JP2003061973A - Ultrasonic tissue fusing apparatus - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a small-sized ultrasonic tissue fusing apparatus capable of anastomosing organic tissues at a low cost without leaving foreign matters inside the body. SOLUTION: The torsional ultrasonic vibration generated for an ultrasonic vibrator 6 is transmitted to the tip side via an ultrasonic probe 7 and a jaw 9 is opened/closed relatively to the top end face of the ultrasonic probe 7, so that the torsional vibration energy is given to the organic tissue and self-heating is started inside the organic tissue. As a result, the organic tissues can be fused together without cavitation.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an ultrasonic tissue welding apparatus which is an ultrasonic surgical instrument for performing a treatment of coagulating and welding tubular tissues such as blood vessels and intestinal tracts to join them.

[0002]

2. Description of the Related Art In recent years, with the increase in organ transplant surgery and the development of cardiovascular surgery, an increasing number of procedures for anastomosing biological tissues such as blood vessels and intestinal tracts. Further, the application of robotic technology to medicine has advanced, and surgery is being performed with a robotic treatment tool.

Conventionally, the following method has been generally used for suturing a living tissue such as a blood vessel or an intestinal tract.
The first method is to use a needle and a thread. This is to attach the thread to the needle, pass the needle through both sides of the biological tissue to be anastomosed, and put the thread there to draw together the tissue surfaces to be anastomosed. After that, the thread is tied and the biological tissue is anastomosed. This method allows anastomosis according to the surgeon's preference, and enables fine anastomosis of living tissue because one needle is sutured.

The second method is a method of anastomosing tissues using an instrument called an automatic suturing device, in which a stapler suitable for each anastomosis is driven and sutured. This method is also applicable to robotic procedures because it facilitates the anastomosis procedure.

Further, Japanese Patent Application Laid-Open No. 11-104143 and Japanese Patent Application Laid-Open No. 2001-79014 show an anastomosis device using energy such as ultrasonic waves and laser. Further, an application example of this ultrasonic energy in the medical field is an ultrasonic scalpel. Then, with this ultrasonic scalpel, incision and coagulation can be performed on the living tissue grasped by utilizing ultrasonic energy.

[0006]

The conventional anastomotic methods using needle threads, staplers, etc. all have their merits, but have the problem of leaving foreign matter such as needle threads or staplers in the body. Therefore, especially after the stapler,
There is a problem in that an accurate image of the stapler position cannot be obtained during the MRI examination. Furthermore, since consumables such as threads and staplers are used, it is expensive.

An anastomosis device using energy such as ultrasonic waves or laser can solve the above problems in an anastomosis method using a needle thread, a stapler or the like. Here, as an example of an application method of ultrasonic vibration, there is a method of applying longitudinal vibration as shown in FIG. Here, the tip portion of the ultrasonic probe c connected to the tip portion of the horn b whose base end portion is connected to the ultrasonic transducer a is in contact with the living tissue H substantially vertically.

In this case, the vibration direction of the ultrasonic vibration transmitted from the ultrasonic transducer a through the horn b to the ultrasonic probe c is vertical to the living tissue H. Therefore, when this device is applied to welding of the biological tissue H, a cavitation phenomenon occurs at the tip of the ultrasonically vibrated ultrasonic probe c, and the biological tissue H to be welded is penetrated. There is a risk.

As another application method of ultrasonic vibration,
As shown in FIG. 8B, there is a method of applying lateral vibration. Here, a vibration direction converter d extending in a direction substantially orthogonal to the axial direction of the ultrasonic probe c is connected to the tip of the ultrasonic probe c. Then, one end of the vibration direction converter d is in contact with the living tissue H substantially vertically.

In this case, the biological tissue H is generated in a state where the vertical vibration direction of the ultrasonic vibration transmitted to the ultrasonic probe c is converted into the horizontal vibration direction by the vibration direction converter d.
Be transmitted to. According to this method, since it is not affected by the cavitation phenomenon, it is advantageous for the welding of the living tissue H, but there is a problem that the vibration direction converter d for converting the vibration direction is required and the apparatus becomes large.

The present invention has been made in view of the above circumstances, and an object thereof is to enable an anastomosis of a tissue such as a blood vessel or an intestinal tract in a short time and reliably, and a foreign substance such as a thread or a stapler at an anastomosis portion. It is an object of the present invention to provide a small-sized ultrasonic tissue welding apparatus capable of welding tissues without leaving any of them.

