JPH01158945A - Ultrasonic suction apparatus - Google Patents

Abstract

PURPOSE:To prevent the clogging with a hematoma, by providing a suction force changing means for intermittently changing suction force to the suction passage of an ultrasonic probe on the discharge side thereof. CONSTITUTION:An ultrasonic probe 6 has an insert part 33 having a fine diameter provided with a hollow suction passage 32 and is connected to a vibrator part 35 on the rear end side thereof. For example, a magnetostriction vibrator is received and ultrasonic vibration due to magnetostriction vibration can be generated by the AC drive signal from a generator 8. The suction passage 32 communicates with the suction cap 36 passing through the hollow part of the vibrator part 35 and the hematoma introduced into the suction passage 32 can be sucked and removed by a suction pump 29. A solenoid valve 41 is mounted on the way of the tube 28 reaching the suction pump 29 from a suction bin 27 and a cable 42 for supplying drive power to the solenoid valve is connected to a valve opening and closing signal generator 43 and the opening and closing degree of the solenoid valve 41 is controlled by the output signal of said signal generator 43. For example, the valve opening and closing signal generator 43 is constituted of a function generator and the cycle of the waveform thereof or the duty thereof can be variably set.

Description

DETAILED DESCRIPTION OF THE INVENTION [Field of Industrial Application] The present invention relates to an ultrasonic aspiration device for suctioning and discharging a hematoma tube without clogging it by ultrasonic aspiration.

[Prior Art] Typical cerebrovascular disorders include cerebral hemorrhage and subarachnoid hemorrhage. In order to remove these intracerebral hematoma ducts after intracerebral hemorrhage, CT Stereotactic brain surgery is performed using the (computed tomography) guided method.

Stereotactic neurosurgery involves fixing a stereotactic neurosurgery device to the patient's head, positioning the device to the affected area in the brain using a positioning device, and inserting treatment tools such as drainage tubes into the affected area. and perform surgery. In recent years, stereotactic neurosurgery has improved the precision of positioning and minimized the invasiveness to the patient by using a 0-cutter to capture and position the affected area using CT tomographic images.

Examples of surgical devices used in stereotactic brain surgery are shown in Japanese Patent Application Publication No. 25377/1986, Japanese Utility Model Application Publication No. 26088/1987, and the like.

By the way, conventionally, as a method for removing intracerebral hematoma by stereotactic brain surgery, a method has been used in which a metal suction tube is inserted into the hematoma and the hematoma is suctioned out using a suction device such as a syringe.

If complete removal is not possible with this method, an indwelling tube is placed in the hematoma membrane and urokinase (tJrokinase) is injected into the hematoma.
A method of injecting a blood 8 lytic agent such as Aspergillus ase) and removing the lysed hematoma from the indwelling tube several hours later by suction is used.

In addition, in recent years, ultrasonic aspiration equipment has been used to crush hematomas,
A method of suction removal is also being used.

Furthermore, biopsies of brain tumors, ablation treatments using Nd-YAG laser light, and the like are performed using stereotactic brain surgery.

[Problems to be solved by the invention] However, in stereotaxic intracerebral hematoma removal using the CT There is a risk of it being damaged. In addition, the intracerebral hematoma may not be completely removed due to excessive efforts to avoid damaging the brain parenchyma.

In addition, in order to avoid damaging the brain parenchyma, surgical operations must be performed while sequentially checking the status of hematoma aspiration using CT, which results in extremely long surgical times, great invasiveness to the patient, and increases the burden on the surgeon. Fatigue will also be extremely high.

Furthermore, when using a suction device such as a syringe to remove a hematoma, the suction pressure must be quite high due to the nature of the hematoma, which is a highly mucous membrane, and the high suction pressure can also aspirate the brain parenchyma. In addition, there is a problem in that the lumen of the suction tube is likely to be clogged with hematoma, and the operation often has to be interrupted.

In order to make it difficult for the hematoma to become clogged, the diameter of the suction tube must be increased, which in turn increases the degree of damage to the brain parenchyma.

In addition, in the hematoma lysis method, the dissolution ability of the hematoma lytic agent is very small, and the situation is not clinically satisfactory. In addition, there is a risk that the catheter will remain in place for a long period of time, causing great pain to the patient.

Furthermore, although the method using an ultrasonic suction device is very effective, conventional methods have the drawback that the vibration used to suction the ultrasonic probe tends to cause hematoma to collect and become trapped in the nodal area, causing clogging. Ta.

The present invention has been made in view of the above point, and an object of the present invention is to provide an ultrasonic suction device that can effectively prevent clogging due to hematoma or the like in the nodal portion.

[Means and effects for solving the problem] In the present invention, by providing a suction force changing means that intermittently changes the suction force of the suction means connected to the discharge side of the suction path of the ultrasonic probe, ultrasonic Even if a hematoma or the like gathers at the node in the probe's motion mode, the suction pressure when increased is used to move the hematoma by suction, thereby preventing the hematoma from clogging and allowing it to be removed by suction.

[Example] Hereinafter, the present invention will be specifically explained with reference to the drawings.

FIGS. 1 to 5 relate to the first embodiment of the present invention.
The figure is a block diagram showing the overall structure of the first embodiment, FIG. 2 is a perspective view showing the structure of a brain surgery apparatus equipped with the first embodiment, and FIG.
The figure is an explanatory diagram showing how the suction pressure is changed by the suction pressure changing means, Figure 4 is a TI explanatory diagram showing the generation of nodes and antinodes during ultrasonic vibration, and Figure 5 is similar to Figure 3. shows how the suction pressure changes when different suction pressures are applied.

As shown in FIG. 2, the brain surgery device 1 equipped with the first embodiment includes a sheath 2, a telescope 3, an adapter 4, a stereotactic brain surgery device 5, an ultrasonic probe 6 as a treatment tool, a fixing device 7, and an ultrasonic wave. It is composed of a generator 8 and the like as a driving means.

The patient's head 9 is inserted into the ring 11 of the stereotactic neurosurgical device 5, and the ring 11 has four wooden head fixing bins 12. . . , 12, it is fixed to the stereotactic neurosurgery device 5. On one side of the ring 11, a positioning station front 13 that can slide in the X, Y, and Z directions and rotate in the α direction is stepped, and this positioning device 13 has a curved rIA 14. They are installed consecutively. The arm 14 is provided with the sheath 2 so as to be slidable in the β direction. Further, at the top of the ring 11, a fixing device 7 is provided in which a curved arm 16 for holding the sheath 2 together with an arm 14 is connected.

The sheath 2 is held by a sheath holder 17 by arms 14 and 16. Further, this sheath holder 17 supports a slide device 19 via a support 18.

The sheath 2 is connected to the telescope 3 with an eyepiece 21 extending diagonally rearward on the side, and the ultrasonic probe 6 is connected to the rear of the telescope 3. The adapter 4 is provided. A light guide cable 22 that can supply illumination light is connected to J3 and the telescope 3, and a water supply tube 23 that can supply water such as physiological saline is connected to the sheath 2.

A cord 24 and a drainage tube 26 extend from the rear end of the ultrasonic probe 6, the cord 24 is connected to the generator 8, and the drainage tube 26 is connected to the generator 8.
It is connected to a collection bin 27 for collecting waste liquid attached to the container. A tube 28 extending from this collection bin 27 is connected to a suction pump 29. A tube 30 attached to the discharge port of this suction pump 29 is connected to a drainage container (not shown).

By the way, the ultrasonic suction device 31 of the first embodiment has a configuration similar to that shown in FIG.

The ultrasonic probe 6 has a small diameter (probe) insertion part 33 provided with a hollow suction path 32, and a transducer part is inserted into the rear end of this insertion part 33 via a horn in a horn cover 34. It is connected to 35.

For example, a magnetostrictive vibrator is housed in the vibrator section 35,
By applying an AC drive signal from the generator 8, ultrasonic vibrations due to magnetostrictive vibrations can be excited.

The suction path 32 is inserted into a suction mouthpiece 36 that passes through the hollow part of the vibrator section 35, and the hematoma that has entered the suction path 32 due to the suction force of the suction pump 29 is removed by suction and discharge.

By the way, in the ultrasonic suction device 31 of the first embodiment, a solenoid valve 41 (or an electromagnetic cock) is attached in the middle of the tube 28 from the suction bottle 27 to the suction pump 29. This solenoid valve 41 has a cable 42 connected to a valve opening/closing signal generator 43 for supplying driving power to a solenoid (not shown) forming this solenoid valve 41.
The output signal of this valve opening/closing signal generator 43 causes the solenoid valve 4 to
1, its opening/closing amount is controlled. This valve opening/closing signal generator 4
Reference numeral 3 is composed of, for example, a function generator, and this function generator serves as an output wave selection means capable of outputting signals of various waveforms, and the period and duty of the waveform can also be variably set. By selecting the output waveform, for example, a pulsating flow wave with a constant period is output, and the opening/closing amount of the solenoid valve 41 is changed according to the level of the pulsating flow wave, thereby changing the suction pressure over time. A suction pressure changing means 44 is formed.

Due to the pulsating flow waves, the suction pressure within the suction device 32 becomes as shown in FIG. By pulsating the suction pressure in this way, an antinode and a node in the ultrasonic longitudinal vibration mode shown in FIG. 4(b) are generated in the longitudinal direction of the insertion portion 33 as shown in FIG. 4(a). Even if hematoma tends to collect in the nodal area, the hematoma can be moved to the IJl exit side by intermittently increasing the suction pressure as shown in Figure 3. There is.

In other words, by setting the cycle of increasing the suction pressure in a pulsating manner (intermittently) to an appropriate value, hematomas that tend to collect at each node can be evacuated each time using the suction pressure when the pressure is high. It can be moved to the side.

Therefore, according to this first embodiment, the ultrasonic probe 6
When the hematoma is crushed at the tip of the hematoma and the crushed hematoma is sucked out into the suction channel 32 by suctioning at the lower suction stage, even if ultrasonic vibration is generated in the longitudinal direction of the insertion portion 33 of the ultrasound probe 6, Even if the hematoma in the suction passage shows a tendency to collect at the nodal part during . Therefore, it is possible to effectively prevent blood tumors that have gathered in the node portion from solidifying and causing clogging in the conventional example.

In the first embodiment, the suction pressure by the suction pressure changing means 44 is in the form of a pulsating wave, but it may be in the form of a triangular wave as shown in FIG. (Also, other shapes of intermittent waves may be used.) Also,
The suction pressure may be changed by changing the driving power to the suction pump 29.

FIG. 6 does not show the main parts of the second embodiment of the present invention.

In this second embodiment, the insertion portion 52 of the ultrasound probe 51 is
A narrow diameter portion 53 is provided with a narrow diameter at the tip end side.

The narrow diameter portion 53 is formed along the length from the tip to the node closest to the tip when ultrasonic vibration is applied. FIG. 7(b) shows an enlarged view of the distal end side of FIG. 6, and shows the suction path 5.
4 has a narrow diameter at a narrow diameter portion 53 as shown in FIG.

In this second embodiment, a tube 56 attached to the ultrasonic probe 51 is connected to a suction pump via a collection bottle (not shown). In this case, suction pressure changing means may be provided as in the first embodiment, or may not be provided.

According to this second embodiment, a narrow diameter portion 53 is provided on the tip side of the ultrasonic probe 51, and the diameter is enlarged on the rear side from the portion corresponding to the vibration node, so that when longitudinal vibration occurs, this node portion Even if a hematoma tries to collect in the area, the enlarged diameter on the rear side prevents the hematoma from collecting.

In other words, even if there is a tendency for the commercial soul 57 to occur within the narrow diameter portion 53 as shown in FIG. 8, this portion corresponds to the belly, and therefore moves toward the rear without adhering to the inner wall. However, since there is not much movement at the joint during vibration, it is likely to become clogged, but since the diameter expands from the position immediately before the joint, it can be smoothly moved rearward by suction.

Note that the narrow diameter portion 53 has a small diameter, even though it has a commercial spirit 57.
Even if this occurs, the size of the commercial spirit 57 is controlled, and the blood clot 57 is smoothly moved in the enlarged diameter 55 without clogging.

FIG. 9 shows the main parts of a third embodiment of the present invention.

In this third embodiment, an antithrombotic material layer 63 is provided on the wall of the lumen forming the suction path 62 of the ultrasonic probe 61.

The ultrasonic probe 61 has a transducer 65 housed within the probe body 64. The vibration of this vibrator 65 is caused by the vibration of the horn 6
An oscillation tube 67 attached to the front end of this horn 66 via
transmitted to.

The hollow portion of the oscillation tube 67 communicates with the hollow portion of a horn 66, and the hollow portion of the horn 66 further forms a suction path 62 that extends through the hollow portion of the vibrator portion 65 to the base portion 68.

A suction tube 69 is connected to this mouthpiece 68 .

A drive signal is applied to the vibrator 65 via a signal cable 71. Further, the outside of the horn 66 is covered with a conical cover 72.

The above-mentioned antithrombotic materials include Teflon (polytetrafluoroethylene), heparin, TDMAC (tridodec
y1methylan+monium), etc. can be used. Further, the antithrombotic material layer 63 may be provided over the entire length of the suction path 62 of the ultrasound probe 61, or may be provided only in the inner cavity of the oscillation tube 67 where hematoma is most likely to adhere. It may be provided. Furthermore, since the nodes of vibration are most likely to generate heat and therefore blood adhesion is likely to occur, it may be provided at least at the nodes.

FIG. 10(a) shows the tip side of an ultrasonic probe 81 in a fourth embodiment of the present invention.

In this figure (a), the tip side of an ultrasonic probe 81 is formed into a tip portion 82 having an obliquely notched shape. Further, as shown in FIGS. 10(b) and 10(c), instead of the diagonal notch, the tip may be provided with a slot 83, or may be provided with an IL 84.

In the conventional example, the tip of the probe is the center ir! Since the probe was cut at right angles to the probe tip and the probe lumen was long and thin, it was easy for blood clots to get stuck in this lumen. Always even if it is imposed on you by the organization? One stream of liquid can flow within the suction channel 85 of the probe 81 . Therefore,
It can effectively prevent clogging.

It should be noted that the shape may be different from that shown in FIG. 10.

11 and 12 show the main parts of an ultrasonic suction device 91 according to a fifth embodiment of the present invention.

This device 91 has a structure in which a scope (optical viewing tube) 93 and an ultrasonic probe 94 (an insertion portion thereof) are inserted into a hollow sheath 92, and the probe 24 radiates heat from a heat radiating member 95''e.

The heat dissipating member 95 has heat dissipating pieces 96,96. ...and the heat dissipation piece 96.
Cylindrical heat dissipation part 9 attached to the end protruding outside of 96
7 and a fixing part 98 for fixing this cylindrical heat radiating part 97 to the sheath 92.

Note that the heat dissipating member 95 may be formed longer than that shown in FIG. 10, or may have a shape different from those shown in these figures.

By the way, in each of the above-mentioned embodiments, the hematoma is crushed by ultrasonic waves and the crushed hematoma is sucked by the suction means, but it can also be used as a skull perforation device 101 as shown in FIG. 13. .

In this device 101, the patient's head 9 is fixed with the stereotactic neurosurgical device 5 described in FIG. (configuring) the tip of the ultrasonic oscillation tube 105 of the ultrasonic probe 104. In this case, the ultrasonic oscillation tube 105 is inserted into the sheath 106, and the irrigation fluid is supplied from the water supply means through the tube 107, while the probe 104
A suction tube 108 connected to the rear end is connected to a suction pump (path shown), and when the hole is punctured, the tissue piece is suctioned and discharged together with the irrigation fluid.

An ultrasonic pendulum is housed in a grip portion 109 on the hand side of the ultrawhite wave probe 104, and AC power for generating ultrasonic waves is supplied from an ultrasonic drive circuit (not shown) via a signal cable 110.

According to this device 101, a hole is drilled into the skull by ultrasonic vibration without using a sharp cutting tool such as a drill as in the conventional example, so that a desired sharp hole can be formed safely and quickly.

By the way, in the first embodiment, for example, the output signal of the generator 8 is superimposed using a drive signal oscillator that sweeps the drive frequency gradually from f to f-8f as shown in FIG. A sonic probe (an ultrasonic transducer) may be driven.

By changing the driving frequency in this way, the position of the surface relative to the probe insertion part 111 is moved from the position PO shown by the solid line to the rear side (right side) as shown in Pi to P2, as shown in FIG. 15, and then again. Return to the initial state and repeat this operation. By υ in this way, the hematoma that tends to collect in the nodal area can be moved to the proximal side, and when the initial state is restored again, the location where the hematoma has collected is at or near the abdomen, so it can be moved to the posterior side. can be moved to

Note that the drive is not limited to the one in which the frequency is gradually lowered, but may be alternately driven at two 5 frequencies to change the position of the node.

[Effects of the Invention] As described above, according to the present invention, since a means for changing the suction force is provided, clogging such as hematoma can be effectively prevented.

[Brief explanation of the drawing]

FIGS. 1 to 5 relate to the first embodiment of the present invention.
The figure is a dimensional block diagram showing the overall structure of the first embodiment, FIG. 2 is a perspective view showing the structure of a brain surgery apparatus equipped with the first embodiment, and FIG.
The figure is an explanatory diagram showing how the suction pressure is changed by the suction pressure changing means, Fig. 4 is an explanatory diagram showing the generation of knots and belly portions during ultrasound imaging, Fig. 5, C51, and Fig. 3. FIG. 6 is an explanatory diagram showing the main part of the second embodiment of the present invention, and FIG. 7 is an illustration of the ultrasound probe in the second embodiment. FIG. 8 is an explanatory view of the operation of the second embodiment; FIG. 9 is a cross-sectional view showing the ultrasonic probe according to the third embodiment of the present invention;
FIG. 10 is a cross-sectional view showing the main part of the fourth embodiment of the present invention and a modification thereof, FIG. 11 is a cross-sectional view of the main part of the fifth embodiment of the present invention, and FIG. 12 is the same as that of FIG. △-B line sectional view,
FIG. 13 is a perspective view showing the sixth embodiment of the present invention, FIG. 14 is an explanatory diagram showing the drive signal output of the drive signal oscillator in the seventh embodiment of the present invention, and FIG. 15 is the drive of FIG. FIG. 6 is an explanatory diagram showing how the position of a node changes due to signal output. 1... Brain surgery device 2... Sheath 3... Scope 5... Stereotactic brain surgery device 6... Ultrasonic probe 8... Generator 29... Suction pump 31... Ultrasonic suction Device 32... Suction path 41... Solenoid valve 43... Valve opening/closing signal generator 44... Suction pressure changing means Fig. 1 Fig. 8 Lehr Fig. 3-Hg Fig. 5 Figure 10 (b) Figure 11 Figure 12

Claims (1)

[Claims] An ultrasonic suction device comprising: an ultrasonic probe provided with an ultrasonic vibrating means and a suction path that vibrate ultrasonically when a drive signal is applied; and a suction means connected to the suction path of the ultrasonic probe. An ultrasonic suction device characterized by being provided with suction force changing means for changing the suction force of a pump.