JPH0523348A - Surgical apparatus - Google Patents

Abstract

PURPOSE:To upgrade both operability and safety of an ultrasonic control means and a high frequency current switching means by detecting conditions thereof so that the operation of any one thereof is limited so as not to allow the oscillation of an ultrasonic wave and the generation of a high frequency excision current simultaneously. CONSTITUTION:When a handpiece 2 is used as ultrasonic scalpel, upon the operation of a foot switch 11, an ultrasonic oscillation switch 9 is closed by a limit means 10 and an ultrasonic vibration from an ultrasonic oscillation means 8 is transmitted to the tip of the hand piece 2. When it used as electric scalpel, upon the operation of an excision switch 5a, a high frequency excision switch 16 is closed by the limit means 10 and a high frequency excision current flows between the tip of the handpiece 2 and a counter pole part from a high frequency generating means 15. In addition, to perform a hemostatic coagulation, a coagulation switch 5b is operated to close a high frequency coagulation switch 17 through a limiting means 10 and a high frequency coagulation current flows from the high frequency current generation means 15.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a surgical operating apparatus having a handpiece having both functions of an ultrasonic knife and an electric knife.

[0002]

2. Description of the Related Art Heretofore, some surgical operating apparatuses having a handpiece having both functions of ultrasonic scalpel and electric scalpel have been proposed in order to make full use of the characteristics of both ultrasonic scalpel and electric scalpel.

The ultrasonic scalpel crushes and emulsifies the affected tissue by transmitting ultrasonic vibrations to the tip of the handpiece, and cuts it off. The elastic tissue such as a relatively thick blood vessel or It has the property that it is difficult to excise nerve tissue and membranous tissue, that is, tissue selectivity. However, the ultrasonic scalpel also has the one aspect that the capillaries are easily excised and bleeding from them cannot be stopped.

On the other hand, the electric scalpel cauterizes tissue by causing a high-frequency current (several hundred kHz to several MHz) to flow between the tip of the handpiece and the counter plate while concentrating the current at the tip of the handpiece. Incision or hemostatic coagulation is possible, and surgery with less bleeding is possible. However, it does not have the tissue selectivity of the ultrasonic scalpel.

As a device which can be used in combination with each other in order to make full use of the characteristics of the ultrasonic knife and the electric knife, for example, US Pat. No. 4,249,901 is known. This is one in which an ultrasonic vibration signal and a high frequency current signal are selectively supplied to one handpiece, so that the handpiece can be used as an ultrasonic knife or an electric knife.

In US Pat. No. 4,931,047, an electric knife is connected to a handpiece as an ultrasonic knife via a detachable adapter, and ultrasonic vibration and high frequency current are applied to the handpiece. It can be supplied at the same time, so that when the handpiece is used as an ultrasonic knife, it can be used as an electric knife at the same time.

[0007]

By the way, the device of US Pat. No. 4,249,901 cannot perform the function of an ultrasonic knife and the function of an electric knife at the same time. That is,
For example, if bleeding occurs while cutting tissue using the handpiece as an ultrasonic scalpel, it is necessary to stop this bleeding with a high frequency current, but an ultrasonic signal is supplied to the handpiece. At that time, the high frequency current cannot be supplied, and it is necessary to temporarily stop the output of the ultrasonic oscillation and then output the high frequency current. Therefore, the operation becomes complicated, and the complicated operation results in the progress being hindered in the surgical operation in which the fine and precise work is continued.

In the device of US Pat. No. 4,931,047, the function of the ultrasonic knife and the function of the electric knife are completely independent. Therefore, if bleeding occurs during the excision of the tissue with the ultrasonic scalpel, the tissue can be hemostatically coagulated by directly outputting the high-frequency coagulation current. However, if a high-frequency incision current is output when the ultrasonic oscillation is output by mistake, the ablation ability of the tissue increases more than necessary, and unintended tissue, for example, a large blood vessel is ablated to cause major bleeding. There is a nature.

