JP2003325539A - Medical operation instrument - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a medical operation instrument which attains the heat insulation effect and miniaturization of a jaw in particular and which has thermal and/or mechanical durability. <P>SOLUTION: The instrument comprises: a cylindrical insertion part (3) whose distal end side is to be inserted to a living body; an operation part (2) provided at the proximal end side of this insertion part (3); a pair of jaws (4a and 4b) provided at the distal end side of this insertion part (3) and opened and closed to each other by the operation part (2); heating means (47a and 47b) provided at least either of these jaws (4a and 4b) to heat by energizing; energizing means (50a and 50b) connected for energizing these heating means (47a and 47b); and a plurality of heat insulation members (100, 101, 102 and 103) arranged divided by each of these parts between the heating means and the jaws (4a and 4b) and/or the energizing means (50a and 50b). <P>COPYRIGHT: (C)2004,JPO

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a surgical instrument having a pair of jaws for grasping, coagulating and incising living tissue.

[0002]

2. Description of the Related Art Generally, a thermocoagulation / dissection forceps is known as a surgical instrument for providing a jaw with a heating element and causing the heating element to generate heat while holding a living tissue to coagulate the living tissue and incise a coagulation site. . This surgical instrument is usually used for various cases such as hemostasis of blood vessels contained in living tissues, lesions on the surface layer of living tissues, cauterization of bleeding points, and oviduct obstruction for the purpose of contraception. Then, a surgical instrument is used for the purpose of hemostasis of blood vessels and occlusion of fallopian tubes, and is capable of coagulating a living tissue to be treated by a patient or incising the coagulated living tissue.

In the surgical instrument as described above, the cable is inserted into the inside of the insertion portion, the jaw or the like, and the heating element connected to the cable is energized via the cable. A heat insulating member is usually provided between the heating element and these parts so that the heat generated from the heating element during use is not transferred to a member to which the heat should not be transferred, for example, the jaw. Conventionally, these heat insulating members are generally manufactured by cutting or molding, and are formed as a single member.

Since the heat insulating member is designed to be thin, the size of the jaw can be reduced, the jaw can be protected from deterioration due to thermal factors of the heating element, and the durability of the surgical instrument can be improved. .

[0005]

However, when a heat insulating member composed of a single member is adopted, there is a limit to thin the thickness of the heat insulating member in order to downsize the jaw. In addition, if the heat insulating member is a single member, it is necessary to match the thickness of all the parts with the thickness of the heat insulating member that is placed in the necessary part in manufacturing, so even for the part that does not need to be insulated. It is conceivable that a heat insulating member is arranged. Therefore, manufacturing the insulation member from a single piece is not suitable for jaw miniaturization. Since the surgical instrument as described above is inserted into the living body, miniaturization of the jaw is one of the most important issues.

Further, in the conventional surgical instrument, when the jaw is opened and closed, the cable is bent between the insertion portion and the jaw, which may apply a force to the heating element connected to the cable. , There is a possibility of damaging these heating elements. Moreover, when the jaw is downsized, it becomes difficult to secure a sufficient space for the bending movement of the cable, so that the influence of the force on the heating element becomes large.

Therefore, it is an object of the present invention to provide a surgical instrument which achieves the heat insulating effect and the downsizing of the jaw, and has thermal and / or mechanical durability.

[0008]

In order to solve the above-mentioned problems, the surgical instrument according to the first aspect of the present invention has a tubular insertion portion whose distal end is inserted into a living body, and a proximal end of this insertion portion. A pair of jaws provided on the side, a pair of jaws provided on the distal end side of the insertion portion and opened and closed by the operation portion, and a heat generating means provided on at least one of the jaws and generating heat by energization. The heat generating means includes an energizing means for energizing the heat generating means, the heat generating means, and a plurality of heat insulating members divided and arranged for each of these parts between the jaw and / or the energizing means.

[0009] Further, a cylindrical insertion portion whose distal end side is inserted into the living body, and an operation portion provided on the proximal end side of the insertion portion,
A pair of jaws that are provided on the distal end side of the insertion portion and that are opened and closed by the operation portion, and a heating means that is provided on at least one of the jaws and that generates heat by energization;
The heating means includes an energizing means for energizing and a fixing member for fixing the energizing means at least partially between the insertion portion and the jaw.

With this structure, since the heat insulating member is divided and arranged for each part to be heat insulated, it is possible to simplify the shape of each heat insulating member. Therefore, the thickness of these heat insulating members can be reduced, and the jaws can be downsized.

Further, by having the fixing means for fixing the energizing means between the inserting portion and the jaw, no force is applied to the energizing means in the inserting portion when the jaw is opened and closed, and the heat generating means connected to the energizing means. Has no effect. Therefore, since the heat generating means is less damaged, the durability of the surgical instrument can be improved.

[0012]

BEST MODE FOR CARRYING OUT THE INVENTION With reference to FIGS. 1 to 4, a thermocoagulation / dissection forceps 1 of a surgical instrument according to a first embodiment of the present invention will be described below. FIG. 1A is a side view of the thermocoagulation incision forceps, and FIG. 1B is a side view of the forceps unit. FIG. 2A is a partial cross-sectional side view showing in detail the operation portion with the forceps unit removed. Figure 2
FIG. 2B shows a state in which the attachment / detachment portion is closed, 2B in FIG. 2A.
2B is a sectional view. FIG. FIG. 2C is a sectional view taken along line 2B-2B of FIG. 2A, showing a state in which the attaching / detaching portion is opened.

FIG. 3 (a) is a thermocoagulation incision forceps K.
FIG. 6 is a partial top sectional view taken along the line K. FIG. 3B is a partial side sectional view of the thermocoagulation / dissection forceps. Figure 4 (a)
4A is a sectional view taken along the line AA, FIG. 4B is a sectional view taken along the line BB, and FIG. 4C is a sectional view taken along the line C-C.
4D is a sectional view taken along the line D-D, and FIG.
Sectional drawing which follows the E line, FIG.4 (f) is sectional drawing which follows the FF line, FIG.4 (g) is sectional drawing which follows the GG line, FIG.4 (h).
Is a sectional view taken along line H-H, FIG. 4 (i) is a sectional view taken along line I-I, and FIG. 4 (j) is a sectional view taken along line J-J.

As shown in FIG. 1A, the thermocoagulation / dissection forceps 1 is composed of an operating portion 2 and a forceps unit 10 which is detachably provided on the operating portion 2. The operation unit 2 has a main body 5, a fixed handle 6 integrally formed with the main body 5, and a pivot shaft 7 supported by the main body 5 so as to be opened and closed with respect to the fixed handle 6. And a movable handle 8 that is rotatably connected.

The tip side of the forceps unit 10 is shown in FIG.
As shown in (b), a cylindrical insertion portion 3 into which the tip side is inserted into the living body is provided, and the tip portion of this insertion portion 3 has a pair of the first jaw 4a and the second jaw 4a. A jaw 4b is provided. In addition, at the base end of the insertion part 3,
A rotation knob 9 that protrudes in an annular shape for rotating the insertion portion 3 around the axis of the insertion portion 3 with respect to the main body portion 5,
An attaching / detaching portion 202 having a circumferential groove 9a formed on the base end side of the rotating knob 9 is attached.

An elongated drive shaft 11 extends from the proximal end portion of the forceps unit 10. The tip end of the drive shaft 11 is coaxially inserted into the insertion portion 3, and the base end of the drive shaft 11 is connected to the connector 200 via the tube 201. The connector 200 is connected to a power supply device (not shown) via a cable. The rotation knob 9 is provided at a connecting portion between the drive shaft 11 and the insertion portion 3.
An attachment / detachment stopper 204 is attached at a predetermined distance in the axial direction from. Further, the drive shaft 11 is formed with a notch portion 203 that is notched in an annular shape. This notch 20
3 is engaged with the movable handle 8 when the forceps unit 10 is connected to the main body portion 5. This engagement will be described later.

FIG. 2A (here, the forceps unit 10 is
As shown by the chain double-dashed line), the fixed handle 6 and the movable handle 8 are located on the same side (lower side in FIG. 2A) with respect to the drive shaft 11. ing. A rod-shaped opening / closing stopper 5a is provided on the rear end surface of the center of the fixed handle 6 so as to project toward the movable handle 8. The opening / closing stopper 5a is positioned so as to abut the substantially central end surface of the movable handle 8 when the handles 6 and 8 are completely closed.

