JPH0130498B2 - - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION The present invention relates to a high-frequency electric scalpel device suitable for removing polyps.

Generally, when a polyp is removed using high frequency, a loop electrode is used as an internal electrode that is introduced endoscopically into the body cavity.The neck of the polyp is tied up with this loop electrode, and then the loop electrode is connected to the skin of the human body. A high-frequency current was passed between the polyp and an external electrode applied to the polyp to remove the polyp. In this case, the high-frequency current flows from the loop electrode through the neck of the polyp to the external electrode, but if the neck of the polyp is too thick, the blood vessels in the neck cannot be sufficiently cauterized, and the output setting of the high-frequency power supply may be too high. If the neck restraint force applied by the loop electrode was too strong, the neck would be instantly severed without sufficiently cauterizing the blood vessels in the neck, posing a great risk of causing major bleeding.

This invention was made based on the above circumstances, and its purpose is to sufficiently cauterize the internal tissue of the neck of a polyp before cutting it by using bipolar internal and external electrodes. It is therefore an object of the present invention to provide a high frequency electric scalpel device which eliminates the risk of bleeding associated with cutting, and which allows such operations to be performed reliably without error.

An embodiment of the present invention will be described below with reference to the drawings. 1 to 7 show a first embodiment of the present invention, in which numeral 1 indicates the main circuit of the high frequency output device 1. FIG. This high frequency output device 1 is provided with a high frequency generation circuit 3 to which a foot switch 2 is connected, and an output circuit 4 is connected to this high frequency generation circuit 3. This output circuit 4 is connected to a primary winding 6 of an output transformer 5, and this secondary winding 7 is connected to a first internal terminal 8 and a second internal terminal 9. The high frequency output device 1 is provided with first to third connection terminals 10, 11, 12, and a changeover switch 13 is provided between these connection terminals 10, 11, 12 and the internal terminals 8, 9. ing. That is, the changeover switch 13 has a first changeover part 14 and a second changeover part 15.
The normally open contact 14a of the first switching section 14 is connected to the first connection terminal 10 together with the first internal terminal 8, and the normally closed contact 14b is connected to the second internal terminal 9. Furthermore, this common contact 14c is connected to the second connection terminal 11. Further, the normally open contact 15a of the second switching section 15 is connected to the second internal terminal 9, and the normally closed contact 15b is open. Furthermore, this common contact 15c is connected to the third connection terminal 12.

The first connection terminal 10 and the second connection terminal 11
That is, a bipolar internal electrode 16 is provided to connect the first electrode 17 and the second electrode 18, respectively. This internal electrode 16 is inserted endoscopically into the body cavity, and the first and second electrodes 1
As shown in FIG. 2, 7 and 18 are inserted into a first through hole 20 and a second through hole 21 which are formed in a sheath 19 made of an insulating material so that they can move forward and backward, respectively.
The distal ends of the first and second electrodes 17 and 18 are bent into a hook shape, and are pre-arranged so that when the distal ends protrude from the sheath 19, they are bent away from each other as shown in FIG. It has a habit. Furthermore, when the first and second electrodes 17 and 18 are drawn into the sheath 19, their positions are shifted so that their tips do not come into contact with each other, as shown in FIG. Therefore, when the neck 23 of the polyp 22 is clamped between the tips of the first and second electrodes 17 and 18 as shown in FIG. 6, the tips of these electrodes 17 and 18 are electrically It is designed to prevent short circuits.

Furthermore, an external electrode 24 that is applied to the patient's skin is connected to the third connection terminal 12.

Next, the operation of the above configuration will be explained. First, the internal electrode 16 is inserted into the patient's body cavity through an endoscope, and the first electrode 17 and second electrode 18
After pinching the neck 23 of the polyp 22, the switch 13 is set to the state shown in FIG. 1, that is, the first state, and the foot switch 2 is turned on. Then, the high frequency generation circuit 3 generates a high frequency signal, this signal is amplified by the output circuit 4 and input to the primary winding 6 of the output transformer 5, and the secondary winding 7
As a result, a high frequency output is generated between the first internal terminal 8 and the second internal terminal 9. Then, the high-frequency current reaches the first electrode 17 of the internal electrode 16 from the first internal terminal 8 via the first connection terminal 10, and from there passes through the neck 23 of the polyp 22 to the second electrode 18. Through this second electrode 1
8 to the common contact 14 of the first switching part 14 of the switching switch 13 via the second connection terminal 11
c and the normally closed contact 14b to the second internal terminal 9. Therefore, since the high-frequency current passes through the inside of the neck 23 of the polyp 22 held between the first electrode 17 and the second electrode 18, the internal tissues and blood vessels are sufficiently cauterized. By continuing this first state for a predetermined period of time, it is possible to cut the neck 23, but when the first and second electrodes 17 and 18 are drawn into the sheath 19 for this purpose, they are Even though the tips are not in contact with each other, they are very close to each other, so the high frequency current causes discharge in the first and second electrodes 17 and 18, which quickly damages the neck 23. cannot be cut.

