Surgical bur, surgical system, and method for operating surgical system

Abstract

To ensure the surgeon's view around the cutting position during the tissue cutting work at a removal target position using a surgical bur, thereby improving the safety, accuracy, and speed of the work.SOLUTION: A surgical bur 10 includes a bar-shaped shaft 11 and a cutting part 13 provided at one axial end of the shaft 11, which rotates around the axis of the shaft 11. The shaft 11 includes a liquid flow generation part 15 formed on the outer peripheral surface on the side of the cutting part 13 in the axial direction and having at least one of a convex part projecting radially outward or a concave part recessed radially inward of the shaft 11.SELECTED DRAWING: Figure 2

Description

[Technical Field]

[0001] The present invention relates to a surgical burr, a surgical system, and a method of operating a surgical system. [Background technology]

[0002] Conventionally, surgical burs used in bone surgery instruments have been known as one type of medical instrument for surgical operations (Patent Documents 1 to 3). Surgical burs have a shaft and a cutting part provided at the tip of the shaft. The cutting part is formed with a blade that serves as a cutting edge for cutting tissue such as bone. The shaft is fixed to a drive shaft of a handpiece or the like. During surgery, the drive shaft is operated to rotate the surgical burr, and the cutting part is pressed against the tissue to be removed (target tissue), causing the tissue to be removed by the rotating cutting blade. The area around the target tissue during cutting is filled with an externally supplied perfusion fluid (sterilized water, saline, irrigation, etc.), and the surgical burr rotates within the perfusion fluid, removing the target tissue. Such surgical burrs are used in a variety of surgical procedures, such as orthopedic surgery, neurosurgery, spinal surgery, and ear, nose, and throat surgery, or in procedures for selectively removing portions of tissue. [Prior art documents] [Patent documents]

[0003] [Patent Document 1] Special Publication No. 2013-502943 [Patent Document 2] Special Publication No. 2016-527003 [Patent Document 3] Special Publication No. 2019-531140 Summary of the Invention [Problem to be solved by the invention]

[0004] However, the surgical burrs disclosed in Patent Documents 1 to 3 have the problem that the tissue at the location to be removed drifts around the area after it has been removed, obstructing the surgeon's field of vision for the cutting operation. Although a certain amount of irrigation fluid is continuously supplied around the location to be removed, this may not be sufficient to improve the surgeon's field of vision at the location to be removed.

[0005] The present invention is intended to solve the above-mentioned problems, and aims to improve the safety, accuracy, and speed of the procedure by ensuring the surgeon's field of vision around the location to be removed during the procedure of removing tissue at the location to be removed using a surgical burr. [Means for solving the problem]

[0006] The present invention comprises the following configurations. (1) A surgical burr comprising a rod-shaped shaft and a cutting part provided at one end of the shaft in the axial direction, the surgical burr being rotated around the axis of the shaft, The shaft portion is provided with a liquid flow generating portion formed on an outer peripheral surface of the cutting portion side in the axial direction, and having at least one of a convex portion protruding radially outward of the shaft portion or a concave portion recessed radially inward, Surgical burr. (2) The surgical burr according to (1), a handpiece having an elongated tubular support that rotatably supports the shaft portion of the surgical burr, with the cutting portion and the fluid flow generating portion exposed from a tip thereof; a rotation control device for rotationally driving the shank of the surgical burr supported on the tubular support; an irrigation fluid device that delivers irrigation fluid toward the cutting portion and the fluid flow generating portion of the surgical burr; A surgical system comprising: (3) A method for operating the surgical operation system according to (2), comprising: a tubular support of the handpiece supporting the surgical burr, the distal end of the support being inserted into the affected area; and the irrigation fluid device delivering the irrigation fluid toward the cutting site by the surgical burr. With the cutting unit and the fluid flow generating unit disposed in the irrigation fluid accumulated in the affected area, the rotation control device rotates the surgical burr to generate a flow of the irrigation fluid using the fluid flow generating unit. A method for operating a surgical system. [Effects of the Invention]

[0007] According to the present invention, during the tissue removal procedure at a target location using a surgical burr, the surgeon can ensure a visual field around the target location, thereby improving the safety, accuracy, and speed of the procedure. [Brief explanation of the drawings]

[0008] [Figure 1] FIG. 1 is a schematic diagram showing the configuration of the main parts of a surgical operation system. [Figure 2] FIG. 2 is a diagram showing the overall configuration of the surgical burr according to the first embodiment. [Figure 3] FIG. 3 is a partial enlarged view showing the tip of a surgical burr attached to a handpiece attachment. [Figure 4] FIG. 4 is an explanatory diagram schematically illustrating the flow of irrigation fluid caused by the rotation of a surgical burr. [Figure 5] FIG. 5 is an explanatory diagram schematically illustrating the flow of irrigation fluid when the surgical burr is rotated in the opposite direction to that shown in FIG. [Figure 6] FIG. 6 is an explanatory diagram that schematically shows the state of surgery using a surgical burr. [Figure 7] FIG. 7 is a partially enlarged view showing the distal end of a surgical burr according to a second embodiment attached to an attachment of a handpiece. [Figure 8] FIG. 8 is a front view of the cutting portion from the tip of the surgical burr. [Figure 9] FIG. 9 is a partial cross-sectional view of the liquid flow generating portion taken along the axial direction. [Figure 10] FIG. 10 is a partial cross-sectional view of the liquid flow generating portion, which serves as a cutting blade, cut in the axial direction. [Figure 11]FIG. 11 is a perspective view of the tip of a surgical burr showing a liquid flow generating portion of a first modified example. [Figure 12] FIG. 12 is a perspective view of the tip of a surgical burr showing a liquid flow generating portion of a second modified example. [Figure 13] FIG. 13 is a cross-sectional view taken along line XIII-XIII shown in FIG. [Figure 14] FIG. 14 is a perspective view of the tip of a surgical burr showing a liquid flow generating portion of a third modified example. DETAILED DESCRIPTION OF THE INVENTION

[0009] Hereinafter, a detailed description will be given of an embodiment of a surgical burr and a surgical system using the surgical burr according to the present invention with reference to the drawings. The surgical system illustrated here is configured for use in spinal surgery, but the application of the present invention is not limited to this.

[0010] <Surgical operation system using a surgical burr> 1 is a schematic diagram of the main components of a surgical system 100. The surgical system 100 includes a control unit 101, a handpiece 103, a connection cable 105 that connects the handpiece 103 to the control unit 101, and a foot switch 107.

[0011] Handpiece 103 includes attachment 103a and grip 103b. Attachment 103a at the tip of handpiece 103 is a long, tubular support that detachably supports surgical burr 10. Grip 103b of handpiece 103 is provided with power source M, such as an air motor or an electric motor, that rotates surgical burr 10. Power source M is controlled to rotate or stop by foot switch 107 connected to control unit 101. Control unit 101 controls various driving operations, such as the rotation speed and direction of surgical burr 10, operated by handpiece 103. This drive control is realized by the operation of a computer including a processor, memory, storage, etc. Power source M and control unit 101 function as a rotation control device that rotates shaft 11 of surgical burr 10 supported by attachment 103a.

[0012] <First embodiment of surgical burr> FIG. 2 is an overall configuration diagram of a surgical burr 10 according to a first embodiment. The surgical burr 10 has a rod-shaped shaft 11 along a rotation axis Lc and a ball-shaped cutting portion 13 provided at one end of the shaft 11. Diamond abrasive grains (not shown) or the like are electroplated on the surface of the cutting portion 13. The cutting portion 13 may be formed with cutting blades instead of the abrasive grains. The term "ball-shaped" as used herein means that the shape of the curved surface enveloping the abrasive grains or cutting edge formed in the cutting portion 13 when the surgical burr 10 is rotated around the rotation axis Lc includes a surface shape that is a sphere or spheroid centered on the rotation axis Lc.

[0013] The shank 11 includes a fluid flow generator 15 formed on its outer peripheral surface on the cutting portion 13 side in the axial direction. The fluid flow generator 15 in this configuration is a helical ridge 17 that protrudes radially outward from the outer peripheral surface of the shank 11 and forms a helical convex portion centered on the rotation axis Lc (also referred to as the axis) along the outer periphery of the shank 11. The helical ridge 17 shown here is a single ridge having a pair of wall surfaces 17a extending circumferentially on both axial sides. The position of the fluid flow generator 15 on the shank 11 is determined depending on the size, application, etc. of the surgical burr 10. For example, the distance S from the base end 13a of the cutting portion 13 to the axial tip of the fluid flow generator 15 may be set within a range of ±20% of the maximum outer diameter Dp of the cutting portion 13.

[0014] Surgical burr 10 is made of a hard material such as stainless steel, cemented carbide (tungsten carbide), etc. Shank 11 has a connecting portion 19 at the base end opposite cutting portion 13, which is fixed to a drive shaft (not shown) of drive source M of handpiece 103.

