JP2005261916A - Heating treatment instrument - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a heating treatment instrument with improved treatment efficiency by optimizing the distribution of temperature of a subject to be heated/treated. <P>SOLUTION: The heating treatment instrument 4 comprises a pair of jaws 24 and 26 to be opened/closed to each other. The jaws 24 and 26 have treatment faces 62 and 86 respectively, and a heating member 64 to generate heat is mounted at least one treatment face 62 of the pair of treatment faces 62 and 86. A heat transfer member 66 to transfer the heat of the heating member 64 in the cross direction of the jaw 24 is mounted near the heating member 64 and on the treatment face 62 side of the jaw 24. <P>COPYRIGHT: (C)2005,JPO&NCIPI

Description

  The present invention relates to an exothermic treatment instrument that heats a treatment object while holding the treatment object between a pair of openable and closable jaws, and performs heat treatment such as coagulation and incision on the treatment object.

  2. Description of the Related Art Conventionally, an exothermic treatment instrument is used that heats a treatment target while holding the treatment target (for example, a living tissue) between a pair of openable and closable jaws, and performs heat treatment such as coagulation or incision on the treatment target. As an example of such an exothermic treatment instrument, there are exothermic treatment instruments disclosed in Patent Documents 1 and 2. In each of the pair of jaws of these heat treatment devices, a treatment surface is formed on the side facing the treatment object to be grasped.

  On one side of the treatment surface of the heat treatment device of Patent Document 1, a plate-like heat generation plate formed of a single member is disposed. The heat generating plate extends in the longitudinal direction of the jaw and protrudes toward the other treatment surface. In addition, a heating element for heating the heating plate is disposed at the base end portion of the heating plate.

  When a heat treatment is performed with this heat treatment tool, the treatment target is held by the heat generating plate and the other treatment surface. Thereafter, the heating plate is heated by the heating element, and the treatment target is heated by the heated heating plate.

  On the other hand, in the exothermic treatment tool of Patent Document 2, a boot-like sleeve is fitted to the tip of each of the pair of jaws. That is, the tip of the jaw is covered with a sleeve, and a treatment surface is formed by this sleeve. The sleeve also has a layer that reflects and dissipates heat inside. A heater wire that generates heat when energized is disposed on the treatment surface of one jaw. This heater wire is extended in the longitudinal direction of the jaw.

When a heat treatment is performed with this heat treatment tool, a treatment target is grasped by a pair of treatment surfaces. Thereafter, the heater wire is energized to generate heat, and the grasped treatment target is heated. At this time, the sleeve prevents the heat of the heater wire from being dissipated to the jaw, and forms a seal zone that is heated to seal the treatment target. That is, a predetermined temperature distribution is formed in the width direction of the jaw to be treated by the heater wire and the sleeve.
Japanese Patent No. 3349139 Special table 2003-506190 gazette

  When performing heat treatment on a treatment target with the heat treatment tool of Patent Document 1, the temperature distribution in the width direction of the jaw to be treated is not necessarily optimal. For example, the treatment target protrudes in the contact area with the heat generating plate and is heated to a high temperature, while the peripheral portion of the contact area requires a long treatment time to form a good solidified state. Only heated to temperature. For this reason, the treatment efficiency of the exothermic treatment tool of Patent Document 1 is not good, and there is room for improvement in the treatment efficiency.

  Moreover, in the exothermic treatment tool of Patent Document 2, the sleeve covers the entire circumferential direction of the jaw. For this reason, when a heat treatment is performed on the treatment target, heat diffuses in addition to the portion functioning as the seal zone. Therefore, when the treatment target is heated with the exothermic treatment tool of Patent Document 2, the temperature distribution in the width direction of the jaw to be treated is not necessarily optimal, and the treatment efficiency of the exothermic treatment tool of Patent Document 2 Is not good.

  The present invention has been made paying attention to the above problems, and an object of the present invention is to provide an exothermic treatment instrument that realizes high treatment efficiency by optimizing the temperature distribution of the treatment target to be heated. It is.

  The invention of claim 1 includes a pair of jaws that open and close each other, a pair of treatment surfaces provided on each of the pair of jaws, and a heat generating member that is provided on at least one of the pair of treatment surfaces and generates heat. A heat treatment device comprising: a heat transfer member provided near the heat generation member and on the treatment surface side of the jaw, and transfers heat of the heat generation member in a width direction of the jaw.

  In the first aspect of the present invention, the treatment target is gripped by the pair of jaws, the heat generating member is heated, the heat of the heat generating member is transferred in the width direction of the jaw by the heat transfer member, and the heat transfer member is heated. The heat treatment is performed on the treatment target by setting the temperature distribution in the width direction of the jaw to be treated as the optimum temperature distribution by the heat generating member and the heat transfer member.

  According to a second aspect of the present invention, the heat generating member generates heat when energized, the heat transfer member is energized and is electrically connected to the heat generating member, and an energization circuit is formed by the heat generating member and the heat transfer member. The heat treatment device according to claim 1, wherein the heat treatment device is formed.

  And in invention of Claim 2, it supplies with electricity to the electricity supply circuit formed with the heat generating member and the heat-transfer member, and heat-generates a heat generating member.

  According to a third aspect of the present invention, at least one of the pair of jaws includes a temperature measuring member, and the temperature measuring member includes an electric resistor having a temperature coefficient larger than a temperature coefficient of the heat generating member, 2. The heat treatment device according to claim 1, wherein the temperature is measured based on the electric resistance value.

  In the invention of claim 3, when performing the heat treatment on the treatment target, the temperature is measured from the electric resistance value of the temperature measuring member, and the heat generation of the heat generating member is controlled based on the measured temperature.

  The invention according to claim 4 is the heat treatment tool according to claim 3, wherein the temperature measuring member is disposed in the vicinity of the heat generating member.

  In the invention of claim 4, the temperature in the vicinity of the heat generating member is measured by the temperature measuring member.

  The invention according to claim 5 is the heat treatment tool according to claim 4, wherein the temperature measuring member has a metal film formed on the heat transfer member.

  And in invention of this Claim 5, the metal film is formed in the heat-transfer member, and it is set as the temperature measurement member.

  According to the present invention, high treatment efficiency is realized by optimizing the temperature distribution of the treatment target to be heated.

  Hereinafter, a first embodiment of the present invention will be described with reference to FIGS. FIG. 1 shows an overall schematic configuration of an exothermic treatment device system 2 of the present embodiment. The exothermic treatment instrument system 2 includes an exothermic treatment instrument 4 that performs a heating treatment on a treatment target in a state where a treatment target (for example, a living tissue) is held. This exothermic treatment tool 4 has a forceps unit 6 for gripping a treatment target. The exothermic treatment instrument 4 includes a treatment unit 8 for performing a heat treatment on the treatment target. The treatment unit 8 is detachably attached to the forceps unit 6.

  One end of the cable 10 is detachably connected to the rear end of the treatment unit 8. The other end of the cable 10 is connected to a power source 12 for supplying power to the heat treatment device 4. A foot switch 14 for controlling the power source 12 is connected to the power source 12.

  As shown in FIG. 2A, the forceps unit 6 has first and second elongated main bodies 16 and 18 made of metal. The first main body 16 and the second main body 18 are pivoted to each other via a pivot shaft 22 at the intersection 20. First and second jaws 24 and 26 for gripping a treatment target are disposed at the distal ends of the first and second main bodies 16 and 18, respectively. Moreover, the 1st and 2nd finger hooks 28 and 30 which a user operates with a finger are arrange | positioned at the base end part of the 1st and 2nd main bodies 16 and 18. FIG. Here, the first jaw 24 and the second jaw 26 are opened and closed by opening and closing the first finger hook 28 and the second finger hook 30 about the pivot shaft 22. . Furthermore, the first jaw 24 is formed with an engagement groove 32 into which the distal end portion of the treatment unit 8 is inserted. Further, the first main body 16 is provided with a connector receiver 34 that receives the proximal end portion of the treatment unit 8 (see FIG. 1) in the vicinity of the first finger hook 28.

  As shown in FIG. 2B, a treatment unit 36 that performs a heating treatment on the treatment target is disposed at the distal end of the treatment unit 8. The treatment portion 36 is fitted and held in the engagement groove 32 (see FIG. 2A). The treatment section 36 has a shape that is gently curved with respect to the longitudinal direction of the treatment unit 8 (see FIG. 2C). An elongated connecting portion 38 extends from the rear end portion of the treatment portion 36. The rear end portion of the connection portion 38 is coupled to the main body portion 40.

  The main body portion 40 is provided with a claw portion 42 that is engaged with the crossing portion 20 by sandwiching the crossing portion 20 (see FIG. 2A) of the first main body 16 of the forceps unit 6 from both sides. Yes. In addition, the body portion 40 is formed with a dent 44 into which the distal end portion of the pivot shaft 22 (see FIG. 2A) is inserted when the body portion 40 is attached to the intersecting portion 20 (see FIG. 2A). Yes. A flexible elongated arm portion 46 extends from the rear end portion of the main body portion 40. The rear end portion of the arm portion 46 is connected to the connector portion 48. One end portion of the cable 10 (see FIG. 1) is detachably attached to the connector portion 48.

