JPH11192232A - Ultrasonic operation tip and ultrasonic operation device with the same - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an ultrasonic operation tip with which an operation can be carried out efficiently with improved power to crush a crystalline lens nucleus and improved blocking of a suction hole. SOLUTION: This tip 6 for ultrasonic operations is attached at the top of the US handpiece which has an ultrasonic vibrator, and is to crush and emulsify a crystalline lens nucleus with ultrasonic vibration from the vibrator. The tip 6 has a small diameter part 61 and a large diameter part 60 which are formed almost uniformly in the axial direction and have different diameters each other. And a sucking pathway 6a whose inner diameter is uniform in the axial direction is formed inside the tip 6. Since the small diameter part 61 is thinner at the top edge surface, the tip can cut well, and the blocking ability of the tip can be improved as the top has a smaller diameter.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an ultrasonic surgical tip for crushing and emulsifying a lens clouded by a cataract by ultrasonic vibration and an ultrasonic surgical apparatus having the same.

[0002]

2. Description of the Related Art As an operation for cataract, a so-called ultrasonic emulsification suction method is known. The ultrasonic surgical device used for this operation is a ultrasonic oscillating handpiece having an ultrasonic vibrator (hereinafter referred to as a US handpiece). Is amplified and transmitted to crush and emulsify the nucleus of the lens.
This crushing tip is formed to have a uniform outer diameter of about 1.1 mm so as to enable surgery with a small incision of about 3 mm, and contains therein a crushed and emulsified nucleus together with a perfusate for aspiration. It is common to form a suction passage having such an inside diameter.

[0003]

However, the tip for crushing uses the amplified transmitted vibration and applies a shock to the lens nucleus at its tip to crush and emulsify the nucleus. Although it is necessary to maintain the strength, if the tip end is thick, the contact pressure tends to decrease and the sharpness tends to deteriorate.

In order to efficiently crush and emulsify the lens nucleus, it is desirable to improve the obstruction of the suction hole at the tip so that the nucleus is attracted to the tip of the tip by suction pressure.

The present invention has been made in view of the above-mentioned prior art, and provides an ultrasonic surgical tip and apparatus which can enhance the crushing power of a lens nucleus, improve the obstruction of a suction hole, and can perform an operation efficiently. Technical issues.

[0006]

Means for Solving the Problems In order to solve the above problems, the present invention is characterized by having the following configuration.

(1) A tubular ultrasonic surgical tip which is attached to a handpiece having an ultrasonic vibrator and crushes and emulsifies a lens nucleus by ultrasonic vibration from the vibrator, and is formed substantially uniformly in both axial directions. A tip region having a different outer diameter and a non-tip region connected to the tip region, wherein the outer diameter of the tip region is smaller than the outer diameter of the non-tip region.

(2) The ultrasonic surgical tip according to (1), characterized in that a suction passage having a substantially uniform inner diameter in the axial direction is formed inside the tip region and the non-tip region.

(3) In the ultrasonic surgical tip of (1), when a sleeve having a hollow portion for supplying a perfusate into the eye is covered, the tip region has a length that does not hang on the sleeve. It is characterized by having been formed.

(4) In the ultrasonic surgical tip according to (1), the diameter of the suction passage formed inside the distal end region is made smaller than the diameter of the suction passage formed inside the non-tip region, and the diameter of the suction passage is reduced. The thickness of the region is made thinner than that of the non-tip region.

(5) An ultrasonic surgical apparatus comprising the ultrasonic surgical tip according to any one of (1) to (4).

[0012]

An embodiment of the present invention will be described below with reference to the drawings. FIG. 1 is a diagram illustrating a schematic configuration of a surgical apparatus according to an embodiment.

Reference numeral 1 denotes a US handpiece held by an operator, and an ultrasonic vibrator 3 made of a piezoelectric element is held in a hollow portion inside the US handpiece. The vibrator 3 generates an ultrasonic vibration by the energy supplied from the driving device 30 via the conducting wire 4. Reference numeral 5 denotes a horn for amplifying the ultrasonic vibration generated by the vibrator 3, and the horn 5 and the vibrator 3 are integrally fixed by bolts and nuts.

