JP2002078714A - Ultrasonic treatment device - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an ultrasonic treatment device which improves releasability, reduces cavitation and improves operability. SOLUTION: In the ultrasonic treatment device provided with a clamping member 21, which faces the treatment part of a probe 1 as a vibration transmitting member for transmitting ultrasonic vibrations generated in an ultrasonic vibrator, for clamping a biological tissue with that treatment part, for performing operation for clamping the biological tissue between the both by moving at least one of the probe 10 and the clamping member 21, a spatula-like part 28 is provided on a top end portion 11 of the probe 10.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to an ultrasonic treatment apparatus for grasping a living tissue and performing a treatment such as incision or coagulation on the living tissue using ultrasonic waves.

[0002]

2. Description of the Related Art Generally, when an ultrasonic treatment tool cuts a living tissue, the ultrasonic vibration is transmitted from an ultrasonic vibrator to a probe, and the living tissue is cut at the tip of the probe heated to a high temperature. . The ultrasonic treatment tool can immediately coagulate the incised bleeding part at the same time as cutting the living tissue by ultrasonic vibration when cutting the living tissue. For this reason, living tissue can be efficiently removed without bleeding. Such an ultrasonic treatment instrument is used for an operation under an endoscope or the like.

[0003] In Japanese Patent Publication No. Hei 8-505801, a clamp is operated by operating a handle provided on a handpiece, and a tissue is gripped between the clamp and a probe.
There is disclosed an ultrasonic treatment instrument which coagulates and cuts tissue by ultrasonic vibration. In this ultrasonic treatment instrument, the tip of the probe is formed in a shape such as a cone or a bulb intended for coagulation and incision.

[0004] Japanese Patent Application Laid-Open No. 9-38098 discloses an ultrasonic treatment instrument which enables a high-frequency treatment using a probe.

Japanese Unexamined Patent Publication No. Hei 11-318918 discloses an ultrasonic treatment instrument in which the tip of a probe is formed in a hook shape, and a spatula-shaped portion is provided on the side opposite to the hook portion. In this method, the tissue can be cut off by hooking, the tissue can be peeled off at the spatula-shaped portion, and coagulation can be performed at the side surface portion of the spatula-shaped portion.

Japanese Unexamined Patent Publication No. 2000-41991 discloses an ultrasonic treatment instrument in which a probe is formed in a curved shape.

Japanese Unexamined Patent Publication No. Hei 8-505801,
Japanese Patent Application Laid-Open Nos. 0-127654 and 9-38098 disclose an ultrasonic coagulation incision device having a probe having a tip portion having a relatively large end surface perpendicular to the probe long axis. I have.

[0008]

[Problems to be Solved by the Invention] JP-T 8-50580
No. 1, JP-A-10-127654, JP-A-9
In the ultrasonic coagulation incision device disclosed in Japanese Patent No. 38098, the following various problems occur because the distal end portion of the probe has a relatively large end surface perpendicular to the long axis of the probe. .

First, cavitation occurs on the distal end surface of the probe, and the tissue is crushed. Therefore, it is difficult to reliably coagulate, which is the original purpose. In addition, since the distal end surface is large, it is difficult to insert a probe between the membranes when exfoliating the tissue, and the exfoliation cannot be easily performed. Further, since the probe is straight, it is difficult to scoop the tissue, and it may not be possible to easily grasp the tissue.

Japanese Patent Application Publication No. Hei 8-505801 discloses an ultrasonic treatment instrument in which the tip of a probe is formed in a conical shape intended for coagulation and incision.
The distal end surface of the probe has a relatively small conical shape, and cannot prevent the probe from puncturing tissue.

[0011] Further, a probe in which the tip of the probe is formed in the shape of a bulb is also disclosed. This is unlikely to pierce the tissue, cavitation is dispersed, and the invasion to the tissue is considered to be small. The large part makes it difficult to insert into tissue and is not suitable for exfoliating tissue.

When a high frequency is used, the current is dispersed due to the large tip, so that a sufficient coagulation effect cannot be obtained.

The ultrasonic treatment instrument disclosed in Japanese Patent Application Laid-Open No. 11-318918 is a probe having a hook shape, and does not have a tissue grasping portion for grasping tissue and performing coagulation incision. If the tissue is dissected without grasping, the pressing force of the tissue against the probe is insufficient, so that the generation of frictional heat is small and sufficient coagulation cannot be performed.

Similarly, Japanese Patent Application Laid-Open No. 2000-41991 does not include a portion for grasping tissue.
As in the case of JP-A-318918, a sufficient coagulation incision cannot be made.

The present invention has been made in view of the above circumstances, and it is an object of the present invention to provide an ultrasonic treatment apparatus having good peelability, little cavitation, and good operability.

[0016]

The invention according to claim 1 is
An ultrasonic oscillator that generates ultrasonic vibration, a handpiece incorporating the ultrasonic oscillator, and a probe connected to the ultrasonic oscillator and serving as a vibration transmission member that transmits the ultrasonic vibration to a treatment unit. A gripping member that is opposed to the treatment section of the probe and grips the living tissue between the treatment section and at least one of the treatment section of the probe and the gripping member to move and grip the living tissue between the two. An ultrasonic treatment apparatus, comprising: a gripping operation means for performing an operation of performing an operation; and a spatula-shaped portion provided at a tip end of the probe.

According to a second aspect of the present invention, there is provided the ultrasonic treatment apparatus according to the first aspect, wherein the spatula-shaped portion is bent and projected from the distal end of the treatment section of the probe.

According to a third aspect of the present invention, there is provided the ultrasonic treatment apparatus according to the first or second aspect, wherein a high-frequency current can be applied to the spatula-shaped portion.

[0019]

DESCRIPTION OF THE PREFERRED EMBODIMENTS <First Embodiment> FIGS.
With reference to FIG. 4, an ultrasonic coagulation and incision apparatus according to a first embodiment of the present invention will be described.

(Construction) The ultrasonic coagulation and incision apparatus includes a handpiece 1 as an ultrasonic treatment tool as shown in FIG.
The handpiece 1 has a handpiece body 2 having a built-in ultrasonic vibrator (not shown). The handpiece body 2 is assembled to a handpiece holding body 3.

A handpiece cord 4 is connected to the handpiece body 2. The handpiece cord 4 is provided with a connector 5 connected to a generator (not shown). The connector 5 is provided with a watertight cap 7 that covers the terminal portion 6 when not in use.
Electric energy generated by a generator (not shown) is supplied to the ultrasonic vibrator through the handpiece cord 4 to drive the ultrasonic vibrator.

A treatment probe 10 for transmitting ultrasonic vibration is connected to the ultrasonic transducer via a horn (not shown). The amplitude of the ultrasonic vibration generated by the ultrasonic vibrator is increased by the horn and transmitted to the tip portion 11 of the probe 10. The probe 10 is covered with a protective sheath 12 except for a tip portion 11 thereof. The protective sheath 12 is connected to the handpiece holding main body 3. Here, the probe 10 and the protective sheath 12 are rotatable around the axis of the handpiece 1 so that the probe 10 and the protective sheath 12 can be rotated together by operating the rotation knob 14. Has become.

FIG. 1 shows the outer periphery of the handpiece body 2.
As shown by a circle, a plurality of projections 15 parallel to the axial direction of the handpiece body 2 are formed at intervals. The provision of these projections 15 makes the probe 10 less slippery and easier to grip when attaching and detaching the probe 10, and further increases the strength against thermal stress during autoclave sterilization by partially increasing the thickness. it can.

At the rear end of the handpiece body 2, there is provided a connecting portion 16 for applying high-frequency current. A high-frequency power supply cord (not shown) is connected to the connection portion 16. In the handpiece 1, there is formed an energizing path through which a high-frequency current can be supplied from the connecting portion 16 for connecting the high-frequency energizing cord to the distal end portion 11 of the probe 10. The energization path is subjected to a process of being electrically insulated from the outside of the handpiece 1.

A gripping member 21 is pivotally attached to the distal end of the protective sheath 12 so as to be opposed to the distal end portion 11 of the probe 10. Further, the tip portion 1 of the probe 10
In FIG. 1, a region that engages with the grip member 21 and grips the tissue protrudes from the distal end of the protective sheath 12, grips the tissue with the grip member 21, and coagulates the tissue.
A probe holding portion 22 is formed as a treatment portion for cutting.

