JP2001190564A - Medical treatment instrument - Google Patents

Medical treatment instrument

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Publication number
JP2001190564A
JP2001190564A JP2000003759A JP2000003759A JP2001190564A JP 2001190564 A JP2001190564 A JP 2001190564A JP 2000003759 A JP2000003759 A JP 2000003759A JP 2000003759 A JP2000003759 A JP 2000003759A JP 2001190564 A JP2001190564 A JP 2001190564A
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Japan
Prior art keywords
portion
treatment
embodiment
heat generating
coagulation
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JP2000003759A
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Japanese (ja)
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JP4315557B2 (en
Inventor
Koji Iida
Makoto Inaba
Naoki Sekino
誠 稲葉
直己 関野
浩司 飯田
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Olympus Optical Co Ltd
オリンパス光学工業株式会社
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Priority to JP2000003759A priority Critical patent/JP4315557B2/en
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Publication of JP4315557B2 publication Critical patent/JP4315557B2/en
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Abstract

PROBLEM TO BE SOLVED: To provide a medical treatment instrument capable of surely coagulating the tissue of a blood vessel or the like grasped between a pair of treatment members, surely incising the coagulated tissue, being recycled, and realizing the low cost. SOLUTION: Openable and closeable grasping parts 8, 9 for grasping the tissue are respectively provided with heat generating parts for coagulation 14, 15 generating the heat in being energized, and a heat generation part 17 for incising.

Description

【発明の詳細な説明】 DETAILED DESCRIPTION OF THE INVENTION

【0001】 [0001]

【発明の属する技術分野】本発明は、体腔内に挿入して例えば血管や臓器等の体腔内組織を凝固及び、または切開等を行う際に使用される外科手術用鉗子等の医療用処置具に関する。 The present invention relates to the coagulating tissue in the body cavity of the insert into a body cavity such as vascular and organ, and the like, and, or a medical treatment tool of a surgical forceps or the like used when performing dissection, etc. on.

【0002】 [0002]

【従来の技術】患者の体腔内組織を凝固切開する処置具として、例えばUSP5,792,137には半導体からなる発熱素子の一部がメス状の切刃を備えたものが示されている。 2. Description of the Related Art As a treatment instrument for coagulation and incision of the tissue inside a body cavity of a patient, for example, a portion of the heat generating element composed of a semiconductor in USP5,792,137 has been shown that with a female-shaped cutting edge.

【0003】また、USP5,716,366には縫合器における組織接触面の一部が熱エレメントからなり、 [0003] Also, some of the tissue contacting surface of the suture instrument is made of heat elements in USP5,716,366,
更に切断路内を動作する切断エレメントを備えたものが示されている。 It has been shown that with a cutting element that operates within the cutting path further.

【0004】 [0004]

【発明が解決しようとする課題】USP5,792,1 The object of the invention is to be Solved USP5,792,1
37の処置具では、発熱素子自体の一部に鋭利なメス状の切刃が設けられているため、この処置具で生体組織を強力に把持した場合には擬固する前に生体組織を切断し、出血を来すおそれがある。 In 37 of the treatment instrument, for sharp scalpel-like cutting edge on a part of the heating element itself is provided, cut the biological tissue prior to quasi if strongly grasp the living tissue in this treatment tool and, there is a possibility that the cause of the bleeding.

【0005】さらに、この処置具で生体組織を切断しない程度の弱い力で把持した場合には、血管等の生体組織を確実には閉塞できないために、その後の切断操作でやはり出血を来す問題がある。 [0005] Further, when gripped by the weak force of a degree which does not cut the living tissue in this treatment tool, because they can not occluded to ensure biological tissue such as a blood vessel, the problem causing the still bleeding in a subsequent cutting operation there is.

【0006】また、USP5,716,366の縫合器では、切断エレメントが鋭利な刃で構成されているので、刃の切れ味を継続して維持することが難しい問題がある。 [0006] In the suture instrument USP5,716,366, since the cutting element is constituted by a sharp blade, there is a problem that it is difficult to continuously maintain the sharpness of the blade. そのため、縫合器自体を滅菌して再使用することができないので、コストが非常に高くなる問題がある。 Therefore, it is not possible to re-use sterile suture instrument itself, there is a problem that the cost becomes very high.

【0007】本発明は上記事情に着目してなされたもので、その目的は、一対の処置部材間で把持した血管等の生体組織を確実に凝固することができ、かつ凝固した生体組織を確実に切開することができるとともに、再使用可能で、低コストを実現可能な医療用処置具を提供することにある。 [0007] The present invention has been made in view of the above circumstances, and its object is ensure it is possible to reliably coagulate the living tissue such as a blood vessel gripped between a pair of treating member, and coagulated biological tissue it is possible to incise the, reusable, it is to provide a medical treatment instrument capable of realizing low cost.

【0008】 [0008]

【課題を解決するための手段】本発明は、先端部に生体組織を把持する開閉可能な把持部が配設され、基端部に前記把持部を開閉操作する手元側の操作部が配設された医療用処置具において、通電されて熱を発生する凝固処置用熱発生部および切開処置用熱発生部を前記把持部にそれぞれ設けたことを特徴とする医療用処置具である。 SUMMARY OF THE INVENTION The present invention is capable of opening and closing gripper for gripping a living tissue is arranged at the distal end portion, the proximal side of the operation unit is disposed for opening and closing operation of the gripping portion on the base end portion in medical treatment tool, a medical treatment tool, characterized in that the coagulation treatment heat generation unit and the incision heat generating portion is energized to generate heat is provided to each of the gripping portion.
そして、本発明では、凝固時には凝固処置用熱発生部を通電加熱させ、一対の把持部間に把持された血管等の生体組織を凝固処置用熱発生部の熱によって凝固させる。 In the present invention, at the time of solidification heat generating portion for coagulation treatment is energized heating is solidified by the biological tissue coagulation treatment heat generation of the heat of the blood vessel or the like which is gripped between a pair of gripping portions.
その後、切開処置用熱発生部を通電加熱させ、凝固部分を切開するようにしたものである。 Thereafter, the heat generating portion for incision by conduction heating, is obtained so as to incise the solidified portion.

【0009】 [0009]

【発明の実施の形態】以下、本発明の第1の実施の形態を図1および図2を参照して説明する。 BEST MODE FOR CARRYING OUT THE INVENTION Hereinafter, a description will be given of a first embodiment of the present invention with reference to FIGS. 図1は本実施の形態の医療用処置具1のシステム全体の概略構成を示すものである。 Figure 1 shows a schematic configuration of the entire system of the medical treatment tool 1 of the present embodiment. 本実施の形態の医療用処置具1のシステムには鉗子2と、この鉗子2に接続された電源装置3とが設けられている。 The system of the medical treatment tool 1 of the present embodiment and the forceps 2, and connected the power supply unit 3 is provided in the forceps 2.

【0010】ここで、鉗子2の本体4には2つの鋏構成部材5,6が設けられている。 [0010] Here, two scissor components 5,6 are provided on the main body 4 of the forceps 2. これらの鋏構成部材5, These scissor constituting members 5,
6は中途部分が略交差する状態に重ねられている。 6 are superimposed in a state where the middle part substantially intersect. さらに、両鋏構成部材5,6の交差部には両鋏構成部材5, Furthermore, the intersection of the two scissor constituting members 5, 6 both scissor constituting members 5,
6を回動自在に連結する支軸7が配設されている。 Support shaft 7 which connects the 6 rotatably is arranged.

【0011】また、鉗子本体4の先端部には生体組織を把持する開閉可能な一対の把持部8,9を備えた処置部10が配設されている。 Further, the distal end portion of the forceps body 4 treatment portion 10 having a pair of gripping portions 8,9 openable to grip the biological tissue is provided. この処置部10は剥離鉗子と略同じ形状に成形されている。 The treatment portion 10 is molded substantially in the same shape as peeling forceps.

【0012】さらに、各鋏構成部材5,6の基端部には略楕円形状の手指挿入リング11,12が形成されている。 Furthermore, the finger inserting rings 11 and 12 of the substantially elliptical shape is formed in the proximal end of the scissor constituting members 5, 6. そして、これらの手指挿入リング11,12の部分によって一対の把持部8,9を開閉操作する手元側の操作部13が形成されている。 Then, the operation section 13 of the proximal opening and closing operation of the pair of grip sections 8,9 with parts of these finger insertion ring 11 and 12 are formed.

【0013】また、鉗子本体4の各把持部8,9には、 [0013] In addition, in each gripping sections 8 and 9 of the forceps body 4,
図2に示すように生体組織との接触面側に略平板状で幅広な矩形断面の凝固処置用熱発生部14,15がそれぞれ配設されている。 Coagulation treatment heat generating portions 14 and 15 of the wide rectangular cross section with substantially flat contact surface with the biological tissue is provided, respectively, as shown in FIG. これらの凝固処置用熱発生部14, These coagulation treatment heat generating unit 14,
15は、例えばセラミックヒーターや、PTCヒーター(positive temperature coefficient材料で形成されたヒーター)等のように通電されて熱を発生する発熱体によって形成されている。 15, for example, a ceramic heater is energized and is formed by a heat generating member for generating heat as such PTC heaters (positive temperature coefficient heater is formed of a material).

【0014】また、一方の把持部8の凝固処置用熱発生部14における生体組織との接触面側には略平滑な平滑面14aが形成されている。 Further, substantially flat smooth surface 14a on the contact surface with the biological tissue in the coagulation treatment heat generating portion 14 of one of the grip portion 8 is formed. さらに、他方の把持部9の凝固処置用熱発生部15における生体組織との接触面側にも同様に略平滑な平滑面15aが形成されている。 Moreover, other similar substantially flat smooth surface 15a to contact surface with the biological tissue in the coagulation treatment heat generating portion 15 of the grip portion 9 is formed.

【0015】また、把持部9側の凝固処置用熱発生部1 Further, the grip portion 9 side of the coagulation treatment heat generating portion 1
5には平滑面15aの略中央部位に把持部9の中心線方向に沿って延出された凹部16が形成されている。 Recess 16 which extends substantially along the center line direction of the grip portion 9 in the center portion of the smooth surface 15a is formed on 5. この凹部16内には切開処置用熱発生部17が配設されている。 Is incision heat generating portion 17 is disposed in the recess 16. この切開処置用熱発生部17は、例えばニクロム線のように通電されて熱を発生する断面略円形の発熱ワイヤによって形成されている。 The incision heat generating portion 17 is formed by a substantially circular cross section of the heating wire is energized to generate heat, for example, as nichrome wire. なお、切開処置用熱発生部17の外端面の位置は、凝固処置用熱発生部15の外表面の平滑面15aと略一致するように配置されている。 The position of the outer end surface of the dissection treatment heat generating portion 17 is arranged so as substantially to match the smooth surface 15a of the outer surface of the coagulation treatment heat generating unit 15.

【0016】さらに、凝固処置用熱発生部14,15の外面の平滑面14a,15a(生体との接触面)には生体組織の焦げ付きを防止するテフロンコーティング層1 Furthermore, the outer surface of the smooth surface 14a of the coagulation treatment heat generating unit 14, 15, 15a Teflon coating layer 1 (the contact surface with the living body) is to prevent scorching of the living tissue
8,19がそれぞれ形成されている。 8, 19 are formed respectively.

【0017】また、図1に示すように一方の鋏構成部材5には1本のリード線21が、他方の鋏構成部材6には2本のリード線22、23がそれぞれ配設されている。 Further, one lead wire 21 on one of the scissor constituting member 5 as shown in FIG. 1, the two lead wires 22 and 23 are respectively arranged on the other scissor constituting member 6 .
ここで、リード線21の先端部は凝固処置用熱発生部1 Here, the tip portion of the lead wire 21 is coagulation treatment heat generating portion 1
4に接続されている。 It is connected to the 4. さらに、リード線22の先端部は凝固処置用熱発生部15に、またリード線23の先端部は切開処置用熱発生部17にそれぞれ接続されている。 Furthermore, the tip end of the lead wire 22 to the coagulation treatment heat generating unit 15, also the tip end of the lead wire 23 are connected to the incision heat generating unit 17.

【0018】また、鋏構成部材5側の手指挿入リング1 Further, the scissor constituting members 5 side finger inserting ring 1
1の外周面には1つのコード接続部24が突設されている。 One cord connecting portion 24 is projected from the outer circumferential surface of 1. さらに、鋏構成部材6側の手指挿入リング12の外周面には2つのコード接続部25,26が突設されている。 Further, the outer peripheral surface of the scissor constituting members 6 side of the finger insertion ring 12 two cord connecting portion 25, 26 is projected. そして、鋏構成部材5側のコード接続部24にはリード線21の基端部が接続されており、リード線22, Then, the cord connecting portions 24 of the scissor constituting members 5 side are proximal end of the lead wire 21 is connected, the lead wires 22,
23は鋏構成部材6側のコード接続部25,26とそれぞれ接続されている。 23 are respectively connected with the cord connecting portion 25, 26 of the scissor constituting members 6 side.

【0019】さらに、これらコード接続部24,25, Furthermore, these cord connecting portions 24 and 25,
26には一端が電源装置3に接続された接続コード2 26 connection cord 2 one end of which is connected to the power supply device 3 in the
7,28,29の他端部が着脱自在に連結されている。 The other end of the 7,28,29 are connected detachably.
なお、電源装置3にはフットスイッチ32がコード33 Note that the power supply device 3 foot switch 32 code 33
を介して接続されている。 It is connected via a. このフットスイッチ32には切開出力操作部30と凝固出力操作部31とが設けられている。 An incision output operation portion 30 and the coagulation output operation portion 31 is provided in the foot switch 32.

【0020】次に、上記構成の本実施の形態の医療用処置具1の作用について説明する。 Next, a description of the operation of the medical treatment tool 1 of the present embodiment having the above structure. まず、鉗子2の先端部の処置部10を閉じた状態で図示しない血管等の被処置部を含む生体組織に差し込む。 First, plug in the body tissue comprising treatment target portion of a blood vessel or the like (not shown) with closed treatment portion 10 of the distal end portion of the forceps 2. その後、一対の把持部8,9を開くことにより、血管等の被処置部を他の生体組織から剥離して露出させる。 Thereafter, by opening the pair of grip sections 8,9 are exposed by peeling the portion being treated, such as blood vessels from other biological tissue.

【0021】続いて、剥離した血管等を鉗子2の各把持部8,9間で凝固処置に適正な加圧力で圧迫した状態で把持する。 [0021] Then, gripping the detached blood vessel or the like in a state of being squeezed proper pressure to coagulation treatment between the gripper 8 and 9 of the forceps 2. この状態で、フットスイッチ32の凝固出力操作部31を操作する。 In this state, operating the solidified output operation portion 31 of the foot switch 32. これにより、凝固処置用熱発生部14と凝固処置用熱発生部15とが通電されて熱を発生する。 Thus, the coagulation treatment heat generating portion 14 and the coagulation treatment heat generation unit 15 generates the energized heat. このときの凝固処置用熱発生部14,15の熱によって把持部8,9間の血管等の被処置部位が凝固処置され、十分に熱凝固される。 The treatment site such as a blood vessel between the grip portion 8, 9 by heat coagulation treatment heat generating portions 14 and 15 at this time is coagulation treatment is well thermocoagulation.

【0022】その後、これに引き続いてフットスイッチ32の切開出力操作部30を操作する。 [0022] Then, operating the incision output operation portion 30 of the foot switch 32 subsequent thereto. これにより、切開処置用熱発生部17が通電されて熱を発生する。 Accordingly, the dissection treatment heat generating unit 17 generates the energized heat. この切開処置用熱発生部17は凝固処置用熱発生部14、凝固処置用熱発生部15と比較して高温に発熱するようになっている。 It is adapted to generate heat to high temperatures this incision heat generating portion 17 as compared to the coagulation treatment heat generating unit 14, coagulation treatment heat generating unit 15. そのため、凝固された血管等の被処置部位の一部がこのときの切開処置用熱発生部17の熱によって局所的に加熱切断される。 Therefore, part of the treatment site, such as coagulated blood vessel is locally heated cleaved by the heat of dissection treatment heat generating portion 17 in this case.

【0023】そこで、上記構成のものにあっては次の効果を奏する。 [0023] Thus, the apparatus having the configuration described above produces the following effects. すなわち、本実施の形態の医療用処置具1 That is, the medical treatment instrument 1 of this embodiment
では鉗子本体4の各把持部8,9に幅広な凝固処置用熱発生部14、凝固処置用熱発生部15をそれぞれ配設したので、鉗子本体4の各把持部8,9間で把持された血管等の被処置部位を適正な加圧力で圧迫した状態でこれらの凝固処置用熱発生部14,15の熱によって確実に熱凝固することができる。 Each gripper 8,9 wider solidification treatment heat generating portion 14 of the forceps body 4, since the coagulation treatment heat generating portion 15 is disposed, respectively, is gripped between the gripper 8 and 9 of the forceps body 4 in a state where the treatment target site was squeezed proper pressure such as a blood vessel it can be reliably thermally coagulated by the heat of these coagulation treatment heat generating portions 14 and 15.

