JP2016123470A - Surgical instrument - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a surgical apparatus vibration of which is suitably suppressed.SOLUTION: A surgical instrument comprises: a destruction unit for destroying living tissue by moving along a straight line; a balancer unit disposed on the straight line and moving along the straight line; and a movement mechanism for moving the destruction unit and the balancer unit in opposite directions on the same straight line, using the power supplied from a power source. The surgical instrument further comprises a gas chamber into which compressed gas is introduced, the compressed gas being generated by a compressed gas generation unit, or the power source. The movement mechanism comprises: a first power transmission unit which constitutes a part of inner walls of the gas chamber, and which moves with the destruction unit in a first direction along the straight line when the compressed gas is introduced into the gas chamber, and a second power transmission unit which constitutes a part of inner walls of the gas chamber, a part different from the part for the first power transmission unit, and which moves with the balancer unit in a second direction, opposite the first direction, when the compressed gas is introduced into the gas chamber.SELECTED DRAWING: Figure 1

Description

  The present disclosure relates to a surgical instrument for destroying material.

  Surgical devices that drive surgical instruments for destroying and aspirating material are known. For example, in a handpiece of an ophthalmic surgical apparatus (vitreous surgical apparatus) disclosed in Patent Document 1, a piston to which an inner cylinder blade is attached is pushed with compressed air, and the inner cylinder blade is moved along the outer cylinder blade. In this manner, the vitreous body sucked from the suction port of the outer cylinder blade is excised. Since the moving force in the return direction is applied to the piston by the biasing force of the spring, when the supply of compressed air is stopped, the piston returns to the position before the movement. The control unit intermittently supplies compressed air to the handpiece, and repeats the forward and backward movements of the inner cylinder blade.

JP 2010-57642 A

  When the blade is moved using power to destroy the material, the surgical instrument may vibrate. For example, vibration is transmitted to the hand of the surgeon who holds the surgical instrument during the operation, which may lead to troubles in the fine operation of the surgeon.

  An object of the present disclosure is to provide a surgical instrument in which vibration is suitably suppressed.

In order to solve the above problems, the present invention is characterized by having the following configuration.
(1) The destruction unit that breaks a living tissue by moving along a straight line, the balancer unit that is arranged on the straight line and moves along the straight line, and the power supplied from a power source. And a movement mechanism for moving the balancer part in the opposite direction on the same straight line.

  According to the present disclosure, it is possible to provide a surgical instrument in which vibration is suitably suppressed.

It is a figure which shows schematic structure of the surgery apparatus and surgical instrument of this embodiment. It is an expanded sectional view of the tip of a blade part and an outer cylinder blade in the state where a destruction part is in a movable start position. It is an expanded sectional view of the front-end | tip of a blade part and an outer cylinder blade in the state which has a destruction part in the middle of a movable range. It is an expanded sectional view of the tip of a blade part and an outer cylinder blade in the state where a destruction part exists in a movable termination position. It is a fragmentary sectional view explaining operation | movement of a destruction part and a balancer part, and is a figure corresponding to FIG. It is a fragmentary sectional view explaining operation | movement of a destruction part and a balancer part, and is a figure corresponding to FIG. It is a fragmentary sectional view explaining operation | movement of a destruction part and a balancer part, and is a figure corresponding to FIG. It is a block diagram which shows the electric constitution of a surgical device. It is explanatory drawing explaining the use condition of a surgical instrument. It is sectional drawing of the example of a change of a surgical instrument.

  Hereinafter, exemplary embodiments of the present disclosure will be described with reference to the drawings. In the present embodiment, the surgical apparatus 1 and the surgical instrument 2 used for performing a vitreous surgery on a patient's eye will be described as an example. Specifically, the surgical apparatus 1 of the present embodiment is an ophthalmic apparatus that can perform both cataract surgery and vitreous surgery. Below, the structure for performing a vitreous surgery among the structures of the surgery apparatus 1 is demonstrated.

  A schematic configuration of the surgical apparatus 1 and the surgical instrument 2 according to the present embodiment will be described with reference to FIGS. As shown in FIG. 1, a surgical instrument 2 is connected to the surgical apparatus 1 of the present embodiment. The surgical apparatus 1 drives the connected surgical instrument 2.

<Schematic configuration of surgical instrument>
The surgical instrument 2 will be described. The surgical instrument 2 of the present embodiment is a vitreous cutter, and destroys (cuts in this embodiment) the vitreous tissue of the patient's eye. In addition, as an example, the surgical instrument 2 of the present embodiment sucks the vitreous tissue together with the perfusate supplied into the eye. As shown in FIG. 1, the surgical instrument 2 includes a housing 3, an outer cylinder blade 4, a breaking portion 9, a first elastic member 15, a first diaphragm 12, a second diaphragm 72, a balancer portion 74, and a second elastic member 76. Etc.

  The housing 3 is a substantially cylindrical member, and holds various configurations such as the outer cylindrical blade 4 and the breaking portion 9. The housing 3 may be made of resin. The housing 3 is grasped by, for example, an operator's finger (see FIG. 9). An internal space 11 is formed inside the housing 3 of the present embodiment. The internal space 11 is partitioned into three rooms by the first diaphragm 12 and the second diaphragm 72. The three chambers are arranged in the order of the first compartment 14, the gas chamber 13, and the second compartment 78 from the front end side. In the surgical instrument 2 of the present embodiment, the cylindrical blade portion 6 penetrates the first compartment 14, the gas chamber 13, and the second compartment 78 (detailed description of the blade portion 6 will be described later).

