JPS62176445A - Handpiece - Google Patents

Abstract

(57) [Summary] This bulletin contains application data before electronic filing, so abstract data is not recorded.

Description

[Detailed Description of the Invention] [Field of Industrial Application] Ultrasonic scalpels that convert high-frequency current into ultrasonic vibrations, transmit and amplify them to a horn that serves as a scalpel at the tip of a handpiece, and crush living tissue. At surgical sites where nerves and other tissues are concentrated, cells to be removed can be crushed, aspirated, and removed without damaging them, and many of them are also equipped with an irrigation mechanism, allowing tissue pieces to be removed with physiological saline. It can also be suctioned and removed.

The present invention relates to an ultrasonic scalpel handpiece suitable for deep in-vivo surgery such as microsurgery.

[Prior art]

Surgical tools that utilize the ability to cut or crush living tissue using ultrasonic waves include tools for cutting bones and joints in the orthopedic and general surgery fields, cataract surgical tools in the ophthalmology field, and ultrasonic tools for removing tartar in the dental field. Sonic surgical instruments and the like have been put into practical use. These ultrasonic surgical tools generally do not exhibit the amplitude and power of ultrasonic vibration that are sufficient to crush tissue over a wide range, and are used as specialized surgical tools for extremely limited surgical procedures. It is something.

The present inventors first discovered a circuit for an ultrasonic scalpel, a horn serving as a scalpel part, and a circuit for an ultrasonic scalpel capable of generating the amplitude and noise of ultrasonic vibration capable of exerting sufficient tissue crushing ability in the field over a wide range of living tissues.
Invented an ultrasonic scalpel consisting of a system for cleaning the area around the surgical site, emulsifying crushed cell debris, and suctioning and removing the emulsified cell debris (Japanese Patent Application Laid-Open No. 58-580
Publication No. 34).

In addition, when the surgical site is relatively close to the body surface or when the surgical method is used with a wide surgical range, it is possible to proceed with the surgery effectively without any hindrance, but if the surgical site is deep within the body. In order to improve the problem that, in cases where the operative scale is extremely narrow, a difficult surgery is required, which takes a long time and hinders the ability to perform an appropriate and accurate surgery, As shown in , the front plate αη connected to the vibrator (Is
A handpiece was developed in which a joint (5) having a length corresponding to an integral multiple of the beam wavelength was provided between a horn (6) serving as a female part and disclosed in Japanese Patent Application No. 59-93028.

However, with the progress and sophistication of medical technology and the expansion of its scope of application, there is a need for surgical tools that are easier to use. On the other hand, there are technical constraints in making the entire surgical tool thinner, and
Making only the joint and horn thinner had problems in terms of mechanical strength and related safety.

[Purpose of the invention]

The present invention aims to solve the current problems of surgical tools that utilize ultrasonic vibrations, that is, ultrasonic scalpels. By doing so, we aim to provide a handpiece for an ultrasonic scalpel that can be used even in cases where the surgical target area is deep within the body and the surgical instrument is extremely narrow, and which has excellent mechanical strength and safety. It is something to do.

[Structure of the invention]

That is, the present invention provides an ultrasonic scalpel handpiece having a joint having a length corresponding to an integral multiple of the wavelength of ultrasonic vibration between a front plate connected to an ultrasonic vibrator and a horn. or more joints are connected,
This handpiece is characterized in that a step or an aperture is provided at a position corresponding to the wavelength range from the end of one or more of the joints.

Hereinafter, a detailed explanation will be given with reference to the drawings.

FIG. 1 is an overall view showing an embodiment of the handpiece for ultrasonic scalpel according to the present invention, and FIG. 2 is a diagram showing the internal structure and vibration characteristics of the handpiece according to the present invention shown in FIG. .

