Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B17/00—Surgical instruments, devices or methods
  • 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
  • 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
  • A61B17/32—Surgical cutting instruments
  • A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
  • A61B2017/320082—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic for incising tissue
• • Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
  • Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
  • Y10S—TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
  • Y10S310/00—Electrical generator or motor structure
  • Y10S310/80—Piezoelectric polymers, e.g. PVDF
• • Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
  • Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
  • Y10S—TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
  • Y10S82/00—Turning
  • Y10S82/904—Vibrating method or tool

Definitions

• the present invention relates to an ultrasonic treatment apparatus used for coagulating and incising a living tissue in a surgical operation such as a surgical operation.
• an ultrasonic therapy apparatus is used as a means for coagulating and incising a living tissue.
• This ultrasonic therapy apparatus has an ultrasonic transducer that oscillates ultrasonic vibrations and an ultrasonic probe that constitutes a treatment section. Then, the ultrasonic vibration oscillated by the ultrasonic transducer is amplified and transmitted to the ultrasonic probe, and the living body tissue is coagulated / incised using the ultrasonic vibration.
• Ultrasonic transducers used in ultrasonic therapy devices include bolted Langevin type transducer structures (see, for example, US Pat. No. 6068647 (Patent Document 1)), magnetostriction, etc.
• a type vibrator structure (for example, see US Pat. No. 6,140,017 (Patent Document 2)) is known.
• the structure of the bolt-clamped Langevin type vibrator has a structure in which piezoelectric elements and electrodes are alternately laminated and the laminated body is fastened and arranged between a horn and a backing plate.
• the structure of the magnetostrictive vibrator has a configuration in which a magnetostrictive material is wound with a coil.
• electrostrictive polymers such as silicone resin and acrylic resin, which are electric field responsive polymer materials called dielectric elastomers, as candidates for artificial muscle materials.
• electrostrictive polymers such as silicone resin and acrylic resin, which are electric field responsive polymer materials called dielectric elastomers, as candidates for artificial muscle materials.
• An electrostrictive polymer has electrodes formed on both sides thereof as a thin film. Then, when a voltage is applied between the electrodes, one side is contracted and the other side is extended.
• an actuator using such an electrostrictive polymer the electrostrictive polymer expands and contracts to generate a desired driving force by periodically applying a voltage between the electrodes.
• Examples of the use of an actuator using such an electrostrictive polymer include artificial hands such as artificial hands such as artificial hands, artificial legs, haptics, and pumps that diagnose soft skin, blood, etc.
• Application to medical devices has been studied (for example, see Non-Patent Document 3 above).
• the distortion factor of a piezoelectric element or a magnetostrictive material used in an ultrasonic transducer generally used in the conventional ultrasonic therapy apparatus having the above-described conventional configuration is about 1%. Therefore, there is a problem that the ultrasonic transducer becomes large when the amplitude of the ultrasonic vibrator is increased to improve the treatment capability. For this reason, the above-described ultrasonic therapy apparatus is required to be reduced in size until it is inserted into a channel provided in an insertion portion of an endoscope and used for a desired treatment, which is required in the treatment using an endoscope. Difficult,
• an electrostrictive polymer can obtain a strain rate of 100%.
• an actuator using an electrostrictive polymer it is not necessary to realize downsizing until it is suitable for treatment.
• the present invention has been made in view of the above circumstances, and an object of the present invention is to provide an ultrasonic treatment apparatus having a simple configuration and capable of promoting miniaturization.
• An embodiment of one aspect of the present invention is an ultrasonic therapy apparatus including a treatment unit that treats a treatment site by ultrasonic vibration, and a drive unit that drives the treatment unit, wherein the drive unit includes: A first actuator body formed of an electrostrictive polymer; and at least a pair of electrodes disposed in a state of being separated from and insulated from the first actuator body; When a voltage is applied to the first actuator, the electrostrictive polymer is expanded and contracted, the second actuator body formed by the electrostrictive polymer, and the second actuator body are separated from each other. And at least a pair of electrodes arranged in an insulated state. When a voltage is applied between the electrodes, the electrostrictive polymer is expanded and contracted, and is connected to the treatment unit.
• a fixing member which is interposed between the serial first Akuchu eta and said second Akuchiyueta, the first and second When the actuator is driven, the electrostrictive polymer of one of the first and second actuators is contracted and the operation of extending and driving the other electrostrictive polymer is alternately and periodically repeated.
• the driving means includes the first actuator and a casing that houses the second actuator, and the first actuator and the second actuator include the casing. It is housed in a retractable way!
• the first actuator is a pair of a first actuator body formed of a cylindrical electrostrictive polymer and a pair of both ends of the cylindrical shape of the first actuator body.
• the second actuator includes a second actuator body formed of a cylindrical electrostrictive polymer, and the cylindrical outer peripheral surface and inner periphery of the second actuator body.
• a pair of electrodes respectively disposed on the surface, and the treatment section is inserted into the cylindrical inner space of the first actuator body of the first actuator body, the shaft
• the distal end portion has a distal end portion and a proximal end portion, and the distal end portion contacts the treatment site to treat the treatment site, and the fixing member is the first actuator of the first actuator.
• the first actuator includes a first positive electrode disposed on the cylindrical front end surface of the first actuator body, and a rear end of the cylindrical shape of the first actuator body.
• a first negative electrode disposed on an end surface and fixed in contact with the fixing member
• the second actuator is disposed on the cylindrical outer peripheral surface of the second actuator main body,
• a negative electrode, and the second positive electrode is electrically connected to the first positive electrode via a positive wiring
• the second negative electrode is fixed to the first negative electrode and the fixed electrode. Parts It is electrically connected via.
• the power supply means synchronously applies an AC voltage having a phase difference of 180 ° between the electrodes of the first actuator and between the electrodes of the second actuator.
• the first and second actuators have a laminated structure in which polymer films formed of electrostrictive polymers and a plurality of internal electrodes are alternately stacked.
• Another embodiment of the present invention has a distal end portion and a proximal end portion, an insertion portion that is inserted into a channel of an endoscope, and is disposed at the distal end portion of the insertion portion, A treatment unit that treats a treatment site by ultrasonic vibration and a drive unit that drives the treatment unit, and treats the treatment site by ultrasonic vibration of the treatment unit under observation by the endoscope
• An ultrasonic treatment apparatus wherein the insertion portion has a distal end portion and a proximal end portion, and has a flexible sheath, and the sheath has the treatment portion connected to the distal end portion.
• the sheath is provided with an operation portion for operating the treatment portion at the base end portion, and the driving means is provided on a first actuator body formed by electrostrictive polymer and the first actuator body. At least a pair of electrodes arranged in a state of being insulated from each other. And when a voltage is applied between the electrodes, the electrostrictive polymer is driven to extend and contract, and the second actuator main body formed by the electrostrictive polymer, the second actuator The actuator body includes at least a pair of electrodes disposed in a state of being insulated from each other, and when a voltage is applied between the electrodes, the electrostrictive polymer is driven to expand and contract.
• the treatment section It comprises a power supply means for vibrating the.
• the treatment portion has a cylindrical blade having a distal end portion and a proximal end portion, and the blade has a suction hole communicating with a lumen of the blade in the distal end portion.
• a suction tube having a proximal end and disposed inside the sheath; The distal end portion communicates with the inner cavity of the blade, and the proximal end portion extends outward from the operation portion and is connected to a suction pump.
• the treatment portion has a distal end portion and a proximal end portion, and has a cylindrical blade in which the driving means is built, a distal end portion and a proximal end portion, and the proximal end portion is the A tip cover member connected to the tip portion of the sheath, a forceps piece rotatably connected to the tip cover member and supported to be openable and closable with respect to the blade, and the forceps piece connected to the blade
• a forceps drive unit that opens and closes to the arm, a distal end portion and a proximal end portion, provided inside the sheath so as to be movable in the direction of the center line of the sheath, and an operation wire for operating the forceps drive portion;
• a handle that is provided in the operation unit, drives the forceps driving unit via the operation wire, and drives the forceps piece to open and close with respect to the blade;
• the blade is disposed in a cylindrical casing, a partition that is disposed inside the casing, and partitions the inner space of the casing into the front and the back, and the partition passes through the center of the casing.
• the tip cover member has a fixed shaft portion that is inserted into an inner portion of the casing and extends to the front end portion side of the casing through the through hole of the partition wall.
• the drive means includes: the first actuator and the second actuator are arranged to face each other with the partition wall sandwiched between the inner space of the casing; and the first and second actuators Assembly means for assembling the attachment to the fixed shaft portion and the tip cover member.
• FIG. 1 is a schematic configuration diagram of a main part showing a cross section of a part of an ultrasonic therapy apparatus according to a first embodiment of the present invention.
• FIG. 2A is a schematic configuration diagram of a main part shown for explaining the first and second actuators of the ultrasonic therapy apparatus according to the first embodiment.
• FIG. 2B shows the first actuator and the first actuator of the ultrasonic therapy apparatus according to the first embodiment.
• FIG. 3 is a schematic configuration diagram of a main part shown for explaining an operation principle of a second actuator.
• FIG. 3 is a diagram showing the relationship between the electric field E and strain of the actuator of FIG. 2B.
• FIG. 4 shows a first actuator and a second actuator of the ultrasonic therapy apparatus according to the first embodiment. It is the figure shown in order to demonstrate the expansion-contraction operation
• FIG. 5 is a characteristic diagram showing a state in which the ultrasonic therapy apparatus according to the first embodiment is attached to the insertion portion of the endoscope.
• FIG. 6 is an enlarged view showing a state where the blade, the first and second cases, and the sheath of the ultrasonic therapy apparatus according to the first embodiment are inserted into the channel of the insertion portion of the endoscope.
• FIG. 7A is a diagram showing an electrode structure of the first actuator in the first modification of the ultrasonic therapy apparatus according to the first embodiment.
• FIG. 7B is a diagram showing an electrode structure of the second actuator in the first modification of the ultrasonic therapy apparatus according to the first embodiment.
• FIG. 8 is a view showing an attachment configuration of the blade and the fixing member in the second modified example of the ultrasonic therapy apparatus according to the first embodiment.
• FIG. 9 is a diagram showing a schematic configuration of a third modification of the ultrasonic therapy apparatus according to the first embodiment.
• FIG. 10 is an explanatory diagram for explaining the voltage application state of the first actuator and the voltage application state of the second actuator according to the third modification.
• FIG. 11A is an explanatory diagram showing an initial state of the first and second actuators of the third modification.
• FIG. 11B is an explanatory diagram showing a state in which the first actuator of the third modification is driven to contract and the second actuator is driven to extend.
• FIG. 11C is an explanatory view showing a state in which the first actuator of the third modification is driven to extend and the second actuator is driven to contract.
• FIG. 12 is a diagram showing the electrode structures of the first and second actuators in the fourth modification of the ultrasonic therapy apparatus according to the first embodiment.
• FIG. 13 is a diagram showing an ultrasonic therapy apparatus according to a second embodiment of the present invention.
• FIG. 14 is a view showing a cross section of an essential part of an ultrasonic therapy apparatus according to a second embodiment in the axial direction.
• FIG. 15 is a diagram showing an ultrasonic therapy apparatus according to a third embodiment of the present invention.
• FIG. 16 is a cross-sectional view of the main part of the ultrasonic therapy apparatus according to the third embodiment.
• Fig. 17 is an exploded view of the main part of the ultrasonic therapy apparatus according to the third embodiment.
• FIG. 18A is an explanatory diagram showing an initial state of the actuator of the ultrasonic therapy apparatus according to the third embodiment.
• FIG. 18B is an explanatory diagram showing a state in which the first actuator of the ultrasonic therapy apparatus according to the third embodiment is driven to contract and the second actuator is driven to extend.
• FIG. 18C is an explanatory view showing a state where the first actuator of the ultrasonic therapy apparatus according to the third embodiment is driven to extend and the second actuator is driven to contract.
• FIG. 1 shows a schematic configuration of a main part of an ultrasonic therapy apparatus 1 used in combination with an endoscope 401 (see FIG. 5).
• FIG. 5 shows a schematic configuration of the endoscope 401.
• the endoscope 401 includes an elongated insertion portion 402 that is inserted into the body, and an operation portion 403 that is coupled to the proximal end portion of the insertion portion 402.
• the insertion portion 402 includes an elongated flexible tube portion 404, a curved portion 405 having a proximal end portion coupled to the distal end portion of the flexible tube portion 404, and a proximal end portion coupled to the distal end portion of the curved portion 405. And a hard tip portion 406.
• the bending portion 405 can be bent into a curved shape even with a normal straight state force that extends straight. As shown in FIG.
• an illumination lens of an illumination optical system (not shown), an objective lens 407 of an observation optical system, a distal end opening 408a of a treatment instrument tunable channel 408, and an illustration No air / water nozzles are provided.
• An imaging element 409 such as a CCD and its connection circuit board are fixed to the distal end rigid portion 406 behind the objective lens 407.
• the distal end portion of an image guide fiber (not shown) may be fixed, and the endoscope 401 is not limited to an electronic scope but may be a single fiber scope.
• the distal rigid portion 406 includes a distal end portion of the treatment instrument passing channel 408, an air supply tube connected to an air supply / water supply nozzle, and a distal end of the water supply tube. Parts are fixed.
• the operation unit 403 is provided with a grip portion 410 that is held by an operator.
• a base end portion of the universal cord 411 is connected to the grip portion 410.
• a connector portion connected to a light source device, a video processor or the like (not shown) is coupled to the distal end portion of the universal cord 411.
• the operation section 403 includes a bending operation knob 412 for bending the bending section 405, a suction button, an air supply / water supply button, various switches for endoscopic photography, and a treatment instrument insertion.
• No. 4 and 13 are provided.
• the treatment instrument insertion base 413 is provided with a treatment instrument insertion inlet 413 a connected to the proximal end portion of the treatment instrument insertion channel 408 disposed in the insertion section 402.
• the ultrasonic treatment apparatus 1 according to the present embodiment, which is a treatment tool for an endoscope, is inserted into the treatment tool insertion channel 408 from the treatment tool fist inlet 413a of the endoscope 401 to the distal end rigid portion 406 side. After the push-in operation, the distal end of the treatment instrument piercing channel 408 is projected to the outside from the opening 408a.
• the ultrasonic therapy apparatus 1 includes a sheath 24 such as a closed coil having elongate flexibility, and a treatment operation section 25 connected to a proximal end portion of the sheath 24.
• the distal treatment section 2 is connected to the distal end portion of the sheath 24 via a connecting tube 23.
• the distal treatment section 2 is provided with a blade 15 that is a treatment section for performing a treatment such as incision and hemostasis of a living tissue, and a drive unit 3 that ultrasonically vibrates the blade 15.
• the drive unit 3 includes a casing 12, a blade fixing member 14, and first and second actuators 10 and 11.
• the casing 12 has a first case 13a disposed on the front side and a second case 13b on the rear side assembled in a state of being inserted into the first case 13a.
• the first case 13a is formed of a cylindrical body.
• the front surface of the first case 13a is closed by the front plate 13al.
• a blade through hole 13a2 is formed in the center of the front plate 13al.
• the distal end portion of the connecting tube 23 at the distal end portion of the sheath 24 is connected to the rear end portion of the first case 13a via a screw portion.
• the second case 13b is formed of a cylindrical body.
• the rear surface of the second case 13b is closed by the rear plate 13bl.
• the rear plate 13bl has two metal plates for wiring.
• the through holes 131a and 131b are formed.
• the blade 15 is formed integrally with the blade fixing member 14, for example.
• the blade 15 is projected forward from the blade through hole 13a2 of the first case 13a.
• the blade fixing member 14 is made of a conductive metal material.
• the blade fixing member 14 is housed in the first and second cases 13a and 13b together with the first and second actuators 10 and 11.
• the first and second actuators 10 and 11 are disposed opposite to each other with the blade fixing member 14 as a conductive member sandwiched between the first and second cases 13a and 13b.
• first and second cases 13a, 13b are formed of a metal material, for example, an insulating tube 16 is coated on the outer peripheral portion of the blade 15 to insulate the first case 13a. Is held in a state where is kept.
• the first and second actuators 10, 11 are each formed by an electrostrictive polymer actuator constituting an ultrasonic transducer.
• a flexible plus electrode 102 and a minus electrode 103 having elasticity are separately attached to both end faces of a cylindrical electrostrictive polymer 101.
• the positive electrode 102 is disposed on the front end surface of the electrostrictive polymer 101 in contact with the first case 13a
• the negative electrode 103 is disposed on the rear end surface of the electrostrictive polymer 101 in contact with the blade fixing member 14.
• the insulation ring 17 is interposed between the positive electrode 102 and the first case 13a, so that the insulation with the first case 13a is maintained.
• a blade 15 is passed through the inner space of the cylinder of the electrostrictive polymer 101 of the first actuator 10.
• a flexible plus electrode 112 and a minus electrode 113 having elasticity are separately attached to an outer peripheral surface and an inner peripheral surface of a cylindrical electrostrictive polymer 111.
• the positive electrode 112 is disposed on the outer peripheral surface of the electrostrictive polymer 111
• the negative electrode 113 is disposed on the inner peripheral surface of the electrostrictive polymer 111.
• the negative electrode 113 is electrically connected so as to be in contact with the blade fixing member 14 in the same manner as the first actuator 10.
• the positive electrode 112 of the second actuator 11 is electrically connected to the positive electrode 102 of the first actuator 10 via the positive wiring 18a.
• the negative electrode 113 of the second actuator 11 is The first actuator 10 is electrically connected to the negative electrode 103 via the blade fixing member 14.
• the electrostrictive polymers 101 and 111 of the first and second actuators 10 and 11 are capacitors having elasticity like rubber, and the electrostrictive polymer is also called an electrostatic elastomer.
• These electrostrictive polymers 101 and 111 are referred to as dielectric elastomers as described in Non-Patent Document 2 described above, and are formed into a cylindrical shape from a resin material such as acrylic, silicon, and polyurethane.
• a resin material such as acrylic, silicon, and polyurethane.
• As the positive electrodes 102 and 112 and the negative electrodes 103 and 113 for example, an electrode formed using photolithography, a carbon electrode in which a binder and carbon fine particles are mixed and sprayed, or the like is used.
• a positive metal plate 19 is disposed in one electrode through hole 131a of the second case 13b, and a negative metal plate 20 is disposed in the other electrode through hole 13lb of the second case 13b. It has been.
• O-rings 22 are attached to the outer peripheral surfaces of the plus metal plate 19 and the minus metal plate 20, respectively.
• the plus metal plate 19 and the minus metal plate 20 are hermetically accommodated in the two through holes 131a and 131b of the second case 13b with an O-ring 22 interposed therebetween, for example.
• the plus electrode 112 of the second actuator 11 is electrically connected to the plus metal plate 19 in the second case 13b via the plus wiring 18a. Connected to the plus metal plate 19 is a plus lead wiring 21 a of the wiring cable 21.
• the negative electrode 113 of the second actuator 11 is electrically connected to the negative metal plate 20 in the second case 13b via the negative wiring 18b.
• This minus metal plate 20 is connected to the minus lead wire 21b of the wiring cable 21.
• the wiring cable 21 is passed through the sheath 24 and extended to the treatment operation unit 25 side.
• the treatment operation unit 25 is provided with a wiring cable outlet 251.
• the wiring cable 21 is pulled out from the outlet 251 of the treatment operation unit 25.
• the wiring cable 21 drawn out from the outlet 251 is connected to a power source 26.
• the power source 26 constitutes power source means for periodically supplying a desired voltage.
• FIG. Figure 2A shows the high electrostriction as shown in Non-Patent Document 3 mentioned above.
• a plate-like actuator model 4 using molecules is shown.
• a positive electrode 6 is formed on one surface of a plate-like electrostrictive polymer 5, and a negative electrode 7 is formed on the other surface.
• a voltage is applied between the positive electrode 6 and the negative electrode 7 in a desired cycle. In this case, an attractive force is generated between the positive electrode 6 and the negative electrode 7 of the electrostrictive polymer 5 in synchronization with the period of the voltage. Therefore, as shown in FIG.
• the electrostrictive polymer 5 is contracted in the direction between the electrodes and extended in the orthogonal direction.
• This distortion rate is proportional to the square of the applied electric field E as shown in FIG. 3, and has been confirmed to be several tens to 300% or more.
• the first and second actuators 10 and 11 operate as follows. That is, when the first and second actuators 10 and 11 are operated, the voltage from the power source 26 is applied between the positive electrodes 102 and 112 and the negative electrodes 103 and 113 at a desired period. At this time, as shown in FIG. 4, the electrostrictive polymer 101 of the first actuator 10 has a thickness direction of the electrostrictive polymer 101 (direction between the electrodes 102 and 103) in synchronization with the period of the voltage. And is stretched in a direction (plate surface direction) perpendicular to the thickness direction of the electrostrictive polymer 101.
• the electrostrictive polymer 111 of the second actuator 11 is contracted in the radial direction of the cylinder of the electrostrictive polymer 111 and extended in the axial direction of the cylinder of the electrostrictive polymer 111 perpendicular to the radial direction of the cylinder.
• the blade 15 provided on the blade fixing member 14 repeats the independent contraction and extension operations of the first actuator 10 and the second actuator 11 alternately and periodically. Then, the blade 15 is ultrasonically vibrated.
• the ultrasonic therapy apparatus 1 of the present embodiment When the ultrasonic therapy apparatus 1 of the present embodiment is used, as shown in FIG. 5, the ultrasonic therapy apparatus 1 passes through the base 413 for inserting the treatment tool of the operation unit 403 of the endoscope 401 and the treatment tool is passed through. Inserted into the channel 408. Then, as shown in FIG. 6, the blade 15 of the distal end treatment portion 2 of the ultrasonic therapy apparatus 1 protrudes to the outside from the distal end opening 408a of the treatment instrument penetration channel 408. In this state, the first and second actuators 10 and 11 in the distal treatment section 2 are supplied from the power source 26 to the positive electrodes 102 and 112 and the negative electrodes 103 and 113 of the electrostrictive polymers 101 and 111, respectively. Are applied in a desired cycle.
• the first actuator 10 and the second actuator 11 are independently extended and contracted and extended, and the blade 15 is ultrasonically vibrated. Therefore, treatment such as incision and hemostasis of living tissue using the blade 15 becomes possible.
• the operation of the present embodiment having the above configuration will be described.
• the insertion portion 402 of the endoscope 401 is inserted into a body cavity.
• an observation image in the body cavity incident through the objective lens 407 of the observation optical system of the endoscope 401 is picked up by the image pickup device 409, and the image is observed by a screen displayed on the monitor, not shown.
• the ultrasonic therapy apparatus 1 is inserted into the treatment instrument communication channel 408 through the treatment instrument insertion base 413 of the operation section 403 of the endoscope 401. Then, as shown in FIG. 6, the blade 15 of the distal treatment section 2 of the ultrasonic therapy apparatus 1 is projected outward from the distal opening 408a of the treatment instrument insertion channel 408.
• the treatment operation unit 25 is operated while observing the affected area with the endoscope 401, and the blade 15 is moved back and forth to match the treatment site.
• an ultrasonic generation operation means (not shown) of the ultrasonic therapy apparatus 1, for example, a foot switch or a hand switch is operated.
• a voltage from the power source 26 is applied to the positive electrodes 102 and 112 and the negative electrodes 103 and 113 of the first and second actuators 10 and 11 in a desired cycle.
• the electrostrictive polymers 101 and 111 of the first and second actuators 10 and 11 are alternately contracted and expanded. Repeated periodically.
• the blade 15 is vibrated ultrasonically to perform an incision and hemostasis treatment of the living tissue.
• the configuration described above has the following effects. That is, in the ultrasonic therapy apparatus 1, the first actuator 10 and the second actuator 11 are disposed in the casing 12 so as to face each other with the blade fixing member 14 interposed therebetween.
• the blade fixing member 14 is provided with a blade 15 that allows the first actuator 10 to pass therethrough, and the first and second actuators 10 and 11 are synchronously driven to expand and contract one and the other is driven to extend.
• the blade 15 is configured to vibrate ultrasonically via the blade fixing member 14.
• one of the first and second actuators 10 and 11 is shrunk at a distortion rate of several tens of percent to several hundreds of percent as shown in Non-Patent Documents 1 and 3 described above. Is stretched at a distortion rate of several 10% to several 100%, and the blade 15 is ultrasonically vibrated. As a result, the blade 15 can be ultrasonically vibrated with a large amplitude. Therefore, small size It is possible to realize a blade 15 having a high treatment capability by using a eater, and to reduce the size of the device.
• a positive electrode 102 and a negative electrode 103 are provided on both side surfaces of the electrostrictive polymer 101 of the first actuator 10, and the electrostrictive polymer of the second actuator 11 is provided.
• the electrode structure of the present invention is not limited to this.
• FIGS. 7A and 7B show a first modification of the ultrasonic therapy apparatus 1 according to the first embodiment.
• FIG. 7A shows the electrode structure of the first actuator 10 of this modification
• FIG. 7B shows the electrode structure of the second actuator 11 of this modification.
• the electrode structure of the first actuator 10 of the present modification is that a plurality of positive internal electrodes extending in the electrostrictive polymer 101 in parallel with the center line of the cylinder of the electrostrictive polymer 101 are provided. 104 and a plurality of negative internal electrodes 105 are disposed.
• the positive internal electrode 104, the negative internal electrode 105, and the film of the electrostrictive polymer 101 are formed in a laminated structure in which they are alternately laminated.
• the plurality of positive internal electrodes 104 are electrically connected to the positive electrode 102 in a state where they are embedded in the electrostrictive polymer 101 with a predetermined interval.
• the plurality of negative internal electrodes 105 are electrically connected to the negative electrode 103 while being embedded in the electrostrictive polymer 101 with a predetermined interval.
• the electrode structure of the second actuator 11 of this modification is such that a plurality of positive internal electrodes 11 are provided in the electrostrictive polymer 111 so as to extend in a direction perpendicular to the center line of the cylinder of the electrostrictive polymer 101. 4 and a plurality of negative internal electrodes 115 are arranged.
• the plus internal electrode 114, the minus internal electrode 115, and the film of the electrostrictive polymer 111 are formed in a laminated structure in which they are alternately laminated.
• the plurality of positive internal electrodes 114 are electrically connected to the positive electrode 112 in a state where they are embedded in the electrostrictive polymer 111 with a predetermined interval.
• the plurality of negative internal electrodes 115 are electrically connected to the negative electrode 113 while being embedded in the electrostrictive polymer 111 at a predetermined interval.
• FIG. 8 shows a second modification of the ultrasonic therapy apparatus 1 according to the first embodiment.
• the force shown in the configuration in which the blade 15 is integrally formed with the blade fixing member 14 is increased.
• the configuration is not limited to the above.
• the blade 15 is fastened to the blade fixing member 14 with screws.
• a screw hole 141 is formed in the blade fixing member 14 of the present modification.
• the screw hole 141 of the blade fixing member 14 is disposed through the inner space of the cylindrical electrostrictive polymer 101.
• a male screw portion 151 is provided at the base end of the blade 15.
• the male thread 151 of the blade 15 is provided so as to be able to be screwed into the screw hole 141 of the blade fixing member 14.
• the base end of the blade 15 is inserted into the inner space of the cylinder of the electrostrictive polymer 101 of the first actuator 10, and then the male screw 151 is screwed into the screw hole 141 of the blade fixing member 14. To be fixed.
• This modification also has the same effect as the ultrasonic therapy apparatus 1 of the first embodiment.
• an insulating tube 16 (see FIG. 1) not shown in FIG. 8 may be interposed between the blade 15 and the blade penetration hole 13a2 of the first case 13a.
• an insulating ring 17 (see FIG. 1) may be interposed between the positive electrode 102 of the first actuator 10 and the first case 13a. In this case, a large output is required, and a particularly good effect can be obtained when a high voltage is applied to the first actuator 10 and the second actuator 11.
• the force configured using the first actuator 10 and the second actuator 11 having different electrode structures is not limited to this.
• the first and second actuators 10 and 11 have the same electrode structure.
• the electrode structure shown in FIG. 9 uses an actuator having the same configuration as that of the second actuator 11 of the first embodiment as the first actuator 10.
• a flexible plus electrode 102A having elasticity is attached to the outer peripheral surface of a cylindrical electrostrictive polymer 101A.
• a flexible, negative electrode 103A having elasticity is attached to the inner peripheral surface of the electrostrictive polymer 101A separately from the positive electrode 102A.
• the first actuator 10 is disposed so as to face the second actuator 11 with the blade fixing member 14 in between.
• the positive electrode 102A is disposed on the outer peripheral surface of the electrostrictive polymer 101A, and the negative electrode 103A is disposed on the inner peripheral surface of the electrostrictive polymer 111.
• the minus electrode 103A is electrically connected in contact with the blade fixing member 14.
• the second actuator 11 is configured in the same manner as the second actuator 11 of the first embodiment.
• the positive electrode 112 of the second actuator 11 is electrically connected to the positive electrode 102A of the first actuator 10 via the positive wiring 18a.
• the negative electrode 113 of the second actuator 11 is electrically connected to the negative electrode 103A of the first actuator 10 via the blade fixing member 14.
• the positive electrodes 102A, 112 of the first and second actuators 10, 11 are arranged so as not to be short-circuited to the blade fixing member 14.
• the positive electrode 102A of the first actuator 10 is connected to the power supply 26a via the positive wiring 264a.
• the positive electrode 112 of the second actuator 11 is connected to the power supply 26a via the positive wiring 264c.
• the negative electrodes 103A and 113 of the first and second actuators 10 and 11 are electrically connected to the blade fixing member 14.
• the negative electrodes 103A and 113 of the first and second actuators 10 and 11 are connected to the power supply 26a via the negative wiring 264b.
• the power supply 26 a includes an AC power supply 261, a bias circuit 262, and an inverting circuit 263.
• the positive electrodes 102A and 112 of the first and second actuators 10 and 11 are connected to the inverting circuit 263 of the power supply 26a so that the voltage has a phase difference of 180 °. That is, since the plus wiring 264a of the first actuator 10 is connected via the inverting circuit 263, there is a phase difference of 180 ° from the voltage of the plus wiring 264c of the second actuator 11.
• the first and second actuators 10 and 11 are driven and controlled by periodically supplying a voltage having a phase difference of 180 ° via the power supply 26a.
• FIG. 10 is an explanatory diagram for explaining the voltage application state of the first actuator 10 and the voltage application state of the second actuator 11 of the present modification.
• P0 indicates the shape of the first and second actuators 10 and 11 in the natural state.
• Pl and P3 are the first and second arcs when the bias voltage Vo is applied from the power supply 26a and the AC voltage is 0V (reference state).
• P2 is the shape of the first and second actuators 10 and 11 when the voltage Vo + Eo is applied from the power supply 26a and contracts.
• P4 is the shape of the first and second actuators 10 and 11 when the voltage Vo—Eo is applied and extended.
• the first and second actuators 10 and 11 have the shapes of the reference states Pl and P3, respectively.
• the first actuator 10 is deformed into a contracted P2 shape by applying the voltage Vo + Eo from the power supply 26a.
• the second actuator 11 is applied with the voltage Vo—Eo and deformed into the extended shape of P4.
• the first and second actuators 10 and 11 have the shapes Pl and P3 in the reference state, respectively.
• the first actuator 10 is deformed into an expanded P4 shape by applying the voltage Vo—Eo from the power source 26a.
• the second actuator 11 is applied with the voltage Vo + Eo and is deformed into a contracted shape of P2.
• the first and second actuators 10 and 11 are set to the initial state as shown in FIG. 11A with the voltage of the power supply 26a from 0V.
• the first and second actuators 10 and 11 As indicated by the arrow 11B, the first actuator 10 is driven to contract and the second actuator 11 is driven to extend.
• the first actuator 10 As shown by the arrow in FIG. 11C. Is driven to extend, and the second actuator 11 is driven to contract. In this way, the first and second actuators 10 and 11 cooperate to vibrate the blade 15 in the axial direction.
• FIG. 12 shows a fourth modification of the ultrasonic therapy apparatus 1 according to the first embodiment.
• an actuator having the same configuration as that of the first actuator 10 of the first embodiment is used as the second actuator 11.
• the second actuator 11 of this modification is a flexible plus electrode 112 having elasticity on both end faces of a cylindrical electrostrictive polymer 111A.
• a and the negative electrode 113A are attached separately.
• the positive electrode 112A is disposed on the rear end surface of the electrostrictive polymer 111A in contact with the second case 13b
• the negative electrode 113A is disposed on the front end surface of the electrostrictive polymer 111A in contact with the blade fixing member 14. It has been.
• the negative electrode 103 of the first actuator 10 and the negative electrode 113A of the second actuator 11 are arranged to face each other via the blade fixing member 14, and are electrically connected to the blade fixing member 14. Has been installed.
• the insulation ring 17 is interposed between the positive electrode 102 and the first case 13a, so that the insulation with the first case 13a is maintained.
• an insulation ring 17 is interposed between the positive electrode 112A and the second case 13b, and insulation between the second case 13b is maintained.
• the first and second actuators 10, 11 are configured so that the positive electrodes 102, 112A and the negative electrode 113A of the second actuator 11 are connected to the power source 26a in a third modification (FIGS. 9 to 11C). Connected as well. That is, the positive electrode 102 of the first actuator 10 is connected to the power supply 26a via the positive wiring 264a. The positive electrode 112A of the second actuator 11 is connected to the power supply 26a via the positive wiring 264c!
• the negative electrodes 103, 113A of the first and second actuators 10, 11 are electrically connected to the blade fixing member 14.
• the negative electrodes 103 and 113A of the first and second actuators 10 and 11 are connected to the power source 26a via the negative wiring 264b.
• the positive electrodes 102, 112A of the first and second actuators 10, 11 are connected to the inverter circuit 263 of the power supply 26a so that the voltage has a phase difference of 180 °. That is, since the plus wiring 264a of the first actuator 10 is connected via the inverting circuit 263, there is a phase difference of 180 ° from the voltage of the plus wiring 264c of the second actuator 11. Then, the first and second actuators 10 and 11 are periodically supplied with a voltage having a phase difference of 180 ° via the power supply 26a and are driven and controlled.
• FIG. 7 a structure in which a plurality of positive internal electrodes 104, 114, negative internal electrodes 105, 115, and films of electrostrictive polymers 101, 111 are alternately stacked is embedded. You can do it.
• FIG. 13 and 14 show a second embodiment of the present invention.
• the same parts as those in the first embodiment are denoted by the same reference numerals, and detailed description thereof is omitted.
• the present invention is applied to an ultrasonic suction apparatus 1A that performs a pulverization and emulsification treatment of a living tissue. That is, in the present embodiment, a through hole 151a is provided in the axial center portion of the blade 15a of the distal treatment section 2, and a through hole 141a is also provided in the axial center portion of the blade fixing member 14a as shown in FIG. ing.
• the blade fixing member 14 a is interposed between the first and second actuators 10 and 11.
• the blade fixing member 14a is provided with the blade 15a protruding from the front end surface.
• a tubular port 27 is protruded from the rear end surface of the blade fixing member 14a.
• the blade 15a is passed through the inner space of the cylindrical body of the first actuator 10 and further protrudes forward from the blade passage hole 13a2 of the first case 13a.
• the port 27 is inserted through the inner space of the cylindrical body of the second actuator 11.
• the second case 13b is provided with a communication hole 13b2.
• the port 27 is hermetically coupled to the front end of the communication hole 13b2 through an O-ring (not shown).
• One end of the discharge tube 28 is attached to the rear end of the communication hole 13b2 via a tubular connecting member 13b3.
• the discharge tube 28 is passed through the sheath 24.
• the treatment operation section 25 is provided with a tube discharge port 252 adjacent to the wiring cable lead-out port 251.
• the proximal end portion of the discharge tube 28 is drawn from the tube discharge port 252 of the treatment operation unit 25 and connected to the discharge pump 29.
• the ultrasonic suction device 1A having the above-described configuration is used to pulverize and emulsify a living tissue
• the endoscope 401 Insert section 402 is inserted into the body cavity.
• an observation image inside the body cavity incident through the objective lens 407 of the observation optical system of the endoscope 401 is picked up by the image pickup device 409, and the image is observed by a screen displayed on a not-shown motor. Check the affected area.
• the ultrasonic arch I device 1A having the above-described configuration is passed through the treatment tool insertion channel 408 through the base for insertion of the treatment tool 41 3 of the operation unit 403 of the endoscope 401. Is inserted into. Then, the blade 15a of the distal treatment section 2 of the ultrasonic suction device 1A having the above-described configuration protrudes to the outside from the distal opening 408a of the treatment instrument communication channel 408 (see FIG. 6).
• the treatment operation unit 25 is operated while observing the affected part, and the blade 15a is moved back and forth. Thereby, the tip of the blade 15a is brought close to the treatment site. Then, an ultrasonic wave generation operation means (not shown) is operated.
• the voltage is applied to the first and second actuators 10 and 11 from the power source 26 between the positive electrodes 102 and 112 and the negative electrodes 103 and 113 in a desired cycle.
• the electrostrictive polymers 101 and 111 of the first and second actuators 10 and 11 are independently contracted and extended in synchronization with the voltage supply cycle from the power source 26. As a result, the blade 15a is ultrasonically vibrated and the biological tissue is crushed and emulsified.
• the discharge pump 29 is driven. Therefore, the pulverized and emulsified biological tissue is sucked into the through hole 151a of the blade 15a and discharged from the discharge pump 29 to a discharge bottle (not shown) through the port 27, the communication hole 13b2, and the tube 28.
• the configuration described above has the following effects. That is, in the ultrasonic suction apparatus 1A of the present embodiment, similarly to the first embodiment, the first and second actuators 10 and 11 using the electrostrictive polymer actuators are used.
• the blade 15 having the treatment ability can be realized, and the ultrasonic suction device 1A having a small size and high treatment ability can be provided.
• the electrode structures of the first and second actuators 10 and 11 are the same as those described in the first embodiment. It can be applied even if an electrode structure is used, and the same effect can be obtained even if it is configured using an electrode structure with a V deviation.
• FIGS. 15 to 18C show a third embodiment of the present invention.
• the same parts as those in the first embodiment are denoted by the same reference numerals, and detailed description thereof is omitted.
• the present invention is applied to an ultrasonic coagulation / cutting apparatus 1B that performs a coagulation / cutting procedure with a living tissue sandwiched therebetween. That is, in the present embodiment, the forceps piece 30 is disposed at the proximal end portion of the blade 15b disposed in the distal treatment section 2 so as to be freely opened and closed.
• a proximal end portion of a cylindrical distal end cover 31 is fixed to a distal end portion of a sheath 24 such as a closed coil. As shown in FIG. 16, an intermediate portion of the forceps piece 30 is pivotally supported on the distal end cover 31 via a main shaft pin 301.
• the distal end portion of the link member 33 is attached to the proximal end portion of the forceps piece 30 via a support pin 331 so as to be rotatable.
• a connecting member 34 is rotatably attached to the base end portion of the link member 33 via an operation pin 341.
• the connecting member 34 is arranged so as to move in the axial direction along the guide groove 313 provided in the tip cover 31. Then, the distal end portion of the operation wire 35 is attached to the connecting member 34. The operation wire 35 is passed through the sheath 24.
• a handle 36 is attached to the treatment operation unit 25 so as to be slidable in the axial direction of the operation wire 35.
• a proximal end portion of the operation wire 35 is fixed to the handle 36.
• the forceps piece 30 is moved through the operation wire 35 by a sliding operation of the handle 36 in the directions of arrows A and B.
• the blade 15b has a blade body 15bl formed in a cylindrical shape as shown in FIGS.
• a partition wall 152b is provided in the middle part of the cylinder of the blade body 15bl.
• the axial center portion of the partition wall 152b has a through hole 151b.
• cylindrical first and second actuators 10 and 11 are accommodated and disposed with a partition wall 152b interposed therebetween.
• the first actuator 10 includes a cylindrical electrostrictive polymer 101, a positive electrode 102 attached to the outer peripheral surface of the electrostrictive polymer 101, and an inner peripheral surface of the electrostrictive polymer 101.
• the negative electrode 103 is provided.
• the second actuator 11 includes a cylindrical electrostrictive polymer 111, a positive electrode 112 attached to the outer peripheral surface of the electrostrictive polymer 111, and an inner peripheral surface of the electrostrictive polymer 111. And a negative electrode 113 attached thereto.
• each cylinder of the first and second actuators 10 and 11 inserted into the blade 15b, and the through hole 151b of the partition wall 152b are provided so as to protrude from the tip cover 31.
• the fixed shaft 311 is inserted.
• a screw portion 312 is provided at the tip of the fixed shaft portion 311. This threaded portion 312 is screwed into a screw hole 321 provided in the cover pressing member 32.
• the first actuator 10 accommodated in the blade 15b is arranged between the partition wall 152b of the blade 15b and the cover pressing member 32, and the second actuator 11 is configured of the partition wall of the blade 15b. It is arranged between 152b and the tip cover 31.
• the first and second actuators 10, 11 have the same electrode structure as that of the third modification of the ultrasonic therapy apparatus 1 of the first embodiment (see FIGS. 9 to 11C). Is formed. That is, the first actuator 10 is disposed opposite to the second actuator 11 with the partition wall 152b interposed therebetween.
• the second actuator 11 is configured in the same manner as the second actuator 11 of the first embodiment.
• the positive electrode 112 of the second actuator 11 is electrically connected to the positive electrode 102 of the first actuator 10 via the positive wiring 18a.
• the negative electrode 113 of the second actuator 11 is connected to the first actuator 10.
• the negative electrode 103 and the partition wall 152b are electrically connected.
• the positive electrodes 102 and 112 of the first and second actuators 10 and 11 are arranged so as not to be short-circuited to the partition wall 152b.
• the positive electrode 102 of the first actuator 10 is connected to the power supply 26a via the positive wiring 264a.
• the positive electrode 112 of the second actuator 11 is connected to the power source 26a via the positive wiring 264c.
• the negative electrodes 103 and 113 of the first and second actuators 10 and 11 are electrically connected to the partition wall 152b. Then, the negative electrodes 103 and 113 of the first and second actuators 10 and 11 are connected to the power supply 26a via the negative self-wire 264b.
• the power source 26 a includes an AC power source 261, a bias circuit 262, and an inverting circuit 263.
• the positive electrodes 102A and 112 of the first and second actuators 10 and 11 are connected to the inverting circuit 263 of the power supply 26a so that the voltage has a phase difference of 180 °. That is, since the plus wiring 264a of the first actuator 10 is connected via the inverting circuit 263, there is a phase difference of 180 ° from the voltage of the plus wiring 264c of the second actuator 11.
• the first and second actuators 10 and 11 are driven and controlled by periodically supplying a voltage having a phase difference of 180 ° via the power supply 26a.
• the positive wiring 264a of the first actuator 10, the positive wiring 264c of the second actuator 11, and the negative wiring 264b of the first and second actuators 10 and 11 are placed in the wiring cable 21. It has been communicated.
• the wiring cable 21 is connected to the power source 26a.
• the first and second actuators 10, 11 are supplied to the positive electrodes 102, 112 and the negative electrodes 103, 113f3 ⁇ 4 by the power supply 26a force 180 as described above.
• a voltage having a phase difference of is applied.
• the first and second actuators 10 and 11 have the initial position shown in FIG. 18A and the first actuator 10 extended in the axial direction as shown in FIG.
• FIG. 18C the second actuator 11 is deformed, and the first actuator 10 is contracted in the axial direction, and the second actuator 11 is expanded. This causes the blade 15b to vibrate ultrasonically.
• the operation of the present embodiment having the above configuration will be described.
• the insertion portion 402 of the endoscope 401 is inserted into a body cavity.
• the observation optical system of the endoscope 401 An observation image inside the body cavity incident through the objective lens 407 is picked up by the image sensor 409, and the image is observed on a screen displayed on a monitor (not shown) to confirm the affected part.
• the ultrasonic coagulation / cutting device 1B having the above-described configuration is inserted into the treatment instrument permeable channel 408 through the base 413 for inserting the treatment instrument of the operation section 403 of the endoscope 401. Is done. Then, the blade 15b of the distal treatment section 2 of the ultrasonic coagulation / cutting device 1B having the above-described configuration projects outward from the distal opening 408a of the treatment instrument penetration channel 408 (see FIG. 6).
• the treatment operation section 25 is operated while observing the affected area, and the blade 15b is moved back and forth. As a result, the tip of the blade 15b is brought close to the treatment site. Thereafter, the handle 36 of the treatment operation unit 25 is pushed out to open the forceps piece 30. In this state, the movement is adjusted so that the affected part is positioned between the blade 15b and the forceps piece 30. Subsequently, after confirming that the affected part is positioned between the blade 15b and the forceps piece 30, the handle 36 is pulled. As a result, the forceps piece 30 is rotated in the closing direction to hold the living tissue between the forceps piece 30 and the blade 15b.
• the treatment operation unit 25 is operated while confirming the clamping state, and a voltage having a phase difference of 180 ° from the power supply 26a is added to the first and second actuators 10 and 11 in a desired cycle. Mark between the electrodes 102 and 112 and the negative electrodes 193 and 113. Then, in synchronization with the supply cycle of the voltage of the power supply 26a, the first and second actuators 10 and 11 are expanded in the axial direction as shown in FIG. 18B, and the second actuator 11 As shown in FIG. 18C, the first actuator 10 is deformed in the axial direction, and the second actuator 11 is expanded. As a result, the blade 15b is ultrasonically vibrated to perform the coagulation / incision treatment of the living tissue held between the forceps piece 30.
• the apparatus having the above configuration has the following effects. That is, in the ultrasonic coagulation / cutting device 1B of the present embodiment, similarly to the first embodiment, the first and second actuators 10 and 11 using the electrostrictive polymer actuator are used. The blade 15b having the treatment capability can be realized, and the ultrasonic coagulation cutting device 1B having a small size and high treatment capability can be provided. Note that also in the ultrasonic coagulation / cutting device IB of the third embodiment, the electrode structures of the first and second actuators 10 and 11 are different from those described in the first embodiment. The same effect can be obtained even if the electrode structure of the modified example is used.

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• 2005
  • 2005-10-28 JP JP2005314324A patent/JP4542499B2/ja not_active Expired - Fee Related
• 2006
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