JP2003093402A - Operation apparatus - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide an operation apparatus capable of performing operation processes from the congelation to the incision in series, with excellent cutting property for tissues, and capable of improving the operability. SOLUTION: The operation apparatus has a pair of grip parts 7 and 8 at the tip of an inserting part for gripping biological tissues, and the grip parts 7 and 8 are opened/closed according to the open/close operation of a hand operating part. At least either the grip part 7 or the grip part 8 has a ceramic heater 22 in which a heater 23 is buried as a heat generating part, and the tissue contact surface of the other grip part, which is disposed opposite from the ceramic heater 22, is made of a heat insulating material 19.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a surgical instrument for incising a coagulation portion after heating and coagulating a living tissue.

[0002]

2. Description of the Related Art Generally, as a medical treatment tool, a surgical instrument is known in which a living tissue such as a blood vessel is heated and coagulated, and then the coagulated portion is incised. For example, USP
In the coagulation treatment tools 5,792,137, as a means for heating a living tissue, a heater means is used which utilizes the fact that the semiconductor generates heat when the semiconductor is energized.

Japanese Laid-Open Patent Publication No. 11-137563 discloses a bipolar forceps having a pair of jaws, and a pair of jaws having scissors for cutting tissue and a portion for gripping the tissue.

Japanese Patent Laid-Open No. 8-505801 discloses a blade having an ultrasonic vibrator, which vibrates in the front-back direction by the ultrasonic vibrator at its tip, and the vibration of the blade moves substantially in the vertical direction. The clamp is configured to grasp tissue by the blade and the clamp to coagulate the tissue, and then perform incision.

US Pat. No. 5,716,366 has a pair of jaws for grasping tissue at its tip and has a heat element, and one jaw is provided with a cutting element capable of advancing and retreating to coagulate the tissue by thermal energy and then make an incision. It was done like this.

[0006]

By the way, USP 5,
When a semiconductor is used as the heater means like 792, 137, it is necessary to cover and insulate the outside of the semiconductor with an insulator so that the current does not leak to the living tissue when the semiconductor is energized.

However, synthetic resins and ceramic materials are usually used as the insulator, but these materials have a problem that they are not suitable for use as heater means because of their low thermal conductivity.

Therefore, Teflon (registered trademark) is used as the metal material.
There is a case where an insulating coating is used, but in this case, if the coating is damaged due to scratches during use and insulation breakdown occurs, it immediately becomes unusable, and there is a problem in durability and reliability.

In Japanese Patent Laid-Open No. 11-137563, since a scissor portion for incising a tissue and a grip portion for grasping the tissue are separately provided, the jaw is closed to grasp and coagulate the tissue, and then the jaw is removed. It requires a troublesome operation of opening once, applying the scissors to the solidified part, and closing it again.

In Japanese Patent Publication No. 8-505801, tissue is coagulated by ultrasonic vibration, which is a burden on the operator because it is structurally complicated and heavy.

USP 5,716,366 is structurally complicated and has complicated operations because the tissue coagulating member and the incising member are separate.

The present invention has been made by paying attention to the above circumstances. The object of the present invention is to provide a simple structure, but the coagulation to incision can be performed in a series of operations, and the tissue incision and operability are excellent. To provide surgical instruments.

[0013]

In order to achieve the above-mentioned object, the present invention provides a pair of grips for gripping a living tissue at a tip end thereof according to Claim 1 In a surgical instrument for opening and closing the grasping part, at least one of the grasping parts has a heat generating part, and the tissue contacting surface of the other grasping part opposite to the heat generating part is made of a heat insulating material. Characterize.

A second aspect of the present invention is characterized in that the tissue contacting surface of the first aspect is a heat insulating material having flexibility.

According to the above construction, at least one of the gripping portions has a heat generating portion, and the tissue contacting surface of the other gripping portion facing the heat generating portion is made of a heat insulating material to generate heat. It is possible to provide a surgical instrument that suppresses the escape of heat from the part and has excellent coagulation and incision properties.

[0016]

BEST MODE FOR CARRYING OUT THE INVENTION Embodiments of the present invention will be described below with reference to the drawings.

1 to 6 show a first embodiment, and FIG.
2 is an overall configuration diagram of the surgical instrument, FIG. 2 is a side view of the surgical instrument, FIG. 3 is a perspective view of a grip portion, FIG. 4 is a sectional view taken along the line AA of FIG. 3, and FIG. 5 is an electric circuit diagram of a power supply device. FIG. 6 is a graph.

As shown in FIG. 1, a thermocoagulation / dissection forceps 1 as a surgical instrument is connected to a power supply device 3 via a cable 2, and a footswitch 4 is connected to the power supply device 3.

As shown in FIGS. 2 to 4, the thermocoagulation / dissection forceps 1 is provided with a hand operation part 5, an insertion part 6 provided in the hand operation part 5, and a tip part of the insertion part 6. It is composed of a pair of first and second grips 7, 8.

The hand-side operation section 5 includes an operation section main body 12, a fixed handle 9 integrally provided with the operation section main body 12, and a movable operation section provided on the operation section main body 12 so as to be rotatable about a pivot shaft 10 as a fulcrum. It is composed of a handle 11. The insertion portion 6 is provided on the operation portion main body 12 by a rotation operation portion 13 so as to be rotatable about an axis.

The insertion portion 6 is formed by a thin pipe,
Inside the insertion portion 6, a drive shaft 14 that can move back and forth in the axial direction is freely installed.
Is interpolated. The base end of the drive shaft 14 is connected to the movable handle 11, and the first and second grips 7 and 8 are provided at the tip. The first and second grips 7 and 8 can be opened and closed with the pivot pin 15 as a fulcrum, and when the movable handle 11 is rotated in the direction a, the drive shaft 14 is retracted and closed, and when it is rotated in the direction b. The drive shaft 14 moves forward and opens.

Further, a connector connecting portion 16a is provided on the operation portion main body 12, and the connector 16 of the cable 2 is detachably connected to the connector connecting portion 16a. Electrical contact 1 of connector connecting portion 16a
6b is electrically connected along the drive shaft 14 to a heater 23 of a ceramic heater 22, which will be described later, provided in the second grip portion 8.

Next, the first and second gripping portions 7 and 8 will be described. The first gripping portion 7 is wide and has a concave portion 17 that opens toward the lower surface and has a downward U-shaped cross section. Is formed in. A serrated anti-slip portion 18 is provided on the lower surface on both sides of the recess 17 so as to sandwich the recess 17.
A heat insulating material 19 made of a flexible material such as Teflon (registered trademark) is embedded in the.

In the second grip portion 8, an arc groove 21 is formed on the upper surface of a heater holding portion 20 having a rectangular cross section which is narrower than the recess 17, and the arc groove 21 has a cylindrical ceramic as a heat generating portion. The heater 22 is fixed. A heater 23 as a heating resistor is embedded inside the ceramic heater 22. Further, the outer surfaces of the first and second grip portions 7 and 8 are coated with Teflon (registered trademark) to prevent the tissue from being scorched.

FIG. 5 shows an electric circuit of the power supply device 3. A power supply circuit 24 connected to a commercial power supply is connected to the cable 2 via an output circuit 25. The output circuit 25 is connected to the control circuit 26 connected to the foot switch 4, and the control circuit 2
Reference numeral 6 is connected to setting means 27 for setting temperature, time and the like.

FIG. 6 shows the temperatures during incision, coagulation and coagulation incision.
Shows a temperature change curve, the horizontal axis is time t (seconds), and the vertical axis is temperature T
(° C). The setting means 27 has a curved line.
At the time of incision, T₁The temperature rises rapidly until
Setting, and when solidifying, gradually increase the T_Two
Setting and coagulation incision to raise temperature up to and hold for several seconds
Time is gradually T_TwoAfter raising the temperature to
As shown, ₁To rise rapidly until
Can be set.

Next, the operation of coagulating / dissecting the coagulation / incision site of the living tissue by the thermocoagulation / dissection forceps 1 configured as described above will be described.

When the operator grips the hand-operated portion 5 and rotates the movable handle 11 with respect to the fixed handle 9 in the direction of arrow b, the drive shaft 14 moves forward to advance the first and second grip portions 7, 8. Opens. In this state, the thermocoagulation and incision forceps 1 is advanced to rotate the movable handle 11 in the direction of arrow a with the coagulation and incision site of the living tissue interposed between the first and second grips 7 and 8. , The drive shaft 14 retracts to move the first and second grips 7,
8 closes.

Then, the coagulation / incision site of the living tissue is grasped in a state of being pressed with a relatively small appropriate pressure suitable for coagulation treatment. When the foot switch 4 is operated and turned on in this state, the thermocoagulation incision forceps 1 is energized from the power supply device 3 via the cord 2. Therefore, the setting means 27 is set in the heater 23 of the ceramic heater 22 provided in the second grip portion 8.
The current set by is applied, and the heater 23 generates heat.

As shown by the curve in FIG. 6, the temperature of the heater 23 is gradually raised to T ₂ and maintained for several seconds, so that the coagulation / incision site of the living tissue is coagulated.
At this time, since the tissue contact surface of the first grip portion 7 is the heat insulating material 19, the heat of the ceramic heater 22 is applied to the first grip portion 7.
There is no escape to the side.

Subsequently, the heater 23 is energized with the current set by the setting means 17, and the temperature is rapidly raised to T ₁ as shown by the curve in FIG. 6, and the movable handle 11 is further moved in the direction of arrow a. When turned to, the drive shaft 14 is retracted to further close the first and second grip portions 7 and 8, and the coagulation / incision site of the living tissue can be incised.

At this time, since the contact surface of the second grip portion 8 with respect to the living tissue is formed by the cylindrical ceramic heater 22, it is in a substantially linear contact state with respect to the living tissue and is excellent in incisability, The incision can be made with a light gripping force between the first and second gripping portions 7 and 8. Therefore, it is possible to provide a thermocoagulation incision forceps that can perform from coagulation to incision by a series of operations and that excels in tissue incision.

FIGS. 7A to 7D show the second embodiment, and the same components as those of the first embodiment are designated by the same reference numerals and the description thereof will be omitted. In (a), a cylindrical ceramic heater 31 is provided in the concave portion 17 of the first grip portion 7, and a heater 32 as a heating resistor is embedded inside the ceramic heater 31 to form the first and second grip portions. Heat energy is applied to both 7 and 8.

In (b), a rectangular ceramic heater 33 is provided in the recess 17 of the first grip portion 7, and a heater 34 as a heating resistor is embedded in the inside of the ceramic heater 33. The heat energy is applied to both of the grip portions 7 and 8.

In (c), the first holding portion 7 is provided with a narrow rectangular heater holding portion 35, the circular arc groove 36 of the heater holding portion 35 is provided with a cylindrical ceramic heater 37, and the ceramic heater 37 is provided. A heater 38 as a heating resistor is embedded inside, and thermal energy is applied by both the first and second grip portions 7 and 8.

(D) shows the heater holding portion 2 of the second grip portion 8.
A narrow rectangular ceramic heater 39 is provided at 0, and a heater 40 as a heating resistor is embedded inside the ceramic heater 39 to improve the incisability. The tip of the ceramic heater 39 of the second grip portion 8 shown in (d) above is C-chamfered as shown in (e), or (f).
As shown in FIG.

According to the present embodiment, as in the first embodiment, a substantially linear contact is made with the living tissue, the incision is excellent, and the light gripping force of the first and second gripping portions 7 and 8 is small. Can be incised with. Therefore, it is possible to provide a thermocoagulation incision forceps that can perform from coagulation to incision by a series of operations and that excels in tissue incision.

