JP2004141342A - Ultrasonic surgical apparatus - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To improve the washing efficiency of the inside of the sheath tube of an insertion part by providing a rotation regulation member which regulates the rotation of a vibration transmission member on the tip side of the inside of the sheath tube of the insertion part. <P>SOLUTION: The outer peripheral shape of the section position 100 of vibration at the tip of the vibration transmission member 9 is formed to be nearly pentagonal, and two rotation regulating members 101a and 101b for regulating the rotation of the transmission member 9 to be fitted to the outer periphery of the nearly pentagonal transmission member are sandwiched at the section position 100 to constitute a rotation regulation member 101 integrally with the transmission member 9. A tip member 102 provided with a jaw 51 is provided at the sheath tube 4 of the insertion part in an attachable and detachable manner, and the inner surface of the proximal end of the tip member 102 has an abutting surface 103 to abut on the upper surface of the regulation member 101. <P>COPYRIGHT: (C)2004,JPO

Description

[0001]
TECHNICAL FIELD OF THE INVENTION
The present invention relates to an ultrasonic surgical apparatus that performs treatment such as incision, excision, or coagulation of a living tissue using ultrasonic waves while grasping the living tissue between an ultrasonic probe and a jaw.
[0002]
[Prior art]
In general, as an ultrasonic surgical apparatus for performing treatment such as incision, excision, or coagulation of a living tissue using ultrasonic waves, for example, US Pat. No. 5,322,055, US Pat. There is an apparatus disclosed in JP-A-2000-33092. In this ultrasonic surgical apparatus, an operation unit on the hand side is connected to a base end of an insertion portion mantle tube, and an ultrasonic vibrator for generating ultrasonic vibration is arranged on the operation unit, and the insertion portion mantle is also provided. A treatment section for treating a living tissue is disposed at the distal end of the tube.
[0003]
In addition, a vibration transmission member that transmits ultrasonic vibrations from the ultrasonic transducer to the ultrasonic probe on the treatment section side is inserted into the insertion portion outer tube. The base end of the vibration transmitting member is connected to the ultrasonic vibrator. Further, the treatment section is provided with a jaw rotatably supported facing the ultrasonic probe.
[0004]
Further, an operation handle for opening and closing the jaw with respect to the ultrasonic probe is provided in the operation unit. Further, an operation rod of a jaw is inserted into the insertion portion outer tube so as to be able to advance and retreat in the axial direction. The operation rod is advanced and retracted in the axial direction with the operation of the operation handle, and the jaw of the treatment section is opened and closed with respect to the ultrasonic probe in conjunction with the advance and retreat operation of the operation rod, and the ultrasonic wave is generated with the jaw closing operation. The living tissue is grasped between the probe and the jaw. Subsequently, in this state, by transmitting the ultrasonic vibration from the ultrasonic transducer to the ultrasonic probe on the treatment section side via the vibration transmission member, incision, excision, or, of the living tissue using the ultrasonic wave Treatment such as coagulation is performed.
[0005]
In Japanese Patent Application Laid-Open No. 2002-159506 and the like, the outer peripheral shape at the node of vibration at the tip of the ultrasonic probe is formed in a substantially pentagonal shape so that the ultrasonic probe on the treatment section accurately faces the jaw. A rotation regulating member for regulating the rotation of the ultrasonic probe fitted to the outer periphery of the substantially pentagonal ultrasonic probe is provided inside the insertion portion outer tube at the node position.
[0006]
[Patent Document 1]
USP 5,322,055
[0007]
[Patent Document 2]
USP 5,873,873
[0008]
[Patent Document 3]
Japanese Patent Publication No. Hei 8-505801
[Patent Document 4]
JP 2000-33092 A
[Patent Document 5]
JP 2002-159506 A
[Problems to be solved by the invention]
However, in the conventional ultrasonic surgical apparatus described in Japanese Patent Application Laid-Open No. 2002-159506, as described above, the rotation restricting member that restricts the rotation of the ultrasonic probe (vibration transmitting member) is provided on the distal end side in the insertion portion mantle tube. When the inside of the insertion tube is cleaned after the treatment, the cleaning fluid must be flown and cleaned using a special brush or the like for the rotation restricting member. There is a problem.
[0012]
The present invention has been made in view of the above circumstances, and an object of the present invention is to improve a cleaning efficiency in an insertion portion outer tube by providing a rotation restricting member for restricting rotation of a vibration transmission member at a distal end side in the insertion portion outer tube. It is an object of the present invention to provide an ultrasonic surgical apparatus that can perform the operation.
[0013]
[Means for Solving the Problems]
An ultrasonic operation apparatus according to the present invention includes an ultrasonic treatment device that performs a treatment by applying ultrasonic vibration from an ultrasonic transducer to a living tissue gripped by a treatment unit, and the ultrasonic transducer of the ultrasonic treatment device. An ultrasonic driving device that ultrasonically vibrates the ultrasonic treatment instrument, wherein the ultrasonic treatment tool is provided on an operation unit connected to a base end portion of the insertion portion outer tube, and the inside of the insertion portion outer tube is provided. The ultrasonic probe for transmitting the ultrasonic vibration from the ultrasonic transducer to the treatment section side is inserted through, and the distal end of the insertion section outer tube is rotatable against the distal end of the ultrasonic probe. A jaw supported by the ultrasonic probe and gripping the living tissue between the distal end of the ultrasonic probe, an operating means disposed on the operation unit, and opening and closing the jaw with respect to the ultrasonic probe; Connecting between the jaw and the operating means, In an ultrasonic surgical apparatus including an operating force transmitting member for transmitting an operating force from the operating means to the jaw side, the jaw is rotatably supported (pivotally supported) provided at a distal end of the insertion portion outer tube. A tip member, and a fitting member integrally fitted and fixed to an asymmetric external portion formed at a node of vibration on the tip side of the ultrasonic probe, and an outer periphery of the fitting member and an inner surface of the tip member are provided. Rotation restricting means for restricting the rotation of the ultrasonic probe by being in contact therewith is constituted.
[0014]
BEST MODE FOR CARRYING OUT THE INVENTION
Hereinafter, embodiments of the present invention will be described with reference to the drawings.
[0015]
1 to 9 relate to an embodiment of the present invention, FIG. 1 is a configuration diagram showing a configuration of an ultrasonic operation apparatus, FIG. 2 is a block diagram showing a configuration of an apparatus main body 1 of FIG. 1, and FIG. 1 is a side view showing a disassembled state of the ultrasonic treatment device, FIG. 4 is a side view showing an assembled state of the entire ultrasonic treatment device of FIG. 1, and FIG. 5 is a cross-sectional view showing a distal end configuration of the insertion portion outer tube of FIG. 6, FIG. 6 is an external view showing a distal end configuration of the insertion portion mantle tube of FIG. 1, FIG. 7 is a cross-sectional view showing a cross section taken along line AA of FIG. 5, and FIG. 8 is a cross-sectional view showing a cross section taken along line BB of FIG. FIG. 9 is a sectional view showing a modification of the section taken along line BB of FIG.
[0016]
As shown in FIG. 1, an ultrasonic treatment instrument 2 and a foot switch 3 are connected to an apparatus main body 1 of the ultrasonic operation apparatus according to the present embodiment.
[0017]
In the ultrasonic treatment instrument 2, a treatment section 5 is disposed at a distal end of an elongated sheath-shaped outer sheath tube 4, and an operation section 6 at a proximal end is disposed at a proximal end. Here, the operation unit 6 has a built-in ultrasonic vibrator (not shown) that generates ultrasonic vibration, and is provided with an operation handle 8 for operating the treatment unit 5.
