JP2004180777A

JP2004180777A - Ultrasonic surgical apparatus

Info

Publication number: JP2004180777A
Application number: JP2002348742A
Authority: JP
Inventors: Toshihiko Hashiguchi; 敏彦橋口; Ryoji Masubuchi; 良司増渕
Original assignee: Olympus Corp
Current assignee: Olympus Corp
Priority date: 2002-11-29
Filing date: 2002-11-29
Publication date: 2004-07-02

Abstract

<P>PROBLEM TO BE SOLVED: To improve the cleaning efficiency of the interior of an insertion portion sheath tube by separating/arranging an operating rod and an ultrasonic probe in the interior. <P>SOLUTION: In the ultrasonic driving device, a vibration transmission member 9 and an operating rod 50 are inserted into the insertion portion sheath tube 4, the inside of the insertion portion sheath tube 4 is covered with a covering member 61, and the vibration transmission members 9 in a plurality of positions that are the nodes of vibration are formed of a thick flange portion 9a. The flange portion 9a that becomes the nodes of vibration is made to internally contact the inside of the insertion portion sheath tube 4, whereby the vibration transmission members 9 are positioned and held in the insertion portion sheath tube 4. The outside surface of the operating rod 50 is covered with a covering member 62 for example, and is arranged in a notch provided in the flange portion 9a. <P>COPYRIGHT: (C)2004,JPO&NCIPI

Description

【０００１】
【発明の属する技術分野】
本発明は、超音波プローブとジョーとの間で生体組織を把持しながら超音波を利用して生体組織の切開、切除、或いは凝固等の処置を行う超音波手術装置に関する。
【０００２】
【従来の技術】
一般に、超音波を利用して生体組織の切開、切除、或いは凝固等の処置を行う超音波手術装置として、例えばＵＳＰ５，３２２，０５５、ＵＳＰ５，８７３，８７３、特表平８−５０５８０１号公報、特開２０００−３３０９２号公報などに示されている装置がある。この超音波手術装置には、挿入部外套管の基端部に手元側の操作部が連結され、この操作部に超音波振動を発生する超音波振動子が配設されるとともに、挿入部外套管の先端部に生体組織を処理するための処置部が配設されている。
【０００３】
また、挿入部外套管の内部には超音波振動子からの超音波振動を処置部側の超音波プローブに伝達する振動伝達部材が挿通されている。この振動伝達部材の基端部は超音波振動子に接続されている。さらに、処置部には超音波プローブに対峙して回動自在に支持されるジョーが配設されている。
【０００４】
また、操作部にはジョーを超音波プローブに対して開閉操作する操作ハンドルが配設されている。さらに、挿入部外套管の内部にはジョーの操作ロッドが軸方向に進退可能に挿入されている。そして、操作ハンドルの操作にともない操作ロッドが軸方向に進退され、この操作ロッドの進退動作に連動して処置部のジョーを超音波プローブに対して開閉操作し、ジョーの閉操作にともない超音波プローブとジョーとの間で生体組織を把持するようになっている。続いて、この状態で、超音波振動子からの超音波振動を振動伝達部材を介して処置部側の超音波プローブに伝達することにより、超音波を利用して生体組織の切開、切除、或いは凝固等の処置を行うようになっている。
【０００５】
【特許文献１】
ＵＳＰ５，３２２，０５５
【０００６】
【特許文献２】
ＵＳＰ５，８７３，８７３
【０００７】
【特許文献３】
特表平８−５０５８０１号公報
【０００８】
【特許文献４】
特開２０００−３３０９２号公報
【０００９】
【発明が解決しようとする課題】
しかしながら、従来の超音波手術装置では、上述したように、挿入部外套管内に操作ロッド及び超音波プローブを分離・配設するためにそれぞれを挿通させるチャンネルとなる専用の中空管部材を挿入部外套管内に設けているが、このような中空管部材を挿入部外套管内に設けると、処置後に挿入部外套管内を洗滌する際に、それぞれの中空管部材内に洗滌流体を流し専用のブラシ等を用いて洗滌しなければならず、洗浄作業が煩雑化し洗滌効率が悪いと行った問題がある。
【００１０】
本発明は、上記事情に鑑みてなされたものであり、内部に操作ロッド及び超音波プローブを分離・配設することで挿入部外套管内の洗滌効率を向上させることのできる超音波手術装置を提供することを目的としている。
【００１１】
【課題を解決するための手段】
本発明の超音波手術装置は、処置部に把持した生体組織に超音波振動子からの超音波振動を加えることで処置を行う超音波処置具と、前記超音波処置具の前記超音波振動子を超音波振動させる超音波駆動装置とを備え、前記超音波処置具は、前記超音波振動子を挿入部外套管の基端部に連結された操作部に設け、前記挿入部外套管の内部に前記超音波振動子からの超音波振動を前記処置部側に伝達する超音波プローブを挿通するとともに、前記超音波プローブの先端部に対峙して回動自在に支持され、前記超音波プローブの先端部との間に前記生体組織を把持するジョーと、前記操作部に配設され、前記ジョーを前記超音波プローブに対して開閉操作する操作手段と、前記ジョーと前記操作手段との間を連結し、前記操作手段からの操作力を前記ジョー側に伝達する操作力伝達部材とを備えた超音波手術装置において、前記超音波プローブの振動の節位置となる前記挿入部外套管の内部の複数の位置に、前記超音波プローブを前記挿入部外套管内に保持する超音波プローブ保持手段を設けると共に、前記操作力伝達部材を前記超音波プローブから分離して保持する操作力伝達部材保持手段を設けて構成される。
