CN1732861A - 复合振动的超声骨骼手术仪 - Google Patents
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Abstract
一种复合振动的超声骨骼手术仪，包括手柄、手术刀具以及主机，手柄的外壳内包括：将超声信号发生器发出的超声信号转换成超声机械波的换能器；将发自换能器的超声机械波进行振幅放大后再传递到手术刀具的变幅杆，以使手术刀具以超声频率纵向振动；安装在手柄的后端，驱动换能器和变幅杆旋转或摆动的驱动电机；安装在所述驱动电机和换能器之间的联轴器上，用于将超声信号发生器发出的超声信号提供至换能器的导电滑环；穿过导电滑环的中心内孔并且将驱动电机的旋转和摆动运动传递到换能器的联轴器。本发明在换能器的基础上安装驱动电机，实现了复合超声振动；实现了冷切割；并可避免手术刀具由于应力集中而引发断裂。
Description
技术领域
本发明涉及一种手术医疗设备，更具体地说，涉及一种其超声手术刀具即既可纵向振动又可旋转的复合振动的超声骨骼手术仪。
背景技术
随着现代医学的迅速发展，超声手术仪已越来越多地应用于临床外科手术治疗中，它将超声能量应用于外科手术，其突出的特点是切割精细、安全、组织选择性和低温止血等，极大地丰富了外科手术的手段，提升了外科手术的质量，一定程度上减轻了患者的病痛。图1是常规超声骨骼手术仪的系统工作原理图，该系统主要由主机、手柄、刀具和脚踏开关组成。其中主机主要包括超声信号发生器、功率放大器和嵌入式计算机。超声信号发生器产生的小功率超声电信号经功率放大器放大后，可驱动手柄中的超声换能器工作；嵌入式计算机主要负责协调和控制整机工作，接收控制指令，显示仪器工作状态，实现人机交互和脚踏控制等功能。另外嵌入式计算机还要完成对超声换能器频率自动跟踪功能。手柄包括超声换能器和变幅杆，完成将超声电信号转化成超声机械波，经变幅杆实现振幅放大后，传递到手术刀具。此外，手柄上还配有冷却液体灌注机构，以降低超声刀切割骨骼时创面的温度。
在公开号为CN1039780C的中国发明专利文献中，公开一种超声手术仪，该超声手术仪包括手柄和主机，其中手柄内设有换能器、变幅杆、冲洗管、电缆、手术刀具等。
在公开号为CN2435054Y所中国实用新型专利文献中，公开了一种超声骨骼切割仪，该切割仪的变幅杆端部结合一手术刀具，该手术刀具的端部采用立刃式结构。手术时，手术刀具的立刃结构在变幅杆的驱动下产生最大幅度的超声波机械振动，立刃结构的超声振动所产生的切割力可对手术部位的软组织或骨骼组织进行切割，从而对患者进行手术。这种骨骼切割仪在患者皮肤上切开的切口较小，可降低出血量，减轻患者的痛苦。
另外，在美国专利文献US5486162A、US5562609A、US5562610A、US6033375A中，也分别公开了可以产生纵向超声振动的超声手术仪。而且，美国专利文献US6497715A中公开了一种用于超声手术仪的超声骨骼刀具，其可用于脊柱的减压手术。
但是，在现有超声手术仪中，超声信号发生器产生的超声电信号驱动手柄中的超声换能器，换能器将超声电信号转化成超声机械波，再经变幅杆实现振幅放大后，传递到手术刀具。这样，手术刀具只能在纵向方向上前后振动，其切割骨骼的效率低，而且手术刀具和创伤表面之间的摩擦力较大，容易引起切割创伤表面温度的升高，甚至会造成切割创伤口附件的神经和血管的热损伤。
另外，现有超声手术仪的手术刀具的形状一般是由安装在变幅杆上的、较粗的一端逐渐过渡到进行切割的、较细的一端，这样切割应力就主要集中在过渡结束的部位，使该部位容易发生疲劳断裂，致使手术刀具损坏。
发明内容
本发明所要解决的技术问题就是提供一种复合振动的超声骨骼手术仪，其手柄在超声换能器上配置驱动电机，使手术刀具既可纵向振动又可旋转，从而提高切割效率。
本发明的另一方面是提供一种复合振动的超声骨骼手术仪，其换能器采用断续脉冲驱动的方式，可避免创伤部位局部热量的积累，实现“冷切割”。
