CN101355910A - 医疗超声器械 - Google Patents

医疗超声器械 Download PDF

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CN101355910A
CN101355910A CNA2006800504134A CN200680050413A CN101355910A CN 101355910 A CN101355910 A CN 101355910A CN A2006800504134 A CNA2006800504134 A CN A2006800504134A CN 200680050413 A CN200680050413 A CN 200680050413A CN 101355910 A CN101355910 A CN 101355910A
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CN101355910B (zh
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K·L·豪泽
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Ethicon Endo Surgery Inc
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
    • A—HUMAN NECESSITIES
    • 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
    • A—HUMAN NECESSITIES
    • 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
    • A61B17/225—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 for extracorporeal shock wave lithotripsy [ESWL], e.g. by using ultrasonic waves
    • A61B17/2251—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 for extracorporeal shock wave lithotripsy [ESWL], e.g. by using ultrasonic waves characterised by coupling elements between the apparatus, e.g. shock wave apparatus or locating means, and the patient, e.g. details of bags, pressure control of bag on patient
    • A—HUMAN NECESSITIES
    • 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
    • A61B17/22012—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 in direct contact with, or very close to, the obstruction or concrement
    • A61B2017/22014—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 in direct contact with, or very close to, the obstruction or concrement the ultrasound transducer being outside patient's body; with an ultrasound transmission member; with a wave guide; with a vibrated guide wire
    • A61B2017/22015—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 in direct contact with, or very close to, the obstruction or concrement the ultrasound transducer being outside patient's body; with an ultrasound transmission member; with a wave guide; with a vibrated guide wire with details of the transmission member
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
    • A61B2017/320089—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic node location

Abstract

一种医疗超声器械，其包括超声换能器、医疗超声刀和用于容纳液体的管。管第一端适于在管中容纳有液体时使邻近管第一端的液体被超声振动以产生超声振动能量波。当管中容纳有液体时，超声刀通过声学方式连接于邻近管第二端的液体。另一种医疗超声器械，其包括热脉冲激发器、医疗超声刀和用于容纳液体的管。热脉冲激发器用于输出具有超声脉冲频率的热脉冲。管第一端适于接收热脉冲激发器输出的热脉冲，其中当管中容纳有液体时，热脉冲的能量足以在该液体中产生超声振动能量波。

