JP3270161B2 - Ultrasound therapy equipment - 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 treatment apparatus for transmitting ultrasonic vibrations to a tissue in a body cavity to perform resection.

[0002]

2. Description of the Related Art In general, there is known an ultrasonic therapy apparatus for transmitting ultrasonic vibrations to a tissue in a body cavity to perform resection. This ultrasonic treatment apparatus is provided with a handpiece and an apparatus main body on the power supply side. In addition, the handpiece is provided with a grip portion having a built-in ultrasonic vibrator and a probe for transmitting ultrasonic vibration generated by the ultrasonic vibrator in the grip portion.

When the ultrasonic vibrator is operated, the ultrasonic vibration generated by the ultrasonic vibrator is transmitted to the distal end side of the probe via the probe, so that the distal end of the probe comes into contact with the diseased tissue of the living body. The ultrasonic vibration crushes or emulsifies the affected tissue of the living body.

[0004] A suction passage penetrating in the direction of the central axis is provided inside the probe and the vibrator. The proximal end of this suction path is connected to a suction pump on the device main body side via a suction tube, and sucks and removes the crushed tissue out of the body cavity.

[0005] Further, a sheath covering the probe is provided around the probe, and a perfusate is sent from a water supply pump on the apparatus main body side to a gap between the probe and the sheath, and the probe is directly cooled to thereby provide an ultrasonic wave. 2. Description of the Related Art It has been practiced to prevent a patient or an operator from being burned by the heat of a probe generated during vibration. In this case, when the perfusate flows out of the distal end opening of the sheath to the outside, it hits the distal end of the ultrasonically vibrating probe and is atomized, which may significantly obstruct the operation field.

Therefore, for example, Japanese Unexamined Patent Publication (Kokai) No. 3-151954 discloses that a double-structured sheath is formed, and a perfusion solution recovery path is provided in this sheath separately from the perfusion solution supply path, thereby recovering the perfusion solution. There is disclosed a configuration in which the perfusion liquid is prevented from flowing out of the sheath from the distal end opening to the outside.

In this case, the inner sheath and the outer sheath are provided in the double-structured sheath. Then, the perfusate sent from the water pump to the handpiece via the water tube from the water pump on the device body flows toward the distal end in a water channel formed between the probe and the inner sheath covering the probe, for example. A state in which a U-turn near the distal end of the sheath flows through the sub-suction path formed between the inner sheath and the outer sheath that covers the inner sheath toward the rear end side, and merges with the flow of the suction fluid in the suction tube. , And is collected to the suction pump side.

In addition, the ultrasonic vibration of the probe can be controlled by a surgeon, for example, by a foot switch. In this case, as shown in FIG. 9, the on / off operation of the water pump is linked to the on / off operation of the ultrasonic vibration of the probe.

When the above-mentioned ultrasonic treatment apparatus is used in open surgery, continuous suction can be used. However, when used in laparoscopic surgery, continuous suction is used. If this is done, the insufflation gas will be sucked, so that the abdominal cavity may be deflated and a sufficient visual field may not be secured.

For this reason, when used in laparoscopic surgery, a pinch valve for crushing the suction tube and cutting off the suction flow path is provided in the middle of the suction tube as disclosed in Japanese Patent Application No. 3-184852. As shown in FIG. 9, by linking the opening and closing operation (suction operation) of the pinch valve with the ultrasonic oscillation, the suction of insufflation gas is suppressed to the minimum necessary.

[0011]

However, since the auxiliary suction passage formed between the outer sheath and the inner sheath for collecting the perfusate is communicated with the suction tube, the ultrasonic wave as in the above-mentioned conventional structure is not provided. In the case where the pinch valve is closed in conjunction with the stop of the oscillation and the suction pressure does not act on the suction tube, the suction path at the distal end side from the communication portion between the sub suction path and the suction tube at the time of the stop of the ultrasonic oscillation. In addition, there is a problem that the fluid remaining in the auxiliary suction path flows backward, flows out into the abdominal cavity from the distal opening of the probe or the distal opening of the sheath, and contaminates the operative site with a perfusate containing blood or body fluid.

SUMMARY OF THE INVENTION The present invention has been made in view of the above circumstances, and has as its object to control an ultrasonic wave capable of preventing a suction object from flowing backward when a suction operation is controlled in conjunction with ultrasonic oscillation. It is to provide a treatment device.

[0013]

SUMMARY OF THE INVENTION The present invention treats living tissue.
An ultrasonic transducer capable of generating ultrasonic vibrations to the front
Driving means for driving the ultrasonic transducer , and
An ultrasonic controller for controlling the operation timing, the ultrasonic sound
Driven by the driving means under the control of the wave control means.
The ultrasonic vibration from the ultrasonic transducer is applied to the living tissue.
An ultrasonic transmission member capable of transmitting the ultrasonic transmission member,
Before being provided at the tip and transmitted by the ultrasonic transmission member
The tissue piece treated by the ultrasonic vibration is opened for recovery.
Opening and a suction pipe having one end communicating with the opening
When connected to the other end of the suction channel, through the suction conduit
Suction means for sucking through the opening and
According to the start timing of the driving means by the control means,
Start the suction operation from the opening by the suction means.
Start control means and the driving by the ultrasonic control means
Timing delayed by a predetermined time from the stop timing of the means
Stops the suction operation from the opening by the suction means
An ultrasonic treatment apparatus characterized by comprising a stop control means, the for.

[0014]

[Function] When the ultrasonic oscillation is stopped, by the stop control means.
From the stop timing of the driving means by the ultrasonic control means
From the opening by the suction means at the timing delayed by a fixed time
When the ultrasonic oscillation is stopped by stopping the suction operation of
The suction in the suction line at the point
It can be collected .

[0015]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS Hereinafter, a first embodiment of the present invention will be described with reference to FIGS. FIG. 1 shows a schematic configuration of the entire ultrasonic therapy apparatus. This ultrasonic therapy apparatus is provided with a handpiece 1 and an apparatus main body 2 on the power supply side.

The handpiece 1 has a gripper 3, an ultrasonic vibrator (ultrasonic oscillation means) 4 built in the gripper 3, and an ultrasonic vibrator 4 in the gripper 3. And a probe 6 for transmitting the transmitted ultrasonic vibration. When the ultrasonic vibrator 4 operates, an electric signal sent from the oscillation circuit 5 in the apparatus main body 2 is converted into mechanical vibration by the ultrasonic vibrator 4, and the mechanical vibration is connected to the tip of the vibrator 4. Is transmitted to the probe 6, and the distal end 6 a of the probe 6 is pressed against the affected tissue,
It is designed to crush the tissue.

Further, inside the probe 6 and the vibrator 4, a suction path 7 penetrating in the direction of the central axis is provided.
The proximal end of the suction path 7 is connected to a suction pump 9 via a suction tube 8. The tissue crushed by the ultrasonic vibration is sucked and removed to the outside of the body cavity through the suction passage 7 and the suction tube 8 with the operation of the suction pump 9.

A double-structured sheath 10 is provided around the probe 6. The sheath 10 is provided with an inner sheath 11 and an outer sheath 12. A water supply passage 13 is formed between the probe 6 and the inner sheath 11, and a sub suction passage 1 is provided between the inner sheath 11 and the outer sheath 12.
4 are formed. In this case, the tip of the probe 6 protrudes more outward than the tip of the outer sheath 12,
The distal end of the outer sheath 12 projects outward from the distal end of the inner sheath 11.

The perfusate sent to the handpiece 1 from the water supply pump 15 of the apparatus body 1 via the water supply tube 16 is supplied to the water supply passage between the probe 6 and the inner sheath 11 as shown by an arrow in FIG. After flowing toward the distal end through the inside of the sheath 13, the U-turn is performed near the distal end of the sheath 10, and flows toward the rear end through the sub-suction path 14 between the inner sheath 11 and the outer sheath 12. The suction fluid is collected by the suction pump 9 in a state where the suction fluid flows into the suction tube 8 via the suction tube 8.

Further, a control circuit 18 formed by, for example, a microcomputer and its peripheral circuits is provided in the apparatus main body 1. The oscillation circuit 5, the suction pump 9, and the water supply pump 15 are connected to the control circuit 18, and a pinch valve 19 and a foot switch 20 are respectively connected to the control circuit 18. In this case, the pinch valve 19 is provided with an operating member that crushes the middle part of the suction tube 8 to shut off the suction channel. When the pinch valve 19 is opened, the operation member is held at a position for holding the suction flow path in the suction tube 8 in an open state, and when the pinch valve 19 is closed, the operation member is held by the operation member.
Of the suction channel by crushing the middle part of the suction channel.

The operation of the oscillation circuit 5, the suction pump 9, the water supply pump 15, and the pinch valve 19 is controlled by the control circuit 1
8. When the ultrasonic therapy apparatus is used, the on / off operation of the ultrasonic transducer 4 in response to the on / off operation of the foot switch 20 by the operator, that is, the oscillation / stop of the ultrasonic vibration of the probe 6 can be controlled. As shown in FIG. 2, the water pump 15 is linked with the oscillation / stop operation of the ultrasonic oscillation.
Are turned on and off, and the water supply state and the stop state are switched.

Further, as shown in FIG. 2, after the ultrasonic oscillation by the ultrasonic vibrator 4 is stopped, the control circuit 18 delays a predetermined time Δt to close the pinch valve 19 to stop the suction operation. Suction control means is provided. In this case, the delay time Δ of the closing operation of the pinch valve 19
t is set so that all the fluid remaining in the suction path 7 and the sub suction path 14 can be sucked.

Next, the operation of the above configuration will be described.
First, when the ultrasonic treatment apparatus is used, the oscillation circuit 5 in the apparatus main body 2 is turned on by the operator's operation of turning on the foot switch 20, and the ultrasonic transducer 4 is driven. Further, in conjunction with the driving of the ultrasonic vibrator 4, the water supply pump 15 is turned on as shown in FIG. 2 to start the water supply operation, and at the same time, the pinch valve 19 is opened and the suction operation by the suction pump 9 is performed. Is started.

At this time, the perfusate supplied from the water supply pump 15 is supplied from the water supply tube 16 to the probe 6 and the inner sheath 1.
After being introduced into the water channel 13 between the
3 flows toward the distal end of the probe 6, and the probe 6
Is cooled directly.

Further, the perfusate that has reached the distal end of the inner sheath 11 makes a U-turn near the distal end of the sheath 10 and
The suction tube 8 flows through the auxiliary suction path 14 between the first sheath 1 and the outer sheath 12 toward the rear end, and passes through the auxiliary suction tube 17.
The liquid is collected to the suction pump 9 in a state where it is merged with the flow of the suction fluid in the inside.

When the operator turns off the foot switch 20, the oscillation circuit 5 in the apparatus main body 2 is turned off, and the driving of the ultrasonic transducer 4 is stopped. Further, in conjunction with the drive stop operation of the ultrasonic vibrator 4, the water supply pump 15 is turned off as shown in FIG. 2, and the water supply operation is stopped.

As shown in FIG. 2, the pinch valve 19 is closed with a delay of a predetermined time Δt from the time when the ultrasonic oscillation of the ultrasonic transducer 4 is stopped. At this time, the operation member of the pinch valve 19 crushes the middle part of the suction tube 8 to cut off the suction flow path and stop the suction operation.

Therefore, in the above configuration, after the ultrasonic oscillation is stopped, the suction operation is continued for a predetermined delay time Δt. The aspirated body fluid such as a piece of tissue or blood, and the perfusate collected through the sub suction path 14 and the sub suction tube 17 are collected without flowing back into the abdominal cavity by the suction operation within the delay time Δt.

Therefore, after the elapse of the delay time Δt, when the pinch valve 19 is closed and the suction is stopped, the suction on the distal end side of the communicating portion between the sub suction path 14 and the suction tube 17 is performed as in the conventional case. The fluid remaining in the passage 7 and the auxiliary suction passage 14 can be prevented from flowing backward to the inside of the abdominal cavity from the distal opening of the probe 6 or the distal opening of the sheath 10, and the operative site can be mixed with blood or body fluid. It is possible to prevent the perfusion solution from being stained.

Further, the delay time Δt of the closing operation of the pinch valve 19 is set to such an extent that all the fluid remaining in the suction path 7 and the sub suction path 14 can be sucked, thereby preventing the insufflation gas from being continuously sucked. You can also.

FIG. 3 shows a handpiece 1 of an ultrasonic therapy apparatus according to a second embodiment of the present invention. This is a modification of the flow of the perfusate in the double-layered sheath 10 of the first embodiment.

That is, in this embodiment, a water supply passage 21 is formed between the inner sheath 11 and the outer sheath 12, and a sub suction passage 22 is formed between the probe 6 and the inner sheath 11. Further, a water supply tube 16 is provided at the base end of the water supply passage 21.
Are connected to each other, and a leak hole 23 communicating between the sub suction path 22 and the suction path 7 is formed at the base end of the probe 6.

The perfusate sent to the handpiece 1 from the water supply pump 15 of the apparatus body 1 via the water supply tube 16 is supplied between the outer sheath 12 and the inner sheath 11 as shown by an arrow in FIG. Flows in the water channel 21 toward the tip,
The U-turn near the distal end of the sheath 10 flows toward the rear end in the sub suction path 22 between the inner sheath 11 and the probe 6, and the probe 6 is cooled.

Further, the perfusate guided to the rear end in the sub suction path 22 passes through the leak hole 23 of the probe 6 and
It merges with the flow of the suction fluid inside, and is collected by the suction pump 9 through the suction tube 8.

Therefore, also in this embodiment, after the ultrasonic oscillation is stopped, the suction operation is continued for a predetermined delay time Δt, so that when the ultrasonic oscillation is stopped, the suction is performed through the suction path 7. The body fluids such as tissue pieces and blood, and the perfusate collected through the auxiliary suction channel 22 can be collected without backflow into the abdominal cavity by the suction operation within the delay time Δt. Therefore, also in this case, similarly to the first embodiment, after the elapse of the delay time Δt, the pinch valve 1
When the suction operation is stopped by the closing operation of the suction pipe 9, the fluid remaining in the suction path 7 and the sub suction path 14 on the distal end side from the communicating portion between the sub suction path 14 and the suction tube 17 is probed as in the related art. 6 can be prevented from flowing back into the abdominal cavity from the distal opening of the sheath 6 or the distal opening of the sheath 10, and the operative site can be prevented from being contaminated with blood or a perfusate mixed with body fluid.

FIG. 4 shows a handpiece 1 of an ultrasonic therapy apparatus according to a third embodiment of the present invention. This is achieved by providing a sheath 31 formed by a single tube on the outer periphery of the probe 6 of the first embodiment, forming a water supply passage 32 between the probe 6 and the sheath 31, and forming a distal end of the probe 6. A leak hole 33 communicating between the water supply passage 32 and the suction passage 7 is formed.

The perfusate sent from the water pump 15 on the device body 1 side to the handpiece 1 via the water supply tube 16 is supplied to the water supply passage 32 between the sheath 31 and the probe 6 as shown by an arrow in FIG. The probe 6 is cooled toward the tip, the probe 6 is cooled, and the probe 6 makes a U-turn near the tip of the sheath 31 to join the flow of the suction fluid in the suction passage 7 through the leak hole 33 of the probe 6, thereby forming a suction tube. After passing through the inside 8, it is collected by the suction pump 9.

Therefore, even in the case of the above-described configuration, after the ultrasonic oscillation is stopped in the same manner as in the first embodiment, the suction operation is continued for a predetermined delay time Δt to thereby control the reverse flow of the suction object. Can be prevented.

FIG. 5 shows a schematic configuration of an entire ultrasonic therapy apparatus according to a fourth embodiment of the present invention. In this embodiment, a high-frequency ablation power source 41 is further added to the ultrasonic treatment apparatus of the first embodiment, and a high-frequency current is supplied to the probe 6 to perform incision and coagulation.

That is, the high-frequency ablation power source 41 is disposed in the apparatus main body 2 of the ultrasonic treatment apparatus, and the high-frequency ablation power source 41 is connected to an on / off operation hand switch 42 and a counter electrode plate 43, respectively. I have.

When the ultrasonic treatment apparatus is used, the surgeon presses the distal end 6a of the probe 6 against the affected tissue of the patient with the return electrode plate 43 attached to the patient, and turns on the foot switch 20. When the affected tissue is crushed by ultrasonic vibration and the hand switch 42 is turned on, a high-frequency current is supplied to the probe 6 to perform incision and coagulation.

Therefore, even in the case of the above-mentioned structure, after the ultrasonic oscillation is stopped in the same manner as in the first embodiment, the suction operation is continued for a predetermined delay time Δt to thereby control the reverse flow of the suction object. Bleeding during crushing of the tissue by ultrasonic vibration, and when the operator stops ultrasonic oscillation and performs high-frequency coagulation, stops the oscillation of the ultrasonic oscillator 4 as in the past. Immediately after that, the suctioned material remaining in the suction path 7 and the sub suction path 14 flows back into the abdominal cavity, so that the operative site becomes dirty and the bleeding site is lost, and it is possible to prevent the bleeding site from becoming unidentifiable.

Further, since there is no possibility that the operative site is flooded due to the backflow of the suctioned material, there is no possibility that the high-frequency current is dispersed and coagulation cannot be performed, and safety can be improved.

FIG. 6 shows a fifth embodiment of the present invention. This is because when the ultrasonic therapy apparatus is used, the water pump 15 is turned on simultaneously with the ultrasonic oscillator 4 and the pinch valve 1
The suction operation by the opening operation of No. 9 is started.

At the same time as the foot switch 20 is turned on, the water supply pump 15 is turned on and the pinch valve 1 is turned on.
Since the suction operation can be started by the opening operation of step 9, the time lags Δt ₁ , Δt ₂ shown in FIG. 6 which occur from when the foot switch 20 is depressed until the ultrasonic vibrator 4 oscillates with a predetermined output. Cooling water can be supplied around the probe 6 during the period.

Since the resonance frequency of the handpiece 1 varies depending on the load applied to the probe 6 and conditions such as water supply and suction, the frequency scan S is started when ultrasonic oscillation is started.
1. It is necessary to find a resonance point by S2. Therefore, a time lag Δt ₁ Δt ₂ shown in FIG. 6 occurs from when the foot switch 20 is depressed until the ultrasonic oscillation is performed at a predetermined output. In this case, the time lags Δt ₁ and Δt ₂ are large,
That is, the time required for the scans S1 and S2 is not constant depending on the load condition of the handpiece 1.

Therefore, in the above configuration, the water supply can be started during the scans S1 and S2 of the ultrasonic vibrator 4 after the foot switch 20 is turned on.
The ultrasonic vibrator 4 with no cooling water around the probe 6
Is not oscillated, and damage to the probe 6 can be prevented. In addition, since suction is started simultaneously with water supply, the perfusate does not flow out of the sheath 10 into the body cavity.

Therefore, even when the perfusion liquid in the sub suction path 22 is completely sucked together with the stop of the oscillation as in the second embodiment of FIG. 3, the cooling around the probe 6 is started at the next start of the oscillation. Ultrasonic vibrator 4 with no liquid
Can be prevented from being started, so that the probe 6 is not cooled until the whole probe 6 is cooled as in the case where water supply is started simultaneously with the start of ultrasonic oscillation of the ultrasonic vibrator 4. The probe 6 can be prevented from generating heat, and the probe 6 can be prevented from being damaged when the ultrasonic transducer 4 oscillates with high amplitude.

The control of the present embodiment is applied not only to the handpiece 1 having the structure shown in FIG. 3 but also to the handpiece 1 having the structure shown in FIGS. May be applied.

FIG. 7 shows a schematic configuration of an entire ultrasonic therapy apparatus according to a sixth embodiment of the present invention. this is,
The handpiece 1 and the ultrasound therapy apparatus main body 2 are provided with connectors 51 and 52 for signal line connection, respectively.
A signal line 53 detachably connected to these connectors 51 and 52 is provided. In this case, connectors 54 and 55 detachably connected to the connectors 51 and 52 are fixed to both ends of the signal line 53, respectively. further,
Signal lines 53 of various lengths are prepared in advance for replacement.

Then, by supplying an electric signal from the oscillation circuit 5 in the apparatus main body 2 to the ultrasonic vibrator 4 through the signal line 53, ultrasonic vibration is excited in the ultrasonic vibrator 4. .

Therefore, in the above configuration, the signal line 5 to be used depends on the size of the operating room where the ultrasonic therapy apparatus is used, the patient bed, the position of the operator, the arrangement of the operating equipment, and the like.
Since the length of the device 3 can be freely changed, the device main body 2 can be arranged at a position in the operating room that does not obstruct the operation.

