JP3693836B2 - Electrosurgical equipment - Google Patents

Description

[0001]
BACKGROUND OF THE INVENTION
The present invention relates to an electrosurgical device.
[0002]
[Prior art]
2. Description of the Related Art Conventionally, an electrosurgical apparatus that performs treatment by coagulating or incising living tissue with high-frequency power is known. In such an electrosurgical apparatus, high-frequency power is generated inside the electrosurgical apparatus body, and this high-frequency power is supplied to a monopolar treatment tool or a bipolar treatment tool connected to the apparatus body to perform treatment of living tissue. .
[0003]
JP-A-8-196543 discloses an impedance monitoring device that monitors the impedance of a living tissue while the living tissue is treated with high-frequency power. More specifically, the minimum impedance is measured, and this minimum is measured. The function of impedance is used to determine the impedance at the end of tissue coagulation.
[0004]
[Problems to be solved by the invention]
However, the prior art including the above-described Japanese Patent Application Laid-Open No. 8-196543 has not been able to arbitrarily change the coagulation level because the conditions for detecting the completion of coagulation are fixed.
[0005]
The present invention has been made paying attention to such a problem, and the object of the present invention is to change the coagulation end condition of the living tissue according to the setting of the coagulation level by the user. An object of the present invention is to provide an electrosurgical device capable of changing the delay time of high frequency output stop according to the setting of the coagulation level .
[0006]
[Means for Solving the Problems]
To achieve the above object, one aspect of the present invention is an electrosurgical apparatus for performing coagulation or incision of the living tissue by the high frequency power output from the high frequency power supply device, prior to performing the coagulation of the living tissue A coagulation level setting means for setting the coagulation level at the end of coagulation, a detection means for detecting the coagulation state of the living tissue during the coagulation operation, and the high-frequency power source based on the coagulation level set by the coagulation level setting means A delay time setting means for setting a delay time until the output of high-frequency power from the apparatus is stopped; and the high-frequency power source based on the coagulation level set by the coagulation level setting means and the coagulation state detected by the detection means on the basis to control the high-frequency output that is output from the device to the delay time set by the delay time setting means the high frequency power source And control means for controlling the output stop of the put these high-frequency power comprises a.
[0007]
DETAILED DESCRIPTION OF THE INVENTION
Hereinafter, embodiments of the present invention will be described in detail with reference to the drawings.
[0008]
(First embodiment)
The first embodiment is characterized in that the current condition for output control, here, output stop (auto stop) is changed according to the setting of the coagulation level by the user.
[0009]
FIG. 1 is a diagram showing an internal configuration of the electrosurgical device according to the first embodiment. A commercial power supply 9 is connected to a power supply circuit 10 that generates desired high-frequency power. Connected to the power supply circuit 10 are a waveform generation circuit 11 for generating a waveform corresponding to an output mode depending on the operation content, and a CPU 13 for controlling the entire electrosurgical apparatus. Connected to the waveform generation circuit 11 and the CPU 13 are an amplifier 15 for amplifying a minute signal from the waveform generation circuit 11 and an output control unit 16 for controlling the output of the amplifier 15 based on a control signal from the CPU 13. Has been.
[0010]
The output transformer 17 has a primary side connected to the amplifier 15 and a secondary side connected to the terminals 21 a and 21 b via the current sensor 18. A bipolar treatment instrument 22a and a bipolar electrode 22b are connected to the terminals 21a and 21b through an active line.
[0011]
In FIG. 1, a bipolar treatment instrument is shown as the treatment instrument, but a monopolar treatment instrument 23 and a monopolar electrode 23a may be connected as shown in FIG. In this case, the feedback electrode 25 is connected to the terminal 21b via a feedback line. The A / D conversion unit 20 is connected between the output of the current sensor 18 and the CPU 13. The CPU 13 is further connected to a foot switch 8, a setting input unit 12 as a setting unit, and a notification unit 14.
[0012]
In the first embodiment, the high frequency output is controlled by controlling the amplifier 15 by the CPU 13 and the output control unit 16 as control means.
[0013]
FIG. 3 is a diagram showing the configuration of the setting input unit 12, and includes a setting switch 12B that allows the user to set the coagulation level, and a coagulation level display unit 12A for displaying the set coagulation level. . The coagulation level display unit 12A displays the coagulation level on the coagulation level display unit 12A while changing from 1 → 2 → 3 → 4 → 1 each time the setting switch 12B is pressed. , 4 are set to output stop current values Istop = 0.6 A, 0.5 A, 0.4 A, and 0.2 A.
