JPH09248308A - Ultrasonic operation device - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an ultrasonic operation device which allows the adjustment of a suction pressure at the operator side of a handpiece according to the kinds and condition of an operation and which allows the easy adjustment of the suction pressure. SOLUTION: This ultrasonic operation device is provided with the handpiece 51 contg. an ultrasonic vibrator transducer and is provided with an ultrasonic transmission member 54 connected to the handpiece 51. The part of this ultrasonic transmission member 54 is provided with a suction hole 59. A suction source is connected to this suction hole 59 and a suction tube 61 having a branch path is connected thereto. The handpiece 52 is provided with a suction pressure control member 65 having a suction pressure control hole 64 capable of controlling the suction pressure by an opening rate and is provided with a tube for connecting this branch path and the suction pressure control member 65. The suction pressure is controlled by controlling the opening rate of the suction pressure control hole 64 of the suction pressure control member 65 by a fingers.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention uses ultrasonic vibration to incise / exfoliate or emulsify biological tissue or crush stones, and removes excised or exfoliated tissue pieces or crushed pieces by suction. The present invention relates to an ultrasonic surgical device.

[0002]

2. Description of the Related Art In recent years, ultrasonic surgical devices of this type have been used for liver surgery with many blood vessels and brain surgery with many nerve tissues.
It has become widely used in surgery in many other fields. In addition, it is beginning to be applied to treatment under endoscopic observation, and the applicable range of this type of ultrasonic surgical device is quite wide.

A generally known ultrasonic surgical device is a handpiece containing an ultrasonic vibrator, a probe connected to the handpiece, a drive power supply unit for exciting and driving the ultrasonic vibrator, and a body cavity. A water supply passage for supplying a perfusate such as physiological saline to a surgical treatment site therein, and a suction passage for sucking and removing the tissue fragments and debris along with the perfusion liquid are provided.

[0004]

By the way, a suction system for sucking and removing the tissue pieces and crushed pieces together with the perfusate has a suction passage connected to a suction passage provided in the handpiece via a suction tube. It will be. Since the suction control in this case is manually set at a location separate from the handpiece, it is not easy to make adjustments that sequentially correspond to the situation during surgery. Then, since it is not possible to adjust the suction to an optimal condition that sequentially corresponds to the situation during surgery, the suction amount tends to be large or small depending on the situation during surgery. For example, there is a possibility that the suction and removal force of the tissue pieces and the crushed pieces may be insufficient or may be excessively sucked, or the situation of the operative field may be hindered.

The present invention has been made in view of the above problems, and its purpose is to adjust the suction pressure at the hand of the handpiece according to the type and situation of the operation, and the suction pressure can be adjusted. An object of the present invention is to provide an ultrasonic surgical device that is extremely easy to adjust.

[0006]

In order to solve the above-mentioned problems, the ultrasonic surgical apparatus of the present invention is provided with a handpiece containing an ultrasonic transducer and a probe connected to the handpiece, At least a suction hole provided at the probe portion, a suction tube having a branched path connecting a suction source to the suction hole, and a suction pressure adjustment capable of adjusting the suction pressure by the opening amount provided in the handpiece The suction pressure adjusting member having a hole is provided, and the branch passage and the tube for connecting the suction pressure adjusting member are provided so that the suction pressure can be adjusted at the hand of the handpiece.

[0007]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS A first embodiment of the present invention will be described with reference to the drawings. FIG. 1 schematically shows the system of the ultrasonic surgical apparatus. In FIG. 1, reference numerals 1a and 1b denote handpieces, which have different sizes, maximum amplitudes, frequencies and the like. As the handpiece 1a, a probe selected from probes 2a, 2b, 2c having different shapes and sizes is attached. Further, the handpiece 1b is also equipped with a probe selected from probes 3a, 3b, 3c having different shapes and sizes. For the handpieces 1a, 1b, the probes 2a, 2b, 2c,
It is possible to use a combination of 3a, 3b and 3c. Here, an A group consisting of the handpiece 1a and probes 2a, 2b, 2c used in combination with it, and a B group consisting of the handpiece 1b and probes 3a, 3b, 3c used in combination with it. It is divided into

Cords 4a and 4b are derived from the handpieces 1a and 1b, respectively.
Connector leads 6 of the drive unit 5 are provided at the lead-out ends of 4b.
It has connectors 7a and 7b for connecting to.

Then, the handpieces 1a, 1b and the probes 2a, 2b, 2c, 3 having different driving characteristics.
Detection means for identifying the types of a, 3b, and 3c are provided. First, as a means for detecting the type of the handpieces 1a, 1b, an identification element (not shown) such as a resistance element or a Zener diode is provided inside the connectors 7a, 7b. In the case of a resistance element, the resistance is changed according to the type of the handpiece 1a, 1b, and in the case of a Zener diode, the Zener voltage value is changed according to the type of the handpiece 1a, 1b. To do. In any case, the identification terminal that is electrically connected to the identification element is projected from the connectors 7a and 7b, and this is connected to a detection contact (not shown) provided in the connector receiver 6 of the drive unit 5. Has become.

Inside the drive unit 5, the handpieces 1a, 1b and the probes 2a,
As means for identifying the type of combination of 2b, 2c, 3a, 3b, 3c, the probes 2a, 2b, 2c, 3a,
The probes 2a, 2b, 2c, 3a, 3b, using the fact that the voltage values or current values for ultrasonic vibration drive of the handpieces 1a, 1b with the 3b, 3c attached are different.
Detection means (not shown) for identifying the type of 3c is provided. As the detecting means, for example, an impedance value (Z) indicated by a ratio of voltage to current (V / I) is detected, and the probe 2a, 2b, 2c, 3a, 3b, 3c thereof is detected.
It is designed to determine the type of.

By performing these two discriminations, the types of the handpieces 1a and 1b and the probes 2a and 1a
A detection means for discriminating the types of 2b, 2c, 3a, 3b, 3c is configured. From the results of this detection means, the handpieces 1a, 1b and the probes 2a, 2b, 2c, 3
The drive device 5 according to the type of combination of a, 3b and 3c
Is set to the optimum driving condition.

On the other hand, the handpieces 1a and 1b are provided for cooling the ultrasonic transducers and the probes 2a, 2b, 2c, 3a, 3b and 3c inside the handpieces 1a and 1b and for cleaning the operative field. A passage (not shown) for supplying a perfusate is formed. This passage is connected via a water supply tube 8 to a water supply pump 9 provided in the drive device 5. The water pump 9 sends the physiological saline stored in the water bottle 10 to the perfusion solution supply passages of the handpieces 1a and 1b as the perfusion solution, and the handpieces 1a and 1b and the probes 2a, 2b, 2c, 3a and 3b, It is designed to cool 3c. The probes 2a, 2b, 2c, 3
The perfusate in a, 3b, and 3c is the probe 2
passages formed in a, 2b, 2c, 3a, 3b, 3c,
Or its probes 2a, 2b, 2c, 3a, 3b, 3
It is supplied through a passage formed by a gap with a sheath (not shown) surrounding c.

The handpieces 1a and 1b and the probe 2a,
Inside the 2b, 2c, 3a, 3b, 3c, a perfusate suction passage (not shown) for sucking the perfusate that has washed the surgical field is formed. This passage is connected to a suction pump 13 provided in the drive device 5 via a suction tube 11 and a suction bottle 12. Then, the perfusate is supplied through the supply passage, and the perfusate is discharged through the suction passage.

By the way, the perfusate is supplied to the handpieces 1a and 1b by the water supply tube 8 and the water supply pump 9 provided in the drive unit 5.
b, and probes 2a, 2b, 2c, 3a, 3b, 3
The required water supply differs depending on the type of c. For this reason, the handpieces 1a, 1b and the probes 2a, 2b, 2c, 3a, 3 identified by the water supply amount automatic setting means 14 are identified.
An initial set value of water supply is automatically set as one of the optimum driving conditions according to the types of b and 3c.

The operation is started under the conditions set in this way, but during the operation, the oscillation output setting means 15 provided in the driving device 5 appropriately sets the oscillation output of ultrasonic vibration according to the tissue to be operated. To do. In this case, when the oscillation output is large, that is, when the amplitude of the ultrasonic vibration is large, the amount of heat generated by the ultrasonic transducer and the probes 2a, 2b, 2c, 3a, 3b, 3c is large, and the required amount of water supply is accordingly increased. Also grows. On the contrary, when the oscillation output is small, that is, when the amplitude is small, the amount of heat generated is small and the required amount of water supply may be small.

Since the required amount of water supply varies depending on the oscillation output set value, the signal S ₂ from the detection means 16 and the signal S ₁ from the oscillation output setting means 15 automatically set the amount of water supply provided in the drive unit 5. The means 14 automatically sets the optimum water supply amount according to the oscillation output setting.

According to this structure, the optimum water supply amount is automatically set according to the oscillation output, so that even if the oscillation output is changed, it is possible to reliably prevent the ultrasonic transducer, the probe, etc. from generating heat or being damaged. be able to.

On the other hand, the supplied perfusion solution is a suction pump 13
Of the probes 2a, 2b, 2c, 3a,
It is collected in the suction bottle 12 from the inside of 3b, 3c through the suction passage and the suction tube 11 in the handpieces 1a, 1b. The amount of the perfusate to be collected also changes depending on the set value (suction force) of the suction pump 13. Therefore, it is preferable that the suction force setting value information S ₃ set by the suction force setting means 17 is also introduced into the water feed amount automatic setting means 14 and the water feed amount is automatically set in consideration of the suction force. In FIG. 1, reference numeral 18 is a foot switch for controlling on / off of the oscillation operation.

According to the above construction, however, the detected handpieces 1a, 1b and the probes 2a, 2b, 2c,
According to the types of 3a, 3b, 3c, and even if the oscillation output changes, the handpiece 1 is automatically set and driven to the set optimum water supply amount according to the oscillation output.
a, 1b ultrasonic transducers, probes 2a, 2b, 2c,
Heat generation of 3a, 3b, 3c can be prevented, and stable and optimal cooling can be performed. Therefore, there is no danger of causing burns to the patient or the operator, and the ultrasonic transducers and the probes 2a, 2
It is possible to prevent damage to b, 2c, 3a, 3b, 3c and the like.
Moreover, the operative field is not obstructed by the water supply, and a good visual field is always obtained. Therefore, the surgery can be performed smoothly. Furthermore, the amount of liquid to be sent can be adjusted and the perfusate can be used without waste, which is economical.

If the suction force setting value information S ₃ set by the suction force setting means 17 is also incorporated into the water feed amount automatic setting means 14, the water feed amount can be automatically set in consideration of the suction force. A higher level of water supply can be adjusted.

FIG. 3 shows another example used as the handpiece. This handpiece 1 is provided with a second cover 22 separately from the first cover 21 of its own, and the second cover 22 is axially inserted into and removed from the first cover 21. The second cover 22 is attached so as to be rotatable around the axis of the first cover 21.

The second cover 22 is provided with a water supply mouthpiece 23 and a suction adjustment mouthpiece 26, and the water supply mouthpiece 23 is provided between the probe 2 and the sheath 25 surrounding it when the second cover 22 is attached. It is formed so as to lead to the water supply passage.
Further, the second cover 22 is provided with a suction pressure adjusting member 28 having a leak port 27 as a suction pressure adjusting hole communicating with the suction adjusting mouthpiece 26 through the pressure pipe 24.
To the suction adjusting mouthpiece 26, a pressure adjusting tube communicating with the middle of the suction tube as shown by a handpiece described later is connected. A suction mouthpiece 30 for connecting the suction tube is provided at the rear end of the first cover 21.

Then, usually, as shown in FIG. 3A, the second cover 22 is attached and used. The suction pressure can be adjusted by selecting the amount by which the leak port 27 of the suction pressure adjusting member 28 is closed with a finger, that is, the leak opening amount.

If it is not necessary to adjust the suction pressure, the second cover 22 can be removed and used as shown in FIG. 3 (b). In this case, only the first cover 21 of the handpiece 1 is replaced by the second cover 22.
The thickness of the grip portion is smaller than that in the case where the handpiece 1 is attached, and the handpiece 1 can be easily operated. Also, the second
The tubes connected to the water supply mouthpiece 23 and the suction adjusting mouthpiece 26 on the cover 22 are also eliminated, and this does not become an obstacle during the operation.

The handpiece 1 shown in FIG. 3C has a second handpiece.
The cover 29 is provided with only the water supply mouthpiece 23, and the suction adjustment mouthpiece 26 and the suction adjustment member 28 are not provided. The second cover 29 of this type and the above-described second cover 22 are attached to the first cover 21 in a replaceable manner.

4 and 5 show another hand piece 31. In this handpiece 31, a probe 32 connected to the handpiece 31 is made of a hollow member, and its inner cavity forms a first suction passage 33. Probe 32
Is surrounded by a sheath 36 having a double structure of an inner sheath 34 and an outer sheath 35. Double structure sheath 36
The gap between the inner sheath 34 and the outer sheath 35 in is configured as a water supply passage 37.
Is connected to the water supply passage 38 of the handpiece 31. Further, the gap between the inner sheath 34 and the probe 32 is configured as a second suction passage 39. The second suction passage 39 communicates with the first suction passage 33 through a leak hole 40 provided in the side wall of the probe 32, and passes through the suction tube 41 shown in FIG.
The suction pump 43 is connected to the suction pump 43 from the position 2 so that the suctioned substance is collected in the suction bottle 42.

Further, a flow rate sensor 44 is provided in the middle of the suction tube 41, whereby the suction amount by the suction tube 41 is constantly monitored and the flow rate sensor 4 is provided.
The signal No. 4 is fed back to the drive device 45, and an alarm is issued in the case of an abnormality, or the oscillation output of water supply or ultrasonic vibration is stopped.

Under normal conditions, almost all of the perfusate flowing through the water supply passage 38 is sucked and recovered through the first suction passage 33 and the leak hole 40 and the second suction passage 39, and the perfusion liquid of the probe 32 is collected. The amount of perfusate flowing from the tip to the surgical field is minimized to ensure a good surgical field.

Here, when the leak hole 40 is blocked by blood, a piece of tissue, etc., the perfusate is hardly recovered through the leak hole 40 and the second suction passage 39, and most of the perfusate is obtained. All will flow from the tip of the probe 32 into the surgical field. For this purpose, the suction tube 4
The suction amount passing through 1 is smaller than that in the normal state, and the change in the suction amount is detected by the flow rate sensor 44, and the leak hole 4
You can see that 0 is blocked.

The flow sensor 44 is connected to the suction tube 41.
Not provided in the middle of, for example, in the suction passage 33, the suction bottle 42
It may be provided at any portion on the suction pump 43 side of the leak hole 40, such as in the vicinity of.

Since the blockage of the leak hole 40 can be detected in this way, damage to the probe 32 and visual field failure due to outflow of the perfusate to the operating field can be prevented. Further, it is possible to detect the blockage of the leak hole 40 and prevent the damage of the probe 32 and the obstruction of the surgical field by the water supply liquid.

FIG. 6 shows an example of another handpiece of the ultrasonic therapeutic device. In this handpiece 51, the amplitude of the ultrasonic vibration in the axial direction generated in the ultrasonic vibration element portion 52 for generating ultrasonic vibration is expanded by the horn 53, and the expanded ultrasonic vibration is transmitted by the ultrasonic transmission member. It is transmitted to the (probe) 54. Then, at the tip of the ultrasonic transmission member 54, work such as cutting, emulsification, or crushing of calculi of the affected tissue (not shown) is performed.

Further, in this ultrasonic treatment device, the ultrasonic vibration element section 52 is provided with a backing plate 55 for balancing resonance, and the ultrasonic vibration element section 52 and the horn 5 are provided.
3 and the backing plate 55 are fixed to each other by bolts 57 and nuts 58 and integrally form an ultrasonic transducer portion 56.

A suction hole 59 communicating with the bolt 57, the horn 53 and the ultrasonic transmission member 54 is formed inside the ultrasonic transducer portion 56. This suction hole 5
9 is connected to a suction pump (not shown) through a suction tube 61, and the suction force from this suction pump suctions and removes the cut, emulsified diseased tissue or crushed stones through the suction hole 59. be able to.

Further, in order to control the strength of the suction pressure on the hand side, a connection member 62 having a branch passage is inserted in the middle of the suction tube 61 communicating with the suction hole 59. . A flexible pressure introducing tube 63 is connected to a branch passage of the connecting member 62 and communicates with the suction tube 61.

The pressure introducing tube 63 is connected to a suction pressure adjusting member 65 having a suction pressure adjusting hole 64. By adjusting the opening amount of the suction pressure adjusting hole 64 with the palm of the finger, the suction leak amount through the suction pressure adjusting hole 64 and the suction pressure through the suction hole 59 can be adjusted. There is.

The suction pressure adjusting member 65 is the handpiece 5
The second cover 69 is attached to the first cover 66 as a separate member, and constitutes a second cover 69 different from the cover 66 of the handpiece 51. The cover 69 is provided with a water supply mouthpiece 67 for supplying the perfusate to the ultrasonic treatment section. The suction pressure adjusting member 65 and the water supply cap 67 are integrally provided. The second cover 69 not only can rotate with respect to the cover 66 of the handpiece 51, but also can be easily attached to and detached from the cover 66. A flexible water supply tube 68 is connected to the water supply mouthpiece 67. Then, the perfusate from a water supply pump (not shown) is pressure-fed to the water supply mouthpiece 67 through the water supply tube 68.

Further, the manifold 71 is screwed into the front surface of the cover 66, and the flange portion of the ultrasonic transducer portion 56 is abutted so that the cover 66 and the manifold 71 sandwich the flange portion of the ultrasonic transducer portion 56. By
The ultrasonic transducer section 56 is fixed to the cover 66. A groove 72 is formed in the outer peripheral portion of the front side of the manifold 71 in the circumferential direction thereof, and a second cover 69 is inserted from the front side of the manifold 71 and attached so as to cover the groove 72. O-rings 74 are provided on both sides of the groove 72, and the O-rings 74 allow the second cover 69 to move.
Keeps the watertightness between the manifold and the manifold 71.

The outlet 75 of the water supply passage 73 inside the second cover 69 leading to the water supply mouthpiece 67 is provided at a position corresponding to the groove 72 of the manifold 71. On the bottom surface of the groove 72, there is a hole 76 communicating with the lumen of the manifold 71,
The perfusate flows out from the outlet 75 of the water supply passage 73 of the second cover 69, enters the groove 72, and further through the hole 76 into the lumen of the manifold 71. A sheath 77 is screwed to the front surface of the manifold 71, and the inner cavity of the manifold 71 and the sheath 77 is connected to the horn 53.
And the ultrasonic transmission member 54 connected to it passes therethrough. Then, the perfusate is fed through the passage formed between the ultrasonic transmission member 54 and the sheath 77.

There is also provided a second cover (not shown) having only a water supply structure without a suction pressure adjusting member,
This and the second cover 69 can be arbitrarily exchanged.

The second cover 69, together with the suction pressure adjusting member 65, can freely rotate on the outer circumference of the cover, so that the operator can adjust the size of his hand and the desired angle before and during the operation. The surgery can be performed together. Further, when the suction pressure adjusting member 65 is rotated, the water supply mouthpiece 67 also rotates together on the outer circumference of the first cover 69, so that the pressure introducing member connected to the suction pressure adjusting member 65 is introduced. The water supply tube 68 connected to the tube 63 and the water supply mouthpiece 67 also rotates on the outer periphery of the cover 66 at the same time, so that they are not entangled with each other. Further, since it can be easily replaced with the second cover provided only with a water supply structure without a suction pressure adjusting member, in the case of surgery in which suction pressure adjustment is unnecessary,
The suction pressure adjusting member 65 does not interfere with the grip of the handpiece 51.

[0042]

As described above, according to the configuration of the present invention, the suction pressure can be adjusted at the hand of the handpiece according to the type and situation of the surgery, and the suction pressure can be easily adjusted. It is possible to provide an ultrasonic surgical apparatus having a good operability in which the adjustment corresponding to the situation during the operation can be performed quickly and the adjusting work is simple.

[Brief description of drawings]

FIG. 1 is an explanatory view schematically showing a system of an ultrasonic operation device.

FIG. 2 is an explanatory view conceptually showing the detection control system of the ultrasonic surgical apparatus.

FIG. 3 is an explanatory diagram of various handpieces.

FIG. 4 is a cross-sectional view near the tip of another handpiece.

FIG. 5 is an explanatory view schematically showing the configuration of a water supply / suction system in the handpiece.

FIG. 6 is a cross-sectional view of still another different handpiece.

[Explanation of symbols]

51 ... Handpiece, 52 ... Ultrasonic vibration element section, 54 ...
Ultrasonic wave transmission member (probe), 59 ... Suction hole, 61 ... Suction tube, 62 ... Connection member, 63 ... Pressure introducing tube, 64 ... Suction pressure adjusting hole, 65 ... Suction pressure adjusting member.

Claims (1)

[Claims] 1. A handpiece including an ultrasonic transducer, a probe connected to the handpiece, a suction hole provided at least in a portion of the probe, and provided between the suction hole and a suction source. A suction tube having a branched passage, a suction pressure adjusting member provided in the handpiece and having a suction pressure adjusting hole capable of adjusting the suction pressure depending on the opening amount, and a tube connecting the branch passage and the suction pressure adjusting member. An ultrasonic surgical device comprising: