JP2009056315A - Ultrasonic operation apparatus - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide an ultrasonic operation apparatus which is prevented from abnormal heat generation and breakage of a probe and can be normally driven without loading a load on a drive power source. <P>SOLUTION: The ultrasonic operation apparatus includes a vibration frequency detection means to detect a vibration frequency at least concerning a resonance point in a probe, a mechanical impedance detection means to detect mechanical impedance in the probe, and a control means to make the vibration frequency detection means and the mechanical impedance detection means cooperate and so as to stop the operation of a drive means based on a result of comparison between the vibration frequency relating to at least the resonance point in a probe detected by the vibration frequency detection means and the predetermined reference frequency or a result of comparison between the mechanical impedance in the probed detected by the mechanical impedance detection means and the predetermined reference mechanical impedance. <P>COPYRIGHT: (C)2009,JPO&INPIT

Description

  The present invention relates to an ultrasonic surgical apparatus having a probe for performing ultrasonic treatment on a living tissue by ultrasonic vibration.

  Conventionally, as an ultrasonic surgical apparatus for performing ultrasonic treatment on a living tissue by ultrasonic vibration, an ultrasonic suction apparatus for emulsifying, crushing, or sucking the living tissue, an ultrasonic coagulating / cutting apparatus for coagulating / cutting the living tissue, etc. It has been known.

  These ultrasonic surgical devices include a driving power source, a vibrator that generates ultrasonic vibrations from the driving power source, and mechanically coupled with the vibrator to vibrate under a specified resonance frequency. And a probe for applying vibration.

  In order for the ultrasonic surgical apparatus to operate normally, it is necessary that the transducer and the probe have a specified resonance frequency in a state where they are mechanically coupled. The vibrator is driven.

  Further, when a mechanical load is applied to the probe, the mechanical impedance increases as a mechanical load state, and the resonance frequency may vary from the normal resonance frequency depending on the load condition. In addition, it is also known that, depending on the shape of the probe, a reflected wave is generated due to a phenomenon called a spurious phenomenon, and a false resonance frequency different from the designed normal resonance frequency appears.

  A general form of a probe for treating a living tissue by such ultrasonic vibration is configured as shown in FIG.

  The probe 101 is input with ultrasonic vibrations from a vibrator provided therein from a proximal end portion 102 and is applied to the living tissue from the distal end portion of the probe 101. Here, the end part of the base end part 102 and the end part of the tip part of the probe 101 are antinodes of vibration, and a vibration node is generated between them.

  The ultrasonic vibration has a characteristic that the amplitude is basically enlarged in proportion to the cross-sectional area of the input end and the output end. It is configured so as to provide a portion in which becomes smaller.

  The probe 101 is mechanically coupled to the vibrator and is shaped so as to have a normal resonance point (a position where the frequency at which vibration is most likely appears) as shown in FIG. The ultrasonic vibration of frequency is driven.

  When driving at a frequency far away from this frequency, the mechanical impedance Z is large and loss is increased, leading to abnormal heat generation and breakage of the probe 101. Therefore, driving at the resonance frequency is always required. It is also known that even when the mechanical impedance at the resonance point is too large, excessive power is required, which places a heavy burden on the drive power supply and cannot be driven normally.

  Further, when the probe 101 has a portion whose shape changes suddenly, for example, when the cross-sectional area is sharply reduced in the horn 104, or when the mass ratio of the base end portion 102 to the tip end portion 103 is large, or the probe 101 In the case of a shape having a bent portion with a large bending angle, a phenomenon called a spurious (reflection) phenomenon occurs in this portion, and a false resonance frequency may appear when this portion is used as a tip.

  For example, the false resonance point due to the false resonance frequency is generated at a frequency different from the normal resonance point (see FIG. 5), and the value of the mechanical impedance Z is often larger than the normal value. It is also known that the frequency and mechanical impedance of the antiresonance point change depending on the situation of the spurious phenomenon.

  When this false resonance point occurs, it is known that if an appropriate mechanical load is applied to the tip of the probe 101, the false resonance point disappears and a normal resonance point appears. This is because the spurious phenomenon due to the rapid shape change as described above is reduced by applying a mechanical load to the tip of the probe 101. In this case, it is also known that the impedance Z of the resonance point also decreases to a normal value.

  Even when the spurious phenomenon does not occur, the frequency and mechanical impedance of the resonance point and the frequency and mechanical impedance of the anti-resonance point may change depending on the state of the mechanical load on the probe 101.

  By the way, as an ultrasonic surgical apparatus provided with such a probe, for example, the above-described ultrasonic suction apparatus emulsifies and crushes a biological tissue by applying ultrasonic vibration to the biological tissue, and from the suction hole formed in the probe. It comes to suck. At this time, since the ultrasonic vibration is applied to the probe continuously for a relatively long time, it is necessary to cool the probe with cooling water in order to prevent breakage due to heat generation of the probe and damage to living tissue, and there is no cooling water. If used in a state, there is a risk of malfunction.

  In order to solve such a problem, in the ultrasonic surgical apparatus described in Japanese Patent Application Laid-Open No. 05-023345, it is detected by a sensor provided in the suction pipe that the cooling water for cooling the probe is filled. In addition, it has been proposed that the vibrator cannot be driven when the cooling water is not filled. On the other hand, in the ultrasonic surgical apparatus described in Japanese Patent Laid-Open No. 03-146048, when the cooling water is filled, the mechanical impedance between the probe and the vibrator is changed, and the cooling water is filled. There has been proposed a sensor that detects a change in mechanical impedance.

  However, in the former (Japanese Patent Laid-Open No. 05-023345) ultrasonic suction device, it is necessary to incorporate a special sensor in the cooling system in order to detect cooling water.

  On the other hand, in the ultrasonic suction device of the latter (Japanese Patent Laid-Open No. 03-146048), the mechanical impedance fluctuates even when, for example, the probe tip is in contact with the living tissue. Therefore, control is performed only with this mechanical impedance. Needed to improve detection accuracy. In the case of the ultrasonic coagulation / cutting device, it is determined whether or not the living tissue is grasped by mechanical impedance. However, in this case, it is difficult to determine only by mechanical impedance.

  As described above, if the probe is mechanically coupled to the transducer and does not vibrate at the normal resonance frequency, the ultrasonic surgical device applies an excessive load to the driving means for driving the transducer and the transducer is normally operated. It becomes difficult to drive, and the probe cannot vibrate optimally, making it difficult to perform a desired treatment on the living tissue.

  The present invention has been made in view of these circumstances, and provides an ultrasonic surgical apparatus that prevents abnormal heat generation and breakage of the probe and that can be driven normally without imposing a burden on the drive power supply. For the purpose.

  A first ultrasonic surgical apparatus of the present invention includes a probe that performs a treatment on a biological tissue by ultrasonic vibration, a vibrator that vibrates the probe, a driving unit that drives the vibrator, and at least the probe. A vibration frequency detecting means for detecting a vibration frequency related to a resonance point; a mechanical impedance detecting means for detecting a mechanical impedance in the probe; and operating both the vibration frequency detecting means and the mechanical impedance detecting means, and A comparison result of at least a vibration frequency related to a resonance point in the probe detected by the vibration frequency detecting means and a predetermined reference frequency, or a mechanical impedance of the probe detected by the mechanical impedance detecting means and a predetermined Based on comparison results with reference mechanical impedance And control means for controlling to stop the operation of the serial drive means, characterized by comprising a.

  A second ultrasonic surgical apparatus according to the present invention includes a probe that performs a treatment on a biological tissue by ultrasonic vibration, a vibrator that vibrates the probe, a driving unit that drives the vibrator, and an abnormality of the probe. Warning means for warning the state, vibration frequency detection means for detecting vibration frequency related to at least a resonance point in the probe, mechanical impedance detection means for detecting mechanical impedance in the probe, vibration frequency detection means, and the The mechanical impedance detection means is operated together, and a comparison result between a vibration frequency at least a resonance point in the probe detected by the vibration frequency detection means and a predetermined reference frequency, or the mechanical impedance detection means The mechanical impedance of the probe detected by the Based on the result of comparison between mechanical impedance, characterized by comprising a control means allowed to activate said warning means.