本发明进一步的发明是提供一种复合振动的超声骨骼手术仪，其安装在手柄上的手术刀具设有多个过渡阶梯，从而使刀具的疲劳应力均匀分布在刀具的多个位置，避免了手术刀具由于疲劳应力的集中而引发的断裂。
本发明的其它方面和/或优点部分将在下面的描述中进行说明，部分可从下面的描述中明显得出，或通过实施本发明而获得教导。
本发明的上述和其它方面是通过下述技术方案实现的，即提供一种复合振动的超声骨骼手术仪，包括手柄、安装在所述手柄前端的手术刀具以及超声信号发生器，其中所述手柄的外壳内包括：换能器，所述换能器将所述超声信号发生器发出的超声信号转换成超声机械波；变幅杆，所述变幅杆将发自所述换能器产生的超声机械波进行振幅放大后再传递到所述手术刀具，以使所述手术刀具纵向超声振动；驱动电机，所述驱动电机设置在所述外壳的后端，并驱动所述换能器和变幅杆旋转或摆动；适配器，所述适配器设置在所述驱动电机和换能器之间，用于将所述超声信号发生器发出的超声信号提供至所述换能器。
在上述超复合振动的超声骨骼手术仪中，由于在所述外壳的后端设置驱动电机，而且该驱动电机驱动换能器和变幅杆旋转，这样就使安装在手柄前端的手术刀具在纵向移动的同时，还可进行旋转，从而产生复合运动，对手术部位的骨骼进行切割、钻孔、磨削等，使手术者可以像握笔一样平稳地控制超声刀对骨骼“雕刻”出任何形状，同时提高了切割效率，降低了刀具与创伤面之间的摩擦力，从而降低了创伤面的切割温度。
在上述骨骼手术仪中，所述适配器是导电滑环，所述导电滑环包括内环和与所述内环电连接的外环，所述外环固定在所述外壳内并电连接外部信号发生器，所述内环与所述换能器同步转动并与其电连接，而且内环和外环之间为电刷式电连接。
根据本发明进一步的方面，在上述骨骼手术仪中，所述超声信号发生器向所述换能器间断地发出脉冲超声信号，以使所述换能器间断地产生超声机械波。
根据本发明更进一步的方面，在上述骨骼手术仪中，所述手术刀具从较粗的一端到较细的一端设有多个过渡阶梯。
在上述骨骼手术仪中，所述手术刀具为带有锯齿的片状切刀。
在上述骨骼手术仪中，所述手术刀具为带有锯齿的圆头状切刀。
在上述骨骼手术仪中，所述手术刀具为带有滚花和滚槽的球形或圆柱形磨刀。
在上述骨骼手术仪中，所述手术刀具为带有滚花和滚槽的锥形磨刀。
在上述骨骼手术仪中，所述手术刀具为平滑的球形止血刀。
在上述骨骼手术仪中，所述手术刀具为中空结构，并且中空结构的开口分别位于手术刀具的端部和侧部。
采用上述结构的超声骨骼手术仪进一步提高了操作安全性和精确性。其独特手术刀具结构可以将超声能量集中送到切割刀具的前端，切割骨骼时刀具前端的能量密度很大，可以获得很好的切割骨骼的效果，而手术刀具的疲劳应力却均匀分布开，提高了刀具的使用寿命。而且手术时，手术人员手持的手柄部分则静止不动，减轻医生的劳动强度，提高了手术质量。此外，这种超声骨骼手术仪在切割骨骼时，对周围的软组织具有良好的保护作用，尤其在人体的关键部位脊柱手术中，可保证脊髓不受损伤。更进一步地，由于超声骨骼手术仪的低温凝血功能，创面不出血，无焦痂，并发症少。
附图说明
通过结合附图对本发明具体实施例的详细描述，会对本发明的发明目的和技术构思有更清楚的了解，其中：
图1是常规超声骨骼手术仪的系统工作原理图；
图2是本发明所述复合振动的超声骨骼手术仪手柄的立体示意图；
图3是图2所示复合振动的超声骨骼手术仪手柄的纵向剖视图；
图4是图3所示导电滑环结构的剖视图；
图5所示的示意图表示带有锯齿的片状切刀式手术刀具；
图6所示的示意图表示带有锯齿的圆头状切刀式手术刀具；
图7所示的示意图表示带有毛刺圆柱形磨刀式手术刀具；
图8所示的示意图表示带有毛刺球形磨刀式手术刀具
图9所示的示意图表示平滑的球形止血刀式手术刀具。
图10表示具有中空结构的手术刀具的剖视图，图中手术刀具连接有抽吸装置。
具体实施方式
下面将对本发明的具体实施进行详细描述，在附图中示出了其实例，其中相同的标号表示相同的部件。
