JP2020195681A - Tip device - Google Patents

Abstract

To provide a technique for achieving stable irradiation of plasma toward a position with high reliability of the existence of a biological tissue when a grip instrument grips the biological tissue.SOLUTION: A tip device 3 includes a grip instrument 15 and a plasma irradiation device 20. The grip instrument 15 has a first action member 16 having a first action part 16A acting on a biological tissue on its tip side, and a second action member having a second action part 64A acting on the biological tissue on its tip side. The grip instrument 15 is configured such that the first action part 16A and the second action part 64A are formed so as to freely come close to or be separated from each other, and grips the biological tissue by sandwiching it between the first action part 16A and the second action part 64A. In the plasma irradiation device 20, a direction of gas emitted from an emission hole 34 faces to a contact position where the first action part 16A and the second action part 64A are abutted on each other or a closest position AR where they are mostly closed without sandwiching the biological tissue.SELECTED DRAWING: Figure 2

Description

The present invention relates to advanced devices.

FIG. 10 of Patent Document 1 discloses a surgical device having a configuration in which a plasma irradiation device is incorporated in an advanced device. This advanced device includes an ultrasonic vibrating part that applies ultrasonic vibration to an acting member acting on a living tissue, and the vibration of the acting member causes an incision action, a peeling action, or a bleeding stopping action on the living tissue. Make up the composition. Further, the plasma irradiation device incorporated in the advanced device can irradiate the living tissue with plasma.

International Publication No. 2018/193997

However, the device of FIG. 10 of Patent Document 1 has room for further improvement in terms of "how should the gas outlet be arranged in order to stably irradiate the plasma at the position where the living tissue exists". ..

The present invention has been made to solve at least a part of the above-mentioned problems, and when the gripping device grips the living tissue, the plasma is stably applied to a position where the living tissue is highly certain to exist. The purpose is to realize a technique capable of irradiating.

The advanced device, which is one of the present inventions, is
It has a first acting member having a first acting part acting on a living tissue on its tip side, and a second acting member having a second acting part acting on a living tissue on its own tip side. A gripping device in which a 1-acting part and the 2nd-acting part are freely approachable and separated, and a biological tissue is sandwiched and gripped between the 1st-acting part and the 2nd-acting part.
A plasma irradiation device having a gas guide path including a flow path for flowing gas along a predetermined direction and a discharge port provided at an end of the flow path, and a discharge section for generating a plasma discharge in the gas guide path. When,
It is an advanced device equipped with
In the plasma irradiation device, when the direction of the gas discharged from the discharge port is the closest to the contact position when the first acting portion and the second acting portion are brought into contact with each other or the living tissue without sandwiching the living tissue. It faces the closest position.

In the above-mentioned advanced device, the direction of the gas released from the discharge port is "the contact position when the first action part and the second action part are brought into contact" or "the first action part and the second action part are living bodies". It is suitable for the "closest position when the tissue is closest to each other without sandwiching it". Therefore, when the gripping device grips the biological tissue, it is possible to stably irradiate the plasma toward a position with high certainty that the biological tissue exists. Therefore, when the user using the advanced device grips the living tissue using the gripping device, the position where the first acting part or the second acting part comes into contact with the living tissue without spending a large amount of effort on the position adjustment. Or the plasma can be easily and accurately applied to the vicinity thereof.

In the advanced device having any of the above configurations, the plasma irradiation device may be attached to any one of the first acting member and the second acting member as an attachment target, and may have a plurality of outlets. .. Then, the plurality of outlets may be arranged on both sides of the attachment target.
The above-mentioned advanced device can not only stably irradiate the plasma toward the above-mentioned contact position or the closest position, but also irradiate a wide range of plasma toward both sides of the attachment target.
Therefore, when the user grips the living tissue using the gripping device, it surely includes not only "the position where the first action part or the second action part contacts in the living tissue or its vicinity" but also the position. It is possible to easily and reliably irradiate plasma over a wide range. Therefore, the operability when the user operates the advanced device is further improved.

In the advanced device having any of the above configurations, the plasma irradiation device may be attached to any one of the first acting member and the second acting member as an attachment target. Then, the first acting portion and the second acting portion may be configured to approach and separate from each other along a predetermined plane direction. Further, the discharge port may be arranged on at least one side of the mounting target in the orthogonal direction orthogonal to the plane direction.
The advanced device can effectively utilize the space in the vicinity of the orthogonal direction in the first acting member or the second acting member, and can provide the discharge port closer to the contact position or the closest approach position. Moreover, the discharge port can be provided in a form that does not easily interfere with the approaching operation and the separating operation of the first acting member and the second acting member.

In the advanced device having any of the above configurations, the plasma irradiation device may be attached to the second working member. The discharge port may be arranged on the side of the first acting member or on the side opposite to the first acting member in the direction in which the first acting portion and the second acting portion approach and separate from each other.
The above-mentioned advanced device effectively utilizes the space in the vicinity of the approaching / separating direction (direction in which the first acting portion and the second acting portion approach and separate) in the first acting member or the second acting member, and described above. The discharge port can be provided closer to the contact position or the closest position.

In the advanced device having any of the above configurations, the second acting portion may have a curved portion that curves toward the first acting portion side toward the distal end side. The contact position or the closest position may include a part of the curved portion on the side of the first acting portion. Then, the discharge port may be arranged on the first acting member side of the second acting member in the direction in which the first acting portion and the second acting portion approach and separate from each other. Then, in the plasma irradiation device, the direction of the gas discharged from the discharge port may be directed to the above-mentioned partial position.
The advanced device can irradiate plasma from a discharge port arranged at a position between the first acting member and the second acting member toward the contact position or the closest position. Therefore, when the first action part and the second action part sandwich the living tissue, the plasma can be irradiated to the living tissue in a positional relationship in which the living tissue is surely located at the tip of the discharge port. In particular, since the working member has a positional relationship that does not easily obstruct the irradiation of plasma, the plasma emitted from the discharge port can easily hit the living tissue more efficiently.
Moreover, the curved portion is curved from the discharge port arranged on the same side as the curved portion (first acting portion side) in the direction in which the first acting portion and the second acting portion approach and separate from each other. Plasma can be irradiated toward a contact position or the closest position (a part of the curved portion on the first acting portion side) located on the same side as the side (first acting portion side). Therefore, when the curved portion sandwiches the living tissue, the plasma can be reliably applied to the living tissue.

In the advanced device having any of the above configurations, the plasma irradiation device may be attached to any one of the first acting member and the second acting member as an attachment target. The first acting portion and the second acting portion are configured to approach or separate from each other along a predetermined plane direction, and have a bent portion that bends to one side along an orthogonal direction orthogonal to the plane direction. You may be. Then, the discharge port may be arranged on one side of the mounting target.
The tip device is directed from the discharge port arranged on the same side as the bending side (the one side in the orthogonal direction) to the inner side surface of the bending portion (the side surface on the concave side in the bending portion). Can irradiate plasma. Therefore, it becomes easy for the plasma to surely hit the living tissue sandwiched between the bent portions, and in particular, the plasma easily reaches the vicinity of the tips of both acting portions.

In the advanced device having any of the above configurations, the plasma irradiation device may have a configuration in which the discharge electrode, the ground electrode, and the dielectric layer are laminated in a stacking direction orthogonal to a predetermined direction. The opening width of the discharge port in the predetermined direction and the lateral direction orthogonal to the stacking direction may be larger than the opening width of the discharge port in the stacking direction.
The above-mentioned advanced device makes it easy to irradiate a living tissue with plasma in a wider range, and in particular, makes it easier to irradiate a wide range of plasma in the lateral direction (direction orthogonal to the stacking direction).

In the advanced device having any of the above configurations, the plasma irradiation device may have a reduced diameter portion in which the gas guide path is reduced in diameter toward the discharge port and itself is reduced in diameter.
Since the advanced device is provided with a reduced diameter portion so that the gas guide path is reduced in diameter toward the discharge port, the flow velocity of the gas can be increased when the gas passes through the reduced diameter portion. Therefore, the above-mentioned advanced device can efficiently supply the gas so as to increase the flow velocity of the gas discharged from the discharge port while suppressing the flow rate of the gas supplied to the gas guide path. Moreover, since the advanced device has a structure in which the diameter-reduced portion is reduced, the diameter-reduced portion can be made thinner, and the direction of the gas is restricted to face the contact position or the closest position. It is a configuration that has a great space advantage in arranging the discharge port in the form.

According to the present invention, when the gripping device grips the biological tissue, the plasma can be stably irradiated toward a position where the biological tissue is highly certain to exist.

It is the schematic which shows schematic the surgical apparatus which comprises the advanced device of 1st Embodiment. FIG. 2 is an enlarged view conceptually showing an enlarged part of the vicinity of the action portion in the advanced device of the first embodiment. FIG. 3 is a perspective view conceptually showing a structure constituting the plasma irradiation device of the advanced device of the first embodiment. FIG. 4 is an exploded perspective view of the structure of FIG. 3 divided into three parts. FIG. 5 is a schematic cross-sectional view schematically showing a cross-sectional configuration of a cut surface obtained by cutting the structure of FIG. 3 at the center position in the third direction (width direction) in a direction orthogonal to the third direction. FIG. 6 is a schematic cross-sectional view schematically showing a cross-sectional configuration of a cut surface obtained by cutting the structure of FIG. 3 at the center position in the first direction in a direction orthogonal to the first direction. FIG. 7 is a schematic cross-sectional view schematically showing a cross-sectional configuration of a cut surface obtained by cutting the structure of FIG. 3 at the center position in the second direction (thickness direction) in a direction orthogonal to the second direction. FIG. 8 is an enlarged view conceptually showing an enlarged part of the vicinity of the action portion in the advanced device of the second embodiment. FIG. 9 is an enlarged perspective view conceptually showing a part of the vicinity of the action portion in the advanced device of the third embodiment in an enlarged manner. FIG. 10 is an enlarged perspective view conceptually showing a part of the vicinity of the action portion in the advanced device of the fourth embodiment in an enlarged manner. FIG. 11 is an enlarged perspective view conceptually showing a part of the vicinity of the action portion in the advanced device of the fifth embodiment in an enlarged manner. FIG. 12 is an enlarged perspective view conceptually showing a part of the vicinity of the action portion in the advanced device of the sixth embodiment in an enlarged manner. FIG. 13 is an enlarged perspective view conceptually showing a part of the vicinity of the action portion in the advanced device of the seventh embodiment in an enlarged manner. FIG. 14 is an enlarged view conceptually showing a configuration in which the vicinity of the second acting portion in the advanced device of the seventh embodiment is viewed from the first acting portion side. FIG. 15 is an enlarged perspective view conceptually showing a part of the vicinity of the action portion in the advanced device of the eighth embodiment in an enlarged manner. FIG. 16 is a perspective view conceptually showing a structure constituting the plasma irradiation device of the advanced device of the eighth embodiment. FIG. 17 is a schematic cross-sectional view schematically showing a cross-sectional configuration of a cut surface obtained by cutting the structure of FIG. 16 at the center position in the second direction (thickness direction) in a direction orthogonal to the second direction. FIG. 18 is an enlarged perspective view conceptually showing a part of the vicinity of the action portion in the advanced device according to Example 1 of another embodiment. FIG. 19 schematically shows a cross-sectional configuration of a cut surface obtained by cutting a structure in an advanced device according to Example 2 of another embodiment at a center position in a second direction (thickness direction) in a direction orthogonal to the second direction. It is sectional drawing which shows. FIG. 20 is an explanatory diagram conceptually showing the vicinity of the structure and the second working portion in the advanced device according to Example 3 of another embodiment.

<First Embodiment>
1. 1. Overall Configuration of Surgical Device The surgical device 1 shown in FIG. 1 is configured as a treatment device capable of incising, peeling or stopping bleeding from a living tissue to be treated. The surgical device 1 is a gas for the tip device 3, the control device 5 which is a device for controlling the ultrasonic vibration unit 12 (driving unit), and the gas guide path 30 (see FIG. 6 and the like) in the tip device 3. A gas supply device 7 for supplying the gas and a power supply device 9 capable of applying a voltage to the plasma irradiation device 20 are provided.

The control device 5 is a device that gives an electric signal for generating ultrasonic vibration to the ultrasonic vibration unit 12. The control device 5 has a configuration capable of giving an electric signal to the ultrasonic vibration unit 12 via a flexible signal cable (not shown) interposed between the tip device 3 and the control device 5.

The gas supply device 7 is a device that supplies an inert gas (hereinafter, also simply referred to as gas) such as helium gas or argon gas. The gas supply device 7 supplies an inert gas to the gas guide path 30 described later through, for example, a flexible pipeline (not shown in FIG. 1) interposed between the tip device 3 and the gas supply device 7. Supply. The gas supply device 7 includes, for example, a regulator for reducing the pressure of high-pressure gas supplied from a cylinder or the like, and a control unit for controlling the flow rate.

The power supply device 9 is a device for applying a desired voltage between the discharge electrode 42 and the ground electrode 44 of the plasma irradiation device 20 described later, and is grounded with the discharge electrode 42 while keeping the ground electrode 44 at the ground potential. An AC voltage having a predetermined frequency is applied between the electrode 44 and the electrode 44. As the power supply device 9, various known circuits can be adopted as long as it is a circuit capable of generating a high voltage (for example, a high voltage having an amplitude of 0.5 kV to 10 kV) having a high frequency (for example, about 20 kHz to 300 kHz). .. The high voltage frequency generated by the power supply device 9 may be a frequency fixed at a constant value or may fluctuate. Further, the voltage applied by the power supply device 9 between the ground electrode 44 and the discharge electrode 42 may be a voltage that changes periodically, may be a sinusoidal AC voltage, or is a non-sinusoidal wave (for example,). It may be an AC voltage (square wave, triangular wave, etc.).

In the example of FIG. 1, a surgical device in which a power supply device 9 for generating an AC voltage is provided outside the advanced device 3 is exemplified, but a power supply circuit for generating an AC circuit is inside the advanced device 3 (for example,). It may be provided inside the case body 14 or the inside of the plasma irradiation device 20 which will be described later).

The tip device 3 is a device that is gripped and used by an operator who performs surgery, and mainly includes a case body 14, a gripping instrument 15, a plasma irradiation device 20, an ultrasonic vibration unit 12, and the like. The case body 14, the gripping device 15, the plasma irradiation device 20, and the ultrasonic vibrating unit 12 are integrally configured as a gripping unit to be gripped by the user, and an inert gas is provided through a flexible member. And power is being supplied.

The case body 14 is formed in a cylindrical shape and extends in a predetermined direction, and mainly includes a base portion 14B and a cylindrical extending portion 14A that is integrally formed with the base portion 14B and extends in a predetermined direction. An ultrasonic vibration unit 12 or the like is housed inside the base portion 14B, and a plasma irradiation device 20 is fixed or integrated in the extension portion 14A.

The ultrasonic vibration unit 12 is configured as a known ultrasonic vibrator, and is driven by the control device 5 described above to generate ultrasonic vibration when a predetermined electric signal is given, and the first working member 16 described later Operates to transmit ultrasonic vibrations to. The ultrasonic vibration unit 12 corresponds to an example of the driving unit, and drives the first acting member 16 so as to cause an action of incising, peeling, or heat-coagulating hemostasis in the vicinity of the first acting portion 16A.

The grip portion 60 is a portion that is gripped by a user who uses the tip device 3, and is configured as a movable member displacement mechanism that employs a known movable mechanism. The grip portion 60 is a fixed grip portion 62 fixed to the base portion 14B of the case body 14 and integrated with the case body 14, and a shaft-shaped second acting member 64 attached so as to be relatively movable with respect to the fixed grip portion 62. It is composed of and.

The gripping instrument 15 is an instrument that can be used to sandwich and grip a living tissue, and has a first acting member 16 and a second acting member 64.

The first acting member 16 is a shaft-shaped member, and is a member provided with a first acting portion 16A acting on a living tissue on its tip side. The first acting portion 16A is a portion that functions as a fixed blade in the vicinity of the tip portion of the first acting member 16. The first acting member 16 has a first acting portion 16A and a shaft portion 16B that transmits the vibration given from the ultrasonic vibrating portion 12 to the first acting portion 16A, and the vibration generated by the ultrasonic vibrating unit 12 Is transmitted to the first acting portion 16A via the shaft portion 16B, so that the first acting portion 16A vibrates. The first acting member 16 causes an incision action, a peeling action, or a hemostatic action on the living tissue by vibrating the first working part 16A in a state where the first working part 16A is approaching or in contact with the living tissue. Works like this.

The second acting member 64 is a shaft-shaped member that functions as a movable member, and is a member that includes a second acting portion 64A that acts on a living tissue on its own tip side (one end side). The second working portion 64A is a portion that functions as a movable blade. The second acting member 64 includes a movable grip portion 64C near the end portion on the rear end side (other end side) of the second acting member 64. In the gripping device 15, the shaft-shaped second acting member 64 is made rotatable about the rotation shaft Z near the tip of the extending portion 14A, and the first acting portion 16A and the second acting portion 64A approach each other. And it is configured to be separable. In the gripping tool 15, the second acting portion 64A (movable blade) approaches the first acting portion 16A (fixed blade) in response to an operation for bringing the movable grip portion 64C closer to the fixed grip portion 62 side. The second working member 64 rotates. On the contrary, the second acting member 64 rotates so that the second acting portion 64A separates from the first acting portion 16A in response to the operation of separating the movable grip portion 64C from the fixed grip portion 62. ..

The advanced device 3 configured in this way can perform an incision treatment, a peeling treatment, and a hemostasis treatment of a living tissue using ultrasonic vibration. For example, when the biological tissue is sandwiched between the first acting portion 16A (fixed blade) and the second acting portion 64A, the living tissue can be excised by transmitting ultrasonic vibration to the first acting portion 16A. .. It is also possible to bring the first acting portion 16A to which ultrasonic vibration is transmitted into contact with a living tissue to generate frictional heat to stop bleeding. It is also possible to perform the peeling treatment by sandwiching the biological tissue between the first acting portion 16A and the second acting portion 64A with or without applying ultrasonic vibration to the first acting member 16. As described above, the advanced device 3 is capable of incision, peeling, or thermal coagulation hemostasis by ultrasonic vibration, and further, minimally invasive hemostasis is also used by irradiation of low temperature plasma from the plasma irradiation device 20 described later. You can also.

2. 2. Configuration of Plasma Irradiation Device As shown in FIG. 1, the plasma irradiation device 20 is incorporated as a part of the advanced device 3 and is configured as a device that generates a dielectric barrier discharge inside the advanced device 3. In the example of FIG. 1, the plasma irradiation device 20 is fixed to the case body 14 in a configuration held by the holding portion 18. As shown in FIG. 2, the low-temperature plasma P generated inside the plasma irradiation device 20 is irradiated to the vicinity of the first acting portion 16A provided at the tip of the first acting member 16.

As shown in FIG. 3, the plasma irradiation device 20 has a structure 20A configured in a predetermined three-dimensional shape (for example, a plate shape and a rectangular parallelepiped shape), and is formed at an end portion of the structure 20A in the longitudinal direction. It is configured to irradiate the low temperature plasma P from the outlet 34.

As conceptually shown in FIG. 4, the structure 20A is provided with the third dielectric layer 53 at the center in the thickness direction, and the fourth dielectric layer 53 is provided on one side in the thickness direction with respect to the third dielectric layer 53. A body layer 54 is provided. Further, the structure 20A is provided with the first dielectric layer 51 and the second dielectric layer 52 on the other side in the thickness direction from the third dielectric layer 53. A discharge electrode 42 and a ground electrode 44 are embedded inside a dielectric region composed of the first dielectric layer 51 and the second dielectric layer 52. In FIG. 4, the structure in which the structure 20A is divided into three is conceptually shown as an exploded perspective view, but the actual structure is the first dielectric layer 51, the second dielectric layer 52, and the third dielectric. Each of the layer 53 and the fourth dielectric layer 54 is configured as part of an integral dielectric portion 50 (FIG. 5).

As shown in FIG. 5, the plasma irradiation device 20 mainly includes a gas guide path 30 and a creepage discharge unit 40.

The gas guideway 30 has an introduction port 32 for introducing gas, a discharge port 34 for discharging gas, and a flow path 36 provided between the introduction port 32 and the discharge port 34. The gas taxiway 30 introduces the inert gas supplied from the gas supply device 7 provided outside the tip device 3 from the introduction port 32, and the gas introduced from the introduction port 32 side is introduced into the space in the flow path 36. It is a taxiway that guides the gas to the discharge port 34. In FIG. 5, the pipeline 7A for guiding the inert gas supplied from the gas supply device 7 to the introduction port 32 is conceptually shown by a two-dot chain line. As shown in FIG. 2, in the gas taxiway 30, the discharge port 34 faces the first acting portion 16A at a position close to the first acting portion 16A, and is the first on the extension of the space of the flow path 36. The relationship is such that the acting unit 16A is located. The gas taxiway 30 has a flow path configuration for discharging gas from the discharge port 34 to the first action unit 16A side, so that the low temperature plasma P is discharged from the discharge port 34 to the first action part 16A side together with the gas. Function.

As shown in FIG. 5, in the present specification, the direction in which the gas guide path 30 extends in the plasma irradiation device 20 is the first direction, and the thickness direction of the dielectric portion 50 is the direction orthogonal to the first direction. It is the second direction, and the direction orthogonal to the first direction and the second direction is the third direction. In the configuration of FIG. 5, the longitudinal direction of the structure 20A in which the dielectric portion 50, the discharge electrode 42, and the ground electrode 44 are integrally provided is the first direction. The lateral direction of the structure 20A on the cut surface obtained by cutting the structure 20A in the plane direction orthogonal to the first direction is the second direction, and the longitudinal direction of the cut surface is the third direction. The second direction is the width direction of the structure 20A, and the third direction is the height direction or the thickness direction of the structure 20A. In the following description, the discharge port 34 side is the front end side of the structure 20A in the first direction, and the introduction port 32 side is the rear end side of the structure 20A in the first direction.

As shown in FIG. 5, in the structure 20A, a gas guide path 30 is configured to allow gas to flow along a predetermined direction (first direction), and a second direction orthogonal to the predetermined direction (first direction). The discharge electrode 42, the ground electrode 44, and the dielectric portion 50 are laminated so as to have a stacking direction. The opening width W3 (FIG. 3) of the discharge port 34 in the predetermined direction (first direction) and the lateral direction (third direction) orthogonal to the stacking direction (second direction) is the discharge port in the stacking direction (second direction). It is larger than the opening width W2 (FIG. 3) of.

The creepage discharge unit 40 corresponds to an example of the discharge unit, and has a first dielectric layer 51, a discharge electrode 42 and a ground electrode 44 arranged so as to face each other with the first dielectric layer 51 interposed therebetween. .. The creepage discharge unit 40 functions to generate an electric field based on the potential difference between the discharge electrode 42 and the ground electrode 44 in the gas guide path 30 to generate a low temperature plasma discharge due to the creepage discharge.

In the creeping discharge section 40, one of the discharge electrode 42 and the ground electrode 44 faces the flow path 36 directly or via the other member, and a voltage that changes periodically flows in response to being applied to the discharge electrode 42. A creepage discharge is generated in the road 36. The "configuration in which one of the discharge electrode 42 or the ground electrode 44 directly faces the flow path 36" means that one of the discharge electrode 42 or the ground electrode 44 is exposed in the space inside the flow path 36 and the other is the flow path. A configuration that forms part of the inner wall is applicable. Further, "a configuration in which one of the discharge electrode 42 or the ground electrode 44 faces the flow path 36 via the other member" means that one of the discharge electrode 42 or the ground electrode 44 is arranged at a position close to the flow path 36. In addition, a configuration in which a part or all of the one is covered with another member is applicable. In the configuration via the other member as described above, the other member forms a part of the inner wall of the flow path, and the main surface of the above "one" is arranged toward the flow path 36. The configuration shown in FIGS. 5 and 6 is a configuration in which the discharge electrode 42 corresponds to the above "one" and the discharge electrode 42 faces the flow path 36 via the other member, but FIG. The second dielectric layer 52, which corresponds to an example of another member, is shown in an omitted form.

As shown in FIG. 6, in the creepage discharge portion 40, the discharge electrode 42 faces the flow path 36 via a part of the dielectric portion 50 (second dielectric layer 52). The ground electrode 44 is provided on the side opposite to the flow path 36 with respect to the discharge electrode 42, and is farther from the flow path 36 than the discharge electrode 42. The creepage discharge unit 40 keeps the potential of the ground electrode 44 at a constant reference potential (for example, a ground potential of 0 V), and in the flow path 36 in response to a voltage that changes periodically is applied to the discharge electrode 42. Generates creepage discharge and low temperature plasma.

As shown in FIG. 6, the dielectric portion 50 includes a first dielectric layer 51, a second dielectric layer 52, a third dielectric layer 53, and a fourth dielectric layer 54, and is configured to be hollow as a whole. Has been done. The first dielectric layer 51 is arranged on one side in the second direction (thickness direction) with respect to the space of the flow path 36, and is configured so that the ground electrode 44 is embedded. That is, the discharge electrode 42 and the ground electrode 44 face each other via the first dielectric layer 51. The second dielectric layer 52 is a ceramic protective layer configured to cover the discharge electrode 42 with a ceramic material, and is arranged so as to cover the discharge electrode 42 on the flow path space side of the first dielectric layer 51. .. The first dielectric layer 51 and the second dielectric layer 52 form an inner wall portion on one side in the second direction in the flow path 36. The fourth dielectric layer 54 is arranged on the other side in the second direction (thickness direction) with respect to the space of the flow path 36, and constitutes an inner wall portion on the other side in the second direction in the flow path 36. The third dielectric layer 53 is arranged between the first dielectric layer 51 and the fourth dielectric layer 54 in the second direction, and is a side wall portion on one side in the third direction and the other side in the third direction in the flow path 36. Consists of the side wall of the. That is, the flow path 36 is defined by the first dielectric layer 51, the second dielectric layer 52, the third dielectric layer 53, and the fourth dielectric layer 54. As the material of the first dielectric layer 51, the second dielectric layer 52, the third dielectric layer 53, and the fourth dielectric layer 54, for example, ceramics such as alumina, glass materials, and resin materials can be preferably used. .. By using alumina having high mechanical strength as the dielectric, it becomes easy to reduce the size of the creepage discharge portion 40.

As shown in FIG. 7, the flow path 36 is configured such that a space surrounded by both sides in the second direction and both sides in the third direction continues in the first direction, and the flow path 36A extends along the first direction. And a second flow path 36B provided on the downstream side of the first flow path 36A. The first flow path 36A is provided in the first region AR1 in the first direction in the structure 20A. The second flow path 36B is provided in the second region AR2 in the first direction in the structure 20A. In FIG. 7, the range in which the first flow path 36A is provided in the first direction is represented as the first region AR1, and the range in which the second flow path 36B is provided in the first direction is represented as the second region AR2.

The first flow path 36A is a flow path in which the shape of the inner wall portion on the cut surface cut in the direction orthogonal to the first direction is rectangular (see FIG. 6). As shown in FIG. 7, in the first flow path 36A, the width of the inner wall surface is constant over the first region AR1 in the first direction, and the height of the inner wall surface is high over the first region AR1 in the first direction. Has a constant height.

As shown in FIG. 7, the second flow path 36B is arranged on the discharge port 34 side (downstream side) of the first flow path 36A in the first direction, and has a width narrower than that of the first flow path 36A. ing. The second flow path 36B includes a narrow flow path 36C and a constant flow path 36D. The narrowed flow path 36C is provided over a part of the second region AR2 AR21 in the first direction, and the width of the inner wall surface gradually narrows as it approaches the discharge port 34 side. The height of the narrowed flow path 36C is constant over the entire range of region AR21. The constant flow path 36D is provided over a part of the area AR22 of the second area AR2 in the first direction, and the width and height of the inner wall surface are constant over the entire range of the area AR22.

As shown in FIG. 7, the structure 20A has a first fixed shape portion 22 and a second fixed shape portion 26 in which the outer shape of the cut surface orthogonal to the first direction is constant over a predetermined range in the first direction. Further, the structure 20A has a diameter-reduced portion 24 whose diameter is reduced so that the outer shape of the cut surface orthogonal to the first direction becomes smaller toward the tip side (see also FIG. 3). A reduced diameter portion 24 follows the tip end side of the first fixed shape portion 22, and a second fixed shape portion 26 follows the tip end side of the reduced diameter portion 24. The tip position of the first fixed shape portion 22 is the rear end position of the reduced diameter portion 24, and the tip position of the reduced diameter portion 24 is the rear end position of the second fixed shape portion 26. The first fixed shape portion 22 is provided in the first region AR1, and the width of the outer wall surface (length in the third direction) and the height of the outer wall surface (length in the first direction) are constant. The reduced diameter portion 24 is provided in a partial region AR21 of the second region AR2, the height of the outer wall surface (length in the second direction) is constant, and the width of the outer wall surface (length in the third direction) is constant. The diameter is reduced so that it becomes smaller toward the tip side. The second fixed shape portion 26 is provided in a part area AR22 of the second area AR2, and the width of the outer wall surface (length in the third direction) and the height of the outer wall surface (length in the second direction) are constant. ing. The first fixed shape portion 22, the reduced diameter portion 24, and the second fixed shape portion 26 all have the same predetermined height on the outer wall surface. On the other hand, the width of the outer wall surface of the first fixed shape portion 22 is larger than the width of the outer wall surface of the second fixed shape portion 26, and is the same as the maximum width (width of the rear end) of the outer wall surface of the reduced diameter portion 24. .. The width of the outer wall surface of the second fixed shape portion 26 is the same as the minimum width (width of the tip) of the outer wall surface of the reduced diameter portion 24.

The gas taxiway 30 is provided with a first flow path 36A in the first fixed shape portion 22, a narrowed flow path 36C provided in the diameter reduction portion 24, and a constant flow path 36D provided in the second fixed shape portion 26. .. That is, in the reduced diameter portion 24, the gas guide path 30 is reduced in diameter toward the discharge port 34. The flow path of the reduced diameter portion 24 (reduced width flow path 36C) has a maximum width at the rear end, and this maximum width coincides with the width of the first flow path 36A. The flow path of the reduced diameter portion 24 (reduced width flow path 36C) has a minimum width at the tip, and this minimum width coincides with the width of the constant flow path 36D.

As shown in FIG. 7, the ground electrode 44 extends linearly in the first direction along the flow path 36, and is, for example, arranged in a predetermined region in the first direction with a constant width and a constant thickness. Has been done. A part of the ground electrode 44 on the tip end side thereof is arranged on the discharge port 34 side of the discharge electrode 42. A part of the ground electrode 44 is located in the arrangement region AR2 of the second flow path 36B in the first direction. In the example of FIG. 7, the tip of the ground electrode 44 is the tip of the narrowed flow path 36C (constant flow path). It is located on the tip side of the rear end of 36D). That is, a part of the ground electrode 44 is located in the arrangement region AR22 of the constant flow path 36D in the first direction. The rear end of the ground electrode 44 is located on the rear end side of the tip of the first flow path 36A, on the rear end side of the tip of the discharge electrode 42, and on the front end side of the rear end of the discharge electrode 42. .. The ground electrode 44 has at least a part of itself (all of itself in FIG. 7) located in the arrangement region AR3 of the first flow path 36A in the third direction. Specifically, the ground electrode 44 has at least a part of itself (a part of itself in FIG. 7) located in the arrangement region AR4 of the constant flow path 36D in the third direction, and the discharge port 34 in the third direction. At least a part of itself (a part of itself in FIG. 7) is located in the formation region.

The discharge electrode 42 extends linearly in the first direction along the flow path 36, and is arranged in a predetermined region in the first direction with a constant width and a constant thickness, for example. Specifically, the discharge electrode 42 is located only in the arrangement region of the first flow path 36A in the first direction. That is, the discharge electrode 42 is located only in the first region AR1 of the first region AR1 and the second region AR2. The tip of the discharge electrode 42 is located on the rear end side of the tip of the first flow path 36A, and the rear end of the discharge electrode 42 is located on the tip side of the rear end of the first flow path 36A. Further, the width of the discharge electrode 42 (length in the third direction) is smaller than the width of the ground electrode 44 (length in the third direction). In the example of FIG. 7, the discharge electrode 42 is housed in the arrangement region AR3 of the first flow path 36A in the third direction. Specifically, the discharge electrode 42 is housed in the arrangement region AR4 of the constant flow path 36D in the third direction, and is housed in the formation area of the discharge port 34 in the third direction. More specifically, the discharge electrode 42 is contained within the arrangement region AR5 of the ground electrode 44 in the third direction. The end of the discharge electrode 42 on one side in the third direction is located on the other side of the third direction from the end of the ground electrode 44 on one side in the third direction, and the end of the discharge electrode 42 on the other side of the third direction is the ground electrode. It is located on one side of the third direction from the end of 44 on the other side of the third direction.

3. 3. Relationship between gas direction and gripping device 15 In FIG. 2, the position of the second acting member 64 when the first acting portion 16A and the second acting portion 64A come into contact with each other is conceptually shown by a two-dot chain line. .. As shown in FIG. 2, in the plasma irradiation device 20, the direction of the gas discharged from the discharge port 34 is directed to the contact position when the first action unit 16A and the second action unit 64A are brought into contact with each other. Because of this configuration, when the first action unit 16A and the second action part 64A are in contact with each other without sandwiching the living tissue as shown in FIG. 2, the first action part 16A and the second action part 64A The gas released from the discharge port 34 reaches the contact position and the boundary between the contact positions.

The "contact position" between the first acting portion 16A and the second acting portion 64A is a region (first contact region) in contact with the second acting portion 64A on the surface of the first acting portion 16A and a second. It means a region (second contact region) in contact with the first acting portion 16A on the surface of the acting portion 64A. That is, in the configuration of FIG. 2, the gas released from the discharge port 34 hits at least one of the first contact region and the second contact region. Further, the boundary of the contact position between the first acting portion 16A and the second acting portion 64A means the outer edge of the first contact region and the second contact region. That is, in the configuration of FIG. 2, the gas discharged from the discharge port 34 also hits the outer edge. In FIG. 2, the range of the “contact position” is conceptually indicated by the reference numeral AR.

Specifically, the "contact position" is located on the movement locus when the opening region of the discharge port 34 (the region forming the space inside the discharge port 34) is translated in the first direction. In addition, in FIGS. 2 and 3, the movement locus (the region where the opening region moves) when the opening region of the discharge port 34 is translated in the first direction is conceptually shown by the alternate long and short dash line Vt.

When the plasma irradiation device 20 configured in this way is operated, the inert gas is supplied so that the inert gas flows through the space in the flow path 36. Then, an AC voltage having a predetermined frequency is applied between the discharge electrode 42 and the ground electrode 44 by the power supply device 9. For example, the power supply device 9 keeps the ground electrode 44 at the ground potential, and sets the potential of the discharge electrode 42 to a potential that is a certain degree lower than + A (V), which is a potential that is a certain degree higher than this potential, centered on the potential of the ground electrode 44. An AC voltage is applied so as to vibrate in the range up to −A (V). In addition, "A" is a positive value. When the AC voltage is applied in this way, a change in the electric field occurs between the electrodes in the form of a barrier formed by the dielectric portion 50, and a dielectric barrier discharge (specifically, a dielectric barrier discharge) occurs in the space inside the gas induction path 30. Creeping discharge) occurs. In the gas guide path 30, the inert gas flows toward the discharge port 34, and the inert gas discharged from the discharge port 34 heads toward the contact position or the object sandwiched between the working portions. ing. That is, the low-temperature plasma generated by the creeping discharge is emitted toward these contact positions when the first acting unit 16A and the second acting unit 64A are in contact with each other, and the first acting unit 16A and the second acting unit 64A Is released toward this living tissue when it sandwiches the living tissue.

4. Example of the effect of this configuration In the above-mentioned advanced device 3, the direction of the gas discharged from the discharge port 34 is directed to the "contact position when the first acting unit 16A and the second acting unit 64A are brought into contact with each other". .. Therefore, when the gripping device 15 grips the living tissue, that is, when the first acting portion 16A and the second acting portion 64A sandwich the living tissue, it is stable toward a position where the living tissue is highly certain to exist. It is possible to irradiate plasma. Therefore, when the user grips the biological tissue using the gripping device 15, the position where the first acting portion 16A or the second acting portion 64A comes into contact with the biological tissue or the position thereof, without spending a large amount of effort on the position adjustment. Plasma can be easily and accurately applied to the vicinity.

Further, in the advanced device 3, the plasma irradiation device 20 has a configuration in which the discharge electrode 42, the ground electrode 44, and the dielectric portion 50 are laminated in a stacking direction (second direction) orthogonal to a predetermined direction (first direction). Nasu. The opening width W3 of the discharge port 34 in the predetermined direction (first direction) and the lateral direction (third direction) orthogonal to the stacking direction (second direction) is the opening of the discharge port 34 in the stacking direction (second direction). It is larger than the width W2. Therefore, the advanced device 3 is likely to irradiate the living tissue with plasma in a wider range, and in particular, is likely to irradiate the plasma over a wide range in the lateral direction (direction orthogonal to the stacking direction).

Further, the plasma irradiation device 20 has a reduced diameter portion 24 in which the gas guide path 30 is reduced in diameter toward the discharge port 34 and the gas guide path 30 is reduced in diameter. As described above, since the tip device 3 is provided with the reduced diameter portion 24 so that the gas guide path 30 is reduced in diameter toward the discharge port 34, the flow velocity of the gas when the gas passes through the reduced diameter portion 24. Can be increased. Therefore, the advanced device 3 can efficiently supply the gas so as to increase the flow velocity of the gas discharged from the discharge port 34 while suppressing the flow rate of the gas supplied to the gas guide path 30. Moreover, since the tip device 3 has a structure in which the diameter-reduced portion 24 is reduced in diameter, the diameter-reduced portion 24 can be made thinner, and the gas is released in a constrained manner so as to face the above-mentioned contact position. The configuration has a great space advantage in arranging the outlet 34.

<Second Embodiment>
Next, the advanced device 203 of the second embodiment will be described with reference to FIG. 8 and the like.
In the following description, the parts of the advanced device 203 of the second embodiment having the same configuration as the advanced device 3 of the first embodiment (FIG. 1 and the like) are designated by the same reference numerals as the corresponding parts of the advanced device 3. A detailed description will be omitted. For example, in the advanced device 203, the plasma irradiation device 20 has the same configuration as the plasma irradiation device 20 provided in the advanced device 3 of the first embodiment, and has the same function. Further, the tip device 203 can be used for the surgical device 1 in the same manner as the tip device 3 shown in FIG. That is, in the surgical device 1 of FIG. 1, the tip device 203 can be provided instead of the tip device 3.

The tip device 203 is different from the tip device 3 only in the gripping device 15, and other configurations and functions are the same as those of the tip device 3. Specifically, in the advanced device 203, the first acting part 16A and the second acting part 64A do not come into contact with each other when the first acting part 16A and the second acting part 64A are brought closest to each other without sandwiching the living tissue. Only the point is different from the first embodiment, and other configurations and functions are the same as those of the advanced device 3. The surgical device provided with the advanced device 203 is also different from the surgical device 1 of FIG. 1 only in that the first acting unit 16A and the second acting unit 64A do not come into contact with each other, and the other points are the same as the surgical device 1 of FIG. It is the same.

In FIG. 8, the position of the second action member 64 when the first action part 16A and the second action part 64A are closest to each other without any intervening object is conceptually shown by the alternate long and short dash line. As shown in FIG. 8, in the plasma irradiation device 20, the direction of the gas discharged from the discharge port 34 is "the first action part and the second action part do not sandwich an object (specifically, a living tissue). It is suitable for the "closest position when it is closest". Because of this configuration, when the first acting unit 16A and the second acting unit 64A are closest to each other without sandwiching the object as shown in FIG. 8, "the second acting on the surface of the first acting unit 16A". The gas released from the discharge port 34 reaches the "first closest region" which is the region closest to the unit 64A. Further, the gas released from the discharge port 34 reaches the "second closest region, which is the region closest to the first acting portion 16A on the surface of the second acting portion 64A". Then, when the first acting unit 16A and the second acting unit 64A are closest to each other without sandwiching the object, the gas discharged from the discharge port 34 between the first closest region and the second closest region. Is designed to enter.

Specifically, as shown in FIG. 8, in a state where the first acting portion 16A and the second acting portion 64A are closest to each other without sandwiching the object, the opening region of the discharge port 34 (inside the discharge port 34). The "closest position" is located on the movement locus when the area forming the space is translated in the first direction. Specifically, in the state as shown in FIG. 8, both the first closest area and the second closest area are located on the movement locus, and the first closest area and the second closest area are located. The space between the regions is also located on the movement locus. In FIG. 8, the movement locus (region in which the opening region moves) when the opening region of the discharge port 34 is translated in the first direction is conceptually shown by the alternate long and short dash line Vt. Further, in FIG. 8, the range in which the first closest region and the second closest region face each other is conceptually indicated by the reference numeral AR.

Even with the configuration of the second embodiment as described above, the same effect as that of the first embodiment can be obtained.

<Third Embodiment>
Next, the advanced device 303 of the third embodiment will be described with reference to FIG. 9 and the like.
The advanced device 303 is different from the advanced device 3 (FIG. 1 and the like) of the first embodiment only in the configuration and arrangement of the plasma irradiation device 20 and the specific shapes of the first acting member 16 and the second acting member 64, and other configurations. And the function is the same as the advanced device 3. Therefore, detailed description of the same points as in the first embodiment will be omitted. For example, in the advanced device 303, each structure 20A has the same configuration as the structure 20A provided in the advanced device 3 of the first embodiment, and has the same function. Further, the advanced device 303 can be used for the surgical device 1 in the same manner as the advanced device 3 shown in FIG. That is, in the surgical device 1 of FIG. 1, the tip device 303 can be provided instead of the tip device 3.

In the advanced device 303, the ultrasonic vibration from the ultrasonic vibrating unit 12 may be applied to the first acting member 16 as in the first embodiment, and the second acting member 64 may be subjected to ultrasonic vibration. The ultrasonic vibration from the ultrasonic vibration unit 12 may be applied. Further, in the example of FIG. 9, the specific shapes of the first acting member 16 and the second acting member 64 are different from those of the first embodiment, but they may be the same as those of the first embodiment.

As shown in FIG. 9, in the advanced device 303, the plasma irradiation device 320 is composed of a plurality of (specifically, two) structures 20A. Then, a plurality of structures 20A are attached to the second acting member 64 as an attachment target, and have a plurality of (specifically, two) outlets 34. The plurality of discharge ports 34 are arranged on both sides of the second acting member 64 to be attached. In the configuration of FIG. 9, a shaft portion 64B is provided on the base end side (rear end side) of the second working portion 64A in the second acting member 64, and two structures 20A are attached to the shaft portion 64B. ing.

In the advanced device 303, the first acting portion 16A and the second acting portion 64A are configured to approach and separate from each other along a predetermined plane direction. Specifically, the direction orthogonal to the rotation axis when the second acting member 64 rotates with respect to the first acting member 16 is the above-mentioned plane direction, and the first acting member 16 and the second acting member 16 64 extends along the plane direction. Then, the tip of the first acting portion 16A and the tip of the second acting portion 64A are configured to approach and separate along one of the plane directions (approaching / separating directions). The plasma irradiation device 320 of FIG. 9 has a discharge port 34 on at least one side (specifically, both sides) of the second working member 64 to be attached in a direction orthogonal to the plane direction (hereinafter, also referred to as an orthogonal direction). Is placed. Specifically, two structures 20A are provided on both sides of the second acting member 64 in the orthogonal direction so as to sandwich the second acting member 64, and two outlets provided in the two structures 20A. 34 are arranged along the above-mentioned "orthogonal direction".

The advanced device 303 may also be configured so that the first acting unit 16A and the second acting unit 64A come into contact with each other as in the first embodiment. Alternatively, as in the second embodiment, the first acting unit 16A and the second acting unit 64A may be configured so as not to come into contact with each other. When the first acting unit 16A and the second acting unit 64A are configured to be in contact with each other, the plasma irradiation device 320 has a plasma irradiation device 320 in which the direction of the gas discharged from the discharge port 34 is the first acting unit 16A and the second acting unit. It is desirable that it faces the contact position when it comes into contact with 64A. Further, when the first acting unit 16A and the second acting unit 64A are configured so as not to come into contact with each other, the plasma irradiation device 320 faces the direction of the gas discharged from the discharge port 34 toward the "closest position". It is desirable to be there. In this case, the "closest approaching position" is the position when the first acting section 16A and the second acting section 64A are closest to each other without sandwiching an object (specifically, a living tissue), and this "closest approaching position". The concept of "position" and the concept of "applying gas to the closest position" are the same as those in the second embodiment. In FIG. 9, the relative position of the first acting portion 16A with respect to the second acting portion 64A when the distance between the first acting portion 16A and the second acting portion 64A is the smallest is conceptually determined by the alternate long and short dash line 16Z. Shown.

The advanced device 303 configured in this way not only stably irradiates the plasma toward the contact position or the closest position, but also irradiates the plasma over a wide range toward both sides of the mounting target. You can also. Therefore, when the user grips the living tissue using the gripping device 15, not only "the position where the first acting portion 16A or the second acting portion 64A contacts in the living tissue or its vicinity" but also the position is determined. It is possible to easily and surely irradiate the plasma over a wide range including the certainty. Therefore, the operability when the user operates the advanced device 303 is further improved.

Further, the advanced device 303 has a configuration in which the first acting portion 16A and the second acting portion 64A approach and separate from each other along a predetermined plane direction, and in the orthogonal direction orthogonal to the plane direction, on both sides of the mounting target. A discharge port 34 is arranged. The advanced device 303 can effectively utilize the space in the vicinity of the orthogonal direction in the second working member 64, and can provide the discharge port 34 closer to the contact position or the closest position. Moreover, the discharge port 34 can be provided so as not to interfere with the approaching operation and the separating operation of the first acting member 16 and the second acting member 64.

<Fourth Embodiment>
Next, the advanced device 403 of the fourth embodiment will be described with reference to FIG. 10 and the like.
The advanced device 403 differs from the advanced device 3 of the first embodiment (FIG. 1 and the like) only in the arrangement of the plasma irradiation device 20 and the specific shapes of the first acting member 16 and the second acting member 64, and has other configurations and functions. Is the same as the advanced device 3. Therefore, detailed description of the same points as in the first embodiment will be omitted. For example, in the advanced device 403, the plasma irradiation device 20 has the same configuration as the plasma irradiation device 20 provided in the advanced device 3 of the first embodiment, and has the same function. Further, the advanced device 403 can be used for the surgical device 1 in the same manner as the advanced device 3 shown in FIG. That is, in the surgical device 1 of FIG. 1, the tip device 403 can be provided instead of the tip device 3.

In the advanced device 403, the ultrasonic vibration from the ultrasonic vibration unit 12 may be applied to the first acting member 16 as in the first embodiment, and the second acting member 64 may be subjected to ultrasonic vibration. The ultrasonic vibration from the ultrasonic vibration unit 12 may be applied. Further, in the example of FIG. 10, the specific shapes of the first acting member 16 and the second acting member 64 are different from those of the first embodiment, but they may be the same as those of the first embodiment.

In the advanced device 403, the first acting unit 16A and the second acting unit 64A are configured to approach and separate from each other along a predetermined plane direction. Specifically, the direction orthogonal to the rotation axis when the second acting member 64 rotates with respect to the first acting member 16 is the above-mentioned plane direction, and the first acting member 16 and the second acting member 16 64 extends along the plane direction. Then, the tip of the first acting portion 16A and the tip of the second acting portion 64A are configured to approach and separate along one of the plane directions (approaching / separating directions).

In the advanced device 403, the plasma irradiation device 20 similar to that of the first embodiment is attached to the second working member 64. Specifically, in the above-mentioned approach / separation direction (the direction in which the tip of the first acting portion 16A and the tip of the second acting portion 64A approach and separate), the second acting member 64 is placed on the first acting member 16 side. A plasma irradiation device 20 is provided. That is, the plasma irradiation device 20 is arranged between the first acting member 16 and the second acting member 64 in the above-mentioned approaching / separating directions. Therefore, the discharge port 34 is also arranged on the first acting member 16 side of the second acting member 64 in the above-mentioned approaching / separating directions.

The advanced device 403 may also be configured so that the first acting unit 16A and the second acting unit 64A come into contact with each other as in the first embodiment. Alternatively, as in the second embodiment, the first acting unit 16A and the second acting unit 64A may be configured so as not to come into contact with each other. When the first acting unit 16A and the second acting unit 64A are configured to be in contact with each other, in the plasma irradiation device 20, the direction of the gas discharged from the discharge port 34 is the first acting unit 16A and the second acting unit. It is desirable that it faces the contact position when it comes into contact with 64A. When the first acting unit 16A and the second acting unit 64A are configured so as not to come into contact with each other, the plasma irradiation device 20 means that the direction of the gas discharged from the discharge port 34 is directed to the "closest position". Is desirable. In this case, the "closest approaching position" is the position when the first acting section 16A and the second acting section 64A are closest to each other without sandwiching an object (specifically, a living tissue), and this "closest approaching position". The concept of "position" and the concept of "applying gas to the closest position" are the same as those in the second embodiment.

The tip device 403 configured in this way provides a space in the second working member 64 near the approaching / separating direction (the direction in which the tip of the first acting portion 16A and the tip of the second acting portion 64A approach and separate). It can be used effectively. Then, in the advanced device 403, the discharge port 34 can be provided closer to the contact position or the closest position.

<Fifth Embodiment>
Next, the advanced device 503 of the fifth embodiment will be described with reference to FIG. 11 and the like.
The advanced device 503 differs from the advanced device 3 of the first embodiment (FIG. 1 and the like) only in the arrangement of the plasma irradiation device 20 and the specific shapes of the first acting member 16 and the second acting member 64, and has other configurations and functions. Is the same as the advanced device 3. Therefore, detailed description of the same points as in the first embodiment will be omitted. For example, in the advanced device 503, the plasma irradiation device 20 has the same configuration as the plasma irradiation device 20 provided in the advanced device 3 of the first embodiment, and has the same function. Further, the advanced device 503 can be used for the surgical device 1 in the same manner as the advanced device 3 shown in FIG. That is, in the surgical device 1 of FIG. 1, the tip device 503 can be provided instead of the tip device 3.

In the advanced device 503, the ultrasonic vibration from the ultrasonic vibration unit 12 may be applied to the first acting member 16 as in the first embodiment, and the second acting member 64 may be subjected to ultrasonic vibration. The ultrasonic vibration from the ultrasonic vibration unit 12 may be applied.

The advanced device 503 has the same configuration and function as the advanced device 403 of the fourth embodiment except for the shapes of the first acting unit 16A and the second acting unit 64A. In the advanced device 503, the first acting unit 16A and the second acting unit 64A are configured to approach and separate from each other along a predetermined plane direction. Specifically, the direction orthogonal to the rotation axis when the second acting member 64 rotates with respect to the first acting member 16 is the above-mentioned plane direction, and the first acting member 16 and the second acting member 16 64 extends along the plane direction. The tip of the first acting portion 16A and the tip of the second acting portion 64A are configured to approach and separate along one of the plane directions (approaching / separating directions). Then, in the advanced device 503, the plasma irradiation device 20 is attached to the second working member 64. Specifically, in the above-mentioned approach / separation direction (the direction in which the tip of the first acting portion 16A and the tip of the second acting portion 64A approach and separate), the second acting member 64 is placed on the first acting member 16 side. A plasma irradiation device 20 is provided. Therefore, the discharge port 34 is also arranged on the first acting member 16 side of the second acting member 64 in the above-mentioned approaching / separating directions.

The advanced device 503 may also be configured so that the first acting unit 16A and the second acting unit 64A come into contact with each other as in the first embodiment. Alternatively, as in the second embodiment, the first acting unit 16A and the second acting unit 64A may be configured so as not to come into contact with each other. When the first acting unit 16A and the second acting unit 64A are configured to be in contact with each other, in the plasma irradiation device 20, the direction of the gas discharged from the discharge port 34 is the first acting unit 16A and the second acting unit. It is desirable that it faces the contact position when it comes into contact with 64A. When the first acting unit 16A and the second acting unit 64A are configured so as not to come into contact with each other, the plasma irradiation device 20 means that the direction of the gas discharged from the discharge port 34 is directed to the "closest position". Is desirable. In this case, the "closest approaching position" is the position when the first acting section 16A and the second acting section 64A are closest to each other without sandwiching an object (specifically, a living tissue), and this "closest approaching position". The concept of "position" and the concept of "applying gas to the closest position" are the same as those in the second embodiment. In FIG. 11, the relative position of the first acting portion 16A with respect to the second acting portion 64A when the distance between the first acting portion 16A and the second acting portion 64A is the smallest is conceptually indicated by the alternate long and short dash line 16Z. Shown.

Further, the second acting portion 64A is configured as a curved portion 564A that curves toward the first acting portion 16A side toward the tip end side. In the configuration of FIG. 11, the second acting portion 64A (curved portion 564A) is curved along the above-mentioned plane direction, and is curved so as to be convex on the side opposite to the first acting portion 16A side. The first working portion 16A is also curved along the above-mentioned plane direction. The first acting portion 16A is curved so as to be convex toward the second acting portion 64A. The above-mentioned contact position or the above-mentioned closest approach position includes a part of the second acting portion 64A (curved portion 564A) on the first acting portion 16A side.

In such a configuration, the discharge port 34 is the first of the second acting member 64 in the above-mentioned approaching / separating direction (the direction in which the tip of the first acting portion 16A and the tip of the second acting portion 64A approach and separate). It is arranged on the working member 16 side. Then, the direction of the gas discharged from the discharge port 34 is directed to the above-mentioned partial position. That is, when the first acting unit 16A and the second acting unit 64A are configured to be in contact with each other, the direction of the gas released from the discharge port 34 is "the first acting unit on the surface of the second acting unit 64A". It is suitable for the area in contact with 16A. Further, when the first acting unit 16A and the second acting unit 64A are configured so as not to come into contact with each other, the direction of the gas released from the discharge port 34 is "the first acting unit on the surface of the second acting unit 64A". It is suitable for "the region closest to 16A".

The advanced device 503 configured in this way irradiates plasma from a discharge port 34 arranged at a position between the first acting member 16 and the second acting member 64 toward the above contact position or the closest position. Can be done. Therefore, when the first action unit 16A and the second action part 64A sandwich the living tissue, the plasma can be irradiated to the living tissue in a positional relationship in which the living tissue is reliably located at the tip of the discharge port 34. In particular, since the working member has a positional relationship that does not easily obstruct the irradiation of the plasma, the plasma emitted from the discharge port 34 can easily hit the living tissue more efficiently.

Moreover, of the directions in which the first acting portion 16A and the second acting portion 64A approach and separate from each other, the side on which the second acting portion 64A (curved portion) curves (that is, the side on which the tip end side of the second acting portion 64A approaches). The discharge port 34 is arranged on the same side as a certain first action unit 16A side). Then, from this discharge port 34, the second acting portion 64A (curved portion) is directed toward a contact position or the closest position (a part of the curved portion on the first acting portion 16A side) located on the same side as the curved side. Can irradiate plasma. Therefore, when the second acting portion 64A (curved portion) sandwiches the living tissue, the plasma can be reliably applied to the living tissue.

<Sixth Embodiment>
Next, the advanced device 603 of the sixth embodiment will be described with reference to FIG. 12 and the like.
The advanced device 603 is different from the fifth embodiment only in that the plasma irradiation device 320 similar to the third embodiment is used instead of the plasma irradiation device 20 and the plasma irradiation device 320 is arranged in the same manner as the third embodiment. , Other points are the same as those in the fifth embodiment.

The advanced device 603 may also be configured so that the first acting unit 16A and the second acting unit 64A come into contact with each other as in the first embodiment. Alternatively, as in the second embodiment, the first acting unit 16A and the second acting unit 64A may be configured so as not to come into contact with each other. Further, also in the advanced device 603, ultrasonic vibration from the ultrasonic vibrating unit 12 may be applied to the first acting member 16 as in the first embodiment, and the second acting member 64 may be subjected to ultrasonic vibration. The ultrasonic vibration from the ultrasonic vibration unit 12 may be applied.

In the tip device 603 of FIG. 12, the first acting portion 16A and the second acting portion 64A are configured to approach and separate from each other along the above-mentioned plane direction. Then, two structures 20A are provided on both sides of the second acting member 64 in a direction orthogonal to the plane direction (orthogonal direction) so as to sandwich the second acting member 64, and are provided on the two structures 20A. The two outlets 34 are arranged along the above-mentioned "orthogonal direction". Also in this configuration, the second acting portion 64A is configured as a curved portion, and is curved toward the first acting portion 16A side toward the tip side, and the contact position or the closest approach position is the second acting portion. It includes a part of the position on the side of the first acting portion 16A at 64A (curved portion). For example, when the first acting unit 16A and the second acting unit 64A are configured to be in contact with each other, the direction of the gas released from the discharge port 34 is "the first acting unit on the surface of the second acting unit 64A". It is suitable for the area in contact with 16A. Further, when the first acting unit 16A and the second acting unit 64A are configured so as not to come into contact with each other, the direction of the gas released from the discharge port 34 is "the first acting unit on the surface of the second acting unit 64A". It is suitable for "the region closest to 16A".

<7th Embodiment>
Next, the advanced device 703 of the seventh embodiment will be described with reference to FIG. 13 and the like.
The advanced device 703 differs from the advanced device 3 of the first embodiment (FIG. 1 and the like) only in the configuration and arrangement of the plasma irradiation device 320 and the specific shapes of the first acting member 16 and the second acting member 64, and has other configurations. And the function is the same as the advanced device 3. Therefore, detailed description of the same points as in the first embodiment will be omitted. Further, the advanced device 703 can be used for the surgical device 1 in the same manner as the advanced device 3 shown in FIG. That is, in the surgical device 1 of FIG. 1, the tip device 703 can be provided instead of the tip device 3.

In the advanced device 703, the ultrasonic vibration from the ultrasonic vibration unit 12 may be applied to the first working member 16 as in the first embodiment, and the second working member 64 may be subjected to ultrasonic vibration. The ultrasonic vibration from the ultrasonic vibration unit 12 may be applied.

In the advanced device 703, the plasma irradiation device 320 has the same configuration as the plasma irradiation device 320 provided in the advanced device 3 of the third embodiment, and has the same function. The advanced device 703 is different from the third embodiment only in the specific shapes of the first acting portion 16A and the second acting portion 64A, and is the same as the third embodiment in other points.

As shown in FIG. 13, in the advanced device 703 of the seventh embodiment, the first acting unit 16A and the second acting unit 64A are configured to approach or separate from each other along a predetermined plane direction. Specifically, the direction orthogonal to the rotation axis when the second acting member 64 rotates with respect to the first acting member 16 is the above-mentioned plane direction, and the first acting member 16 and the second acting member 16 64 extends along the plane direction. Then, the tip of the first acting portion 16A and the tip of the second acting portion 64A are configured to approach and separate along one of the plane directions (approaching / separating directions). In the configuration of FIG. 13, the plasma irradiation device 320 has two structures sandwiching the second working member 64 on both sides of the second working member 64 to be mounted in the direction orthogonal to the plane direction (orthogonal direction). 20A are provided respectively. The two outlets 34 provided in the two structures 20A are arranged in the above-mentioned "orthogonal direction". Also in the configuration of FIG. 13, in the second acting member 64, the shaft portion 64B is provided on the base end side (rear end side) of the second acting portion 64A, and two structures 20A are attached to the shaft portion 64B. ing.

Further, in this configuration, both the first acting portion 16A and the second acting portion 64A have a bent portion that bends to one side along the orthogonal direction orthogonal to the plane direction. Specifically, each of the first acting portion 16A and the second acting portion 64A is configured as a bent portion, and all of them are bent to one side in the orthogonal direction. For example, the second acting portion 64A is configured as a bending portion 764A, is bent along the direction of the virtual plane orthogonal to the approaching / separating direction, and the tip side is bent toward one side and described above. It is bent so that the side opposite to one side is convex. Similarly, the first action portion 16A is configured as a bending portion 716A, is bent along the direction of the virtual plane orthogonal to the approach / separation direction, and the tip side is bent toward one side. It is bent so that the side opposite to the one side is convex.

In such a configuration, the two structures 20A are arranged on both sides in the orthogonal direction with respect to the second acting member 64 to be attached, and the two outlets 34 are also arranged with respect to the second acting member 64. They are arranged on both sides in the orthogonal direction (see also FIG. 14).

The advanced device 703 may also be configured so that the first acting unit 16A and the second acting unit 64A come into contact with each other as in the first embodiment. Alternatively, as in the second embodiment, the first acting unit 16A and the second acting unit 64A may be configured so as not to come into contact with each other. When the first acting unit 16A and the second acting unit 64A are configured to be in contact with each other, the plasma irradiation device 320 has a plasma irradiation device 320 in which the direction of the gas discharged from the discharge port 34 is the first acting unit 16A and the second acting unit. It is desirable that it faces the contact position when it comes into contact with 64A. When the first acting unit 16A and the second acting unit 64A are configured so as not to come into contact with each other, the plasma irradiation device 320 shall have the direction of the gas discharged from the discharge port 34 facing the "closest position". Is desirable. In this case, the "closest approaching position" is the position when the first acting section 16A and the second acting section 64A are closest to each other without sandwiching an object (specifically, a living tissue), and this "closest approaching position". The concept of "position" and the concept of "applying gas to the closest position" are the same as those in the second embodiment. In FIG. 13, the relative position of the first acting portion 16A with respect to the second acting portion 64A when the distance between the first acting portion 16A and the second acting portion 64A is the smallest is conceptually determined by the alternate long and short dash line 16Z. Shown.

In the advanced device 703, the discharge port 34 is arranged on the same side as the side where the first acting portion 16A (bending portion 716A) and the second acting portion 64A (bending portion 764A) bend (the one side in the orthogonal direction). Has been done. Then, plasma can be irradiated from the discharge port 34 arranged on the same side toward the inner side surface of the bent portions 716A and 764A (the side surface on the concave side in the bent portions 716A and 764A). Therefore, it becomes easy for the plasma to surely hit the living tissue sandwiched between the bent portions 716A and 764A, and in particular, the plasma easily reaches the vicinity of the tips of both acting portions.

<8th Embodiment>
Next, the advanced device 803 of the eighth embodiment will be described with reference to FIG. 15 and the like.
The advanced device 803 is different from the third embodiment only in that the plasma irradiation device 820 is used instead of the plasma irradiation device 320, and is the same as the third embodiment in other points. Specifically, it differs from the third embodiment only in that each structure 20A is changed to each structure 320A.

The advanced device 803 may also be configured so that the first acting unit 16A and the second acting unit 64A come into contact with each other as in the first embodiment. Alternatively, as in the second embodiment, the first acting unit 16A and the second acting unit 64A may be configured so as not to come into contact with each other. Further, in the advanced device 803, the ultrasonic vibration from the ultrasonic vibrating unit 12 may be applied to the first acting member 16 as in the first embodiment, and the second acting member 64 may be subjected to ultrasonic vibration. The ultrasonic vibration from the ultrasonic vibration unit 12 may be applied.

Also in the configuration of FIG. 15, two structures 820A are provided on both sides of the second acting member 64 in the orthogonal direction so as to sandwich the second acting member 64, and the two structures 820A are provided in the above-mentioned "orthogonal direction". Are lined up along.

As shown in FIG. 16, each structure 820A has two outlets 34, and has a configuration capable of emitting plasma from the two outlets 34. As shown in FIG. 17, the structure 820A has a configuration including two structures 20A (FIG. 7 and the like) used in the advanced device 3 of the first embodiment, and the two structures 20A are integrated. Is doing. In the example of FIG. 17, the intermediate position in the second direction of the structure 820A is indicated by the alternate long and short dash line C, and the region on one side and the region on the other side of the alternate long and short dash line C have the same configuration as the structure 20A. There is. Although the electrode corresponding to the ground electrode 44 (FIG. 7) is omitted in FIG. 17, the ground electrode may be provided so as to face each discharge electrode 42 as in FIG. 7, and both discharge electrodes A common ground electrode may be provided so as to straddle 42. The outer shape of the structure 820A shown in FIGS. 16 and 17 is just an example, and the outer shape can have various shapes.

In the configuration of FIG. 15, the structures 820A configured as shown in FIGS. 16 and 17 are arranged on both sides in the direction orthogonal to the second working member 64, respectively, and a plurality of structures 820A are arranged (FIG. 15). In the example of 15, two outlets 34) are arranged along the plane direction. Specifically, in each structure 820A, two outlets 34 are arranged along the approaching / separating directions.

With such an advanced device 803, the same effect as that of the first embodiment or the second embodiment and the same effect as that of the third embodiment can be obtained. Further, since the two discharge ports 34 are lined up along the approach / separation direction, plasma can be irradiated in a wider range in the approach / separation direction.

<Other embodiments>
The present invention is not limited to each aspect of the embodiments described above and in the drawings, and for example, the features of a plurality of embodiments can be combined within a consistent range. The following examples are also included in the technical scope of the present invention.

In the above embodiment, one of the two working members is the first working member 16, the other is the second working member 64, and a plasma irradiation device is attached in the vicinity of the second working member 64 or the second working member 64. However, it may be reversed. That is, the acting member that was the first acting member 16 may be the second acting member, and the acting member that was the second acting member 64 may be the first acting member. In this case, the plasma irradiation device is attached to the first working member or the vicinity of the first working member.

In the configurations of FIGS. 9 to 20, an example in which the plasma irradiation device is attached to the second acting member 64 is shown, but in any of the configurations of FIGS. 9 to 20, the plasma irradiation device is attached to the first acting member 16. It may be attached.

In the third, sixth, seventh, and eighth embodiments, the discharge ports 34 are arranged on both sides of the mounting target in the orthogonal direction orthogonal to the plane direction, but the discharge ports 34 are released only on one side of the mounting target. The exit 34 may be arranged. For example, in the configuration of FIG. 9, one of the structures 20A may be omitted.

In the fourth embodiment, in the above-mentioned approach / separation direction (direction in which the tip of the first acting portion 16A and the tip of the second acting portion 64A approach and separate), the first acting member 16 side of the second acting member 64 Although the configuration in which the discharge port 34 is arranged is illustrated, the configuration is not limited to this configuration. For example, in the above-mentioned approaching / separating directions, the discharge port may be arranged on the side of the second acting member opposite to the first acting member. For example, a second working member may be interposed between the discharge port and the first working member.

In the fifth and sixth embodiments, an example in which the entire second acting portion is configured as a curved portion is shown, but only a part of the second acting portion may be configured as a curved portion.

In the seventh embodiment, an example in which the discharge ports 34 are arranged on both sides of the above-mentioned "orthogonal direction" with respect to the second acting member 64 to be attached is shown, but the example is shown in the "orthogonal direction" with respect to the attachment target. The outlet may be arranged on only one side. For example, in the configuration of FIG. 13, the discharge port 34 arranged on the side opposite to the bending side may be omitted.

In the above embodiment, an example is shown for each shape of the first acting member and the second acting member, but any of the acting members can be changed to various shapes. For example, in the configuration of FIG. 10, the shape of the second acting member may be changed to obtain the advanced device 903 as shown in FIG. Further, such a change in the shape of the working member may be applied to any embodiment.

In the eighth embodiment, the structure 20A of the advanced device 303 of the third embodiment is changed to the structure 820A, but the structure of any embodiment can be changed to the structure 820A. When the structure 820A is applied to any of the embodiments, the structure 820A may be arranged so that a plurality of outlets provided in the structure 820A are arranged in the above-mentioned approach / separation directions, and the above-mentioned orthogonality may be obtained. It may be arranged so as to line up in a direction. Further, when the structure 820A is applied to any of the embodiments, the number of outlets may be 3 or more.

In the eighth embodiment, a structure 820A having a plurality of outlets 34 is shown as an example, and an example in which plasma is emitted from each outlet 34 along a first direction (longitudinal direction of the structure 820A) is shown. However, the direction of the plasma emitted from the outlet 34 is not limited to this example. For example, as shown in FIG. 19, plasma may be irradiated in a direction inclined with respect to the first direction. In the structure 820A of FIG. 19, the flow path near each discharge port 34 is an inclined flow path inclined with respect to the first direction. The structure 820A is configured such that the plasma emitted from the discharge port 34 on one side in the third direction is directed to one side in the first direction and the other side in the third direction. Further, the structure 820A is configured such that the plasma emitted from the discharge port 34 on the other side in the third direction is directed to one side in the first direction and one side in the third direction. In addition, in the configuration other than the eighth embodiment, the plasma may be irradiated in a direction inclined with respect to the first direction.

In the above-described embodiment, an example in which the structure 20A or the structure 820A constituting the plasma irradiation device is formed in a straight line is shown, but the structure constituting the plasma irradiation device may be adjusted to the shape of the attachment target. Good. For example, when the first working member, the second working member, or a member close to any of the working members has an outer surface such as a curved surface or a bent surface, the structure is configured with an outer shape that matches the outer surface. You may. Specifically, for example, the configuration in the vicinity of the working member may be as shown in FIG. The configuration of FIG. 20 is a bent surface in which the outer surface of the shaft portion 64B of the second working member 64 is partially bent, and the structure 20A is configured in a shape that matches the bent surface.

In the above-described embodiment, the configuration in which the plasma irradiation device is incorporated in the advanced device capable of performing ultrasonic vibration is illustrated, but the plasma irradiation device having any of the above configurations is incorporated in the advanced device having other electrical functions. It may have a different configuration. Alternatively, a plasma irradiation device having any of the above configurations may be incorporated in a tip device configured as a known surgical instrument (for example, forceps) having no electrical function.

In the above-described embodiment, the example in which the drive unit is arranged inside the case body (case body in which the working member is incorporated) forming a part of the advanced device is shown, but the drive unit is arranged outside the case body. You may be. When the drive unit is arranged outside the case body in this way, the drive unit may be regarded as a part of the advanced device, and the drive unit may not be regarded as a part of the advanced device.

In the claims and specification, "acting on living tissue" means that the working member affects living tissue and makes at least one of incision, exfoliation and hemostasis. The working member exemplified in the above-described embodiment is merely an example, and if the working member affects the living tissue and can perform at least one of incision, peeling, and hemostasis, other than the above-described embodiment. Various configurations can be adopted.

3,203,303,403,503,603,703,803,903 ... Advanced device 15 ... Grip device 16 ... First working member 16A ... First working part 20, 320, 820 ... Plasma irradiation device 24 ... Reduced diameter part 30 ... Gas guide path 32 ... Introduction port 34 ... Discharge port 36 ... Flow path 40 ... Creeping discharge part (discharge part)
64 ... Second action member 64A ... Second action part 564A ... Curved part 716A, 764A ... Bending part

Claims (8)

It has a first acting member having a first acting part acting on a living tissue on its tip side, and a second acting member having a second acting part acting on a living tissue on its own tip side. A gripping device in which a 1-acting part and the 2nd-acting part are freely approachable and separated, and a biological tissue is sandwiched and gripped between the 1st-acting part and the 2nd-acting part.
A plasma irradiation device having a gas guide path including a flow path for flowing gas along a predetermined direction and a discharge port provided at an end of the flow path, and a discharge section for generating a plasma discharge in the gas guide path. When,
It is an advanced device equipped with
In the plasma irradiation device, when the direction of the gas discharged from the discharge port is the closest to the contact position when the first acting portion and the second acting portion are brought into contact with each other or the living tissue without sandwiching the living tissue. Advanced device facing the closest position. The plasma irradiation device is attached to any one of the first acting member and the second acting member as an attachment target, and has a plurality of the outlets.
The advanced device according to claim 1, wherein the plurality of outlets are arranged on both sides of the mounting target. The plasma irradiation device is attached to any one of the first acting member and the second acting member as an attachment target.
The first acting portion and the second acting portion are configured to approach and separate from each other along a predetermined plane direction, and the outlet is provided on at least one side of the mounting target in an orthogonal direction orthogonal to the plane direction. The advanced device according to claim 1 or 2, which is arranged. The plasma irradiation device is attached to the second working member and is attached to the second working member.
The outlet is arranged on the side of the second acting member on the side opposite to the first acting member or on the side opposite to the first acting member in the direction in which the first acting portion and the second acting portion approach and separate from each other. The advanced device according to claim 1 or 2. The second acting portion has a curved portion that curves toward the first acting portion side toward the tip end side.
The contact position or the closest position includes a part of the curved portion on the side of the first acting portion.
The outlet is arranged on the side of the first acting member of the second acting member in a direction in which the first acting portion and the second acting portion approach and separate from each other.
The advanced device according to claim 4, wherein the plasma irradiation device is such that the direction of the gas discharged from the discharge port is directed to the partial position. The plasma irradiation device is attached to any one of the first acting member and the second acting member as an attachment target.
The first acting portion and the second acting portion are configured to approach or separate from each other along a predetermined plane direction, and have a bent portion that bends to one side along an orthogonal direction orthogonal to the plane direction. And
The advanced device according to claim 1, wherein the outlet is arranged on one side of the attachment target. The plasma irradiation device has a configuration in which a discharge electrode, a ground electrode, and a dielectric layer are laminated in a stacking direction orthogonal to the predetermined direction.
The tip according to any one of claims 1 to 6, wherein the opening width of the outlet in the predetermined direction and the lateral direction orthogonal to the stacking direction is larger than the opening width of the discharge port in the stacking direction. device. The advanced device according to any one of claims 1 to 7, wherein the plasma irradiation device has a reduced diameter portion in which the gas guide path is reduced in diameter toward the discharge port and is reduced in diameter by itself.

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