【0024】さらに、把持部9側の凝固処置用熱発生部15の平滑面15aに凹部16を形成し、この凹部16 Furthermore, a recess 16 on the smooth surface 15a of the grip portion 9 side of the coagulation treatment heat generating portion 15, the recess 16
内に切開処置用熱発生部17を配設したので、凝固処置用熱発生部14,15の熱によって血管等の被処置部位を熱凝固させた後、凝固した血管等の被処置部位の組織を切開処置用熱発生部17の発熱により直ちに切断することができる。 Having disposed incising heat generating portion 17 within, after the treatment target site such as a blood vessel is thermally coagulated by heat coagulation treatment heat generating units 14 and 15, of the treatment site, such as coagulated blood vessel tissue it can be immediately cut the heat generated by the dissection treatment heat generating unit 17. そのため、生体組織を刃物で切断する場合のように使用の繰返しによって切開能が次第に劣化して再使用ができなくなるおそれがなく、コスト的にも有利となる。 Therefore, the living tissue is no risk of incising capability can not be gradually deteriorated and reused repeated use by, as in the case of cutting with a knife, it is advantageous in terms of cost.

【0025】また、図3(A)は本発明の第2の実施の形態を示すものである。 Further, FIG. 3 (A) shows a second embodiment of the present invention. 本実施の形態は第1の実施の形態(図1および図2参照)の医療用処置具1における鉗子2の先端の処置部10の構成を次の通り変更したものである。 This embodiment is obtained by changing as constituting the following treatment portion 10 at the tip of the forceps 2 at the medical treatment tool 1 of the first embodiment (see FIGS. 1 and 2).

【0026】すなわち、本実施の形態では、把持部9側の凝固処置用熱発生部15における平滑面15aの側端に凹部16が配置され、この凹部16内に切開処置用熱発生部17が配設されている。 [0026] That is, in this embodiment, the recess 16 in the side edge of the smooth surface 15a is disposed in the grip portion 9 side of the coagulation treatment heat generating unit 15, the incision heat generating portion 17 in the recess 16 It is disposed. なお、これ以外の部分の構成は第1の実施の形態と同様である。 The configuration of the other portions are the same as in the first embodiment.

【0027】次に、上記構成における作用について説明する。 Next, a description will be given of the operation in the above configuration. 本実施の形態の鉗子2を使用して第1の実施の形態と同様の処置を行う場合には、次のような作業が行われる。 When performing the same treatment as in the first embodiment by using the forceps 2 of the present embodiment, operations such as the following is performed. まず、第1の実施の形態と同様の手順で鉗子2を操作して体腔内組織の血管等の被処置部位を剥離し、剥離した血管等を鉗子2の各把持部8,9間で凝固処置に適正な加圧力で圧迫した状態で把持する。 First, the same procedure as in the first embodiment by operating the forceps 2 is peeled off the treatment target site such as a blood vessel in the body cavity tissue, coagulate peeling vessel like between the gripper 8 and 9 of the forceps 2 gripping while compressing under appropriate pressure treatment. この状態で、 In this state,
凝固処置用熱発生部14と凝固処置用熱発生部15とが通電加熱され、把持部8,9間の血管等の被処置部位が熱凝固される。 A coagulation treatment heat generating portion 14 and the coagulation treatment heat generating portion 15 is energized and heated, the treatment site such as a blood vessel between the grip portion 8, 9 are thermally solidified.

【0028】その後、一旦、把持部8,9を開いて凝固状態を確認した後、これに引き続いて切開処置用熱発生部17を凝固した処置部位の中心位置に合わせてセットした状態で、把持部8,9を再度閉じる。 [0028] Thereafter, once, after checking the solidified state by opening the gripping portions 8,9, at setting to match the center position of the solidified treatment site of dissection treatment heat generating portion 17 subsequently thereto, the gripping Close the part 8, 9 again. この状態で、 In this state,
フットスイッチ32の切開出力操作部30を操作する。 Operating the incision output operation portion 30 of the foot switch 32.
これにより、切開処置用熱発生部17が通電加熱され、 Thus, the incision heat generating unit 17 is energized and heated,
凝固された血管等の被処置部位の一部がこのときの切開処置用熱発生部17の熱によって局所的に加熱切断される。 Some of the treatment site, such as coagulated blood vessel is locally heated cleaved by the heat of dissection treatment heat generating portion 17 in this case.

【0029】そこで、上記構成のものにあっては次の効果を奏する。 [0029] Thus, the apparatus having the configuration described above produces the following effects. すなわち、本実施の形態の鉗子2では把持部9側の切開処置用熱発生部17を凝固処置用熱発生部15上の側端に配置したので、鉗子2の先端の処置部1 That is, since the dissection treatment heat generating portion 17 of the forceps 2, the grip portion 9 side of the present embodiment is disposed on a side end of the coagulation treatment heat generating unit 15, the treatment portion at the distal end of the forceps 2 1
0を側方から目視することにより、把持部9側の切開処置用熱発生部17を簡単に確認できる。 0 by visually from the side, you can easily check the grip portion 9 side of the dissection treatment heat generating unit 17. そのため、一旦、凝固した生体組織を後から切開する場合に、鋏を操作する場合のように切断位置を術者の意のままに合わせ易くなり、安全に切開操作を行うことができる。 Therefore, once, when the incision later solidified body tissue, easily move the cutting position to the left of the operator at will, such as when operating the scissors can be performed safely incision operation.

【0030】また、図3(B)は本発明の第3の実施の形態を示すものである。 Further, FIG. 3 (B) show a third embodiment of the present invention. 本実施の形態は第1の実施の形態(図1および図2参照)の医療用処置具1における鉗子2の先端の処置部10の構成を次の通り変更したものである。 This embodiment is obtained by changing as constituting the following treatment portion 10 at the tip of the forceps 2 at the medical treatment tool 1 of the first embodiment (see FIGS. 1 and 2).

【0031】すなわち、第1の実施の形態では把持部9 [0031] That is, in the first embodiment gripping portion 9
側の凝固処置用熱発生部15のみに切開処置用熱発生部17を配設した構成を示したが、本実施の形態ではこれに加えて把持部8の凝固処置用熱発生部14にも同様に平滑面14aの略中央部位に把持部8の中心線方向に沿って延出された凹部16を形成し、この凹部16内に切開処置用熱発生部17を配設したものである。 A configuration has been shown which is disposed an incision heat generating unit 17 only coagulation treatment heat generating portion 15 of the side, in this embodiment also coagulation treatment heat generating portion 14 of the grip portion 8 in addition to the Similarly at a substantially central portion of the smooth surface 14a along the center line direction of the grip portion 8 is formed a recess 16 which extends, in which is disposed the incising heat generating portion 17 in the recess 16.

【0032】次に、上記構成における作用について説明する。 Next, a description will be given of the operation in the above configuration. 本実施の形態の鉗子2を使用して第1の実施の形態と同様の処置を行う場合には、次のような作業が行われる。 When performing the same treatment as in the first embodiment by using the forceps 2 of the present embodiment, operations such as the following is performed. まず、第1の実施の形態と同様の手順で鉗子2を操作して体腔内組織の血管等の被処置部位を剥離し、剥離した血管等を鉗子2の各把持部8,9間で凝固処置に適正な加圧力で圧迫した状態で把持する。 First, the same procedure as in the first embodiment by operating the forceps 2 is peeled off the treatment target site such as a blood vessel in the body cavity tissue, coagulate peeling vessel like between the gripper 8 and 9 of the forceps 2 gripping while compressing under appropriate pressure treatment. この状態で、 In this state,
凝固処置用熱発生部14と凝固処置用熱発生部15とが通電加熱され、把持部8,9間の血管等の被処置部位が熱凝固される。 A coagulation treatment heat generating portion 14 and the coagulation treatment heat generating portion 15 is energized and heated, the treatment site such as a blood vessel between the grip portion 8, 9 are thermally solidified.

【0033】その後、これに引き続いてフットスイッチ32の切開出力操作部30を操作する。 [0033] Then, operating the incision output operation portion 30 of the foot switch 32 subsequent thereto. これにより、両方の把持部8,9の切開処置用熱発生部17が同時に通電加熱され、凝固された血管等の被処置部位の一部がこのときの両側の切開処置用熱発生部17の熱によって局所的に加熱切断される。 Thus, dissection treatment heat generating portion 17 of both the gripping portion 8, 9 are energized simultaneously heated, a part of the treatment site, such as coagulated blood vessels on both sides of the dissection treatment heat generating portion 17 in this case It is locally heated cleaved by heat.

【0034】そこで、上記構成のものにあっては次の効果を奏する。 [0034] Thus, the apparatus having the configuration described above produces the following effects. すなわち、本実施の形態の鉗子2では把持部9側の凝固処置用熱発生部15および把持部8側の凝固処置用熱発生部14の両方にそれぞれ切開処置用熱発生部17を配設したので、両側の切開処置用熱発生部1 That was disposed incising heat generating unit 17, respectively in both the coagulation treatment heat generating portion 14 of the coagulation treatment heat generating section 15 and the grip portion 8 side of the forceps 2 grasp portion 9 side of the embodiment since the heat generation unit 1 for each side of the incision
7から血管等の被処置部位の熱凝固部に局所的に熱を集中することができる。 It can concentrate locally heat to the heat coagulation of the treatment site, such as a blood vessel from 7. そのため、凝固された血管等の被処置部位の熱凝固部を両側の切開処置用熱発生部17の発熱により、容易に切開することができるので、熱凝固した生体組織をさらに切開し易くなり、処置時間の短縮が図れる。 Therefore, heat generated by the thermal coagulation of the treatment site, such as coagulated blood vessels on both sides of the dissection treatment heat generating unit 17, it is possible to easily incision tends to further dissected thermocoagulation living tissue, shortening of the treatment time can be reduced.

【0035】また、図3(C)は本発明の第4の実施の形態を示すものである。 Further, FIG. 3 (C) is shows a fourth embodiment of the present invention. 本実施の形態は第1の実施の形態(図1および図2参照)の医療用処置具1における鉗子2の先端の処置部10の構成を次の通り変更したものである。 This embodiment is obtained by changing as constituting the following treatment portion 10 at the tip of the forceps 2 at the medical treatment tool 1 of the first embodiment (see FIGS. 1 and 2).

【0036】すなわち、第1の実施の形態では把持部9 [0036] That is, in the first embodiment gripping portion 9
側の凝固処置用熱発生部15の平滑面15aの略中央部位に凹部16を形成し、この凹部16内に切開処置用熱発生部17を配設するとともに、把持部8側の凝固処置用熱発生部14における凝固処置用熱発生部15との対向面には平滑面14aのみを設ける構成を示したが、本実施の形態では把持部8側の凝固処置用熱発生部14の平滑面14aにおける把持部9側の切開処置用熱発生部17との対向部位に、例えば多孔質からなるセラミックのような断熱材34を配設したものである。 A recess 16 at a substantially central portion of the smooth surface 15a side of the coagulation treatment heat generating section 15, together with arranging the incision heat generating portion 17 in the recess 16, for coagulation treatment of the grip portion 8 side Although the surface facing the coagulation treatment heat generating portion 15 in the heat generating unit 14 showing a configuration in which only the smooth surface 14a, the smooth surface of the grip portion 8 side of the coagulation treatment heat generating portion 14 in this embodiment the opposing portion between the grip portion 9 side of the dissection treatment heat generating portion 17 in 14a, in which is disposed a heat insulating material 34 such as a ceramic made of, for example, porous.

【0037】そこで、本実施の形態の鉗子2では切開処置用熱発生部17が通電加熱され、切開処置用熱発生部17が発熱した際に、把持部8側の凝固処置用熱発生部14の平滑面14aの断熱材34によって切開処置用熱発生部17の熱が把持部8側に逃げることを防ぐことができる。 [0037] Thus, the forceps 2 at incision heat generating unit 17 of this embodiment is energized heating, when the incision heat generator 17 generates heat, the grip portion 8 side of the coagulation treatment heat generating portion 14 thermal insulation 34 by incising heat generation unit 17 of the smooth surface 14a can be prevented from escaping to the grip portion 8 side. そのため、切開処置用熱発生部17の熱を鉗子2の各把持部8,9間の血管等の被処置部位の熱凝固部に集中的に作用させることができるので、熱凝固した生体組織を切開し易くなる効果がある。 Therefore, since the heat of the dissection treatment heat generating portion 17 can be made to act intensively on the thermal coagulation of the treatment site such as a blood vessel between the respective gripping portions 8,9 of the forceps 2, heat coagulated biological tissue there is an incision to facilitate become effective.

【0038】また、図3(D)は本発明の第5の実施の形態を示すものである。 Further, FIG. 3 (D) shows a fifth embodiment of the present invention. 本実施の形態は第1の実施の形態(図1および図2参照)の医療用処置具1における鉗子2の先端の処置部10の構成を次の通り変更したものである。 This embodiment is obtained by changing as constituting the following treatment portion 10 at the tip of the forceps 2 at the medical treatment tool 1 of the first embodiment (see FIGS. 1 and 2).

【0039】すなわち、本実施の形態では一対の把持部8,9のうちの一方の把持部8のみに凝固処置用熱発生部14を設け、他方の把持部9における生体組織との接触面9a側には略中央部位に把持部9の中心線方向に沿って延出された凹部9bを形成し、この凹部9b内に切開処置用熱発生部17を配設したものである。 [0039] That is, in this embodiment provided with one grip portion 8 only coagulation treatment heat generating portion 14 of the pair of gripping portions 8,9, the contact surface 9a of the biological tissue in the other handle portion 9 side an extending out recesses 9b formed along the center line direction of the grip portion 9 in a substantially central portion in the one in which is disposed the incising heat generating portion 17 in the recess 9b.

【0040】そして、本実施の形態でも第1の実施の形態と略同様の効果が得られる。 [0040] Then, the form and substantially the same effect of the first embodiment can be obtained in this embodiment. なお、把持部9における生体組織との接触面9a側にテフロンコーティング層を設けてもよい。 Incidentally, Teflon coating layer may be provided on the contact surface 9a side of the body tissue in the grip portion 9. さらに、凝固処置用熱発生部は把持部9 Furthermore, the heat-generating portion for coagulation treatment gripper 9
側のみに設け、ここに切開処置用熱発生部17を配設する構成にしてもよい。 Provided only on the side, it may be configured to dispose the incision heat generator 17 here.

【0041】また、図4乃至図6(A),(B)は本発明の第6の実施の形態を示すものである。 Further, FIGS. 4 to 6 (A), (B) shows a sixth embodiment of the present invention. 本実施の形態では第1の実施の形態(図1および図2参照)の医療用処置具1における鉗子2の構成を次の通り変更したものである。 In this embodiment is that the configuration of the forceps 2 at the medical treatment tool 1 of the first embodiment (see FIGS. 1 and 2) as follows.

【0042】すなわち、本実施の形態の鉗子2では把持部9側の切開処置用熱発生部17を図5(A),(B) [0042] That is, the dissection treatment heat generating portion 17 of the forceps 2, the grip portion 9 side of the present embodiment FIG. 5 (A), (B)
に示す待機位置と、図6(A),(B)に示す使用位置とに移動可能にしたものである。 And a standby position, FIG. 6 (A) shown in is obtained by movable in the use position shown in (B).

【0043】ここで、本実施の形態の鉗子2には図5 [0043] Figure 5 herein, the forceps 2 of the present embodiment
(A),(B)に示すように把持部9側に切開処置用熱発生部17の移動用の空間35が形成されている。 (A), it is formed a space 35 for moving the incision heat generating portion 17 to the grip portion 9 side as shown in (B). さらに、把持部9側の凝固処置用熱発生部15にはこの移動用空間35に連通する間隙35aが中心線上に設けられている。 Moreover, gaps 35a communicating with the movement space 35 is provided on the center line in the grip portion 9 side of the coagulation treatment heat generating unit 15.

【0044】また、把持部9側の移動用空間35の内部には切開処置用熱発生部17の移動をガイドする前部および後部の2つの三角形状のガイド部材36がそれぞれ固定されている。 [0044] Further, front and rear two triangular shaped guide member 36 therein for guiding the movement of the dissection treatment heat generating portion 17 of the grip portion 9 side movement space 35 are respectively fixed.

【0045】さらに、切開処置用熱発生部17は支持部材37によって支持されている。 [0045] Further, the dissection treatment heat generating portion 17 is supported by the support member 37. この支持部材37の前端部及び後端部にはガイド部材36の傾斜面と接する円柱状の滑り部材37a,37bがそれぞれ固定されている。 This front end and the rear end portion of the support member 37 is a cylindrical sliding member 37a in contact with the inclined surface of the guide member 36, 37b are respectively fixed. そして、切開処置用熱発生部17は支持部材37の滑り部材37a,37bがガイド部材36の傾斜面に沿って移動する状態で、図5(A),(B)に示す待機位置と、図6(A),(B)に示す使用位置とに移動可能に保持されている。 Then, the dissection treatment heat generating portion 17 in a state where the sliding member 37a of the supporting member 37, 37b move along the inclined surface of the guide member 36, FIG. 5 (A), the a standby position (B), the Fig. 6 (a), and it is movably held in the use position shown in (B). ここで、図5(A),(B)に示す待機位置では切開処置用熱発生部17は把持部8の凝固処置用熱発生部14から離れた状態で保持されている。 Here, FIG. 5 (A), the is held in a state away from the coagulation treatment heat generating portion 14 of the dissection treatment heat generating unit 17 grip portion 8 in the standby position shown in (B).
そして、図6(A),(B)に示す使用位置では切開処置用熱発生部17は把持部8の凝固処置用熱発生部14 Then, FIG. 6 (A), the the dissection treatment heat generating portion 17 is in the position of use shown in (B) coagulation treatment heat generating portion 14 of the grip portion 8
に当接される方向に移動されるようになっている。 It is adapted to be moved in a direction to abut against the.

【0046】また、鋏構成部材6の支軸7と手指挿入リング12との間には前後方向に進退する操作レバー38 [0046] The operation lever 38 between the support shaft 7 and the finger insertion ring 12 of the scissor constituting member 6 forward and backward in the longitudinal direction
が配設されている。 There has been arranged. この操作レバー38は図4中に実線で示す前進位置から同図中に点線で示す後退位置まで進退可能に支持されている。 The operating lever 38 is movably supported from the forward position shown by the solid line in FIG. 4 to the retracted position shown by a dotted line in FIG.

