JPH105237A - Ultrasonic processor - Google Patents

Ultrasonic processor

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Publication number
JPH105237A
JPH105237A JP16580696A JP16580696A JPH105237A JP H105237 A JPH105237 A JP H105237A JP 16580696 A JP16580696 A JP 16580696A JP 16580696 A JP16580696 A JP 16580696A JP H105237 A JPH105237 A JP H105237A
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JP
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Prior art keywords
portion
hook
sheath
ultrasonic
probe
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Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Pending
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JP16580696A
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Japanese (ja)
Inventor
Makoto Miyawaki
Mitsumasa Okada
宮脇  誠
光正 岡田
Original Assignee
Olympus Optical Co Ltd
オリンパス光学工業株式会社
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Abstract

PROBLEM TO BE SOLVED: To provide a multifunctional ultrasonic processor which is capable of peeling biomedical tissue and other works easily. SOLUTION: At the tip of a probe, where ultrasonic vibration is transmitted, a hook-shape processing part 41 is formed. Relatively transferring between a sheath 11 and the probe along the axis direction of the sheath 11, biomedical tissue between the processing part 41 and the end of the sheath 11 can be processed not only in a way of nipping but only peeling and the like.

Description

【発明の詳細な説明】 DETAILED DESCRIPTION OF THE INVENTION

【0001】 [0001]

【発明の属する技術分野】本発明は超音波を利用して切開、切除或いは凝固等の処置を行う超音波処置具に関する。 The present invention relates to the incision using ultrasonic relates to an ultrasonic treatment instrument for performing ablation or treatment such as coagulation.

【0002】 [0002]

【従来の技術】一般に、超音波処置具として、例えばU In general, the ultrasonic treatment apparatus, for example, U
SP3,636,943号には次のような構成にした装置が示されている。 Apparatus configured as follows is shown in No. SP3,636,943. ここでは、超音波処置具本体のシース内にこのシースの軸心方向にスライド移動可能な超音波プローブが配設されている。 Here, the axial direction in slidable ultrasonic probe of the sheath in the sheath of the ultrasonic instrument body is disposed. さらに、シースの先端部には略L字状に屈曲されたフック形受け部材が設けられている。 Further, a hook shape receiving member which is bent in a substantially L shape is provided at the distal end of the sheath. そして、この超音波処置具の使用時には超音波プローブの先端部とフック形受け部材との間に血管等の生体組織を挟み込んだ状態で、超音波プローブの先端部に超音波振動を伝達することにより、血管の結紮等の超音波処置を施すようになっている。 Then, in a state in which sandwich the biological tissue such as a blood vessel between the tip and the hook form receiving members of the ultrasonic treatment apparatus in use ultrasound probe, it transmits the ultrasonic vibrations at the tip of the ultrasonic probe by, so that the performing ultrasonic treatment for ligation or the like of a blood vessel.

【0003】 [0003]

【発明が解決しようとする課題】上記USP3,63 The object of the invention is to be Solved by the USP3,63
6,943号の装置では超音波プローブの先端部に超音波振動を伝達する構成になっているので、超音波処置中はシースの先端部の略L字状のフック形受け部材には超音波振動が伝達されない静止状態で保持されている。 Since the apparatus of No. 6,943 is in the configuration for transmitting ultrasonic vibration to the distal end of the ultrasonic probe, it is substantially L-shaped hook form receiving member of the distal end portion of an ultrasonic treatment sheath ultrasonic It is held in a stationary state where vibration is not transmitted. そのため、シースの先端部の略L字状のフック形受け部材を使用して例えば膜状の生体組織を剥離する等の作業を行う場合に生体組織がフック形受け部材から滑りやすいので、超音波処置具を使用してこれらの作業を行うことは困難であったのが実情である。 Therefore, since the biological tissue is slippery from the hook shape receiving member when working, such as by using the substantially L-shaped hook form receiving member of the distal end portion of the sheath is peeled off, for example, film-like biological tissue, ultrasonic is the reality of it has been difficult to perform these tasks using a treatment instrument.

【0004】また、例えばシースの先端部のフック形受け部材に騒音防止のために軟質な接触部材(例えばUS Further, for example, soft contact members for noise prevention in hook form receiving member of the distal end portion of the sheath (e.g., US
P5,322,055号参照)を設けた場合にはフック部の先端側では超音波振動による生体組織の剥離等の処置や、高周波通電を用いた処置等が不可能であり、超音波処置具を多機能化することが難しい問題がある。 In case of providing the reference No. P5,322,055) is at the tip end of the hook portion and the treatment of the peeling of the living tissue by ultrasonic vibration, it is impossible to treat the like using high frequency current, ultrasonic treatment apparatus there is a difficult problem to be multi-functional to.

【0005】本発明は上記事情に着目してなされたもので、その目的は、生体組織を剥離する等の作業を簡単に行うことができ、多機能な超音波処置具を提供することにある。 [0005] The present invention has been made in view of the above circumstances, and an object can be easily performed operations such as peeling the biological tissue is to provide a multi-functional ultrasonic treatment apparatus .

【0006】 [0006]

【課題を解決するための手段】本発明は、処置具本体の基端部に配設され、超音波振動子が内蔵されたハンドピースと、前記超音波振動子に接続され、超音波振動を前記処置具本体の先端部側に伝達するプローブと、このプローブを覆うシースと、前記プローブの先端部に前記シースの軸方向に対して略直交する方向に屈曲形成され、 The present invention SUMMARY OF] is disposed at the proximal end of instrument body, a handpiece ultrasonic transducers are built, which is connected to the ultrasonic transducer, ultrasonic vibrations a probe for transmitting the tip side of the treatment instrument main body, and a sheath covering the probe, is bent in a direction substantially perpendicular to the axial direction of the sheath to the distal end of the probe,
生体組織に対して処置を行うフック形状の処置部と、前記シースと前記プローブとの間を前記シースの軸方向に沿って相対的に移動させ、前記プローブの処置部と前記シースの先端部との間に生体組織を挟み込む操作手段とを具備したことを特徴とする超音波処置具である。 A treatment portion of the hook-shaped take action to the living tissue, and the sheath and moved relatively along the axial direction of the sheath between the probe distal end portion of the sheath and the treatment portion of the probe an ultrasonic treatment instrument characterized by comprising an operating means for clamping the body tissue between.

【0007】上記構成により、シースとプローブとの間をシースの軸方向に沿って相対的に移動させ、プローブの処置部とシースの先端部との間に生体組織を挟み込んだ状態で、プローブの処置部に超音波振動を伝達することにより、プローブの処置部とシースの先端部との間の生体組織、例えば血管の結紮等の超音波処置を施す。 [0007] With this configuration, between the sheath and probe are relatively moved along the axial direction of the sheath, in a state sandwiched living tissue between the treatment portion and the sheath of the tip of the probe, the probe by transmitting ultrasonic vibration to the treatment section, the living tissue between the treatment portion and the sheath of the distal portion of the probe, for example, an ultrasonic treatment of ligation such as the blood vessel is subjected. さらに、プローブの先端部のフック形状の処置部に超音波振動を伝達させた状態で、プローブのフック形状の処置部の先端部を例えば膜状の生体組織に当てることにより、生体組織がフック形状の処置部から滑ることを防止して膜状の生体組織を剥離する等の作業を簡単に行うことができるようにしたものである。 Further, in a state of being transmitting the ultrasonic vibration to the treatment portion of the hook-shape of the tip portion of the probe, by directing the tip portion of the treatment portion of the hook shape of the probe, for example, film-like biological tissue, the biological tissue is hook-shaped it is obtained to be able to perform the tasks, such as to prevent the slipping of the treatment unit for peeling the film-like body tissue easily.

【0008】 [0008]

【発明の実施の形態】以下、本発明の第1の実施の形態を図1乃至図6を参照して説明する。 BEST MODE FOR CARRYING OUT THE INVENTION Hereinafter, a description will be given of a first embodiment of the present invention with reference to FIGS. 図1は超音波処置具である超音波切開凝固装置の概略構成を示すものである。 Figure 1 shows a schematic configuration of an ultrasonic dissection coagulation apparatus is an ultrasonic treatment instrument. この超音波切開凝固装置の装置本体(処置具本体) Apparatus main body of the ultrasonic dissection coagulation apparatus (instrument body)
1には保護部材である細長い筒状のシース11の基端部に超音波振動を発生する超音波振動子51(図2 The ultrasonic transducer 51 to 1 to generate ultrasonic vibration to the proximal end of the elongated tubular sheath 11 which is a protective member (FIG. 2
(A),(B)参照)を内蔵したハンドピース2が配設されている。 (A), it is arranged handpiece 2 with a built-in (B) refer). このハンドピース2には超音波振動子51 The ultrasonic transducer 51 in the hand piece 2
を収容する管状の振動子カバー33が設けられている。 The tubular transducer cover 33 which houses are provided.

【0009】この振動子カバー33には固定ハンドル3 [0009] The fixed handle 3 to the transducer cover 33
1及び可動操作ハンドル32を有する操作部(操作手段)3が設けられている。 Operation unit having first and movable operating handle 32 (operating means) 3 is provided. ここで、振動子カバー33には固定ハンドル31が一体的に形成されている。 Here, the fixed handle 31 is formed integrally with the transducer cover 33. さらに、この振動子カバー33の側面には窓部33aが形成されている。 Furthermore, the window portion 33a is formed on the side surface of the transducer cover 33.

【0010】なお、ハンドピース2の端末部には電気メス等の高周波処置用の電源が接続される電極プラグ13 [0010] The electrode plug power supply for high-frequency treatment such as an electric knife is connected to the terminal portion of the handpiece 2 13
Aが突設されているとともに、超音波振動子51の駆動用電源に接続される電気コード13Bが連結されている。 With A is projected, electrical cord 13B is connected to the power source for driving the ultrasonic transducer 51 is connected.

【0011】また、シース11の内部には超音波振動子51からの超音波振動を装置本体1の先端部側に伝達する図2(A),(B)に示すプローブ52が配設されている。 Further, the inside of the sheath 11 Figure 2 for transmitting the ultrasonic vibration to the distal end portion side of the apparatus main body 1 from the ultrasonic transducer 51 (A), is arranged the probe 52 shown in (B) there. このプローブ52には超音波振動子51に連結されるホーン21と、振動伝達棒43と、生体組織に対して処置を行うフック形状の処置部41とが設けられている。 This is the probe 52 and horn 21 connected to the ultrasonic transducer 51, a vibration transmission rod 43, the treatment portion 41 of the hook-shaped take action is provided to the living tissue. そして、超音波振動子51で発生する振動をホーン21及び振動伝達棒43を介してフック形状処置部41 The hook-shaped treatment portion 41 a vibration generated by the ultrasonic oscillator 51 via the horn 21 and the vibration transmission rod 43
に伝達する振動子ユニット2Aが構成されており、このプローブ52の先端のフック形状処置部41によって生体組織に対して処置を行うようになっている。 Vibrator unit 2A for transmitting is configured, it is adapted to perform treatment with respect to the living tissue by the hook-shaped treatment portion 41 at the tip of the probe 52.

【0012】なお、プローブ52には電極プラグ13が図示しないリード線を介して接続されている。 [0012] The electrode plug 13 is connected via a lead wire (not shown) in the probe 52. そして、 And,
このプローブ52に必要に応じて高周波電流を通電してプローブ52の先端のフック形状処置部41によって生体組織に対して電気メス等の高周波処置を施すことができるようになっている。 Thereby making it possible to apply a high-frequency treatment such as the electric knife to the living tissue by the hook-shaped treatment portion 41 of the tip of the probe 52 by applying a high frequency current as needed to the probe 52.

【0013】さらに、フック形状処置部41には軸体5 [0013] In addition, the shaft 5 in the hook-shaped treatment section 41
3の先端部に例えばフライス加工によって略L字状のフック部54が形成されている。 It is formed substantially L-shaped hook portion 54 to the third distal end, for example by milling. このフック部54はシース11の軸方向に対して略直交する方向に屈曲形成されている。 The hook portion 54 is bent in a direction substantially perpendicular to the axial direction of the sheath 11. このフック形状処置部41は、音響効果が高く、生体適合性のよいチタン材や、アルミニウム材、あるいはこれらの合金材料によって形成されている。 The hook-shaped treatment portion 41 has a high sound effects, and biocompatibility good titanium material is formed by aluminum material, or their alloy.

【0014】また、振動伝達棒43の両端部には雄ねじ43c,43dが形成されている。 Further, the external thread 43c at both end portions of the vibration transmission rod 43, 43d are formed. さらに、フック形状処置部41の基端部には振動伝達棒43の先端部の雄ねじ43cに螺合する図示しないねじ穴、ホーン21の先端部には振動伝達棒43の基端部の雄ねじ43dに螺合する図示しないねじ穴がそれぞれ形成されている。 Furthermore, hook-shaped screw holes (not shown) screwed to the male screw 43c of the distal end portion of the vibration transmission to the proximal end portion of the treatment portion 41 rod 43, the proximal end portion of the vibration transmission rod 43 in the distal end portion of the horn 21 male thread 43d are formed screw holes (not shown) screwed on. そして、振動伝達棒43の先端部にフック形状の処置部41 The treatment portion 41 of the hook-shaped distal end portion of the vibration transmission rod 43
の基端部が着脱可能に螺合されるとともに、振動伝達棒43の基端部にホーン21の先端部が着脱可能に螺合されるようになっている。 With a base end portion is screwed removably in the tip of the horn 21 to the base end portion of the vibration transmission rod 43 is adapted to be screwed detachably.

【0015】なお、図2(C)に示すように振動伝達棒43の両端部に雌ねじ43e,43fを形成してもよい。 [0015] Incidentally, the internal thread 43e at both ends of the vibration transmission rod 43 as shown in FIG. 2 (C), it may be formed 43f. このとき、フック形状の処置部41の基端部には振動伝達棒43の先端部の雌ねじ43eに対応する雄ねじ41a、ホーン21の先端部には振動伝達棒43の基端部の雌ねじ43fに対応する雄ねじ21aがそれぞれ形成されている。 At this time, the male screw 41a at the base end portion of the treatment portion 41 of the hook-shape corresponding to the internal thread 43e of the front end portion of the vibration transmission rod 43, the distal end portion of the horn 21 into the female screw 43f of the base end portion of the vibration transmission rod 43 corresponding external thread 21a is formed respectively.

【0016】また、超音波振動子51で発生した振動を伝達するプローブ52の各構成部材としては、音響効果が高く、生体適合性のよいチタン材やアルミニウム材あるいはこれらの合金が用いられる。 Further, as the respective components of the probe 52 for transmitting the vibration generated by the ultrasonic oscillator 51, the sound effect is high, biocompatible good titanium material or an aluminum material or an alloy thereof. 本実施の形態ではフック形状の処置部41と、超音波振動子で発生した超音波振動を振動伝達棒43に供給するホーン21とは耐久性のあるチタン材で形成され、ホーン21とフック形状の処置部41との間を連結する中継部材である振動伝達棒43は安価なアルミニウム部材で形成されている。 In this embodiment the treatment portion 41 of the hook-shaped, and the horn 21 for supplying the ultrasonic vibration generated by the ultrasonic vibrator to the vibration transmission rod 43 is formed of titanium material durable, horn 21 and the hook-shaped vibration transmission rod 43 is a relay member for connecting the treatment portion 41 of is formed of inexpensive aluminum member.

【0017】また、図3(A)に示すように振動子ユニット2Aの超音波振動子51は振動子カバー33の透孔33bに軸心方向に移動可能に収容されている。 Further, the ultrasonic transducer 51 of the transducer unit 2A as shown in FIG. 3 (A) is movably accommodated in the axial direction hole 33b of the transducer cover 33. そして、この超音波振動子51は振動子カバー33の内孔3 Then, the inner bore 3 of the ultrasonic transducer 51 is the transducer cover 33
3bの長手方向に摺動自在に挿通された管状の接続手段である後述するローター48に接続されている。 And it is connected to the rotor 48 to be described later in the longitudinal direction of the 3b is slidably inserted through the tubular connection section.

【0018】また、可動操作ハンドル32の上端部には略U字状の連結アーム55が設けられている。 Further, substantially U-shaped connecting arm 55 is provided at an upper end portion of the movable operating handle 32. この連結アーム55の上下方向略中央部位はハンドル支点ピン3 Vertically substantially central portion of the connecting arm 55 is a handle pivot pin 3
4を介して振動子カバー33に回動自在に軸着されている。 4 through are pivotally attached rotatably to the transducer cover 33.

【0019】さらに、この可動操作ハンドル32の連結アーム55の上端部には図4に示す係止体35が、振動子カバー33の窓部33aから臨まれる中心軸方向に向かって回動自在に設けられている。 Furthermore, engagement member 35 shown in FIG. 4 the upper end of the connecting arm 55 of the movable operating handle 32 is pivotally toward the central axis direction of facing the window portion 33a of the transducer cover 33 It is provided. この係止体35には係止爪35aが突設されている。 Locking pawl 35a is projected in this engaging member 35. この係止爪35aは振動子カバー33内のローター48に着脱自在に係止されている。 The engagement claw 35a is locked freely engaged detachably to the rotor 48 in the transducer cover 33.

【0020】また、ローター48の中央部には振動子カバー33の内孔33bに摺接する突出部48bが形成されている。 Further, sliding contact protrusion 48b is formed in the inner hole 33b of the transducer cover 33 in a central portion of the rotor 48. この突出部48bには溝部48cが形成されている。 It is formed grooves 48c in the protrusion 48b. この溝部48cには可動操作ハンドル32の係止爪35aが係入されている。 Locking claws 35a of the movable operating handle 32 is engaged in the groove 48c. そして、可動操作ハンドル32を固定ハンドル31側に閉じる方向に操作することによって、振動子ユニット2A全体が後退してフック形状処置部41のフック部54がシース11の先端の後述する受け部材56の先端開口面58側に接近する方向に移動するようになっている。 Then, by operating in a direction of closing the movable operating handle 32 to the stationary handle 31 side, the hook portion 54 of the hook-shaped treatment portion 41 across the transducer unit 2A is retracted the receiving member 56 to be described later of the distal end of the sheath 11 moves in the direction toward the tip end aperture plane 58 side.

【0021】また、図4に示すように振動子カバー33 Further, the transducer cover 33, as shown in FIG. 4
の内孔33bに挿入されているローター48の溝部48 It grooves 48 of the rotor 48 to the inner hole 33b of being inserted
cから可動操作ハンドル32の係止体35の係止爪35 The locking claw 35 of the engaging body 35 of the movable operating handle 32 from the c
aを外すことによって、振動子カバー33の内孔33b By removing the a, inner hole 33b of the transducer cover 33
からローター48を容易に取り外せるようになっている。 So that the removal of the rotor 48 easily from. なお、図3(B)に示すように振動子カバー33に固定ハンドル31及び可動操作ハンドル32を一体的にした操作ハンドル33cを設けるようにしてもよい。 Incidentally, the fixed handle 31 and the movable operating handle 32 to the transducer cover 33 may be provided with an operating handle 33c which is integrally as shown in Figure 3 (B).

