JP5849501B2 - Fluid ejecting apparatus and medical device - Google Patents

Description

  The present invention relates to a fluid ejection device and a medical device having an ejection tube and a suction tube.

  A method of excising, incising, and crushing a living tissue using a fluid ejecting apparatus has excellent characteristics as a surgical tool, such as being free from thermal damage and capable of preserving tubule tissue such as blood vessels. When an operation or the like is performed using such a fluid ejecting apparatus, the ejected liquid or ablated tissue may accumulate in the surgical site and a visual field may not be secured. For this purpose, there are some which are provided with a suction tube for sucking and removing liquid and excised tissue.

  As an example of such a fluid ejecting apparatus, there has been proposed an ejecting pipe that ejects high-pressure fluid in a suction channel of the suction pipe and concentrically with the suction channel (for example, Patent Document 1).

  As another example, there has been proposed a fluid ejecting apparatus in which an ejecting pipe for ejecting high-pressure fluid is inserted in a state of being eccentric with respect to an inner peripheral surface of a suction pipe (see, for example, Patent Document 2). .

  Further, there is a fluid ejecting apparatus that rapidly changes the volume of a fluid chamber by volume changing means to convert the fluid into a pulsating flow and ejects the fluid at high speed in a pulsed manner from an ejection opening (for example, see Patent Document 3).

Japanese Patent Laid-Open No. 1-313047 JP-A-6-90957 JP 2008-82202 A

  In patent document 1 mentioned above, it arrange | positions so that the internal peripheral surface of a suction tube and the outer peripheral surface of an injection tube may become concentric. The size of the suction channel (the gap size between the inner peripheral surface of the suction tube and the outer peripheral surface of the injection tube) is ½ of the difference between the inner diameter of the suction tube and the outer diameter of the injection tube. In a suction channel having such a large length and a long channel length, a large excised tissue is likely to be clogged in the middle and difficult to suck and flow. Further, when the diameter of the suction tube is increased in order to ensure the size of the suction channel, there is a problem that it is difficult for the operator to recognize the position of the ejection opening.

  Moreover, in patent document 2, since the injection tube is inserted in the state eccentric to the inner peripheral surface of the suction tube, the size of the suction channel is determined by the inner diameter of the suction tube and the outer diameter of the injection tube. When the suction pipe having the same inner diameter and the injection pipe having the same outer diameter as in Patent Document 1 are used, the difference becomes larger than the case of concentricity. However, if the ejection opening is eccentric with respect to the suction tube, it is difficult to recognize the position of the ejection opening, and thus there is a problem that it is difficult to eject the fluid to an accurate position with respect to the surgical site.

  When jetting high-pressure fluid, vibration may occur near the tip of the jet tube, that is, near the jet opening, making it more difficult to jet the fluid to the target surgical site.

  In addition, the fluid ejection device according to Patent Document 3 can be excised with a smaller flow rate than that of the above-described Patent Document 1 or Patent Document 2 in which the high-pressure fluid is ejected in a continuous flow, but improves the visibility of the surgical site. Therefore, it may be required to provide a suction tube for suctioning or removing the excised tissue. In such a case, in order to enlarge the suction flow path, it is possible to employ a structure in which the injection tube is inserted in a state of being eccentric with respect to the inner peripheral surface of the suction tube as in Patent Document 2. However, when the fluid is ejected in pulses, the vibration of the ejection tube is expected to be greater than that of continuous flow ejection.

  When vibration occurs in the injection tube, the suction tube and the suction tube hit to generate an abnormal sound, or the suction tube resonates due to vibration of the tip (injection opening) of the injection tube. It becomes difficult to eject the fluid to the nozzle.

  SUMMARY An advantage of some aspects of the invention is to solve at least a part of the problems described above, and the invention can be implemented as the following forms or application examples.

  Application Example 1 A fluid ejecting apparatus according to this application example includes a gripping portion, a suction pipe projecting from the gripping portion, and being eccentrically inserted into the suction tube and projecting from the gripping portion. An injection pipe having an injection opening, a bubble generating member for generating bubbles in the injection pipe, a suction flow path formed between an inner peripheral surface of the suction pipe and an outer peripheral surface of the injection pipe, and the suction flow A suction opening formed at an end of the passage, and the spray opening and the suction pipe are concentrically disposed in the vicinity of the spray opening.