[0012]

According to a first aspect of the present invention, there is provided an ultrasonic vibrator for generating a torsional vibration, and a torsional vibration generated by the ultrasonic vibrator having a base end portion connected to the ultrasonic vibrator. The ultrasonic tissue welding device is characterized by comprising: a vibration transmitting member for transmitting the vibration to the distal end side; and a jaw that opens and closes relative to the distal end surface of the vibration transmitting member.
In the invention of claim 1, the jaw is opened and closed relative to the tip end surface of the vibration transmitting member, and the living tissue is grasped between the tip end surface of the vibration transmitting member and the jaw. The ultrasonic vibration of the torsional vibration output from the sonic oscillator is transmitted to the tip side via the vibration transmission member, and the torsional vibration energy is applied to the living tissue, causing self-heating inside the living tissue and causing cavitation. The biological tissues are welded to each other without causing the influence of.

According to a second aspect of the present invention, an ultrasonic vibrator for generating a torsional vibration and a base end portion of the ultrasonic vibrator are connected to transmit the torsional vibration generated by the ultrasonic vibrator to the tip end side. A vibration transmitting member, a first gripping portion that is provided at the tip of the vibration transmitting member, and that treats the tissue to be treated by the transmitted vibration energy, and is rotatable in opposition to the first gripping portion. And an ultrasonic tissue welding apparatus characterized in that the ultrasonic tissue welding device is provided with a second gripping part for gripping a biological tissue between the first gripping part. In the invention according to claim 2, the first grip portion and the second grip portion at the tip of the vibration transmitting member are provided.
When the living tissue is gripped between the gripping part of the body and the ultrasonic vibration of the torsional vibration output from the ultrasonic vibrator is transmitted to the tip side via the vibration transmission member, the living tissue is twisted. The vibration energy is applied to cause self-heating inside the living tissues, and the living tissues are welded to each other without causing the influence of cavitation.

According to a third aspect of the present invention, a cylindrical vibrating member for transmitting ultrasonic vibration is provided at the tip of the insertion part that is inserted into the tubular tissue, and the cylindrical vibrating member has a circumferential surface. In the ultrasonic tissue welding apparatus that performs solidification welding, the ultrasonic vibrator that generates the ultrasonic vibrations is a torsional vibrator that generates torsional vibrations. Then, in the invention of claim 3, ultrasonic vibration of torsional vibration is transmitted from the ultrasonic vibrator of the torsional vibrator to the cylindrical vibrating member at the tip of the insertion part inserted into the inside of the tubular tissue. The solidification welding is performed by ultrasonic vibration of torsional vibration on the circumferential surface of the columnar vibration member.

[0015]

BEST MODE FOR CARRYING OUT THE INVENTION A first embodiment of the present invention will be described below with reference to FIG. FIG. 1 shows a schematic configuration of the whole ultrasonic tissue welding apparatus 1 of the present embodiment. The ultrasonic tissue welding apparatus 1 is provided with a handpiece 2 and an ultrasonic generator 3 which form a tweezers type treatment tool.

Further, the handpiece 2 is provided with a substantially V-shaped tweezers member 4. The tweezers member 4 is provided with two bar-shaped gripping portions 4A and 4B whose base ends are rotatably connected about a rotating portion 5. An ultrasonic transducer 6 for generating torsional vibration and an ultrasonic probe (vibration transmitting member) 7 are provided on the tip side of one of the first gripping portions 4A.
Is connected to the ultrasonic unit 8. Here, the torsional vibration of the ultrasonic vibrator 6 is an ultrasonic vibration in which a relative change in angular displacement occurs between two points on the rotary shaft. Further, a jaw 9 is arranged at the tip of the other second grip 4B. The jaw 9 is arranged to face the tip of the ultrasonic probe 7 at a distance.

The two grips 4 of the tweezers member 4 are also provided.
A substantially U-shaped leaf spring member 10 is disposed in the vicinity of the rotating portion 5 between the base end portions of A and 4B. The tweezers member 4 is held by the leaf spring member 10 by the spring force.
A state in which the tip end side is urged in a direction in which the tip end side opens between A and the grip portion 4B, that is, the tip end portion of the ultrasonic probe 7 and the jaw 9 are held in an open state. In this state,
The operator holds the tweezers type handpiece 2 and performs an operation of closing the tip end sides of the two gripping portions 4A and 4B, so that the living body tissue is sandwiched between the ultrasonic probe 7 and the jaw 9. The tissue can be grasped.

