JPH10201770A - Electrical surgical device - Google Patents

Abstract

PROBLEM TO BE SOLVED: To perform a surgical treatment on a living body and to properly and optimally coagulate the affected part. SOLUTION: An electrocautery device, one of the electrical surgical instruments, consists of a controller 10, a high frequency current control circuit 30, and a handpiece 34. The handpiece 34 is provided with an infrared temperature sensor 32 (temperature sensor) in addition to a blade 36. This sensor 32 measures the average temperature of the affected part (coagulation area 42 formed on the living body 40) and outputs the temperature to the controller 10 (output unit). In the controller 10, the temperature is shown on a display 14, and/or the output of the high frequency current control circuit 30 is controlled so that the temperature of the affected part becomes a target temperature. On the basis of the temperature of the affected part thus measured, a surgical treatment can be performed properly. Consequently, in performing a surgical treatment on the living body, the affected part can be coagulated properly and optimally.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an electrosurgical apparatus and, more particularly, to a technique for performing a surgical treatment on a living body to optimally coagulate the affected part without excess or deficiency.

[0002]

2. Description of the Related Art Electrosurgical devices include surgical devices such as an electrosurgical device, an inert gas plasma gas discharge device, a laser scalpel, and a microwave device. A technique for performing a surgical treatment on a living body using this electrosurgical device to coagulate the affected part is disclosed in Japanese Utility Model Publication No. 4-40665. According to the technique disclosed in this publication, a surgical procedure is performed on a living body according to preset control conditions. The surgical procedure allows the affected area to be heated to a predetermined temperature and coagulated. Sutures and bleeds the wound by coagulating the affected area.

[0003]

However, in order to properly coagulate an affected part by performing a surgical procedure, control conditions are required for each affected part. Therefore, it is difficult to set control conditions in advance for all affected parts of the living body. Even when a surgical procedure is performed in accordance with the preset control conditions, whether or not the affected part has coagulated is usually visually determined by an operator. Therefore, depending on the condition of the living body, the affected part may be excessively heated, and coagulate healthy living tissue other than the part to be treated. In this case, blood often seeps out from the underlying tissue or burns. Conversely, depending on the condition of the living body, the temperature of the affected part may not be heated to an appropriate temperature, and the entire affected part may not be coagulated. The present invention has been made in view of such a point, and to provide an electrosurgical device that appropriately maintains the temperature of an affected part undergoing a surgical procedure and appropriately coagulates the affected part without excess or shortage. With the goal.

[0004]

According to a first aspect of the present invention, there is provided an electrosurgical apparatus for performing a surgical treatment on a living body to coagulate an affected part of the living body. , And a temperature sensor for measuring the temperature and outputting the temperature to an output device. Here, “performing a surgical procedure on a living body” is a procedure of converting electrical energy into laser, microwave, plasma gas discharge, or the like and irradiating the affected part of the living body with the electric energy. Further, the term “coagulate” means not only the coagulation of a living tissue (affected part) but also a procedure for suturing a wound or performing hemostasis such as formation of a scab (scab). According to the first aspect of the present invention, the temperature of the coagulation site formed in the living body is measured by the temperature sensor, and the temperature is output to the output device. Therefore, the surgeon can perform a surgical procedure based on the temperature of the coagulation site output to the output device. Therefore, the temperature of the affected part undergoing the surgical procedure can be appropriately maintained, and the affected part can be appropriately coagulated without excess or shortage.

[0005]

According to a second aspect of the present invention, there is provided an electrosurgical apparatus according to the first aspect, wherein the output device controls an output for performing a surgical procedure. It is a control device or a display device for displaying temperature. According to the invention described in claim 2, the output control device controls the output for performing the surgical procedure based on the temperature of the coagulation site formed in the living body by the temperature sensor, or the temperature is displayed on the display device. Is done. The output control device increases or decreases the output for performing the surgical procedure according to the temperature of the coagulation site. In addition, if the temperature of the affected part undergoing the surgical procedure is displayed on the display device, the operator can know the current temperature and can increase or decrease the output for performing the surgical procedure. Therefore, in any case, the affected part can be appropriately coagulated without excess or shortage.

