JPH07110278B2 - Ultrasonic surgery equipment - Google Patents

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a surgical operating apparatus (ultrasonic scalpel) using ultrasonic waves.

[0002]

2. Description of the Related Art In a surgical operation tool, a scalpel is intended to incise living tissue. Electric scalpels and laser scalpels have the function of cauterizing cellular tissues as well as cauterizing blood vessels such as capillaries, and having the function of performing hemostasis as well as making incisions, and are surgical instruments suitable for the surgical field of performing hemostasis simultaneously with incision. However, since these surgical instruments simultaneously cut blood vessels and nerves at the same time as incision of tissue, surgical sites where a large number of blood vessels and nerves are accumulated, such as liver and brain tissue,
Alternatively, it is quite difficult to use an electric scalpel or a laser scalpel in a surgery where it is desired to leave blood vessels or nerves at other surgical sites, and it relies on a stainless steel blade, a steel blade or a mosquito that has been conventionally used.

Further, as a surgical instrument to which the ability of cutting or crushing tissue by ultrasonic waves is applied, in the fields of orthopedic surgery and general surgery, a surgical instrument for cutting bones and joints, a surgical instrument for cataract in the ophthalmic field, and a dental instrument. Ultrasonic surgical tools for removing tartar have been put to practical use. However, these conventional ultrasonic surgical tools do not exert the ultrasonic vibration amplitude and power enough to crush tissue over a wide range, but are used as surgical tools dedicated to extremely limited surgical fields. is there.

[0004]

DISCLOSURE OF THE INVENTION The present invention is intended to cut and remove cells to be excised by crushing at a surgical site where blood vessels and nerves are concentrated as described above without damaging the blood vessels and nerves. At the same time, it is an object of the present invention to provide a novel ultrasonic scalpel capable of producing the amplitude and power of ultrasonic vibration capable of exhibiting sufficient tissue crushing ability in a wide range of biological tissues.

[0005]

That is, the present invention provides a power supply unit,
An ultrasonic oscillator basically composed of an amplifying section, a matching section, and a feedback section, and a metal front plate and a backing plate are arranged in front of and behind the electrostrictive vibrator, and are connected by bolts with pressure. An ultrasonic transducer that converts the ultrasonic signal of the ultrasonic oscillator into mechanical vibration and a suction hole opened at the tip end are included and connected to the front plate of the ultrasonic transducer to amplify the mechanical vibration of the ultrasonic wave. An ultrasonic surgical device comprising a handpiece part configured to transmit and apply the ultrasonic vibration to a living tissue at its tip part, and a circuit of each part constituting the ultrasonic oscillator. However, the power supply unit connects an inrush current mitigating circuit (7) to the front stage of the rectifier circuit (8) and a smoothing circuit (9) to the rear stage for converting the AC voltage supplied from the AC power source (6) into DC. Then, the amplification unit includes a power amplification circuit (1 ) Connect the power amplifier circuit (11)
An amplitude adjusting circuit (14) and a start shock mitigating circuit are connected to each of them, and an electric signal output from the power amplifier circuit (11) is input to a spike wave removing circuit (13). Comprises a spike wave removing circuit (13), a matching circuit (15), an amplitude level setting circuit (16) and a feedback signal detecting circuit (17) connected in this order. The feedback section is a feedback signal detecting circuit. From (17), a feedback signal Q adjustment circuit (20) and a feedback signal filter circuit (21) are connected to the power amplification circuit (11) so as to be feedback input.

The details will be described below with reference to the drawings. As shown in FIG. 1, the ultrasonic surgical device (ultrasonic scalpel) of the present invention basically comprises a power supply section (1), an amplification section (2), a matching section (3), and a feedback section (4). As shown in FIG. 2, a front plate (32) and a backing plate (30) are arranged in front of and behind the electrostrictive oscillator (31), and the ultrasonic waves are connected by tightening with bolts. Transducer (5) and tip (3
3) of the ultrasonic horn (10) which has the suction hole (34) opened in 5), amplifies and transmits the ultrasonic vibration, and applies the ultrasonic vibration to the biological tissue at the tip portion (35) to crush it.
It consists of two parts.

Then, the ultrasonic transducer (5) and the ultrasonic horn (10) are connected and integrated to form a handpiece portion which is a surgical instrument for cutting or crushing living tissue. .

