JP3772039B2 - Surgical device - Google Patents

Description

[0001]
BACKGROUND OF THE INVENTION
The present invention relates to a surgical apparatus, and more particularly to a surgical apparatus characterized by a portion for supplying electric energy to a surgical instrument for performing a percutaneous operation.
[0002]
[Prior art]
In recent years, surgical instruments that treat an affected area by being inserted into an abdominal cavity or joint cavity using a trocar or the like under endoscopic observation with a rigid endoscope or the like have been widely used.
[0003]
For example, Japanese Examined Patent Publication No. 2-43501 proposes a surgical tool which is an intracorporeal excision device which is inserted into a joint cavity and excises cartilage or the like by driving an electric drill with a motor.
[0004]
[Problems to be solved by the invention]
However, the surgical tool proposed in the above Japanese Patent Publication No. 2-43501 is provided with a battery for driving a motor in the operation part of the surgical tool, and this battery is relatively heavy. If used for a long time, there will be a heavy burden on the fingers and there is a risk that reliable surgery will not be possible. In addition, when power is supplied to the surgical tool from the outside, a cord for supplying power must be connected to the operation unit. Such a cord hinders operation in the operation unit, and there is a risk that reliable operation cannot be performed. There is.
[0005]
In addition, since the weight of the battery is heavy as described above, there is a problem that the arrangement of the battery is restricted in order to improve the balance of the surgical tool.
[0006]
The present invention has been made in view of the above circumstances, and provides a surgical apparatus capable of reliably supplying electric energy to a surgical instrument with a simple configuration and improving the operability at the operation part of the surgical instrument. The purpose is to do.
[0007]
[Means for Solving the Problems]
The surgical apparatus of the present invention is a surgical instrument having a trocar that can be inserted into a body cavity percutaneously, an insertion portion that can be inserted into the trocar, and a distal treatment portion formed at the distal end of the insertion portion. When the insertion portion is inserted into the trocar, the distal treatment portion can be connected to the trocar with a surgical instrument for treating the tissue by applying electric energy to a predetermined tissue in the body cavity. In addition, the surgical device includes an energy supply unit that serves as a source of electrical energy for the surgical tool, and the surgical tool extends from the proximal end side of the surgical tool along the insertion axis of the insertion portion. The trocar includes a power supply electrode that can be connected to the energy supply means, a hollow portion through which the insertion portion of the surgical tool can be inserted, and a proximal end side of the hollow portion. Formed proximal opening An electrode disposed on the opening end surface outside the base end side opening, and is connected to the power supply electrode and contacts the surgical instrument side electrode when the surgical instrument is inserted into the trocar. And a trocar side electrode which can be contacted.
[0009]
DETAILED DESCRIPTION OF THE INVENTION
Embodiments of the present invention will be described below with reference to the drawings.
[0010]
1 to 5 relate to the first embodiment of the present invention, FIG. 1 is a block diagram showing the configuration of the surgical apparatus, FIG. 2 is a block diagram showing the configuration of the surgical instrument in FIG. 1, and FIG. FIG. 4 is an explanatory diagram for explaining an example of surgery using the surgical device of FIG. 1, and FIG. 5 is a diagram showing a configuration of a modified example of the surgical instrument of FIG. .
[0011]
As shown in FIG. 1, the surgical apparatus 1 of the present embodiment includes, for example, a trocar 2 that is percutaneously placed on the abdominal wall 8 and a jaw-type ultrasonic incision coagulation instrument that is inserted into the trocar 2. The surgical tool 3 is comprised.
[0012]
The trocar 2 includes an insertion portion 4 that is percutaneously inserted into a body cavity, and a proximal portion 5 that is connected to the proximal end of the insertion portion 4. A power cord 6 can be attached to and detached from the proximal portion 5. The other end of the power cord 6 is connected to a medical device power supply (not shown) for medical devices which is made safe (low voltage ensuring insulation). The insertion part 4 and the hand part 5 are hollow through which the surgical tool 3 can be inserted. The surgical tool 3 is inserted from the proximal end opening of the hand part 5 and the surgical tool 3 is inserted from the distal end opening of the insertion part 4. The tip can be protruded.
