WO2005122917A1 - 超音波手術装置 - Google Patents
超音波手術装置 Download PDFInfo
- Publication number
- WO2005122917A1 WO2005122917A1 PCT/JP2005/010723 JP2005010723W WO2005122917A1 WO 2005122917 A1 WO2005122917 A1 WO 2005122917A1 JP 2005010723 W JP2005010723 W JP 2005010723W WO 2005122917 A1 WO2005122917 A1 WO 2005122917A1
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- Prior art keywords
- ultrasonic
- signal
- temperature
- treatment section
- control circuit
- Prior art date
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Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
- A61B17/320092—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/00017—Electrical control of surgical instruments
- A61B2017/00022—Sensing or detecting at the treatment site
- A61B2017/00084—Temperature
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
- A61B2017/320069—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic for ablating tissue
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
- A61B2017/320082—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic for incising tissue
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
- A61B17/320092—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw
- A61B2017/320094—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw additional movable means performing clamping operation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
- A61B17/320092—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw
- A61B2017/320095—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw with sealing or cauterizing means
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00005—Cooling or heating of the probe or tissue immediately surrounding the probe
- A61B2018/00011—Cooling or heating of the probe or tissue immediately surrounding the probe with fluids
- A61B2018/00029—Cooling or heating of the probe or tissue immediately surrounding the probe with fluids open
Definitions
- the present invention relates to an ultrasonic surgical apparatus for grasping a living tissue and performing ultrasonic treatment such as incision and coagulation on the living tissue.
- An ultrasonic surgical apparatus is an apparatus that performs ultrasonic treatment such as incision and coagulation on a living tissue.
- an ultrasonic vibrator is disposed on an operation unit on a hand side, and an ultrasonic probe is disposed on a distal end side.
- the ultrasonic probe transmits the ultrasonic vibration generated by the ultrasonic vibrator to treat a living tissue!
- the ultrasonic surgical apparatus is provided with a jaw rotatably supported against the ultrasonic probe.
- a movable handle for opening and closing the jaws is provided on the operation unit.
- the conventional ultrasonic surgical apparatus is configured to open and close the jog with respect to the ultrasonic probe by operating the movable handle, thereby causing the ultrasonic probe to move between the ultrasonic probe and the jog. Now comes to grasp living tissue!
- the conventional ultrasonic surgical apparatus transmits ultrasonic vibrations from the ultrasonic transducer to an ultrasonic probe while holding a living tissue. By doing so, ultrasonic treatment such as incision and coagulation is performed on the grasped living tissue.
- Such a conventional ultrasonic surgical apparatus is proposed in, for example, Japanese Patent Application Laid-Open No. 9-299381 and Japanese Patent Application Laid-Open No. 11-70118.
- the ultrasonic surgical device described in the above-mentioned Japanese Patent Application Laid-Open No. 9-299381 discloses an ultrasonic output from the ultrasonic transducer at the start of the ultrasonic treatment based on a set value during normal operation. Is also bigger. Then, after the start of the ultrasonic treatment, the ultrasonic surgical apparatus is configured to switch and control the operation state so that the ultrasonic output from the ultrasonic transducer becomes the set output value. [0007] Further, the ultrasonic surgical apparatus described in Japanese Patent Application Laid-Open No.
- H11-70118 discloses that the current supplied to the ultrasonic vibrator is controlled by a constant current in order to reduce the load on the ultrasonic vibrator.
- the voltage applied to the wave oscillator is monitored. Then, when the voltage reaches the limit amount by monitoring, the ultrasonic surgical apparatus is configured to switch to a drive method of constant current control force and energy limit control (constant power drive, constant voltage drive) and drive. ing.
- Patent Document 1 Japanese Patent Application Laid-Open No. 9-299381
- Patent Document 2 Japanese Patent Application Laid-Open No. H11-70118, while the ultrasonic surgical apparatus described in the above-mentioned Japanese Patent Application Laid-Open No. H9-299381, switching of the ultrasonic output value is performed after a predetermined set time which has been set in advance. is there. For this reason, in the ultrasonic surgical apparatus described in the above publication, there is a possibility that the same effect cannot be obtained if the gripping part temperature at the start of incision and coagulation of the living tissue is different.
- An ultrasonic operation apparatus includes a treatment unit configured to treat a living tissue by ultrasonic vibration, a heat sensor provided in the treatment unit, and detecting a temperature of the treatment unit, and the heat sensor. Control means for controlling the temperature of the treatment section based on the detected temperature information.
- FIG. 1 is an overall configuration diagram showing an ultrasonic operation apparatus according to a first embodiment.
- FIG. 2 is a schematic sectional view showing the configuration of the ultrasonic treatment device in FIG. 1.
- FIG. 3 is a circuit block diagram of the ultrasonic surgical apparatus in FIG. 1.
- FIG. 4 is a flowchart showing an operation in an incision mode according to the first embodiment.
- FIG. 5 is a flowchart showing an operation in a coagulation mode according to the first embodiment.
- FIG. 6 is an overall configuration diagram showing an ultrasonic operation apparatus according to a second embodiment.
- FIG. 7 is a schematic sectional view showing the configuration of the ultrasonic treatment device in FIG. 6.
- FIG. 8 is a circuit block diagram of the ultrasonic operating apparatus in FIG. 6.
- FIG. 9 is a flowchart showing an operation in an incision mode according to the second embodiment.
- FIG. 10 is a flowchart showing an operation in a coagulation mode according to the second embodiment.
- FIG. 11 is an overall configuration diagram showing an ultrasonic operation apparatus according to a third embodiment.
- FIG. 12 is a schematic sectional view showing the configuration of the ultrasonic treatment device in FIG.
- FIG. 13 is a circuit block diagram of the ultrasonic operating apparatus in FIG. 11.
- FIG. 14 is a flowchart showing an operation in an incision mode according to the third embodiment.
- FIG. 15 is a flowchart showing an operation in a coagulation mode according to the third embodiment.
- the present invention provides an ultrasonic surgical apparatus capable of controlling the administration of energy to a living tissue without being conscious of an operator, and capable of preventing an excessive rise in temperature of the living tissue.
- FIG. 1 is an overall configuration diagram showing an ultrasonic operation apparatus according to the first embodiment. As shown in FIG. 1, an ultrasonic surgical apparatus 1 according to the present embodiment is
- the ultrasonic treatment tool 3 and the foot switch 4 are connected to the apparatus main body 2.