图2是本发明所述复合振动的超声骨骼手术仪手柄的立体示意图，图3是图2所示复合振动的超声骨骼手术仪手柄的纵向剖视图。参照图2和3，该复合振动的超声骨骼手术仪包括手柄1、安装在手柄1前端的手术刀具16以及超声信号发生器，其中手柄1的外壳2内包括：换能器9、变幅杆10、驱动电机4和适配器。换能器9将超声信号发生器发出的超声信号转换成超声机械波，变幅杆10将发自换能器9的超声机械波进行振幅放大后再传递到手术刀具16，以使手术刀具16纵向超声振动，驱动电机4通过固定在外壳2上的支架3安装在外壳2的后端，驱动电机4的输出轴5通过联轴器7连接至换能器的后部，以驱动换能器9和变幅杆10旋转，同时驱动电机也可通过联轴器7与换能器9和变幅杆10连接，以使安装在变幅杆10前端的手术刀具16产生摆动，优选地，联轴器7通过绝缘垫20与换能器9连接，以在联轴器7和换能器之间进行电绝缘。该适配器设置在驱动电机4和换能器9之间，用于将所述超声信号发生器发出的超声信号提供至所述换能器，优选地，适配器是导电滑环6，也可以是其它能够从固定的导线给旋转部件供电的装置，比如类似电动机或发动机中的电刷式结构。进一步地，在外壳前端的外部，设有注水架12，该注水架12上支撑有注水管14，用于对手术刀具16进行降温。手术刀具16后部较粗的部分外面还设有保护套15。
参照图4，在上述骨骼手术仪中，导电滑环6包括内环8和与该内环8电连接的外环11。更具体地说，外环11固定在外壳2内，外环11上设置有导电凹槽13，外部信号发生器通过设置在导电凹槽13中的导线连接至固定在外环11上的导电刷17。内环设置成与换能器9同步转动，在一优选实施例中，驱动电机4可通过穿过内环8中心通孔的联轴器7驱动换能器9。内环8与联轴器之间通过顶丝(或键槽)固定，这样驱动电机4便可带动内环8做与换能器同步的摆动或旋转运动，其中可通过使换能器连续的正反向转动而实现手术刀具的摆动。在内环8上设置有导电体18，该导电体18的位置与导电刷17的位置相对应并且紧密地电接触。这样，当内环8转动时，外部信号发生器的电信号可传输到随内环11转动的导电体18，并进一步通过设置在内环8中的凹槽19内的导线传输到与内环11同步转动的换能器9，从而将信号发生器产生的超声信号传输到换能器9。在上述导电滑环6的结构中，内环8和外环11之间为电刷式电连接，但本发明并不局限于此，也可以采用其它结构代替，只要可将信号发生器的超声信号传输到做摆动或旋转运动的换能器9即可。
在上述复合振动超声骨骼手术仪的手柄中，由于在外壳2的后端设置驱动电机4，而且该驱动电机4驱动换能器9和变幅杆10旋转，这样在进行骨骼切割手术时，在外部信号发生器的控制下，安装在手柄1前端的手术刀具16纵向振动，同时手术刀具16还由于电机的旋转而进行旋转或摆动，以产生复合振动，进而对手术部位的骨骼进行切割、钻孔、磨削等，使手术者可以像握笔一样平稳地控制超声刀具对骨骼“雕刻”出任何形状，既提高了切割效率，又由于降低了刀具与创伤面之间的摩擦力，而降低了创伤面的切割温度。
优选地，在本发明所述的骨骼手术仪中，控制超声信号发生器向换能器9间断地发出的超声信号，以使所述换能器间断地产生超声机械波。实验证明：在有灌注水冷却的情况下，超声刀切割骨骼时，创面附近1到2mm的小范围内产生的温度为50-90℃。由于在本发明中，超声手术刀具16所释放出的能量是瞬间爆破型的，在发射超声能量的间隙，切割创伤表面因摩擦产生的热量可得到充分地扩散，避免了创伤面的局部热量积累，这样可实现“冷切割”，创面温度为40℃以下，防止对创伤面以及周围神经和血管过度热损伤。
图5-9示出了各种手术刀具16的具体实施例，图5-8所示的手术刀具从较粗的一端到较细的一端设有多个过渡阶梯。众所周知，超声手术刀具16一般工作在20至60KHz，在这样高的频率下工作，手术刀具16很容易因为高度疲劳而断裂。现有技术中的手术刀具16，为避免其断裂，所采取的技术措施往往是增加刀具的厚度，但这样不能适应精细骨骼手术的需要。为此，有人把手术刀具设计成由较粗的安装端逐渐过渡到较细的手术端，但试验表明，这样的刀具其工作应力都作用在过渡结束的部位，因此过渡结束的部位容易断裂。而本发明的手术刀具结构可以将超声能量集中送到切割刀具的前端，切割骨骼时刀具前端的能量密度很大，可以获得很好的切割骨骼的效果，而手术刀具的疲劳应力却均匀分布开，避免了由于疲劳应力的集中而引发刀具断裂的现象，提高了刀具的使用寿命。
为适应各种临床骨骼手术的需要，在本发明中，手术刀具16可以为带有锯齿21的片状切刀和圆头状切刀，这样可实现对骨骼的切割。手术刀具16也可以为带有滚花和滚槽22的球形、锥形或圆柱形磨刀，以实现对骨骼的钻孔、磨削等。进一步地，手术刀具16还可以为平滑的球形止血刀，以实现对创伤部位的止血，使创面不出血，无焦痂，并发症少。
优选地，如图10所示，在上述骨骼手术仪中，手术刀具16为中空结构，并且中空部分的开口分别位于手术刀具的端部和侧部，这样可从手术刀具16的侧部开口处连接抽吸装置，该抽吸装置包括储存室23和负压系统24。手术时，该抽吸装置利用负压系统24的抽吸力，可把手术刀具16产生的骨渣等残留物通过手术刀具的中空部分抽出，并储存在储存室23中，这样可清理手术人员的视野，使手术部位清晰可见，避免误伤人体的神经等不须手术的部位。
本发明上述实例和实施方式可认为是实例性的，而不是限定性的，而且本发明并不局限于本说明书所给出的细节，而是在随附权利要求书及其等同替换的范围之内，可以进行改进。
Claims (10)
1、一种复合超声振动的超声骨骼手术仪，包括手柄、安装在所述手柄前端的手术刀具以及超声信号发生器，其中所述手柄的外壳内包括：
超声换能器，所述超声换能器将所述超声信号发生器发出的超声信号转换成超声机械波；
变幅杆，所述变幅杆将发自所述超声换能器的超声机械波进行振幅放大后再传递到所述手术刀具，以使所述手术刀具纵向超声振动；
驱动电机，所述驱动电机设置在所述手柄的后端，并驱动所述换能器和变幅杆旋转或摆动；
适配器，所述适配器设置在所述驱动电机和换能器之间，用于将所述超声信号发生器发出的超声电信号提供至所述换能器。
2、如权利要求1所述的骨骼手术仪，其中所述是导电滑环，所述导电滑环包括内环和与所述内环电连接的外环，所述外环固定在所述外壳内并电连接外部信号发生器，所述内环与所述换能器同步转动并与其电连接。
3、如权利要求2所述的骨骼手术仪，其中所述内环和外环之间为电刷式电连接。
4、如权利要求1或2或3所述的骨骼手术仪，其中所述超声信号发生器向所述换能器间断地发出的脉冲超声信号，以使所述换能器间断地产生超声机械波。
5、如权利要求1-4中的任一项所述的骨骼手术仪，其中所述手术刀具从较粗的一端到较细的一端设有多个过渡阶梯。
6、如权利要求1-5中的任一项所述的骨骼手术仪，其中所述手术刀具为带有锯齿的片状切刀或圆头状切刀。
7、如权利要求1-5中的任一项所述的骨骼手术仪，其中所述手术刀具为带有滚花和滚槽的球形或圆柱形磨刀。
8、如权利要求1-5中的任一项所述的骨骼手术仪，其中所述手术刀具为带有滚花和滚槽的锥形磨刀。
9、如权利要求1-5中的任一项所述的骨骼手术仪，其中所述手术刀具为平滑的球形止血刀。
10、如权利要求6-9中的任一项所述的骨骼手术仪，其中所述手术刀具为中空结构，并且中空结构的开口分别位于手术刀具的端部和侧部。
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Also Published As
| Publication number | Publication date |
|---|---|
| CN100394897C (zh) | 2008-06-18 |
| US20060030797A1 (en) | 2006-02-09 |
| JP2008508065A (ja) | 2008-03-21 |
| WO2006012797A1 (fr) | 2006-02-09 |
| DE112005001878T5 (de) | 2007-06-28 |
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