JP2004188012A - Medical instrument - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a medical instrument for obtaining stable coagulation and incision effects without being affected by the presence of fat in an operation field, physiologic saline, or a body fluid, etc., and also arbitrarily changing incision performance and coagulation performance by selecting the shape of a blade in a second grip part. <P>SOLUTION: The medical instrument 1 includes a treatment tool for treating organism tissue by heat. The instrument 1 comprises: a heat generating part having a heat surface for heating the organism tissue; and a holding member with heat insulation, where a storage part for storing the heat generating part with the heat surface externally exposed is formed, and which holds and fixes the heat surface so as to be on nearly the same surface as the outer front surface of the holding member or internally recessed; a blade member having a projected blade part; and an operating part which can be movably operated in a state where the blade part is abutted or not abutted on the heat surface. <P>COPYRIGHT: (C)2004,JPO&NCIPI

Description

[0001]
TECHNICAL FIELD OF THE INVENTION
The present invention relates to a medical instrument that heats a living tissue while holding the living tissue between a pair of jaws that can be opened and closed, and performs heat treatment such as coagulation of the living tissue and incision of a coagulated site.
[0002]
[Prior art]
2. Description of the Related Art In general, medical instruments are known which perform heating treatment such as coagulation of living tissue or incision of coagulated living tissue by causing a heating element to generate heat. This medical device includes a pair of grips (jaws) that open and close so as to grip a living tissue, and has a heating element on one or both of the grips. This medical device is usually used for various purposes such as hemostasis of blood vessels contained in a living tissue, cauterization of a lesion or bleeding part on the surface layer of the living tissue, coagulation, occlusion of a fallopian tube for contraception, and the like. It is used for various surgical cases. This medical instrument performs a heating treatment such as coagulation of a living tissue and incision of the coagulated living tissue.
[0003]
In addition, when performing various treatments such as hemostasis, cauterization, coagulation, occlusion, or incision of a living tissue, the target tissue and the surrounding tissue are mechanically evacuated and grasped in advance using a surgical instrument such as a peeling forceps. Then, various operations such as peeling and the like are performed, and a surgical operation for securing a visual field of the endoscope and a working area of the medical instrument is performed.
[0004]
For example, Japanese Patent Application Publication No. 2001-522622 (see Patent Document 1) discloses a bipolar (bipolar) electrosurgical instrument for sealing a blood vessel to stop bleeding. In this surgical instrument, a structure is disclosed in which a socket is provided on a jaw at the tip of the instrument, and an electrode plate is detachably attached to the socket. In this surgical instrument, a current is directly applied to a living tissue to obtain a coagulation effect.
[0005]
In the surgical instrument disclosed in Japanese Patent Application Laid-Open No. 2001-522622, the electrode plate or the conductive wire is easily removed from the jaw even during surgery, and is replaced with a new one, so that electrical insulation can be reliably maintained. For this reason, this surgical instrument is capable of generating an unexpected current path when the electrical insulation around the electrode plate and the conductive wire is broken, thereby damaging parts other than the living tissue to be treated. It has been prevented by replacement.
[0006]
Further, Japanese Patent Application Laid-Open No. 2001-198137 (see Patent Document 2) discloses a surgical instrument in which a heating element such as a ceramic heater is provided on at least one of a pair of relatively open / close grips.
[0007]
In this instrument, one of the grips is provided with a heating plate (treatment section) protruding in the shape of a blade that comes into contact with the living tissue. A heating element is provided, a heating element as a heat source is fixed to the heating plate, and heat generated by the heating element is transmitted to the heating plate. The heating plate is adapted to perform a heating treatment on the contacted or pressed living tissue.
[0008]
[Patent Document 1]
Japanese Unexamined Patent Publication No. 2001-522622 (pages 8 to 12, FIG. 1)
[0009]
[Patent Document 2]
JP 2001-198137 A (Page 3-8, FIG. 3)
[0010]
[Problems to be solved by the invention]
In the case of the surgical instrument disclosed in JP-T-2001-522622, a living tissue to be treated is sandwiched between electrode plates provided on a pair of jaws, and a high-frequency current or the like is directly passed through the tissue to remove the living tissue. Coagulation or incision is performed, and there is a problem that the resistance value may change due to contamination on the surface of each electrode and the treatment effect is not stable.