- the foot switch 4 includes an incision switch 4a and a coagulation switch 4b. Incision switch
- the coagulation switch 4b is for performing the coagulation mode.
- the ultrasonic treatment instrument 3 is provided with a treatment section 12 at the distal end of an elongated sheath-shaped insertion tube 4, and a handpiece 13 at the proximal end.
- the handpiece 13 has a built-in ultrasonic vibrator to be described later that generates ultrasonic vibration. Further, the handpiece 13 is provided with an operation window 14 for operating the treatment section 12.
- the operation handle 14 is composed of a fixed handle 14a and a movable handle 14b.
- the fixed handle 14a is provided integrally with the handpiece 13.
- the movable handle 14b is provided to be able to open and close with respect to the handpiece 13.
- the insertion portion mantle tube 11 is provided with an ultrasonic probe 15 for transmitting ultrasonic vibration from the ultrasonic transducer to the treatment section 12. The distal end of the ultrasonic probe 15 is exposed at the distal end of the insertion portion outer tube 11.
- An ultrasonic cable 16 that is electrically connected to the ultrasonic transducer extends from the handpiece 13.
- the ultrasonic cable 16 is detachably connected to the apparatus main body 2.
- the handpiece 13 has a heat sensor cable 17 electrically connected to a heat sensor described later. This heat sensor cable 17 is detachably connected to the apparatus main body 2.
- a power switch 22, an operation display unit 23, an ultrasonic cable connection unit 24, and a heat sensor cable connection unit 25 are provided on a front panel 21 of the apparatus main body 2.
- a foot switch cable 18 of the foot switch 4 is detachably connected to the rear panel of the apparatus main body 2.
- the ultrasonic cable 16 of the ultrasonic treatment instrument 3 is detachably connected to the ultrasonic cable connecting section 24. Further, the heat sensor cable 17 of the ultrasonic treatment instrument 3 is detachably connected to the heat sensor cable connection portion 25.
- the operation display unit 23 includes a setting switch 26 and a display unit 27.
- the setting switch 26 is for setting the magnitude of the ultrasonic output during normal operation when performing ultrasonic treatment.
- the display unit 27 digitally displays the magnitude of the ultrasonic output set by the setting switch 26.
- the setting switch 26 includes an output increasing switch 26a and an output decreasing switch 26b.
- the power increase switch 26a is used to change the size of the ultrasonic output (increase the calorific value).
- the output reduction switch 26b is for changing (reducing) the magnitude of the ultrasonic output.
- FIG. 2 is a schematic sectional view showing the configuration of the ultrasonic treatment device in FIG.
- the ultrasonic treatment device 3 has an ultrasonic transducer 31 provided on the base end side of the ultrasonic probe 15. Further, the ultrasonic probe 15 is provided with a distal treatment section 32.
- the distal treatment section 32 has a substantially circular cross-sectional shape.
- a horn 33 for expanding the amplitude is connected to the tip of the ultrasonic transducer 31. The distal end of the horn 33 is attached to the proximal end of the ultrasonic probe 15.
- the ultrasonic vibrator 31 generates an ultrasonic vibration when a drive signal is supplied from the apparatus main body 2 via the ultrasonic cable 16.
- the ultrasonic vibration generated by the ultrasonic transducer 31 is transmitted to the ultrasonic probe 15 after its amplitude is increased by the horn 33.
- the ultrasonic vibration transmitted to the ultrasonic probe 15 is transmitted to the distal treatment section 32 and is applied to the living tissue! /
- a jaw 34 that can be opened and closed is provided in the treatment section 12.
- the jaw 34 is rotatably supported by a pivot shaft 35 at the distal end of the insertion tube 11.
- the tip of an operation rod 36 is connected to the pivot shaft 35.
- the operation rod 36 is disposed on the insertion portion outer tube 11.
- the rear end of the operating rod 36 is connected to the operating force adjusting section 37.
- the operating force adjusting section 37 is connected to the movable handle 14b.
- the operating force adjusting section 37 moves the operating rod 36 forward and backward while adjusting the amount of operating force from the movable handle 14b by the biasing force of the coil spring 38.
- the reciprocating operation rod 36 opens and closes the jaw 34 via the pivot shaft 35!
- the operating force adjustment section 37 operates the operating force from the movable handle 14b.
- the operation rod 36 is pushed out to the distal end side while adjusting the position, and the jaw 34 is closed around the pivot shaft 35 with respect to the distal treatment section 32 of the ultrasonic probe 15.
- the jaw 34 is provided with a heat sensor 40 at the tip where the heat is highest.
- the heat sensor 40 is composed of, for example, a thermocouple, a thermostat, or the like.
- the thermal sensor 40 has a thermal sensor signal line 41 extending therefrom. This heat sensor signal line 41 is connected to a heat sensor terminal 42.
- the heat sensor terminal 42 is configured such that the heat sensor cable 17 is detachably connected thereto.
- the heat sensor 40 detects the temperature of the jaw 34 and transmits information on the detected temperature to the apparatus main body 2.
- the number of times of sampling by the heat sensor 40 is, for example, 10 times or more per second.
- FIG. 3 is a circuit block diagram of the ultrasonic surgical apparatus in FIG.
- the device main body 2 has a heat detection circuit 51, a foot switch detection circuit 52, an ultrasonic output circuit 53, and a control circuit 54.
- the heat detection circuit 51 acquires temperature information from the heat sensor 40 of the ultrasonic treatment instrument 3 and detects the temperature of the jaw 34. The heat detection circuit 51 detects the temperature of the detected jaw 34.
- the foot switch detection circuit 52 receives the on / off signal of the foot switch 4 and outputs the received on / off signal to the control circuit 54.
- the ultrasonic output circuit 53 receives an on / off signal and an ultrasonic amplitude value signal from the control circuit 54, and outputs a drive signal for controlling and driving the ultrasonic transducer 31 of the ultrasonic treatment instrument 3. I have.
- the control circuit 54 controls the ultrasonic output circuit 53 based on the on / off signal output from the foot switch detection circuit 52 and the temperature information of the jaw 34 output from the heat detection circuit 51. .
- the control circuit 54 receives the input of the on / off signal of the foot switch 4 and the temperature information, and outputs the on / off signal and the ultrasonic amplitude value signal to the ultrasonic output circuit 53.
- the treatment section 12 in the coagulation mode, is configured to keep a predetermined temperature at which the treatment section 12 (jaw 34) coagulates without cutting the living tissue. The operation of the control circuit 54 will be described with reference to a flowchart described later.
- the ultrasonic surgical apparatus 1 configured as described above can effectively perform ultrasonic treatment such as incision and coagulation on a living tissue.
- the surgeon turns on the power switch 22 of the apparatus main body 2.
- the heat sensor 40 of the ultrasonic treatment instrument 3 detects the temperature of the jaw 34 and starts transmitting the detected temperature information to the apparatus main body 2 via the heat sensor cable 17.
- the operator places a finger other than the thumb on the fixed handle 14 a against the urging force of the coil spring 38, and puts the thumb on the movable handle 14 b and grips the operation handle 14 of the ultrasonic treatment instrument 3.
- the ultrasonic treatment instrument 3 is operated by the operating force adjusting portion 37. While adjusting the amount of operating force from 14b, push the operating rod 36 toward the distal end.
- the force transmitted by the advance of the operating rod 36 acts on the jaw 34 in a direction to close around the pivot shaft 35.
- the jaw 34 sandwiches the living tissue between the distal end treatment section 32 of the ultrasonic probe 15 and closes the distal end treatment section 32 of the ultrasonic probe 15 so that the jaw 34 and the distal end treatment section 32 have a living body. Grasp the tissue.
- the operator steps on the foot switch 4 and performs ultrasonic treatment on the living tissue grasped between the jaw 34 and the distal end treatment section 32 of the ultrasonic probe 15.
- the grasped living tissue is subjected to ultrasonic treatment such as coagulation or incision by frictional heat with the distal treatment section 32 vibrating at a high speed.
- the ultrasonic operation apparatus 1 operates according to the flowchart shown in FIG. 4 or FIG.
- FIG. 4 is a flowchart showing the operation in the incision mode in the first embodiment.
- the foot switch 4 When the operator steps on the incision switch 4 a of the foot switch 4, the foot switch 4 outputs an incision ON signal via the foot switch cable 18.
- control circuit 54 starts control as shown in FIG.
- the control circuit 54 determines whether or not the incision switch 4a of the foot switch 4 has been pressed (step Sl).
- the control circuit 54 is connected to the foot switch detection circuit 52 via the foot switch detection circuit 52.
- control circuit 54 when the control circuit 54 receives an incision ON signal from the foot switch 4 via the foot switch detection circuit 52, the control circuit 54 outputs an ON signal to the ultrasonic output circuit 53 to start ultrasonic output. (Step S2).
- control circuit 54 receives the temperature information of the jaw 34 via the heat detection circuit 51.
- the control circuit 54 controls the ultrasonic output circuit 5 based on the received temperature information from the jaw 34.
- An ultrasonic amplitude value signal is output so that the ultrasonic amplitude of the drive signal output from 3 is constant.
- the ultrasonic output circuit 53 outputs a drive signal with a constant ultrasonic amplitude based on the ultrasonic amplitude value signal from the control circuit 54.
- the drive signal from the device body 2 is transmitted through the ultrasonic cable 16 to the ultrasonic
- the ultrasonic oscillator 31 is transmitted to the wave oscillator 31 to drive the same.
- the ultrasonic transducer 31 receives the drive signal and performs ultrasonic vibration so that the ultrasonic amplitude becomes constant (Step S3). This ultrasonic vibration is transmitted to the distal treatment section 32 of the ultrasonic probe 15. The distal treatment section 32 vibrates at a high speed so that the ultrasonic amplitude becomes constant. The grasped living tissue is incised by frictional heat with the distal treatment section 32 that vibrates at a high speed.
- the foot switch 4 outputs an incision off signal via the foot switch cable 18.
- the control circuit 54 outputs an off signal to the ultrasonic output circuit 53 when receiving the incision off signal from the foot switch 4 via the foot switch detection circuit 52.
- the ultrasonic output circuit 53 stops outputting the drive signal to the ultrasonic transducer 31 based on the off signal from the control circuit 54 (Step S4).
- the ultrasonic transducer 31 stops the ultrasonic vibration, and the ultrasonic treatment ends.
- the ultrasonic amplitude is always constant in the incision mode.
- FIG. 5 is a flowchart showing the operation in the coagulation mode according to the first embodiment.
- the foot switch 4 When the operator depresses the coagulation switch 4b of the foot switch 4 and turns it on, the foot switch 4 outputs a coagulation ON signal via the foot switch cable 18.
- control circuit 54 starts control as shown in FIG. Control circuit
- step Sl l determines whether or not the coagulation switch 4b of the foot switch 4 has been pressed.
- control circuit 54 when the control circuit 54 receives the solidified ON signal from the foot switch 4 via the foot switch detection circuit 52, the control circuit 54 outputs an ON signal to the ultrasonic output circuit 53 to start ultrasonic output. (Step S12).
- the control circuit 54 immediately after the start of the ultrasonic output, the control circuit 54 generates an ultrasonic amplitude value signal so that the ultrasonic amplitude becomes maximum, and outputs the signal to the ultrasonic output circuit 53.
- the ultrasonic output circuit 53 outputs a drive signal with the maximum ultrasonic amplitude based on the ultrasonic amplitude signal from the control circuit 54.
- the drive signal from the apparatus main body 2 is transmitted to the ultrasonic oscillator 31 of the ultrasonic treatment instrument 3 via the ultrasonic cable 16, and drives the ultrasonic oscillator 31.
- the ultrasonic transducer 31 receives the driving signal and performs ultrasonic vibration so that the ultrasonic amplitude becomes maximum (step S13). This ultrasonic vibration is transmitted to the distal treatment section 32 of the ultrasonic probe 15. The distal treatment section 32 vibrates at a high speed so that the ultrasonic amplitude becomes maximum. The grasped living tissue starts to coagulate due to frictional heat with the distal treatment section 32 that vibrates at a high speed.
- the control circuit 54 monitors the temperature T of the treatment section 12 during the coagulation treatment, and controls the ultrasonic amplitude so that the temperature of the treatment section 12 becomes a predetermined temperature Tl (around 120 ° C.). It's about to do.
- This temperature Tl (around 120 ° C) is a temperature at which the living tissue is thermally denatured without performing the incision procedure.
- control circuit 54 sets the temperature T of the treatment section 12 to the preset temperature Tl (1
- step S14 It is determined whether or not the force exceeds 20 ° C) (step S14).
- the ultrasonic output circuit 53 outputs a drive signal that minimizes the ultrasonic amplitude based on the ultrasonic amplitude value signal from the control circuit 54.
