CA1296067C - Ultrasonic surgical apparatus - Google Patents
Ultrasonic surgical apparatusInfo
- Publication number
- CA1296067C CA1296067C CA000530524A CA530524A CA1296067C CA 1296067 C CA1296067 C CA 1296067C CA 000530524 A CA000530524 A CA 000530524A CA 530524 A CA530524 A CA 530524A CA 1296067 C CA1296067 C CA 1296067C
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- ultrasonic
- flexible
- surgical apparatus
- tube
- horn
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Abstract
ABSTRACT OF THE DISCLOSURE
Disclosed is an ultrasonic surgical apparatus for crushing, sucking, and removing undesirable substances inside the body, such as an ulcerous tissue, thrombus, and clot.
calcium clod by means of ultrasonic vibrations of a flexible ultrasonic probe. The ultrasonic surgical apparatus comprises an ultrasonic probe constituted by a flexible linear transmitting member which is secured to a tip of a horn for transmitting mechanical vibrations of an ultra-sonic frequency to an ultrasonic vibration source and has a working portion for effecting mechanical vibration of an ultrasonic frequency, a horn cover at least a portion of which is made of a flexible material, a branch tube con-nected to said horn cover, and a flexible tube in which a suction device and a liquid injector are connected to one of the branch tubes, said ultrasonic probe being provided in an inner hole of the branch tube.
Disclosed is an ultrasonic surgical apparatus for crushing, sucking, and removing undesirable substances inside the body, such as an ulcerous tissue, thrombus, and clot.
calcium clod by means of ultrasonic vibrations of a flexible ultrasonic probe. The ultrasonic surgical apparatus comprises an ultrasonic probe constituted by a flexible linear transmitting member which is secured to a tip of a horn for transmitting mechanical vibrations of an ultra-sonic frequency to an ultrasonic vibration source and has a working portion for effecting mechanical vibration of an ultrasonic frequency, a horn cover at least a portion of which is made of a flexible material, a branch tube con-nected to said horn cover, and a flexible tube in which a suction device and a liquid injector are connected to one of the branch tubes, said ultrasonic probe being provided in an inner hole of the branch tube.
Description
FIELD OF THE INVENTION
The present invention relates to an ultrasonic surgical apparatus for crushing, sucking, and removing undesirable substances existing in the body, such as ulcerous tissue, thrombuses, calcification aggregates, etc. by means of ultrasonic vlbrations of a flexible ultrasonic probe.
. DESCRIPTION OF THE PRIOR ART - -As conventional methods of removing thrombuses, -the following methods are known: one in which a catherteris inserted into a thrombus portion and the thrombus is dissolved by injecting thereinto a thrombolytic agent such as streptokinase (e.g., Japanese Patent Unexamined Publication No. 173065/1982), one in which a catherter is withdrawn while maintaining the balloon of a balloon catherter in an expanded state, and, at the same time, a ~ ~ thrombus is removed (e.g., Japanese Patent Examined ; ~ Publication No. 16472/lg74), and one in which a thrombus portion is clamped by two expanded balloons, the thrombus is softened by injecting a thrombolytic agent thereinto, a catherter is then withdrawn, and, at the same time, the thrombus is removed (e.g., Published Japanese Translation :
of PCT Appln., Publication No. 501983/1983).
However, even if the thrombolytic agent is injected locally after the insertion of the catherter, there is a ~' i7 1 drawback in that the thrombolytic agent f lows into normal terminal blood vessels and the like, thereby entailing the risk of hemorrhage in the terminal blood vessels and the like. Meanwhile, in the case where the catherter is withdrawn by maintaining the balloon of the balloon catherter in a expanded state and, at the same time, the thrombus is removed from the body, there is the risk of causing damage to the inner wall of a blood vessel since a safety measure against a tensile stress applied to the inner : 10 wall of the blood vessel has not been taken. In the case where a catherter provided with two balloons is used as a similar method of removing a thrombus, when a thrombus 27 is clamped by two balloons 31, 32, as shown in Fig. 7, the balloon 32 located closer to the tip of a catherter 30 needs to be inserted from a position 34 in front of a thrombus 27 up to an innermost position 35 which is farther from the thrombus 27, so that there is the danger of causing the balloon 32 to push the thrombus 27 in the inserting direc-tion 33, thereby moving the thrombus 27 to another part, such as a terminal blood vessel.
Furthermore, as a method of mechanically removing a thrombus, there is one in which a drill bit is provided to the tip of a bar-like member, the drill bit is made to rotate by rotating the bar-like member, and the thrombus is crushed by the rotating drill bit. With this method, however, a torsional stress is applied to the inner wall of the blood vessel, so that there is a drawback in that the blsod vessel may be cut off by said stress, and adjustment 1 of the number of revolutions and the like is hence made difficult.
