JP2003220076A - Heat treating implement - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a heat treating implement which can surely close a living tissue. <P>SOLUTION: The heat treating implement comprises a clip 30 for closing a living issue, a gripping unit having first and second contact surfaces for gripping the clip 30, a gripping unit drive means for moving the first and second contact surfaces to close the clip, a heater for heating by energizing to treat the living tissue, and an energizing means for energizing the heater. <P>COPYRIGHT: (C)2003,JPO

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a thermal treatment device.

[0002]

2. Description of the Related Art In surgical procedures, for example, various treatment tools have been conventionally used for closing, anastomosing, suturing, fusing and cutting tissue.

For example, Japanese Utility Model Laid-Open No. 5-74508 discloses a clip means for closing a tissue. In addition, Japanese Examined Patent Publication No. 6-57217 and Jikken Sho 4
Japanese Patent Publication No. 7-11909 discloses a needle holder used for suturing a tissue.

It is also known to use an automatic suturing device or the like to perform fusion and cutting of tissue.

Further, Japanese Unexamined Patent Publication No. 8-19547 and Japanese Unexamined Patent Publication No. 8-19597 disclose vascular anastomotic devices for anastomosing tissues.

[0006]

However, in the closure of the tubular member by the clip means disclosed in Japanese Utility Model Laid-Open No. 5-74508 described above, the position of the clip means is displaced after the clip means is held and the certainty of the closure is ensured. I had a problem with. Therefore, in the actual treatment, a plurality of clip means are used to increase the certainty. Further, in the conventional example, there is also a clip means in which a high-frequency current is passed to improve the certainty of occlusion, but there is a problem that the degree of coagulation of the tissue becomes excessive because the current flows to the tissue. It was

Further, in the needle holder disclosed in Japanese Patent Publication No. 6-57217 and Japanese Utility Model Publication No. 47-11909, when suturing a minute portion or a tissue rich in elasticity,
There is a problem that the tip of the needle slips due to the tissue and it is difficult to suture the desired position.

Further, in the above-mentioned ordinary automatic suturing device, the staples exert a strong stress on the lung tissue at the time of suturing, so that the recurrence of the bra may occur at the staple portion. Further, there is a problem that automatic suturing cannot be performed when the lung tissue is weakened due to emphysema or the like.

Further, in the blood vessel anastomotic apparatus disclosed in JP-A-8-19547 and JP-A-8-19597,
When connecting blood vessels, to attach a resin collar,
The thin blood vessel could not be anastomosed.

The present invention has been made in view of the above problems, and the first object thereof is to provide a thermal treatment instrument capable of performing reliable closure. It is in.

A second object of the present invention is to provide a thermal treatment instrument capable of suturing a fine portion or a tissue rich in elasticity at a desired position.

A third object of the present invention is to provide a thermal treatment tool which does not exert a strong stress on lung tissue.

A fourth object of the present invention is to provide a thermal treatment instrument capable of anastomosing even a thin blood vessel without any foreign matter remaining in the body after anastomosis.

[0014]

In order to achieve the above object, a first invention is a clip means for closing a living tissue, and first and second clip means for gripping the clip means.
Gripping portion having a contact surface, a gripping portion driving means that moves the first and second contact surfaces to close the clip means, and generates heat when energized to treat the living tissue. A heating element and an energizing means for energizing the heating element are provided.

A second aspect of the present invention is a grasping portion having first and second contact surfaces for grasping the suture needle, and the suture needle by moving the first and second contact surfaces. A gripping part driving means for gripping the wire, a heating element that heats the first contact surface by heating when the current is applied, and a heating element that heats the suture needle, and an energizing means that applies current to the heating element. To do.

A third aspect of the present invention is a gripping portion having first and second contact surfaces for gripping a living tissue, and gripping the living tissue by moving the first and second contact surfaces. And a heating element that generates heat when energized, and an energization means that energizes the heating element. Protrusions are provided on the first and second contact surfaces, and the heat generation is performed. When the body heats up, the living tissue is treated through the protrusion.

A fourth aspect of the present invention is a pair of plate-shaped bodies having a hole in the center thereof, which can be opened and closed, a protrusion provided on the surface of the pair of plate-shaped bodies, and a surface of the pair of plate-shaped bodies. Is provided in
A hole into which the protrusion is inserted when the pair of plate-shaped bodies are overlapped with each other, and heat is generated by energizing while the protrusion is inserted into the hole to perform treatment of living tissue. A body and an energizing means for energizing the heating element are provided.

[0018]

BEST MODE FOR CARRYING OUT THE INVENTION (First Embodiment) (Structure) A first embodiment of the present invention will be described below. FIG. 1 is an overall configuration diagram of a system of a clip applier as a thermal treatment tool according to the first embodiment. FIG. 2 is a sectional view of the grip portion of the clip applier. Figure 1
As shown in, the clip applier 1 is connected via a cable 2 to a power supply device 3 as an energizing means, and a foot switch 4 is connected to the power supply device 3. In addition, the power supply device 3 is provided with a setting operation unit 19 and a display unit 20 that can set the heat generation temperature of the heating element. In the display unit 20,
The set heating temperature of the heating element is displayed. The heat generation temperature can be set by the setting operation unit 19, and the button 2
Pressing 1 raises the set temperature, and pushing button 22 lowers the set temperature.

The main body of the clip applier 1 is
Two scissor components 5, 6 are provided. These scissors constituting members 5 and 6 are overlapped in such a manner that the middle portions thereof substantially intersect. Further, a fulcrum pin 7 that rotatably connects the scissors constituting members 5 and 6 is arranged at the intersection of the scissors constituting members 5 and 6.

At the tip of the clip applier 1, a gripping portion having a pair of jaws 8 and 9 having first and second abutment surfaces and capable of opening and closing a clip to be described later is arranged. It is set up. The jaws 8 and 9 are engaged with the engaging portions of the clip, and the clip holding hole 1 for holding the clip 1
0, 11 (FIG. 2) are provided. The surface of the jaw 9 is further provided with two electrodes 12, 13 (FIG. 2).

Finger insertion rings 14 and 15 are formed at the base ends of the scissors constituting members 5 and 6, respectively. Then, the pair of jaws 8 and 9 are formed by these finger insertion rings 14 and 15.
A hand operation part (grip part driving means) 16 for opening and closing is formed. Further, the hand-side operation portion 16 is provided with a connector connecting portion 17, and the connector connecting portion 17 includes
The connector 18 of the cable 2 is detachably connected.

Further, the connector connecting portion 17 is electrically connected to the electrodes 12 and 13 on the jaw 9 described above.

FIG. 3 shows the structure of the clip 30. The clip 30 is made of an insulating material such as resin,
Two ligatures 32 and 33 are opened and closed centering on the open / close center 31 and are locked by a hook 34 provided on the tip side of the ligatures 32 and 33 at the time of closure. At this time, a target site is sandwiched and ligated. Is. Also, clip 3
0 is the engaging portions 35, 36 on the outside of the distal ends of the ligating portions 32, 33.
Is protruding. In the clip 30, the engaging portions 35 and 36 are engaged with the clip holding holes 10 and 11 provided on the tip side of the jaws 8 and 9 shown in FIG. 2, and are held inside the jaws 8 and 9. ing.

Further, in FIG. 3, a heating element 37 made of a material such as a metal thin film, which generates heat by resistance when energized, is disposed inside the ligation portion 32. Both ends of the heating element 37 are inserted through the through holes 38 and 39 and are in electrical contact with the electrode means 40 and 41 outside the clip.

As the heating element 37, for example, a molybdenum thin film resistance heating element having a small size and a high heating efficiency is used. Alternatively, a ceramic heater, a cartridge heater, a PTC heater or the like may be used.