【0047】さらに、この操作レバー38には切開処置用熱発生部17を移動操作する操作ワイヤ39の基端部が固定されている。 [0047] Further, the base end portion of the operating wire 39 to move operating a dissection treatment heat generating portion 17 is fixed to the operation lever 38. この操作ワイヤ39の先端部は支持部材37の後端に固定されている。 Distal end of the operation wire 39 is fixed to the rear end of the support member 37. そして、操作レバー38は図4中に実線で示す前進位置で保持されている場合には切開処置用熱発生部17は図5(A),(B)に示す待機位置で保持されるようになっている。 The operation lever 38 is incision heat generating portion 17 when it is held in the forward position shown by the solid line in FIG. 4 FIG. 5 (A), the to be retained at the standby position shown in (B) going on. また、操作レバー38が図4中に点線で示す後退位置まで移動操作された場合には切開処置用熱発生部17は図6 Further, the dissection treatment heat generating portion 17 when the operation lever 38 is operated to move to the retracted position shown by a dotted line in Figure 4. Figure 6
(A),(B)に示す使用位置に移動されるようになっている。 (A), it is adapted to be moved to the use position shown in (B).

【0048】次に、上記構成における作用について説明する。 Next, a description will be given of the operation in the above configuration. 本実施の形態の鉗子2を使用して第1の実施の形態と同様の処置を行う場合には、次のような作業が行われる。 When performing the same treatment as in the first embodiment by using the forceps 2 of the present embodiment, operations such as the following is performed. まず、鋏構成部材6の操作レバー38は通常は図4中に実線で示す前進位置で保持され、切開処置用熱発生部17は図5(A),(B)に示す待機位置で保持される。 First, the operation lever 38 of the scissor constituting members 6 are normally held in the forward position shown by the solid line in FIG. 4, the dissection treatment heat generating unit 17 FIG. 5 (A), the held at the standby position shown in (B) that. この状態で、第1の実施の形態と同様の手順で鉗子2を操作して体腔内組織の血管等の被処置部位を剥離し、把持部8,9間で把持して熱凝固を行う。 In this state, the same procedure as in the first embodiment by operating the forceps 2 is peeled off the treatment target site such as a blood vessel in the tissue inside a body cavity, for heat coagulation and gripped between the gripper 8 and 9.

【0049】その後、これに引き続いて操作レバー38 [0049] Then, operation subsequent to this lever 38
が図4中に実線で示す前進位置から点線で示す後退位置に移動操作される。 There is movement operation in a retracted position indicated by a dotted line from the forward position shown with a solid line in FIG. このとき、操作レバー38の後退動作にともない操作ワイヤ39が後方に引かれ、支持部材37の滑り部材37a,37bが傾斜部材38の傾斜部に沿って後方に傾斜移動する。 At this time, the operation wire 39 with the backward movement of the operation lever 38 is pulled rearwardly, sliding member 37a of the supporting member 37, 37b is inclined moved backward along the inclined portion of the inclined member 38. その結果、切開処置用熱発生部17は図6(A),(B)に示す使用位置に移動され、この切開処置用熱発生部17が凝固処置用熱発生部14に当接される。 As a result, the dissection treatment heat generating unit 17 FIG. 6 (A), the moved to the use position (B), the the incision heat generating portion 17 is brought into contact with coagulation treatment heat generating portion 14.

【0050】この状態で、フットスイッチ32の切開出力操作部30を操作すると切開処置用熱発生部17が通電加熱され、熱凝固された生体組織が切開処置用熱発生部17の熱によって切断される。 [0050] In this state, an incision output operation unit 30 and operates the incision heat generating portion 17 of the foot switch 32 is energized and heated, heat solidified body tissue is cut by the heat of the dissection treatment heat generating portion 17 that.

【0051】そこで、上記構成のものにあっては次の効果を奏する。 [0051] Thus, the apparatus having the configuration described above produces the following effects. すなわち、本実施の形態の鉗子2では切開処置用熱発生部17を図5(A),(B)に示す待機位置と、図6(A),(B)に示す使用位置とに移動可能にしたので、熱凝固された生体組織を切開する場合には切開処置用熱発生部17を図6(A),(B)に示す使用位置に移動させ、凝固処置用熱発生部14に当接させて密着させることができる。 That is, the forceps 2 at incision heat generating unit 17 of the present embodiment FIG. 5 (A), the a standby position shown in (B), FIG. 6 (A), the movable to the use position shown in (B) since the FIG. 6 dissection treatment heat generating portion 17 in the case of cutting the heat solidified body tissue (a), is moved to the use position (B), the coagulation treatment heat generating portion 14 equivalents it can be adhered by contact. そのため、熱凝固された生体組織を熱的に確実に切断することができ、生体組織が切れ残ることがなくなる効果がある。 Therefore, heat solidified biological tissue can be thermally reliably cut, there is an effect that it is no longer living tissue remains off.

【0052】また、図7および図8は本発明の第7の実施の形態を示すものである。 [0052] Further, FIGS. 7 and 8 shows a seventh embodiment of the present invention. 本実施の形態は第6の実施の形態(図4乃至図6(A),(B)参照)の医療用処置具1の構成を次の通り変更したものである。 This embodiment sixth embodiment (FIGS. 4 to 6 (A), (B) refer) is modified as constituting the following medical treatment tool 1 of the.

【0053】すなわち、本実施の形態の鉗子2では第6 [0053] That is, first the forceps 2 of the present embodiment 6
の実施の形態で示した操作レバー38の後退位置に切開処置用熱発生部17のオンオフ操作用のスイッチ手段4 Switching means for on-off operation of the dissection treatment heat generating portion 17 in the retracted position of the operating lever 38 shown in the embodiment 4
0がさらに配設されている。 0 is further disposed. このスイッチ手段40にはリード線41の一端部が接続されている。 One end of the lead wire 41 is connected to the switching means 40. このリード線41の他端部は鋏構成部材6の手指挿入リング12の外周面に突設されたコード接続部42の内端部に接続されている。 The other end of the lead wire 41 is connected to the inner end portion of the cord connecting portion 42 projecting from the outer peripheral surface of the finger inserting ring 12 of the scissor constituting members 6. このコード接続部42の外端部には、接続コード43の一端が着脱自在に連結されている。 The outer end of the cord connecting portion 42, one end of the connecting cord 43 is connected detachably. この接続コード43の他端部は電源装置3に接続されている。 The other end of the connecting cord 43 is connected to the power supply 3.

【0054】また、電源装置3には凝固出力操作部44 [0054] Further, the power supply device 3 coagulation output operation portion 44
を備えたフットスイッチ45がコード46を介して接続されている。 Foot switch 45 having a are connected via a cord 46. さらに、電源装置3の内部には図8に示すように、出力回路47、制御回路48及び検知回路49 Further, the internal power supply 3, as shown in FIG. 8, the output circuit 47, control circuit 48 and the detection circuit 49
がそれぞれ設けられている。 There has been provided, respectively. ここで、制御回路48には出力回路47と、検知回路49と、電源装置3の操作パネルに配設されたパネル入力・表示部53と、フットスイッチ45とがそれぞれ接続されている。 Here, the output circuit 47 to the control circuit 48, a detection circuit 49, a panel input and display unit 53 arranged on the operation panel of the power unit 3, a foot switch 45 are connected, respectively. なお、制御回路48はパネル入力・表示部53とはデータの入力および出力が双方向に行われるように接続されている。 The control circuit 48 includes a panel input and display unit 53 are connected to the input and output of data is performed in both directions. そして、パネル入力・表示部53では出力または温度の設定入力や、その設定温度の表示などが行われるようになっている。 The output or setting input and the temperature in the panel input and display unit 53, and display of the set temperature and the like are performed.

【0055】さらに、電源装置3に設けられている接続コネクタ50の内端部側は出力回路47とは3本の出力ライン51で接続され、検知回路49とは検知ライン5 [0055] Further, the inner end of the connector 50 provided in the power supply device 3 is connected with three output lines 51 and the output circuit 47, sensing line 5 and the detection circuit 49
2で接続されている。 It is connected by two.

【0056】次に、上記構成における作用について説明する。 Next, a description will be given of the operation in the above configuration. 本実施の形態の鉗子2を使用して第1の実施の形態と同様の処置を行う場合には、次のような作業が行われる。 When performing the same treatment as in the first embodiment by using the forceps 2 of the present embodiment, operations such as the following is performed. まず、第6の実施の形態と同様に鋏構成部材6の操作レバー38が図7中に実線で示す前進位置で保持され、切開処置用熱発生部17が待機位置で保持されている状態(図5(A),(B)に示す)で、第1の実施の形態と同様の手順で鉗子2を操作して体腔内組織の血管等の被処置部位を剥離し、把持部8,9間で把持する。 First, a state where the operation lever 38 of the sixth pincers member 6 as in the embodiment of is held in the forward position shown by the solid line in FIG. 7, the dissection treatment heat generating portion 17 is held at the standby position ( FIG. 5 (a), the in shown in (B)), by operating the forceps 2 is peeled off the treatment target site such as a blood vessel in the tissue inside a body cavity by the same procedure as in the first embodiment, the grip portion 8, 9 to grip between.
このとき、フットスイッチ45の凝固出力操作部44を操作することにより、凝固処置用熱発生部14と凝固処置用熱発生部15が通電加熱され、血管等の被処置部位が熱凝固される。 At this time, by operating the solidified output operation portion 44 of the foot switch 45, coagulation treatment heat generating portion 14 and the coagulation treatment heat generating portion 15 is energized and heated, the treatment site such as a blood vessel is thermally solidified.

【0057】その後、これに引き続いて操作レバー38 [0057] Then, operation subsequent to this lever 38
が図7中に実線で示す前進位置から点線で示す後退位置に移動操作される。 There is movement operation in a retracted position indicated by a dotted line from the forward position shown by the solid line in FIG. このとき、操作レバー38の後退動作にともない操作ワイヤ39が後方に引かれ、切開処置用熱発生部17が図6(A),(B)に示す使用位置に移動されてこの切開処置用熱発生部17が凝固処置用熱発生部14に当接される。 At this time, the operation wire 39 with the backward movement of the operation lever 38 is pulled rearwardly, the dissection treatment heat generating portion 17 Figure 6 (A), (B) is moved to the use position shown in heat for the incising generator 17 is brought into contact with coagulation treatment heat generating portion 14. さらに、操作レバー38が後退位置に移動操作されるとスイッチ手段40が作動し、 Further, when the operation lever 38 is operated to move the retracted position switching means 40 is actuated,
このスイッチ手段40から信号が出力される。 Signal is output from the switching means 40. このとき、スイッチ手段40から出力される信号は電源装置3 At this time, the signal output from the switching means 40 power supply 3
の検知回路49に入力される。 Is input to the detection circuit 49. そのため、この検知回路49によって操作レバー38が後退位置に移動した状態が検知される。 Therefore, the state in which the operation lever 38 is moved to the retracted position by the detection circuit 49 is detected. この操作レバー38が後退位置に移動した作動状態の検知時には、制御回路48が出力回路47 During detection of the operating state of the operating lever 38 is moved to the retracted position, the control circuit 48 is output circuit 47
の出力を制御し、切開処置用熱発生部17が通電加熱され、熱凝固された生体組織が切開処置用熱発生部17の熱によって切断される。 Controlling the output of the dissection treatment heat generating unit 17 is energized and heated, heat solidified body tissue is cut by the heat of the dissection treatment heat generating unit 17.

【0058】そこで、上記構成のものにあっては次の効果を奏する。 [0058] Thus, the apparatus having the configuration described above produces the following effects. すなわち、本実施の形態の医療用処置具1 That is, the medical treatment instrument 1 of this embodiment
では操作レバー38を後退位置まで操作すると同時にスイッチ手段40が作動し、電源装置3の出力を切り換えるようにしている。 In the operation of the operation lever 38 to the retracted position switch means 40 is actuated simultaneously, so that switch the output of the power supply device 3. そのため、フットスイッチ45の踏み間違えによって凝固処置用熱発生部14,15と、切開処置用熱発生部17とを誤って作動させるおそれがなく、安全に凝固、切開操作を行える効果がある。 Therefore, the coagulation treatment heat generating parts 14 and 15 by mistake depression of foot switch 45, incision heat generating portion 17 and there is no possibility of actuating accidentally, safely coagulate, there is an effect that allows the incision operation.

【0059】また、図9(A),(B)は本発明の第8 [0059] Further, FIG. 9 (A), (B) the eighth of the present invention
の実施の形態を示すものである。 It shows the embodiment. 本実施の形態は、医療用処置具として内視鏡下手術に使用される手術用処置具54に本発明を適用したものである。 This embodiment is an application of the present invention to operative instrument 54 for use in endoscopic surgery as a medical treatment tool. 図9(A)は手術用処置具54全体の概略構成を示すものである。 FIG. 9 (A) is schematically shows the structure of the entire treating instrument 54.

【0060】本実施の形態の処置具54には、図示しないトラカール外套管を通して生体内に挿入される細長い挿入部55と、この挿入部55の基端部に連結された手元側の操作部56とが設けられている。 [0060] the treatment instrument 54 of this embodiment comprises an elongated insertion portion 55 to be inserted into the living body through the trocar cannula (not shown), the proximal side is connected to the proximal end of the insertion portion 55 operating portion 56 door is provided.

【0061】また、挿入部55には管状の挿入管体57 [0061] In addition, the tubular insertion portion 55 inserted tube 57
が設けられている。 It is provided. この挿入管体57内には挿入部55 Insert 55 in the insert tube 57
の軸方向に相対運動される駆動軸58が挿通されている。 Drive shaft 58 in the axial direction is relative motion is inserted. さらに、挿入部55の先端部には処置部59が配設されている。 Further, the distal end of the insertion portion 55 is disposed on the treatment portion 59. この処置部59には開閉可能な一対の把持部材60a,60bが設けられている。 Openable pair of gripping members 60a, 60b is provided in the treatment portion 59. ここで、一対の把持部材60a,60bは例えばカム機構等の図示しない駆動機構を介して駆動軸58の先端部に連結されている。 Here, a pair of gripping members 60a, 60b is connected to the distal end of the drive shaft 58 via a drive mechanism (not shown) such as a cam mechanism, for example. そして、駆動軸58の進退動作に伴ない駆動機構を介して処置部59の把持部材60a,60b間が開閉駆動されるようになっている。 Then, the gripping member 60a of the treatment section 59 through the companion no drive mechanism in forward and backward movement of the drive shaft 58, between 60b is adapted to be opened and closed.

【0062】また、本実施の形態の把持部材60a,6 [0062] Further, in this embodiment the gripping members 60a, 6
0bは第6の実施の形態(図4乃至図6(A),(B) 0b the sixth embodiment (FIGS. 4 to 6 (A), (B)
参照)の鉗子2における各把持部8,9と略同様に構成される。 Substantially the same configuration as each gripping unit 8,9 of the forceps 2 of the reference).

【0063】すなわち、本実施の形態の把持部材60 [0063] That is, the gripping member 60 of this embodiment
a,60bの内部には第6の実施の形態の各把持部8, a, 6 each gripping portion 8 of the embodiment of the internal 60b,
9と同様に図5(A),(B)、図6(A),(B)に示す凝固処置用熱発生部14、凝固処置用熱発生部1 Similar to Figure 9 5 (A), (B), FIG. 6 (A), the coagulation treatment heat generating unit 14 (B), the coagulation treatment heat generating portion 1
5、切開処置用熱発生部17、及び支持部材37、滑り部材37a,37b、ガイド部材36、操作ワイヤ39 5, incision heat generating unit 17, and the support member 37, sliding member 37a, 37b, the guide member 36, the operating wire 39
が備えられている。 It is provided.

【0064】また、手元側操作部56には挿入部55の基端部を回転自在に保持する操作部本体62が設けられている。 [0064] The operation portion main body 62 for holding rotatably the base end portion of the insertion portion 55 is provided on the proximal side operating portion 56. この操作部本体62には固定ハンドル63が一体的に形成されている。 Fixed handle 63 is formed integrally in the operation portion main body 62. なお、操作部本体62の先端部には挿入部55の基端部を回転操作する回転操作ノブ6 The rotation operation knob to the tip portion of the operation portion main body 62 for rotating the proximal end portion of the insertion portion 55 6
4が配設されている。 4 is disposed.

【0065】さらに、固定ハンドル63には可動ハンドル65の連結部が支軸66を介して回動自在に連結されている。 [0065] Further, the connecting portion of the movable handle 65 is rotatably connected to via a support shaft 66 fixed handle 63. この可動ハンドル65には駆動軸58の基端部が連結されている。 Proximal end of the drive shaft 58 is coupled to the movable handle 65.

【0066】また、固定ハンドル63の末端部には操作者の手指が挿入可能な第1の指当てリング67aが形成されている。 [0066] Further, the end portion of the fixed handle 63 first finger rest ring 67a capable inserted finger of the operator is formed. さらに、可動ハンドル65の末端部には同様に操作者の手指が挿入可能な第2の指当てリング67 Further, the second finger contacting the distal end of the movable handle 65 is finger similarly operator who can insert ring 67
bが形成されている。 b is formed. そして、固定ハンドル63に対する可動ハンドル65の開閉(回動)操作にともない駆動軸58が軸心方向に沿って進退駆動され、処置部59の把持部材60間が開閉駆動されるようになっている。 Then, the drive shaft 58 with the opening and closing (turning) operation of the movable handle 65 is driven back and forth along the axial direction, while the gripping members 60 of the treatment section 59 is adapted to be opened and closed relative to the stationary handle 63 .

【0067】さらに、本実施の形態の固定ハンドル63 [0067] In addition, fixed handle 63 of this embodiment
には切開処置用熱発生部17を図5(A),(B)に示す待機位置と、図6(A),(B)に示す使用位置とに移動操作する操作レバー61が配設されている。 Figure 5 a dissection treatment heat generating section 17 (A), (B) and a standby position shown in, FIG. 6 (A), the operating lever 61 operated to move the use position shown in (B) is arranged to ing. この操作レバー61は図9(A)中に実線で示す前進位置から同図中に点線で示す後退位置まで進退可能に支持されている。 The operating lever 61 is movably supported from the forward position shown by a solid line in FIG. 9 (A) to the retracted position shown by a dotted line in FIG. そして、このレバー61の操作にともない切開処置用熱発生部17が凝固処置用熱発生部14に対して接離する方向に移動するようになっている。 The incision heat generating unit 17 with the operation of the lever 61 is moved in the direction toward and away from relative coagulation treatment heat generating portion 14.

【0068】次に、上記構成の作用について説明する。 Next, a description will be given of the operation of the above configuration.
本実施の形態の手術用処置具54の使用時には固定ハンドル63のリング67a内および可動ハンドル65のリング67b内にそれぞれ操作者の手指が挿入される。 When using the treating instrument 54 of this embodiment each operator's fingers into the ring 67b of the ring 67a and in the movable handle 65 of the fixed handle 63 is inserted. この状態で、固定ハンドル63に対して可動ハンドル65 In this state, the movable handle 65 relative to fixed handle 63
を回動させる。 A is rotated. このときの可動ハンドル65の回動操作にともない駆動軸58が挿入部55に対し軸方向に運動し、駆動機構を介して挿入部55の先端の処置部59の把持部材60a,60b間が開閉駆動される。 Moving in the axial drive shaft 58 with the rotational operation of the movable handle 65 is relative to the insert 55 of this time, the grip member 60a of the distal end of the treatment portion 59 of the insertion portion 55 through the drive mechanism, between 60b is opened and closed It is driven.

【0069】さらに、リング67a,67bに挿入している以外の手指でレバー61を操作することにより切開処置用熱発生部17の操作ワイヤ39が挿入部55に対し軸方向に運動し、切開処置用熱発生部17が把持部6 [0069] Furthermore, the ring 67a, to the operation wire 39 of the dissection treatment heat generating portion 17 inserting part 55 by operating the lever 61 with fingers other than those inserted in 67b moving in the axial direction, the incision treatment is use heat generating unit 17 grip part 6
0aに備えられた凝固処置用熱発生部14の組織把持面に対して接離する方向に移動操作される。 It is operated to move toward or away from to the tissue gripping surface of the coagulation treatment heat generating portion 14 provided in 0a.

【0070】また、本実施の形態の処置具54を使用して第6の実施の形態と同様に生体組織における血管等の被処置部を処置する場合には第6の実施の形態と同様の操作で、体腔内組織の血管等の被処置部位を剥離し、把持部60a,60bで把持して熱凝固を行う。 [0070] Furthermore, when treating the treatment portion of the blood vessel or the like in the same way the living tissue in the sixth embodiment by using the treatment instrument 54 of this embodiment is the same as in the sixth embodiment in operation, stripping the treatment target site such as a blood vessel in the tissue inside a body cavity, for heat coagulation gripping portion 60a, is gripped by 60b.

【0071】これに引き続いてレバー61を図9(A) [0071] Figure 9 the lever 61 is subsequently thereto (A)
中で実線位置から点線位置まで移動操作すると、ワイヤ39が後方に引かれ、支持部材37に固定された滑り部材37a,37bが傾斜部材38の傾斜部に沿って後方に傾斜移動する。 When the move operation from the solid line position to the dotted line position in the middle, the wire 39 is pulled rearwardly, fixed to the support member 37 the sliding member 37a, 37b is inclined moves backward along the inclined portion of the inclined member 38. その結果、図6(A),(B)に示すように切開処置用熱発生部17が凝固処置用熱発生部1 As a result, FIG. 6 (A), the heat generation unit 1 for incision heat generating portion 17 is coagulation treatment, as shown in (B)
4に当接する。 4 to abut. この状態でフットスイッチ32の切開出力操作部30を操作することにより、切開処置用熱発生部17が通電加熱され、熱凝固された組織が切断される。 By operating an incision output operation portion 30 of the foot switch 32 in this state, the dissection treatment heat generating unit 17 is energized and heated, heat coagulated tissue is cut.

【0072】そこで、上記構成のものにあっては次の効果を奏する。 [0072] Thus, the apparatus having the configuration described above produces the following effects. すなわち、本実施の形態の処置具54では切開処置用熱発生部17を凝固処置用熱発生部14の中心線上で突没するようにしたため、熱凝固された生体組織を熱的に確実に切断することができ、生体組織の切れ残りが生じず、処置時間の短縮が図れる。 That is, since the treatment tool 54 at incision heat generating unit 17 of the present embodiment is configured to project and retract on the center line of the coagulation treatment heat generating unit 14, the heat solidified body tissue thermally reliably cut it can be, cut the remaining living tissues does not occur, can be shortened treatment time.

【0073】また、図10および図11(A),(B) [0073] Further, FIGS. 10 and 11 (A), (B)
は本発明の第9の実施の形態を示すものである。 It shows a ninth embodiment of the present invention. 図10 Figure 10
は本実施の形態の医療用処置具71である鉗子72の構成を示すものである。 It shows the structure of a forceps 72 which is a medical treatment tool 71 of the present embodiment.

【0074】ここで、鉗子72の本体73には2つの鋏構成部材74,75が設けられている。 [0074] Here, two scissor components 74 and 75 are provided in the main body 73 of the forceps 72. これらの鋏構成部材74,75は中途部分が略交差する状態に重ねられている。 These pincers members 74 and 75 are superimposed in a state where the middle part substantially intersect. さらに、両鋏構成部材74,75の交差部には両鋏構成部材74,75を回動自在に連結する支軸76 Further, the support shaft 76 to the intersection of the two scissor constituting members 74 and 75 for connecting the two scissor components 74 and 75 rotatably
が配設されている。 There has been arranged.

【0075】また、鉗子本体73の先端部には生体組織を把持する開閉可能な一対の把持部77,78を備えた処置部79が配設されている。 [0075] Further, the distal end portion of the forceps body 73 treatment portion 79 having a grip portion 77 and 78 open in a pair for gripping a living tissue is provided. この処置部79は剥離鉗子と略同じ形状に成形されている。 The treatment portion 79 is formed substantially in the same shape as peeling forceps.

【0076】さらに、各鋏構成部材74,75の基端部には略楕円形状の手指挿入リング80,81が形成されている。 [0076] Further, the finger inserting rings 80, 81 of the substantially elliptical shape is formed in the proximal end of the scissor constituting members 74 and 75. そして、これらの手指挿入リング80,81の部分によって一対の把持部77,78を開閉操作する手元側の操作部82が形成されている。 Then, the operation unit 82 of the proximal opening and closing operation of the pair of gripping portions 77 and 78 by a portion of these finger insertion ring 80, 81 is formed.

【0077】また、鉗子本体73の処置部79には、図11(A)に示すように略円弧状に緩く湾曲された湾曲部83が形成されている。 [0077] Further, the treatment portion 79 of the forceps body 73, the curved portion 83 which is curved loosely in a substantially arcuate shape as shown in FIG. 11 (A) is formed. さらに、鉗子本体73の各把持部77,78には、図11(B)に示すように生体組織との接触面側に略平板状で幅広な矩形断面の凝固処置用熱発生部84,85がそれぞれ配設されている。 In addition, each gripper 77, 78 of the forceps body 73, FIG. 11 (B) of the wide rectangular cross section with substantially flat contact surface with the biological tissue as illustrated in coagulation treatment heat generating portions 84 and 85 There are disposed, respectively. これらの凝固処置用熱発生部84,85は、例えばセラミックヒーターや、PTCヒーター等のように通電されて熱を発生する発熱体によって形成されている。 These coagulation treatment heat generating section 84 and 85, for example, a ceramic heater is formed by a heating element is energized to generate heat so that such PTC heater.

【0078】なお、凝固処置用熱発生部84,85の外面(生体との接触面)には生体組織の焦げ付きを防止するテフロンコーティング層86,87がそれぞれ形成されている。 [0078] Incidentally, on the outer surface of the coagulation treatment heat generating portions 84 and 85 (contact surface with the living body) Teflon coating layer 86, 87 to prevent scorching of the living tissue it is formed.

【0079】さらに、処置部79の各把持部77,78 [0079] In addition, each gripping portion of the treatment portion 79 77, 78
における幅方向の中央部分には、図11(A)に示すように湾曲部83の湾曲形状に沿って円弧状に緩く湾曲された間隙88が設けられている。 The central portion in the width direction of the gap 88 which is curved loosely in an arc shape along the curved shape of the curved portion 83 as shown in FIG. 11 (A) is provided. この間隙88は凝固処置用熱発生部84,85まで同じ幅で貫通する状態で形成されている。 The gap 88 is formed in a state penetrating the same width to the freezing treatment heat generating portions 84 and 85. なお、この間隙88の先端部は各把持部77,78の先端部で開放された構造となっている。 Incidentally, the distal end portion of the gap 88 is an open structure at the tip of each gripping portions 77 and 78.

【0080】また、図10に示すように一方の鋏構成部材74には1本のリード線89が、他方の鋏構成部材7 [0080] Further, one lead wire 89 on one of the scissor constituting member 74 as shown in FIG. 10, the other scissor constituting member 7
5にも1本のリード線90がそれぞれ配設されている。 One lead 90 are respectively disposed to 5.
ここで、リード線89の先端部は凝固処置用熱発生部8 Here, the tip portion of the lead wire 89 is coagulation treatment heat generator 8
4に、リード線90の先端部は凝固処置用熱発生部85 4, the tip portion of the lead wire 90 is coagulation treatment heat generating portion 85
にそれぞれ接続されている。 They are respectively connected to.

【0081】さらに、鋏構成部材74側の手指挿入リング80の外周面には1つのコード接続部91が突設されている。 [0081] Further, on the outer peripheral surface of the scissor constituting members 74 side of the finger insertion ring 80 one cord connecting portion 91 is projected. さらに、鋏構成部材75側の手指挿入リング8 Further, the finger inserting rings of scissor constituting member 75 side 8
1の外周面にも1つのコード接続部92が突設されている。 One cord connecting portion 92 is protruded to the outer circumferential surface of 1. そして、鋏構成部材74側のコード接続部91にはリード線89の基端部が接続されており、リード線90 Then, the cord connecting portions 91 of the scissor constituting members 74 side are the base end portion of the lead wire 89 is connected, the lead wires 90
は鋏構成部材75側のコード接続部92と接続されている。 It is connected to the cord connecting portion 92 of the scissor constituting members 75 side.

【0082】次に、上記構成の本実施の形態の医療用処置具71の作用について説明する。 Next, a description of the operation of the medical treatment tool 71 of the present embodiment having the above structure. まず、鉗子72の先端部の処置部79を閉じた状態で図示しない血管等の被処置部を含む生体組織に差し込む。 First, plug in the body tissue comprising treatment target portion of a blood vessel or the like (not shown) with closed treatment portion 79 of the distal end portion of the forceps 72. その後、一対の把持部77,78を開くことにより、血管等の被処置部を他の生体組織から剥離して露出させる。 Thereafter, by opening the pair of grip sections 77 and 78 are exposed by peeling the portion being treated, such as blood vessels from other biological tissue.

【0083】続いて、剥離した血管等を鉗子72の各把持部77,78間で凝固処置に適正な加圧力で圧迫した状態で把持する。 [0083] Then, gripping the detached blood vessel or the like in a state of being squeezed proper pressure to coagulation treatment between each gripping portions 77 and 78 of the forceps 72. この状態で、図示しない電源装置を出力すると各把持部77,78の凝固処置用熱発生部8 In this state, when the output power device, not shown coagulation treatment heat generating portion 8 of each gripping portions 77 and 78
4,85が通電されて熱を発生する。 4,85 generates the energized heat. このときの凝固処置用熱発生部84,85の熱によって把持部77,78 Gripper by heat coagulation treatment heat generating portions 84 and 85 of this case 77, 78
間の血管等の被処置部位が十分に熱凝固される。 The treatment site such as a blood vessel between is sufficiently thermally coagulated.

【0084】その後、この状態で、図示しない外科用メスや、高周波メスを処置部79の各把持部77,78の間隙88に差し込んで凝固された血管等の被処置部位の切開が行われる。 [0084] Then, in this state, a scalpel and not shown, incision of the treatment site such as a blood vessel that has been solidified by inserting into the gap 88 of each gripping portions 77 and 78 of the treatment portion 79 of the high frequency knife is made.

【0085】そこで、上記構成のものにあっては次の効果を奏する。 [0085] Thus, the apparatus having the configuration described above produces the following effects. すなわち、本実施の形態の医療用処置具1 That is, the medical treatment instrument 1 of this embodiment
では鉗子本体73の各把持部77,78に幅広な凝固処置用熱発生部84,85を配設したので、鉗子本体73 In so it was provided with wide coagulation treatment heat generating portions 84 and 85 on each gripper 77 and 78 of the forceps body 73, a forceps body 73
の各把持部77,78間で把持された血管等の被処置部位を適正な加圧力で圧迫した状態でこれらの凝固処置用熱発生部84,85の熱によって確実に熱凝固することができる。 It can be reliably thermally coagulated by the heat of these coagulation treatment heat generating portions 84 and 85 in a state of compression at an appropriate pressure to be a treatment site of a blood vessel or the like which is gripped between the gripper 77 and 78 of the .

【0086】さらに、本実施の形態では処置部79の各把持部77,78における幅方向の中央部分に間隙88 [0086] Furthermore, the central portion in the width direction of each gripping portions 77 and 78 of the treatment portion 79 in this embodiment the gap 88
を設けたので、血管等の被処置部位を熱凝固させた後、 Since the provided, after the treatment target site such as a blood vessel was thermally coagulated,
処置部79における把持部77,78の間隙88に外科用メスや、高周波メスのような別の切開手段を挿入して凝固した血管等の被処置部位の組織を切断することができる。 And scalpel in a gap 88 of the grip portion 77, 78 in the treatment portion 79, of the treatment site such as a blood vessel which insert another incision means solidified was as high frequency scalpel tissue can be cut to. そのため、特に開腹手術なとでは簡単迅速に処置することができる。 Therefore, it is possible to easily fast treatment, especially in open surgery of capital. また、被処置部位の組織の凝固機能と切開機能とを一つの器械で行う機械に比べて構成が簡単になり、コスト的にも有利となる。 The configuration as compared to the machine performing the dissection function and coagulation features of the treatment site tissue in one instrument is simplified, it is advantageous in terms of cost.

【0087】また、図12(A),(B)は本発明の第10の実施の形態を示すものである。 [0087] Further, FIG. 12 (A), (B) shows a tenth embodiment of the present invention. 本実施の形態は第9の実施の形態(図10および図11(A),(B)参照)の医療用処置具71における鉗子72の先端の処置部79の構成を次の通り変更したものである。 This embodiment obtained by changing as constituting the following ninth embodiment (FIGS. 10 and 11 (A), (B) refer) at the tip of the forceps 72 in a medical treatment tool 71 of the treatment portion 79 it is.

【0088】すなわち、本実施の形態では、一方の鋏構成部材74の把持部77側には間隙88を設けず、他方の鋏構成部材75の把持部78側のみに間隙88を設けたものである。 [0088] That is, in this embodiment, in which the gripping part 77 side of one of the scissor constituting members 74 without providing the gap 88 and the gap 88 is provided only to the grip portion 78 side of the other scissor constituting member 75 is there.

【0089】次に、上記構成における作用について説明する。 Next, a description will be given of the operation in the above configuration. 本実施の形態の鉗子72を使用して第9の実施の形態と同様の処置を行う場合には、次のような作業が行われる。 When performing the same treatment in the ninth embodiment using forceps 72 of the present embodiment, operations such as the following is performed. まず、第9の実施の形態と同様の手順で鉗子7 First, forceps 7 in the same procedure as in the ninth embodiment
2を操作して、体腔内組織の血管等の被処置部位を剥離し、把持部77,78で把持して熱凝固を行う。 2 by operating the, separating the treatment target site such as a blood vessel in the tissue inside a body cavity, for heat coagulation is gripped by the gripping portions 77, 78.

【0090】その後、この状態で、図示しない外科用メスや、高周波メスを処置部79の一方の把持部78の間隙88に差し込んで凝固された血管等の被処置部位の切開が行われる。 [0090] Then, in this state, a scalpel and not shown, incision of the treatment site, such as a plug is coagulated blood vessels in the gap 88 of one of the grip portion 78 of the treatment portion 79 of the high frequency knife is made.

【0091】そこで、上記構成のものにあっては次の効果を奏する。 [0091] Thus, the apparatus having the configuration described above produces the following effects. すなわち、本実施の形態では外科用メスや、高周波メスを間隙88に挿入した際に、メスの先端は処置部79の把持部77の凝固処置用熱発生部84の表面に押し当たってそれ以後の挿入操作が止められる。 That, and the scalpel in the present embodiment, when inserting the high frequency knife into the gap 88, the tip of the female thereafter presses against the surface of the coagulation treatment heat generating portion 84 of the grip portion 77 of the treatment section 79 the insertion operation is stopped.
そのため、メスの先端が間隙88の外に突き抜けることが防止されるので、被処置部以外の部分を切開してしまうおそれがなく、安全である。 Therefore, the tip of the knife is prevented from penetrating out of the gap 88, there is no fear of incision portions other than the portion being treated, is safe.

【0092】また、図13は本発明の第11の実施の形態を示すものである。 [0092] Further, FIG. 13 shows an eleventh embodiment of the present invention. 本実施の形態は第9の実施の形態(図10および図11(A),(B)参照)の医療用処置具71における鉗子72の先端の処置部79の構成を次の通り変更したものである。 This embodiment obtained by changing as constituting the following ninth embodiment (FIGS. 10 and 11 (A), (B) refer) at the tip of the forceps 72 in a medical treatment tool 71 of the treatment portion 79 it is.

【0093】すなわち、本実施の形態でも第10の実施の形態(図12(A),(B)参照)と同様に、一方の鋏構成部材74の把持部77側には間隙88を設けず、 [0093] That is, in this embodiment the tenth embodiment (FIG. 12 (A), (B) refer) in the same manner as, without providing the gap 88 to the grip portion 77 side of one of the scissor constituting members 74 ,
他方の鋏構成部材75の把持部78側のみに間隙88を設けている。 It is provided a gap 88 only to the grip portion 78 side of the other scissor constituting member 75. さらに、本実施の形態ではこれに加えて鋏構成部材74の把持部77側には把持部78側の間隙8 Further, the gap of the gripper 78 side to the grip portion 77 side of the scissor constituting members 74 in addition to this in the present embodiment 8
8と対応する部位に、例えばタングステンのような超硬金属からなる受け部材93が代わりに配設されている。 8 and the corresponding sites, for example, the receiving member 93 made of a hard metal such as tungsten is disposed instead.

【0094】次に、上記構成における作用について説明する。 Next, a description will be given of the operation in the above configuration. 本実施の形態の鉗子72を使用して第9の実施の形態と同様の処置を行う場合には、次のような作業が行われる。 When performing the same treatment in the ninth embodiment using forceps 72 of the present embodiment, operations such as the following is performed. まず、第9の実施の形態と同様の手順で鉗子7 First, forceps 7 in the same procedure as in the ninth embodiment
2を操作して、体腔内組織の血管等の被処置部位を剥離し、把持部77,78で把持して熱凝固を行う。 2 by operating the, separating the treatment target site such as a blood vessel in the tissue inside a body cavity, for heat coagulation is gripped by the gripping portions 77, 78.

【0095】その後、この状態で、図示しない外科用メスや、高周波メスを処置部79の一方の把持部78の間隙88に差し込んで凝固された血管等の被処置部位の切開が行われる。 [0095] Then, in this state, a scalpel and not shown, incision of the treatment site, such as a plug is coagulated blood vessels in the gap 88 of one of the grip portion 78 of the treatment portion 79 of the high frequency knife is made.

【0096】そこで、上記構成のものにあっては次の効果を奏する。 [0096] Thus, the apparatus having the configuration described above produces the following effects. すなわち、本実施の形態では外科用メスや、高周波メスを間隙88に挿入した際に、メスの先端は把持部77の受け部材93の表面に押し当たってそれ以後の挿入操作が止められる。 That, and the scalpel in the present embodiment, when inserting the high frequency knife into the gap 88, the tip of the female surface press hit by subsequent insertion operation of the receiving member 93 of the grip portion 77 is stopped. そのため、メスの先端が間隙88の外に突き抜けることが防止されるので、被処置部以外の部分を切開してしまうおそれがなく、安全である。 Therefore, the tip of the knife is prevented from penetrating out of the gap 88, there is no fear of incision portions other than the portion being treated, is safe.

【0097】さらに、本実施の形態では受け部材25が超硬金属材料で構成されるため、メス先端が受け部材2 [0097] Further, since the member 25 received in the present embodiment is composed of a hard metal material, receiving female distal end member 2
5に押し当たるときに表面に生じる傷などによる劣化を防ぐことができる。 It is possible to prevent the deterioration due to flaws generated on the surface when pressed against the 5.

【0098】また、図14は本発明の第12の実施の形態を示すものである。 [0098] Further, FIG. 14 shows a twelfth embodiment of the present invention. 本実施の形態は第9の実施の形態(図10および図11(A),(B)参照)の医療用処置具71における鉗子72の先端の処置部79の構成を次の通り変更したものである。 This embodiment obtained by changing as constituting the following ninth embodiment (FIGS. 10 and 11 (A), (B) refer) at the tip of the forceps 72 in a medical treatment tool 71 of the treatment portion 79 it is.

【0099】すなわち、本実施の形態では、処置部79 [0099] That is, in this embodiment, the treatment section 79
の各把持部77,78の間隙88の先端部を閉止する閉止部94を設け、各把持部77,78の間隙88の先端部が開放されていない構成にしたものである。 The closure 94 for closing the front end portion of the gap 88 of each gripping portions 77 and 78 provided in the one in which the distal end portion of the gap 88 of each gripping portions 77 and 78 has a configuration that is not open.

【0100】そこで、上記構成のものにあっては外科用メスや、高周波メスを間隙88に挿入して処置部位を切開する際に、メスの移動範囲は間隙88の先端部の閉止部94と、この間隙88の終端部95との間で規制される。 [0100] Therefore, the configuration described above and a scalpel, when cutting the insert to the treatment site the high frequency knife into the gap 88, the movement range of the female and the closing part 94 of the distal end portion of the gap 88 It is regulated between the end portion 95 of the gap 88. そのため、特に肝臓などの実質臓器を凝固して切開する場合などで、間隙88の先端部側にメスが移動して切開目的部位以外の凝固されていない部位などを切開して出血させてしまうおそれがなく、安全に処置することができる効果がある。 Fear Therefore, the thus particularly in a case of solidified by incising the solid organ such as the liver, bled by incising the like sites scalpel tip side of the gap 88 is not solidified non moved incision target site there is no, there is an effect that can be safely treated.

【0101】また、図15は本発明の第13の実施の形態を示すものである。 [0102] Further, FIG. 15 shows a thirteenth embodiment of the present invention. 本実施の形態は第9の実施の形態(図10および図11(A),(B)参照)の医療用処置具71における鉗子72の先端の処置部79を高周波処置用に変更したものである。 This embodiment is a modified embodiment of the ninth (FIGS. 10 and 11 (A), (B) refer) the treatment portion 79 of the tip of the forceps 72 in a medical treatment tool 71 of the high-frequency treatment is there.

【0102】すなわち、本実施の形態では、鉗子72における鉗子本体73は全体が絶縁材で構成されている。 [0102] That is, in this embodiment, the entire forceps body 73 in the forceps 72 is made of an insulating material.
さらに、鉗子本体73の各把持部77,78には間隙8 In addition, each gripper 77, 78 of the forceps body 73 gap 8
8の内面側に絶縁材で覆われる絶縁部96,97がそれぞれ形成される構造となっている。 Insulating portion 96, 97 is covered with an insulating material has a structure which is formed respectively on the 8 inner surface of.

【0103】また、各把持部77,78には間隙88の両側の絶縁部96,97の外側に断面矩形の一対の電極98,99が対向する位置にそれぞれ配設されている。 [0103] Further, both sides of the insulating part a rectangular cross section of the pair of electrodes 98 and 99 on the outside of the 96 and 97 of the gap 88 is disposed at positions opposing to each gripper 77 and 78.
ここで、各電極98,99はリード線を介して図示しない高周波電源装置に接続されている。 Here, each electrode 98 and 99 is connected to a high frequency power supply (not shown) via a lead wire.

【0104】次に、上記構成における作用について説明する。 Next, a description will be given of the operation in the above configuration. 本実施の形態の鉗子72を使用して第9の実施の形態と同様の処置を行う場合には、次のような作業が行われる。 When performing the same treatment in the ninth embodiment using forceps 72 of the present embodiment, operations such as the following is performed. まず、第9の実施の形態と同様の手順で鉗子7 First, forceps 7 in the same procedure as in the ninth embodiment
2を操作して、体腔内組織の血管等の被処置部位を剥離し、把持部77,78で把持したのち、各把持部77, 2 by operating the, after peeling off the treatment target site such as a blood vessel in the tissue inside a body cavity, is gripped by the gripping portions 77 and 78, each gripping portion 77,
78の電極98,99間で高周波通電して凝固を行う。 Performing solidification with high-frequency current between the 78 electrodes 98, 99.

【0105】その後、この状態で、図示しない外科用メスや、高周波メスを処置部79の一方の把持部78の間隙88に差し込んで凝固された血管等の被処置部位の切開が行われる。 [0105] Then, in this state, a scalpel and not shown, incision of the treatment site, such as a plug is coagulated blood vessels in the gap 88 of one of the grip portion 78 of the treatment portion 79 of the high frequency knife is made.

【0106】そこで、上記構成のものにあっては次の効果を奏する。 [0106] Thus, the apparatus having the configuration described above produces the following effects. すなわち、本実施の形態の鉗子72では高周波によるバイポーラ通電により処置部位を凝固すると同時に、高周波電源装置をモノポーラに切り換えることにより、高周波メスで凝固部位を切断することができる。 That is, in the forceps 72 of the present embodiment at the same time solidifying the treatment site by a bipolar current supply due to the high frequency, by switching the high-frequency power supply device in monopolar, can be cut coagulation site at a high frequency scalpel. そのため、一台の電源装置で凝固および切開が可能であり、コスト的に有利となる。 Therefore, it is possible coagulation and cutting by a single power supply, a cost advantage.

【0107】また、図16は本発明の第14の実施の形態を示すものである。 [0107] Further, FIG. 16 shows a fourteenth embodiment of the present invention. 本実施の形態は第9の実施の形態(図10および図11(A),(B)参照)の医療用処置具71の構成を次の通り変更したものである。 This embodiment ninth embodiment (FIGS. 10 and 11 (A), (B) refer) is modified as constituting the following medical treatment tool 71.

【0108】すなわち、本実施の形態では、第13の実施の形態(図15参照)と同様に鉗子72の先端の処置部79に高周波処置用の電極98,99を設けた構成に変更し、高周波通電により生体組織を凝固する構成にしたものである。 [0108] That is, in this embodiment, by changing the treatment portion 79 of the distal end of the thirteenth embodiment (see FIG. 15) as well as the forceps 72 to a structure in which an electrode 98 and 99 of the high-frequency treatment, it is obtained by the configuration of coagulating biological tissue by high frequency current. ここで、一方の把持部77側の電極98 Here, the one grip portion 77 side electrode 98
は、リード線89を介して鋏構成部材74側の手指挿入リング80のコード接続部91の内端部に接続されている。 It is connected to the inner end portion of the cord connecting portion 91 of the scissor constituting members 74 side of the finger insertion ring 80 via a lead wire 89. さらに、他方の把持部78側の電極99は、リード線90を介して鋏構成部材75側の手指挿入リング81 Furthermore, the other gripping portion 78 side of the electrode 99, the finger inserting rings via leads 90 pincers member 75 side 81
のコード接続部92の内端部に接続されている。 It is connected to the inner end portion of the cable connection portion 92.

【0109】また、コード接続部91の外端部には、接続コード100の一端が、コード接続部92の外端部には、接続コード101の一端がそれぞれ着脱自在に連結されている。 [0109] Also, the outer end portion of the cord connecting portion 91, one end of a connection cord 100, the outer end portion of the cord connecting portion 92, one end of the connection cord 101 is detachably connected, respectively. これらの接続コード100,101の他端部は高周波電源装置102と接続されている。 The other end of the connecting cord 100 and 101 is connected to the high-frequency power supply device 102.

【0110】また、高周波電源装置102の接続コード101の途中には切替え装置103が介設されている。 [0110] Further, the switching device 103 in the middle of the connection cord 101 in the high-frequency power supply device 102 is interposed.
この切替え装置103には高周波メス104がコード1 Frequency knife 104 is in the switching device 103 is code 1
05を介して接続されている。 It is connected via a 05. そして、高周波メス10 Then, the high-frequency scalpel 10
4はこの切替え装置103を経由して高周波電源装置1 4 via the switching device 103 high-frequency power supply device 1
02と接続されている。 02 to be connected. なお、高周波電源装置102にはコード106を介してフットスイッチ107が接続されている。 Note that the high-frequency power supply device 102 foot switch 107 through a cord 106 are connected. このフットスイッチ107には切開出力操作部108と凝固出力操作部109とが設けられている。 An incision output operation unit 108 and the solidified output operation unit 109 is provided in the foot switch 107.

【0111】次に、上記構成における作用について説明する。 Next, a description will be given of the operation in the above configuration. 本実施の形態の鉗子72を使用して第13の実施の形態と同様の処置を行う場合には、次のような作業が行われる。 When performing the same treatment as the thirteenth embodiment using forceps 72 of the present embodiment, operations such as the following is performed. まず、第9の実施の形態と同様の手順で鉗子72を操作して、体腔内組織の血管等の被処置部位を剥離し、把持部77,78で把持したのち、フットスイッチ107における凝固出力操作部109を操作する。 First, by operating the forceps 72 in the same procedure as in the ninth embodiment, after peeling off the treatment target site such as a blood vessel in the tissue inside a body cavity, is gripped by the gripping portions 77, 78, coagulation output on the foot switch 107 operating the operation unit 109. これにより、電極98と99との間で高周波通電して把持部77,78間の血管等の被処置部位の凝固を行う。 Thus, performing the solidification of the treatment site such as a blood vessel between and RF current conductor grip portion 77, 78 between the electrodes 98 and 99.

【0112】その後、この状態で、高周波メス104を処置部79の各把持部77,78の間隙88に差し込んで切替え装置103の通電経路を切り換え、フットスイッチ107における切開出力操作部108を操作することにより、高周波メス104から鉗子72における電極99に切開電力が通電されて被処置部位が切開される。 [0112] Then, in this state, switching the current path of the switching device 103 by inserting the high frequency knife 104 into the gap 88 of each gripping portions 77 and 78 of the treatment portion 79, operates the incision output operation unit 108 in the foot switch 107 it makes the incision power to the electrodes 99 in the forceps 72 from the high-frequency knife 104 is the treatment site is energized is incised.

【0113】そこで、上記構成のものにあっては次の効果を奏する。 [0113] Thus, the apparatus having the configuration described above produces the following effects. すなわち、本実施の形態の鉗子72では血管等の被処置部位を切開する際に、モノポーラに切り換えることなく、バイポーラだけで被処置部位の切開処置ができ、安全な処置が可能になる。 That is, when incising the treatment site in the forceps 72 such as a blood vessel of the present embodiment, without switching the monopolar, just can incision of the treatment site bipolar allows safe treatment.

【0114】また、図17および図18(A),(B) [0114] Further, FIG. 17 and FIG. 18 (A), (B)
は本発明の第15の実施の形態を示すものである。 It shows a fifteenth embodiment of the present invention. 図1 Figure 1
7は本実施の形態の医療用処置具である凝固切開処置具111の構成を示すものである。 7 shows a configuration of a coagulation dissection treatment instrument 111 is a medical treatment instrument of this embodiment.

【0115】ここで、凝固切開処置具111の本体11 [0115] Here, the body 11 of the coagulating dissection treatment instrument 111
2には2つの鋏構成部材113,114が設けられている。 Two pincers members 113 and 114 are provided in two. これらの鋏構成部材113,114は中途部分が略交差する状態に重ねられている。 These pincers members 113 and 114 are superimposed in a state where the middle part substantially intersect. さらに、両鋏構成部材113,114の交差部には両鋏構成部材113,11 Furthermore, both the scissor components in the intersection of the two scissor constituting members 113, 114 113,11
4を回動自在に連結する支軸115が配設されている。 4 shaft 115 that rotatably connected is arranged.

【0116】また、処置具本体112の先端部には生体組織を把持する開閉可能な一対のジョー116,117 [0116] Further, the treatment instrument open pair of jaws at the distal end of the body 112 to grip the biological tissue 116, 117
を備えた処置部118が配設されている。 It is arranged the treatment portion 118 having a. さらに、各鋏構成部材113,114の基端部には略楕円形状の手指挿入リング119,120が形成されている。 Further, the finger inserting rings 119, 120 of substantially elliptical shape is formed in the proximal end of the scissor constituting members 113 and 114. そして、 And,
これらの手指挿入リング119,120の部分によって一対のジョー116,117を開閉操作する手元側の操作部121が形成されている。 Operation unit 121 of the proximal opening and closing operation of the pair of jaws 116, 117 by the portion of these finger insertion ring 119 and 120 is formed.

【0117】また、各ジョー116,117には生体組織Hを凝固するためのヒーター122,123が設けられている。 [0117] Further, a heater 122, 123 for coagulating the living tissue H is provided in each jaw 116 and 117. 各ヒーター122,123には生体組織の滑り止めのための歯部124が設けられている。 Each heater 122 and 123 teeth 124 for slip of the living tissue is provided. なお、ヒーター122,123はセラミックヒーター、PTCヒーター、半導体ヒーター、電熱線など、公知のヒーター手段のいずれでも構わない。 Incidentally, the heater 122 and 123 may a ceramic heater, PTC heater, a semiconductor heater, heating wire, such as any known heater means.

【0118】また、操作部121の各手指挿入リング1 [0118] Further, each of the finger inserting ring of the operation unit 121 1
19,120にはコード接続部125,126がそれぞれ突設されている。 Cable connection portion 125 and 126 are protruded respectively to 19,120. ここで、一方のコード接続部125 Here, one of the cable connection portion 125
の内端部にはヒーター122、他方のコード接続部12 Heater 122 at the inner end of the other cable connection portion 12
6の内端部にはヒーター123がそれぞれリード線を介して接続されている。 Heater 123 at the inner end of the 6 are connected through leads, respectively. さらに、コード接続部125,1 Furthermore, cable connection portion 125,
26の外端部には各ヒーター122,123に通電するための接続コードが接続されている。 26 connecting cord for the outer end portion for energizing the respective heaters 122 and 123 are connected.

【0119】また、各ジョー116,117には生体組織Hを切開する切開処置用のハサミブレード127,1 [0119] Also, scissor blades for incision in each jaw 116, 117 to incise the body tissue H 127,1
28がそれぞれ設けられている。 28 are provided, respectively. これらのハサミブレード127,128は、図18(B)に示すように略U字状の断面形状に形成されている。 These scissor blades 127 and 128 is formed into a substantially U-shaped cross section as shown in FIG. 18 (B). そして、各ハサミブレード127,128は、各ジョー116,117の外周面側を囲む状態で各ジョー116,117に装着されている。 Each scissor blades 127 and 128 are attached to each jaw 116, 117 in a state of surrounding an outer peripheral surface of each jaw 116, 117.

【0120】また、各ジョー116,117の両側面にはハサミブレード127,128を前後方向に移動可能にガイドするスライド溝129,130が形成されている。 [0120] Further, slide grooves 129 and 130 are formed for movably guiding the scissors blades 127 and 128 in the longitudinal direction on both sides of each jaw 116, 117. さらに、各ハサミブレード127,128にはこのスライド溝129,130に挿入されるガイド突起12 Further, guide projections 12 on each scissor blade 127, 128 to be inserted into the slide groove 129, 130
7a,128aが突設されている。 7a, 128a are projected. そして、各ハサミブレード127,128はジョー116,117の各スライド溝129,130に沿って前後にそれぞれスライド可能に支持されている。 Each scissor blades 127 and 128 are respectively slidably supported in the longitudinal along the slide grooves 129 and 130 of the jaws 116 and 117. なお、各ハサミブレード12 In addition, each scissors blade 12
7,128のU字状断面の一側部側には鋭利な刃部12 Sharp at one side portion of the U-shaped cross section of 7,128 blade section 12
7b,128bがそれぞれ形成されている。 7b, 128b are formed respectively.

【0121】また、各ハサミブレード127,128には操作棒131,132の先端部が連結されている。 [0121] The tip portion of the operation rod 131, 132 are connected to each scissor blade 127, 128. これらの操作棒131,132の基端部は操作部121の近傍側に配置されたレバー133,134に連結されている。 Proximal end of control rod 131, 132 is connected to the lever 133 and 134 arranged near the side of the operation unit 121. そして、各レバー133,134の前後方向のスライド操作にともない操作棒131,132を介して各ハサミブレード127,128がジョー116,117 Each scissor blades 127 and 128 through the operation rod 131, 132 with the longitudinal direction of the slide operation of the levers 133 and 134 the jaws 116, 117
のスライド溝129,130に沿って前後にそれぞれスライド操作されるようになっている。 Is adapted to be respectively slid back and forth along the slide grooves 129 and 130.

【0122】次に、上記構成の作用について説明する。 [0122] Next, a description will be given of the operation of the above configuration.
本実施の形態の凝固切開処置具111の使用時には、生体組織Hの切開時以外の通常時はハサミブレード12 When using the coagulation dissection treatment instrument 111 of this embodiment, the normal time other than the incision of the living tissue H scissors blades 12
7,128は図17に示すように処置具本体112の手元側に引き戻された待機位置で保持されている。 7,128 is held in a standby position retracted to the proximal side of the treatment instrument main body 112 as shown in FIG. 17. この状態で、操作部121によってジョー116,117を開いたのち、図17に示すように、ジョー116,117 In this state, after opening the jaws 116, 117 by the operation unit 121, as shown in FIG. 17, the jaws 116, 117
を閉じ、上下のヒーター122,123間で生体組織H Closed, the living tissue H between the upper and lower heaters 122 and 123
を把持する。 The gripping. このとき、ハサミブレード127,128 In this case, scissors blade 127 and 128
は生体組織Hとは非接触の状態で保持される。 Is a living tissue H is held in a non-contact state. そして、 And,
この状態で、上下のヒーター122,123が通電加熱され、上下のヒーター122,123間の生体組織Hの凝固を行う。 In this state, the upper and lower heaters 122 and 123 are energized and heated, perform coagulation of the living tissue H between the upper and lower heaters 122 and 123.

【0123】次に、一旦、ジョー116,117を開いた後、各ハサミブレード127,128のレバー13 [0123] Then, once, after opening the jaws 116 and 117, of each scissors blade 127 and 128 lever 13
3,134を先端側に向けて押出し操作して、図18 3,134 and extrusion operation toward the distal end side, FIG. 18
(A)に示すようにハサミブレード127,128をジョー116,117の先端位置まで移動させる。 Moving the scissor blades 127 and 128 as shown in (A) to the end position of the jaws 116 and 117.

【0124】その状態で、ジョー116,117を閉じることにより、上下のハサミブレード127,128間であたかもハサミのように生体組織Hが剪断されて切開される。 [0124] In this state, by closing the jaws 116 and 117, the living tissue H, as if it were scissors between the upper and lower scissor blades 127 and 128 it is incised been sheared.

【0125】そこで、上記構成のものにあっては次の効果を奏する。 [0125] Thus, the apparatus having the configuration described above produces the following effects. すなわち、本実施の形態では処置具本体1 That is, in this embodiment instrument body 1
12の処置部118の各ジョー116,117に生体組織Hを凝固するためのヒーター122,123を設けるとともに、生体組織Hを切開する切開処置用のハサミブレード127,128を各ジョー116,117の前後方向に移動可能に設けている。 Each jaw 116, 117 of the 12 of the treatment section 118 is provided with the heater 122, 123 for coagulating biological tissue H, a scissor blade 127, 128 for dissection treatment to incise the body tissue H of each jaw 116, 117 It is movable in the longitudinal direction. そのため、ハサミブレード127,128を図17に示すように処置具本体11 Therefore, the treatment instrument main body 11 as shown scissors blades 127 and 128 in FIG. 17
2の手元側に引き戻された待機位置で保持している状態で、生体組織Hの凝固処置を行い、ハサミブレード12 While held in the standby position retracted into the second hand side, performs coagulation treatment of the living tissue H, scissors blade 12
7,128を図18(A)に示すようにジョー116, Jaw 116 as shown in FIG. 18 (A) to 7,128,
117の先端位置まで移動させた状態で、生体組織Hの切開処置を行うことができる。 In a state of being moved to the end position of the 117, it is possible to perform dissection treatment of the living tissue H. したがって、本実施の形態では処置具本体112の処置部118の各ジョー11 Therefore, each jaw 11 of the treatment portion 118 of the instrument body 112 in this embodiment
6,117の先端部で凝固処置と、切開処置とを行うことができるので、繊細な処置ができる効果がある。 And coagulation treatment at the tip of 6,117, since incision and may be performed, there is an effect that it is delicate treatment.

【0126】さらに、生体組織Hの切開処置を行う場合には鋏構成部材113,114をハサミのように開閉する動作で生体組織Hの切開処置ができるため、操作性がよく、一層、繊細な切開処置が可能となる。 [0126] Further, since it is incision of the living tissue H in operation for opening and closing the scissor components 113 and 114 as scissors when performing dissection treatment of the living tissue H, good operability, more delicate incision is made possible.

【0127】また、図19は本発明の第16の実施の形態を示すものである。 [0127] Further, FIG. 19 shows a sixteenth embodiment of the present invention. 本実施の形態は第15の実施の形態(図17および図18(A),(B)参照)の凝固切開処置具111における処置具本体112の先端部の処置部118の構成を次の通り変更したものである。 This embodiment fifteenth embodiment (FIG. 17 and FIG. 18 (A), (B) refer) as constituting the following of the distal end portion of the treatment portion 118 of the instrument body 112 in the coagulation incision treatment tool 111 it is modified.

【0128】すなわち、本実施の形態では、第15の実施の形態のヒーター122,123を廃してジョー11 [0128] That is, in the present embodiment, the heater 122, 123 of the fifteenth embodiment and waste jaws 11
6,117自体によってバイポーラ電極135を構成したものである。 6,117 is obtained by constituting the bipolar electrode 135 by itself. また、ジョー116,117とナイフブレード127,128との間には絶縁層136,137 The insulating layer between the jaws 116, 117 and knife blade 127 and 128 136 and 137
が設けられ、凝固時にナイフブレード127,128に電流が流れないように構成されている。 It is provided and is configured such that no current flows through the knife blade 127, 128 at the time of solidification.

【0129】そして、本実施の形態では処置具本体11 [0129] Then, in this embodiment the treatment instrument main body 11
2の処置部118の各ジョー116,117の先端部のバイポーラ電極135で凝固処置を行うとともに、両側のジョー116,117のナイフブレード127,12 Performs coagulation treatment in bipolar electrode 135 of the distal portion of each jaw 116, 117 of the second treatment section 118, the knife blade 127,12 on both sides of the jaws 116, 117
8によって切開処置を行うことができる。 It is possible to perform dissection treatment by 8. そのため、本実施の形態でも第15の実施の形態の凝固切開処置具1 Therefore, also in this embodiment the coagulation dissection treatment instrument of the fifteenth embodiment 1
11と同様に処置具本体112の処置部118の各ジョー116,117の先端部で凝固処置と、切開処置とを行うことができるので、繊細な処置ができる効果がある。 And coagulation treatment at the distal end of each jaw 116, 117 similarly in the treatment portion 118 of the instrument body 112 and 11, since the incision and may be performed, there is an effect that it is delicate treatment.

【0130】また、図20は本発明の第17の実施の形態を示すものである。 [0130] Further, FIG. 20 shows a seventeenth embodiment of the present invention. 本実施の形態は第16の実施の形態(図19参照)の凝固切開処置具111における処置具本体112の先端部の処置部118の片側のジョー1 This embodiment one side of the jaw 1 of the treatment instrument main body 112 of the distal end portion of the treatment portion 118 in the coagulation dissection treatment instrument 111 of the sixteenth embodiment (see FIG. 19)
17のみにナイフブレード128を設けたものである。 Only 17 is provided with a knife blade 128.

【0131】そして、本実施の形態では処置具本体11 [0131] Then, in this embodiment the treatment instrument main body 11
2の処置部118の各ジョー116,117の先端部のバイポーラ電極135で凝固処置を行うとともに、片側のジョー117のナイフブレード128によって切開処置を行うことができる。 It performs coagulation treatment in bipolar electrode 135 of the distal portion of each jaw 116, 117 of the second treatment section 118 can perform the dissection treatment by the knife blade 128 on one side of the jaw 117. そのため、本実施の形態でも第16の実施の形態の凝固切開処置具111と同様に、繊細な処置ができる効果がある。 Therefore, similarly to the coagulation dissection treatment instrument 111 of the present embodiment also the sixteenth embodiment, there is an effect that it is delicate treatment.

【0132】なお、本実施の形態のナイフブレード12 [0132] It should be noted that the knife blade 12 of the present embodiment
8に切開電流を通電し、ナイフブレード128に通電加熱することにより、生体組織Hの切開処置を行う構成にしてもよい。 An incision current energized 8, by electrically heating the knife blade 128 may be configured to perform the incision of the living tissue H.

【0133】また、図21は本発明の第18の実施の形態を示すものである。 [0133] Further, FIG. 21 shows an eighteenth embodiment of the present invention. 本実施の形態は第15の実施の形態(図17および図18(A),(B)参照)の凝固切開処置具111における処置具本体112の先端部の処置部118の構成を次の通り変更したものである。 This embodiment fifteenth embodiment (FIG. 17 and FIG. 18 (A), (B) refer) as constituting the following of the distal end portion of the treatment portion 118 of the instrument body 112 in the coagulation incision treatment tool 111 it is modified.

【0134】すなわち、本実施の形態では、処置部11 [0134] That is, in this embodiment, the treatment unit 11
8の両側のジョー116,117の各ナイフブレード1 Each knife blade 1 of 8 on both sides of the jaws 116, 117
27,128の先端部に例えばニクロム線などの切開処置用熱発生部138を設け、この切開処置用熱発生部1 The incision heat generating portion 138, such as the tip of 27,128 for example, a nichrome wire is provided, the heat generating portion 1 for the dissection treatment
38によって切開処置を行う構成にしたものである。 38 is obtained by the configuration in which the dissection treatment by.

【0135】そして、本実施の形態では処置具本体11 [0135] Then, in this embodiment the treatment instrument main body 11
2の処置部118の各ジョー116,117の先端部のバイポーラ電極135で凝固処置を行うとともに、両側のジョー116,117の各切開処置用熱発生部138 Performs coagulation treatment in bipolar electrode 135 of the distal portion of each jaw 116, 117 of the second treatment section 118, the dissection treatment heat generating portion 138 on both sides of the jaws 116, 117
によって切開処置を行うことができる。 It is possible to perform dissection treatment by. そのため、本実施の形態でも第15の実施の形態の凝固切開処置具11 Therefore, coagulation and incision treatment tool 11 of the present embodiment also the fifteenth embodiment
1と同様に処置具本体112の処置部118の各ジョー116,117の先端部で凝固処置と、切開処置とを行うことができるので、繊細な処置ができる効果がある。 1 and the coagulation treatment at the distal end of each jaw 116, 117 of the treatment portion 118 similarly instrument body 112, since the incision and may be performed, there is an effect that it is delicate treatment.

【0136】また、図22および図23(A),(B) [0136] Further, FIG. 22 and FIG. 23 (A), (B)
は本発明の第19の実施の形態を示すものである。 It shows a nineteenth embodiment of the present invention. 本実施の形態は第15の実施の形態(図17および図18 This embodiment fifteenth embodiment (FIGS. 17 and 18
(A),(B)参照)の凝固切開処置具111における処置具本体112の先端部の処置部118の構成を次の通り変更したものである。 (A), it is modified as constituting the following of the distal end portion of the treatment portion 118 of the instrument body 112 in the coagulation incision treatment tool 111 of the (B) refer).

【0137】すなわち、本実施の形態の処置部118の一方のジョー117には、図23(A)に示すように他方のジョー116と噛み合う側の把持面141の一部に面状の発熱素子142が設けられている。 [0137] That is, one of the jaws 117 of the treatment portion 118 of the present embodiment, part planar heat generating element side of the gripping surface 141 which meshes with the other jaw 116 as shown in FIG. 23 (A) 142 is provided.

【0138】さらに、このジョー117の把持面141 [0138] In addition, the gripping surface 141 of the jaws 117
の略中心部位にはジョー117の中心線方向に延出される切開具ガイド溝143が形成されている。 Cutting instrument guide grooves 143 extending in the direction of the center line of the jaws 117 is substantially at the center portion of is formed. この切開具ガイド溝143は発熱素子142を越えてこの把持面1 The cutting instrument guide groove 143 beyond the heating device 142 the gripping surface 1
41の先端側から末端側に亘って延設されている。 And it extends over the distal from the 41 distal end side of the. そして、この切開具ガイド溝143には第15の実施の形態のハサミブレード127,128とは異なる構成の切開具144がこの切開具ガイド溝143に沿ってスライド自在に配設されている。 Then, it is arranged freely incision instrument 144 of different configurations slides along the incision tool guide groove 143 and the scissor blades 127 and 128 of the embodiment of the 15th to the incision tool guide groove 143.

【0139】この切開具144には棒状の柄部145の先端部に切開具ガイド溝143の外部側に突出されるフック部146が連結されている。 [0139] hook 146 protrudes outside of the incision instrument guide groove 143 the distal end of the rod-shaped handle portion 145 is connected to this incision tool 144. このフック部146にはニクロムワイヤー147が取り付けられている。 Nichrome wire 147 is attached to the hook portion 146. さらに、切開具144の柄部147の末端側には図22に示すように切開具ガイド溝143の外部側に突出される指掛け部148が形成されている。 Further, the terminal side of the shank 147 of the cutting instrument 144 finger hook 148 protrudes outside of the incision instrument guide groove 143 as shown in FIG. 22 are formed.

【0140】また、ジョー116側には、図23(B) [0140] Furthermore, the jaws 116 side, FIG. 23 (B)
に示すように対向するジョー117の把持面141と噛み合う把持面149の一部に面状の発熱素子150が設けられている。 Planar heat generating element 150 in a part of the gripping surface 149 that meshes with the gripping surface 141 of the opposing jaws 117 is provided as shown in. さらに、このジョー116の把持面14 Furthermore, the gripping surface 14 of the jaw 116
9の略中心部位には切開具144のフック部146が挿入されるフック部ガイド溝151が形成されている。 Hook guide groove 151 which hook portion 146 of the cutting instrument 144 is inserted into the substantially central portion of 9 are formed. このフック部ガイド溝151は発熱素子150の長手方向の長さを越えて把持面149の先端側から末端側に亘って延設されている。 The hook guide groove 151 is extended over the distal from the longitudinal beyond the length distal end side of the gripping surface 149 of the heating element 150. そして、このフック部ガイド溝15 Then, the hook portion guide grooves 15
1の深さは一対のジョー116,117を噛み合わせたときに切開具144の先端側のフック部146がほぼ埋没する寸法に設定されている。 1 depth is set to dimension the tip side of the hook portion 146 of the incision tool 144 is substantially buried when mated pair of jaws 116 and 117.

【0141】また、一対のジョー116,117の各把持面141及び149と発熱素子142及び150の表面には滑り止めのための細かい凹凸152が形成されている。 [0141] In addition, fine irregularities 152 for slip is formed on the surface of each gripping surfaces 141 and 149 and the heating elements 142 and 150 of a pair of jaws 116 and 117.

【0142】さらに、発熱素子142及び150にはそれぞれ通電用ケーブル153及び154が接続され、手指挿入リング119,120からそれぞれ引き出されている。 [0142] Further, each of the heating elements 142 and 150 energized cables 153 and 154 are connected, are drawn out from each of the finger inserting rings 119 and 120. なお、ニクロムワイヤー147にも通電用ケーブル155が接続されている。 Incidentally, the current-carrying cable 155 is connected to the nichrome wire 147. この通電用ケーブル155 The current-carrying cable 155
は手指挿入リング120から引き出されている。 It is drawn from the finger insertion ring 120. そして、引き出された各通電用ケーブル153,154,1 Then, each of the current-carrying cable has been pulled out 153,154,1
55は図示しない通電用電源に接続されている。 55 is connected to a current supply source, not shown.

【0143】次に、上記構成の作用について説明する。 [0143] Next, a description will be given of the operation of the above configuration.
本実施の形態では、凝固切開処置具111の使用時には予め切開具144の先端側フック部はジョー117の切開具ガイド溝143の先端側の終端部位置に移動させた待機位置で保持される。 In this embodiment, distal end hook portion of the pre-incision tool 144 during use of the coagulation dissection treatment instrument 111 is held at the standby position is moved to the terminal end position of the distal end of the incision tool guide grooves 143 of the jaw 117. この状態で、手元側の操作部1 In this state, the hand-side operation section 1
21の手指挿入リング119,120に手指を挿入して処置具本体112のジョー116,117を開閉操作し、目的部位(例えば血管)を一対のジョー116,1 21 by inserting the fingers into the finger inserting rings 119 and 120 and opening and closing the jaws 116, 117 of the instrument body 112 of the jaws to the target site (e.g., blood vessel) of a pair 116,1
17間で把持する。 To hold between 17. この状態で、発熱素子142、15 In this state, the heating element 142,15
0に通電し、発熱素子142、150を発熱させて血管を凝固する。 Energized to 0, the heating elements 142 and 150 to generate heat to coagulate the blood vessels.

【0144】続いて、この把持状態を維持したまま、ニクロムワイヤー147に通電する。 [0144] Subsequently, while maintaining the grasping state, energizing the nichrome wire 147. そして、ニクロムワイヤー147が発熱した状態で指掛け部148を末端側に引いてニクロムワイヤー147をジョー117の先端側から末端側へ移動させる。 Then, move the nichrome wire 147 by pulling the finger grips 148 on the distal side in a state of nichrome wire 147 generates heat from the distal end side of the jaw 117 to the distal side. これにより、血管の凝固部分がニクロムワイヤー147によって切開される。 Thus, solidified portion of the vessel is incised by nichrome wire 147.

【0145】そこで、上記構成のものにあっては次の効果を奏する。 [0145] Thus, the apparatus having the configuration described above produces the following effects. すなわち、本実施の形態では、目的部位を把持したまま凝固と切開を連続的に行えるので、切開時の位置決め操作が不要で、また切開部位を誤る心配も無い。 That is, in this embodiment, not so incise and solidified while holding the target site continuously positioning operation when the incision is not required, also worry about erroneous incision site. 従って、術者の負担が減り、且つ凝固切開処置の精度が向上する。 Therefore, it reduced the burden of the operator, and the accuracy of the coagulation dissection treatment is improved.

【0146】さらに、本発明は上記実施の形態に限定されるものではなく、本発明の要旨を逸脱しない範囲で種々変形実施できることは勿論である。 [0146] Further, the present invention is not limited to the above embodiments, it is needless to say that various modifications may be implemented without departing from the scope of the present invention. 次に、本出願の他の特徴的な技術事項を下記の通り付記する。 Next, other characteristic technical items of the present application is appended as follows. 記 (付記項1) 処置具本体の先端部に開閉可能な一対の開閉要素を備えた処置部が配設され、前記処置具本体の基端部に前記一対の開閉要素を開閉操作する手元側の操作部が配設された医療用処置具において、前記処置部の前記開閉要素に配置される生体組織を把持する把持部と、これら把持部に設けられ、通電加熱されて前記把持部間に把持された生体組織を凝固および、または切開する複数の熱発生部とを具備したことを特徴とする医療用処置具。 Serial (Note 1) treatment instrument treatment portion having a pair of closing elements that can be opened and closed at the distal end of the main body is provided, proximal to opening and closing the pair of closure element to the proximal end of the instrument body of the operating unit is a medical treatment instrument which is arranged, and a grip portion for gripping the closing element arranged the living tissue of the treatment section, provided in these gripping portion, between said holding part is energized heating coagulating the grasped living tissue and, or medical treatment instrument, characterized by comprising a plurality of heat generating portions of the incision.

【0147】(付記項2) 付記項1において、把持部の少なくとも一方に生体組織との接触面積が異なる複数の熱発生部を設けた。 [0147] In (Note 2) according to Note 1, the contact area with the living tissue on at least one of the grip portion is provided with a plurality of different heat generating portion.

【0148】(付記項3) 付記項1にさらに熱発生部に通電する電源装置を備えた医療用処置装置において、 [0148] In (Additional Item 3) The medical treatment apparatus includes a power supply device for energizing further heat generation portion to Additional Item 1,
複数の熱発生部にそれぞれ独立して電力を供給する出力回路を備えた。 With an output circuit for supplying power independently to the plurality of heat generating portions.

【0149】(付記項4) 付記項1において、少なくとも一つの熱発生部が前記把持部の開閉方向と同じ方向に移動させる熱発生部移動手段を備えた。 [0149] In (Note 4) according to Note 1, at least one heat generating part comprising a heat generating portion moving means for moving in the same direction as the closing direction of the gripping portion.

【0150】(付記項5) 付記項4において前記手元側の操作部に熱発生部の移動を操作する操作手段を設けた。 [0150] in step (Additional Item 5) according to Note 4 provided an operating means for operating the transfer of heat generating portion in the operation portion of the proximal side.

【0151】(付記項1〜5の発明の属する技術分野) [0151] (Field of the Invention according to Note 5)
本発明は、体腔内に挿入して例えば血管や臓器等の体腔内組織を凝固及び、または切開等を行う際に使用される外科手術用鉗子等の医療用処置具に関する。 The present invention, coagulate tissue in the body cavity of the insert and for example, such as a blood vessel or an organ in the body cavity and, or a medical treatment tool of a surgical forceps or the like used when performing dissection or the like.

【0152】(付記項1〜5の従来技術) 患者の体腔内組織を凝固切開する処置具として、例えば米国特許U [0152] As a treatment instrument for coagulation and incision of the tissue inside a body cavity of a patient (prior art according to Note 5), for example, U.S. Pat. U
SP5,792,137には半導体からなる発熱素子の一部がメス状の切刃を備えたものが示されている。 Some of the heat generating element composed of a semiconductor has been shown that with a female-like cutting edge in SP5,792,137.

【0153】また、米国特許USP5,716,366 [0153] In addition, US patent USP5,716,366
には縫合器における組織接触面の一部が熱エレメントからなり、更に切断路内を動作する切断エレメントを備えたものが示されている。 Some of the tissue contacting surface of the suture instrument is made of heat elements have been shown as having a cut element for operating the further cutting path to.

【0154】(付記項1〜5が解決しようとする課題) [0154] (Problem to Additional Item 1-5 is to Solve)
米国特許USP5,792,137の処置具では、発熱素子自体の一部に鋭利なメス状の切刃が設けられているため、組織を強力に把持した場合には擬固する前に組織を切断し出血を来す恐れが有る。 In U.S. Pat USP5,792,137 of the treatment instrument, for sharp scalpel-like cutting edge on a part of the heating element itself is provided, the tissue prior to quasi if strongly grasping tissue cutting fear of causing the bleeding there. 一方、組織を切断しない程度に弱く組織を把持した場合には、血管等を確実に閉塞できないために、その後の切断操作にてやはり出血を来す問題が有る。 On the other hand, when the weakened tissue is gripped so as not to cut the tissue, in order not reliably occlude the blood vessel or the like, also the problem causing bleeding exists at a subsequent cutting operation.

【0155】また、米国特許USP5,716,366 [0155] In addition, US patent USP5,716,366
の縫合器では、切断エレメントが鋭利な刃で構成されており、刃の切れ味を継続して維持することが出来ないため縫合器自体を滅菌して再使用することが出来ず、コストが非常に高くなる問題が有る。 Of the suture instrument, the cutting element is constituted by a sharp blade, can not be sterilized and reused suture instrument itself because it is not possible to maintain continuously the sharpness of the blade, the cost is very high becomes a problem there.

【0156】(付記項1〜5の目的) 本発明は上記事情に着目してなされたもので、その目的は、一対の処置部材間で把持した血管等の生体組織を確実に凝固することが出来ると共に、凝固した組織を確実に切開すると同時に再使用可能で低コストを実現可能な医療用処置具を提供することに有る。 [0156] The present invention (the purpose of Additional Item 5) has been made in view of the above circumstances, and its object is to be securely coagulate the living tissue such as a blood vessel gripped between a pair of treating member together we can is to provide a coagulated tissue can be realized reliably incision to the low cost reusable simultaneously a medical treatment tool.

【0157】(付記項1の課題を解決するための手段) [0157] (Means for Solving the Problems of Additional Item 1)
処置具本体の先端部に開閉可能な一対の開閉要素を備えた処置部が配設され、前記処置具本体の基端部に前記一対の開閉要素を開閉操作する手元側の操作部が配設された医療用処置具において、前記処置部の前記開閉要素に配置される生体組織を把持する把持部と、これら把持部に設けられ、通電加熱されて前記把持部間に把持された生体組織を凝固および、または切開する複数の熱発生部とを具備したことを特徴とする医療用処置具である。 Treatment portion having a pair of closing elements that can be opened and closed at the distal end of the instrument body is disposed, a proximal-side operation section for opening and closing the pair of closure element to the proximal end of the instrument body is disposed in medical treatment tool, a grip portion for gripping a living tissue disposed on the closure element of the treatment section, provided in these gripping portion, the living tissue grasped between the grasping unit is energized heating coagulation and or a medical treatment tool, characterized by comprising a plurality of heat generating portions of the incision.

【0158】(付記項1の作用) そして、凝固時には処置部における一部の熱発生部を通電加熱させ、一対の把持部間に把持された血管等の組織を熱発生部の熱によって凝固させる。 [0158] The (effect of Additional Item 1), at the time of solidification is energized heat a portion of the heat generating portion in the treatment unit, to coagulate tissue such as a blood vessel, which is gripped between a pair of gripping portions by heat of the heat generating portion . その後、処置部における別の熱発生部を通電加熱させ、前記凝固部分を切開するようにしたものである。 Then, another heat-generating part in the treatment unit is energized heating is obtained by the so incising the solidified portion.

【0159】(付記項1〜5の効果) 本発明によれば処置部の各開閉要素における把持部に複数の発熱部を設け、一対の把持部間に把持された生体組織を一部の熱発生部の熱によって凝固すると共に、別の熱発生部熱発生部の熱によって組織を切開するようにしたので、確実に熱凝固および切開ができると共に、切開手段の切開能の劣化を来すことのない医療用処置具を提供することができる。 [0159] a plurality of heat generating portions to the grip portion of each closure element of the treatment unit according to (Note the effect of the claim 1 to 5) The present invention, part of the heat gripping living tissue between the pair of gripping portions with it solidified by the occurrence of the heat, because so as to incise the tissue by another heat generating part heat generation of the heat, it is surely heat coagulation and incision, to cause the deterioration of the incision ability incision means it is possible to provide a free medical treatment tool.

【0160】(付記項6) 処置具本体の先端部に開閉可能な一対の開閉要素を備えた処置部が配設され、前記処置具本体の基端部に前記一対の開閉要素を開閉操作する手元側の操作部が配設された医療用処置具において、 [0160] treatment portion having a pair of closing elements that can be opened and closed at the distal end of the (Note 6) instrument body is disposed to open and close operation of said pair of opening and closing elements to the proximal end of the instrument body a medical treatment tool a proximal-side operation section is disposed,
前記処置部の前記開閉要素に配置される生体組繊を把持する把持部と、これら把持部の少なくとも一方に設けられ、通電加熱されて前記把持部間に把持された生体組織を凝固するの熱発生部と前記少なくとも一方の把持部に設けられた間隙と、を具備したことを特徴とする医療用処置具。 A gripping portion for gripping a living body set fiber disposed in the closure element of the treatment unit, provided on at least one of the gripping portion, the heat to coagulate the living tissue grasped between the grasping unit is energized heating medical treatment tool, characterized by comprising a gap and generating unit provided in said at least one gripping portion.

【0161】(付記項7) 処置具本体の先端部に開閉可能な一対の開閉要素を備えた処置部が配設され、前記処置具本体の基端部に前記一対の開閉要素を開閉操作する手元側の操作部が配設された医療用処置具において、 [0161] (Note 7) treatment section having a pair of closing elements that can be opened and closed at the distal end of the instrument body is disposed to open and close operation of said pair of opening and closing elements to the proximal end of the instrument body a medical treatment tool a proximal-side operation section is disposed,
前記処置部の前記開閉要素に配置される生体組織を把持する把持部と、これら把持部に設けられ、高周波通電される電極部と、前記少なくとも一方の把持部に設けられた間隙と、を具備したことを特徴とする医療用処置具。 Comprising a grip portion for gripping a living tissue disposed on the closure element of the treatment section, provided in these gripping portion, the electrode portion being a high frequency current, and a gap provided in said at least one gripping portion medical treatment tool, characterized in that the.

【0162】(付記項6、7の発明の属する技術分野) [0162] (Field of the Invention according to Note 6, 7)
本発明は、体腔内に挿入して例えば血管や臓器等の体腔内組織を凝固及び、または切開等を行う際に使用される外科手術用鉗子等の医療用処置具に関する。 The present invention, coagulate tissue in the body cavity of the insert and for example, such as a blood vessel or an organ in the body cavity and, or a medical treatment tool of a surgical forceps or the like used when performing dissection or the like.

【0163】(付記項6、7の従来技術) 患者の体腔内組織を凝固切開する処置具として、例えば米国特許U [0163] As a treatment instrument for coagulation and incision of the tissue inside a body cavity of a patient (prior art according to Note 6, 7), for example, U.S. Pat. U
SP5,792,137には半導体からなる発熱素子の一部がメス状の切刃を備えたものが示されている。 Some of the heat generating element composed of a semiconductor has been shown that with a female-like cutting edge in SP5,792,137.

【0164】また、米国特許USP5,716,366 [0164] In addition, US patent USP5,716,366
には縫合器における組織接触面の一部が熱エレメントからなり、更に切断路内を動作する切断エレメントを備えたものが示されている。 Some of the tissue contacting surface of the suture instrument is made of heat elements have been shown as having a cut element for operating the further cutting path to.

【0165】(付記項6、7が解決しようとする課題) [0165] (Problem to Additional Item 6 and 7 to be Solved)
米国特許USP5,792,137の処置具では、発熱素子自体の一部に鋭利なメス状の切刃が設けられているため、組織を強力に把持した場合には凝固する前に組織を切断し出血を来す恐れが有る。 In U.S. Pat USP5,792,137 of the treatment instrument, for sharp scalpel-like cutting edge on a part of the heating element itself is provided, in the case of strongly gripping the tissue cut tissue before coagulation fear of causing the bleeding there. 一方、組織を切断しない程度に弱く組織を把持した場合には、血管等を確実に閉塞できないために、その後の切断操作にてやはり出血を来す問題が有る。 On the other hand, when the weakened tissue is gripped so as not to cut the tissue, in order not reliably occlude the blood vessel or the like, also the problem causing bleeding exists at a subsequent cutting operation.

【0166】また、米国特許USP5,716,366 [0166] In addition, US patent USP5,716,366
の縫合器では、切断エレメントが鋭利な刃で構成されており、刃の切れ味を継続して維持することが出来ないため縫合器自体を滅菌して再使用することが出来ず、コストが非常に高くなる問題が有る。 Of the suture instrument, the cutting element is constituted by a sharp blade, can not be sterilized and reused suture instrument itself because it is not possible to maintain continuously the sharpness of the blade, the cost is very high becomes a problem there.

【0167】さらに両者ともに凝固手段および切開手段を一つの器械に組み込んでいるために、構成が非常に複雑になるという問題があった。 [0167] In order to further incorporate into a single instrument coagulation means and cutting means in both cases, there is a problem that the construction becomes very complicated.

【0168】(付記項6、7の目的) 本発明は上記事情に着目してなされたもので、その目的は、一対の処置部材間で把持した血管等の生体組織を確実に凝固することが出来ると共に、凝固した組織を確実に切開すると同時に再使用可能で簡単な構成で低コストを実現可能な医療用処置具を提供することに有る。 [0168] The present invention (the purpose of Additional Item 6) has been made in view of the above circumstances, and its object is to be securely coagulate the living tissue such as a blood vessel gripped between a pair of treating member together can is to provide a medical treatment instrument capable of realizing low cost coagulated tissue reliably incision to the reusable and simple construction at the same time.

【0169】(付記項6、7の課題を解決するための手段) 処置具本体の先端部に開閉可能な一対の開閉要素を備えた処置部が配設され、前記処置具本体の基端部に前記一対の開閉要素を開閉操作する手元側の操作部が配設された医療用処置具において、前記処置部の前記開閉要素に配置される生体組織を把持する把持部と、これら把持部の少なくとも一方に設けられ、通電加熱されて前記把持部間に把持された生体組織を凝固するの熱発生部と前記少なくとも一方の把持部に設けられた間隙とを具備したことを特徴とする医療用処置具である。 [0169] treatment portion having a pair of closing elements that can be opened and closed at the distal end of the instrument body (Means for Solving the Problems according to Note 6, 7) is disposed, the treatment instrument proximal end of the body in the medical treatment tool of a proximal-side operation section is arranged to open and close operation of said pair of closing elements, a grip portion for gripping a living tissue disposed on the closure element of the treatment unit, of the grip portion provided on at least one, for medical use, characterized by comprising a provided in the heat generating portion and said at least one gripping portion to coagulate the living tissue grasped between the grasping unit is energized and heated gap it is a treatment tool.

【0170】(付記項6、7の作用) そして、凝固時には処置部における一対の熱発生部を通電加熱させ、把持部間に把持された血管等の組織を熱発生部の熱によって凝固させる。 [0170] (Operation of Additional Item 6) Then, during solidification is energized heating a pair of heat generating portions in the treatment unit, causing the tissue such as a blood vessel, which is gripped between the gripping portion coagulated by the heat of the heat generating portion. その後、把持部の間隙に別の切開手段を挿入し、前記凝固部分を切開するようにしたものである。 Then, insert another incision means in the gap of the gripping portion, in which so as to incise the solidified portion.

【0171】(付記項6、7の効果) 本発明によれば処置部の各開閉要素における把持部に発熱部または高周波通電部を設け、一対の把持部間に把持された生体組織を熱発生部の熱または高周波通電によって凝固すると共に、把持部に設けられた間隙に別の切開手術を挿入し、 [0171] The heating portion or the RF current conductors to the grip portion of each closure element of the treatment unit according to the present invention (the effect of Additional Item 6) provided, the heat generating grasped living tissue between the pair of gripping portions with solidified by heat or high frequency power parts, insert another surgery in the gap provided in the grip portion,
組織を切開するようにしたので、確実に凝固および切開ができると共に、簡単な構成でコスト的に有利な医療用処置具を提供することができる。 Since so as to cut tissue, it is surely coagulation and incision, it is possible to provide a cost effective medical treatment tool with a simple structure.

【0172】(付記項8) 互いに開閉する一対のジョーを有し、前記ジョーの少なくとも一方に凝固部と切開部を有する凝固切開処置具において、前記切開部が凝固部に対して操作手段によって凝固部の近くまで選択的にスライド可能であるとともに、ジョーの開閉にともない切開可能なことを特徴とする凝固切関処置具。 [0172] a pair of jaws to open and close (Note 8) with one another, coagulated in the coagulation dissection treatment instrument having a cutout and solidified portion on at least one of the jaws, the incision by the operation means against the solidified portion near with being selectively slid to parts, coagulation Setsuseki treatment instrument, wherein the possible incisions with the opening and closing of the jaws.

【0173】(付記項9) 付記項8において、前記凝固部にヒーターを有するもの。 [0173] (Note 9) In Addition to claim 8, having a heater to the solidified portion.

【0174】(付記項10) 付記項8において、前記切開部が剪断刃であるもの。 [0174] (Note 10) In Addition to claim 8, what the incision is shear blade.

【0175】(付記項11) 付記項10において、前記切開部がさらに上下1組からなるハサミ状剪断刃であるもの。 [0175] (Note 11) In Addition to claim 10, those wherein incision is further scissor-like shearing blade consisting of upper and lower pair.

【0176】(付記項12) 付記項8において、前記凝固部にバイポーラ電極を有するもの。 [0176] (Note 12) In Addition to claim 8, having a bipolar electrode on the solidified portion.

【0177】(付記項13) 付記項8において、前記切開部が切開用の電熱線で形成されたもの。 [0177] (Note 13) In Addition to claim 8, which the incision is formed in the heating wire for incision.

【0178】(付記項8〜13の従来技術) 従来、特開平11−137563のようにジョーの凝固部と切開部(ハサミ)を備えることで、一つの処置具で凝固切開可能なものがあった。 [0178] Conventional (prior art according to Note 8-13), by providing solidified portion of the jaw and the incision as JP 11-137563 (the scissors), there is capable coagulotomy in one treatment instrument It was.

【0179】一方、特開平9−108234、特願平8 [0179] On the other hand, JP-A-9-108234, Japanese Patent Application No. 8
−199189のように凝固ジョー部にナイフブレードがスライドするものがあった。 Knife blade was something to slide solidified jaws as -199189.

【0180】(付記項8〜13が解決しようとする課題) しかし、前者の先行技術は凝固部と切開部の位置があらかじめ決まっているため、処置具の先端部ではあらかじめ決まっている凝固が切開のどちらか一方しか処置できなかった。 [0180] (Problem Additional Item 8-13 is to Solve) However, since the former prior art position of the incision and coagulation part is determined in advance, the solidification is predetermined at the distal end portion of the treatment instrument dissection On the other hand one of the only could not be treated. しかし、通常、処置具では正確で繊細な処置を行うため、見やすくて細い先端部を使用することが望まれており、前記の点は非常に大きな問題点であった。 However, usually, for accurate and delicate treatment in the treatment instrument, which is desired to use a legible, thin tip, the points of a very large problem.

【0181】一方、後者ではナイフブレードで押しながら切開するため細かい操作ができず、ハサミに比べると煩雑で操作性が悪いという問題があった。 [0181] On the other hand, the latter in can not fine operation for cutting while holding a knife blade, complicated and operability as compared with the scissors there is a problem that bad.

【0182】(付記項8〜13の目的) 上記問題を考慮して、本願は繊細な処置が可能な先端部で凝固・切開のいずれも可能で、かつ切開についてはハサミ状の動作とすることで、操作性の良い凝固切開処置具を提供することを目的とするものである。 [0182] In view of the above problems (objects of Additional Item 8-13), the present application any possible coagulation and incision in a tip capable of delicate treatment, and that the scissors-like action for incision in, it is an object to provide a good operability coagulation dissection treatment instrument.

【0183】(付記項14) 先端部に開閉自在に設けた一対の開閉手段を備えた処置具であって、一対の開閉手段の噛み合う面に設けた凝固手段と、同面に設けた切開手段とを有し、切開手段が凝固手段面の長手方向に移動可能としたことを特徴とする凝固切開処置具。 [0183] (Note 14) A treatment instrument having a pair of opening and closing means arranged to be openable and closable at the tip, and solidifying means provided on a surface meshing of the pair of switching means, incision means provided in the same plane it has the door, coagulation and incision treatment instrument incision means is characterized by being movable in the longitudinal direction of the solidification means surface.

【0184】(付記項15) 凝固手段が面状の発熱体で、切開手段が線状の発熱体である付記項1. [0184] (Note 15) coagulation means in the planar heating element, according to Note 1 incision means is a linear heating element. の凝固切開処置具。 Of coagulation incision treatment tool.

【0185】(付記項14,15の従来技術) 特開平11−137563に示されるような鋏の噛み合い部分に凝固手段と切開手段をシリーズに配置した処置具があった。 [0185] there is a treatment tool arranged coagulation means and incision means meshing portions of the scissors as shown in JP-A-11-137563 in series (prior art according to Note 14, 15).

【0186】(付記項14,15が解決しようとする課題) 凝固手段と切開手段がシリーズに配置されているため、凝固操作の後、一度鋏の噛み合いを開いて、凝固部に切開手段を合わせながら鋏を閉じて切開操作を行わなくてはならない。 [0186] Since the (trying Additional Item 14, 15 resolved by object) solidifying means and incision means are arranged in series, after the coagulation operation, once open the engagement of scissors, combined incision means solidified portion It must be made an incision operation to close the scissors while. このため操作が煩雑になり、また、 Because of this operation becomes complicated, also,
凝固部と切開部の位置ズレが生じるおそれもある。 Possibility of misalignment between the solidified portion incision arises also.

【0187】(付記項14,15の目的) 本発明は、 [0187] (object of Additional Item 15) The present invention,
凝固した部位を簡便且つ正確に切開できる凝固切開処置具を提供することを目的とする。 Providing a coagulation dissection treatment instrument coagulated portion can be easily and accurately dissected an object.

【0188】(付記項14,15の課題を解決するための手段と作用) 処置具先端部の開閉手段の噛み合う面に凝固手段と切開手段を設け、切開手段が凝固手段の長手方向に移動するようにした。 [0188] The (means and operation for solving the problems according to Note 14, 15) solidified means and incision means a surface meshing of opening and closing means of the treatment instrument distal end portion is provided, the incision means are moved in the longitudinal direction of the solidification means It was so. これによって所望の部位を開閉手段で把持し凝固した後、把持したままの状態で切開手段を移動させることで凝固部位を確実に切開できる。 This was gripped solidified closing means desired site, it can be reliably incised coagulation sites by moving the incision means in a state of gripping.

【0189】 [0189]

【発明の効果】本発明によれば、生体組織を把持する開閉可能な把持部に通電されて熱を発生する凝固処置用熱発生部および切開処置用熱発生部をそれぞれ設けたので、把持部で把持した血管等の生体組織を確実に凝固することができ、かつ凝固した生体組織を確実に切開することができるとともに、生体組織を切開する切開能の劣化を防止して再使用可能で、低コストを実現することができる。 According to the present invention, since the coagulation treatment heat generating portion is energized to open the gripping portion for gripping a living tissue to generate heat and dissection treatment heat generating portion is provided respectively, gripping portions in the grasped living tissue such as a blood vessel can be reliably coagulated, and with the solidified body tissue can be reliably incised, reusable to prevent deterioration of the incision ability to incise the body tissue, it is possible to achieve a low cost.

【図面の簡単な説明】 BRIEF DESCRIPTION OF THE DRAWINGS

【図1】 本発明の第1の実施の形態の医療用処置具のシステム全体の概略構成図。 [1] first schematic diagram of the overall system of the medical treatment tool of an embodiment of the present invention.

【図2】 図1のII−II線断面図。 [Figure 2] II-II line sectional view of FIG.

【図3】 (A)は本発明の第2の実施の形態を示す要部の縦断面図、(B)は本発明の第3の実施の形態を示す要部の縦断面図、(C)は本発明の第4の実施の形態を示す要部の縦断面図、(D)は本発明の第5の実施の形態を示す要部の縦断面図。 3 (A) and the second longitudinal cross-sectional view of a main portion showing an embodiment of the present invention, (B) is a longitudinal sectional view of a main part showing a third embodiment of the invention, (C ) fourth sectional view of a main part showing an embodiment of, (D) is a longitudinal sectional view of a main part showing a fifth embodiment of the present invention of the present invention.

【図4】 本発明の第6の実施の形態を示す鉗子全体の平面図。 [4] 6 plan view of the entire forceps showing an embodiment of the present invention.

【図5】 (A)は第6の実施の形態の鉗子における切開処置用熱発生部が凝固処置用熱発生部から離れた待機位置で保持されている状態を示す図4のVA−VA線断面図、(B)は(A)のVB−VB線断面図。 [5] (A) is a 6 VA-VA line in FIG. 4 that the heat generating portion for incision in the forceps showing a state held at the standby position away from the coagulation treatment heat generating portion of the embodiment of sectional view, (B) is the line VB-VB cross-sectional view of (a).

【図6】 (A)は第6の実施の形態の鉗子における切開処置用熱発生部が凝固処置用熱発生部に当接された状態を示す鋏構成部材の要部の縦断面図、(B)は(A) 6 (A) is a longitudinal sectional view of a main part of the scissor constituting members showing a state where the dissection treatment heat generating portion of a forceps according to the sixth embodiment is in contact with the heat-generating portion for coagulation treatment, ( B) is (a)
のVIB−VIB線断面図。 Line VIB-VIB cross-sectional view of.

【図7】 本発明の第7の実施の形態の医療用処置具のシステム全体の概略構成図。 [7] Seventh schematic diagram of the overall system of the medical treatment tool of an embodiment of the present invention.

【図8】 第7の実施の形態の医療用処置具のシステムにおける電源装置の電気回路を示す概略構成図。 Figure 8 is a schematic block diagram showing an electric circuit of the power supply device in a seventh system medical treatment tool of the embodiment of.

【図9】 本発明の第8の実施の形態の医療用処置具を示すもので、(A)は医療用処置具全体の側面図、 [9] shows a medical treatment tool according to the eighth embodiment of the present invention, (A) is a side view of the entire medical treatment tool,
(B)は処置部の把持部材の開状態を示す要部の側面図。 (B) is a side view of a main part showing the open state of the gripping member of the treatment portion.

【図10】 本発明の第9の実施の形態の医療用処置具を示す全体の側面図。 [10] Ninth side view of the whole showing a medical treatment tool of an embodiment of the present invention.

【図11】 (A)は第9の実施の形態の医療用処置具の開閉要素の湾曲部を示す要部の平面図、(B)は処置部の横断面図。 11 (A) is a plan view of a main part showing a curved portion of the closure element of the medical treatment tool of an embodiment of the 9, (B) is a cross-sectional view of the treatment portion.

【図12】 本発明の第10の実施の形態の医療用処置具を示すもので、(A)は医療用処置具の開閉要素の湾曲部を示す要部の平面図、(B)は湾曲部の横断面図。 [Figure 12] shows the medical treatment tool of the tenth embodiment of the present invention, (A) is a plan view of a main part showing a curved portion of the closure element of the medical treatment instrument, (B) is curved cross-sectional view of the parts.

【図13】 本発明の第11の実施の形態の医療用処置具を示す要部の横断面図。 [13] Eleventh cross-sectional view of a main part showing a medical treatment tool of the embodiment of the present invention.

【図14】 本発明の第12の実施の形態の医療用処置具の開閉要素の湾曲部を示す要部の平面図。 [14] 12 plan view of an essential part showing a curved portion of the closure element of the medical treatment tool of the embodiment of the present invention.

【図15】 本発明の第13の実施の形態の医療用処置具を示す要部の横断面図。 [15] The 13 cross-sectional view of a main part showing a medical treatment tool of an embodiment of the present invention.

【図16】 本発明の第14の実施の形態の医療用処置具のシステム全体の概略構成図。 [16] 14 schematic diagram of the overall system of the medical treatment tool of an embodiment of the present invention.

【図17】 本発明の第15の実施の形態の医療用処置具を示す全体の平面図。 [17] 15 a plan view of the whole showing a medical treatment tool of an embodiment of the present invention.

【図18】 (A)は第15の実施の形態の医療用処置具のハサミブレードが先端側にスライドされた状態を示す平面図、(B)は(A)の18B−18B線断面図。 [18] (A) is a plan view showing a state in which the scissor blade of the medical treatment tool of an embodiment of the 15 is slid distally, (B) is 18B-18B line cross-sectional view of (A).

【図19】 本発明の第16の実施の形態の医療用処置具を示す要部の横断面図。 [19] The 16 cross-sectional view of a main part showing a medical treatment tool of an embodiment of the present invention.

【図20】 本発明の第17の実施の形態の医療用処置具を示す要部の横断面図。 [Figure 20] 17 cross-sectional view of a main part showing a medical treatment tool of an embodiment of the present invention.

【図21】 本発明の第18の実施の形態の凝固切開処置具を示す全体の平面図。 [Figure 21] 18 plan view of the whole showing a coagulation dissection treatment instrument according to the embodiment of the present invention.

【図22】 本発明の第19の実施の形態の凝固切開処置具を示す全体の平面図。 [Figure 22] 19 plan view of the whole showing a coagulation dissection treatment instrument according to the embodiment of the present invention.

【図23】 (A)は第19の実施の形態の凝固切開処置具における一方のジョーの把持面の発熱素子の取付け状態を示す斜視図、(B)は凝固切開処置具における他方のジョーの把持面のガイド溝を示す斜視図。 [23] (A) is a perspective view showing a mounting state of the heating element of the gripping surface of one of the jaws in the coagulation incision treatment tool of an embodiment of the 19, (B) is the other jaw in the coagulation incision treatment tool perspective view of a guide groove of the gripping surface.

【符号の説明】 DESCRIPTION OF SYMBOLS

2 鉗子(処置具) 4 鉗子本体 8,9 把持部 13 操作部 14,15 凝固処置用熱発生部 17 切開処置用熱発生部 2 forceps (treatment instrument) 4 forceps body 8,9 grip portion 13 operating portion 14, 15 coagulation treatment heat generating portion 17 incision heat generating unit

───────────────────────────────────────────────────── フロントページの続き (72)発明者 飯田 浩司 東京都渋谷区幡ヶ谷2丁目43番2号 オリ ンパス光学工業株式会社内 Fターム(参考) 4C060 FF01 KK03 KK04 KK15 KK22 KK23 MM24 MM25 ────────────────────────────────────────────────── ─── front page of the continuation (72) inventor Koji Iida Shibuya-ku, Tokyo Hatagaya 2-chome No. 43 No. 2 Olympus optical industry Co., Ltd. in the F-term (reference) 4C060 FF01 KK03 KK04 KK15 KK22 KK23 MM24 MM25

Claims (1)

    【特許請求の範囲】 [The claims]
  1. 【請求項1】 先端部に生体組織を把持する開閉可能な把持部が配設され、基端部に前記把持部を開閉操作する手元側の操作部が配設された医療用処置具において、 通電されて熱を発生する凝固処置用熱発生部および切開処置用熱発生部を前記把持部にそれぞれ設けたことを特徴とする医療用処置具。 1. A closable gripper for gripping a living tissue is arranged at the distal end portion, in the medical treatment tool of a proximal-side operation section is arranged to open and close operation of the grip portion to the base end portion, medical treatment tool, characterized in that the energized coagulation treatment heat generating portion that generates heat and incision heat generating portions respectively provided on said holding part.
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