Recently, as a surgical apparatus using ultrasonic, an apparatus is known in which an ultrasonic probe is connected to a source of ultrasonic vibration, tissue, a calcification aggregate, thrombus, or the like is crushed by mechanical vibrations of an ultrasonic frequency generated at the tip of the ultrasonic probe, and the crushed tissue, calcification aggregate, thrombus, or the like is removed through an inner hole provided in the ultrasonic probe (e.g., Japanese Patent Examined Publication Nos. 5139/1985 and 21989/1974). With such an apparatus, however, since the ultrasonic probe having a wor~ing portion which mechanically vibrates at an ultrasonic frequency is not flexible, there is a drawback in that it is diffucult to insert the ultrasonic probe into a tubular tissue inside the body.
SUMMARY OF THE INVENTION
Accordingly, an object of the present invention is to provide an ultrasonic surgical apparatus which is capable of allowing a flexible ultrasonic probe to be . inserted directly into the affected part, crushing an unde-~ sirable subs-tance in the body such as a thrombus, a calcification aggregate, or the like by means of mechanical vibrations of an ultrasonic fr~quency, and removing the same by suction without affecting the normal surrounding tissue, thereby overcoming the drawbacks of the prior art, including : ~ - 3 -1 the risk of hemorrhage caused by a thrombolytic agent, the risk of causing damage to a blood vessel owing -to a tensile or torsional stress applied to the inner wall of the blood vessel by the use of a balloon catherter, and the drawback o movement of the thrombus at the time of insertion of the balloon catherter.
Another object of the pxesent invention is to provide an ultrasonic surgical apparatus which is capable o crushing and removlng a thrombus, a calcification aggre-gate, or the like in the tubular tissue of such as a bentblood vessel, for which an operation has been difficult using a conventional ultrasonic surgical apparatus.
To this end, the present invention provides an ultrasonic surgical apparatus having an ultrasonic vibration source for generating ultrasonic vibrations, an oscillator for supplyi.ng high-frequency electric energy lo the ultra-sonic vibration source, a horn connected to t~e ultrasonic vibration source and adapted to transmit and amplify mechanical vibrations of an ultrasonic frequency, and a suction device for sucking and removing an undesirable substance from an operated part, comprising an ultrasonic probe which is constituted by a flexible linear transmitting member, is secured at one end thereof to a tip of the horn and has at the other end thereof a working portion for ~5 effecting mechanical vibration of an ultrasonic frequency, ~; a horn cover at least a portion of which is made of a flexible material, at least one inner tube, at least one branch tube communicating with the inner tube, and a l flexible tube connected to the horn cover, wherein -the ultrasonic probe is installed in the inner hole, and the suction device is connected to the branch tube.
BRIEF DESCRIP~ION OF THE DRAWINGS
Fig. l is a diagram schematically illustrating the overall arrangement of an ultrasonic surgical apparatus in accordance with an embodimen~ of the present invention;
Fig. 2 is an enlarged diagram of a handpiece portion and illustrates the arrangement of the interior of a horn cover;
Figs. 3(a~ and 3(b) are enlarged diagrams of a bellows portion, in which Fig. 3(a~ shows a state in which the bellows portion is extendedr while Fig. 3(b) shows a state in which the bellows portion is shrunk;
Fig. 4 is a diagram illustrating another example of the configuration of the handpiece;
Figs. 5(a) and 5(b) are diagrams explaining an example of using the apparatus in accordance with the presen~
invention;
Figs. 6(a) and 6(b) are diagrams illustrating the cross-sectional structure of a flexible tube in accordance with the embodiments of the present invention; and Fig. 7 is a diagram illustrating a conventional method.
:
DESCRIPTION OF THE PREFERRED EMBODIMENTS
Referring now to the accompanying drawings, a :"
~L2~
1 detailed description will be made of the present invention.
Fig. 1 is a diagram schematically illustrating the overall arrangement of an ultrasonic surgical apparatus in accord-ance with an embodiment of the present invention. As shown in Fig. 1, the apparatus is comprised of the following four sections: a section for generating mechanical vibrations of an ultrasonic frequency which is constituted by an oscil-lator 1 and a handpiece 36, a suction section constituted by a suction device 11 and a suction bottle 12, a liquid injecting section constituted by a liquid injector 14, and a catherter section constituted by a flexible tube 8, branch tubes 7, 9, and 47.
High-frequency electric energy is supplied from the oscillator 1 to the handpiece 36 via cables 2, 3. As shown in Fig. 2, the handpiece 36 is consti-tuted by an ultrasonic vibration source 4, a horn 5, a horn cover 6, and an ultrasonic probe 17. The high-frequency electric energy is supplied to the ultrasonic vibration source 4, which in turn generates mechanical vibrations af an ultrasonic frequency and transmits the same to the horn 5. The mechanical vibrations are enlarged by the horn 5 and are transmitted to the ultrasonic probe 17.
