JP2021003487A - Tip device - Google Patents

Abstract

To provide a tip device that can easily stably hold a distance between a biological tissue and a plasma emission port when an action part is made to work on the biological tissue and that can easily stably supply plasma generated in a discharge part to the vicinity of the action part.SOLUTION: The tip device comprises a plasma irradiation device 20. The plasma irradiation device 20 includes: an action member which has an action part for working on a biological tissue, on the own tip side; a gas guide passage 30; and a discharge part 40. The gas guide passage 30 has a flow passage 36 for making gas flow, and an emission port 34 installed in an end part of the flow passage 36, with a structure for discharging gas to the action part side through the emission port 34. The discharge part 40 has a first electrode 42 and a second electrode 44, with plasma discharge generated in the gas guide passage 30. Further, in the action part, there is installed a third electrode 70 in which own electric potential is made ground potential.SELECTED DRAWING: Figure 5

Description

The present invention relates to advanced devices.

Patent Document 1 discloses an example of a medical device that performs tissue welding. In this medical device, low-temperature plasma generation in a plasma head is controlled so that an RF power source is controlled to supply plasma generation RF power to the plasma head. It is configured in. FIG. 3 of Patent Document 1 discloses an example in which a center electrode and a ground electrode are provided at the tip of the plasma head.

Special Table 2014-51987

In this type of advanced device, a discharge electrode (an electrode whose potential fluctuates greatly) and a ground electrode (an electrode maintained at the ground potential) are provided in the vicinity of a portion acting on a living tissue as in the configuration of Patent Document 1. The configuration was common. In such a configuration, both "a configuration in which an electrode whose potential fluctuates greatly does not have an adverse effect on living tissue" and "a configuration in which more plasma can be stably supplied to living tissue" are compatible. It was difficult to do. For example, if the discharge part (both electrodes) is arranged so as to be easily close to the living tissue, it becomes easier to stably supply more plasma to the living tissue, but the "electrode whose potential fluctuates greatly" adversely affects the living tissue. There was a problem that it became easy to cause. On the contrary, if the discharge part (both electrodes) is arranged so as not to be close to the living tissue (arranged away from the living tissue), the adverse effect of the "electrode whose potential fluctuates greatly" on the living tissue is suppressed, but the plasma causes the living tissue. There was a problem that it became difficult to supply to.

The present invention has been made to solve at least a part of the above-mentioned problems, and when the acting part acts on the living tissue, plasma is easily stably supplied to the living tissue, and an electrode whose potential fluctuates greatly is provided to the living tissue. An object of the present invention is to provide an advanced device that can easily suppress adverse effects.

The advanced device, which is one of the present inventions, is
An action member that has an action part that acts on living tissue on its tip side,
A gas guide path that includes a flow path through which gas flows and a discharge port provided at an end of the flow path and discharges gas to the action unit side through the discharge port, and a first electrode and a second electrode. A plasma irradiation device including a discharge unit that is provided and generates a plasma discharge in the gas guide path.
Is an advanced device with
It has a third electrode provided in the working portion and whose own potential is the ground potential.

In the above-mentioned advanced device, since the third electrode is provided in the working part and the third electrode is used as the ground potential, the plasma generated in the discharging part can be easily stably supplied to the vicinity of the working part, and the working part eventually becomes. When acting on a living tissue, plasma is likely to be stably supplied to the living tissue. Moreover, since the position closer to the living tissue can be stabilized at the ground potential, the adverse effect of the electrode whose potential fluctuates greatly on the living tissue can be suppressed.

In the above-mentioned advanced device, the action portion may extend along the first direction, and the third electrode acts on one side of the action portion with which the gas contacts in the second direction orthogonal to the first direction. It may be provided so as to be exposed on the outer surface of the portion, or may be provided near the outer surface on one side of the working portion. Further, the working portion may have a ground wiring portion that is arranged on the other side in the second direction from the third electrode and is electrically connected to the third electrode.
In this way, if the third electrode is provided so as to be exposed on one side where the gas comes into contact, or if the third electrode is provided near the outer surface on one side in the second direction in the working portion, it occurs in the discharging portion. It becomes easier to supply the plasma to be generated near the working part. Further, if the ground wiring portion electrically connected to the third electrode is arranged on the other side of the second direction from the third electrode, the influence of the ground wiring portion on the plasma is suppressed, and the third electrode is plasma. The effect on the plasma can be relatively increased.

In the above-mentioned advanced device, the action part may include a first action part acting on the living tissue and a second action part acting on the living tissue. Then, the working member may include a first working member having a first working part on its own tip side and a second working member having a second working part on its own tip side. Further, the plasma irradiation device includes a first acting member and a second acting member, and the first acting portion and the second acting portion are configured to be close to each other and separated from each other, and the first acting portion and the second acting portion are connected to each other. It may have a gripping device that sandwiches and grips the living tissue between them. Then, the third electrode may be provided in at least one of the first acting portion and the second acting portion.
In this way, if the third electrode is provided in at least one of the first acting portion and the second acting portion that grip the living tissue, the plasma is stable in the vicinity of the portion that grips the living tissue. It becomes easy to be supplied to. Therefore, in the case of a procedure in which the biological tissue is grasped by the first action portion and the second action portion and the plasma is irradiated toward the biological tissue, the plasma is likely to be stably supplied to the gripped biological tissue. Become.

In the above-mentioned advanced device, the plasma irradiation device may be attached to the second working member and may have a plurality of outlets. The plurality of outlets may be arranged on both sides of the second acting member, and the third electrode may be provided on the second acting portion of the second acting member.
As described above, if the plasma is configured to be emitted from both sides of the second acting member, the plasma can be more easily supplied in the vicinity of the second acting portion. Moreover, since the third electrode is provided in the second acting portion, the plasma emitted from both sides can be easily supplied to the vicinity of the second acting portion, and more plasma can be supplied to the vicinity of the second acting portion. Can exert a synergistic effect.

In the above-mentioned advanced device, the plasma irradiation device may be attached to the second working member. 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. Then, the discharge port may be arranged on at least one side of the second working member in the orthogonal direction orthogonal to the plane direction. Then, the third electrode may be provided in the second acting portion of the second acting member.
With such a configuration, the space in the vicinity of the orthogonal direction in the second working member can be effectively used, and the movement of the first working part and the second working part to grip the living tissue is not easily hindered. A discharge port can be provided at. Moreover, since the discharge port is easily arranged close to the second action portion and the third electrode is provided in the second action portion, more plasma can be supplied to the vicinity of the second action portion. Can exert a synergistic effect.

In the above-mentioned advanced device, the plasma irradiation device may be attached to the second working member. Then, 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. Then, the third electrode may be provided in the second acting portion.
With such a configuration, the space in the vicinity of the approaching / separating direction in the second working member can be effectively used. Moreover, since the discharge port is easily arranged close to the second action portion and the third electrode is provided in the second action portion, more plasma can be supplied to the vicinity of the second action portion. Can exert a synergistic effect.

In the above-mentioned advanced device, the second acting portion may have a curved portion that curves toward the first acting portion side toward the distal end side. 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, the third electrode may be provided on the side of the first acting portion in the curved portion.
In the above-mentioned advanced device, the discharge port is arranged on the curved side (first action part side) in the direction in which the first action part and the second action part approach and separate from each other, and the discharge port is arranged at the curved part. The third electrode is arranged on the same side as the arrangement side (first acting part side). Therefore, the plasma emitted from the discharge port is easily supplied to the vicinity of the third electrode, and the plasma is easily stably supplied to the vicinity of the second working portion provided with the third electrode.

In the above-mentioned advanced device, the plasma irradiation device may be attached to the second working member. Further, the advanced device has a configuration in which the first acting portion and the second acting portion approach or separate from each other along a predetermined plane direction, and bend to one side in the orthogonal direction along the orthogonal direction orthogonal to the plane direction. It may have a bent portion to be bent. The discharge port may be arranged on one side of the second acting member in the orthogonal direction. Then, the third electrode may be provided on one side in the orthogonal direction in the second acting portion.
In the above-mentioned advanced device, the outlet is arranged on the same side as the side where the bent portion bends (the above one side in the above orthogonal direction), and the same side as the side where the bent portion bends in the second action portion (in the above orthogonal direction). A third electrode is provided on one side of the above). With such a configuration, the plasma emitted from the discharge port is easily supplied to the vicinity of the third electrode, and the plasma is easily stably supplied to the vicinity of the second working portion provided with the third electrode.

In the above-mentioned advanced device, the plasma irradiation device is configured such that the flow path allows gas to flow along a predetermined direction, and the first electrode, the second electrode, and the dielectric layer are laminated in a stacking direction orthogonal to the predetermined direction. It may have a different configuration. 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 above-mentioned advanced device, the plasma irradiation device may have a diameter-reduced 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 gas so as to increase the flow rate of the gas discharged from the discharge port while suppressing the flow rate of the gas supplied to the gas taxiway. Moreover, since the above-mentioned advanced device has a structure in which the diameter-reduced portion is reduced, the diameter-reduced portion can be made thinner, and there is a great space advantage in arranging the discharge port.

According to the present invention, it is possible to realize an advanced device in which plasma is easily stably supplied to a living tissue when the acting part acts on the living tissue, and the adverse effect of an electrode whose potential fluctuates greatly on the living tissue is easily suppressed. be able to.

FIG. 1 is a schematic view schematically showing a surgical device including the advanced device of the first 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 the cross-sectional structure of a cut surface obtained by cutting the structure of FIG. 3 at the center position in the Z-axis direction (width direction) in a direction orthogonal to the Z-axis direction, together with the cross-sectional structure of the working member. Is. 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 Y-axis direction (thickness direction) in a direction orthogonal to the Y-axis direction. FIG. 8 is a schematic view schematically showing a surgical device including 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 Y-axis direction (thickness direction) in a direction orthogonal to the Y-axis 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 the Y-axis direction (thickness direction) in a direction orthogonal to the Y-axis 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. FIG. 21 is an explanatory diagram conceptually showing the vicinity of the structure and the working portion in the advanced device according to Example 4 of another embodiment. FIG. 22 is an explanatory diagram conceptually showing the vicinity of the structure and the working portion in the advanced device according to Example 5 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 supplies gas to 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 (FIG. 6) in the tip device 3. A gas supply device 7 for operation 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 in which an electric signal can be given 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.).

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

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 to the working member 16 described later. Operates to transmit ultrasonic vibrations. The ultrasonic vibration unit 12 corresponds to an example of the driving unit, and drives the operating member 16 so that an action of incising, peeling, or heat-coagulating hemostasis occurs in the vicinity of the acting unit 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 formed by 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 working member 64 attached so as to be relatively movable with respect to the fixed grip portion 62. It is configured.

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

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

The acting member 64 is a shaft-shaped member that functions as a movable member, and is a member that includes an acting portion 64A that acts on a living tissue on its own tip side (one end side). The working portion 64A is a portion that functions as a movable blade. The working member 64 is provided with a movable grip portion 64C near the end portion on the rear end side (other end side) of the working member 64. In the gripping tool 15, the shaft-shaped working member 64 is rotatable about the rotating shaft Z near the tip of the extending portion 14A, and the working portion 16A and the acting portion 64A are configured to be freely approachable and separated from each other. ing. The gripping tool 15 has an acting member 64 so that the acting portion 64A (movable blade) approaches the 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. Rotates. On the contrary, the acting member 64 rotates so that the acting portion 64A is separated from the 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 acting portion 16A (fixed blade) and the acting portion 64A, the living tissue can be excised by transmitting ultrasonic vibration to the acting portion 16A. It is also possible to bring the 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 acting portion 16A and the acting portion 64A with or without applying ultrasonic vibration to the 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 working portion 16A provided at the tip end portion of the working member 16. In FIG. 2, the position of the acting member 64 when the acting portion 16A and the acting portion 64A come into contact with each other is conceptually shown by a two-dot chain line.

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 a 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. Inside the dielectric region composed of the first dielectric layer 51 and the second dielectric layer 52, a discharge electrode 42 corresponding to an example of the first electrode and a ground electrode 44 corresponding to an example of the second electrode are embedded. It has been. 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. 6).

As shown in FIG. 5, the plasma irradiation device 20 mainly includes a gas guide path 30 and a 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 (FIG. 1) provided outside the tip device 3 from the introduction port 32, and the gas introduced from the introduction port 32 side flows through the flow path. It is a taxiway that guides the discharge port 34 through the space inside the 36. 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. 5, in the gas taxiway 30, the discharge port 34 faces the acting portion 16A at a position close to the acting portion 16A, and the acting portion 16A is located on the extension of the space of the flow path 36. It has become. The gas guide path 30 has a flow path configuration for discharging gas from the discharge port 34 to the action unit 16A side, and functions so as to discharge the low temperature plasma P together with the gas from the discharge port 34 to the action unit 16A side.

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 X-axis direction, and the thickness direction of the dielectric portion 50 is the direction orthogonal to the X-axis direction. The Y-axis direction, and the direction orthogonal to the X-axis direction and the Y-axis direction is the Z-axis direction (FIG. 6). 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 X-axis direction. Then, as shown in FIG. 6, the lateral direction of the structure 20A on the cut surface (FIG. 6) obtained by cutting the structure 20A in the plane direction orthogonal to the X-axis direction is the Y-axis direction, and the longitudinal direction of the cut surface is The direction is the Z-axis direction. The Z-axis direction is the width direction of the structure 20A, and the Y-axis 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 X-axis direction, and the introduction port 32 side is the rear end side of the structure 20A in the X-axis 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 (X-axis direction), and the Y-axis direction orthogonal to the predetermined direction (X-axis direction). The discharge electrode 42, the ground electrode 44, and the dielectric portion 50 are laminated so as to have a stacking direction of. The opening width W3 (FIG. 3) of the discharge port 34 in the lateral direction (Z-axis direction) orthogonal to the predetermined direction (X-axis direction) and the stacking direction (Y-axis direction) is the discharge port in the stacking direction (Y-axis direction). It is larger than the opening width W2 (FIG. 3) of.

The discharge unit 40 has a first dielectric layer 51, and 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 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 creeping discharge.

In the discharge unit 40, one of the discharge electrode 42 and the ground electrode 44 faces the flow path 36 directly or via the other member, and the flow path responds to the application of a periodically changing voltage to the discharge electrode 42. A creeping discharge is generated within 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 discharge portion 40, the discharge electrode 42 faces the flow path 36 via a part of the dielectric portion 50 (second dielectric layer 52), and specifically, the dielectric It is arranged in the body portion 50 at the first position in the Y-axis direction with a first thickness. The ground electrode 44 is arranged in the dielectric portion 50 at the second position in the Y-axis direction with a second thickness, and specifically, is provided on the side opposite to the flow path 36 with respect to the discharge electrode 42. At the same time, it is farther from the flow path 36 than the discharge electrode 42. The discharge unit 40 keeps the potential of the ground electrode 44 at a constant reference potential (for example, a ground potential of 0 V) in the flow path 36 in response to the application of a periodically changing voltage to the discharge electrode 42. A creepage discharge is generated to generate a 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 Y-axis 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 Y-axis direction in the flow path 36. The fourth dielectric layer 54 is arranged on the other side in the Y-axis 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 Y-axis 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 Y-axis direction, and is a side wall portion on one side in the Z-axis direction and the other side in the Z-axis 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 discharge unit 40.

As shown in FIG. 7, the flow path 36 is configured such that a space surrounded by both sides in the Y-axis direction (FIG. 6) and both sides in the Z-axis direction continues in the X-axis direction, and extends along the X-axis direction. It includes one flow path 36A 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 X-axis direction in the structure 20A. The second flow path 36B is provided in the second region AR2 in the X-axis direction in the structure 20A. In FIG. 7, the range in which the first flow path 36A is provided in the X-axis direction is represented as the first region AR1, and the range in which the second flow path 36B is provided in the X-axis 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 X-axis 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 X-axis direction, and the height of the inner wall surface is high over the first region AR1 in the X-axis 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 X-axis 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 X-axis 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 second region AR2 AR22 in the X-axis direction, and the width and height of the inner wall surface are constant over the entire range of the region AR22.

As shown in FIG. 7, the structure 20A has a first fixed shape portion 22 and a second fixed shape portion 26 having a constant outer shape of the cut surface orthogonal to the X axis direction over a predetermined range in the X axis 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 X-axis 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 Z-axis direction) and the height of the outer wall surface (length in the X-axis 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 Y-axis direction) is constant, and the width of the outer wall surface (length in the Z-axis 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 Z-axis direction) and the height of the outer wall surface (length in the Y-axis 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 X-axis direction along the flow path 36, and is arranged in a predetermined region in the X-axis direction. 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 X-axis 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 X-axis 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 Z-axis 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 Z-axis direction, and the discharge port 34 in the Z-axis direction. At least a part of itself (a part of itself in FIG. 7) is located in the formation region.

As shown in FIG. 7, the discharge electrode 42 includes a plurality of (specifically, three) linear electrode portions 42A configured in a straight line so that the linear electrode portions 42A follow the flow path 36. It extends linearly in the X-axis direction, and each linear electrode portion 42A functions as a linear electrode. Each linear electrode portion 42A is composed of a conductor having a constant width and a constant thickness, and is arranged in a predetermined region in the X-axis direction. The plurality of linear electrode portions 42A are connected at the rear end portion, are electrically connected to each other, and have the same potential as each other. The discharge electrode 42 is located only in the arrangement region of the first flow path 36A in the X-axis 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 (length in the Z-axis direction) of each of the linear electrode portions 42A is smaller than the width (length in the Z-axis direction) of the ground electrode 44.

3. 3. Third Electrode As shown in FIG. 5, the tip device 3 includes a third electrode 70. The third electrode 70 is an electrode whose own potential is a ground potential, and is provided in the working portion 16A.

In the following description, of the working member 16 and the working member 64, one working member to which the plasma irradiation device 20 is directly or indirectly attached via another member is the second working member, and the other working member is the second working member. 1 Working member. That is, in the example of FIG. 5, the acting member 16 is the second acting member. The direction in which the working portion (in the example of FIG. 5, the working portion 16A) on which the third electrode 70 is provided extends is the first direction. In the example of FIG. 5, the structure 20A may be directly attached to the working member 16 or the structure 20A may be indirectly attached via another member, but the structure 20A is the case body 14. An example of being indirectly attached to the working member 16 via the above will be described as a typical example.

As shown in FIG. 5, the acting portion 16A extends along the first direction. When the direction orthogonal to the first direction is the second direction, the third electrode 70 is provided near the outer surface of one side (the side of the second direction in which the gas comes into contact) of the acting portion 16A. A ground wiring portion 72 is arranged on the other side of the working portion 16A from the third electrode 70 (the side opposite to the side with which the gas contacts).

Specifically, when the direction parallel to the X-axis direction and the Y-axis direction is the third direction among the directions orthogonal to the first direction (second direction), the third electrode 70 is the action unit 16A. Inside, it is provided near the end of the working portion 16A on one side in the third direction. In FIG. 5, the outer surface of the action unit 16A, which is the end on one side in the third direction, is indicated by reference numeral 16C, and the outer surface, which is the end on the other side in the third direction, is indicated by reference numeral 16D. The third electrode 70 is provided, for example, in a plate shape or a layered shape with a predetermined thickness so that the third direction is the thickness direction. In the example of FIG. 5, in the working member 16, the axial portion arranged around the third electrode 70 and the ground wiring portion 72 is an insulator.

Further, the ground wiring portion 72 is provided on the other side of the third electrode 70 in the third direction, is electrically connected to the third electrode 70, and extends along the first direction in the working portion 16A. The ground wiring portion 72 extends to the rear end side of the third electrode 70, and more specifically, extends to the rear end side of the discharge electrode 42 and the ground electrode 44. The ground wiring portion 72 is electrically connected to a ground (not shown) arranged on the rear end side of the third electrode 70, and is maintained at a ground potential (for example, 0 V). The ground wiring portion 72 may be configured as a metal layer or may be configured by an electric wire as long as it can secure an electrical connection by a conductor.

As shown in FIG. 5, in the plasma irradiation device 20, the direction of the gas discharged from the discharge port 34 is directed to the third electrode 70. Specifically, the third electrode 70 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 X-axis direction. In addition, in FIG. 5, the movement locus (the region in which the opening region moves) when the opening region of the discharge port 34 is translated in the X-axis direction is conceptually shown by the alternate long and short dash line Vt (FIGS. 2 and FIG. See also 3).

The plasma irradiation device 20 configured in this way supplies the inert gas so as to flow the inert gas into the space in the flow path 36 when the operation is started, and the discharge electrode 42 and the ground electrode 44 are supplied by the power supply device 9. An AC voltage of a predetermined frequency is applied between the and. 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 while performing such a discharge operation, and the inert gas discharged from the discharge port 34 is the above-mentioned third electrode 70. It is easy to go to the vicinity. Therefore, when the working portion 16A and the working portion 64A provided with the third electrode 70 sandwich the living tissue, the low temperature plasma generated by the creeping discharge is likely to be supplied to the vicinity of the living tissue.

4. Example of the effect of this configuration In the above-mentioned advanced device 3, since the positional relationship between the working parts 16A and 64A and the discharge port 34 is fixed at a position close to the working parts 16A and 64A, the working parts 16A and 64A are used as living tissues. When acting, it becomes easy to maintain a stable distance between the living tissue and the discharge port 34. Moreover, since the third electrode 70 is provided in the working section 16A and the third electrode 70 is maintained at the ground potential, the plasma generated in the discharging section 40 can be easily stably supplied to the vicinity of the working section 16A, which in turn makes it easier to stably supply the plasma. , It becomes easy to stably supply plasma to living tissue. Further, since the position closer to the living tissue can be stabilized at the ground potential, the adverse effect of the electrode (discharge electrode 42) whose potential fluctuates greatly on the living tissue can be suppressed.

Further, in the advanced device 3, the acting portion 16A extends along the first direction. Then, the third electrode 70 is closer to the outer surface of one side of the working portion 16A that is in contact with the gas in the second direction orthogonal to the first direction (specifically, one side of the third direction). It is provided near the outer surface). Further, the plasma irradiation device 20 includes a ground wiring unit 72, and the ground wiring unit 72 is arranged in the working unit 16A on the other side (specifically, the other side in the third direction) of the third electrode 70 in the second direction. It is also electrically connected to the third electrode 70. In this way, if the third electrode 70 is provided near the outer surface on one side where the gas comes into contact, the plasma generated in the discharge unit 40 can be more easily supplied to the vicinity of the action unit 16A. Further, if the ground wiring portion 72 is arranged on the other side in the second direction (specifically, the other side in the third direction) from the third electrode 70, the influence of the ground wiring portion 72 on the plasma is suppressed. The influence of the third electrode 70 on the plasma can be relatively increased. For example, it is possible to prevent the plasma from gathering too much near the ground wiring portion 72 on the rear end side of the third electrode 70, and it becomes easier to blow the plasma to the third electrode 70 side (that is, the more advanced side).

Further, in the advanced device 3, the acting portion 64A corresponds to an example of the first acting portion, the acting portion 16A corresponds to an example of the second acting portion, and the acting member 64 corresponds to an example of the first acting member. The member 16 corresponds to an example of the second working member. The gripping device 15 is configured such that the acting portion 64A (first acting portion) and the acting portion 16A (second acting portion) can be approached and separated from each other, and the acting portion 64A (first acting portion) and the acting portion 16A ( It is configured to sandwich and grip the living tissue with the second action unit). The third electrode 70 is provided on the acting portion 16A (second acting portion). In this way, if the third electrode 70 is provided in at least one of the first acting portion and the second acting portion that grip the living tissue, the plasma is stable in the vicinity of the portion that grips the living tissue. It becomes easy to be supplied. Therefore, in the case of a procedure in which the biological tissue is grasped by the first action portion and the second action portion and the plasma is irradiated toward the biological tissue, the plasma is likely to be stably supplied to the gripped biological tissue. Become.

More specifically, the plasma irradiation device 20 is directly or indirectly attached to the working member 16 (second working member) via another member. Then, the discharge port 34 is on the action member 64 side (first) of the action member 16 (second action member) in the direction in which the action part 64A (first action part) and the action part 16A (second action part) approach and separate. It is located on the working member side). The third electrode 70 is provided on the acting portion 16A (second acting portion). With such a configuration, the space in the vicinity of the approaching / separating direction in the acting member 16 (second acting member) can be effectively used. Moreover, since the discharge port 34 is easily arranged close to the acting portion 16A (second acting portion) and the third electrode 70 is provided on the acting portion 16A (second acting portion), the acting portion is provided. A synergistic effect can be exerted in supplying more plasma in the vicinity of 16A (second working part).

Further, in the advanced device 3, the plasma irradiation device 20 has a configuration in which the flow path 36 allows gas to flow along a predetermined direction (X-axis direction). Then, the discharge electrode 42 (first electrode), the ground electrode 44 (second electrode), and the dielectric layer (first dielectric layer 51, second dielectric layer 52, third dielectric layer 53, fourth dielectric layer). 54) is laminated in the stacking direction (Y-axis direction) orthogonal to the predetermined direction. The opening width of the discharge port 34 in the lateral direction orthogonal to the predetermined direction (X-axis direction) and the stacking direction (Y-axis direction) is larger than the opening width of the discharge port 34 in the stacking direction. 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, in the advanced device 3, since the reduced diameter portion 24 is provided so that the gas guide path 30 is reduced in diameter toward the discharge port 34, the flow velocity of the gas is increased when the gas passes through the reduced diameter portion 24. I can let you. Therefore, the advanced device 3 can efficiently supply the gas so as to increase the flow rate 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 advanced 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 there is a great space advantage in arranging the discharge port 34. Become.

<Second Embodiment>
Next, the second embodiment will be described.
FIG. 8 illustrates a surgical device 201 comprising the advanced device 203 of the second embodiment. In the following description, in the surgical device 201 including the advanced device 203, the portion having the same configuration as the surgical device 1 (FIG. 1) including the advanced device 3 of the first embodiment is referred to as the surgical device 1 ( The same reference numerals as those in FIG. 1) are assigned, and detailed description thereof will be omitted. For example, in the surgical device 201 and the tip device 203, the plasma irradiation device 20 has the same configuration as the plasma irradiation device 20 provided in the tip device 3 of the first embodiment, and has the same function. Further, the gas supply device 7 and the power supply device 9 have the same configuration as that used for the surgical device 1 (FIG. 1).

As shown in FIG. 8, the advanced device 203 includes an acting member 216 having an acting portion 216A acting on a living tissue, a control device 205 (driving unit) for driving the acting member 216, and a plasma irradiation device 20. Be prepared. Also in this advanced device 203, the plasma irradiation device 20 is incorporated as a part of the advanced device 203, and is fixed to the case body 214 in a configuration held by the holding portion 18. The gas taxiway 30 is configured to discharge gas from the discharge port 34 to the action unit 216A side. The case body 214, the working member 216, and the plasma irradiation device 20 are integrally configured as a gripping unit to be gripped by the user, and the inert gas and electric power are supplied through the flexible member. It has become like.

The control device 205 is configured as a high-frequency current supply unit that supplies a high-frequency current, and corresponds to an example of a drive unit. The working member 216 is formed in a shaft shape by, for example, a metal material, and functions as an electrode portion through which a high frequency current supplied from the control device 205 (high frequency current supply unit) flows. The working member 216 can function as a known electric knife, and can cause an incision action, a peeling action, or a thermal coagulation hemostatic action on a living tissue by a high frequency current flowing through the working member 216 (electrode portion). Note that FIG. 8 conceptually shows a configuration in which the control device 205 (driving unit) is provided on the outside of the case body 214, but the control device 205 is referred to as the case body 214 inside or outside the case body 214. It may be provided integrally. That is, the control device 205 may be provided as a separate body from the plasma irradiation device 20, or may be provided integrally with the plasma irradiation device 20.

In the advanced device 203, the common advanced device 203 performs incision, peeling, or thermal coagulation hemostasis of living tissue by a high-frequency current flowing through the working member 216 and minimally invasive hemostasis by irradiation of low-temperature plasma from the plasma irradiation device 20. Can be done.

