JPH10225462A - Electric operating device - Google Patents

Abstract

PROBLEM TO BE SOLVED: To obtain stable coagulating performance and hemostatic performance by detecting the state change of treatment energy to be supplied to a treating means for treating a viable tissue, installing a biological information detecting means for obtaining biological information of the viable tissue to be treated based on the detection data and controlling an output based on biological information. SOLUTION: In an electric operating device 1, a treating tool, a patient electrode 4 and a foot switch are respectively connected to a high frequency ignition power source 2 and an activating electrode 3a disposed in a mono-polar treating tool 3A as the treating tool, a current sensor 13 and a voltage sensor 14 for detecting current and a voltage between the patient electrode 4 and a feedback electrode are arranged. Respective sensor signals are inputted to CPU 9 with an A/D converter 15. CPU 9 detects voltage change or current change from an input signal, the most proper value within the change of parameters such as an initial value, MAX. and MIN. values and a change rate, etc., is adopted as an ignition end condition and the output of a high frequency signal is controlled by actuation to an output transducer 12.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an electrosurgical apparatus for performing treatment such as resection of living tissue or hemostasis using high frequency power.

[0002]

2. Description of the Related Art Generally, an electrosurgical apparatus such as an electric scalpel is used for performing a surgical operation or a medical operation such as incision of a living tissue or a treatment for coagulation and hemostasis. This electrosurgical apparatus includes a high-frequency ablation power supply (hereinafter, ablation power supply)
And a treatment tool connected to the cautery power supply. Here, the treatment tool is provided with a contact portion that comes into contact with the living tissue, and a treatment electrode is attached to the contact portion.

[0003] When the electrosurgical apparatus is used, high-frequency power (electric energy) for treatment is supplied to the treatment electrode in a state where the contact portion of the treatment tool is in contact with the treatment portion, and the living tissue is treated. It has become.

[0004]

In the above-described conventional configuration, the output setting of the high-frequency power output from the power supply for cauterization of the electrosurgical apparatus when performing a procedure such as incision of a living tissue or coagulation and hemostasis is performed. It is determined by the intuition and experience of the surgeon.
In the actual hemostasis operation in the electrosurgery, the degree of hemostasis and the coagulation quality are determined based on the output time and visual observation of the high-frequency power output from the cautery power supply. Therefore, it is difficult to optimally control the high-frequency power output from the ablation power supply, and there is a problem that it is difficult to efficiently perform ablation or coagulation / hemostatic work using the optimum high-frequency power.

[0005] Some electrosurgical devices automatically control the output of high-frequency power. However, the conditions for using electrosurgical devices differ from case to case,
A problem that the output of high-frequency power cannot be controlled with high precision because the degree of cauterization varies due to differences in the living tissue to be treated, variations in the ablation site, electrodes, and contact strength of the electrodes with the tissue. There is.

The present invention has been made in view of the above circumstances, and an object thereof is to provide an electrosurgical apparatus capable of controlling the output of treatment energy with high accuracy and obtaining stable coagulation performance and hemostasis performance. It is to provide a device.

[0007]

According to the present invention, there is provided a treatment instrument having treatment means for treating a living tissue, and energy supply means for supplying treatment energy to the treatment means,
In the electrosurgical apparatus which performs the treatment of the living tissue by supplying the treatment energy to the treatment means during the treatment of the living tissue by the treatment means, a state change of the treatment energy supplied to the treatment means is detected. An electrosurgical apparatus comprising: biological information detecting means for obtaining biological information of the living tissue to be treated based on the detection data; and output control means for controlling an output based on the biological information. is there. Then, at the time of treatment such as incision or coagulation hemostasis of the living tissue, a change in the state of the treatment energy supplied to the treatment means is detected by the living body information detecting means, and the living body information of the living tissue to be treated is obtained based on the detected data. Thus, the output is controlled based on the biological information.

[0008]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS Hereinafter, a first embodiment of the present invention will be described with reference to FIGS. FIG. 1 shows a schematic configuration of an entire system of an electrosurgical apparatus 1 according to the present embodiment. The electrosurgical apparatus 1 of the present embodiment is provided with a high-frequency ablation power supply apparatus (hereinafter, referred to as a power supply for ablation) 2. The cautery power source 2 includes a treatment instrument 3 and a patient electrode 4.
And a foot switch 5 are respectively connected. Note that the treatment tool 3 used in the electrosurgical device 1 of the present embodiment includes a monopolar treatment tool 3A shown in FIG.
There is a bipolar treatment tool 3B shown in FIG.

The ablation power supply 2 includes a power supply circuit 7 for generating various voltages through an insulating transformer (not shown) from the power supplied from the commercial power supply 6 as shown in FIG.
A waveform generating circuit 8 for generating a high-frequency output waveform signal corresponding to various treatments such as cutting or coagulation of the electric power generated by the power supply circuit 7, a control CPU (output control means) 9,
A D / A converter 10 for receiving a control signal from the CPU 9 and outputting a high-frequency signal; a high-frequency power amplifier 11 for high-frequency amplifying the signal generated by the waveform shaping circuit 8;
An output transformer (energy supply means) 12 is provided. The output port of the output transformer 12 is connected to the monopolar treatment instrument 3A and the patient electrode 4 respectively.

In the electrosurgical apparatus 1 of the present embodiment, the current between the active electrode (treatment means) 3a provided on the monopolar treatment instrument 3A and the return electrode of the patient electrode 4 is determined.
A current sensor (biological information detecting means) 13 for detecting voltage and a voltage sensor (biological information detecting means) 14 are provided. Further, the current sensor 13 and the voltage sensor 14 are connected to the A / D converter 15. This A / D converter 15 is connected to the CPU 9. The A / D converter 15 takes in the current detection data from the current sensor 13 and the voltage detection data from the voltage sensor 14, converts the data from analog to digital, and supplies it to the CPU 9.

The CPU 9 detects a voltage change or a current change based on an input signal input from the A / D converter 15 or detects at least one of the voltage change and the current change. A control function for controlling the output of the high-frequency signal is provided with the most appropriate value of the changes in the parameters as the conditions for terminating the cauterization.

The CPU 9 is connected to a display unit 16 for displaying various information related to the high frequency treatment. As shown in FIG. 6, a CUT for displaying information such as high-frequency power at the time of a living tissue excision procedure and its set value, as shown in FIG.
A display unit 16b, and a COAG display unit 16 for displaying information such as high-frequency power during coagulation treatment of a living tissue and set values thereof.
a, and an impedance display section 16c for displaying the biological information of the living tissue to be treated.

[0013] Here, 4-digit digital display elements 17a ₁ ~17a ₄ is provided to the impedance display unit 16c. Each digital display elements 17a ₁ ~17a ₄ is to digitally display the numbers 0 to 9 by 7 segment. Then, at the time of high-frequency treatment by the electrosurgical apparatus 1 of the present embodiment, the impedance is obtained by the CPU 9 from the current value and the voltage value detected by the current sensor 13 and the voltage sensor 14, and the value is sent to the display unit 16.
Displays in direct numeric digital display elements 17a ₁ ~17a ₄ The results of the four digits of the impedance display section 16c display unit 16 so as to notify the current impedance value.

