CN115500900B - Cutting part, transition part and ultrasonic surgical knife for ultrasonic surgical knife - Google Patents

Cutting part, transition part and ultrasonic surgical knife for ultrasonic surgical knife Download PDF

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Publication number
CN115500900B
CN115500900B CN202211108842.XA CN202211108842A CN115500900B CN 115500900 B CN115500900 B CN 115500900B CN 202211108842 A CN202211108842 A CN 202211108842A CN 115500900 B CN115500900 B CN 115500900B
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China
Prior art keywords
cutting
ultrasonic surgical
torsion
vibration
transition
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CN202211108842.XA
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Chinese (zh)
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CN115500900A (en
Inventor
王磊
郑少腾
刘柯
颜忠余
骆威
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Innolcon Medical Technology Suzhou Co Ltd
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Innolcon Medical Technology Suzhou Co Ltd
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Priority to CN202211108842.XA priority Critical patent/CN115500900B/en
Publication of CN115500900A publication Critical patent/CN115500900A/en
Priority to PCT/CN2023/078380 priority patent/WO2024055527A1/en
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Classifications

    • 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
    • A61B17/32—Surgical cutting instruments
    • A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
    • A61B2017/320069—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic for ablating tissue
    • 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
    • A61B2017/32007—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with suction or vacuum means
    • 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
    • A61B2017/320072—Working tips with special features, e.g. extending parts
    • 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
    • A61B2017/320072—Working tips with special features, e.g. extending parts
    • A61B2017/320078—Tissue manipulating surface
    • 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
    • A61B2017/320082—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic for incising tissue
    • 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
    • A61B2017/320098—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with transverse or torsional motion

Abstract

The application relates to the technical field of medical equipment and provides a cutting part, transition portion and ultrasonic scalpel for ultrasonic scalpel, the tip of cutting part is provided with a plurality of cutting teeth, and the first cutting edge and the second cutting edge of cutting tooth are located the minimum external diameter cladding scope of cutting part tip, guarantee the tissue safety that is in the minimum external diameter scope of cutting part tip to improve the security of tissue ablation and/or excision operation. And by setting the cutting teeth in a far-small and near-large shape, the overall strength of the cutting teeth is ensured, and when shallow tissue removal is implemented, the relatively sharp part of the cutting teeth, which is closer to the end part, can more rapidly complete tissue excision; when deep tissue removal is implemented, the part, close to the end part, of the cutting tooth is responsible for cutting a passage, so that the part, relatively far away from the end part, is ensured to implement crushing and segmentation on the tissue, the part, far away from the end part, is relatively thick, on the cutting tooth, stable support is provided, and the integral strength and cutting smoothness of the cutting tooth are ensured.

Description

Cutting part, transition part and ultrasonic surgical knife for ultrasonic surgical knife
Technical Field
The application relates to the technical field of medical instruments, in particular to a cutting part, a transition part and an ultrasonic scalpel for an ultrasonic scalpel.
Background
In the prior art, an ultrasonic surgical knife with a longitudinal vibration mode is provided, and the normal tissue is effectively ablated and resected while being prevented from being destroyed by the longitudinal vibration mode of the ultrasonic surgical knife.
In the conventional tissue ablation and excision process, the ultrasonic scalpel in the longitudinal vibration mode comprises an ultrasonic scalpel head and a vacuum suction system matched with the ultrasonic scalpel head, the simple ultrasonic scalpel head can meet the operation requirement by matching with the vacuum suction system, but in the cutting of certain fibrous lesion connective tissues and fibrous tissues or more complex soft tissue cutting or hard tissues such as bones, only the longitudinal vibration mode can not cut rapidly and accurately due to the large adhesion force and friction force between the scalpel head and the tissues, and particularly the ultrasonic scalpel in the longitudinal vibration mode can not meet the operation requirement with higher precision in the face of application scenes needing grinding or debridement. Conventional ultrasonic blades have difficulty in performing efficient ablation of diseased tissue.
Disclosure of Invention
In the conventional tissue ablation and excision process, the simple ultrasonic knife head can meet the operation requirement by matching with the vacuum suction system, but for cutting some fibrous lesion connective tissues, fibrous tissues or relatively complex soft tissues or hard tissues such as bones, the conventional ultrasonic knife is difficult to effectively excise the lesion tissues, and aiming at the problem, the embodiment of the application provides a cutting part, a transition part and an ultrasonic surgical knife for the ultrasonic surgical knife.
A first aspect of the embodiments of the present application provides a cutting part for an ultrasonic surgical blade, wherein a plurality of cutting teeth are provided at an end of the cutting part, a first cutting edge and a second cutting edge connected at a tooth tip are provided on the cutting teeth, and the first cutting edge and the second cutting edge are located on an outer circumferential surface of the cutting part;
the cutting teeth are also provided with third cutting edges connected with the first cutting edge and the second cutting edge at the tooth tops;
the third cutting edge gradually approaches the axis of the cutting portion from the distal end to the proximal end.
In one implementation, the first and second cutting edges are arcuate in configuration and are angled from the axis of the cutting portion.
In one implementation, a fourth cutting edge is also disposed between two adjacent cutting teeth.
In one implementation, the fourth cutting edge is located closer to the proximal end than the outer portion is located inside the end surface, wherein the inner portion refers to a direction closer to the cutting portion axial direction, and the outer portion refers to a direction away from the cutting portion axial direction.
In one implementation, the line connecting the tooth root to the tooth tip is parallel to the axis of the cutting portion or is inclined at an angle to the axis of the cutting portion.
In one implementation, the tip of the cutting tooth is of blunt face construction.
In one implementation, the cutting portion is provided with a pre-suction hole communicating with a central through hole of the cutting portion.
