JP3887485B2 - Ultrasonic treatment device - Google Patents

Description

[0001]
BACKGROUND OF THE INVENTION
The present invention relates to an ultrasonic treatment apparatus that transmits ultrasonic vibration through a probe and treats a living tissue with the ultrasonic vibration.
[0002]
[Prior art]
In Japanese Patent No. 2544880, a part of the abdominal cavity that is inhaled by the insufflation apparatus is cauterized by an ablation apparatus such as a high-frequency ablation apparatus or a laser apparatus while being observed with an endoscope. Some have incorporated a smoke removal system that removes smoke. In this smoke removal system, the ablation apparatus, the insufflation apparatus, and the suction apparatus for smoke removal are operated in cooperation by the control means.
[0003]
[Problems to be solved by the invention]
(Problems of conventional technology)
In the smoke removal system proposed in Japanese Patent No. 2544880, in order to remove smoke generated by an ablation device such as a high-frequency ablation device or a laser device, the operations of the ablation device, the insufflation device, and the suction device are performed. Although linked, it is necessary to use a signal line for connecting each device for input / output of each device. For this reason, a dedicated interface is required for each device. Further, since the specifications of the output signal line are not clear, it is necessary to prepare all dedicated devices, and there is a disadvantage that there is no room for selection for the operator.
On the other hand, an ultrasonic treatment apparatus that transmits ultrasonic vibration through a probe and treats a living tissue with ultrasonic vibration is known (see Japanese Patent Publication No. 8-505801). In this ultrasonic treatment apparatus, no smoke is generated even when a probe that vibrates ultrasonically is contacted with a living tissue in order to treat the living tissue. However, in the case of the treatment using this ultrasonic treatment apparatus, a phenomenon called cavitation may cause the water around the surgical site that the probe has contacted to scatter and float in the form of a mist.
The mist generated in this manner has a larger mass than the smoke particles, and thus disappears in a short time, but may drift in the abdominal cavity, and the visual field of the surgical site is deteriorated. For surgeons who are particularly worried about the field of view, it is necessary to replace the pneumoperitoneal gas in the abdominal cavity by using a trocar opening valve, etc. I was bothering my hands.
[0004]
(the purpose)
The present invention has been made paying attention to the above circumstances, and the object of the present invention is to appropriately remove the mist generated by the ultrasonic vibration without bothering the operator's hand and always provide a good field of view to the operator. near to provide a treatable ultrasonic treatment device while ensuring is, also, possible to provide an ultrasonic treatment apparatus that can be linked to operation of the device other than the ultrasonic treatment device to the output of the ultrasonic treatment It is in.
[0005]
[Means for Solving the Problems]
The present invention includes an ultrasonic vibration generation unit that generates ultrasonic vibrations, a probe that includes an ultrasonic treatment unit applied to a living tissue, and that transmits the ultrasonic vibrations to the treatment unit, and a distal end in the vicinity of the ultrasonic treatment unit. It is formed by a sheath that opens and covers the probe portion excluding the ultrasonic treatment portion and a space around the probe surrounded by the sheath, or is formed at the tip of the ultrasonic treatment portion and formed on the probe A handpiece provided with a suction path formed by a through-passage,
A suction source connected via a relay tube connected to the suction path;
Ultrasonic oscillation means for generating ultrasonic vibration electric energy to be given to the ultrasonic vibration generator, and ultrasonic output is performed when the ultrasonic oscillation means is outputting the ultrasonic electric energy An apparatus main body having an external signal terminal for outputting a signal indicating that;
It is provided separately from the apparatus main body and is connected to the external signal terminal and receives a signal indicating that the ultrasonic output is being performed from the external signal terminal, and passes the suction path on the way of the relay tube. open suction pathway floating mist generated by the ultrasonic treatment unit through the suction path of the handpiece to-edge or et suction tip or the ultrasonic treatment section of the sheath having an opening in the vicinity of the ultrasonic treatment unit A suction control device that controls to remove via
An ultrasonic treatment apparatus comprising:
[0006]
DETAILED DESCRIPTION OF THE INVENTION
[First Embodiment]
A first embodiment of the present invention will be described with reference to FIGS.
(Constitution)
FIG. 1 shows a schematic configuration of the entire ultrasonic treatment apparatus 1. The ultrasonic treatment apparatus 1 includes an apparatus main body 2, a foot switch (or hand switch) 3 connected to the apparatus main body 2, and a hand piece 4 of an ultrasonic treatment instrument. The handpiece 4 is connected to the apparatus body 2 so as to be detachable and replaceable.
