JPH0584170B2 - - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION [Industrial Application Field] The present invention relates to a handpiece for an ultrasonic surgical scalpel for crushing or cutting and separating biological tissue by ultrasonic vibration.

[Conventional technology]

Surgical tools that utilize the ability to cut, cut, or crush living tissue using ultrasound include tools for cutting bones and joints and removing cancer cells in the fields of orthopedics and general surgery, and surgical tools for cataracts in the ophthalmology field. Furthermore, in dentistry, ultrasonic surgical tools for removing tartar and the like have been put into practical use.

These ultrasonic surgical tools basically consist of an ultrasonic vibration source that converts high-frequency current into ultrasonic vibration;
It consists of a horn that is connected to the vibration source and amplifies and transmits ultrasonic vibrations, and a working part (female part) at the tip of the horn that comes into contact with living tissue and crushes or cuts it. It is equipped with an irrigation mechanism that supplies irrigation liquid (washing liquid) such as physiological saline to the surrounding area for cleaning, and a suction mechanism that suctions and removes crushed and emulsified cell debris.

An example of the structure of a hand piece of an ultrasonic scalpel for surgical operation equipped with such an irrigation mechanism and a suction mechanism will be described in some detail with reference to FIG. 4. This handpiece generally includes a cable 31 connected to an ultrasonic oscillator, a connector 32, a grip part 33, a protection tube 34, a horn 35, and an irrigation pipe 3 for supplying physiological saline etc. to the surgical site.
6. It is composed of a holder 37 for fixing the irrigation pipe close to the horn 35, and a suction pipe 38 for suctioning and removing liquid substances from the surgical site. The connecting tube 39 is a pipe that mechanically connects the grip portion 33 and the protective tube 34 with a screw or the like. Grip portion 33, connection tube 39 and protection tube 34
is made of a light and corrosion-resistant metal such as aluminum or duralumin, or synthetic resin, in order to be easily handled by the operator. The horn 35, which serves as the ultrasonic scalpel part, is made of a material such as ultra-superduralumin or titanium alloy, which has good transmission of high-frequency mechanical vibrations and is strong against breakage. A suction hole 40 is provided on the outside of the protective tube 34 to aspirate and remove blood, physiological saline for washing, cell fragments crushed by the horn 35, etc. It is connected to the suction pipe 38 via a connected pipe joint 41.
A suction nipple 42 is connected to the other end of the suction pipe 38 by a suitable method such as welding. A suction device such as a vacuum pump is connected to this suction nipple 42 via a trap such as a glass bottle. The irrigation pipe 36 is for supplying irrigation fluid such as physiological saline to the surgical site, and the horn 3
An open end is provided near the tip of the pipe 5, and the pipe joint 41 is fixed or connected to the pipe joint 41 by an appropriate method. At the other end of the irrigation pipe 36,
The irrigation nipple 43 is connected by a suitable method such as melting, and is further connected to an irrigation device consisting of a roller type pump such as a pellister pump. The pipe stopper 44 is connected to the suction pipe 3.
8, and a stopper for fixing the irrigation pipe 36 to the grip portion 33.

FIG. 4b is a diagram showing the internal structure of the handpiece, in which high-quality materials such as duralumin or high-strength aluminum alloy are installed in the front and rear (left and right in the figure) of the vibrator 45, which is an electrostrictive vibrator or a magnetostrictive vibrator. A back plate 46 and a front plate 47 made of a high tensile strength metal material are provided, and the back plate 46, the vibrator 45, and the front plate 47 are tightly connected and fixed to each other by bolts made of a high tensile strength metal material. The front plate 47 and the horn 35 are connected and fixed by screws such as set screws 48 made of a high-tensile metal material.

However, in this handpiece, the irrigation pipe 36 runs along the outside of the horn 35, and the holder 37 is provided near the tip of the horn 35, so that the irrigation pipe 36 and the holder 37 can be used for surgery. The disadvantage is that the visual field of the target area is obstructed, which necessitates a rather difficult surgery, which requires a long operative time and poses a problem in performing an appropriate and accurate surgery.

In order to eliminate these drawbacks of conventional handpieces, the present inventors created a joint whose length corresponds to an integral multiple of 1/2 wavelength between the front plate 47 connected to the vibrator 45 and the horn 35. (Japanese Unexamined Patent Publication No. 60-236638), a handpiece in which the horn 35 is made thinner by providing a step or aperture at a position corresponding to the length of 1/4 wavelength from the end of the joint (Unexamined Japanese Patent Publication No. 60-236638) In addition, the entire handpiece or the tip of the horn can be bent by bending the entire handpiece or the tip of the horn, such as a handpiece in which the front part of the horn 35 is bent according to the situation of the surgical site (Japanese Patent Application No. 109671/1982). A series of inventions have been made and previously disclosed for making the surgical target site easier to see by making it thinner or curved.

On the other hand, there are also well-known examples in which the method of forming the suction holes and the irrigation fluid passages is devised. For example, as shown in FIG. 5, in Japanese Patent Publication No. 47-39197 and U.S. Pat. An annular space between the tool tip 50 and the jacket 52 is provided as an irrigation fluid passage 53. Also the 6th
In the illustrated U.S. Pat. No. 3,526,219, the space inside the hollow horn 54 is used as a cleaning liquid passage 53, and the space between the horn 54 and the outer cover 52 is used as a suction passage 55. Further, in Japanese Patent Publication No. 60-6654 shown in FIG. 7, the inside of the horn 54 is made into a suction hole 51, and the space between the horn 54 and the outer cover 52 is made into a cleaning liquid passage 53. However, in all of these examples, since the outer sheath 52 is provided concentrically on the outside of the horn 54 or the tool tip 50, the tip of the handpiece becomes unnecessarily large, making it difficult to handle. This method could not be applied to the handpiece invented by the inventors in which the tip of the horn was bent.

[Purpose of the invention]

The present invention aims to solve the current problems of surgical tools that utilize ultrasonic vibrations, that is, handpieces for ultrasonic scalpels, and is aimed at solving the current problems of surgical tools that utilize ultrasonic vibrations, such as handpieces for ultrasonic scalpels. An object of the present invention is to provide a handpiece for an ultrasonic scalpel, which makes it easier to see the surgical target area by eliminating the gating tube, and which is also equipped with an irrigation mechanism that can be applied to a new type of handpiece with a bent tip of the horn. It is something.

[Structure of the invention]

That is, the present invention provides a surgical handpiece for crushing or cutting and separating biological tissues using ultrasonic vibrations, in which a horn that is connected to an ultrasonic vibration source and generates mechanical vibrations at an ultrasonic frequency comes into contact with biological tissues. This handpiece is characterized in that a small-diameter tube serving as a passage for irrigation liquid is disposed in a suction hole provided axially penetrating through at least a portion of the handpiece including the distal end working portion.

Hereinafter, the present invention will be explained in detail based on the drawings.
FIG. 1 is a sectional view of a handpiece for an ultrasonic scalpel according to an embodiment of the present invention. By mechanically connecting the vibrator 11 and the horn 1 with screws, etc.
Suction hole 12 and horn 1 provided in vibrator 11
A suction hole is provided so as to connect the suction hole 2 provided inside and pass through the entire handpiece.
The vibrator 11 is fixed to the grip portion 14 by an appropriate method such as screws at a flange portion 13 that becomes a node of the amplitude mode of the vibrator 11.
The front part of the horn 1 and the front part of the horn 1 are covered with a cover 3.
The cover 3 is attached to the grip part 14 so as not to come into contact with the vibrator 11 and the horn 1, but it is desirable that the tip of the horn 1 protrudes from the end of the cover 3 by 7 to 13 mm. Further, from the rear end of the vibrator 11 and the grip part 14, a suction pipe 15 connected to the suction hole 12, an irrigation tube 16 disposed in the suction holes 2 and 12, and an ultrasonic oscillator are connected. The cable 17 that is connected is coming out. Irrigation tube 16 is suction pipe 1
A hole is made in the side of the tube 5 and the tube is pulled out from there.
Sealed with resin. At the rear end of the suction pipe 15, there is a nipple 18, which is a flexible tube, for connecting to a suction device such as a vacuum pump. A nipple 19 is attached to connect a flexible tube made of vinyl chloride resin, silicone resin, etc., which supplies irrigation liquid (cleaning liquid) such as physiological saline using a pump.

The irrigation tube 16 disposed within the suction holes 2 and 12 has an open end in front of the tip of the horn 1. The distance from the tip of the horn 1 to the open end is preferably about 0.5 to 5 mm, preferably about 1 to 3 mm. It is necessary to use a flexible tube with a small diameter as the irrigation tube 16, and the material is not particularly limited as long as it is flexible and has excellent abrasion resistance and heat resistance. For example, fluorine-based resins, polyimide-based resins, etc. may be mentioned. In addition, the irrigation tube 16 passes through the suction holes 2 and 12, and needs to be thick enough not to interfere with the suction of crushed cell fragments, etc. Since the inner diameter of 12 is approximately 2 to 3 mm, the outer diameter of the irrigation tube 16 is
It is best to set it to about 0.7 to 1.5 mm. The irrigation tube 16 is in a state where it extends over the bottom of the suction holes 2 and 12 when they lie on their sides, and the irrigation tube 16 and the suction holes 2 and 12 need to be concentric. There isn't. There is no particular problem even if the suction holes 2 and 12 are not fixed, but if necessary, the adhesive may It may be fixed to the inner wall of the suction hole using, for example.

FIG. 2 shows another embodiment in which the suction hole 21 extends out from the middle of the handpiece and runs along the side, and the present invention can be applied to such a case in the same manner as the example shown in FIG. 1. Drill a suction hole 21 to the center of the horn 1 side of the vibrator 11 at an angle of about 20 to 50 degrees with respect to the axis of the handpiece.
2 and penetrate. The suction hole 21 is connected to the suction pipe 22 via a pipe joint 23 connected to the outside of the cover 3 in an appropriate manner.

FIG. 3 shows an example in which the tool tip 25 at the tip of the horn 1 of the handpiece is bent.
An irrigation tube 16 is passed through the suction hole 2, and irrigation fluid can be supplied without disturbing the field of view of the surgical target area, regardless of the degree of bending of the tip of the horn 1.

〔Effect of the invention〕

According to the ultrasonic scalpel handpiece of the present invention,
The surgical target area is not obstructed by irrigation tubes, suction pipes, or holders that hold them, and in combination with a handpiece with a bent horn tip, the surgical target area is Even when the surgical field is extremely narrow due to the deep part of the body, the surgery can proceed without disturbing the surgical field.
Appropriate and qualified surgeries can be performed in a short time without any problems.

[Brief explanation of the drawing]

1 and 2 are cross-sectional views of a hand piece for an ultrasonic scalpel according to an embodiment of the present invention, and FIG. 3 is a cross-sectional view of a horn tip of a hand piece according to another embodiment of the present invention. be. FIG. 4 is a diagram showing an example of a conventional handpiece for an ultrasonic scalpel, in which a is an external view and b is a diagram showing an internal structure. Further, FIGS. 5 to 7 are diagrams showing the structure of the front part of a conventional handpiece for an ultrasonic scalpel, and the arrows in each diagram indicate the flow direction of the irrigation liquid or the drained liquid.

Claims (1)

[Claims] 1. In a surgical handpiece for crushing or cutting and separating biological tissue by ultrasonic vibration, a horn that is connected to an ultrasonic vibration source and performs mechanical vibration at an ultrasonic frequency is connected to a biological tissue. A hand piece characterized in that a small diameter tube serving as a passage for irrigation liquid is disposed in a suction hole provided axially penetrating at least a portion including a contacting tip working part. 2. The handpiece according to claim 1, wherein the small diameter tube serving as a passage for irrigation liquid is flexible.