WO1999002098A1

WO1999002098A1 - Lesioned site detector for celiotomy and laparoscopic surgery

Info

Publication number: WO1999002098A1
Application number: PCT/JP1998/002752
Authority: WO
Inventors: Takeshi Ohdaira
Original assignee: Takeshi Ohdaira
Priority date: 1997-07-07
Filing date: 1998-06-19
Publication date: 1999-01-21

Abstract

A lesioned site detector for locating a lesioned site at the time of celiotomy or laparoscopic surgery. When a lesioned site of organs such as the stomach or the intestines is cut off by a surgical operation, it has been a practice in the past to endoscopically fit a clip to the site to detect the clip by feeling it from the outside at the time of surgery and to operate the site, or to inject a dye into the lesioned site at the time of inspection. These methods are not reliable and involve a safety problem. The detector of the invention detects by pinpointing a metallic clip or a magnetic clip fitted endoscopically at the time of inspection with a sensor disposed at the distal end portion, and can specify the detected site as the lesioned site. The detector has a shape suitable for celiotomy or laparoscopic surgery.

Description

Description Lesion site detection device for laparotomy and laparoscopic surgery

The present invention relates to a lesion site detecting apparatus for confirming a lesion site during a surgical operation, for example, when excision of a lesion such as a cancer, ulcer, or polyp. Background art

With the advancement of medical science today, we can detect lesions that do not show macroscopic changes such as deformity, stenosis and color tone of the normal digestive tract, such as early gastrointestinal cancer, and surgical treatment such as resection. The remedy has a remarkable life-saving effect. It is important to confirm the resection site during the operation. If the lesion is early and fine, it is extremely difficult to directly confirm the lesion site if the lesion occurs on the inner wall of an organ such as the stomach or intestine, even if the organ is exposed by laparotomy or laparoscopy .

Therefore, to date, trial and error has been repeated on the method of confirming the lesion site. As a result, the most frequently used method at present is the dye injection identification method. The dye injection identification method is a method of injecting a dye such as ink into the lesion site or the vicinity thereof, and marking the lesion site so that the lesion site can be visually identified if the lesion site is identified at the time of examination prior to surgery. Since the lesion is marked by an ink, the lesion can be confirmed using the ink at the time of surgery. However, this method may inadvertently inject the ink into the abdominal cavity and may not be able to identify the injection site at all.In addition, there is the danger of causing severe infection at the ink injection site or the sprayed abdominal cavity. . Also, depending on the type of ink, it may be washed away by the tissue fluid and the injection site may not be completely determined. It may become impossible to separate. In addition, if thick fat tissue exists outside the injection site, the injection site may not be confirmed due to the fat tissue. Such a problem can lead to a severe situation for both the practitioner and the patient, such as unresected or overexcised lesions.

As a method of overcoming such difficulties, a method of confirming a lesion site using a clip has been proposed. In this method, the lesion is endoscopically clipped and marked at the time of the examination performed before the operation. The practitioner checks the clip by touch at the time of laparotomy, and at the time of laparoscopic surgery, checks the clip with an endoscope to confirm the lesion site.

However, the clips were so small that they could not be found during surgery. In such a case, the practitioner should perform the surgery by referring to the preoperative examination findings to determine the location of the lesion, or to perform endoscopy during the procedure, which is likely to make the procedure environment unclean. He has experienced situations in which he had to perform a mirror examination and a radiological examination during the operation. As described above, whether a lesion is confirmed or not, whether using a method using ink or a method using clips, is affected by the skill and skill of the practitioner. In addition, even experienced practitioners may not be able to confirm the lesion site due to external factors. For example, as described above, if the outside of a lesion site is covered with adipose tissue, it is difficult to confirm the lesion site using an ink clip.

As described above, the conventional method of confirming the lesion site is uncertain, and if the lesion site could not be confirmed, it may be necessary to restart the operation or accidentally cut the cancer lesion itself. In such cases, the spread of cancer cells and the resulting recurrence of peritoneal dissemination may occur, and the physical and mental burden on the recipient as well as the recipient will be great. SUMMARY OF THE INVENTION The present invention has been made in view of the above-described conventional problems, and has as its object to provide a lesion site detecting device for promptly and surely confirming a lesion site during laparoscopic surgery and laparoscopic surgery. And Disclosure of the invention

In order to achieve the above object, the present invention has the following configuration.

That is, a lesion site detection device for detecting a clip attached to a lesion site from the back surface of the lesion site, and a sensor that outputs a signal having an intensity corresponding to a distance from the clip is provided at a distal end portion. A sensor unit, and an output unit that performs either or both of display and audio output according to the signal intensity output from the sensor, wherein the sensor is located within a range substantially covered by the sensor unit tip. The output signal reaches a peak for the clip of.

Also preferably, the clip is made of metal, and the sensor is a metal sensor for detecting metal.

Also preferably, the clip is magnetic, and the sensor is a magnetic sensor for detecting magnetism.

Also preferably, the output unit is housed in a housing integrated with the sensor unit, and the housing includes a holding unit including the output unit for holding by an operator, and the sensor unit.

Also preferably, the sensor section has a shape bent at a predetermined angle near the rear end of the sensor.

Preferably, the sensor section and the output section are housed in independent casings connected by signal lines.

Also preferably, the sensor unit has a joint near the rear end of the sensor, and further includes a handle for bending the sensor unit to a desired angle by the joint. BRIEF DESCRIPTION OF THE FIGURES

FIG. 1 is a perspective view of a lesion site detecting device for laparotomy.

FIG. 2 is a perspective view of a lesion site detecting device for laparoscopic surgery.

FIG. 3 is a perspective view showing a use state of the laparoscopic surgery lesion site detecting device.

FIG. 4 is a diagram showing the appearance of a metal clip.

FIG. 5 is a diagram showing a circuit configuration of the lesion site detecting device.

FIG. 6 is a diagram showing dimensions of a double coil used for a metal sensor.

FIG. 7 is a diagram showing a state of a magnetic field generated by a coil of the metal sensor.

FIG. 8 is a sectional view showing an arrangement of cables of the lesion site detecting device. FIG. 9 is a perspective sectional view showing the arrangement of cables of the lesion site detecting device.

FIG. 10 is a diagram of a detection device using a magnetic sensor instead of a metal sensor.

FIG. 11 is a perspective view of a lesion site detecting device having a joint in a sensor unit.

FIG. 12 is a perspective view of an angle-type lesion site detecting device in which a sensor section is bent.

FIG. 13 is a perspective view showing a connection portion of a lesion site detecting device capable of replacing a sensor unit. BEST MODE FOR CARRYING OUT THE INVENTION

[First Embodiment] (Outline of equipment)

In this embodiment, in order to confirm a diseased part and perform a surgical operation using the diseased part detection device according to the present invention, a lesioned part of a patient is previously endoscopically marked with a metal clip. . The shape of the metal clip used is not particularly limited, but has a sufficient mass for metal detection. Fig. 4 shows an example of the metal clip used. As this clip, a stainless steel clip weighing about 8 O mg or a clip made of an alloy of stainless steel and titanium, which is conventionally used for marking, can be used.

FIG. 1 is an external view of a handy type lesion site detecting device 1 having a metal sensor 2 at the tip. Since the device according to the present invention is used inside a human body, it is necessary that the device be small enough not to hinder the operation and have a shape that does not damage human tissue. Therefore, the detection device 1 includes a drip portion having a diameter that can be held by one hand and a sensor portion provided with the metal sensor 2 at the tip. Both portions may be integrally formed of metal, resin, or the like, or may be formed separately as described later. The grip section is held by the practitioner, and stores circuit components and a power supply to be described later. The sensor section is formed in an elongated shape so that the sensor section can be used even in a narrow section and the practitioner can easily identify the detected location. In the present embodiment, the sensor section has a cylindrical shape with a diameter of about 10 mm and a length of about 15 Omm.

The entire detection device 1 has a watertight structure in order to prevent invasion of a chemical solution or body fluid from the outside or to prevent bacterial infection from the inside of the detection device to the human body.