The basic structure of this handpiece is the same as that previously disclosed by the inventors in Japanese Patent Application No. 59-93028, and includes a cable (1) connected to the ultrasonic female part, a connector (2), Grip 9 parts (3), protection tube (4), joint (
5), a horn (6) which is an ultrasonic scalpel part, an irrigation A-bu (7) that supplies physiological saline etc. to the surgical site, a holder that fixes this irrigation nozzle close to the horn (6); It consists of a suction nozzle (8) for suctioning and removing liquid substances, etc. from the surgical site. The connecting pipe (9) is a /ξ iso which mechanically connects the grip portion (3) and the protective tube (4) with a screw or the like. Grip part (3),
The connecting tube (9) and the protective tube (4) are made of a light and corrosion-resistant metal such as aluminum or duralumin, or a synthetic resin, so that they can be easily and conveniently handled by the operator. The joint (5) and the horn (6) serving as the ultrasonic scalpel are made of materials such as ultra-super duralumin and titanium alloy, which have good transmission of high-frequency mechanical vibrations and are resistant to breakage. ) and the horn (6) include a suction hole (C) for suctioning and removing blood generated at the surgical site, physiological saline for washing, cell debris crushed by the horn (6), etc. (to) is provided, and this suction hole (to) is connected to the suction nozzle (8) via a screw joint aυ connected in an appropriate manner to the outside of the protective tube (4).

Next, the internal structure, vibration characteristics, etc. of this handpiece will be explained. A backing plate ae and a front plate αη made of a high-tensile metal material such as guralumin or high-tensile aluminum alloy are provided before and after the vibrator α9 (left and right in FIG. 2) made of an electrostrictive type vibrator or a magnetostrictive type vibrator, Backing plate αQ1 oscillator α
9 and the front plate αη are tightly connected and fixed to each other by bolts made of a high-tensile metal material (not shown). It is desirable to connect the joint (5) and the front plate aη with a set screw made of high-tensile metal material, such as set screw α camphor, and to connect the joint (5) and the horn (6) with a set screw, or with a set screw. The joint (5) side is female threaded, and the horn (
6) side is male threaded, or joint (5) side is male threaded,
A screw connection may be used in which the horn (6) side has either a female thread.

The magnitude of the amplitude at the tip of the horn (6), which is one of the characteristics of the ultrasonic scalpel, is determined by the ratio of the cross-sectional area of the left end of the joint (5) (11) and the cross-sectional area of the tip of the horn (6). Since it is roughly inversely proportional to the area to be treated, the degree of surgery, etc., horn shapes with various amplitudes can be obtained by changing this cross-sectional area. ) may be a stepped shape as shown in FIG. 3, or may be a stepped shape as shown in FIG.
, (c) to d). In conventional handpieces for ultrasonic scalpels, only one step or constriction is provided in a part of the horn near the tip, reducing the cross-sectional area and making the entire body thinner in order to obtain a large amplitude at the tip. In addition, if only one step or aperture is provided near the front plate aD, stress tends to concentrate there, or the joint (5) or horn (6)
) There was a risk of metal fatigue and damage. Therefore, in the present invention, in addition to the horn (6), one or more steps or constrictions are provided at the joint part to reduce the cross-sectional area in several stages. There is no risk of damage due to metal fatigue, and the front half of the handpiece can be made thinner than conventional handpieces.

The relationship between the frequency f of the ultrasonic wave (C1) at which the ultrasonic wave passes through the transmission medium and the wavelength λ of the ultrasonic wave is expressed as λ=c/f. In a metal material, the wavelength λ is determined by the sound speed of the ultrasonic wave transmitted at a predetermined frequency f, so the length of the joint (5) is at the station of this wavelength λ, that is, a length corresponding to an integral multiple of a half wavelength. It is necessary to take it seriously. Furthermore, the step or aperture starts at a position corresponding to the length of the wavelength λ, and the diameter on the tip side is narrower than the starting point of the step or aperture. The amplitude is expanded. Furthermore, in the case of an aperture, the length of the joint (5) is slightly longer than an integral multiple of 1/2 wavelength compared to the case of a step. This is caused by the characteristics of high-speed vibration transmission at the diaphragm 9 portion.

In addition, when providing two or more steps or apertures in the joint part, connect multiple joints with a length corresponding to an integral multiple of the working wavelength using set screws, etc., and connect 1/4 from the end of the joint. A step or aperture is provided at a position corresponding to the length of the wavelength.

