JP2000070280A - High-frequency treatment implement - Google Patents

Abstract

PROBLEM TO BE SOLVED: To make it possible to surely prevent the electrical shorting between a pair of claming members and to ensure the fail-proof execution of coagulation and incision of tissue. SOLUTION: This high-frequency treatment implement includes an insertion part which may be inserted into the body, a pair of the clamping parts 8a, 8b which are arranged at the front end of the insertion part and clamp the biotissue for the purpose of coagulation or incision and a manipulation section which are connected to the base end of the insertion part and is manipulated to open and close the clamping parts. The implement coagulates and incises the biotissue held by the clamping parts by supplying high-frequency current to electrodes disposed at the clamping surfaces of the clamping parts. The clamping surface of the at least one of clamping parts is provided with electrical insulating parts 12. These electrical insulating parts 12 come into contact with the clamping surface of the other clamping part in the state that the clamping parts are completely closed, thereby forming a prescribed clearance C between the clamping surfaces of the respective clamping parts. As a result, the shorting between the electrode parts of the respective clamping parts may be prevented.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

[0001] The present invention relates to a medical device,
The present invention relates to a high-frequency treatment device capable of grasping tissue for coagulation and incision.

[0002]

2. Description of the Related Art Generally, a high-frequency treatment device capable of grasping and coagulating and incising a living tissue is provided with a pair of jaws as grasping members for grasping the living tissue, and each jaw is provided with an electrode for energizing a high frequency. Disposed bipolar forceps are known. In this bipolar forceps, when a high-frequency current is applied between the electrodes of each jaw while the living tissue to be treated is held between the pair of jaws, the living tissue between the jaws is coagulated or cut.

[0003] Bipolar forceps of this type are usually used in various cases such as hemostasis of blood vessels contained in living tissue, cauterization of lesions and bleeding points on the surface layer of living tissue, occlusion of fallopian tubes for contraception, and the like. And disclosed in, for example, JP-A-8-317936.

[0004]

By the way, in the conventional bipolar forceps, particularly when a thin film-like tissue or the like is gripped by the jaws, the metal portions of the jaws come into contact with each other. A high-frequency current may flow between the sections. That is, the jaws are electrically short-circuited. Therefore, in this case, the high-frequency current does not flow through the tissue held between the jaws, and the tissue cannot be reliably coagulated and incised. Further, if the complete coagulation treatment cannot be performed, there is a problem that bleeding occurs at the subsequent incision.

The present invention has been made in view of the above circumstances. It is an object of the present invention to prevent an electric short circuit between a pair of gripping members and to surely coagulate and dissect tissue. It is an object of the present invention to provide a high-frequency treatment device that can perform the treatment.

[0006]

Means for Solving the Problems In order to solve the above-mentioned problems, an invention according to claim 1 includes an insertion portion which can be inserted into a body, and a living tissue which is disposed at a distal end portion of the insertion portion and grips a living tissue. A pair of gripping portions for coagulating or incising, and an operating portion connected to the base end of the insertion portion for opening and closing the gripping portion, and an electrode portion provided on a gripping surface of the gripping portion. In a high-frequency treatment instrument for coagulating and incising a living tissue grasped by the grasping portion by applying a high-frequency current, at least one of the grasping portions is provided with an electrical insulating portion on a grasping surface, and the grasping portion is completely closed. In this state, a predetermined gap is formed between the gripping surfaces of the gripping portions by the electrical insulating portion abutting on the gripping surfaces of the other gripping portions, and thereby, between the electrode portions of the gripping portions. Characterized by preventing short circuit of You.

According to a second aspect of the present invention, there is provided an insertion portion which can be inserted into a body, and a pair of grip portions which are arranged at a distal end portion of the insertion portion and which grip a living tissue to coagulate or incise. An operation unit connected to the base end of the insertion unit and configured to open and close the grip unit. When a high-frequency current is supplied to an electrode unit provided on a grip surface of the grip unit, the grip unit In a high-frequency treatment instrument for coagulating and incising a grasped living tissue, an electric insulating portion is provided on a grasping surface of one grasping portion, and in a state where the grasping portion is completely closed, the grasping surface of the other grasping portion is the same as the grasping surface. A short circuit between the electrode portions of each gripping portion is prevented by contacting only with the electric insulating portion.

According to a third aspect of the present invention, there is provided an insertion portion which can be inserted into a body, and a pair of grip portions which are arranged at a distal end portion of the insertion portion and grip and coagulate or dissect living tissue. An operation unit connected to the base end of the insertion unit and configured to open and close the grip unit. When a high-frequency current is supplied to an electrode unit provided on a grip surface of the grip unit, the grip unit In a high-frequency treatment tool for coagulating and incising a grasped living tissue, at least one of the grasping surfaces of the grasping portion is brought into contact with the other grasping surface in a state where the grasping portion is completely closed, and an electrode portion of each grasping portion is provided. An electrical insulating portion for preventing a short circuit between them is provided.

[0009]

Embodiments of the present invention will be described below with reference to the drawings. 1 and 2 show a first embodiment of the present invention. As shown in FIG. 1, a bipolar forceps 1 as a high-frequency treatment tool according to the present embodiment includes an elongated insertion portion 2 inserted into a body cavity of a patient.
A treatment unit 3 disposed at the distal end of the insertion unit 2 for grasping and coagulating or incising a living tissue, and an operation unit 4 connected to the base end of the insertion unit 2. In addition, treatment section 3
, A high-frequency current is supplied through a conductive member (not shown). Thereby, the living tissue grasped by the treatment section 3 is coagulated or incised.

