JP3265012B2 - Surgical liquid suction device - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a surgical fluid capable of instantly switching a suction pressure, a suction amount, and an ultrasonic energy level applied to a fluid in a living body to various desired values during various operations. It relates to a suction device.

[0002]

2. Description of the Related Art Living organisms, including the human body, have various sacs separated by a membrane, and liquid in the living body is filled in the sacs made of the membrane. Some liquids in one sac may be separated by another membrane depending on the partial position and have different concentrations and viscosities. The fluid in one capsule may also need to be replaced with an appropriate medical fluid for reasons such as dysfunction or illness. When replacing the liquid in one capsule, it is important to perform the operation while maintaining the bulging shape of the capsule, so as not to damage the adjacent living tissue. For that purpose, it is necessary to perform the discharge amount of the liquid and the supply amount of the injection liquid in parallel.
As a typical example of replacing the liquid in one capsule,
There is an intraocular treatment operation. In the present invention, an eye operation will be described as an example. First, an outline of the structure of the human eye will be described with reference to FIG.

FIG. 6 shows the structure of the human eye. The eyeball 20 has a diameter of 23 to 24 mm and is filled with a vitreous body 21. The outermost surface of the eye is a transparent cornea 22, which is filled with an anterior aqueous humor 26, followed by an iris 23 and a pupil 24, followed by a crystalline lens 25. Crystalline lens 25
The thickness is changed by the tension of the ciliary body 27 and the chin small band 28. The crystalline lens 25 is a so-called lens whose thickness is adjusted so that the focal length is adjusted and an image is formed on the retina 29 accurately.

The crystalline lens 25 deteriorates due to aging or injury and becomes cloudy. When the crystalline lens 25 becomes cloudy, light is irregularly reflected or the light does not enter the retina 29. Therefore, surgery is performed and regeneration of the crystalline lens 25 is performed. Now, behind the cornea 22, there is an anterior aqueous humor 26, such as low viscosity water, and behind it is a high viscosity lens 25. The lens 25 is adjacent to the aqueous humor 26, and it is necessary to extract the lens 25 after extracting the aqueous humor 26 for replacement. The lens 25 has a higher viscosity than the aqueous humor 26 and is hardened in a gel state, so that it is called a nucleus in surgical terms. Well, for surgery of treatment inside the eyeball,
There is replacement of the lens of the eye, that is, the crystalline lens 25 (hereinafter referred to as “nucleus”). As an operation for the deterioration of the lens 25, a deliberate extracorporeal sac in which the nucleus that has deteriorated and further solidified is cut open through the cornea 22 and the aqueous humor 26 is extracted and the nucleus is extracted without injecting a substitute liquid. Extirpation (hereinafter PE
CCE) and ultrasonic vibration energy to crush the solidified nucleus (hereinafter referred to as emulsification) and absorb and discharge the nucleus while injecting artificial aqueous humor (hereinafter referred to as “K”).
PE ”).

[0005] As shown in FIG. 7, the KPE is a surgical tube 3 in which an ultrasonic absorbing tube (hereinafter also referred to as a “tube portion”) 30 and an artificial aqueous humor supply tube (hereinafter also referred to as a “sleeve”) 31 are combined.
2 (hereinafter referred to as “chip”) into the aqueous humor 26 chamber,
The nucleus of the lens 25 is broken by the ultrasonic wave transmitted through the ultrasonic absorption tube 30, and is taken out through the hole 33 of the ultrasonic absorption tube 30. At this time, so that the shape of the eyeball sac does not collapse,
The artificial aqueous humor 34 is supplied to the 26 aqueous humor from the artificial aqueous humor supply pipe 31. This KPE requires only a small incision to insert a single tube through the cornea 22 and is a technique that only causes minimal damage to the eyeball. However, more than half of the operations are still performed with PECCE that does not provide artificial aqueous humor. The reason why the PKE for supplying the artificial aqueous humor 34 has not yet been widely used is considered to be a problem to be solved.

[0006] Ultrasonic emulsification and suction (KPE) has been
It was first reported to the world by Charles Michael in 7 years, and it has been introduced in Japan for more than 20 years, but even now, more than half of surgeons still use planned extracapsular resection (PE)
(CCE) at present. KP in the future
We must pursue three points: expanding the adaptation of E, improving safety, and improving efficiency. The key to overcoming these problems is to first fully understand the characteristics of the device and to understand the surgical procedure from a three-dimensional viewpoint. multi-modulated phaco emulsificat
The ion (hereinafter, MMP) is a method of performing emulsification suction while changing the setting of the device so as not to hurt the affected part as much as possible during the operation. The application of KPE has been further expanded by this MMP, and it has become possible to efficiently and safely extract even the case of a considerably hard nucleus.

