U.S. patent number 3,897,787 [Application Number 05/428,892] was granted by the patent office on 1975-08-05 for power source device for an electric surgical knife.
This patent grant is currently assigned to Olympus Optical Company, Ltd.. Invention is credited to Yuji Ikuno, Yutaka Kato.
United States Patent |
3,897,787 |
Ikuno , et al. |
August 5, 1975 |
Power source device for an electric surgical knife
Abstract
Power source device for an electric surgical knife for use with
an endoscope comprising, means for supplying a high frequency
signal to an electric surgical knife, a selector for determining
whether or not the high frequency signal is attenuated before it is
supplied to the knife, a level detecting circuit for detecting the
voltage level of the high frequency signal which is attenuated and
supplied to the treatment electrode of the knife, a level
difference detecting circuit for detecting different voltages
between the high frequency signal supplied to the treatment
electrode and that supplied to the fixed electrode of the knife,
and means for determining whether the conductive state of the knife
is normal or abnormal using output signals from the level detecting
circuit and level difference detecting circuit.
Inventors: |
Ikuno; Yuji (Fuchu,
JA), Kato; Yutaka (Tama, JA) |
Assignee: |
Olympus Optical Company, Ltd.
(Tokyo, JA)
|
Family
ID: |
11504952 |
Appl.
No.: |
05/428,892 |
Filed: |
December 27, 1973 |
Foreign Application Priority Data
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|
|
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Dec 29, 1972 [JA] |
|
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48-1562 |
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Current U.S.
Class: |
606/35;
361/86 |
Current CPC
Class: |
A61B
18/1233 (20130101); A61B 18/16 (20130101) |
Current International
Class: |
A61B
18/12 (20060101); A61B 18/16 (20060101); A61B
18/14 (20060101); A61b 017/36 () |
Field of
Search: |
;128/303.14,303.13,303.17,303.18,2.1P ;317/27R |
References Cited
[Referenced By]
U.S. Patent Documents
Foreign Patent Documents
Primary Examiner: Gaudet; Richard A.
Assistant Examiner: Cohen; Lee S.
Attorney, Agent or Firm: Flynn & Frishauf
Claims
What we claim is:
1. A power source device for supplying high frequency electrical
signals on first and second output lines which are respectively
adapted to be connected to active and fixed electrodes of an
electrosurgical knife, comprising:
means for generating a high frequency signal;
means for supplying a high frequency signal to first and second
output lines;
selector means connected to said supplying means for selectively
passing said high frequency signal to said supplying means or for
attenuating said high frequency signal before passing same to said
supplying means;
level detecting means coupled to said supplying means for detecting
the voltage level of the high frequency signal supplied to said
first output line;
level difference detecting means coupled to said supplying means
and to said level detecting means for detecting a difference
between the voltage levels of output signals corresponding to the
signals appearing on said first and second output lines;
level comparison means fro comparing the voltage level of an output
signal from said level detecting means with a first fixed voltage
level;
level difference comparison means for comparing the voltage level
of an output signal from said level difference detecting means with
a second fixed voltage level;
determining means responsive to the output signals from both said
level comparison means and said level difference comparison means
for determining whether or not the signals supplied to said first
and second output lines are "normal" so as to render an electric
knife in a normal conduction state; and
indicating means responsive to the output of said determining means
for indicating whether or not said signals supplied to said first
and second output lines are "normal".
2. A power source device according to claim 1 wherein said means
for supplying a high frequency signal comprises means for
amplifying the voltage and power of the high frequency signal; and
an output circuit means for eliminating a direct current component
from the amplified high frequency signal.
3. A power source according to claim 2 wherein said high frequency
signal supplying means further comprises a low frequency signal
generator for generating a square wave signal of low frequency; a
clamping and differentiating circuit means connected to said low
frequency signal generator so as to form a damped wave signal by
repeating damping at a repititive frequency equal to the frequency
of said low frequency signal; and means for amplitude modulating
said high frequency signal with said damped low frequency
signal.
4. A power source according to claim 3 wherein said selector means
comprises means coupled to said low frequency signal generator for
forming a pulse signal from a low frequency signal generated by
said low frequency signal generator; a first gate means connected
to said determining means and to the output of said modulating
means so as to supply said high frequency signal without
attenuation when an output signal from said determining means which
indicates a normal state is delivered to said first gate means; a
second gate means connected to said pulse signal forming means and
to said high frequency signal generator and enabled intermittently
each time a pulse signal formed by said pulse signal forming means
is supplied to said second gate means; and a signal forming circuit
means connected to the output terminal of said second gate means so
as to cause said high frequency signal to be attenuated when said
second gate means is enabled, thereby causing the attenuated high
frequency signal to be supplied by said supplying means to the
first and second output lines.
5. A power source according to claim 1 wherein said selector means
comprises a signal generator means for generating a gate signal; a
detecting switch means connected to said gate signal generator
means and provided with a normally open contact and normally closed
contact; a first gate means connected to said gate signal generator
means so as to supply the high frequency signal to said output
lines without attenuation when said first gate means is supplied
with a signal from the normally closed contact of the detecting
switch means; a second gate means connected to said gate signal
generator means and enabled when supplied with a gate signal
through the normally open contact of the detecting switch means;
and an output adjusting circuit means connected to the output
terminal of said second gate means and to said means for supplying
so as to cause said high frequency signal to be attenuated
6. A power source according to claim 5 wherein said means for
supplying a high frequency signal includes an output circuit means
for eliminating a direct current component from the high frequency
signal; and wherein said voltage level detecting means comprises a
first detector electrically coupled to said output circuit means
for detecting the amount of current supplied by said supplying
means to the said first output line; a first converter and
rectifier circuit means coupled to the output of the first
detector; a third gate means coupled to the normally open contact
of the detecting switch means and to an output of the first
converter and rectifier circuit means, the operation of the third
gate means being controlled by a gate signal supplied thereto
through the normally open contact of the detecting switch means;
and a first amplifier means coupled to the third gate means for
amplifying an output signal from the third gate means.
7. A power source according to claim 6 wherein said voltage level
difference detecting means comprises a second detector electrically
coupled to said output circuit means for detecting the amount of
current supplied by said supplying means to said second output
line; a second converter and rectifier circuit means coupled to the
output of the second detector; a fourth gate means coupled to the
normally open contact of the detecting switch means and to the
output of the second converter and rectifier circuit means, the
operation of the fourth gate means being controlled by a gate
signal supplied to the fourth gate means through the normally open
contact of the detecting switch means; a second amplifier mena
connected to the output terminal of the fourth gate; and a
differential amplifier coupled to the outputs of the first and
second amplifier means.
8. A power source according to claim 5 wherein said determining
means comprises a first flip-flop coupled to the output of said
level comparison means; a second flip-flop coupled to the output of
said level difference comparison means, said first and second
flip-flops being coupled to said selector means and being
controlled by a gate signal from said selector means; and an AND
gate means coupled to the outputs of both said first and second
flip-flops; and wherein said indicating means includes a display
means coupled to the output of said AND gate means.
9. A power source according to claim 1 wherein said selector means
comprises a signal generator means for generating a gate signal; a
detecting switch means connected to said gate signal generator
means and provided with a single contact; a first gate means
connected to said means for generating a high frequency signal and
to an output of said determining means for supplying said high
frequency signal without attenuation when an output signal from
said determining means which indicates a normal condition is
supplied to said first gate means; a second gate means connected to
said gate signal generator means and enabled when the contact of
the detecting switch means is closed; and a signal forming circuit
means connected to the output terminal of said second gate means so
as to cause said high frequency signal to be attenuated when said
second gate means is enabled, thereby causing an attenuated high
frequency signal to by supplied by said supplying means to the
first and second output lines.
10. A power source device according to claim 1 wherein said level
comparison means comprises a standard voltage level setting circuit
means for generating said first fixed voltage level; and a first
Schmitt circuit means coupled to the output of the level detecting
means and to the output of the standard voltage level setting
circuit means, for producing an output signal of its own when the
voltage level of an output signal from the level detecting means is
higher than said first fixed voltage level.
11. A power source device according to claim 1 wherein said level
difference comparison means comprises a standard voltage level
difference setting circuit means for generating said second fixed
voltage level representing a preset standard difference; and a
second Schmitt circuit means coupled to an output of the level
difference detecting means and to the output of the standard
voltage level difference setting circuit means, for producing an
output signal of its own when the voltage level of an output signal
from the level difference detecting means is lower than said second
fixed voltage level.
