JPH0938098A - Ultrasonic treatment device - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an ultrasonic treatment device which is capable of using a galvanocautery and an ultrasonic knife respectively, and can be used easily and safely. SOLUTION: A handpiece 2 incorporates a vibrator 11, and a drive signal is applied to the vibrator 11 from a drive circuit 34 formed in a drive device 3. This ultrasonic wave is transmitted by a probe 15, the tip of which can be used for medical treatment such as blood coagulation. In addition, the medical treatment by galvanocautery can be performed by applying a galvanocautery signal to the probe from a galvanocautery device 8. The drive device 3 is internally equipped with a detection circuit 39 for detecting whether the galvanocautery signal is present in a line for transmitting the galvanocautery signal. The output from this detection circuit 39 is applied to a control circuit 41. The control circuit 41 turns OFF a drive signal from the drive circuit 34 so that the drive signal is not output to the vibrator 11 side, if the galvanocautery signal is detected. Thus the safe operation of the an ultrasonic treatment device is ensured by inhibiting both blood coagulation and galvanocautery treatments simultaneously.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an ultrasonic treatment apparatus having a function such as cutting with an electric scalpel and performing treatment such as incision by utilizing ultrasonic vibration.

[0002]

2. Description of the Related Art As a conventional example, there are an ultrasonic suction device which performs suction by utilizing ultrasonic vibration, and an ultrasonic scalpel device which performs incision by utilizing ultrasonic vibration. In addition, there is an electric scalpel device that applies a high-frequency signal from the probe tip to living tissue to perform incision and the like.

For example, in the first conventional example disclosed in Japanese Patent Laid-Open No. 60-80446, an ultrasonic surgical operating apparatus is provided with a function of an electric scalpel, and ultrasonic waves are used to crush living tissues.
In addition, a high-frequency current is passed through the tip horn to stop the blood vessel from bleeding. By operating a switch, ultrasonic waves can be supplied or a high-frequency current can be passed.

Further, for example, a second conventional example of Japanese Patent Laid-Open No. 60-227748 discloses an apparatus combining the functions of an ultrasonic knife and an electric knife. This second conventional example is devised so that the output of the ultrasonic wave and the output of the electric scalpel act simultaneously.

[0005]

However, this causes the device to become large and expensive. In addition, the electrocautery carries the risk of leakage current, which must not be increased in combination with the ultrasonic knife.

Further, since the electric function and the ultrasonic knife have different medical functions and effects, it may be better not to operate them at the same time.

The present invention has been made in view of the above points, and an object thereof is to provide an ultrasonic treatment apparatus which can use an electric knife and an ultrasonic knife, respectively, and which can be used simply and with high safety. And

[0008]

In an ultrasonic treatment device for treating a living tissue by utilizing ultrasonic vibration, a probe for transmitting the ultrasonic vibration to a treatment section and an ultrasonic vibration generated by being connected to the probe. A vibrator, a driving means for generating a driving signal for ultrasonically vibrating the vibrator, an electric knife signal supplying means for supplying an electric knife signal to the probe, and a state in which the electric knife signal is applied to the probe. The detection means for detecting and the control means for controlling ON / OFF of the supply of the drive signal to the probe according to the result of the detection means are provided, and both ultrasonic treatment and electric scalpel treatment can be used. At the same time, it is possible to secure safety with a simple configuration by prohibiting the use of both at the same time.

[0009]

BEST MODE FOR CARRYING OUT THE INVENTION Embodiments of the present invention will be specifically described below with reference to the drawings. First, the basic configuration of the present invention will be described with reference to the conceptual configuration diagram of FIG. An ultrasonic transducer (hereinafter simply referred to as transducer) 1 is a handpiece 2 that performs ultrasonic vibration and treatment with an electric knife on a living body.
1 and a probe 15 that transmits this ultrasonic wave and performs treatment such as coagulation at the tip. A drive signal is applied to the vibrator 11 from the drive circuit 34 in the drive device 3, and ultrasonic vibration occurs due to the application of the drive signal.

