JP4493625B2 - Ultrasonic surgery system - Google Patents

Description

The present invention relates to ultrasonic surgical systems for treating a living tissue by ultrasonic vibration.

  In general, an ultrasonic surgical apparatus that cuts a living tissue while coagulating it using ultrasonic vibration has been put into practical use. In this type of ultrasonic surgical apparatus, an ultrasonic transducer that generates ultrasonic vibrations inside the handpiece that includes a treatment unit that treats living tissue, and the ultrasonic vibrations from the ultrasonic transducers are treated as described above. It has a structure with a built-in probe that transmits to the part. The ultrasonic surgical apparatus is applied to endoscopic surgery, and the jaw as a tissue gripping tool provided at the tip of the handpiece is ultrasonically vibrated by the operation of the handle provided on the handpiece. The tissue is operated to close toward the probe, and the living tissue is sandwiched between the probe and the jaws, and ultrasonic vibration energy is applied, so that the tissue is coagulated and incised.

  In such an ultrasonic surgical apparatus, the gripping force between the probe and the jaw is excessive, or the base portion of the probe and the jaw is clogged, and the load on the ultrasonic vibration of the probe is excessive. Then, the ultrasonic vibration is not output.

Corresponding to this, for example, in Japanese Patent Application Laid-Open No. 11-70118 by the applicant of the present application, while performing treatment by outputting ultrasonic vibration, a load state with respect to ultrasonic vibration is detected and displayed as a bar graph. Is disclosed. In this ultrasonic surgical apparatus, by notifying the user of the state, the grasping force is made appropriate or the handpiece tip portion is urged to be cleaned so that the operation can proceed smoothly.
JP-A-11-70118

  As described above, in the conventional ultrasonic surgical apparatus, the handpiece can be washed and sterilized and used repeatedly. However, when washing or autoclave sterilization is performed, the cable and the watertight structure are damaged and super There is a possibility that a vapor or moisture may slightly enter the case of the handpiece incorporating the acoustic wave oscillator, or the cable may be broken or short-circuited. In addition, the ultrasonic transducer may deteriorate as it is repeatedly used over a long period of time. Furthermore, the change in characteristics due to the ingress of moisture into the case of the handpiece, etc., is not a problem if it is slight, but if it penetrates more than a certain level, it does not generate sufficient vibration in the ultrasonic vibrator. May become unstable. However, in the above-described ultrasonic surgical apparatus, it is possible to monitor the load state on the ultrasonic transducer only while performing the treatment by outputting ultrasonic vibration, and it is possible to quickly know the handpiece failure state and abnormality. It was.

The present invention has been made in view of these circumstances, and an object thereof is to provide an ultrasonic surgical system capable of examining the fault condition or abnormality of the handpiece to earlier.

The ultrasonic surgical system according to the present invention includes a handpiece having an ultrasonic transducer capable of generating ultrasonic vibration, and a detachable connection of the handpiece to generate a drive signal for driving the ultrasonic transducer. An ultrasonic surgical system comprising: an apparatus main body having an oscillating means for: sweeping means provided in the apparatus main body for sweeping the frequency of the oscillating means in a predetermined frequency range; and Detection means for detecting the impedance of the ultrasonic transducer when the drive frequency is changed, detection result writing means for writing a detection result in the detection means in a memory means provided in the handpiece, and the handpiece Detection result for reading out the previous detection result written by the detection result writing means from the memory means when connected to the apparatus main body An abnormality determining means for comparing the previous detection result read by the output means, the detection result reading means with the current detection result detected by the detection means, and determining the abnormality of the handpiece based on the difference; Notification means for notifying when an abnormality is determined by the abnormality determination means.

According to the present invention, it is possible to provide an ultrasonic surgical system capable of examining the fault condition or abnormality of the handpiece to earlier.

  Embodiments of the present invention will be described below with reference to the drawings.

(First embodiment)
1 and 2 show an ultrasonic surgical system according to the first embodiment of the present invention applied to an ultrasonic coagulation / cutting device, FIG. 1 is an explanatory diagram showing the entire system, and FIG. It is explanatory drawing which shows an ultrasonic treatment tool.

