JP2000271142A - Electric-driven medical implement - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an electric-driven medical implement allowing an operator to adjust the treatment output of the treatment part speedily and easily and to smoothly perform a delicate operation or an operation requiring accuracy. SOLUTION: This ultrasonic treatment implement 1A has an operating lever 5 in an operating part 3 at the rear end of an inserting part 2 to be inserted into the body cavity. The operating lever 5 is movably operated by fingers of an operator grasping the lever. According to the quantity of the operating force of the lever 5, outputs of plural piezoelectric elements of a piezoelectric switch 39 which constitutes an output adjusting mechanism 31 change, and the outputs are detected by a control circuit 23 to variably set a gain of the GCA 22 in a resonator driving part 13. An ultrasonic driving signal having passed the GCA 22 is applied to an ultrasonic resonator 12 to generate ultrasonic vibrations. The ultrasonic vibrations, passing an ultrasonic transmitting rod 16, are transmitted to a treatment part 17 at the top of the rod 16, so that the ultrasonic treatment output to be outputted to a patient, etc., from the treatment part 17 can be adjusted according to the quantity of the movable operation of the operating lever 5.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an electric drive type treatment instrument for performing treatment for a subject by a treatment section.

[0002]

2. Description of the Related Art In a surgical operation or the like, a surgical tool or a treatment tool which is inserted into a subject to perform a treatment for treatment is widely used. For example, in the first conventional example of Japanese Patent Publication No. 2-43501, an operation unit is provided on the rear side of an insertion shaft inserted into a body cavity, and a battery (battery) that drives a treatment unit in the insertion unit is provided.
And an electric drive type treatment instrument provided with a switch for turning on / off an output of a battery for driving the treatment section.

A second conventional example of Japanese Patent Application Laid-Open No. 9-299381 relates to an ultrasonic treatment instrument, in which a handle for operating a surgical section provided on an insertion side is provided on the operation section side. By operating the handle, incision and coagulation can be performed.

[0004]

In the first prior art, the output of the treatment section could not be controlled because no device for controlling the drive output was provided. For this reason, it has been difficult to smoothly perform a delicate operation requiring precise control of the treatment output of the treatment unit or a surgery requiring precision.

In the second conventional example, the output of the operating section must be controlled by operating a dial or the like of a control device provided separately from the operating device. Could not be done.

(Object of the Invention) The present invention has been made in view of the above-mentioned points, and is capable of adjusting a treatment output of a treatment section quickly and easily, and which facilitates a delicate operation or an operation requiring precision smoothly. It is an object of the present invention to provide a driven treatment instrument.

[0007]

An insertion section to be inserted into a subject, a treatment section provided at a distal end of the insertion section for performing treatment on the subject, and a drive for driving the treatment section Transmitting means for transmitting a force or the like to the treatment section, an operation section provided on the proximal end side of the insertion section, a movable section movably provided on the operation section, and detecting an operation state of the movable section. Detecting means, and according to a detection output of the detecting means,
By providing control means for variably controlling the treatment output of the treatment section, it is possible to quickly and easily adjust (variable control) the treatment output of the treatment section by operating the movable means provided on the operation section. Surgery or surgery requiring precision is facilitated.

[0008] An insertion portion to be inserted into the subject, a treatment portion provided at the distal end of the insertion portion for performing a treatment on the subject, and a driving force for driving the treatment portion, and the like. A transmitting unit for transmitting to the treatment unit, an operating unit provided on the proximal end side of the insertion unit, a movable unit movably provided on the operating unit by a predetermined amount, and detecting a movable amount of the movable unit. Operating the movable means provided in the operation unit by providing movable amount detection means and control means for variably controlling the treatment output of the treatment unit according to the movable amount detected by the movable amount detection means Thus, the treatment output of the treatment section can be quickly and easily adjusted (variable control), and a delicate operation or an operation requiring precision can be smoothly performed.

In addition, an insertion portion to be inserted into a subject, a treatment portion provided at a distal end of the insertion portion for performing a treatment on the subject, and a driving force for driving the treatment portion, etc. Transmitting means for transmitting to the treatment section; an operating section provided on the proximal end side of the insertion section; movable means movably provided on the operating section; and movable force detection for detecting a movable force of the movable means. Means for controlling the treatment output of the treatment section variably in accordance with the movable force detected by the movable force detection means, thereby controlling the treatment section by operating the movable means provided on the operation section. The output of the treatment can be quickly and easily adjusted (variable control), so that a delicate operation or an operation requiring precision can be easily performed.

[0010]

Embodiments of the present invention will be described below with reference to the drawings. (First Embodiment) FIGS. 1 to 3 relate to a first embodiment of the present invention, FIG. 1 shows an external appearance of an ultrasonic treatment device according to the first embodiment, and FIG. FIG. 3 shows a detailed configuration of the treatment tool, and FIG. 3 shows a configuration of an output adjustment mechanism of the ultrasonic treatment.

As shown in FIG. 1, an ultrasonic treatment device 1 as an electric drive type treatment device has an elongated insertion portion 2 inserted into a body cavity.
And an operation unit 3 provided at the rear end of the insertion unit 2 and operated by being gripped. The operation unit 3 includes a handle unit 4 and a movable operation lever 5.

As shown in FIG. 2, this ultrasonic treatment instrument 1
An ultrasonic vibrator 12 is housed in an outer case 11 of the operation unit 3. The ultrasonic vibrator 12 includes a vibrator driving unit 13
The ultrasonic vibration is caused by the supply of the drive signal from.