Further, it is possible to apply an electric scalpel signal from the electric scalpel device 8 to the probe 15 so that treatment with the electric scalpel can be performed. A detection circuit 39 for detecting whether or not the electric knife signal is present in the line for transmitting the electric knife signal is provided in the drive device 3, and the output of the detection circuit 39 is output to the control circuit 41. Control circuit 4
When the electric knife signal is detected, 1 warns the speaker 42 and also notifies the display 43, and further turns off the drive signal of the drive circuit 34 so as not to be output to the vibrator 11 side. On the other hand, when the electric knife signal is not detected, the drive signal is output to the vibrator 11 and turned on.

In this way, even in an apparatus capable of selectively performing treatment by ultrasonic waves and treatment by electric scalpel by performing ON / OFF control of the drive signal in accordance with the detection result of the electric scalpel signal, both are mistakenly performed. Safety is ensured by preventing simultaneous drive and treatment.

(First Embodiment) FIGS. 2 to 5 relate to a first embodiment of an ultrasonic treatment apparatus of the present invention, and FIG. 2 shows an ultrasonic coagulation / cutting apparatus of the first embodiment. 1 shows the overall configuration of FIG. 1, FIG. 3 shows the configuration of the handpiece in an exploded manner,
FIG. 4 shows the electrical configuration of the handpiece and its drive system,
FIG. 5 shows a more detailed structure of the driving device.

As shown in FIG. 2, the ultrasonic coagulation / cutting apparatus 1 according to the first embodiment of the present invention includes a handpiece 2 having a built-in vibrator for coagulation and cutting by ultrasonic waves, and the inside of the handpiece 2. A drive device 3 for supplying a drive signal to the vibrator of FIG. 1 via a drive signal transmission cord 4, a foot switch 5 connected to the drive device 3 for performing ON / OFF operation of the drive signal, and provided on the handpiece 2. Is connected to the treatment electrode receiver (active cord pin receiver) 6 via an active cord 7 provided with a detachable connector 7a, and the electrocautery signal from the distal end side of the handpiece 2 to the living body side via the active cord 7. An electrosurgical knife device 8 for generating an electrosurgical knife signal for flowing and excising, and a living body via an electric knife signal return cord 9 connected to the electric knife device 8. A return electrode 9a which is placed in contact with the wide portion is connected to the electric knife device 8, a foot switch 10 for performing ON / OFF operation of the electrocautery signal
It is composed of

FIG. 3 shows the construction of the handpiece 2 in an exploded view. A vibrator 11 (see FIG. 4) is incorporated inside the vibrator cover 12, and the ultrasonic vibration generated by the vibrator 11 is made of a metal member (for example, titanium or aluminum) having good ultrasonic transmission characteristics. ) 13 formed by
After being transmitted to the horn 13 and amplified by the horn 13, vibration is transmitted to the probe (or vibration transmission rod) 15 which is screwed into the horn 13 with a screw 14 and formed of a metal member having a good transmission characteristic of ultrasonic waves. Further, the vibration is transmitted to the fixed blade 16 in which the tip of the probe 15 has a small diameter. This fixed blade 1
6 is not limited to a so-called knife-shaped blade, but may be a rod-shaped blade as shown in FIG.

At the rear end of the fixed blade 16, a tip connecting member 18 formed of a member having a good insulating property (for example, fluororesin such as polytetrafluoroethylene) is attached, and the tip connecting member 18 rotates. Movable blade 17 is pin 19
Is rotatably attached with the fulcrum as a fulcrum, and the operation rod 20 whose tip is connected to the movable blade 17 moves to open and close with respect to the fixed blade 6 by forward and backward movement.

The operating rod 20 is fixed to the central axis of the probe 15 by means of a substantially elliptic connecting member 21 formed of a member having good insulating properties, which is connected to the probe 15 at regular intervals (in the longitudinal direction). The operation rod 20 is supported at a distance, and the rear end of the operating rod 20 is connected to the front end of a hollow cylindrical rotor 22.