[0018]
Further, a vibration transmission member 9 (ultrasonic probe) for transmitting ultrasonic vibration from the ultrasonic transducer to the treatment section 5 is provided inside the insertion portion outer tube 4. The distal end of the vibration transmission member 9 is exposed to the outside from the distal end of the insertion portion outer tube 4.
[0019]
An operation panel 12 is provided on the front surface of the apparatus main body 1. The operation panel 12 is provided with a power switch 13, an operation display panel 14, and a connection portion 15 of the ultrasonic treatment instrument 2. Here, one end of a handpiece cord 16 is connected to the operation unit 6 of the ultrasonic treatment instrument 2. The handpiece plug 17 provided at the other end of the handpiece cord 16 is detachably connected to the connection portion 15 of the ultrasonic treatment instrument 2 of the apparatus main body 1.
[0020]
The operation display panel 14 of the apparatus main body 1 has a setting switch 18 for setting the magnitude of the ultrasonic output during normal operation when performing the ultrasonic treatment, and the magnitude of the ultrasonic output set by the setting switch 18. And a display unit 19 for digitally displaying the result. The setting switch 18 is provided with an output increasing switch 18a that changes (increases or decreases) the magnitude of the ultrasonic output and an output decreasing switch 18b.
[0021]
Further, as shown in FIG. 2, a drive circuit 20 for supplying electric energy to the ultrasonic vibrator in the handpiece 2 is built in the apparatus main body 1. The drive circuit 20 includes an oscillation circuit 21 that generates an AC signal having an ultrasonic frequency, a D / A converter 22 that generates a signal indicating the magnitude of an ultrasonic output, and a signal from the D / A converter 22. A VCA circuit 23 for controlling the magnitude of the AC signal of the oscillation circuit 21 based on the output of the VCA circuit 23; and a power amplifier 24 for amplifying the output of the VCA circuit 23 and generating electric power for driving the ultrasonic transducer in the ultrasonic treatment instrument 2. , A relay 25 for turning on and off the output line of the drive circuit 20, a control circuit 26 for controlling the operation of the ultrasonic surgical apparatus, and an interface (I / I) for transmitting an operation signal from the foot switch 3 to the control circuit 26 and the relay 25. F) circuit 27 is provided.
[0022]
Further, the control circuit 26 sets the ultrasonic output from the ultrasonic transducer in the ultrasonic treatment instrument 2 to be larger than the set output value by the setting switch 18 at the start of the ultrasonic treatment by operating the foot switch 3, An operation state switching means for controlling the ultrasonic output from the ultrasonic vibrator to become the set output value when a predetermined time set in advance elapses after the start of the treatment is incorporated. Note that the relay 25 of the drive circuit 20 is interposed between the ultrasonic treatment instrument connection unit 15 and the power amplifier 24.
[0023]
As shown in FIGS. 3 and 4, the ultrasonic treatment instrument 2 includes three assembly units that can be disassembled into three units, that is, a handle unit 31, a probe unit 32, and a transducer unit 33. . These three units 31 to 33 are to be assembled in a state shown in FIG.
[0024]
The vibrator unit 33 is provided with a handpiece 34 that is detachably connected to the handle unit 31. The handpiece 34 incorporates an ultrasonic vibrator (not shown) for generating ultrasonic vibration in a cylindrical cover 34a.
[0025]
A horn (not shown) for expanding the amplitude is connected to the distal end side of the ultrasonic transducer, and the distal end side of the horn is attached to the proximal end side of the probe.
[0026]
In addition, the cylindrical cover 34a is provided with a unit connecting portion 34b which is detachably connected to the vibrator connecting portion b of the operating portion main body 6a of the handle unit 31 at the distal end portion. An engagement ring 39 (a so-called C-ring) having a C-shape in which a part of the ring is cut off is mounted on an outer peripheral surface of the unit connecting portion 34b. The engaging ring 39 has a substantially half-moon cross section whose outer periphery is an arc.
[0027]
The rear end of the cylindrical cover 34a is connected to a handpiece cord 16 having a handpiece plug 17 at the end.
[0028]
Further, the probe unit 32 is provided with an elongated, substantially rod-shaped vibration transmission member 9 which is detachably connected to a tip end of a horn (not shown) in the transducer unit 33.
[0029]
At the base end of the vibration transmitting member 9, a mounting screw 41a connected to the probe mounting portion 36a of the horn is formed. The mounting screw 41a is screwed and fixed in a screw hole of the probe mounting portion 36a of the vibrator unit 33. Thereby, the probe unit 32 and the transducer unit 33 are integrally assembled.
[0030]
Further, in the vibration transmitting member 9 of the present embodiment, a proximal horn 41c that performs amplitude expansion in a second stage is disposed in front of the second node from the proximal end side. Further, on the distal end side of the proximal horn 41c, an intermediate section 41d for transmitting ultrasonic vibration, a distal horn 41e for finally increasing the amplitude, and a treatment section 41f are sequentially arranged.
[0031]
Further, the handle unit 31 includes an elongated insertion sheath portion 31a, a distal end working portion 31b disposed at a distal end portion of the insertion sheath portion 31a, and an operation portion 6 disposed at a base end portion of the insertion sheath portion 31a. Consists of Here, the operation unit 6 of the handle unit 31 is provided with a substantially cylindrical operation unit main body 6a. A transducer connecting portion 6b is formed at the base end of the operation portion main body 6a.
[0032]
A fixed handle 42 and a rotatable movable handle 43 that constitutes an operation means are provided on the outer peripheral surface of the operation unit main body 6a, and the operation handle 8 (see FIG. 1) is provided by the fixed handle 42 and the movable handle 43. Be composed. At the rear end of the cylindrical cover 34a, an electrode pin 44 for high-frequency connection is provided adjacent to the handpiece cord 16, and the ultrasonic treatment instrument 2 is connected to a high-frequency power supply device (not shown) at the high-frequency electrode pin 44. High-frequency power is supplied to the vibration transmitting member 9.
[0033]
The upper portion of the fixed handle 42 is integrally formed with the cylindrical operation portion main body 6a. Further, the operation end of the fixed handle 42 is provided with a finger hole 42a into which a plurality of fingers other than the thumb can be selectively inserted. Is provided.
[0034]
Further, a bifurcated connecting portion 43b is formed on the upper end side of the movable handle 43. These bifurcated connecting portions 43b are arranged on both sides of the operation portion main body 6a. Further, at the lower end of each connecting portion 43b, a handle pivot shaft 45 is provided so as to project inward. These handle pivot shafts 45 are connected to the operation unit main body 6a at fulcrums at positions below the axis of the insertion unit outer tube 4. Thus, the movable handle 43 is pivotally supported by the handle pivot shaft 45. Note that an insulating cap for high-frequency insulation is attached to the handle pivot shaft 45.
[0035]
Further, an operating shaft 47 is provided above the handle pivot shaft 45 in each connecting portion 43 b of the movable handle 43. The operating shaft 47 transmits an advance / retreat force to an operating rod 50 (see FIG. 5: operating force transmitting member) inserted through the insertion portion outer tube 4. Then, with the operation of moving the operation rod 50 in the axial direction, an opening / closing operation of a later-described jaw 51 is performed on the treatment section 41f. That is, the movable handle 43 and the operating shaft 47 constitute operating means. The operating shaft 47 is disposed substantially on the axis of the insertion tube 4.
[0036]
In the present embodiment, when closing the movable handle 43 by grasping the handle, the ultrasonic treatment instrument 2 applies a forward force to the handle pivot shaft 45 and moves to the front side, and the operating shaft 47 moves to the rear side. Thus, the operation rod 50 is pulled rearward, and the jaw 51 is closed with respect to the treatment section 41f.
[0037]
The insertion sheath portion 31a is provided with the insertion portion outer tube 4 as described above, and the base end of the insertion portion outer tube 4 is attached to the distal end portion of the operation portion main body 6a together with the rotation knob 48. 6a so as to be rotatable in the direction around the axis of the center line. Here, the insertion portion outer tube 4 is formed by attaching an insulating tube 49 to an outer peripheral surface of a metal tube (not shown). The insulating tube 49 is provided so as to cover most of the outer peripheral surface of the insertion portion outer tube 4 up to the base end.
[0038]
In the handle unit 31, a one-sided jaw 51 for gripping a living tissue is rotatably attached to the distal end working portion 31b.
[0039]
The insertion portion outer tube 4 is provided with a jaw holding portion 52 for holding the jaw 51 at the distal end. Further, the jaw 51 is provided with a gripping member 54 for gripping a living tissue (organ). The gripping member 54 has a substantially saw-toothed tooth portion 55. The gripping member 54 is made of a low friction material such as PTFE (Teflon: trade name of DuPont). Moreover, since the gripping member 54 alone has poor rigidity, the rigidity may be secured by attaching a metal strength member (not shown).
[0040]
Further, as shown in FIG. 5, the jaw 51 is provided with an operation rod 50 that passes through the inside of the insertion portion outer tube 4.
[0041]
Further, the gripping member 54 and the treatment section 41f of the vibration transmission member 9 come into contact with each other over a wide area, and the temperature of the living tissue sandwiched therebetween can be broadly and slowly raised, and effective coagulation can be realized.
[0042]
The vibration transmitting member 9 of the probe unit 32 is inserted into the inside of the insertion portion outer tube 4. Further, the inside of the insertion portion outer tube 4 is provided in parallel with the vibration transmitting member 9, and the operation rod 50 is inserted so as to be able to advance and retreat.
[0043]
At the time of closing the jaw 51, the living tissue is gripped between the treatment section 41 f and the gripping member 54 of the jaw 51 by pressing the gripping member 54 of the jaw 51 against the treatment section 41 f of the probe unit 32. Has become. The grasped living tissue is subjected to ultrasonic treatment for coagulation or incision by friction with the treatment section 41f vibrating at high speed. The jaws 51 are also used for exfoliating living tissue.
[0044]
As shown in FIG. 6, the vibration transmitting member 9 and the operation rod 50 are inserted through the insertion portion mantle tube 4. The vibration transmitting member 9 and the operation rod 50 are arranged to accurately face the treatment section 41 f on the treatment section side to the jaw 51. Of the vibration transmitting member 9 having a substantially pentagonal shape at the nodal position 100 of the vibration at the tip of the vibration transmitting member 9 fitted to the outer periphery of the substantially pentagonal vibration transmitting member 9 at the nodal position 100 A regulating member 101 is provided.
[0045]
More specifically, the outer periphery of the vibration transmitting member 9 at the distal end of the vibration transmitting member 9 is formed in a substantially pentagonal shape, and the vibration transmitting member 9 is fitted to the outer periphery of the substantially pentagonal vibration transmitting member 9 at the node position 100. The rotation restricting member 101 is integrally formed with the vibration transmitting member 9 with two rotation restricting members 101a and 101b restricting the rotation of the member 9 therebetween. Here, the rotation regulating members 101a and 101b are made of a low friction material such as PTFE (Teflon: registered trademark of DuPont).
[0046]
On the other hand, a distal end member 102 provided with a jaw 51 is provided on the insertion portion outer tube 4, and a proximal inner surface of the distal end member 102 has a contact surface 103 that comes into contact with the upper surface of the rotation regulating member 101. I have. Further, a notch 104 is provided in the thick portion on the contact surface side of the distal end member 102 to allow the operation rod 50 to pass therethrough.