Further, the advanced device 203 is provided with a third electrode 70 at the working portion 216A. The third electrode 70 is an electrode whose own potential is a ground potential, and has the same configuration as the third electrode 70 of the first embodiment. Further, although not shown, a ground wiring portion similar to the ground wiring portion 72 of the first embodiment is electrically connected to the third electrode 70. The configuration of the working portion 216A, the third electrode 70, the ground wiring portion, and the discharge port 34 in the advanced device 203 and their positional relationship are as shown in FIG. 5 in the advanced device 3 of the first embodiment. , The configuration and positional relationship of the third electrode 70, the ground wiring portion 72, and the discharge port 74 may be the same, or may be slightly changed.

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 differs from the advanced device 3 (FIG. 1, etc.) of the first embodiment only in the configuration and arrangement of the plasma irradiation device 20, the specific shapes of the working member 16 and the working member 64, and the arrangement of the third electrode 70. , Other configurations and functions are the same as those of 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 vibration unit 12 may be applied to the working member 16 as in the first embodiment, and the ultrasonic vibration to the working member 64. The ultrasonic vibration from the unit 12 may be applied. Further, in the example of FIG. 9, the specific shapes of the working member 16 and the working member 64 are different from those of the first embodiment, but they may be the same as those of the first embodiment.

In the example of FIG. 9, the structure 20A constituting the plasma irradiation device 320 is attached directly to the working member 64 or indirectly via another member. Therefore, the acting member 64 corresponds to an example of the second acting member, and the acting member 16 corresponds to an example of the first acting member. The acting unit 64A corresponds to an example of the second acting unit, and the acting unit 16A corresponds to an example of the first acting unit. A third electrode 70 is provided on the working portion 64A, and the direction in which the working portion 64A extends is set as the first direction. In the example of FIG. 9, the entire working member 64 extends along the first direction.

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 working 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 working member 64 to be attached. In the configuration of FIG. 9, the working member 64 is provided with a shaft portion 64B on the base end side (rear end side) of the working portion 64A, and two structures 20A are attached to the shaft portion 64B.

In the advanced device 303, the acting unit 16A and the 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 acting member 64 rotates with respect to the acting member 16 is the plane direction, and the working member 16 and the working member 64 are along the plane direction. It is extending. The tip of the working portion 16A and the tip of the working portion 64A are configured to approach and separate along one of the plane directions (approaching / separating directions). In the plasma irradiation device 320 of FIG. 9, the discharge port 34 is arranged on at least one side (specifically, both sides) of the working member 64 to be attached in a direction orthogonal to the plane direction (hereinafter, also referred to as an orthogonal direction). Has been done. Specifically, two structures 20A are provided on both sides of the working member 64 in the orthogonal direction so as to sandwich the working member 64, and the two outlets 34 provided in the two structures 20A are described above. They are lined up along the "orthogonal direction" of.

The advanced device 303 is configured so that the acting portion 16A and the acting portion 64A come into contact with each other. Then, in the plasma irradiation device 320, the direction of the gas discharged from the discharge port 34 is directed to the contact position when the action unit 16A and the action unit 64A are brought into contact with each other. In FIG. 9, the relative position of the acting portion 16A with respect to the acting portion 64A when the acting portion 16A and the acting portion 64A come into contact with each other is conceptually shown by the alternate long and short dash line 16Z.

The third electrode 70 is arranged on the acting portion 16A side in the above-mentioned approaching / separating direction (the direction in which the tip of the acting portion 16A and the tip of the acting portion 64A approach and separate) in the acting portion 64A. The third electrode 70 may be exposed on the acting portion 16A side in the approaching / separating direction in the acting portion 64A, and may be exposed to the end portion of the acting portion 64A in the approaching / separating direction (in a non-exposed manner). It may be embedded in the working portion 16A).

Even with the advanced device 303 as described above, the same effect as that of the first embodiment can be obtained.
Further, in the advanced device 303 of this configuration, the plasma irradiation device 320 is attached to the working member 64 (second working member) and has a plurality of outlets 34 and 34. The plurality of discharge ports 34, 34 are arranged on both sides of the working member 64 (second working member). The third electrode 70 is provided on the acting portion 64A (second acting portion). As described above, if the plasma is configured to be emitted from both sides of the acting member 64 (second acting member), the plasma is more easily supplied to the vicinity of the acting portion 64A (second acting portion). Moreover, since the third electrode 70 is provided in the acting portion 64A (second acting portion), the plasma emitted from both sides can be easily supplied to the vicinity of the acting portion 64A, and more plasma is provided in the vicinity of the acting portion 64A. Can exert a synergistic effect in supplying plasma.

In addition, the advanced device 303 can not only stably irradiate the plasma toward the vicinity of the third electrode 70, but also irradiate the plasma over a wider range toward the vicinity thereof. Therefore, when the user grips the living tissue using the gripping device 15, not only "the position where the working part 16A or the working part 64A contacts in the living tissue or its vicinity" but also the position is surely included. Plasma can be easily and reliably irradiated over a wide range. Therefore, the operability when the user operates the advanced device 303 is further improved.

Further, in the advanced device 303, the acting unit 16A (first acting unit) and the second acting unit 64A (second acting unit) are configured to approach and separate from each other along a predetermined plane direction. Then, in the orthogonal direction orthogonal to the plane direction, the discharge port 34 is arranged on at least one side (specifically, both sides) of the working member 64 (second working member). The third electrode 70 is provided on the acting portion 64A (second acting portion). According to this configuration, the space in the vicinity of the orthogonal direction in the acting member 64 (second acting member) can be effectively used, and the acting section 16A (first acting section) and the second acting section 64A (second acting section) can be used. The discharge port 34 can be provided in a form that does not easily hinder the operation of gripping the living tissue. Moreover, since the discharge port 34 is easily arranged close to the acting portion 64A (second acting portion) and the third electrode 70 is provided on the acting portion 64A (second acting portion), the acting portion is provided. A synergistic effect can be exerted in supplying more plasma in the vicinity of 64A (second working part).

<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, etc.) only in the arrangement of the plasma irradiation device 20, the specific shapes of the working member 16 and the working member 64, and the arrangement of the third electrode 70. The configuration and function of the device 3 are the same as those of 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 working member 16 as in the first embodiment, and the ultrasonic vibration to the working member 64. The ultrasonic vibration from the unit 12 may be applied. Further, in the example of FIG. 10, the specific shapes of the working member 16 and the working member 64 are different from those of the first embodiment, but they may be the same as those of the first embodiment.

In the example of FIG. 10, the structure 20A of the plasma irradiation device 20 is attached directly to the working member 64 or indirectly via another member. Therefore, the acting member 64 corresponds to an example of the second acting member, and the acting member 16 corresponds to an example of the first acting member. The acting unit 64A corresponds to an example of the second acting unit, and the acting unit 16A corresponds to an example of the first acting unit. A third electrode 70 is provided on the working portion 64A, and the direction in which the working portion 64A extends is set as the first direction. In the example of FIG. 10, the entire working member 64 extends along the first direction.

