JP2001025468A - Ultrasonic surgical apparatus - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an ultrasonic surgical apparatus capable of safely and easily coagulation, in a relatively wide range, a biological tissue, being applicable in the care of stopping bleeding from a stump after hepatectomy or the like. SOLUTION: A concave ultrasonic wave radiation section 10 is formed at the tip of an ultrasonic probe 7, the tip of a sheath 9 covering the ultrasonic probe 7 is extended forward of the ultrasonic wave emission section 10, and an ultrasonic treatment space holding means 12 for holding an ultrasonic treatment space S between the ultrasonic wave radiator section 10 of the ultrasonic probe 7 and a biological tissue H of an object to be treated at a fixed set space is provided.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an ultrasonic surgical instrument for performing a treatment such as coagulation without contacting a living tissue with a living tissue.

[0002]

2. Description of the Related Art In general, surgical instruments for performing treatment such as coagulation without contacting a living tissue with a living tissue have been developed. For example, Japanese Patent Application Laid-Open No. 3-155852 discloses a shock wave crushing treatment apparatus for crushing a treatment site such as a cancer tissue in a patient's body or a calculus by a shock wave obtained by transmitting ultrasonic waves, and the convergence energy of continuous ultrasonic waves. There is disclosed an ultrasonic therapy apparatus for crushing and treating cancer tissue or the like by a thermal action or the like.

[0003] Also, Japanese Utility Model Laid-Open No. 63-180021,
Japanese Utility Model Application Laid-Open No. 63-56022 discloses an apparatus for performing hyperthermia treatment for cancer or the like in a body by converging an ultrasonic wave output from an ultrasonic oscillator with a concave acoustic lens.

Other conventional techniques include a high-frequency scalpel, which is a high-frequency ablation apparatus using argon gas, and an apparatus, such as a laser, capable of coagulating a wide range of living tissues without contact. Further, US Pat. No. 5,263,957 describes a coagulation / incision device using ultrasonic waves.

[0005]

However, in the device disclosed in Japanese Patent Application Laid-Open No. 3-155852, the size of the device is large, so that the operator cannot handle the device as a hand-held device, and the position control is mechanically fine. There are issues that need to be done.

Also, Japanese Utility Model Application Laid-Open No. 63-180021 discloses
The apparatus disclosed in Japanese Utility Model Application Laid-Open No. 63-56022 also has problems such as an increase in size of the apparatus and a necessity of finely controlling the position, and a problem of lack of coagulation ability to prevent bleeding. Furthermore, since the ultrasonic waves output from the ultrasonic oscillator are converged by the concave acoustic lens, the heat treatment is intensively applied to cancers in the body, so that the surface of the living tissue is treated. There is also a problem that cannot be done.

[0007] Further, the high-frequency scalpel has a problem in terms of safety for patients, because a stray current may flow in the body. Further, the laser has a problem that the apparatus becomes expensive. In addition, since all of the coagulation and incision devices of US Pat. No. 5,263,957 come into contact with living tissue, there is a possibility that a coagulated portion of the living tissue is fixed to a contact portion of the coagulation and incision device. Therefore, in this case, when the coagulation and incision device is peeled off from the coagulated living tissue, the coagulated living tissue may be torn and rebleed. In addition, there is a problem that there is no ability to coagulate a wide area.

The present invention has been made in view of the above circumstances, and an object thereof is to coagulate a relatively wide area of a living tissue safely and easily, for example, bleeding from a stump after liver resection. It is an object of the present invention to provide an ultrasonic surgical instrument that can be used for preventing the occurrence of an ultrasonic wave.

[0009]

According to the present invention, there is provided an ultrasonic probe which emits ultrasonic waves, wherein a concave ultrasonic convergence surface is formed at a distal end of the ultrasonic probe, and the ultrasonic probe is disposed at a distal end of a sheath covering the ultrasonic probe. An ultrasonic surgical instrument comprising ultrasonic treatment space holding means for holding an ultrasonic treatment space between an ultrasonic convergence surface of a probe and a living tissue to be treated at a predetermined interval. In the present invention, the ultrasonic treatment space between the ultrasonic convergence surface of the ultrasonic probe and the living tissue to be treated is set to a constant value by the ultrasonic treatment space holding means at the distal end of the sheath covering the ultrasonic probe. It is designed to be held at intervals.