- the ultrasonic transducer 31 receives the drive signal and performs ultrasonic vibration so that the ultrasonic amplitude is minimized (Step S15). This ultrasonic vibration is transmitted to the distal treatment section 32 of the ultrasonic probe 15. The distal treatment section 32 oscillates at a low speed so that the ultrasonic amplitude becomes minimum.
- the temperature T of the treatment section 12 becomes the temperature Tl (around 120 ° C).
- the operator does not release the foot from the coagulation switch 4b of the foot switch 4. Yes.
- the foot switch 4 outputs a coagulation off signal via the foot switch cable 18.
- the control circuit 54 determines whether or not the coagulation switch 4b of the foot switch 4 is on (step S16). The control circuit 54 repeats S14 to S16 until a coagulation off signal from the foot switch 4 is received via the foot switch detection circuit 52.
- the control circuit 54 when receiving the solidified off signal from the foot switch 4 via the foot switch detecting circuit 52, the control circuit 54 outputs an off signal to the ultrasonic output circuit 53.
- the ultrasonic output circuit 53 stops outputting the drive signal to the ultrasonic transducer 31 based on the off signal from the control circuit 54 (Step S17).
- the ultrasonic transducer 31 stops the ultrasonic vibration, and the ultrasonic treatment ends.
- the ultrasonic surgical apparatus 1 rapidly ultrasonically vibrates from the start of the ultrasonic output until the temperature reaches the preset temperature T1, and when the temperature reaches the temperature T1, the incision is not performed and the heat is denatured. Ultrasonic vibration at low speed to coagulate.
- the ultrasonic surgical apparatus 1 can control the temperature rise of the treatment section 12 and the grasped living tissue by controlling the frictional heat.
- the ultrasonic surgical apparatus 1 can control the energy application to the living tissue without the operator's consciousness, and can prevent an excessive rise in the temperature of the living tissue.
- the first embodiment controls the ultrasonic amplitude value so that the treatment section 12 maintains a predetermined temperature.
- the second embodiment determines the treatment section 12 by cooling by air supply and water supply. It is configured to keep the temperature of
- the other configuration is almost the same as that of the first embodiment, and therefore the description is omitted, and the same configuration is denoted by the same reference numeral.
- FIG. 6 is an overall configuration diagram showing an ultrasonic operation apparatus according to the second embodiment.
- the ultrasonic surgical apparatus 1B in the present embodiment is provided with an air / water supply device 61.
- the air supply / water supply device 61 is a device for supplying air and water to the ultrasonic treatment device 3B in order to cool the treatment section 12 of the ultrasonic treatment device 3B.
- an air supply / water supply device 61 is connected to an air / water supply control cable connection unit 28 via an air / water supply control cable 62.
- the ultrasonic treatment tool 3B is a handpiece It is connected to the air / water supply device 61 by an air / water supply cable 63 extending from the distal end side.
- the apparatus body 2B is provided with an air / water interlocking switch 64 on the front panel 21! By depressing the air / water interlocking switch 64, the apparatus main body 2B can perform the air / water interlocking on / off operation.
- the air supply / water supply device 61 is connected to the apparatus main body via an air / water supply control cable 62.
- the air is supplied to the ultrasonic probe 15 through the air / water supply cable 63 by being controlled by 2B.
- the air supply / water supply device 61 includes a water supply bottle (not shown) for supplying water.
- FIG. 7 is a schematic sectional view showing the configuration of the ultrasonic treatment device in FIG.
- the ultrasonic treatment instrument 3B is provided with an air supply / water supply conduit 65 on the tip side of the handpiece.
- the air supply line 65 extends to the vicinity of the jaw 34.
- the treatment section 12 is cooled by a fluid such as gas or water passing through the air / water supply conduit 65.
- Air supply / water supply conduit 65 is connected to air supply / water supply base 66. This air / water supply base 66 is detachably connected to the air / water supply cable 63!
- FIG. 8 is a circuit block diagram of the ultrasonic surgical apparatus in FIG. As shown in FIG. 8, the device body 2B is provided with an air / water supply output circuit 67 for controlling and driving the air / water supply device 61.
- the air / water output circuit 67 is controlled by the control circuit 54B. That is, the air / water supply output circuit 67 receives the on / off signal and the air / water supply amount signal from the control circuit 54B, and outputs a control signal for controlling and driving the air / water supply device 61.
- control circuit 54B Based on the on / off signal output from the foot switch detection circuit 52 and the temperature information of the jaw 34 output from the heat detection circuit 51, the control circuit 54B includes an air supply / water supply output circuit in addition to the ultrasonic output circuit 53. Controls 67.
- control circuit 54B receives the input of the on / off signal of the foot switch 4 and the temperature information, outputs the on / off signal and the ultrasonic amplitude signal to the ultrasonic output circuit 53, and outputs the air / water output circuit 67 An on / off signal and an air / water supply signal are output to the system.
- the air supply / water supply unit 61 is configured to perform the air supply or water supply for a predetermined time in conjunction with the off signal from the foot switch 4.
- the treatment section 12 in the second embodiment, similarly to the first embodiment, in the coagulation mode, is configured to maintain a predetermined temperature at which the treatment section 12 coagulates while incising the living tissue. ing.
- the operation of the control circuit 54B will be described with reference to a flowchart described later.
- the other configuration is almost the same as that of the first embodiment, and the description is omitted.
- the ultrasonic surgical apparatus 1B configured as described above can effectively perform ultrasonic treatment such as incision and coagulation on a living tissue.
- the surgeon turns on the power switch 22 of the apparatus main body 2B.
- the heat sensor 40 of the ultrasonic treatment instrument 3B detects the temperature of the jaw 34 and starts transmitting the detected temperature information to the apparatus main body 2B.
- the operator turns on the air / water link switch 64.
- the apparatus main body 2B can control and drive the air / water supply device 61 in conjunction with the OFF signal of the foot switch 4.
- the surgeon places a finger other than the thumb on the fixed handle 14a and the thumb on the movable handle 14b against the urging force of the coil spring 38. Then, the operator holds the operation nozzle 14 of the ultrasonic treatment instrument 3B, and grasps the living tissue between the jaw 34 and the distal treatment section 32 of the ultrasonic probe 15.
- the operator steps on the foot switch 4 and performs ultrasonic treatment on the living tissue grasped between the jaw 34 and the distal end treatment section 32 of the ultrasonic probe 15.
- the grasped living tissue is subjected to ultrasonic treatment such as coagulation or incision by frictional heat with the distal treatment section 32 vibrating at a high speed.
