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
  • A61B2017/320071—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with articulating means for working tip
• • 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

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 ultrasonic therapy apparatus is an ultrasonic therapy apparatus that includes a treatment unit that treats a treatment site by ultrasonic vibration, and a drive unit that drives the treatment unit.
• the driving means includes an actuator body formed of an electrostrictive polymer, and at least a pair of electrodes arranged in a state of being separated from and insulated from the actuator body, and a voltage is provided between the electrodes. Is applied to the electrostrictive polymer, and power supply means for supplying a voltage between the electrodes of the actuator.
• the treatment section includes the power of the actuator.
• the treatment site is treated by ultrasonic vibration in conjunction with the expansion and contraction drive of the strained polymer.
• the treatment section includes a blade that is joined to the actuator, ultrasonically vibrates in conjunction with the extension drive of the actuator, and treats the treatment site,
• the power supply supplies an AC voltage between the electrodes of the actuator.
• the actuator is disposed in an actuator body formed of an electrostrictive polymer, a positive electrode disposed in one end portion of the actuator body, and a second end portion of the actuator body. And a negative electrode.
• the actuator body includes a plurality of positive internal electrodes and a plurality of negative electrodes in a state in which the actuator body extends substantially parallel to the center line direction of the actuator body and is arranged substantially parallel to each other.
• An internal electrode is embedded, and each of the plurality of positive internal electrodes has one end connected to the positive electrode, and each of the plurality of negative internal electrodes has one end connected to the negative electrode.
• the positive internal electrodes and the plurality of negative internal electrodes are alternately arranged with a predetermined interval.
• the actuator is an actuator main body formed of a rectangular parallelepiped electrostrictive polymer, a plus electrode disposed on one side of the rectangular parallelepiped shape of the actuator main body, and the rectangular parallelepiped of the actuator main body. A negative electrode disposed on the other side of the shape.
• the actuator main body includes a plurality of positive internal electrodes extending in a direction substantially parallel to a direction perpendicular to the center line of the actuator main body and arranged substantially parallel to each other. And a plurality of negative internal electrodes, one end of each of the plurality of positive internal electrodes being connected to the positive electrode, and one end of each of the plurality of negative internal electrodes being connected to the negative electrode, The plurality of negative internal electrodes and the plurality of positive internal electrodes are alternately arranged with a predetermined interval.
• the actuator is a pair of an actuator body formed of a cylindrical electrostrictive polymer, and a pair of cylindrical outer peripheral surfaces and inner peripheral surfaces of the actuator main body. Electrode.
• the actuator body is provided with a positive electrode on the outer peripheral surface of the cylindrical shape and a negative electrode on the inner peripheral surface of the cylindrical shape.
• the treatment section has a fixed shaft that supports the actuator, the actuator includes at least two film-like electrostrictive polymers, and the electrostrictive polymer is brazed on one side.
• Each of the two films has a negative electrode formed on the other surface.
• the electrostrictive polymer is joined in a state where the negative electrodes overlap each other, and the two membrane-like electrostrictive polymers are joined together, and the joined structure is spirally formed on the fixed shaft.
• the above-mentioned actuator is formed by being wound around the wire.
• An ultrasonic therapy apparatus includes a distal end portion and a proximal end portion, an insertion portion that is inserted into a channel of an endoscope, and the distal end portion of the insertion portion.
• An ultrasonic therapy apparatus for treating a treatment site wherein the insertion portion has a distal end portion and a proximal end portion, a flexible sheath, and the sheath is connected to the treatment portion at the distal end portion;
• the sheath is provided with an operation portion for operating the treatment portion at the base end portion
• the driving means includes an actuator main body formed of an electrostrictive polymer, and an actuator main body formed on the actuator main body.
• At least a pair of spaced apart and insulated Comprising an electrode, and when a voltage is applied between the electrodes, an actuator in which the electrostrictive polymer is expanded and contracted, and a power supply means for supplying a voltage between the electrodes of the actuator.