Next, the changeover switch 13 is switched to connect the common contact 14c of the first switching section 14 to the normally open contact 14a, and the second switching section 1
The common contact 15c of No. 5 is connected to the normally open contact 15a. Then, in this second state, the high frequency current flows from the first internal terminal 8 to the first and second electrodes 17 and 18 via the first and second connection terminals 10 and 11.
From there, it passes through the neck 23 of the polyp 22 and the patient's body to reach the external electrode 24. From this external electrode 24, the third connection terminal 12 and the common contact 15c of the second switching section 15 and the normally open contact 15 are connected.
a to the second internal terminal 9. Therefore, the neck 23 of the polyp 22 is completely cauterized in the second state after the internal tissues and blood vessels have been sufficiently cauterized in the first state. The first and second electrodes 17, 18 of
By drawing the polyp 22 into the sheath 19 and continuing to apply electricity, the polyp 22 is moved to the neck 2.
3 can be cut without causing bleeding. The main circuit of the high frequency output device 1 shown in FIG. 1 is provided with display means as shown in FIG. That is, the changeover switch 13 is provided with a third changeover section 25, and this common contact 25c is connected to the output side of the footswitch 2. Further, the normally open contact 25a of the third switching section 25 is connected to the first resistor 2.
6 to the oscillation circuit 27, normally closed contact 25
b is connected to the oscillation circuit 27 via a second resistor 28 having a different resistance value from the first resistor 26 . An oscillation capacitor 29 is connected to the oscillation circuit 27, and a speaker 30 is connected to the output side.

According to such a configuration, when the foot switch 2 is turned on in the first state shown in FIG. 7, voltage is applied to the common contact 25c of the third switching section 25, so that the second A current flows through the resistor 28. Therefore, since the oscillation circuit 27 oscillates at a frequency determined by the second resistor 28 and the capacitor 29, and sound is generated from the speaker 30, this sound causes high-frequency energization in the first state. can be confirmed. Furthermore, when the changeover switch 13 is switched, the common contact 25c of the third switching section 25 is connected to the normally open contact 25a, so a current flows through the first resistor 26, and the first resistor 26 and capacitor 29 are connected to each other. The oscillation circuit 27 oscillates at the determined frequency, and sound is generated from the speaker 30. Since the first resistor 26 has a different resistance value from the second resistor 28, a different sound is generated than in the first state, and this sound causes high-frequency energization in the second state. This can be confirmed. That is, without looking at the changeover switch 13, the first
It is possible to know in which of the second states high frequency energization is being performed.

FIG. 8 shows a second embodiment of the invention. In this embodiment, in addition to the first footswitch 2, a second footswitch 31 is connected to the high frequency generating circuit 3, and the second footswitch 31 is connected to a relay for switching the changeover switch 13 via a relay drive circuit 32. 33 was connected.

According to such a configuration, when the first foot switch 2 is turned on, high frequency energization is performed in the first state as in the first embodiment. Further, when the second foot switch 31 is turned on, the relay 33 is driven and the changeover switch 13 is switched, so that high frequency current is applied in the second state.

FIG. 9 shows a third embodiment of the invention, which is a combination of the first embodiment shown in FIG. 7 and the second embodiment shown in FIG. That is, the second resistor 28 is connected to the output side of the first footswitch 2, and the first resistor 28 is connected to the output side of the second footswitch 31.
A resistor 26 is connected.

According to such a configuration, the relay 33 can perform high-frequency energization in the first or second state according to the operation of each foot switch 2, 31, and different sounds can be generated depending on the high-frequency energization state at that time. That will happen.

FIG. 10 shows the embodiment of FIG. 4 of the present invention,
In the third embodiment shown in FIG.
The means of displaying the status of the vehicle has been changed from sound to light. That is, the second resistor 28 connected to the output side of the first footswitch 2 is connected to the base of the first transistor 34, and the first resistor 26 connected to the output side of the second footswitch 31 is connected to the base of the first transistor 34. It was connected to the base of the second transistor 35. First and second light emitting diodes 36 and 3 are connected to the collectors of the first and second transistors 34 and 35, respectively.
Connect the cathodes of 7 and these light emitting diodes 3
A third resistor 38 for current limiting was connected to the anodes 6 and 37, and a voltage of 5V was applied to the third resistor 38. Also, each transistor 3
Emitters 4 and 35 were connected to the zero volt point.