A foot switch 11 is connected to the ultrasonic generator 3. The foot switch 11 is used to turn on / off the ultrasonic oscillation from the ultrasonic transducer 6.

Next, the operation of the above configuration will be described.
When the ultrasonic tissue welding apparatus 1 according to the present embodiment is used, the operator holds the tweezers type handpiece 2 and performs an operation to close the distal end sides of the two gripping portions 4A and 4B, whereby the biological tissue to be anastomosed The two are sandwiched between the ultrasonic probe 7 and the jaw 9. At this time, the living tissue is grasped in a state of being sandwiched with an appropriate amount of force.

After that, the foot switch 11 is turned on, and the ultrasonic vibration of the torsional vibration is oscillated from the ultrasonic vibrator 6. At this time, the torsional ultrasonic vibration generated by the ultrasonic transducer 6 is transmitted to the ultrasonic probe 7, and the torsional vibration is generated on the working surface of the tip of the ultrasonic probe 7. As a result, the energy of the torsional ultrasonic vibration is 2 at the joint portion of the two living tissues sandwiched between the working surface of the tip of the ultrasonic probe 7 and the contact surface of the jaw 9 with the living tissue.
Since the two living tissues are added in the direction of rubbing each other, the joint portion of the living tissues is solidified and welded, and the anastomosis is completed.

Then, the foot switch 11 is turned off to stop the oscillation of ultrasonic vibration from the ultrasonic vibrator 6. Then, the next welding work is started. Repeat the same operation as necessary for the anastomosis.

Therefore, the following effects are obtained with the above-mentioned structure. That is, according to the ultrasonic tissue welding apparatus 1 of the present embodiment, the jaw 9 is opened / closed relative to the tip surface of the ultrasonic probe 7 so that the tip surface of the ultrasonic probe 7 and the jaw 9 are separated from each other. While holding the living tissue with
The ultrasonic vibration of the torsional vibration output from the ultrasonic vibrator 6 is transmitted to the distal end side via the ultrasonic probe 7 and the torsional vibration energy is applied to the living tissue to cause self-heating inside the living tissue. Thus, the living tissues can be welded to each other. At this time, since ultrasonic vibration in the vertical direction is not applied to the living tissue, the living tissue is not destroyed by cavitation and only the action of coagulation / welding can be given to the living tissue. Therefore, tissues such as blood vessels and intestinal tracts can be anastomosed reliably in a short time, and the tissues can be welded to each other without leaving a foreign substance such as a thread or stapler at the anastomosis portion.

2 and 3 show a second embodiment of the present invention. The present embodiment is provided with a handpiece 21 having a configuration different from the handpiece 2 of the ultrasonic tissue welding apparatus 1 of the first embodiment (see FIG. 1).

That is, the handpiece 2 of the present embodiment
1, an ultrasonic transducer unit 22 is provided.
The ultrasonic oscillator unit 22 includes an ultrasonic oscillator 23 that generates torsional vibration and a horn 24 that amplifies the ultrasonic vibration generated by the ultrasonic oscillator 23. This ultrasonic transducer 23 is electrically connected via a cord 25 to a generator 26 that supplies electric energy as in the first embodiment. A foot switch 27 is connected to the generator 26.

Further, the horn 24 is connected with a probe 28 as a rod-shaped vibration transmitting member for transmitting the ultrasonic vibration amplified thereby. A first grip portion 29 for gripping and treating a living tissue is formed at the tip of the probe 28.

Further, a jaw 31 is rotatably connected to a substantially central portion of the probe 28 via a shaft body 30.
A second grip portion 32 for gripping a living tissue between the jaw 31 and the first grip portion 29 of the probe 28 is provided at the tip portion of the jaw 31. Further, a finger hook 33 for hooking the thumb of the hand is provided at the base end of the jaw 31. Then, the ultrasonic transducer unit 22 is held by one hand, and the jaw 31 is rotated about the central axis of the shaft body 30 with the thumb of the hand hooked on the finger hook 33 of the jaw 31. , The first grip 2 of the probe 28
9 between the facing portion of the jaw 9 and the second grip portion 32 of the jaw 31.
The opening / closing operation can be performed between the closed position and the open position in the direction of arrow A.

