JP3911334B2 - Shochu hemostasis device - Google Patents

Description

[0001]
BACKGROUND OF THE INVENTION
The present invention relates to an ablation hemostasis device using a heating element having a temperature coefficient in its own impedance.
[0002]
[Prior art]
2. Description of the Related Art In recent years, endoscopes that can perform diagnosis or therapeutic treatment in a body cavity by inserting an elongated insertion portion into the body cavity without requiring an incision from the body surface are widely used. Such an endoscope is generally provided with a hollow channel through which various treatment tools are inserted in addition to the observation means, and is operated by a treatment tool inserted through the channel according to symptoms in the body cavity. It is possible to perform hemostasis such as ulcer using various treatments under the visual observation of the person.
[0003]
At present, many high-frequency current generators (hereinafter referred to as electric scalpels) are commercially available and are often used for cutting and coagulating tissues. However, this technique of generating heat by the current flowing through the living body cannot predict or control the damage or necrosis caused by it, and in many cases the current itself flows into the living body within the scope of this technique. ing.
[0004]
Many tissue coagulation devices with lasers are also known, but it is difficult to accurately direct the laser beam to the target, and the device itself is expensive, and the laser is optically unfavorable. Not up to.
[0005]
Japanese Laid-Open Patent Publication No. 58-69556 discloses a cautery hemostasis probe using a simpler and safer Zener diode as a heating element, which is different from the above procedure. This probe and the main unit for controlling the probe use a characteristic that the Zener voltage of the Zener diode shifts with its own temperature rise, and controls it so as to keep it at a constant voltage, that is, a constant temperature. Since the Zener diode acts as a heating element, it does not pass current through the living body, and so it presses the hot iron, so it can be expected to have a hemostatic effect due to the pressing pressure in addition to the heat action. . In this method, rapid heating and cooling can effectively coagulate tissue without causing undue necrosis. However, rapid heating and cooling depend on the heat capacity of the probe, and as a heating element, an element other than a Zener diode is used. May be used.
[0006]
[Problems to be solved by the invention]
By the way, the control method of the ablation hemostasis device using the Zener diode and the probe tip structure need to have a complicated configuration as disclosed in Japanese Patent Application Laid-Open No. 58-69556. As can be seen, when the Zener diode is used as a heating element, not only the structure of the probe tip is complicated, but it is also necessary to provide an adjustment resistor for each probe in order to absorb variations in the Zener diode. In particular, there is a disadvantage that the tip portion and the connector portion have a complicated structure.
[0007]
Furthermore, even if a check function for checking the Zener voltage of the Zener diode is provided, it is not possible to check during heat generation due to the switching method using a relay or the like. In addition, since such a probe has a built-in resistance as described above, it cannot be applied to an autoclave sterilizer and must be immersed in a disinfectant solution for a long time for disinfection and sterilization. It took effort.
[0008]
The cautery hemostasis device of the present invention has been made paying attention to such a problem, and the object is to use a resistive element as a heating element, and to control and maintain the heating element at a constant temperature. The device for monitoring the resistance value of the device is configured with a simple circuit to simplify the configuration of the probe, thereby reducing a manufacturing cost and providing a cautery hemostasis device capable of simplifying disinfection and sterilization processing. There is.
[0009]
[Means for Solving the Problems]
To achieve the above object, cautery hemostatic device according to a first aspect of the present invention, arranged a heating element in the interior of the probe to be introduced into the body cavity, to supply electrical energy to the heating element heating by, a cautery hemostasis device for performing hemostasis treatment by cauterizing bleeding portion has a temperature coefficient to its impedance, a heating element built in the probe, connected to the heating element, the heating element The first electric energy supply means for supplying electric energy so that the resistance value of the heat generating element becomes constant during the heat generation operation, and an arbitrary amount between the heat generating element and the first electric energy supply means is connected to the connection point, during the heat generation operation of the heating element, and a second electric energy supply means for supplying electrical energy to the heating element regardless of the time of non-heating operation, from the second electrical energy supply means When electrical energy to the serial heating element is supplied, it comprises a, the resistance value monitoring means resistance value of the heating element to monitor whether within a predetermined range.