  According to this application example, since the injection opening and the suction tube are concentrically disposed in the vicinity of the injection opening, the operator can easily recognize the position of the injection opening and apply fluid to the target operation part. It becomes easy to inject.

  On the other hand, the injection pipe is inserted eccentrically with respect to the inner peripheral surface of the suction pipe in most length regions other than the vicinity of the injection opening. For example, if the inner diameter of the suction tube is d1 and the outer diameter of the injection tube is d2, the size of the suction channel (gap size) is d1-d2, and the suction tube and the injection tube are simply concentric. The size of the suction channel is (d1-d2) / 2. Therefore, the size of the suction channel when eccentric is larger than that when concentric. Therefore, even when the suction channel is long, the excised tissue can be sucked and removed. Furthermore, when the bubble generating member uses an optical fiber to generate a vapor method bubble, the laser emitted from the tip of the optical fiber is highly linear, so when the liquid in the injection tube is low, Although there is a possibility of being damaged by the laser, depending on the present application example, there is an effect of preventing the laser beam from being directly irradiated to the injection target object by bending and decentering the injection tube. Further, when the suction pipe comes into contact with the ejection pipe, heat is transmitted to the suction pipe via the ejection pipe, and there is an effect that heat generation of the ejected liquid can be suppressed.

  Application Example 2 In the fluid ejection device according to the application example described above, the suction tube and the ejection tube are fixed at least on the ejection opening side of a region where the suction tube and the ejection tube are eccentric. It is characterized by.

  According to this application example, since the injection tube is fixed to the inner peripheral surface of the suction tube in the vicinity of the injection opening, it is possible to suppress vibration at the tip of the injection tube. In addition, the vibration of the injection pipe and the suction pipe is prevented from being generated by vibration, and the tip of the injection pipe (injection opening) is not moved by the vibration. The resonance of the suction pipe generated by this vibration is prevented. This is effective in that the fluid can be accurately ejected to the surgical site.

  Application Example 3 In the fluid ejecting apparatus according to the application example described above, the ejection pipe is configured such that the ejection opening is opened eccentrically with respect to the ejection pipe, and a wall portion is formed at the periphery of the ejection opening. It is characterized by.

  According to this application example, the injection pipe is eccentric with respect to the suction pipe, and only the injection opening is concentric. Therefore, the suction opening and the suction channel can be made larger than in the case of concentricity.

  When the ejection opening is decentered with respect to the ejection pipe, a wall is formed at the periphery of the ejection opening. Here, when a high pressure is generated by a pulsating flow generation unit as in Patent Document 3 and a fluid is jetted at high speed in a pulsed manner, the pressure wave of the fluid propagates from the pulsating flow generation unit through the inside of the injection tube, and the periphery of the injection opening It reaches to the wall part of the light and reflects, and returns to the pulsating flow generation part. This resonance effect of the pressure wave has an effect that the fluid can be pulsed more strongly.

  Application Example 4 In the fluid ejecting apparatus according to the application example described above, the suction pipe is provided with a notch portion formed around the periphery of the suction opening.

  According to this application example, by forming the notch portion around the periphery of the suction opening portion, the operator can more clearly recognize the position of the ejection opening portion, and the suction opening portion can be recognized as the notch portion. Can be increased by as much as

  Application Example 5 A medical device according to this application example includes the fluid ejection device according to any one of the above.

  According to this application example, by using the fluid ejecting apparatus as a medical device, it is possible to provide more excellent characteristics as a surgical instrument or a medicine ejecting apparatus.

