JPH0779989A - Ultrasonic surgical operation equipment - Google Patents

Abstract

PURPOSE:To make possible to minimize the loss of carbon oxide gas in an operation, to secure the field of view in an operation, and to prevent clogging of the inner part of the handpiece by sucked substance. CONSTITUTION:This is an operation equipment comprising a handpiece 13 composed of an ultrasonic vibration source and a vibration transmitting body, a liquid supply circuit, a suction circuit, a vibration circuit and a control part which comprises a supply pump control circuit 2, a suction pump control part 4, a starting circuit 8 and a delay circuit 9. The vibration circuit including a vibrator 10 is activated and stopped directly by a foot switch 7 and the starting circuit, the liquid supply circuit including a roller pump 1 via the supply pump control circuit, and the suction circuit including a suction pump 3 via the delay circuit and the suction pump control circuit.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an ultrasonic surgical apparatus for crushing, aspirating and removing an unwanted substance from a living body by ultrasonic vibration.

[0002]

2. Description of the Related Art As a surgical operating apparatus for crushing, cutting or separating biological tissue by ultrasonic vibration, it occurs in ophthalmology for crushing and sucking out the lens cured by cataract and in the brain, spine, digestive tract, etc. BACKGROUND ART A surgical operation device for soft tissue for crushing and removing tumors and hematomas for general surgery is known. More recently, an ultrasonic surgical apparatus has been used that can cut and separate hard tissue by ultrasonic vibration.

Further, among various techniques and devices for performing minimally invasive and non-invasive treatment, in particular in the gastrointestinal field, surgery for removing the gallbladder using a laparoscope is compared with open surgery. Since there is little surgical invasion, recovery is quick,
It is becoming widespread due to the short hospitalization days, quick return to society, light post-operative pain, and extremely small surgical wounds.

In this operation, the abdominal cavity is insufflated by carbon dioxide gas or the like without laparotomy, and an endoscope, forceps,
An electric scalpel or the like is inserted to remove the gallbladder under the view of the endoscope. The point is to safely and accurately detach the gallbladder duct and gallbladder artery from the Calot triangle, clip and cut, and further detach the gallbladder bottom from the liver bed to remove the gallbladder with forceps. It is to be.

However, if it is attempted to apply this endoscopic surgery to all cases of gallstone disease, using only ordinary treatment tools, the degree of gallbladder inflammation, the position of gallstones, the shape of gallbladder ducts and gallbladder arteries, etc. Depending on the patient's age or the like, problems such as heavy bleeding from the arteries and the hepatic bed and difficulty in fixing the gallbladder duct and the gallbladder artery may occur, and there is a risk of having to switch to open surgery during the operation.

On the other hand, countermeasures such as improving the hemostatic effect by improving the shape of the tip of the electric scalpel and stopping the bleeding by using a laser knife have been taken, but the smoke obstructs the visual field and the gallbladder duct. Since the mechanical tearing force of the forceps is used for detaching the gallbladder artery, it does not fundamentally prevent bleeding.

Therefore, these operations are performed by using an ultrasonic operation apparatus using ultrasonic vibration capable of selectively preserving elastic bodies such as blood vessels, and the effect is improved. In the device used here, as shown in FIG. 4, the physiological saline (19) is sent to the irrigation nipple (12) through the irrigation tube (20) by the roller pump (1), and the saline (19) is supplied to the cover (11). It spouts from the tip through the inside. At the same time when the roller pump (1) is activated, the oscillator (1
0) High frequency power is supplied to the ultrasonic vibration source inside the handpiece (13) to be converted into mechanical ultrasonic vibration, and the ultrasonic vibration is transmitted and expanded by the vibration transmitting body, and the living tissue of the surgical site is expanded. It is crushed and passed through the suction passage inside the vibration transmitter and the ultrasonic vibration source by the suction pump (3) and further discharged from the suction nipple (15) through the suction tube (18) to the suction bottle (17). During this period, the suction pump is in continuous operation and is constantly sucking to prevent clogging of the suction passage.

