JPH0546428Y2 - - Google Patents

Description

[Detailed description of the invention] <<Industrial application field>> This invention uses ultrasonic vibration to cut biological tissue.
The present invention relates to an ultrasonic horn of a surgical device for separation.

《Prior Art》 Traditionally, surgical scalpels have been used to cut and separate biological tissue, especially bone tissue and cartilage tissue, but the cutting operation is inefficient, takes a long time, and requires a lot of labor from the operator. This method has disadvantages in that it takes a lot of time and requires advanced technology for cutting and separation.

In addition, many surgical tools have been developed that utilize ultrasonic waves, which vibrate the operation part connected to an ultrasonic vibration source to shatter biological tissue that comes into contact with it.
Surgical tools for suction removal (e.g.,
39197 Publication) and a surgical tool that has a saw-shaped operating part connected to an ultrasonic vibration source, which was developed for cutting and separating hard and soft biological tissue, is known. However, surgical instruments that use ultrasonic vibrations to crush, emulsify, and suction remove the surface layer of soft biological tissue, in which a vibrating body has a plane operating part perpendicular to the vibration direction, do not operate at ultrasonic frequencies. Since the tissue is broken by hitting the surface layer of the biological tissue with mechanical vibration, it is difficult to cut and separate the tissue by inserting the operation part deeply into the biological tissue, and it is difficult to cut the tissue even harder. was inappropriate. In addition, surgical tools that cut and separate biological tissue using a saw-like operating part that vibrates ultrasonically have devised the shape of the operating part to improve cutting efficiency; ~
Due to the amplitude of the operating part of about 50 μm, frictional heat is generated between the operating part and the biological tissue to be cut, and even if the operating part is made of a titanium alloy with excellent thermal conductivity, the surface temperature can reach several hundred degrees. The tissue being reached and cut is carbonized. Furthermore, thin operating parts such as blade shapes deteriorate due to frictional heat and may break.

In addition, conventional horns have a large working part and an excessively large contact area, resulting in the problem of crushing biological tissue more than necessary.

《Problems to be solved by the invention》 The purpose of this invention is to solve these problems with conventional surgical tools. The purpose of this invention is to provide a medical ultrasonic horn having a shape suitable for detailed work while also solving the problem of overlapping.

<<Means for Solving the Problems>> That is, the present invention is an ultrasonic horn for a surgical device that cuts and separates biological tissue by ultrasonic vibration, and the horn has a blade-shaped cutting part near its tip, and It has an irrigation liquid passage therein, the irrigation liquid passage has an angle of 5° to 90° with respect to the cutting part, and is connected to one or more irrigation jet holes located on the root side of the cutting part. This is a medical ultrasonic horn characterized by the fact that the

Hereinafter, the present invention will be described in detail with reference to the drawings.

FIG. 1 is a diagram showing the configuration of a medical ultrasonic horn and a device using the same, which is an embodiment of the present invention. A high frequency current at a resonant frequency is sent from the ultrasonic oscillator 1 through the cable 2 to the ultrasonic vibration source 3, and the ultrasonic vibration source 3 causes mechanical ultrasonic vibration. As the ultrasonic vibration source 3, either a magnetostrictive type or an electrostrictive type can be used, and a bolted Languevin type vibrator is particularly preferable, and the number and diameter of the drive elements are not particularly limited, but 2 to 8 drive elements are Φ8 ~
A diameter of 20 mm is preferable, and it is preferable to use insulating ceramic or washer because the entire device can be applied to surgeries near the heart.

The mechanical ultrasonic vibrations generated by the ultrasonic vibration source 3 are propagated to the ultrasonic horn 4, and further transmitted to the ultrasonic horn 4.
is expanded by the curved portion 5 and propagated to a portion 6 near the tip of the ultrasonic horn 4.

The near-tip portion 6 has a long axis 18 as shown in FIG.
It has a cutting part 9 with a blade shape parallel to the direction of
has a plurality of groove-shaped depressions 10, and the cutting portion 7,
9 directly contacts the biological tissue and cuts and separates the biological tissue by mechanical ultrasonic vibration.

When cutting and separating by the cutting parts 7 and 9, the roller pump 13 is operated in conjunction with the activation of the ultrasonic oscillator 1 by a switch such as the foot switch 12, and the saline solution 14 is pumped into the irrigation tube 15. The liquid passes through the irrigation liquid passages 16 and 17 and is ejected from the irrigation jetting hole 8 located at the root side of the cutting part 9 as shown in FIG. It enters in the form of a mist and prevents the generation of frictional heat due to ultrasonic vibration during cutting and cutting, and the temperature of the hard tissue near the cut area is 15 to 15 degrees when the irrigation liquid temperature is 10 to 25 degrees Celsius.
The temperature is maintained at around 30℃. Furthermore, the ultrasonic vibrations of the cutting parts 7 and 9 wash away the fine particles of hard tissue removed from the cut part, constantly exposing new hard tissue surfaces, smoothing the surface of the cut part, and removing osteoblasts, etc. This has a positive effect on the recovery of the amputated area.

The amount of physiological saline is determined by the relationship between the hardness of the hard tissue to be cut and the amplitude of the ultrasonic vibration of the cutting parts 7 and 9, but it is necessary to cool the cutting parts 7 and 9 and the ultrasonic vibration source 3. In consideration of this, the rate is preferably 10 to 50 ml/min.
The angle of the ejection hole 8 is preferably 5° to 90°, and this angle allows the cutting portion to be reliably cooled. Further, when the inner diameter of the irrigation ejection hole 8 is the same or smaller than the inner diameter of the irrigation liquid passage 17, the ejection efficiency of the physiological saline for cooling can be synergized with the ultrasonic vibration.

Further, the groove-shaped recess 10 can have various shapes when viewed from the side, such as a circular arc shape, an inverted trapezoid, and a rectangle, and is not particularly limited, but a circular arc shape with no corners is preferable. In that case, the arc size varies depending on the thickness and shape of the cutting part 9, but the radius
The depth of the depression 10 is 0.1 to 2 with an arc of 0.3 to 2.5 mm.
mm, preferably 0.5 to 1.5 mm, and the pitch of the depressions 10 is 1.5 to 7 mm, preferably 2 to 3 mm.
By having this arc shape, 100 ~
Even with a high amplitude of about 300 μm, there is no damage, and even if the cutting part 9 is impacted in the hard tissue, the contact resistance between the hard tissue and the cutting part 9 is reduced by the depression 10, and the cutting efficiency is reduced. This can be improved by 20 to 30% compared to the shape without.

In addition, when cutting and separating hard tissue, the cutting parts 7 and 9
The blade shape of the blade penetrates into the interior of the hard tissue surface through mechanical ultrasonic vibration even when the blade is lightly touched, so there is no chatter vibration that would interfere with the operator's operation, and precision is achieved. This makes it possible to perform various tasks. Furthermore, due to the characteristics of ultrasonic vibration, elastic tissues such as periosteum within hard tissues will not be damaged by the contact of the cutting parts 7 and 9, and can be safely cut.
Can be cut. From the viewpoint of the hardness of the hard tissue, the cutting time, and the safety of soft tissue within the hard tissue, the cutting part 7 that first penetrates into the hard tissue should be at an angle of 0° to 0° with respect to the vibration direction of the tip of the horn. 90°, preferably
It forms an angle of 60° to 90°, and can be selected from a straight line or a circular arc shape, but preferably a semicircular arc shape. The thickness of the blade shape of cutting parts 7 and 9 is
0.1 to 7 mm, particularly preferably 0.2 to 1.5 mm.

The curve of the curved portion 5 is preferably a circular arc shape, a catenoidal curve, an exponential curve, a tapered shape, a Fourier curve, etc., but is not particularly limited. Further, the end of the curved portion 5 on the side of the ultrasonic vibration source 3 is preferably located at a node of ultrasonic vibration or at a position close to the node, but is not particularly limited.

