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WO2000054671A1 - Cannula for ultrasonic surgical instrument handpiece - Google Patents

Cannula for ultrasonic surgical instrument handpiece Download PDF

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Publication number
WO2000054671A1
WO2000054671A1 PCT/FR2000/000669 FR0000669W WO0054671A1 WO 2000054671 A1 WO2000054671 A1 WO 2000054671A1 FR 0000669 W FR0000669 W FR 0000669W WO 0054671 A1 WO0054671 A1 WO 0054671A1
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WO
WIPO (PCT)
Prior art keywords
cannula
flexible sleeve
sleeve
handpiece
cannula according
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/FR2000/000669
Other languages
French (fr)
Inventor
Dominique Mariaulle
Thierry Casabonne
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Societe pour la Conception des Applications des Techniques Electroniques SAS
Original Assignee
Societe pour la Conception des Applications des Techniques Electroniques SAS
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Filing date
Publication date
Application filed by Societe pour la Conception des Applications des Techniques Electroniques SAS filed Critical Societe pour la Conception des Applications des Techniques Electroniques SAS
Publication of WO2000054671A1 publication Critical patent/WO2000054671A1/en
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods
    • A61B17/22Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/22004Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves
    • A61B17/22012Implements for squeezing-off ulcers or the like on inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; for invasive removal or destruction of calculus using mechanical vibrations; for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves in direct contact with, or very close to, the obstruction or concrement
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods
    • A61B2017/00831Material properties
    • A61B2017/0084Material properties low friction
    • A61B2017/00849Material properties low friction with respect to tissue, e.g. hollow organs
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods
    • A61B2017/00831Material properties
    • A61B2017/00853Material properties low friction, hydrophobic and corrosion-resistant fluorocarbon resin coating (ptf, ptfe, polytetrafluoroethylene)
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods
    • A61B17/32Surgical cutting instruments
    • A61B17/320068Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
    • A61B2017/320084Irrigation sleeves

Definitions

  • the present invention relates to irrigation cannulas used on surgical handpieces, as well as a method for manufacturing them.
  • Surgical handpieces which essentially consist of a sonotrode which is subjected to ultrasonic vibrations under the action of motor elements consisting of piezoelectric pellets which are excited by a low frequency electric current.
  • the sonotrode consists of a essentially frustoconical metal tip pierced with an internal channel and it is capped with a cannula made of synthetic material which, on the one hand, provides insulation between the sonotrode and healthy tissue and, on the other hand, serves to bring to the level of the active end of the sonotrode an irrigation liquid which circulates between its internal surface and the external surface of the sonotrode.
  • cannulas of this type have a short longevity due to the manifestation of a second cavitation phenomenon, which arises between the end of the cannula and the external wall of the sonotrode.
  • a second cavitation phenomenon which arises between the end of the cannula and the external wall of the sonotrode.
  • they also prove to be dangerous for the surrounding healthy tissue when, after a period of use, small burrs are formed at the periphery of their ends which behave as as many cutting tools with respect to healthy tissue.
  • the destruction by cavitation of the anterior end of the cannula represents a risk, namely that of introducing into the body the residues resulting from this destruction.
  • the present invention aims to provide a cannula to avoid the aforementioned drawbacks.
  • the present invention thus relates to a cannula intended to cover a surgical handpiece of the type comprising a sonotrode driven by a movement of ultrasonic vibrations, characterized in that it is produced in two parts, namely a rigid posterior sleeve intended to be secured to the handpiece and an anterior flexible sleeve whose free end consists of a polymer with a low coefficient of friction. Preferably this coefficient of friction will be between 0.02 and 0.2. It has been found that materials of the polytetrafluoroethylene type prove to be particularly advantageous.
  • the anterior part of the cannula with a small thickness, preferably between substantially 0.05 mm and 0.1 mm.
  • a small thickness preferably between substantially 0.05 mm and 0.1 mm.
  • the fixing and sealing means on the handpiece may consist of an O-ring maintained semi embedded in a groove at its rear end and which will come to bear in a recess of the handpiece.
  • the friction of the O-ring on the wall of the recess will be sufficient to ensure its maintenance in said recess.
  • the flexible sleeve will be formed from a heat-shrinkable sheath, that is to say a sheath which shrinks under the action of heat.
  • the present invention also relates to a method of manufacturing a cannula intended to cover a surgical handpiece, comprising a rigid posterior sleeve and an anterior flexible sleeve, characterized in that it consists in making the flexible sleeve from '' a sheath of a heat-shrinkable material which is disposed on a mandrel whose external surface has the shape and the dimensions which it is desired to give to the internal surface of the flexible sleeve, the assembly then being brought to the shrinking temperature of the sheath.
  • Figure 1 is a longitudinal sectional view of an embodiment of a cannula according to the invention.
  • Figure 2 is a longitudinal sectional view of a cannula according to the invention shown in the position of use on a sonotrode of a surgical handpiece.
  • FIG 3 is an enlarged schematic view of a surgical handpiece coated with a cannula of normal thickness, in the working position.
  • the cannula 1 according to the invention shown in Figures 1 and 2 consists of a rigid posterior support sleeve 11 and a flexible anterior sleeve 13.
  • the support sleeve 11 is made of an easily moldable plastic, such as for example polycarbonate, which is interesting in terms of manufacturing costs. It comprises three zones, namely a first cylindrical zone 3, the external surface of which has a circular groove provided with an O-ring 5 which is intended on the one hand to provide a sealing function with a cylindrical recess 15 of a part to be hand 19 in which it will be arranged and on the other hand the mechanical support relative to the latter.
  • the O-ring 5 is thus able to create such friction against the wall of the recess 15, that it makes it possible to immobilize the cannula 1 in a position chosen by the practitioner.
  • This first cylindrical zone 3 is followed by a second zone 7 which is of frustoconical shape, and which is itself followed by a third zone 20 of smaller diameter and of form cylindrical.
  • the shape of these frustoconical areas is such that it allows the sleeve 13 to match the shape of the sonotrode 17, on which it is arranged, it being understood that a space of the order of 0.2 mm is provided between these two elements, so as to allow circulation between them of the irrigation liquid intended to supply the active anterior end of the sonotrode 17.
  • the second part of the cannula which consists of the flexible frustoconical sleeve 13 is very thin, namely about 0.05 to 0.1 mm. It is made of a material with a low coefficient of friction compared to the titanium constituting the sonotrode 17, and in particular in this case in a fluorinated polymer which is, in the present example, polytetrafluoroethylene (PTFE).
  • PTFE polytetrafluoroethylene
  • the cannula 1 is shorter than the sonotrode 17 so that the latter protrudes by a distance d from the sleeve 13 and allows the active anterior part 17 ′ to be released from the sonotrode 17 constituting the tool. It is thus possible for the practitioner to adjust the distance d whose end is in withdrawal from the end of the sonotrode 17 of the handpiece 19.
  • the external diameter of the rear part of the sleeve 13 is slightly greater than the internal dimension of the cylindrical zone 20 of the support sleeve 11, so as to favor the fixing of the flexible sleeve 13 in the support sleeve 11 by gluing in the cylindrical zone 20. To do this, beforehand, an etching of the external surface of the sleeve 13 will have previously been carried out, the assembly being ensured using an appropriate adhesive such as, for example, of epoxy or cyanoacrylate type.
  • this drawback is eliminated by producing a flexible sleeve whose thickness of the anterior end part is approximately five times less than that of the cannulas used hitherto in this field, thus improving the visibility of the operating field offered to the practitioner.
  • the sleeve 13 can, advantageously, be obtained from a heat-shrinkable sheath. To do this, a metal mandrel will be produced beforehand, the external shapes and dimensions of which correspond to the internal shapes and dimensions of the flexible sleeve 13 that it is desired to obtain.
  • the heat-shrinkable sheath will be placed on the mandrel and the assembly will be brought to a temperature at least equal to the shrinking temperature of this sheath, so that, under the effect of heat, the latter contracts on the mandrel. by rigorously marrying the external shape of it.
  • the flexible sleeve 13 is cut to length by cutting its end, either by mechanical means or by water jet cutting means. Next, the flexible sleeve 13 is bonded into the rigid sleeve 11.

