JP3103614B2 - Ultrasound surgical handpiece - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an ultrasonic surgical handpiece for performing an operation using ultrasonic vibration.

[0002]

2. Description of the Related Art Conventionally, there has been known an ultrasonic surgical handpiece for ablating or crushing a living body by using the vibration energy of ultrasonic vibration. This type of ultrasonic surgical handpiece usually has an ultrasonic oscillator and a vibration amplification horn disposed in a cover body, and the vibration transmission member is fixed to the horn by fixing means such as screw fastening. Connected. Then, the ultrasonic vibrator is driven in a state where the tip of the vibration transmitting member is applied to a treatment target such as a living tissue or a calculus, and the ultrasonic vibration generated by the ultrasonic vibrator is transmitted to the vibration amplification horn and the vibration transmitting member. The treatment object such as a living tissue or a calculus is sequentially applied to the treatment object, and the treatment object can be cut or crushed by the vibration energy.

In the above-mentioned ultrasonic surgical handpiece, since a vibration transmitting member for transmitting ultrasonic vibrations has a high temperature, a means for cooling the vibration transmitting member is provided. This is performed by a method in which cooling water is caused to flow around the vibration transmitting member also to wash the treatment target site, and the cooling water is directly fed to the treatment target site. For example, US Pat. No. 4,223,676. In the specification, a water supply mouthpiece is provided on a cover that covers the vibration transmission member near the rear end of the vibration transmission member, and a water supply tube is connected to the water supply mouthpiece so that cooling water flows around the vibration transmission member in the cover. To cool the vibration transmitting member.

[0004] Further, an unpublished application (Japanese Patent Application No. 2-32099)
No.) In the specification, a swelling portion swelling upward is provided on the upper wall portion of a cylindrical handpiece, a water supply passage is formed in the swelling portion, and a water supply mouthpiece is provided at a rear end of the handpiece. A water supply tube is connected to the water supply tube, and the cooling water sent to the water supply tube is supplied to the vicinity of the vibration transmitting member through a water supply passage in the bulging portion to cool the vibration transmitting member.

Further, in US Pat. No. Re30536, cooling water introduced into the handpiece from the rear end of the handpiece is guided to the vibration transmitting member through the periphery of the ultrasonic vibrator.

[0006]

SUMMARY OF THE INVENTION However, USP
In the water supply mechanism disclosed in the specification of Japanese Patent No. 4222367, a water supply tube disposed near the rear end of the vibration transmitting member is located outside the handpiece, which may obstruct the field of view in a surgical operation. In addition, during the operation, the water supply tube hinders the handpiece from being properly grasped, and thus the handpiece cannot be operated properly.

[0007] On the other hand, Japanese Patent Application No. 2-32099 having a water supply channel inside the handpiece can solve the above-mentioned problems, however, the upper wall of the cylindrical handpiece has an upper part. Since the bulging portion is provided in the bulging portion and the water supply channel is formed in the bulging portion, the overall outer shape is not a cylindrical shape but a different shape, and there is a limitation on a gripping method of the operator. . In addition, since the water passage is formed by providing a long hole having a small diameter in the bulging portion of the handpiece, it is difficult to process the water passage, and when cleaning the water passage after surgery, a special brush is used. Is required. In addition, even if a special brush is used, if the water channel is bent in a complicated manner, it is difficult to reliably clean the bent portion,
In addition, such a bent portion is very difficult to dry, and there is a possibility that water accumulates and bacteria grow.

Further, in the water supply mechanism described in US Pat. No. Re30536, the external shape of the handpiece is cylindrical, and the operability is not impaired by the water supply tube, but the cooling water introduced into the handpiece is superfluous. When the ultrasonic vibrator is vibrated at a high amplitude, the ultrasonic vibrator generates considerable heat. The temperature of the contacting cooling water rises, and the cooling water may not be able to sufficiently exert its cooling function on the vibration transmitting member. Further, when the temperature of the cooling water becomes extremely high due to the heat generated by the ultrasonic vibrator, a new problem arises in that proteins in the operative site tissue may be denatured by the hot water. Further, the vibrator to which the cooling water can be brought into direct contact is only the magnetostrictive vibrator, and there is a disadvantage that it cannot be applied to a vibrator using an electrostrictive vibrator.