  In FIG. 1, the ultrasonic surgical system 1 is provided with an apparatus main body 2, a foot switch 3 connected to the apparatus main body 2, and a hand piece 4A of the first ultrasonic treatment instrument 100A. Further, the base end portion of the connection cable 5 is connected to the handpiece 4A. A connector 6 is connected to the tip of the connection cable 5. Here, on the front panel 7 of the apparatus main body 2, an ultrasonic treatment tool connecting portion 8 is provided. Then, the connector 6 of the first ultrasonic processing tool 100A is detachably connected to the connecting portion 8.

  Note that examples of the ultrasonic treatment instrument used in the present invention include the first ultrasonic treatment instrument 100A shown in FIG. 1 and the second ultrasonic treatment instrument 100B shown in FIG. Here, the handpiece 4A of the first ultrasonic treatment instrument 100A of FIG. 1 includes an elongated sheath 9, a proximal-side operation unit 10 connected to the proximal end portion of the sheath 9, and a distal end portion of the sheath 9 There is a treatment section 11 installed in. The handpiece 4A includes an ultrasonic transducer that generates ultrasonic vibrations and a probe 12 that transmits the ultrasonic vibrations from the ultrasonic transducers to the treatment unit 11. Further, the treatment portion 11 is provided with a rotatable gripping portion (jaw) 13 at the distal end portion of the sheath 9. The gripping portion 13 can be brought into contact with and separated from the distal end portion of the probe 12.

  In addition, a fixed handle 14a and a movable bundle 14b are provided in the operation unit 10 on the hand side of the handpiece 4A. Then, by opening and closing the movable handle 14b with respect to the fixed handle 14a, the grip portion 13 of the treatment portion 11 can be brought into contact with and separated from the distal end portion of the probe 12. With such a structure, the treatment unit 11 treats a living tissue.

  On the other hand, the handpiece 4B of the second ultrasonic treatment instrument 100B is provided with a treatment section 15 having a configuration different from that of the first ultrasonic treatment instrument 100A. The treatment portion 15 is provided with a substantially L-shaped receiving portion 16 fixed to the distal end portion of the sheath 9 and an abutting portion 17 slidable in the axial direction within the sheath 9. Here, either one of the receiving part 16 and the abutting member 17 is connected to the probe 12 that vibrates ultrasonically.

  In both of the first and second ultrasonic treatment tools 100B, the living tissue is grasped by the distal treatment section by opening and closing the fixed handle 14a and the movable bundle 14b, and the foot switch 3 is operated. Ultrasonic vibration is generated and the tissue can be coagulated and incised.

FIG. 3 is a perspective view showing the apparatus main body 2 of FIG. 1 in more detail.
The front panel 7 of the apparatus main body 2 is provided with a power switch 18 and a display panel 19 as shown in FIG. Further, the display panel 19 is provided with a setting display unit 20 indicating a value in which the magnitude (amplitude magnitude) of the ultrasonic vibration is set, and a bar graph display unit 22 displaying the state of the ultrasonic transducer. . The setting unit 21 includes an up switch 21a and a down switch 21b for setting. The front panel 7 is provided with a start switch 23 for starting an operation for checking the state of the ultrasonic transducer.

FIG. 4 is a block diagram showing a circuit configuration of the apparatus main body 2.
In FIG. 4, inside the apparatus main body 2, a signal generator 24 that generates a drive frequency of the ultrasonic transducer, an amplifier 25 that amplifies a signal generated by the signal generator 24, and a drive output from the amplifier 25. A detection unit 26 that detects the voltage and current of the signal and an output transformer 27 that insulates and separates the ultrasonic transducer and the drive device are provided.

  An ID means 28 indicating the type of the handpiece is provided inside the handpiece 4A. On the other hand, the apparatus main body 2 is provided with handpiece type discrimination means 29. The handpiece type discriminating means 29 discriminates the type of the handpiece by reading the ID means 28. The result is transmitted to the drive control unit 30, and the drive control unit 30 sets drive parameters (basic frequency, current value, maximum continuous output time, etc.) according to the type of each handpiece, and the ultrasonic transducer A signal related to the drive start frequency and the magnitude of the ultrasonic output is transmitted to the signal generator 24 based on the detection result of the voltage and current of the drive signal, and the ultrasonic vibration output is performed by operating the foot switch 3. It is like that.

