U.S. patent application number 10/245403 was filed with the patent office on 2003-01-30 for ultrasonic trocar.
This patent application is currently assigned to OLYMPUS OPTICAL CO., LTD.. Invention is credited to Ishikawa, Manabu, Okada, Mitsumasa.
Application Number | 20030023257 10/245403 |
Document ID | / |
Family ID | 26436401 |
Filed Date | 2003-01-30 |
United States Patent
Application |
20030023257 |
Kind Code |
A1 |
Ishikawa, Manabu ; et
al. |
January 30, 2003 |
Ultrasonic trocar
Abstract
A trocar is provided having a needle unit. The needle unit has a
paracentetic section, which is substantially pyramidal. The
paracentetic section has two curved surfaces that diagonally oppose
each other. The surfaces are formed by cutting the ridges of the
section, which diagonally oppose each other. The remaining two
ridges of the paracentetic section make, respectively, sharp
cutting edges for cutting living tissues. The cutting edges are
substantially symmetrical to each other with respect to the axis of
the needle unit.
Inventors: |
Ishikawa, Manabu;
(Hachioji-shi, JP) ; Okada, Mitsumasa;
(Hachioji-shi, JP) |
Correspondence
Address: |
FRISHAUF, HOLTZ, GOODMAN & CHICK, PC
767 THIRD AVENUE
25TH FLOOR
NEW YORK
NY
10017-2023
US
|
Assignee: |
OLYMPUS OPTICAL CO., LTD.
Tokyo
JP
|
Family ID: |
26436401 |
Appl. No.: |
10/245403 |
Filed: |
September 17, 2002 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
|
10245403 |
Sep 17, 2002 |
|
|
|
09350671 |
Jul 9, 1999 |
|
|
|
Current U.S.
Class: |
606/169 |
Current CPC
Class: |
A61B 2017/320078
20170801; A61B 17/3476 20130101; A61B 2017/320071 20170801; A61B
2017/320069 20170801; A61B 2017/32007 20170801; A61B 2017/320089
20170801; A61B 2017/320082 20170801; A61B 2017/320088 20130101 |
Class at
Publication: |
606/169 |
International
Class: |
A61B 017/32 |
Foreign Application Data
Date |
Code |
Application Number |
Jul 16, 1998 |
JP |
10-201964 |
Apr 1, 1999 |
JP |
11-095112 |
Claims
1. An ultrasonic medical device comprising an ultrasonic
oscillator, a horn for amplifying the ultrasonic waves generated by
the ultrasonic oscillator, a vibration-transmitting member having a
proximal part, a fastening part fastening the proximal part to the
horn and a distal part to contact living tissues, for receiving
ultrasonic waves from the ultrasonic oscillator through the horn,
and a fastening member for removably coupling the distal part of
the vibration-transmitting member to the horn, wherein the
vibration-transmitting member has a torque-generating section which
is to be held with fingers and to apply a torque to the
vibration-transmitting member to couple and remove the
vibration-transmitting member with and from the horn.
2. An ultrasonic medical device comprising an ultrasonic
oscillator, a horn and a vibration transmitting member, wherein the
horn and the vibration-transmitting member are coupled in screw
engagement, wherein the vibration-transmitting member has a
fastening means which is operated with fingers to set the
vibration-transmitting member into screw engagement with the
horn.
3. An ultrasonic medical device according to claim 2, wherein the
fastening means is removably coupled to the vibration-transmitting
member.
4. An ultrasonic medical device according to claim 2, wherein the
fastening means is provided independently of the
vibration-transmitting member and has rotation-preventing means at
a junction with the vibration-transmitting member.
5. An ultrasonic medical device according to claim 2, wherein the
fastening means is combined with the vibration-transmitting member,
forming an integral member.
6. An ultrasonic medical device according to claim 4, wherein the
rotation-preventing means is constituted by a portion of the
vibration-transmitting member and a hole made in an inner
circumferential surface of the fastening means, said portion having
a cross section of a special shape and having made by cutting a
part of the vibration-transmitting member, forming two opposing
flat surfaces substantially parallel to each other.
7. An ultrasonic medical device according to claim 4, wherein the
rotation-preventing means is constituted by projections provided on
the vibration transmitting member and recesses made in an inner
circumferential surface of the fastening means, for holding the
projections of the vibration-transmitting member.
8. An ultrasonic medical device comprising an ultrasonic
oscillator, a horn, and a vibration transmitting member, wherein
the horn and the vibration-transmitting member are coupled in screw
engagement, wherein the vibration-transmitting member has a
torque-generating means which is operated with fingers to apply a
torque to the vibration-transmitting member, thereby to couple and
disconnect the vibration-transmitting member to and from the horn,
said torque-generating means having grooves to be operated easily
with fingers.
9. An ultrasonic medical device according to claim 8, wherein the
torque-generating means has the grooves in a part which has a
diameter larger, than a diameter of the vibration-transmitting
member.
10. An ultrasonic medical device according to claim 8, wherein the
torque-generating means extends forwards from an antinode of an
ultrasonic ware, which is located at a proximal end of the
vibration transmitting member, to a node of the ultrasonic wave,
for a quarter of a length of the ultrasonic wave.
11. An, ultrasonic medical device comprising an ultrasonic
oscillator, a horn for amplifying the ultrasonic waves generated by
the ultrasonic oscillator, a vibration-transmitting member set in
screw engagement with the horn, wherein the vibration-transmitting
member has a torque-generating section which is to be held with
fingers and to applying, when rotated, a torque to the
vibration-transmitting member to couple and remove the
vibration-transmitting member with and from the horn, and which has
a constant-force mechanism for applying a predetermined fastening
force to the vibration-transmitting member, thereby to set the
vibration-transmitting member into screw engagement with the
horn.
12. An ultrasonic medical device comprising an ultrasonic
oscillator, a horn for amplifying the ultrasonic waves generated by
the ultrasonic oscillator, a vibration-transmitting member set in
screw engagement with the horn, wherein the vibration-transmitting
member has a torque-generating section which is located at a node
of ultrasonic vibration of the vibration-transmitting member, which
is to be held with fingers and to applying, when rotated, a torque
to the vibration-transmitting member to couple and remove the
vibration-transmitting member with and from the horn, and which has
a constant-force mechanism for applying a predetermined fastening
force to the vibration-transmitting member, thereby to set the
vibration-transmitting member into screw engagement with the horn.
Description
[0001] This is a Division of U.S. patent application Ser. No.
09/350,671 filed Jul. 9, 1999.
BACKGROUND OF THE INVENTION
[0002] The present invention relates to an ultrasonic trocar having
a paracentetic section which is designed to penetrate the abdominal
wall and to which ultrasonic vibration may be transmitted.
[0003] Disposable trocars are mainly used at present as devices
that guide medical instrument into the abdominal cavity of a
patient. U.S. Pat. No. 5,314,417 discloses a trocar of this type,
which has a needle and a tubular sheath. The needle is pointed at
its distal end and can penetrate the abdominal wall. The needle is
inserted in the tubular sheath. The pointed distal end of the
needle is a blade-shaped knife-edge. It is at the knife-edge that
the needle penetrates the abdominal wall of the patient.
[0004] Most disposable trocars incorporate a safety shield
mechanism. The mechanism works as a safety guard when the trocar is
manipulated to pierce the abdominal wall with the needle. The
mechanism has a safety shield. The safety shield contacts and
covers the pierced part of the wall when the distal end of the
needle penetrates into the abdominal cavity. Thus, the mechanism
prevents the needle from further moving into the abdominal cavity,
and thus preventing the tissues present in the abdominal cavity
from being damaged.
[0005] Another type of a trocar is disclosed in U.S. Pat. No.
5,267,965. The needle of this trocar has a star-shaped distal end.
It is at the star-shaped distal end that the needle penetrates the
abdominal wall of the patient.
[0006] Reusable trocars are known. A reusable trocar is washed and
sterilized after every use and is used again. Developed as reusable
trocars are ultrasonic trocars, each having a paracentetic section
to which ultrasonic vibration can be transmitted. The paracentetic
section receives ultrasonic vibration during the use of the
ultrasonic trocar. This enables the doctor to pass the paracentetic
section through the abdominal wall with a relatively small
force.
[0007] The paracentetic section of the needle of a typical
ultrasonic trocar is shaped like a triangular pyramid. After every
use of the ultrasonic trocar, the paracentetic section is
sterilized with gas or heat so that the trocar may be used
again.
[0008] The conventional trocars of the various types described
above are disadvantageous in the following respects.
[0009] The disposable trocar has a safety shield that prevents the
needle from further moving into the abdominal cavity. Having the
safety shield, the disposable trocar is more complex in structure
than otherwise. In other words, the disposable trocar has more
parts, inevitably increasing the manufacturing cost. To make
matters worse, the disposable trocar cannot be sterilized with gas
or heat after it has been used once. It cannot be used again at
all.
[0010] In the case of the disposable trocar disclosed in U.S. Pat.
No. 5,314,417, the knife-edge becomes dull after use. Were the
trocar used again, the doctor should apply a large force to pass
the paracentetic section through the abdominal wall. Hence, the
paracentetic section might move too deep into the abdominal cavity,
possibly damaging the organs which exist in the abdominal cavity
and which need not be treated at all.
[0011] In the case of conventional ultrasonic trocar, the
paracentetic section, shaped like a triangular pyramid, makes a
triangular incision hole in the abdominal wall. The incision hole
is relatively large and possibly left open even after the
ultrasonic trocar is removed from the abdominal wall. As a
consequence, it may take a long time to heal the tissues in the
abdominal wall. If the paracentetic section is a conical one, as
the case may be, it will be more difficult for the doctor to pass
this section through the abdominal wall than in the case where the
section is shaped like a triangular pyramid. This is because the
conical paracentetic section receives higher resistance while being
passed through the abdominal wall than the triangular pyramidal
one.
BRIEF SUMMARY OF THE INVENTION
[0012] The present invention has been made in consideration of the
above. Its object is to provide an ultrasonic trocar that can be
reusable, that can be manufactured at low cost, and that has a
paracentetic section easy to pass through the abdominal wall, and
that does not delay the healing of the tissues present in the
abdominal wall.
[0013] To attain the object, the present invention provides an
ultrasonic trocar, which has a tubular sheath and a needle unit
inserted in the tubular sheath and designed to penetrate the
abdominal wall while vibrated with ultrasonic waves. The ultrasonic
trocar is characterized in that the needle unit has a substantially
pyramidal paracentetic section at a distal end, and the
paracentetic section has two cutting surfaces formed by cutting
diagonally opposing two ridges, and two sharp cutting edges for
cutting living tissues. The sharp cutting edges are provided at the
two other diagonally opposing ridges and positioned symmetrically
with respect to an axis of the needle unit.
[0014] To set the tubular sheath in an incision made in the
abdominal wall, ultrasonic vibration is transmitted to the needle
unit. The paracentetic section of the needle unit, which is
vibrating, is brought into contact with the abdominal wall. At
least the cutting edges at the distal portion of the two opposing
ridges of the paracentetic section cut the abdominal wall easily,
making an incision in the abdominal wall and the peritoneum. As the
paracentetic section of the needle unit is inserted into the
incision, the cutting edges of the paracentetic section gradually
cut the abdominal wall. As a result, the paracentetic section is
inserted into the abdominal cavity. The paracentetic section, which
is the thickest part of the needle unit, receives a larger force
than any other part of needle unit. Hence, the cutting edges, which
constitute the thickest part of the unit, cut the abdominal wall
efficiently. The distal end portion of the insertion section of the
tubular sheath can therefore be smoothly inserted into the incision
made in the abdominal wall. In the process of incising the
abdominal wall, the curved surfaces of the paracentetic section do
not damage the tissues existing in the abdominal wall. This helps
to heal the tissue in the abdominal wall within a relatively short
time.
[0015] The distal end part of the needle unit has curved surfaces
and two ridges. The ridges are symmetrical with respect to the axis
of the needle unit, each defined by at least two curved surfaces.
Edges for cutting living tissues are provided at the distal parts
of the ridges and at the proximal, or thickest parts of the ridges.
Thus, the present invention can provide an ultrasonic trocar which
can used again and again, helping to decrease medical cost, which
can be smoothly inserted into the incision made in the abdominal
wall and which does not damage the tissues in the abdominal
wall.
[0016] Additional objects and advantages of the invention will be
set forth in the description which follows, and in part will be
obvious from the description, or may be learned by practice of the
invention. The objects and advantages of the invention may be
realized and obtained by means of the instrumentalities and
combinations particularly pointed out hereinafter.
BRIEF DESCRIPTION OF THE SEVERAL VIEWS OF THE DRAWING
[0017] The accompanying drawings, which are incorporated in and
constitute a part of the specification, illustrate presently
preferred embodiments of the invention, and together with the
general description given above and the detailed description of the
preferred embodiments given below, serve to explain the principles
of the invention.
[0018] FIG. 1A is a partly perspective view of the ultrasonic
trocar system according to the first embodiment of the
invention;
[0019] FIG. 1B is a plan view of the paracentetic section that the
needle of the ultrasonic trocar shown in FIG. 1A;
[0020] FIG. 2 is a diagram representing the vibration
characteristic of the needle of the ultrasonic trocar shown in FIG.
1A;
[0021] FIG. 3A is a plan view of the paracentetic section, showing
the cutting edges of the paracentetic section;
[0022] FIG. 3B is a side view of the paracentetic section of the
needle;
[0023] FIG. 3C is a sectional view of the paracentetic section,
taken along line 3C-3C in FIG. 3A;
[0024] FIG. 3D is a longitudinal sectional view, showing the layer
coated on the paracentetic section of the needle;
[0025] FIG. 4A is a plan view of the paracentetic section of the
ultrasonic trocar according to the second embodiment, showing the
cutting edges of the paracentetic section of the needle;
[0026] FIG. 4B is a side view of the paracentetic section shown in
FIG. 4A;
[0027] FIG. 5 is a plan view of the paracentetic section of the
needle unit of the ultrasonic trocar according to the third
embodiment, illustrating the cutting edges of the paracentetic
section;
[0028] FIG. 6 is a plan view of the paracentetic section of the
needle unit of the ultrasonic trocar according to the fourth
embodiment;
[0029] FIG. 7 is a side view of the paracentetic section of the
needle unit of the ultrasonic trocar according to the fifth
embodiment;
[0030] FIG. 8A is a side view of the tubular sheath of the
ultrasonic trocar according to the sixth embodiment of the
invention;
[0031] FIG. 8B is a side view of the distal end of the tubular
sheath shown in FIG. 8A;
[0032] FIG. 8C is a side view of the paracentetic section of the
needle;
[0033] FIG. 9 is a longitudinal sectional view showing the tubular
sheath shown in FIG. FIG. 8A and the needle unit partly inserted in
the tubular sheath;
[0034] FIG. 10 is a longitudinal sectional view of an ultrasonic
medical device according to the seventh embodiment of the
invention;
[0035] FIG. 11 is a side view of the probe of the ultrasonic
medical device shown in FIG. 10;
[0036] FIG. 12A is a longitudinal sectional view of the probe of an
ultrasonic medical device according to the eighth embodiment of the
invention;
[0037] FIG. 12B is a sectional view, taken along line 12B-12B in
FIG. 12A;
[0038] FIG. 13A is a longitudinal sectional view of the probe of an
ultrasonic medical device according to the ninth embodiment of this
invention;
[0039] FIG. 13B is a sectional view, taken along line 13B-13B in
FIG. 13A;
[0040] FIG. 14A is a cross sectional view of the first modification
of the probe of the seventh embodiment of the invention;
[0041] FIG. 14B is a cross sectional view of the second
modification of the probe of the seventh embodiment of the
invention;
[0042] FIG. 14C is a cross sectional view of the third modification
of the probe of the seventh embodiment of the invention;
[0043] FIG. 15 is a longitudinal sectional view of the probe of an
ultrasonic medical device according to the tenth embodiment of the
invention;
[0044] FIG. 16 is a longitudinal sectional view of the probe of an
ultrasonic medical device according to the eleventh embodiment of
this invention;
[0045] FIG. 17 is a longitudinal sectional view of the probe of an
ultrasonic medical device according to the twelfth embodiment of
the invention;
[0046] FIG. 18 is a longitudinal sectional view of the probe of an
ultrasonic medical device according to the thirteenth embodiment of
the invention;
[0047] FIG. 19A is a side view of the probe of an ultrasonic
medical device according to the fourteenth embodiment, showing the
main section of the probe;
[0048] FIG. 19B is a longitudinal sectional view of the probe
illustrated in FIG. 19A;
[0049] FIG. 19C is a sectional view, taken along line 19C-19C in
FIG. 19B;
[0050] FIG. 20A is a side view of the torque-generating section of
the probe of an ultrasonic medical device according to the
fifteenth embodiment of the present invention;
[0051] FIG. 20B is a front view of the torque-generating section
shown in FIG. 20A;
[0052] FIG. 21A is an exploded view of an ultrasonic medical
device, which is the sixteenth embodiment of the invention;
[0053] FIG. 21B is a front view of one end of a rotary ring shown
in FIG. 21A;
[0054] FIG. 21C is a partly sectional side view of the rotary ring
shown in FIG. 21A;
[0055] FIG. 21D is a front view of the other end of the rotary ring
shown in FIG. 21A;
[0056] FIG. 22 is a partly sectional side view of the rotary ring
of an ultrasonic medical device according to the seventeenth
embodiment of the present invention;
[0057] FIG. 23 is a front view of the needle unit of an ultrasonic
trocar, which is the eighteenth embodiment of the invention;
[0058] FIG. 24 is a sectional view, taken along line 24-24 in FIG.