• the treatment section includes a blade that is joined to the actuator and ultrasonically vibrates in conjunction with the extension / contraction drive of the actuator to treat the treatment site.
• the treatment section includes a cylindrical blade having a distal end portion and a proximal end portion, and the blade has a suction hole communicating with the lumen of the blade in the distal end portion.
• the sheath has a distal end portion and a proximal end portion, a suction tube disposed inside the sheath, and the tube has the distal end portion communicating with the lumen of the blade, and the proximal end portion is operated by the operation It is extended to the outside and connected to a suction pump.
• the treatment section 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;
• the forceps drive provided through the operation wire provided in the operation unit And a handle for driving the forceps piece to open and close with respect to the blade.
• the actuator when a voltage is applied between the electrodes, the actuator is contracted in one direction corresponding to the electrostrictive polymer electrode, and the other direction orthogonal to the one direction is several tens.
• the treatment section By stretching at a distortion rate of% to several hundred%, it is driven to expand and contract in synchronization with the period of the voltage from the power supply means, and the treatment section is ultrasonically vibrated.
• the treatment section can be ultrasonically vibrated with a large amplitude, and a treatment section having a high treatment capability can be realized using a small actuator, and the apparatus can be miniaturized.
• Fig. 1 is a schematic configuration diagram of a main part of a section of an ultrasonic therapy apparatus according to a first embodiment of the present invention.
• FIG. 2 is a perspective view showing an actuator and a blade of the ultrasonic therapy apparatus according to the first embodiment.
• FIG. 3 is a longitudinal sectional view of the actuator and blade of FIG.
• Fig. 4 is a schematic configuration diagram showing a relationship between an actuator and a power source of the ultrasonic therapy apparatus according to the first embodiment.
• FIG. 5A is a schematic configuration diagram of a main part shown for explaining an actuator model of the ultrasonic therapy apparatus according to the first embodiment.
• FIG. 5B is a schematic configuration diagram of the main part shown to explain the operating principle of the model of the actuator of the ultrasonic therapy apparatus according to the first embodiment.
• FIG. 6 is a characteristic diagram showing the relationship between electric field E and strain in the model of the actuator shown in FIG. 5B.
• FIG. 7 is a longitudinal sectional view showing a state in which a resin tube is coated on the actuator and the sheath of the ultrasonic therapy apparatus according to the first embodiment.
• FIG. 8 is a longitudinal sectional view showing a state in which a resin tube is coated on the actuator of the ultrasonic therapy apparatus according to the first embodiment.
• FIG. 9 is a schematic configuration diagram showing a state in which the ultrasonic therapy apparatus according to the first embodiment is mounted in a state of being inserted into a channel of an insertion portion of an endoscope.
• FIG. 10 is an enlarged view of a state in which 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. It is the longitudinal section shown.
• FIG. 11 is a schematic configuration diagram of a main part showing a first modified example of the actuator of the ultrasonic therapy apparatus according to the first embodiment.
• FIG. 12 is an exploded perspective view showing a second modification of the actuator of the ultrasonic therapy apparatus according to the first embodiment.
• FIG. 13 is a cross-sectional view showing a mounting state of an actuator according to a second modified example.
• FIG. 14 is a perspective view of a main part showing an example of attachment of an actuator and a pressing member according to a second modified example.
• FIG. 15 is a schematic configuration diagram of a main part showing a third modification of the actuator of the ultrasonic therapy apparatus according to the first embodiment.
• FIG. 16 is a longitudinal sectional view of an actuator according to a third modification.
• FIG. 17 is a perspective view showing a fourth modified example of the actuator of the ultrasonic therapy apparatus according to the first embodiment.
• FIG. 18 is a longitudinal sectional view of an actuator according to a fourth modified example.
• FIG. 19 is a schematic configuration diagram of a main part showing an ultrasonic suction device according to a second embodiment of the present invention.