  The size of the ultrasonic output is displayed on the setting display unit 20. The size of the ultrasonic output can be set by the setting unit 21.

  The apparatus main body 2 is further provided with a vibrator state detection control unit 31 that receives the result of the handpiece type determination means 29 and detects the state of each handpiece based on the detection result of the voltage current. In this case, the apparatus body 2 operates the start switch 23 so that the vibrator state detection control unit 31 causes the drive control unit 30 to detect the frequency and the magnitude of the ultrasonic output necessary for detecting the state of the vibrator. An instruction signal is transmitted, and the obtained result is displayed on the status display unit 22.

  With such a configuration, the signal generator 24, the amplifier 25, and the output transformer 27 serve as an oscillation unit that generates a drive signal that drives the ultrasonic transducer. The drive control unit 30 is a sweep unit that sweeps the frequency of the oscillation unit in a predetermined frequency range. The detection unit 26 and the transducer state detection control unit 31 are detection units that detect the impedance of the ultrasonic transducer when the drive frequency of the drive signal is changed by the sweep unit. The status display unit 22 serves as a notification unit that notifies the detection result of the detection unit. The sweep range of the sweep means is a frequency range including the resonance frequency of the ultrasonic transducer. Furthermore, the vibrator state detection control unit 31 includes a holding unit that holds the maximum value of the detection result of the detection unit.

(Function)
Here, the characteristics of the ultrasonic transducer inside the handpiece will be described with reference to FIG.
FIG. 5 is an explanatory diagram for explaining the electrical characteristics of a general ultrasonic transducer. FIG. 5 (a) shows the ultrasonic transducer with an electric circuit symbol, and FIG. 5 (b) shows FIG. 5 (a). The ultrasonic transducer is shown by an electrical equivalent circuit.

  In general, the ultrasonic transducer 41 shown in FIG. 5A includes a series resonance part of an inductance component L, a capacitance component C, and a resistance component R shown in FIG. 5B, and a physical capacitance component (braking capacitance) Cb. The parallel circuit is shown.

  FIG. 6 is an explanatory diagram for explaining the electrical characteristics of an ultrasonic transducer that is more efficient than FIG. 5. FIG. 6A shows the ultrasonic transducer with an electric circuit symbol, and FIG. ) Shows the ultrasonic transducer of FIG. 6A in an electrically equivalent circuit.

  In order to drive the ultrasonic transducer 41 efficiently, an inductance Lm is inserted in parallel as shown in FIG. As a result, as shown in FIG. 6B, Lm and Cb cause parallel resonance at the resonance frequency, and the energy flowing through them is substantially canceled.

FIG. 7 is an explanatory diagram for explaining the operation based on the impedance characteristics of the ultrasonic transducer in the state of FIG.
FIG. 7A shows the impedance characteristics in the state of FIG.

  The parallel connection of the ultrasonic transducer 41 and the inductance Lm exhibits the impedance characteristics shown in FIG. 7A when the frequency f changes around the resonance frequency fr that is the minimum value (= R). In this case, fl and f2 are anti-resonance frequencies, and the impedance | Z | takes the maximum value at these two locations. When the ultrasonic transducer 41 is normal, it shows a change as shown by a solid line in the figure. Show.

  FIG. 7B shows a case where the frequency f applied to the vibrator is changed from the fl side to the f2 side by operating the function of holding the peak of the detected impedance | Z | The detection result is shown. In this case, as can be seen from this figure, since the peak of the magnitude of the impedance | Z | is high when the handpiece is normal, the indicator 22 displays a high level based on the result, and in the case of a fault condition, the impedance Since the peak of the magnitude of | Z | decreases, the result can be indicated by the indicator 22 so that the state of the handpiece can be notified.

FIG. 8 is a flowchart showing the operation of such an ultrasonic surgical system.
As shown in FIG. 8, first, when the power switch 18 is turned on in step S1, the apparatus main body 2 is connected to the handpiece type discriminating means 29 in step S2, confirming the connection state of the handpiece. In this case, in step S3, the type of the handpiece is determined, and various parameters are set according to the result. After that, when the handpiece check start switch 23 is pressed in step S4, the drive control unit 30 proceeds to the process of step S5 and performs the main driving (ultrasonic vibration) with respect to the signal generated by the signal generation unit 24. Is set to a signal level for checking smaller than that in the state where the treatment is performed), the process proceeds to step S6, and the frequency f is set to the scanning range according to each handpiece for the signal generator 24. In step S7, the vibrator state detection control unit 31 starts scanning to peak-hold the magnitude of the impedance | Z |, and displays the result on the indicator of the state display unit 22 in step S8.

  Here, if the impedance | Z | is significantly reduced, it is determined that a failure has occurred in step S9, and the process proceeds to step S10 to notify the fact without performing ultrasonic output. In this case, the state is also displayed on the indicator 22. If the impedance | Z | has not decreased so much, it is determined in step S9 that there is no problem, and the process proceeds to a process of performing ultrasonic output for ultrasonic treatment in step S11.

  FIG. 9 is a graph showing the results of scanning of the impedance | Z | in various states of the handpiece. A is when the handpiece is normal, B is when there is a failure such as moisture ingress, and C is when the cord to the handpiece is broken. In this case, D indicates a short-circuited case.

  The state A is the same as the actual battle state in FIG. 5A, and the state B is the same as the broken line state in FIG. In a state where the cord to the C handpiece is disconnected, the state of the maximum value on the measurement is shown regardless of the frequency f. When D is short-circuited, impedance | Z | is 0.

  FIG. 10 is an explanatory diagram showing impedance display by the indicator 22, FIG. 10 (a) is the state of FIG. 9A, FIG. 10 (b) is the state of FIG. 9B, and FIG. 10 (c) is the state of FIG. FIG. 10 (d) shows the display in the state of C, FIG. 10 (d).

  10, the indicator 22 displays the magnitude of the impedance | Z | by a bar graph type, and the light emitting portions 44, 44... Of a plurality of light emitting diodes (LEDs) are arranged side by side. In this case, the light emitting portion 44 that emits light is indicated by hatching.

  FIG. 10A shows a state in which 85% of the light emitting unit 44 is lit from the left and the impedance | Z | is large (about 85% of the maximum value in measurement). FIG. 10B shows a state where 40% from the left of the light emitting unit 44 is turned on and the impedance | Z | is small (about 40% of the maximum value in measurement). FIG. 10C shows a state in which all of the light emitting units 44 are turned on and the impedance | Z | FIG. 10D shows a state in which all the light emitting units 44 are turned off and the impedance | Z | is zero.

  By displaying the indicator 22 as shown in FIGS. 10A to 10D, it is possible to notify a failure state or abnormality. In addition, as shown in FIG. 10C and FIG. 10D, when the state can be clearly discriminated as disconnection or short, the abnormal state may be notified by another display means.

(effect)
According to this embodiment, since the operation of checking the state of the ultrasonic transducer is started by the start switch 23, the failure of the handpiece is indicated by the display of the impedance | Z | The state, for example, moisture intrusion into the handpiece, secular change, and disconnection or short circuit can be confirmed before use. You can also know the level of the abnormality. Thereby, it is possible to investigate the failure state and abnormality of the handpiece at an early stage, and the handpiece can be replaced or repaired at an appropriate time.

FIG. 11 is a perspective view showing a modification of the apparatus main body 2 of FIG.
As shown in FIG. 11, the apparatus main body 2 of this modification is provided with display means (for example, a liquid crystal display panel) 32 that shows how the impedance | Z |

  In the present modification, the state of the handpiece can be grasped more accurately by displaying the change of the impedance | Z |

(Second Embodiment)
Hereinafter, the second embodiment will be described with reference to FIGS. 12 and 13. In this case, the circuit configuration will be described with reference to FIGS.

  FIG. 12 is a graph showing the characteristic of the impedance | Z | when the ultrasonic transducer is in a failure state and the braking capacitance Cb (see FIGS. 5 and 6) is larger than the normal state.

  In FIG. 12, the solid line indicates the characteristic of the impedance | Z | when the ultrasonic vibrator is in a normal state, and the broken line indicates the characteristic of the impedance | Z | when the ultrasonic vibrator is in a failure state. The characteristic of the impedance | Z | of the ultrasonic transducer is that the Cb value increases in the failure state, so that the normal resonance points fl and f2 move to the low-frequency resonance points f3 and f4, respectively. The magnitude of | Z | is unbalanced. Utilizing this fact, the apparatus main body 2 (see FIGS. 4 and 5) detects the state by the vibrator state detection control unit 31, and notifies the handpiece of the failure state or abnormality.

(Function)
FIG. 13 is a flowchart showing the operation of the second embodiment, and the description of the same processing as the flowchart of FIG. 8 is omitted.

In FIG. 13, the operation before step S21 is the same as the operation up to step S6 shown in FIG. In step S21, the frequency scanning operation is started, and the magnitude of the impedance | Z | is determined by the frequency of the first maximum point (fl), the minimum point = resonance point (fr), and the second maximum point (f2). The magnitude of the impedance | Z | Next, in step S22, the frequency difference from fl to fr is compared with the frequency difference from fr to f2, and the equivalence is displayed on the indicator in step S23. If the two difference values are extremely different, it is determined that the handpiece has failed, and notification is made in step S25. If the two difference values are not so different, it is determined that the handpiece is normal, the process of step S11 shown in FIG. 8 is performed, and the process ends.
It is also possible to determine the state of the handpiece based on the level difference between fl and f2 instead of the frequency difference.

(effect)
According to this embodiment, since the state of the change of the braking capacitance component of the ultrasonic transducer can be understood, some of the wires connected to the ultrasonic transducer inside the handpiece are disconnected or short-circuited. You can also understand the state of repairs, and repairs can be performed quickly.

(Third embodiment)
Next, a third embodiment will be described with reference to FIGS.
FIG. 14 is a block diagram showing a third embodiment according to the present invention.
The handpieces 204A and 204B are provided with memory means 233A and 233B in which stored contents are set for each handpiece. The apparatus main body 202 is provided with means 234 for reading and writing the contents of the memory means 233A and 233B and a control unit 231 for controlling the means 234. In the apparatus main body 202, the driving means 235 equivalent to the driving means (signal generator 24, signal generator 24, amplifier 25, detector 26, output transformer 27, drive controller 30) of the ultrasonic transducer in FIG. Is provided.

  Here, in the first embodiment shown in FIG. 1 to FIG. 10, the state detection result is temporarily stored by the apparatus main body 2, but in this embodiment, the state detection result is stored. Are stored in memory means (RAM) 233A, 233B provided on the handpieces 204A, 204B side.

(Function)
FIG. 15 is a flowchart for explaining the operation in the third embodiment.
In FIG. 15, first, when the power switch 18 is turned on in step S31, the apparatus main body 202 reads the previous state detection result from the memory means in the handpiece in step S32. After that, in step S33, the handpiece check is started, and the scan is started by applying the frequency f to the ultrasonic transducer within the scan range according to each handpiece at a check signal level smaller than that at the time of driving. Then, the magnitude of the impedance | Z | is peak-held. In this case, information on the frequency f may be detected as in the second embodiment. Thereafter, in step S34, the check results are compared with the previous check results stored in the memory means. The comparison result is referred to in step S35 to determine whether or not there is a difference. If the difference is large, it is determined to be abnormal, and notification is made in step S36. The level is displayed on the indicator.

In step S35, if the difference is not large, it is determined to be normal, and the process proceeds to the ultrasonic output process in step S37. In addition, the current check result is written in the RAM on the handpiece 204A, 204B side in step S37.
The first check result or the factory shipment result may be left in the RAM without being erased, and the change with time may be seen.

(effect)
According to the third embodiment, since the check result of each handpiece is left as data in the handpiece itself, the history can be found by reading this data, and it can be separated by sending the data to a remote place. Even from here, it is possible to check the state of the handpiece.

[Appendix]
According to the above-described embodiment of the present invention described in detail above, the following configuration can be obtained.
(1) An ultrasonic transducer comprising an ultrasonic transducer that generates ultrasonic vibrations, a probe that transmits the ultrasonic vibrations to a treatment unit, and a drive unit that generates a drive signal for ultrasonically vibrating the ultrasonic transducers. In the sonic surgery system,
In the driving means, monitoring means for observing the relationship between the frequency applied to the ultrasonic transducer and the impedance; and
Notification means for notifying the state of the ultrasonic transducer based on the result of the monitoring means;
An ultrasonic surgical system comprising:

  (2) A frequency signal in an arbitrary range near the resonance frequency of the ultrasonic transducer is applied to the ultrasonic transducer, an impedance value with respect to the frequency is measured, and the value is displayed on the indicator means. The ultrasonic surgical apparatus according to Supplementary Note 1.

  (3) Apply a continuously variable frequency signal in an arbitrary range near the resonance frequency of the ultrasonic transducer to the ultrasonic transducer, measure the impedance value for the frequency, and hold the maximum value at that time The ultrasonic surgical apparatus according to appendix 1, wherein the value is displayed on the indicator means.

BRIEF DESCRIPTION OF THE DRAWINGS Explanatory drawing which shows 1st Embodiment of the ultrasonic surgery system which concerns on this invention. Explanatory drawing which shows the 2nd ultrasonic treatment tool which can be used for the ultrasonic surgery system of FIG. The perspective view which shows the apparatus main body of FIG. 1 in further detail. The block diagram which shows the circuit structure of the apparatus main body of FIG. Explanatory drawing explaining the electrical property of the general ultrasonic transducer | vibrator used for the ultrasonic surgery system of FIG. FIG. 6 is an explanatory diagram for explaining electrical characteristics of an ultrasonic transducer that is more efficient than FIG. 5. Explanatory drawing explaining the operation | movement by the impedance characteristic in the state of FIG.6 (b). The flowchart which shows operation | movement of the ultrasonic surgery system of FIG. The graph which shows the result of the scan of the impedance in the various states of the handpiece of FIG. Explanatory drawing which shows the impedance display by the indicator of FIG. The perspective view which shows the modification of the apparatus main body of FIG. The graph for demonstrating 2nd Embodiment which concerns on this invention. The flowchart which shows the operation | movement of 2nd Embodiment based on this invention. The block diagram which shows 3rd Embodiment which concerns on this invention. The flowchart which shows the operation | movement of 3rd Embodiment based on this invention.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 ... Ultrasonic surgery system 2 ... Apparatus main body 3 ... Foot switch 4A ... Handpiece 11 ... Treatment part 12 ... Probe 24 ... Signal generation part 25 ... Amplifier 26 ... Detection part 27 ... Output transformer 30 ... Drive control part 31 ... Vibrator State detection control unit 100A ... Ultrasonic treatment instrument

Claims (1)

  A handpiece having an ultrasonic transducer capable of generating ultrasonic vibration;
  An apparatus main body having oscillating means for detachably connecting the handpiece and generating a drive signal for driving the ultrasonic transducer;
  In an ultrasonic surgical system comprising:
  Provided in the apparatus body, sweeping means for sweeping the frequency of the oscillation means in a predetermined frequency range;
  Detecting means for detecting an impedance of the ultrasonic transducer when the drive frequency of the drive signal is changed by the sweep means;
  A detection result writing means for writing a detection result in the detection means into a memory means provided in the handpiece;
  When the handpiece is connected to the apparatus main body, detection result reading means for reading out the previous detection result written by the detection result writing means from the memory means;
  An abnormality determination unit that compares the previous detection result read by the detection result reading unit with the current detection result detected by the detection unit and determines an abnormality of the handpiece based on the difference;
  Notification means for notifying when an abnormality is determined by the abnormality determination means;
  An ultrasonic surgical system comprising:

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