Ultrasonic surgical apparatus

 

(57) Abstract:

Usage: for disruption, extraction and removal of unwanted materials in the body (ulcerative tissue, blood clots and vascular calcification) by mechanical vibrations of the flexible ultrasonic probe. The inventive surgical apparatus includes an emitter connected to a source of ultrasonic vibrations and intended for the transmission and amplification of mechanical vibrations of ultrasonic frequency, ultrasonic probe, containing a flexible linear transmitting element having a working item, intended for the implementation of mechanical vibrations from the ultrasonic frequency, the casing of the radiator, at least part of which is made of flexible material, and a flexible tube having one internal hole or at least two internal openings, and one discharge pipe or at least two branch tubes communicating with the inner hole (holes) and connected to the casing of the radiator through one outlet tube. The ultrasonic probe is located in one of the inner hole communicated with the last one outlet tube. The suction device, suction system and injectors stiffness connected with any IATA for destruction, suction and removal of unwanted materials in the body (ulcerative tissue, blood clots, vascular calcification) with ultrasonic vibrations of the flexible ultrasonic probe.

A known method of removing thrombus by insertion of a catheter into the affected blood clot zone and dissolution of the clot by injection box in this area dissolving the clot of substance, such as streptokinase or method with removal of the catheter and the retention balloon of the balloon catheter in the expanded state with the simultaneous removal of a blood clot.

However, dissolving the clot substance flows in normal end blood vessels and as a result there is a risk of bleeding in them. In addition, if the catheter is displayed, and remains a balloon of a balloon catheter in the expanded state, to simultaneously remove the clot from the body can cause damage to the inner wall of the blood vessel as security measures against the impact of the tension force applied to the inner wall of the blood vessel, are missing.

Known ultrasonic surgical apparatus in which the ultrasonic probe is connected to a source of ultrasonic vibrations. They are used for tissue destruction,zvukovogo probe. The destroyed tissue, vascular calcification, blood clots are removed through the inner hole provided in the ultrasonic probe [2] [3] However, when using such equipment, since the ultrasonic probe having a working part that is mechanically oscillates at ultrasonic frequency, is not flexible, it is difficult to insert it in a curved blood vessel or tubular tissue within the body.

The aim of the invention is to improve the effectiveness of exposure and safety.

For this purpose, the ultrasonic surgical apparatus containing a source of ultrasonic vibrations, coupled with the high-frequency generator, the emitter connected to a source of ultrasonic vibrations for transmission and amplification of mechanical vibrations of ultrasonic frequency, ultrasonic probe, one end of which is attached to the tip of the emitter, and the other has a working part for the implementation of mechanical vibrations from the ultrasonic frequency, and the suction system of unwanted material from the operated area, equipped with a flexible tube connected to the casing, which is installed inside the emitter, with the casing partially made of a flexible material with a corrugated part, and in gibco. In addition, the ultrasonic probe is made in the form of a flexible linear-transmitting element, and a suction system connected to one of the branch tubes. Moreover, the corner sections of the working part of the ultrasonic probe is made rounded. The apparatus has a fluid injectors, United with one or more drainage tubes and fixing tank, located near the working part of the ultrasonic probe and connected through the hole with one of the holes of the flexible tube. In addition, the surface of the holes of the flexible tube, inside of which is an ultrasonic probe, and an outer side surface of the flexible tube covered antithrombotic material.

In Fig.1 shows a device, a General view of Fig.2 tip and the interior of the casing of the radiator; Fig.3 the state when the corrugations of the bellows is expanded, and Fig. 4 corrugations of the bellows is compressed, and Fig.5 shows an example execution of the handle; Fig.6 and 7 are examples that illustrate the use of the apparatus of Fig.8 and 9, examples of the cross-section of the flexible tube; Fig.10 is an example showing a conventional method of surgery.

The device contains four blocks, including the block to generate mechanical vibrations of ultrasonic frequency, which obrane, block injection fluid, formed by the injectors 14 and catheter unit formed by a flexible tube 8 and drainage tubes 7, 9 and 47.

High-frequency electric power is supplied from the generator 1 to the tip 36 through the cables 2, 3. The tip 36 (see Fig.2) formed by the source 4 of ultrasonic vibrations, the emitter 5, the casing 6 of the emitter and the ultrasonic probe 17. High-frequency electric power is supplied to the source 4 of ultrasonic vibrations. It creates mechanical vibrations of ultrasonic frequency, which is transmitted to the radiator 5. Mechanical vibrations are amplified by the emitter 5 and transmitted to the ultrasonic probe 17.

The generator 1 has an oscillating circuit, which is capable of feeding a high-frequency electric energy corresponding to the fluctuations in the condition of the mechanical load of the emitter 5 and the ultrasonic probe 17. Although the frequency of 15-40 kHz usable as the oscillation frequency, the preferred frequency of 20-30 kHz from the point of view of mechanical vibrations of ultrasonic frequency and the ability of the ultrasonic probe 17 to destruction.

Although the source connection 4 ultrasonic vibrations and the emitter 5 shows a screw, but it may be the issue is occasional electrical energy magnetostrictive type, electrostatic type or similar mechanical vibrations. As the material of the emitter 5 is metal, which can transmit and amplify the mechanical vibrations of ultrasonic frequency and has a fatigue strength sufficient to withstand mechanical vibrations, it is preferable to use stainless steel, duralumin, an alloy of titanium.

In addition, as a method of connection of the emitter 5 and the ultrasonic probe 17 can be used, for example, screw connection, welding. Ultrasonic probe 17 is formed fixing element 43 and a flexible onanoperation element 44. As a way of connecting the locking element 43 and the linear transmitting element 44 can be used in welding, gluing or the like. The materials of the locking element 43 and the linear transmitting element 44 are virtually unlimited, if they can transmit mechanical vibrations of ultrasonic frequency and have a fatigue strength that can withstand these mechanical vibrations. However, the materials through which it cannot pass x-rays are preferred; metals, such as stainless steel, aluminium and titanium alloy, and t is the switch located around the emitter 5 and the flexible ultrasonic probe 17. One end of the casing 6 emitter connected to the source 4 of ultrasonic vibrations in an appropriate way, while the other end is connected to the tube 7 by adhesive, to ensure airtightness. However, such method is not the only one. The inner part of the casing 6 of the radiator is divided into partitioned chamber 23 and is confined within the chamber 45 by means of rubber rings 22, and the rubber ring 22 located in the host portion, where the amplitude of the mechanical vibrations in the longitudinal direction 46 of the radiator 5 is minimal, and block the fluid channel. In addition, due to the supply side of the casing 6 of the radiator bellows 10 made of elastic material, you can move the branched tube 7 forward and backward by increasing the contraction of bellows 10 in the longitudinal direction 46.

Ultrasonic probe 17 passes through the outlet tube 7 and is located within the inner bore of the flexible tube 8 (see Fig.1). As shown in Fig.3, the end of the ultrasonic probe 17 has such a diameter that when the bellows 10 is in the expanded condition, the end will not extend beyond the end 16 of the flexible tube 8. With this design, when the flexible tube 8 is inserted into the body and the tip of the ultrasonic probe 17 respoond 17 is prevented.

The suction device 11 is connected with an inner bore of the flexible tube 8 through the outlet tube 9, the switching valve 13, the suction vessel 12 and tubes 38, 39 and 40 (see Fig.1). In addition, the injectors 14 of the liquid is connected with an inner bore of the flexible tube 8 through the outlet tube 47, the tube 37, the switching valve 15 and the tube 41. In Fig.5 shows an example in which the discharge tube 9 and 47 attached to the casing 6 of the radiator with an appropriate adhesive.

Partitioned chamber 23 and the inner bore 42, 20 filled with liquid, which does not harm the tissues of the body, such as physiological saline solution, by an appropriate means so as to facilitate the sliding of the linear transmitting element 44 mounted inside the discharge tube 7 and the flexible tube 8. For example, the channel passing to the partitioned chamber 23, is provided on the side of the casing 6 of the radiator, and fluid (physiological saline), injected into the partitioned chamber 23 and the inner bore 42, 20 through this channel and the channel is then filled. In addition, the internal suction inlet 19 of the flexible tube and the inner hole of the outlet tube 9 provided with a suction device 11 is filled with gidrostal fluid, and delivery tube 17 and the inner hole 20 is similarly filled with a liquid (physiological saline solution).

Corresponding to the position of the end of the line transmitting element 44, projecting x-ray radiation, a flexible tube is inserted into the body and is inserted to the treated area, for example area of the clot. For example, there is a cylinder 26 (see Fig.6) located adjacent to the end 16 of the flexible tube 8. The cylinder 26 is temporarily extended, using the inner hole provided in the flexible tube 8 to a cylinder of this size, so as not to affect the blood flow 24 to set the end of the 16th, because the flexible tube 8 swings under the action of the blood inside the vessel 25. At that time the mutual arrangement of the flexible tube 8 and the linear transmitting element 44 corresponds to that shown in Fig.3. Then, when the compression of the corrugation of the bellows 10 in the direction of the arrow 28 and retain part of the casing 6 of the radiator-side discharge tube 7 relative to the cylinder 10, the working part of item 21 of the ultrasonic probe 17 will protrude out of the end 16 of the flexible tube 8 (see Fig.4). Then the cylinder 26 will be compressed after changing the position relative to the clot 27. Then (see Fig.7) ultrasonic probe 17 will perform mechanical kolebaniya destroyed particles clot absorbed suction device 11 of the suction system through the internal suction hole 19 (see Fig. 8) and removed from the body. In addition, when the position of the thrombus 27 it is not clear, a contrast medium is injected through the inner bore 18 of the liquid injection using opryskivatel 14, and the operation is carried out in accordance with the position of the thrombus 27.

Flexible tube 8 may be made of a material that is commonly used for medical catheter, such as soft vinyl chloride resin. Material drainage tubes 7, 9 and 47 is not limited, but it is advisable to use a material that can stick together with the flexible tube 8. The inner hole and the outer side surface of the flexible tube 8 and the inner bore of drainage tubes 7, 9 and 47 are covered with an antithrombotic material. As an antithrombotic material it is advisable to use polyurethane, hydrogel, heparinbinding polymer associated urokinase polymer and the like.

In addition, the number of internal openings of the flexible tube 8 is not specifically limited. For example, even if the inner hole 20 is provided as shown in Fig.9, this inner bore 20 having an ultrasonic probe can be used for messages with suction device 11 and the injectors 14 liquid ultrasonic probe 17, as it is necessary to prevent damage to the inner wall of the blood vessel. Although the configuration of the end surface is not limited to a particular variant of execution, it is advisable to use obtuse-angled or arcuate configuration.

The proposed device can be widely used for the destruction and removal of other unwanted substances from the body.

Ultrasonic probe, can be injected directly into the affected area, which is undesirable material, such as thrombus, calcification, ulcer. Destruction of unwanted material by mechanical vibrations of ultrasonic frequency and instantaneous removal from the body is harmless to normal surrounding tissue. In addition, the incised portion of the surface of the body can be made only slightly larger than the diameter of the flexible tube surrounding the ultrasonic probe. Therefore, the operation, which causes a very low level of stress in the patient, can be performed within a short period of time and stress on the patient after the operation can be significantly reduced.

1. ULTRASONIC SURGICAL APPARATUS containing a source of ultrasonic vibrations, the United the amplification of mechanical vibrations for transmission and amplification of mechanical vibrations of ultrasonic frequency, ultrasonic probe, one end of which is attached to the tip of the emitter, and the other has a working part for the implementation of mechanical vibrations from the ultrasonic frequency, and the suction system of the operated area, characterized in that, to improve the efficiency and safety impacts, it is equipped with a flexible tube connected to the casing, which is installed inside the emitter, with the casing partially made of a flexible material with a corrugated part, and a flexible tube made of at least one hole, United with the appropriate number of drainage tubes, in addition, the ultrasonic probe is made in the form of a flexible linear-transmitting element, and a suction system connected to one of the branch tubes.

2. The apparatus according to p. 1, characterized in that the angular sections of the working part of the ultrasonic probe is made rounded.

3. The apparatus according to p. 1, characterized in that it is equipped with injectors fluid connected to one or more drainage tubes.

4. The apparatus according to p. 1, characterized in that it is provided with a fixing tank, located near the working part of the ultrasonic probe and connected through the hole with one of otveti which is an ultrasonic probe, and the outer side surface of the flexible tube covered antithrombotic material.

 

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FIELD: medical engineering.

SUBSTANCE: device has ultrasonic surgical instrument manufactured as staged ampoule-type concentrator which cylindrical part of greater diameter is coupled with the ampoule-type part by means of a stage, is resonator fixed in sealed casing and has at least one electromechanical element of piezoelectric type with contact surfaces connected to power supply generator. The electromechanical element is mounted on the resonator end located oppositely with respect to the stage. The resonator is fixed in sealed casing by means of axial compression on the casing part. The force applied between the stage and outer contact surface of electromechanical element is equal to a=(0,35-0.65)λ, where λ is the wavelength of longitudinal elastic resonator displacement coincident wave.

EFFECT: reduced device weight; high surgical instrument fatigue strength.

2 cl, 1 dwg

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