The present invention has been made in view of the above circumstances, and an object of the present invention is to provide a surgical operating apparatus which has the characteristics of both an ultrasonic knife and an electric knife, and which has high operability and safety. To provide.

[0010]

SUMMARY OF THE INVENTION In order to solve the above problems, the present invention provides an ultrasonic oscillating device for a surgical operating apparatus having a handpiece having both functions of an ultrasonic knife and an electric knife. Means, control means for controlling the oscillation of ultrasonic waves, high-frequency current generation means for generating high-frequency incision current and high-frequency coagulation current, switching means for switching and controlling the high-frequency current, and the control means and the switching means. Limiting means for limiting the operation of either one of the ultrasonic oscillating means and the high frequency current generating means so that the ultrasonic wave is not oscillated and the high frequency incision current is not generated at the same time by detecting the state. It is equipped. Therefore, the oscillation of ultrasonic waves and the generation of high-frequency incision current are not performed at the same time.

[0011]

Embodiments of the present invention will be described below with reference to the drawings. FIG. 1 shows a first embodiment of the present invention. The surgical operating apparatus 1 according to the present embodiment includes an ultrasonic scalpel device 4
And an electric knife device 6 and a handpiece 2 that performs the functions of both devices 4, 6.

The ultrasonic knife device 4 is connected to the ultrasonic oscillating means 8 for oscillating ultrasonic waves, and the ultrasonic oscillating switch 9 for controlling the oscillation of ultrasonic waves from the ultrasonic oscillating means 8. And a limiting means 10 to be described later that is electrically connected to the ultrasonic oscillation switch 9. The ultrasonic oscillating means 8 is connected to the handpiece 2 via the ultrasonic oscillating switch 9 and can transmit ultrasonic vibration to the tip of the handpiece 2.

The electrosurgical knife device 6 includes a high-frequency current generating means 15 for generating high-frequency currents for incision and hemostatic coagulation (hereinafter referred to as high-frequency incision current and high-frequency coagulation current, respectively) and high-frequency current generating means 15. A high-frequency incision switch 16 connected to the incision current generator,
It has a high frequency coagulation switch 17 connected to a coagulation current generation part (not shown) of the high frequency current generation means 15. Then, the high-frequency current generating means 15 uses these switches 1
It is connected to the handpiece 2 via 6 and 17, and is also connected to the counter electrode plate 18, which allows a high-frequency incision current and a high-frequency coagulation current to flow between the tip of the handpiece 2 and the counter electrode plate. it can.

The limiting means 10 provided in the ultrasonic scalpel device 4 is connected to a foot switch 11 for the user to operate the oscillation of ultrasonic waves, and a high-frequency incision provided in the electric scalpel device 6 is connected. The switch 16 and the high frequency coagulation switch 17 are connected to each other. Further, the limiting means 10 is connected to an incision coagulation changeover switch 5 provided on the handpiece 2. The incision coagulation changeover switch 5 has an incision switch 5a and a coagulation switch 5b, and a user can perform a switching operation between the high frequency incision current and the high frequency coagulation current by the incision coagulation changeover switch 5. Next, the operation of the surgical operating apparatus 1 having the above configuration will be described.

When the handpiece 2 is used as an ultrasonic knife, the foot switch 11 is first operated. In this case, the ultrasonic oscillation switch 9 is closed by the limiting means 10, and the ultrasonic vibration from the ultrasonic oscillation means 8 is transmitted to the tip of the handpiece 2. When the handpiece 2 is used as an electric knife to incise an affected tissue or the like, the incision switch 5a of the incision coagulation changeover switch 5 of the handpiece 2 is pushed, for example. In this case, the high-frequency cutting switch 16 is closed by the limiting means 10, and the high-frequency cutting current is passed from the high-frequency current generating means 15 between the tip of the handpiece 2 and the counter plate. When performing hemostatic coagulation, the limiting means 10 is operated by pushing the coagulation switch 5b of the incision coagulation changeover switch 5.
The high frequency coagulation switch 17 may be closed via. As a result, the high-frequency current generating means 15 is connected to the handpiece 2
A high-frequency coagulation current is passed between the tip of the electrode and the counter plate.