FIGS. 8 to 10 show various modifications of the display unit 16 provided in the electrosurgical apparatus 1 according to the first embodiment. The impedance display section 16c of the first modification of FIG. 8 is formed by a bar graph display section. An impedance graduation 17b ₁ of numerical values showing impedance values are arranged in parallel in the vertical direction in the impedance display unit 16c, LED 17b of the rectangle respectively disposed next to each value of the impedance scale 17b _1
2 is provided. Then, if the impedance values obtained from CPU9 during high-frequency treatment is greater than the number in the bar graph display of the impedance display unit 16c to display impedance graduation 17b ₁ in the present modification,
LE of square part beside the numerical value of impedance scale 17b ₁
By D17b ₂ is turned, so as to notify the current impedance value.

Also, while the impedance display section 16c of the display section 16 of FIGS. 6 and 8 displays the absolute value of the impedance, the second modification of FIG. 9 and the third modification of FIG.
In the modified example, level display sections 17c and 17d for displaying the level of the impedance value are provided respectively. Here, the level display unit 17c of the second modification of FIG.
Digit digital display elements 17c ₁ and 17c ₂ are provided. Each of the digital display elements 17c ₁ and 17c ₂ digitally displays a number from 0 to 9 by seven segments. In the present modified example has a level of impedance to display numerically each digital display elements 17c _1, 17c _2. In this case, for example, level 1
Is displayed, the level of the impedance value predetermined by the manufacturer or the user indicating about 200Ω is displayed.

Furthermore, the third the level display portion 17d of the modification of the level scale 17d ₁ of numerical values are juxtaposed in the vertical direction to indicate the level of the impedance, next to each value of the impedance scale 17d ₁ of FIG. 10 and LED17d ₂ square respectively disposed is provided. By LED 17b ₂ of the rectangular portion of the side of the numerical level scale 17d ₁ during high-frequency treatment and the corresponding impedance values obtained from CPU9 is turned in this modified example, to announce the current level of impedance values Has become.

The following technique is another display method. For example, each digital display elements 17a ₁ to 17 in FIG. 6, if the manufacturer is within a predetermined set impedance value
a ₄ and each digital display elements 17c _1, 17c in FIG. 9
And ₂ of 7 segments, each LED17d ₂ emits light in the green of each LED 17b ₂ and 10 in FIG. 8, may be configured to change the light emission color to red when exceeding the set impedance value. Furthermore, the or 7 segments each digital display elements 17c _1, 17c ₂ of the digital display elements 17a ₁ ~17a ₄ and 9 of Figure 6, if within the predetermined setting impedance value of each LED 17b ₂ and 10 in FIG. 8 each LED17d ₂ lights, may be performed discoloration such as these flashes when exceeding the set impedance value.

Next, the operation of the above configuration will be described.
When performing treatment such as coagulation and hemostasis of living tissue using the electrosurgical apparatus 1 of the present embodiment, high-frequency power is supplied from the cautery power supply 2 to the active electrode 3a of the monopolar treatment instrument 3A, and coagulation and hemostasis of the living tissue is performed. Are performed. During this treatment, as shown in FIGS. 3 and 4, the supply of high-frequency power is started, and from the treatment start time T ₀ at which the coagulation of the living tissue is started, as the coagulation (carbonization) of the living tissue progresses, the voltage sensor 14 is increased. The voltage detection data from the current sensor 13 changes as shown in FIG. 3, and the current detection data from the current sensor 13 changes as shown in FIG.

[0019] That is, the voltage detection data from the voltage sensor 14 gradually increases as time passes from the treatment start time T _0. And coagulation (carbonization) of living tissue
Approaching the end, the rate of increase of the voltage gradually decreases. The current detection data from the current sensor 13 gradually decreases over time from the treatment start time T _0. Then, as the coagulation (carbonization) of the living tissue approaches the end, the rate of decrease in the current gradually decreases.

When a living tissue is treated, the voltage change rate (.DELTA.V / .DELTA.T) and current change rate (.DELTA.I / .DELTA.T) based on an input signal inputted from the A / D converter 15 by the CPU 9.
T) are respectively detected.

At this time, ΔV = Δy = y (T ₂ ) −y (T ₁ ). The voltage change rate ΔV / ΔT is ΔV / ΔT = y (T ₂ ) −y (T ₁ ) / T ₂ −T ₁ .

The voltage change rate (ΔV /
ΔT) when a state where the rate of change is below a certain rate of change is detected, or when a state where the voltage detection data is out of the range of y _MAX and y _MIN is detected, or y _{| N | When} a state outside the range of _MAX , _yMIN is detected, a control signal for stopping cauterization or automatically lowering the output is output. Also, the current change rate (ΔI / Δ
T) When a state where a rate of change below a certain rate of change is detected, or when a state where current detection data is out of the range of y _MAX and y _MIN is detected, or y _{| N |
When} a state outside the range of _MAX , _yMIN is detected, a control signal for stopping cauterization or automatically lowering the output is output.

The monopolar treatment device 3 of the present embodiment
A may be used in combination with an endoscope 18a as shown in FIG. The endoscope 18a is provided with an insertion portion 18b to be inserted into the body of a patient, and an operation portion 18c on the proximal side connected to a base end of the insertion portion 18b.

Further, the operation section 18c is provided with an entrance for the insertion channel 18d of the treatment instrument. The outlet of the insertion channel 18d is arranged at the tip of the insertion portion 18b. After the monopolar treatment tool 3A is inserted from the entrance of the insertion channel 18d, it passes through the insertion channel 18d, protrudes from the outlet of the insertion channel 18d, and is guided to the treatment target tissue in the patient's body. .

Therefore, the above configuration has the following effects. That is, the voltage change rate (ΔV / ΔT) and the current change rate (ΔI /
By detecting ΔT), the CPU 9 obtains the biological information of the living tissue to be treated, and based on the detected data, the initial value and the most appropriate value among the changes in the parameters such as the MAX, MIN value and the change rate. Is set as the condition for terminating the cauterization, the output of the high-frequency signal is controlled, so that the output of the high-frequency power can be controlled with high accuracy, and stable coagulation performance and hemostasis performance can be obtained. Therefore, stable cauterization of a certain quality can be performed in accordance with the variation of the treatment conditions such as the active electrode 3a of the monopolar treatment instrument 3A and the human body.

Further, since excessive carbonization of the living tissue and short-circuit of the electrodes of the monopolar treatment device 3A can be detected and prevented, wasteful output from the active electrode 3a of the monopolar treatment device 3A can be prevented. be able to.

Further, based on the current detection data from the current sensor 13 and the voltage detection data from the voltage sensor 14, the active electrode 3a of the monopolar treatment instrument 3A and the patient electrode 4
5 to detect the initial impedance, the rate of change of the impedance, and the upper and lower limits of the impedance, as shown in FIG. The output may be automatically and semi-automatically controlled using the most appropriate value of the parameter change as the condition for terminating cauterization.

The ablation power source 2 of the electrosurgical apparatus 1 is provided with a switch for selectively switching between high-frequency output control to an automatic control mode and a manual mode, and controls the high-frequency output to an automatic control mode and a manual mode. Alternatively, a configuration in which the switching can be selectively performed may be adopted.

Further, the display section 16 of the present embodiment is not limited to the electrosurgical apparatus 1 of the present embodiment, but can be applied to the electrosurgical apparatus 1 of another embodiment.

FIGS. 11A and 11B and FIG.
Shows a second embodiment of the present invention. In this embodiment, an electrosurgical device 21 having a coagulation mode using a heating element is provided as an electrosurgical device.