【0022】また、シース11の後端部にはリング状の連結部材12が取付けられている。 Further, the rear end portion of the sheath 11 is attached a ring-shaped connecting member 12. そして、この連結部材12によってハンドピース2の振動子カバー33の先端部に例えばねじ式の連結手段を介して着脱可能に連結されている。 Then, the distal end portion of the transducer cover 33 of the hand piece 2 for example via a connecting means of screw is detachably connected by the connecting member 12. このシース11は耐熱性があり、滑りやすい材料、例えばテフロン等のフッ素樹脂製チューブによって形成されている。 The sheath 11 has a heat resistance, and is formed by a slippery material, such as fluorine resin tube such as Teflon. なお、シース11の材料はポリアセタール、ポリエチレンでもよい。 The material of the sheath 11 is polyacetal, or polyethylene.

【0023】また、シース11の先端部には図5 Further, the distal end portion of the sheath 11 5
(A),(B)に示すように略円筒状の受け部材56が固定されている。 (A), it is fixed a substantially cylindrical receiving member 56 as shown in (B). この受け部材56は振動伝達棒43がシース11の内周面に直接接触することを防止する保持手段で、例えばテフロンなどの摺動性の高いフッ素樹脂材料で形成されている。 The receiving member 56 is formed with retaining means for preventing the vibration transmission rod 43 in direct contact with the inner peripheral surface of the sheath 11, e.g., a high fluorocarbon resin material sliding property such as teflon. さらに、この受け部材56の内径寸法は図5(B)に示すようにシース11の内径寸法より小さくなるように設定されている。 Further, the inner diameter of the receiving member 56 is set smaller than the inner diameter of the sheath 11 as shown in FIG. 5 (B).

【0024】また、受け部材56の後端部外周面には先端部側に比べて小径なリング状の小径部57が切欠形成されている。 Further, receiving the small-diameter ring-shaped small-diameter portion 57 at the rear end outer peripheral surface than the front end portion of the member 56 are notches formed. この小径部57の外径寸法はシース11の内径寸法と略同径に形成されている。 Outer diameter of the small diameter portion 57 is formed to have a substantially same diameter as the inner diameter of the sheath 11. そして、この受け部材56の後端部の小径部57にシース11の先端部が圧入状態で外嵌されている。 The distal end portion of the sheath 11 is fitted in a press fit state to the small-diameter portion 57 of the rear end portion of the receiving member 56.

【0025】さらに、受け部材56の先端部両側面には図5(A),(C)に示すように先細状に絞られた絞り部58が形成されている。 Furthermore, FIG 5 is a tip portion sides of the receiving member 56 (A), it is formed aperture portions 58 is narrowed in a tapered as shown in (C). この絞り部58の先端開口部59はフック形状処置部41のフック部54の正面形状と略対応する略小判型断面形状に形成されている。 The distal opening 59 of the diaphragm portion 58 is formed to have a substantially oval cross-sectional shape that front shape substantially corresponding hook portion 54 of the hook-shaped treatment portion 41.

【0026】また、フック形状処置部41のフック部5 [0026] In addition, the hook portion 5 of the hook-shaped treatment section 41
4はこの絞り部58の先端開口部59から外部側に突出された状態で保持されている。 4 is held in a state of being protruded to the outer side from the distal end opening portion 59 of the diaphragm portion 58. ここで、図6に示すようにフック形状処置部41のフック部54におけるシース11の受け部材56との対向面側の端面54bはシース11の軸方向と直交する方向に対する傾斜角が0°、受け部材56におけるフック部54との対向面側の端面5 Here, the end face 54b of the surface facing the receiving member 56 of the sheath 11 in the hook 54 of the hook-shaped treatment portion 41 as shown in FIG. 6 the inclination angle is 0 ° with respect to a direction perpendicular to the axial direction of the sheath 11, the end surface 5 of the side facing the hook portion 54 of the receiving member 56
6aはシース11の軸方向と直交する方向に対する傾斜角が0°の状態にそれぞれ設定されている。 6a is set to the state of inclination angle 0 ° relative to a direction perpendicular to the axial direction of the sheath 11. そして、フック形状処置部41のフック部54の端面54bと受け部材56の端面56aとの間で生体組織が挟持されるようになっている。 Then, so that the living body tissue is held between the end face 56a of the receiving and the end face 54b of the hook portion 54 of the hook-shaped treatment portion 41 members 56.

【0027】また、絞り部58の先端開口部59の内周縁部とフック部54の一側部の擦り合わせ面54aとの間には図5(C)に示すように凝固能力に応じた一定間隔Lの隙間60が形成されている。 Further, constant corresponding to the coagulation ability, as shown in FIG. 5 (C) between one side of lapping surface 54a of the inner peripheral edge portion of the distal end opening portion 59 of the throttle portion 58 and the hook portion 54 gap 60 spacing L is formed. そして、可動操作ハンドル32を固定ハンドル31側に閉じる方向に操作した際に、図5および図6中に矢印で示すようにプローブ52全体が手元側に移動する動作にともないプローブ5 Then, upon operation in a direction of closing the movable operating handle 32 to the stationary handle 31 side, the probe 5 with the operation of the entire probe 52 is moved proximally as indicated by arrow in FIG. 5 and FIG. 6
2の処置部41と、シース11の先端部の受け部材56 And 2 of the treatment portion 41, receiving the distal end portion of the sheath 11 members 56
における絞り部57の先端開口部59の周縁部位との間に生体組織を挟み込み、その一部を絞り部58の先端開口部59の内周縁部とフック部54の一側部の擦り合わせ面54aとの間の隙間60内に挿入させた状態で、擦り合わせ、生体組織を切除するようになっている。 Rubbing surfaces 54a of the pinching body tissue, one side of the inner peripheral edge portion and the hook portion 54 of the distal end opening 59 of the diaphragm portion 58 a part between the peripheral edge portion of the distal end opening 59 of the diaphragm portion 57 in in a state of being inserted into the gap 60 between the, rubbed, so as to ablate the biological tissue.

【0028】次に、上述のように構成されている本実施の形態の超音波切開凝固装置の作用を説明する。 [0028] Next, the operation of the ultrasonic dissection coagulation apparatus of this embodiment is configured as described above. ここでは、超音波切開凝固装置の本体1を腹腔内に挿通して処置を行なう場合の例について説明する。 Here, an example of a case of performing the treatment by the body 1 of the ultrasonic dissection coagulation apparatus is inserted into the abdominal cavity.

【0029】まず、処置対象となる生体組織の場所に装置本体1の先端部を移動させる。 Firstly, to move the distal end portion of the apparatus main body 1 in place of the biological tissue to be treated. 続いて、操作部3の可動操作ハンドル32を固定ハンドル31側に閉じる方向に操作する。 Subsequently, it operated in a direction of closing the movable operating handle 32 of the operation portion 3 to the fixed handle 31 side. この可動操作ハンドル32の操作にともない可動操作ハンドル32の係止体35の係止爪35aが図1中で、ハンドル支点ピン34を中心に反時計回り方向に回動する。 Locking claws 35a of the engagement member 35 of the movable operating handle 32 with the operation of the movable operation handle 32 in FIG. 1, rotated about the handle pivot pin 34 in the counterclockwise direction. そのため、この係止爪35aによってローター48がシース11の軸心方向に沿って後方側に引っ張り操作され、このローター48と一緒に振動子ユニット2A全体が後方側に移動する。 Therefore, the rotor 48 by the engagement claw 35a is operated pull the rear side along the axial direction of the sheath 11, the entire transducer unit 2A with the rotor 48 moves rearward.

【0030】そして、このときプローブ52が図5および図6中に矢印で示すように手元側に移動する動作にともないプローブ52の先端処置部41のフック部54 [0030] Then, the hook portion 54 of the distal end treatment portion 41 of the probe 52 with the operation this time the probe 52 is moved proximally as indicated by arrow in FIG. 5 and FIG. 6
と、シース11の先端部の受け部材56における絞り部57の先端開口部59の周縁部位との間に生体組織を挟み込み把持するとともに、その一部を絞り部58の先端開口部59の内周縁部とフック部54の一側部の擦り合わせ面54aとの間の隙間60内に挿入させた状態で、 If, while pinching grasp the living tissue between the peripheral portion of the distal end opening 59 of the diaphragm portion 57 of the receiving member 56 of the distal end portion of the sheath 11, the inner peripheral edge of the distal opening 59 of the diaphragm portion 58 a part of parts and in a state of being inserted into the gap 60 between the one side of the lapping surface 54a of the hook portion 54,
擦り合わせる。 It rubbed.

【0031】その後、この状態で、超音波振動子駆動電源によりハンドピース2内の超音波振動子51を駆動させて超音波を発生させる。 [0031] Then, in this state, the ultrasonic transducer driving power to drive the ultrasonic transducer 51 in the hand piece 2 generates ultrasonic waves. この超音波振動子51で発生した超音波振動は、ホーン21,振動伝達棒43を介してフック形状処置部41に伝達される。 The ultrasonic vibration generated by the ultrasonic transducer 51, the horn 21 is transmitted to the hook-shaped treatment portion 41 via the vibration transmission rod 43. このときのフック形状処置部41の超音波振動がフック形状処置部41 Ultrasonic vibration hooks of the hook-shaped treatment portion 41 of the case-shaped treatment portion 41
のフック部54と、シース11の先端部の受け部材56 And the hook portion 54, the receiving member of the distal end portion of the sheath 11 56
との間で把持されている生体組織に伝達され、摩擦熱が発生して生体組織を凝固する。 Is transmitted to the grip has been that the biological tissue with the frictional heat is generated to coagulate the living tissue.

