JP2013094338A - Therapeutic treatment apparatus - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a therapeutic treatment apparatus having a heat-generating chip and a wiring member insulated and sealed.SOLUTION: The cross section of a first high-frequency electrode 110 is L-shaped. The heat-generating chip 140, a flexible board 150 for wiring and a bonding wire, etc. are disposed on the first high-frequency electrode. The cross section of a first cover member 120 is L-shaped. The first cover member 120 is disposed in such a way as to cover the heat-generating chip 140, and creates a space for housing the heat-generating chip 140 together with the first high-frequency electrode 110. The space is filled with a sealant with adhesiveness. The heat-generating chip, the flexible board 150 for wiring and the bonding wire, etc. are electrically insulated and waterproofed by the sealant 170.

Description

  The present invention relates to a therapeutic treatment apparatus.

  In general, therapeutic treatment apparatuses that treat living tissue using high-frequency energy or thermal energy are known. For example, Patent Document 1 discloses the following therapeutic treatment apparatus. That is, this therapeutic treatment apparatus has an openable and closable holding portion that holds a biological tissue that is a treatment target. A high-frequency electrode for applying a high-frequency voltage is provided on a portion of the holding portion that contacts the living tissue. Further, the high frequency electrode is provided with a heat generating chip for heating the high frequency electrode. The high frequency electrode is provided with wiring for the high frequency electrode and the heat generating chip. The holding unit is provided with a cutter. In the use of such a therapeutic treatment apparatus, the holding unit first holds the living tissue. The holding unit applies a high-frequency voltage to the living tissue, and further heats the living tissue using a heat generating chip, thereby anastomosing the living tissue. Moreover, it is also possible to excise in the state which joined the biological tissue edge part with the cutter with which the holding | maintenance part was equipped.

JP 2009-247893 A

  In order to operate the therapeutic treatment apparatus as described above accurately and to ensure the durability of the apparatus, it is necessary to ensure the insulation and waterproofness of the member through which the current flows. For example, heat insulation elements such as heat generating chips placed on high frequency electrodes that function as heat transfer members that transmit heat to living tissue, and wiring for high frequency electrodes and heat generating chips ensure electrical insulation and waterproofing There is a need to.

  Therefore, an object of the present invention is to provide a therapeutic treatment apparatus in which a heat generating element and a wiring member are insulated and sealed.

  In order to achieve the above object, one embodiment of the therapeutic treatment apparatus of the present invention is a therapeutic treatment apparatus for heating and treating a living tissue, and includes a first main surface and a second main surface that are front and back. And a heat transfer member that contacts the living tissue on the first main surface and transfers heat to the living tissue, a heating element that joins the second main surface and heats the heat transfer member, A wiring member configured to supply electric power to the heat generating element; a cover member that surrounds the heat generating element and the wiring member together with the heat transfer member in combination with the heat transfer member; and the heat transfer member; And a sealing agent filled in a space surrounded by the cover member.

  According to the present invention, the heating element and the wiring member are surrounded by the heat transfer member and the cover member, and the enclosed space is filled with the sealing agent, so that the heating chip and the wiring member are insulated and sealed. A treatment device can be provided.

Schematic which shows the structural example of the treatment system for treatment which concerns on each embodiment of this invention. It is the schematic of the cross section which shows the structural example of the shaft and holding | maintenance part of the energy treatment tool which concerns on each embodiment of this invention, (A) is a figure which shows the state which the holding | maintenance part closed, (B) is a holding | maintenance part open. FIG. It is the schematic which shows the structural example of the 1st holding member of the holding part which concerns on the 1st Embodiment of this invention, (A) is a top view, (B) follows the 3B-3B line | wire shown to (A). A longitudinal section and (C) is a transverse section which meets the 3C-3C line shown in (A). The top view which shows the outline of the structural example of the heat generating chip | tip which concerns on each embodiment of this invention. It is a figure which shows the outline of the structural example of the heat generating chip | tip which concerns on each embodiment of this invention, Comprising: Sectional drawing which follows the 4B-4B line | wire shown to FIG. 4A. Sectional drawing which shows the outline of the structural example of the flexible substrate which concerns on each embodiment of this invention. The top view which shows the outline of structural examples, such as a 1st high frequency electrode, a heat generating chip, a flexible substrate, and various wiring which concern on the 1st Embodiment of this invention. FIG. 3 is a cross-sectional view schematically illustrating a configuration example of a first high-frequency electrode and a heating chip according to the first embodiment of the present invention. The top view which shows the outline of the structural example of the 1st cover member which concerns on the 1st Embodiment of this invention. Sectional drawing which shows the outline of the structural example of the 1st cover member which concerns on the 1st Embodiment of this invention. The top view which shows the outline of the 1st electrode part which concerns on the 1st Embodiment of this invention. The side view which shows the outline of the 1st electrode part which concerns on the 1st Embodiment of this invention. Sectional drawing which shows the outline of the 1st electrode part which concerns on the 1st Embodiment of this invention. Sectional drawing which shows the outline of the 1st electrode part which concerns on the 2nd Embodiment of this invention. Sectional drawing which shows the outline of the 1st electrode part which concerns on the modification of the 2nd Embodiment of this invention. The top view which shows the outline of the 1st electrode part which concerns on the 3rd Embodiment of this invention. Sectional drawing which shows the outline of the 1st electrode part which concerns on the 4th Embodiment of this invention. Sectional drawing which shows the outline of the 1st electrode part which concerns on the 5th Embodiment of this invention.