That is, the electric scalpel device 2 of the present embodiment
As shown in FIG. 11 (A), a selection button 22 is provided in the apparatus 1 for selectively switching between an incision mode and a coagulation mode. The selection button 22 includes a CUT button 23 for an incision mode for treating a living tissue with a high-frequency output;
A coagulation mode COAG button 24 for treating living tissue with an output from the heating element is provided.

Further, as shown in FIG. 11 (B), a coagulation treatment means using a heating element 26 such as a nichrome wire is provided at the distal end of the treatment tool 25 connected to the electric knife device 21 of the present embodiment. ing. Further, the treatment tool 25 has a heating element 26 near the heating element 26 at the time of coagulation of living tissue.
And a temperature sensor 27 for detecting one or both temperatures of the living tissue.

FIG. 12 shows the inside of the electric scalpel device 21.
As shown in the figure, an output circuit 28 of the heating element 26 and a CPU 29 for controlling the output circuit 28 are provided. The temperature sensor 27 is connected to the CPU 29. The CPU 29 analyzes the temperature detected by the temperature sensor 27 or a change in temperature, determines the optimum value of the coagulation output, and controls the output circuit 28 of the heating element 26.

Next, the operation of the above configuration will be described.
When using the electrosurgical unit 21 of the present embodiment, the CUT button 23 or the CUT button 23 of the selection button 22 of the electrosurgical unit 21 is used.
One of the OAG buttons 24 is operated. When the incision mode CUT button 23 is selected and operated, the living tissue H is treated by the high-frequency output.

The COAG button 24 for the coagulation mode
Is selected, the living tissue H is treated by the output of the heating element 26 of the treatment tool 25. At this time,
The heating element 26 and the living tissue H are detected by the temperature sensor 27.
By detecting one or both temperatures, information such as the temperature of the living tissue H is detected.

Further, temperature data detected by the temperature sensor 27 is input to the CPU 29. At this time, the CPU 29
Then, the temperature detected by the temperature sensor 27 or a change in the temperature is analyzed, and the optimum value of the coagulation output is determined to control the output circuit 28 of the heating element 26.

Therefore, the above configuration has the following effects. That is, the electric scalpel device 21 is provided with a selection button 22 for selectively switching between the incision mode and the coagulation mode, and when the COAG button 24 for the coagulation mode is selected and operated, the CPU 29 of the electric scalpel device 21 uses the temperature sensor 27 to detect the temperature. Analyze the detected temperature or temperature change, etc.
Determine the optimum value of coagulation output and output circuit 2 of heating element 26
8, the information such as the temperature of the living tissue H can be easily detected. Therefore, compared to the case where the coagulation of the living tissue H is performed by a high-frequency output, there is less concern about noise, burns, and the like, and the temperature detection is technically easy and the price is low.

Furthermore, since the state of the living tissue H is detected in real time and the coagulation output is controlled to an optimum value, the coagulation treatment of the living tissue H can be performed uniformly, and there is no problem such as carbonization. Also, there is no wasteful output.

FIGS. 13 and 14 show a third embodiment of the present invention.
1 shows an embodiment of the present invention. In this embodiment, FIG.
As shown in FIG. 3, one of the two electrodes 32, 33 of the bipolar treatment instrument 31 for treating the living tissue H while holding the living tissue H is caused to detect an acoustic reflected wave and a means for acoustic reflection such as a transducer. Means (not necessarily integral) 34 are provided. The means 34 detects the state in the living tissue H (whether the protein is denatured or the like) by using an ultrasonic transducer or the like.

As shown in FIG. 14, the electric scalpel device to which the bipolar treatment tool 31 is connected has an output circuit 35 for the two electrodes 32 and 33 of the bipolar treatment tool 31, and a CPU 36 for controlling the output circuit 35. Is provided.
Further, an acoustic wave transmitter 34a and an acoustic reflected wave receiver 34b are connected to the CPU 36, and an imaging means 37 is connected to the CPU 36. Then, the CPU 36 detects the state of the living tissue based on the information obtained from the acoustic reflected wave receiver 34b, and determines an optimal output value of the incision / coagulation based on the detected information.
5 is controlled. The data detected by the CPU 36 is imaged by the imaging means 37 as necessary.

Therefore, in the above-mentioned configuration, the acoustic reflected wave receiver 34 is used during a procedure such as incision / coagulation of the living tissue H.
b, the state of the living tissue is detected in real time by the CPU 36 based on the detection data from the acoustic reflected wave receiver 3.
Since output control is performed with the optimal output value of the incision / coagulation based on the information obtained from 4b, the treatment of the incision / coagulation can be performed uniformly. Therefore, as in the bipolar mode of a conventional high-frequency ablation power supply device (hereinafter referred to as an electric scalpel), due to the type of the electrode and the impedance change of the living tissue, the incision / coagulation state fluctuates and the cutting method becomes uneven, There is no danger of sharpness. Further, it is possible to prevent a problem that the output is too strong and carbonization occurs locally in a part of the living tissue. In addition, it is possible to simplify the operation, shorten the operation time, and save power.

FIG. 15 shows a fourth embodiment of the present invention. The electrocautery device 41 of the present embodiment includes a high-frequency power generator 42 and an output transformer 43, and includes an impedance detection unit 44, an impedance detection signal processing unit 45, and a main control unit 46. Have been.

Here, the impedance detecting section 44 is a circuit for detecting the impedance of the living tissue between the pair of electrodes of the bipolar treatment instrument 47 connected to the output port of the output transformer 43. Further, the impedance detection signal processing unit 45 is a circuit that processes the signal detected by the impedance detection unit 44. The main control unit 46 is a circuit that controls the entire electric scalpel device 41. The main control unit 46 automatically controls the energization / disconnection of the high-frequency power based on the signal output from the impedance detection signal processing unit 45.

Next, the operation of the above configuration will be described.
When performing a treatment such as coagulation and hemostasis of a living tissue using the electrosurgical device 41 of the present embodiment, one of the bipolar treatment tools 47 is used.
The impedance | z | of the living tissue between the pair of electrodes is detected by the impedance detection unit 44. At this time, the potential at the point (a) of the impedance detecting unit 44 changes according to the detected value of the impedance | z |, and this potential is compared with a reference value (V _ref ) to start high-frequency energization. And automatic control of stop is performed.

With the above configuration, (1) when the load | z | is low, such as before the start of cauterization, the output signal of the impedance detection signal processing unit 45 becomes “H”, and energization is started. (2) After the cauterization is started, if the load | z | is high, the output signal of the impedance detection signal processing unit 45 becomes “L”,
The energization is stopped. The control may be performed by directly converting the potential at the point (a) into a digital signal.

Therefore, in the above configuration, the load |
Since the energization / interruption of the high-frequency power can be automatically controlled while monitoring the state of z |, a safe and reliable treatment can be performed regardless of the visibility of the treatment site. Therefore, when performing treatment using an electric scalpel in a bipolar mode for a minute part, the visibility of the cauterized part is deteriorated by the influence of a treatment tool or the like because the target part is mainly in a minute range. Even if there is, there is no risk of over-cauterization of the treatment site.

FIGS. 16A and 16B show a fifth embodiment of the present invention. As shown in FIG. 16A, a high-frequency power generator 52 and an output transformer 53 are provided in the electric scalpel device 51 of the present embodiment.
The output port of the output transformer 53 is connected to a pair of electrodes of the bipolar treatment instrument 54.

Further, an ultrasonic transducer 55 is built in a pair of electrodes of the bipolar treatment tool 54 of the present embodiment. The ultrasonic transducer 55 is driven by a control circuit 56 shown in FIG.