; The oscillator 1 has an oscillation circuit which is capable of supplving high-frequency electric energy corresponding to fluctuations in the state of the mechanical load of the horn 5 and the ultrasonic probe 17. Although 15 - 40 kHz is suitable as an osclllation frequency, 20 - 30 kHz is suitable in view of the mechanical vibrations of the 1 ultrasonic frequency o~ the ultraso~ic probe 17 and the crushing capability thereof.
Although the connection between the ultrasonic vibration source 4 and the horn S is effected by a screwing method, said connection should not be restricted to that type. The ultrasonic vibration source 4 should not be particularly restricted insofar as it is capable of converting high-frequency electric energy of the magneto-striction type, the electrostatiction type, or the li~e into mechanical vibrations. As for the material of the horn 5, a metallic material which is capable of transmitting and enlarging the mechanical vibrations of an ultrasonic frequency and has a fatigue strength sufficient to withstand the mechanical vibrations, and stainless steel, duralumin, a titanium alloy, or the like is preferable.
In addition, as for a method of connecting the horn 5 and the ultrasonic probe 17, the screwing method, welding, or the like is suitable. The ultrasonic probe 17 is constituted by a fixing member 43 and a flexible linear transmitting member 44, and, as for a method of connecting the fixing member 43 and the linear transmitting member 44, welding, adhesion, or the like is suitable. The materials of the fixing member 43 and the linear transmitting member are not particularly restricted if they are capable of transmitting the mechanical vibrations of an ultrasonic frequency and have a fatigue strength sufficient to withstand the mechanical vibrations. However, said materials should preferably be such that an X-ray cannot be transmitted .
1 therethrough, and a metallic material, lncludlng stalnless steel, duralumin, and a tltanlum alloy, or a composite material such as carbon flber-reinforced plastlcs is preferable. The horn cover 6 ls provlded around the horn 5 and the flexible ultrasonic probe 17. O~e end of the horn cover 6 is connected to the ultrasonlc vibration source 4 by an appropriate method, whlle the other end thereof is connected to the branch tube 7 by means of an adhesive so as to retain airtightness. However, the method of this connection should not be restricted to the same. The interior of the horn cover 6 is divided into partitioned chambers 23, 45 by means of a rubber O-ring 22, the rubber O-ring 22 being located at a knot portion where the longi-tudinal (46) amplitude of the mechanical vibrations of the horn 5 is the mlnimum so as to shield the passage of the liquid. In addition, by providing a portion of the horn cover 6 with a bellows portion 10 formed of a flexible material, it is possible to move the branch tube 7 back and forth by virtue of the longitudinal (46) expansion and shrinkage of the bellows portion (10).
The ultrasonic probe 17 is installed through the branch tube 7 and inside ~he inner hole of the flexible tube 8 shown in Fig. 1. As shown in Fig. 3(a), the tip of the ultrasonic probe 17 has such a dimension that, when the 2S bellows portion 10 is in an extended state, said tip will not protrude from the tip 16 of the flexible tube 8.
Consequently, when the flexible tube 8 is inserted into the body, the tip of the ultrasonic probe 17 is located in the 1 inner hole of the flexible tube 8, thereby making it possible to prevent the occurrence OL damage to a blood vessel or the like caused by the tip of the ultrasonic probe 17.
As shown in Fig. 1, the suction device 11 is com-municated with the lnner hole of the flexible tube 8 via the branch pipe 9, a changeover valve 13, the suction bottle 12, and tubes 38, 39, and 40. The liquid injector 14 is communicated with the inner hole of the flexible tube 8 via the branch tube 47, a pipe 37, a changeover valve 15, and a tube 41. As for a method of arranging the branch tubes 9 and 47, although Fig. 4 illustrates an example in which the branch tubes 9 and 47 are secured to the horn cover 6 by means of an appropriate adhesive, the arrange-ment may be such as to provide a configuration that facilitates the use of the apparatus by the operator and should not be restricted to the illustrated example.
As for the method of using this apparatus, the : partitioned chamber 23 and the inner holes 42, 20 are filled with a li~uid which is not harmful to the bodily tissue, such as physiological saline, by an appropriate means so as to facilitate slippage of the linear transmit-ting member 44 installsd inside the branch tube and the flexible tube 8. For instance, a passage leading to the partitioned chamber 23 is provided on the side of the horn ~: cover 6, a liquid such as physiological saline is injected into the partitioned chamber 23 and the inner hole 42, 20 through that passage, and the passage is then closed. Also, _ g _ ", i7 1 the inner suction hole 19 of the flexible tube 8 communi-cating with the suction device 11 and the inner hole of the branch tube 9 are filled with a liquid such as physiological saline by means of the operation of the suction device 11 and the changeover valve 13. With respect to the liquid injector as well, the branch tube 47 and the inner hole 20 are similarly filled with a liquid such as physiological saline.