[First Embodiment]
A first embodiment of the present invention will be described with reference to the drawings. The therapeutic treatment apparatus according to the present embodiment is an apparatus for use in treatment of living tissue. This therapeutic treatment apparatus causes high-frequency energy and thermal energy to act on a living tissue. As shown in FIG. 1, the therapeutic treatment apparatus 300 includes an energy treatment tool 310, a control device 370, and a foot switch 380.

  The energy treatment tool 310 is a linear type surgical treatment tool for performing treatment by, for example, penetrating the abdominal wall. The energy treatment device 310 includes a handle 350, a shaft 340 attached to the handle 350, and a holding unit 320 provided at the tip of the shaft 340. The holding unit 320 can be opened and closed, and is a treatment unit that holds a living tissue to be treated and performs treatment such as coagulation and incision of the living tissue. Hereinafter, for the sake of explanation, the holding portion 320 side is referred to as a distal end side, and the handle 350 side is referred to as a proximal end side. The handle 350 includes a plurality of operation knobs 352 for operating the holding unit 320. The handle 350 is provided with a non-volatile memory (not shown) that stores eigenvalues and the like related to the energy treatment tool 310. The shape of the energy treatment device 310 shown here is, of course, an example, and other shapes may be used as long as they have the same function. For example, the shape may be a forceps or the shaft may be curved.

  The handle 350 is connected to the control device 370 via the cable 360. Here, the cable 360 and the control device 370 are connected by a connector 365, and this connection is detachable. That is, the therapeutic treatment apparatus 300 is configured such that the energy treatment tool 310 can be exchanged for each treatment. A foot switch 380 is connected to the control device 370. The foot switch 380 operated with a foot may be replaced with a switch operated with a hand or other switches. When the operator operates the pedal of the foot switch 380, ON / OFF of the supply of energy from the control device 370 to the energy treatment tool 310 is switched.

  An example of the structure of the holding part 320 and the shaft 340 is shown in FIG. 2A shows a state in which the holding unit 320 is closed, and FIG. 2B shows a state in which the holding unit 320 is opened. The shaft 340 includes a cylindrical body 342 and a sheath 343. The cylindrical body 342 is fixed to the handle 350 at its proximal end. The sheath 343 is disposed on the outer periphery of the cylindrical body 342 so as to be slidable along the axial direction of the cylindrical body 342.

  A holding part 320 is disposed at the tip of the cylindrical body 342. The holding unit 320 includes a first holding member 322 and a second holding member 324. The base portion of the first holding member 322 is fixed to the distal end portion of the cylindrical body 342 of the shaft 340. On the other hand, the base portion of the second holding member 324 is rotatably supported by the support pin 346 at the distal end portion of the cylindrical body 342 of the shaft 340. Therefore, the second holding member 324 rotates around the axis of the support pin 346 and opens or closes with respect to the first holding member 322.

  In a state in which the holding part 320 is closed, the cross-sectional shape of the base part of the first holding member 322 and the base part of the second holding member 324 is circular. The second holding member 324 is biased by an elastic member 347 such as a leaf spring so as to open with respect to the first holding member 322. When the sheath 343 is slid to the distal end side with respect to the cylindrical body 342 and the base portion of the first holding member 322 and the base portion of the second holding member 324 are covered by the sheath 343, as shown in FIG. The first holding member 322 and the second holding member 324 are closed against the urging force of the elastic member 347. On the other hand, when the sheath 343 is slid to the proximal end side of the cylindrical body 342, the second holding member 324 is moved relative to the first holding member 322 by the urging force of the elastic member 347 as shown in FIG. open.

  The cylindrical body 342 includes a first high-frequency electrode energization line 162 connected to a first high-frequency electrode 110, which will be described later, and a second high-frequency electrode energization line 262 connected to the second high-frequency electrode 210. It is inserted. In addition, the cylindrical body 342 includes a pair of first heating chip energization lines 164 connected to a heating chip 140 which is a heating member described later, and a pair of second heating chip energizations connected to the heating chip 240. Line 264 is inserted.

  A drive rod 344 connected to one of the operation knobs 352 on the base end side is installed inside the cylinder 342 so as to be movable along the axial direction of the cylinder 342. On the distal end side of the drive rod 344, a thin plate-like cutter 345 having a blade formed on the distal end side is installed. When the operation knob 352 is operated, the cutter 345 is moved along the axial direction of the cylindrical body 342 via the drive rod 344. When the cutter 345 moves to the distal end side, the cutter 345 is accommodated in a first cutter guide groove 332 and a second cutter guide groove 334 described later formed in the holding portion 320.

  As shown in FIG. 3, the first holding member 322 has a first cutter guide groove 332 for guiding the cutter 345 described above. The first holding member 322 is provided with a first high-frequency electrode 110 formed of, for example, a copper thin plate. The first high-frequency electrode 110 is configured to come into contact with a living tissue on one main surface (first main surface) thereof. Since the first high-frequency electrode 110 has the first cutter guide groove 332, the planar shape thereof is a U-shape as shown in FIG. As shown in FIG. 2, the first high-frequency electrode 110 is electrically connected to a first high-frequency electrode energization line 162. The first high-frequency electrode 110 is connected to the control device 370 via the first high-frequency electrode energization line 162 and the cable 360.

  As will be described in detail later, a plurality of heat generating chips 140 are joined to the surface (second main surface) of the first high-frequency electrode 110 that does not contact the living tissue. Further, a flexible substrate 150 is disposed on the second main surface for wiring to the heat generating chip 140. The first cover member 120 is disposed so as to cover the heating chip 140, the wiring including the flexible substrate 150, and the first high-frequency electrode 110. The first cover member 120 is made of, for example, resin. A gap between the first high-frequency electrode 110 at the base end and the first cover member 120 is filled with an end sealant 180. This space surrounded by the first high-frequency electrode 110, the first cover member 120, and the end sealant 180 is filled with a sealant 170. The sealant 170 is a substance having an electrical insulating property and a heat insulating property by hardening after filling with a fluid pre-curing substance. In FIG. 2, the cover member 120, the sealant 170, and the end sealant 180 are not shown for simplification of the drawing.

  In this way, the first electrode portion 100 surrounded by the first high-frequency electrode 110 and the first cover member 120 is formed. The first electrode unit 100 is embedded and fixed in a first holding member body 326 having electrical insulation properties and heat insulation properties. A configuration example of the first electrode unit 100 will be described in detail later.

  As shown in FIG. 2, the second holding member 324 has a shape that is symmetric to the first holding member 322 and has the same structure as the first holding member 322. That is, a second cutter guide groove 334 is formed in the second holding member 324 at a position facing the first cutter guide groove 332. Further, the second holding member 324 is provided with a second high-frequency electrode 210 at a position facing the first high-frequency electrode 110. The second high-frequency electrode 210 is configured to come into contact with the living tissue on one main surface thereof. The second high-frequency electrode 210 is connected to the control device 370 via the second high-frequency electrode energization line 262 and the cable 360.

  Further, a heat generating chip 240 similar to the heat generating chip 140 is bonded to the surface of the second high-frequency electrode 210 that does not contact the living tissue. A second cover member similar to the first cover member 120 is provided so as to cover the heat generating chip 240, wiring including a flexible substrate for connection to the heat generating chip 240, and the second high-frequency electrode 210. Has been placed. Base end portions of the second high-frequency electrode 210 and the second cover member are filled with an end sealant. A space between the second high-frequency electrode 210 and the second cover member is filled with a sealant. In this way, the second electrode part 200 surrounded by the second high-frequency electrode 210 and the second cover member 220 is formed. The second electrode unit 200 is embedded and fixed in the second holding member main body 328.

The first electrode unit 100 will be described in detail. The second electrode unit 200 has the same structure as that of the first electrode unit 100, and thus the description of the second electrode unit 200 is omitted.
The heat generating chip 140 will be described with reference to FIGS. 4A and 4B. Here, FIG. 4A is a top view, and FIG. 4B is a cross-sectional view taken along line 4B-4B shown in FIG. 4A. The heat generating chip 140 is formed using an alumina substrate 141. On one surface of the main surface of the substrate 141, a resistance pattern 143 that is a Pt thin film for heat generation is formed. In addition, rectangular electrodes 145 are formed on the surface of the substrate 141 in the vicinity of the two short sides of the rectangle. Here, the electrode 145 is connected to each end of the resistance pattern 143. An insulating film 147 made of, for example, polyimide is formed on the surface of the substrate 141 including the resistance pattern 143 except for the portion where the electrode 145 is formed.

  A bonding metal layer 149 is formed on the entire back surface of the substrate 141. The electrode 145 and the bonding metal layer 149 are multilayer films made of, for example, Ti, Cu, Ni, and Au. The electrodes 145 and the bonding metal layer 149 have stable strength against soldering or the like. For example, the bonding metal layer 149 is provided so that the bonding is stable when the heating chip 140 is soldered to the first high-frequency electrode 110.

  The heat generating chip 140 is disposed on the surface (second main surface) opposite to the surface (first main surface) in contact with the living tissue of the first high-frequency electrode 110. Here, the heat generating chips 140 are fixed by soldering the surface of the bonding metal layer 149 and the second main surface of the first high-frequency electrode 110, respectively. Note that the heating chip 240 fixed to the second high-frequency electrode 210 also has the same structure as the heating chip 140 described above.

  A cross-sectional view schematically showing the flexible substrate 150 is shown in FIG. As shown in this figure, a wiring 151 made of, for example, copper is formed on a substrate 151 made of, for example, polyimide. The wiring 152 is covered with an insulating film 153. However, part of the wiring 152 is not covered with the insulating film 153, and the exposed wiring 152 functions as the electrode 154. The flexible substrate 150 is different in size and shape as necessary, but the basic structure is as described above.

  The first high-frequency electrode 110, the heat generating chip 140 on the first high-frequency electrode 110, and electrical connections related to them will be described with reference to FIGS. 6A and 6B. As shown in FIG. 6A, the planar shape of the first high-frequency electrode 110 is U-shaped so as to form a first cutter guide groove 332. A first wall 112 standing perpendicular to the main surface of the first high-frequency electrode 110 is formed on the outer edge of the U-shape, that is, the edge where the first cutter guide groove 332 is not formed. The first wall 112 is formed by bending the end of the first high-frequency electrode 110. FIG. 6B is a cross-sectional view taken along line 6B-6B shown in FIG. 6A. As shown in this figure, when attention is paid to one of the first cutter guide grooves 332 as a boundary, the cross-sectional shape of the first high-frequency electrode 110 is L-shaped.

  Six heating chips 140 are discretely arranged on the first high-frequency electrode 110. That is, three heat generating chips 140 are arranged in two rows symmetrically with the first cutter guide groove 332 sandwiched from the base end side toward the tip end side. The heating chips 140 arranged in one row (upper row in FIG. 6A) will be referred to as a first heating chip 1401, a second heating chip 1402, and a third heating chip 1403 in order from the base end side. . Similarly, the heat generating chips arranged in the other row (the lower row in FIG. 6A) are referred to as a fourth heat generating chip 1404, a fifth heat generating chip 1405, and a sixth heat generating chip 1406 in order from the base end side. To.