23;
[0059] FIG. 25 is a side view of the needle unit of an ultrasonic
trocar, which is the nineteenth embodiment of the invention;
and
[0060] FIG. 26 is a longitudinal sectional view of an ultrasonic
trocar according to the twentieth embodiment of the invention,
showing the tubular sheath and the needle unit partly inserted in
the tubular sheath.
DETAILED DESCRIPTION OF THE INVENTION
[0061] The first embodiment of the present invention will be
described with reference to FIGS. 1A and 1B, FIG. 2 and FIGS. 3A to
3D. FIG. 1A shows the ultrasonic trocar system according to the
first embodiment. The system comprises an ultrasonic trocar 1, an
ultrasonic oscillation device 2, and a foot switch 3. The
ultrasonic oscillation device 2 is connected to the ultrasonic
trocar 1. The foot switch 3 is connected to the ultrasonic
oscillation device 2 to turn the oscillation device 2 on and
off.
[0062] The ultrasonic trocar 1 comprises a tubular sheath 4 and a
needle unit 5. The needle unit 5 is removably inserted in the
tubular sheath 4. The tubular sheath 4 has a thin, long insertion
section 6 and a grip section 7. The insertion section 6 will be set
in an incision made in the boy wall of the patient (e.g., the
abdominal wall) during the use of the ultrasonic trocar 1. The grip
section 7 is coupled to the proximal end of the insertion section
6. The section 6 is tapered at the circumferential surface 6a. The
grip section 7 has a gas inlet cap 8 on the circumferential
surface. Pneumoperitoneal gas is supplied into the tubular sheath 4
through the gas inlet cap 8, if necessary. A three-way valve 9 is
provided on the gas inlet cap 8.
[0063] The grip section 7 has an opening made in the top. It is
through this opening that the needle unit 5, the insertion sections
of endoscopes, and various medical instruments may be inserted into
a body cavity of the patient. An outer seal 10 is mounted on the
top of the grip section 7. The outer seal 10 is a ring-shaped seal
member 10a, which surrounds the opening made in the top of the grip
section 7.
[0064] The seal member 10a has an inner diameter smaller than the
outer diameter of the needle unit 5, the outer diameters of
endoscopes and the outer diameters of the medical instruments.
While the needle unit 5, an endoscope or a medical instrument is
being forced into the tubular sheath 4 through the outer seal 10,
the seal member 10a keeps closing the gap between the tubular
sheath 4 and the needle unit 5, the endoscope or the medical
instrument. This prevents the pneumoperitoneal gas from leaking
from the abdominal cavity.
[0065] A valve (not shown), i.e., inner seal, is provided in the
tubular sheath 4. The valve remains closed, no matter whether the
unit 5, an endoscope or a medical instrument is inserted into the
abdominal cavity or pulled therefrom.
[0066] The needle unit 5 comprises an elongated probe 11, a hand
piece 12, and a knob 13. The hand piece 12 is connected to the
proximal end of the probe 11. The knob 13 is provided on the distal
end of the hand piece 12. The hand piece 12 incorporates an
ultrasonic oscillation device (not shown) and has a horn 13A
connected to the proximal end of the probe 11. The horn 13A is
coaxial with the knob 13. The horn 13A has a screw hole (not shown)
in the distal end.
[0067] The probe 11 has a rod-shaped probe body 14. As shown in
FIG. 2, the probe body 14 has a male screw 15 at the proximal end.
The male screw 15 is set in the screw hole of the horn 13A, whereby
the probe 11 is fastened to the horn 13A.
[0068] The probe body 14 has a proximal section 16 and a middle
section 17. The proximal section 16 has a diameter D1 and a
predetermined length and is connected to and made integral with the
distal end of the proximal section 16. The middle section 17 has a
diameter D2 and a prescribed length and is connected to and made
integral with the distal end of the middle section 17. A
paracentetic section 18 is connected to and made integral with the
distal end of the middle section 17. The paracentetic section 18 is
shaped and has a predetermined length. The thickest part of the
section 18 has a diameter D3. The diameter D2 of the middle section
17 is smaller than the diameter D1 of the proximal section 16, and
the diameter D3 of the thickest part of the paracentetic section 18
is larger than the diameter D1 of the proximal section 16. Namely,
D3>D1>D2.
[0069] As shown in FIG. 2, too, the proximal end of the proximal
section 16 is located at the antinode of an ultrasonic wave that
represents the ultrasonic vibration characteristic of the probe 11.
The junction between the proximal section 16 and middle section 17
of the probe 11 is located at a node of the ultrasonic wave, and
the distal end of the paracentetic section 18 of the probe 11 is
located at the antinode of the ultrasonic wave, which precedes said
node.
[0070] As illustrated in FIG. 3C, the paracentetic section 18,
which is pyramidal, has two curved surfaces 21a and 21b that
diagonally oppose each other. The surfaces 21a and 21b are formed
by cutting the ridges 20a and 20b of the section 18, which
diagonally oppose each other. The remaining two ridges 22a and 22b
of the paracentetic section 18 make sharp cutting edges 23a and
23b, respectively.
[0071] As shown in FIG. 3B, a tip 24 of the paracentetic section 18
is rounded as viewed from above either curved surface (21a or 21b).
The tip 24 has a radius R of curvature of, for example, about 3 mm
or less.
[0072] FIG. 3A shows the paracentetic section 18 rotated around its
axis by 90.degree. from the position shown in FIG. 3B. As shown in
FIG. 3A, a sharp tip 25 of the paracentetic section 18 is pointed
as viewed from above either cutting edges (23a or 23b). The angle
.theta. at which the tip 25 is pointed ranges, for example, from
45.degree. to 90.degree..
[0073] As shown in FIG. 3D, the paracentetic section 18 is coated
with a layer 26. The layer 26 is made of, for example, TiN, and is
formed by means of TiN coating (PVD). Due to the layer 26, the
paracentetic section 18 is resistant to wear, as a whole.
[0074] The probe 11 has two diametrically opposing flat surfaces
27, a little distal of the male screw 15. It is at these flat
surfaces 27 that the probe 11 can be held with a spanner or the
like, in the process of setting the male screw 15 in, or removing
the male screw 15, the screw hole of the hand piece 12 or removing
the male screw 15 from the screw hole.
[0075] The knob 13 of the needle unit 5 has a recess (not shown) in
the distal end. The recess has the same shape as the outer seal 10
and is coaxial with the knob 13. When the needle unit 5 is inserted
into the tubular sheath 4, it is set in the grip section 7 of the
tubular sheath 4, with the outer seal 10 fitted in the recess made
in the distal end of the grip section 13 of the needle unit 5. At
this time, the paracentetic section 18 of the needle unit 5
protrudes from the distal end of the insertion section 6 of the
tubular sheath 4.