In the advanced device 403, the acting unit 16A and the 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 acting member 64 rotates with respect to the acting member 16 is the plane direction, and the working member 16 and the working member 64 are along the plane direction. It is extending. The tip of the working portion 16A and the tip of the working portion 64A are configured to approach and separate along one of the plane directions (approaching / separating directions).

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

The advanced device 403 is configured so that the acting unit 16A and the acting unit 64A come into contact with each other. Then, 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 action unit 16A and the action unit 64A are brought into contact with each other.

The third electrode 70 is arranged on the acting portion 16A side in the above-mentioned approaching / separating direction (the direction in which the tip of the acting portion 16A and the tip of the acting portion 64A approach and separate) in the acting portion 64A. The third electrode 70 may be exposed on the acting portion 16A side in the approaching / separating direction in the acting portion 64A, and may be exposed to the end portion of the acting portion 64A in the approaching / separating direction (in a non-exposed manner). It may be embedded in the working portion 16A).

Even with the advanced device 403 as described above, the same effect as that of the first embodiment can be obtained.
Further, in the advanced device 403, in the discharge port 34 in the approaching / separating direction (the direction in which the acting portion 16A and the acting portion 64A approach and separate), the acting member 16 side (first acting) of the acting member 64 (second acting member) It is arranged on the member side). The third electrode 70 is provided on the acting portion 64A (second acting portion). With such a configuration, the space in the vicinity of the approaching / separating direction in the acting member 64 (second acting member) can be effectively used. Moreover, since the discharge port 34 is easily arranged close to the acting portion 64A (second acting portion) and the third electrode 70 is provided on the acting portion 64A (second acting portion), the acting portion is provided. A synergistic effect can be exerted in supplying more plasma in the vicinity of 64A (second working part).

Further, in the advanced device 403, when the acting unit 16A and the acting unit 64A sandwich the living tissue, the living tissue can be irradiated with plasma in a positional relationship in which the living tissue is reliably located at the tip of the discharge port 34. In particular, the working member has a positional relationship that does not easily interfere with plasma irradiation. The effect of these characteristics, combined with the effect of the third electrode 70, makes it easier for the plasma emitted from the discharge port 34 to hit the living tissue more efficiently.

<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 (FIG. 1, etc.) of the first embodiment only in the arrangement of the plasma irradiation device 20, the specific shapes of the working member 16 and the working member 64, and the arrangement of the third electrode 70. The configuration and function of the device 3 are the same as those of 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 working member 16 as in the first embodiment, and the ultrasonic vibration to the working member 64. The ultrasonic vibration from the 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 acting portion 16A and the acting portion 64A. Also in the example of FIG. 11, the structure 20A of the plasma irradiation device 20 is attached directly to the working member 64 or indirectly via another member. Therefore, the acting member 64 corresponds to an example of the second acting member, and the acting member 16 corresponds to an example of the first acting member. The acting unit 64A corresponds to an example of the second acting unit, and the acting unit 16A corresponds to an example of the first acting unit. A third electrode 70 is provided on the working portion 64A, and the direction in which the working portion 64A extends is set as the first direction. In the example of FIG. 11, the entire working member 64 extends along the first direction.

In the advanced device 503, the acting unit 16A and the 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 acting member 64 rotates with respect to the acting member 16 is the plane direction, and the working member 16 and the working member 64 are along the plane direction. It is extending. The tip of the working portion 16A and the tip of the working 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 working member 64. Specifically, the plasma irradiation device 20 is provided on the working member 16 side of the working member 64 in the above-mentioned approaching / separating direction (the direction in which the tip of the working part 16A and the tip of the working part 64A approach and separate). There is. Therefore, the discharge port 34 is also arranged on the working member 16 side of the working member 64 in the above-mentioned approaching / separating directions.

The advanced device 503 is configured so that the acting portion 16A and the acting portion 64A are in contact with each other. Then, 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 action unit 16A and the action unit 64A are brought into contact with each other. In FIG. 11, the relative position of the acting portion 16A with respect to the acting portion 64A when the acting portion 16A and the acting portion 64A come into contact with each other is conceptually shown by the alternate long and short dash line 16Z.

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

In such a configuration, the discharge port 34 is arranged on the working member 16 side of the working member 64 in the above-mentioned approaching / separating direction (the direction in which the tip of the working part 16A and the tip of the working part 64A approach and separate). There is. Then, the direction of the gas discharged from the discharge port 34 is directed to the above-mentioned partial position (contact position). That is, the direction of the gas discharged from the discharge port 34 is directed to the "region in contact with the acting portion 16A on the surface of the acting portion 64A".

The third electrode 70 is arranged on the curved portion 564A on the acting portion 16A side in the above-mentioned approaching / separating direction (the direction in which the tip of the acting portion 16A and the tip of the acting portion 64A approach and separate). The third electrode 70 may be exposed on the acting portion 16A side in the approaching / separating direction in the curved portion 564A, and may be exposed to the end portion in the bending portion 564A in the approaching / separating direction (in a non-exposed manner). It may be embedded in the working portion 16A).

Even with the advanced device 503 as described above, the same effect as that of the first embodiment can be obtained.
Further, in the tip device 503, in the above-mentioned approach / separation direction (direction in which the tip of the action portion 16A and the tip of the action portion 64A approach and separate), the curved portion 564A is released to the curved side (action portion 16A side). The exit 34 is arranged. Then, in the curved portion 564A, the third electrode 70 is arranged on the same side (acting portion 16A side) as the arrangement side of the discharge port 34. Therefore, the plasma emitted from the discharge port 34 can be easily supplied to the vicinity of the third electrode 70, and the plasma can be stably supplied to the vicinity of the acting portion 64A (second acting portion) provided with the third electrode 70. ..

Further, in the advanced device 503, when the acting unit 16A and the acting unit 64A sandwich the living tissue, the living tissue can be irradiated with plasma 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, in the direction in which the acting portion 16A and the acting portion 64A approach and separate from each other, the side on which the acting portion 64A (curved portion 564A) is curved (that is, the acting portion 16A side on which the tip end side of the acting portion 64A approaches) The discharge port 34 is arranged on the same side. Then, plasma can be irradiated from the discharge port 34 toward a contact position located on the same side as the curved side of the acting portion 64A (curved portion 564A). Therefore, when the acting portion 64A (curved portion 564A) sandwiches the living tissue, the plasma can be reliably applied to the living tissue. The effect of these characteristics, combined with the effect of the third electrode 70, makes it easier for the plasma emitted from the discharge port 34 to hit the living tissue more efficiently.

<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.

In the advanced device 603, the ultrasonic vibration from the ultrasonic vibration unit 12 may be applied to the working member 16 as in the first embodiment, and the ultrasonic vibration unit 12 may be applied to the working member 64. Ultrasonic vibration from may be applied.

Also in the example of FIG. 12, the structure 20A constituting the plasma irradiation device 320 is attached directly to the working member 64 or indirectly via another member. Therefore, the acting member 64 corresponds to an example of the second acting member, and the acting member 16 corresponds to an example of the first acting member. The acting unit 64A corresponds to an example of the second acting unit, and the acting unit 16A corresponds to an example of the first acting unit. A third electrode 70 is provided on the working portion 64A, and the direction in which the working portion 64A extends is set as the first direction. In the example of FIG. 12, the entire working member 64 extends along the first direction.