Further, the cautery hemostasis device according to the second aspect of the present invention is the first aspect, wherein a first diode for preventing backflow is disposed between the first electrical energy supply means and the connection point. In addition, a second diode for preventing backflow is disposed between the second electric energy supply means and the connection point.
According to a third aspect of the present invention, there is provided a cautery hemostasis device according to the first or second aspect, wherein the electric energy detecting means for detecting the electric energy supplied to the heating element, and the electric energy detecting means detect the electric energy. And a calorific value monitoring means for monitoring the calorific value of the heat generating element based on the electrical energy.
The cautery hemostasis device according to the fourth aspect of the present invention is the cautery hemostasis device according to the third aspect, wherein the calorific value monitoring means performs voltage-frequency conversion on the detection signal from the electrical energy detection means, and the converted pulse. The calorific value is monitored by counting.
[0010]
DETAILED DESCRIPTION OF THE INVENTION
Embodiments of the present invention will be described below in detail with reference to the drawings.
First, the outline of the present invention will be described. In the conceptual diagram of FIG. 1, for example, the resistor 1, which is a heat generating element having a temperature coefficient in its own impedance, is supplied with power from the power supply unit 2. The power supply unit 2 changes the supplied power so as to keep the resistance value of the resistor 1 constant based on a signal representing the resistance value detected by the resistance value detection unit 3.
[0011]
Further, another power supply unit 4 always supplies a current to the resistor 1 regardless of whether the resistor 1 generates heat or does not generate heat. The abnormality detection unit 5 detects the resistance value of the resistor 1 at this time and monitors whether the resistance value is within a predetermined range. If the resistance value is outside the predetermined range, the resistor 1 is abnormal. It is judged that.
[0012]
In general, the resistance value of the resistor 1 increases with increasing temperature due to its own temperature coefficient. With this characteristic, if the resistance value of the resistor 1 at a predetermined temperature is monitored, the temperature of the resistor 1 can be fed back as a resistance value. That is, if the power supply unit 2 is controlled so that the resistance value of the resistor 1 becomes a target value, constant temperature control of the resistor 1 can be realized.
[0013]
In addition, the circuit can be simplified by eliminating a switching unit such as a relay by always allowing a minute power to flow through another power supply unit 4.
The abnormality detection unit 5 is configured to determine that the probe is normal if the resistance value of the resistor 1 is within a range of values from a low temperature to a high temperature (heat generation). Accordingly, it is possible to detect the attachment / detachment state of the probe as well as an abnormality such as open / short of the resistor 1. Since this can be detected regardless of whether the heat is generated or not, the connector of the probe can be a minimum of two pins for supplying power to the resistor 1.
[0014]
By using the configuration as described above, control for keeping the resistor 1 as a heating element having a temperature coefficient in its impedance at a constant temperature according to the temperature of the probe, and means for monitoring an abnormality in the resistance value of the resistor 1; Can be configured with a simple circuit, and thereby the configuration of the probe can be simplified. This leads to an effect that the disinfection and sterilization can be performed relatively easily and does not cause undue necrosis of the tissue.
[0015]
FIG. 2 is a perspective view showing the appearance of the cautery hemostasis device according to the first embodiment of the present invention. In FIG. 2, a cautery hemostasis device 11 includes a main body portion 13 provided with an operation panel 12 on the front surface, an ablation probe device 16 detachably connected to the main body portion 13 via an electrical connector 14 and a water supply connector 15, The foot switch 19 is detachably attached to the main body 13 by a connector 18 provided on the cable 17, and the washing water tank 20 is detachably attached to the side surface of the main body 13.
[0016]
The foot switch 19 is provided with a water supply switch 19a and a heating switch 19b.
The ablation probe device 16 described above includes an elongated and flexible sheath 21, an ablation probe 22 connected to the distal end of the sheath 21, and the electrical connector 14 and the water supply connector 15 provided on the base side of the sheath 21. The sheath 21 and the ablation probe 22 at the tip of the sheath 21 can be inserted into a treatment instrument channel of an endoscope (not shown), and the ablation probe 22 can be introduced into the body cavity through this channel.
[0017]
As shown in FIG. 3, a coaxial cable 31 is inserted into the sheath 21 in the center in the axial direction so as to energize a resistor 32 that is a heating element provided in the ablation probe 22 at the tip, In the direction of the outer peripheral axis of the coaxial cable 31 in the sheath 21, a water supply pipe 34 is formed to pump cleaning water to a plurality of nozzles 33, 33,... (See FIG. 4) formed on the outer periphery of the ablation probe 22. Yes. The washing water is fed in a jet form by the nozzles 33, 33,. 4 is a cross-sectional view taken along line AA in FIG.
[0018]
Next, heat generation control of the cautery hemostasis device 11 according to the present embodiment will be described with reference to FIG. During heat generation, electric power is supplied so that the resistance value of the resistor R as a heating element becomes a predetermined resistance value. In this embodiment, in the bridge circuit including the resistors 101, 102, 103 and the resistor R as the heating element shown in FIG. 5, the ratio between the resistance value of the resistor 101 and the resistance value of the resistor 102 and the resistance value of the resistor R are shown. And the supplied power are adjusted so that the ratio of the resistance value of the resistor 103 is the same. More specifically, the operational amplifier 104 amplifies the difference between the two ratios, and drives the power transistor 106 to change the supplied power so that the difference becomes zero. In other words, the base circuit of the transistor 108 that drives the base current of the power transistor 106 is turned on and off by the switch 109 so that the operation and stop of the heat generating circuit composed of the bridge circuit and the operational amplifier 104 can be switched. The power transistor 106, the transistor 108 that drives the base current of the power transistor 106, and the switch 109 that turns on and off the base potential of the transistor 108 constitute a first electric energy supply means.
[0019]
A diode 107 is provided between the output of the power transistor 106 and the bridge circuit. The bridge circuit is further connected to a power source 111 and a power source 112 as second electric energy supply means via a diode 110. The power supplies 111 and 112 may be any of constant current, constant voltage, and constant power. In the present embodiment, the power supplies 111 and 112 are constant currents. The power source 111 as a substantial power source including the three-terminal regulator 111 a has lower supply power (current in the embodiment) than the power source 112, and supplies power to the bridge circuit by the power source 111. The power source 112 is for preventing overpower from being supplied to the resistor R when the power source 111 fails. The power source 112 is configured not to interfere with the operation of the power source 111 when there is no failure.
[0020]
For example, in the case of a probe configuration as described in the specification of Japanese Patent Application No. 8-143113, if the supply power is 0.2 W or less, the heat generated by the probe may damage the patient or the endoscope may be heated. There is no such thing as breaking. Therefore, the values of the power supplies 111 and 112 are set so as not to exceed this value in combination with the probe.
[0021]
In this embodiment, in order to detect an abnormality in the resistance value of the resistor R, the concept of the resistance ratio in the bridge circuit is used. That is, in the above bridge circuit and another bridge circuit including the resistors 113, 114, 115, and 116, the ratio between the resistance value of the resistor R and the resistance value of the resistor 103 is equal to the resistance value of the resistor 113 and the resistance 114. The window comparator 117 detects whether the resistance value is within the range from the ratio of the resistance value to the ratio of the resistance value of the resistor 115 to the resistance value of the resistor 116. Each ratio is set by a resistance lower limit value in a non-heating state and a resistance upper limit value in a heating state. Here, the two bridge circuits, the window comparator 117, and the control unit 118 described above constitute a resistance abnormality detection unit.
[0022]
When the foot switch 19b is pressed, the control unit 118 turns off the switch 109 and starts a heat generating operation. If there is an abnormality during heat generation, that is, if the output of the window comparator 117 indicates abnormality, the heat generation is stopped by turning on the switch 109.
[0023]
The power supplies 111 and 112 operate as constant current sources until the voltage applied to the resistor R and the resistor 103 becomes high and becomes inoperable. In other words, when the voltage applied to the resistor R is low even in a heat generation state, specifically, considering a drop due to each resistor or the like, if it is about 13 V or less, it operates as a constant current, and if it is a voltage higher than that, it is completely It is comprised so that an electric current may not be sent. The diodes 107 and 110 are provided so that the reverse bias is not applied to the power sources 111 and 112 and the potential on the output side of the power transistor 106 as described above. Incidentally, instead of providing the separate power sources 111 and 112 in this way, a fine power (0.2 W or less) may be supplied by the power transistor 106.
[0024]
By using the circuit configuration as described above, a current flows through the resistor R regardless of whether it is in a heat generation state or a non-heat generation state. The value can be monitored.
[0025]
According to the first embodiment described above, the cautery and hemostasis device of the present embodiment includes a bridge circuit including a heating element that is a resistor having a temperature coefficient, a heating circuit configured by an error amplification circuit, and a separate power source. Because it has a resistance abnormality detection unit that constantly monitors the resistance of the heating element by flowing a current regardless of whether it generates heat or not, constant temperature heat generation control can be performed with a simple circuit configuration. It becomes possible to detect a resistance abnormality of the heating element.
[0026]
As a result, the resistance abnormality detection result of the heating element can be used to determine whether or not the probe is connected to the ablation device, and the probe connector is composed of only two pins for supplying power to the heating element. Can do. In addition, since it is not necessary to incorporate electrical components other than connectors and cables in the probe, it is possible to provide a probe with a simplified structure. This is inherently useful in the process of disinfecting and sterilizing probes that have a complex configuration, for example, it can be resistant to autoclave sterilizers, and indirect infection without the need for cumbersome processes. Thus, it is possible to provide a cautery hemostasis device that does not give such a risk to the patient.
[0027]
By the way, such a cautery hemostasis device needs to monitor the total amount of energy given to the living body and inform the user. Such monitoring can be realized by a calorific value detection circuit including the voltage detection unit 120, the current detection unit 121, the analog multiplier 122, the VF converter 123, and the control unit 118 shown in FIG. In such a configuration, the analog detector 122 converts the outputs of the voltage detector 120 and the current detector 121 applied to the probe into power values, which are supplied to the VF converter 123 for VF conversion (voltage-frequency). Convert.
[0028]
Since the integration of the output of the analog multiplier 122 to obtain the total amount of energy (joule) and counting the pulses after VF conversion have the same meaning, the control unit 118, for example, the amount of energy that is being generated easily by the CPU As a result, the total amount of energy applied to the living body can be easily and freely monitored, and there is an advantage that the signal can be easily isolated because the electric power is converted into the frequency. In particular, the latter feature is very significant in the case of a medical device in which a circuit that is insulated from a patient is basically used and the control unit 118 is provided in a circuit that is insulated from the heat generation circuit. .
[0029]
Although not shown, the control unit 118 can count how many times the surgeon has stepped on the heating foot switch 19b to display the number of times.
The second embodiment of the present invention will be described below. FIG. 6 is a view showing a main part of a cautery hemostasis device according to the second embodiment of the present invention.
[0030]
In the second embodiment, as shown in FIG. 6, the bridge circuit of the first embodiment is changed, and the voltage and current supplied to the heating element are transferred to the AD converters 203 and 204 via the voltage detection unit 201 and the current detection unit 202. Then, the data is converted into digital data and taken into the control unit 205. The control unit 205 calculates the resistance of the heating element, and controls the power supply unit 206 so that this value is constant.
[0031]
In the case of this embodiment, there is an advantage that the circuit configuration is further simplified, and it is not simply that the resistance value of the heating element is made constant, but instead of the supply power and the resistance value of the heating element at that time, Therefore, it is possible to easily realize a control that slightly changes the power supply depending on the probe status, such as whether the heat is generated continuously or during continuous heat generation, and a cautery hemostasis device having a more effective hemostasis capability can be provided.
[0032]
The specific embodiments described above include inventions having the following configurations.
(1) In a cauterization hemostasis apparatus that disposes a heating element inside a probe to be introduced into a body cavity, supplies electric energy to the heating element to generate heat, cauterizes a bleeding part, and performs hemostasis treatment.
A temperature coefficient in its own impedance, a heating element built in the probe,
First electric energy supply means for supplying electric energy so that a resistance value of the heat generating element becomes constant during a heat generating operation of the heat generating element;
Second electric energy supply means for supplying electric energy to the heat generating element regardless of whether the heat generating element generates heat or does not generate heat;
Resistance value monitoring means for monitoring whether or not the resistance value of the heating element to which electrical energy is supplied by the second electrical energy supply means is within a predetermined range;
A cautery hemostasis device comprising:
(2) The electric energy from the second electric energy supply means is set to a value such that the heat generation temperature of the probe is a temperature that does not adversely affect the human body and the endoscope used in combination. The cauterization hemostasis device according to the configuration (1), wherein
(3) The cautery hemostasis device according to the configuration (1), wherein the second electric energy supply means includes two power supplies in order to prevent abnormal heat generation at the time of component failure.
(4) The resistance value monitoring means determines that the heating element is normal if the resistance value of the probe is between a resistance value when no heat is generated and a resistance value when heat is generated. The ablation hemostasis device according to (1).
(5) The ablation according to the configuration (1), further comprising a heat generation amount monitoring unit that detects the amount of heat generated by the heat generation element by detecting the electric energy supplied to the heat generation element by an electric energy detection unit. Hemostatic device.
(6) In the configuration (5), the heat generation amount monitoring unit monitors the heat generation amount by performing voltage-frequency conversion on the detection signal from the electrical energy detection unit and counting the converted pulses. The ablation hemostasis device described.
[0033]
【The invention's effect】
According to the present invention, constant temperature heat generation control can be performed with a simple circuit configuration, and resistance abnormality detection of the heating element including the attached / detached state of the probe can be realized. As a result, the probe structure is simplified, and for example, an autoclave sterilization is possible, there is no risk of infection, and a low-cost probe and a cautery hemostasis device capable of effectively controlling the probe can be provided.
[Brief description of the drawings]
FIG. 1 is a conceptual diagram showing a conceptual configuration of the present invention.
FIG. 2 is an external perspective view of the cautery hemostasis device according to the first embodiment of the present invention.
FIG. 3 is a cross-sectional view showing a tip of an ablation probe in the first embodiment of the present invention.
4 is a cross-sectional view taken along line AA in FIG.
FIG. 5 is a principle explanatory view of a cautery hemostasis device according to the first embodiment of the present invention.
FIG. 6 is a principle explanatory view of a cautery hemostasis device according to a second embodiment of the present invention.
[Explanation of symbols]
1 ... resistor,
2 ... power supply,
3 ... resistance value detection unit,
4 ... power supply,
5: An abnormality detection unit.

Claims (4)

Arranged a heating element in the interior of the probe to be introduced into the body cavity, by heating by supplying electrical energy to the heating element, a cautery hemostasis device for performing hemostasis treatment by cauterizing bleeding portion,
A temperature coefficient in its own impedance, a heating element built in the probe,
A first electric energy supply means connected to the heat generating element for supplying electric energy so that a resistance value of the heat generating element is constant during a heat generating operation of the heat generating element;
The supply and heating element, which is connected to any connection point between the first electric energy supply means, at heat generation operation of the heating element, the electrical energy to the heating element regardless of the time of non-heating operation Second electrical energy supply means;
Resistance value monitoring means for monitoring whether or not the resistance value of the heating element is within a predetermined range when electrical energy is supplied to the heating element from the second electrical energy supply means;
A cautery hemostasis device comprising: A first diode for preventing backflow is disposed between the first electric energy supply means and the connection point, and between the second electric energy supply means and the connection point. The cautery hemostasis device according to claim 1, wherein a second diode for preventing backflow is arranged. Electric energy detecting means for detecting electric energy supplied to the heat generating element; and heat generation amount monitoring means for monitoring the heat generation amount of the heat generating element based on the electric energy detected by the electric energy detecting means. The cautery hemostasis device according to claim 1 or 2, characterized in that: The cauterization hemostasis according to claim 3, wherein the calorific value monitoring means performs voltage-frequency conversion on a detection signal from the electrical energy detection means, and counts the pulses after the conversion, thereby monitoring the calorific value. apparatus.

Images