  The attachment of the treatment unit 8 to the forceps unit 6 will be described with reference to FIG. As shown in FIG. 3A, when the treatment unit 8 is attached to the forceps unit 6, the treatment unit 8 is arranged in parallel with the first main body 16 of the forceps unit 6. Further, as shown in FIG. 3B, the treatment portion 36 of the treatment unit 8 is fitted and held in the engagement groove 32 of the first jaw 24 of the forceps unit 6. And the nail | claw part 42 of the main-body part 40 of the treatment unit 8 is engaged with the cross | intersection part 20, pinching the cross | intersection part 20 of the 1st main body 16 of the forceps unit 6 from both sides. Although not shown in FIG. 3B, the tip end portion of the pivot shaft 22 is fitted in the recess 44 of the main body portion 40. In this way, the main body 40 is attached to the intersection 20. Further, the connector portion 48 of the treatment unit 8 is attached to the connector receiver 34.

  The detailed configuration of the first and second jaws 24 and 26 and the treatment section 36 will be described with reference to FIG. As shown in FIG. 4A, the first jaw 24 has a jaw body 50. The jaw body 50 is made of metal, such as stainless steel or titanium, from the viewpoint of strength. Further, a heat insulating cover 52 is externally provided on the outer peripheral surface of the jaw main body 50 for heat insulation in the rear direction. The heat insulating cover 52 is made of a material having low heat conductivity and good heat resistance, for example, a fluororesin such as Teflon (tetrafluoroethylene), a resin such as polyimide, PEEK (polyetheretherketone).

  As shown in FIGS. 4C to 4E, the jaw body 50 and the heat insulating cover 52 have a semi-cylindrical shape whose central axis extends in the longitudinal direction of the first jaw 24. A gap 54 is formed between the jaw body 50 and the heat insulating cover 52 so as to block heat conduction from the jaw body 50 to the heat insulating cover 52. The gap 54 is filled with a filler such as silicon.

  Referring to FIG. 4B again, the treatment portion 36 of the treatment unit 8 has a treatment portion main body 56. The treatment portion main body 56 is preferably formed of a material having a low thermal conductivity, for example, a material similar to the material exemplified for the heat insulating cover 52. A convex portion 60 is formed at the distal end portion of the treatment portion main body 56, and the convex portion 60 is engaged with a concave portion 58 formed at the distal end portion of the engaging groove 32.

  On the other hand, a receiving portion 84 is covered on the side of the second jaw 26 facing the first jaw 24. The receiving portion 84 extends in the longitudinal direction of the second jaw 26. The receiving portion 84 is preferably formed of a flexible material, for example, rubber such as silicon rubber, or Teflon (tetrafluoroethylene).

  Here, as shown in FIGS. 4C and 4D, the first and second jaws 24 and 26 are gripped on the side of the treatment portion main body 56 facing the second jaw 26. A first treatment surface 62 that faces the treatment target is formed. Further, a second treatment surface 86 is formed on the side of the second jaw 26 facing the first jaw 24.

  Referring to FIG. 4B again, a heating wire (heating member) 64 that generates heat is extended on the first treatment surface 62 along the longitudinal direction of the treatment portion main body 56. The heating wire 64 is made of a material that generates Joule heat when energized, for example, nichrome or iron chrome.

  A support plate (heat transfer member) 66 that transfers the heat of the heating wire 64 is extended between the treatment portion main body 56 and the heating wire 64 along the longitudinal direction of the treatment portion main body 56. The support plate 66 is preferably formed of a material having high thermal conductivity and good electrical insulation, for example, ceramics such as aluminum nitride. Instead, the support plate 66 may be formed by applying an insulating coating to a metal surface having a high thermal conductivity. Here, for example, copper, a copper alloy, aluminum, or an aluminum alloy is used as the metal, and as the insulating coating, for example, a resin coating such as Teflon (tetrafluoroethylene) or a ceramic (spraying) such as alumina is used. Moreover, it is preferable that the insulating coating has non-adhesiveness.

  Hereinafter, detailed configurations of the heating wire 64 and the support plate 66 will be described. As shown in FIG. 4B, the heating wire 64 is folded back at the distal end portion of the support plate 66 and disposed between the treatment portion main body 56 and the support plate 66. Hereinafter, the portion where the heating wire 64 is folded is referred to as a folded portion 68. The folding portion 68 restricts the positional deviation of the heat treatment wire 64 in the longitudinal direction of the treatment portion main body 56 with respect to the support plate 66.

  One end portion of the folded heating wire 64 is connected to the distal end portion of the first heat insulating plate 70 disposed on the distal end side of the support plate 66 between the treatment portion main body 56 and the support plate 66. A first conducting wire 72 extends from the rear end portion of the first heat insulating plate 70. Here, the first heat insulating plate 70 prevents the first conducting wire 72 from being damaged by the heat generated by the heating wire 64, and is formed of a metal having high electrical conductivity and low thermal conductivity, such as stainless steel. Has been. Further, the first conductive wire 72 is covered with insulation for electrical insulation. The first conducting wire 72 extends between the treatment portion main body 56 and the support plate 66 toward the rear end side in the longitudinal direction of the treatment portion main body 56.

  On the other hand, the heating wire 64 extends from the front end side to the rear end side of the support plate 66 in the longitudinal direction of the treatment portion main body 56 along the lower surface of the support plate 66. The heating wire 64 extends beyond the rear end portion of the support plate 66 and is accommodated in a lead receiving portion 74 disposed at the rear end portion of the treatment portion main body 56. The rear end portion of the heating wire 64 is disposed on the lower surface in the conductor receiving portion 74. A rear end portion of the heating wire 64 is connected to a front end portion of the second heat insulating plate 76 disposed on the lower surface in the conductor receiving portion 74. The second heat insulating plate 76 is the same as the first heat insulating plate 70. A second conducting wire 78 extends from the upper surface of the second heat insulating plate 76. The second conductive wire 78 is covered with an insulation for electrical insulation.

  Here, a gap 80 is disposed between the rear end portion of the support plate 66 and the conducting wire receiving portion 74, and the lower surface of the supporting plate 66 and the lower surface in the conducting wire receiving portion 74 are substantially in the same plane. For this reason, the heating wire 64 is bent at the rear end portion of the support plate 66 and the front end portion of the conductive wire receiving portion 74. Hereinafter, the bent portion of the heating wire 64 is referred to as a bent portion 82. The bending portion 82 restricts the positional deviation of the heat treatment wire 64 in the longitudinal direction of the treatment portion main body 56 with respect to the support plate 66.

  As shown in FIG. 4C, the support plate 66 has a trapezoidal cross section perpendicular to the longitudinal direction of the treatment portion main body 56, and the upper bottom surface faces the second jaw 26. Yes. Further, the support plate 66 is fixed to a first groove portion 88 that extends in the longitudinal direction of the treatment portion main body 56 in the treatment portion main body 56.

  In the vicinity of the distal end portion of the treatment plate main body 56 in the longitudinal direction of the support plate 66, the heating wire 64 is disposed in the center portion in the width direction of the upper and lower surfaces of the support plate 66. Further, the first heat insulating plate 70 is fitted and fixed in the second groove portion 90 extending in the longitudinal direction of the treatment portion main body 56 in the first groove portion 88. That is, the first heat insulating plate 70 is fixed in the width direction of the treatment portion main body 56 with respect to the support plate 66. For this reason, the heating wire 64 is displaced in the width direction of the treatment portion main body 56 with respect to the support plate 66. Is regulated.

  As shown in FIG. 4 (D), the heating wire 64 is disposed at the center of the lower surface of the support plate 66 near the middle portion of the support plate 66 in the longitudinal direction of the treatment portion body 56, and the first conductor 72 is The support plate 66 is disposed at the center of the upper surface. The first conducting wire 72 is fitted and fixed in a third groove 92 extending in the longitudinal direction of the treatment portion main body 56.

  As shown in FIG. 4E, a fourth groove portion 94 extends in the longitudinal direction of the treatment portion main body 56 in the treatment portion main body 56 at the rear of the support plate 66 in the longitudinal direction of the treatment portion main body 56. . The fourth groove portion 94 has a reverse concave shape in a cross section perpendicular to the longitudinal direction of the treatment portion main body 56. The lead wire receiving portion 74 has a concave cross section perpendicular to the longitudinal direction of the treatment portion main body 56, and is fitted and fixed in the fourth groove portion 94.

  A second heat insulating plate 76 is fitted and fixed to the lower surface side of the concave portion of the conducting wire receiving portion 74. That is, the second heat insulating plate 76 is fixed in the width direction of the treatment portion main body 56 with respect to the support plate 66. For this reason, the displacement of the heat generating wire 64 in the width direction of the treatment portion main body 56 with respect to the support plate 66. Is regulated. Further, the first and second conductive wires 72 and 78 are inserted into the concave portion of the conductive wire receiving portion 74. These first and second conducting wires 72 and 78 are extended to the rear end side in the longitudinal direction of the treatment unit 8 in the treatment unit 8 and are electrically connected to the connector portion 48 (see FIG. 2). Yes.

  Next, the operation of the heat treatment tool 4 of the present embodiment having the above configuration will be described. When performing heat treatment on the treatment target, the treatment unit 8 is first attached to the forceps unit 6. Then, the treatment unit 8 and the power source 12 are connected by the cable 10. Thereafter, the heat treatment instrument 4 is brought close to the treatment target, the first and second finger hooks 28 and 30 are closed, and the first and second jaws 24 and 26 are closed, as shown in FIG. The object to be treated is held between the first and second jaws 24 and 26. Here, the treatment target is pressed by the heating wire 64 and the support plate 66.

  Subsequently, the foot switch 14 is operated to output the power supply 12. As a result, the current flows in the order of the power source 12, the cable 10, the connector portion 48, the first conducting wire 72, the heating wire 64, the second conducting wire 78, the connector portion 48, the cable 10, and the power source 12. Here, the heating wire 64 is energized to generate heat. Heat generated by the heating wire 64 is transferred to the support plate 66. Then, heat is applied to the treatment target held by the first and second jaws 24 and 26 from the heating wire 64 and the support plate 66.

  At this time, the pressure distribution and temperature distribution of the treatment target in the width direction of the first jaws 24 and 26 are as shown in FIG. That is, the pressure and temperature are substantially constant in the region to be treated (coagulation region) in the vicinity of the support plate 66, and both the pressure and temperature are higher in the region to be treated (incision region) near the heating wire 64 than in the coagulation region. It has become. Here, the change in temperature between the incision zone and the coagulation zone is gentle. For comparison, FIG. 5C shows a temperature distribution of a treatment target when the support plate 66 is not provided.

  As a result of such temperature distribution, in the incision area, the treatment target is heated together with the pressure and becomes high temperature, and the treatment target is cut off by being dried (incision action). On the other hand, in the coagulation zone, the treatment target is heated together with pressing, and drying is promoted. However, since the temperature and pressure in the coagulation area are lower than the temperature and pressure in the incision area, the treatment target is not disconnected (coagulation action). In this way, the coagulation treatment and the incision treatment are performed on the treatment target.

  Therefore, the above configuration has the following effects. Since the heat generated in the heating wire 64 is transferred to the support plate 66, when performing the heating treatment on the treatment object held by the first and second jaws 24 and 26, The temperature difference from the solidification zone in the vicinity of the support plate 66 is small. In other words, the temperature distribution of the treatment target in the width direction of the first jaws 24 and 26 is optimal, and heat shortage is less likely to occur in the solidification zone. As a result, the heat treatment can be performed in a short time, and the treatment efficiency is improved.

  In addition, almost all of the heat generated by the heating wire 64 is recovered by the support plate 66. The support plate 66 is fixed to the first treatment surface 62 of the heat-insulating treatment portion main body 56, and the heat-insulating heat-insulating cover 52 is externally mounted on the jaw body 50 to which the treatment portion main body 56 is fitted and fixed. A gap 54 for heat insulation is formed between the main body 50 and the heat insulation cover 52. For this reason, useless heat radiation from the support plate 66 to the treatment portion main body 56, the jaw main body 50, and the heat insulating cover 52 is prevented to the maximum extent. Therefore, heat is locally concentrated on the heating wire 64 and the support plate 66, and an efficient heating treatment is possible.

  6 and 7 show a second embodiment of the present invention. The same components as those in the first embodiment are denoted by the same reference numerals and description thereof is omitted. In the exothermic treatment instrument 4 of the present embodiment, a temperature measuring member 260 for measuring temperature is provided on the support plate 66 of the exothermic treatment instrument 4 of the first embodiment. FIG. 6 is a diagram showing the first treatment surface 62 side of the first jaw 24 of the heat treatment tool 4 of the present embodiment. The support plate 66 of this embodiment is formed of a material having electrical insulation. A heating wire 64 extends in the longitudinal direction of the first jaw 24 at approximately the center of the support plate 66.

  On the first treatment surface 62 side of the support plate 66, as shown in FIG. 7A, a first electrical resistor 260a is disposed. The first electric resistor 260a is a metal thin film formed on the support plate 66 by PVD (Physical Vapor Deposition), CVD (Chemical Vapor Deposition), or the like. Instead, the first electric resistor 260a may be a thick metal film formed by a printing method or the like. The first electric resistor 260a is made of a material having a large amount of change in electric resistance value (hereinafter referred to as a temperature coefficient) with respect to the amount of change in temperature, for example, platinum, molybdenum, nickel, or copper. The first electric resistor 260a is extended in the longitudinal direction of the support plate 66 at substantially the center of the support plate 66 so as to be in contact with the heating wire 64 (see FIG. 6). An insulating layer (not shown) is disposed between the first electric resistor 260 a and the heating wire 64. This insulating layer is formed by resin coating such as Teflon or by spraying alumina or the like. In this embodiment, the width W of the first electric resistor 260a is substantially the same as the width of the heating wire 64 (see FIG. 6), but can be appropriately selected according to the range in which the temperature is to be measured. The distal end portion of the first electrical resistor 260 a is connected to a through hole 262 formed at the distal end portion of the support plate 66.

  On the other hand, as shown in FIG. 7B, a second electrical resistor 260b is disposed on the treatment section main body 56 (see FIG. 4) side of the support plate 66. The second electric resistor 260b is formed of a material having a small temperature coefficient that does not affect temperature measurement, for example, an alloy such as stainless steel. Further, the second electric resistor 260 b extends in the longitudinal direction of the support plate 66, and the tip thereof is connected to the through hole 262.

  As shown in FIG. 7C, the front ends of the first electric resistor 260a and the second electric resistor 260b are electrically connected to each other through the through hole 262. Also, third and fourth conducting wires 264 and 266 are connected to the rear ends of the first electric resistor 260a and the second electric resistor 260b, respectively. That is, a temperature measuring member 260 for measuring temperature is formed by the first and second electric resistors 260a and 260b, and the third conductor 264, the first and second electric resistors 260a and 260b, In addition, a measurement circuit is formed by the fourth conductor 266.

  The third and fourth conducting wires 264 and 266 are connected to the connector in the longitudinal direction of the treatment unit 8 in the treatment unit 8 with reference to FIGS. 1, 2, 6 and 7. The part 48 is electrically connected. The third and fourth conductors 264 and 266 are electrically connected to the power supply 12 via the cable 10. The power source 12 measures the electrical resistance value of the temperature measuring member 260 and measures the temperature according to the correspondence relationship between the electrical resistance value recorded in advance and the temperature. The power source 12 controls the voltage applied to the heating wire 64 so that the measured temperature matches the desired temperature. This desired temperature may be set in advance or may be input to the power supply 12 from the outside. Further, the power supply 12 forcibly stops the output to the heating wire 64 when the temperature exceeds a predetermined limit temperature.

  In the present embodiment, the support plate 66 is formed of a material having electrical insulation, but may be formed of a conductive material such as metal. In this case, as shown in FIG. 7D, it is necessary to form an insulating layer 268 between the first and second electric resistors 260a and 260b and the support plate 66. The insulating layer 268 is made of, for example, SiN or glass.

  Next, the operation of the heat treatment tool 4 of the present embodiment having the above configuration will be described. When performing a heating treatment on the treatment target, the heat treatment tool 4 is operated in the same manner as in the first embodiment. At this time, the electric resistance value of the first electric resistor 260a changes sharply according to the temperature of the first electric resistor 260a. The power source 12 measures the temperature by measuring the electrical resistance value of the temperature measuring member 260, and controls the voltage applied to the heating wire 64 so that the measured temperature matches the desired temperature. In the present embodiment, since the first electric resistor 260a is disposed on the support plate 66 so as to be in contact with the heating wire 64 with substantially the same width as the heating wire 64, the temperature in the vicinity of the heating wire 64 is measured. That is, since the temperature of the incision area shown in FIG. 5B is measured, the desired incision temperature is used as the desired temperature. Further, when the measured temperature exceeds a predetermined limit temperature, the power supply 12 forcibly stops the output to the heating wire 64.

  Therefore, the above configuration has the following effects. Conventionally, the electric resistance value of the heating wire 64 is measured to measure the temperature, and the voltage applied to the heating wire 64 is controlled so that the measured temperature matches the desired temperature. However, since the nichrome wire generally used as the heating wire 64 has a very small temperature coefficient and it is difficult to accurately measure the temperature from the resistance value, it is difficult to appropriately control the temperature. . In addition, since the measurement temperature is inaccurate, even if the heating wire is excessively heated, it may not be detected, causing a problem in the durability of the heat treatment device. On the other hand, when a platinum wire or the like having a large temperature coefficient is used as the heating wire, accurate temperature control is possible to some extent, but it is necessary to pass a large current through the heating wire to obtain a sufficient amount of heat for the heating treatment. It is necessary to thicken the power supply lead. For this reason, it is almost impossible to employ in practice.

  In the present embodiment, the temperature measuring member 260 having the first electric resistor 260 a having a large temperature coefficient is disposed on the first jaw 24, and the temperature is measured based on the electric resistance value of the temperature measuring member 260. . Therefore, accurate temperature measurement is possible, and accurate temperature control based on accurate temperature measurement is possible. Therefore, the treatment efficiency is improved. Further, based on accurate temperature measurement, when the measured temperature exceeds a predetermined limit temperature, the output to the heating wire 64 is forcibly stopped. For this reason, excessive heat generation of the heating wire 64 is prevented, and the durability of the heat treatment tool 4 is improved.

  Further, the first electric resistor 260 a is disposed on the support plate 66 so as to be in contact with the heating wire 64 with substantially the same width as the heating wire 64. For this reason, it is possible to accurately measure and control the temperature near the heating wire 64. That is, it is possible to accurately measure and control the temperature of the incision area, and it is possible to accurately control the temperature of the coagulation area through control of the temperature of the incision area. For this reason, the treatment efficiency is further improved.