A conventional example of a method and apparatus for performing KPE by MMP will be described first. As shown in FIG. 7, the chip 32 itself is an ultrasonic vibrator, and is driven by electric vibration described later. Artificial aqueous humor 34
Is supplied into the eyeball by emulsifying the crystalline lens 25 with the tip 32.
As a result, the cornea adheres to the ciliary body due to the discharge of aqueous humor, thereby eliminating the risk of causing corneal endothelial damage.

In a conventional apparatus used for KPE surgery, the tip 32 communicates with a pump 36, and the pump 36 applies a suction pressure P to the tip of the cylindrical portion 30 of the tip 32.
Works. The sleeve 31 communicates via a tube 37 with a perfusion bottle 38 containing artificial humor. An electromagnetic valve 39 for opening and closing a passage in the tube 37 is provided in the middle of the tube 37. In FIG. 7, a foot pedal 40 is connected to a potentiometer 41, and the potentiometer 40 changes the amplification of an amplifier 42. The amplifier 42 supplies a drive signal to a drive circuit 43 of the pump 36. The setting positions of the potions 1, 2, and 3 of the potentiometer 41 are changed by the foot pedal 40. The ultrasonic oscillator 45 supplies mechanical ultrasonic waves to the tube 35 connected to the chip 32 at a constant energy rate.

The perfusion bottle 38 is arranged at a position h higher than the eyeball H, and the artificial aqueous humor perfuses from the perfusion bottle 38 to the eyeball H via the tube 37, the solenoid valve 39 and the sleeve 31. At the time of the operation, the lens 25 is emulsified by the ultrasonic energy E from the tip 32, and the emulsified lens is sucked and discharged through the cylinder 30 by the function of the pump 36. With the operation of the pump 36, the electromagnetic valve 39 is opened, and the artificial aqueous humor perfuses into the eyeball H from the perfusion bottle 38 through the tube 37. However, conventionally, for perfusion rate,
With a structure in which the middle of the tube 37 leading from the perfusion bottle 38 is simply opened and closed by the electromagnetic valve 39, the amount of artificial aqueous humor cannot be instantaneously changed to a desired flow rate, so that it is possible to cope with an efficient operation. Could not.

Next, a conventional example in which the pump 36 used at the time of KPE is a peristaltic pump will be further described. At present, there are about 10 types of ultrasonic emulsification suction devices, most of which use a peristaltic (peristaltic) pump as the suction device, and a mechanism for rotating this to obtain a suction pressure. This section introduces the suction function of the peristaltic pump. The tube perfusion rate of the operation flowing through the artificial aqueous humor supply pipe 30 of the above-described tip 32 is 3 bottles.
8 and the lumen area of the tube 37, and unless changed, the maximum perfusion rate q is constant.
Further, the suction flow rate Q is first set to an arbitrary value, and is kept at that constant value. In the "position 1" where the foot pedal 40 is depressed by one step, if the eyeball is completely water tight, the tension of the liquid is strong, the perfusate cannot penetrate, and the negative pressure p of the suction is small. Rarely done.

When the foot pedal 40 is further depressed one step to "position 2", the rotational speed of the pump (peristaltic pump) 36 is increased, and the suction flow rate Q rises at about 25 cc / min. At this time, the suction pressure p at the tip of the tip 32 (the cylindrical portion 30) is changed to the basic suction pressure (in this case, about 10
Called P). When the basic suction pressure P is applied, the nucleus is attracted and captured by the suction port at the tip of the tip 32. This nuclear capture reduces the discharge cross-section and temporarily reduces the suction flow rate Q. However, in the case of a peristaltic pump, the rotation speed of the pump 36 is increased in order to keep the suction flow rate Q constant, and the suction is performed simultaneously with the nuclear capture. The pressure p increases. Then, due to the increase in the suction pressure, the nucleus further closes the suction port 33, and accordingly, the suction pressure p is reduced to a certain level (often 60 to 20).
0mmHg). At this level, the foot pedal 40 is further depressed to “position 3”, the rotation speed of the pump 36 is increased, and emulsification suction of the nucleus is performed.
When the nuclei are crushed and sucked and the suction port 33 is opened, the suction flow rate Q rapidly increases, and at the same time, the suction pressure p rapidly returns to the basic suction pressure P. At this time, the same suction flow rate Q as the first
But the suction tube 3 that was actually crushed
When 5 returns to the original space, the suction flow rate Q transiently increases, and the anterior chamber becomes shallow (the swelling form of the capsule decreases).
Sometimes.