The structure explanatory view showing the fluid ejecting device as a surgical instrument concerning this embodiment. Sectional drawing which shows the cut surface which cut | disconnected the bubble generation member, injection tube, and suction tube which concern on 1st Example along the injection direction of the fluid. The front-end | tip part structure of the injection pipe and suction pipe which concerns on 2nd Example is shown, (A) is a fragmentary sectional view, (B) is the front view visually recognized from the front-end | tip direction (E direction shown in the figure) of (A). The fragmentary sectional view which shows the front-end | tip part structure of the injection pipe and suction pipe which concern on 3rd Example. The fragmentary sectional view which shows the front-end | tip part structure of the injection pipe and suction pipe which concern on 4th Example. The fragmentary sectional view which shows the front-end | tip part structure of the injection pipe and suction pipe which concern on 5th Example. The front-end | tip part structure of the injection pipe and suction pipe which concerns on 6th Example is shown, (A) is a fragmentary sectional view, (B) is the front view visually recognized from the front-end | tip direction. Structure explanatory drawing which shows the fluid injection apparatus as a surgical tool which concerns on other embodiment. Sectional drawing which shows the cut surface which cut | disconnected the bubble generation member, injection tube, and suction tube which concern on other embodiment along the injection direction of the fluid.

Hereinafter, embodiments of the present invention will be described with reference to the drawings.
Note that the drawings referred to in the following description are schematic views in which the vertical and horizontal scales of members or portions are different from actual ones for convenience of illustration.
(Embodiment 1)

  FIG. 1 is a configuration explanatory view showing a fluid ejection device as a surgical instrument according to the present embodiment. Therefore, the fluid described below is physiological saline. In FIG. 1, the fluid ejecting apparatus 1 includes a gripping part 22, a suction pipe 80 projecting from the gripping part 22, an ejection opening part projecting from the gripping part 22 while being eccentrically inserted into the suction pipe 80. 72, the bubble generating member 31 for generating bubbles in the injection tube 70, the suction flow path 81 formed between the inner peripheral surface of the suction tube 80 and the outer peripheral surface of the injection tube 70, and suction The suction opening 82 formed at the end of the flow path 81, the fluid supply container 2 for containing fluid, the supply pump 10 as the fluid supply means, the suction pump 11 as the suction means, and the sucked drained liquid And a drainage container 3 for storing the excised tissue. The ejection pipe 70, the supply pump 10, and the fluid supply container 2 are connected by a fluid supply tube 4. The suction tube 80, the suction pump 11, and the drainage container 3 are connected by the suction tube 5.

  The bubble generating member 31 converts the fluid supplied from the supply pump 10 into a pulsating flow (hereinafter sometimes referred to as a pulse flow). As the bubble generating member 31, any method capable of converting a fluid into a pulsating flow and jetting it in a pulsed manner, such as a piezoelectric method using a piezoelectric element or a bubble jet (registered trademark) method, is applicable. However, the bubble generating member 31 described below will be described by exemplifying a method of generating vapor bubbles using an optical fiber. The optical fiber 31 extends to the outside of the grip portion 22 and is connected to the laser source 30.

  The ejection pipe 70 has an ejection flow path 71 that communicates with the fluid supply tube 4, and an ejection opening 72 having a reduced flow path is opened at the tip.

  The ejection tube 70 is eccentrically inserted into the suction tube 80 so that the outer peripheral surface is in contact with the inner peripheral surface of the suction tube 80. The injection pipe 70 is bent in the vicinity of the injection opening 72, and the injection opening 72 and the suction pipe 80 are disposed concentrically. A gap formed between the inner peripheral surface of the suction pipe 80 and the outer peripheral surface of the injection pipe 70 is a suction flow path 81, and a suction opening 82 is provided at the end of the suction flow path 81 on the injection opening 72 side. It is done. It is desirable that the ejection pipe 70 has a rigidity that does not deform during fluid ejection, and that the suction pipe 80 has a higher rigidity than the ejection pipe 70.

  Next, the flow of fluid in the fluid ejecting apparatus 1 configured as described above will be briefly described. The fluid stored in the fluid supply container 2 is sucked by the supply pump 10 and is supplied to the ejection flow path 71 of the ejection pipe 70 through the fluid supply tube 4 at a constant pressure.

  When the laser source 30 stops driving, the fluid supplied at a constant pressure from the supply pump 10 passes through the ejection flow path 71 and is continuously ejected from the ejection opening 72. At this time, the flow rate of the liquid flowing from the ejection opening 72 is small (for example, 0.2 cc / s) and the speed is low (for example, 1 m / s or less). In this flow, since the tissue cannot be excised as a surgical apparatus, it is safe even if liquid flows out from the ejection opening 72. Next, when the pulse laser is emitted into the liquid from the tip 31A of the optical fiber 31 in a state where the ejection flow path 71 is filled with the liquid, the energy is absorbed by the liquid and the liquid is vaporized instantaneously. Thereby, vapor bubbles are generated around the tip 31 </ b> A of the optical fiber 31. Due to the generation of the vapor bubbles, the internal pressure of the ejection flow path 71 rises rapidly, and the liquid pushed by this pressure is ejected at once from the ejection opening 72 as a pulse jet. At this time, the ejection speed of the pulse jet ejected from the ejection opening 72 is as high as 10 m / s to 80 m / s, and has a tissue excision ability. After the pulse jet is generated, a part of the ejection flow path 71 becomes hollow, but the liquid is filled into the ejection flow path 71 in a short time by the liquid feeding from the supply pump 10. Then, it becomes possible to inject a pulse jet again. As described above, the pulsating flow is generated by intermittently generating bubbles in the ejection pipe, and the fluid can be ejected in a pulse form from the ejection opening 72.

  Here, the pulsating flow means a fluid flow in which the fluid flow direction is constant and the fluid flow rate or flow velocity is accompanied by periodic or irregular fluctuations. The pulsating flow includes an intermittent flow in which the flow and stop of the fluid are repeated. However, since the flow rate or flow rate of the fluid only needs to change periodically or irregularly, the pulsating flow is not necessarily an intermittent flow.

  Similarly, ejecting fluid in a pulsed manner means ejecting fluid in which the flow rate or moving speed of the fluid to be ejected varies periodically or irregularly. An example of pulsed injection is intermittent injection in which fluid injection and non-injection are repeated. However, since the flow rate or moving speed of the fluid to be injected only needs to fluctuate periodically or irregularly, it is not always intermittent injection. Need not be.

  Next, suction will be described. The fluid ejected from the ejection opening 72 stays as drainage at the surgical site. In the surgical site, there is a removed living tissue (hereinafter referred to as a resected tissue). The drainage and excised tissue are sucked from the suction opening 82 by the suction pump 11 and are stored in the drainage container 3 through the suction channel 81 and the suction tube 5. The suction pump 11 may be driven in conjunction with the drive of the laser source 30, or may be driven intermittently periodically or when necessary.

  Note that several shapes and structures of the injection tube 70 and the suction tube 80 are conceivable. Therefore, they will be described as specific embodiments with reference to the drawings.

(First embodiment)
First, the first embodiment will be described.
FIG. 2 is a cross-sectional view showing a cut surface obtained by cutting the bubble generating member 31, the injection pipe 70, and the suction pipe 80 according to the present embodiment along the fluid injection direction. A flexible fluid supply tube 4 is connected to the opening of the grip portion 22 from the supply pump 10. Thereby, the flow path in the fluid supply tube 4 communicates with the cavity inside the ejection flow path 71. Then, the liquid (water in this embodiment) is supplied to the ejection flow path 71 through the fluid supply tube 4 from the supply pump.

  In addition, for example, a quartz-based optical fiber 31 is passed through the holding portion 22 through the ejection flow path 71. In addition, it is sealed so that the liquid may not leak between the optical fiber 31 and the grip part 22 and between the grip part 22 and the ejection flow path 71. The optical fiber 31 extends to the outside of the grip portion 22 and is connected to the laser source 30. In the present embodiment, a laser source 30 that supplies pulsed light of a Holmig laser (Ho-YAG laser: wavelength 2.1 μm) is used.

  The gripping part 22 supports the optical fiber 31 with the tip 31 </ b> A of the optical fiber 31 protruding into the ejection flow path 71. The tip 31A of the optical fiber 31 corresponds to the emission surface of the pulse laser.

  In addition, a suction tube 80 as a mantle tube of the injection tube 70 protrudes from the grip portion 22. An opening 83 penetrating the tube wall is opened near the proximal end of the suction tube 80 on the gripping portion 22 side, and the suction tube 5 is attached so as to communicate with the opening 83. Since the surgeon grips and operates the grip portion 22, the operability can be improved by setting the extending direction of the suction tube 5 near the grip portion 22 to the same direction as the fluid supply tube 4. .

  As shown in the drawing, the ejection pipe 70 is inserted in the suction pipe 80 in an eccentric state. The injection pipe 70 is bent in the vicinity of the injection opening 72, and the injection opening 72 and the suction pipe 80 are disposed concentrically. P represents the center of the ejection opening 72 and the suction pipe 80.

  In this embodiment, the outer peripheral surface of the injection tube 70 is in contact with the inner peripheral surface of the suction tube 80. In such a structure, the injection tube 70 is inserted into the suction tube 80 and fixed with an adhesive or the like in a state where the inner peripheral surface of the suction tube 80 and the outer peripheral surface of the injection tube 70 are in contact with each other. If it press-fits into the holding part 22, it can be assembled. At this time, as shown in FIG. 2, the proximal end portion of the ejection tube 70 on the gripping portion 22 side protrudes from the proximal end portion of the suction tube 80 and is press-fitted into the gripping portion 22, and the suction tube 80 is free from the gripping portion 22. What is necessary is just to fix with an adhesive etc. in relation to intuition. In order to fix the injection tube 70 and the suction tube 80 to the grip portion 22, it is desirable to reinforce the sealing with an adhesive, a brazing material, or the like.

  The injection tube 70 and the suction tube 80 are preferably fixed in the entire contact range in the lengthwise direction, but at least the vicinity of the tip of the injection opening 72 (the range shown in FIG. 2 and FIG. 2B) may be fixed. . For example, the range of B in the figure is provided on the side closer to the injection opening 72 than half of the entire length of the injection pipe 70. In this case, after inserting the injection tube 70 and the suction tube 80 in this order into the grip portion 22, the range shown in FIG. B may be bonded and fixed with an adhesive, brazing material, or the like, or fixed using a fixing means such as welding. .

  When the gap between the inner peripheral surface of the suction tube 80 and the outer peripheral surface of the injection tube 70 is the suction flow channel 81, the flow channel diameter of the suction tube 80 is d1, and the outer diameter of the injection tube 70 is d2, (d1-d2 ) Is the size of the suction channel 81.

  By the way, in Patent Document 1, the injection tube 70 is inserted so as to be concentric with the suction tube 80. In this case, the size of the suction channel 81 is (d1−d2) / 2, and even though the total area of the suction channel 81 is the same, the size of the suction channel 81 is eccentric. The example is bigger.

  In the present embodiment, the injection tube 70 and the suction tube 80 are concentric in the vicinity of the tip. Therefore, the size of the suction channel 81 in the concentric range is (d1−d2) / 2. Therefore, the suction channel is smaller than the eccentric area. For this reason, the bent portion position 70a of the injection pipe 70 is preferably as close to the tip as possible in production.

  Further, it is desirable that the size of the flow path of the opening 83 and the suction tube 5 provided in the suction pipe 80 is the same as or larger than the flow path cross-sectional area of the suction opening 82.

  In FIG. 2, the inner peripheral surface of the suction tube 80 and the outer peripheral surface of the injection tube 70 are disposed so as to contact each other, but there may be a slight gap.

  Next, the pulse flow ejection operation of the optical fiber 31 in the present embodiment will be described with reference to FIGS. A fluid is supplied to the injection pipe 70 at a constant pressure by the supply pump 10. The fluid supply amount from the supply pump 10 may be an amount that is substantially equal to the pulse flow injection amount from the injection opening 72. Here, when the optical fiber 31 does not operate, the fluid flows into the ejection pipe 70 due to the difference between the discharge force of the supply pump 10 and the flow path resistance on the entire fluid supply tube 4 side.

  Further, for example, a quartz-based optical fiber 31 is passed through the opening of the ejection flow path 71 of the ejection pipe 70 through the grip portion 22. In addition, it is sealed so that a liquid may not leak between the optical fiber 31 and the holding part 22, and between the optical fiber 31 and the injection pipe 70, respectively. The optical fiber 31 extends to the outside of the grip portion 22 and is connected to the laser source 30. In the present embodiment, a laser source 30 that supplies pulsed light of a Holmig laser (Ho-YAG laser: wavelength 2.1 μm) is used.

  According to the first embodiment described above, the surgeon recognizes the position of the ejection opening 72 because the ejection opening 72 and the suction tube 80 are concentrically disposed in the vicinity of the ejection opening 72. It becomes easy to inject a fluid to the target operation part easily.

  Further, the injection pipe 70 is inserted eccentrically with respect to the inner peripheral surface of the suction pipe 80 in most length regions other than the vicinity of the injection opening 72. Therefore, the size of the suction channel 81 when eccentric is larger than the size of the suction channel 81 when concentric. Therefore, even if the suction channel 81 is long, the flow resistance of the excised tissue can be reduced and removed by suction. Further, since the laser emitted from the tip of the optical fiber 31 has high straightness, when the liquid in the injection tube 70 is reduced, there is a possibility that the injection target may be damaged by the laser. Since 70 is bent by the suction tube 80 and is eccentric, there is an effect of preventing the laser beam from being directly applied to the injection target. Further, when the ejection pipe 70 comes into contact with the suction pipe 80, heat is transmitted to the suction pipe 80 via the ejection pipe 70, and there is an effect that heat generation of the ejected liquid can be suppressed.

  In addition, by arranging the injection opening and the suction pipe concentrically, it may be impossible to ensure a large gap between the suction pipe and the injection pipe in the vicinity of the suction port. In this case, even if the excised tissue is sucked into the suction port, if the suction force is adjusted, the excised tissue sucked up can be removed relatively easily. On the other hand, if the excised tissue is clogged in the middle of the suction flow path, it is difficult to remove it. Therefore, as in the present embodiment, the suction flow path 81 is configured to be large except for the tip. The suction channel 81 preferably has a wider gap from the suction port toward the suction side, or at least maintains the same gap.

  Further, since the injection pipe 70 is fixed to the inner peripheral surface of the suction pipe 80 in the vicinity of the injection opening 72, the vibration of the tip end portion of the injection pipe 70 can be suppressed. In addition, it is possible to prevent an abnormal sound from being generated due to the vibration of the injection tube 70 and the suction tube 80, and the tip (injection opening 72) of the injection tube 70 does not move due to the vibration. The resonance of the suction tube 80 is suppressed, and there is an effect that the fluid can be accurately ejected to the surgical site position.

  In addition, although the structure which fixes the suction pipe 80 to the holding part 22 was illustrated in the present Example, it is also possible to make the holding part 22 protrude and to use as a suction pipe. Further, although the arrangement position and the extending direction of the suction tube 5 are not particularly limited, since the operator grips and operates the grip portion 22, the suction tube 5 and the fluid supply tube 4 are connected in the vicinity of the grip portion 22. By extending so as to extend along each other, the balance when operating can be improved, and the operability can be improved.

(Second embodiment)
Next, a second embodiment will be described with reference to the drawings. In the present embodiment, the injection opening 72 is concentric with the suction pipe 80, whereas the first embodiment described above bends the injection opening 72 and the suction pipe 80 concentrically. It is characterized by that. Therefore, the same reference numerals as those in the first embodiment are used for explanation, focusing on the differences from the first embodiment.

  FIG. 3 is a partial cross-sectional view showing the tip structure of the injection tube 70 and the suction tube 80 according to the present embodiment. (A) is a fragmentary sectional view, (B) is the front view visually recognized from the front-end | tip direction (illustration E direction) of (A). The injection tube 70 is inserted eccentrically with respect to the suction tube 80. At the distal end portion (in the range B in the figure), the injection tube 70 and the suction tube 80 are fixed using an adhesive, a brazing material, or the like, or a fixing means such as welding.

  In the injection pipe 70, the injection opening 72 is opened eccentrically with respect to the injection flow path 71. The ejection opening 72 is disposed at a position that is concentric with the suction pipe 80. Therefore, a wall 73 is formed on the periphery of the ejection opening 72.

  Since the ejection tube 70 and the suction tube 80 are eccentric to the length range of the suction tube 80 including the suction opening 82, the entire length of the suction channel 81 can be made larger than that of the concentric case. As a result, a large excised tissue can be aspirated and removed.

(Third embodiment)
Next, a third embodiment will be described with reference to the drawings. This embodiment is a modification of the above-described second embodiment, and is characterized in that the injection opening is formed by a nozzle. Therefore, the difference from the second embodiment will be mainly described.

