CN100406080C - Method, system and device for altrasonic action on blood vessel or cavernous body - Google Patents
Method, system and device for altrasonic action on blood vessel or cavernous body Download PDFInfo
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- CN100406080C CN100406080C CNB028135741A CN02813574A CN100406080C CN 100406080 C CN100406080 C CN 100406080C CN B028135741 A CNB028135741 A CN B028135741A CN 02813574 A CN02813574 A CN 02813574A CN 100406080 C CN100406080 C CN 100406080C
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- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B17/22004—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61B2217/00—General characteristics of surgical instruments
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- A61B2217/005—Auxiliary appliance with suction drainage system
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B2217/00—General characteristics of surgical instruments
- A61B2217/002—Auxiliary appliance
- A61B2217/007—Auxiliary appliance with irrigation system
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
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Abstract
The inventive device for ultrasonic action on a blood vessel or a cavernous body comprises a concentrator-waveguide having a pointed end for piercing the wall of the vessel or cavernous body and a working part which is introduced into said vessel or cavernous body through the puncture thereof. Said ultrasonic device is incorporated into a system which additionally comprises an ultrasonic generator, a channel or channels for transferring a liquid phase and a unit for supplying and evacuating said liquid phase provided with a push-and-pull drive. Said drive operates in such a way that it collects the liquid phase through the channel or channels for transferring said liquid phase during the direct motion and evacuates it through the channel or channels for transferring said liquid phase during the reverse motion.
Description
Technical field
The present invention relates to engineering in medicine, the processing that undergos surgery of the instrument of and other medical domain sick, its medium vessels or spongy body (cavernous body) especially for vascular surgery, rectum.
Background technology
Hemorrhoid are a kind of spongy bodies, and the method for known a kind of surgical operation therapy hemorrhoid just comprises that the application of vascular suture is (with reference to " the sick guide of learning of colorectum ", V.P.Rivkin, F.S.Bronshtein, S.N.Fa ' yin, M.Medpractica publishing house, 2001).The enforcement of described method provides stitching and the ligation of carrying out the hemorrhoid spongy body, and the excision of internal hemorrhoid and external hemorrhoid makes mucosa injury place closure by various suture ways then.For implementing described method, often adopt traditional surgical instrument (Luer, Kocher, AllisShi tweezers).Weak point operation of this method gets involved requires great effort, and this method can cause the anus catheter mucous membrane to organize to a great extent damage, and this damage is also with massive blood loss.Particularly highly damage also probably causes the convalescent period of surgical patient very long.
The method of the inwall of known a kind of vasoactive or vein and spongy body comprises injection sclerotherapy, the medicament (sclerosant) that causes the hardening of tissue by injection is to vascular tissue's inner chamber (blood vessel or spongy body), as described, as " Therapeutic Method of angiopathy ", it is internist's a guide, and Savel ' yev V.S.M. compiles, A.N.Bakoulev operation on vessels of heart center, RAMS, 1999,32 pages; And doctor of medicine Solov ' yovO.L., " sclerotherapy of hemorrhoid outpatient procedures ", the volga lattice are reined in, 1996,23 pages the abstract of a thesis.Described method is effective inadequately, because be subjected to the restriction of a kind of sclerosant of disposable use, a kind of sclerosant of excessive use that this method just needs to have a mind to is to promote the chemical interaction of this sclerosing agent and blood vessel wall.But sclerosant self is a kind of for uncomfortable suitable medium, and overtreatment uses will cause tissue necrosis.Belong in inventor's the description of the invention of certificate SU 1158196A and disclosed a kind of phonophoresis equipment, this phonophoresis equipment comprises an a plurality of half wave length ultrasonic ripple concentrator, and the working portion way of realization of this concentrator is-sphere.Such phonophoresis equipment design idea is the inside ultrasonic therapy of blood vessel and allows medicine intravasation wall.It inserts blood vessel to use this type of equipment requirements, and blood vessel is wanted temporary transient and blood flow is isolated, and, use a kind of special surgical instrument on blood vessel wall, to open a hole, the hole will enough can make working portion pass greatly.The deficiency of the phonophoresis equipment of this prior art comprises the surgical operation passage of a complexity that must be implemented to blood vessel or spongy body, and this passage can involve the tissue around blood vessel or the spongy body, comprises the large-scale impairment of skin.The great damage and the massive blood loss of tissue near such surgical operation passage can cause.Tissue injury can prolong postoperative regeneration (recovery) process that is organized on a large scale.The arduousness of operation itself and long persistent period also are considerable, require the temporary transient and blood flow of that section blood vessel of performing an operation to keep apart because open a hole by surgical instrument, will use other technology instrument during isolation, as vascular clamp.
