JP3523800B2 - Air supply device - Google Patents

Description

Description: BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a gas supply device for puncturing a living body and injecting gas into the living body and a gas supply source. The present invention relates to an air supply device for adjusting the flow rate while reducing the pressure of a gas from a source and sending the gas to the gas injection device. 2. Description of the Related Art In recent years, so-called laparoscopic surgery, in which a treatment is performed while observing a treatment tool and a treatment site with an endoscope without opening the abdomen in order to reduce invasion to the patient, is called a laparoscopic surgery. Many surgeries have been performed. [0003] This operation is performed by puncturing a patient's abdomen with a trocar for guiding an observation endoscope into the abdominal cavity and a trocar for guiding a treatment tool to a treatment site. At this time, gas such as carbon dioxide is injected into the abdominal cavity by an air supply device in order to secure an observation field of view of the endoscope and a treatment space in the abdominal cavity. [0004] As an insufflation device for injecting gas into the abdominal cavity, various devices have been conventionally proposed. In this type of insufflation apparatus, it is extremely important to accurately measure the flow rate of gas sent into the abdominal cavity and control the flow rate to an appropriate flow rate. For example, in an air supply device disclosed in German Patent DE 3611018, a flow meter, a pressure gauge, and a pressure reducer are connected to one gas conduit, and gas is supplied through a gas conduit through a gas injection device such as an insufflation needle. To supply it to the body. In addition, an electropneumatic proportional valve is used as the pressure reducer to accurately measure the abdominal cavity pressure and control the flow rate. The electro-pneumatic proportional valve is configured so that the pressure is electrically adjusted by changing the force of a pressure reducing spring acting on the pressure control thin film by an electromagnet formed of a magnet coil and a magnetic needle. [0005] The above German patent DE3
In the air supply device disclosed in Japanese Patent No. 6111018, the output (pressure) of the electropneumatic proportional valve is adjusted to a set value of the abdominal cavity pressure to perform the air supply. When the flow rate value exceeds the threshold value, it is determined that there is a difference between the abdominal cavity pressure and the set pressure, and the output pressure of the electropneumatic proportional valve is adjusted to a value of 50 mmHg, and air is supplied. However, in such a control mode,
Regardless of the type of gas injecting device used, such as insufflation needles, the output pressure of the electropneumatic proportional valve is always adjusted to 50 mmHg and air is supplied, so when using a gas injecting device with a large resistance There is a difference in flow rate between the case of using a gas injection device having a small resistance. Therefore, when the surgeon uses a gas injection device with a large resistance assuming a flow rate obtained when using a gas injection device with a small resistance, the gas is controlled to be flown at a flow rate smaller than the flow rate originally desired to be controlled. Will be. For this reason, the recovery time of the abdominal cavity pressure takes a longer time than intended by the operator due to a leak or the like, and the operation field cannot be secured, which may hinder the operation. The present invention has been made in view of the above circumstances, and an object of the present invention is to quickly set the pressure in a living body cavity to a desired pressure in consideration of the characteristics of pressure and flow rate with respect to the human body. An object of the present invention is to provide a highly reliable air supply device. According to the present invention, there is provided a gas injection device for puncturing a living body and injecting gas into the living body, and a gas supply source. An air supply device for adjusting the flow rate while reducing the pressure to supply the gas to the gas injection device, wherein an air supply line for supplying gas from the gas supply source to the gas injection device; Setting means for setting a set value of an air supply flow rate and a pressure in a living body cavity flowing through a passage; and a control signal, through which the pressure of a gas flowing through the air supply passage is reduced to a predetermined pressure while passing through the air supply passage. Pressure adjusting means for adjusting the flow rate of the flowing gas, flow rate measuring means for measuring the flow rate of the gas flowing through the air supply pipe downstream of the pressure adjusting means, and pressure measuring means for measuring the pressure in the body cavity The above The measurement of the air supply flow rate flowing through the airway and the measurement of the pressure in the living body cavity are alternately performed at fixed time intervals, and the integration of the air supply flow rate is performed. Control means for interrupting the air supply supplied through the air supply line when it is determined that the value is equal to a value determined in relation thereto, and performing the pressure measurement in the living body cavity. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS An air supply device according to an embodiment of the present invention will be described with reference to FIGS. FIG. 1 schematically shows the entire configuration of an insufflation device 1 as an air supply device according to the present embodiment. This insufflation device 1
Has an apparatus main body 2. Gas supply cap 3
And an air supply base 4. A gas cylinder 6 serving as a gas supply source is connected to a gas supply base 3 through a pipe hose 5.