The material of the ultrasonic horn 4 is preferably a titanium alloy, a stainless steel alloy, or a composite material of a titanium alloy and a stainless steel alloy, and there is no particular limitation on coating or other treatments applied to the cut parts 7 and 9. Coatings such as silicon (silicone, zirconia), titanium nitride, titanium carbide, etc., and Kanigen treatment have excellent wear resistance. In addition, the surface roughness of the portion 6 near the tip of the ultrasonic horn 4 including the cutting portions 7 and 9 is determined by taking into account wear and chipping during cutting, etc.
The thickness is preferably 0.2 to 12 μm, preferably 1.6 to 8 μm.

Next, FIG. 3 shows a portion 6 near the tip of the ultrasonic horn 4.
This embodiment has an angle, which is suitable for cutting operations when the affected area is deep and the surgical field is limited. 90°, preferably 10° to 30°. Note that the direction in which the cutting parts 7 and 9 are bent is not limited as long as they are in the same plane as the long axis 18.

FIG. 4 shows an embodiment in which the portion 6 near the tip can be attached to and detached from the ultrasonic horn 4 using screws 19 and 20. The diameter of the screw depends on the ultrasonic vibration and the joining position, but it is preferably a triangular screw with a diameter of M3 to M6 and a pitch of 0.8 to 1 mm. Note that the horn 4 may be bent on the side of the curved portion 5 of the screw 20, or a bending point 22 may be formed near the cutting portion 9 as shown in FIG. 4c.
You may also set Cutting parts 7, 9 and long axis 18
It is good if they are in the same plane.

FIG. 5 is a diagram showing an example of the shape of the cutting parts 7 and 9, and b is a sectional view taken along line A-A' in figure a.
, c shows the cutting parts 7 and 9 at the tip of the horn 4 seen from the direction of arrow B in figure a, and d shows an example of the cutting parts 7 and 9 and the recess 10 seen from the direction of arrow C. There is. Note that the shape and number of cutting parts are not particularly limited to the embodiments of the present invention.

《Effects of the invention》 According to the invention, operations such as cutting biological tissues, especially bones, and separating deposits such as calcium lumps can be performed without requiring much technical skill compared to conventional surgical tools.
It also enables quick cutting and separation, promotes post-operative healing by preventing deterioration of cellular tissue around the cut surface due to frictional heat, and allows the surgeon to perform precise cutting safely and without disturbing the field of view. A surgical procedure that cuts, cuts, and separates biological tissue by allowing cutting work, achieving high amplitude due to the stress concentration and dispersion shape of the blade shape, and improving cutting efficiency, and which can be used continuously at high amplitude for a long period of time. Suitable as an ultrasonic horn for the device.

[Brief explanation of the drawing]

FIG. 1 is a diagram showing the configuration of a medical ultrasonic horn and a device using the same, which is an embodiment of the present invention. FIG. 2 is an enlarged three-dimensional view of an embodiment of the cutting part of the ultrasonic horn according to the present invention. Figures 3 and 4 show other embodiments of the ultrasonic horn according to the present invention; Figure 3 shows an example in which the portion near the tip is bent, and Figure 4 shows an example in which the portion near the tip is detachable. It is a diagram. Moreover, FIG. 5 is a diagram showing the shape of the cutting part of the ultrasonic horn according to the present invention.

Claims (1)

[Claims for Utility Model Registration] (1) An ultrasonic horn for a surgical device that cuts and separates biological tissue by ultrasonic vibration, the horn having a blade-shaped cutting part near its tip and an irrigation section inside. The irrigation liquid passage has an angle of 5° to 90° with respect to the cutting part, and is connected to one or more irrigation jetting holes located on the root side of the cutting part. A medical ultrasonic horn characterized by: (2) The medical ultrasonic horn according to claim (1), wherein the blade-shaped cutting portion has one or more groove-like depressions. (3) The vicinity of the tip of the ultrasonic horn according to claim (1) or claim (2) is bent at an angle of 0 to 90 degrees with respect to the long axis direction of the horn. Features of the medical ultrasonic horn. (4) The cutting portion in the vicinity of the tip of the ultrasonic horn according to any one of claims (1), (2), or (3) has one or more cutting portions parallel to the vibration direction of the tip of the horn. A medical ultrasonic horn comprising a blade shape and a straight or arcuate blade shape having an angle of 1° to 90° with respect to the vibration direction.