Summary of the invention
The purpose of this invention is to provide a kind of method, system and instrument, be used for pipe (vascular, blood vessel, conduit etc., below explanation only be called blood vessel) or the inner chamber of spongy body apply the ultrasound wave effect, to alleviate tissue injury, reduce followed when instrument inserts in blood vessel or the spongy body hemorrhage, avoid using, improve the efficient of sclerosing agent simultaneously blood vessel or the effect of spongy body inner chamber with blood vessel and the isolated instrument of blood flow.
For reaching described technical result, a kind of ultrasonic instrument that has concentrator-waveguide has tip and the outstanding working portion that is provided for puncturing blood vessel or sponge body wall, and most advanced and sophisticated and outstanding working portion is used for transmitting wall and the inner chamber that blood vessel or spongy body are treated in the ultrasonic frequency mechanical vibration.
The tip of this ultrasonic instrument makes ultrasonic instrument itself just can utilize additional ultrasound wave effect directly to open a hole in blood vessel wall, when opening described hole, the more convenient and property the followed damage that significantly alleviates near the tissue skin and the blood vessel of ultrasound wave effect.Ultrasound field is concentrated in the tip, and in second, in fact tissue and blood vessel wall itself near local failure skin, the blood vessel do not have big damage part.Working portion and most advanced and sophisticated minimum distance arrange and make user can visually control the mode in the inner chamber that working portion penetrates tissue and blood vessel or spongy body, and can guarantee that the size in the hole that will open and the size of working portion are consistent.Perforate and working portion almost carry out simultaneously by the arrangement that blood vessel or spongy body are inserted in institute's perforate, and this just makes that amount of bleeding drops to minimum, and has avoided blood vessel or spongy body and the isolated necessity of blood flow.
The working portion of this ultrasonic instrument has the convex-concave shape of protrusion, and perhaps way of realization is the rotation geometry body.The tip is a rotation geometry shape or polyhedron-shaped.Concentrator-waveguide is successive, and concentrator-waveguide basis has the passage that feed flow passes through mutually, perhaps is included at least one passage in the tip in addition in working portion.
This concentrator-waveguide is rigidity or flexibility.The shape of cross section of concentrator-waveguide or rectangle, or the rectangle of band round edge or circle rib, or circular or oval.
In a kind of particular embodiment, the most advanced and sophisticated longitudinal axis and the longitudinal axis of working portion be conllinear not.
Blood vessel or spongy body are being applied in the described system of ultrasound wave effect, used a kind of ultrasonic instrument, this ultrasonic instrument has comprised a concentrator-waveguide, concentrator-waveguide has a tip and outstanding working portion, and most advanced and sophisticated and outstanding working portion is used for transmitting the ultrasonic frequency mechanical vibration with to blood vessel or sponge body wall or inner chamber effect.This system comprises a ultrasonic signal generator, is used for supplying with this ultrasonic instrument signal; Be used for transmitting and discharging the device of liquid phase, this device has at least one passage that is used for transmitting liquid phase; Liquid phase transmission and discharger, liquid phase transmission and discharger have a bidirectional driving apparatus, are applicable to when positive movement and collect liquid phase by at least one liquid phase transmission channel, and discharge liquid phase by at least one liquid phase transmission channel when reverse movement.
The feature of this bidirectional driving apparatus allows metering transmission (meter delivery) liquid phase in intravascular space.
The collection of liquid phase is finished by identical or different liquid phase transmission channels with discharging.
This liquid phase transmission and discharger are by the running of hand drive device, for example when this device way of realization is syringe; Perhaps by electronic tool driving device running, when liquid phase transmission and discharger way of realization are piston type or rotor type motor tool discharger as described.
Under the situation of using ultrasound ripple instrument, concentrator-waveguide has the passage that passes through for liquid in concentrator itself and working portion, perhaps also be included at least one passage in the tip, at least one passage that is used for the liquid phase transmission is suitable for being connected to the corresponding passage of ultrasonic instrument; For example, form being connected of passage in liquid phase transmission channel and the ultrasonic instrument by connecting ultrasonic instrument.
According to an aspect of the present invention, a kind of system that is used for blood vessel or spongy body are applied the ultrasound wave effect comprises above-mentioned ultrasonic instrument, supplies with the ultrasonic signal generator of ultrasonic instrument signal; Be used to transmit and discharge the device of liquid phase, this device has at least one passage that is used to transmit liquid phase; Liquid phase transmission and discharger have bidirectional driving apparatus, when the bidirectional driving apparatus positive movement, be suitable for collecting liquid phase, and when adverse movement, be suitable for discharging liquid phase by at least one passage that is used to transmit liquid phase by at least one passage that is used to transmit liquid phase.