Here, the detection device according to the present invention will be described in accordance with its use example. If there is a lesion inside the stomach, a metal clip should be attached endoscopically around the lesion at the time of examination prior to surgery. In the case of laparotomy, The surgeon brings the lesion detection device 1 close to the exposed outer wall of the stomach and scans along the outer wall. When the metal sensor 2 approaches the metal clip F, the arrangement of the LEDs 4 electrically connected to the output signal lines of the metal sensor 2 is sequentially turned on according to the degree of the proximity. By checking the number or position of the lit LEDs, the practitioner can visually check how close the detection device 1 is to the metal clip. Further, since the distance scale 5 indicating the distance between the detection device 1 and the clip F is provided along the arrangement of the LEDs 4, the distance from the metal clip F is indicated by a numerical value.

If an electronic buzzer circuit is connected to the output signal line of the metal sensor 2 and a circuit is provided to sound the buzzer 6 when the distance between the sensor clips becomes less than a predetermined distance, the approach to the metal clip F can be heard by hearing. You can check. Furthermore, if the buzzer 6 is configured to sound intermittently at intervals according to the output signal value from the metal sensor 2 or to sound at a volume according to the output signal value, the detection device 1 and the metal clip F The degree of approach can be known from the degree to which the buzzer sounds intermittently.

From the position of the metal clip indicated by the detection device 1, the practitioner confirms the resection range of the lesion site, determines the cut end, and resects the lesion site. By using the detection device 1 in this manner, the practitioner can perform a quick, accurate, and safe laparotomy.

(Internal configuration of detection device)

Fig. 5 shows the circuit configuration of the detection device 1.

In FIG. 5, an oscillation circuit 501 is an oscillation circuit having a frequency of 100 kHz. The signal output from the oscillation circuit 501 is input to the metal sensor 2 to the oscillation coil 503. The metal sensor 2 includes an oscillating coil 503 and a receiving coil 502, which are made of copper wires and are wound in a wrapped manner. When a signal having a frequency of 100 kHz is input from the oscillation circuit 501, an alternating magnetic field having a frequency of 100 kHz is generated from the oscillation coil 503. Due to this alternating magnetic field, an AC signal having the same frequency of 100 kHz is generated in the receiving coil 502. At this time, if there is a metal piece in the alternating magnetic field, a current is generated in the metal piece in such a direction as to cancel the change in the alternating magnetic field due to the induced electromotive force. As a result, the strength of the alternating magnetic field weakens, and the level of the AC signal generated by the receiving coil also decreases. The AC signal generated by the receiving coil is amplified by the amplification circuit 504 and then detected by the detection circuit 504. The detected signal strength indicates the presence or absence of metal in the alternating magnetic field. The detected signal is increased ij¾ by a DC amplifier 506 and converted into a digital signal, etc., and then an input signal for lighting an LED according to an output level in an LED level meter 507 is used. When the signal value exceeds a predetermined level, it is used to sound the electronic buzzer -508.

FIG. 6 shows the dimensions of the coil of the metal sensor unit 2 in the present embodiment. The outer shape of the winding is about 10 mm, the receiving coil 502 is about 25 mm in length and wound about 90 turns, and the oscillating coil 503 is the same as the receiving coil 502. Around the center, the length is about 10 mm and about 30 turns are wound in contact with the receiving coil. That is, the turn ratio of the oscillation coil to the reception coil is 1: 3. Thus, the receiving coil 502 is located near the center where the magnetic flux density generated by the oscillating coil 503 is higher, and the number of turns is about three times that of the oscillating coil. Therefore, the detection device according to the present invention has sufficient sensitivity. In addition, a metal (carbon-iron) rod with an outer diameter of about 10 mm and a length of about 30 mm is inserted inside the coil. The coil formed in this way has an effective range of approximately 10 mm in diameter where the clip can be detected through the digestive tract wall. The smaller the diameter, the higher the detection accuracy. However, in practice, a diameter of 10 mm is selected as a sufficient value. By passing an alternating current through this coil, as shown in Fig. 7, the magnetic flux density of the peripheral part is about 2 mG in the area of about 20 mm in diameter and about 50 mm in length around the oscillation coil. Form an alternating magnetic field. Here, the detection accuracy at the sensor tip is not directly related to the length of the magnetic field. It is said that the living body is affected when the magnetic flux density is about 4 mG, so it is necessary to keep it at most 4 mG or less. Due to the magnetic field formed in this way, the all-generating sensor 2 has a structure that exhibits sharp detection characteristics at its tip, and the detection output is approximately within the error range of the cross section of the tip (radius of about 5 mm). It becomes a peak. For this reason, if the detection output indicates a peak, the metal clip can be identified as being within the range covered by the sensor tip, and the position of the metal clip is visualized as the position of the sensor tip itself. can do. As a result, when the output from the sensor (LED display or buzzer sound) shows a peak, accurate treatment can be performed by performing procedures such as incision and resection at the position indicated by the tip of the sensor. Become.