[0010]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS A first embodiment of the present invention will be described below with reference to FIGS. FIG. 1 shows an ultrasonic surgical instrument 1 according to the present embodiment. The ultrasonic surgical instrument 1 is provided with a handpiece 2 that is handled as a handheld tool by an operator, and an ultrasonic power supply unit 4 connected to the handpiece 2 via an electric cord 3.

The handpiece 2 has an ultrasonic vibrator 5 for converting electric energy into mechanical ultrasonic vibration,
A horn 6 whose base end is connected to the ultrasonic transducer 5;
Ultrasonic probe 7 connected to the tip of this horn 6
And a transducer cover 8 covering the electric cord 3 and the ultrasonic transducer 5, and a sheath 9 covering the ultrasonic probe 7. Here, electric energy is supplied to the ultrasonic transducer 5 from the ultrasonic power supply unit 4 via the electric cord 3. Further, when the ultrasonic transducer 5 is driven, the amplitude of the ultrasonic vibration generated from the ultrasonic transducer 5 is transmitted to the ultrasonic probe 7 in a state expanded by the horn 6.

Further, the tip end surface of the ultrasonic probe 7
A concave ultrasonic radiating portion (ultrasonic convergence surface) 10 is formed. The ultrasonic vibration transmitted to the ultrasonic probe 7 is transmitted to the ultrasonic radiating section 10 on the distal end face of the ultrasonic probe 7.
It is radiated from. At this time, the ultrasonic vibration radiated from the ultrasonic radiating section 10 is converged to a predetermined convergence point P in front of the ultrasonic probe 7 by the concave surface of the ultrasonic radiating section 10 as shown in FIG. I have.

The distal end of the sheath 9 is connected to the ultrasonic radiating section 1.
It extends to the front of 0. Here, the distance between the distal end surface 11 of the sheath 9 and the ultrasonic radiating section 10 is a predetermined fixed interval, that is, the convergence point of the ultrasonic waves radiated from the ultrasonic radiating section 10 of the ultrasonic probe 7. P is maintained at an interval that is maintained in a state where P is disposed slightly forward of the distal end surface 11 of the sheath 9. Thereby, the ultrasonic treatment space holding means 12 for holding the ultrasonic treatment space S between the ultrasonic radiation section 10 of the ultrasonic probe 7 and the living tissue H to be treated at a predetermined set interval is formed. .

Next, the operation of the above configuration will be described.
When using the ultrasonic surgical instrument 1 of the present embodiment, an operator treats the handpiece 2 as a handheld tool. Then, the tip of the handpiece 2 is set to face the living tissue H to be treated. At this time, the sheath 9 of the handpiece 2
Is approached to the living tissue H to be treated, and the convergence point P of the ultrasonic wave radiated from the ultrasonic radiating section 10 of the ultrasonic probe 7 is slightly ahead of the distal end surface 11 of the sheath 9 of the handpiece 2. It is set to be placed.

After the setting of the handpiece 2, the ultrasonic transducer 5 is driven. When the ultrasonic oscillator 5 is driven, the ultrasonic vibration generated from the ultrasonic oscillator 5 is transmitted to the ultrasonic probe 7 with the amplitude of the ultrasonic vibration expanded by the horn 6. The ultrasonic vibration transmitted to the ultrasonic probe 7 is further radiated from the ultrasonic radiating section 10 on the end face of the ultrasonic probe 7. At this time, the ultrasonic vibration radiated from the ultrasonic radiating section 10 is converged to a convergence point P in front of the ultrasonic probe 7 by the concave surface of the ultrasonic radiating section 10 as shown in FIG. Then, by applying ultrasonic vibration to the surface of the living tissue H to be treated at the convergence point P, the living tissue H is coagulated under the influence of the ultrasonic vibration.