Is connected. Further, a connection device (gas injection device) 8 such as a trocar or an insufflation needle is connected to the air supply base 4 via an air supply tube 7. As a connecting device 8 for injecting gas, for example, as shown in FIG.
a, a trocar 8b having an inner diameter of 5 mm, an insufflation needle 8c, and the like. These connecting devices 8 can be inserted into the abdominal wall of a patient and can perform a treatment for injecting gas supplied from the pneumoperitoneum apparatus 1 through the air supply tube 7 into the abdominal cavity. Here, each of the trocars 8a and 8b is selected and connected to a suction tube 22 which leads to an external gas suction source described later. The gas supply base 3 is provided in the apparatus main body 2.
An air supply line 9 for performing air supply from the air supply base 4 side is provided. A gas supply pressure sensor (meter) 11, a primary pressure reducer 12, an electropneumatic proportional valve 13 as a secondary pressure reducer, and a flow rate The measuring unit 14 is connected. The gas supply pressure sensor 11 measures the pressure of the gas (gas) supplied from the gas cylinder 6, thereby measuring the remaining amount of gas that can be supplied and allowing the operator to recognize it. The measurement range of the gas supply pressure sensor 11 is, for example, 0 to 100 kgf / cm2. The primary pressure reducer 12 reduces the pressure of the gas supplied from the gas cylinder 6 in two stages. As a specific example, the first stage decompression mechanism is 10k
gf / cm2, and 4 kgf
/ Cm2. The opening of the electropneumatic proportional valve 13 is adjusted by a control signal from the control unit 15 (by applying a control voltage). In step 12, the pressure of the gas reduced to 4 kgf / cm2 is reduced to the range of 0 to 100 mmHg, and the gas supply flow rate is adjusted to the range of 0 to 50 L / min. In the air supply line 9, the electropneumatic proportional valve 13
A first valve 16, which is controlled to be opened and closed by the control unit 15, is provided between the flow rate measurement unit 14 and a second valve, which is also controlled to be opened and closed by the control unit 15, downstream of the flow measurement unit 14. A valve 17 is provided. The air supply line 9 between the first valve 16 and the second valve 17
Are provided with a first pressure sensor 18a and a second pressure sensor 18b having a measurement range of 0 to 10 mmHg. The valves 16 and 17 are electrically connected to a control unit 15, and their opening and closing operations are controlled by the control unit 15. Further, the gas supply pressure sensor 11, the electropneumatic proportional valve 13, the flow rate measurement unit 14, and the two pressure sensors 18a, 18b are also electrically connected to the control unit 15. Further, the insufflation device 1 is provided with a suction means which is connected to an external gas suction source and suctions gas in the body cavity. That is, the pinch valve 21 is provided, and the pinch valve 21 is electrically connected to the control unit 15. Then, an operation means for activating or stopping the operation of sucking the gas in the body cavity by the pinch valve 21 is configured. The operating portion 21a of the pinch valve 21 is provided so as to protrude outside from the front outer surface of the apparatus main body 2. The operating portion 21a sandwiches a middle portion of the suction tube 22. The tip of the suction tube 22 is the trocar 8
a, and the proximal end of the suction tube 22 is connected to a suction pump 23 installed outside the apparatus main body 2 as an external gas suction source. The external gas suction source is a suction pump 2
Instead of 3, it may be used by connecting to a wall suction facility of a hospital (not shown). An input switch connector 25 is provided on the outer side surface of the device main body 2 of the insufflation device 1. To this connector 25, a foot switch 26 installed outside the apparatus main body 2 is connected. Further, an operation section 27 is provided on a front panel of the apparatus main body 2 of the insufflation apparatus 1. The operation unit 27 is electrically connected to the control unit 15 and includes various input switches and a display unit. The operation unit 27 is provided with a display unit for displaying the air supply flow rate, the abdominal cavity pressure of the patient, and the like. FIG. 2 shows the set flow rate (Q) and the electropneumatic proportional valve 1
3 is a diagram showing a correlation with an output pressure (V) of FIG. In FIG. 2, a line indicated by a symbol A has an inner diameter of 1 where the pipeline resistance is small.