At the tip of the horn 5, a tubular crushing tip 6 made of a titanium alloy for crushing and emulsifying the lens nucleus is provided.
Is fixed with screws. The tip 6 is covered with a tapered sleeve 7 made of silicon resin or the like.
Is attached to the tip of the US handpiece 1.
The sleeve 7 has an inner wall having a diameter larger than the outer diameter of the tip 6, and the perfusate is supplied to the tip through a gap secured by the inner wall and the tip 6. The perfusate is supplied to the perfusion device 32
And is sent into the sleeve 7 through the perfusion tube 9 connected to the perfusion passage 8 formed in the US handpiece 1. The perfusion device 32 can be configured so that, for example, the perfusion solution in the perfusion bottle suspended from the pole is sent out by controlling the opening and closing of the control valve. The details of the tips of the tip 6 and the sleeve 7 will be described later.

Suction passage 6a provided inside chip 6
Are suction passages 10 formed in the horn 5, the vibrator 3, and the like.
And the rear end of the suction passage 10 is connected to the suction tube 1.
Connected to 1. A suction pressure is applied to the suction tube 11 by a suction device 31 composed of a suction pump or the like, and the waste sucked from the tip of the chip 6 is discharged to a waste liquid bag crying.

Reference numeral 33 denotes a control device for controlling each device, to which an input section 34 having various operation switches and indicators and a foot switch 35 are connected. The control device 33 controls the operations of the driving device 30, the suction device 31, and the perfusion device 32 according to the setting signal from the input unit 34 and the signal of the stepping position of the foot switch 35.

Next, the shape of the tip of the chip 6 will be described with reference to FIG. FIG. 2A is a perspective view of the vicinity of the distal end portion in a state where the chip 6 is covered with the sleeve 7, and FIG. 2B is a cross-sectional view thereof. The sleeve 7 has a tapered shape, and an outflow hole 7a for supplying the perfusate delivered through the handpiece 1 into the eyeball is provided on both sides near the tip.
Is provided. The tip end face of the tip 6 is cut obliquely, and is usually used with the pointed side down during surgery (hereinafter, the up and down of the tip 6 refers to the state shown in FIG. 2). The tip end face of the tip 6 may not be cut diagonally. The suction passage 6 a inside the tip 6 is formed to have a substantially uniform inner diameter from the front end to the rear, and is connected to the suction passage 10 of the handpiece 1. On the outer side of the tip 6, a large-diameter portion 60 in the tip rear region covered with the sleeve 7 and a small-diameter portion 61 in the tip end region having a smaller diameter than that.
Are formed, and the thickness of the small-diameter portion 61 is smaller than that of the large-diameter portion 60. For example, for the chip 6 having a total length of about 20 mm, the inner diameter of the suction passage 6 a is 0.8 mm, the outer diameter of the large diameter section 60 is 1.1 mm, and the thickness of the large diameter section 60 is 0.15 mm. The outer diameter of the portion 61 is formed to be φ0.9 to 1.0 mm to make it thinner. The length of the small diameter portion 61 in the axial direction is about 0.7 to 0.8 mm from the top end of the tip 6 so as not to be caught on the sleeve 7 to be covered. Thus, the perfusate flowing through the gap secured between the tip 6 and the sleeve 7 is prevented from flowing out from the tip of the sleeve 7 and flows out from the outflow hole 7a.

The operation of the surgical apparatus having the above-described configuration according to the ultrasonic emulsification and suction method will be described. Before the operation is started, the sterilized sleeve 7 is attached to the handpiece 1 so that the small diameter portion 61 of the tip 6 projects. After incising the surgical eye, the distal end of the sleeve 7 and the tip 6 are inserted from the incision.

When the operator operates the foot switch 35,
The control unit 33 supplies the perfusion solution by the perfusion device 32, applies the suction by the suction device 31, and supplies the US by the driving device 30 by the signal input corresponding to the position of the foot switch 35.
Each operation of the handpiece 1 is controlled. When the vibrator 3 is driven under the control of the driving device 30, ultrasonic vibration is generated and the tip 6 vibrates in the axial direction, and the tip 6 applies a shock to the lens nucleus at its tip to crush and emulsify the nucleus. The crushed and emulsified nucleus is sucked through the suction hole at the tip by applying suction pressure, and is discharged outside the body.