The tip connector 18 and the connector 21 connected to the probe 15 are rotatably connected.
That is, the probe 1 is attached to the tip connector 18 and the connector 21.
5 has an inner diameter hole that substantially matches the outer diameter of the operation rod 20 and an inner diameter hole that substantially matches the outer diameter of the operation rod 20. The probe 15 and the operation rod 20 are rotatable while passing through the respective holes. .

A peripheral groove 23 is formed on the outer peripheral surface of the rotor 22 by fixing a pair of rings in parallel, or by notching the rotor 22 itself, and the rotor 22 is mounted inside the vibrator cover 12. Then, the circumferential groove 23 is provided so as to be located inside the window 24 provided in the vibrator cover 12, and the action bar 26 provided on the rear handle 25 outside the vibrator cover 12 is provided.
Can be engaged with.

That is, the action rod 26 can be moved to the outside or the inside as shown by the arrow in FIG.
It can be inserted in a state of being engaged inward, or can be released by rotating outward.

After that, the handle 25 is connected to the vibration cover 12 at a handle fulcrum 27, and can be rotated about the handle fulcrum 27. The oscillator cover 12
A front handle 28 is integrally molded with the front handle 28.

The rotor 22 is formed of, for example, an insulating member, and the probe 15 can be used even when the horn 13 is fitted in the hollow portion of the rotor 22 and when the operating rod 20 side and the movable blade 17 are made of metal. Keep insulated from.

A rotating adapter 30 for performing a rotating operation is provided at the rear end of the sheath 29 formed of an insulating member that can cover the probe 15, and the rotating adapter 30 is a vibrator. It is detachably connected to the front end of the cover 12. In the assembled state as shown in FIG. 1, with the rear handle 25 on the handle fulcrum 27 as a fulcrum, for example, the front handle 28 on the front in the counterclockwise direction in the direction of arrow A.
When the operation for rotating the action rod 26 to the side is performed, the action rod 26 rotates and moves to the rear side.

Since the circumferential groove 23 with which the action rod 26 is engaged moves backward as indicated by the arrow B, the rotor 22 and the operating rod 20 also move backward. This operation causes the movable blade 17 to move to the arrow C.
Rotate in the direction of. As a result, the tissue between the movable blade 16 and the movable blade 16 can be ablated by heating with frictional heat by ultrasonic vibration.
Also, the blood vessel can be heated to coagulate.

By rotating the rotary adapter 30, the sheath 29 rotates. The inner diameter of the sheath 29 is not circular, but is irregular, and the connector 21 and the tip connector 1
The connector 21 and the tip connector 18, the operating rod 20, and the rotor 22 can rotate about the fixed blade 16 as an axis center by the rotation of the sheath 29. The action rod 26 is provided with a circumferential groove 23 in a circumferential shape, and the engagement state is invariable with respect to this rotation, that is, the engagement state is maintained with respect to rotation.

The tissue sandwiched between the fixed blade 16 and the movable blade 17 is cut off by ultrasonic vibration.
If it has a knife-like sharp shape, it will be sharper than general scissors. Further, when the fixed teeth 16 have a blunt shape, the tissue can be cauterized and excised by frictional heat generated by ultrasonic vibration, and hemostasis can be achieved.

FIG. 4 shows the electrical internal structure of the handpiece 2. As shown in FIG. 4, the transducer cover 12 of the handpiece 2 has disk-shaped transducers 11 stacked therein, and the stacked transducers 11 are coupled to the probe 15 via the horn 13. ing. Two voltage input electrodes 32a and 32b are provided on both sides of each vibrator 11, and in this embodiment, one voltage input electrode 32b is provided.
Is electrically connected by a line 33 to a metallic (conductive in a broader sense) probe 15.

The treatment electrode receiver 6 serving as an electric knife input unit also has a line 33 connected to the voltage input electrode 32b on one side.
Is electrically connected to Therefore, a part of the electric knife signal of the electric knife signal generating circuit 35 in the electric knife device 8 appears in the drive circuit 34 of the vibrator 11 through the line 33, and this is used for detection. Then, the more specific structure of the driving device 3 is as shown in FIG.

