JP2001128990A - 電気外科用器具及び電気外科用ツール変換器 - Google Patents
電気外科用器具及び電気外科用ツール変換器Info
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B18/1492—Probes or electrodes therefor having a flexible, catheter-like structure, e.g. for heart ablation
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Abstract
(57)【要約】
【課題】 組織に過大な損傷を与えることなく、必要と
する組織の場所にエネルギー供給を限定できる電気外科
用器具及び電気外科用ツール変換器の提供を課題とす
る。 【解決手段】 電気外科用器具は導電性材料で作られ同
軸伝送線路を構成する同軸の内部及び外部の筒状部材
１、２を持つ。内部部材１は好適には内部部材１の遠位
端１Ｄを超えて突出するツールの作動要素と共に腹腔施
術器具を受けるような寸法に作られる。或いは内部部材
１そのものがその遠位端に作動要素を内蔵することもで
きる。外部部材２は内部部材１の遠位端１Ｄから離れた
場所で内部部材１に接続され、内部及び外部部材の間の
接続点７の遠位側で無線周波（ｒ．ｆ）フィーダ４が内
部部材１に接続される。接続点の間では内部部材１によ
って形成されるか、又はそれに関連する無線周波（ｒ．
ｆ）分離構造が備えられて器具の動作周波数で両接続点
４、７間の直列インピーダンスを形成する。
する組織の場所にエネルギー供給を限定できる電気外科
用器具及び電気外科用ツール変換器の提供を課題とす
る。 【解決手段】 電気外科用器具は導電性材料で作られ同
軸伝送線路を構成する同軸の内部及び外部の筒状部材
１、２を持つ。内部部材１は好適には内部部材１の遠位
端１Ｄを超えて突出するツールの作動要素と共に腹腔施
術器具を受けるような寸法に作られる。或いは内部部材
１そのものがその遠位端に作動要素を内蔵することもで
きる。外部部材２は内部部材１の遠位端１Ｄから離れた
場所で内部部材１に接続され、内部及び外部部材の間の
接続点７の遠位側で無線周波（ｒ．ｆ）フィーダ４が内
部部材１に接続される。接続点の間では内部部材１によ
って形成されるか、又はそれに関連する無線周波（ｒ．
ｆ）分離構造が備えられて器具の動作周波数で両接続点
４、７間の直列インピーダンスを形成する。
Description
【０００１】
【発明の属する技術分野】本発明は電気外科用器具及び
電気外科用ツール変換器に関し、更に詳しくは純粋に機
械的な腹腔施術器具のような外科用器具を電気外科的処
置の目的に変換する装置に関する。
電気外科用ツール変換器に関し、更に詳しくは純粋に機
械的な腹腔施術器具のような外科用器具を電気外科的処
置の目的に変換する装置に関する。
【０００２】
【従来の技術】腹腔施術器具の分野では、電気外科用の
無線周波（ｒ．ｆ）出力を供給して組織を凝固させる機
能がよく知られている。また腹腔施術器具として機械的
操作または機械的機能を行わせることも知られている。
これらの属性を兼ね備えたツールには単電極の器具とし
て使用できる絶縁シャフトを備えた金属性器具が含まれ
る。この様なツールにはいくつかの問題がある。先ず、
単電極でパワーを供給する場合、長い導電性の経路によ
り人等の組織に過大な損傷を与える可能性がある。これ
は特に大きな電流供給を伴う深部での凝固を行う場合に
問題となる。第２の問題は、その様な大きな電流供給を
流すと組織と電極との間の電気的界面に負荷をかけ、組
織に炭化または付着、或いはその両方を引き起こすこと
である。また別の問題として、器具の金属性のシャフト
が、侵入口や他の近接して結合された器具への無線周波
（ｒ．ｆ）エネルギーの容量性結合を引き起こすことで
ある。これらの問題を解決するために従来行われてきた
１つの方法は、双極の器具を使用することである。この
場合、２つの電極が電力を組織に供給するのに使用され
る。これによりパワーの分布が局限され、隣接する組織
への損傷の危険性が軽減される。
無線周波（ｒ．ｆ）出力を供給して組織を凝固させる機
能がよく知られている。また腹腔施術器具として機械的
操作または機械的機能を行わせることも知られている。
これらの属性を兼ね備えたツールには単電極の器具とし
て使用できる絶縁シャフトを備えた金属性器具が含まれ
る。この様なツールにはいくつかの問題がある。先ず、
単電極でパワーを供給する場合、長い導電性の経路によ
り人等の組織に過大な損傷を与える可能性がある。これ
は特に大きな電流供給を伴う深部での凝固を行う場合に
問題となる。第２の問題は、その様な大きな電流供給を
流すと組織と電極との間の電気的界面に負荷をかけ、組
織に炭化または付着、或いはその両方を引き起こすこと
である。また別の問題として、器具の金属性のシャフト
が、侵入口や他の近接して結合された器具への無線周波
（ｒ．ｆ）エネルギーの容量性結合を引き起こすことで
ある。これらの問題を解決するために従来行われてきた
１つの方法は、双極の器具を使用することである。この
場合、２つの電極が電力を組織に供給するのに使用され
る。これによりパワーの分布が局限され、隣接する組織
への損傷の危険性が軽減される。
【０００３】
【発明が解決しようとする課題】しかしこの様な器具は
より複雑であり、鉗子やはさみなどのために可動要素が
必要な場合には特に複雑になる。更に、効果が及ぶ深さ
は電極間の距離によって決まってしまう。
より複雑であり、鉗子やはさみなどのために可動要素が
必要な場合には特に複雑になる。更に、効果が及ぶ深さ
は電極間の距離によって決まってしまう。
【０００４】そこで本発明の目的は、上記の問題点等を
改良した器具を提供することである。
改良した器具を提供することである。
【０００５】
【課題を解決するための手段】本発明の第１の態様によ
れば、電気外科用器具は、近位端と遠位端を備えた細長
い筒状の内部部材であって、前記両端間で直流電流が流
れるように少なくともその内部部材の一部が導電性を有
するものと、細長い筒状の導電性の外装で、内部部材を
取り囲んでいるが内部部材の導電性材料からは間隔を開
けて配置され、電気的に絶縁性のジャケットを形成する
外装であって、内部部材と外装が同軸の伝送線路を構成
し、外装は遠位端よりも近位側の位置で内部部材と電気
的に接続されているものと、外装と内部部材の間の接続
部分よりも遠位側で内部部材に接続されたフィーダと、
内部部材とフィーダおよび内部部材と外装との両接続点
の間の無線周波（ｒ．ｆ）絶縁構造であって、該絶縁構
造が器具の動作周波数において上記両接続点間に直列イ
ンピーダンスを形成するものとを含んで構成される。
れば、電気外科用器具は、近位端と遠位端を備えた細長
い筒状の内部部材であって、前記両端間で直流電流が流
れるように少なくともその内部部材の一部が導電性を有
するものと、細長い筒状の導電性の外装で、内部部材を
取り囲んでいるが内部部材の導電性材料からは間隔を開
けて配置され、電気的に絶縁性のジャケットを形成する
外装であって、内部部材と外装が同軸の伝送線路を構成
し、外装は遠位端よりも近位側の位置で内部部材と電気
的に接続されているものと、外装と内部部材の間の接続
部分よりも遠位側で内部部材に接続されたフィーダと、
内部部材とフィーダおよび内部部材と外装との両接続点
の間の無線周波（ｒ．ｆ）絶縁構造であって、該絶縁構
造が器具の動作周波数において上記両接続点間に直列イ
ンピーダンスを形成するものとを含んで構成される。
【０００６】絶縁構造の形成は動作周波数に依存する。
一般に、絶縁構造は器具の動作周波数に対応した共振周
波数を有する共振要素、又は複数の要素からなる共振ア
センブリによって構成される。比較的高い電気外科用の