(Operation) Next, the operation of the clip applier 1 configured as described above will be described. First, as shown in FIG. 2, the clip 30 is held by the jaws 8 and 9 with the grip portion at the tip of the clip applier 1 being opened. In this state, the tip of the jaws 8 and 9 is inserted with a living tissue including a processed portion such as a blood vessel (not shown).

Next, the blood vessel or the like is gripped between the jaws 8 and 9 while being compressed with an appropriate pressing force. Then clip 3
The outside of 0 is pressed by the jaws 8 and 9 to close the clip 30, and the hook portion 34 is fitted and locked (FIG. 4). Further, the two electrodes 12 and 13 provided on the surface of the jaw 9 are electrically joined to the electrodes 41 and 40 provided on the outer surface of the clip 30. In this state, when the foot switch 4 is stepped on and the power supply device 3 is output, current is applied to the heating element 37 of the clip 30 via the cable 2. Due to the electric resistance when energized, the heating element generates heat,
A treated portion such as a blood vessel that is in contact with the surface of the heating plate is coagulated.

(Effect) According to the first embodiment, in addition to the holding force of the clip 30, a holding force of fusing with heat can be expected,
A reliable ligation is possible. Further, the position of the clip 30 does not shift after being held, and reliable closure is possible. Therefore, it is not necessary to use a plurality of clips, and the burden on the doctor is reduced.

Moreover, since no high-frequency current is used, no current flows through the tissue, and the degree of coagulation of the tissue is maintained at an appropriate level.

(Second Embodiment) A second embodiment of the present invention will be described below. Descriptions of parts having the same configurations as those in the first embodiment will be appropriately omitted.

(Structure) FIG. 5 is a diagram showing details of the grip portion 51 at the tip of the clip applier 50 in the second embodiment. The grip 51 has a pair of jaws 52, 5
3 are provided. A heating element 55 is housed on the inner surface of one of the jaws 53, and a heating plate 56 is attached to the heating element 55. The heating element 55 is connected to the connector 18 (FIG. 1) via the scissors constituting member 6.

As the heating element 55, as in the first embodiment, a small size and high heating efficiency, for example, a molybdenum thin film resistance heating element, a ceramic heater, a cartridge heater, a PTC heater or the like is used. The heat generating plate 56 is made of a material having good thermal conductivity such as copper, silver, or tungsten. 57 and 58 are clip holding holes,
0 is a clip.

FIG. 6 is a diagram showing the structure of the clip 60. The clip 60 is made of metal, and the two ligating portions 62 and 63 are opened and closed around the opening / closing center portion 61 and are locked by the hook portion 64 provided on the tip side of the ligating portions 62 and 63 when closed. Further, the clip 60 has engaging portions 65 and 66 projecting outward from the outer ends of the ligating portions 62 and 63, and engages with clip holding holes 57 and 58 provided on the distal ends of the jaws 52 and 53. It is designed to be held inside the members 52 and 53.

FIG. 7 is a view showing a state where the clip 60 is pressed by the clip applier 50.

(Operation) Next, the operation of the second embodiment will be described. Similar to the first embodiment, the blood vessels are set to the jaws 52, 53.
When gripped in the state of being pressed with, the clip 60 is closed and locked. At this time, the heat generating plate 56 installed on the inner surface of the jaw 53 is in close contact with the outside of the clip 60.
When the power supply device 3 (FIG. 1) is output in this state, the heating element 5
5 generates heat due to electric resistance, and heats the heating plate 56. Further, the heat heats the clip 60, so that the living tissue of the treated portion such as a blood vessel occluded by the clip 60 is heated and coagulated.

(Effects) The second embodiment has the same effects as the first embodiment. Further, since it is not necessary to provide the electrode portion on the clip 60, there is an effect that the cost of the consumable part is reduced.

(Third Embodiment) (Structure) In the third embodiment, the clip is made of a thermoplastic resin such as polylactic acid. Other configurations are similar to those of the second embodiment.

(Function) Similar to the second embodiment, when the jaw holds the living tissue and the power supply device is driven, the heating element generates heat and heats the heating plate. The heat is transmitted to the clip and melts the clip, so that both ligatures are securely fused.

(Effects) The third embodiment has the same effects as the second embodiment.

(Fourth Embodiment) (Structure) The fourth embodiment relates to a needle holder that holds and operates a needle for suturing soft tissue or skin of a living body.

FIG. 8 shows the structure of the needle holder in the fourth embodiment, and FIG. 9 is a diagram showing the details of the grip portion of the needle holder.

The main body 70 of the needle holder has two scissors constituting members 7.
1, 72 are provided. These scissors constituting members 71,
72 is overlapped in such a manner that the middle portions thereof substantially cross each other.
Further, a fulcrum pin 73 that rotatably connects the scissors-constituting members 71 and 72 is arranged at the intersection of the scissors-constituting members 71 and 72.

At the tip of the main body of the needle holder 70, there is provided a grip portion having a pair of openable and closable jaws 74, 75 for gripping the surgical suture needle. Furthermore, each scissor component 71,
Substantially elliptical finger insertion rings 78 and 79 having ratchets 76 and 77 are formed at the end of 72. A hand operation section 80 for opening and closing the pair of jaws 74, 75 is formed by the finger insertion rings 78, 79.

Further, on the inner surface of one of the jaws 74, in order to surely and stably hold the needle, a saw-toothed anti-slip portion 81 composed of a large number of projections and grooves or a combination thereof is provided. ing. The other Joe 75
A heating element 82 (Fig. 9) is embedded in the inner surface of the jaw 7
It is joined to the heat generating plate 83 provided on the gripping surface side of Nos. 4 and 75. The surface of the heating plate 83 forms a sawtooth-shaped gripping surface 84.

(Operation) The operation of the needle holder 70 configured as described above will be described below. The surgical suture needle is sandwiched between the grips of the needle device 70, and the ratchets 76, 77 are inserted.
Hold and hold the needle. After that, by applying the tip of the needle to the portion to be sutured and operating the foot switch 4 (FIG. 1) to output the power supply device 3 (FIG. 1), an electric current is applied to the heating element 82 via the cable 2 (FIG. 1). Energized, heating element 82
Generate heat, and the needle held by the heat generating plate 83 is heated. In this state, the needle is inserted into the tissue.

(Effect) According to the fourth embodiment, by heating the needle, it is possible to reduce the puncture force of the needle. Further, even when a fine portion or a tissue rich in elasticity is sutured, the tip of the needle does not slip due to the tissue, and suturing can be performed at a desired position.

(Fifth Embodiment) (Structure) A fifth embodiment of the present invention will be described below. The fifth embodiment relates to a treatment tool for cutting tissue.

FIG. 10 is a block diagram of this system. The treatment tool 90 includes a hand operation section 91 as a grip section driving means,
The insertion portion 92 and a pair of gripping portions 93 and 94 having first and second contact surfaces provided at the tip of the insertion portion are included.

The hand operation unit 91 includes an operation unit main body 95, a fixed handle 96 integrally provided on the operation unit main body 95,
The operation unit main body 95 includes a movable handle 98 rotatably provided about a shaft 97 as a fulcrum.

The operation section main body 95 is provided with the insertion section 92 rotatably about an axis by a rotation operation section 99. The insertion portion 92 is formed of a small-diameter pipe, and inside the insertion portion 92, a drive shaft 100 that is movable in the axial direction is inserted. The base end portion of the drive shaft 100 is connected to the movable handle 98, and the tip end portion is provided with the first and second grip portions 93 and 94. The first and second grips 93, 94 can be opened and closed with the pin 101 as a fulcrum, and when the movable handle 98 is rotated in the direction a in the figure, the drive shaft 100 retracts and closes. .

The operation section main body 91 is provided with a connector connecting section 102, and the connector section of the cable 2 is detachably connected to the connector connecting section 102. The connector connecting portion 102 is electrically connected to a heating element, which will be described later, provided on the first and second grip portions 93 and 94 along the drive shaft 100.

FIG. 11 is a detailed view of the treatment section at the distal end of the treatment instrument described above, and FIG. 12 is a sectional view of the treatment section. FIG. 13 is a diagram showing a state in which a living tissue is grasped by the present treatment tool.

As shown in FIG. 12, the first and second grip portions 93, 94 are provided with open grooves 103, 104. The concave grooves 103 and 104 are provided in the grip portions 93 and 94.
Are provided in front of and behind each. Groove 103,
The heating elements 105 and 106 are housed in 104,
The heat generating plates 105 and 107 are attached to the heat generating plates 105 and 106.
Are provided in a joined state.

The heat generating plate 107 has a first plane portion 107a,
It has a second flat surface portion 107b and a projection portion 107c protruding from the flat surface portion. A flat surface portion 1 having a width d at the tip of the protrusion
07d is provided. The protrusion 107c is located at a position displaced by a predetermined amount D from the central axis X of the cross section of the heat generating plate.
3 are provided in the front-back direction. That is, the planes 107b and 108b are formed wider than the planes 107a and 108a.

Similarly, the heating plate 108 has flat portions 108a, 1a.
08b, the protrusion 108c, and the flat portion 108 on the protrusion
have d.

The protrusions 107c and 108c are arranged at positions facing each other. In addition, the first grip 93, the second
Surrounding the concave grooves 103 and 104 of the grip portion 94, saw-tooth-shaped anti-slip portions 109 are provided on both side edges.

(Operation) Next, the operation of the treatment tool constructed as described above will be described. When the operator grips the hand-held operation part 91 and rotates the movable handle 98 with respect to the fixed handle 96 in the b direction, the drive shaft 100 advances and the first grip part 93 and the second grip part 94 open. . In this state, the treatment instrument 90 is advanced to rotate the movable handle 98 in the a direction with the portion of the living tissue desired to be coagulated and separated interposed between the first and second grips 93 and 94 to grip the grip. Close 93 and 94. At this time, the protruding portions 107c, 108c of the treatment instrument 90
Is grasped in a direction biased to the tissue T1 side to be separated from the living body. The planes 107b and 108b are brought into contact with the remaining tissue T2 side.

Then, the coagulation cut site of the living tissue T is grasped in a state of being pressed with a pressure suitable for coagulation treatment. That is, the living tissue is compressed between the heat generating plate 107 and the heat generating plate 108. At this time, a particularly strong pressure is applied between the protrusions 107c and 108c, but the flat portions 107d and 108c.
Since there is d, the tips of the protrusions 107c and 108c of the heat generating plate are not sharp enough to cut the living tissue and have a sharp shape, and the living tissue is not incised.

Next, from the power supply device 3 to the heating elements 105, 106.
When the heating elements 105 and 106 are heated by energizing them, the heating plates 107 and 108 generate heat by heat transfer, and the protruding portions 107c
And a protruding portion 108c are coagulated under a high pressure in a portion in contact with each other with a narrow width, moisture of the living tissue evaporates, and the fragile living tissue is cut and cut.

At this time, since the flat portions 107a and 107b and the flat portions 108a and 108b are gripped with a pressure lower than that of the protruding portions, only solidification is performed without separation. In addition, the living tissue portion grasped between the plane portions 107b and 108b, and the plane portion 107a and the plane portion 10
The range of the living tissue portion grasped between 8a and 8a is different,
A larger coagulation range can be obtained on the remaining tissue T2 side.

