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WO2008012357A1 - Instruments de découpe pour chirurgie par ultrasons - Google Patents

Instruments de découpe pour chirurgie par ultrasons Download PDF

Info

Publication number
WO2008012357A1
WO2008012357A1 PCT/EP2007/057756 EP2007057756W WO2008012357A1 WO 2008012357 A1 WO2008012357 A1 WO 2008012357A1 EP 2007057756 W EP2007057756 W EP 2007057756W WO 2008012357 A1 WO2008012357 A1 WO 2008012357A1
Authority
WO
WIPO (PCT)
Prior art keywords
tang
surgical instrument
length
instrument
khz
Prior art date
Application number
PCT/EP2007/057756
Other languages
English (en)
Inventor
Cornelio Blus
Original Assignee
Cornelio Blus
Priority date (The priority date 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 date listed.)
Filing date
Publication date
Application filed by Cornelio Blus filed Critical Cornelio Blus
Publication of WO2008012357A1 publication Critical patent/WO2008012357A1/fr

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/32—Surgical cutting instruments
    • A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/32—Surgical cutting instruments
    • A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
    • A61B2017/320072—Working tips with special features, e.g. extending parts

Definitions

  • the present invention relates to cutting instruments to be used in ultrasonic surgery for cutting flesh and the like, such as mucosa, skin, vessels, cysts, tumoral tissues, gingival tissues, etc. and cartilage.
  • the instruments according to the invention are intended for use, particularly but not exclusively, in the fields of orthopaedic surgery, otorhinolaringologic surgery, dentistry, neurosurgery, maxillofacial surgery, vascular surgery, cosmetic surgery and veterinary surgery.
  • figures 1 and 2 are a perspective view and a side view, respectively, of a first embodiment of a surgical cutting instrument according to the invention
  • figure 3 is a side view of a second embodiment of an instrument according to the invention
  • figure 4 is a perspective view schematically showing an apparatus for vibrating the instruments of figures 1 to 3 at ultrasonic frequencies
  • figure 5 schematically shows a control panel of the apparatus of figure 4.
  • a first embodiment of a surgical instrument for ultrasonic bone surgery according to the invention (figures 1 and 2) is indicated as a whole at 10.
  • the instrument 10 consisting of an elongate body made of titanium alloy, preferably titanium grade 5 alloy, extends along a central axis x having a succession of straight and curved lengths lying in a plane herein defined "vertical".
  • the instrument 10 comprises a proximal length or locking tang 11 of rectilinear shape, a thin, straight distal length 12 with a sharp cutting end 13 and an intermediate length 14 which includes two successive curved portions with respective concavities facing opposite directions, as described hereinafter.
  • the tang 11 substantially cylindrical and having an increased diameter with respect to that of the distal length 12, is adapted to be clamped or screwed or otherwise steadily mounted onto a cylindrical handpiece M (shown only in part in figures 1 to 3) that the surgeon will grip.
  • the handpiece M is part of a medical ultrasonic apparatus which electrically supplies a set of piezoelectric transducers housed in the handpiece, so as to vibrate the instrument 10 at a frequency in the ultrasonic range.
  • the constructional and functional features of the aforementioned apparatus are not per se relevant for the understanding of the invention and will not therefore be described in detail. Suffice it here to say that said apparatus allows to adjust the input power and the frequency of the vibrations imparted to the instrument.
  • FIG 4 shows by way of example an ultrasonic apparatus A with a handpiece M connected through a cable C.
  • Indicated F is a flowmeter for measuring the flow rate of a cooling physiological solution supplied by means of a peristaltic pump P.
  • Apparatus A is equipped with an on/off foot pedal B and a control panel CP (figure 5) comprised of keys 1, 2, 3 for selecting frequency channels as a function of the type of instrument being used, keys 4, 5, 6 for adjusting the flow rate supplied by the pump P, a knob 8 for selecting the frequency of the instrument mounted on the handpiece.
  • CP figure 5)
  • keys 1, 2, 3 for selecting frequency channels as a function of the type of instrument being used
  • keys 4, 5, 6 for adjusting the flow rate supplied by the pump P
  • a knob 8 for selecting the frequency of the instrument mounted on the handpiece.
  • Keys Bl and B2 allow to select the power level supplied to the handpiece M, whereas displays Dl and D2 show the selected power and flow rate levels. A further display D3 shows the time the apparatus has been used. It can be reset by a key 9. Vibrations are transmitted to the tang 11 in form of pulses along the axis x and are propagated and amplified through the intermediate length 14 and transmitted to the distal length 12 and the cutting end 13 that is brought in contact with the biological tissue to cut.
  • the intermediate and distal lengths 14 and 12 are progressively flattened and get thinner when measured in directions yl, y2 which are perpendicular, in each point, to the central axis x and lie in the aforesaid vertical plane.
  • the intermediate length 14 has a first curved portion 14a with its concavity directed upwardly in the vertical plane, a second curved portion 14b with a downwardly facing concavity radiused to the distal length 12 so that the latter is inclined (at an angle ⁇ of about 45°-70°) with respect to the tang 11.
  • the bending radius of the first curved portion 14a is definitely greater than that of the second curved portion 14b.
  • the intermediate length 14 has a straight portion 14c, substantially aligned with the tang 11 and connecting the first curved portion 14a with the tang.
  • the thickness S 1 as measured in direction y at the junction between the tang 11 and the intermediate length 14, ranges between 2.0 and 3.0 mm, whereas the thickness S2 of distal length 12 near the sharp cutting end 13 is preferably ranging between 0.4 and 0.6 mm.
  • the overall length of the instrument, without the tang, is preferably of about 30 mm.
  • the instrument shown in figures 3 differs from that of figures 1 and 2 in the orientation of the blades of the sharp cutting end 13, which lie in a vertical plane instead of an inclined plane perpendicular to said vertical plane.
  • the instruments of the present invention when used in the aforesaid operational conditions, cut the flesh without causing appreciable bleeding, by causing the cut blood vessels to close temporarily.
  • This result controverts the opinion, widespread in the medical field, that the ultrasonic technique, widely used in bone surgery, does not cause cuts in the flesh.
  • the instruments of the present invention have proven to operate practically as an electrosurgical knife since almost no bleeding occurs, but with the advantage of not burning, and therefore not necrotizing, the flesh being cut.
  • Another advantageous aspect of the invention is that the cut resulting from the use of an instrument according to the invention is particularly accurate and thin.
  • the invention is not intended to be limited to the embodiments described and illustrated herein, which should be considered as examples of a surgical cutting instrument. Rather, the invention may be modified with regard to constructional and functional details, particularly concerning the shape of the sharp cutting end and the orientation of its blade (or blades) which, depending on the specific use the instrument is intended for, may indifferently be straight or saw -toothed, with one or two straight or curved blades, etc.

Landscapes

  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Mechanical Engineering (AREA)
  • Biomedical Technology (AREA)
  • Dentistry (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)
  • Dental Tools And Instruments Or Auxiliary Dental Instruments (AREA)

Abstract

Un instrument chirurgical (10) est capable de découper de la chair et du cartilage par vibration à des fréquences ultrasonores comprises entre 23kHz et 36kHz. L'instrument comprend un corps en alliage de titanium constitué d'un tenon droit (11), d'une longueur distale droite (12) possédant une extrémité libre acérée (13) et d'une longueur intermédiaire (14) située entre le tenon (11) et la longueur distale (12). La longueur intermédiaire comporte deux parties recourbées successives (14a, 14b) dont les concavités se font face dans deux directions opposées perpendiculaires à un axe central (x) de l'instrument. Les longueurs intermédiaire (14) et distale (12) sont aplaties progressivement et s'affinent depuis le tenon (11) jusqu'à l'extrémité (13).
PCT/EP2007/057756 2006-07-27 2007-07-27 Instruments de découpe pour chirurgie par ultrasons WO2008012357A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
ITTO20060558 ITTO20060558A1 (it) 2006-07-27 2006-07-27 Punte taglienti per chirurgia ad ultrasuoni
ITTO2006A000558 2006-07-27

Publications (1)

Publication Number Publication Date
WO2008012357A1 true WO2008012357A1 (fr) 2008-01-31

Family

ID=38556347

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/EP2007/057756 WO2008012357A1 (fr) 2006-07-27 2007-07-27 Instruments de découpe pour chirurgie par ultrasons

Country Status (2)

Country Link
IT (1) ITTO20060558A1 (fr)
WO (1) WO2008012357A1 (fr)

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP2119403A1 (fr) * 2008-05-16 2009-11-18 Cornelio Blus Ostéotome pour la chirurgie osseuse par ultrasons, en particulier pour la chirurgie maxillofaciale, dentaire et orthopédique
US9375230B2 (en) 2011-03-30 2016-06-28 Covidien Lp Ultrasonic surgical instruments
US10729458B2 (en) 2011-03-30 2020-08-04 Covidien Lp Ultrasonic surgical instruments

Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US2984241A (en) 1958-11-06 1961-05-16 Esar R Wren Powered osteotome
US4188952A (en) 1973-12-28 1980-02-19 Loschilov Vladimir I Surgical instrument for ultrasonic separation of biological tissue
DE3507672A1 (de) * 1985-03-05 1986-09-11 Otto 6900 Heidelberg Meyer Instrument mit chirurgischem werkzeug zum durchtrennen oder naehen von geweben
EP0238667A1 (fr) 1985-09-20 1987-09-30 Sumitomo Bakelite Company Limited Instrument a ultrasons pour interventions chirurgicales
US5318570A (en) * 1989-01-31 1994-06-07 Advanced Osseous Technologies, Inc. Ultrasonic tool
WO2003086223A1 (fr) * 2002-04-12 2003-10-23 San Diego Swiss Machining, Inc. Instruments dentaires ultrasonores a microtube et leurs procedes d'utilisation

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US2984241A (en) 1958-11-06 1961-05-16 Esar R Wren Powered osteotome
US4188952A (en) 1973-12-28 1980-02-19 Loschilov Vladimir I Surgical instrument for ultrasonic separation of biological tissue
DE3507672A1 (de) * 1985-03-05 1986-09-11 Otto 6900 Heidelberg Meyer Instrument mit chirurgischem werkzeug zum durchtrennen oder naehen von geweben
EP0238667A1 (fr) 1985-09-20 1987-09-30 Sumitomo Bakelite Company Limited Instrument a ultrasons pour interventions chirurgicales
US5318570A (en) * 1989-01-31 1994-06-07 Advanced Osseous Technologies, Inc. Ultrasonic tool
WO2003086223A1 (fr) * 2002-04-12 2003-10-23 San Diego Swiss Machining, Inc. Instruments dentaires ultrasonores a microtube et leurs procedes d'utilisation

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP2119403A1 (fr) * 2008-05-16 2009-11-18 Cornelio Blus Ostéotome pour la chirurgie osseuse par ultrasons, en particulier pour la chirurgie maxillofaciale, dentaire et orthopédique
US9375230B2 (en) 2011-03-30 2016-06-28 Covidien Lp Ultrasonic surgical instruments
US10729458B2 (en) 2011-03-30 2020-08-04 Covidien Lp Ultrasonic surgical instruments

Also Published As

Publication number Publication date
ITTO20060558A1 (it) 2008-01-28

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