The above is the principle of nuclear capture and emulsification suction in the peristaltic pump. The important thing here is that
The basic suction pressure P is a primary factor affecting the nuclear tracking and capture. The basic suction pressure P is the cylindrical portion 3 of the tip 32
It is determined by the zero area and the initially set suction flow rate Q. If the suction flow rate Q is set too high, the anterior chamber becomes shallow (the swelling form of the sac may be deflated, and the cornea may stick to the ciliary body and cause corneal endothelial damage), so that the value is limited. Therefore, in order to increase the basic suction pressure P and improve the followability and capture of the nucleus, the cross-sectional area of the inner cylinder 33 of the tip 32 must be reduced.

What has been developed based on this principle is "S
-Tip ", the cross-sectional area of which is about 60% as compared with the conventional regular tip. As a result, even if the suction flow rate Q is the same, the basic suction pressure P becomes 1.5 times or more, and the followability and capture of the nucleus is remarkably improved. On the other hand, the maximum suction pressure p can be theoretically set to infinity, and it should be emphasized here that it is misunderstood that if the maximum suction pressure p is increased, the anterior chamber tends to disappear. The maximum suction pressure p is chip 3.
This is applied when the tip 2 is completely closed by the nucleus. When the tip 32 is not closed, only the basic suction pressure P is applied. The maximum suction pressure p is a force for holding the nucleus in the suction port (cylindrical portion 30), and contributes to the efficiency of emulsification suction. That is, if the nucleus is securely held at the tip of the tip 32, emulsification suction is easy, and troubles such as the nucleus being blocked in the tip 32 can be prevented.

The reason that the anterior chamber becomes shallow for a moment immediately after crushing and aspirating the nucleus is that the volume of the tube 35 from the handpiece to the main body of the instrument fluctuates temporarily. That is, the tube 35 from the tip 32 to the peristaltic pump 36 is
An elastic material such as silicone is used. Therefore, when the nucleus is captured and the suction pressure increases, the tube 3
5 collapses and its volume decreases, but immediately after the crushed, emulsified and sucked nuclei pass through the tube 35, the tube 35
In order to return to the original volume due to elasticity, the suction flow rate increases temporarily. If the suction tube 35 is made of a hard material that does not easily change in volume, or if there is a sensor that can measure the pressure in the anterior chamber, it is considered that such a defect can be solved.

The time from the capture of nuclei to the maximum suction pressure p is determined by the suction flow rate Q. Therefore, when the suction flow rate Q is small, it takes a long time to increase to the maximum suction pressure p. However, when the suction flow rate Q is large, the suction rate increases in a short time to facilitate the capture of nuclei. However, when the suction flow rate Q is large, there is also a disadvantage that the shallow anterior chamber is easily brought before capturing the nucleus. The suction flow rate was adjusted by positions 1, 2, and 3. However, since the maximum irrigation flow rate to be supplied was constant in the middle, position 1 was too large and position 3 was too large.
Then it was too little, which also caused the anterior chamber. In addition, since the ultrasonic energy E given to the nucleus is constant, the nucleus is hardly emulsified, it takes time, and conversely, the emulsification is fast, causing a shallow anterior chamber.

Next, a case where the pump 36 used at the time of KPE is a conventional venturi pump will be described. The Venturi pump utilizes the principle of a Venturi tube, and creates a negative pressure by the flow of gas to perform suction. Therefore, the rise of the suction pressure p can be set high, and the suction flow rate Q increases in proportion to the suction pressure p. The difference from the peristaltic pump is that the flow of the gas to be driven is controlled on the pump side, and the negative pressure is controlled regardless of whether the suction port 33 is closed or released. The point that reacts. However, if the suction pressure p is increased, the suction flow rate Q also increases.
It is impossible to increase the suction pressure p too much. Since the basic suction pressure P can be easily changed even when the suction port 33 is open, the capture and following of the nucleus is generally better than that of the peristaltic pump.

If the suction pressure p or the suction flow rate Q can be controlled simultaneously with the crushing and suctioning of the nuclei in the Venturi pump, the maximum suction pressure p required for holding the nuclei can be increased. However, under the present circumstances, it is impossible to strictly determine the time when the suction flow rate rapidly increases immediately after the nucleus is crushed and sucked, so that there is a drawback that the shallow anterior chamber is easily caused here as well. Therefore, it is difficult to hold the nucleus because the maximum suction pressure cannot be increased with a hard nucleus, and the efficiency is lower than that of the peristaltic pump.

[0018]

Conventionally, it has been explained that the suction flow rate is directly related to the maintenance of the anterior chamber and the posterior chamber in both the peristaltic pump and the venturi pump. In a series of operations of capturing, holding, emulsifying and sucking nuclei, there is a problem that it is impossible to set the most important appropriate ultrasonic energy, appropriate amount of artificial aqueous humor, suction flow rate, and maximum suction pressure. The present invention has been made in view of the above circumstances, and it is possible to instantaneously change a perfusion flow rate of a surgical solution to a desired amount according to a surgical situation, and to capture, hold, and emulsify and aspirate a nucleus. In a series of operations, the most appropriate ultrasonic energy E, the appropriate artificial aqueous humor q, the suction flow rate Q, and the maximum suction pressure P can be set, and a surgical liquid suction that enables safe and efficient surgery. It is intended to provide a device.

[0019]

SUMMARY OF THE INVENTION The present invention is directed to a first tube for sucking and discharging the old liquid when replacing the old liquid filled in the sac made of the membrane with a new liquid. A tube which is inserted into the capsular bag in parallel with a second tube for supplying liquid, an ultrasonic generator for generating ultrasonic energy to be transmitted to the tube, and an ultrasonic energy A power setting section for setting a limit value of the level, a bomb connected to the first pipe for generating a suction pressure for sucking and discharging the old liquid, and a suction pressure for generating the suction pressure which this pump will generate. A suction pressure setting section for setting a limit value,
A pressure sensor for detecting the suction pressure, a first control unit for controlling the operation of the pump in accordance with an instruction from the pressure sensor and the set limit value of the suction pressure, and a fluid for flowing through the first pipe. A suction amount setting unit for setting a limit value of the suction amount, a flow sensor provided downstream of the pump for detecting the flow rate, and controlling the operation of the pump according to an instruction of the flow sensor and the limit value of the suction amount. A second control unit, a supply tank that supplies the new liquid, and an irrigation flow setting unit that sets a limit value of an irrigation flow when the new liquid is supplied by flowing down the second pipe by natural fall. When,
In a surgical liquid suction apparatus employing a third control unit that controls the perfusion flow according to the limit value, the supply tank is configured by a plurality of independent supply tanks having different height differences,
Each of these supply tanks is provided with a supply valve, the irrigation flow rate setting unit and the power setting unit, the suction pressure setting unit, and the suction amount setting unit are each divided into a plurality of sections, and when the liquid is replaced, the liquid is removed from the membrane. In response to one swelling state of the sac, the supply limit value is set in advance in one section of the perfusion flow setting unit as the supply limit value of one perfusion flow obtained by combining a plurality of opening and closing of the supply valve. For each discharge limit value, one level of discharge limit value for the ultrasonic energy is set in one section of the power setting section, and one discharge limit value for suction pressure generated by the pump is set to the suction pressure. In one section of the setting section, one discharge limit value regarding the suction amount of the fluid flowing through the first pipe is set in advance in one section of the suction amount setting section, and the threshold value corresponds to another bulging state of the capsule. And other perfusion The supply limit value is preset in another section of the perfusion rate setting section, and for each discharge limit value, another level of discharge limit value is set in another section of the power setting section. When another discharge limit value is set in another section of the suction pressure setting section, and another discharge limit value is set in advance in the other section of the suction amount setting section with respect to the suction amount, when the liquid is replaced. The supply limit value is set from among the plurality of sections of the perfusion rate setting unit, and the ultrasonic energy discharge limit value is set to the power setting so as to keep the changing swelling state of the membrane sac in the desired optimum state. A plurality of sections of the section, a limit value for suction pressure discharge is selected from the plurality of sections of the suction pressure setting section, and a limit value for suction amount discharge is selected from the plurality of sections of the suction amount setting section by the same switch. And the selected According to the supply limit value, the opening and closing of the supply valve of each of the supply tanks is controlled by the third control unit to limit the irrigation flow rate of the new liquid to be supplied and to perform the discharge of the selected ultrasonic energy. According to the limit value, the ultrasonic generator is controlled to transmit generated ultrasonic energy to the tube, and the first control unit controls the pump according to the selected discharge limit value of the suction pressure. The second control unit controls the pump to limit the suction amount of the fluid flowing through the first pipe, according to the discharge limit value of the suction amount further selected. The gist of the present invention is to perform the operation of exchanging the liquid and sequentially perform the operation in accordance with the next change of the bulging state of the capsule by selecting the best partition position by the changeover switch.

