JP3192340B2 - Ultrasound surgery device - 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 apparatus for sucking and removing tissue crushed and emulsified by ultrasonic vibration.

[0002]

2. Description of the Related Art Surgical devices for crushing, cutting, or separating biological tissue by ultrasonic vibration are used in ophthalmology for crushing and aspirating and removing the lens hardened by cataract, and in the brain, spine, digestive tract, and the like. 2. Description of the Related Art Surgical apparatuses for soft tissues for general surgery that crush and remove a wound or hematoma are known. More recently, ultrasonic surgical devices that can cut and separate hard tissue by ultrasonic vibration have been used.

[0003] In order to properly perform inspection and repair of an ultrasonic surgical apparatus, it is necessary to accurately grasp the history of the apparatus. No. In the conventional device, the accumulated oscillation time is displayed, and by stepping on a foot switch connected to the starting circuit, first, the liquid supply pump is driven by an output signal from the control circuit of the liquid supply pump, An irrigation liquid such as saline is sent to the handpiece. At the same time, high-frequency power is supplied from the oscillator to the ultrasonic vibration source inside the handpiece, and is converted into ultrasonic vibration to crush and emulsify the living tissue at the operation site.
In addition, the suction pump is driven by an output signal from the control circuit of the suction pump, and the crushed / emulsified tissue is sucked and discharged from the operative site into the suction bottle. The timer connected to the starting circuit accumulates the time for each time the foot switch is kept depressed, and displays the sum as the oscillation time.

However, even if the operator forgets to connect the connector between the oscillator and the handpiece, or notices that the handpiece cable is disconnected or the like and the handpiece does not oscillate, the user steps on the foot switch. The time during that period is accumulated and displayed on the timer, and a time different from the actual oscillation time is displayed, so that the accurate oscillation time cannot be grasped.

[0005] In addition, in the case where the operative section is diversified, it is necessary to record the oscillating time before starting in order to know from the timer how long the oscillating time has been given to a certain operative section. However, there is a problem that the oscillation time is not immediately known.

[0006] In ordinary laparotomy, continuous suction is performed separately from liquid supply and oscillation in order to prevent the suction passage in the handpiece from being blocked, but continuous suction is performed during laparoscopic surgery. When inhaled, carbon dioxide in the abdominal cavity was discharged out of the body, and the abdominal wall was lowered, which could obstruct the operative field.

[0007] In the case of laparoscopic surgery, carbon dioxide is used for insufflation, but since a pressure of about 8 mmHg is applied,
It may increase the concentration of carbon dioxide in the blood and affect living tissues. Therefore, at the time of surgery, it is important how much carbon dioxide is absorbed into the body. In addition, the insufflation is performed by an automatic insufflation device that automatically senses intra-abdominal pressure and supplies carbon dioxide gas from outside the body to the abdominal cavity. However, it is difficult to measure the amount of carbon dioxide absorbed in the body.

[0008]

SUMMARY OF THE INVENTION The present invention has been made to solve such a problem of a conventional ultrasonic surgical apparatus which displays only the accumulated time during which a foot switch is kept depressed. It is an object of the present invention to provide an ultrasonic surgical apparatus capable of displaying the accumulated time at the time of oscillation and displaying the accumulated time at each oscillation.

[0009]

That is, the present invention provides a handpiece comprising an ultrasonic vibration source for generating ultrasonic vibration and a horn for transmitting and expanding the ultrasonic vibration, and supplying a liquid to the tip of the handpiece. And an oscillator for supplying high-frequency power to the ultrasonic vibration source via a connector, and a control unit for controlling the oscillator and the liquid supply pump. The control unit includes a liquid supply pump control circuit and a start circuit, and the start circuit is connected to the liquid supply pump control circuit and the oscillator by a start signal line. In addition,
A suction pump for sucking and removing tissue crushed and emulsified by the ultrasonic vibration from the tip of the handpiece is provided, and a suction pump control circuit for controlling the suction pump is added to the control unit. The suction pump control circuit is connected to a start circuit by a start signal line, the connector is connected to the oscillator by two signal lines of ultrasonic output and identification detection, and an oscillation detection signal is connected to a detection circuit of the oscillator. An ultrasonic surgical apparatus characterized in that timers 1 and 2 are connected by wires, and a reset switch connected to the timer 1 is provided on an operation panel surface of the apparatus main body.