The control circuit 56 includes a driving section 57 for ultrasonically oscillating the transducer 55, an amplitude detection section 58 for detecting the amplitude of the ultrasonic vibration, and a signal processing for amplifying and processing the amplitude detection signal. A section 59 and a main control section 60 for controlling the entire apparatus are provided. The main controller 60 automatically controls the energization / interruption of the high-frequency output according to the acoustic impedance of the living tissue during the cauterization process.

Next, the operation of the above configuration will be described.
When performing treatment such as coagulation and hemostasis of a living tissue using the electrosurgical device 51 of the present embodiment, one of the bipolar treatment tools 54 is used.
As the living tissue is cauterized between the pair of electrodes, the cauterized portion hardens, and the acoustic impedance increases. On the other hand, immediately before the start of cauterization, the acoustic impedance of the living tissue is low. Therefore, the acoustic impedance is detected based on the amplitude of the ultrasonic wave from the ultrasonic vibrator 55, and is compared with a threshold value, thereby automatically controlling the energization / interruption of the high-frequency power.

Therefore, in the above configuration, the energization / interruption of the high-frequency power can be automatically controlled while acoustically monitoring the state of the cauterized tissue, so that it is safe and reliable regardless of the visibility of the treatment site. Measures can be implemented. Therefore, when performing treatment using an electric scalpel in bipolar mode for a micro site, because the target site is mainly a micro range,
Even when the visibility of the cauterized site is deteriorated due to the influence of the treatment tool or the like, there is no risk of overcauterization of the treated site.

FIGS. 17 and 18 (A) and (B)
Shows a sixth embodiment of the present invention. The electric scalpel device 71 of the present embodiment includes a high-frequency power generator 72.
And a variable power supply 73 that supplies DC power to the high-frequency power in order to generate high-frequency power according to the set value, a power meter 74 that monitors the actual output power, and an output voltage of the variable power supply 73 and the high-frequency power. A non-volatile memory 75 in which function data is stored in advance, and a main control unit 76 are provided. During treatment of the living tissue, the output power is stabilized irrespective of the load | z | by monitoring the actual output power with the wattmeter 74 and changing the voltage value of the variable power supply 73 in accordance with the function data of the nonvolatile memory 75. It is controlled to keep it. FIG. 18A is a characteristic diagram showing a relationship between a variable power supply output voltage and output power according to the present embodiment, and FIG. 18B is a characteristic diagram showing a relationship between a change in bioimpedance and an actual output. .

Next, the operation of the above configuration will be described.
When a treatment such as coagulation and hemostasis of a living tissue is performed using the electrocautery device 71 of the present embodiment, the power actually output by the wattmeter 74 is detected, and this signal is output by the A / D converter 77. After being converted into a digital signal, it is taken into the main control unit 76.

Further, the main controller 76 compares the actual output power with the initial set value and corrects the voltage value of the variable power supply 73 according to the function data of the nonvolatile memory 75 so that the actual output power approaches the set value. Such data is sent to the D / A converter 78.

Therefore, in the present embodiment, stable high-frequency power can always be supplied at a set value irrespective of the load impedance, so that stable basic performance (incision ability, coagulation ability) can be obtained regardless of the application and the target part. Can demonstrate. Further, the quality of coagulation can be detected from the difference between the set output and the actual output, and the output can be automatically stopped.

FIGS. 19 to 21 show a seventh embodiment of the present invention. In the present embodiment, FIG.
An infrared sensor 85 for measuring the temperature of the living tissue H at the treatment site is provided on one of a pair of electrodes 83 and 84 of the bipolar treatment instrument 82 shown in FIG. I have.

Further, the high-frequency ablation power supply 81 has a display unit 8 provided with a metamorphosis end LED 86 for displaying the degree of metamorphosis of the living tissue H based on the detection signal from the infrared sensor 85.
7 are provided. The display unit 87 is connected to a control circuit 89 that controls an output circuit 88 of the high-frequency ablation power supply device 81. Further, an infrared sensor 85 is connected to the control circuit 89.

Next, the operation of the above configuration will be described.
When a treatment such as coagulation and hemostasis of living tissue H is performed using the high-frequency ablation power supply device 81 of the present embodiment, a detection signal of the infrared sensor 85 of the bipolar treatment tool 82 is input to the control circuit 89 of the high-frequency ablation power supply device 81. Then, the temperature of the living tissue H is calculated. When the temperature reaches the set temperature, the shift end LED 86 is turned on.

[0059] However, measurement by the infrared sensor 85 to the high-frequency power sleep period T _A in controlling the output circuit 88 by the control circuit 89 as shown in FIG. 21 is performed. Further, the infrared sensor 85 may be a thermocouple.

Therefore, in the above configuration, when performing treatment such as coagulation and hemostasis of the living tissue H, the illuminated state of the denaturation end LED 86 of the high-frequency ablation power supply device 81 is checked, so that the treatment site is directly visually observed. The degree of denaturation of the living tissue H can be easily known without performing.

FIGS. 22 to 24 show an eighth embodiment of the present invention. FIG. 22 shows a schematic configuration of the entire system of the electrosurgical apparatus 91 according to the present embodiment. An electrosurgical power supply 92 is provided in the electrosurgical apparatus 91 of the present embodiment. A monopolar treatment instrument 93 and a patient electrode 94 are connected to output connectors 92a and 92b of the cautery power supply 92, respectively.

The ablation power supply 92 includes a power supply circuit 95 that generates various voltages from power supplied from a commercial power supply (not shown) through an insulating transformer (not shown), and a power supply circuit 9.
A waveform generating circuit 96 for generating a high-frequency output waveform signal corresponding to various treatments such as incision or coagulation of the electric power generated in step 5, a control circuit 97 for control, and an output transformer 98 are provided. The output port of the output transformer 98 is connected to a monopolar treatment instrument 93 and a patient electrode 94 via output connectors 92a and 92b, respectively.

In the electrosurgical apparatus 91 of the present embodiment, the current and voltage between the active electrode (treatment electrode) 93a provided on the monopolar treatment instrument 93 and the return electrode of the patient electrode 94 are controlled. A current detection unit 99 and a voltage detection unit 100 for detection are provided. Here, the voltage detection unit 100 is formed by a winding provided on the primary side of the output transformer 98 for measuring a voltage.

Further, the current detecting section 99 and the voltage detecting section 100 are connected to the impedance detecting circuit 101. The impedance detection circuit 101 is provided with a control circuit 97
It is connected to the. And the impedance detection circuit 1
At 01, the current detection data from the current detection unit 99 and the voltage detection data from the voltage detection unit 100 are fetched, and the active electrode 93a of the monopolar treatment instrument 93 and the patient electrode 94 are taken.
And the impedance of the living tissue between the return electrode and the return electrode.

The impedance detection signal output from the impedance detection circuit 101 is input to the control circuit 97. The control circuit 97 includes a power supply circuit 95 and a waveform generation circuit 9 based on an impedance detection signal input from the impedance detection circuit 101.
6, a control function is provided for stopping the output of the high frequency signal when the fluctuation range of the impedance exceeds a certain value. The control function of the control circuit 97 may be configured to reduce the output of the high-frequency signal when the fluctuation range of the impedance exceeds a certain value.

Next, the operation of the above configuration will be described.
When performing treatment such as coagulation and hemostasis of a living tissue using the electrosurgical apparatus 91 of the present embodiment, high-frequency power is supplied from the cautery power supply 92 to the active electrode 93a of the monopolar treatment tool 93, and coagulation and hemostasis of the living tissue are performed. Etc. are performed.

