JP3017224B2 - Ultrasonic vibration treatment device - Google Patents

Description

Description: BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an ultrasonic vibration treatment apparatus that performs a treatment such as cutting off a tissue in a living body by ultrasonic vibration.

[Related Art] Generally, in an ultrasonic vibration treatment apparatus using ultrasonic vibration, an ultrasonic vibrator is connected to a base of an ultrasonic transmission member formed of a pipe, and a suction path is provided in the ultrasonic transmission member. It has a formed structure. Then, the distal end of the ultrasonic transmission member is brought into contact with the tissue of the affected part, the ultrasonic vibration is transmitted to the affected part, and the tissue is excised. Thereafter, the excised tissue is sucked through the suction path and discharged to the outside. .

[Problems to be Solved by the Invention] However, since this type of ultrasonic vibration treatment apparatus utilizes ultrasonic vibration, there is no denaturation and whitening of living tissue. Further, since the high-frequency current does not flow, there is an advantage that no perforation or electrical trouble occurs.

However, on the other hand, there is a problem that bleeding is apt to occur due to the suction force at the time of excision and discharge of the tissue.

To address this problem, for example, countermeasures such as those disclosed in Japanese Patent Application Laid-Open No. Sho 62-211,057 and US Pat. No. 4,750,488 have been taken. That is, in Japanese Patent Application Laid-Open No. 62-211,057, a hemostatic means is provided at the distal end of the ultrasonic transmission member to stop bleeding by heating with a nichrome wire or the like. USP 4,7
In the specification of Japanese Patent No. 50,488, a means for stopping hemostasis by a high-frequency current is provided.

However, with respect to the former where the hemostatic means is provided at the distal end of the ultrasonic transmission member, the hemostatic means provided at the distal end of the ultrasonic transmission member is easily damaged by the ultrasonic vibration of the ultrasonic transmission member.

In the latter case, hemostasis is performed by high-frequency current. However, there are many drawbacks in terms of electrical safety, and there are drawbacks such as a large electrical effect on the ultrasonic vibration treatment device. Was.

The present invention has been made by paying attention to the problematic point in the conventional ultrasonic vibration treatment apparatus as described above, and it is safe, simple and reliable to prevent bleeding that occurs when resected by ultrasonic vibration. It is an object of the present invention to provide a durable ultrasonic vibration treatment device that can be stopped at a certain point.

Means and Action for Solving the Problems In order to solve the above problems, the present invention relates to an ultrasonic vibration treatment apparatus having an ultrasonic transmission member for transmitting an ultrasonic vibration to a target site in a living body. A main body of the ultrasonic vibration treatment apparatus, an ultrasonic transmission member extending from a base end of the main body, and covering at least a part of a base end of the main body and at least a part of the ultrasonic transmission member. A cover member provided so as to be able to advance and retreat with respect to the base end of the main body and the ultrasonic transmission member; and a cover member provided at a base end of the main body at a position covered by the cover member. Switch means for controlling the supply of energy to the ultrasonic transmission member in accordance with the advance and retreat of the ultrasonic vibration member.

Further, the present invention further includes a hemostatic means provided at the tip of the covering member and generating heat when energized, and wherein the switch means energizes the hemostatic means in accordance with advance / retreat of the covering member. The energy supply to the ultrasonic transmission member is selectively switched.

Further, according to the present invention, the switch means performs control so as to switch a supply level of energy to the ultrasonic transmission member to a low level in accordance with advance and retreat of the cover member.

Then, the bleeding that occurs when resected by ultrasonic vibration,
With hemostatic means provided on a sheath covering the ultrasonic transmission member,
It can be stopped quickly, easily, safely and securely.

[Embodiment] FIGS. 1 and 2 show a first embodiment of the present invention.

