JP2702991B2 - Ultrasound therapy equipment - Google Patents

Description

Description: BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an improvement in an ultrasonic therapy apparatus for treating a patient with ultrasonic vibration.

[Prior Art] An ultrasonic therapy apparatus for performing therapy using ultrasonic vibrations has a structure as disclosed in Japanese Patent Application Nos. 60-1201 and 60-210510. .

That is, in the ultrasonic therapy apparatus, an ultrasonic vibrator (ultrasonic vibration generating unit) is connected via a horn to a base of a probe (corresponding to a vibration transmitting member) which can be inserted into a living body constituted by a pipe or the like. Structure is used. The ultrasonic vibrator is driven at a drive frequency determined on the belly of the probe end, so that a vibration required for treatment is generated at the tip of the probe.

When used, the tip of the probe is pressed against the diseased part using an endoscope, etc., and ultrasonic vibration is applied to the tissue, so that the diseased part (prostate, etc.) is excised or destroyed (calculus, etc.). Or was.

By the way, such an ultrasonic treatment may cause bleeding during the treatment. If such bleeding occurs, the bleeding site must be stopped immediately.

Conventionally, using laser, high frequency, infrared, etc.
When bleeding occurred, the bleeding site was irradiated with laser light, high frequency, infrared rays, etc. to stop the bleeding site.

[Problems to be Solved by the Invention] However, hemostasis using such lasers, high frequency waves, infrared rays, etc., has the drawback that the ultrasonic treatment device becomes large and the operation becomes troublesome. It is not very good because it involves danger to the living body.

The present invention has been made in view of such a problem, and an object of the present invention is to provide an ultrasonic therapy apparatus that can easily and safely stop bleeding while preventing the apparatus from being enlarged.

[Means for Solving the Problems] In order to solve the above problems, an ultrasonic therapy apparatus of the present invention provides an ultrasonic vibration generating section and an ultrasonic vibration from the ultrasonic vibration generating section to a target position in a living body. A vibration transmitting member for transmitting,
The oscillation unit for driving the ultrasonic vibration generator and the oscillation frequency of the oscillation unit are set such that the ultrasonic vibration at the tip of the vibration transmitting member that contacts the target position in the living body is used as the antinode of the vibration to cut the living body. A first driving frequency for performing the treatment, a frequency higher than the first driving frequency and a shorter frequency, the ultrasonic vibration at the tip of the vibration transmitting member being the antinode of the vibration, and the most distal end of the vibration transmitting member. The second drive frequency for generating hemostasis at a position closer to the distal end of the vibration transmitting member than the position of the node of the ultrasonic vibration generated on the side at a position closer to the distal end of the vibration transmission member compared to the position generated when driven at the first drive frequency; , And frequency switching means for switching the frequency in the frequency switching means.

[Operation] According to the ultrasonic therapy apparatus, during normal therapy, the oscillation frequency is switched to the first drive frequency for performing the therapy, and the ultrasound therapy is performed. Then, during treatment, if bleeding is observed, the oscillation frequency is switched to the second drive frequency. Then, the node of the vibration on the vibration transmission member at the forefront side is formed at a position close to the tip of the vibration transmission member. As a result, the portion near the tip of the vibration transmitting member generates heat at a high frequency at a high frequency, and the heat stops the bleeding portion by cauterization. That is, when excision of a prostate, crushing of a calculus, or the like is performed, a treatment such as excision of a living body is performed by using ultrasonic vibration at the tip of a vibration transmitting member in contact with a target position in the living body as an antinode of vibration.
When the probe is vibrated at the driving frequency to perform a desired treatment, while the hemostasis is performed, the frequency is changed to a frequency higher than the first driving frequency and shorter in wavelength by the switch means. The ultrasonic vibration at the tip of the member is regarded as the antinode of the vibration, and the position of the node of the ultrasonic vibration generated at the most distal side of the vibration transmitting member is compared with the position generated when driven at the first drive frequency. The probe is vibrated by switching to a second drive frequency at which the vibration is generated at a position closer to the tip of the vibration transmitting member and performs hemostasis, and the hemostasis is realized without using a laser, a high frequency, an infrared ray, or the like. By selecting such a second frequency, it is possible to simultaneously achieve hemostasis while performing ablation, and the energy ratio between the ablation and hemostasis is such that the position of the node is close to the probe tip. It is possible to change by selecting or. In addition, since the wavelength is shorter, not only the node of the vibration can be generated at a position closer to the tip of the vibration transmitting member, but also the heating value of the probe is proportional to the frequency and the amplitude. Can be increased, and cavitation generally does not easily occur at higher frequencies, so that high output without tissue damage can be obtained, and the ultrasonic component transmitted to the tissue has the same frequency. Is high, it can also generate heat in the tissue itself, and since the free end of the probe is the antinode of vibration, the driving impedance is low, so high output can be output even at high frequencies. Can exert an effective operation and effect.