[0013]
In addition, as shown in FIG. 2, the surgical instrument 3 includes an elongated insertion portion 11 that is inserted through the trocar 2, a forceps portion 12 that cuts and coagulates tissue with ultrasonic waves provided at the distal end of the insertion portion 11, and a forceps portion 12. And an operation unit 13 connected to the base end of the insertion unit 11. The operation unit 13 includes a fixed grip unit 14 and a movable grip unit 15. The forceps unit 12 can be opened and closed by moving the movable grip 15 relative to the fixed grip 14.
[0014]
An ultrasonic driving unit 16 including an ultrasonic wave generating unit for supplying ultrasonic waves to the forceps unit 12 is provided in the fixed grip unit 14, and the ultrasonic driving unit 16 is provided in the movable grip unit 15. Further, a lead antenna 19 is electrically connected to a rod antenna-like terminal 18 that extends parallel to the insertion axis of the insertion portion 11 from the operation portion 13 and extends to the distal end side of the insertion portion via the switch 17. Here, the rod antenna-shaped terminal 18 is a stretchable terminal biased by a spring in the extending direction, the outer periphery is insulated, and only the tip can be conducted. Note that the number of terminals 18 is one in FIG. 2 for ease of explanation, but two terminals 18 are actually provided on the circumferences of different diameters centering on the insertion axis of the insertion portion 11. Yes.
[0015]
As shown in FIG. 3, the insertion shaft of the insertion portion 5 is in contact with the terminal 18 and is electrically connected to the opening surface of the proximal portion 5 of the hand portion 5 of the trocar 2 when the surgical instrument 3 is inserted into the trocar 2. A groove electrode 21 is provided on the ring centered at the center. Further, the hand portion 5 is provided with a power electrode portion 22 to which one end of the power cord 6 is detachably connected. The power electrode 22 is electrically connected to the groove electrode 21 via a lead wire (not shown). . For ease of explanation, the number of groove electrodes 21 is one in FIG. 3, but in reality, centering on the insertion axis of the insertion portion 5 corresponding to each of the two rod antenna-like terminals 18. Two different diameters are provided.
[0016]
It is desirable to provide means for suppressing the generation of noise such as a surge absorber between the groove electrodes 21 of the trocar 3 and on the surgical instrument 3 side.
[0017]
(Function)
Next, the operation of the surgical apparatus 1 of the present embodiment configured as described above will be described.
[0018]
For example, the surgical apparatus 1 is used under endoscopic observation with a rigid endoscope inserted percutaneously. In the surgical apparatus 1, the surgical tool 3 is percutaneously inserted into the body cavity of the hand portion 5 of the trocar 2. Insertion starts from the proximal opening. When the surgical instrument 2 is inserted into the trocar 2 by a predetermined amount, the distal end of the telescopic terminal 18 of the surgical instrument 3 comes into contact with the groove electrode 21 of the trocar 2 and is supplied from the power supply for medical equipment via the power cord 6. A current can be supplied to the sonic drive unit 16.
[0019]
Subsequently, when the surgical tool 3 is pushed in, the insertion portion 11 of the surgical tool 3 is inserted into the insertion portion 4 of the trocar 2 in a state where the distal end of the expandable terminal 18 of the surgical tool 3 is in contact with the groove electrode 21 of the trocar 2. The forceps part 12 finally protrudes from the distal end of the trocar 2 and the operation can be performed by operating the movable grip part 15 and the switch 17.
[0020]
For example, as shown in FIG. 4, in the case of a surgical operation in which a diseased part 41 such as gastric cancer is locally excised, observation of both an endoscope 42 inserted orally and a rigid endoscope (not shown) inserted percutaneously. Do it below. In the endoscope 42 inserted orally, the high-frequency treatment tool 43 protrudes from the treatment tool channel to treat the gastric wall mucosal surface, and in the surgical apparatus 1 of the present embodiment, the surgical tool through the trocar 2 inserted percutaneously. 3 treats the outer surface of the stomach. The endoscope 42 is orally inserted into the body cavity, and the high-frequency treatment instrument 43 is inserted through the treatment instrument channel 42 of the endoscope while imaging the affected part 41 at the tip and observing it with a monitor or the like. The affected area 41 is treated.
[0021]
When the surgical instrument 3 is rotated with respect to the trocar 2 during this operation, the telescopic terminal 18 of the surgical instrument 3 slides in the ring-shaped groove electrode 21 provided on the trocar 1 to a necessary position. The surgical tool 3 can be rotated. Accordingly, the surgical tool 3 can freely move back and forth and rotate with respect to the trocar 2.
[0022]
(effect)
As described above, in the present embodiment, power is reliably supplied to the ultrasonic drive unit 16 of the surgical instrument 3 by a simple configuration in which the tip of the telescopic terminal 18 of the surgical instrument 3 is brought into contact with the groove electrode 21 of the trocar 2. Since the surgical tool 3 can be moved back and forth and rotated with respect to the trocar 2 and the operation unit 13 of the surgical tool 3 is not provided with a battery, a power cord, or the like, the surgical tool 3 can be supplied. The operability at the operation unit 13 can be improved.
[0023]
As shown in FIG. 5, a rechargeable battery 51 may be provided in the operation unit 13 of the surgical instrument 3, and this recharge is possible when using the trocar 2 having the groove electrode 21 of the present embodiment. By using the surgical apparatus 1 while charging the battery 51, even when performing surgery using a normal trocar without the groove electrode 21, the battery 51 supplies power to the ultrasonic drive unit 16 of the surgical instrument 3. Surgery is possible.
[0024]
Further, the terminal 18 of the surgical instrument 3 is made to be extendable and retractable. However, the present invention is not limited to this, and the electrode side of the trocar 2 may be made to be extendable and the terminal 18 of the surgical instrument 3 slides on the groove electrode 21 of the trocar 2. However, the present invention is not limited to this, and the electrode side of the trocar 2 may be formed of a rotatable connector, and the extendable terminal 18 may be inserted into the connector.
[0025]
In the present embodiment, the jaw type ultrasonic incision and coagulation tool is illustrated as an example of the surgical instrument 3, but the present invention is not limited to this, and the surgical instrument may be a hook type ultrasonic incision and coagulation tool, a high-frequency treatment instrument, or a thermal knife. There may be.
[0026]
FIG. 6 is a configuration diagram showing the configuration of the surgical apparatus according to the second embodiment of the present invention.
[0027]
Since the second embodiment is almost the same as the first embodiment, only different points will be described, and the same components are denoted by the same reference numerals and description thereof will be omitted.
[0028]
(Configuration and action)
In general, in order to treat the abdominal cavity, the trocar for forceps that lifts and expels the organ, the trocar for forceps to give appropriate tension to the treatment site, the trocar for inserting a surgical instrument, and the organ are observed. A plurality of trocars such as a trocar for inserting an endoscope for performing the operation are required.
[0029]
Therefore, in this embodiment, a surgical apparatus capable of performing surgery by inserting a plurality of surgical tools into such a plurality of trocars will be described.
[0030]
As shown in FIG. 6, in the surgical operation apparatus 101 of the present embodiment, a plurality of, for example, three trocars of a first trocar 102a, a second trocar 102b, and a third trocar 102c can be used. A desired surgical tool (not shown) can be inserted into the trocar 102b and the third trocar 102c to perform surgery.
[0031]
The first trocar 102a includes an input electrode 103 for detachably connecting the power cord 6, and an output electrode 104 for supplying power to the second trocar 102b and the third trocar 102c.
[0032]
The power cord 6 is connected to the input electrode 103 of the first trocar 102a, one end of the connecting cord 105 is connected to the output electrode 104 of the first trocar 102a, and the connecting cord 105 branches into two on the way The other end of the branched connection cord 105 is connected to the electrodes of the second trocar 102b and the third trocar 102c.
[0033]
Therefore, when the power cord 6 is connected to a power supply for medical equipment (not shown), the current is supplied to the first trocar 102a, the second trocar 102b, and the third trocar 102c, and is inserted into each trocar. It becomes possible to drive a surgical tool or the like.
[0034]
(effect)
As described above, in this embodiment, in addition to the effects of the first embodiment, the operator can supply power to a plurality of trocars by connecting the power cord 6 to one trocar, and pre-operative setup is easy. And does not interfere with the operation of the surgeon.
