted, and the inside of the inner passage from the distal end of the insertion passage. An outer tube capable of protruding the distal end of the needle, a first electrode provided at the distal end of the inner needle, a second electrode provided at the inner needle disposed closer to the hand than the first electrode, Current supply means for independently supplying a treatment current to each of the first electrode and the second electrode; a contact state between the first electrode and the subject;
Detecting means for independently detecting the contact state between the electrode and the subject, and the first electrode or the second
If it is detected that the electrode and the subject are not in contact,
The first electrode or the second electrode from the current supply means.
Control means for cutting off each current supplied to the poles .