JPH11197158A - Cautery hemostatic apparatus - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a cautery homeostatic apparatus which is simplified in the constitution of a probe by constituting the control to maintain an exothermic element at a specified temp. and a means for monitoring the resistance value of the exothermic element with simple circuits. SOLUTION: This cautery hemostatic apparatus executes hemostatic treatment by cauterizing a bleeding part by supplying electric power to the exothermic element 1 disposed in the probe to be introduced into the celom and allowing the element to generate heat. The apparatus described above has the exothermic element 1 which has a temp. coefft. in itself and is built in the probe, a power source section 2 which supplies electric energy so as to maintain the specified resistance value of the exothermic element 1 at the time of exothermic operation of the exothermic element 1, a power source section 4 which supplied the electric energy to the exothermic element 1 regardless of the time of the exothermic and non-exothermic operation of the exothermic element 1 and an abnormality detecting section 5 which monitors whether the resistance value of the exothermic element 1 supplied with the electric energy by the power source section 4 is within a prescribed range or not.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a cautery hemostasis device using a heating element having a temperature coefficient in its own impedance.

[0002]

2. Description of the Related Art In recent years, endoscopes capable of performing diagnostic or therapeutic treatment in a body cavity without inserting an incision from the body surface by inserting an elongated insertion portion into the body cavity have been widely used. Such an endoscope is generally provided with a hollow channel through which various treatment tools are inserted in addition to the observation means, and is operated by a treatment tool inserted through the channel in accordance with symptoms in a body cavity. Hemostasis of ulcers and the like can be performed using various treatments under the visual observation of a person.

At present, a large number of high-frequency current generators (hereinafter referred to as electric scalpels) are commercially available and are often used for cutting or coagulating tissue. However, this technique of generating heat by passing an electric current through a living body cannot predict or suppress damage or necrosis due to it, and in many cases, applying an electric current through a living body itself narrows the scope of this procedure. ing.

There are many known laser coagulation devices, but it is difficult to accurately direct a laser beam to a target, and the device itself is expensive, and the laser is optically unfavorable. Not yet widely used.

Japanese Patent Application Laid-Open No. 58-69556 discloses a cauterization hemostasis probe using a simpler and safer Zener diode as a heating element, which is different from the above-mentioned procedure. The probe and the main unit that controls the probe use a characteristic in which the Zener voltage of the Zener diode shifts due to its own temperature rise, and controls the probe to maintain a constant voltage, that is, a constant temperature. Since the Zener diode acts as a heating element, it does not pass current to the living body, so it can be pressed against a heated iron, so it can also expect a hemostatic effect due to the pressure applied other than the action of heat. . With this method, rapid heating and cooling can effectively coagulate the tissue without causing undue necrosis.However, since rapid heating and cooling depend on the heat capacity of the probe, elements other than Zener diodes are used as heating elements. May be used.

[0006]

Incidentally, the control method of the cauterization and hemostasis device using the Zener diode and the probe tip structure need to have a complicated structure as disclosed in Japanese Patent Application Laid-Open No. 58-69556. As can be seen, when a Zener diode is used as a heating element, not only does the structure of the probe tip become complicated, but it is necessary to provide an adjustment resistor for each probe in order to absorb variations in the Zener diode. In particular, there is a disadvantage in that the distal end and the connector have a complicated structure.

Further, even if a check function for checking the Zener voltage of the Zener diode is provided, it is not possible to check for heat generation due to a switching system using a relay or the like. In addition, since such a probe has a built-in resistor as described above, it cannot be applied to an autoclave sterilizer, and must be immersed in a disinfecting solution for a long time for disinfection and sterilization. Effort was needed.

The cautery hemostasis device of the present invention has been made in view of such a problem, and an object of the invention is to use a resistive element as a heating element and control the heating element at a constant temperature. A cautery hemostasis device that can reduce manufacturing costs and simplify disinfection and sterilization by simplifying the configuration of the probe by configuring the probe and the means for monitoring the resistance value of the heating element with a simple circuit. Is to provide.

[0009]

According to the present invention, a heating element is provided inside a probe to be introduced into a body cavity, and electric energy is supplied to the heating element to generate heat. Thus, in a cautery hemostasis device that cauterizes a bleeding part and performs hemostasis treatment, a heating element having a temperature coefficient in its own impedance, and a heating element built in a probe, and a resistance of the heating element during a heating operation of the heating element. First electric energy supply means for supplying electric energy so that the value becomes constant, and second electric energy supply means for supplying electric energy to the heat generating element regardless of whether the heat generating element generates heat or not. And a resistance value monitoring means for monitoring whether or not the resistance value of the heating element to which electric energy is supplied by the second electric energy supply means is within a predetermined range. That.