In the tip device 603 of FIG. 12, the working portion 16A and the 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 working member 64 in a direction orthogonal to the plane direction (orthogonal direction) so as to sandwich the working member 64, and two releases provided on the two structures 20A. The exits 34 are lined up along the "orthogonal direction". In this configuration as well, the acting portion 64A is configured as a curved portion 564A, and is curved toward the acting portion 16A side toward the tip side, and the contact position (the position where the acting portion 16A and the acting portion 64A come into contact) acts. Includes a partial position on the acting portion 16A side of the portion 64A (curved portion 564A).

The third electrode 70 is arranged on the curved portion 564A on the acting portion 16A side in the above-mentioned approaching / separating direction (the direction in which the tip of the acting portion 16A and the tip of the acting portion 64A approach and separate). Also in this example, the third electrode 70 may be exposed on the working portion 16A side in the curved portion 564A, or may be embedded in a position closer to the acting portion 16A in the curved portion 564A in a non-exposed form.

Even with the advanced device 503 as described above, the same effect as that of the first and third embodiments can be obtained.

<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 (FIG. 1, etc.) of the first embodiment only in the configuration and arrangement of the plasma irradiation device 320, the specific shapes of the working member 16 and the working member 64, and the arrangement of the third electrode 70. , Other configurations and functions are the same as those of 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 working member 16 as in the first embodiment, and the ultrasonic vibration to the working member 64. The ultrasonic vibration from the 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 differs from the third embodiment only in the specific shapes of the working portion 16A and the acting portion 64A and the arrangement of the third electrode 70, and is the same as the third embodiment in other points.

Also in the example of FIG. 13, the structure 20A of the plasma irradiation device 320 is attached directly to the working member 64 or indirectly via another member. Therefore, the acting member 64 corresponds to an example of the second acting member, and the acting member 16 corresponds to an example of the first acting member. The acting unit 64A corresponds to an example of the second acting unit, and the acting unit 16A corresponds to an example of the first acting unit. A third electrode 70 is provided on the working portion 64A, and the direction in which the working portion 64A extends is set as the first direction. In the example of FIG. 13, the entire working member 64 extends along the first direction.

As shown in FIG. 13, in the advanced device 703 of the seventh embodiment, the acting unit 16A and the 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 acting member 64 rotates with respect to the acting member 16 is the plane direction, and the working member 16 and the working member 64 are along the plane direction. It is extending. The tip of the working portion 16A and the tip of the working portion 64A are configured to approach and separate along one of the plane directions (approaching / separating directions). In the configuration of FIG. 13, in the plasma irradiation device 320, two structures 20A are provided on both sides of the working member 64 to be mounted in the direction orthogonal to the plane direction (orthogonal direction) so as to sandwich the working member 64. Has been done. 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, the shaft portion 64B is provided on the base end side (rear end side) of the working portion 64A with respect to the working portion 64A, and two structures 20A are attached to the shaft portion 64B.

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

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

The advanced device 703 is also configured so that the acting portion 16A and the acting portion 64A come into contact with each other as in the first embodiment. Then, in the plasma irradiation device 320, the direction of the gas discharged from the discharge port 34 is directed to the contact position when the action unit 16A and the action unit 64A are brought into contact with each other. In FIG. 13, the relative position of the acting portion 16A with respect to the acting portion 64A when the acting portion 16A and the acting portion 64A come into contact with each other is conceptually shown by the alternate long and short dash line 16Z.

As shown in FIG. 13, the bent portion 764A is configured to bend in one side in the orthogonal direction along the above-mentioned orthogonal direction, and one of the two discharge ports 34 and 34, the discharge port 34A, acts. The member 64 (second acting member) is arranged on one side in the orthogonal direction. Then, as shown in FIG. 14, the third electrode 70 is provided on one side of the acting portion 64A (second acting portion) in the orthogonal direction. Specifically, the third electrode 70 is arranged closer to the end 64C of the end 64C on one side in the orthogonal direction and the end 64D on the opposite side in the orthogonal direction in the working portion 64A. The third electrode 70 is arranged in a plate shape or a layered shape so that its own plate surface is arranged along the plane direction or its own plate surface is arranged slightly inclined with respect to the plane direction. Moreover, the bent portion 764A is arranged so as to extend in the extending direction.

Even with the advanced device 703 as described above, the same effect as that of the first and third embodiments can be obtained.
Further, in the tip device 703, one discharge port 34A is arranged on the same side as the side where the bent portion 764A bends (the one side in the orthogonal direction). A third electrode 70 is provided on the same side (one side in the orthogonal direction) as the bending portion 764A in the acting portion 64A (second acting portion). With such a configuration, the plasma emitted from the discharge port 34A can be easily supplied to the vicinity of the third electrode 70, and the plasma gathers in the vicinity of the acting portion 64A (second acting portion) provided with the third electrode 70. It will be easier.

<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 820A.

In the example of FIG. 15, the structure 820A of the plasma irradiation device 820 is attached directly to the working member 64 or indirectly via another member. Therefore, the acting member 64 corresponds to an example of the second acting member, and the acting member 16 corresponds to an example of the first acting member. The acting unit 64A corresponds to an example of the second acting unit, and the acting unit 16A corresponds to an example of the first acting unit. A third electrode 70 is provided on the working portion 64A, and the direction in which the working portion 64A extends is set as the first direction. In the example of FIG. 13, the entire working member 64 extends along the first direction.

In the advanced device 803, the ultrasonic vibration from the ultrasonic vibration unit 12 may be applied to the working member 16 as in the first embodiment, and the ultrasonic vibration unit 12 may be applied to the working member 64. Ultrasonic vibration from may be applied.

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

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 of the structure 820A in the Z-axis direction 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 that of 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 orthogonal direction with respect to the working member 64, respectively, and in each structure 820A, a plurality of structures (FIG. 15) are arranged. In the example, two outlets 34) are arranged along the plane direction. Specifically, in each structure 820A, two outlets 34 are arranged along the approaching / separating directions. The advanced device 803 is also configured so that the acting unit 16A and the acting unit 64A are in contact with each other, and the direction of the gas discharged from the discharge port 34 is the direction when the acting unit 16A and the acting unit 64A are brought into contact with each other. It is suitable for the contact position.

The third electrode 70 is arranged on the acting portion 16A side in the above-mentioned approaching / separating direction (the direction in which the tip of the acting portion 16A and the tip of the acting portion 64A approach and separate) in the acting portion 64A. In this example as well, the third electrode 70 may be exposed on the acting portion 16A side in the approaching / separating direction in the acting portion 64A, and the end portion in the approaching / separating direction in the acting portion 64A in an unexposed form. It may be embedded closer (closer to the working portion 16A).

Even with such an advanced device 803, the same effect as that of the first and third embodiments can be obtained. Further, since the two outlets 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-described embodiment, the configuration in which the third electrode 70 is embedded in the working portion and is not exposed is mainly exemplified, but in any of the configurations of any of the embodiments, the third electrode 70 is exposed and arranged in the working portion. It may have been done.

