JPH0795985A - Handpiece for surgical operation - Google Patents

Abstract

PURPOSE:To provide an ultrasonic vibration and high frequency current combined-use type handpiece capable of being used in the field of fine operation incapable of using a conventional handpiece, especially, in the field of cerebral surgical operation and capable of being used in the field of general surgical operation as is conventional. CONSTITUTION:An ultrasonic vibrator 1, a joint part 2 and a tip part 3 are received in and covered with a protective cover consisting of a main body cover 8 and a tip cover 13. The vibrator consisting of the joint part and the tip part is used as an opposed electrode to supply a high frequency current to the electrode provided to the leading end of the tip cover through the connection wire 15 embedded in the side wall of the tip cover.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a surgical handpiece for crushing and removing living tissue by ultrasonic vibration and for incising, coagulating or mixing the living tissue by high-frequency current.

[0002]

2. Description of the Related Art Conventionally, ultrasonic vibration transmitters having a structure in which a high-frequency current is passed (for example, Japanese Utility Model Publication No. 60-33925 and Japanese Utility Model Publication No. 60-33926), ultrasonic vibration transmitters and electric scalpels. A structure in which the electrodes are separately projected (for example, Japanese Utility Model Publication No. 61-36253)
However, these configurations have the limitation that the one for the return electrode must be used. For this reason, in the field of microsurgery, especially in brain surgery, it is not preferable that a high-frequency current flows in a region other than the coagulation site because it damages the brain, and it has the drawback that it cannot be actually used while having a function as an electric scalpel. It was

[0003]

SUMMARY OF THE INVENTION The present invention is intended to solve the above problems of the conventional surgical handpiece which can use both ultrasonic vibration and high frequency current. A surgical hand that can be used in the field of microsurgery, especially in the field of brain surgery, where a combination of vibration and high frequency current handpieces could not be used, and in the field of general surgery can also be used for conventional incision and coagulation work. It is intended to provide a piece.

[0004]

That is, the present invention is for surgical operation for crushing or cutting and separating foreign matter of living tissue by ultrasonic vibration and for cutting, coagulating or mixing living tissue by high-frequency current. A handpiece,
A high-frequency source, an electrode connected to the high-frequency source for supplying a high-frequency current, an ultrasonic vibration source, and an ultrasonic vibration source connected to the ultrasonic vibration source to expand and propagate mechanical vibration of an ultrasonic frequency, It is composed of a vibrating body that also serves as an electrode for passing an electric current, and a protective cover of an insulator that houses and covers the ultrasonic vibration source and the vibrating body, and the protective cover serves as an electrode at the tip and a counter electrode. A surgical handpiece characterized in that the surgical handpiece is mounted so as to be movable back and forth so as to come into contact with the tip of the vibrating body and rotatable about the axis of the vibrating body.

Further, the vibrating body is composed of a joint portion and a tip portion, and a protective cover includes a body cover for accommodating the ultrasonic vibration source and a part of the joint portion, and a tip portion and a part of the joint portion. Which is a combination of a chip cover for coating a high frequency current, an electrode for energizing a high frequency current is attached to the tip of the chip cover by projecting a part of the electrode, and a connection line with a high frequency generation source of the chip cover. It is embedded in the side wall, and is characterized in that the tip of the tip is bent so as to come into contact with the electrode at the tip of the tip cover.

The present invention will be described in detail below with reference to the drawings. FIG. 1 is a view for explaining a basic structure of a surgical handpiece according to an embodiment of the present invention, FIG. 2 is a structure of a tip cover, and FIG. 3 is a surgical handpiece according to the present invention. It is a figure which shows the whole system which does.

As shown in FIG. 1 (a), the ultrasonic transducer (1) is joined by a means such as a screw to a vibrating body which also serves as an electrode consisting of a joint portion (2) and a tip portion (3) having a small diameter. Is
Inside these, a suction passage (4) is provided penetrating in the length direction. These members that vibrate ultrasonically are housed and covered with a protective cover made of a heat-resistant resin having an insulating property. As shown in FIGS. 1B and 1C, the protective cover includes a main body cover (8) for accommodating the ultrasonic transducer (1) and a part of the joint part (2), and a joint part (2). ) And a tip cover (13) for covering the tip portion (3).

