WO2015045199A1 - Ultrasonic probe, ultrasonic treatment tool and treatment system - Google Patents

Ultrasonic probe, ultrasonic treatment tool and treatment system Download PDF

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Publication number
WO2015045199A1
WO2015045199A1 PCT/JP2013/085122 JP2013085122W WO2015045199A1 WO 2015045199 A1 WO2015045199 A1 WO 2015045199A1 JP 2013085122 W JP2013085122 W JP 2013085122W WO 2015045199 A1 WO2015045199 A1 WO 2015045199A1
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WIPO (PCT)
Prior art keywords
treatment
exposed surface
vertical direction
ultrasonic
curved
Prior art date
Application number
PCT/JP2013/085122
Other languages
French (fr)
Japanese (ja)
Inventor
谷内　千恵
石川　学
莊平 植田
Original Assignee
オリンパスメディカルシステムズ株式会社
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Publication date
Application filed by オリンパスメディカルシステムズ株式会社 filed Critical オリンパスメディカルシステムズ株式会社
Priority to PCT/JP2013/085122 priority Critical patent/WO2015045199A1/en
Priority to PCT/JP2014/075459 priority patent/WO2015046347A1/en
Priority to JP2015516307A priority patent/JP5836540B2/en
Priority to EP14849531.0A priority patent/EP3050529A4/en
Priority to CN201480053226.6A priority patent/CN105578977A/en
Publication of WO2015045199A1 publication Critical patent/WO2015045199A1/en
Priority to US15/040,668 priority patent/US9662134B2/en

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Definitions

  • the present invention relates to an ultrasonic probe in which a treatment portion is provided at a distal end portion and the treatment portion treats a treatment target using transmitted ultrasonic vibration.
  • the present invention also relates to an ultrasonic treatment instrument including the ultrasonic probe and a treatment system including the ultrasonic treatment instrument.
  • Patent Document 1 discloses an ultrasonic treatment apparatus that cuts a treatment target such as a bone using ultrasonic vibration.
  • This ultrasonic treatment apparatus includes an ultrasonic probe that extends along the longitudinal axis and transmits ultrasonic vibration from the proximal direction to the distal direction.
  • a distal end portion of the ultrasonic probe is provided with a treatment portion that performs a treatment for cutting the treatment target using the transmitted ultrasonic vibration.
  • one direction perpendicular to the longitudinal axis is defined as a first vertical direction
  • a direction opposite to the first vertical direction is defined as a second vertical direction.
  • the treatment portion is provided with a curved protrusion that curves in the first vertical direction with respect to the longitudinal axis, and the curved protrusion protrudes in the first vertical direction.
  • a contact surface (contact portion) provided at the protruding end that is the first vertical direction end of the curved protruding portion is brought into contact with the treatment target.
  • the treatment target is shaved by longitudinally vibrating the treatment portion by ultrasonic vibration (vibrating in parallel with the longitudinal axis). As the treatment target is cut, the contact surface enters the first vertical direction with respect to the treatment target.
  • the treatment target is cut to a desired cutting depth.
  • the ultrasonic treatment apparatus of Patent Document 1 it is difficult for an operator to properly recognize the cutting depth of the treatment target while performing the treatment of cutting the treatment target. For this reason, in the treatment for cutting the treatment target, there is a possibility that the treatment target is cut deeper than the desired cutting depth.
  • the present invention has been made to solve the above-described problems, and the object of the present invention is to appropriately recognize the shaving depth of the treatment target by the operator in the treatment of cutting the treatment target using ultrasonic vibration.
  • An ultrasonic probe, an ultrasonic treatment tool, and a treatment system are provided.
  • an ultrasonic probe includes a probe body that extends along a longitudinal axis and transmits ultrasonic vibrations from a proximal direction to a distal direction, and the probe body A treatment unit that is provided on the distal direction side and performs treatment of a treatment target using ultrasonic vibrations transmitted through the probe main body, and includes an exposed surface and the transmitted super
  • the contact portion that treats the treatment target while invading in the intrusion direction toward the inside of the treatment target from the state in contact with the treatment target by sound wave vibration, and the direction opposite to the intrusion direction from the contact portion on the exposed surface
  • a treatment part provided with an indicator part provided on the side and formed with an indicator showing an intrusion amount of the contact part in the entry direction with respect to the treatment target.
  • an ultrasonic probe an ultrasonic treatment tool, and a treatment system in which a surgeon appropriately recognizes a cutting depth of a treatment target in a treatment of cutting the treatment target using ultrasonic vibration. it can.
  • FIG. 3 is a cross-sectional view schematically illustrating a configuration of a vibrator unit according to the first embodiment. It is the schematic which shows the structure of the ultrasonic probe which concerns on 1st Embodiment. It is a perspective view showing roughly the composition of the treatment part of the ultrasonic probe concerning a 1st embodiment. It is the schematic which shows the state which is shaving the treatment target in the treatment part which concerns on 1st Embodiment. It is the schematic which shows an example of the to-be-photographed image displayed on a display unit in the state which is shaving the treatment target in the treatment part which concerns on 1st Embodiment.
  • FIG. 1 is a diagram showing a treatment system 1 of the present embodiment.
  • the treatment system 1 is used for treatment of a joint J between a bone B1 and a bone B2, for example, at a shoulder, a knee, or the like.
  • the treatment system 1 includes an ultrasonic treatment device 2 and an arthroscopic device 100 that is an endoscope device.
  • the arthroscopic device 100 includes an arthroscope 101 that is an endoscope.
  • the arthroscope 101 includes an insertion part (arthroscope insertion part) 102 and a holding part (arthroscope holding part) 103.
  • the distal end portion of the insertion portion 102 is inserted into the joint space S.
  • One end of a universal cord 105 is connected to the holding unit 103.
  • the other end of the universal cord 105 is connected to an image processing unit 106 such as an image processor.
  • the image processing unit 106 is electrically connected to a display unit 107 such as a monitor.
  • An image sensor 108 is provided at the distal end of the insertion portion 102.
  • the image sensor 108 images a subject through an observation window (not shown).
  • the imaging element 108 is electrically connected to the image processing unit 106 via an imaging cable (not shown) that extends through the insertion unit 102, the holding unit 103, and the universal cord 105. Yes.
  • the image processing unit 106 performs image processing on the captured subject image. Then, the subject image that has undergone image processing is displayed on the display unit 107.
  • the arthroscopic device 100 is provided with a light source unit (not shown), and the light emitted from the light source unit is irradiated onto the subject.
  • the ultrasonic treatment apparatus 2 includes an ultrasonic treatment tool (handpiece) 3 and a power supply unit 6.
  • the ultrasonic treatment instrument 3 has a longitudinal axis C.
  • one of the two directions parallel to the longitudinal axis C is the distal direction (the direction of the arrow C1 in FIG. 1), and the direction opposite to the distal direction is the proximal direction (the direction of the arrow C2 in FIG. 1).
  • the ultrasonic treatment instrument 3 includes a transducer unit 11, a holding unit 12, a sheath 13, and an ultrasonic probe 15.
  • One end of a cable 5 is connected to the vibrator unit 11.
  • the other end of the cable 5 is connected to the power supply unit 6.
  • the holding unit 12 includes a cylindrical holding case 17 extending along the longitudinal axis C.
  • the vibrator unit 11 is inserted into the holding case 17 from the proximal direction side, and the sheath 13 is inserted into the holding case 17 from the distal direction side.
  • the sheath 13 is coupled to the transducer unit 11 inside the holding case 17.
  • the ultrasonic probe 15 is inserted through the sheath 13.
  • the ultrasonic probe 15 is connected to the transducer unit 11 inside the holding case 17.
  • An energy operation input button 18 that is an energy operation input unit is attached to the holding case 17. Further, the ultrasonic probe 15 protrudes from the distal end of the sheath 13 in the distal direction.
  • FIG. 2 is a diagram showing a configuration of the vibrator unit 11.
  • the transducer unit 11 includes a transducer case 21 and an ultrasonic transducer 22 that is a vibration generating unit provided inside the transducer case 21.
  • the sheath 13 is connected to the vibrator case 21.
  • the ultrasonic transducer 22 is provided with piezoelectric elements 23A to 23D (four in this embodiment) that change the current into ultrasonic vibration.
  • One end of electrical wires 25A and 25B is connected to the ultrasonic transducer 22.
  • the electrical wirings 25 ⁇ / b> A and 25 ⁇ / b> B extend through the inside of the cable 5, and the other end is connected to the power supply unit 6.
  • the vibrator unit 11 includes a horn member 26.
  • the ultrasonic transducer 22 is attached to a horn member 26, and the horn member 26 is supported by the transducer case 21.
  • the ultrasonic vibration generated by the ultrasonic vibrator 22 is transmitted to the horn member 26.
  • the horn member 26 is provided with a cross-section changing portion 27 in which the cross-sectional area perpendicular to the longitudinal axis C decreases as going toward the tip.
  • the amplitude of the ultrasonic vibration is expanded by the cross-section changing unit 27.
  • a female screw portion 28 ⁇ / b> A is provided at the tip of the horn member 26.
  • a male screw portion 28 ⁇ / b> B is provided at the proximal end portion of the ultrasonic probe 15.
  • the ultrasonic probe 15 is connected to the horn member 26 by the male screw portion 28B being screwed into the female screw portion 28A. Thereby, the ultrasonic probe 15 is coupled to the transducer unit 11.
  • FIG. 3 is a diagram showing a configuration of the ultrasonic probe 15.
  • the ultrasonic probe 15 includes a probe main body 31 that extends along the longitudinal axis C, and a treatment section 32 that is provided on the distal direction side of the probe main body 31.
  • the treatment portion 32 includes an exposed surface 34 that is exposed to the outside.
  • the ultrasonic vibration generated by the ultrasonic transducer 22 is transmitted to the probe main body 31 of the ultrasonic probe 15 via the horn member 26. And in the probe main body 31, it is transmitted to the front end direction from the proximal end direction.
  • the treatment unit 32 treats the treatment target using the ultrasonic vibration transmitted through the probe main body 31.
  • the ultrasonic probe 15 (the probe main body 31 and the treatment unit 32) performs longitudinal vibration in which the vibration direction is parallel to the distal direction and the proximal direction in a state where ultrasonic vibration is transmitted.
  • FIG. 4 is a diagram illustrating a configuration of the treatment unit 32.
  • one of the directions perpendicular to the longitudinal axis C is defined as a first vertical direction (the direction of the arrow P1 in FIG. 4), and a direction opposite to the first vertical direction is defined as a second vertical direction (FIG. 4).
  • Direction of arrow P2 the treatment section 32 includes a rake portion 33 that is a curved protrusion formed in a rake shape.
  • the rake portion 33 is curved in the first vertical direction with respect to the longitudinal axis C. For this reason, the rake part 33 protrudes toward the first vertical direction.
  • the exposed surface 34 of the treatment portion 32 includes a protruding end surface 35 that serves as a protruding end (end on the first vertical direction side) of the rake portion 33.
  • the protruding end surface 35 serves as a contact portion that is brought into contact with the treatment target in the treatment.
  • the protruding end surface 35 is located on the first vertical direction side from the longitudinal axis C.
  • a protruding end surface 35 that is a protruding end of the rake portion 33 is an end of the rake portion 33 on the first vertical direction side.
  • the exposed surface 34 of the treatment portion 32 includes a first curved exposed surface 36 that faces the distal direction in the rake portion (curved protrusion) 33, a second curved exposed surface 37 that faces the proximal direction in the rake portion 33, and a rake.
  • the portion 33 includes a third curved exposed surface 38 facing the third vertical direction, and the rake portion 33 includes a fourth curved exposed surface 39 facing the fourth vertical direction.
  • the first curved exposed surface 36 forms the distal end of the treatment portion 32 (the distal end of the ultrasonic probe 15).
  • the first curved exposed surface 36 and the third curved exposed surface 38 are provided with an index portion 40.
  • the index unit 40 includes at least one (five in this embodiment) index lines 41A to 41E.
  • index lines 41A to 41E extend along the third vertical direction and the fourth vertical direction.
  • index lines 41A to 41E extend along the distal direction and the proximal direction. That is, the index lines 41A to 41E are extended so as to intersect the first vertical direction and the second vertical direction.
  • Each of the index lines 41A to 41E has a predetermined interval (0.4 mm to 0.7 mm in this embodiment) with respect to the adjacent index lines (41A to 41E) in the first vertical direction and the second vertical direction. ) Just away.
  • the index portion 40 is positioned on the second vertical direction side of the protruding end surface 35 on the first curved exposed surface 36 and the third curved exposed surface 38. is doing. Further, the first curved exposed surface 36 faces the tip direction that is one of the directions perpendicular to the first vertical direction and the second vertical direction. The third curved exposed surface 38 faces the third vertical direction, which is one of the directions perpendicular to the first vertical direction and the second vertical direction. Therefore, the indicator portion 40 provided with the indicator lines 41A to 41E is provided at a portion of the exposed surface 34 of the treatment portion 32 that faces one of the first vertical direction and the direction perpendicular to the second vertical direction. Yes.
  • the sheath 13 and the ultrasonic probe 15 of the ultrasonic treatment device 2 are inserted into the joint space S as illustrated in FIG. 1. Further, the insertion portion 102 of the arthroscopic device 100 is inserted into the joint space S. Then, for example, the bone B ⁇ b> 2 is cut as a treatment target in the joint J by the treatment unit 32 of the ultrasonic probe 14.
  • the protruding end surface 35 that is the contact portion is brought into contact with the bone B2.
  • the energy operation input button 18 is pressed to input the energy operation.
  • the power is transmitted to the power supply unit 6 via an electric signal line (not shown).
  • power is output from the power supply unit 6 and the output power is transmitted to the ultrasonic vibrator 22, so that ultrasonic vibration is generated in the ultrasonic vibrator 22.
  • the ultrasonic vibration generated by the ultrasonic vibrator 22 is transmitted to the ultrasonic probe 15 via the horn member 26.
  • ultrasonic vibration is transmitted from the proximal end direction to the distal end direction in the probe body 31 of the ultrasonic probe 15.
  • the treatment unit 32 performs a treatment for cutting the bone B2 using the transmitted ultrasonic vibration.
  • the probe main body 31 and the treatment section 32 transmit ultrasonic vibrations, thereby performing longitudinal vibrations whose vibration directions are parallel to the proximal direction and the distal direction.
  • FIG. 5 is a diagram illustrating a state in which the treatment target (bone B2) is being sharpened by the treatment unit 32.
  • the bone B ⁇ b> 2 is shaved when the treatment portion 32 vibrates longitudinally with the protruding end surface 35 of the treatment portion 32 in contact with the bone B ⁇ b> 2.
  • the rake portion 33 which is a curved protruding portion, enters the inside of the bone B2 from the protruding end surface 35. That is, by cutting the bone B2, the protruding end surface 35 enters (moves) toward the bone B2 in the first vertical direction (the direction of the arrow P1 in FIG. 5).
  • the direction in which the protruding end surface 35 that is the contact portion enters (moves) into the treatment target (bone B2) when the bone B2 that is the treatment target is shaved is defined as the penetration direction.
  • the first vertical direction is the intrusion direction
  • the second vertical direction is the anti-intrusion direction that is opposite to the intrusion direction. Therefore, the protruding end surface 35 as a contact portion treats the treatment target while entering the treatment target in the intrusion direction toward the inside of the treatment target.
  • the indicator portion 40 including the indicator lines 41A to 41E is provided on the anti-intrusion direction side (the second vertical direction side in this embodiment) from the protruding end surface 35 that is the contact portion. It is done.
  • the indicator unit 40 has one of a direction perpendicular to the intrusion direction (first vertical direction in the present embodiment) and the anti-entry direction on the exposed surface 34 of the treatment unit 32 (in the present embodiment, the distal direction or the first direction). 3 in the vertical direction) (in the present embodiment, the first curved exposed surface 36 and the third curved exposed surface 38).
  • the bone B ⁇ b> 2 and the treatment unit 32 are imaged as a subject by the imaging element 108 provided in the insertion unit 102 of the arthroscope 101. For this reason, the index part 40 is imaged as a subject. Then, the subject image subjected to the image processing by the image processing unit 106 is displayed on the display unit 107.
  • FIG. 6 is a diagram illustrating an example of a subject image displayed on the display unit 107 in a state where the treatment target (bone B2) is being sharpened by the treatment unit 32.
  • the index portion 40 is displayed as a subject in the subject image displayed on the display unit 107 in a state where the bone B2 is being shaved.
  • the surgeon enters the treatment end (bone B ⁇ b> 2) into the treatment target (bone B ⁇ b> 2) in the intrusion direction (first vertical direction in the present embodiment). Recognize (movement amount). For example, in the example shown in FIG.
  • the index lines 41A and 41B are located on the intrusion direction side (first vertical direction side) from the surface of the bone B2, and the index lines 41C to 41E are on the anti-intrusion direction side from the surface of the bone B2. It is recognized that the projecting end surface 35 has entered the bone B2 in the intrusion direction until it is located on the (second vertical direction side). That is, the indicator 40 is an indicator that indicates the amount of penetration (movement amount) of the protruding end surface 35 that is a contact portion into the treatment target in the penetration direction.
  • the cutting depth of the treatment object corresponds to the amount of intrusion in the intrusion direction with respect to the treatment object of the protruding end surface 35 which is a contact portion.
  • the index portion 40 is provided on the first curved exposed surface 36 and the third curved exposed surface 38, but the present invention is not limited to this.
  • the index portion 40 (index lines 41A to 41E) is provided only on the first curved exposed surface 36. It may be provided.
  • the indicator portion 40 is not provided on the first curved exposed surface 36 and the third curved exposed surface 38, but only on the second curved exposed surface 37 and the fourth curved exposed surface 39. It may be provided. Furthermore, in another modification, the indicator portion 40 may be provided only on the second curved exposed surface 37. That is, the index portion 40 (index lines 41A to 41E) is at least one of the first curved exposed surface 36, the second curved exposed surface 37, the third curved exposed surface 38, and the fourth curved exposed surface 39. As long as it is provided.
  • the index unit 40 may include a plurality (four in this modification) of colored surfaces 42A to 42D instead of the index lines 41A to 41E.
  • the indicator portion 40 is provided on the first curved exposed surface 36 and the third curved exposed surface 38, and from the projecting end surface (projecting end) 35 that is a contact portion. It is provided on the anti-intrusion direction side (second vertical direction (P2) side).
  • the colored surfaces 42A to 42D are continuously arranged in the penetration direction (first vertical direction P1) and the anti-penetration direction (second vertical direction P2).
  • the colored surfaces 42A to 42D are provided in the anti-intrusion direction from the protruding end surface 35 that is a contact portion.
  • Each of the colored surfaces 42A to 42D is different in color from the adjacent colored surfaces (42A to 42D).
  • the colored surface 42A is red
  • the colored surface 42B is green
  • the colored surface 42C is yellow
  • the colored surface 42D is blue.
  • the indicator portion 40 has an intrusion amount in the intrusion direction (first vertical direction) with respect to the treatment target (bone B2) of the protruding end surface 35 which is a contact portion ( (Movement amount).
  • the index unit 40 may include a plurality of (four in this modification) index surfaces 43A to 43D.
  • the indicator portion 40 is provided only on the first curved exposed surface 36, and is on the anti-intrusion direction side (second vertical direction (P2) side) from the protruding end surface (projecting end) 35 that is a contact portion. Is provided.
  • the indicator surfaces 43A to 43D are continuously arranged in the penetration direction (first vertical direction P1) and the anti-penetration direction (second vertical direction P2). That is, the index surfaces 43A to 43D are provided in the anti-intrusion direction from the protruding end surface 35 that is a contact portion.
  • the respective index surfaces 43A to 43D have different angles with respect to the intrusion direction (first vertical direction) with respect to the adjacent index surfaces (43A to 43D).
  • the angle with respect to the intrusion direction is 120 ° on the index surface 43A
  • the angle with respect to the intrusion direction is 150 ° on the index surface 43B.
  • the index plane 43C has an angle of 0 ° (parallel to the penetration direction)
  • the index plane 43D has an angle of 30 ° with respect to the penetration direction.
  • a hook portion 45 formed in a hook shape instead of the rake portion 33 may be provided as a curved protruding portion.
  • the hook portion 45 is curved in the first vertical direction (the direction of the arrow P1 in FIG. 10) with respect to the longitudinal axis C, and protrudes in the first vertical direction.
  • a protruding end surface 50 is provided as a contact portion at the protruding end (first vertical direction end) of the hook portion 45.
  • the protruding end surface 50 serves as a contact portion that is brought into contact with the treatment target in the treatment of cutting the treatment target (bone).
  • the exposed surface 34 of the treatment portion 32 includes a first curved exposed surface 46 facing the distal end direction in the hook portion 45, a second curved exposed surface 47 facing the proximal direction in the hook portion 45, and a hook portion 45.
  • a fourth curved exposed surface (not shown).
  • the first vertical direction is the intrusion direction and the second vertical direction is the anti-intrusion direction.
  • the index portion 40 is provided only on the third curved exposed surface 48, and the index portion 40 includes at least one (four in the present modification) index lines 51A to 51D. Like the index lines 41A to 41E of the first embodiment, the index lines 51A to 51D are extended so as to intersect the intrusion direction and the anti-intrusion direction.
  • the index part 40 is located on the anti-intrusion direction side (second vertical direction side) from the protruding end surface 50 that is a contact part. Therefore, also in this modified example, the index portion 40 is an index indicating the amount of penetration (movement amount) in the penetration direction (first vertical direction) with respect to the treatment target of the protruding end surface 50 that is the contact portion.
  • the treatment portion (32) is curved in the first vertical direction (P1) that is the intrusion direction with respect to the longitudinal axis (C), so that the first vertical direction is obtained.
  • a curved protrusion (33; 45) protruding toward the direction (P1) is provided.
  • the distal end of the treatment portion (32) is formed by a curved protrusion (33; 45).
  • the contact part (35; 50) made to contact with a treatment object in the treatment which cuts off a treatment object is located in the projection end which is an end by the side of the 1st perpendicular direction (P1) of a curved projection part (33; 45).
  • the indicator portion (40) is provided on the anti-intrusion direction side (second vertical direction (P2) side) from the protruding end.
  • FIG. 11 is a view showing the treatment section 32 of the ultrasonic probe 15 of the present embodiment.
  • the treatment unit 32 includes a curette unit 52.
  • the treatment portion 32 extends along the longitudinal axis C without being curved.
  • the exposed surface 34 of the treatment portion 32 includes a first outer periphery exposed surface 54 that faces the first vertical direction (the direction of the arrow P1 in FIG. 11) on the outer periphery of the treatment portion 32 and a second vertical surface on the outer periphery of the treatment portion 32.
  • a second outer peripheral exposed surface 58 that faces the direction (the direction of the arrow P2 in FIG. 11).
  • An opening hole 53 is defined in the curette part 52 by a hole defining surface 57.
  • the opening hole 53 is opened at the first opening end E ⁇ b> 1 located on the first outer peripheral exposed surface 54.
  • the hole defining surface 57 extends from the first opening end E1 in the second vertical direction.
  • An opening end blade portion 55 is provided at the edge of the first opening end E1 of the opening hole 53.
  • the open end blade portion 55 serves as a contact portion that is brought into contact with the treatment target.
  • the open end edge portion 55 is located on the first vertical direction side from the longitudinal axis C.
  • the opening hole 53 is opened at the second opening end E ⁇ b> 2 located on the second outer peripheral exposed surface 58. Accordingly, the opening hole 53 passes through the curette portion 52 of the treatment portion 32 along the first vertical direction and the second vertical direction between the first opening end E1 and the second opening end E2. Yes.
  • the hole defining surface 57 is exposed to the outside of the treatment portion 32 as the opening hole 53 penetrates the curette portion 52. Therefore, in the present embodiment, the hole defining surface 57 is a part of the exposed surface 34 of the treatment portion 32.
  • the outer periphery of the treatment portion 32 is continuously extended along the first vertical direction and the second vertical direction between the first outer peripheral exposed surface 54 and the second outer peripheral exposed surface 58.
  • An outer peripheral relay surface 56 is provided. The distal end of the treatment portion 32 is formed by the outer peripheral relay surface 56. The outer peripheral relay surface 56 becomes a part of the exposed surface 34 of the treatment portion 32.
  • the hole defining surface 57 is continuous between the first outer peripheral exposed surface 54 and the second outer peripheral exposed surface 58 along the first vertical direction and the second vertical direction. It is extended to.
  • a portion other than the hole defining surface 57 (for example, the first outer peripheral exposed surface 54, the second outer peripheral exposed surface 58, and the outer peripheral relay surface 56) on the exposed surface 34 of the treatment portion 32 is the treatment portion. 32.
  • the outer peripheral relay surface 56 and the hole defining surface 57 continuously extend along the first vertical direction and the second vertical direction between the first outer peripheral exposed surface 54 and the second outer peripheral exposed surface 58. It becomes the relay exposed surface.
  • the relay exposed surfaces (56, 57) include an outer peripheral relay surface 56 that is an outer relay surface located outside the opening hole 53, a hole defining surface 57 that is an inner relay surface located inside the opening hole 53, and Is provided.
  • the relay exposed surfaces (56, 57) become part of the exposed surface 34 of the treatment section 32.
  • the treatment target (bone) is shaved by longitudinally vibrating the treatment portion 32 by ultrasonic vibration in a state where the open end blade portion 55 that is a contact portion is in contact with the treatment target.
  • the open end blade portion 55 penetrates into the inside of treatment object from the 1st outer periphery exposed surface 54 (opening edge blade part 55). That is, by cutting the treatment target (bone), the open end blade portion 55 moves in the first vertical direction with respect to the treatment target.
  • the first vertical direction is an intrusion direction in which the open end blade portion 55 that is a contact portion enters (moves) into the treatment target when the treatment target is cut.
  • the second vertical direction is the anti-intrusion direction that is the opposite direction to the intrusion direction.
  • the indicator portion 40 is provided on the outer peripheral relay surface 56 and the hole defining surface 57. That is, the indicator part 40 is provided on the relay exposed surface (56, 57). Since the indicator portion 40 is provided on the relay exposed surface (56, 57), the indicator portion 40 is in the intrusion direction (first vertical direction) and the anti-intrusion direction (second vertical direction) on the exposed surface 34 of the treatment portion 32. ) Is located in a part facing one of the directions perpendicular to the vertical axis. In addition, the indicator portion 40 is located on the anti-intrusion direction side (second vertical direction side) from the open end blade portion 55 that is a contact portion.
  • the indicator portion 40 includes indicator lines 61A and 61B provided on the outer peripheral relay surface 56 and indicator lines 62A to 62C provided on the hole defining surface 57.
  • the index lines 61A, 61B, 62A to 62C intersect the intrusion direction (first vertical direction) and the anti-intrusion direction (second vertical direction) in the same manner as the index lines 41A to 41E of the first embodiment.
  • the indicator portion 40 is an indicator that indicates the amount of penetration (movement amount) of the protruding end surface 35 that is a contact portion into the treatment target in the penetration direction.
  • the surgeon recognizes the amount of penetration of the open end blade portion 55 that is the contact portion into the treatment target in the penetration direction.
  • the surgeon can appropriately recognize the cutting depth of the treatment target while performing the treatment of cutting the treatment target.
  • the indicator portions 40 are provided on both the outer peripheral relay surface 56 that is the outer relay surface and the hole defining surface 57 that is the inner relay surface.
  • the present invention is not limited to this.
  • the indicator portion 40 may be provided only on the outer peripheral relay surface 56 or only on the hole defining surface 57.
  • a pipe part 60 may be formed in the treatment part 32 instead of the curette part 52.
  • the exposed surface 34 of the treatment portion 32 is a first outer periphery exposed surface that faces the first vertical direction (the direction of the arrow P1 in FIG. 12) on the outer periphery of the treatment portion 32.
  • An opening hole 65 is defined by the hole defining surface 59, and the opening hole 65 opens at an opening end (first opening end) E ′ 1 positioned on the first outer peripheral exposed surface 64.
  • An opening end blade portion 66 that is a contact portion is provided at the edge of the opening end E ′ 1 of the opening hole 65.
  • the opening hole 65 opens only at the opening end E ′ 1 of the first outer peripheral exposed surface 64, and does not open to the outside of the treatment portion 32 at the second outer peripheral exposed surface 69. . For this reason, the opening hole 65 does not penetrate the pipe part 60 in the first vertical direction and the second vertical direction. For this reason, unlike the second embodiment, the hole defining surface 59 is not exposed to the outside of the treatment portion 32 and is not included in the exposed surface 34 of the treatment portion 32.
  • the exposed surface 34 includes a tip exposed surface 63 that forms the tip of the treatment portion 32.
  • the tip exposed surface 63 faces the tip direction perpendicular to the first vertical direction and the second vertical direction.
  • the tip exposed surface 63 is a relay exposed surface continuously extending along the first vertical direction and the second vertical direction between the first outer peripheral exposed surface 64 and the second outer peripheral exposed surface 69.
  • the first vertical direction and the second vertical direction are major axis directions, and the third vertical direction (the direction of the arrow P3 in FIG. 12) and the fourth vertical direction (the direction of the arrow P4 in FIG. 12). ) Is formed in an elliptical shape in the minor axis direction.
  • a passage 68 extending along the longitudinal axis C through the inside of the probe main body 31 is formed in the ultrasonic probe 15.
  • the passage 68 communicates with the opening hole 65 in the pipe portion 60 of the treatment portion 32.
  • the open end blade portion 66 that is the contact portion enters the treatment target in the first vertical direction. Therefore, also in this modification, the first vertical direction is the intrusion direction, and the second vertical direction is the anti-intrusion direction.
  • the shaved bone is sucked and collected by a suction unit (not shown) through the opening hole 65 and the passage 68.
  • the indicator portion 40 is provided on the tip exposed surface 63 which is a relay exposed surface.
  • the index unit 40 includes index lines 67A and 67B.
  • the index lines 67A and 67B are extended so as to intersect the intrusion direction and the anti-intrusion direction, similarly to the index lines 41A to 41E of the first embodiment.
  • the index part 40 is located on the anti-intrusion direction side (second vertical direction side) from the open end blade part 66 that is the contact part. Therefore, also in this modified example, the index portion 40 serves as an index indicating the amount of penetration (movement amount) in the penetration direction (first vertical direction) with respect to the treatment target of the open end blade portion 66 that is the contact portion.
  • the index unit 40 may be provided with the same configuration (see FIG. 9) as the plurality of index surfaces described above.
  • the treatment portion (32) is formed with an opening hole (53; 65) that opens at the first opening end (E1; E′1) of the first outer peripheral exposed surface (54; 56).
  • the contact part (55; 66) made to contact with a treatment object in the treatment which cuts off a treatment object is located in the 1st opening end (E1; E'1).
  • the indicator portion (40) is provided on the relay exposed surface (56, 57; 63).
  • the contact portion (35; 50; 55; 66) that is brought into contact with the treatment object in the treatment of cutting the treatment object is first perpendicular to the longitudinal axis C. It is located on the direction (P1) side. And the penetration
  • the indicator portion (40) is provided on the anti-intrusion direction side (second vertical direction (P2) side) from the contact portion (35; 50; 55; 66).
  • FIG. 14 is a diagram showing the treatment section 32 of the ultrasonic probe 15 of the present embodiment.
  • the treatment portion 32 includes a blade portion 70.
  • the treatment portion 32 extends along the longitudinal axis C without being curved.
  • the dimensions in the first vertical direction (upwardly perpendicular to the paper surface in FIG. 14) and the second vertical direction (the direction perpendicular to the paper surface in FIG. 14) are reduced.
  • the dimensions in the vertical direction (the direction of arrow P3 in FIG. 14) and the fourth vertical direction (the direction of arrow P4 in FIG. 14) are increased.
  • the exposed surface 34 of the treatment portion 32 includes a sharp distal tip 72 and an outer peripheral exposed surface 71 extending from the distal tip 72 toward the proximal direction (C2) on the outer periphery of the treatment portion 32.
  • the distal end of the treatment portion 32 is formed by the distal tip 72.
  • the tip apex 72 is a contact portion that is brought into contact with the treatment target in a treatment for cutting the treatment target using ultrasonic vibration.
  • two directions of the clockwise direction and the counterclockwise direction around the longitudinal axis C are defined as the longitudinal axis direction.
  • the outer peripheral exposed surface 71 extends over the entire circumference in the direction around the longitudinal axis. Therefore, in the outer peripheral exposed surface 71, the exposed surface 34 of the treatment portion 32 faces one of the directions perpendicular to the longitudinal axis C.
  • the treatment portion 32 is vibrated longitudinally by ultrasonic vibration in a state in which the tip cusp 72 that is a contact portion is in contact with the treatment target, thereby entering the inside of the treatment target from the tip cusp 72. That is, the tip cusp 72 moves toward the tip with respect to the treatment target.
  • the tip direction (C1) is that the tip apex portion 72 that is a contact portion enters the treatment target when the treatment portion 32 enters the treatment target. Is the direction of entry (moving).
  • the proximal direction is the anti-intrusion direction that is opposite to the intrusion direction.
  • the indicator portion 40 is provided on the outer peripheral exposed surface 71.
  • the indicator 40 may be provided over the entire circumference in the direction around the longitudinal axis, or may be provided over a part of the range in the direction around the longitudinal axis. Since the indicator portion 40 is provided on the outer peripheral exposed surface 71, the indicator portion 40 has one of the directions perpendicular to the intrusion direction (distal direction) and the anti-intrusion direction (proximal direction) on the exposed surface 34 of the treatment portion 32. It is located in the facing part.
  • the indicator portion 40 is provided on the anti-intrusion direction side (base end direction side) from the tip apex portion 72 which is a contact portion.
  • the indicator unit 40 includes 73A to 73F. Like the index lines 41A to 41E of the first embodiment, the index lines 73A to 73F intersect the intrusion direction (front end direction in the present embodiment) and the anti-intrusion direction (base end direction in the present embodiment). The state is extended. Therefore, the index unit 40 is an index indicating the amount of penetration (movement amount) of the distal apex 72 as a contact portion in the penetration direction with respect to the treatment target. Thereby, in the treatment which penetrates the treatment part 32 into the treatment object, the surgeon recognizes the amount of penetration of the tip cusp 72 which is a contact part into the treatment object in the treatment direction. Thus, the surgeon can appropriately recognize the cutting depth of the treatment target while performing the treatment of cutting the treatment target.
  • a drill portion 75 may be formed in the treatment portion 32 instead of the blade portion 70.
  • the exposed surface 34 of the treatment portion 32 extends toward the proximal direction from the sharp tip 76 and the distal tip 76 on the outer periphery of the treatment portion 32.
  • the tip apex 76 becomes a contact portion that is brought into contact with the treatment target in the treatment of cutting the treatment target using ultrasonic vibration.
  • the probe main body 31 and the treatment section 32 do not perform longitudinal vibration in a state of transmitting ultrasonic vibration, and the vibration direction is the direction around the longitudinal axis (the direction of the arrow R1 and the arrow R2 in FIG. 15).
  • Direction torsional vibration. Therefore, in the ultrasonic transducer 22 (see FIG. 2), ultrasonic vibration is generated in a state where the probe main body 31 and the treatment portion 32 perform torsional vibration.
  • a groove upper part 78 extends in a spiral shape with the longitudinal axis C as the center on the outer peripheral exposed surface 79.
  • the treatment object (bone) is shaved by the torsional vibration of the treatment part 32 by ultrasonic vibration in a state in which the tip 76 as a contact part is in contact with the treatment object.
  • the distal tip 76 moves toward the distal direction with respect to the treatment target.
  • the distal direction (C1) is an intrusion direction in which the distal apex 76 as a contact portion enters (moves) the treatment target when the treatment target is cut.
  • the proximal direction (C2) is the anti-intrusion direction that is opposite to the intrusion direction.
  • the indicator portion 40 is provided on the outer peripheral exposed surface 79.
  • the index unit 40 includes index lines 77A to 77D. Like the index lines 41A to 41E of the first embodiment, the index lines 77A to 77D are extended so as to intersect the intrusion direction and the anti-intrusion direction. Also in this modified example, the indicator portion 40 is located on the anti-intrusion direction side (base end direction side) with respect to the tip apex portion 76 that is a contact portion. Therefore, also in this modified example, the index portion 40 is an index indicating the amount of penetration (movement amount) in the penetration direction (tip direction) with respect to the treatment target of the tip cusp 76 which is a contact portion.
  • the index unit 40 may be provided with the same configuration (see FIG. 8) as the plurality of colored surfaces described above. Further, instead of the index lines 73A to 73F of the third embodiment, the index unit 40 may be provided with the same configuration (see FIG. 9) as the plurality of index surfaces described above.
  • the contact portion (72; 76) is located at the distal end of the treatment portion (32). And the penetration
  • a bone is treated as a treatment target, but it is needless to say that the treatment target can be applied to cartilage and soft tissue (for example, synovium) other than bone.
  • cartilage and soft tissue for example, synovium
  • the contact portion (35; 50; 55; 66; 72; 76) is intrusion direction (P1; C1) from the state in contact with the treatment object to the inside of the treatment object by the ultrasonic vibration transmitted to the treatment portion (32). )
  • the exposed surface (34) of the treatment portion (32) is provided with the indicator portion (40) on the side opposite to the intrusion direction (P2; C2) from the contact portion (35; 50; 55; 66; 72; 76). It has been.
  • the index portion (40) is an index indicating the amount of intrusion of the contact portion (35; 50; 55; 66; 72; 76) in the intrusion direction (P1; C1) with respect to the treatment target.
  • FIG. 16 shows a reference example of the present invention.
  • tip part of the ultrasonic treatment tool 3 of a reference example is shown.
  • the ultrasonic probe 15 performs longitudinal vibration in which the vibration direction is parallel to the distal direction and the proximal direction in a state where ultrasonic vibration is transmitted.
  • the distal end of the treatment portion 32 is an antinode position A ⁇ b> 1 of ultrasonic vibration.
  • the node position N1 located on the most distal direction side among the node positions of the ultrasonic vibration is defined.
  • the sheath 13 that protects the ultrasonic probe 15 from the outside extends in the distal direction to the proximal end of the treatment portion 32.
  • the sheath 13 extends in the distal direction only up to the vicinity of the node position N1. That is, in the first embodiment, the position of the proximal end of the treatment portion 32 in the direction parallel to the longitudinal axis C substantially coincides with the position of the distal end of the sheath 13, whereas in this reference example, the treatment portion The proximal end of 32 is located on the distal direction side of the distal end of the sheath 13.
  • a ring-shaped elastic member 82 is provided between the sheath 13 and the ultrasonic probe 15 at the node position N1.
  • the elastic member 82 keeps the space between the sheath 13 and the ultrasonic probe 15 fluid-tight. Thereby, the inflow of the liquid from the distal direction side to the inside of the sheath 13 is effectively prevented.
  • a thin tube member 81 is coated on the outer surface of the probe main body 31 between the node position N1 and the proximal end of the treatment portion 32 in the direction parallel to the longitudinal axis C. Therefore, even the portion of the probe body 31 that is not covered by the sheath 13 is protected from the outside by the tube member 81.
  • the tube member 81 By covering the tube member 81 instead of the sheath 13, the dimension in the radial direction of the ultrasonic treatment instrument 3 is reduced between the distal end of the sheath 13 and the proximal end of the treatment portion 32. Thereby, it becomes easy to insert the treatment portion 32 into the joint space S.
  • a coating may be applied to the outer surface of the probe main body 31 between the node position N1 and the proximal end of the treatment portion 32 in a direction parallel to the longitudinal axis C. Also in this case, the portion of the probe body 31 that is not covered with the sheath 13 is protected from the outside by coating.
  • the distal end of the sheath 13 is located in the vicinity of the node position N1 located on the most distal direction side, but is not limited thereto.
  • the distal end of the sheath 13 may be positioned in the vicinity of the node position N2 that is secondly positioned on the distal direction side.
  • the tube member 81 is covered on the outer surface of the probe main body 31 between the node position N2 and the proximal end of the treatment portion 32 in the direction parallel to the longitudinal axis C.
  • An elastic member (82) is provided at the node position N2, and the space between the sheath 13 and the ultrasonic probe 15 is kept liquid-tight.
  • the node position N2 is located on the distal direction side from the distal end of the holding unit 12.

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Abstract

A contact portion provided on an exposed surface of a treatment unit treats, with transmitted ultrasonic vibration, a treatment target while entering in an entry direction from a state contacting the treatment target. On the exposed surface of the treatment unit, an indicator unit is provided to the side opposite of the entry direction with respect to the contact portion. The indicator unit is an indicator that shows the amount that the contact unit has entered into the treatment target in the entry direction.

Description

超音波プローブ、超音波処置具及び処置システムUltrasonic probe, ultrasonic treatment instrument and treatment system
　本発明は、先端部に処置部が設けられ、伝達された超音波振動を用いて処置部が処置対象を処置する超音波プローブに関する。また、その超音波プローブを備える超音波処置具、及び、その超音波処置具を備える処置システムに関する。 The present invention relates to an ultrasonic probe in which a treatment portion is provided at a distal end portion and the treatment portion treats a treatment target using transmitted ultrasonic vibration. The present invention also relates to an ultrasonic treatment instrument including the ultrasonic probe and a treatment system including the ultrasonic treatment instrument.
　特許文献１には、超音波振動を用いて骨等の処置対象を削る超音波処置装置が開示されている。この超音波処置装置は、長手軸に沿って延設され、基端方向から先端方向へ超音波振動を伝達する超音波プローブを、備える。そして、超音波プローブの先端部には、伝達された超音波振動を用いて処置対象を削る処置を行う処置部が、設けられている。ここで、長手軸に対して垂直な方向の１つを第１の垂直方向とし、第１の垂直方向とは反対方向を第２の垂直方向とする。処置部には、長手軸に対して第１の垂直方向に湾曲する湾曲突出部が設けられ、湾曲突出部は、第１の垂直方向に向かって突出している。処置対象を削る処置においては、湾曲突出部の第１の垂直方向側の端である突出端に設けられる接触面（接触部）を、処置対象に接触させる。この状態において、超音波振動によって処置部を縦振動させる（長手軸に対して平行に振動させる）ことにより、処置対象が削られる。処置対象が削られることにより、接触面は、処置対象に対して第１の垂直方向へ侵入される。 Patent Document 1 discloses an ultrasonic treatment apparatus that cuts a treatment target such as a bone using ultrasonic vibration. This ultrasonic treatment apparatus includes an ultrasonic probe that extends along the longitudinal axis and transmits ultrasonic vibration from the proximal direction to the distal direction. A distal end portion of the ultrasonic probe is provided with a treatment portion that performs a treatment for cutting the treatment target using the transmitted ultrasonic vibration. Here, one direction perpendicular to the longitudinal axis is defined as a first vertical direction, and a direction opposite to the first vertical direction is defined as a second vertical direction. The treatment portion is provided with a curved protrusion that curves in the first vertical direction with respect to the longitudinal axis, and the curved protrusion protrudes in the first vertical direction. In the treatment for cutting the treatment target, a contact surface (contact portion) provided at the protruding end that is the first vertical direction end of the curved protruding portion is brought into contact with the treatment target. In this state, the treatment target is shaved by longitudinally vibrating the treatment portion by ultrasonic vibration (vibrating in parallel with the longitudinal axis). As the treatment target is cut, the contact surface enters the first vertical direction with respect to the treatment target.
特開平７－２５５７３６号公報Japanese Patent Laid-Open No. 7-255736
　前記特許文献１の超音波処置装置等を用いて骨等の処置対象を削る処置では、処置対象は所望の削り深さまで削られる。しかし、前記特許文献１の超音波処置装置では、処置対象を削る処置を行っている最中において、術者は、処置対象の削り深さを適切に認識し難い。このため、処置対象を削る処置において、所望の削り深さよりさらに深くまで処置対象を削ってしまう可能性がある。 In the treatment of cutting a treatment target such as a bone using the ultrasonic treatment apparatus of Patent Document 1, the treatment target is cut to a desired cutting depth. However, in the ultrasonic treatment apparatus of Patent Document 1, it is difficult for an operator to properly recognize the cutting depth of the treatment target while performing the treatment of cutting the treatment target. For this reason, in the treatment for cutting the treatment target, there is a possibility that the treatment target is cut deeper than the desired cutting depth.
　本発明は前記課題を解決するためになされたものであり、その目的とするところは、超音波振動を用いて処置対象を削る処置において、処置対象の削り深さが術者に適切に認識される超音波プローブ、超音波処置具及び処置システムを提供することにある。 The present invention has been made to solve the above-described problems, and the object of the present invention is to appropriately recognize the shaving depth of the treatment target by the operator in the treatment of cutting the treatment target using ultrasonic vibration. An ultrasonic probe, an ultrasonic treatment tool, and a treatment system are provided.
　前記目的を達成するために、本発明のある態様の超音波プローブは、長手軸に沿って延設され、基端方向から先端方向へ超音波振動を伝達するプローブ本体と、前記プローブ本体の前記先端方向側に設けられ、前記プローブ本体を介して伝達された超音波振動を用いて処置対象の処置を行う処置部であって、露出面と、前記露出面に設けられ、伝達された前記超音波振動によって、前記処置対象に接触した状態から前記処置対象の内部に向かう侵入方向に侵入ながら、前記処置対象を処置する接触部と、前記露出面において前記接触部より前記侵入方向とは反対方向側に設けられ、前記処置対象に対する前記侵入方向への前記接触部の侵入量を示す指標が形成された指標部と、を備える処置部と、を備える。 In order to achieve the above object, an ultrasonic probe according to an aspect of the present invention includes a probe body that extends along a longitudinal axis and transmits ultrasonic vibrations from a proximal direction to a distal direction, and the probe body A treatment unit that is provided on the distal direction side and performs treatment of a treatment target using ultrasonic vibrations transmitted through the probe main body, and includes an exposed surface and the transmitted super The contact portion that treats the treatment target while invading in the intrusion direction toward the inside of the treatment target from the state in contact with the treatment target by sound wave vibration, and the direction opposite to the intrusion direction from the contact portion on the exposed surface A treatment part provided with an indicator part provided on the side and formed with an indicator showing an intrusion amount of the contact part in the entry direction with respect to the treatment target.
　本発明によれば、超音波振動を用いて処置対象を削る処置において、処置対象の削り深さが術者に適切に認識される超音波プローブ、超音波処置具及び処置システムを提供することができる。 According to the present invention, it is possible to provide an ultrasonic probe, an ultrasonic treatment tool, and a treatment system in which a surgeon appropriately recognizes a cutting depth of a treatment target in a treatment of cutting the treatment target using ultrasonic vibration. it can.
本発明の第１の実施形態に係る処置システムを示す概略図である。It is the schematic which shows the treatment system which concerns on the 1st Embodiment of this invention. 第１の実施形態に係る振動子ユニットの構成を概略的に示す断面図である。FIG. 3 is a cross-sectional view schematically illustrating a configuration of a vibrator unit according to the first embodiment. 第１の実施形態に係る超音波プローブの構成を示す概略図である。It is the schematic which shows the structure of the ultrasonic probe which concerns on 1st Embodiment. 第１の実施形態に係る超音波プローブの処置部の構成を概略的に示す斜視図である。It is a perspective view showing roughly the composition of the treatment part of the ultrasonic probe concerning a 1st embodiment. 第１の実施形態に係る処置部で処置対象を削っている状態を示す概略図である。It is the schematic which shows the state which is shaving the treatment target in the treatment part which concerns on 1st Embodiment. 第１の実施形態に係る処置部で処置対象を削っている状態において、表示ユニットに表示される被写体像の一例を示す概略図である。It is the schematic which shows an example of the to-be-photographed image displayed on a display unit in the state which is shaving the treatment target in the treatment part which concerns on 1st Embodiment. 第１の変形例に係る超音波プローブの処置部の構成を概略的に示す斜視図である。It is a perspective view which shows roughly the structure of the treatment part of the ultrasonic probe which concerns on a 1st modification. 第２の変形例に係る超音波プローブの処置部の構成を概略的に示す斜視図である。It is a perspective view which shows roughly the structure of the treatment part of the ultrasonic probe which concerns on a 2nd modification. 第３の変形例に係る超音波プローブの処置部の構成を概略的に示す斜視図である。It is a perspective view which shows roughly the structure of the treatment part of the ultrasonic probe which concerns on a 3rd modification. 第４の変形例に係る超音波プローブの処置部の構成を示す概略図である。It is the schematic which shows the structure of the treatment part of the ultrasonic probe which concerns on a 4th modification. 第２の実施形態に係る超音波プローブの処置部の構成を概略的に示す斜視図である。It is a perspective view which shows roughly the structure of the treatment part of the ultrasonic probe which concerns on 2nd Embodiment. 第５の変形例に係る超音波プローブの処置部の構成を概略的に示す斜視図である。It is a perspective view which shows roughly the structure of the treatment part of the ultrasonic probe which concerns on a 5th modification. 第５の変形例に係る超音波プローブの構成を長手軸に平行な断面で概略的に示す断面図である。It is sectional drawing which shows schematically the structure of the ultrasonic probe which concerns on a 5th modification in a cross section parallel to a longitudinal axis. 第３の実施形態に係る超音波プローブの処置部の構成を示す概略図である。It is the schematic which shows the structure of the treatment part of the ultrasonic probe which concerns on 3rd Embodiment. 第６の変形例に係る超音波プローブの処置部の構成を概略的に示す斜視図である。It is a perspective view which shows roughly the structure of the treatment part of the ultrasonic probe which concerns on a 6th modification. 参照例に係る超音波処置部の先端部の構成を示す概略図である。It is the schematic which shows the structure of the front-end | tip part of the ultrasonic treatment part which concerns on a reference example.
　（第１の実施形態）　
　本発明の第１の実施形態について、図１乃至図６を参照して説明する。図１は、本実施形態の処置システム１を示す図である。図１に示すように、処置システム１は、例えば、肩、膝等において、骨Ｂ１と骨Ｂ２との間の関節Ｊの処置に用いられる。処置システム１は、超音波処置装置２と、内視鏡装置である関節鏡装置１００と、を備える。 (First embodiment)
A first embodiment of the present invention will be described with reference to FIGS. FIG. 1 is a diagram showing a treatment system 1 of the present embodiment. As shown in FIG. 1, the treatment system 1 is used for treatment of a joint J between a bone B1 and a bone B2, for example, at a shoulder, a knee, or the like. The treatment system 1 includes an ultrasonic treatment device 2 and an arthroscopic device 100 that is an endoscope device.
　関節鏡装置１００は、内視鏡である関節鏡１０１を備える。関節鏡１０１は、挿入部（関節鏡挿入部）１０２と、保持部（関節鏡保持部）１０３と、を備える。処置システム１を用いた処置においては、挿入部１０２の先端部が関節腔Ｓに挿入される。保持部１０３には、ユニバーサルコード１０５の一端が接続されている。ユニバーサルコード１０５の他端は、画像プロセッサ等の画像処理ユニット１０６に接続されている。画像処理ユニット１０６は、モニタ等の表示ユニット１０７に電気的に接続されている。 The arthroscopic device 100 includes an arthroscope 101 that is an endoscope. The arthroscope 101 includes an insertion part (arthroscope insertion part) 102 and a holding part (arthroscope holding part) 103. In the treatment using the treatment system 1, the distal end portion of the insertion portion 102 is inserted into the joint space S. One end of a universal cord 105 is connected to the holding unit 103. The other end of the universal cord 105 is connected to an image processing unit 106 such as an image processor. The image processing unit 106 is electrically connected to a display unit 107 such as a monitor.
　挿入部１０２の先端部には、撮像素子１０８が設けられている。撮像素子１０８は、観察窓（図示しない）を通して、被写体を撮像する。撮像素子１０８は、挿入部１０２の内部、保持部１０３の内部及びユニバーサルコード１０５の内部を通って延設される撮像ケーブル（図示しない）を介して、画像処理ユニット１０６に電気的に接続されている。画像処理ユニット１０６によって、撮像された被写体像が、画像処理される。そして、表示ユニット１０７に、画像処理された被写体像が表示される。なお、関節鏡装置１００には、光源ユニット（図示しない）が設けられ、光源ユニットから出射された光が被写体に照射される。 An image sensor 108 is provided at the distal end of the insertion portion 102. The image sensor 108 images a subject through an observation window (not shown). The imaging element 108 is electrically connected to the image processing unit 106 via an imaging cable (not shown) that extends through the insertion unit 102, the holding unit 103, and the universal cord 105. Yes. The image processing unit 106 performs image processing on the captured subject image. Then, the subject image that has undergone image processing is displayed on the display unit 107. The arthroscopic device 100 is provided with a light source unit (not shown), and the light emitted from the light source unit is irradiated onto the subject.
　超音波処置装置２は、超音波処置具（ハンドピース）３と、電源ユニット６とを備える。超音波処置具３は、長手軸Ｃを有する。ここで、長手軸Ｃに平行な２方向の一方を先端方向（図１の矢印Ｃ１の方向）とし、先端方向とは反対方向を基端方向（図１の矢印Ｃ２の方向）とする。超音波処置具３は、振動子ユニット１１と、保持ユニット１２と、シース１３と、超音波プローブ１５と、を備える。振動子ユニット１１には、ケーブル５の一端が接続されている。ケーブル５の他端は、電源ユニット６に接続されている。 The ultrasonic treatment apparatus 2 includes an ultrasonic treatment tool (handpiece) 3 and a power supply unit 6. The ultrasonic treatment instrument 3 has a longitudinal axis C. Here, one of the two directions parallel to the longitudinal axis C is the distal direction (the direction of the arrow C1 in FIG. 1), and the direction opposite to the distal direction is the proximal direction (the direction of the arrow C2 in FIG. 1). The ultrasonic treatment instrument 3 includes a transducer unit 11, a holding unit 12, a sheath 13, and an ultrasonic probe 15. One end of a cable 5 is connected to the vibrator unit 11. The other end of the cable 5 is connected to the power supply unit 6.
　保持ユニット１２は、長手軸Ｃに沿って延設される筒状の保持ケース１７を備える。振動子ユニット１１は、基端方向側から保持ケース１７の内部に挿入され、シース１３は、先端方向側から保持ケース１７の内部に挿入される。そして、保持ケース１７の内部で、振動子ユニット１１にシース１３が連結される。また、超音波プローブ１５は、シース１３に挿通されている。超音波プローブ１５は、保持ケース１７の内部で振動子ユニット１１に連結されている。保持ケース１７には、エネルギー操作入力部であるエネルギー操作入力ボタン１８が、取付けられている。また、超音波プローブ１５は、シース１３の先端から先端方向へ向かって突出している。 The holding unit 12 includes a cylindrical holding case 17 extending along the longitudinal axis C. The vibrator unit 11 is inserted into the holding case 17 from the proximal direction side, and the sheath 13 is inserted into the holding case 17 from the distal direction side. The sheath 13 is coupled to the transducer unit 11 inside the holding case 17. The ultrasonic probe 15 is inserted through the sheath 13. The ultrasonic probe 15 is connected to the transducer unit 11 inside the holding case 17. An energy operation input button 18 that is an energy operation input unit is attached to the holding case 17. Further, the ultrasonic probe 15 protrudes from the distal end of the sheath 13 in the distal direction.
　図２は、振動子ユニット１１の構成を示す図である。図２に示すように、振動子ユニット１１は、振動子ケース２１と、振動子ケース２１の内部に設けられる振動発生部である超音波振動子２２と、を備える。振動子ケース２１に、シース１３が連結される。超音波振動子２２には、電流を超音波振動に変化する（本実施形態では４つの）圧電素子２３Ａ～２３Ｄが設けられている。超音波振動子２２には、電気配線２５Ａ，２５Ｂの一端が接続されている。電気配線２５Ａ，２５Ｂは、ケーブル５の内部を通って延設され、他端が電源ユニット６に接続されている。電源ユニット６から電気配線２５Ａ，２５Ｂを介して超音波振動子２２に電力が供給されることにより、超音波振動子２２で超音波振動が発生する。 FIG. 2 is a diagram showing a configuration of the vibrator unit 11. As shown in FIG. 2, the transducer unit 11 includes a transducer case 21 and an ultrasonic transducer 22 that is a vibration generating unit provided inside the transducer case 21. The sheath 13 is connected to the vibrator case 21. The ultrasonic transducer 22 is provided with piezoelectric elements 23A to 23D (four in this embodiment) that change the current into ultrasonic vibration. One end of electrical wires 25A and 25B is connected to the ultrasonic transducer 22. The electrical wirings 25 </ b> A and 25 </ b> B extend through the inside of the cable 5, and the other end is connected to the power supply unit 6. When power is supplied from the power supply unit 6 to the ultrasonic vibrator 22 via the electrical wirings 25 </ b> A and 25 </ b> B, ultrasonic vibration is generated in the ultrasonic vibrator 22.
　また、振動子ユニット１１は、ホーン部材２６を備える。超音波振動子２２は、ホーン部材２６に取付けられ、ホーン部材２６は、振動子ケース２１によって支持されている。超音波振動子２２で発生した超音波振動は、ホーン部材２６に伝達される。ホーン部材２６には、先端方向へ向かうにつれて長手軸Ｃに垂直な断面積が減少する断面変化部２７が、設けられている。断面変化部２７によって、超音波振動の振幅が拡大される。ホーン部材２６の先端部には、雌ネジ部２８Ａが設けられている。そして、超音波プローブ１５の基端部には、雄ネジ部２８Ｂが設けられている。雌ネジ部２８Ａに雄ネジ部２８Ｂが螺合することにより、超音波プローブ１５がホーン部材２６に接続される。これにより、超音波プローブ１５が振動子ユニット１１に連結される。 Further, the vibrator unit 11 includes a horn member 26. The ultrasonic transducer 22 is attached to a horn member 26, and the horn member 26 is supported by the transducer case 21. The ultrasonic vibration generated by the ultrasonic vibrator 22 is transmitted to the horn member 26. The horn member 26 is provided with a cross-section changing portion 27 in which the cross-sectional area perpendicular to the longitudinal axis C decreases as going toward the tip. The amplitude of the ultrasonic vibration is expanded by the cross-section changing unit 27. A female screw portion 28 </ b> A is provided at the tip of the horn member 26. A male screw portion 28 </ b> B is provided at the proximal end portion of the ultrasonic probe 15. The ultrasonic probe 15 is connected to the horn member 26 by the male screw portion 28B being screwed into the female screw portion 28A. Thereby, the ultrasonic probe 15 is coupled to the transducer unit 11.
　図３は、超音波プローブ１５の構成を示す図である。図３に示すように、超音波プローブ１５は、長手軸Ｃに沿って延設されるプローブ本体３１と、プローブ本体３１の先端方向側に設けられる処置部３２と、を備える。処置部３２は、外部に対して露出する露出面３４を備える。超音波振動子２２で発生した超音波振動は、ホーン部材２６を介して、超音波プローブ１５のプローブ本体３１に伝達される。そして、プローブ本体３１において、基端方向から先端方向へ伝達される。処置部３２は、プローブ本体３１を介して伝達された超音波振動を用いて、処置対象を処置する。なお、超音波振動は基端方向から先端方向へ伝達されるため、先端方向が超音波振動の伝達方向となる。また、本実施形態では、超音波プローブ１５（プローブ本体３１及び処置部３２）は、超音波振動を伝達する状態において、振動方向が先端方向及び基端方向に平行な縦振動を行う。 FIG. 3 is a diagram showing a configuration of the ultrasonic probe 15. As shown in FIG. 3, the ultrasonic probe 15 includes a probe main body 31 that extends along the longitudinal axis C, and a treatment section 32 that is provided on the distal direction side of the probe main body 31. The treatment portion 32 includes an exposed surface 34 that is exposed to the outside. The ultrasonic vibration generated by the ultrasonic transducer 22 is transmitted to the probe main body 31 of the ultrasonic probe 15 via the horn member 26. And in the probe main body 31, it is transmitted to the front end direction from the proximal end direction. The treatment unit 32 treats the treatment target using the ultrasonic vibration transmitted through the probe main body 31. Note that since the ultrasonic vibration is transmitted from the proximal direction to the distal direction, the distal direction becomes the transmission direction of the ultrasonic vibration. In the present embodiment, the ultrasonic probe 15 (the probe main body 31 and the treatment unit 32) performs longitudinal vibration in which the vibration direction is parallel to the distal direction and the proximal direction in a state where ultrasonic vibration is transmitted.
　図４は、処置部３２の構成を示す図である。ここで、長手軸Ｃに対して垂直な方向の１つを第１の垂直方向（図４の矢印Ｐ１の方向）とし、第１の垂直方向とは反対方向を第２の垂直方向（図４の矢印Ｐ２の方向）とする。図４に示すように、処置部３２は、レーキ形状に形成される湾曲突出部であるレーキ部（rake portion）３３を備える。レーキ部３３は、長手軸Ｃに対して第１の垂直方向に湾曲している。このため、レーキ部３３は、第１の垂直方向へ向かって突出する。処置部３２の露出面３４は、レーキ部３３の突出端（第１の垂直方向側の端）となる突出端面３５を備える。突出端面３５が、処置において処置対象に接触させる接触部となる。突出端面３５は、長手軸Ｃより第１の垂直方向側に位置している。そして、レーキ部３３の突出端である突出端面３５が、レーキ部３３の第１の垂直方向側の端となる。 FIG. 4 is a diagram illustrating a configuration of the treatment unit 32. Here, one of the directions perpendicular to the longitudinal axis C is defined as a first vertical direction (the direction of the arrow P1 in FIG. 4), and a direction opposite to the first vertical direction is defined as a second vertical direction (FIG. 4). Direction of arrow P2). As shown in FIG. 4, the treatment section 32 includes a rake portion 33 that is a curved protrusion formed in a rake shape. The rake portion 33 is curved in the first vertical direction with respect to the longitudinal axis C. For this reason, the rake part 33 protrudes toward the first vertical direction. The exposed surface 34 of the treatment portion 32 includes a protruding end surface 35 that serves as a protruding end (end on the first vertical direction side) of the rake portion 33. The protruding end surface 35 serves as a contact portion that is brought into contact with the treatment target in the treatment. The protruding end surface 35 is located on the first vertical direction side from the longitudinal axis C. A protruding end surface 35 that is a protruding end of the rake portion 33 is an end of the rake portion 33 on the first vertical direction side.
　ここで、長手軸Ｃに垂直で、かつ、第１の垂直方向及び第２の垂直方向に垂直な２方向を第３の垂直方向（図４の矢印Ｐ３の方向）及び第４の垂直方向（図４の矢印Ｐ４の方向）とする。処置部３２の露出面３４は、レーキ部（湾曲突出部）３３において先端方向を向く第１の湾曲露出面３６と、レーキ部３３において基端方向を向く第２の湾曲露出面３７と、レーキ部３３において第３の垂直方向を向く第３の湾曲露出面３８と、レーキ部３３において第４の垂直方向を向く第４の湾曲露出面３９と、を備える。第１の湾曲露出面３６によって、処置部３２の先端（超音波プローブ１５の先端）が形成されている。 Here, two directions perpendicular to the longitudinal axis C and perpendicular to the first vertical direction and the second vertical direction are defined as the third vertical direction (the direction of the arrow P3 in FIG. 4) and the fourth vertical direction ( (Direction of arrow P4 in FIG. 4). The exposed surface 34 of the treatment portion 32 includes a first curved exposed surface 36 that faces the distal direction in the rake portion (curved protrusion) 33, a second curved exposed surface 37 that faces the proximal direction in the rake portion 33, and a rake. The portion 33 includes a third curved exposed surface 38 facing the third vertical direction, and the rake portion 33 includes a fourth curved exposed surface 39 facing the fourth vertical direction. The first curved exposed surface 36 forms the distal end of the treatment portion 32 (the distal end of the ultrasonic probe 15).
　第１の湾曲露出面３６及び第３の湾曲露出面３８には、指標部４０が設けられている。指標部４０は、少なくとも１つ（本実施形態では５本）の指標線４１Ａ～４１Ｅを備える。第１の湾曲露出面３６では、第３の垂直方向及び第４の垂直方向に沿って、指標線４１Ａ～４１Ｅが延設されている。また、第３の湾曲露出面３８では、先端方向及び基端方向に沿って、指標線４１Ａ～４１Ｅが延設されている。すなわち、第１の垂直方向及び第２の垂直方向に対して交差する状態で、指標線４１Ａ～４１Ｅが延設されている。指標線４１Ａ～４１Ｅのそれぞれは、第１の垂直方向及び第２の垂直方向について、隣設する指標線（４１Ａ～４１Ｅ）に対して所定の間隔（本実施形態では０．４ｍｍ～０．７ｍｍ）だけ離れている。 The first curved exposed surface 36 and the third curved exposed surface 38 are provided with an index portion 40. The index unit 40 includes at least one (five in this embodiment) index lines 41A to 41E. On the first curved exposed surface 36, index lines 41A to 41E extend along the third vertical direction and the fourth vertical direction. On the third curved exposed surface 38, index lines 41A to 41E extend along the distal direction and the proximal direction. That is, the index lines 41A to 41E are extended so as to intersect the first vertical direction and the second vertical direction. Each of the index lines 41A to 41E has a predetermined interval (0.4 mm to 0.7 mm in this embodiment) with respect to the adjacent index lines (41A to 41E) in the first vertical direction and the second vertical direction. ) Just away.
　前述のように、指標線４１Ａ～４１Ｅが設けられることにより、指標部４０は、第１の湾曲露出面３６及び第３の湾曲露出面３８において、突出端面３５より第２の垂直方向側に位置している。また、第１の湾曲露出面３６は、第１の垂直方向及び第２の垂直方向に垂直な方向の１つである先端方向を向いている。そして、第３の湾曲露出面３８は、第１の垂直方向及び第２の垂直方向に垂直な方向の１つである第３の垂直方向を向いている。したがって、指標線４１Ａ～４１Ｅが設けられる指標部４０は、処置部３２の露出面３４において、第１の垂直方向及び第２の垂直方向に垂直な方向の１つを向く部位に、設けられている。 As described above, by providing the index lines 41A to 41E, the index portion 40 is positioned on the second vertical direction side of the protruding end surface 35 on the first curved exposed surface 36 and the third curved exposed surface 38. is doing. Further, the first curved exposed surface 36 faces the tip direction that is one of the directions perpendicular to the first vertical direction and the second vertical direction. The third curved exposed surface 38 faces the third vertical direction, which is one of the directions perpendicular to the first vertical direction and the second vertical direction. Therefore, the indicator portion 40 provided with the indicator lines 41A to 41E is provided at a portion of the exposed surface 34 of the treatment portion 32 that faces one of the first vertical direction and the direction perpendicular to the second vertical direction. Yes.
　次に、本実実施形態の超音波プローブ１５及び処置システム１の作用及び効果について説明する。超音波処置装置２を備える処置システム１を用いて処置を行う際には、図１に示すように、超音波処置装置２のシース１３及び超音波プローブ１５を関節腔Ｓに挿入する。また、関節鏡装置１００の挿入部１０２を関節腔Ｓに挿入する。そして、超音波プローブ１４の処置部３２によって、関節Ｊにおいて例えば骨Ｂ２が処置対象として、削られる。 Next, operations and effects of the ultrasonic probe 15 and the treatment system 1 according to the present embodiment will be described. When a treatment is performed using the treatment system 1 including the ultrasonic treatment device 2, the sheath 13 and the ultrasonic probe 15 of the ultrasonic treatment device 2 are inserted into the joint space S as illustrated in FIG. 1. Further, the insertion portion 102 of the arthroscopic device 100 is inserted into the joint space S. Then, for example, the bone B <b> 2 is cut as a treatment target in the joint J by the treatment unit 32 of the ultrasonic probe 14.
　処置対象である骨Ｂ２を削る際には、接触部である突出端面３５を骨Ｂ２に接触させる。そして、エネルギー操作入力ボタン１８を押圧し、エネルギー操作を入力する。これにより、電源ユニット６に電気信号線（図示しない）を介して伝達される。そして、電源ユニット６から電力が出力され、超音波振動子２２に出力された電力が伝達されることにより、超音波振動子２２で超音波振動が発生する。超音波振動子２２で発生した超音波振動は、ホーン部材２６を介して超音波プローブ１５に伝達される。そして、超音波プローブ１５プローブ本体３１において基端方向から先端方向へ超音波振動が伝達される。そして、処置部３２が、伝達された超音波振動を用いて、骨Ｂ２を削る処置を行う。プローブ本体３１及び処置部３２は、超音波振動を伝達することにより、振動方向が基端方向及び先端方向平行な縦振動を行う。 When cutting the bone B2 that is the treatment target, the protruding end surface 35 that is the contact portion is brought into contact with the bone B2. Then, the energy operation input button 18 is pressed to input the energy operation. Thereby, the power is transmitted to the power supply unit 6 via an electric signal line (not shown). Then, power is output from the power supply unit 6 and the output power is transmitted to the ultrasonic vibrator 22, so that ultrasonic vibration is generated in the ultrasonic vibrator 22. The ultrasonic vibration generated by the ultrasonic vibrator 22 is transmitted to the ultrasonic probe 15 via the horn member 26. Then, ultrasonic vibration is transmitted from the proximal end direction to the distal end direction in the probe body 31 of the ultrasonic probe 15. Then, the treatment unit 32 performs a treatment for cutting the bone B2 using the transmitted ultrasonic vibration. The probe main body 31 and the treatment section 32 transmit ultrasonic vibrations, thereby performing longitudinal vibrations whose vibration directions are parallel to the proximal direction and the distal direction.
　図５は、処置対象（骨Ｂ２）を処置部３２で削っている状態を示す図である。図５に示すように、処置部３２の突出端面３５を骨Ｂ２に接触させた状態で処置部３２が縦振動することにより、骨Ｂ２が削られる。骨Ｂ２が削られることにより、湾曲突出部であるレーキ部３３が突出端面３５から骨Ｂ２の内部に侵入される。すなわち、骨Ｂ２が削られることにより、突出端面３５が骨Ｂ２に対して第１の垂直方向（図５の矢印Ｐ１の方向）に向かって侵入（移動）する。ここで、処置対象である骨Ｂ２を削る際に接触部である突出端面３５が処置対象（骨Ｂ２）に対して侵入される（移動する）方向を、侵入方向とする。本実施形態では、第１の垂直方向が侵入方向となり、第２の垂直方向（図５の矢印Ｐ２の方向）が侵入方向とは反対方向である反侵入方向となる。したがって、接触部である突出端面３５は、処置対象の内部へ向かう侵入方向へ処置対象に対して侵入しながら、処置対象を処置している。 FIG. 5 is a diagram illustrating a state in which the treatment target (bone B2) is being sharpened by the treatment unit 32. As shown in FIG. 5, the bone B <b> 2 is shaved when the treatment portion 32 vibrates longitudinally with the protruding end surface 35 of the treatment portion 32 in contact with the bone B <b> 2. By cutting the bone B2, the rake portion 33, which is a curved protruding portion, enters the inside of the bone B2 from the protruding end surface 35. That is, by cutting the bone B2, the protruding end surface 35 enters (moves) toward the bone B2 in the first vertical direction (the direction of the arrow P1 in FIG. 5). Here, the direction in which the protruding end surface 35 that is the contact portion enters (moves) into the treatment target (bone B2) when the bone B2 that is the treatment target is shaved is defined as the penetration direction. In the present embodiment, the first vertical direction is the intrusion direction, and the second vertical direction (the direction of the arrow P2 in FIG. 5) is the anti-intrusion direction that is opposite to the intrusion direction. Therefore, the protruding end surface 35 as a contact portion treats the treatment target while entering the treatment target in the intrusion direction toward the inside of the treatment target.
　前述のように方向が定義されることにより、指標線４１Ａ～４１Ｅを備える指標部４０は、接触部である突出端面３５より反侵入方向側（本実施形態では第２の垂直方向側）に設けられる。また、指標部４０は、処置部３２の露出面３４において、侵入方向（本実施形態では第１の垂直方向）及び反侵入方向に垂直な方向の１つ（本実施形態では、先端方向又は第３の垂直方向）を向く部位（本実施形態では第１の湾曲露出面３６及び第３の湾曲露出面３８）に、設けられている。 By defining the direction as described above, the indicator portion 40 including the indicator lines 41A to 41E is provided on the anti-intrusion direction side (the second vertical direction side in this embodiment) from the protruding end surface 35 that is the contact portion. It is done. In addition, the indicator unit 40 has one of a direction perpendicular to the intrusion direction (first vertical direction in the present embodiment) and the anti-entry direction on the exposed surface 34 of the treatment unit 32 (in the present embodiment, the distal direction or the first direction). 3 in the vertical direction) (in the present embodiment, the first curved exposed surface 36 and the third curved exposed surface 38).
　図５に示すように、処置対象である骨Ｂ２を削る処置において、骨Ｂ２及び処置部３２が、関節鏡１０１の挿入部１０２に設けられる撮像素子１０８によって、被写体として撮像される。このため、指標部４０が被写体として撮像される。そして、画像処理ユニット１０６によって画像処理された被写体像が、表示ユニット１０７に表示される。 As shown in FIG. 5, in the treatment of cutting the bone B <b> 2 that is the treatment target, the bone B <b> 2 and the treatment unit 32 are imaged as a subject by the imaging element 108 provided in the insertion unit 102 of the arthroscope 101. For this reason, the index part 40 is imaged as a subject. Then, the subject image subjected to the image processing by the image processing unit 106 is displayed on the display unit 107.
　図６は、処置対象（骨Ｂ２）を処置部３２で削っている状態において、表示ユニット１０７に表示される被写体像の一例を示す図である。図６に示すように、骨Ｂ２を削っている状態において表示ユニット１０７に表示される被写体像には、指標部４０が被写体として表示される。術者は、表示ユニット１０７に表示される指標部４０に基づいて、接触部である突出端面３５の処置対象（骨Ｂ２）に対する侵入方向（本実施形態では第１の垂直方向）への侵入量（移動量）を、認識する。例えば、図６に示す一例では、指標線４１Ａ，４１Ｂが骨Ｂ２の表面より侵入方向側（第１の垂直方向側）に位置し、指標線４１Ｃ～４１Ｅが骨Ｂ２の表面より反侵入方向側（第２の垂直方向側）に位置する状態まで、突出端面３５が骨Ｂ２に対して侵入方向へ侵入されたことが、認識される。すなわち、指標部４０は、接触部である突出端面３５の処置対象に対する侵入方向への侵入量（移動量）を示す指標となる。 FIG. 6 is a diagram illustrating an example of a subject image displayed on the display unit 107 in a state where the treatment target (bone B2) is being sharpened by the treatment unit 32. As shown in FIG. 6, the index portion 40 is displayed as a subject in the subject image displayed on the display unit 107 in a state where the bone B2 is being shaved. Based on the index portion 40 displayed on the display unit 107, the surgeon enters the treatment end (bone B <b> 2) into the treatment target (bone B <b> 2) in the intrusion direction (first vertical direction in the present embodiment). Recognize (movement amount). For example, in the example shown in FIG. 6, the index lines 41A and 41B are located on the intrusion direction side (first vertical direction side) from the surface of the bone B2, and the index lines 41C to 41E are on the anti-intrusion direction side from the surface of the bone B2. It is recognized that the projecting end surface 35 has entered the bone B2 in the intrusion direction until it is located on the (second vertical direction side). That is, the indicator 40 is an indicator that indicates the amount of penetration (movement amount) of the protruding end surface 35 that is a contact portion into the treatment target in the penetration direction.
　ここで、処置対象を削る処置において、処置対象の削り深さは、接触部である突出端面３５の処置対象に対する侵入方向への侵入量に、対応している。前述のようにして突出端面３５の処置対象（骨Ｂ２）に対する侵入方向への侵入量が認識されることにより、術者は、処置対象を削る処置を行っている最中において、処置対象の削り深さを適切に認識することができる。したがって、処置対象を削る処置において、所望の削り深さに適切に処置対象が削られる。 Here, in the treatment of cutting the treatment object, the cutting depth of the treatment object corresponds to the amount of intrusion in the intrusion direction with respect to the treatment object of the protruding end surface 35 which is a contact portion. By recognizing the amount of intrusion of the protruding end surface 35 into the treatment target (bone B2) as described above, the surgeon cuts the treatment target while performing the treatment of cutting the treatment target. Depth can be properly recognized. Therefore, in the treatment for cutting the treatment target, the treatment target is appropriately cut to a desired cutting depth.
　（第１の実施形態の変形例）　
　なお、第１の実施形態では、第１の湾曲露出面３６及び第３の湾曲露出面３８に、指標部４０が設けられているが、これに限るものではない。例えば、第１の変形例として図７に示すように、第１の湾曲露出面３６のみに指標部４０（指標線４１Ａ～４１Ｅ）が、
設けられてもよい。 (Modification of the first embodiment)
In the first embodiment, the index portion 40 is provided on the first curved exposed surface 36 and the third curved exposed surface 38, but the present invention is not limited to this. For example, as shown in FIG. 7 as a first modified example, the index portion 40 (index lines 41A to 41E) is provided only on the first curved exposed surface 36.
It may be provided.
　また、別の変形例では、指標部４０は、第１の湾曲露出面３６及び第３の湾曲露出面３８に設けられず、第２の湾曲露出面３７及び第４の湾曲露出面３９のみに設けられてもよい。さらに、別の変形例では、指標部４０は、第２の湾曲露出面３７のみに設けられてもよい。すなわち、指標部４０（指標線４１Ａ～４１Ｅ）は、第１の湾曲露出面３６、第２の湾曲露出面３７、第３の湾曲露出面３８、及び、第４の湾曲露出面３９の少なくとも１つに設けられていればよい。 In another modification, the indicator portion 40 is not provided on the first curved exposed surface 36 and the third curved exposed surface 38, but only on the second curved exposed surface 37 and the fourth curved exposed surface 39. It may be provided. Furthermore, in another modification, the indicator portion 40 may be provided only on the second curved exposed surface 37. That is, the index portion 40 (index lines 41A to 41E) is at least one of the first curved exposed surface 36, the second curved exposed surface 37, the third curved exposed surface 38, and the fourth curved exposed surface 39. As long as it is provided.
　また、第２の変形例として図８に示すように、指標部４０は、指標線４１Ａ～４１Ｅの代わりに、複数（本変形例では４つ）の有色表面４２Ａ～４２Ｄを備えてもよい。本変形例でも、第１の実施形態と同様に、指標部４０は、第１の湾曲露出面３６及び第３の湾曲露出面３８に設けられ、接触部である突出端面（突出端）３５より反侵入方向側（第２の垂直方向（Ｐ２）側）に設けられている。有色表面４２Ａ～４２Ｄは、侵入方向（第１の垂直方向Ｐ１）及び反侵入方向（第２の垂直方向Ｐ２）について連続的に並設されている。すなわち、有色表面４２Ａ～４２Ｄは、接触部である突出端面３５から反侵入方向へ向かって設けられている。それぞれの有色表面４２Ａ～４２Ｄは、隣設する有色表面（４２Ａ～４２Ｄ）に対して、色が異なる。例えば、有色表面４２Ａは赤色、有色表面４２Ｂは緑色、有色表面４２Ｃは黄色、有色表面４２Ｄは青色となる。前述のように有色表面４２Ａ～４２Ｄが形成されることにより、指標部４０は、接触部である突出端面３５の処置対象（骨Ｂ２）に対する侵入方向（第１の垂直方向）への侵入量（移動量）を示す指標となる。 Further, as shown in FIG. 8 as a second modification, the index unit 40 may include a plurality (four in this modification) of colored surfaces 42A to 42D instead of the index lines 41A to 41E. Also in this modified example, as in the first embodiment, the indicator portion 40 is provided on the first curved exposed surface 36 and the third curved exposed surface 38, and from the projecting end surface (projecting end) 35 that is a contact portion. It is provided on the anti-intrusion direction side (second vertical direction (P2) side). The colored surfaces 42A to 42D are continuously arranged in the penetration direction (first vertical direction P1) and the anti-penetration direction (second vertical direction P2). That is, the colored surfaces 42A to 42D are provided in the anti-intrusion direction from the protruding end surface 35 that is a contact portion. Each of the colored surfaces 42A to 42D is different in color from the adjacent colored surfaces (42A to 42D). For example, the colored surface 42A is red, the colored surface 42B is green, the colored surface 42C is yellow, and the colored surface 42D is blue. By forming the colored surfaces 42A to 42D as described above, the indicator portion 40 has an intrusion amount in the intrusion direction (first vertical direction) with respect to the treatment target (bone B2) of the protruding end surface 35 which is a contact portion ( (Movement amount).
　また、第３の変形例として図９に示すように、指標部４０は、複数（本変形例では４つ）の指標面４３Ａ～４３Ｄを備えてもよい。本変形例では、指標部４０は、第１の湾曲露出面３６のみに設けられ、接触部である突出端面（突出端）３５より反侵入方向側（第２の垂直方向（Ｐ２）側）に設けられている。指標面４３Ａ～４３Ｄは、侵入方向（第１の垂直方向Ｐ１）及び反侵入方向（第２の垂直方向Ｐ２）について連続的に並設されている。すなわち、指標面４３Ａ～４３Ｄは、接触部である突出端面３５から反侵入方向へ向かって設けられている。それぞれの指標面４３Ａ～４３Ｄは、隣設する指標面（４３Ａ～４３Ｄ）に対して、侵入方向（第１の垂直方向）に対する角度が異なる。例えば、指標面４３Ａでは侵入方向に対する角度が１２０°となり、指標面４３Ｂでは侵入方向に対する角度が１５０°となる。そして、指標面４３Ｃでは侵入方向に対する角度が０°（侵入方向に対して平行）となり、指標面４３Ｄでは侵入方向に対する角度が３０°となる。前述のように指標面４３Ａ～４３Ｄが形成されることにより、指標部４０は、接触部である突出端面３５の処置対象（骨Ｂ２）に対する侵入方向（第１の垂直方向）への侵入量を示す指標となる。 Further, as shown in FIG. 9 as a third modified example, the index unit 40 may include a plurality of (four in this modification) index surfaces 43A to 43D. In this modification, the indicator portion 40 is provided only on the first curved exposed surface 36, and is on the anti-intrusion direction side (second vertical direction (P2) side) from the protruding end surface (projecting end) 35 that is a contact portion. Is provided. The indicator surfaces 43A to 43D are continuously arranged in the penetration direction (first vertical direction P1) and the anti-penetration direction (second vertical direction P2). That is, the index surfaces 43A to 43D are provided in the anti-intrusion direction from the protruding end surface 35 that is a contact portion. The respective index surfaces 43A to 43D have different angles with respect to the intrusion direction (first vertical direction) with respect to the adjacent index surfaces (43A to 43D). For example, the angle with respect to the intrusion direction is 120 ° on the index surface 43A, and the angle with respect to the intrusion direction is 150 ° on the index surface 43B. The index plane 43C has an angle of 0 ° (parallel to the penetration direction), and the index plane 43D has an angle of 30 ° with respect to the penetration direction. By forming the index surfaces 43A to 43D as described above, the index unit 40 can reduce the intrusion amount in the intrusion direction (first vertical direction) with respect to the treatment target (bone B2) of the protruding end surface 35 which is a contact portion. It becomes an indicator to show.
　また、第４の変形例として図１０の示すように、レーキ部３３の代わりにフック形状に形成されるフック部（hook portion）４５が湾曲突出部として設けられてもよい。フック部４５は、レーキ部３３と同様に、長手軸Ｃに対して第１の垂直方向（図１０の矢印Ｐ１の方向）に湾曲し、第１の垂直方向へ向かって突出する。そして、フック部４５の突出端（第１の垂直方向側の端）に、突出端面５０が接触部として設けられている。本変形例では、突出端面５０が、処置対象（骨）を削る処置において、処置対象に接触させる接触部となる。また、処置部３２の露出面３４は、フック部４５において先端方向を向く第１の湾曲露出面４６と、フック部４５において基端方向を向く第２の湾曲露出面４７と、フック部４５において第３の垂直方向Ｐ３（図１０で紙面に対して鉛直上方向）を向く第３の湾曲露出面４８と、フック部４５において第４の垂直方向Ｐ４（図１０で紙面に対して鉛直下方向）を向く第４の湾曲露出面（図示しない）と、を備える。 Further, as shown in FIG. 10 as a fourth modified example, a hook portion 45 formed in a hook shape instead of the rake portion 33 may be provided as a curved protruding portion. Similarly to the rake portion 33, the hook portion 45 is curved in the first vertical direction (the direction of the arrow P1 in FIG. 10) with respect to the longitudinal axis C, and protrudes in the first vertical direction. A protruding end surface 50 is provided as a contact portion at the protruding end (first vertical direction end) of the hook portion 45. In the present modification, the protruding end surface 50 serves as a contact portion that is brought into contact with the treatment target in the treatment of cutting the treatment target (bone). In addition, the exposed surface 34 of the treatment portion 32 includes a first curved exposed surface 46 facing the distal end direction in the hook portion 45, a second curved exposed surface 47 facing the proximal direction in the hook portion 45, and a hook portion 45. A third curved exposed surface 48 facing the third vertical direction P3 (vertically upward with respect to the paper surface in FIG. 10) and a fourth vertical direction P4 (downwardly perpendicular to the paper surface in FIG. 10) at the hook portion 45. And a fourth curved exposed surface (not shown).
　本変形例でも、第１の実施形態と同様に、第１の垂直方向が侵入方向となり、第２の垂直方向が反侵入方向となる。本変形例では、第３の湾曲露出面４８のみに、指標部４０が設けられ、指標部４０は、少なくとも１つ（本変形例では４つ）の指標線５１Ａ～５１Ｄを備える。指標線５１Ａ～５１Ｄは、第１の実施形態の指標線４１Ａ～４１Ｅと同様に、侵入方向及び反侵入方向に対して交差する状態で、延設されている。本変形例でも、指標部４０は、接触部である突出端面５０より反侵入方向側（第２の垂直方向側）に位置している。したがって、本変形例でも、指標部４０は、接触部である突出端面５０の処置対象に対する侵入方向（第１の垂直方向）への侵入量（移動量）を示す指標となる。 Also in this modification, as in the first embodiment, the first vertical direction is the intrusion direction and the second vertical direction is the anti-intrusion direction. In the present modification, the index portion 40 is provided only on the third curved exposed surface 48, and the index portion 40 includes at least one (four in the present modification) index lines 51A to 51D. Like the index lines 41A to 41E of the first embodiment, the index lines 51A to 51D are extended so as to intersect the intrusion direction and the anti-intrusion direction. Also in this modified example, the index part 40 is located on the anti-intrusion direction side (second vertical direction side) from the protruding end surface 50 that is a contact part. Therefore, also in this modified example, the index portion 40 is an index indicating the amount of penetration (movement amount) in the penetration direction (first vertical direction) with respect to the treatment target of the protruding end surface 50 that is the contact portion.
　前述の第１の実施形態及びその変形例では、処置部（３２）は、長手軸（Ｃ）に対して侵入方向である第１の垂直方向（Ｐ１）に湾曲することにより、第１の垂直方向（Ｐ１）へ向かって突出する湾曲突出部（３３；４５）を備える。処置部（３２）の先端は、湾曲突起部（３３；４５）によって形成されている。そして、処置対象を削る処置において処置対象に接触させる接触部（３５；５０）は、湾曲突出部（３３；４５）の第１の垂直方向（Ｐ１）側の端である突出端に位置している。そして、指標部（４０）は、突出端より反侵入方向側（第２の垂直方向（Ｐ２）側）に設けられている。 In the first embodiment described above and its modification, the treatment portion (32) is curved in the first vertical direction (P1) that is the intrusion direction with respect to the longitudinal axis (C), so that the first vertical direction is obtained. A curved protrusion (33; 45) protruding toward the direction (P1) is provided. The distal end of the treatment portion (32) is formed by a curved protrusion (33; 45). And the contact part (35; 50) made to contact with a treatment object in the treatment which cuts off a treatment object is located in the projection end which is an end by the side of the 1st perpendicular direction (P1) of a curved projection part (33; 45). Yes. The indicator portion (40) is provided on the anti-intrusion direction side (second vertical direction (P2) side) from the protruding end.
　（第２の実施形態）　
　次に、本発明の第２の実施形態について、図１１を参照して説明する。第２の実施形態は、第１の実施形態の構成を次の通り変形したものである。なお、第１の実施形態と同一の部分については同一の符号を付して、その説明は省略する。 (Second Embodiment)
Next, a second embodiment of the present invention will be described with reference to FIG. In the second embodiment, the configuration of the first embodiment is modified as follows. In addition, the same code | symbol is attached | subjected about the part same as 1st Embodiment, and the description is abbreviate | omitted.
　図１１は、本実施形態の超音波プローブ１５の処置部３２を示す図である。図１１に示すように、処置部３２は、キュレット部５２を備える。本実施形態では、処置部３２は、長手軸Ｃに沿って湾曲することなく延設されている。処置部３２の露出面３４は、処置部３２の外周において第１の垂直方向（図１１の矢印Ｐ１の方向）を向く第１の外周露出面５４と、処置部３２の外周において第２の垂直方向（図１１の矢印Ｐ２の方向）を向く第２の外周露出面５８と、を備える。キュレット部５２には、開口孔５３が、孔規定面５７によって規定されている。開口孔５３は、第１の外周露出面５４に位置する第１の開口端Ｅ１で開口している。そして、孔規定面５７は、第１の開口端Ｅ１から第２の垂直方向へ向かって延設されている。 FIG. 11 is a view showing the treatment section 32 of the ultrasonic probe 15 of the present embodiment. As shown in FIG. 11, the treatment unit 32 includes a curette unit 52. In the present embodiment, the treatment portion 32 extends along the longitudinal axis C without being curved. The exposed surface 34 of the treatment portion 32 includes a first outer periphery exposed surface 54 that faces the first vertical direction (the direction of the arrow P1 in FIG. 11) on the outer periphery of the treatment portion 32 and a second vertical surface on the outer periphery of the treatment portion 32. A second outer peripheral exposed surface 58 that faces the direction (the direction of the arrow P2 in FIG. 11). An opening hole 53 is defined in the curette part 52 by a hole defining surface 57. The opening hole 53 is opened at the first opening end E <b> 1 located on the first outer peripheral exposed surface 54. The hole defining surface 57 extends from the first opening end E1 in the second vertical direction.
　開口孔５３の第１の開口端Ｅ１の縁部には、開口端刃部５５が設けられている。超音波振動によって処置対象（骨）を削る処置においては、開口端刃部５５が、処置対象に接触させる接触部となる。開口端刃部５５は、長手軸Ｃより第１の垂直方向側に位置している。開口孔５３は、第２の外周露出面５８に位置する第２の開口端Ｅ２で開口している。したがって、開口孔５３は、第１の開口端Ｅ１と第２の開口端Ｅ２との間で第１の垂直方向及び第２の垂直方向に沿って、処置部３２のキュレット部５２を貫通している。開口孔５３がキュレット部５２を貫通することにより、孔規定面５７は、処置部３２の外部に対して露出する。したがって、本実施形態では、孔規定面５７は、処置部３２の露出面３４の一部となる。 An opening end blade portion 55 is provided at the edge of the first opening end E1 of the opening hole 53. In the treatment of cutting the treatment target (bone) by ultrasonic vibration, the open end blade portion 55 serves as a contact portion that is brought into contact with the treatment target. The open end edge portion 55 is located on the first vertical direction side from the longitudinal axis C. The opening hole 53 is opened at the second opening end E <b> 2 located on the second outer peripheral exposed surface 58. Accordingly, the opening hole 53 passes through the curette portion 52 of the treatment portion 32 along the first vertical direction and the second vertical direction between the first opening end E1 and the second opening end E2. Yes. The hole defining surface 57 is exposed to the outside of the treatment portion 32 as the opening hole 53 penetrates the curette portion 52. Therefore, in the present embodiment, the hole defining surface 57 is a part of the exposed surface 34 of the treatment portion 32.
　また、処置部３２の外周には、第１の外周露出面５４と第２の外周露出面５８との間で第１の垂直方向及び第２の垂直方向に沿って連続的に延設される外周中継面５６が、設けられている。外周中継面５６によって、処置部３２の先端が形成されている。外周中継面５６は、処置部３２の露出面３４の一部となる。また、開口孔５３の内部では、孔規定面５７は、第１の外周露出面５４と第２の外周露出面５８との間で第１の垂直方向及び第２の垂直方向に沿って連続的に延設される。 Further, the outer periphery of the treatment portion 32 is continuously extended along the first vertical direction and the second vertical direction between the first outer peripheral exposed surface 54 and the second outer peripheral exposed surface 58. An outer peripheral relay surface 56 is provided. The distal end of the treatment portion 32 is formed by the outer peripheral relay surface 56. The outer peripheral relay surface 56 becomes a part of the exposed surface 34 of the treatment portion 32. Further, inside the opening hole 53, the hole defining surface 57 is continuous between the first outer peripheral exposed surface 54 and the second outer peripheral exposed surface 58 along the first vertical direction and the second vertical direction. It is extended to.
　なお、本実施形態では、処置部３２の露出面３４において孔規定面５７以外の部位（例えば、第１の外周露出面５４、第２の外周露出面５８及び外周中継面５６）が、処置部３２の外周となる。そして、外周中継面５６及び孔規定面５７が、第１の外周露出面５４と第２の外周露出面５８との間で第１の垂直方向及び第２の垂直方向に沿って連続的に延設される中継露出面となる。そして、中継露出面（５６，５７）は、開口孔５３の外部に位置する外側中継面である外周中継面５６と、開口孔５３の内部に位置する内側中継面である孔規定面５７と、を備える。そして、中継露出面（５６，５７）は、処置部３２の露出面３４の一部となる。 In the present embodiment, a portion other than the hole defining surface 57 (for example, the first outer peripheral exposed surface 54, the second outer peripheral exposed surface 58, and the outer peripheral relay surface 56) on the exposed surface 34 of the treatment portion 32 is the treatment portion. 32. The outer peripheral relay surface 56 and the hole defining surface 57 continuously extend along the first vertical direction and the second vertical direction between the first outer peripheral exposed surface 54 and the second outer peripheral exposed surface 58. It becomes the relay exposed surface. The relay exposed surfaces (56, 57) include an outer peripheral relay surface 56 that is an outer relay surface located outside the opening hole 53, a hole defining surface 57 that is an inner relay surface located inside the opening hole 53, and Is provided. The relay exposed surfaces (56, 57) become part of the exposed surface 34 of the treatment section 32.
　本実施形態では、接触部である開口端刃部５５を処置対象に接触させた状態で処置部３２が超音波振動によって縦振動することにより、処置対象（骨）が削られる。これにより、第１の外周露出面５４（開口端刃部５５）から処置対象の内部に侵入される。すなわち、処置対象（骨）が削られることにより、開口端刃部５５が処置対象に対して第１の垂直方向に向かって移動する。このため、本実施形態でも、第１の垂直方向が、処置対象を削る際に接触部である開口端刃部５５が処置対象に対して侵入される（移動する）侵入方向となる。そして、第２の垂直方向が、侵入方向とは反対方向である反侵入方向となる。 In this embodiment, the treatment target (bone) is shaved by longitudinally vibrating the treatment portion 32 by ultrasonic vibration in a state where the open end blade portion 55 that is a contact portion is in contact with the treatment target. Thereby, it penetrate | invades into the inside of treatment object from the 1st outer periphery exposed surface 54 (opening edge blade part 55). That is, by cutting the treatment target (bone), the open end blade portion 55 moves in the first vertical direction with respect to the treatment target. For this reason, also in this embodiment, the first vertical direction is an intrusion direction in which the open end blade portion 55 that is a contact portion enters (moves) into the treatment target when the treatment target is cut. The second vertical direction is the anti-intrusion direction that is the opposite direction to the intrusion direction.
　本実施形態では、外周中継面５６及び孔規定面５７に指標部４０が設けられる。すなわち、中継露出面（５６，５７）に指標部４０が設けられている。指標部４０が中継露出面（５６，５７）に設けられるため、指標部４０は、処置部３２の露出面３４において、侵入方向（第１の垂直方向）及び反侵入方向（第２の垂直方向）に垂直な方向の１つを向く部位に、位置している。また、指標部４０は、接触部である開口端刃部５５より反侵入方向側（第２の垂直方向側）に位置している。 In the present embodiment, the indicator portion 40 is provided on the outer peripheral relay surface 56 and the hole defining surface 57. That is, the indicator part 40 is provided on the relay exposed surface (56, 57). Since the indicator portion 40 is provided on the relay exposed surface (56, 57), the indicator portion 40 is in the intrusion direction (first vertical direction) and the anti-intrusion direction (second vertical direction) on the exposed surface 34 of the treatment portion 32. ) Is located in a part facing one of the directions perpendicular to the vertical axis. In addition, the indicator portion 40 is located on the anti-intrusion direction side (second vertical direction side) from the open end blade portion 55 that is a contact portion.
　指標部４０は、外周中継面５６に設けられる指標線６１Ａ，６１Ｂと、孔規定面５７に設けられる指標線６２Ａ～６２Ｃと、を備える。指標線６１Ａ，６１Ｂ，６２Ａ～６２Ｃは、第１の実施形態の指標線４１Ａ～４１Ｅと同様に、侵入方向（第１の垂直方向）及び反侵入方向（第２の垂直方向）に対して交差する状態で、延設されている。したがって、指標部４０は、接触部である突出端面３５の処置対象に対する侵入方向への侵入量（移動量）を示す指標となる。これにより、処置対象を削る処置において、接触部である開口端刃部５５の処置対象に対する侵入方向への侵入量が、術者によって認識される。これにより、術者は、処置対象を削る処置を行っている最中において、処置対象の削り深さを適切に認識することができる。 The indicator portion 40 includes indicator lines 61A and 61B provided on the outer peripheral relay surface 56 and indicator lines 62A to 62C provided on the hole defining surface 57. The index lines 61A, 61B, 62A to 62C intersect the intrusion direction (first vertical direction) and the anti-intrusion direction (second vertical direction) in the same manner as the index lines 41A to 41E of the first embodiment. In the state to be extended. Therefore, the indicator portion 40 is an indicator that indicates the amount of penetration (movement amount) of the protruding end surface 35 that is a contact portion into the treatment target in the penetration direction. Thus, in the treatment for cutting the treatment target, the surgeon recognizes the amount of penetration of the open end blade portion 55 that is the contact portion into the treatment target in the penetration direction. Thus, the surgeon can appropriately recognize the cutting depth of the treatment target while performing the treatment of cutting the treatment target.
　（第２の実施形態の変形例）　
　なお、第２の実施形態では、外側中継面である外周中継面５６及び内側中継面である孔規定面５７の両方に指標部４０が設けられているが、これに限るものではない。例えば、変形例として、外周中継面５６のみ又は孔規定面５７のみに、指標部４０が設けられてもよい。 (Modification of the second embodiment)
In the second embodiment, the indicator portions 40 are provided on both the outer peripheral relay surface 56 that is the outer relay surface and the hole defining surface 57 that is the inner relay surface. However, the present invention is not limited to this. For example, as a modification, the indicator portion 40 may be provided only on the outer peripheral relay surface 56 or only on the hole defining surface 57.
　また、第５の変形例として図１２及び図１３の示すように、キュレット部５２の代わりにパイプ部６０が、処置部３２に形成されてもよい。本変形例でも第２の実施形態と同様に、処置部３２の露出面３４は、処置部３２の外周において第１の垂直方向（図１２の矢印Ｐ１の方向）を向く第１の外周露出面６４と、処置部３２の外周において第２の垂直方向（図１２の矢印Ｐ２の方向）を向く第２の外周露出面６９と、を備える。そして、孔規定面５９によって開口孔６５が規定され、開口孔６５は、第１の外周露出面６４に位置する開口端（第１の開口端）Ｅ´１で開口している。そして、開口孔６５の開口端Ｅ´１の縁部には、接触部である開口端刃部６６が設けられている。 As a fifth modification, as shown in FIGS. 12 and 13, a pipe part 60 may be formed in the treatment part 32 instead of the curette part 52. Also in the present modification, as in the second embodiment, the exposed surface 34 of the treatment portion 32 is a first outer periphery exposed surface that faces the first vertical direction (the direction of the arrow P1 in FIG. 12) on the outer periphery of the treatment portion 32. 64 and a second outer peripheral exposed surface 69 facing the second vertical direction (the direction of the arrow P2 in FIG. 12) on the outer periphery of the treatment portion 32. An opening hole 65 is defined by the hole defining surface 59, and the opening hole 65 opens at an opening end (first opening end) E ′ 1 positioned on the first outer peripheral exposed surface 64. An opening end blade portion 66 that is a contact portion is provided at the edge of the opening end E ′ 1 of the opening hole 65.
　ただし、本変形例では、開口孔６５は、第１の外周露出面６４の開口端Ｅ´１のみで開口し、第２の外周露出面６９では処置部３２の外部に対して開口していない。このため、開口孔６５は、第１の垂直方向及び第２の垂直方向についてパイプ部６０を貫通していない。このため、第２の実施形態とは異なり、孔規定面５９は、処置部３２の外部に対して露出せず、処置部３２の露出面３４に含まれない。 However, in the present modification, the opening hole 65 opens only at the opening end E ′ 1 of the first outer peripheral exposed surface 64, and does not open to the outside of the treatment portion 32 at the second outer peripheral exposed surface 69. . For this reason, the opening hole 65 does not penetrate the pipe part 60 in the first vertical direction and the second vertical direction. For this reason, unlike the second embodiment, the hole defining surface 59 is not exposed to the outside of the treatment portion 32 and is not included in the exposed surface 34 of the treatment portion 32.
　また、本変形例では、露出面３４は、処置部３２の先端を形成する先端露出面６３を備える。先端露出面６３は、第１の垂直方向及び第２の垂直方向に垂直な先端方向を向いている。先端露出面６３は、第１の外周露出面６４と第２の外周露出面６９との間で第１の垂直方向及び第２の垂直方向に沿って連続的に延設される中継露出面となる。先端露出面６３は、第１の垂直方向及び第２の垂直方向が長径方向で、第３の垂直方向（図１２の矢印Ｐ３の方向）及び第４の垂直方向（図１２の矢印Ｐ４の方向）が短径方向となる楕円状に形成されている。 In the present modification, the exposed surface 34 includes a tip exposed surface 63 that forms the tip of the treatment portion 32. The tip exposed surface 63 faces the tip direction perpendicular to the first vertical direction and the second vertical direction. The tip exposed surface 63 is a relay exposed surface continuously extending along the first vertical direction and the second vertical direction between the first outer peripheral exposed surface 64 and the second outer peripheral exposed surface 69. Become. In the tip exposed surface 63, the first vertical direction and the second vertical direction are major axis directions, and the third vertical direction (the direction of the arrow P3 in FIG. 12) and the fourth vertical direction (the direction of the arrow P4 in FIG. 12). ) Is formed in an elliptical shape in the minor axis direction.
　また、本変形例では、超音波プローブ１５に、プローブ本体３１の内部を通って長手軸Ｃに沿って延設される通路６８が形成されている。処置部３２のパイプ部６０の内部において、通路６８は、開口孔６５と連通している。超音波振動を用いて処置対象（骨）を削ることにより、接触部である開口端刃部６６は、第１の垂直方向に向かって処置対象に対して侵入される。したがって、本変形例でも、第１の垂直方向が侵入方向となり、第２の垂直方向が反侵入方向となる。削られた骨は、開口孔６５及び通路６８を介して、吸引ユニット（図示しない）に吸引回収される。 Further, in the present modification, a passage 68 extending along the longitudinal axis C through the inside of the probe main body 31 is formed in the ultrasonic probe 15. The passage 68 communicates with the opening hole 65 in the pipe portion 60 of the treatment portion 32. By cutting the treatment target (bone) using ultrasonic vibration, the open end blade portion 66 that is the contact portion enters the treatment target in the first vertical direction. Therefore, also in this modification, the first vertical direction is the intrusion direction, and the second vertical direction is the anti-intrusion direction. The shaved bone is sucked and collected by a suction unit (not shown) through the opening hole 65 and the passage 68.
　本変形例では、中継露出面である先端露出面６３に、指標部４０が設けられている。指標部４０は、指標線６７Ａ，６７Ｂを備える。指標線６７Ａ，６７Ｂは、第１の実施形態の指標線４１Ａ～４１Ｅと同様に、侵入方向及び反侵入方向に対して交差する状態で、延設されている。本変形例でも、指標部４０は、接触部である開口端刃部６６より反侵入方向側（第２の垂直方向側）に位置している。したがって、本変形例でも、指標部４０は、接触部である開口端刃部６６の処置対象に対する侵入方向（第１の垂直方向）への侵入量（移動量）を示す指標となる。 In the present modification, the indicator portion 40 is provided on the tip exposed surface 63 which is a relay exposed surface. The index unit 40 includes index lines 67A and 67B. The index lines 67A and 67B are extended so as to intersect the intrusion direction and the anti-intrusion direction, similarly to the index lines 41A to 41E of the first embodiment. Also in this modified example, the index part 40 is located on the anti-intrusion direction side (second vertical direction side) from the open end blade part 66 that is the contact part. Therefore, also in this modified example, the index portion 40 serves as an index indicating the amount of penetration (movement amount) in the penetration direction (first vertical direction) with respect to the treatment target of the open end blade portion 66 that is the contact portion.
　なお、第２の実施形態の指標線６１Ａ，６１Ｂの代わりに、前述した複数の有色表面と同様の構成（図８参照）を、指標部４０に設けてもよい。また、第２の実施形態の指標線６１Ａ，６１Ｂの代わりに、前述した複数の指標面と同様の構成（図９参照）を、指標部４０に設けてもよい。 In addition, you may provide the structure (refer FIG. 8) similar to the several colored surface mentioned above in the parameter | index part 40 instead of the index line 61A, 61B of 2nd Embodiment. Further, instead of the index lines 61A and 61B of the second embodiment, the index unit 40 may be provided with the same configuration (see FIG. 9) as the plurality of index surfaces described above.
　前述の第２の実施形態及びその変形例では、露出面（３４）は、処置部（３２）の外周において第１の垂直方向（Ｐ１）を向く第１の外周露出面（５４；６４）と、処置部（３２）の外周において第２の垂直方向（Ｐ２）を向く第２の外周露出面（５８；６９）と、第１の外周露出面（５４；６４）と第２の外周露出面（５８；６９）との間で第１の垂直方向（Ｐ１）及び第２の垂直方向（Ｐ２）に沿って連続的に延設される中継露出面（５６，５７；６３）と、を備える。そして、処置部（３２）には、第１の外周露出面（５４；５６）の第１の開口端（Ｅ１；Ｅ´１）で開口する開口孔（５３；６５）が形成されている。そして、処置対象を削る処置において処置対象に接触させる接触部（５５；６６）は、第１の開口端（Ｅ１；Ｅ´１）に位置している。そして、指標部（４０）は、中継露出面（５６，５７；６３）に設けられている。 In the second embodiment described above and its modification, the exposed surface (34) and the first outer peripheral exposed surface (54; 64) facing the first vertical direction (P1) on the outer periphery of the treatment portion (32). The second outer peripheral exposed surface (58; 69), the first outer peripheral exposed surface (54; 64), and the second outer peripheral exposed surface facing the second vertical direction (P2) on the outer periphery of the treatment portion (32). (58; 69), and a relay exposed surface (56, 57; 63) continuously extending along the first vertical direction (P1) and the second vertical direction (P2). . The treatment portion (32) is formed with an opening hole (53; 65) that opens at the first opening end (E1; E′1) of the first outer peripheral exposed surface (54; 56). And the contact part (55; 66) made to contact with a treatment object in the treatment which cuts off a treatment object is located in the 1st opening end (E1; E'1). The indicator portion (40) is provided on the relay exposed surface (56, 57; 63).
　（第１の実施形態及び第２の実施形態の変形例）　
　第１の実施形態、第２の実施形態及びこれらの変形例では、処置対象を削る処置において処置対象に接触させる接触部（３５；５０；５５；６６）は、長手軸Ｃより第１の垂直方向（Ｐ１）側に位置している。そして、処置対象が削られている状態での接触部（３５；５０；５５；６６）の侵入方向は、第１の垂直方向（Ｐ１）と一致している。そして、指標部（４０）は、接触部（３５；５０；５５；６６）より反侵入方向側（第２の垂直方向（Ｐ２）側）に設けられている。 (Modification of the first embodiment and the second embodiment)
In the first embodiment, the second embodiment, and the modifications thereof, the contact portion (35; 50; 55; 66) that is brought into contact with the treatment object in the treatment of cutting the treatment object is first perpendicular to the longitudinal axis C. It is located on the direction (P1) side. And the penetration | invasion direction of the contact part (35; 50; 55; 66) in the state in which the treatment target is shaved corresponds with the 1st perpendicular direction (P1). The indicator portion (40) is provided on the anti-intrusion direction side (second vertical direction (P2) side) from the contact portion (35; 50; 55; 66).
　（第３の実施形態）　
　次に、本発明の第３の実施形態について、図１４を参照して説明する。第３の実施形態は、第１の実施形態の構成を次の通り変形したものである。なお、第１の実施形態と同一の部分については同一の符号を付して、その説明は省略する。 (Third embodiment)
Next, a third embodiment of the present invention will be described with reference to FIG. In the third embodiment, the configuration of the first embodiment is modified as follows. In addition, the same code | symbol is attached | subjected about the part same as 1st Embodiment, and the description is abbreviate | omitted.
　図１４は、本実施形態の超音波プローブ１５の処置部３２を示す図である。図１４に示すように、処置部３２は、ブレード部７０を備える。本実施形態では、処置部３２は、長手軸Ｃに沿って湾曲することなく延設されている。ブレード部７０では、第１の垂直方向（図１４で紙面に対して鉛直上方向）及び第２の垂直方向（図１４で紙面に対して鉛直した方向）についての寸法が小さくなり、第３の垂直方向（図１４の矢印Ｐ３の方向）及び第４の垂直方向（図１４の矢印Ｐ４の方向）についての寸法が大きくなる。 FIG. 14 is a diagram showing the treatment section 32 of the ultrasonic probe 15 of the present embodiment. As shown in FIG. 14, the treatment portion 32 includes a blade portion 70. In the present embodiment, the treatment portion 32 extends along the longitudinal axis C without being curved. In the blade portion 70, the dimensions in the first vertical direction (upwardly perpendicular to the paper surface in FIG. 14) and the second vertical direction (the direction perpendicular to the paper surface in FIG. 14) are reduced. The dimensions in the vertical direction (the direction of arrow P3 in FIG. 14) and the fourth vertical direction (the direction of arrow P4 in FIG. 14) are increased.
　処置部３２の露出面３４は、鋭利な先端尖部７２と、処置部３２の外周において先端尖部７２から基端方向（Ｃ２）へ向かって延出される外周露出面７１と、を備える。先端尖部７２によって、処置部３２の先端が形成されている。また、先端尖部７２は、超音波振動を用いた処置対象を削る処置において処置対象に接触させる接触部である。ここで、長手軸Ｃを中心とする時計回り方向及び反時計回り方向の２方向を長手軸回り方向とする。本実施形態では、外周露出面７１は、長手軸回り方向について全周に渡って延設されている。したがって、外周露出面７１では、処置部３２の露出面３４は、長手軸Ｃに対して垂直な方向の１つを向いている。 The exposed surface 34 of the treatment portion 32 includes a sharp distal tip 72 and an outer peripheral exposed surface 71 extending from the distal tip 72 toward the proximal direction (C2) on the outer periphery of the treatment portion 32. The distal end of the treatment portion 32 is formed by the distal tip 72. In addition, the tip apex 72 is a contact portion that is brought into contact with the treatment target in a treatment for cutting the treatment target using ultrasonic vibration. Here, two directions of the clockwise direction and the counterclockwise direction around the longitudinal axis C are defined as the longitudinal axis direction. In the present embodiment, the outer peripheral exposed surface 71 extends over the entire circumference in the direction around the longitudinal axis. Therefore, in the outer peripheral exposed surface 71, the exposed surface 34 of the treatment portion 32 faces one of the directions perpendicular to the longitudinal axis C.
　本実施形態では、接触部である先端尖部７２を処置対象に接触させた状態で処置部３２が超音波振動によって縦振動することにより、先端尖部７２から処置対象の内部に侵入される。すなわち、先端尖部７２が処置対象に対して先端方向に向かって移動する。このため、本実施形態では前述の実施形態とは異なり、先端方向（Ｃ１）が、処置対象の内部に処置部３２を侵入する際に接触部である先端尖部７２が処置対象に対して侵入される（移動する）侵入方向となる。そして、基端方向が、侵入方向とは反対方向である反侵入方向となる。 In the present embodiment, the treatment portion 32 is vibrated longitudinally by ultrasonic vibration in a state in which the tip cusp 72 that is a contact portion is in contact with the treatment target, thereby entering the inside of the treatment target from the tip cusp 72. That is, the tip cusp 72 moves toward the tip with respect to the treatment target. For this reason, in this embodiment, unlike the above-mentioned embodiment, the tip direction (C1) is that the tip apex portion 72 that is a contact portion enters the treatment target when the treatment portion 32 enters the treatment target. Is the direction of entry (moving). The proximal direction is the anti-intrusion direction that is opposite to the intrusion direction.
　本実施形態では、外周露出面７１に指標部４０が設けられる。指標部４０は、長手軸回り方向について全周に渡って設けられてもよく、長手軸回り方向について一部の範囲に渡って設けられてもよい。指標部４０が外周露出面７１に設けられるため、指標部４０は、処置部３２の露出面３４において、侵入方向（先端方向）及び反侵入方向（基端方向）に垂直な方向の１つを向く部位に、位置している。また、指標部４０は、接触部である先端尖部７２より反侵入方向側（基端方向側）に設けられている。 In the present embodiment, the indicator portion 40 is provided on the outer peripheral exposed surface 71. The indicator 40 may be provided over the entire circumference in the direction around the longitudinal axis, or may be provided over a part of the range in the direction around the longitudinal axis. Since the indicator portion 40 is provided on the outer peripheral exposed surface 71, the indicator portion 40 has one of the directions perpendicular to the intrusion direction (distal direction) and the anti-intrusion direction (proximal direction) on the exposed surface 34 of the treatment portion 32. It is located in the facing part. In addition, the indicator portion 40 is provided on the anti-intrusion direction side (base end direction side) from the tip apex portion 72 which is a contact portion.
　指標部４０は、７３Ａ～７３Ｆを備える。指標線７３Ａ～７３Ｆは、第１の実施形態の指標線４１Ａ～４１Ｅと同様に、侵入方向（本実施形態では先端方向）及び反侵入方向（本実施形態では基端方向）に対して交差する状態で、延設されている。したがって、指標部４０は、接触部である先端尖部７２の処置対象に対する侵入方向への侵入量（移動量）を示す指標となる。これにより、処置対象に処置部３２を侵入する処置において、接触部である先端尖部７２の処置対象に対する侵入方向への侵入量が、術者によって認識される。これにより、術者は、処置対象を削る処置を行っている最中において、処置対象の削り深さを適切に認識することができる。 The indicator unit 40 includes 73A to 73F. Like the index lines 41A to 41E of the first embodiment, the index lines 73A to 73F intersect the intrusion direction (front end direction in the present embodiment) and the anti-intrusion direction (base end direction in the present embodiment). The state is extended. Therefore, the index unit 40 is an index indicating the amount of penetration (movement amount) of the distal apex 72 as a contact portion in the penetration direction with respect to the treatment target. Thereby, in the treatment which penetrates the treatment part 32 into the treatment object, the surgeon recognizes the amount of penetration of the tip cusp 72 which is a contact part into the treatment object in the treatment direction. Thus, the surgeon can appropriately recognize the cutting depth of the treatment target while performing the treatment of cutting the treatment target.
　（第３の実施形態の変形例）　
　第６の変形例として図１５の示すように、ブレード部７０の代わりにドリル部７５が、処置部３２に形成されてもよい。本変形例でも第３の実施形態と同様に、処置部３２の露出面３４は、鋭利な先端尖部７６と、処置部３２の外周において先端尖部７６から基端方向へ向かって延出される外周露出面７９と、を備える。そして、先端尖部７６は、超音波振動を用いた処置対象を削る処置において処置対象に接触させる接触部となる。 (Modification of the third embodiment)
As a sixth modification, as shown in FIG. 15, a drill portion 75 may be formed in the treatment portion 32 instead of the blade portion 70. Also in the present modification, as in the third embodiment, the exposed surface 34 of the treatment portion 32 extends toward the proximal direction from the sharp tip 76 and the distal tip 76 on the outer periphery of the treatment portion 32. An outer peripheral exposed surface 79. The tip apex 76 becomes a contact portion that is brought into contact with the treatment target in the treatment of cutting the treatment target using ultrasonic vibration.
　ただし、本変形例では、プローブ本体３１及び処置部３２は、超音波振動を伝達する状態において、縦振動は行わず、振動方向が長手軸回り方向（図１５の矢印Ｒ１の方向及び矢印Ｒ２の方向）に平行なねじり振動を行う。したがって、超音波振動子２２（図２参照）では、プローブ本体３１及び処置部３２がねじり振動を行う状態に、超音波振動が発生する。また、外周露出面７９には、溝上部７８が、長手軸Ｃを中心とする螺旋状に延設されている。 However, in this modification, the probe main body 31 and the treatment section 32 do not perform longitudinal vibration in a state of transmitting ultrasonic vibration, and the vibration direction is the direction around the longitudinal axis (the direction of the arrow R1 and the arrow R2 in FIG. 15). Direction) torsional vibration. Therefore, in the ultrasonic transducer 22 (see FIG. 2), ultrasonic vibration is generated in a state where the probe main body 31 and the treatment portion 32 perform torsional vibration. Further, a groove upper part 78 extends in a spiral shape with the longitudinal axis C as the center on the outer peripheral exposed surface 79.
　接触部である先端尖部７６を処置対象に接触させた状態で処置部３２が超音波振動によってねじり振動することにより、処置対象（骨）が削られる。処置対象（骨）に処置部３２が侵入されることにより、先端尖部７６が処置対象に対して先端方向に向かって移動する。このため、第３の実施形態と同様に、先端方向（Ｃ１）が、処置対象を削る際に接触部である先端尖部７６が処置対象に対して侵入される（移動する）侵入方向となる。そして、基端方向（Ｃ２）が、侵入方向とは反対方向である反侵入方向となる。 The treatment object (bone) is shaved by the torsional vibration of the treatment part 32 by ultrasonic vibration in a state in which the tip 76 as a contact part is in contact with the treatment object. When the treatment portion 32 enters the treatment target (bone), the distal tip 76 moves toward the distal direction with respect to the treatment target. For this reason, as in the third embodiment, the distal direction (C1) is an intrusion direction in which the distal apex 76 as a contact portion enters (moves) the treatment target when the treatment target is cut. . The proximal direction (C2) is the anti-intrusion direction that is opposite to the intrusion direction.
　本変形例では、外周露出面７９に、指標部４０が設けられている。指標部４０は、指標線７７Ａ～７７Ｄを備える。指標線７７Ａ～７７Ｄは、第１の実施形態の指標線４１Ａ～４１Ｅと同様に、侵入方向及び反侵入方向に対して交差する状態で、延設されている。本変形例でも、指標部４０は、接触部である先端尖部７６より反侵入方向側（基端方向側）に位置している。したがって、本変形例でも、指標部４０は、接触部である先端尖部７６の処置対象に対する侵入方向（先端方向）への侵入量（移動量）を示す指標となる。 In the present modification, the indicator portion 40 is provided on the outer peripheral exposed surface 79. The index unit 40 includes index lines 77A to 77D. Like the index lines 41A to 41E of the first embodiment, the index lines 77A to 77D are extended so as to intersect the intrusion direction and the anti-intrusion direction. Also in this modified example, the indicator portion 40 is located on the anti-intrusion direction side (base end direction side) with respect to the tip apex portion 76 that is a contact portion. Therefore, also in this modified example, the index portion 40 is an index indicating the amount of penetration (movement amount) in the penetration direction (tip direction) with respect to the treatment target of the tip cusp 76 which is a contact portion.
　なお、第３の実施形態の指標線７３Ａ～７３Ｆの代わりに、前述した複数の有色表面と同様の構成（図８参照）を、指標部４０に設けてもよい。また、第３の実施形態の指標線７３Ａ～７３Ｆの代わりに、前述した複数の指標面と同様の構成（図９参照）を、指標部４０に設けてもよい。 In addition, instead of the index lines 73A to 73F of the third embodiment, the index unit 40 may be provided with the same configuration (see FIG. 8) as the plurality of colored surfaces described above. Further, instead of the index lines 73A to 73F of the third embodiment, the index unit 40 may be provided with the same configuration (see FIG. 9) as the plurality of index surfaces described above.
　第３の実施形態及びその変形例では、接触部（７２；７６）は、処置部（３２）の先端に位置している。そして、処置対象が削られている状態での接触部（７２；７６）の侵入方向は、先端方向（Ｃ１）と一致する。そして、指標部（４０）は、接触部（７２；７６）より反侵入方向側（基端方向（Ｃ２）側）に設けられている。 In the third embodiment and its modifications, the contact portion (72; 76) is located at the distal end of the treatment portion (32). And the penetration | invasion direction of the contact part (72; 76) in the state in which the treatment target is shaved corresponds with the front-end | tip direction (C1). And the indicator part (40) is provided in the anti-intrusion direction side (proximal direction (C2) side) rather than the contact part (72; 76).
　（その他の変形例）　
　なお、前述の実施形態及び変形例では、処置対象として骨を処置することを説明してきたが、処置対象として骨以外の軟骨や軟組織（例えば、滑膜等）に適用できることは勿論である。 (Other variations)
In the above-described embodiment and modification, it has been described that a bone is treated as a treatment target, but it is needless to say that the treatment target can be applied to cartilage and soft tissue (for example, synovium) other than bone.
　前述の実施形態及び変形例では、超音波プローブ（１５）の処置部（３２）の露出面（３４）に、処置対象を削る処置において処置対象に接触される接触部（３５；５０；５５；６６；７２；７６）が、設けられている。接触部（３５；５０；５５；６６；７２；７６）は、処置部（３２）に伝達された超音波振動によって、処置対象に接触した状態から処置対象の内部に向かう侵入方向（Ｐ１；Ｃ１）に侵入しながら、処置対象を処置する。そして、処置部（３２）の露出面（３４）には、接触部（３５；５０；５５；６６；７２；７６）より反侵入方向（Ｐ２；Ｃ２）側に、指標部（４０）が設けられている。指標部（４０）は、処置対象に対する侵入方向（Ｐ１；Ｃ１）への接触部（３５；５０；５５；６６；７２；７６）の侵入量を示す指標となる。 In the above-described embodiment and modification, the contact surface (35; 50; 55; which is in contact with the treatment object in the treatment of cutting the treatment object on the exposed surface (34) of the treatment part (32) of the ultrasonic probe (15). 66; 72; 76). The contact portion (35; 50; 55; 66; 72; 76) is intrusion direction (P1; C1) from the state in contact with the treatment object to the inside of the treatment object by the ultrasonic vibration transmitted to the treatment portion (32). ) To treat the treatment target. The exposed surface (34) of the treatment portion (32) is provided with the indicator portion (40) on the side opposite to the intrusion direction (P2; C2) from the contact portion (35; 50; 55; 66; 72; 76). It has been. The index portion (40) is an index indicating the amount of intrusion of the contact portion (35; 50; 55; 66; 72; 76) in the intrusion direction (P1; C1) with respect to the treatment target.
　（参照例）　
　図１６は、本発明の参照例を示している。図１６では、参照例の超音波処置具３の先端部の構成を示している。本参照例でも、第１の実施形態と同様に、超音波プローブ１５は、超音波振動を伝達する状態において、振動方向が先端方向及び基端方向に平行な縦振動を行う。超音波プローブ１５では、処置部３２の先端が超音波振動の腹位置Ａ１となる。ここで、超音波振動の節位置の中で最も先端方向側に位置する節位置Ｎ１を規定する。第１の実施形態では、超音波プローブ１５を外部から保護するシース１３は、処置部３２の基端まで先端方向へ延設されている。これに対し、本参照例では、シース１３は、節位置Ｎ１の近傍までしか、先端方向へ延設されていない。すなわち、第１の実施形態では、長手軸Ｃに平行な方向について処置部３２の基端の位置は、シース１３の先端の位置と略一致しているのに対し、本参照例では、処置部３２の基端は、シース１３の先端より先端方向側に位置している。 (Reference example)
FIG. 16 shows a reference example of the present invention. In FIG. 16, the structure of the front-end | tip part of the ultrasonic treatment tool 3 of a reference example is shown. Also in this reference example, as in the first embodiment, the ultrasonic probe 15 performs longitudinal vibration in which the vibration direction is parallel to the distal direction and the proximal direction in a state where ultrasonic vibration is transmitted. In the ultrasonic probe 15, the distal end of the treatment portion 32 is an antinode position A <b> 1 of ultrasonic vibration. Here, the node position N1 located on the most distal direction side among the node positions of the ultrasonic vibration is defined. In the first embodiment, the sheath 13 that protects the ultrasonic probe 15 from the outside extends in the distal direction to the proximal end of the treatment portion 32. On the other hand, in this reference example, the sheath 13 extends in the distal direction only up to the vicinity of the node position N1. That is, in the first embodiment, the position of the proximal end of the treatment portion 32 in the direction parallel to the longitudinal axis C substantially coincides with the position of the distal end of the sheath 13, whereas in this reference example, the treatment portion The proximal end of 32 is located on the distal direction side of the distal end of the sheath 13.
　また、節位置Ｎ１では、シース１３と超音波プローブ１５との間に、リング状の弾性部材８２が設けられている。弾性部材８２によって、シース１３と超音波プローブ１５との間が液密に保たれる。これにより、シース１３の内部への先端方向側からの液体の流入が有効に防止される。 Further, a ring-shaped elastic member 82 is provided between the sheath 13 and the ultrasonic probe 15 at the node position N1. The elastic member 82 keeps the space between the sheath 13 and the ultrasonic probe 15 fluid-tight. Thereby, the inflow of the liquid from the distal direction side to the inside of the sheath 13 is effectively prevented.
　また、長手軸Ｃに平行な方向について節位置Ｎ１と処置部３２の基端との間には、プローブ本体３１の外表面に、薄いチューブ部材８１が被覆されている。したがって、プローブ本体３１においてシース１３に覆われていない部分でも、チューブ部材８１によって、外部から保護されている。シース１３の代わりにチューブ部材８１が被覆されることにより、シース１３の先端と処置部３２の基端との間では、超音波処置具３の径方向についての寸法が小さくなる。これにより、関節腔Ｓに処置部３２を挿入し易くなる。 Further, a thin tube member 81 is coated on the outer surface of the probe main body 31 between the node position N1 and the proximal end of the treatment portion 32 in the direction parallel to the longitudinal axis C. Therefore, even the portion of the probe body 31 that is not covered by the sheath 13 is protected from the outside by the tube member 81. By covering the tube member 81 instead of the sheath 13, the dimension in the radial direction of the ultrasonic treatment instrument 3 is reduced between the distal end of the sheath 13 and the proximal end of the treatment portion 32. Thereby, it becomes easy to insert the treatment portion 32 into the joint space S.
　なお、チューブ部材８１の代わりに、長手軸Ｃに平行な方向について節位置Ｎ１と処置部３２の基端との間において、プローブ本体３１の外表面に、コーティングが施されてもよい。この場合も、プローブ本体３１においてシース１３に覆われていない部分でも、コーティングよって、外部から保護されている。 In addition, instead of the tube member 81, a coating may be applied to the outer surface of the probe main body 31 between the node position N1 and the proximal end of the treatment portion 32 in a direction parallel to the longitudinal axis C. Also in this case, the portion of the probe body 31 that is not covered with the sheath 13 is protected from the outside by coating.
　また、本参照例では、シース１３の先端は、最も先端方向側に位置する節位置Ｎ１の近傍に位置しているが、これに限るものではない。例えば、２番目に先端方向側に位置する節位置Ｎ２の近傍に、シース１３の先端が位置してもよい。この場合、長手軸Ｃに平行な方向について節位置Ｎ２と処置部３２の基端との間において、プローブ本体３１の外表面に、チューブ部材８１が被覆される。そして、節位置Ｎ２に、弾性部材（８２）が設けられ、シース１３と超音波プローブ１５との間が、液密に保たれる。ただし、節位置Ｎ２は、保持ユニット１２の先端より先端方向側に位置している。 Further, in the present reference example, the distal end of the sheath 13 is located in the vicinity of the node position N1 located on the most distal direction side, but is not limited thereto. For example, the distal end of the sheath 13 may be positioned in the vicinity of the node position N2 that is secondly positioned on the distal direction side. In this case, the tube member 81 is covered on the outer surface of the probe main body 31 between the node position N2 and the proximal end of the treatment portion 32 in the direction parallel to the longitudinal axis C. An elastic member (82) is provided at the node position N2, and the space between the sheath 13 and the ultrasonic probe 15 is kept liquid-tight. However, the node position N2 is located on the distal direction side from the distal end of the holding unit 12.
　以上、本発明の実施形態等について説明したが、本発明は前記の実施形態等に限定されるものではなく、本発明の要旨を逸脱しない範囲で種々の変形ができることは勿論である。 As mentioned above, although embodiment etc. of this invention were described, this invention is not limited to the said embodiment etc., Of course, various deformation | transformation can be made in the range which does not deviate from the summary of this invention.

Claims (16)

  1. 　長手軸に沿って延設され、基端方向から先端方向へ超音波振動を伝達するプローブ本体と、
    　前記プローブ本体の前記先端方向側に設けられ、前記プローブ本体を介して伝達された超音波振動を用いて処置対象の処置を行う処置部であって、
    　　露出面と、
    　　前記露出面に設けられ、伝達された前記超音波振動によって、前記処置対象に接触した状態から前記処置対象の内部に向かう侵入方向に侵入ながら、前記処置対象を処置する接触部と、
    　　前記露出面において前記接触部より前記侵入方向とは反対方向側に設けられ、前記処置対象に対する前記侵入方向への前記接触部の侵入量を示す指標が形成された指標部と、
    　　を備える処置部と、
    　を具備する超音波プローブ。     A probe body extending along the longitudinal axis and transmitting ultrasonic vibrations from the proximal direction to the distal direction;
    A treatment section that is provided on the distal direction side of the probe body and performs treatment of a treatment target using ultrasonic vibrations transmitted through the probe body;
    Exposed surface;
    A contact portion for treating the treatment target while invading in an intrusion direction toward the inside of the treatment target from a state in contact with the treatment target by the ultrasonic vibration transmitted and transmitted to the exposed surface;
    An indicator portion provided on the opposite side of the intrusion direction from the contact portion on the exposed surface, and an indicator indicating an intrusion amount of the contact portion in the intrusion direction with respect to the treatment target; and
    A treatment section comprising:
    An ultrasonic probe comprising:
  2. 　前記指標部は、前記処置部の前記露出面において、前記侵入方向に対して垂直な方向の１つを向く部位に、設けられている請求項１の超音波プローブ。 The ultrasonic probe according to claim 1, wherein the indicator portion is provided on a portion of the exposed surface of the treatment portion that faces one of directions perpendicular to the intrusion direction.
  3. 　前記長手軸に対して垂直な方向の１つを第１の垂直方向とし、前記第１の垂直方向とは反対方向を第２の垂直方向とした場合に、前記接触部は、前記長手軸より前記第１の垂直方向側に位置し、
    　前記接触部の前記侵入方向は、前記第１の垂直方向と一致し、
    　前記指標部は、前記接触部より前記第２の垂直方向側に設けられている、
    　請求項１の超音波プローブ。     When one of the directions perpendicular to the longitudinal axis is the first vertical direction and the direction opposite to the first vertical direction is the second vertical direction, the contact portion is more than the longitudinal axis. Located on the first vertical side;
    The intrusion direction of the contact portion coincides with the first vertical direction;
    The indicator portion is provided on the second vertical direction side from the contact portion.
    The ultrasonic probe according to claim 1.
  4. 　前記処置部は、前記長手軸に対して前記第１の垂直方向に湾曲することにより、前記第１の垂直方向へ向かって突出する湾曲突出部を備え、
    　前記処置部の露出面は、前記湾曲突出部において前記先端方向を向き、前記処置部の先端を形成する第１の湾曲露出面を備え、
    　前記接触部は、前記湾曲突出部の前記第１の垂直方向側の端である突出端に位置し、
    　前記指標部は、前記突出端より前記第２の垂直方向側に設けられている、
    　請求項３の超音波プローブ。     The treatment portion includes a curved protrusion that protrudes toward the first vertical direction by bending in the first vertical direction with respect to the longitudinal axis.
    The exposed surface of the treatment portion includes a first curved exposed surface that faces the distal direction in the curved protrusion and forms the distal end of the treatment portion,
    The contact portion is located at a protruding end that is an end on the first vertical direction side of the curved protruding portion,
    The indicator portion is provided on the second vertical direction side from the protruding end.
    The ultrasonic probe according to claim 3.
  5. 　前記長手軸に垂直で、かつ、前記第１の垂直方向及び前記第２の垂直方向に垂直な２方向を第３の垂直方向及び第４の垂直方向とした場合に、前記処置部の前記露出面は、前記湾曲突出部において前記基端方向を向く第２の湾曲露出面と、前記湾曲突出部において前記第３の垂直方向を向く第３の湾曲露出面と、前記湾曲突出部において前記第４の垂直方向を向く第４の湾曲露出面と、を備え、
    　前記指標部は、前記第１の湾曲露出面、前記第２の湾曲露出面、前記第３の湾曲露出面、及び、前記第４の湾曲露出面の少なくとも１つに、設けられている、
    　請求項４の超音波プローブ。     The exposure of the treatment portion when two directions perpendicular to the longitudinal axis and perpendicular to the first vertical direction and the second vertical direction are defined as a third vertical direction and a fourth vertical direction. The curved projecting portion includes a second curved exposed surface facing the proximal direction, a third curved exposed surface facing the third vertical direction at the curved projected portion, and the second curved exposed surface at the curved projected portion. A fourth curved exposed surface facing the vertical direction of 4,
    The indicator portion is provided on at least one of the first curved exposed surface, the second curved exposed surface, the third curved exposed surface, and the fourth curved exposed surface.
    The ultrasonic probe according to claim 4.
  6. 　前記処置部は、前記長手軸に沿って湾曲することなく延設され、
    　前記処置部の前記露出面は、前記処置部の外周において前記第１の垂直方向を向く第１の外周露出面と、前記処置部の前記外周において前記第２の垂直方向を向く第２の外周露出面と、前記第１の外周露出面と前記第２の外周露出面との間で前記第１の垂直方向及び前記第２の垂直方向に沿って連続的に延設される中継露出面と、を備え、
    　前記処置部は、前記第１の外周露出面に位置する第１の開口端で開口する開口孔を規定し、前記第１の開口端から前記第２の垂直方向へ向かって延設される孔規定面を備え、
    　前記接触部は、前記開口孔の前記第１の開口端に位置し、
    　前記指標部は、前記中継露出面に設けられている、
    　請求項３の超音波プローブ。     The treatment section is extended without being curved along the longitudinal axis,
    The exposed surface of the treatment section includes a first outer peripheral exposed surface that faces the first vertical direction on the outer periphery of the treatment section, and a second outer periphery that faces the second vertical direction on the outer periphery of the treatment section. An exposed surface, and a relay exposed surface continuously extending along the first vertical direction and the second vertical direction between the first outer peripheral exposed surface and the second outer peripheral exposed surface. With
    The treatment portion defines an opening hole that opens at a first opening end located on the first outer peripheral exposed surface, and extends from the first opening end toward the second vertical direction. It has a regulation surface,
    The contact portion is located at the first opening end of the opening hole,
    The indicator portion is provided on the relay exposure surface,
    The ultrasonic probe according to claim 3.
  7. 　前記開口孔は、前記第２の外周露出面に位置する第２の開口端で開口し、前記第１の開口端と前記第２の開口端との間で前記第１の垂直方向及び前記第２の垂直方向に沿って前記処置部を貫通し、
    　前記中継露出面は、前記開口孔の外部に位置する外側中継面と、前記孔規定面として前記開口孔を規定する内側中継面と、を備える、
    　請求項６の超音波プローブ。     The opening hole is opened at a second opening end located on the second outer peripheral exposed surface, and the first vertical direction and the first opening between the first opening end and the second opening end. Through the treatment section along the vertical direction of 2;
    The relay exposure surface includes an outer relay surface located outside the opening hole, and an inner relay surface that defines the opening hole as the hole defining surface.
    The ultrasonic probe according to claim 6.
  8. 　前記プローブ本体の内部を通って前記長手軸に沿って延設され、前記開口孔と連通する通路をさらに具備する、請求項６の超音波プローブ。 The ultrasonic probe according to claim 6, further comprising a passage extending along the longitudinal axis through the inside of the probe main body and communicating with the opening hole.
  9. 　前記接触部は、前記処置部の先端に位置し、
    　前記接触部の前記侵入方向は、前記先端方向と一致し、
    　前記指標部は、前記接触部より前記基端方向側に設けられている、
    　請求項１の超音波プローブ。     The contact portion is located at the distal end of the treatment portion,
    The intrusion direction of the contact portion coincides with the tip direction,
    The indicator portion is provided on the proximal direction side from the contact portion,
    The ultrasonic probe according to claim 1.
  10. 　前記処置部は、前記長手軸に沿って湾曲することなく延設され、
    　前記処置部の前記露出面は、前記処置部の外周において前記接触部から前記基端方向へ向かって延設される外周露出面を備え、
    　前記指標部は、前記外周露出面に設けられている、
    　請求項９の超音波プローブ。     The treatment section is extended without being curved along the longitudinal axis,
    The exposed surface of the treatment portion includes an outer peripheral exposed surface extending from the contact portion toward the proximal direction on the outer periphery of the treatment portion,
    The indicator portion is provided on the outer peripheral exposed surface,
    The ultrasonic probe according to claim 9.
  11. 　前記長手軸を中心とする時計回り方向及び反時計回り方向の２方向を長手軸回り方向とした場合に、前記プローブ本体及び前記処置部は、前記超音波振動を伝達する状態において、振動方向が前記長手軸回り方向に平行なねじり振動を行い、
    　前記処置部は、前記外周露出面において前記長手軸を中心とする螺旋状に延設される溝状部を備える、
    　請求項１０の超音波プローブ。     When the two directions of the clockwise direction and the counterclockwise direction around the longitudinal axis are defined as the longitudinal axis direction, the probe main body and the treatment section have a vibration direction in a state of transmitting the ultrasonic vibration. Performing torsional vibration parallel to the direction around the longitudinal axis;
    The treatment portion includes a groove-like portion that extends spirally around the longitudinal axis on the outer peripheral exposed surface,
    The ultrasonic probe according to claim 10.
  12. 　前記指標部は、前記侵入方向に対して交差する状態で延設される指標線を備える、請求項１の超音波プローブ。 The ultrasonic probe according to claim 1, wherein the indicator section includes an indicator line extending in a state of intersecting the intrusion direction.
  13. 　前記指標部は、前記接触部から前記侵入方向とは反対方向側に向かって複数の有色表面を備え、
    　それぞれの前記有色表面は、隣設する前記有色表面に対して、色が異なる、
    　請求項１の超音波プローブ。     The indicator portion includes a plurality of colored surfaces from the contact portion toward a direction opposite to the intrusion direction,
    Each colored surface is different in color from the adjacent colored surface,
    The ultrasonic probe according to claim 1.
  14. 　前記指標部は、前記接触部から前記侵入方向とは反対方向側に向かって複数の指標面を備え、
    　それぞれの前記指標面は、隣設する前記指標面に対して、前記侵入方向に対する角度が異なる、
    　請求項１の超音波プローブ。     The indicator portion includes a plurality of indicator surfaces from the contact portion toward the direction opposite to the intrusion direction,
    Each of the index surfaces is different in angle with respect to the intrusion direction with respect to the index surface adjacent thereto.
    The ultrasonic probe according to claim 1.
  15. 　請求項１の超音波プローブと、
    　前記超音波プローブの前記基端方向側に設けられ、前記超音波プローブに伝達される前記超音波振動を発生する振動発生部と、
    　を具備する、超音波処置具。     The ultrasonic probe of claim 1;
    A vibration generating unit that is provided on the proximal direction side of the ultrasonic probe and generates the ultrasonic vibration transmitted to the ultrasonic probe;
    An ultrasonic treatment device comprising:
  16. 　請求項１５の超音波処置具と、
    　挿入部を備える内視鏡であって、前記挿入部は、前記超音波処置装置による前記処置対象の前記処置において、前記処置対象及び前記処置部の前記指標部を被写体として撮像する撮像素子を備える、内視鏡と、
    　前記撮像素子によって撮像された被写体像を画像処理する画像処理ユニットと、
    　前記画像処理ユニットによって画像処理された前記被写体像が表示される表示ユニットと、
    　を具備する、処置システム。     The ultrasonic treatment device according to claim 15;
    An endoscope including an insertion unit, wherein the insertion unit includes an imaging element that images the treatment target and the index portion of the treatment unit as subjects in the treatment of the treatment target by the ultrasonic treatment apparatus. , Endoscope,
    An image processing unit that performs image processing on a subject image captured by the image sensor;
    A display unit for displaying the subject image image-processed by the image processing unit;
    A treatment system comprising:
PCT/JP2013/085122 2013-09-27 2013-12-27 Ultrasonic probe, ultrasonic treatment tool and treatment system WO2015045199A1 (en)

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