FIG. 23 shows a general change state of the impedance of the living tissue at the time of the high frequency ablation treatment. Here, from the treatment start time T ₀ the supply of high frequency power is started, to the time T ₁ that protein denaturation of the living tissue (coagulation) is initiated impedance of the living tissue is held constant normal state.

The impedance of the living tissue gradually increases from the time T ₁ at which the protein denaturation of the living tissue is started. Further, as protein denaturation progresses, carbonization of living tissue starts. The start time T ₂ subsequent carbonization varies extremely impedance of the living tissue, an increase in impedance, decreases and is repeated.

In the electrosurgical apparatus 91 of the present embodiment, the operation shown in the flowchart of FIG. That is, in step S1, the minimum value Z of the impedance of the living tissue after the start of the high-frequency cauterization treatment
min is set, and the number of measurements n is set to 0.

Further, in step S2, the measured value Z of the impedance is detected. Subsequently, in step S3, the number of times n of impedance measurement is calculated as 1. In step S4, the measured impedance Z of step S2 is compared with the minimum impedance Zmin. Here, if Z <Zmin, the measured value Z of the impedance in step S2 is replaced with Zmin in the next step S5.

If Z <Zmin is not satisfied, or if the value of Z is replaced with Zmin in step S5, it is determined in next step S6 whether or not the number n of impedance measurements is 10 or more. Here, in cases other than n ≧ 10, the operations of steps S2 to S6 are repeated.

If it is determined in step S6 that n.gtoreq.10, the measured value Z of the impedance is detected in the next step S7. Subsequently, in step S8, the measured value Z of the impedance in step S7 is compared with the minimum value Zmin of the impedance. Here, if Z <Zmin, in the next step S9, the measured value Z of the impedance in step S7 is replaced with Zmin.

If Z <Zmin is not satisfied, or if the measured impedance Z in step S7 is replaced with Zmin in step S9, the process proceeds to step S10.
And the function f (Zmin) of the minimum value of the impedance Zmin
To calculate the reference value ΔZre of the impedance variation range ΔZ.
f is set.

Further, in the next step S11, the past 10
The maximum value Zmax (1
0) is selected, and in step S12, the lowest value Zmin (10) of the ten measured impedance values Z in the past is selected.

In the next step S13, the fluctuation width ΔZ of the measured value Z of the impedance in the past 10 times is Zmax (10)
−Zmin Calculated from (10). Then, step S14
Then, ΔZ and ΔZref are compared, and if ΔZ> ΔZref is not satisfied, the operations of steps S7 to S14 are repeated.

If it is determined in step S14 that ΔZ> ΔZref, the supply of high frequency power is stopped. Here, instead of stopping the supply of the high-frequency power, control for reducing the output of the high-frequency power may be performed.

Therefore, the above configuration has the following effects. That is, the electrosurgical device 9 according to the present embodiment
In 1, when performing a treatment such as coagulation and hemostasis of a living tissue, the current detection data from the current detection unit 99 and the voltage detection unit 100
Voltage detection data from the impedance detection circuit 101
The impedance detection circuit 101 detects the impedance of the living tissue between the active electrode 93a of the monopolar treatment instrument 93 and the return electrode of the patient electrode 94, and outputs the impedance output from the impedance detection circuit 101. The power supply circuit 95 and the waveform generation circuit 96 are controlled by the control circuit 97 based on the detection signal so that the variation width ΔZ of the impedance becomes a constant value ΔZref.
In this case, the output of the high-frequency signal is stopped when the frequency exceeds the limit, so that the output of the high-frequency power can be controlled with high accuracy, and carbonization of the living tissue during the high-frequency ablation treatment can be minimized.

Further, in this embodiment, the output transformer 9
The voltage detection unit 100 is formed by windings for measuring the voltage provided on the primary side of the monopolar treatment instrument 9.
There is no need to provide a measuring means for measuring the voltage in the patient circuit, such as 3 or the feedback electrode of the patient electrode 94. for that reason,
The structure of the entire electrosurgical apparatus 91 is simple.

In this embodiment, the impedance of the living tissue is detected by the impedance detection circuit 101, and when the variation width ΔZ of the impedance exceeds a certain value ΔZref, the control for stopping the output of the high-frequency signal is performed. Although the configuration has been described, a configuration may be employed in which the same high-frequency signal output control is performed using only one of the current detection data from the current detection unit 99 and the voltage detection data from the voltage detection unit 100.

FIGS. 25 to 28 show a ninth embodiment of the present invention. FIG. 25 shows a schematic configuration of the entire system of the electrosurgical apparatus 111 according to the present embodiment. An electrosurgical power supply 112 is provided in the electrosurgical apparatus 111 of the present embodiment. This cautery power supply 11
A monopolar treatment instrument 113 and a patient electrode 114 are connected to the second output connectors 112a and 112b, respectively.

The ablation power supply 112 includes a power supply circuit 115 for generating power from a commercial power supply (not shown) through an insulating transformer (not shown) to generate various voltages, and an electric power generated by the power supply circuit 115. Alternatively, a waveform generating circuit 116 for generating a high-frequency output waveform signal corresponding to various treatments such as coagulation, a control circuit 117 for control, and an output transformer 118 are provided. The output ports of the output transformer 118 have output connectors 112a and 112a.
monopolar treatment instrument 113 and patient electrode 1 through b
14 are respectively connected.

Further, the electrosurgical device 111 of the present embodiment
The active electrode (treatment electrode) 113a provided on the monopolar treatment instrument 113 on the secondary side of the output transformer 118
And a voltage detection unit 119 and a current detection unit 120 for detecting the voltage and current between the patient electrode 114 and the feedback electrode.

Further, the voltage detecting section 119 and the current detecting section 120 are connected to the phase difference detecting circuit 121. The phase difference detection circuit 121 is connected to the control circuit 117. In the phase difference detection circuit 121, the voltage detection unit 1
The phase difference between the output voltage and the output current is detected by taking in the voltage detection data from the current detector 19 and the current detection data from the current detector 120.

The phase difference detection signal output from the phase difference detection circuit 121 is input to the control circuit 117. The control circuit 117 includes a phase difference detection circuit 1
Power supply circuit 1 based on the phase difference detection signal
15 and the waveform generation circuit 116, and when the value of the phase difference is out of a predetermined range, or when the rate of change of the phase difference exceeds a predetermined value, or when the variation width of the phase difference is a predetermined value, A control function is provided for stopping the output of the high-frequency signal when the frequency exceeds the limit. The control function of the control circuit 117 is performed when the value of the phase difference is out of the predetermined range, or when the rate of change of the phase difference exceeds the predetermined value, or when the fluctuation width of the phase difference exceeds the predetermined value. A configuration may be adopted in which the output of the high-frequency signal is reduced when the output exceeds the threshold.

Further, the electrosurgical apparatus 11 of the present embodiment
1 is provided with a power detection circuit 122 for measuring the voltage, current, and power supplied to the primary side of the output transformer 118. The power detection circuit 122 is connected to the control circuit 117. When the power detected by the power detection circuit 122 is lower than the set value, the control circuit 117 increases the voltage of the power supply circuit 115 or changes the waveform signal of the high-frequency output from the waveform generation circuit 116. A control function for controlling is provided.

