JP2001017444A - Coagulation hemostasis tool for surgery - Google Patents

Abstract

PROBLEM TO BE SOLVED: To stop bleeding in a broad range without burning a living body tissue, by arranging a flat treatment portion for coagulation hemostasis treatment in a substantially flat shape putted on the living body tissue substantially parallel with the oscillation direction at the tip of a transmitting member for transmitting ultrasonic oscillation from an ultrasonic oscillator to a treatment portion. SOLUTION: Ultrasonic oscillation outputted from an ultrasonic oscillator of a hand piece 2 of this surgery coagulation hemostasis tool 1 is transmitted to a desired treatment portion through a slender ultrasonic probe (transmitting member) 5. The ultrasonic probe is supplied with electric energy from a generator 4 through an electric cord 3. The tip of the ultrasonic probe 5 is projected forward from the tip opening of a sheath 7, and a stantially flat-shaped treatment portion 8 for coagulation hemostasis to be put on a flat living body tissue is provided at a front projection portion of the tip of the ultrasonic probe 5, and the flat treatment portion 8 is arranged in substantially parallel with the oscillation direction of ultrasonic oscillation of the ultrasonic probe 5.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a surgical coagulation hemostatic device for stopping bleeding during incisions and procedures in surgical operations.

[0002]

2. Description of the Related Art In general, since a surgical operation always involves bleeding, a device for stopping the bleeding or a device for performing incision or treatment without bleeding is often used. A typical surgical instrument is an electric scalpel. When a high-frequency current is applied to a bleeding site by applying a scalpel electrode to the bleeding site, heat is applied to the living tissue to explode in water vapor, losing water, causing drying and coagulation to stop bleeding.

Similarly, when instruments such as a laser and a heat scalpel are used, the living tissue can be coagulated by applying heat to the living tissue with these instruments to stop the bleeding.

Further, US Pat. No. 5,263,957 discloses a coagulation instrument using ultrasonic vibration. Here, the ultrasonic vibration is transmitted to the treatment instrument probe, and frictional heat is generated by the ultrasonic vibration in the distal treatment section of the treatment instrument probe, so that the incision can be performed while coagulating the living tissue.

[0005]

However, the above-mentioned conventional treatment tool has the following problems. When an electric scalpel is used, there is a problem in that the living tissue is scorched on the scalpel tip electrode, or when the living tissue is heated to an unnecessarily high temperature, the living tissue is scorched and carbonized, resulting in slow healing.
In addition, laser and heat scalpels cannot cope with widespread coagulation and thus cannot cope with gradual bleeding.

Further, US Pat.
In the coagulation instrument of 263957, since incision and coagulation of the living tissue are performed simultaneously, there is a problem that it is difficult to perform only coagulation of the living tissue.

SUMMARY OF THE INVENTION The present invention has been made in view of the above circumstances, and an object of the present invention is to provide a surgical coagulative hemostatic device capable of stopping a wide range of bleeding without scorching a living tissue.

[0008]

According to the present invention, an ultrasonic vibration output from an ultrasonic vibrator is disposed at a distal end of a transmission member for transmitting the ultrasonic vibration to a target treatment section, substantially in parallel with the vibration direction,
A surgical coagulation / hemostatic device comprising a substantially flat coagulation / hemostatic treatment portion adapted to be applied to a living tissue. Then, in the present invention, when the ultrasonic vibration output from the ultrasonic transducer is transmitted to the flattening treatment section via the transmission member at the time of bleeding from the living tissue, the flattening treatment section for coagulation / hemostatic treatment is performed on the living tissue. By applying to the bleeding site from this surface, the bleeding site from this surface is subjected to extensive hemostasis treatment. At this time, since the living tissue does not adhere to the flattened treatment section, problems such as rebleeding can be solved.

[0009]

DESCRIPTION OF THE PREFERRED EMBODIMENTS A first embodiment of the present invention will be described below with reference to FIGS. 1 (A), 1 (B) and 2.
FIG. 1A shows a schematic configuration of a surgical coagulation hemostat 1 according to the present embodiment. The surgical coagulation device 1 includes a handpiece 2 that is handled as a handheld device by an operator, and a generator 4 connected to the handpiece 2 via an electric cord 3.

The handpiece 2 also includes an ultrasonic transducer (not shown), an elongated ultrasonic probe (transmission member) 5 for transmitting ultrasonic vibrations output from the ultrasonic transducer to a target treatment section, A transducer cover 6 for covering the acoustic transducer;
A sheath 7 covering the ultrasonic probe 5 is provided.

Here, the ultrasonic vibrator is supplied with electric energy from the generator 4 via the electric cord 3 to generate ultrasonic vibration. Further, at the time of driving the ultrasonic vibrator, ultrasonic vibration generated from the ultrasonic vibrator is transmitted to the ultrasonic probe 5.

The distal end of the ultrasonic probe 5 projects forward from the distal opening of the sheath 7. FIG. 1B shows a front protruding portion of the tip of the ultrasonic probe 5.
As shown in FIG. 1, a flattened treatment section 8 for coagulation / hemostatic treatment having a substantially flat shape which is applied to a planar living tissue is provided. The flattening section 8 is arranged substantially parallel to the vibration direction of the ultrasonic vibration of the ultrasonic probe 5.

Further, on the outer peripheral surface of the vibrator cover 6, a switch 9 for ON / OFF operation of ultrasonic vibration is provided. By operating the switch 9, on / off of the ultrasonic vibrator in the vibrator cover 6 is switched.

Next, the operation of the above configuration will be described.
FIG. 2 shows a usage state of the surgical coagulation / hemostatic device 1 of the present embodiment. In FIG. 2, H is a living tissue, and H1 is a living tissue.
Is an extensive bleeding part formed in the living tissue H and serving as a target treatment part.

When using the surgical coagulation / hemostatic device 1 of the present embodiment, the switch 9 of the handpiece 2 is turned on.
By this switch operation, electric energy is supplied from the generator 4 to the ultrasonic vibrator in the handpiece 2, and ultrasonic vibration is generated. This ultrasonic vibration is transmitted to the distal end side by the ultrasonic probe 5, and the flat treatment section 8 at the distal end of the ultrasonic probe 5 vibrates in the vertical direction.

In this state, the flat treatment section 8 at the distal end of the handpiece 2 is caused to approach the living tissue H to be treated, and the flat treatment section 8 at the distal end of the ultrasonic probe 5 is brought into contact with the target treatment section of the biological tissue H. The bleeding part H1 is contacted over a wide area. At this time, frictional heat is generated between the flat portion of the flattening treatment portion 8 and the surface of the bleeding portion H1 by rubbing the flat surface of the flat treatment portion 8 against the bleeding portion H1. Thereby, the bleeding part H1 of the living tissue H is coagulated, so that the bleeding part H1 of the living tissue H can be stopped.

Therefore, the above configuration has the following effects. That is, in the present embodiment, a flattened treatment section for coagulation / hemostatic treatment having a substantially flat shape which is disposed at the tip of the ultrasonic probe 5 of the handpiece 2 substantially in parallel with the vibration direction and is applied to the living tissue H 8 is provided. When bleeding from the living tissue H, the ultrasonic vibration output from the ultrasonic vibrator of the handpiece 2 is transmitted to the ultrasonic probe 5.
The flat treatment unit 8 is applied to the bleeding part H1 from the surface of the living tissue H while the flat treatment unit 8 is transmitted to the flat treatment unit 8 via
The bleeding part H1 from this surface can be subjected to hemostasis treatment over a wide area by performing this operation a number of times. At this time, since the flattening treatment section 8 performs ultrasonic vibration, the flattening treatment section 8 does not have a possibility that the living tissue H sticks to the flattening treatment section 8, and has an effect of eliminating problems such as rebleeding.

