JPH03126452A - Ultrasonic surgical operation device for ophthalmology - Google Patents

Abstract

PURPOSE:To decrease the generation of a cavitation of a pouring flow liquid in a pouring flow liquid passage formed between a horn and a transfer tube, and an outer cylinder and a protective tube by forming a connecting part of the transfer tube and the horn to an outside diameter shape which becomes <=60 deg. against the vibration direction of ultrasonic vibration. CONSTITUTION:A connecting part of a vibrator 10 of a transfer tube provided on a horn 12, and the horn 12 is formed in an outside diameter shape of <=60 deg. against the vibration direction 46 of ultrasonic vibration, and cut to inclined surfaces 38, 40 of <=60 deg.. In such a way, the generation of a cavitation is prevented. That is, in a pouring flow liquid passage, disorder of a low of a pouring flow liquid decreases. Therefore, bubbles (cavitation) generated in the pouring flow liquid decrease, a visual field of the affected part becomes clear, and the time for an operation is shortened and the accuracy is improved.

Description

Detailed Description of the Invention [Industrial Application Field] The present invention relates to an ophthalmological ultrasonic surgical instrument, and particularly in lens removal surgery in which irrigation fluid is supplied, ultrasonic vibrations are transmitted to the affected area to remove cataract tissue. This relates to, for example, a horn of an ophthalmic ultrasonic surgical instrument that crushes and aspirates.

[Prior Art] Currently, ophthalmological ultrasonic surgical instruments that are widely used in the medical field use a horn to amplify the amplitude of ultrasonic vibrations generated by a vibrator to a level that can crush the affected tissue. This ultrasonic vibration with amplified amplitude is transmitted to the affected area, the cataract tissue in the affected area is crushed, and the crushed tissue pieces are suctioned and removed together with the irrigation fluid.

In other words, an ophthalmological ultrasonic surgical instrument generally includes an ultrasonic vibrating section consisting of a horn for crushing cataract tissue, and an ultrasonic vibrating section formed coaxially with this horn, which cools and cleans the affected area and maintains pressure in the anterior chamber of the eyeball. It is composed of an irrigation section that also serves as an irrigation fluid, and a suction section that sucks and removes crushed cataract tissue pieces together with the irrigation fluid through a passage formed in the horn.

FIG. 4 shows an example of such a conventional ophthalmic ultrasonic surgical instrument, and FIG. 4 is a side view showing a cross section of the ophthalmic ultrasonic surgical instrument. The structure and operation of this will be explained.

In the figure, a vibrator 10, such as an electrostrictive vibrator, converts an electric signal supplied from a power supply section (not shown) into ultrasonic vibration. This vibrator 10 is connected to a transmission pipe 14 as shown in the figure.
The transmission pipe 14 transmits the ultrasonic vibrations generated by the vibrator 10.

A tapered pipe-shaped horn 12 is provided at the other end of the transmission tube 14, and this horn 12 amplifies the amplitude of the ultrasonic vibration to a level capable of crushing the affected tissue. By bringing the part into contact with the affected area, the affected tissue is crushed and emulsified.

An irrigation fluid suction passage 16 is communicated with the axial center of the vibrator 10, transmission tube 14, and horn 12, and one end of this irrigation fluid suction passage 16 contacts the affected area filled with irrigation fluid. The other end is connected to suction means such as a suction pump (not shown).

A cylindrical and tapered protective tube 1 is provided on the outer periphery of the horn 12.
8 is provided to surround the transmission tube 14, and this protection tube 18 is connected to an outer cylinder 24 that houses the above-mentioned vibrator 10 and transmission tube 14.

Then, an irrigation fluid 20 is supplied coaxially with the horn 12 between the horn 12 and the transmission tube 14, and the outer tube 24 and the protective tube 18, which serves to cool and clean the affected area and maintain pressure in the anterior chamber of the eyeball. An irrigation fluid supply passage 22 is formed.

According to the ophthalmic ultrasonic surgical instrument configured as described above, in order to remove cataract tissue by crushing and suctioning, the operator uses the tip of the surgical instrument,
That is, the tip of the horn 12 is brought into contact with the affected area.

In this state, an electric signal is supplied to the vibrator 10 from a power feeding section (not shown), and the amplitude of the ultrasonic vibration generated in the vibrator 10 is transmitted to the horn 12 via the transmission pipe 14.
to amplify it to a predetermined level.