周波数、例えば３００ＭＨｚ以上の場合は、上記の絶縁
構造は内装と外装及び内装とフィーダとの両接続点の間
にある内部部材の区間から構成され、この区間はｍλ／
４という電気的な長さを持つ。ここでｍは奇数であり、
λは問題の動作周波数に関係付けられた波長である。こ
の区間の近位側の端では、少なくとも高周波において外
装が内装部材に対して結合されているので、この区間が
フィーダとの接続点で高いインピーダンスを形成するイ
ンピーダンス変成器として働く。低い周波数では、外装
及びフィーダへの両接続点の間にある内部部材の区間で
形成されるインダクタンスのような集中要素が好まし
く、この内部部材の区間がフェライトリングのような透
磁率の高い材料で覆われていることが望ましい。共振コ
ンデンサが、例えば外装からなる接地部分と内部部材に
接続されたフィーダの導電体との間に結合され、動作周
波数での並列共振構造を構成する。
一般に、絶縁構造は器具の動作周波数に対応した共振周
波数を有する共振要素、又は複数の要素からなる共振ア
センブリによって構成される。比較的高い電気外科用の
周波数、例えば３００ＭＨｚ以上の場合は、上記の絶縁
構造は内装と外装及び内装とフィーダとの両接続点の間
にある内部部材の区間から構成され、この区間はｍλ／
４という電気的な長さを持つ。ここでｍは奇数であり、
λは問題の動作周波数に関係付けられた波長である。こ
の区間の近位側の端では、少なくとも高周波において外
装が内装部材に対して結合されているので、この区間が
フィーダとの接続点で高いインピーダンスを形成するイ
ンピーダンス変成器として働く。低い周波数では、外装
及びフィーダへの両接続点の間にある内部部材の区間で
形成されるインダクタンスのような集中要素が好まし
く、この内部部材の区間がフェライトリングのような透
磁率の高い材料で覆われていることが望ましい。共振コ
ンデンサが、例えば外装からなる接地部分と内部部材に
接続されたフィーダの導電体との間に結合され、動作周
波数での並列共振構造を構成する。
【０００７】例えば３００ＭＨｚを超える高い動作周波
数と３００ＭＨｚよりも低い動作周波という２つの非常
に離れた周波数で、内部部材の近位側端部をフィーダの
接続から絶縁する絶縁構造を構成することが可能であ
る。前記２つの周波数は典型的にはそれぞれ２．４５Ｇ
Ｈｚと５ＭＨｚである。この場合、互いに電気的に直列
に配置された内部部材の２つの区間は、それぞれ高い周
波数と低い周波数での共振アセンブリ、又は共振ユニッ
トの要素を構成する。第１の区間は、内部部材から外装
への接続点と、内部部材と外装との間の減結合容量との
間に延設することができ、第２の区間は減結合容量と外
装から内部部材への直流接続点との間に延設される。こ
の後者の接続点は内部部材の遠位端から最も離れた位置
にある。第１の区間は上で説明した電気的な長さで４分
の１波長の長さを持ち、一方、第２の区間は透磁率の高
い材料で覆われており、その結果、２つの区間はそれぞ
れ高い周波数と低い周波数での絶縁のためにインピーダ
ンス変成器及び直列インダクタンスを形成する。減結合
容量は、高い周波数では外装と内部部材の間の低インピ
ーダンス接続を可能にするが、低い周波数ではそうでは
ないことが理解されるであろう。低い周波数では、第１
の区間は低い直列インピーダンスとして働くのである。
数と３００ＭＨｚよりも低い動作周波という２つの非常
に離れた周波数で、内部部材の近位側端部をフィーダの
接続から絶縁する絶縁構造を構成することが可能であ
る。前記２つの周波数は典型的にはそれぞれ２．４５Ｇ
Ｈｚと５ＭＨｚである。この場合、互いに電気的に直列
に配置された内部部材の２つの区間は、それぞれ高い周
波数と低い周波数での共振アセンブリ、又は共振ユニッ
トの要素を構成する。第１の区間は、内部部材から外装
への接続点と、内部部材と外装との間の減結合容量との
間に延設することができ、第２の区間は減結合容量と外
装から内部部材への直流接続点との間に延設される。こ
の後者の接続点は内部部材の遠位端から最も離れた位置
にある。第１の区間は上で説明した電気的な長さで４分
の１波長の長さを持ち、一方、第２の区間は透磁率の高
い材料で覆われており、その結果、２つの区間はそれぞ
れ高い周波数と低い周波数での絶縁のためにインピーダ
ンス変成器及び直列インダクタンスを形成する。減結合
容量は、高い周波数では外装と内部部材の間の低インピ
ーダンス接続を可能にするが、低い周波数ではそうでは
ないことが理解されるであろう。低い周波数では、第１
の区間は低い直列インピーダンスとして働くのである。
【０００８】内部部材の導電性材料と外装の導電性材料
との間の絶縁ジャケットは２つの機能を果たすことがで
き、内部導体としての内部部材と外部シールドとしての
外装とからなる同軸伝送線路の絶縁性媒体を構成するだ
けでなく、器具が内視鏡として使われる時には、内部部
材の遠位端に隣接する施術部位を照明し或いはその部位
を観察するための光学的経路としての役割も果たすこと
ができる。従って、内部部材と外装との間隙にはガラス
または透明プラスティックのような誘電性光学材料を筒
状、棒状または繊維状に成形して充填することが出来
る。この光学材料は外装の中で内部部材を支持する機能
を果たすこともできる。
との間の絶縁ジャケットは２つの機能を果たすことがで
き、内部導体としての内部部材と外部シールドとしての
外装とからなる同軸伝送線路の絶縁性媒体を構成するだ
けでなく、器具が内視鏡として使われる時には、内部部
材の遠位端に隣接する施術部位を照明し或いはその部位
を観察するための光学的経路としての役割も果たすこと
ができる。従って、内部部材と外装との間隙にはガラス
または透明プラスティックのような誘電性光学材料を筒
状、棒状または繊維状に成形して充填することが出来
る。この光学材料は外装の中で内部部材を支持する機能
を果たすこともできる。
【０００９】本発明の第２の態様によれば、最低でも３
００ＭＨｚの動作周波数で行う電気外科的処置用の電気
外科用器具が提供される。この電気外科用器具は、機械
的または光学的な機能を持つ要素を収容する内腔と、内
腔の遠位端にあって内腔と電気的に結合された電極と、
内腔の周囲に同軸的に配置され、内腔の遠位端に隣接す
る遠位端を有する細長い導電性の外装であって、外装と
内腔とが組み合わされて同軸伝送線路を形成するように
絶縁層（これは空気であっても良い）を取り囲む寸法に
作られているものと、外装内での電気外科用電流の流れ
を制約するために、外装の遠位端に関係付けられた絶縁
構造とを含んで構成される。
００ＭＨｚの動作周波数で行う電気外科的処置用の電気
外科用器具が提供される。この電気外科用器具は、機械
的または光学的な機能を持つ要素を収容する内腔と、内
腔の遠位端にあって内腔と電気的に結合された電極と、
内腔の周囲に同軸的に配置され、内腔の遠位端に隣接す
る遠位端を有する細長い導電性の外装であって、外装と
内腔とが組み合わされて同軸伝送線路を形成するように
絶縁層（これは空気であっても良い）を取り囲む寸法に
作られているものと、外装内での電気外科用電流の流れ
を制約するために、外装の遠位端に関係付けられた絶縁
構造とを含んで構成される。
【００１０】本発明の第２の態様によれば、最低でも３
００ＭＨｚの動作周波数での電気外科的処置を行うため
に、細長い外科用ツールを電気外科用器具に変換する電
気外科用ツール変換器が提供される。この電気外科用ツ
ール変換器は、内腔の開放した遠位端を超えて露出して
内腔と電気的に結合した電極を形成する作動要素を備え
たツールを受け入れる細長い導電性の内腔と、内腔の周
囲に同軸的に配置され、内腔の遠位端に隣接する遠位端
を有する導電性の細長い外装であって、外装と内腔とが
組み合わされて同軸の伝送線路を形成するように絶縁層
を取り囲む寸法に作られているものと、外装内での電気
外科用電流の流れを制約するように外装の遠位端に関係
付けられた絶縁構造とを含んで構成される。
００ＭＨｚの動作周波数での電気外科的処置を行うため
に、細長い外科用ツールを電気外科用器具に変換する電
気外科用ツール変換器が提供される。この電気外科用ツ
ール変換器は、内腔の開放した遠位端を超えて露出して
内腔と電気的に結合した電極を形成する作動要素を備え
たツールを受け入れる細長い導電性の内腔と、内腔の周
囲に同軸的に配置され、内腔の遠位端に隣接する遠位端
を有する導電性の細長い外装であって、外装と内腔とが
組み合わされて同軸の伝送線路を形成するように絶縁層
を取り囲む寸法に作られているものと、外装内での電気
外科用電流の流れを制約するように外装の遠位端に関係
付けられた絶縁構造とを含んで構成される。
【００１１】上記の絶縁構造は平衡不平衡変成器を含む
ことができるが、これは通常は４分の１波長スリーブに
よる平衡不平衡変成器である。この１波長スリーブによ
る平衡不平衡変成器は、例えば鉗子の爪の対、又ははさ
みの刃の対のような器具の作動要素が取り付けられる外
装の遠位端領域において、十分に平衡が取れた給電点を
生じさせる。本発明の好適な例では、外装は、動作周波
数での電流に関して、近位側で内腔に結合される。そし
て内腔それ自身は、外装への結合点から軸方向に離れた
場所で給電構造に結合されている。この軸方向の間隔
は、動作周波数で内腔が外装に電気的に短絡され、外装
と内腔は動作周波数で給電構造から絶縁される様な間隔
とする。通常、外装−内腔間結合と給電構造の内腔への
結合点との間の距離は４分の１波長であり、この場合の
波長は、外装と内腔とで構成される伝送線路での電気外
科用エネルギーの電気的な波長である。
ことができるが、これは通常は４分の１波長スリーブに
よる平衡不平衡変成器である。この１波長スリーブによ
る平衡不平衡変成器は、例えば鉗子の爪の対、又ははさ
みの刃の対のような器具の作動要素が取り付けられる外
装の遠位端領域において、十分に平衡が取れた給電点を
生じさせる。本発明の好適な例では、外装は、動作周波
数での電流に関して、近位側で内腔に結合される。そし
て内腔それ自身は、外装への結合点から軸方向に離れた
場所で給電構造に結合されている。この軸方向の間隔
は、動作周波数で内腔が外装に電気的に短絡され、外装
と内腔は動作周波数で給電構造から絶縁される様な間隔
とする。通常、外装−内腔間結合と給電構造の内腔への
結合点との間の距離は４分の１波長であり、この場合の
波長は、外装と内腔とで構成される伝送線路での電気外
科用エネルギーの電気的な波長である。
【００１２】給電構造と外装における各不連続部、特に
外装の遠位端、との間の軸方向の距離は、外装と内腔で
構成される伝送線路が給電構造と同じ特性インピーダン
スを持たなくてもよいように、対応する電気的な長さが
半波長、又はその整数倍となるようにすることが好まし
い。λ／２の整数倍の構造とすることにより、給電構造
から離れた端で給電構造の特性インピーダンスにほぼ対
応した電源インピーダンスが得られる。事実、例えば外
装が直径の異なる部分を持つことにより異なる特性イン
ピーダンスを持つ複数の区間を有するように伝送線路を
構成することが可能である。その様な状況では、各区間
はλ／２の整数倍である電気的な長さを持つことが好ま
しい。
外装の遠位端、との間の軸方向の距離は、外装と内腔で
構成される伝送線路が給電構造と同じ特性インピーダン
スを持たなくてもよいように、対応する電気的な長さが
半波長、又はその整数倍となるようにすることが好まし
い。λ／２の整数倍の構造とすることにより、給電構造
から離れた端で給電構造の特性インピーダンスにほぼ対
応した電源インピーダンスが得られる。事実、例えば外
装が直径の異なる部分を持つことにより異なる特性イン
ピーダンスを持つ複数の区間を有するように伝送線路を
構成することが可能である。その様な状況では、各区間
はλ／２の整数倍である電気的な長さを持つことが好ま
しい。
【００１３】３００ＭＨｚと１００ＧＨｚの間の周波数
で電気外科用パワーを供給することにより、いくつかの
利点が得られる。電気外科用エネルギーはほとんど誘電
体によって伝播され、そのため電極と組織との間の導電
性の界面は低周波の場合に比べてあまり重要ではない。
電場を制約することにより、小さな電極で比較的大きな
範囲を処置できるように、処置範囲を定めることができ
る。コスト上の利点のためには、特に鉗子の様な操作可
能な器具に関して、作動要素はコストの高い金属製作技
術ではなく埋め込み導体を有する誘電体で構成できる。
ＵＨＦエネルギーの吸収、特にＩＳＭ（産業／科学／医
療）用周波数である２４５０ＭＨｚでのエネルギーの吸
収は水分によって決まるが、このことは変動しやすい組
織の性能が事実上排除されることを意味する。例えば通
常の低周波数での電気外科処置では、導電性によって性
能が決定される。脂肪の導電性は血液や胆汁のような導
電性の高い体液の数分の１に過ぎない場合がある。しか
し水分の値は余り違わず、従ってＵＨＦ性能はそれほど
変動しない。
で電気外科用パワーを供給することにより、いくつかの
利点が得られる。電気外科用エネルギーはほとんど誘電
体によって伝播され、そのため電極と組織との間の導電
性の界面は低周波の場合に比べてあまり重要ではない。
電場を制約することにより、小さな電極で比較的大きな
範囲を処置できるように、処置範囲を定めることができ
る。コスト上の利点のためには、特に鉗子の様な操作可
能な器具に関して、作動要素はコストの高い金属製作技
術ではなく埋め込み導体を有する誘電体で構成できる。
ＵＨＦエネルギーの吸収、特にＩＳＭ（産業／科学／医
療）用周波数である２４５０ＭＨｚでのエネルギーの吸
収は水分によって決まるが、このことは変動しやすい組
織の性能が事実上排除されることを意味する。例えば通
常の低周波数での電気外科処置では、導電性によって性
能が決定される。脂肪の導電性は血液や胆汁のような導
電性の高い体液の数分の１に過ぎない場合がある。しか
し水分の値は余り違わず、従ってＵＨＦ性能はそれほど
変動しない。
【００１４】上で述べた近位側のトラップと遠位端の平
衡不平衡変成器により、ＵＨＦ動作周波数では電気外科
用電流を器具の選択された領域に隔離することができ
る。従って、例えば内腔と外装がそれらの全長を通じて
導電性を持っているために、器具がその構造全体で電気
的に連続していたとしても、選択された領域だけが電気
外科用の電流と電圧を帯びる。例えば、器具、或いは器
具と挿入された電気外科用でないツールとの組み合わせ
は、処置範囲と電気的に導通している露出した金属製の
握り部またはハンドルを持っていても、使用者に危険は
無い。このことはまた、ツールが内腔の内に収容される
ロッドアクチュエータ等を含んで、完全に金属だけで作
られていても良く、また従ってより堅固に製作できるこ
とを意味する。
衡不平衡変成器により、ＵＨＦ動作周波数では電気外科
用電流を器具の選択された領域に隔離することができ
る。従って、例えば内腔と外装がそれらの全長を通じて
導電性を持っているために、器具がその構造全体で電気
的に連続していたとしても、選択された領域だけが電気
外科用の電流と電圧を帯びる。例えば、器具、或いは器
具と挿入された電気外科用でないツールとの組み合わせ
は、処置範囲と電気的に導通している露出した金属製の
握り部またはハンドルを持っていても、使用者に危険は
無い。このことはまた、ツールが内腔の内に収容される
ロッドアクチュエータ等を含んで、完全に金属だけで作
られていても良く、また従ってより堅固に製作できるこ
とを意味する。
【００１５】外装は通常、近位側に備えられた側部開口
部から、同軸伝送線路によって或いは５ＧＨｚを超える
周波数では導波管によって供給される。内腔と外装の間
の環状の断面空間には、照明及び観察のための光ファイ
バー、又はロッドレンズを含む誘電性媒体と、流体の注
入または取り出しのための流体通路を収納できる。上で
述べたＵＨＦ電気外科用エネルギーの選択的な結合によ
り、標準的な腹腔施術器具または内視鏡を、組織に対す
る電気外科的用途に変換することが可能になる。本発明
はまた、腹腔施術用の電気外科用器具にも適用可能であ
る。従って本発明によれば、上記ツール変換器と内腔の
中に収納された外科用ツールの組み合わせからなる電気
外科用器具が提供できる。そしてこの場合、前記外科用
ツールは内腔の遠位端から突出して組織の電気外科的処
置用の電極を形成する作動要素と、内腔の近位端から突
出した握り部を備えている。
部から、同軸伝送線路によって或いは５ＧＨｚを超える
周波数では導波管によって供給される。内腔と外装の間
の環状の断面空間には、照明及び観察のための光ファイ
バー、又はロッドレンズを含む誘電性媒体と、流体の注
入または取り出しのための流体通路を収納できる。上で
述べたＵＨＦ電気外科用エネルギーの選択的な結合によ
り、標準的な腹腔施術器具または内視鏡を、組織に対す
る電気外科的用途に変換することが可能になる。本発明
はまた、腹腔施術用の電気外科用器具にも適用可能であ
る。従って本発明によれば、上記ツール変換器と内腔の
中に収納された外科用ツールの組み合わせからなる電気
外科用器具が提供できる。そしてこの場合、前記外科用
ツールは内腔の遠位端から突出して組織の電気外科的処
置用の電極を形成する作動要素と、内腔の近位端から突
出した握り部を備えている。
【００１６】この器具は、また比較的低い周波数、即ち
３００ＭＨｚ未満、通常は１００ＫＨｚと４０ＭＨｚの
間で動作するようにすることもできる。この場合、チョ
ークが、外装と内腔とで形成された伝送線路の近位側端
で、内腔の周囲に配置される。これによって低周波の電
気外科用電流が、内腔或いは内腔の中に収容された外科
用ツールのシャフトを伝わって近位側に流れるのを防止
する。同じ給電構造を低周波数及びＵＨＦの電気外科用
エネルギーの供給に使用できる。チョークは集中インピ
ーダンス回路を構成し、また組織から給電構造に接続さ
れた無線周波（ｒ．ｆ）発生源に戻る帰還経路は、患者
と接地されているであろう帰還導体との間の浮遊容量を
経由する。
３００ＭＨｚ未満、通常は１００ＫＨｚと４０ＭＨｚの
間で動作するようにすることもできる。この場合、チョ
ークが、外装と内腔とで形成された伝送線路の近位側端
で、内腔の周囲に配置される。これによって低周波の電
気外科用電流が、内腔或いは内腔の中に収容された外科
用ツールのシャフトを伝わって近位側に流れるのを防止
する。同じ給電構造を低周波数及びＵＨＦの電気外科用
エネルギーの供給に使用できる。チョークは集中インピ
ーダンス回路を構成し、また組織から給電構造に接続さ
れた無線周波（ｒ．ｆ）発生源に戻る帰還経路は、患者
と接地されているであろう帰還導体との間の浮遊容量を
経由する。
【００１７】
【発明の実施の形態】以下、本発明の実施の形態を添付
図面を参照しながら説明する。
図面を参照しながら説明する。
【００１８】図１において、腹腔施術用ツールを電気外
科用器具に変換する装置は、細長い導電性の筒状の内腔
１と、内腔１の周囲に同軸的に配設されて内腔１の遠位
端１Ｄに隣接する遠位端２Ｄを有する細長い導電性の外
装２とからなる。外装２は絶縁層３を取り囲む寸法に作
られ、これによって外装２と内腔１とで給電構造４から
外装２の遠位端２Ｄに延びる同軸伝送線路を構成する。
ここで内腔１は遠位端１Ｄで終端となる突出遠位端部を
持つ。外装２の遠位端は絶縁構造として構成され、本形
態では、外装はその筒状本体６内に筒５として形成され
た小径の内側遠位端部を有する。筒５はその近位側の外
周で本体６に電気的に接続され、本体６と内側部５と
が、それらの間に薄い環状の空間Ｓを持って、重なった
形状とされる。この空間Ｓは主要な外装２内空間３内の
媒体とは誘電率が異なる材料（図示せず）で充填される
ことができる。重なり部分の電気的な長さは４分の１波
長、或いは４分の１波長の奇数倍とし、それにより内側
の筒５と重なる場所における外装２の本体６がスリーブ
状平衡不平衡変成器を構成する。このスリーブ状平衡不
平衡変成器は、内腔１が外装の遠位端２Ｄから出てくる
位置で、通常、平衡状態を促進する。この構造が外装２
の近位端２Ｐと内腔１の間の低インピーダンス接続７
（この場合は短絡）と組み合わされることによって、電
気外科用の電場が内腔１の遠位端１Ｄで生じ、一方、外
装２は平衡不平衡変成器の近位側の外全長にわたって実
質的に大地電位に維持される。
科用器具に変換する装置は、細長い導電性の筒状の内腔
１と、内腔１の周囲に同軸的に配設されて内腔１の遠位
端１Ｄに隣接する遠位端２Ｄを有する細長い導電性の外
装２とからなる。外装２は絶縁層３を取り囲む寸法に作
られ、これによって外装２と内腔１とで給電構造４から
外装２の遠位端２Ｄに延びる同軸伝送線路を構成する。
ここで内腔１は遠位端１Ｄで終端となる突出遠位端部を
持つ。外装２の遠位端は絶縁構造として構成され、本形
態では、外装はその筒状本体６内に筒５として形成され
た小径の内側遠位端部を有する。筒５はその近位側の外
周で本体６に電気的に接続され、本体６と内側部５と
が、それらの間に薄い環状の空間Ｓを持って、重なった
形状とされる。この空間Ｓは主要な外装２内空間３内の
媒体とは誘電率が異なる材料（図示せず）で充填される
ことができる。重なり部分の電気的な長さは４分の１波
長、或いは４分の１波長の奇数倍とし、それにより内側
の筒５と重なる場所における外装２の本体６がスリーブ
状平衡不平衡変成器を構成する。このスリーブ状平衡不
平衡変成器は、内腔１が外装の遠位端２Ｄから出てくる
位置で、通常、平衡状態を促進する。この構造が外装２
の近位端２Ｐと内腔１の間の低インピーダンス接続７
（この場合は短絡）と組み合わされることによって、電
気外科用の電場が内腔１の遠位端１Ｄで生じ、一方、外
装２は平衡不平衡変成器の近位側の外全長にわたって実
質的に大地電位に維持される。
【００１９】無線周波（ｒ．ｆ）給電構造４は同軸フィ
ーダからなり、その内部導体４Ｉは外装２の側部開口部
８を通って、低インピーダンス接続点７から離れた位置
で内腔１と接続される。この間隔（Ｂ）は４分の１波長
ｍλ／４（ｍは好適には１に等しい）の奇数倍とし、内
腔１を給電構造４から離れた場所で大地から絶縁できる
ようにし、内腔１はその近位端において無線周波（ｒ．
ｆ）給電４のスクリーンに接続された外装２との接続に
より接地される。
ーダからなり、その内部導体４Ｉは外装２の側部開口部
８を通って、低インピーダンス接続点７から離れた位置
で内腔１と接続される。この間隔（Ｂ）は４分の１波長
ｍλ／４（ｍは好適には１に等しい）の奇数倍とし、内
腔１を給電構造４から離れた場所で大地から絶縁できる
ようにし、内腔１はその近位端において無線周波（ｒ．
ｆ）給電４のスクリーンに接続された外装２との接続に
より接地される。
【００２０】給電構造またはフィーダ４の特性インピー
ダンスは通常は５０Ωである。内腔１と外装２（内側の
遠位端部５を含む）によって形成される伝送線路は、２
つの異なる特性インピーダンスを有する２つの区間を持
っている。第１の区間はフィーダ４から内側部５の近位
縁まで延び、通常は１０Ω以下である第１の特性インピ
ーダンスを持っている。第２の区間は外装２の遠位端部
５で構成され、第１の区間の場合よりも多少低い第２の
特性インピーダンスを持つ。これらの特性インピーダン
スは、フィーダ４の特性インピーダンスとは異なり、ま
た互いに異なり、内側部５の電気的長さ及び外装２の無
線周波（ｒ．ｆ）給電点から遠位端２Ｄまでの電気的長
さは、λ／２の整数倍である（ここで整数倍とは、１以
上の任意の整数を意味する）。これにより少なくとも近
似的には、遠位端２Ｄでの動作インピーダンスはフィー
ダ４でのインピーダンスに等しくなる。内腔１の内部経
路１Ｐは、鉗子、はさみ、又は内視鏡のような腹腔施術
用ツールを受け入れるような寸法とする。当該技術分野
に習熟した者にとっては他の可能性も明白であろう。ツ
ールは、図示してないが、組織の電気外科処置のための
能動電極を形成するように、ツールの作動要素または作
動部分が内腔１の遠位端１Ｄから突出すると共に内腔１
に電気的に結合しているといった形で取り付けられてい
る。
ダンスは通常は５０Ωである。内腔１と外装２（内側の
遠位端部５を含む）によって形成される伝送線路は、２
つの異なる特性インピーダンスを有する２つの区間を持
っている。第１の区間はフィーダ４から内側部５の近位
縁まで延び、通常は１０Ω以下である第１の特性インピ
ーダンスを持っている。第２の区間は外装２の遠位端部
５で構成され、第１の区間の場合よりも多少低い第２の
特性インピーダンスを持つ。これらの特性インピーダン
スは、フィーダ４の特性インピーダンスとは異なり、ま
た互いに異なり、内側部５の電気的長さ及び外装２の無
線周波（ｒ．ｆ）給電点から遠位端２Ｄまでの電気的長
さは、λ／２の整数倍である（ここで整数倍とは、１以
上の任意の整数を意味する）。これにより少なくとも近
似的には、遠位端２Ｄでの動作インピーダンスはフィー
ダ４でのインピーダンスに等しくなる。内腔１の内部経
路１Ｐは、鉗子、はさみ、又は内視鏡のような腹腔施術
用ツールを受け入れるような寸法とする。当該技術分野
に習熟した者にとっては他の可能性も明白であろう。ツ
ールは、図示してないが、組織の電気外科処置のための
能動電極を形成するように、ツールの作動要素または作
動部分が内腔１の遠位端１Ｄから突出すると共に内腔１
に電気的に結合しているといった形で取り付けられてい
る。
【００２１】ＵＨＦ以上での電気外科用パワーの結合
は、内腔１と挿入されたツールの間の容量結合または電
磁結合によって間接的に行える。かかる外科用ツールは
通常はステンレス鋼で作られるが、このステンレス鋼は
導電体としては比較的劣る材料である。内腔１は銀また
は銅で外面がメッキされる。或いは内腔１が外科用ツー
ル自体のシャフトを構成する場合は、そのシャフトに銀
または銅でメッキされた外側層を持たせてもよい。外装
２は、低損失の誘電性スペーサ（図示せず）によって内
腔１から分離することができ、或いは空間３は誘電性の
光ファイバーまたはロッドで満たしてもよい。この誘電
性の光ファイバーまたはロッドは、施術部位の照明また
は観察、乃至その両方の光学的機能を行うだけでなく、
外装２内での内腔１の支持も行う。
は、内腔１と挿入されたツールの間の容量結合または電
磁結合によって間接的に行える。かかる外科用ツールは
通常はステンレス鋼で作られるが、このステンレス鋼は
導電体としては比較的劣る材料である。内腔１は銀また
は銅で外面がメッキされる。或いは内腔１が外科用ツー
ル自体のシャフトを構成する場合は、そのシャフトに銀
または銅でメッキされた外側層を持たせてもよい。外装
２は、低損失の誘電性スペーサ（図示せず）によって内
腔１から分離することができ、或いは空間３は誘電性の
光ファイバーまたはロッドで満たしてもよい。この誘電
性の光ファイバーまたはロッドは、施術部位の照明また
は観察、乃至その両方の光学的機能を行うだけでなく、
外装２内での内腔１の支持も行う。
【００２２】外装２の直径は、主に必要とされる特性イ
ンピーダンスによって支配される。図１は模式的なもの
であり、正しい縮尺の図ではないことに留意すべきであ
る。特性インピーダンスが５０Ω以上の場合は、外装２
の内径Ｅと内腔１の外径Ｆの比は非常に大きく、図１に
示した構造がその中に挿入された外科用ツールの３倍も
の直径を持つことがある。内腔１と外装２の間の空間３
が光ファイバーまたは流体の管のために利用される場合
は、この大きな比が有利であろう。しかし凝固性能は低
い特性インピーダンスの使用によって改善されることが
多く、対象となる組織のインピーダンスは通常５０Ω未
満である。この様な状況では、外装２の内径Ｅと内腔１
の外径Ｆとの比（Ｅ／Ｆ）を小さくすることができる。
実際、外装２の特性インピーダンスは１０Ω程度まで小
さくでき、その結果、内腔１（通常４フレンチ又は５フ
レンチのツールを収納する）の外径Ｆよりも器具の直径
がわずか２０％から３０％ほど大きいだけとなる。
ンピーダンスによって支配される。図１は模式的なもの
であり、正しい縮尺の図ではないことに留意すべきであ
る。特性インピーダンスが５０Ω以上の場合は、外装２
の内径Ｅと内腔１の外径Ｆの比は非常に大きく、図１に
示した構造がその中に挿入された外科用ツールの３倍も
の直径を持つことがある。内腔１と外装２の間の空間３
が光ファイバーまたは流体の管のために利用される場合
は、この大きな比が有利であろう。しかし凝固性能は低
い特性インピーダンスの使用によって改善されることが
多く、対象となる組織のインピーダンスは通常５０Ω未
満である。この様な状況では、外装２の内径Ｅと内腔１
の外径Ｆとの比（Ｅ／Ｆ）を小さくすることができる。
実際、外装２の特性インピーダンスは１０Ω程度まで小
さくでき、その結果、内腔１（通常４フレンチ又は５フ
レンチのツールを収納する）の外径Ｆよりも器具の直径
がわずか２０％から３０％ほど大きいだけとなる。
【００２３】好適には、中間の特性インピーダンスを持
つ伝送線路からなる４分の１波長の変成器区間（図示せ
ず）を５０Ωのフィーダ４と開口部８の間に直列に挿入
し、外装２と内腔１の組み合わせの特性インピーダンス
を前記フィーダ４の特性インピーダンスにマッチングす
る。この変成器は外装２を含むツール変換器構造の中に
組み込まれたフィーダ自体の一部であってもよい。これ
により、例えこれらの影響が上記の半波長構造の使用に
よって改善されるとしても、インピーダンスが適合して
いない場合に生じる定在波の発生を回避できる。当該技
術分野でよく知られているように、かかる変成器（図示
せず）のインピーダンスはマッチングされた２つのイン
ピーダンスの幾何平均である。
つ伝送線路からなる４分の１波長の変成器区間（図示せ
ず）を５０Ωのフィーダ４と開口部８の間に直列に挿入
し、外装２と内腔１の組み合わせの特性インピーダンス
を前記フィーダ４の特性インピーダンスにマッチングす
る。この変成器は外装２を含むツール変換器構造の中に
組み込まれたフィーダ自体の一部であってもよい。これ
により、例えこれらの影響が上記の半波長構造の使用に
よって改善されるとしても、インピーダンスが適合して
いない場合に生じる定在波の発生を回避できる。当該技
術分野でよく知られているように、かかる変成器（図示
せず）のインピーダンスはマッチングされた２つのイン
ピーダンスの幾何平均である。
【００２４】図１の装置の変形例を図２に示す。図２に
おいては、４分の１波長の平衡不平衡変成器が図１とは
異なる構成になっている。それで外装２はフィーダ４と
外装２の遠位端２Ｄの間で一定の内径Ｅとなっている。
図１における内側の遠位端の代わりに、外装２には該外
装２の本体６に電気的に接続された１つの縁を持つ４分
の１波長スリーブ１５が設けられている。スリーブ１５
の他方の縁は開路とされている。２つの部材（６と１
５）の間の薄い環状の空間Ｓの電気的長さは、軸方向に
λ／４に等しくされる。この場合も、外装２は平衡不平
衡変成器の区間からある距離だけ遠位側に突出し、内腔
１は環状の絶縁物１６によって支持されている外装の遠
位端２Ｄから先に突出する。本例においても、外装２に
おけるフィーダ４と遠位端２Ｄの間の全電気的な長さ
は、好適には半波長の整数倍である。
おいては、４分の１波長の平衡不平衡変成器が図１とは
異なる構成になっている。それで外装２はフィーダ４と
外装２の遠位端２Ｄの間で一定の内径Ｅとなっている。
図１における内側の遠位端の代わりに、外装２には該外
装２の本体６に電気的に接続された１つの縁を持つ４分
の１波長スリーブ１５が設けられている。スリーブ１５
の他方の縁は開路とされている。２つの部材（６と１
５）の間の薄い環状の空間Ｓの電気的長さは、軸方向に
λ／４に等しくされる。この場合も、外装２は平衡不平
衡変成器の区間からある距離だけ遠位側に突出し、内腔
１は環状の絶縁物１６によって支持されている外装の遠
位端２Ｄから先に突出する。本例においても、外装２に
おけるフィーダ４と遠位端２Ｄの間の全電気的な長さ
は、好適には半波長の整数倍である。
【００２５】図３は通常５ＧＨｚよりも高い周波数で使
用される別の例であり、導波管フィーダ４Ｗを有するも
のを示す。この導波管の横断面寸法は動作周波数に反比
例する。導波管内には、寸法を更に小さくするために、
空気よりも誘電率の高い低損失の誘電体を充填してもよ
い。導波管フィーダ４Ｗからのエネルギーは外装２の側
部開口部８Ｗを通じて同軸伝送線路に結合され、それに
より内腔１と外装２の組み合わせにより構成された伝送
線路に結合される。短絡された端部を有する筒状の側部
スタブ２０は２タイプの伝送線路の間のマッチングを行
う。
用される別の例であり、導波管フィーダ４Ｗを有するも
のを示す。この導波管の横断面寸法は動作周波数に反比
例する。導波管内には、寸法を更に小さくするために、
空気よりも誘電率の高い低損失の誘電体を充填してもよ
い。導波管フィーダ４Ｗからのエネルギーは外装２の側
部開口部８Ｗを通じて同軸伝送線路に結合され、それに
より内腔１と外装２の組み合わせにより構成された伝送
線路に結合される。短絡された端部を有する筒状の側部
スタブ２０は２タイプの伝送線路の間のマッチングを行
う。
【００２６】状況によっては、同一の器具を使ってＵＨ
Ｆ以上の周波数ともっと低い周波数の両方の電気外科用
エネルギーを、施術用電極に供給できることが有利な場
合もある。実際、両方の周波数成分を同時に供給するこ
とは有利であろう。図４の例ではこれが可能となる。こ
の例は図２に示した例と類似しているが、フィーダ４か
ら中央内腔１への接続と外装２の近位端での内腔との間
における高い直列インピーダンス成分という特徴が付け
加わっている。低周波数（通常１００ＫＨｚから４０Ｍ
Ｈｚ）だけでなく３００ＭＨｚまでの周波数で動作させ
るために、内腔１の内面と挿入された器具のシャフトの
間に導電性の経路が設けられる（図示せず）。
Ｆ以上の周波数ともっと低い周波数の両方の電気外科用
エネルギーを、施術用電極に供給できることが有利な場
合もある。実際、両方の周波数成分を同時に供給するこ
とは有利であろう。図４の例ではこれが可能となる。こ
の例は図２に示した例と類似しているが、フィーダ４か
ら中央内腔１への接続と外装２の近位端での内腔との間
における高い直列インピーダンス成分という特徴が付け
加わっている。低周波数（通常１００ＫＨｚから４０Ｍ
Ｈｚ）だけでなく３００ＭＨｚまでの周波数で動作させ
るために、内腔１の内面と挿入された器具のシャフトの
間に導電性の経路が設けられる（図示せず）。
【００２７】図１〜３に示した上記の各例と同様、フィ
ーダ４から電気的に適切な距離だけ離れて、内腔１と外
装２とを低インピーダンス成分をもって接続することに
より、ＵＨＦでの電気外科用エネルギーは外装の近位端
及び器具から絶縁される。本例では、低周波数電圧を内
腔１と外装２の間で発生させる必要があり、低インピー
ダンス成分はＵＨＦで事実上短絡する分路コンデンサ２
５として形成される。このコンデンサは通常、内腔１の
周囲の環状の誘電体で構成することができ、それにより
この領域内で対向する外装２と内腔１とが十分に高い値
のコンデンサを形成するようにする。低周波数成分は、
金属性短絡部と直列インダクタンスによって外装２の近
位端と器具からそれぞれ独立に絶縁されている。前記金
属性短絡部は内腔１と外装２の拡張部分２Ｅの間の導電
性エンドプレート（端面板）３０によって形成される。
また前記直列インダクタンスは、（ａ）内腔１のコンデ
ンサ２５とエンドプレート接続３０との間の内腔１の区
間３１によって形成され、及び（ｂ）拡張部分２Ｅの外
装壁と内腔１との間の空間を満たすリング３２によって
形成される。
ーダ４から電気的に適切な距離だけ離れて、内腔１と外
装２とを低インピーダンス成分をもって接続することに
より、ＵＨＦでの電気外科用エネルギーは外装の近位端
及び器具から絶縁される。本例では、低周波数電圧を内
腔１と外装２の間で発生させる必要があり、低インピー
ダンス成分はＵＨＦで事実上短絡する分路コンデンサ２
５として形成される。このコンデンサは通常、内腔１の
周囲の環状の誘電体で構成することができ、それにより
この領域内で対向する外装２と内腔１とが十分に高い値
のコンデンサを形成するようにする。低周波数成分は、
金属性短絡部と直列インダクタンスによって外装２の近
位端と器具からそれぞれ独立に絶縁されている。前記金
属性短絡部は内腔１と外装２の拡張部分２Ｅの間の導電
性エンドプレート（端面板）３０によって形成される。
また前記直列インダクタンスは、（ａ）内腔１のコンデ
ンサ２５とエンドプレート接続３０との間の内腔１の区
間３１によって形成され、及び（ｂ）拡張部分２Ｅの外
装壁と内腔１との間の空間を満たすリング３２によって
形成される。
【００２８】リング３２はニッケル・亜鉛・フェライト
混合物のような高い透磁率を持つ磁性材料で作られる。
例として、５ＭＨｚで動作するのに適した材料はフェア
ライト（ＦａｉｒＲｉｔｅ）のニッケル・亜鉛・フェラ
イト混合物＃６１である。この材料は５ＭＨｚでは相対
透磁率が１２０、Ｑ値が１００を超える。その結果得ら
れる直列インピーダンスは、角周波数、フェライト製ス
ラグ３２の相対透磁率及び断面の磁束部分の有効面積の
積を、磁束経路の有効長さで割った値である。この場
合、スラグの長さ３０ｍｍ（寸法Ｇ）、外径２８ｍｍ、
及び内腔の外径（Ｅ）を２．３ｍｍとすると、５ＭＨｚ
でフィーダ４の活導体と接地導体の間の誘導性リアクタ
ンスは４０Ωとなる。インダクタンス３１、３２が低い
動作周波数で共振回路を形成するために、外装２と内腔
１に接続されたフィーダ４の導体４Ｉとの間にコンデン
サが接続される。
混合物のような高い透磁率を持つ磁性材料で作られる。
例として、５ＭＨｚで動作するのに適した材料はフェア
ライト（ＦａｉｒＲｉｔｅ）のニッケル・亜鉛・フェラ
イト混合物＃６１である。この材料は５ＭＨｚでは相対
透磁率が１２０、Ｑ値が１００を超える。その結果得ら
れる直列インピーダンスは、角周波数、フェライト製ス
ラグ３２の相対透磁率及び断面の磁束部分の有効面積の
積を、磁束経路の有効長さで割った値である。この場
合、スラグの長さ３０ｍｍ（寸法Ｇ）、外径２８ｍｍ、
及び内腔の外径（Ｅ）を２．３ｍｍとすると、５ＭＨｚ
でフィーダ４の活導体と接地導体の間の誘導性リアクタ
ンスは４０Ωとなる。インダクタンス３１、３２が低い
動作周波数で共振回路を形成するために、外装２と内腔
１に接続されたフィーダ４の導体４Ｉとの間にコンデン
サが接続される。
【００２９】図５に図４で述べた器具を２周波数の電気
外科用発生器に接続した状態で示す。低い動作周波数で
インダクタンス３１、３２と共振するコンデンサは、出
力発生器４０内で、図５に示すように、フィーダケーブ
ル３４そのもの、又はフィーダ内に置かれたより低周波
数の同調リアクタンス３６（これはケーブル３４のリア
クタンスによって、容量リアクタンスであったり電磁リ
アクタンスであったりする）、或いはその両方で構成す
ることができる。
外科用発生器に接続した状態で示す。低い動作周波数で
インダクタンス３１、３２と共振するコンデンサは、出
力発生器４０内で、図５に示すように、フィーダケーブ
ル３４そのもの、又はフィーダ内に置かれたより低周波
数の同調リアクタンス３６（これはケーブル３４のリア
クタンスによって、容量リアクタンスであったり電磁リ
アクタンスであったりする）、或いはその両方で構成す
ることができる。
【００３０】出力発生器は、２．４５ＧＨｚで動作する
第１のＵＨＦ発生源４２、通常５ＭＨｚで動作する第２
の長波発生源４４という２つの電気外科用無線周発生源
を含む。それぞれ出力線４２Ａ、４４Ａを持ち、フィー
ダ４に接続された出力発生器４０の出力を構成する出力
４６Ａを持つ結合器に電力を供給する。器具の近位端に
おける低周波数の分離のための同調リアクタンスは、こ
こでは出力線４４Ａ中の分路リアクタンス３６からな
る。２つの無線周波発生源４２、４４は出力発生器４０
内のコントローラモジュール４８によって制御され、コ
ントローラには出力発生器の起動のためのフットスイッ
チ、又は手元スイッチ５０に接続された入力４８Ａが供
給される。
第１のＵＨＦ発生源４２、通常５ＭＨｚで動作する第２
の長波発生源４４という２つの電気外科用無線周発生源
を含む。それぞれ出力線４２Ａ、４４Ａを持ち、フィー
ダ４に接続された出力発生器４０の出力を構成する出力
４６Ａを持つ結合器に電力を供給する。器具の近位端に
おける低周波数の分離のための同調リアクタンスは、こ
こでは出力線４４Ａ中の分路リアクタンス３６からな
る。２つの無線周波発生源４２、４４は出力発生器４０
内のコントローラモジュール４８によって制御され、コ
ントローラには出力発生器の起動のためのフットスイッ
チ、又は手元スイッチ５０に接続された入力４８Ａが供
給される。
【図１】本発明による第１のツール変換器で、２４５０
ＭＨｚで動作するものを示し、（Ａ）は縦断面図、
（Ｂ）は横断面図である。
ＭＨｚで動作するものを示し、（Ａ）は縦断面図、
（Ｂ）は横断面図である。
【図２】ツール変換器の変形例を示し、（Ａ）は縦断面
図、（Ｂ）は横断面図である。
図、（Ｂ）は横断面図である。
【図３】導波管給電構造を持つツール変換器の変形例を
示し、（Ａ）は縦断面図、（Ｂ）は横断面図である。
示し、（Ａ）は縦断面図、（Ｂ）は横断面図である。
【図４】図２に示したものと同様の、ただし１００ＫＨ
ｚから４０ＭＨｚまでの周波数範囲でも動作可能である
点が異なるツール変換器を示し、（Ａ）は縦断面図、
（Ｂ）は横断面図である。
ｚから４０ＭＨｚまでの周波数範囲でも動作可能である
点が異なるツール変換器を示し、（Ａ）は縦断面図、
（Ｂ）は横断面図である。
【図５】電気外科用の出力発生器に接続された図４のツ
ール変換器を示す図である。
ール変換器を示す図である。
１ 内腔 １Ｄ 遠位端 ２ 外装 ４ 無線周波（ｒ．ｆ）給電構造（フィーダ） ６ 本体 ７ 接続点
───────────────────────────────────────────────────── フロントページの続き (72)発明者 フランシス アモアー イギリス国， ウェールズ， シーエフ14 １ティーイー， カーディフ， ウィッ トチャーチ， グリーンフィールド ロー ド 36 (72)発明者 コリン チャールズ オーウェン ゴブル イギリス国， ウェールズ， シーエフ64 １エーティー， サウス グラモーガ ン， ペナース， クリーブ クレセン ト， オズボーン ハウス ５ Ｆターム(参考） 4C060 FF12 GG28 KK04 KK06 KK08 KK22
Claims (28)
- 【請求項１】 近位端と遠位端を有する細長い筒状の内
部部材であって、 前記両端間が直流的に導通するように該部材の少なくと
も一部が導電性を持つ内部部材と、 前記内部部材を取り囲む細長い筒状の導電性の外装であ
って、内部部材の導電性材料からは間隔を開けて配置さ
れることにより、内部部材と外装とで同軸伝送線路を構
成し、遠位端よりも近位側に離れた位置で内部部材に電
気的に結合されている外装と、 外装と内部部材の間の接続部よりも遠位側で内部部材に
結合されたフィーダと、 内部部材とフィーダ及び外装との前記両結合部の間の無
線周波（ｒ．ｆ）絶縁構造であって、器具の動作周波数
において前記結合部間に直列インピーダンスを形成する
無線周波（ｒ．ｆ）絶縁構造とを含むことを特徴とする
電気外科用器具。 - 【請求項２】 絶縁構造が前記結合部の間の内部部材の
１区間から構成され、この区間が、ｍを奇数とし、また
λを動作周波数に関係付けられた波長として、ｍλ／４
の電気的な長さをもっていることを特徴とする請求項１
に記載の電気外科用器具。 - 【請求項３】 絶縁構造が前記両結合部の間の内部部材
の１区間によって形成されるインダクタンスを含み、こ
の区間が透磁率の高い材料の部材によって覆われている
請求項１に記載の電気外科用器具。 - 【請求項４】 高い動作周波数及び低い動作周波数で動
作し、絶縁構造がフィーダと減結合容量部の間に延びる
内部部材の追加区間を含み、この容量部がフィーダと高
透磁率体で覆われた前記内部部材の区間との間の位置で
内部部材と外装の間に接続されており、内部部材の追加
の区間が、ｍを奇数とし、λを高い方の動作周波数に関
係付けられた波長として、ｍλ／４の電気的長さを持つ
ことを特徴とする請求項３に記載の電気外科用器具。 - 【請求項５】 絶縁構造が器具の動作周波数で共振する
ことを特徴とする請求項１〜４の何れかに記載の電気外
科用器具。 - 【請求項６】 外装と内部部材に接続されたフィーダの
導体との間に結合されたコンデンサを更に含み、該コン
デンサは器具の動作周波数において前記インダクタンス
と共振することを特徴とする請求項３又は４に記載の電
気外科用器具。 - 【請求項７】 絶縁性ジャケットが、照明を内部部材の
遠位端まで伝え、或いはまた画像用の光を遠位端から内
部部材の近位端へ伝えるための誘電性光学材料を含んで
いることを特徴とする請求項１〜６の何れかに記載の電
気外科用器具。 - 【請求項８】 筒状の内部部材の中に収容される金属性
シャフトを有する外科用ツールを含んでおり、該外科用
ツールは内部部材の遠位端から突出すると共に、内部部
材の導電性材料に電気的に結合された可動の作動要素を
含んでいることを特徴とする請求項１〜７の何れかに記
載の電気外科用器具。 - 【請求項９】 少なくとも３００ＭＨｚの動作周波数で
の電気外科的な処置を行うための電気外科用器具であっ
て、 機械的または光学的な機能要素を収容する細長い導電性
の内腔と、 内腔の遠位端にあって内腔と電気的に結合された電極
と、 内腔の周囲に同軸的に配置される細長い導電性の外装で
あって、内腔の遠位端に隣接する遠位端を有し、外装と
内腔とによって同軸伝送線路を形成するよう絶縁層を内
包する寸法にされたものと、 外装内での電気外科用電流の流れを制約するために外装
の遠位端に関係付けられた絶縁構造とを含むことを特徴
とする電気外科用器具。 - 【請求項１０】 絶縁構造が外装の遠位端領域内でほぼ
平衡状態となる給電点を生じさせるようにした平衡不平
衡変成器を含んでいることを特徴とする請求項９に記載
の電気外科用器具。 - 【請求項１１】 平衡不平衡変成器が４分の１波長のス
リーブ平衡不平衡変成器であることを特徴とする請求項
９又は１０に記載の電気外科用器具。 - 【請求項１２】 外装が動作周波数での電流に関して近
位側で内腔に結合され、また内腔が外装への結合点から
軸方向に離れた位置で給電構造に結合されており、その
距離は前記結合部の近位側に延長される内腔部分が動作
周波数において給電構造から電気的に絶縁されるような
距離であることを特徴とする請求項９〜１１の何れかに
記載の電気外科用器具。 - 【請求項１３】 給電構造は外装の側部開口部を含んで
いることを特徴とする請求項１２に記載の電気外科用器
具。 - 【請求項１４】 給電構造と外装の遠位端との間の軸方
向距離が実質的にｎλ／２という電気的な長さに対応
し、ここでｎは整数（１、２、３・・）であり、λは動
作周波数での前記同軸伝送線路における波長であること
を特徴とする請求項１２又は１３に記載の電気外科用器
具。 - 【請求項１５】 給電構造の近位側の内腔に関係付けら
れた低周波数絶縁チョークを含み、該チョークは４０Ｍ
Ｈｚ未満の第２の動作周波数において有効であることを
特徴とする請求項１２〜１４の何れかに記載の電気外科
用器具。 - 【請求項１６】 最低でも３００ＭＨｚの動作周波数で
電気外科的処置を行うために、細長い外科用ツールを電
気外科用器具に変換する電気外科用ツール変換器であっ
て、 細長い導電性の内腔であって、内腔の開放した遠位端を
超えて露出した作動要素を持つツールを収容し、内腔の
周囲に同軸的に配設されて内腔の遠位端に隣接する遠位
端を持つ細長い導電性の外装を形成するものと、 内腔と組み合わされることで同軸の伝送線路を形成する
ように絶縁層を包みこむ寸法にされた外装と、 外装内での電気外科用電流の流れを制約するように外装
の遠位端に関係付けられた絶縁構造とを含むことを特徴
とする電気外科用ツール変換器。 - 【請求項１７】 絶縁構造が外装の遠位端の領域内でほ
ぼ平衡状態となる給電点を生じさせるようにした平衡不
平衡変成器を含んでいることを特徴とする請求項１６に
記載の電気外科用ツール変換器。 - 【請求項１８】 平衡不平衡変成器は４分の１波長のス
リーブ平衡不平衡変成器であることを特徴とする請求項
１６又は１７に記載の電気外科用ツール変換器。 - 【請求項１９】 外装が動作周波数での電流に関して近
位側で内腔に結合され、また内腔が外装への結合点から
軸方向に離れた位置で給電構造に結合されており、その
距離は、前記結合部の近位側に延長される内腔部分が動
作周波数において給電構造から電気的に絶縁されるよう
な距離であることを特徴とする請求項１６〜１８の何れ
かに記載の電気外科用ツール変換器。 - 【請求項２０】 給電構造が外装の側部開口部を含んで
いることを特徴とする請求項１９に記載の電気外科用ツ
ール変換器。 - 【請求項２１】 給電構造と外装の遠位端との間の軸方
向距離が実質的にｎλ／２という電気的な長さに対応
し、ここでｎは整数（１、２、３・・）であり、λは動
作周波数での前記同軸伝送線路における波長であること
を特徴とする請求項１９又は２０に記載の電気外科用ツ
ール変換器。 - 【請求項２２】 給電構造の近位側の内腔に関係付けら
れた低周波数絶縁チョークを含み、該チョークは３００
ＭＨｚ未満の第２の動作周波数において有効であること
を特徴とする請求項１９〜２１の何れかに記載の電気外
科用ツール変換器。 - 【請求項２３】 チョークが４０ＭＨｚ未満の動作周波
数において有効であることを特徴とする請求項２２に記
載の電気外科用ツール変換器。 - 【請求項２４】 請求項１６〜２３の何れかに記載の電
気外科用ツール変換器と、内腔に収容された外科用ツー
ルとの組み合わせからなる電気外科用器具であって、電
気外科用ツールが、組織の電気外科処置用の電極を形成
するために内腔の遠位端を超えて突出する作動要素と、
内腔の近位端から突出する握り部とを備えていることを
特徴とする電気外科用器具。 - 【請求項２５】 腹腔施術器具であることを特徴とする
請求項２４に記載の電気外科用器具。 - 【請求項２６】 遠位端の可動の作動要素に対して接続
される往復運動可能な作動ロッドを有することを特徴と
する請求項２４又は２５に記載の電気外科用器具。 - 【請求項２７】 往復運動可能な作動ロッドは鉗子であ
ることを特徴とする請求項２６に記載の電気外科用器
具。 - 【請求項２８】 往復運動可能な作動ロッドは、はさみ
であることを特徴とする請求項２６に記載の電気外科用
器具。
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| GBGB9912627.8A GB9912627D0 (en) | 1999-05-28 | 1999-05-28 | An electrosurgical instrument |
| GB9912627.8 | 1999-05-28 |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| JP2001128990A true JP2001128990A (ja) | 2001-05-15 |
Family
ID=10854473
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| JP2000156193A Pending JP2001128990A (ja) | 1999-05-28 | 2000-05-26 | 電気外科用器具及び電気外科用ツール変換器 |
Country Status (5)
| Country | Link |
|---|---|
| EP (1) | EP1055400A1 (ja) |
| JP (1) | JP2001128990A (ja) |
| AU (1) | AU3645500A (ja) |
| CA (1) | CA2308953A1 (ja) |
| GB (1) | GB9912627D0 (ja) |
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| Publication number | Priority date | Publication date | Assignee | Title |
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| US6682528B2 (en) | 1998-10-23 | 2004-01-27 | Sherwood Services Ag | Endoscopic bipolar electrosurgical forceps |
| US6726686B2 (en) | 1997-11-12 | 2004-04-27 | Sherwood Services Ag | Bipolar electrosurgical instrument for sealing vessels |
| USD496997S1 (en) | 2003-05-15 | 2004-10-05 | Sherwood Services Ag | Vessel sealer and divider |
| USD499181S1 (en) | 2003-05-15 | 2004-11-30 | Sherwood Services Ag | Handle for a vessel sealer and divider |
| US7642451B2 (en) | 2008-01-23 | 2010-01-05 | Vivant Medical, Inc. | Thermally tuned coaxial cable for microwave antennas |
| US7655007B2 (en) | 2003-05-01 | 2010-02-02 | Covidien Ag | Method of fusing biomaterials with radiofrequency energy |
| JP2010050975A (ja) * | 2008-08-25 | 2010-03-04 | Vivant Medical Inc | 二重帯域ダイポールマイクロ波切除アンテナ |
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Also Published As
| Publication number | Publication date |
|---|---|
| EP1055400A1 (en) | 2000-11-29 |
| GB9912627D0 (en) | 1999-07-28 |
| CA2308953A1 (en) | 2000-11-28 |
| AU3645500A (en) | 2000-11-30 |
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