JPH0489041A - Hand piece for ultrasonic operation - Google Patents

Abstract

PURPOSE:To obtain good cooling efficiency by arranging a hand switch on an outer cover serving as a manual rotary member, and providing a water feed port feeding water to a vibration transfer member and a communicating path communicating the water feed port to a water feed source. CONSTITUTION:A water feed port 32 opened at the position faced to a vibration transfer member 16 on the inner periphery of the tip side of an outer cover 20 and a communicating path 34 communicated to the water feed port 32 and extended in the outer cover 20 are provided. When a hand piece 10 is to be used, the outer cover 20 is rotated against an inner cover 18, and a hand switch 24 is arranged at the most easily operable position. The position of the water feed port 32 can be easily confirmed at the position of the hand switch 2. The feed liquid from an external water feed source is communicated to the communicating path 34 opened on the inner periphery of the rear end side of the outer cover 20, it is guided into the communicating path 34 in the outer cover 20 and reaches the water feed port 32, and it is sprayed downward from the water feed port 32. The vibration transfer member 16 can be efficiently cooled.

Description

DETAILED DESCRIPTION OF THE INVENTION [Industrial Application Field] The present invention relates to an ultrasonic surgical handpiece having an ultrasonic vibrator and a vibration transmission member.

[Prior Art] Generally, when performing treatment using this type of ultrasonic surgical handpiece, the tip of the vibration transmitting member is applied to the living tissue or stone to be treated. Then, ultrasonic vibrations from the ultrasonic vibrator are applied to the living tissue or calculus through this vibration transmission member, and the treatment area is excised or crushed by this vibration energy.

In such an ultrasonic surgical handpiece, the vibration transmission member generates heat due to the vibration energy during ultrasonic vibration, and in the worst case, there is a risk of breakage. Therefore, it is necessary to supply cooling water from the outside to cool the vibration transmission member.

The handpiece described in Special Publication No. 63-500572 is
A general method in which a water supply spout connected to an external cooling water source is provided on the cover of the handpiece or the tip sheath, and cooling water is sent to the tip from an annular passage arranged between the tip sheath and the vibration transmission member. It has a unique structure. This water supply cap is integrally fixed to the handpiece, and supplies cooling water to the vibration transmission member only from a fixed direction regardless of the orientation of the handpiece.

Furthermore, Japanese Patent Laid-Open No. 61-279239 is an example in which a water supply cap is rotatably attached to a handpiece. In this handpiece, the water supply cap is rotatably attached to the distal sheath.

[Problems to be Solved by the Invention] The ultrasonic vibration on/off switch or the high frequency current on/off switch for operating the ultrasonic surgical handpiece can be a remote control switch such as a foot switch. However, in order to improve operability, it is desirable to arrange these operation switches on the handpiece and to make them rotatable on the outer periphery of the handpiece.

When the operation switch is rotatably arranged on the handpiece, the operator can operate it while holding the handpiece in the most convenient direction depending on the location of the area to be treated, and Treatment can be performed at any location of your choice.

However, when arranging the operation switch so that it can be rotated in this way to improve operability, if the water supply mouthpiece is fixed like in the conventional handpiece mentioned above, cooling may occur depending on the direction in which the handpiece is gripped. Water may hardly contact the vibration transmission member. Even if cooling water is supplied to the handpiece, the vibration transmission member cannot be cooled down, and in the worst case, it may break. It is extremely dangerous if such a situation occurs during surgery. In addition, if the water supply cap is rotatably attached to the handpiece, the water supply cap should be rotated according to the orientation of the handpiece being held and set at a position that provides a high cooling effect. However, it is extremely troublesome to adjust the position of the water supply mouthpiece and to set the operating switches and the like to the operator's preferred position, and the operability is reduced.

The present invention has been made in view of the above, and an object of the present invention is to provide an ultrasonic surgical handpiece that improves operability and provides good cooling efficiency.

[Means for Solving the Problems] The ultrasonic surgical handpiece of the present invention is an ultrasonic surgical handpiece having an ultrasonic vibrator and a vibration transmission member, and includes a manual rotation part on the outer periphery of the handpiece. A movable member is disposed, and a manual operation member for operating the handpiece is disposed on the manual rotation member, and a water supply port for supplying water to the vibration transmission member and the water supply port are fixed relative to the position of the manual operation member. It is characterized by comprising a communication path which is disposed at a predetermined position and communicates the water supply port with a water supply source.

[Function] In the ultrasonic surgical handpiece of the present invention, since the relative position of the water supply port that supplies water to the vibration transmission member is fixed,
When the manual rotation member is rotated to shift the position of the manual operation member, the position of the water supply port is shifted in accordance with the position of the manual operation member. Then, water is sent from an external water supply source to the water supply port via the communication path, and from this water supply port to the vibration transmission member.

[Embodiment] FIGS. 1 to 4 show an ultrasonic surgical handpiece according to a first embodiment of the present invention.

As shown in FIG. 1, the ultrasonic surgical handpiece 10 includes an ultrasonic vibrator 12, a horn 14, and a vibration transmitting member 16 connected in order from the distal end side of the ultrasonic vibrator 12. Ultrasonic transducer 1
2 and the horn 14 are supported within an inner cover 18, and an outer cover 20 is disposed outside the inner cover 18.

This outer cover 20 is rotatably attached to the inner cover 18 and forms a manual rotation member. Further, a distal sheath 22 is attached to the distal end of the outer cover 20 to cover the vibration transmission member 1.6 through an annular gap 17, and the outer periphery serves as a manual operation member for turning on and off the ultrasonic transducer 12. A hand switch 24 is arranged.

FIG. 2 shows the wiring of the hand switch 24. In this embodiment, the hand switch 24 is connected to the slip ring 26.
It is electrically connected to the high frequency drive power source of the ultrasonic transducer 12 via 28. Connect the conductor 25 to the switch 24
．． Outer slip ring 26.2 connected via 25
6 is arranged on the inner peripheral surface of the outer cover 20, and an inner slip ring 28 is arranged on the outer peripheral surface of the inner cover 18 correspondingly. The conductors 29 connected to the inner slip ring 28 are combined into one power cord 30, and this power cord 3
0 penetrates the rear end side of the inner cover 18 and extends outward as shown in FIG. As shown in FIG. 3, the inner slip ring 28 comes into sliding contact with the inner surface of the outer slip ring 26 via a plurality of protrusions 28a that protrude outward in the radial direction, so that the outer cover 20 can be rotated to any position. Ensure electrical connection at all times.

Furthermore, this handpiece 10 includes a water supply mechanism for cooling the vibration transmission member 16.

As shown in FIG.
a water inlet 32 that opens at a position facing the water inlet 3;
2 and a communication path 34 extending into the outer cover 20. This communication path 34 extends in the axial direction inside the outer cover 20, and its rear end side is open to the inner circumferential surface. FIG. 4 shows this communication path 34 to the hand switch 24.
and the relative positional relationship of the water supply ports 32.

In this way, the water supply port 32 and the communication path 34 are connected to the outer cover 2.
It is preferable to arrange it on the same side as 0.

A water supply spout 38 connected to a water supply source is attached to the rear end of the inner cover 18. This water supply mouthpiece 38 communicates with an axial passage and a radial passage formed in the inner cover 18 in order, and furthermore, this radial passage communicates with a circumferential groove 36 formed over the entire outer circumference of the inner cover 18. do. This circumferential groove 36 communicates with a communication path 34 that opens on the inner circumferential surface of the outer cover 20 on the rear end side. Reference numeral 40 is an O-ring for preventing leakage.

As shown in FIG. 5, the outer cover 20 has an axial branch passage 37 extending therethrough that communicates with the communication passage 34.
The rear end of the external force bar 200 may be opened at the rear end surface of the external force bar 200. The rear end opening of this branch passage 37 is sealed openably and closably with a plug, cap, or screw 35. By providing such a branch path 37, the connecting path 3 can be connected simply by removing the screw 35.
4. Brush cleaning can be easily performed.

Note that the outer cover 20 may be shaped into an appropriate structure, but a finger rest 44 may be formed in the area near the hand switch 24 where the finger touches, as shown in FIGS. 6 to 8. . Reference numeral 42 is a gripping recess on the rear end side of the outer cover 20, and 42a is a protrusion or groove for preventing slipping. As shown in FIGS. 6 and 7, the outer cover 20 is divided into two parts, front and rear, into a part where the finger rest 44 is formed and a part where the recessed part 42 is formed, and is relatively rotatable. Alternatively, it may be formed integrally as shown in FIG. In either case, by providing a finger rest 44 near the hand switch 24, slipping during the operation can be prevented and the position of the hand switch 24 can be easily confirmed.

When using the handpiece 1o of the first embodiment,
The outer cover 20 is rotated with respect to the inner cover 18, and the hand switch 24 is placed at the position where it is most easily operated according to the surgeon's preference. As shown in FIGS. 1 and 4, the connecting path 34
and the water supply port 32 are arranged within the outer cover 20 on the side of this hand switch 24, and the relative positional relationship with respect to the hand switch 24 is determined, so when the outer cover 20 is rotated, communication is made corresponding to the amount of rotation. Channel 34 and water inlet 32 also rotate. The position of water inlet 32 is hand switch 2
It can be easily confirmed at position 4.

Since the operator generally sets the hand switch 24 above the hand piece 10, the water supply port 32 and the communication path 34 are also arranged and placed above the hand piece 10. Therefore, the water supply liquid from the external water supply source passes through the water supply cap 38, the axial and radial passages, and the annular groove 36, and passes through the communication path that opens on the inner circumferential surface of the rear end of the outer cover 20. 34. Then, the water is guided through the communication path 34 in the outer cover 20 and reaches the water inlet 32, and is ejected downward from the water inlet 32 to efficiently cool the vibration transmission member 16.

The water supply liquid supplied to the vibration transmitting member 16 flows toward the distal end through an annular gap 17 formed between the vibration transmitting member 16 and the distal sheath 22.

Therefore, this handpiece 10 is the hand switch 2.
4, the water supply port 32 and the communication path 34 can be placed at an upper position where the vibration transmission member 16 can be cooled well, improving operability and cooling the vibration transmission member 16 well. I can do it.

9 and 10 show a hunt piece 10 according to a second embodiment.

In the handpiece 1o of the second embodiment, the outer cover 20 forms a main body cover integral with the inner cover, and does not rotate. A rotating cover 46, which is a manually rotating member, is rotatably mounted around the vibration transmitting member 16 on the distal end side of the outer cover 20. This rotating cover 46
A distal sheath 22 is attached to the distal end side of the rotary cover 46, and a hand switch 24 for controlling on/off operation of the hand piece 10 is attached to this rotating cover 46. For the electrical connection of the hand switch 24, a slip ring may be used as in the first embodiment, or an aluminum wire or other suitable means may be used.

The water supply mechanism of the hand piece 1o of the second embodiment is
As shown in the drawings and FIG. 10, a radial hole is formed through the rotary cover 46 on the same side as the hunt switch 24, and a water supply mouthpiece 38 is directly mounted in the radial hole. Therefore, the hunt piece 10 of the second embodiment
The water supply port 32 that supplies the water supply liquid to the vibration transmission member 16 is formed by the opening end of the water supply mouthpiece 38 that opens on the inner circumferential surface of the rotating cover 46 or the inner opening of the radial hole, and
A communication path 3 that guides water to the water supply port 32, such as a portion passing through the water supply mouthpiece 38, a rotating cover 46, or a radial hole.
4 is formed.

When using this handpiece 10, the water supply hose 39 that communicates with the water supply source is connected to the water supply cap 38 as shown in FIG. A hand switch 24 is arranged at a position where it is easiest to operate. At the same time, the positions of the water supply port 32 and the communication path 34 are also set.

The water supply liquid from the external water supply source is guided through the water supply hose 39, the water supply spout 38, and the communication path 34, reaches the water supply port 32, and is ejected downward from the water supply port 32, and is ejected from the vibration transmission member 16. Cool efficiently. The water supply liquid supplied to the vibration transmission member 16 flows toward the tip through an annular gap 17 formed between the vibration transmission member 16 and the sheath 22.

According to the handpiece 10 of the second embodiment,
Improved operability and good cooling of the vibration transmission member 16 are possible, and the manual rotation member, that is, the rotating cover 4
6 is small, and the entire handpiece 10 can be downsized.

11 and 12 show a handpiece 10 according to a third embodiment.

In the handpiece 10 of the third embodiment, the outer cover 20 forms a main body cover integral with the inner cover, as in the second embodiment,
It doesn't rotate. A recess into which the distal sheath 22 is mounted is formed at the distal end of the outer cover 2o. The distal sheath 22 is rotatably mounted within this recess via two O-rings 40, forming a manual rotation member. This tip sheath 22
The diameter of the portion adjacent to the tip of the outer cover 20 is expanded,
A hand switch 24, which is a manual operation member, is attached to this enlarged diameter portion. For electrical connection of the hand switch 24, a slip ring may be used as in the first embodiment, or other appropriate means may be used.

In the handpiece 10 of the third embodiment, the water supply mouthpiece 38 of the water supply mechanism is attached to the non-rotatable outer cover 20, and a guide path 48 with one end communicating with the water supply mouthpiece 38 is inserted into the outer cover 20. Nobu, set up. The other end of this guide path 48 opens to the inner peripheral surface of the four parts to which the distal sheath 22 is attached. A communication path 34 formed by an annular groove is provided at the rear end of the distal sheath 22 installed in the recess of the outer cover 20.
A water supply port 32 formed by a radial hole communicating with this communication path 34 is provided. The annular groove forming the communication path 34 is formed between the two O-rings 40, 40 at a position corresponding to the opening of the guide path 48, and the radial hole forming the water supply port 32 is formed between the two O-rings 40, 40 at a position corresponding to the opening of the guide path 48. is formed on the same side as the vibration transmitting member 16, and is located at the periphery of the vibration transmitting member 16.

When using the hand piece 10 according to the third embodiment, the distal sheath 22 is rotated by the hand as described in the first embodiment. Second
As in the embodiment, the hand switch 24 is placed at the operator's preferred position that is easiest to operate. This hand switch 2
4, the water supply port 32 and communication path 34 for supplying water to the vibration transmission member 16 can also be arranged at the upper position. Therefore, the water supply liquid sent to the water supply mouthpiece 38 from the external water supply source passes through the guide passage 48 into the annular groove and reaches the communication passage 34, and from this communication passage 34,
2 to the vibration transmission member 16 from above.

Therefore, the handpiece 10 of the third embodiment also improves operability and enables good cooling of the vibration transmission member 16, and although it is miniaturized, the hand switch 24 and the water supply mouthpiece 38 are Since it can be formed as a separate member, the water supply cap 38 does not get in the way when positioning the hand switch 24.

FIG. 13 shows an ultrasonic transducer 12 that can be used in the handpiece 10 of each of the above embodiments.

This ultrasonic transducer 12 is a flange portion 14a of the horn]4.
It has a structure in which electrostrictive elements 12a and electrodes 12b are alternately stacked adjacent to each other. These electrostrictive elements 12a and electrodes 12
b is attached to a bolt 12d whose one end is fixed to the horn 14, and is firmly tightened using the backing plate 12 (which also serves as a nut).

In this ultrasonic transducer 12, the bending portion of each electrode has a radius R.
It has a curvature of ゛.

By forming the bent portion of the electrode 12b into a curve with the radius R in this manner, the impedance value of the vibrator 12 is lowered, and it is possible to drive it with a relatively low voltage. Therefore, dielectric breakdown and leakage current of the vibrator can be reduced, increasing safety for both the patient and the operator.

14 to 22 are disclosed examples of an ultrasonic treatment device, that is, a hand piece 50 for ultrasonic surgery.

The handpiece 50 in FIG. 14 connects the water pipe 56 to the probe 5.
4, it ensures the maximum field of view for the operator.

In this handpiece 50, the water supply tube 56 is connected to the main body 5.
2 through the gap between the vibration transmitting member or probe 54 and the distal sheath 58 . The distal end of the water supply tube 56 does not protrude from the distal sheath 58;
Located inside this.

FIG. 15 shows a modification of the handpiece 50 shown in FIG. 14. In this case, the distal end portion of the distal sheath 58 is formed into an even thinner diameter portion 58a.

These I\end pieces 50 in Figs. 14 and 15
Since the water supply tube 56 is disposed within the distal sheath 58 and the distal end can be formed thin, a sufficient field of view for the operator can be ensured and insertion into the deep part of the body can be facilitated.

The hand piece 50 shown in FIG. 16 has a water pipe 56 extending through the gap between the probe 54 and the distal sheath 58 in the same way as in FIGS. This water pipe 56 has a structure that protrudes beyond the distal end of the distal sheath 58. In this case, the central axis 54a of the probe 54 is connected to the distal sheath 58.
It is arranged eccentrically with respect to the central axis 58a.

Thereby, the diameter of the distal sheath 58 can be formed to be slightly larger than the sum of the diameter of the probe 54 and the diameter of the water pipe 56.

FIG. 17 shows a manifold member 64 that can be easily attached to a casing 62 that accommodates a vibrator 60.
It is 0.

It has a structure in which the vibrator flange part 61 and the manifold member flange part 65 are abutted against the flange part of the casing 62, and these flanges 61 and 65 are fixed to the casing 62 with nuts 66.

Water is communicated from a water supply cap 70 attached to the cover 68 via an annular groove 72 of the manifold member 64 to a water supply pipe 56 attached to the manifold member.

According to this, when the water pipe 56 is disposed below the probe 54, the vibrator 6 is
Even if the respective central axes of the manifold member 64 and the sheath following it are offset, the manifold member 64
There is no need to position and attach the casing 62 in the rotational direction, and the assembly can be easily performed.

18 to 22, the water pipe 56 is connected to the manifold member 6.
4 shows a hand bead 50 that is easy to attach and detach.

The handpiece 50 extends from the interior of the body 52 through the gap between the probe 54 and the distal sheath 58, similar to that of FIG. The water pipe 56 is, for example, the 17th
It is attached to a manifold member 72 as shown in the figure.

The mounting mechanism for the water pipe 56 shown in FIG. 19 is such that a manifold member 72 is provided with an elastic body 74 such as an O-ring, and the base end of the water pipe 56 is inserted into the elastic body 74.

The water pipe 56 is prevented from falling off due to the frictional force with the elastic body 74, and at the same time, liquid tightness is ensured. Further, the mounting mechanism shown in FIG. 20 is such that a water pipe attachment piece 64a is provided on the manifold member 64, and the water pipe 56 is detachably mounted via this water pipe attachment piece.

The mounting mechanism shown in FIG. 21 is almost the same as that shown in FIG. 19, except that the insertion portion on the proximal end of the water pipe 56 is formed into a rigid pipe shape. Further, this rigid insertion portion has an inclined surface 56a whose outer diameter gradually decreases toward the proximal end. 21st
Although the illustrated inclined surface 56a is formed at a relatively large inclination angle with respect to the axial direction, it may be formed with a small inclination angle with respect to the axial direction, as in the case of the inclined surface 56b shown in FIG.

In either case, the water pipe 56 is installed in a liquid-tight manner so that it can be easily attached and detached, and even if it is damaged, it can be replaced very easily.

[Effects of the Invention] As is clear from the above, according to the present invention, the manual rotation member can be rotated to shift the position of a manual operation member such as a hand switch according to the operator's preference. Since the relative position of the water supply port with respect to the manual operation member is fixed, the operability of the ultrasonic surgical handpiece is improved and good cooling efficiency can be obtained.

[Brief explanation of the drawing]

FIG. 1 is a schematic sectional view of an ultrasonic surgical handpiece according to a first embodiment of the present invention, and FIG. 2 is a wiring diagram showing the electrical connection relationship of a hand switch provided in the handpiece of FIG. 1. Figure 3 is a schematic cross-sectional view along the line ■-■ in Figure 1;
FIG. 4 is a schematic cross-sectional view taken along line IV-IV in FIG.
FIG. 5 is a schematic cross-sectional view of an ultrasonic surgical handpiece as a modification of the first embodiment, and FIGS. 6 to 8 are explanatory diagrams illustrating the external structure of the outer cover of the first embodiment. . 9 and 10 schematically show the ultrasonic surgical handpiece of the second embodiment, with FIG. 9 being a partial sectional view and FIG. 10 being an external view thereof. 11 and 12 show an ultrasonic surgical handpiece according to the third embodiment, FIG. 11 is a sectional view of a part thereof, and FIG. 12 is a sectional view taken along the line xn-xn in FIG. 11. be. 13 to 17 each show a disclosed example of an ultrasonic treatment device, FIG. 13 is an explanatory diagram of an electrode of an ultrasonic vibrator, FIG. 14 is an external view of a treatment device containing a water pipe, and FIG. The figure is a sectional view of a part of a modified example of the treatment device shown in FIG. 14, FIG. 16 is an external view of still another modified example, and FIG. 17 is a sectional view of a part of the ultrasonic treatment device that is easy to assemble. . 1st
8 to 22 show still other disclosed examples of the ultrasonic treatment device, FIG. 18 is an external view, and FIGS. 19 to 21 are schematic cross-sectional views of the water pipe attachment mechanism, and FIG. 22 respectively. is a cross-sectional view of a portion of a water pipe. 10... Hand piece, 12... Ultrasonic vibrator, 1
4... Horn, 16... Vibration transmission member, 18...
Inner cover 20...Outer cover 22...Tip sheath, 24...Hand switch (manual operation member), 26
28... Slip ring, 32... Water inlet, 34...
..., communication path, 36... annular groove, 38... water supply cap, 40... 0 ring.

Claims (1)

[Claims] An ultrasonic surgical handpiece having an ultrasonic transducer and a vibration transmission member, wherein a manual rotation member is disposed on the outer periphery of the handpiece, and the manual rotation member is provided with a manual operation for operating the handpiece. At the same time as arranging the member, a water supply port for supplying water to the vibration transmission member, a communication path for arranging the water supply port at a predetermined position fixed with respect to the position of the manual operation member, and communicating the water supply port to a water supply source. An ultrasonic surgical handpiece characterized by: