JP2000254136A - Ultrasonic instrument - Google Patents

Abstract

PROBLEM TO BE SOLVED: To easily put the side surface of a probe tip part (treating part) on the tissue and also to easily observe the probe tip part in the case of an ultrasonic treatment by forming a tip treating part by means of plural curved surfaces. SOLUTION: An ultrasonic treating instrument is formed of a vibrator for generating an ultrasonic vibration by energizing, a probe for transmitting the vibration generated in the vibrator and a sheath for covering a part except the probe tip treating part and a tip treating part 11 for incising and coagulating viable tissue is arranged in the tip of the probe. Then the both side surfaces of the tip treating part 11 are formed as the curved surfaces 12 and 13 which are bent by a radius with a comparatively large curvature mutually at a same side and a hook part 14 is formed in the part 11 by arranging a notch at one side of edges in each curved surface. The notches for forming the hook part 14 are arranged to have a gentle slope toward the root side of the part 11 from the bottom surface of the recessed part of the hook part 14.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an ultrasonic surgical instrument for performing coagulation and incision of a portion to be treated by ultrasonic vibration.

[0002]

2. Description of the Related Art In a surgical operation, there is generally known an ultrasonic treatment tool for cutting and coagulating a living tissue by ultrasonic vibration. Such an ultrasonic treatment instrument is, for example, U
SP 5,324,299, USP 5,346,502
No. 4, Japanese Patent Application Laid-Open No. 4-212338, etc., the distal end portion of a probe that transmits ultrasonic vibration (treatment section)
Is processed into a flat plate shape, and a concave portion (hook portion) for hooking a living tissue is formed at a part of the edge of the distal end portion. Further, a sheath for blocking ultrasonic vibration of the probe is covered around the probe. The sheath is engaged with the probe only at the position of the node of the ultrasonic vibration, and has a structure in which the outer diameter is expanded in other parts to block the ultrasonic vibration and does not contact the probe.

[0003] In the ultrasonic treatment instrument having such a configuration, a tissue is hooked on the hook at the distal end to make an incision, and the side surface of the flat distal end is brought into contact with the tissue to generate frictional heat due to ultrasonic vibration. By generating it, it is possible to coagulate the bleeding site by the frictional heat.

[0004]

However, in the conventional ultrasonic treatment instrument of the above construction, the side surface of the flat tip of the probe is parallel to the longitudinal center axis (insertion axis) of the probe. When the portion of the sheath located near the hand interferes with the tissue, there is a problem that it is very difficult to apply the side surface of the distal end portion to the tissue.

If the side surface of the flat tip of the probe is parallel to the central axis in the longitudinal direction of the probe, the tip of the probe may be displaced during endoscopic surgery depending on the direction of the field of view of the endoscope. It may be difficult to observe with an endoscope.

The present invention has been made in view of the above circumstances, and an object of the present invention is to make it possible to easily touch the side surface of the distal end portion (treatment section) of a probe to tissue and to perform ultrasonic treatment. It is an object of the present invention to provide an ultrasonic treatment instrument that facilitates observation of a probe tip (treatment section) in the above.

[0007]

In order to solve the above-mentioned problems, the present invention provides a vibrator for generating ultrasonic vibration, a probe for transmitting ultrasonic vibration generated by the vibrator, and a probe provided at a tip of the probe. An ultrasonic treatment tool comprising a tip treatment section that is subjected and performs ultrasonic treatment in contact with living tissue,
The distal treatment section is formed by a plurality of curved surfaces.

[0008]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS An embodiment of the present invention will be described below with reference to the drawings.

As shown in FIG. 1 and FIG. 2, an ultrasonic treatment instrument 1 according to the present embodiment transmits an ultrasonic vibration generated by the vibrator 2 to generate an ultrasonic vibration when energized. And a sheath 4 that covers the probe 3 other than the treatment section. From the rear end of the vibrator 2,
A cord 5 connected to a power supply body for supplying a current extends.