The detection device 1 according to the present invention is required to accurately detect the position of a metal clip such as stainless steel weighing about 8 Omg through the stomach wall and the intestinal wall. Therefore, if the sensitivity is too high, it becomes easier to detect the metal clip, but it is difficult to pinpoint the position, and if the sensitivity is too low, the detection itself becomes difficult. The strength of the formed magnetic field and the distribution of the lines of magnetic force are thus determined from the mass of the metal clip to be detected and the required detection accuracy, and have the values described above in the present embodiment. For this reason, if the mass of the metal clip used or the thickness of the stomach wall or intestinal wall of the subject changes significantly, the sensitivity can be adjusted according to those changes to achieve more accurate position detection. Desirable for. For this purpose, a mechanism for adjusting the current flowing through the oscillation coil may be provided in the oscillation circuit 501 or between the oscillation circuit 501 and the coil. This In this case, the practitioner calibrate the detection device in advance according to the conditions to be used.

As described above, the number of turns and the size of the coil described above are determined based on the mass of the clip, the magnitude and strength of the generated magnetic field, and the shape of the device main body. It is not limited to this value in order to achieve the purpose of detecting with high accuracy through. It is important that the characteristics of the sensor be set appropriately so as to realize a sensor in which the detected position of the metal clip is approximately within the range covered by the tip of the sensor unit.

In the sensing device of the present embodiment, the coil is arranged at the tip of the sensor unit, and the other circuits are arranged at the grip unit. Therefore, the conductors connecting the oscillation coil 503 and the oscillation circuit 501 and the reception coil 502 and the amplification circuit 504 respectively extend over a distance of 10 cm or more. Therefore, simply passing these wires through a hollow tube interferes with each other via the magnetic field generated around the wires. In particular, when the positional relationship between the conductors changes, the signal detected by the detection circuit 504 changes, which causes a reduction in detection accuracy and a malfunction. Therefore, they must always be kept fixed.

FIG. 8 is a cross-sectional view of the sensor unit. The resin shell is filled with polyurethane foam, in which the conductors that connect the coil to the oscillator and amplifier circuits are embedded. As a result, not only is the conductor fixed, but also an effect of reinforcing a long and narrow sensor portion having a diameter of about 10 mm can be obtained.

FIG. 9 is a diagram showing another way of fixing the conductor. The main body is reinforced by passing a PVC pipe 901 with an outer diameter of about 8 mm inside the outer shell of the main body, and a vinyl chloride pipe with an inner diameter of about 2 mm that allows two conductors to pass through it. Pass the pipes 90 2 and 90 3 through. Urethane foam inside the pipe 91 Fill with etc. The wiring from the coil passes through the pipes 90 2 and 90 3 to the circuit of the grip section. This configuration not only reduces the variation in detection sensitivity and improves the strength of the device main body by holding the conductors in a fixed state, but also when a failure such as a disconnection occurs in the coil or wiring. In addition, since the wire can be inserted and removed, it is possible to easily repair the failed part.

With the above configuration, when a diseased tissue such as a cancer, an ulcer, or a polyp is excised by laparotomy, the diseased organ is externally scanned by the detection device 1 and indicated by a metal clip attached in advance. The lesion site can be found accurately and reliably. As a result, there are no surgical mistakes such as re-operation due to residual diseased tissue, recurrence due to amputation of the cancer itself, or excessive resection, and both the practitioner and the patient can begin the operation with confidence. In addition, the ability to quickly detect the lesion site can shorten the operation time, avoid the adverse effects of long-term anesthesia, and increase the safety of surgery.

Furthermore, since the structure of the detection device is very simple, it can be provided at a low cost, and is small enough to be portable. It is very easy.

