JPS6321502B2 - - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION The present invention relates to an electric scalpel that is inserted into a body cavity through an endoscope to perform resection, incision, etc. of diseased tissue. Sudden movement of (human body) (stretch reflex, etc.)
This invention relates to a high-frequency output device for an electric scalpel that stops high-frequency output to prevent unnecessary resection, incision, etc.

Generally, high-frequency power is supplied from a high-frequency power supply device between an electric scalpel having a loop-shaped or needle-shaped electrode inserted into an endoscope and a grounding plate that is in contact with the patient's body skin. An electric scalpel device is known that performs resection, incision, blood coagulation, etc. of an affected area by passing a high frequency current through the patient and generating heat generated by the current concentrated on the electrodes of the electric scalpel. When such an electric scalpel is inserted into a rigid endoscope and inserted into the urethra to remove a prostate gland, cancer, etc., the patient's stretch reflex (in deep tissues such as muscle spindles and tendons) It is a reflex caused by the receptors and is called a deep reflex, and it is called an intrinsic reflex because it causes contraction in the same muscle as the receptor and occurs in the extensor muscles.It is a reflex that causes the quadriceps femoris and biceps femoris to move the body like a stick. There is a risk that the straightening motion, that is, the raising of the waist, may cause the electrode of the electric scalpel located inside the urethra to cut into the tissue regardless of the operator's operation.

In the past, the surgeon had to be agile in responding to such unexpected movements of the human body, and there was a risk that the surgeon would cut out too much of the area.

This invention has been made in view of the above-mentioned points, and is provided with a motion detection means that detects sudden movements of the human body such as stretch reflexes and turns off the high frequency output. To provide a high-frequency output device for an electric scalpel that immediately stops supplying high-frequency current when movement occurs, and prevents resection or incision using an electric scalpel from extending beyond the intended resection, incision, or coagulation range. purpose.

The present invention will be specifically described below with reference to the drawings. 1 to 3 show a first embodiment of the invention. FIG. 1 shows an operating table and a human body placed on the operating table. In this figure, reference numeral 1 denotes an operating table, which is designed to place and support the upper part of the patient's body 2 from the buttocks 3, and on which the operator can enter between the legs 4 of the human body 2 placed on the operator 1. A footrest 6 is attached to extend forward to support the thighs 5 of both legs 4 which are opened to the left and right so that surgery can be performed. A fixing band 7 for fixing the thigh 5 is attached to the footrest 6, and a ground plate 8 that is closely fixed to the thigh 5 is also provided. Further, the operating table 1 is provided with a detector 9 for detecting the movement of the human body at a position where the buttocks are placed.
As shown in FIG. 2, this detector 9 includes a fixed terminal 11 inside a hollow casing 10 made of an electrically insulating elastic material such as silicone rubber.
When the buttock 3 rests on this casing 10, it bends or moves together with the casing, and the terminal 11
A movable terminal 12 is disposed in electrical contact with the body, forming a switch circuit that is electrically opened and closed by the weight of the human body.

On the other hand, the electric scalpel device connects the output end of the high frequency power supply 13 to the input end of the output control circuit 14 as shown in FIG.
5, and its output end is connected to a foot switch 16, a grounding plate 8, and an electric scalpel 17. This electric scalpel 17 is inserted into a rigid endoscope 18 having an illumination optical system and an observation optical system, and the loop-shaped electrode 19 at the tip is inserted into the tip by operating the proximal operation section of the rigid endoscope 18. It is configured to extend and retract from the insulating sheath 20 into a body cavity, for example, into the bladder. The detector 9 also includes a detection circuit 21 that outputs a detection signal when the detector is turned off.
The control circuit 14 is connected to the input end of the output control circuit 14 via the detection signal, and the output of this detection signal turns off the control circuit 14 and cuts off the output of the high frequency current to the electric scalpel 17.

In such a configuration, the rigid endoscope 18 is inserted into the bladder through the urethra, and the foot switch 16 is
The surgeon turns on the output control circuit 14 to supply high-frequency current to the electric scalpel 17 to prevent sudden movements of the human body 2 during surgery to remove the praecalis, for example, the nerves that control stretch reflexes that operate even under general anesthesia. When the buttocks 3 rises due to stimulation (high frequency or mechanical), the detector 9 is turned off, a motion detection signal is output from the detection circuit 21, the output control circuit 14 is turned off, and the electric knife 1 is turned off.
Cut off the high frequency current output to 7. Therefore, the rigid endoscope 18 or the electric scalpel 17 can be moved by this sudden movement of the human body 2 to resect or incise tissue other than the target area, such as muscle tissue, regardless of the operator's operation. Prevented.

A second embodiment of the invention is shown in FIGS. 4 and 5. In this embodiment, two switch circuits of the detector 9, that is, a fixed terminal 11 and a movable terminal 12, are connected in series, and each one is placed at a position on which both of the buttocks 3 are placed. When turned off, a detection signal is output from the detection circuit 21 as described above, and the output control circuit 14 is turned off to cut off the supply of high frequency current to the electric scalpel 17. With such a configuration, it is possible to track and detect partial movements of the human body, and it is also possible to detect, for example, a twisting motion of the lower back where one buttock is in contact with the detector 9 and the other buttock is separated. . Incidentally, in the above-mentioned embodiments of the present invention, mechanical detection means have been explained, but the present invention is not limited to this, but electric detection means, for example, a piezoelectric element may be provided as a detection means, or this detection means may be used as a detection means. It is also possible to use a logic circuit that includes a plurality of piezoelectric elements and outputs a high frequency wave only when all the piezoelectric elements are in an output state, and does not output at other times.

Further, the detector 9 used in the present invention may be provided separately from the operating table 1 or may be integrated therein.

Furthermore, the electric scalpel of the present invention is used in various endoscopes, and is used for cutting and incising various diseased tissues, or for coagulating blood.

As described above, this invention is provided with a motion detection means that detects unexpected movements of the human body such as stretch reflexes and turns off the high frequency output, so that even if there is an unexpected movement of the human body, it is possible to achieve the object. excision,
There is no risk of cutting or incising areas other than the area of incision and coagulation, and there is an effect that surgery using an electric scalpel can be performed safely.

[Brief explanation of the drawing]

FIG. 1 is a schematic diagram showing the operating table according to the first embodiment of the present invention, FIG. 2 is a sectional view of the detector, FIG. 3 is a circuit diagram of the electric scalpel device, and FIG. 4 is the second embodiment of the present invention. A plan view showing the detector according to the embodiment, FIG.
FIG. 1... Operating table, 8... Ground plate, 9... Detector,
14... Output control circuit, 17... Electric scalpel, 18
... Endoscope, 19 ... Electrode, 21 ... Detection circuit.

Claims (1)

[Scope of Claims] 1. An electric scalpel device used in combination with an endoscope, characterized in that it is provided with a motion detection means for detecting unexpected movements of the human body such as a stretch reflex and controlling high frequency output. High frequency output device for female. 2 The motion detection means is turned on and off depending on the weight of the human body.
The high frequency output device for an electric scalpel according to claim 1, which is a switch that turns off.