CN101390785A - 操作超声机头的方法 - Google Patents

操作超声机头的方法 Download PDF

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CN101390785A
CN101390785A CNA2008101769379A CN200810176937A CN101390785A CN 101390785 A CN101390785 A CN 101390785A CN A2008101769379 A CNA2008101769379 A CN A2008101769379A CN 200810176937 A CN200810176937 A CN 200810176937A CN 101390785 A CN101390785 A CN 101390785A
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V·P·英杰夫
R·J·斯昂尼
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Abstract

一种采用具有至少一组在以相关共振频率激励时被极化来产生纵向运动的压电元件的机头的方法。压电晶体连接到附接切割尖端的超声变幅杆。该变幅杆和/或切割尖端包含多个对角裂缝或凹槽。该裂缝或凹槽在压电晶体被以第二共振频率激励时在切割尖端中产生优化的扭转运动。当处于扭转模式时，物质可能阻塞切割尖端。本方法包括在检测到阻塞时提供尖端的纵向运动的脉冲的步骤。

Description

操作超声机头的方法
技术领域
本发明涉及超声设备，并且更具体地，涉及用于控制眼科晶状体乳化机头的设备。
背景技术
适于眼科手术的典型超声外科手术设备包括：超声驱动的机头、附接的空心切割尖端、冲洗套管和电子控制台。机头组件通过电缆和柔性管附接到控制台。通过该电缆，控制台改变通过机头传输到附接的切割尖端的功率水平，并且通过机头组件，柔性管提供冲洗液体到眼睛以及从眼睛抽取吸出液体。
机头的操作部分是直接附接到一组压电晶体的位于中央的空心共振杆或变幅杆(horn)。该晶体提供在晶状体乳化期间驱动变幅杆和附接的切割尖端所需的必要超声振动且由控制台控制。通过相对固定的支架，晶体/变幅杆组件在其节点悬挂在机头的空心体或壳内。机头体终止于体远端处的直径减少部分或头锥。头锥外部刻有螺纹以接受冲洗套管。同样，变幅杆孔在其远端内部刻有螺纹以容纳切割尖端的外部螺纹。冲洗套管也具有内部刻有螺纹的孔，其拧到头锥的外部螺纹上。调整切割尖端，使得该尖端仅凸出超过冲洗套管的开口端预定量。超声机头和切割尖端在美国专利No.3,589,363；4,223,676；4,246,902；4,493,694；4,515,583；4,589,415；4,609,368；4,869,715；以及4,922,902中更全面地描述，在此通过引用并入其全部内容。
当用于执行晶状体乳化时，切割尖端和冲洗套管的末端被插入眼组织的角膜、巩膜或其它位置的预定宽度的小切口中，以便获得访问眼睛的前腔室。切割尖端通过晶体驱动的超声变幅杆(ultrasonic horn)在冲洗套管内沿其纵轴超声地振动，由此通过接触在原处选择的组织而使其乳化。切割尖端的空心孔与变幅杆中的孔接口，该变幅杆中的孔再与从机头到控制台的吸出线接口。控制台中减少的压力或真空源通过切割尖端的开口端、切割尖端的孔、变幅杆孔、以及抽吸线，从眼睛中汲取或抽吸乳化的组织，并收集到收集设备中。由通过冲洗套管的内表面和切割尖端的外表面之间的小环形缝隙注入手术点的盐冲洗液或冲洗剂，来帮助乳化组织的抽吸。该冲洗剂还维持眼睛中的液体平衡并且帮助眼睛保持其形状。
已经有之前的尝试来组合切割尖端的超声纵向运动与尖端的旋转运动，见美国专利No.5,222,959(Anis)、5,722,945(Anis等人)和4,504,264(Kelman)，在此通过引用并入其全部内容。这些之前的尝试已经使用了电动马达来提供尖端的旋转，这要求O环或其它封装，其除了增加的复杂性和可能的马达故障外，还可能出现故障。