When this device is used for endoscopic surgery, the pneumoperitoneum gas in the body cavity is sucked when approaching the operation site, and the pneumoperitoneum gas is discharged to the outside of the body to dent the abdominal wall to perform surgery. Becomes an obstacle. Further, there is a method of operating the suction pump in synchronization with the start-up of the oscillator (1), but since it is synchronized with the oscillator (1), suction is stopped at the same time when the oscillation is stopped, and endoscopic surgery is performed. Vibration transmitter for use has a total length of 400
Since it is as long as ~ 500 mm, crushed pieces and blood clots remain in the thin internal suction passage having an inner diameter of about 1 to 3 mm, which becomes a core when re-sucking, which easily causes clogging. In endoscopic surgery, various instruments are inserted through a trocar that is punctured in the abdomen, so that the use interval is long and the fragments in the suction passage are more likely to solidify.

Further, when crushing / removing adipose tissue or the like and fixing the vascular tissue, it is necessary to wash the surrounding tissue before and after that, but at present, the handpiece is pulled out from the trocar and another washing instrument is used. Is inserted and processed. When the same cleaning operation was attempted with the handpiece, the flow rate of the physiological saline set at the time of ultrasonic vibration was different from the flow rate at the time of cleaning, so it was necessary to reset the flow rate, and the operation was complicated.

In the suction system, there is a method of pressurizing the inside of the suction tube at the same time as stopping the suction to apply a positive pressure to release the residual negative pressure in the tube (JP-A-3-9742). However, it is dangerous to apply extra positive pressure from other than the pneumoperitoneum device, and it is also inappropriate because it causes a decrease in carbon dioxide concentration.

[0011]

SUMMARY OF THE INVENTION It is an object of the present invention to solve the above problems of an ultrasonic surgical apparatus which uses a handpiece having a long effective length, such as endoscopic surgery. Thus, it is possible to prevent clogging of the suction passage inside the handpiece, prevent the discharge of excess pneumoperitoneum gas, and provide an ultrasonic surgical device that can be used as a cleaning device.

[0012]

That is, the present invention provides an ultrasonic vibration source for generating ultrasonic vibrations, and a vibration transmission body connected to the ultrasonic vibration source for transmitting and expanding mechanical vibrations at ultrasonic frequencies. A handpiece, a liquid supply circuit for supplying a liquid to a working portion at the tip of the handpiece, a suction circuit for sucking and removing an undesired substance from the working portion,
A surgical apparatus comprising an oscillation circuit for supplying high-frequency power to the ultrasonic vibration source, and a control unit for controlling the oscillation circuit, the liquid supply circuit, and the suction circuit, wherein the control unit is a supply pump control unit. Circuit, suction pump control circuit, starting circuit, and delay circuit, the liquid supply circuit is operated or stopped by the starting circuit via the supply pump control circuit, and the suction circuit via the delay circuit and the suction pump control circuit. The ultrasonic surgical device is characterized by being activated or deactivated by a starting circuit.

The present invention will be described in detail below with reference to the drawings. FIG. 1 shows an ultrasonic surgical apparatus according to an embodiment of the present invention. The handpiece (13) is composed of a magnetostrictive or electrostrictive vibrator serving as an ultrasonic vibration source, a vibration transmitter connected to the vibrator, and a handle made of an insulating material incorporating the vibrator. Inside the vibrator and the vibration transmitter, there is a suction passage communicating with the suction nipple (15), and the suction passage is opened to the working portion (14) on the tip surface of the vibration transmitter. An annular space formed between the vibration transmitter and the protective cover (11) covering the vibration transmitter communicates with the irrigation nipple (12) and serves as a passage for supplying the irrigation liquid. Is the working unit (1
There is an opening near 4).

The liquid supply circuit for supplying the irrigation liquid to the operative site includes a physiological saline (19) container, a roller pump (1), and an irrigation tube (2).
0) and a supply pump control circuit (2) for controlling the roller pump, and the suction circuit for sucking and removing undesired substances from the surgical site includes a suction pump (3) and a solenoid valve (6). , A suction bottle (17), a suction tube (18), and a suction pump control circuit (4) for controlling the suction pump.

When the apparatus of the present invention is used for endoscopic surgery, the cover (11) of the handpiece (13) is inserted into the trocar punctured in the abdomen, and the working portion ( 14) is located at the target surgical site. Then, when the foot switch (7) is stepped on and turned on, a start signal is sent to the delay circuit (9), the oscillator (10), and the supply pump control circuit (2) via the start circuit (8). The roller pump (1) and the oscillator (10) operate simultaneously,
By the roller pump (1), the saline solution (19) having a preset flow rate in the supply pump control circuit (2) is supplied to the handpiece (13) through the irrigation tube (20) and the irrigation nipple (12),
The physiological saline is jetted to the working portion (14) through the passage between the inner surface of the cover (11) and the vibration transmitter.

On the other hand, high frequency power is supplied from the oscillator (10) to the vibrator inside the handpiece (13), converted into mechanical ultrasonic vibration, transmitted and expanded by the vibration transmitter, and the working unit (14). Generates the maximum amplitude vibration. Further, a start signal is also sent from the delay circuit (9) to the suction pump (3) via the suction pump control circuit (4). At the time of start-up, the delay circuit (9) delays the start-up of the solenoid valve (6) and the suction pump (3) so that the working part (14) passes through the handpiece (13), the suction nipple (15), and the suction tube (18). The crushed pieces are sucked out into a suction bottle (17). Delay time is 0.1 to 2 seconds, preferably 0.1 to
0.5 seconds. Due to this delay, it is possible to prevent the tissue of the surgical site from being sucked into the working part (14), and it does not become a load when the vibration of the vibration transmitter rises, so that there is an advantage that no vibration failure occurs. Further, since the suction is performed only when necessary, it is possible to avoid unnecessary suction and discharge of the pneumoperitoneum gas. In the handpiece for endoscopic surgery, the vibration transmitter is elongated, which makes it sensitive to the load at the start of vibration of the working unit (14) and makes it difficult to start, but this method is less susceptible to these loads. There is a feature.

Next, the case where the work is stopped will be described. First, when the foot switch (7) is turned off, a stop signal is sent from the foot switch (7) via the starting circuit (8) to the delay circuit (9), the oscillator (10), and the supply pump control circuit (2). Sent. The rotation of the roller pump (1) and the vibration of the vibrator inside the handpiece (13) immediately stop, the suction pump (3) stops and the solenoid valve (6) closes with a slight delay. This delay time is 1 to 5 seconds, preferably about 1 to 2 seconds, and varies depending on the circuit volume of the suction tube (18) and the like. As a result, blood coagulates, crushed and emulsified tissue pieces, and the like in the suction passage inside the handpiece (13) are sucked and discharged without remaining, and clogging of the suction passage can be prevented.

As means for stopping the suction, in FIG. 1, the suction pump is stopped through the suction pump control circuit (4), and the pipe between the handpiece (13) and the suction pump (3) is connected by the solenoid valve (6). Although the method of blocking is illustrated,
Suction may be stopped by stopping the suction pump (3) or shutting off the electromagnetic valve (6), and the electromagnetic valve (6) does not necessarily have to be used. In addition to the solenoid valve, it is also preferable to provide a pinch valve or the like for crushing the tube between the handpiece (13) and the suction bottle (17) to shut it off, and the method of shutting off the pipe is not particularly limited.