[0010] Further, in order to enable treatment by high-frequency current, the ultrasonic treatment instrument 1 has a connection pin 6 to which a connection cord for supplying a high-frequency current from a high-frequency ablation power supply device can be attached. The connecting pin 6 is connected to the vibrator 2
Is electrically connected to the horn 7 fixed to the tip of the vibrator 2 via an internal circuit of the horn 7. The horn 7 transmits the generated ultrasonic vibration and increases the amplitude by reducing the cross-sectional area.

At the tip of the horn 7, a screw portion 8 to which the probe 3 is connected is provided. At the rear end of the probe 3, there is provided a screw portion 9 which is detachably connected to the screw portion 8 of the horn 7. Further, the probe 3 has a cutout portion 10 near the screw portion 9 where a tool used to connect the probe 3 to the horn 7 is set.
In addition, by connecting the probe 3 and the horn 7, the probe 3 is electrically connected to the connection pin 6, thereby enabling high-frequency treatment.

At the tip of the probe 3, a living tissue is incised.
A distal treatment section 11 for coagulation is provided. The length of the probe 3 is set to an integral multiple of a half wavelength λ / 2 (λ is the wavelength) of the vibration frequency, and the probe 3 is designed so that the distal treatment section 11 is positioned exactly at the antinode of the vibration.

The probe 3 can reduce the cross-sectional area perpendicular to the axial direction at the position of the node of the vibration in the middle, so that the amplitude can be further increased to obtain the ultrasonic energy required for the treatment. I can do it. When the distal treatment section 11 comes into contact with the living tissue, frictional heat required for incision and coagulation is generated by the expanded amplitude, and a desired treatment can be performed.

At the position of the node closest to the distal treatment section 11 of the probe 3, a ring 15 made of an elastic member serving as a stabilizer for the inner surface of the sheath 4 is attached. As a result, the probe 3 does not contact the inner surface of the sheath 4 over the entire length from the rear end to the front end,
Parts other than the distal treatment section 11 are shielded from ultrasonic vibration.

A sheath 4 is covered outside the probe 3 from the rear end of the distal treatment section 11 to the vibrator 2. The sheath 4 includes an insertion portion 16 to be inserted into a body cavity, and an electrically insulating holding portion 17 to be held by an operator. The insertion section 16 and the holding section 17 are connected and fixed to each other. In addition, the insertion portion 16 includes an inner metal pipe 18,
An insulating tube 19 is provided on the outside of the metal pipe 18 in a laminated state and insulates high-frequency current. The outer diameter of the distal end of the insertion portion 16 is reduced by one step, and is formed by distal members 20 and 21 having electrical insulation and heat resistance. In addition, these tip members 20, 2
1 is fixed to the tip of the metal pipe 18 and the insulating tube 19. As a result, the probe 3 is electrically insulated except for the distal treatment section 11, and the high-frequency treatment instrument 1
Functions as an electrically safe device.

A connection portion 23 is fixed inside the holding portion 17 so as to engage with an inner surface of an attachment 22 fixed to the vibrator 2. A plurality of arms 24 extend from the rear end of the connecting portion 23, and these arms 24 are attached to and detached from the attachment 22 by a snap lock method so that the connecting portion 23 is attached to and detached from the attachment 22. It has become. That is, the protrusion 24a is provided on the outer surface of the end of the arm 24. When the arm 24 is inserted into the inner hole of the attachment 22 and the sheath 4 is abutted against the attachment 22, the protrusion 24a is attached to the attachment 22. The connection part 23 is fixed to the attachment 22 by engaging with a step part inside the inside. In this fixing mode, the connection state between the connection portion 23 and the attachment 22 cannot be released unless a predetermined force or more is applied to the sheath 4 in the axial direction.

The connecting portion 23 is provided with a sealing member 25. The seal member 25 is in close contact with the inner surface of the attachment 22 to keep the inside of the sheath 4 and the rear end side airtight. Maintaining such an airtight state is effective in preventing the insufflation gas from flowing out of the body, particularly when an insufflation is required in endoscopic surgery.