[0047]
FIGS. 7 and 8 show a cross section taken along line AA and a line BB in FIG. As shown in FIG. 7, at the node position 100, the outer circumference of the rotation restricting member 101 integrally formed with the vibration transmitting member 9 is in close contact with the inner surface of the insertion portion mantle tube 4, and the contact surface 103 and the upper surface of the rotation restricting member 101 are in contact with each other. The treatment portion 41f is accurately opposed to the jaw 51 by the close contact of the jaw 51. At other positions as shown in FIG. 8, the vibration transmitting member 9 is inserted inside the insertion portion outer tube 4 with a predetermined clearance, and the cross section of the insertion portion outer tube 4 is shown in FIG. It may be formed in such a cross section.
[0048]
As described above, according to the present embodiment, the rotation restricting member 101 provided integrally with the vibration transmitting member 9 as a unit for accurately opposing the treatment portion 41f to the jaw 51 is used. And the distal end member 102 is configured to be detachable with respect to the insertion portion outer tube 4, so that in cleaning after the treatment is completed, the inside of the insertion portion outer tube 4 is removed. The inside of the distal end of the insertion portion outer tube 4 can be easily washed simply by pouring water into the tube and using a brush.
[0049]
The present invention is not limited to the above-described embodiment, and various changes and modifications can be made without departing from the spirit of the present invention.
[0050]
【The invention's effect】
As described above, according to the present invention, by providing a rotation restricting member for restricting the rotation of the vibration transmission member on the distal end side in the insertion portion outer tube, it is possible to improve the cleaning efficiency in the insertion portion outer tube. is there.
[Brief description of the drawings]
FIG. 1 is a configuration diagram showing a configuration of an ultrasonic surgical apparatus according to an embodiment of the present invention. FIG. 2 is a block diagram showing a configuration of an apparatus main body 1 in FIG. 1. FIG. FIG. 4 is a side view showing a disassembled state of FIG. 4; FIG. 5 is a side view showing an assembled state of the entire ultrasonic treatment tool of FIG. 1; FIG. FIG. 7 is a cross-sectional view showing a cross section taken along the line AA of FIG. 5; FIG. 8 is a cross-sectional view showing a cross section taken along the line BB of FIG. 5; Sectional view showing a modified example of the section taken along the line BB of FIG.
DESCRIPTION OF SYMBOLS 1 ... Device main body 2 ... Ultrasonic treatment tool 3 ... Foot switch 4 ... Insert part outer tube 5 ... Treatment part 6 ... Operation part 9 ... Vibration transmission member (ultrasonic probe)
31 Handle unit 32 Probe unit 33 Transducer unit 50 Operating rod 100 Joint positions 101, 101a, 101b Rotation regulating member 102 Tip member 103 Contact surface

Claims (1)

An ultrasonic treatment tool that performs treatment by applying ultrasonic vibration from an ultrasonic transducer to the living tissue gripped by the treatment unit,
An ultrasonic drive device that ultrasonically vibrates the ultrasonic vibrator of the ultrasonic treatment tool,
The ultrasonic treatment instrument,
The ultrasonic vibrator is provided on an operation unit connected to a proximal end of the insertion tube,
Inserting an ultrasonic probe that transmits ultrasonic vibrations from the ultrasonic transducer to the treatment section side inside the insertion portion outer tube,
A jaw that is rotatably supported at the distal end of the insertion portion outer tube facing the distal end of the ultrasonic probe and grips the living tissue between the distal end of the ultrasonic probe,
Operating means disposed on the operating section, for opening and closing the jaw with respect to the ultrasonic probe,
An ultrasonic surgical apparatus comprising: an operating force transmitting member that connects the jaw and the operating means and transmits an operating force from the operating means to the jaw side.
A tip member provided at the tip of the insertion portion mantle tube and rotatably supported (pivoted) by the jaw;
A fitting member integrally fitted and fixed to an asymmetric outer portion formed at a node of vibration on the tip side of the ultrasonic probe,
An ultrasonic surgical apparatus, wherein rotation restricting means for restricting rotation of the ultrasonic probe by contacting the outer periphery of the fitting member and the inner surface of the distal end member is configured.

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