The ultrasonic vibration (driving force) of the ultrasonic vibrator 12 is applied to a horn 14 and an ultrasonic transmission rod 16 connected to the horn 14 and inserted through a hollow sheath 15 forming the insertion portion 2. The ultrasonic transmission rod 16 is transmitted to the ultrasonic treatment section 17 at the distal end (projecting from the distal end of the sheath 15) of the ultrasonic transmission rod 16 via the With the ultrasonic vibration, the affected part can be ultrasonically heated to perform treatment for treatment such as incision or coagulation. The connecting portion between the horn 14 and the ultrasonic transmission rod 16 has a structure in which a sealing O-ring 18 is interposed to keep the inside of the rear side watertight.

The vibrator driving section 13 comprises an oscillating circuit 21 for electrically oscillating, and a gain control amplifier (abbreviated as GCA) 22 having a variable amplification factor (gain) for changing the oscillation output of the oscillating circuit 21. The gain of the GCA 22 is variably controlled by the control circuit 23. This GC
The oscillation output having the amplitude amplified by the gain of A22 is applied to the ultrasonic transducer 12. The ultrasonic vibrator 1
Reference numeral 2 denotes a bolted Langevin vibrator in which piezoelectric ceramics are stacked and bolted together.

A battery (battery) 24 is stored in a battery storage room near the lower end of the handle portion 4, for example.
The battery 24 supplies power for operating the control circuit 23 via a power switch (not shown). Further, power supply power is further supplied to the vibrator driving unit 13 via the switch 43.

The battery compartment is closed at its open end by a lid 25, and the battery 24 can be replaced by moving the lid 25 downward, for example. In addition, a sealing member such as an O-ring 26 is provided so as to contact the lid 25,
The inside of the handle portion 4 has a watertight structure.

In the present embodiment, the operation of the operation lever 5 is performed in accordance with the amount of movement thereof (more broadly, the operation state when the operation lever 5 is moved is detected and the ultrasonic wave is accordingly detected). An output adjustment mechanism 31 that adjusts (variably controls) the ultrasonic treatment output of the treatment section 17 is provided. Specifically, as shown in FIGS. 2 and 3, a pin 32 provided at a base end of the operation lever 5 is engaged with a guide groove 33 (provided on the operation unit 3), and is movable in a longitudinal direction of the guide groove 33. It is. In addition, as shown in FIG. 2, the portion of the outer case 11 where the guide groove 33 is provided is made thick.

The arm 34 protrudes toward the handle portion 4 from, for example, the vicinity of the center of the operation lever 5 in the longitudinal direction, and a finger is hooked on the finger hook portion of the operation lever 5 to pull the operation lever 5 toward the handle portion 4. By doing so, the cylinder 35 provided at the distal end of the arm 34 on the handle portion side can be moved in a direction parallel to the longitudinal direction of the guide groove 33 (indicated by reference numeral A in FIG. 3).

The outer case 11 of the handle portion 4 is provided with a cylinder fitting hole into which the cylinder 35 can be fitted. Also, an O-ring 3 is provided on the wall surface of the cylinder fitting hole.
6 are interposed to form a watertight structure.

In the cylinder 35, a piston 38 displaced by a spring 37 so as to protrude from the cylinder 35 is fitted and accommodated, and a piezoelectric switch 39 is disposed on the side where the piston 38 protrudes. .

As shown in FIG. 3, the piezoelectric switch 39 includes, for example, four piezoelectric elements 40a, 40b, 40c, and 40d.
Are generated, and a voltage is generated on both surfaces thereof in response to the pressed force, and the voltage is output to the control circuit 23 from electrodes (not shown) provided on both surfaces.

The four piezoelectric elements 40a, 40b, 40c,
40d has a different sensitivity when generating a voltage corresponding to the pressing force. For example, the piezoelectric element 40a has the highest sensitivity, the next has the highest sensitivity of the piezoelectric element 40b, and further has the sensitivity of the piezoelectric element 40c. And the sensitivity of the piezoelectric element 40d is set to be the lowest. In a state where the piezoelectric element 40a is pressed with a weak force by the spring 37, no voltage is generated even in the piezoelectric element 40a having the highest sensitivity.

The piezoelectric elements 40a, 40b, 40c, 40d
(Voltage) output from the four comparators 4 in the control circuit 23
1a, 41b, 41c, and 41d are input and compared with, for example, a reference voltage value divided and set by resistors R1 and R2. These four comparators 41a, 41b, 41c, 41
The output of d is input to the decoder 42, and the decoder 42
The two outputs are decoded to generate a gain control signal proportional to the pressing force, for example, and applied to the gain control terminal of the GCA 22.

The GCA 22 amplifies and outputs an input signal with a gain proportional to a voltage value of a gain control signal applied to a gain control terminal, for example. That is, GCA
The output signal of the oscillation circuit 21 input to the GCA 22 is the GCA
The signal is amplified by a gain proportional to the voltage value of the gain control signal applied to the gain control terminal 22 and applied to the ultrasonic transducer 12. The output of the comparator 41a is provided in series with the power switch (not shown) from the battery 24, and controls ON / OFF of an analog switch 43 provided between the power switch and the power supply terminal of the vibrator driving unit 13. That is,
An oscillation circuit that constitutes the vibrator driving unit 13 from the battery 24 only when the operation lever 5 is operated to a value at which the output of the comparator 41a having the highest sensitivity becomes “H” level (from “L” level) or more. Drive power is supplied to the GCA 21 and the GCA 22.

That is, in this embodiment, when the power switch is operated, the control circuit 23 and the analog switch 43
Is supplied with power from a battery, but the vibrator driving unit 13 is supplied with power when the operation lever 5 is moved to at least a certain value or more, so that the vibrator when the operation lever 5 is not moved is provided. The consumption of electric energy in the drive unit 13 is reduced.