[Second embodiment]

The first embodiment is a detection device suitable for use in laparotomy. As a second embodiment, a detection device suitable for laparoscopic surgery will be described. The sensor unit for detecting the clip and the circuit configuration accompanying the sensor unit conform to the first embodiment, but the configuration of the apparatus main body and the arrangement of the circuits are different. In laparoscopic surgery, the practitioner pierces the abdomen of the subject, passes through a hole with a diameter of about 12 mm called a trolling force, and passes through a trocar. To perform necessary procedures by inserting surgical instruments into the abdominal cavity. For this reason, the detection device used is also passed through the trocar.

FIG. 2 shows an external view of a lesion site detecting device 14 for laparoscopic surgery. The detection device 14 includes a sensor unit 9 having a diameter of about 10 mm and a length of about 300 mm having a metal sensor 7 at the tip, a control unit 10 connected to the sensor unit 9 by a cable 13, and It is a separate type consisting of a control unit 10 and a display unit 12 connected by a cable. The display unit is provided with an LED array, a scale 5 indicating the distance to the clip, and a speed 6 indicating the distance to the clip. The fact that the sensor unit is independent is that the sensor unit must be long enough to reach the abdominal cavity throughout the abdominal cavity in the state where it is passed by the trolling force, so that it is integrated as in the first embodiment. One of the reasons is that the operability becomes worse if it is lost. In laparoscopic surgery, the practitioner views images taken by a camera inserted into the abdominal cavity while viewing the images on the abdominal cavity monitor. One of the reasons is that the closer the abdominal cavity monitor and the display unit 12 are, the easier it is to confirm the lesion site.

FIG. 3 shows a pattern of a laparoscopic operation using the detection device 14. FIG. 3 shows how the sensor unit 9 is used for gastric and intestinal operations. The practitioner inserts the sensor unit 9 having the metal sensor 7 at the tip into the trocar 9a inserted into the hole in the abdominal wall, and searches for a lesion site in the same manner as described in the first embodiment. . A metal clip is attached around the lesion in advance at the time of examination. Then, the arrangement of the LEDs connected to the metal sensor 7 is turned on via the cable 13 and the control unit 10 according to the degree of approach to the metal clip F, and the sensor sensitivity can be visually recognized. Further, by reading the distance scale 5, the distance between the sensor and the clip can be confirmed by a numerical value. Also, if the buzzer 17 sounds so that the distance between the sensor clips becomes less than the predetermined distance, The approach to the lesion site can be confirmed. Therefore, the practitioner confirms the resection range of the lesion site and determines the cut end while viewing the image on the display unit 12 and the image on the laparoscopic monitor 17, and performs the treatment. Thereby, an accurate and safe laparoscopic operation can be performed, and the effect as described in the first embodiment can be achieved.

If the sensor unit and the control unit are separated from each other, the length of the signal line becomes longer, and noise is likely to occur due to external influences. For this reason, a configuration may be adopted in which an AZD converter is provided in the sensor unit, the signal is digitized at any time, and the digital signal is sent to the control unit.

[Third Embodiment]

FIG. 11 is a diagram showing an appearance of a lesion site detecting apparatus 1100 according to the third embodiment of the present invention. The detection device 1100 has a structure in which a joint that can be fixed at a desired angle is provided to the detection device for laparoscopic surgery in the second embodiment. FIG. 11 (A) is a view showing a state where the joint is extended. In the figure, a sensor section 1102 containing a metal sensor 1101 and a main body section 1104 are rotatably stopped by a rotating shaft 1103. In the vicinity of the end of the main body 1104 opposite to the sensor section, the handle lever 1105 is also rotatably stopped by an axis passing near the diameter of the main body. Both sides of the axis of the handle lever 1 105 and both sides of this axis of the sensor unit are connected by a flexible wire or a thin string of a material that is hard to stretch, which is arranged along the longitudinal direction of the main body. ing. The sensor section 1102 and the main body section 1194 are covered with a cover 1106 such as soft vinyl having high flexibility and high watertightness from above, thereby ensuring safety during use.

Since the handle lever 1105 and the sensor unit 1102 are connected by a wire, the user turns the handle lever 1105 around the axis as shown in Fig. 11 (B) and Fig. 11 (C). By moving, according to the amount of rotation The direction of the sensor changes. If the axis 1103 is not easily turned even if a slight force is applied to the sensor section 1102, the direction of the sensor section can be maintained in a desired direction.