Next, while confirming the position of the tip of the linear transmitting member 44 while projecting X-rays, the flexible tube 8 is inserted into the body and is insert-ed up to a portion to be operated on, 2 .g., a thrombus portion. For example, as shown in Fig. 5(a), a balloon 26 is provided in the vicinity of the tip 16 of the flexible tube 8. The balloon 26 is temporarily expanded using an inner hole (This inner hole is not illustrated, but when the balloon is used the inner hole similar to an inner hole 18 is additionally provided.) provided in the flexible tube 8 ~or the balloon to such an extent that an adverse effect will not be exerted on the flow of blood 24, so as to position ana secure the tip 16 since the flexible tube 8 oscillates owing to the flow of the blood inside a blood vessel 25. At this time, the mutual relationships between the flexible tube 8 and the linear transmitting member 44 are in the state shown in Fig. 3(a). Subsequently, when the bellows portion 10 is shrun~ in the direction of the arrow 28 while holding a part of the horn cover 6 on the side of the branch tube 7 in relation to the bellows 1 portion 10, a working portion 21 of the ultrasonic probe 17 can be made -to project from the tip 16 of the flexible tube 8, as shown in Fig. 3(b). Hence, the balloon 26 is shrunk after adjusting the position of the working portion 21 in relation to the thrombus 27. Then, as shown in Fig. 5(b), the ultrasonic probe 17 is mechanically vibrated at an ultrasonic frequency, the working portion 21 is brought into contact with the thrombus 27 to crush the thrombus 27.
The small crushed pieces of the thrombus are sucked by the suction device ll from the inner suction hole l9 shown in Fig. 6(a) and are removed out of the body. In addition, when the position of the thrombus 27 is unclear, a contrast medium or the like is injected from the liquid-injecting inner hole 18 shown in Fig. 6(a) by means of the liquid injec-tor 14, and the above-described operation is carried out while confirming the position of the thrombus 27.
The material of the flexible tube 8 may be the one which is normally used for a medical catherter, such as soft vinyl chloride resin. On the other hand, the materials of the branch tubes 7, 9, and 47 are not particularly restxicted, but one which is capable of adhering with the flexible tube 8 is preferable. The inner hole and outer periphery of the flexible tube 8 and the inner holes of ~ the branch tubes 7, 9, 47 are coated with an antithrombotic substance. As for this antithrombotic substance, poly-urethane, hydrogel, heparinated polymer, urokinase~coupled polymer, or the like is preferable, but the substance is not particularly restricted.
1 Furthermore, the number of the inner holes of the flexible tube 8 is no-t particularly restricted. For instance~ in a case where one inner hole 20 is provided, as shown in Fig. ~(b), the inner hole 20 haviny the ultra-sonic probe 17 can be used by being changed over by means of a changeover valve such as to communicate with the suction device 11 and the li~uid injector 14.
As for the working portion 21 at the tip of the ultrasonic probe 17, an acute-angled portion thereof has been removed so as to prevent damage to the inner wall of a blood vessel and the like. Although the configuration of an end surface thereof is not particularly restricted, it is preferable to make the same oblique-angled or arcuate.
Although a detailed description has been made with respect to a case where the apparatus in accordance with the present invention is used for removal of a thrombus in a blood vessel as one embodiment thereof, the usage of the present apparatus should not be restricted to such, and it goes without saying that the apparatus can be suitably used e~tensively for crushing or removing other undesirable substances in the body.
~ s described above, in accordance with the present invention, it is possible to insert an ultrasonic probe directly into the affected part where an undesirable substance, such as a thrombus, calcification aggregate, ulcer, or the like occuring in a narrow tubular tissue such as a bent blood vessel is present and crush the unde-sirable substance by means of mechanical vibrations of an ~ 12 -~2~
1 ultrasonic frequency and immediately remove the same out of the body without adversely affec-ting the normal surrounding tissue. At the same time, an incised portion at the body surface can be made only slightly larger than the diameter of a flexible tube enveloping an ultrasonic probe. Hence, an operation which gives a very low level of stress to the patient is can be carried out within a short period of time.
Consequentlyr the burden on the patient after the operation can be alleviated substantially, so that the apparatus of the present invention can be suitably used as an ultrasonic surgical apparatus.
The present invention relates to an ultrasonic surgical apparatus for crushing, sucking, and removing undesirable substances existing in the body, such as ulcerous tissue, thrombuses, calcification aggregates, etc. by means of ultrasonic vlbrations of a flexible ultrasonic probe.
. DESCRIPTION OF THE PRIOR ART - -As conventional methods of removing thrombuses, -the following methods are known: one in which a catherteris inserted into a thrombus portion and the thrombus is dissolved by injecting thereinto a thrombolytic agent such as streptokinase (e.g., Japanese Patent Unexamined Publication No. 173065/1982), one in which a catherter is withdrawn while maintaining the balloon of a balloon catherter in an expanded state, and, at the same time, a ~ ~ thrombus is removed (e.g., Japanese Patent Examined ; ~ Publication No. 16472/lg74), and one in which a thrombus portion is clamped by two expanded balloons, the thrombus is softened by injecting a thrombolytic agent thereinto, a catherter is then withdrawn, and, at the same time, the thrombus is removed (e.g., Published Japanese Translation :
of PCT Appln., Publication No. 501983/1983).
However, even if the thrombolytic agent is injected locally after the insertion of the catherter, there is a ~' i7 1 drawback in that the thrombolytic agent f lows into normal terminal blood vessels and the like, thereby entailing the risk of hemorrhage in the terminal blood vessels and the like. Meanwhile, in the case where the catherter is withdrawn by maintaining the balloon of the balloon catherter in a expanded state and, at the same time, the thrombus is removed from the body, there is the risk of causing damage to the inner wall of a blood vessel since a safety measure against a tensile stress applied to the inner : 10 wall of the blood vessel has not been taken. In the case where a catherter provided with two balloons is used as a similar method of removing a thrombus, when a thrombus 27 is clamped by two balloons 31, 32, as shown in Fig. 7, the balloon 32 located closer to the tip of a catherter 30 needs to be inserted from a position 34 in front of a thrombus 27 up to an innermost position 35 which is farther from the thrombus 27, so that there is the danger of causing the balloon 32 to push the thrombus 27 in the inserting direc-tion 33, thereby moving the thrombus 27 to another part, such as a terminal blood vessel.
Furthermore, as a method of mechanically removing a thrombus, there is one in which a drill bit is provided to the tip of a bar-like member, the drill bit is made to rotate by rotating the bar-like member, and the thrombus is crushed by the rotating drill bit. With this method, however, a torsional stress is applied to the inner wall of the blood vessel, so that there is a drawback in that the blsod vessel may be cut off by said stress, and adjustment 1 of the number of revolutions and the like is hence made difficult.
Recently, as a surgical apparatus using ultrasonic, an apparatus is known in which an ultrasonic probe is connected to a source of ultrasonic vibration, tissue, a calcification aggregate, thrombus, or the like is crushed by mechanical vibrations of an ultrasonic frequency generated at the tip of the ultrasonic probe, and the crushed tissue, calcification aggregate, thrombus, or the like is removed through an inner hole provided in the ultrasonic probe (e.g., Japanese Patent Examined Publication Nos. 5139/1985 and 21989/1974). With such an apparatus, however, since the ultrasonic probe having a wor~ing portion which mechanically vibrates at an ultrasonic frequency is not flexible, there is a drawback in that it is diffucult to insert the ultrasonic probe into a tubular tissue inside the body.
SUMMARY OF THE INVENTION
Accordingly, an object of the present invention is to provide an ultrasonic surgical apparatus which is capable of allowing a flexible ultrasonic probe to be . inserted directly into the affected part, crushing an unde-~ sirable subs-tance in the body such as a thrombus, a calcification aggregate, or the like by means of mechanical vibrations of an ultrasonic fr~quency, and removing the same by suction without affecting the normal surrounding tissue, thereby overcoming the drawbacks of the prior art, including : ~ - 3 -1 the risk of hemorrhage caused by a thrombolytic agent, the risk of causing damage to a blood vessel owing -to a tensile or torsional stress applied to the inner wall of the blood vessel by the use of a balloon catherter, and the drawback o movement of the thrombus at the time of insertion of the balloon catherter.
Another object of the pxesent invention is to provide an ultrasonic surgical apparatus which is capable o crushing and removlng a thrombus, a calcification aggre-gate, or the like in the tubular tissue of such as a bentblood vessel, for which an operation has been difficult using a conventional ultrasonic surgical apparatus.
To this end, the present invention provides an ultrasonic surgical apparatus having an ultrasonic vibration source for generating ultrasonic vibrations, an oscillator for supplyi.ng high-frequency electric energy lo the ultra-sonic vibration source, a horn connected to t~e ultrasonic vibration source and adapted to transmit and amplify mechanical vibrations of an ultrasonic frequency, and a suction device for sucking and removing an undesirable substance from an operated part, comprising an ultrasonic probe which is constituted by a flexible linear transmitting member, is secured at one end thereof to a tip of the horn and has at the other end thereof a working portion for ~5 effecting mechanical vibration of an ultrasonic frequency, ~; a horn cover at least a portion of which is made of a flexible material, at least one inner tube, at least one branch tube communicating with the inner tube, and a l flexible tube connected to the horn cover, wherein -the ultrasonic probe is installed in the inner hole, and the suction device is connected to the branch tube.