[0020]

In FIG. 1, two perfusion bottles 5, 6 are arranged at a position higher than the eyeball 20, and the perfusion bottles 5, 6 are arranged.
, The artificial aqueous humor perfuses into the eyeball 20 via the tubes 5a and 6a and the solenoid valve described later, respectively. The horizontal position of the perfusion bottle 5 is higher than that of the perfusion bottle 6, and the solenoid valves V1 and V
2 can be opened and closed independently.

The body 1 is provided with pinch knobs 7 and 8, the above-mentioned peristaltic pump and ultrasonic oscillator are built in, and a chip 32 is provided via a suction tube 35. In addition, control box 2
Are connected, and a rotary switch 3 is connected to the control box 2. The control box 2 is composed of three channels, and the channel 1 has a knob E1 for setting ultrasonic energy and a knob P for setting suction pressure.
1. A knob Q1 for setting a suction flow rate is provided as a set. The channel 2 is provided with a knob E2 for setting ultrasonic energy, a knob P2 for setting suction pressure, and a knob Q2 for setting suction flow rate. Knob E for setting ultrasonic energy to channel 3
3. A knob P3 for setting the suction pressure and a knob Q3 for setting the suction flow rate are provided as a set. Each of the channels 1, 2, and 3 is an equivalent circuit, but is set with a different set value and any one of the channels is selected.

Next, the circuit configuration of each channel will be described with reference to FIG. Channel 1 has knob E in register R1
1, the values of P1, Q1 (e1, p1, q1) are set, the channel 2 is set with the knobs E2, P2, Q2 (e2, p2, q2) in the register R2, and the channel 3 is set with the knobs in the register R3. The values of E3, P3, Q3 (e3, p3,
q3) is set. The set value of each of the registers R1, 2, and 3 selects the value of any one of the channels by the selector S1. The selector S1 performs a selection function according to the setting position of the rotary switch 3. As shown in FIG. 1, the rotary switch 3 can select OFF, channel 1, channel 2, or channel 3 according to the angular position. Each channel 1,
Knobs E1, E2, and E3 of a few are weak, medium, and strong scales of the ultrasonic energy, and knobs P1, P2, and P3
Indicates the low, medium, and strong scales for the suction pressure, and the knob Q1,
Q2 and Q3 have low, medium, small, medium, and many scale positions for the suction flow rate. The output of the selector S1 is given to the buffer register R4, and the ultrasonic energy set amount e1
Is transferred to the drive unit in FIG. 4, and the suction pressure is set to the set amount p1, and the set amount q1 of the suction flow rate is transferred to the control unit in FIG.

The ultrasonic energy set amount e1 designates the amplitude value of the oscillator D2 of the driving device in FIG. 4, and the ultrasonic signal generated by the oscillator D2 causes the vibrator O1 to vibrate according to the amplitude value. This mechanical vibration is transmitted to the tip 32 via the suction tube 35. Further, the set amount p3 of the suction pressure is transferred to the first comparator C1 in FIG. 3, where it is compared with the negative pressure p from the pressure sensor 19. The first comparator is e1
> P, the signal 1 is output to the OR circuit 18, and the OR circuit 1
8 supplies the signal 1 to the drive circuit D1. The set amount q1 of the suction flow rate is transferred to the second comparator C2 in FIG. 3, and is compared with the flow rate q from the flow rate sensor 17 in the second comparator C2.
If q1> q, the second comparator outputs the signal 1 to the OR circuit 18, and the OR circuit 18 supplies the signal 1 to the drive circuit D1.
The drive circuit D1 rotates the motor of the pump 15 as long as the signal 1 is continuously received from any of them.