[0010]

Embodiments of the present invention will be described below in detail with reference to the drawings. First, the outline of the present invention will be described. In the conceptual diagram of FIG. 1, for example, a resistor 1 which is a heating element having a temperature coefficient in its own impedance is supplied with power from a power supply unit 2. The power supply unit 2 changes the supply power based on a signal indicating the resistance value detected by the resistance value detection unit 3 so as to keep the resistance value of the resistor 1 constant.

Further, another power supply unit 4 generates heat of the resistor 1,
The current is always supplied to the resistor 1 regardless of the non-heating operation.
The abnormality detection unit 5 detects the resistance value of the resistor 1 at this time and monitors whether or not the resistance value is within a predetermined range. Is determined to be.

Generally, the resistance value of the resistor 1 increases with the temperature due to its own temperature coefficient. By this characteristic, if the resistance value of the resistor 1 at a predetermined temperature is monitored, the temperature of the resistor 1 can be fed back by the resistance value. That is, if the power supply unit 2 is controlled so that the resistance value of the resistor 1 becomes a target value, constant temperature control of the resistor 1 can be realized.

[0013] Further, since a minute electric power always flows through another power supply section 4, a switching section such as a relay can be eliminated, and the circuit can be simplified. The abnormality detection unit 5 is configured to determine that the probe is normal if the resistance value of the resistor 1 is in a range from a low temperature to a high temperature (heat generation). This makes it possible to detect not only an abnormality such as open / short of the resistor 1 but also a detached state of the probe. Since this can be detected regardless of a heat generation state or a non-heat generation state, the probe connector is a minimum for supplying power to the resistor 1.
It becomes possible to pin.

By using the above-described configuration, control is performed to keep the resistor 1 as a heating element having a temperature coefficient in its own impedance depending on the temperature of the probe at a constant temperature, and to monitor the resistance value of the resistor 1 for abnormality. Means can be configured with a simple circuit, whereby the configuration of the probe can be simplified. This leads to an effect that disinfection and sterilization can be performed relatively easily and that the tissue does not unduly necrotize.

FIG. 2 is a perspective view showing the appearance of the cautery hemostasis device according to the first embodiment of the present invention. In FIG. 2, a cautery hemostasis device 11 includes a main body 13 having an operation panel 12 on a front surface, a cautery probe device 16 detachably connected to the main body 13 via an electric connector 14 and a water supply connector 15, Foot switch 19 detachably attached to main body 13 by connector 18 provided on cable 17
And a washing water tank 20 detachably attached to the side surface of the main body 13.

The foot switch 19 is provided with a water supply switch 19a and a heating switch 19b. The ablation probe device 16 described above comprises an elongated and flexible sheath 21, an ablation probe 22 connected to the distal end of the sheath 21, and the electric connector 14 and the water supply connector 15 provided on the base side of the sheath 21. The sheath 21 and the ablation probe 22 at the distal end thereof can be inserted into a treatment tool channel of an endoscope (not shown), and the ablation probe 22 can be introduced into a body cavity through this channel.

As shown in FIG. 3, a coaxial cable 31 is inserted through the sheath 21 at the center in the axial direction so as to supply current to a resistor 32 which is a heating element provided in the cauterizing probe 22 at the distal end. A plurality of nozzles 33, 33,... Formed on the outer periphery of the cauterization probe 22 in the axial direction of the coaxial cable 31 in the sheath 21 (see FIG. 4).
A water supply conduit 34 for pumping the washing water is formed. The cleaning water is sent in a jet form by the nozzles 33, 33,. FIG. 4 is a sectional view taken along line AA of FIG.

Next, the heat generation control of the cautery hemostasis device 11 according to the present embodiment will be described with reference to FIG. During the heat generation, electric power is supplied so that the resistance value of the resistor R as a heating element becomes a predetermined resistance value. In this embodiment, in a bridge circuit including the resistors 101, 102, and 103 and the resistor R as a heating element shown in FIG. 5, the ratio between the resistance of the resistor 101 and the resistor 102 and the resistance of the resistor R The supply power is adjusted so that the ratio between the resistance and the resistance value of the resistor 103 becomes the same. More specifically, the difference between the two ratios is amplified by the operational amplifier 104, and the power transistor 106 is driven to change the supplied power so that the difference becomes zero. That is, by turning on and off the base potential of the transistor 108 that drives the base current of the power transistor 106 by the switch 109, it is possible to switch between the operation and the stop of the heating circuit including the bridge circuit and the operational amplifier 104. The power transistor 106, a transistor 108 for driving a base current of the power transistor 106, and a switch 109 for turning on and off the base potential of the transistor 108
Constitutes first electric energy supply means.

A diode 107 is provided between the output of the power transistor 106 and the bridge circuit. The bridge circuit further includes a power supply 111 and a power supply 112 as second electric energy supply means via a diode 110.
And are connected. The power sources 111 and 112 may be any of a constant current, a constant voltage, and a constant power, and in the present embodiment, are constant current. The power supply 111 as a substantial power supply including the three-terminal regulator 111a has a lower supply power (current in the embodiment) than the power supply 112, and supplies power to the bridge circuit by the power supply 111. The power supply 112 is for preventing over-power from being supplied to the resistor R when the power supply 111 fails, and is configured not to hinder the operation of the power supply 111 when there is no failure.

In the case of a probe configuration as described in Japanese Patent Application No. 8-143113, for example, 0.2
If the supplied power is less than W, the heat generated by the probe does not damage the patient or damage the endoscope due to the heat. Therefore, the values of the power supplies 111 and 112 are set to values not exceeding this value in combination with the probe.

In this embodiment, the concept of the ratio of the resistance in the bridge circuit is used to detect an abnormality in the resistance value of the resistor R. That is, in the above-described bridge circuit and another bridge circuit including the resistors 113, 114, 115, and 116, the resistance value of the resistor R and the resistance
The window comparator 117 determines whether or not the ratio between the resistance value of the resistor 113 and the resistance value of the resistor 114 is in the range from the ratio of the resistance value of the resistor 113 to the resistance value of the resistor 114. It has a configuration to detect. Each ratio is set by the lower limit of the resistance in the non-heating state and the upper limit of the resistance in the heating state. Here, the two bridge circuits, the window comparator 117 and the control unit 118 constitute a resistance abnormality detection unit.

When the foot switch 19b is pressed, the control unit 118 turns off the switch 109 and starts a heating operation. If an abnormality occurs during the heat generation, that is, if the output of the window comparator 117 indicates an abnormality, the switch 109 is turned on to stop the heat generation.

The power sources 111 and 112 include a resistor R and a resistor 1
It operates as a constant current source until the voltage applied to the input terminal 03 becomes inoperable. In other words, even when the voltage applied to the resistor R is low even in the heat generation state, specifically, when the voltage is about 13 V or less in consideration of the drop due to each resistor or the like, the resistor R operates as a constant current. It is configured so that no current flows. Diode 107
And 110 are provided so that reverse bias is not applied to the power sources 111 and 112 and the output potential of the power transistor 106 respectively. Incidentally, instead of providing the separate power supplies 111 and 112 as described above, a minute power (0.2 W or less) may be supplied by the power transistor 106.

By using the above-described circuit configuration, a current flows through the resistor R regardless of the state of heat generation or non-heat generation. The resistance value of R can be monitored.

According to the above-described first embodiment, the ablation hemostasis device according to the present embodiment has a heating circuit composed of a bridge circuit including a heating element that is a resistor having a temperature coefficient, and an error amplification circuit. It has a resistance abnormality detection unit that constantly monitors the resistance of the heating element by passing current regardless of the state of heat generation or non-heat generation by a separate power supply, so that constant-temperature heat generation control can be performed with a simple circuit configuration. It is possible to always detect the resistance abnormality of the heating element.

Thus, the result of the detection of the resistance abnormality of the heating element can be used to determine whether or not the probe is connected to the cautery device. The connector of the probe needs only two pins for supplying power to the heating element. Can be configured. Further, since it is not necessary to incorporate electric components except for the connector and the cable in the probe, it is possible to provide a probe having a simplified structure. This is useful in the process of disinfecting and sterilizing probes that are inherently complex, for example, making them resistant to autoclave sterilization equipment and indirect infection without the need for cumbersome processes. This makes it possible to provide an ablation hemostasis device that does not give such a risk to a patient.

By the way, in such a cautery hemostasis device, it is necessary to monitor the total amount of energy applied to the living body and notify the user of the amount. Such monitoring is performed by the voltage detector 12 shown in FIG.
0, a current detection unit 121, an analog multiplier 122, a VF converter 123, and a heat generation amount detection circuit including a control unit 118. In such a configuration, the output of the voltage detection unit 120 and the current detection unit 121 applied to the probe is converted into a power value by the analog multiplier 122, and this is supplied to the VF converter 123 and
F conversion (voltage-frequency conversion) is performed.

Integrating the output of the analog multiplier 122 to obtain the total amount of energy (joules) and counting the pulses after VF conversion have the same meaning. In addition to being able to monitor the total amount of energy given to the living body simply and flexibly, there is an advantage that the power can be converted into a frequency so that the signal can be easily isolated. In particular, the latter feature is very significant when the control unit 118 is provided in a circuit insulated from the heating circuit in the case of a medical device which basically forms a circuit insulated from the patient. .

Although not shown, the control unit 118 counts how many times the operator steps on the heating foot switch 19b.
And the number of times can be displayed. Hereinafter, a second embodiment of the present invention will be described. FIG. 6 is a view showing a main part of an ablation hemostasis device according to a second embodiment of the present invention.

In the second embodiment, the bridge circuit of the first embodiment is replaced with the bridge circuit of the first embodiment, as shown in FIG. And 204, the digital data is converted into digital data and taken into the control unit 205. The control unit 205 calculates the resistance of the heating element, and controls the power supply unit 206 to keep this value constant.

In the case of this embodiment, there is an advantage that the circuit configuration is further simplified. Further, instead of simply making the resistance value of the heating element constant, fluctuations in the supplied power and the resistance value of the heating element at that time are obtained. Thus, it is possible to easily realize a control for slightly changing the supplied power depending on the condition of the probe, such as whether the heat is generated from a low temperature or continuous heat generation, and to provide an ablation hemostasis device having more effective hemostatic ability.

The above-described specific embodiment includes the invention having the following configuration. (1) A cautery hemostasis device for arranging a heating element inside a probe to be introduced into a body cavity and supplying electric energy to the heating element to generate heat, thereby cauterizing a bleeding part and performing hemostatic treatment. A heating element having a temperature coefficient in impedance of the probe, and a first electric energy supply means for supplying electric energy such that a resistance value of the heating element becomes constant during a heating operation of the heating element. A second electric energy supply means for supplying electric energy to the heat generating element regardless of whether the heat generating element generates heat or not, and wherein the second electric energy supply means supplies electric energy. A cautery hemostasis device, comprising: a resistance value monitoring unit that monitors whether a resistance value of the heating element is within a predetermined range. (2) The electric energy from the second electric energy supply means is set to a value such that the temperature of the heat generated by the probe does not adversely affect the human body and the endoscope used in combination. The cautery hemostasis device according to the configuration (1), characterized in that: (3) The cautery hemostasis device according to configuration (1), wherein the second electric energy supply unit is configured with two power sources to prevent abnormal heat generation at the time of component failure. (4) The configuration wherein the resistance value monitoring means determines that the heating element is normal if the resistance value of the probe is between the resistance value during non-heating and the resistance value during heating. The cautery hemostasis device according to (1). (5) The cauterization according to the configuration (1), further comprising a calorific value monitoring means for monitoring the calorific value of the heating element by detecting electric energy supplied to the heating element by an electric energy detecting means. Hemostatic device. (6) The configuration according to (5), wherein the heat generation amount monitoring means monitors the heat generation amount by voltage-to-frequency conversion of a detection signal from the electric energy detection means and counting the converted pulses. The cautery hemostasis device according to claim 1.

[0033]

According to the present invention, constant-temperature heat generation control can be performed with a simple circuit configuration, and resistance abnormality detection of a heating element including a detached state of a probe can be realized. As a result, the probe structure is simplified, and for example, an inexpensive probe that can be sterilized in an autoclave and has no risk of infection and a cautery hemostasis device that can effectively control the probe can be provided.

[Brief description of the drawings]

FIG. 1 is a conceptual diagram showing a conceptual configuration of the present invention.

FIG. 2 is an external perspective view of the cautery hemostasis device according to the first embodiment of the present invention.

FIG. 3 is a cross-sectional view showing a tip of an ablation probe according to the first embodiment of the present invention.

FIG. 4 is a sectional view taken along line AA of FIG. 3;

FIG. 5 is a principle explanatory view of the cautery hemostasis device according to the first embodiment of the present invention.

FIG. 6 is a principle explanatory view of an ablation hemostasis device according to a second embodiment of the present invention.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 ... Resistor, 2 ... Power supply part, 3 ... Resistance value detection part, 4 ... Power supply part, 5 ... Abnormality detection part.

Claims (1)

[Claims] 1. A cautery hemostasis device for arranging a heating element inside a probe to be introduced into a body cavity and supplying electric energy to the heating element to generate heat, thereby cauterizing a bleeding part to perform hemostatic treatment. A heating element having a temperature coefficient in its own impedance, built in the probe, and a first electric energy for supplying electric energy such that a resistance value of the heating element becomes constant during a heating operation of the heating element. Supply means; second electric energy supply means for supplying electric energy to the heat generating element regardless of whether the heat generating element generates heat or non-heat generating operation; and electric energy is supplied by the second electric energy supply means. A cautery hemostasis device, comprising: a resistance monitoring means for monitoring whether or not the resistance value of the heating element is within a predetermined range.