FIG. 3 shows a first embodiment (FIG. 1).
(A), (B) and FIG. 2).
FIG. In this modification, as shown in FIG. 3, the flattened treatment section 8 at the tip of the ultrasonic probe 5 is formed by an inclined surface slightly inclined with respect to the vibration direction of the ultrasonic vibration of the ultrasonic probe 5. .

In the present modification, the flattening section 8 of the ultrasonic probe 5 can be more easily applied to the living tissue H, and the operability of the handpiece 2 of the surgical coagulation / hemostatic device 1 is further improved. Can be.

FIGS. 4A and 4B show a second embodiment of the present invention.
1 shows an embodiment of the present invention. FIG. 4A shows a handpiece 11 of a coagulation / hemostatic device applicable to an operation under an endoscope. The configuration of the main part of the handpiece 11 of the present embodiment is similar to that of the handpiece 2 of the surgical coagulation hemostatic device 1 of the first embodiment (see FIGS. 1A, 1B and 2).
4A and 4B, the same parts as those of the handpiece 2 of the first embodiment are denoted by the same reference numerals, and the description thereof is omitted. In the following, only the parts different from the handpiece 2 of the first embodiment will be described.

That is, the handpiece 1 of the present embodiment
A long sheath 12 that can be inserted into a trocar for endoscopic surgery and a similar ultrasonic probe 13 are attached to 1. Further, at the tip of the ultrasonic probe 13, there is a flat treatment section 14 which is substantially parallel to the vibration direction and is flat. As shown in FIG. 4B, the flattening section 14 is formed in an elliptical shape that can be inserted into the trocar.

In this embodiment, when the switch 9 is operated, electric energy is supplied from the generator 4 (see FIG. 1) to the ultrasonic vibrator in the handpiece 11, and ultrasonic vibration is generated. This ultrasonic vibration is transmitted to the distal end by the ultrasonic probe 13, and the flattening section 14 at the distal end of the ultrasonic probe 11 vibrates in the vertical direction. When the ultrasonic vibrator in the handpiece 11 is driven, contact between the ultrasonic probe 13 vibrated by the sheath 12 and the trocar is avoided.

Therefore, in this embodiment, the handpiece 1
1 is provided at the tip of the ultrasonic probe 13 in the plane 1 with a flat treatment section 14 substantially parallel to the vibration direction, and the flat treatment section 14 is formed in an elliptical shape that can be inserted into the trocar. 11 and the flattening section 14 of the ultrasonic probe 13 can be inserted into a trocar for endoscopic surgery. And the ultrasonic probe 1
The flattened treatment section 14 at the tip of No. 3 is brought into contact with a wide-range bleeding part H1 serving as a target treatment part of the living tissue H. At this time, the flat surface of the flat treatment section 1 is applied to the bleeding section H1 so as to be stroked, so that the flat section of the flat treatment section 14 and the bleeding section H1 are bleeding.
Frictional heat is generated between the surfaces. Thereby, the bleeding part H1 of the living tissue H is coagulated, so that the bleeding part H1 of the living tissue H can be stopped. At this time, the flattening section 1
Is ultrasonically vibrated, so that the living tissue H is less likely to stick to the flattened treatment section 1.

FIGS. 5A to 5F show a plurality of ultrasonic probes 5 in the surgical coagulation / stopper 1 according to the first embodiment (see FIGS. 1A, 1B and 2). FIG.

FIG. 5A shows a first modification of the ultrasonic probe 5. This modified example is an example in which a flat portion of a flat treatment section 8 that is applied to a living tissue H is provided with a coating section 21 in which a fluorine coating such as Teflon (trade name) is applied. FIG. 5B shows a second modified example of the ultrasonic probe 5. This modification is an example in which a cap 22 made of a fluororesin such as Teflon is provided in the flat treatment section 8 which is applied to the living tissue H. The coating section 21 and the cap 22 can prevent the living tissue H from sticking to the flat treatment section 8.