[0035]
[Appendix]
(Additional Item 1) A trocar inserted percutaneously into a body cavity;
An insertion portion inserted into the trocar, the distal end of the insertion portion protrudes from the body cavity, and the tissue is treated by applying energy from the distal end of the insertion portion to the tissue in the body cavity by electric energy Surgical tools to do,
In a surgical apparatus configured to include energy supply means for supplying the electrical energy to the surgical tool,
The surgical tool is provided along an insertion axis of the insertion portion, and includes a contact electrode that can be expanded and contracted in the insertion axis direction,
The trocar includes a contact contact that contacts the contact electrode and is electrically connected to the contact electrode when the surgical instrument is inserted, and is electrically connected to the contact contact from the energy supply means. A surgical apparatus comprising an electrical energy receiving terminal for receiving electrical energy.
[0036]
(Additional Item 2) The surgical apparatus according to Additional Item 1, wherein the contact contact and the contact electrode are electrically connected to be rotatable about the insertion shaft.
[0037]
(Additional Item 3) A trocar inserted into a body cavity percutaneously;
An insertion portion that is inserted into the trocar, the distal end of the insertion portion protrudes from the body cavity, and the tissue is treated by applying energy from the distal end of the insertion portion to the tissue in the body cavity by electric energy. Surgical tools to do,
In a surgical apparatus configured to include energy supply means for supplying the electrical energy to the surgical tool,
The surgical tool includes a contact electrode provided along an insertion axis of the insertion portion,
The trocar is in contact with the contact electrode and electrically connected to the contact electrode when the surgical instrument is inserted, and is electrically connected to the contact contact from the energy supply means. An electrical energy receiving terminal for receiving electrical energy;
One of the contact electrode and the contact point is extendable and retractable in the insertion axis direction.
[0038]
(Additional Item 4) The surgical apparatus according to Additional Item 3, wherein the contact contact and the contact electrode are electrically connected to be rotatable about the insertion shaft.
[0039]
【The invention's effect】
According to the surgical apparatus of the present invention described above, there is an effect that it is possible to supply electric energy to ensure the surgical instrument by easy single structure, improve the operability of the operation portion of a surgical instrument .
[Brief description of the drawings]
FIG. 1 is a configuration diagram showing a configuration of a surgical apparatus according to a first embodiment of the present invention. FIG. 2 is a configuration diagram showing a configuration of a surgical instrument in FIG. 1. FIG. FIG. 4 is an explanatory view for explaining an example of surgery using the surgical apparatus of FIG. 1. FIG. 5 is a block diagram showing the configuration of a modified example of the surgical instrument of FIG. Schematic diagram showing the configuration of the surgical apparatus according to the second embodiment
DESCRIPTION OF SYMBOLS 1 ... Surgical apparatus 2 ... Tracar 3 ... Surgical tools 4, 11 ... Insertion part 5 ... Hand part 6 ... Power cord 12 ... Forceps part 13 ... Operation part 14 ... Fixed grip part 15 ... Movable grip part 16 ... Ultrasonic drive part 17 ... Switch 18 ... Terminal 19 ... Lead wire 21 ... Groove electrode 22 ... Power electrode part

Claims (1)

A trocar that can be inserted percutaneously into a body cavity;
A surgical instrument having an insertion section that can be inserted into the trocar and a distal treatment section formed at the distal end of the insertion section, and when the insertion section is inserted into the trocar, the distal treatment section A surgical tool for applying electrical energy to a predetermined tissue in the body cavity to treat the tissue;
Energy supply means connectable to the trocar and serving as a source of electrical energy for the surgical instrument ;
In a surgical apparatus comprising:
The surgical tool is
A surgical instrument side electrode provided extending from the proximal end side of the surgical instrument along the insertion axis of the insertion part,
The trocar is
A power supply electrode connectable with the energy supply means;
A hollow portion through which the insertion portion of the surgical instrument can be inserted;
A proximal end opening formed on the proximal end side of the hollow portion;
An electrode disposed on the opening end surface outside the proximal end opening, connected to the power supply electrode, and abutted against the surgical instrument side electrode when the surgical instrument is inserted into the trocar The trocar side electrode,
A surgical apparatus comprising:

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