Therefore, the above configuration has the following effects. That is, in the present embodiment, a concave ultrasonic radiation section 10 is formed on the distal end face of the ultrasonic probe 7, and the distal end of the sheath 9 is extended forward of the ultrasonic radiation section 10, and the distal end of the sheath 9 is extended. Surface 11 and ultrasonic radiation section 10
Is set at a predetermined interval, that is, the convergence point P of the ultrasonic wave radiated from the ultrasonic wave radiating portion 10 of the ultrasonic probe 7 is disposed slightly ahead of the distal end surface 11 of the sheath 9. The ultrasonic treatment space S is maintained at a predetermined set interval because the ultrasonic radiation space 10 is maintained at the interval maintained in the state, and the ultrasonic treatment space S between the ultrasonic radiation unit 10 of the ultrasonic probe 7 and the living tissue H to be treated. be able to. Therefore, since the ultrasonic radiating portion 10 of the ultrasonic probe 7 can coagulate the living tissue H without being in contact with the living tissue H, there is no possibility that the coagulated portion of the living tissue H is fixed to the ultrasonic probe 7. Therefore, there is an effect that rebleeding from the coagulated portion of the living tissue H can be prevented and damage to the living tissue H can be reduced.

In the present embodiment, the ultrasonic surgical instrument 1
The operator can freely move the handpiece 2, so that coagulation of a relatively wide range of living tissue H can be easily performed, and thus the fatigue of the operator can be reduced. Further, since ultrasonic waves are used, safe treatment can be performed as compared with high-frequency waves.

FIG. 3 shows a second embodiment of the present invention. The present embodiment is provided with operating means 21 of the ultrasonic probe 7 for moving the ultrasonic probe 7 of the first embodiment (see FIGS. 1 and 2) relative to the sheath 9 in the central axis direction. is there.

In the present embodiment, the ultrasonic probe 7 is moved relative to the sheath 9 in the axial direction by the operating means 21 of the ultrasonic probe 7, and the ultrasonic radiating section 10 of the ultrasonic probe 7 is moved forward. By moving, the convergence point P of the ultrasonic wave radiated from the ultrasonic wave radiating section 10 of the ultrasonic probe 7 is defocused.

Therefore, in the present embodiment, the convergence point P of the ultrasonic wave can be defocused by the operating means 21 of the ultrasonic probe 7, so that the coagulation range of the living tissue H is widened and hemostasis can be performed over a wide range. . Further, since the depth of the coagulated portion of the living tissue H is reduced and only the surface of the living tissue H can be coagulated, there is an effect that invasion of the living tissue H is reduced.

FIG. 4 shows a third embodiment of the present invention. In this embodiment, the convergence angle of the ultrasonic wave radiated from the ultrasonic wave radiating section 10 of the ultrasonic probe 7 to the distal end of the sheath 9 of the handpiece 2 of the first embodiment (see FIGS. 1 and 2) The tapered portion 22 having substantially the same inclination angle is provided. Further, a tip opening 23 is provided at the tip of the tapered portion 22.
Then, the ultrasonic waves radiated from the ultrasonic wave radiating section 10 converge slightly before the front end opening 23.

Therefore, the above configuration has the following effects. That is, in the present embodiment, since the tapered portion 22 is provided at the distal end of the sheath 9, the distal end of the sheath 9 is thinner than in the first embodiment. Therefore, since the visual field of the distal end portion of the sheath 9 of the handpiece 2 is good, it is easy to confirm the coagulated portion of the living tissue H to be treated,
The safety of the treatment can be increased. Further, the convergence point P of the ultrasonic wave radiated from the ultrasonic wave radiating section 10 is easily understood, and there is an effect that the operability is good.

FIG. 5 shows a fourth embodiment of the present invention. In the present embodiment, the configuration of the handpiece 2 of the ultrasonic surgical instrument 1 of the third embodiment (see FIG. 4) is changed as follows.

That is, in this embodiment, the rubber film 24 for closing the distal end opening 23 of the tapered portion 22 of the sheath 9 is provided. Further, a ring-shaped groove 25 is provided on the outer peripheral surface of the distal end portion of the ultrasonic probe 7. Watertight means such as an O-ring 26 is fitted in the ring-shaped groove 25. The O-ring 26 provides a watertight seal between the distal end of the ultrasonic probe 7 and the sheath 9.

Further, an inner space of the distal end of the sheath 9, that is, a rubber film 24 of the distal opening 23 of the tapered portion 22,
An internal space (between the distal end portion of the ultrasonic probe 7 and the sheath 9) between the watertight seal portion and the O-ring 26 is filled with an ultrasonic medium such as water 27.

In the present embodiment, the ultrasonic waves radiated from the ultrasonic radiating section 10 of the ultrasonic probe 7
The light is transmitted forward through the inside, and converges through the rubber film 24 slightly in front of the distal end opening 23.

Therefore, in the above configuration, the surgeon applies the rubber film 24 to the living tissue H and then ultrasonically oscillates to coagulate the living tissue H near the rubber film 24. Can be. In the present embodiment, since the water 27 is used as a transmission medium of the ultrasonic wave radiated from the ultrasonic radiating section 10 of the ultrasonic probe 7, the transmission medium of the ultrasonic wave as in the third embodiment is used. As compared with the case where air is used, there is an effect that the transmission efficiency of ultrasonic waves is better and the coagulation ability is higher.

FIGS. 6 and 7A and 7B show a fifth embodiment of the present invention. In the present embodiment, the configuration of the handpiece 2 of the ultrasonic surgical instrument 1 of the first embodiment (see FIGS. 1 and 2) is changed as follows.

That is, in this embodiment, the rubber film 31 for closing the distal end opening 9a of the sheath 9 is provided.
In addition, a water passage is formed between the sheath 9 and the ultrasonic probe 7.

Further, a water supply mouthpiece 32 protrudes from the rear end of the transducer cover 8 or the sheath 9. An external water supply tube 33 is connected to the water supply base 32.

Next, the operation of the above configuration will be described.
In the present embodiment, water is filled into the water supply path between the sheath 9 and the ultrasonic probe 7 through the water supply tube 33.
Here, the amount of water in the water supply path between the sheath 9 and the ultrasonic probe 7 is maintained at the set amount shown in FIG. 7A in the initial state (normal position). In this state, the convergence point P of the ultrasonic wave radiated from the ultrasonic wave radiating section 10 of the ultrasonic probe 7 is located at the tip of the rubber film 31.

As shown in FIG. 7B, the convergence point P
Is defocused to expand the coagulation range of the living tissue H to be treated, water in the water supply path between the sheath 9 and the ultrasonic probe 7 is sucked through the water supply tube 33, and the sheath 9 and the ultrasonic probe 7 to reduce the amount of water inside the water channel.

When it is desired to coagulate the living tissue H to be treated in a point-wise manner, water is again supplied from the water supply tube 33 to increase the water inside the water supply passage between the sheath 9 and the ultrasonic probe 7. By doing so, the ultrasonic radiation section 10
What is necessary is just to widen the distance between the rubber film 31 and the tip of the rubber film 31.

Therefore, the above configuration has the following effects. That is, in the present embodiment, the operator can freely change the coagulation range of the living tissue H to be treated by controlling the amount of water supplied inside the water supply path between the sheath 9 and the ultrasonic probe 7. . Thereby, there is an effect that the optimum coagulation ability according to each use and case can be selected.

Further, 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. (Appendix 1) The probe tip end surface is formed in a concave surface,
An ultrasonic surgical instrument, wherein a sheath formed so as to cover the probe is provided so that a constant distance is always provided between the distal end face of the probe and a target tissue.

(Supplementary claim 2) The ultrasonic surgical instrument according to claim 1, wherein the distance between the distal end face of the probe and the target tissue is a positional relationship in which ultrasonic waves emitted from the distal end face of the probe converge.

(Supplementary note 3) The ultrasonic surgical instrument according to claim 1, wherein a transmission medium such as water for facilitating transmission of ultrasonic waves is sealed in a space between the end face of the probe and the target tissue. .

(Prior Art of Supplementary Items 1 to 3)
No. 155852 discloses a shock wave crushing treatment device that crushes a treatment site such as a cancer tissue or a calculus by a shock wave obtained by ultrasonic wave transmission and the like, and crushes a cancer tissue or the like by a thermal action by the convergence energy of continuous ultrasonic waves, An ultrasonic therapy device for treating is shown. JP-A-63-180021,
Japanese Utility Model Application Laid-Open No. 63-56022 discloses an apparatus for performing hyperthermia treatment of cancer or the like in a body by converging an ultrasonic wave.

Other conventional techniques include a high-frequency ablation device using argon gas and a device such as a laser capable of coagulating a wide area without contacting tissue. USP 5263957
Describes a coagulation / incision apparatus using ultrasonic waves.

(Problems to be Solved by Additional Items 1 to 3)
The problems of Japanese Patent Application Laid-Open No. 3-155852 are that the size of the apparatus is increased, the position is controlled mechanically finely, and the like, and the operator cannot handle the apparatus as a handheld tool. Showa 6
Japanese Patent Application Laid-Open No. 3-180021 and Japanese Utility Model Application Laid-Open No. 63-56022 do not have a coagulation ability for preventing bleeding, in addition to an increase in the size of the device and a finer position control. Also, the tissue surface cannot be treated.

Further, the high-frequency scalpel may be dangerous to patients, such as a stray current flowing in the body. Further, the laser has a problem that the apparatus is expensive. USP 5263957
Coagulation and incision devices also make contact with tissue. Also, there is no ability to solidify a wide area.

(Purpose of Supplementary Items 1 to 3) The distal end face of the probe is formed in a concave surface, and the sheath formed so as to cover the probe has a constant distance between the distal end face of the probe and the target tissue. The object of the present invention is to provide a solidified material that can be solidified over a relatively wide area safely and easily. For example, it can be used to prevent bleeding from the stump after liver resection.

(Effects of Supplementary Items 1 to 3) Since the treatment instrument can coagulate the tissue without being in contact with the tissue, rebleeding can be prevented and tissue damage can be reduced. In addition, since coagulation in a relatively wide area can be easily performed, fatigue of the operator can be reduced. In addition, since ultrasonic waves are used, safe treatment can be performed as compared with high-frequency waves.

[0044]

According to the present invention, a concave ultrasonic focusing surface is formed at the distal end of the ultrasonic probe, and the ultrasonic focusing surface of the ultrasonic probe is provided at the distal end of the sheath covering the ultrasonic probe.
Since the ultrasonic treatment space holding means for holding the ultrasonic treatment space between the living tissue to be treated and the living tissue at a predetermined set interval is provided, the living tissue is held in a state where the tip of the ultrasonic probe is not in contact with the living tissue. Can solidify. Therefore, prevention of rebleeding,
It can reduce damage to living tissues, and can be used, for example, when preventing bleeding from a stump after liver resection. In addition, since a relatively wide range of the living tissue can be coagulated safely and easily, fatigue of the operator can be reduced. further,
Since ultrasonic waves are used, safe treatment can be performed as compared with high-frequency waves.

[Brief description of the drawings]

FIG. 1 is a schematic configuration diagram of an entire ultrasonic surgical instrument according to a first embodiment of the present invention.

FIG. 2 is a longitudinal sectional view of a main part for describing the operation of the ultrasonic surgical instrument according to the first embodiment.

FIG. 3 is a longitudinal sectional view showing a configuration of a main part of an ultrasonic surgical instrument according to a second embodiment of the present invention.

FIG. 4 is a longitudinal sectional view showing a main part configuration of an ultrasonic surgical instrument according to a third embodiment of the present invention.

FIG. 5 is a longitudinal sectional view showing a configuration of a main part of an ultrasonic surgical instrument according to a fourth embodiment of the present invention.

FIG. 6 is a schematic configuration diagram of an entire ultrasonic surgical instrument according to a fifth embodiment of the present invention.

7A and 7B are views for explaining the operation of the ultrasonic surgical instrument according to the fifth embodiment, and FIG. 7A is a longitudinal sectional view of a main part showing a state where a rubber film of the ultrasonic surgical instrument is in a normal position; (B) is a longitudinal sectional view of a main part showing a state in which the distance between the ultrasonic wave radiating part of the ultrasonic surgical instrument and the tip of the rubber film is widened.

[Explanation of symbols]

 7 Ultrasonic Probe 9 Sheath 10 Ultrasonic Radiation Unit (Ultrasonic Convergence Surface) 11 Tip Surface H Living Tissue S Ultrasonic Treatment Space 12 Ultrasonic Treatment Space Holding Means

 ──────────────────────────────────────────────────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 EE21 JJ22 JJ27

Claims (1)

[Claims] An ultrasonic probe that emits ultrasonic waves has a concave ultrasonic focusing surface formed at a distal end thereof, and an ultrasonic focusing surface of the ultrasonic probe is formed at a distal end of a sheath covering the ultrasonic probe. An ultrasonic surgical instrument comprising ultrasonic treatment space holding means for holding an ultrasonic treatment space between a living tissue to be treated and a predetermined set interval.