This amplified ultrasonic vibration can have an amplitude amplified by about 10 times, for example.

Since the distal end of the protective tube 18 is inserted into the anterior chamber of the eyeball near the affected area, the distal end of the horn 12 is manually brought into contact with the affected area by the operator. As a result, an impact of ultrasonic vibration with amplified amplitude is applied to the affected area, and the cataract tissue in the affected area can be crushed.

At this time, from the irrigation fluid supply vibe 26 to the irrigation fluid supply passage 2
2 flows out from the tip of the passage (in the direction of the arrow shown in the figure), and the irrigation liquid 20 is used to cool and clean the affected area and reduce the pressure in the anterior chamber of the eyeball as shown by the arrow in the figure. maintain.

Thereafter, the crushed tissue pieces are suctioned and removed together with the irrigation fluid 20 from the tip suction port 28 of the horn 12 by a suction means (not shown). That is, the crushed tissue pieces are transported together with the irrigation fluid 20 from the tip of the horn 12 to the irrigation fluid suction passage 16.
In this order, it is suctioned in the direction of the arrow and removed from the affected area.

After the cataract tissue in the affected area is crushed and removed in this way, the tip of the surgical instrument, that is, the tip of the horn 12, is pulled out from the affected area, thereby completing the surgery.

[Problem to be Solved by the Invention 81 According to the conventional ophthalmic ultrasonic surgical instrument described above, the horn 12 used is made of titanium, for example, and as shown in FIG. A horn tip 29 connected to the tube 14, an outer diameter changing portion 30, and a hook for a tool such as a spanner are integrally formed with a stepped portion 32, a flange portion 34, and a threaded portion 36 for attachment to the vibrator 10.

Note that the horn 12 shown in FIG. 5 has a tool hook in which a stepped portion 32 and a flange portion 34 are integrated.

In FIG. 5, the outer diameter changing portion 30 and the flange portion 3 are shown.
2 is a curved surface 30a that is nearly perpendicular to the ultrasonic vibration direction (length direction) 46 of the arrow shown in the figure or a surface 34 that is perpendicular to it.
It has a.

For this reason, as shown in FIG.
The perfusate 20 sent into the perfusate supply passage 22 from
Cavitation occurs on the curved surface 30a and the right-angled surface (90°) 34a, and the generated air bubbles flow into the anterior chamber of the eyeball, which obstructs the surgeon's view of the affected area when performing surgery using a microscope. There was a problem.

Purpose of the Invention The present invention has been made in view of the above-mentioned conventional problems,
The purpose is to provide an ophthalmic ultrasonic surgical instrument that can reduce the generation of bubbles, clarify the field of view of the affected area, and improve the time and accuracy of surgery.

[Means for Solving the Problems] In order to achieve the above object, an ophthalmic ultrasonic surgical instrument according to the present invention includes a vibrator that converts an electric signal into ultrasonic vibration,
a transmission tube that is formed integrally with the vibrator and transmits ultrasonic vibrations generated by the vibrator; a horn that is connected to the transmission tube and comes into contact with the affected tissue to crush the affected tissue; the horn and the It has a protective tube that surrounds the transmission tube, and an irrigation fluid passageway that allows irrigation fluid to flow between the horn, the transmission tube, and the protection tube, and supplies the irrigation fluid to the affected area to crush and suction the affected tissue. In the ophthalmological ultrasonic surgical instrument, the connecting portion between the transmission tube and the horn is set at 60° with respect to the vibration direction of the ultrasonic vibration.
It is characterized by having an outer diameter shape that is less than .

[Function] With the above configuration, according to the ophthalmological ultrasonic surgical instrument according to the present invention, the connecting portion between the vibrator of the transmission tube provided in the horn and the horn can be connected to the vibration of ultrasonic vibration. Cavitation is prevented by having an outer diameter shape of 60° or less with respect to the direction and cutting into an inclined surface of 60' or less.

That is, the turbulence of the flow of the irrigation fluid in the irrigation fluid passageway is reduced. Therefore, bubbles (cavitation) generated in the irrigation fluid are reduced, the field of view of the affected area is made clear, and the time and accuracy of surgery can be improved.

[Example] FIG. 1 is a side view of an ophthalmic ultrasonic surgical instrument according to the present invention,
FIG. 2 shows a perspective view thereof.