The gripping member 21 is provided on the protective sheath 1.
2 is pivotally attached to the tip of the second unit via a pin 23 and is rotated by operating means 24 provided on the handpiece holding main body 3. The operating means 24 includes a fixed handle 25 and a movable handle 26. The movable handle 26 of the operating means 24
Is pivotally connected to the handpiece holding body 3 by a shaft pin 27.

The movable handle 26 of the operating means 24
By rotating the gripping member 21 via a connecting rod (not shown), the tissue can be gripped with the probe gripping portion 22 at the distal end portion 11 of the probe 10. By applying ultrasonic vibration to the probe 10 while grasping the tissue,
The tissue can be coagulated and dissected by the frictional heat and mechanical vibration. In addition, by applying high-frequency current to the probe 10, high-frequency treatment can be performed by the distal end portion 11 of the probe 10.

As shown in FIGS. 2, 3, and 4, at the distal end portion 11 of the probe 10, the distal end portion of the probe gripping portion 22 that engages with the gripping member 21 and grips the tissue is a spatula-shaped portion 28. . This spatula 28 is solidified
It is located on the distal end side of the region of the probe gripping portion 22 as a treatment section to be excised, and is made relatively thin, round, and integral with the probe 10 using the distal end portion of the probe 10. As shown in FIGS. 3 and 4, the spatula-shaped portion 28 is provided so as to protrude in the axial direction of the probe 10 beyond the tip of the gripping member 21 and the region of the probe gripping portion 22. As shown in FIG. 4, when viewed from above, the spatula-shaped portion 28 is formed in a rounded shape that is wider than the width of the probe gripping portion 22 and has a side protruding to the side of the probe gripping portion 22.

(Operation) When performing coagulation and incision of tissue using the handpiece 1, first, a spatula-shaped portion 28 is inserted and inserted between the membranes of the tissue, and the tissue membrane is inserted between the membranes. Is peeled off. Then, the target tissue is scooped up and the gripping member 2
The tissue is sandwiched between the probe holder 1 and the probe holding part 22, and ultrasonic vibration is applied to the probe 10 to perform coagulation and incision of the tissue.

When the tissue is to be treated with high frequency, the spatula 28 at the tip of the probe 10 is applied to the tissue, a high-frequency current is supplied through the probe 10, and the tissue is subjected to high-frequency treatment.

(Effect) In the present embodiment, since the spatula-shaped portion 28 is provided at the tip of the probe 10, the surface perpendicular to the long axis of the probe 10 is small. For this reason, occurrence of cavitation is small, and unexpected bleeding can be prevented. Probe 10
Is a thin spatula-shaped portion 28, so that treatment for tissue detachment is easy at the spatula-shaped portion 28. Since the tip shape of the probe 10 having the spatula-shaped portion 28 is round, the invasion to the tissue is small even if a sudden puncture or the like is performed. Further, in the case where the tissue is treated with high frequency, the spatula-shaped portion 28 at the tip of the probe 10 can be applied to the tissue, so that the high frequency treatment can be performed intensively.

<Second Embodiment> An ultrasonic coagulation and incision apparatus according to a second embodiment of the present invention will be described with reference to FIGS.

(Structure) In the present embodiment, the spatula-shaped portion 35 formed at the tip of the probe 10 has an angle θ with respect to the probe long axis of 45 ° or less, as shown in FIG. It is bent upward at an angle to the side to form a thin, round, spatula-shaped portion 35. Except for this, the configuration is the same as that of the above-described first embodiment.

(Function) When performing coagulation and incision of tissue using the handpiece 1 of the present embodiment, first, a spatula-shaped portion 35 is inserted between the membranes, and the tissue is peeled off. Thereafter, the target tissue is scooped up, the tissue is sandwiched between the probe gripping part 22 and the gripping member 21, and coagulation and incision of the tissue is performed.

(Effect) Since the back surface of the spatula 35 has an inclination of 45 ° or less with respect to the long axis of the probe, there is little component perpendicular to the long axis of the probe. Therefore, the occurrence of cavitation is relatively small, and bleeding can be prevented as much as possible. Further, since the tip is thin, the tissue is easily separated.
Furthermore, since the tip shape is round, the tissue is easily peeled off, and the invasion is small even if a sudden puncture is performed. Furthermore, since the spatula-shaped portion 35 has an inclination at the tip of the probe, the tissue can be easily scooped up and the operability is good.

<Third Embodiment> An ultrasonic coagulation and incision apparatus according to a third embodiment of the present invention will be described with reference to FIGS.

(Structure) The spatula-shaped portion 36 formed on the distal end portion 11 of the probe 10 according to the present embodiment engages with the gripping member 21 and extends beyond the region of the probe gripping portion 22 where the tissue is gripped and coagulated and resected. Over, the lower side part,
That is, by cutting off the surface portion on the side opposite to the side where the gripping member 21 is located, the distal end side is formed to be thin. The upper surface of the spatula-shaped portion 36 and the upper surface of the probe holding portion 22 are flatly connected. Further, the spatula-shaped portion 36 is formed in a thin band shape, but is connected to the back surface of the probe holding portion 22 by an inclined surface 37.

The width of the spatula 36 is equal to the width of the probe grip 22. The spatula portion 36 is formed at a portion protruding from the region of the probe holding portion 22. As shown in FIG. 9, the tip of the spatula-shaped portion 36 is formed in a semicircular shape. Further, the spatula-shaped portion 36 has a shape similar to the width of the probe gripping portion 22 and does not protrude laterally beyond the width. As shown in FIG. 8, the peripheral edge of the spatula-shaped portion 36 is formed as a roundness 39 having the thickness as a diameter, and is not formed as an end surface portion perpendicular to the probe long axis. Except for this, the configuration is the same as that of the above-described first embodiment.

(Function) When performing coagulation and incision of a tissue using the handpiece 1, first, a spatula-shaped portion 36 is inserted and inserted between the membranes of the tissue. Is peeled off. Thereafter, the target tissue is scooped up, the tissue is sandwiched between the probe gripping portion 22 and the gripping member 21, and ultrasonic vibration is applied to the probe 10 to perform coagulation incision.

(Effect) Since the tip portion 11 of the probe 10 according to the present embodiment has few surfaces perpendicular to the long axis of the probe, cavitation is less generated and unexpected bleeding can be prevented. Since the tip of the spatula-shaped portion 36 is thin, the tissue is easily separated. In addition, since the tip of the spatula-shaped portion 36 is round, invasion is small even if a sudden puncture or the like is performed. Further, since the width of the spatula-shaped portion 36 is as narrow as the probe gripping portion 22, the insertability into the tissue is better than in the first embodiment.

<Fourth Embodiment> An ultrasonic coagulation and incision apparatus according to a fourth embodiment of the present invention will be described with reference to FIGS.

(Configuration) In this embodiment, a spatula-shaped portion 41 formed thinly at the tip of the probe 10 is curved and rises toward the gripping member 21 with respect to the probe long axis, as shown in FIG. . Although there is no particular limitation on the dimension of the radius of curvature R, it is desirable that the entire spatula-shaped portion 41 bends obliquely with respect to the probe long axis as shown in FIG.

The tip of the spatula 41 is formed in a round and semicircular shape. The spatula 41 is the probe gripper 2
The shape does not protrude to the side than the width of 2. As shown in FIG. 10, the edge of the spatula-shaped portion 41 is formed as a roundness 42 whose diameter is the thickness thereof, and no flat portion is formed with respect to the long axis of the probe. Except for this, the configuration is the same as that of the above-described second embodiment.

(Operation) When performing coagulation and incision of a tissue using the handpiece 1 of the present embodiment, first, a spatula-shaped portion 41 is inserted between the membranes to exfoliate the tissue. Then, the target tissue is scooped up. And the probe gripper 2
The scooped tissue is sandwiched between the gripping member 2 and the gripping member 21 to perform a coagulation incision.

(Effect) Since the back surface of the spatula-shaped portion 41 is a curved surface, cavitation is dispersed and unexpected bleeding can be prevented. Further, since the tip of the spatula-shaped portion 41 is thin, the tissue is easily separated. Furthermore, since the tip shape is round, the tissue is easily separated. In addition, even if a sudden stab is performed, the invasion is small. In addition, the spatula-shaped portion 41
Since the tip of the probe 10 has a curvature and an inclination, the tissue can be easily scooped up, and the operability when peeling the tissue is good.

<Fifth Embodiment> An ultrasonic coagulation / cutting apparatus according to a fifth embodiment of the present invention will be described with reference to FIG.

(Structure) As shown in FIG. 12, the distal end portion 11 of the probe 10 of the present embodiment is curved at the distal end side from the probe gripping portion 22 which engages with the gripping member 21 and coagulates and cuts the tissue. And a thin and round spatula-shaped portion 43. A notch is provided on the side of the spatula 43 to form a hook 44. The other points are the same as those of the above-described fourth embodiment.

(Effect) When performing coagulation and incision of tissue, first, a spatula-shaped portion 43 is inserted between the membranes to exfoliate the tissue. Thereafter, the target tissue is scooped up by the spatula-shaped portion 43, inserted between the probe gripping portion 22 and the gripping member 21, and the tissue is sandwiched to perform a coagulation incision. In addition, the tissue can be cut off by hooking the tissue on the hook portion 44.

(Effects) In addition to the effects of the fourth embodiment,
The provision of the hook portion 44 makes it possible to hook and cut the tissue, thereby further improving the convenience.

<Sixth Embodiment> Referring to FIG. 13, an ultrasonic coagulation and incision apparatus according to a sixth embodiment of the present invention will be described.

At the distal end grip 51 of the handpiece 1, the gripping member 21 exposed from the distal end of the protective sheath 12
Are provided with graduations 52 at equal intervals, for example, every 1 mm.

The scale 52 is formed by laser marking, printing,
It is drawn by etching, engraving, inking, etc. The color of the scale should be easy to understand, such as solid black or green, which is complementary to blood.

(Effect) Since the size of the grasped tissue or blood vessel can be immediately known, the operator can perform the operation with ease.

<Seventh Embodiment> An ultrasonic coagulation / cutting apparatus according to a seventh embodiment of the present invention will be described with reference to FIG.

In the above-described sixth embodiment, the scales 52 are provided on the side surfaces of the holding member 21. In the present embodiment, the scales 52 are provided at equal intervals, for example, every 1 mm over the entire circumference of the probe holding portion 22. It is.

The scale 52 is used for laser marking, printing,
It is drawn by etching, inking, etc. The color of the scale should be easy to understand, such as solid black or green, which is complementary to blood. The gripping member 2
A scale 52 may be attached to 1 as well.

(Effect) In the operation under the endoscope, since the direction of observing the treatment portion is limited, the position of the distal end grasping portion 51 of the handpiece 1 is moved in the rotation direction about the probe 10 to rotate the treatment portion. The ultrasonic vibration may be output after sufficient confirmation. Even if such an operation is performed, the scale 52 can be checked from any direction, and the size of the grasped tissue or blood vessel can be immediately known. Can be done.

The configuration in which the scale 52 is provided in the sixth and seventh embodiments can be applied to the other embodiments described above.

The present invention is not limited to the above embodiments. According to the above description, each item listed in the following supplementary notes and those obtained by arbitrarily combining those items can be obtained.

[Supplementary Notes] An ultrasonic oscillator that generates ultrasonic vibration, a handpiece incorporating the ultrasonic oscillator, and a probe connected to the ultrasonic oscillator and serving as a vibration transmission member that transmits the ultrasonic vibration to a treatment unit. A gripping member that is opposed to the treatment section of the probe and grips the living tissue between the treatment section and at least one of the treatment section of the probe and the gripping member to move and grip the living tissue between the two. An ultrasonic treatment apparatus, comprising: a gripping operation means for performing an operation of performing an operation, wherein a spatula-shaped portion is provided at a distal end portion of the probe.

[0061] 2. 2. The ultrasonic treatment apparatus according to claim 1, wherein the spatula-shaped portion is bent or curved from the distal end of the treatment section. 3. 2. The ultrasonic treatment apparatus according to claim 1, wherein high-frequency current can be applied to the spatula-shaped portion.

4. 2. The ultrasonic treatment apparatus according to claim 2, wherein the spatula-shaped portion has a bending angle of 45 ° or less. 5. 2. The ultrasonic treatment apparatus according to claim 1, wherein a hook portion is provided on the spatula-shaped portion.

6. An ultrasonic oscillator that generates ultrasonic vibration, a handpiece incorporating the ultrasonic oscillator, and a probe connected to the ultrasonic oscillator and serving as a vibration transmission member that transmits the ultrasonic vibration to a treatment unit. A gripping member that is opposed to the treatment section of the probe and grips the living tissue between the treatment section and at least one of the treatment section of the probe and the gripping member to move and grip the living tissue between the two. An ultrasonic treatment apparatus, comprising: grip operation means for performing an operation to perform; and a scale attached to a treatment section or a grip member of the probe.

