JP2019084168A - Ultrasound surgical tip - Google Patents

Ultrasound surgical tip Download PDF

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JP2019084168A
JP2019084168A JP2017215992A JP2017215992A JP2019084168A JP 2019084168 A JP2019084168 A JP 2019084168A JP 2017215992 A JP2017215992 A JP 2017215992A JP 2017215992 A JP2017215992 A JP 2017215992A JP 2019084168 A JP2019084168 A JP 2019084168A
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tip
crushing
present
axis
rotation axis
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JP7205052B2 (en
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鈴木　信雄
Nobuo Suzuki
信雄 鈴木
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Nidek Co Ltd
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Nidek Co Ltd
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Abstract

To provide an ultrasound surgical tip in which heat generation due to torsional vibration is suppressed.SOLUTION: An ultrasound surgical tip for smashing eye tissue includes: a shank formed in a cylindrical shape with the rotational axis as the central axis; a cylindrical smashing part which is folded in a direction of a tilted axis crossing the rotational axis with respect to the shank and connected to the distal end of the shank; and a smashing end formed at the tip of the smashing part. At least a part of the smashing end is formed halfway in the folding or immediately after the folding. Further, the smashing end is formed on a tilted plane that is tilted toward the distal end of the rotational axis with respect to a plane orthogonal to the tilted axis.SELECTED DRAWING: Figure 2

Description

本開示は、白内障等によって白濁した水晶体核を破砕乳化する際に使用される超音波手術用チップに関する。   The present disclosure relates to a tip for ultrasonic surgery used when crushing and emulsifying a lens nucleus that has become cloudy due to a cataract or the like.

特許文献１には、ハンドピースに取り付けられることにより、長手方向及び／または横方向（ねじれ方向）に振動可能な切断チップが開示されている。   Patent Document 1 discloses a cutting tip that can be vibrated in a longitudinal direction and / or a lateral direction (torsion direction) by being attached to a hand piece.

特許第５６２４１３４号公報Patent No. 5624134 gazette

特許文献１の切断チップにて例示されるようなねじれ振動を行うチップにおいて、チップの一部又は全体がねじれ振動によって発熱することがあった。チップは治療対象組織のみならず、チップ外周にあるスリーブを介して、他の眼組織（角膜，虹彩等）にも接触する可能性がある。この発熱が大きくなるほど、チップに接触する他の眼組織への負担になる恐れがあった。   In a chip that performs torsional vibration as exemplified by the cutting chip of Patent Document 1, part or the whole of the chip may generate heat due to the torsional vibration. The tip may contact not only tissue to be treated but also other eye tissues (cornea, iris, etc.) via a sleeve at the tip periphery. As this heat increases, there is a risk that it may be a burden on other eye tissues that come in contact with the tip.

そこで、本開示は上記した問題点を解決するためになされたものであり、ねじれ振動時のチップの発熱を抑制した超音波手術用チップを提供することを目的とする。   Accordingly, the present disclosure has been made to solve the above-described problems, and it is an object of the present disclosure to provide a tip for ultrasonic surgery in which heat generation of the tip at the time of torsional vibration is suppressed.

上記課題を解決するために、本発明は以下のような構成を備えることを特徴とする。
（１）眼組織を破砕する超音波手術用チップであって、回転軸を中心軸として筒状に形成される軸部と、前記軸部に対して前記回転軸と交差する傾斜軸の方向に折り曲げられ、前記軸部の先端に接続される筒状の破砕部と、前記破砕部の先端に形成される破砕端と、を備え、前記破砕端の少なくとも一部は、前記折り曲げ途中又は前記折り曲げ直後に形成されている。 In order to solve the above-mentioned subject, the present invention is characterized by having the following composition.
(1) A tip for ultrasonic surgery for fracturing eye tissue, which is formed in a cylindrical shaft portion with a rotation axis as a central axis, and in the direction of an inclined axis intersecting the rotation axis with respect to the shaft portion A cylindrical crushing part which is bent and connected to the tip of the shaft part, and a crushing end formed at the tip of the crushing part, at least a part of the crushing end is in the middle of the bending or the bending It is formed immediately after.

本開示の超音波手術用チップによれば、ねじれ振動時の眼組織のチップの発熱を抑制できる。   According to the ultrasonic surgical tip of the present disclosure, it is possible to suppress heat generation of the tip of the eye tissue during torsional vibration.

本実施形態のＵＳハンドピースの左側面図（一部断面図）である。It is a left view (partly sectional view) of the US handpiece of this embodiment. 本実施形態のチップの左側面図である。It is a left side view of the chip of this embodiment. 本実施形態のチップの平面図である。It is a top view of the chip of this embodiment. 本実施形態のチップの正面図である。It is a front view of the chip of this embodiment. 本実施形態のチップの先端付近の断面図である。It is sectional drawing of tip vicinity of the chip | tip of this embodiment. ねじれ振動時に受ける水圧の説明図である。It is explanatory drawing of the water pressure received at the time of a torsional vibration. 変容例のチップの図であり、先端付近の左側面図である。It is a figure of the tip of a modification, and is a left side view near the tip.

本開示の典型的な実施形態を図面に基づいて説明する。本実施形態のＵＳハンドピース１は、白内障によって白濁した水晶体核を超音波振動により破砕乳化し、破砕乳化した水晶体核を吸引して除去する手術器具である。図１に示すように、本実施形態のＵＳハンドピース１は、ＵＳハンドピース本体１１とスリーブ１２を有する。   Exemplary embodiments of the present disclosure will be described based on the drawings. The US handpiece 1 of the present embodiment is a surgical instrument for crushing and emulsifying the lens nucleus that has become turbid due to a cataract by ultrasonic vibration, and sucking and removing the lens nucleus that has been crushed and emulsified. As shown in FIG. 1, the US handpiece 1 of the present embodiment has a US handpiece body 11 and a sleeve 12.

本実施形態のＵＳハンドピース本体１１は、ホーン２１、チップ２２（超音波手術用チップ）、及び吸引通路２３を備えている。ホーン２１は、振動子（不図示）で発生した超音波振動を増幅する。   The US handpiece body 11 of the present embodiment includes a horn 21, a tip 22 (tip for ultrasonic surgery), and a suction passage 23. The horn 21 amplifies ultrasonic vibration generated by a vibrator (not shown).

本実施形態のチップ２２は筒状（例えば、円筒状）に形成され、ホーン２１の先端に固定されている。なお本実施形態のチップ２２は、ホーン２１に対して着脱可能である。チップ２２は、水晶体核（「眼組織」の一例）を破砕乳化するものであり、例えばチタン合金により形成されている。本実施形態のチップ２２は、吸引孔３１と吸引通路３２を備えている。本実施形態の吸引孔３１はチップ２２の先端（眼組織を吸引する側の端部）に形成されており、吸引通路３２に連通している。吸引孔３１は一例として、破砕乳化した水晶体核と、スリーブ１２に設けられる流出孔（不図示）から眼内に供給された灌流液（例えば、生理食塩水）とを吸引できる。本実施形態の吸引通路３２は、吸引通路２３（図１参照）に連通している。チップ２２については、さらに後述する。   The tip 22 of the present embodiment is formed in a cylindrical shape (for example, a cylindrical shape) and is fixed to the tip of the horn 21. The chip 22 of the present embodiment is attachable to and detachable from the horn 21. The tip 22 breaks and emulsifies the lens nucleus (an example of “eye tissue”), and is formed of, for example, a titanium alloy. The tip 22 of the present embodiment includes a suction hole 31 and a suction passage 32. The suction hole 31 of the present embodiment is formed at the tip of the tip 22 (the end on the side for sucking eye tissue) and is in communication with the suction passage 32. As an example, the suction hole 31 can suction the crushed and emulsified lens nucleus and a perfusion solution (for example, physiological saline) supplied into the eye from an outflow hole (not shown) provided in the sleeve 12. The suction passage 32 of the present embodiment is in communication with the suction passage 23 (see FIG. 1). The chip 22 will be further described later.

本実施形態の吸引通路２３は、ホーン２１及び振動子等に形成されている。本実施形態の吸引通路２３は、一方の端部がチップ２２の吸引通路３２に連通し、他方の端部が吸引装置（不図示）に連通している。本実施形態では吸引通路３２の基端と吸引通路２３の先端が接続され、吸引流路が形成される。   The suction passage 23 of the present embodiment is formed in the horn 21 and a vibrator or the like. One end of the suction passage 23 of the present embodiment is in communication with the suction passage 32 of the tip 22 and the other end is in communication with a suction device (not shown). In the present embodiment, the proximal end of the suction passage 32 and the distal end of the suction passage 23 are connected to form a suction passage.

本実施形態のスリーブ１２は、筒状（例えば、円筒状）に形成され、ＵＳハンドピース本体１１に固定されている。なお本実施形態のスリーブ１２は、ＵＳハンドピース本体１１に対して着脱可能である。本実施形態のスリーブ１２は軟性を有し、シリコン樹脂等の材質で形成されている。本実施形態のスリーブ１２は、チップ２２の先端を突出（露出）させた状態でチップ２２を被覆している。   The sleeve 12 of the present embodiment is formed in a cylindrical (for example, cylindrical) shape, and is fixed to the US handpiece main body 11. The sleeve 12 of the present embodiment is removable from the US handpiece body 11. The sleeve 12 of the present embodiment is flexible and is formed of a material such as silicon resin. The sleeve 12 of the present embodiment covers the tip 22 in a state where the tip of the tip 22 is exposed (exposed).