The graph of the vibration characteristics of the handpiece shown in Figure 2 is a join of the length corresponding to the glaze wavelength) (using 511 pieces,
This shows an example in which a diaphragm Q4 is provided in the center. This graph shows the vibration noturns in the axial direction of each part inside the handpiece, the axial center of the vibrator α3, and the aperture curve of the 1/2 wavelength center of the joint (5).
The amplitude is zero near the center of the horn (6), and the amplitude becomes zero near the diaphragm start point (c) of the horn (6), and the amplitude is zero near the diaphragm of the horn (6). Between the shank Q4 and the choking start part (c) of the horn (6), an arc shape is formed with peaks near the α barrel of the set screw and the joint (end), respectively. Also, between the left end ■ of the backing plate αG and the camera element a9, and between the aperture start part (to) and the tip part (5) of the horn (6), the left end ■ of the backing plate αe and the horn ( 6) It becomes a half-arc shape with maximum amplitude at the tip slope. and,
The amplitude near the joint (to) is larger than the amplitude near the set screw αυ, and the amplitude at the tip (5) is even larger. The amplitude is expanded by steps or diaphragms such as the pick, the diaphragm (goods), and the choking start (c), and the amplitude gradually increases toward the tip of the handpiece.

The tip of the horn (6), which is one of the features of the ultrasonic scalpel (
The amplitude of 2) is approximately inversely proportional to the ratio of the cross-sectional area of the root of the joint (5) to the cross-sectional area of the tip (2) of the horn (6), so it may vary depending on the area to be treated, the degree of surgery, etc. By changing this cross-sectional area, and by changing the step or aperture at the center of the wavelength length, horn shapes with various amplitudes can be obtained.

The joint according to the present invention may be straight or bent through the joint as shown in FIGS. 1 and 2. In addition, if the joint part is composed of two or more joints, one (11t) or two or more of them may be bent so that the joint part as a whole forms an appropriate angle. good.

The degree of this bending can be changed depending on the treatment target area and the operator's preference, and the angle is 0 to 60 degrees, preferably 0 to 20 degrees.
It is better to take it as a degree.

It is desirable that the irrigation chisel (7) of the handpiece according to the present invention to which the joint (5) is connected is extended and opened to the vicinity of the tip of the horn (6), and this irrigation chisel (7) is Along the axial direction of the handpiece, insert the slot stopper α, ζ joint I.
, to be fixed by holding personnel. A suction system in the handpiece penetrates through the horn (6) to aspirate and remove blood generated at the surgical site, physiological saline for washing, cell debris crushed by the horn (6), etc. Suction hole drilled to the appropriate position of suction hole (2) and joint (5)■
I'll do it at The connection between the suction hole (end) in this joint and the suction nozzle (8) is made by an appropriate method at the αυ portion of the joint.

〔Effect of the invention〕

The handpiece for an ultrasonic scalpel of the present invention has a thinner front half compared to conventional ones, so even when the surgical target area is deep inside the body and the surgical meter is extremely narrow, the scalpel can be used easily. The horn can be inserted deep into the living body, and even in the case of surgical techniques such as microsurgery, the surgery can proceed without disturbing the surgical instrument, so it is possible to perform appropriately qualified surgeries in a short time without any problems, and To provide an excellent surgical device that is safe and has no risk of breakage during use because stress is not concentrated on a part of the joint or horn, and that can fully demonstrate the original function of an ultrasonic scalpel. I can do it.

[Brief explanation of drawings]

Fig. 1 is an overall view showing an embodiment of the handpiece for ultrasonic scalpel according to the present invention, Fig. 2 is a view showing the internal structure and vibration characteristics of Fig. 1, and Fig. 3 is a diagram showing the joint) K of the present invention. The level difference 9 provided is a diagram showing the shape of the diaphragm. In addition, Fig. 4 is an overall view showing a conventional handpiece for ultrasonic scalpels, and Fig.
The figure is a diagram showing the internal structure of FIG. 4.

Claims (4)

[Claims] (1) Between the front plate connected to the ultrasonic vibrator and the horn,
In a handpiece for an ultrasonic scalpel having a joint with a length corresponding to an integral multiple of 1/2 wavelength of ultrasonic vibration, 1
or 2 or more joints are connected, and 1/4 from the end of one or more of the joints.
A handpiece characterized by having a step or an aperture at a position corresponding to the length of the wavelength. (2) One or more of the one or more joints constituting the joint part is bent,
2. The handpiece according to claim 1, wherein the joint portion is bent at an angle of 0 to 60 degrees as a whole. (3) The handpiece according to any one of claims 1 and 2, characterized in that a suction hole is provided through the entire length of the horn and an appropriate position within the joint. (4) Claims 1 and 2, characterized in that an irrigation pipe that opens near the tip of the horn is attached along the axial direction of the handpiece.
The handpiece according to any of paragraph 3.