The operation of the ultrasonic treatment instrument 1 according to the first embodiment having such a configuration will be described. For example, in the case of performing a surgical operation in which the affected part is resected by inserting it into the abdomen or stopping the bleeding part, an endoscope (not shown) is inserted into the abdomen with a trocar so that the affected part can be observed and ultrasonic treatment is performed. The tool 1 is inserted using the trocar as a guide. And
With the endoscope, the affected part and the distal end side of the ultrasonic treatment instrument 1 can be observed, and the power switch of the ultrasonic treatment instrument 1 is turned on.
N, the control circuit 23 is activated, the treatment section 17 at the distal end of the insertion section 2 is brought into contact with the affected area, the handle section 4 of the operation section 3 is grasped with the palm in this state, and a finger is put on the operation lever 5 with a finger hook. Then, the operation of pulling the operation lever 5 toward the handle portion 4 is performed.

When the piston 38 is pressed by the elastic force of the spring 37, the pressing force proportional to the operating force of pulling the operating lever 5 toward the handle portion 4 is applied to the four piezoelectric switches 39. Piezoelectric element 40
a, 40b, 40c, and 40d.

When the voltage generated by the piezoelectric element 40a having the highest sensitivity due to the pressing force exceeds the reference value, the comparator 41
The output of “a” becomes “H” level, the switch 43 is turned on, and the power is supplied to the vibrator driving unit 13.
Then, the oscillation circuit 21 oscillates, and its oscillation output is GCA
The signal is applied to the ultrasonic vibrator 12 via 22.

When the pressing force is small, the piezoelectric element 4
When the voltage of only 0a exceeds the reference value and the pressing force increases,
The voltages of all the piezoelectric elements 40a, 40b, 40c, 40d exceed the reference value.

In this case, when only the output of the comparator 41a is at "H" level, the gain of the GCA 22 is small, and the amplitude of the transducer drive signal applied to the ultrasonic transducer 12 is also small. The value of the ultrasonic treatment output of No. 17 is also small.

Further, all the comparators 41a, 41b, 41
When the outputs of c and 41d attain an "H" level, GC
The gain of A22 is the largest, the amplitude of the transducer drive signal applied to the ultrasound transducer 12 is also the largest, and the value of the ultrasound treatment output of the treatment section 17 is also the largest.

Therefore, by adjusting the force for pulling the operating lever 5 toward the handle portion 4 so as to obtain an ultrasonic output suitable for the incision treatment, the ultrasonic treatment output can be variably set to an ultrasonic treatment output proportional to the force. The treatment can be performed with a suitable value of the ultrasonic treatment output.

Also, when coagulation treatment is performed on a bleeding diseased part, the ultrasonic treatment output proportional to the force can be variably set by adjusting the force of pulling the operation lever 5 toward the handle portion 4 side. In addition, the treatment can be performed with an ultrasonic treatment output value suitable for coagulating a portion to be coagulated.

According to the present embodiment, by operating the operation lever 5 with the finger of the hand holding the operation section 3 of the ultrasonic treatment instrument 1, the insertion section 2 is almost in proportion to the operation force.
Since the output of the treatment section 17 at the tip of can be easily variably controlled (variably set), the treatment output desired by the operator can be easily set, and the treatment for treatment can be performed quickly. In addition, since the value of the treatment output can be variably set by a simple operation of the hand holding the hand, it is easy to perform a fine operation or the like that requires precision in the treatment.

FIG. 4 shows an output adjusting mechanism 31 'according to a modification.
Is shown. In this modification, the piezoelectric switch 39 shown in FIG.
Instead, an elastic conductive device 46 having conductivity and having elasticity, such as conductive rubber, whose resistance is reduced in proportion to the compressive force or according to the compressive force by being compressed is employed. One end of the elastic conductive device 46 is fixed to a restricting plate 47 protruding from the outer case, and the other end is in contact with a piston 38 which is deenergized by a spring 37.

One of the electrodes at both ends of the elastic conductive device 46 is connected to the power supply terminal Vc (the positive electrode of the battery 24), and the other is connected to the ground terminal (the negative electrode of the battery 24) via the resistor R3.
And connected to each non-inverting output terminal of the comparators 41a, 41b, 41c, 41d constituting the control circuit 23 '.

As in FIG. 3, the inverting output terminal of the comparator 41a is grounded via a resistor R1, and the inverting output terminal of the comparator 41d is connected to a power supply terminal via a resistor R2. Further, in the present embodiment, the resistors R4, R5, R5 are connected between the inverted output terminal of the comparator 41a and the inverted output terminal of the comparator 41d, respectively.
6 are connected.

The other configuration is the same as that of the first embodiment. In this modification, the operation lever 5 is operated,
When the piston 38 is pressed toward the regulating plate 47, the resistance between both ends of the elastic conductive device 46 decreases (proportionally or according to the pressing force), and the comparators 41a, 41b, 41
The voltage value applied to each non-inverting output terminal of c and 41d increases.

When this voltage value exceeds the reference value of the inverting input terminal of the comparator 41a, the switch 43 is turned on, and the outputs of the comparators 41a, 41b, 41c, 41d are decoded by the decoder 42 and, for example, the elastic conductive Device 4
6 (or the comparators 41a, 41 at that time)
A gain control signal proportional to the voltage value applied to each of the non-inverting output terminals b, 41c, and 41d) is applied to the GCA 22 to control the amplitude of a drive signal for driving the ultrasonic transducer 12.

The treatment output by the treatment section 17 is set to a value corresponding to the amplitude of the drive signal. That is, it has substantially the same operation and effect as the first embodiment.

When the piezoelectric switch 39 is employed, the voltage generated in the piezoelectric elements 40a, 40b, 40c, and 40d is easily neutralized by the movement of electric charges or the like in an appropriate time (for this reason, the operation of the operation lever 5) If the speed at which the operating force changes is slow, the generated voltage tends to decrease.)
The modified example has an advantage that such influence is not exerted.

(Second Embodiment) Next, a second embodiment of the present invention will be described with reference to FIG. This embodiment is basically different from the first embodiment in the operation part of the output adjustment mechanism. The ultrasonic treatment device 1B according to the second embodiment of the present invention shown in FIG. 5 includes an output adjustment mechanism 51 that is partially different from the output adjustment mechanism 31 according to the first embodiment.

A shaft 52 provided at the base end of the operation lever 5 is fitted into a hole of the outer case 11 and is rotatably supported. An angle detecting device 53 such as a potentiometer is attached to an end of the shaft 52 protruding into the exterior case 11.

When the operating lever 5 is turned, a potentiometer as an angle detecting device 53 connected to the shaft 52 is also turned, and the resistance value changes in proportion to the turning angle.

A scale plate 54 is mounted around the shaft 52 at the base end of the operation lever 5, and a projection 55 based on the rotation angle when the shaft 52 is rotated by operating the operation lever 5.
Can be visually recognized (confirmed) from the scale position where.

Further, a spring 56 is provided between the operation lever 5 and the handle portion 4, and the spring 56 urges the operation lever 5 in the opening direction. The angle detection device 53 outputs a resistance value or a voltage value according to the rotation angle of the operation lever 5 to the control circuit 57.

The control circuit 57 sends a signal proportional to the output value of the angle detector 53 to the GCA 22 of the vibrator drive unit 13. The control circuit 57 has the comparator 41a shown in FIG. 3. When the output value of the angle detection device 53 exceeds a small reference value when the operation lever 5 is slightly rotated to the handle portion 4, the vibrator is driven. The power supplied to the unit 13 is
Is controlled by ON / OFF.

The battery 24 supplies operating power to the control circuit 57 and supplies operating power to the vibrator driving unit 13 via the switch 43. Other configurations are the same as those of the first embodiment.

This embodiment has the same operation as the first embodiment. Specifically, by operating the operation lever 5, the shaft 52 rotates substantially in proportion to the amount of operation force, and when the rotation angle exceeds a reference value, the control circuit 57 turns on the switch 43 to drive the vibrator. The power is supplied to the unit 13 and the control circuit 57 outputs a gain control signal proportional to the rotation angle to the GCA 22 so that the amplitude of the drive signal of the ultrasonic transducer 12 becomes a value proportional to the rotation angle. Control. The treatment output from the treatment section 17 is transmitted to the operation lever 5.
Is set to a value that is approximately proportional to the amount of operating force for operating.

Therefore, according to the present embodiment, the operation lever 5 is operated by the operation of the finger of the hand holding the operation section 3 of the ultrasonic treatment instrument 1, so that the insertion is performed almost in proportion to the operation force. Since the output of the treatment section 17 at the distal end of the section 2 can be easily variably controlled (variably set), the treatment output desired by the operator can be easily set, and the treatment for treatment can be performed quickly.

Further, since the value of the treatment output can be variably set by a simple operation of the hand while grasping the value of the treatment output, it is easy to perform a fine operation or the like that requires precision in the treatment. Further, in the present embodiment, since the rotation angle or the amount of operation force of the operation lever 5 can be confirmed by the scale plate 54 or the like, the value of the treatment output in the treatment section 17 can be confirmed from the value. That is, in the present embodiment, the value of the treatment output variably set can be confirmed from the position of the projection 55 on the scale plate 54.

Also in the first embodiment, a scale is provided in the longitudinal direction of the guide groove 33 so that the position of the base pin 32 of the operation lever 5 in the guide groove 33 can be confirmed. Similarly, the value of the treatment output can be confirmed. Further, the present invention is not limited to the case where the value of the treatment output is confirmed by such a scale plate 54 or the like.
2, the output values (voltage, current, power) actually applied may be electrically displayed.

Third Embodiment Next, a third embodiment of the present invention will be described with reference to FIGS. FIG. 6 shows a configuration of a main part of a high-frequency treatment device according to a third embodiment of the present invention, and FIG. 7 shows a configuration of a distortion detection device. This embodiment is a high-frequency treatment, but basically differs from the first embodiment in the output adjustment mechanism.

The high-frequency treatment instrument 1C shown in FIG. 6 has the following output adjustment mechanism 61. The operation lever 5 has a base end rotatably provided about a rotation shaft 62. A hemispherical projection 63 is provided near the base end of the operation lever 62, and a distortion detecting device 64 is embedded therein. An elastic rubber 65 having elasticity is provided on the handle 4 at a position facing the projection 63. In addition,
The protrusion 63 is also formed of an elastic member having a higher hardness than the elastic rubber 65, and transmits the force applied to the protrusion 63 to the internal strain detection device 64.

When the operation lever 5 is operated, the protrusion 63 provided on the operation lever 5 is
In step 5, the pressing is performed, and an output corresponding to the pressing force is input from the distortion detecting device 64 to the control circuit 66. Further, when the elastic rubber 65 hits the elastic rubber 65, the elastic rubber 65 is deformed so that the operation lever 5 can rotate around the rotation shaft 62.

The control circuit 66 turns off the switch 43 when the signal input from the distortion detecting device 64 exceeds the reference value.
Then, a control operation of turning on the high-frequency treatment tool and an operation of controlling the high-frequency treatment instrument driving section 67 by an output signal proportional to a signal input from the distortion detection device 64 are performed.

The high-frequency treatment instrument driving section 67 includes, for example, an oscillator 67a and a G for amplifying the oscillation output of the oscillator 67a.
The control circuit 66 performs an operation of variably controlling the gain of the GCA 67b, for example, in proportion to the signal input from the distortion detection device 64, thereby controlling the GCA6.
The high-frequency treatment output from the treatment section at the tip is variably controlled via the electrode rods 68a and 68b connected to the electrode 7b.