【００１２】
【発明の実施の形態】
以下、図面を参照しながら本発明の実施の形態について述べる。
【００１３】
図１ないし図１９は本発明の一実施の形態に係わり、図１は超音波手術装置の構成を示す構成図、図２は図１の装置本体の構成を示すブロック図、図３は図１の超音波処置具の分解状態を示す側面図、図４は図１の超音波処置具全体の組立状態を示す側面図、図５は図１の超音波処置具の振動伝達部材（超音波プローブ）を保持する超音波プローブ保持手段であるフランジ部を説明する図、図６は図５のＡ−Ａ線断面を示す断面図、図７は図５のＢ−Ｂ線断面を示す断面図、図８は図１の超音波処置具の振動伝達部材（超音波プローブ）を保持する超音波プローブ保持手段の第１の変形例を説明する図、図９は図１の超音波処置具の振動伝達部材（超音波プローブ）を保持する超音波プローブ保持手段の第２の変形例を説明する図、図１０は図１の超音波処置具の振動伝達部材（超音波プローブ）を保持する超音波プローブ保持手段の第３の変形例を説明する図、図１１は図１の超音波処置具の振動伝達部材（超音波プローブ）を保持する超音波プローブ保持手段の第４の変形例を説明する図、図１２は図１１のＣ−Ｃ線断面を示す断面図、図１３は図１１のＤ−Ｄ線断面を示す断面図、図１４は図１の超音波処置具の振動伝達部材（超音波プローブ）を保持する超音波プローブ保持手段の第５の変形例を説明する図、図１５は図１４のＥ−Ｅ線断面を示す断面図、図１６は図１４のＦ−Ｆ線断面を示す断面図、図１７は図１の超音波処置具の振動伝達部材（超音波プローブ）を保持する超音波プローブ保持手段の第６の変形例を説明する図、図１８は図１７の超音波プローブ保持手段の第６の変形例の外観を示す図、図１９は図１７のＧ−Ｇ線断面を示す断面図である。
【００１４】
図１に示すように、本実施の形態の超音波手術装置の装置本体１には超音波処置具２およびフットスイッチ３がそれぞれ接続されている。
【００１５】
また、超音波処置具２には細長いシース状の挿入部外套管４の先端部に処置部５、基端部に手元側の操作部６がそれぞれ配設されている。ここで、操作部６には超音波振動を発生する図示しない超音波振動子が内蔵され、処置部５を操作する操作ハンドル８とが設けられている。
【００１６】
さらに、挿入部外套管４の内部には超音波振動子からの超音波振動を処置部５に伝える振動伝達部材９（超音波プローブ）が配設されている。この振動伝達部材９の先端部は挿入部外套管４の先端から外部側に露出される。
【００１７】
また、装置本体１の前面には操作盤１２が設けられている。この操作盤１２には電源スイッチ１３と、操作表示パネル１４と、超音波処置具２の接続部１５とが設けられている。ここで、超音波処置具２の操作部６にはハンドピースコード１６の一端が連結されている。そして、このハンドピースコード１６の他端部に配設されたハンドピースプラグ１７が装置本体１の超音波処置具２の接続部１５に着脱可能に接続されるようになっている。
【００１８】
また、装置本体１の操作表示パネル１４には超音波処置を行う際の通常運転時の超音波出力の大きさを設定する設定スイッチ１８と、この設定スイッチ１８で設定される超音波出力の大きさをデジタル表示する表示部１９とが設けられている。この設定スイッチ１８には超音波出力の大きさを変更（増減）する出力増加スイッチ１８ａと、出力低減スイッチ１８ｂとが設けられている。
【００１９】
さらに、装置本体１の内部には図２に示すように超音波処置具２内の超音波振動子に電気エネルギを供給するための駆動回路２０が内蔵されている。この駆動回路２０には超音波周波数の交流信号を発生する発振回路２１と、超音波出力の大きさを指示する信号を生成するＤ／Ａコンバータ２２と、このＤ／Ａコンバータ２２からの信号に基づいて発振回路２１の交流信号の大きさを制御するＶＣＡ回路２３と、ＶＣＡ回路２３の出力を増幅して超音波処置具２内の超音波振動子を駆動する電力を生成するパワーアンプ２４と、駆動回路２０の出力ラインを入切するリレー２５と、超音波手術装置の動作を制御する制御回路２６と、フットスイッチ３からの操作信号を制御回路２６およびリレー２５に伝達するインターフェース（Ｉ／Ｆ）回路２７とが設けられている。
【００２０】
また、制御回路２６にはフットスイッチ３の操作による超音波処置の開始時に超音波処置具２内の超音波振動子からの超音波出力を設定スイッチ１８による設定出力値よりも大きくし、超音波処置開始後、予め設定された所定の設定時間が経過した時点で、超音波振動子からの超音波出力が設定出力値になるように制御する運転状態切換え手段が内蔵されている。なお、駆動回路２０のリレー２５は超音波処置具接続部１５とパワーアンプ２４との間に介設されている。
【００２１】
図３及び図４に示すように、超音波処置処置具２は、３つのユニットに分解可能な３つの組み立てユニット、即ち、ハンドルユニット３１と、プローブユニット３２と、振動子ユニット３３とから構成される。これらの３つのユニット３１〜３３は、図４で示す状態に組み立てられるようになっている。
【００２２】
振動子ユニット３３は、ハンドルユニット３１に着脱可能に連結されるハンドピース３４が設けられている。このハンドピース３４は、円筒状カバー３４ａ内に超音波振動を発生するための超音波振動子（不図示）が内蔵されている。
【００２３】
この超音波振動子は、先端側に振幅拡大を行なうホーン（不図示）が連結され、このホーンの先端側がプローブの基端側に取り付けられるようになっている。
【００２４】
また、円筒状カバー３４ａは、この先端部にハンドルユニット３１の後述する操作部本体６ａの振動子接続部６ｂに着脱可能に連結されるユニット連結部３４ｂが設けられている。このユニット連結部３４ｂの外周面は、リングの一部を切り離したＣ字型の形状をしている係合リング３９（所謂Ｃリング）が装着されている。尚、係合リング３９は、この断面形状が外周を円弧とする略半月状の断面形状に形成されている。
【００２５】
また、円筒状カバー３４ａの後端部は、端部にハンドピースプラグ１７を設けたハンドピースコード１６が接続されている。
【００２６】
また、プローブユニット３２は、振動子ユニット３３における図示しないホーンの先端側に着脱可能に連結される細長い略棒状の振動伝達部材９が設けられている。
【００２７】
この振動伝達部材９の基端部は、ホーンのプローブ取付部３６ａに連結される取付けねじ４１ａが形成されている。そして、この取付けねじ４１ａが振動子ユニット１３におけるプローブ取付部３６ａのねじ穴部にねじ込み固定されている。これにより、プローブユニット３２と、振動子ユニット３３との間が一体的に組み付けられている。
【００２８】
更に、振動伝達部材９は、基端側から伝達される超音波振動の節の位置（複数個所）にフランジ状の支持体４１ｂが設けられている。この支持体４１ｂは、弾性部材でリング状に形成されている。
【００２９】
また、本実施の形態の振動伝達部材９は、基端部側から２つ目の節の前方に第２段階の振幅拡大を行なう基端側ホーン４１ｃが配設されている。更に、この基端側ホーン４１ｃの先端部側は、超音波振動の伝達を行う中間部４１ｄ、最終的な振幅拡大を行う先端側ホーン４１ｅ、処置部４１ｆが順次配設されている。ここで、振動伝達部材９の最先端部に配置された処置部４１ｆは、略円形の断面形状に形成されている。
【００３０】
また、ハンドルユニット３１は、細長い挿入シース部３１ａと、この挿入シース部３１ａの先端部に配設された先端作用部３１ｂと、挿入シース部３１ａの基端部に配設された操作部６とから構成される。ここで、ハンドルユニット３１の操作部６は、略円筒状の操作部本体６ａが設けられている。そして、この操作部本体６ａの基端部に振動子接続部６ｂが形成されている。
【００３１】
また、操作部本体６ａの外周面は、固定ハンドル４２と、操作手段を構成する回動可能な可動ハンドル４３とが設けられ、固定ハンドル４２及び可動ハンドル４３によって操作ハンドル８（図１参照）が構成される。
【００３２】
また、固定ハンドル４２の上側部分は、円筒状の操作部本体６ａと一体成形されている。更に、固定ハンドル４２の操作端部は、親指以外の指の複数のものを選択的に差し込める指掛け孔４２ａが設けられ、可動ハンドル４３の操作端部は、同じ手の親指を掛ける指掛け孔４３ａが設けられている。
【００３３】
また、可動ハンドル４３の上端部側は、二股状の連結部４３ｂが形成されている。これらの二股状の連結部４３ｂは、操作部本体６ａの両側に配置されている。更に、各連結部４３ｂの上端部は、ハンドル枢支軸４５が内方向に向けて突設されている。これらのハンドル枢支軸４５は、挿入部外套管４の軸線より上側位置の支点で操作部本体６ａに連結されている。これにより、可動ハンドル４３は、ハンドル枢支軸４５によって回動可能に枢支されている。そして、ハンドル枢支軸４５は、可動ハンドル４３のハンドル操作に対して前後方向に進退可能に保持されている。
【００３４】
更に、可動ハンドル４３の各連結部４３ｂは、ハンドル枢支軸４５の下側に作動軸４７が設けられている。この作動軸４７は、挿入部外套管４内を挿通する操作ロッド５０（図５参照：操作力伝達部材）に進退力を伝達するためのものである。そして、操作ロッド５０は、軸方向に進退させる動作に伴い、処置部４１ｆに対して後述のジョー５１の開閉操作が行われるようになっている。即ち、可動ハンドル４３と作動軸４７とは、操作手段を構成している。なお、作動軸４７は挿入部外套管４の略軸線上に配置されている。
【００３５】
本実施の形態では、超音波処置具２は、ハンドルを握って可動ハンドル４３を閉操作すると、ハンドル枢支軸４５を中心として時計回りに旋回し作動軸４７が前側に移動することで、操作ロッド５０を前側に押し出し、処置部４１ｆに対してジョー５１が閉じるように構成されている。
【００３６】
また、挿入シース部３１ａは、上述したように、挿入部外套管４が設けられ、この挿入部外套管４の基端部は、回転ノブ４８と共に、操作部本体６ａの先端部にこの操作部本体６ａの中心線の軸回り方向に回転可能に取付けられている。
【００３７】
また、ハンドルユニット３１は、先端作用部３１ｂに生体組織を把持するための片開き型のジョー５１が回動自在に取り付けられている。
【００３８】
挿入部外套管４は、この先端部にジョー５１を保持するジョー保持部５２が設けられている。更に、ジョー５１は、生体組織（臓器）を把持する把持部材５４が取り付けられている。この把持部材５４は、略鋸歯状の歯部５５が形成されている。尚、把持部材５４は、例えばＰＴＦＥ（テフロン：デュポン社商標名）等の低摩擦材料で形成されている。また、把持部材５４は、単体では、剛性に乏しいので、図示しない金属製の強度部材を取り付けて剛性を確保しても良い。
【００３９】
また、ジョー５１は、把持部材５４の図示しない支持用の支持ピンがそれぞれ内向きに突設されている。更に、このジョー５１は、操作ロッド５０が係合するようになっている。
【００４０】
また、把持部材５４と振動伝達部材９の処置部４１ｆとは、広い面積で接触し、間に挟んだ生体組織を広く緩やかに温度上昇させることが可能であり、効果的な凝固を実現できる。ここで、把持部材５４の把持面と振動伝達部材９の処置部４１ｆとの間は、円弧状の曲面同士で接触していることにより自然に中心を一致させる効果が発生する。これにより、処置部４１ｆの偏心や傾斜をキャンセルすることができる。
【００４１】
また、挿入部外套管４の内部は、プローブユニット３２の振動伝達部材９が挿通されている。また、この挿入部外套管４の内部は、振動伝達部材９に併設されて、操作ロッド５０が進退自在に挿通されている。尚、操作ロッド５０は、挿入部外套管４に隙間を残して配置されている。
【００４２】
ジョー５１の閉操作時は、プローブユニット３２の処置部４１ｆに対してジョー５１の把持部材５４を押し付けることにより、処置部４１ｆとジョー５１の把持部材５４との間で生体組織を把持するようになっている。そして、把持された生体組織は、高速で振動する処置部４１ｆとの摩擦によって凝固或いは切開等も超音波処置を施される。尚、ジョー５１は、生体組織の剥離にも使用されるようになっている。
【００４３】
振動伝達部材９及び操作ロッド５０は、図５に示すように、挿入部外套管４内に挿通されており、挿入部外套管４の内面は例えばＰＴＦＥ（テフロン：デュポン社商標名）等の低摩擦材料等よりなる被覆部材６１により被覆され、また振動の節となる複数の位置の振動伝達部材９を太径のフランジ部９ａに形成しており、振動の節となるフランジ部９ａが挿入部外套管４の内面に被覆部材６１を介在させて内接することで、振動伝達部材９を挿入部外套管４内に位置決めし保持している。
【００４４】
また、操作ロッド５０は、外表面が例えばＰＴＦＥ（テフロン：デュポン社商標名）等の低摩擦材料等よりなる被覆部材６２により被覆され、また、図５のＡ−Ａ線断面である図６に示すように、フランジ部９ａに設けられた切り欠き部９ｂに配置されるようになっている。なお、図５のＢ−Ｂ線断面である図７に示すように、振動伝達部材９の非フランジ部分は被覆部材６２に対して所定の間隔を維持している。
【００４５】
このように本実施の形態によれば、振動伝達部材９の振動の節となる複数の位置の振動伝達部材９を太径のフランジ部９ａに形成し、フランジ部９ａの切り欠き部９ｂに操作ロッド５０を配置し、振動伝達部材９及び操作ロッド５０を挿入部外套管４内に保持しているので、処置が終わった後の洗滌においては、振動伝達部材９を抜去すると挿入部外套管４内は（単一）単独の空間となるので、挿入部外套管４内に水を流しブラシを用いるだけで容易に一度の洗滌作業で挿入部外套管４内部を洗滌することができる。
【００４６】
なお、図８に示すように、操作ロッド５０を薄い板状部材とし、振動伝達部材９との間隔を確保し、振動伝達部材９と操作ロッド５０の接触を防止することで、操作ロッド５０の被覆部材６２を省略した構造とすることが可能である。
【００４７】
また、振動伝達部材９の中心軸は挿入部外套管４の挿入軸と同軸であるが、図９に示すように、振動伝達部材９の非フランジ部分の中心軸を挿入部外套管４の挿入軸に対して偏心させることで、操作ロッド５０の径を太くし、操作ロッド５０の剛性を向上させるようにしてもよい。
【００４８】
さらに、図１０に示すように、操作ロッド５０及びフランジ部９ａの切り欠き部９ｂを円切片状に形成してもよく、切り欠き部９ｂをこのような形状にすることで、切り欠き部９ｂの加工が容易になる。
【００４９】
また、フランジ部９ａに切り欠き部９ｂを設けるとしたが、図１１及び図１１のＣ−Ｃ線断面である図１２に示すように、挿入部外套管４の内面を被覆した被覆部材６１に切り欠き部７１を設けると共に、操作ロッド５０を円弧状の板状に形成し被覆部材６１の切り欠き部７１に配置するようにしてもよい。なお、この場合、操作ロッド５０の端面を被覆部材６１の切り欠き部７１に当接させることで、操作ロッド５０をフランジ部９ａに対してクリアランスを持たせて被覆部材６１の切り欠き部７１に配置することができる。なお、図１１のＤ−Ｄ線断面を図１３に示す。
【００５０】
また、図１１及び図１２においては、振動の節となる複数の位置の振動伝達部材９を太径のフランジ部９ａに形成するとしたが、図１４及び図１４のＥ−Ｅ線断面である図１５に示すように、振動伝達部材９の振動の節となる複数の位置の外周に溝部８１を形成し、溝部８１に太径のリング状の例えばＰＴＦＥ（テフロン：デュポン社商標名）等の低摩擦材料等またはゴム材料よりなる弾性部材８２を一体的に設け、この弾性部材８２を被覆部材６１に内接させて、振動伝達部材９を挿入部外套管４内に保持すると共に、操作ロッド５０を被覆部材６１の切り欠き部７１に配置するようにしてもよい。なお、図１４のＦ−Ｆ線断面を図１６に示す。
【００５１】
さらに、本実施の形態では、振動の節となる複数の位置の振動伝達部材９を太径のフランジ部９ａに形成しフランジ部９ａの切り欠き部９ｂに操作ロッド５０を配置するとしたが、図１７ないし図１９に示すように、振動伝達部材９の振動の節となる複数の位置の外周に太径のリンク状の切り欠き部９０を有する例えばＰＴＦＥ（テフロン：デュポン社商標名）等の低摩擦材料等またはゴム材料よりなる弾性部材９１を設け、この弾性部材９１を被覆部材６１に内接させて振動伝達部材９を挿入部外套管４内に保持すると共に、操作ロッド５０を弾性部材９１の切り欠き部９０に配置するようにしてもよい。
【００５２】
本発明は、上述した実施の形態に限定されるものではなく、本発明の要旨を変えない範囲において、種々の変更、改変等が可能である。
【００５３】
【発明の効果】
以上説明したように本発明によれば、内部に操作ロッド及び超音波プローブを分離・配設することで挿入部外套管内の洗滌効率を向上させることができるという効果がある。
【図面の簡単な説明】
【図１】本発明の一実施の形態に係る超音波手術装置の構成を示す構成図
【図２】図１の装置本体の構成を示すブロック図
【図３】図１の超音波処置具の分解状態を示す側面図
【図４】図１の超音波処置具全体の組立状態を示す側面図
【図５】図１の超音波処置具の振動伝達部材（超音波プローブ）を保持する超音波プローブ保持手段であるフランジ部を説明する図
【図６】図５のＡ−Ａ線断面を示す断面図
【図７】図５のＢ−Ｂ線断面を示す断面図
【図８】図１の超音波処置具の振動伝達部材（超音波プローブ）を保持する超音波プローブ保持手段の第１の変形例を説明する図
【図９】図１の超音波処置具の振動伝達部材（超音波プローブ）を保持する超音波プローブ保持手段の第２の変形例を説明する図
【図１０】図１の超音波処置具の振動伝達部材（超音波プローブ）を保持する超音波プローブ保持手段の第３の変形例を説明する図
【図１１】図１の超音波処置具の振動伝達部材（超音波プローブ）を保持する超音波プローブ保持手段の第４の変形例を説明する図
【図１２】図１１のＣ−Ｃ線断面を示す断面図
【図１３】図１１のＤ−Ｄ線断面を示す断面図
【図１４】図１の超音波処置具の振動伝達部材（超音波プローブ）を保持する超音波プローブ保持手段の第５の変形例を説明する図
【図１５】図１４のＥ−Ｅ線断面を示す断面図
【図１６】図１４のＦ−Ｆ線断面を示す断面図
【図１７】図１の超音波処置具の振動伝達部材（超音波プローブ）を保持する超音波プローブ保持手段の第６の変形例を説明する図
【図１８】図１７の超音波プローブ保持手段の第６の変形例の外観を示す図
【図１９】図１７のＧ−Ｇ線断面を示す断面図
【符号の説明】
１…装置本体
２…超音波処置具
３…フットスイッチ
４…挿入部外套管
５…処置部
６…操作部
９…振動伝達部材（超音波プローブ）
９ａ…フランジ部
９ｂ…切り欠き部
３２…ハンドルユニット
３３…プローブユニット
３４…振動子ユニット
５０…操作ロッド
６１、６２…被覆部材[0001]
TECHNICAL FIELD OF THE INVENTION
The present invention relates to an ultrasonic surgical apparatus that performs treatment such as incision, excision, or coagulation of a living tissue using ultrasonic waves while grasping the living tissue between an ultrasonic probe and a jaw.
[0002]
[Prior art]
In general, as an ultrasonic surgical apparatus for performing treatment such as incision, excision, or coagulation of a living tissue using ultrasonic waves, for example, US Pat. No. 5,322,055, US Pat. There is an apparatus disclosed in JP-A-2000-33092. In this ultrasonic surgical apparatus, an operation unit on the hand side is connected to a base end of an insertion portion mantle tube, and an ultrasonic vibrator for generating ultrasonic vibration is arranged on the operation unit, and the insertion portion mantle is also provided. A treatment section for treating a living tissue is disposed at the distal end of the tube.
[0003]
In addition, a vibration transmission member that transmits ultrasonic vibrations from the ultrasonic transducer to the ultrasonic probe on the treatment section side is inserted into the insertion portion outer tube. The base end of the vibration transmitting member is connected to the ultrasonic vibrator. Further, the treatment section is provided with a jaw rotatably supported facing the ultrasonic probe.