[0007]
A power switch 6 and a display panel 7 are provided on the front panel 5 of the apparatus body 2. As shown in FIG. 2, the apparatus body 2 is provided with a power supply circuit 8 for generating a drive signal to be applied to an ultrasonic transducer, which will be described later, a current amplifier 9 for supplying power to the drive signal, a pinch valve 10, and a control circuit 11. It has been. The power supply circuit 8 has ultrasonic oscillation means for generating electrical energy for applying ultrasonic vibration.
[0008]
As shown in FIG. 3, the handpiece 4 covers an ultrasonic transducer 12 that generates ultrasonic vibrations, a probe 14 that transmits ultrasonic vibrations from the ultrasonic transducer 12 to the treatment unit 13, and the probe 14. An elongated sheath 15, a proximal side operation unit 17 connected to the base end portion of the sheath 15 and screwed to a case 16 surrounding the ultrasonic transducer 12, and a suction tube provided at the base end portion of the sheath 15 And a connection unit 18.
[0009]
A suction tube 19 as a relay tube is connected to the suction tube connection portion 18, and this suction tube 19 passes through the pinch valve 10 and is connected to an external suction means such as a wall suction facility (not shown). The pinch valve 10 constitutes a valve mechanism that opens and closes the path of the suction communication means to be described later by sandwiching or releasing the middle part of the suction tube 19 to seal or open the lumen of the suction tube 19. .
[0010]
The suction tube 19 communicates with the sheath 15 through the suction tube connection portion 18. A suction path extending from the suction tube 19 to the sheath 15 is formed, and a suction communication means for communicating an external suction means (suction source) to the distal end opening (suction port) of the sheath 15 by the suction path is configured. Here, the suction path of the suction communication means is divided into a handpiece side suction path 20 a in the sheath 15 and a relay tube side suction path 20 b of the suction tube 19, both of which communicate with each other through the suction tube connection portion 18. . The pinch valve 10 selectively sandwiches a midway portion of the relay tube side suction path 20b, opens and closes the suction path 20b, and controls suction through the suction path of the suction communication means.
[0011]
The operation of the pinch valve 10 is controlled in synchronization with the ultrasonic output of the apparatus body 2 as shown in FIG. 4, and the pinch valve 10 is closed when the ultrasonic output is off, and the pinch valve 10 is opened when the ultrasonic output is on. . That is, the suction path is opened in conjunction with the operation of the ultrasonic oscillating means.
[0012]
(Function)
In the above configuration, by driving the ultrasonic transducer 12 in the handpiece 4, ultrasonic vibration is transmitted to the treatment unit 13 via the probe 14, and ultrasonic treatment is performed by applying the treatment unit 13 to the living tissue. Can be applied.
[0013]
For example, when performing lymph node dissection using this ultrasonic treatment apparatus 1, the sheath 15 portion of the handpiece 4 is introduced into the abdominal cavity through an unillustrated trocar or the like, and is observed under an endoscope. Then, ultrasonic treatment is performed on the site to be treated by the probe 14.
[0014]
Here, the operation of the pinch valve 10 is synchronized with the ultrasonic output of the apparatus main body 2 as shown in FIG. 4, and is generated by ultrasonic treatment by opening the suction path of the suction communication means at the time of ultrasonic output. The floating mist can be sucked and removed from the body through the suction path of the suction communication means from the distal end opening of the sheath 15.
[0015]
(effect)
With the above-described configuration, the mist generated by the ultrasonic output at the time of ultrasonic output can be sucked and removed outside the body, and a good visual field can be secured for the operator.
[0016]
[Second Embodiment]
A second embodiment of the present invention will be described based on FIG. However, the same components as those in the first embodiment are denoted by the same reference numerals, and detailed description thereof is omitted.
[0017]
(Constitution)
The suction communication means in this embodiment forms a suction path in the handpiece 4 from the ultrasonic transducer 12 to the probe 14 and penetrates the probe 14 and the ultrasonic transducer 12. It is formed linearly by the communicating through passage 21. The suction port is formed by the tip opening of the probe 14.
[0018]
A suction tube connecting portion 18 communicating with the through passage 21 is provided at the rear end of the case 16 in which the ultrasonic transducer 12 is built. A suction tube 19 as a relay tube is connected to the suction tube connection portion 18.