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  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Vascular Medicine (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Mechanical Engineering (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Abstract

The invention concerns a cannula designed to cover a surgical instrument handpiece (19) comprising a sonotrode (17) driven by an ultrasonic vibratory motion, characterised in that it consists of two parts, namely a rear rigid sleeve (11) designed to be made integral with the handpiece (19) and a front sleeve (13) whereof the free end consists of a polymer with low friction coefficient.

Description

CANULE POUR PIÈCE A MAIN CHIRURGICALE A ULTRASONS CANNULA FOR ULTRASONIC SURGICAL HANDPIECE

La présente invention concerne les canules d'irrigation utilisées sur les pièces à main chirurgicales, ainsi qu'un procédé de fabrication de celles-ci.The present invention relates to irrigation cannulas used on surgical handpieces, as well as a method for manufacturing them.

On connaît des pièces à main chirurgicales qui sont essentiellement constituées d'une sonotrode qui est soumise à des vibrations ultrasonores sous l'action d'éléments moteurs constitués de pastilles piézoélectriques qui sont excitées par un courant électrique basse fréquence. Dans de telles pièces à main chirurgicales la sonotrode est constituée d'un embout métallique essentiellement tronconique percé d'un canal interne et elle est coiffée d'une canule en matière de synthèse qui, d'une part, assure une isolation entre la sonotrode et les tissus sains et, d'autre part, sert à amener au niveau de l'extrémité active de la sonotrode un liquide d'irrigation qui circule entre sa surface interne et la surface externe de la sonotrode.Surgical handpieces are known which essentially consist of a sonotrode which is subjected to ultrasonic vibrations under the action of motor elements consisting of piezoelectric pellets which are excited by a low frequency electric current. In such surgical handpieces the sonotrode consists of a essentially frustoconical metal tip pierced with an internal channel and it is capped with a cannula made of synthetic material which, on the one hand, provides insulation between the sonotrode and healthy tissue and, on the other hand, serves to bring to the level of the active end of the sonotrode an irrigation liquid which circulates between its internal surface and the external surface of the sonotrode.

On sait que l'action de la partie active de la sonotrode sur les tissus malades provoque la destruction de ceux-ci en fragments, qui sont ensuite aspirés par le canal central de la sonotrode. L'efficacité de cette dernière est accrue par la formation, en raison de la présence du liquide d'irrigation, d'un phénomène de cavitation qui se produit en extrémité de la sonotrode et qui amplifie fortement l'effet destructeur des vibrations.It is known that the action of the active part of the sonotrode on the diseased tissues causes the destruction of these in fragments, which are then aspirated by the central channel of the sonotrode. The effectiveness of the latter is increased by the formation, due to the presence of the irrigation liquid, of a cavitation phenomenon which occurs at the end of the sonotrode and which greatly amplifies the destructive effect of the vibrations.

Cependant on a constaté que les canules de ce type ont une faible longévité en raison de la manifestation d'un second phénomène de cavitation qui prend naissance quant à lui entre l'extrémité de la canule et la paroi externe de la sonotrode. Outre les inconvénients dus à l'usure prématurée de ces canules, celles-ci se révèlent par ailleurs dangereuses pour les tissus sains environnants lorsque, après une période d'utilisation, il se forme en périphérie de leur extrémité de petites bavures qui se comportent comme autant d'outils de coupe à l'égard des tissus sains. Par ailleurs la destruction par cavitation de l'extrémité antérieure de la canule représente un risque, à savoir celui d'introduire dans l'organisme les résidus provenant de cette destruction.However, it has been found that cannulas of this type have a short longevity due to the manifestation of a second cavitation phenomenon, which arises between the end of the cannula and the external wall of the sonotrode. In addition to the drawbacks due to the premature wear of these cannulas, they also prove to be dangerous for the surrounding healthy tissue when, after a period of use, small burrs are formed at the periphery of their ends which behave as as many cutting tools with respect to healthy tissue. Furthermore, the destruction by cavitation of the anterior end of the cannula represents a risk, namely that of introducing into the body the residues resulting from this destruction.