The ultrasonic vibration generator 1 of the ultrasonic vibration treatment device shown in FIG. 1 has a Langevin vibrator 3 bolted inside an outer case 2. The Langevin vibrator 3 includes piezoelectric elements 4 and electrodes 5 alternately stacked, and a power cord 6 is connected to the electrodes 5. The power cord 6 passes through the rear end wall of the outer case 2 and is led out to the outside, and is connected to a drive power supply (not shown).

The Langevin vibrator 3 is provided with a vibration amplitude amplifying horn 7 at the front end thereof, a rear metal block 8 at the rear end thereof, and tightening the piezoelectric element 4 and the electrode 5 laminated by bolts 9 and nuts 10 to clamp them. Are integrally connected.

The Langevin vibrator 3 is supported and fixed to the outer case 2 by using a flange portion 7a integrally formed on the outer periphery of the horn 7 near a node of the vibration.

An ultrasonic vibration transmitting member 11 formed of a metal hollow pipe is detachably connected to the tip of the horn 7 by screwing. A through hole is formed in the horn 7 and the bolt 9, and together with the hollow hole 11 a of the ultrasonic vibration transmitting member 11 communicating with the horn 7 and the bolt 9, a suction inner hole 12 is formed. The inner hole 12 is fitted to the rear end of the bolt 9 and connected to communicate with a base 13 provided through the rear end wall of the outer case 2. Further, a suction tube (not shown) is connected to the base 13. This suction tube is connected to a suction pump (not shown).

On the other hand, the front outer case having a hole 14 through which the ultrasonic vibration transmitting member 11 penetrates at the front opening edge of the outer case 2
15 is installed. Further, a slide cover 16 is attached to the front outer case 15 so as to cover it. The slide cover 16 is fixed to the front outer case 15 so as to be slidable in the front-rear direction. It is fixed at a predetermined position by a locking means described later.

That is, the front outer case 15 is provided with a click stop 17 on its side wall, and the click stop 17 is provided with a spring 17.
A ball 17b urged inward by a is provided. On the other hand, corresponding to this, a plurality of click holes 18 are provided on the outer periphery of the front outer case 15 so as to be shifted in the front-rear direction. Then, the slide cover 16 is moved back and forth, the click hole 18 is selected, the ball 17b urged by the spring 17a is dropped, and the ball 17b is fixed at that position by engaging.

Further, the front outer case 15 is provided with a slide switch 20 configured with an energizing blade 20a provided inside the slide cover 16. A lead wire 21 derived from the slide switch 20 passes through a lead wire introduction hole 22 formed in the wall of the outer case 15 and is led out together with the power cord 6 to the outside.

Further, a sheath 22 that covers the ultrasonic vibration transmission member 11 is connected to a tip of the slide cover 16. A base 23 and a connector 24 are attached to the base of the sheath 22. A circumferential groove 26 is provided on the inner peripheral wall near the base of the sheath 22. The ultrasonic vibration transmitting member 11 is
An annular sealing member 25 such as an O-ring, for example, which is joined to the outer periphery of the device, is fitted therein. Thus, the inside of the sheath 22 and the subsequent portions is kept watertight.

In addition, a water supply tube (not shown) is connected to the base 23, and the water supply tube is connected to a water supply pump (not shown).

Further, a heating means 30 that generates heat by resistance heat when energized is provided on the outer periphery of the distal end of the sheath 22. A conductive means 31 is connected to the heating means 30, and the conductive means 31 has a band-shaped or linear electric wire 32 therein until reaching the connector 24.
It contains. This is disposed along the outer wall of the sheath 22. The connector 24
A cord 33 connected to the heating control driving device is detachably connected to the heating device.

The heating means 30 is configured as shown in FIG. That is, the heating means 30 is constituted by a heating blade 35 covered with a coating layer 34 made of a heat-resistant and insulating resin such as Teflon. Further, the conductive means
The coating of 31 and the coating layer 34 are integrally formed, and the heating means 30 is fixed to the distal end of the sheath 22 by a heat-resistant adhesive or a Teflon heat-shrinkable tube (not shown).

In the ultrasonic vibration treatment apparatus configured as described above,
The ultrasonic vibration excited by the Langevin vibrator 3 of the ultrasonic vibration generator 1 is amplified by the horn 7 and transmitted through the ultrasonic vibration transmitting member 11. Ultrasonic vibration transmission member 11
By vibrating the tip of the body, the living tissue in contact with the body is cut off, and at the same time, suction is performed.

In addition, by sliding the slide cover 16 forward, the sheath 22 protrudes and the slide switch is
By the switching operation of 20, the heating blade 35 in the heating means 30 provided at the distal end of the sheath 22 is electrically heated.

Therefore, the temperature rise of the coating layer 34 that covers the heating blade 35 can quickly coagulate and seal the bleeding part generated by the excision and suction. In addition, the coating layer 34
Is made of Teflon resin, the tissue can be prevented from adhering to the heating means 30 by heating.

Therefore, according to this embodiment, the distal end of the ultrasonic vibration transmitting member 11 is applied to the treatment target site, and the tissue can be cut off by the ultrasonic vibration transmitted through the ultrasonic vibration transmitting member 11. In addition, the excised tissue piece is
Can be removed by suction.

If bleeding occurs at this time, the slide cover 16 is slid forward by a finger or the like, thereby operating the slide switch 20 of the ultrasonic vibration generator 1 itself and operating the sheath 22 forward. Then, the tip of the sheath 22 is protruded before the tip of the ultrasonic vibration transmission member 11. Then, the blood is stopped by applying a current to the heating means 30 at the distal end of the sheath 22 to the bleeding part. Further, the heating operation of the heating means 30 is automatically performed by operating the slide switch 20 in conjunction with the forward movement of the slide cover 16. And this hemostatic treatment can be performed promptly, reliably and simply.

In addition, the slide operation of the slide cover 16 can switch the cutoff by ultrasonic vibration and the action of hemostasis by heating, and the heating means 30 is provided with a coating layer 34 made of Teflon resin or the like.
Therefore, since the sheath 22 and the outside are insulated, electrical safety against a human body or the like is improved.

FIG. 3 to FIG. 5 show a second embodiment of the present invention. This is an example of an electric circuit of a drive unit that drives the ultrasonic vibration generator 1 in the ultrasonic vibration treatment device.

Operation signals of the external operation switch 40 installed outside, such as the hand-side operation slide switch 20 incorporated in the ultrasonic vibration generator 1 and the foot switch, are input to the operation control circuit 41. This operation control circuit 41 includes an oscillator 42 using a PLL or the like for performing ultrasonic oscillation,
An operation control signal is output to the heating control circuit 43 for operating the hemostatic means 30 and the suction / water supply control circuit 44 for controlling the operation of the suction / water supply pump. Oscillator 42 has power amplifier 45
Are connected, and the ultrasonic transducer 3 is driven by the signal amplified by the power amplifier 45. The heating control circuit 43 is connected to the heating blade 35 inside the heating means 30 via the power cord 33, the connector 24, and the conductive means 31.
The suction / water supply control circuit 44 is connected to a suction pump 46 and a water supply pump 47.

According to the driving unit configured as described above, in accordance with the operation state of each of the connected switches 20 and 40, the ultrasonic vibration generator 1 is operated to perform the excision and suction operation state and the hemostatic operation state. It can be switched and operated.

FIG. 4 shows an operation state of the ultrasonic vibration treatment apparatus driven by the driving unit. The switching of the slide switch 20 by the slide operation of the slide cover 16 of the ultrasonic vibration generator 1 stops the ultrasonic oscillation and energizes the heating blade 35. However, the resonance tracking drive state of the ultrasonic transducer 3 is maintained. To continue, the ultrasonic transducer 3 may be continuously vibrated at a small amplitude even during the hemostatic treatment as illustrated. This makes it possible to smoothly switch between hemostasis and excision without causing a time lag required to lock the drive signal to the resonance frequency of the ultrasonic transducer 3 when switching to the next excision mode.

Also, as shown in FIG. 5, by activating an external switch 40 such as a foot switch, for example, if bleeding is observed after ultrasonic ablation / aspiration is performed, only the water supply pump 47 is driven to perform cleaning. And then the suction pump
After the bleeding site is determined by driving only 46, it is possible to control a series of treatments of performing heat hemostasis.

Therefore, according to this embodiment, not only can the operation be switched as intended, but also an ultrasonic vibration treatment apparatus which is prepared for smooth operation switching and adapted to the actual position can be realized. Can be.

6 (a), 6 (b) and 6 (c) show modified examples of the distal end portion of the sheath 22 of the ultrasonic vibration treatment apparatus provided with the heating means 30, respectively.

That is, in FIG. 6 (a), the heating means 30 is provided at a position partially limited to the outer periphery of the distal end portion of the sheath 22.

Therefore, when the bleeding site is small, the bleeding can be stopped only at that site. Therefore, the living body is not damaged by heating to an unnecessary part.

When the cross-sectional shape of the sheath 22 is formed as a polygon such as a triangle or a rhombus as shown in FIGS. 6 (b) and 6 (c), one or more heating means 30 may be provided at each edge portion. The operability of stopping bleeding at a partial bleeding site is dramatically improved.

[Effects of the Invention] As described above, according to the present invention, an ultrasonic vibration treatment apparatus capable of safely, simply, and reliably stopping bleeding that occurs when excision and suction is performed by ultrasonic vibration by a simple operation. Can be provided. Further, the durability can be improved without damaging the heating means by the ultrasonic vibration.

[Brief description of the drawings]

1 and 2 show a first embodiment of the present invention. FIG. 1 is a sectional view of the ultrasonic vibration treatment apparatus, and FIG. 2 (a).
FIG. 2 is a side sectional view of the distal end portion of the sheath provided with the hemostatic means by heating, and FIG. 2 (b) is a cutaway perspective view of the hemostatic means by heating. 3 to 5 show a second embodiment of the present invention, FIG. 3 is a structural view showing a drive unit of an ultrasonic vibration generator, and FIGS. 4 and 5 are ultrasonic vibration treatment apparatuses thereof. 6 is a time chart showing the operation state of FIG. 6 (a), 6 (b) and 6 (c) are cross-sectional views showing the structure of a modification of the tip portion of the ultrasonic vibration generator. DESCRIPTION OF SYMBOLS 1 ... Ultrasonic vibration generator, 2 ... Outer case, 3 ... Langevin vibrator, 4 ... Piezoelectric element, 5 ... Electrode, 7 ...
… Horn, 11… vibration transmission member, 15… front outer case, 16… slide cover, 20… slide switch,
30 ... heating means, 31 ... conductive means, 35 ... heating blade.

Claims (3)

(57) [Claims] 1. An ultrasonic vibration treatment device having an ultrasonic transmission member for transmitting ultrasonic vibration to a target part in a living body, wherein: a main body of the ultrasonic vibration treatment device; and a base end of the main body. An ultrasonic transmission member extending from the portion, covering at least a part of the ultrasonic transmission member and at least a part of a base end of the main body, and a base end of the main body and the ultrasonic transmission member. A cover member provided so as to be able to advance and retreat, and provided at a position covered by the cover member at the base end of the main body, and supplies energy to the ultrasonic transmission member in accordance with the advance and retreat of the cover member. An ultrasonic vibration treatment apparatus, comprising: switch means for controlling; 2. The apparatus according to claim 1, further comprising: a hemostatic means provided at a tip of said cover member and generating heat when energized, wherein said switch means energizes said hemostatic means and switches said ultra-high current in response to advance / retreat of said cover member. The ultrasonic vibration treatment apparatus according to claim 1, wherein the supply of energy to the sound wave transmission member is selectively switched. 3. The apparatus according to claim 1, wherein said switch means switches a supply level of energy to said ultrasonic transmission member to a low level in accordance with advance and retreat of said cover member. Ultrasonic vibration treatment device.