The driving circuit D1 rotates the motor of the pump 15 as long as the signal 1 is continuously received from the first comparator C1 and the second comparator C2. The pressure sensor 19 is a suction tube 3
5 and is provided upstream of the pump 15. The flow sensor 17 communicates with the inner diameter of the suction tube 35 and is provided downstream of the pump 15. The pinch knobs 7 and 8 on the main body 1 set control values 0 or 1 in registers R5 and R6 in FIG. The selector S2 selects one of the registers R5 and R6 or the registers R5 and R6 at the same time for the set value (0, 1) of the registers R5 and R6. The selector S2 performs a selection function according to the setting position of the rotary switch 3.

Next, an operation of performing an operation using the apparatus will be described. First, module 1 for selecting channel 1 will be described. In a natural state, the eyeball is swollen, and the position where the ultrasonic wave is first applied is considerably close to the cornea 22. At first, the operation range of the tip 32 is also limited to the inside of the anterior chamber. What is important here is to maintain a deep anterior chamber to minimize corneal endothelial damage caused by ultrasound. Therefore, the perfusion G is sufficient, the suction flow Q is low,
The maximum suction pressure P is low to medium so that the chip does not sink into the nucleus. The ultrasonic energy E depends on the hardness of the nucleus, but is set at a medium level. The pinch knobs 7 and 8 are both in the ON position. In the channel 1, the knob E1 is on the "medium" scale of the ultrasonic energy, and the knob P is on.
Numeral 1 is set to a scale of "low" of the suction pressure, and knob Q1 is set to a scale of "small" of the suction flow rate.

When the channel 1 is selected by the pen-type rotary switch 3, the suction flow rate Q is low, the maximum suction pressure P is low, the ultrasonic energy E is medium, and the perfusion G is a sufficient amount of high perfusion. Each of the bottles 5 is set instantaneously. In order to reduce the basic suction amount Q, one method is to turn the bevel of the chip downward so that the tip of the chip easily contacts the nucleus and reduce the suction area. By changing the oscillation direction of the ultrasonic energy E by turning the tip downward, the endothelial damage to the cornea 22 may be reduced. The suction flow rate Q and the maximum suction pressure P are set low, and the ultrasonic energy E is set at a moderate level (or high according to the hardness of the nucleus). The selection of channel 1 is module 1. Tip operation
The main task is to remove the nucleus by "pushing" the nucleus.
Suction is the next step.

Next, module 2 for selecting channel 2 will be described. If the nucleus 25 is cut to some extent, the anterior chamber becomes slightly deeper. At this point, the process proceeds to the next step of capturing and emulsifying the nucleus. At this stage, the gap between the chip and the endothelium of the cornea 22 is larger than in the case of module 1, so that the perfusion G supplies a maximum and sufficient amount and does not become so nervous to changes in the anterior chamber depth. You may. Also, the ultrasonic energy E
Can be strengthened. What is important here is how to efficiently perform emulsification suction. The operation of the chip is module
In the case of 2, the main method is "trapping", in which emulsification and suction are performed efficiently while attracting the nucleus. As described above, in order to easily capture the nucleus, it is necessary to increase the basic suction pressure P. Therefore, here, the suction flow rate Q is set to be the highest, and the maximum suction pressure P is also set to a higher value. Therefore, the perfusion G is set to the maximum amount, the suction flow rate Q is set to the maximum, and the maximum suction pressure P is set to the maximum. The ultrasonic energy E is set to be the strongest.

The pinch knobs 7 and 8 are both in the ON position.
In channel 2, knob E2 is the ultrasonic energy "
The scale of "strong", the knob P2 is set to the "high" scale of suction pressure, and the knob Q2 is set to the "high" scale of suction flow rate. When the channel 2 is selected by the pen-type rotary switch 3, The suction flow rate Q is set to be large, the maximum suction pressure P is set to be high, the ultrasonic energy E is set to be strong, and the perfusion G is set to be used instantaneously by the maximum amount of both the perfusion bottles 5 and 6. By doing so, the peripheral nuclei can also be attracted to the center by the tip, securely held, and efficient emulsification suction can be performed efficiently with high energy.In this case, the tip bevel is turned sideways, and immediately before emulsification suction of the nucleus Pay attention to erroneous aspiration of the sac and posterior capsule, that is, set the suction flow rate high, the maximum suction pressure high, and the ultrasonic energy strength.
ule 2.

