JPH0767463B2 - Ultrasonic treatment device - Google Patents

Description

Description: TECHNICAL FIELD The present invention relates to improvement of an ultrasonic treatment device that performs treatments such as prostatectomy and calculus destruction by ultrasonic vibration.

[Conventional technology]

In the past, transurethral resection of the prostate has been performed by cauterizing the affected tissue with a high-frequency current to remove it.

However, such ablation makes it difficult to determine the ablation area because the cauterized living tissue is denatured and whitened, and there is a risk that even normal tissue is ablated.

Therefore, recently, cutting has been performed with an ultrasonic treatment device. As shown in Japanese Patent Application Laid-Open No. 55-155641, Japanese Patent Application No. 601201, and Japanese Patent Application No. 60-210510, a probe (eg, a pipe) that can be inserted into a living body ( A structure in which an ultrasonic vibrator (ultrasonic vibration generator) is connected to a base of a vibration transmitting member) via a horn is used. And sheath (guide tube) for treatment
A probe was used to guide the probe to the prostate gland, the tip of the probe was pressed against the affected area, and then the tissue was resected by applying ultrasonic vibration to the tissue through the probe. Of course, this also applies when destroying stones.

[Problems to be solved by the invention]

By the way, in the ultrasonic treatment device, ultrasonic vibration (standing wave) is transmitted at a frequency with the tip of the probe as an antinode of the amplitude so that the largest ultrasonic vibration can be obtained at the tip of the probe. Specifically, as shown in FIG. 8, an ultrasonic transducer b connected to the probe a is used to oscillate a standing wave in which the tip of the probe a is used as an antinode and nodes and antinodes are alternately formed. .

However, such an ultrasonic treatment device has a drawback that the node serving as the node of the probe a is apt to be fatigued due to the displacement distribution of the standing wave whose tip is set to the belly.

That is, the node portion is the position where the largest strain occurs and also the position where the maximum stress occurs, and fatigue is likely to occur due to the addition of stress.

Therefore, at the time of treatment (cutting, breaking, etc.), as shown in FIG. 8, there is a risk that the node portion of the probe a will be cut (from breaking etc.) due to fatigue failure and will come out of the sheath c and be left in the living body. there were.

The present invention has been made in view of such a problem, and an object thereof is to prevent the cut portion from being left in the living body even if the node portion of the vibration transmitting member is cut.

[Means and Actions for Solving Problems]

In this device, when a cut occurs in the vibration transmission member, the engagement portion provided on the vibration transmission member and the engagement portion provided on the guide tube are engaged with each other to prevent the cut portion of the vibration transmission member from coming off. By providing the retaining means for preventing the cut piece from coming out into the living body, the cut portion of the guide tube is taken out from the living body.

〔Example〕

The present invention will be described below with reference to the first embodiment shown in FIGS. 1 and 2. FIG. 2 shows the whole of the ultrasonic treatment apparatus. Reference numeral 1 is a grip portion in which an ultrasonic transducer 2 (corresponding to an ultrasonic vibration generator) is incorporated, and 3 is a conical shape arranged on the tip side of the grip portion 1. Is the horn. The ultrasonic transducer 2 has
Although not shown, a Langevin type is used in which a plurality of piezoelectric elements and a plurality of electrode plates are alternately arranged and sandwiched between a front metal block and a rear metal block. The front metal block is connected to the horn. Further, a probe 4 (vibration transmitting member) made of a pipe is connected to the tip of the horn 3 so that the ultrasonic vibration generated by the ultrasonic transducer 2 can be transmitted to the tip of the probe 4. A passage (not shown) communicating with the lumen of the probe 4 is provided in the center of the grip 1 (the center of the ultrasonic transducer 2, the horn 3, etc.) and constitutes a suction path together with the lumen. ing. Then, a suction pump (not shown) is connected to the suction port body 5 which is the end of this passage via a suction tube 6 so that suction can be performed from the tip opening of the probe 4. In addition, 7 is an ultrasonic transducer 2
Shows the cable leading to. Of course, the cable 7 connects to a power supply device (not shown).

On the other hand, 8 is a sheath, and 9 is a scope such as a laparoscope. The sheath 8 can be inserted into a living body. Then, by inserting the probe 4 together with the scope 9 into the sheath 8 as a guide of the sheath 8, the affected area can be treated by ultrasonic vibration. Reference numeral 8a denotes a cock for perfusion of a perfusion solution (such as physiological saline) into the living body through the sheath 8.

Then, the seal 8 and the probe 4 of such an ultrasonic processing device
Further, as shown in FIG. 1, a retaining portion 10 (corresponding to retaining means) is provided. The retaining portion 10 has a technique in which the strength of the node portion A closest to the horn 3 on the probe 4 is weaker than the strength of other node portions (not shown), and the probe portion on the tip side from the node portion A is sheathed. It is used together with the technology to prevent it from falling from 8.

More specifically, in the technique of weakening the strength of the knot portion A, a structure in which a ring-shaped groove is formed on the outer circumference of the knot portion A and only that portion is made thin is used. A
Is weaker than other nodes. Then, by this, the portion to be intentionally destroyed is determined so that the probe 4 will not be destroyed from other node portions first. Further, as a technique for preventing the tip side portion from dropping from the node portion A, the collar portion 12 is provided on the tip side outer circumference of the probe 4 with the thin portion 11 as a boundary.
Attach (engagement part). Then, at the end portion of the sheath 8 corresponding to the collar portion 12, the expanding portion 13 into which the collar portion 12 can be freely inserted.
And a stepped portion 13a (engagement portion) that abuts the collar portion 12 is formed at the boundary of the expanded portion 13, and the collar portion 1
By engaging the second step portion 13a with the stepped portion 13a, the portion after the tip of the thin portion 11 is prevented from coming off.

When destroying the calculi 14 in the bladder using such an ultrasonic treatment apparatus, the probe 4 is inserted together with the scope 9 into the sheath 8 inserted into the bladder through the body cavity wall as shown in FIG. Then, the tip of the probe is pressed against the target stone 14. After this, if ultrasonic vibration is applied from the ultrasonic oscillator 2 to the calculus 14 and suction force is applied to perform perfusion, the calculus 14 is destroyed by the transmitted ultrasonic vibration, and the destroyed calculus 14 With the perfusate,
It is discharged to the outside of the body through the suction passage.

However, during such ultrasonic treatment, the maximum stress is generated in each node. If fatigue due to this stress is applied to the nodes for a long period of time, fatigue failure will occur.
Here, since the strength of the knot portion A is lower than that of the other knot portions (not shown), the specific knot portion A causes fatigue fracture. Specifically, a break occurs at the node portion A, and the probe 4 is cut at the node portion A as a boundary.
As a result, the probe 4 is cut, and at the same time, the cut piece (cut portion) on the tip side that is cut is dropped into the bladder.

However, the collar 12 of the cut piece comes into contact with the stepped portion 13a of the sheath 8 as it falls. As a result, the cut pieces are held by the sheath 8 due to the locking of the two pieces, and do not come out into the body cavity.

Thus, the cut piece is prevented from coming off. Moreover, if the seal 8 is then withdrawn from the body cavity, the cut piece together with the sheath 8 can be safely removed from the body cavity.

Therefore, it is possible to prevent the cut pieces from being left inside the body cavity. Moreover, the structure in which the specific node portion A is broken to prevent the node from coming off has an advantage of being able to handle the cutting safely and effectively.

The present invention is not limited to the first embodiment, but the second embodiment shown in FIG. 3, the third embodiment shown in FIG. 4, the fourth embodiment shown in FIG. 5, and the sixth embodiment shown in FIG. The fifth embodiment shown in FIG. 6 and the sixth embodiment shown in FIG. 7 may be used.

That is, in the second embodiment shown in FIG. 3, the probe 4 and the sheath 8 are formed in a tapered shape so that the diameter becomes smaller toward the distal end side to form the retaining portion 10. That is, even if the probe 4 is cut due to fatigue fracture,
Since the sheath and the sheath 8 are tapered, the cut probe 4 does not come out by fitting.

In the third embodiment shown in FIG. 4, the probe 4 is formed in a taper shape such that the diameter thereof becomes smaller toward the distal end side, and the probe 4 is combined with a straight scope 9. Then, the sheath 8 is provided with the probe 4 and the spoop 9 arranged in parallel.
Molded into a taper shape that corresponds to the outer shape of
Therefore, like the second embodiment, the probe 4 is prevented from coming off from the fitting. Of course, in this case, the diameter S through which the probe 4 at the tip of the sheath passes is made smaller than the diameter T of the node portion A.

In the fourth embodiment shown in FIG. 5, the outer peripheral surface of the probe 4 is
Pre-projection at the position on the tip side of each node A ...
In addition to applying the coat 20a formed by forming the 20, a narrowed portion 21 is provided on the inner surface of the distal end portion of the sheath 8 so as to come into contact with the convex portions 20 ... The probe 4 is prevented from coming off from being locked with.

A fifth embodiment shown in FIG. 6 is a modification of the fourth embodiment, and instead of the convex portion, rubber, resin,
It is provided with an apple-shaped stopper 25 ... Of metal or the like.

FIG. 7 shows that the first collar portion 28 is provided on the outer periphery of the probe 4 instead of the convex portion and the stopper described above, and the first collar portion 28 is formed on the outer periphery of the tip portion of the scope 9 aligned with the probe 4. The second flange portion 29 that comes into contact is provided to prevent the probe 4 from slipping out from the engagement between the flange portions 28 and 28. However,
In this case, the sheath 8 may also be provided with a collar portion so as to have more certainty.

In addition, in each of the embodiments shown in FIGS. 5 to 7, the retaining members are provided on the front side of the knot portion so that the retaining effect is maximized. However, the retaining members may be omitted.

〔The invention's effect〕

As described above, according to the present invention, the vibration transmitting member cut by fatigue fracture is brought into contact with the engaging portion provided on the vibration transmitting member and the engaging portion provided on the guide tube side. In addition, the cut vibration transmitting member can be safely processed. As a result, even if the node portion of the vibration transmitting member is cut, the cut portion can be prevented from being left in the living body, and safe treatment can always be performed.

[Brief description of drawings]

1 and 2 show a first embodiment of the present invention,
FIG. 1 is a sectional view showing a main part, FIG. 2 is a perspective view showing an ultrasonic treatment apparatus together with a treatment state, and FIG. 3 is a sectional view showing a main part of a second embodiment of the present invention. 4 is a sectional view showing an essential part of a third embodiment of the present invention, FIG. 5 is a sectional view showing an essential part of a fourth embodiment of the present invention, and FIG. 6 is a fifth part of the present invention. FIG. 7 is a sectional view showing an essential part of an embodiment, FIG. 7 is a sectional view showing an essential part of a sixth embodiment of the present invention, and FIG. 8 shows a conventional ultrasonic treatment device together with a displacement distribution of ultrasonic vibrations. FIG. 2 ... Ultrasonic transducer (ultrasonic vibration generator), 4 ... Probe (vibration transmitting member), 8 ... Sheath (guide tube), 9 ...
… Scope, 10 …… Retaining part (retaining means), 12…
... Collar part (engaging part), 13a ... Step part (engaging part).

Front page continued (72) Akira Shiga 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optical Industry Co., Ltd. (72) Akio Nakata 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optical Kogyo Co., Ltd. (72) Inventor Ryoichi Kono 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optical Industry Co., Ltd. (72) Kouji Taguchi 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optical Industry Co., Ltd. (72) Inventor Masaaki Hayashi 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optical Industry Co., Ltd. (72) Inventor Tadao Hagino 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Within Optical Industry Co., Ltd. (72) Inventor Shinji Hatta 2-43-2 Hatagaya, Shibuya-ku, Tokyo Inside Olympus Optical Industry Co., Ltd.

Claims (1)

[Claims] 1. An ultrasonic vibration generating section, a vibration transmitting member for transmitting the ultrasonic vibration generated by the ultrasonic vibrating section to a tip, a guide tube for inserting the vibration transmitting member into a living body, and this guide. When the vibration transmitting member inserted into the pipe is cut, the cut portion of the vibration transmitting member is formed by engaging the engaging portion provided on the vibration transmitting member with the engaging portion provided on the guide tube side. An ultrasonic treatment device, characterized in that the ultrasonic treatment device is provided with a retaining means for preventing the detachment.