Around the pivot shaft 7 connecting the handles 6 and 8, a torsion coil spring (first torsion coil spring) 305 of a type in which both ends are bent in an L shape.
Is provided. This first torsion coil spring 305
One end portion of the movable handle 8 is fitted to a substantially central portion of the movable handle 8, an intermediate portion thereof is wound coaxially with the pivot shaft 7, and the other end portion thereof is parallel to the pivot shaft 7. It bends and engages with the proximal end of the movable handle 8. The first torsion coil spring 305 biases the movable handle 8 toward the fixed handle 6 so that the pair of handles 6, 8 close with respect to each other.

The forceps unit 10 is attached to the base end portion of the movable handle 8 and the cutout portion 2 of the drive shaft 11 is attached.
An engaging portion 306 that engages with 03 is provided. Also,
A holding hole 302 having a shape substantially complementary to the outer peripheral surface of the attaching / detaching portion 202 is formed at the base end portion of the fixed handle 6. The attaching / detaching portion 2 is provided on the inner peripheral surface of the holding hole 302.
No. 02 of the annular groove 5a engageable with the circumferential groove 9a.
Are formed. The holding hole 302 is formed in the upper body 300 and the lower body 3 located at the base end of the fixed handle 6.
01 is defined by the facing surface. The lower main body 301 has the lower main body portion 5 by another pin 402 at the lower portion.
It is fixed to. Further, as shown in FIG. 2B, the upper body 300 and the lower body 301 are pivotally supported at one end by a pivot pin 401 so that the holding hole 302 can be opened and closed in the arrow C direction. Has been done.

Straight type torsion coil springs (second torsion coil springs) 304 are attached to the other end of the upper body 300 at both ends. A claw member 303 having a claw-shaped portion 303a formed at its tip is rotatably attached to the second main body 300 of the second torsion coil spring 304. And this claw member 303
Is urged in the clockwise direction by the second torsion coil spring 304.

At the other end of the lower main body 301, a convex portion 5c engageable with the claw-shaped portion 303a is formed. Thus, when the upper main body 300 is closed with respect to the lower main body 301, the claw member 303 is closed by the second body.
The upper body 300 and the lower body 301 can be locked by engaging the convex portion 5c by the biasing force of the torsion coil spring.

With the upper main body 300 open to the lower main body 301 (FIG. 2B), the attaching / detaching part 20 is
2 is accommodated in the holding hole 302, and the notch portion 203 engages with the engaging portion 306. Thus, the forceps unit 10 is operatively attached to the operation section 2. The forceps unit 10 is detached from the main body portion 5 in a state where the upper main body 300 is closed with respect to the lower main body 301 (FIG. 2C). Therefore, the forceps unit 10 is attachable / detachable to / from the operation section 2 at the attachment / detachment section 202 by opening / closing the upper body 300 with respect to the lower body 301.

When the forceps unit 10 is attached to the operating portion 2, the movable handle 8 is rotated in the direction of arrow a by engaging the notch portion 203 and the engaging portion 306. When the drive shaft 11 moves forward and rotates in the direction of arrow b, the drive shaft 11 moves backward. In this operation, the movable handle 8 moves with the arrow a.
When it is moved in the direction, the opening / closing stopper 5a prevents the movable handle 8 from rotating more than necessary in the direction of arrow b.

As shown in FIGS. 3 (a) and 3 (b), the insertion portion 3 has a small diameter portion 33 formed with a channel through which the drive shaft 11 is inserted so as to move forward and backward. Further, the drive shaft 11 is formed with a channel for energizing means.

The proximal arm portion 35 of the first jaw 4a is
It is formed in a bifurcated shape, and the bifurcated part is the connecting pin 36.
Is rotatably connected to the drive shaft 11.
Similarly, the base end arm portion 37 of the second jaw 4b is also formed in a bifurcated shape, and the bifurcated portion is rotatably connected to the insertion portion 3 by a connecting pin 34. Further, the base end arm portion 37 of the second jaw 4b is formed into a bifurcated shape, so that the insertion space 37a (see FIG.
(See (g) to (i)) are formed. The first
Base arm 35 of the jaw 4a of the second jaw and the second jaw 4b
The base end arm portion 37 is connected to each other by a connecting pin 38 so as to be openable and closable.

When the drive shaft 11 is moved forward, the first
The jaw 4a rotates upward with the connecting pin 38 as a fulcrum, and the second jaw 4b rotates downward with the pivotal pin 34 as a fulcrum. Therefore, the two jaws 4a, 4b open with respect to each other. On the contrary, when the drive shaft 11 is retracted, the first jaw 4a rotates downward with the connecting pin 38 as a fulcrum, and the second jaw 4b moves upward with the pivotal pin 34 as a fulcrum. Turn to. Therefore, the two jaws 4a, 4b close to each other.

The tips of the pair of jaws 4a and 4b are
The jaws 4a and 4b are curved in a direction orthogonal to the plane of rotation, and are formed so that biological tissue can be easily peeled off. Further, on the gripping surface of the first jaw 4a, that is, on the contact surface side with the living tissue, a thin plate-shaped heat generating plate 40 made of a material having excellent thermal conductivity is provided, and the second jaw 4b is gripped. A flexible member 41 is provided on the surface.
The heat generating plate 40 is a rectangular metal plate arranged along the longitudinal direction of the first jaw 4a, and the tip of the heat generating plate 40 has a curved shape of the tip of the first jaw 4a. Curved to fit. The lower portion of the heat generating plate 40 has a blade portion 42 which is tapered so as to become thinner toward the tip and is formed along the longitudinal direction (see, for example, FIG. 4D).

The blade 42 and the flexible member 41 abut each other when the two jaws 4a and 4b are closed. Also, the first jaw 4a and the second jaw 4a
Each tip portion of the jaws 4b extends in the longitudinal direction from the blade portion 42 and the flexible member 41, and forms a gripping surface on the surfaces facing each other. This gripping surface has a planar shape that is opposed to the jaws 4a and 4b at a predetermined distance from each other so that the distance between the tip portions of the jaws 4a and 4b becomes narrow. With such a configuration, the peeling operability of biological tissue is improved.

A plurality of projecting pieces 43a, 43b, which are spaced apart from each other in the longitudinal direction by a predetermined distance, are provided on the heat generating plate 40.
(Two in the drawing) are formed upward.
Slots are formed on the rear end surfaces of the projecting pieces 43a and 43b, and the heating plate 4 is formed in the slots.
The heating elements 47a and 47b such as a thin-film heating resistance element which constitutes a heating means together with 0 are inserted. These heating elements 4
7a and 47b are in contact with the heat generating plate 40 in the slot, and thermal coupling portions 44a and 44b are defined between them. The heating elements 47a and 47b are arranged at equal intervals so that the temperature distribution is uniform,
Coaxial cable 50 as an energizing means independently of each other
a, 50b.

The tip of the heat generating plate 40 has the heat generating member 4
It is extended to the tip side from 7a, and the tip portions of the jaws 4a and 4b can be downsized.

The heat generating plate 40 is preferably made of a material having good thermal conductivity such as copper, silver, or tungsten.
The heating elements 47a and 47b may be composed of a thin film resistance element, a ceramic heater, a cartridge heater, a PCT heater, or the like. Further, as the material of the flexible member 41, rubber (silicone rubber, fluorine rubber, ethylene propyl rubber, butyl rubber, etc.), gel (α gel based on silicone, etc.), Teflon (registered trademark), etc. are used. It is not limited to these.

The heat generating plate 4 is attached to the first jaw 4a.
0 is formed on both sides and the upper side of 0, and the first to fourth heat insulating members 100, 100 are formed in the cavity.
101, 102, 103 are filled. The plurality of heat insulating members 100, 101, 102, 103 are arranged adjacent to the heat generating means in the first jaw 4a.

The first heat insulating member 100 extends from the tip side of the jaw 4a to the base end side along one side of the heat generating plate 40, and the second heat insulating member 101 is the other heat generating plate 40. It extends to the base end side along the side. Further, the third heat insulating member 102 is arranged between the one coaxial cable 50a and the protruding portion 43b of the heat generating plate. further,
The fourth heat insulating member 103 extends above the heat generating plate 40 and extends in the longitudinal direction along the heat generating plate 40.

[0034] The protruding piece 43a of the first jaw 4a is
With the fixing pins 48 and 104 penetrating in the lateral direction,
The heat insulating members 100, 10 arranged on both sides of the protruding piece 43a.
It is fixed at 1. In addition, the base end of the heat generating plate 40
This heat is generated by the fixing pin 49 that penetrates in the lateral direction.
The heat insulating members 100 and 101 arranged on both sides of the plate 40 are fixed to each other.
It is fixed.

The first heat insulating member 100 and the second heat insulating member 101 are relatively thick, and the third heat insulating member 102 and the fourth heat insulating member 103 are the first heat insulating member. It can be formed thin according to the size of the jaw 4a. In this way, these heat insulating members 100, 101, 102, 10
Even if the jaws 4a and 4b are miniaturized, the elements 3 can be formed independently of each other, so that they do not hinder the design of the jaws 4a and 4b.

The heat insulating members 100, 101, 102, 1
As the material of 03, resin such as tetrafluoroethylene or
A ceramic such as alumina is used, but it is not limited to these as long as the heat from the heating elements 47a and 47b is thermally insulated from other components adjacent thereto. Further, the number, positions, and dimensions of these heat insulating members may be appropriately changed without being limited to the above description as long as they have an effective heat insulating action.

Both the coaxial cables 50a and 50b are partially enclosed in a single resin tube 105, which is a fixing member, at least in the insertion space 37a, and are slidably bundled in the resin tube 105. There is. These coaxial cables 50a and 50b are connected to the heating elements 47a and 47a.
It extends from b through the insertion space 37a and into a channel for energizing means formed in the drive shaft 11. In the present embodiment, the resin tube 105
Encloses the two coaxial cables 50a and 50b over the entire insertion space 37a, but the portion and / or range in which the coaxial cables 50a and 50b are enclosed are such that the coaxial cables 50a and 50b are fixed. It can be transformed.

The tip portion of the resin tube 105 is located at the base end portion of the first jaw 4a and is bonded to the first heat insulating member 100 and the second heat insulating member 101, respectively. The outer diameter of the resin tube 105 is larger than the width of the gap between the first and second heat insulating members 100 and 101, and the resin tube 105 is assembled so as to be pushed into this gap. Further, the base end portion of the resin tube 105 is adhered to the tip end portion of the channel inside the channel formed on the drive shaft 11.

Since the coaxial cables 50a and 50b each have an outer diameter smaller than the inner diameter of the resin tube 105, the resin tube 105 fixed as described above.
Even if the resin tube 105 is inserted inside, the resin tube 105 can slide following the bending movement.

In the present embodiment, the heat generating means is
It is provided only on the first jaw 4a, but only on the second jaw 4b, or on the first and second jaws 4a, 4b.
May be provided in both. In accordance with this, the heat insulating members 100, 101, 102, 103 and the coaxial cables 50a, 50b also have only the second jaw 4b.
Alternatively, it may be provided on both the first and second jaws 4a and 4b.

The operation of the surgical instrument according to the embodiment of the present invention having the above-described structure will be described below with reference to FIGS. The surgical instrument grips living tissue (not shown) with the first and second jaws 4a and 4b, and in this state, the heating element 4 provided on the first jaw 4a.
By heating 7a and 47b, living tissue is coagulated and incised.

This surgical instrument includes a main body 5 of the operating section 2.
The forceps unit 10 can be attached to the. At the time of this mounting, the upper main body 3 provided on the main body 5 is
00 is opened, and the attachment / detachment portion 202 between the rotation knob 9 and the attachment / detachment stopper 204 is placed on the inner peripheral surface of the lower body 301 side, that is, the lower surface of the holding hole 302. Then, the notch portion 203 and the engaging portion 306, and the circumferential groove 9a and the protruding portion 5b are engaged with each other. In this state, the upper main body 300 is closed, and the claw member 303 and the convex portion 5c are engaged with each other, so that the forceps unit 10 is rotatable in the longitudinal direction with respect to the main body portion 5. Can be locked.

In operating the surgical instrument, the thumb is inserted into the movable handle 8 and the middle finger is inserted into the fixed handle 6, and the index finger is hung on the rotary knob 9 to hold the operating portion 2. Then, the surgical instrument is inserted into the living tissue in a state where the first jaw 4a and the second jaw 4b are closed.

The movable handle 8 is indicated by an arrow a in FIG.
When it is rotated in the direction, the drive shaft 11 moves forward, and the first jaw 4a rotates upward and the second jaw 4b rotates downward with the connecting pin 38 as a fulcrum. By this operation, the two jaws 4a, 4a
b is opened, and the treated portion such as a blood vessel can be peeled off and exposed from other living tissues.

The movable handle 8 is attached to the arrow b in FIG. 1 (a).
When it is rotated in the direction, the drive shaft 11 retracts, the first jaw 4a rotates upward and the second jaw 4b rotates downward with the connecting pin 38 as a fulcrum. By this operation, the two jaws 4a, 4a
When b is closed, it can be grasped in a compressed state with a relatively small pressing force appropriate for the coagulation treatment. Therefore,
The heat generating plate 40 and the living tissue are in contact with each other. At this time, since the gripping surfaces of the tips of the two jaws 4a and 4b are flat and the distance between the two jaws 4a and 4b is narrow, the peeling operability of the jaws is high.

When the movable handle 8 is rotated to open and close the jaws 4a and 4b, and the drive shaft 11 is advanced and retracted by the movable handle 8, the energizing means bonded in the channel of the drive shaft 11 is used. A coaxial cable 5
0a and 50b are also moved. At this time, the coaxial cables 50a and 50b are fixed to the resin tube 1 which is a fixing member.
Since it is enclosed by 05 and can be slid and bundled in one, it is hardly affected by the force applied by the advancing and retracting of the drive shaft 11. Therefore, since excessive force is not applied to the heating elements 47a, 47b connected to the coaxial cables 50a, 50b, the heating elements 47a, 47b are prevented from being damaged.

Further, when the jaws 4a, 4b are downsized and the insertion space 37a is narrowed, it is considered that the coaxial cables 50a, 50b are limited in their movable space in the insertion space 37a. (For example, the drive shaft 11 is caught in the forward / backward movement). However, these coaxial cables 50a, 50
Since b is enclosed in the resin tube 105, the jaws 4a and 4b can be appropriately opened and closed even in a relatively narrow space.

As described above, in a state where the living tissue is grasped, the connector 20 is fed from the power supply device (not shown).
0 and the coaxial cables 50a, 50b connected to the connector 200, the heating elements 47a, 47
A current is applied to each of b. The two heating elements 47a, 47b that are energized generate heat due to their electrical resistance,
This heat is transferred to the heat generating plate 40 via the heat coupling portions 44a and 44b. Then, the living tissue of the treated portion such as a blood vessel which is in contact with the surface of the heat generating plate 40 is coagulated and incised.

The two heating elements 47a, 47b are independently connected to the power supply unit via the coaxial cables 50a, 50b. Therefore, it is possible to control the heating elements 47a and 47b to independently set heating temperatures.

That is, when the amount of heat generated on the portion of the heat generating plate 40 which is in contact with the living tissue, for example, the tip side of the heat generating plate 40 decreases and the temperature decreases, the heat generating plate 40 is positioned corresponding to this part. The resistance value of the exothermic body 47a on the distal end side is detected and the output of the exothermic body 47a is controlled to increase. When the amount of heat generation increases and the temperature rises, it is possible to detect the resistance value of the heating element 47b on the base end side located corresponding to this portion and perform control to reduce the output of this heating element 47b. Therefore, it is possible to prevent temperature unevenness of the heat generating plate 40 and quickly and surely perform coagulation and incision.

The surgical instrument according to the present invention includes the heating plate 40.
Of the plurality of heat insulating members 100, 101, 102, 103 in addition to the both sides of the
Are provided separately. Therefore, in controlling the heating plate 40 as described above, it is possible to prevent the jaws 4a, 4b and the coaxial cables 50a, 50b from being thermally damaged.

Further, the heat insulating members 100, 101, 10
Since a plurality of heat insulating members 2 and 103 are provided, a heat insulating member having a large thickness is arranged in a place where high heat insulating is required, and a thin heat insulating member is arranged in a place requiring a small space. The degree of freedom in designing is high. Therefore, the jaws 4a and 4b can be easily miniaturized.

A second embodiment of the surgical instrument according to the present invention will be described with reference to FIG. FIG. 5A is a partial side sectional view of the thermocoagulation / dissection forceps according to the second embodiment. FIG. 5B is a sectional view taken along line L-L of FIG. FIG. 5C is a sectional view taken along the line MM of FIG. The basic configuration and operation in this embodiment are the same as those in the first embodiment. The points different from the first embodiment will be described below.

In this embodiment, the first heat insulating member 100 and the second heat insulating member 101 on the bonded portion of the resin tube 105 of the first embodiment, that is, on the base end side of the first jaw 4a. A metal pipe 106 is inserted between the space between and and the tip end side in the channel formed in the drive shaft 11. In the fixed portion where these metal pipes 106 are inserted, the resin tube 105 is reduced by the thickness of these metal pipes 106. The resin tube 105 penetrates the two metal pipes 106. This resin tube encloses a cable that is a current-carrying means, as in the previous embodiment.

With the above structure, the metal pipe 106 fixes the resin tube 105, so that the drive shaft 11 and the resin tube 105 are simply connected.
The cable has a stronger fixing force than the to and glued together.

In the present embodiment, a plurality of single wire cables are used as the energizing means instead of the coaxial cable.

[Supplementary Note 3] It is preferable that the fixing member is a single flexible tube that bundles and encloses the energizing means at least partially. [Supplementary Note 4] It is preferable that the fixing member is at least partially supported by a metal pipe.

With the structure as shown in appendix 3, even when the energizing means is bent between the insertion portion and the jaw, they do not become entangled with each other. Achieve good operation. Further, with the structure as shown in appendix 4, the fixing force of the energizing means is further increased, so that damage to the heat generating means can be prevented more effectively.

[0059]

According to the present invention, since the heat insulating member is divided and arranged for each heat insulating component, the shape of each heat insulating member can be simplified. Therefore,
The thickness of these heat insulating members can be reduced, and the jaws can be downsized.

Further, according to the present invention, by having the fixing means for fixing the current-carrying means, no force is applied to the current-carrying means in the insertion portion when the jaw is opened and closed, and the heat-generating means connected thereto is not affected. Therefore, since the heat generating means is less damaged, the durability of the surgical instrument can be improved.

The above-mentioned effects are not limited to the thermocoagulation / dissection forceps described above, and are the same in other surgical instruments using a heat generating means such as the heat dissection / force coagulation forceps.

[Brief description of drawings]

FIG. 1 (a) is a side view of a thermocoagulation / dissection forceps. FIG. 1B is a side view of the forceps unit.

FIG. 2 (a) is a partial cross-sectional side view showing in detail the operation section with the forceps unit removed. Figure 2
FIG. 2B shows a state in which the attachment / detachment portion is open, 2B in FIG. 2A.
2B is a sectional view. FIG. FIG. 2C is a sectional view taken along line 2B-2B in FIG. 2A, showing a state in which the attachment / detachment portion is closed.

FIG. 3 (a) is a partial top cross-sectional view of the thermocoagulation / dissection forceps taken along line KK. FIG. 3B is a partial side sectional view of the thermocoagulation / dissection forceps.

FIG. 4 (a) to FIG. 4 (j) are respectively FIG.
It is sectional drawing cut | disconnected along the AA or JJ line of (b).

FIG. 5 (a) is a partial side sectional view of a thermocoagulation / dissection forceps according to a second embodiment. FIG. 5B is the same as FIG.
It is a LL sectional view of (a). FIG. 5C is a diagram of FIG.
It is MM sectional drawing of (a).

[Explanation of symbols]

1 Thermocoagulation incision forceps 2 operation part 3 Insert 4a, 4b Joe 10 Forceps unit 11 drive shaft 40 heating plate 47a, 47b heating element 50a, 50b coaxial cable 100, 101, 102, 103 Thermal insulation member 105 resin tube 106 metal pipe 202 Detachable part 302 holding hole 303 Claw member

Claims (2)

[Claims] 1. A tubular insertion part having a distal end inserted into a living body, an operation part provided on a proximal end side of the insertion part, and an operation part provided on a distal end side of the insertion part and mutually operated by the operation part. A pair of jaws that are opened and closed, a heat generating means that is provided on at least one of the jaws and generates heat by energizing, a current supplying means that supplies current to the heat generating means, the heat generating means, the jaw and / or the current supplying means. And a plurality of heat insulating members that are divided into a plurality of positions and are disposed between the two. 2. A tubular insertion part whose distal end side is inserted into a living body, an operation part provided on the proximal end side of the insertion part, and an operation part provided on the distal end side of the insertion part, and which are mutually operated by the operation part. A pair of jaws that are opened and closed, a heat generating means that is provided on at least one of the jaws and generates heat by energization, an energizing means that energizes the heat generating means, and the energizing means between the insertion portion and the jaws. And a fixing member for fixing at least partially.