JPH03155853A - Ultrasonic medical treatment device - Google Patents

Abstract

PURPOSE:To improve the workability of bleeding stop, coagulation, etc., of the part to be treated by providing a non-contact electric conduction means for bringing a high frequency current to electric conduction to the treated part side through conductive gas supplied to the tip part of an ultrasonic probe at the time of using a high frequency electric surgical knife. CONSTITUTION:In a handpiece 1, an ultrasonic vibrator part 2 is provided, and connected to an ultrasonic driving device 10. In such a state, at the time of using the handpiece 1, first of all, ultrasonic vibration is generated by driving the ultrasonic vibrator part 2, and in a state that the ultrasonic vibration is amplified to necessary amplitude by a horn part 5 and a vibration transfer member 6. The vibration transfer member 6 is placed on the part to be treated, and the part to be treated is crushed by the ultrasonic vibration. Also, when bleeding, etc., are generated in the course of crushing work, the work such as bleeding stop, coagulation, etc., by a high frequency electric surgical knife is executed, the tip part of the handdpiece 1 is held in a state separated from the treated part side of the human body 14 and argon gas is supplied to the tip part, a high frequency electric surgical knife device 13 is driven and the work such as bleeding stop, coagulation, etc., of the part to be treated is executed. Accordingly, the workability of bleeding stop, coagulation, etc., of the part to be treated can be improved.

Description

[Detailed Description of the Invention] [Field of Industrial Application] The present invention relates to an ultrasonic treatment device in which an electrode for high-frequency electric scalpel is provided at the tip of an ultrasonic probe that crushes living tissue and stones by ultrasonic vibration. Regarding improvements.

[Prior Art] Generally, as an ultrasonic treatment device, for example, Japanese Patent Application Laid-Open No. 80-22
As shown in Publication No. 7748, an electrode for a high-frequency electric scalpel is provided at the tip of an ultrasonic probe that crushes living tissues and stones by ultrasonic vibration, and the ultrasonic probe is used to crush living tissues and stones. A configuration is known in which operations such as hemostasis and coagulation can be performed using a high-frequency electric scalpel. In this case, when performing operations such as hemostasis and coagulation using a high-frequency electric scalpel, the scalpel tip electrode for the high-frequency electric scalpel placed at the tip of the ultrasonic probe is brought into contact with the area to be treated such as living tissue, and the scalpel tip electrode is placed at the tip of the ultrasound probe. The high-frequency current was passed through the patient's body to the return electrode.

[Problem 8 to be solved by the invention] In the above-mentioned conventional structure, when performing operations such as hemostasis and coagulation using a high-frequency electric scalpel, the scalpel tip electrode for the high-frequency electric scalpel is brought into direct contact with the part to be treated such as living tissue. Therefore, there is a problem in that a part of the tissue such as a hemostatic area or a coagulated area of the treated area sticks relatively firmly to the scalpel tip electrode in an adhesive state. Therefore, after performing operations such as hemostasis and coagulation on the treated area, when the scalpel tip electrode is pulled away from the hemostasis or coagulation area of the treatment area, part of the tissue such as the hemostasis or coagulation area may be removed by the scalpel photoelectron. Since it is pulled off while still attached to the blood, there is a problem that the hemostasis area may bleed again. In this way, if rebleeding occurs from the treated area, it is necessary to repeat the work to stop the bleeding and coagulate the treated area, which reduces work efficiency and prevents bleeding and coagulation from the treated area. There was a problem in trying to improve workability.

This invention was made in view of the above-mentioned circumstances, and it is possible to prevent re-bleeding at the hemostasis area when the electrode for a high-frequency electric scalpel is separated from the area to be treated during operations such as hemostasis and coagulation of the area to be treated. It is an object of the present invention to provide an ultrasonic treatment device that can improve workability such as hemostasis and coagulation of a treated area.

[Means for Solving the Problems] The present invention provides an electrode for high-frequency electric scalpel at the tip of an ultrasonic probe, and a conductive gas supply means for supplying conductive gas to the tip of the ultrasonic probe, When the high-frequency electric scalpel is used, a non-contact energizing means is provided for applying a high-frequency current to the treated area via the conductive gas supplied to the tip of the ultrasonic probe.

[Effect] During operations such as hemostasis and coagulation of the treated area, a high-frequency current is passed from the electrode for high-frequency electric scalpel at the tip of the ultrasonic probe to the treated area through conductive gas, and the high-frequency electric scalpel is By preventing the electrode from coming into direct contact with the treated area, it prevents parts of tissue such as hemostasis and coagulation areas from sticking to the high-frequency electric scalpel electrode at the tip of the ultrasound probe. This prevents re-bleeding at the hemostatic site when the electrode for the high-frequency electric scalpel is pulled away from the treated area.

[Example] A first example of the present invention will be described below with reference to FIGS. 1 and 2.

Figure 1 shows the schematic configuration of the entire ultrasound treatment device.
1 is a hand piece of an ultrasonic treatment device formed by an ultrasonic probe. This handpiece 1 is provided with an ultrasonic transducer section 2. A piezoelectric element 3 made of, for example, PZT and an electrode 4 are connected to the ultrasonic transducer section 2 in a laminated state. Further, a substantially conical horn portion 5 is connected to the ultrasonic transducer portion 2, and a vibration transmitting member 6 formed of a tubular body is further connected to the tip of the horn portion 5. The ultrasonic vibrations generated by the ultrasonic transducer section 2 are amplified by the horn section 5 and the vibration transmission member 6 to an amplitude necessary for crushing living tissue, stones, and the like.

In addition, a suction hole 7 that communicates with the inside of the tube 6a of the vibration transmitting member 6 is provided in the ultrasonic vibrator section 2 and the horn section 5 of the hand piece 1 in a state that the suction hole 7 is penetrated back and forth along the central axis of the hand piece 1. It is formed.

Further, a sheath 8 made of an insulating material is attached to the hand piece 1 so as to cover the vibration transmitting member 6, the horn portion 5, and the like. A flow path 9 is formed between the sheath 8, the vibration transmission member 6, the horn portion 5, etc., through which a fluid such as a cooling liquid or gas flows.

Furthermore, the handpiece 1 is connected to an ultrasonic drive device 10. This ultrasonic driving device 10 has a built-in suction device (not shown). The suction hole 7 of the hand piece 1 is connected to this suction device via a connecting pipe 11.

Furthermore, an electrode 12 for a high-frequency electric scalpel is provided at the tip of the hand piece 1. This electrode 12 is formed, for example, by the tip of the vibration transmission member 6. moreover,
This electrode 12 is connected to a high frequency electric scalpel device 13. This high frequency electric scalpel device 13 has a P plate (return electrode plate) installed in contact with the human body 14 side such as a patient, for example.
15 are connected. Further, an argon gas supply source 16 for supplying a conductive gas such as argon gas is provided inside the high frequency electric scalpel device 13. The base end of an argon gas supply pipe 17 is connected to this argon gas supply [16]. Furthermore, the tip of this argon gas supply pipe 17 is connected to a connection base 18 formed on the sheath 8 of the handpiece 1. Argon, which is a conductive gas, is supplied to the tip of the handpiece 1 through the argon gas supply source 16, the argon gas supply pipe 17, the fluid flow path 9 between the sheath 8, the vibration transmission member 6, the horn part 5, etc. A conductive gas supply means 19 for supplying gas is formed. Furthermore, this ultrasonic treatment device has a second
As shown in the figure, when using a high-frequency electric scalpel, the human body 14 is
Non-contact energizing means 2 for energizing high frequency current to the treated area side
0 is set. Note that 21 is an A cord that connects between the high frequency electric scalpel device 13 and the electrode 12, and 22 is a P cord that connects between the high frequency electric scalpel device 13 and the P plate 15.

Next, the operation of the above configuration will be explained.

First, when using the handpiece 1, the ultrasonic vibrator section 2 is first driven to generate ultrasonic vibrations.

Then, the ultrasonic vibration generated by the ultrasonic transducer section 2 is amplified by the horn section 5 and the vibration transmission member 6 to an amplitude necessary for crushing living tissue and stones, and then the vibration transmission member 6 is transferred to the living body. It is applied to treated areas such as tissues and stones, and these treated areas are crushed by ultrasonic vibration.

For example, if bleeding occurs from the treated area during the crushing operation using ultrasonic vibration, operations such as hemostasis and coagulation are performed using a high-frequency electric scalpel.

During operations such as hemostasis and coagulation of the treated area, the distal end of the handpiece 1 is held apart from the treated area of the human body 14. In this state, the argon gas supply pipe 17 is
, argon gas is supplied to the distal end of the handpiece 1 through the fluid flow path 9 between the sheath 8, the vibration transmission member 6, the horn portion 5, etc. in this order. Further, in this state, the high frequency electric scalpel device 13 is driven. As the high-frequency electric scalpel device 13 is driven, a high-frequency current is applied to the P plate 15 from the high-frequency electric scalpel electrode 12 at the tip of the hand piece 1 through the conductive argon gas and the human body 14. Operations such as hemostasis and coagulation of the treated area are performed.

Therefore, in the case of the above-mentioned structure, during work such as hemostasis and coagulation of the treated area, conductive argon gas is passed from the electrode 12 for high-frequency electric scalpel at the tip of the hand piece 1 to the treated area of the human body 14. Since the high frequency current is applied to the side, it is possible to prevent the electrode 12 for the high frequency electric scalpel from directly contacting the side of the treated area during operations such as +h- blood removal and coagulation of the treated area. Therefore, it is possible to prevent part of the tissue such as the hemostatic area or coagulation area of the treated area from sticking to the electrode 12 for high-frequency electric scalpel at the tip of the hand piece 1, as in the past. Re-bleeding at the hemostasis area can be prevented when the electrode 12 is pulled away from the treated area. Furthermore, it is possible to omit the troublesome work of repeatedly performing hemostasis and coagulation on re-bleeding areas from the treated area, which is required in the past. can increase efficiency,
Workability such as hemostasis and coagulation of the treated area can be improved. In addition, during operations such as hemostasis and coagulation of the treated area, argon gas is sprayed onto the hemostatic and coagulated areas of the treated area, so this argon gas can blow away moisture from the hemostatic and coagulated areas. can. Therefore, for example, during the work of crushing a body tissue, a stone, or the like to be treated using ultrasonic vibration, a cooling liquid or the like is supplied into the fluid flow path 9 between the sheath 8, the vibration transmission member 6, the horn part 5, etc. Even if the area near the treated area is filled with water, argon gas can be used to blow away the water from the hemostasis and coagulation areas of the treated area to perform operations such as hemostasis and coagulation. Workability can be further improved.

Note that this invention is not limited to the above embodiments. For example, as in the second embodiment shown in FIGS. 3 and 4, the tip of the argon gas supply pipe 17 is connected to the connection pipe 11 with the suction device of the hand piece 1, and the From the argon gas supply source 16 to the argon gas supply pipe 17, the connecting pipe 11, the suction hole 7 and the vibration transmission member 6
Argon gas may be supplied to the tip of the hand piece 1 sequentially through the inside of the tube 6a.

Furthermore, it goes without saying that various other modifications can be made without departing from the gist of the invention.

Further, FIG. 5 shows a first disclosed example.

In this method, an electrode 12 for high-frequency electric scalpel is provided at the tip of a sheath 8 of a hand piece 1 formed of an insulating material, and this electrode 12 and a high-frequency electric scalpel device 13 are connected via an A cord 21. When using the high-frequency electric scalpel, the electrode 12 is brought into direct contact with a part of the human body 14 to be treated. And high frequency electric scalpel device 1
3, a high-frequency current is applied from this electrode 12 to the P plate 15 via the human body 14, and a monopolar electric scalpel function is provided to perform operations such as hemostasis and coagulation of the treated part of the human body 14. Therefore, in this case, the operability can be improved compared to the case where the hand piece 1 and the high-frequency electric scalpel of the ultrasonic treatment device are provided separately and independently.

Furthermore, FIGS. 6 and 7 show a second disclosed example.

It is made of insulating material /% beads 1
One electrode 3 for high frequency electric scalpel is attached to the tip of the sheath 8.
1, one connection cord 32 of the high-frequency electrosurgical unit 13 is connected to this electrode 31, and the other connection cord 33 of the high-frequency electrosurgical unit 13 is connected to the horn part 5 of the handpiece l. vibration transmission member 6
The other electrode 34 for high-frequency electric scalpel is provided at the tip. When using the high-frequency electric scalpel, these electrodes 31 and 34 are brought into direct contact with the treated area of the human body 14, and as the high-frequency electric scalpel device 13 is driven, a high-frequency current is applied from one electrode 31 to the other through the human body 14. The device is equipped with a bipolar electric scalpel function that performs operations such as hemostasis and coagulation of the treated area of the human body 14 by energizing the electrode 34 of the human body 14. In this case, as shown in FIG. 7, an insulating plate 35 is provided between the horn part 5 of the handpiece 1 and the ultrasonic transducer part 2,
By electrically insulating between the horn section 5 and the ultrasonic transducer section 2 of the handpiece 1, the high frequency current on the horn section 5 side flows through the ultrasonic transducer section 2 to the transducer drive control circuit side. It is designed to prevent energization.

