JP3333154B2 - Medical equipment - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a medical device, and more particularly to a medical device for excision of a lesion in a living body.

[0002]

2. Description of the Related Art Conventionally, in medical equipment, when performing treatment such as excision of a living tissue such as a lesion site, a treatment tool such as a high-frequency snare is used to apply energy such as high-frequency current to the treatment tool. As a result, a predetermined treatment is performed.

[0003]

However, when the treatment tool is brought into contact with a living tissue at a lesion site and a predetermined energy is supplied to the treatment tool to treat the tissue with the energy,
In order to operate the treatment tool so that the treatment does not reach a part which should not be treated, the skill of the operator is required.

In view of the above problems, an object of the present invention is to provide a medical device which can prevent a treatment from reaching a part which should not be treated without the operator's particular care. is there.

[0005]

According to the present invention, there is provided a medical device comprising: a medical device configured to perform a predetermined treatment on a subject;
A treatment means for contacting the treatment means;
Medical equipment for treating the subject with energy
Te, said treatment hands energy to treat the subject
Connection between the energy supply means for supplying the step and the treatment means;
Wherein at the site touch by detecting the hardness of the object, the hardness
Hardness detection means for generating a detection signal according to
Based on the detection signal output from the detection means,
And the hardness of the subject at the contacted portion set in advance.
Comparing means for comparing the calculated value with a predetermined value, and the comparing means
Based on the result of the comparison,
When it is determined that the hardness of the subject has exceeded the predetermined value,
Energy from the energy supply means to the treatment means.
Control means for stopping the supply of gear .

Further, the medical device according to the present invention can
A treatment that comes into contact with the subject to perform a prescribed treatment
Means, and the energy supplied to the treatment means
The medical device for treating the subject
And energy supply means for supplying energy to treat the body to the treatment means, when contacted with the subject, before
Detecting the stress applied to the treatment means from the subject ,
Stress detection means for generating a detection signal according to the magnitude of the stress of, the detection signal output from the stress detection means
Based on the obtained magnitude of the stress from the subject and the
Comparing means for comparing the order set predetermined value, the ratio
A response from the subject based on the comparison result by the comparing means.
When it is determined that the magnitude of the force exceeds the predetermined value,
Energy from the energy supply means to the treatment means.
Control means for stopping the supply of gear .

[0007]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS The embodiments of the present invention will be described below with reference to illustrated examples.

FIG. 1 shows an intelligent treatment instrument device 41 according to a first embodiment of the present invention. The treatment tool device 41 is attached to a high-frequency snare 42 for performing ablation or the like with a high-frequency current, a high-frequency application device 43 that applies a high-frequency current for ablation to the high-frequency snare 42, and attached to the high-frequency snare 42.
The strain gauge 44 includes a strain gauge 44 for detecting a push-pull force, and a strain detector 45 that performs signal processing based on an output signal of the strain gauge 44 and controls the operation of the high frequency application device 43.

In the high-frequency snare 42, a snare wire 47 is inserted into a hollow tube sheath 46, and the tip of the snare wire 47 is a snare 48 functioning as a cutout.
And the rear end of the snare wire 47 is connected to the slider 4
9 is connected. The rear end of the tube sheath 46 is connected to the handle body 51. Each of the handle body 51 and the slider 49 is provided with a finger hook portion, and the finger can be passed through the finger hook portion to move the slider 49 back and forth with respect to the handle body 51 so that the snare 48 is moved forward from the distal end of the tube sheath 46. The snare 48 is moved backward by moving the snare 48 backward.
6 can be stored in the opening.

As shown in FIG. 2, the slider 49 is provided with a plug 52, and the snare wire 47 is connected to the high-frequency application device 43 via two contacts of the plug 52 so that a high frequency can be applied to the snare 48. It has become.
A strain gauge 44 is attached near the tip of the snare wire 47 near the snare 48.
The output signal of No. 4 reaches the plug 52 of the slider 49 via the signal line 53 inserted through the snare wire 47, for example, and transmits the output signal from the plug 52 to the distortion detecting device 45.

FIG. 3 shows the configuration of the distortion detecting device 45.
The output signal of the strain gauge 44 is input to a strain detection circuit 55,
After an output signal of the strain gauge 44 is subjected to signal processing such as amplification, the signal is input to a comparison circuit 56 and compared with an output signal of a hardness setting circuit 57 for setting a level at which energization is prohibited. The output of the comparison circuit 56 is output to the high frequency application device 43 via the control circuit 58, and controls the energization of the high frequency application device.

For example, the output detected by the strain gauge 44 is
When the level exceeds the set level of the hardness setting circuit 57, the comparison circuit 5
The output of 6 outputs a stop signal for interrupting (prohibiting the passage of) high-frequency current supplied from the high-frequency application device 43 to the high-frequency snare 42 via the control circuit 58.

According to this embodiment, the high-frequency snare 42
Can detect the hardness of the resection site by the gripping force, restrict the resection range, and prevent resection of a site that should not be resected, for example, a muscle layer or the like. FIG. 4 is an explanatory diagram showing this state.

As shown in FIG. 4A, the tumor portion on which the snare 48 is hung is a mucosal layer 59 (or a submucosal layer, a serosa).
If only the slider 49 is soft, the output of the strain gauge 44 is small even if the slider 49 is pulled. Incidentally, in FIG.
The lower part of 9 represents the muscle layer 60. On the other hand, FIG.
In the case where the muscle layer 60 extends over the snare 48 as shown in (b), when the snare 48 cuts off the mucous layer 59 and reaches the muscle layer 60 thereunder, the muscle layer 60 is hard, so the slider is used. The force to pull 49 increases. Accordingly, the output of the strain gauge 44 increases, and this output change is identified by the strain detection device 45, and a stop signal is output to the high frequency application device 43 to stop the supply of the high frequency current.

According to this embodiment, there is an effect that the muscle layer 60 can be prevented from being cut without any special attention by the operator. In this embodiment, the energization of the high-frequency application device 43 is controlled based on the output signal of the strain gauge 44. However, as shown by the dotted line in FIG. 3, a switch 50 for turning ON / OFF the energization / interruption control is provided. Alternatively, the energization control may be performed according to the operator's selection or may be selectively set so as not to be performed.

FIG. 5 shows a block configuration of a treatment tool device according to a second embodiment of the present invention. This embodiment is a high-frequency snare 6
1, a high-frequency application device 62 for supplying a high-frequency current to the high-frequency snare 61, and transmission and reception (ultrasonic) transducers 63 and 64 provided for controlling high-frequency application.
A driving circuit 65 for driving the transmitting transducer 63, a detector 66 for processing a signal received by the receiving transducer 64,
It comprises a driving circuit 65 and a comparator 67 for comparing the output of the detector 66 with the output. The output of the comparator 67 controls the energization of the high frequency application device 62. The control of the energization / interruption can be selected by an ON / OFF switch 68.

6 and 7 show the structure of the high-frequency snare 61 on the tip side. A snare wire 72 is inserted into the tube sheath 71, and a loop-shaped snare 73 is formed at the tip of the snare wire 72. A sensor section 74 provided with a transmitting vibrator 63 and a receiving vibrator 64 is attached to the inside of the distal end of the tube sheath 71, and the driving circuit 65 and the detecting circuit are connected via signal lines 75 and 76, respectively. Connected to the vessel 66.

In this embodiment, the subject is irradiated with ultrasonic waves having a constant frequency fo by the transmitting vibrator 63 to vibrate, while the receiving vibrator 64 detects the ultrasonic waves having the frequency fx in real time. The hardness of the object is detected by comparing the two frequencies fo and fx with the comparator 67. For example, when the sensor unit 74 is pressed against the subject with a constant contact pressure, the contact area decreases if the subject is sufficiently hard, so that the frequency change amount is due to the stiffness effect of the subject, and the soft subject is soft. In the case of (1), the contact area increases and the mass effect occurs, and the hardness / softness of the subject can be detected in real time by obtaining the frequency change at that time.

When the comparator 67 determines that the hardness is equal to or higher than a predetermined frequency, it outputs a stop signal to the high frequency applying device 62 (when the ON / OFF switch 68 is turned ON. The ON / OFF switch 68 is turned OFF). , The stop signal is not output.) The operation and effect of this embodiment are almost the same as those of the first embodiment. Further, according to this embodiment, the hardness of the deep part can be detected.

FIG. 8 shows the overall configuration of a treatment tool device according to a third embodiment of the present invention. This embodiment includes a high-frequency snare 71 using a superelastic alloy, a high-frequency application device 72, and a resistance detection unit 73 of the high-frequency snare 71.
A superelastic alloy wire such as Ni-Ti is used for the snare wire and the snare portion of the high-frequency snare 71 or at least one of them. This superelastic alloy has a characteristic that, in a superelastic region, when a stress is applied, the resistance value increases.

In this embodiment, the resistance value of the high-frequency snare 71 is detected by the resistance value detecting section 73, and if a resistance value equal to or higher than a predetermined value is detected, it is determined that the muscle layer is grasped, and the high-frequency application device 72 An energization is stopped by outputting a high frequency stop signal. FIG. 9 shows a specific configuration of the resistance detection unit 73.

The high-frequency snare 71 is connected to a high-frequency application device 72 and also to a resistance value detection circuit 74, and detects the resistance value of a snare line including a snare 71a formed of, for example, a Ni-Ti wire, and a comparison circuit. 75 is input to one input terminal. A reference value set by a hardness (resistance value) setting circuit 76 is input to the other input terminal of the comparison circuit 75. When the comparison circuit 75 detects a resistance value exceeding this reference value, the control circuit 77 Outputs a detection signal. When the detection signal is input, the control circuit 77 outputs a stop signal to the high frequency application device 72. The operation and effect of this embodiment are almost the same as those of the first embodiment. Further, there is an advantage that the diameter can be reduced because the high-frequency snare 71 itself becomes a sensor.

FIG. 10 shows a hand side of a high-frequency snare according to a modification of the third embodiment. This variant is
When the resistance value detection unit 73 shown in FIG. 8 or 9 determines that the resistance value is equal to or greater than a preset resistance value, it outputs a signal for energizing the stopper 80 by SMA provided in the middle of the movable range of the slider 79, The slider 80 is made to protrude so that the slider 79 cannot be slid further, thereby preventing the muscle layer or the like from being cut off.

In this case, it is not necessary to stop the energization output of the high frequency application device 72, and the movement of the operation unit is regulated at a level lower than the level at which the energization output is stopped, and energization is prohibited at a higher level. You may do it. The application of this modification is not limited to the third embodiment, but can be applied to, for example, the first and second embodiments. The stopper 80 may be operated by the SMA according to the hardness detection signal. Further, the present invention is effective not only for the high-frequency snare but also for other treatment tools such as biopsy forceps.

[0025]

As described above, according to the present invention, when the hardness of the tissue to be treated exceeds a predetermined level, the supply of energy to the treatment instrument is stopped to remove the tissue other than the predetermined site. The operator is fed back to the operator that he / she is about to perform the treatment, so that the operator can perform the treatment in response to the direct operation.

[Brief description of the drawings]

FIG. 1 is an overall configuration diagram of a treatment tool device according to a first embodiment of the present invention.

FIG. 2 is a perspective view showing a hand side of a high-frequency snare according to the first embodiment.

FIG. 3 is a block diagram illustrating a configuration of a distortion detection device according to the first embodiment.

FIG. 4 is an explanatory view showing a state of being cut off by the treatment tool device of the first embodiment.

FIG. 5 is a block diagram showing a configuration of a treatment tool device according to a second embodiment of the present invention.

FIG. 6 is a plan view showing a tip side of a high-frequency snare.

FIG. 7 is a cross-sectional view showing the tip side of a high-frequency snare.

FIG. 8 is a block diagram illustrating a configuration of a treatment tool device according to a third embodiment of the present invention.

FIG. 9 is a block diagram illustrating a configuration of a resistance value detection unit according to a third embodiment.

FIG. 10 is a plan view showing the near side of a high-frequency snare according to a modification of the third embodiment.

[Explanation of symbols]

 43: High frequency application device (energy supply means) 44: Strain gauge (hardness detection means) 48: Snare (treatment means) 58: Control circuit (control means) 74: Sensor unit (stress detection means)

────────────────────────────────────────────────── ─── Continuing on the front page (72) Inventor Koichi Umeyama 2-43-2 Hatagaya, Shibuya-ku, Tokyo Within O-limpus Optical Industry Co., Ltd. (72) Eiichi Fuse 2-43-2 Hatagaya, Shibuya-ku, Tokyo Inside the Olympus Optical Co., Ltd. (72) Michio Sato 2-43-2 Hatagaya, Shibuya-ku, Tokyo Inside the Olympus Optical Co., Ltd. Masaichi Nakamura 2-43-2 Hatagaya, Shibuya-ku, Tokyo No. Within Olympus Optical Co., Ltd. (72) Inventor Yasuhito Tanaka 2-43-2 Hatagaya, Shibuya-ku, Tokyo Inside Olympus Optical Co., Ltd. (72) Takashi Fukaya 2-43, Hatagaya, Shibuya-ku, Tokyo 2. Olympus Optical Industry Co., Ltd. (72) Inventor Kiyotaka Matsuno 2-43-2 Hatagaya, Shibuya-ku, Tokyo Optical Industry Co., Ltd. (72) Inventor Katsuya Suzuki 2-43-2 Hatagaya, Shibuya-ku, Tokyo O-Limpus Optical Industry Co., Ltd. Examiner Yoshikazu Tsuchida (56) References JP-A-63-147449 (JP, A JP-A-58-94846 (JP, A) JP-A-59-77844 (JP, A) JP-A-61-87530 (JP, A) (58) Fields investigated (Int. Cl. ⁷ , DB name) A61B 18/14 A61B 1/00 334

Claims (2)

(57) [Claims] 1. A method for performing a predetermined treatment on a subject.
A treatment means for contacting the subject;
Medical treatment for treating the subject with the supplied energy
In the device, an energy supply unit that supplies energy for treating the subject to the treatment unit, and a hardness of the subject at a contact portion with the treatment unit is detected, and a detection corresponding to the hardness is performed. Hardness detection means for generating a signal, based on the detection signal output from the hardness detection means
The hardness of the subject at the obtained contact site and
Comparing means for comparing a predetermined value set in advance, and the contact portion based on a comparison result by the comparing means.
That the hardness of the subject exceeds the predetermined value at
When the treatment hand is identified from the energy supply means,
Control means for stopping supply of energy to the stage . 2. Performing predetermined treatment on a subject
A treatment means for contacting the subject;
Medical treatment for treating the subject with the supplied energy
In devices, wherein the energy supply means for supplying said treatment means energy for treating a subject, when in contact with the subject, by detecting the stress applied from the subject to the treatment means, the stress According to the size of
Based on the detection signal output from the stress detection means.
And the magnitude of the obtained stress from the subject and presetting
Comparing means for comparing the obtained predetermined value with the predetermined value, and determining whether the subject
Identify that the magnitude of these stresses exceeds the specified value.
From the energy supply means to the treatment means.
A medical device, comprising: control means for stopping supply of energy .