JPH105237A - Ultrasonic processor - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a multifunctional ultrasonic processor which is capable of peeling biomedical tissue and other works easily. SOLUTION: At the tip of a probe, where ultrasonic vibration is transmitted, a hook-shape processing part 41 is formed. Relatively transferring between a sheath 11 and the probe along the axis direction of the sheath 11, biomedical tissue between the processing part 41 and the end of the sheath 11 can be processed not only in a way of nipping but only peeling and the like.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an ultrasonic treatment device for performing a treatment such as incision, resection or coagulation using ultrasonic waves.

[0002]

2. Description of the Related Art Generally, ultrasonic treatment tools such as U
SP3,636,943 discloses an apparatus having the following configuration. Here, an ultrasonic probe slidable in the axial direction of the sheath is provided in a sheath of the ultrasonic treatment instrument main body. Further, a hook-shaped receiving member bent substantially in an L-shape is provided at the distal end of the sheath. When using the ultrasonic treatment instrument, ultrasonic vibration is transmitted to the distal end of the ultrasonic probe while a living tissue such as a blood vessel is sandwiched between the distal end of the ultrasonic probe and the hook-shaped receiving member. Thereby, an ultrasonic treatment such as ligation of a blood vessel is performed.

[0003]

The above USP 3,63
In the apparatus of No. 6,943, the ultrasonic vibration is transmitted to the distal end of the ultrasonic probe. Therefore, during the ultrasonic treatment, an ultrasonic wave is applied to the substantially L-shaped hook-shaped receiving member at the distal end of the sheath. It is held in a stationary state where vibration is not transmitted. Therefore, when performing an operation such as peeling off a membrane-like living tissue using the substantially L-shaped hook-shaped receiving member at the distal end portion of the sheath, the living tissue is easily slipped from the hook-shaped receiving member. In fact, it has been difficult to perform these operations using a treatment tool.

Further, for example, a soft contact member (for example, US Pat.
(See P5, 322, 055), it is impossible to perform treatment such as separation of living tissue by ultrasonic vibration or treatment using high-frequency power supply at the distal end side of the hook portion. There is a problem that it is difficult to multi-function.

The present invention has been made in view of the above circumstances, and an object of the present invention is to provide a multifunctional ultrasonic treatment instrument which can easily perform operations such as peeling of a living tissue. .

[0006]

According to the present invention, there is provided a handpiece having a built-in ultrasonic vibrator disposed at a base end portion of a treatment instrument main body and connected to the ultrasonic vibrator to generate ultrasonic vibration. A probe that transmits to the distal end side of the treatment instrument body, a sheath that covers the probe, and a distal end portion of the probe that is bent and formed in a direction substantially orthogonal to the axial direction of the sheath,
A hook-shaped treatment unit for performing treatment on a living tissue, and relatively moving between the sheath and the probe along an axial direction of the sheath, a treatment unit of the probe and a distal end of the sheath. And an operation means for sandwiching a living tissue between the ultrasonic treatment tools.

With the above arrangement, the probe and the sheath are relatively moved along the axial direction of the sheath, and the living tissue is sandwiched between the treatment section of the probe and the distal end of the sheath. By transmitting ultrasonic vibration to the treatment section, ultrasonic treatment such as ligation of a living tissue, for example, a blood vessel, between the treatment section of the probe and the distal end of the sheath is performed. Furthermore, by applying the ultrasonic vibration to the hook-shaped treatment section at the distal end of the probe and applying the distal end of the hook-shaped treatment section to, for example, a membrane-like biological tissue, the living tissue is hook-shaped. In this way, it is possible to easily perform operations such as peeling off a membrane-like living tissue by preventing slipping from the treatment section.

[0008]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS Hereinafter, a first embodiment of the present invention will be described with reference to FIGS. FIG. 1 shows a schematic configuration of an ultrasonic incision coagulation device which is an ultrasonic treatment tool. The main body of the ultrasonic incision coagulation device (the main body of the treatment tool)
1 includes an ultrasonic vibrator 51 (FIG. 2) that generates ultrasonic vibrations at the base end of an elongated tubular sheath 11 which is a protective member.
(See (A) and (B)). The handpiece 2 has an ultrasonic vibrator 51
Is provided.

The fixed handle 3 is attached to the vibrator cover 33.
An operation unit (operation means) 3 having a movable operation handle 32 and a movable operation handle 32 is provided. Here, the fixed handle 31 is formed integrally with the vibrator cover 33. Further, a window 33a is formed on a side surface of the vibrator cover 33.

The terminal of the handpiece 2 has an electrode plug 13 to which a power source for high-frequency treatment such as an electric scalpel is connected.
A is protruded, and an electric cord 13B connected to a power supply for driving the ultrasonic transducer 51 is connected thereto.