[0019]
The through passage 21 and the suction tube connecting portion 18 are provided coaxially along the central axis of the handpiece 4, and the suction tube 19 is coaxially connected thereto. Further, the ultrasonic transducer 12, the probe 14, and the suction tube connecting portion 18 are arranged coaxially to form an integral unit, and are attached to the case 16 so as to be rotatable around the axis. The ultrasonic transducer 12 and the suction tube connecting portion 18 are slidably held with respect to the case 16 via an O-ring 22.
[0020]
(Function)
The path of the suction communication means in this embodiment is formed in the inside from the ultrasonic transducer 12 to the probe 14, and sucks mist generated and floated by ultrasonic treatment from the tip opening of the probe 14.
[0021]
(effect)
Since the mist floating in the body cavity is sucked from the distal end opening of the probe 14 positioned in front of the distal end of the sheath 15, the mist floating in the front visual field can be actively sucked, which is favorable. A field of view can be secured.
Further, since the suction tube 19 is led out behind the handpiece 4, the suction tube 19 is not entangled with the sheath 15 even if the handpiece 4 is rotated during the operation. Further, since the suction tube connecting portion 18 is attached to the case 16 so as to be rotatable about the axis, the suction tube 19 is not twisted even if the handpiece 4 is rotated during the operation.
[0022]
[Third Embodiment]
A third embodiment of the present invention will be described with reference to FIGS. However, the same components as those in the first embodiment are denoted by the same reference numerals, and detailed description thereof is omitted.
[0023]
(Constitution)
In the third embodiment, an external input terminal 31, a suction control unit 32, and a suction control device 33 provided with a pinch valve 10 are provided separately from the device main body 2, and the device main body 2 has an external signal terminal. 34 and switching means 35 for switching the output status of the signal to the external signal terminal 34.
[0024]
(Function)
In the above configuration, the apparatus main body 2 is controlled as shown in FIG. 7 by operating the switching means 35 in synchronization with the ultrasonic output based on a command from the control circuit 11. That is, while the ultrasonic output is being performed, a signal indicating that the ultrasonic output is being performed can be taken out from the external signal terminal 34, and this signal is suction controlled from the external input terminal 31 of the suction control device 33. Incorporated into part 32. Then, the mist is sucked and removed as described above by opening the pinch valve 10 in the suction control device 33 at a timing synchronized with the ultrasonic output of the apparatus body 2.
[0025]
By using this signal, for example, in order to improve the hemostasis effect, the operation of a device not intended for suction control such as applying a bipolar output by a high-frequency cautery device may be linked with the ultrasonic output. Further, a plurality of devices may be controlled.
[0026]
(effect)
With the above-described configuration, it is possible to synchronize the operation of a plurality of devices with the ultrasonic output by using an external signal terminal as well as mist suction.
[0027]
[Fourth Embodiment]
A fourth embodiment of the present invention will be described with reference to FIGS. However, the same code | symbol is attached | subjected to the part of the structure same as 1st-3rd embodiment, and those detailed description is abbreviate | omitted.
[0028]
(Constitution)
FIG. 8 shows a hand piece 40 of an ultrasonic coagulation / cutting device among ultrasonic treatment devices. The handpiece 40 is provided with a support member 41 penetrating the vicinity of the distal end portion of the probe 14 in the distal end portion of the sheath 15, and a gripping member (jaw) 42 facing the distal end portion of the probe 14 is pivoted on the support member 41. It is worn. The support member 41 is provided with a suction hole (penetration path) 43 penetrating along the axial direction of the sheath 15. A relay tube 44 inserted into the sheath 15 is connected to the suction hole 43. The relay tube 44 is connected so as to communicate with the suction tube connection portion 18 provided at the rear end of the proximal side operation portion 17. Further, a suction tube 19 as a relay tube is connected to the suction tube connection portion 18. A suction path communicating with the suction hole 43, the relay tube 44, and the suction tube 19 is formed to constitute a suction communication means.
[0029]
The front end opening of the suction hole 43 is opened and closed by a sealing lid member 45 that is interlocked with the rotation of the gripping member 42. The sealing lid member 45 is held by an elastic member 46 attached to the back surface of the gripping member 42 and can be rocked elastically to some extent. As shown in FIG. 8, the sealing lid member 45 opens the distal end opening of the suction hole 43 only when the gripping member 42 is in a gripping state in which the gripping member 42 is tilted in a direction in contact with the distal end portion of the probe 14. In addition, as shown in FIG. 9, the sealing lid member 45 closes the distal end opening of the suction hole 43 in the grip release state in which the grip member 42 is raised.
