WO2023177210A1

WO2023177210A1 - Ultrasonic suction liver and brain cutter having coagulation function using bipolar energy

Info

Publication number: WO2023177210A1
Application number: PCT/KR2023/003470
Authority: WO
Inventors: 윤삼열
Original assignee: 인제대학교 산학협력단
Priority date: 2022-03-16
Filing date: 2023-03-15
Publication date: 2023-09-21
Also published as: KR20230135344A

Abstract

Disclosed is an ultrasonic suction liver and brain cutter having a coagulation function using bipolar energy. The present invention comprises: electrode bodies which are electrically connected to an electrosurgical apparatus, bipolar, and composed of high-frequency current lead-in and lead-out electrodes to perform a coagulation procedure for body tissue; a pump body which is provided inside the electrode bodies and between the electrode bodies, connected to the electrosurgical apparatus, and driven by positive pressure and negative pressure to supply and suction a saline solution for a coagulation procedure; and a body in which is installed a vibration member for providing ultrasonic vibration to a coagulation treatment area through the electrode body, and which is provided with a control circuit member for controlling a high-frequency power source.

Description

Ultrasonic aspiration liver and brain cutting device with coagulation function using bipolar energy

The present invention relates to a liver and brain cutting device that uses ultrasound waves of 20 kHz or higher to induce tissue cavitation and then cauterizes bleeding blood vessels and biliary structures using a bipolar electrosurgical device that generates less smoke and debris.

With the development of science and technology, many recent developments in the medical field, especially medical devices including surgical instruments, have made it possible to perform complex and difficult surgeries relatively simply and safely with the help of precise surgical tools and medicines.

However, many problems still remain to be solved in technology to treat specific diseases, including cancer, or diseases in specific areas, such as the brain.

In particular, in the case of the brain, it is the most important part of the human body, so if an abnormality occurs in the brain, even if the disease is minor, treatment is difficult and brain surgery is known to be life-threatening.

It is a relatively simple surgery that is frequently performed among brain surgeries. It is a relatively simple surgery that occurs when water accumulates in the space between the skull and the brain surface (hypodural edema) or when blood accumulates and becomes watery over time (chronic There is a burr hole drainage procedure performed to remove subdural hematoma.

In case of intraventricular hemorrhage or cerebral hemorrhage due to high blood pressure, blood spreads to the ventricle and cerebrospinal fluid flow in the ventricle is blocked (acute hydrocephalus). External Ventricular Drainage is performed as an emergency.

Extraventricular drainage is similar to perforator drainage, but the difference is that the catheter penetrates the brain tissue and enters the ventricle.

In addition, a relatively common surgery for hydrocephalus is the ventricul-operitoneal shunt, which creates a passage through a catheter between the water sac (ventricle) in the head and the abdominal cavity.

After general anesthesia, a craniotomy is performed, in which the skull is opened wide, the meninges are incised, and brain lesions (hematomas, tumors, foreign bodies, etc.) are removed.

Looking at these brain surgeries, it is necessary to make an incision in the scalp at the surgical site, make a hole in the skull, cut the meninges, and insert a catheter through the hole, or even insert a catheter through the brain tissue into the ventricle to drain the brain.

As you know, the brain is intertwined with important blood vessels and nerves, so making a hole in the skull, cutting the meninges, and then inserting a catheter into the hole or piercing the brain tissue and inserting a catheter into the ventricle is a serious risk that can pose a very serious risk to the patient. It is clear that it was surgery.

However, to date, the process of incising the scalp at the surgical site, making a hole in the skull, incising the meninges, or piercing brain tissue has relied on blind procedures based on the doctor's personal experience.

Among the surgical instruments that incise the parenchyma of the liver and brain, there is a device called CUSA (cavitron ultrasonic surgical aspirator).

This equipment uses ultrasound waves of about 20Khz or higher to cause cavitation of cellular structures in the liver or brain parenchyma, and selects a method of cauterizing blood vessels or biliary structures using a monopolar electrosurgical device.

However, in this case, the unipolar electrosurgical device generates smoke and debris, which causes clogging of the Cusa inhaler and the generation of anti-cancer substances (carconogen) due to the smoke, which causes inconvenience in use.

The electrosurgical electrode of the present invention is an electrode for electrosurgery that is electrically connected to an electrosurgical machine to perform procedures such as incision and coagulation of body tissues. It is composed of bipolar polarity and causes tissue cavitation during procedures on body tissues. The purpose is to prevent significant production of smoke and debris by cauterizing blood vessels and biliary structures with severe bleeding.

The present invention includes an electrode body electrically connected to an electrosurgical device, bipolar, and composed of input and output electrodes for high-frequency current to perform a coagulation procedure on body tissue; and a pump body provided inside and between the electrode body, connected to the electrosurgical device, and driven by positive and negative pressure to supply and suction saline solution for performing a coagulation procedure. A body equipped with a vibration member for providing ultrasonic vibration to the coagulation treatment area through the electrode body and a control circuit member for controlling high-frequency power; The purpose of the present invention is sufficiently achieved by providing a configuration including.

In a configuration in which the object of the present invention is achieved, the electrode body is a first pipe and a second pipe with a thin diameter and an empty interior, and one end of the first pipe and the second pipe is installed in the body. The end extends in the direction of the treatment area, and the vibrating shaft for transmitting ultrasound is preferably inserted into the empty space of the first pipe and the second pipe.

In a configuration in which the object of the present invention is achieved, the first pipe and the second pipe are equipped with a coupling having a frame at the center at one end and the other end, and the vibrating shaft is inserted into the first pipe and the second pipe. It is mounted through the center of the empty space of the first pipe and the second pipe by the frame, and at the same time, a saline solution supply hole for performing coagulation treatment is formed between the vibrating shaft and the empty space of the first pipe and the second pipe. It is desirable to configure it so that it is equipped.

In a configuration in which the object of the present invention is achieved, the pump body has a supply tube connected to one end of the first pipe and the second pipe installed in the body from a static pressure pump outside the body and connected to an internal supply pipe. It is preferable that the saline solution for performing the coagulation procedure is supplied through the saline solution supply holes of the first pipe and the second pipe.

In a configuration in which the object of the present invention is achieved, the pump body has a diameter of the first pipe and the second pipe of the electrode body, and the suction pipe is installed between the first and second pipes in the direction of the treatment area of the body body. and a suction tube connected from a negative pressure pump outside the body to an internal suction tube to suction the saline solution supplied to perform the coagulation procedure.

In a configuration in which the object of the present invention is achieved, the electrode body is connected to a vibrating shaft for ultrasonic transmission inserted into the empty space of the first tube, and the vibrator horn of the vibrator of the body is connected to the transmission shaft of the first tube and It is preferable that the vibrating shaft of the second pipe is connected to the connecting band, and the high-frequency power source of the control circuit member for bipolar configuration is connected to the connecting band.

According to the present invention, both unipolar or bipolar connection of the electrosurgical device that applies high-frequency current to the electrode during the procedure is possible, and there is no need to use a counter electrode (patient electrode or ground pad) in contact with the patient, making electrode use and procedure convenient. There is an advantage to doing so.

In particular, the procedure can be performed under a lower voltage compared to existing unipolar procedures, suppressing the generation of sparks between body tissues and electrodes to minimize carbonization of tissues, and minimizing the transmission path of high-frequency current through the electrode, resulting in burns or electrical shock caused by high-frequency current. Improved effectiveness in preventing shock, etc. can be obtained.

1 is an overall state diagram of a brain cutting machine to which the present invention is applied.

Figure 2 is a detailed front view of the body of the brain cutting machine of the present invention.

Figure 3 is an overall state diagram from different angles of the brain cutter to which the present invention is applied.

Figure 4 is a projection perspective view showing the internal configuration of the body of the present invention.

Figure 5 is a cross-sectional perspective view showing the internal structure of the electrode body of the body of the present invention.

Figure 6 is a partial enlarged perspective view of the electrode body of the present invention.

Hereinafter, with reference to the attached drawings, a preferred embodiment of the present invention's ultrasonic aspiration liver and brain cutting machine with coagulation function using bipolar energy will be described.

Figure 1 is a diagram showing the overall state of a brain cutter to which the present invention is applied.

Power is supplied from the outside to the RF high-frequency generator 440 and the ultrasonic generator 430, which are electrically connected to the electrosurgical device 400 to provide high-frequency current and ultrasonic current.

An electrode body 200 is provided that is bipolar and consists of incoming and outgoing electrodes for high-frequency current to perform coagulation of body tissues.

The electrode body 200 is provided inside the electrode body 200 and between the electrode body 200 and connected to the electrosurgical device 400, and supplies and suctions saline solution for performing coagulation procedures. To achieve this, a pump body 300 driven by positive pressure and negative pressure is provided.

In addition, a vibration member 130 is installed to provide ultrasonic vibration to the coagulation treatment area through the electrode body 200, and includes a body 100 provided with a control circuit member 120 for controlling high frequency power. It is composed by:

Figure 2 is a detailed state of the body of the brain cutter of the present invention, Figure 3 shows the overall state of the brain cutter to which the present invention is applied from a different angle, and Figure 4 is an internal view of the body of the brain cutter of the present invention. It is a perspective state showing the structure, Figure 5 shows a cross-sectional state showing the internal structure of the electrode body of the body of the present invention, and Figure 6 shows a partially enlarged state of the electrode body of the present invention.

The electrode body 200 includes a first pipe 210 and a second pipe 230 that are thin in diameter and have an empty space inside like a pipe, and one end of the first pipe 210 and the second pipe 230 is When installed on the body 100, the end extends in the direction of the treatment area.

A vibrating shaft 240 for transmitting ultrasonic waves is inserted into the empty space of the first pipe 210 and the second pipe 230.

A vibrating shaft 240 is installed in the empty space inside the first pipe 210 and the second pipe 230, and for this purpose, it is located in the center at one end and the other end of the first pipe 210 and the second pipe 230. The coupling 250 provided with the frame 252 is installed.

The vibration shaft 240 is inserted into the first pipe 210 and the second pipe 230 by making the diameter smaller than the empty space inside the first pipe 210 and the second pipe 230. The vibration shaft 240 is inserted into the frame 252 and is placed in the center of the empty space of the first pipe 210 and the second pipe 230, thereby forming the first pipe 210 and the second pipe 230. A saline solution supply hole 260 for performing a coagulation procedure is formed in the empty space of 230.

Ultrasound transmission inserted into the first pipe 210 among the vibrating shafts 240 for ultrasonic transmission that are inserted into the empty space of the first pipe 210 and the second pipe 230 to form the saline solution supply hole 260. The vibrating shaft 240 is connected to the vibrator 131 installed inside the body 100, and is connected through the vibrator horn 133.

Figure 4 is a perspective view showing the internal structure of the body of the present invention, and a configuration that transmits ultrasonic vibration from the vibration shaft of the first tube to the vibration shaft of the second tube is illustrated.

With the vibrator 131 connected to the vibration shaft 240 of the first pipe 210, the ultrasonic vibration generated by the vibrator 131 is transmitted to the vibration shaft 240 inserted into the empty space of the second pipe 230. In order to transmit to the side, a connection band 270 is installed on the vibration shaft 240 of the first pipe 210 and the vibration shaft 240 of the second pipe 230, so that the ultrasonic vibration generated from the vibrator 131 is transmitted to the connection band. It is configured to be transmitted to each vibration shaft (240) by (270).

And, the high-frequency current line 410 is connected to the connection band 270 that connects the vibration shaft 240 of the first pipe 210 and the vibration shaft 240 of the second pipe 230 to form a body. (100) RF high frequency current is supplied from the externally provided RF high frequency generation (440).

If RF high-frequency current is applied to the vibration shaft 240 of the first pipe 210 and the vibration shaft 240 of the second pipe 230, bipolar electricity can be supplied to the lesion site to be treated.

When the tips of the first pipe 210 and the second pipe 230 approach the lesion area, coagulation treatment can be performed on the treatment area using RF high-frequency power supplied along with ultrasonic vibration.

Since the ends of the first pipe 210 and the second pipe 230 of the electrode body 200 are required to be bent at a predetermined angle for smooth coagulation procedure, the first pipe 210 and the second pipe 230 It is desirable to bend the end of (230) within the range of 10 to 30 degrees to form an inclined shape.

The pump body 300 connects a supply pipe 310 for supplying saline solution to one end of the first pipe 210 and the second pipe 230 installed in the body 100.

The inside of the body 100 is connected to the supply tube 320 connected from the static pressure pump 330 installed outside the body 100, and the saline solution is supplied to the first pipe 210 and the second pipe 230. Saline water is supplied to the coagulation treatment area through the hole 260.

The saline solution supplied to the coagulation treatment site through the supply hole 260 of the body 100 is supplied to the body through the suction pipe 340 installed between the first pipe 210 and the second pipe 230. (100) Ensure that it is absorbed to the outside.

The suction pipe 340 is made to have the diameter of the first pipe 210 and the second pipe 230 and is connected to the suction tube 350 inside the body 100, and the suction tube 350 is connected to the body ( 100) It is configured to be connected to an external negative pressure pump 360, so that the saline solution supplied to the coagulation treatment area is suctioned and discharged toward the negative pressure pump 360 through the suction pipe 340.

The control circuit member 120 provided inside the body 100 is a vibration shaft 240 for ultrasonic transmission inserted into the first pipe 210 and the second pipe 230 through the connection band 270. A vibrator 131 of the vibration member 130 that transmits ultrasonic vibration is provided.

A button 122 is provided to control the RF high frequency supply line (R) and power, and a circuit is provided to drive a preset program by connecting the ultrasonic power line (H) and the control signal line (C). A circuit board 121 is provided.

The present invention, which consists of the above configuration, involves the operator holding the body 100 and approaching the distal ends of the first pipe 210 and the second pipe 230 to the lesion area to be treated for coagulation, thereby forming the body 100. Press button 1220 to select the required previously input drive function.

With that selection, the ultrasonic generation 430 is driven and vibration is generated by ultrasonic current in the electrically connected vibrator 131, and the generated vibration is transmitted through the connection band 270 to the first pipe 210 and the second pipe 230. ) is transmitted to the vibration shaft 240 mounted on the.

At this time, when output through the end of the vibration shaft 240, ultrasonic vibration of 20 kHz or more is output, causing cavitation of the cellular structure of the contacted liver or brain parenchyma.

At the same time, the RF high-frequency current is applied according to the program input to the control circuit member 120, and the RF high-frequency current is converted into bipolar energy between the anodes of the tip of the vibration shaft 240 of the first pipe 210 and the second pipe 230. A state in which the generation of soot and debris is significantly reduced for heavily bleeding blood vessels and biliary structures during procedures such as resection, hemostasis, coagulation, incision, and dissection on nearby or contacted lesion areas by printing and cauterizing and coagulating the treatment area. achieves

In particular, when ultrasonic vibration causes cavitation of cellular structures in the liver or brain parenchyma, the static pressure pump 330 is driven by a program input to the control circuit member 120 to supply saline solution to the supply tube 320 and the supply pipe 310. Saline water is supplied to the coagulation treatment site through the saline solution supply hole 260 provided in the empty space of the first pipe 210 and the second pipe 230.

At the same time, the suction function is driven in the suction pipe 340 by the suction force generated by the negative pressure pump 360.

When this suction function is activated, debris, blood, and soot generated during the cauterization process are discharged through the suction pipe 340 to the negative pressure pump 360 operated outside the body 100.

Claims

An electrode body electrically connected to an electrosurgical device, bipolar, and composed of input and output electrodes for high-frequency current to perform a coagulation procedure on body tissue;

A pump body provided inside and between the electrode body, connected to the electrosurgical device, and driven by positive and negative pressure to supply and suction saline solution for performing coagulation procedures; and

A body equipped with a vibration member for providing ultrasonic vibration to the coagulation treatment area through the electrode body and a control circuit member for controlling high-frequency power; Ultrasonic aspiration liver and brain cutting machine with coagulation function using bipolar energy, including:
According to paragraph 1,

The electrode body is,

The first and second tubes are thin in diameter and have an empty space inside.

With one end of the first pipe and the second pipe installed in the body, the ends extend in the direction of the treatment area, and a vibrating shaft for ultrasound transmission is inserted into the empty space of the first pipe and the second pipe. Ultrasonic aspiration liver and brain cutting machine with coagulation function using bipolar energy.
According to paragraph 2,

The above Subsections 1 and 2 are:

A coupling having a frame at the center is mounted on one end and the other end, and the vibration shaft inserted into the first pipe and the second pipe is positioned in the center of the empty space of the first pipe and the second pipe by the frame. At the same time as it is penetrated,

An ultrasonic aspiration liver and brain cutting machine with a coagulation function using bipolar energy, characterized in that a saline solution supply hole for performing a coagulation procedure is provided between the vibrating shaft and the empty space of the first pipe and the second pipe.
According to paragraph 1,

The pump body is,

At one end of the first pipe and the second pipe installed in the body,

Characterized in that it consists of a supply tube connected from a static pressure pump outside the body and connected to an internal supply pipe, so that saline water for performing a coagulation procedure is supplied through the saline solution supply holes of the first pipe and the second pipe, Ultrasonic aspiration liver and brain cutting machine with coagulation function using bipolar energy.
According to paragraph 4,

The pump body is,

a suction pipe having a diameter of the first and second pipes of the electrode body and installed between the first and second pipes in the direction of the treatment area of the body;

Ultrasonic suction liver with coagulation function using bipolar energy, characterized in that it consists of a suction tube connected from a negative pressure pump outside the body to an internal suction tube to suction the saline solution supplied to perform the coagulation procedure. Brain Slicer.
According to paragraph 1,

The electrode body is,

The vibrator horn of the vibrator of the body is connected to a vibrating shaft for ultrasonic transmission inserted into the empty space of the first pipe,

The transmission shaft of the first pipe and the vibration shaft of the second pipe are connected by a connecting band, and the connecting band is connected to a high-frequency power source for a control circuit member for bipolar configuration, and has a coagulation function using bipolar energy. This is accompanied by ultrasonic aspiration liver and brain excision.