As described in the first embodiment, when a metal sensor is used, a magnetic field having a magnetic flux density of 2 mG and a diameter of 20 mm from the oscillation coil are used to increase the directivity as a sensor. It is generated to have an area of about 50 mm in length. For this reason, it has a structure that shows sharp detection characteristics at the tip of the sensor. However, during laparoscopic surgery, the position where the detector is inserted is limited, so the tip of the metal sensor cannot always be scanned so that it contacts the outer wall surface of the stomach and intestine . In such a case, since scanning is performed on the side surface of the metal sensor, clip detection accuracy is reduced, and the original effect of the detection device according to the present invention of high detection accuracy is impaired.

On the other hand, the detection device 110 of the present embodiment can move the angle between the metal sensor portion and the main body to a desired angle after inserting the device from the trolling force while maintaining a straight shape. It has a structure that can be held by. Therefore, by adjusting the direction of the sensor section so that the sensor section is substantially perpendicular to the surface to be scanned, scanning can be performed so that the tip of the sensor is in contact with the scan target such as the stomach and intestine. it can. Therefore, the detection accuracy can always be maintained at a high level regardless of the position where the detection device 110 is inserted.

In addition, since the detection device 1400 can freely move the metal sensor unit, it can be used for intestinal and bladder operations inside the pelvis where the insertion position of the detection device is limited. The surface of the organ can also be scanned by keeping the main body 1104 stationary without moving it, and moving the sensor unit 1102 by the operator using the handle lever 1105. As described above, the lesion site detection device according to the present embodiment significantly improves operability and further improves clip detection accuracy.

[Fourth embodiment]

FIG. 12 shows the appearance of a detection device 1200 for open surgery in the fourth embodiment. The detection device 1200 is basically the same as the detection device of the first embodiment, such as an electric circuit, but differs from the device of the first embodiment in two points. First, the sensor section 1221 has a shape bent at an appropriate angle. Second, the sensor section 1221 and the main body section 122 can be separated. Since the sensor section 1 201 is bent behind the metal sensor, even if there is a lesion on the side of the organ exposed by laparotomy, the tip of the sensor is perpendicular to the surface to be scanned. You can guess. Therefore, the operability can be improved, and the detection device can be used without reducing the detection accuracy. For this reason, when the device insertion position is limited, for example, when there is a lesion in the intestine or bladder in the pelvis, the organ surface is scanned with the tip of the sensor without being restricted by the insertion angle of the device body. This significantly contributes to the improvement of the detection accuracy of the lesion site.

In addition, the probe section can be easily exchanged because of the force bra structure capable of separating the sensor section 1221 and the main body section 122. FIG. 13 is a diagram showing a force bra structure. The sensor section 1301 has an electrode pin 134 for connecting the cable drawn from the coil to the main body.The main body 1302 has an electrode pin corresponding to the electrode pin 134. A socket 133 is provided in close contact with the sensor 1303 and the sensor section 1301, to prevent the intrusion of liquid.

As described above, since the sensor unit has a replaceable structure, the sensor unit having the straight structure according to the first embodiment or the sensor unit according to the present embodiment can be used. The angled structure that is bent in this way can be replaced and used depending on the lesion site.

In the detection device for a laparoscope described in the second embodiment, since the sensor unit is separate, if a cable for connecting to the control unit can be inserted and removed with a plug or the like. The sensor can be easily replaced.

[Fifth Embodiment]

In the first to fourth embodiments, the configuration has been described in which the metal clip is attached to the lesion and the metal clip is scanned by the detection device having the metal sensor unit. However, a magnetic clip can be used instead of a metal clip to indicate the lesion, and the clip can be detected.

In this case, a clip having a magnetic quantity sufficiently responsive to magnetic force measurement is used as the magnetic clip. Also, a magnetic sensor is used instead of the metal sensor unit. As shown in Fig. 10, by using a linear Hall element (SHS110, etc.) 1001 as a magnetic sensor, the Hall voltage is measured according to the magnetic flux density of the magnetic field in which the element is placed. Then, the distance of the magnetic clip is determined according to the value, and is output by display or voice.