La présente invention a pour but de proposer une canule permettant d'éviter les inconvénients précités. La présente invention a ainsi pour objet une canule destinée à recouvrir une pièce à main chirurgicale du type comprenant une sonotrode animée d'un mouvement de vibrations ultrasonores, caractérisée en ce qu'elle est réalisée en deux parties, à savoir un manchon postérieur rigide destiné à être solidarisé de la pièce à main et un manchon souple antérieur dont l'extrémité libre est constituée d'un polymère de faible coefficient de frottement. Préférablement ce coefficient de frottement sera compris entre 0,02 et 0,2. On a constaté que les matériaux du type polytétrafluoréthylène se révélaient particulièrement intéressants .The present invention aims to provide a cannula to avoid the aforementioned drawbacks. The present invention thus relates to a cannula intended to cover a surgical handpiece of the type comprising a sonotrode driven by a movement of ultrasonic vibrations, characterized in that it is produced in two parts, namely a rigid posterior sleeve intended to be secured to the handpiece and an anterior flexible sleeve whose free end consists of a polymer with a low coefficient of friction. Preferably this coefficient of friction will be between 0.02 and 0.2. It has been found that materials of the polytetrafluoroethylene type prove to be particularly advantageous.

On a également constaté qu'il était possible, suivant l'invention, de donner à la partie antérieure de la canule une faible épaisseur, comprise préférablement entre sensiblement 0,05mm et 0,1mm. Une telle disposition permet notamment d'améliorer la visibilité offerte au chirurgien de l'extrémité active de l'instrument, notamment lorsque l'intervention s'effectue sous contrôle microscopique.It has also been found that it is possible, according to the invention, to give the anterior part of the cannula with a small thickness, preferably between substantially 0.05 mm and 0.1 mm. Such an arrangement makes it possible in particular to improve the visibility offered to the surgeon of the active end of the instrument, in particular when the intervention is carried out under microscopic control.

Les moyens de fixation et d'étanchéité sur la pièce à main pourront être constitués d'un joint torique maintenu semi encastré dans une rainure de son extrémité postérieure et qui viendra en appui dans un chambrage de la pièce à main. Dans ce mode de mise en oeuvre le frottement du joint torique sur la paroi du chambrage sera suffisant pour assurer son maintien dans ledit chambrage.The fixing and sealing means on the handpiece may consist of an O-ring maintained semi embedded in a groove at its rear end and which will come to bear in a recess of the handpiece. In this embodiment, the friction of the O-ring on the wall of the recess will be sufficient to ensure its maintenance in said recess.

Avantageusement le manchon souple sera constitué à partir d'une gaine thermorétractable, c'est-à-dire d'une gaine qui se rétracte sous l'action de la chaleur.Advantageously, the flexible sleeve will be formed from a heat-shrinkable sheath, that is to say a sheath which shrinks under the action of heat.

La présente invention a également pour objet un procédé de fabrication d'une canule destinée à recouvrir une pièce à main chirurgicale, comprenant un manchon rigide postérieur et un manchon souple antérieur, caractérisé en ce qu'il consiste à réaliser le manchon souple à partir d'une gaine en un matériau thermorétractable qui est disposée sur un mandrin dont la surface externe possède la forme et les dimensions que l'on souhaite donner à la surface interne du manchon souple, l'ensemble étant porté ensuite à la température de rétreint de la gaine.The present invention also relates to a method of manufacturing a cannula intended to cover a surgical handpiece, comprising a rigid posterior sleeve and an anterior flexible sleeve, characterized in that it consists in making the flexible sleeve from '' a sheath of a heat-shrinkable material which is disposed on a mandrel whose external surface has the shape and the dimensions which it is desired to give to the internal surface of the flexible sleeve, the assembly then being brought to the shrinking temperature of the sheath.

On décrira ci-après à titre d'exemple non limitatif, des formes d'exécution de la présente invention, en référence au dessin annexé sur lequel : La figure 1 est une vue en coupe longitudinale d'un mode de mise en oeuvre d'une canule suivant l'invention.Embodiments of the present invention will be described below by way of non-limiting example, with reference to the attached drawing in which: Figure 1 is a longitudinal sectional view of an embodiment of a cannula according to the invention.

La figure 2 est une vue en coupe longitudinale d'une canule suivant l'invention représentée en position d'utilisation sur une sonotrode d'une pièce à main chirurgicale.Figure 2 is a longitudinal sectional view of a cannula according to the invention shown in the position of use on a sonotrode of a surgical handpiece.