The insertion section 2 has a rotatable sheath 5. A rod 7 is provided in the sheath 5 so as to be able to advance and retreat. A pair of jaws 8 a and 8 b constituting the treatment section 3 are connected to the distal end of the rod 7 via a link mechanism 10. These jaws 8a and 8b function as grasping members for grasping tissue, and are formed as electrodes for passing a high-frequency current through the grasped tissue.

As shown in detail in FIG. 2, the link mechanism 10 has a pair of links 21 and 22 rotatably connected to the tip of the rod 7 via a pivot pin 29.
The first link 21 is rotatably connected to the base end of one jaw 8b via a pivot pin 23. The second link 22 is rotatably connected to the base end of the other jaw 8a via a pivot pin 24. The pair of jaws 8a and 8b are rotatably connected to each other via pins 25 supported by a pair of arms 20 extending from both sides of the distal end of the sheath 5. Therefore, according to this configuration, when the rod 7 is advanced and retracted, the link mechanism 10 is operated, and the jaws 8a and 8b rotate about the pin 25 (the treatment section 3 opens and closes). In addition, Joe 8
a, 8b so that the living tissue can be reliably grasped,
On the inner gripping surfaces of the jaws 8a and 8b, saw-toothed portions 26 that mesh with each other when the treatment section 3 is closed are formed.

The distal ends of the jaws 8a and 8b are formed as insulating portions 12. The insulating part 12 is provided with the jaw 8
The entirety of the distal ends of the jaws 8a and 8b may be formed of a material having electrical insulation, and the outer surfaces of the distal ends of the jaws 8a and 8b may be formed by applying an insulating coating. Is also good. In this embodiment, in the state of FIG. 2 in which the treatment section 3 is completely closed, only the insulating portions 12 of the jaws 8a and 8b are brought into meshing contact with each other, and each jaw except the insulating portions 12 and 12 is brought into contact. 8
A predetermined gap C is formed between the gripping surfaces (saw-tooth portions 26) of a and 8b. That is, each jaw 8
a and 8b are such that, when the tissue is grasped, the current-carrying portions through which the high-frequency current is applied do not come into contact with each other (jaw 8).
a, 8b is not electrically short-circuited).

As shown in FIG. 1, the jaws 8a, 8
The conductive member electrically connected to b extends through the inside of the sheath 5 and is connected to a connector receiver 13 provided on the operation unit 4. The cable 14 extending from the high-frequency ablation power supply 15 is connected to the connector receiver 13. The high-frequency ablation power supply 15 has a foot switch 1 for turning on / off the power supply 15.
6 are provided.

The operation unit 4 includes a grip 6 which can be gripped by hand. The grip 6 is provided with finger hanging portions 6a and 6b for hanging the index finger and the middle finger. The grip 6 is provided with a trigger 17 as forceps operating means. The trigger 17 is rotatably connected to the upper end of the grip 6 via a rotation pin 18.
The proximal end of the rod 7 is connected to the trigger 17. The trigger 17 is provided with a finger hook 17a on which the surgeon puts his thumb.

Next, a case where the tissue is coagulated using the bipolar forceps 1 having the above-described configuration will be described. First, the cable 14 is connected to the connector receiver 13 of the bipolar forceps 1, and the bipolar forceps 1 and the high-frequency ablation power supply device 15 are electrically connected. Subsequently, the rod 7 is retracted toward the hand side by rotating the trigger 17 of the operation unit 4 in the direction of arrow a, and the jaws 8a and 8b are
(Treatment unit 3) is closed. In this state, the bipolar forceps 1
Is inserted into the body of the patient, and the treatment section 3 at the distal end of the insertion section 2 is guided to a position near the tissue to be treated in the body.

When the treatment section 3 is located near the tissue to be treated, the rod 7 is moved forward by rotating the trigger 17 in the direction of arrow b, and the jaws 8a and 8b (the treatment section 3) are moved via the link mechanism 10. )open. After the living tissue is inserted between the expanded jaws 8a and 8b, the trigger 17 is operated again to close the jaws 8a and 8b, and the living tissue is gripped by the jaws 8a and 8b. At this time, even if the living tissue is a thin film-shaped tissue, the energized portions of the jaws 8a and 8b to which the high-frequency current is applied do not come into contact with each other (an electrical short circuit occurs between the jaws 8a and 8b). . This is because, when the treatment section 3 is completely closed, only the insulating portions 12, 12 of the jaws 8a, 8b are in meshing contact with each other, and the gripping surfaces (saw teeth) of the jaws 8a, 8b except the insulating portions 12, 12 are formed. This is because a predetermined gap C is formed between the portions 26).

In this state, if a high-frequency current is passed from the high-frequency ablation power supply device 15 to the connector receiver 13 via the cable 14, a coagulation current of a predetermined frequency flows between the jaws 8a and 8b, and a living tissue can be coagulated.