A probe 52 shown in FIGS. 2A and 2B for transmitting the ultrasonic vibration from the ultrasonic transducer 51 to the distal end of the apparatus main body 1 is provided inside the sheath 11. I have. The probe 52 is provided with a horn 21 connected to the ultrasonic transducer 51, a vibration transmission rod 43, and a hook-shaped treatment unit 41 for performing treatment on a living tissue. The vibration generated by the ultrasonic vibrator 51 is transmitted to the hook-shaped treatment section 41 via the horn 21 and the vibration transmission rod 43.
The probe unit 52 is configured to perform a treatment on a living tissue by a hook-shaped treatment unit 41 at the distal end of the probe 52.

The electrode plug 13 is connected to the probe 52 via a lead wire (not shown). And
When necessary, a high-frequency current is supplied to the probe 52 so that a high-frequency treatment such as an electric scalpel can be performed on the living tissue by the hook-shaped treatment portion 41 at the tip of the probe 52.

The hook-shaped treatment section 41 has a shaft 5
A substantially L-shaped hook portion 54 is formed at the distal end of No. 3 by, for example, milling. The hook portion 54 is formed to bend in a direction substantially orthogonal to the axial direction of the sheath 11. The hook-shaped treatment section 41 is formed of a titanium material, an aluminum material, or an alloy material having a high acoustic effect and good biocompatibility.

Male screws 43c and 43d are formed at both ends of the vibration transmission rod 43. Further, the proximal end of the hook-shaped treatment section 41 has a screw hole (not shown) screwed into the male screw 43c at the distal end of the vibration transmission rod 43, and the distal end of the horn 21 has a male screw 43d at the proximal end of the vibration transmission rod 43. And screw holes (not shown) that are screwed into the respective holes. A hook-shaped treatment section 41 is attached to the tip of the vibration transmission rod 43.
Are detachably screwed to the base end of the vibration transmission rod 43, and the tip of the horn 21 is detachably screwed to the base end of the vibration transmission rod 43.

As shown in FIG. 2C, female threads 43e and 43f may be formed at both ends of the vibration transmission rod 43. At this time, a male screw 41a corresponding to the female screw 43e at the distal end of the vibration transmission rod 43 is provided at the proximal end of the hook-shaped treatment section 41, and a female screw 43f at the proximal end of the vibration transmission rod 43 is provided at the distal end of the horn 21. Corresponding male threads 21a are respectively formed.

Further, as each component of the probe 52 for transmitting the vibration generated by the ultrasonic transducer 51, a titanium material, an aluminum material, or an alloy thereof having a high acoustic effect and good biocompatibility is used. In the present embodiment, the hook-shaped treatment section 41 and the horn 21 that supplies the ultrasonic vibration generated by the ultrasonic vibrator to the vibration transmission rod 43 are formed of a durable titanium material, and the horn 21 and the hook-shaped The vibration transmission rod 43, which is a relay member for connecting with the treatment section 41, is formed of an inexpensive aluminum member.

As shown in FIG. 3A, the ultrasonic vibrator 51 of the vibrator unit 2A is accommodated in the through hole 33b of the vibrator cover 33 so as to be movable in the axial direction. The ultrasonic vibrator 51 is connected to the inner hole 3 of the vibrator cover 33.
3b, which is connected to a rotor 48 described later, which is a tubular connecting means slidably inserted in the longitudinal direction.

At the upper end of the movable operation handle 32, a substantially U-shaped connecting arm 55 is provided. A substantially central portion of the connecting arm 55 in the vertical direction is a handle fulcrum pin 3
4, is rotatably mounted on the vibrator cover 33 via a shaft.

Further, at the upper end of the connecting arm 55 of the movable operation handle 32, a locking member 35 shown in FIG. 4 is rotatable in the direction of the central axis facing the window 33a of the vibrator cover 33. Is provided. The locking body 35 is provided with a locking claw 35a. The locking claw 35a is detachably locked to a rotor 48 in the vibrator cover 33.

A protruding portion 48b is formed at the center of the rotor 48 so as to be in sliding contact with the inner hole 33b of the vibrator cover 33. A groove 48c is formed in the protrusion 48b. The locking claw 35a of the movable operation handle 32 is engaged with the groove 48c. When the movable operation handle 32 is operated in the direction to close to the fixed handle 31, the entire vibrator unit 2 </ b> A is retracted, and the hook portion 54 of the hook-shaped treatment section 41 is connected to a receiving member 56 of the distal end of the sheath 11 which will be described later. It moves in a direction approaching the tip opening surface 58 side.

Also, as shown in FIG.
Groove 48 of rotor 48 inserted in inner hole 33b
c, the locking claw 35 of the locking body 35 of the movable operation handle 32
a, the inner hole 33b of the vibrator cover 33 is removed.
The rotor 48 can be easily removed from the shaft. As shown in FIG. 3B, an operation handle 33c in which the fixed handle 31 and the movable operation handle 32 are integrated into the vibrator cover 33 may be provided.

A ring-shaped connecting member 12 is attached to the rear end of the sheath 11. The connecting member 12 is detachably connected to the distal end of the vibrator cover 33 of the handpiece 2 via, for example, a screw type connecting means. The sheath 11 is made of a heat-resistant and slippery material, for example, a tube made of fluororesin such as Teflon. The material of the sheath 11 may be polyacetal or polyethylene.

FIG. 5 shows the distal end of the sheath 11.
A substantially cylindrical receiving member 56 is fixed as shown in FIGS. The receiving member 56 is a holding means for preventing the vibration transmission rod 43 from directly contacting the inner peripheral surface of the sheath 11, and is made of, for example, a highly slidable fluororesin material such as Teflon. Further, the inner diameter of the receiving member 56 is set to be smaller than the inner diameter of the sheath 11 as shown in FIG.

A ring-shaped small-diameter portion 57 having a smaller diameter than that of the front end is formed by cutting out the outer peripheral surface of the rear end of the receiving member 56. The outer diameter of the small diameter portion 57 is formed to be substantially the same as the inner diameter of the sheath 11. The distal end of the sheath 11 is fitted to the small diameter portion 57 at the rear end of the receiving member 56 in a press-fit state.

Further, as shown in FIGS. 5A and 5C, tapered portions 58 are formed on both side surfaces of the distal end portion of the receiving member 56. The distal end opening 59 of the narrowed portion 58 is formed in a substantially oval cross-sectional shape substantially corresponding to the front shape of the hook portion 54 of the hook-shaped treatment portion 41.

The hook portion 5 of the hook shape treatment portion 41
Numeral 4 is held in a state protruding outward from the distal end opening 59 of the diaphragm 58. Here, as shown in FIG. 6, the end surface 54b of the hook portion 54 of the hook-shaped treatment portion 41 on the side facing the receiving member 56 of the sheath 11 has an inclination angle of 0 ° with respect to a direction orthogonal to the axial direction of the sheath 11, End face 5 of receiving member 56 on the side facing hook portion 54
Reference numeral 6a denotes a state where the inclination angle of the sheath 11 with respect to a direction orthogonal to the axial direction is 0 °. The living tissue is sandwiched between the end surface 54b of the hook portion 54 of the hook-shaped treatment portion 41 and the end surface 56a of the receiving member 56.

As shown in FIG. 5 (C), there is a constant gap between the inner peripheral edge of the distal end opening 59 of the narrowed portion 58 and the rubbing surface 54a on one side of the hook portion 54 in accordance with the solidification ability. A gap 60 having an interval L is formed. When the movable operation handle 32 is operated in the direction to close to the fixed handle 31 side, the probe 52 moves with the movement of the entire probe 52 toward the hand side as shown by the arrow in FIGS. 5 and 6.
2 and a receiving member 56 at the distal end of the sheath 11.
The living tissue is sandwiched between the peripheral portion of the distal end opening 59 of the narrowing portion 57 and a part thereof is rubbed with the inner peripheral portion of the distal end opening 59 of the narrowing portion 58 and one side of the hook portion 54. In the state of being inserted into the gap 60 between them, they are rubbed together to cut off the living tissue.

Next, the operation of the ultrasonic incision coagulation apparatus of the present embodiment configured as described above will be described. Here, an example in which the main body 1 of the ultrasonic incision coagulation device is inserted into the abdominal cavity to perform a treatment will be described.

First, the distal end of the apparatus main body 1 is moved to the place of the living tissue to be treated. Subsequently, the movable operation handle 32 of the operation unit 3 is operated in a direction to close to the fixed handle 31 side. With the operation of the movable operation handle 32, the locking claw 35a of the locking body 35 of the movable operation handle 32 rotates counterclockwise around the handle fulcrum pin 34 in FIG. Therefore, the rotor 48 is pulled rearward along the axial direction of the sheath 11 by the locking claw 35a, and the entire transducer unit 2A moves rearward together with the rotor 48.

At this time, the hook portion 54 of the distal end treatment portion 41 of the probe 52 is moved in accordance with the operation of the probe 52 moving toward the hand side as indicated by an arrow in FIGS.
The living tissue is sandwiched and gripped between the distal end portion of the sheath 11 and the peripheral portion of the distal end opening 59 of the restricting portion 57 in the receiving member 56 at the distal end of the sheath 11, and a part of the living tissue is inner peripheral edge of the distal end opening 59 of the restricting portion 58. In the gap 60 between the portion and the rubbing surface 54a on one side of the hook portion 54,
Rub them together.

Thereafter, in this state, the ultrasonic vibrator 51 in the handpiece 2 is driven by the ultrasonic vibrator driving power source to generate ultrasonic waves. The ultrasonic vibration generated by the ultrasonic vibrator 51 is transmitted to the hook-shaped treatment unit 41 via the horn 21 and the vibration transmission rod 43. At this time, the ultrasonic vibration of the hook-shaped treatment section 41 is
And a receiving member 56 at the distal end of the sheath 11.
Is transmitted to the grasped living tissue, and frictional heat is generated to coagulate the living tissue.

Further, while ultrasonic vibration is being applied to the living tissue, the movable operation handle 32 is further operated toward the fixed handle 31 to increase the gripping force for gripping the living tissue. Thereby, the hook part 5 of the hook shape treatment part 41
When the 4 further approaches the receiving member 56, the incision of the grasped living tissue without bleeding from the living tissue is completed.

The hook-shaped treatment section 4 of the probe 52
In a state where the ultrasonic vibration is transmitted to 1, the tip of the hook portion 54 of the hook-shaped treatment section 41 is applied to, for example, a film-like living tissue to perform an operation such as peeling of the film-like living tissue. be able to. At this time, the distal end of the hook-shaped treatment section of the probe that is ultrasonically vibrated can be prevented from slipping from the hook-shaped treatment section by, for example, contacting the distal end of the treatment section with the membrane. Work such as exfoliation of a living tissue in a shape can be easily performed.

By supplying a high-frequency current to the probe 52 as necessary, a high-frequency treatment such as an electric scalpel can be performed on the living tissue by the hook-shaped treatment portion 41 at the tip of the probe 52.

Therefore, the ultrasonic incision coagulation apparatus of the present embodiment having the above configuration has the following effects. That is,
The distal end of the probe 52 is provided with the hook-shaped treatment section 41 bent and formed in a direction substantially perpendicular to the axial direction of the sheath 11, so that one ultrasonic incision coagulation device can be used as described above. In a state where the living tissue is sandwiched between the hook portion 54 of the hook-shaped treatment portion 41 of the probe 52 and the receiving member 56 at the distal end portion of the sheath 11, the hook-shaped treatment portion 41 of the probe 52 By transmitting the ultrasonic vibration, ultrasonic treatment such as ligation of a living tissue, for example, a blood vessel, between the hook-shaped treatment portion 41 of the probe 52 and the receiving member 56 at the distal end portion of the sheath 11, and the hook-shaped treatment of the probe 52 In a state where the ultrasonic vibration is transmitted to the portion 41, the distal end of the hook portion 54 of the hook-shaped treatment portion 41 is applied to, for example, a film-like living tissue, thereby separating the film-like living tissue. By applying a high-frequency current to the probe 52 or performing a high-frequency treatment such as an electric scalpel on living tissue by the hook-shaped treatment section 41 at the tip of the probe 52, the operation can be performed. it can. Therefore, since one ultrasonic incision coagulation apparatus of the present embodiment can be used for multiple functions, the usability of the ultrasonic incision coagulation apparatus is greatly improved as compared with the related art, and there is an effect that it can be used conveniently.

When a high-frequency current is applied to the probe 52 and a high-frequency treatment such as an electric scalpel is applied to the living tissue by the hook-shaped treatment section 41 at the tip of the probe 52, the hook-shaped treatment section 41 of the probe 52 is used. Since the high-frequency current is supplied to the probe 52 while transmitting the ultrasonic vibration to the probe 52, it is possible to prevent the living tissue ablated by the high-frequency treatment from sticking to the probe 52 during the high-frequency treatment. Therefore, after the high frequency treatment, a troublesome operation of dropping the living tissue stuck to the probe 52 using a tool such as a file can be omitted.

Since the sheath 11 is made of a heat-resistant and slippery material, for example, a tube made of a fluororesin such as Teflon, the inner peripheral surface of the sheath 11 comes into contact with the probe 52 which is ultrasonically vibrated, and Even when frictional heat with the probe 52 is generated in the
There is no risk of melting. Therefore, the gap between the inner peripheral surface of the sheath 11 and the probe 52 that vibrates ultrasonically does not need to be set particularly large, so that the gap between the inner peripheral surface of the sheath 11 and the probe 52 is set relatively small. can do. As a result, the entire outer diameter of the sheath 11 can be reduced, which is advantageous in manufacturing a thin ultrasonic incision coagulation device.

Further, the receiving member 5 at the distal end of the sheath 11
Since the inner diameter of the sheath 6 is set to be smaller than the inner diameter of the sheath 11, the portion of the receiving member 56 that protrudes inside the sheath 11 functions as a spacer, and the ultrasonic vibration probe 52 It can be made difficult to contact the peripheral surface.

Further, since the narrowed portions 58 narrowed in a tapered shape are formed on both side surfaces of the distal end portion of the receiving member 56, the endoscope visual field around the distal end portion of the sheath 11 is shielded by the distal end portion of the sheath 11 during treatment. Can be reduced. For this reason, it is possible to secure the endoscope visual field around the distal end of the sheath 11 in a state in which it is easy to see.

Further, as shown in FIG. 5 (C), the solidification ability is reduced between the inner peripheral edge of the distal end opening 59 of the narrowed portion 58 of the receiving member 56 and the rubbing surface 54a on one side of the hook portion 54. Since the gap 60 having the predetermined constant interval L is formed, when the movable operation handle 32 is operated in the direction to close the fixed handle 31 side, the treatment section 41 of the probe 52 and the sheath 11
The living tissue is sandwiched between the peripheral portion of the distal end opening 59 of the narrowed portion 57 in the receiving member 56 at the distal end of the narrowed portion, and a part of the living tissue is part of the inner peripheral edge of the distal end opening 59 of the narrowed portion 58 and The rubbing can be performed in a state of being inserted into the gap 60 between the rubbing surface 54a of the side portion. Therefore, a gap 60 between the inner peripheral edge of the distal end opening 59 of the narrowed portion 58 and the rubbing surface 54 a on one side of the hook 54 is provided.
The living tissue inserted therein can be reliably coagulated.

Further, by replacing the hook-shaped treatment portion 41, which is screw-connected to the tip of the vibration transmission rod 43, with one having a shape, size, or surface treatment suitable for the treatment as needed, the treatment can be efficiently performed. It can be performed. Further, when locking the rotor 48 to the operation unit 3, the rotor 4
The same operation and effect can be obtained by providing a convex portion on 8 and providing a concave portion on the locking body and locking.

In the above embodiment, the configuration in which the sheath 11 is formed of a fluororesin tube is shown.
The sheath 11 may be formed of a tube made of a metal material, and the inner peripheral surface of the tube made of a metal material may be coated with a heat-resistant and slippery material such as Teflon.

Further, in the above-described embodiment, the structure in which the separate receiving member 56 is fixed to the distal end portion of the sheath 11 has been described. However, the receiving member 56 may be integrally formed at the distal end portion of the sheath 11.

FIG. 7 shows a main configuration of an ultrasonic incision coagulation apparatus according to a second embodiment of the present invention. In the present embodiment, the configuration of the receiving member 56 of the first embodiment (see FIGS. 1 to 6) is changed as follows. That is, in the present embodiment, the end surface 56 a of the receiving member 56 on the side facing the hook portion 54 of the hook-shaped treatment portion 41 has an inclination angle of 0 with respect to a direction orthogonal to the axial direction of the sheath 11.
7 (a state where the upper side of the end surface 56a in FIG. 7 is inclined in a direction approaching the hook portion 54 side of the hook-shaped treatment portion 41).

Therefore, in this embodiment, the living tissue sandwiching space formed between the end face 54b of the hook 54 of the hook-shaped treatment section 41 and the end face 56a of the receiving member 56 is shown in FIG.
Since the width of the upper opening side is smaller than the width of the lower closing section, the end surface 54b of the hook 54 of the hook-shaped treatment section 41 and the end surface 56a of the receiving member 56 are formed. This has the effect of making it difficult for the living tissue sandwiched between them to come off.

FIG. 8 shows a main configuration of an ultrasonic incision coagulation apparatus according to a third embodiment of the present invention. In the present embodiment, the configuration of the hook-shaped treatment section 41 of the first embodiment (see FIGS. 1 to 6) is changed as follows. That is, in the present embodiment, the hook-shaped treatment section 41
The end surface 54b of the hook portion 54 on the side facing the receiving member 56 has a tilt angle with respect to a direction orthogonal to the axial direction of the sheath 11 larger than 0 ° (the upper side of the end surface 54b in FIG. (A state of inclining in the approaching direction).

Therefore, in the present embodiment, the living tissue holding space formed between the end surface 54b of the hook portion 54 of the hook-shaped treatment portion 41 and the end surface 56a of the receiving member 56 is shown in FIG.
Since the width of the upper opening side is smaller than the width of the lower closing section, the hook-shaped treatment section 41 is similar to the second embodiment (see FIG. 7). The living tissue sandwiched between the end surface 54b of the hook portion 54 and the end surface 56a of the receiving member 56 has an effect of being difficult to come off.

FIG. 9 shows a main configuration of an ultrasonic incision coagulation apparatus according to a fourth embodiment of the present invention. In the present embodiment, the configurations of the receiving member 56 and the hook-shaped treatment section 41 of the first embodiment (see FIGS. 1 to 6) are changed as follows. That is, in the present embodiment, the hook portion 54 of the hook-shaped treatment portion 41 of the receiving member 56 is
The end surface 56a on the side opposite to the end surface 56a is in a state in which the inclination angle with respect to the direction orthogonal to the axial direction of the sheath 11 is larger than 0 ° (see FIG. 7) as in the second embodiment (see FIG. 7). The side is inclined in a direction approaching the hook part 54 side of the hook-shaped treatment part 41). Further, the receiving member 5 in the hook portion 54 of the hook shape treatment portion 41
The end surface 54b on the side facing the surface 6 is the third embodiment (FIG. 8).
Similarly to the state shown in FIG. 8, the inclination angle of the sheath 11 with respect to the direction orthogonal to the axial direction is larger than 0 ° (the end face 54b in FIG. 8).
Is inclined in a direction in which the upper side of the front side approaches the receiving member 56 side).

Therefore, in this embodiment, the living tissue holding space formed between the end surface 54b of the hook portion 54 of the hook-shaped treatment portion 41 and the end surface 56a of the receiving member 56 is shown in FIG.
Since the width dimension of the upper opening side is smaller than the width dimension of the lower closing part side, the hook of the hook-shaped treatment section 41 is similar to the second and third embodiments. Part 54
There is an effect that the living tissue sandwiched between the end surface 54b of the receiving member 56 and the end surface 56a of the receiving member 56 is difficult to come off.

FIG. 10 shows a main configuration of an ultrasonic incision coagulation apparatus according to a fifth embodiment of the present invention. In the present embodiment, the configuration of the hook-shaped treatment section 41 of the first embodiment (see FIGS. 1 to 6) is changed as follows. That is, in the hook-shaped treatment section 71 of the present embodiment, a center hole 72a is formed in the distal end surface of the shaft body 72, and the base end of the wire member 73 bent in a substantially L shape is formed in the center hole of the shaft body 72. It is fixed in a state of being inserted into 72a. In this case, the wire member 73 is fixed to the center hole 72a of the shaft body 72 in an inserted state, and the distal end side of the fixed portion 74 is bent toward the eccentric position away from the center line of the shaft body 72. A bent portion 75 and a sheath 1
Hook portions 76 that are bent in a direction substantially perpendicular to one axial direction are formed respectively.

Therefore, in this embodiment, the hook-shaped treatment portion 71 is formed in a linearly formed shaft 72 and this shaft 7
Divided into two parts of a wire member 73 fixed to 2,
Since the substantially L-shaped hook portion 76 is formed to be bent on the wire member 73, the wire member 73 is made of an expensive titanium material or the like having a high acoustic effect and a high biocompatibility like the hook shape treatment portion 41 of the first embodiment. A substantially L-shaped hook portion 54 is provided at the tip of the shaft 53.
The processing cost of the hook-shaped treatment section 71 can be reduced as compared with the case where the cutting is integrally performed by milling, and the inexpensive probe 52 can be manufactured.

Further, in the present embodiment, a center hole 72a is formed in the distal end surface of the shaft 72, and the wire member 73 is fixed with the base end inserted into the center hole 72a of the shaft 72. Therefore, when the wire member 73 is fixed to the shaft 72, there is no need to position the mounting position of the wire 73 in the circumferential direction of the shaft 72. Therefore, the hook shape treatment unit 7
There is also an effect that the manufacturing operation of (1) can be simplified.

FIG. 11 shows a main configuration of an ultrasonic incision coagulation apparatus according to a sixth embodiment of the present invention. In the present embodiment, the configuration of the hook-shaped treatment section 41 of the first embodiment (see FIGS. 1 to 6) is changed as follows. That is, in the hook-shaped treatment portion 81 of the present embodiment, a linear slit portion 82a is formed on the distal end surface of the shaft body 82, and the base end of the plate-shaped member 83 cut and formed in a substantially L-shape. The shaft 82 is fixed in a state of being inserted into the slot 82a. In this case, the plate-shaped member 83 is fixed to the slot 82a of the shaft body 82 by being fixed in an inserted state.
And an eccentric portion 85 cut toward the eccentric position away from the center line of the shaft body 82 on the distal end side of the fixed portion 84, and a distal end of the eccentric portion 85 in a direction substantially orthogonal to the axial direction of the sheath 11. Each of the cut hook portions 86 is formed.

Therefore, in the present embodiment, the hook 82 having the hook-shaped treatment portion 81 formed linearly and the shaft 8
Since the plate-shaped member 83 is divided into two parts and the substantially L-shaped hook portion 86 is cut and formed in the plate-shaped member 83, the plate-shaped member 83 is similar to the hook-shaped treatment portion 41 of the first embodiment. In comparison with the case where a substantially L-shaped hook portion 54 is integrally cut at the tip end of a shaft 53 made of an expensive titanium material or the like having a high biocompatibility with a milling process, a hook shape treatment portion is provided. 81 can reduce the processing cost,
An inexpensive probe 52 can be manufactured.

FIG. 12 shows a main configuration of an ultrasonic incision coagulation apparatus according to a seventh embodiment of the present invention. In the present embodiment, the configuration of the hook-shaped treatment section 41 of the first embodiment (see FIGS. 1 to 6) is changed as follows. That is, in the hook-shaped treatment section 91 of the present embodiment, a linear mounting groove 92a is formed in the outer peripheral surface of the distal end portion of the shaft body 92 along the axial direction, and the wire member 93 bent substantially in an L-shape is formed. It is fixed with the base end inserted into the mounting groove 92a of the shaft 92. In this case, the wire member 9
A fixed portion 94 fixed to the mounting groove 92a of the shaft body 92 in an inserted state, and a sheath 11
And a hook portion 95 bent in a direction substantially perpendicular to the axial direction of the hook.

Therefore, in the present embodiment, the hook-shaped treatment section 91 is formed in a linearly formed shaft body 92 and the shaft body 9.
Divided into two parts of a wire member 93 fixed to 2,
Since the hook portion 95 having a substantially L-shape is formed by bending the wire member 93, the wire member 93 is made of an expensive titanium material or the like having a high acoustic effect and a high biocompatibility like the hook-shaped treatment portion 41 of the first embodiment. A substantially L-shaped hook portion 54 is provided at the tip of the shaft 53.
The machining cost of the hook-shaped treatment section 91 can be reduced as compared with a case where the probe is integrally cut by milling, and the inexpensive probe 52 can be manufactured.

FIG. 13 shows an essential configuration of an ultrasonic incision coagulation apparatus according to an eighth embodiment of the present invention. In the present embodiment, the configuration of the receiving member 56 of the first embodiment (see FIGS. 1 to 6) is changed as follows. That is, in the present embodiment, the hook 54 of the hook-shaped treatment section 41 at the distal end opening 59 of the distal end of the receiving member 56 is provided.
And a pressing surface 101 is formed by closing a portion facing the above.

Therefore, in the present embodiment, since the contact area of the receiving member 56 with the living tissue can be increased, the end face 54 b of the hook 54 of the hook-shaped treatment section 41 can be increased.
The living tissue sandwiched between the end portion 56a of the receiving member 56 and the receiving portion 5
6 can be surely gripped with the pressing surface 101.

The present invention is not limited to the above embodiment. For example, in the above embodiment, when the movable operation handle 32 is operated, the probe 52 moves toward the hand side, and the hook portion 54 of the distal end treatment section 41 of the probe 52 is moved to the stop portion 57 of the receiving member 56 at the distal end portion of the sheath 11. Although the configuration in which the living tissue is sandwiched in a state of being pressed against the peripheral portion of the distal end opening portion 59 is shown, the probe 52 is held in a fixed state when the movable operation handle 32 is operated, and the receiving member 56 at the distal end portion of the sheath 11 is held. By moving in the direction approaching the hook portion 54 of the distal treatment section 41 of the probe 52, the two may relatively move.

Further, it goes without saying that various modifications can be made without departing from the spirit of the present invention. next,
Other characteristic technical matters of the present application are additionally described as follows. (Appendix 1) An ultrasonic vibrator for generating ultrasonic vibration,
A vibration transmitting member connected to the handpiece incorporating the ultrasonic vibrator and the ultrasonic vibrator and transmitting the ultrasonic vibration to a treatment section for performing treatment on a living tissue, and a tip of the vibration transmitting member. In an ultrasonic coagulation and incision apparatus having an auxiliary member for performing coagulation / incision by sandwiching tissue between a treatment section provided, a sheath covering the vibration transmitting member, and the treatment section, the treatment section has a hook shape. An ultrasonic coagulation / incision apparatus characterized by the above-mentioned.

(Additional Item 2) The ultrasonic coagulation and incision device according to additional item 1, wherein the inner surface of the sheath is made of a sliding material. (Additional Item 3) The ultrasonic coagulation and incision device according to additional item 1, wherein the sheath is made of a fluororesin tube.

(Additional Item 4) An ultrasonic vibrator for generating ultrasonic vibration, a handpiece containing the ultrasonic vibrator, and the ultrasonic vibrator are connected to the ultrasonic vibrator, and the ultrasonic vibration is applied to a living tissue. In an ultrasonic coagulation and incision apparatus having a vibration transmitting member for transmitting a treatment to a treatment portion for performing a treatment, a hook-shaped treatment portion provided at the distal end of the vibration transmitting member, and a sheath covering the vibration transmitting member, the sheath distal end portion An ultrasonic coagulation and incision apparatus is provided with an auxiliary member for rubbing a tissue with a treatment section.

(Additional Item 5) The ultrasonic coagulation and incision apparatus according to additional item 4, wherein the auxiliary member has an inner diameter smaller than an inner diameter of the sheath. (Additional Item 6) The ultrasonic coagulating and incising apparatus according to Additional Item 4, wherein the auxiliary member is made of a fluororesin.

(Additional Item 7) The ultrasonic coagulation and incision device according to additional item 4, wherein the auxiliary member has a slit-shaped opening. (Supplementary note 8) The supplementary member according to Supplementary note 4, wherein a fixed distance corresponding to the coagulation ability is maintained between the rubbing surface of the treatment portion of the auxiliary member and the hook-shaped treatment portion side surface. Sonic coagulation incision device. (Additional Item 9) The ultrasonic coagulation and incision device according to Additional Item 4, wherein the auxiliary member has a thin tip.

(Supplementary note 10) An ultrasonic vibrator for generating ultrasonic vibration, a handpiece containing the ultrasonic vibrator and the ultrasonic vibrator are connected to the ultrasonic vibrator, and the ultrasonic vibration is applied to a living tissue. A vibration transmitting member for transmitting to a treatment section for performing a treatment, a hook-shaped treatment section provided at a distal end of the vibration transmitting member and having a treatment end face for cutting off tissue, a sheath covering the vibration transmitting member, and In an ultrasonic coagulation and incision apparatus having an auxiliary member provided at a distal end portion of a sheath and having a distal end surface for rubbing a tissue with a treatment portion, an angle formed between the treatment end surface and the auxiliary member distal end surface is larger than 0 °. Ultrasonic coagulation and incision apparatus characterized by the above-mentioned.

(Additional Item 11) The ultrasonic coagulating and incising apparatus according to additional item 10, wherein the angle of the treatment end surface is perpendicular to the vibration axis direction. (Additional Item 12) The ultrasonic coagulation and incision device according to additional item 10, wherein the angle of the tip end surface of the auxiliary member is perpendicular to the vibration axis direction.

(Supplementary item 13) The ultrasonic coagulation / cutting apparatus according to supplementary item 10, wherein neither the angle of the treatment end face nor the angle of the tip end face of the auxiliary member is perpendicular to the vibration axis direction.

(Supplementary Item 14) An ultrasonic vibrator for generating ultrasonic vibration, a handpiece containing the ultrasonic vibrator and the ultrasonic vibrator are connected to the ultrasonic vibrator, and the ultrasonic vibration is applied to a living tissue. An ultrasonic coagulation / incision apparatus having a vibration transmitting member for transmitting to a treatment section for performing a treatment, a hook-shaped treatment section provided at a tip of the vibration transmitting member, and a sheath covering the vibration transmitting member, An ultrasonic coagulation and incision device, wherein a treatment section is fixed to the vibration transmission member.

(Additional Item 15) The ultrasonic coagulation and incision apparatus according to additional item 14, wherein the hook-shaped treatment section is formed of a wire-like member. (Additional Item 16) The ultrasonic coagulation and incision device according to additional item 14, wherein the hook-shaped treatment section is formed of a plate-shaped member.

(Additional Item 17) The ultrasonic coagulation and incision apparatus according to additional item 15, wherein the central axis of the hook-shaped treatment section and the central axis of the vibration transmitting member coincide at least at the fixing portion.

[0071]

According to the present invention, a hook-shaped treatment section is formed at the distal end of a probe for transmitting ultrasonic vibration to the distal end side of the treatment instrument body in a direction substantially orthogonal to the axial direction of the sheath. , The sheath and the probe are relatively moved along the axial direction of the sheath, and the living tissue is treated in a state where the living tissue is sandwiched between the treatment section of the probe and the distal end of the sheath. Since the living tissue can be treated only by the part, the operation of exfoliating the living tissue can be easily performed, and multi-functionalization can be achieved.

[Brief description of the drawings]

FIG. 1 is a perspective view showing a schematic configuration of an ultrasonic incision coagulation apparatus according to a first embodiment of the present invention.

FIG. 2 is an explanatory view showing a probe of the device according to the first embodiment.

FIG. 3 is an explanatory diagram showing a relationship between a vibrator unit of the device according to the first embodiment and a vibrator cover forming an operation unit.

FIG. 4 is a diagram illustrating an example of a locked state between an operation unit and a rotor of the device according to the first embodiment.

FIG. 5 is a diagram illustrating a relationship between a hook-shaped treatment section and a sheath of the device according to the first embodiment.

FIG. 6 is a side view for explaining the operation of the hook-shaped treatment section of the device according to the first embodiment.

FIG. 7 is a side view of a hook-shaped treatment unit of the device according to the second embodiment of the present invention.

FIG. 8 is a side view of a hook-shaped treatment unit of the device according to the third embodiment of the present invention.

FIG. 9 is a side view of a hook-shaped treatment unit of a device according to a fourth embodiment of the present invention.

FIG. 10 is a perspective view of a hook-shaped treatment unit of a device according to a fifth embodiment of the present invention.

FIG. 11 is a perspective view of a hook-shaped treatment unit of a device according to a sixth embodiment of the present invention.

FIG. 12 is a perspective view of a hook-shaped treatment unit of the device according to the seventh embodiment of the present invention.

FIG. 13 is a perspective view illustrating a relationship between a hook-shaped treatment section and a sheath of the device according to the eighth embodiment of the present invention.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 Ultrasonic incision coagulation apparatus main body (treatment tool main body) 2 Handpiece 3 Operation part (operation means) 4 Treatment part 11 Sheath 51 Ultrasonic transducer 52 Probe 53 Hook shape treatment part

Claims (1)

[Claims] 1. A handpiece having a built-in ultrasonic vibrator disposed at a base end of a treatment instrument main body, and a handpiece connected to the ultrasonic vibrator for applying ultrasonic vibration to a distal end side of the treatment instrument main body. A probe that transmits the probe, a sheath covering the probe, and a hook-shaped treatment unit that is formed at the distal end of the probe in a direction substantially perpendicular to the axial direction of the sheath and that performs treatment on living tissue. The relative movement between the sheath and the probe along the axial direction of the sheath,
An ultrasonic treatment instrument comprising: operating means for sandwiching a living tissue between a treatment section of the probe and a distal end of the sheath.