  FIG. 8 shows a third embodiment of the present invention. The same components as those in the first embodiment are denoted by the same reference numerals and description thereof is omitted. The support plate 98 of the heat treatment tool 96 of this embodiment is formed of a metal having high electrical conductivity and high thermal conductivity, for example, copper, copper alloy, aluminum, or aluminum alloy. An insulating coating is applied to the lower surface and the front end surface of the support plate 98. The material for this insulating coating is the same as the material exemplified in the first embodiment.

  Further, the folded portion of the heating wire 64 is connected to the upper surface of the support plate 98 by brazing, for example. The first conductive wire 72 is electrically connected to the upper surface of the rear end portion of the support plate 98. That is, the first conducting wire 72, the support plate 98, the heating wire 64, and the second conducting wire 78 form an energization circuit. For this reason, the heat treatment tool 96 does not have the first heat insulating plate 70 and the third groove 92.

  A plurality of pins 100 project from the upper surface of the support plate 98. The support plate 98 and the pin 100 are joined by brazing. These pins 100 are fitted into the fixing holes 101 formed in the treatment portion main body 56, and are fixed to the fixing holes 101 by adhesion, caulking, or the like.

  Next, the operation of the heat treatment tool 96 of the present embodiment having the above configuration will be described. When the power switch 12 is output by operating the foot switch 14, the current is supplied from the power supply 12, the cable 10, the connector 48, the first conductor 72, the support plate 98, the heating wire 64, the second conductor 78, The connector portion 48, the cable 10 and the power source 12 flow in this order.

  Therefore, the above configuration has the following effects. An energization circuit is formed by the first conducting wire 72, the support plate 98, the heating wire 64, and the second conducting wire 78. Since the support plate 98 is a part of the energization circuit, a conducting wire extending from the front end portion to the rear end portion along the upper surface of the support plate 98 is not necessary. For this reason, the structure of the heat treatment tool 96 can be simplified and downsized.

  Further, one end of the heating wire 64 is directly connected to the tip of the upper surface of the support plate 98. For this reason, it is possible to transfer and recover the heat generated by the heating wire 64, which is originally waste heat due to heat radiation, to the support plate 98. Therefore, the heat generated by the heating wire 64, which is originally waste heat, can be used for the heat generation of the support plate 98, and the treatment can be performed efficiently.

  In the present embodiment as well, temperature control can be performed using the temperature measuring member 260 as in the second embodiment. Since the support plate 98 of the present embodiment is formed of a material having high electrical conductivity, the first and second electric resistors 260a and 260b, the support plate 66, and the like, as shown in FIG. It is necessary to form an insulating layer 268 between them.

  FIG. 9 shows a fourth embodiment of the present invention. The same components as those in the first embodiment are denoted by the same reference numerals and description thereof is omitted. The exothermic treatment instrument 102 of the present embodiment is not provided with the exothermic wire 64, the first conducting wire 72, the second conducting wire 78, and the like. Instead, as illustrated in FIG. 9A, the treatment blade 104 is disposed on the first treatment surface 62 of the treatment portion main body 56. The treatment blade 104 is preferably made of a material having high thermal conductivity, such as copper, copper alloy, aluminum, aluminum alloy, tungsten, or the like. The treatment blade 104 is extended in the longitudinal direction of the first jaw 24 and protrudes toward the second jaw 26.

  As shown in FIG. 9B, a plurality of concave portions 106 are extended on the upper surface of the treatment blade 104 in the longitudinal direction of the treatment blade 104. A heating element 108 is disposed in the recess 106. The heating element 108 is, for example, a heating element having a thin or thick resistor on the surface. In addition, a conducting wire 110 for energizing the heating element 108 is connected to the rear end portion of the heating element 108. These conducting wires 110 extend in the treatment unit 8 in the longitudinal direction of the treatment unit 8 and are electrically connected to the connector portion 48 (see FIG. 2).

  As shown in FIG. 9C, a sharp blade 112 is disposed at the lower part of the treatment blade 104. In addition, side plates (heat transfer members) 114 a and 114 b are arranged in parallel on both side surfaces of the treatment blade 104. These side plates 114 a and 114 b extend in the longitudinal direction of the treatment portion main body 56 along the treatment blade 104. The side plates 114 a and 114 b are preferably made of a metal having a high thermal conductivity, but need to be made of a material having a slightly lower thermal conductivity than the treatment blade 104. The side plates 114a and 114b are thermally connected to the treatment blade 104 by brazing, welding, or the like.

  Next, the operation of the heat treatment tool 102 of the present embodiment having the above configuration will be described. When the treatment target is to be heated, the first and second finger hooks 28 and 30 are closed, and the first and second jaws 24 and 26 are closed. As shown in FIG. The object to be treated is held between the second jaws 24 and 26.

  Then, the power switch 12 is output by operating the foot switch 14. As a result, the heating element 108 is energized through the conducting wire 110 to generate heat. The heat generated by the heating element 108 is transferred to the treatment blade 104. Further, the heat transferred to the treatment blade 104 is transferred to the side plates 114a and 114b. Then, heat is applied to the treatment target held by the first and second jaws 24 and 26 from the treatment blade 104 and the side plates 114a and 114b.

  At this time, the pressure distribution and temperature distribution of the treatment target in the width direction of the first jaws 24 and 26 are as shown in FIG. That is, the pressure and temperature are substantially constant in the region to be treated (coagulation region) near the side plates 114a and 114b, and the pressure and temperature in the region to be treated (incision region) near the treatment blade 104 are higher than those in the coagulation region. Both are high. Here, the change in temperature between the incision zone and the coagulation zone is gentle. As a result of such temperature distribution, an incision action and a coagulation action similar to those in the first embodiment occur in the treatment target. For comparison, FIG. 10C shows the temperature distribution of the treatment target when the side plates 114a and 114b are not provided. When the treatment blade 104 and the side plates 114a and 114b are made of the same material and have the same thermal conductivity, the temperature is constant in the incision area and the coagulation area as shown in FIG. 10 (D). It becomes.

  Therefore, the above configuration has the following effects. The heat generated by the heating element 108 and transferred to the treatment blade 104 is further transferred to the side plates 114a and 114b. For this reason, when the treatment target held by the first and second jaws 24 and 26 is heated, there is a temperature difference between the incision area near the treatment blade 104 and the coagulation area near the side plates 114a and 114b. It is getting smaller. In other words, the temperature distribution of the treatment target in the width direction of the first jaws 24 and 26 is optimal, and heat shortage is less likely to occur in the solidification zone. As a result, the heat treatment can be performed in a short time, and the treatment efficiency is improved.

  Also, almost all of the heat generated by the heating element 108 is recovered by the treatment blade 104 and the side plates 114a and 114b. The treatment blade 104 and the side plates 114a and 114b are fixed to the first treatment surface 62 of the heat-insulating treatment portion main body 56. 52 is packaged, and a gap 54 for heat insulation is formed between the jaw body 50 and the heat insulation cover 52. For this reason, useless heat radiation from the treatment blade 104 and the side plates 114a and 114b to the treatment portion main body 56, the jaw main body 50, and the heat insulating cover 52 is prevented to the maximum. Therefore, heat is concentrated locally on the treatment blade 104 and the side plates 114a and 114b, and an efficient heating treatment is possible.

  FIG. 11 shows a fifth embodiment of the present invention. The same components as those in the fourth embodiment are denoted by the same reference numerals and description thereof is omitted. The heat treatment tool 116 of this embodiment has a heat generating plate 118. The heat generating plate 118 has substantially the same shape as the treatment blade 104 of the fourth embodiment, but does not have the concave portion 106 and the heating element 108 unlike the treatment blade 104. Instead, a resistor 120 such as a thin film or a thick film is disposed on the surface of the heating plate 118, and the heating plate 118 itself is a heating element. A conductive wire 122 is connected to the rear end of the resistor 120. This conducting wire extends in the treatment unit 8 in the longitudinal direction of the treatment unit 8, and is electrically connected to the connector portion 48 (see FIG. 2).

  Next, the operation of the heat treatment tool 116 of the present embodiment having the above configuration will be described. When the power switch 12 is output by operating the foot switch 14, the resistor 120 is energized through the conductor 122 and the heat generating plate 118 generates heat. The heat generated by the heat generating plate 118 is transferred to the side plates 114a and 114b. Therefore, the above configuration has the same effect as the fourth embodiment.

  Hereinafter, a first reference embodiment relating to the present invention will be described with reference to FIGS. FIG. 12 shows an overall schematic configuration of the heat treatment device system 130 according to the present embodiment. The exothermic treatment instrument system 130 includes an exothermic treatment instrument 132 that performs a heating treatment on the treatment target while holding the treatment target.

  The exothermic treatment instrument 132 has first and second main bodies 134 and 136. The first main body 134 and the second main body 136 are pivotally supported by a pivot shaft 137 at the intersection. First and second jaws 138 and 140 for gripping the treatment object are disposed on the distal ends of the first and second main bodies 134 and 136, respectively. On the other hand, on the rear end side of the first and second main bodies 134 and 136, first and second finger hooks 142 and 144 are arranged for the operator to insert and operate the fingers, respectively. By opening and closing the first and second finger hooks 142 and 144, the first and second jaws 138 and 140 are opened and closed. That is, an operating means for opening and closing the first and second jaws 138 and 140 is formed by the first and second finger hooks 142 and 144.

  A connector portion 146 that is electrically connected to a heating element 170 (described later) of the first jaw 138 is disposed in the vicinity of the first finger hook 142 of the first main body 134. A cable 148 extends from the connector portion 146. The other end of the cable 148 is connected to the power supply 150. The power source 150 is connected to a foot switch 152 that is operated by a surgeon with his / her foot to adjust ON / OFF of the power source 150, output settings, and the like.

  As shown in FIG. 13A, the first and second jaws 138 and 140 are formed by connecting the first and second jaw bodies 154 and 156 forming the outer portion of the first and second jaws 138 and 140, respectively. Have. The outer surfaces of the first and second jaw bodies 154 and 156 are smooth surfaces that are gradually narrowed toward the tip, and form first and second peeling surfaces 158 and 160.

  On the side of the first jaw body 154 facing the second jaw 140, a groove 162 extends in the longitudinal direction of the first jaw 138. A heat insulating frame 164 is fitted in the groove 162. The heat insulating frame 164 extends in the longitudinal direction of the first jaw 138. The heat insulating frame 164 is formed of a material having low thermal conductivity, such as a fluororesin, silicon rubber, ceramics, or the like.

  A heat transfer section 166 is disposed on the side of the heat insulating frame 164 facing the second jaw 140. The heat transfer section 166 extends in the longitudinal direction of the first jaw 138 and protrudes toward the second jaw 140. The heat transfer section 166 is made of a material having high thermal conductivity, such as copper, copper alloy, aluminum alloy, tungsten, molybdenum, or the like.

  A plurality of convex portions 168 are arranged in parallel in the longitudinal direction of the first jaw 138 on the upper portion of the heat transfer portion 166. A heating element 170 projects from the rear end surface of each convex portion 168. These heating elements 170 are formed of a heat generating element that is energized to generate Joule heat, such as a thick film or thin film resistor. Alternatively, a nichrome wire may be used as the heating element 170. The leading end side of the heating element 170 is embedded in the heat transfer section 166. Here, the heat transfer section 166 and the heating element 170 form a heat generating section that generates heat and heats the treatment target.

  A lead wire 172 for energizing the heating element 170 is connected to the rear end side of the heating element 170. These lead wires 172 extend rearward, are bundled near the rear end portion of the heat transfer section 166, and are inserted into the sheath 174. The sheath 174 extends in the first main body 134 in the longitudinal direction of the first main body 134, and the lead wire 172 is electrically connected to the connector portion 146 (see FIG. 12).

  On the other hand, on the side of the second jaw main body 156 facing the first jaw 138, a receiving portion 178 is disposed at a position facing the heat transfer portion 166. The receiving portion 178 extends in the longitudinal direction of the second jaw 140.

  Further, as shown in FIG. 13B, the first and second jaws 138 and 140 are curved in a cross section perpendicular to the pivot shaft 137 and the longitudinal direction of the first and second jaws 138 and 140. The first and second curved portions 180a and 180b are provided.

  Hereinafter, a detailed configuration of the first and second jaws 138 and 140 will be described with reference to FIG. A cross section perpendicular to the longitudinal direction of the first jaw 138 of the first jaw body 154 has a dome shape. Moreover, the cross section of the groove part 162 is a rectangular shape, and the cross section of the heat insulation frame 164 is a reverse concave shape.

  The upper end side of the heat transfer part 166 is fitted into the recess of the heat insulating frame 164. A contact portion 182 is disposed on the lower end side of the heat transfer portion 166. The contact portion 182 extends in the width direction of the first jaw 138 and covers the lower surface of the heat insulating frame 164. Further, a thin non-adhesive film is formed on the surface of the contact portion 182 with a fluororesin or the like in order to prevent the treatment target and blood from adhering. The lower surface of the contact portion 182 forms a first contact surface 184 that comes into contact with the treatment target.

  On the other hand, the upper surface of the receiving portion 178 forms a second contact surface 186 that comes into contact with the treatment target. The first contact surface 184 and the second contact surface 186 are brought into close contact with each other when the first jaw 138 and the second jaw 140 are closed. Here, as shown in the hardness distribution diagram of FIG. 14 (B), the receiving portion 178 has a hard central portion along the width direction of the second jaw 140 and becomes softer as the distance from the central portion increases. . For example, when the receiving portion 178 is formed of rubber, as shown in FIG. 14 (A), the inner portion of the receiving portion 178 is small and increases as the distance from the central portion increases. This is realized by distributing bubbles. Here, the heat generating part and the receiving part 178 form a treatment means capable of adjusting the pressure applied to the grasped treatment target.

  Next, the operation of the heat treatment device system 130 of the present embodiment having the above-described configuration will be described. When performing heat treatment on the treatment target, the heat treatment tool 132 is brought close to the treatment target, the first and second finger hooks 142 and 144 are closed, the first and second jaws 138 and 140 are closed, and the first treatment is performed. And the treatment target is held between the second jaws 138 and 140. At this time, the treatment target is pressed by the first contact surface 184 of the contact portion 182 and the second contact surface 186 of the receiving portion 178.

  Subsequently, the foot switch 14 is operated to output the power supply 12. As a result, the heating element 170 is energized through the cable 148 and the lead wire 172, and the heating element 170 generates heat. The heat generated by the heating element 170 is transferred to the heat transfer unit 166, that is, the contact unit 182, and is given to the treatment target through the first contact surface 184.

  In parallel with the heat generation operation, the first and second finger hooks 142 and 144 are more strongly closed, and the treatment target is further pressed by the first contact surface 184 and the second contact surface 186. Since the hardness of the receiving portion 178 is high at the central portion in the width direction of the second jaw 140 and decreases as it is separated from the central portion, the deformation of the receiving portion 178 is small at the central portion and increases as it is separated from the central portion. As a result, the pressure applied to the treatment object by the first contact surface 184 and the second contact surface 186 is large at the center and decreases as the distance from the center is increased.

  Then, incision ability is improved in the portion to be treated where the pressure applied by the first contact surface 184 and the second contact surface 186 is large. On the other hand, the coagulation ability is improved in the portion to be treated where the pressure applied by the first contact surface 184 and the second contact surface 186 is small. As a result, with respect to the width direction of the second jaw 140, a sufficient incision action occurs in the central portion of the treatment target, and a sufficient coagulation action occurs in the peripheral portion.

  By the way, during the surgical operation, if necessary, the tissue is peeled off by the first and second peeling surfaces 158 and 160 with the first and second jaws 138 and 140 closed. Further, cord-like tissues such as blood vessels and nerves are handled at the distal ends of the first and second jaws 138 and 140.

  Therefore, the above configuration has the following effects. The treatment target is gripped and pressed by the first contact surface 184 of the contact portion 182 and the second contact surface 186 of the receiving portion 178, and the treatment target is heated. Here, the hardness of the receiving portion 178 is high in the central portion in the width direction of the second jaw 140 and decreases as the distance from the central portion increases. For this reason, the deformation of the receiving portion 178 is small at the central portion and increases as the distance from the central portion increases, and the pressure applied to the treatment object by the first contact surface 184 and the second contact surface 186 is largely at the central portion. It becomes smaller as it gets away from the part. Here, the incision ability is improved in the portion of the treatment target where the pressure applied by the first contact surface 184 and the second contact surface 186 is large, and the first contact surface 184 and the second contact surface 186 The coagulation ability is improved in the portion to be treated where the applied pressure is small. Therefore, both incision ability and coagulation ability are improved, and incision treatment and coagulation treatment can be performed in a balanced manner.

  Hereinafter, modifications of the first reference embodiment relating to the present invention will be described. These modifications differ only in the configuration of the heat treatment instrument system 130 of the first reference form and the receiving part. As will be described below, in these modified examples, the hardness distribution shown in FIG. 14B is realized by a method different from the receiving portion 178 of the first reference embodiment.

  The receiving portion of the first modification is spaced apart from the central portion with a high density of hard plastic, ceramics and the like along the width direction of the second jaw 140 inside the receiving portion formed of rubber. The distribution is such that the density decreases with time.

  As shown in FIG. 15A, the receiving portion 190 of the second modification has a double laminated structure including an upper soft member 192 and a lower hard member 194. Here, the hard member 194 has a triangular cross section perpendicular to the longitudinal direction of the second jaw 140. That is, along the width direction of the second jaw 140, the soft member 192 is thin at the center and thicker as it is separated from the center, whereas the hard member 194 is thick at the center and is spaced from the center. As it gets thinner.

  As shown in FIG. 15B, a gap layer 198 is formed on both sides in the width direction of the second jaw 140 in the receiving portion 196 of the third modified example. These gap layers 198 extend from both side surfaces of the receiving portion 196 toward the center in the width direction of the second jaw 140, and a plurality of the gap layers 198 are arranged in the height direction of the second jaw 140. Moreover, the length of the gap layer 198 is a length that does not reach the center, and is longer as the upper gap layer 198. Further, the gap layer 198 is disposed symmetrically with respect to the center portion.

  FIG. 16 shows a second reference embodiment relating to the present invention. The same components as those in the first reference embodiment are denoted by the same reference numerals and description thereof is omitted. As shown in FIG. 16, the exothermic treatment device 200 of the present embodiment has a heat insulating frame 202 in which the first jaw 138 has a dome-shaped cross section in the longitudinal direction. A groove portion 204 is formed on the surface of the heat insulating frame 202 facing the second jaw 140.

  The upper part of the heat transfer part 206 is fitted and fixed in the groove part 204. A cross section perpendicular to the longitudinal direction of the first jaw 138 of the heat transfer section 206 has a semicircular shape protruding downward. A heating element 208 is disposed on the upper surface of the heat transfer unit 206. The heating element 208 is accommodated in the groove portion 204.