According to such a configuration, when the first footswitch 2 is stepped on to perform high-frequency energization in the first state, current flows through the second resistor 28 and the first transistor 34 is turned on, so that the third A current flows through the first light emitting diode 36 through the resistor 38,
This first light emitting diode 36 lights up. Furthermore, when the second foot switch 31 is stepped on to perform high-frequency energization in the second state, current flows through the first resistor 26 and turns on the second transistor 35. A current flows through the second light emitting diode 37, and the second light emitting diode 37 lights up. That is, it is possible to know whether high-frequency energization is being performed in the first or second state by the lighting states of the first and second light emitting diodes 36 and 37.

Although not shown, the light display means shown in FIG. 10 and the sound display means shown in FIG. 9 can be combined to display the first state and the second state by light and sound.
It is clear that the state can be displayed.

FIG. 11 shows a fifth embodiment of the present invention, and this embodiment differs from the first embodiment shown in FIG. 1 in the output transformer 5. That is, the output transformer 5
The secondary side of the switch 13 is divided into a first secondary winding 39 and a second secondary winding 40, and the switch 13 is provided with first to third switching sections 41, 42, 4.
3 was established. One of the first secondary windings 39 is connected to the normally closed contact 41b of the first switching section 41, and the other is connected to the normally closed contact 42 of the second switching section 42.
Connected to b. Further, one of the second secondary windings 40 is connected to the first switching section 41 and the second switching section 4.
The two normally open contacts 41a and 42a are connected to each other, and the other is connected to the normally open contact 43a of the third switching section 43. The common contact 41c of the first switching section 41 is connected to the first connection terminal 10, and the common contact 41c of the first switching section 41
The two common contacts 42c were connected to the second connection terminal 11. Further, the common contact 4 of the third switching section 43
3c is connected to the third connection terminal 12, and this normally closed contact 43b is open.

According to such a configuration, the high frequency output generated by the first secondary winding 39 can be applied to the internal electrode 16 in the first state, and the high frequency output generated by the second secondary winding 39 can be applied to the internal electrode 16 in the second state. A high frequency power generated on line 40 can be applied between inner electrode 16 and outer electrode 24. That is, high-frequency energization in the first state and the second state can be performed with different high-frequency outputs.

As described above, the present invention performs high-frequency ablation treatment in a first state in which current is applied between the first and second electrodes of a bipolar internal electrode, and in a second state in which current is applied between the internal electrode and external electrode. In addition to making it possible to switch between the two states, it is also possible to display a display corresponding to the switching state. Therefore, in the first state, the internal tissues and blood vessels in the neck of the polyp held between the first and second internal electrodes are sufficiently cauterized, and in the second state, the neck is completely cauterized. Therefore, the polyp can be removed safely without causing bleeding, and since the display corresponding to the first state and the second state is displayed, the first state and the second state can be easily removed. Treatment for condition 2 can be performed without error.

[Brief explanation of drawings]

1 to 7 show a first embodiment of the present invention, FIG. 1 is a schematic configuration diagram of the entire device, FIG. 2 is a sectional view of the internal electrode, and FIG. 2
FIG. 4 is a plan view of the state in which the first and second electrodes are retracted;
FIG. 5 is a side view taken along the line V-V in FIG. 4, FIG. 6 is a side view of the neck of the polyp being held between the first and second internal electrodes, and FIG. Schematic diagrams of the entire apparatus, Figures 8 to 1
FIG. 1 is a schematic diagram of the entire apparatus showing second to fifth embodiments of the present invention. DESCRIPTION OF SYMBOLS 1... High frequency output device, 13... Changeover switch, 16... Internal electrode, 17... First electrode,
18... second electrode, 24... external electrode, 27...
...Oscillation circuit, 30...Speaker, 33...Relay, 36, 37...Light emitting diode.

Claims (1)

[Claims] 1. A first state in which one end of the high frequency output terminal is connected to the first electrode of the bipolar internal electrode and the other end is connected to the second electrode; A switching means for switching between a second state in which the electrode is connected to the first and second electrodes and the other end is connected to an external electrode, and a switching means corresponding to the first state and the second state switched by the switching means. A high-frequency electric scalpel device characterized in that it is provided with a display means for displaying information. 2. The high-frequency electric scalpel device according to claim 1, wherein the display means displays the first state and the second state using light. 3. The high-frequency electric scalpel device according to claim 1, wherein the display means displays the first state and the second state by sound. 4 The display means is a combination of light and sound.
2. The high-frequency electric scalpel device according to claim 1, wherein the high-frequency electric scalpel device displays a state and a second state. 5. The switching means is provided with a first switch means that generates a high frequency output in a first state and a second switch means that generates a high frequency output in a second state. A high-frequency electric scalpel device according to scope 1.