A second aspect of embodiments of the present application provides a transition for an ultrasonic surgical blade, the transition disposed between a connecting portion and a cutting portion, the connecting portion proximally coupled to an ultrasonic handle,
the transition part is provided with at least one torsion part to convert the longitudinal vibration provided by the ultrasonic handle into composite vibration and transmit the converted composite vibration to the cutting part, wherein the composite vibration comprises the longitudinal vibration and the torsion vibration;
At least one stabilizing portion is further arranged on the transition portion and located in the direction of the proximal end of the torsion portion, so that torsional vibration transmitted to the proximal end by the torsion portion is eliminated.
In one implementation, the distance from the center of the torsion portion to the end of the cutting portion is an odd multiple of λ/4, where λ is the wavelength of the torsional vibration.
In one implementation, the distance between the stabilizing portion and the torsion portion is such that a longitudinal vibration node is located between the stabilizing portion and the torsion portion and at a proximal end of the torsional vibration node, and the distance between the longitudinal vibration node and the torsional vibration node is less than λ/4, λ being a wavelength of torsional vibration, the torsional vibration node being a center of the torsion portion.
In one implementation, the distance between the stabilizer center and the torsional node is nλ/2, λ being the wavelength of torsional vibration and n being an integer.
In one implementation, the stabilizing portion is at least one of an obliquely cut groove ripple groove and a thread groove structure;
and/or the number of the groups of groups,
the torsion part is at least one of an oblique groove corrugated groove and a thread groove structure.
In one implementation, the torsion portion is a chamfer groove circumferentially arranged at the transition portion, an axis of the chamfer groove being at an angle to an axis of the transition portion.
A third aspect of the present embodiments provides an ultrasonic surgical blade, the ultrasonic surgical blade including a connection portion, the connection portion being coupled to an ultrasonic handle at a proximal end, the ultrasonic surgical blade further including the cutting portion for an ultrasonic surgical blade provided in the first aspect of the present embodiments, and further including the transition portion for an ultrasonic surgical blade provided in the second aspect of the present embodiments.
As can be seen from the above technical solutions, the embodiments of the present application provide a cutting portion, a transition portion, and an ultrasonic surgical blade for an ultrasonic surgical blade, where a plurality of cutting teeth are provided at an end portion of the cutting portion, and a first cutting edge and a second cutting edge connected at a tooth tip are provided on the cutting teeth, and the first cutting edge and the second cutting edge are located on an outer circumferential surface of the cutting portion; namely, the first cutting edge and the second cutting edge are positioned in the minimum outer diameter cladding range of the end part of the cutting part, so that the accuracy of the cutting range is ensured, the safety of tissues outside the minimum outer diameter range of the end part of the cutting part is ensured, and the safety of tissue ablation and/or excision operation is improved. The cutting teeth are also provided with third cutting edges connected with the first cutting edges and the second cutting edges at tooth tops; the third cutting edge gradually approaches the axis of the cutting portion from the distal end to the proximal end. The structure design of the third cutting edge enables the cutting teeth to form a structure with a small far end and a large near end, and can effectively convert the longitudinal vibration of the ultrasonic knife into the combined longitudinal vibration and torsional vibration so as to improve the working efficiency and cutting precision of the ultrasonic knife; in the actual working process, the cutting teeth are arranged to be far small and near large, so that the overall strength of the cutting teeth is ensured, the cutting habit of the cutting teeth is met, and when shallow tissue removal is implemented, the relatively sharp part, which is closer to the end part, of the cutting teeth can quickly complete tissue excision; when deep tissue removal is implemented, the part, close to the end part, of the cutting tooth is responsible for cutting a channel, the part, relatively far away from the end part, is ensured to implement crushing and segmentation on the tissue, the part, far away from the end part, is relatively thick, on the cutting tooth is provided with stable support, the integral strength and cutting smoothness of the cutting tooth are ensured, meanwhile, the third cutting edge is used for implementing crushing treatment on the edge of the tissue, so that the cutting tooth is easier to penetrate into the tissue, and the removed tissue block is ensured to be positioned in the range of a central hole of the instrument.
In addition, the embodiment of the application provides a transition part for an ultrasonic surgical knife, the transition part is provided with a torsion part, ultrasonic vibration torsional vibration energy is provided, and the cutting part can simultaneously generate pushing force and shearing force when contacting with a tissue part in a mode of combining longitudinal vibration and torsional vibration, so that the purpose of rapidly cutting the cutting part is achieved; in addition, the torsional vibration opposite to the torsional part is generated by the stabilizing part, so that the torsional vibration influence of the torsional part on the connecting part is reduced to the minimum, and the stable connection between the connecting part and the handle is ensured while the efficient cutting and stable running of the ultrasonic knife are maintained; furthermore, the connecting part is not influenced by torsional vibration of the torsional part due to the arrangement of the stabilizing part, so that the position of the connecting part does not need to be increased or decreased by 1/2 torsional vibration wavelength of the torsional part, the length of the connecting part can be freely set according to specific requirements, and the surgical operation distance suitable for a user can be conveniently selected; in the end cutting process of the cutting part, the maximum torsion stress position is designed between the stabilizing part and the torsion part, so that the influence of stress on the cutting part is reduced, the cutting part is not easily influenced by stress to break, and the use stability and reliability of the cutting part are improved.
Drawings
In order to more clearly illustrate the technical solutions of the present application, the drawings that are needed in the embodiments will be briefly described below, and it will be obvious to those skilled in the art that other drawings can be obtained from these drawings without inventive effort.