[0004]
Further, an operation handle for opening and closing the jaw with respect to the ultrasonic probe is provided in the operation unit. Further, an operation rod of a jaw is inserted into the insertion portion outer tube so as to be able to advance and retreat in the axial direction. The operation rod is advanced and retracted in the axial direction with the operation of the operation handle, and the jaw of the treatment section is opened and closed with respect to the ultrasonic probe in conjunction with the advance and retreat operation of the operation rod, and the ultrasonic wave is generated with the jaw closing operation. The living tissue is grasped between the probe and the jaw. Subsequently, in this state, by transmitting the ultrasonic vibration from the ultrasonic transducer to the ultrasonic probe on the treatment section side via the vibration transmission member, incision, excision, or, of the living tissue using the ultrasonic wave Treatment such as coagulation is performed.
[0005]
[Patent Document 1]
USP 5,322,055
[0006]
[Patent Document 2]
USP 5,873,873
[0007]
[Patent Document 3]
Japanese Patent Publication No. Hei 8-505801
[Patent Document 4]
JP 2000-33092 A
[Problems to be solved by the invention]
However, in the conventional ultrasonic surgical apparatus, as described above, a dedicated hollow tube member serving as a channel through which each of the operation rod and the ultrasonic probe is inserted to separate and dispose the operation rod and the ultrasonic probe in the insertion portion outer tube is inserted into the insertion portion. Although provided in the mantle tube, if such a hollow tube member is provided in the insertion portion mantle tube, when the inside of the insertion portion mantle tube is washed after the treatment, a cleaning fluid is flowed into each hollow tube member and a dedicated fluid is supplied. Cleaning has to be performed using a brush or the like, and the cleaning operation is complicated, resulting in a problem that cleaning efficiency is low.
[0010]
SUMMARY OF THE INVENTION The present invention has been made in view of the above circumstances, and provides an ultrasonic surgical apparatus capable of improving the cleaning efficiency of an insertion portion outer tube by separating and disposing an operation rod and an ultrasonic probe inside. It is intended to be.
[0011]
[Means for Solving the Problems]
An ultrasonic operation apparatus according to the present invention includes an ultrasonic treatment device that performs a treatment by applying ultrasonic vibration from an ultrasonic transducer to a living tissue gripped by a treatment unit, and the ultrasonic transducer of the ultrasonic treatment device. An ultrasonic driving device that ultrasonically vibrates the ultrasonic treatment instrument, wherein the ultrasonic treatment tool includes an ultrasonic vibrator provided on an operation unit connected to a base end portion of the insertion portion outer tube, and an inner portion of the insertion portion outer tube. An ultrasonic probe for transmitting ultrasonic vibrations from the ultrasonic transducer to the treatment section is inserted therethrough, and is rotatably supported facing the distal end of the ultrasonic probe. A jaw for gripping the living tissue between the distal end portion, an operating means disposed on the operating section, for opening and closing the jaw with respect to the ultrasonic probe, and a gap between the jaw and the operating means. And connect the operating force from the operating means. An ultrasonic operating device having an operating force transmitting member that transmits the ultrasonic probe to the jaw side, wherein the ultrasonic probe is provided at a plurality of positions inside the insertion portion mantle tube which are nodes of vibration of the ultrasonic probe. An ultrasonic probe holding means for holding the insertion probe in the outer tube is provided, and an operation force transmission member holding means for holding the operation force transmission member separately from the ultrasonic probe is provided.
[0012]
BEST MODE FOR CARRYING OUT THE INVENTION
Hereinafter, embodiments of the present invention will be described with reference to the drawings.
[0013]
1 to 19 relate to an embodiment of the present invention, FIG. 1 is a configuration diagram showing a configuration of an ultrasonic operation apparatus, FIG. 2 is a block diagram showing a configuration of an apparatus main body in FIG. 1, and FIG. 4 is a side view showing a disassembled state of the ultrasonic treatment device, FIG. 4 is a side view showing an assembled state of the entire ultrasonic treatment device of FIG. 1, and FIG. 5 is a vibration transmission member (ultrasonic probe) of the ultrasonic treatment device of FIG. FIG. 6 is a sectional view showing a section taken along line AA of FIG. 5, FIG. 7 is a sectional view showing a section taken along line BB of FIG. 5, FIG. 8 is a view for explaining a first modification of the ultrasonic probe holding means for holding the vibration transmitting member (ultrasonic probe) of the ultrasonic treatment tool of FIG. 1, and FIG. 9 is a diagram illustrating the vibration of the ultrasonic treatment tool of FIG. FIG. 10 is a view for explaining a second modification of the ultrasonic probe holding means for holding the transmission member (ultrasonic probe). FIG. 11 is a view for explaining a third modification of the ultrasonic probe holding means for holding the vibration transmitting member (ultrasonic probe) of the ultrasonic treatment instrument of FIG. 1. FIG. FIG. 12 is a cross-sectional view showing a cross section taken along line CC of FIG. 11, and FIG. 13 is a cross-sectional view showing a cross section taken along line DD of FIG. FIG. 14 is a sectional view showing the fifth embodiment of the ultrasonic probe holding means for holding the vibration transmitting member (ultrasonic probe) of the ultrasonic treatment tool of FIG. 1, and FIG. FIG. 16 is a cross-sectional view showing a cross section taken along the line FF of FIG. 14, and FIG. 17 is an ultrasonic probe holding a vibration transmitting member (ultrasonic probe) of the ultrasonic treatment tool of FIG. FIG. 18 is a view for explaining a sixth modification of the means, and FIG. 6 shows an appearance of a modification of the stage, FIG. 19 is a sectional view showing a line G-G cross section in FIG. 17.
[0014]
As shown in FIG. 1, an ultrasonic treatment instrument 2 and a foot switch 3 are connected to an apparatus main body 1 of the ultrasonic operation apparatus according to the present embodiment.
[0015]
In the ultrasonic treatment instrument 2, a treatment section 5 is disposed at a distal end of an elongated sheath-shaped outer sheath tube 4, and an operation section 6 at a proximal end is disposed at a proximal end. Here, the operation unit 6 has a built-in ultrasonic vibrator (not shown) that generates ultrasonic vibration, and is provided with an operation handle 8 for operating the treatment unit 5.
[0016]
Further, a vibration transmission member 9 (ultrasonic probe) for transmitting ultrasonic vibration from the ultrasonic transducer to the treatment section 5 is provided inside the insertion portion outer tube 4. The distal end of the vibration transmission member 9 is exposed to the outside from the distal end of the insertion portion outer tube 4.
[0017]
An operation panel 12 is provided on the front surface of the apparatus main body 1. The operation panel 12 is provided with a power switch 13, an operation display panel 14, and a connection portion 15 of the ultrasonic treatment instrument 2. Here, one end of a handpiece cord 16 is connected to the operation unit 6 of the ultrasonic treatment instrument 2. The handpiece plug 17 provided at the other end of the handpiece cord 16 is detachably connected to the connection portion 15 of the ultrasonic treatment instrument 2 of the apparatus main body 1.
[0018]
The operation display panel 14 of the apparatus main body 1 has a setting switch 18 for setting the magnitude of the ultrasonic output during normal operation when performing the ultrasonic treatment, and the magnitude of the ultrasonic output set by the setting switch 18. And a display unit 19 for digitally displaying the result. The setting switch 18 is provided with an output increasing switch 18a that changes (increases or decreases) the magnitude of the ultrasonic output and an output decreasing switch 18b.
[0019]
Further, a drive circuit 20 for supplying electric energy to the ultrasonic transducer in the ultrasonic treatment instrument 2 is built in the apparatus main body 1 as shown in FIG. The drive circuit 20 includes an oscillation circuit 21 that generates an AC signal having an ultrasonic frequency, a D / A converter 22 that generates a signal indicating the magnitude of an ultrasonic output, and a signal from the D / A converter 22. A VCA circuit 23 for controlling the magnitude of the AC signal of the oscillation circuit 21 based on the output of the VCA circuit 23; and a power amplifier 24 for amplifying the output of the VCA circuit 23 and generating electric power for driving the ultrasonic transducer in the ultrasonic treatment instrument 2. , A relay 25 for turning on and off the output line of the drive circuit 20, a control circuit 26 for controlling the operation of the ultrasonic surgical apparatus, and an interface (I / I) for transmitting an operation signal from the foot switch 3 to the control circuit 26 and the relay 25. F) circuit 27 is provided.
[0020]
Further, the control circuit 26 sets the ultrasonic output from the ultrasonic transducer in the ultrasonic treatment instrument 2 to be larger than the set output value by the setting switch 18 at the start of the ultrasonic treatment by operating the foot switch 3, An operation state switching means for controlling the ultrasonic output from the ultrasonic vibrator to become the set output value when a predetermined time set in advance elapses after the start of the treatment is incorporated. Note that the relay 25 of the drive circuit 20 is interposed between the ultrasonic treatment instrument connection unit 15 and the power amplifier 24.
[0021]
As shown in FIGS. 3 and 4, the ultrasonic treatment instrument 2 includes three assembly units that can be disassembled into three units, that is, a handle unit 31, a probe unit 32, and a transducer unit 33. You. These three units 31 to 33 are to be assembled in a state shown in FIG.
[0022]
The vibrator unit 33 is provided with a handpiece 34 that is detachably connected to the handle unit 31. The handpiece 34 incorporates an ultrasonic vibrator (not shown) for generating ultrasonic vibration in a cylindrical cover 34a.
[0023]
A horn (not shown) for expanding the amplitude is connected to the distal end side of the ultrasonic transducer, and the distal end side of the horn is attached to the proximal end side of the probe.
[0024]
The cylindrical cover 34a is provided at its distal end with a unit connecting portion 34b that is detachably connected to a vibrator connecting portion 6b of an operating portion main body 6a of the handle unit 31 described later. An engagement ring 39 (a so-called C-ring) having a C-shape in which a part of the ring is cut off is mounted on an outer peripheral surface of the unit connecting portion 34b. The engaging ring 39 has a substantially half-moon cross section whose outer periphery is an arc.
[0025]
The rear end of the cylindrical cover 34a is connected to a handpiece cord 16 having a handpiece plug 17 at the end.
[0026]
Further, the probe unit 32 is provided with an elongated, substantially rod-shaped vibration transmission member 9 which is detachably connected to a tip end of a horn (not shown) in the transducer unit 33.
[0027]
At the base end of the vibration transmitting member 9, a mounting screw 41a connected to the probe mounting portion 36a of the horn is formed. The mounting screw 41a is screwed and fixed in a screw hole of the probe mounting portion 36a of the vibrator unit 13. Thereby, the probe unit 32 and the transducer unit 33 are integrally assembled.
[0028]
Further, the vibration transmitting member 9 is provided with a flange-shaped support 41b at positions (a plurality of positions) of nodes of the ultrasonic vibration transmitted from the base end side. This support 41b is formed in a ring shape by an elastic member.
[0029]
Further, in the vibration transmitting member 9 of the present embodiment, a proximal horn 41c that performs amplitude expansion in a second stage is disposed in front of the second node from the proximal end side. Further, on the distal end side of the proximal horn 41c, an intermediate section 41d for transmitting ultrasonic vibration, a distal horn 41e for finally increasing the amplitude, and a treatment section 41f are sequentially arranged. Here, the treatment section 41f arranged at the most distal end of the vibration transmission member 9 is formed in a substantially circular cross-sectional shape.
[0030]
Further, the handle unit 31 includes an elongated insertion sheath portion 31a, a distal end working portion 31b disposed at a distal end portion of the insertion sheath portion 31a, and an operation portion 6 disposed at a base end portion of the insertion sheath portion 31a. Consists of Here, the operation unit 6 of the handle unit 31 is provided with a substantially cylindrical operation unit main body 6a. A transducer connecting portion 6b is formed at the base end of the operation portion main body 6a.
[0031]
A fixed handle 42 and a rotatable movable handle 43 that constitutes an operation means are provided on the outer peripheral surface of the operation unit main body 6a, and the operation handle 8 (see FIG. 1) is provided by the fixed handle 42 and the movable handle 43. Be composed.
[0032]
The upper portion of the fixed handle 42 is integrally formed with the cylindrical operation portion main body 6a. Further, the operation end of the fixed handle 42 is provided with a finger hole 42a into which a plurality of fingers other than the thumb can be selectively inserted. Is provided.
[0033]
Further, a bifurcated connecting portion 43b is formed on the upper end side of the movable handle 43. These bifurcated connecting portions 43b are arranged on both sides of the operation portion main body 6a. Further, a handle pivot shaft 45 protrudes inward from the upper end of each connecting portion 43b. These handle pivot shafts 45 are connected to the operation section main body 6a at fulcrums above the axis of the insertion section outer tube 4. Thus, the movable handle 43 is pivotally supported by the handle pivot shaft 45. The handle pivot shaft 45 is held so as to be able to advance and retreat in the front-rear direction with respect to the handle operation of the movable handle 43.
[0034]
Further, an operating shaft 47 is provided below the handle pivot shaft 45 in each connecting portion 43 b of the movable handle 43. The operating shaft 47 transmits an advance / retreat force to an operating rod 50 (see FIG. 5: operating force transmitting member) inserted through the insertion portion outer tube 4. Then, with the operation of moving the operation rod 50 in the axial direction, an opening / closing operation of a later-described jaw 51 is performed on the treatment section 41f. That is, the movable handle 43 and the operating shaft 47 constitute operating means. The operating shaft 47 is disposed substantially on the axis of the insertion tube 4.