By the way, during each of the above operations, the limiting means 10
Always detects the open / closed state of the switches 9, 16 and 17. That is, when the foot switch 11 is operated, the ultrasonic oscillation switch 9 is closed, and at the time of ultrasonic oscillation in which ultrasonic vibration is transmitted to the tip of the handpiece 2, even the incision coagulation changeover switch 5 provided on the handpiece 2 Even if the incision switch 5a is pressed, the limiting means 10 operates so that the high-frequency incision switch 16 does not close. On the other hand, when the coagulation switch 5b is pressed during the ultrasonic oscillation, the limiting means 10 closes the high frequency coagulation switch 17 so that the high frequency coagulation current is generated between the tip of the handpiece 2 and the counter plate simultaneously with the ultrasonic oscillation. It works so that it flows in between.

On the contrary, the high-frequency incision switch 16 is closed by pressing the incision switch 5a of the handpiece 2, and the high-frequency current generating means 15 causes the handpiece 2 to move.
At the time of high-frequency incision in which a high-frequency incision current is passed between the tip of the electrode and the counter electrode, the limiting means 10 operates so that the ultrasonic oscillation switch 9 does not close even if the foot switch 11 is operated.

FIG. 4 shows how the ultrasonic wave is oscillated and the high-frequency current is generated according to this embodiment. As can be seen from this figure, the ultrasonic wave and the high-frequency incision current, and the high-frequency coagulation current can be independently output, and the ultrasonic wave and the high-frequency coagulation current can be generated simultaneously,
Ultrasonic waves and high frequency incision current cannot be generated at the same time.

Therefore, the surgical operating apparatus 1 of the present embodiment
Can generate a high-frequency coagulation current for hemostasis in a state where the handpiece 2 is used as an ultrasonic knife, but the generation of a high-frequency incision current is limited. Also,
While using the handpiece 2 as an electric knife,
Neither can ultrasonic oscillation be performed. Therefore, since the surgical operating apparatus 1 does not simultaneously oscillate ultrasonic waves and generate high-frequency incision current, the incision ability is increased more than necessary, and unintended tissue may be incised to cause major bleeding. There is no property and it is safe.

Further, the surgical operating apparatus 1 can generate a high-frequency coagulation current without stopping the ultrasonic oscillation if the bleeding occurs at the time of tissue incision by ultrasonic vibration. good.

In this embodiment, each switch 9,
The types 16 and 17 may be of a type other than those described above, and the limiting means 10 may be provided in the electric knife device 6. Further, in FIG. 4, the ultrasonic wave oscillation is prioritized over the generation of the high-frequency incision current, but this may be reversed. Alternatively, the priority order may be set according to the order in which the switches are pressed.

2 and 3 show a second embodiment of the present invention. The surgical operating apparatus 20 of the present embodiment has an ultrasonic scalpel device 21, an electric scalpel device 22, and a handpiece 27 that is connected to both of these devices 21 and 22 and is used as an ultrasonic scalpel and an electric scalpel. The ultrasonic scalpel device 21 and the control device 25 for controlling the electric scalpel device 22 are provided.

The ultrasonic scalpel device 21 is provided with ultrasonic oscillating means 21 for oscillating ultrasonic waves. The ultrasonic oscillating means 21 is connected to an output end of a first AND gate 31 (see FIG. 3) described later of the control device 25 and the handpiece 27, and can transmit ultrasonic vibration to the tip of the handpiece 27. .. The ultrasonic wave oscillating means 21 is further connected via the first AND gate 31 of the control device 25 to a foot switch 26 for the user to operate the ultrasonic wave oscillation.

The electrosurgical knife device 22 is provided with a high frequency current generating means 24 for generating a high frequency incision current and a high frequency coagulation current. An unillustrated incision current generator of the high-frequency current generator 24 is connected to an output terminal of a second AND gate 32 (see FIG. 3), which will be described later, of the control device 25, and via the second AND gate 32. Is connected to an incision switch 28a of an incision coagulation changeover switch 28 provided on the handpiece 27. Also,
The coagulation current generator (not shown) of the high-frequency current generator 24 is connected to the coagulation switch 28b of the incision coagulation changeover switch 28 provided on the handpiece 27 via the control device 25. The high-frequency current generating means 24 is connected to the handpiece 27 and the counter electrode plate 29, and a high-frequency incision current and a high-frequency coagulation current can flow between the tip of the handpiece 2 and the counter electrode plate.

As shown in FIG. 3, the control device 25
Is configured as a flip-flop with two AND gates 31 and 32. The foot switch 26 is connected to the input terminal of the first AND gate 31 of the two AND gates 31 and 32. Also, the second AND gate 3
The incision switch 28a of the incision coagulation changeover switch 28 is connected to the input end of 2. Therefore, the control device 25 having the flip-flop circuit is configured so that the foot switch 26 and the incision switch 28a are turned on / off.
By the respective inputs by the F operation, in other words, the states of the foot switch 26 and the incision switch 28a are detected, and the ultrasonic oscillator 23 and the high frequency current generator 24 connected to the output ends of the AND gates 31 and 32 are incised. It is possible to operate only one of the current generators so that the oscillation of ultrasonic waves and the generation of high-frequency incision current are not performed at the same time.

In this construction, of course, as in the first embodiment, the high frequency coagulation current can be generated simultaneously with the ultrasonic oscillation. The operation of ultrasonic wave oscillation and high-frequency current generation according to this embodiment is similar to that of the first embodiment (see FIG. 4).

In each of the above embodiments, a configuration may be added in which a warning is issued when the switch 5a is pressed to generate a high-frequency incision current while oscillating ultrasonic waves.

[0028]

As described above, since the surgical operating apparatus of the present invention does not oscillate ultrasonic waves and generate high-frequency incision current at the same time, the incision ability increases more than necessary and is not intended. It is safe without the risk of cutting tissue and causing major bleeding.

Further, if bleeding occurs during tissue incision by ultrasonic vibration, a high-frequency coagulation current can be generated without stopping the ultrasonic oscillation, so the operability is good.

[Brief description of drawings]

FIG. 1 is a circuit diagram of a surgical operating apparatus showing a first embodiment of the present invention.

FIG. 2 is a circuit diagram of a surgical operating apparatus showing a second embodiment of the present invention.

3 is a circuit diagram showing an internal configuration of the control device of FIG.

FIG. 4 is a diagram showing output states of ultrasonic waves and high frequencies in the first and second embodiments.

[Explanation of symbols]

1, 20 ... Surgical operating device, 2, 27 ... Handpiece,
5, 28 ... Incision coagulation changeover switch (changeover means),
8, 23 ... Ultrasonic oscillating means, 9 ... Ultrasonic oscillating switch (control means), 10 ... Limiting means, 11, 26 ... Foot switch, 15, 24 ... High frequency current generating means, 16 ... High frequency incision switch, 17 ... High frequency Coagulation switch, 25 ... Control device (limitation means).

Claims (1)

Claim: What is claimed is: 1. A surgical operating apparatus having a handpiece having both functions of an ultrasonic knife and an electric knife.
Ultrasonic oscillating means, control means for controlling ultrasonic oscillation, high-frequency current generating means for generating high-frequency incision current and high-frequency coagulation current, switching means for switching and controlling the high-frequency current, the control means and the switching A limit for limiting the operation of either one of the ultrasonic oscillating means and the high frequency current generating means so that the ultrasonic wave oscillating and the high frequency incising current are not simultaneously generated by detecting the state of the means. And a surgical operating apparatus.