Fig. 1 is a schematic view of a first embodiment of a cutting portion for an ultrasonic surgical blade according to an embodiment of the present application;
FIG. 2 is a schematic view of a second embodiment of a cutting portion for an ultrasonic surgical blade according to an embodiment of the present application;
FIG. 3 is a schematic view of a third embodiment of a cutting portion for an ultrasonic surgical blade according to an embodiment of the present application;
FIG. 4 is a schematic view of a fourth embodiment of a cutting portion for an ultrasonic surgical blade according to an embodiment of the present application;
FIG. 5 is a schematic view of a fifth embodiment of a cutting portion for an ultrasonic surgical blade provided in an embodiment of the present application;
FIG. 6 is a schematic view of a sixth embodiment of a cutting portion for an ultrasonic surgical blade according to an embodiment of the present application;
FIG. 7 is a schematic view of a seventh embodiment of a cutting portion for an ultrasonic surgical blade according to an embodiment of the present application;
FIG. 8 is a schematic view of an eighth embodiment of a cutting portion for an ultrasonic surgical blade according to an embodiment of the present application;
FIG. 9 is a schematic view of a first embodiment of a transition portion for an ultrasonic surgical blade provided in an embodiment of the present application;
fig. 10 is a schematic structural diagram of a transition portion provided with only a torsion portion according to an embodiment of the present application;
FIG. 11 is a schematic view of a second embodiment of a transition for an ultrasonic surgical blade provided in an embodiment of the present application;
FIG. 12 is a schematic view of a third embodiment of a transition for an ultrasonic surgical blade provided in an embodiment of the present application;
FIG. 13 is a schematic view of a fourth embodiment of a transition for an ultrasonic surgical blade provided in an embodiment of the present application;
FIG. 14 is a schematic view of a fifth embodiment of a transition for an ultrasonic surgical blade provided in an embodiment of the present application;
fig. 15 is a schematic view of the overall structure of an ultrasonic surgical blade according to the embodiment.
In the figure: 1-connecting part, 2-transition part, 21-torsion part, 22-stabilizing part, 3-cutting part, 31-fourth cutting edge, 4-pre-suction hole, 5-cutting tooth, 51-first cutting edge, 52-second cutting edge, 53-third cutting edge, 6-spanner position.
Detailed Description
It should be noted that, in the technical solution provided in the present application, for convenience of description, one end of the surgical instrument placed in the human body is called a distal end, and the distal end is mainly used for performing a surgical operation on a tissue; the end located outside the body is called the proximal end, which is mainly used for the operator to perform the operation. The distal end of each component is referred to herein as the end proximal to the body side, and the proximal end of each component is referred to herein as the end proximal to the body side, unless otherwise indicated.
In the conventional tissue ablation and excision process, the simple ultrasonic knife head can meet the operation requirement by matching with the vacuum suction system, but for some diseased connective tissues and fibrous tissues which are rich in fibers or hard tissues such as soft tissues or bones which are relatively complex, the conventional ultrasonic knife is difficult to effectively ablate the diseased tissues, aiming at the problem, the first aspect of the embodiment of the application provides a cutting part for the ultrasonic surgical knife,
as shown in fig. 1, the proximal end of the cutting part 3 is coupled with an ultrasonic handle through a transition part 2 and a connecting part 1, the end part of the cutting part 3 is provided with a plurality of cutting teeth 5, the cutting teeth 5 are provided with a first cutting edge 51 and a second cutting edge 52 which are connected at the tooth tops, and the first cutting edge 51 and the second cutting edge 52 are positioned on the outer circumferential surface of the cutting part 3; i.e. the first cutting edge 51 and the second cutting edge 52 are located within the minimum outer diameter cladding range of the end part of the cutting part 3, thereby ensuring the accuracy of the cutting range and ensuring the safety of the tissues outside the minimum outer diameter range of the end part of the cutting part 3, thereby improving the safety of the tissue ablation and/or excision operation.
As shown in fig. 2, the cutting tooth 5 is further provided with a third cutting edge 53 connected to the first cutting edge 51 and the second cutting edge 52 at the tooth tip; the third cutting edge 53 gradually extends towards the axial direction of the cutting part 3 from the distal end to the proximal end, that is, the cutting teeth 5 form a structure with small distal end and large proximal end through the structural design of the third cutting edge 53, so that the longitudinal vibration of the ultrasonic knife can be effectively converted into the combined longitudinal vibration and torsional vibration, and the working efficiency and cutting precision of the ultrasonic knife can be improved; in the actual working process, the cutting teeth 5 are arranged to be far small and near large, so that the overall strength of the cutting teeth 5 is ensured, the cutting habit of the cutting teeth 5 is met, and when shallow tissue removal is implemented, the relatively sharp part, which is closer to the end part, of the cutting teeth 5 can quickly complete tissue excision; when deep tissue removal is implemented, the part, close to the end part, of the cutting tooth 5 is responsible for cutting a channel, the part, relatively far away from the end part, is used for breaking and dividing tissues, the part, far away from the end part, of the cutting tooth 5 is used for providing stable support, the whole strength and cutting smoothness of the cutting tooth 5 are guaranteed, meanwhile, the third cutting edge 53 is used for breaking the edges of the tissues, so that the cutting tooth 5 is easier to penetrate into the tissues, and the removed tissue blocks are guaranteed to be in the range of a central hole of the instrument.
In some embodiments of the present application, as shown in fig. 2, a fourth cutting edge 31 is further provided between two adjacent cutting teeth 5 to connect the first cutting edge 51 of the first cutting tooth 5 and the second cutting edge 52 of the second cutting tooth 5, or to connect the second cutting edge 52 of the first cutting tooth 5 and the first cutting edge 51 of the second cutting tooth 5.
For example, among three cutting teeth 5 in succession, a first cutting edge 51 of a first cutting tooth 5 is connected to a second cutting edge 52 of a second cutting tooth 5 by a fourth cutting edge 31; the first cutting edge 51 of the second cutting tooth 5 is connected to the second cutting edge 52 of the third cutting tooth 5 by the fourth cutting edge 31.
Through the design mode, when the adjacent cutting teeth 5 are cut, the tooth top positions of the cutting teeth 5 are discontinuously distributed in multiple points and are discontinuous, so that the cutting efficiency is ensured, and the effectiveness and the reliability of cutting are ensured.
As shown in fig. 2 and 3, in the embodiment of the present application, the inner portion of the end surface where the fourth cutting edge 31 is located is closer to the proximal end than the outer portion, wherein the inner portion refers to the direction closer to the axial direction of the cutting portion 3, the outer portion refers to the direction away from the axial direction of the cutting portion 3, that is, the inner portion is deeper and shallower than the end surface S where the fourth cutting edge 31 is located, wherein the inner portion refers to the direction closer to the axis of the cutting portion 3, the outer portion refers to the direction away from the axis of the cutting portion 3, the deep portion refers to the direction closer to the proximal end, and the shallow portion refers to the direction closer to the distal end.