  The outer cylinder blade 4 extends straight from the inside of the housing 3 to the tip side. The outer cylinder blade 4 is fixed to the housing 3. The shape of the outer cylindrical blade 4 is a cylindrical shape (for example, a cylindrical shape) whose tip is closed by a wall portion. A suction port 5 that is an opening for sucking a substance (for example, vitreous tissue) is formed in the vicinity of the distal end portion of the cylindrical portion of the outer cylindrical blade 4. In the present embodiment, the distal end portion of the outer cylinder blade 4 is inserted into the vitreous body of the patient's eye, and the vitreous tissue is sucked from the suction port 5 (see FIG. 9). The outer cylinder blade 4 may be formed of metal.

  The destruction part 9 destroys the biological material by moving. The breaking portion 9 of the present embodiment has a blade portion 6 and a piston 10. The blade portion 6 has a cylindrical shape (so-called inner cylinder blade). You may form the blade part 6 with a metal. The blade portion 6 is movable along a straight line (axis A extending in the left-right direction in FIGS. 2 to 7) inside the outer cylindrical blade 4. As shown in FIGS. 2 to 4, the outer diameter of the blade portion 6 of the present embodiment substantially matches the inner diameter of the outer cylinder blade 4. An opening 7 is formed at the tip of the blade 6. The inside of the cylindrical blade portion 6 constitutes a part of a suction path 8 for sucking a substance. That is, the suction path 8 extends from the suction port 5 of the outer cylindrical blade 4 through the inside of the blade portion 6 to a waste liquid bag 33 (see FIG. 1) described later.

  The piston 10 is used to move the blade portion 6 along a straight line. Specifically, the piston 10 receives the pressure of the compressed gas via the first elastic member 15 and moves the blade portion 6 in the direction of the tip end of the axis A using the received pressure. The piston 10 also serves to move the blade portion 6 in the direction of the rear end of the axis A using the biasing force received from the first elastic member 15. The piston 10 is formed in a mode in which a columnar member and a disk-shaped member are connected. The piston 10 has a hole communicating from the rear end side to the front end side. The piston 10 may be made of resin. The destruction part 9 of this embodiment has the piston 10 bonded to the middle of the rod-shaped blade part 6. Specifically, the piston 10 is bonded to the blade portion 6 with the blade portion 6 being passed through the hole of the piston 10. As a result, when a force from a direction parallel to the axis A is applied to the piston 10, the entire breaking portion 9 including the blade portion 6 moves in the direction of the axis A. Note that the piston 10 is bonded to the blade portion 6 in a state where the disk-shaped member is disposed on the rear end side.

  A first elastic member 15 and a piston 10 are arranged in a first compartment 14 formed in front of the first diaphragm 12. The first elastic member 15 of the present embodiment is disposed between the tip in the first compartment 14 and the piston 10. The first elastic member 15 applies an urging force to the piston 10 in the axially rearward direction (rightward in FIG. 1). When the first elastic member 15 is elastically biased, the destruction portion 9 moved by the power from the compressed gas generation portion 21 is in a position before the movement (may be referred to as an initial position in the following description). Push back in the direction. The first elastic member 15 of the present embodiment is a spring. The first elastic member 15 may be a compression coil spring formed of metal. The shape of the first elastic member 15 of the present embodiment is a cylindrical shape (that is, a cylindrical coil spring), and the blade portion 6 penetrates the inside of the cylindrical shape.

  The housing 3 forming the first compartment 14 is formed with a first ventilation hole 16 extending from the inside of the first compartment 14 to the outside of the housing 3. Therefore, even if the piston 10 moves in the axial direction and the volume of the first compartment 14 changes, the pressure in the first compartment 14 is maintained at atmospheric pressure. A first restricting portion 60 is formed on the rear end side of the first compartment 14. The first restricting part 60 restricts the movement of the destruction part 9 in the distal direction. In this embodiment, the 1st control part 60 is formed by sinking the inner wall which forms the 1st compartment 14 in the direction away from the axis | shaft A. As shown in FIG.

  A first diaphragm 12 is disposed closer to the base end side than the piston 10. The 1st diaphragm 12 is used in order to push out the destruction part 9 to a front-end | tip direction. In detail, the 1st diaphragm 12 pushes the destruction part 9 to a front-end | tip direction by using the compressed gas introduce | transduced into the gas chamber 13 as motive power. The first diaphragm 12 of this embodiment is a disk-shaped member having a hole in the center. The first diaphragm 12 has elastic characteristics. The first diaphragm 12 may be formed of resin. The first diaphragm 12 of the present embodiment has an annular bellows-shaped portion centered on the aforementioned hole. The bellows-shaped portion is used when the first diaphragm 12 is deformed. The first diaphragm 12 may not have the bellows-shaped portion. For example, a material that increases (extends) the surface area by an external force may be applied to the first diaphragm 12. The diameter of the hole formed at the center of the first diaphragm 12 is slightly smaller than the cylindrical diameter of the blade portion 6. Due to the elastic characteristics of the first diaphragm 12, the blade portion 6 passes through a hole formed in the center of the first diaphragm 12.

  The edge of the first diaphragm 12 is fixed to the housing 3 over the entire circumference. That is, in the present embodiment, the first diaphragm 12 is used to divide at least a part of the internal space 11 into the first compartment 14 and the gas chamber 13. As a result, the first diaphragm 12 of the present embodiment forms a part of the inner wall of the gas chamber 13 and the first direction (tip) along the straight line (axis A) by introducing the compressed gas into the gas chamber 13. The first power transmission unit moves in the direction) together with the destruction unit 9. The first diaphragm 12 of the present embodiment is deformed by receiving the compressed gas and pushes out the breaking portion 9. That is, a part of the deformed first diaphragm 12 moves in the distal direction together with the breaking portion 9. The blade 6 may be moved directly by the first elastic member 15 without using the piston 10. For example, a method of bonding the first elastic member 15 and the blade portion 6 can be considered. Further, for example, the first elastic member 15 may not be used. In such an embodiment, the piston 10 forms part of the inner wall of the gas chamber 13. In this case, if an annular packing (O-ring) is formed at the peripheral edge of the piston 10, it is considered that gas leaking from the gas chamber 13 to the first compartment 14 is reduced, which is more preferable.