In the configuration of FIG. 1, an example in which the plasma irradiation device is indirectly attached to the working member 16 is shown, but the plasma irradiation device may be directly attached to the acting member 16 and to the acting member 64. The plasma irradiation device may be attached directly or indirectly via another member. Further, in the configurations of FIGS. 9 to 20, an example in which the plasma irradiation device is attached to the working member 64 is shown, but in any of the configurations, the working member 16 is directly or indirectly via another member. A plasma irradiation device 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 first embodiment, the discharge port 34 is arranged on the acting portion 64A side of the acting member 16 in the above-mentioned approaching / separating direction (the direction in which the tip of the acting portion 16A and the tip of the acting portion 64A approach and separate). The configuration is illustrated, but 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 working member 16 opposite to the working portion 64A.

In the fourth and fifth embodiments, in the above-mentioned approach / separation directions (directions in which the tip of the action unit 16A and the tip of the action unit 64A approach and separate), the discharge port is on the side of the first action member of the second action member. The configuration in which 34 is arranged is illustrated, but 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 opposite to the first acting member in the second 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 working member 64 to be mounted is shown, but one side of the "orthogonal direction" with respect to the mounting target is shown. The outlet may be arranged only on the outlet. 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 arranged. 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 discharge ports 34 is shown as an example, and an example in which plasma is emitted from each discharge port 34 along the X-axis 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 X-axis 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 X-axis direction. The structure 820A is configured such that the plasma emitted from the discharge port 34 on one side in the Z-axis direction is directed to one side in the X-axis direction and the other side in the Z-axis direction. Further, the structure 820A is configured such that the plasma emitted from the discharge port 34 on the other side in the Z-axis direction is directed to one side in the X-axis direction and one side in the Z-axis direction. In addition, in the configuration other than the eighth embodiment, the plasma may be irradiated in the direction inclined with respect to the X-axis 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 structure of FIG. 20 is a bent surface in which the outer surface of the shaft portion 64B of the working member 64 is partially bent, and the structure 20A is configured in a shape that matches the bent surface.

In the second embodiment, an example of an advanced device (FIG. 8) configured as an electric knife having one working member 216 is shown, but an example of an advanced device having only one operating member is limited to this example. Not done. For example, as in the advanced device 1003 exemplified in FIG. 21, the plasma irradiation device 820 similar to the eighth embodiment may be provided directly or indirectly to the working member 216 via another member. In this advanced device 1003, two structures 820A are arranged so as to sandwich the acting member 216, and plasma is irradiated from each discharge port 34 of each structure 820A toward the distal end side of the acting portion 216A. It has become. A third electrode 70 is provided on the tip side of each discharge port 34 in the working portion 216A so that the third electrode 70 is maintained at the ground potential. Alternatively, the plasma irradiation device 1120 may be provided as in the advanced device 1103 illustrated in FIG. 22. In the plasma irradiation device 1120 provided in the advanced device 1103, the structure 1120A has a structure similar to that of the structure 820A, and is provided only on one side of the working member 216. The structure 1120A is mainly different from the structure 820A in that the outer surface of the end portion has a tapered shape, and other configurations are the same as those of the structure 820A. Although the external shape of the working portion 216A of the advanced device 1103 is different from that of the advanced device 203 (FIG. 8) and the advanced device 1103 (FIG. 21), various known external shapes other than these can be applied.

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 an advanced device configured as a known surgical instrument (for example, forceps or the like) 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 the specification, "acting on a living tissue" means that the working member affects the 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.

3,203,303,403,503,603,703,803,903,1003,1103 ... Advanced device 15 ... Gripping device 16 ... Acting member 16A ... Acting part 20,320,820,1120 ... Plasma irradiation device 24 ... Shrinking Diameter 30 ... Gas guide path 34 ... Discharge port 36 ... Flow path 40 ... Discharge section 42 ... Discharge electrode (first electrode)
44 ... Ground electrode (second electrode)
51 ... First dielectric layer (dielectric layer)
52 ... Second dielectric layer (dielectric layer)
53 ... Third dielectric layer (dielectric layer)
54 ... Fourth dielectric layer (dielectric layer)
64 ... Working member 64A ... Working part 70 ... Third electrode 72 ... Ground wiring part 564A ... Curved part 716A, 764A ... Bending part

Claims (10)

An action member that has an action part that acts on living tissue on its tip side,
A gas guide path that includes a flow path through which gas flows and a discharge port provided at an end of the flow path and discharges gas to the action unit side through the discharge port, and a first electrode and a second electrode. A plasma irradiation device including a discharge unit that is provided and generates a plasma discharge in the gas guide path.
Is an advanced device with
An advanced device provided in the working portion and having a third electrode whose own potential is a ground potential. The working part extends along the first direction and
The third electrode is provided on one side of the working portion in contact with the gas in the second direction orthogonal to the first direction so as to be exposed to the outer surface of the working portion, or in the working portion. Provided near the outer surface on one side,
The advanced device according to claim 1, further comprising a ground wiring portion that is arranged on the other side of the third electrode in the second direction and electrically connected to the third electrode. .. The working part includes a first working part that acts on a living tissue and a second working part that acts on a living tissue.
The working member includes a first working member having the first working part on its own tip side and a second working member having the second working part on its own tip side.
Further, the first acting member and the second acting member are provided, and the first acting portion and the second acting portion are configured to be approachable and separated from each other, and the first acting portion and the second acting portion are formed. Has a gripping device that sandwiches and grips living tissue between
The advanced device according to claim 1 or 2, wherein the third electrode is provided in at least one of the first acting portion and the second acting portion. The plasma irradiation device is attached to the second working member and has a plurality of the outlets.
The plurality of outlets are arranged on both sides of the second working member.
The advanced device according to claim 3, wherein the third electrode is provided in the second acting portion of the second acting member. The plasma irradiation device is attached to the second working member and is attached to the second working member.
The first acting portion and the second acting portion approach and separate from each other along a predetermined plane direction, and in an orthogonal direction orthogonal to the plane direction, the release is provided on at least one side of the second acting member. Exits are placed,
The advanced device according to claim 3 or 4, wherein the third electrode is provided in the second acting portion of the second acting member. 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 3, wherein the third electrode is provided in the second acting portion. The second acting portion has a curved portion that curves toward the first acting portion side toward the tip end side.
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 6, wherein the third electrode is provided on the side of the first acting portion in the curved portion. The plasma irradiation device is attached to the second working member and is attached to the second working member.
The first acting portion and the second acting portion are configured to approach or separate from each other along a predetermined plane direction, and are bent to one side in the orthogonal direction along the orthogonal direction orthogonal to the plane direction. Have and
The outlet is arranged on one side of the second acting member in the orthogonal direction.
The advanced device according to claim 3, wherein the third electrode is provided on one side of the second working portion in the orthogonal direction. The plasma irradiation device has a configuration in which the flow path allows gas to flow along a predetermined direction, and the first electrode, the second electrode, and the dielectric layer are laminated in a stacking direction orthogonal to the predetermined direction. Make up,
The tip according to any one of claims 1 to 8, 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 9, 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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