  FIG. 4 is a partial cross-sectional view showing the tip structure of the ejection tube 70 and the suction tube 80 according to the present embodiment. A nozzle 75 is inserted at the tip of the injection tube 70. The nozzle 75 is provided with an injection opening 76, and the injection opening 76 is concentric with the suction pipe 80. A wall 77 is formed on the periphery of the injection opening 76. The injection opening 76 corresponds to the injection opening 72 in FIG. 3, and the wall 77 corresponds to the wall 73 in FIG.

  Therefore, the present embodiment can obtain the same effect as the second embodiment described above. Further, since the injection opening 72 of the second embodiment is opened at the tip of the elongated injection pipe 70, the injection opening 76 is opened in the nozzle 75, so that the manufacturing is easy.

(Fourth embodiment)
Next, a fourth embodiment will be described with reference to the drawings. The present embodiment is a modification of the first embodiment described above, and is characterized in that the size of the suction opening 82 is made to be approximately the same as the size of the suction channel 81. Therefore, it demonstrates centering on a different location from 1st Example.

  FIG. 5 is a partial cross-sectional view showing the tip structure of the ejection tube 70 and the suction tube 80 according to the present embodiment. The distal end portion 84 of the suction tube 80 is widened in the vicinity of the bent portion position 70 a of the ejection tube 70 than the other portions. The distal end portion 84 and the injection opening 72 are concentric. The flow path 81 a at the distal end portion 84 is substantially the same size as the suction flow path 81.

  Therefore, the effect that the injection opening 72 and the suction pipe 80 are concentric is obtained, and the suction opening 82 and the suction flow path 81 are continuous with substantially the same size, so that the first embodiment On the other hand (see FIG. 2), a larger excised tissue can be aspirated.

  In addition, the shape of the front-end | tip part 84 is good also as a taper shape extended in a front-end | tip direction.

(5th Example)
Next, a fifth embodiment will be described with reference to the drawings. In the present embodiment, the fluid ejection direction of the first to fourth embodiments described above is a direction inclined with respect to the ejection flow path 71 with respect to being linear or parallel to the ejection flow path 71. It is characterized by being suitable for.
Depending on the surgical site, excision may be performed at a position deviating from the extending direction of the ejection tube 70. The present embodiment has a form that can cope with such a case. In addition, based on the structure of 1st Example, the same code | symbol is attached | subjected and demonstrated to a common functional element with 1st Example.

  FIG. 6 is a partial cross-sectional view showing the tip structure of the ejection tube 70 and the suction tube 80 according to the present embodiment. The injection tube 70 and the suction tube 80 are bent at the distal end, and the injection tube 70 and the suction tube 80 are concentric at the distal end from the bent portion. Therefore, the ejection opening 72 is disposed on the center line P of the suction pipe 80. And it fixes to the internal peripheral surface of the suction pipe 80 using fixing means, such as welding or the other, fixing with an adhesive agent, brazing material, etc. in the base end side rather than a bending part.

  In addition, when the flow path diameter of the suction pipe 80 is d1, and the bending height of the injection pipe 70 is represented by h, the flow path diameter d1 is set to satisfy the relationship of h <d1. By doing in this way, it becomes possible to insert the injection pipe 70 in the suction pipe 80.

  According to such a configuration, it is possible to perform excision at a position displaced from the straight line of the ejection tube 70 (suction tube 80) and suction removal of the excised tissue.

(Sixth embodiment)
Next, a sixth embodiment will be described with reference to the drawings. As described in each of the above-described embodiments, the ejection opening 72 is disposed concentrically with the suction tube 80, which makes it easier for the operator to recognize the position of the ejection opening 72. The present embodiment is characterized in that the injection opening 72 is configured to be visible by providing a notch portion in the suction tube 80 around the periphery of the suction opening 82. In addition, based on the structure of 1st Example, the same code | symbol is attached | subjected and demonstrated to a common functional element with 1st Example.

  FIG. 7 is a partial cross-sectional view showing the tip structure of the injection tube 70 and the suction tube 80 according to the present embodiment. (A) is a fragmentary sectional view, (B) is a front view viewed from the tip direction (arrow E direction). 7A and 7B, a notch 86 is formed in the vicinity of the injection opening 72 of the suction pipe 80. The notch 86 is formed at a position on the periphery of the suction opening 82, so that the operator can visually recognize the distal end portion (jet opening position) of the ejection tube 70.