[0015] 3 is a partially enlarged view showing the tip of surgical burr 10 attached to attachment 103a of handpiece 103. Surgical burr 10 has shaft 11 rotatably supported by handpiece 103, with cutting section 13 and fluid flow generating section 15 exposed from the tip of attachment (tubular support) 103a. Surgical burr 10 is fixed to a rotating shaft, and cutting section 13 and fluid flow generating section 15 are rotated about rotation axis Lc by rotational drive from handpiece 103.

[0016] <Operation of the surgical system> In this surgical system 100, the surgeon rotates surgical burr 10 at high speed by operating foot switch 107 while holding handpiece 103 shown in FIG. 1. Then, when the surgeon moves handpiece 103 while pressing cutting part 13 of surgical burr 10 against the desired site, the rotating cutting part 13 cuts that site. An irrigation fluid such as saline or sterile water is supplied to the cutting site (also called the affected area) during surgery, and fluid flow generator 15 generates a flow of irrigation fluid around the affected area by the rotation of surgical burr 10. This flow of irrigation fluid improves the surgeon's view of the affected area.

[0017] FIG. 4 is an explanatory diagram schematically illustrating the flow of perfusion fluid due to the rotation of surgical burr 10. As shown in FIG. 4, surgical burr 10 rotates in the Rc direction (clockwise as viewed from above rotation axis Lc) around rotation axis Lc. Because helical ridge 17 of fluid flow generating unit 15 is right-handed (the same helical shape as a right-handed screw), wall surface 17a of helical ridge 17 advances along shaft 11 from cutting unit 13 toward handpiece 103, resulting in a feeding motion. This feeding motion of helical ridge 17 causes a flow, as indicated by arrow FL1, in perfusion fluid W present around helical ridge 17. As perfusion fluid W flows in the direction of arrow FL1, perfusion fluid W containing tissue fragments P cut by cutting unit 13 is removed from the vicinity of cutting unit 13 by the flow of perfusion fluid W. Then, new perfusion fluid W, which is highly transparent and does not contain tissue fragments P, flows into the vicinity of the cutting area 13, thereby maintaining a good field of view around the cutting area 13. In other words, a good field of view around the cutting site can be maintained during the cutting operation, improving the operator's workability.

[0018] FIG. 5 is an explanatory diagram schematically illustrating the flow of perfusion fluid when surgical burr 10 is rotated in the opposite direction to that shown in FIG. 4. As shown in FIG. 5, surgical burr 10 rotates in the Ruc direction (counterclockwise when viewed from above rotation axis Lc) around rotation axis Lc. This results in a feeding motion in which wall surface 17a of spiral ridge 17 of fluid flow generating unit 15 advances along shaft 11 from handpiece 103 toward cutting unit 13. This feeding motion of spiral ridge 17 generates a flow, as indicated by arrow FL2, in perfusion fluid W present around spiral ridge 17, and the suspended perfusion fluid W containing tissue fragments P cut by cutting unit 13 is removed from the vicinity of cutting unit 13 by the flow of perfusion fluid W.

[0019] The flow direction of the perfusion fluid W may be either the arrow FL1 or FL2, but if a circulation path is formed for the perfusion fluid W, it is preferable to point the flow direction in the discharge direction of the perfusion fluid W. The rotation direction of the surgical burr 10 can be set by the control unit 101 shown in Figure 1 and can be changed appropriately by the surgeon depending on the situation. The flow rate of the perfusion fluid W can be easily adjusted by increasing or decreasing the rotation speed of the surgical burr 10 by the control unit 101.

[0020] Furthermore, by changing the spiral ridge 17 of the surgical burr 10 from a right-handed spiral to a left-handed spiral, the flow direction of the perfusion fluid W can be reversed. When the outer diameter of the shaft portion 11 is 1.5 mm, the pitch of the spiral of the spiral ridge 17 (the axial advancement of the spiral ridge 17 per one rotation of the shaft) is preferably, for example, 0.3 mm to 2.5 mm, and more preferably 0.5 mm to 1.5 mm. Furthermore, the spiral ridge 17 is not limited to a single protrusion, and may be multiple protrusions of two or more protrusions. The axial length of the liquid flow generating portion 15 is preferably 2 mm to 10 mm, and more preferably 3 mm to 5 mm.

[0021] 3, helical ridge 17 preferably has a tapered shape such that its radially outward protrusion height decreases the closer it is to cutting portion 13. In other words, when surgical burr 10 is rotated, envelope Lh of the outer edge of helical ridge 17 is tapered such that its distance from rotation axis Lc decreases the closer it is to cutting portion 13. By decreasing the protrusion height of helical ridge 17 the closer it is to cutting portion 13, obstruction of the surgeon's field of view near cutting portion 13 by helical ridge 17 during surgery is suppressed, making it easier to ensure a wide field of view.

[0022] Furthermore, it is preferable that the maximum outer diameter Dp of the spiral ridge 17 is smaller than the maximum outer diameter Dc of the cutting portion 13. This prevents the spiral ridge 17 from blocking the surgeon's field of vision during surgery, making it easier for the surgeon to ensure a field of vision near the cutting portion 13. Furthermore, because the protruding height of the spiral ridge 17 is lower than that of the cutting portion 13, it is less likely that the spiral ridge 17 will inadvertently damage tissue that does not need to be cut.

[0023] <Example of surgery using a surgical burr> Figure 6 is an explanatory diagram that shows a schematic diagram of a surgical procedure using surgical burr 10. The surgical system used further includes a cylindrical sheath 21, an endoscope device (percutaneous spinal endoscope) 23, and an irrigation fluid device 25 in addition to the configuration already shown in Figure 1. Here, the procedure will be described taking as an example a case where a patient's bone 27 is cut.

[0024] The perfusion fluid device 25 has a fluid delivery unit 25A that delivers perfusion fluid W toward the affected area, and a fluid recovery unit 25B that aspirates and discharges the perfusion fluid W from the affected area. The fluid delivery unit 25A and the fluid recovery unit 25B are provided with pumps (not shown) that deliver or recover the perfusion fluid. In this configuration, the fluid delivery unit 25A delivers the perfusion fluid W to the affected area through the endoscope device 23 in the cylindrical sheath 21, and the fluid recovery unit B aspirates the perfusion fluid W around the affected area through the cylindrical sheath 21 and recovers the perfusion fluid W that accumulates around the affected area.

[0025] The endoscopic device 23 includes a cylindrical insertion section 33 to be inserted into the affected area, an observation optical system 35 that sends illumination light to the tip of the insertion section 33 and acquires an observation image while illuminating the affected area around the cutting section 13 with the illumination light, a working lumen 37 into which various instruments are inserted, and a supply path 39 that supplies irrigation fluid W to the working lumen 37. The endoscopic device 23 is configured to output imaging information of the observation image, including image information acquired from an imaging optical system (not shown) and various information such as imaging conditions and imaging position, but may also be configured so that the surgeon visually observes the observation image acquired by the observation optical system 35. In the case of a configuration that outputs imaging information, an image display device (not shown) such as a monitor that displays the imaging information is connected to the endoscopic device 23, and the surgeon can easily visually confirm the imaging information on the display of the image display device.

[0026] The sheath 21 is provided with a discharge path 41 for discharging the perfusion fluid W from the sheath 21. The supply path 39 is connected to the fluid supply section 25A of the perfusion fluid device 25, and the discharge path 41 is connected to the fluid recovery section 25B.

[0027] First, the patient's skin 29, muscle 31, etc. are incised, and the sheath 21 is inserted to the vicinity of the bone 27 to be cut. Then, the insertion section 33 of the endoscopic device 23 is inserted into the sheath 21. After the insertion section 33 of the endoscopic device 23 is inserted into the body cavity, the fluid supply section 25A of the perfusion device 25 supplies the perfusion fluid W to the working lumen 37 through the supply path 39. As a result, the perfusion fluid W is supplied from the working lumen 37 to the affected area, and the cutting section 13 and the fluid flow generating section 15 are placed in the perfusion fluid W that accumulates in the affected area. Furthermore, the perfusion fluid W around the affected area is discharged by suction through the discharge path 41 by the fluid collecting section 25B. In this way, the perfusion fluid W around the affected area is successively replaced without stagnation.

[0028] Then, attachment 103a of handpiece 103, which has surgical burr 10 attached to its tip, is inserted into working lumen 37 of endoscopic device 23. Surgical burr 10 at the tip of inserted attachment 103a is driven to rotate by a rotation control device consisting of power source M and control unit 101, enabling bone cutting by rotating cutting unit 13. The surgeon can visually confirm the cutting by cutting unit 13 by looking into an observation image obtained by irradiating illumination light from the tip of observation optical system 35, or by displaying a captured image of the observation image on an image display device such as a monitor.

[0029] As described above, the surgeon operates handpiece 103 while visually checking even the finest details of the observation image acquired from observation optical system 35, and cuts the bone with surgical burr 10 while turning the rotation of surgical burr 10 on and off using foot switch 107 shown in Figure 1.