12. A power source according to claim 1 wherein said determining
means comprises a first bistable multivibrator coupled to the
output of said level comparison means; a second bistable
multivibrator coupled to the output of said level difference
comparison means; and gating means coupling the outputs of said
first and second bistable multivibrators to said indicating
means.
13. An electric surgical knife device comprising:
an electric surgical knife provided with an active electrode and a
fixed electrode whose contact area is larger than that of said
active electrode;
a high frequency signal generator for generating a high frequency
signal;
means for supplying the high frequency signal to the active and
fixed electrodes of the electric surgical knife;
selector means connected to said supplying means for selectively
passing said high frequency signal to said supplying means or for
attenuating said high frequency signal before passing same to said
supplying means;
level detecting means coupled to said supplying means for detecting
the voltage level of the high frequency signal supplied to the
active electrode of the knife;
level difference detecting means coupled to said supplying means
and to said level detecting means for detecting a difference
between the voltage levels of output signals corresponding to the
signals supplied to the active electrode and to the fixed
electrode;
level comparison means for comparing the voltage level of an output
signal from said level detecting means with a first fixed voltage
level;
level difference comparison means for comparing the voltage level
of an output signal from said level difference detecting means with
a second fixed voltage level;
determining means responsive to the output signals from both said
level comparison means and said level difference comparison means
for determining whether or not the signals supplied to said
electric knife are such as to render said electric knife in a
normal conductive state; and
indicating means responsive to the output of said determining means
for indicating whether or not said signals supplied to said
electric knife are such as to render said electric knife in a
normal conductive state.
Description
BACKGROUND OF THE INVENTION
This invention relates to an electrosurgical knife device which is
introduced into the abdominal cavity of a human body through an
endoscope and more particularly to a power source for an
electrosurgical knife capable of preventing patient from getting
burnt in any other part of his body than a diseased part due to
concentrated current.
An electrosurgical knife is known which comprises an active
electrode which is shaped like a needle or a blade and has a very
small contact area and a fixed electrode which is shaped like a
plate and has a large contact area, wherein a high frequency signal
is conducted between the active (or treatment) electrode and the
fixed electrode through a human body. The high frequency current
which is concentrated aroung the end of the active electrode whose
contact area is very small causes Joule heat to be generated; this
Joule heat gives rises to the explosion of a gas in the human body,
thereby enabling the incision and excision of an affected part.
Moreover, a signal having a little higher frequency than that of
the signal for the incision and excision or a high frequency signal
which is amplitude modulated by a damped low frequency signal is
selectively transmitted through the human body between the active
electrode and the fixed electrode, thereby thermally coagulating
body proteins at an incised or excised surface to close a lymphatic
vessel and a fine vessel with the resultant hemostasis or stoppage
of bleeding.
Already known are a power source provided with a high frequency
signal generator whose output signal is amplified in voltage and
power and supplied to the electric or radio surgical knife, thereby
enabling the incision and excision of a human body, and another
power source provided with a high frequency generator whose output
signal is amplitude modulated by a damped low frequency signal,
enabling the stoppage of bleeding or hemostasis.
When the electric surgical knife is driven by any of the prior art
power sources, accidents frequently occur wherein the patient gets
burnt at the part which is not diseased and moreover contacts any
other electrical device than the electrodes of the electric
surgical knife, because the concentrated current unnecessarily
flows through the patient's body when he touches said other device,
while a lead line between the power source and the electric
surgical knife is disconnected or a contact resistence between the
patient and the electrodes of the electric surgical knife
increases.
The object of this invention resides in providing a power source
for an electric surgical knife introduced into the abdominal cavity
of a human body through an endoscope, which detects a conductive
state between the patient and the electric surgical knife or
between said knife and the power source, thereby saving a patient
from an accident of an electrical shock causing him to get burnt at
any other part than the affected one due to concentrated current
flowing through said other part when he touches a different device
from the electrodes of the surgical knife.