Next, the operation of the above configuration will be described.
When performing treatment such as coagulation and hemostasis of living tissue using the electrosurgical device 111 of the present embodiment, high-frequency power is supplied from the cautery power supply 112 to the active electrode 113a of the monopolar treatment instrument 113, and coagulation and hemostasis of the living tissue are performed. Etc. are performed.

FIG. 26 shows how the phase difference between the output voltage and the output current changes during the high-frequency ablation procedure. Here, from the treatment start time T ₀ at which the supply of the high-frequency power is started, a time T ₁ at which the protein denaturation (coagulation) of the living tissue is started.
Until the normal state, the phase difference between the output voltage and the output current is constant.

The phase difference between the output voltage and the output current gradually changes from the time T ₁ at which the protein denaturation of the living tissue is started. Further, as protein denaturation progresses, carbonization of living tissue starts. This variation of the phase difference at the start T ₂ thereafter the output voltage of the hydrocarbon and the output current is extremely varied, an increase in phase difference, reduction and is repeated.

Also, the electrosurgical device 111 according to the present embodiment
Then, the operation shown in the flowcharts of FIGS. 27 and 28 is performed at the time of the high frequency cauterization treatment. That is, in step S1, the maximum value θmax and the minimum value θmin of the phase difference between the output voltage and the output current after the start of the high-frequency cauterization treatment are set, and the number of measurements n is set to zero.

Further, in step S2, the measured value θ of the phase difference is detected. Subsequently, in step S3, the number n of phase difference measurements is calculated as 1. In step S4, the measured value θ of the phase difference in step S2 is compared with the minimum value θmin. Here, if θ <θmin, the next step S
In step 5, the measured value θ of the phase difference in step S2 is replaced with θmin.

If θ <θmin is not satisfied, or if the value of θ is replaced with θmin in step S5, the measured value θ of the phase difference in step S2 is compared with the maximum value θmax in the next step S6. You. Here, if θ> θmax, the measured value θ of the phase difference in step S2 is replaced with θmax in the next step S7.

If θ> θmax is not satisfied, or if the value of θ is replaced with θmax in step S7, it is determined in next step S8 whether the number n of phase difference measurements is 10 or more. Here, in cases other than n ≧ 10, the operations of steps S2 to S8 are repeated.

If it is determined in step S8 that n ≧ 10, the second operation of steps S2 to S8 is performed. In step S8 of the second operation, n ≧ 1
If it is determined to be 0, the function F (θmax, θmin) of the maximum value θmax and the minimum value θmin of the phase difference is determined in the next step S9.
) Is calculated to set the reference value Δθref of the variation width Δθ of the phase difference shown in FIG.

Further, in the next step S10, the past 10
The maximum value θmax (10) of the phase difference measurement values θ is selected, and the minimum value θmin (10) of the past ten phase difference measurement values θ is selected in step S11.

In the next step S12, the fluctuation width Δθ of the measured values of the phase difference θ in the past ten times is θmax (10) −θmin
It is calculated from (10). Subsequently, in the next step S13, the measured value θ of the phase difference is set to a maximum value H (θmin, θmax) and a minimum value G (θmin, θma) of a predetermined set range R.
x) is determined. here,
When it is determined that the measured value θ of the phase difference is out of the setting range R, the supply of the high-frequency power is stopped. Here, instead of stopping the supply of the high-frequency power, control for reducing the output of the high-frequency power may be performed.

In step S13, G (θmin, θ
max) <θ <H (θmin, θmax), the next step S14 is performed. This step S14
Then, Δθ and Δθref are compared. And Δθ <Δ
The state of θref, that is, the variation width Δθ of the phase difference is the reference value Δ
When it is determined that it is smaller than θref, the operations of the second step S2 to step S8 are performed, and the operations of step S9 to step S14 are repeated.

In step S14, the state other than Δθ <Δθref, that is, the variation width Δθ of the phase difference is changed to the reference value Δθre
If it is determined to be larger than f, the supply of the high-frequency power is stopped. Here, instead of stopping the supply of the high-frequency power, control for reducing the output of the high-frequency power may be performed.

Therefore, the above configuration has the following effects. That is, the electrosurgical apparatus 1 according to the present embodiment
In step 11, when performing treatment such as coagulation and hemostasis of a living tissue, the voltage detection data from the voltage detection unit 119 and the current detection unit 1
20 is input to the phase difference detection circuit 121, the phase difference detection circuit 121 detects the phase difference between the output voltage and the output current, and outputs the phase difference detection signal output from the phase difference detection circuit 121. The power supply circuit 115 and the waveform generation circuit 1
16 when the value of the phase difference is out of a predetermined range, or when the rate of change of the phase difference exceeds a predetermined value, or when the fluctuation width of the phase difference exceeds a predetermined value. Since the output of the high-frequency signal is stopped, the output of the high-frequency power can be controlled with high precision, and carbonization of the living tissue during the high-frequency ablation treatment can be minimized.

Further, the electrosurgical apparatus 11 of the present embodiment
1 is provided with a power detection circuit 122 for measuring the voltage, current, and power supplied to the primary side of the output transformer 118,
When the power detected by the power detection circuit 122 is lower than the set value, the control circuit controls the control function to increase the voltage of the power supply circuit 115 or change the waveform signal of the high frequency output from the waveform generation circuit 116. 117, the signal transmission means for transmitting the measurement signal between the patient circuit and the secondary circuit of the output transformer 118 as in the case where the measurement means for measuring the voltage, current and power is provided on the patient circuit side. No need to provide. Therefore, the voltage, current,
The structure of the entire apparatus can be simplified as compared with the case where a measuring unit for measuring electric power is provided.

It should be noted that the present invention is not limited to the above-described embodiment, and it goes without saying that various modifications can be made without departing from the spirit of the present invention. Next, other characteristic technical matters of the present application will be additionally described as follows. (Additional Item 1) In an electrosurgical apparatus having a means for measuring a current or a voltage or both between an active electrode and a return electrode, a voltage change or a current change is detected or at least one of them is detected, and an initial value is determined. , MAX, M
An electrosurgical apparatus characterized in that the output is controlled automatically and semi-automatically by using the most appropriate value of the parameter changes such as the IN value and the rate of change as a condition for terminating cauterization.

(Additional Item 2) The surgical apparatus according to Additional Item 1, wherein output control can be manually selected.

(Conventional Techniques of Supplementary Items 1 and 2) The hemostasis in electrosurgery is determined by the output setting of an electric scalpel and the degree of hemostasis by the output time and visual observation based on the feeling and experience of the conventional operator.
The solidification grade was being judged. In some devices, the output is automatically controlled, but the strength of the ablation site, the electrode, and the contact of the electrode with the tissue varies, which is of little use because the degree of ablation varies. Did not.

(Purposes of Additional Items 1 and 2) Provide stable coagulation performance and hemostasis performance.

(Appendix 3) An electrosurgical apparatus having an impedance detection circuit between an active electrode and a return electrode has an initial impedance, a rate of change of impedance, and upper and lower limits of impedance. An electrosurgical apparatus characterized in that the output is controlled automatically and semi-automatically by using the most appropriate value of the changes in the ablation as a condition for ending cauterization.

(Additional Item 4) The surgical apparatus according to additional item 3, wherein output control can be manually selected.

(Conventional Techniques in Supplementary Notes 3 and 4) In the case of hemostasis in electric surgery, the degree of hemostasis was determined by the output setting of the electric scalpel and the output time and visual observation according to the feeling of the conventional surgeon. In some devices, the output is automatically controlled, but the ablation site, electrodes, and variations in the strength of contact of the electrodes with the tissue are of little use because the degree of ablation varies. It was a situation.

