CN101453958A - 超声手术器具 - Google Patents

超声手术器具 Download PDF

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CN101453958A
CN101453958A CNA2007800191420A CN200780019142A CN101453958A CN 101453958 A CN101453958 A CN 101453958A CN A2007800191420 A CNA2007800191420 A CN A2007800191420A CN 200780019142 A CN200780019142 A CN 200780019142A CN 101453958 A CN101453958 A CN 101453958A
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CN101453958B (zh
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迈克尔·约翰·拉德利·扬
斯蒂芬·迈克尔·拉德利·扬
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32Surgical cutting instruments
    • A61B17/320068Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32Surgical cutting instruments
    • A61B17/320068Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
    • A61B17/320092Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017Electrical control of surgical instruments
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017Electrical control of surgical instruments
    • A61B2017/00137Details of operation mode
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00017Electrical control of surgical instruments
    • A61B2017/00137Details of operation mode
    • A61B2017/00141Details of operation mode continuous, e.g. wave
    • A61B2017/00146Details of operation mode continuous, e.g. wave with multiple frequencies
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00353Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery one mechanical instrument performing multiple functions, e.g. cutting and grasping
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32Surgical cutting instruments
    • A61B17/320068Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
    • A61B2017/320089Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic node location

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  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Mechanical Engineering (AREA)
  • Dentistry (AREA)
  • Surgical Instruments (AREA)

Abstract

在手术器具的近端处,具有第一装置(3)以生成扭转剪切模态的超声振动。还具有第二装置(2)以生成纵向压缩模态的超声振动。波导(4)可操作地连接至两个生成装置,并且从所述生成装置处向设有切割及/或凝结装置的远端延伸nλ/2的距离。所述纵向压缩波的波长与所述扭转剪切波的波长之比λC∶λT为奇数。较佳为λC=NxλT(N为奇整数,且x为整数)。所述扭转超声振动模态的精巧剪切运动与所述纵向压缩波超声振动的更有力的激励相结合。

Description

超声手术器具
技术领域
本发明涉及一种用于切割及/或切除肌肉或血管之类软材料的超声手术器具。尤其涉及但不限于一种用于软材料的止血切割的器具,特别是用在腹腔镜手术系统中。
背景技术
长久以来公知的是通过以纵向模态振动的超声器具来切割及/或烧灼组织。这些器具的不利之处在于长时间使用于该模态会对在所用器具的端部周围的区域内的组织造成影响。首要的原因在于,业已开发出采用扭转模态超声振动的器具,如第GB2333709-B专利所描述的。使用这种可扭转振动的装置可使能量非常精确地指向具体的点。然而,某些情况下,比如待处理的组织较大,增大波导的远端处的爪的尺寸是有益的。在这种情况下,该扭转模态振动的较短波长就成为了其有利之处。
若扭转超声振动模态的精巧剪切运动带来的优点与纵向压缩波超声振动的更有力的激励相结合,这样是有利的。
单频率激活提供给有效长度与该工作频率的四分之一波长相关的远侧刀片。频率越高,刀片的工作长度越短。因此,对于扭转模态下工作频率为50kHz的钛波导,刀片长度应限制在15.5mm,该长度为限定第一远侧模态位置的四分之一波长。50kHz压缩波的相应刀片长度应为24.5mm。
各振动模态都有其自身的优点,但是,在任何情况下,以两种模态同时操作该器具都是不适当的。
发明内容
因此,本发明的一个目的是提供一种器具,其波导可以两种不同的交替频率间歇地操作,其中之一以扭转模态激发,另一个以纵向模态激发。为了生产实用系统,当然其必须能够在界限清楚的节点平面处隔离该波导。这只能通过确保这两种工作模态中的位移节点有重合而达成。
根据本发明的第一方面,提供了一种手术器具,包括:在其近端处生成扭转剪切模态超声振动的第一装置和生成纵向压缩模态超声振动的第二装置,可操作地连接至所述第一及所述第二生成装置的波导,所述波导从所述生成装置处向设有切割及/或凝结装置的远端延伸nλ/2的距离,其中所述纵向压缩波的波长与所述扭转剪切波的波长之比λCT为奇数。
较佳地,所述比为λC=NxλT,N为奇整数,且x为整数。
较佳地,N为3且x为1,这样所述比为3:1。
无论如何,所述波长较长的压缩波具有与所述波长较短的扭转波的至少一些节点重合的节点。
这样,所述波导被支撑在及/或隔离在所述共有节点处。
有利的是,所述器具可在一部分时间内以纵向振动模态操作,且在一部分时间内以扭转振动模态操作。
由外科医生或设备的使用者来选择在任一时候下运转的振动模态。
或者,该器具适用于在所述振动模态间交替。
所述振动模态以预定频率交替。
所述预定频率为0.5~5kHz之间,最好为2kHz左右。
附图说明
参考附图,以实例的方式,现更加具体地描述本发明的实施例,其中:
图1示意地示出了实现本发明的超声驱动手术器具;
图2示出了可沿着该器具生成的波形;
具体实施方式
参考附图,图1示出了主要用于腹腔镜检查过程中使用的手术器具。
该手术器具包括位于其近端的连接有两个压电陶瓷换能器超声驱动器的转换角状件1、在纵向方向作用来生成波长为λC的纵向压缩波的第一驱动器2、以及切线地作用以生成波长为λT的扭转波的第二驱动器3。
工作中,这些波形中的任意一个都沿着波导4传递,对于λC和λT这两者来说,波导4的长度俱为nλ/2。
波导4的远端处为一个铰接的爪结构,该爪结构带有由该波导形成的该爪的一条可振动臂以及该爪的另一条不可振动的被动臂5,被动臂5铰接至该波导的护罩(未示),并且可操作移动该被动臂5而使其与该爪的可振动臂接触或脱离。
现参考图2,其示出了沿该器具长度的两种模态的示意波形,可知在该爪的远端处传递的功率由下式给出。
扭转波功率PT定义为:
P T = 1 / 2 W ∫ 0 φ i ( ξ T 0 cos φ ) 2 . dφ
其中
Figure A200780019142D0005160639QIETU
为远端尖部处的质点速度;
Figure A200780019142D00051
代表与该远端之间的相位角;而W为组织阻抗。W等于ρ.c,其中为该组织的密度而c为该组织中的声速。注意:该远端尖部处
Figure A200780019142D00052
该爪枢轴处
压缩波功率PC定义为:
P C = 1 / 2 F ∫ 0 φ i ξ Co cos φ . dφ
其中
Figure A200780019142D0005160740QIETU
为该压缩波的质点速度,F为刀片/组织界面处的平均摩擦力。F等于p.a.μ,其中p为施加至该组织的压力,a为刀片与组织间的接触面积,μ为摩擦界面处的摩擦系数。
轮流适用各波形,波转换频率以约2kHz为较佳。功率传输为PT1的积与PT2的积之和,其中T1及T2分别为扭转波间隔和压缩波间隔。然而,这些间隔可根据基于所采用间隔的预定程序而改变。
使用实现本发明的该器具将可以在比一般常规材料更大的材料上采取使用更为独特的扭转模态技术。

Claims (10)

1、一种手术器具,包括:在其近端处的、生成扭转剪切模态超声振动的第一装置和生成纵向压缩模态超声振动的第二装置,可操作地连接至所述第一及所述第二生成装置的波导,所述波导从所述生成装置处向设有切割及/或凝结装置的远端延伸nλ/2的距离,其中所述纵向压缩波的波长与所述扭转剪切波的波长之比λCT为奇数。
2、如权利要求1所述的器具,其中所述比为λC=NxλT,N为奇整数,且x为整数。
3、如权利要求2所述的器具,其中N为3且x为1,这样所述比为3:1。
4、如前述权利要求任一项所述的器具,其中所述波长较长的压缩波具有与所述波长较短的扭转波的至少一些节点重合的节点。
5、如权利要求4所述的器具,其中所述波导被支撑在及/或隔离在所述共有节点处。
6、如前述权利要求任一项所述的器具,其中所述器具可在一部分时间内以纵向振动模态操作,且在一部分时间内以扭转振动模态操作。
7、如权利要求6所述的器具,其中由外科医生或设备的使用者来选择在任一时候下运转的振动模态。
8、如权利要求6所述的器具,其中所述器具适用于在所述振动模态间交替。
9、如权利要求6所述的器具,其中所述振动模态以预定频率从一个交替至另一个。
10、如权利要求9所述的器具,其中所述预定频率为0.5~5kHz之间,最好为2kHz左右。
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Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
GB0610715A GB2438679A (en) 2006-05-31 2006-05-31 Ultrasonic surgical tool having two modes of vibration
GB0610715.5 2006-05-31
PCT/GB2007/001968 WO2007138295A1 (en) 2006-05-31 2007-05-25 Ultrasonic surgical tool

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CN101453958B CN101453958B (zh) 2012-07-18

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AT (1) ATE491400T1 (zh)
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CA (1) CA2652740A1 (zh)
DE (1) DE602007011254D1 (zh)
ES (1) ES2356573T3 (zh)
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AU2007266881B2 (en) 2012-12-20
GB2438679A (en) 2007-12-05
US20100004667A1 (en) 2010-01-07
CA2652740A1 (en) 2007-12-06
EP2023830B1 (en) 2010-12-15
EP2023830A1 (en) 2009-02-18
JP2009538660A (ja) 2009-11-12
JP5232774B2 (ja) 2013-07-10
GB0610715D0 (en) 2006-07-12
WO2007138295A1 (en) 2007-12-06
DE602007011254D1 (de) 2011-01-27
ATE491400T1 (de) 2011-01-15
HK1131535A1 (en) 2010-01-29
US9173672B2 (en) 2015-11-03
ZA200810148B (en) 2010-02-24
ES2356573T3 (es) 2011-04-11
AU2007266881A1 (en) 2007-12-06
CN101453958B (zh) 2012-07-18

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