La figure 3 est une vue schématique agrandie d'une pièce à main chirurgicale revêtue d'un canule d'épaisseur normale, en position de travail. La canule 1 suivant l'invention représentée sur les figures 1 et 2 est constituée d'un manchon support postérieur rigide 11 et d'un manchon antérieur souple 13. Le manchon support 11 est réalisé dans une matière plastique facilement moulable, telle que par exemple du polycarbonate, ce qui est intéressant en ce qui concerne les coûts de fabrication. Il comprend trois zones à savoir une première zone cylindrique 3 dont la surface externe présente une rainure circulaire pourvue d'un joint torique 5 qui est destiné à assurer d'une part une fonction d'étanchéité avec un chambrage cylindrique 15 d'une pièce à main 19 dans laquelle elle sera disposée et d'autre part le maintien mécanique par rapport à cette dernière. Le joint torique 5 est ainsi apte à créer un frottement tel contre la paroi du chambrage 15, qu'il permet d'immobiliser la canule 1 dans une position choisie par le praticien. Cette première zone cylindrique 3 est suivie d'une seconde zone 7 qui est de forme tronconique, et qui est elle-même suivie d'une troisième zone 20 de plus petit diamètre et de forme cylindrique. La forme de ces zones tronconiques est telle qu'elle permet au manchon 13 d'épouser la forme de la sonotrode 17, sur laquelle elle est disposée, étant entendu qu'un espace de l'ordre de 0,2 mm est prévu entre ces deux éléments, de façon à permettre une circulation entre eux du liquide d'irrigation destiné à alimenter l'extrémité antérieure active de la sonotrode 17.Figure 3 is an enlarged schematic view of a surgical handpiece coated with a cannula of normal thickness, in the working position. The cannula 1 according to the invention shown in Figures 1 and 2 consists of a rigid posterior support sleeve 11 and a flexible anterior sleeve 13. The support sleeve 11 is made of an easily moldable plastic, such as for example polycarbonate, which is interesting in terms of manufacturing costs. It comprises three zones, namely a first cylindrical zone 3, the external surface of which has a circular groove provided with an O-ring 5 which is intended on the one hand to provide a sealing function with a cylindrical recess 15 of a part to be hand 19 in which it will be arranged and on the other hand the mechanical support relative to the latter. The O-ring 5 is thus able to create such friction against the wall of the recess 15, that it makes it possible to immobilize the cannula 1 in a position chosen by the practitioner. This first cylindrical zone 3 is followed by a second zone 7 which is of frustoconical shape, and which is itself followed by a third zone 20 of smaller diameter and of form cylindrical. The shape of these frustoconical areas is such that it allows the sleeve 13 to match the shape of the sonotrode 17, on which it is arranged, it being understood that a space of the order of 0.2 mm is provided between these two elements, so as to allow circulation between them of the irrigation liquid intended to supply the active anterior end of the sonotrode 17.

La seconde partie de la canule, qui est constituée du manchon tronconique souple 13 est de très faible épaisseur, à savoir environ 0,05 à 0,1 mm. Elle est réalisée dans un matériau à faible coefficient de frottement par rapport au titane constituant la sonotrode 17, et notamment en l'espèce en un polymère fluoré qui est, dans le présent exemple, du polytétrafluoréthylène (PTFE) . Ce manchon 13 est de forme sensiblement tronconique, de façon à lui permettre d'épouser la surface externe de la sonotrode 17 en prévoyant entre leurs surfaces interne et externe respectives un passage de l'ordre de 0,2 mm destiné à la circulation du liquide d'irrigation. Il a été constaté que, dans ces conditions, on évitait toute destruction de l'extrémité antérieure de ce manchon sous l'effet notamment de la- cavitation.The second part of the cannula, which consists of the flexible frustoconical sleeve 13 is very thin, namely about 0.05 to 0.1 mm. It is made of a material with a low coefficient of friction compared to the titanium constituting the sonotrode 17, and in particular in this case in a fluorinated polymer which is, in the present example, polytetrafluoroethylene (PTFE). This sleeve 13 is of substantially frustoconical shape, so as to allow it to match the external surface of the sonotrode 17 by providing between their respective internal and external surfaces a passage of the order of 0.2 mm intended for the circulation of the liquid irrigation. It was found that, under these conditions, any destruction of the anterior end of this sleeve was avoided under the effect in particular of cavitation.