【0032】さらに、生体組織に超音波振動を与えている状態で、可動操作ハンドル32をさらに固定ハンドル31側に操作して生体組織を把持する把持力量を増加させる。 Furthermore, with the condition that the ultrasonic vibrations to a living tissue, thereby increasing the gripping force by operating the further stationary handle 31 side movable operating handle 32 for gripping the biological tissue. これにより、フック形状処置部41のフック部5 Thus, the hook portion 5 of the hook-shaped treatment portion 41
4が受け部材56にさらに近づくことにより、生体組織から出血させることなく把持されている生体組織の切開が完了する。 4 by further closer to the receiving member 56, the incision of the living tissue being grasped without bleeding from the tissue is completed.

【0033】また、プローブ52のフック形状処置部4 Further, hook-shaped treatment section 4 of the probe 52
1に超音波振動を伝達させた状態で、このフック形状処置部41のフック部54の先端部を例えば膜状の生体組織に当てることにより、膜状の生体組織を剥離する等の作業を行うことができる。 In a state of being transmitted ultrasonic vibrations to 1, by applying the tip of the hook portion 54 of the hook-shaped treatment section 41, for example, film-like biological tissue, performs work such as peeling the film-shaped living tissue be able to. このとき、超音波振動しているプローブのフック形状の処置部の先端部を例えば膜状の生体組織に当てることにより、生体組織がフック形状の処置部から滑ることを防止することができ、膜状の生体組織を剥離する等の作業を簡単に行うことができる。 At this time, by applying a distal end portion of the treatment portion of the hook shape of the probe that ultrasonic vibration, for example, film-like biological tissue, can be living tissue is prevented from slipping from the treatment portion of the hook-shaped, film Jo living tissue can be easily performed operations such as peeling the.

【0034】また、必要に応じてプローブ52に高周波電流を通電することにより、プローブ52の先端のフック形状処置部41によって生体組織に対して電気メス等の高周波処置を施すことができる。 Further, by applying a high frequency current to the probe 52 as required, it can be subjected to a high-frequency treatment such as the electric knife to the living tissue by the hook-shaped treatment portion 41 of the tip of the probe 52.

【0035】そこで、上記構成の本実施の形態の超音波切開凝固装置にあっては次の効果を奏する。 [0035] Therefore, in the ultrasonic dissection coagulation apparatus of this embodiment having the above structure has the following effects. すなわち、 That is,
プローブ52の先端部にシース11の軸方向に対して略直交する方向に屈曲形成されたフック形状処置部41を設けたので、1台の超音波切開凝固装置を使用して上述したような複数の種類の処置、すなわちプローブ52のフック形状処置部41のフック部54とシース11の先端部の受け部材56との間に生体組織を挟み込んだ状態で、プローブ52のフック形状処置部41に超音波振動を伝達することにより、プローブ52のフック形状処置部41とシース11の先端部の受け部材56との間の生体組織、例えば血管の結紮等の超音波処置や、プローブ52のフック形状処置部41に超音波振動を伝達させた状態で、このフック形状処置部41のフック部54の先端部を例えば膜状の生体組織に当てることにより、膜状の生体組織を剥離 Is provided with the hook-shaped treatment portion 41 which is bent in a direction substantially perpendicular to the axial direction of the sheath 11 to the distal end of the probe 52, a plurality, such as described above using a single ultrasound dissection coagulation apparatus types of treatment, namely in a state of sandwiching the living tissue between the tip portion of the receiving member 56 of the hook portion 54 and the sheath 11 of the hook-shaped treatment portion 41 of the probe 52, the hook-shaped treatment portion 41 of the probe 52 super by transmitting ultrasonic vibration, the biological tissue, for example, ultrasonic treatment of ligation such as the blood vessels and, hook-shaped treatment probe 52 between the receiving member 56 of the distal end portion of the hook-shaped treatment portion 41 and the sheath 11 of the probe 52 the part 41 in a state of being transmitted ultrasonic vibration, by applying the tip of the hook portion 54 of the hook-shaped treatment section 41, for example, film-like biological tissue, stripping the film-like biological tissue る等の作業や、プローブ52に高周波電流を通電することにより、プローブ52の先端のフック形状処置部41によって生体組織に対して電気メス等の高周波処置を施す等の各種の処置を行うことができる。 Work and the like that, by applying a high frequency current to the probe 52, is possible to perform various treatments such as applying a high-frequency treatment such as the electric knife to the living tissue by the hook-shaped treatment portion 41 of the tip of the probe 52 it can. そのため、本実施の形態の1台の超音波切開凝固装置を多機能に使用することができるので、従来に比べて大幅に超音波切開凝固装置の使い勝手を高め、便利に使用できる効果がある。 Therefore, it is possible to use a single ultrasound dissection coagulation apparatus of this embodiment to the multi-function, greatly enhances the usability of the ultrasonic dissection coagulation apparatus as compared with the conventional, there is a convenient effect that can be used.

【0036】また、プローブ52に高周波電流を通電して、プローブ52の先端のフック形状処置部41によって生体組織に対して電気メス等の高周波処置を施す際に、プローブ52のフック形状処置部41に超音波振動を伝達させた状態で、プローブ52に高周波電流を通電するようにしたので、高周波処置中に、高周波処置により焼灼された生体組織がプローブ52に焦げ付くことを防止することができる。 Further, by applying a high frequency current to the probe 52, in performing the high-frequency treatment such as the electric knife to the living tissue by the hook-shaped treatment portion 41 of the tip of the probe 52, hook-shaped treatment portion 41 of the probe 52 in in a state of being transmitted ultrasonic vibration. Thus high-frequency current flows to the probe 52, in the high-frequency treatment, a biological tissue that has been cauterized by the high-frequency treatment can be prevented from scorching the probe 52. そのため、高周波処置後に、プローブ52に焦げ付いた生体組織をやすり等の工具を使用して落とす面倒な作業を省略することができる。 Therefore, after high-frequency treatment, a biological tissue burnt the probe 52 can be omitted troublesome work to drop using a tool file or the like.

【0037】また、シース11は耐熱性があり、滑りやすい材料、例えばテフロン等のフッ素樹脂製チューブによって形成されているので、シース11の内周面が超音波振動するプローブ52と当接し、シース11にプローブ52との摩擦熱が発生した場合であってもシース11 Further, the sheath 11 has a heat resistance, slippery material, for example because it is formed by a fluorine resin tube such as Teflon, contacts the probe 52 to the inner peripheral surface of the sheath 11 is ultrasonic vibration, the sheath 11 the sheath even if the frictional heat of the probe 52 occurs 11
が溶けるおそれがない。 There is no possibility that the melt. そのため、シース11の内周面と超音波振動するプローブ52との間の隙間を格別に大きく設定する必要がないので、シース11の内周面とプローブ52との間の隙間を比較的小さく設定することができる。 Therefore, it is not necessary to set particularly large a gap between the probe 52 to the inner peripheral surface and the ultrasonic vibration of the sheath 11, a relatively small set the gap between the inner peripheral surface and the probe 52 of the sheath 11 can do. その結果、シース11の外径寸法全体を細くすることができ、細い超音波切開凝固装置を製造する上で、有利となる。 As a result, it is possible to narrow the overall outer diameter of the sheath 11, in the manufacture of thin ultrasonic dissection coagulation apparatus is advantageous.

【0038】さらに、シース11の先端部の受け部材5 [0038] Further, the receiving member 5 of the distal end portion of the sheath 11
6の内径寸法をシース11の内径寸法より小さくなるように設定したので、受け部材56におけるシース11の内側に突出する部分がスぺーサとして機能し、超音波振動するプローブ52がシース11の内周面に接触しにくくさせることができる。 Since the inner diameter of 6 was set to be smaller than the inner diameter of the sheath 11, receiving the inner portion projecting sheath 11 functions as spacer in member 56, the probe 52 of the ultrasonic vibration of the sheath 11 it can be difficult to contact the peripheral surface.

【0039】また、受け部材56の先端部両側面に先細状に絞られた絞り部58を形成したので、処置時にシース11の先端部の周囲の内視鏡視野がシース11の先端部によって遮られる量を少なくすることができる。 Further, since the formation of the throttle portion 58 is narrowed to form tapered distal end sides of the receiving member 56, an endoscope visual field around the distal end portion of the sheath 11 is shielding the distal end portion of the sheath 11 during treatment the amount can be a reduced being. そのため、処置中のシース11の先端部の周囲の内視鏡視野を見易い状態で確保することができる。 Therefore, it is possible to secure the endoscope visual field around the distal end portion of the sheath 11 during treatment at easily visible state.

【0040】さらに、受け部材56の絞り部58の先端開口部59の内周縁部とフック部54の一側部の擦り合わせ面54aとの間に図5(C)に示すように凝固能力に応じた一定間隔Lの隙間60を形成したので、可動操作ハンドル32を固定ハンドル31側に閉じる方向に操作した際に、プローブ52の処置部41と、シース11 [0040] Further, receiving the clotting ability as shown in FIG. 5 (C) between one side of lapping surface 54a of the inner peripheral edge portion and the hook portion 54 of the distal end opening 59 of the diaphragm portion 58 of the member 56 since the formation of the gap 60 of the fixed interval L corresponding to the time of operating in a direction of closing the movable operating handle 32 to the stationary handle 31 side, the treatment portion 41 of the probe 52, the sheath 11
の先端部の受け部材56における絞り部57の先端開口部59の周縁部位との間に生体組織を挟み込み、その一部を絞り部58の先端開口部59の内周縁部とフック部54の一側部の擦り合わせ面54aとの間の隙間60内に挿入させた状態で、擦り合わせることができる。 Sandwiching the living tissue between the peripheral edge portion of the distal end opening 59 of the diaphragm portion 57 of the receiving member 56 of the distal end portion of one of the inner peripheral edge portion and the hook portion 54 of the distal end opening 59 of the diaphragm portion 58 a part of in a state of being inserted into the gap 60 between the lapping surface 54a of the side it can be rubbed. そのため、絞り部58の先端開口部59の内周縁部とフック部54の一側部の擦り合わせ面54aとの間の隙間60 Therefore, the gap between the lapping surface 54a of one side of the inner peripheral edge portion of the distal end opening portion 59 of the throttle portion 58 and the hook portion 54 60
内に挿入させた生体組織を確実に凝固させることができる。 The biological tissue is inserted within can be reliably coagulated.

【0041】さらに、振動伝達棒43の先端部に螺合接続されるフック形状処置部41を必要に応じて処置に適した形状、或いはサイズ、表面処理のものに交換することによって、効率良く処置を行うことができる。 [0041] Further, a shape suitable for treatment according to need hook-shaped treatment portion 41 which is threaded connection to the front end portion of the vibration transmission rod 43, or the size, by replacing those surface treatment, efficiently treated It can be performed. さらに、ローター48を操作部3に係止する際、ローター4 Moreover, when locking the rotor 48 on the operation unit 3, the rotor 4
8に凸部を設け、係止体に凹部を設けて係止することによって同様の作用・効果を得ることができる。 8 a convex portion is provided, it is possible to obtain the same advantages by engaging a concave portion is provided on the locking member.

【0042】なお、上記実施の形態ではシース11をフッ素樹脂製チューブによって形成した構成を示したが、 [0042] Although in the above embodiment shows a configuration of forming the sheath 11 by a fluorine resin tube,
シース11を金属材料製チューブによって形成し、この金属材料製チューブの内周面に耐熱性があり、滑りやすい材料、例えばテフロン等のコーティングを施す構成にしてもよい。 The sheath 11 is formed of a metal material tubes, there is heat resistance at the inner peripheral surface of the metallic material tubes, slippery material, it may be configured to apply a coating, for example Teflon or the like.

【0043】さらに、上記実施の形態ではシース11の先端部に別体の受け部材56を固定する構成を示したが、シース11の先端部に受け部材56を一体成形する構成にしてもよい。 [0043] Further, in the above embodiment shows a structure for fixing the receiving member 56 separate the distal end of the sheath 11, but the member 56 received in the distal end portion of the sheath 11 may be configured to integrally molded.

【0044】また、図7は本発明の第2の実施の形態の超音波切開凝固装置の要部構成を示すものである。 [0044] Further, FIG. 7 shows a configuration of a main part of an ultrasonic dissection coagulation apparatus according to the second embodiment of the present invention. 本実施の形態は第1の実施の形態(図1〜図6参照)の受け部材56の構成を次の通り変更したものである。 This embodiment is that the configuration of the receiving member 56 of the first embodiment (see FIGS. 1 to 6) as follows. すなわち、本実施の形態では受け部材56におけるフック形状処置部41のフック部54との対向面側の端面56aはシース11の軸方向と直交する方向に対する傾斜角が0 That is, the end face 56a of the side facing the hook portion 54 of the hook-shaped treatment portion 41 of the receiving member 56 in the present embodiment the inclination angle with respect to a direction perpendicular to the axial direction of the sheath 11 is 0
°より大きい状態(図7中で端面56aの上側がフック形状処置部41のフック部54側に接近する方向に傾斜する状態)に設定されている。 ° larger state is set to (the upper end surface 56a in FIG. 7 is a state inclined in a direction approaching the hook portion 54 side of the hook-shaped treatment portion 41).

【0045】そこで、本実施の形態ではフック形状処置部41のフック部54の端面54bと受け部材56の端面56aとの間に形成される生体組織の挟持空間は図7 [0045] Therefore, clamping space of the living tissue to be formed between the In this embodiment the end face 56a of the receiving and the end face 54b of the hook portion 54 of the hook-shaped treatment portion 41 members 56 7
中で上側の開口部側の幅寸法が下側の閉塞部側の幅寸法よりも狭くなるように形成されるので、フック形状処置部41のフック部54の端面54bと受け部材56の端面56aとの間に挟持された生体組織が抜けにくくなる効果がある。 Since the upper width of the opening side at medium is formed to be narrower than the width of the closed portion side of the lower end face 56a of the receiving and the end face 54b of the hook portion 54 of the hook-shaped treatment portion 41 members 56 it is held living tissue is less likely to escape effect between.

【0046】また、図8は本発明の第3の実施の形態の超音波切開凝固装置の要部構成を示すものである。 [0046] Further, FIG. 8 shows a main configuration of a third embodiment of the ultrasonic dissection coagulation apparatus of the present invention. 本実施の形態は第1の実施の形態(図1〜図6参照)のフック形状処置部41の構成を次の通り変更したものである。 This embodiment is that the configuration of the hook-shaped treatment portion 41 of the first embodiment (see FIGS. 1 to 6) as follows. すなわち、本実施の形態ではフック形状処置部41 That is, in this embodiment the hook-shaped treatment portion 41
のフック部54における受け部材56との対向面側の端面54bはシース11の軸方向と直交する方向に対する傾斜角が0°より大きい状態(図8中で端面54bの上側が受け部材56側に接近する方向に傾斜する状態)に設定されている。 Of the end face 54b of the surface facing the receiving member 56 at the hook portion 54 on the upper side bearing member 56 side of the end face 54b in the inclination angle relative to the direction of 0 ° greater than the state (FIG. 8 perpendicular to the axial direction of the sheath 11 It is set to a state) which is inclined in a direction approaching.

【0047】そこで、本実施の形態でもフック形状処置部41のフック部54の端面54bと受け部材56の端面56aとの間に形成される生体組織の挟持空間は図8 [0047] Therefore, clamping space of the living tissue to be formed between the end face 56a of the end face 54b and the receiving member 56 of the hook portion 54 of the hook-shaped treatment portion 41 in this embodiment FIG. 8
中で上側の開口部側の幅寸法が下側の閉塞部側の幅寸法よりも狭くなるように形成されるので、第2の実施の形態(図7参照)と同様にフック形状処置部41のフック部54の端面54bと受け部材56の端面56aとの間に挟持された生体組織が抜けにくくなる効果がある。 Since the upper width of the opening side at medium is formed to be narrower than the width of the closed portion side of the lower side, the second embodiment (see FIG. 7) as well as hook-shaped treatment portion 41 there are held living tissue is less likely to escape the effect between the end face 56a of the end face 54b and the receiving member 56 of the hook portion 54.

【0048】また、図9は本発明の第4の実施の形態の超音波切開凝固装置の要部構成を示すものである。 [0048] Further, FIG. 9 shows a main configuration of the ultrasonic dissection coagulation apparatus according to the fourth embodiment of the present invention. 本実施の形態は第1の実施の形態(図1〜図6参照)の受け部材56およびフック形状処置部41の構成を次の通り変更したものである。 This embodiment is that the configuration of the receiving member 56 and the hook-shaped treatment portion 41 of the first embodiment (see FIGS. 1 to 6) as follows. すなわち、本実施の形態では受け部材56におけるフック形状処置部41のフック部54 That is, the hook portion 54 of the hook-shaped treatment portion 41 of the receiving member 56 in this embodiment
との対向面側の端面56aは第2の実施の形態(図7参照)と同様にシース11の軸方向と直交する方向に対する傾斜角が0°より大きい状態(図7中で端面56aの上側がフック形状処置部41のフック部54側に接近する方向に傾斜する状態)に設定されている。 The end face 56a of the surface facing the second embodiment (see FIG. 7) as well as the inclination angle with respect to a direction perpendicular to the axial direction is greater than 0 ° state of the sheath 11 (on the end surface 56a in FIG. 7 side is set to a state) which is inclined in a direction approaching the hook portion 54 side of the hook-shaped treatment portion 41. さらに、フック形状処置部41のフック部54における受け部材5 Further, the receiving member 5 at the hook portion 54 of the hook-shaped treatment portion 41
6との対向面側の端面54bは第3の実施の形態(図8 The end face 54b of the side facing a 6 the third embodiment (FIG. 8
参照)と同様にシース11の軸方向と直交する方向に対する傾斜角が0°より大きい状態(図8中で端面54b Inclination angle relative to a direction perpendicular to the axial direction of the well as the sheath 11 and the reference) is greater than 0 ° state (end surface 54b in FIG. 8
の上側が受け部材56側に接近する方向に傾斜する状態)に設定されている。 Is set to a state) to tilt in the direction in which the upper approaches the receiving member 56 side.

