WO2003045468A1 - Piece a main pour la liposuccion assistee par ultrasons - Google Patents

Piece a main pour la liposuccion assistee par ultrasons Download PDF

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Publication number
WO2003045468A1
WO2003045468A1 PCT/EP2002/013502 EP0213502W WO03045468A1 WO 2003045468 A1 WO2003045468 A1 WO 2003045468A1 EP 0213502 W EP0213502 W EP 0213502W WO 03045468 A1 WO03045468 A1 WO 03045468A1
Authority
WO
WIPO (PCT)
Prior art keywords
handpiece according
section
pocket
cannula
handpiece
Prior art date
Application number
PCT/EP2002/013502
Other languages
German (de)
English (en)
Inventor
Zuzana Frank
Vladimir N. Khmelev
Michael Zisser
Original Assignee
Tometric Ag Scweiz
Priority date (The priority date 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 date listed.)
Filing date
Publication date
Application filed by Tometric Ag Scweiz filed Critical Tometric Ag Scweiz
Priority to AU2002352184A priority Critical patent/AU2002352184A1/en
Publication of WO2003045468A1 publication Critical patent/WO2003045468A1/fr

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
    • A61B2017/32007—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with suction or vacuum means
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
    • A61B2017/320072—Working tips with special features, e.g. extending parts
    • A61B2017/320078—Tissue manipulating surface
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
    • A61B2017/320084—Irrigation sleeves
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2202/00—Special media to be introduced, removed or treated
    • A61M2202/08—Lipoids