Ainsi que représenté sur la figure 2, la canule 1 est de plus faible longueur que la sonotrode 17 de façon que celle-ci dépasse d'une distance d du manchon 13 et permette de dégager la partie antérieure active 17 ' de la sonotrode 17 constituant l'outil. Il est ainsi possible au praticien d'ajuster la distance d dont son extrémité se trouve en retrait par rapport à l'extrémité de la sonotrode 17 de la pièce à main 19.As shown in FIG. 2, the cannula 1 is shorter than the sonotrode 17 so that the latter protrudes by a distance d from the sleeve 13 and allows the active anterior part 17 ′ to be released from the sonotrode 17 constituting the tool. It is thus possible for the practitioner to adjust the distance d whose end is in withdrawal from the end of the sonotrode 17 of the handpiece 19.

Le diamètre externe de la partie postérieure du manchon 13 est légèrement supérieur à la dimension interne de la zone cylindrique 20 du manchon support 11, de façon à favoriser la fixation du manchon souple 13 dans le manchon support 11 par collage dans la zone cylindrique 20. Pour ce faire, au préalable, on aura précédemment procédé à un mordançage de la surface externe du manchon 13 , 1 ' assemblage étant assuré à l'aide d'une colle appropriée telle que par exemple de type époxy ou cyanoacrylate .The external diameter of the rear part of the sleeve 13 is slightly greater than the internal dimension of the cylindrical zone 20 of the support sleeve 11, so as to favor the fixing of the flexible sleeve 13 in the support sleeve 11 by gluing in the cylindrical zone 20. To do this, beforehand, an etching of the external surface of the sleeve 13 will have previously been carried out, the assembly being ensured using an appropriate adhesive such as, for example, of epoxy or cyanoacrylate type.

On sait par ailleurs que, lorsqu'une pièce à main 19 se trouve en position de travail par rapport à des tissus 25 que le chirurgien souhaite traiter, l'observation par celui- ci du champ opératoire se fait par exemple, ainsi que représenté sur la figure 3, suivant un axe yy' et que, dans cette position d'observation, l'épaisseur de la canule 1 masque sensiblement aux yeux du chirurgien l'extrémité active 17' de la sonotrode. Ce masquage est d'autant plus gênant que les interventions chirurgicales qui font appel aux appareils utilisant des canules suivant l'invention se font la plupart du temps sous contrôle microscopique.We also know that, when a handpiece 19 is in the working position relative to tissue 25 that the surgeon wishes to treat, the observation by the latter of the operating field is done for example, as shown in Figure 3, along an axis yy 'and that, in this observation position, the thickness of the cannula 1 substantially masks the eyes of the surgeon the active end 17' of the sonotrode. This masking is all the more embarrassing as the surgical procedures which use the devices using cannulas according to the invention are most of the time under microscopic control.

Dans le mode de mise en oeuvre particulier de l'invention décrit précédemment on élimine cet inconvénient en réalisant un manchon souple dont l'épaisseur de la partie extrême antérieure est environ cinq fois inférieure à celle des canules utilisées jusqu'à présent dans ce domaine, améliorant d'autant la visibilité du champ opératoire offerte au praticien.In the particular embodiment of the invention described above, this drawback is eliminated by producing a flexible sleeve whose thickness of the anterior end part is approximately five times less than that of the cannulas used hitherto in this field, thus improving the visibility of the operating field offered to the practitioner.

On pourrait bien entendu, suivant l'invention, utiliser notamment pour réaliser le manchon 13 tout autre matériau susceptible de présenter par rapport à celui constituant la sonotrode 17 un faible coefficient de frottement préférablement compris entre 0,02 et 0,2, et notamment de l'éthylène propylène fluoré (FEP) ou du perfluoroalkoxy (PFA) . Le manchon souple 13 pourra, de façon intéressante, être obtenu à partir d'une gaine thermorétractable. Pour ce faire, on réalisera préalablement un mandrin métallique dont les formes et dimensions externes correspondront aux formes et dimensions internes du manchon souple 13 que l'on souhaite obtenir. On disposera la gaine thermorétractable sur le mandrin et l'on portera l'ensemble à une température au moins égale à la température de rétreint de cette gaine, de façon que, sous l'effet de la chaleur, cette dernière se contracte sur le mandrin en épousant rigoureusement la forme externe de celui-ci.It would of course be possible, according to the invention, to use in particular to produce the sleeve 13 any other material capable of having, relative to that constituting the sonotrode 17, a low coefficient of friction preferably between 0.02 and 0.2, and in particular of fluorinated ethylene propylene (FEP) or perfluoroalkoxy (PFA). The flexible sleeve 13 can, advantageously, be obtained from a heat-shrinkable sheath. To do this, a metal mandrel will be produced beforehand, the external shapes and dimensions of which correspond to the internal shapes and dimensions of the flexible sleeve 13 that it is desired to obtain. The heat-shrinkable sheath will be placed on the mandrel and the assembly will be brought to a temperature at least equal to the shrinking temperature of this sheath, so that, under the effect of heat, the latter contracts on the mandrel. by rigorously marrying the external shape of it.

Bien entendu on choisira pour ce faire des gaines thermorétractables dont la température de rétreint sera très au-dessus des températures de travail de l'instrument.Of course, heat shrinkable sheaths will be chosen for this, the shrinkage temperature will be much above the working temperatures of the instrument.

Une fois le manchon souple 13 obtenu, on met celui- ci à longueur par découpe de son extrémité, soit par des moyens mécaniques, soit des moyens de découpage à jet d'eau. On procédera ensuite au collage du manchon souple 13 dans le manchon rigide 11. Once the flexible sleeve 13 has been obtained, it is cut to length by cutting its end, either by mechanical means or by water jet cutting means. Next, the flexible sleeve 13 is bonded into the rigid sleeve 11.

Claims

REVENDICATIONS 1.- Canule destinée à recouvrir une pièce à main chirurgicale (19) du type comprenant une sonotrode (17) animée d'un mouvement de vibrations ultrasonores, caractérisée en ce qu'elle est réalisée en deux parties, à savoir un manchon postérieur rigide (11) destiné à être solidarisé de la pièce à main (19) et un manchon souple antérieur (13) dont l'extrémité libre est constituée d'un polymère de faible coefficient de frottement. 2. - Canule suivant la revendication 1 caractérisée en ce que le coefficient de frottement du matériau constituant l'extrémité antérieure du manchon souple est compris entre 0,02 et 0,1.- Cannula intended to cover a surgical handpiece (19) of the type comprising a sonotrode (17) driven by a movement of ultrasonic vibrations, characterized in that it is produced in two parts, namely a rigid posterior sleeve (11) intended to be secured to the handpiece (19) and an anterior flexible sleeve (13) whose free end consists of a polymer with a low coefficient of friction. 2. - Cannula according to claim 1 characterized in that the coefficient of friction of the material constituting the front end of the flexible sleeve is between 0.02 and 0, 2.2. 3.- Canule suivant l'une des revendications 1 ou 2, caractérisée en ce que la partie antérieure de la canule est constituée d'un matériau de type polytétrafluorét ylène .3.- Cannula according to one of claims 1 or 2, characterized in that the front part of the cannula consists of a material of polytetrafluorét ylène type. 4.- Canule suivant l'une des revendications précédentes, caractérisée en ce que l'épaisseur maximale de la partie antérieure du manchon souple (13) est comprise entre 0,05 mm et 0,1 mm.4.- Cannula according to one of the preceding claims, characterized in that the maximum thickness of the front part of the flexible sleeve (13) is between 0.05 mm and 0.1 mm. 5.- Canule suivant l'une des revendications précédentes, caractérisée en ce que ses moyens de fixation et d'étanchéité sur la pièce à main sont constitués d'un joint torique (5) maintenu semi encastré dans une rainure de son extrémité postérieure et qui vient en appui dans un chambrage (15) de la pièce à main.5.- Cannula according to one of the preceding claims, characterized in that its fixing and sealing means on the handpiece consist of an O-ring (5) kept semi-embedded in a groove at its rear end and which comes to bear in a recess (15) of the handpiece. 6. - Canule suivant la revendication 5 caractérisée en ce que le frottement du joint torique (5) sur la paroi du chambrage (15) est suffisant pour assurer son maintien dans ledit chambrage .6. - Cannula according to claim 5 characterized in that the friction of the O-ring (5) on the wall of the recess (15) is sufficient to maintain it in said recess. 7.- Canule suivant l'une des revendications précédentes, caractérisée en ce que le manchon souple (13) est constitué à partir d'une gaine thermorétractable.7.- Cannula according to one of the preceding claims, characterized in that the flexible sleeve (13) is formed from a heat-shrinkable sheath. 8.- Canule suivant l'une des revendications précédentes, caractérisée en ce que le diamètre de la partie externe postérieure du manchon souple (13) est légèrement supérieur à celui de la partie interne antérieure du manchon rigide (11) , de façon à améliorer le contact de ces deux éléments .8.- Cannula according to one of the preceding claims, characterized in that the diameter of the rear external part of the flexible sleeve (13) is slightly greater than that of the front internal part of the rigid sleeve (11), so as to improve the contact of these two elements. 9.- Procédé de fabrication d'une canule destinée à recouvrir une pièce à main chirurgicale, comprenant un manchon rigide postérieur (11) et un manchon souple antérieur (13), caractérisé en ce qu'il consiste à réaliser le manchon souple (13) à partir d'une gaine en un matériau thermorétractable qui est disposée sur un mandrin dont la surface externe possède la forme et les dimensions que l'on souhaite donner à la surface interne du manchon souple (13) , l'ensemble étant porté ensuite à la température de rétreint de la gaine .9.- A method of manufacturing a cannula intended to cover a surgical handpiece, comprising a rigid posterior sleeve (11) and an anterior flexible sleeve (13), characterized in that it consists in producing the flexible sleeve (13 ) from a sheath made of a heat-shrinkable material which is disposed on a mandrel whose external surface has the shape and dimensions which it is desired to give to the internal surface of the flexible sleeve (13), the assembly then being carried at the shrinkage temperature of the sheath. 10.- Procédé suivant la revendication 9, caractérisé en ce que l'on réalise la mise à longueur du manchon souple (13) par des moyens de découpe à jet d'eau. 10.- Method according to claim 9, characterized in that one carries out the lengthening of the flexible sleeve (13) by water jet cutting means.
PCT/FR2000/000669 1999-03-17 2000-03-17 Cannula for ultrasonic surgical instrument handpiece Ceased WO2000054671A1 (en)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
FR99/03297 1999-03-17
FR9903297A FR2790940B1 (en) 1999-03-17 1999-03-17 CANNULA FOR ULTRASONIC SURGICAL HANDPIECE

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WO2000054671A1 true WO2000054671A1 (en) 2000-09-21

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WO (1) WO2000054671A1 (en)

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* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR3018042B1 (en) * 2014-03-03 2021-03-19 Scorpion REMOVABLE NOZZLE FOR DESCALING INSERT AND CORRESPONDING DESCALING KIT

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0554616A2 (en) * 1992-01-24 1993-08-11 Scimed Life Systems, Inc. Apparatus for intravascular cavitation or delivery of low frequency mechanical energy
EP0629379A1 (en) * 1993-06-01 1994-12-21 Antonio La Rosa Ultrasonic apparatus for detaching sclerotic plaque
WO1998037815A1 (en) * 1997-02-28 1998-09-03 Ethicon Endo-Surgery, Inc. Damping ultrasonic transmission components

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0554616A2 (en) * 1992-01-24 1993-08-11 Scimed Life Systems, Inc. Apparatus for intravascular cavitation or delivery of low frequency mechanical energy
EP0629379A1 (en) * 1993-06-01 1994-12-21 Antonio La Rosa Ultrasonic apparatus for detaching sclerotic plaque
WO1998037815A1 (en) * 1997-02-28 1998-09-03 Ethicon Endo-Surgery, Inc. Damping ultrasonic transmission components

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FR2790940A1 (en) 2000-09-22

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