[0006]

According to a third aspect of the present invention, in the electrosurgical apparatus according to the first aspect, an infrared temperature sensor is used as a temperature sensor. According to the third aspect of the present invention, the infrared temperature sensor can measure the temperature without contacting the affected part undergoing the surgical procedure. Therefore, a measurement error due to blood or the like is prevented, and the temperature of the affected part can be accurately measured. Moreover, since it does not come into contact with the affected part, it is sanitary.

[0007]

Embodiments of the present invention will be described below with reference to the drawings. [Embodiment 1] First, Embodiment 1 is an application of the present invention to an electrosurgical apparatus (formally an electrosurgical apparatus), which will be described with reference to FIGS. Here, FIG. 1 shows a schematic configuration of the electric scalpel device in a block diagram. FIG. 2 is a flowchart showing the temperature display process, and FIG. 3 is a flowchart showing the temperature control process. Here, the electrocautery device has an incision mode in which the blade (scalpel blade) is incised while flowing a high-frequency current while being in contact with the living body, and a spray in which the blade is slightly separated from the living body to cause arc discharge to coagulate. There is a coagulation mode. In the first embodiment, an example in which the present invention is applied to the latter spray coagulation mode will be described.

First, an electric scalpel device is a device for performing incision and coagulation of a living tissue using high-frequency energy. As shown in FIG.
0, a high-frequency current control circuit 30, and a handpiece 34. The control unit 10 displays the average temperature of the diseased part, that is, the coagulation area 42 on the living body 40 undergoing the surgical procedure, and controls the magnitude of the high-frequency current output from the high-frequency current control circuit 30 according to the average temperature. The specific configuration and the like of the control unit 10 will be described later. The high-frequency current control circuit 30 is a circuit for generating a high-frequency current of several MHz, and is configured so that its output value changes in response to an operation command from the control unit 10. The handpiece 34 is provided with an infrared temperature sensor 32 in addition to the blade 36. The infrared temperature sensor 32 is one of radiation temperature sensors (that is, radiation thermometers), and emits infrared light (I
R) is detected and its average temperature is measured. Solidification area 4
Reference numeral 2 denotes a range in which a part of the living body 40 is coagulated by a high-frequency current generated by an arc discharge generated between the blade 36 and the living body 40 (a range indicated by hatching in the drawing).

The control unit 10 includes a CPU 20, a ROM 12,
RAM 22, display unit 14, input unit 16, output processing circuit 2
4, an input processing circuit 26. CPU
20 controls the entire control unit 10 according to an output control program stored in the ROM 12. The output control program includes a program for realizing a temperature display process and a temperature control process described later. An EPROM is generally used for the ROM 12, but the present invention is not limited to this, and a storage medium such as an EEPROM or a flash memory may be used. The RAM 22 stores various data such as a target temperature and a current temperature or input / output signals.
Generally, a DRAM is used for the RAM 22.
A storage medium such as a RAM or a flash memory may be used.

The display unit 14 includes a display control circuit and a display device for displaying the current temperature and the like. A liquid crystal display device is generally used for the display device, but the display device is not limited to this, but may be a CRT or an LED display device (including a display device in which a plurality of LEDs are arranged adjacent to each other in a grid pattern, not limited to a single LED). May be. The input unit 16 inputs a target temperature or the like stored in the RAM 22 in advance. This input unit 1
Although a keyboard is used for 6, another device for inputting a target temperature or the like may be used. For example, there is a pointing device such as a mouse. The input processing circuit 26
An analog temperature signal output from the infrared temperature sensor 32 is received, converted into digital temperature data that can be processed in the control unit 10, and transferred to the CPU 20 (or the RAM 22) via the bus 18. The output processing circuit 24 is a CPU
In response to the output data sent from the bus 20 via the bus 18, an operation command is sent to the high-frequency current control circuit 30.

The electric scalpel device having the above-described configuration is used for the living body 4
In order to display the temperature of the solidification area 42 at 0, etc.
The controller 10 performs the temperature display processing shown in FIG. 2 or the temperature control processing shown in FIG. Each of these processes is executed by executing an output control program stored in the ROM
This is realized by U20 executing at an appropriate time. In the temperature display process shown in FIG.
Is measured at step S10. Specifically, in step S10, a temperature signal output from the infrared temperature sensor 32 provided in the handpiece 34 is received, and the temperature signal is converted into temperature data. Then, the converted temperature data is displayed on the display unit 14 (Step S12). When the operator views the temperature displayed on the display unit 14 in this manner, it is possible to determine whether the temperature is appropriate. In addition, by adjusting the magnitude of the high-frequency current by the operator as necessary, the affected part can be appropriately coagulated without excess or deficiency while appropriately maintaining the temperature of the coagulation area 42 (coagulation site).

Next, the temperature control process shown in FIG. 3 is executed on condition that the target temperature is input from the input unit 16 and stored in the RAM 22 in advance. The target temperature is referred to in step S24 described below. First, the current temperature in the solidification area 42 is measured (step S2).
0), the temperature is displayed on the display unit 14 (step S2).
Step 2) is the same as steps S10 and S12 in FIG. Then, the preset target temperature is compared with the current temperature (step S24). As a result of the comparison,
If the target temperature is higher than the current temperature, the high-frequency current is increased (step S26). If the target temperature is lower than the current temperature, the high-frequency current is reduced (step S28). If the target temperature is equal to the current temperature, nothing is performed. The process is returned to Specifically, in step S26, an operation command for increasing the high-frequency current is output to the high-frequency current control circuit 30, and in step S28, an operation command for reducing the high-frequency current is output to the high-frequency current control circuit 30. In this case, by repeating the temperature control process, the current temperature of the solidification area 42 can be shifted to and maintained at the target temperature by feedback control.

According to the first embodiment, the temperature of the coagulation area 42 (coagulation site) formed in the living body 40 is measured by the infrared temperature sensor 32 (temperature sensor), and the temperature is controlled by the control unit 10 (output device). Is output to for that reason,
Based on the current temperature of the coagulation area 42, an appropriate surgical procedure can be performed. Therefore, the temperature of the coagulation area 42 where the surgical procedure is being performed can be appropriately maintained, and the affected part can be coagulated appropriately without excess or shortage. Further, based on the current temperature of the coagulation area 42 formed in the living body 40 by the infrared temperature sensor 32, the control unit 10 (output control device) performs a high-frequency current control circuit 30 for performing a surgical procedure.
Control the size (output) of the display or the temperature of the display
4 (display device). The control unit 10 increases or decreases the magnitude of the high-frequency current according to the temperature of the solidification area 42. Further, if the current temperature of the coagulation area 42 is displayed on the display unit 14, the operator can know the temperature and can adjust the output for performing a surgical procedure. Therefore, in any case, the coagulation area 42 at the optimum coagulation temperature is used.
Can be subjected to surgical procedures. Therefore, it is possible to prevent poor coagulation (insufficient) and burns to healthy cell tissues due to an excessive rise in temperature. Therefore, the affected part can be optimally coagulated without excess or shortage. further,
The infrared temperature sensor 32 (temperature sensor) can measure the temperature without contacting the coagulation area 42 undergoing the surgical procedure. Therefore, a measurement error due to blood or the like is prevented, and the temperature of the coagulation area 42 can be accurately measured. In addition, it is sanitary because it does not come into contact with the affected part (coagulation area 42).

When treating malignant cells,
A target temperature is set in advance to a temperature at which the malignant cells are killed. By doing so, it is possible to kill only the malignant cells and minimize the effect on healthy cell tissues around or deeply around the malignant cells. On the other hand, application to treatment of skin diseases and the like in plastic surgery is also possible. That is, the surface of the living body 40 is heated at a low temperature in the excision operation, and after the excision, the bleeding site (coagulation area 42) is heated to a high temperature to stop the bleeding while monitoring the current temperature of the bleeding site. Hemostasis can be performed quickly and appropriately.

[Embodiment 2] Next, Embodiment 2
A plasma gas discharge apparatus to which the present invention is applied will be described with reference to FIG. Here, FIG. 4 is a block diagram showing a schematic configuration of the plasma gas discharge device. In FIG. 4, the same elements as those in FIG. 1 are denoted by the same reference numerals.

The plasma gas discharge device is a device for performing plasma gas discharge to an affected part of a living body with an inert gas to cut or coagulate a living tissue. As shown in FIG. 4, the plasma gas discharge device includes a control unit 1
0, transmission circuit 54, drive circuit 52, high voltage generation coil 5
0, a handpiece 56. The configuration and functions of the control unit 10 have already been described in the first embodiment, and a description thereof will be omitted. The transmission circuit 54 is a PWM
(Pulse Width Modulation) or PFM (Pulse Freq
This is a circuit that generates a pulse of a predetermined amplitude by a modulation method such as uency modulation. The drive circuit 52 is a circuit that amplifies the amplitude of the pulse generated by the transmission circuit 54. The high voltage generating coil 50 is a coil that receives a pulse amplified by the drive circuit 52 and generates a high voltage. The handpiece 56 is provided with an infrared temperature sensor 32 in addition to the pipe 58. An inert gas and a high voltage output from the high voltage generating coil 50 are supplied to the handpiece 56, and plasma gas discharge is performed from the pipe 58 to the affected part of the living body 40, that is, the coagulation area 42. That is, spray coagulation using a gas is performed. Note that, similarly to Embodiment 1, the infrared temperature sensor 32 provided on the handpiece 56 measures the average temperature of the coagulation area 42 and outputs a temperature signal to the input processing circuit 26.

In the plasma gas discharge device having the above configuration, the control unit 10 performs the temperature display processing shown in FIG. 2 or the temperature control processing shown in FIG. 3 in order to display the temperature of the coagulation area 42 in the living body 40. Done. Therefore, the temperature of the coagulation area 42 is displayed on the display unit 14 by performing step S12 in FIG. 2, and the plasma gas discharge performed from the pipe 58 to the coagulation area 42 by performing steps S24, S26, and S28 in FIG. Size can be controlled. Therefore, according to the second embodiment, the surgical treatment can be performed at the optimum coagulation temperature in the coagulation area 42 (coagulation site). Therefore, it is possible to prevent poor coagulation (insufficient) and burns to healthy cell tissues due to an excessive rise in temperature. Therefore, the affected part can be optimally coagulated without excess or shortage. In the case of treating a malignant cell, a target temperature (generally 42 ° C. or higher) is set in advance to a temperature at which the malignant cell is killed. By doing so, it is possible to kill only the malignant cells and minimize the influence on healthy cell tissues around or deeply adjacent to the malignant cells.

[Other Embodiments] The structure, shape, size, material,
The number, arrangement, operating conditions, and the like are not limited to the above embodiment. For example, each of the following embodiments to which the above embodiment is applied may be implemented. (1) Although the present invention has been applied to the spray coagulation and plasma gas discharge devices in an electrosurgical device, the present invention is not limited to these electrosurgical devices, but also applies to other electrosurgical devices such as a laser scalpel and a microwave device. Can be applied. Even when applied to these other electrosurgical devices,
The same effects as in the above embodiment can be obtained. (2) In Embodiments 1 and 2, the present temperature is realized in the coagulation area 42 of the living body 40 on the display unit 14. Not limited to this mode, the current temperature of the solidification area 42 may be displayed on another site or device.
For example, as shown in FIG. 5, a display unit 35 may be provided on the handpiece 34, and the current temperature of the solidification area 42 may be displayed on the display unit 35.

(3) In the first and second embodiments, a mode in which one target temperature is stored in the RAM 22 in advance is realized.
A plurality of target temperatures may be stored in the RAM 22 in advance. In this case, in step S24 shown in FIG. 3, one of the stored target temperatures is referred to. As described above, as means for selecting one target temperature from among a plurality of target temperatures, the handpiece 34 is provided with a plurality of selection buttons 31 as shown in FIG. The target temperature to be referenced is the pressed selection button 3
It is determined according to 1. By doing so, the living body 4
When it is necessary to perform treatment at a plurality of temperatures depending on the affected part of 0, the affected part can be optimally coagulated without excess or deficiency only by operating the selection button 31. Note that RAM2
The plurality of target temperatures stored in 2 can be input from the input unit 16, for example. When the target temperature is empirically obtained and does not change, the target temperature may be stored in the ROM 12. (4) In the first and second embodiments, one target temperature is set to RA
Although the mode in which the target temperature is stored in the M22 is realized, the target temperature may be continuously variable and may be stored in the RAM 22. In this case, as a means for storing the target temperature in the RAM 22, as shown in FIG.
4 is provided with an adjustment knob 33, and information of the target temperature is transmitted from the adjustment knob 33 to the control unit 10. FIG. 6B shows an example of the rotary adjustment knob 33. By doing so, it is possible to perform treatment at an appropriate temperature corresponding to each affected area by the empirical knowledge of the operator,
The affected area can be optimally coagulated without excess or deficiency.

(5) In the first and second embodiments, the temperature signal output from the infrared temperature sensor 32 is transmitted by wire to the input processing circuit 26 of the control unit 10. The present invention is not limited to this mode, and the temperature signal may be transmitted wirelessly. That is, this is realized by providing a wireless transmitter together with the infrared temperature sensor 32 in the handpiece 34 and providing a wireless receiver in the control unit 10. In addition, the temperature signal is transmitted in analog form for both wired and wireless, but may be configured to be transmitted in digital form. E for digital
By adding redundant data such as CC (Error Correcting Code) to the temperature data, the influence of noise can be reduced. (6) In the second embodiment, the inert gas is helium gas (He), neon gas (Ne), argon gas (Ar), or these gases and carbon dioxide (CO ₂ ), oxygen (O ₂ ), etc. May be used. In this case, depending on the type of gas, coagulation can be promoted, and effects such as sterilization can be obtained. (7) Although the infrared temperature sensor 32 is applied as a sensor for measuring the temperature of the solidification area 42 (solidification site), another radiation thermometer may be applied. For example, thermopiles, bolometers, pyroelectric elements, photoelectric tubes, photomultipliers, PbS,
Sensors (detectors) such as Ge (Au) and InSb (PC)
There is.

[0021]

According to the present invention, the temperature of the coagulation site formed in the living body is measured by the temperature sensor, and the temperature is output to an output device (for example, an output control device or a display device). Therefore, a surgical procedure can be performed based on the current temperature of the coagulation site formed in the living body. Therefore, the temperature of the affected part undergoing the surgical procedure can be appropriately maintained, and the affected part can be appropriately coagulated without excess or shortage.

[Brief description of the drawings]

FIG. 1 is a block diagram showing a schematic configuration of an electrosurgical apparatus.

FIG. 2 is a flowchart showing a procedure of a temperature display process.

FIG. 3 is a flowchart illustrating a procedure of a temperature control process.

FIG. 4 is a block diagram showing a schematic configuration of a plasma gas discharge device.

FIG. 5 is an enlarged view showing a part of FIG. 1;

FIG. 6 is a view showing the appearance of a handpiece.

[Explanation of symbols]

 Reference Signs List 10 control unit 12 ROM 14 display unit 16 input unit 20 CPU 22 RAM 24 output processing circuit 26 input processing circuit 30 high-frequency current control circuit 32 infrared temperature sensor 34 handpiece 36 blade 40 living body 42 coagulation area 50 high voltage generating coil 52 drive circuit 54 Transmission circuit 56 Handpiece 58 Pipe

 ──────────────────────────────────────────────────続 き Continuing on the front page (72) Inventor Masayoshi Uchida 28, Kitaimaji, Seta, Onishi-shi, Aichi Pref. Inside

Claims (3)

[Claims] 1. An electrosurgical apparatus for performing a surgical treatment on a living body to coagulate an affected part thereof, comprising a temperature sensor for measuring the temperature of a coagulation site formed in the living body and outputting the temperature to an output device. An electrosurgical device, characterized in that: 2. The electrosurgical device according to claim 1, wherein the output device is an output control device for controlling an output for performing a surgical procedure or a display device for displaying a temperature. Electrosurgical device. 3. The electrosurgical device according to claim 1, wherein an infrared temperature sensor is used as the temperature sensor.