[0076] How the ultrasonic trocar system is operated will be
explained. To use the ultrasonic trocar 1, the needle unit 5 is
inserted into the tubular sheath 4. The needle unit 5 is set in the
tubular sheath 4, with the paracentetic section 18 protruding from
the distal end of the insertion section 6 of the tubular sheath
4.
[0077] Thereafter, the foot switch 3 is operated, driving the
ultrasonic oscillation device 2. The device 2 generates ultrasonic
vibration, which is transmitted to the hand piece 12 of the
ultrasonic trocar 1. The ultrasonic vibration is transmitted from
the hand piece 12 to the probe 11 and further to the paracentetic
section 18 of the needle unit 5. To use the ultrasonic trocar 1, a
doctor manipulates the trocar 1 as will be described below.
[0078] First, the doctor holds, with the hand, grip section 7 of
the tubular sheath 4, together with the grip section 13 of the
needle unit 5. Next, he or she sets the paracentetic section 18 of
the needle unit 5 in contact with the abdominal wall of the
patient.
[0079] The doctor can easily make, in the abdominal wall and the
peritoneum, an incision that extends into the abdominal cavity.
This is because the sharp tip 25 of the paracentetic section 18,
contacting the abdominal wall, is vibrating. The doctor inserts the
ultrasonic trocar 1 into the incision. As the paracentetic section
18 of the needle unit 5 is inserted into the incision, the cutting
edges 23a and 23b at the ridges 22a and 22b of the paracentetic
section 18 gradually cut the abdominal wall. As a result, the
paracentetic section 18 is inserted into the abdominal cavity.
[0080] In the process of pushing the ultrasonic trocar 1 into the
abdominal cavity, the paracentetic section 18, which is the
thickest part of the needle unit 5, receives a larger force than
any other part of needle unit 5. Hence, the cutting edges 23a and
23b, which constitute the thickest part of the unit 5, cut the
abdominal wall efficiently. The doctor only needs to move the
trocar 1 toward the abdominal cavity with a small force. The distal
end portion of the insertion section 6 of the tubular sheath 4 can
therefore be smoothly inserted into the incision made in the
abdominal wall.
[0081] In the process of pushing the ultrasonic trocar 1 onto the
abdominal cavity to incise the same, the curved surfaces 21a and
21b of the paracentetic section 18 do not damage the tissues
existing in the abdominal wall. As described above, the curved
surfaces 21a and 21b diagonally oppose each other. Hence, after the
ultrasonic trocar 1 is pulled out of the abdominal cavity, the
incision closes, forming a scar, which is substantially straight
and linear.
[0082] The ultrasonic trocar 1 is advantageous in the following
respects.
[0083] As mentioned above, the paracentetic section 18, i.e., the
distal end portion of the probe 11 of the needle unit 5, is shaped
pyramidal. The section 18 has two curved surfaces 21a and 21b
formed by cutting the diagonally opposing two ridges 20a and 20b
and also has two cutting edges 23a and 23b. The cutting edges 23a
and 23b are the two other diagonally opposing ridges 22a and 22b
and designed to cut living tissues. Thus, when ultrasonic vibration
is transmitted to the paracentetic section 18 set in contact with
the abdominal wall, the cutting edges 23a and 23b easily cut the
abdominal wall, making an incision in the abdominal wall and the
peritoneum.
[0084] Further, the cutting edges 23a and 23b, which constitute the
thickest part of the unit 5, can cut the abdominal wall
efficiently. This is because the paracentetic section 18, i.e., the
thickest part of the needle unit 5, receives a larger force than
any other part of needle unit 5 while the ultrasonic trocar 1 is
inserted into the abdominal cavity. Hence, the distal end portion
of the tubular sheath 4 can be smoothly inserted into the incision
made in the abdominal wall, along with the paracentetic section 18.
The doctor only needs to move the trocar 1 toward the abdominal
cavity with a small force. This reduces the paracentetic section 18
from being inserted deeper into the abdominal cavity than necessary
and from damaging the organs present in the abdominal cavity.
[0085] The larger the diameter of the insertion section of the
trocar 1, the less the force with which to insert the ultrasonic
trocar 1 into the abdominal cavity. The experiments conducted by
the inventors hereof showed that the force was particularly small
when the paracentetic section 18 had a diameter ranging from 3 mm
to 12 mm. Thus, the ultrasonic trocar 1 is advantageous, in safety,
over the conventional reusable trocars and disposable trocars.
[0086] The ultrasonic trocar 1 does not have such a complex safety
shield mechanism as the conventional disposable trocars. Therefore,
the trocar 1 can be sterilized with gas or heat after every use.
That is, the trocar 1 is reusable, helping to decrease medical
cost.
[0087] The curved surfaces 21a and 21b of the paracentetic section
18 neither cut nor damage the tissues in the abdominal wall in the
process of incising the abdominal wall. Since the surfaces 21a and
21b diagonally oppose each other, the incision closes, forming a
scar, which is substantially straight and linear, after the
ultrasonic trocar 1 is pulled out of the abdominal cavity. This
serves to heal the tissues present in the abdominal wall within a
relatively short time.
[0088] As shown in FIG. 3B, the tip 24 of the paracentetic section
18 is rounded as viewed from above either curved surface (21a or
21b). Nonetheless, the paracentetic section 18 can smoothly and
reliably penetrate the peritoneum from the abdominal wall, because
the rounded tip 24 has a radius R of curvature of about 3 mm or
less. If the radius R exceeds 3 mm, it will be difficult for the
section 18 to penetrate the peritoneum. In this case, cavitation
may occur, separating the peritoneum from the abdominal wall.
[0089] FIGS. 4A and 4B show the paracentetic section of the needle
unit of the ultrasonic trocar according to the second embodiment.
The cutting edges of this paracentetic section are modification of
the cutting edges 23a and 23b of the first embodiment.
[0090] More specifically, sharp edges 23a1 and 23a2 are formed at
only the distal (thinnest) and proximal (thickest) parts of the
ridge 22a of the paracentetic section 18, respectively. And two
other sharp edges 23b1 and 23b2 are formed respectively at only the
distal (thinnest) and proximal (thickest) parts of the other ridge
22b that diagonally opposes the ridge 22a. (Namely, the edges 23a1,
23a2, 23b1 and 23b2 are provided at only the parts of the ridges
22a and 22b, which are indicated by circles in FIGS. 4A and 4B.)
The middle parts of the ridges 22a and 22b are cut, forming flat
surfaces 31.
[0091] Since each of the ridges 22a and 22b has two cutting edges
at the distal and proximal parts, respectively, and a flat surface
at the middle part, the needle unit 5 is easier to manipulate. The
ultrasonic trocar according to the second embodiment is more
advantageous than the first embodiment.
[0092] The sharp edges 23a1 and 23b1 formed at the distal parts of
the opposing ridges 22a and 22b of the paracentetic section 18 can
make an incision in the abdominal wall and the peritoneum as easily
as the cutting edges 23a and 23b of the first embodiment. Further,
the sharp edges 23a2 and 23b2 formed at the proximal parts of the
ridges 22a and 22b can cut the abdominal wall and the peritoneum as
smoothly as the cutting edges 23a and 23b of the first embodiment,
as the ultrasonic trocar 1 is pushed toward the abdominal
cavity.
[0093] FIG. 5 shows the ultrasonic trocar according to the third
embodiment of the invention. More precisely, it is a plan view of
the paracentetic section 18 of the needle unit 5 of the ultrasonic
trocar. This paracentetic section 18 is a modification of that of
the first embodiment (FIGS. 1A and 1B, FIG. 2, and FIGS. 3A to 3D),
as will be described below.
[0094] In the third embodiment, the pyramidal paracentetic section
18 is shaped such that the apex angle .theta.1 is smaller than the
tip angle .theta.2 (.theta.2>.theta.1) and that the tip angle
.theta.2 ranges from 45.degree. to 90.degree.
(45.degree..ltoreq..theta.2.ltoreq.90.degre- e.). The tip angle
.theta.2 is the one that the section 18 has as viewed from above
either cutting edge (23a or 23b).
[0095] Since the apex angle .theta.1 is smaller than the tip angle
.theta.2 (.theta.2>.theta.1), the paracentetic section 18 is
relatively short. This decreases the possibility that the distal
end portion of the section 18 that has penetrated the abdominal
wall may damage the organs present in the abdominal cavity.
Moreover, since the tip angle .theta.2 ranges from 45.degree. to
90.degree. (45.degree..ltoreq..theta.2.ltoreq.90.degree.), the tip
of the paracentetic section 18 need not be machined further. In
other words, the section 18 can be machined with ease and
efficiency.
[0096] FIG. 6 shows the paracentetic section of the needle unit of
the ultrasonic trocar according to the fourth embodiment. The
paracentetic section 18 of the fourth embodiment is a modification
of the paracentetic section of the first embodiment (FIGS. 1A and
1B, FIG. 2, and FIGS. 3A to 3D), as will be described below.
[0097] AS shown in FIG. 6, the section 18 has a small,
needle-shaped projection 41 protruding from the apex. The
projection 41 is sharp, making it easy to incise the abdominal wall
when the ultrasonic trocar 1 is pushed onto the abdominal wall. As
a result, the paracentetic section 18 can easily and smoothly
penetrate the peritoneum from the abdominal wall. Thus, the
peritoneum would not be separated from the abdominal wall as in the
case of cavitation.
[0098] The fourth embodiment is an ultrasonic trocar 1, like the
first to third embodiments. Nonetheless, it may be used as a trocar
in which no ultrasonic vibration is transmitted to the paracentetic
section. In this case, too, the needle-shaped projection 41 serves
to accomplish reliable incision of the abdominal wall when the
trocar is pushed onto the abdominal wall.
[0099] FIG. 7 is a side view of the paracentetic section of the
needle unit of the ultrasonic trocar according to the fifth
embodiment. The needle unit 5 of the fifth embodiment is a
modification of that of the first embodiment (FIGS. 1A and 1B, FIG.
2, and FIGS. 3A to 3D), as will be described below.
[0100] As illustrated in FIG. 7, the probe 11 and the grip section
13 are connected together by a connection probe 51. The connection
probe 51 has an appropriate length, adjusting the length of the
needle unit 5. During the use of the ultrasonic trocar 1, the
connection probe 51 amplifies the ultrasonic vibration transmitted
to the paracentetic section 18. The section 18 is therefore
vibrated vigorously. This reduces the force that the doctor needs
to apply to pass the trocar through the abdominal wall. The
ultrasonic trocar 1 can be inserted into the abdominal cavity more
smoothly than otherwise.
[0101] FIGS. 8A to 8C and FIG. 9 show an ultrasonic trocar
according to the sixth embodiment. More correctly, FIGS. 8A and 8B
show the tubular sheath 4 of the trocar, FIG. 8C shows the
paracentetic section 18 of the needle unit 5, and FIG. 9 shows the
tubular sheath 4 and the needle unit 5 partly inserted in the
sheath 4. The sixth embodiment is a modification of the first
embodiment (FIGS. 1A and 1B, FIG. 2, and FIGS. 3A to 3D), as will
be described below.
[0102] As shown in FIGS. 8A and 8B, two projections 61 extend from
the distal end of the insertion section 6 of the tubular sheath 4.
(The section 6 is tapered at the circumferential surface 6a.)
Further, the paracentetic section 18 of the needle unit 5 has two
engagement grooves 62 cut in the thickest part, as is illustrated
in FIG. 8C. The projections 61 will fit into the grooves 62 when
the needle unit 5 is inserted into the tubular sheath 4.
[0103] How the ultrasonic trocar according to the sixth embodiment
is used will be explained.
[0104] First, the needle unit 5 is inserted into the tubular sheath
4. The ultrasonic trocar 1, i.e., a combination of the sheath 4 and
the unit 5, is pushed onto the abdominal wall H. The paracentetic
section 18 of the needle unit 5 penetrates the abdominal wall H,
making an incision hole H1 in the abdominal wall H. As the distal
end of the insertion section 6 of the tubular sheath 4 enters the
incision hole H1, a force is applied from the inner surface of the
hole H1 to both projections 61 that extend from the distal end of
the section 6. The projections 61 are resiliently bent inwards,
fitting into the engagement grooves 62 cut in the thickest part of
the paracentetic section 18 as shown in FIG. 9. Hence, no stepped
part exists between the tubular sheath 4 and the needle unit 5, and
the junction between the sheath 4 and the unit 5 therefore smoothly
passes the rim of the incision hole Hi. Hence, the ultrasonic
trocar 1 can be easily and smoothly inserted in the abdominal wall
H.
[0105] The projections 61 may be permanently bent inwards. In this
case, the projections 61 fit into the grooves 62 when the needle
unit 5 is inserted into the tubular sheath 4, thus assembling the
ultrasonic trocar 1. The trocar 1, thus assembled, can be inserted
in the abdominal wall H more smoothly than in the case where the
projections 61 are resiliently bent inwards as the distal end of
the insertion section 6 of the sheath 4 enters the incision hole
H1.
[0106] Further, the insertion section 6 of the tubular sheath 4 may
have only one projection, three projections or more projections,
instead of two projections 61, and the paracentetic section 18 may
have only one groove, three grooves or more grooves, instead of two
grooves 62.
[0107] The sixth embodiment is an ultrasonic trocar 1. Nonetheless,
it may be used as a trocar in which no ultrasonic vibration is
transmitted to the paracentetic section.
[0108] An ultrasonic medical device 71, which is the seventh
embodiment of the present invention, will be described with
reference to FIGS. 10 and 11.
[0109] As shown in FIG. 10, the ultrasonic medical device 71 has a
hand piece 72. The hand piece 72 is electrically connected to the
ultrasonic oscillation device 2 shown in FIG. 2. The hand piece 72
incorporates a vibration unit 75 that comprises an ultrasonic
oscillator 73 and a horn 74. The ultrasonic oscillator 73 is a
means for generating ultrasonic waves, such as a bolted Langevin
type oscillator. The horn 74 is coupled with the ultrasonic
oscillator 73 and amplifies the ultrasonic waves the oscillator 73
has generated. A cover 76 is removably mounted on the vibration
unit 75, forming a grip section. The ultrasonic oscillator 73 has a
plurality of elements that are laid one upon another. These
elements may be either electrostrictive ones or magnetostrictive
ones.
[0110] A probe 77 (vibration-transmitting member) is connected to
the distal end of the vibration unit 75 incorporated in the hand
piece 72. The probe 77 is made of metal such as titanium alloy or
duralumin. As shown in FIG. 11, the probe 77 has male screw 78 at
the proximal end. The male screw 78 is set in engagement with the
female screw (not shown) provided in the distal end of the horn 74.
Thus, the probe 77 is removably coupled, at its proximal end, to
the distal end of the horn 74. The probe 77 may be coupled to the
horn 74 by any means other than screw engagement, provided that it
can be removably connected to the horn 74 when rotated.
[0111] A tubular sheath 76a covers the probe 77. The tubular sheath
76a is made integral with the cover 76. An annular space is
provided between the outer circumferential surface of the horn 74
and the circumferential surface of the probe 77, on the one hand,
and the inner circumferential surface of the tubular sheath 76a, on
the other hand. The annular space may be used as a passage for
guiding cooling fluid to the distal end of the sheath 76a.
[0112] In the ultrasonic medical device 71, the ultrasonic
oscillator 73 is driven with the power supplied from the ultrasonic
oscillation device 2. Thus driven, the ultrasonic oscillator 73
generates ultrasonic waves. The horn 74 amplifies the ultrasonic
waves. The waves amplified are transmitted to the probe 77. The
distal end portion of the probe 77 is thereby vibrated.
[0113] FIG. 11 shows the probe 77 removed from the hand piece 72.
The probe 77 is a solid, rod-shaped member. The distal end portion
of the probe 77 forms a cutting edge, like the distal end portion
of the paracentetic section 18 of the needle unit 5.
[0114] A torque-generating section 79 (not shown in FIG. 10), which
is an annular member, is mounted on the probe 77 and located near
the male screw 78. The torque-generating section 79 is made of
plastic, such as PEEK (Polyetherethyle-ketone), PTFE (Teflon) or
PsF (Polysulfone). The surface of the section 79 is knurled, having
projections and depressions. The torque-generating section 79 is
removably and rotatably connected to the probe 77.