As shown in FIG. 5, the drive circuit 34 includes a vibrator 1
1 generates a high frequency sine wave signal of a predetermined frequency for resonance driving, and outputs the high frequency signal to the output transformer 36.
Becomes a drive signal via the contacts 37a, 3
It is applied to the vibrator 11 in the handpiece 2 through 7a and vibrates ultrasonically. The secondary coil L of the output transformer 36 is a resonance coil that is connected in parallel with the vibrator 11 and resonates at the oscillation frequency of the drive circuit 34 to excite it.
When an electric knife signal is applied to the treatment electrode receiver 6 serving as the electric knife input portion of the handpiece 2, it is converted into direct current and detected by the peak detection type detection circuit 39 as described below.

The detection circuit 39 divides the voltage with the capacitors C1 and C2, detects the AC electric female signal appearing on the capacitor C2 with the detector D, and charges the capacitor C3 to obtain its peak value (peak value). Has been adopted.

The output of the detection circuit 39 is input to the control circuit 41 via the buff 40. In this control circuit 41, for example, a built-in comparator compares the level of the input signal with a reference value, and when the level of the input signal exceeds the reference value, the output of the comparator causes the CPU (not shown) to output an electric knife signal. Is added to the probe 16 (or there is an electric knife signal), and if the reference value is not exceeded, it is judged that the electric knife signal is not added.

When the CPU determines that the electric knife signal is applied by the output of the comparator, the electric knife signal is applied by the warning sound from the speaker 42 through the warning sound generation circuit (not shown), and the ultrasonic drive is stopped. In addition to prompting the user to do so, it is in a state in which an electric knife signal is applied by the display device 43 via a display drive circuit (not shown), and a display indicating that the driving of ultrasonic waves is stopped is displayed.

Further, the CPU turns off the contacts 37a, 37a (when it judges that the electric knife signal is applied) so that no current flows through the solenoid 37b of the relay 37.
At the same time, the drive circuit 34 is controlled to stop the generation of a signal for driving the vibrator 11. By turning off the relay 37, the drive signal is not applied to the ultrasonic transducer 11 of the handpiece 2.

On the other hand, when the CPU determines that the electric knife signal is not applied by the output of the comparator, the drive circuit 34 is turned on, that is, the signal is output to the output transformer 36 side, and the contacts 37a and 37b of the relay 37 are provided. To ON state. Therefore, in this case, coagulation by ultrasonic waves or incision treatment can be performed.

In the present embodiment, when the electric knife signal is detected, the relay 37 is turned off to disconnect the handpiece 2 from the drive circuit 34, and the handpiece 2 becomes the same as a mere treatment tool.
Therefore, it is possible to eliminate the risk that the signal of the electric knife flows into the drive device 3 side and the high-frequency leakage current increases.

Further, the drive circuit 34 is the same as in the conventional example.
With the electric knife signal applied, various countermeasures for eliminating the noise and driving the ultrasonic transducer in resonance are unnecessary, so the device itself can be simplified (ultrasonic vibration and electric knife output). Are not done at the same time).

According to the present embodiment, there is provided an electric knife signal detection (detection) means, and when the electric knife signal is detected by the output of this detection means, a drive signal for ultrasonically vibrating the probe 15 side. When the electric knife signal is not detected by the output of the detection means, a drive signal for ultrasonic vibration is output to the probe 15 side so that ultrasonic treatment can be performed. Therefore, both the ultrasonic treatment and the electric scalpel treatment can be performed with a simple configuration, and both treatments are not performed at the same time (form a prohibition means that prohibits both treatments). Exist)
Therefore, safety can be secured.

In this embodiment, when the electric knife signal is detected, the signal output of the drive circuit 34 is stopped (this is also included in the meaning of OFF in this specification), and
Although the output line of the drive signal is also turned off by the relay 37 provided on the output side, only one of them is turned off (that is, the signal output is turned off, or the relay 37 is used to contact 37).
The invention is also included in the present invention.

(Second Embodiment) FIG. 6 shows a second embodiment of the present invention.
The structure of the principal part of the ultrasonic coagulation and incision device 51 of the embodiment is shown. The handpiece 52 in this device 51 is shown in FIG.
Further, in the handpiece 2 according to the first embodiment shown in FIG. 5 and the like, the treatment electrode receiver 6 provided at the rear end of the transducer cover 12 is not connected to the line 33, but via the connection lead 53. Is connected to a transmission rod 20 (fixed to the rotor 22), and the transmission rod 20 is electrically connected to the movable blade 17. Further, the connecting tool 21 and the tip connecting tool 18 are both formed of an insulating member.

Therefore, the connecting lead 53 is connected to the probe 15
It is insulated from the side. Further, in the drive device 54 in the present embodiment, the input end of the detection circuit 39 is not connected to the line 33, but is connected to the active cord 4 connected to the treatment electrode receiver 6. Other configurations are the same as those of the ultrasonic coagulating and incising apparatus 1 of the first embodiment.

In this embodiment, the functions such as coagulation and incision by ultrasonic vibration are the same as those in the first embodiment, and the excision function by the electric knife is performed by the movable blade 17. The electric knife signal detection mechanism is the same as that of the first embodiment except that the detection line is common or different from the ultrasonic drive signal transmission line. The effect of this embodiment is similar to that of the first embodiment.

FIG. 7 shows the distal end side of the handpiece 61 in the modification of the second embodiment. In the first and second embodiments, the electric knife signal is the probe 15 or the movable blade 17.
However, in this modification, in addition to the probe 15 and the movable blade 17, a treatment electrode 62 for an electric scalpel is further inserted into the sheath 63.

An electric knife signal is applied to the rear end (not shown) of the treatment electrode 62. The detection means for detecting whether the electric knife signal is output to the treatment electrode 62 can be detected as shown in FIG. 5 or FIG.

(Third Embodiment) In the above-described embodiments and the like, when the electric knife signal detection means is provided on the drive device 3 side and the electric knife signal is detected based on the output of this detection means. However, the present invention is not limited to this. For example, a drive signal from the drive circuit 34 on the electric knife device side is transmitted to the vibrator 11. It is also possible to provide a detection means (detection means) for determining whether or not the voltage is applied and to control ON / OFF of the electric knife signal of the electric knife device according to the output of the detection means.

A schematic structure of the third embodiment is shown in FIG. 8. The drive device 3'includes a drive circuit 34, and a drive signal from the drive circuit 34 is applied to the vibrator 11. On the other hand, the electrosurgical knife device 8 ′ has an electrosurgical knife signal generation circuit 35.
, Detection circuit 39 ', control circuit 41' and speaker 4
2'and a display 43 'are built in. The electric knife signal generation circuit 35 generates an electric knife signal, and this electric knife signal is applied to the probe 15 of the handpiece 2 via the active cord.

The detection circuit 39 'detects the drive signal applied to the vibrator 11 by the peak detection method or the like, and outputs the output to the control circuit 41'. This control circuit 41 'judges whether the output of the detection circuit 39' is a driving signal via a comparator or the like, and when it judges that the driving signal is present, the electric knife generating circuit 35's At least the electric knife signal is transmitted to the probe 1 by stopping the oscillation of the electric knife signal or cutting off the line output to the probe 15 side.
It is controlled so that it is not output to the 5 side.

Further, when the control circuit 41 'determines that the drive signal is detected, the speaker 42' gives a sound or a warning such as interruption of the electrosurgical knife signal, and the display 43 'visually. Notice.

On the other hand, when it is judged from the output of the detection circuit 39 'that the drive signal does not exist, the electric knife signal of the electric knife generation circuit 35 is output to the probe 15 side and maintained in the ON state, and the electric knife is used. Allows treatment. The operation and effect of this embodiment are almost the same as those of the first embodiment.

Also in the third embodiment, the structure of the handpiece may be that of the first embodiment or the embodiment of the stand 2 shown in FIG.

Further, a configuration in which the above-described respective embodiments are partially combined to have a different structure also belongs to the present invention. For example, when the detecting means 39 detects an electric knife signal, the ultrasonic wave function is controlled to be stopped.
The function of the electric scalpel device side may be stopped, or which one may be selectively set. In addition, for example, when the detection means 39 detects an electric knife signal, the ultrasonic function is stopped or a function of the electric knife device is stopped after a warning is given by a voice warning, a visual warning, or both for a certain time. It may be stopped.

[Additional Notes] 1. Furthermore, it has a notification means for notifying the detection result.

2. Further, it has a notifying means for notifying the detection result and a means for electrically disconnecting the probe and the driving device.

3. In a device for treating living tissue using ultrasonic vibration, a probe for transmitting the ultrasonic vibration to a treatment portion, a vibrator connected to the probe for generating ultrasonic vibration, and a drive device for ultrasonically vibrating the vibrator. 3. Means for supplying an electric knife signal to the treatment section, means for detecting that the electric knife signal is applied to the treatment section, and controlling the drive device according to the result of the detection means. Furthermore, it has a notification means for notifying the detection result.

5. Further, it has a notifying means for notifying the detection result and a means for electrically disconnecting the probe and the driving device.

6. In an ultrasonic treatment device for treating living tissue using ultrasonic vibration, a probe that transmits ultrasonic vibration to a treatment section, a transducer that is connected to the probe and that generates ultrasonic vibration, and the transducer are provided. Driving means for generating a driving signal for ultrasonic vibration, electric knife signal supplying means for supplying an electric knife signal to the probe, and detection for detecting a state where one of the electric knife signal and the driving signal is applied to the probe side An ultrasonic treatment device comprising: a means and a control means for controlling ON / OFF of supply of one of a drive signal and an electric knife signal according to a result of the detection means.

[0055]

As described above, according to the present invention, in an ultrasonic treatment apparatus for treating living tissue by utilizing ultrasonic vibration, a probe for transmitting the ultrasonic vibration to a treatment section,
A vibrator connected to the probe for generating ultrasonic vibration, a drive unit for generating a drive signal for ultrasonically vibrating the vibrator, an electric knife signal supply unit for supplying an electric knife signal to the probe, Detecting means for detecting a state in which an electric knife signal is applied to the probe, and ON / OF for supplying a drive signal to the probe according to the result of the detecting means.
Since it has a control means for controlling F, both ultrasonic treatment and electric scalpel treatment can be used, and since both are prohibited at the same time, safety is ensured with a simple configuration. it can.

[Brief description of drawings]

FIG. 1 is a conceptual configuration diagram of the present invention.

FIG. 2 is an overall configuration diagram of the first embodiment of the present invention.

FIG. 3 is an exploded perspective view showing a structure of a handpiece.

FIG. 4 is an electrical internal configuration diagram of the handpiece.

FIG. 5 is a configuration diagram of a drive device including an electric knife signal detection unit.

FIG. 6 is a configuration diagram of a main part of a second embodiment of the present invention.

FIG. 7 is a perspective view of a distal end side of a handpiece according to a modified example of the second embodiment.

FIG. 8 is a schematic configuration diagram of a third embodiment of the present invention.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 ... Ultrasonic coagulation / cutting device 2 ... Handpiece 3 ... Drive device 4 ... Transmission code 5, 10 ... Foot switch 6 ... Treatment electrode receiver 7 ... Active code 8 ... Electrocautery device 11 ... Transducer 12 ... Transducer cover 13 ... Horn 15 ... Probe 34 ... Drive circuit 35 ... Electric knife signal generation circuit 37 ... Relay 39 ... Detection circuit 41 ... Control circuit 42 ... Speaker 43 ... Indicator

Claims (1)

[Claims] 1. An ultrasonic treatment apparatus for treating living tissue using ultrasonic vibration, comprising: a probe for transmitting ultrasonic vibration to a treatment section; and a vibrator connected to the probe for generating ultrasonic vibration. Driving means for generating a driving signal for ultrasonically vibrating the vibrator, electric knife signal supplying means for supplying an electric knife signal to the probe, and detecting means for detecting a state in which the electric knife signal is applied to the probe An ultrasonic treatment device, comprising: a control unit configured to control ON / OFF of supply of a drive signal to the probe according to a result of the detection unit.