Hereinafter, the present invention will be described in detail with reference to the drawings. FIG. 1 is a diagram showing an overall configuration of an ultrasonic surgical apparatus according to one embodiment of the present invention, and FIG. 2 is a partially enlarged view mainly showing an oscillator and a control unit.

The handpiece (27) is composed of a magnetostrictive or electrostrictive vibrator serving as an ultrasonic vibration source, a horn connected to the vibrator and serving as a vibration transmitter, and a handle made of an insulating material incorporating the horn. It is configured. A suction passage is provided inside the vibrator and the horn, and is open to the tip (30) at the tip of the horn. An annular space formed between the tip (30) and the cover (29) covering the tip (30) communicates with the irrigation nipple (28) and serves as a passage for supplying an irrigation liquid. It is open near (30).

The liquid supply circuit for supplying the irrigation liquid to the operative site includes an irrigation liquid (22) bottle such as saline, a liquid supply pump (23), an irrigation tube (26), and a liquid supply pump. It comprises a liquid supply pump control circuit (3) for controlling. In addition, a suction circuit for suctioning and removing tissue crushed and emulsified by ultrasonic vibration at the operation site includes a suction pump (2).
4), a suction bottle control circuit (5) for controlling the suction bottle (32), the suction tube (31) and the suction pump.
It is composed of

The contents of the operation (for example, cutting of bones, etc.)
Depending on the horn, continuous suction is required other than at the time of ultrasonic vibration of the horn.On the other hand, when the suction passage cannot be provided due to the structure of the horn, or when it is desired to perform suction separately from the ultrasonic vibration of the horn. There are many cases. In such a case, a crushed / emulsified tissue or the like may be removed by suction using a suction pump or a vacuum pipe in a hospital and using a Fraser suction pipe. It is not always necessary to provide a suction pump and a suction pump control circuit in an apparatus used for such an application, but this is, of course, included in the scope of the present invention. Hereinafter, a case where a suction pump and a suction pump control circuit are provided will be described.

An oscillator (4) for supplying high frequency power to the handpiece (27) (within a frame indicated by a dashed line)
Oscillation circuit (7) and detection circuit (6) (in the frame indicated by the dotted line)
The detection circuit (6) further includes a frequency detection circuit (9), a handpiece identification detection circuit (10), and a comparison circuit (11).

To use the apparatus of the present invention, the foot switch (21) is first turned on by stepping on it. Starter circuit (1)
Via a start signal line (2) to the liquid supply pump control circuit (3), the suction pump control circuit (5), and the oscillation circuit (7), and the liquid supply pump (23)
The suction pump (24) and the oscillator (4) operate simultaneously.

In the liquid supply circuit, the liquid supply pump (23) causes the liquid supply pump control circuit (3) to supply the irrigation liquid at a predetermined flow rate to the handpiece (27) through the irrigation tube (26) and the irrigation nipple (28). ) And cover (29)
Through the passage between the inner surface of the chip and the vibration transmitter
Spouted at 0). In the suction circuit, crushing and emulsification were performed by the suction pump (24) from the opening of the tip (30) at the tip of the handpiece (27) through the suction passage inside the horn and the vibrator and the suction tube (31). The tissue is suctioned and discharged into a suction bottle (32).