FIG. 2 shows an embodiment in which the oscillator (10) and the suction circuit are linked. Since the vibration transmitter of the endoscopic surgical handpiece is about three times longer than in the case of normal surgery, the heat generated by the ultrasonic vibration of the working unit (14) is almost the entire length of the vibration transmitter. It tends to increase in proportion. Immediately before the start of vibration of the working part (14), a delay circuit (9) is provided between the starting circuit (8) and the oscillator (10) for the purpose of preventing these heat generation and cleaning the operating part immediately before treatment. The physiological saline (19) inside the cover (11) is spouted by the roller pump (1). The suction pump (3) is also activated by the delay circuit (9) with a delay. The oscillator (10) and the suction pump (3) may have the same delay time, but the oscillator (10) starts earlier than the suction pump (3) due to the load at the time of the vibration rise of the working unit (14). Is preferred. Delay time is 0.1 seconds to 2
The second is preferably 0.1 second to 1 second.

FIG. 3 shows an embodiment for further enhancing the cooling effect. The rotation speed of the roller pump (1) is set in advance to the low speed side and the high speed side by the selection circuit (21), and the working unit (14). Has a large amplitude, that is, in the case of surgery that requires crushing force such as liver resection, an activation signal is sent to the supply pump control circuit (22) on the high speed side, and in the case of liposuction such as gallbladder resection, the amplitude is low. Therefore, the start signal is sent to the supply pump control circuit (2) on the low speed side. As a result, it is possible to prevent the vibration transmitter from generating heat, and also in endoscopic surgery, it is possible to perform surgery with an ultrasonic surgical device that has a crushing speed close to that of normal laparotomy, and it is a minimally invasive treatment that places less burden on the patient. It becomes an important device.

[0021]

According to the present invention, since suction is performed only when necessary, excessive suction of pneumoperitoneum gas is prevented in endoscopic surgery, and visual field obstruction due to movement of the abdominal wall during surgery is prevented. It is possible to prevent clogging of the suction circuit inside the handpiece, set a wide range of amplitude, improve the durability of the vibration transmitter, and expand the indication cases.
It is useful as an ultrasonic surgical device.

[Brief description of drawings]

FIG. 1 is a diagram showing a basic structure of an ultrasonic surgical apparatus according to an embodiment of the present invention.

FIG. 2 is a diagram showing another embodiment of the present invention, in which the starting and stopping of the oscillator is delayed.

FIG. 3 is a diagram showing another embodiment of the present invention, showing a structure capable of selecting a flow rate of a roller pump.

FIG. 4 is a diagram showing a structure of a conventional ultrasonic surgical device.

[Explanation of symbols]

 1 Roller Pump 2, 22 Supply Pump Control Circuit 3 Suction Pump 4 Suction Pump Control Circuit 6 Solenoid Valve 7 Foot Switch 8 Starting Circuit 9 Delay Circuit 10 Oscillator 11 Cover 14 Working Section 21 Selection Circuit

Claims (3)

[Claims] 1. A handpiece comprising: an ultrasonic vibration source for generating ultrasonic vibration; and a vibration transmitter connected to the ultrasonic vibration source for transmitting and expanding mechanical vibration of ultrasonic frequency. A liquid supply circuit for supplying liquid to the tip working unit, a suction circuit for sucking and removing undesired quality from the working unit, an oscillation circuit for supplying high-frequency power to the ultrasonic vibration source, and the oscillation circuit and the above A surgical apparatus comprising a liquid supply circuit and a control unit for controlling the suction circuit, wherein the control unit includes a supply pump control circuit, a suction pump control circuit, a starting circuit, and a delay circuit. Is activated or deactivated by the starting circuit via the supply pump control circuit, and the suction circuit is activated or deactivated by the starting circuit via the delay circuit and the suction pump control circuit. An ultrasonic surgical device characterized by the above. 2. The ultrasonic surgical apparatus according to claim 1, wherein the oscillating circuit is activated or deactivated by a starting circuit via a delay circuit. 3. The ultrasonic wave according to claim 1, wherein the liquid supply circuit is operated or stopped by a starting circuit via a liquid flow rate selection circuit and a supply pump control circuit. Surgical equipment.