  A flexible substrate 150 is disposed on the first high-frequency electrode 110 in order to connect each heat generating chip 140. First, the flexible substrate 150 is disposed at the base end on the side where the first heat generating chip 1401 is disposed. This flexible substrate 150 is referred to as a first flexible substrate 1501. Similarly, a second flexible substrate 1502 is disposed at the proximal end of the first high-frequency electrode 110 on the side where the fourth heat generating chip 1404 is disposed.

  One of the pair of first heating chip energization lines 164 is electrically connected to the electrode 154 on the proximal end side of the first flexible substrate 1501. Similarly, the other of the pair of first heating chip energization lines 164 is electrically connected to the electrode 154 on the proximal end side of the second flexible substrate 1502. The first high-frequency electrode conducting line 162 is electrically connected to the proximal end portion of the first high-frequency electrode 110.

  The electrode 154 on the distal end side of the first flexible substrate 1501 and the electrode 145 on the proximal end side of the first heat generating chip 1401 are electrically connected by a wire 156 by wire bonding. As described above, the first heat generating chip energization line 164 is electrically connected to the first heat generating chip 1401 via the first flexible substrate 1501. Similarly, the first heating chip energization line 164 is electrically connected to the fourth heating chip 1404 via the second flexible substrate 1502.

  A third flexible substrate 1503 is disposed between the first heat generating chip 1401 and the second heat generating chip 1402 on the first high-frequency electrode 110. An electrode 154 on the proximal end side of the third flexible substrate 1503 and an electrode 145 on the distal end side of the first heat generating chip 1401 are electrically connected by a wire 156 by wire bonding. Similarly, the electrode 154 on the distal end side of the third flexible substrate 1503 and the electrode 145 on the proximal end side of the second heat generating chip 1402 are electrically connected by a wire 156 by wire bonding. Thus, the first heat generating chip 1401 and the second heat generating chip 1402 are electrically connected in series.

  Similarly, a fourth flexible substrate 1504 is disposed between the second heat generating chip 1402 and the third heat generating chip 1403. The second heat generating chip 1402 and the third heat generating chip 1403 are electrically connected in series via the fourth flexible substrate 1504. A fifth flexible substrate 1505 is disposed between the third heat generating chip 1403 and the sixth heat generating chip 1406. The third heat generating chip 1403 and the sixth heat generating chip 1406 are electrically connected in series via the fifth flexible substrate 1505. Similarly, the sixth heat generating chip 1406 and the fifth heat generating chip 1405 are electrically connected in series via the sixth flexible substrate 1506. The fifth heat generating chip 1405 and the fourth heat generating chip 1404 are electrically connected in series via the seventh flexible substrate 1507. As described above, the six heat generating chips 140 are connected in series between the pair of first heat generating chip energization lines 164.

  Each heat generating chip 140 is connected to the control device 370 via a first heat generating chip energization line 164 and a cable 360. The control device 370 controls the power input to the heat generating chip 140. The current output from the control device 370 flows through each resistance pattern 143 of each heat generating chip 140. As a result, each resistance pattern 143 generates heat. When the resistance pattern 143 generates heat, the heat is transmitted to the first high-frequency electrode 110. The living tissue in contact with the first high-frequency electrode 110 is cauterized by this heat.

  A configuration example of the first cover member 120 will be described with reference to FIGS. 7A and 7B. The first cover member 120 includes a plate having a shape equivalent to the outer edge of the first high-frequency electrode 110. A U-shaped second wall 122 perpendicular to the plate is formed on the plate so as to form a first cutter guide groove 332. When attention is paid to one side of the first cutter guide groove 332 as a boundary, the cross-sectional shape of the first cover member 120 is L-shaped. One inlet 125 is provided on the distal end side of the first cover member 120. Two discharge ports 126 are provided on the base end side of the first cover member 120 so as to face each other with the first cutter guide groove 332 interposed therebetween.

  The height of the first wall 112 is equal to the height of the second wall 122. Therefore, when the first high-frequency electrode 110 and the first cover member 120 are combined, the first electrode portion 100 is formed as shown in FIGS. 8A, 8B, and 8C. Here, FIG. 8A is a top view of the first electrode unit 100 viewed from the first cover member 120 side, FIG. 8B is a side view, and FIG. 8C is a line 8C-8C shown in FIG. 8A. FIG. As shown in FIG. 8C, the first high-frequency electrode 110 and the first cover member 120 are combined to form a space including the heat generating chip 140 and the like. That is, paying attention to the cross-sectional shape, a space including the heating chip 140 and the like is formed by the two L-shaped sides of the first high-frequency electrode 110 and the two L-shaped sides of the first cover member 120. .

  When the first high-frequency electrode 110 and the first cover member 120 are combined, the base end thereof is an open end. In this embodiment, the open end is sealed with an end sealant 180. Further, the space surrounded by the first high-frequency electrode 110, the first cover member 120, and the end sealant 180 is filled with the sealant 170.

  In order to efficiently transmit the heat generated in the heat generating chip 140 to the first high-frequency electrode 110, the sealant 170, the first cover member 120, and the first holding member main body 326 therearound are provided with the first high-frequency electrode. It is preferable to have a thermal conductivity lower than that of 110 or the substrate 141. Since the thermal conductivity of the sealant 170, the first cover member 120, and the first holding member main body 326 is low, the heat loss generated in the heat generating chip 140 is reduced.

  A method for forming the sealant 170 will be described. First, the heat generating chip 140 and the flexible substrate 150 are disposed on the first high-frequency electrode 110, and the wire 156 is formed by wire bonding. Further, the first high-frequency electrode energization line 162 is connected to the first high-frequency electrode 110, and the first heating chip energization line 164 is connected to the first flexible substrate 1501 and the second flexible substrate 1502, respectively. .

  Subsequently, the first high-frequency electrode 110 and the first cover member 120 are combined and arranged. Here, the opening portion on the base end side where the first high-frequency electrode energization line 162 and the first heating chip energization line 164 are connected is sealed with the end sealant 180.

  Next, the sealant 170 is formed. The sealant 170 is made of an addition-curing material. Here, the addition-curing type substance is a substance that cures when energy such as heat energy is applied from the outside in a fluid state. That is, in this embodiment, in order to form the sealant 170, a fluid pre-curing substance is injected from the injection port 125 toward the discharge port 126. When the space surrounded by the first high-frequency electrode 110 and the first cover member 120 is filled with the pre-curing substance, the whole including the first high-frequency electrode 110 and the first cover member 120 is heated. . By this heating, the pre-curing substance is cured, and a sealant 170 that seals the space surrounded by the first high-frequency electrode 110 and the first cover member 120 is formed. In addition, the substance before hardening has adhesiveness, and joins the 1st high frequency electrode 110 and the 1st cover member 120, when hardening. By using an addition-curing material, the material before curing is reliably cured by heating, for example.

  The viscosity of the material before curing is preferably 10 Pa · s or less. When the viscosity is higher than 10 Pa · s, there is a possibility that bubbles are mixed without being filled with the pre-curing substance. By being 10 Pa · s or less, the pre-curing substance is easily filled in the space surrounded by the first high-frequency electrode 110 and the first cover member 120 without a gap.

  The sealant 170 seals exposed electrodes such as the heat generating chip 140 and the flexible substrate 150 to make it watertight. Further, the sealant 170 joins the first high-frequency electrode 110 and the first cover member 120. Although the first electrode unit 100 has been described above, the second electrode unit 200 has the same structure as the first electrode unit 100.

  Thus, for example, the first high-frequency electrode 110 and the second high-frequency electrode 210 function as a heat transfer member that contacts the living tissue on the first main surface and transfers heat to the living tissue. For example, the heat generating chip 140 or the heat generating chip 240 functions as a heat generating element that is bonded to the second main surface of the heat transfer member and heats the heat transfer member. For example, the flexible substrate 150, the flexible substrate 250, and the wire 156 function as a wiring member configured to supply power to the heating element. For example, the first cover member 120 and the second cover member function as a cover member that surrounds the heat generating element and the wiring member together with the heat transfer member. For example, the sealant 170 functions as a sealant filled in a space surrounded by the heat transfer member and the cover member.

  Next, the operation of the medical treatment apparatus 300 according to this embodiment will be described. The surgeon operates the input unit of the control device 370 in advance to set the output conditions of the therapeutic treatment device 300, for example, the set power of the high frequency energy output, the target temperature of the heat energy output, the heating time, and the like. In the therapeutic treatment apparatus 300, each value may be set individually, or a set of setting values corresponding to the surgical procedure may be selected.

  The holding part 320 and the shaft 340 of the energy treatment tool 310 are inserted into the abdominal cavity through the abdominal wall, for example. The operator operates the operation knob 352 to open and close the holding unit 320, and grasps the living tissue to be treated by the first holding member 322 and the second holding member 324. At this time, the first main surface of both the first high-frequency electrode 110 provided on the first holding member 322 and the second high-frequency electrode 210 provided on the second holding member 324 is subjected to treatment. Living tissue comes into contact.

  When the operator grasps the biological tissue to be treated by the holding unit 320, the operator operates the foot switch 380. When the foot switch 380 is switched to ON, the first high-frequency electrode 110 and the second high-frequency electrode 210 are preset from the control device 370 via the first high-frequency electrode energization line 162 passing through the cable 360. High frequency power is supplied. The supplied power is, for example, about 20W to 80W. As a result, the living tissue generates heat and the tissue is cauterized. By this cauterization, the tissue is denatured and solidified.

  Next, after stopping the output of the high frequency energy, the control device 370 supplies power to each of the heat generating chips 140 such that the temperatures of the first high frequency electrode 110 and the second high frequency electrode 210 become the target temperatures. Here, the target temperature is 200 ° C., for example. At this time, the current flows from the control device 370 through the resistance pattern 143 of each heat generating chip 140 via the cable 360 and the first heat generating chip conducting line 164. The resistance pattern 143 of each heat generating chip 140 generates heat by current. The heat generated in the resistance pattern 143 is transmitted to the first high-frequency electrode 110 through the substrate 141 and the bonding metal layer 149. As a result, the temperature of the first high-frequency electrode 110 increases.

  Similarly, power is supplied from the control device 370 to the heat generating chip 240 via the cable 360 and the second heat generating chip energization line 264, and the heat generating chip 240 generates heat. Due to the heat generated in the heat generating chip 240, the temperature of the second high-frequency electrode 210 rises.

  The biological tissue in contact with the first high-frequency electrode 110 or the second high-frequency electrode 210 is further cauterized and further solidified by these heats. When the living tissue is solidified by heating, the output of thermal energy is stopped. Finally, the operator operates the operation knob 352 to move the cutter 345 and cut the living tissue. The treatment of the living tissue is thus completed.

  According to this embodiment, the sealing agent 170 having adhesiveness insulates and seals the heat generating chip 140, the flexible substrate 150, and the like, and bonds the first high-frequency electrode 110 and the first cover member 120 together. By reliably insulating and sealing the heat generating chip 140, the flexible substrate 150, and the like, the durability of the energy treatment device 310 is improved, and the energy treatment device 310 can operate accurately. In addition, the first high-frequency electrode 110 and the first cover member 120 are bonded by the sealant 170, so that the sealing process and the bonding process of the first high-frequency electrode 110 and the first cover member 120 are performed. Can be the same step. As a result, the work efficiency at the time of manufacture is good.

  The space in which the heat generating chip 140 and the flexible substrate 150 are arranged and filled with the sealant 170 includes the first high-frequency electrode 110 having an L-shaped cross-sectional shape and the first cover member 120 having an L-shaped cross-sectional shape. It is formed by combining. By adopting such a structure, it is not necessary to use a special joining member other than the first high-frequency electrode 110 and the first cover member 120.

  The first high-frequency electrode 110 has a first wall 112 formed by bending, and its cross-sectional shape is L-shaped. For this reason, the 1st high frequency electrode 110 has rigidity compared with the case where the 1st wall 112 is not formed. Therefore, it is easy to handle the first high-frequency electrode 110 in the manufacturing process. Since the first wall 112 can be formed by bending a copper plate, it is easier to form the first wall 112 on the outer peripheral side than on the first cutter guide groove 332 side. When the first wall 112 is provided on the first cutter guide groove 332 side, it is difficult to form the first wall 112 by bending because there is not enough material in the first cutter guide groove 332 portion.

  On the other hand, the first cover member 120 is made of resin. Resins are relatively easy to form in various shapes. For this reason, when the resin is used, it is relatively easy to form the first cover member 120 having a shape as shown in FIG. 7B.

  By providing the inlet 125 and the outlet 126 in the first cover member 120, the space formed by the first high-frequency electrode 110 and the first cover member 120 is uniformly filled with the sealant 170. Can be done efficiently. The inlet 125 and the outlet 126 are located at the top when the first electrode unit 100 is placed with the first high-frequency electrode 110 as a bottom surface. Therefore, the first high-frequency electrode 110 can be left as a bottom so that the pre-curing substance does not drip until the sealant 170 is cured. Therefore, the positions of the inlet 125 and the outlet 126 are convenient in manufacturing the first electrode unit 100.

  Note that the flexible substrate 150 may be changed to a hard substrate such as a glass epoxy substrate. Without using the wires 156, the heat generating chips 140 can be electrically connected using a flexible substrate and bumps, a flexible substrate and solder, a flexible substrate and conductive paste, or the like. Further, a thermosetting substance may not be used for the sealant 170. For example, an ultraviolet curable material can be used for the sealant 170. In this case, for example, the sealant 170 can be formed by forming the first cover member 120 from a transparent material, and irradiating with ultraviolet rays after filling the material before curing. As described above, various materials can be used for the sealant 170. Further, the shape of the first high-frequency electrode 110 shown in the description of the present embodiment and the arrangement of the heat generating chip 140 and the flexible substrate 150 on the first high-frequency electrode 110 are arbitrary.

[Second Embodiment]
A second embodiment will be described. Here, differences from the first embodiment will be described, and the same portions will be denoted by the same reference numerals and description thereof will be omitted. In the present embodiment, the structures of the first electrode unit 100 and the second electrode unit 200 are different from the structures of the first electrode unit 100 and the second electrode unit 200 according to the first embodiment. Also in this embodiment, the structure of the first electrode unit 100 and the structure of the second electrode unit 200 are the same as each other. Therefore, the structure of the first electrode unit 100 will be described as an example.

  FIG. 9 shows a sectional view corresponding to FIG. 8C of the first electrode unit 100 according to the present embodiment. As shown in this figure, the first high-frequency electrode 110 according to the present embodiment does not have the first wall 112 and has a flat plate shape. On the other hand, the first cover member 120 according to the present embodiment forms the first wall 123 that forms the outer peripheral side surface of the first electrode unit 100 and the inner side surface that forms the first cutter guide groove 332. Second wall 124. That is, when attention is paid to one side of the first cutter guide groove 332 as a boundary, the first high-frequency electrode 110 has an I-shaped cross-sectional shape, and the first cover member 120 has a U-shaped cross-sectional shape. have. A space including the heat generating chip 140 is formed by one I-shaped side of the first high-frequency electrode 110 and three U-shaped sides of the first cover member 120. Also in this embodiment, this space surrounded by the first high-frequency electrode 110 and the first cover member 120 is filled with the sealing agent 170. Other configurations are the same as those in the first embodiment.

  According to this embodiment, the same effect as that of the first embodiment can be obtained. That is, by filling and curing the sealing agent 170 having adhesive properties from the inlet 125 to the outlet 126, the first high-frequency electrode 110 and the first high-frequency electrode 110 can be cured without using a special bonding member. Reliable sealing and joining with the cover member 120 can be efficiently performed in the same process. As a result, high durability and accurate operation of the energy treatment tool 310 are realized. In addition, since the first high-frequency electrode 110 is a simple flat plate, it is easier to manufacture the first high-frequency electrode 110 than in the first embodiment.

[Modification of Second Embodiment]
Only a different part from the second embodiment will be described as a modification of the second embodiment. FIG. 10 shows a sectional view corresponding to FIG. 9 of the first electrode unit 100 according to this modification. As shown in this figure, the first high-frequency electrode 110 according to this embodiment forms a first wall 113 that forms the outer peripheral side surface of the first electrode unit 100 and a first cutter guide groove 332. And a second wall 114 forming an inner side surface. On the other hand, the first cover member 120 according to the present embodiment has a flat plate shape. That is, when attention is paid to one side of the first cutter guide groove 332 as a boundary, the first high-frequency electrode 110 has a U-shaped cross-sectional shape, and the first cover member 120 has an I-shaped cross-sectional shape. have. A space including the heat generating chip 140 is formed by the three U-shaped sides of the first high-frequency electrode 110 and the I-shaped one side of the first cover member 120. Also in the present embodiment, the space surrounded by the first high-frequency electrode 110 and the first cover member 120 is filled with the sealing agent 170. Other configurations are the same as those in the second embodiment. According to this modification, it is easier to manufacture the first cover member 120 than in the first embodiment.

  The first high-frequency electrode 110 and the first cover member 120 have different functions. For example, the first high-frequency electrode 110 is required to have high thermal conductivity, and the first cover member 120 is required to have low thermal conductivity. The optimum material used for the first high-frequency electrode 110 and the first cover member 120 differs depending on the function. The processing methods that can be used for manufacturing differ depending on the material. Therefore, the one that can use a more complicated processing method of the first high-frequency electrode 110 and the first cover member 120 is formed into a U-shape, and the other is formed into an I-shape. Can be easily manufactured.

[Third Embodiment]
A third embodiment will be described. Here, differences from the first embodiment will be described, and the same portions will be denoted by the same reference numerals and description thereof will be omitted. In this embodiment, the material of the sealing agent 170 is different from that in the first embodiment. That is, the sealing agent 170 according to the present embodiment is formed by curing a pre-curing substance having condensation-curing adhesiveness.

  The condensation curing type pre-curing substance is cured by reacting with moisture in the air. Therefore, by using the condensation-curing type pre-curing substance, the cured sealant 170 can be formed simply by allowing the pre-curing substance to stand at room temperature. That is, by using a condensation-curing type pre-curing substance, a step for curing the pre-curing substance such as heating can be omitted. On the other hand, the condensation-curing type pre-curing substance is hard to be cured at a portion that does not come into contact with air. Therefore, in order to sufficiently cure the material before curing, in the present embodiment, a plurality of openings 128 smaller than the inlet 125 and the outlet 126 are formed in the first cover member 120 as shown in FIG. In particular, the opening 128 is formed immediately above the heat generating chip 140.

  According to the present embodiment, by using a condensation-curing type pre-curing substance for forming the sealant 170, the pre-curing substance is placed in the space surrounded by the first high-frequency electrode 110 and the first cover member 120. The sealant 170 can be formed simply by filling and allowing to stand at room temperature. Therefore, the process for hardening can be reduced compared with the case of using an addition hardening type pre-hardening substance. In addition, by forming the plurality of openings 128, it is possible to form the sealing agent 170 which is surrounded by the first high-frequency electrode 110 and the first cover member 120 with high hermeticity and cured to the inside even in the space. it can. Further, the formation time of the sealant 170, that is, the curing time can be shortened.

  In addition, since the surface layer of the flexible substrate 150 is sealed with an insulating layer, it is particularly necessary to seal the electrode 145 of the heat generating chip 140, the electrode 154 of the flexible substrate 150, and the wire 156. Since the opening 128 is formed immediately above the heat generating chip 140, the sealant 170 can be reliably and effectively cured at a portion where the necessity of sealing is particularly high.

[Fourth Embodiment]
A fourth embodiment will be described. Here, differences from the first embodiment will be described, and the same portions will be denoted by the same reference numerals and description thereof will be omitted. FIG. 12 shows a cross-sectional view corresponding to FIG. 8C of the first electrode unit 100 according to this embodiment. As shown in this figure, in the present embodiment, the first high-frequency electrode 110 and the first cover member 120 are bonded together by an adhesive 132 applied to the joint portion.

  If there is a slight gap at the joint between the first high-frequency electrode 110 and the first cover member 120, the pre-curing substance with low viscosity forming the sealant 170 may leak out. According to this embodiment, this leakage can be prevented.

  A manufacturing process of the first electrode unit 100 according to this embodiment will be described. First, the adhesive 132 is applied to the joint portion between the first high-frequency electrode 110 and the first cover member 120 on which the heat generating chip 140 and the like are disposed, and the adhesive 132 is cured by combining both members. Next, the open part on the proximal end side of the first electrode part 100 is sealed with an end sealant 180. Next, a material before curing of the sealant 170 is filled from the inlet 125 toward the outlet 126 to cure the sealant 170.

  The adhesive 132 used in the present embodiment is preferably an epoxy adhesive. This is because epoxy adhesives have stronger adhesive strength than silicone adhesives. On the other hand, a silicone-based sealant is preferably used for the sealant 170. Silicone sealants have a certain degree of flexibility even after curing. For this reason, it is prevented that the 1st electrode part 100 is fixed by the abnormal shape by using a silicone type sealing agent. For example, the volume of epoxy sealants decreases after curing. Therefore, when an epoxy-based sealant is used for the sealant 170, the volume of the first electrode part 100 after curing is reduced in an abnormally deformed state because the volume is reduced at the time of curing after filling with the material before curing. There is a risk that.

  According to this modification, it is possible to prevent the pre-curing substance of the sealant 170 from leaking from the gap between the first high-frequency electrode 110 and the first cover member 120. In the step of bonding the first high-frequency electrode 110 and the first cover member 120 by making the viscosity of the adhesive 132 before curing higher than the viscosity of the pre-curing material forming the sealant 170, it is unnecessary. Problems due to the adhesive 132 protruding from the portion can be prevented.

[Fifth Embodiment]
A fifth embodiment will be described. Here, differences from the first embodiment will be described, and the same portions will be denoted by the same reference numerals and description thereof will be omitted. FIG. 13 shows a cross-sectional view corresponding to FIG. 8C of the first electrode unit 100 according to this embodiment. As shown in this figure, the first high-frequency electrode 110 and the first cover member 120 according to the present embodiment are each provided with a step at a portion where they are in contact with each other. These steps have complementary shapes. That is, these steps are engaged. More specifically, the step 119 of the first electrode unit 100 protrudes outside the space surrounded by the first high-frequency electrode 110 and the first cover member 120, and the first cover member 120. The step 129 protrudes from the inside of the space surrounded by the first high-frequency electrode 110 and the first cover member 120.

  According to the present embodiment, it is possible to suppress leakage of the pre-curing substance of the sealant 170 from the contact portion between the first high-frequency electrode 110 and the first cover member 120. The first high-frequency electrode 110 is made of a metal material such as copper, and the first cover member 120 is made of a resin material, for example. In general, the resin material has a larger thermal expansion coefficient than the metal material. For this reason, by providing the convex portion of the step of the first high-frequency electrode 110 on the outer surface side and providing the convex portion of the step of the first cover member 120 on the inner surface side, it is possible that both of them peel due to deformation due to thermal expansion. Can be prevented.

  Note that the present invention is not limited to the above-described embodiment as it is, and can be embodied by modifying the constituent elements without departing from the scope of the invention in the implementation stage. In addition, various inventions can be formed by appropriately combining a plurality of components disclosed in the embodiment. For example, even if some constituent elements are deleted from all the constituent elements shown in the embodiment, the problem described in the column of problems to be solved by the invention can be solved and the effect of the invention can be obtained. The configuration in which this component is deleted can also be extracted as an invention.

  DESCRIPTION OF SYMBOLS 100 ... 1st electrode part, 110 ... 1st high frequency electrode, 112 ... 1st wall, 113 ... 1st wall, 114 ... 2nd wall, 119 ... Level | step difference, 120 ... 1st cover member, 122 2nd wall, 123 ... 1st wall, 124 ... 2nd wall, 125 ... injection port, 126 ... discharge port, 128 ... opening, 129 ... step, 132 ... adhesive, 140 ... heating chip, 141 ... Substrate, 143 ... resistance pattern, 145 ... electrode, 147 ... insulating film, 149 ... bonding metal layer, 150 ... flexible substrate, 151 ... substrate, 152 ... wiring, 153 ... insulating film, 154 ... electrode, 156 ... wire, 162 ... First high-frequency electrode energization line, 164 ... first heating chip energization line, 170 ... sealant, 180 ... end sealant, 200 ... second electrode part, 210 ... second high-frequency electrode 220: Second cover member 240 ... exothermic chip, 250 ... flexible substrate, 262 ... second energizing line for high frequency electrodes, 264 ... second energizing line for exothermic chip, 300 ... treatment device for treatment, 310 ... energy treatment device, 320 ... holding part, 322 ... 1st holding member, 324 ... 2nd holding member, 326 ... 1st holding member main body, 328 ... 2nd holding member main body, 332 ... 1st cutter guide groove, 334 ... 2nd cutter guide Groove, 340 ... shaft, 342 ... cylinder, 343 ... sheath, 344 ... drive rod, 345 ... cutter, 346 ... support pin, 347 ... elastic member, 350 ... handle, 352 ... operation knob, 360 ... cable, 365 ... connector 370 ... Control device, 380 ... Foot switch.

Claims (15)

A therapeutic treatment apparatus for heating and treating living tissue,
A heat transfer member that contacts the living tissue on the first main surface of the first main surface and the second main surface forming the front and back surfaces and transfers heat to the living tissue;
A heating element joined to the second main surface and heating the heat transfer member;
A wiring member configured to supply power to the heating element;
In combination with the heat transfer member, a cover member surrounding the heat generating element and the wiring member together with the heat transfer member;
A sealant filled in a space surrounded by the heat transfer member and the cover member;
A therapeutic treatment apparatus comprising: The cross-sectional shape of the portion where the heat transfer member and the cover member are combined is as follows:
The heat transfer member has an L-shape;
The cover member is L-shaped;
The space is formed by the two L-shaped sides of the heat transfer member and the two L-shaped sides of the cover member.
The therapeutic treatment device according to claim 1. The planar shape of the heat transfer member is U-shaped,
The cross-sectional shape of the heat transfer member is the L shape having a side wall on the outer peripheral side of the U shape.
The therapeutic treatment device according to claim 2. The cross-sectional shape of the portion where the heat transfer member and the cover member are combined is as follows:
The heat transfer member has an I-shape;
The cover member is U-shaped;
The I-shaped one side of the heat transfer member and the U-shaped three sides of the cover member form the space.
The therapeutic treatment device according to claim 1. The cross-sectional shape of the portion where the heat transfer member and the cover member are combined is as follows:
The heat transfer member is U-shaped,
The cover member is I-shaped;
The space is defined by the three U-shaped sides of the heat transfer member and the I-shaped one side of the cover member.
The therapeutic treatment device according to claim 1.   The treatment apparatus according to any one of claims 1 to 5, wherein the sealant is an addition-curing substance.   The therapeutic treatment apparatus according to any one of claims 1 to 5, wherein the sealant is a condensation curable substance.   The therapeutic treatment apparatus according to claim 7, wherein the cover member has an opening.   The therapeutic treatment device according to claim 8, wherein the opening is formed corresponding to the heating element.   The therapeutic treatment apparatus according to any one of claims 1 to 9, wherein a viscosity of the sealant before curing is 10 Pa · s or less.   The therapeutic treatment apparatus according to any one of claims 1 to 10, wherein a portion where the heat transfer member and the cover member come into contact with each other is bonded with an adhesive.   The therapeutic apparatus according to any one of claims 1 to 10, wherein the sealant has adhesiveness.   13. A step having a shape complementary to each other is provided in the heat transfer member and the cover member at a portion where the heat transfer member and the cover member are in contact with each other. The therapeutic treatment apparatus of any one of them.   The therapeutic treatment device according to any one of claims 1 to 13, wherein the sealant is a silicone sealant.   The therapeutic treatment device according to claim 11, wherein the adhesive is an epoxy adhesive.

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