JP2001190561A - Coagulation treatment tool - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a coagulation treatment tool capable of dispensing with the covering of an outer surface of a heater body with an insulating body, and having superior durability and reliability. SOLUTION: A coagulation treatment part 8 for coagulating the tissue is formed by mounting ceramic heaters 13, 14 made of an insulating material, on a pair of jaws 6, 7 openably and closeably supported for grasping the tissue.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a coagulation treatment tool for coagulating a living tissue by heating it.

[0002]

2. Description of the Related Art In general, a coagulation treatment tool for performing a coagulation treatment for heating and coagulating a living tissue such as a blood vessel as a medical treatment tool is known. For example, USP 5,79
In the coagulation instruments 2 and 137, as a means for heating a living tissue, a heater means having a configuration utilizing the fact that the semiconductor generates heat due to electric resistance when the semiconductor is energized is shown.

[0003]

By the way, USP 5,
When a semiconductor is used as the heater means as in 792 and 137, it is necessary to cover the outside of the semiconductor with an insulator so as to prevent current from leaking to a living tissue when the semiconductor is energized and to insulate the semiconductor.

[0004] However, synthetic resins and ceramic materials are usually used as insulators, but these materials have a low thermal conductivity and are not suitable for use as heater means.

[0005] Therefore, there is a case where a metal material coated with insulating material such as Teflon is used. In this case, if the coating is damaged due to scratches during use and dielectric breakdown occurs,
Immediately, it becomes unusable and has problems in durability and reliability.

The present invention has been made in view of the above circumstances, and has as its object to provide a coagulation treatment tool which is excellent in durability and reliability without having to cover the outer surface of the heater body with an insulator. It is in.

[0007]

SUMMARY OF THE INVENTION The present invention comprises a pair of jaws which are openably and closably supported and which hold a living tissue, wherein heater means made of an insulating material is disposed on at least one of the jaws. A coagulation treatment device characterized by forming a coagulation treatment section for coagulating a. In the present invention, the coagulation treatment section for coagulating the living tissue is formed by the heater means made of an insulating material, so that the heater means does not need to be insulated and the durability and reliability are improved. is there.

[0008]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS A first embodiment of the present invention will be described below with reference to FIGS. 1 (A) to 1 (C) and FIGS. 2 (A) and 2 (B). FIG. 1A shows a schematic configuration of a coagulation treatment tool 1 according to the present embodiment. The body 2 of the coagulation treatment tool 1 of the present embodiment is provided with two scissors constituting members 3 and 4. These scissors constituting members 3 and 4 are superimposed so that the halfway portions substantially intersect. Furthermore, both scissors constituting member 3,
At the intersection of 4, a fulcrum pin 5 for rotatably connecting both scissors constituting members 3, 4 is arranged.

A treatment section 8 having a pair of openable and closable jaws 6 and 7 for grasping a living tissue is provided at the distal end of the treatment instrument main body 2. The treatment section 8 is formed in substantially the same shape as the peeling forceps.

Furthermore, finger insertion rings 9 and 10 having a substantially elliptical shape are formed at the base end of each of the scissors constituting members 3 and 4. The finger insertion rings 9 and 10 form a hand-side operation unit 11 for opening and closing the pair of jaws 6 and 7.

The treatment section 8 of the treatment instrument main body 2 includes
As shown in FIG. 2 (B), a curved portion 1 which is gently curved in a substantially arc shape.
2 are formed. Further, as shown in FIG. 1 (A), the jaws 6 and 7 of the treatment instrument main body 2 are provided with ceramic heaters (heater means) 13 and 14 for coagulating the living tissue on the contact surface side with the living tissue. Have been.

Each of the ceramic heaters 13 and 14 is shown in FIG.
As shown in (B), the heat transfer unit 15 is made of a ceramic which is an insulator, and a heat generator 16 buried inside the heat transfer unit 15. Here, examples of the type of ceramic of the heat transfer section 15 include alumina, aluminum nitride, and silicon nitride. Further, as the material of the heating element 16, a metal such as tungsten is often selected. Usually, the heat transfer section 15 and the heating element 16 are integrally baked and hardened, and the ceramic heaters 13 and 14 are formed.