The ultrasonic transducer (5) is an electrostrictive transducer (3
Before and after 1), and in Fig. 2 left and right, backing plates (3
0) and the front plate (32), and the backing plate (30), the electrostrictive vibrator (31), and the front plate (32) are tightly connected to each other by bolts (not shown) made of a high-strength metal material. A so-called BLT (Bolting Langevin type oscillator) type oscillator structure is used for fixing. Electrostrictive vibrator (31)
Is preferably PZT (lead zirconate titanate), and its natural frequency is 1 to 100 MHZ, preferably 10 to 20 MHZ. Backing plate (30) and front plate (32) attached to both sides of the electrostrictive vibrator (31)
Is a back plate (30), an electrostrictive vibrator (31), a front plate (32), and a horn (10), and the frequency of the handpiece is 20 to 40 KHZ, preferably 23 to 28 K.
Determine the diameter and length to be HZ.

The front plate (32) of the ultrasonic transducer (5) and the horn (10), which is a female part, are connected and fixed by means of a set screw (33) made of a high tensile metal material. The shape of the horn (10) is an important factor that determines the amplitude of its tip (35), but generally the tip (3) of the horn (10).
The amplitude of 5) is inversely proportional to the ratio of the cross-sectional area of the root (36) of the horn (10) to the cross-sectional area of the tip (35) of the horn (10). The horn (1 used for the ultrasonic scalpel of the present invention
The amplitude of the tip portion (35) of (0) is 50 to 250 μ, preferably 100 to 150 μ. Also horn (1
The material of 0) is a high-strength metal material, preferably a titanium alloy.

Compared with the ultrasonic transducer (5) of the present invention using the electrostrictive oscillator (31) made of PZT, in the case of another oscillator, for example, a magnetostrictive oscillator using ferrite, Strong against axial compression but weak against elongation, resulting in inability to increase amplitude. Further, in the case of a nickel-based magnetostrictive oscillator, the shock resistance is poorer than that of the electrostrictive oscillator of the present invention, and there is a risk of damage if the load applied to the tip of the horn is large, and The target Q is inevitably lower than that of the electrostrictive oscillator, and as a result, the electrical loss increases, which causes heat generation in the oscillator, and the generated heat must be removed by cooling means such as water. There is a problem that it leads to damage.

In the ultrasonic transducer type ultrasonic knife using the electrostrictive vibrator of the present invention, the tip portion (3) of the horn (10) is used.
It is strong against the load applied to 5) and has a high mechanical Q, so there is little electric loss, there is little heat generation of the vibrator, and there are advantages that it can exhibit sufficient durability without using cooling means,
It is ideal for applications that require the most reliability, such as ultrasonic scalpels.

Next, the vibration characteristics of the ultrasonic transducer (5) using the electrostrictive vibrator of the present invention will be described with reference to FIG.
The graph shown in the upper part of FIG. 2 is an amplitude pattern in the axial direction of each part of the ultrasonic transducer (5), and the electrostrictive vibrator (3
Zero amplitude in the axial center of 1), and horn (10)
The amplitude is zero in the vicinity of the diaphragm starting portion (37), and between the electrostrictive oscillator (31) and the horn (10) the diaphragm starting portion (37) has an arc shape having a peak in the vicinity of the set screw (33). Also,
Left end (38) of backing plate (30) and electrostrictive vibrator (31)
In the meantime, the left end (38) of the backing plate (30) has a semi-arc shape with the maximum amplitude. The horn (10) is provided between the aperture start portion (37) of the horn (10) and the tip end portion (35) of the horn (10).
It becomes a semi-arc shape in which the tip end (35) has the maximum amplitude. The tip (3) of the horn (10), which is one of the performances of the ultrasonic knife,
The magnitude of the amplitude of 5) depends on the cross-sectional area of the root portion (36) of the horn (10) and the tip portion (3) of the horn (10) as described above.
Since the ratio is substantially inversely proportional to the ratio of the cross-sectional area of 5), the cross-sectional area can be changed depending on the treatment target area of the ultrasonic scalpel, the degree of surgery, etc.

In order to carry out a surgical operation with an ultrasonic scalpel smoothly and safely, it is necessary to stabilize the generation of ultrasonic vibrations in the ultrasonic transducer (5) constituting the handpiece part. Next, details of a basic circuit of the ultrasonic oscillator shown in FIG. 1 for obtaining ultrasonic vibration suitable for the above purpose will be described in detail with reference to FIG.

The power supply unit (1) in FIG. 1 comprises an inrush current mitigating circuit (7), a rectifying circuit (8), and a smoothing circuit (9). Power is supplied from a commercial AC power supply (6) by AC100V or an appropriate AC voltage, and is connected to the inrush current mitigation circuit (7). Inrush current mitigation circuit (7)
When powering on the oscillating circuit of the ultrasonic scalpel, an excessive current flowing when the power is turned on destroys the rectifying element in the rectifying circuit (8), which is an A-D converting circuit for converting an AC power supply into a DC power supply. In some cases, it is provided to alleviate this. The inrush current mitigation circuit (7) is used to protect and stabilize the power supply circuit. If the ripple rate of the pulsating flow of the DC waveform obtained by the rectifier circuit (8) is large, the mechanical vibration system composed of the ultrasonic transducer (5) and the horn (10) lacks stability. A smoothing circuit (9) is provided for the purpose of reducing the ripple rate. By this smoothing circuit (9), extremely stable ultrasonic vibration is obtained at the tip of the horn (10) which is the tip of the scalpel.

The amplification section (2) includes a power amplification circuit (11),
Start shock mitigation circuit (12), spike wave removal circuit (1
3) and an amplitude adjusting circuit (14). The power amplifier circuit (11) uses a low-loss circuit system that enables continuous oscillation without cooling. Generally, when a high power is generated by an ultrasonic oscillator circuit, the power amplification element and the ultrasonic transducer (5) are often subjected to an electrical shock at the start of oscillation, resulting in performance deterioration or destruction. Further, the mechanical vibration system composed of the ultrasonic transducer (5) and the horn (10) is
In many cases, it is difficult to start up in a loaded state. In order to solve these problems, the present invention is provided with a starting shock absorbing circuit (12), a power amplification circuit (11) and an ultrasonic transducer (5). Protects and stabilizes the machine, and makes it easier for the mechanical vibration system of the handpiece to rise under load.

Moreover, the power amplifier circuit (11) generates a spike wave which is superimposed on the square wave which is the voltage waveform of the output, and the spike wave is often twice or more the square wave. This tends to cause characteristic deterioration and destruction of the amplification element and the ultrasonic transducer (5). In the present invention,
By providing the spike wave removal circuit (13) after the power amplification circuit (11), the spike wave is removed, and the amplification element and the ultrasonic transducer (5) in the power amplification circuit (11) are protected and stabilized. I made it possible. Further, an amplitude adjusting circuit (14) is provided to make it possible to continuously change the vibration amplitude of the tip of the horn (10), that is, the tip of the scalpel, thereby facilitating the adjustment of the degree of crushing according to the state of the operation target site. .

Next, the matching section (3) has a matching circuit (1
5), the amplitude level setting circuit (16), the return signal detection circuit (17), the power detection unit (18) for detecting the power applied to the ultrasonic wave changer (5), and the amplitude of the horn (10). It is composed of an amplitude detector (19) for displaying. The matching circuit (15) applies electrical power to the ultrasonic transducer (5) without decreasing the vibration amplitude of the knife tip even when the load on the tip of the horn (10), that is, the knife tip, increases. This is a circuit for inputting with a low loss, whereby the power of ultrasonic vibration can be maintained against changes in the load on the surgical site.

In order to operate the ultrasonic transducer (5) stably, it is important to optimize the drive amplitude, but in the present invention, the ultrasonic transducer (5) is controlled by the amplitude level setting circuit (16). We are aiming for low loss and stabilization. The feedback signal detection circuit (17) is a circuit that detects the resonance frequency and amplitude of the mechanical vibration system that changes depending on the load condition applied to the tip of the horn (10) and the temperature. Feedback to the amplifier circuit (11) enables constant amplitude control and automatic frequency tracking.

The feedback section (4) comprises a feedback signal Q adjusting circuit (20) and a feedback signal filter circuit (21). The resonance frequency and amplitude of the mechanical vibration system detected by the feedback signal detection circuit (17) are fed to the power amplification circuit (11) via the feedback signal Q adjustment circuit (20) and the feedback signal filter circuit (21). It is to return.
In order to sharpen the rise of ultrasonic oscillation, it is necessary to increase the Q of the feedback circuit at the start of oscillation, but on the other hand, after the ultrasonic oscillation enters the steady state, it is against the load fluctuation of the horn (10). In order to maintain stable vibration, the Q of the feedback circuit should be low. The adjusting circuit (20) for the feedback signal Q serves to stabilize the transient state and steady state of vibration by automatically adjusting the Q of the feedback circuit.

On the other hand, the ultrasonic transducer (5) and the horn (1
The mechanical vibration system consisting of (0) and (1) often has several spurious frequencies in addition to the main resonance frequency, and these spurious frequencies often become an unstable element as an ultrasonic knife. In the present invention, for the purpose of removing this spurious frequency, a feedback signal filter circuit (21) is adopted to enable stabilization as an ultrasonic knife.

Next, one embodiment of the handpiece portion of the ultrasonic knife of the present invention will be described in detail with reference to FIGS. 2 and 4. FIG. 4 is an overall view of the handpiece portion of the ultrasonic knife according to the present invention.

As shown in FIG. 2, in the handpiece part in which the ultrasonic transducer (5) and the horn (10) are integrally connected, the grip part (42) and the protective tube (43) are screwed together with the connecting tube (46). Stored in a housing that is mechanically connected by
A cable (40) connected to the matching section (3) of the ultrasonic oscillator is connected to the rear end portion thereof via a connector (41). An irrigation pipe (44) for supplying physiological saline or the like is provided to the surgical site at the tip of the horn (10) along the side of the handpiece part, and the surgical site is provided inside the horn (10). The rear end side of the suction hole (34) for sucking and removing the liquid substances such as blood, physiological saline for washing, and crushed cell debris generated at step is opened to the rear side of the horn (10). Furthermore, it is connected to an ultrasonic transducer or a suction pipe (45) provided along the side of the grip (42).

The suction hole (34) is connected to the suction pipe (45) through a pipe joint (47) connected to the outside of the protection pipe (43) by a suitable method. A suction nipple (48) is connected to the rear end of the suction pipe (45) by a suitable method such as brazing or argon welding. The suction nipple (48) is connected to a suction device such as a vacuum pump (not shown) through a trap such as a glass bottle (not shown), but a negative suction pressure of vinyl chloride resin, silicone resin, or the like. Connect a flexible tube with a material and shape that can withstand.

The irrigation pipe (44) is for supplying a cleaning solution such as physiological saline to the surgical site, but has an open end near the tip of the horn (10) and does not contact the horn (10). It is desirable to place them close to each other. When the horn (10) comes into contact with the horn (10), the irrigation pipe (44) may be damaged because the horn (10) is ultrasonically vibrated.
If it is too far away from (0), in the case of microsurgery such as brain surgery, this irrigation pipe (4
4) may get in the way. The irrigation pipe (44) is fixed or connected to the pipe joint (47) by an appropriate method to prevent contact with the horn (10),
Alternatively, prevent it from being too far from the horn (10). An irrigation nipple (49) is connected to the rear end of the irrigation pipe (44) by a suitable method such as brazing or argon welding. This irrigation nipple (4
In FIG. 9), a roller type pump such as a perister pump (not shown) is used to squeeze a roller type pump such as vinyl chloride resin or silicone resin which supplies washing water such as saline (not shown). A flexible tube with a material and shape that can withstand and is medically safe is connected. The suction pipe (45) and the irrigation pipe (44) are fixed to the grip portion (42) by a pipe stopper (50).

As the material of the housing consisting of the grip portion (42), the connecting pipe (46) and the protective pipe (43), aluminum or aluminum is used in order to reduce the weight of the whole handpiece and to make the handling of the operator easy and easy. Light metals such as duralumin and strong against corrosion, or phenol resin, ABS
It is desirable to use a synthetic resin having high strength such as resin. Further, the horn (10) serving as the ultrasonic knife portion is made of a material such as ultra-super duralumin, titanium alloy, etc., which has a high transmissibility of high-frequency mechanical vibration and is resistant to breakage.

The material of the suction pipe (45), the irrigation pipe (44), the suction nipple (48), the irrigation nipple (49), the pipe joint (47) and the pipe stopper (50) is stainless steel or the like. It is desirable that it has excellent corrosion resistance and solvent resistance.

Further, another embodiment of the ultrasonic transducer of the ultrasonic scalpel according to the present invention will be described with reference to FIGS. 4 and 5. As described above, since the vibrator of the ultrasonic transducer of the ultrasonic knife according to the present invention uses the electrostrictive vibrator, the electric loss of the vibrator is small, and as a result, the heat generation of the vibrator unit can be reduced, Furthermore, it is clear that if the heat generated in the vibrator part can be removed, the durability of the vibrator is much improved.

Therefore, as shown in FIG. 5, the rear end side of the suction hole (34) provided in the horn (10) is an ultrasonic transducer (5 ') using a hollow electrostrictive vibrator (52). ) Is connected to a suction hole (55) that penetrates the entire length of the shaft, and washing water such as physiological saline supplied to the surgical site is sucked into the suction hole (3).
The hollow electrostrictive oscillator (52) can be cooled by sucking it from 4) and passing it through the suction hole (55). Here, the irrigation pipe for supplying the cleaning water may be set by the same method as that of the embodiment of FIG. 4, and the ultrasonic transducer (5 ') and the horn (10) may be connected. The set screw (53) is also a hollow type, and the airtightness with the suction holes (34) and (55) may be achieved by an appropriate sealing method such as an O-ring or a Teflon sealing tape (not shown). . Further, in FIG. 5, the suction hole is provided over the entire length of the handpiece, but if it is on the backing plate (54), the extraction hole of the suction hole is provided in the direction perpendicular to the axis of the ultrasonic transducer (5 '). May be.

[0029]

As described above in detail, the ultrasonic surgical apparatus according to the present invention can crush and cut living tissue around the horn without damaging blood vessels, nerves, etc., and has a larger amplitude at the tip of the horn. It is possible to obtain sufficient power, to exert sufficient tissue crushing ability in a wide range of fields, and to perform the operation smoothly and safely. Therefore, it is extremely useful as a surgical instrument.

[Brief description of drawings]

FIG. 1 is a basic block diagram of an ultrasonic scalpel according to the present invention.

FIG. 2 is a diagram showing a structure and vibration characteristics of a handpiece portion of an ultrasonic knife according to an embodiment of the present invention.

3 is a detailed view of the basic block diagram shown in FIG. 1. FIG.

FIG. 4 is a schematic view showing an example of a handpiece portion of an ultrasonic knife according to the present invention.

FIG. 5 is a view showing another embodiment of the handpiece portion of the ultrasonic knife according to the present invention.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 power supply section 2 amplification section 3 matching section 4 feedback section 5, 5'ultrasonic converter 8 rectifier circuit 10 horn 11 power amplification circuit 15 matching circuit 20 feedback signal Q adjustment circuit 21 feedback signal filter circuit 30, 54 backing plate 31, 52 electrostrictive vibrator 32 front plate 34, 55 suction hole 44 irrigation pipe

Claims (3)

[Claims] 1. An ultrasonic oscillator basically composed of a power source section, an amplifying section, a matching section, and a feedback section, and a metal front plate and a backing plate arranged in front of and behind an electrostrictive vibrator. It is connected by tightening with a bolt and includes an ultrasonic transducer that converts the ultrasonic signal of the ultrasonic oscillator into mechanical vibration and a suction hole opened at the tip end, and is connected to the front plate of the ultrasonic transducer. An ultrasonic surgical device comprising a handpiece part configured to amplify and transmit mechanical vibrations of ultrasonic waves and to apply the ultrasonic vibrations to living tissue at its tip.
In the circuit of each unit constituting the ultrasonic oscillator, the power supply unit directly supplies the AC voltage supplied from the AC power supply (6).
Inrush current in front of the rectifier circuit (8) for converting into current
Connect the relaxation circuit (7) and the smoothing circuit (9) in the subsequent stage.
The amplifier section connects the power amplifier circuit (11) to the smoothing circuit (9).
Next, the power amplifier circuit ( 11) has an amplitude adjustment circuit (14).
And a start shock mitigation circuit are connected respectively, and power amplification
The electric signal output from the circuit (11) is converted into a spike wave removing circuit (1
3), the matching section is connected to the spike wave removing circuit (13),
Circuit (15), amplitude level setting circuit (16) and feedback signal
The signal detection circuit (17) is connected in this order, and the feedback section outputs the feedback signal Q from the feedback signal detection circuit (17).
Adjustment circuit (20) and feedback signal filter circuit (21)
Via the power amplifier circuit (11)
An ultrasonic surgical device characterized by being connected . 2. A rear end side of a suction hole provided inside the ultrasonic horn is connected to a suction pipe opened at a rear side portion of the ultrasonic horn and provided along a side portion of the handpiece portion. and with which, established the irrigation pipe at a position close to the ultrasonic horn, the rear end is characterized in that disposed in parallel to the suction pipe, as claimed in claim 1, wherein <br/> ultrasonic surgical apparatus. 3. An electrostrictive oscillator of an ultrasonic transducer is hollow, and a suction hole provided inside the ultrasonic horn penetrates the inside of the ultrasonic transducer and opens at a rear end thereof. The ultrasonic surgical device according to claim 1, wherein