JPH0546429Y2 - - 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 crush biological tissues that come into contact with it.
Surgical tools for suction removal (e.g.,
39197) and a surgical tool that has a saw-like operating part connected to an ultrasonic vibration source and has been developed for cutting and separating hard and soft biological tissue. 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 that is 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 insert the operation part deeply into the biological tissue to cut and separate the tissue, and it is difficult to cut the tissue even harder. was inappropriate. In addition, surgical instruments that cut and separate biological tissue with a saw-like operating part that vibrates ultrasonically have devised the shape of the operating part to improve cutting efficiency, but the shape of the operating part is devised to improve cutting efficiency.
Due to the amplitude of the operating part of about 30 to 50 μm, frictional heat is generated between the operating part and the biological tissue to be cut.
Even in the case of the operating part, for example, a titanium alloy with excellent thermal conductivity, the surface temperature reaches several hundred degrees, and the tissue being 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 a contact area that is too large, which causes the problem of crushing biological tissues 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 inside, which penetrates to the tip of the horn or stops near the tip, has an angle of 5° to 90° with respect to the cutting part, and has an angle of 5° to 90° with respect to the cutting part. This medical ultrasonic horn is connected to one or more irrigation nozzles located at the root side of the section and at the cutting section, respectively.

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 drive elements are particularly limited, but 2 to 8 φ3 piece
~φ20 mm is preferable, and it is preferable to use an insulating ceramic washer because the entire device can be applied to surgery 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 7 with a blade shape parallel to the direction of , and a cutting part 8 with a blade shape forming an arc having an angle of 45° to 90° with respect to the vibration direction of the cutting part. has a plurality of groove-shaped depressions 10, and the cutting parts 7, 8
comes into direct contact with biological tissue and cuts and separates the biological tissue using mechanical ultrasonic vibrations.

When cutting and separating by the cutting parts 7 and 8, 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 holes 9 and 11 of the cutting parts 7 and 8 as shown in FIG.
8 and biological tissues, especially hard tissues, in the form of a mist, which prevents the generation of frictional heat due to ultrasonic vibrations during cutting and cutting, and reduces the temperature of the hard tissues near the cut area. 15-30℃ when the temperature is 10-25℃
It is maintained at a certain level. Furthermore, the ultrasonic vibrations of the cutting parts 7 and 8 wash away the fine particles of the hard tissue removed from the cutting part, constantly exposing new hard tissue surfaces, smoothing the surface of the cutting part, and removing osteoblasts, etc. This has a positive effect on the recovery of the amputated area because it stimulates the body.

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 8, but it is necessary to cool the cutting parts 7 and 8 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 9 is preferably 5° to 90°, and this angle allows the cutting portion to be reliably cooled. Furthermore, if the inner diameter of the irrigation outlet holes 9, 11, and 23 is the same or smaller than the inner diameter of the irrigation fluid passage 17, the efficiency of squirting the physiological saline solution for cooling will be better. In case of interference, the irrigation nozzle 11 may be omitted.

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 7, 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 ~
There is no damage even at high amplitudes of about 300 μm, and even if the cutting part 7 is impacted in hard tissue, the contact resistance between the hard tissue and the cutting part 7 is reduced by the depressions 10, and the cutting efficiency is improved without making depressions. It can be improved by 20-30% compared to the shape.

In addition, when cutting and separating hard tissue, the cutting parts 7 and 8
The blade shape penetrates into the inside of the hard tissue surface through mechanical ultrasonic vibrations when it is lightly touched, so it does not give the operator chatter vibrations that would interfere with the operation, allowing precise precision. Work becomes possible. 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 8, and thus can be safely cut.
Can be cut. In addition, from the viewpoints of hardness, thickness, cutting time, safety for soft tissue within the hard tissue, etc., the cutting part 8 that first penetrates into the hard tissue is
It forms an angle of 45° to 90°, preferably 60° to 90°, with respect to the vibration direction of the tip of the horn, and can have a straight or circular arc shape, but preferably a semicircular arc shape. . The thickness of the blade shape of the cutting parts 7 and 8 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. Although there is no particular limitation on coating or other treatments applied to the cutting parts 7 and 8, ceramics (for example, nitrided 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 horn 4 including the cutting portions 7 and 8 is 0.2~
The thickness is preferably 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, and 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 8 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 7 as shown in FIG. 4c.
The cutting parts 7, 8 and the long axis 18 may be provided.
It is good if they are in the same plane.

Furthermore, in each of the embodiments shown in FIGS. 2 to 4,
Although the cutting part 7 is located only on one side of the tip vicinity part 6 of the ultrasonic horn 4, this is not particularly limited, and there may be a cutting part on both sides or in the shape of a blade parallel to a plurality of vibration directions. It is well within the scope 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, prevents deterioration of tissue around the cut surface due to frictional heat, facilitates post-operative treatment, and allows the surgeon to perform precise cutting safely and without obstructing 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 showing 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.

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 penetrates to the tip of the horn or stops near the tip, and has an angle of 5° to 90° with respect to the cutting part, and the irrigation liquid passage is on the root side of the cutting part. and a medical ultrasonic horn, each of which is connected to one or more irrigation nozzles located in the cutting section. (2) The medical ultrasonic horn according to claim (1), characterized in that 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° with respect to the long axis direction of the horn. Features of the medical ultrasonic horn. (4) The cutting portion near the tip of the ultrasonic horn according to claim (1), (2) or claim (3) is
A medical ultrasonic horn comprising a blade shape parallel to the vibration direction at the tip of the horn, and a straight or arcuate blade shape having an angle of 45° to 90° with respect to the vibration direction.