FIG. 7 shows the details of the distortion detecting device 65. This strain detecting device 65 includes, for example, three strain gauges 69a, 69
b and 69c form a bridge, and output a signal of a distortion amount corresponding to the amount of pressing force of the operation lever 5 to the control circuit 66. Other configurations are the same as those of the first embodiment.

In the present embodiment, the high-frequency power generated by the high-frequency treatment tool driving section 67 is transmitted to the treatment section at the distal end by the electrode rods 68a and 68b, and the treatment section performs high-frequency ablation or other treatment. It is.

Also in the present embodiment, the high-frequency treatment instrument driving section 67 is controlled in accordance with the amount of operation force for rotating the operation lever 5 and the like.
And a treatment output for performing a high-frequency treatment transmitted to the treatment section via the electrode rods 68a and 68b can be variably controlled. Therefore, the present embodiment has substantially the same effect as the first embodiment or its modification.

As a modification of the present embodiment, FIG.
Instead of providing the strain detecting device 64 in the protrusion 63 of the above, the strain detecting device 64 may be provided in a portion on the elastic rubber 65 side. In this way, the output signal of the distortion detecting device 64 can be simply transmitted to the control circuit 66 without inputting the output signal of the distortion detecting device 64 to the control circuit 66 via the signal line provided in the movable operation lever 5. And can be realized with a simpler configuration.

(Fourth Embodiment) Next, a fourth embodiment of the present invention will be described with reference to FIGS. FIG. 8 shows an appearance of an ultrasonic treatment device according to a fourth embodiment of the present invention, and FIG. 9 shows a configuration of a main part of the ultrasonic treatment device.

As shown in FIG. 8, the ultrasonic treatment instrument 1D includes an insertion portion 72 and an operation portion 73. The operation portion 73 has a handle portion 74 and an operation lever 75, and an on / off switch is provided on the upper surface of the operation portion 73. A switch 76 for turning off is provided. Further, an output adjustment switch 71 using conductive rubber is provided at, for example, a position near the upper portion of the handle 74.

The output adjustment switch 71 has a structure similar to that of the one in which the resistance value changes by pressing the conductive elastic device 46 shown in FIG. The resistance value of the conductive elastic device inside the output adjustment switch 71 changes according to the operation of pressing with the thumb or the like, and the control circuit 88 detects the resistance value as a voltage value, and outputs the vibrator drive signal of the vibrator drive unit 13. Is variably controlled.

In the present embodiment, the treatment section 77 at the distal end of the insertion section 72 includes a fixed jaw 78a and a movable jaw 78b, and the movable jaw 78b is inserted through the operation wire 79 (see FIG. The movable jaw 7 is connected to a pulley 81 (see FIG. 9) provided near the base end of the operating lever 75 via the operating lever 75.
8b is pivoted about its proximal pin to provide a fixed jaw 78a.
It is structured to open and close with respect to.

FIG. 9 shows the detailed structure of the operation lever 74 and the handle 75. A gear 80 is provided near the base end of the operation lever 74.
And a pulley 81 are provided rotatably with respect to a rotation shaft 82. The gear 80 is a gear 8 that meshes with the gear 80.
3, a motor 8 attached to the rotating shaft of the gear 83
4 and the gear 83 with the rotation of the motor 84.
Also rotate.

The pulley 8 which is rotatable together with the gear 80
When the pulley 81 rotates, the movable jaw 78b opens and closes with respect to the fixed jaw 78a.

A pressure-sensitive sensor fixing portion 85 is provided around the base end side of the operation lever 74. The pressure-sensitive sensor fixing portion 85 has a substantially U-shape, and as shown in FIG. It is rotatably supported by a rotating shaft 86 of the section. Pressure-sensitive sensors 87a and 87b that detect pressure are provided at both ends of the fork portion of the pressure-sensitive sensor fixing portion 85, and each can contact a side end of the operation lever 75.

The battery 24 is an ON / OFF switch 7
Power is supplied to the control circuit 88 and the vibrator driving unit 13 through the control unit 6.

The outputs of the pressure sensors 87a and 87b are input to a control circuit 88, and the rotation of the motor 84 is controlled by the outputs of the pressure sensors 87a and 87b.

More specifically, the pressure sensors 87a, 87
b, the pressure-sensitive output is input to the control circuit 88 when the pressure-sensitive detection is performed. The control circuit 88 drives the motor 84 to rotate as long as the pressure-sensitive output is present.
The control for stopping the rotation drive of No. 4 is performed.

In other words, the operation lever 75 is electrically driven by the motor 84 following the operation of the operation lever 75, and the movable lever 78 is moved with a small force to move the movable jaw 78b. The fixed jaw 78a can be opened and closed.

The control circuit 88 includes an output adjustment switch 71
Is also input, the output adjustment switch 71
The vibrator drive unit 13 (the gain of the GCA 22 thereof) is controlled by the amount of operation force.

When the operating lever 75 is slightly moved in the closing direction (counterclockwise in FIG. 9) in a state where the power is turned on (supplied) to the control circuit and the like by the switch 76, the side of the operating lever 75 The end presses the pressure sensor 87a,
The output of the pressure sensor 87a sensing the pressing is input to the control circuit 88, which drives the motor 84 to drive the gear 83,
The operating lever 75 is rotated in the closing direction via the operating wire 80, and the operating wire 79 is extended to move the movable jaw 7 at the tip thereof.
8b is driven in the closing direction.

When the operating lever 75 is slightly moved in the opening direction (clockwise in FIG. 9), the side end of the operating lever 75 presses the pressure sensor 87b, and the pressure sensor 87b detects the pressing. The output is input to the control circuit 88 and the motor 84 is driven to drive the operation lever 7 via the gears 83 and 80.
5 is rotated in the opening direction, the operation wire 79 is wound around the pulley 81, the operation wire 79 is pulled rearward, and the movable jaw 78b at the tip is driven in the opening direction.

When the output adjustment switch 71 is operated, a signal proportional to the amount of pressing force of the output adjustment switch 71 is also input to the control circuit 88, and the control circuit 88 drives the vibrator in proportion to the amount of pressing force. Part 13 (GCA
22 gain).

Therefore, in this embodiment, the operating lever 75 can be operated in the opening direction or the closing direction with a small force, and the treatment section 77 at the distal end of the insertion section 72 can be operated with a small force.
Can be opened and closed.

The driving of the motor 84 can be stopped by moving the side end of the operating lever 35 to an intermediate position where the side end of the operating lever 35 does not contact the pressure-sensitive sensors 78a and 78b. Further, by operating the output adjustment switch 71, the ultrasonic treatment output of the treatment section 77 can be variably adjusted, and the same effects as those of the first embodiment and the like can be obtained.

(Fifth Embodiment) Next, a fifth embodiment of the present invention will be described with reference to FIG. This embodiment is different from the fourth embodiment in that the movable jaw portion 78b is normally set in the open state so that the closing operation can be performed with a light operation force.

Specifically, the ultrasonic treatment instrument 1E of FIG. 10 is different from the ultrasonic treatment instrument 1D of FIG. 9 in that a J-shaped pressure-sensitive sensor fixing portion is used instead of the U-shaped pressure-sensitive sensor fixing portion 85. 85 ′, and a magnet 91 is attached to the motor 84 provided with the gear 83, for example, the (gear 83) of the motor 84.
The shaft (on the side opposite to the side provided with) is engaged with the guide groove 92 so as to be movable in the horizontal direction.

The electromagnet 93 faces the magnet 91.
Is provided, the electromagnet 93 is connected to the control circuit 88,
When a current is supplied to the electromagnet 93 under the control of the control circuit 88, a magnetic force for repelling the magnet 91 is generated, and the motor 84 and the gear 83 are moved along the guide groove 92 into the gear 80.
It can be moved to the side.

When no current is supplied to the electromagnet 93,
As shown in FIG. 10, the magnet 91 is attracted to the electromagnet 93, and the gear 83 is separated from the gear 80 in this state.

The other structure is the same as that of the fourth embodiment shown in FIG.

Next, the operation of the present embodiment will be described. When the operation lever 48 is slightly moved in the closing direction, the side end of the operation lever 48 presses the pressure-sensitive sensor 87a, the output of the pressure-sensitive sensor 87a is input to the control circuit 88, and electricity is supplied to the electromagnet 93. , The magnet 91
And the motor 84 move the guide groove 92 toward the gear 80 so that the gears 83 and 80 are engaged with each other.
The operation lever 75 is rotated in the closing direction by the rotation of the gears 83 and 80.

The side end of the operating lever 75 is a pressure-sensitive sensor 87
When the position is not pressed, the pressure-sensitive sensor 87a does not output the pressure-sensitive signal, and the control circuit 88 to which the output of the pressure-sensitive sensor 87a is input stops receiving the current and supplies the current to the electromagnet 93. As a result, the magnet 91 and the electromagnet 93 are attracted, the engagement and connection of the gears 80 and 83 are released, and the rotation of the motor 84 is stopped.

When the output adjustment switch 71 is operated, a signal proportional to the amount of pressing force of the output adjustment switch 71 is input to the control circuit 88, and the control circuit 88 drives the vibrator in proportion to the amount of pressing force. Part 13 (GCA
22 gain). According to the present embodiment, the same effect as that of the fourth embodiment can be obtained in the closing direction.

(Sixth Embodiment) Next, a sixth embodiment of the present invention will be described with reference to FIG. This embodiment is different from the fourth embodiment in that limiter means for detecting the operation range of the operation lever 75 is further provided, and when the operation lever 75 is operated beyond the operation range by the limiter means, the motor 84 is used. The operation is stopped.

That is, the ultrasonic treatment instrument 1F shown in FIG.
In the ultrasonic treatment tool 1D, both pressure-sensitive sensors 87a, 8
Limit switches 89a and 89b for limiter detection are provided on both outer sides of 7b, respectively.

The output signals of the limit switches 89a and 89b are input to the control circuit 88. Then, the control circuit 88
When the pressure-sensitive signal is input from the limit switches 89a and 89b, the control of stopping the rotation of the motor 84 is performed.

In other words, the control circuit 88 sets the range between the limit switches 89a and 89b as the movable range of the operating lever 75, and when the operating lever 75 is operated within this movable range, performs the same control as in the case of FIG. When the operation lever 75 is operated beyond the movable range, the rotation of the motor 84 is stopped. Other configurations are the same as those of the ultrasonic treatment device 1D shown in FIG.

Next, the operation of the present embodiment will be described. For example, when the operation lever 75 is slightly moved in the closing direction, the side end portion of the operation lever 75 presses the pressure-sensitive sensor 87a, and the output of the pressure-sensitive sensor 87a is input to the control circuit 88 to drive the motor 84. Operation lever 75 via gears 83 and 80
Is rotated in the closing direction.

When the operation lever 75 is slightly moved in the opening direction opposite to the closing direction, the side end of the operation lever 75 presses the pressure-sensitive sensor 78b, and the output of the pressure-sensitive sensor 78b is sent to the control circuit 88. The motor 84 is input and drives the motor 84 to drive the gear 83,
The operation lever 75 is rotated in the closing direction via 80.