Further, in the present embodiment, as shown in FIG. 3, the first and second gripping portions 29 and 32 are curved so as to substantially follow the outer peripheral surface of the living tissue. In addition, an uneven member for holding a living tissue may be arranged on the surfaces of the grips 29, 32.

Next, the operation of the above configuration will be described.
When using the ultrasonic tissue welding apparatus 1 of the present embodiment, first, the ultrasonic transducer unit 22 is held by one hand, and the thumb of the hand is hooked on the finger hook 33 of the jaw 31.
In this state, as shown in FIG. 3, the first grip portion 29 of the probe 28 is placed along the outer wall of one tubular tissue H1 to be anastomosed, and the second grip portion 32 of the jaw 31 is anastomosed on the other side. Along the outside of the tissue H2.

Then, for example, the end edge portion H1 of each tubular tissue H1, H2 is grasped by a gripping portion of a treatment tool such as tweezers.
With the a and H2a rolled up, the jaw 31 and the ultrasonic transducer unit 22 are operated in the closing direction. With this operation, the rolled-up portions of the end edges H1a and H2a of the tubular tissues H1 and H2 are sandwiched between the grip surface 29a of the first grip portion 29 and the grip surface 32a of the second grip portion 32,
Between the jaw 31 and the ultrasonic transducer unit 22, the rolled-up portions of the edge portions H1a and H2a of the tubular tissues H1 and H2 are gripped.

Then, in this state, the foot switch 27
Is operated to drive the generator 26. This allows
The electric energy generated by the generator 26 is transmitted to the ultrasonic transducer 23 via the cord 25 and converted into torsional vibration energy.

This vibration energy is amplified by the horn 24, transmitted to the probe 28, supplied to the first gripping portion 29 located at the tip of the probe 28, and torsional vibration in the direction indicated by arrow B in FIG. Occurs. Thereby, the grip surface 29a of the first grip portion 29 and the second grip portion 3
Friction heat is generated between the second grip surface 32a and the grip surface 29a of the first grip portion 29 and the grip surface 32 of the second grip portion 32.
The rolled-up portions of the end edge portions H1a and H2a of the tubular tissues H1 and H2 that are gripped between them are solidified and welded.
By repeating the same operation at a plurality of locations along the circumferential direction of each tubular tissue H1, H2, the anastomosis between the tubular tissues H1, H2 is completed.

Therefore, according to the present embodiment, when the ultrasonic tissue welding apparatus 1 is used, the grip surface 2 of the first grip portion 29 is used.
9a and the gripping surface 32a of the second gripping portion 32, the edge portions H1a and H2a of the tubular tissues H1 and H2 being gripped.
By applying the torsional vibration energy to the rolled-up portion, self-heating is caused inside the living tissue, and the rolled-up portions of the edge portions H1a and H2a of the tubular tissues H1 and H2 can be welded to each other. At this time, each tubular tissue H
Since longitudinal ultrasonic vibration is not applied to the rolled-up portions of the edge portions H1a and H2a of H1 and H2, the rolled-up portions of the edge portions H1a and H2a of the tubular tissues H1 and H2 are destroyed by cavitation. It does not occur, and only the action of coagulation / welding can be given to the living tissue. Therefore, tissues such as blood vessels and intestinal tracts can be anastomosed reliably in a short time, and the tissues can be welded to each other without leaving a foreign substance such as a thread or stapler at the anastomosis portion.

Further, particularly in this embodiment, the intestinal tract,
Since the coagulation anastomosis between the tubular tissues H1 and H2 such as blood vessels can be performed in a form that matches the shape of the tubular tissues H1 and H2, the treatment time for the anastomosis can be shortened and the treatment can be simplified.

Further, FIGS. 4 to 6 show a third embodiment of the present invention. The ultrasonic tissue welding apparatus 41 according to the present embodiment includes an ultrasonic generator 42 for supplying electric energy to the ultrasonic vibrator, and a power supply cord for supplying electric energy from the ultrasonic generator 42 to the ultrasonic vibrator. 43 and a small torsional oscillator 44 connected to the tip of the cord 43 to generate torsional vibration
And are provided. A foot switch 45 is connected to the generator 42.

Further, as shown in FIG. 5, the small torsional vibrator 44 has a vibrating element 46 for converting electric energy into ultrasonic vibration, and a cylindrical horn 47 connected to the vibrating element 46. And are provided.