Definitions

  • the invention relates to a handpiece for ultrasound-controlled liposuction with a cannula coupled to an ultrasound generator, which one
  • Ultrasonic generator facing proximal section and a distal section.
  • Liposuction methods have been developed in recent decades with which subcutaneous fat can be suctioned off, which has accumulated in certain regions of the body, for example on the hip or on the thighs, and which does not respond or does not respond well to diets or physical training.
  • a cannula is inserted into the adipose tissue through an incision through the skin with one hand of the surgeon continuously moved back and forth while a negative pressure is applied to the cannula.
  • the reciprocating movement of the cannula loosens parts of the adipose tissue and sucks it off through the cannula by means of the negative pressure, so that tubular cavities are created within the adipose tissue, the shape of which the surgeon has to continuously check with the other hand, while with one hand the The cannula is moved through the adipose tissue to balance the structures.
  • This liposuction procedure has a number of disadvantages in that the continued movement of the cannula through the adipose tissue can injure other body tissues or damage blood vessels.
  • this liposuction procedure is physically very demanding for the surgeon, and this effort must be maintained over a long period of time in order to achieve averaging with regard to the formation of the tubular cavities by a large number of cannula movements, so as to give the cotton-like structure of the remaining adipose tissue to avoid under the skin.
  • ultrasound-controlled liposuction in which ultrasound is generated by means of an ultrasound generator, which facilitates the movement of the cannula through the fatty tissue, since the ultrasound accelerates and shreds the fat in the direction of the longitudinal axis of the cannula dispersed in the rinsing solution, whereby the heating of the fat also supports the dispersion and its subsequent suction.
  • This light, gentle suction in conjunction with the fat liquefaction helps to avoid a shear effect and thus reduces damage to neighboring structures such as connective tissue, lymphatic and blood vessels.
  • ultrasound-controlled liposuction therefore results in less postoperative swelling and hematoma.
  • the invention has for its object to design a handpiece of the type mentioned in such a way that undesired overheating of the fatty tissue can be avoided.
  • This design has the advantage that a larger area is available on the distal section in order to deliver the ultrasound power to the fatty tissue, with an increase in the area both on the end face of the distal section and in its circumferential direction when the cannula is used widens in its distal section from the proximal section to its free end.
  • the area given in the circumferential direction is inclined to the proximal section due to the expansion.
  • the inner circumferential surface of the pocket extends inclined to the longitudinal axis of the cannula with the circumference growing towards the free end of the distal section.
  • a focal effect occurs that concentrates the ultrasonic energy forward and generates the hydrodynamic flows particularly effectively.
  • the pocket is arranged on the end face of the distal section with an opening cross section which is larger than the cross section of the proximal section. This embodiment is characterized first of all by its symmetrical structure of the distal section, which in particular enables a uniform flow.
  • Radiation area given, from a surface that corresponds to the cross section of the distal portion at its free end to a surface that is given by the entire circumferential inner surface.
  • the inner surface of the distal section corresponds to the surface of a truncated cone.
  • the ultrasonic vibrations are focused at a distance from the free end of the distal section, so that a large part of the energy delivered can be distributed undisturbed by the cannula into the external medium.
  • the onset of hydrodynamic flow is particularly strongly directed forward and sweeps away the adipose tissue that is heated up. This also occurs
  • Flow component that is exactly opposite to the acoustic axis of the system, that is directed towards the pocket to replace the outflowing medium.
  • This shape gives the distal section the properties of a pump and sucks the liquid through the pocket into the cannula, so that it is advantageous if the pocket is connected to a suction channel formed in the cannula and is designed as a suction opening.
  • the inner circumferential surface is formed by a plurality of truncated cones arranged one behind the other, the inner angle of which becomes larger towards the free end.
  • two of the truncated cones are separated by a section of the inner circumferential surface of constant diameter.
  • the inner circumferential surface of the distal section corresponds to the surface of a hemisphere or a paraboloid.
  • the outer surface of the distal section corresponds to the surface of a truncated cone or a hemisphere or a paraboloid.
  • the shape of the outer surface is chosen so that it is as small as possible in relation to the enclosed volume in order to keep the loss of energy that is not emitted over the inner peripheral surface small, the shape of the outer surface being independent of the Choice of the shape of the inner surface is.
  • Truncated cone merges into a cylindrical surface, or that the outer surface of the distal section merges from the surface of an expanding truncated cone into a surface tapering towards the free end.
  • the end face of the distal section is preferably rounded.
  • the cannula preferably its distal section, is assigned a thermal sensor connected to an evaluation unit, which is formed by a Pt-100 element to save space and is part of a thermal safety system with which the temperature in the operating field can be precisely monitored ,
  • the opening angle of the bag is less than 90 ° and greater than 0 °, the choice of the optimal opening angle depending on the desired area of use, that is to say it can be varied depending on whether the cannula is to be used in relatively thick fatty tissue or rather in thin layers of fat, such as those found on the face or on the upper arms.
  • the opening angle correlates with the range of the resulting hydrodynamic flow, since the focus range also changes, which in turn
  • the inner angle of the outer surface of the distal section is less than 90 ° and greater than 0 °.
  • the distal section is detachably connected to the proximal section, since this gives the possibility that distal sections can be used which are adapted to the anatomical conditions of the desired area of application and which can be used with regard to the Shaping and the inner and outer surface as well as the
  • the pocket has rounded edges, so that, as a result, it is also ensured in this area that air molecules or cavitation bubbles do not adhere to the
  • Handpiece arranged the ultrasonic generator and connected to the cannula via an ultrasonic concentrator as a connecting element to the vibration system.
  • This embodiment is characterized by a particularly compact design, in which the transmission losses from the ultrasound generator via the cannula into the fatty tissue are minimized, since the transmission lengths can also be kept very short.
  • the inner peripheral surface of the pocket for focusing the ultrasonic energy inside the pocket and / or outside the pocket and / or in the plane of the End face (8) is shaped, with this design influencing the effect of the handpiece, which is rather soft with a focus inside, while a focus outside the cannula causes a hard cutting effect. It is possible, for example by axially staggering the shape of the inner circumferential surface, to combine several focal points with their typical effects.
  • FIG. 1 shows a longitudinal section through a schematically illustrated handpiece with attached cannula
  • FIG. 2 shows a longitudinal section through the distal section of a cannula in a further embodiment
  • FIG. 3 a representation corresponding to FIG. 2 of a further embodiment
  • FIG. 6 a representation corresponding to FIG. 2 of a further embodiment
  • FIG. 7 shows a representation corresponding to FIG. 2 of a further embodiment
  • Fig. 9 is a representation corresponding to FIG. 2 of a further embodiment.
  • Fig. 10 is a representation corresponding to Fig. 1
  • the handpiece 1 shown in FIG. 1 is intended for ultrasound-controlled liposuction and has an ultrasound generator arranged inside a housing of the handpiece 1, which is formed, for example, by a piezoelectric transmission motor in the usual manner and not shown in detail in the drawing
  • the handpiece 1 further consists of a cannula 2 connected to the ultrasound generator via an ultrasound concentrator as a connecting element to the vibration system, which has a proximal section 3 facing the ultrasound generator and a distal section 4
  • the cannula 2 widens in its distal section 4 from the proximal section 3 to its free end 5.
  • the distal section 4 also has a pocket 6, which in FIGS. 1-9 is connected to a suction channel 7 formed in the cannula 2 and is arranged on the end face 8 of the distal section 4.
  • the opening cross section of the pocket 6 is larger than the cross section of the substantially cylindrical proximal section 3 and corresponds to that in FIG
  • FIG. 1 shows the cross-section of the distal section 4 at its free end 5.
  • the end face 8 of the distal section 4 is rounded, to which a thermal sensor connected to an evaluation unit, in particular a Pt-100 element, is assigned.
  • a recess 12 is formed in the end face 8 of the distal section 4 from FIGS. 6 and 7 in the circumferential direction.
  • the inner circumferential surface 9 of the pocket 6 extends inclined to the longitudinal axis of the cannula 2 with the circumference growing towards the free end of the distal section 4.
  • the inner surface 9 of the distal section 4 is shaped in accordance with the surface of a truncated cone, but can also have the surface of a hemisphere (FIG. 8) or a paraboloid (FIG. 9). 4, several, namely two truncated cones are arranged one behind the other, the inside angle of which increases toward the free end. 5 shows an example in which two of the
  • Truncated cones are separated by a section of the inner circumferential surface of constant diameter.
  • the opening angle of the pocket 6 is less than 90 ° and greater than 0 °.
  • the outer surface 10 of the distal section 4 in the exemplary embodiments shown in FIGS. 1 and 2 is again shaped in accordance with the surface of a truncated cone, with an internal angle which lies in the interval between 0 ° and 90 °. 2, the outer surface merges with the free end of the distal section from the surface of a truncated cone into a cylindrical surface. 7 therefore shows that the outer surface of the distal section merges from the surface of an expanding truncated cone into a surface which tapers towards the free end.
  • the distal section 4 is detachably connected to the proximal section 3, so it can be replaced.
  • the cannula 2 is encased by a protective sheath 11, which consists of elastic material and is connected to a liquid reservoir via a liquid line.
  • the material for the protective cover 11 is selected so that it has a large positive coefficient of thermal expansion at the operating temperature, that is to say approximately at the body temperature of a person.
  • Conduit channels for the liquid are formed in the inner surface of the protective sheath 11 and / or in the outer surface of the cannula 2, the cross section of the conduit channels being matched to the required delivery rate. In order to achieve an extension of the conduit channels at the given length of the cannula, these are in one Helix around the longitudinal axis of the cannula 2 out.
  • the protective sheath 11 is detachably connected to the cannula 2 and consists of a material with properties similar to latex, with Teflon or, with regard to latex allergies to possible patients, latex-free material, known under the name Lastrokran, being known as further suitable materials.
  • the cannula 2 itself can also be formed from flexible glass fibers, as are known from endoscopes.
  • Fig. 10 shows an embodiment in which a blind hole connected to the liquid reservoir is formed in the cannula as part of the thermal security system.
  • the ultrasound generator arranged in the handpiece 1 is generally connected to an external energy source, while the suction channel 7 leading to the pocket 6 leads to a storage vessel in the cannula 2.
  • the protective cover 11 is connected to the liquid reservoir, and a saline solution can be used as the liquid, for example, which is supplied to the protective cover 11 by a pump.
  • the cannula 2 of the handpiece 1 can be inserted into the subcutaneous fat tissue into which the saline solution can be flushed in by the pump. Subsequently or simultaneously, it is possible to dispense and melt the adipose tissue by introducing ultrasound, due to the shape of the distal section 4 Hydrodynamic flows are generated, which flow on the one hand from the end face 8 and the inner surface 9 of the distal section 4, on the other hand from the outer surface 10 directed towards the proximal section 3 from the cannula 2 and a large-scale dissipation of the

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  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Mechanical Engineering (AREA)
  • Biomedical Technology (AREA)
  • Dentistry (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Abstract

L'invention concerne une pièce à main pour la lipossuccion assistée par ultrasons, dotée d'une canule (2) couplée à un générateur d'ultrasons, ladite canule présentant une partie proximale (3) tournée vers le générateur d'ultrasons ainsi qu'une partie distale (4). Une poche (6) est formée dans l'extrémité libre de la partie distale (4) pour mettre à disposition une surface périphérique intérieure (9).
PCT/EP2002/013502 2001-11-30 2002-11-29 Piece a main pour la liposuccion assistee par ultrasons WO2003045468A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
AU2002352184A AU2002352184A1 (en) 2001-11-30 2002-11-29 Handpiece for liposuction driven by ultrasound

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE10158725A DE10158725A1 (de) 2001-11-30 2001-11-30 Handstück für die ultraschallgesteuerte Fettabsaugung
DE10158725.2 2001-11-30

Publications (1)

Publication Number Publication Date
WO2003045468A1 true WO2003045468A1 (fr) 2003-06-05

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ID=7707477

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/EP2002/013502 WO2003045468A1 (fr) 2001-11-30 2002-11-29 Piece a main pour la liposuccion assistee par ultrasons

Country Status (3)

Country Link
AU (1) AU2002352184A1 (fr)
DE (1) DE10158725A1 (fr)
WO (1) WO2003045468A1 (fr)

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE10352296A1 (de) * 2003-11-08 2005-06-16 Klein, Rainer, Dr. Endstück und Verfahren für die Vakuumabsaugung von partikelbeladenen Flüssigkeiten
WO2015077115A1 (fr) * 2013-11-20 2015-05-28 Ethicon Endo-Surgery, Inc. Instrument chirurgical ultrasonore comprenant des composants permettant de former des bulles pour augmenter la cavitation

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5255669A (en) * 1989-04-12 1993-10-26 Olympus Optical Co., Ltd. Ultrasonic treatment apparatus
WO1999044515A1 (fr) * 1998-03-02 1999-09-10 Mentor Corporation Sonde de liposuccion a ultrasons
DE20113290U1 (de) * 2001-08-09 2002-01-17 Zisser Michael Gekühltes Handstück zur ultraschallgesteuerten Fettabsaugung

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5255669A (en) * 1989-04-12 1993-10-26 Olympus Optical Co., Ltd. Ultrasonic treatment apparatus
WO1999044515A1 (fr) * 1998-03-02 1999-09-10 Mentor Corporation Sonde de liposuccion a ultrasons
DE20113290U1 (de) * 2001-08-09 2002-01-17 Zisser Michael Gekühltes Handstück zur ultraschallgesteuerten Fettabsaugung

Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE10352296A1 (de) * 2003-11-08 2005-06-16 Klein, Rainer, Dr. Endstück und Verfahren für die Vakuumabsaugung von partikelbeladenen Flüssigkeiten
DE10352296B4 (de) * 2003-11-08 2012-11-15 Rainer Klein Endstück und Verfahren für die Vakuumabsaugung von partikelbeladenen Flüssigkeiten
WO2015077115A1 (fr) * 2013-11-20 2015-05-28 Ethicon Endo-Surgery, Inc. Instrument chirurgical ultrasonore comprenant des composants permettant de former des bulles pour augmenter la cavitation
US9763688B2 (en) 2013-11-20 2017-09-19 Ethicon Llc Ultrasonic surgical instrument with features for forming bubbles to enhance cavitation
US10639058B2 (en) 2013-11-20 2020-05-05 Ethicon Llc Ultrasonic surgical instrument with features for forming bubbles to enhance cavitation

Also Published As

Publication number Publication date
DE10158725A1 (de) 2003-06-12
AU2002352184A1 (en) 2003-06-10

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