[0035]
In the present embodiment, when the ultrasonic treatment instrument 2 grips the handle and closes the movable handle 43, the ultrasonic treatment instrument 2 pivots clockwise about the handle pivot shaft 45, and the operation shaft 47 moves forward, whereby the operation is performed. The rod 50 is pushed forward, and the jaws 51 are closed with respect to the treatment section 41f.
[0036]
As described above, the insertion sheath portion 31a is provided with the insertion portion outer tube 4, and the base end of the insertion portion outer tube 4 is attached to the distal end of the operation portion main body 6a together with the rotation knob 48. The main body 6a is attached so as to be rotatable around the center line.
[0037]
In the handle unit 31, a one-sided jaw 51 for gripping a living tissue is rotatably attached to the distal end working portion 31b.
[0038]
The insertion portion outer tube 4 is provided with a jaw holding portion 52 for holding the jaw 51 at the distal end. Further, the jaw 51 is provided with a gripping member 54 for gripping a living tissue (organ). The gripping member 54 has a substantially saw-toothed tooth portion 55. The gripping member 54 is made of a low friction material such as PTFE (Teflon: trade name of DuPont). Moreover, since the gripping member 54 alone has poor rigidity, the rigidity may be secured by attaching a metal strength member (not shown).
[0039]
In the jaw 51, support pins (not shown) for supporting the gripping member 54 are respectively provided to protrude inward. Further, the jaw 51 is adapted to be engaged with the operation rod 50.
[0040]
Further, the gripping member 54 and the treatment section 41f of the vibration transmission member 9 come into contact with each other over a wide area, and the temperature of the living tissue sandwiched therebetween can be broadly and slowly raised, and effective coagulation can be realized. Here, the center between the grasping surface of the grasping member 54 and the treatment section 41f of the vibration transmitting member 9 is naturally brought into contact with each other because the arc-shaped curved surfaces are in contact with each other. Thereby, the eccentricity and inclination of the treatment section 41f can be canceled.
[0041]
The vibration transmitting member 9 of the probe unit 32 is inserted into the inside of the insertion portion outer tube 4. Further, the inside of the insertion portion outer tube 4 is provided in parallel with the vibration transmitting member 9, and the operation rod 50 is inserted so as to be able to advance and retreat. The operation rod 50 is arranged in the insertion portion outer tube 4 with a gap left.
[0042]
At the time of closing the jaw 51, the living tissue is gripped between the treatment section 41 f and the gripping member 54 of the jaw 51 by pressing the gripping member 54 of the jaw 51 against the treatment section 41 f of the probe unit 32. Has become. The grasped living tissue is subjected to ultrasonic treatment for coagulation or incision by friction with the treatment section 41f vibrating at high speed. The jaws 51 are also used for exfoliating living tissue.
[0043]
As shown in FIG. 5, the vibration transmitting member 9 and the operation rod 50 are inserted into the insertion portion outer tube 4, and the inner surface of the insertion portion outer tube 4 is made of, for example, PTFE (Teflon: trade name of DuPont) or the like. A plurality of vibration transmitting members 9 which are covered with a covering member 61 made of a friction material or the like, and are formed at a plurality of positions serving as nodes of vibration are formed on a large-diameter flange portion 9a. By inscribing the inner surface of the outer tube 4 with the covering member 61 interposed therebetween, the vibration transmitting member 9 is positioned and held in the insertion portion outer tube 4.
[0044]
The outer surface of the operating rod 50 is coated with a coating member 62 made of a low-friction material such as PTFE (Teflon: trade name of DuPont), and FIG. 6 is a cross-sectional view taken along line AA of FIG. As shown, it is arranged in a notch 9b provided in the flange 9a. In addition, as shown in FIG. 7 which is a cross section taken along the line BB of FIG.
[0045]
As described above, according to the present embodiment, the vibration transmitting member 9 at a plurality of positions serving as nodes of vibration of the vibration transmitting member 9 is formed in the large-diameter flange portion 9a, and the notch 9b of the flange portion 9a is operated. Since the rod 50 is arranged and the vibration transmitting member 9 and the operating rod 50 are held in the insertion portion outer tube 4, in cleaning after the treatment is completed, when the vibration transmitting member 9 is removed, the insertion portion outer tube 4 is removed. Since the inside is a (single) single space, it is possible to easily wash the inside of the insertion portion outer tube 4 by a single washing operation simply by flowing water into the insertion portion outer tube 4 and using a brush.
[0046]
As shown in FIG. 8, the operation rod 50 is formed as a thin plate-shaped member, a space between the vibration transmission member 9 and the vibration transmission member 9 is prevented, and the operation rod 50 is prevented from contacting with the operation rod 50. It is possible to adopt a structure in which the covering member 62 is omitted.
[0047]
The center axis of the vibration transmitting member 9 is coaxial with the insertion axis of the insertion portion outer tube 4, but as shown in FIG. 9, the center axis of the non-flange portion of the vibration transmitting member 9 is inserted into the insertion portion outer tube 4. By eccentricity with respect to the axis, the diameter of the operation rod 50 may be increased, and the rigidity of the operation rod 50 may be improved.
[0048]
Further, as shown in FIG. 10, the notch 9b of the operation rod 50 and the flange 9a may be formed in a circular section shape, and by forming the notch 9b in such a shape, the notch 9b is formed. Processing becomes easy.
[0049]
Although the notch 9b is provided in the flange 9a, as shown in FIG. 11 and FIG. 12, which is a cross-sectional view taken along the line CC of FIG. 11, the covering member 61 that covers the inner surface of the insertion portion outer tube 4 is provided. The notch 71 may be provided, and the operating rod 50 may be formed in an arc-shaped plate and arranged in the notch 71 of the covering member 61. In this case, the end surface of the operating rod 50 is brought into contact with the notch 71 of the covering member 61 so that the operating rod 50 has a clearance with respect to the flange portion 9a and is formed in the notch 71 of the covering member 61. Can be arranged. FIG. 13 shows a cross section taken along line DD of FIG.
[0050]
Also, in FIGS. 11 and 12, the vibration transmitting member 9 at a plurality of positions serving as nodes of vibration is formed on the large-diameter flange portion 9a, but is a cross-sectional view taken along line EE in FIGS. As shown in FIG. 15, a groove 81 is formed on the outer periphery of a plurality of positions serving as nodes of vibration of the vibration transmitting member 9, and a large ring-shaped low-profile material such as PTFE (Teflon: trade name of DuPont) or the like is formed in the groove 81. An elastic member 82 made of a friction material or a rubber material is integrally provided, and the elastic member 82 is inscribed in the covering member 61 to hold the vibration transmitting member 9 in the insertion portion outer tube 4 and to operate the operating rod 50. May be arranged in the notch 71 of the covering member 61. FIG. 16 shows a cross section taken along line FF of FIG.