  According to the present invention, abnormal heat generation and breakage of the probe can be prevented, and the driving power source can be controlled in an appropriate state without imposing a burden on the driving power source. Get the effect of improving the sex and quality.

  Embodiments of the present invention will be described below with reference to the drawings.

(First embodiment)
1 and 2 relate to a first embodiment of the present invention, and FIG. 1 is an overall configuration diagram showing an entire configuration of an ultrasonic suction apparatus as an ultrasonic surgical apparatus of the first embodiment of the present invention. FIG. 2 is a configuration diagram illustrating a detailed configuration of the ultrasonic aspirator body of FIG.

  As shown in FIG. 1, an ultrasonic suction apparatus 1 as an ultrasonic surgical apparatus includes, for example, an ultrasonic suction body 2, a water feeder 3 that supplies cooling water to the ultrasonic suction body 2, and the ultrasonic suction. The power source 4 mainly supplies power and cooling water to the main body 2. The water feeder 3 includes a cooling water bottle 3a and a water pump 3b, and may include a suction pump and a suction container (not shown) as necessary.

  The ultrasonic aspirator body 2 is mechanically coupled to a vibrator 11 that generates ultrasonic waves and the vibrator 11, and transmits ultrasonic waves from the vibrator 11 via a horn 12 to treat a living tissue. And a hand piece 10 provided with a probe 13 for applying the above.

The power supply 4 includes a water supply circuit 21 for supplying cooling water supplied from the water supply pump 3b of the water supply 3 to the handpiece 10, a drive circuit 22 for driving the vibrator 11, and FIG. By detecting the frequency of the resonance point and the frequency of the anti-resonance point and the mechanical impedance Z described in the above, a detection circuit 23 for detecting a false resonance point, and an abnormal state is notified based on the result of the detection circuit 23 It is mainly comprised from the alerting | reporting part 24 to do. In addition, you may provide the attraction | suction circuit for attracting | sucking cooling water and a biological tissue as needed.
The detection circuit 23 can measure frequency characteristics in a state where the probe 13 and the vibrator 11 are mechanically coupled, and controls the drive circuit 22 according to the detection result. It has become.

Next, the detailed configuration of the ultrasonic aspirator body 2 will be described with reference to FIG.
The probe 13 is coupled to a horn 12 mechanically coupled to the vibrator 11 by a connecting portion 31 so that power from the power source 4 is supplied by a power cord 4a at the rear end of the hammer piece 10. It has become. A suction path 33 is formed from the probe 13 through the vibrator 11 to the suction port 32, and a living tissue can be sucked from the tip of the probe 13 by a suction means (not shown).

The probe 13 is bent at a bent portion 34, and is easy to use, for example, when used under a surgical microscope. The probe 13 is covered with a sheath 35, and a gap between the probe 13 serves as a cooling water channel 36, and communicates with the water supply port 37 so that the cooling water can be sent to the tip of the probe 13.
Further, the probe 13 is formed so that the spurious phenomenon occurs as described above in a no-load state, and when the cooling water is filled, an appropriate load is applied and the spurious phenomenon disappears.

  Although not shown, the detection circuit 23 includes a resonance point detection circuit that detects a resonance point and an antiresonance point of the probe 13 in comparison with a reference vibration of a reference oscillator provided inside the drive circuit 22, for example. And a mechanical impedance detection circuit for detecting mechanical impedance by a signal from a cooling water detection sensor provided in the sheath 35. The resonance point detection circuit and the mechanical impedance The detection circuit detects a false resonance point with a frequency characteristic waveform by using a combination of parameters such as the frequency of the resonance point and the antiresonance point and the value of the mechanical impedance Z.

