ES2206562T3 - Aparato quirurgico ultrasonico con modo de funcionamiento doble. - Google Patents

Aparato quirurgico ultrasonico con modo de funcionamiento doble.

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ES2206562T3
ES2206562T3 ES96905980T ES96905980T ES2206562T3 ES 2206562 T3 ES2206562 T3 ES 2206562T3 ES 96905980 T ES96905980 T ES 96905980T ES 96905980 T ES96905980 T ES 96905980T ES 2206562 T3 ES2206562 T3 ES 2206562T3
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frequency
transducer
ultrasonic
tissue
surgical
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William W. Cimino
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Covidien AG
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Sherwood Service AG
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    • 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
    • B—PERFORMING OPERATIONS; TRANSPORTING
    • B06—GENERATING OR TRANSMITTING MECHANICAL VIBRATIONS IN GENERAL
    • B06B—METHODS OR APPARATUS FOR GENERATING OR TRANSMITTING MECHANICAL VIBRATIONS OF INFRASONIC, SONIC, OR ULTRASONIC FREQUENCY, e.g. FOR PERFORMING MECHANICAL WORK IN GENERAL
    • B06B1/00—Methods or apparatus for generating mechanical vibrations of infrasonic, sonic, or ultrasonic frequency
    • B06B1/02—Methods or apparatus for generating mechanical vibrations of infrasonic, sonic, or ultrasonic frequency making use of electrical energy
    • B06B1/0207—Driving circuits
    • B06B1/0223—Driving circuits for generating signals continuous in time
    • B06B1/0269—Driving circuits for generating signals continuous in time for generating multiple frequencies
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B2017/00017—Electrical control of surgical instruments
    • A61B2017/00137—Details of operation mode
    • A61B2017/00141—Details of operation mode continuous, e.g. wave
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B2017/00017—Electrical control of surgical instruments
    • A61B2017/00137—Details of operation mode
    • A61B2017/00141—Details of operation mode continuous, e.g. wave
    • A61B2017/00146—Details of operation mode continuous, e.g. wave with multiple frequencies
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B2017/00017—Electrical control of surgical instruments
    • A61B2017/00137—Details of operation mode
    • A61B2017/00141—Details of operation mode continuous, e.g. wave
    • A61B2017/00146—Details of operation mode continuous, e.g. wave with multiple frequencies
    • A61B2017/0015—Details of operation mode continuous, e.g. wave with multiple frequencies applied simultaneously
    • 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
    • A61B2017/320069—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic for ablating tissue
    • 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
    • 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
    • A61B2017/320089—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic node location
    • B—PERFORMING OPERATIONS; TRANSPORTING
    • B06—GENERATING OR TRANSMITTING MECHANICAL VIBRATIONS IN GENERAL
    • B06B—METHODS OR APPARATUS FOR GENERATING OR TRANSMITTING MECHANICAL VIBRATIONS OF INFRASONIC, SONIC, OR ULTRASONIC FREQUENCY, e.g. FOR PERFORMING MECHANICAL WORK IN GENERAL
    • B06B2201/00—Indexing scheme associated with B06B1/0207 for details covered by B06B1/0207 but not provided for in any of its subgroups