一例として、以上のような構成のＵＳハンドピース１は、ＵＳハンドピース１に接続された機器の駆動信号にて振動子が駆動される。振動子は駆動信号に基づく超音波振動を発生し、チップ２２を振動させる。チップ２２が眼内に差し込まれた状態では、ＵＳハンドピース１は、振動するチップ２２の先端で水晶体核に衝撃を加え、水晶体核を破砕乳化できる。本実施形態のＵＳハンドピース１は更に、破砕乳化した水晶体核と、スリーブ１２に設けられる流出孔から眼内に供給する灌流液とを、チップ２２の先端の吸引孔３１から吸引できる。つまり本実施形態のＵＳハンドピース１は、水晶体核と灌流液を体外に排出できる。水晶体核と灌流液は、吸引装置により吸引通路３２と吸引通路２３を介して吸引される。このように、本実施形態のＵＳハンドピース１は、水晶体核を超音波振動により破砕乳化できる。また本実施形態のＵＳハンドピース１は、破砕乳化した水晶体核を吸引して除去できる。   As an example, in the US handpiece 1 configured as described above, the vibrator is driven by the drive signal of the device connected to the US handpiece 1. The vibrator generates ultrasonic vibration based on the drive signal to vibrate the tip 22. In the state where the tip 22 is inserted into the eye, the US handpiece 1 can apply an impact to the crystalline nucleus at the tip of the vibrating tip 22 and break and emulsify the crystalline nucleus. Furthermore, the US handpiece 1 of the present embodiment can suction the shattered and emulsified lens nucleus and the perfusion solution supplied into the eye from the outflow hole provided in the sleeve 12 from the suction hole 31 at the tip of the tip 22. That is, the US handpiece 1 of the present embodiment can drain the lens nucleus and the perfusion fluid outside the body. The lens nucleus and the perfusate are aspirated by the aspiration apparatus through the aspiration passage 32 and the aspiration passage 23. Thus, the US handpiece 1 of this embodiment can break and emulsify the crystalline nucleus by ultrasonic vibration. Further, the US handpiece 1 of the present embodiment can remove the crushed and emulsified lens nucleus by suction.

次に、図２〜６を用いて、本実施形態のチップ２２を更に説明する。本実施形態のチップ２２は、軸部４１と破砕部４２を備える。   Next, the chip 22 of the present embodiment will be further described using FIGS. The tip 22 of the present embodiment includes a shaft 41 and a crushing part 42.

本実施形態の軸部４１は、回転軸Ｒ（仮想軸）を中心軸として円筒状に形成される中空の細管である。つまり本実施形態の軸部４１の断面形状は、回転軸Ｒに対して対称である。これにより、軸部４１は、チップ２２がねじれ振動しても水圧を受け難い。軸部４１の一端（先端側）には、破砕部４２が接続されている。詳細は後述するが、本実施形態の破砕部４２の断面形状は、回転軸Ｒに対して非対称である。これにより軸部４１は、チップ２２がねじれ振動すると水圧を受け易い。   The shaft portion 41 in the present embodiment is a hollow thin tube formed in a cylindrical shape with the rotation axis R (virtual axis) as a central axis. That is, the cross-sectional shape of the shaft portion 41 in the present embodiment is symmetrical with respect to the rotation axis R. Thus, the shaft portion 41 is unlikely to receive the water pressure even if the tip 22 is torsionally vibrated. The crushing part 42 is connected to one end (tip end side) of the shaft part 41. Although the details will be described later, the cross-sectional shape of the crushing portion 42 of the present embodiment is asymmetric with respect to the rotation axis R. As a result, when the tip 22 twists and vibrates, the shaft 41 is susceptible to water pressure.

軸部４１の他端（基端側）には、ホーン２１（図１参照）が接続されている。本実施形態の軸部４１は、図４の矢印Ａに示されるように、振動子により回転軸Ｒを中心にして所定角度の範囲内を往復するように回転（ねじれ振動）する。詳細には、本実施形態のチップの基端（軸部４１の基端）は２°回転し、チップ２２の先端（破砕部４２の先端）は１４°回転（振れ幅０．２ｍｍ）する。つまり、チップの基端と先端の間でもねじれが生じる。本実施形態の軸部４１は３０ｋＨｚで往復回転する。なお、軸部４１は、振動子により、回転軸Ｒ方向に沿って直進するように振動可能であるとしてもよい。   The horn 21 (see FIG. 1) is connected to the other end (proximal end side) of the shaft portion 41. The shaft portion 41 of the present embodiment is rotated (twist vibration) so as to reciprocate within a range of a predetermined angle around the rotation axis R by a vibrator as shown by an arrow A in FIG. 4. Specifically, the base end of the chip of this embodiment (the base end of the shaft portion 41) rotates 2 °, and the tip of the chip 22 (the tip of the crushing portion 42) rotates 14 ° (oscillation width 0.2 mm). That is, a twist also occurs between the proximal end and the distal end of the tip. The shaft portion 41 of the present embodiment is reciprocally rotated at 30 kHz. The shaft portion 41 may be vibrated by the vibrator so as to go straight along the rotation axis R direction.