The limit switches 89a and 89b are provided outside the pressure-sensitive sensor fixing portion 85, and the operation lever 7
5 is moved in the closing direction, and when the fork of the pressure-sensitive sensor fixing portion 85 presses the limit switch 89a, the press is sensed by the limit switch 89a and sent to the control circuit 88, which receives the signal. The rotation of the motor 84 is stopped.

When the operating lever 75 is moved in the opening direction, and the fork of the pressure-sensitive sensor fixing portion 85 presses the limit switch 89b, the pressing is sensed by the limit switch 89b and sent to the control circuit 88. In response, the motor 88 stops the rotation of the motor 84.

When the output adjusting switch 71 is operated, a signal proportional to the amount of pressing force of the output adjusting switch 71 is input to the control circuit 88, and the control circuit 88 drives the vibrator in proportion to the amount of pressing force. Part 13 (GCA
22 gain). According to the present embodiment, the same effects as those of the fourth embodiment can be obtained within the movable range of the operation lever 75, and when the operation lever 75 is operated beyond the movable range, the operation lever 75 can be electrically moved. The operation to be performed can be stopped, and the operation can be prevented from being performed more than necessary. It should be noted that embodiments and the like configured by partially combining the above-described embodiments and the like also belong to the present invention.

[Supplementary Notes] An insertion section to be inserted into the subject, a treatment section provided at the distal end of the insertion section for performing a treatment on the subject, and transmitting a driving force for driving the treatment section to the treatment section; A transmission unit, an operation unit provided on the proximal end side of the insertion unit, and a movable unit movably provided on the operation unit,
An electric drive type treatment instrument comprising: detection means for detecting an operation state of the movable means; and control means for variably controlling a treatment output of the treatment section in accordance with a detection output of the detection means. .

2. An insertion section to be inserted into the subject, a treatment section provided at the distal end of the insertion section for performing a treatment on the subject, and transmitting a driving force for driving the treatment section to the treatment section; A transmission unit, an operation unit provided on the base end side of the insertion unit, a movable unit movably provided on the operation unit by a predetermined amount, and a movable amount detection unit for detecting a movable amount of the movable unit. Control means for variably controlling the treatment output of the treatment section in accordance with the movable amount detected by the movable amount detecting means.

3. An insertion portion to be inserted into the subject, a treatment portion provided at the distal end of the insertion portion for performing a treatment on the subject, and transmitting a driving force for driving the treatment portion to the treatment portion; A transmitting unit, an operating unit provided on a base end side of the insertion unit, a movable unit movably provided on the operating unit, a movable force detecting unit for detecting a movable force of the movable unit, Control means for variably controlling the treatment output of the treatment section according to the movable force detected by the power detection means,
An electrically driven treatment instrument comprising:

4. An insertion section to be inserted into the subject, a treatment section provided at the distal end of the insertion section for performing a treatment on the subject, and transmitting a driving force for driving the treatment section to the treatment section; A transmitting unit, an operating unit provided on a base end side of the insertion unit, a movable unit movably provided on the operating unit, a movable amount detecting unit for detecting a movable amount of the movable unit, and a movable unit. Control means for variably controlling the treatment output of the treatment section according to the movable amount detected by the quantity detection means,
An electrically driven treatment tool comprising:

5. In Addition 4, the detecting means has a piezoelectric switch including a plurality of piezoelectric elements for generating a voltage according to the amount of movement of the movable means. 6. In Supplementary Note 4, the detection unit includes a resistance value changing unit that changes a resistance value according to a movable amount of the movable unit. 7. In Addition 6, the resistance value changing means has a conductive member having elasticity whose resistance value changes in accordance with the amount of pressing by movement.

8. In Supplementary Note 6, the resistance value changing means includes a potentiometer whose resistance value changes according to a movable amount. 9. In Supplementary Note 4, the treatment unit is an ultrasonic treatment unit that performs a treatment using ultrasonic waves. 10. In Appendix 9, the control means variably controls the amplitude of an ultrasonic drive signal for driving a vibrator drive section that supplies ultrasonic vibration to the ultrasonic treatment section in accordance with the movable amount of the movable section.

11. In Supplementary Note 4, the treatment section is a high-frequency treatment section that performs a treatment using high-frequency power. 12. In Supplementary Note 11, the control unit variably controls the amplitude of a high-frequency drive signal for driving a high-frequency drive unit that supplies high-frequency power to the high-frequency wave treatment unit according to the movable amount of the movable unit. 13. In Supplementary Note 4, the detection means has a strain detection gauge whose resistance value changes by a stress corresponding to the amount of movement of the movable means.

14. In Supplementary Note 4, a movement detecting means for detecting whether or not the movable means is moved by following the movement of the movable means, and electrically detecting a position of the movable means by the output of the movable detection means. And moving means driving means for moving the moving means. 15. Appendix 14 includes a movable range detection unit that detects whether the movable unit has deviated from a predetermined movable range. 16. In Supplementary Note 15, when it is detected that the movable means deviates from a predetermined movable range, the movable means driving means stops the electric drive of the movable means.

[0104]

As described above, according to the present invention, an insertion section to be inserted into a subject, a treatment section provided at a distal end of the insertion section to perform treatment on the subject, A transmitting unit that transmits a driving force or the like for driving the unit to the treatment unit, an operating unit provided on a proximal end side of the insertion unit,
A movable unit movably provided on the operation unit, a detection unit for detecting an operation state of the movable unit, and a control unit for variably controlling a treatment output of the treatment unit in accordance with a detection output of the detection unit. , The operation output of the treatment section can be quickly and easily adjusted (variable control) by operating the movable means provided on the operation section, and a delicate operation or an operation requiring precision can be easily performed smoothly.