[0115] The torque-generating section 79 can be held with fingers
and rotated around the probe 77. When the section 79 is rotated so,
it imparts a torque large enough to secure the probe 77 to, and
remove the probe from, the horn 74. The ratio of the outer diameter
B of the section 79 to the diameter of the probe 77, i.e., B/A
(A<B), the width H of the section 79, and the position at which
the section 97 is secured to the probe 77 are set such that the
medical device 71 can serve to perform an ultrasonic treatment.
(That is, the ratio B/A, the width H and the position do not reduce
the efficiency of generating ultrasonic waves.) Preferably, the
ratio B/A is less than 3 (B/A<3). This relation does not depends
on the oscillation frequency of the ultrasonic oscillator 73. If
the ratio B/A is equal to or greater than 3, various problems
(e.g., changes in impedance) during the transmission of ultrasonic
waves. It has been found out that the probe 77 cannot be vibrated
at all or will stop vibrating while the oscillator 73 is operating,
if the ratio B/A is equal to or greater than 3.
[0116] The position, at which the torque-generating section 79 is
secured to the probe 77, is important. If the section 79 takes a
position near the male screw 78 as shown in FIG. 11, the section 79
will effectively apply a torque to the probe 77, facilitating the
screw-engagement of the probe 77 with the distal end of the horn
74. In this case, however, the torque-generating section 79 is
located at an antinode of the ultrasonic wave. Nonetheless, the
section 79 can be driven, along with the probe 77, if the
ultrasonic oscillator 73 has an oscillation frequency of 23.5 Hz,
the width H is 10 mm or less and the ratio B/A is less than 3. This
prevent the amplitude of ultrasonic vibration of the probe 77 from
decreasing. If the amplitude of ultrasonic vibration of the probe
77 is large, the torque-generating section 79 may be located at a
node of the ultrasonic wave.
[0117] The torque-generating section 79 may be removably fastened
to the probe 77, by means of either screw engagement or elastic
snapping. Alternatively, the section 79 can be permanently secured
to the probe 77.
[0118] The use of the torque-generating section 79 results in the
following advantages.
[0119] First, the torque-generating section 79 is large enough to
impart a torque to the probe 77 when held with fingers and rotated.
The probe 77 can therefore be easily fastened to, and separated
from, the horn 74, when rotated with fingers. Any tool whatever,
such as a spanner, need not be used to fasten the section 79 to the
probe 77, or to remove the section 79 from the probe 77. This makes
it possible to replace the probe 77 with another within a short
time.
[0120] Secondly, the torque-generating section 79 need not be
removed from the probe 77 during the use of the ultrasonic
oscillation device 2. This is because section 79 does not obstruct
the ultrasonic wave treatment performed by the use of the
ultrasonic oscillation device 2. Since the section 79 can remain
attached to the probe 77 during the use of the device 2, there is
no need to worry about losing of the torque-generating section
79.
[0121] Thirdly, the doctor can perceive how firmly or loosely the
probe 77 is fastened to the horn 74, by applying a force to rotate
the section 79, more easily and accurately than in the case where
the probe 77 is fastened to the horn 74 with a spanner or the
like.
[0122] FIGS. 12A and 12B illustrate the probe of an ultrasonic
medical device according to the eighth embodiment of the invention.
In the eighth embodiment, the torque-generating section 79 is
secured to the probe 77, unable to rotate with respect thereto. As
shown in FIGS. 12A and 12B, the probe 77 has two grooves 77a in the
circumferential surface and the section 79 has two projections 79a
on the inner circumferential surface. The section 79 is mounted on
the probe 77, with the projections 79a fitted in the grooves 77a.
Therefore, the torque-generating section 79 cannot rotate at all
with respect to the probe 77.
[0123] FIGS. 13A and 13B show the probe of an ultrasonic medical
device according to the ninth embodiment of this invention. As
shown in FIGS. 13A and 13B, the probe 77 has two projections 77b on
the circumferential surface and the torque-generating section 79
has two holes 79b in the inner circumferential surface. The section
79 is mounted on the probe 77, with the projections 77b fitted in
the holes 79b. Thus, the torque-generating section 79 cannot rotate
at all with respect to the probe 77.
[0124] FIGS. 14A to 14C show three modifications of the probe 77 of
the seventh embodiment (FIGS. 10 and 11), each designed to prevent
the torque-generating section 79 from rotating with respect to the
probe 77.
[0125] The first modification of the probe 77, shown in FIG. 14A,
has a part having an oblate cross section. The first modified probe
has a portion 83 having a cross section of a special shape, for
holding the torque-generating section 79. The portion 83 has been
made by cutting a part of a round bar 81, forming two opposing flat
surfaces 82 that are parallel to each other. The torque-generating
section 79 is mounted on that part of the round bar 81.
[0126] The second modification of the probe 77, shown in FIG. 14B,
has a part 84 having a square cross section.
[0127] The second modified probe has been made by cutting a part of
a round bar, forming four flat surfaces.
[0128] The torque-generating section 79 is mounted on that part of
the round bar.
[0129] The third modification of the probe 77, shown in FIG. 14C,
has a part 85 having a rectangular cross section. The third
modified probe has been made by cutting a part of a round bar,
forming four flat surfaces. The torque-generating section 79 is
mounted on that part of the round bar.
[0130] If the first modified probe shown in FIG. 14A is used, the
torque-generating section 79 has an oblate hole and mounted on that
part of the first modified probe which has an oblate cross section.
If the second modified probe shown in FIG. 14B is used, the
torque-generating section 79 has a square hole and mounted on that
part of the second modified probe which has a square cross section.
If the third modified probe shown in FIG. 14C is used, the
torque-generating section 79 has a rectangular hole and mounted on
that part of the third modified probe which has a rectangular cross
section.
[0131] FIG. 15 illustrates the probe of an ultrasonic medical
device according to the tenth embodiment of the invention. The
tenth embodiment is characterized in that a rod 77 and a
torque-generating section 79 are combined, forming a probe 86.
[0132] FIG. 16 shows the probe of an ultrasonic medical device
according to the eleventh embodiment of this invention. The
eleventh embodiment is characterized in that the probe 86, which is
similar to the probe of the tenth embodiment (FIG. 15), has an
axial though hole 87. That is, the probe 86 is a hollow member. The
ultrasonic oscillator 73 and the horn 74 are also hollow members
and are connected to a suction means. This enables the ultrasonic
medical device to draw fluids from any tissue or organ that is
being treated by the use of the device.
[0133] The structure of the seventh embodiment (FIGS. 10 and 11)
can be applied to the ultrasonic trocars 1 according to the first
embodiment (FIGS. 1A and 1B, FIG. 2, FIGS. 3A to 3D) to the sixth
embodiment (FIGS. 8A and 8B). If so, the probe 77 of the ultrasonic
medical device 71 will function as the needle unit 5 of the trocar
1, with its proximal end removably connected to the horn 74
incorporated in the hand piece 72. The ultrasonic vibration will be
transmitted from the ultrasonic oscillator 73 to the distal end of
the probe 77 through the horn 74.
[0134] An medical instrument can be inserted into the abdominal
cavity through the trocar 1, in the following process.
[0135] At first, a pneumoperitoneal stylus is forced into the
abdominal cavity through the abdominal wall. Gas is introduced into
the cavity through the pneumoperitoneal stylus, thereby expanding
the abdominal cavity so that medical instrument may be moved in the
cavity easily.
[0136] Thereafter, the pneumoperitoneal stylus is pulled out of the
abdominal cavity. The probe 77 is inserted into the guide hole of
the tubular sheath 4 of the trocar 1. The probe 77 is vibrated with
the ultrasonic waves supplied from the oscillator 73 via the horn
74. The probe 77 vibrating and functioning as a needle is pushed,
at its distal end, onto the abdominal wall. The probe 77 makes an
incision in the abdominal cavity and eventually pierces the
abdominal wall, together with the tubular sheath 4. Thus, the
ultrasonic trocar 1 is inserted into the expanded abdominal cavity
through the incision made in the abdominal wall.
[0137] After the trocar 1 is set in the abdominal wall, extending
into the abdominal cavity, the probe 77 is pulled from the
abdominal cavity through the guide hole of the tubular sheath 4. A
medical instrument is inserted into the abdominal cavity through
the guide hole of the tubular sheath 4.