SUMMARY OF THE INVENTION The present invention has been made in view of the above circumstances, and an object of the present invention is to provide an ultrasonic surgical hand which has good operability and cleanability and can sufficiently cool a vibration transmitting member. To provide a piece.

[0010]

In order to solve the above-mentioned problems, the present invention provides an ultrasonic vibrator , an amplifying horn for amplifying an ultrasonic vibration generated from the ultrasonic vibrator , and an amplifying horn. the ultrasonic surgical handpiece having a vibration transmitting member for connecting to and receiving the ultrasonic vibrator
A transducer cover has detachably accommodates the transducer cover
Housing and the outer surface of the transducer cover Howe to
And a water channel formed by a gap with the inner surface of the jing.
It is characterized by the following.

[0011]

The cooling water sent into the ultrasonic surgical handpiece from the outside reaches the vibration transmitting member through the water supply passage between the vibrator cover and the housing. At this time, since the cooling water does not directly contact the ultrasonic vibrator held inside the vibrator cover, the cooling effect is not impaired by the heat generated by the ultrasonic vibrator. Further, since the water passage is formed between the vibrator cover and the housing, the shape of the handpiece that is easily gripped is not damaged, and the handpiece is easily gripped, the visual field is easily secured, and the operability is improved.

Further, since the housing can be attached to and detached from the vibrator cover, the water supply passage can be exposed by removing the housing when cleaning the water supply passage. Therefore, cleaning is easy and drying is easy.

[0013]

Embodiments of the present invention will be described below with reference to the drawings. 1 and 2 show a first embodiment of the present invention. The ultrasonic surgical handpiece 1 of the present embodiment includes:
A cylindrical vibrator cover 3 in which an ultrasonic vibrator (not shown) is installed is provided. The vibrator cover 3 includes a vibrator accommodating portion 3a for accommodating the ultrasonic vibrator and a fixing member connecting portion 3b located at a tip of the vibrator accommodating portion 3a and connected to a housing fixing member 12 described later. Become. The outer diameter of the fixing member connecting portion 3b is formed smaller than that of the transducer accommodating portion 3a. Incidentally, the ultrasonic transducer,
It can be driven by receiving power supply via a power supply cord 24 connected to a power supply (not shown).

A cylindrical housing fixing member 12 is connected to the fixing member connecting portion 3b. As shown in FIG. 2, the housing fixing member 12 includes a screw portion 12a having a thread formed on the outer periphery thereof and a flange portion 12b formed at the tip of the screw portion 12a. 3 is formed on the inner surface of the fixing member connecting portion 3b and screwed into a screw (not shown) to fix the fixing member connecting portion 3b.
b. Flange 1
Reference numeral 2b allows a flange portion 2a of the housing 2 to be described later to be sandwiched between the vibrator housing portion 3a of the vibrator cover 3 and the like.

An amplifying horn 6 for amplifying the ultrasonic wave generated from the ultrasonic vibrator is connected to the tip of the ultrasonic vibrator housed in the vibrator housing 3a. Reference numeral 6 denotes a vibrator cover 3 through which the distal end portion passes through the fixing member connecting portion 3b and the housing fixing member 12.
Protruding from the tip of the A hollow probe 5 as a vibration transmitting member is connected to a tip of the protruding amplification horn 6 by a fixing means such as a screw.

On the other hand, a cylindrical housing 2 is detachably provided on the outer periphery of the vibrator cover 3. A nozzle-shaped sheath 18 is detachably provided at the tip of the housing 2, and an O-ring 16 is interposed between the housing 2 and the sheath 18 in a liquid-tight manner.

The sheath 18 is provided so as to house the probe 5 and the amplification horn 6 therein.
A water supply gap 25 is formed between the inner peripheral surface and the outer peripheral surfaces of the probe 5 and the amplification horn 6. The tip of the probe 5 protrudes from the opening 29 of the sheath 18 toward the tip.

An inwardly projecting flange portion 2a is formed on the inner surface of the housing 2. The housing 2 has the flange portion 2a positioned on the outer periphery of the fixed member connecting portion 3b of the vibrator cover 3. It is fitted on the outer periphery of the vibrator cover 3. An O-ring 14 is interposed between the rear ends of the transducer cover 3 and the housing 2 in a liquid-tight manner.

As described above, the housing 2 fitted to the outer periphery of the vibrator cover 3 is screwed with the housing fixing member 12 into the fixing member connecting portion 3b, so that the flange portion 2a becomes the flange of the housing fixing member 12. Part 12b
And the distal end surface of the fixing member connecting portion 3b. When removing the housing 2, the housing fixing member 12 may be loosened and removed. in this way,
The housing 2 is detachably provided to the vibrator cover 3 by the housing fixing member 12.

When the vibrator cover 3 and the housing 2 are fitted together, a gap 10 is formed between the outer peripheral surface of the fixing member connecting portion 3b and the inner peripheral surface of the flange portion 2a. . The gap 10 communicates with the gap 25 formed by the sheath 18, the probe 5, and the amplification horn 6 through a plurality of through holes 12 c provided in the housing fixing member 12. And a part of the water supply passage 4 of the handpiece 1.

Further, as shown in FIG. 1D, three water supply grooves 9 communicating with the gap 10 are formed at equal intervals along the axial direction on the outer peripheral surface of the vibrator cover 3. . On the outer peripheral surface of the vibrator cover 3, an annular groove 9 a connecting each water supply groove 9 is formed, and is formed between the plurality of water supply grooves 9 and the annular groove 9 a and the inner surface of the housing 2. The closed space forms a part of the water supply channel 4 of the handpiece 1.

As shown in FIG. 1E, the water supply passage 4 formed by the vibrator cover 3 and the housing 2 has two axially symmetrical portions on the outer peripheral surface of the vibrator cover 3.
It may be formed by cutting along the axial direction. The space formed between the cut portion and the inner surface of the housing 2 becomes the water supply channel 4. In addition, the water supply groove 9 may have various shapes such as a rectangle, and the number thereof may be appropriately set according to the situation.

At the rear end of the handpiece 1, there are provided a water supply base 20 to which a water supply tube (not shown) is connected, and a suction base 22 to which a suction tube (not shown) is connected. The water supply groove 9 and the annular groove 9a of the child cover 3 are inserted into the water supply base 20 through a communication path 26 provided in the rear end of the handpiece 1, as shown in FIG. Communicating. As a result, the cooling water sent by the water supply tube is supplied to the communication passage 26 of the vibrator cover 3 and the annular groove 9 a through the water supply mouthpiece 20.
Water can be supplied to the water supply groove 9. FIG.
(C), a water supply mouthpiece 20 may be provided in the housing 2 and the inside of the water supply mouthpiece 20 may be directly communicated with the water supply groove 9.

Therefore, as shown in FIG. 2, the housing 2 is fitted to the outer periphery of the vibrator cover 3, and the housing fixing member 12 is screwed into the fixing member connecting portion 3b, so that the flange portion 2a on the inner surface of the housing 2 is connected to the housing. When the housing 2 is mounted and fixed on the vibrator cover 3 by pressing the fixing member 12 and the vibrator housing 3a, the annular groove 9a is formed.
The space between the water supply groove 9 and the inner surface of the housing 2 and the gap 10 between the outer peripheral surface of the fixing member connecting portion 3b and the inner peripheral surface of the flange portion 2a form the water supply passage 4 of the handpiece 1. . That is, the water passage 4 of the handpiece 1 is formed by a gap between the vibrator cover 3 and the housing 2. The water supply path 4 is connected to the sheath 18 through the through hole 12 c of the housing fixing member 12.
It is communicated with the gap 25 for water supply formed in the inside.

With this, the cooling water sent to the water supply mouthpiece 20 via a water supply tube (not shown) passes through the communication passage 26 provided in the rear end of the handpiece 1 and the annular groove 9a and the water supply groove. 9, a space 10 between the outer peripheral surface of the fixing member connecting portion 3b and the inner peripheral surface of the flange portion 2a, and a through hole 12 of the housing fixing member 12.
c, and a water supply gap 25 formed in the sheath 18.
, And is discharged from the opening 29 of the sheath 18. And the probe 5
Is cooled and the treatment subject is washed. Also,
When cleaning the water passage 4 of the handpiece 1, the housing 2 may be removed from the vibrator cover 3 by loosening the screw of the housing fixing member 12, and the water passage 4 may be exposed to the outside.

As described above, the ultrasonic surgical handpiece 1 of the present embodiment comprises the vibrator cover 3 and the housing 2.
The water supply passage 4 for supplying cooling water to the probe 5 is formed by the gap between the probe 5 and the water supply tube.
As in the conventional case where the handpiece 1 is located near the rear end, the surgical field of view is obstructed by the water supply tube, or the water supply tube is in the way, and the handpiece 1 cannot be grasped well and the handpiece 1 cannot be operated properly. Can be avoided.

Since the water supply channel 4 is formed without impairing the cylindrical shape that the handpiece 1 can easily grasp,
The handpiece 1 is easily gripped, and the gripping method is not restricted.

Further, since the housing 2 is detachably provided on the outer periphery of the vibrator cover 3, if the housing 2 is removed, the water supply passage 4 can be exposed to the outside.
Therefore, the formation of the water passage 4 is very simple, and the water passage 4 can be easily and reliably washed.
In addition, this makes it possible to easily dry the water supply channel 4,
Propagation of bacteria and the like can be prevented.

Further, since the cooling water to be sent does not directly contact the ultrasonic vibrator inside the vibrator cover 3, the cooling effect is not impaired by the heat generated by the ultrasonic vibrator. In the present embodiment, the water supply grooves 9 and 9a are provided on the outer periphery of the vibrator cover 3, but they may be provided on the housing 2 side.

FIG. 3 shows a second embodiment of the present invention. The ultrasonic surgical handpiece 40 of the present embodiment is different from the first embodiment in that the housing 2 is not fixed to the vibrator cover 3 by the housing fixing member 12 but formed on the inner peripheral surface of the housing 2. The fitting convex portion 2b and the snap-fit concave portion 3c formed on the outer peripheral surface of the vibrator cover 3 are fixed to the vibrator cover 3 by engaging with each other. Other configurations are the same as those of the first embodiment. The same is true.

Therefore, the ultrasonic surgical handpiece 40 having the above-described configuration can obtain the same effects as those of the first embodiment, and when the housing 2 is fitted to the vibrator cover 3, the snap-fit concave portion is used. 3c and the snap-fit projection 2b are engaged with each other, so that the housing 2 can be securely attached to the vibrator cover 3 without any intervening other members.
Can be fixed against Further, since the housing 2 can be attached to and detached from the vibrator cover 3 with one touch, it is very easy to handle.

FIG. 4 shows a third embodiment of the present invention. The ultrasonic surgical handpiece 50 of the present embodiment has a sheath 51 in which the housing 2 and the sheath 18 are integrally formed.
And a grip 5 at the rear end of the handpiece 50.
2 and the other configuration is the same as that of the second embodiment.

Therefore, the ultrasonic surgical handpiece 50 having the above-described structure can obtain the same effects as those of the second embodiment, and also, as shown in FIG. The attachment / detachment work with the
It is very convenient because it can be done by grasping with hand. In addition, since the housing 51 has a structure in which the housing 2 and the sheath 18 are integrally formed, a troublesome operation of removing the sheath 18 from the housing 2 and then removing the housing 2 from the transducer cover 3 is performed. No need, very easy to handle. Furthermore, since the outer peripheral surface of the housing 51 becomes smooth, when blood or the like adheres to the outer peripheral surface of the housing 51, it can be easily and reliably washed off.

By the way, as the water supply mechanism of the ultrasonic surgical handpiece, various things can be considered in addition to the above embodiments. For example, in the ultrasonic surgical handpiece 60 shown in FIG. 5A, a vibrator 62 serving as an oscillation source is arranged inside a vibrator cover 61, and the vibrator 62 is connected to a horn 65 for amplitude expansion. Are linked. A treatment probe 69 having a suction hole 69a is fastened to the tip of the horn 65. A sheath 68 is provided on the outer periphery of the probe 69. The sheath 68 includes an outer sheath 68a and an inner sheath 68 coaxially disposed in the outer sheath 68a.
b, and a probe 69 is disposed inside the inner sheath 68b.

On the side wall of the outer sheath 68a, a water supply mouthpiece 67 is provided.
And a water supply tube 77 is connected to the water supply base 67. Then, the outer sheath 68a and the inner sheath 68
The cooling water can be supplied to the annular space (water supply passage 70) between the cooling water and the b. The water passage 70 is provided with the handpiece 60.
The distal end communicates with the annular space (water supply / recovery passage 71) between the inner sheath 68b and the probe 69. The water supply / recovery passage 71 communicates with the inside of a first suction tube 76 connected to the first suction base 66 via a first suction base 66 provided on a side wall of the inner sheath 68b.

Therefore, the cooling water sent from the water supply tube 77 flows through the water supply passage 70 to the tip side of the handpiece 60 to cool the probe 69, and the cooling water is supplied to the water supply collection passage near the tip of the handpiece 60. The water is again sent to the rear end side by 71 and the probe 69 is cooled again and collected by the suction tube 76.

On the other hand, the tissue collected by the probe 69 passes through the suction hole 69a of the probe 69 and is collected from the second suction tube 63 connected to the second suction base 64 at the rear end of the handpiece 60.

The tip structure of the handpiece 60 is as shown in FIG. That is, an annular sliding member 72 is fitted to the distal end of the inner sheath 68b with a slight gap between the inner sheath 68b and the probe 69. The sliding member 72 is formed of a material having a low coefficient of friction, such as a fluororesin, and is provided coaxially with the inner sheath 68b. On the side wall of the inner sheath 68 b immediately behind the sliding member 72, a leak hole 79 for feeding the cooling water in the water supply channel 70 into the water supply / recovery channel 71 is provided. Further, when a high-frequency current is passed through the probe 69 and the tip of the probe is used as an electric scalpel, the tip of the outer sheath 68a on the tip side of the sliding member 72 is prevented in order to prevent the tip of the outer sheath 68a from burning due to the high-frequency current. Is fitted with an annular beak 73 made of a heat-resistant material such as ceramic. Then, the inner surface of the beak 73 and the probe 69
Is longer than the distance between the inner surface of the sliding member 72 and the probe 69.

The sliding member 72 does not come into contact with the probe 69 in a normal state, but when the inner sheath 68b and the probe 69 are not arranged coaxially, or as shown in FIG. As shown in ()), when a load is applied to the distal end portion of the sheath 68, it comes into contact with the probe 69. The sliding member 72 prevents the beak 73 from contacting the probe 69 by contacting the probe 69.

Therefore, according to the ultrasonic surgical handpiece 60 having the above configuration, the inner sheath 68b and the probe 6
9 is not coaxially arranged, or even if a load is applied to the distal end of the sheath 68, the sliding member 72 having a low friction coefficient comes into contact with the probe 69, and the beak 73 Is prevented from contacting the probe 69, the beak 73 can be prevented from damaging the probe 69, and the tip of the outer sheath 68a is not burned by the high-frequency current. Therefore, the operation can be performed safely, and the life of the probe 69 can be improved. Further, by providing the sliding member 72 as a spacer in this manner, the coaxiality between the inner sheath 68b and the probe 69 is obtained, and the sliding member 72 itself is not damaged.

The sliding member is not limited to the handpiece 60 having a double sheath structure as shown in FIG.
Can be applied to a general ultrasonic surgical handpiece 80 as shown in FIG.

FIG. 6 shows a state in which a sheath 83
Shows a tip structure of a handpiece 80 having a single tube sheath structure provided to form an annular nozzle. An annular sliding member 82 is fitted to the distal end of the sheath 83 with a slight gap between the sheath 83 and the probe 84. An annular beak 81 is fitted to the distal end of the sheath 83 on the distal end side of the sliding member 82. The distance between the inner surface of the beak 81 and the probe 84 is larger than the distance between the inner surface of the sliding member 81 and the probe 84. The cooling water sent into the handpiece 80 is the sheath 83 and the probe 8
4 and discharged at the tip of the handpiece 80. Further, a part of the water supply liquid is supplied to the suction passage 8 in the probe 84.
4a. Therefore, the same effect as the handpiece 60 shown in FIG. 5 can be obtained by the handpiece 80 having the above configuration.

[0043]

As described above, according to the present invention,
The operability and cleanability are good, and the vibration transmitting member can be sufficiently cooled. That is, the cooling water sent from the outside into the ultrasonic surgical handpiece reaches the vibration transmitting member through a gap between the vibrator cover and the housing, which is a water supply passage, and at this time, the cooling water is Since the ultrasonic vibrator held inside the vibrator cover does not come into direct contact with the ultrasonic vibrator, heat generated by the ultrasonic vibrator does not impair the cooling effect. Therefore, the vibration transmitting member can be sufficiently cooled.

Further, since the water passage is formed between the vibrator cover and the housing, the shape of the handpiece which is easy to grasp is not impaired, the handpiece is easy to grasp, the visual field is easily secured, and the operability is easy. It will be good.

Further, since the housing can be attached to and detached from the vibrator cover, the water supply channel can be exposed by removing the housing when cleaning the water supply channel. Therefore, cleaning can be performed easily and reliably, and drying is easy.

[Brief description of the drawings]

1A is a cross-sectional view of an ultrasonic surgical handpiece according to a first embodiment of the present invention, and FIG. 1B shows a water supply mechanism at the rear end of the ultrasonic surgical handpiece of FIG. Sectional view,
(C) is a sectional view showing a modification of the water supply mechanism of (b),
(D) is a sectional view showing a water channel of the ultrasonic surgical handpiece of (a), and (e) is a cross-sectional diagram showing a modification of the water channel of (d).

FIG. 2 is a schematic view showing a method of attaching and detaching a transducer cover and a housing of the ultrasonic surgical handpiece of FIG. 1;

FIG. 3 is a sectional view of an ultrasonic surgical handpiece according to a second embodiment of the present invention.

FIG. 4 (a) is a sectional view of an ultrasonic surgical handpiece according to a second embodiment of the present invention, and FIG. 4 (b) is a sectional view of a transducer cover and a housing of the ultrasonic surgical handpiece of FIG. It is the schematic which shows the attachment / detachment method.

FIG. 5 (a) is a cross-sectional view of an ultrasonic surgical handpiece,
(B) is an enlarged sectional view showing the distal end structure of the ultrasonic surgical handpiece of (a), and (c) is an enlarged sectional view showing a state in which the distal end of the ultrasonic surgical handpiece of (a) is deformed by an external force. FIG.

6 is an enlarged sectional view showing a modification of the distal end structure of the ultrasonic surgical handpiece of FIG.

[Explanation of symbols]

 1, 40, 50: Handpieces for ultrasonic surgery 2, 51: Housing 3: Vibrator cover 4: Water channel 5: Probe 6: Horn for amplification

Claims (1)

(57) [Claims] And 1. A ultrasonic transducer, an amplifying horn to amplify the ultrasonic vibration generated from the ultrasonic vibrator, ultrasonic surgical handpiece having a vibration transmitting member for connecting to the amplifying horn in the gap between the transducer cover housing the ultrasonic transducer, a housing accommodating the transducer cover detachably, and an outer surface and an inner surface of the housing of the transducer cover
An ultrasonic surgical handpiece , comprising: a water supply channel formed therebetween .