本実施形態の破砕部４２は、回転軸Ｒに対して傾斜する傾斜軸Ｉ（仮想軸）を中心軸として、円筒状に形成される中空の細管である。本実施形態の破砕部４２を傾斜軸Ｉの先端側から見ると、破砕部４２の先端に形成されている破砕端４２ａの輪郭形状は円形である。なお、図２に示すように互いに直交するＸＹＺ軸を定義する場合、回転軸ＲがＸ軸方向に沿って形成されているとしたときに、傾斜軸ＩはＸＺ軸面において回転軸Ｒに対してＺ軸方向側に傾斜するように形成されている。本実施形態の破砕部４２の一端（先端側）には、水晶体核に接触するための破砕端４２ａが形成されている。一方、破砕部４２の他端（基端側）には、軸部４１が接続されている。なお、破砕部４２と軸部４１は滑らかな形状（曲面）で接続されている。本実施形態の破砕部４２は傾斜軸Ｉと平行に伸びる筒状部と、筒状部と軸部４１をつなぐ所定方向に湾曲した折り曲げ部を有する。折り曲げ部の横断面形状は円形である。   The crushing part 42 of the present embodiment is a hollow thin tube formed in a cylindrical shape with a tilt axis I (virtual axis) inclined with respect to the rotation axis R as a central axis. When the crushing part 42 of this embodiment is viewed from the tip side of the inclined axis I, the outline shape of the crushing end 42 a formed at the tip of the crushing part 42 is circular. When defining the XYZ axes orthogonal to each other as shown in FIG. 2 and assuming that the rotation axis R is formed along the X axis direction, the inclined axis I is with respect to the rotation axis R in the XZ axis plane. It is formed to be inclined toward the Z-axis direction side. At one end (tip end side) of the crushing part 42 of the present embodiment, a crushing end 42 a for contacting the crystalline lens nucleus is formed. On the other hand, the shaft portion 41 is connected to the other end (proximal end side) of the crushing portion 42. In addition, the crushing part 42 and the axial part 41 are connected by smooth shape (curved surface). The crushing part 42 of the present embodiment has a cylindrical part extending in parallel to the inclined axis I, and a bent part which is curved in a predetermined direction connecting the cylindrical part and the shaft part 41. The cross-sectional shape of the bent portion is circular.

以上のような軸部４１と破砕部４２を有するチップ２２において、軸部４１は、振動子により、図４の矢印Ａに示されるように回転軸Ｒを中心にして所定角度の範囲内で往復するように回転する。すると、これにより、破砕部４２の破砕端４２ａは、当該破砕端４２ａの径方向（図２や図４に示すＹ軸方向）について、所定角度（本実施形態では１４°（振れ幅０．２ｍｍ））の範囲内で往復するように回転（ねじれ振動）する。本実施形態のチップ２２の先端ＰＡ（図４参照）は、回転軸Ｒの周方向へと２００μｍの範囲内でねじれ振動する。先端ＰＡは、チップ２２の最先端（回転軸Ｒの先端方向）であり、また、回転軸Ｒから最も離れた破砕端４２ａの部位である。このようにして、本実施形態のチップ２２は、ねじれ振動（トーショナル・バイブレーション）を行うことができる。   In the tip 22 having the shaft portion 41 and the crushing portion 42 as described above, the shaft portion 41 reciprocates within a range of a predetermined angle around the rotation axis R as shown by the arrow A in FIG. Rotate as you want. Then, thereby, the crushing end 42a of the crushing part 42 is 14 degrees (run width 0.2 mm in this embodiment) about the radial direction (Y-axis direction shown in FIG.2 and FIG.4) of the said crushing end 42a. Rotate (twist) to reciprocate within the range of). The tip PA (see FIG. 4) of the tip 22 of the present embodiment torsionally vibrates in the range of 200 μm in the circumferential direction of the rotation axis R. The tip PA is the tip end of the tip 22 (the tip direction of the rotation axis R), and is a portion of the fracture end 42a most distant from the rotation axis R. In this manner, the tip 22 of the present embodiment can perform torsional vibration.

図５，６を更に併用して、本実施形態のチップ２２をより詳細に説明する。本実施形態のチップ２２の全長ＬＡ（図２参照）は２５ｍｍである。本実施形態の軸部４１の外径ＴＨは０．８ｍｍである。本実施形態では、筒状の軸部４１と筒状の破砕部４２とが接続されて吸引通路３２が形成されている。本実施形態の吸引通路３２の通路径ＤＰ（図５参照）は０．６ｍｍである。本実施形態では破砕端４２ａの基端から軸部４１の基端まで、吸引通路３２の横断面面積と横断面形状が一定である。本実施形態では破砕部４２の長さＬＢ（回転軸Ｒと平行な方向）は１．１ｍｍである。破砕部４２の長さＬＢは、チップ２２の全長ＬＡの１０％以下が好ましく、本実施形態ではより好ましい５％以下としている。なお、前述したチップ２２の形状は一例である。   The chip 22 of the present embodiment will be described in more detail by further using FIG. The total length LA (see FIG. 2) of the chip 22 of the present embodiment is 25 mm. The outer diameter TH of the shaft portion 41 in the present embodiment is 0.8 mm. In the present embodiment, the cylindrical shaft portion 41 and the cylindrical crushing portion 42 are connected to form the suction passage 32. The passage diameter DP (see FIG. 5) of the suction passage 32 of the present embodiment is 0.6 mm. In the present embodiment, the cross sectional area and the cross sectional shape of the suction passage 32 are constant from the proximal end of the crushing end 42 a to the proximal end of the shaft portion 41. In the present embodiment, the length LB (direction parallel to the rotation axis R) of the crushing portion 42 is 1.1 mm. The length LB of the fractured portion 42 is preferably 10% or less of the total length LA of the chip 22, and is more preferably 5% or less in the present embodiment. The shape of the chip 22 described above is an example.