In order to use a linear Hall element, the circuit of the control unit in Fig. 5 also needs to be partially changed. If the current flowing through the Hall element is DC, an oscillation circuit is not required, and a power supply for generating a DC current applied to the control electrode of the element is provided instead of the oscillation circuit 501. A linear Hall element is used as the sensor instead of the coil. If the current applied to the control electrode is DC, the amplification circuit 504 and the detection circuit 505 are unnecessary. In addition, an amplifier circuit that amplifies the Hall voltage output from the linear Hall element is necessary as in Fig. 5, and the output drives the level meter on the display and an electronic buzzer. In addition, AC is applied to the control electrode for the linear Hall element. When a current is applied, an oscillation circuit for generating a signal to be applied, a detection circuit for detecting an output signal, and the like are required.

As described above, the magnetic sensor can be applied to the detection devices of the first to fourth embodiments.

Further, it is possible to realize a detection device that combines the technologies in the above-described embodiments. In other words, each of the detection devices using a metal sensor for detecting a metal clip or a magnetic sensor for detecting a magnetic clip has a configuration of an independent type (for open surgery) and a separate type (for laparoscopic surgery). I do. In addition, there are two types of stand-alone types: an integral type that cannot remove the sensor unit, and an exchange type that can replace the sensor unit. In addition, for each of the independent type and the separate type, there are a fixed shape type in which the shape of the sensor unit is fixed, and a variable shape type in which the operator can change the shape. As for the fixed shape type, there are a straight type with a straight shape and a curved angle type.

Lastly, the inventor of the present application has been conducting experiments on the effect of the lesion site detecting apparatus according to the present invention. As a result of the experiment, the position of the clip was able to be reliably detected within an error of at most about 5 mm, that is, within the range of the sensor end face, and the device of the present invention has a great effect in a clinical setting. It is being confirmed. Industrial applicability

As described above, according to the lesion site detection device of the present invention, when cutting or resecting a lesion tissue such as a cancer, an ulcer, or a polyp by laparotomy or laparoscopic surgery, as described above, The site can be confirmed accurately and reliably without any intuition or touch by the practitioner. For this reason, there are no surgical mistakes such as re-operation due to residual lesions or excessive resection. Therefore, both the practitioner and the patient can start the operation with peace of mind. It also contributes to shortening the operation time.

Further, the lesion site detecting device of the present invention has a simple structure, is hardly broken down, is provided at low cost, and has extremely good operability.

Claims

The scope of the claims

1. A lesion site detection device for detecting a clip attached to a lesion site from the back side of the lesion site,

A sensor unit provided at a front end with a sensor that outputs a signal having an intensity corresponding to the distance from the clip,

An output unit that performs one or both of display and audio output according to the signal strength output from the sensor,

The sensor according to claim 1, wherein an output signal of the sensor has a peak with respect to a clip in a range substantially covered by the tip of the sensor unit.

2. A clip that can be attached to the lesion,

The lesion site detecting device, wherein an output signal of the sensor has a peak with respect to a clip within a range substantially covered by a tip of the sensor unit.

3. The lesion detecting device according to claim 1, wherein the clip is made of metal, and the sensor is a metal sensor for detecting metal.

4. The lesion site detecting device according to claim 1, wherein the clip is magnetized, and the sensor is a magnetic sensor that detects magnetism.

5. The output unit and the sensor unit are housed in a housing that integrates them, and the housing is the output unit for an operator to hold. 3. The lesion site detecting device according to claim 1, comprising a holding unit including: a sensor unit, and the sensor unit.

6. The lesion site detecting device according to claim 5, wherein the sensor section has a shape bent at a predetermined angle near a rear end of the sensor.

7. The lesion site detecting device according to claim 1, wherein the sensor unit and the output unit are respectively housed in independent housings.

8. The sensor unit according to claim 7, wherein the sensor unit has a joint near the rear end of the sensor, and further includes a handle unit that bends the sensor unit to a desired angle by the joint. Lesion site detection device.

9. The sensor section generates a magnetic field having a magnetic flux density of about 2 milligauss near a boundary of the area in a region having a diameter of about 20 millimeters along a longitudinal direction thereof. Lesion site detection described in item 3