As shown in FIG. 3, the distal treatment section 11
Are formed as curved surfaces 12 and 13 whose both side surfaces are curved to the same side with a relatively large radius of curvature. The hook portion 14 is formed in the distal treatment section 11 by providing a cutout on one side of the edges of the curved surfaces 12 and 13. The notch forming the hook portion 14 is provided with a gentle inclination from the bottom surface of the concave portion of the hook portion 14 toward the root of the distal end treatment portion 11.

FIGS. 4 to 7 show other forms of the distal treatment section 11. FIG. Tip treatment unit 11 shown in FIG.
In A, both side surfaces are formed as curved surfaces 27 and 28 which are curved to the same side with a relatively large radius of curvature. In this case, the curved directions of the curved surfaces 27 and 28 are opposite to the curved directions of the curved surfaces 12 and 13 in FIG. The hook portion 26 is formed in the distal treatment section 11A by providing a cutout on one side of the edges of the curved surfaces 27 and 28. The distal treatment section 11A having such a shape is properly used for the distal treatment section 11 having the shape shown in FIG. 3 depending on the direction of the treatment tool with respect to the treatment site.

The distal treatment section 11B shown in FIG. 5 has side surfaces on both sides formed as curved surfaces 30 and 31 curved to the same side with a relatively large radius of curvature. In this case, the curved directions of the curved surfaces 30 and 31 correspond to the curved surfaces 12 and 1 in FIG.
3 is opposite to the bending direction. Further, a hook portion 29 is formed in the distal treatment section 11B by providing a cutout on one side of the edges of the curved surfaces 30, 31. The distal treatment section 11B is formed to have a larger diameter than the probe 3 at the proximal end. As described above, if the distal treatment section 11B is formed to have a larger diameter than the proximal end portion of the probe 3, the hook section 29 becomes larger than the hook section 14 in FIG. In addition, when the hook portion 29 is observed at a shallow angle with respect to the axial direction of the insertion portion 16, the visibility of the hook portion 29 is improved. Also, curved surface 3
Since 0 and 31 also become large, the curved surface 30 located particularly outside the curved surface can coagulate the tissue on a wider surface.

The distal treatment section 11C shown in FIG. 6 is provided with parallel flat portions 33a and 33b on both sides of the hook portion 32, and a convex curved surface portion 34 at a portion opposite to the hook portion 32.
Are provided, and the shape is easy to hit the tissue. The flat portions 33a and 33b and the curved portion 34 are curved surfaces 36a and 36b smoothly connected to the flat portions 33a and 33b.
And smoothly connected to the curved surfaces 36a and 36b,
a and 33b are connected to each other by plane portions 35a and 35b forming a predetermined angle. In such a form, the hook portion 32 can be used as a spatula, and is mainly effective for incision of frangible tissue. In addition, there is an advantage that insertion into a narrow portion of the tissue is facilitated and incision of a frangible tissue or the like is facilitated. Further, the curved surface portion 34 facilitates coagulation of the tissue.

The distal treatment section 11D shown in FIG. 7 is provided with parallel flat portions 38a and 38b on both sides of the hook portion 37, and the distal half is formed in a flat plate shape. Also, a curved surface 39,
40 are formed. In such a form, the flat plate-like portion on the distal end side is easier to use as a spatula-shaped treatment tool than that shown in FIG.

FIG. 8 shows an ultrasonic output control hand switch 4 detachably attached to the holding portion 17 of the sheath 4.
1 is shown. A cord 42 for sending an output signal to the main body extends from the hand switch 41. The hand switch 41 has a button 43 for outputting a MAX output and a button 4 for outputting a set output value.
4 are provided. In addition, the hand switch 41 is provided with a display unit 45 capable of displaying an output setting state, an output display at the time of output, and an abnormality content at the time of abnormality detection.

The display unit 45 has a structure that can withstand a specified sterilization method. Also, an output control button 43,
Reference numeral 44 denotes that the output setting is raised (UP) or lowered (DOW) when the mode changeover switch 46 is pressed.
N) Functions as a setting output change button.

An arm 47 which can be engaged with the holding portion 17 of the sheath 4 is provided below the hand switch 41. The arm portion 47 is detachably engaged with the holding portion 17 by a snap lock method by elastically deforming itself (see FIG. 9).

As described above, the ultrasonic treatment tool 1 of the present embodiment has the hooks 4 and the distal treatment section 11 which is the distal end of the probe 3 has a plurality of curved surfaces 12 and 1.
3 are formed. Therefore, the side surface of the distal treatment section 11 (11A to 11D) can be easily applied to the tissue, and coagulation treatment can be facilitated, and the distal end (treatment section) of the probe 3 can be easily observed during ultrasonic treatment. Become. In particular, in the present embodiment, since the base end side of the hook portions 14 is cut out and the distal end side of the sheath 4 is narrowed down by one step, a shallow angle with respect to the axial direction of the insertion portion 16 in the endoscopic surgical operation. The visibility of the hook portions 14 when the hook portions 14 are observed is improved.

The ultrasonic treatment device 1 of the present embodiment has a connection pin 6 to which a connection cord for supplying a high-frequency current from a high-frequency ablation power supply device can be attached. Therefore, the coagulation / incision of the living tissue can be selectively performed by the high-frequency current and the ultrasonic energy, and a more effective treatment can be achieved by utilizing the respective advantages.

The ultrasonic treatment tool 1 of the present embodiment includes a hand switch 41 for controlling ultrasonic waves. Therefore, even if it is used alternately with the high-frequency treatment tool, the output switch is not mistaken and the operator can be relieved from the trouble. ON / OFF of generation of ultrasonic wave as before
When a high-frequency treatment tool is used in combination, two foot switches for the high-frequency treatment tool and the ultrasonic treatment tool are arranged at the feet of the operator, which makes the operation operation extremely troublesome. However, if the hand switch 41 for ultrasonic control is provided on the treatment tool 1 side as in the present embodiment, it is necessary to arrange two foot switches at the foot of the operator when using a treatment using high-frequency current. And the operator can be relieved from the hassle.

Further, in the ultrasonic treatment instrument 1 of the present embodiment,
The output display function and output adjustment function are
Therefore, the surgeon can perform the treatment while confirming the settings as intended without giving instructions to the assistant or checking the settings. Conventionally, the same applies to the high-frequency treatment instrument, but the output setting can be performed only on the panel on the generator side, and the operator has to give an instruction to the assistant every time when confirming and changing the setting during the operation. . However, if the hand switch 41 is provided with an output setting display and an output setting adjustment function as in the present embodiment, the operator can make settings as intended without the assistance of an assistant. I can concentrate.

FIG. 10 shows a modification of the above embodiment. As shown in the figure, an output control button 5 for outputting a maximum output and a setting output is provided on the holding portion 17 of the sheath 4.
0, 51, and a display unit 52 capable of displaying an output setting state, an output display at the time of output, and the content of abnormality at the time of abnormality detection are provided. The output control buttons 50 and 51 function as buttons for changing output settings when the mode changeover switch 53 is pressed. That is, in this configuration,
The hand switch 41 is not provided with various functions as in the above embodiment, but the holding unit 17 itself is provided with various functions.

The holding unit 17 has a built-in element for recording the number of times of temperature change (for example, counting when exposed to specified autoclave conditions). The number of times is changed by pressing the display switching button
Will be displayed. A cord 55 for transmitting an output signal or the like to the main body extends from the rear end of the holding portion 17 of the sheath 4. Further, serial numbers 57 and 58 are described on the sheath 4 and the probe 3, respectively, so that the relationship between the combinations can be confirmed on a one-to-one basis.

According to this configuration, the same operation and effect as those of the above-described embodiment can be obtained, and the number of use cases of the sheath and the probe can be managed by clearly indicating the combination with the sheath. By making it easier for the user to grasp the safer usable state, the safety of the treatment tool can be ensured. That is, a probe that performs ultrasonic vibration may cause fatigue damage due to vibration during long-term use, and it is actually difficult for the user to manage the number of use cases. Therefore, by providing a function of recording and displaying the number of use cases as in the present configuration, it is possible to positively disclose the life of the treatment tool to the user and prevent accidents such as sudden damage of the treatment tool. It becomes possible.

According to the technical contents described above, the following various configurations can be obtained.

1. An ultrasonic treatment instrument using ultrasonic vibration, wherein a distal treatment section is constituted by a plurality of curved surfaces.

2. 2. The ultrasonic treatment instrument according to claim 1, wherein the ultrasonic treatment instrument has a curved surface for applying tissue to the distal treatment section.

3. 3. The ultrasonic treatment device according to claim 1, wherein a hook portion for pulling a tissue is provided in the distal treatment section.

4. The ultrasonic wave according to any one of claims 1 to 3, wherein a hand-operated switch unit having output control, output adjustment, and output setting change functions is detachably provided in the holding unit. Treatment tools.

5. An index indicating the relationship between the probe and the sheath is provided, and a function of recording and displaying the number of times of the specified sterilization method is incorporated in an output control function, an output adjustment function, an output setting change function, and a designated sterilization method in the holding section of the sheath. The first
Item 4. The ultrasonic treatment device according to any one of Items 3 to 3.

[0039]

As described above, according to the ultrasonic treatment instrument system of the present invention, since the distal treatment section is formed by a plurality of curved surfaces, the side surface of the distal treatment section can be easily applied to the tissue. The treatment of coagulation becomes easier and
Observation of the distal treatment section of the probe during ultrasonic treatment is facilitated.

[Brief description of the drawings]

FIG. 1 is a side view of an ultrasonic treatment device according to an embodiment of the present invention.

FIG. 2 is a sectional view of a main part of the ultrasonic treatment device in FIG.

3A is a plan view of a distal treatment section of the ultrasonic treatment device of FIG. 1, and FIG. 3B is a side view of the distal treatment section of FIG.

4A is a plan view of a first modification of the distal treatment section, and FIG. 4B is a side view of the distal treatment section of FIG.

5A is a plan view of a second modification of the distal treatment section, and FIG. 5B is a side view of the distal treatment section of FIG.

6A is a plan view of a third modification of the distal treatment section, FIG. 6B is a side view of the distal treatment section of FIG. 6A, and FIG. 6C is a front view of the distal treatment section.

7A is a plan view of a fourth modification of the distal treatment section, FIG. 7B is a side view of the distal treatment section of FIG. 7A, and FIG. 7C is a front view of the distal treatment section.

FIG. 8 is a perspective view of a hand switch detachably attached to a holding portion of the ultrasonic treatment instrument in FIG.

9 is a perspective view showing a state in which the hand switch of FIG. 8 is attached to a holding portion of the ultrasonic treatment instrument.

FIG. 10 is a perspective view showing a mode in which a hand switch function is provided in a holding section of the ultrasonic treatment instrument.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 ... Ultrasonic treatment tool 2 ... Vibrator 3 ... Probe 11, 11A, 11B, 11C, 11D ... Tip treatment part 12, 13, 27, 28, 30, 31 ... Curved surface

Claims (1)

[Claims] 1. A vibrator for generating ultrasonic vibration, a probe for transmitting ultrasonic vibration generated by the vibrator, and a distal treatment section provided at a distal end of the probe and performing ultrasonic treatment in contact with a living tissue. An ultrasonic treatment instrument comprising: the ultrasonic treatment instrument, wherein the distal treatment section is formed by a plurality of curved surfaces.