Further, as shown in FIG. 1C, teeth 17 are provided on the surface of the heating element 16 of each of the ceramic heaters 13 and 14 for preventing the living tissue from slipping. In the present embodiment, the teeth 17 are formed by a large number of substantially trapezoidal projections 18 protruding from the surface of the heating element 16. The teeth 17 are formed by cutting the surface of the heating element 16.

Further, each of the ceramic heaters 13, 14
In order to prevent the living tissue from scorching (sticking) to the outer surface (contact surface with the living tissue) of the heating element 16, the heating element 1
6, a Teflon coating layer 19 is formed to cover the surface with Teflon coating or the like.

As shown in FIG. 1A, the scissors constituting members 3 and 4 are provided with insulated lead wires 20 and 21, respectively. Here, the tip of the insulating lead wire 20 on one scissor component 3 is connected to the ceramic heater 13, and the tip of the insulating lead wire 21 on the other scissor component 4 is connected to the ceramic heater 14.

The finger insertion ring 9 on the scissors constituting member 3 side
One cord connecting portion 22 is also provided on the outer peripheral surface of the finger insertion ring 10 on the scissor constituting member 4 side, and one cord connecting portion 23 is also provided on the outer peripheral surface of the finger inserting ring 10 on the scissor constituting member 4 side. The base end of the insulated lead wire 20 is connected to the cord connecting portion 22 on the scissors constituting member 3 side, and the insulating lead wire 21 is connected to the cord connecting portion 23 on the scissor constituting member 4 side. Further, the other ends of the connection cords 24 and 25, one ends of which are connected to a power supply (not shown), are detachably connected to the cord connection parts 22 and 23. Then, power is supplied to the ceramic heaters 13 and 14 from a power supply device (not shown).

Next, the operation of the coagulation treatment tool 1 according to the present embodiment having the above configuration will be described. First, with the treatment section 8 at the distal end of the coagulation treatment instrument 1 closed, the treatment section 8 is inserted into a living tissue including a treatment target such as a blood vessel (not shown). Thereafter, by opening the pair of jaws 6 and 7, the treatment target portion such as a blood vessel is peeled off from another living tissue and exposed.

Subsequently, the detached blood vessel or the like is gripped between the jaws 6 and 7 of the coagulation treatment tool 1 with a relatively small and appropriate pressing force suitable for coagulation treatment. In this state, when a power supply (not shown) is output, power is supplied to the heating elements 16 of the ceramic heaters 13 and 14 of the jaws 6 and 7 via the connection cords 20 and 21. The heating element 16 generates heat due to the electric resistance at the time of energization, heats the heat transfer section 15, and coagulates a living tissue of a treatment target such as a blood vessel in contact with the surface of the heat transfer section 15. At this time, since the heat transfer unit 15 is an insulator, the current flowing through the heat generator 16 does not leak into the living tissue of the treatment target part.

Therefore, the above configuration has the following effects. That is, in the present embodiment, the treatment instrument main body 2
Ceramic heaters 13 and 14 are disposed on each of the jaws 6 and 7. Therefore, since the ceramic heaters 13 and 14 that are in direct contact with the living tissue of the part to be treated such as blood vessels are insulators, the ceramic heaters 1 of the jaws 6 and 7 are insulated.
There is no need to apply another insulating coating to the layers 3 and 14, and there is an effect that the durability and reliability of the coagulation treatment tool 1 can be improved.

FIG. 3 shows a modification of the jaws 6 and 7 of the coagulation treatment tool 1 according to the first embodiment. In this modification, the teeth 17 on the surface of the heating element 16 of each of the ceramic heaters 13 and 14 of the jaws 6 and 7 are formed by providing a plurality of lateral grooves 31.

FIG. 4 shows a second embodiment of the present invention. In this embodiment, the ceramic heaters 13 of the jaws 6 and 7 of the coagulation treatment tool 1 of the first embodiment (see FIGS. 1A to 1C and FIGS. 2A and 2B) are used.
14 is covered with a reinforcing metal cover 32. In addition,
It is desirable that the surface of the reinforcing metal cover 32 be coated with Teflon to prevent sticking.

Therefore, in this embodiment, since the ceramic heaters 13 and 14 are covered with the reinforcing metal cover 32, the strength of the jaws 6 and 7 of the coagulation treatment tool 1 can be further increased. Note that the present invention is not limited to the above-described embodiment, and may be a treatment tool suitable for endoscopic surgery.

FIGS. 5A and 5B and FIG.
(A), (B) and (C) show a third embodiment of the present invention. In this embodiment, the jaws 6 and 7 of the treatment tool main body 2 in the coagulation treatment tool 1 of the first embodiment (see FIGS. 1A to 1C and FIGS. 2A and 2B) are used. The configuration of the fixing portion for fixing the ceramic heaters 13 and 14 is changed as follows.

That is, in this embodiment, FIG.
As shown in (B), a connecting plate (intermediate connecting member) 41 is brazed to the inner surfaces (joining surfaces with the jaws 6 and 7) of the ceramic heaters 13 and 14. This connection plate 41
In order to reduce the thermal stress at the time of brazing, a thin metal plate is preferable, and stainless steel or copearl (a metal containing iron and cobalt) can be considered as a material.

Further, the connection plate 41 is provided with a plurality of connection pins 42 projecting therefrom. Here, the jaws 6 and 7 are formed with holes 43 into which the connection pins 42 of the connection plate 41 are inserted. After the connection pins 42 of the connection plate 41 are inserted into the holes 43 of the jaws 6 and 7,
(The X part circled in FIG. 5B)
Are fixed to the jaws 6 and 7 by laser welding. Alternatively, the connection pins 42 may be screws. Further, as shown in FIG. 6C, the connection pins 42 themselves may be directly brazed to the ceramic heaters 13 and 14.

The connection between the ceramic heaters 13 and 14 and the connection plate 41 may be by bonding instead of brazing, although the strength is slightly reduced. Also, the connection between the connection plate 41 and the jaws 6 and 7 may be directly bonded without using the connection pins 42.

Therefore, the above configuration has the following effects. That is, in the present embodiment, the coagulation treatment tool 1
In fixing the ceramic heaters 13 and 14 to the jaws 6 and 7 of the treatment instrument main body 2 in the above, after the thin connection plate 41 is brazed to the ceramic heaters 13 and 14, the connection pins 42 of the connection plate 41 are connected to the jaws 6 and 6, respectively. 7 is mechanically connected to the jaws 6 and 7 by bonding or laser welding in a state of being inserted into the hole 43 of FIG. Therefore, the flexible jaws 6 and 7 formed of a metal material and the hard and brittle ceramic heaters 13 and 1 are provided.
4 are connected via the connection pins 42 of the connection plate 41, so that the ceramic heaters 13 and 14 and the jaws 6 and 7 are connected.
The bending of the jaws 6 and 7 can be absorbed by the small gap between the ceramic heaters 13 and 14 and the load acting on the ceramic heaters 13 and 14 can be reduced. As a result, ceramic heater 1
3, 14 can be reliably and easily connected to the jaws 6, 7 whose coefficient of thermal expansion differs greatly from that of ceramic.

Further, as in the case where the hard and brittle ceramic heaters 13 and 14 are brazed directly to the jaws 6 and 7 having a large volume and a large coefficient of thermal expansion and firmly connected thereto, excessive load is applied to the ceramic heaters 13 and 14. Of the ceramic heaters 13 and 1 can be prevented.
This has the effect of improving the strength of the connecting portion between the jaws 4 and the jaws 6 and 7. In particular, there is an effect that the connection strength can be further increased by making the connection plate 41 a copearl having a low coefficient of thermal expansion.

FIG. 7A shows a connecting plate 4 for connecting between the jaws 6 and 7 of the treatment tool main body 2 and the ceramic heaters 13 and 14 in the coagulation treatment tool 1 of the third embodiment.
9 shows a first modification of the mounting structure of FIG. In this modification, the ceramic heaters 13 and
A heater fixing claw 41a is protrudingly provided on the connecting portion side with the jaw 6, and a jaw fixing claw 4a is provided on the connecting portion side with the jaws 6 and 7.
1b. These heater fixing claws 4
1a and the jaw fixing claw 41b are extended over a part of the connection plate 41 or over the entire length.

The heater fixing claw 41 of the connection plate 41
a is mechanically engaged with the ceramic heaters 13 and 14 by caulking or the like, and the jaw fixing claw 41b is similarly mechanically engaged with the jaws 6 and 7 by caulking or the like. In addition, the heater fixing claw 41a
May be provided on the jaws 6 and 7.

FIG. 7B shows a connecting plate 4 for connecting between the jaws 6 and 7 of the treatment tool main body 2 and the ceramic heaters 13 and 14 in the coagulation treatment tool 1 of the third embodiment.
9 shows a second modification of the mounting structure of FIG. In this modification, the connection plate 41 is formed in a shape that covers the bottom surfaces of the ceramic heaters 13 and 14, and fixed claws 41 c projecting from both sides of the connection plate 41 are attached to the ceramic heaters 13 and 1.
4 and the jaws 6 and 7 are mechanically engaged by means such as caulking.

In the first and second modified examples, the third
As in the case of the coagulation treatment tool 1 of the embodiment, there is an effect that the ceramic heaters 13 and 14 can be reliably and easily connected to the jaws 6 and 7 whose coefficient of thermal expansion is greatly different from that of ceramic.

FIGS. 8A and 8B show a fourth embodiment of the present invention.
1 shows an embodiment of the present invention. In the present embodiment, the third
(FIGS. 5A and 5B and FIGS. 6A and
The configuration of the fixing portion for fixing the ceramic heaters 13 and 14 to the jaws 6 and 7 of the treatment tool main body 2 of the coagulation treatment tool 1 of (B) is further modified as follows.

That is, in the present embodiment, the connection pin 42 of the connection plate 41 of the third embodiment
, And a large-diameter engaging portion 42b is provided at the tip of the cracked portion 42a. And this connection pin 4
2 is inserted into the holes 43 of the jaws 6 and 7, the engaging portion 42 b at the tip of the cracked portion 42 a is inserted into the holes 43 of the jaws 6 and 7.
The ceramic heaters 13 and 14 are configured to be freely and detachably fixed to the jaws 6 and 7 by engaging with the peripheral portions of the ceramic heaters 13 and 14.

In this embodiment, the ceramic heaters 13, 1 are also provided in the same manner as in the coagulation treatment tool 1 of the third embodiment.
4 is a jaw having a coefficient of thermal expansion greatly different from that of ceramic.
7 can be easily and reliably connected.

FIG. 9 shows a fifth embodiment of the present invention. This embodiment is a third embodiment (see FIGS. 5A and 5B and FIGS. 6A and 6B).
Jaws 6 and 7 of treatment instrument body 2 in coagulation treatment instrument 1
Connecting plate 41 for fixing ceramic heaters 13 and 14 to
Formed of an elastic member such as rubber. And
In the present embodiment, the connection plate 41 is the ceramic heater 1
3, 14 and the jaws 6, 7 are respectively adhered and fixed.

Therefore, in the above-described structure, the connection plates 41 are made of an elastic member such as rubber, so that the flexible jaws 6 and 7 made of a metal material are easily bent. Positive absorption, ceramic heater 1
There is an effect that the load acting on the third and the fourth can be surely reduced.

FIGS. 10 and 11 show the sixth embodiment of the present invention.
1 shows an embodiment of the present invention. FIG. 10 shows a schematic configuration of the entire system of the medical treatment tool 51 of the present embodiment. The system of the medical treatment tool 51 of the present embodiment is provided with a power supply device 52 and a substantially scissor-shaped thermocoagulating incision forceps 53. Here, an output connector 54 and an initial resistance measurement switch 55 are provided on the front surface of the power supply device 52. A thermocoagulation forceps 53 is connected to an output connector 54 of the power supply device 52 via a cable 56.

A pair of openable / closable jaws 5 for grasping a living tissue is provided at the distal end of the main body 57 of the thermocoagulating incision forceps 53.
A treatment section 60 provided with 8, 59 is provided. Furthermore, heaters 61, 6 are provided on each jaw 58, 59, respectively.
2 are incorporated. These heaters 61 and 62 are, for example, ceramic heaters.

The power supply 52 has heaters 61 and 6.
2 is connected to a foot switch 63 for controlling the energization. Here, an example in which the foot switch 63 is connected to the power supply device 52 is shown.
A configuration may be employed in which a hand switch for controlling the energization of the first and the second 62 is provided.

FIG. 11 is a block diagram showing an electric circuit inside the power supply device 52. A power supply unit 64, which is a power supply for a heater, is provided inside the power supply device 52. The power supply unit 64 is, for example, a constant voltage power supply.

Further, output portions 65a and 65b are provided to the two heaters 61 and 62 of the thermocoagulating and dissecting forceps 53, respectively.
And resistance value measuring units 66a and 66b.
Then, the two heaters 61, 6 of the thermocoagulating incision forceps 53
2, independent output control and resistance value measurement are possible.