SUMMARY OF THE INVENTION
This invention provides an electric surgical knife introduced into
the cavity of a human body through an endoscope comprising a high
frequency signal generator; means for supplying a high frequency
signal to the radio sirgical knife; a selector device for
determining whether the high frequency signal is supplied to the
surgical knife in an attenuated or nonattenuated state; a
level-detecting circuit for detecting the amplitude level of the
high frequency current which flows through the treatment electrode
of the electric surgical knife when the attenuated high frequency
signal is supplied to the electric surgical knife; a level
difference detecting circuit for detecting different amplitude
levels between the high frequency current supplied to the treatment
electrode and that supplied to the fixed electrode of the electric
surgical knife when the attenuated high frequency signal is
supplied to the knife; and a means for determining whether the
conductive state of the knife is normal or abnormal using output
signals from the level-detecting circuit and level
difference-detecting circuit, whereby the high frequency signal is
supplied to the knife without being attenuated when the conductive
state of the knife is normal.
BRIEF DESCRIPTION OF THE DRAWINGS
FIG. 1 is a block diagram of one embodiment of this invention;
FIG. 2 is a block diagram of one modification of the embodiment
shown in FIG. 1;
FIG. 3 is a block diagram of another embodiment of this invention;
and
FIG. 4 is a block diagram of a further embodiment of this
invention.
DETAILED DESCRIPTION OF THE INVENTION
As shown in FIG. 1, a selector device 78 comprises first and second
gates 81 and 82, a gate signal generator 71 and a detector switch
72. There is provided a high frequency signal generator 11 whose
output terminal is connected to an OR circuit 62 through the first
gate 81. The output terminal of the high frequency signal generator
11 is also connected to an output adjusting circuit 12 comprising a
variable resistor through a second gate 82 and the output terminal
of the output adjusting signal 12 is coupled to the OR circuit 62.
The output signal of the OR circuit 62 is supplied to an output
transformer 31 through a series connection of a voltage amplifier
21 and a power amplifier 22. Capacitors 32 and 33 for blocking
direct current are connected to the output terminal of the output
transformer 31. An output transformer 31 and capacitors 32 and 33.
An output signal from the output circuit 3 is supplied to an
electric surgical knife 4 having an active electrode 41 and fixed
electrode 42.
There is provided between the capacitor 32 and active electrode 41
a first level detector 91 for detecting the high frequency current
supplied to the active electrode 41. An output signal A from the
detector 91 is supplied to a third gate 83 through a series
connection of a first voltage converter 99 comprising a transformer
and a rectifier circuit 101. The output signal of third gate 83 is
conducted to a first level detecting signal amplifier 111. A level
detecting circuit 911 comprises the first dectector 91, first
voltage converter 99, a first rectifier cicuit 101 and first
amplifier 111. A second level detector 92 is provided between the
capacitor 33 and fixed electrode 42. The second level detector 92
is used for detecting the amplitude level of the high frequency
current supplied to the fixed electrode 42. An output signal B from
the second level detector 92 is supplied to a fourth gate 84
through the second voltage converter 100 comprising a transformer
and the second rectifier circuit 102. An output signal from the
fourth gate 84 is transmitted to a differential amplifier 121 via a
second level signal amplifier 112. A differential amplifier 121 is
also provided with output signals from the first level signal
amplifier 111. Level-detecting circuit 911, second detector, second
voltage converter 100, second rectifier circuit 102, fourth gate
84, second amplifier 112 and differential amplifier 121 form a
level difference-detecting circuit 912.
An output signal from the first level signal amplifier 111 is
supplied to the first Schmitt circuit 131 whose input terminal also
receives a standard level voltage signal from a standard level
voltage setting circuit 141. Schmitt circuit 131 and standard level
voltage setting circuit constitute a level comparison circuit 341.
The value of the standard level voltage is determined
experimentally and corresponds to an output voltage from the first
level signal amplifier 111 of the first level-detecting circuit 911
upon supply of 200 mA current to the active electrode 41 of the
electric surgical knife 4 in case a patient's diseased part is a
stomach, and is equal to an output voltage from the first level
signal amplifier 111 upon impression of a detecting signal for a
conductive state on the active electrode 41 instead of the 200 mA
current. An output signal from the first Schmitt circuit 131 is
supplied to a first flip-flop 151. The input terminal of the first
flip-flop 151 receives a signal from the gate signal generator 71
of the selector device 78 via the normally open contact of the
detecting switch 72. The first flip-flop 151 is reset at the rise
of an output signal from gate signal generator 71 of selector
device 78 and is set at the fall of an output signal from the first
Schmitt circuit 131 to send a set output signal to an AND gate
153.
An output signal from the differential amplifier 121 of the level
difference-detecting circuit 912 is conducted to the second Schmitt
circuit 132 and a standard level difference voltage is also
supplied to the second Schmitt circuit 132 from the standard level
difference voltage-setting circuit 142. The second Schmitt circuit
132 and standard level difference voltage 141 constitute a level
difference comparison circuit 342. The value of the standard level
difference voltage is determined experimentally and corresponds to
an output voltage from the differential amplifier 121 of the level
difference-detecting circuit 912 where a difference between the
amount of current supplied to the active electrode 41 and that
supplied to the fixed electrode 42 is maximum within an allowable
range. When an output signal from the differential amplifier 121 is
lower voltage than the standard level difference voltage, namely,
the electric surgical knife 4 is in a normal conductive state,
thereby causing an output signal to be produced at the output
terminal of the Schmitt circuit 132. An output signal from the
second Schmitt circuit 132 is transmitted to a second flip-flop
152. An output from the gate signal generator 71 of the selector
switch 78 is also conducted to the second flip-flop 152 via the
normally open contact of the detecting switch 72. The second
flip-flop 152 is set at the rise of an output signal from the gate
signal generator 71 of the selector device 78 and is reset at the
fall of an output signal from the second Schmitt circuit 132 of the
level difference comparison circuit 342, thereby causing the second
flip-flop 152 now brought to a set state to produce a set signal,
which in turn is supplied to the AND gate 153. The flip-flop 151
and 152 and AND gate 153 form a determination circuit 150.
An output signal from the AND gate 153 of the determination circuit
150 is supplied to a display circuit 161. The display circuit 161
indicates that the electric surgical knife 4 is in a normal state
when the AND gate 153 supplies an output signal to the display
circuit 161 and that the electric surgical knife 4 is in an
abnormal state when the AND gate 153 does not produce any output
signal.
An output signal from gate signal generator 71 is supplied to the
second, third and fourth gates 82, 83 and 84 through the normally
open contact of the detecting switch 72 and to the first gate 81
through the normally closed contact of the detecting switch 72. The
gates 81, 82, 83 and 84 are opened when a gate control signal is
impressed thereon and closed when a gate control signal is not
supplied thereto. The flip-flops 151 and 152 are in a reset state
when the power source is initially brought into an operative state.
The embodiment shown in FIG. 1 is operated as follows.
When the electric surgical knife device is initially brought to an
operative state, the first and second flip-flop 151 and 152 are in
a reset state and neither of flip-flops 151 and 152 produces any
set output signal, thereby preventing the AND gate 153 from
producing any output signal with the result that the display device
161 shows the abnormal state of the electric surgical knife 4. As
the detecting switch 72 is not operated at this stage, the normally
open contact thereof is left open and the normally closed contact
thereof remains closed. An output signal from gate signal
generating circuit 72 is supplied only to the first gate 81 to open
it, with the result that as high frequency signal is supplied to
the electric surgical knife 4 via the first gate 81 without being
attenuated. Since the second, third, and fourth gates 82, 83 and 84
remain closed, any high frequency current is not supplied to the
output control circuit 12, nor is impressed any signal of the
flip-flops 151 and 152, thereby causing the flip-flops 151 and 152
to remain reset. Under such condition the display circuit 161 shows
the abnormal state of the electric surgical knife 4. However, this
does not mean that the electric surgical knife 4 is abnormally
rendered conducting but warns that the knife 4 is going to be
operated before the conductive state of the knife device is
detected or examinaed.
When the fixed electrode 42 of the electric knife 4 is attached to
a patient and the normally open contact of the detecting switch 71
is closed, then the second, third and fourth gate 82, 83 and 84 are
opened, the first flip-flop 151 is brought to a set state and the
second flip-flop 152 to a reset state. Since, at this same time,
the normally closed contact of the detecting switch 72 is opened,
the first gate 81 is closed and the second gate 82 is opened. When,
therefore, the active electrode 41 is made to contact a patient,
high frequency current is supplied to the output control circuit 12
through the second gate 82 and has its voltage reduced by the
adjusting circuit 12 to such a low level as does not affect any
organ of a patient. Said high frequency current thus attenuated is
supplied to the electric surgical knife 4 so as to detect its
conductive state through the connecting circuit 62, voltage and
power amplifiers 21 and 22. The conductive state-detecting currents
which are supplied to the active electrode 41 and the fixed
electrode 42 are detected in the form of detecting signals A and B
respectively. The detecting signals A and B are conducted to the
voltage converters 99 and 100 and rectifiers 101 and 102, from
which signals of positive voltage are derived. These signals of
positive voltage are amplified in the signal amplifiers 111 and
112. The voltage level of output signals from the amplifier 111 is
compared with the standard voltage level which is produced by the
standard voltage level setting circuit. Where the voltage level of
the detecting signal A for detecting the high frequency signal
supplied to the active electrode 41 with the voltage amplified by
the amplifier 111 is larger than the standard voltage level preset,
i.e. the conductive state of a circuit connecting together the
power source, electric knife and a patient's body is normal, and
the normal amount of current is supplied to the active electrode
41, then the first Schmitt circuit 131 produces an output signal
and the first flip-flop 151 becomes ready to be set. This state
ready to be set is actually changed to a set state when the first
Schmitt circuit 131 ceases to generate an output signal and a
falling output signal therefrom is supplied to the first flip-flop
151, that is, when the active electrode 41 is removed from a
patient 43 or the third gate 83 is closed by again opening the
previously closed normally open normally open contact of the
detecting switch 72. Where the voltage level of the detecting
signal A for detecting the high frequency signal supplied to the
active electrode 41 with the voltage amplied by the amplifier 111
is lower than the standard voltage level preset, i.e. where a
normal amount of current is not supplied to the active electrode 41
for the reason that a lead line for the electric surgical knife 4
is disconnected or a contact resistance between the electrodes 41
and 42 of the electric knife 4 and patient 43 is very large, and
where the active electrode 41 does not contact the patient 43, then
the first Schmitt circuit 131 does not produce any output signal
and the first flip-flop 151 remains reset.
The voltage level of the detecting signal A of the high frequency
signal supplied to the active electrode 41 is compared with that of
the detecting signal B in the differential amplifier 121, and a
difference between the voltages of the detecting signals A and B is
compared in the second Schmitt circuit 132 with the standard
voltage difference level preset in the standard voltage level
difference setting circuit 142. Where the difference between the
voltage levels of the detecting signals A and B is larger than the
standard voltage level difference, that is, where the high
frequency detection current does not flow through a normal circuit
route for the reason that the lead line of the fixed electrode 42
of the electric surgical knife 4 is disconnected or a contact
resistance between the fixed electrode 42 and patient 43 is very
large, thereby causing the high frequency current to pass through
any other device than the electrodes 41 and 42 of the electric
surgical knife 4, then the second Schmitt circuit 132 produces an
output signal so as to render the second flip-flop 152 ready to be
reset. When the active electrode 41 is disconnected from the
patient 43 or the third and fourth gates 83 and 84 are closed by
again opening the previously closed normally open contact of the
detecting switch 72, then both detecting signals A and B stop
entering the differential amplifiers 121 which in turn ceases to
produce any output signal, therey preventing any output signal from
being delivered from the second Schmitt circuit 132, with the
result that the fall of an output signal from the second Schmitt
circuit renders the second flip-flop 152 ready to be reset. Where a
difference between the voltage levels of the detecting signal for
high frequency currents supplied to the active electrode 41 and the
fixed electrode 42 is lower than the standard voltage level
difference, i.e. the conductive condition of a circuit connecting
together a power source, electric surgical knife and patient is
normal and no leakage of current occurs through any other device
than the surgical knife 4, then the second Schmitt circuit 132 does
not produce any output signal and the second flip-flop 152 remains
set.