[0138] Having the probe 77 with a torque-generating section 79, the
ultrasonic trocar 1 is advantageous in the following respects.
[0139] That is, the torque-generating section 79 of the probe 77,
which is the needle of the trocar 1, can have a diameter greater,
by 10 mm or more, than the probe for use in combination with an
ordinary ultrasonic coagulation-incision device or the like. Hence,
a large torque can be applied to the probe 77 by rotating the
torque-generating section 79, without twisting the probe 77. This
makes it easy to fasten the probe 77 to the horn 74 and separate
the probe 77 therefrom.
[0140] FIG. 17 shows the probe of an ultrasonic medical device
according to the twelfth embodiment of the invention. The probe is
the first modification of the probe of the seventh embodiment
(FIGS. 10 and 11). This modified probe has a torque-generating
section 79 that is long, extending forwards from an antinode to a
node of the ultrasonic wave, for a quarter of-the wavelength. In
addition, the section 79 has a tapered end portion 88 at said node
of the ultrasonic wave. The tapered end portion 88 can amplify the
ultrasonic vibration, as may be well understood in the art. In
other words, the torque-generating section 79 extends for a quarter
of the wavelength from the antinode to the immediate node of the
ultrasonic wave, and the probe 77 greatly decreases in diameter at
this node. The ultrasonic vibration of the probe 77 can therefore
be amplified.
[0141] FIG. 18 depicts the probe of an ultrasonic medical device
according to the thirteenth embodiment of the invention. The probe
is the second modification of the probe of the seventh embodiment
(FIGS. 10 and 11). The second modified probe is characterized in
that the torque-generating section 79 is mounted on the probe 77
and coupled thereto by a constant-force mechanism 91 so that the
section 79 may function as a torque wrench.
[0142] More precisely, the inner circumferential surface of the
section 79 is a ratchet surface 92 on which tooth are formed. Tooth
93 are formed on the circumferential surface of the probe 77 and
can mesh with the tooth provided on the ratchet surface 93. The
ratchet surface 92 and the tooth 93 constitute the constant-force
mechanism 91. When the section 79 is rotated in the direction of
the arrow (FIG. 18) to fasten the male screw 78 of the probe 77 to
the horn 74, the tooth on the ratchet surface 92 93 of the probe 77
abut on the tooth 93 of the probe 77. A torque is thereby applied
to the probe 77. When the torque applied to the probe 77 exceeds a
predetermined value, the tooth on the ratchet surface 92 slip over
the tooth 93 of the probe 77. That is, the constant-force mechanism
91 serves to fasten the probe 77 to the horn 74, preventing the
probe 77 from rotated with an excessively large force.
[0143] Hence, the probe 77 is fastened to the horn 74, always with
an optimal fastening force. As a result, the horn 74 can transmit
the ultrasonic vibration to the probe 77 with stability and
reliability. Since the probe 77 is fastened to the horn 74 with an
appropriate force, it would not be coupled with the horn 74 so
firmly that it is hardly disconnected from the horn 74.
[0144] It is desired that the torque-generating section 79 be
attached to the probe 77 at a node of the ultrasonic wave. If the
section 79 is so attached, the probe 77 will not vibrate at the
node of the ultrasonic wave, and neither heat nor noise will be
generated at the junction between the probe 77 and the section
79.
[0145] FIGS. 19A to 19C illustrate the probe of an ultrasonic
medical device according to the fourteenth embodiment of the
present invention. This probe is the third modification of the
probe of the seventh embodiment (FIGS. 10 and 11). As shown in FIG.
19B, an annular flange 101 is mounted on that part of the probe 77
which is located at a node of the ultrasonic wave. The flange 101
serves to fasten the torque-generating section 79 to the probe 77.
As shown in FIG. 19C, the flange 101 has four flat surfaces on the
circumferential surface and, therefore, has a substantially square
cross section.
[0146] The torque-generating section 79 comprises a pipe-shaped
base member 102 and a pipe-shaped fastening member 103. The
fastening member 103 is inserted in the base member 102 in screw
engagement. The base member 102 consists of a small-diameter part
104 and a large-diameter part 105. The small-diameter part 104 has
an inner diameter smaller than the inner diameter of the
large-diameter part 105. The large-diameter part 105 has a screw
hole 106.
[0147] The fastening member 103 has a ring-shaped head 107 at one
end. A male screw 108 is cut in the outer circumferential surface
of the fastening member 103, except the ring-shaped head 107. The
male screw 108 is set in engagement with the screw hole 106 of the
torque-generating section 79.
[0148] An annular groove 109 is made in the inner circumferential
surface of the base member 102, at the bottom of the screw hole 106
of the torque-generating section 79. The annular groove 109 has a
diameter larger than the inner diameter of the small-diameter part
104.
[0149] As shown in FIG. 19B, the flange 101 on the probe 77 is
clamped between the torque-generating section 79 and the fastening
member 103 set in screw engagement with the section 79. The section
79 is thereby fastened to the probe 77, at the node of the
ultrasonic wave. The torque-generating section 79 is fastened to
the flange 101, with a gap 110 provided between the outer
circumferential surface of the probe 77 and the inner
circumferential surface of the section 79.
[0150] As shown in FIG. 19C, a plurality of parallel, axial grooves
111 are cut in the outer circumferential surface of the base member
102 of the torque-generating section 79. These grooves 111 make it
easy for the doctor to hold the torque-generating section 79.
[0151] The ultrasonic medical device, which is the fourteenth
embodiment of the invention, is advantageous in the following
respects.
[0152] Even if the probe 77 vibrate a little at the node of the
ultrasonic wave, heat will hardly be generated at the interface
between the probe 77 and the torque-generating section 79. This is
because the gap 110 is provided between the outer circumferential
surface of the probe 77 and the inner circumferential surface of
the section 79. Heat, if any, generated at this interface will be
scarcely transmitted to the section 79, also thanks to the gap
110.
[0153] The constant-force mechanism 91 used in the thirteenth
embodiment (FIG. 18) may be employed in the fourteenth embodiment.
If this is the case, the torque-generating section 79 may function
as a torque wrench. Further, it is easy to rotate the
torque-generating section 79, because the section 79 has a
plurality of axial grooves 111 cut in the outer circumferential
surface.
[0154] FIGS. 20A and 20B show the torque-generating section 79 of
an ultrasonic medical device according to the fifteenth embodiment
of the invention. This torque-generating section 79 is, so to
speak, a modification of the section 79 of the seventh embodiment
(FIGS. 10 and 11). The section 79 has two finger rests 121, which
extend from the outer circumferential surface in the radial
direction of the section 79. By virtue of the finger rests 121, the
section 79 can generate a large torque when held with fingers and
rotated around its axis.
[0155] FIGS. 21A to 21D show an ultrasonic medical device, which is
the sixteenth embodiment of the present invention. The sixteenth
embodiment is identical to the seventh embodiment (FIGS. 10 and
11), except for the mechanism for securing the probe 77 to, and
separating the probe 77 from, the horn 74. The components similar
or identical to those shown in FIGS. 10 and 11 are designated at
the same reference numerals and will not described in detail.
[0156] In the sixteenth embodiment, the probe 77 can be secured to
and removed from the hand piece 72 by means of a rotary ring 131.
FIG. 21A shows two probes 77A and 77B which different in diameter.
The first probe 77A has a diameter of, for example, 10 mm. The
second probe 77B has a diameter of, for example, 5 mm.
[0157] The probes 77A and 77B have each a male screw 132 at the
proximal end. The male screws 132 of both probes 77A and 77B have
the same diameter.
[0158] The horn 74 of the hand piece 72 has a screw hole 133 in its
distal end portion. The probes 77A and 77B is interchangeably
fastened to the horn 74, with the male screw 132 set in the screw
hole 133 made in the distal end portion of the horn 74.
[0159] The rotary ring 131 has an engagement hole 131a in one end,
and a screw hole 131b in the other end. As shown in FIG. 21C, an
annular groove 131c is cut in the inner circumferential surface of
the rotary ring 131 and located between the engagement hole 131a
and the screw hole 131b. As shown in FIG. 21B, a pair of recesses
131a1 are made in the inner circumferential surface of rotary ring
131 and located at the engagement hole 131a. The recesses 131a1
extend in the opposite directions.
[0160] The probes 77A and 77B have each an engagement part 134 at
the proximal end and near the male screw 132. The engagement part
134 of either probe can be set into the engagement hole 131a of the
rotary ring 131. The part 134 has a pair of projections 134a, which
protrude in the opposite directions from the circumferential
surface of the engagement part 134. Once the engagement part 134 is
set in the engagement hole 131a, extending through the hole 131a
for a predetermined distance, the projections 134a fit into the
recesses 131a1 that are made in the inner circumferential surface
of rotary ring 131. The engagement parts 134 of the probes 77A and
77B, each having two projections 134a, are identical in shape and
size.
[0161] A torque-generating section 135 is mounted on the horn 74 of
the hand piece 72. The torque-generating section 135 has a male
screw 136 on its circumferential surface. The male screw 136 can be
set in the screw hole 131b of the rotary ring 131, to a
predetermined depth from the proximal end of the rotary ring
131.
[0162] The annular groove 131c cut in the inner circumferential
surface of the rotary ring 131 is a width greater than that of the
torque-generating section 135. Thus, the section 135 can loosely
fit in the annular groove 131c and can be rotated.
[0163] How the ultrasonic medical device according to the sixteenth
embodiment is used will be explained.
[0164] First, the torque-generating section 135 of the horn 74 is
set into the screw hole 131b of the rotary ring 131. Then, the
rotary ring 131 is rotated until the section 135 reaches the
annular groove 131c and rotatably fits into the annular groove
131c. The rotary ring 131 is thereby rotatably coupled to the horn
74. Thereafter, the engagement part 134 of the probe 77A or 77B is
inserted into the engagement hole 131a of the rotary ring 131. The
rotary ring 131 is rotated, rotating the probe 77A or 77B. As a
result, the male screw 132 of the probe 77A or 77B is set into the
screw hole 133 of the horn. Either the probe 77A or the probe 77B
is thereby coupled to the horn 74.
[0165] The sixteenth embodiment is advantageous in that the probes
77A and 77B having different diameters can be easily secured to and
removed from the hand piece 71, without the necessity of using a
spanner. In the sixteenth embodiment it is desired that the rotary
ring 131 be always secured to the horn 74, so as not to go
astray.
[0166] FIG. 22 shows the rotary ring of an ultrasonic medical
device according to the seventeenth embodiment of the invention.
This device is a modification of the sixteenth embodiment (FIGS.
21A to 21C). As shown in FIG. 22, a leaf spring 141 is provided in
the engagement hole 131a of the rotary ring 131. The leaf spring
141 pushes the projections 134a of the probe 77 toward the hand
piece 72, which are inserted in the engagement hole 131a. Hence,
when the probe 77 is inserted into the rotary ring 131, the leaf
spring 141 pushes the probe 77 toward the hand piece 72. This makes
it easy to set the male screw 132, i.e., the proximal end portion
of the probe 77, into the screw hole 133 made in the distal end
portion of the horn 74.
[0167] FIGS. 23 and 24 illustrates the needle unit of an ultrasonic
trocar, which is the eighteenth embodiment of the invention. The
needle unit is a modification of the needle unit 5 of the
ultrasonic trocar according to the fifth embodiment (FIG. 7).
[0168] As shown in FIG. 23, the probe 11 and the grip section 13
are connected together by a connection probe 51. The connection
probe 51 is located at a node of the ultrasonic wave. The
connection probe 51 has a wrench section 151 that is similar in
shape to the torque-generating section 79 of the fourteenth
embodiment (FIGS. 19A to 19C). The wrench section 151 is made of
plastic, such as PEEK (Polyetherethyle-ketone), PTFE (Teflon) or
PsF (Polysulfone).
[0169] The maximum diameter of the wrench section 151 is equal to
or smaller than the maximum diameter of the paracentetic section 18
of the needle unit 5. The trocar 1 can therefore be smoothly
inserted into the tubular sheath 4.
[0170] In the eighteenth embodiment, tubular sheath 4 having
different diameters can be interchangeably used. Whenever the
sheath 4 is replaced with another, the needle unit 5 must be
replaced with another. To be replaced with another, the needle unit
5 must be disconnected from the horn 13A of the hand piece 12. The
needle unit 5 must be disconnected from the hand piece 12, also to
be washed or stored away. To disconnect the unit 5 from the horn
13A, the doctor only need to hold and rotate the wrench section 151
with fingers. To secure the unit 5 to the horn 13A appropriately,
too, it suffices to hold the wrench section 151 with fingers and
rotate the section 151 in the opposite direction.
[0171] The needle unit 5 has two diametrically opposing flat
surfaces 27. It is at these flat surfaces 27 that the needle unit 5
can be held with a tool such as a spanner or the like. It may
become impossible to rotate the wrench section 151 to adjust the
torque because the needle unit 5 has been secured to the horn 13A,
too firmly and tightly due to the ultrasonic vibration. In this
case, the probe 11 is held with a spanner or the like, at the flat
surfaces 27 and rotated to remove the needle unit 5 from the horn
13A of the hand piece 12.
[0172] FIG. 25 is a side view of the needle unit 5 of an ultrasonic
trocar, which is the nineteenth embodiment of the invention. The
needle unit 5 is a modification of the needle unit 5 of the
eighteenth embodiment (FIGS. 23 and 24).
[0173] As shown in FIG. 25, the wrench section 151 of the needle
unit 5 has flat surfaces 152. At these flat surfaces 152, the probe
11 is held and rotated with a spanner or the like.
[0174] The flat surfaces 152 may be provided at any part of the
needle unit 5. However, if the surfaces 152 are provided at a
position other than a node of the ultrasonic wave and that part of
the unit 5 which has the surfaces 152 is deformed when held with a
spanner, the needle unit 5 may fail to vibrate in desired manner.
In view of this it required that the flat surfaces 152 be formed on
the wrench section 151, because the wrench section 151 is located
at a node of the ultrasonic wave.
[0175] The flat surfaces 152 are therefore formed on the wrench
section 151 in the nineteenth embodiment. If the wrench section 151
cannot be rotated with hand in either direction, the wrench section
151 may be held with a wrench at the flat surfaces 152 and may be
rotated by the use of the spanner. In addition, it is easy for
anyone using the ultrasonic trocar to know where the flat surfaces
152 are provided. It is because he or she often holds and rotate
the wrench section 151 with fingers to secure or remove the needle
unit 5 to or from the horn 13A and because the surfaces 152 are
formed on the wrench section 151.
[0176] FIG. 26 illustrates an ultrasonic trocar according to the
twentieth embodiment of the invention. The twentieth embodiment is
a modification of the first embodiment (FIGS. 1A and 1B, FIG. 2,
and FIGS. 3A to 3D).
[0177] As shown in FIG. 26, the tubular sheath 4 contains a flap
valve 161 and a spring 162. The spring 163 pushes the flap valve
161 onto the needle unit 5. As the needle unit 5 is inserted into
the tubular sheath 4, the flap valve 161 contacts the
circumferential surface of the wrench section 151 of the needle
unit 5, which is located at a node of the ultrasonic wave.
[0178] In an ordinary trocar, the flap valve contacts the needle
unit as the needle unit is inserted into the tubular sheath 4. In
an ultrasonic trocar, the needle unit moves in frictional contact
with the flap valve while undergoing ultrasonic vibration,
inevitably making noise and forming wear dust. To make matters
worse, the interface between the needle unit and the flap valve
hinders the ultrasonic vibration of the needle unit.
[0179] In the ultrasonic trocar according to the twentieth
embodiment of the invention, the interface between the needle unit
5 and the flap valve 161 does not hinder the ultrasonic vibration
of the needle unit 5. This is because the wrench section 151 of the
needle unit 5 is located at the node of ultrasonic vibration of the
needle unit 5, and also because the flap valve 161 contacts the
circumferential surface of the wrench section 151.
[0180] The present invention is not limited to the embodiments
described above. Various changes and modifications can of course be
made, without departing from the scope and spirit of the
invention.
[0181] Additional advantages and modifications will readily occur
to those skilled in the art. Therefore, the invention in its
broader aspects is not limited to the specific details and
representative embodiments shown and described herein. Accordingly,
various modifications may be made without departing from the spirit
or scope of the general inventive concept as defined by the
appended claims and their equivalents.
* * * * *