JPH0326609B2 - - Google Patents

Description

[Detailed Description of the Invention] [Field of Industrial Application] The present invention relates to a surgical tool for crushing and emulsifying biological tissue to be excised using ultrasonic vibration and irrigation function, and suctioning it out of the living body. be.

[Prior art] An ultrasonic transmitter is connected to an ultrasonic vibration source that converts high-frequency current into ultrasonic vibrations, and the ultrasonic vibrations are transmitted.
Ultrasonic surgical equipment that amplifies and crushes biological tissue at the working part that comes into contact with biological tissue can crush the tissue to be removed without damaging blood vessels, nerves, etc. in surgical sites where blood vessels and nerves are concentrated. It can be removed by suction, and it is also equipped with an irrigation function, so crushed tissue pieces can be emulsified with an irrigation solution such as physiological saline, and easily suctioned and removed outside the living body. It has excellent features as a surgical device.

Conventionally, as a surgical tool that applied the ability to crush living tissue using ultrasonic waves, there was
There is an ultrasonic scalpel disclosed in Japanese Patent No. 58034, and Japanese Utility Model Application No. 58-44289 discloses a method for fixing an irrigation liquid injection pipe.

However, with conventional ultrasonic scalpels, when the surgical site is relatively close to the body surface or when the surgical method allows for a wide surgical field, it is possible to proceed with the surgery effectively without any hindrance. If the area is deep within the body and the surgical field is extremely narrow, there is a risk that the side part of the ultrasonic vibration transmitting device that is vibrating ultrasonic waves may come into contact with normal tissue.
Because the generation of frictional heat caused by ultrasonic vibrations may damage normal tissue, the surgeon must either open the surgical field wider than necessary or take extra care, resulting in a considerably more difficult surgery. is,
As the surgical time became longer, it became difficult to perform the surgery appropriately and accurately.

Further, during long-term surgery, continuous ultrasonic vibrations generate heat in the ultrasonic vibration transmitting device, which may deteriorate the strength of the ultrasonic vibrating device.

FIG. 6 shows these conventional techniques, in which an ultrasonic vibration transmission device 10 is connected to an ultrasonic vibration source 4, and an irrigation pipe 26 provided along the ultrasonic vibration transmission device 10 is connected to the ultrasonic vibration source 4. Sound wave vibration transmitter 1
0, and the physiological saline etc. flows out from the opening 28 through the passage 21 in the irrigation pipe 26. In order to solidify the irrigation pipe 26 in close proximity to the ultrasonic vibration transmitter 10, the irrigation pipe 26 is held by a fixture 27 made of plastic such as Teflon (trade name). In addition, the biological tissue crushed by the ultrasonic vibration of the working part 18 is transported through the opening 20 to the passage 22 in the ultrasonic vibration transmitting tool 10.
is removed from the body through the

With this shape, when performing a surgery with an extremely narrow surgical field such as microsurgery, the irrigation pipe 26 and fixture 27 make it difficult to insert the working part 18 into the affected area deep inside the living body. In some cases, it may not be possible to insert the tube, and when performing surgery under a microscope, the irrigation pipe 26 and fixture 27 often obstruct the field of vision, making the surgery itself difficult. Furthermore, when performing surgery on a deep affected area within a living body, the side surface of the ultrasonic vibration transmitting device 10 may come into contact with normal tissue, and as a result, there is a risk of damaging the normal tissue due to frictional heat.

[Purpose of the invention]

In order to improve this problem of the conventional method, the present invention provides an ultrasonic vibration transmitter provided with a channel for irrigation fluid and a channel for discharging biological tissue crushed by ultrasonic vibration, and The purpose of this invention is to provide a surgical tool that can be effectively used in surgical operations, particularly microsurgery, which is composed of a protective cover to prevent contact between normal tissue and an ultrasonic vibration transmitting device. It is.

[Structure of the invention]

That is, the present invention provides a surgical tool for an ultrasonic surgical device having the function of crushing or cutting and separating living tissue by ultrasonic vibration, in which an ultrasonic vibration transmitting device mechanically vibrating at an ultrasonic frequency,
The ultrasonic vibration transmission device has a working part that comes into contact with biological tissue and two passages passing through the interior of the ultrasonic vibration transmitter, and the passage for suctioning and removing the crushed or cut and separated living tissue has an opening at the tip of the working part. and the passage serving as the irrigation fluid passage has a laterally facing opening on the side near the working part or at a position rearward from the opening. It is.

The present invention will be explained in detail below with reference to the drawings.

FIG. 1 is a diagram showing the configuration of an apparatus using a surgical tool according to an embodiment of the present invention, and FIG. 2 is a diagram showing an example of the cross-sectional shape of the side surface of the ultrasonic vibration transmitting device. An electrical signal at an ultrasonic frequency is sent from the ultrasonic oscillation circuit 1 to an ultrasonic vibration source 4 through cables 2 and 3, and the ultrasonic vibration source 4 generates mechanical vibration at an ultrasonic frequency. As the ultrasonic vibration source 4, either a magnetostrictive type or an electrostrictive type can be used, and the mechanical vibration of the ultrasonic frequency generated by the ultrasonic vibration source 4 is propagated to the ultrasonic vibration transmitter 10, and further , is expanded at the joint 7 of the ultrasonic vibration transmitting tool 10 and propagated to the working part 18. The working part 18 directly contacts the biological tissue and finely crushes the biological tissue by mechanical vibration at an ultrasonic frequency. When the working part 18 is mechanically vibrating at an ultrasonic frequency, irrigation fluid such as physiological saline is supplied from the irrigation fluid injection device 5 through the tube 6 and pipe 8 as shown in FIG. 2a. It passes through the tube 23, enters the passage 21 of the ultrasonic vibration transmitter 10, and flows out from the opening 19 of the working part 18. By passing this irrigation liquid through the passage 19 inside the ultrasonic vibration transmitting tool 10, the heat generated by the mechanical ultrasonic vibration of the ultrasonic vibration transmitting tool 10 during continuous use is suppressed, and the ultrasonic vibration transmitting tool 10 Deterioration of mechanical strength can be prevented. The material of the ultrasonic vibration transmitter 10 is not particularly limited, but it is preferable to use a titanium alloy having high tensile strength and fatigue strength.

Next, as shown in FIG. 2a, the crushed and emulsified biological tissue is removed by the suction device 13
is suctioned from the opening 20 by the passage 2.
2, tube 24, pipe 17 and tube 16
and is discharged into the suction bottle 15.

By providing the passageway 19 inside the ultrasonic vibration transmission device 10, it is possible to widen the operator's field of view and perform surgery with a narrower opening area in the living body compared to conventional ultrasonic surgical tools, thereby making it possible to perform surgery on the patient. It also reduces the burden on

A cover 9 is provided around the outer periphery of the ultrasonic vibration transmitter 10. The cover 9 prevents contact between normal tissue and the side surface of the ultrasonic vibration transmission device 10, and when performing surgery on an affected area deep within a living body, can prevent normal tissues other than the affected area from being damaged by the frictional heat of ultrasonic vibration. . The cover 9 is made of a material such as plastic or metal, preferably Teflon (trade name), polycarbonate, stainless steel, etc., but is not limited to these materials.

FIG. 2a is a side sectional view showing an embodiment of the ultrasonic vibration transmitting device 10 of the present invention.

One end of the passage 21, which serves as a passage for the irrigation liquid, is connected to the working part 18 of the passage 22 for suctioning and discharging the fine biological tissues crushed in the working part 18.
It opens into a side facing opening 19 located rearward from the opening 20 located at. The opening 19 and the opening 20 form the ultrasonic vibration transmitter 10.
There is essentially no problem even if the opening 19 is on a plane perpendicular to the length direction, but by shifting the position as shown in Figure 2a and opening the opening 19 to the side. Therefore, as shown in FIG. 4, even when injection of irrigation liquid, crushing by ultrasonic vibration, and suction and discharge of crushed fine biological tissue are performed simultaneously, the biological tissue 29 does not block the opening 19. Irrigation fluid can be constantly injected without any need for surgery, allowing the surgery to be carried out smoothly.

FIG. 2b is a sectional view of the vicinity of the working part 18 showing another embodiment of the ultrasonic vibration transmitting device 10 of the present invention.
Irrigation liquid passes through the passage 21, and an opening 19 is provided in the side surface of the ultrasonic vibration transmitting tool 10 at a position closer to the working part 18 than the end surface 11 of the cover 9 of the ultrasonic vibration transmitting tool 10. The opening 20 is for suction and discharge. As shown in Figure 5, opening 1
9 on the side surface of the ultrasonic vibration transmitter 10, when injecting irrigation liquid, crushing by ultrasonic vibration, and suctioning and discharging the crushed fine biological tissue at the same time, this shape allows the biological tissue 29 to be opened. Irrigation liquid can be constantly injected without blocking the part 19.

Furthermore, depending on the location of the affected area and the circumstances of the surgery, it is also effective to provide an opening that will serve as an injection hole for irrigation fluid as well as an opening that will serve as a suction hole on the side surface of the ultrasonic vibration transmitting device.

FIG. 3 is an enlarged cross-sectional view of section E in FIG. 1, showing a method of attaching the cover 9 by cutting screws to the outer cylinder 25 of the ultrasonic vibration source 4 and fixing the cover 9 with a bag nut 12. .

〔Effect of the invention〕

According to the present invention, the opening area on the surface of the living body can be narrowed when performing surgery on a deep affected area within the living body using an ultrasonic surgical device, and the operative field can be widened when performing surgery under a microscope. , there is no risk of contact between normal tissue other than the affected area and the side of the ultrasonic vibration transmitting device, and damage to normal tissue can be prevented, reducing the burden on both the patient and the operator, making it a surgical tool. It is suitable as

[Brief explanation of drawings]

FIG. 1 is a diagram showing the configuration of an apparatus using a surgical tool according to an embodiment of the present invention, FIGS. FIG. 3 is an enlarged cross-sectional view showing a cap nut portion for attaching a cover, FIGS. 4 and 5 are views showing an example of operation using the surgical tool of the present invention, and FIG. 6 is a view showing a conventional technique. .

Claims (1)

[Scope of Claims] 1. An ultrasonic vibration transmission device that mechanically vibrates at an ultrasonic frequency in a surgical tool of an ultrasonic surgical device that has the function of crushing or cutting and separating living tissue by ultrasonic vibration. has a working part that comes into contact with biological tissue and two passages passing through the inside of the ultrasonic vibration transmitter, and a passage for suctioning and removing the crushed or cut and separated living tissue is provided at the tip of the working part. The surgical method is characterized in that the passage has an opening, and the passage serving as a passage for the irrigation fluid has an opening facing laterally on a side near the working part or at a position rearward from the opening. Surgical tools. 2. The surgical tool according to claim 1, characterized in that a cover is provided on the outer periphery of the ultrasonic vibration transmitting tool.