JP2013106909A - Therapeutic treatment apparatus - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a therapeutic treatment apparatus which is excellent in heat conductivity and makes temperature distribution of a high frequency electrode uniform.SOLUTION: Heat generating chips are arranged on a first high frequency electrode 110. The heat generating chips are connected serially between a pair of electricity conducting lines 164 for the first heat generating chip and generates heat when supplied with power to heat the first high frequency electrode 110. A conductive coating 132 connected to an electricity conducting line 162 for the first high frequency electrode is formed on a first cover member 120. When the first high frequency electrode 110 and the first cover member 120 are assembled together, the conductive coating 132 contacts a tab 114 of the first high frequency electrode 110 and the conducting coating and the tab are conducted. By making thermal resistance of the conductive coating 132 sufficiently high, heat generated by the heat generating chips is prevented from flowing out from the electricity conducting line 162 for the first high frequency electrode.

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

  The high-frequency power line for supplying high-frequency power to the above-described high-frequency electrode is formed of a conductive material having a thickness that can withstand a high voltage to be supplied. When the high-frequency power line is directly connected to the high-frequency electrode, heat generated in the heat generating chip can flow out of the high-frequency power line through the high-frequency electrode when the living tissue is heated. That is, the thermal efficiency of the therapeutic treatment apparatus may be deteriorated, and the temperature of the high-frequency electrode may be uneven depending on the location.

  Therefore, an object of the present invention is to provide a therapeutic treatment apparatus that has high thermal efficiency and a uniform temperature distribution of the high-frequency electrode.

  In order to achieve the above object, according to one aspect of the present invention, a therapeutic treatment apparatus is a therapeutic treatment apparatus for treating a living tissue by applying energy to the first and second main surfaces. A conductive high-frequency electrode for applying a high-frequency voltage to the living tissue and heating the living tissue in contact with the living tissue on the first main surface of the second main surface; A heating element that is joined to the main surface and heats the high-frequency electrode, an insulating cover member that surrounds the heating element together with the high-frequency electrode, and at least a portion is formed on the cover member, and is electrically connected to the high-frequency electrode. Insulating property between the connected conductive part and the high-frequency electrode is ensured and electrically connected to the conductive part, and a high-frequency power line that supplies a high-frequency current to the high-frequency electrode through the conductive part; It is characterized by having To.

  According to the present invention, since the high-frequency power line supplies power to the high-frequency electrode through the conductive portion, it is possible to provide a therapeutic treatment apparatus that has high thermal efficiency and uniform temperature distribution of the high-frequency electrode.

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 concerning 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. The disassembled perspective view which shows the structural example of the 1st electrode part which concerns on the 1st Embodiment of this invention. The disassembled perspective view which shows the structural example of the 1st electrode part which concerns on the 1st Embodiment of this invention. The perspective view which shows the structural example of the 1st electrode part which concerns on the 1st Embodiment of this invention. The perspective view which shows the structural example of the 1st electrode part which concerns on the 1st Embodiment of this invention. The figure for demonstrating the heat flow in a conductive coating. The perspective view which shows the structural example of the 1st electrode part which concerns on the 2nd Embodiment of this invention. The disassembled perspective view which shows the structural example of the 1st electrode part which concerns on the 2nd Embodiment of this invention. The disassembled perspective view which shows the structural example of the 1st electrode part which concerns on the 3rd Embodiment of this invention. The perspective view which shows the structural example of the 1st cover member which concerns on the 3rd Embodiment of this invention. The disassembled perspective view which shows the structural example of the 1st electrode part which concerns on the 3rd Embodiment of this invention. The disassembled perspective view which shows the structural example of the 1st electrode part which concerns on the 4th 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. The control device 370 controls the operation of each part of the therapeutic treatment device 300. Note that the control device 370 acquires information related to the energy treatment tool 310 from a nonvolatile memory provided in the handle 350.

  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 that supplies power to a first high-frequency electrode 110, which will be described later, and a second high-frequency electrode energization line 262 that supplies power to the second high-frequency electrode 210. And are inserted. Further, the cylindrical body 342 includes a pair of first heating chip energization lines 164 for supplying power to a heating chip 140 which is a heating member described later, and a pair of second heating chips for supplying power to the heating chip 240. The energization line 264 for use 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 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 and has electrical insulation. The main surface of the first cover member 120 that faces the first high-frequency electrode 110 is referred to as a third main surface, and the back side of the third main surface is referred to as a fourth main surface. The third main surface of the first cover member 120 is provided with a conductive coating 132 that comes into contact with the first high-frequency electrode 110 as will be described later. A first high-frequency electrode energization line 162 is connected to the conductive coating 132 by, for example, soldering. As a result, the first high-frequency electrode 110 is connected to the control device 370 via the conductive coating 132, the first high-frequency electrode energization line 162, and the cable 360.