The resistance measuring units 66a and 66b and the output units 65a and 65b are connected to a control unit 67.
Output correction suitable for each individual can be performed. An operation unit 68 is connected to the control unit 67. The operation section 68 is provided with an initial resistance measurement switch 55.

Next, the operation of the above configuration will be described.
When the system of the medical treatment tool 51 of the present embodiment is used, the operation is controlled as follows. Here, the medical treatment tool 51 of the present embodiment is connected as shown in FIG.
First, the initial resistance measurement switch 55 is depressed.

Then, the resistance value measuring units 66 a and 66 b measure the respective heater resistance values of the heaters 61 and 62 of the thermocoagulation / cutting forceps 53 and send data to the control unit 67. This value is determined as the initial resistance value of the heaters 61 and 62 of the thermocoagulation / cutting forceps 53.

When the measurement of the initial resistance value is completed, the output by the foot switch 63 becomes possible. Note that even if the foot switch 63 is pressed before measuring the initial resistance values of the heaters 61 and 62 of the thermocoagulating forceps 53, a warning is issued by a buzzer or the like, and no output is made.

When the foot switch 63 is pressed,
The control unit 67 sends an output correction signal to the output units 65a and 65b according to the initial resistance values of the heaters 61 and 62, respectively.
This correction method is, for example, as follows.

The power supply voltage is V and the heater initial resistance value is Ri.
(1) The voltage V is adjusted so that V ² / Ri becomes a predetermined value, and a constant voltage output is performed at the voltage V. (2) Assuming that the voltage duty ratio is D, (V × D)
Output is performed at a voltage duty ratio D such that ² / Ri becomes a predetermined value. The output units 65a and 65b perform output by any of the correction methods described above.

Therefore, the above configuration has the following effects. That is, in the present embodiment, even if there is a variation in the heater resistance value, the heat generation characteristics of the heaters 61 and 62 can be made substantially the same, and there is an effect that a stable coagulation ability can be obtained.

FIG. 12 shows a seventh embodiment of the present invention. In the present embodiment, the initial resistance measuring switch 55 is omitted from the power supply device 52 of the sixth embodiment (see FIGS. 10 and 11), and the thermocoagulating incision forceps 53 is connected after the power supply of the power supply device 52 is turned on. In the meantime, the control unit 67 controls the operation according to the flowchart of FIG. The other parts have the same configuration as the system of the medical treatment tool 51 of the sixth embodiment, and are the same as those of the medical treatment tool 5 of the first embodiment.
The same components as those of the first system are denoted by the same reference numerals, and description thereof is omitted here.

Next, the operation of the above configuration will be described.
In the present embodiment, the control unit 67 operates as shown in FIG. 1 after the power of the power supply device 52 is turned on and before the thermocoagulation / cutting forceps 53 are connected.
The operation is controlled according to the flowchart of FIG. First, in step S1, the resistance value measurement units 66a and 66b repeat the measurement of the resistance value at regular time intervals. In the next step S2, it is determined whether or not the resistance value is 100Ω or less. Here, if the thermocoagulating dissection forceps 53 is not connected, the resistance value becomes an open value. If it is determined in step S2 that the resistance value is not less than 100Ω, the process proceeds to the next step S3, where it is determined that the output is impossible. In this case, the process returns to step S1 to repeat the measurement of the resistance value.

If it is determined in step S2 that the resistance value is equal to or less than 100Ω, the process proceeds to the next step S4. In step S4, a resistance value of 100Ω or less is stored as an initial resistance value. Subsequently, the process proceeds to the next step S5,
The operation is switched to the output enabled state, and the processing ends. Although the threshold value of the resistance value is set to 100Ω in the present embodiment, it may be determined in advance to a value suitable for the heater to be used.

Thereafter, as in the sixth embodiment, when the foot switch 63 is pressed, an output corrected with the initial resistance value is performed.

Therefore, with the above-described configuration, the same effect as that of the sixth embodiment can be obtained, and in this embodiment, particularly, the initial resistance is automatically measured. There is an effect that the operation is further simplified.

FIGS. 13A and 13B show an eighth embodiment of the present invention. This embodiment is the sixth embodiment.
Power supply device 5 of the embodiment (see FIGS. 10 and 11)
2 is provided with a temperature display section 71 on the front surface. The temperature display section 71 is connected to the control section 67.

The temperature display section 71 is configured to display the temperatures of the heaters 61 and 62 of the thermocoagulation / cutting forceps 53. The other parts have the same configuration as the system of the medical treatment tool 51 of the sixth embodiment, and the same parts as those of the system of the medical treatment tool 51 of the first embodiment have the same configuration. The reference numerals are used and the description is omitted here.

Next, the operation of the above configuration will be described.
In the present embodiment, first, a seventh embodiment (see FIG. 12)
Similarly to the above, the initial resistance value is measured after the power of the power supply device 52 is turned on and the thermocoagulation incision forceps 53 are connected.

Subsequently, the control section 67 sets the thermocoagulating incision forceps 53
Using the fact that the resistance values of the heaters 61 and 62 change with the temperature, the temperatures of the heaters 61 and 62 of the thermocoagulating incision forceps 53 are calculated from the resistance measurement values of the resistance measurement units 66a and 66b. At this time, the temperature error due to the variation in the heater resistance value is corrected in consideration of the initial resistance value. The obtained heater temperature is displayed on the temperature display section 71.

The temperature displayed on the temperature display section 71 is
Any of the higher temperature, the lower temperature, and the average temperature of the heaters 61 and 62 may be used. Further, the temperature display unit 71 may display both temperatures. Further, it is obvious that the output of the power supply device 52 may be controlled so that the heater temperature becomes a predetermined temperature.

Therefore, the above configuration has the following effects. That is, in the present embodiment, the temperature of the heaters 61 and 62 of the thermocoagulation / cutting forceps 53 can be measured without a temperature sensor, and there is an effect that the temperature accuracy can be improved even if the heater resistance value varies.

Further, the sixth embodiment (see FIGS. 10 and 11) to the eighth embodiment (FIG. 13A,
(B)), the heater 61 of the thermocoagulating incision forceps 53,
PTC heater as 62 (positive temperature c
A heater (a heater formed of an efficient material) may be used.

In the case of the above configuration, if a constant voltage is applied to the PTC heater, when the heater temperature reaches the Curie temperature, the resistance value rises sharply to suppress heat generation.
As a result, the temperature is controlled near the Curie temperature.

As described above, when the PTC heater is used as the heaters 61 and 62 of the thermocoagulating incision forceps 53, the sixth to the sixth can be obtained.
In all of the eight embodiments, a temperature limiter can be easily provided.

For example, when it is desired to set the upper limit of the heater temperature to around 200 ° C. in order to protect the Teflon coating, if a PTC heater having a Curie temperature of 190 ° C. is used, no special circuit or control is required on the power supply device 52 side. A desired temperature limiter can be configured.

Therefore, in the above configuration, since the PTC heater is used as the heater, the temperature limiter can be easily set by setting the Curie temperature of the PTC heater in accordance with the member having the lowest heat resistance temperature. There is an effect that can be made.

For example, the Curie temperature is set to 200 ° C. or less to protect the Teflon coating of the forceps. The Curie temperature is set to about 150 ° C. to prevent overheating of the living tissue. Thus, a temperature limiter can be provided without any special configuration.

Further, the present invention is not limited to the above-described embodiment, and it goes without saying that various modifications can be made without departing from the spirit of the present invention. Next, other characteristic technical matters of the present application will be additionally described as follows. (Supplementary item 1) A coagulation treatment tool having a pair of jaws that open and close to each other and having a solidified portion on at least one of the jaws, wherein the solidified portion is a heater means made of an insulating material.

(Additional Item 2) In the additional item 1, the heater means is a ceramic heater having a heat transfer portion made of ceramic and a heating element provided in the heat transfer portion.

(Additional Item 3) In the additional item 2, the ceramic is made of silicon nitride.

(Additional Item 4) In the additional item 2, the ceramic is made of aluminum nitride.

(Additional Item 5) In the additional item 2, the ceramic is made of alumina.

(Additional Item 6) In the additional item 1, the heater means is reinforced by a reinforcing member made of metal.

(Additional Item 7) The heater device according to Additional Item 1, wherein the surface of the heater means is coated to prevent tissue sticking.

(Additional Item 8) In the additional item 7, the coating is Teflon-coated.

(Conventional Techniques of Supplementary Items 1 to 8)
As in P5792137, there was one having a heater in the solidification part. In the prior art, as a heater means, the fact that electricity is supplied to the semiconductor and the semiconductor generates heat by electric resistance is used.

(Problems to be Solved by Additional Items 1 to 8)
However, since it is a semiconductor, it is necessary to insulate the tissue so that current does not leak, and it is necessary to cover the outside with an insulator. Usually, there are resins and ceramics as insulators, but they are not suitable for use because of their low thermal conductivity. For this reason, there has been a case where a metal insulated with Teflon or the like is used. However, if the coating is damaged due to a scratch or the like and the insulation is destroyed, it immediately becomes unusable, and there is a problem in durability and reliability.

(Purpose of Supplementary Items 1 to 8) In view of the above problems, the present application is a durable coagulation treatment tool which does not need to cover the outer surface with an insulator by forming the heater body with an insulator. The purpose is to provide.

(Supplementary Item 9) In a coagulation treatment tool having a pair of stainless steel jaws that open and close to each other and a ceramic heater connected to at least one of the jaws, an intermediate connection member is provided between the ceramic heater and the jaws. Things.

(Additional Item 10) In the additional item 9, the intermediate connecting member is connected to the ceramic heater by the first connecting means and connected to the jaw by the second connecting means.

(Additional Item 11) In the additional item 9, the intermediate connecting member is made of a thin metal plate.

(Additional Item 12) In the additional item 9, the intermediate connecting member is a pin member.

(Additional Item 13) In the additional item 11, the first connecting means is brazing.

(Additional Item 14) In Additional Item 11, the second connecting means is formed by mechanically engaging the metal plate and the jaw.

(Prior Art in Additional Items 9 to 14) The ceramic heater is a jaw of forceps (usually made of stainless steel)
There was a coagulation treatment tool provided in the. A typical connection method between the ceramic heater and the jaw is brazing.

On the other hand, there has been a device such as US Pat. No. 5,792,137 having a heater made of a semiconductor in a solidified portion. In the above-mentioned prior art, the heater is provided at the tip of the forceps, but no details of a method of connecting to the forceps are described.

(Problems to be Solved by Additional Items 9 to 14) When a ceramic heater is directly brazed to a jaw having a large volume and a large coefficient of thermal expansion, it is a technique to increase the connection strength due to a difference in the coefficient of thermal expansion. There is a problem that it is difficult and takes time. That is, in order to lower the thermal stress as much as possible, it is necessary to perform heating / cooling very slowly at the time of brazing, and equipment and experience therefor are also required.

(Object of Supplementary Items 9 to 14) In order to solve the above-mentioned problems, the present application aims to reliably and easily connect a ceramic heater to a jaw of a forceps having a significantly different coefficient of thermal expansion from ceramic by brazing. It is what it was.

(Supplementary Item 15) A power supply for thermocoagulated incision forceps, comprising: a resistance value measuring means for measuring a resistance value of the heater; and a control means for controlling electric power supplied to the heater in accordance with the initial resistance value of the heater.

(Additional Item 16) An additional item characterized by having a measurement switch for measuring the initial resistance value, and measuring the resistance value of the heater when the measurement switch is pressed to obtain the initial resistance value. 15 devices.

(Appendix 17) The apparatus according to Appendix 15, wherein the initial resistance value is automatically measured when a forceps having a built-in heater is connected.

(Supplementary Item 18) Resistance value measuring means for measuring the resistance value of the heater, temperature measuring means for calculating the heater temperature from the resistance value of the heater, and means for correcting the temperature using the initial resistance value of the heater And a power supply for thermal coagulation incision.

(Additional Item 19) The apparatus according to additional items 15 to 18, characterized in that if the initial resistance value of the heater is not measured, the heater is controlled so as not to output.

(Conventional Techniques of Supplementary Items 15 to 19) Generally, ceramic heaters have a large variation in resistance value, and if this is not taken into consideration, the heat generation characteristics of the heater will vary. Heretofore, there has been known an apparatus that measures a heater resistance value with a tester or the like and switches a dip switch on a substrate according to the measured resistance value.

(Problems to be Solved by Additional Items 15 to 19) However, this method is troublesome, and is an unacceptable operation when it is necessary to replace a new heater on the way at a medical site.

(Objects of Additional Items 15 to 19) It is an object of the present invention to obtain a stable coagulation and incision ability by easily correcting the variation in the heater resistance value and making the heat generation characteristics constant. Another object of the present invention is to correct the heater temperature obtained from the heater resistance value to improve the temperature measurement accuracy.

(Means for Solving the Problems in Additional Items 15 to 19) Means for measuring the initial resistance value of the heater;
It comprises means for controlling the power supplied to the heater according to the initial resistance value of the heater.

It comprises means for measuring the initial resistance value of the heater, means for calculating the heater temperature from the resistance value of the heater, and means for correcting the temperature using the initial resistance value of the heater.

(Operation of Supplementary Items 15 to 19) The initial resistance value of the heater is measured, and the supplied power is controlled according to the initial resistance value.

The initial resistance value of the heater is measured, and the obtained heater temperature is corrected with the initial resistance value.

(Effects of Additional Items 15 to 19) According to the present invention, a stable coagulation incision ability can be obtained even if there is a variation in the heater resistance value. When the temperature is obtained from the heater resistance value, the temperature accuracy can be improved.

[0101]

According to the present invention, a coagulation treatment section for coagulating a living tissue is formed by disposing a heater means made of an insulating material on at least one of a pair of jaws which are supported to be openable and closable and hold the living tissue. As a result, the outer surface of the heater body does not need to be covered with an insulator, and the durability and reliability are excellent.

[Brief description of the drawings]

FIG. 1 shows a first embodiment of the present invention;
(A) is a side view of the whole coagulation treatment tool, (B) is a plan view showing a curved shape of a jaw of the coagulation treatment tool, and (C) is a perspective view showing teeth for preventing a living tissue of a heating element from slipping.

FIG. 2A is an enlarged side view showing a jaw portion of the coagulation treatment tool according to the first embodiment, and FIG.
IB-IIB sectional drawing.

FIG. 3 is a perspective view of a main part showing a modification of the jaw of the coagulation treatment tool according to the first embodiment.

FIG. 4 is a cross-sectional view of a main part of a coagulation treatment tool according to a second embodiment of the present invention.

FIG. 5 shows a third embodiment of the present invention;
(A) is a side view of the entire coagulation treatment tool, and (B) is a side view of a main part showing a part of a jaw of the coagulation treatment tool in cross section.

FIG. 6A is a side view partially showing a state before attachment of an intermediate connecting member of a jaw of a coagulation treatment tool according to a third embodiment, and FIG. 6B is a side view showing VIB− of FIG. FIG. 7C is a cross-sectional view taken along the line VIB, and FIG.

FIG. 7A is a longitudinal sectional view showing a first modified example of the mounting structure of the intermediate connecting member in the coagulation treatment tool according to the third embodiment, and FIG. 7B is a coagulation treatment according to the third embodiment. The longitudinal section showing the 2nd modification of the attachment structure of the intermediate connection member in the tool.

FIG. 8 shows a fourth embodiment of the present invention.
(A) is a side view showing a partial cross section of a state of the jaw of the coagulation treatment tool before the intermediate connecting member is attached, and (B) is (A).
VIIIB-VIIIB line sectional view of FIG.

FIG. 9 is a side view showing a state in which a part of a jaw of a coagulation treatment tool according to a fifth embodiment of the present invention before attachment of an intermediate connection member is partially sectioned.

FIG. 10 is a perspective view showing a schematic configuration of an entire system of a coagulation treatment tool according to a sixth embodiment of the present invention.

FIG. 11 is a schematic configuration diagram showing an electric circuit of a system of a coagulation treatment tool according to a sixth embodiment.

FIG. 12 is a flowchart showing the operation of the coagulation treatment tool according to the seventh embodiment of the present invention.

FIG. 13 shows an eighth embodiment of the present invention.
(A) is a perspective view showing a schematic configuration of the entire system of the coagulation treatment tool, and (B) is a schematic configuration diagram showing an electric circuit of the system of the coagulation treatment tool.

[Explanation of symbols]

 6,7 jaw 8 coagulation treatment part 13,14 ceramic heater (heater means)

Claims (1)

[Claims] 1. A coagulation treatment section comprising a pair of jaws supported to be openable and closable and gripping a living tissue, and a heater means made of an insulating material is arranged on at least one of the jaws to coagulate the living tissue. A coagulation treatment tool characterized by being formed.