本実施形態のチップ２２を換言するなら、チップ２２の基端から先端まで筒状に形成されており、その先端部分が、回転軸Ｒに対して傾斜する傾斜軸Ｉの方向に折り曲げられている。つまり、本実施形態のチップ２２は筒状部材の先端部分を折り曲げて破砕部４２を形成している。本実施形態のチップ２２は筒状部材の先端を折り曲げて成形されており、例えば、チップ２２の製造が容易である。折り曲げ部（湾曲部）は破砕部４２の基端に配置されている。折り曲げ部は回転軸Ｒに沿って伸びる筒状部材（軸部４１）と傾斜軸Ｉに沿って伸びる筒状部材（破砕部４２の讃嘆側）を滑らかに接続する湾曲形状の筒状領域である。なお本実施形態のチップ２２は折り曲げ直後に吸引孔３１の少なくとも一部が形成されている。また破砕部４２と軸部４１とは滑らかに接続されている。なお本実施形態では折り曲げ箇所及び折り曲げ箇所の前後で、吸引通路３２の横断面面積と横断面形状が一定である。本実施形態のチップ２２は、例えば、破砕端４２ａで破砕乳化した水晶体核が、破砕部４２に詰まり難い。なぜなら、例えば、曲げが破砕部４２（破砕端４２ａ）に近く、曲げによる流れ（吸引）の影響を小さく出来るためである。   In other words, the tip 22 of the present embodiment is cylindrically formed from the base end to the tip of the tip 22, and the tip portion is bent in the direction of the inclined axis I inclined with respect to the rotation axis R . That is, in the tip 22 of the present embodiment, the crushing portion 42 is formed by bending the tip portion of the cylindrical member. The tip 22 of the present embodiment is formed by bending the tip of the cylindrical member, and for example, the tip 22 can be easily manufactured. The bent portion (curved portion) is disposed at the proximal end of the crushing portion 42. The bent portion is a curved cylindrical region that smoothly connects the cylindrical member (shaft portion 41) extending along the rotation axis R and the cylindrical member (the crush side of the crushing portion 42) extending along the inclined axis I. is there. In the tip 22 of this embodiment, at least a part of the suction hole 31 is formed immediately after bending. Moreover, the crushing part 42 and the axial part 41 are connected smoothly. In the present embodiment, the cross sectional area and the cross sectional shape of the suction passage 32 are constant before and after the bending portion and the bending portion. In the tip 22 of the present embodiment, for example, the crystalline nucleus crushed and emulsified at the crushing end 42 a is less likely to be clogged in the crushing portion 42. This is because, for example, the bending is close to the fractured portion 42 (crushed end 42a), and the influence of the flow (suction) by the bending can be reduced.

回転軸Ｒと傾斜軸Ｉとがなす角度Ｂ（図５参照）は２０〜３０°の範囲内が好ましい。本実施形態の角度Ｂは２５°である。一例として、角度Ｂを小さくするほど長さＬＢ（図２参照）が長くなり易く、ねじれ振動中に水圧を受け易い。なお長さＬＢを維持したまま角度Ｂを小さくすると、ねじれ振動時に水圧を受け難いが、ねじれ振幅自体が減少してしまい易い。一方、角度Ｂを大きくするほど長さＬＢを短くし易いが、角度Ｅが鋭角になり易い。角度Ｅが鋭角になるほど、破砕部４２を眼に挿入する際に、眼組織に負担をかける恐れが増し易い。   The angle B (see FIG. 5) formed by the rotation axis R and the inclination axis I is preferably in the range of 20 to 30 °. The angle B in this embodiment is 25 °. As one example, the smaller the angle B, the longer the length LB (see FIG. 2), and the easier it is to receive water pressure during torsional vibration. If the angle B is reduced while maintaining the length LB, it is difficult to receive water pressure during torsional vibration, but the torsional amplitude itself tends to be reduced. On the other hand, the larger the angle B, the shorter the length LB, but the angle E tends to be acute. The sharper the angle E, the more likely it is that the tissue of the eye is strained when inserting the fractured portion 42 into the eye.

本実施形態では破砕部４２の先端に、破砕端４２ａが形成されている。破砕端４２ａは傾斜軸Ｉと交差する傾斜面４４上に形成されている。本実施形態では破砕端４２ａの少なくとも一部が、チップ２２の折り曲げ直後に形成されている。詳細には、破砕端４２ａの基端部位ＰＢは、折り曲げ終端である終端部位ＰＣよりも回転軸Ｒの先端側に設けられている（図５参照）。本実施形態では回転軸Ｒと平行な方向において、終端部位ＰＣから基端部位ＰＢまでの長さＬＤは、折り曲げ開始部位である開始部位ＰＤから終端部位ＰＣまでの長さＬＣよりも短い。このように、本実施形態では折り曲げ直後に破砕端４２ａの少なくとも一部が形成されている。   In the present embodiment, a crushing end 42 a is formed at the tip of the crushing part 42. The crushing end 42 a is formed on the inclined surface 44 intersecting the inclined axis I. In the present embodiment, at least a part of the crushing end 42 a is formed immediately after the tip 22 is bent. Specifically, the proximal end portion PB of the fractured end 42a is provided on the distal end side of the rotation axis R with respect to the end portion PC which is a bending end (see FIG. 5). In the present embodiment, in the direction parallel to the rotation axis R, the length LD from the termination site PC to the base end site PB is shorter than the length LC from the start site PD, which is the bending start site, to the termination site PC. Thus, in the present embodiment, at least a part of the crushing end 42a is formed immediately after bending.