In FIGS. 1 and 2, which are the first embodiment, the horn 1
The outer diameter changing portion 30 and the flange portion 34 of No. 2 vibrate in the vibration direction 4.
They are formed on inclined surfaces 38 and 40 cut at an angle of 60° or less of θl and θ2 with respect to 6.

The tool hook between the outside diameter changing part 30 and the flange part 34 is cut into a plane 42 parallel to the axis so that a part of the tool hook part 32 covers the outside diameter changing part 30, and this plane 42 and a part of the flange portion 34 forms an inclined surface 44.
It has been cut into.

In this embodiment, a case is shown in which two planes 42 and two inclined surfaces 44 are provided.

An ophthalmological ultrasonic surgical instrument to which the horn 12 having the above configuration is applied has different diameter portions such as the outer shape changing portion 30 and the flange portion 34 of the horn 12 at an angle of θ1 with respect to the vibration direction 46 of the ultrasonic vibration. θ
2 is formed at an inclination angle of 60 degrees or less, the irrigation fluid 20 supplied to the irrigation fluid supply passage 22 described above flows smoothly toward the outlet at the tip, thereby reducing the occurrence of cavitation. , the generation of bubbles can be reduced.

FIG. 3 shows a second embodiment of the present invention, in which the outer diameter changing portion 30 of the horn 12 is 60″ of θ1 with respect to the vibration direction 46.
It is formed on an inclined surface 38 cut at the following angle.

In the first embodiment, the tool hook is configured so that the portion 32 and the flange portion 34 have different diameters, but in the second embodiment, the tool hook has the portion 32 and the flange portion 34 integrated with the same diameter. With this configuration, the different diameter portion of the outer peripheral surface of the horn 12, that is, the protruding portion of the flange is reduced, and the irrigation fluid 20 can easily flow through the irrigation fluid supply passage 22. Therefore, the occurrence of cavitation can be further reduced, and the generation of bubbles can also be further reduced.

The figure shows, as an example, a case in which four cut planes 42 and four shaped slopes 44 are provided.

C Effects of the Invention C As described above, according to the ophthalmological ultrasonic surgical instrument of the present invention, the different diameter portion of the horn is adjusted to 6° in the vibration direction of the ultrasonic vibration.
Since the sloped surface is cut at an angle of 0° or less, there are few places in the irrigation fluid passage formed between the horn and transmission tube and the outer cylinder and protection tube that would disturb the flow of irrigation fluid. This reduces the occurrence of bubbles (cavitation).

For this reason, the number of air bubbles flowing into the anterior chamber of the affected eyeball is reduced,
For the surgeon who performs the surgery using a microscope, the field of view of the affected area becomes clearer, and the effect of shortening the time and improving the accuracy of the surgery can be obtained.

[Brief explanation of the drawing]

Fig. 1 is a side view showing a horn according to one embodiment of the present invention applied to an ophthalmic ultrasonic surgical instrument, Fig. 2 is an external perspective view of this horn, and Fig. 3 is a side view showing another embodiment of the horn. 4 is a sectional view showing an ophthalmic ultrasonic surgical instrument, and FIG. 5 is a side view of a conventional horn applied to this ophthalmic ultrasonic surgical instrument. 0 2 4 6 8 0 2 4 0 2 Vibrator horn transmission tube Irrigation liquid suction passage Protection tube Irrigation liquid Irrigation liquid supply passage Outer cylinder outer diameter changing part Tool hook is at the stepped part.

Claims (1)

[Scope of Claims] A transducer that converts an electric signal into ultrasonic vibrations, a transmission tube formed integrally with the transducer and transmitting the ultrasonic vibrations generated by the transducer, and connected to the transmission tube. a horn that comes into contact with the affected tissue to crush the affected tissue; a protective tube that surrounds the horn and the transmission tube; and an irrigation fluid passageway that allows irrigation fluid to flow between the horn and the transmission tube and the protective tube. In an ophthalmological ultrasonic surgical instrument that supplies irrigation fluid to the affected area to crush and suction the affected tissue, the connecting portion between the transmission tube and the horn is at an angle of 60° or less with respect to the vibration direction of the ultrasonic vibration. An ophthalmic ultrasonic surgical instrument characterized by having an outer diameter shape to prevent cavitation in the irrigation fluid generated at the connecting portion.