Description

医疗超声器械
技术领域
本发明总体上涉及医疗器械，更具体而言涉及具有医疗超声刀的一种医疗超声器械。
背景技术
已知的医疗超声器械包括那些具有钛棒形式的超声手术刀的医疗超声器械。所述超声手术刀用于切割患者的组织和闭合血管以防止出血。该超声手术刀连接到手持件上，并以声学方式连接到容纳在该手持件中的超声换能器。该超声换能器通过电缆可操作地连接于超声发生器。还已知的是可进行关节运动的医用导管，例如，内窥镜管。
尽管如此，科学家和工程师仍在继续寻求具有医疗超声刀的改进的医疗超声器械。
发明内容
本发明的第一实施方式的第一种表现形式是一种医疗超声器械，该医疗超声器械包括超声换能器、医疗超声刀和管。该管用于容纳液体，并具有管第一端和管第二端。管第一端适于在管中容纳有液体时使邻近管第一端的液体被超声振动以便产生超声振动能量波。当管中容纳有液体时，超声刀通过声学方式连接到邻近管第二端的液体。
本发明的第二实施方式的第一种表现形式是一种医疗超声器械，该医疗超声器械包括热脉冲激发器、医疗超声刀和管。该热脉冲激发器适于输出具有超声脉冲频率的热脉冲。该管适于容纳液体，并具有管第一端和管第二端。管第一端适于接收热脉冲激发器输出的热脉冲。当管中容纳有液体时，超声刀通过声学方式连接到邻近管第二端的液体。
从本发明的一种或者多种实施方式可以得到数种益处和优点。在第一和/或第二实施方式的一种实施例中，所述管是柔性管，并且可以在医疗操作过程中由使用者控制地弯曲，以允许医疗超声刀更容易接近患者身上的目标位置。
本发明可应用于、但不限于带有或不带有夹钳臂的直线型或者弧型超声手术刀，以及手动器械和机器人辅助器械。
附图说明
图1是本发明的医疗超声器械的第一实施方式的部分以剖面示出的示意图，其中发生器位于容纳超声换能器的壳体的外面，并且护套是短护套；
图2是类似于图1的图1中器械的替换实施方式的视图，其中发生器位于容纳超声换能器的壳体的内部，并且护套是长护套；
图3是类似于图1的图1中器械的替换实施方式的视图，其中管具有肩部，并且没有护套；
图4是本发明的医疗超声器械的第二实施方式的部分以剖面示出的示意图，所述医疗超声器械包括热脉冲激发器，该热脉冲激发器是电阻性或者射频柔性电线的一端的形式；以及
图5是图4中热脉冲激发器及相关组件的替换实施方式的示意图，其中该热脉冲激发器是柔性激光纤维的一端的形式。
具体实施方式
在详细说明本发明之前，应该注意到，本发明的应用或者使用不限于附图和说明书所示部件的结构和布置的细节。本发明的示例性实施方式可以其他实施方式、改变和变型来实施，或者结合到其他实施方式、改变和变型中，并且可以各种方式实践或者实现。此外，除非另外指出，这里采用的术语和措辞是用于说明本发明的示例性实施方式以便读者理解，而不是为了限制本发明。
应该理解，任意一种或者多种下述实施方式、实施例等可以与任意一种或者多种其他下述实施方式、实施例等结合。
现在参考附图，其中相同的附图标记表示相同的元件，图1示出了本发明的第一实施方式。图1中实施方式的第一种表现形式是一种医疗超声器械10，其包括超声换能器12、医疗超声刀14(例如但不限于钛超声刀)和管16。管16适于容纳液体18，并且具有管第一端20和管第二端22。管第一端20适于在管16中容纳有液体18时使邻近管第一端20的液体18被超声振动，以产生超声振动能量波。当管16中容纳有液体18时，超声刀14通过声学方式连接于邻近管第二端22的液体18。注意，术语“邻近”包括但不限于术语“在…处”。在一种未示出的实施例中，所述管是刚性管。
在图1中实施方式的第一种表现形式的一种实施例中，管16是柔性管，并且充有液体18。在同样的或者另外的实施方式中，液体18是一种至少部分脱气的液体或者基本上脱气的液体。在一种实施例中，超声振动时脱气液体比不脱气液体更不易于形成空穴。在同样的或者另外的实施例中，液体18是加压液体。在一种实施例中，超声振动时加压液体比不加压液体更不易于形成空穴。在同样的或者另外的实施例中，液体18主要包括水或者矿物油。
在图1中实施方式的第一种表现形式的一种结构中，超声刀14具有刀近端26和刀远侧部分28，并且刀远侧部分28适于接触和医治患者组织。在一种变型例中，该超声振动能量波具有振动波腹30，并且刀近端26靠近振动波腹30设置。在一种示意例中，该超声振动能量波作为压力脉冲传输通过液体18，并且超声刀14以一种在该压力脉冲传输时允许刀近端26运动和将能量回归到运动的方式被保持在管16上。
在一种变型例中，医疗超声器械10包括容纳超声换能器12的壳体24，其中管16连接到壳体24上。在一种实现方式中，壳体24和管16基本上不振动。在一种实施例中，壳体24和管16适于在刀远侧部分28接触和医治患者组织时由使用者把持。在一种实施方式中，医疗超声器械10包括超声发生器36，该超声发生器36设置于壳体24的外部并(例如通过长的电缆38)可操作地连接于超声换能器12。
在一种不同的实施例中，如图2中替换实施方式所示，其中护套132被略去，管116而不是壳体124适于在刀远侧部分128接触和医治患者组织时由使用者把持。在一种不同的实施方式中，如图2中替换实施方式所示，医疗超声器械110还包括超声发生器136，该超声发生器136设置于壳体124的内部并(例如通过短的电缆138)可操作地连接于超声换能器112。
如图3中替换实施方式所示的一种结构中，管216在管第一端220和管第二端222之间具有肩部217。在该结构中，管216在管第一端220和肩部217之间具有第一内径，并且在肩部217和管第二端222之间具有第二内径，其中该第一内径与第二内径不同。这将为压力脉冲提供增益步长。如图3所示，当第一内径大于第二内径时，增益步长大于一。当第一内径小于第二内径时(未示出)，增益步长小于一。图3中的实施方式还示出了医疗超声器械210的超声换能器212、超声刀214、壳体224、超声发生器236和电缆238。应当注意的是，在图3的实施方式中没有护套。
在图1中实施方式的第一种表现形式的第一种应用中，医疗超声器械10包括围绕并连接到超声刀14上的护套32。在一种实施例中，所连接的超声刀14具有至少一个振动节点34，并且护套32邻近所连接的超声刀14的所述至少一个振动节点34而连接到超声刀14。在一种变型例中，护套32是柔性的，并且不延伸至壳体24。在一种变型例中，护套32和壳体24适于在刀远侧部分28接触和医治患者组织时由使用者把持。在一种方式中，管16为相对短的管，并且使用者相对于手持式壳体24操纵手持式护套32，以便在医疗操作过程中弯曲管16，从而允许超声刀14更容易接近患者身上的目标位置。
在第二种应用中，如图2中替换实施方式所示，医疗超声器械110的护套132围绕并连接到管116上。在一种变型例中，护套132至少从刀近端126延伸至壳体124。在一种修改例中，护套132具有柔性部分140(其可在护套的整个长度上延伸)，并且当刀远侧部分128接触和医治患者组织时，是护套132而不是壳体124适于由使用者把持。在一种方式中，管116为相对长的管，壳体124设置于地板(或者其他合适的位置)上，并且使用者相对于非手持式壳体124操作手持式护套132，以便在医疗操作过程中弯曲管116，从而允许超声刀114更容易接近患者身上的目标位置。
在未示出的第三种应用中，其中所述管是柔性管，护套围绕该管并至少从刀近端延伸至壳体，该护套是连接于该管的遥控的可进行关节运动的护套(类似于柔性内窥镜的插入管)。
再次参考附图，图4示出了本发明的第二种实施方式。图4中实施方式的第一种表现形式是一种医疗超声器械42，该医疗超声器械42包括热脉冲激发器44、医疗超声刀46和管48。热脉冲激发器44适于输出具有超声脉冲频率的热脉冲。管48适于容纳液体50，并且具有管第一端52和管第二端54。管第一端52适于接收热脉冲激发器44输出的热脉冲。当管48中容纳有液体50时，超声刀46通过声学方式连接到邻近管第二端54的液体50。应当注意的是，该热脉冲的能量足以使液体50到达临界温度，这又导致液体50膨胀并形成压力波，该压力波在液体50中产生超声振动能量波，这些是本领域的技术人员可以理解的。在一种实施例中，管48充满液体18。在一种未示出的实施例中，所述管是柔性管。
图4中实施方式的第一种表现形式的一种实现方式中，管48是刚性管。在图4中实施方式的第一种表现形式的应用中，热脉冲激发器44由电源56驱动，并且热脉冲激发器44包括可操作地连接至电源56上的电阻性或者(双极)射频柔性电线60的端部58。在一种未示出的方式中，热脉冲激发器包括多个电阻性或者射频柔性电线的端部。在一种不同的应用中，如图5中替换实施方式所示，热脉冲激发器144由激光源156驱动，并且热脉冲激发器144包括可操作地连接至激光源156的柔性激光纤维160的端部158。在一种未示出的方式中，热脉冲激发器包括多个柔性激光纤维的端部。也可采用本领域的技术人员所知的其他热脉冲激发器。
应当注意的是，图1中第一实施方式以及图2和图3中替换实施方式的变型、构建、应用(包括护套)等同样可应用于将“超声换能器”替换为“热脉冲激发器”的图4中第二实施方式和图5中替换实施方式的第一种表现形式。
从本发明的一种或者多种实施方式可以得到几方面好处和优点。在第一和/或第二实施方式的一种实施例中，所述管是柔性管，并在医疗操作过程中由使用者可操作地弯曲以便允许该医疗超声刀更容易接近患者身上的目标位置。
虽然通过几种实施方式的描述对本发明做出了说明，但并不是用于约束或者限制所附权利要求的精神和范围。本领域的技术人员在不背离本发明的范围的条件下可做出许多其他变更、改变和替换。例如，该医疗超声器械应用在机器人辅助手术中，其中考虑了针对这种系统、组件、与这种机器人系统兼容的方法的各种修改。应该理解，前述说明是通过实施例进行的，并且本领域技术人员在不背离所附权利要求的范围和精神的条件下可做出其他修改。

Claims (20)

1.一种医疗超声器械，包括：
a)超声换能器；
b)医疗超声刀；以及
c)能够容纳液体的管，所述管具有管第一端和管第二端，其中所述管第一端能够在所述管中容纳有液体时使邻近所述管第一端的液体被超声振动，以便产生超声振动能量波，并且当所述管中容纳有液体时，所述超声刀通过声学方式连接到邻近所述管第二端的液体。
2.根据权利要求1所述的医疗超声器械，其中所述管是柔性管并且充有所述液体。
3.根据权利要求2所述的医疗超声器械，其中所述液体是至少部分脱气的液体。
4.根据权利要求2所述的医疗超声器械，其中所述液体是加压液体。
5.根据权利要求2所述的医疗超声器械，其中所述液体主要包括水或者矿物油。
6.根据权利要求2所述的医疗超声器械，其中所述超声刀包括刀近端和刀远侧部分，并且所述刀远侧部分能够接触和医治患者组织。
7.根据权利要求6所述的医疗超声器械，其中所述超声振动能量波具有振动波腹，并且所述刀近端邻近所述振动波腹设置。
8.根据权利要求7所述的医疗超声器械，还包括容纳所述超声换能器的壳体，其中所述管连接到所述壳体。
9.根据权利要求8所述的医疗超声器械，其中所述壳体和所述管在所述刀远侧部分接触和医治患者组织时能够由使用者把持。
10.根据权利要求9所述的医疗超声器械，还包括超声发生器，其设置于所述壳体的外面并能够操作地连接到所述超声换能器上。
11.根据权利要求8所述的医疗超声器械，其中在所述刀远侧部分接触和医治患者组织时使用者把持所述管而不是所述壳体。
12.根据权利要求11所述的医疗超声器械，还包括超声发生器，其设置于所述壳体的内部并能够操作地连接到所述超声换能器上。
13.根据权利要求2所述的医疗超声器械，其中所述管在所述管第一端和所述管第二端之间具有肩部，所述管在所述管第一端和所述肩部之间具有第一内径，所述管在所述肩部和所述管第二端之间具有第二内径，并且所述第一内径与所述第二内径不同。
14.根据权利要求2所述的医疗超声器械，还包括围绕并连接于所述超声刀上的护套。
15.根据权利要求2所述的医疗超声器械，还包括围绕并连接于所述管上的护套。
16.一种医疗超声器械，包括：
a)热脉冲激发器，用于输出具有超声脉冲频率的热脉冲；
b)医疗超声刀；以及
c)能够容纳液体的管，所述管具有管第一端和管第二端，其中所述管第一端能够接收由所述热脉冲激发器输出的所述热脉冲，并且其中在所述管中容纳有液体时，所述超声刀通过声学方式连接到邻近所述管第二端的液体。
17.根据权利要求16所述的医疗超声器械，其中所述管充有所述液体。
18.根据权利要求17所述的医疗超声器械，其中所述管是刚性管。
19.根据权利要求17所述的医疗超声器械，其中所述热脉冲激发器由电源驱动，并且所述热脉冲激发器包括能够操作地连接到所述电源上的电阻性或者射频柔性电线的一端。
20.根据权利要求17所述的医疗超声器械，其中所述热脉冲激发器由激光源驱动，并且所述热脉冲激发器包括能够操作地连接到所述激光源上的柔性激光纤维的一端。
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