JP3877873B2 - Perfusion suction device - Google Patents

Description

[0001]
BACKGROUND OF THE INVENTION
The present invention relates to a perfusion suction apparatus that supplies a perfusate to a surgical site and sucks it together with a removed tissue.
[0002]
[Prior art]
There is known a perfusion suction device that injects a perfusate into an affected area and sucks and removes it together with a removed tissue of the affected area. Especially in the field of ophthalmology, this perfusion suction device is used in cataract surgery, vitreous surgery and the like. In the cataract surgery, the apparatus sucks the removed tissue together with the perfusate supplied to the patient's eye and the handpiece having a tip having a suction hole attached to the tip, and discharges the waste fluid from the other end of the suction tube.
[0003]
By the way, in this type of device, a mechanism for controlling the suction pressure during surgery is indispensable. For this reason, a suction pressure detection system and a connection part are provided in the middle of the suction tube, and the suction pressure is controlled by a pressure sensor through this connection part. What is known is well known. However, since the pressure sensor directly detects the pressure in the suction tube, the removed tissue sucked from the patient's eye may enter the suction pressure sensor unit. When the waste liquid enters the suction pressure detection system, various germs propagate in that part and flow back into the tube, so it cannot be said that there is no possibility of nosocomial infection during the operation. As a countermeasure against this, a method has been adopted in which a disposable filter or the like is attached to the connecting portion between the pressure sensor and the suction tube to prevent movement of germs and body tissues.
[0004]
[Problems to be solved by the invention]
However, in the method of attaching a filter or the like to the connection part, it is difficult to accurately detect the suction pressure due to the filter resistance and the clogging of the tissue attached to the filter.
[0005]
In addition, when removing the suction tube from the apparatus, tissue or fluid sucked from the patient's eyes may flow out from the connection portion with the apparatus, and the apparatus and its surroundings may be soiled.
[0006]
In view of the above problems, it is an object of the present invention to provide a perfusion suction device that can accurately detect a suction pressure while preventing the suction liquid from entering the suction pressure detection system.
[0007]
It is another object of the present invention to provide a perfusion suction device in which a suction tube can be easily attached to and detached from a suction pressure detection system.
[0008]
[Means for Solving the Problems]
In order to solve the above problems, the present invention is characterized by having the following configuration.
[0009]
(1) In a perfusion suction apparatus that supplies perfusate to a surgical site, sucks it from the suction hole of the handpiece and discharges it to the waste liquid bag through the suction tube, suction to the suction tube and the waste liquid bag connected to the handpiece A chamber connected to a tube, in which a piston and a piston rod are movably arranged in a state of being sealed by a diaphragm, and a case for mounting the chamber, orthogonal to the axial direction of the suction tube A pressing means that presses either the piston or the piston rod with a predetermined load from the direction to be pressed , and a load detection element that contacts the other piston or piston rod that is not pressed are arranged on the opposite side of the pressing means with respect to the suction tube . A chamber mounting case for mounting the chamber between the pressing means and the load detecting element, and the piston The surface in contact with the liquid flow piston or piston rod is large with respect to the surface in contact with the pressing means, characterized in that.
[0015]
DETAILED DESCRIPTION OF THE INVENTION
Hereinafter, embodiments of the present invention will be described with reference to the drawings. FIG. 1 is a schematic external view of a perfusion suction apparatus according to an embodiment, and FIG. 2 is a schematic configuration diagram of a main part.
[0016]
Reference numeral 1 denotes an apparatus main body of the perfusion suction apparatus, and reference numeral 2 denotes a US handpiece held by an operator. A tubular crushing tip 2a having a suction hole is attached to the tip of the US handpiece 2, and the nucleus of the crystalline lens is crushed and emulsified by applying ultrasonic vibration to the crushing tip 2a. 3 is an operation panel which is an input unit for performing various settings such as perfusion pressure and suction pressure, and 4 is a cable for supplying electric power for generating ultrasonic vibration in the crushing tip 2a of the US handpiece 2. . The main body 1 houses a control unit 5 that controls the entire apparatus.
[0017]
Reference numeral 10 denotes a perfusion bottle containing a perfusion solution such as physiological saline for supplying to the patient's eye E, and reference numeral 11 denotes a perfusion tube for guiding the perfusion solution to the patient's eye E. The perfusion bottle 10 is suspended from a pole 12, and the pole 12 is moved up and down so that the height of the perfusion bottle 10 can be changed. The height of the perfusion bottle 10 is set so as to maintain the pressure in the patient's eye E appropriately.
[0018]
A control valve 14 is provided in the middle of the perfusion tube 11, and the outflow control of the perfusate is performed by opening and closing the control valve 14. One end of the perfusion tube 11 is connected to the perfusion bottle 10 side, and the other end is connected to the US handpiece 2 side for crushing. As the US handpiece 2, various handpieces such as a perfusion suction handpiece are selected according to an operation stage, an operation method, and the like, and are used by being connected.