  A space surrounded by the first high-frequency electrode 110 and the first cover member 120 is filled with a sealant 170. In FIG. 2, the first cover member 120 and the sealant 170 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 a second high-frequency electrode energization line 262, a conductive coating, and a 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. 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.

  Configuration examples of the first high-frequency electrode 110 and the first cover member 120 will be described with reference to FIGS. 5 and 6. FIG. 5 is an exploded perspective view of the first electrode unit 100 including the first high-frequency electrode 110 and the first cover member 120 as viewed from the fourth main surface side of the first cover member 120. FIG. 6 is an exploded perspective view of the first electrode unit 100 including the first high-frequency electrode 110 and the first cover member 120 as viewed from the first main surface side of the first high-frequency electrode 110. As shown in these drawings, the planar shapes of the first high-frequency electrode 110 and the first cover member 120 are U-shaped so as to form the first cutter guide groove 332. The first high-frequency electrode 110 is provided with a wall 112 on the second main surface side so as to surround the outer periphery thereof. The wall 112 is formed by bending the end of the first high-frequency electrode 110. However, the wall 112 is not provided on the base end side of the first high-frequency electrode 110. In addition, a claw 114 that is a protrusion is provided on the wall 112 at the tip of the first high-frequency electrode 110.

  On the other hand, the first cover member 120 is U-shaped like the first high-frequency electrode 110. Here, the planar shapes of the first cover member 120 and the first high-frequency electrode 110 are substantially equal, and the lengths from the proximal end to the distal end are substantially equal to each other. The first cover member 120 is provided with a first wall 122 on the third main surface facing the first high-frequency electrode 110 so as to surround the outer periphery thereof. Further, the first cover member 120 is provided with a second wall 124 so as to surround the inner periphery thereof. The second wall 124 forms a first cutter guide groove 332, and the second walls 124 facing each other across the first cutter guide groove 332 are connected to each other at the end portion on the fourth main surface side. ing. Neither the first wall 122 nor the second wall 124 is provided on the base end side of the first cover member 120. Further, a notch portion 126 in which the claw 114 is accommodated is provided at the distal end portion of the first cover member 120.

  On the first main surface of the first high-frequency electrode 110, six heat generating chips 140 are discretely arranged as shown in FIG. 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. A flexible substrate 150 is arranged on the first main surface of the first high-frequency electrode 110 so as to avoid the heat generating chip 140. The flexible substrate 150 is provided with electrodes 152 so as to connect the electrodes 145 of adjacent heat generating chips. The electrode 145 of the heat generating chip 140 and the electrode 152 of the flexible substrate 150 facing the electrode 145 are electrically connected by a wire 156 formed by wire bonding. As described above, the six heat generating chips 140 are electrically connected in series.

  Electrodes 154 are also formed on the flexible substrate 150 on the further proximal sides of the two heat generating chips 140 that are opposed to each other with the first cutter guide groove 332 disposed on the most proximal side. The two electrodes 154 are also electrically connected to the electrodes 145 of the adjacent heat generating chips 140 by wires 156 formed by wire bonding. Further, each of the pair of first heat generating chip energization lines 164 is connected to the two electrodes 154 using, for example, solder. Therefore, 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.

  As shown in FIG. 6, a conductive coating 132 is provided on the third main surface of the first cover member 120. The conductive coating 132 is made of, for example, conductive plating or conductive resin. The conductive coating 132 is thinner than the first cover member 120. The conductive coating 132 is formed from the proximal end to the distal end of the first cover member 120. The tip portion of the conductive coating 132 is disposed so as to come into contact with the claw 114 of the first high-frequency electrode 110 when the first cover member 120 is assembled by being covered with the first high-frequency electrode 110. . A first high-frequency electrode conducting line 162 is connected to the proximal end portion of the conductive coating 132 by, for example, soldering. As a result, the first high-frequency electrode 110 is connected to the control device 370 via the conductive coating 132, the first high-frequency electrode energization line 162, and the cable 360.

  The first electrode unit 110 is manufactured as follows. The first high-frequency electrode 110 is provided with a heat generating chip 140, a flexible substrate 150, a wire 156, a first heat generating chip energization line 164, and the like. The first cover member 120 is provided with a conductive coating 132, a first high-frequency electrode energization line 162, and the like. Thereafter, the first high-frequency electrode 110 and the first cover member 120 are combined.

  FIG. 7 is a perspective view of the first electrode unit 100 as viewed from the front end side of the first cover member 120 when the first cover member 120 is combined with the first high-frequency electrode 110. A perspective view seen from the end side is shown in FIG. As shown in these drawings, the height from the third main surface of the wall 112 of the first high-frequency electrode 110 and the second wall 124 of the first cover member 120 is substantially equal. As a result, the second main surface and the third main surface face each other substantially in parallel, and are surrounded by the first high-frequency electrode 110, the wall 112, the first cover member 120, and the second wall 124. Thus, a space including the heat generating chip 140 and the like is formed. Note that the first wall 122 of the first cover member 120 is positioned outside the wall 112 of the first high-frequency electrode 110. Further, the claw 114 of the first high-frequency electrode 110 fits in the notch 126 of the first cover member 120. The conductive coating 132 is in contact with the claw 114 of the first high-frequency electrode 110 and is conductive. It is assumed that the conductive coating 132 is not in contact with anything other than the first cover member 120, the claw of the first high-frequency electrode 110, and the first high-frequency electrode conducting line 162. Further, the first high-frequency electrode energization line 162 is located in a space surrounded by the first high-frequency electrode 110 and the first cover member 120 except for a portion connected to the conductive coating 132. Absent.

  After the first high-frequency electrode 110 and the first cover member 120 are combined, the space surrounded by the first high-frequency electrode 110 and the first cover member 120 is filled with the sealant 170. . For the sealant 170, for example, a thermosetting substance is used. In this case, a space that is surrounded by the first high-frequency electrode 110 and the first cover member 120 is filled with a substance that is a source of the fluid sealing agent 170 and is then heat-treated to be sealed. Is formed. The sealant 170 seals exposed electrodes such as the heat generating chip 140 and the flexible substrate 150 to make it watertight. In this way, the first electrode unit 100 is formed.

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 and is transmitted to the living tissue with high efficiency. .
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 conductive high-frequency electrodes that apply a high-frequency voltage to the living tissue and heat the living tissue. For example, the heat generating chip 140 and the heat generating chip 240 function as heat generating elements that heat the high-frequency electrode. For example, the first cover member 120 and the second cover member 220 function as an insulating cover member that surrounds the heating element together with the high-frequency electrode. For example, at least a part of the conductive coating 134 is formed on the cover member and functions as a conductive portion that is electrically connected to the high-frequency electrode. For example, the first high-frequency electrode energization line 162 and the second high-frequency electrode energization line 262 function as a high-frequency power line that supplies a high-frequency current to the high-frequency electrode through the conductive portion. For example, the sealant 170 functions as an insulating member having a lower thermal conductivity than the high-frequency electrode filled between the conductive portion and the high-frequency power line and the high-frequency electrode.

  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, power is supplied from the control device 370 to the first electrode unit 100 via the first high-frequency electrode energization line 162 passing through the cable 360, and the second high-frequency electrode use Electric power is supplied to the second electrode unit 200 through the energization line 262. As a result, the high frequency power of the preset power is supplied to the first high frequency electrode 110 through the conductive coating 134. Similarly, high-frequency power of a preset power is supplied to the second high-frequency electrode 210. 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 the present embodiment, the first high-frequency electrode 110 and the first high-frequency electrode conducting line 162 are connected via the conductive coating 132, so that the first high-frequency electrode 110 and the first high-frequency electrode use line are connected. Heat flow to the energization line 162 can be suppressed.

This heat flow will be described. The temperature T1 of the _first high-frequency electrode 110 is a predetermined value determined according to, for example, a surgical procedure. In order to reduce the amount of heat flowing out from the first electrode portion 100 via the first high-frequency electrode energization line 162, the thermal conductivity, length, etc. of the first high-frequency electrode energization line 162 are determined. In this case, it is necessary to reduce the temperature difference between both ends of the first high-frequency electrode energization line 162. That is, the temperature T ₂ of the connection portion of the conductive coating 132 and the first high-frequency electrode energization line 162, the other end of the temperature of the first high-frequency electrode energization line 162, for example, it is preferable to room temperature.

  Since the conductive coating 132 has a high temperature on the side in contact with the first high-frequency electrode 110 and a low temperature on the side to which the first high-frequency electrode conducting line 162 is connected, the heat is applied to the first high-frequency electrode 110. The current flows from the contact side to the side where the first high-frequency electrode energization line 162 is connected. The amount of heat Q per unit length moving through the conductive coating 132 is represented by Q = A · q where A is the cross-sectional area of the conductive coating 132 and q is the heat flux. In order to reduce the amount of heat Q that moves through the conductive coating 132, the cross-sectional area A or the heat flux q of the conductive coating 132 may be reduced.

The heat flow in the conductive coating 132 will be described with reference to FIG. An x-axis is defined along the length of the conductive coating 132. Let L be the length of the conductive coating 132. The x coordinate of one end of the conductive coating 132 is a, and the x coordinate of the other end is b. a temperature of _{T 1} in x = a, the temperature at x = b and _{T 2.} Here, T ₁ > T ₂ .

また、熱伝導のフーリエの法則は下記式（２）で表される。

ここで、ｑは熱流束、λは熱伝導率を表す。 At this time, the temperature T at an arbitrary position between x = a and x = b is expressed by the following formula (1).

In addition, Fourier's law of heat conduction is expressed by the following formula (2).

Here, q represents heat flux and λ represents thermal conductivity.

導電性コーティング１３２内の熱流束ｑを小さくするためには、上述のとおり温度Ｔ_２及び温度Ｔ_１が所定の値であるとすると、上記式（３）より、導電性コーティング１３２の材質によって決まる熱伝導率λを小さくするか、導電性コーティング１３２の長さＬを大きくすることが好ましい。 That is, the following formula (3) is established.

In order to reduce the heat flux q conductive coating 132, when the temperature T ₂ and temperatures T ₁ as described above is assumed to be a predetermined value, from the formula (3), depends on the material of conductive coating 132 It is preferable to decrease the thermal conductivity λ or increase the length L of the conductive coating 132.

  As described above, in order to reduce the amount of heat that moves through the conductive coating 132, the cross-sectional area A of the conductive coating 132 is reduced, or a material having a low thermal conductivity λ is used as a material for forming the conductive coating 132. It is preferable to increase the length L of the conductive coating 132. That is, it is preferable that the thermal resistance, which is difficult to transmit heat, is high. In this embodiment, in order to reduce the cross-sectional area A, the conductive coating 132 is a thin film. Further, in order to increase the length L of the conductive coating 132, the conductive coating 132 contacts the first high-frequency electrode 110 on the distal end side of the first cover member 120, and the proximal end of the first cover member 120. It is connected to the first high-frequency electrode energization line 162 on the side. As long as the conductive coating 132 having a sufficient length is provided and is in contact with the first high-frequency electrode, the conductive coating 132 may have any shape and arrangement.

  According to the present embodiment, by reducing the cross-sectional area A of the conductive coating 132 and increasing the length L, the thermal resistance of the conductive coating 132 can be increased, and the heat flow can be retained in the conductive coating 132. it can. Thus, the conductive coating 132 has a higher thermal resistance than the first high-frequency electrode energization line 162.

  According to this embodiment, the heat of the first high-frequency electrode 110 can be efficiently transmitted to the living tissue. That is, an energy efficient therapeutic treatment device can be realized. In addition, the configuration of the present embodiment is also effective in making the heat distribution of the first high-frequency electrode 110 uniform. That is, when the heat flows out from the first high-frequency electrode energization line 162, the temperature of the first high-frequency electrode 110 is locally lowered at the portion where the first high-frequency electrode energization line 162 is connected. Can be prevented.

  The present embodiment is also effective in the step of connecting the first high-frequency electrode energization line 162 to the conductive coating 132 at the time of manufacturing the therapeutic treatment apparatus by solder. In other words, since the conductive coating 132 has a low thermal conductivity, it quickly reaches a high temperature during soldering, so that the soldering operation time can be shortened.

  In the present embodiment, the conductive coating 132 is formed on the third main surface of the first cover member 120, but may be formed on other portions. For example, it may be formed on the second wall 124. Further, the conductive coating 132 may be formed on a fourth main surface that forms a front and back surface with the third main surface. Also in these cases, the conductive coating 132 is electrically connected to the first high-frequency electrode 110, and the first high-frequency electrode conducting line 162 is connected to the conductive coating 132. The conductive coating 132 may not be in direct contact with the first high-frequency electrode 110, and the conductive coating 132 and the first high-frequency electrode 110 may be connected via a conductor. In this case, if the conductive coating 132 and the conductor are combined and have a sufficiently large thermal resistance as described above, the same effect as in the present embodiment can be obtained. However, the insulating property of the conductive coating 132, the insulating property of the first high-frequency electrode conducting line 162 and the conductive coating 132, the shape of the first electrode unit 100, the ease of manufacture, etc. In consideration, as in the first embodiment, the conductive coating 132 is preferably formed on the third main surface.

  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. Further, the sealant 170 may be a fluid having low thermal conductivity such as air or silicone oil. In addition, the shape of the first high-frequency electrode 110 and the arrangement of the heat generating chip 140 and the flexible substrate 150 on the first high-frequency electrode 110 shown in the description of the present embodiment are examples, and 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. 10 is a perspective view showing the first electrode unit 100 according to this embodiment. As shown in this figure, the length in the longitudinal direction of the first high-frequency electrode 110 according to this embodiment is a length L1. On the other hand, the length of the first cover member 120 in the longitudinal direction is a length L2 that is longer than the length L1 by S.

  FIG. 11 shows an exploded perspective view of the first electrode member 100 as viewed from the third main surface side of the first cover member 120. As shown in this figure, the first high-frequency electrode conducting line 162 is connected to the conductive coating 132 in the portion of the length S of the first cover member 120 that protrudes because it is longer than the first high-frequency electrode 110. Has been. Further, the portion where the first high-frequency electrode energization line 162 is connected to the conductive coating 132 is covered with an insulating material to ensure electrical insulation from other members. The configuration of other parts is the same as that of the first embodiment.

  According to the present embodiment as described above, the length of the conductive coating 132 can be sufficiently secured, and the heat flux of the conductive coating 132 can be sufficiently reduced. Further, the heat flow flowing from the first high-frequency electrode 110 to the first high-frequency electrode energization line 162 through the sealant 170 can be reduced. As a result, the same effect as that of the first embodiment can be obtained.

[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 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.

  In the first embodiment, the flexible substrate 150 disposed on the second main surface of the first high-frequency electrode 110 is used for wiring to the heat generating chip 140. On the other hand, in this embodiment, wiring to the heat generating chip 140 is performed by a conductive coating formed on the third main surface of the first cover member 120. In the present embodiment, as shown in FIG. 12, only the heat generating chip 140 is disposed on the second main surface of the first high-frequency electrode 110, and no flexible substrate is disposed. On the other hand, the third main surface of the first cover member 120 is provided with wiring for the first high-frequency electrode 110 and wiring for the heat generating chip 140.

  FIG. 13 shows a perspective view of the first cover member 120 according to the present embodiment as viewed from the third main surface side. As shown in this figure, the third main surface of the first cover member 120 is provided with a conductive coating 132 (hereinafter referred to as a conductive coating 132) for connecting the first high-frequency electrode 110 and the first high-frequency electrode conducting line 162. , Referred to as the first conductive coating 132), and the heat generating chip conductive coating 134 (hereinafter referred to as a second conductive coating 134) for connecting the first heat generating chip energization line 164 and each heat generating chip 140. A conductive coating 134) is disposed. The first conductive coating 132 and the second conductive coating 134 are arranged so as not to cross each other. A pair of first heating chip energization lines 164 are connected to the most proximal end side of the conductive coating 134.

  The second conductive coating 134 and the electrode 145 of the heat generating chip 140 are connected by a bump (projection electrode) 146 provided on the electrode 145 of the heat generating chip 140. FIG. 14 is a perspective view showing a state of connection between the second conductive coating 134 and the electrode 145 of the heat generating chip 140. In this figure, the first cover member 120 is not shown for easy understanding. In this way, the six heat generating chips 140 are connected in series via the second conductive coating 134 and the bumps 146 between the pair of first heat generating chip energization lines 164. As described above, the wiring for supplying power to the first high-frequency electrode 110 and the heat generating chip 140 is provided in the first cover member 120. The configuration of other parts is the same as that of the first embodiment.

  According to the present embodiment, it is not necessary to arrange the first heating chip energization line 164 on the first high-frequency electrode 110. Therefore, the heat flowing out from the first high-frequency electrode 110 through the first heating chip energization line 164 can be significantly suppressed. According to the present embodiment, it is possible to realize a treatment apparatus that is more energy efficient than the first embodiment. In addition, the configuration of the first high-frequency electrode 110 can be simplified.

[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. 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.

  An exploded perspective view of the first electrode unit 100 of the present embodiment is shown in FIG. As shown in this figure, in the present embodiment, a heating chip 140 and a flexible substrate 150 are arranged on the second main surface of the first high-frequency electrode 110 as in the first embodiment. Each heat generating chip 140 is electrically connected to the electrode of the flexible substrate 150 by a wire 156 by wire bonding.

The first heating chip energization line 164 is connected to a conductive coating (not shown) disposed on the third surface of the first cover member 120. The conductive coating and the flexible substrate 150 are connected by bumps 136. The bump 136 is designed to have a high thermal resistance. Therefore, the heat that moves from the first high-frequency electrode 110 to the first heating chip energization line 164 via the bump 136 is suppressed. The configuration of other parts is the same as that of the first embodiment.
According to this embodiment, the same effect as that of the third embodiment can be obtained.

  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. Furthermore, constituent elements over different embodiments may be appropriately combined.

  DESCRIPTION OF SYMBOLS 100 ... 1st electrode part, 110 ... 1st high frequency electrode, 112 ... Wall, 114 ... Claw, 120 ... 1st cover member, 122 ... 1st wall, 124 ... 2nd wall, 126 ... Notch , 132 ... conductive coating, 134 ... conductive coating, 136 ... bump, 140 ... heating chip, 141 ... substrate, 143 ... resistance pattern, 145 ... electrode, 146 ... bump, 147 ... insulating film, 149 ... bonding metal 150, flexible substrate, 152, electrode, 154, electrode, 156, wire, 162, first energization line for high-frequency electrode, 164, first energization line for heating chip, 170, sealant, 200, first Two electrode portions, 210 ... second high-frequency electrode, 220 ... second cover member, 240 ... heating chip, 262 ... second high-frequency electrode conducting line, 264 ... second heat generation Energizing line, 300 ... treatment device, 310 ... energy treatment device, 320 ... holding portion, 322 ... first holding member, 324 ... second holding member, 326 ... first holding member main body, 328 ... second holding member main body, 332 ... first cutter guide groove, 334 ... second cutter guide groove, 340 ... shaft, 342 ... cylindrical body, 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 (7)

A therapeutic treatment device for treating a living tissue by applying energy,
Conductivity for applying a high-frequency voltage to the living tissue and heating the living tissue by contacting the living tissue on the first main surface of the first main surface and the second main surface forming the front and back surfaces. A high frequency electrode,
A heating element bonded to the second main surface and heating the high-frequency electrode;
An insulating cover member surrounding the heating element together with the high-frequency electrode;
A conductive portion formed at least in part on the cover member and electrically connected to the high-frequency electrode;
Insulation with the high-frequency electrode is ensured and electrically connected to the conductive portion, and a high-frequency power line that supplies a high-frequency current to the high-frequency electrode through the conductive portion;
A therapeutic treatment apparatus comprising: The cover member has a third main surface facing the second main surface,
The conductive portion is formed on the third main surface,
The therapeutic treatment device according to claim 1. The high-frequency power line is connected to the conductive portion at a connection portion located at an end portion of the cover member, and is not located in a space surrounded by the high-frequency electrode and the cover member except for the connection portion,
The cover member has a lower thermal conductivity than the high-frequency electrode;
The therapeutic treatment device according to claim 1, wherein the treatment device is a therapeutic treatment device.   The treatment apparatus according to any one of claims 1 to 3, wherein the conductive portion has a thermal resistance higher than that of the high-frequency power line.   The insulating member having a thermal conductivity lower than that of the high-frequency electrode, which is filled between the conductive portion and the high-frequency power line and the high-frequency electrode, is further provided. A therapeutic treatment apparatus according to claim 1. The cover member has an extending portion that protrudes from the high-frequency electrode,
The conductive part is also formed in the extension part,
The high-frequency power line is connected to the conductive portion in the extending portion,
The therapeutic treatment device according to any one of claims 1 to 5, wherein: A heating power line disposed on the cover member for transmitting power supplied to the heating element;
A connecting member for connecting the heating power line and the heating element;
The therapeutic treatment apparatus according to claim 1, further comprising:

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