[0014]
FIG. 4 shows the relationship between the characteristics of the high-frequency current (I) and the output of the power supply circuit 10, and shows that the output of the amplifier 15 is stopped when the current condition for stopping the output is satisfied.
[0015]
The operation of the first embodiment will be described below with reference to the flowchart of FIG.
[0016]
When the foot switch 8 for starting the constant power output of the electrosurgical device is turned on (step S1), the initial setting is performed (step S2). Here, the set power P1 = 40 W input by the user via the setting input unit 12 is substituted into the variable Pout relating to the output power and the coagulation level is set. Here, the current value as the current condition for stopping the output Istop is set. The set value input by the user is stored in the storage unit in the CPU 13 for use in the next operation.
[0017]
Next, it is determined whether or not the foot switch 8 is turned off (step S3). If the foot switch 8 is turned off, 0 is substituted for the output power Pout (step S5), and the high-frequency output is stopped to end this flow. If it is not OFF, the current value I detected by the current sensor 18 is measured (step S4), and then it is determined whether or not the measured current value I falls below the set current value Istop ( Step S6) If NO, return to Step S3. If the current value I measured after a predetermined time falls below the set current value Istop, the determination in step S6 is YES, so the process proceeds to step S7 and 0 is substituted for the output power Pout (step S7). The high-frequency output is stopped and the notification unit 14 informs the user by outputting sound from the speaker (buzzer sounding) or turning on the LED (step S8), and then the present flow ends.
[0018]
According to the first embodiment described above, the coagulation level at the time of auto-stop can be changed according to the user's selection by changing the current condition for detecting the completion of coagulation.
[0019]
(Second Embodiment)
A second embodiment of the present invention will be described below with reference to the drawings. The second embodiment is characterized in that the voltage condition for stopping output is changed according to the setting of the coagulation level by the user.
[0020]
FIG. 6 is a diagram showing an internal configuration of the electrosurgical device according to the second embodiment. This configuration is basically the same as that of the first embodiment except that a voltage sensor 19 is provided instead of the current sensor 18.
[0021]
Also in the second embodiment, the voltage condition can be set using the configuration of the setting input unit 12 as shown in FIG. However, in this case, output stop voltage values Vstop = 60V, 90V, 120V, and 150V are set corresponding to the setting of the respective coagulation levels 1, 2, 3, and 4.
[0022]
FIG. 7 shows the relationship between the characteristics of the high-frequency voltage (V) and the output of the power supply circuit 10, and shows that the output of the amplifier 15 is stopped when the voltage condition for stopping the output is satisfied.
[0023]
The operation of the second embodiment will be described below with reference to the flowchart of FIG.
[0024]
When the foot switch 8 for starting the constant power output of the electrosurgical device is turned on (step S11), the initial setting is performed next (step S12). Here, the set power P1 = 40 W input by the user via the setting input unit 12 is substituted into the variable Pout related to the output power and the coagulation level is set. Here, the voltage value as a voltage condition for stopping the output Vstop is set.
[0025]
Next, it is determined whether or not the foot switch 8 is turned off (step S13). If the foot switch 8 is turned off, 0 is substituted for the output power Pout (step S15), the high frequency output is stopped, and this flow is finished. If not, the voltage value V detected by the voltage sensor 19 is measured (step S14), and then it is determined whether or not the measured voltage value V exceeds the set voltage value Vstop ( Step S16), if NO, return to Step S13. If the voltage value V measured after a predetermined time exceeds the set voltage value Vstop, the determination in step S16 is YES, so the process proceeds to step S17 and 0 is substituted for the output power Pout (step S17). The high-frequency output is stopped, and the notification unit 14 informs the user by outputting sound from the speaker (buzzer sounding) or turning on the LED (step S18), and then ends the present flow.
[0026]
According to the second embodiment described above, the coagulation level at the time of auto-stop can be changed according to the user's selection by changing the voltage condition for detecting the end of coagulation.
[0027]
(Third embodiment)
A third embodiment of the present invention will be described below with reference to the drawings. The third embodiment is characterized in that the impedance condition for stopping output is changed according to the setting of the coagulation level by the user.
[0028]
FIG. 9 is a diagram showing an internal configuration of the electrosurgical device according to the third embodiment. This configuration is a configuration obtained by adding FIG. 1 and FIG. 6 described above, and an impedance calculation unit 24 is provided instead of the A / D conversion unit 20.