Further, in the ultrasonic tissue welding apparatus 41 of the present embodiment, as shown in FIG.
Are used in combination. This tightener 48 has 2
Two rotating arms 49, 50 are provided. The pivot arms 49 and 50 intersect at substantially the center, and the pivot pin 51 is connected to the intersection.

Further, substantially semicircular arc-shaped crimping portions 52 and 53 are formed at the tips of the rotating arms 49 and 50, respectively. Further, handles 54 and 55 are provided at the base end portions of the rotating arms 49 and 50. The arcuate pressure-bonding portions 52, 53 of the rotating arms 49, 50 are formed in a shape corresponding to the cylindrical horn 47 of the small vibrator 44.

Next, the operation of the ultrasonic tissue welding device 41 of the present embodiment having the above configuration will be described. When the ultrasonic tissue welding device 41 of the present embodiment is used, as shown in FIG. 5, two tubular tissues H1 and H2 such as blood vessels and intestinal tracts are used.
A small torsional oscillator 44 at the part where the edges of the
And the power supply cord 43 are set in the inserted state.

In this state, at the portion where the end edges of the two tubular tissues H1 and H2 are butted against each other, the tightening device 4 is applied from the outside.
8 arc-shaped crimping portions 52, 53 are set. This time,
By closing the handles 54, 55, the crimp portion 5
The portion where the two tubular tissues H1 and H2 are abutted by 2, 53 is pressed against the outer peripheral portion of the cylindrical horn 47 of the small vibrator 44.

Subsequently, drive power is supplied from the generator 42 to the small vibrator 44, and the vibration element 46 of the small vibrator 44 generates a torsion ultrasonic signal. This torsional vibration is transmitted to the horn 47, and this vibration generates frictional heat due to ultrasonic vibration at the portion where the two tubular tissues H1 and H2 are butted. Thereby, the two tubular tissues H1,
The portion where H2 is butted is coagulated and welded, and the two tubular tissues H1 and H2 are anastomosed.

Therefore, according to the present embodiment, when the ultrasonic tissue welding apparatus 1 is used, the arc-shaped crimping portions 52 and 53 of the tightening device 48 and the cylindrical horn 47 of the small vibrator 44 are used.
By applying torsional vibration energy to a portion where two tubular tissues H1 and H2 held by being sandwiched between the tubular tissues H1 and H2 are caused to self-heat inside the living tissue, It is possible to weld the parts where H2 is butted. At this time, each tubular tissue H
Since longitudinal ultrasonic vibration is not applied to the portion where the tubular tissues H1 and H2 are abutted, the portion where the tubular tissues H1 and H2 are abutted is not destroyed by cavitation,
Only the action of coagulation and welding can be given to living tissue. Therefore, tissues such as blood vessels and intestinal tracts can be anastomosed reliably in a short time, and the tissues can be welded to each other without leaving a foreign substance such as a thread or stapler at the anastomosis portion.

Furthermore, according to the present embodiment, in particular, 2
Since the portions where the two tubular tissues H1 and H2 are butted against each other can be reliably fixed and coagulated and welded in one operation, the time for the anastomosis operation can be shortened.

FIG. 7 shows a modification of the ultrasonic tissue welding device 41 of the third embodiment. In this modification, a circumferential groove 61 is formed on the outer peripheral surface of the cylindrical horn 47 of the small vibrator 44. Furthermore, the tightening device 48
A ring-shaped convex portion 62 having a shape corresponding to the circumferential groove portion 61 of the horn 47 of the small vibrator 44 is provided on the pressing surface on the inner peripheral surface side of the arc-shaped crimp portions 52 and 53. Then, by the tightening device 48, the two tubular tissues H1 and H2 are
When the portions where the end edges of the above are abutted are sandwiched, the convex portions 62 of the crimp portions 52 and 53 are engaged in a state of being sandwiched by the circumferential groove portion 61 on the horn 47 of the small vibrator 44.

Therefore, in this modification, the small vibrator 44 is used.
Since the area of the horn 47 of the small vibrator 44 can be increased as compared with the case where the outer peripheral surface of the horn 47 is smooth,
It is possible to coagulate and weld in a wide area the portions where the end edges of the two tubular tissues H1 and H2 such as blood vessels and intestinal tracts abut.

The present invention is not limited to the above embodiment, and it goes without saying that various modifications can be made without departing from the scope of the present invention. Next, other characteristic technical matters of the present application will be additionally described as follows. Note (Appendix 1) An ultrasonic transducer that generates torsional vibration,
An ultrasonic transducer that is connected to the ultrasonic transducer and that transmits a torsional vibration generated by the ultrasonic transducer, and a jaw that opens and closes relative to the tip surface of the ultrasonic vibration transmitting member. Sonic tissue welding device.

(Additional Item 2) An ultrasonic vibrator for generating a torsional vibration, and a vibration transmission member connected to the ultrasonic vibrator for transmitting a torsional vibration generated by the ultrasonic vibrator.
A first gripping portion that is provided at the tip of the vibration transmitting member and that treats the tissue to be treated by the transmitted vibration energy, and a first gripping portion that is rotatable in opposition to the first gripping portion. An ultrasonic tissue welding device, comprising:

(Additional Item 3) A cylindrical vibrating member to which ultrasonic vibration is transmitted is provided at a tip end portion inserted into the inside of a tubular tissue, and superposition for performing solidification welding on the circumferential surface of the cylindrical vibrating member. In the ultrasonic tissue welding apparatus, the ultrasonic vibrator is a torsional vibrator, which is an ultrasonic tissue welding apparatus.

(Field of Industrial Use) The present invention relates to an ultrasonic surgical instrument for coagulating and welding tubular tissues such as blood vessels and intestinal tracts to join them.

(Prior Art of Additional Items 1 to 3)
-104143 publication, Unexamined-Japanese-Patent No. 2001-79014 publication. In recent years, with the increase in organ transplant surgery and the development of cardiovascular surgery, there have been many procedures for anastomosing tissue. Further, the application of robotic technology to medicine has progressed, and surgery has been performed with a robotic treatment tool.

Conventionally, when suturing a living tissue such as a blood vessel or an intestinal tract, the following method is usually used.
The first method is to use a needle and a thread. This is to attach the thread to the needle, pass the needle through both sides of the biological tissue to be anastomosed, and put the thread there to draw together the tissue surfaces to be anastomosed. After that, the thread is tied and the biological tissue is anastomosed. This method allows anastomosis according to the surgeon's preference, and enables fine anastomosis of living tissue because one needle is sutured.

The second method is a method of anastomosing tissues using an instrument called an automatic suturing device, in which a stapler suitable for each living tissue to be anastomosed is driven and sutured. This method is also applicable to robotic procedures because it facilitates the anastomosis procedure.

(Problems to be solved by the additional items 1 to 3)
The conventional anastomosis method using a needle thread or stapler has all merits, but since foreign matter remains in the body, the stapler cannot obtain an accurate image of the stapler position during postoperative MRI examination. There is a problem that such problems occur. Furthermore, since consumable items such as threads and staplers are used, it is expensive.

As a solution to this problem, an anastomosis device using energy such as ultrasonic waves or laser has been proposed. Applications of this ultrasonic energy in the medical field are ultrasonic scalpels. Incision and coagulation can be performed on the grasped living tissue using ultrasonic energy. As an application method of ultrasonic vibration, there is a method of applying longitudinal vibration as shown in FIG. In this case, since the vibration direction is vertical to the biological tissue, when applying to welding, a cavitation phenomenon occurs at the tip of the probe that is vibrating ultrasonically and penetrates the tissue to be welded. There was a problem.

On the other hand, as another application method of ultrasonic vibration, there is a method of applying lateral vibration as shown in FIG. 8 (B). According to this method, since it is not affected by the cavitation phenomenon, it is advantageous for tissue welding, but there is a problem that a device for changing the vibration direction is required and the device becomes large.

(Purposes of Supplementary Items 1 to 3) The present invention has been made in view of the above problems, and an object thereof is to perform anastomosis of living tissue inexpensively without leaving any foreign matter in the body. It is possible to provide a small ultrasonic tissue welding device.

(Means for Solving the Problem of Supplementary Note 1)
Ultrasonic tissue composed of a vibration transmitting member that is connected to an ultrasonic transducer and that transmits the vibration generated by the ultrasonic transducer, and a jaw that opens and closes relative to the tip surface of the ultrasonic vibration transmitting member. In the welding device, by applying a torsional vibration energy to living tissue by causing the ultrasonic transducer to be a torsional oscillator, self-heating is caused inside the tissue,
Welds tissues without the effect of cavitation.

(Effects of Supplementary Items 1 to 3) According to the present invention, tissues such as blood vessels and intestinal tracts can be anastomosed reliably in a short time, and foreign substances such as threads and staplers are left at the anastomosis portion. Since the tissues can be welded together without being damaged, the postoperative condition can be maintained in good condition.

[0058]

According to the first aspect of the present invention, the ultrasonic vibration of the torsional vibration output from the ultrasonic vibrator is transmitted to the tip end side through the vibration transmitting member, and the jaw is attached to the tip end surface of the vibration transmitting member. By opening and closing relative to each other, the torsional vibration energy is applied to the living tissues to cause self-heating inside the living tissues, so that the living tissues are welded to each other without causing the influence of cavitation. , It is possible to anastomosate tissues such as blood vessels and intestinal tract in a short time and surely, and maintain good postoperative condition by welding the tissues together without leaving any foreign matter such as threads or stapler in the anastomotic part. It is possible to provide a small-sized ultrasonic tissue welding device that can perform anastomosis of biological tissue at low cost.

According to the second aspect of the present invention, the ultrasonic transducer outputs the tissue while holding the living tissue between the first grip and the second grip at the tip of the vibration transmitting member. By transmitting the ultrasonic vibration of the torsional vibration to the tip side through the vibration transmission member, the torsional vibration energy is applied to the living tissue to cause self-heating inside the living tissue and to cause the influence of cavitation. The biological tissues can be welded together without the need.

According to the third aspect of the present invention, ultrasonic vibration of torsional vibration is transmitted from the ultrasonic vibrator of the torsional vibrator to the cylindrical vibrating member at the tip of the insertion part that is inserted into the tubular tissue, Solidification welding can be performed on the circumferential surface of the cylindrical vibrating member.

[Brief description of drawings]

FIG. 1 is a schematic configuration diagram showing an ultrasonic tissue welding apparatus according to a first embodiment of the present invention.

FIG. 2 is a schematic configuration diagram showing an ultrasonic tissue welding apparatus according to a second embodiment of the present invention.

FIG. 3 is a perspective view of a main part showing a curved shape portion of first and second gripping portions of the ultrasonic probe in the ultrasonic tissue welding apparatus according to the second embodiment.

FIG. 4 is a schematic configuration diagram showing an ultrasonic tissue welding apparatus according to a third embodiment of the present invention.

FIG. 5 is a schematic configuration diagram of a main part showing a usage state of an ultrasonic probe in the ultrasonic tissue welding apparatus according to the third embodiment.

FIG. 6 is a perspective view of a tightener used in combination with the ultrasonic tissue welding apparatus according to the third embodiment.

FIG. 7 is a schematic configuration diagram of a main part showing a modified example of an ultrasonic probe in the ultrasonic tissue welding apparatus according to the third embodiment.

FIG. 8A is a vertical cross-sectional view of a main part showing a usage state of an ultrasonic anastomosis device to which a conventional vertical vibration of ultrasonic vibration is applied,
(B) is a longitudinal cross-sectional view of a main part showing a usage state of an ultrasonic anastomosis device to which a lateral vibration of a conventional ultrasonic vibration is applied.

[Explanation of symbols]

4A First grip part 4B Second grip part 6 Ultrasonic transducer 7 Ultrasonic probe (vibration transmitting member) 9 Joe

Claims (3)

[Claims] 1. An ultrasonic transducer for generating a torsional vibration, and a vibration transmission member having a base end portion connected to the ultrasonic transducer and transmitting a torsional vibration generated by the ultrasonic transducer to a tip end side. An ultrasonic tissue welding apparatus, comprising: a jaw that opens and closes relative to a tip end surface of the vibration transmitting member. 2. An ultrasonic transducer for generating a torsional vibration, and a vibration transmission member having a base end portion connected to the ultrasonic transducer and transmitting a torsional vibration generated by the ultrasonic transducer to a tip end side. A first gripping portion that is provided at the tip of the vibration transmitting member and that treats the tissue to be treated by the transmitted vibration energy; and a first gripping portion that is rotatable in opposition to the first gripping portion.
An ultrasonic tissue welding apparatus, comprising: a second gripping part for gripping a living tissue between the gripping part and the other gripping part. 3. A cylindrical vibrating member, to which ultrasonic vibration is transmitted, is provided at the tip of an insertion part that is inserted into the inside of a tubular tissue, and a solidification welding is performed on the circumferential surface of this cylindrical vibrating member. The ultrasonic tissue welding apparatus according to claim 1, wherein the ultrasonic oscillator that generates the ultrasonic vibration is a torsional oscillator that generates torsional vibration.