As shown in FIG. 2, the tip cover (13) has an inner cavity (14) through which the tip portion (3) is inserted, and a connecting wire (15) embedded in the side wall thereof for conducting a high frequency current. ) Has. An annular space formed between the tip portion (3) and the tip portion (3) when the tip portion (3) is inserted into the lumen (14) is used as a passage for supplying an irrigation liquid such as physiological saline, and is provided at the rear end of the tip cover (13). An irrigation nipple (11) serving as an inlet for irrigation liquid near the part
And a connector (10) for connecting the high frequency power supply (23) and the connecting wire (15). At the tip of the tip cover (13), as shown in FIG.
It has an electrode (12) which is formed as a detachable separate component and serves as an electric knife portion.

The tip cover (13) is fitted and attached to the main body cover (8), and as shown in FIG.
Tip cover at the position corresponding to the node of vibration of the vibrating body (1
It is held by contact with a protrusion (16) provided on the inner surface of (3) and can rotate about the axis of the vibrating body. Furthermore, the working part (5) at the tip of the tip part (3) and the electrode (1) at the tip of the tip cover (13)
2) Body cover (8) to allow contact with
At the fitting portion of the main body cover, the notch (27) at the tip of the main body cover and the two grooves (28) provided on the inner surface of the rear portion of the chip cover can be moved back and forth in the longitudinal direction by the stroke.

The method of using the surgical handpiece according to the present invention is as shown in FIG.
To the ultrasonic vibrator (1) in the handpiece (17) to supply high-frequency power having a resonance frequency, and generate ultrasonic vibration there, thereby forming a vibrating body in which the joint part (2) and the tip part (3) are combined. Ultrasonic vibrations are transmitted and expanded, and the work part (5) at the tip of the tip part (3) is used for crushing living tissue and the like, and a connecting wire from the high frequency generator (23) to the tip cover (13) ( A method of supplying a high-frequency current to 15) and sandwiching a living tissue or the like between the electrode (12) serving as the tip female portion and the tip working portion (5) of the tip portion (3) serving as the counter electrode for coagulation. However, in addition to this, a counter electrode plate (22) serving as a counter electrode is placed in opposition, and a high frequency current is supplied to the electrode (12) or the tip working part (5) of the tip part (3) to incise a living tissue or the like, A method of performing coagulation is also possible.

When used as an ultrasonic surgical instrument, the working part (5) is first attached to the electrode (12) at the tip of the tip cover (13) so that the working part (5) at the tip of the tip part (3) does not come into contact with the electrode (12). The roller pump (21) is made to protrude and the roller pump (21) is actuated at the same time when the vibration starts, and the bottle (18) is connected to the irrigation tube (18) and the irrigation nipple (1).
The irrigation liquid is injected into the chip cover (13) through 1). Use the tip cover (1
3) through the annular passage between the inner wall and the tip portion (3), from the tip of the tip cover (13) toward the working portion (5),
Ejected by ultrasonic vibration. The irrigation liquid and ultrasonic vibration of the working unit (5) crush and emulsify the living tissue. The emulsified debris should be removed with a suction pump (2
The suction pressure of (0) passes through the tip part (3), the joint part (2), the suction passage (4) inside the ultrasonic transducer (1), the suction nipple (7) and the suction tube (26), Collected in a suction bottle (24).

When used as an electrosurgical unit, 2
There is one, and one is the case where it is used in the field of microsurgery, particularly brain surgery, which is the object of the present invention.
A high frequency current is supplied to the connecting wire (15) buried in the side wall of 3) and the vibrating body, and as shown in FIG. 5, the living tissue (30) or the like is placed between the electrode (12) and the working part (5). The other is a method of performing coagulation by sandwiching the electrode, and the other is the case of using in a general surgical operation. In the same manner as an ordinary electric scalpel, a counter electrode plate (22) is placed oppositely across the surgical site, and an electrode (12) is placed. Alternatively, it is a method of supplying a high-frequency current to the tip working portion (5) of the tip portion (3) and the counter electrode plate (22), and incising and coagulating a biological tissue or the like at the tip thereof. In any case, when used in endoscopic surgery, smoke generated can be discharged to the outside of the body by using a suction method similar to that of an ultrasonic surgical instrument, and therefore, visual field obstruction due to smoke can be reduced. The electrode (12) at the tip of the tip cover (13) is provided at the tip (tip) of the tip of the tip cover (13) which is obliquely cut, and at the proximal end, as shown in FIG. There is method (b),
When a living tissue is sandwiched between the electrode (12) and the tip working part of the tip part to perform coagulation, the bent working part (5) is turned toward the electrode (12) as shown in FIG. use.
When using a counter electrode, as shown in FIG.
It is convenient to have a wide field of view by setting it at a position opposite to the bending direction of (5).