• FIG. 20 is a longitudinal sectional view of an actuator of the ultrasonic suction device according to the second embodiment.
• FIG. 21 is a transverse sectional view of an actuator of the ultrasonic suction device according to the second embodiment.
• FIG. 22 is a longitudinal sectional view showing a state in which a protective resin tube is coated on the outer peripheral surfaces of the actuator and the sheath of the ultrasonic suction device according to the second embodiment.
• FIG. 23 is a longitudinal sectional view of a main part showing a modification of the ultrasonic suction device according to the second embodiment.
• FIG. 24 is a schematic view of an essential part of an ultrasonic coagulation / cutting device according to a third embodiment of the present invention. It is a block diagram.
• FIG. 25 is a longitudinal sectional view showing the main part of the ultrasonic coagulation / cutting device according to the third embodiment.
• FIG. 26 is an exploded perspective view for explaining the positional relationship between the blade and the actuator of the ultrasonic coagulation / cutting device according to the third embodiment.
• FIG. 27 is a longitudinal sectional view of a main part showing a state where a resin tube is coated on an actuator of the ultrasonic coagulation / cutting device according to the third embodiment.
• FIG. 28A is an explanatory diagram showing an initial position of an actuator of the ultrasonic coagulation / cutting device according to the third embodiment.
• FIG. 28B is an explanatory view showing an operating state of the actuator of the ultrasonic coagulation / cutting device according to the third embodiment.
• 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. 9).
• FIG. 9 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 are shown. 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 end rigid part 406 includes a treatment instrument piercing channel 408 The tip of the tube, the air supply tube connected to the air / water supply nozzle, and the tip of the water supply tube are fixed.
• the operating section 403 is provided with a gripping section 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 unit 403 includes a bending operation knob 412 for bending the bending portion 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 has an elongated flexible sheath 17 and a treatment operation section 18 connected to the proximal end portion of the sheath 17.
• the distal treatment section 2 is connected to the distal end of the sheath 17.
• the distal treatment section 2 is configured with a blade 16 that is a treatment section that performs treatment such as cutting and stopping hemostasis of a living tissue, and an ultrasonic transducer that vibrates the blade 16 ultrasonically.
• An actuator 10 is provided.
• the proximal end portion of the blade 16 is joined to the distal end portion of the actuator 10 by a joining method such as adhesion, spot welding, or brazing.
• the actuator 10 includes a tube-shaped electrostrictive polymer 11, a stretchable plus electrode 12 disposed on the outer peripheral surface of the electrostrictive polymer 11, and an electrostrictive polymer 11. And a retractable minus electrode 13 disposed on the inner peripheral surface.
• the electrostrictive polymer 11 is an elastic capacitor such as rubber, and is referred to as a dielectric elastomer as shown in Non-Patent Document 2 described above.
• the electrostrictive polymer 11 is formed in a tube shape from a resin material such as acrylic, silicon, or polyurethane.
• the positive electrode 12 and the negative electrode 13 are electrodes formed by photolithography, for example, or A carbon electrode or the like obtained by mixing and spraying a solder and carbon fine particles is used.
• a positive electrode connecting end 121 bent toward the inner peripheral surface of the electrostrictive polymer 11 is formed at the tip of the positive electrode 12 of the above-described actuator 10.
• the positive electrode connecting end 121 extends to the inner peripheral surface of the electrostrictive polymer 11.
• a wiring cable 14 is disposed in the inner space 171 of the sheath 17. Inside the wiring cable 14, a positive wiring 14 a and a negative wiring 14 b are passed. The tip end of the positive wiring 14 a is connected to the positive electrode connection end 121. The leading end of the negative wire 14b is connected to the negative electrode 13!
• the proximal end portion of the wiring cable 14 extends to the treatment operation portion 18 side on the proximal side through the inner space portion 171 of the sheath 17.