Next, module 3 for selecting channel 3 will be described. As the emulsification suction progresses, the operation space of the tip becomes wider, but it is important for the module 3 to prevent breakage of the posterior capsule. In other words, since most of the nucleus has been lost, the shape of the posterior capsule is lost, the behavior of the posterior capsule becomes unstable due to a change in the internal pressure of the eyeball, and the chip is easily erroneously aspirated. As described above, the transient increase in suction flow rate due to the change in tube lumen volume immediately after emulsification suction (elevation of the posterior capsule due to a decrease in intraocular pressure) is proportional to the maximum suction pressure.
Then, the maximum suction pressure P is a low standard. In many cases, a high ultrasonic energy E is not required here, so that it is a standard to lower the energy as much as possible. In addition, in order to maintain the efficiency, the suction flow rate Q is moderate. In channel 3, pinch knobs 7 and 8 are both in the ON position, and knob E
3 is a knob of P3 on the "weak" scale of ultrasonic energy.
Is set to a "low" scale of the suction pressure, and the knob Q3 is set to a "medium" scale of the suction flow rate. When the channel 3 is selected by the rotary switch 3, the suction flow rate Q is set to moderate, the maximum suction pressure P is low, the ultrasonic energy E is weak, and the perfusion flow q is set to the lowest perfusion bottle 6 instantly. This is module 3.

In this way, the conditions can be easily set at hand, so that a safer and more efficient emulsification suction operation can be performed. The following is a summary of the condition settings. module 1 module 2 module 3 Channel 1 Channel 2 Channel 3 Suction flow rate Q Low Multi Medium Suction pressure P Low / Medium High Low Ultrasonic energy E Medium Strong Weak Perfusion rate q Maximum Maximum Minimum

In order to further expand the adaptation and perform the KPE efficiently, the setting is not limited to the above setting, and a setting most suitable for each situation can be selected. As described herein, the KPE is roughly composed of three aspects, and it is possible to set the suction flow rate, the maximum suction pressure, the ultrasonic energy, and the basic suction pressure determined by them according to each of the three aspects. In the KPE of the present application, the suction flow rate, the maximum suction pressure, the ultrasonic energy, and the irrigation flow rate are selected according to the skill of the operator or the hardness of the nucleus, and if the setting is appropriately and instantaneously changed according to the situation, Emulsification suction can be performed smoothly from the beginning to the end. Time loss is eliminated, and operation time can be reduced. When it is desired to finely adjust the perfusion flow according to the progress of the operation, three or more perfusion bottles and corresponding solenoid valves are provided. In this case, the height of all perfusion bottles will be different.

[0032]

As described above, according to the surgical liquid suction device according to the present invention, the perfusion flow rate of the surgical liquid can be instantaneously changed to a desired amount in accordance with the operation situation. In a series of operations of capturing, holding, and emulsifying suction of the nucleus, the most appropriate ultrasonic energy E, the appropriate amount of artificial aqueous humor g, the suction flow rate Q, and the maximum suction pressure P can be set, and a safe and efficient operation can be performed. You can now do. For example, it is possible to prevent the occurrence of corneal endothelial damage during eyeball surgery, and to shorten the operation time. Further, in the above-described embodiment, an example in which the surgical solution is perfused into the eyeball has been described. However, the present invention is not limited to the operation of the eyeball, and any other method may be used as long as the surgical solution is perfused to a substantially closed position. It can also be applied to surgery.

[Brief description of the drawings]

FIG. 1 is a diagram showing an overall configuration of a surgical liquid suction device of the present application.

FIG. 2 is a diagram showing a main part of a control circuit of the surgical liquid suction device of the present application.

FIG. 3 is a diagram showing a main part of a drive circuit of the surgical liquid suction device of the present application.

FIG. 4 is a view showing a related structure of a tip of the surgical liquid suction device of the present application.

FIG. 5 is a partial cross-sectional view of a general surgical tip and an eyeball showing a state during a surgical operation.

FIG. 6 is a partial sectional view of a general eyeball.

FIG. 7 is a view showing the overall configuration of a conventional surgical tip and a surgical liquid suction device.