    • B06B2201/70—Specific application
    • B06B2201/76—Medical, dental

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Abstract

UN APARATO ULTRASONICO QUIRURGICO SIMPLE (10), PUEDE PROPORCIONAR UN EFECTO DE CORTE SUSTANCIAL EN TEJIDO, UN EFECTO DE COAGULACION SUSTANCIAL EN TEJIDO, Y UNA MEZCLA APROPIADA DE EFECTOS SIMULTANEOS DE CORTE Y DE COAGULACION EN TEJIDO. EL APARATO ULTRASONICO QUIRURGICO (10) ESTA COMPUESTO DE UN MANGO (11), QUE INCORPORA UN TRANSDUCTOR (14) Y UNA HERRAMIENTA QUIRURGICA (16), UNA FUENTE DE ENERGIA ELECTRICA (17), UN CONTROLADOR (18), Y UN INTERRUPTOR (19). EL APARATO PUEDE ACCIONARSE A DOS FRECUENCIAS DENTRO DEL ESPECTRO ULTRASONICO, DONDE LA PRIMERA FRECUENCIA (22) SE SELECCIONA DEL EXTREMO BAJO DEL ESPECTRO PARA UNA REALIZACION REALZADA DE CORTE DE TEJIDO, Y LA SEGUNDA FRECUENCIA (23) ES APROXIMADAMENTE TRES VECES MAS ALTA PARA UNA REALIZACION REALZADA DE COAGULACION DE TEJIDO. LAS DOS FRECUENCIAS PUEDEN ACCIONARSE SELECTIVAMENTE O SIMULTANEAMENTE, Y PUEDEN SER AJUSTABLES INDEPENDIENTEMENTE EN AMPLITUD. EL TRANSDUCTOR (14) PUEDE ESTAR COMPUESTO DE ELEMENTOS MAGNETOESTRICTIVOS O PIEZOELECTRICOS (20 O 21). EL CIRUJANO PUEDE ESTABLECER LA AMPLITUD DESEADA DE LAS VIBRACIONES MECANICAS. EL TRANSDUCTOR (14) ESTA MONTADO DENTRO DEL MANGO (11), EN UNA SITUACION QUE CORRESPONDE A UN NODO DE VIBRACION COMUN, TANTO A LA PRIMERA FRECUENCIA (22) COMO A LA SEGUNDA FRECUENCIA (23). SE REIVINDICA TAMBIEN UN PROCEDIMIENTO PARA SU USO, INCLUYENDO LAS ETAPAS DE: DESARROLLAR UNA RESONANCIA ULTRASONICA A UNA PRIMERA FRECUENCIA (22); DESARROLLAR UNA RESONANCIA ULTRASONICA A UNA SEGUNDA FRECUENCIA (23), QUE SEA APROXIMADAMENTE TRES VECES MAYOR QUE LA PRIMERA FRECUENCIA (22); RESONAR UN TRANSDUCTOR ULTRASONICO (14) A LA PRIMERA FRECUENCIA (22) SIMULTANEAMENTE CON LA SEGUNDA FRECUENCIA (23); Y APOYAR EL TRANSDUCTOR (14) DONDE LOS NODOS DE VIBRACION A LA PRIMERA FRECUENCIA (22) SEAN SUSTANCIALMENTE COINCIDENTES CON LOS NODOS DE VIBRACION A LA SEGUNDA FRECUENCIA (23).

Description

Aparato quirúrgico ultrasónico con modo de funcionamiento doble.
Campo de la invención
La invención se refiere a un aparato quirúrgico de ultrasonidos, mejorado, para cortar y coagular tejido de un paciente, y más concretamente, a un aparato quirúrgico de ultrasonidos que tiene la capacidad de emisión selectiva y/o simultánea de energía ultrasónica a dos frecuencias diferentes. El documento US-A-5451220 describe, de forma combinada, las características técnicas expuestas más adelante en la parte pre-caracterizadora de la reivindicación 1.
Antecedentes de la descripción
Las herramientas actuales de accionamiento no eléctrico para la disección de tejido, tales como el escalpelo e instrumentos asociados, tienden a causar hemorragia en el área incidida. No hay nada inherente a la herramienta que consiga la hemostasia. La electrocauterización, o de manera más general, las herramientas a base de energía electromagnética de radiofrecuencia, pueden lograr la hemostasia a través de la aplicación de corrientes eléctricas en el tejido que cauterizan de modo efectivo el tejido sangrante mediante calentamiento óhmico. La desventaja de las herramientas de electrocauterización es que no constituyen herramientas de disección muy buenas, puesto que la aplicación de energía no se controla de modo preciso y las puntas de las herramientas pueden pegarse al tejido.
Los expertos en la técnica conocen que el uso de energía ultrasónica en procedimientos quirúrgicos es un recurso valioso para cortar y fragmentar tejido de un paciente. La mayor parte de estos aparatos incorporan una señal sinusoidal de activación que hace que la punta mecánica vibre con una frecuencia seleccionada, generalmente en el margen entre 20 y 60 kHz. La señal sinusoidal de activación puede derivarse de una onda cuadrada con la misma frecuencia o puede ser inherente al diseño. Además, algunos dispositivos utilizan formas de onda moduladas de ciclo de trabajo para lograr un efecto deseado.
También es conocido por los expertos en la técnica que en la parte inferior del espectro de frecuencias preferido, es decir, entre 20 y 40 kHz, son posibles desplazamientos mayores de la punta. Es conocido, también, que los desplazamientos mayores de la punta proporcionan un mejor efecto de corte de tejido que los desplazamientos pequeños de la punta.
La energía ultrasónica en la parte superior del espectro de frecuencias preferido, es decir, entre 40 y 60 kHz, puede tener un efecto hemostático mayor. Esto se debe a la mayor capacidad del tejido para absorber energía de frecuencia más elevada. Sin embargo, a estas frecuencias no son factibles los desplazamientos grandes de la punta. Por lo tanto, los dispositivos que funcionan en este ámbito tienen prestaciones de corte de tejido reducidas.
Se han descrito distintos dispositivos quirúrgicos de ultrasonidos que intentan proporcionar tanto la función de corte como la de coagulación. La patente norteamericana 5.026.387 cedida a Ultracision, Inc., tiene varios modos de funcionamiento. La potencia se transmite al instrumento con una frecuencia ultrasónica a un nivel relativamente alto cuando va a efectuarse una función quirúrgica, y la carga del instrumento es relativamente alta. La potencia se transmite al instrumento a un nivel relativamente bajo durante los periodos inactivos de uso. Puede seleccionarse manualmente un modo de coagulación de alta potencia con retorno automático a un nivel de potencia en modo inactivo cuando la cuchilla no esté en contacto con el tejido. No se reivindica el funcionamiento a frecuencias diferentes.
En la patente norteamericana 5.263.957, cedida a Ultracision, Inc., la forma de una cuchilla ultrasónica está dispuesta para proporcionar una función de corte y una función de coagulación. Una parte de la cuchilla está dispuesta para cortar tejido. Una segunda parte de la cuchilla está dispuesta para proporcionar acoplamiento con fricción entre el borde de la cuchilla y el tejido, para obtener movimiento del tejido que produzca generación de calor y un efecto 
\hbox{hemostático.}
La patente extranjera WO 9.314.709 describe una cuchilla de ultrasonidos con un gancho formado en la cuchilla que tiene bordes planos, no afilados y relativamente romos. Esto facilita el corte y la coagulación del tejido cuando se aplica la energía ultrasónica al tejido.
Compendio de la invención
El objeto general de esta invención es proporcionar un solo aparato quirúrgico de ultrasonidos que pueda proporcionar un efecto sustancial de corte del tejido, un efecto sustancial de coagulación en el tejido y una mezcla apropiada de efectos simultáneos de corte y coagulación del tejido. Esto se lleva a cabo haciendo funcionar el aparato a dos frecuencias dentro de los límites del espectro ultrasónico, seleccionándose la primera frecuencia en la parte inferior del espectro para mejorar las prestaciones de corte de tejido, y siendo la segunda frecuencia, aproximadamente, tres veces mayor, para mejorar las prestaciones de coagulación en el tejido. Las dos frecuencias pueden aplicarse selectiva o simultáneamente y pueden ajustarse de modo independiente en lo que se refiere a la amplitud. La relación 1:3 entre la primera frecuencia y la segunda frecuencia es una consideración importante de diseño que no ha sido valorada hasta ahora en el diseño de dispositivos quirúrgicos de ultrasonidos. La relación permite que los nodos de las frecuencias primera y segunda de las vibraciones que se producen a lo largo del transductor lleguen a estar alineados, proporcionando, de ese modo, puntos de unión apropiados entre el transductor y una cubierta o mango.
En general, el aparato quirúrgico de ultrasonidos comprende un mango, un transductor, una herramienta quirúrgica, una fuente de energía eléctrica, un controlador y un conmutador. El mango tiene un extremo proximal que es retenido y controlado por el cirujano y un extremo distal que es posicionado junto al tejido del paciente. El transductor puede estar compuesto de elementos magnetostrictivos o piezoeléctricos. El transductor está asegurado en el interior del mango y es capaz de producir vibraciones mecánicas ultrasónicas, selectiva o simultáneamente, a una primera frecuencia y a una segunda frecuencia, siendo la segunda frecuencia, aproximadamente, tres veces más elevada que la primera frecuencia.
Aunque se entiende que un transductor que es hecho funcionar a una frecuencia fundamental tendrá también energía en los armónicos más elevados, lo que se describe en este caso es la capacidad de accionar el transductor a dos frecuencias. La herramienta quirúrgica está asegurada en el transductor y se extiende, al menos parcialmente, más allá del extremo distal del mango. Está previsto que la herramienta quirúrgica tenga un efecto sustancial de corte en el tejido cuando el transductor esté produciendo vibraciones mecánicas ultrasónicas a la frecuencia primera (inferior), y está previsto que la herramienta quirúrgica tenga un efecto sustancial de coagulación en el tejido cuando el transductor esté produciendo vibraciones mecánicas ultrasónicas a la segunda frecuencia (superior). Cuando la primera frecuencia y la segunda frecuencia se apliquen simultáneamente, se obtendrá un efecto sustancial de coagulación y corte en el tejido del paciente.
La fuente de energía eléctrica está conectada al transductor. El controlador está conectado a la fuente de energía eléctrica y, también, al transductor, para controlar de modo estable la frecuencia y la amplitud de las vibraciones mecánicas ultrasónicas. Para lograrlo, el controlador detecta la frecuencia y la amplitud y, a continuación, ajusta la fuente de energía eléctrica de modo que mantenga la frecuencia y la amplitud deseadas del transductor.
Hay un conmutador conectado al controlador para seleccionar vibraciones mecánicas ultrasónicas con la primera frecuencia, vibraciones mecánicas ultrasónicas con la segunda frecuencia o vibraciones mecánicas ultrasónicas simultáneamente con la primera frecuencia y con la segunda frecuencia.
En una realización, el controlador puede ser ajustado por el cirujano. Ello hace posible que el cirujano establezca la amplitud deseada de las vibraciones mecánicas. Para ello, hay un regulador conectado al controlador. El regulador sería capaz de ajustar de modo independiente la amplitud de las vibraciones mecánicas ultrasónicas mientras se está funcionando a la primera frecuencia o a la segunda frecuencia.
Otra ventaja de disponer las dos frecuencias en la relación 1:3 es que habrá, al menos, una posición nula a lo largo del transductor en la que los nodos de vibración de ambas frecuencias estarán sustancialmente alineados. En la posición nula habrá poco movimiento relativo entre el transductor y la cubierta del mango. Por lo tanto, será posible unir el transductor a la cubierta del mango con un soporte ubicado en una posición nula.
La invención es útil en un método para usar un aparato quirúrgico de ultrasonidos que incluye los pasos de: generar una resonancia ultrasónica a una primera frecuencia; generar una resonancia ultrasónica a una segunda frecuencia que sea aproximadamente tres veces más elevada que la primera frecuencia; y hacer que un transductor ultrasónico entre en resonancia a la primera frecuencia de modo simultáneo con la segunda frecuencia. También puede contarse con los pasos adicionales de: ajustar la amplitud de la primera frecuencia y ajustar la amplitud de la segunda frecuencia.
En un método de fabricación del aparato quirúrgico de ultrasonidos, el transductor está montado en el interior de la cubierta del mango, y las ubicaciones de montaje se seleccionan en posiciones, a lo largo del transductor, que correspondan a los nodos de desplazamiento de vibración comunes a la primera frecuencia y a la segunda frecuencia.
Breve descripción de los dibujos
la figura 1 es un diagrama de bloques esquemático de un aparato quirúrgico de ultrasonidos de modo doble.
La figura 2 es un diagrama de bloques esquemático de una realización de un mango para un aparato quirúrgico de ultrasonidos de modo doble.
La figura 3 es un diagrama de bloques esquemático de una realización alternativa de un mango para un aparato quirúrgico de ultrasonidos de modo doble.
La figura 4 es un gráfico normalizado que representa la relación entre la primera frecuencia y la segunda frecuencia.
Descripción detallada de la invención
En la figura 1 se muestra un aparato 10 quirúrgico de ultrasonidos de modo doble. En general, el aparato quirúrgico de ultrasonidos está compuesto de un mango 11, un transductor 14, una herramienta 16 quirúrgica, una fuente 17 de energía eléctrica, un controlador 18 y un conmutador 19. El aparato 10 tiene un mango 11 con un extremo proximal 12 y un extremo distal 13. El mango 11 tiene un transductor ultrasónico 14 asegurado en el interior de una cubierta 15. Una herramienta 16 quirúrgica está soportada en el transductor ultrasónico 14.
El mango 11 tiene un extremo proximal 12 que es retenido y controlado por el cirujano, y un extremo distal 13 que se posiciona junto al tejido del paciente. El transductor 14 puede estar compuesto de elementos magnetostrictivos 20, como se muestra en la figura 2. Alternativamente, el transductor 14 puede estar compuesto de elementos piezoeléctricos 21, como se muestra en la figura 3.
El transductor 14 es capaz de producir vibraciones mecánicas ultrasónicas, selectiva o simultáneamente, a una primera frecuencia 22 y a una segunda frecuencia 23, como se muestra en la figura 4. Las frecuencias 22 y 23 se muestran de forma normalizada en la figura 4, porque la consideración de diseño importante es la relación entre las dos frecuencias 22 y 23. La segunda frecuencia 23 es, aproximadamente, tres veces mayor que la primera frecuencia 22. Las ubicaciones de los nodos de vibración correspondientes tanto a la primera frecuencia 22 como a la segunda frecuencia 23 se muestran como ubicaciones 24 y 25 en la figura 4.
La herramienta quirúrgica 16 está soportada en el transductor 14 y se extiende, al menos parcialmente, más allá del extremo distal 13 del mango. Está previsto que la herramienta 16 quirúrgica tenga un efecto sustancial de corte en el tejido cuando el transductor 14 esté produciendo vibraciones mecánicas ultrasónicas a la primera frecuencia 22, y está previsto que la herramienta quirúrgica 16 tenga un efecto sustancial de coagulación en el tejido cuando el transductor 14 esté produciendo vibraciones mecánicas ultrasónicas a la segunda frecuencia 23.
La fuente 17 de energía eléctrica está conectada al transductor 14. El diseño de la fuente de energía eléctrica 17 puede realizarse de muchas formas, que son antiguas y bien conocidas en la técnica. El controlador 18 está conectado a la fuente 17 de energía eléctrica y también al transductor 14, para controlar de modo estable la frecuencia y la amplitud de las vibraciones mecánicas ultrasónicas. Para lograrlo, el controlador 18 detecta la frecuencia y la amplitud y, a continuación, ajusta la fuente 17 de energía eléctrica de modo que se mantengan la frecuencia y la amplitud deseadas del transductor 14. El diseño específico del controlador 18 puede ser realizado de muchas formas, que son antiguas y bien conocidas en la técnica.
Un conmutador 19 está conectado al controlador para seleccionar vibraciones mecánicas ultrasónicas con la primera frecuencia 22, o vibraciones mecánicas ultrasónicas con la segunda frecuencia 23 o vibraciones mecánicas ultrasónicas simultáneamente con la primera frecuencia 22 y con la segunda frecuencia 23.
En una realización, el controlador 18 puede ser ajustado por el cirujano. Ello hace posible que el cirujano regule la amplitud deseada de las vibraciones mecánicas. Para ello, hay un regulador 26 conectado al controlador 18. El regulador 26 es capaz de ajustar de modo independiente la amplitud de las vibraciones mecánicas ultrasónicas mientras que se funciona a la primera frecuencia 22 o a la segunda frecuencia 23.
Otra ventaja de disponer las dos frecuencias en la relación 1:3 es que habrá al menos una posición nula a lo largo del transductor 14 en la que los nodos de vibración de ambas frecuencias 22 y 23 estarán alineados. Por lo tanto, no habrá movimiento relativo del transductor 14 en esa ubicación y será posible unir el transductor 14 a la cubierta 15. En consecuencia, puede conectarse al menos un soporte 27 entre la cubierta 15 y el transductor 14, y el soporte 27 puede posicionarse, a lo largo del transductor, en una ubicación que corresponda a un nodo de vibración común a la primera frecuencia 24 y a la segunda frecuencia 25, como se muestra en la figura 4.
También se reivindica un método para usar un aparato 10 quirúrgico ultrasónico que incluye los pasos de: generar una resonancia ultrasónica a una primera frecuencia 22; generar una resonancia ultrasónica a una segunda frecuencia 23 que sea aproximadamente tres veces mayor que la primera frecuencia 22; y hacer que un transductor ultrasónico 14 entre en resonancia a la primera frecuencia 22 simultáneamente con la segunda frecuencia 23, estando los nodos de vibración del transductor 14 a la primera frecuencia 22 alineados con los nodos de vibración del transductor 14 a la segunda frecuencia 23, como se muestra en las ubicaciones 24 y 25 de la figura 4.
En una realización, puede haber, también, los pasos adicionales de ajustar la amplitud de la primera frecuencia 22, ajustar la amplitud de la segunda frecuencia 23 y ajustar la amplitud de la primera frecuencia 22 de modo independiente de la segunda frecuencia 23. También se reivindica un método para fabricar un aparato 10 quirúrgico ultrasónico de modo doble en el que el transductor 14 está montado dentro de un mango 11 en ubicaciones 27 de montaje que están en posiciones seleccionadas a lo largo del transductor 14, que corresponden a nodos de vibración comunes a la primera frecuencia 22 y a la segunda frecuencia 23, como se muestra mediante las posiciones 24 y 25 de la figura 4.

Claims (6)

1. Un aparato (10) quirúrgico ultrasónico para ser usado por un cirujano para operar sobre tejido de un paciente que comprende:
un mango (11) que tiene un extremo proximal (12) que es retenido y controlado por el cirujano;
un extremo distal (13) en el mango para posicionarlo junto al tejido del paciente;
un transductor (14), soportado en el interior del mango, siendo el transductor capaz de producir vibraciones mecánicas ultrasónicas sustancialmente a una primera frecuencia (22) y sustancialmente a una segunda frecuencia (23), siendo la segunda frecuencia, aproximadamente, tres veces mayor que la primera frecuencia;
una herramienta quirúrgica (16) soportada en el transductor y que se extiende generalmente más allá del extremo distal, teniendo la herramienta quirúrgica un efecto sustancial de corte en el tejido cuando es hecha funcionar, de modo selectivo, a la primera frecuencia, teniendo la herramienta quirúrgica un efecto sustancial de coagulación en el tejido cuando es hecha funcionar, de modo selectivo, a la segunda frecuencia, teniendo la herramienta quirúrgica efectos sustanciales de corte y coagulación en el tejido cuando es hecha funcionar, simultáneamente, a las frecuencias primera y segunda;
una fuente (17) de energía eléctrica para conectar al transductor;
un controlador (18), conectado entre la fuente de energía eléctrica y el transductor, para generar señales a fin de controlar de modo estable las frecuencias y las amplitudes de las vibraciones mecánicas ultrasónicas del transductor, y,
un conmutador (19) conectado al controlador, para seleccionar las señales a fin de controlar de modo estable las vibraciones mecánicas ultrasónicas del transductor a la primera frecuencia, cuando el conmutador está en una primera posición, y las vibraciones mecánicas ultrasónicas del transductor a la segunda frecuencia, cuando el conmutador está en una segunda posición;
caracterizado porque:
el conmutador tiene una tercera posición, para generar vibraciones mecánicas ultrasónicas del transductor, simultáneamente, a la primera frecuencia y a la segunda frecuencia, cuando el conmutador está en una tercera posición.
2. El aparato de la reivindicación 1, en el que un regulador (26) está conectado al controlador, siendo el regulador capaz de ser usado por el cirujano para cambiar las señales generadas por el controlador a fin de ajustar la amplitud de las vibraciones mecánicas ultrasónicas.
3. El aparato de las reivindicaciones 1 ó 2, en el que el transductor incluye un elemento piezoeléctrico (21).
4. El aparato de las reivindicaciones 1 ó 2, en el que el transductor incluye un elemento magnetostrictivo (20).
5. El aparato de cualquiera de las reivindicaciones precedentes, en el que al menos un soporte (27) está conectado entre el mango y el transductor, estando el soporte posicionado a lo largo del transductor en una ubicación que corresponda, sustancialmente, a un nodo de vibración común a la primera frecuencia y a la segunda frecuencia.
6. Un método para fabricar un mango quirúrgico de ultrasonidos según la reivindicación 1, que incorpora un componente de cubierta (15) que es retenido por un cirujano y un componente de transductor que está soportado en el interior de la cubierta, siendo el componente de transductor capaz de producir vibraciones mecánicas ultrasónicas a la primera frecuencia y a la segunda frecuencia, comprendiendo el método los pasos de:
montar el transductor, en el interior de la cubierta, en una o más ubicaciones de montaje, y seleccionar las ubicaciones de montaje en posiciones a lo largo del transductor que correspondan, sustancialmente, a nodos de vibración comunes a la primera frecuencia y a la segunda frecuencia.
ES96905980T 1994-12-21 1996-04-04 Aparato quirurgico ultrasonico con modo de funcionamiento doble. Expired - Lifetime ES2206562T3 (es)

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US08/360,538 US5628743A (en) 1994-12-21 1994-12-21 Dual mode ultrasonic surgical apparatus
CA002228659A CA2228659A1 (en) 1994-12-21 1996-04-04 Dual mode ultrasonic surgical apparatus
PCT/IB1996/000280 WO1997037598A1 (en) 1994-12-21 1996-04-04 Dual mode ultrasonic surgical apparatus

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EP0891154A1 (en) 1999-01-20
NO980326D0 (no) 1998-01-26
JPH11503061A (ja) 1999-03-23
NO980326L (no) 1998-03-26
DE69629946D1 (de) 2003-10-16
CA2228659A1 (en) 1997-10-16
MX9801152A (es) 1998-05-31
EP0891154B1 (en) 2003-09-10
AU4952496A (en) 1997-10-29
WO1997037598A1 (en) 1997-10-16
DE69629946T2 (de) 2004-07-15
ATE249174T1 (de) 2003-09-15
US5628743A (en) 1997-05-13

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