Further, the insertion part to be inserted into the subject, the treatment part provided at the distal end of the insertion part for performing treatment on the subject, and the driving force for driving the treatment part are described above. A transmitting unit for transmitting to the treatment unit, an operating unit provided on the proximal end side of the insertion unit, a movable unit movably provided on the operating unit by a predetermined amount, and detecting a movable amount of the movable unit. Since the movable amount detecting means and the control means for variably controlling the treatment output of the treatment section in accordance with the movable amount detected by the movable amount detecting means are provided, the movable means provided in the operating section is operated. Thus, the treatment output of the treatment section can be quickly and easily adjusted (variable control), and a delicate operation or an operation requiring precision can be smoothly performed.

Also, the insertion part to be inserted into the subject, the treatment part provided at the distal end of the insertion part to perform treatment on the subject, and the driving force for driving the treatment part, etc. Transmitting means for transmitting to the treatment section; an operating section provided on the proximal end side of the insertion section; movable means movably provided on the operating section; and movable force detection for detecting a movable force of the movable means. Means, and control means for variably controlling the treatment output of the treatment section in accordance with the movable force detected by the movable force detection means, so that the treatment is performed by operating the movable means provided on the operation section. The treatment output of the section can be quickly and easily adjusted (variable control), and a delicate operation or an operation requiring precision can be smoothly performed.

[Brief description of the drawings]

FIG. 1 is an external view of an ultrasonic treatment device according to a first embodiment of the present invention.

FIG. 2 is a detailed configuration diagram of the ultrasonic treatment instrument.

FIG. 3 is a diagram showing a configuration of an output adjustment mechanism for ultrasonic treatment.

FIG. 4 is a diagram showing an output adjustment mechanism in a modified example.

FIG. 5 is a diagram illustrating a configuration of an output adjustment mechanism and the like of an ultrasonic treatment tool according to a second embodiment of the present invention.

FIG. 6 is a diagram showing a configuration of an output adjustment mechanism and the like of a high-frequency treatment device according to a third embodiment of the present invention.

FIG. 7 is a configuration diagram of a distortion detection device.

FIG. 8 is an external view of an ultrasonic treatment device according to a fourth embodiment of the present invention.

FIG. 9 is a diagram showing a configuration of a main part of the ultrasonic treatment instrument.

FIG. 10 is a diagram showing a configuration of a main part of an ultrasonic treatment device according to a fifth embodiment of the present invention.

FIG. 11 is a diagram showing a configuration of a main part of an ultrasonic treatment device according to a sixth embodiment of the present invention.

[Explanation of symbols]

 1A Ultrasonic treatment tool 2 Insertion section 3 Operation section 4 Handle section 5 Operation lever 11 Outer case 12 Ultrasonic vibrator 13 Vibrator drive section 14 Horn 15 Sheath 16 Ultrasonic transmission rod Reference Signs List 17 treatment unit 21 oscillation circuit 22 GCA 23 control circuit 24 battery (battery) 25 lid 31 output adjustment mechanism 32 pin 33 guide groove 34 arm 35 cylinder 37 spring 38 piston 39 Piezoelectric switches 40a-40d ... piezoelectric elements 41a-41d ... comparator 42 ... decoder 43 ... switch

 ──────────────────────────────────────────────────続 き Continuing on the front page (72) Inventor Tomohisa Sakurai 2-43-2 Hatagaya, Shibuya-ku, Tokyo Inside Olympus Optical Industrial Co., Ltd. (72) Inventor Akira Shiga 2-43-2 Hatagaya, Shibuya-ku, Tokyo No. Olympus Optical Co., Ltd. (72) Masaru Karasawa, Inventor 2-43-2, Hatagaya, Shibuya-ku, Tokyo Olympus Optical Co., Ltd., (72) Takeo Usui, 2-43, Hatagaya, Shibuya-ku, Tokyo No. 2 Inside Olympus Optical Co., Ltd. (72) Inventor Takeaki Nakamura 2-43-2 Hatagaya, Shibuya-ku, Tokyo F-term inside Olympus Optical Co., Ltd. (reference) 4C060 GG02 JJ22 JJ23 JJ25 KK03 KK04 KK10 KK23 4C061 AA00 BB00 CC00 DD00 GG15 HH56

Claims (3)

[Claims] An insertion section inserted into a subject; a treatment section provided at a distal end of the insertion section for performing a treatment on the subject; and a driving force for driving the treatment section. A transmitting unit for transmitting to the treatment unit; an operating unit provided on the base end side of the insertion unit; a movable unit movably provided on the operating unit; and a detecting unit for detecting an operation state of the movable unit. An electric drive type treatment instrument comprising: control means for variably controlling a treatment output of the treatment section in accordance with a detection output of the detection means. 2. An insertion section to be inserted into a subject, a treatment section provided at a distal end of the insertion section to perform a treatment on the subject, and a driving force for driving the treatment section. A transmitting means for transmitting to the treatment section; an operating section provided on the base end side of the insertion section; a movable section provided movably by a predetermined amount on the operating section; and detecting a movable amount of the movable section. An electrically driven treatment tool comprising: a movable amount detection unit; and a control unit that variably controls a treatment output of the treatment unit according to the movable amount detected by the movable amount detection unit. 3. An insertion section to be inserted into a subject, a treatment section provided at a distal end of the insertion section to perform a treatment on the subject, and a driving force for driving the treatment section. A transmitting unit for transmitting to the treatment unit; an operating unit provided on the base end side of the insertion unit; a movable unit movably provided on the operating unit; and a movable force detection for detecting a movable force of the movable unit. Means, and control means for variably controlling the treatment output of the treatment section in accordance with the movable force detected by the movable force detection means.