[0030]
In addition, a fixed handle 51 and a movable handle 52 are provided on the operation unit 17 on the hand side of the handpiece 40. By rotating the movable handle 52 with respect to the fixed handle 51, the gripping member 42 rotates with respect to the support member 41, and comes into contact with and separates from the distal end portion of the probe 14. That is, as the movable handle 52 is closed, the gripping member 42 rotates in the closing direction toward the distal end side of the probe 14, so that the gripping member 42 and the distal end portion of the probe 14 are shown in FIG. 9. For example, a living tissue such as a blood vessel in the human body can be gripped.
[0031]
(Function)
In the above configuration, by driving the ultrasonic transducer 12 in the handpiece 40, the treatment portion 13 grips the living tissue between the distal end portion of the probe 14 and the gripping member 42, and applies ultrasonic vibration to the probe 14. In addition, the grasped living tissue can be coagulated and incised.
[0032]
Here, when the living tissue is coagulated and incised, the living tissue is gripped until the coagulation and incision is completed, and the gripping member 42 and the tip of the probe 14 are closed as shown in FIG. The distal end opening of 43 is opened, and is in a state of opening to the maximum immediately before the coagulation incision is completed. Therefore, when the living tissue is grasped, the suction operation through the suction hole 43 is started, and the mist floating in the body cavity is sucked and removed outside the body through the suction path of the suction communication means.
[0033]
(effect)
Since the tip opening of the suction hole 43 of the suction communication means is opened and closed in conjunction with the movement of the gripping member 42, a means for controlling suction such as a pinch valve is not required outside the handpiece 40, and the structure is It is simple and low-cost, and mist can be removed by suction.
[0034]
[Fifth Embodiment]
A fifth embodiment of the present invention will be described with reference to FIG. However, the same components as those in the first to fourth embodiments are denoted by the same reference numerals, and detailed description thereof is omitted.
[0035]
(Constitution)
In the fifth embodiment, a suction control device 60 configured separately from the device main body 2 of the ultrasonic treatment device 1 and a sound collecting means 61 for detecting ambient sound and a probe based on the ultrasonic output of the device main body 2 are used. A detection circuit 62, a control circuit 63, and a pinch valve 10 are provided for separating and detecting the generated sound in the ultrasonic frequency band generated when the 14 vibrates ultrasonically from the ambient sound.
[0036]
(Function)
In the above configuration, the ambient sound measured by the sound collecting means 61 is determined by the detection circuit 62 to determine whether there is a frequency component in the ultrasonic frequency band, and if detected, ultrasonic output is performed. The mist generated by opening the pinch valve 10 can be removed by suction.
[0037]
In order to further improve the detection accuracy and usability, a threshold value may be set at the opening timing so that the pinch valve 10 is opened only when frequency components in a continuous ultrasonic frequency band of a certain time or longer are detected. .
[0038]
(effect)
With the above configuration, the mist generated by the ultrasonic output can be sucked and removed from the body regardless of the type of the ultrasonic treatment apparatus 1.
[0039]
<Appendix>
1. An elongated probe that transmits ultrasonic vibration to a living tissue, an ultrasonic vibration generating unit that generates the ultrasonic vibration, a handpiece having the ultrasonic vibration generating unit, and an ultrasonic wave that is applied to the ultrasonic vibration generating unit In an ultrasonic treatment apparatus having ultrasonic oscillation means for generating electrical energy for vibration,
A communication means that forms a suction path that communicates from the tip of the probe or near the tip to an external suction source; and a suction control means that controls suction through the suction path of the communication means. In conjunction with the operation, the ultrasonic treatment apparatus is characterized in that the suction path is opened by the suction control means, and the generated floating mist is sucked and removed through the suction communication means.
2. A probe that transmits ultrasonic vibrations to a tissue, a handpiece having a vibration generating unit for generating ultrasonic vibrations, and an ultrasonic device that generates electrical energy for applying ultrasonic vibrations to the vibration generating unit of the handpiece. In an ultrasonic treatment apparatus having a sound wave oscillating means, a suction port for sucking mist into the handpiece, a suction path communicating from the suction port to an external suction means, and a suction control means for controlling the state of the suction path An ultrasonic treatment apparatus characterized in that the suction control means is operated in synchronization with the operation of the ultrasonic oscillation means, the suction path is opened, and the generated mist is suctioned and removed.
[0040]
3. The ultrasonic treatment apparatus according to any one of Items 1 and 2, wherein the suction control means is provided in a suction path of the handpiece.
4). The ultrasonic treatment apparatus according to any one of Items 1 and 2, wherein the suction control unit is provided in a suction port of the handpiece.
5). The ultrasonic treatment apparatus according to any one of Items 1 and 2, wherein the suction control unit operates in synchronization with on / off of the ultrasonic output.
6). The ultrasonic treatment apparatus according to any one of Items 1 and 2, wherein the suction control unit operates by detecting a frequency generated by ultrasonic output.
[0041]
【The invention's effect】
According to the present invention described above, the mist generated by the ultrasonic vibration can be suitably removed without troubling the operator, Ri treatable der while always ensuring good visibility to the surgeon, also The operation of devices other than the ultrasonic treatment apparatus can be linked to the output of the ultrasonic treatment.
[Brief description of the drawings]
FIG. 1 is an explanatory diagram schematically showing the entirety of an ultrasonic treatment apparatus according to a first embodiment.
FIG. 2 is an electric circuit diagram of the ultrasonic treatment apparatus.
FIG. 3 is a longitudinal sectional view of the vicinity of the hand piece of the ultrasonic treatment apparatus.
FIG. 4 is an operational characteristic diagram of the ultrasonic treatment apparatus.
FIG. 5 is a longitudinal sectional view of the vicinity of a hand piece of an ultrasonic treatment apparatus according to a second embodiment.
FIG. 6 is an electric circuit diagram of an ultrasonic treatment apparatus according to a third embodiment.
FIG. 7 is an operational characteristic diagram of the ultrasonic treatment apparatus.
FIG. 8 is an explanatory view of the vicinity of a hand piece of an ultrasonic treatment apparatus according to a fourth embodiment.
FIG. 9 is an explanatory diagram of a use state of the handpiece of the ultrasonic treatment apparatus.
FIG. 10 is a longitudinal sectional view of a treatment portion of the handpiece of the ultrasonic treatment apparatus.
FIG. 11 is an explanatory diagram schematically showing the entirety of an ultrasonic treatment apparatus according to a fifth embodiment.
[Explanation of symbols]
DESCRIPTION OF SYMBOLS 1 ... Ultrasonic treatment apparatus, 2 ... Apparatus main body, 4 ... Handpiece, 8 ... Power supply circuit,
DESCRIPTION OF SYMBOLS 9 ... Current amplifier, 10 ... Pinch valve, 11 ... Control circuit, 12 ... Ultrasonic transducer,
13 ... treatment part, 14 ... probe, 15 ... sheath, 17 ... hand side operation part,
18 ... suction tube connection part, 19 ... suction tube, 20a, 20b ... suction path.

Claims (1)

An ultrasonic vibration generating unit that generates ultrasonic vibrations, a probe that includes an ultrasonic treatment unit that is applied to living tissue, a probe that transmits the ultrasonic vibrations to the treatment unit, and a tip that opens near the ultrasonic treatment unit and the above Formed by a sheath covering the probe portion excluding the ultrasonic treatment section and a space around the probe surrounded by the sheath, or formed by a through passage opened at the tip of the ultrasonic treatment section and formed in the probe A handpiece provided with a suction path,
A suction source connected via a relay tube connected to the suction path;
Ultrasonic oscillation means for generating ultrasonic vibration electric energy to be given to the ultrasonic vibration generator, and ultrasonic output is performed when the ultrasonic oscillation means is outputting the ultrasonic electric energy An apparatus main body having an external signal terminal for outputting a signal indicating that;
It is provided separately from the apparatus main body and is connected to the external signal terminal and receives a signal indicating that the ultrasonic output is being performed from the external signal terminal, and passes the suction path on the way of the relay tube. open suction pathway floating mist generated by the ultrasonic treatment unit through the suction path of the handpiece to-edge or et suction tip or the ultrasonic treatment section of the sheath having an opening in the vicinity of the ultrasonic treatment unit A suction control device that controls to remove via
An ultrasonic treatment apparatus comprising:

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