BRIEF DESCRIP~ION OF THE DRAWINGS
Fig. l is a diagram schematically illustrating the overall arrangement of an ultrasonic surgical apparatus in accordance with an embodimen~ of the present invention;
Fig. 2 is an enlarged diagram of a handpiece portion and illustrates the arrangement of the interior of a horn cover;
Figs. 3(a~ and 3(b) are enlarged diagrams of a bellows portion, in which Fig. 3(a~ shows a state in which the bellows portion is extendedr while Fig. 3(b) shows a state in which the bellows portion is shrunk;
Fig. 4 is a diagram illustrating another example of the configuration of the handpiece;
Figs. 5(a) and 5(b) are diagrams explaining an example of using the apparatus in accordance with the presen~
invention;
Figs. 6(a) and 6(b) are diagrams illustrating the cross-sectional structure of a flexible tube in accordance with the embodiments of the present invention; and Fig. 7 is a diagram illustrating a conventional method.
:
DESCRIPTION OF THE PREFERRED EMBODIMENTS
Referring now to the accompanying drawings, a :"
~L2~
1 detailed description will be made of the present invention.
Fig. 1 is a diagram schematically illustrating the overall arrangement of an ultrasonic surgical apparatus in accord-ance with an embodiment of the present invention. As shown in Fig. 1, the apparatus is comprised of the following four sections: a section for generating mechanical vibrations of an ultrasonic frequency which is constituted by an oscil-lator 1 and a handpiece 36, a suction section constituted by a suction device 11 and a suction bottle 12, a liquid injecting section constituted by a liquid injector 14, and a catherter section constituted by a flexible tube 8, branch tubes 7, 9, and 47.
High-frequency electric energy is supplied from the oscillator 1 to the handpiece 36 via cables 2, 3. As shown in Fig. 2, the handpiece 36 is consti-tuted by an ultrasonic vibration source 4, a horn 5, a horn cover 6, and an ultrasonic probe 17. The high-frequency electric energy is supplied to the ultrasonic vibration source 4, which in turn generates mechanical vibrations af an ultrasonic frequency and transmits the same to the horn 5. The mechanical vibrations are enlarged by the horn 5 and are transmitted to the ultrasonic probe 17.
; The oscillator 1 has an oscillation circuit which is capable of supplving high-frequency electric energy corresponding to fluctuations in the state of the mechanical load of the horn 5 and the ultrasonic probe 17. Although 15 - 40 kHz is suitable as an osclllation frequency, 20 - 30 kHz is suitable in view of the mechanical vibrations of the 1 ultrasonic frequency o~ the ultraso~ic probe 17 and the crushing capability thereof.
Although the connection between the ultrasonic vibration source 4 and the horn S is effected by a screwing method, said connection should not be restricted to that type. The ultrasonic vibration source 4 should not be particularly restricted insofar as it is capable of converting high-frequency electric energy of the magneto-striction type, the electrostatiction type, or the li~e into mechanical vibrations. As for the material of the horn 5, a metallic material which is capable of transmitting and enlarging the mechanical vibrations of an ultrasonic frequency and has a fatigue strength sufficient to withstand the mechanical vibrations, and stainless steel, duralumin, a titanium alloy, or the like is preferable.
In addition, as for a method of connecting the horn 5 and the ultrasonic probe 17, the screwing method, welding, or the like is suitable. The ultrasonic probe 17 is constituted by a fixing member 43 and a flexible linear transmitting member 44, and, as for a method of connecting the fixing member 43 and the linear transmitting member 44, welding, adhesion, or the like is suitable. The materials of the fixing member 43 and the linear transmitting member are not particularly restricted if they are capable of transmitting the mechanical vibrations of an ultrasonic frequency and have a fatigue strength sufficient to withstand the mechanical vibrations. However, said materials should preferably be such that an X-ray cannot be transmitted .
1 therethrough, and a metallic material, lncludlng stalnless steel, duralumin, and a tltanlum alloy, or a composite material such as carbon flber-reinforced plastlcs is preferable. The horn cover 6 ls provlded around the horn 5 and the flexible ultrasonic probe 17. O~e end of the horn cover 6 is connected to the ultrasonlc vibration source 4 by an appropriate method, whlle the other end thereof is connected to the branch tube 7 by means of an adhesive so as to retain airtightness. However, the method of this connection should not be restricted to the same. The interior of the horn cover 6 is divided into partitioned chambers 23, 45 by means of a rubber O-ring 22, the rubber O-ring 22 being located at a knot portion where the longi-tudinal (46) amplitude of the mechanical vibrations of the horn 5 is the mlnimum so as to shield the passage of the liquid. In addition, by providing a portion of the horn cover 6 with a bellows portion 10 formed of a flexible material, it is possible to move the branch tube 7 back and forth by virtue of the longitudinal (46) expansion and shrinkage of the bellows portion (10).