なお、基端部位ＰＢが折り曲げ途中に形成されていてもよい。図７は変容例のチップ２２であり、終端部位ＰＣ（折り曲げ終端）よりも回転軸Ｒの基端側に基端部位ＰＢ’（破砕端４２ａの少なくとも一部）が形成されている。なお図７では変容例のチップ２２の形状を実線で示し、本実施形態のチップ２２の形状を点線で示している。基端部位ＰＢ’を折り曲げ途中に形成することで、例えば、ねじれ振動中に受ける水圧をより低減し易い。また、破砕乳化した水晶体核が破砕部４２でより詰まり難くなり易い。   The proximal end portion PB may be formed in the middle of bending. FIG. 7 shows a modified example of the chip 22. A base end site PB '(at least a part of the fractured end 42a) is formed on the proximal end side of the rotation axis R with respect to the end site PC (bending end). In FIG. 7, the shape of the tip 22 of the modification example is indicated by a solid line, and the shape of the tip 22 of the present embodiment is indicated by a dotted line. By forming the proximal end portion PB 'in the middle of bending, for example, it is easier to reduce the water pressure received during torsional vibration. In addition, the crushed and emulsified lens nucleus is more likely to be less likely to be clogged in the crushing portion 42.

このように、基端部位（ＰＢ又はＰＢ’）を折り曲げ直後又は折り曲げ途中に形成することで、例えば、ねじれ振動時の水圧の影響を抑制しつつ、水晶体核を効率よく破砕乳化し易い。つまり基端部位ＰＢを折り曲げ直後又は折り曲げ途中に形成することで、ねじれ振動時の水圧の影響を抑制でき、チップ２２の意図せぬ変形を抑制できる。従って、チップ２２の発熱を抑制し易い。   As described above, by forming the proximal end portion (PB or PB ') immediately after or during bending, for example, the lens nucleus can be efficiently crushed and emulsified while suppressing the influence of water pressure at the time of torsional vibration. That is, by forming the base end portion PB immediately after or during bending, the influence of water pressure at the time of torsional vibration can be suppressed, and unintended deformation of the tip 22 can be suppressed. Therefore, the heat generation of the chip 22 can be easily suppressed.

引続き本実施形態のチップ２２の形状をより詳細に説明する。本実施形態の傾斜面４４は、傾斜軸Ｉに直交する面に対して回転軸Ｒの先端方向（図５では紙面右側）に傾斜している。換言するなら、本実施形態の傾斜面４４は、回転軸Ｒに直交する面に対して回転軸Ｒの基端方向（図５では紙面左側）に角度Ｄで傾斜している。なお本実施形態では、傾斜軸Ｉに平行な線分と傾斜面４４とがなす角度を角度Ｅとする。前述した角度Ｄを大きくするほど角度Ｅが鋭角になり易く、ねじれ振動中に水晶体核を破砕し易くなる。しかし角度Ｅが鋭角になるほど、患者眼の角膜に形成された切開創にチップ２２を挿入する際に、患者眼の角膜を傷付け易い恐れがある。角度Ｄは０〜３０°の範囲内が好ましく、本実施形態では１５°である。また、角度Ｅは４５〜５５°の範囲内が好ましく、本実施形態では５０°である。   Subsequently, the shape of the tip 22 of the present embodiment will be described in more detail. The inclined surface 44 of the present embodiment is inclined in the direction of the tip of the rotation axis R (right side in the drawing of FIG. 5) with respect to the plane orthogonal to the inclination axis I. In other words, the inclined surface 44 of the present embodiment is inclined at an angle D with respect to a plane orthogonal to the rotation axis R at the proximal direction (left side in the drawing of FIG. 5) of the rotation axis R. In the present embodiment, an angle between a line segment parallel to the inclination axis I and the inclined surface 44 is an angle E. As the above-mentioned angle D is increased, the angle E tends to be acute, and the lens nucleus is easily broken during torsional vibration. However, the more acute the angle E, the easier it is for the cornea of the patient's eye to be easily scratched when the tip 22 is inserted into the incision formed in the patient's eye. The angle D is preferably in the range of 0 to 30 °, and is 15 ° in the present embodiment. The angle E is preferably in the range of 45 to 55 °, and is 50 ° in the present embodiment.

次いで図６を用いて、破砕部４２が受ける水圧を説明する。なお図６では、本実施形態の破砕部４２を点線で示し、比較用の破砕部１４２を実線で示している。比較用の破砕部１４２は、本実施形態の破砕部４２を回転軸Ｒの先端方向に引き伸ばした形状と言える。比較用の破砕部１４２の長さＬＥは、本実施形態の破砕部４２の長さＬＢの２倍である。比較用の破砕部１４２の傾斜軸Ｊと回転軸Ｒとがなす角度は、本実施形態の傾斜軸Ｉ（図５参照）と回転軸Ｒとがなす角度よりも小さい。なお、本実施形態の先端ＰＡと比較用の破砕部１４２先端ＰＡ’とは、回転軸Ｒからの距離Ｈが同じである。   Next, the water pressure received by the crushing unit 42 will be described with reference to FIG. In addition, in FIG. 6, the crushing part 42 of this embodiment is shown by a dotted line, and the crushing part 142 for comparison is shown as a continuous line. The crushing part 142 for comparison can be said to be a shape in which the crushing part 42 of the present embodiment is stretched in the tip direction of the rotation axis R. The length LE of the crushing part 142 for comparison is twice the length LB of the crushing part 42 of the present embodiment. The angle between the tilt axis J and the rotation axis R of the fractured portion 142 for comparison is smaller than the angle between the tilt axis I (see FIG. 5) and the rotation axis R in this embodiment. In addition, the distance H from the rotation axis R is the same as the tip PA of the present embodiment and the tip of the crushing part 142 for comparison.

チップ２２がねじれ振動すると、回転軸Ｒに対して非対称な形状である破砕部（４２，１４２）は、ねじれ振動中に水圧の影響を受け易い。図６では、比較用の破砕部１４２にて、水圧の影響を受け易いチップ２２の領域ＳＢをハッチングで示している。本実施形態の破砕部４２の領域ＳＡの面積は、領域ＳＢの面積よりも小さい。なお領域ＳＡは領域ＳＢに対応する。本実施形態の破砕部４２は、比較用の破砕部１４２よりも、ねじれ振動中に水圧を受け難い。つまり本実施形態のチップ２２は、ねじれ振動中に受ける水圧が抑制されており、ねじれ振動中のチップ２２の意図せぬ変形又は振動が抑制されている。したがって本実施形態のチップ２２は、チップ２２の一部又は全体の発熱が抑制されている。   When the tip 22 torsionally vibrates, the fractured portions (42, 142) having an asymmetric shape with respect to the rotation axis R are susceptible to the influence of water pressure during the torsional vibration. In FIG. 6, the area SB of the tip 22 susceptible to the influence of water pressure is hatched in the crushing portion 142 for comparison. The area of the area SA of the crushing unit 42 of the present embodiment is smaller than the area of the area SB. The area SA corresponds to the area SB. The crushing part 42 of this embodiment is less susceptible to water pressure during torsional vibration than the comparative crushing part 142. That is, in the tip 22 of the present embodiment, the water pressure received during torsional vibration is suppressed, and unintended deformation or vibration of the tip 22 during torsional vibration is suppressed. Therefore, in the chip 22 of the present embodiment, heat generation of a part or the whole of the chip 22 is suppressed.

以上説明したように、眼組織を破砕する本開示のチップ２２は、回転軸Ｒを中心軸として筒状に形成される軸部４１と、軸部４１に対して回転軸Ｒと交差する傾斜軸Ｉの方向に折り曲げられ、軸部４１の先端に接続される筒状の破砕部４２と、破砕部４２の先端に形成される破砕端４２ａとを備える。破砕端４２ａの少なくとも一部は、折り曲げ途中又は折り曲げ直後に形成されている。これにより、例えば、ねじれ振動中に受ける水圧が低減し、ねじれ振動時のチップ２２の発熱が抑制される。   As described above, the tip 22 of the present disclosure for crushing eye tissue has a shaft portion 41 formed in a cylindrical shape with the rotation axis R as a central axis, and an inclined axis intersecting the rotation axis R with respect to the shaft portion 41. The cylindrical crushing part 42 bent in the direction of I and connected to the tip of the shaft part 41 and the crushing end 42 a formed at the tip of the crushing part 42 are provided. At least a part of the crushing end 42a is formed during or immediately after the bending. Thereby, for example, the water pressure received during the torsional vibration is reduced, and the heat generation of the tip 22 during the torsional vibration is suppressed.

また本実施形態のチップ２２にて、破砕端４２ａは、傾斜軸Ｉに直交する面に対して回転軸Ｒの先端方向に傾斜した傾斜面４４上に形成されている。これにより、破砕端４２ａが傾斜面４４上に形成されていることで、例えば、チップ２２の発熱の抑制と水晶体核の破砕乳化とを両立し易い。また本実施形態のチップ２２は、破砕部４２の先端には眼組織を吸引するための吸引孔３１が形成されており、回転軸Ｒは開口孔を貫通する。これにより、例えば、破砕乳化した水晶体核が破砕部４２内（吸引通路内）で詰まり難い。   Further, in the tip 22 of the present embodiment, the crushing end 42 a is formed on the inclined surface 44 inclined in the tip direction of the rotation axis R with respect to the plane orthogonal to the inclination axis I. Thereby, by forming the crushing end 42a on the inclined surface 44, for example, it is easy to achieve both suppression of heat generation of the tip 22 and crushing and emulsification of the crystalline nucleus. Further, in the tip 22 of the present embodiment, a suction hole 31 for suctioning ocular tissue is formed at the tip of the crushing part 42, and the rotation axis R penetrates the opening hole. Thereby, for example, the fractured and emulsified lens nucleus is not easily clogged in the fracture portion 42 (in the suction passage).

