JPH0984800A - Aqua-washer device for operation - Google Patents

Abstract

PROBLEM TO BE SOLVED: To spray a wash to a relatively wide range from an nozzle, and surely remove only a lesion without removing the periosteum in therapy of empyema and the like by setting the pressure of the wash sprayed from the nozzle within a specified range. SOLUTION: In the use of an operation aqua-washer device, each valve 11 is opened to supply a wash from a supply tank 1 to a pump device 21. The wash is stored in an accumulator 31, and the pressure of the wash is regulated by a pressure regulating valve 33. The selector valve of a hand piece 4 connected to a flexible hose 12 is, switched to spray the wash from a nozzle 5. The wash sprayed from the nozzle 5 is specified within a pressure range of 2-50kgf/cm<2> . In treatment of empyema, for example, the wash is sprayed from the nozzle 5 to a relatively wide range, and the lesion is surely removed without removing the periosteum.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an aqua washer device for surgery.

[0002]

2. Description of the Related Art Conventionally, in the treatment of pyometra, the maxillary sinus,
In the treatment of the ethmoid sinus and frontal sinus, lesions that are difficult to see from the outside and are inflamed are cut out with forceps and a laser knife.

However, the conventional method has the following problems. <B> When forceps and laser scalpels are used, the periosteum is also removed, and thus there is a risk that the development of facial bones may be impaired in children, and sequelae such as cysts in adults have become a problem. <B> With forceps, laser scalpel, etc., there were some areas that could not be reached, some lesions remained, and there was a possibility of recurrence.

[0004]

SUMMARY OF THE INVENTION It is an object of the present invention to provide an aqua washer device which has a relatively wide injection range, can surely remove a lesion without removing the periosteum, and has a cleaning action.

[0005]

SUMMARY OF THE INVENTION The present invention is directed to a supply tank for supplying a cleaning liquid, a pump for pumping the cleaning liquid supplied from the supply tank, a discharge nozzle for injecting the cleaning liquid pumped from the pump, and the pump. An accumulator connected between the discharge nozzle and the discharge nozzle, a pressure adjusting valve, and a suction nozzle for sucking the sprayed cleaning liquid, and the cleaning liquid having a pressure of ^{2 to} 50 kgf / cm ² is sprayed from the discharge nozzle. A surgical aqua washer device or a pump characterized by removing a lesion adjacent to the urine is provided with a plunger piston slidably disposed in a housing, and an eccentric shaft is attached to one end of the plunger piston. Contact with each other, the plunger piston slides according to the eccentric rotation of the eccentric shaft, the pump chamber is arranged at the other end of the plunger piston, and it enters the inlet opening of the pump chamber. A small plunger piston type structure in which a valve is disposed and an outlet valve is disposed in an outlet opening portion, and which is driven by a DC motor, an aqua washer device for surgery, or a supply tank for supplying a cleaning liquid; ,
A pressure vessel for pressure-feeding the cleaning liquid supplied from the supply tank, a discharge nozzle for ejecting the cleaning fluid pressure-fed from the pressure container, and a connection between the supply tank and the pressure vessel via a pressure regulator And a suction nozzle for sucking the sprayed cleaning liquid.
A surgical aqua washer device characterized by ejecting a cleaning liquid having a pressure of kgf / cm ² to remove a lesion adjacent to a bone part, or continuous discharge of the cleaning liquid when discharging the cleaning liquid from the discharge nozzle. The surgical aqua washer device is characterized by having a handpiece for controlling intermittent discharge by pneumatic pressure.

[0006]

Embodiments of the present invention will be described below with reference to the drawings. <A> Surgery Aqua Washer Device (FIGS. 1 to 4) As the cleaning liquid sprayed from the nozzle 5, distilled water, physiological saline or the like is used and stored in the supply tank 1. An example of an aqua washer device is shown in FIGS. At the time of this use, each valve 11 is opened to supply cleaning water to the pump device 21. The pump device 21 drives the pump with a motor to apply pressure to the wash water and outputs the wash water to the nozzle side. On the output side of the pump device 21, an accumulator 31, a pressure gauge 32 and a pressure adjusting valve 33 are arranged in addition to the handpiece 4 provided with the nozzle 5, and the injection pressure is determined by adjusting the pressure of the cleaning liquid. .

The accumulator 31 stores the cleaning liquid, absorbs and absorbs pulsation and impact pressure, and can shorten the rising time after the cleaning liquid is discharged. Pressure control valve 33
Is for adjusting the liquid pressure supplied to the nozzle 5, and is discharged to the supply tank side when a predetermined liquid pressure is exceeded.

The handpiece 4 is a flexible hose 1.
A switching valve that is connected to the nozzle 2 and supplies the cleaning liquid to the nozzle 5 is provided and can be switched by the foot switch 6. Also,
The control unit 7 controls the pump circuit unit 2 and the pressure adjusting unit 3 to control the pressure of the pump device 21, monitor the pressure, control the liquid level of the supply tank 1, control the air pressure supplied to the handpiece 4, and the like. . The power supply circuit unit 8 supplies electric power for driving the pump.

An example of another aqua washer device which applies pressure to the cleaning liquid by using the compressed air cylinder 21 'without using the pump device 21 is shown in FIGS. The valve 11 from the compressed air cylinder 21 'to the nozzle 5 is opened, and the cleaning liquid in the pressure vessel 31''is pressurized. The pressure is adjusted by a pressure adjuster 31 ', and a predetermined air pressure is applied to the pressure vessel 31''. The cleaning liquid to which pressure is applied is applied to the nozzle 5, and the cleaning liquid is jetted from the nozzle 5 by the operation of the foot switch 6. The control unit 7 controls the air pressure from the compressed air source 2'with the pressure adjusting unit 3'and applies pressure to the cleaning liquid with the pressure tank 3 ''.

<B> Pump Device (FIG. 5) As the pump device 21, a small pump device having high response capability is suitable. For example, the plunger piston type pump 205 as shown in FIG. 5 is driven by a DC motor. Housing 20
Plunger piston 209 is slidably arranged in 1,
The eccentric shaft 203 is brought into contact with one end of the plunger piston 209. The eccentric shaft 203 is eccentrically attached to the rotary shaft 202 of the motor, and eccentrically rotates about the rotary shaft center 204 to give a reciprocating motion to the plunger piston 209 of the pump 205. A pump chamber 208 is arranged at the other end of the plunger piston 209, an inlet valve 206 is arranged at an inlet opening portion of the pump chamber 208, and an outlet valve 207 is arranged at an outlet opening portion.

The cleaning liquid is sucked into the pump 205 through a filter (not shown) by the reciprocating motion of the plunger piston 209, and the inlet valve 206 and the outlet valve 207 are provided.
A pressure is applied through and is discharged. As described above, since the plunger piston pump 205 has a simple structure, it can be easily sterilized, is small and lightweight, and has excellent responsiveness, and is suitable for an aqua washer device for surgery. The hydraulic pump 205 is made of stainless steel at a portion through which the cleaning liquid passes, so that sterilization can be performed.

<C> Handpiece (FIG. 6) The handpiece 4 is operated by air, and has continuous discharge (cleaning mode) and intermittent discharge (peeling mode for surgery, 0.01).
~ 3 seconds interval) can be switched. If continuous discharge is used, it is possible to clean with a low-pressure cleaning liquid. Further, when intermittent discharge is used, the discharge flow rate can be regulated, and lesions can be removed with a small amount of cleaning liquid.

In the handpiece 4, the foot switch 6 turns on / off the discharge of the cleaning liquid, and the changeover switch of the controller 7 switches between continuous discharge and intermittent discharge. In this control, when air pressure is applied from the air port 44 of the handpiece 4, the piston 43 slides due to its strength, and accordingly the needle 4
1 slides and the opening / closing operation with the valve portion 42 controls the discharge of the cleaning liquid from the cleaning liquid port 45 to the discharge nozzle 51.

<D> Nozzle (FIG. 7, FIG. 8, FIG. 9, FIG.
0) The nozzle 5 has a discharge nozzle 51 and a suction nozzle 52,
It has a main part 54 extending from the connecting part 55 and a tip part 53 near the tip bent from the main part 54, and is formed by bending a hollow tube. Since the discharge nozzle 51 is for spraying the cleaning liquid at a predetermined pressure to remove the lesioned mucous membrane and spraying it in a predetermined range, the inner diameter is preferably 0.5 to 1.5 mm, for example, an inner diameter made of stainless steel. 1 mm, outer diameter 2 m
m tubes were used. The tip of the discharge nozzle 51 is bent to facilitate the injection to the lesion area and eliminate the blind spot. Suction nozzle 52
Since it discharges the sprayed cleaning liquid and the removed lesion, the one having a diameter larger than that of the discharge nozzle 51 is usually used. It is preferable that these nozzles are suitable for sterilization and bending workability, and for example, the material thereof is preferably stainless steel.

As the nozzle 5, the discharge nozzle 51 and the suction nozzle 52 are formed separately, or as shown in FIG.
The suction nozzle 52 and the suction nozzle 52 are arranged substantially adjacent to each other, or the discharge nozzle 51 is placed inside the suction nozzle 52 as shown in FIG. The juxtaposed type as shown in FIG. 7 is used especially when the suction tube alone cannot be used. Alternatively, the double tube type as shown in FIG. 8 is used especially when the suction tube cannot be inserted. These nozzles 5
Are used depending on the number and size of the tools (endoscope, suction nozzle, headlight, etc.) to be put into the nostrils, or individual differences among patients.

The inner tube of the discharge nozzle 51 is, for example, a tube having an inner diameter of 1 mm and an outer diameter of 2 mm, and the outer tube of the suction nozzle 52 is, for example, a tube having an inner diameter of 4 mm and an outer diameter of 6 mm.
At the tip of the nozzle 5, the discharge nozzle 51 projects from the suction nozzle 52 by about 1 to 2 mm. The tip portion 53 of the discharge nozzle 51 is, as shown in FIGS. 9 and 10, 90 ° (A type), 60 ° (B type), or a special type,
It can be injected into the lesion without blind spots.

<E> Use example of nozzle (FIG. 11) An example of using the nozzle in the maxillary sinus 9 is shown in FIG. 11. When the maxillary sinus 9 is divided into four regions, the region a can be handled with forceps or the like. A 90 ° nozzle (FIG. 9A) can be used in the region b, and the region b can be covered by moving the nozzle to the left or right. The injection pressure in this case is usually 10 to 3
It is performed at 0 kgf / cm ² . Area c of the lower part is 60 °
Nozzles (FIGS. 9 (B) (C) (D) and FIG. 10 (A)) can be used. The injection pressure in this case is usually 20 to 40 kgf /
Perform in cm ² . A special type nozzle (FIGS. 10B and 10C) can be used in the area d near the root. The injection pressure in this case is usually 30 to 50 kgf / cm ² . Wash 2
It is carried out at 10 kgf / cm ² . The range of these injection pressures is
It is adjusted according to the condition of the lesion and individual differences among patients. Also,
When it is necessary to remove the periosteum depending on the condition of the lesion, a nozzle having an inner diameter of 0.1 to 0.5 mm can be used.

[0018]

[Example] The following is an example of treatment using an aqua washer device. <a> Treatment of chronic sinusitis The aqua washer device is a chronic sinus cavity that causes inflammation in the maxillary sinus 9 or frontal sinus due to the obstruction of the communication path with the nose due to inflammation of the ethmoid sinus. It is suitable for the treatment of inflammation (animal encephalopathy). This treatment is performed stepwise from the inside of the nose while visually observing the condition with an endoscope, a microscope, etc., without performing a major operation. This is roughly divided into two stages.

<B> First Stage Treatment In the first stage, a special forceps is used to remove the lesion of the ethmoid region, and a sufficient communication path with other sinuses such as the maxillary sinus 9 is secured.

<C> Second Stage Treatment If the treatment in the first stage is not cured, the lesion is removed from the traffic route secured in the first stage by using an aqua washer device or forceps. The aqua washer device can remove the mucosa of the lesion, leaving the periosteum behind. Moreover, since the nozzle 5 can be ejected without a blind spot by forming the nozzle 5 in a dedicated shape, it is possible to sufficiently perform lesion exfoliation and washing at the same time along the bone wall.
At this time, the cleaning liquid is 2 to 5 depending on the position and degree of the lesion.
It is injected at a pressure of 0 kgf / cm ² . As a result, the normal periosteum is not removed and only the lesion is removed, so that the healing rate can be increased.

<D> Treatment Results (Table 1) Regarding 222 cases where the maxillary sinus 9 has a lesion (one side is located on each side of the maxillary sinus 9) (see Table 1), , 70% of the mild mucous membrane with slight swelling is healed, and 41 of the moderate mucosal lesion is 41
% Healed and 37% of all mucosa with high lesions healed. On the other hand, by using the aqua-washer device in the second stage, all mild and moderate ones were healed, and high ones were healed by 70%. Also,
The number of sides in the first stage is mild 43 side, moderate 42 side, altitude 13
The total is 222 on the 7th side, and the healing rate is 6 months after the operation. The number of sides in the second stage is mild 6
Side, moderate 9 side, altitude 16 side were 31 side in total. As described above, it is shown that the healing rate in the second stage is high, and the healing rate in the second stage is high even if the healing is not performed in the first stage. Moreover, both the first stage and the second stage surgery are 2
I have been hospitalized for about 3 days. Furthermore, when the aqua washer device is used, the periosteum is left behind, so that the device can be applied to children, and the sequelae of adults are eliminated. Thus, in the case of surgery for a blind hole such as a sinus, it is possible to remove only the lesion, leaving only the periosteum, which controls the diameter and shape of the nozzle, the discharge flow rate and discharge pressure, and the injection time. Can be realized. Note that the aqua washer device can be effectively applied to not only animal sickness but also exfoliation and cleaning of the uterus.

[Table 1]

[0022]

According to the present invention, the following effects can be obtained. <a> The aquawasher device can be applied to intractable diseases such as empyema, and can remove lesions by leaving the periosteum. Therefore, it can prevent facial bone growth disorders in children, and prevent sequelae such as cysts in adults. it can. <B> Since the aqua-washer device has a relatively wide injection range to the affected area, it is possible to sufficiently remove the lesion and to sufficiently wash the lesion. As a result, it is possible to achieve a very high cure rate of 90% or more for intractable pyometra. <C> Using an aqua washer device simplifies surgery and allows hospitalization for about 2 to 3 days. <D> By using the accumulator, it is possible to absorb and buffer pulsation and impact pressure, and further shorten the rising time after the cleaning liquid is discharged. <E> It is possible to switch between continuous discharge and intermittent discharge. In the case of continuous discharge, cleaning with a low-pressure cleaning liquid is possible, and in the case of intermittent discharge, lesions can be removed with a small discharge flow rate. <F> By using various nozzles, the cleaning liquid can be sprayed onto the lesion without blind spots. <G> By using a nozzle in which the discharge nozzle and the suction nozzle are integrated, the burden on the operator can be reduced. <H> Since the handpiece is air-operated, there is no risk of electric leakage and safety can be improved.

[Brief description of drawings]

FIG. 1 is a block diagram of an aqua washer device using a pump.

FIG. 2 is a block diagram of an aqua washer device using a pump.

FIG. 3 is a block diagram of an aqua washer device using a compression cylinder.

FIG. 4 is a block diagram of an aqua washer device using a compression cylinder.

FIG. 5 is a sectional view of a plunger piston type pump.

FIG. 6 is a block diagram of a handpiece.

FIG. 7 is a configuration diagram of a nozzle using a double pipe.

FIG. 8 is a configuration diagram of a discharge nozzle and a suction nozzle that are adjacent to each other.

FIG. 9 is another configuration diagram of the discharge nozzle.

FIG. 10 is another configuration diagram of the discharge nozzle.

FIG. 11 is an explanatory view of using the nozzle for the maxillary sinus.

 ─────────────────────────────────────────────────── ─── Continuation of the front page (72) Inventor Takashi Ito Nakase 8000, Hamakita City, Shizuoka Nisshinbo Ltd. Hamakita Seiki Co., Ltd.

Claims (4)

[Claims] 1. A supply tank for supplying a cleaning liquid, a pump for pumping the cleaning liquid supplied from the supply tank, a discharge nozzle for injecting the cleaning liquid pumped from the pump, and a space between the pump and the discharge nozzle. A connected accumulator, a pressure control valve, and a suction nozzle for sucking the sprayed cleaning liquid are provided, and the cleaning liquid having a pressure of ^{2 to} 50 kgf / cm ² is sprayed from the discharge nozzle to remove the lesion adjacent to the bone part. An aqua washer device for surgery, which is characterized in that 2. The surgical aqua washer device according to claim 1, wherein the pump has a plunger piston slidably arranged in a housing, and an eccentric shaft is in contact with one end of the plunger piston. The plunger piston slides according to the eccentric rotation of the eccentric shaft, the pump chamber is arranged at the other end of the plunger piston, and the inlet valve is arranged at the inlet opening of the pump chamber.
An aqua-washer device for surgery, which has a small plunger piston type structure in which an outlet valve is arranged in an outlet opening portion, is driven by a DC motor, and the passage of the cleaning liquid is made of stainless steel that can be sterilized. 3. A supply tank for supplying a cleaning liquid, a pressurizing container for pumping the cleaning liquid supplied from the supply tank, a discharge nozzle for injecting the cleaning liquid pumped from the pressurizing container, the supply tank, and A pressure vessel connected between the pressure vessels via a pressure regulator and a suction nozzle for sucking the sprayed cleaning liquid are provided, and the cleaning liquid having a pressure of ^{2 to} 50 kgf / cm ² is sprayed from the discharge nozzle. A surgical aqua washer device characterized by removing lesions adjacent to the bone part. 4. The surgical aqua washer device according to claim 1, further comprising a handpiece for pneumatically controlling continuous discharge and intermittent discharge of the cleaning liquid when the cleaning liquid is discharged from the discharge nozzle. An aqua washer device for surgery, which is characterized in that