As described above, in the bipolar forceps 1 of the present embodiment, only the insulating portions 12, 12 of the jaws 8a, 8b are brought into meshing contact with each other in a state where the treatment section 3 is completely closed. Each jaw 8a, 8b except 12, 12
A predetermined gap C is formed between the gripping surfaces (saw-tooth-like portions 26). That is, each jaw 8a, 8b
Is designed such that, while holding the tissue, the current-carrying portions through which the high-frequency current flows are not in contact with each other. Therefore, when the tissue is gripped by the jaws 8a and 8b, an electrical short circuit does not occur between the jaws 8a and 8b, so that the coagulation treatment and the incision treatment can be surely performed even with a thin film-like tissue. In addition, Japanese Patent Application Laid-Open No. 8-317936, which is cited as a prior art, discloses a configuration in which a U-shaped insulating member is disposed on a gripping surface of a jaw. This is for applying pressure to the grasped tissue for tightening, and does not prevent an electrical short circuit between the jaws.

Further, the bipolar forceps 1 of the present embodiment
The insulating portion 12 is provided only at the distal ends of the jaws 8a and 8b. Therefore, it is possible to widen the coagulation range of the tissue without short-circuiting the current-carrying portion (the current-carrying area to the tissue can be increased).

In this embodiment, the insulating portion 12 is provided on each of the jaws 8a and 8b, but may be provided on only one of the jaws 8a (8b). The point is that at least one of the jaws 8a and 8b that come into contact with each other when the treatment section 3 is closed may be formed as the insulating section 12.

FIG. 3 shows a second embodiment of the present invention. The high-frequency treatment device according to the present embodiment includes the jaws 8a and 8b
The only difference is the shape of the saw-tooth-like portion 26 formed on the gripping surface of the first embodiment, and the other configuration is completely the same as that of the first embodiment. Therefore, the same operation and effect as in the first embodiment can be obtained.

FIG. 4 shows a third embodiment of the present invention. In the high-frequency treatment device of the present embodiment, in the configuration of the first embodiment, the passage of the high-frequency current to the jaws 8a and 8b is formed by the rod 7 and the links 21 and 22. That is, at the tip of the rod 7,
A pair of links 21 and 22 are rotatably connected via a pivot pin 29. The first link 21 is rotatably connected to the base end of one jaw 8b via a pivot pin 23. The second link 22 is connected to the pivot pin 2.
4, and is rotatably connected to the base end of the other jaw 8a. The pair of jaws 8a and 8b are rotatably connected to each other via pins 25 supported by a pair of arms 20 extending from both sides of the distal end of the sheath 5.

The rod 7 has two conductive regions 7a and 7b which are electrically insulated from each other by an insulating member 7c. Of these, the conductive region 7a is the second link 2
2, and is electrically connected to one jaw 8a. The conductive region 7b is electrically connected to the other jaw 8b via the first link 21. In order to electrically insulate the current path formed by the conductive region 7a and the second link 22 from the current path formed by the conductive region 7b and the first link 21, each pivot pin 24, 25 and 29 are covered with an insulating tube. Other configurations such as the insulating portion 12 are the same as those of the first embodiment.

Therefore, according to this embodiment, the same operation and effect as those of the first embodiment can be obtained, and the energization path for each of the jaws 8a and 8b can be simplified.

FIG. 5 shows a fourth embodiment of the present invention. The bipolar forceps as a high-frequency treatment instrument according to the present embodiment includes an elongated insertion portion 2 inserted into a body cavity of a patient,
The treatment unit 3 is disposed at the distal end of the insertion unit 2 for grasping and coagulating or incising a living tissue, and includes an operation unit (not shown) connected to a base end of the insertion unit 2. Since the configuration of the operation unit of the present embodiment is the same as that of the operation unit 4 of the first embodiment, the same reference numerals as in the first embodiment denote the same, and a description thereof will be omitted.

The insertion section 2 has a rotatable outer sheath 39.
And an inner sheath 30 which is inserted into the outer sheath 39 so as to be able to advance and retreat. The inner sheath 30 is inserted through the inside of the grip 6 constituting the operation unit, and the base end thereof is connected to the trigger 17. An electrically insulating cap 33 is connected and fixed to the distal end of the inner sheath 30.

An electrically insulating holding member 31 is fitted in the inner sheath 30, and a pair of elastic members 32a and 32b are fixedly held by the holding member 31. These elastic members 32a and 32b are composed of conductive rods 35 formed of spring steel or the like. The outer periphery of the conductive rod 35 is covered with an insulating tube 36. The elastic members 32a and 32b have their base ends connected to the connector receiver 13 provided on the operation unit 4, and
The distal end protrudes from the distal end of the inner sheath 30. Each of the elastic members 32a and 32b has a jaw 8 at its tip.
a, 8b, and is constantly urged in the direction of expanding the jaws 8a, 8b.

Therefore, in such a configuration, when the trigger 17 is operated in the direction b in FIG.
0 moves forward in the axial direction, and the elastic members 32a and 32b are relatively drawn into the inner sheath 30 (see FIG. 5B). Thereby, the elastic members 32a, 32
2b is pressed inward by the inner surface of the inner sheath 30, and the jaws 8a, 8b close. On the other hand, when the trigger 17 is operated in the direction a in FIG. 1, the elastic members 32a and 32b relatively protrude from the inner sheath 30, and the elastic members 32a and 32b
The jaws 8a, 8b are opened by the restoring force of 32b.

