JPH0464262B2 - - Google Patents

Description

Detailed Description of the Invention [Industrial Application Field] The present invention relates to an ultrasonic surgical instrument, in particular, to transmit ultrasonic vibrations to an affected area of a subject, crush and suction the tissue of the affected area, and remove foreign substances within the subject. This relates to an ultrasonic surgical instrument that removes such things.

[Prior art] Ultrasonic surgical instruments, which are currently widely used in the medical field, use a horn or the like to increase the amplitude of ultrasonic vibrations generated by a transducer and transmit them to the affected area within the subject. However, living tissue within the subject, such as a stone, is crushed and the crushed tissue pieces are aspirated.

According to this type of ultrasonic surgical instrument, the ultrasonic vibrations used are capable of being transmitted to relatively hard materials, and elastic tissue absorbs the vibrations and does not shatter. It is effective in brain surgery, liver surgery, and other abdominal surgery, which have a relatively large amount of soft tissue and are rich in blood vessels and nerves.

In other words, this ultrasonic surgical instrument can, for example, crush stones in body cavities: suction or thrombus,
It is used to remove and suction out hemolymph, and is used to remove foreign substances from the subject's body.

An example of a conventional ultrasonic surgical instrument is shown in FIG. 3, and FIG. 3 is a side view showing a cross section of the ultrasonic surgical instrument, and the structure and operation of the figure will be explained below.

In the figure, the vibrator section 10 includes a vibrator 14 and a horn 16. This vibrator 1
An oscillating section (not shown) (on the main body side) is connected to one end of 4, and the vibrator 14 converts an electric signal output from the oscillating section into ultrasonic vibration. A horn 16 is provided at the other end of the vibrator 14, and this horn 16 is connected to the vibrator 14.
The ultrasonic vibrations generated by the machine are amplified to a level that can crush the affected tissue. Furthermore, a cylindrical transmission pipe 18 is provided at the tip of the horn 16 and is integrated with the horn 16 . Therefore, this transmission pipe 18
By bringing its tip into contact with the affected area, the ultrasonic vibration amplified by the horn 16 can be transmitted to the affected area through the transmission tube 18.

Thereby, the affected area can be crushed, and after the affected area has been crushed, the tissue pieces can be suctioned through the transmission tube 18. That is, the inside of the transmission pipe 18 is hollow, and the horn 16 and the vibrator 14 forming the vibrator section 10 are also hollow as shown by the broken line in the figure. This creates a passageway for suctioning and discharging tissue pieces. Therefore, suction is performed by the suction pump connected via the tube 11, which makes it possible to suction the crushed tissue pieces.

According to conventional ultrasonic surgical instruments, foreign objects inside the subject are crushed and suctioned to remove them from the body.
The operator manually inserts the distal end of the transmission tube 18 into the desired region to be examined and brings it into contact with a foreign object. Then, a shock of amplified ultrasonic vibration is applied to the foreign object,
Foreign tissue can be crushed.

Thereafter, as shown in the figure, the crushed tissue pieces are suctioned from the suction port at the distal end of the transmission tube 18 by a suction pump (not shown). That is, the crushed tissue pieces are transferred to the hollow transmission tube 1.
8 -> horn 16 -> vibrator 14 -> tube 11 in this order, passing through the path indicated by the broken line, being sucked as shown by the arrow, and being discharged out of the subject.

Thereby, this ultrasonic surgical instrument can completely remove foreign objects from the subject's body.

An application for an ultrasonic surgical instrument similar to this has been filed in Japanese Patent Application Laid-open No. 599469/1983, in which an elastic Ti--Ni alloy is used as the material for the distal end of the surgical instrument and the transmission tube 18.

[Problems to be Solved by the Invention] According to the conventional ultrasonic surgical instrument described above, the transmission tube 18, which is a pipe forming the distal end of the surgical instrument shown in FIG. Hard materials were used to transmit the signal to the affected area. For this reason, the transmission tube 18 is not flexible and cannot be bent, which limits the surgical sites that can be inserted into the body cavity as a rigid scope.