- the ultrasonic operation apparatus 1B operates according to the flowchart shown in FIG. 9 or FIG. First, the incision mode will be described.
- FIG. 9 is a flowchart showing the operation in the incision mode in the second embodiment.
- control circuit 54B starts control as shown in FIG.
- the control circuit 54B determines whether the incision switch 4a of the foot switch 4 has been pressed. Disconnect (step S21). If the control circuit 54B has not received the incision ON signal from the foot switch 4, the control circuit 54B ends this flow.
- control circuit 54B when the control circuit 54B receives an incision ON signal from the foot switch 4 via the foot switch detection circuit 52, the control circuit 54B outputs an ON signal to the ultrasonic output circuit 53 to start ultrasonic output. (Step S22).
- control circuit 54B receives the temperature information of the jaw 34 via the heat detection circuit 51.
- the control circuit 54B outputs an ultrasonic amplitude value signal based on the received temperature information from the jaw 34.
- the ultrasonic output circuit 53 outputs a drive signal based on the ultrasonic amplitude signal from the control circuit 54B.
- the drive signal from the apparatus main body 2B is transmitted to the ultrasonic transducer 31 of the ultrasonic treatment instrument 3B via the ultrasonic cable 16, and drives the ultrasonic transducer 31.
- the ultrasonic transducer 31 receives the drive signal and performs ultrasonic vibration. This ultrasonic vibration is transmitted to the distal treatment section 32 of the ultrasonic probe 15. The distal treatment section 32 vibrates at high speed
- the grasped living tissue is incised by frictional heat with the distal treatment section 32 that vibrates at a high speed.
- the control circuit 54B determines whether or not the incision switch 4a of the foot switch 4 is turned off.
- Step S23 When the control circuit 54B has not received the incision off signal from the foot switch 4, the control circuit 54B returns to S22 and continues the ultrasonic output. On the other hand, when receiving the incision off signal from the foot switch 4 via the foot switch detection circuit 52, the control circuit 54B outputs an off signal to the ultrasonic output circuit 53.
- the ultrasonic output circuit 53 stops outputting the drive signal to the ultrasonic vibrator 31 based on the OFF signal from the control circuit 54B (step S24), and the ultrasonic vibrator 31 stops the ultrasonic vibration. Stop.
- control circuit 54B controls the air / water supply output circuit 67 to start the air / water supply (step S25).
- the control circuit 54B based on the received temperature information from the jaw 34, the control circuit 54B generates an air / water supply amount signal so as to perform air / water supply for a predetermined time, and sends an ON signal and an air / water supply output circuit 67 to the air / water supply output circuit 67. Outputs the air / water flow signal.
- the air / water supply output circuit 67 outputs a control signal based on the ON signal and the air / water supply amount signal from the control circuit 54B so that air or water is supplied for a predetermined time.
- a control signal from the apparatus main body 2 is transmitted to an air / water supply device 61 via an air / water supply control cable 62 to drive the air supply / water supply device 61.
- the air supply / water supply device 61 receives the control signal and performs air supply or water supply for a predetermined time, for example, for about 3 seconds.
- Air supply / water supply device 61 supplies a fluid such as gas or water to ultrasonic treatment instrument 3B.
- fluid such as gas or water supplied from the air / water supply device 61 is supplied to the vicinity of the jaw 34 via the air / water supply cable 63.
- Treatment unit 12 is an air supply
- control circuit 54B After a predetermined time, the control circuit 54B outputs an off signal to the air / water supply output circuit 67.
- the air / water output circuit 67 outputs an air / water supply based on the OFF signal from the control circuit 54B.
- Air supply 'water supply 61 stops air supply or water supply (step S26)
- the ultrasonic surgical apparatus 1B can lower the temperature of the treatment section 12 immediately after the incision of the living tissue, and prevent thermal denaturation of the surrounding biological tissue due to contact with the treatment section 12. it can.
- FIG. 10 is a flowchart showing the operation in the coagulation mode in the second embodiment.
- the foot switch 4 When the operator depresses and turns on the coagulation switch 4b of the foot switch 4, the foot switch 4 outputs a coagulation ON signal via the foot switch cable 18.
- control circuit 54B starts control as shown in FIG.
- the control circuit 54B determines whether or not the coagulation switch 4b of the foot switch 4 has been pressed (step S31).
- the control circuit 54B receives the coagulation ON signal from the foot switch 4 via the foot switch detection circuit 52, and in this case, terminates this flow.
- control circuit 54B transmits a signal from the foot switch 4 via the foot switch detection circuit 52. If the fixed ON signal is received, an ON signal is output to the ultrasonic output circuit 53 to start ultrasonic output (step S32).
- control circuit 54B generates an ultrasonic amplitude value signal and outputs the signal to the ultrasonic output circuit 53.
- the ultrasonic output circuit 53 outputs a drive signal based on the ultrasonic amplitude value signal from the control circuit 54B.
- the drive signal from the apparatus main body 2B is transmitted to the ultrasonic vibrator 31 of the ultrasonic treatment instrument 3B via the ultrasonic cable 16, and drives the ultrasonic vibrator 31.
- the ultrasonic transducer 31 receives the drive signal and performs ultrasonic vibration. This ultrasonic vibration is transmitted to the distal treatment section 32 of the ultrasonic probe 15.
- the distal treatment section 32 vibrates at a high speed.
- the grasped living tissue starts to coagulate due to frictional heat with the distal treatment section 32 vibrating at a high speed.
- control circuit 54B monitors the temperature T of the treatment section 12 during the coagulation treatment, and performs cooling control so that the temperature T of the treatment section 12 becomes a predetermined temperature Tl (around 120 ° C). Is to be performed.
- control circuit 54B sets the temperature T of the treatment section 12 to the preset temperature T1 (
- step S33 It is determined whether or not the force is equal to or higher than (around 120 ° C.) (step S33). If the temperature T of the treatment section 12 is equal to or higher than the temperature T1, the control circuit 54B controls the air / water output circuit 67 to start the air / water supply (step S34).
- the control circuit 54B generates an air / water supply signal so that the amount of the air / water supply is an amount that suppresses the temperature rise of the treatment section 12 due to the frictional heat, and outputs an ON signal to the air / water supply output circuit 67. And the air / water flow signal is output.
- the air / water supply output circuit 67 controls the air / water supply amount based on the ON signal and the gas / water supply amount signal from the control circuit 54B so as to suppress the temperature rise of the treatment section 12 due to frictional heat. To output a control signal.