  Therefore, by providing the notch portion 86 at the distal end portion of the suction tube 80, the operator can directly recognize and operate the distal end portion (ejection opening position) of the ejection tube 70. Therefore, it is possible to inject and excise the fluid to an accurate surgical site.

  In addition, by providing the notch 86, the size of the suction opening 82 can be further supplemented, and the ability to suck and remove the excised tissue can be improved.

  The position of the notch 86 is not limited to the eccentric side of the injection opening 72 as shown in FIG. 7 and may be opposite to the eccentric side of the injection opening 72. Further, the number of the notches 86 is not limited to one, and a plurality of the notches 86 may be provided. For example, it is possible to provide another notch at a position facing the notch 86 shown in FIG. If a plurality of notches 86 are provided in this way, the suction ability of the excised tissue in the suction opening 82 can be enhanced.

(Other embodiments)
The above-described embodiments are for facilitating the understanding of the present invention, and are not intended to limit the present invention. The present invention can be changed and improved without departing from the gist thereof, and it is needless to say that the present invention includes equivalents thereof.

<About fluid supply container>
FIG. 8 is a configuration explanatory view showing a fluid ejection device as a surgical instrument according to another embodiment. In the above-described embodiment, the fluid supply container 2 that contains the fluid is used. However, the present invention is not limited to this. As shown in FIG. It may be used. Liquid is supplied from the infusion bag 92 to the ejection flow path 71 at a specified pressure. As a result, when the laser source 30 does not operate, the liquid flows into the ejection flow path 71 due to the difference between the ejection force of the infusion bag 92 and the fluid resistance value on the entire fluid supply tube 4 side.

<About optical fiber>
FIG. 9 is a cross-sectional view showing a cut surface obtained by cutting the bubble generating member, the ejection pipe 70, and the suction pipe 80 according to another embodiment along the fluid ejection direction. In the above-described embodiment, the vapor bubbles are generated using the optical fiber 31 as the bubble generating member, but the present invention is not limited to this. For example, vapor bubbles may be generated using discharge from an electrode. Further, for example, as shown in FIG. 9, vapor bubbles may be generated using a heater 94 as a bubble generating member.

  DESCRIPTION OF SYMBOLS 1 ... Fluid injection apparatus 2 ... Fluid supply container 3 ... Drainage container 4 ... Fluid supply tube 5 ... Suction tube 10 ... Supply pump 11 ... Suction pump 22 ... Grasping part 30 ... Laser source 31 ... Optical fiber (bubble generating member) 31A ... Tip 70: Injection pipe 70a ... Bending part position 71 ... Injection flow path 72 ... Injection opening 73 ... Wall part 75 ... Nozzle 76 ... Injection opening 77 ... Wall part 80 ... Suction pipe 81 ... Suction flow path 81a ... Flow path 82 ... suction opening 83 ... opening 84 ... tip part 86 ... notch part 92 ... infusion bag 94 ... heater (bubble generating member).

Claims (4)

A gripping part;
A suction pipe protruding from the gripping part;
An injection pipe that is eccentrically inserted into the suction pipe and has an injection opening projecting from the grip portion;
A bubble generating member for generating bubbles in the injection tube;
Anda suction opening formed in an end portion of the suction passage and the suction passage formed between an outer peripheral surface of the injection pipe and the inner peripheral surface of said suction tube,
In the vicinity of the injection opening, the injection opening and the suction pipe are arranged concentrically ,
The fluid ejection device according to claim 1, wherein the ejection opening is opened eccentrically with respect to the ejection tube, and a wall portion is formed at a peripheral edge of the ejection opening . The fluid ejection device according to claim 1,
The fluid ejecting apparatus, wherein the suction tube and the ejection tube are fixed at least on the ejection opening side of a region where the suction tube and the ejection tube are eccentric. The fluid ejection device according to claim 1 or 2,
Wherein the suction tube, fluid ejecting apparatus characterized by notch over the periphery of the suction opening is provided.   A medical device comprising the fluid ejection device according to any one of claims 1 to 3.

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