JPH08299351A - Ultrasonic discission coagulation device - Google Patents

Abstract

PURPOSE: To appropriately and easily perform a treatment by ultrasonic oscillation and a treatment by high frequency current for an organism tissue. CONSTITUTION: A holding member 6 constituting a processing part 2 is connected to a high frequency power supply 28 via transmission member 10, an engaging member 24, a conductive member 25, the first high frequency current cord 7, and a high frequency current connector 7a for a holding member, in an ultrasonic cut coagulation device 1. Further, a probe 5 constituting the processing part 2 is connected to the high frequency power supply 28 via an ultrasonic oscillator 16, the second high frequency current cord 8, and a high frequency current connector 8a for the probe. And the ultrasonic oscillator 16 is connected to an ultrasonic oscillator drive power supply 29 via a cord 9 for driving an ultrasonic oscillator and a connector 9a for driving the ultrasonic oscillator. A body plate 30 connected to the return side of the high frequency power supply 28. The holding member 6 and the probe 5 are thus completely electrically isolated.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an ultrasonic cutting and coagulating apparatus capable of performing a treatment with a high-frequency current in addition to a treatment of cutting or coagulating a living tissue by ultrasonic vibration.

[0002]

2. Description of the Related Art In recent years, by inserting an elongated insertion portion into a body cavity, various organs in the body cavity are observed, and various medical treatments are performed under observation with an endoscope as necessary.

As one of the methods for carrying out a therapeutic treatment under the observation of the endoscope, a biological tissue is adsorbed or grasped, and ultrasonic vibration is applied to a member that adsorbs or grasps the biological tissue to excise or coagulate it. It is known that the above treatment is performed.

For example, Japanese Unexamined Patent Publication (Kokai) No. 62-127042 discloses an ultrasonic crushed stone probe which holds a calculus and crushes it by ultrasonic vibration. In addition, JP-A-1
Japanese Patent No. 232944 discloses a surgical operating apparatus in which a living tissue is grasped and fixed by a grasping forceps, and an incision is made with a probe that vibrates ultrasonically. Furthermore, JP-A 1-23
Japanese Patent No. 2945 discloses a surgical operation apparatus in which a living tissue is adsorbed and fixed, and an incision is made with a knife that vibrates ultrasonically. Further, Japanese Unexamined Patent Publication No. 1-232948 discloses a surgical cutting forceps that can efficiently cut living tissue by applying ultrasonic vibration to the cutting forceps. Further, in Japanese Patent Application Laid-Open No. 1-232949, as in the above-mentioned Japanese Patent Application Laid-Open No. 1-232944, the living tissue is fixed by a grasping means, and the living tissue is treated by a movable member to which ultrasonic vibration is applied. A surgical device is shown. Further, USP5322055 is provided with a gripping member rotatable toward an ultrasonic probe, and the living tissue is coagulated by gripping the living tissue with the ultrasonic probe and the gripping member and applying ultrasonic vibration. A clamp coagulator and cutting system for an ultrasonic surgical instrument adapted for dissection and cutting is shown. Since the device for performing treatment using these ultrasonic waves can perform treatment while grasping the living tissue like using ordinary surgical forceps, it is possible to perform better treatment than when performing the treatment with the probe alone.

On the other hand, a treatment instrument for endoscopic surgery as disclosed in Japanese Patent Laid-Open No. 6-179049 is generally used as a treatment instrument that can perform treatment with a high-frequency current, and most of the treatment instruments use a high-frequency current called a monopolar treatment instrument. It was a type that the treatment was carried out by flowing it through the biological tissue to the return part called the body electrode plate. This type of treatment tool had excellent hemostasis performance.

On the other hand, the treatment tool called bipolar disclosed in Japanese Patent Laid-Open No. 6-30947 is a type in which a high-frequency current circuit is incorporated between the grasping members of the forceps. In this type of treatment tool, a high-frequency current is prevented from flowing in an unnecessary portion of the living tissue, the forceps member is electrically insulated, and the transmission member that drives the forceps member and the sheath are insulated. Each had a power supply means.

[0007]

However, the above-mentioned JP-A-62-127042 and JP-A-1-2329 have been proposed.
The apparatus for performing treatment using ultrasonic waves, which is disclosed in Japanese Patent Laid-Open No. 44-32, Japanese Patent Application Laid-Open No. 1-232948, etc., can only perform treatment by ultrasonic vibration on living tissue. In general, treatment using ultrasonic vibration is inferior in hemostatic ability to treatment using high-frequency current. Therefore, in the case of urgent hemostasis, a treatment instrument using ultrasonic vibration must be replaced with a treatment instrument using high-frequency current. No, it was not easy to use.

On the other hand, in the endoscopic surgical treatment tool disclosed in Japanese Unexamined Patent Publication No. 6-179049, which can perform treatment with a high frequency current, in addition to the problem that a current may flow to an unnecessary portion of the living tissue, the above high frequency An endoscopic treatment tool that uses electric current can only perform treatment with high-frequency current, and has good hemostatic performance, but it has a large effect on living tissues and may cause excessive cauterization. .

Therefore, it is ideal for the operator who actually performs the treatment to perform the treatment by ultrasonic vibration as much as possible and perform the treatment by the high frequency current only when necessary. It was impossible to perform treatment by ultrasonic vibration with the tool alone and treatment with high frequency current only when necessary.

Therefore, in order to solve these problems, JP-A-3-111037 and JP-A-5-23348 are used.
Japanese Patent Laid-Open Publication No. 4931047 and U.S. Pat. No. 4,931,047 disclose an ultrasonic treatment device called an ultrasonic aspirator or the like which can use both ultrasonic vibration and treatment with high frequency current. In these devices, a rod-shaped or spatula-shaped probe is pressed against a living tissue for treatment. Therefore, it is difficult to surely press the probe against the target living tissue to perform the treatment, and it is necessary to assist with a plurality of forceps or the like in addition to performing a fine operation. However, even in operations that are not a problem in normal open surgery, in endoscopic surgery, using forceps, which is a treatment tool for endoscopic surgery, can open many holes in living tissue. Therefore, there was a problem in that it was minimally invasive. Furthermore, it is difficult to perform remote operation while observing the endoscopic image displayed on the screen of the monitor, and it is difficult to operate in cooperation with a plurality of treatment tools. Was wanted. Although the clamp coagulation device and the cutting system of USP5322055 solves this problem, there is a problem in that the treatment using the high frequency current cannot be used together as described above.

The present invention has been made in view of the above circumstances, and an object thereof is to provide an ultrasonic treatment instrument capable of appropriately and easily treating living tissue with ultrasonic vibration and high-frequency current. I am trying.

[0012]

The ultrasonic cutting and coagulating apparatus of the present invention comprises a probe for applying ultrasonic vibration from an ultrasonic vibrator to living tissue and a gripping member which is rotatable opposite to the probe. A treatment section, an insertion section for inserting the treatment section into a living body, an operation section for opening and closing a grip member of the treatment section with respect to a probe, and a transmission member for transmitting an operation force of the operation section to the grip member. An ultrasonic incision coagulation apparatus including: an electric insulation unit that electrically insulates the transmission member and the probe from each other and electrically insulates the transmission member and the probe from the outside. are doing.

[0013]

According to this structure, since the transmission member and the probe are electrically insulated from the outside and the transmission member and the probe are electrically insulated from each other, a high frequency current is applied to the probe or the forceps member. The living tissue can be treated by flushing.

[0014]

Embodiments of the present invention will be described below with reference to the drawings. 1 to 6 relate to an embodiment of the present invention.
3 is a diagram showing a schematic configuration of the ultrasonic cutting coagulation apparatus, FIG. 2 is a cross-sectional view for explaining a distal end side of the insertion section of the ultrasonic cutting coagulation apparatus, FIG.
2 is a cross-sectional view taken along the line AA of FIG. 2, FIG. 4 is a cross-sectional view taken along the line BB of FIG. 2, FIG. 5 is a cross-sectional view illustrating the insertion section proximal side and the operating section of the ultrasonic dissection coagulator, and FIG. It is a schematic diagram explaining the circuit structure of an incision coagulation apparatus.

As shown in FIG. 1, an ultrasonic cutting and coagulating apparatus 1
Is a treatment section 2, an insertion section 3 having a conduit for inserting the treatment section 2 into a body cavity, which will be described later, and an operation section 4 having a fixed operation handle 4a and a movable operation handle 4b for operating the treatment section 2. And so on. The treatment section 2 is located at the tip of the insertion section 3 and is composed of a probe 5 and a gripping member 6 that project from the tip surface of the insertion section 3. An ultrasonic transducer, which will be described later, that supplies ultrasonic vibrations to the probe 5 forming the treatment section 2 is built in the operation section. Reference numeral 7 is a first high frequency current code, reference numeral 8 is a second high frequency current code, and reference numeral 9 is an ultrasonic transducer driving code.

As shown in FIG. 2, the treatment section 2 located on the distal end side of the insertion section 3 has a probe 5 protruding from the distal end surface of the insertion section 3 and a gripping member 6 arranged so as to face the probe 5. It consists of and. When the operator operates the movable operation handle 4b of the operation portion 4, the gripping member 6 moves the transmission member 10 connecting the movable operation handle 4b and the gripping member 6 forward and backward in the longitudinal direction, The gripping member 6 is opened and closed with respect to the probe 5.

The insertion part 3 is a sheath 11 which is an electrically insulating means and is made of a resin member such as polysulfone or BEEK having an electrically insulating property.
In FIG. 1, a probe insertion pipe line 1 through which the probe 5 is inserted
2 and a transmission member pipe line 13 through which a transmission member 10 connected to the grip member 6 is inserted are provided so as to be completely electrically insulated.

As shown in FIGS. 2 and 3, a distal end cover 14 having electrical insulation is fitted and fixed in the distal end side opening of the transmission member conduit 13, and like the sheath 11, polysulfone or BEEK. It is formed of a resin material such as or ceramics. The grip member 6 is rotatably attached to the tip cover 14 by a first pin 21.

Further, as shown in FIGS. 2 and 4, the second pin 22 rotatably and slidably fixes the gripping member 6 and the transmission member 10 for transmitting the operating force of the movable operating handle 4b. Accordingly, the gripping member 6 rotates about the first pin 21 with respect to the probe 5 in response to the forward / backward movement of the transmission member 10.

Then, as shown in FIG. 2 to FIG. 4, the probe 5 is provided at the tip end side opening portion of the probe insertion conduit 12.
The protective member 15 for preventing the sheath 11 from being damaged by coming into contact with the sheath 11 and vibrating ultrasonically.
Is provided. The protection member 15 is formed of a member such as ceramic or PTFE that has resistance to ultrasonic vibrations, excellent heat resistance, and electrical insulation.

In addition, for example, an insulating coating such as PTFE or alumina which prevents high-frequency current from leaking to the exposed surface portion of the gripping member 6 other than the surface facing the probe 5 and the portion exposed from the sheath 11 of the tip cover 14. A ceramic having an electrically insulating property such as a ceramic is CVD coated.

Also, like the gripping member 6, the probe 5
Also, by applying CVD coating to exposed surface portions other than the tip side portion other than the surface facing the gripping member 6, it is possible to further prevent leakage of high-frequency current into living tissue and increase safety. .

As shown in FIG. 5, the operation section 4 is provided at the proximal end of the insertion section 3, and an ultrasonic transducer 16 is provided inside the operation section 4. Further, the insertion portion 3 is connected and fixed to the upper portion of the fixed handle 4a located on the distal end side of the operation portion 4. A movable handle 4b is rotatably supported on the fixed handle 4a by a third pin 23, and the rotational movement of the movable handle 4b is transmitted to the transmission member 1.
It is transmitted to 0. The fixed handle 4a and the movable handle 4b are both made of an electrically insulating material such as polysulfone or BEEK.

An engaging member 24 having a spherical portion 24a is fixed to the proximal end of the transmitting member 10. The spherical portion 24a is rotatably slidably held in an engaging groove 24 formed in an upper portion of the movable handle 4b. A conductive member 25 is provided in the engagement groove 24 so as to come into contact with the spherical portion 24a. The first conductive member 25 supplies a high frequency current from a high frequency power source to the gripping member 6.
The high frequency current cord 7 is connected. A second high-frequency current cord 8 for supplying a high-frequency current to the probe 5 from the rear portion of the ultrasonic oscillator 16 and an ultrasonic oscillator driving unit for supplying a driving current to the ultrasonic oscillator 16 Cord 9 is connected.

The sheath 11 constituting the insertion portion 3
The first portion is provided at the opening where the end of the transmission member pipeline 13 is located.
The packing 31a is provided, and the transmission member conduit 1 is provided.
It prevents that gas such as pneumoperitoneum leaks from 3.

Further, an electric insulation means formed of a resin member such as PTFE having resistance to ultrasonic vibration, heat resistance and electric insulation at the end portion on the proximal side of the probe insertion conduit 12 A tube 26, which serves as the above, penetrates through the inside of the movable handle 4b and is provided up to the ultrasonic transducer housing 27. Therefore, the probe 5
Is completely separated from other members between the probe insertion conduit 12 and the ultrasonic transducer housing 27.

Further, the ultrasonic transducer housing 27
The rear part of is sealed by a second packing 32, and the front exit of the first high-frequency current cord 7 is also sealed by the third packing 3.
It is sealed by 3.

That is, in the ultrasonic cutting and coagulating apparatus 1, the probe 5 and the ultrasonic transducer 16 and the engaging member 24, the transmitting member 10, the tip cover 14 and the gripping member 6 are electrically completely insulated from each other. At the same time, the probe 5, the ultrasonic transducer 16, the engaging member 24, the transmitting member 10,
The tip cover 14 and the grip member 6 are also electrically insulated from the outside.

As shown in FIG. 6, in the ultrasonic cutting and coagulating apparatus 1, the gripping member 6 constituting the treatment section 2 is the transmission member 1
0, the engaging member 24, the conductive member 25, the first high-frequency current cord 7, and the high-frequency current connector 7a for gripping members, and is connected to the high-frequency power source 28. On the other hand, the probe 5 constituting the treatment section 2 is connected to the high frequency power supply 28 via the ultrasonic transducer 16, the second high frequency current cord 8 and the probe high frequency current connector 8a. Furthermore, the ultrasonic transducer 16
Is connected to an ultrasonic oscillator drive power source 29 via an ultrasonic oscillator drive cord 9 and an ultrasonic oscillator drive connector 9a.

Further, the body electrode plate 30 is connected to the high frequency power source 28 on the feedback side. Thus, the gripping member 6 and the probe 5 are electrically completely insulated.

The operation of the ultrasonic incision coagulation apparatus 1 configured as described above will be described. First, the ultrasonic incision coagulation apparatus 1 is made to face the target living tissue in the living body. Then, the movable handle 4b of the operation unit 4 is operated so as to be in an open state, and the grip member 6 is opened with respect to the probe 5.

Next, the movable handle 4b is operated so as to be in a closed state in order to sandwich the target biological tissue between the grasping member 6 and the probe 5, and the grasping member 6 is closed with respect to the probe 5. Grasp living tissue.

Next, in this state, an ultrasonic vibrator driving current is supplied from the ultrasonic vibrator driving power source 29.
To drive the ultrasonic transducer 16. Then, the ultrasonic transducer 16 vibrates to transmit the ultrasonic vibration to the probe 5, and the ultrasonic vibration is applied to the living tissue to incise or coagulate the living tissue.

On the other hand, when a treatment using a high-frequency current is performed, a living tissue is grasped between the grasping member 6 and the probe 5, and either the grasping member 6 or the probe 5 or both the grasping member 6 and the probe 5 is grasped. A high frequency current is supplied from the high frequency power supply 28. At this time, the gripping member 6 and the probe 5
A high-frequency current is passed from the body electrode plate 30 to the body electrode plate 30 through the living tissue as shown by the broken line in FIG. 6, and is returned to the high-frequency power source 28 to cut or coagulate the living tissue.

The living tissue is grasped by the holding member 6 and the probe 5.
Alternatively, the probe 5 may be pressed against the living tissue without being gripped between them and ultrasonic vibration may be applied to perform the treatment. Alternatively, the biological tissue may be grasped by the grasping member 6 and the probe 5 without using the body electrode plate 30, and a treatment may be performed by passing a high frequency current between the grasping member 6 and the probe 5. . Further, the living tissue may be separated by the grasping member 6 and the probe 5 without grasping it, or one of them may be pressed to perform the treatment.

As described above, since the gripping member and the probe are electrically insulated from each other, when the treatment with the high frequency current is performed, the high frequency current does not leak and the treatment can be safely performed.

Further, since it is possible to perform the treatment with ultrasonic vibration and the treatment with high frequency current at the same time, the treatment with ultrasonic vibration is performed as much as possible, and the treatment with high frequency current is performed only when necessary to obtain good hemostatic performance. And, both effects of preventing excessive tissue degeneration can be obtained.

Further, when a treatment is performed by applying a high frequency current, the treatment is performed by passing a high frequency current through the body tissue using a body electrode plate, or the body tissue is grasped between the grasping member and the probe without using the body electrode plate. The operator has a wider range of choices, such as gripping between them and applying a high-frequency current to the living tissue between the gripping member and the probe to perform treatment.

FIG. 7 is a diagram for explaining the relationship between the ultrasonic incision coagulator and the power source. As shown in the figure, in this embodiment, a gripping member high frequency current connector 71 for supplying a high frequency current to the gripping member 6 is provided on the upper portion of the operation portion 4. Then, the high-frequency current connector 71 for gripping member and the high-frequency power source 28 are connected by the high-frequency current power supply cord 34. On the other hand, the probe high frequency current and the ultrasonic oscillator driving connector 72 for supplying a high frequency current to the probe 5 and an ultrasonic oscillator driving current to the ultrasonic oscillator 16 are connected to the probe high frequency current. It is provided on the ultrasonic transducer driving cord 35. Inside the connector 72 for driving the probe high-frequency current / ultrasonic transducer, a probe power feeding terminal 36 and an ultrasonic transducer power feeding terminal 37 are provided independently of each other. The probe 5 and the ultrasonic vibration are respectively provided. It is connected to the child 16. Then, the probe high-frequency current / ultrasonic transducer driving cord 35 provided with the probe high-frequency current / ultrasonic transducer driving connector 72 is used to drive an ultrasonic transducer with a built-in high-frequency power source for the probe. It is used by connecting to the body power source 41. As a result, the power supply to the probe and the power supply to the ultrasonic transducer can be connected at one time, and the gripping member and the probe and the ultrasonic transducer can be handled separately, which is convenient for repairs and the like. is there. A high frequency power source can be used when supplying a high frequency current to the gripping member.

FIG. 8 is a diagram for explaining another relationship between the ultrasonic incision coagulator and the power source. As shown in the figure, in the present embodiment, a gripping member / probe high frequency current connector 73 for supplying a high frequency current to the gripping member 6 and the probe 5.
Are provided on the gripping member / probe high-frequency cord 38. This gripping member / high frequency current connector for probe 7
A gripping member power supply terminal 39 and a probe power supply terminal 40 are independently provided inside the unit 3, and are connected to the gripping member 6 and the probe 5, respectively. The gripping member / probe high frequency cord 38 having the gripping member / probe high frequency current connector 73 is connected to the high frequency power source 28 for use.

As a result, the high frequency current can be connected at one time, and the high frequency power source and the ultrasonic transducer driving power source can be handled separately.

FIG. 9 is a view for explaining another relationship between the ultrasonic incision coagulator and the power source. As shown in the figure, in this embodiment, a high-frequency current is supplied to the gripping member 6 and the probe 5, and a high-frequency current for the ultrasonic probe 16 and a high-frequency current for the ultrasonic probe are supplied to the ultrasonic vibrator 16. An acoustic wave transducer driving connector 74 is provided on the gripping member, the probe, and the ultrasonic transducer cord 42. Inside the gripping member / probe high-frequency current / ultrasonic transducer driving connector 74, a gripping member power feeding terminal 43, a probe power feeding terminal 44, and an ultrasonic transducer power feeding terminal 45 are independently provided. Gripping member 6, probe 5,
It is connected to the ultrasonic transducer 16. Then, the gripping member, the high frequency current for the probe, the gripping member provided with the ultrasonic transducer driving connector 74, the probe, the ultrasonic transducer cord 42, and the ultrasonic transducer driving high frequency provided with the high frequency power source for the gripping member and the probe. It is used by connecting to the integrated power supply 46. This allows all connections to be made at once and all power sources to be integrated.

FIG. 10 is a view for explaining another relationship between the ultrasonic incision coagulator and the power source. As shown in the figure, in this embodiment, the gripping member, the high frequency current for the probe, and the gripping member having the ultrasonic transducer driving connector 74, the probe, and the ultrasonic transducer cord 47 are detachable from the operating portion 4. ing. For this reason, a gripping member / probe high-frequency current / ultrasonic transducer driving operation-side connector 75 is provided in the operating portion 4, and the gripping member / probe / ultrasonic transducer cord 47 is provided with the gripping member / probe high-frequency current. A detachable holding member, a probe high-frequency current, and an ultrasonic transducer driving cord side connector 76 are provided on the ultrasonic transducer driving operation side connector 75. Then, the gripping member, the probe and the ultrasonic transducer cord are connected to the ultrasonic transducer driving high frequency integrated power source 48 and used. This allows the ultrasonic dissection coagulator and the cord to be separated,
It becomes easy to replace cords that are prone to troubles such as disconnection. In addition, since the cords can be separated during the cleaning and sterilization, the workability is improved. Further, it is possible to use cords having different lengths, and it is possible to easily exchange cords that are likely to cause troubles such as disconnection.

[Additional Notes] 1. A treatment unit configured by a probe for applying ultrasonic vibration from an ultrasonic transducer to a living body tissue and a gripping member rotatable opposite to the probe, an insertion unit for inserting the treatment unit into a living body, and the treatment In an ultrasonic dissection and coagulation apparatus including an operation unit that opens and closes a gripping member of a portion with respect to a probe, and a transmission member that transmits an operating force of the operation unit to the gripping member, the transmission member and the probe are An ultrasonic incision coagulation apparatus comprising electrical insulating means for electrically insulating the transmission member and the probe from each other.

2. Note 1 in which an ultrasonic transducer for supplying ultrasonic vibration to the probe is arranged in the operation unit.
The ultrasonic dissection and coagulation device described.

3. The ultrasonic dissection and coagulation device according to appendix 1, wherein the transmission member is inserted through the insertion portion.

4. 2. The ultrasonic cutting and coagulating apparatus according to appendix 1, wherein the conduit through which the transmission member is inserted and the conduit through which the probe is inserted are electrically insulated.

As a result, the four pipe lines through which the transmission member and the gripping member and the probe are inserted are independent in the insertion portion,
Since the respective conduits are electrically insulated, it is possible to reliably insulate the transmission member and the probe without applying treatment such as insulation coating to the outer peripheral surface of the probe and the transmission member.

5. 6. The ultrasonic dissection and coagulation apparatus according to Supplementary Note 1 and Supplementary Note 4, wherein a gripping member power supply means for connecting a high frequency power source for supplying a high frequency current to the gripping member is provided.

With this, it is possible to easily connect or disconnect the high frequency power source to the ultrasonic cutting and coagulating device, so that the work of cleaning and sterilizing the ultrasonic cutting and coagulating device and the replacement thereof become easy. .

6. 6. The ultrasonic dissection and coagulation apparatus according to any one of appendices 1 to 5, further comprising a probe feeding means for connecting a high frequency power source for feeding a high frequency current to the probe.

7. 6. The ultrasonic cutting and coagulating apparatus according to appendix 5, wherein the gripping member power feeding means is a connector provided in an operating portion.

8. 7. The ultrasonic incision coagulation apparatus according to appendix 6, wherein the probe power feeding means is a connector provided in an operating portion.

9. 9. The ultrasonic dissection and coagulation device according to appendix 7 and 8, which has a substantially cord-shaped member that separates the connector from the operation portion.

10. 9. The ultrasonic dissection and coagulation apparatus according to supplementary note 7 or supplementary note 8, wherein an integrated connector in which a connector for supplying electric power to each of the gripping member and the probe is integrated is provided. 11. 11. The ultrasonic cutting and coagulating apparatus according to appendix 10, wherein terminals for supplying power to the gripping member and the probe are separately arranged in the integrated connector.

Thus, when connecting to the high frequency power source, the connection can be made at once.

12. The ultrasonic vibrator has an ultrasonic vibrator power feeding means for connecting the ultrasonic vibrator and an ultrasonic driving power source for supplying a driving current to the ultrasonic vibrator, and the ultrasonic vibrator power feeding means is provided in the operation unit. The ultrasonic dissection and coagulation apparatus according to any one of appendices 7 to 11, which is a connector.

13. 13. The ultrasonic cutting and coagulating apparatus according to appendix 12, comprising a substantially cord-shaped member that separates the connector from the ultrasonic cutting and coagulating apparatus.

14. Note that the connector for supplying power to the ultrasonic vibrator and the probe is respectively integrated, while terminals for supplying power to the ultrasonic vibrator and the probe are separately arranged in the connector. 12 and the ultrasonic incision coagulator according to Appendix 13.

As a result, when the power source for driving the ultrasonic transducer which has the built-in high frequency power source for the probe is used, there is an effect that the connection can be made at once.

15. A connector for supplying power to the ultrasonic vibrator, the probe, and the grip member is integrated, and terminals for supplying power to the ultrasonic vibrator, the probe, and the grip member are provided in the connector. The ultrasonic incision coagulation apparatus according to appendix 14, which is separately arranged.

As a result, when the power source for driving the ultrasonic transducer which has the built-in high frequency power source for the probe and the holding member is used, the connection can be made at once.

[0063]

As described above, according to the present invention, it is possible to provide an ultrasonic treatment instrument capable of appropriately and easily treating living tissue with ultrasonic vibration and treatment with high-frequency current.

[Brief description of drawings]

1 to 6 relate to an embodiment of the present invention, and FIG. 1 is a diagram showing a schematic configuration of an ultrasonic dissection and coagulation apparatus.

FIG. 2 is a cross-sectional view illustrating the distal end side of the insertion portion of the ultrasonic dissection coagulator.

FIG. 3 is a sectional view taken along line AA of FIG.

4 is a sectional view taken along line BB of FIG.

FIG. 5 is a cross-sectional view illustrating a proximal side of an insertion portion and an operation portion of an ultrasonic incision coagulation device.

FIG. 6 is a schematic diagram illustrating a circuit configuration of an ultrasonic dissection coagulator.

FIG. 7 is a diagram for explaining the relationship between the ultrasonic dissection coagulator and a power supply.

FIG. 8 is a diagram for explaining another relationship between the ultrasonic incision coagulator and the power source.

FIG. 9 is a view for explaining another relationship between the ultrasonic incision coagulator and the power supply.

FIG. 10 is a view for explaining another relationship between the ultrasonic incision coagulator and the power supply.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 ... Ultrasonic incision coagulator 2 ... Treatment part 3 ... Insertion part 6 ... Gripping part 10 ... Transmission member 11 ... Sheath (electrical insulation means)

Claims (1)

[Claims] 1. A treatment section composed of a probe for applying ultrasonic vibration from an ultrasonic transducer to a living tissue and a gripping member which is rotatable opposite to the probe, and an insertion for inserting the treatment section into a living body. An ultrasonic incision coagulation apparatus comprising: a portion, an operating portion that opens and closes a gripping member of the treatment portion with respect to a probe, and a transmission member that transmits an operating force of the operating portion to the gripping member. And an electric insulation means for electrically insulating the transmission member and the probe from the outside, and electrically insulating the probe and the probe from each other.