[0029]
Also in the third embodiment, the impedance condition can be set using the configuration of the setting input unit 12 as shown in FIG. However, in this case, three types of variables, P_dZ (impedance change rate (Ω / sec)), P_mZ (multiplier calculation number), and P_Z (impedance value (Ω)), are used as impedance conditions for the output stop to be set. Corresponding to the setting of the coagulation levels 1, 2, 3, 4 is determined as follows.
[0030]
Coagulation level 1: P_dZ = 300, P_mZ = 3, P_Z = 300
Coagulation level 2: P_dZ = 400, P_mZ = 3, P_Z = 400
Coagulation level 3: P_dZ = 500, P_mZ = 4, P_Z = 500
Coagulation level 4: P_dZ = 600, P_mZ = 4, P_Z = 600
FIG. 10 shows the relationship between the characteristic of impedance (Z) and the output of the power supply circuit 10, and shows that the output of the amplifier 15 is stopped when the impedance condition of output stop is satisfied.
[0031]
The operation of the third embodiment will be described below with reference to the flowchart of FIG.
[0032]
When the foot switch 8 for starting the constant power output of the electrosurgical device is turned on (step S21), the initial setting is performed (step S22). Here, the set power P1 = 40 W input by the user via the setting input unit 12 is substituted into the variable Pout related to the output power, and 10 KΩ is substituted into the variable Zmin related to the minimum impedance value. Further, P_dZ, P_mZ, and P_Z are set by setting the coagulation level by the user. Also, determination variable Cn1 = 0 and determination variable Cn2 = 0 are substituted.
[0033]
Next, it is determined whether or not the foot switch 8 is turned off (step S23). If it is turned off, 0 is substituted for the output power Pout (step S25), the high frequency output is stopped, and this flow is finished. If not OFF, the impedance Z and the change rate dZ of the impedance Z are calculated (step S24). Next, it is determined whether or not the calculated impedance Z is smaller than the minimum impedance value Zmin (step S26). If YES, the calculated impedance Z is substituted into the minimum impedance value Zmin (step S27) and the process proceeds to step S23. Return.
[0034]
On the other hand, if the determination in step S26 is no, the process proceeds to step S28 in FIG. 12 to determine whether the calculated impedance change rate dZ is equal to or greater than P_dZ. In the case of YES here, 1 is substituted for the decision variable Cn1 (step S29), and the process proceeds to step S30. If the determination in step S28 is no, the process immediately proceeds to step S30.
[0035]
In step S30, it is determined whether the impedance Z is equal to or greater than the result obtained by multiplying the minimum impedance value Zmin by the calculated number P_m. In the case of YES here, 1 is substituted for the decision variable Cn2 (step S31), and the process proceeds to step S32. If the determination in step S30 is no, the process immediately proceeds to step S32.
[0036]
In step S32, it is determined whether or not the determination variable Cn1 × Cn2 is equal to 1. Here, in the case of YES, 0 is substituted for the output power Pout (step S33) to stop the high-frequency output, and the notification unit 14 outputs a sound from the speaker (buzzer sound) or lights the LED (step S34). ) To inform the user, and this flow is finished.
[0037]
If NO in step S32, it is determined whether impedance Z is equal to or greater than minimum impedance value Zmin + initially set impedance value P_Z (step S35). Step S33 and subsequent steps are executed. If NO, the process returns to step S23 of FIG.
[0038]
As can be seen from the above, in the third embodiment, the high frequency output is stopped when the impedance satisfies one of the following conditions a) and b).
a) When the impedance change rate dZ indicates P_dZ or more at least once, and the impedance value Z becomes equal to or greater than the minimum impedance value Zmin × P_m.
[0039]
b) The impedance value Z is equal to or greater than the minimum impedance value Z_min + P_Z.
[0040]
According to the third embodiment described above, by changing the impedance condition for detecting completion of coagulation, the coagulation level at the time of auto-stop can be changed according to the user's selection.
[0041]
(Fourth embodiment)
A fourth embodiment of the present invention will be described below with reference to the drawings. The fourth embodiment is characterized in that the output stop delay time is changed according to the setting of the coagulation level by the user.
[0042]
The internal configuration of the electrosurgical device according to the fourth embodiment is the same as that of the above-described third embodiment. Also in the fourth embodiment, the output stop delay time can be set using the configuration of the setting input unit 12 as shown in FIG. However, in this case, output stop delay time T = 0 seconds, 1 second, 2 seconds, and 3 seconds are set corresponding to the setting of each coagulation level 1, 2, 3, and 4. Moreover, P_dZ (impedance change rate), P_mZ (multiplication calculation number), and P_Z (impedance value) as impedance conditions are fixed to P_dZ = 300 (Ω / sec), P_mZ = 3, and P_Z = 500 (Ω).
[0043]
The operation of the fourth embodiment of the present invention will be described below. The flowchart of FIG. 11 is also used in the fourth embodiment, but here, the delay time T is set in the initial setting in step S22. The difference is that the flowchart shown in FIG. 13 is used in the fourth embodiment as a flowchart showing the process between AB in FIG. Since the flowchart of FIG. 11 has already been described, only the flowchart of FIG. 13 will be described here. First, in step S38, it is determined whether or not the calculated impedance change rate dZ is equal to or greater than P_dZ (here, 300 (Ω / sec)). In the case of YES here, 1 is substituted into the decision variable Cn1 (step S39), and the process proceeds to step S40. If the determination in step S38 is no, the process immediately proceeds to step S40.
[0044]
In step S40, it is determined whether the impedance Z is equal to or greater than the result obtained by multiplying the minimum impedance value Zmin by the calculated number P_m (here, 3). In the case of YES here, 1 is substituted into the decision variable Cn2 (step S41), and the process proceeds to step S42. If the determination in step S40 is no, the process immediately proceeds to step S42.
[0045]
In step S42, it is determined whether the determination variable Cn1 × Cn2 is equal to 1. If YES, the process proceeds to step S44 and waits until the delay time T elapses. When the delay time T has elapsed, the determination in step S44 is YES, and the process proceeds to step S45. In step S45, after substituting 0 for the output power Pout to stop the high frequency output, the notification unit 14 informs the user by outputting sound from the speaker (buzzer sounding) or lighting the LED (step S46). This flow is finished.
[0046]
If the determination in step S42 is NO, the process proceeds to step S43 to determine whether the impedance Z is equal to or greater than the minimum impedance value Zmin + initially set impedance value P_Z (here, 500 (Ω)). If YES, step S44 and subsequent steps are executed. If NO, the process returns to step S23 of FIG.
[0047]
As can be seen from the above, in the fourth embodiment, the high-frequency output is stopped when the delay time T elapses after the impedance satisfies one of the following conditions a) and b).
[0048]
a) The impedance change rate dZ shows + 300Ω / sec or more at least once, and the impedance value Z becomes the minimum impedance value Zmin × 3 or more.
[0049]
b) When the impedance value Z is not less than the minimum impedance value Z_min + 500Ω.
[0050]
According to the above-described fourth embodiment, the coagulation level at the time of auto-stop can be changed according to the selection of the delay time by the user, and the same threshold value (current, voltage, impedance, etc.) conditions are used, and thus detection is performed. There is an effect that there is no variation.
[0051]
(Fifth embodiment)
The fifth embodiment of the present invention will be described below. 5th Embodiment combines the above-mentioned 1st-4th embodiment, FIG. 14 is a figure which shows the internal structure of the electrosurgical apparatus which concerns on 1st Embodiment. In this case, the setting input unit 12 is configured as shown in FIG. 15, and the user can select any one of the current selection button 12C, voltage selection button 12D, impedance selection button 12E, and delay time selection button 12F by pressing any button. The output stop condition can be specified, and then the coagulation level can be set by pressing the setting switch 12B. After the above setting is performed, processing is performed according to each embodiment described above according to each setting.
[0052]
According to the fifth embodiment described above, a desired output stop condition can be set.
[0053]
The specific embodiments described above include inventions having the following configurations.
[0054]
(1) An electrosurgical device that supplies high-frequency power from a high-frequency power supply device to a treatment instrument arranged in association with a biological tissue to coagulate or incise the biological tissue,
Prior to performing tissue coagulation, setting means for variably setting the coagulation level at the end of coagulation,
Detecting means for detecting the coagulation state of the tissue during the coagulation operation;
Control means for controlling the high-frequency output output from the high-frequency power supply device based on the coagulation level set by the setting means and the coagulation state detected by the detection means;
An electrosurgical device comprising:
[0055]
(2) The high frequency current and high frequency voltage from the high frequency power supply device are detected to calculate the impedance of the tissue, and the control is performed when the impedance value at this time satisfies the variable impedance condition set by the setting means The electrosurgical device according to (1), wherein the high-frequency output is controlled by means.
[0056]
(3) The electrosurgical device according to (2), wherein the variable impedance condition is a condition in which an impedance change rate and an impedance value are combined.
[0057]
(4) The impedance condition indicates that the impedance change rate indicates at least once a predetermined value or more and the impedance value is equal to or greater than a predetermined multiple of the minimum impedance value, or the impedance value is equal to or higher than the minimum impedance value. The electrosurgical device according to (3), wherein one of the two cases is satisfied when it is large.
[0058]
(5) The electrosurgical device according to (1), further comprising means for notifying a user by at least one of an audio method and a visual method when the high-frequency output is controlled while satisfying the impedance condition.
[0059]
(6) A threshold value for controlling the high frequency output by detecting a high frequency current and a high frequency voltage from the electrosurgical device is calculated, and a variable delay time elapses depending on the setting after reaching the threshold value The electrosurgical device according to (1), wherein the high frequency output is controlled when the operation is performed.
[0060]
(7) The electrosurgical device according to (6), wherein the impedance condition is a combination of an impedance change rate and an impedance value.
[0061]
(8) The electrosurgery according to (6), further comprising means for notifying a user by at least one of an audible and visual method when the high-frequency output is controlled after the delay time has elapsed. apparatus.
[0062]
(9) The electrosurgical device according to (1), wherein a high frequency current from the high frequency power supply device is detected, and the high frequency output is controlled when the detected current value falls below a variable current threshold value by setting. .
[0063]
(10) The electrosurgical device according to (1), wherein a high frequency voltage from the high frequency power supply device is detected, and the high frequency output is controlled when the detected voltage value exceeds a variable voltage threshold value by setting. .
[0064]
(11) The electrosurgical device according to (1), wherein the setting unit includes a setting unit that can set at least two of impedance, high-frequency current, and high-frequency voltage of a living tissue.
[0065]
【The invention's effect】
According to the present invention, the condition for ending the coagulation of the living tissue can be changed according to the setting of the coagulation level by the user, and in particular, the delay time for stopping the high frequency output can be changed according to the setting of the coagulation level by the user. .
[Brief description of the drawings]
FIG. 1 is a diagram showing an internal configuration of an electrosurgical device according to a first embodiment of the present invention.
FIG. 2 is a view showing a monopolar treatment tool.
FIG. 3 is a diagram illustrating a configuration of a setting input unit 12;
4 is a diagram showing the relationship between the characteristics of high-frequency current (I) and the output of the power supply circuit 10. FIG.
FIG. 5 is a diagram for explaining the operation of the first embodiment of the present invention.
FIG. 6 is a diagram showing an internal configuration of an electrosurgical device according to a second embodiment of the present invention.
7 is a diagram showing the relationship between the characteristics of the high-frequency voltage (V) and the output of the power supply circuit 10. FIG.
FIG. 8 is a diagram for explaining the operation of the second embodiment of the present invention.
FIG. 9 is a diagram showing an internal configuration of an electrosurgical device according to a third embodiment of the present invention.
10 is a diagram illustrating a relationship between impedance (Z) characteristics and the output of the power supply circuit 10. FIG.
FIG. 11 is a diagram for explaining the operation (part 1) of the third embodiment of the present invention;
FIG. 12 is a diagram for explaining the operation (No. 2) of the third embodiment of the present invention.
FIG. 13 is a diagram for explaining the operation of the fourth embodiment of the present invention.
FIG. 14 is a diagram showing an internal configuration of an electrosurgical device according to a fifth embodiment of the present invention.
FIG. 15 is a diagram illustrating a configuration of a setting input unit 12 according to a fifth embodiment of the present invention.
[Explanation of symbols]
8 ... Foot switch,
9 ... Commercial power supply,
10 ... power supply circuit,
11 ... Waveform generation circuit,
12 ... Setting input section,
13 ... CPU,
14… Notification Department,
15 ... Amplifier,
16 ... Output control unit,
17 ... Output transformer,
18 ... Current sensor,
19 ... Voltage sensor,
20 ... A / D converter,
21a, 21b ... terminals,
22a ... bipolar treatment tool,
22b ... bipolar electrode,
23 ... Monopolar treatment tool,
23a ... Monopolar electrode,
24: Impedance calculation unit,
25 ... Return electrode.

Claims (1)

By the high frequency power output from the high frequency power supply device to a electrosurgical apparatus for performing coagulation or incision of the living tissue,
Prior to coagulation of the living tissue, coagulation level setting means for setting the coagulation level at the end of coagulation,
Detection means for detecting the coagulation state of the living tissue during the coagulation operation;
Delay time setting means for setting a delay time until the high frequency power output from the high frequency power supply device is stopped based on the coagulation level set by the coagulation level setting means;
Based on the coagulation level set by the coagulation level setting means and the coagulation state detected by the detection means, the high frequency output output from the high frequency power supply device is controlled and the delay set by the delay time setting means is set. Control means for controlling output stop of high-frequency power from the high-frequency power supply device based on time ;
An electrosurgical device comprising:

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