Using the ultrasonic suction device 1 configured as described above, an ultrasonic treatment is performed on a living tissue.
When the user prepares for use and turns on the power, the detection circuit 23 detects the false resonance point described in FIG.
Then, the detection circuit 23 determines that the state is abnormal and issues a command so that the drive circuit 22 cannot operate. At the same time, the detection circuit 23 issues a command to the notification unit 24 to perform warning notification of an abnormal state. Although not shown, the warning notification may be configured such that a light emitting body such as an LED provided in the power supply 4 emits light or a beep sound is generated by a speaker. These warning notifications may be provided on the handpiece 10.

  Next, the user operates the water supply circuit 21 according to this warning notification to fill the cooling water channel 36 with the cooling water so that the entire probe 13 is covered with the cooling water. Then, an appropriate mechanical load is applied to the probe 13 by the cooling water, the above-mentioned spurious phenomenon is reduced, the normal resonance point is detected by the detection circuit 23, the drive circuit 22 becomes operable, and the ultrasonic aspirator body 2 Can be used.

  The detection method in this case is performed by complex detection based on the frequency of the resonance point and the anti-resonance point and the value of the mechanical impedance Z. Differences in mechanical load such as absence of touch or touching a living tissue can be highly discriminated.

  For example, the probe 13 is designed so that the spurious phenomenon does not occur, and when the determination of the presence or absence of the cooling water is performed only by the mechanical impedance Z, when the probe 13 touches the living tissue without the cooling water, There is a possibility that the same value is detected accidentally when the cooling water is filled and malfunctions.

  In order to prevent this, measures such as increasing the detection accuracy of the mechanical impedance Z are required, and it was difficult to improve the accuracy. However, the frequency of the resonance point and antiresonance point and the mechanical impedance Z If the parameter of value is used in combination and is recognized by the waveform of the frequency characteristic, the detection accuracy can be easily improved.

  Thereby, the possibility that the vibrator 11 is driven in a state where the cooling water is not filled and the probe 13 is damaged or the living tissue is burned is avoided.

  Further, in the situation where the cooling water is filled and normally operated, the above-described values fluctuate even when the tip of the probe 13 is strongly pressed against a living tissue or is forced against a very hard tissue, for example. Therefore, the detection circuit 23 can detect and stop the drive circuit 22.

  For example, in the case of removal of a brain tumor, the hardness of the tumor is different for each patient even in the same type of tumor, and is often different depending on the periphery and the inside of the tumor. Therefore, for example, when it is determined from the above-described parameters that the tissue is very soft, the output of the drive circuit 22 is automatically reduced so that a strong output is not inadvertently applied, or suddenly a hard tissue is formed. It is also possible to automatically increase the output when there is a change.

  In other words, according to the present embodiment, the frequency of the resonance point and the antiresonance point and the value of the mechanical impedance Z change automatically and safely using the mechanical load applied to the probe 13. It is possible to adjust to the operating state, and it is possible to improve the quality of the operation.

(Second Embodiment)
FIG. 3 is a configuration diagram showing ultrasonic coagulation / cutting forceps constituting an ultrasonic coagulation / cutting device as an ultrasonic surgical device according to the second embodiment of the present invention.
In the first embodiment, the present invention is applied using the ultrasonic suction device 1 as an ultrasonic surgical device. However, as the second embodiment, the ultrasonic surgical device is an ultrasonic surgical device. It is set as the structure which applied this invention to the ultrasonic coagulation incision apparatus using the ultrasonic coagulation incision forceps.

As shown in FIG. 3, the ultrasonic coagulation / incision forceps 50 is connected to a power supply similar to the power supply 4 described in FIG. 1 via a power cord 4a, and is used as an ultrasonic coagulation / cutting apparatus.
The ultrasonic coagulation / incision forceps 50 includes a probe 51 mechanically coupled to the transducer 11, and a jaw 52 facing the tip of the probe 51 is provided at the tip of the insertion portion 50a. The jaw 52 opens and closes the probe 51 in conjunction with the movable handle 54 attached to the handpiece 53 on the proximal side by opening and closing the fixed handle 55. The insertion portion 50a is provided with a rotation knob 56. By rotating the knob 50, the insertion portion 50a and the accompanying probe 51 and jaw 52 can be rotated about the major axis direction. It has become. Reference numeral 57 denotes a sheath that covers the probe 51 and an opening / closing operation transmitting portion (not shown) of the jaw 52.

  Here, as in the first embodiment, the probe 51 generates a spurious phenomenon in an unloaded state, and is caused by a mechanical load generated by gripping the living tissue within a range of a prescribed force with the jaw 52 and the probe 51. The spurious phenomenon is formed to disappear.

  Therefore, in a state where the target living tissue to be coagulated and incised is not grasped, the drive circuit 22 described with reference to FIG. Further, after the living tissue is grasped and the coagulation incision is performed, the living tissue is cut and the jaw 52 is separated from the probe 51, and the jaw 52 directly applies force to the probe 51, so that the living tissue is grasped with a predetermined force. As described in the first embodiment, since the frequency and the impedance Z of the resonance point and the antiresonance point are different, the drive circuit 22 is stopped by the detection circuit 23. Further, even when the living tissue is grasped with less than or more than a predetermined amount of force, the drive circuit 22 does not operate because the above-described parameters change. At this time, a warning notification may be made by the notification unit 24 as in the first embodiment.

  As a result, in the second embodiment, since ultrasonic vibration does not occur except in a good gripping state, the possibility of bleeding or the like that occurs when a living tissue is gripped and treated with an insufficient or excessive force is avoided. In addition, it is possible to prevent the ultrasonic vibration from being inadvertently applied to the living tissue and being damaged.

  As described above in the embodiment, in the ultrasonic surgical apparatus that treats living tissue using ultrasonic vibration, the resonance point and the anti-resonance point indicate whether or not the mechanical load state is within a predetermined range. By detecting the false resonance point and controlling the drive circuit by detecting the frequency and mechanical impedance of the device, it is possible to perform control more easily and with high accuracy. The embodiment is not particularly limited as long as it improves the quality.

  Note that embodiments configured by partially combining the above-described embodiments and the like also belong to the present invention.

[Appendix]
(Additional Item 1) A probe that performs a treatment on a living tissue by ultrasonic vibration, a vibrator that vibrates the probe, a driving unit that drives the vibrator, and a normal resonance point of the probe have frequencies. An ultrasonic surgical apparatus comprising: detection means for detecting different false resonance points; and control means for controlling the drive means based on a result of the detection means.

  (Additional Item 2) A probe that performs treatment on a living tissue by ultrasonic vibration, a vibrator that vibrates the probe, a driving unit that drives the vibrator, and a normal resonance point of the probe have frequencies. An ultrasonic surgical apparatus comprising: a detection unit that detects different false resonance points; and a notification unit that notifies an abnormal state based on a result of the detection unit.

  (Additional Item 3) A probe that performs a treatment on a living tissue by ultrasonic vibration, a vibrator that vibrates the probe, a driving unit that drives the vibrator, a sheath that covers the probe, the sheath, Water supply means for allowing cooling water to flow between the probe and a stop means for detecting a false resonance point having a frequency different from a normal resonance point by a reflected wave of the probe and stopping the drive means An ultrasonic surgical device characterized by the above.

  (Additional Item 4) The ultrasonic surgical apparatus according to Additional Item 3, wherein the cooling water is attached to the probe to be in a load state in the predetermined range.

  (Additional Item 5) The ultrasonic surgical apparatus according to Additional Items 1 to 3, wherein when the probe is in contact with a living tissue, the load state is in the predetermined range.

  (Additional Item 6) The superstructure according to Additional Item 5, further comprising: a jaw that opens and closes the probe for grasping a living tissue between the probe and a handle that operates the jaw. Sonic surgery device.

  (Additional Item 7) The ultrasonic surgical apparatus according to Additional Items 1 to 3, which has a shape that resonates at the false resonance point according to a mechanical load state received by the probe.

  (Additional Item 8) The ultrasonic surgical apparatus according to Additional Items 1 to 3, which has a shape that resonates at the false resonance point when a mechanical load state received by the probe is an unloaded state.

  (Additional Item 9) The ultrasonic surgical apparatus according to Additional Items 1 to 3, further comprising a control unit that stops the driving unit when the false resonance point is detected.

  (Additional Item 10) The additional items 1 to 3, wherein the drive mode of the driving means at the defined resonance point has at least one different mode corresponding to each of the defined resonance points. The ultrasonic surgical apparatus as described.

  (Supplementary Item 11) The supplementary note, wherein the probe has a plurality of resonance points having different frequencies, respectively, in a mechanical no-load state and at least one mechanical load state in a predetermined range. The ultrasonic surgical apparatus of claim | item 1-3.

  (Additional Item 12) The driving means can drive the vibrator only when at least one defined resonance point is detected among the plurality of different resonance points. The ultrasonic surgical apparatus of additional remarks 1-3 which do.

  (Additional Item 13) The ultrasonic surgical apparatus according to Additional Item 7, wherein mechanical impedance is used as a parameter at least as a frequency of a resonance point and a mechanical load state for distinguishing the plurality of resonance frequencies.

  (Additional Item 14) The ultrasonic surgical apparatus according to Additional Item 13, wherein a frequency of an antiresonance point is used at least for the resonance point as the parameter.

  (Additional Item 15) The ultrasonic surgical apparatus according to Additional Item 14, wherein two or more antiresonance points are used from the closest to the resonance point.

  (Additional Item 16) The ultrasonic surgical apparatus according to Additional Items 14 and 15, wherein at least the frequency and mechanical impedance of the anti-resonance point are used as the parameter.

1 is an overall configuration diagram showing an overall configuration of an ultrasonic suction device as an ultrasonic surgical device according to a first embodiment of the present invention. The block diagram explaining the detailed structure of the ultrasonic aspirator main body of FIG. The block diagram which shows the ultrasonic coagulation incision forceps which comprise the ultrasonic coagulation incision apparatus as an ultrasonic operation apparatus based on the 2nd Embodiment of this invention Explanatory drawing explaining the basic form of a probe Explanatory drawing explaining the normal resonance point of the ultrasonic vibration which appears in the probe of FIG. 4, an antiresonance point, and a false resonance point

Explanation of symbols

1 ... Ultrasonic suction device (ultrasonic surgical device)
DESCRIPTION OF SYMBOLS 2 ... Ultrasonic suction device main body 3 ... Water feeder 4 ... Power supply 10 ... Handpiece 11 ... Vibrator 13 ... Probe 21 ... Water supply circuit 22 ... Drive circuit 23 ... Detection circuit 24 ... Notification part 33 ... Suction path 36 ... Cooling water path

Claims (2)

A probe for treating a living tissue by ultrasonic vibration;
A vibrator for vibrating the probe;
Driving means for driving the vibrator;
Vibration frequency detecting means for detecting a vibration frequency related to at least a resonance point in the probe;
Mechanical impedance detection means for detecting mechanical impedance in the probe;
The vibration frequency detection means and the mechanical impedance detection means are operated together, and a comparison result between a vibration frequency related to at least a resonance point in the probe detected by the vibration frequency detection means and a predetermined reference frequency, or Control means for controlling to stop the operation of the drive means based on a comparison result between the mechanical impedance of the probe detected by the mechanical impedance detection means and a predetermined reference mechanical impedance;
An ultrasonic surgical apparatus comprising: A probe for treating a living tissue by ultrasonic vibration;
A vibrator for vibrating the probe;
Driving means for driving the vibrator;
Warning means for warning the abnormal state of the probe;
Vibration frequency detecting means for detecting a vibration frequency related to at least a resonance point in the probe;
Mechanical impedance detection means for detecting mechanical impedance in the probe;
The vibration frequency detection means and the mechanical impedance detection means are operated together, and a comparison result between a vibration frequency related to at least a resonance point in the probe detected by the vibration frequency detection means and a predetermined reference frequency, or Control means for activating the warning means based on a comparison result between the mechanical impedance of the probe detected by the mechanical impedance detection means and a predetermined reference mechanical impedance;
An ultrasonic surgical apparatus comprising:

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