【0049】そこで、本実施の形態ではフック形状処置部41のフック部54の端面54bと受け部材56の端面56aとの間に形成される生体組織の挟持空間は図9 [0049] Therefore, clamping space of the living tissue to be formed between the In this embodiment the end face 56a of the receiving and the end face 54b of the hook portion 54 of the hook-shaped treatment portion 41 members 56 9
中で上側の開口部側の幅寸法が下側の閉塞部側の幅寸法よりも狭くなるように形成されるので、第2,第3の実施の形態と同様にフック形状処置部41のフック部54 Since the upper width of the opening side at medium it is formed to be narrower than the width of the closed portion side of the lower, second, third embodiment of the same hook of the hook-shaped treatment portion 41 part 54
の端面54bと受け部材56の端面56aとの間に挟持された生体組織が抜けにくくなる効果がある。 Is held living tissue is less likely to escape the effect between the end face 56a of the end face 54b and the receiving member 56.

【0050】また、図10は本発明の第5の実施の形態の超音波切開凝固装置の要部構成を示すものである。 [0050] Further, FIG. 10 shows a main configuration of the ultrasonic dissection coagulation apparatus according to a fifth embodiment of the present invention. 本実施の形態は第1の実施の形態(図1〜図6参照)のフック形状処置部41の構成を次の通り変更したものである。 This embodiment is that the configuration of the hook-shaped treatment portion 41 of the first embodiment (see FIGS. 1 to 6) as follows. すなわち、本実施の形態のフック形状処置部71には軸体72の先端面に中心穴72aを形成し、略L字状に屈曲されたワイヤ部材73の基端部を軸体72の中心穴72aに挿入させた状態で固定したものである。 That is, the center hole of the hook-shaped treatment portion 71 of this embodiment forms a center hole 72a on the distal end surface of the shaft body 72, a base end portion of the wire member 73 which is bent into a substantially L-shape shaft 72 those fixed in a state of being inserted in 72a. この場合、ワイヤ部材73には軸体72の中心穴72aに挿入状態で固定される固定部74と、この固定部74の先端側に軸体72の中心線から離れる偏心位置方向に屈曲された屈曲部75と、この屈曲部75の先端にシース1 In this case, the wire member 73 and the fixed portion 74 to be fixed in the inserted state into the center hole 72a of the shaft 72, which is bent at an eccentric position away from the center line of the shaft 72 to the distal end side of the fixing portion 74 a bent portion 75, the sheath 1 at the tip of the bent portion 75
1の軸方向に対して略直交する方向に屈曲されたフック部76とがそれぞれ形成されている。 And a hook portion 76 which is bent in a direction substantially perpendicular are formed respectively first axis direction.

【0051】そこで、本実施の形態ではフック形状処置部71を直線状に形成された軸体72およびこの軸体7 [0051] Therefore, the shaft member 72 and is formed in a straight line the hook-shaped treatment portion 71 in this embodiment the shaft body 7
2に固定されるワイヤ部材73の2部品に分割形成し、 Divided form into two parts of a wire member 73 that is fixed to 2,
ワイヤ部材73に略L字状のフック部76を屈曲形成したので、第1の実施の形態のフック形状処置部41のように音響効果が高く、生体適合性のよい高価なチタン材等からなる軸体53の先端部に略L字状のフック部54 Since the bent form substantially L-shaped hook portion 76 to the wire member 73, the sound effect is high, of a biocompatible good expensive titanium material such as hook-shaped treatment portion 41 of the first embodiment substantially L-shaped hook portion 54 to the distal end of the shaft 53
をフライス加工によって一体に切削加工する場合に比べてフック形状処置部71の加工費用を低減することができ、安価なプローブ52を製造することができる。 The can reduce the processing cost of the hook-shaped treatment portion 71 as compared with the case of cutting together by milling, it is possible to manufacture an inexpensive probe 52.

【0052】さらに、本実施の形態では軸体72の先端面に中心穴72aを形成し、ワイヤ部材73の基端部を軸体72の中心穴72aに挿入させた状態で固定する構成にしたので、軸体72にワイヤ部材73を固定する際にワイヤ部材73の取付け位置を軸体72の周方向に位置決めする必要がない。 [0052] Further, in this embodiment forms a center hole 72a on the distal end surface of the shaft 72, and a proximal end portion of the wire member 73 configured to fix in a state of being inserted into the center hole 72a of the shaft 72 since, there is no need to position the mounting position of the wire member 73 in the circumferential direction of the shaft body 72 when fixing the wire member 73 to the shaft 72. そのため、フック形状処置部7 Therefore, hook-shaped treatment section 7
1の製造作業を簡略化することができる効果もある。 Effect capable of simplifying the manufacturing operations for one also.

【0053】また、図11は本発明の第6の実施の形態の超音波切開凝固装置の要部構成を示すものである。 [0053] Further, FIG. 11 shows a configuration of a main part of an ultrasonic dissection coagulation apparatus of the sixth embodiment of the present invention. 本実施の形態は第1の実施の形態(図1〜図6参照)のフック形状処置部41の構成を次の通り変更したものである。 This embodiment is that the configuration of the hook-shaped treatment portion 41 of the first embodiment (see FIGS. 1 to 6) as follows. すなわち、本実施の形態のフック形状処置部81には軸体82の先端面に直線状のすり割り部82aを形成し、略L字状に切削形成された板状部材83の基端部を軸体82のすり割り部82aに挿入させた状態で固定したものである。 That is, the hook-shaped treatment portion 81 of this embodiment forms a straight slit portion 82a on the distal end surface of the shaft body 82, a base end portion of the plate-like member 83 which is cut formed in a substantially L shape those fixed in a state of being inserted into the slit portion 82a of the shaft 82. この場合、板状部材83には軸体82のすり割り部82aに挿入状態で固定される固定部84 In this case, fixing portions 84 to the plate-like member 83 which is fixed in the inserted state in the slit portion 82a of the shaft 82
と、この固定部84の先端側に軸体82の中心線から離れる偏心位置方向に切削された偏心部85と、この偏心部85の先端にシース11の軸方向に対して略直交する方向に切削されたフック部86とがそれぞれ形成されている。 When an eccentric portion 85 which is cut at an eccentric position away from the center line of the shaft 82 to the distal end side of the fixing portion 84, in a direction substantially orthogonal to the distal end of the eccentric portion 85 in the axial direction of the sheath 11 a hook portion 86 which is cut are formed.

【0054】そこで、本実施の形態ではフック形状処置部81を直線状に形成された軸体82およびこの軸体8 [0054] Therefore, the shaft body 82 is formed a hook-shaped treatment portion 81 in a straight line in this embodiment and the shaft 8
2に固定される板状部材83の2部品に分割形成し、板状部材83に略L字状のフック部86を切削形成したので、第1の実施の形態のフック形状処置部41のように音響効果が高く、生体適合性のよい高価なチタン材等からなる軸体53の先端部に略L字状のフック部54をフライス加工によって一体に切削加工する場合に比べてフック形状処置部81の加工費用を低減することができ、 Divided form into two parts of the plate-like member 83 which is fixed to 2, since the substantially L-shaped hook portion 86 to the plate-like member 83 was cut formed, as a hook-shaped treatment portion 41 of the first embodiment the high sound effects, hook-shaped treatment section as compared with the case of cutting the integral substantially L-shaped hook portion 54 by milling to the tip of the shaft 53 of a biocompatible good expensive titanium material etc. it is possible to reduce the 81 processing costs,
安価なプローブ52を製造することができる。 It is possible to manufacture an inexpensive probe 52.

【0055】また、図12は本発明の第7の実施の形態の超音波切開凝固装置の要部構成を示すものである。 [0055] Further, FIG. 12 shows a configuration of a main part of an ultrasonic dissection coagulation apparatus of the seventh embodiment of the present invention. 本実施の形態は第1の実施の形態(図1〜図6参照)のフック形状処置部41の構成を次の通り変更したものである。 This embodiment is that the configuration of the hook-shaped treatment portion 41 of the first embodiment (see FIGS. 1 to 6) as follows. すなわち、本実施の形態のフック形状処置部91には軸体92の先端部外周面に軸方向に沿って直線状の取付け溝92aを形成し、略L字状に屈曲されたワイヤ部材93の基端部を軸体92の取付け溝92aに挿入させた状態で固定したものである。 That is, the shaft 92 is a hook-shaped treatment portion 91 of this embodiment along the axial direction in the tip outer peripheral surface to form a linear attachment groove 92a, the wire member 93 which is bent in a substantially L shape it is obtained by fixing the base end portion while being inserted into the mounting groove 92a of the shaft 92. この場合、ワイヤ部材9 In this case, the wire member 9
3には軸体92の取付け溝92aに挿入状態で固定される固定部94と、この固定部94の先端側にシース11 A fixing portion 94 fixed in the inserted state into the mounting groove 92a of the shaft body 92 to 3, the sheath 11 to the distal end side of the fixing portion 94
の軸方向に対して略直交する方向に屈曲されたフック部95とがそれぞれ形成されている。 And a hook portion 95 which is bent in a direction substantially perpendicular are formed respectively in the axial direction.

【0056】そこで、本実施の形態ではフック形状処置部91を直線状に形成された軸体92およびこの軸体9 [0056] Therefore, the shaft member 92 and is formed a hook-shaped treatment portion 91 in a straight line in this embodiment the shaft body 9
2に固定されるワイヤ部材93の2部品に分割形成し、 Divided form into two parts of a wire member 93 that is fixed to 2,
ワイヤ部材93に略L字状のフック部95を屈曲形成したので、第1の実施の形態のフック形状処置部41のように音響効果が高く、生体適合性のよい高価なチタン材等からなる軸体53の先端部に略L字状のフック部54 Since the bent form substantially L-shaped hook portion 95 to the wire member 93, the sound effect is high, of a biocompatible good expensive titanium material such as hook-shaped treatment portion 41 of the first embodiment substantially L-shaped hook portion 54 to the distal end of the shaft 53
をフライス加工によって一体に切削加工する場合に比べてフック形状処置部91の加工費用を低減することができ、安価なプローブ52を製造することができる。 The can reduce the processing cost of the hook-shaped treatment portion 91 as compared with the case of cutting together by milling, it is possible to manufacture an inexpensive probe 52.