The ultrasonic probe 17 is installed through the branch tube 7 and inside ~he inner hole of the flexible tube 8 shown in Fig. 1. As shown in Fig. 3(a), the tip of the ultrasonic probe 17 has such a dimension that, when the 2S bellows portion 10 is in an extended state, said tip will not protrude from the tip 16 of the flexible tube 8.
Consequently, when the flexible tube 8 is inserted into the body, the tip of the ultrasonic probe 17 is located in the 1 inner hole of the flexible tube 8, thereby making it possible to prevent the occurrence OL damage to a blood vessel or the like caused by the tip of the ultrasonic probe 17.
As shown in Fig. 1, the suction device 11 is com-municated with the lnner hole of the flexible tube 8 via the branch pipe 9, a changeover valve 13, the suction bottle 12, and tubes 38, 39, and 40. The liquid injector 14 is communicated with the inner hole of the flexible tube 8 via the branch tube 47, a pipe 37, a changeover valve 15, and a tube 41. As for a method of arranging the branch tubes 9 and 47, although Fig. 4 illustrates an example in which the branch tubes 9 and 47 are secured to the horn cover 6 by means of an appropriate adhesive, the arrange-ment may be such as to provide a configuration that facilitates the use of the apparatus by the operator and should not be restricted to the illustrated example.
As for the method of using this apparatus, the : partitioned chamber 23 and the inner holes 42, 20 are filled with a li~uid which is not harmful to the bodily tissue, such as physiological saline, by an appropriate means so as to facilitate slippage of the linear transmit-ting member 44 installsd inside the branch tube and the flexible tube 8. For instance, a passage leading to the partitioned chamber 23 is provided on the side of the horn ~: cover 6, a liquid such as physiological saline is injected into the partitioned chamber 23 and the inner hole 42, 20 through that passage, and the passage is then closed. Also, _ g _ ", i7 1 the inner suction hole 19 of the flexible tube 8 communi-cating with the suction device 11 and the inner hole of the branch tube 9 are filled with a liquid such as physiological saline by means of the operation of the suction device 11 and the changeover valve 13. With respect to the liquid injector as well, the branch tube 47 and the inner hole 20 are similarly filled with a liquid such as physiological saline.
Next, while confirming the position of the tip of the linear transmitting member 44 while projecting X-rays, the flexible tube 8 is inserted into the body and is insert-ed up to a portion to be operated on, 2 .g., a thrombus portion. For example, as shown in Fig. 5(a), a balloon 26 is provided in the vicinity of the tip 16 of the flexible tube 8. The balloon 26 is temporarily expanded using an inner hole (This inner hole is not illustrated, but when the balloon is used the inner hole similar to an inner hole 18 is additionally provided.) provided in the flexible tube 8 ~or the balloon to such an extent that an adverse effect will not be exerted on the flow of blood 24, so as to position ana secure the tip 16 since the flexible tube 8 oscillates owing to the flow of the blood inside a blood vessel 25. At this time, the mutual relationships between the flexible tube 8 and the linear transmitting member 44 are in the state shown in Fig. 3(a). Subsequently, when the bellows portion 10 is shrun~ in the direction of the arrow 28 while holding a part of the horn cover 6 on the side of the branch tube 7 in relation to the bellows 1 portion 10, a working portion 21 of the ultrasonic probe 17 can be made -to project from the tip 16 of the flexible tube 8, as shown in Fig. 3(b). Hence, the balloon 26 is shrunk after adjusting the position of the working portion 21 in relation to the thrombus 27. Then, as shown in Fig. 5(b), the ultrasonic probe 17 is mechanically vibrated at an ultrasonic frequency, the working portion 21 is brought into contact with the thrombus 27 to crush the thrombus 27.
The small crushed pieces of the thrombus are sucked by the suction device ll from the inner suction hole l9 shown in Fig. 6(a) and are removed out of the body. In addition, when the position of the thrombus 27 is unclear, a contrast medium or the like is injected from the liquid-injecting inner hole 18 shown in Fig. 6(a) by means of the liquid injec-tor 14, and the above-described operation is carried out while confirming the position of the thrombus 27.
The material of the flexible tube 8 may be the one which is normally used for a medical catherter, such as soft vinyl chloride resin. On the other hand, the materials of the branch tubes 7, 9, and 47 are not particularly restxicted, but one which is capable of adhering with the flexible tube 8 is preferable. The inner hole and outer periphery of the flexible tube 8 and the inner holes of ~ the branch tubes 7, 9, 47 are coated with an antithrombotic substance. As for this antithrombotic substance, poly-urethane, hydrogel, heparinated polymer, urokinase~coupled polymer, or the like is preferable, but the substance is not particularly restricted.
1 Furthermore, the number of the inner holes of the flexible tube 8 is no-t particularly restricted. For instance~ in a case where one inner hole 20 is provided, as shown in Fig. ~(b), the inner hole 20 haviny the ultra-sonic probe 17 can be used by being changed over by means of a changeover valve such as to communicate with the suction device 11 and the li~uid injector 14.
As for the working portion 21 at the tip of the ultrasonic probe 17, an acute-angled portion thereof has been removed so as to prevent damage to the inner wall of a blood vessel and the like. Although the configuration of an end surface thereof is not particularly restricted, it is preferable to make the same oblique-angled or arcuate.
Although a detailed description has been made with respect to a case where the apparatus in accordance with the present invention is used for removal of a thrombus in a blood vessel as one embodiment thereof, the usage of the present apparatus should not be restricted to such, and it goes without saying that the apparatus can be suitably used e~tensively for crushing or removing other undesirable substances in the body.
~ s described above, in accordance with the present invention, it is possible to insert an ultrasonic probe directly into the affected part where an undesirable substance, such as a thrombus, calcification aggregate, ulcer, or the like occuring in a narrow tubular tissue such as a bent blood vessel is present and crush the unde-sirable substance by means of mechanical vibrations of an ~ 12 -~2~
1 ultrasonic frequency and immediately remove the same out of the body without adversely affec-ting the normal surrounding tissue. At the same time, an incised portion at the body surface can be made only slightly larger than the diameter of a flexible tube enveloping an ultrasonic probe. Hence, an operation which gives a very low level of stress to the patient is can be carried out within a short period of time.
Consequentlyr the burden on the patient after the operation can be alleviated substantially, so that the apparatus of the present invention can be suitably used as an ultrasonic surgical apparatus.
Claims (6)
1. An ultrasonic surgical apparatus having an ultra-sonic vibration? source for generating ultrasonic vibrations, an oscillator for supplying high-frequency electric energy to said ultrasonic vibration source, a horn connected to said ultrasonic vibration source and adapted to transmit and amplify mechanical vibrations of an ultrasonic fre-quency, and a suction device for sucking and removing an undesirable substance from an operated part, comprising an ultrasonic probe which is constituted by a flexible linear transmitting member, is secured at one end thereof to a tip of said horn and has at the other end thereof a working portion for effecting mechanical vibration of an ultrasonic frequency, a horn cover at least a portion of which is made of a flexible material, at least one inner tube, at least one branch tube communicating with said inner tube, and a flexible tube connected to said horn cover, wherein said ultrasonic probe is installed in said inner hole, and said suction device is connected to said branch tube.
2. An ultrasonic surgical apparatus according to Claim 1, wherein a bellows-like portion is provided to a portion of said horn cover made of a flexible material to form said horn cover such as to be flexible.
3. An ultrasonic surgical apparatus according to Claim 1 , wherein all of an angular portion of said working portion of said ultrasonic probe is oblique-angled or circular in shape.
4. An ultrasonic surgical apparatus according to any of Claims 1 to 3, wherein a liquid injector for inecting an irrigation liquid or the like is connected to said branch tube of said flexible tube.
5. An ultrasonic surgical apparatus according to any of Claims 1 to 3, wherein said flexible tube has a balloon in the vicinity of said working portion of said ultrasonic probe installed in said inner hole thereof, and said balloon being adapted to be expanded and shrunk through said inner hole.
6. An ultrasonic surgical apparatus according to any of Claims 1 to 3, wherein the surfaces of said inner hole and outer periphery of said flexible tube are coated with an antithrombotic substance.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CA000530524A CA1296067C (en) | 1987-02-25 | 1987-02-25 | Ultrasonic surgical apparatus |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CA000530524A CA1296067C (en) | 1987-02-25 | 1987-02-25 | Ultrasonic surgical apparatus |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CA1296067C true CA1296067C (en) | 1992-02-18 |
Family
ID=4135043
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CA000530524A Expired - Fee Related CA1296067C (en) | 1987-02-25 | 1987-02-25 | Ultrasonic surgical apparatus |
Country Status (1)
| Country | Link |
|---|---|
| CA (1) | CA1296067C (en) |
Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| WO2016200729A1 (en) * | 2015-06-08 | 2016-12-15 | Misonix, Incorporated | Ultrasonic surgical apparatus and associated method |
-
1987
- 1987-02-25 CA CA000530524A patent/CA1296067C/en not_active Expired - Fee Related
Cited By (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| WO2016200729A1 (en) * | 2015-06-08 | 2016-12-15 | Misonix, Incorporated | Ultrasonic surgical apparatus and associated method |
| US10092741B2 (en) | 2015-06-08 | 2018-10-09 | Misonix, Inc. | Ultrasonic surgical apparatus and associated method |
| US11096711B2 (en) | 2015-06-08 | 2021-08-24 | Misonix, Incorporated | Ultrasonic surgical apparatus and associated method |
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