CN110049737B

CN110049737B - Treatment tool

Info

Publication number: CN110049737B
Application number: CN201680091412.8A
Authority: CN
Inventors: 长田礼佑
Original assignee: Olympus Corp
Current assignee: Olympus Corp
Priority date: 2016-12-05
Filing date: 2016-12-05
Publication date: 2022-06-14
Anticipated expiration: 2036-12-05
Also published as: WO2018104995A1; JP6643504B2; CN110049737A; JPWO2018104995A1

Abstract

The treatment instrument (1) has a housing (3). An end effector (5) is provided at the tip of the shaft (2) attached to the housing (3). The operator grips the handle (22) of the housing (3) by sandwiching it between the palm (H1) and thumb (F1) of the right hand (H0), and hooks the middle finger (F3), ring finger (F4), and little finger (F5) to the handle (27). The grip pieces (12, 13) of the end effector (5) can be opened and closed by rotating the handle (27). The tip of the index finger (F2) abuts on a ridge (45A) formed on the 1 st outer surface (31A) of the housing (3). By doing so, it is possible to prevent the 1 st side button (41A) mounted on the 1 st outer surface (31A) from being erroneously pressed by the index finger (F2). When a 2 nd side button (41B) attached to a 2 nd outer surface (31B) of a housing (3) is pressed with a thumb (F1), a treatment instrument (1) operates in a1 st operation mode. When a front button (43) attached to the distal end outer surface (33) of the housing (3) is pressed with an index finger (F2), the treatment instrument (1) operates in the 2 nd operation mode.

Description

Treatment tool

Technical Field

The present invention relates to a treatment instrument provided with a casing that can be held, and a handle that can be moved relative to a grip of the casing.

Background

US2015/0282874a1 discloses a treatment instrument having a housing that can be held. In this treatment instrument, the shaft is attached to the housing from the distal end side, and the housing includes a housing main body extending along the longitudinal axis of the shaft and a handle extending from the housing in a direction intersecting the longitudinal axis. Further, a handle is attached to the housing, and the handle is positioned on the distal end side of the grip. The handle is moved toward the distal end side or the proximal end side with respect to the grip, whereby the handle is opened or closed with respect to the grip. Thus, for example, in an end effector provided at the distal end portion of the shaft, the pair of grip pieces can be opened or closed, and the treatment object can be gripped between the grip pieces.

When performing a treatment with a treatment instrument such as US2015/0282874a1, the palm of the right or left hand is brought into contact with the handle from the proximal end side. Further, the handle is sandwiched between the palm and the thumb in the width direction of the housing, holding the housing. In addition, at least 1 finger of the index finger, the middle finger, the ring finger and the little finger is hooked on the handle. In response to an operating force from a hooked finger, the handle moves toward the proximal end side or the distal end side with respect to the grip, and the handle is closed or opened with respect to the grip. At this time, stable holding of the housing is sought.

Disclosure of Invention

The invention aims to provide a treatment instrument, wherein a handle is positioned at the top end side of a handle of a shell and can stably hold the shell.

In order to achieve the above object, a treatment instrument according to one aspect of the present invention includes: a shaft having a base end and a tip end, the shaft extending from the base end along a length axis to the tip end; a housing to which the shaft is attached, the housing including a housing main body extending along the length axis and a handle extending from the housing main body in a direction crossing the length axis, the housing having a1 st outer surface and a 2 nd outer surface facing a side opposite to the 1 st outer surface; a grip provided at a position closer to a distal end side than the grip, the grip being movable toward a proximal end side or toward the distal end side with respect to the grip along a movement surface that is a virtual plane between the 1 st outer surface and the 2 nd outer surface; and a protrusion protruding in a direction intersecting the movement surface on the 1 st outer surface, the protrusion being located closer to the distal end side than the handle and located between the longitudinal axis and the handle, the protrusion being located at a distance from the distal end of the case main body smaller than a distance from the proximal end of the case main body, the protrusion being located at a distance from the handle smaller than a distance from the longitudinal axis.

A treatment instrument according to another aspect of the present invention includes: a shaft having a base end and a tip end, the shaft extending from the base end along a length axis to the tip end; a housing to which the shaft is attached, the housing including a housing main body extending along the longitudinal axis and a handle extending from the housing main body in a direction intersecting the longitudinal axis, and the housing having a1 st outer surface and a 2 nd outer surface facing a side opposite to the 1 st outer surface, the housing being held by a palm of a user in a state of abutting on the handle from a base end side; a handle provided at a position closer to a distal end side than the grip, and configured to be hooked by at least 1 of an index finger, a middle finger, a ring finger, and a little finger, the handle being configured to move toward the proximal end side or the distal end side with respect to the grip along a movement surface that is a virtual plane between the 1 st outer surface and the 2 nd outer surface in accordance with an operation force from the hooked finger; and a raised portion raised in a direction intersecting the movement surface on the 1 st outer surface, provided at a position where at least one of the index finger and the middle finger can be brought into contact with, and capable of applying a pressing force from the longitudinal axis toward one side of the handle by the index finger or the middle finger.

Drawings

Fig. 1 is a schematic view of the treatment instrument of embodiment 1 as viewed from one side in the width direction of the housing.

Fig. 2 is a schematic view of the treatment instrument of embodiment 1 as viewed from the side opposite to the side where the handle is located with respect to the longitudinal axis.

Fig. 3 is a schematic view showing the structure of the housing and its vicinity of embodiment 1 in a state viewed from the opposite side to fig. 1 in the width direction of the housing.

Fig. 4 is a schematic diagram showing the configuration of the housing and its vicinity of embodiment 1 as viewed from the distal end side.

Fig. 5 is a schematic view showing the configuration of the housing and its vicinity according to embodiment 1, as viewed from the proximal end side.

Fig. 6 is a schematic diagram showing a state in which the housing of embodiment 1 is held with one hand.

Fig. 7 is a schematic view showing a state in which the hand holding the housing of embodiment 1 is used to operate the bending dial.

Fig. 8 is a schematic view of the housing of modification 1 as viewed from one side in the width direction of the housing.

