JPS6331222B2 - - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION The present invention relates to an electric scalpel device that is inserted into a body cavity through an endoscope to perform resection, incision, etc. of diseased tissue, and particularly relates to an electric scalpel device that is inserted into a body cavity through an endoscope to perform resection, incision, etc. In case of unexpected movement of the patient (human body) (stretch reflex, etc.), high frequency output is stopped and unnecessary ablation is performed.
This invention relates to a high frequency output device for an electric scalpel that prevents incisions and the like.

Generally, high-frequency power is supplied from a high-frequency power supply device between an electric scalpel having a loop-shaped or needle-shaped electrode inserted into an endoscope and a grounding plate that is in contact with the patient's body skin. An electric scalpel device is known that performs resection, incision, blood coagulation, etc. of an affected area by passing a high frequency current through the patient and generating heat generated by the current concentrated on the electrodes of the electric scalpel. When such an electric scalpel is inserted into a rigid endoscope and inserted into the urethra to remove a prostate gland, cancer, etc., the patient's stretch reflex (muscle spindles, tendons, and other deep tissues) It is a reflex caused by a certain receptor and is called a deep reflex, and because it causes contraction in the same muscle as the receptor, it is called an intrinsic reflex and occurs in the extensor muscles. There is a risk that the straightening movement, that is, the raising of the waist, may cause the electrode of the electric scalpel located inside the urethra to cut into the tissue regardless of the operator's operation.

In the past, the surgeon had to be agile in responding to such unexpected movements of the human body, and there was a risk that the surgeon would cut out too much of the area.

This invention was made in view of the above-mentioned points.
By providing a motion detection means that detects unexpected movements of the human body such as stretch reflexes and turns off the high frequency output, the stretch reflex of the human body can be detected by using a ground plate that is tightly fixed to the human body when using the electric scalpel. An electric scalpel designed for safety by immediately stopping the supply of high-frequency current in the event of unexpected movement caused by such things, and preventing the electric scalpel from extending the resection or incision beyond the intended resection, incision, or coagulation range. The purpose is to provide a high frequency output device.

The present invention will be specifically described below with reference to the drawings. 1 to 4 show a first embodiment of the invention. FIG. 1 shows an operating table and a human body placed on the operating table. In this figure, reference numeral 1 denotes an operating table, on which the buttocks 3 of the patient's body 2 are placed and supported, and the operator enters between the legs 4 of the human body 2 placed on the operating table 1. Both legs opened to the left and right for surgery 4
A footrest 6 for supporting the thigh 5 of the foot is extended forward and attached. A fixing band 7 having a fastening portion at the end and fixing the thigh 5 is attached to the footrest 6. Further, the operating table 1 is provided with a ground plate 8 at the position where the buttocks are placed, and a band 9 having a fastening portion is attached to the ground plate 8, and the ground plate 8 is tightened with its upper surface in close contact with the buttocks 3.・It is becoming permanently installed. As shown in FIG. 2, the ground plate 8 has a ground portion 8A made of an elastic conductive metal plate on the upper surface of a casing 10 formed in a hollow shape from an elastic material having electrical insulation properties, such as silicone rubber. , fixed terminal 11 in the hollow of the casing 10
When the buttock 3 rests on this casing 10, it bends or moves together with the casing, and the terminal 11
A movable terminal 12 that electrically contacts is disposed to form a motion detection switch circuit section 8B that is electrically opened and closed by the weight of the human body.

On the other hand, the electric scalpel device connects the output end of the high frequency power supply 13 to the input end of the output control circuit 14 as shown in FIG.
5, and its output ends are connected to the foot switch 16, the grounding portion 8A of the grounding plate 8, and the electric scalpel 17, respectively. This electric scalpel 1
7 is inserted into a rigid endoscope 18 having an illumination optical system and an observation optical system, and the loop-shaped electrode 19 at the tip is inserted into the insulating sheath 20 at the tip by operating the proximal operation part of the rigid endoscope 18. It is configured to be inserted into a body cavity, such as the bladder. Further, an operation detection switch circuit section 8B disposed within the ground plate 8
is connected to the input terminal of the output control circuit 14 via a detection circuit 21 which outputs a detection signal when the detection switch circuit system is turned off, and turns off the control circuit 14 by outputting this detection signal and turns off the electricity. It is configured to cut off the output of high frequency current to the female 17.