(Effects) According to the fifth embodiment, it is possible to separate at the same time as coagulation and to separate without bleeding. Also,
The living tissue is not cut in the non-fever state. Further, since a larger coagulation range can be obtained on the side of the remaining tissue at the time of cutting, a wide range of tissues on the remaining side can be joined, and a reliable hemostatic effect can be obtained. Tissues can be joined without causing stress like the automatic suturing device. Moreover, since a wide range can be joined with a small amount of stress, it is possible to separate even when the living tissue is weak.

(Sixth Embodiment) The sixth embodiment relates to a blood vessel anastomotic apparatus. FIG. 14 is a perspective view of the blood vessel anastomosing appliance of the present embodiment, and FIG. 15 is a sectional view showing a blood vessel anastomosing state by the blood vessel anastomosing appliance of the present embodiment.

The blood vessel anastomotic apparatus 120 of this embodiment comprises a pair of gripping devices 121 and 122. Gripping device 12
Reference numerals 1 and 122 have through-holes 123 and 124 in the center, and a substantially semi-disc shaped gripping portion 121 cut into two from the center.
a, 121b, 122a, 122b are formed. Parallel planes 125 and 126 are formed at two positions above and below the outer circumference of the grips 121a, 121b, 122a and 122b. Also, both grips 121a, 121b, 122a, 1
22b is openably and closably coupled by hinges 127 and 128, and is engaged by hooks 129 and 130.

Recesses 131 and 132 are formed around the grip portion through holes 123 and 124. Recesses 131, 13
Heat generating elements 133 and 134 are embedded in the inside of the unit 2 so as to fit into the recesses 131 and 132. Heating element 13
Heat generating plates 135 and 136 are thermally coupled to the surfaces of the plates 3 and 134. Support pins 137a to 137c, 138a to 138c for supporting the blood vessel V inserted through the through holes 123 and 124 and insertion holes 139a into which the support pins 137a to 137c and 138a to 138c are inserted on the surfaces of the heat generating plates 135 and 136. ˜139c, 140a˜140c are provided. Pins 137a to 137c, 138a to 13
8c and the heat generating plates 135, 136 are preferably formed of a metal having a high thermal conductivity such as copper, silver, or tungsten, but other metals such as stainless steel may be used. Also heating element 1
33 and 134 are, for example, molybdenum thin film resistance heating elements or the like that are small and have high heat generation efficiency.

The support pins 137a-137c, 138
a-138c and pin insertion holes 139a-139c, 140
When the flat surfaces 125 and 126 of the gripping devices 121 and 122 are held in a state of being superposed on each other, a to 140c are arranged at positions facing each other.

A cable 14 is attached to the gripping devices 121 and 122.
1, 142 are installed and electrically coupled to the heating elements 133 and 134 embedded in the grip portion. The other ends of the cables 141 and 142 are integrated into one and connected to the power supply device 3 as an energizing means.

(Operation) Next, the blood vessel V1 cut by the blood vessel anastomotic apparatus 120 of the present embodiment having the above-described structure,
The procedure for anastomosing V2 will be described.

First, the hooks 129 and 130 of both gripping devices 121 and 122 are engaged and held in the closed state. Then, the grasping device 12 holds the ends of the cut blood vessels V1 and V2.
1, 122 through the through holes 123 and 124,
As shown in the right side of FIG. 15, the mouth is widened and the support pins 137a to
137c and 138a to 138c are held by penetrating (left side in FIG. 15). Next, the mutual gripping devices 121,
The gripping device 121 and the gripping device 122 are coupled to each other so that the flat surfaces 125 and 126 face each other. At this time, the support pin 137 provided in the gripping device 121
a to 137c are insertion holes 14 provided in the gripping device 122.
0a to 140c, and the support pins 138a to 138c provided on the gripping device 122 have insertion holes 139a to 13c.
9c, which are directly opposed to each other, are naturally inserted into the corresponding pin insertion holes and coupled.

After that, the power source device 3 is used to heat the heating element 13.
Heats 3,134. Then, the heating elements 133 and 134
The heat generating plates 135, 136 coupled to
The blood vessel portion supported by both gripping devices 121, 122 is coagulated and welded, and the blood vessels are anastomosed.

After that, both gripping devices 121 and 122 are pulled out to release the connection, the hooks 129 and 130 are released to open the gripping devices 121 and 122, and the gripping devices 121 and 122 are removed from the blood vessel V.

(Effect) In the sixth embodiment, since the present blood vessel anastomotic apparatus does not need to be press-fitted, the blood vessel can be anastomosed without using a press-fitting jig or the like. Further, it is not necessary to indwell the foreign body in the living body.

(Appendix) 1. Clip means for occluding biological tissue, a grip portion having first and second contact surfaces for gripping the clip means, and the clip means by moving the first and second contact surfaces. A thermal treatment instrument comprising: a gripping portion driving means that is closed; a heating element that generates heat when energized to treat the living tissue; and an energizing means that energizes the heating element.

2. The heating element is provided in the clip means and heats a living tissue contacting surface of the clip means. The thermal treatment instrument described.

3. 1. The heating element heats a first contact portion that holds the clip means. The thermal treatment instrument described.

[0075]

According to the invention described in claim 1, it is possible to provide a thermal treatment instrument capable of performing reliable closure.

According to the second aspect of the present invention, it is possible to provide a thermal treatment instrument capable of suturing a fine portion or a tissue rich in elasticity at a desired position.

According to the third aspect of the present invention, it is possible to provide a thermal treatment tool which does not exert a strong stress on lung tissue.

According to the fourth aspect of the present invention, it is possible to provide a thermal treatment instrument capable of performing anastomosis even with a thin blood vessel without foreign matter remaining in the body after anastomosis.

[Brief description of drawings]

FIG. 1 is an overall configuration diagram of a clip applier system according to a first embodiment of the present invention.

FIG. 2 is a sectional view of a grip portion of the clip applier.

FIG. 3 is a diagram showing a configuration of a clip 30.

FIG. 4 is a view showing a state in which a clip 30 is held by jaws 8 and 9.

FIG. 5 is a diagram showing details of a grip portion 51 at the tip of a clip applier 50 according to the second embodiment of the present invention.

FIG. 6 is a diagram showing a configuration of a clip 60.

FIG. 7 is a diagram showing a state in which the clip 60 is pressed by the clip applier 50.

FIG. 8 is a diagram showing a configuration of a needle holder according to a fourth embodiment of the present invention.

9 is a diagram showing details of a grip portion of the needle holder shown in FIG.

FIG. 10 is a system configuration diagram in a fifth embodiment of the present invention.

FIG. 11 is a detailed view of the treatment section at the distal end of the treatment tool.

12 is a view showing a cross section of the treatment portion shown in FIG.

FIG. 13 is a diagram showing a state where a living tissue is grasped by the present treatment tool.

FIG. 14 is a perspective view of a blood vessel anastomosing appliance according to a sixth embodiment of the present invention.

FIG. 15 is a cross-sectional view showing an anastomotic state of blood vessels by the blood vessel anastomosing appliance of the sixth embodiment.

[Explanation of symbols]