还已经有之前的尝试来产生纵向和扭转运动而不使用电动马达。例如，在美国专利No.6,028,387、6,077,285和6,402,769(Boukhny)中，描述了具有两对压电晶体的机头。一对被极化来产生纵向运动。另一对被极化来产生扭转运动。两个分开的驱动信号被用于驱动两对晶体。在实际实践中，制造使用在纵向和扭转方向上共振的两对晶体的机头难以实现。一种可能的解决方案在美国专利公开No.US 2001/0011176 A1(Boukhny)中描述。该引用文献公开了一种机头，具有产生纵向运动的单组压电晶体，以及在机头的变幅杆或尖端上的一系列对角裂缝，其在变幅杆或尖端以压电晶体的共振频率驱动时产生扭转运动。再次，在实践中，压电晶体和变幅杆或尖端的共振频率不一致，因此同时的纵向和扭转运动难以实现。
因此，持续存在对将同时或分开地在纵向和扭转上振动的可靠超声机头的需要。
发明内容
本发明通过提供一种具有至少一组在以相关共振频率激励时被极化来产生纵向运动的压电元件的机头，改进了现有技术超声机头操作方法。压电晶体连接到附接有切割尖端的超声变幅杆。该变幅杆和/或切割尖端包含多个对角裂缝或凹槽。该裂缝或凹槽在压电晶体被以第二共振频率激励时在切割尖端中产生优化的扭转运动。当处于扭转模式时，物质可能阻塞切割尖端。本方法包括在检测到阻塞时提供尖端的纵向运动的脉冲的步骤。
因此，本发明的一个目地是，提供一种具有纵向和扭转运动两者的超声机头。
本发明的另一目地是，提供一种具有变幅杆的超声机头，该变幅杆具有一系列对角裂缝来产生扭转运动。
参照附图以及附图的以下描述和权利要求，本发明的其它目的、特征和优点将变得明显。
附图说明
图1是可用于本发明的方法的、移除了外壳的机头的透视图。
图2是可用于本发明的方法的超声变幅杆的透视图。
图3是可用于本发明的驱动电路的方块图。
图4是可用于本发明的机头和控制台的透视图。
具体实施方式
如图4中最佳所见，适于本发明使用的外科手术控制台320可以是任何商业可获得的外科手术控制台，如从Alcon Laboratories公司(Fort Worth，得克萨斯)可获得的
Figure A200810176937D0007110647QIETU
外科手术系统。控制台320通过冲洗线322和抽吸线50连接到机头10，并且由用户例如经由脚踏开关326来控制通过线322和50的流动。电力通过电缆400提供给机头。
如图1中最佳所见，本发明的机头10通常包括超声变幅杆12，其典型地由钛合金制成。变幅杆12具有多个螺旋状裂缝，其将在以下描述。多个(典型地1或2对)环形压电元件14由压缩螺母15保持与变幅杆12相对。抽吸轴16通过变幅杆12、压电元件14、螺母15以及通过机头10远端处的塞子18向下延伸机头10的长度。抽吸管16允许物质通过附接到变幅杆12的空心尖端20被抽吸，并且通过和吸出机头10。塞子18流体密封机头10的外壳11，允许机头10被加高压灭菌而没有不利地影响压电元件14。在变幅杆12上提供了用于密封O环垫圈(未示出)的附加凹槽22。
如图2中最佳所见，变幅杆12包含多个螺旋状裂缝24。优选地，裂缝24的宽度在变幅杆12的外径的2％和65％之间。这当然将影响在变幅杆12上能够制造多少个裂缝24(例如，如果裂缝24为变幅杆12的外径的65％，则在变幅杆12上只能制造1个裂缝24)。选择的裂缝24宽度将取决于期望的扭转运动。裂缝24在变幅杆12中的深度优选地在变幅杆12的外径的4％和45％之间。裂缝24可以具有平的或方形的切割底部，但优选地具有圆的或切成圆弧的底部，其易于制造。裂缝24的长度优选地在变幅杆12的较大直径的长度的8％和75％之间。裂缝24的螺距优选地在变幅杆12的较大直径的125％和500％之间。通过示例的方式，发明人已经发现，具有0.475英寸外径的变幅杆12上的裂缝24的一种适当配置为总共8个裂缝24，其具有0.04英寸的宽度、0.140的深度(具有全圆角底部)、0.7英寸的长度以及1.35英寸的螺距，给出变幅杆12的适当扭转运动，而不危害变幅杆12的纵向运动。
如图1中最佳所见，纵向和扭转节点(具有各自模式的零速度的点)的位置对于机头10的合适机能是重要的。扭转节点26优选地位于最接近的纵向节点28，使得扭转节点26和纵向节点28一致，例如，这两个节点都位于塞子18上。机头10还包含位于变幅杆12的直径减少部分32处的远端纵向节点30。
如图3中最佳所见，可用于本发明的机头10的驱动电路34优选地类似于在美国专利No.5,431,664中描述的驱动电路，在此通过引用并入其全部内容，其中，该驱动电路34跟踪机头10的导纳并控制机头10的频率以维持恒定导纳。然而，驱动电路34监视扭转模式和纵向模式，并且使用两个不同驱动频率来控制机头10中的这些模式。优选地，扭转驱动信号为大约32kHz而纵向驱动信号为44kHz，但是，这些频率将根据使用的压电元件14和变幅杆12和裂缝24的大小和形状而改变。尽管纵向或扭转驱动信号可以以持续方式提供，但是优选地纵向驱动信号和扭转驱动信号交替，使得驱动信号以一个频率的期望脉冲提供，然后切换到另一个频率用于类似脉冲，在两个频率之间没有重叠，但在驱动信号中没有间隔或暂停。选择性地，驱动信号可以以所述类似的方式操作，但可引入驱动信号中的短的暂停或间隔。此外，驱动信号的幅度可对于每个频率独立地调整和设置。
驱动信号之间的暂停或间隔可以用于各种目的。一个目的是允许压电元件14和变幅杆12的超声运动衰减或停止，使得晶状体碎片能够再次被吸到尖端20并且重新建立吸留，由此增加对于晶状体碎片的保持力。重新建立吸留将增加后续超声脉冲的切割效率，无论纵向或扭转。驱动信号之间的暂停或间隔的另一个目的是允许在另一个(纵向或扭转)模式被激励之前，压电元件14和变幅杆12的超声运动衰减或停止。驱动信号之间的这种衰减将减少系统中的潜在非线性相互作用的量，系统中的潜在非线性相互作用能够产生不期望的热并导致压电元件14的太早劣化或整个组件的机械故障。
替代地，在纵向和扭转驱动信号之间可以有轻微的重叠。该重叠可在扭转和纵向位移的增加动作导致特别快速率的晶状体乳化时，提供相对短的时间间隔，并且该重叠足够短以便防止作为过度应力的结果压电元件14太早劣化或整个组件的机械故障。
另一替代是如果纵向和扭转驱动信号完全重叠因此导致当两个信号重叠时施加高的应力水平到晶状体物质，在吸留自身重新建立和真空建立之间留下暂停，因此改进了后续脉冲应用的效率。
另一替代是施加连续纵向信号以及脉动扭转信号，或反之亦然，施加连续扭转信号以及脉动纵向信号。扭转超声的连续应用不会引起斥力，因为尖端20的运动方向垂直于尖端20与晶状体接合的方向，并且纵向超声的脉冲应用足够短，以便防止压电元件14的过热或机械损害。
此外，如上面讨论的，纵向和扭转驱动信号可被连续和同时地施加，两种信号的幅度被选择成使得减少系统的过热和过度机械应力。如果这样的驱动方案被使用，则优选两组压电元件14，扭转信号施加到一组压电元件，而纵向信号施加到另一组压电元件。
最后，尖端的纵向运动以类似于蠕动泵浦的方式来帮助清除被吸入尖端的物质。尖端的扭转运动不产生该蠕动运动。结果，尖端20在使用纯扭转运动时可趋于阻塞。尖端的阻塞通过抽吸线50中的抽吸真空的升高而明显，这样的真空由泵70产生。因此，当抽吸真空的增加在抽吸线50中被压力传感器60检测到时，传感器60提供该信息给驱动电路34。当检测的真空超过预定阈值时，纵向模式能够被暂时使能或强度或持续时间被增加以帮助清除任何阻塞。本领域技术人员将认识到：能够根据要求来进行纵向脉冲的持续时间和/或定时的变化以充分清除尖端的任何阻塞。此外，一定的较高扭转功率水平可能比较低功率水平更倾向于阻塞。因此，当扭转功率水平达到预先选择的功率水平时，纵向运动可被自动触发并且处于变化的功率水平。本领域技术人员还将认识到：术语“功率水平”包括幅度(冲程)和脉冲占空因数。
尽管上面已经描述了本发明的某些实施例，然而给出这些描述用于图示和解释的目的。可以采用上面公开的系统和方法的变化、改变、修改和偏离，而不偏离本发明的范围或精神。例如，主要驱动信号可以具有第一频率并且使能扭转运动，同时次要驱动信号可以具有第二频率并且使能纵向运动，或反之亦然。

Claims (23)

1.一种操作超声机头的方法，包括：
a)提供具有机头外壳、连接到超声变幅杆的多个压电元件以及抽吸线的超声机头，所述压电元件和变幅杆保持在所述外壳内；
b)使所述压电元件经受具有第一频率的驱动信号，所述第一频率在变幅杆中产生扭转运动；
c)检测所述抽吸线中的真空；以及
d)当检测的抽吸线中的真空超过预定阈值时，使所述压电元件经受具有第二频率的驱动信号，所述第二频率在变幅杆中产生纵向运动。
2.如权利要求1所述的方法，其中，具有第一频率的驱动信号和具有第二频率的驱动信号不重叠。
3.如权利要求1所述的方法，其中，具有第一频率的驱动信号和具有第二频率的驱动信号重叠。
4.如权利要求1所述的方法，其中，具有第一频率的驱动信号被连续地施加，以及响应于检测的抽吸线中的真空而脉动地施加具有第二频率的驱动信号。
5.如权利要求4所述的方法，其中，具有第一频率的驱动信号或具有第二频率的驱动信号具有可变脉冲持续时间和/或定时。
6.一种操作超声机头的方法，包括：
a)提供具有机头外壳、连接到超声变幅杆的多个压电元件以及抽吸线的超声机头，所述压电元件和变幅杆保持在所述外壳内；
b)使所述压电元件经受主要驱动信号；
c)检测抽吸线中的真空；以及
d)当检测的抽吸线中的真空超过预定阈值时，使所述压电元件经受次要驱动信号。
7.如权利要求6所述的方法，其中，所述主要驱动信号和次要驱动信号不重叠。
8.如权利要求6所述的方法，其中，所述主要驱动信号和次要驱动信号重叠。
9.如权利要求6所述的方法，其中，所述主要驱动信号被连续地施加，以及响应于检测的抽吸线中的真空而脉动地施加所述次要驱动信号。
10.如权利要求6所述的方法，其中，所述主要驱动信号具有可变脉冲持续时间和/或定时。
11.如权利要求6所述的方法，其中，所述主要驱动信号或次要驱动信号具有可变脉冲持续时间和/或定时。
12.一种操作超声机头的方法，包括：
a)提供具有机头外壳、连接到超声变幅杆的多个压电元件的超声机头，所述压电元件和变幅杆保持在所述外壳内；
b)使所述压电元件经受主要驱动信号；以及
c)当所述主要驱动信号达到预先选择的功率水平时，使所述压电元件经受次要驱动信号。
13.如权利要求12所述的方法，其中，所述主要驱动信号和次要驱动信号不重叠。
14.如权利要求12所述的方法，其中，所述主要驱动信号和次要驱动信号重叠。
15.如权利要求12所述的方法，其中，所述主要驱动信号被连续地施加，而所述次要驱动信号被脉动地施加。
16.如权利要求12所述的方法，其中，所述主要驱动信号或次要驱动信号具有可变脉冲持续时间和/或定时。
17.如权利要求12所述的方法，其中，所述次要驱动信号具有可变功率水平。
18.一种操作超声机头的方法，包括：
a)提供具有机头外壳、连接到超声变幅杆的多个压电元件的超声机头，所述压电元件和变幅杆保持在所述外壳内；
b)使所述压电元件经受可变主要驱动信号；以及
c)当所述主要驱动信号达到预先选择的功率水平时，使所述压电元件经受可变次要驱动信号。
19.如权利要求18所述的方法，其中，所述主要驱动信号和次要驱动信号不重叠。
20.如权利要求18所述的方法，其中，所述主要驱动信号和次要驱动信号重叠。
21.如权利要求18所述的方法，其中，所述主要驱动信号被连续地施加，而所述次要驱动信号被脉动地施加。
22.如权利要求18所述的方法，其中，所述主要驱动信号或次要驱动信号具有可变脉冲定时。
23.如权利要求18所述的方法，其中，所述次要驱动信号具有可变功率水平。
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CN104185460A (zh) * 2011-07-08 2014-12-03 爱尔康研究有限公司 白内障超声乳化术手持件的动力的真空度控制
CN104840252A (zh) * 2014-02-14 2015-08-19 柯惠Lp公司 止端检测
CN104840252B (zh) * 2014-02-14 2019-02-01 柯惠Lp公司 止端检测
CN113367772A (zh) * 2015-12-18 2021-09-10 史赛克公司 超声手术工具系统
CN109310520A (zh) * 2016-06-24 2019-02-05 诺华股份有限公司 具有柔性叶轮泵的超声乳化手持件
CN110753522A (zh) * 2017-01-17 2020-02-04 雷德利科学有限公司 用于整形外科手术的扭转超声波发生器
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