According to an aspect of the present invention, a kind of method that is used to form system, described system are used for blood vessel or pipe or spongy body are applied the ultrasound wave effect, and described method comprises: above-mentioned ultrasonic instrument is provided; The ultrasonic signal generator of supplying with the ultrasonic instrument signal is provided; Be provided for transmitting and discharging the device of liquid phase, this device has at least one passage that is used to transmit liquid phase; The ultrasonic frequency mechanical vibration are applied on the ultrasonic instrument, ultrasonic instrument has concentrator-waveguide, concentrator-waveguide comprises most advanced and sophisticated and outstanding working portion, and most advanced and sophisticated and working portion is used for transmitting the ultrasonic frequency mechanical vibration, with to blood vessel or sponge body wall and inner chamber effect; By being used to transmit at least one channel transfer and the discharge liquid phase of liquid phase.
Described technique effect also can be finished by a kind of method that is used for blood vessel or spongy body are applied the ultrasound wave effect, and described method comprises the steps:
The ultrasonic frequency mechanical vibration are applied on the ultrasonic instrument, this ultrasonic instrument has a concentrator-waveguide, concentrator-waveguide has a tip and outstanding working portion, most advanced and sophisticated and outstanding working portion is used for transmitting the ultrasonic frequency mechanical vibration, with to blood vessel or sponge body wall or inner chamber effect;
By the tip of instrument, puncture blood vessel or sponge body wall; And
By described acanthopore, working portion is inserted in blood vessel or the spongy body, working portion applies the ultrasound wave effect to blood vessel or spongy body inside.
The ultrasound wave effect that is applied to blood vessel or spongy body inner chamber directly connects realization by ultrasonic instrument, perhaps also uses the liquid phase that is transferred in blood vessel or the spongy body so that the intermediate liquid media between ultrasonic instrument and blood vessel or the spongy body inner chamber to be provided in addition.
Liquid phase is transferred in blood vessel or the spongy body by the bar passage in the ultrasonic instrument or by the other acanthopore in blood vessel or the sponge body wall.
In the process that the ultrasound wave effect applies, liquid phase is transferred in blood vessel or the spongy body, and when finishing, liquid phase is discharged from blood vessel or spongy body.
Liquid phase is discharged from blood vessel or spongy body by the passage in the ultrasonic instrument or by the other acanthopore in blood vessel or the sponge body wall.
This liquid phase comprises the material (sclerosizing substance) that causes the hardening of tissue, for example, ethoxy sclerosing agent (ethoxysclerol), thrombosis is stuck with paste.
When this method is used to blood vessel or spongy body that thrombi partly or entirely is housed are done the time spent, working portion is inserted into the zone that fills pathological tissue or thrombi of blood vessel or spongy body.
Do the time spent when pathological tissue or thrombi are subjected to ultrasound wave in long time, they have just formed the passage that condenses, and by the passage that condenses, when the liquid phase in being transferred to blood vessel or spongy body also was used, described liquid phase was transmitted, and thrombi is discharged from.
Liquid phase is transferred to blood vessel or spongy body by the passage in the ultrasonic instrument or by the other acanthopore in blood vessel or the sponge body wall.
Spongy body is subjected to described effect up to its passage that condenses that forms predefined parameter, and for example, channel cross-section has a predetermined shape, near the passage angle of inclination of the tissue relative spongy body, the spatial form of the channel range and the passage longitudinal axis.These parameters can form the ligament organ and stop blood vessel or spongy body prolapsus.
Description of drawings
-ultrasonic instrument, system is used for blood vessel or spongy body are applied the ultrasound wave effect, and the described implementation step of the method that blood vessel or spongy body be subjected to the ultrasound wave effect that makes all explains in the drawings, wherein:
Fig. 1 is the sectional view of ultrasonic instrument, and this ultrasonic instrument has comprised a concentrator-waveguide, and concentrator-waveguide has a tip and outstanding working portion;
Fig. 2 (a-B) is the different shape of ultrasonic instrument working portion;
(a б) is most advanced and sophisticated different shape to Fig. 3;
(a б) is ultrasonic instrument to Fig. 4, and this ultrasonic instrument has the inner passage of transmission liquid phase;
Fig. 5 is a ultrasonic instrument, and this ultrasonic instrument has transmission and discharges the inner passage of liquid phase;
Fig. 6 is a kind of cross sectional shape of concentrator-waveguide;
(a б) is the longitudinal axis multi-form during conllinear not of the most advanced and sophisticated longitudinal axis and working portion to Fig. 7;
Fig. 8 is used for blood vessel or spongy body are applied the functional diagram of the system of ultrasound wave effect;
(a is to be used for blood vessel or spongy body are applied the different collocation form figure of a part of the system of ultrasound wave effect б) to Fig. 9;
Figure 10-the 13rd implements to be used for blood vessel or spongy body are applied the step of the claimed method of ultrasound wave effect.
The specific embodiment
Figure 1 shows that ultrasonic instrument 1, ultrasonic instrument 1 comprises concentrator-waveguide 2, concentrator-waveguide 2 has pointed tip or most advanced and sophisticated 4 and by the outstanding working portion 3 of concentrator-waveguide 2, working portion 3 and other parts are used for transmitting the ultrasonic frequency mechanical vibration, with to blood vessel (or pipe, vascular, conduit etc.) or sponge body wall or inner chamber effect.Ultrasonic instrument 1 is successive, wherein the longitudinal axis conllinear at the longitudinal axis of concentrator-waveguide and tip 4.Ultrasonic instrument is generally by stable or compatible (biologically inert) material manufacture biologically, titanium alloy BT-5 for example, BT-6, OT-4.
Working portion 3 generally is a convex, almost can be made into different shape, as the shape of the parallelepiped of Fig. 2 (a).The side of working portion 3 or incline or lateral edge can be the circle or be not round, the use of non-round incline can't cause any significant impact to the distribution of the ultrasound field around the working portion, but can become an other source of the mechanical injuries of blood vessel or spongy body inner surface.
In a series of enforcements, advantageously mode is, the working portion 3 of ultrasonic instrument 1 can be a convex concave, or semi-convex half is recessed or the protruding one side of one side is recessed, for example shown in Fig. 2 (б), the form that just recessed hemisphere 5 is such, the center of the recessed hemisphere of recessed hemisphere 5 has most advanced and sophisticated 4.The edge of this class hemisphere is embodied as edge circle or that corner angle are arranged or circle.As a special case, the groove 6 that the working portion 3 that Fig. 2 (B) shows has the convex-concave shape.The audition in this convexo-concave shape permission control liquid phase or the direction of audio frequency flux.
The only way of realization of working portion 3 is rotation geometry bodies, for example, and ellipsoid or ball.Working portion has this shape, and near the ultrasound field it can distribute with the most uniform form, so just can be applied to blood vessel or spongy body inner chamber with acting on uniformly.
Most advanced and sophisticated 4 is elements of ultrasonic instrument 1, and terminal effect is to puncture blood vessel wall so that working portion 3 can be by in the acanthopore intravasation.Most advanced and sophisticated 4 high-frequency mechanical vibration has reduced to organize the desired power of middle punch (acanthopore) greatly near blood vessel wall and blood vessel, this is owing to the vibratory impulse effect, has therefore eliminated the deformed region of the biological tissue that is subjected to the ultrasonic instrument action of points greatly.
Most advanced and sophisticated 4 way of realization is a rotary body, for example, and cone.Most advanced and sophisticated 4 also can with polyhedral form and non-circle or corner angle or sharp form, for example pyramid among Fig. 3 (б) arranged.
When implementing by liquid phase according to the ultrasound wave effect of the embodiment of ultrasonic instrument, ultrasound wave inside is provided with the passage shown in Fig. 4 (a).Usually, a passage 7 and a passage 8 in the working portion 3 in concentrator-waveguide 2 are just enough, but more even for the supply that makes blood vessel that inflow treated or the intravital liquid phase of sponge, passage 7 and 8 quantity can be more.In some cases, favourable mode is at least one passage 9 in most advanced and sophisticated 4 to be set, just shown in Fig. 4 (б).When organizing thrust instantaneous, this class passage can make the easier tissue that thrusts of instrument, and this is reducing and local cavitation owing to the frictional force between instrument and the tissue; And raising is caused the accurate transmission of the medicament or the material intravasation wall of the hardening of tissue.All passages 7,8,9,10, the selection of 11 lateral dimension wants to guarantee the straightway passage of liquid phase.
Comprise the medicament that causes the hardening of tissue, as ethoxy sclerosing agent (ethoxysclerol) or thrombosis paste, solution be used as liquid phase.The example of these solution has in below with reference to document and is described in detail: " Therapeutic Method of angiopathy ", it is internist's a guide, Savel ' yev V.S.M. compiles, the A.N.Bakoulev operation on vessels of heart center of RAMS, 1999,32 pages; And " chronic venous deficiency ", M. " Bereg " publishing house, 1999-128 page or leaf.
When blood vessel or spongy body inner chamber are exposed to ultrasonic instrument, cause in the liquid phase hardening of tissue or scleratogenous medicament or material intravasation inner chamber, and blood vessel or sponge body wall are thrust in the effect lower prong part at ultrasonic instrument, have guaranteed to cause the accurate transmission of the medicament or the scleratogenous material of the hardening of tissue thus.Compare with traditional sclerotherapy technology, will hang down by the sclerosing agent consumption that this accurate transmission means is injected.
Concentrator-waveguide can be flexible to dissect the path that blood vessel is provided with so that working portion is passed, and the surgical operation passage that can provide working portion to invade along the minimum level of curvilinear path.Concentrator-waveguide can for example have the circular section, as shown in Figure 6.This class cross sectional shape can not hinder concentrator-waveguide bend.
Be the surgical operation passage make things convenient for working portion to invade along the minimum level of curvilinear path, or when from the side near blood vessel or spongy body, the most advanced and sophisticated longitudinal axis can be made and the longitudinal axis of the working portion form of conllinear not.This class configuration as shown in Figure 7; According to first embodiment as Fig. 7 (a), the angle [alpha] that spool tilted of most advanced and sophisticated axle and working portion; In second kind of form shown in Fig. 8 (б), most advanced and sophisticated axle is parallel with the axle of working portion, but a side-play amount A or a Δ arranged.The value of angle [alpha] is preferably in 30 °-45 ° the scope, but its actual value can be in 0.1 °-90 ° scope.The preferred value of offset is in the 0.01-0.5 of the maximum transverse size of working portion scope doubly.
Figure 8 shows that the sketch that utilizes 1 pair of blood vessel of ultrasonic instrument or spongy body to apply the system of ultrasound wave effect, ultrasonic instrument 1 comprises concentrator-waveguide, concentrator-waveguide has most advanced and sophisticated and outstanding working portion, working portion and other parts are used for transmitting the ultrasonic frequency mechanical vibration, apply effect with wall and inner chamber to blood vessel 14 (spongy body).System also comprises generator 13, and generator 13 is used for producing ultrasonic signal so that by acoustic elements 12 signal is passed to ultrasonic instrument; And comprise that the device 15 that is used for transmitting and discharging liquid phase, this device have at least one passage that is used for transmitting liquid phase; Liquid phase transmission and discharger 15 comprise bidirectional driving apparatus 16, discharge or mobile liquid phase by at least one liquid phase transmission channel 17 when bidirectional driving apparatus 16 positive movements, pass through to collect liquid phases to liquid phase transmission channel of bar 17 when reverse movement.
The collection of liquid phase is finished by same liquid channel 17 or by different passages with discharging; Ultrasonic instrument is equipped with two passes 17 and 17 ' at least, is used for being undertaken by the different passages in the ultrasonic instrument collection and the discharge of liquid phase.Transmission can have different cross sectional shapes or area with the passage 17 of discharging liquid phase with 17 '.
Transmission and the device 16 of discharging liquid phase have manual driving device, and this device way of realization can be, for example, and the form of syringe; Or having electric mechanical driving device, form is piston type or rotator type discharger.For clarity sake, (a б) has only schematically shown piston type charger or loading machine to Fig. 9.
The passage 17 that is used for transmitting liquid phase is designed to link to each other with respective channel in the ultrasonic instrument, for example links to each other with passage 7 among Fig. 4 (a); But in a series of enforcements, liquid phase is by an independent passage 17 " transmission, passage 17 " directly link to each other with blood vessel 14 or spongy body inner chamber, promptly not by the passage in the ultrasonic instrument 1.Individual passage 17 " be used for linking to each other with 17 ' with passage 17 or with passage 17, perhaps replace the two.
For liquid phase transmission channel 17 being connected to the passage in the ultrasonic instrument 1, used the connecting device that is used for connecting ultrasonic instrument.
For this reason, passage 17 or link to each other with passage in the acoustic elements 12, ultrasonic instrument 1 is connected with acoustic elements 12, shown in Fig. 8 and 9 (a), and by Reference numeral 17 " expression, passage 17 or the such direct and ultrasonic instrument 1 shown in Fig. 9 (б) link to each other, by Reference numeral 17 expressions.
An example realizing described method is to make hemorrhoid be subjected to action of ultrasonic waves.Figure 10 has schematically shown the anus catheter 19 that hemorrhoid 14 are arranged.For acting on hemorrhoid, use ultrasonic instrument 1, ultrasonic instrument 1 comprises concentrator-waveguide, and concentrator-waveguide has tip and working portion, most advanced and sophisticated and working portion is used for transmitting the ultrasonic frequency mechanical vibration, and purpose is that wall and the inner chamber to hemorrhoid 14 (a kind of spongy body) applies effect.The ultrasonic frequency mechanical vibration offer ultrasonic instrument 1 from generator and acoustic elements (not shown).The wall of hemorrhoid 14 is thrust at the tip of ultrasonic instrument 1, and by described acanthopore the working portion 3 that applies the ultrasound wave effect in hemorrhoid 14 is inserted, as shown in figure 11.Simultaneously, sclerosing agent or sclerosant 20 from the quantifier (not shown) by the channel transfer in the ultrasonic instrument 1 in hemorrhoid 14.Sclerosing agent infiltrates the wall of hemorrhoid 14 dearly under action of ultrasonic waves.The tissue that concentrator-the waveguide heating contacts with concentrator-waveguide surface reaches temperature to make the degree of described coagulation of tissues.Agglomerative result has formed passage 21, can not collapse at this place's wall, and promptly they safeguard inner chamber after instrument is drawn back, as shown in figure 12.This class passage 12 is called the passage that condenses.Along the passage 21 that condenses, after instrument 1 is drawn back, in the independent inner chamber that any excessive medicament that causes the hardening of tissue or material all flow out to rectum, shown in the arrow among Figure 12 22.The outflow of any excessive medicament that causes the hardening of tissue can reduce the downright bad probability of chemistry of hemorrhoid.According to another embodiment, before drawing back instrument 1, the excessive medicament that causes the hardening of tissue is discharged by the ground of the being forced to property of passage in working portion and the concentrator-waveguide.
Optimal way is that the following parameters of the passage 21 that condenses should select to make the ligament organ of formation that the most effective function subsequently is provided:
The length of passage is the 15-40 millimeter, terminates near the rectum muscular wall;
The cross section of passage is irregular geometry;
With the angle of inclination of anus tube wall about 15 °-45 °;
The longitudinal axis of passage is a curve;
The time of bearing the ultrasound wave effect is about 10 to 20 seconds.
Blood vessel or spongy body are applied the described method of ultrasound wave effect, and the application in practice of system and instrument has obtained lasting effectively effect, and particularly in the treatment of hemorrhoid in third and fourth stage, following Example can be issued a certificate.
Example 1Patient V. is born in nineteen thirty-seven, suffers from hemorrhoid 15 years.Nearest 5 years, hemorrhoid were often from the prolapsus of anus pipeline and can only it holder be returned with hands during each defecation.Have 2-3 time hemorrhage every year, but amount of bleeding is little.
Check and find the internal hemorrhoid hypertrophy, its diameter is 3,7, and the diameter of the position at 11 o'clock reaches 2.5 centimetres.External hemorrhoid does not have hyperplasia, does not have hyperemia.
This patient adopts sclerotherapy to utilize ultrasonic instrument to treat.Using the amount of thrombosis paste is 2.0 milliliters.The piercing portion of instrument is thrust hemorrhoid wall and near tissue, and the rectum muscular wall is brought in concentrator-waveguide into, and bears the ultrasound wave effect after 15 seconds at this position, and instrument is drawn back.The position at 3,7,11 o'clock has been carried out this processing simultaneously.Any painful symptom do not occur, the patient restarted work (his work is the assembling electrician) in second day.
Further inspection after one month, to be objective, the position at 3,7,11 o'clock in anus catheter, hemorrhoidal tissue exists not obviously grows, and diameter is 0.8 centimetre; There is not hyperemia.Subjectively say, report: defecate every day, do not have pain; Without any hemorrhoid prolapsus or hemorrhage generation.
Example 2Patient L. is born in 1948, suffers from hemorrhoid 20 years.Nearest 6 years, bleeding hemorrhoids and from the prolapsus of anus pipeline and can only it holder be returned during each defecation with hands.Amount when hemorrhage was very big in nearest 1 year.
Check and find the internal hemorrhoid hypertrophy, its diameter is 3,7, and the diameter of the position at 11 o'clock reaches 2.5 centimetres.The mucous membrane tissue edema, hyperemia.
This patient adopts sclerotherapy to utilize ultrasonic instrument to treat.The amount of using thrombosis to stick with paste is 2.0 milliliters.Any painful symptom do not occur, the patient does not call in sick.
Further inspection after one month, to be objective, in the position at 3,7,11 o'clock of anus pipeline, hemorrhoid reduce 1.0 centimetres and do not have pain; Do not find mucous membrane tissue hyperemia.Subjectively say, report: defecate every day, do not have pain; Without any hemorrhoid prolapsus or hemorrhage generation.
Example 3Patient G. is born in nineteen sixty-five, suffers from hemorrhoid 10 years.Hemorrhoid are from the prolapsus of anus pipeline, often edema during defecation.Amount when hemorrhage was very big in nearest 1 year.Once because of the massive hemorrhage hospitalization.
Check to find the hemorrhoid hypertrophy, diameter reaches 2.5-3.0 centimetre, and is hemorrhage and be converted into external hemorrhoid during contact.
This patient adopts sclerotherapy to utilize ultrasonic instrument to treat.Handle simultaneously the position at 3,7,11 o'clock.Moderate pain is taken the ketane pill and has promptly easily been alleviated misery.The patient does not call in sick.
After one month, adopt sclerotherapy to utilize ultrasonic instrument to treat once more.Hemorrhoid are handled in the position at 11 o'clock.Any painful symptom do not occur, the patient does not call in sick.Further check result after two months is as follows, to be objective, in the position at 3,7,11 o'clock of anus pipeline, finds that an intensive hemorrhoidal tissue grows into 0.8 centimetre of diameter, and mucous membrane tissue does not have hyperemia.External hemorrhoid has been shunk and has been reduced.Subjectively say, report: defecate every day, do not have pain; Do not have the hemorrhoid prolapsus, do not repeat hemorrhage.
Claims (20)
1. ultrasonic instrument, comprise concentrator-waveguide, concentrator-waveguide has tip and the outstanding working portion that is provided for puncturing blood vessel or sponge body wall, and most advanced and sophisticated and outstanding working portion is used for transmitting the ultrasonic frequency mechanical vibration to the wall of blood vessel or spongy body and inner chamber and to the wall and the inner chamber effect of blood vessel or spongy body.
2. ultrasonic instrument according to claim 1 is characterized in that working portion is a convex.
3. ultrasonic instrument according to claim 1 is characterized in that working portion is the convex-concave shape.
4. ultrasonic instrument according to claim 1 is characterized in that working portion is embodied as the rotation geometry body.
5. ultrasonic instrument according to claim 1 is characterized in that the tip is the form of rotary body.
6. ultrasonic instrument according to claim 1 is characterized in that the tip is embodied as polyhedron.
7. according to claim 5 or 6 described ultrasonic instruments, it is characterized in that the tip is the form of pin.
8. ultrasonic instrument according to claim 1 is characterized in that the tip is dismountable.
9. according to each the described ultrasonic instrument among the claim 1-8, it is characterized in that the concentrator-waveguide of ultrasonic instrument is provided with the passage that is used for the liquid phase transmission.
10. ultrasonic instrument according to claim 9 is characterized in that most advanced and sophisticated interior at least one passage of arranging.
11., it is characterized in that concentrator-waveguide is flexible according to each the described ultrasonic instrument among the claim 1-10.
12. ultrasonic instrument according to claim 1, the longitudinal axis that it is characterized in that the most advanced and sophisticated longitudinal axis and working portion is conllinear not.
13. a system that is used for blood vessel or spongy body are applied the ultrasound wave effect comprises according to each described ultrasonic instrument among the claim 1-12, supplies with the ultrasonic signal generator of ultrasonic instrument signal; Be used to transmit and discharge the device of liquid phase, this device has at least one passage that is used to transmit liquid phase; Liquid phase transmission and discharger have bidirectional driving apparatus, when the bidirectional driving apparatus positive movement, be suitable for collecting liquid phase, and when adverse movement, be suitable for discharging liquid phase by at least one passage that is used to transmit liquid phase by at least one passage that is used to transmit liquid phase.
14. system according to claim 13 is characterized in that the collection of liquid phase and discharges by one and be that same liquid phase transmission channel is carried out.
15. system according to claim 13 is characterized in that being used to transmitting and the device of discharging liquid phase is provided with manual driving device.
16. system according to claim 15 is characterized in that being used to transmitting and the device of discharging liquid phase is embodied as syringe.
17. system according to claim 13 is characterized in that being used to transmitting and the device of discharging liquid phase is provided with electric mechanical driving device.
18. system according to claim 17 is characterized in that being used to transmitting and the device of discharging liquid phase is embodied as the form of piston type or rotator type discharger.
19. system according to claim 13 is characterized in that at least one liquid phase transmission channel is suitable for linking to each other with respective channel in the ultrasonic instrument.
20. system according to claim 19, it is further characterized in that the device that is used to connect ultrasonic instrument, is provided for the liquid phase transmission channel is connected to passage in the ultrasonic instrument.
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| RU2001119003 | 2001-07-06 | ||
| RU2001119003/14A RU2214193C2 (en) | 2001-07-06 | 2001-07-06 | Method, system and instrument for ultrasonic action on blood vessel or cavernous body |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CN1529568A CN1529568A (en) | 2004-09-15 |
| CN100406080C true CN100406080C (en) | 2008-07-30 |
Family
ID=20251554
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CNB028135741A Expired - Fee Related CN100406080C (en) | 2001-07-06 | 2002-07-05 | Method, system and device for altrasonic action on blood vessel or cavernous body |
Country Status (5)
| Country | Link |
|---|---|
| CN (1) | CN100406080C (en) |
| EA (1) | EA005660B1 (en) |
| RU (1) | RU2214193C2 (en) |
| UA (1) | UA76763C2 (en) |
| WO (1) | WO2003003929A1 (en) |
Families Citing this family (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| RU2463090C1 (en) * | 2011-07-20 | 2012-10-10 | Сергей Иванович Ларин | Method of sclerosing therapy of hemorrhoid with use of vibroacoustic exposure |
| EA031620B1 (en) * | 2015-10-28 | 2019-01-31 | Республиканское Инновационное Унитарное Предприятие "Научно-Технологический Парк Бнту "Политехник" | Device for removal of blood vessel obstruction |
| RU2625277C1 (en) * | 2016-05-11 | 2017-07-12 | федеральное государственное бюджетное образовательное учреждение высшего образования "Ростовский государственный медицинский университет" Министерства здравоохранения Российской Федерации (ФГБОУ ВО РостГМУ Минздрава России) | Method for chronic haemorrhoid low-invasive treatment |
| WO2022260556A2 (en) * | 2021-06-11 | 2022-12-15 | Общество С Ограниченной Ответственностью "Научно-Производственное Объединение"Симбитек" | Device for performing surgical operations using ultrasonic vibrations |
Citations (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| RU2033754C1 (en) * | 1990-08-14 | 1995-04-30 | Леонтьева Татьяна Николаевна | Method of treatment of chronic sphenoiditis and device for treatment |
| CN2235269Y (en) * | 1996-02-09 | 1996-09-18 | 清华大学 | Ultrasonic surgical instrument |
| CN2280497Y (en) * | 1996-03-13 | 1998-05-06 | 南京铁道医学院 | Multifunction supersonic operation scalpel |
| RU2126660C1 (en) * | 1996-09-11 | 1999-02-27 | Педдер Валерий Викторович | Method of recovery of uterine tube permeability and device for its realization |
| CN1277064A (en) * | 1999-06-10 | 2000-12-20 | 上海东方肝胆外科医院 | Supersonic melting system for treating liver cancer and portal vein cancer |
Family Cites Families (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| SU1507353A1 (en) * | 1987-07-06 | 1989-09-15 | МВТУ им.Н.Э.Баумана | Ultrasonic surgical instrument for the rupture of vein valves |
| AU6418394A (en) * | 1993-03-22 | 1994-10-11 | Aziz Yehia Anis | Removal of tissue |
-
2001
- 2001-07-06 RU RU2001119003/14A patent/RU2214193C2/en not_active IP Right Cessation
-
2002
- 2002-05-07 UA UA2004020836A patent/UA76763C2/en unknown
- 2002-07-05 EA EA200400151A patent/EA005660B1/en not_active IP Right Cessation
- 2002-07-05 WO PCT/RU2002/000326 patent/WO2003003929A1/en not_active Application Discontinuation
- 2002-07-05 CN CNB028135741A patent/CN100406080C/en not_active Expired - Fee Related
Patent Citations (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| RU2033754C1 (en) * | 1990-08-14 | 1995-04-30 | Леонтьева Татьяна Николаевна | Method of treatment of chronic sphenoiditis and device for treatment |
| CN2235269Y (en) * | 1996-02-09 | 1996-09-18 | 清华大学 | Ultrasonic surgical instrument |
| CN2280497Y (en) * | 1996-03-13 | 1998-05-06 | 南京铁道医学院 | Multifunction supersonic operation scalpel |
| RU2126660C1 (en) * | 1996-09-11 | 1999-02-27 | Педдер Валерий Викторович | Method of recovery of uterine tube permeability and device for its realization |
| CN1277064A (en) * | 1999-06-10 | 2000-12-20 | 上海东方肝胆外科医院 | Supersonic melting system for treating liver cancer and portal vein cancer |
Also Published As
| Publication number | Publication date |
|---|---|
| WO2003003929A1 (en) | 2003-01-16 |
| UA76763C2 (en) | 2006-09-15 |
| RU2214193C2 (en) | 2003-10-20 |
| CN1529568A (en) | 2004-09-15 |
| EA200400151A1 (en) | 2004-06-24 |
| EA005660B1 (en) | 2005-04-28 |
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| C10 | Entry into substantive examination | ||
| SE01 | Entry into force of request for substantive examination | ||
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Granted publication date: 20080730 Termination date: 20180705 |