In such a configuration, the rigid endoscope 18 is inserted into the bladder through the urethra, and the foot switch 16 is
The surgeon turns on the output control circuit 14 to supply high-frequency current to the electric scalpel 17 to remove sudden movements of the human body 2 during surgery to remove the prostate gland, for example, to the nerves that control stretch reflexes that operate even under general anesthesia. When the buttocks 3 rise due to stimulation (high frequency or mechanical), the motion detection switch circuit section 8B turns off and the detection circuit 21
A motion detection signal is output from , which turns off the output control circuit 14 and cuts off the output of high frequency current to the electric scalpel 17 . Therefore, the rigid endoscope 18 or the electric scalpel 17 moves due to this sudden movement of the human body 2, and it is possible to resect or incise tissue other than the target area, such as muscle tissue, regardless of the operator's operation. Prevented.

A second embodiment of the invention is shown in FIGS. 5 and 6. In this embodiment, two motion detection switch circuit parts 8B in the ground plate 8, that is, a fixed terminal 11 and a movable terminal 12, are connected in series, and each one is arranged at a position on which both of the buttocks 3 are placed. If even one of them is turned off, a detection signal is output from the detection circuit 21 as described above, the output control circuit 14 is turned off, and the supply of high frequency current to the electric scalpel 17 is cut off. With such a configuration, it is possible to track and detect partial movements of the human body, and it is also possible to detect even a twisting movement of the lower back, such as lifting one of the buttocks.

In the above-mentioned embodiments of the present invention, mechanical detection means have been described, but the present invention is not limited to this, and electrical detection means, such as a piezoelectric element, may be used as a detection means, or this invention may be used as a detection means. It is also possible to use a logic circuit that includes a plurality of piezoelectric elements and outputs a high frequency wave only when all the piezoelectric elements are in an output state, and does not output at other times.

Further, the ground plate 8 used in the present invention may be provided separately from the operating table 1 or may be provided incorporated therein.

Further, the electric scalpel of the present invention is used in various endoscopes, and is used for cutting and incising various diseased tissues, or for coagulating blood.

As described above, in this invention, the ground plate of an electric scalpel that uses high-frequency output is provided with a motion detection means for detecting sudden movements of the human body such as stretch reflexes and turning off the high-frequency output. If there is any unexpected movement caused by the electric scalpel, etc., the supply of high-frequency current to the electric scalpel is immediately stopped, and as a result, the electric scalpel is able to prevent the cutting or incision from reaching anything other than the intended resection, incision, or coagulation, making it safe. Furthermore, by tightly fixing the ground plate to an appropriate location on the human body, there is an effect that the high frequency output can be controlled against the above-mentioned unexpected movement of the human body.

[Brief explanation of the drawing]

1 to 4 show a first embodiment of the present invention, FIG. 1 is a schematic diagram showing an operating table and a human body, FIG. 2 is a sectional view of a ground plate, and FIG. A circuit diagram, FIG. 4 is a circuit diagram of an electric scalpel device, FIG. 5 is a sectional view of a grounding plate according to a second embodiment of the present invention, and FIG.
The figure is the circuit diagram of FIG. 1...Operating table, 8...Grounding plate, 8A...Grounding part, 8B
...Operation detection switch circuit section, 14...Output control circuit, 17...Electric scalpel, 18...Endoscope, 19...Electrode.

Claims (1)

[Claims] 1. In an electric scalpel device used in combination with an endoscope, a ground plate of the electric scalpel having an electrical grounding function detects unexpected movements of the human body such as stretch reflexes and emits high-frequency output. A high frequency output device for an electric scalpel, characterized in that it is provided with a motion detection means for controlling. 2. The high-frequency output device for an electric scalpel according to claim 1, wherein the ground plate is made of a material that has appropriate flexibility so that it can bend in the vertical direction. 3. The high-frequency output device for an electric scalpel according to claim 1, wherein the ground plate is provided with a band having a fastening means at an end so that it can be tightly fixed to a human body. 4. The motion detection means is turned on and off depending on the weight of the human body.
The high frequency output device for an electric scalpel according to claim 1, which is a switch that turns off.