【0057】また、図13は本発明の第8の実施の形態の超音波切開凝固装置の要部構成を示すものである。 [0057] Further, FIG. 13 shows a configuration of a main part of an ultrasonic dissection coagulation apparatus according to an eighth embodiment of the present invention. 本実施の形態は第1の実施の形態(図1〜図6参照)の受け部材56の構成を次の通り変更したものである。 This embodiment is that the configuration of the receiving member 56 of the first embodiment (see FIGS. 1 to 6) as follows. すなわち、本実施の形態では受け部材56の先端部の先端開口部59におけるフック形状処置部41のフック部54 That is, the hook portion 54 of the hook-shaped treatment portion 41 at the distal end opening 59 of the distal end portion of the receiving member 56 in this embodiment
との対向部分を閉塞して押し当て面101を形成したものである。 It is obtained by forming a contact surface 101 pressing the opposing partial obstruction to the.

【0058】そこで、本実施の形態では受け部材56における生体組織との接触面積を増やすことができるので、フック形状処置部41のフック部54の端面54b [0058] Therefore, it is possible to increase the contact area with the living tissue in the receiving member 56 in this embodiment, the end face 54b of the hook portion 54 of the hook-shaped treatment portion 41
と受け部材56の端面56aとの間に挟持された生体組織をフック形状処置部41のフック部54と受け部材5 Receiving a hook portion 54 of the hook-shaped treatment portion 41 held living tissue between the receiving end surface 56a of the member 56 member 5
6の押し当て面101との間で確実に把持することができる。 It can be reliably gripped between the pressing surfaces 101 of 6.

【0059】なお、本発明は上記実施の形態に限定されるものではない。 [0059] The present invention is not limited to the above embodiment. 例えば、上記実施の形態では可動操作ハンドル32の操作時にプローブ52が手元側に移動してプローブ52の先端処置部41のフック部54が、シース11の先端部の受け部材56における絞り部57の先端開口部59の周縁部位に生体組織を押し付ける状態で挟み込む構成のものを示したが、逆に可動操作ハンドル32の操作時にプローブ52を固定状態で保持し、シース11の先端部の受け部材56がプローブ52の先端処置部41のフック部54に接近する方向に移動することにより、両者が相対移動する構成にしてもよい。 For example, the hook portion 54 of the distal end treatment portion 41 of the probe 52 probe 52 is moved proximally during operation of the movable operation handle 32 in the above embodiment is of the diaphragm portion 57 of the receiving member 56 of the distal end portion of the sheath 11 showed that the structure sandwiched in a state of pressing the peripheral portion to the biological tissue of the distal end opening portion 59, to hold the probe 52 in a fixed state during the operation of the movable operation handle 32 in the opposite, receiving the distal end portion of the sheath 11 members 56 There by moving in a direction to approach the hook portion 54 of the distal end treatment portion 41 of the probe 52, may be configured to both be moved relative.

【0060】さらに、その他、本発明の要旨を逸脱しない範囲で種々変形実施できることは勿論である。 [0060] In addition, other, it is needless to say that various modifications may be implemented without departing from the scope of the present invention. 次に、 next,
本出願の他の特徴的な技術事項を下記の通り付記する。 Other characteristic technical matters of the present application is appended as follows. 記 (付記項1) 超音波振動を発生する超音波振動子と、 Serial and ultrasonic transducers (Note 1) generates ultrasonic vibration,
前記超音波振動子を内蔵したハンドピースと前記超音波振動子に接続され、前記超音波振動を生体組織に対して処置を行うための処置部へ伝達する振動伝達部材と前記振動伝達部材先端に設けられた処置部と前記振動伝達部材を覆うシースと前記処置部との間に組織を挟み込み凝固/切開を行うための補助部材を有する超音波凝固切開装置において、前記処置部はフック形状であることを特徴とする超音波凝固切開装置。 Wherein the built-in handpiece an ultrasonic vibrator connected to the ultrasonic transducer, the ultrasonic vibration to the vibration transmitting member tip and the vibration transmission member for transmitting to the treatment portion for performing a treatment to the living tissue the ultrasonic coagulation and incision apparatus having an auxiliary member for performing pinching coagulation / cutting tissue between the sheath and the treatment portion and provided with a treatment portion covering the vibration transmitting member, the treatment portion is a hook-shaped ultrasonic coagulation and incision apparatus characterized by.

【0061】(付記項2) 前記シース内面が摺動材料でできていることを特徴とする付記項1の超音波凝固切開装置。 [0061] (Note 2) ultrasonic coagulation and incision apparatus according to Note 1, wherein the sheath inner surface, characterized in that is made of sliding material. (付記項3) 前記シースがフッ素樹脂製チューブよりできていることを特徴とする付記項1の超音波凝固切開装置。 (Additional Item 3) wherein the sheath ultrasonic coagulation and incision apparatus according to Note 1, characterized in that is made from the fluororesin tube.

【0062】(付記項4) 超音波振動を発生する超音波振動子と、前記超音波振動子を内蔵したハンドピースと前記超音波振動子に接続され、前記超音波振動を生体組織に対して処置を行うための処置部へ伝達する振動伝達部材と前記振動伝達部材先端に設けられたフック状の処置部と前記振動伝達部材を覆うシースとを有する超音波凝固切開装置において、前記シース先端部には処置部と擦り合わせ組織を切除する補助部材が設けられていることを特徴とする超音波凝固切開装置。 [0062] and ultrasonic transducers for generating (Note 4) ultrasonic vibration to the said and built-in the handpiece an ultrasonic vibrator connected to the ultrasonic transducer, the ultrasonic vibration of biological tissue the ultrasonic coagulation and incision apparatus and a sheath covering the vibration transmitting member and the vibration transmitting member and the vibration transmitting member hook-shaped treatment portion provided at a distal end for transmission to the treatment portion for performing a treatment, the sheath tip ultrasonic coagulation and incision apparatus, characterized in that it is provided an auxiliary member for ablating tissue rubbing the treatment portion to.

【0063】(付記項5) 前記補助部材はシース内径より小さい内径を持つことを特徴とする付記項4の超音波凝固切開装置。 [0063] (Note 5) said auxiliary member is an ultrasonic coagulation and incision apparatus according to Note 4, characterized in that with small internal diameter than the sheath inner diameter. (付記項6) 前記補助部材はフッ素樹脂であることを特徴とする付記項4の超音波凝固切開装置。 (Note 6) the auxiliary member is an ultrasonic coagulation and incision apparatus according to Note 4, characterized in that a fluorine resin.

【0064】(付記項7) 前記補助部材にはスリット状の開口部を持つことを特徴とする付記項4の超音波凝固切開装置。 [0064] (Note 7) ultrasonic coagulation and incision apparatus according to Note 4, wherein the auxiliary member, characterized by having a slit-shaped opening. (付記項8) 前記補助部材の処置部の擦り合わせ面とフック状の処置部側面との間には凝固能力に応じた一定の距離が保たれていることを特徴とする付記項4の超音波凝固切開装置。 According to Note 4, characterized in that a constant distance is maintained in accordance with the clotting ability between (Note 8) The treatment portion rubbing surface and the hook-shaped treatment portion side of the auxiliary member super ultrasonic coagulation and incision apparatus. (付記項9) 前記補助部材は先端が細くなっていることを特徴とする付記項4の超音波凝固切開装置。 (Additional Item 9) The auxiliary member is an ultrasonic coagulation and incision apparatus according to Note 4, characterized in that the tip is tapered.

【0065】(付記項10) 超音波振動を発生する超音波振動子と、前記超音波振動子を内蔵したハンドピースと前記超音波振動子に接続され、前記超音波振動を生体組織に対して処置を行うための処置部へ伝達する振動伝達部材と前記振動伝達部材先端に設げられ組織を切除するための処置用端面を持ったフック状の処置部と前記振動伝達部材を覆うシースと前記シース先端部に設けられ処置部と擦り合わせ組織を切除する先端端面を有する補助部材を有する超音波凝固切開装置において、前記処置用端面と前記補助部材先端端面とのなす角度が0゜より大きいことを特徴とする超音波凝固切開装置。 [0065] and ultrasonic transducers for generating (Note 10) ultrasonic vibration to the said and built-in the handpiece an ultrasonic vibrator connected to the ultrasonic transducer, the ultrasonic vibration of biological tissue wherein the sheath covers the vibration transmission member and hook-shaped treatment portion for having an end face treatment for ablating a vibration transmission member of said vibration transmitting member tip 設Ge is tissue that transmits to the treatment portion for performing treatment the ultrasonic coagulation and incision apparatus having an auxiliary member having a tip end surface to ablate the treatment section and the grinding tissue provided in the sheath tip, said said treatment end face forms an angle between the auxiliary member distal end surface larger than 0 ° ultrasonic coagulation and incision apparatus according to claim.

【0066】(付記項11) 前記処置用端面角度は振動軸方向に垂直であることを特徴とする付記項10の超音波凝固切開装置。 [0066] (Note 11) The treatment end face angle ultrasonic coagulation and incision apparatus according to Note 10, characterized in that is perpendicular to the oscillation axis direction. (付記項12) 前記補助部材先端端面の角度は振動軸方向に垂直であることを特徴とする付記項10の超音波凝固切開装置。 (Additional Item 12) ultrasonic coagulation and incision apparatus according to Note 10 angle of the auxiliary member distal end face, characterized in that it is perpendicular to the oscillation axis direction.

【0067】(付記項13) 前記処置用端面角度及び前記補助部材先端端面の角度はいずれも振動軸方向に垂直ではないことを特徴とする付記項10の超音波凝固切開装置。 [0067] (Note 13) ultrasonic coagulation and incision apparatus according to Note 10 none the angle of the treatment end face angle and the auxiliary member distal end face is characterized by not perpendicular to the vibration axis.

【0068】(付記項14) 超音波振動を発生する超音波振動子と、前記超音波振動子を内蔵したハンドピースと前記超音波振動子に接続され、前記超音波振動を生体組織に対して処置を行うための処置部へ伝達する振動伝達部材と前記振動伝達部材先端に設けられたフック状の処置部と前記振動伝達部材を覆うシースとを有する超音波凝固切開装置において、前記フック状の処置部は前記振動伝達部材に固着されていることを特徴とする超音波凝固切開装置。 [0068] and ultrasonic transducers (Note 14) for generating ultrasonic vibration, to the above and built-in the handpiece an ultrasonic vibrator connected to the ultrasonic transducer, the ultrasonic vibration of biological tissue the ultrasonic coagulation and incision apparatus and a sheath covering the vibration transmission member and hook-shaped treatment portion provided on the vibration transmitting member tip and the vibration transmission member for transmitting to the treatment portion for performing a treatment, like the hook ultrasonic coagulation and incision apparatus treatment unit, characterized in that it is fixed to the vibration transmitting member.

【0069】(付記項15) 前記フック状の処置部はワイヤー状部材からなることを特徴とする付記項14の超音波凝固切開装置。 [0069] (Note 15) the hook-shaped treatment portion is an ultrasonic coagulation and incision apparatus according to Note 14, characterized in that it consists of wire-like member. (付記項16) 前記フック状の処置部は板状部材からなることを特徴とする付記項14の超音波凝固切開装置。 (Additional Item 16) ultrasonic coagulation and incision apparatus according to Note 14, wherein the hook-shaped treatment portion, characterized in that a plate-like member.

【0070】(付記項17) 前記フック状の処置部の中心軸と振動伝達部材の中心軸は少なくとも固着部で一致していることを特徴とする付記項15の超音波凝固切開装置。 [0070] (Note 17) ultrasonic coagulation and incision apparatus according to Note 15, characterized in that the central axis of the vibration transmitting member of the hook-shaped treatment portion is coincident with at least fixing section.

【0071】 [0071]

【発明の効果】本発明によれば超音波振動を処置具本体の先端部側に伝達するプローブの先端部にシースの軸方向に対して略直交する方向にフック形状の処置部を屈曲形成し、シースとプローブとの間をシースの軸方向に沿って相対的に移動させ、プローブの処置部とシースの先端部との間に生体組織を挟み込む状態で生体組織を処置するとともに、フック形状処置部のみでも生体組織を処置できるようにしたので、生体組織を剥離する等の作業を簡単に行うことができ、多機能化を図ることができる。 The treatment portion of the hook-shaped and bent in a direction substantially perpendicular to the axial direction of the sheath ultrasonic vibration according to the present invention the tip portion of the probe which transmits the front end portion of the instrument body according to the present invention , between the sheath and probe are relatively moved along the axial direction of the sheath, as well as treating the living tissue in a state of sandwiching the living tissue between the treatment portion and the sheath of the tip of the probe, hook-shaped treatment since even only in parts and to be able to treat a living tissue, makes it easy to work such as separating the biological tissue, it is possible to achieve multiple functions.

【図面の簡単な説明】 BRIEF DESCRIPTION OF THE DRAWINGS

【図1】 本発明の第1の実施の形態の超音波切開凝固装置の概略構成を示す斜視図。 Perspective view showing a schematic configuration of an ultrasonic dissection coagulation apparatus according to the first embodiment of the present invention; FIG.

【図2】 第1の実施の形態の装置のプローブを示す説明図。 FIG. 2 is an explanatory view showing the probe of the apparatus of the first embodiment.

【図3】 第1の実施の形態の装置の振動子ユニットと操作部を構成する振動子カバーとの関係を示す説明図。 Figure 3 is an explanatory diagram showing the relationship between the transducer cover constituting the vibrator unit and the operating unit of the apparatus of the first embodiment.

【図4】 第1の実施の形態の装置の操作部とローターとの係止状態の1例を説明する図。 Figure 4 is a diagram illustrating an example of a locking state between the operating element and the rotor of the apparatus of the first embodiment.

【図5】 第1の実施の形態の装置のフック形状処置部とシースとの関係を説明する図。 Figure 5 illustrates a relationship between the first embodiment hook-shaped treatment portion and the sheath of the device.

【図6】 第1の実施の形態の装置のフック形状処置部の動作を説明するための側面図。 Figure 6 is a side view for explaining the operation of the hook-shaped treatment portion of the apparatus of the first embodiment.

【図7】 本発明の第2の実施の形態の装置のフック形状処置部の側面図。 Figure 7 is a side view of the hook-shaped treatment portion of the apparatus of the second embodiment of the present invention.

【図8】 本発明の第3の実施の形態の装置のフック形状処置部の側面図。 [8] The third hook-shaped treatment section side view of the embodiment of apparatus in accordance with the present invention.

【図9】 本発明の第4の実施の形態の装置のフック形状処置部の側面図。 [9] fourth side view of the hook-shaped treatment portion of the apparatus of the embodiment of the present invention.

【図10】 本発明の第5の実施の形態の装置のフック形状処置部の斜視図。 Figure 10 is a perspective view of a hook-shaped treatment portion of the apparatus of the fifth embodiment of the present invention.

【図11】 本発明の第6の実施の形態の装置のフック形状処置部の斜視図。 [11] Sixth perspective view of the hook-shaped treatment portion of the apparatus of the embodiment of the present invention.

【図12】 本発明の第7の実施の形態の装置のフック形状処置部の斜視図。 [12] Seventh perspective view of the hook-shaped treatment portion of the apparatus of the embodiment of the present invention.

【図13】 本発明の第8の実施の形態の装置のフック形状処置部とシースとの関係を説明する斜視図。 [13] Eighth perspective view illustrating the relationship between the hook-shaped treatment portion and the sheath of the apparatus of the embodiment of the present invention.

【符号の説明】 DESCRIPTION OF SYMBOLS

1 超音波切開凝固装置本体(処置具本体) 2 ハンドピース 3 操作部(操作手段) 4 処置部 11 シース 51 超音波振動子 52 プローブ 53 フック形状処置部 1 ultrasonic dissection coagulation apparatus main body (instrument body) 2 handpiece 3 operation unit (operation means) 4 treatment portion 11 the sheath 51 ultrasonic transducer 52 probe 53 hook-shaped treatment portion

Claims (1)

    【特許請求の範囲】 [The claims]
  1. 【請求項1】 処置具本体の基端部に配設され、超音波振動子が内蔵されたハンドピースと、前記超音波振動子に接続され、超音波振動を前記処置具本体の先端部側に伝達するプローブと、このプローブを覆うシースと、前記プローブの先端部に前記シースの軸方向に対して略直交する方向に屈曲形成され、生体組織に対して処置を行うフック形状の処置部と、前記シースと前記プローブとの間を前記シースの軸方向に沿って相対的に移動させ、 1. A disposed at the proximal end of the instrument body, a handpiece ultrasonic transducers are built, which is connected to the ultrasonic transducer, the distal end portion side of the instrument body ultrasonic vibrations a probe for transmitting to, and a sheath covering the probe, the formed bent in a direction substantially perpendicular to the axial direction of the sheath to the distal end of the probe, the treatment portion of the hook-shaped take action against body tissue , between the sheath and the probe are relatively moved along the axial direction of the sheath,
    前記プローブの処置部と前記シースの先端部との間に生体組織を挟み込む操作手段とを具備したことを特徴とする超音波処置具。 Ultrasonic treatment apparatus characterized by comprising an operating means for clamping the body tissue between the distal end portion of the sheath and the treatment portion of the probe.
JP16580696A 1996-06-26 1996-06-26 Ultrasonic processor Pending JPH105237A (en)

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JP16580696A JPH105237A (en) 1996-06-26 1996-06-26 Ultrasonic processor
US08842637 US5906628A (en) 1996-06-26 1997-04-16 Ultrasonic treatment instrument

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US4792821A (en) * 1987-01-12 1988-12-20 Canon Kabushiki Kaisha Auto-focus apparatus in a camera
US6328703B1 (en) 1999-07-02 2001-12-11 Olympus Optical Co., Ltd. Ultrasonic treating apparatus
JP2008528242A (en) * 2005-02-02 2008-07-31 デピュイ・スパイン・インコーポレイテッドDePuy Spine,Inc. Ultrasonic cutting device
JP2008212693A (en) * 2001-02-08 2008-09-18 Tyco Healthcare Group Lp Ultrasonic surgical instrument
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US9226767B2 (en) 2012-06-29 2016-01-05 Ethicon Endo-Surgery, Inc. Closed feedback control for electrosurgical device
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US6328703B1 (en) 1999-07-02 2001-12-11 Olympus Optical Co., Ltd. Ultrasonic treating apparatus
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