FIG. 8 shows the third embodiment and is a perspective view of the scissors-type thermocoagulation / dissection forceps 41 of the present embodiment. The body 42 of the thermocoagulation / dissection forceps 41 has two scissors constituting members 43, 44.
Is provided. These scissors-constituting members 43 and 44 are piled up in such a manner that their middle portions substantially intersect. Further, at the intersection of the scissors constituting members 43, 44, the scissors constituting members 43,
A fulcrum pin 45 that rotatably connects 44 is provided.

Further, a pair of jaws 46, 4 serving as an openable / closable gripping portion for gripping a living tissue is provided at the tip of the main body 42.
A treatment section 48 having the number 7 is provided. Further, ratchets 49a, 5a are provided at the base end portions of the scissors constituting members 43, 44.
Substantially elliptical finger insertion rings 49 and 50 having 0a are formed. And these finger insertion rings 4
A hand operation unit 51 for opening and closing the pair of jaws 46 and 47 is formed by the portions 9 and 50.

Further, the treatment portion 48 of the main body 2 is formed with a curved portion 52 which is gently curved in a substantially arc shape. further,
The inner surface of one jaw 47 has a serrated anti-slip portion 47a.
Is provided, and a cylindrical ceramic heater 46a in which a heater for coagulating the living tissue is embedded is provided on the inner surface of the other jaw 46, that is, the contact surface side with the living tissue. The ceramic heater 46a is connected to the connector 53 via the scissors-constituting member 43, and the connector 53 is connected to a cable 54 for connecting to a power supply device (not shown).

Next, the operation of the thermocoagulation / dissection forceps 41 configured as described above will be described. First, the treatment portion 48 at the tip portion of the main body 42 is inserted into a living tissue including a treatment portion such as a blood vessel (not shown) in a closed state. Then, by opening the pair of jaws 46 and 47, the treated portion such as a blood vessel is peeled off from the other living tissue and exposed.

Subsequently, the separated blood vessel or the like is removed from each jaw 46,
It is grasped in a compressed state with a relatively small appropriate pressing force suitable for coagulation treatment between 47. In this state, when a power supply device (not shown) is output, each jaw 47 is connected via the cable 54.
The current shown in FIG. 6 is applied to the heater of the ceramic heater 46a. Due to the electric resistance during the energization, the ceramic heater 46a generates heat, and the living tissue of the treated portion such as the blood vessel which is in contact with the surface of the ceramic heater 46a is coagulated. Then, when incising the coagulation site, the current shown in FIG. 6 is applied to the heater of the ceramic heater 46a of each jaw 46 through the cable 54. When the jaws 46 and 47 are further closed in this state, the coagulation site of the living tissue is incised.

According to the present embodiment, as in the first embodiment, a substantially linear contact is made with the living tissue, the incision is excellent, and the incision can be made with a light gripping force of each jaw 46, 47. . Therefore, it is possible to provide a thermocoagulation incision forceps that can perform from coagulation to incision by a series of operations and that excels in tissue incision.

FIG. 9 shows a fourth embodiment, (a) is a side view of the entire scissors-type coagulation treatment tool, (b) is a plan view of the treatment portion, and (c) is a perspective view of the jaw. . The main body 62 of the coagulation treatment tool 61 of this embodiment has two scissors constituting members 63, 64.
Is provided. These scissors-constituting members 63, 64 are stacked in such a manner that the midway portions thereof intersect substantially. Further, at the intersection of the scissors constituting members 63, 64, the scissors constituting members 63,
A fulcrum pin 65 that rotatably connects 64 is provided.

Further, a treatment section 68 having a pair of openable and closable jaws 66, 67 for grasping a living tissue is arranged at the tip of the main body 62. Substantially elliptical finger insertion rings 69, 70 are formed at the base ends of the scissors constituting members 63, 64. Then, these finger insertion rings 69, 7
A hand operation section 71 for opening and closing the pair of jaws 66, 67 is formed by the 0 portion.

Further, the treatment portion 68 of the main body 62 is formed with a curved portion 72 which is gently curved in a substantially arc shape as shown in FIG. Further, on the rear side of each jaw 66, 67, a ceramic heater 7 having a rectangular shape for coagulating the living tissue on the contact surface side with the living tissue and having a wide contact surface with the living tissue.
3, 74 are provided.

Each of the ceramic heaters 73 and 74 is formed by embedding a heater inside a ceramic which is an insulator. The outer surface (contact surface with living tissue) of each ceramic heater 73, 74 is coated with Teflon (registered trademark) in order to prevent burning (sticking) of living tissue.

Further, grippers 75 and 76 for gripping living tissue are provided on the front sides of the jaws 66 and 67. As shown in (c), the grip portions 75 and 76 are provided with serrated slip-proof portions 75a and 76a.

Further, as shown in (a), both scissors constituting members 6
Insulated lead wires 77 and 78 are arranged on 3 and 64, respectively. Here, the tip of the insulating lead wire 77 on the one scissors constituting member 63 side is connected to the ceramic heater 73, and the tip of the insulating lead wire 78 on the other scissor constituting member 64 side is connected to the ceramic heater 74.

Further, one cord connecting portion 79 is provided on the outer peripheral surface of the finger inserting ring 69 on the scissors constituting member 63 side, and one cord connecting portion 80 is similarly provided on the outer peripheral surface of the finger inserting ring 70 on the scissor constituting member 64 side. Are projected respectively. And
The base end portion of the insulating lead wire 77 is connected to the cord connecting portion 79 on the scissors constituting member 63 side, and the insulating lead wire 78 is connected to the cord connecting portion 80 on the scissors constituting member 64 side.
Further, the cord connecting portions 79 and 80 are detachably connected to the other ends of the connecting cords 81 and 82, one ends of which are connected to a power supply device (not shown). Then, the ceramic heaters 73 and 74 are energized from a power supply device (not shown).

Next, the operation of the coagulation treatment tool constructed as described above will be described. First, the treatment section 68 at the distal end of the coagulation treatment instrument 61 is inserted into a living tissue including a treated section such as a blood vessel (not shown) in a closed state. After that, by opening the pair of jaws 66, 67, the treated portion such as a blood vessel is peeled off from other living tissues and exposed.

Subsequently, the detached blood vessel or the like can be grasped by the grasping portions 75 and 86 in front of the treatment portion 68 and pulled out to the front side, and the jaws 66 and 6 of the coagulation treatment instrument 61 can be pulled out.
The ceramic heaters 73 and 74 of No. 7 are gripped in a state of being pressed with an appropriate pressing force for coagulation treatment. In this state, when a power supply device (not shown) is output, the heaters of the ceramic heaters 73 and 74 of the jaws 66 and 67 are energized via the connection cords 81 and 82. The electric resistance at the time of energization causes the heater to generate heat and coagulates the living tissue of the treated portion such as a blood vessel that is in contact with this surface. At that time, the ceramic heater 7
Since 3 and 74 are insulators, the electric current flowing through the heater does not leak to the living tissue of the treated portion.

Therefore, in this embodiment, the ceramic heaters 73 and 74 are provided on the jaws 66 and 67 of the main body 62. Therefore, since the ceramic heaters 73 and 74 themselves, which are in direct contact with the living tissue of the treated portion such as a blood vessel, are insulators, the ceramic heaters 73 and 74 of the jaws 66 and 67 are not used.
There is no need to apply another insulating coating to the coagulation treatment tool 6
1 has the effect of enhancing the durability and reliability.

10 and 11 show a fifth embodiment, the distal treatment section is the same as the treatment section 68 of the fourth embodiment, and other than the distal treatment section, it is the same as the first embodiment. It has a configuration that can be inserted into the body through an endoscope, and the same components are given the same numbers and their explanations are omitted, but the same effects as those of the fourth embodiment can be obtained.

FIGS. 12 and 13 show Disclosure Example 1, and FIG.
Reference numeral 2 denotes a storage case 90 that stores the coagulation treatment tool 61 shown in the fourth embodiment. The storage case 90 is made of a material having high thermal conductivity, for example, an aluminum material subjected to alumite treatment. The storage case 90 has a coagulation treatment tool 61.
A substantially V-shaped recessed groove 91 for accommodating the main body 62 including the treatment portion 68 is provided, and the coagulation treatment tool 61 is provided on the tip side of the recessed groove 91.
A holding member 92 is provided to hold and hold. Further, the storage case 90 is provided with a fixing band 93.

During the surgery, the storage case 90 is placed on a sterilizing cloth 94 covering the patient's body at the time of surgery, and the fixing band 93 is sterilized with forceps 95 such as a Pean, as shown in FIG.
The storage case 90 can be securely fixed by gripping and fixing the storage case 90.

The coagulation treatment tool 61 used for the surgery is the treatment section 6
Although 8 is heated to a high temperature, by placing the main body 62 including the treatment portion 68 of the coagulation treatment tool 61 in the recessed groove 91, the heat of the treatment portion 68 is conducted to the storage case 90 and is shortened. To be cooled. Therefore, there is an effect that the safety is high and the temperature control can be performed accurately when it is reused.

14 to 16 show Disclosure Example 2, and FIG.
Is a side view showing the whole ultrasonic coagulation / incision device, FIG. 15 is a perspective view of a treatment section, and FIG. 16 is a sectional view when the treatment section is closed.

The body 101 of the ultrasonic coagulation / cutting device 100 is provided with an insertion portion 102, and a rotatable jaw 103 is provided at the tip of the insertion portion 102. Joe 1
Reference numeral 03 is adapted to be rotated by a hand operation unit 104 provided on the main body 101, and a saw-toothed anti-slip portion 105 is provided on the lower surface.

Furthermore, the probe 106 is provided in the insertion portion 102.
Is inserted so as to be movable back and forth in the axial direction, and the probe 106
The base end of the ultrasonic transducer 107 is provided on the main body 101.
The probe 106 is vibrated in the axial direction by the ultrasonic transducer 107.

A plurality of ridges 108 are provided at the tip of the probe 106 in parallel with the vibration direction, and when the jaw 103 is closed and grips the living tissue, the ridges 108 of the probe 106 contact the living tissue. However, the concave streak portion 109 does not come into contact with the living tissue.

Therefore, the jaw 103 is closed and the probe 1
When the living tissue is grasped between the probe 106 and the probe 106 and ultrasonically vibrates the probe 106, the living tissue is coagulated by the heat generated by the ultrasonic vibration. Then, when the jaw 103 is further closed, the coagulation site is the ridge 108 of the probe 106.
The living tissue is incised because it comes into line contact with. When the ultrasonic vibration of the ultrasonic vibrator 107 is stopped, the probe 1
No. 06 has a large heat dissipation area due to the convex stripes 108 and the concave stripes 109, so that the temperature drops sharply.

According to each of the above-mentioned embodiments, the following structure can be obtained.

(Supplementary Note 1) In a surgical instrument which has a pair of grips for gripping a living tissue at the tip thereof and which opens and closes the grips in accordance with the opening / closing operation of the hand operation part, at least one of the grips is heated. A surgical instrument having a heat generating part, wherein a tissue contacting surface of the heat generating part is formed in an arc-shaped cross section.

(Supplementary Note 2) In a surgical instrument which has a pair of grips for gripping a living tissue at the tip and which opens and closes the grips in accordance with the opening and closing operation of the operating part at hand, heat is applied to at least one of the grips. A surgical instrument having a heat generating part, wherein the tissue contacting surface of the heat generating part is smaller in area than the tissue contacting surface of the gripping part facing the heat generating part.

(Supplementary Note 3) The surgical instrument according to Supplementary Note 1 or 2, wherein the tissue contacting surface of the other gripping portion arranged to face the heat generating portion is made of a heat insulating member.

(Supplementary Note 4) The surgical instrument according to Supplementary Note 1 or 2, wherein the grip portion has a curved structure.

(Supplementary Note 5) The surgical instrument according to Supplementary Note 1 or 2, wherein the gripping portion has a double-opening structure.

(Supplementary Note 6) The surgical instrument according to Supplementary Note 1 or 2, wherein the other gripping portion arranged to face the heat generating portion is provided with a non-slip portion.

(Supplementary Note 7) The surgical instrument according to Supplementary Note 1 or 2, wherein the outer surfaces of the pair of gripping portions are coated with a coating for preventing scorching of tissue.

(Supplementary Note 8) The surgical instrument according to Supplementary Note 1 or 2, wherein the tissue contacting surface of the other gripping portion arranged to face the heat generating portion is a heat generating portion having a rectangular cross section.

(Supplementary Note 9) The surgical instrument according to Supplementary Note 1 or 2, wherein the edge of the tissue contact surface of the heat generating portion is chamfered or chamfered.

(Supplementary note 10) The surgical instrument according to supplementary note 1 or 2, wherein the tissue contacting surface of the other gripping portion arranged to face the heat generating portion is a heat insulating material having flexibility.

(Supplementary Note 11) In a power supply device for supplying electric power to the heat generating section, an output circuit for outputting electric power to the heat generating section, setting means for setting the output, temperature and output mode, and the setting means. And a control means for controlling the output to the heat generator based on the above.

[0075]

As described above, according to the present invention, at least one of the gripping portions has a heat generating portion, and the tissue contacting surface of the other gripping portion arranged to face the heat generating portion is heat insulating material. With this configuration, it is possible to suppress the escape of heat from the heat generating portion. Therefore, there is an effect that the structure is simple, the coagulation to the incision can be performed by a series of operations, the coagulation and incision properties of the tissue are excellent, and the operability can be improved.

[Brief description of drawings]

FIG. 1 is an overall configuration diagram of a surgical instrument showing a first embodiment of the present invention.

FIG. 2 is a side view of the surgical instrument according to the embodiment.

FIG. 3 is a perspective view of a grip portion of the same embodiment.

4 is a sectional view taken along the line AA of FIG.

FIG. 5 is an electric circuit diagram of the same embodiment.

FIG. 6 is a graph of the same embodiment.

FIG. 7 shows a second embodiment of the present invention, in which (a)-
(D) is a cross-sectional view of the treatment portion, (e) and (f) are second views of (d).
Sectional drawing which expanded the holding part of this.

FIG. 8 is a perspective view of a thermocoagulation / dissection forceps showing a third embodiment of the present invention.

9A and 9B show a fourth embodiment of the present invention, wherein FIG. 9A is a side view of the entire scissors-type coagulation treatment tool, FIG. 9B is a plan view of a treatment section, and FIG.

FIG. 10 is a side view of the entire thermocoagulation / dissection forceps showing a fifth embodiment of the present invention.

FIG. 11 is a side view showing a partial cross section of the treatment portion of the same embodiment.

FIG. 12 is a perspective view of a storage case that stores the coagulation treatment tool according to the first disclosed example.

FIG. 13 is a perspective view of the storage case of the first disclosure example in a used state.

FIG. 14 is a side view showing an entire ultrasonic coagulation / incision instrument showing Disclosure Example 2;

FIG. 15 is a perspective view of a treatment portion according to the second disclosure example.

FIG. 16 is a cross-sectional view when the treatment section of the second disclosed example is closed.

[Explanation of symbols]

1. Thermocoagulation incision forceps 5 ... Hand control unit 6 ... insertion part 7, 8 ... Grip 19 ... Insulation 22 ... Ceramic heater 23 ... Heater

Continued front page    (72) Inventor Hideto Yoshimine             2-43 Hatagaya, Shibuya-ku, Tokyo Ori             Inside Npus Optical Industry Co., Ltd. F-term (reference) 4C060 JJ22 KK47 MM24

Claims (2)

[Claims] 1. A surgical instrument having a pair of grips for gripping a biological tissue at its distal end and opening and closing the grips in accordance with the opening and closing operation of a hand operation unit, wherein at least one of the grips has a heat generating part. And a tissue contacting surface of the other gripping portion that is arranged so as to face the heat generating portion, is made of a heat insulating material. 2. The surgical instrument according to claim 1, wherein the tissue contact surface is a heat insulating material having flexibility.