Further, FIG. 8 shows a third disclosed example.

This is a high frequency electric scalpel device 13 that is provided with a monopolar electric scalpel function and a bipolar electric scalpel function, and is also provided with a changeover switch 41 that switches between the monopolar electric scalpel function and the bipolar electric scalpel function. In this case, one connection cord 42 of the high-frequency electric scalpel device 13 is connected to the first electrode 43 at the tip of the sheath 8,
The other connection cord 44 of this high frequency electric scalpel device 13 is connected to a changeover switch 41. Furthermore, one end of each of a pair of switching cords 45 and 46 is connected to this changeover switch 41. The other end of one switching cord 45 of this switching switch 41 is connected to the P plate 15, and the other end of the other switching cord 46 is connected to the horn portion 5 of the hand piece 1. As the changeover switch 41 changes, the connection state between the connection cord 44 and the changeover cords 45 and 46 is changed, and the connection between the connection cord 44 and one changeover cord 45 is changed. The monopolar electric scalpel function can be selected in the connected state, and the bipolar electric scalpel function can be selected in the state that the connection cord 44 and the other switching cord 46 are connected. Therefore, in this case, either the monopolar electric scalpel function or the bipolar electric scalpel function of the high frequency electric scalpel device 13 can be selectively used, and usability can be improved.

Furthermore, FIG. 9 shows a fourth disclosed example.

The electrode 12 for the high-frequency electric scalpel (monopolar electric scalpel function) at the tip of the sheath 8 of the handpiece 1 is formed by a substantially plate-shaped slide plate 51, and the slide plate 51 is formed at the tip of the sheath 8. A guide groove 52 is provided, and the slide plate 51 can be slid along the guide groove 52 to protrude and retract toward the outside. Therefore, in this case, the contact area between the electrode 12 and the treated part of the human body 14 can be made smaller than when the entire circumferential surface of the distal end of the sheath 8 is used as the electrode 12, and accurate treatment fMf can be achieved. G can be performed.

"Effects of the Invention" According to this invention, the tip of the ultrasonic probe has K, 14
In addition to providing an electrode for the wave electric scalpel, a conductive gas supply means for supplying conductive gas to the tip of the ultrasonic glove is provided, so that when using the high frequency electric scalpel, the conductive gas supplied to the tip of the ultrasonic probe is Since we have provided a non-contact energizing means that passes a high-frequency current to the treated area through the It is possible to prevent re-bleeding at the hemostasis area when separating, and it is possible to improve the workability of hemostasis, coagulation, etc. of the treated area.

[Brief explanation of the drawing]

1 and 2 show a first embodiment of the present invention, and FIG. 1 is a schematic configuration diagram of the entire ultrasonic treatment device,
The figure shows a schematic configuration diagram of a high-frequency electric scalpel, FIGS. 3 and 4 show a second embodiment of the present invention, FIG. A vertical cross-sectional view showing the schematic configuration of the tip of the sonic probe, FIG. 5 is a schematic configuration diagram of the entire device showing the first disclosed example, and FIGS. 6 and 7 show the second disclosed example, FIG. 6 is a schematic configuration diagram of the entire device, FIG. 7 is a side view showing the ultrasonic transducer section of the ultrasound probe, FIG. 8 is a schematic configuration diagram of the entire device showing the third disclosure example, and FIG. 9 FIG. 3 is a perspective view of main parts showing a fourth disclosed example. 1... Hand piece (ultrasonic probe), 12...
Electrode for high frequency electric scalpel, 19... conductive gas supply means, 20... non-contact current supply means.

Claims (1)

[Claims] An electrode for high-frequency electric scalpel is provided at the tip of the ultrasonic probe, and a conductive gas supply means for supplying conductive gas is provided at the tip of the ultrasonic probe, so that when the high-frequency electric scalpel is used, the ultrasonic probe 1. An ultrasonic treatment device characterized by being provided with a non-contact current supply means for supplying a high frequency current to a treated area through a conductive gas supplied to a distal end of the ultrasound treatment apparatus.