7. 7. The ultrasonic treatment apparatus according to claim 6, wherein the scales are provided at equal intervals on the side surface from the tip to the root. 8. 7. The ultrasonic treatment apparatus according to claim 6, wherein the scales are provided at equal intervals around the entire circumference from the tip to the root of the probe.

(Problems to be Solved by Sections 6 to 8) When coagulating and incising tissue, the surgeon generally determines, empirically, how large a blood vessel can be coagulated and incised. It is carried out. However, when using it under an endoscope, it is difficult to understand how thick the blood vessels in the tissue to be coagulated and incised are. May be connected. Therefore, the tissue grasped to solve this problem,
Items according to paragraphs 6 to 8 allow an operator to perform an operation with peace of mind by immediately knowing the size of a blood vessel.

[0066]

As described above, according to the present invention,
It is possible to provide an ultrasonic treatment apparatus with good peelability, little cavitation, and good operability.

[Brief description of the drawings]

FIG. 1 is a perspective view of a handpiece section of an ultrasonic coagulation / incision apparatus according to a first embodiment of the present invention.

FIG. 2 is a perspective view of a treatment unit of the ultrasonic coagulation / incision apparatus according to the first embodiment.

FIG. 3 is a side view of a treatment unit of the ultrasonic coagulation / incision apparatus according to the first embodiment.

FIG. 4 is a plan view of a treatment unit of the ultrasonic coagulation / incision apparatus according to the first embodiment.

FIG. 5 is a side view of a treatment section of the ultrasonic coagulation / incision apparatus according to the second embodiment of the present invention.

FIG. 6 is a perspective view of a treatment unit of the ultrasonic coagulation / incision apparatus according to the second embodiment.

FIG. 7 is a perspective view of a treatment section of an ultrasonic coagulation / incision apparatus according to a third embodiment of the present invention.

FIG. 8 is a side view of a treatment unit of the ultrasonic coagulation / incision apparatus according to the third embodiment.

FIG. 9 is a plan view of a treatment unit of the ultrasonic coagulation / incision apparatus according to the third embodiment.

FIG. 10 is a side view of a treatment unit of an ultrasonic coagulation / incision apparatus according to a fourth embodiment of the present invention.

FIG. 11 is a perspective view of a treatment unit of the ultrasonic coagulation / incision apparatus according to the fourth embodiment.

FIG. 12 is a side view of a treatment section of an ultrasonic coagulation / incision apparatus according to a fifth embodiment of the present invention.

FIG. 13 is a perspective view of a treatment unit of an ultrasonic coagulation / incision apparatus according to a sixth embodiment of the present invention.

FIG. 14 is a perspective view of a treatment section of an ultrasonic coagulation / incision apparatus according to a seventh embodiment of the present invention.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 ... Handpiece of ultrasonic coagulation incision apparatus 2 ... Handpiece main body part which incorporated the ultrasonic vibrator 3 ... Handpiece holding main body 10 ... Treatment probe which transmits ultrasonic vibration 11 ... Tip part of probe 12 ... Protection Sheath 16 ... Connecting part for conducting high frequency current 21 ... Gripping member 22 ... Probe gripping part 24 ... Operation means 28 ... Spatial part

Claims (3)

[Claims] 1. An ultrasonic vibrator for generating ultrasonic vibration, a handpiece containing the ultrasonic vibrator, and a vibration transmission connected to the ultrasonic vibrator and transmitting the ultrasonic vibration to a treatment section A probe as a member, a gripping member that is opposed to the treatment section of the probe and grips the living tissue between the treatment section, and at least one of the treatment section of the probe and the gripping member is moved to move the gripping member therebetween. An ultrasonic treatment apparatus, further comprising: gripping operation means for gripping a living tissue, wherein a spatula-shaped portion is provided at the tip of the probe. 2. The ultrasonic treatment apparatus according to claim 1, wherein the spatula-shaped portion bends and protrudes from the distal end of the treatment section of the probe. 3. The ultrasonic treatment apparatus according to claim 1, wherein a high-frequency current can be applied to the spatula-shaped portion.