• a cable outlet 181 is projected from the treatment operation unit 18.
• the distribution cable 14 is drawn out from the cable outlet 181. Further, the wiring cable 14 drawn out from the cable outlet 181 is connected to the power supply 15 constituting the power supply means.
• a voltage is applied from the power source 15 to the positive electrode 12 and the negative electrode 13 in a desired cycle.
• FIG. 5A shows a plate-like actuator model 4 using an electrostrictive polymer, as shown in Non-Patent Document 3 described above.
• this actuator model 4 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. As shown in FIG. 6, this distortion rate is proportional to the square of the applied electric field E and is confirmed to be several tens to 300% or more.
• the above-described actuator 10 operates as follows. That is, during operation of the actuator 10, the voltage from the power source 15 is applied between the positive electrode 12 and the negative electrode 13 in a desired cycle. At this time, the electrostrictive polymer 11 generates an attractive force between the plus electrode 12 and the minus electrode 13 in synchronization with the voltage cycle as shown in Non-Patent Document 3 described above. As a result, the electrostrictive polymer 11 is It is contracted in a direction perpendicular to the center line direction (direction from the outer peripheral surface of the electrostrictive polymer 11 to the inner peripheral surface), and is extended in the center line direction of the tube. This shape change (contraction and extension operation) of the electrostrictive polymer 11 is repeated in synchronization with the voltage cycle, and the blade 16 is ultrasonically oscillated in conjunction with this operation.
• the protective resin tube 19 is formed of a resin material such as Teflon (registered trademark), polyethylene, acrylic, silicon, and polyurethane.
• the resin tube 19 may be provided so as to cover the actuator 10 at least as shown in FIG. As a result, the protection of the actuator 10 can be promoted.
• the blade 16, the actuator 10, and the sheath 17 are arranged on the proximal side of the insertion portion 402 of the endoscope 401 as shown in FIG. And inserted into the channel 408 of the insertion part 402 through the base 413. Then, as shown in FIG. 10, the blade 16 of the distal treatment section 2 of the ultrasonic therapy apparatus 1 is protruded to the outside from the distal opening 408a of the treatment instrument penetration channel 408.
• the actuator 10 applies the voltage from the power source 15 to the positive electrode 12 and the negative electrode 13 of the electrostrictive polymer 11 at a desired cycle. Thereby, the electrostrictive polymer 11 is driven to expand and contract in the axial direction of the tube, and the blade 16 is ultrasonically vibrated. Therefore, treatments such as incision and hemostasis of living tissue using the blade 16 are possible.
• 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.
• the blade 16 of the distal treatment section 2 of the ultrasonic therapy apparatus 1 protrudes outside from the distal opening 408a of the treatment instrument insertion channel 408.
• the treatment operation unit 18 is operated while observing the affected area with the endoscope 401, and the blade 16 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 is applied from the power source 15 to the plus electrode 12 and the minus electrode 13 of the actuator 10 in a desired cycle.
• the electrostrictive polymer 11 is expanded and contracted in the axial direction of the tube in synchronization with the voltage supply cycle from the power supply 15. Therefore, the blade 16 is ultrasonically vibrated to perform incision and hemostasis treatment of the living tissue.
• the configuration described above has the following effects. That is, in the ultrasonic treatment device 1, the positive electrode 12 and the negative electrode 13 are arranged on the electrostrictive polymer 11, and when a voltage is applied between the electrodes 12 and 13, the electrostrictive polymer 11 is driven to expand and contract.
• the actuator 16 is provided, and the electrostrictive polymer 11 is expanded and contracted by supplying a voltage to the plus electrode 12 and the minus electrode 13 of the actuator 10 in a predetermined cycle, so that the blade 16 is ultrasonically vibrated. .
• the blade 16 can be ultrasonically vibrated with a large amplitude, and the blade 16 having a high treatment capability can be realized by using the small actuator 10 and the apparatus can be downsized. .
• FIG. 11 shows a first modification of the actuator 10 of the ultrasonic therapy apparatus 1 of the first embodiment (see FIGS. 1 to 10).
• 1S is shown in which the electrostrictive polymer 11 of the actuator 10 is bonded to the blade 16 by a technique such as adhesion, spot welding, brazing, and the like.
• the present invention is not limited to this.
• the attachment means for attaching the electrostrictive polymer 11 of the actuator 10 to the blade 16 is changed as follows.
• a fixed shaft 21 that is inserted into the electrostrictive polymer 11 is protruded from the blade 16.
• a male screw portion 211 is formed at the tip of the fixed shaft 21.
• a pressing member 20 is disposed on the rear end surface of the electrostrictive polymer 11 of the actuator 10. The pressing member 20 is provided with a screw hole 201.
• the electrostrictive polymer 11 of the actuator 10 is fixed to the blade 16 by screwing the threaded portion 211 of the fixed shaft 21 of the blade 16 into the screw hole 201 of the pressing member 20. It has become. In this case, the same effect as the first embodiment can be obtained.
• the fixed shaft 21 is made of, for example, conductive metal
• the fixed shaft 21 is fixed.
• a configuration in which the insulating tube 22 is covered around the shaft 21 may be adopted.
• FIGS. 12 to 14 show a second modification of the actuator 10 of the ultrasonic therapy apparatus 1 of the first embodiment (see FIGS. 1 to 10).
• the configuration in which the electrostrictive polymer 11 of the actuator 10 is fixed to the blade 16 using the fixed shaft 21 and the holding member 20 of the first modification (see FIG. 11) is changed as follows. It is.
• At least two film-like electrostrictive polymers 1 la are used.
• a positive electrode 12 is formed on one side
• a negative electrode 13 is formed on the other side.
• the two film-like electrostrictive polymers 11a are joined, for example, in a state where the negative electrodes 13 are overlapped with each other.
• a bonded structure 1 lb in which two film-like electrostrictive polymers 1 la are bonded is formed.
• the joint structure l ib is wound around the fixed shaft 21 in a spiral shape.
• the actuator 10 is formed between the blade 16 and the pressing member 20.
• a fixed shaft through hole 202 and a pair of electrode through holes 203a, 203b are provided at the rear end of the pressing member 20. Yes.
• the fixed shaft through hole 202 is disposed in the axial center portion of the rear end portion of the pressing member 20.
• a fixed shaft 21 fixed to the blade 16 is passed through the fixed shaft through hole 202.
• a fixing member 23 is attached to the end of the fixed shaft 21 and fixed to the holding member 20.
• a positive electrode connection end 12la connected to the positive electrode 12 is passed through one electrode through hole 203a.
• a negative electrode connection end 131 (see FIG. 12) connected to the negative electrode 13 is inserted into the other electrode through hole 203b.
• the positive electrode connecting end 121 a is connected to the positive wiring 14 a of the wiring cable 14, and the negative electrode connecting end 131 is connected to the negative wiring 14 b of the wiring cable 14. Then, it is connected to the power source 15 via the wiring cable 14.
• the electrostrictive polymer 11a can be formed in a stretched state in advance, and the strain when a voltage is applied to the plus electrode 12 and the minus electrode 13 is increased. It becomes possible to set. Therefore, the distortion rate can be further improved.
• a spiral spring may be used instead of the fixed shaft 21, but the use of the fixed shaft 21 can increase the rigidity and improve the frequency characteristics. Can be improved.
• FIGS. 15 and 16 show a third modification of the actuator 10 of the ultrasonic therapy apparatus 1 according to the first embodiment (see FIGS. 1 to 10).
• the force shown in the configuration in which the electrostrictive polymer 11 of the finisher 10 is a tube-shaped one is not limited to this.
• the electrostrictive polymer 11 is changed as follows.
• FIG. 15 and FIG. 16 the same parts as those in FIG. 1 to FIG. 10 are given the same reference numerals and their detailed explanations are omitted.
• the electrostrictive polymer 111 formed in a rectangular shape is provided.
• a positive electrode 12 is disposed on one end surface of the electrostrictive polymer 111, and a negative electrode 13 is disposed on the other end surface.
• the positive electrode 12 and the negative electrode 13 are connected to the power source 15.
• FIG. 16 shows the internal configuration of the electrostrictive polymer 111.
• a plurality of positive internal electrodes 12a and a plurality of negative internal electrodes 13a are embedded.
• the plurality of plus internal electrodes 12a and the plurality of minus internal electrodes 13a are arranged in parallel substantially in a state of extending substantially parallel to the center line of the electrostrictive polymer 111.
• One ends of the plurality of plus internal electrodes 12a are connected to the plus electrode 12.
• one end portions of the plurality of minus internal electrodes 13 a are connected to the minus electrode 13.
• the plurality of plus internal electrodes 12a and the plurality of minus internal electrodes 13a are alternately arranged with a predetermined interval.
• FIGS. 17 and 18 show a fourth modification of the actuator 10 of the ultrasonic therapy apparatus 1 according to the first embodiment.
• a rectangular electrostrictive polymer 112 is formed as shown in FIG.
• a positive electrode 12 is disposed on the upper surface of the rectangular electrostrictive polymer 112, and a negative electrode 13 is disposed on the lower surface of the electrostrictive polymer 112.
• the positive electrode 12 and the negative electrode 13 are connected to the power source 15.
• FIG. 18 shows the internal configuration of the electrostrictive polymer 112.
• a plurality of positive internal electrodes 12b and a plurality of negative internal electrodes 13b are embedded.
• Multiple plastic The internal electrode 12b and the plurality of negative internal electrodes 13b are juxtaposed in parallel in a state of extending in a direction substantially orthogonal to the center line of the electrostrictive polymer 112.
• One end portions of the plurality of positive internal electrodes 12b are connected to the positive electrode 12.
• one end portions of the plurality of negative inner electrodes 13 b are connected to the negative electrode 13.
• the plurality of positive internal electrodes 12b and the plurality of negative internal electrodes 13b are alternately arranged with a predetermined interval therebetween.
• FIG. 19 to 23 show a second embodiment of the present invention.
• the present invention is applied to an ultrasonic suction apparatus 1A that performs pulverization and emulsification treatment of a living tissue as the ultrasonic therapy apparatus 1.
• the same parts as those in the first embodiment are denoted by the same reference numerals, and detailed description thereof is omitted.
• a through hole 161 is provided in the axial center portion of the blade 16 of the distal treatment section 2.
• the actuator 10 of the present embodiment uses the electrostrictive polymer 11a having the configuration of the second modification (see FIGS. 12 to 14) of the first embodiment.
• a suction tube 24 is passed through the sheath 17.
• the distal end portion of the tube 24 is passed through the inner space of the electrostrictive polymer 11a of the actuator 10 and then fixed in a state where it is inserted into the through hole 161 of the blade 16.
• the treatment operation portion 18 is provided with a tube discharge port 182 adjacent to the cable lead-out port 181.
• the proximal end portion of the tube 24 is drawn from the tube discharge port 182 of the treatment operation unit 18 and connected to the discharge pump 25.
• the wiring cables 14 connected to the positive electrode connecting end 121a connected to the positive electrode 12 of the actuator 10 and the negative electrode connecting end 131 connected to the negative electrode 13 are connected to the sheath 17 respectively. It extends to the treatment operation section 18 through a gap between the inner space 171 and the tube 24.
• the wiring cable 14 is drawn out from a cable outlet 181 and connected to the power source 15.
• the outer peripheral surfaces of the actuator 10 and the sheath 17 are covered with a protective resin tube 19 as shown in FIG. 22, for example, and fixed with an adhesive, for example.
• the protective resin tube 19 is formed of a resin material such as Teflon (registered trademark), polyethylene, acrylic, silicon, polyurethane, and the like as in the first embodiment.
• the resin tube 19 may be provided so as to cover the actuator 10 at least as in the modification shown in FIG. As a result, the protection of the actuator 10 can be promoted.
• the insertion portion 402 of the endoscope 401 is inserted into a body cavity.
• an observation image inside the body cavity that has entered through the objective lens 407 of the observation optical system of the endoscope 40 1 is picked up by the image pickup element 409, and the image is observed on a screen displayed on a monitor (not shown).
• the ultrasonic suction device 1A having the above-described configuration is inserted into the treatment instrument insertion channel 408 through the treatment tool insertion base 413 of the operation section 403 of the endoscope 401.
• the blade 16 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 penetration channel 408 (see FIG. 10).
• the treatment operation section 18 is operated while observing the affected area, and the blade 16 is moved back and forth. Thereby, the front-end
• a voltage is applied from the power source 15 to the plus electrode 12 and the minus electrode 13 of the actuator 10 in a desired cycle.
• the electrostrictive polymer 11 a is expanded and contracted in the axial direction of the tube in synchronization with the voltage supply cycle from the power supply 15. As a result, the blade 16 is ultrasonically vibrated and the biological tissue is crushed and emulsified.
• the discharge pump 25 is driven. Therefore, the pulverized and emulsified biological tissue is sucked into the through-hole 161 of the blade 16 and discharged from the discharge pump 25 to the discharge bottle (not shown) through the tube 24.
• the configuration described above has the following effects. That is, in this embodiment, the positive electrode 12 and the negative electrode 13 are arranged on the electrostrictive polymer 11a, and when a voltage is applied between the electrodes 12 and 13, the electrostrictive polymer 11a is expanded and contracted. The voltage is supplied to the plus electrode 12 and the minus electrode 13 of the actuator 10 at a predetermined period to drive the electrostrictive polymer 11a to expand and contract, thereby causing the blade 16 to vibrate ultrasonically. Therefore, it is possible to provide an ultrasonic suction apparatus 1A that has a simple configuration as in the first embodiment and can be promoted in size reduction.
• 24 to 28B show a third embodiment of the present invention.
• the present invention is applied to an ultrasonic coagulation and incision apparatus 1B that performs coagulation and incision treatment with a living tissue interposed therebetween as an ultrasonic therapy apparatus.
• 24 to 28B the same parts as those of the first embodiment (see FIGS. 1 to 10) are denoted by the same reference numerals, and detailed description thereof is omitted.
• the forceps piece 27 is disposed at the proximal end portion of the blade 26 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 28 is fixed to a distal end portion of a sheath 17 such as a closed coil. As shown in FIG. 25, an intermediate portion of the forceps piece 27 is pivotally supported on the distal end cover 28 via a main shaft pin 281.
• the distal end portion of the link member 29 is rotatably attached to the proximal end portion of the forceps piece 27 via a support pin 291.
• a connecting member 30 is rotatably attached to the base end portion of the link member 29 via an operation pin 301.
• the connecting member 30 is arranged so as to move in the axial direction along the guide groove 282 provided in the tip cover 28. Then, the distal end portion of the operation wire 31 is attached to the connecting member 30. The operation wire 31 is passed through the sheath 17.
• a handle 32 is attached to the treatment operation section 18 so as to be slidable in the axial direction of the operation wire 31.
• the proximal end of the operation wire 31 is fixed to the handle 32.
• the forceps piece 27 is moved through the operation wire 31 by a sliding operation of the handle 32 in the directions of arrows A and B.
• the link member 29 is pulled to the near side via the connecting member 30 and the operation pin 301.
• the forceps piece 27 is rotated counterclockwise around the spindle pin 281.
• the forceps piece 27 moves in a direction approaching the blade 26 (closed direction).
• the blade 26 has a blade body 26a formed in a bottomed cylindrical shape as shown in FIGS.
• the cylindrical tip of the blade body 26a is closed by an end plate 26al.
• a cylindrical actuator 10 is accommodated in the inner space of the blade body 26a.
• the actuator 10 includes a cylindrical electrostrictive polymer 11, a positive electrode 12 attached to the outer peripheral surface of the electrostrictive polymer 11, and a negative electrode attached to the inner peripheral surface of the electrostrictive polymer 11. And an electrode 13.
• the tip of the electrostrictive polymer 11 of the actuator 10 is attached in contact with the end plate 26al of the blade body 26a.
• a distal end portion of a distal end cover 28 is attached to a proximal end portion of the actuator 10 inserted into the blade 26.
• the actuator 10 accommodated in the blade 26 is disposed between the end plate 26al of the blade 26 and the tip of the tip cover 28.
• the actuator 10 can be of any configuration described in the ultrasonic therapy apparatus 1 of the first embodiment, and the same effect can be obtained.
• the outer peripheral surface of the actuator 10 inserted into the blade 26 is covered with a protective resin tube 19 as shown in FIG. 27, for example, and fixed with an adhesive, for example.
• the protective resin tube 19 is formed of a resin material such as Teflon (registered trademark), polyethylene, acrylic, silicon, polyurethane, and the like as in the first and second embodiments. Thereby, the protection of the actuator 10 can be promoted.
• a wiring cable 14 connected to the plus electrode 12 and the negative electrode 13 of the actuator 10 is passed through the tip cover 28, and the wiring cable 14 is connected to the power source 15.
• the actuator 10 applies a voltage from the power source 15 between the positive electrode 12 and the negative electrode 13 through the wiring cable 14, and the initial position shown in FIG. As shown in 28B, it is deformed between the extension position extended in the direction of arrow B (axial direction).
• the insertion portion 402 of the endoscope 401 is inserted into a body cavity.
• the image of the body cavity incident through the objective lens 407 of the observation optical system of the endoscope 401 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. To do.
• 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 26 of the distal treatment section 2 of the ultrasonic coagulation / cutting device 1B having the above-described configuration protrudes outside from the distal opening 408a of the treatment instrument penetration channel 408 (see FIG. 6).
• the treatment operation unit 18 is operated while observing the affected part, and the blade 26 is moved back and forth. Thereby, the front-end
• the treatment operating unit 18 is operated while confirming the clamping state, and the voltage of the power source 15 is applied to the plus electrode 12 and the minus electrode 13 of the actuator 10 at a desired cycle.
• the electrostrictive polymer 11 of the actuator 10 synchronizes with the supply cycle of the voltage of 15 power sources, and the extension that extends in the initial position shown in FIG. 28A and the arrow B direction (axial direction) as shown in FIG. 28B. It is expanded and contracted in the axial direction between the positions.
• the blade 26 is ultrasonically vibrated. A coagulation / incision treatment of the living tissue held between the forceps pieces 27 is performed.
• the above configuration has the following effects. That is, in the ultrasonic coagulation / cutting device 1B according to the present embodiment, it is possible to realize the blade 26 having high treatment capability using the actuator 10 using the electrostrictive polymer 11, and it is small and has high treatment capability. A sonic coagulation / cutting device 1B can be provided.

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• 2005
  • 2005-10-28 JP JP2005314323A patent/JP4657082B2/ja not_active Expired - Fee Related
• 2006
  • 2006-10-26 WO PCT/JP2006/321417 patent/WO2007049718A1/ja not_active Ceased
  • 2006-10-26 CN CN200680036235XA patent/CN101277653B/zh not_active Expired - Fee Related
• 2008
  • 2008-04-25 US US12/109,920 patent/US20080221603A1/en not_active Abandoned

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