  A second diaphragm 72 is disposed on the rear end side of the first diaphragm 12. The second diaphragm 72 of the present embodiment is the same member as the first diaphragm 12. Similarly to the first diaphragm 12, the blade portion 6 passes through the hole at the center of the second diaphragm 72. The edge of the second diaphragm 72 is fixed to the housing 3 over the entire circumference. That is, in the present embodiment, at least a part of the internal space 11 is divided into the second compartment 78 and the gas chamber 13 using the second diaphragm 72. As a result, the second diaphragm 72 of the present embodiment forms a part of the inner wall of the gas chamber 13 that is different from the first power transmission unit, and the compressed gas is introduced into the gas chamber 13 in the first direction (front end). 2nd power transmission part which moves with balancer part 74 in the 2nd direction (rear end direction) opposite to (direction). Instead of using the first diaphragm 12 or the second diaphragm 72, other elastic members may be used. What is necessary is just to be able to move the destruction part 9 or the balancer part 74 mentioned later with the compressed gas introduced into the gas chamber 13.

  As described above, the surgical instrument 2 of the present embodiment is a diaphragm that deforms at least one of the first power transmission unit and the second power transmission unit (both in the present embodiment) in accordance with a change in pressure in the gas chamber 13. It is said. Further, the first power transmission unit and the second power transmission unit are arranged to face each other on a straight line (on the axis A) through the space in the gas chamber 13. Moreover, the surface area of the part which faces the gas chamber 13 among the 1st power transmission parts and the surface area of the part which faces the gas chambers 13 among the 2nd power transmission parts are made the same. Thereby, for example, the first power transmission unit (first diaphragm 12) and the second power transmission unit (second diaphragm 72) receive the same kinetic energy from the compressed gas introduced into the gas chamber 13. In addition, the surface area of the part which faces the gas chamber 13 among 1st power transmission parts and the surface area of the part which faces the gas chamber 13 among 2nd power transmission parts may not be exactly the same.

  The first diaphragm 12 and the second diaphragm 72 are spaced apart. A gap formed between the first diaphragm 12 and the second diaphragm 72 becomes a gas chamber 13 into which compressed gas is introduced. A compressed gas is introduced into the gas chamber 13 through a gas introduction tube 17 connected to the housing 3. As described above, the space in the internal space 11 behind the first diaphragm 12 and surrounded by the second diaphragm 72 is the gas chamber 13 into which compressed gas is introduced. . Therefore, the 1st diaphragm 12 and the 2nd diaphragm 72 comprise a part of inner wall of the gas chamber 13 in which the compressed gas which the compressed gas generation part 21 mentioned later generates is introduced. The surgical instrument 2 according to the present embodiment has a moving mechanism (first power) that moves the destruction unit 9 and the balancer unit 74 in the opposite directions on the same straight line by power supplied from a power source (compressed gas generation unit 21). A transmission portion and a second power transmission portion). In the present embodiment, a protruding portion that protrudes into the internal space 11 is formed between the first diaphragm 12 and the second diaphragm 72. The projecting portion includes a first contact portion 64 and a second contact portion 66. This projecting portion is used to place the breaking portion 9 and the balancer portion 74 at the initial position (details will be described later).

  A balancer portion 74 and a second elastic member 76 are arranged in the second compartment 78 formed behind the second diaphragm 72. Specifically, the balancer portion 74 is disposed on the rear end side of the second diaphragm 72, and the second elastic member 76 is disposed between the balancer portion 74 and the rear end in the second compartment 78.

  The balancer unit 74 is used to attenuate the vibration of the surgical instrument 2 that occurs when the destruction unit 9 moves. The balancer portion 74 of this embodiment is a disk-shaped member having a hole in the center. The blade portion 6 passes through a hole formed in the center of the balancer portion 74. The balancer part 74 may be formed of metal, resin, or the like. The balancer part 74 of this embodiment is formed with the same mass as the destruction part 9. In the present embodiment, the balancer portion 74 is bonded to the second diaphragm 72 so that a gap is formed between the blade portion 6 and the balancer portion 74 on a plane orthogonal to the axis A. Thereby, the friction which arises between the balancer part 74 and the blade part 6 when the balancer part 74 moves is suppressed. Note that this embodiment is an example, and the balancer portion 74 may not be bonded to the second diaphragm 72. For example, the blade portion 6 or the balancer portion 74 may be lubricated. The lubrication coating reduces friction when the respective members come into contact with each other, and the balancer portion 74 can move more suitably.

  The second elastic member 76 is used to elastically bias the balancer portion 74. More specifically, the second elastic member 76 applies a force in the distal direction to the balancer portion 74. In other words, when the second elastic member 76 is elastically biased, the balancer unit 74 moved by the power from the compressed gas generation unit 21 is pushed back toward the position before the movement. The second elastic member 76 of this embodiment is a spring. The second elastic member 76 may be made of metal. The shape of the second elastic member 76 is a cylindrical shape (that is, a cylindrical coil spring), and the blade portion 6 penetrates the inside of the cylindrical shape. Note that different members are used for the first elastic member 15 and the second elastic member 76 of the present embodiment. The constant (spring constant) of the second elastic member 76 is set so that the destruction portion 9 and the balancer portion 74 are in contact with the housing 3 at the same time.

  In the second compartment 78, a second restricting portion 62 that restricts the movement of the balancer portion 74 is formed. In the present embodiment, the second restricting portion 62 is formed by sinking the inner wall forming the second compartment 78 in a direction away from the axis A. A second ventilation hole 77 extending from the inside of the second compartment 78 to the outside of the housing 3 is formed in the housing 3. Thereby, even if the balancer part 74 moves in the axial direction and the volume of the second compartment 78 changes, the pressure in the second compartment 78 is maintained at atmospheric pressure. In the present embodiment, in the initial position (a state in which no compressed gas is introduced into the gas chamber 13), the balancer unit 74 and the second regulating unit 62 are more than the distance between the breaking unit 9 and the first regulating unit 60. The second restricting portion 62 is formed so that the distance is shorter. Thereby, the full length (axis A direction) of the surgical instrument 2 held by the surgeon is suppressed. The first elastic member 15 and the second elastic member 76 may be the same type of member. In this case, in this embodiment, since the destruction part 9 and the balancer part 74 are the same mass, in the initial position, the distance between the destruction part 9 and the first restriction part 60, the balancer part 74 and the second restriction part 62. It is preferable to form the first restricting portion 60 and the second restricting portion 62 so that the distance between the first restricting portion and the second restricting portion is the same.

  A gas introduction tube 17 and a suction tube 18 are connected to the rear portion of the housing 3. The gas introduction tube 17 becomes a part of a path for moving gas between the surgical apparatus 1 and the gas chamber 13. In this embodiment, as an example, the gas introduced into the gas chamber 13 by the gas introduction tube 17 is air. The suction tube 18 connects a fluid path formed in the cylindrical blade 6 to the surgical apparatus 1.

<Operation of the destruction part and balancer part>
Operation | movement of the destruction part 9 and the balancer part 74 of the surgical instrument 2 of this embodiment is demonstrated using FIGS. As shown in FIG. 2, when the cutting power is not applied to the breaking portion 9, the opening 7 at the tip of the blade portion 6 is at the movable start position on the rear end side with respect to the suction port 5. In this state, since the suction path 8 is completely open, when a suction pressure (negative pressure) is applied to the fluid in the suction path 8, the substance is drawn into the suction path 8 from the suction port 5.

  In the state of FIG. 2, the first elastic member 15 elastically biases the breaking portion 9. In other words, the first elastic member 15 biases the breaking portion 9 toward the rear end. Further, the second elastic member 76 elastically biases the balancer portion 74. In other words, the second elastic member 76 biases the balancer portion 74 in the distal direction. Therefore, as shown in FIG. 5, the piston 10 of the breaking portion 9 is pressed against the first contact portion 64 projecting into the internal space 11 by the first elastic member 15. Further, the balancer portion 74 is pressed against the second contact portion 66 projecting into the internal space 11 by the second elastic member 76.

  That is, the piston 10 is sandwiched between the first elastic member 15 and the first contact portion 64, and the breaking portion 9 is held at the initial position. Further, the balancer portion 74 is sandwiched between the second elastic member 76 and the second contact portion 66 and is held at the initial position. The initial position is a position before the destruction part 9 (or the balancer part 74) moves. In other words, the initial position is a standby position where the destruction unit 9 (or the balancer unit 74) waits in a state where the compressed gas is not introduced into the gas chamber 13.

  As shown in FIGS. 2 and 3, when cutting power is applied to the breaking portion 9, the breaking portion 9 (blade portion 6) moves within the movable range toward the movable end position. As a result, the opening 7 of the blade portion 6 comes into contact with the substance drawn from the suction port 5 and the substance is cut. That is, the opening part 7 of the blade part 6 functions as a blade for cutting the substance. In addition, as the destruction part 9 (blade part 6) approaches the movable end position, the suction port 5 is gradually closed by the blade part 6.

  The state of FIG. 2 will be described with reference to FIG. When compressed gas is introduced into the gas chamber 13, the first diaphragm 12 and the second diaphragm 72 are deformed. As shown in FIG. 6, the 1st diaphragm 12 and the 2nd diaphragm 72 deform | transform in the direction which mutually distances. Thereby, the deformed first diaphragm 12 pushes the piston 10 and moves the breaking portion 9 in the distal direction. In addition, the deformed second diaphragm 72 pushes the balancer unit 74 and moves the balancer unit 74 in the rear end direction. In addition, the surgical instrument 2 of this embodiment will start the movement of the destruction part 9 and the balancer part 74 simultaneously, when compressed gas is introduce | transduced into the gas chamber 13. FIG.

  Returning to FIG. As shown in FIG. 4, when sufficient cutting power is applied to the breaking portion 9, the substance is completely cut and the suction port 5 is closed by the blade portion 6. In the present embodiment, in a state where the breaking portion 9 is positioned at the movable end position, the opening portion 7 of the blade portion 6 is located slightly on the rear end side (the rear end side in the axial direction) from the wall portion of the outer cylindrical blade 4. To do. That is, at the movable end of the breaking portion 9, the opening portion 7 of the blade portion 6 and the wall portion of the outer cylindrical blade 4 are separated from each other. As a result, an event in which the tip of the opening 7 in contact with the wall portion of the outer cylinder blade 4 is damaged (blade spilling) is suppressed. In the present embodiment, when the breaking portion 9 reaches the movable end position, the suction port 5 of the outer cylindrical blade 4 is completely closed by the blade portion 6.

  The state of FIG. 4 will be described with reference to FIG. In FIG. 7, the piston 10 is in contact with the first restricting portion 60. That is, when the piston 10 comes into contact with the first restricting portion 60, the movement of the breaking portion 9 is stopped. In the present embodiment, the balancer portion 74 contacts the second restricting portion 62 at the timing when the piston 10 contacts the first restricting portion 60. Since the piston 10 and the balancer portion 74 are in contact with the housing 3 at the same time, the vibration of the housing 3 when the breaking portion 9 moves is attenuated. More specifically, the kinetic energy Ka immediately before the breaking portion 9 contacts the first restricting portion 60 and the kinetic energy Kb immediately before the balancer portion 74 contacts the second restricting portion 62 are the same and in the opposite direction. The member which comprises the surgical instrument 2 is formed so that it may become. It is preferable to set the elastic coefficient of the second elastic member 76 and the movable amount of the balancer part 74 so that the kinetic energy Ka and the kinetic energy Kb are the same. For example, it is preferable that the mass of the balancer portion 74 is the same as the mass of the breaking portion 9. For example, it is preferable to use the same member for the first diaphragm 12 and the second diaphragm 72.

  Note that the kinetic energy Ka and the kinetic energy Kb do not have to be exactly the same. For example, the kinetic energy Kb may be 50% of the kinetic energy Ka. Even in this case, the vibration is attenuated as compared with the case where the balancer portion 74 is not provided. Further, the direction of the kinetic energy Ka and the direction of the kinetic energy Kb do not have to be strictly opposite directions. For example, the balancer unit 74 may move in an axial direction different from the axis A. It is sufficient if the force (impact) applied to the housing 3 when the breaking portion 9 contacts the first restriction portion 60 can be reduced by the force applied to the housing 3 when the balancer portion 74 contacts the second restriction portion 62.

  As described above, the surgical instrument 2 of the present embodiment destroys the substance by moving the destruction unit 9. More specifically, the cutting edge portion 6 of the breaking portion 9 is moved in one direction (in the present embodiment, the distal end side in the axial direction) when cutting power is applied, and cuts the substance through the opening 7 at the distal end. Further, when the application of cutting power to the breaking portion 9 is stopped, the breaking portion 9 is moved in the opposite direction (the rear end side in the axial direction in this embodiment). In the present embodiment, the first elastic member 15 elastically biases the breaking portion 9 and moves the breaking portion 9 in the opposite direction (rear end direction). Further, the second elastic member 76 elastically biases the balancer portion 74 and moves the balancer portion 74 in the opposite direction (front end direction).

  The surgical apparatus 1 of the present embodiment makes one round trip of the destruction part 9 as one cycle, and repeats this cycle to cut the substance intermittently. In the present embodiment, the closed state of the suction path 8 changes as the destruction part 9 moves. In addition, before the destruction part 9 returns to an initial position, you may advance next advance. In other words, the compressed gas may be supplied to the gas chamber 13 and the piston 10 may be advanced in the distal direction before the piston 10 returns to the initial position (on the way to return) by the urging of the first elastic member 15. The balancer portion 74 described above attenuates the vibration of the surgical instrument 2 even while the material is being intermittently cut. FIG. 9 shows an example of the usage state of the surgical instrument 2. The balancer 74 makes it difficult for vibration to be transmitted to the operator's finger holding the surgical instrument 2, and makes it easier for the operator to operate the surgical instrument 2.

<Schematic configuration of surgical device>
Next, the surgical apparatus 1 will be described. As shown in FIG. 1, the surgical apparatus 1 of the present embodiment includes a compressed gas generation unit 21, a regulator 22, a gas pressure sensor 23, an electromagnetic valve 25, a muffler 30, a suction pump 32, a waste liquid bag 33, and the like.

  The compressed gas generation unit 21 (compressor) is used as a power source for moving the destruction unit 9 of the surgical instrument 2. That is, in this embodiment, the surgical instrument 2 is driven by introducing the compressed gas generated by the compressed gas generation unit 21 into the gas chamber 13 of the surgical instrument 2. In the present embodiment, the compressed gas generator 21 is incorporated in the surgical apparatus 1. However, the compressed gas generation unit 21 may be provided outside the surgical apparatus 1. Moreover, although the surgery apparatus 1 of this embodiment compresses and uses air, it is also possible to use gases other than air.

  The regulator 22 is provided in a gas path extending from the compressed gas generation unit 21 to the electromagnetic valve 25. The regulator 22 makes the pressure of the compressed gas sent from the compressed gas generator 21 toward the electromagnetic valve 25 equal to or lower than the set pressure. In the present embodiment, an electric drive regulator that is electrically driven by a signal from a control unit including the CPU 50 (see FIG. 8) is used. However, a regulator in which the user manually adjusts the set pressure may be employed.

  The gas pressure sensor 23 is provided in a gas path extending from the regulator 22 to the electromagnetic valve 25. The gas pressure sensor 23 detects the pressure of the compressed gas supplied from the regulator 22 to the electromagnetic valve 25. The gas pressure sensor 23 may be provided in a gas path extending from the electromagnetic valve 25 to the gas introduction tube 17.

  The electromagnetic valve 25 switches between introduction of compressed gas into the gas chamber 13 of the surgical instrument 2 and stop of introduction. In the present embodiment, an inlet P, an exhaust port R, an output port A, and an output port B are provided in the housing of the electromagnetic valve 25. When the electromagnetic coil 26 of the electromagnetic valve 25 is energized, the movable iron core is drawn toward the fixed iron core and the valve moves. As a result, the inlet P and the output port B are connected (the valve is opened). When the energization of the electromagnetic coil 26 is interrupted, the valve is moved by the urging force of the spring 27. As a result, the exhaust port R and the output port B are connected, and the injection port P and the output port A are connected. Since the output port A is provided with the lid 28, the inlet P is closed (the valve is closed) while the energization to the electromagnetic coil 26 is interrupted. The CPU 50 (see FIG. 8) controls ON / OFF of energization to the electromagnetic coil 26, whereby the electromagnetic valve 25 is opened and closed, and the introduction of the compressed gas into the gas chamber 13 and the stop of the introduction are switched.

  The ON / OFF cycle (one cycle time) of the solenoid valve 25 is set based on the cut rate (cutting speed). The cut rate is the number of cycles executed per unit time, and is expressed in units of “number of times / minute” in the present embodiment. The ON time in one cycle is set as a duty ratio (that is, the ratio of the ON time during which cutting power is applied to the time of one cycle). The CPU 50 of the present embodiment cuts the vitreous tissue finely by repeatedly reciprocatingly moving the destruction part 9 of the surgical instrument 2 based on the set value.

  The muffler 30 is connected to a gas path extending from the exhaust port R of the electromagnetic valve 25. The compressed gas discharged from the surgical instrument 2 through the electromagnetic valve 25 is discharged to the outside through the muffler 30. As a result, noise generated by exhaust is reduced.

  The suction pump 32 sucks fluid from the suction port 5 of the surgical instrument 2 by applying suction pressure to the fluid in the suction path 8. Various configurations can be used for the suction pump 32. For example, a peristaltic pump (peristaltic pump) that generates suction pressure by rotating while pressing a flexible flow path can be employed. Further, a venturi pump that generates a low pressure by sending pressurized gas to the venturi pipe may be adopted. In addition, the surgical apparatus 1 may include a plurality of types of suction pumps 32. The fluid sucked by the suction pressure from the suction pump 32 is discharged to the waste liquid bag 33 connected to the suction path 8.

<Electrical configuration of surgical device>
Next, with reference to FIG. 8, the electrical configuration of the surgical apparatus 1 of the present embodiment will be described. The surgical apparatus 1 includes a CPU 50 that controls the surgical apparatus 1. The CPU 50 performs various controls including drive control of the surgical instrument 2. That is, the CPU 50 is a part of the control unit of the surgical apparatus 1. The CPU 50 includes a RAM 51, a ROM 52, a nonvolatile memory 53, a display unit 55, an operation unit 56, a foot switch 57, an external communication I / F 58, a compressed gas generation unit 21, a regulator 22, a gas pressure sensor 23, an electromagnetic valve 25, and A suction pump 32 is connected via a bus.

  The RAM 51 temporarily stores various information. The ROM 52 stores programs executed by the CPU 50, various initial values, and the like. The nonvolatile memory 53 is a non-transitory storage medium that can retain stored contents even when power supply is interrupted.

  The display unit 55 displays various information. The operation unit 56 receives input of various operation instructions from the user by being operated by the user. As the operation unit 56, various configurations such as an operation panel including various buttons, a touch panel provided on the surface of the display unit 55, and a mouse can be employed. The foot switch 57 is operated by the user's foot so that the user (operator) inputs an operation instruction of the surgical instrument 2. The external communication I / F 58 can perform communication (wired communication or wireless communication) between the surgical apparatus 1 and the external apparatus 100.

<Examples of changes in surgical instruments>
Next, a modification example of the surgical instrument 2 will be described with reference to FIG. FIG. 10 is a schematic explanatory diagram of a surgical instrument 102 shown as a modification example. In addition, description of the location of the same code | symbol as the surgical instrument 2 shown in FIG. 1 is abbreviate | omitted. The surgical instrument 102 does not have the first elastic member 15 and the second elastic member 76 that the surgical instrument 2 described above has. The surgical instrument 102 includes a second gas chamber 82, a third gas chamber 88, a third power transmission unit, and a fourth power transmission unit. Compressed gas generated by the compressed gas generator 21 is introduced into the second gas chamber 82 and the third gas chamber 88 via a gas introduction tube 86 connected to the surgical instrument 102. The gas introduction tube 86 is a route different from the gas introduction tube 17 and transmits the power generated by the compressed gas generation unit 21 to the surgical instrument 2.

  The second gas chamber 82 of the present embodiment is a chamber into which the compressed gas generated by the compressed gas generation unit 21 is introduced, and is disposed closer to the distal direction side than the first power transmission unit (first diaphragm 12). . The third gas chamber 88 of the present embodiment is a chamber into which the compressed gas generated by the compressed gas generation unit 21 is introduced, and is arranged on the rear end direction side of the second power transmission unit (second diaphragm 72). Yes.

  The third power transmission unit is a transmission mechanism that forms a part of the inner wall of the second gas chamber 82 and moves together with the destruction unit 9 in the rear end direction when the compressed gas is introduced into the second gas chamber 82. . In the present embodiment, the first diaphragm 12 is used as the third power transmission unit. In other words, the first diaphragm 12 is shared by the first power transmission unit and the third power transmission unit. The fourth power transmission unit is a transmission mechanism that forms part of the inner wall of the third gas chamber 88 and moves together with the balancer unit 74 in the distal direction when the compressed gas is introduced into the third gas chamber 88. In the present embodiment, the second diaphragm 72 is used as the fourth power transmission unit. In other words, the second diaphragm 72 is shared by the second power transmission unit and the fourth power transmission unit.

  The surgical instrument 102 of the modified example is the same as the surgical instrument 2 until the compressed gas is introduced into the gas chamber 13 and the piston 10 and the balancer part 74 are moved. On the other hand, the introduction of the compressed gas into the gas chamber 13 is stopped, and then the direction of the position before the piston 10 and the balancer part 74 are moved by the compressed gas introduced into the surgical instrument 2 through the gas introduction tube 86. The point returned to is different from the surgical instrument 2 described above. Specifically, the compressed gas is introduced into the first compartment 14 (second gas chamber 82) and the second compartment 78 (third gas chamber 88), and the piston 10 and the balancer portion 74 are in positions before the movement (initial position). Returned to the direction.

  In addition, control of the compressed gas introduced into the gas chamber 13, the 1st compartment 14, and the 2nd compartment 78 is not restricted to this. For example, the compressed gas may be introduced into the first compartment 14 and the second compartment 78 while the compressed gas is introduced into the gas chamber 13. Accordingly, it is considered that more complicated movement control of the piston 10 or the balancer part 74 can be performed in contrast to the case where the elastic members (the first elastic member 15 and the second elastic member 76) are used for the movement of the piston 10 or the balancer part 74. It is done. In addition, when using the elastic members (the first elastic member 15 and the second elastic member 76) for moving the piston 10 or the balancer portion 74, precise assembly when assembling the surgical instrument 2 and variations in springs are performed. In addition, variations in assembly are suppressed. Thereby, the surgical instrument 2 can be manufactured easily.

<Action and effect>
The surgical instrument 2 of the present embodiment includes a destruction unit 9 that destroys a living tissue by moving along a straight line (axis A), a balancer unit 74 that is arranged on the straight line and moves along the straight line, and a power source A moving mechanism (for example, the first diaphragm 12 and the second diaphragm 72) that moves the destruction unit 9 and the balancer unit 74 in the opposite directions on the same straight line by the power supplied from the (for example, the compressed gas generation unit 21). I have. Thereby, the vibration of the surgical instrument 2 generated when the biological tissue is destroyed by the destruction unit 9 can be suitably damped. For example, it is easy for the surgeon to perform a delicate operation while holding the surgical instrument 2. Moreover, even if the destruction part 9 is driven at a high speed, the vibration is suitably damped and the operation of the surgical instrument 2 becomes easy.

  In addition, the surgical instrument 2 of the present embodiment includes a gas chamber 13 into which compressed gas generated by the compressed gas generation unit 21 that is a power source is introduced, and a moving mechanism (for example, the first diaphragm 12 and the second diaphragm). 72) forms part of the inner wall of the gas chamber 13 and moves together with the breaking portion 9 in the first direction (for example, the front end direction) along the straight line (axis A) by introducing the compressed gas into the gas chamber 13. The first power transmission unit (for example, the first diaphragm 12) and the inner wall of the gas chamber 13 form a portion different from the first power transmission unit, and the compressed gas is introduced into the gas chamber 13 in the first direction. Is provided with a second power transmission unit (for example, the second diaphragm 72) that moves together with the balancer unit 74 in the second direction (for example, the rear end direction) opposite to the above. Thereby, for example, the enlargement of the surgical instrument 2 can be suppressed, and handling of the surgical instrument 2 during the operation becomes easy. Further, the configuration of the surgical instrument 2 is simplified, and the surgical instrument 2 can be provided at a low cost.

  In addition, the surgical instrument 2 of the present embodiment changes at least one of the first power transmission unit (for example, the first diaphragm 12) and the second power transmission unit (for example, the second diaphragm 72) to a change in pressure in the gas chamber 13. The diaphragm is deformed accordingly. Accordingly, the surgical instrument 2 can be provided with a simpler configuration. For example, when the surgical instrument 2 is a disposable type (disposable type), it is possible to provide an inexpensive surgical instrument 2 in which vibration is suitably damped. Moreover, since the enlargement of the surgical instrument 2 can be suppressed, the surgical instrument 2 with favorable operability can be provided.

  In addition, the surgical instrument 2 of the present embodiment has a first power transmission unit (for example, the first diaphragm 12) and a second power transmission unit (for example, the second diaphragm 72) arranged in a straight line through the space in the gas chamber 13. They are placed facing each other. Thereby, for example, the destruction part 9 and the balancer part 74 can be driven together in one gas chamber (gas chamber 13). Further, the balancer unit 74 can efficiently attenuate the vibration. The enlargement of the surgical instrument 2 can be suppressed, and the surgical instrument 2 can have a simple configuration.

  Further, the surgical instrument 2 of the present embodiment has a surface area of a portion facing the gas chamber 13 in the first power transmission unit (for example, the first diaphragm 12) and a second power transmission unit (for example, the second diaphragm 72). Of these, the surface area of the portion facing the gas chamber 13 is the same. Thereby, for example, the first power transmission unit and the second power transmission unit receive the same kinetic energy from the compressed gas introduced into the gas chamber 13. Therefore, vibration can be damped more efficiently. Further, for example, the first power transmission unit and the second power transmission unit can be formed by one type of diaphragm. Thereby, the increase in the kind of member which comprises the surgical instrument 2 can be suppressed, and the surgical instrument 2 with which the vibration was attenuate | damped suitably can be manufactured cheaply.

  In addition, the surgical instrument 102 of the modification example of the present embodiment is disposed closer to the first direction (for example, the distal direction) than the first power transmission unit (for example, the first diaphragm 12), and is compressed by the compressed gas generation unit 21. The second gas chamber 82 into which the gas is introduced and a part of the inner wall of the second gas chamber 82, and the compressed gas is introduced into the second gas chamber 82 in the second direction (for example, the rear end direction). 3 includes a third power transmission unit (for example, the first diaphragm 12) that moves together with the destruction unit 9. Thereby, for example, the internal space 11 of the housing 3 can be configured simply, and the surgical instrument 2 can be manufactured at low cost. In addition, when the destruction portion 9 is moved in the second direction using the elastic member, individual differences (individual differences in the elastic member or individual differences in the elastic member) of the surgical instrument 2 are less likely to occur, and the destruction. It is considered that complicated movement control of the unit 9 becomes possible.

  In addition, the surgical instrument 102 of the modification example of the present embodiment is disposed on the second direction (rear end direction) side of the second power transmission unit (for example, the second diaphragm 72), and the compressed gas generation unit 21 is generated. The third gas chamber 88 into which the compressed gas to be introduced is formed and a part of the inner wall of the third gas chamber 88, and the compressed gas is introduced into the third gas chamber 88 in the first direction (tip direction). 4 includes a fourth power transmission unit (for example, the second diaphragm 72) that moves together with the balancer unit 74. Accordingly, for example, the surgical instrument 2 in which vibration is suitably damped while suppressing the number of parts of the surgical instrument 2 can be provided.

  In addition, the moving mechanism of the surgical instrument 2 according to the present embodiment includes an elastic member (second elastic member 76), and the elastic member is elastically biased, whereby the power from the power source (for example, the compressed gas generation unit 21). The balancer part 74 moved by is pushed back in the direction of the position before the movement. Thereby, for example, even if the inside of the surgical instrument 2 has a simple flow path structure, the balancer part 74 moved by the power from the power source can be preferably pushed back in the direction of the position before the movement.

  Moreover, the destruction part 9 of the surgical instrument 2 of this embodiment advances to the front end side along the straight line (axis A) by the power from a power source (for example, compressed gas generation part 21), and the balancer part 74 is a destruction part. It is arranged on the rear end side with respect to 9. Thereby, for example, the vibration of the surgical instrument 2 can be suitably damped without increasing the volume or weight on the distal end side of the housing 3. The surgical instrument 2 that is easy for an operator to grip can be provided.

  Moreover, the surgical instrument 2 of this embodiment contacts the balancer part 74 moved by the 1st control part 60 which controlled the movement amount of the destruction part 9 by contacting the destruction part 9 moved by power, and power. The second regulating unit 62 that regulates the amount of movement of the balancer unit 74 is provided, and the timing at which the destruction unit 9 contacts the first regulating unit 60 and the timing at which the balancer unit 74 contacts the second regulating unit 62. Are configured at the same time. Thereby, although it is a simple structure, the vibration of the surgical instrument 2 can be damped more suitably. The surgical instrument 2 does not have the first diaphragm 12 (or the second diaphragm 72), and the breaker 9 (or the balancer 74) moves directly by receiving the pressure of the compressed gas.

  In addition, the surgical instrument 2 of the present embodiment has a balancer part 74 formed with the same mass as the destruction part 9. Thereby, although it is a simple structure, the vibration of the surgical instrument 2 can be damped more suitably.

  In the present embodiment, compressed gas is used to drive the destruction unit 9 or the balancer unit 74, but the present invention is not limited to this. For example, an actuator (for example, a motor, a solenoid, etc.) may be mounted on the surgical instrument 2, and the destruction unit 9 or the balancer unit 74 may be moved by inputting an electrical signal. That is, the destruction part 9 and the balancer part 74 may be moved in the opposite directions on a straight line using an electric signal (power signal or control signal) input to the surgical instrument 2 as power. Further, the destruction unit 9 or the balancer unit 74 may be moved by introducing a liquid.

  It should be thought that embodiment disclosed this time is an illustration and restrictive at no points. The scope of the present invention is defined by the terms of the claims, rather than the description above, and is intended to include any modifications within the scope and meaning equivalent to the terms of the claims.

1: Surgical device 2: Surgical instrument 9: Destruction unit 74: Balancer unit 21: Compressed gas generation unit 12: First diaphragm 72: Second diaphragm

Claims (10)

A destructive part that destroys biological tissue by moving along a straight line;
A balancer unit disposed on the straight line and moving along the straight line;
A moving mechanism that moves the destruction part and the balancer part in the opposite direction on the same straight line by power supplied from a power source;
A surgical instrument comprising: The surgical instrument according to claim 1,
Further comprising a gas chamber into which a compressed gas generated by the compressed gas generation unit as the power source is introduced;
The moving mechanism is
A first power transmission unit that forms part of the inner wall of the gas chamber and moves together with the destruction unit in a first direction along the straight line by introducing the compressed gas into the gas chamber;
The inner wall of the gas chamber forms a part different from the first power transmission unit and moves with the balancer unit in a second direction opposite to the first direction by introducing the compressed gas into the gas chamber. A second power transmission unit,
A surgical instrument comprising: The surgical instrument according to claim 2, wherein
At least one of the first power transmission unit and the second power transmission unit is a diaphragm that deforms according to a change in pressure in the gas chamber. The surgical instrument according to claim 2 or 3,
The surgical instrument, wherein the first power transmission unit and the second power transmission unit are arranged to face each other on the straight line through the space in the gas chamber. The surgical instrument according to any one of claims 2 to 4, wherein
The surgical instrument, wherein a surface area of a portion of the first power transmission unit facing the gas chamber is the same as a surface area of a portion of the second power transmission unit facing the gas chamber. The surgical instrument according to any one of claims 2 to 5,
A second gas chamber disposed closer to the first direction than the first power transmission unit and into which the compressed gas generated by the compressed gas generation unit is introduced;
A third power transmission part that forms part of the inner wall of the second gas chamber and moves together with the destruction part in the second direction by introducing the compressed gas into the second gas chamber;
A surgical instrument further comprising: The surgical instrument according to any one of claims 1 to 5,
The moving mechanism includes an elastic member,
The surgical instrument, wherein the balancer portion moved by the power from the power source is pushed back toward the position before the movement by elastically urging the elastic member. The surgical instrument according to any one of claims 1 to 7,
The destructive portion is advanced to the tip side along the straight line by power from the power source,
The surgical instrument according to claim 1, wherein the balancer portion is arranged on a rear end side with respect to the destruction portion. The surgical instrument according to any one of claims 1 to 8,
A first restricting portion for restricting the amount of movement of the destruction portion by contacting the destruction portion moved by the power;
A second regulating unit that regulates a movement amount of the balancer unit by contacting the balancer unit moved by the power;
The surgical instrument characterized in that the timing at which the destruction part contacts the first regulation part and the timing at which the balancer part contacts the second regulation part are simultaneous. The surgical instrument according to any one of claims 1 to 9,
The surgical instrument, wherein the balancer part is formed with the same mass as the destruction part.