The invention relates to a sonotrode for an ultrasonic surgical instrument. The sonotrode comprises a shaft and an instrument head, on which a structure for ablating tissue is arranged. The instrument head is situated at a distal end of the shaft. A channel extends within the shaft from an outlet opening at the instrument head to a channel opening.
By way of example, such ultrasonic surgical instruments can be used for removing necrotic tissue and coatings. To this end, the sonotrode is connected to a handpiece. An ultrasonic transducer arranged in the handpiece generates high-frequency mechanical vibrations and transmits these to the connected sonotrode. As a result, the sonotrode is excited to vibrate. If the structure for ablating tissue arranged at the instrument head of the sonotrode is then brought into contact with the necrotic tissue, said tissue is ablated.
Undertaking a rinsing with a rinsing liquid during the procedure for the purposes of removing the ablated tissue is known. In the ultrasonic surgical instruments known from the prior art, a rinsing pipe guiding the rinsing liquid from the rinsing pipe into the channel of the sonotrode is arranged in the handpiece. The rinsing liquid then flows through the channel and emerges in the vicinity of the instrument head of the sonotrode in order to rinse ablated tissue away. Pressure variations produced by the ultrasound moreover lead to cavitation, which assists in the ablation of the tissue.
A disadvantage of this arrangement is that there needs to be sterile processing of not only the sonotrode but also the handpiece with the rinsing pipe arranged therein after the use of the ultrasonic surgical instrument.
The invention is based on the object of presenting a sonotrode which renders possible reduced cleaning outlay of the ultrasonic surgical instrument. Proceeding from the prior art set forth at the outset, the object is achieved by the features of the independent claims. Advantageous embodiments are found in the dependent claims.
According to the invention, the channel opening is arranged in the lateral surface of the sonotrode and an attachment piece is connected to the channel opening. The attachment piece is provided with a liquid connector. A liquid supplied to the liquid connector can enter into the channel of the sonotrode through the channel opening.
Using the attachment piece according to the invention renders it possible to connect a rinsing tube to the liquid connector of the attachment piece. A rinsing liquid guided through the rinsing tube can then flow into the channel opening of the sonotrode via the attachment piece and onward in the channel within the sonotrode. The rinsing liquid can emerge through the outlet opening arranged at the distal end of the sonotrode and it can remove ablated tissue. The invention has identified that a significantly more user-friendly and more economic use of the ultrasonic surgical instrument becomes possible by attaching an attachment piece in the region of the channel opening of the sonotrode. In the case of ultrasonic surgical instruments known from the prior art, it is necessary to guide the rinsing liquid through the handpiece. Since remains of the rinsing liquid remain in parts of the handpiece after use and since these liquid remains may form a nutrient medium for the multiplication of germs, it is necessary in the previously known ultrasonic surgical instruments for sterile processing of the handpiece to be carried out after each use. As a result of the attachment piece according to the invention, it is no longer necessary to guide the rinsing liquid through a rinsing pipe within the handpiece. Hence, the handpiece does not come into contact with the rinsing liquid or the patient and it is therefore not necessary for sterile processing to be carried out after use. This significantly reduces the outlay for sterile processing of the ultrasonic surgical instrument.
The sonotrode is configured to be connected to an ultrasonic transducer which makes the sonotrode vibrate. The connection between the sonotrode and the ultrasonic transducer is regularly established by way of the proximal end of the sonotrode, for example by virtue of the proximal end being inserted in a relevant receptacle. In order to enable this, the attachment piece is preferably at a distance from the proximal end of the sonotrode. The channel openings preferably have a distance from the proximal end of the sonotrode. Preferably, the channel openings and the attachment piece have substantially the same distance from the proximal end of the sonotrode. The distance is preferably selected in such a way that the channel openings are arranged in the vicinity of a vibration node of the sonotrode. A vibration node of the sonotrode denotes such a region of the sonotrode that is deflected as little as possible by the ultrasonic vibrations of the sonotrode. Channel openings arranged at this location lead to a small impairment of the vibration property of the sonotrode. Moreover, the connection stability between an attachment piece arranged in the vicinity of a vibration node and the sonotrode is impaired as little as possible by the ultrasonic vibrations. The distance between the channel openings and the sonotrode can be greater than 20%, preferably greater than 35% and more preferably approximately 50% of the length of the sonotrode.
The vibration property of the sonotrode depends on the design of the channel. It was found that it is advantageous for the vibration property of the sonotrode if the channel within the sonotrode is embodied substantially symmetrically relative to the vibration axis. The channel may comprise a main channel which, at least in sections, extends coaxially to the longitudinal axis of the shaft. Moreover, the channel may comprise a channel section which extends from the longitudinal axis of the sonotrode to the channel opening in the lateral surface. The channel portion can extend in a straight line. Preferably, provision is made for the channel section to include a right angle with the longitudinal axis of the shaft. Embodiments in which the channel section includes an angle with the longitudinal axis that is different from 90° are also comprised.
Preferably, a plurality of channel openings are provided in the lateral surface of the sonotrode. It is particularly advantageous for the channel openings to be arranged symmetrically around the longitudinal axis of the shaft. In this case, the term “symmetrical arrangement around the longitudinal axis” comprises an axial symmetry in relation to the longitudinal axis in the mathematical sense. However, furthermore, a rotational symmetry around the longitudinal axis about a specific angle is also comprised. The channel openings are then distributed uniformly around the longitudinal axis such that, after a rotation of the sonotrode around the longitudinal axis thereof about a specific angle, a channel opening respectively assumes the position which the adjacent channel opening had prior to the rotation.
Preferably, the channel sections which extend from the channel openings in the direction of the longitudinal axis of the shaft are arranged symmetrically in the aforementioned sense around the longitudinal axis of the sonotrode. By way of example, provision can be made for three channel openings to be provided, which are respectively offset by an angle of 120° in the circumferential direction. Disadvantageous effects on the vibration property of the sonotrode are avoided as a result of the symmetric arrangement of the channel openings and the channel sections leading to the channel openings. Preferably, the channel sections are formed by drilling.
During use, the ultrasonic surgical instrument is usually guided by a user and moved in any direction. Here, a secure connection between the attachment piece and the sonotrode is important. The attachment piece preferably encloses the sonotrode about the longitudinal axis thereof. Enclosing the sonotrode about the longitudinal axis thereof constitutes a simple type of connection, in which forces between the attachment piece and the sonotrode, which occur as a result of the movement of the sonotrode, can be absorbed in the radial direction. By way of example, the forces acting on the attachment piece in the longitudinal direction can be absorbed by way of frictional engagement with the sonotrode.
Preferably, provision is made for a sealing element which is arranged between the attachment piece and the sonotrode. A sealing element between the attachment piece and the sonotrode ensures a liquid-tight connection there. A liquid which enters the attachment piece from a tube by way of the liquid connector is therefore prevented from emerging in an unwanted manner. In order to prevent slippage of the sealing element relative to the sonotrode, the sealing element preferably engages in a groove situated in the lateral surface of the sonotrode. Preferably, two sealing elements are arranged between the attachment piece and the sonotrode such that the sealing elements enclose the channel opening therebetween. There can be frictional engagement between the attachment piece and the sealing element, by means of which the attachment piece is held on the sonotrode. Additional fastening means between the attachment piece and the sonotrode can then be dispensed with such that the attachment piece can easily be detached from the sonotrode and connected therewith. However, additional fastening means are not precluded.
The attachment piece and the two sealing elements preferably include a cavity therebetween, into which cavity the channel opening opens. The cavity can extend around the sonotrode. Preferably, the cavity extends as an annular space around the sonotrode. A liquid which reaches the attachment piece through the liquid connector can then spread in the annular space around the sonotrode. The liquid connector can be directed to the channel opening in order to enable a direct passage into the channel opening. However, provision can also be made for the liquid connector not to be directed to the channel opening. What is also ensured in this case is that a liquid which is guided into the attachment element is able to flow onward into the channel opening via the cavity.
Preferably, the liquid connector of the attachment piece is displaceable in the circumferential direction around the sonotrode. The liquid connector can then be brought into any angular position relative to the sonotrode. What is ensured in all angular positions is that the liquid can reach the channel opening since the annular space extends around the sonotrode in the circumferential direction and the channel opening opens into the annular space. The free adjustability of the angular position of the liquid connector and a liquid line connected thereto renders ideal operation of the ultrasonic surgical instrument possible for a user. The user can select the angular position in such a way that a connected tube interferes as little as possible during the procedure.
A mechanism, by means of which the alignment of the liquid connector can be set, can be provided within the attachment piece. In an advantageous embodiment, the attachment piece is designed in such a way that it can be rotated as a whole relative to the sonotrode. By way of example, this can be achieved by virtue of the frictional engagement between the attachment piece and the sonotrode being designed in such a way that it can be overcome by manual force. The sliding surface between the attachment piece and the sonotrode is preferably cylindrical.
In order to ease cleaning and sterilization of the sonotrode, the attachment piece is preferably connected to the sonotrode in a detachable manner. The attachment piece can then be detached from the sonotrode prior to cleaning and sterilization. The attachment piece can be a disposable article. Alternatively, the attachment piece is likewise sterilized and subsequently reconnected to the sonotrode.
Provision can be made for a liquid line, for example a tube, to be connectable to the liquid connector of the attachment piece with the aid of a plug-in connection. Alternatively, the liquid line can also be securely connected to the liquid connector of the attachment piece.
The sonotrode preferably consists of metal. The sonotrode can be configured as a turned part or, alternatively, as a milled part.
The subject matter of the invention moreover relates to an ultrasonic surgical instrument which comprises a sonotrode according to the invention and a handpiece. The handpiece is configured in a manner connectable to the sonotrode. The sonotrode is coupled to an ultrasonic transducer of the handpiece. When the attachment piece of the sonotrode is at a distance from the proximal end of the sonotrode, the proximal end can be inserted into the handpiece.
Below, a preferred embodiment of the invention is described in an exemplary manner with reference to the attached drawings. In detail:
An ultrasonic surgical instrument in
An ultrasonic transducer 3 is situated within the handpiece 2. The ultrasonic transducer 3 converts an electric AC voltage signal, obtained by a signal generator not depicted in
In order to remove the ablated tissue, a rinsing liquid can be supplied by way of a tube 8. The tube 8 is inserted into a liquid connector of an attachment piece 9. The attachment piece encloses the sonotrode 1 in a circular fashion. The attachment piece 9 is at a distance from the proximal end 17 of the sonotrode 1 so that the proximal part 17 of the sonotrode 1 can be used for establishing the screwed connection to the handpiece 2 without the attachment piece 9 being obstructive in the process.
Two sealing rings 10 and 11 are arranged between the sonotrode 1 and the attachment piece 9. The sealing rings 10, 11 are fastened to the sonotrode 1 by frictional engagement and they enclose the sonotrode 1 in a circular fashion. Here, the sealing rings 10, 11 respectively engage in a groove 21, 22. The grooves 21, 22 are let into the lateral surface of the sonotrode 1 in a circular fashion. Moreover, the attachment piece 9 is connected by way of frictional engagement with the sealing rings 10, 11. The sealing rings 10, 11 enclose an annular cavity 14 between them and the attachment piece 9. The attachment piece 9 and the annular cavity 14 are arranged in the region of channel openings 12, 13 which are situated in the lateral surface of the sonotrode 1. Hence, the channel openings 12, 13 open into the cavity 14. A channel section 15 respectively extends from the channel openings 12, 13 to a main channel 16. The two channel sections 15 meet the main channel 16 perpendicularly. The main channel 16 extends along the longitudinal axis of the sonotrode up to the outlet opening 7 arranged at the distal end.
A rinsing liquid supplied through the tube 8 can spread in the annular space 14 through the attachment piece 9. As a result of the connection between the annular space 14 and the channel sections 15 by way of the channel openings 12, 13, the rinsing liquid can then flow into the main channel 16. At the distal end, the rinsing liquid emerges by way of the outlet opening 7 and it can remove ablated tissue in the treated area by way of cavitation.
In the embodiment shown in
Number | Date | Country | Kind |
---|---|---|---|
10 2013 214 944.1 | Jul 2013 | DE | national |
Filing Document | Filing Date | Country | Kind |
---|---|---|---|
PCT/EP2014/065609 | 7/21/2014 | WO | 00 |