FIG. 5C shows a third modification of the ultrasonic probe 5. The present modification is an example in which a rough-finished flat surface 23 is provided in which the flat surface of the flat treatment section 8 applied to the living tissue H is rough-finished. Then, the rough finishing plane 23 of the flattening treatment section 8 can enhance the effect of friction.

FIG. 5D shows a fourth modification of the ultrasonic probe 5. In the present modification, a distal end member 32 is provided in which the distal end of the ultrasonic probe 5 is separated from the probe main body 31, and the flat treatment section 8 is provided at the distal end of the distal end member 32. Further, a male screw portion 34 screwed into a screw hole 33 on the probe main body 31 side is provided at a base end portion of the distal end member 32. And this tip member 32
This is an example in which the flat treatment portion 8 of the distal end member 32 can be exchanged with respect to the probe main body 31 side by detachably screw-connecting the male screw portion 34 of the probe main body 31 and the screw hole 33 of the probe main body 31 side. Thus, the flat treatment section 8 of the distal end member 32 with respect to the probe main body 31 can be appropriately replaced and used according to the intended use.

FIGS. 5E and 5F show a fifth modification of the ultrasonic probe 5. FIG. In this modification,
This is an example in which a curved surface 41 processed into a convex surface is provided in a flat treatment section 8 applied to a living tissue H. Thus, the flat treatment section 8 can be easily stroked on the living tissue H. Further, a blade 42 may be provided on the side opposite to the flattening treatment section 8 so that the living tissue H can be incised by the blade 42.

FIG. 6 shows a third embodiment of the present invention. This embodiment is directed to an ultrasonic probe 5 according to the first embodiment (see FIGS. 1A, 1B and 2).
Bending part 5 that changes the direction of ultrasonic probe 5 in the middle part of
1 is provided. Thus, the flat treatment section 8 at the tip of the probe 5 can be easily applied to the living tissue H.

FIG. 7 shows a fourth embodiment of the present invention. In this embodiment, a battery 61 for supplying electric energy is built in the handpiece 2 of the surgical coagulation / hemostatic device 1 of the first embodiment (see FIGS. 1A, 1B and 2). Battery-type coagulation hemostat 62
Is provided.

That is, the coagulation hemostat 62 according to the present embodiment.
Inside the handpiece 63, an ultrasonic vibrator 64,
Driving unit 65 for ultrasonically vibrating ultrasonic vibrator 64
And a battery 61 for supplying electric energy to the drive unit 65, and a switch 66 for turning on / off the ultrasonic vibration.

Further, an ultrasonic probe 67 for transmitting ultrasonic vibration to the distal end side is attached to the distal end of the handpiece 63. A flat treatment section 68 having a flat portion substantially parallel to the vibration direction of the probe 67 is provided at the tip of the probe 67.

When the switch 66 is operated, power is supplied from the battery 61 to the drive section 65, and the ultrasonic vibrator 64 is ultrasonically vibrated. This vibration is transmitted by the probe 67 to the flattening treatment section 68 on the distal end side. In this state, by applying the flat treatment section 68 to the living tissue H, the living tissue H can be coagulated by friction to stop bleeding.
Furthermore, in the present embodiment, by using a battery type,
Since the electric cord 3 of the first embodiment (see FIG. 1) is not required, the operability of the handpiece 63 is also improved.

FIG. 8 shows a fifth embodiment of the present invention. In the present embodiment, the handpiece 2 of the first embodiment (see FIGS. 1A, 1B and 2) is provided with a coagulation hemostatic device 71 having a suction function with a suction function added. .

That is, the coagulation hemostat 71 according to the present embodiment.
The handpiece 72 is provided with a flat treatment part 74 having a flat part substantially parallel to the vibration direction at the tip of the ultrasonic probe 73. Further, a suction hole 75 extends through the axial center of the ultrasonic probe 73 over the entire length. A base end of the suction hole 75 is connected to a suction tube 76 on an external suction device side.

In the present embodiment, the ultrasonic vibration is transmitted to the distal end side by the ultrasonic probe 73. At this time, the living tissue H is emulsified by bringing the peripheral portion of the distal end opening of the suction hole 75 of the ultrasonic probe 73 into contact with the living tissue H, and unnecessary living tissue H is then removed from the suction hole 7.
Suction from the tip opening of No. 5 to remove it from the body. further,
With respect to bleeding from the treated surface, coagulation and hemostasis can be performed by applying the flat portion of the flattened treatment section 74.

Therefore, according to the present embodiment, since the coagulation hemostatic device 71 having a suction function with the suction function added to the handpiece 2 of the first embodiment is provided, the ultrasonic suction device having no hemostatic function is provided. Thus, an ultrasonic suction device having a coagulation / hemostatic function can be configured by eliminating the disadvantages described above.

Furthermore, the present invention is not limited to the above-described embodiment, and it goes without saying that various modifications can be made without departing from the spirit of the present invention. Next, other characteristic technical matters of the present application will be additionally described as follows. (Supplementary note 1) In a surgical instrument including an ultrasonic vibrator and a transmission member that transmits ultrasonic vibrations to a target treatment unit, the distal end of the transmission member has a substantially horizontal and flat shape in the vibration direction. A surgical coagulation / hemostatic device, characterized in that a treatment section adapted to be applied to a tissue is provided.

(Supplementary claim 2) The surgical coagulation / stopper according to claim 1, wherein the treatment section at the tip is coated.

(Supplementary note 3) The surgical coagulation / hemostatic device according to claim 1, wherein a cap made of Teflon is provided at the treatment section at the distal end.

(Supplementary claim 4) The surgical coagulation / hemostatic device according to claim 1, wherein the treatment section at the distal end has a roughened surface.

(Supplementary claim 5) The surgical coagulation hemostatic device according to claim 1, wherein the treatment section at the distal end has a treatment surface formed in a convex shape.

(Supplementary claim 6) The surgical coagulation / hemostatic device according to claim 1, wherein the treatment portion at the distal end has a blade portion on the side opposite to the treatment surface.

(Supplementary Item 7) In a surgical instrument including an ultrasonic vibrator and a transmission member for transmitting ultrasonic vibration to a target treatment section, a drive circuit for driving a battery, a switch, and an ultrasonic vibrator in a handpiece. A surgical coagulation hemostat comprising:

(Prior art of Supplementary items 1 to 7) Since a surgical operation always involves bleeding, a device for stopping the bleeding or a device for performing incision or treatment without bleeding is often used. A typical surgical instrument is an electric scalpel. When a scalpel electrode is applied to a bleeding site and a high-frequency current is applied, the tissue loses water due to steam explosion due to heat, and can dry and coagulate to stop bleeding. Similarly, a laser, a scalpel, or the like can coagulate the tissue by applying heat to the tissue to stop the bleeding.

Further, as disclosed in US Pat. No. 5,263,957, a coagulation instrument using ultrasonic vibration has been proposed.
In this proposal, ultrasonic vibration is transmitted to a treatment instrument probe, and frictional heat is generated by the ultrasonic vibration in the distal treatment section, so that an incision can be made while coagulating tissue.

(Problems to be Solved by Additional Items 1 to 7)
Such a treatment tool has the following disadvantages.
When an electric scalpel is used, the tissue burns to the electrode of the scalpel or the tissue is heated to an unnecessarily high temperature, resulting in carbonization of the tissue and slow healing. In addition, since it is not possible to coagulate extensively, it is not possible to cope with gradual bleeding. It is difficult to perform only coagulation with the coagulation instrument using ultrasonic vibration.

(Purpose of Supplementary Items 1 to 7) An object of the present invention is to provide a device for preventing tissue from burning and preventing a wide range of bleeding.

(Effects of Supplementary Items 1 to 7) In a surgical instrument including an ultrasonic vibrator and a transmitting member for transmitting ultrasonic vibration to a target treatment section, a distal end portion of the transmitting member is substantially arranged in a vibration direction. By providing a treatment section that is applied to the tissue in a horizontal and flat shape, bleeding from the surface can be stopped. In addition, since the tissue does not stick, problems such as rebleeding can be solved.

[0050]

According to the present invention, the ultrasonic vibration output from the ultrasonic vibrator is disposed substantially parallel to the vibration direction at the distal end of the transmitting member for transmitting the ultrasonic vibration to the target treatment section. Since the flattening section for coagulation and hemostasis treatment having a substantially flat shape to be applied is provided, the living tissue is not scorched and bleeding in a wide area can be stopped.

[Brief description of the drawings]

FIG. 1 shows a first embodiment of the present invention;
(A) is a schematic configuration diagram of a surgical coagulation / hemostatic device, and (B) is a plan view showing a treatment section for coagulation / hemostatic treatment.

FIG. 2 is a perspective view showing a use state of the surgical coagulation / hemostatic device according to the first embodiment;

FIG. 3 is a perspective view showing a modified example of the surgical coagulation / hemostatic device according to the first embodiment.

FIG. 4 shows a second embodiment of the present invention.
(A) is a perspective view of a surgical coagulation / hemostatic device, and (B) is a plan view showing a treatment section for coagulation / hemostatic treatment.

FIG. 5 shows a modification of the ultrasonic probe in the surgical coagulation / hemostatic device according to the first embodiment.
(B) is a perspective view showing a second modification, (C) is a perspective view showing a third modification, (D) is a perspective view showing a fourth modification, (E) is a front view of a flattened treatment section of an ultrasonic probe showing a fifth modification, and (F) is a perspective view of a flattened treatment section of the fifth modification.

FIG. 6 is a perspective view of a surgical coagulation hemostatic device showing a third embodiment of the present invention.

FIG. 7 is a perspective view of a surgical coagulation hemostatic device according to a fourth embodiment of the present invention.

FIG. 8 is a perspective view of a surgical coagulation hemostat according to a fifth embodiment of the present invention.

[Explanation of symbols]

 2 Handpiece 5 Ultrasonic probe (transmission member) 8 Flat treatment section H Living tissue

 ──────────────────────────────────────────────────の Continuing on the front page (72) Inventor Yoshikiyo Shibata 2-43-2 Hatagaya, Shibuya-ku, Tokyo Inside Olympus Optical Industrial Co., Ltd. (72) Inventor Kenichi Kimura 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optical Co., Ltd. (72) Takahiro Ogasaka, Inventor 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olimpus Optical Industries Co., Ltd. (72) Masaaki Ueda 2-43-2, Hatagaya, Shibuya-ku, Tokyo Inside Olympus Optical Co., Ltd. (72) Inventor Hiroshi Okabe 2-43-2, Hatagaya, Shibuya-ku, Tokyo Inside Olympus Optical Co., Ltd. (72) Kazutaka Nakachi 2-43-2, Hatagaya, Shibuya-ku, Tokyo No. Olympus Optical Co., Ltd. (72) Inventor Akira Shiga 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olimpa The Optical Industry Co., Ltd. (72) inventor Nakamura Takeaki Tokyo, Shibuya-ku, Hatagaya 2-chome No. 43 No. 2 Olympus Optical Industry Co., Ltd. in the F-term (reference) 4C060 JJ13 JJ23 JJ27

Claims (1)

[Claims] 1. A flattened member disposed substantially parallel to a vibration direction at a distal end of a transmission member for transmitting ultrasonic vibration output from an ultrasonic vibrator to a target treatment section and applied to a living tissue. A surgical coagulation hemostatic device comprising a flat treatment section for coagulation hemostasis treatment having a shape.