When the normally closed contact of the detecting switch 72 is
again closed after once opened, then the first gate 81 is opened,
the second, third and fourth gates 82, 83 and 84 are closed, and
the first and second Schmitt circuits 131 and 132 do not give forth
any output signal and the falling portions of output signals from
said Schmitt circuits 131 and 132 are supplied to the flip-flops
151 and 152 respectively, thereby causing the flip-flops 151 and
152 to be changed from a state ready to be set or reset to the one
actually set or reset. When both first and second flip-flops are
brought to a set state i.e. the previously opened normally closed
contact of the detecting switch 72 is again closed where the
detecting signal A has a voltage level higher than the standard
voltage level and a difference between the voltage levels of both
detecting signals A and B is lower than the standard voltage
difference level, i.e. the conductive state of a circuit connecting
together a patient, electric surgical knife 4 and power source is
normal, then the AND gate 153 produces an output signal and the
display circuit 161 indicates the normal operational condition of
the surgical knife 4, thereby rendering the knife device 4 ready
for operation. When the electric surgical knife 4 is in a proper
operational condition and the active electrode 41 is made to
contact a patient 43, and a high frequency signal generated by the
high frequency generator 11 is supplied directly to a series
connection of the voltage amplifier 21 and power amplifier 22, a
direct current component of an output signal from the amplifier 22
is blocked by the output circuit 3 and an output signal from the
output circuit 3 is supplied to the electric surgical knife 4.
When the conductive state of the electric surgical knife device is
in a normal condition, the incision and exision of the affected
part of the patient 43 is performed through the movement of the
active electrode 41 under control of the high frequency signal.
Where at least either the flip-flop 151 or flip-flop 152 is in a
reset state it also means that there occurs an abnormal state of
conduction between the patient and the electric surfical knife and
between the electric surgical knife and the power source for the
reason that the lead line of the electric surgical knife 4 is
disconnected, the electrode 41 and 42 of the electric surgical
knife 4 poorly contacts the patient, or current does not run
through a normal route. In such case, the AND gate 153 does not
produce any output signal and the display device 161 continues to
display the abnormal conductive state of the surgical knife 4,
thereby reliably preventing the occurrence of an accident and
protecting a patient therefrom.
If the detecting switch 72 has its normally open contact closed
during a surgical operation to close the first AND gate 81 thereby
preventing the high frequency current from passing therethrough and
also to open the second, third and fourth gates 82, 83 and 84
thereby supplying a high frequency detecting signal to the electric
surgical knife 4, then the conductive state of any circuit section
is examined and whether or not there occur any abnormal conductive
state of the circuit is displayed by display circuit 161 during the
surgical operation, thereby saving a patient from an accident.
According to the above described embodiment, the conductive states
between the patient and electric surgical knife and between the
electric surgical knife and power source, such as the state of
contact resistance between the patient and the electric surgical
knife, and the state of a lead line are detected by a relatively
attenuated high frequency detecting signal, and the passage of
current through any other device than the electric knife 4 when
touched by the patient is detected using said relatively attenuated
high frequency detecting signal to save the patient from getting
burnt and also from receiving an electric shock at any other part
of his body than the affected one during a surgical operation due
to concentrated current passing through said unrelated part of the
patient's body contacted by a different device from the electric
surgical knife 4.
FIG. 2 is a block circuit diagram of one modification of an
electric surgical knife device according to an application of the
embodiment of FIG. 1. In addition to elements of the embodiment
shown in FIG. 1, the electric surgical knife device according to
the second embodiment of FIG. 2 further comprises a low frequency
signal generator 51 for generating an unsynmmetrical square wave
signal whose positive side is longer than the negative side
thereof; a modulator 61 inserted between the high frequency signal
generator 11 and the first gate 81; a clamping and differentiator
circuit 52 for damping the low frequency square wave signal at the
positive side and differentiating the clamped signal so as to give
forth a clamped low frequency signal having a repititive frequency
equal to the frequency of the low frequency square wave signal; and
a selector device 53 for selectively supplying the damped low
frequency signal to a modulator 61 so as to selectively amplitude
modulating the high frequency signal with the damped low frequency
signal, thereby the incision and excision of the affected part of a
patient's body are performaed upon supply of the unmodulated high
frequency signal to the surgical knife 4 and bleeding is stopped
upon supply of the damped modulated high frequency signal to the
electric surgical knife 4.