Fig. 9 is a schematic view of the housing of modification 2 as viewed from one side in the width direction of the housing.

Fig. 10 is a schematic view of the treatment instrument of modification 3 as viewed from one side in the width direction of the housing.

Detailed Description

(embodiment 1)

Embodiment 1 of the present invention will be described with reference to fig. 1 to 7. Fig. 1 and 2 are views showing a treatment instrument 1 according to the present embodiment. As shown in fig. 1, the treatment instrument 1 includes a shaft (sheath) 2, and the shaft 2 has a longitudinal axis C as a central axis. Here, one side in the direction along the longitudinal axis C is a distal end side (arrow C1 side), and the opposite side to the distal end side is a proximal end side (arrow C2 side). The shaft 2 has a base end and a tip end, which is provided extending along the length axis C from the base end to the tip end.

The treatment instrument 1 includes a housing 3 that can be held. The shaft 2 is attached to the housing 3 from the distal end side. Further, an end effector 5 is provided at the distal end portion of the shaft 2. The shaft 2 is located on the proximal end side toward the housing 3 and on the distal end side toward the end effector 5. The shaft 2 is rotatable relative to the housing 3 about a length axis C.

The end effector 5 is rotatable with the shaft 2 about the length axis C relative to the housing 3. By rotating the end effector 5 about the length axis C, the angular position of the end effector 5 about the length axis C changes. In the present embodiment, the end effector 5 is bendable with respect to the shaft 2 (the longitudinal axis C). The bending direction of the end effector 5 (the direction shown by the arrow B1 and the arrow B2) intersects (is substantially perpendicular to) the length axis C. The end effector 5 includes a relay member 11, a1 st gripping piece 12, and a 2 nd gripping piece 13. The relay member 11 is attached to the tip end of the shaft 2 so as to be bendable with respect to the shaft 2. Thus, a bending joint 15 is formed between the shaft 2 and the relay member 11. In the end effector 5, the pair of

grip pieces

12 and 13 can be opened and closed. The opening and closing directions (directions indicated by arrows X1 and X2) of the

grip pieces

12 and 13 intersect (are substantially perpendicular to) the longitudinal axis C and intersect (are substantially perpendicular to) the bending direction of the end effector 5.

Here, in one embodiment, one of the

grip pieces

12, 13 is integrated with the relay member 11 or fixed to the relay member 11, and the other grip piece is rotatably attached to the relay member 11. Further, in another embodiment, both the

grip pieces

12, 13 are rotatably attached to the relay member 11. In another embodiment, a rod member (not shown) is provided extending from the inside of the relay member 11 toward the distal end side, and one of the

holding pieces

12 and 13 is formed by a protruding portion of the rod member protruding from the relay member 11 toward the distal end side. The other of the

grip pieces

12 and 13 is rotatably attached to the relay member 11.

The housing 3 includes a housing main body 21 extending along the longitudinal axis C of the shaft 2. The case main body 21 has a base end E1 and a tip end E2. The housing main body 21 extends from the base end E1 to the tip end E2 with its central axis coaxial or substantially coaxial with the longitudinal axis C. The housing 3 further includes a grip (fixed handle) 22 extending from the housing main body 21 in a direction intersecting the longitudinal axis. In the present embodiment, the handle 22 is formed integrally with the housing main body 21. One end of a cable 23 is connected to the housing 3. In the present embodiment, for example, one end of the cable 23 is connected to the distal end side end portion of the grip 22 with respect to the housing main body 21 (the longitudinal axis C). The other end of the cable 23 is connected to an energy control device (not shown).

In the present embodiment, a rotation knob 25 as a rotation operation member is attached to the distal end side of the housing main body 21. The shaft 2 is inserted into the inside of the rotation knob 25 and the inside of the housing main body 21 from the distal end side, and is attached to the housing 3 from the distal end side. The rotation knob 25 is fixed relative to the shaft 2 and is rotatable with the shaft 2 and the end effector 5 about the length axis C relative to the housing 3. An operation for rotating the shaft 2 and the end effector 5 about the longitudinal axis C can be input to the rotation knob 25 as a rotation operation member. That is, when an operation force for rotating the rotation knob 25 about the longitudinal axis C is applied, the shaft 2 and the end effector 5 perform a rotational operation about the longitudinal axis C with respect to the housing 3.

Fig. 3 to 5 are diagrams showing the housing 3 and the structure in the vicinity of the housing 3. Here, a direction (substantially perpendicular) intersecting (substantially perpendicular to) the longitudinal axis C and intersecting the extending direction (the direction indicated by the arrow Y1 and the arrow Y2) of the handle 22 is set as the width direction (the direction indicated by the arrow W1 and the arrow W2) of the housing 3. Fig. 1 shows a state in which the housing 3 is viewed from one side in the width direction, and fig. 3 shows a state in which the housing 3 is viewed from the opposite side to fig. 1. Further, fig. 2 shows a state in which the housing 3 is viewed from the side opposite to the side where the handle 22 is located with respect to the length axis C. Fig. 4 shows a state in which the housing 3 is viewed from the distal end side, and fig. 5 shows a state in which the housing 3 is viewed from the proximal end side.

As shown in fig. 1 to 5, the housing 3 has a1 st outer surface (1 st side outer surface) 31A facing one side (arrow W1 side) in the width direction and a 2 nd outer surface (2 nd side outer surface) 31B facing the opposite side to the 1 st outer surface 31A. The housing 3 has a distal outer surface 33, a proximal outer surface 35, and a relay outer surface 36 extending between the

outer surfaces

31A and 31B. The distal end outer surface 33 faces the distal end side, and forms a distal end E2 of the housing main body 21. Further, the base end outer surface 35 faces the base end side, forming a base end E1 of the case main body 21. Further, the relay outer surface 36 forms an end of the side of the housing main body 21 opposite to the side where the handle 22 is located, toward the side opposite to the side where the handle 22 is located with respect to the length axis C.

A handle (movable handle) 27 is rotatably attached to the housing 3. Here, a movement plane T is defined as a virtual plane between the 1 st outer surface 31A and the 2 nd outer surface 31B in the width direction. The movement surface T is a surface substantially perpendicular to the width direction, and is, for example, a center surface in the width direction of the housing 3. Therefore, a direction intersecting (substantially perpendicular to) the movement plane T coincides with the width direction of the housing 3. The handle 27 is moved to the proximal end side or the distal end side with respect to the grip 22 along the movement surface T by being rotated with respect to the housing 3. That is, the handle 27 can be opened and closed with respect to the grip 22. The handle 27 includes an urging portion 28 for applying an operation force for opening or closing the handle 27 with respect to the grip 22. The biasing portion 28 of the handle 27 is provided on the distal end side of the grip 22. Therefore, when the handle 27 is moved to the distal end side, the handle 27 is opened with respect to the grip 22, and when the handle 27 is moved to the proximal end side, the handle 27 is closed with respect to the grip 22. The biasing portion 28 of the handle 27 is located on the side of the longitudinal axis C where the grip 22 is located. Since the handle 27 has the above-described configuration, the treatment instrument 1 is a so-called pistol-type treatment instrument in the present embodiment.

When the operating force is applied by the urging portion 28, the handle 27 moves along the movement surface T with respect to the grip 22, and a movable member (not shown) extending inside the shaft 2 moves along the longitudinal axis C with respect to the shaft 2 and the housing 3. Thereby, at least one of the

grip pieces

12, 13 rotates with respect to the relay member 11, and the

grip pieces

12, 13 open or close. Therefore, the end effector 5 can grip a treatment target such as a living tissue between the

grip pieces

12 and 13.

A bending dial (bending operation member) 38 is mounted as a bending operation member on the housing 3. An operation for bending the end effector 5 with respect to the shaft 2 can be input by the bending dial 38. A bending operation wire (not shown) extending inside the shaft 2 is moved along the longitudinal axis C with respect to the shaft 2 and the housing 3 by an input operation using the bending dial (bending operation member) 38, for example, by rotating the bending dial 38. Thereby, the end effector 5 is bent with respect to the shaft 2 by the bending joint 15. In the present embodiment, a curved dial 38 is attached to the base end surface of the housing main body 21 as a part of the base end outer surface 35. Also, the rotational axis of the curved dial 38 intersects (is substantially perpendicular to) the length axis C. Preferably, the curved dial 38 is provided at a location through which the length axis C passes. The curved dial 38 may be rotatable about the longitudinal axis C together with the shaft 2, the end effector 5, and the rotation knob 25 with respect to the housing 3, or may not be rotatable about the longitudinal axis C together with the shaft 2, the end effector 5, and the rotation knob 25. Further, the bending operation member does not need to be the bending dial 38, and an operation lever or the like may be provided instead as the bending operation member.

In the housing 3, a1 st side button (operation member) 41A is attached to a1 st outer surface 31A, and a 2 nd side button (operation member) 41B is attached to a 2 nd outer surface 31B. Further, a front button (operation member) 43 is mounted on the tip outer surface 33. The

side buttons

41A, 41B and the front button 43 are provided between the longitudinal axis C of the housing main body 21 and the biasing portion 28 of the handle 27. The

side buttons

41A and 41B and the front button 43 are positioned on the distal end side of the handle 22. The front outer surface 33 on which the front button 43 is provided on the front end side of the

side buttons

41A and 41B. The bending dial 38 as a bending operation member is located closer to the proximal end side than the

side buttons

41A and 41B. The distance L2 of each of the

side buttons

41A, 41B from the force applying portion 28 of the handle 27 is smaller than the distance L1 of each of the

side buttons

41A, 41B from the length axis C. Therefore, the

side buttons

41A and 41B are located at positions on the side close to the biasing portion 28 between the longitudinal axis C of the housing main body 21 and the biasing portion 28 of the handle 27. Further, it is preferable that the distance L4 from the distal end E2 of the case main body 21 of each of the

side buttons

41A, 41B is smaller than the distance L3 from the proximal end E1 of the case main body 21 of each of the

side buttons

41A, 41B. That is, the

side buttons

41A and 41B are preferably located on the side close to the distal end E2 between the proximal end E1 of the case main body 21 and the distal end E2 of the case main body 21.

The operation of operating the treatment instrument 1 in the 1 st operation mode can be input to both the

side buttons

41A and 41B. That is, the treatment instrument 1 operates in the 1 st operation mode based on the operation at the 1 st side button 41A or the 2 nd side button 41B. Further, an operation for operating the treatment instrument 1 in the 2 nd operation mode different from the 1 st operation mode can be input in the front button 43. That is, the treatment instrument 1 operates in the 2 nd operation mode based on the operation of the front button 43. In each of the 1 st operation mode and the 2 nd operation mode, electric energy is supplied from the energy control device (not shown) to the treatment instrument 1, for example, in the same manner as in a known treatment instrument, and treatment energy used for treatment of a treatment target by the end effector 5 is generated. Then, any one of high-frequency current, ultrasonic vibration, and heater heat is applied as treatment energy to the treatment object gripped between the

gripping pieces

12, 13. In one embodiment, in both the 1 st and 2 nd modes of operation, electrical energy is supplied from the energy control device to an electric motor (not shown) to drive the electric motor. Thus, the staple pierces the treatment object gripped between the

gripping pieces

12 and 13.

In addition, in the case 3, a raised portion (1 st raised portion) 45A is provided on the 1 st outer surface 31A, and a raised portion (2 nd raised portion) 45B is provided on the 2 nd outer surface 31B. The

ridge portions

45A, 45B each protrude toward the outside (the side away from the moving surface T) in the width direction. Further, the

ridge portions

45A, 45B are formed integrally with the housing 3. The

protuberances

45A and 45B are provided on the distal end side of the grip 22 and between the longitudinal axis C and the biasing portion 28 of the handle 27. In addition, a constriction is formed in a portion adjacent to the

ridge portions

45A, 45B on the side closer to the longitudinal axis C than the

ridge portions

45A, 45B. That is, the 1 st outer surface 31A and the 2 nd outer surface 31B each have a constricted portion, and the constricted portions are formed in shapes suitable for placement of a thumb, an index finger, and the like, which will be described later.

The

side buttons

41A and 41B are located closer to the base end side than the raised

portions

45A and 45B, respectively. In the present embodiment, the 1 st side button 41A is provided adjacent to the base end side of the ridge portion 45A, and the 2 nd side button 41B is provided adjacent to the base end side of the ridge portion 45B. Due to the above-described configuration, the bending dial 38 as the bending operation member is located closer to the proximal end side than the

ridge portions

45A and 45B.

The distance D2 of each of the

protuberances

45A, 45B from the urging portion 28 of the handle 27 is smaller than the distance D1 of each of the

protuberances

45A, 45B from the longitudinal axis C of the housing main body 21. Therefore, the

protuberances

45A and 45B are located at a position on the side close to the biasing portion 28 between the longitudinal axis C and the biasing portion 28 of the handle 27. Further, the distance D4 of each of the humps 45A, 45B from the tip end E2 of the case main body 21 is smaller than the distance D3 of each of the humps 45A, 45B from the base end E1 of the case main body 21. That is, the

ridges

45A and 45B are located at a position on the side close to the distal end E2 between the proximal end E1 of the case main body 21 and the distal end E2 of the case main body 21.

The front button 43 provided on the distal outer surface 33 is provided closer to the longitudinal axis C than the

ridges

45A and 45B. In the present embodiment, the distal end outer surface 33 is provided with a distal end raised portion 46 that is raised toward the distal end side. The tip end bulge portion 46 is formed integrally with the case 3. In the present embodiment, the distal end ridge portion 46 is continuous with the

ridge portions

45A and 45B. Therefore, a ridge shape continuing from the ridge portion 45A to the ridge portion 45B through the tip ridge portion 46 is formed on the outer surface of the housing 3. Further, the tip end raised portion 46 is formed between the front surface button 43 and the urging portion 28 in a state of being disposed adjacent to the front surface button 43. In addition, in one embodiment, the tip end raised portion 46 may not be provided, but the raised shape may be discontinuous between the raised

portions

45A, 45B.

Further, in the present embodiment, each of the

side buttons

41A, 41B also protrudes outward (a side away from the movement surface T) in the width direction of the housing 3. In the bulge portion 45A, the distance from the movement surface (the center surface in the width direction of the housing 3) T is largest at the projecting end (1 st position) PA, and in the bulge portion 45B, the distance from the movement surface T is largest at the projecting end (1 st position) PB. Further, in the 1 st side button 41A, the distance from the movement surface (the center surface in the width direction of the housing 3) T at the protruding end (2 nd position) QA is largest, and in the 2 nd side button 41B, the distance from the movement surface T at the protruding end (2 nd position) QB is largest. Further, the projecting end (1 st position) PA of the raised portion 45A is located closer to the side of the longitudinal axis C than the projecting end (2 nd position) QA of the 1 st side knob 41A, and the projecting end (1 st position) PB of the raised portion 45B is located closer to the side of the longitudinal axis C than the projecting end (2 nd position) QB of the 2 nd side knob 41B. That is, the projecting end (2 nd position) QA of the 1 st side knob 41A is located on the side closer to the biasing portion 28 than the projecting end (1 st position) PA of the swelling portion 45A, and the projecting end (2 nd position) QB of the 2 nd side knob 41B is located on the side closer to the biasing portion 28 than the projecting end (1 st position) PB of the swelling portion 45B. The protruding ends (PA; PB) of the raised portions (45A; 45B) and the protruding ends (QA; QB) of the side buttons (41A; 41B) may be at the same distance from the moving surface T or at different distances from the moving surface T. In the case where the distance from the moving surface T to the projecting end PA of the bulge portion 45A is larger than the distance from the moving surface T to the projecting end QA of the side button 41A, it is easy to prevent the erroneous operation of the side button 41A.

The raised portion 45A is provided with an inclined surface (1 st inclined surface) 51A extending from the projecting end PA toward the side close to the longitudinal axis C, and the raised portion 45B is provided with an inclined surface (1 st inclined surface) 51B extending from the projecting end PB toward the side close to the longitudinal axis C. The inclined surfaces 51A, 51B are inclined with respect to the movement surface (the center surface in the width direction of the housing 3) T, respectively. The

inclined surfaces

51A and 51B are inclined so as to extend outward in the width direction as they extend toward the biasing portion 28 of the handle 27.

Further, the 1 st side push button 41A is provided with an inclined surface (2 nd inclined surface) 53A extending from the projecting end QA toward the side close to the longitudinal axis C, and the 2 nd side push button 41B is provided with an inclined surface (2 nd inclined surface) 53B extending from the projecting end QB toward the side close to the longitudinal axis C. The inclined surfaces 53A, 53B are inclined with respect to the movement surface (the central surface in the width direction of the housing 3) T, respectively. The

inclined surfaces

53A and 53B are inclined so as to extend outward in the width direction as they extend toward the biasing portion 28 of the handle 27.

The inclined surface (1 st inclined surface) 51A has an acute angle (1 st acute angle) α 1 as an inclination angle with respect to the motion surface T, and the inclined surface (1 st inclined surface) 51B has an acute angle (1 st acute angle) α 2 as an inclination angle with respect to the motion surface T. The inclined surface (2 nd inclined surface) 53A has an acute angle (2 nd acute angle) β 1 as an inclination angle with respect to the motion plane T, and the inclined surface (2 nd inclined surface) 53B has an acute angle (2 nd acute angle) β 2 as an inclination angle with respect to the motion plane T. The acute angle α 1 of the inclined surface 51A is larger than the acute angle β 1 of the inclined surface 53A, and the acute angle α 2 of the inclined surface 51B is larger than the acute angle β 2 of the inclined surface 53B.

In the present embodiment, the operation of operating the treatment instrument 1 in the 1 st operation mode is input by pressing the inclined surface (2 nd inclined surface) 53A of the 1 st side push button 41A toward the biasing portion 28 of the handle 27. Then, the operation of operating the treatment instrument 1 in the 1 st operation mode is inputted by pressing the inclined surface (2 nd inclined surface) 53B of the 2 nd side push button 41B toward the biasing portion 28 of the handle 27.

However, the pressing direction of the operation of each of the

side buttons

41A and 41B is not limited to this. For example, in one embodiment, an operation to operate the treatment instrument 1 in the 1 st operation mode is input by pressing a side button (41A; 41B) inward in the width direction. The 1 st side push button 41A may be supported to be rotatable about the axis of a pivot shaft (not shown) with respect to the 1 st outer surface 31A, and may be formed in a lever type. Similarly, the 2 nd side push button 41B may be supported to be rotatable about the axis of a pivot shaft (not shown) with respect to the 2 nd outer surface 31B, and may be formed in a lever type.

In the present embodiment, the 1 st outer surface 31A is provided with the step 55A, and the 2 nd outer surface 31B is provided with the step 55B. The step 55A is provided between the raised portion 45A and the 1 st side push button 41A, and the installation surface of the 1 st side push button 41A is located inward of the raised portion 45A in the width direction of the housing 3 by the step 55A. The step 55B is provided between the raised portion 45B and the 2 nd side button 41B, and the installation surface of the 2 nd side button 41B is located inward of the raised portion 45B in the width direction of the housing 3 by the step 55B.

Next, the operation and effect of the treatment instrument 1 of the present embodiment will be described. When a treatment target such as a living tissue is treated using the treatment instrument 1, an operator (user) holds the housing 3 with one hand (left hand or right hand) and inserts the end effector 5 into a body cavity such as an abdominal cavity. Then, the shaft 2 and the end effector 5 are rotated about the longitudinal axis C by rotating the rotation knob (rotation operation member) 25, or the end effector 5 is bent with respect to the shaft 2 by an operation on the bending dial (bending operation member) 38, whereby the position and posture of the end effector 5 are adjusted in the body cavity. After the position and posture of the end effector 5 are adjusted to a state in which the treatment target is disposed between the

grip pieces

12 and 13, the handle 27 is moved toward the proximal end side along the movement plane T with respect to the grip 22, and the handle 27 is closed with respect to the grip 22. This closes the

grip pieces

12 and 13, and the treatment object is gripped between the

grip pieces

12 and 13. While holding the treatment object, the operator inputs an operation using the side button (41A or 41B) or inputs an operation using the front button 43. Thus, the treatment instrument 1 operates in the 1 st operation mode or the 2 nd operation mode, and applies treatment energy (high-frequency current or the like) to the grasped treatment object or punctures the staple as described above.

Fig. 6 and 7 are views showing a state in which the housing 3 of the treatment instrument 1 is held by one hand (right hand in fig. 6 and 7) H0. Here, fig. 6 and 7 are views of the housing 3 viewed from the side toward which the 2 nd outer surface 31B faces in the width direction. Fig. 6 shows a state in which the hand H0 holding the housing 3 is not operated to any of the rotation knob 25, the curved dial 38, the

side buttons

41A and 41B, and the front button 43, and fig. 7 shows a state in which the hand is operated by the curved dial 38.

As shown in fig. 6, in a state where the housing 3 is held by one hand (right hand or left hand) H0, the palm H1 abuts the handle 22 from the proximal end side. At least 1 of the index finger F2, the middle finger F3, the ring finger F4, and the little finger F5 is hooked on the biasing portion 28 of the handle 27. Generally, the middle finger F3, the ring finger F4, and the little finger F5 are hooked on the biasing unit 28, but depending on the size of the hand of the operator, the preference of the operator, the posture of the treatment instrument 1 during treatment, and the like, only the ring finger F4 and the little finger F5 may be hooked on the biasing unit 28, and all the index finger F2, the middle finger F3, the ring finger F4, and the little finger F5 may be hooked on the biasing unit 28. Then, the finger hooked on the biasing portion 28 is bent or extended, thereby applying an operation force for moving the grip 27 along the movement surface T with respect to the grip 22.

Further, in a state where no operation is performed with the bent dial 38, the handle 22 is sandwiched between the palm H1 and the thumb F1 in the width direction of the housing 3. At this time, the thumb F1 is extended on one of the 1 st outer surface 31A and the 2 nd outer surface 31B (the aforementioned constricted portion). Of the index finger F2, the middle finger F3, the ring finger F4, and the little finger F5, the finger not hooked on the handle 27 extends on the other surface (the aforementioned constricted portion) of the 1 st outer surface 31A and the 2 nd outer surface 31B. For example, in a case where the housing 3 is held with the right hand (H0) and is not operated with the curved dial 38, the thumb F1 is provided extending over the 2 nd outer surface 31B, and the index finger F2 is provided extending over the 1 st outer surface 31A. Further, for example, in a case where the housing 3 is held with the left hand (H0) and no operation is performed with the curved dial 38, the thumb F1 is provided extending over the 1 st outer surface 31A, and the index finger F2 is provided extending over the 2 nd outer surface 31B.

When the end effector 5 is rotated about the longitudinal axis C, the rotation knob 25 is rotated mainly by the index finger F2, and the rotation knob 25 may be rotated by the middle finger F3 depending on the size of the hand of the operator, the preference of the operator, and the like. That is, the operation of the rotation knob 25 is performed by the index finger F2 or the middle finger F3. Further, the front button 43 is pressed with the index finger F2 or the middle finger F3. That is, the operation of the front button 43 is performed with the index finger F2 or the middle finger F3.

The

side buttons

41A, 41B are pressed by the thumb F1. That is, the thumb F1 is used to operate the

side buttons

41A and 41B. Here, for example, when the housing 3 is held by the right hand (H0) and the thumb F1 is extended on the 2 nd outer surface 31B, the input operation is performed by the 2 nd side button 41B. Further, when the case 3 is held by the left hand (H0) and the thumb F1 is extended on the 1 st outer surface 31A, the operation is input by the 1 st side button 41A. In the present embodiment, the 1 st outer surface 31A is provided with the 1 st side button 41A, and the 2 nd outer surface 31B is provided with the 2 nd side button 41B. Therefore, the treatment instrument 1 can be operated in the 1 st operation mode in both the case where the housing 3 is held by the right hand (H0) and the case where the housing 3 is held by the left hand (H0).

The

side buttons

41A and 41B have inclined surfaces (53A; 53B), and the operation of operating the treatment instrument 1 in the 1 st operation mode is input by pressing the inclined surfaces (53A; 53B) of the

side buttons

41A and 41B toward the biasing portion 28 of the handle 27. In the state where the thumb F1 is extended as described above, the thumb F1 can be easily moved toward the biasing portion 28 of the handle 27. Further, in the state where the thumb F1 is extended as described above, the tip end portion of the thumb F1 is positioned closer to the longitudinal axis C than the side buttons (41A; 41B). Therefore, the pressing force toward the urging portion 28 can be easily applied to the side button (41A; 41B) by the fingertip side portion of the thumb F1. This facilitates the operation of operating the treatment instrument 1 in the 1 st operation mode.

In the present embodiment, the fingertip portion of the index finger F2 is brought into contact with the ridge portion (45A or 45B) in a state where the operation of the rotary knob 25 and the operation of the front button 43 are not performed. At this time, depending on the size of the hand of the operator, the preference of the operator, the posture of the treatment instrument 1 at the time of treatment, and the like, the tip side portion of the middle finger F3 may be brought into contact with the ridge portion (45A or 45B) instead of the index finger F2. Since the bulge portion 45A is arranged as described above, at least one of the index finger F2 and the middle finger F3 can come into contact with the bulge portion 45A when the housing 3 is held by the right hand (H0). Further, since the ridge portion 45B is disposed as described above, at least one of the index finger F2 and the middle finger F2 can come into contact with the ridge portion 45B when the case 3 is held by the left hand (H0).

In a state where the operation of the rotation knob 25 and the operation of the front button 43 are not performed, the pressing force N1 is applied to the bulge portion (45A; 45B) from the longitudinal axis C toward the side of the urging portion 28 of the handle 27 by the fingertip side portion of the index finger F2 or the middle finger F3. Thus, a rotational moment M1 is generated in the handle 22, which is directed toward the proximal end side with the bulge portion (45A; 45B) to which the pressing force N1 is applied as the center. Here, as described above, the palm H1 abuts the handle 22 from the proximal end side in a state where the housing 3 is held by one hand H0. Therefore, even if the rotation moment M1 is generated, the rotation of the handle 22 by the rotation moment M1 can be suppressed by the palm H1. Therefore, the housing 3 can be stably held by the index finger F2 or the middle finger F3 abutting against the bulge portion (45A; 45B) and the palm H1 abutting against the handle 22 from the proximal end side. Further, since the base end side of the handle 22 is pressed against the palm H1 by the rotation moment M1, the force of gripping the housing 3 with the hand H0 can be reduced. Therefore, by using the housing 3, the generation of fatigue of the operator is suppressed.

By stably holding the housing 3, the end effector 5 is easily moved in the body cavity, and the respective operations of the handle 27, the rotation knob 25, the

side buttons

41A and 41B, and the front button 43 are easily performed. This increases the workability of the treatment.

Further, when the end effector 5 is bent with respect to the shaft 2, an operation at the bend dial (bend operation member) 38 is input with the thumb F1. At this time, the thumb F1 is moved largely from the state where the operation on the curved dial 38 is not performed, and the operation on the curved dial 38 is performed. That is, when the operation of the bending dial 38 is performed, the thumb F1 needs to be moved largely from the state of fig. 6 to the state shown in fig. 7. Since the thumb F1 is moved to a large extent, the handle 22 is not sandwiched between the palm H1 and the thumb F1 in the width direction of the housing 3 in the state of being operated with the bent dial 38. However, at this time, the case 3 is also held in a state where the index finger F2 or the middle finger F3 abuts on the ridge portion (45A; 45B) and the palm H1 abuts on the grip 22 from the proximal end side. Thus, the housing 3 can be stably held as described above. This facilitates the operation of the bending dial 38.

In the present embodiment, the projecting end (1 st position) PA of the raised portion 45A is located closer to the longitudinal axis C than the projecting end (2 nd position) QA of the 1 st side button 41A, and the projecting end (1 st position) PB of the raised portion 45B is located closer to the longitudinal axis C than the projecting end (2 nd position) QB of the 2 nd side button 41B. Therefore, when the housing 3 is held by the right hand (H0), the protruding portion 45A can prevent the index finger F2 or the middle finger F3 from erroneously touching the 1 st side button 41A. That is, the protuberance 45A prevents the 1 st side button 41A from being erroneously operated by the index finger F2 or the middle finger F3. Further, even when the right hand (H0) of the operator holding the housing 3 is large, the bulge portion 45B prevents the thumb F1 from erroneously touching the 2 nd side button 41B. That is, the raised portion 45B can prevent the 2 nd side button 41B from being erroneously operated by the thumb F1.

Similarly, when the housing 3 is held by the left hand (H0), the bulge 45B prevents the index finger F2 or the middle finger F3 from erroneously touching the 2 nd side button 41B. That is, the protrusion 45B prevents the 2 nd side button 41B from being erroneously operated by the index finger F2 or the middle finger F3. Further, even in the case where the left hand (H0) of the operator holding the housing 3 is large, the situation where the thumb F1 erroneously contacts the 1 st side button 41A can be prevented by the bulge portion 45A. That is, the raised portion 45A can prevent the 1 st side button 41A from being erroneously operated by the thumb F1.

In the present embodiment, the acute angle α 1 of the inclined surface 51A of the raised portion 45A is larger than the acute angle β 1 of the inclined surface 53A of the 1 st side button 41A. The acute angle α 2 of the inclined surface 51B of the ridge 45B is larger than the acute angle β 2 of the inclined surface 53B of the 2 nd side button 41B. Therefore, the side buttons (41A; 41B) are further effectively prevented from being erroneously operated by the thumb F1, the index finger F2, and the middle finger F3, respectively.

(modification example)

In addition, in embodiment 1, the curved dial 38 is attached to the base end surface of the housing main body 21, but the position of the curved dial 38 is not limited to this. For example, in modification 1 shown in fig. 8, the curved dial 38 is attached to the housing main body 21 and exposed to the outside of the housing 3 at the 1 st outer surface 31A, the 2 nd outer surface 31B, and the relay outer surface 36. Further, the axis of rotation of the curved dial 38 is substantially parallel to the length axis C. Further, the curved dial 38 is preferably provided at a position where the longitudinal axis C passes through, and more preferably, the rotational axis of the curved dial 38 is substantially coaxial with the longitudinal axis C.

In the present modification, the bending dial 38 as the bending operation member is located closer to the proximal end side than the raised

portions

45A and 45B and closer to the proximal end side than the

side buttons

41A and 41B. Therefore, the operation of the bending dial 38 is performed by the thumb F1 while the housing 3 is held by one hand H0 as described above.

In this modification, the raised

portions

45A and 45B are also provided as in embodiment 1. Therefore, as in embodiment 1, the case 3 can be stably held by the index finger F2 or the middle finger F3 abutting against the raised portion (45A; 45B) and the palm H1 abutting against the grip 22 from the proximal end side. In addition, as in embodiment 1, the protrusions (45A, 45B) effectively prevent the side buttons (41A, 41B) from being erroneously operated by the thumb F1, index finger F2, and middle finger F3, respectively.

In one modification, a rotation knob (25) for rotating the shaft 2 and the end effector 5 about the longitudinal axis C may be provided at a position of the curved dial 38 shown in fig. 8. In this case, the bending dial 38 may be provided at the same position as that of embodiment 1, or the bending dial (bending operation member) 38 may not be provided.

In addition, in the 2 nd modification shown in fig. 9, the rotation knob 25 as the rotation operation member is attached to the base end E1 of the case main body 21. In the present modification, the shaft 2 and the end effector 5 are rotated about the longitudinal axis C together with the rotation knob 25 with respect to the housing 3 by an input operation using the rotation knob 25. Further, a bending dial 38 as a bending operation member is mounted on the rotation knob 25. In the present modification, the rotation knob 25 and the bend dial 38 are located closer to the base end side than the

ridge portions

45A, 45B and closer to the base end side than the

side buttons

41A, 41B. Therefore, the operation of the rotary knob 25 and the operation of the curved dial 38 are performed by the thumb F1 while the housing 3 is held by the one hand H0 as described above.

In this modification, the

protrusions

45A and 45B are also provided as in embodiment 1. Therefore, as in embodiment 1, the case 3 can be stably held by the index finger F2 or the middle finger F3 abutting against the raised portion (45A; 45B) and the palm H1 abutting against the grip 22 from the proximal end side. For example, in the present modification, the grip 22 is not sandwiched between the palm H1 and the thumb F1 in the width direction of the housing 3 in both the state of being operated by the rotation knob 25 and the state of being operated by the bent dial 38. However, at this time, the case 3 is also held in a state where the index finger F2 or the middle finger F3 abuts on the ridge portion (45A; 45B) and the palm H1 abuts on the grip 22 from the proximal end side. Therefore, the housing 3 can be stably held as described above, and the respective operations of the rotation knob 25 and the curved dial 38 are facilitated. In the present modification as well, as in embodiment 1, the raised portions (45A, 45B) effectively prevent the side buttons (41A, 41B) from being erroneously operated by the thumb F1, the index finger F2, and the middle finger F3, respectively.

In addition, in the 3 rd modification shown in fig. 10, the bending dial 38 as the bending operation member is not provided, but the vibrator unit 60 is provided. The vibrator unit 60 is attached to the case main body 21 from the proximal end side. The transducer unit 60 includes a transducer case 61 and an ultrasonic transducer (not shown) provided inside the transducer case 61. In the present modification, one end of the cable 23 is connected to the transducer case 61. In the present modification, a rod member 62 formed of a material having high vibration transmissibility is inserted through the shaft 2. Further, inside the housing main body 21, a rod member 62 is connected to the distal end side of the ultrasonic transducer. In the present modification, the portion of the lever member 62 that protrudes from the shaft 2 toward the distal end side is the 1 st gripping piece 12. The 2 nd gripping piece 13 is rotatably attached to the distal end portion of the shaft 2. In the present modification, the end effector 5 is formed of the

grip pieces

12 and 13, and does not perform a bending operation with respect to the shaft 2 (longitudinal axis C).

In this modification, the

protrusions

In one modification, the ridge portion (45A; 45B) may be provided in a configuration in which neither the bending operation member (38) nor the vibrator unit (60) is provided. In another modification, the raised portion (45A; 45B) may be provided in a configuration in which the rotation operation member (25) is not provided.

In the above-described embodiments and the like, the outer surface (31A; 31B) of the housing (3) is provided with the raised portion (45A; 45B), and the raised portion (45A; 45B) is raised in a direction intersecting the movement surface (T) of the handle (27). The bulge (45A; 45B) is located on the tip side of the grip (22) and between the longitudinal axis (C) and the handle (27). A distance (D4) from the ridge (45A; 45B) to a tip end (E2) of the case main body (21) is smaller than a distance (D3) from the ridge (45A; 45B) to a base end (E1) of the case main body (21), and a distance (D2) from the ridge (45A; 45B) to the handle (27) is smaller than a distance (D1) from the ridge (45A; 45B) to the length axis (C).

While the embodiments of the present invention have been described above, it is needless to say that the present invention is not limited to the above-described embodiments and the like, and various modifications can be made without departing from the gist of the present invention.

Claims

1. A treatment tool, wherein,

the treatment instrument includes:

a shaft having a base end and a tip end, the shaft extending from the base end along a length axis to the tip end;

a housing to which the shaft is attached, the housing including a housing main body extending along the length axis and a handle extending from the housing main body in a direction crossing the length axis, the housing having a1 st outer surface and a 2 nd outer surface facing a side opposite to the 1 st outer surface;

a grip provided at a position closer to a distal end side than the grip, the grip being movable toward a proximal end side or toward the distal end side with respect to the grip along a movement surface that is a virtual plane between the 1 st outer surface and the 2 nd outer surface; and

a protrusion protruding in a direction intersecting the movement surface on the 1 st outer surface, the protrusion being located closer to the distal end side than the handle and located between the longitudinal axis and the handle, the protrusion being located at a distance from the distal end of the case main body smaller than a distance from the proximal end of the case main body, the protrusion being located at a distance from the handle smaller than a distance from the longitudinal axis,

a side button provided on an outer surface of the housing, the side button being adjacent to a base end side of the ridge portion,

the side button comprises a1 st side button on the 1 st outer surface,

the raised portion has a1 st inclined surface inclined with respect to the movement surface in a state in which the 1 st inclined surface extends outward in the direction intersecting the movement surface as the inclined surface extends toward the handle,

the 1 st side push button has a 2 nd inclined surface inclined with respect to the movement surface in a state of extending outward in the direction intersecting the movement surface as extending toward the grip,

a1 st acute angle as an inclination angle of the 1 st inclined surface with respect to the running surface is larger than a 2 nd acute angle as an inclination angle of the 2 nd inclined surface with respect to the running surface.

2. The treatment instrument of claim 1,

the 1 st side button is provided on the base end side of the protuberance and on the distal end side of the grip, and is capable of inputting an operation for operating the treatment instrument, and the distance from the 1 st side button to the handle is smaller than the distance from the 1 st side button to the longitudinal axis.

3. The treatment appliance of claim 2,

a1 st position in the protuberance, which is the largest in distance from the movement surface in the direction intersecting the movement surface, is located at a position closer to one side of the length axis than a 2 nd position in the 1 st side button, which is the largest in distance from the movement surface in the direction intersecting the movement surface.

4. The treatment appliance of claim 2,

in the 1 st side button, the operation of operating the treatment instrument is input by pressing the 2 nd inclined surface toward the side of the handle.

5. The treatment appliance of claim 2,

the housing has a distal end outer surface extending toward the distal end side between the 1 st outer surface and the 2 nd outer surface and provided at a position closer to the distal end side than the 1 st side push button,

the treatment instrument further includes a front button provided on the distal end outer surface at a position closer to the longitudinal axis than the ridge portion, and configured to allow an input of an operation for operating the treatment instrument.

6. The treatment instrument of claim 1,

the treatment instrument further includes a 2 nd raised part raised in the 2 nd outer surface in a direction intersecting the movement surface, the 2 nd raised part being located closer to the distal end side than the handle and between the longitudinal axis and the handle, a distance of the 2 nd raised part from the distal end of the case main body being shorter than a distance of the 2 nd raised part from the base end of the case main body, and a distance of the 2 nd raised part from the handle being shorter than a distance of the 2 nd raised part from the longitudinal axis.

7. The treatment appliance of claim 6,

the side button further includes a 2 nd side button provided on the 2 nd outer surface, and capable of inputting an operation for operating the treatment instrument.

8. The treatment instrument of claim 7,

the 2 nd side push button is provided at a position closer to the base end side than the 2 nd raised portion and closer to the tip end side than the grip, and a distance from the 2 nd side push button to the grip is smaller than a distance from the 2 nd side push button to the longitudinal axis.

9. The treatment appliance of claim 8,

a 3 rd position in the 2 nd rising part, which is the largest in distance from the movement surface in the direction intersecting the movement surface, is located at a position closer to one side of the length axis than a 4 th position in the 2 nd side button, which is the largest in distance from the movement surface in the direction intersecting the movement surface.

10. The treatment appliance of claim 8,

the 2 nd rising portion has a 3 rd inclined surface inclined with respect to the movement surface in a state of extending outward in the direction intersecting the movement surface as extending toward the grip,

the 2 nd side push button has a 4 th inclined surface inclined with respect to the movement surface in a state of extending outward in the direction intersecting the movement surface as extending toward the grip,

a 3 rd acute angle as an inclination angle of the 3 rd inclined face with respect to the running face is larger than a 4 th acute angle as an inclination angle of the 4 th inclined face with respect to the running face.

11. The treatment appliance of claim 10,

in the 2 nd side button, the operation of operating the treatment instrument is input by pressing the 4 th inclined surface toward the side of the handle.

12. The treatment instrument of claim 1,

the treatment instrument further includes:

an end effector provided at a distal end portion of the shaft; and

and an operation member that is attached to the housing main body of the housing, is provided at a portion closer to a base end side than the bulge portion, and can input an operation for operating the end effector.

13. The treatment appliance of claim 12,

the length axis of the shaft passes through the operating member.

14. The treatment instrument of claim 1,

the direction intersecting the motion surface is the same as the width direction of the housing, the width direction intersects the length axis and intersects the extending direction of the handle,

the 1 st outer surface faces one side of the width direction of the housing.

15. A treatment tool, wherein,

the treatment instrument includes:

a housing to which the shaft is attached, the housing including a housing main body extending along the longitudinal axis and a handle extending from the housing main body in a direction intersecting the longitudinal axis, and the housing having a1 st outer surface and a 2 nd outer surface facing a side opposite to the 1 st outer surface, the housing being held by a palm of a user in a state of abutting on the handle from a base end side;

a handle provided at a position closer to a distal end side than the grip, and configured to be hooked by at least 1 of an index finger, a middle finger, a ring finger, and a little finger, the handle being configured to move toward the proximal end side or the distal end side with respect to the grip along a movement surface that is a virtual plane between the 1 st outer surface and the 2 nd outer surface in accordance with an operation force from the hooked finger; and

a raised portion raised in a direction intersecting the movement surface on the 1 st outer surface, provided at a position where at least one of the index finger and the middle finger can be brought into contact, the raised portion being capable of applying a pressing force from the longitudinal axis toward one side of the handle by the index finger or the middle finger,

the side button comprises a1 st side button on the 1 st outer surface,

a1 st acute angle as an inclination angle of the 1 st inclined face with respect to the running face is larger than a 2 nd acute angle as an inclination angle of the 2 nd inclined face with respect to the running face.