[0011]
In the surgical instrument disclosed in Japanese Patent Application Laid-Open No. 2001-198137, the entire blade portion is exposed. Therefore, when an attempt is made to treat a tissue covered with thick fat, a body fluid such as blood, or a tissue covered with saline, the entire blade portion is immersed in the body fluid or saline. For this reason, much of the heat of the heating plate escapes to the body fluid or physiological saline, and there is a risk that sufficient heat treatment cannot be performed.
[0012]
In addition, since the two surgical instruments have a fixed tissue incision ability and coagulation ability, the incision ability is given priority in order to increase the speed of the operation, and the safety of the operation (certainty of hemostasis) is increased. It is not possible to select or switch to give priority to coagulation ability.
[0013]
[Object of the invention]
The present invention has been made in view of the above circumstances, and an object of the present invention is to perform a safe treatment without flowing an electric current directly to a living tissue, and to remove a body fluid such as fat or blood in a surgical field. An object of the present invention is to provide a medical device capable of stably obtaining a treatment effect such as coagulation or incision without being affected by a state of physiological saline or the like.
[0014]
Another object of the present invention is to provide a medical instrument capable of arbitrarily changing incision performance and coagulation performance.
[0015]
[Means for Solving the Problems]
In order to solve the above problems and achieve the object, a medical instrument of the present invention is configured as follows.
[0016]
The medical device according to one embodiment of the present invention includes an operation unit that relatively opens and closes a pair of jaws, and includes a treatment tool that performs a heating treatment on the living tissue while the living tissue is held between the pair of jaws. Medical instruments
Heat is generated by energization, and a heating unit having a heating surface for heating the living tissue,
A housing portion for housing the heat generating portion with the heating surface exposed to the outside is formed, and a heat insulating property for holding and fixing the heating surface to the outer surface of the heating portion so as to be substantially the same or depressed inward. And a holding member of
A blade-shaped member having a convex blade portion,
With
The operating part is movably operable relative to the heating surface between a state in which the blade portion is in contact with the heating surface and a state in which the blade is not in contact with the heating surface.
[0017]
As shown in the above configuration, the holding member is heat insulating and holds and fixes the heating surface so that the heating surface is depressed inward with respect to the outer surface of the holding member. For this reason, the heat of the heat generating portion is concentrated on the heating surface, and the heat is not easily taken away by the surrounding body fluid during the treatment. Therefore, the medical device of this embodiment can obtain a stable coagulation and incision effect without being affected by the presence or absence of fat, physiological saline, body fluid, or the like in the surgical field.
[0018]
Further, the medical device of this aspect includes a blade-shaped member having a convex blade portion. Therefore, when the living tissue is sandwiched between the blade portion and the heating surface and closed, only the tip of the convex blade portion reaches the heating surface located inside and comes into contact therewith. Therefore, the blade-shaped member can easily lift the target tissue from fat, physiological saline, or body fluid, as compared to a case where the blade-shaped member does not have a convex blade portion. Therefore, the medical device of this aspect can directly transmit heat to the target tissue without the heated surface being immersed in the body fluid, and can obtain a stable coagulation and incision effect.
[0019]
In addition, a medical device according to another aspect of the present invention includes an operation unit that relatively opens and closes a pair of jaws, and performs a treatment of heating the living tissue while the living tissue is held between the pair of jaws. Medical instruments with tools
Heat is generated by energization, and a heating unit having a heating surface for heating the living tissue,
A housing portion for housing the heat generating portion with the heating surface exposed to the outside is formed, and a heat insulating property for holding and fixing the heating surface to the outer surface of the heating portion so as to be substantially the same or depressed inward. And a holding member of
A blade-shaped member having a convex blade portion,
With
The operating portion is movably operable relative to the heating surface in a state in which the blade portion is in contact with the heating surface and in a non-contact state,
The contact area between the heating surface and the blade can be changed.
[0020]
As shown in the above configuration, in the medical instrument of this aspect, the heat of the heating surface can be reliably transmitted to the target tissue by the heat-resistant holding member, and a stable coagulation or incision effect can be obtained.
[0021]
Further, since the contact area between the heating surface and the blade portion can be changed, the medical instrument of this embodiment can arbitrarily change the incision performance and the coagulation performance.