[0030] When cutting bone begins, the resulting tissue fragments mix with the perfusion fluid, causing the perfusion fluid W to become suspended, making it difficult to see the cutting process in the observation image. However, fluid flow generator 15 provided on surgical burr 10 of this configuration generates a flow of perfusion fluid W by rotational drive, so the suspended perfusion fluid W near the cutting site is forced to flow to other areas and replaced with new perfusion fluid W. As a result, the area around cutting portion 13 is constantly filled with new perfusion fluid W, allowing for a clear field of view to be obtained for observation images of the area near the cutting site.

[0031] The flow of perfusion fluid W generated by fluid flow generating unit 15 is directed toward the base end, opposite cutting portion 13, of surgical burr 10 as shown in Figure 4. In this way, when fluid flow generating unit 15 generates a flow of perfusion fluid W around cutting portion 13 toward fluid flow generating unit 15 along shaft 11, the suspended perfusion fluid W is caused to flow from around cutting portion 13 and can be smoothly discharged from working lumen 37 by suction of perfusion fluid W by fluid recovery unit 25B.

[0032] Furthermore, by directing the flow of perfusion fluid W toward cutting portion 13 of surgical burr 10 shown in Figure 5, new perfusion fluid W delivered from fluid delivery unit 25A can be supplied to cutting portion 13. In other words, fluid flow generator 15 generates a fluid flow that directs perfusion fluid W around cutting portion 13 in the direction opposite to shank 11. This allows the area around cutting portion 13 to be constantly filled with new perfusion fluid W, enabling observation images to be obtained with a good field of view.

[0033] Regardless of the direction of the flow of the perfusion fluid W, the perfusion fluid W does not stagnate, the cutting part 13 can be cooled quickly, and the temperature rise of the cutting part 13 and the affected part being cut by the cutting part 13 is suppressed. Therefore, bone damage due to the heat generated when cutting the bone 27 is less likely to occur. As a result, the surgeon's field of vision around the cutting position can be stably secured during the cutting operation of the tissue to be removed. This improves the safety, accuracy, and speed of the operation.

[0034] Although sheath 21 and endoscope device 23 were used in the above surgery, it is also possible to supply irrigation fluid W to the incised affected area and cut the affected area by rotating surgical burr 10 while operating handpiece 103. Even in this case, by rotating cutting portion 13 and fluid flow generating portion 15 of surgical burr 10 within irrigation fluid W, the cutting operation described above can be visually observed with a good field of view.

[0035] <Second embodiment of surgical burr> 7 is a partially enlarged view showing the distal end of a surgical burr 10 according to a second embodiment attached to an attachment 103a of a handpiece 103. The cutting portion 13A of the surgical burr 10 of this configuration has multiple rows of cutting blades 43 that extend from the axial leading end to the axial trailing end of the cutting portion 13A and are formed at rotationally symmetrical positions about the rotation axis Lc. Between each pair of the multiple rows of cutting blades 43, a groove 49 is provided, recessed from the periphery, and including a rake face 45 of one cutting blade 43 and a relief face 47 of the other cutting blade 43, among the circumferentially adjacent cutting blades 43.

[0036] FIG. 8 is a front view of cutting portion 13A as seen from the tip of surgical burr 10. Cutting portion 13A of this configuration has four cutting blades 43, and cutting blades 43 and grooves 49 are arranged alternately in the circumferential direction of cutting portion 13A. As shown in FIG. 7, the rows of cutting blades 43 are formed in a spiral shape along the axial direction, and therefore grooves 49 are also formed in a spiral shape. Therefore, as surgical burr 10 rotates Rc, a spiral flow indicated by arrow FL3 occurs in the irrigation fluid W in grooves 49.

[0037] The flow FL3 of perfusion fluid W from the cutting portion 13A flows in the same direction as the flow FL1 generated by the spiral ridge 17 in the fluid flow generating portion 15, and promotes the flow FL1. As a result, the perfusion fluid W containing the tissue fragments P cut by the cutting portion 13A is efficiently removed from the vicinity of the cutting portion 13A, and highly transparent perfusion fluid W that does not contain the tissue fragments P flows into the vicinity of the cutting portion 13A. This further improves the field of view around the cutting portion 13A, improving the field of view of the tissue removal position during the cutting operation.

[0038] <Top of the spiral ridge> 9 is a partial cross-sectional view of the liquid flow generating unit 15 taken in the axial direction. The spiral ridge 17, which is the liquid flow generating unit 15, has a ridge 17b at its tip that protrudes radially outward to a reduced height, making the axial cross-sectional shape of the ridge 17b flat. By removing the sharply pointed portion from the ridge 17b of the spiral ridge 17, it is possible to prevent the tissue from being damaged even if the spiral ridge 17 accidentally comes into contact with the tissue during surgery.

[0039] On the other hand, by sharpening the top of the spiral ridge 17, the spiral ridge 17 can also function as a cutting blade. 10 is a partial cross-sectional view of the liquid flow generating unit 15A, which serves as a cutting blade, cut in the axial direction. The spiral ridge 17A formed on the liquid flow generating unit 15A has a sharply pointed tip 17c at the tip of the protrusion. The tip 17c contributes to cutting tissue. Therefore, by pressing both the cutting unit 13 and the tip 17c of the spiral ridge 17A against the tissue to be cut during surgery, a wide area of ​​tissue can be removed efficiently.

[0040] <Modification of the liquid flow generating unit> Next, modified examples of the liquid flow generating unit will be described. The liquid flow generating unit 15 is not limited to the spiral ridge 17 described above, and there are no limitations on its shape as long as it can move the perfusion fluid. For example, it may have a shape that has the effect of stirring the perfusion fluid. Each of the modified examples of the liquid flow generating unit shown below is a simplified version of the shape, but the exemplified shapes and configurations may also be included as part of the liquid flow generating unit.

[0041] 11 is a perspective view of the tip of surgical burr 10, showing liquid flow generating unit 15B of a first modified example. Liquid flow generating unit 15B is a flat plate 51 that protrudes radially outward from the outer circumferential surface of shank 11 and is a convex portion extending along rotation axis Lc, and has wall surface 51a that continues along rotation axis Lc. Flat plate 51 is provided in at least one location around the circumference of shank 11, and preferably in multiple locations that are rotationally symmetrical. With this configuration, as surgical burr 10 rotates, wall surface 51a of flat plate 51 agitates the surrounding irrigation fluid, causing the irrigation fluid to flow.

[0042] Furthermore, although not shown, the liquid flow generating unit 15B may have all or part of the flat plate 51 shown in FIG. 11 inclined from the rotation axis Lc toward one side in the circumferential direction of the shaft 11. That is, the wall surfaces 51a of the flat plate 51 may be inclined in the same direction at a predetermined angle from the rotation axis Lc like a screw. In this case, as the surgical burr 10 rotates, a flow of the perfusion fluid W along the shaft 11 occurs. Note that the flat plate 51 is not limited to a configuration in which the entire plate is inclined, and may be configured such that, for example, any part of the plate is inclined in the axial direction along the rotation axis Lc.

[0043] FIG. 12 is a perspective view of the tip of surgical burr 10, showing liquid flow generating unit 15C of a second modified example. FIG. 13 is a cross-sectional view taken along line XIII-XIII in FIG. 12. Liquid flow generating unit 15C has groove 53, which is a recess that is recessed radially inward of shank 11. Groove 53 is provided in at least one location, preferably multiple locations that are rotationally symmetrical, around the circumference of shank 11. Groove 53 has inner wall surface 53a that conforms to shank 11. Inner wall surface 53a agitates irrigation fluid W as surgical burr 10 rotates, causing the irrigation fluid W to flow.

[0044] Although not shown, in fluid flow generating unit 15C, all or part of groove 53 shown in FIG. 12 may be inclined from rotation axis Lc toward one side in the circumferential direction of shank 11. In other words, inner wall surface 53a of groove 53 may be configured to be inclined in a spiral shape at a predetermined angle from rotation axis Lc. In this case, as surgical burr 10 rotates, perfusion fluid W flows along shank 11.

[0045] As described above, the liquid flow generating part 15, 15A, 15B, 15C, as long as it has irregularities that protrude radially outward from the shaft part 11 or that recess radially inward, can generate a flow in the perfusion fluid W in either case.

[0046] FIG. 14 is a perspective view of the distal end of surgical burr 10, showing a fluid flow generating unit 15D of a third modification. This fluid flow generating unit 15D has multiple rods 55, which are convex portions protruding radially outward from the outer circumferential surface of shank 11. The rods 55 preferably include multiple distal rods 57 with long protrusions located closer to cutting portion 13 and multiple proximal rods 59 with short protrusions located farther from cutting portion 13. An arbitrary number of rods 55 are arranged circumferentially, preferably at multiple locations that are rotationally symmetrical about rotation axis Lc. Additional rods may be provided between the distal rods 57 and the proximal rods 59. As surgical burr 10 rotates, the rods 55 agitate the irrigation fluid W, causing it to flow.

[0047] The present invention is not limited to the above-described embodiments, and can be appropriately modified, improved, etc. In addition, the material, shape, dimensions, numerical values, form, number, location, etc. of each component in the above-described embodiments are arbitrary and not limited as long as they can achieve the present invention.

[0048] As described above, the present specification discloses the following: (1) A surgical burr having a rod-shaped shaft and a cutting part provided at one end of the shaft, the surgical burr being rotated around the axis of the shaft, the shank portion is formed on an outer peripheral surface on the cutting portion side in the axial direction, and is equipped with a liquid flow generating portion having at least one of a convex portion protruding radially outward of the shank portion and a concave portion recessed radially inward of the shank portion. With this surgical burr, the convex or concave fluid flow generating portion on the shaft allows the perfusion fluid supplied to the affected area during surgery to flow, removing the perfusion fluid containing tissue fragments that have formed around the cutting area from around the cutting position, thereby ensuring the surgeon's stable field of vision around the cutting position.

[0049] (2) The surgical burr according to (1), wherein the liquid flow generating portion includes a spiral ridge that protrudes radially outward from the outer peripheral surface of the shaft portion and is formed in a spiral shape centered on the axis along the outer periphery of the shaft portion. According to this surgical burr, a flow of irrigation fluid is generated around the spiral ridge by the feeding motion of the spiral ridge caused by rotating the shaft portion.

[0050] (3) The surgical burr according to (2), wherein the spiral ridges have a lower radially outward protrusion height as they approach the cutting portion. This surgical burr prevents the surgeon's field of view near the cutting area from being obstructed by the spiral ridge during surgery, making it easier to ensure a wide field of view.

[0051] (4) The surgical burr according to (2), wherein the maximum outer diameter of the spiral ridge is smaller than the maximum outer diameter of the cutting portion. This surgical burr prevents the surgeon's field of vision from being obstructed by the spiral ridges during surgery, making it easier for the surgeon to maintain a clear view of the area near the cutting portion. In addition, because the protruding height of the spiral ridges is lower than the cutting portion, it is less likely that the spiral ridges will inadvertently damage tissue that does not need to be cut.

[0052] (5) A surgical burr according to any one of (1) to (4); a handpiece having an elongated tubular support that rotatably supports the shaft portion of the surgical burr, with the cutting portion and the fluid flow generating portion exposed from a tip thereof; a rotation control device for rotationally driving the shank of the surgical burr supported on the tubular support; an irrigation fluid device for supplying irrigation fluid toward the affected area; A surgical system comprising: According to this surgical system, the cutting portion of the surgical burr and the fluid flow generating portion are rotated within the irrigation fluid at the affected area, allowing for a clear visual field to observe the cutting operation.

[0053] (6) a sheath whose cylindrical tip is inserted into the affected area and into which the tubular support of the handpiece is inserted; an observation optical system for obtaining an observation image of the affected area around the cutting portion of the surgical burr; Equipped with The surgical system according to (5), wherein the irrigation fluid device supplies the irrigation fluid into the tube of the sheath. According to this surgical operation system, cutting can be performed with a surgical burr through a sheath inserted into the affected area, and the cutting state can be captured by an observation optical system inside the sheath.

[0054] (7) The surgical system according to (6), wherein the irrigation fluid device suctions the irrigation fluid from within the sheath tube and discharges it outside the sheath tube. According to this surgical system, the irrigation fluid that accumulates near the affected area can be removed by suctioning the irrigation fluid inside the sheath tube.

[0055] (8) The surgical system according to (6), wherein the observation optical system includes an endoscope device that acquires the observation image from the tip of an insertion portion that is inserted into the affected area. According to this surgical operation system, the surgeon can easily visually check the cutting state of the cutting section using the endoscope device.

[0056] (9) A method for operating the surgical operation system according to (5), comprising: a tubular support of the handpiece supporting the surgical burr, the distal end of the support being inserted into the affected area; and the irrigation fluid device delivering the irrigation fluid toward the cutting site by the surgical burr. A method for operating a surgical system, wherein the cutting unit and the fluid flow generating unit are placed in the irrigation fluid that accumulates in the affected area, and the rotation control device rotates the surgical burr to generate a flow of the irrigation fluid using the fluid flow generating unit. According to the operating method of this surgical system, the irrigation fluid suspended near the cutting site is replaced with new irrigation fluid, and the area around the cutting site is constantly filled with new irrigation fluid, thereby obtaining an observation image with a good field of view.

[0057] (10) A method of operating a surgical system as described in (9), wherein the fluid flow generating unit generates a fluid flow of the irrigation fluid around the cutting portion along the shaft portion toward the fluid flow generating unit as the surgical burr is rotated by the rotation control device. According to the operating method of this surgical system, the perfusion fluid around the cutting part flows along the shaft toward the fluid flow generating part, thereby removing tissue pieces cut by the cutting part from around the cutting part and constantly filling the area around the cutting part with new perfusion fluid.

[0058] (11) A method of operating a surgical system as described in (9), wherein the fluid flow generating unit generates a fluid flow in which the irrigation fluid around the cutting portion flows in a direction opposite to the shaft portion as the surgical burr is rotated by the rotation control device. According to the operating method of this surgical system, new irrigation fluid is supplied to the cutting section, and tissue pieces cut by the cutting section are removed from around the cutting section, thereby allowing the area around the cutting section to be constantly filled with new irrigation fluid. [Explanation of symbols]

[0059] 10 Surgical Burs 11 Shaft 13,13A cutting part 13a proximal end 15 Liquid flow generation section 17 Spiral protrusion 19 Connection 21 Sheath 23 Endoscopic equipment 25 Irrigation fluid equipment 25A Liquid delivery section 25B Liquid recovery section 27 bones 29 Skin 31 Muscle 33 Insertion section 35 Observation optical system 36 Image display device 37 Working lumen 39 Feed route 41 Exhaust channel 43 Cutting blade 45 scooping face 47 Flank 49 Groove 51 Flat plate (convex part) 51a Wall 53 Groove (recess) 53a Inner wall 55 Rod body (convex part) 57 Tip side rod body (convex part) 59 Base end rod body (convex part) 100 Surgical Systems 101 Control unit 103 Handpiece 103a Attachment (Tubular support) 103b Grip part 105 Connection Cable 107 Footswitch M Power Source W perfusate

Claims

1. A surgical burr comprising a rod-shaped shaft and a cutting portion provided at one end of the shaft in the axial direction, the surgical burr being rotated around an axis of the shaft, The shaft portion is provided with a liquid flow generating portion formed on an outer peripheral surface of the cutting portion side in the axial direction, and having at least one of a convex portion protruding radially outward of the shaft portion or a concave portion recessed radially inward, Surgical burr.

2. The liquid flow generating portion includes a spiral protrusion that protrudes radially outward from the outer circumferential surface of the shaft portion and is formed in a spiral shape centered on the axis along the outer periphery of the shaft portion.

10. The surgical burr of claim 1.

3. the spiral protrusion has a lower radially outward protrusion height as it approaches the cutting portion; 3. The surgical burr of claim 2.

4. The maximum outer diameter of the spiral protrusion is smaller than the maximum outer diameter of the cutting portion.

3. The surgical burr of claim 2.

5. A surgical burr according to any one of claims 1 to 4; a handpiece having an elongated tubular support that rotatably supports the shaft portion of the surgical burr, with the cutting portion and the fluid flow generating portion exposed from a tip thereof; a rotation control device for rotationally driving the shank of the surgical burr supported on the tubular support; an irrigation fluid device that delivers irrigation fluid toward the cutting portion and the fluid flow generating portion of the surgical burr; A surgical system comprising:

6. a sheath into which a cylindrical tip portion is inserted into an affected area and into which the tubular support of the handpiece is inserted; an observation optical system for obtaining an observation image of the affected area around the cutting portion of the surgical burr; Equipped with The irrigation fluid device supplies the irrigation fluid into the sheath. The surgical system of claim 5 .

7. the perfusion fluid device sucks the perfusion fluid from inside the sheath tube and discharges it outside the sheath tube; The surgical system of claim 6.

8. the observation optical system includes an endoscope device that acquires the observation image from a tip of an insertion part that is inserted into the affected area, The surgical system of claim 6.

9. 6. A method of operating a surgical system according to claim 5, comprising: a tubular support of the handpiece supporting the surgical burr, the distal end of the support being inserted into the affected area; and the irrigation fluid device delivering the irrigation fluid toward the cutting site by the surgical burr. With the cutting unit and the fluid flow generating unit disposed in the irrigation fluid accumulated in the affected area, the rotation control device rotates the surgical burr to generate a flow of the irrigation fluid using the fluid flow generating unit. A method for operating a surgical system.

10. the fluid flow generating unit generates a fluid flow of the irrigation fluid around the cutting portion along the shaft portion toward the fluid flow generating unit as the surgical burr is rotated by the rotation control device. The method of operating a surgical system according to claim 9.

11. the fluid flow generating unit generates a fluid flow of the irrigation fluid around the cutting portion in a direction opposite to the shaft portion as the surgical burr is rotated by the rotation control device. The method of operating a surgical system according to claim 9.

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