(Purpose of Additional Items 3 and 4) Provide stable coagulation performance and hemostasis performance.

(Appendix 5) Means for coagulation treatment using a heating element, means for detecting the temperature of one or both of the heating element and the living tissue at the time of coagulation, and analyzing the temperature or temperature change by the temperature detection, An electric scalpel provided with means for determining and determining an optimum value of coagulation output and an output mechanism for outputting an output indicated by the optimum value.

(Prior Art of Appendix 5) In the coagulation mode of the conventional high-frequency ablation power supply device, coagulation is performed by high-frequency output. However, high-frequency treatment has problems in that it generates noise, may cause unintended burns, and requires sufficient knowledge and consideration for handling. In addition, it is difficult to grasp the state of the electrode and the tissue in real time by the discharge phenomenon due to the high frequency.

(Purpose of Supplementary Item 5) A coagulation mode using a heating element is provided. Means for detecting the state of the living tissue in real time and performing output control is provided.

(Appendix 6) A bipolar mode is provided.
A means for acoustically reflecting the living tissue, a means for detecting a state of the living tissue based on information obtained from the acoustic reflection, a means for determining and controlling an output value of incision / coagulation based on the information, An electric scalpel provided with an output mechanism for performing an output indicated by an optimum value.

(Prior Art in Appendix 6) In the bipolar mode of the conventional high-frequency ablation power supply (hereinafter referred to as an electric scalpel), depending on the type of electrode, impedance change of the living tissue, and the like,
The state of incision / coagulation fluctuates. For this reason, there has been a problem that the cutting method is not uniform, and the output is too strong and carbonization occurs locally.

(Purpose of Supplementary Item 6) The state of a living tissue is detected in real time and output control is performed.

(Appendix 7) In the electrocautery device,
(1) an impedance detection unit for detecting a tissue impedance between electrodes, (2) an impedance detection signal processing unit for processing a signal detected by the impedance detection unit,
(3) a main control unit for controlling the entire electrocautery device, wherein the main control unit automatically controls energization / cutoff of high-frequency power based on a signal output from the impedance detection signal processing unit. Electric scalpel device.

(Appendix 8) In the electrocautery device,
(1) an ultrasonic vibrator built in the electrode; (2) a drive unit for ultrasonically vibrating the vibrator; (3) an amplitude detecting unit for detecting the amplitude of the ultrasonic vibration; and (4) an amplitude detecting signal. A signal processing unit for performing amplification and processing, and (5) a main control unit for controlling the entire apparatus, which automatically controls the energization / interruption of the high-frequency output according to the acoustic impedance of the tissue accompanying the ablation process. It is characterized by having done.

(Conventional Techniques of Supplementary Items 7 and 8) When a small portion is treated with an electric scalpel, the bipolar mode may be used. In this bipolar mode, the tissue in a minute area is sandwiched by a treatment instrument like Forceps and energization is performed, so the path of the high-frequency current is clearer than in the monopolar mode, and there is less possibility of causing burns due to shunting. Is also expensive. However, as described above, since the target site is mainly in a microscopic range, the visibility of the cauterized site is poor due to the influence of a treatment tool or the like, and re-bleeding and perforation are caused by over-cauterization or the like. There was fear.

(Purpose of Supplementary Items 7 and 8) Provided is a bipolar electric scalpel capable of performing hemostasis safely and reliably.

(Supplementary Note 9) In the electrosurgical unit, a high-frequency power generator, a variable power supply for supplying DC power to the high-frequency power, and an actual output power are monitored in order to generate high-frequency power according to the set value. A power monitor, a non-volatile memory that stores function data between the variable power supply voltage and the high-frequency power in advance, and a main control unit, wherein the variable power supply voltage value is changed according to the function data while monitoring the actual output power. And controlling the output power to be stable regardless of the load | z |.

(Prior Art in Appendix 9) An electric scalpel is indispensable in treatments in a wide range of medical fields such as general surgery, urology, and internal medicine. Normally, the output of an electric scalpel uses high-frequency power of several hundred KHz to stimulate the myocardial system and prevent electric shock. However, the output power changes depending on the tissue | z | Conventionally, there has been a problem in the conventional electrosurgical apparatus that a stable output according to a set value cannot be supplied and basic performance (incision ability, coagulation ability) cannot be sufficiently exhibited.

(Purpose of Additional Item 9) Regardless of the load fluctuation,
Provision of an electric scalpel that can always output stable electric power.

(Appendix 10) In the high-frequency ablation power supply device, means for measuring the temperature of the treatment site, means for displaying the degree of tissue denaturation, and signals from the means for measuring the temperature of the treatment site A high-frequency ablation power supply device having a control circuit for controlling a means for displaying a degree of metamorphosis of the tissue.

(Prior Art in Additional Item 10) When using the conventional high-frequency ablation power supply, the surgeon visually checked the degree of denaturation of the tissue at the treatment site. However, when the tissue cannot be visually observed due to the shape of the active electrode or the like, it has been difficult to confirm the degree of denaturation.

(Purpose of Supplementary Item 10) Provided is a high-frequency ablation power supply device capable of easily knowing the degree of tissue degeneration without visually observing the treatment site.

(Appendix 11) An electrosurgical apparatus having means for measuring tissue impedance during output of an electric scalpel, wherein the output is stopped when the fluctuation range of the impedance exceeds a certain value. apparatus.

(Appendix 12) An electrosurgical apparatus having a means for measuring the impedance of tissue during output of an electric scalpel, wherein the output is reduced when the fluctuation range of impedance exceeds a certain value. apparatus.

(Additional Item 13) The additional value is characterized in that the constant value is calculated from the lowest value from the start of output.
Or 12 electrosurgical devices.

(Problems to be Solved by Additional Items 11 to 13) Conventionally, arc discharge has been detected, but there has been a disadvantage that the circuit becomes complicated.

(Purpose of Additional Items 11 to 13) A simple method of preventing carbonization of tissue is provided.

(Operation of Supplementary Items 11 to 13) The output is stopped when the variation width of the impedance is large.

(Supplementary Note 14) In an electrosurgical apparatus having a transformer connected to a means for supplying power on one side and a circuit including an output terminal, a winding for measuring a voltage on the transformer. An electrosurgical device characterized by the provision of.

(Problem to be solved in Additional Item 14)
Conventionally, the measuring means was directly connected between the output terminals. However, the signal had to be transmitted between the patient circuit and the secondary circuit which were electrically separated, and there was a disadvantage that the structure became complicated.

(Purpose of Supplementary Item 14) Provided is an output voltage monitoring means having a simple structure in an electrosurgical apparatus.

(Effect of Additional Item 14) Since the present invention does not have a measuring means in the patient circuit, the structure is simple.

(Appendix 15) In an electrosurgical apparatus having means for detecting a phase difference between an output voltage and an output current, the output is stopped (or reduced) when the value of the phase difference is out of a predetermined range. An electrosurgical device characterized by the following.

(Additional Item 16) In an electrosurgical apparatus having means for detecting a phase difference between an output voltage and an output current, the output is stopped (or reduced) when the rate of change of the phase difference exceeds a predetermined value. 1.) An electrosurgical device characterized in that:

(Additional Item 17) In an electrosurgical apparatus having a means for detecting a phase difference between an output voltage and an output current, the output is stopped when the fluctuation width of the phase difference exceeds a predetermined value (or
An electrosurgical device characterized by lowering).