[0022]
BEST MODE FOR CARRYING OUT THE INVENTION
Hereinafter, embodiments of the present invention will be described with reference to the drawings.
[0023]
(First Embodiment)
First, a medical device according to the first embodiment will be described with reference to FIGS.
[0024]
(Structure) (Action)
FIG. 1 shows an entire system of a medical instrument according to the present embodiment. The medical instrument 1 controls a scissors-type treatment tool 2, a power supply device 3 for supplying power to the treatment tool 2, ON-OFF of the power supply device 3, adjustment of an output setting of the treatment tool 2, and the like. And a foot switch 12. The treatment tool 2 is connected to the power supply 3 by a cable 11, and the power switch 3 is connected to a foot switch 12.
[0025]
The treatment tool 2 has a pair of substantially linear operation arms (first operation arm 4 and second operation arm 5) that are operation units. The first and second operation arms 4 and 5 are connected via a common rotary shaft 6 at an intermediate portion, and can freely rotate about the rotary shaft 6.
[0026]
Further, a pair of grippers (a first gripper 7 and a second gripper 8) that can be opened and closed are provided on the distal ends of the first and second operation arms 4 and 5 with respect to the rotation shaft 6 respectively. ing. Specifically, a first grip 7 is provided on the distal end of the first operation arm 4, and a second grip 8 is provided on the distal end of the second operation arm 5.
[0027]
Also, on the hand side of the first and second operation arms 4 and 5, there are provided ring portions 9 and 10 for an operator to insert a finger and operate the treatment tool. By operating the ring portions 9 and 10 in the opening / closing direction, the first grip portion 7 and the second grip portion 8 open and close relatively.
[0028]
Hereinafter, the first grip 7 and the second grip 8 will be described in detail with reference to FIGS. 2 (a), 2 (b), and 3. FIG. FIG. 2A is a schematic cross-sectional view showing the first grip 7 and the second grip 8 of the treatment tool 2 in FIG. 1 along the opening / closing direction and the longitudinal direction of the treatment tool. FIG. 2B is a schematic cross-sectional view showing the first grip 7 in FIG. 1 along a direction orthogonal to the opening and closing direction of the treatment tool. FIG. 3 is a schematic cross-sectional view showing the treatment tool 2 in FIG. 1 along the opening / closing direction of the treatment tool and along a direction orthogonal to the longitudinal direction.
[0029]
As shown in FIG. 2A, on the outer sides of the first grip 7 and the second grip 8, peeling surfaces 7 b and 8 b having a shape that is smooth and gradually narrows toward the tip are formed. . As shown in FIG. 2B, the first grip 7 and the second grip 8 have curved portions 7a and 8a that are curved on a plane perpendicular to the surface that opens and closes.
[0030]
The treatment tool 2 performs a surgical operation in which the first and second peeling surfaces 7b and 8b come into contact with the operative site while the first grip 7 and the second grip 8 are closed. As a specific example of this surgical operation, the first and second peeling surfaces 7b and 8b are used to rub or insert living tissue to move or remove tissue, and to peel between tissues. And handling of cord-like tissue such as blood vessels and nerves with the tip. Since the first and second peeling surfaces 7b and 8b are gradually narrowed toward the distal end and are formed smoothly, the above-mentioned surgical operation can be performed safely and reliably.
[0031]
As shown in FIGS. 2A, 2B and 3, a heat insulating frame 13 having a substantially dome-shaped cross section is provided inside the first holding portion 7. The heat insulating frame 13 is made of a material that does not easily conduct heat, such as fluororesin, silicone rubber, and ceramics. The dome-shaped heat-insulating frame 13 constitutes an accommodating portion for accommodating a heat generating portion for heating the living tissue.
[0032]
The heat generating section includes a heat generating element 15 that generates heat when energized, and a heat transfer section 16 that receives heat of the heat generating element 15 and performs a heating treatment on a living tissue.
[0033]
As the heating element 15, a heat generating element such as a silicone semiconductor or a molybdenum thin film resistor, or a substance that converts electricity into heat, such as a nichrome wire, is used.
[0034]
The heat transfer section 16 is formed of a material that efficiently transfers heat, such as copper, a copper alloy, an aluminum alloy, tungsten, or molybdenum. In addition, the heat transfer section 16 has a lower surface 16a that is a heating surface for heating the living tissue. The lower surface 16a is disposed in the housing so as to be retracted inside (upward in FIGS. 2A and 3) from the lower surface 13a of the heat insulating frame 13 as shown in FIGS. Have been. In other words, in the opening / closing direction of the treatment tool 2, the lower surface 13a protrudes toward the second gripping portion from the lower surface 16a.
[0035]
The lower surface 7c of the first grip 7 is also set at a position where it is retracted upward in FIG. 3 from the lower surface 16a of the heat transfer unit 16. The lower surface 16a of the heat transfer section 16 is provided with a thin non-adhesive film such as a fluororesin in order to prevent adherence of living tissue and blood. Note that three heat generating elements 15 as heat generating elements are attached to the heat transfer section 16 of the present embodiment, and these heats are transmitted. The heating element 15 may be one, two, or four in accordance with the length and thickness of the first grip 7 and the second grip 8 and the total amount of heat required for the treatment. More than one.
[0036]
In the present embodiment, as shown in FIG. 2A and FIG. 2B, a plurality of lead wires for supplying electricity to each heating element 15 are provided for the heating element 15 which is a heating element. 18 are connected. Each of the lead wires 18 extends rearward (toward the ring portions 9 and 10 with respect to the distal end). Each of the lead wires 18 is bundled together near the rear end of the heat transfer section 16, further extended to the hand side, and connected to the above-described cable 11.
[0037]
On the other hand, as shown in FIG. 3, the second gripping section 8 has a blade 19 and a blade holding section 19a.
The blade 19 is a blade-shaped member, and is provided so as to face the lower surface 16a of the heat transfer section 16 as shown in FIG. The lower end of the blade 19 is fixed by a blade holding portion 19a. The blade 19 is formed so that the cross-sectional shape becomes thinner toward the heat transfer part (upward). More specifically, the blade 19 has a convex blade portion whose tip is narrowed in the direction toward the heat transfer portion 16 such that the tip is located at the center in the width direction of the second gripping portion 8. Have. The blade portion of the blade 19 has a narrow ridge line portion 20 at the tip.
[0038]
When the first grip 7 and the second grip 8 are closed, the ridge 20 abuts on the lower surface 16a of the heat transfer section over the entire length. The blade 19 is made of a soft material such as silicone rubber or fluorine resin, and strongly closes the first grip 7 and the second grip 8 even if the lower surface 16a of the heat transfer section and the ridge 20 are slightly inclined. Thus, the entire ridge line portion 20 can abut on the lower surface 16a.
[0039]
The blade holding portion 19a is a groove provided on the upper surface 8b which is a surface facing the first grip portion 7. The blade holding portion 19a extends along the entire length of the blade 19 along the longitudinal direction. Further, the blade holding portion 19a has a rigid rib 21 along its own longitudinal direction. The rib 21 is arranged in the groove at a substantially central portion in a direction orthogonal to the longitudinal direction of the blade holding portion. The ribs 21 extend into the blade 19 and prevent the blade from falling down in the lateral direction.
[0040]
(effect)
As shown in the above configuration, the heat transfer section 16 is housed in the heat insulating frame 13 and is formed so that only the lower surface 16a serving as a heating surface is exposed to the outside. At the same time, the lower surface 16a is located inside the lower surface 13a of the heat insulating frame 13. For this reason, in the heat transfer section 16, the heat of the heating element 15 is concentrated on the lower surface 16a, and the heat is less likely to be taken away by the surrounding body fluid during the treatment. Therefore, the medical device 1 of the present embodiment can obtain a stable coagulation and incision effect without being affected by the presence or absence of fat, physiological saline, body fluid, or the like in the surgical field.
[0041]
In addition, the second grip 8 of the present embodiment has a blade 19 provided with a convex blade. At the same time, when the tissue to be treated is sandwiched between the first gripper and the second gripper and closed, only the ridgeline portion 20 of the blade 19 reaches the lower surface 16a located inside and comes into contact therewith. . Therefore, only the portion to be processed can be brought into contact with the lower surface 16a, and the heat of the heat generating portion is not easily taken away, and the target portion can be more reliably heated. Since the blade 19 has a convex shape, the target tissue can be easily lifted from fat, physiological saline, or body fluid. Thus, when the target tissue is lifted, the lower surface is prevented from coming into contact with the body fluid or the like, and the heat of the lower surface 16a is directly transmitted to the target tissue, so that a stable coagulation or incision effect can be obtained.
[0042]
(Second embodiment)
A second embodiment will be described with reference to FIGS. 4, 5A and 5B. FIG. 4 is a cross-sectional view showing the first grip of the treatment tool according to the present embodiment. FIG. 5A is a cross-sectional view showing the treatment tool having the first grip in FIG. FIG. 5B is a cross-sectional view showing the treatment tool in FIG. 5A after blade replacement. In the medical device 1 of the present embodiment, the same components as those of the first embodiment are denoted by the same reference numerals, and the description thereof will be omitted.
[0043]
(Structure) (Action)
The first grip 27 is configured similarly to the first grip 7 of the first embodiment, but the configuration of the heat transfer section 30 is different from that of the heat transfer section 16 of the first embodiment. I have.
[0044]
Heat transfer unit 30 of the present embodiment has lower surface 30a. The lower surface 30a is positioned so as to be retracted inward (upward in FIG. 4) from the lower surface 13a of the heat insulating frame 13, as in the first embodiment. The lower surface 30a of the heat transfer unit according to the present embodiment has at least one narrow rib 31, at least two grooves 32 on both sides thereof, and a flat portion 36. The ribs 31 and the grooves 32 extend over the entire length of the heat transfer section 30 in the longitudinal axis direction.
[0045]
The rib 31 has substantially the same width as the ridge line portion 20 of the first embodiment, and is formed such that the tip is located substantially at the center of the first grip portion 27 in the width direction. The flat portion 36 extends on both sides of the groove 32 and is substantially flush with the rib 31.
[0046]
The second grip 33 of the present embodiment is configured in the same manner as the first embodiment, but is configured so that the blade can be replaced. Specifically, the second gripping part 33 of the present embodiment can replace the blade 19 held by the blade holding part 19a. FIG. 5A shows a blade holder 19a that holds the blade 19 according to the first embodiment. FIG. 5B shows the blade holding portion 19 a after the blade 19 has been replaced with a blade 34 having a ridge wider than the blade 19. The blade 34 has a rib 31 and a ridge 35 that is wider than the groove 32 on both sides thereof. That is, the ridge 35 extends in the width direction beyond the groove 32 to a position facing the plane 36.
[0047]
The width of the ridge portion 20 of the blade 19 and the width of the rib 31 substantially match. For this reason, in the treatment tool 2 in FIG. 5A, when the first grip portion 27 and the second grip portion 33 are closed, the ridge portion 20 abuts only on the rib 31. Therefore, the treatment tool 2 has the same effect as that of the first embodiment.
[0048]
The width of the ridge 35 of the blade 34 extends to the plane 36. For this reason, in the treatment tool 2 in FIG. 5B, when the first grip portion 27 and the second grip portion 33 are closed, the ridge portion 35 comes into contact with the rib 31 and the flat portion 36.
[0049]
(effect)
The treatment tool 2 of the present embodiment can be replaced with a blade. Thus, the treatment tool 2 of the present embodiment can change the contact area between the lower surface 30a and the blade by changing the width of the ridge of the blade to be replaced. Thereby, the treatment tool 2 can arbitrarily change the width of the heat treatment on the living tissue. Specifically, when the width of the ridge line portion of the blade of the second grip portion 33 is reduced, the target tissue is linearly (locally) gripped between the blade and the heat transfer surface and heat is applied. Is more easily cut. When the width of the ridge portion of the blade is increased, the tissue can be gripped in a planar manner (widely) between the blade and the heat transfer surface and heat can be applied, so that the tissue can be cauterized widely and uniformly.
[0050]
The heat transfer section 30 of the present embodiment has a rib 31 at the center in the width direction. Since the treatment tool 2 of the present embodiment can bring the living tissue into contact with only the ribs 31 in this way, it is possible to heat-treat only the target living tissue more reliably and locally.
[0051]
Further, in this embodiment, only the width of the blade is changed at the time of blade replacement, but it is also possible to change the length and height in the longitudinal direction, and the material (strength, thermal conductivity, etc.) Can also be changed. Further, the cross-sectional shape of the blade can be arbitrarily changed by the replacement. For example, the ridge 35 may be changed from a flat one as in the present embodiment to a curved one, or a blade having a sharp tip. With this change, the treatment tool 2 of the present embodiment can change the cutting ability and the heat treatment ability for the living tissue.
[0052]
In replacing the blade, only the blade may be exchangeably exchanged for the same second gripping portion 33, or the entire second gripping portion may be exchanged while the second gripping portion and the blade are integrated. It may be.
[0053]
(Third embodiment)
A third embodiment will be described with reference to FIGS. 6, 7A and 7B. FIG. 6 is a cross-sectional view showing a first grip of the treatment tool according to the present embodiment. FIG. 7A is a cross-sectional view showing the treatment tool having the first grip in FIG. FIG. 7B is a cross-sectional view showing the treatment tool in FIG. 7A after blade replacement. In the medical device 1 of the present embodiment, the same components as those of the first or second embodiment are denoted by the same reference numerals, and the description thereof will be omitted.
[0054]
(Structure) (Action)
The first grip 37 is configured similarly to the first grip 27 of the second embodiment, but the configuration of the heat transfer unit 40 is different from that of the heat transfer unit 30 of the second embodiment. I have.
[0055]
The heat transfer section 40 of the present embodiment has a lower surface 40a. The lower surface 40a is positioned so as to be retracted inward (upward in FIG. 6) from the lower surface 13a of the heat insulating frame 13, as in the second embodiment. The lower surface 40a of the heat transfer section according to the present embodiment has a plurality of ribs 41 similar to the ribs 31 according to the second embodiment and a plurality of grooves 42 having the same configuration as the groove 32. More specifically, the ribs 41 are uniformly arranged on both sides in the width direction at the same pitch from the center in the width direction of the heat transfer section 40, and the grooves 42 are formed adjacent to the respective ribs 41. The ribs 41 and the grooves 42 extend over the entire length of the heat transfer section 30 in the longitudinal direction of the heat transfer section 30.
[0056]
The second grip 43 of the present embodiment has the same configuration as the second grip 33 of the second embodiment. FIG. 7A shows a blade holder 19a that holds the blade 19 according to the first embodiment. FIG. 7B shows the blade holding portion 19a after the blade 19 has been replaced with a blade 44 having a wider ridge line than the blade 19. The blade 44 has a ridge 45 extending to a position facing the plane 36 in the width direction.
[0057]
As shown in FIG. 7A, when the blade 19 is mounted on the second gripping part 43, the first gripping part 37 and the second gripping part 43 are closed as in the second embodiment. At this time, the ridge portion 45 contacts only one central rib 41. Therefore, the treatment tool 2 has the same effect as that of the first embodiment.
[0058]
As shown in FIG. 7B, when the blade 44 is mounted on the second gripping portion 43, when the first gripping portion 37 and the second gripping portion 43 are closed, all the ribs 45 41 and the flat part 36.
[0059]
(effect)
In the treatment tool 2 of the present embodiment, since the blade can be replaced, the same effect as in the second embodiment can be obtained.
[0060]
Further, in the treatment tool 2 of the present embodiment, since the ribs 41 are evenly arranged over a wide range, when the width of the ridge of the blade is widened, the living tissue can be more uniformly heated. it can. In addition, when the width of the ribs and the pitch of the grooves on the heat transfer surface of the first gripping portion are narrowed, the treatment tool 2 is preferable because the heat treatment can be performed more uniformly.
[0061]
In addition, since the treatment tool 2 of the present embodiment has the plurality of ribs 41, the blade can be changed so that the rib 41 at an arbitrary position in the width direction comes into contact with the blade. Further, the blade may be configured such that the blade comes into contact with only an arbitrary number of ribs 41. Therefore, the treatment tool 2 of the present embodiment can arbitrarily set the heat treatment site by replacing the blade.
[0062]
(Fourth embodiment)
A fourth embodiment will be described with reference to FIGS. 8, 9A and 9B. FIG. 8 is a cross-sectional view showing the first grip of the treatment tool according to the present embodiment. FIG. 9A is a cross-sectional view showing the treatment tool having the first grip in FIG. FIG. 9B is a cross-sectional view showing the treatment tool in FIG. 9A after the replacement of the second grip. In the medical device 1 of the present embodiment, the same components as those of the first embodiment are denoted by the same reference numerals, and the description thereof will be omitted.
[0063]
(Structure) (Action)
The first grip 47 is configured similarly to the first grip 7 of the first embodiment, but the configuration of the heat transfer unit 50 is different from that of the heat transfer unit 16 of the first embodiment. I have.
[0064]
As shown in FIG. 8, the heat transfer unit 50 of the present embodiment has two shoulders 52 and a lower surface 50a. The shoulders 52 face the second grip 53, respectively, and are disposed at both ends in the width direction of the heat transfer unit 50. The shoulder 52 is positioned so as to be retracted inward (upward in FIG. 8) from the lower surface 13 a of the heat insulating frame 13.
[0065]
The lower surface 50a has a curved substantially concave shape in which the central portion is recessed more deeply than the shoulder portions 52 on both sides. Therefore, the lower surface 50a has an inclined surface formed by the concave portion. Since the lower surface 50a is concave, this inclined surface is referred to as a concave inclined surface in this specification. The lower surface 50a has a larger surface area than that of the first embodiment in which the lower surface 16a is flat due to the concave inclined surface.
[0066]
A relatively narrow rib 51 is provided at the center of the lower surface 50a. The tip of the rib 51 is formed lower than the shoulder 52 in the direction toward the second grip 53. Each of the shoulder 52 and the rib 51 extends along the entire length of the heat transfer section 50 in the longitudinal axis direction.
[0067]
The second grip of the present embodiment is formed integrally with the blade, and is replaceable with respect to the first grip 47. In the present embodiment, the treatment tool 2 is replaceable with a second grip 53a and a second grip 53b having different blades. Specifically, as shown in FIG. 9A, the second gripping portion 53a includes a blade 55a having a ridge portion 54a having a width substantially equal to the width of the rib 51. As shown in FIG. 9B, the second grip 53b includes a blade 55b having a ridge 54b wider than the ridge 54a in FIG. 9A.
[0068]
The blade 55b has an inclined surface inclined at substantially the same angle as the inclined surface on the lower surface. Since the blade 55b has a convex shape, the inclined surface thereof is referred to as a convex inclined surface in this specification. In the second grip 53b, the blade 55b is positioned so that its convex inclined surface is relatively meshed with the concave inclined surface of the first grip 47.
[0069]
In the treatment tool 2 in FIG. 9A, when the first grip 47 and the second grip 53a are closed, the ridge 54a abuts only on the rib 51. Therefore, the treatment tool 2 has the same effect as that of the first embodiment.
[0070]
In the treatment tool 2 shown in FIG. 9B, when the first grip 47 and the second grip 53b are closed, the ridge 54b simultaneously contacts the shoulders 52 on both sides. At this time, the concave inclined surface and the convex inclined surface come into contact with each other.
[0071]
The ridge 54a of the second grip 53a and the ridge 54b of the second grip 53b are covered with film portions 56a and 56b, which are elastic film members such as soft rubber, respectively.
[0072]
(effect)
Since the treatment tool 2 of the present embodiment has concave and convex inclined surfaces, the surface area is increased as compared with the case where the lower surface 50a and the blade 55b are flat. Therefore, when the width of the ridgeline portion of the blade is widened and these inclined surfaces are configured to abut, the lower surface 50a can abut the biological tissue to be processed over a wider range. Therefore, the treatment tool 2 of the present embodiment can uniformly cauterize a wider range of living tissue.
[0073]
In addition, since the surfaces of the ridges 54a and 54b are covered with elastic films 56a and 56b, when the first grip 47 and the second grip 53a are closed, the shape of the living tissue to be treated is reduced. Obey. Therefore, the ridge portions 54a and 54b abut uniformly on the region of the living tissue where treatment is to be performed. Therefore, the treatment tool 2 of the present embodiment enables more uniform heat treatment.
[0074]
So far, some embodiments have been specifically described with reference to the drawings. However, the present invention is not limited to the above-described embodiments, and all the embodiments may be performed without departing from the gist thereof. Including implementation.
[0075]
【The invention's effect】
INDUSTRIAL APPLICABILITY The medical device of the present invention can provide a stable coagulation or incision effect without being affected by the presence or absence of fat, physiological saline, or body fluid in the surgical field.
[0076]
In addition, the medical instrument of the present invention can arbitrarily change the incision performance and the coagulation performance by selecting the shape of the blade of the second grip.
[Brief description of the drawings]
FIG. 1 shows an entire system of a medical instrument according to a first embodiment.
FIG. 2A is a schematic cross-sectional view showing a first grip portion and a second grip portion of the treatment tool 2 in FIG. 1 along the opening / closing direction and the longitudinal direction of the treatment tool. . FIG. 2B is a schematic cross-sectional view showing a first grip portion in FIG. 1 along a direction orthogonal to the opening and closing direction of the treatment tool.
FIG. 3 is a schematic cross-sectional view showing the treatment tool in FIG. 1 along a direction perpendicular to a longitudinal direction and along a direction in which the treatment tool is opened and closed.
FIG. 4 is a cross-sectional view showing a first grip of a treatment tool according to a second embodiment.
FIG. 5A is a cross-sectional view showing a treatment tool having a first grip in FIG. FIG. 5B is a cross-sectional view showing the treatment tool in FIG. 5A after blade replacement.
FIG. 6 is a cross-sectional view showing a first grip of the treatment tool according to the third embodiment.
FIG. 7A is a cross-sectional view showing a treatment tool having a first grip in FIG. FIG. 7B is a cross-sectional view showing the treatment tool in FIG. 7A after blade replacement.
FIG. 8 is a cross-sectional view showing a first grip of a treatment tool according to a fourth embodiment.
9A is a cross-sectional view showing a treatment tool having a first grip in FIG. FIG. 9B is a cross-sectional view showing the treatment tool in FIG. 9A after the replacement of the second grip.
[Explanation of symbols]
1 medical instruments
2 treatment tools
3 power supply
4,5 Operation arm
7, 27, 37, 47 First gripper
8, 33, 43, 53, 53a, 53b Second gripper
13 Insulation frame
13a Lower surface of heat insulation frame
15 Heating element
16, 30, 40, 50 Heat transfer section
16a, 30a, 40a, 50a Lower surface of heat transfer section
19, 34, 44, 55a, 55b Blade
20, 35, 45, 54a, 54b Ridge part
21, 31, 41, 51, rib
32, 42 groove
56a, 56b film part

Claims (5)

A medical instrument including an operation unit that relatively opens and closes a pair of jaws, and a medical instrument including a treatment tool that performs a heating treatment on the living tissue while holding the living tissue between the pair of jaws;
Heat is generated by energization, and a heating unit having a heating surface for heating the living tissue,
A housing portion for housing the heat generating portion with the heating surface exposed to the outside is formed, and a heat insulating property for holding and fixing the heating surface to the outer surface of the heating portion so as to be substantially the same or depressed inward. And a holding member of
A blade-shaped member having a convex blade portion,
The medical device further comprising: the operating unit is movable relative to the heating surface in a state in which the blade unit is in contact with the heating surface and in a non-contact state. A medical instrument including an operation unit that relatively opens and closes a pair of jaws, and a medical instrument including a treatment tool that performs a heating treatment on the living tissue while holding the living tissue between the pair of jaws;
Heat is generated by energization, and a heating unit having a heating surface for heating the living tissue,
A housing portion for housing the heat generating portion with the heating surface exposed to the outside is formed, and a heat insulating property for holding and fixing the heating surface to the outer surface of the heating portion so as to be substantially the same or depressed inward. And a holding member of
A blade-shaped member having a convex blade portion,
With
The operating area is a contact area between the heating surface and the blade portion, which is movably operable relative to the heating surface in a state where the blade portion is in contact with the heating surface and in a non-contact state. A medical device characterized by being changeable. The medical instrument according to claim 2, wherein the protruding blade portions having different widths are replaceable. The medical instrument according to claim 1, wherein the blade has an elastic film-shaped member. In the width direction of the heat generating portion, a concave inclined surface is provided on one side or both sides of the heat generating portion,
A convex inclined surface is provided on one side or both sides of the blade member,
The medical instrument according to any one of claims 1 to 4, wherein the concave inclined surface and the convex inclined surface are positioned so as to relatively mesh with each other.

Images