JP2523249B2 - Ultrasonic surgical instrument - Google Patents

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,
In particular, the present invention relates to an ultrasonic surgical instrument having a horn and a horn cover and used for cataract surgery.

[0002]

2. Description of the Related Art An ultrasonic surgical instrument is one in which ultrasonic vibration from a vibrator is transmitted to a horn and the living tissue is crushed by the ultrasonic vibration at the tip of the horn.

In a conventional ultrasonic surgical instrument, as shown in FIG. 6, a horn 1 is surrounded by a horn cover 5 coaxial with the horn 1, and the horn 1 is fixed to the horn cover 5. The gap between the horn 1 and the horn cover 5 is a flow path 11 for flowing the perfusate, the side wall of the horn 1 and the open end of the horn cover 5 are formed so as to maintain watertightness, and the perfusate has an outflow hole 12. It is formed to flow out from. Providing the outflow hole 12 in the side wall of the horn cover 5 causes a corneal endothelium injury when the perfusate is directly exposed to the front, and the water pressure pushes the operation site to be fractured forward, which makes the operation very difficult. This is because

[0004]

However, in the conventional ultrasonic surgical instrument, since the positional relationship between the horn and the horn cover is fixed, the horn is dug deeper than the exposed length of the horn cover. In addition, there is a problem that when the horn is exposed longer than the horn cover and pierced, it cannot be removed from the living tissue. If the horn remains in the tissue,
The ultrasonic vibration of the horn causes burns on the living tissue.

Therefore, the present invention relates to an ultrasonic surgical instrument capable of crushing living tissue to a desired depth and easily removing the horn from the living body even when the horn is stuck. .

[0006]

In order to solve the above problems, the present invention provides a horn having a tubular shape and transmitting ultrasonic vibrations from a vibrator to crush living tissue, and an open end on a peripheral wall of the horn. In an ultrasonic surgical instrument that abuts so as to maintain watertightness, has a tubular horn cover that is provided around the horn, and uses a flow path for the perfusate between the horn and the horn cover,
The tip of the horn moves back and forth with respect to the horn cover,
The horn cover has at least one notch extending in the longitudinal direction from the opening end thereof, and the horn has a protrusion on the circumferential wall that is slidable in a watertight manner with the longitudinal side of the notch,
When the tip of the horn protrudes from the opening end of the horn cover, the protruding portion forms an opening together with the vibrator-side end of the notch to allow the perfusion solution to flow out to the side of the horn cover. In a state where the horn tip is pulled into the horn cover, the protruding portion abuts on the vibrator side end of the notch to open the horn cover opening end side of the notch, and further to the horn tip. It is characterized in that a gap is formed between the tip portions of the horn covers to allow the perfusate to flow out forward.

[0007]

In the present invention, when crushing living tissue with the present ultrasonic surgical instrument, the tip of the horn is projected from the opening end of the horn cover so that the horn is projected and the horn is provided on the horn. The protruding portion thus formed forms an opening with the end side of the horn cover notch on the side of the vibrator, so that the perfusate can flow out to the side of the horn cover. Further, in the present invention, since the tip portion of the horn moves back and forth with respect to the horn cover, in order to crush the living tissue deeply, the tip portion of the horn is exposed longer than the horn cover for crushing.

Further, when the horn pierces the living tissue, the tip of the horn is pulled into the horn cover. At that time, since the living tissue is pressed by the horn cover, it is easy to remove the horn from the living tissue. Becomes When the tip of the horn is pulled into the horn cover, the projecting portion abuts on the vibrator-side end of the cutout portion to close the opening, and instead, the opening end side of the cutout portion is opened to open the horn. Since a gap is formed between the tip and the tip of the horn cover,
Since the flow path is formed in the front, the perfusate flows out in the front, and the living tissue is pushed by the water pressure, so that the tip of the horn can be easily pulled out.

[0009]

Embodiments of the present invention will be described with reference to the drawings.

As shown in FIG. 1, the ultrasonic surgical instrument according to the present embodiment has a horn 1 for transmitting ultrasonic vibrations from a vibrator to crush living tissue, and a horn cover provided around the horn 1. 5 and. The horn 1 has a cylindrical shape,
In cataract surgery, it has a shape in which the tip is cut obliquely to secure the field of view. Also, the horn cover 5 is
A horn cover body 8 having a cylindrical shape, a horn cover opening end 10 that abuts against the peripheral wall of the horn so as to maintain watertightness, and a conical horn cover tip portion 9 between the opening end 10 and the body 8. Consists of. A gap is provided between the horn 1 and the horn cover 5, and this gap serves as a flow path for the perfusate.

A characteristic of the present invention is that a pair of notches 13 extending in the longitudinal direction from the horn cover opening end 10 to the horn cover body 8 are provided symmetrically, and further, the outer wall of the horn 1 has the above-mentioned structure. That is, there is provided a pair of projecting portions 3 that are slidable in a watertight manner with respect to the longitudinal side of the cutout portion 13. The protruding portion 3 has an inclined surface 4 that is inclined toward the tip.

The state of use of the ultrasonic surgical instrument of this embodiment is as follows. That is, when the living tissue is crushed by ultrasonically vibrating the horn 1, as shown in FIG. 2A, the tip of the horn 1 is projected from the horn cover opening end 10 and crushed by the horn 1. I do. In the state where the horn 1 is projected, the inclined surface 4 of the protruding portion 3 forms substantially the same surface as the outer peripheral surface of the tip portion 9 of the horn cover, and the vibrator-side end of the protruding portion 3 and the vibrator of the notch 13 are formed. Opening 1 at the side edge
4 is formed so that the perfusate can flow out from the flow channel. When the living tissue is disrupted, the perfusate flows out laterally, which does not hinder the operation.

Next, when the horn 1 pierces the living tissue while crushing the living tissue with the horn 1, as shown in FIG. 2B, the tip of the horn 1 is pulled into the horn cover 5. . Then, since the horn cover opening end 10 presses the living tissue, the horn 1 can be easily pulled out, and at the same time, the vibrator-side end of the projecting portion 3 abuts on the vibrator-side end of the cutout portion, and the opening 14 is formed. Closed, notch 1 instead
Since the open end side of 3 is opened and a gap is further formed between the horn 1 and the open end 10 of the horn cover, the perfusate is caused to flow forward. Therefore, since the living tissue is pushed forward by the water pressure of the perfusate, the horn 1 can be easily detached.

The overall structure of the ultrasonic surgical instrument is shown in FIG.
Like the ultrasonic surgical instrument A shown in FIG. 1, the sliding portion 17 is provided on the cover portion 15 that is connected to the horn cover 5 so that the horn cover 5 slides back and forth. Further, the horn cover 5 may be slid back and forth by the bellows 19 and the adjusting lever 21 as in the ultrasonic surgical instrument B shown in FIG. Further, as shown in the ultrasonic surgical instrument C in FIG. 5, the micromotor 22 fixed to the main body side is operated by operating the switch 24 to drive the worm gear 2.
3 may be rotated to move the horn 1 attached to the transducer side back and forth.

[0015]

The present invention is constructed as described above, and since the tip of the horn moves back and forth with respect to the horn cover, it can be crushed to a desired depth in the living tissue, and unnecessary ultrasonic waves can be crushed. It is possible to rapidly disrupt the crystalline lens without applying vibration to surrounding tissues.

Further, the outflow direction of the perfusate can be switched, and during crushing, corneal endothelium damage due to direct exposure of the perfusate can be prevented, and even when the horn is stuck, the horn cover holds down the living tissue and the tip of the horn. When the part is pulled into the horn cover, the perfusate flows out forward, so that the horn can be easily removed from the living body.

[Brief description of drawings]

FIG. 1 is a diagram showing a tip portion of each member of an ultrasonic surgical instrument, (a) is a perspective view of a tip portion of a horn, and (b) is a perspective view of a tip portion of a horn cover.

FIG. 2 is a view showing a usage state of the ultrasonic surgical instrument,
(A) is a perspective view showing a case where the horn is projected,
(B) is a perspective view showing a case where the horn is retracted.

FIG. 3 is an explanatory diagram showing the overall structure of an ultrasonic surgical instrument.

FIG. 4 is an explanatory view showing the overall structure of another embodiment of the ultrasonic surgical instrument.

FIG. 5 is an explanatory view showing the overall structure of another embodiment of the ultrasonic surgical instrument.

FIG. 6 is a perspective view showing a tip shape of a conventional ultrasonic surgical instrument.

[Explanation of symbols]

 1 Horn 3 Projection 4 Slope 5 Horn Cover 7 Horn Cover Base 9 Horn Cover Tip 10 Horn Cover Open End 13 Notch 14 Opening

Claims (1)

(57) [Claims] 1. A horn having a tubular shape and transmitting ultrasonic vibrations from a vibrator to crush living tissue, and an open end is in contact with a peripheral wall of the horn in a watertight manner, and is provided around the horn. In an ultrasonic surgical instrument having a tubular horn cover and using the horn cover as a perfusion fluid flow path, the tip of the horn moves back and forth with respect to the horn cover, and the horn cover has an opening. The horn has at least one notch extending in the longitudinal direction from the end, and the horn has a projection on the peripheral wall that is slidable in a watertight manner with the longitudinal side of the notch, and the projection is the tip of the horn. In the state where the part protrudes from the opening end of the horn cover, the opening is formed together with the end side of the notch part on the oscillator side to allow the perfusate to flow out to the side of the horn cover, and the tip part of the horn enters the horn cover. When retracted, The protruding portion comes into contact with the vibrator-side end of the cutout portion to open the horn cover opening end side of the cutout portion, and further forms a gap between the horn tip portion and the horn cover tip portion to perfuse forward. An ultrasonic surgical instrument characterized by allowing liquid to flow out.