(Additional Item 18) The additional item 1 is characterized in that the above range and value are determined by initial values after the start of output.
5-17 electrosurgical devices.

(Problems to be Solved in Additional Items 15 to 18) Conventionally, arc discharge was detected, but there was a disadvantage that the circuit became complicated.

(Purpose of Additional Items 15 to 18) A simple method of preventing carbonization of tissue is provided.

(Operation of Additional Items 15 to 18) The output is stopped by the phase difference between the voltage and the current.

(Appendix 19) In an electric scalpel having an output transformer, the voltage supplied to the primary side of the transformer /
An electrosurgical apparatus comprising a current / power measuring means and a control circuit for controlling an output based on the value.

(Problem to be Solved in Additional Item 19)
Conventionally, measurement means was provided on the patient circuit side.
Since signals are transmitted between the next circuits, the structure is complicated.

(Purpose of Supplementary Item 19) Provided is a device having a simple configuration and stable incision ability.

(Operation of Supplementary Item 19) The power supply from the power supply circuit is measured and feedback is applied.

(Effect of Additional Item 19) According to the present application, since the measuring means is provided on the secondary side, the configuration can be simplified.

(Supplementary Item 20) A treatment tool having a treatment electrode attached to a contact portion that comes into contact with a living tissue is provided, and treatment electric energy is supplied to the treatment electrode to perform treatment on the living tissue. In the electrosurgical apparatus, a biological information detecting means for detecting a change in the state of the treatment electric energy flowing through the treatment electrode and obtaining biological information of the living tissue to be treated based on the detected data is provided. An electrosurgical device characterized by controlling output based on the output.

[0147]

According to the present invention, there is provided a biological information detecting means for detecting a change in the state of the treatment energy supplied to the treatment means and obtaining biological information of a living tissue to be treated based on the detected data. Since the output of the treatment energy is controlled based on the information, the output of the treatment energy can be controlled with high accuracy, and stable coagulation performance and hemostatic performance can be obtained.

[Brief description of the drawings]

FIG. 1 is a schematic configuration diagram of an entire system of an electrosurgical apparatus according to a first embodiment of the present invention.

FIG. 2A is a schematic configuration diagram showing an electric circuit in a state where a monopolar treatment tool is connected to the electrosurgical apparatus according to the first embodiment, and FIG. 2B is a bipolar treatment tool connected to the electrosurgical apparatus; FIG.

FIG. 3 is a characteristic diagram showing an example of a change state of a detection voltage value between an active electrode and a feedback electrode when the device according to the first embodiment is used.

FIG. 4 is a characteristic diagram showing an example of a change state of a detected current value between an active electrode and a feedback electrode when the device according to the first embodiment is used.

FIG. 5 is a characteristic diagram illustrating an example of a change state of a detected impedance value between an active electrode and a return electrode when the device according to the first embodiment is used.

FIG. 6 is a front view showing a display unit of the device according to the first embodiment.

FIG. 7 is a schematic configuration diagram showing a state in which the monopolar treatment tool of the device according to the first embodiment is used in combination with an endoscope system.

FIG. 8 is an exemplary front view showing a first modification of the display unit according to the first embodiment;

FIG. 9 is an exemplary front view showing a second modification of the display unit according to the first embodiment;

FIG. 10 is an exemplary front view showing a third modification of the display unit according to the first embodiment;

FIG. 11A is a schematic configuration diagram of an entire system of an electrosurgical apparatus according to a second embodiment of the present invention, and FIG. 11B is a side view showing a state where a temperature sensor is attached to an electric scalpel.

FIG. 12 is a schematic configuration diagram showing a control circuit of the electric scalpel according to the second embodiment.

FIG. 13 is a schematic configuration diagram of a main part of an electrosurgical apparatus according to a third embodiment of the present invention.

FIG. 14 is a schematic configuration diagram illustrating a control circuit of a bipolar treatment tool of the electrosurgical apparatus according to the third embodiment.

FIG. 15 is a schematic configuration diagram of an electrosurgical apparatus according to a fourth embodiment of the present invention.

FIG. 16 shows a fifth embodiment of the present invention,
(A) is a schematic configuration diagram of an electrosurgical apparatus, and (B) is a schematic configuration diagram showing a control circuit of an ultrasonic transducer.

FIG. 17 is a schematic configuration diagram of an electrosurgical apparatus according to a sixth embodiment of the present invention.

FIG. 18A is a characteristic diagram illustrating a relationship between a variable power supply output voltage and an output power according to the sixth embodiment, and FIG. 18B is a characteristic diagram illustrating a relationship between a change in bioimpedance and an actual output.

FIG. 19 is a schematic configuration diagram of a main part of a treatment tool of an electrosurgical apparatus according to a seventh embodiment of the present invention.

FIG. 20 is a schematic configuration diagram of an electrosurgical apparatus according to a seventh embodiment.

FIG. 21 is a characteristic diagram for explaining inspection timing of the electrosurgical apparatus according to the seventh embodiment.

FIG. 22 is a schematic configuration diagram of an electrosurgical apparatus according to an eighth embodiment of the present invention.

FIG. 23 is a characteristic diagram showing a change state of impedance at the time of treatment by the electrosurgical apparatus according to the eighth embodiment.

FIG. 24 is a flowchart for explaining the operation of the electrosurgical apparatus according to the eighth embodiment.

FIG. 25 is a schematic configuration diagram of an electrosurgical apparatus according to a ninth embodiment of the present invention.

FIG. 26 is a characteristic diagram showing a change state of a phase difference between voltage and current during a high-frequency ablation treatment by the electrosurgical apparatus according to the ninth embodiment.

FIG. 27 is a flowchart for explaining the operation of the electrosurgical apparatus according to the ninth embodiment.

FIG. 28 is a flowchart illustrating the operation of the electrosurgical apparatus according to the ninth embodiment.

[Explanation of symbols]

 3A, 93, 113 Monopolar treatment device 3a, 93a, 113a Active electrode (treatment unit) 9 CPU (output control unit) 12 Output transformer (energy supply unit) 13 Current sensor (biological information detection unit) 14 Voltage sensor (biological information detection) Means) 101 Impedance detection circuit 121 Phase difference detection circuit (biological information detection means)

 ──────────────────────────────────────────────────続 き Continuing on the front page (72) Inventor Akihisa Ogawa 2-43-2 Hatagaya, Shibuya-ku, Tokyo Inside Olympus Optical Industrial Co., Ltd. (72) Inventor Yoshito Ichikawa 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optical Co., Ltd. (72) Inventor Takashi Mihori 2-43-2, Hatagaya, Shibuya-ku, Tokyo Olympus Optical Industries Co., Ltd. (72) Kazue Yamashina 2-43-2, Hatagaya, Shibuya-ku, Tokyo Olympus Optical Co., Ltd.

Claims (1)

[Claims] 1. A treatment instrument having a treatment means for treating a living tissue, and an energy supply means for supplying treatment energy to the treatment means, wherein the treatment means treats the living tissue by the treatment means. An electrosurgical apparatus that supplies the treatment energy to perform treatment on the living tissue, wherein a state change of the treatment energy supplied to the treatment unit is detected, and a living body of the treatment target living tissue is detected based on the detected data. An electrosurgical apparatus comprising: biological information detecting means for obtaining information; and output control means for controlling an output based on the biological information.