Through designing terminal surface S into inside and outside shallow structural style, fourth cutting edge 31 is in terminal surface S outside, and is in on the outer periphery of cutting portion 3, in the practical application in-process, and inside and outside is shallow in terminal surface S, guarantee the biggest cutting scope of fourth cutting edge 31 can ensure again that the tissue edge that is cut off receives terminal surface S extrusion after forming certain angle of cutting (laminating terminal surface S), thereby can be smooth pass through the centre bore of cutting portion 3 keeps away from the operation position.
In the embodiment of the present application, the end face S is designed to have a structure with a shallow inner depth and a shallow outer depth, so that the maximum cutting range of the cutting portion 3 is ensured, and the edge of the cut tissue is ensured to have a certain angle, so that the cut tissue can be smoothly separated from the surgical site through the central hole. The end face S is designed to be shallow and deep, and compared with the design mode of shallow and deep inside and outside, the design mode of shallow and deep inside and outside reduces the cutting range of the cutting part 3, but can further enhance the reliability of the cut tissue passing through the central hole and reduce the blocking possibility of the central hole. The end surface S is designed in such a way that the edges 51, 52 and 31 are flush with each other, so that the angle between the adjacent structural surfaces of the edges is increased, that is, the sharpness of the edges is reduced, and the cutting capability is reduced, but the design has a significant advantage in the cutting process for the tissue with shallower depth, that is, the cutting effect is mainly provided by the third cutting edge 53, and the first, second and fourth cutting edges 51, 52 and 31 provide smaller cutting effect, but the end surface S provides stronger shearing force to facilitate the cutting by the third cutting edge 53.
In the practical application process, the cutting efficiency of the design modes of the three end faces S is as follows: the cutting efficiency of the inner depth and the outer depth is greater than that of the inner depth and the outer depth, and meanwhile, the cutting efficiency of the inner depth and the outer depth is greater than that of the inner and outer flush; the cutting efficiency of the design mode of the three end faces S is as follows: the processing difficulty of interior dark outside is less than the processing difficulty of interior shallow outside, simultaneously, the processing difficulty of interior shallow outside is less than the processing difficulty of interior parallel and level, and the user can select the tool bit of different grade type according to different use scenes to compromise the apparatus cost when realizing the operation effect.
As shown in fig. 2 and fig. 3, in some embodiments of the present application, the first cutting edge 51 and the second cutting edge 52 are arc-shaped and form a certain angle with the axis of the cutting portion 3, when cutting tissue, a certain angle is formed with the axis of the cutting portion 3, and the first cutting edge 51 and the second cutting edge 52 with arc-shaped structures conform to the mechanical principle, and bear nonlinear acting force in the cutting process, so that the reaction force borne by the cutting teeth 5 is ensured to be within the allowable range, and due to the existence of torsional vibration, the first cutting edge 51 and the second cutting edge 52 can generate shearing force on the resected tissue, so that the tissue is cut more rapidly.
In some embodiments of the present application, as shown in fig. 6, a line L between the tooth root and the tooth tip of the cutting tooth 5 forms an inclination angle with the axis of the cutting portion 3; namely, inclined teeth are formed at the end of the cutting portion 3 and arranged clockwise or anticlockwise around the axis, wherein the inclined direction of the cutting teeth 5 and the torsion direction of the torsion portion 21 (chamfer groove) can be the same or different, and a better cutting effect can be achieved through the inclined cutting teeth 5, but in the embodiment of the application, the inclined arrangement of the cutting teeth 5 is not limited, and in the practical application process, the cutting teeth 5 can be extended clockwise along the axis for different pathological tissues, different operation positions and in consideration of operation cost, namely, as shown in fig. 7, the connecting line L of the cutting teeth 5 from the tooth root to the tooth top is parallel to the axis of the cutting portion 3.
In order to improve operability of medical staff, make accurate cutting, reduce operation risk caused by misoperation, and avoid damage to normal tissues by the cutting teeth 5 before cutting the tissues, as shown in fig. 2 to 7, in some embodiments of the present application, tooth tops of the cutting teeth 5 are in a blunt surface structure, for example, the cutting teeth 5 are arranged in a blunt surface structure with a substantially triangular or circular arc chamfer surface. When the tooth top of the cutting tooth 5 is in a blunt surface structure and contacts with normal tissues, the blunt surface structure is abutted against the surface of the normal tissues due to the high toughness of the normal tissues, so that the cutting tooth 5 is ensured not to damage the normal tissues.
The ultrasonic surgical knife that this application embodiment relates to, transition portion 2 with cutting portion 3 is the hollow structure that the inside was provided with central through-hole, and central through-hole is connected with vacuum equipment, provides the negative pressure flow that the size is adjustable cutting tooth 5 of cutting portion 3 can provide the pulling force when contacting with the tissue for the tissue produces certain surface tension, guarantees cutting tooth 5 is cut more smoothly. When the cutting position area is great, the degree of depth is darker, cutting teeth 5 exist and are covered by the tissue completely, lead to the condition that negative pressure system blockked up, to this, in this application, as shown in fig. 2 through 7, be provided with on the cutting part 3 and inhale hole 4 in advance, the hole 4 in advance communicates the central through-hole of cutting part 3, through the hole 4 in advance of setting, guarantee that the central hole can not be blocked up completely, avoid causing the threat to healthy tissue, guarantee vacuum equipment's steady operation, and then ensure the safe steady operation of entire system.