Switching between these two methods is performed by the work selection switch of the high frequency generator (23), and the counter electrode (2
2) and electrode (12) or tip working part (5) of the tip part
Even if both are connected to the high frequency generator (23), the high frequency current flows only to the one selected by the work selection switch.

As a safety mechanism, an ultrasonic oscillator (2
5) and the high frequency generator (23) are simultaneously operated so that an accident due to a leakage current or the like does not occur and the internal circuit does not simultaneously operate.

[0015]

INDUSTRIAL APPLICABILITY According to the present invention, an ultrasonic wave which can be used in the field of microsurgery, which cannot be used conventionally, especially in the field of brain surgery, and can be used also in the field of general surgery for conventional incision and coagulation work. It is useful as a surgical handpiece that has the functions of a scalpel and an electric scalpel.

[Brief description of drawings]

FIG. 1 is a view showing a basic structure of a surgical handpiece according to an embodiment of the present invention, (a) is a cross-sectional view in which an ultrasonic vibration source and a vibrating body are connected, and (b) is a main body cover. Is a side view with the main body cover and the chip cover attached.

FIG. 2 is a sectional view showing an example of the structure of a chip cover according to the present invention.

FIG. 3 shows an overall system using a surgical handpiece according to the present invention.

FIG. 4 is a diagram showing an example of a tip cover tip structure in the present invention.

FIG. 5 is a view showing an example of use of the surgical handpiece according to the present invention as an electrosurgical instrument.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 Ultrasonic transducer 2 Joint part 3 Tip part 4 Suction passage 5 Working part 7 Suction nipple 8 Body cover 10 Connector 11 Irrigation nipple 12 Electrode 13 Chip cover 15 Connection line 22 High frequency generator 25 Ultrasonic oscillator 27 Notch 28 Groove 30 Living tissue

Claims (6)

[Claims] 1. A surgical handpiece for crushing or cutting and separating foreign matter of a living tissue by ultrasonic vibration to remove it, and for incising, coagulating or mixing the living tissue by a high-frequency current, which is a high-frequency generation source. An electrode connected to the high-frequency generation source for supplying a high-frequency current, an ultrasonic vibration source, which transmits and expands mechanical vibration of an ultrasonic frequency connected to the ultrasonic vibration source and supplies a high-frequency current to the electrode A vibrating body also serving as a counter electrode for protecting the vibrating body, and an ultrasonic vibration source and a protective cover of an insulator that covers the vibrating body. The protective cover is a vibrating body serving as the counter electrode and the electrode at the tip of the vibrating body. A surgical handpiece, which is movable back and forth so as to be able to come into contact with the distal end portion, and is attached so as to be rotatable about the axis of the vibrating body. 2. The surgical handpiece according to claim 1, wherein the vibrating body comprises a joint portion and a tip portion. 3. The protective cover is a combination of a main body cover that houses the ultrasonic vibration source and a part of the joint part, and a tip cover that covers the tip part and a part of the joint part. The surgical handpiece according to claim (2). 4. An electrode for passing a high frequency current,
The surgical hand according to claim 3, wherein a part of the tip cover is attached to the tip end of the tip cover so as to project therefrom, and a connection line to a high-frequency generation source is embedded in the side wall of the tip cover. piece. 5. The surgical handpiece according to claim 4, wherein the tip of the tip is bent so as to come into contact with the electrode at the tip of the tip cover. 6. The surgical handpiece according to claim 1, wherein a switch for turning on and off a high frequency current is attached to an outer peripheral wall of the main body cover.