[0051]
Further, in the present embodiment, the vibration transmitting members 9 at a plurality of positions serving as nodes of vibration are formed in the large-diameter flange portion 9a, and the operation rod 50 is disposed in the notch 9b of the flange portion 9a. As shown in FIG. 17 to FIG. 19, a low-profile material such as PTFE (Teflon: trade name of DuPont) having a large-diameter link-shaped cutout portion 90 on the outer periphery of a plurality of positions serving as nodes of vibration of the vibration transmission member 9. An elastic member 91 made of a friction material or a rubber material is provided. The elastic member 91 is inscribed in the covering member 61 to hold the vibration transmitting member 9 in the insertion portion outer tube 4, and the operating rod 50 is connected to the elastic member 91. May be arranged in the notch 90.
[0052]
The present invention is not limited to the above-described embodiment, and various changes and modifications can be made without departing from the spirit of the present invention.
[0053]
【The invention's effect】
As described above, according to the present invention, there is an effect that the efficiency of cleaning the inside tube of the insertion portion can be improved by separating and disposing the operation rod and the ultrasonic probe inside.
[Brief description of the drawings]
FIG. 1 is a configuration diagram showing a configuration of an ultrasonic surgical apparatus according to an embodiment of the present invention. FIG. 2 is a block diagram showing a configuration of an apparatus main body in FIG. 1. FIG. FIG. 4 is a side view showing a disassembled state. FIG. 4 is a side view showing an assembled state of the entire ultrasonic treatment device in FIG. 1. FIG. 5 is an ultrasonic wave holding a vibration transmitting member (ultrasonic probe) of the ultrasonic treatment device in FIG. FIG. 6 is a sectional view showing a section taken along line AA of FIG. 5; FIG. 7 is a sectional view showing a section taken along line BB of FIG. 5; FIG. FIG. 9 is a view for explaining a first modification of the ultrasonic probe holding means for holding the vibration transmitting member (ultrasonic probe) of the ultrasonic treatment tool. FIG. 9 is a diagram illustrating the vibration transmitting member (ultrasonic probe) of the ultrasonic treatment tool of FIG. FIG. 10 is a view for explaining a second modification of the ultrasonic probe holding means for holding the ultrasonic treatment instrument. FIG. 11 is a view for explaining a third modification of the ultrasonic probe holding means for holding the dynamic transmission member (ultrasonic probe). FIG. 11 is a view showing the ultrasonic transmission member for holding the vibration transmission member (ultrasonic probe) of the ultrasonic treatment tool in FIG. FIG. 12 is a cross-sectional view showing a cross section taken along line CC of FIG. 11; FIG. 13 is a cross-sectional view showing a cross section taken along line DD of FIG. 11; FIG. 15 is a view for explaining a fifth modification of the ultrasonic probe holding means for holding the vibration transmitting member (ultrasonic probe) of the ultrasonic treatment tool in FIG. 1; FIG. 15 is a sectional view showing a cross section taken along line EE in FIG. 16 is a cross-sectional view showing a cross section taken along line FF of FIG. 14. FIG. 17 is a sixth modification of the ultrasonic probe holding means for holding the vibration transmitting member (ultrasonic probe) of the ultrasonic treatment tool of FIG. FIG. 18 illustrates a sixth modification of the ultrasonic probe holding means in FIG. Sectional view showing a line G-G cross-section of FIG. 19 FIG. 17 showing a watch EXPLANATION OF REFERENCE NUMERALS
DESCRIPTION OF SYMBOLS 1 ... Device main body 2 ... Ultrasonic treatment tool 3 ... Foot switch 4 ... Insert part outer tube 5 ... Treatment part 6 ... Operation part 9 ... Vibration transmission member (ultrasonic probe)
9a: Flange 9b: Notch 32: Handle unit 33: Probe unit 34: Transducer unit 50: Operating rods 61, 62: Covering member

Claims

An ultrasonic treatment tool that performs treatment by applying ultrasonic vibration from an ultrasonic transducer to the living tissue gripped by the treatment unit,
An ultrasonic drive device that ultrasonically vibrates the ultrasonic vibrator of the ultrasonic treatment tool,
The ultrasonic treatment instrument,
The ultrasonic vibrator is provided on an operation unit connected to a proximal end of the insertion tube,
Inserting an ultrasonic probe that transmits ultrasonic vibrations from the ultrasonic transducer to the treatment section side inside the insertion portion outer tube,
A jaw that is rotatably supported facing the distal end of the ultrasonic probe and grips the living tissue between the distal end of the ultrasonic probe,
Operating means disposed on the operating section, for opening and closing the jaw with respect to the ultrasonic probe,
An ultrasonic surgical apparatus comprising: an operating force transmitting member that connects the jaw and the operating means and transmits an operating force from the operating means to the jaw side.
A plurality of ultrasonic probe holding means for holding the ultrasonic probe in the insertion portion outer tube at a plurality of positions inside the insertion portion outer tube serving as nodes of vibration of the ultrasonic probe,
An ultrasonic surgical apparatus, comprising: an operating force transmitting member holding unit that holds the operating force transmitting member separately from the ultrasonic probe.

The ultrasonic probe holding means is configured by a large-diameter flange of the ultrasonic probe inscribed in the insertion portion mantle tube formed at the node of the vibration,
The ultrasonic operating apparatus according to claim 1, wherein the operating force transmitting member holding means is configured by a notch formed in the flange.

Having a covering member for covering the inner surface of the insertion portion mantle tube,
The ultrasonic probe holding means is constituted by a large-diameter flange of the ultrasonic probe inscribed in the insertion portion mantle tube formed at the node of the vibration,
The ultrasonic operation apparatus according to claim 1, wherein the operation force transmitting member holding means is configured by a notch formed in the covering member.

Having a covering member for covering the inner surface of the insertion portion mantle tube,
The ultrasonic probe holding means is constituted by an elastic member inscribed in the insertion portion outer tube provided on the outer periphery of the ultrasonic probe at a node position of the vibration,
The ultrasonic operation apparatus according to claim 1, wherein the operation force transmitting member holding means is configured by a notch formed in the covering member.

The ultrasonic probe holding means is constituted by an elastic member inscribed in the insertion portion outer tube provided on the outer periphery of the ultrasonic probe at a node position of the vibration,
The ultrasonic operating apparatus according to claim 1, wherein the operation force transmitting member holding unit is configured by a notch formed in the elastic member.