In this embodiment, the tip of the jaw 8a on one side is formed as an insulating portion 12. The insulating portion 12 may be formed by forming the entire distal end of the jaw 8a with a material having electrical insulation, or by applying an insulating coating to the outer surface of the distal end of the jaw 8a. May be. In the present embodiment, the treatment section 3 is completely closed in FIG.
In the state (b), only the insulating portion 12 of the jaw 8a meshes with and contacts the tip of the jaw 8b on the other side.
The gripping surface of the jaw 8a excluding the insulating portion 12 (saw tooth portion 26)
A predetermined gap C is formed between the jaw 8b and the gripping surface (saw-tooth-like portion 26) of the jaw 8b. In other words, the jaws 8a and 8b are configured such that the current-carrying portions through which the high-frequency current is applied do not come into contact with each other (there is no electrical short-circuit between the jaws 8a and 8b) while the tissue is being gripped. The other configuration is the same as that of the first embodiment.

Therefore, according to the bipolar forceps of the present embodiment, the same operation and effect as those of the first embodiment can be obtained. FIG. 6 shows a fifth embodiment of the present invention. The high-frequency treatment tool of the present embodiment is a pair of forceps members 41a, 41a of the same shape, which are scissors-shaped forceps for laparotomy surgery.
1b. The forceps members 41a and 41b are made of a conductive member, and are rotatably connected to each other by a pivot 42 at a substantially middle portion thereof. The proximal ends of the forceps members 41a and 41b are formed as finger hooks 44a and 44b, and cables 45a and 45b connected to a high-frequency ablation power supply (not shown) are connected to the finger hooks 44a and 44b.

The jaws 42a and 42b are provided at the distal ends of the forceps members 41a and 41b. Joe 42a,
The jaw 42a, 42b has a jaw 42 on its inner gripping surface so that the living tissue can be securely gripped by the jaw 42b.
a, serrated portions 2 meshing with each other when closed
6 are formed.

The pair of forceps members 41a and 41b and the pivot 42 are covered with an insulating member 46, and only the saw-tooth-like portions 26 provided on the jaws 42a and 42b are exposed from the insulating member 46 to form an electrode portion. are doing. In addition, bent portions 43, 43 bent inward are formed at the tips of the jaws 42a, 42b.

In this embodiment, the jaws 42
In the state of FIG. 6A in which a and 42b are completely closed,
Each jaw 42a, 42 covered with an insulating member 46
b, only the bent portions 43, 43 (corresponding to the insulating portion 12 in the first embodiment) are brought into meshing contact with each other, and
A predetermined gap C is formed between the gripping surfaces (saw-tooth-like portions 26) of each of the jaws 42a and 42b except 43. That is, in the jaws 42a and 42b, the current-carrying portions (saw-tooth-shaped portions 26) through which the high-frequency current flows are not in contact with each other while holding the tissue (jaws 42a and 4b).
No electrical short circuit occurs between 2b).

In the laparotomy forceps 40 having such a configuration, the living tissue is grasped between the sawtooth portions 26, 26 of the jaws 42a, 42b, and the forceps members 41a, 41 are held.
By causing a coagulation current or an incision current to flow through the saw-tooth-like portion 26 through the conductive portion b, coagulation or incision of the living tissue can be performed.

As described above, the forceps 40 for laparotomy according to the present embodiment has only the bent portions (insulating portions) 43 of the jaws 42a and 42b in a state where the jaws 42a and 42b are completely closed. Are in meshing contact with each other,
A predetermined gap C is formed between the gripping surfaces (saw-tooth-like portions 26) of the jaws 42a and 42b except for the members 3 and 43. That is, in the jaws 42a and 42b, the current-carrying portions (saw-tooth-like portions 26) to which the high-frequency current is applied do not come into contact with each other while holding the tissue. Therefore, when the tissue is grasped by the jaws 42a and 42b, an electrical short circuit does not occur between the jaws 42a and 42b, so that the coagulation treatment and the incision treatment can be reliably performed even with a thin film-like tissue.

FIGS. 7 to 9 show a sixth embodiment of the present invention. As shown in FIG. 7A, the high-frequency treatment device of the present embodiment has a pair of grasping members 50 and 51 for grasping and coagulating and incising a living tissue. The grip members 50 and 51 are opened and closed by, for example, a mechanism similar to that of the fourth embodiment shown in FIG. The configurations of the insertion section and the operation section that hold the grip members 50 and 51 are the same as those of the insertion section and the operation section of the fourth embodiment, for example.
Therefore, hereinafter, regarding the insertion portion and the operation portion, the fourth
In this embodiment, the same components as those in the fourth embodiment will be denoted by the same reference numerals, and description thereof will be omitted.

As shown in FIG. 7C, one gripping member 51 is formed as a first electrode portion made of a conductive material. The first electrode portion 51 has a through hole 52 extending along the longitudinal direction thereof, thereby forming a substantially loop shape.

As shown in FIG. 7B, the other gripping member 50 has two electrode portions 53 and 54 that are electrically insulated from each other by an insulating member 55. The insulating member 55 has a shape substantially corresponding to the first electrode portion 51, and is in contact with the first electrode portion 51 in a state of FIG. 8B in which the gripping members 50 and 51 are closed. Is located. In addition, the second member located outside the insulating member 55
Electrode part 53 functions as an electrode for coagulation,
5 and is located on both sides of the first electrode portion 51 so as to surround the first electrode portion 51 in the state of FIG. 8B with the gripping members 50 and 51 closed. It has become. Further, the third member located inside the insulating member 55
Electrode portion 54 functions as an incision electrode, and the insulating member 5
5 protrudes from the gripping surface of the holding member 5
In the state shown in FIG.
One of the through holes 52 is inserted.