When a 2 mm trocar 8a is connected to the air supply tube 7 and air is supplied, the Q-V of the correlation between the output pressure of the electropneumatic proportional valve 13 and the flow rate that can be actually supplied is shown.
Line. In the insufflation device 1 of the present embodiment, the data of the QV line shown in FIG. 2 is stored in the storage section in advance, and the control section 15 is inputted from the operation section 27 based on the data. Electro-pneumatic proportional valve 1 at the start of air supply according to flow rate set value
Set the output pressure of 3. Next, the operation of the insufflation device 1 having the above configuration will be described. First, a predetermined connection device, for example, an insufflation needle 8c is connected to the air supply tube 7, and the insufflation needle 8c is punctured into the abdominal wall. Then, various input switches provided on the operation unit 27 are operated to set a set pressure (abdominal pressure set value) in the abdominal cavity of the patient and a set flow rate (flow set value) of the gas to be supplied. A start button (not shown) is operated. Thus, the open / close state of each of the valves 16 and 17 is controlled by the control unit 15, and the flow rate of the gas supplied from the gas cylinder 6 is controlled through the air supply line 9. Gas is injected into the abdominal cavity through the air supply tube 7. The control of the flow rate of the gas supplied through the gas supply line 9 is repeated, for example, between a state in which the gas flows through the gas supply line 9 and a state in which the gas flow through the gas supply line 9 is cut off. . More specifically, the control unit 15 detects the actual pressure in the abdominal cavity by the pressure sensors 18a and 18b, and sets the preset pressure in the abdominal cavity of the patient by the operation unit 27 and the actual pressure in the abdominal cavity. Is constantly monitored, and when the difference between the intraperitoneal set pressure and the actual intraperitoneal pressure is large, a control voltage corresponding to the flow rate set value is applied to the electropneumatic proportional valve 13, and the electropneumatic proportional valve Adjust the flow rate of the gas flowing through 13. Hereinafter, the air supply control method will be described with reference to FIG. FIG. 3 is a timing chart of the abdominal cavity pressure and the output pressure of the electropneumatic proportional valve. As shown in FIG. 3A, when control is started at time t0, the output pressure of the electropneumatic proportional valve 13 is set to 100 mmHg because the difference between the set pressure and the intraperitoneal pressure is large. As the insufflation pressure increases and approaches the set pressure, the output pressure of the electropneumatic proportional valve 13 gradually decreases. The output pressure of these electropneumatic proportional valves 13 is determined by the difference between the set pressure and the intraperitoneal pressure, which is determined based on the straight line A in FIG. For example, as shown in FIG. 4, when the difference between the set pressure and the intraperitoneal pressure is 2 mmHg, the output pressure of the electropneumatic proportional valve 13 is set to 20 mmHg. Further, as shown in FIG. 3B, the air supply time T1 is a fixed time, for example, 2 seconds, and air is supplied during that time. As shown in FIG. 3 (c), the abdominal cavity pressure is usually measured at a time avoiding the air supply time T1. FIG. 5 shows the characteristics of general human body air supply and pressure rise. For example, the pressure in the abdominal cavity is 14 mmHg
In order to raise the gas, it is necessary to supply one liter of gas. The pressure and air supply coefficient according to this characteristic are stored in the control device 15 in advance. By setting the pressure, the control device 15 calculates the amount of air required for a general human body according to the coefficient. At the air supply started at time t0, the instantaneous air supply flow rate is measured, and the control unit 15 integrates the air supply flow rate. During air supply, the integrated value of the air supply flow rate is always compared with the required air supply amount calculated, and when the integrated flow reaches the air supply amount calculated, the air supply time is in the middle of the air supply time T1. However, the insufflation is interrupted and the intraperitoneal pressure is measured. Thus, the problem that the pressure cannot be measured during a fixed air supply can be solved, and the pressure overshoot can be prevented. Note that the present invention is not limited to the above-described embodiment, and various modifications can be made without departing from the scope of the present invention. As described above, according to the present invention, the air supply flow rate is integrated, and when it is determined that the integrated result is equal to a value determined in proportion to the target body cavity pressure, the air supply is performed. Since the Qi is interrupted and the measurement of the pressure in the living body cavity is performed, an appropriate insufflation can be performed reliably and promptly.

BRIEF DESCRIPTION OF THE DRAWINGS FIG. 1 is an explanatory view schematically showing an insufflation device according to a first embodiment. FIG. 2 is a diagram showing a correlation between a set flow rate (Q) and an output pressure (V) of an electropneumatic proportional valve in the insufflation device. FIG. 3 is a timing chart of the abdominal cavity pressure and the output pressure of the electropneumatic proportional valve when the suction function is not used in the insufflation device. FIG. 4 is a diagram showing a correlation between a difference between a set pressure and an intraperitoneal pressure and an output pressure of an electropneumatic proportional valve in the insufflation device. FIG. 5 is a chart showing intraperitoneal pressure, output of an electropneumatic proportional valve, suction operation, and timing of measuring abdominal pressure when the suction operation performed using a foot switch in the insufflation device is linked. [Description of Signs] 1 ... Insufflation device 2 as an air supply device 2 ... Device main body 3 ... Gas supply base 4 ... Air supply base 6 ... Gas cylinder 7 ... Air supply tube 8 ... Connected equipment 9 ... Air supply line 11 ... Gas supply Pressure sensor 12 Primary depressurizer 13 Electropneumatic proportional valve 14 Flow rate measuring unit 15 Control unit 16 First valve 17 Second valve 21 Pinch valve 22 Suction tube 23 Suction pump 25 Input switch connection Connector 26: Foot switch 27: Operation unit

──────────────────────────────────────────────────続 き Continued on the front page (58) Field surveyed (Int. Cl. ⁷ , DB name) A61B 1/00-1/32 A61B 17/00-17/60

Claims (1)

(57) [Claim 1] A gas injection device for puncturing a living body to inject gas into the living body and a gas supply source, and decompressing the gas from the gas supply source. An air supply device that adjusts the flow rate and feeds the gas to the gas injection device; and an air supply line for supplying gas from the gas supply source to the gas injection device; and Setting means for setting a set value of a flowing air flow rate and a set value of a pressure in a living body cavity; and a gas flowing through the air supply line while receiving a control signal and reducing the pressure of the gas flowing through the air supply line to a predetermined pressure. Pressure adjusting means for adjusting the flow rate of the gas, flow rate measuring means for measuring the flow rate of the gas flowing through the air supply pipe downstream of the pressure adjusting means, pressure measuring means for measuring the pressure in the body cavity, Through the air line The measurement of the flowing air supply flow rate and the measurement of the pressure in the living body cavity are alternately performed at fixed time intervals, and the integration of the air supply flow rate is performed, and the result of the integration is related to the target pressure in the living body cavity. An air supply device, comprising: control means for interrupting the air supply supplied through the air supply line when it is determined that the value is equal to the determined value, and performing the pressure measurement in the living body cavity.