  On the other hand, a recess 212 having a semicircular cross section in the longitudinal direction of the second jaw 140 is formed on the upper surface of the receiving portion 210 of the second jaw 140. The first contact surface 184 of the heat transfer unit 206 and the second contact surface 186 of the receiving unit 210 are brought into close contact with each other when the first jaw 138 and the second jaw 140 are closed. It has become. Moreover, the receiving part 210 has the same double laminated structure as the receiving part 190 of the 2nd modification of a 1st reference form. That is, the soft member 214 is disposed above the receiving portion 210, and the hard member 216 having a triangular cross section perpendicular to the longitudinal direction of the second jaw 140 is disposed below the receiving portion 210. .

  Further, the operation of the heat treatment system of the present reference embodiment is the same as that of the first reference embodiment.

  Therefore, the configuration described above has the following effects. The cross section perpendicular to the longitudinal direction of the second jaw 140 of the heat transfer section 206 is a semicircular shape protruding downward, and the longitudinal section of the second jaw 140 is semicircular on the upper surface of the receiving section 210. A recess 212 is formed. Furthermore, the first contact surface 184 of the heat transfer unit 206 and the second contact surface 186 of the receiving unit 210 are brought into close contact with each other when the first jaw 138 and the second jaw 140 are closed. It has become so. For this reason, when the treatment target is gripped by the heat transfer section 206 and the receiving section 210, the treatment target does not shift in the width direction of the second jaw 140, and the treatment target can be reliably gripped. It has become.

  Further, when the treatment target is gripped by the heat transfer unit 206 and the receiving unit 210, the area where the heat transfer unit 206 and the receiving unit 210 are in contact with the treatment target is large. Therefore, the treatment efficiency is improved.

  FIG. 17 shows a third reference embodiment relating to the present invention. The same components as those in the first reference embodiment are denoted by the same reference numerals and description thereof is omitted. A plate-shaped heat transfer section 220 is disposed on the heat insulation frame 164 of the heat treatment tool 218 of the present embodiment. The heat transfer section 220 extends in the longitudinal direction of the first jaw 138 and protrudes toward the second jaw 140. Further, tapers are provided on both side surfaces of the front end portion of the heat transfer section 220, and a blade section 222 is formed.

  On both sides of the heat transfer section 220, first and second side heat transfer sections 224 and 226 are disposed. The first and second side heat transfer units 224 and 226 are smaller than the heat transfer unit 220 but have a relatively large thermal conductivity. The first and second side heat transfer portions 224 and 226 have L-shaped and inverted L-shaped cross sections perpendicular to the longitudinal direction of the first jaw 138, respectively, and cover the lower surface of the heat insulating frame 164. ing. Further, the first and second side heat transfer portions 224 and 226 are extended in the longitudinal direction of the first jaw 138. Here, the position of the front end portion of the heat transfer section 220 is offset toward the second jaw 140 with respect to the positions of the lower surfaces of the first and second side heat transfer sections 224 and 226. Further, the heat transfer section 220 and the first and second side heat transfer sections 224 and 226 form a heat generating section that generates heat and heats the treatment target.

  The second jaw 140 is provided with a receiving portion 228 at a position facing the heat transfer portion 220 and the first and second side heat transfer portions 224 and 226. The receiving portion 228 extends in the longitudinal direction of the second jaw 140. Unlike the first reference embodiment, the hardness of the receiving portion 228 is not changed depending on the position. When the first jaw 138 and the second jaw 140 are closed, the heat transfer section 220 and the receiving section 228 are brought into contact with each other.

  Next, the operation of the heat treatment device system according to this embodiment having the above-described configuration will be described. When performing the heating treatment on the treatment target, the first and second jaws 138 and 140 are closed and the treatment target is held between the first and second jaws 138 and 140. At this time, the treatment target is lightly contacted by the first and second side heat transfer units 224 and 226 while being subjected to a strong pressure by the heat transfer unit 220.

  In this state, the heat generator 170 is heated to heat the heat transfer section 220. Heat is transferred from the heated heat transfer section 220 to the first and second side heat transfer sections 224 and 226. Since the thermal conductivity of the first and second side heat transfer units 224 and 226 is smaller than that of the heat transfer unit 220, the temperature of the first and second side heat transfer units 224 and 226 is higher than that of the heat transfer unit 220. Also lower.

  Between the heat transfer part 220 and the receiving part 228, a high pressure and a high temperature are applied to the treatment target, and the incision ability is improved. On the other hand, the first and second side heat transfer parts 224, 226 Between the receiving part 228, a low pressure and a low temperature are applied to the treatment target, and the coagulation ability is improved. As a result, the incision action is promoted in the treatment object between the heat transfer unit 220 and the receiving part 228, and the first and second side heat transfer parts 224, 226 and the receiving part 228 coagulate in the treatment object. The action is promoted.

  Therefore, the above configuration has the following effects. On both sides of the heat transfer section 220, first and second side heat transfer sections 224 and 226 are disposed. Here, the position of the front end portion of the heat transfer section 220 is offset toward the second jaw 140 with respect to the positions of the lower surfaces of the first and second side heat transfer sections 224 and 226. The first and second side heat transfer units 224 and 226 are smaller than the heat transfer unit 220 but have a relatively large thermal conductivity. For this reason, when a heat treatment is performed on the treatment target, a high pressure and a high temperature are applied to the treatment target between the heat transfer unit 220 and the receiving unit 228, and the first and second lateral heat transfers are performed. Between the parts 224, 226 and the receiving part 228, a low pressure and a low temperature are applied to the treatment target. Therefore, incision ability and coagulation ability are improved, and incision treatment and coagulation treatment can be performed in a well-balanced manner.

  FIG. 18 shows a fourth reference embodiment relating to the present invention. The same components as those in the first reference embodiment are denoted by the same reference numerals and description thereof is omitted. A receiving unit 234 is disposed on the second main body 136 of the heat treatment device 232 of the heat treatment device system of the present embodiment. The receiving unit 234 includes an adjustment rod 236 that extends in the longitudinal direction of the second main body 136. The adjusting rod 236 is disposed so as to be rotatable about its own axis with respect to the second main body 136.

  An adjustment knob 238 is connected to the rear end portion of the adjustment rod 236. The adjustment knob 238 is disposed in the vicinity of the second finger rest 144. The adjustment knob 238 is rotatable about its own axis with respect to the second main body 136, and the adjustment rod 236 is rotated by rotating the adjustment knob 238. On the other hand, a receiving portion 240 is disposed at the tip of the adjusting rod 236.

  As shown in FIG. 18B, the first jaw main body 154 has a semi-cylindrical shape whose central axis extends in the longitudinal direction of the first jaw 138. A heat insulating frame 164 is fitted and fixed in the groove portion 162 of the first jaw main body 154, and a heat transfer portion 242 is fitted and fixed in a concave portion of the heat insulating frame 164. On the lower surface of the contact portion 244 of the heat transfer portion 242, a concave portion 246 having a 1/4 circular cross section perpendicular to the longitudinal direction of the second jaw 140 is formed.

  The second jaw body 156 has a semi-cylindrical shape whose central axis extends in the longitudinal direction of the second jaw 140. A receiving portion 240 is arranged on the first jaw 138 side of the second jaw main body 156. The cross section perpendicular to the longitudinal direction of the second jaw 140 of the receiving portion 240 has a shape in which a circle corresponding to the concave portion 246 on the lower surface of the contact portion 244 is cut out as shown in FIG. Yes.

  Here, as shown in FIG. 18B, the receiving portion 240 includes a first contact surface 248 and a second contact surface 250 whose cross section perpendicular to the longitudinal direction of the second jaw 140 has an arc shape. Is extended in the longitudinal direction of the receiving portion 240. The area of the first contact surface 248 is smaller than the area of the second contact surface 250.

  The adjustment rod 236 is disposed at the center position of the circle corresponding to the above-described recess 246 in the cross section perpendicular to the longitudinal direction of the second jaw 140. When the adjusting rod 236 is rotated, the receiving portion 240 is rotated. By rotating the receiving portion 240, the first contact surface 248 or the second contact surface 250 is arranged at a position facing the contact portion 244. That is, when the first jaw 138 and the second jaw 140 are closed, the first contact surface 248 or the second contact surface 250 comes into contact with and comes into close contact with the contact portion 244. That is, the adjusting rod 236 and the adjusting knob 238 form a switching means for switching between the first and second contact surfaces 248 and 250 that are in contact with the treatment target.

  Next, the operation of the heat treatment device system according to this embodiment having the above-described configuration will be described. When performing heat treatment on the treatment target, the heat treatment device 232 is moved, the first and second jaws 138 and 140 are closed, and the treatment target is placed between the first jaw 138 and the second jaw 140. To place. When performing an incision treatment on a treatment target, as shown in FIG. 18B, the adjustment knob 238 is rotated to place the first contact surface 248 at a position facing the contact portion 244. Thereafter, the first and second jaws 138 and 140 are further closed, and the treatment target is grasped and pressed by the contact portion 244 and the first contact surface 248. At this time, the treatment target is applied with a strong pressure by the contact portion 244 and the first contact surface 248.

  In this state, the heat generator 170 is heated to heat the heat transfer section 242. Heat is transferred from the heated heat transfer section 242 to the treatment target. Since a high pressure is applied to the treatment target between the contact portion 244 and the first contact surface 248, the incision ability is improved. As a result, the incision action is promoted in the treatment target between the contact portion 244 and the first contact surface 248.

  On the other hand, when the coagulation treatment is performed on the treatment target, as shown in FIG. 18C, the adjustment knob 238 is rotated to place the second contact surface 250 at a position facing the contact portion 244. Thereafter, the first and second jaws 138 and 140 are further closed, and the treatment target is grasped and pressed by the contact portion 244 and the second contact surface 250. At this time, the treatment object is applied with a weaker pressure than the incision treatment by the contact portion 244 and the second contact surface 250.

  In this state, the heat generator 170 is heated to heat the heat transfer section 242. Heat is transferred from the heated heat transfer section 242 to the treatment target. Since a relatively weak pressure is applied to the treatment target between the contact portion 244 and the second contact surface 250, the coagulation ability is improved. As a result, the coagulation action is promoted in the treatment target between the contact portion 244 and the second contact surface 250.

  Therefore, the above configuration has the following effects. By rotating the adjustment knob 238 to rotate the receiving portion 240, the first contact surface 248 or the second contact surface 250 is arranged at a position facing the contact portion 244. In addition, the area of the first contact surface 248 is smaller than the area of the second contact surface 250. Therefore, when the treatment target is heated, when the first and second jaws 138 and 140 are closed and the treatment target is gripped and pressed by the contact portion 244 and the first contact surface 248, the contact portion The 244 and the first contact surface 248 apply a strong pressure to the treatment target and improve the incision ability. On the other hand, when the treatment target is gripped and pressed by the contact portion 244 and the second contact surface 250, relatively weak pressure is applied to the treatment target by the contact portion 244 and the second contact surface 250, and the coagulation ability is increased. Is improved. Accordingly, the incision ability and the coagulation ability are improved, and the incision treatment and the coagulation treatment are performed in a balanced manner by switching between the first contact surface 248 and the second contact surface 250 by the adjustment knob 238 at hand. It is possible.

  FIG. 19 shows a fifth reference embodiment relating to the present invention. The same components as those in the third reference embodiment are denoted by the same reference numerals, and the description thereof is omitted. Skirt portions 258a and 258b are disposed on both sides of the heat generation frame 256 of the heat treatment tool 254 of the present embodiment. These skirt portions 258 a and 258 b are extended in the longitudinal direction of the first jaw 138 and protrude in the direction toward the second jaw 140.

  Next, the operation of the heat treatment device system according to this embodiment having the above-described configuration will be described. When the treatment target is gripped by the first jaw 138 and the second jaw 140, the treatment target is pressed by the skirt portions 258a and 258b in addition to the heat transfer portion 220. In this state, the heating element 170 is heated to heat the heat transfer section 220, the first and second side heat transfer sections 224, 226 (not shown in FIG. 19), and the heat transfer section 220, first and second The treatment target is heated by the second side heat transfer units 224 and 226. At this time, the skirt portions 258a and 258b prevent blood, dirty perfusate, and the like from flowing into the heat treatment area from the outside of the skirt portions 258a and 258b.

  Therefore, the configuration described above has the following effects. Skirt portions 258 a and 258 b are disposed on both sides of the heat generating frame 256. When the treatment target is gripped by the first jaw 138 and the second jaw 140, the treatment target is pressed by the skirt portions 258a and 258b in addition to the heat transfer portion 220. When the heat treatment is performed on the treatment target, the skirt portions 258a and 258b prevent blood, dirty perfusate, and the like from flowing into the heat treatment region from the outside of the skirt portions 258a and 258b. For this reason, it is possible to perform a stable heat treatment on the treatment target regardless of the situation around the treatment target.

Next, other characteristic technical matters of the present application are appended as follows.
Record
(Additional item 1)
A pair of jaws that open and close each other;
Operating means for opening and closing the pair of jaws;
A heat generating portion provided on one of the pair of jaws to generate heat and heat the treatment target, and a treatment target in cooperation with the heat generating portion provided on the other of the pair of jaws when the pair of jaws are closed And a treatment means capable of adjusting the pressure applied to the grasped treatment object,
An exothermic treatment instrument comprising:

(Appendix 2)
The exothermic treatment tool according to additional item 1, wherein the receiving portion is easily deformable depending on a position.

(Additional Item 3)
The exothermic treatment tool according to appendix 1, wherein a degree of protrusion of the heat generating portion in the direction of the receiving portion is changed depending on a position.

(Appendix 4)
The receiving portion has a plurality of contact surfaces with different areas that are in contact with the treatment target when the treatment target is gripped by the heat generating portion and the receiving portion, and the treatment means contacts the treatment target. The exothermic treatment tool according to Additional Item 1, further comprising switching means for switching the contact surface.

(Title of Invention of Supplementary Items 1 to 4) Fever Treatment Tool (Technical Field of Supplementary Items 1 to 4)
The inventions of additional items 1 to 4 relate to an exothermic treatment instrument that heats a treatment target while holding the treatment target between a pair of openable and closable jaws, and performs heat treatment such as coagulation or incision of a coagulation site on the treatment target.

(Background technology of additional items 1 to 4)
2. Description of the Related Art Conventionally, an exothermic treatment tool that performs a heat treatment such as coagulation or incision of a coagulation site on a treatment target has been used. Such an exothermic treatment instrument has a pair of jaws that open and close each other and grip a treatment target. One or both of these jaws is provided with a heat generating portion that generates heat.

  Such a fever treatment tool is used in various surgical cases. Examples of surgical cases include hemostasis of blood vessels contained in living tissues, cauterization and coagulation of lesions and bleeding parts on the surface of living tissues, and occlusion of fallopian tubes for the purpose of contraception.

  In addition, when various treatments such as hemostasis, cauterization, coagulation, occlusion, or incision are performed on the living tissue, a surgical operation is performed to secure the field of view of the endoscope and the work area of the heat treatment device. For example, each operation such as mechanical exclusion, gripping, and peeling is performed on the target tissue and surrounding tissues with a surgical instrument such as a peeling forceps.

  As an example of the exothermic treatment tool used for the heating treatment, there is a surgical instrument of Patent Document 1 of Additional Items 1 to 4. In this surgical instrument, a heating plate is disposed on the first jaw. The heat generating plate extends along the longitudinal direction of the first jaw and protrudes toward the second jaw. The tip of the heat generating plate has a blade shape. A heat generating element that generates heat and transmits heat to the heat generating plate is disposed at the base end of the heat generating plate. A ceramic heater or the like is used as a heating element. The second jaw is provided with a receiving portion at a portion facing the front end portion of the heat generating plate. This receiving part consists of a flexible member.

  When heat treatment is performed on the treatment target with this surgical instrument, the pair of jaws are opened and closed to grip the treatment target between the tip portion of the heat generating plate and the receiving portion. At this time, the treatment target is pressed by the distal end portion and the receiving portion of the heat generating plate. Then, the heat generating element generates heat to heat the heat generating plate, and the heat treatment is performed on the treatment target.

(Patent Document 1 of Additional Items 1 to 4) Japanese Patent No. 3349139 (Disclosure of Inventions of Additional Items 1 to 4)
(Problems to be solved by the inventions of Supplementary Items 1 to 4)
In the surgical instrument of Patent Literature 1, when a heat treatment is performed on a treatment target, strong pressure is applied to the contact area between the distal end portion of the heat generating plate and the treatment target. As a result, heat concentrates on the contact area, and heat may not be sufficiently applied to the treatment target around the contact area, so that the target site may not be sufficiently solidified. For this reason, the surgical instrument of Patent Document 1 has room for improvement.

  In addition, it is possible to make the front-end | tip part of a heat generating plate into the shape where a contact area with a treatment object becomes large. In this case, sufficient heat is applied to the treatment target in the contact area, and sufficient coagulation treatment can be performed. However, with such a shape of the heating plate, the incision property is lowered, and the function as the incision device is impaired.

  The inventions of the supplementary items 1 to 4 have been made by paying attention to the above-mentioned problems, and the object thereof is to have excellent incision ability and coagulation ability, and to perform incision treatment and coagulation treatment in a balanced manner. It is to provide a possible fever treatment device.

(Means for Solving the Problems in Additional Items 1 to 4)
The invention of appendix 1, the pair of jaws that open and close each other,
Operating means for opening and closing the pair of jaws;
A heat generating portion provided on one of the pair of jaws to generate heat and heat the treatment target, and a treatment target in cooperation with the heat generating portion provided on the other of the pair of jaws when the pair of jaws are closed And a treatment means capable of adjusting the pressure applied to the grasped treatment object,
It is the exothermic treatment tool characterized by comprising.

  In the invention of the supplementary item 1, the pair of jaws are opened / closed by the operating means, the treatment target is gripped by the heat generating portion and the receiving portion, and the heated treatment target is heated by heating the heat generating portion. At this time, the pressure applied to the treatment target is adjusted.

  The invention of Additional Item 2 is the heat treatment tool according to Additional Item 1, wherein the ease of deformation of the receiving portion is changed depending on the position.

  And in invention of this supplementary item 2, when changing the ease of deformation | transformation of a receiving part with a position, when performing a heat treatment to the treatment target grasped, the pressure applied by the position of a treatment target is changed. It is what.

  The invention of Additional Item 3 is the heat treatment device according to Additional Item 1, wherein the degree of protrusion of the heat generating portion in the direction of the receiving portion is changed depending on a position.

  Further, in the invention of the supplementary item 3, when the heating treatment is performed on the grasped treatment target by changing the degree of protrusion of the heat generating portion in the receiving portion direction according to the position, the pressure applied depending on the position of the treatment target. Is something that changes.

  The invention according to appendix 4, wherein the receiving part has a plurality of contact surfaces having different areas where any one of the receiving part contacts the treatment object when the treatment object is gripped by the heat generating part and the receiving part. The means is the heat treatment tool according to additional item 1, characterized in that the means includes a switching means for switching a contact surface to be contacted with the treatment target.

  And in invention of this supplementary item 4, it heat-processes to the hold | gripped treatment object by switching the contact part contacted with a treatment object by a switching means, and changing the contact area of a treatment object and a receiving part. At this time, the pressure applied to the treatment target is changed.

(Effects of the Inventions of Supplementary Items 1 to 4)
According to the first to fourth aspects of the present invention, it is possible to achieve excellent incision ability and coagulation ability, and to perform incision treatment and coagulation treatment in a well-balanced manner.

(Industrial applicability of additional items 1 to 4)
The inventions of the supplementary items 1 to 4 have excellent incision ability and coagulation ability, and are capable of performing the incision treatment and the coagulation treatment in a well-balanced manner while holding the treatment target between a pair of openable and closable jaws. Provided is a medical instrument that heats a treatment target and performs heat treatment such as coagulation or incision of a coagulation site on the treatment target.

  The present invention heats a treatment target while holding the treatment target between a pair of openable and closable jaws, which achieves high treatment efficiency by optimizing the temperature distribution of the treatment target to be heated. Provided is a fever treatment tool for performing heat treatment such as coagulation and incision.

BRIEF DESCRIPTION OF THE DRAWINGS Explanatory drawing which shows the schematic structure of the whole the exothermic treatment tool system of 1st Embodiment of this invention. (A) is a side view showing the forceps unit of the fever treatment tool of the first embodiment of the present invention, (B) is a side view showing the treatment unit of the fever treatment tool of the embodiment, and (C) is the same. The top view which shows the treatment unit of the exothermic treatment tool of embodiment. (A) is a top view which shows the heat treatment tool of 1st Embodiment of this invention, (B) is a side view which shows the heat treatment tool of the embodiment. (A) is a side view showing the tip of the fever treatment device of the first embodiment of the present invention, (B) is a longitudinal sectional view showing the tip of the fever treatment device of the embodiment, (C), The cross-sectional view which cut | disconnects and shows the front-end | tip part of the exothermic treatment tool of the embodiment along the IVC-IVC line of (B), (D) is the front-end | tip part of the exothermic treatment tool of the same embodiment of (B). The cross-sectional view which cuts and shows along the IVD-IVD line, (E) is a cross-sectional view which cuts and shows the front-end | tip part of the exothermic treatment tool of the embodiment along the IVE-IVE line of (B). (A) is a cross-sectional view showing the distal end portion of the exothermic treatment instrument of the first embodiment of the present invention in a state where a treatment target is gripped, and (B) is a treatment at the time of heating treatment of the exothermic treatment instrument of the embodiment. Explanatory drawing which shows temperature distribution and pressure distribution of object, (C) is explanatory drawing which shows temperature distribution and pressure distribution of the treatment object at the time of the heating treatment of the conventional heat-generating treatment instrument. The figure which shows the 1st treatment surface side of the 1st jaw of the exothermic treatment tool of 2nd Embodiment of this invention. (A) is a figure which shows the 1st treatment surface side of the support plate of 2nd Embodiment of this invention, (B) is a figure which shows the treatment part main body side of the support plate of the embodiment, (C) is The longitudinal cross-sectional view which cuts and shows the temperature measurement member periphery along the VIIC-VIIC line of (A), (D) is a longitudinal cross-sectional view which shows the temperature measurement member periphery of the modification of the embodiment. (A) is a longitudinal sectional view showing the distal end portion of the fever treatment device of the third embodiment of the present invention, and (B) is a VIIIB-VIIIB line of (A) the distal end portion of the fever treatment device of the same embodiment. (C) is a cross-sectional view shown by cutting along the line VIIIC-VIIIC of (A), (D) The cross-sectional view which cuts and shows the front-end | tip part of the exothermic treatment tool of the embodiment along the VIIID-VIIID line of (A). (A) is a side view showing the distal end portion of the exothermic treatment instrument of the fourth embodiment of the present invention, (B) is a longitudinal sectional view showing the distal end portion of the exothermic treatment instrument of the embodiment, (C), The cross-sectional view which cuts and shows the front-end | tip part of the exothermic treatment tool of the embodiment along the IXC-IXC line of (B). (A) is a cross-sectional view showing the distal end portion of the exothermic treatment instrument of the fourth embodiment of the present invention in a state where the treatment target is gripped, and (B) is a treatment at the time of heating treatment of the exothermic treatment instrument of the embodiment. Explanatory drawing which shows temperature distribution and pressure distribution of object, (C) is explanatory drawing which shows temperature distribution and pressure distribution of treatment object at the time of heating treatment of the conventional exothermic treatment tool, (D) is the 4th of this invention. Explanatory drawing which shows the temperature distribution and pressure distribution of the treatment target at the time of a heat treatment at the time of forming a treatment blade and a side plate with the same material in the exothermic treatment tool of embodiment. (A) is a longitudinal sectional view showing the distal end portion of the fever treatment device of the fifth embodiment of the present invention, and (B) is the XIB-XIB line of (A) the distal end portion of the fever treatment device of the same embodiment. The cross-sectional view which cuts and shows along. BRIEF DESCRIPTION OF THE DRAWINGS Explanatory drawing which shows the schematic structure of the whole the heat treatment tool system of the 1st reference form regarding this invention. (A) is sectional drawing which cuts and shows the front-end | tip part of the exothermic treatment tool of the 1st reference form regarding this invention perpendicularly | vertically to the width direction of the 1st and 2nd jaw, (B) is the heat_generation | fever of the reference form. Sectional drawing which cut | disconnects and shows the front-end | tip part of a treatment tool perpendicularly to the height direction of the 1st and 2nd jaw. (A) is sectional drawing which cuts perpendicularly | vertically to the longitudinal direction of the 1st and 2nd jaw of the 1st and 2nd jaw of the exothermic treatment tool of 1st reference form regarding this invention, (B) is shown. The graph which shows the hardness distribution of the receiving part of the exothermic treatment tool of the reference form. (A) is sectional drawing which shows the 2nd jaw of the 2nd modification of the 2nd modification of the 1st reference form concerning the present invention perpendicularly to the longitudinal direction of the 2nd jaw, and (B) shows this book Sectional drawing which cuts and shows the 2nd jaw of the exothermic treatment tool of the 3rd modification of the 1st reference form regarding an invention perpendicularly | vertically to the longitudinal direction of a 2nd jaw. Sectional drawing which shows the 1st and 2nd jaw of the exothermic treatment tool of the 2nd reference form regarding this invention cut | disconnected perpendicularly | vertically to the longitudinal direction of the 1st and 2nd jaw. Sectional drawing which shows the 1st and 2nd jaw of the exothermic treatment tool of 3rd reference form regarding this invention cut | disconnected perpendicularly | vertically to the longitudinal direction of the 1st and 2nd jaw. (A) is explanatory drawing which shows schematic structure of the whole heat treatment apparatus system of the 4th reference form regarding this invention, (B) receives the 1st and 2nd jaw of the heat treatment apparatus of the same reference form. Sectional drawing cut | disconnected perpendicularly | vertically to the longitudinal direction of a 1st and 2nd jaw in the state which the 1st contact surface of the part faced the heat-transfer part, (C) is the exothermic treatment tool of the same reference form Sectional drawing which shows a 1st and 2nd jaw cut | disconnected perpendicularly | vertically to the longitudinal direction of a 1st and 2nd jaw in the state which the 2nd contact surface of the receiving part faced the heat-transfer part, (D) These are explanatory drawings which show the shape of the heat-transfer part and the receiving part of the 1st and 2nd jaw of the heat treatment tool of the same reference form cut perpendicularly to the longitudinal direction of the 1st and 2nd jaws. Sectional drawing which shows the 1st and 2nd jaw of the exothermic treatment tool of 5th reference form regarding this invention cut | disconnected perpendicularly | vertically to the longitudinal direction of the 1st and 2nd jaw.

Explanation of symbols

  4 ... exothermic treatment tool, 24, 26 ... a pair of jaws, 62, 86 ... treatment surface, 64 ... exothermic member, 66 ... heat transfer member.

Claims (5)

A pair of jaws that open and close each other;
A pair of treatment surfaces provided on each of the pair of jaws;
A heating member that is provided on at least one of the pair of treatment surfaces and generates heat;
A heat transfer member provided in the vicinity of the heat generating member and on the treatment surface side of the jaw and transferring heat of the heat generating member in the width direction of the jaw;
An exothermic treatment instrument comprising:   The heat generating member generates heat when energized, the heat transfer member is energizable and is electrically connected to the heat generating member, and an energization circuit is formed by the heat generating member and the heat transfer member. The exothermic treatment tool according to claim 1.   At least one of the pair of jaws has a temperature measuring member, and the temperature measuring member has an electric resistor having a temperature coefficient larger than the temperature coefficient of the heat generating member, and based on the electric resistance value. The exothermic treatment device according to claim 1, wherein the temperature is measured.   The heat treatment device according to claim 3, wherein the temperature measurement member is disposed in the vicinity of the heat generation member.   The heat treatment device according to claim 4, wherein the temperature measurement member includes a metal film formed on the heat transfer member.

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