For this reason, the operating room is tidy, and during the operation, the operation staff blocks the movement of the apparatus main body 2 or arranges the non-sterilized apparatus main body 2 near the sterilization area, thereby invading the sterilization area. Can be prevented, and safety can be improved.

FIG. 8 shows a schematic configuration of an entire ultrasonic therapy apparatus according to a seventh embodiment of the present invention. this is,
Another extension signal line 53 is connected between the connector 51 of the handpiece 1 and the connector 54 of the signal line 53 or between the connector 52 of the apparatus body 2 and the connector 55 of the signal line 53 in the sixth embodiment. It is made possible. In this case, any number of extension signal lines 53 can be added. Therefore, even with the above configuration, the same effects as in the sixth embodiment can be obtained. It should be noted that the present invention is not limited to the above-described embodiment, and it is needless to say that various modifications can be made without departing from the spirit of the present invention.

[0055]

According to the present invention, the driving by the ultrasonic control means is performed.
Timing that is delayed for a predetermined time from the stop timing of the moving means
Stop to stop the suction operation from the opening by the suction means.
The stop control means is provided so that when controlling the suction operation in conjunction with the ultrasonic oscillation,
The suctioned material in the pipe can be collected without backflow.

Therefore, the suction operation is linked with the ultrasonic oscillation.
When controlling the
Aspirate or perfusate mixed with body fluid flows back through the suction line
Can be prevented.

[Brief description of the drawings]

FIG. 1 is a schematic configuration diagram of an entire ultrasonic therapy apparatus according to a first embodiment of the present invention.

FIG. 2 is a characteristic diagram for explaining an operation timing of suction control by an ultrasonic vibrator, a water pump, and a pinch valve.

FIG. 3 is a longitudinal sectional view showing a handpiece according to a second embodiment of the present invention.

FIG. 4 is a longitudinal sectional view showing a handpiece according to a third embodiment of the present invention.

FIG. 5 is a schematic configuration diagram of an entire ultrasonic therapy apparatus according to a fourth embodiment of the present invention.

FIG. 6 is a characteristic diagram for explaining an operation timing of suction control by a foot switch, an ultrasonic vibrator, a water pump, and a pinch valve according to a fifth embodiment of the present invention.

FIG. 7 is a schematic configuration diagram of an entire ultrasonic therapy apparatus according to a sixth embodiment of the present invention.

FIG. 8 is a schematic configuration diagram of an entire ultrasonic therapy apparatus according to a seventh embodiment of the present invention.

FIG. 9 shows an ultrasonic transducer using a conventional ultrasonic treatment apparatus,
FIG. 4 is a characteristic diagram for explaining operation timing of suction control by a water supply pump and a pinch valve.

[Explanation of symbols]

4 ... Ultrasonic vibrator, 6 ... Probe, 7 ... Suction path (suction means), 8 ... Suction tube (Suction means), 9 ... Suction pump (Suction means), 18 ... Control circuit, 19 ... Pinch valve (Suction control) means).

──────────────────────────────────────────────────続 き Continued on the front page (58) Field surveyed (Int. Cl. ⁷ , DB name) A61B 18/00 A61B 17/22 330 A61M 1/00 500

Claims (1)

(57) [Claims] An ultrasonic vibration for treating a living tissue is provided.
Ultrasonic vibrator that can be generated, driving means for driving the ultrasonic vibrator, and ultrasonic control means for controlling operation timing of the driving means
And the driving means based on the control of the ultrasonic control means.
The ultrasonic vibration from the moved ultrasonic transducer is
An ultrasonic transmission member capable of transmitting to living tissue; and an ultrasonic transmission member provided at a distal end of the ultrasonic transmission member.
Treated by the ultrasonic vibration transmitted by the contact member
An opening that is open so that a piece of tissue can be collected, a suction line having one end communicating with the opening, and connected to the other end of the suction line, via the suction line
Suction means for suctioning through the opening , and starting timing of the driving means by the ultrasonic control means
Suction from the opening by the suction means according to the
Start control means for starting an operation, and timing for stopping the drive means by the ultrasonic control means
At a timing delayed by a predetermined time from
Stop control means for stopping the suction operation from the opening
If, ultrasonic therapy apparatus characterized by comprising a.