[Embodiment] Hereinafter, the present invention will be described based on a first embodiment shown in FIG. 1 to FIG. FIG. 3 shows the whole of the ultrasonic therapy apparatus, 1 is a grip portion, and 2 is an ultrasonic vibrator (corresponding to an ultrasonic vibration generating portion) built in a rear side of an outer case 1a constituting the grip portion 1. Reference numeral 3 denotes a conical horn disposed on the tip side of the outer case 1a. As the ultrasonic vibrator 2, a Langevin type in which a plurality of piezoelectric elements 4 and a plurality of electrode plates 5 are alternately arranged and sandwiched between a front metal block 6 and a rear metal block 7 is used. ing. In addition, pinching not shown is by bolting.
The front metal block 6 and the horn 3 are integrally connected. The tip of the horn 3 is connected to a pipe-shaped probe 8 (vibration transmitting member) made of, for example, β titanium alloy (Ti-15Mo-5Zn-3Al). Can be transmitted to the tip of the probe 8. In addition, a passage 9 communicating with the lumen of the probe 8 is provided at the center of the gripper 1 (the center of the ultrasonic vibrator 2, the horn 3, etc.), and forms a suction path together with the lumen. A suction pump (not shown) is connected to a suction port body 10 which is an end of the passage 9 via a suction tube 11 so that suction can be performed from a distal end opening of the probe 8.

On the other hand, 12 is a power supply, and 13 is a foot switch. The foot switch 13 includes two types of operation units, for example, an on / off operation unit 13a and a frequency switching operation unit 13b. The foot switch 13 is connected to the input side of the power supply device 12 via a cable 14.
The output side of the power supply device 12 is connected to each electrode plate 5 of the ultrasonic transducer 2 via a cable 15. FIG. 4 shows a circuit configuration of the power supply device 12.

Here, the power supply device 12 will be described. Reference numeral 16 denotes an oscillating unit for driving the ultrasonic transducer 2. This oscillator 16
Are connected via an amplifier 18 to an oscillation transformer 19 connected to the ultrasonic transducer 2. Thereby, the ultrasonic transducer 2 can be vibrated.

Reference numeral 20 denotes a control unit (comprising a microcomputer and its peripheral circuits). The foot switch 13 is connected to the input side of the control unit 20. The output side of the control section 20 and the input side of the oscillation section 16 are connected via a frequency switching circuit 21. Then, by the operation of the control unit 20 and the frequency switching circuit 21, whether or not to operate the frequency switching operation unit 13b, the oscillation frequency of the oscillation unit 16, the driving frequency for performing treatment, and higher than the driving frequency It can be switched to the frequency.

Specifically, for example, the frequency switching circuit 21 includes an oscillation frequency A suitable for ultrasonic therapy with the probe tip as an antinode, and an oscillation frequency B having a higher frequency and a shorter wavelength than the oscillation frequency A shown in FIG. A circuit that can switch between these two frequencies is used. The control section 20 switches the frequency switching circuit 21 to the oscillation frequency A side when the frequency switching operation section 13b is turned off, and switches the frequency switching circuit 21 to the oscillation frequency B side when the frequency switching operation section 13b is turned on. And the frequency can be switched in accordance with the operation of the foot switch 13.

An on / off operation unit 13a is connected to the control unit 20, and the operation of the on / off operation unit 13a causes the power supply unit 1 to operate.
2 is turned on and off. A suction pump (not shown) is also connected to the control unit 20.

When treating an affected part using such an ultrasonic treatment apparatus, the probe 8 is first inserted into the affected part using, for example, an endoscope or a sheath 22. Then, the tip of the probe is pressed against the target affected part. Thereafter, the on / off operation section 13a is operated with the foot. Thus, the ultrasonic transducer 2 is driven, and oscillates at the oscillation frequency A. Then, the ultrasonic vibration having the tip at the antinode as shown in FIG. 1 is transmitted to the probe 8. However, the affected part is resected (or destroyed) by the amplitude of the ultrasonic vibration applied to the tip of the probe. The excised tissue and the like are discharged out of the body through the suction path by the suction force of the suction pump that operates in response to the operation of the ultrasonic transducer 2.

When bleeding occurs during such ultrasonic treatment, the frequency switching operation unit 13b is operated with a foot. Thereby, the oscillation frequency A is switched to the oscillation frequency B having a higher frequency (short wavelength) shown in FIG. Then
By this frequency switching, the frontmost node X located far from the tip of the probe at the time of the previous ultrasound treatment approaches the tip of the probe as the frequency increases.

Here, since the position of the node X is always constant and has almost no amplitude, the maximum stress of vibration concentrates on the portion of the probe 8 corresponding to the node X. That is, the probe portion corresponding to the node X generates heat by vibration. Of course, it gets quite hot.

Therefore, the bleeding site in contact with the probe tip is cauterized by the heat generated from the node X near the probe tip, and the bleeding stops.

Thus, since the hemotherapy is performed by also using the ultrasonic therapy apparatus itself as the hemostatic apparatus, the apparatus does not become large.
In addition, since the blood is stopped using ultrasonic vibration, there is no danger such as laser or high frequency. In addition, the operation is simple because only the oscillation frequency needs to be switched.

Note that a switching switch (not shown) may be attached to the power supply device 12 instead of the foot switch 13 to switch the oscillation frequency.

Further, the present invention is not limited to the first embodiment, but the second embodiment shown in FIGS. 5 and 6, the third embodiment shown in FIG. 7, and the fourth embodiment shown in FIG. , 9 and 10 may be used.

In the second embodiment, a sheath 22 used with the probe 8 is used.
A heat generating member 25 is provided on the inner peripheral portion of the tip of the probe 8 so as to be in contact with the outer peripheral surface of the probe 8 so that the heat generating member 25 generates heat by friction caused by the vibration of the probe 8. And
The heat obtained by this friction heats the sheath tip to stop bleeding at the bleeding site. However, the sheath 22 is formed of a heat-resistant plastic with a rear end portion left, with a distal end portion left.

In the figure, reference numeral 26 denotes a control system for controlling the flow rate of the cooling liquid flowing in the sheath 22 for efficiently raising the temperature of the sheath tip. Specifically, this is a temperature sensor at the sheath tip
27 will be provided. The temperature sensor 27 and a coolant pump 28 for sending coolant are connected to a control unit 29. Then, depending on the temperature at the sheath tip, the coolant pump
By controlling the discharge flow rate of 28, the temperature at the distal end of the sheath is efficiently raised during hemostasis. However, 27a is a lead wire of the temperature sensor 27, and the heating member 25 is provided with a coolant passage 30, so that the affected part can be washed with the coolant flowing through the coolant passage 30.

The third embodiment is a modification of the second embodiment, in which a heating member 25 is formed in a cylindrical shape with a large-diameter portion 25a at the tip, and the heating member 25 is attached to the tip of the sheath 22. It is what I wore.

When stopping bleeding, connect the tip of the probe to the heating member 25.
After retreating, the large-diameter portion 25a that generates heat due to friction with the probe 8 is brought into contact with the bleeding site. In other words, in the present embodiment, the large diameter portion 25a is used as a contact for a bleeding site to stop bleeding.

The fourth embodiment is a modification of the second embodiment, in which an inflatable / retractable probe holding member, for example, a balloon 35 is attached to the distal end of the probe 8, and a fluid flow channel is attached to the balloon 35. Connect 36 and balloon from hand side
35 is made to expand and contract.

Such a structure performs the ultrasonic treatment in a state where the balloon 35 is deflated. And if bleeding occurs, balloon 35
Is inflated as shown by a two-dot chain line, and the probe 8 is forcibly pressed against the sheath 22 by the balloon 35. As a result, the distal end of the sheath generates heat from friction caused by vibration. Then, the tip of the heated probe is brought into contact with the bleeding site to stop bleeding.

Fifth Embodiment An endoscope for guiding an ultrasonic therapy apparatus to an affected area
40 light source devices 41, an illumination system 42 for endoscopic observation,
A laser system 43 for hemostasis is provided, and a laser beam is applied to a bleeding site using the light guide 40a of the endoscope 40 at the time of hemostasis by switching the optical path.

Specifically, as shown in FIG. 10, the light source device 41 is, for example, 45 mm on the axial extension of the connected light guide 40a.
回 動 -shaped movable mirror 44, also fixed mirror 4
5 is provided sequentially. An illumination lamp 46 is provided on the optical axis of the movable mirror 44 coupled to the light guide 40a, and a laser generator 47 is also provided on the optical axis of the fixed mirror 45. Then, the position of the movable mirror 44 is switched between an optical axis side of the light guide 40a and a side away from the optical axis by control means (not shown).

Thus, during the ultrasonic treatment, the movable mirror 44 is moved to the optical axis side of the light guide 40a, and the illumination light of the illumination lamp 46 is guided to the light guide. When an operation signal from the operation unit (not shown) enters the control unit in order to stop bleeding, the movable mirror 44 rotates to a position retreated from the optical axis of the light guide as shown by a two-dot chain line. That is, the laser light from the laser generator 47 is applied to the bleeding site through the light guide 40a to stop the bleeding.

In addition, in FIG. 9, 48 is a power supply of the ultrasonic therapy apparatus,
49 is a forceps port of the endoscope 40, 50 is a suction pump, and 51 is a receiving tank.

[Effects of the Invention] As described above, according to the present invention, hemostasis is performed by using the ultrasonic therapy device itself as a hemostatic device, so that the device does not become large. Moreover, since the blood is stopped using ultrasonic vibration, there is no danger such as a laser or high frequency. In particular, it is advantageous because hemostasis can be simultaneously performed while performing resection.

In addition, the operation is simple because only the oscillation frequency needs to be switched.

[Brief description of the drawings]

1 to 4 show a first embodiment of the present invention.
FIG. 1 is a diagram showing ultrasonic vibrations during ultrasonic treatment together with an ultrasonic treatment device, FIG. 2 is a diagram showing ultrasonic vibrations during hemostasis together with an ultrasonic treatment device, and FIG. 3 is a structure of the ultrasonic treatment device. FIG. 4 is a block diagram showing a circuit for switching the oscillation frequency, FIG. 5 is a sectional view showing a main part of a second embodiment of the present invention, and FIG. FIG. 7 is a cross-sectional view taken along a line VI, FIG. 7 is a cross-sectional view showing a main part of a third embodiment of the present invention, FIG. 8 is a cross-sectional view showing a main part of a fourth embodiment of the present invention, FIG. 13 is a block diagram showing a fifth embodiment of the present invention.
FIG. 10 is a configuration diagram showing the light source device. 2 ... Ultrasonic vibrator (ultrasonic vibration generator), 8 ... Probe (vibration transmitting member), 13,20,21 ... Foot switch,
Control section, frequency switching circuit (frequency switching means), 16 oscillating section.

 ────────────────────────────────────────────────── ─── Continuing on the front page (72) Inventor Kazuya Hijii 2-43-2 Hatagaya, Shibuya-ku, Tokyo O-limpus Optical Industry Co., Ltd. (72) Inventor Shoichi Gotanda 2-43 Hatagaya, Shibuya-ku, Tokyo No. 2 Inside Olympus Optical Co., Ltd. (72) Tomonasa Sakurai, Inventor 2-43-2, Hatagaya, Shibuya-ku, Tokyo Inside Olympus Optical Co., Ltd. (72) Hitoshi Karasawa 2-43, Hatagaya, Shibuya-ku, Tokyo No. 2 Inside Olympus Optical Co., Ltd. (72) Inventor Yuichi Ikeda 2-43-2 Hatagaya, Shibuya-ku, Tokyo In-house Olympus Optical Co., Ltd. (72) Hiroaki Kagawa 2-43 Hatagaya, Shibuya-ku, Tokyo No. 2 O Olympus Optical Co., Ltd. (72) Inventor Eiichi Fuse 2-43-2 Hatagaya, Shibuya-ku, Tokyo O-rin Scan Optical Industry Co., Ltd. in the (72) inventor Tadao Hagino Shibuya-ku, Tokyo Hatagaya 2-chome No. 43 No. 2 Olympus Optical Industry Co., Ltd. in the (56) Reference Patent Sho 62-211058 (JP, A)

Claims (1)

(57) [Claims] 1. An ultrasonic vibration generator, a vibration transmitting member for transmitting ultrasonic vibration from the ultrasonic vibration generator to a target position in a living body, and an oscillator for driving the ultrasonic vibration generator. A first drive frequency for performing treatment such as ablation of a living body by using an oscillation frequency of an oscillating portion as an antinode of ultrasonic vibration at a tip of a vibration transmitting member that contacts a target position in the living body; The frequency is higher than the frequency and shorter in wavelength, and the ultrasonic vibration at the tip of the vibration transmitting member is set as the antinode of the vibration, and the position of the node of the ultrasonic vibration generated at the most distal end of the vibration transmitting member is the first position. Frequency switching means for switching to a second driving frequency for generating hemostasis at a position closer to the distal end of the vibration transmitting member as compared to a position generated when driving at a driving frequency of An ultrasonic treatment apparatus comprising: switch means for switching a wave number.