In the embodiment of FIG. 2, where the stoppage of bleeding or
hemostasis, as well as the incision and excision of a patient's
affected part, is attained, the conductive state of the surgical
knife device is also examined so as to save the patient from an
accident of an electric shock.
The process of switching over operation from the incision and
excision to the stoppage of bleeding has already been set forth in
greater detail in the U.S. Patent Application Ser. No. 424,433,
filed Dec. 13, 1973 with regard to "Electrical surgical device and
method of operating same."
The embodiment of FIG. 3 is different from that of FIG. 1 only in
that the normally closed contact of the detecting switch 72 is
omitted and the output terminal of the AND gate 153 is connected to
the first gate 81 to control its condition, whereby an output
signal from the gate signal generator controls the first gate 81
indirectly and the second, third and fourth gates 82, 83 and 84
directly.
While the power source is initially rendered conducting, the
detecting switch 72 remains open and the second, third and fourth
gates 82, 83 and 84 remain closed, thereby preventing the AND gate
153 from giving forth any output signal with the first gate 81 kept
closed. Neither operational nor detecting current is supplied to
the electric surgical knife 4. When the detecting switch 72 is
closed, the gates 82, 83 and 84 are opened to supply detecting
current to the electric surgical knife 4 for detection of its
conductive state. When the conductive state is normal, the display
circuit 161 indicate that the surgical knife 4 is in operational
state, and the first gate 81 opens upon supply of an output signal
from the AND gate 153 to the gate 81, making the electric knife
device ready for operation. When the conductive state is abnormal,
the AND gate 153 does not produce any output signal and the display
circuit 161 continues to indicate said abnormal operational state
with the first gate 81 closed, thereby preventing a high frequency
operational signal from being supplied to the electric surgical
knife 4.
Accordingly, the embodiment of FIG. 3 attains the same effect as
that of FIG. 1 and moreover with better reliability. While the
knife device is initially rendered conducting, the high frequency
detecting signal is not supplied to the surgical knife 4 until the
detection of the conductive state of the knife device is completed.
Therefore, the embodiment of FIG. 3 also saves a patient from an
electric shock.
It is also possible to obtain the above described effect by
combining the embodiment of FIG. 3 with the power source for
selectively carrying out the surgical operation or the stoppage of
bleeding as shown in FIG. 2.
The embodiment of FIG. 4 is different from that of FIG. 3 in that
the gate signal generator 71 and detecting switch 72 are omitted;
the circuit for selectively carrying out the surgical operation or
the hemostasis comprising a low frequency signal generator 51, a
clamping and differentiating circuit 52, selector switch 53 and
modulator 61 is provided; and an inverter 54 is connected between
the low frequency signal generator 51 and second gate 82. A low
frequency output signal from the low frequency signal generator 51
is used as a signal for controlling the selector device 78 instead
of an output signal from the gate signal generator 71. A low
frequency output signal from the generator 51 is an unsymmetrical
square wave signal whose positive side is longer than the negative
side. The low frequency square wave signal is supplied to the
inverter 54 to be formed into a pulse signal which in turn is
supplied to the second, third and fourth gate 82, 83 and 84 and
flip-flops 151 and 152, thereby enabling the conductive state of
the knife device to be detected with an interval synchronized with
the frequency of the pulse signal.
The embodiment of FIG. 4 can also save the patient from an accident
such as an electric shock and eliminates the necessity of providing
the gate signal generator 71 and detecting switch 72, thereby
simplifying the construction of the power source of the electric
knife 4. Further, the detection operation is performed
automatically without manually operating the detecting switch.
As described above, there is provided an electric surgical knife
device for use with an endoscope, said knife device being fitted
with a power source device for detecting a conductive state between
a patient and the surgical knife and between said knife and power
source and determining the state of contact resistance between the
patient and knife, the connecting state of a lead line and the
conductive route of the high frequency current, wherein, when the
patient touches any other device than the electric surgical knife,
current is prevented from running through the adnormal route,
namely, through said other device, and the patient is saved from
getting burnt by concentrated current at any other part of his body
than the affected one touched by a different device from the knife
and from an accident such as an electric shock.
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