- the control signal from the apparatus main body 2 is transmitted to the air / water transmitter 61 via the air / water control cable 62, and drives the air / water transmitter 61.
- the air supply / water supply device 61 performs air supply or water supply in response to a control signal.
- Air supply ⁇ Water supply device 61 is an ultrasonic treatment tool
- a gas such as gas or water supplied from the water supply / water supply device 61 is supplied to the vicinity of the jaw 34 via the gas / water supply cable 63.
- the treatment section 12 is cooled by a fluid such as gas or water supplied from the air supply / water supply device 61, and the temperature T of the treatment section 12 becomes a predetermined temperature Tl (120 ° (Near C).
- the control circuit 54B determines whether or not the coagulation switch 4b of the foot switch 4 is in the ON state force (step S35). When the coagulation switch 4b of the foot switch 4 is in the ON state, the control circuit 54B returns to S33 and repeats the above S33 to S35 until the coagulation off signal from the foot switch 4 is received via the foot switch detection circuit 52. repeat. On the other hand, when receiving the coagulation off signal from the foot switch 4 via the foot switch detection circuit 52, the control circuit 54B outputs an off signal to the ultrasonic output circuit 53.
- the ultrasonic output circuit 53 stops outputting the drive signal to the ultrasonic vibrator 31 based on the OFF signal from the control circuit 54 (step S36), and the ultrasonic vibrator 31 stops the ultrasonic vibration. I do.
- the control circuit 54B outputs an OFF signal to the air / water supply output circuit 67 to stop the air / water supply by the air / water supply device 61 (step S37), and the ultrasonic treatment ends.
- an OFF signal is output to the air / water supply output circuit 67 to stop the air / water supply by the air / water supply device 61 (step S38).
- the control circuit 54B determines whether or not the solidification switch 4b of the foot switch 4 is in the ON state force (step S39). When the coagulation switch 4b of the foot switch 4 is in the ON state, the control circuit 54B returns to S32 and repeats the above S32 to S39 until the coagulation off signal from the foot switch 4 is received via the foot switch detection circuit 52. repeat.
- the control circuit 54B when receiving the solidified off signal from the foot switch 4 via the foot switch detecting circuit 52, the control circuit 54B outputs an off signal to the ultrasonic wave output circuit 53.
- Ultrasonic output The power circuit 53 stops outputting the drive signal to the ultrasonic vibrator 31 based on the OFF signal from the control circuit 54 (step S40), and the ultrasonic vibrator 31 stops ultrasonic vibration.
- control circuit 54B includes the air / water output circuit in the same manner as described in the incision mode.
- the air supply / water supply is started by controlling 67 (step S41).
- the control circuit 54B Based on the received temperature information from the jaw 34, the control circuit 54B generates an air supply / water supply amount signal so that air supply or water supply is performed for a predetermined time in the same manner as in the incision mode, and the air supply / water supply signal is generated.
- the output circuit 67 outputs an ON signal and an air / water supply amount signal.
- the air / water supply output circuit 67 receives a control signal via the air / water supply control cable 62 based on the ON signal and the air / water supply amount signal from the control circuit 54B so that air or water is supplied for a predetermined time. Is output and air is supplied. ⁇ The water supply device 61 is driven. The air supply / water supply device 61 performs air supply or water supply for a predetermined time in response to the control signal, and the treatment section 12 is cooled.
- the control circuit 54B outputs an off signal to the air / water supply output circuit 67 after a predetermined time.
- the air / water output circuit 67 outputs an air / water supply based on the OFF signal from the control circuit 54B.
- Air supply 'water supply 61 stops air supply or water supply (step S42)
- the ultrasonic treatment device 3B ends the ultrasonic treatment.
- the ultrasonic surgical apparatus 1B maintains the temperature of the treatment section 12 at a predetermined temperature at which the incision of the living tissue is not performed, so that the operator can administer the energy to the living tissue. Reliable coagulation of living tissue can be performed without control.
- the ultrasonic surgical apparatus 1B cools the treatment section 12 and the living tissue by air supply and air supply linked with the ultrasonic wave or air supply after the ultrasonic output. As a result, it becomes possible to control the temperature rise of the living tissue.
- the ultrasonic operation apparatus 1B can obtain the same effects as those of the first embodiment.
- the first embodiment is configured to control the ultrasonic amplitude value so that the treatment section 12 maintains a predetermined temperature.
- the third embodiment controls the amount of gripping force for gripping a living tissue.
- the treatment section 12 is configured to maintain a predetermined temperature.
- the other configuration is almost the same as that of the first embodiment, so that the description is omitted, and the same configuration is denoted by the same reference numeral.
- FIG. 11 is an overall configuration diagram showing an ultrasonic surgical apparatus according to the third embodiment. As shown in FIG. 11, the ultrasonic surgical apparatus 1C according to the third embodiment has an ultrasonic treatment tool 3C provided with an electromagnet 72 described later for adjusting the amount of gripping force on a living tissue to be gripped. It is configured.
- the output cable 71 for the electromagnet which also extends to the distal end of the handpiece, is connected to the output cable connection portion 29 for the electromagnet of the apparatus main body 2C.
- FIG. 12 is a schematic sectional view showing the configuration of the ultrasonic treatment device in FIG.
- a pair of electromagnets 72 are provided in the operation force adjusting section 37 so as to repel each other.
- Signal lines 73 extending from these electromagnets 72 are connected to electromagnet terminals 74.
- the electromagnet terminal 74 is configured such that an electromagnet output cable 71 is detachably connected thereto.
- the electromagnet 72 generates a magnetic force by a current supplied from the apparatus main body 2C, and generates repulsive forces repelling each other.
- the ultrasonic treatment instrument 3 C causes the operating rod 36 to move forward by the repulsive force of the electromagnet 72 in addition to the urging force of the coil spring 38, and the jaw 34 to the distal treatment section 32 of the ultrasonic probe 15. Is acting in the closing direction.
- FIG. 13 is a circuit block diagram of the ultrasonic operating apparatus in FIG. As shown in FIG. 13, the device main body 2C is provided with an electromagnet current output circuit 75 for controlling and driving the electromagnet 72.
- the electromagnet current output circuit 75 is controlled by the control circuit 54C. That is, the electromagnet current output circuit 75 receives the on / off signal and the current value signal of the control circuit 54C, and outputs a current for controlling and driving the electromagnet 72.
- the control circuit 54C controls the electromagnet 72 in addition to the ultrasonic output circuit 53, based on the on / off signal output from the foot switch detection circuit 52 and the temperature information of the jaw 34 output from the heat detection circuit 51. It's like this.
- the control circuit 54C receives the input of the on / off signal of the foot switch 4 and the temperature information, outputs the on / off signal and the ultrasonic amplitude value signal to the ultrasonic output circuit 53, and outputs the current output circuit 75 for the electromagnet. And an on / off signal and a current value signal.
- the treatment section 12 is configured to maintain a predetermined temperature at which the treatment section 12 coagulates without cutting the living tissue. ! / ⁇ The operation of the control circuit 54C will be described with reference to a flowchart described later.
- the ultrasonic surgical apparatus 1C configured as described above can effectively perform ultrasonic treatment such as incision and coagulation on a living tissue.
- the operator turns on the power switch 22 of the apparatus main body 2C.
- the heat sensor 40 of the ultrasonic treatment instrument 3C detects the temperature of the jaw 34 and starts transmitting the detected temperature information to the apparatus main body 2C via the heat sensor cable 17.
- the surgeon places a finger other than the thumb on the fixed handle 14a and the thumb on the movable handle 14b against the urging force of the coil spring 38. Hold the operation nozzle 14 of the ultrasonic treatment tool 3C.
- the ultrasonic treatment tool 3C pushes the operation rod 36 toward the distal end while the operation force adjustment unit 37 adjusts the operation force from the movable handle 14b.
- the force transmitted by the advance of the operation rod 36 acts on the jaw 34 in a direction to close around the pivot shaft 35.
- the jaw 34 sandwiches the living tissue between the distal end treatment section 32 of the ultrasonic probe 15 and closes the distal end treatment section 32 of the ultrasonic probe 15 so that the jaw 34 and the distal end treatment section 32 have a living body. Grasp the tissue.
- the operator steps on the foot switch 4 and performs ultrasonic treatment on the living tissue grasped between the jaw 34 and the distal end treatment section 32 of the ultrasonic probe 15.
- the grasped living tissue is subjected to ultrasonic treatment such as coagulation or incision by frictional heat with the distal treatment section 32 vibrating at a high speed.
- the ultrasonic operating apparatus 1C operates according to the flowchart shown in FIG. 14 or FIG. First, the incision mode will be described.
- FIG. 14 is a flowchart showing the operation in the incision mode in the third embodiment.
- the control circuit 54C starts control as shown in FIG.
- the control circuit 54C determines whether or not the incision switch 4a of the foot switch 4 has been pressed (step S41). If the control circuit 54C has not received the incision ON signal from the foot switch 4, the control circuit 54C ends this flow.
- the control circuit 54C when receiving the cut-on signal from the foot switch 4 via the foot switch detection circuit 52, the control circuit 54C outputs an ON signal to the ultrasonic output circuit 53 to start ultrasonic output. (Step S42).
- control circuit 54 C receives temperature information of jaw 34 via heat detection circuit 51.
- the control circuit 54C outputs an ultrasonic amplitude value signal based on the received temperature information from the jaw 34.
- the ultrasonic output circuit 53 outputs a drive signal based on the ultrasonic amplitude value signal of the control circuit 54C.
- the drive signal of the apparatus main body 2C is transmitted to the ultrasonic vibrator 31 of the ultrasonic treatment instrument 3C via the ultrasonic cable 16, and drives the ultrasonic vibrator 31.
- the ultrasonic transducer 31 receives the drive signal and performs ultrasonic vibration. This ultrasonic vibration is transmitted to the distal treatment section 32 of the ultrasonic probe 15. The distal treatment section 32 vibrates at a high speed. The grasped living tissue is incised by frictional heat with the distal treatment section 32 that vibrates at a high speed.
- control circuit 54C controls the current output circuit 75 for electromagnets to control the amount of gripping force.
- the control circuit 54C generates a current value signal so that the amount of gripping force becomes maximum, and outputs an ON signal and a current value signal to the current output circuit 75 for electromagnets.
- the electromagnet current output circuit 75 outputs the maximum current based on the ON signal and the current value signal from the control circuit 54C (step S43).
- the maximum current from the apparatus main body 2C is transmitted to the electromagnets 72 of the ultrasonic treatment device 3C via the electromagnet output cable 71, and the electromagnets 72 generate the maximum magnetic force to generate the maximum repulsive force.
- the maximum repulsive force acts on the distal end treatment section 32 of the ultrasonic probe 15 in the direction in which the jaw 34 closes by moving the operating rod 36 forward in addition to the urging force of the coil spring 38.
- the maximum repulsive force of the electromagnet 72 and the amount of gripping force of the treatment section 12 are maximized, and the distal treatment section 32 of the ultrasonic probe 15 is strongly in contact with the living tissue. Therefore, the grasped living tissue receives the maximum ultrasonic vibration from the distal treatment section 32 of the ultrasonic probe 15 and is quickly cut.
- the control circuit 54C returns to S41, and determines whether or not the incision switch 4a of the foot switch 4 has been turned off. When the control circuit 54C has not received the incision off signal from the foot switch 4, the process returns to S42 and continues the ultrasonic output. On the other hand, when the control circuit 54C receives the incision off signal from the foot switch 4 via the foot switch detection circuit 52, it outputs an off signal to the ultrasonic output circuit 53.
- the ultrasonic output circuit 53 stops outputting the drive signal to the ultrasonic vibrator 31 based on the off signal of the control circuit 54C (Step S44), and the ultrasonic vibrator 31 stops the ultrasonic vibration. Stop.
- the control circuit 54C outputs an off signal to the electromagnet current output circuit 75.
- the electromagnet current output circuit 75 stops the current supply based on the off signal of the control circuit 54C (step S45). In the ultrasonic treatment device 3C, only the urging force of the coil spring 38 becomes the amount of grasping force of the biological tissue, the ultrasonic treatment is stopped, and the ultrasonic treatment is finished.
- the ultrasonic surgical apparatus 1C can apply the ultrasonic vibration from the distal end treatment section 32 of the ultrasonic probe 15 to the grasped living tissue to the maximum extent, and can quickly perform the operation. A tissue incision can be made.
- FIG. 15 is a flowchart showing the operation in the coagulation mode in the third embodiment.
- the foot switch 4 When the operator depresses and turns on the coagulation switch 4b of the foot switch 4, the foot switch 4 outputs a coagulation ON signal via the foot switch cable 18.
- the control circuit 54C starts control.
- the control circuit 54C determines whether or not the coagulation switch 4b of the foot switch 4 has been pressed (step S51).
- the control circuit 54C receives the coagulation ON signal from the foot switch 4 via the foot switch detection circuit 52, and in this case, terminates this flow.
- control circuit 54C outputs the signal from the foot switch 4 via the foot switch detection circuit 52.
- an ON signal is output to the ultrasonic wave output circuit 53 to start ultrasonic wave output (step S52).
- control circuit 54C receives temperature information of the jaw 34 via the heat detection circuit 51.
- the control circuit 54C outputs an ultrasonic amplitude value signal based on the received temperature information from the jaw 34.
- the ultrasonic output circuit 53 outputs a drive signal based on the ultrasonic amplitude value signal of the control circuit 54C.
- the drive signal of the apparatus main body 2C is transmitted to the ultrasonic vibrator 31 of the ultrasonic treatment instrument 3C via the ultrasonic cable 16, and drives the ultrasonic vibrator 31.
- the ultrasonic transducer 31 receives the drive signal and performs ultrasonic vibration. This ultrasonic vibration is transmitted to the distal treatment section 32 of the ultrasonic probe 15. The distal treatment section 32 vibrates at a high speed. The grasped living tissue starts to coagulate due to frictional heat with the distal treatment section 32 vibrating at a high speed.
- control circuit 54C controls the current output circuit 75 for electromagnets to control the amount of gripping force.
- the control circuit 54C generates a current value signal so that the amount of gripping force becomes maximum, and outputs an ON signal and a current value signal to the current output circuit 75 for electromagnets.
- the electromagnet current output circuit 75 outputs the maximum current based on the ON signal and the current value signal from the control circuit 54C (step S53).
- the maximum current from the apparatus main body 2C is transmitted to the electromagnets 72 of the ultrasonic treatment instrument 3C via the electromagnet output cable 71, and the electromagnets 72 generate the maximum magnetic force to generate the maximum repulsive force.
- the maximum repulsive force acts on the distal end treatment section 32 of the ultrasonic probe 15 in the direction in which the jaw 34 closes by moving the operating rod 36 forward in addition to the urging force of the coil spring 38.
- the maximum repulsive force of the electromagnet 72 and the amount of gripping force of the treatment section 12 are maximized, and the distal treatment section 32 of the ultrasonic probe 15 is strongly in contact with the living tissue. Therefore, the grasped living tissue receives the maximum ultrasonic vibration from the distal treatment section 32 of the ultrasonic probe 15 and is quickly coagulated.
- control circuit 54C monitors the temperature T of the treatment section 12 during the coagulation treatment, and determines the amount of gripping force so that the temperature T of the treatment section 12 becomes a predetermined temperature Tl (around 120 ° C). To control ing.
- control circuit 54C sets the temperature T of the treatment section 12 to the preset temperature T1 (
- step S54 It is determined whether or not the force is equal to or higher than about (120 ° C) (step S54).
- control circuit 5 when temperature T of treatment section 12 is equal to or higher than temperature T1 (go to “Y” in S54), control circuit 5
- the electromagnet current output circuit 75 outputs a reduced current based on the current value signal from the control circuit 54C (step S55).
- the ultrasonic treatment instrument 3C has a gripping force amount that suppresses the temperature rise of the treatment section 12 due to frictional heat, and the distal treatment section 32 of the ultrasonic probe 15 is weakly abutted on the living tissue, so that the ultrasonic vibration is reduced. give.
- the grasped living tissue is thermally denatured and coagulated without performing an incision treatment due to frictional heat with the distal treatment section 32 vibrating at a low speed.
- the temperature T of the treatment section 12 becomes the temperature Tl (around 120 ° C).
- the operator does not release his foot from the coagulation switch 4b of the foot switch 4.
- the foot switch 4 outputs a coagulation off signal via the foot switch cable 18.
- the control circuit 54C determines whether or not the coagulation switch 4b of the foot switch 4 is in the ON state force (step S56). When the coagulation switch 4b of the foot switch 4 is in the ON state, the control circuit 54C returns to S53 and repeats the above steps S53 to S55 until the coagulation off signal from the foot switch 4 is received via the foot switch detection circuit 52. repeat.
- the control circuit 54C when receiving the solidified off signal from the foot switch 4 via the foot switch detecting circuit 52, the control circuit 54C outputs an off signal to the ultrasonic wave output circuit 53.
- the ultrasonic output circuit 53 stops outputting the drive signal to the ultrasonic vibrator 31 based on the OFF signal from the control circuit 54 (step S57), and the ultrasonic vibrator 31 stops ultrasonic vibration.
- the control circuit 54C outputs an off signal to the current output circuit 75 for electromagnets.
- the magnetic stone current output circuit 75 stops the current supply based on the off signal from the control circuit 54C (step S58).
- the ultrasonic treatment device 3C only the urging force of the coil spring 38 becomes the amount of grasping force of the living tissue, the ultrasonic treatment is stopped, and the ultrasonic treatment device 3C ends.
- the ultrasonic surgical apparatus 1C maintains the temperature of the treatment section 12 at a predetermined temperature at which coagulation of the living tissue is not performed, thereby enabling the operator to administer energy to the living tissue. Reliable coagulation of living tissue can be performed without control.
- the ultrasonic surgical apparatus 1C controls the frictional heat by changing the amount of gripping force during the ultrasonic output based on the fed back temperature information, and increases the temperature of the treatment section 12 and the temperature of the living tissue. Can be controlled.
- the ultrasonic surgical apparatus 1C can obtain the same effects as those of the first embodiment.
- the gripping force is controlled using the repulsive force by the electromagnet 72, but the present invention is not limited to this, and the gripping force is controlled using the attractive force of the electromagnet 72.
- the gripping force may be controlled by combining the repulsive force and the attractive force.
- the ultrasonic surgical apparatus according to the present invention has an effect that it is possible to control the administration of energy to living tissue without being conscious of the operator and to prevent an excessive rise in temperature of living tissue.
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Abstract
Description
Claims
Priority Applications (1)
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US11/570,881 US20080058845A1 (en) | 2004-06-16 | 2005-06-10 | Ultrasonic Surgical Operation Instrument |
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JP2004178914A JP4343778B2 (ja) | 2004-06-16 | 2004-06-16 | 超音波手術装置 |
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US20080058845A1 (en) | 2008-03-06 |
JP2006000322A (ja) | 2006-01-05 |
JP4343778B2 (ja) | 2009-10-14 |
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