また本実施形態のチップ２２は、筒状に形成される軸部４１の横断面形状は円形であり、傾斜軸Ｉの開口側からみると、吸引孔３１の形状は円形である。これにより、例えば、破砕乳化した水晶体核が破砕部４２内（吸引通路内）でより詰まり難い。また、本実施形態のチップ２２は、折り曲げによらず、筒状にて形成される中空部の横断面面積は一定である。これにより、これにより、例えば、破砕乳化した水晶体核が破砕部４２内（吸引通路内）で詰まり難い。 Further, in the tip 22 of the present embodiment, the cross-sectional shape of the shaft portion 41 formed in a tubular shape is circular, and when viewed from the opening side of the inclined axis I, the shape of the suction hole 31 is circular. Thereby, for example, the crushed and emulsified lens nucleus is less likely to be clogged in the crushing portion 42 (in the suction passage). Further, the cross-sectional area of the hollow portion formed in a tubular shape is constant regardless of bending of the tip 22 of the present embodiment. Thereby, for example, the crushed and emulsified lens nucleus is not easily clogged in the crushing portion 42 (in the suction passage).

今回開示された実施形態はすべての点で例示であって、制限的なものではないと考えられるべきである。本発明の範囲は、上記した説明ではなく、特許請求の範囲によって示され、特許請求の範囲及びこれと均等の意味及び範囲内でのすべての変更が含まれることが意図される。   The embodiment disclosed this time should be considered as illustrative in all points and not restrictive. The scope of the present invention is shown not by the above description but by the scope of claims, and is intended to include all modifications within the scope of claims and equivalents thereof.

２２ チップ
４１ 軸部
４２ 破砕部
４２ａ 破砕端
Ｉ 傾斜軸
Ｒ 回転軸
22 Tip 41 Shaft portion 42 Crushed portion 42 a Crushed end I Inclined axis R Rotational axis

Claims (5)

眼組織を破砕する超音波手術用チップであって、
回転軸を中心軸として筒状に形成される軸部と、
前記軸部に対して前記回転軸と交差する傾斜軸の方向に折り曲げられ、前記軸部の先端に接続される筒状の破砕部と、
前記破砕部の先端に形成される破砕端と、を備え、
前記破砕端の少なくとも一部は、前記折り曲げ途中又は前記折り曲げ直後に形成されている、
ことを特徴とする超音波手術用チップ。 Ultrasonic surgery tip for breaking up eye tissue,
An axial portion formed in a cylindrical shape with the rotation axis as a central axis;
A cylindrical crushing part which is bent in the direction of an inclined axis intersecting the rotation axis with respect to the shaft part and connected to the tip of the shaft part;
And c) a crush end formed at a tip of the crusher,
At least a part of the crushing end is formed during or immediately after the bending,
A tip for ultrasonic surgery characterized by 請求項１に記載の超音波手術用チップであって、
前記破砕端は、傾斜軸に直交する面に対して前記回転軸の先端方向に傾斜した傾斜面上に形成されている、
ことを特徴とする超音波手術用チップ。 The tip for ultrasonic surgery according to claim 1, wherein
The crushing end is formed on an inclined surface which is inclined in the direction of the tip of the rotation axis with respect to a plane orthogonal to the inclination axis.
A tip for ultrasonic surgery characterized by 請求項１または２に記載の超音波手術用チップであって、
前記破砕部の先端には眼組織を吸引するための吸引孔が形成されており、
前記回転軸は前記吸引孔を貫通する、
ことを特徴とする超音波手術用チップ。 The ultrasonic surgical tip according to claim 1 or 2, wherein
At the tip of the crushing part, a suction hole for suctioning eye tissue is formed,
The rotary shaft passes through the suction hole.
A tip for ultrasonic surgery characterized by 請求項３に記載の超音波手術用チップであって、
筒状に形成される前記軸部の横断面形状は円形であり、
前記傾斜軸の開口側からみると、前記吸引孔の形状は円形である、
ことを特徴とする超音波手術用チップ。 The ultrasonic surgical tip according to claim 3, wherein
The cross-sectional shape of the shaft portion formed in a tubular shape is circular,
When viewed from the opening side of the inclined shaft, the shape of the suction hole is circular,
A tip for ultrasonic surgery characterized by 請求項３または４に記載の超音波手術用チップであって、
前記折り曲げによらず、筒状にて形成される中空部の横断面面積は一定である、
ことを特徴とする超音波手術用チップ。
The ultrasonic surgical tip according to claim 3 or 4, wherein
The cross sectional area of the hollow portion formed in a cylindrical shape is constant regardless of the bending.
A tip for ultrasonic surgery characterized by
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Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2021193546A1 (en) * 2020-03-24 2021-09-30 株式会社ニデック Crush tip

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EP0482847A1 (en) * 1990-10-26 1992-04-29 Alcon Surgical, Inc., Method and apparatus for selectively removing body tissue
JP2006223865A (en) * 2005-02-18 2006-08-31 Alcon Inc Phacoemulsification tip
WO2011151837A1 (en) * 2010-05-31 2011-12-08 Ram Srikanth Mirlay Micro incision phaco needle assembly

Patent Citations (3)

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Publication number Priority date Publication date Assignee Title
EP0482847A1 (en) * 1990-10-26 1992-04-29 Alcon Surgical, Inc., Method and apparatus for selectively removing body tissue
JP2006223865A (en) * 2005-02-18 2006-08-31 Alcon Inc Phacoemulsification tip
WO2011151837A1 (en) * 2010-05-31 2011-12-08 Ram Srikanth Mirlay Micro incision phaco needle assembly

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2021193546A1 (en) * 2020-03-24 2021-09-30 株式会社ニデック Crush tip

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