[0019]
Reference numeral 16 denotes a flexible suction tube, which is used to discharge tissues such as cataract nuclei crushed and emulsified together with the perfusate sucked from the suction hole of the crushing tip 2a attached to the US handpiece 2 to the outside of the body. The In the middle of the rear side of the suction tube 16, there are provided a pressure detection unit 30 for detecting the suction pressure (details will be described later) and a peristaltic suction pump unit 20 for generating the suction pressure. The suction pump unit 20 is controlled by the control unit 5 and its suction flow rate is adjusted. The sucked waste liquid is discharged into the waste liquid bag 17.
[0020]
Further, the suction tube 16 is connected to the front side of the control valve 14 of the perfusion tube 11 by a bypass tube 15, and a vent valve 18 for guiding the perfusion liquid to the suction tube 16 side to lower the suction pressure is provided in the middle. Is provided.
[0021]
Reference numeral 6 denotes a foot switch, and the control unit 5 drives and controls the apparatus in response to a signal of the position position. For example, when the US handpiece 2 is used, three position positions of a perfusion mode in which only perfusion is performed, a perfusion / aspiration mode in which perfusion and suction are performed, and a perfusion / aspiration / fracturing mode in which perfusion, suction and ultrasonic crushing are performed There is.
[0022]
Next, the structure of the pressure detection part 30 is demonstrated based on sectional drawing shown in FIG. A chamber 40 in which a piston 42 is incorporated is connected to the suction tube 16, and the piston 42 is coupled to a piston rod 41 that penetrates the chamber 40. The piston 42 and the piston rod 41 are movable in the vertical direction in FIG. 3 while being sealed in the chamber 40 by diaphragms 43a and 43b (in this embodiment, rubber films are used).
[0023]
The chamber 40 to which the suction tube 16 is connected is mounted between a lower case 31 and an upper case 32 (see FIG. 1) protruding from the side surface of the apparatus main body 1. A load cell 45 that is a load detection element that outputs a load applied as a change in voltage is fixedly disposed in the lower case 31, and the chamber 40 is inserted by inserting its lower end into a recess 31 a formed in the lower case 31. The piston 42 is mounted so that the lower surface of the piston 42 contacts the detection surface of the load cell 45.
[0024]
A pressing unit 50 is provided in the upper case 32 to press the piston rod 41 of the chamber 40 toward the load cell 45 with a predetermined load. The pressing unit 50 holds a chamber presser 51 for holding the chamber 40 with the load cell 45, a first spring 52 for biasing the chamber presser 51 toward the chamber 40, and the chamber presser 51 and the first spring 52. Holder 53 to be held in the holder 53 so as to be movable up and down, a pressing rod 54 for pressing the piston rod 41, a second spring 55 for urging the pressing rod 54 toward the piston rod 41, and a pressing force of the pressing rod 54 It is comprised by the adjustment screw 56 for adjusting. The pressing unit 50 is configured to be lowered to the state shown in FIG. 3 by turning a lever 33 provided on the upper case 32. The chamber 40 is held between the load cell 45 and the chamber holder 51 by lowering the pressing unit 50. At the same time, the piston rod 41 is pushed toward the load cell 45 by the pushing rod 54 that receives the spring force of the second spring 55. This pressing load can be adjusted in advance to a known value by removing the cover of the upper case 32 and turning the adjusting screw 56.
[0025]
The operation of the apparatus having the above configuration will be described below. During the operation, the position of the perfusion bottle 10, the attachment of each tube to the US handpiece 2 and the suction pump unit 20, and other necessary preparations are performed. The chamber 40 connected in the middle of the suction tube 16 is positioned by inserting the lower end of the chamber 40 into the recess 31a of the lower case 31 as described above, and lowering the pressing unit 50 by tilting the lever 33 forward. To do.
[0026]
Once the necessary settings have been made on the device side, the surgeon inserts the tip 2a of the US handpiece 2 into the eye, and steps on the foot switch 6 to control the perfusion fluid supply operation, suction operation and ultrasonic vibration operation. Surgery using ultrasonic emulsification is performed. When the suction signal from the foot switch 6 is input, the control unit 5 drives the suction pump 20. The suction pressure generated by the suction pump 20 reaches the US handpiece 2 through the suction tube 16, and the waste liquid in the eye is sucked from the suction hole of the crushing tip 2a.
[0027]
The pressure detector 30 always detects the suction pressure in the suction tube 16. Hereinafter, detection of the suction pressure will be described. The piston 42 in the chamber 40 is pressed against the detection surface of the load cell 45 with a constant load by the pressing unit 50 via the piston rod 41. When the inside of the suction tube 16 is in a negative pressure state by the suction operation by the suction pump 20, the surface of the piston 42 in contact with the suction flow is wider than the surface of the piston rod 41 in contact with the pressing rod 54. Therefore, the piston 42 serves as an operating plate. A load in the direction of pulling the load cell 45 is generated. However, since the pressing rod 54 presses the piston 42 with a constant load via the piston rod 41, the piston 42 is not pulled away from the load cell 45 (adjusted to such a load). At this time, a load expressed by the following equation acts on the load cell 45 according to Pascal's law.
[0028]
L = Lo− (Sp- Sr) * Pa
Where L: Load acting on the load cell
Lo: Constant load acting on the piston rod
Sp: Piston area
Sr: Piston rod cross-sectional area
Pa: The suction pressure in the suction tube (the part below the atmospheric pressure is displayed as a positive value).
[0029]
With such a relationship, the control unit 5 can obtain the suction pressure in the suction tube 16 from the output signal of the voltage change from the load cell 45. In addition, when the inside of the suction tube is in a positive pressure state, the piston 42 acts in a direction in which the piston 42 is pressed against the load cell 45, but the relationship of the above formula is maintained.
[0030]
When the pressure detection unit 30 detects that the suction pressure in the suction tube 16 has reached the set value, the control unit 5 stops the suction pump unit 20 and then maintains the pressure in the suction tube 16 at the set value. . If necessary, the vent valve 18 is opened and the perfusate is guided to the suction tube 16 side to lower the suction pressure.
[0031]
When the operation is completed and the suction tube 16 is removed, the lever 33 is raised. By this operation, the suction tube 16 can be easily removed from the apparatus together with the chamber 40. Further, since the suction liquid flowing in the suction tube 16 is isolated from the load cell 45 on the apparatus main body side by the above structure, the suction pressure is always detected with high accuracy while preventing the suction liquid from entering the apparatus side. be able to. Since there is no leakage of the suction liquid when the suction tube 16 is removed, there is no fear of infection to medical personnel due to this.
[0032]
Various modifications can be made to the embodiment described above. FIG. 4 shows a modification example of the pressure detection unit 30. In contrast to the previous embodiment, in the modification example of FIG. 4, the arrangement direction of the piston 42 ′ and the piston rod 41 ′ in the chamber 40 is different. That is, the piston 42 ′ that moves in response to fluctuations in the suction pressure is in contact with the pressing rod 50 on the pressing unit 50 side, and the piston rod 41 ′ is in contact with the detection surface of the load cell 45. Therefore, when the inside of the suction tube 16 is in a negative pressure, the piston 42 ′ moves to the load cell 45 side and a load is generated in a direction in which the piston rod 41 ′ is pressed against the load cell 45, contrary to the previous configuration. At this time, a load expressed by the following equation acts on the load cell 45 according to Pascal's law.
[0033]
L = Lo + (Sp- Sr) * Pa
Where L: Load acting on the load cell
Lo: Constant load acting on the piston rod
Sp: Piston area
Sr: Piston rod cross-sectional area
Pa: The suction pressure in the suction tube (the part below the atmospheric pressure is displayed as a positive value).
[0034]
When the inside of the suction tube 16 is in a positive pressure state, a load is generated in a direction that separates the piston 42 ′ from the load cell 45, but the load cell 45 is pressed with a constant load by the piston rod 41 ′. Although the load on which ′ pushes the load cell 45 is reduced, it will not become undetectable away.
[0035]
Further, as means for applying a constant load to the load cell 45, air pressure, magnetic force, electric force, gravity, or the like can be used instead of an elastic body such as a spring.
[0036]
【The invention's effect】
As described above, according to the present invention, the suction pressure can be detected in a state isolated from the tissue sucked from the patient's eye and the waste liquid, so that the suction pressure can be accurately applied while preventing these intrusions into the apparatus side. It can be detected. For this reason, hospital infection and device failure can be prevented. Further, the suction tube can be attached to and detached from the suction pressure detection system very easily, and there is no fear that the sucked liquid leaks during the removal.
[Brief description of the drawings]
FIG. 1 is a schematic external view of a perfusion suction device.
FIG. 2 is a schematic configuration diagram of a main part of the perfusion suction device.
FIG. 3 is a cross-sectional view showing a configuration of a pressure detection unit of the perfusion suction device.
FIG. 4 is a cross-sectional view showing a modification example of the pressure detection unit of the perfusion suction device.
[Explanation of symbols]
16 Suction tube 40 Chamber 41 Piston rod 42 Piston 45 Load cell 50 Press unit

Claims (1)

In a perfusion suction device that supplies perfusate to the surgical site, sucks it from the suction hole of the handpiece and discharges it to the waste liquid bag through the suction tube , it connects to the suction tube connected to the handpiece and the suction tube to the waste liquid bag A chamber in which the piston and the piston rod are movably arranged in a state of being sealed by a diaphragm, and a case for mounting the chamber from a direction orthogonal to the axial direction of the suction tube one of the piston and the piston rod is arranged a pressing means for pressing with a predetermined load, to the pressing means opposite to the pressed without other piston or load detection element a suction tube in contact with the piston rod, pushes the chamber A chamber mounting case mounted between the means and the load detecting element, wherein the piston Surface of the piston or piston rod contacting is largely against the surface in contact with the pressing means, irrigation suction device, characterized in that.

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