In the practical application process, when the tool bit pointed end is stopped up, the perfusate of cooling can't pass through central through-hole and get into inside the handle, can't form complete cooling circuit, leads to the handle to generate heat aggravately, and the working point takes place to deviate from, reduces work effect. In addition, when the cutter head is blocked, the pressure in the pipeline can rise sharply, and a relatively large traction tension is formed on tissues near the wound, so that unexpected traction damage is generated. However, the existence of the pre-suction hole 4 corresponds to an artificial damage at the front end of the waveguide rod (where the pre-suction hole 4 is located), and a fine design is required to prevent the pre-suction hole 4 from causing unpredictable damage to the overall performance and strength. In order to most effectively avoid unavoidable damage to tissues caused by cutter head blockage, the position of the pre-suction hole 4 needs to be close to the tip of the cutter head, and the pressure can be released in time when the cutter head is blocked. Too close of the pre-suction holes 4 to the tip may also lead to tissue blockage, with the risk of blockage of the pre-suction holes 4. Furthermore, the presence of the pre-suction holes 4 locally increases internal stresses, increasing the probability of damage to the cutting portion 3. The pre-suction hole 4 is required to be placed in a region where the stress is small, and for the present embodiment, it is not preferable to place the pre-suction hole 4 in a region where the taper (the diameter of the cutting portion 3 becomes smaller gradually from the proximal end toward the distal end) is gradually changed, and it is required to place in a region where the diameter is uniform. And the position is not too close to the tip of the cutter head, the optimal design distance is 4mm to 8mm, and the optimal design is 6mm. In addition, the shape of the pre-suction hole 4 is not preferably polygonal, and the polygonal structure has the problem of uneven transition and easy stress concentration, and is preferably a circular structure. And the diameter is not suitable to be too large, the cutter head strength can be obviously reduced due to the too large aperture, and the fracture risk is increased. As shown in fig. 8, in the cross-sectional shape of the cutting portion 3, the pre-suction aperture is D, the central through hole aperture is D, the central angle α corresponding to the diameter D of the pre-suction aperture is 2arcsin (D/2D), and the ratio of the central angle α to pi/2 is preferably equal to or less than 0.1, where pi is the circumference ratio. If the diameter of the pre-suction hole 4 is too small, it is difficult to exert the design effect, and too large increases the risk of causing damage to the cutter head, the diameter of the pre-suction hole 4 optimal in this embodiment is between 0.7mm and 0.9mm, preferably 0.8mm. It should be noted that, when the ultrasonic surgical knife with the traditional longitudinal vibration mode cuts soft tissues such as liver or hard tissues such as bone during surgery, the longitudinal vibration mode along the axis of the knife head cannot meet all the surgical requirements, and under the application scenes of grinding, debridement and the like, effective ultrasonic vibration torsional vibration energy is required to ensure that the ultrasonic knife head has higher working efficiency, so that the ultrasonic knife head with the longitudinal vibration and torsional vibration combined ultrasonic vibration working mode is inoculated.
The traditional compound vibration ultrasonic tool bit is characterized in that a torsional part is arranged on a tool handle or a connecting part, so that the tool bit generates longitudinal vibration and torsional vibration, but in the compound vibration mode, although higher working efficiency can be realized, the tool handle or the connecting part is unstable in connection with a handle due to the torsional vibration on the tool handle or the connecting part, and therefore looseness between the tool handle or the connecting part and the handle is caused.
In order to avoid the problem that the connection of the handle or the connecting part and the handle is unstable and the loosening between the handle or the connecting part and the handle is caused by the conventional compound vibration (longitudinal vibration + torsional vibration) tool bit, the second aspect of the embodiment of the present application provides a transition part for an ultrasonic surgical knife, as shown in fig. 9, the transition part 2 is arranged between the connecting part 1 and the cutting part 3, the ultrasonic handle is coupled to the proximal end of the connecting part 1, the ultrasonic handle is used for providing a vibration source (longitudinal vibration), and the cutting part 3 is used for performing the excision and/or the ablation actions on the tissue.
It should be noted that, the transition portion 2 provided in the second aspect of the embodiment of the present application is not limited to the cutting portion 3 used in the present application, and other cutting structures that need to implement vibration conversion may be applied in the practical application process.
As shown in fig. 9, at least one torsion portion 21 is disposed on the transition portion 2, in the practical application process, the ultrasonic handle provides longitudinal vibration, when vibration waves of the longitudinal vibration are transmitted to the torsion portion 21, the torsion portion 21 converts the longitudinal vibration into compound vibration, and transmits the converted compound vibration to the cutting portion 3, where the compound vibration includes longitudinal vibration and torsional vibration, and the longitudinal vibration and the torsional vibration are transmitted to the cutting portion 3, so as to implement cutting and/or ablation actions of the cutting portion 3.
As shown in fig. 9, the transition portion 2 is further provided with at least one stabilizing portion 22, the stabilizing portion 22 is located at the proximal direction of the torsion portion 21, and in the compound vibration converted by the torsion portion 21, there are longitudinal vibration and torsional vibration, wherein the torsional vibration will be transmitted to the proximal end and the distal end in a bidirectional manner, and after reaching the stabilizing portion 22, the torsional vibration transmitted to the proximal end is gradually consumed due to the effect of the stabilizing portion 22, so that the torsional vibration transmitted to the proximal end by the torsion portion 21 is eliminated. In this embodiment of the present application, through setting up the stabilizing part 22 in the proximal end of torsion part 21, effectual elimination torsional vibration is transmitted to connecting portion 1 to avoid traditional compound vibration (longitudinal vibration + torsional vibration) tool bit, lead to connecting portion 1 and ultrasonic handle's connection unstable, thereby arouse the problem of becoming flexible between connecting portion 1 and the ultrasonic handle.
In addition, in the conventional composite vibration (longitudinal vibration+torsional vibration) tool bit, by adopting a special design for the length of the transition portion 2, the influence of torsional vibration on the connection portion 1 can be reduced as much as possible, for example, as shown in fig. 10, the distance from the proximal end of the connection portion 1 to the torsional vibration stage of the transition portion 2 is an integer multiple of λ/2, that is, the distance from the proximal end of the connection portion 1 to the torsional vibration stage of the transition portion 2 is nλ/2, where λ is the wavelength of torsional vibration, n is a positive integer, in other words, according to the vibration wave transmission principle of torsional vibration, the amplitude of the position of the proximal end of the connection portion 1 is synchronized with the amplitude of the torsional vibration node, and this design can reduce the influence of torsional vibration on the connection portion 1 to a certain extent, but in this way, there is a strict limitation on the length of the transition portion 2, so that the increase or decrease of the length of the transition portion 2 can only be realized by an integer multiple of λ/2, which is extremely easy to cause that in a partial scene, the length of the transition portion 2 and the whole cutting portion 3 or the whole length 3 cannot be influenced, and the whole length 3 cannot be cut.
In this regard, in this embodiment, by setting the stabilizing portion 32, the position of the stabilizing portion 32 on the transition portion 2 may be adjusted, or the structural form of the stabilizing portion 32 may provide vibration opposite to torsional vibration generated by the torsional portion 21 on the thread (connecting portion 1), so that torsional (combined) vibration at the thread is zero, and only longitudinal vibration exists, so, as shown in fig. 11, the distance between the proximal end of the connecting portion 1 and the torsional vibration node may be any value meeting the requirement of a driving signal, and the limitation that the distance between the proximal end of the connecting portion 1 and the torsional vibration stage of the transition portion 2 is an integer multiple of λ/2 is eliminated, thereby ensuring that the design of the corresponding length of the transition portion 2 may be implemented according to the actual use requirement, and avoiding the overall lengths of the transition portion 2 and the cutting portion 3 from being too long or too short.
In some embodiments of the present application, in order to achieve a better cutting effect at the end of the cutting portion 3, as shown in fig. 12, the distance from the center of the torsion portion 21 to the end of the cutting portion 3 is an odd multiple (mλ/4) of λ/4, where λ is the wavelength of torsional vibration, and m is an odd number, and the center of the torsion portion 21 is a torsional vibration node, so that the torsional vibration efficiency of the end of the cutting portion 3 is maximized when the torsion portions 21 with the same structure are configured.
Further, in some embodiments of the present application, as shown in fig. 12, the distance between the stabilizing portion 22 and the torsion portion 21 is satisfied, so that a longitudinal vibration node is located between the stabilizing portion 22 and the torsion portion 21 and is located at a proximal end of the torsion node, and the distance between the longitudinal vibration node and the torsion node is less than λ/4, which is a wavelength of the torsional vibration.
As shown in fig. 10, in the embodiment of the present application, by adjusting the distance between the stabilizing portion 22 and the torsion portion 21, as shown in fig. 11, the maximum stress point of the ultrasonic scalpel is located between the stabilizing portion 22 and the torsion portion 21, so that the maximum stress position of the ultrasonic scalpel is generated on the cylindrical outer surface between the torsion portion 21 and the stabilizing portion 22 under the combined action of the torsion portion 21 and the stabilizing portion 22, and the diameter of the transition portion 2 is larger and the shape change is gentle and the distance from the cutting portion 3 is further than that of the composite vibration scalpel with only the torsion structure, compared with that of the composite vibration scalpel with only the torsion structure, thereby improving the safety performance of the ultrasonic scalpel.
Specifically, in the embodiment of the present application, as shown in fig. 11 to 13, the torsion portion 21 is a chamfer groove circumferentially arranged at the transition portion 2, and an axis of the chamfer groove forms an angle with an axis of the transition portion 2. The structural form of the stabilizing portion 22 and the torsion portion 21 may be identical, that is, as shown in fig. 11 to 13, both the stabilizing portion 22 and the torsion portion 21 may be implemented in the form of diagonal grooves, wherein in fig. 11, the axial directions of the diagonal grooves of the stabilizing portion 22 and the torsion portion 21 are not identical, and in fig. 13, the axial directions of the diagonal grooves of the stabilizing portion 22 and the torsion portion 21 are identical; alternatively, as shown in fig. 14, the stabilizer 22 and the torsion portion 21 may have different structural forms, and the stabilizer 22 may have at least one of an inclined groove, a corrugated groove, and a thread groove structure.
The torsion portion 21 is not limited to be provided in the form of an inclined groove, but may be provided in other structures capable of converting the longitudinal vibration into the composite vibration, for example, at least one of an inclined groove, a thread groove, and a corrugated groove, and the corrugated groove is a corrugated-shaped bar-shaped groove, and the bar-shaped groove may be provided along the axial direction of the transition portion 2 or may be provided at an angle with the axial direction of the transition portion 2.
In fig. 9 and fig. 11 to 14, only one stabilizer 22 is shown, and when a plurality of stabilizers 22 are provided, the plurality of stabilizers 22 may be arranged side by side along the axial direction of the transition portion 2, and if a plurality of stabilizers 22 are provided, the plurality of stabilizers 22 may be considered as a whole structure when determining the torsional vibration node and the longitudinal vibration node of the transition portion 2, in other words, it may be considered that: by providing a plurality of sets of the undercut or thread groove structures described below as one stabilizing portion 22, that is, one stabilizing portion 22 is not limited to one set of the undercut or thread groove structures, but one stabilizing portion 22 may include a plurality of sets of the undercut or thread groove structures arranged side by side in the axial direction of the transition portion 2, or a vibration compensating structure as can be appreciated by those skilled in the art. By setting the stabilizing portion, the effect of ensuring stable connection between the connecting portion 1 and the ultrasonic handle is within the scope of the present invention as long as the effect is effective in eliminating transmission of torsional vibration to the connecting portion 1.
Further, in order to eliminate the twisting action of the twisting portion 21 on the proximal end of the connecting portion 1, the position and structure of the stabilizing portion 22 are adjusted by the stabilizing portion 22 according to different vibration frequencies and wavelengths, for example, parameters such as a skew center axis angle, a skew depth, a skew width, and a skew number of the skew grooves are adjusted when the stabilizing portion 22 is a skew groove.
As in fig. 13, the chute depth ranges from 1 to 1.2mm in depth and from 0.6 to 1.5mm in width, preferably 1mm; the number of which is 3 to 8, preferably 6; the inclination angle is between-60 DEG and 60 DEG, preferably 20 DEG + -10 DEG or-20 DEG + -10 deg.
In a preferred embodiment, in order to ensure that the stabilizing portion 22 applies torsional vibration of the same magnitude and opposite direction to the torsion portion 21 to the connecting portion 1, a distance between a center node (not shown in the drawing) of the stabilizing portion 22 and the torsional vibration node is nλ/2, λ is a wavelength of the torsional vibration, and n is an integer.
A transition part for an ultrasonic surgical blade according to a second aspect of the present embodiment is provided, the transition part 2 is disposed between the connection part 1 and the cutting part 3, the connection part 1 is coupled to an ultrasonic handle at a proximal end, at least one torsion part 21 is disposed on the transition part 2 to convert a longitudinal vibration provided by the ultrasonic handle into a composite vibration, and the converted composite vibration is transmitted to the cutting part 3, and the composite vibration includes the longitudinal vibration and the torsion vibration; at least one stabilizing portion 22 is further provided on the transition portion 2, the stabilizing portion 22 being located in the proximal direction of the torsion portion 21 to eliminate torsional vibrations transmitted proximally by the torsion portion 21. In the practical application process, the stabilizing portion 22 is arranged at the proximal end of the torsion portion 21, so that torsional vibration is effectively eliminated and transmitted to the connecting portion 1, and the problem that the connecting portion 1 and the ultrasonic handle are unstable due to unstable connection of the connecting portion 1 and the ultrasonic handle caused by the traditional composite vibration (longitudinal vibration + torsional vibration) tool bit is avoided.
Furthermore, the connecting part is not influenced by torsional vibration of the torsional part due to the arrangement of the stabilizing part, so that the position of the connecting part does not need to be increased or decreased by 1/2 torsional vibration wavelength of the torsional part, the length of the connecting part can be freely set according to specific requirements, and the surgical operation distance suitable for a user can be conveniently selected; in the end cutting process of the cutting part, the maximum torsion stress position is designed between the stabilizing part and the torsion part, so that the influence of stress on the cutting part is reduced, the cutting part is not easily influenced by stress to break, and the use stability and reliability of the cutting part are improved.
The third aspect of the embodiment of the present application further provides an ultrasonic surgical blade, as shown in fig. 15, where the ultrasonic surgical blade includes a connection portion 1, and the proximal end of the connection portion 1 is coupled with an ultrasonic handle, and the ultrasonic surgical blade further includes the cutting portion for an ultrasonic surgical blade provided in the first aspect of the embodiment of the present application, and further includes the transition portion for an ultrasonic surgical blade provided in the second aspect of the embodiment of the present application.
The connecting part 1 is further provided with a wrench position 6, and the wrench position 6 is used for facilitating torque application when the connecting part 1 is coupled with the handle.
As can be seen from the above technical solutions, the present embodiment of the application provides a cutting portion, a transition portion, and an ultrasonic surgical blade for an ultrasonic surgical blade, wherein a plurality of cutting teeth 5 are provided at an end portion of the cutting portion 3, a first cutting edge 51 and a second cutting edge 52 connected at a tooth tip are provided on the cutting teeth 5, and the first cutting edge 51 and the second cutting edge 52 are located on an outer circumferential surface of the cutting portion 3; i.e. the first cutting edge 51 and the second cutting edge 52 are located within the minimum outer diameter cladding range of the end part of the cutting part 3, thereby ensuring the accuracy of the cutting range and ensuring the safety of the tissues outside the minimum outer diameter range of the end part of the cutting part 3, thereby improving the safety of the tissue ablation and/or excision operation. And, the cutting tooth 5 is further provided with a third cutting edge 53 connected to the first cutting edge 51 and the second cutting edge 52 at the tooth tip; the third cutting edge 53 gradually approaches the axis of the cutting portion 3 from the distal end to the proximal end. Namely, by the structural design of the third cutting edge 53, the cutting tooth 5 forms a structure with a small distal end and a large proximal end, in the actual working process, the overall strength of the cutting tooth 5 is ensured by setting the cutting tooth 5 to be in a shape with a small distal end and a large proximal end, the cutting habit of the cutting tooth 5 is met, and when shallow tissue removal is implemented, the relatively sharp part of the cutting tooth 5, which is closer to the end, can more quickly complete tissue excision; when deep tissue removal is implemented, the part, close to the end part, of the cutting tooth 5 is responsible for cutting a channel, the part, relatively far away from the end part, is used for breaking and dividing tissues, the part, far away from the end part, of the cutting tooth 5 is used for providing stable support, the whole strength and cutting smoothness of the cutting tooth 5 are guaranteed, meanwhile, the third cutting edge 53 is used for breaking the edges of the tissues, so that the cutting tooth 5 is easier to penetrate into the tissues, and the removed tissue blocks are guaranteed to be in the range of a central hole of the instrument.
Reference throughout this specification to "multiple embodiments," "some embodiments," "one embodiment," or "an embodiment," etc., means that a particular feature, component, or characteristic described in connection with the embodiment is included in at least one embodiment. Thus, appearances of the phrases "in various embodiments," "in some embodiments," "in at least one other embodiment," or "in an embodiment" in various places throughout this specification are not necessarily all referring to the same embodiment. Furthermore, the particular features, components, or characteristics may be combined in any suitable manner in one or more embodiments. Thus, a particular feature, component, or characteristic shown or described in connection with one embodiment may be combined, in whole or in part, with features, components, or characteristics of one or more other embodiments, without limitation. Such modifications and variations are intended to be included within the scope of the present application.
It should be noted that the above-mentioned embodiments illustrate rather than limit the application, and that those skilled in the art will be able to design alternative embodiments without departing from the scope of the appended claims. In the claims, any reference signs placed between parentheses shall not be construed as limiting the claim. The word "comprising" does not exclude the presence of elements or steps not listed in a claim. The word "a" or "an" preceding an element does not exclude the presence of a plurality of such elements. The application may be implemented by means of hardware comprising several distinct elements, and by means of a suitably programmed computer. In the unit claims enumerating several means, several of these means may be embodied by one and the same item of hardware. The use of the words first, second, third, etc. do not denote any order. These words may be interpreted as names. The steps in the above embodiments should not be construed as limiting the order of execution unless specifically stated.
The foregoing is merely a specific embodiment of the application to enable one skilled in the art to understand or practice the application. Various modifications to these embodiments will be readily apparent to those skilled in the art, and the generic principles defined herein may be applied to other embodiments without departing from the spirit or scope of the application. Thus, the present application is not intended to be limited to the embodiments shown herein but is to be accorded the widest scope consistent with the principles and novel features disclosed herein.
Finally, it should be noted that: the above embodiments are only for illustrating the technical solution of the present application, and are not limiting thereof; although the present application has been described in detail with reference to the foregoing embodiments, it should be understood by those of ordinary skill in the art that: the technical scheme described in the foregoing embodiments can be modified or some technical features thereof can be replaced by equivalents; such modifications and substitutions do not depart from the spirit and scope of the corresponding technical solutions.

Claims (13)

1. A cutting part for an ultrasonic surgical blade, characterized in that the end of the cutting part (3) is provided with a plurality of cutting teeth (5), the cutting teeth (5) are provided with a first cutting edge (51) and a second cutting edge (52) connected at the tooth tip, the first cutting edge (51) and the second cutting edge (52) are on the outer circumferential surface of the cutting part (3);
The cutting teeth (5) are also provided with third cutting edges (53) connected with the first cutting edges (51) and the second cutting edges (52) at tooth tops;
the third cutting edge (53) gradually approaches the axis of the cutting part (3) from the distal end to the proximal end.
2. The cutting portion for an ultrasonic surgical blade according to claim 1, wherein the first and second cutting edges (51, 52) are arc-shaped structures and are angled with respect to the axis of the cutting portion (3).
3. Cutting portion for an ultrasonic surgical blade according to claim 1 or 2, characterized in that a fourth cutting edge (31) is also provided between two adjacent cutting teeth (5).
4. A cutting portion for an ultrasonic surgical blade according to claim 3, wherein the fourth cutting edge (31) is located inside the end face closer to the proximal end than the outside, wherein inside means a direction closer to the axial direction of the cutting portion (3) and outside means a direction away from the axial direction of the cutting portion (3).
5. Cutting unit for ultrasonic surgical blades according to claim 1 or 2, characterized in that the line of the cutting tooth (5) from the tooth root to the tooth tip is parallel to the axis of the cutting unit (3) or at an oblique angle to the axis of the cutting unit (3).
6. The cutting portion for an ultrasonic surgical blade according to claim 1 or 2, wherein the tip of the cutting tooth (5) is of a blunt face structure.
7. Cutting portion for an ultrasonic surgical blade according to claim 1, characterized in that the cutting portion (3) is provided with a pre-suction hole (4), which pre-suction hole (4) communicates with a central through hole of the cutting portion (3).
8. The cutting portion for an ultrasonic surgical blade according to claim 7, wherein the diameter of the pre-suction hole (4) is D, the diameter of the central through hole where the pre-suction hole (4) is located is D, the diameter D of the pre-suction hole (4) corresponds to a central angle α on the cross section of the central through hole, wherein α = 2arcsin (D/2D), and the ratio of the central angle α to pi/2 is less than or equal to 0.1.
9. An ultrasonic surgical blade comprising a connecting portion (1), the connecting portion (1) being proximally coupled to an ultrasonic handle, characterized in that the ultrasonic surgical blade further comprises a cutting portion for an ultrasonic surgical blade according to any one of claims 1-8, and further comprises a transition portion (2);
the transition portion (2) is arranged between the connecting portion (1) and the cutting portion (3), and the proximal end of the connecting portion (1) is coupled with the ultrasonic handle, and is characterized in that: at least one torsion part (21) is arranged on the transition part (2) so as to convert the longitudinal vibration provided by the ultrasonic handle into compound vibration and transmit the converted compound vibration to the cutting part (3), wherein the compound vibration comprises the longitudinal vibration and the torsion vibration;
At least one stabilizing part (22) is further arranged on the transition part (2), and the stabilizing part (22) is positioned in the proximal direction of the torsion part (21) so as to eliminate torsional vibration transmitted to the proximal end by the torsion part (21);
the distance from the center of the torsion part (21) to the end of the cutting part (3) is an odd multiple of lambda/4, wherein lambda is the wavelength of torsional vibration.
10. The transition for an ultrasonic surgical blade according to claim 9, characterized in that the distance between the stabilizing section (22) and the torsion section (21) is such that a longitudinal vibration node is located between the stabilizing section (22) and the torsion section (21) and at the proximal end of the torsion vibration node, and the distance between the longitudinal vibration node and the torsion vibration node is less than λ/4, λ being the wavelength of the torsion vibration, the torsion vibration node being the center of the torsion section (21).
11. The transition for an ultrasonic surgical blade according to claim 10, wherein the distance between the center of the stabilizing portion (22) and the torsional node is nλ/2, λ being the wavelength of the torsional vibration and n being an integer.
12. The transition for an ultrasonic surgical blade according to claim 9, wherein the stabilizing portion (22) is at least one of an angled slot, a corrugated slot, and a threaded slot configuration;
And/or the number of the groups of groups,
the torsion part (21) is at least one of an inclined groove, a corrugated groove and a thread groove structure.
13. The transition for an ultrasonic surgical blade according to claim 12, characterized in that the torsion portion (21) is a chamfer groove arranged circumferentially at the transition (2), the axis of the chamfer groove being at an angle to the axis of the transition (2).
CN202211108842.XA 2022-09-13 2022-09-13 Cutting part, transition part and ultrasonic surgical knife for ultrasonic surgical knife Active CN115500900B (en)

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