JPH03280944A - Ultrasonic medical treatment device - Google Patents

Abstract

PURPOSE:To make good medical treatment work possible without deteriorating an observation through visual field by providing the second suction path connected to a feed water path, and connecting a suction means respectively independently to the first and second suction paths. CONSTITUTION:A suction means is connected respectively independently to the first and second suction paths 21, 26 while the second suction path 26 is connected to a feed water path 25. When an ultrasonic vibrator 4 is used by transmitting its ultrasonic vibration to a probe 20, it is heated to normal or more. When a feed amount of water through the feed water path 25 is increased in order to prevent a temperature rise according to this heating, the amount of water, sucked directly to the second suction path 26 through a communication path 35, is also increased without feeding into the part of body cavity from the feed water path 25, and as a result, the amount of water, fed into the part of body cavity, is decreased. Accordingly, medical treatment work can be prevented from failure without accumulating a too much amount of the fed water in the part of body cavity and without generating a spray of water to deteriorate an observation visual field.

Description

DETAILED DESCRIPTION OF THE INVENTION [Industrial Application Field] The present invention relates to an ultrasonic treatment device that uses ultrasonic vibrations to incise or emulsify living tissue or to crush stones.

[Prior Art] Generally, an ultrasonic treatment apparatus is configured by connecting an ultrasonic vibration transmitting probe to an ultrasonic vibration generating section having an ultrasonic transducer. Furthermore, the ultrasonic vibration transmission probe
Usually, it is formed from a hollow vibrator, and the inside thereof serves as a suction path. A probe in which a water supply pipe is attached to the outside of the probe is known from, for example, Japanese Unexamined Utility Model Publication No. 61-203010 and Japanese Utility Model Application No. 63-135615. A device in which the probe portion is covered with a sheath and the space between the probe and the sheath is used as a water supply channel is known, for example, from Japanese Patent Publication No. 47-39197.

During treatment, the heat generated by the probe is released by sending water into the body cavity through the water supply channel, and once the water has flowed into the body cavity, the water is transferred to the tissue that has been ablated and emulsified by ultrasonic vibration. , or crushed stone fragments, are suctioned out to the outside through a suction channel.

However, when the ultrasonic vibration generator of an ultrasonic treatment device is oscillated at high output and the ultrasonic vibration is transmitted to the probe,
The probe generates more heat than normal.

Along with this, the temperature of the water supply liquid increases.

Therefore, in order to prevent the temperature of the water supply fluid from rising, it may be possible to increase the amount of water supply, but doing so may cause too much water supply fluid to accumulate in the body cavity, or cause water splashes, which may impair the observation field of view. This may impair the therapeutic work.

Therefore, the present applicant has developed an ultrasonic treatment device that solves the above-mentioned problems, and has filed an application as Japanese Patent Application No. 1-289652. This method cools the probe by guiding perfusion fluid to the tip of the sheath through the space between the inner sheath and the probe, which is provided to surround the probe. Wash off the
Excess perfusate is sucked and collected through the space between the inner sheath and outer sheath to prevent a large amount of perfusate from flowing into the treated area or from forming a strong mist at the tip of the probe. .

[Problems to be Solved by the Invention] However, in the above-mentioned ultrasonic treatment device, when the amount of irrigation fluid is increased in order to increase the cooling efficiency of the probe, the amount of irrigation fluid that is applied through the space between the inner sheath and the outer sheath is reduced. If collection is not done in time, the amount of perfusate flowing to the tip of the probe increases, resulting in problems such as overflowing of the perfusate into the treated area, or the perfusate becoming violently atomized at the tip of the probe, impairing visibility.

The present invention was made with attention to the above-mentioned problem, and its purpose is to change the suction pressure in accordance with the change in the amount of water delivered, thereby preventing too much fluid from accumulating in the body cavity or causing water splashes. It is an object of the present invention to provide an ultrasonic treatment device capable of performing good treatment work without deteriorating the observation field of view.

C Means and Effects for Solving the Problems] In order to solve the above problems, the present invention provides an ultrasonic transducer, a probe that transmits ultrasonic vibrations of the ultrasonic transducer to a treated part,
In an ultrasonic treatment device comprising a first suction path provided to penetrate the ultrasonic transducer and the probe, and a sheath surrounding the probe and forming a water supply channel, the water supply channel A second suction path is provided which communicates with the second suction path, and suction means are independently connected to the first suction path and the second suction path.

When water is supplied from the water supply channel on the sheath side, a part of it is directly sucked into the second suction channel through the communication channel, and
Treatment work is performed while changing the suction pressure according to the amount of water supplied by the suction means communicating with the second suction path.

[Example code] Hereinafter, each embodiment of the present invention will be described based on the drawings.

1 and 2 show a first embodiment of the present invention. As shown in Fig. 1, this ultrasonic treatment device:
It is configured as a hand piece 1. The grip portion 2 of the hand piece 1 is provided with an ultrasonic vibrator 4 as an ultrasonic generator inside a cover 3. The ultrasonic transducer 4 is formed by laminating a piezoelectric element (for example, PZT) 5 and an electrode 6.

A horn portion 7 that amplifies the amplitude of the ultrasonic vibrations generated by the ultrasonic vibrator 4 is connected to the front end of the ultrasonic vibrator 4 . A backing plate 8 is connected to the rear end of the ultrasonic transducer 4. The ultrasonic vibrator 4 is sandwiched and fastened between the horn part 7 and the backing plate 8 by a bolt (not shown) passing through the ultrasonic vibrator 4 and the backing plate 8 and a nut screwed into the bolt. are integrally connected. 9 is a power cord connected to the electrode 6 of the ultrasonic transducer 4.

Further, a suction hole 13 is formed in the center of the horn portion 7, and in a bolt that passes through the ultrasonic vibrator 4 and the backing plate 8, so as to communicate with each other and pass through the bolt back and forth.

The rear end of this suction hole 13 is connected to a first suction tube 16 via a suction cap 15 that penetrates the rear end wall of the cover 3 in a watertight manner using an O-ring 14 . This first suction tube 16 is connected to a first suction pump 18 . A portion of the outer periphery of the horn portion 7 is held on the inner surface of the cover 3 of the grip portion 2 in a watertight manner using an O-ring 17. Each O-ring 14.17
Therefore, the ultrasonic transducer 4 is housed inside the cover 3 in a watertight manner.

On the other hand, a vibration transmission probe 20 consisting of a hollow metal vibrator as a vibration transmission member is attached to the tip of the horn portion 7.
is detachably connected. The hollow hole of the probe 20 forms a first suction path 21 that communicates with the suction hole 13 .

Further, a sheath 22 is provided to cover the outer periphery of the probe 20 and the horn section 7, and the proximal end of the sheath 22 is screwed onto the outer periphery of the tip of the cover 3, as will be described later.

That is, the sheath 22 is composed of a double tube consisting of an inner sheath 22a and an outer sheath 22b that covers it, and the inner sheath 22a has a tapered tube on the proximal side that covers the outer periphery of the horn portion 7. A cover portion 23 forming the inner surface is integrally formed. The cover portion 23 is screwed onto the outer periphery of the front end of the cover 3 of the gripping portion 2 and is detachably attached thereto. An O-ring 24 is interposed between the inner surface of the tip of the cover portion 23 and the outer periphery of the tip of the horn portion 7 to provide a watertight seal between them.

Further, the outer sheath 22'b of the sheath 22 has its proximal end portion removably screwed into the outer periphery of the cover portion 23 of the inner sheath 22a.

Thus, the inner sheath 22a is fitted onto the probe 20 concentrically, forming a gap therebetween.

Further, the outer sheath 22b is also fitted concentrically to the probe 20 and the inner sheath 22a, and the inner sheath 22b
A gap is formed between it and 2J1.

A gap between the probe 20 and the inner sheath 22a covering the probe 20 is configured as a water supply channel 25.

ing.

Near the proximal end of the sheath 22, there is a water supply cap 27 and a second
A suction cap 28 is provided. And water supply cap 2
7 communicates with the water supply channel 25, and the second suction mouthpiece 28 communicates with the second suction channel 26. The water supply cap 27 is connected to a water supply pump 32 via a water supply tube 31. Further, a second suction tip 33 is connected to the second suction mouthpiece 28 . The second suction tube 33 is connected to a second suction pump 34 .

Further, the distal end of the inner sheath 22a is connected to the outer sheath 2.
2b, and the inner sheath 22a is
It is formed shorter than the outer sheath 22b. In other words,
The water supply channel 25 and the second suction channel 26 are connected to the inner sheath 2
By shortening the distal end of the outer sheath 22b, the outer sheath 22b communicates with each other through a communication path 35 formed around the entire circumference within the distal end portion of the outer sheath 22b.

Next, the operation of the ultrasonic treatment device with the above configuration will be explained.
2 is introduced into the body cavity. and,
The first suction pump 18 and the second suction pump 34 are operated to remove the first suction tube 16 and the second suction tube 3.
3, a suction action is exerted on the first suction path 21 and the second suction path 26.

In addition, the water pump 32 is operated to send water from the water tube 31 to the water supply channel 25 through the water supply mouthpiece 27 and to the tip side of the water supply channel 25.

Most of the water supplied in this way is normally sent into the body cavity, but a part of it does not flow out from the distal end of the outer sheath 22b and flows into the communication passage 35 inside the distal end.
through which it is sucked directly into the second suction path 26.

In addition, the water that has been fed into the body cavity and used to wash the body cavity is sucked through the first suction path 21 . In addition, fragments of tissues and stones that are generated when treated with the probe 20 as a vibration transmitting member are also removed from the probe 20 along with the perfusate.
The liquid is sucked through the first suction path 21 at. In this way, the tissue and perfusion fluid suctioned through the first suction path 21 are further transferred to the first suction tube 1 through the suction hole 13.
Sent out on 6th.

Moreover, without being sent into the body cavity from the water supply channel 25,
The water directly sucked into the second suction path 26 is sent out to the second suction pump 34 side through the second suction tube 33.

By the way, when the ultrasonic transducer 4 of this ultrasonic treatment apparatus is operated to oscillate at high output and the ultrasonic vibration is transmitted to the probe 20, the probe 20 generates more heat than usual. In order to prevent the temperature rise due to this heat generation,
Increase the amount of water sent through 5. In addition, at this time, the first
It is desirable to strengthen the suction force through the suction tube 16.

In this way, when the amount of water is increased, the amount of water that is sucked directly into the second suction path 26 through the communication path 35 without being sent into the body cavity from the water supply channel 25 increases, and as a result, the amount of water that is sucked directly into the second suction path 26 through the communication path 35 increases. Less water is pumped into the tank.

Therefore, it is possible to prevent a large amount of water supply fluid from accumulating in the body cavity, or from causing water splashes and deteriorating the observation field of view, thereby preventing damage to the treatment work.

3 and 4 show a second embodiment of the invention. In this embodiment, the suction pressure adjustment hole 37 of the hand piece 1 communicates with the branch portion 39 of the first suction tube 16 connected to the rear end side of the ultrasonic transducer 4 via the suction pressure adjustment tube 38. There is.

According to this embodiment, when in use, the operator closes the open end 36 of the suction pressure adjustment hole 37 with his finger 40, thereby eliminating the introduction of atmospheric air and increasing the suction pressure of the first suction path 21. By reducing the area that closes the open end 36, the atmosphere is introduced through the suction pressure adjustment hole 37, and the suction pressure of the first suction path 21 can be reduced. Furthermore, even if the suction pressure at the tip of the probe 20 is changed by changing the amount of occlusion of the suction pressure adjustment hole 37, the suction pressure in the second suction channel 26 communicating with the water supply channel 25 near the tip of the sheath 22 does not change. Therefore, the inconveniences such as increases and decreases in the amount of perfusate in the treated part and changes in the state of atomization of the perfusate at the tip of the probe 20 can be solved without increasing or decreasing the amount of perfusate that reaches the treated part.

In this case as well, part of the water sent through the water supply channel 25 can be directly sucked from the second suction channel 26 without being sent into the body cavity. Therefore, especially when the amount of water is increased, the amount of water that is sucked directly into the second suction path 26 without being sent into the body cavity from the water supply channel 25 also increases, reducing the amount of water that is sent into the body cavity. .

Therefore, it is possible to prevent a large amount of water supply fluid from accumulating in the body cavity, or from causing water splashes and deteriorating the observation field of view, thereby preventing damage to the treatment work.

FIG. 5 shows a third embodiment of the invention. In this embodiment, a water supply cap 4 is provided near the proximal end of the sheath 22.
First and second suction caps 42 are provided. The water supply mouthpiece 41 communicates with a water supply channel 43 formed between the inner sheath 22a and the outer sheath 22b, and the second suction mouthpiece 42
communicates with a second suction path 44 between the probe 20 and the inner sheath 22a. The water supply tube 31 is connected to the water supply mouthpiece 41, and the second suction chinibe 33 is connected to the second suction mouthpiece 42.

Therefore, inside the probe 20 and outside the probe 20, the inside of the inner sheath 22a is used as the suction path, and the outer sheath 2
The inside of 2b can be formed into a water supply channel.

FIG. 6 shows a fourth embodiment of the present invention. This embodiment differs from the first embodiment in that the inner sheath 45 is made of an elastic material, and a spiral groove 46 is formed on the outer side of the inner sheath 45, thereby forming a spiral protrusion 47 on the inner side. By lightly contacting the outer circumferential surface of the probe 20, the helical protrusion 47 prevents the central axis 20 of the probe 20 from being inclined with respect to the central axis of the inner sheath 45. Irrigation fluid is configured to flow between the inner sheath 45 and the outer sheath 48 along the groove 46.

Note that FIG. 7 shows an ultrasonic treatment device that prevents the broken probe tip from falling off even if the probe breaks during use. That is, the probe 51 connected to the ultrasonic transducer 50 is long in the axial direction, and has a distal end portion 5 on the distal end side of which the diameter gradually decreases from the middle toward the distal end.
It has 2. The tip 52 of the probe 51 is configured to vibrate so that the tip is the antinode of vibration and there is at least one node in the middle.

An axially long sheath 53 is provided around the probe 51, and this sheath 53 is connected to a grip portion 54 at the rear end side. A narrow diameter portion 55 having an inner diameter smaller than the intermediate portion 53a of the sheath 53 is provided on the distal end side of the sheath 53. The narrow diameter portion 55 of the sheath 53 is provided at a position on the distal end portion 52 of the probe 51 so as to surround the probe 51 on the distal side of the node closest to the distal end.

With this configuration, the distal end 52 of the probe 51 can be prevented from shaking against the sheath 53, and when in use, the distal end of the probe 51 can be easily positioned relative to the treated area, and the sheath 53 can be easily positioned. Since the outer diameter of the tip can be made small, the tip of the probe 51 is not obstructed by the tip of the sheath 53 and becomes difficult to see. Furthermore, by making the inner diameter of the narrow diameter portion 55 of the sheath 53 smaller than the outer diameter of the intermediate portion 51a of the probe 51, even if the probe 51 breaks during use, it is possible to prevent the broken probe tip from falling off, thereby increasing safety. We can provide a high quality ultrasonic treatment device.

[Effects of the Invention] As explained above, in the present invention, even if the amount of irrigation fluid is increased in order to increase the cooling efficiency of the probe, the second suction channel that communicates with the water supply channel near the tip of the sheath is maintained. By increasing the suction pressure of the suction means, it is possible to increase the amount of perfusate collected without changing the suction pressure at the probe tip, which increases the amount of perfusate flowing to the probe tip and perfuses the treated area. This eliminates the problem of fluid overflowing or the perfusion fluid becoming violently atomized at the tip of the probe, which impairs visibility, allowing for better treatment work.

[Brief explanation of drawings]

1 and 2 show a first embodiment of the present invention, FIG. 1 is a side sectional view of an ultrasonic treatment device, FIG. 2 is a system diagram of a water supply channel and a suction channel, and FIGS. Fig. 4 is a side sectional view of an ultrasonic treatment device showing a second embodiment of the present invention, Fig. 4 is a system diagram of a water supply channel and a suction channel, and Fig. 5 is an ultrasonic wave treatment device showing a third embodiment of the present invention. FIG. 6 is a side sectional view of the ultrasonic treatment device showing a fourth embodiment of the present invention, and FIG. 7 is a side sectional view of the ultrasonic treatment device with added safety. . 4... Ultrasonic transducer, 18... First suction pump (
Suction means) 20... Probe, 21... First suction path, 22... Sheath, 22a... Inner sheath, 2
2b...Outer sheath, 26...Second suction path, 27
...Communication path, 34...Second suction pump (suction means).

Claims (1)

[Claims] an ultrasonic transducer; a probe that transmits ultrasonic vibrations of the ultrasonic transducer to a treated area; a first suction path provided through the ultrasonic transducer and the probe; and the probe. an ultrasonic treatment device comprising a sheath surrounding the water supply channel and forming a water supply channel, a second suction channel communicating with the water supply channel is provided, and a second suction channel is provided between the first and second suction channels. An ultrasonic treatment device characterized in that suction means are independently connected to each other.