The operating portions 4 are connected to the electrode portions 51, 53, 54 via the conductive rods 35 of the elastic members 32a, 32b.
The high frequency ablation power supply 15 is supplied with a high frequency current via a cable 14.

FIG. 9 shows stepwise how the living tissue P is coagulated and incised by the gripping members 50 and 51 having the above configuration. FIG. 9A shows a state in which the holding members 50 and 51 are opened as shown in FIG.
A state is shown in which the living tissue P is positioned between 0 and 51, and thereafter, the grasping members 50 and 51 are closed and the living tissue P is sandwiched between the grasping members 50 and 51. At this time,
Even if the living tissue P is a thin film-like tissue, the electrode portions 51 and 53 or the electrode portion 5 through which the high-frequency current flows are supplied.
1, 54 do not contact each other. This is because the gripping members 50 and 51 are completely closed and the first electrode 5
1 is in contact with the insulating member 55 only. In this state, the second electrode portion 5 which is a coagulation electrode
A coagulation current is caused to flow between the third electrode portion 51 and the first electrode portion 51 to coagulate the living tissue P.

When the coagulation treatment is completed, as shown in FIG. 9B, the gripping members 50 and 51 are slightly opened to switch the current to the incision current. And again, the gripping member 5
0, 51 are closed, and as shown in FIG. 9 (c), an incision current is caused to flow between the third electrode portion 54, which is an incision electrode, and the first electrode portion 51, and the living tissue is Dissect P.

As described above, in the high-frequency treatment device of the present embodiment, the first electrode portion 51 comes into contact only with the insulating member 55 in a state where the gripping members 50 and 51 are completely closed. . That is, in a state where the tissue is grasped by the grasping members 50 and 51, the electrode portion 5 to which the high-frequency current is applied is applied.
The electrodes 1 and 53 or the electrodes 51 and 54 do not contact each other. Therefore, the gripping members 50, 51
No electrical short circuit occurs between them, so that even thin membranes can be reliably coagulated and dissected.

In the present embodiment, even if the trigger 17 of the operation section is squeezed firmly, the electrode sections do not short-circuit, so that coagulation and incision can be reliably performed, and fine adjustment of the operation force of the trigger 17 can be performed. Since operability is not required, operability is improved.

In this embodiment, the electrode portions 51, 5
In order to prevent a short circuit between the insulating members 55, the gripping surface of the insulating member 55 is not formed on the same surface, and the height of the distal end region 55a of the gripping surface of the insulating member 55 is higher than the heights of the other regions. You may set it larger. With this setting, as in the first embodiment, only the distal end portion of the first electrode portion 51 and the distal end region 55a come into contact with the grip members 50 and 51 being completely closed, and the grip member A predetermined gap is formed between the gripping surfaces 50 and 51.

FIGS. 10 to 12 show a seventh embodiment of the present invention. As shown in FIG. 10, a bipolar forceps 60 as a high-frequency treatment device according to the present embodiment includes a sheath 61 as an insertion portion to be inserted into a body cavity of a patient, and a living tissue disposed at a distal end of the sheath 61. It comprises a treatment section 62 for coagulating or incising by grasping the same, and an operation section 63 connected to the proximal end of the sheath 61. In addition, the sheath 61 is rotated by operating a rotation operation unit 64 provided on the operation unit 63 side.

The treatment section 62 includes a pair of openable and closable jaws 7.
1,72. The operation unit 63 includes a fixed handle 65 and a movable handle 66, and the jaws 71 and 72 are opened and closed by rotating the movable handle 66.

The jaws 71 and 72 are electrically connected to a conductive member serving as a high-frequency current passage. This conductive member extends through the inside of the sheath 61 and is connected to a connector receiver 67 provided on the operation section 63. A cable 68 extending from the high-frequency ablation power supply 69 is connected to the connector receiver 67. In addition, the high frequency ablation power supply 69 has ON / OFF of the power supply 69.
Is provided.
The foot switch 70 is provided with a switch for incision and a switch for coagulation.

As shown in detail in FIG.
The first jaw 71 on one side of the second jaw 2 is made of a conductive material and has a U-shaped main body 74 in cross section. Both sides of the main body 74 are sawtooth-shaped grips 74a, 74a.
It is formed as. In addition, an insulating member 73 that holds the tissue together with the holding portions 74a, 74a is provided on the main body 74.
Are fixed in a state of being sandwiched between the grip portions 74a, 74a. The insulating member 73 is provided over substantially the entire length of the main body 74. On the other hand, the second jaw 72 on the other side constituting the treatment section 62 is formed as a rod having a circular cross section made of a conductive material. Further, the second jaw 72 is positioned so as to contact only the insulating member 73 in a state where the treatment section 62 is closed.

FIG. 12 shows a bipolar forceps 60 having the above configuration.
5 shows a state in which the tissue P is coagulated and incised step by step. FIG. 12A shows the grip portion 7 of the first jaw 71.
The state in which the tissue P is sandwiched between 4a, 74a and the second jaw 72 is shown. At this time, even if the tissue P is a thin film-like tissue, the jaw 7 to which the high-frequency current flows is supplied.
1, 72 do not contact each other. This is the treatment section 6
This is because the second jaw 72 comes into contact only with the insulating member 73 in a state in which the second jaw 2 is completely closed.
In this state, a coagulation current flows between the jaws 71 and 72,
The tissue P is coagulated.

When the coagulation treatment is completed, an incision current is applied between the jaws 71 and 72 in this state, and the tissue P is incised.
Also at this time, the jaws 71 and 72 do not come into contact with each other. As described above, the bipolar forceps 60 of the present embodiment is
Is such that the second jaw 72 contacts only the insulating member 73 of the first jaw 71 when the treatment section 62 is completely closed. That is, while the tissue is gripped by the jaws 71 and 72, the electrode portions to which the high-frequency current is applied do not come into contact with each other. Therefore,
There is no electric short circuit between the jaws 71 and 72, so that the coagulation treatment and the incision treatment can be reliably performed even with a thin film-like tissue.

Further, the bipolar forceps 60 of the present embodiment
In the first embodiment, an insulating member 73 is provided between the holding portions 74a, 74a of the first jaw 71, and the tissue can also be held by the insulating member 73. Therefore, the tissue can be reliably grasped without escaping and the coagulation / incision can be reliably performed. (The same can be said for the sixth embodiment, but in particular, as in the present embodiment, a part of the jaw is used. When grasping tissue or when the jaws are in the shape of a rod, it is very advantageous to provide an insulating member that serves both as a grasping means and a short-circuit preventing means). On the other hand, the high-frequency treatment device disclosed in DE4032471C2 is configured to grasp the tissue with three rod electrodes, and the tissue escapes when grasped,
The tissue cannot be reliably grasped. Therefore, the coagulation / incision procedure cannot be performed well.

FIG. 13 shows an eighth embodiment of the present invention. The high-frequency treatment device according to the present embodiment is different from the seventh embodiment in the configuration of the second jaw 72. That is, in the present embodiment, the second jaw 72 is disposed at a substantially central portion of the main body 76 made of a material having electrical insulation, and extends over substantially the entire length of the main body 76. And an electrode portion 77 made of a conductive material. Main unit 7
6 are gripping portions 74a, 74a of the first jaw 71.
Are formed as saw-tooth-shaped grip portions 76a, 76a that can be meshed with. The other configuration is the same as that of the seventh embodiment.

According to such a configuration, the second jaw 7
Since the holding portions 76a, 76a are also formed on the two sides,
The area for grasping the tissue is larger than that of the seventh embodiment, so that the grasp can be surely performed.

FIGS. 14 to 16 show a ninth embodiment of the present invention. As shown in FIG. 14, the bipolar forceps as the high-frequency treatment tool according to the present embodiment has a treatment section including a first jaw 80 and a second jaw 81. The first jaw 80 has two coagulating electrode portions 83 and 84 that are electrically insulated from each other by an insulating member 82. In this case, the first coagulation electrode portion 83 and the second coagulation electrode portion 84 are respectively located on both sides of the insulating member 82 such that the insulating member 82 is sandwiched between the electrode portions 83 and 84. Further, each of the electrode portions 83, 84
Are formed as saw-toothed grip portions 83a, 84a. On the other hand, the second jaw 81 is formed of a rod having a circular cross section made of a conductive material, and is formed as an incision electrode portion. The second jaw (electrode portion) 81
Is positioned so as to contact only the insulating member 82 with the treatment section closed.

The high-frequency ablation power supply 69 for supplying a high-frequency current to each of the electrode portions 81, 83, 84 is configured as shown in FIG. In the drawing, reference numeral 85 denotes an output circuit for supplying a high-frequency current; 86, a control circuit for controlling a high-frequency output from the output circuit 85 in accordance with a control signal from a foot switch 70; 86 is a setting means for inputting to the connector 86; 92 is a connector to which an energizing cable extending from the bipolar forceps is connected;
Lines 90 and 91 connect the output circuit 85 and the connector 92, and correspond to the respective electrode portions 81, 83 and 84, respectively. A detection circuit 87 detects a high-frequency current flowing through the lines 89, 90, and 91 and sends a detection signal to the control circuit 86. The other configuration is the same as that of the seventh embodiment.

FIG. 16 shows stepwise a state in which the tissue P is coagulated and incised using the bipolar forceps having the above configuration. FIG. 16A shows a state where the tissue P is held between the first jaw 80 and the second jaw 81.
At this time, even if the tissue P is a thin film-like tissue, the jaws 80 and 81 to which the high-frequency current flows are not in contact with each other. This is when the treatment section is completely closed,
This is because the second jaw 81 comes into contact only with the insulating member 82. In this state, the first jaw 8
A coagulation current is caused to flow between the two coagulation electrode portions 83 and 84 to coagulate the tissue P.

When the coagulation treatment is completed, the first
Coagulation electrode part 83 and incision electrode part (second jaw) 81
And an incision current is passed between the second coagulation electrode portion 84 and the incision electrode portion (second jaw) 81 to incise the tissue P. Also at this time, the jaws 80 and 81 do not come into contact with each other.

As described above, in the bipolar forceps of this embodiment, the second jaw 81 comes into contact only with the insulating member 82 of the first jaw 80 in a state where the treatment section is completely closed. I have. That is, while the tissue is gripped by the jaws 80 and 81, the electrodes to which the high-frequency current is applied do not come into contact with each other. Therefore, no electrical short circuit occurs between the jaws 80 and 81,
Therefore, a coagulation treatment and an incision treatment can be reliably performed even with a thin film-like tissue.

In the bipolar forceps of this embodiment, an insulating member 82 is provided between the two electrode portions 83 and 84 of the first jaw 80, and the tissue can be gripped by the insulating member 82. I have. Therefore, the tissue can be securely grasped without escaping, and coagulation / incision can be reliably performed. In the present embodiment, each of the electrode portions 81 and 8 can be used.
Three lines 89, 90, 91 corresponding to 3, 84 are provided in the high-frequency ablation power supply 69. Therefore, there is no need to provide a switch for switching between incision and coagulation in the operation unit or the like on the bipolar forceps side.

In this embodiment, a coagulation current can be passed between the two coagulation electrodes 83 and 84, so that the coagulation range can be made larger than in the seventh and eighth embodiments.

FIG. 17 shows a tenth embodiment of the present invention. The high frequency treatment device according to the present embodiment is different from the ninth embodiment in the configuration of the second jaw 81. That is, in the present embodiment, the second jaw 81 is disposed at a substantially central portion of the main body 95 made of an electrically insulating material and extends over substantially the entire length of the main body 95. And an electrode portion 96 made of a conductive material. Both sides of the main body 95 are provided with the gripping portions 83a, 84 of the first jaw 80.
are formed as saw-tooth-shaped grip portions 95a, 95a that can mesh with a. The other configuration is the same as that of the ninth embodiment.

According to such a configuration, the second jaw 8
Since the holding parts 95a, 95a are also formed on one side,
The area for grasping the tissue is increased as compared with the ninth embodiment, so that the grasp can be reliably performed.

According to the technical contents described above, the following various configurations can be obtained. 1. An insertion portion that can be inserted into the body, a pair of grip portions arranged at the distal end portion of the insertion portion for gripping and coagulating or incising a living tissue, and a grip portion connected to the base end portion of the insertion portion and opening and closing the grip portion An operation unit for operating, and a high-frequency treatment tool that coagulates and dissects a living tissue grasped by the grasping unit by applying a high-frequency current to an electrode unit provided on a grasping surface of the grasping unit, At least one gripping surface of the gripping portion is provided with an electrical insulating portion that abuts on the other gripping surface in a state where the gripping portion is completely closed to prevent a short circuit between the electrode portions of each gripping portion. A high-frequency treatment device, characterized in that:

2. An insertion portion that can be inserted into the body, a pair of grip portions arranged at the distal end portion of the insertion portion for gripping and coagulating or incising a living tissue, and a grip portion connected to the base end portion of the insertion portion and opening and closing the grip portion An operation unit for operating,
In a high-frequency treatment instrument that coagulates and dissects a living tissue grasped by the grasping portion by applying a high-frequency current to an electrode portion provided on the grasping surface of the grasping portion, at least one of the grasping surfaces of the grasping portion is electrically operated. An insulating portion is provided, and in a state where the grip portion is completely closed, a predetermined gap is formed between the grip surfaces of each grip portion by the electrical insulating portion abutting against the grip surface of the other grip portion. Thus, a short-circuit between the electrode portions of the grip portions is prevented, thereby providing a high-frequency treatment instrument.

3. 3. The high-frequency treatment device according to claim 2, wherein the electrical insulating portion is provided at a distal end of a grip portion. 4. 4. The high-frequency treatment instrument according to claim 3, wherein the electrical insulating portion is formed by forming the entire distal end portion of the grip portion with a material having electrical insulation. 5. The high-frequency treatment device according to claim 3, wherein the electrical insulating portion is configured by applying an insulating coating to an outer surface of a tip portion of the grip portion.

6. An insertion portion that can be inserted into the body, a pair of grip portions arranged at the distal end portion of the insertion portion for gripping and coagulating or incising a living tissue, and a grip portion connected to the base end portion of the insertion portion and opening and closing the grip portion An operation unit for operating,
In a high-frequency treatment instrument that coagulates and dissects a living tissue grasped by the grasping portion by applying a high-frequency current to an electrode portion provided on the grasping surface of the grasping portion, an electric insulating portion is provided on the grasping surface of one grasping portion. Is provided, and in a state where the grip portion is completely closed, the short-circuit between the electrode portions of each grip portion is prevented by the grip surface of the other grip portion being in contact only with the electrical insulating portion. High-frequency treatment tool characterized.

7. The other grip portion is configured as a first electrode portion made of a conductive material and has a through hole extending along the longitudinal direction thereof, and the one grip portion is electrically insulated from each other by an insulating member. 2nd and 3rd
The first insulating member has a shape substantially corresponding to the first electrode portion, and the first insulating member has a first electrode portion in a closed state.
The second electrode unit is positioned so as to contact the electrode unit of
It is located outside the insulating member and functions as an electrode for coagulation. It is located on both sides of the first electrode portion in a state where the grip portion is closed, and the third electrode portion is located inside the insulating member. 7. The high-frequency device according to claim 6, wherein the high-frequency device functions as an incision electrode, protrudes from the grip surface of the insulating member, and enters the through-hole of the first electrode portion with the grip portion closed. Treatment tools.

8. At least one of a high-frequency treatment instrument having an insertion section and an operation section at the proximal side of the insertion section, and having a pair of grip members capable of gripping tissue by operating the operation section and applying high-frequency current to the gripped tissue. A high-frequency treatment device characterized in that an insulating portion is provided on a part of the gripping member of the above (1), and a short circuit does not occur when the gripping member is closed by the insulating portion.

9. A high-frequency treatment device having a pair of gripping members having an insertion portion and an operation portion on the proximal side of the insertion portion, gripping tissue by operating the operation portion, and having an electrode capable of applying high-frequency current to the gripped tissue. A high-frequency treatment instrument characterized in that an insulating portion is provided on at least a part of at least one gripping member, and at least one insulating portion contacts the other electrode when the gripping member is closed.

10. A high-frequency treatment instrument having an insertion section and a pair of gripping members having an operation section at a hand side of the insertion section, and gripping tissue by operating the operation section, and applying high-frequency current to the gripped tissue. A high-frequency treatment instrument characterized in that an insulating portion is provided on at least one of the contacting portions of each gripping member when the closing member is closed.

[0071]

As described above, according to the high-frequency treatment device of the present invention, an electrical short circuit between a pair of grasping members can be prevented, and coagulation and incision of tissue can be reliably performed.

[Brief description of the drawings]

FIG. 1 is a side view of a high-frequency treatment device according to a first embodiment of the present invention.

FIG. 2 is an enlarged side view of a treatment section of the high-frequency treatment instrument of FIG.

FIG. 3 is an enlarged side view of a treatment section of a high-frequency treatment instrument according to a second embodiment of the present invention.

FIG. 4A is a cross-sectional view showing a main part of a high-frequency treatment device according to a third embodiment of the present invention, and FIG.
It is a longitudinal cross-sectional view along a line.

5A is a cross-sectional view showing a main part of a high-frequency treatment device according to a fourth embodiment of the present invention, FIG. 5B is a longitudinal sectional view of the high-frequency treatment device of FIG. It is sectional drawing which follows the BB line of (a).

6A is a side view of a high-frequency treatment device according to a fifth embodiment of the present invention in a closed state, FIG. 6B is a side view of an open state of the high-frequency treatment device of FIG. (A) is sectional drawing which follows CC line, (d) is sectional drawing which follows DD line of (a).

7A is a side view of a main part of a high-frequency treatment device according to a sixth embodiment of the present invention, FIG. 7B is a view in the direction of arrow E in FIG. 7A, and FIG. It is an arrow F view.

FIG. 8 is a sectional view taken along the line GG of FIG.

9 is a cross-sectional view showing a use mode of the high-frequency treatment device of FIG.

FIG. 10 is a side view of a high-frequency treatment device according to a seventh embodiment of the present invention.

FIG. 11 is a sectional view taken along the line HH in FIG. 10;

FIG. 12 is a cross-sectional view showing a use mode of the high-frequency treatment device of FIG.

FIG. 13A is a perspective view of a main part of a high-frequency treatment device according to an eighth embodiment of the present invention, and FIG. 13B is a cross-sectional view of a treatment portion of the high-frequency treatment device of FIG.

FIG. 14 is a cross-sectional view of a treatment section of a high-frequency treatment instrument according to a ninth embodiment of the present invention.

15 is a circuit configuration diagram of a power supply device that supplies a high-frequency current to the treatment section in FIG.

FIG. 16 is a sectional view showing a use mode of the treatment section of FIG. 14;

FIG. 17 is a sectional view of a treatment section of a high-frequency treatment instrument according to a tenth embodiment of the present invention.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 ... Bipolar forceps (high frequency treatment tool) 2 ... Insertion part 4 ... Operation part 8a, 8b ... Jaw (grip part) 12 ... Insulation part C ... Gap

Claims (3)

[Claims] 1. An insertion portion that can be inserted into a body, a pair of grip portions disposed at a distal end portion of the insertion portion for gripping and coagulating or incising a living tissue, and connected to a base end portion of the insertion portion. And an operating unit for opening and closing the gripping unit, and a high-frequency current is applied to an electrode unit provided on the gripping surface of the gripping unit to coagulate and dissect the living tissue gripped by the gripping unit. In the high-frequency treatment tool, an electrical insulating portion is provided on a grip surface of at least one grip portion, and when the grip portion is completely closed, the electrical insulating portion comes into contact with a grip surface of the other grip portion. A high-frequency treatment instrument wherein a predetermined gap is formed between the gripping surfaces of the gripping portions, thereby preventing a short circuit between the electrode portions of the gripping portions. 2. An insertion portion that can be inserted into a body, a pair of grip portions disposed at a distal end portion of the insertion portion for gripping and coagulating or incising a living tissue, and connected to a base end portion of the insertion portion. And an operating unit for opening and closing the gripping unit, and a high-frequency current is applied to an electrode unit provided on the gripping surface of the gripping unit to coagulate and dissect the living tissue gripped by the gripping unit. In the high-frequency treatment instrument, an electrical insulating portion is provided on a grip surface of one grip portion, and in a state where the grip portion is completely closed, the grip surface of the other grip portion contacts only the electrical insulating portion, A high-frequency treatment instrument wherein a short circuit between electrode portions of each grip portion is prevented. 3. An insertion portion which can be inserted into a body, a pair of grip portions disposed at a distal end portion of the insertion portion for gripping and coagulating or incising a living tissue, and connected to a base end portion of the insertion portion. And an operating unit for opening and closing the gripping unit, and a high-frequency current is applied to an electrode unit provided on the gripping surface of the gripping unit to coagulate and dissect the living tissue gripped by the gripping unit. In the high-frequency treatment instrument, at least one gripping surface of the gripping portion has an electrical insulating portion that abuts on the other gripping surface in a state where the gripping portion is completely closed to prevent a short circuit between the electrode portions of each gripping portion. A high-frequency treatment instrument characterized by being provided with: