JP3585265B2 - Ophthalmic ultrasound surgery device - Google Patents

Description

[0001]
[Industrial applications]
The present invention relates to an ultrasonic surgical apparatus, and is particularly suitable for an ultrasonic surgical apparatus that crushes, emulsifies, and aspirates a clouded lens nucleus.
[0002]
[Prior art]
In the field of ophthalmology, an ultrasonic surgical device used for so-called emulsification and suction of the lens has a tubular tip attached to the tip of the probe, and the vibration of the ultrasonic transducer is amplified and transmitted to the tip to break the nucleus of the lens. It is emulsified. This device crushes and emulsifies the nucleus of the lens while supplying the perfusate into the eye, and aspirates the crushed and emulsified nucleus together with the perfusate out of the body via a suction passage provided in the chip.
[0003]
In general, a through hole having a uniform diameter was formed in the chip as the suction passage.
In addition, there has been proposed a configuration in which the opening diameter at the tip is made larger than the diameter at the rear hole in order to increase the crushing force.
[0004]
[Problems to be solved by the invention]
However, the former through-hole having a uniform diameter tends to be thick at the tip of the chip, and has a problem that the crushing efficiency is poor.
In the latter chip, the rear port diameter needs to be sufficiently smaller than the tip opening diameter in order to reduce the anterior chamber fluctuation at the time of nuclear aspiration. There was a problem that it was not easy in manufacturing technology.
[0005]
The present invention has been made in view of the above problems, and a technical problem of the present invention is to provide an ultrasonic surgical apparatus that can reduce intraocular pressure fluctuation during surgery and that can be easily processed.
[0006]
[Means for Solving the Problems]
The present invention has the following configuration to solve the above problems.
[0007]
(1) In an ophthalmic ultrasonic surgical apparatus having a probe having an ultrasonic transducer and a tip attached to the tip of the probe, a suction passage of the tip provided for sucking the crushed emulsion. A suction hole having a first opening diameter, a smallest outflow hole provided in the middle of the suction passage, and a rear suction hole having a diameter smaller than the first opening diameter. The diameter of the passage from the outlet to the outlet hole is gradually reduced, and the diameter of the passage from the outlet to the rear suction hole is gradually increased .
[0010]
【Example】
Hereinafter, an embodiment of the present invention will be described with reference to the drawings. FIG. 1 is a diagram showing a schematic configuration of the apparatus of the embodiment.
Reference numeral 1 denotes a probe held by an operator. In a hollow portion inside the probe 1, a vibrator 3 made of a piezoelectric element molded with silicon rubber is held via an insulating film 2. The vibrator 3 generates an ultrasonic vibration by a driving signal supplied from the driving device 30 via the conducting wire 4. Reference numeral 5 denotes a horn for amplifying the ultrasonic vibration. The horn 5 and the vibrator 3 are integrally fixed by bolts and nuts 6 (not shown).
[0011]
A suction passage 7 penetrating in the axial direction is formed in the vibrator 3, the horn 5 and the nut 6, and a rear end portion of the suction passage 7 is connected to a suction tube 8. Suction pressure is generated in the suction tube 8 by a suction device 31 composed of a pump or the like, and the waste liquid is discharged into a waste liquid bag by the suction pressure.
[0012]
The tip 20 for crushing and emulsifying the lens core is screwed to the tip of the horn 5. The entire tip 20 has a tubular shape, and its suction passage communicates with the suction passage of the horn 5. The tip shape of the tip 20 will be described later.
[0013]
Numeral 9 is a cylindrical tapered sleeve covered by a chip 20, and the tip of the sleeve 9 is provided with an outlet (not shown) for supplying a perfusate into the eye. The rear end of the sleeve 9 is attached to the front end of the probe 1. Reference numeral 10 denotes a perfusion passage for guiding the perfusate to the sleeve 9, and the perfusate is sent from the perfusion apparatus 32 through the perfusion tube 11.
Reference numeral 12 denotes an O-ring mounted on the outer periphery of the horn 5 to keep the piezoelectric element waterproof .
[0014]
Reference numeral 33 denotes a control device for controlling the entire apparatus, and reference numeral 34 denotes a control switch section for setting various conditions. Reference numeral 35 denotes a foot switch, and the control device 33 drives the driving device 30, the suction device 31, and the perfusion device 32 in accordance with the signal of the position position.
[0015]
Next, details of the tip shape of the chip 20 will be described with reference to FIG. FIG. 2 is an enlarged view of the tip portion A of the chip 20 of FIG.
Reference numeral 22 denotes a tip surface of the tip 20 to which ultrasonic vibration is transmitted to crush and emulsify the cataract lens nucleus . The tip surface 22 is formed at an angle θ with respect to the vertical plane of the axis, and this angle θ is selected from various angles including zero. Reference numeral 23 denotes a tip suction hole for sucking the crushed emulsion, and the inside diameter of the tip suction hole 23 is larger than the inside diameter of the suction passage 21. For this reason, the thickness of the side wall of the distal end suction hole 23 is formed thin, and the pressure on the affected tissue is increased, so that the crushing efficiency is increased.
[0016]
The distal end suction hole 23 and the suction passage 21 communicate with each other through an outflow hole 24 having a diameter sufficiently smaller than the diameter of the suction passage 21. The length of the outflow hole 24 in the axial direction does not need to be particularly long, and can be shortened to facilitate processing. By providing the outflow holes 24, even if the suction pressure is increased, the suction flow rate per unit time can be reduced, so that the anterior chamber fluctuation can be reduced.
[0017]
A stepped hole 25 is provided from the distal end suction hole 23 to the outflow hole 24 so that the inner diameter gradually decreases in a stepwise manner. The step-like end face portion 25a of the step hole 25 further crushes the crushed emulsion sucked from the tip suction hole 23, thereby improving the crushing efficiency and preventing the outflow hole 24 from being blocked.
[0018]
The operation of the apparatus having the above configuration will be briefly described.
The surgeon grasps the probe 1 and inserts the tip 20 into the eye from the wound opening in the limbus of the patient's eye. The operator operates the foot switch 35 to operate the driving device 30, the suction device 31, and the perfusion device 32 while moving the tip of the tip 20 finely. The perfusion solution is supplied into the eye by the operation of the perfusion device 32.
[0019]
The driving device 30 causes the vibrator 3 to generate ultrasonic vibration, and the generated vibration is amplified by the horn 5 and transmitted to the chip 20. The tip surface 22 of the tip 20 repeats advancing and retreating due to the vibration, and impacts the nucleus of the crystalline lens to crush and emulsify the nucleus. A suction pressure is generated in the suction tube 8 by the operation of the suction device 31, and the crushed nucleus and the perfusate are sucked through the tip suction hole 23 of the tip 20. The nucleus sucked from the tip suction hole 23 is further finely crushed by the stepped end face portion 25 a and passes through the outlet hole 24. In addition, since the flow rate sucked from the distal end suction hole 23 is suppressed low by the inner diameter of the outflow hole 24, the anterior chamber fluctuation is suppressed to a small amount without abrupt suction and outflow. For this reason, the surgeon can operate with a high suction pressure.
[0020]
The above embodiment can be variously modified. For example, it is not always necessary to provide a step-shaped step hole 25 extending from the tip suction hole 23 to the outflow hole 24, and may be as shown in FIG. Such changes are included in the present invention as long as the technical ideas are the same.
[0021]
【The invention's effect】
As described above, according to the present invention, by providing outflow holes having a diameter smaller than the front and rear suction passages in the middle of the chip, fluctuations of the anterior chamber can be suppressed small, and high suction pressure can be suctioned. At the same time, the outflow hole of the small hole may be short, so that the working becomes easy.
[0022]
In addition, the crushing efficiency can be improved by making the opening diameter of the tip larger than the suction passage behind the small outflow hole.
[Brief description of the drawings]
FIG. 1 is a diagram showing a schematic configuration of an apparatus according to an embodiment.
FIG. 2 is a diagram showing a tip shape of a tip of an embodiment.
FIG. 3 is a diagram showing an example of changing the shape of a chip.
[Explanation of symbols]
DESCRIPTION OF SYMBOLS 1 Probe 3 Vibrator 20 Chip 21 Suction passage 23 Tip suction hole 24 Outflow hole

Claims (1)

A probe having an ultrasonic vibrator, and a tip attached to the tip of the probe , in an ophthalmic ultrasonic surgical apparatus having a tip, a suction passage of the tip provided for sucking the crushed emulsion, A tip suction hole having a first opening diameter, a smallest outflow hole provided in the middle of the suction passage, and a rear suction hole having a diameter smaller than the first opening diameter are provided and flow out from the tip suction hole. Ophthalmic ultrasound capable of reducing the diameter of the passage to the hole gradually and gradually increasing the diameter of the passage from the outflow hole to the rear suction hole. Surgical equipment.

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