That is, for example, it was limited to relatively straight and wide esophagus such as esophagus and anus. As a result, in the past, the transmission tube 18 could not be inserted into relatively intricately curved, curved, and narrow ducts such as ureters and blood vessels. Furthermore, when used as a flexible scope, it has been difficult to crush and aspirate foreign objects, or to remove and aspirate blood clots and blood clots.

Furthermore, since the conventional surgical instrument tip uses a transmission tube 18 and transmits ultrasonic vibrations to the transmission tube itself, it may come into contact with living tissue other than the affected area within the subject. Ta. For this reason, there has been a problem in that living tissues other than the affected area are also injured.

In conventional ultrasonic surgical instruments, the tip of the surgical instrument body inserted into the subject has a bendable structure.
In addition, there has been no ultrasonic surgical instrument that can be freely inserted into curved canals such as ureters and blood vessels within a subject, and that can reliably crush and aspirate only the desired affected area.

Purpose of the Invention The present invention was made in view of the above-mentioned conventional problems.The purpose of the present invention is to enable the invention to be inserted freely into curved ducts within the subject, and to crush, aspirate, and remove only the desired foreign matter within the subject. An object of the present invention is to provide an ultrasonic surgical instrument capable of sucking liquid and discharging it out of the body.

[Means for Solving the Problems] In order to achieve the above object, an ultrasonic surgical instrument according to the present invention includes a vibrator that converts an electric signal output from an oscillating part into ultrasonic vibration, and a diameter of the distal end side of the vibrator. A horn that increases the amplitude of vibrations from a vibrator, and a member that is connected to the tip of the horn and transmits the vibrations of the horn to the outside,
A flexible linear transmission part, a flexible protective cover that encloses the transmission part and forms a passage around the transmission part between the transmission part and the transmission part, and a flexible protective cover for holding the transmission part. A horn cover that is connected to the cover, encloses the horn, and forms a horn outer circumferential suction passage between the horn and the horn, and a horn cover that extends from the inside of the horn to an opening provided on the circumferential surface of the intermediate portion of the horn, The horn internal passage is connected to the suction passage, and foreign matter inside the subject can be suctioned and discharged from the horn internal passage.

[Function] With the above configuration, according to the ultrasonic surgical instrument according to the present invention, the tip of the surgical instrument can be bent by the flexible linear transmission section and the rib-shaped protective cover section. forming a section. Therefore, it can be freely inserted into a body cavity such as a complicatedly curved duct, and the tip of the transmission section can be brought into contact with a foreign object to transmit the generated ultrasonic vibrations to the foreign object. This makes it possible to reliably crush only the desired foreign matter.

In addition, since the conduit-shaped protective cover part encloses the transmission part, foreign matter and liquid inside the subject can be aspirated.

As a result, it becomes possible to reliably expel foreign matter from the subject.

Furthermore, in the ultrasonic surgical instrument of the present invention, the transmission section is not exposed by the protective cover section, so when inserting or withdrawing the tip of the surgical instrument into the subject, the tip of the transmission section may be exposed to tissue other than the affected area. Since there is no contact with the body, damage to living tissue can be prevented.

As a result, it becomes possible to perform surgery reliably and quickly.

Furthermore, since the suction port 20 is provided in the middle of the horn 16, the adverse effects of the curved portion of the passage inside the horn can be eliminated, and foreign matter can be efficiently discharged.

[Embodiment] FIGS. 1 and 2 show cross-sectional views of an ultrasonic surgical instrument according to an embodiment of the present invention. FIG. 1 and FIG. 2 show a structure in which a wire-like transmission part and a rib-like protective cover part are provided, and the structure is capable of crushing foreign objects and aspirating foreign objects and liquid.

In the present invention, the flexible transmission section is made of a material such as an elastic alloy, stainless steel, or titanium alloy.

Incidentally, the same members as those in the conventional example shown in FIG. 3 are given the same reference numerals, and the explanation of their structure and operation will be omitted below.

Characteristic features of the present invention include a flexible transmission part for contacting and crushing foreign objects, and a flexible ridge-like structure that encloses the transmission part and sucks foreign objects and liquids. A protective cover part is provided, whereby foreign matter and liquid can be sucked and discharged from the subject.

In FIG. 1 showing the first embodiment of the present invention, a suction portion 26 is formed from a transmission portion 22 and a protective cover 24, and a suction port is provided in a horn 16 for suctioning and discharging foreign matter, liquid, etc. It is shown that 20 were provided.

That is, in FIG. 1, what is different from the conventional example shown in FIG. a flexible transmission section 22 for transmitting sound wave vibrations to a foreign object, and the transmission section 2
The suction portion 26 is formed from a flexible, rib-shaped protective cover 24 for suctioning foreign matter. Therefore, the distal end of the surgical instrument of this embodiment has flexibility and can be bent, which was impossible in the past. For example, it has become possible to freely insert it into a subject's body through complicatedly curved ducts such as ureters and blood vessels.

Furthermore, in the first embodiment of the present invention, the horn 16 is provided with, for example, two suction ports 20 at opposing positions, thereby making it possible to effectively discharge the suctioned foreign matter, liquid, etc. (FIG. 1B).

That is, as shown in FIG. 1, the suction unit 26 suctions foreign matter and liquids, for example, due to crushing a stone in a body cavity or removing a blood clot or blood clot. Then, it passes through the passage as shown by the arrow in the figure, passes through the protective cover, and further passes through the horn cover 28 and enters the suction port 20.

In this way, the crushed foreign matter and liquid are further removed from the hollow horn 16→vibrator 14→
The tube 11 passes through the passage indicated by the broken line, is sucked in by the suction pump as shown by the arrow, and is discharged out of the subject.

As described above, according to the embodiment, the conventional inflexible transmission section 18 could only be used with a rigid endoscope, but the flexible transmission section and the rib-shaped protective cover section By employing this, the present invention can be used in combination with a flexible endoscope for the treatment of stone fragmentation, or can be inserted into a blood vessel along the blood vessel for the treatment of blood clots.

[Effects of the Invention] As described above, according to the ultrasonic surgical instrument according to the present invention, the surgical instrument tip includes the flexible transmission section and the linear transmission section, and the flexible The ridge-shaped protective cover part can be bent, and it is possible to crush foreign matter inside the subject, as well as suction and discharge the foreign matter and liquid from the subject. Furthermore, since the ultrasonic surgical instrument of the present invention has a bendable tip structure, it can be used in combination with a flexible endoscope, and can be effectively inserted into affected parts of the subject's body, such as curved ducts. can. Furthermore, when inserting the tip of the ultrasonic surgical instrument into the subject, the rib-shaped protective cover protects the
This has the effect of preventing the tip of the transmission portion from touching in-vivo tissue other than the affected area.

Furthermore, since the suction port 20 is provided in the middle of the horn 16, the adverse effects of the curved portion of the passage inside the horn can be eliminated, and foreign matter can be efficiently discharged.

[Brief explanation of the drawing]

1A and 1B are diagrams showing a first embodiment of an ultrasonic surgical instrument of the present invention, and FIG. 2 is a sectional view showing a conventional ultrasonic surgical instrument. 16... Horn, 20... Suction port, 22... Transmission part,
24...protective cover, 26...suction section, 28...horn cover, 28a...discharge port.

Claims (1)

[Scope of Claims] 1. A vibrator that converts an electric signal output from an oscillator into ultrasonic vibrations, a horn that has a smaller diameter on the tip side and increases the amplitude of vibrations from the vibrator, and A flexible linear transmission part that is connected to the tip of the horn and transmits the vibrations of the horn to the outside;
a flexible protective cover, which is a member forming an outer circumferential passage of the transmission part; and a member that is connected to the protective cover, encloses the horn, and forms a horn outer circumferential suction passage between the protective cover and the horn; It has a horn cover, and an internal horn passage that extends from the inside of the horn to an opening provided on the circumferential surface of the middle part of the horn and is connected to a suction passage around the horn, and suctions foreign matter inside the subject from the internal passage of the horn. An ultrasonic surgical instrument characterized by being ejectable.