At the time of such an operation, the tip end surface of the tip 6 is formed thin by the small diameter portion 61, so that the contact pressure with the nucleus is increased and the cut is good, and the crushing force is increased to efficiently crush the nucleus. Can be emulsified. In addition, a small operation can be performed by reducing the diameter of the distal end, and the operation in the eye can be easily performed. At the time of crushing and emulsifying the divided nuclei, the nuclei are crushed by attracting the nuclei to the tip of the chip 6 by suction pressure. In addition, as shown in FIG. 2B, depending on the shape of the nucleus 100, if the diameter of the tip is large, a gap between the nucleus 100 and the suction hole at the tip is likely to be formed.
Although the attraction of 0 becomes weaker, the smaller diameter of the tip improves the obstruction, so that the nucleus can be crushed while being attracted to the suction hole. Since the perfusion solution is supplied into the eye through the outflow hole 7a on the side surface while suppressing the outflow from the tip of the sleeve 7, it is favorable even when attracting the nucleus.

Next, a modified example of the shape of the chip 6 will be described with reference to FIG. FIG. 3 shows an axial cross-sectional shape near the tip of a tip 65 which is a modified example. The outer outer diameter of the tip 65 is a large diameter portion 66 in the tip rear region covered with the sleeve 7 and a small diameter portion 67 in the tip end region having a smaller diameter.
The diameter of the large diameter portion 66 is the same as that of the above-described embodiment, and the outer diameter of the small diameter portion 67 is further reduced. The suction passage formed inside the tip 65 has a substantially uniform inner diameter from the front end to the rear in the previous embodiment, whereas the suction passage 68b inside the small diameter portion 67 has a larger diameter. The diameter of the small-diameter portion 67 is smaller than that of the large-diameter portion 66.

For example, the outer diameter of the large-diameter portion 66 is φ1.1 mm as in the previous example, the inner diameter of the suction passage 68a is φ0.8 mm in the same manner as in the previous example, and the wall thickness is 0.15 mm. On the other hand, the outer diameter of the small diameter portion 67 is φ0.8 mm and the diameter of the suction passage 68 b is 0.7 mm, which is smaller than the thickness of the large diameter portion 66.

The tip 65 having such a shape also has a high crushing force because the tip is formed to be thin similarly to the previous embodiment, and the small diameter of the tip improves operability and closes the suction hole. Is improved. In addition, by making the suction hole, which is the tip of the suction passage 68b, thin, the efficiency of suction is slightly reduced, but since the anterior chamber holding is improved by restricting the suction flow rate, a higher suction pressure can be applied. it can. Also, clogging of the crushed and emulsified lens nucleus inside the chip can be easily prevented. Further, by applying high suction, it is possible to easily suction a relatively soft peripheral part (Epi-Nucleous) with respect to the central part of the nucleus.

[0024]

As described above, according to the present invention,
The crushing force can be increased, the obstruction of the suction hole is improved, and the operation can be performed efficiently. In addition, the operability in the eye is improved.

[Brief description of the drawings]

FIG. 1 is a diagram showing a schematic configuration of a surgical apparatus according to an embodiment.

FIG. 2 is a diagram illustrating the shape of the tip of a tip.

FIG. 3 is a diagram showing an example of a change in the shape of the tip of the tip.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 US handpiece 3 Oscillator 6 Crushing tip 7 Sleeve 6a Suction passage 60 Large diameter part 61 Small diameter part

Claims (5)

[Claims] 1. A tubular ultrasonic surgical tip which is attached to a handpiece having an ultrasonic vibrator and crushes and emulsifies a lens nucleus by ultrasonic vibration from said vibrator, and is formed substantially uniformly in both axial directions. An ultrasonic surgical tip comprising: a tip region having a different outer diameter; and a non-tip region connected to the tip region, wherein the outer diameter of the tip region is smaller than the outer diameter of the non-tip region. 2. The ultrasonic surgical tip according to claim 1, wherein a suction passage having a substantially uniform inner diameter is formed in the axial direction inside the distal end region and the non-tip end region. . 3. The ultrasonic surgical tip according to claim 1, wherein when the sleeve having a hollow portion for supplying a perfusate into the eye is covered, the tip region is formed so as not to be caught by the sleeve. An ultrasonic surgical tip characterized by the following. 4. The ultrasonic surgical tip according to claim 1, wherein a diameter of a suction passage formed inside the distal end region is smaller than a diameter of a suction passage formed inside the non-tip region and the distal end region. Wherein the thickness of the tip is smaller than that of the non-tip region. 5. An ultrasonic surgical apparatus comprising the ultrasonic surgical tip according to claim 1.