The present invention relates to an ultrasonic treatment tool and an endoscope system.
In a medical field, it is known that various treatments are performed on a subject by using an ultrasonic treatment tool that generates ultrasonic vibration. WO2019/055870A discloses an ultrasonic treatment tool comprising a pair of grip parts for gripping a structure such as a blood vessel and an ultrasound oscillator (ultrasonic transducer), and configured to transmit ultrasonic vibration through the grip parts and to perform a treatment such as sealing or incision of the blood vessel or the like. The ultrasound oscillator is composed of various devices such as a piezoelectric material, and converts supplied power into ultrasonic vibration.
In the ultrasonic treatment tool as disclosed in WO2019/055870A, there is a need to raise a temperature of the grip part in a short time to about 60° C. to 90° C., which is a denaturation temperature of a protein or the like, in order to seal the blood vessel or the like gripped by the grip parts. In order to raise the temperature of the grip part in a short time, each device in the ultrasonic transducer needs to be supplied with as much power as possible.
However, the power supplied to the ultrasound oscillator is not all converted into ultrasonic vibration, but some of the power is converted into heat generation due to an inefficient transmission of vibration and heat generation due to a dielectric loss. In a case in which a proportion of power that is converted to anything other than ultrasonic vibration, particularly to heat generation, in the supplied power is large, a temperature of the device itself increases excessively while the ultrasound oscillator is being driven, which may cause failure or degradation of the ultrasound oscillator, such as loss of piezoelectricity due to depolarization of the piezoelectric material, or deterioration of an acoustic matching layer.
An object of the present invention is to provide an ultrasonic treatment tool and an endoscope system with which it is possible to improve an efficiency of transmitting ultrasonic vibration to a structure such as a blood vessel and absorbing the ultrasonic vibration by the structure, and to suppress a temperature rise of a device by increasing an efficiency of conversion into ultrasonic vibration with respect to supplied power.
An ultrasonic treatment tool according to an aspect of the present invention comprises: a grip part; and an ultrasound oscillator, in which a piezoelectric material constituting the ultrasound oscillator has a mechanical quality coefficient of 500 or more. The grip part is provided at a distal end portion of the ultrasonic treatment tool and grips a structure in a subject. The ultrasound oscillator is provided in the grip part and disposed at a position facing the structure gripped by the grip part.
It is preferable that a direction of ultrasonic vibration by the ultrasound oscillator is parallel to a gripping direction of the grip part.
It is preferable that the ultrasound oscillator is driven by an AC voltage signal having a frequency of which a difference from a resonance frequency corresponding to a thickness dimension of the piezoelectric material is within 20%. It is preferable that an AC voltage signal for driving the ultrasound oscillator is continuously supplied.
It is preferable that the piezoelectric material is lead zirconate titanate.
It is preferable that the grip part grips a blood vessel as the structure. It is preferable that the ultrasonic treatment tool is an endoscope treatment tool that is inserted into the subject through a forceps channel of an endoscope.
It is preferable that the grip part, the ultrasound oscillator, a tubular flexible sheath, an operation wire provided integrally with the grip part and inserted through the flexible sheath, and an operating part provided at a base end portion of the flexible sheath are provided.
It is preferable that the grip part includes a pair of gripping pieces that grips the structure, at least one of the gripping pieces being provided with the ultrasound oscillator.
An endoscope system according to an aspect of the present invention comprises: the ultrasonic treatment tool described above; a power supply device that outputs an AC voltage signal for driving the ultrasound oscillator; and an endoscope having a forceps channel.
According to the present invention, it is possible to improve an efficiency of transmitting ultrasonic vibration to a structure such as a blood vessel and absorbing the ultrasonic vibration by the structure, and to suppress a temperature rise of a device by increasing an efficiency of conversion into ultrasonic vibration with respect to supplied power.
As shown in
The endoscope 12 is optically connected to the light source device 14 and electrically connected to the processor device 15. The endoscope 12 includes an insertion part 12a to be inserted into a subject, an operating part 12b provided at a base end portion of the insertion part 12a, a bendable part 12c provided on a distal end side of the insertion part 12a, and a distal end portion 12d. By operating an angle knob 12e of the operating part 12b, the bendable part 12c is bent. As a result, the distal end portion 12d is directed in a desired direction. In addition to the angle knob 12e, a forceps port 21 (see
An observation window and an illumination window are provided on a distal end surface of the distal end portion 12d, although not shown. An image sensor (not shown) or the like is disposed on the inside of the observation window, and an optical fiber cable (not shown) is disposed on the inside of the illumination window. A signal line of the image sensor and the optical fiber cable are connected to the processor device 15 and the light source device 14, respectively.
The processor device 15 is electrically connected to the display 16 and the keyboard 17. The processor device 15 performs image processing or the like on an endoscopic image captured by the image sensor and displays the processed image on the display 16.
As shown in
The ultrasonic treatment tool 18 is an endoscope treatment tool to be inserted into a subject together with the insertion part 12a through the forceps channel 23. In the present embodiment, the ultrasonic treatment tool 18 is mentioned as the endoscope treatment tool to be combined with the endoscope 12, but, in practice, the present invention is not limited to this, and treatment tools such as biopsy forceps, snares, or electric scalpels are also combined with the endoscope 12.
The ultrasonic treatment tool 18 comprises a flexible sheath 31, an operation wire 32 (see
The operating part 35 comprises an operating part main body 36 and a slider 37 that is slidably supported by the operating part main body 36. The operating part main body 36 is installed consecutively to a base end portion of the flexible sheath 31. The operating part main body 36 is provided with a finger hook portion 36A, a cylindrical portion 36B, and a connector portion 36C. The cylindrical portion 36B extends in a direction parallel to an axial direction of the flexible sheath 31. The slider 37 is engaged with the cylindrical portion 36B and slidably moves along the cylindrical portion 36B in the axial direction of the flexible sheath 31. In a case in which a patient is treated, a thumb of a user is hooked on the finger hook portion 36A, and an index finger and a middle finger of the same user are hooked on the slider 37. A base end of the operation wire 32 is fixed to the slider 37. Therefore, the operation wire 32 is pushed and pulled in the flexible sheath 31 in the axial direction with the sliding movement of the slider 37. The connector portion 36C is electrically connected to the ultrasonic power supply device 19 as described below.
As shown in
The link mechanism 42 comprises a link plate 42A, a connecting pin 42B, and a fitting pin 42C. One end portion of the link plate 42A is connected to the pair of gripping pieces 41 via the connecting pin 42B. A position at which the pair of gripping pieces 41 is connected to the link plate 42A is a base end portion of the gripping pieces 41, which is located on a base end side with respect to the support shaft 41B. The other end portion of the link plate 42A is connected to a connecting member 32A provided at a distal end of the operation wire 32 via the fitting pin 42C. The fitting pin 42C rotatably connects the link plate 42A to the connecting member 32A.
The connecting member 32A is formed in a cylindrical shape. The connecting member 32A is partially located inside the flexible sheath 31 through a through-hole 43A formed in the support member 43. The support member 43 is formed in a substantially cylindrical shape and is fixed to a distal end of the flexible sheath 31. The support member 43 has a notch 43B notched from a distal end thereof. Since the pair of gripping pieces 41 and the link plate 42A move inside the notch 43B, the support member 43 does not hinder the movement of the gripping pieces 41 and the link plate 42A.
The link mechanism 42 converts a linear motion caused by the pushing-pulling operation of the operation wire 32 into a rotational motion, and opens and closes the gripping pieces 41. That is, in a case in which the slider 37 is pulled toward the finger hook portion 36A, the gripping pieces 41 are closed to close the grip part 33 as shown in
As shown in
The ultrasound oscillator 51 is composed of a piezoelectric material 54 (also referred to as a piezoelectric element) and electrodes 56 and 57. The piezoelectric material 54 is formed in a plate shape. The electrodes 56 and 57 are formed in a plate shape thinner than the piezoelectric material 54, and are laminated on both surfaces of the piezoelectric material 54. The ultrasound oscillator 51 is disposed in parallel to the inner surface 41A of the gripping piece 41. That is, the ultrasound oscillator 51 is disposed at a position facing a structure such as a blood vessel gripped by the grip part 33. In addition, a direction in which the ultrasound oscillator 51 vibrates is parallel to a direction in which the piezoelectric material 54 and the electrodes 56 and 57 are laminated. Accordingly, a direction of ultrasonic vibration by the ultrasound oscillator 51 is parallel to a gripping direction Y of the grip part 33.
As the piezoelectric material 54, a material having a mechanical quality coefficient Qm of 500 or more is used. The mechanical quality coefficient Qm is a coefficient representing an elasticity loss due to vibration, and is represented by a reciprocal of a mechanical loss coefficient. In a case in which the piezoelectric material 54 elastically vibrates, an internal loss occurs and is converted into heat.
Here, the characteristics of the piezoelectric material 54 will be described.
The piezoelectric material 54 has an elasticity loss as well as a dielectric loss. A phase difference of δm is also generated in strain with respect to stress caused by an AC electric field. There is a relationship of [Expression 2] between the phase difference δm due to the elasticity loss and the mechanical quality coefficient Qm.
Further, the mechanical quality coefficient Qm has a relationship of [Expression 3] between an equivalent capacitance C1, a resonance resistance R1, an angular frequency ωs, an equivalent inductance L1, a resonance impedance Zr, a capacitance C, a resonance frequency fr, and an anti-resonance frequency fa in the equivalent circuit of the piezoelectric material 54 in a case in which elasticity loss occurs.
In the scope of the present specification and claims, the mechanical quality coefficient Qm defined by [Expression 2] and [Expression 3] is used. The magnitude of the mechanical quality coefficient Qm affects the sharpness of mechanical vibration at the resonance frequency. In the piezoelectric material 54 having a high mechanical quality coefficient Qm, a value of the dielectric loss tan δ that causes heat generation is small, and deterioration of the polarization state is less likely to occur.
That is, in a case in which the mechanical quality coefficient Qm is low, a high vibration velocity cannot be obtained because vibration causes heat generation, but, in a case in which the mechanical quality coefficient Qm is high, a loss is small inside the piezoelectric material 54. That is, it is possible to efficiently convert the supplied power into ultrasonic vibration. Accordingly, in the piezoelectric material 54 having a high mechanical quality coefficient Qm, heat generation is less likely to occur even in a case in which the piezoelectric material 54 vibrates with large power, and a high vibration velocity can be obtained.
As the piezoelectric material 54, lead zirconate titanate (PZT) is preferably used. The piezoelectric material 54 is not limited to this, as long as it is a piezoelectric material having a high mechanical quality coefficient Qm, for example, hard piezoelectric ceramics other than PZT may be used.
The electrodes 56 and 57 are connected to the connector portion 36C of the operating part 35 via a signal cable (not shown). The signal cable is wired along an inner peripheral surface or an outer peripheral surface of the flexible sheath 31, for example. In a case in which the ultrasonic power supply device 19 is connected to the connector portion 36C, the electrodes 56 and 57 are electrically connected to the ultrasonic power supply device 19 via the signal cable and the connector portion 36C. Of the electrodes 56 and 57, one is connected to the ground via the signal cable or the like, and the other is supplied with power of an AC voltage signal, which is described below, from the ultrasonic power supply device 19.
The acoustic matching layer 53 is provided to achieve acoustic impedance matching between a human body of a patient and the ultrasound oscillator 51. The acoustic matching layer 53 is disposed outside the ultrasound oscillator 51, and strictly speaking, as shown in
Since the acoustic matching layer 53 is provided, it is possible to increase a transmittance of the ultrasonic wave. As a material of the acoustic matching layer 53, various organic materials whose acoustic impedance values are closer to that of the human body of the patient than the piezoelectric material of the ultrasound oscillator 48 can be used. Specific examples of the material of the acoustic matching layer 53 include epoxy resin, silicone rubber, polyimide, and polyethylene. In addition, the acoustic matching layer 53 is formed of a plurality of layers, and the material and the number of formed layers are appropriately selected according to a required acoustic impedance value.
The backing material layer 52 supports the ultrasound oscillator 51 from a back side (a side opposite to the acoustic matching layer 53). A backing material is made of, for example, a rigid material such as hard rubber. In addition, an air gap layer 58, that is, a gap interposed between the backing material layer 52 and the ultrasound oscillator 51 is formed between the backing material layer 52 and the ultrasound oscillator 51. Since the air gap layer 58 can reflect the ultrasonic wave by internal air, it has a function of reflecting the ultrasonic wave emitted from the back side of the ultrasound oscillator 51. Accordingly, the ultrasonic vibration can be efficiently transmitted to a structure such as a blood vessel S. Note that the present invention is not limited to this, and the backing material layer 52 may be filled with a material for reflecting the ultrasonic wave without providing the air gap layer 58.
As shown in
The signal transmitter 61 outputs an AC voltage signal having a frequency in a predetermined range and a waveform of a sin wave. The frequency in a predetermined range is a frequency of which a difference from a resonance frequency of the piezoelectric material 54 is within 20%. The piezoelectric material 54 has a resonance frequency corresponding to a thickness dimension, and specifically, assuming that the thickness dimension is D1 (m), a resonance frequency corresponding to the thickness dimension D1 is f (Hz), and a sound velocity of the piezoelectric material 54 (a velocity of a sound wave transmitted through the piezoelectric material 54) is v (m/sec), a relationship of D1 = v/2f is obtained.
In order to supply power to a pair of the ultrasound oscillators 51, the amplifier 62 and the impedance matching circuit 63 are provided for each ultrasound oscillator 51. The signal transmitter 61 outputs AC voltage signals having the same frequency and the same waveform to the amplifiers 62, respectively. The amplifier 62 amplifies the AC voltage signal output from the signal transmitter 61 to a voltage at a level at which the ultrasound oscillator 51 can be driven. The impedance matching circuit 63 is connected in series with the amplifier 62, and can match an input impedance of the AC voltage signal output from the amplifier 62 with an impedance of the ultrasound oscillator 51.
The current probe 64 measures a current value to be input to the ultrasound oscillator 51 from the impedance matching circuit 63, and inputs the current value to the control unit 65. The control unit 65 controls the signal transmitter 61 such that the ultrasound oscillator 51 is driven at a frequency at which the current value measured by the current probe 64 peaks.
In the present embodiment, the control unit 65 first controls the signal transmitter 61 to scan and output the AC voltage signal within a frequency range in which a difference from the resonance frequency corresponding to the thickness dimension D1 of the piezoelectric material 54 described above is within 20%. Within the frequency range in which the scan-output is performed, the frequency at which the current value measured by the current probe 64 peaks is detected, and thereafter, the ultrasound oscillator 51 is driven at the peak frequency.
In addition, the control unit 65 controls the signal transmitter 61 to continuously supply the AC voltage signal for driving the ultrasound oscillator 51. The term “continuously supply” as used herein means that the AC voltage signal is continuously output from the signal transmitter 61 without interruption at least during the driving of the ultrasound oscillator 51.
An operation in a case in which a doctor who is a user performs a treatment with the ultrasonic treatment tool 18 using the endoscope system 1 will be described. First, the doctor inserts the insertion part 12a of the endoscope 12 into a body of a patient, which is a subject, and observes an endoscopic image captured by an image sensor to discover, for example, a position of a blood vessel S (see
While observing the endoscopic image captured by the image sensor of the endoscope 12, the doctor makes the ultrasonic treatment tool 18 protrude from the forceps outlet 22 and operates the operating part 35 to open the grip part 33. Accordingly, the position of the pair of gripping pieces 41 can be aligned with a position at which the blood vessel S is interposed (state shown in
Next, the operating part 35 is operated to rotate the gripping pieces 41 from an opened position to a closed position to grip the blood vessel S (state shown in
As described above, since the piezoelectric material 54 constituting the ultrasound oscillator 51 has a mechanical quality coefficient Qm of 500 or more, heat generation is less likely to occur in the piezoelectric material 54 even in a case in which the piezoelectric material 54 vibrates with large power, thereby making it possible to obtain a high vibration velocity. That is, it is possible to improve an efficiency of transmitting the ultrasonic vibration to the structure such as the blood vessel S and absorbing the ultrasonic vibration by the structure, and to raise a temperature of the blood vessel S in a short time to about 60° C. to 90° C., which is a denaturation temperature of a protein or the like. Accordingly, a treatment such as sealing or incision of the blood vessel S can be easily performed. Further, since the piezoelectric material 54 can efficiently perform conversion into ultrasonic vibration with respect to the supplied power, a temperature rise of the piezoelectric material 54 itself, which is a device, can be suppressed, thereby preventing failure or deterioration of the ultrasound oscillator 51.
In addition, in the present embodiment, since the direction of the ultrasonic vibration V and the gripping direction Y of the grip part 33 are parallel to each other, it is possible to further improve the efficiency of transmitting the ultrasonic vibration V by the ultrasound oscillator 51 to a structure such as a blood vessel and absorbing the ultrasonic vibration V by the structure. In addition, since the ultrasound oscillator 51 is driven by the AC voltage signal having a difference of which a difference from the resonance frequency of the piezoelectric material 54 is within 20%, it is possible to drive the ultrasound oscillator 51 with larger power, thereby obtaining a high vibration velocity.
Hereinafter, verification results for verifying the effects of the present invention will be described. The verification was performed by comparing the piezoelectric material of Examples 1 to 4, which has the mechanical quality coefficient Qm of 500 or more applied to the present invention, with the piezoelectric material of Comparative Examples 1 and 2, which does not have the mechanical quality coefficient Qm of 500 or more applied to the present invention, as the piezoelectric material 54 used for the ultrasound oscillator 51. Table 1 shows the type of the piezoelectric material, the mechanical quality coefficient Qm, and the ultrasonic intensity retention rate in Examples 1 to 4 and Comparative Examples 1 and 2. The piezoelectric materials used in Examples 1 to 4 and Comparative Examples 1 and 2 are piezoelectric ceramics manufactured by Fuji Ceramics Corporation, each of which has a different material. In addition, the ultrasonic intensity retention rate is a ratio of an ultrasonic intensity (proportional to the vibration velocity) in an initial state in which the ultrasound oscillator was driven to an ultrasonic intensity measured after the driving for a certain period of time.
As shown in Table 1, in Examples 1 to 4 in which the mechanical quality coefficient Qm applied to the present invention is 500 or more, the ultrasonic intensity retention rate is high (ultrasonic intensity retention rate is 75% or more). That is, even in a case in which the ultrasound oscillator composed of the piezoelectric material of Examples 1 to 4 is driven, since the loss is small inside the piezoelectric material, the temperature rise of the device itself is less likely to occur, and the deterioration or the like is less likely to occur, so that a favorable performance can be obtained in that the ultrasound oscillator 51 can be driven with large power.
On the other hand, in Comparative Examples 1 and 2 in which the mechanical quality coefficient Qm applied to the present invention is not 500 or more, the ultrasonic intensity retention rate is low (ultrasonic intensity retention rate is 40% or less). That is, in a case in which the ultrasound oscillator composed of the piezoelectric material of Comparative Examples 1 and 2 is driven, since the loss is large inside the piezoelectric material, the temperature of the device itself tends to rise, which may cause deterioration or the like.
From the above description, it has been confirmed that the ultrasonic treatment tool 18 having a favorable performance can be obtained by carrying out the present invention.
In the above-described embodiment, the ultrasound oscillator 51 is provided on both of the pair of gripping pieces 41 constituting the grip part 33, and the ultrasonic vibration is transmitted to the structure from the both ultrasound oscillators 51, but the present invention is not limited to this, and the ultrasound oscillator 51 may be provided only on any one of the pair of gripping pieces 41 constituting the grip part 33. In this case, it is preferable that the ultrasound oscillator 51 is disposed parallel to the inner surface 41A of one gripping piece 41, and that the inner surface 41A of the other gripping piece 41 facing the ultrasound oscillator 51 is formed of a material for reflecting the ultrasonic vibration by the ultrasound oscillator 51.
In addition, in the above-described embodiment, the endoscope 12 to be combined with the ultrasonic treatment tool of the embodiment of the present invention is not specified, and the endoscope 12 need only comprise a forceps channel into which the treatment tool is inserted, for example, a bronchoscope, an upper gastrointestinal endoscope, or a lower gastrointestinal endoscope.
Number | Date | Country | Kind |
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2020-173294 | Oct 2020 | JP | national |
This application is a Continuation of PCT International Application No. PCT/JP2021/038094 filed on 14 Oct. 2021, which claims priority under 35 U.S.C §119(a) to Japanese Patent Application No. 2020-173294 filed on 14 Oct. 2020. The above application is hereby expressly incorporated by reference, in its entirety, into the present application.
Number | Date | Country | |
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Parent | PCT/JP2021/038094 | Oct 2021 | WO |
Child | 18299775 | US |