1 Clip applier body 2 cables 3 power supply 4 foot switch 5 Scissors components 6 Scissors components 7 fulcrum pin 8 Joe 9 Joe 10 Clip holding hole 11 Clip holding hole 12 electrodes 13 electrodes 14 Finger insertion ring 15 Finger insertion ring 16 Hand control unit 17 Connector connection part 18 connectors 19 Setting operation section 20 Display 30 clips 31 Opening / closing center 32 ligature 33 ligature 34 Hook part 35 Engagement part 36 Engagement part 37 heating element 38 through hole 39 through hole 40 electrodes 41 electrodes 50 clip applier body 51 grip 52 Joe 53 Joe 55 Heating element 56 Heating plate 57 Clip holding hole 58 clip holding hole 60 clips 61 Opening / closing center 62 ligature 63 ligature 64 Hook part 65 Engagement part 66 Engagement part 70 needle holder 71 Scissors components 72 Scissors component 73 Support pin 74 Joe 75 Joe 76 ratchet 77 Ratchet 78 finger insertion ring 79 Finger insertion ring 80 Hand control unit 81 Anti-slip part 82 heating element 83 Heating plate 84 gripping surface 90 treatment tools 91 Hand control unit 92 Insert 93 grip 94 grip 95 Control unit body 96 fixed handle 97 axis 98 Movable handle 99 Rotation operation part 100 drive shaft 101 pin 102 Connector connection part 103 groove 104 groove 105 heating element 106 heating element 107 Heating plate 108 Heating plate 109 Anti-slip part 120 vascular anastomotic device 121 gripping device 122 gripping device 123 through hole 124 through hole 125 plane 126 plane 127 hinges 128 hinges 129 hook 130 hooks 131 recess 132 recess 133 heating element 134 heating element 135 Heating plate 136 heating plate 137 Support pin 138 Support pin 139 insertion hole 140 insertion holes 141 cable 142 cable

─────────────────────────────────────────────────── ─── Continuation of the front page (51) Int.Cl. ⁷ Identification code FI theme code (reference) A61B 17/38 (72) Inventor Shuichi Kimura 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optical Co., Ltd. In-house (72) Inventor Hidetoshi Saito 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optical Co., Ltd. (72) Inventor Yoshitaka Honda 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optical Co., Ltd. In-house (72) Inventor Toshiya Sugai 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optical Co., Ltd. (72) Inventor Kenichi Kimura 2-43-2 Hatagaya, Shibuya-ku, Tokyo Olympus Optical Co., Ltd. In-house (72) Inventor Toru Shinmura 2-43-2 Hatagaya, Shibuya-ku, Tokyo Inside Olympus Optical Co., Ltd. (72) Inventor Takeaki Nakamura 2-43-2, Hatagaya, Shibuya-ku, Tokyo F-term in Olympus Optical Co., Ltd. (reference) 4C060 BB01 BB05 DD03 DD05 DD16 DD26 GG02 GG05 GG06 KK47 KK50

Claims (4)

[Claims] 1. Clip means for closing biological tissue, a grip portion having first and second contact surfaces for gripping the clip means, and movable first and second contact surfaces. And a gripping portion driving means for closing the clip means, a heating element for generating heat by applying electricity to treat the living tissue, and an energizing means for energizing the heating element. Treatment tool. 2. A first and a second for gripping a suture needle
A gripping portion having a contact surface, a gripping portion driving means for moving the first and second contact surfaces to grip the suture needle, and generating heat when energized to generate the first contact surface. A heat treatment tool comprising: a heating element that heats the suture needle by heating the heating needle; and an energizing unit that energizes the heating element. 3. A grip portion having first and second contact surfaces for griping the biological tissue, and grip portion driving means for moving the first and second contact surfaces to grip the biological tissue. A heating element that generates heat when energized, and an energization unit that energizes the heating element. Protrusions are provided on the first and second contact surfaces, and when the heating element generates heat. A thermal treatment instrument that treats the living tissue through the protrusion. 4. A pair of plate-like bodies having a hole in the center thereof, which can be opened and closed, a protrusion provided on the surfaces of the pair of plate-like bodies, and a pair of plate-like bodies provided on the surfaces of the pair of plate-like bodies. A hole into which the protrusion is inserted when the plate-shaped bodies are stacked, and a heating element that heats the body tissue to generate heat when the protrusion is inserted into the hole to treat the living tissue. A thermal treatment instrument comprising: an energizing unit that energizes the heating element.