JP2016055135A - Ultrasonic coagulation device having roughened surface end effector blade - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an ultrasonic coagulation device in which a clamp surface of a blade for ultrasonic vibration is constituted from a roughened surface for improving cutting-off, coagulation force and agglutination force for a tissue.SOLUTION: An end effector 2 is constituted from a blade having a first tissue contact surface and a second tissue contact surface. Since the tissue contact surfaces of a blade for ultrasonic vibration are roughened surfaces, frictional force in the case of vibration under clamp is improved, modification in a protein in the clamped tissue is facilitated, and shortening in the modification time and reduction in electric energy required for the modification can be achieved.SELECTED DRAWING: Figure 1A

Description

The present invention generally relates to an ultrasonic surgical system, and more particularly, an end effector that allows a surgeon to perform tissue cutting and coagulation, as well as improved tissue dissection, with less mist and splash and at higher speeds. Related to ultrasonic equipment with a rough blade.

Ultrasonic surgical instruments are increasingly being used in surgical procedures due to the unique performance characteristics of such instruments. Depending on the specific instrument configuration and operating parameters, the ultrasonic surgical instrument can provide homeostasis due to tissue cutting and coagulation at substantially the same time to desirably minimize patient trauma. The cutting action is typically accomplished by an end effector or blade tip at the distal end of the instrument, which transmits ultrasonic energy to the tissue that the end effector contacts. An ultrasonic instrument of this nature can be configured for open surgical applications including robot-assisted procedures, laparoscopic or endoscopic surgical procedures.

Some surgical instruments utilize ultrasonic energy for both precise incision and coagulation control purposes. The ultrasonic energy cuts and solidifies using a temperature lower than that used in electrosurgery. An ultrasonic blade that vibrates at a high frequency (for example, 55,500 times per second) denatures proteins in the tissue to form a solid clot. The pressure exerted on the tissue by the blade surface disrupts the blood vessel and allows the clot to form a hemostatic seal. The accuracy of cutting and coagulation is controlled by surgeon techniques and adjustment of power level, blade edge, tissue traction, and “blade pressure”.

Ultrasonic surgical instruments have been developed that include a clamping mechanism for pressing tissue against an end effector blade to couple ultrasonic energy to the patient's tissue. Such a configuration (sometimes also referred to as a clamp coagulator shears or an ultrasonic crossing device) is described in U.S. Pat. Nos. 5,322,055, 5,873,873, And in US Pat. No. 6,325,811. The surgeon activates the clamp arm and presses the clamp handle against the blade by squeezing the grip or trigger handle. The clamp coagulation configuration also allows the surgeon to incise the tissue.

Constructing a rough blade for the end effector increases the coefficient of friction for the clamped tissue, which in turn facilitates denaturation of the protein in the clamped tissue, shortens the denaturation time, and provides the electricity required for denaturation. Enable energy reduction effect. This is not a conventional cord type, but can provide an epoch-making mechanism capable of providing a small-sized ultrasonic coagulation apparatus that can be driven with a smaller voltage, and enables a surgeon to cut various tissues.

US Pat. No. 5,322,055 US Pat. No. 5,873,873 US Pat. No. 6,325,811

The conventional ultrasonic coagulation apparatus has a low “blade pressure” because the tissue contact surface of the blade of the end effector is smooth. In order to obtain a high frictional force, it was necessary to generate a lot of vibrations. Mist and splash generated during the vibration are one of the causes of airborne infections such as AIDS and hepatitis virus to medical personnel during surgery.

In the ultrasonic coagulation apparatus, the “blade pressure” can be improved by roughening the tissue contact surface of the blade of the end effector. Since a high frictional force can be obtained with a smaller vibration energy, the power used can be reduced. In addition, by forming the rough surface with micro processing like a micro groove or tread pattern of a tire that does not spray well, mist that causes air infection of diseases such as AIDS and hepatitis virus to medical personnel during surgery And the occurrence of splash can be reduced as much as possible.

The higher the vibration frequency of the ultrasonic coagulator, the smaller the travel distance and blur due to the vibration of the blade of the end effector. For this reason, splash and mist during operation are reduced. Reduces healing and cutting power. The rough surface blade according to the present invention has an effect of compensating for a decrease in healing and cutting force accompanying an increase in frequency by improving the frictional force by making the tissue contact surface of the blade rough.

The perspective view of the structure by the rough surface blade of this invention of an ultrasonic surgical instrument. 1 is a clamp blade. 2 is a rough blade of the end effector. The perspective view of one example of the structure by the grooved blade of this invention of an ultrasonic surgical instrument. 3 is a clamp blade. 4 is a groove blade. The perspective view of one example of the structure by the tread pattern blade of this invention of an ultrasonic surgical instrument. 5 is a clamp blade. 6 is a tread pattern blade. The perspective view of the conventional general structure of an ultrasonic surgical instrument. 7 is a clamp blade. 8 is a blade using a metal having a smooth tissue contact surface. The figure observed from the front at the time of the clamp of the conventional common ultrasonic surgical instrument. 9 shows that fine water droplets of splash and mist are diffused around the tissue. These include pathogenic viruses.

The present invention is particularly directed to an improved ultrasonic surgical instrument configured to perform tissue dissection, cutting and / or coagulation during surgery. The instrument is configured to facilitate soft tissue access in open or laparoscopic surgery. The selective use of ultrasonic energy facilitates versatile applications. When the ultrasound element of the device is not activated, the tissue can be manipulated as desired without incising or damaging the tissue. When the ultrasound component is activated, the ultrasound energy alone provides tissue cutting and coagulation, or tissue coagulation.

As will become apparent from the following description, the surgical device of the present invention is specifically configured for disposable applications utilizing its straightforward structure. Thus, the device is used in conjunction with an ultrasonic generator unit, either in a surgical system part or encapsulated in an instrument, so that ultrasonic energy from the generator unit is used for the surgical instrument. It is believed to provide the desired ultrasonic actuation of It will be appreciated that a surgical instrument embodying the principles of the present invention is configured to be non-disposable or used multiple times and can be non-removably integrated with an associated ultrasound generator unit. Will be done. However, it is preferred in the present invention that the surgical instrument of the present invention be removably connected to an associated ultrasonic oscillator unit to make the device for single patient use.

FIG. 1A shows that the tissue contact surface of the end effector blade at the tip of the ultrasonic coagulation apparatus is rough. FIG. 1B shows an embodiment in which a constant groove (in microns) is configured in the tissue contacting surface of the end effector blade. FIG. 1C shows an example in which a groove incorporating a tread technique of a car tire with less water repellency is formed on the tissue contact surface of the end effector.

(1) An ultrasonic medical device comprising: an ultrasonic waveguide having a proximal end and a distal end; and an ultrasonically activated blade attached to the distal end of the waveguide. An ultrasonic medical device having a rough tissue contact surface.
(2) The ultrasonic medical device according to (1), wherein the blade is straight.
(3) The ultrasonic medical device according to (1), wherein the blade is curved.
(4) The ultrasonic medical device according to (1), wherein the tissue contact surface of the blade activated by ultrasonic waves forms a constant groove.
(5) The ultrasonic medical device according to (1), wherein the tissue contact surface of the blade activated by ultrasonic waves forms a tread pattern-like groove of a car tire.

Claims (5)

An ultrasonic medical device, an ultrasonic waveguide having a proximal end and a distal end, and a tissue contacting surface of an ultrasonically activated blade attached to the distal end of the waveguide An ultrasonic medical device having a rough surface. The ultrasonic medical device of claim 1, wherein the blade is straight. The ultrasonic medical device according to claim 1, wherein the blade is curved. The ultrasonic medical device of claim 1, wherein the tissue contacting surface of the blade activated by ultrasound forms a constant groove. The ultrasonic medical device according to claim 1, wherein the tissue contact surface of the blade activated by ultrasonic waves forms a tread pattern-like groove of a car tire.

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