On the other hand, in the oscillator, when the frequency detection signal is received from the frequency detection signal line (14) by the frequency detection circuit (9), when the frequency is in the oscillation frequency range of the handpiece, the comparison circuit (11) is sent to the comparison circuit (11). Frequency detection output line (13)
The frequency detection output signal is sent through The handpiece identification detection circuit (10) is driven since the power of the device is turned on and turned on, and receives the identification detection signal through the identification detection signal line (15) when the connector (16) is connected, If the connector (16) is connected,
The comparison circuit (1) is output from the handpiece identification detection circuit (10).
1) An identification detection output signal is sent through an identification detection output signal line (12).

In the comparison circuit (11), only when the frequency detection output signal and the identification detection output signal are received, the oscillation circuit (7) and the timer 1 (1) are connected by the oscillation detection signal line (17).
8) Send an oscillation detection signal to the timer 2 (19). Then, high frequency power is supplied from the oscillation circuit (7) to the vibrator inside the handpiece (27) via the ultrasonic output signal line (8), the connector (16), and the handpiece cable, and the mechanical ultrasonic wave is transmitted. It is converted to vibration and transmitted and expanded by the horn and tip to produce a vibration of maximum amplitude at the tip of the tip (30).

At this time, the timer 1 (18) and the timer 2
(19) integrates and displays the time while receiving the oscillation detection signal from the oscillation detection signal line (17). After stopping once, when the foot switch (21) is stepped on again to oscillate, the timer 1 (18) and the timer 2 (19)
The oscillation time is added to the previously displayed time and displayed. If the connector (16) has come off or the oscillation frequency range has gone out, the footstep switch (21)
No oscillation detection signal is output from the comparison circuit (11) even if the step is pressed, so that the time is not accumulated in the timer 1 (18) and the timer 2 (19), and only the time actually oscillated is accumulated and displayed. Therefore, it is possible to know an accurate oscillation time.

When the timer 1 (18) connected to the reset switch (20) is pressed, the timer 1 is returned to the initial state, that is, 0 seconds, by pressing the reset switch (20). Therefore, by using the timer 1, it is possible to grasp the exact oscillation time required for each surgical site. It is preferable that the reset switch (20) is mounted on a main body operation panel which is easy to operate. As for the mounting position of the timer 1 (18) and the timer (19), it is preferable that the timer 1 be provided at a position that is easy for the operator to see, on the main body operation panel or on the side surface of the main body.
Since is not seen during the treatment, it may be provided on the back of the main body or the like, but is not limited to this position.

Further, it is a preferable embodiment to provide a function selecting circuit (33) between the starting circuit (1) and the suction pump control circuit (5). In some cases, suction may be temporarily stopped due to the difference in the operation method or the operation site. At this time, if the suction pump (24) is set in advance in the function selection circuit so as not to be driven, the foot switch (21) can be operated. The suction pump does not operate even when depressed, further increasing operability.

Further, a hand switch (34) for oscillation is provided on the side surface of the handpiece (27) instead of the foot switch (21), which is one of preferred embodiments.
By arranging the hand switch on the side surface of the handpiece, oscillation and stopping can be performed more reliably. In addition, since the operation can be performed only by the hand switch for the surgeon, the operation can be performed in a reasonable posture, and the device can perform a safe and smooth operation of liquid supply, oscillation, and suction.

In laparoscopic surgery, when the foot switch (21) or the hand switch (34) is operated, the oscillation and the suction are linked, so that the timer (18) determines the suction time, the set value of the suction pressure and the suction pressure. The amount of carbon dioxide discharged from the abdominal cavity can be calculated from the time. This makes it possible to calculate the amount of carbon dioxide absorbed in the body, enabling the surgeon to monitor the state of carbon dioxide absorption during surgery, and perform safe and smooth liquid supply, oscillation, and suction operations. Device.

[0024]

According to the present invention, not only is the oscillation time accumulated and displayed only when the handpiece actually oscillates and ultrasonically vibrates, but also the oscillation time for each operation is accumulated according to the contents of the operation. Since it can be displayed, the accurate oscillation time can be instantaneously grasped as the operation progresses, and the history of the apparatus can be correctly grasped to perform appropriate maintenance, which is useful as an ultrasonic surgical apparatus.

[Brief description of the drawings]

FIG. 1 is a diagram showing an overall basic configuration of an ultrasonic surgical apparatus according to one embodiment of the present invention.

FIG. 2 is a partially enlarged view mainly showing an oscillator and a control unit of FIG. 1;

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 Start-up circuit 2 Start-up signal line 3 Liquid supply pump control circuit 4 Oscillator 5 Suction pump control circuit 6 Detection circuit 7 Oscillation circuit 8 Ultrasonic output signal line 9 Frequency detection circuit 10 Handpiece identification detection circuit 11 Comparison circuit 12 Identification detection output signal Line 13 Frequency detection output signal line 14 Frequency detection signal line 15 Identification detection signal line 16 Connector 17 Oscillation detection signal line 18 Timer 1 19 Timer 2 20 Reset switch 21 Foot switch 22 Irrigation liquid 23 Liquid supply pump 24 Suction pump 26 Irrigation tube 27 Handpiece 28 Irrigation nipple 29 Cover 30 Tip 31 Suction tube 32 Suction bottle 33 Function selection switch 34 Hand switch

──────────────────────────────────────────────────続 き Continued on the front page (58) Fields surveyed (Int.Cl. ⁷ , DB name) A61B 17/22 A61B 18/00-18/28 A61B 1/00 A61F 9/00

Claims (6)

(57) [Claims] 1. A handpiece comprising an ultrasonic oscillation source for generating ultrasonic vibration and a horn for transmitting and expanding the ultrasonic vibration, a liquid supply pump for supplying a liquid to the tip of the handpiece, An ultrasonic surgical apparatus comprising: an oscillator for supplying high-frequency power to a sound wave vibration source via a connector; and a control unit for controlling the oscillator and a liquid supply pump, wherein the control unit is a liquid supply pump. A control circuit and a starting circuit, the starting circuit being connected to a liquid supply pump control circuit and an oscillator by a starting signal line,
The connector is connected to the oscillator by two signal lines of ultrasonic output and identification detection. Timer 1 and Timer 2 are connected to the detection circuit of the oscillator by an oscillation detection signal line and connected to the timer 1. An ultrasonic surgical apparatus, wherein a reset switch is provided on an operation panel of a main body of the apparatus. 2. The ultrasonic surgical apparatus according to claim 1,
A suction pump for sucking and removing tissue crushed and emulsified by the ultrasonic vibration from the tip of the handpiece is provided, and a suction pump control circuit for controlling the suction pump is added to the control unit. An ultrasonic surgical apparatus, wherein a suction pump control circuit is connected to a start circuit by a start signal line. 3. An oscillation circuit connected to the connector by an ultrasonic output signal line and connected to the starter circuit by a start signal line, an oscillator circuit connected to the connector by an identification detection signal line, and an oscillation detection signal line. The ultrasonic surgical apparatus according to claim 1 or 2, further comprising a detection circuit connected to the timer 1 and the timer 2 by the following. 4. A frequency detection circuit connected to the oscillation circuit by a frequency detection signal line and a frequency detection circuit connected to the comparison circuit by a frequency detection output signal line; and a connector by an identification detection signal line; The ultrasonic surgical apparatus according to any one of claims 1 to 3, further comprising a handpiece identification detection circuit connected to the comparison circuit by an identification detection output signal line. 5. The method according to claim 1, further comprising the step of:
The ultrasonic surgical apparatus according to any one of claims (2) to (4), further comprising a function selection circuit. 6. The device according to claim 1, wherein the oscillation and the stop are performed by a foot switch connected to a starting circuit or a hand switch provided on a side surface of the handpiece.
The ultrasonic operation apparatus according to any one of claims 1 to 5.