[Explanation of symbols]

 2 set setting section (control box) 3 changeover switch (rotary switch) 15 pump 18 flow rate sensor 19 pressure sensor 20 capsule (eyeball) 32 main body 34 new liquid (artificial aqueous humor) 34 tube (chip) C1 first control section C2 Second control unit E1, E2, E3 Power setting unit O1, D2 Ultrasonic generator P1, P2, P3 Suction pressure setting unit Q1, Q2, Q3 Suction amount setting unit

──────────────────────────────────────────────────続 き Continued on the front page (58) Field surveyed (Int. Cl. ⁷ , DB name) A61M 1/00 A61B 18/00 A61F 9/007

Claims (2)

(57) [Claims] 1. A first pipe for sucking and discharging the old liquid and a second pipe for supplying the new liquid for replacing old liquid filled in a sac made of a membrane with new liquid. Are coupled and inserted into the capsule, an ultrasonic generator that generates ultrasonic energy to be transmitted to the tube, and a power setting that sets a limit value of the level of the ultrasonic energy. A bomb connected to the first tube to generate a suction pressure for sucking and discharging the old liquid; and a suction pressure setting unit for setting a limit value of a suction pressure that the pump will generate. A pressure sensor for detecting the suction pressure, a first control unit for controlling the operation of the pump according to an instruction from the pressure sensor and the set limit value of the suction pressure, and a fluid that will flow in the first pipe. Suction to set the limit value of suction volume An amount setting unit, a flow sensor provided downstream of the pump to detect the flow rate, a second control unit that controls the operation of the pump according to an instruction from the flow sensor and a limit value of the suction amount, and the new control unit. A supply tank for supplying a liquid, a perfusion rate setting unit for setting a limit value of a perfusion rate when the new liquid flows down the second pipe by natural fall, and a perfusion rate according to the limit value. And a third control unit for controlling the flow rate. The supply tank is constituted by a plurality of independent supply tanks having different height differences, and a supply valve is provided in each of these supply tanks. And the power setting unit, the suction pressure setting unit, and the suction amount setting unit are each divided into a plurality of sections, and corresponding to one swelling state of the sac, In one section of the perfusion rate setting unit, the supply limit value of one perfusion flow in which a plurality of opening and closing are combined, and for each discharge limit value, the one-level discharge limit value for the ultrasonic energy is set in the power setting. In one section of the section, one discharge limit value is set for the suction pressure generated by the pump, and in one section of the suction pressure setting section, one discharge limit value is set for the suction amount of the fluid flowing through the first pipe. Is set in advance in one section of the suction amount setting section, and each is set in accordance with another swelling state of the sac, and another supply limit value of the perfusion rate is set in another section of the perfusion rate setting section. For each discharge limit value, another level of the discharge limit value in another section of the power setting unit, and for the suction pressure, another discharge limit value of the suction pressure setting unit in another section, The other discharge limit value for the suction amount is Preliminarily set as a set in the other section of the fixed part, respectively, and further set a plurality of sets of the supply limit value and the discharge limit value in another section in advance, respectively, in accordance with further various bulging states, When the operation is started, the supply limit value is set from among the plurality of sections of the perfusion rate setting unit, and the ultrasonic energy discharge limit value is set so as to keep the changing bulging state of the capsule at a desired optimum state. From the plurality of sections of the power setting section, the same changeover switch is used to set the discharge limit value of the suction pressure from the plurality of sections of the suction pressure setting section, and the discharge limit value of the suction amount from the plurality of sections of the suction amount setting section. Selecting a set, controlling the opening and closing of the supply valve of each supply tank by the third control unit in accordance with the selected supply limit value, and restricting the perfusion flow rate of the new liquid to be supplied; , Selected The ultrasonic generator is controlled according to the discharge limit value of the ultrasonic energy to transmit the generated ultrasonic energy to the tube, and the first ultrasonic discharge device is controlled according to the discharge limit value of the selected suction pressure. The control unit controls the pump to limit the suction pressure, and further according to the selected discharge limit value of the suction amount, the second control unit controls the pump to suction the fluid flowing through the first pipe. Limit the amount of
Perform the operation of replacing the liquid, and then, in response to a change in the swelling state of the sac with the progress of surgery, switch to select another set with the changeover switch, and select the selected supply limit value and each A surgical liquid suction apparatus for performing an operation while keeping the sac in the best condition based on a discharge limit value. 2. The surgical liquid suction device according to claim 1, wherein the changeover switch comprises a pen-type rotary switch manually operated.