JP5703360B2 - 超音波手術装置 - Google Patents
超音波手術装置 Download PDFInfo
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/1662—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for particular parts of the body
- A61B17/1664—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for particular parts of the body for the hip
- A61B17/1666—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for particular parts of the body for the hip for the acetabulum
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/1662—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for particular parts of the body
- A61B17/1675—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for particular parts of the body for the knee
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/1662—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for particular parts of the body
- A61B17/1684—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans for particular parts of the body for the shoulder
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B2017/320004—Surgical cutting instruments abrasive
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
- A61B2017/320072—Working tips with special features, e.g. extending parts
- A61B2017/320074—Working tips with special features, e.g. extending parts blade
- A61B2017/320077—Working tips with special features, e.g. extending parts blade double edge blade, e.g. reciprocating
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
- A61B2017/320072—Working tips with special features, e.g. extending parts
- A61B2017/320078—Tissue manipulating surface
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/08—Accessories or related features not otherwise provided for
- A61B2090/0801—Prevention of accidental cutting or pricking
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Description
図1から図7を参照し、第1の実施形態について説明する。
図1に示すように整形外科用の超音波手術装置1は、例えば整形外科手術における処置対象部位を処置するハンドピース10と、超音波振動駆動装置50と、フットスイッチ70とを有している。処置対象部位とは、例えば骨や軟骨などの硬組織等である。処置とは、例えば切除や切削などである。
x=V/π/fr
例えば100%の出力条件において、振動速度Vは略7.4m/s〜略22.1m/sの範囲にすることが好ましい。
本変形例の処置部31の形状は、第1の実施形態の処置部31とは異なる。本変形例の処置部31は、先端の尖った略平板形状を有している。また第1のエッジ31aと第2のエッジ31bは、それぞれエッジに沿って、半円形状の複数の窪み部31cを略等間隔に有している。窪み部31cの半径は略0.2mm〜略0.6mmであり、隣り合う窪み部31c間のピッチは略0.5mm〜略2mmである。
本変形例の処置部31の形状は、第1の実施形態の処置部31とは同様である。しかしながら本変形例の処置部31には、エッジに沿って、例えばPVDやCVDによる窒化チタンからなる硬質のコーティング層33が形成されている。コーティング層33は、エッジから所望の距離、例えばエッジから処置部31の内側に向かって1mmの範囲に形成されている。
本変形例は、コーティング層33が形成されているため、磨耗、損傷に対する処置部31の耐久性が向上する。また本変形例は、処置部31の磨耗、損傷の程度を、コーティング層33の状態(例えばコーティング層33が処置部31から剥がれたか否か)により、視覚的に確認することが容易である。
本変形例における壁部22の先端外周部には、コールドナイフ23ではなく、ナイフ電極35が一体的に設けられている。ナイフ電極35は、ステンレス等の通電可能な金属材料からなる。ナイフ電極35の後端側には、高周波出力用接続ケーブル36の一端が接続されている。ナイフ電極35の後端側と高周波出力用接続ケーブル36の一端との接続部は、絶縁部材37により覆われている。また、高周波出力用接続ケーブル36の他端は、図示しない高周波駆動装置に接続されている。よって、ナイフ電極35は、高周波出力用のモノポーラ電極として機能する。つまりナイフ電極35は、電気メスとして機能する。
本実施形態においてシース20には、コールドナイフ23やナイフ電極35が設けられていない。また本実施形態における処置部31は、四角錘形状の複数の突起40aが形成されている第1の処置面41aと、突起40aよりも小さい四角錘形状の複数の突起40bが形成されている第2の処置面41bとを有している。第1の処置面41aは、長手軸方向5を中心に第2の処置面41bと略対称に配設されている。
本変形例の処置部31の形状は、第2の実施形態の処置部31とは異なる。本変形例の処置部31は、第1の実施形態における図4と図5とに示す略平板形状と、第1の実施形態の第1の変形例における図8A乃至図8Cに示す先端の尖った略平板形状と、の組み合わせである。
また本実施形態における処置部31は、四角錘形状の複数の突起45aが形成されている第1の処置面46aのみを有している。
本変形例の処置部31の形状は、第2の実施形態の処置部31とは異なる。図18A乃至図18Cに示すように、処置部31は、略平板形状を有し、また先端部48aに向かって湾曲した形状を有している。先端部48aには、超音波振動によって処置対象部位を処置する処置面48bが形成されている。
図22に示すように本変形例の本体20aには、係合部26bと係合可能な凹部81a,81b,81cが設けられている。凹部81a,81b,81cは、長手軸方向5の周方向において略等間隔に配設されている。つまり凹部81a,81b,81cは、長手軸方向5の周方向において略120度離れている。
係合部26bが凹部81aに係合すると、図23に示すように第1の処置面82aは開口部25から露出し、第2の処置面82bと第3の処置面82cが先端部材20bに収納されることとなる。
また係合部26bが凹部81bに係合すると、図24に示すように第2の処置面82bは開口部25から露出し、第1の処置面82aと第3の処置面82cが先端部材20bに収納されることとなる。
また係合部26bが凹部81cに係合すると、図25に示すように第3の処置面82cは開口部25から露出し、第1の処置面82aと第2の処置面82bが先端部材20bに収納されることとなる。
処置部31は、第1の処置面82aと第2の処置面82bと第3の処置面82cとのいずれかが処置対象部位に接触することで、超音波振動によって処置対象部位を処置することとなる。
また一般に、超音波振動の振幅は、プローブ30の先端から基端に向かって減少する。ここで、突起83cは、長手軸方向5において、プローブ30の先端側から基端側に向けて突起83cの大きさ(突起83c間のピッチ)が小さくなるように形成されている。つまり突起83cの大きさは、超音波振動の振幅の大きさに略比例するように形成されている。
なお、突起83cの大きさは、超音波振動の振幅の大きさに略比例するように形成されている。よって、先端側の突起83cにおける処置は荒削りとなり、基端側の突起83cにおける処置は仕上げ削りとなる。
Claims (5)
- 超音波振動を発生する超音波振動子と、
前記超音波振動子と接続され、前記超音波振動子にて発生した超音波振動を伝達する長手軸を規定する伝達部材と、
前記伝達部材の先端部に配設された処置部であって、前記伝達部材の長手軸周りの外周面に硬組織を処置するための処置領域が形成された処置部と、
前記伝達部材が挿通されるシースであって、
先端部と基端部とを有し、前記先端部が前記処置部の先端付近に位置すると共に、前記基端部に向かって前記長手軸の方向に沿って直線状に延出する中空な本体部と、
前記本体部の前記先端部において、前記本体部の先端から前記基端部の方向に前記本体部の側面の一部を切り欠くことによって前記処置部の前記処置領域を露出させるため開口部と、
前記本体部の前記先端から前記長手軸と交差する方向に延出すると共に前記処置部の先端との間に所定の空間を形成する壁部と、
を有するシースと、
を具備し、
前記シースを前記シースの先端側からみたときに、前記処置部が常に前記本体部における前記先端部の投影面内に配置されていることを特徴とする超音波手術装置。 - 前記シースの前記先端側は、透明な部材によって形成されていることを特徴とする請求項1に記載の超音波手術装置。
- 前記壁部は、前記伝達部材の前記長手軸と交差する位置まで延出していることを特徴とする請求項1に記載の超音波手術装置。
- 前記処置部の先端は、尖鋭な頂点を有し、
前記壁部は、前記頂点まで延出している、ことを特徴とする請求項1に記載の超音波手術装置。 - 前記処置部は、前記外周面の異なる位置に、複数の第1突起が形成された第1の処置領域と、前記第1突起よりも小さい複数の第2突起が形成された第2の処置領域と、を有し、
前記シースは、前記第1の処置領域が前記硬組織を処置する際、前記第1の処置領域が前記開口部を介して露出し、且つ前記第2の処置領域が前記本体部によって覆われる第1の状態、または前記第2の処置領域が前記硬組織を処置する際、前記第2の処置領域が前記開口部を介して露出し、且つ前記第1の処置領域が前記本体部によって覆われる第2の状態になるように、前記伝達部材に対して前記長手軸周りに回転する、ことを特徴とする請求項1に記載の超音波手術装置。
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US7389608P | 2008-06-19 | 2008-06-19 | |
US61/073,896 | 2008-06-19 |
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JP2013215875A Expired - Fee Related JP5703360B2 (ja) | 2008-06-19 | 2013-10-16 | 超音波手術装置 |
JP2015033140A Expired - Fee Related JP5930247B2 (ja) | 2008-06-19 | 2015-02-23 | 超音波手術装置 |
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