JP3255885B2 - Medical treatment tools - Google Patents

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a medical treatment tool such as scissors forceps which is inserted into a body cavity to coagulate and cut a blood vessel or the like.

[0002]

2. Description of the Related Art As a medical treatment tool to be inserted into a patient's body, for example, German Patent DE 29702 608 U
1 shows an electric heating scissors. The electric heating scissors are provided with two scissor components that are rotatably connected around a pivot pin. An electrically heatable layer is provided in a part of the incision area arranged at the tip of these scissor constituent members.

In US Pat. No. 5,342,381, a treatment section provided with a pair of treatment members which can be opened and closed at a distal end portion of the treatment instrument body is provided, and a pair of treatment members are opened and closed at a base end portion of the treatment instrument body. A treatment tool provided with an operation unit on the operation side is shown. In this treatment tool, a grasping portion for grasping a living tissue is disposed on the distal end side of the treatment section, and scissors for incision are disposed at the rear end of the grasping portion. In this treatment tool, when used, a high-frequency current is applied to the grasping portion by bipolar, and after the living tissue grasped by the grasping portion is coagulated by the high-frequency current, a coagulated portion of the living tissue is incised by scissors. It has become.

[0004]

The German patent DE 29
In the electric heating scissors of 7 02 608 U1, the two scissors constituting members are each formed by a relatively thin cutting blade having a small plate thickness. Therefore, when a living tissue, for example, a blood vessel or the like is gripped between the two scissor constituent members,
The contact area between the two scissors components and the living tissue is small. As a result, a living tissue such as a blood vessel cannot be sufficiently pressed between the two scissors constituting members, and thus there is a problem that the living tissue such as a blood vessel cannot be sufficiently heat-coagulated.

Further, in the treatment tool of US Pat. No. 5,342,381, since a high frequency is applied to the grasping portion on the distal end side of the treatment portion by bipolar, the scissor portion at the rear end of the grasping portion cannot be made of metal. . Therefore, USP 5,342,3
In the treatment tool 81, the scissors portion of the treatment section is formed of an insulator made of ceramic. However, when the ceramic scissors are used as described above, there is a problem that the incision ability is gradually deteriorated due to friction between the sliding portions of the scissors during use.

The present invention has been made in view of the above circumstances, and an object thereof is to reliably coagulate a living tissue such as a blood vessel gripped between a pair of treatment members,
It is an object of the present invention to provide a medical treatment tool capable of reducing deterioration of the incision ability of an incision by scissors during use and maintaining sharpness of the incision for a long period of time.

[0007]

According to a first aspect of the present invention, a treatment section provided with a pair of openable and closable elements is provided at a distal end portion of a treatment instrument main body, and the treatment instrument main body is provided at a base end portion of the treatment instrument main body. In a medical treatment tool provided with a hand-side operation unit that opens and closes a pair of opening and closing elements, a grasping unit that is disposed on a distal end side of each of the opening and closing elements of the treatment unit and grasps a living tissue, provided in the interior of at least one of the gripper, itself heat generated by energization, the heat thus generated
The living tissue gripped between the gripping portions is heated and coagulated.
A medical treatment device comprising: a heat generating element that solidifies; and an incision portion that is disposed behind the grip portion in each of the opening / closing elements and constitutes a scissor made of a metal material that incises the living tissue. Tool. In the first aspect of the present invention, when used, the heat generating element on the distal end side of the treatment section is electrically heated, and the heat generated there solidifies and welds the tissue . After that, the coagulated portion of the living tissue is incised by an incision made of scissors made of a metal material on the rear side of the grip portion in the treatment section.

According to a second aspect of the present invention, a treatment section having a pair of openable and closable elements is provided at a distal end portion of the treatment instrument main body,
In a medical treatment tool in which a proximal operation unit that opens and closes the pair of opening and closing elements is disposed at a base end of the treatment instrument main body, the medical treatment tool is disposed on a distal end side of each of the opening and closing elements of the treatment unit, A grip portion for gripping a living tissue, and provided inside at least one of these grip portions, which are energized by themselves.
A heat generating element that generates body heat, heats and coagulates the living tissue gripped between the gripping portions by the generated heat ,
Longitudinal direction on one grip side of the treatment section
And protruding toward the other gripping portion side, an incision blade portion for incising the living tissue, and the other gripping portion side
And a concave portion formed so as to extend in the longitudinal direction thereof and mesh with the blade portion. In the above-described structure according to claim 2, in use is energized heating the heat generating elements of the distal end portion side of the treatment unit, where
The generated heat causes the tissue to solidify and weld. Thereafter, the coagulated portion of the living tissue is cut open by engaging the blade portion of the treatment section with the concave portion.

[0009]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS Hereinafter, a first embodiment of the present invention will be described with reference to FIGS. 1 to 5 (A) to 5 (C). FIG. 1 shows a schematic configuration of an entire system of a medical treatment tool 1 according to the present embodiment. The medical treatment tool 1 of the present embodiment is provided with scissors forceps 2 and a generator 3 connected to the scissors forceps 2.

The forceps body (treatment instrument body) 4 of the scissors forceps 2 is provided with two scissors constituting members 5, 6 as shown in FIG. These scissors constituting members 5, 6 are superimposed so that the halfway portions substantially intersect. Further, a support shaft 7 for rotatably connecting the scissors constituting members 5 and 6 is disposed at the intersection of the scissors constituting members 5 and 6.

A treatment section 10 having a pair of openable and closable elements 8 and 9 is formed at the distal end of the forceps body 4. The treatment section 10 is formed in substantially the same shape as the peeling forceps.

Furthermore, finger insertion rings 11 and 12 having a substantially elliptical shape are formed at the base ends of the scissors constituting members 5 and 6, respectively. A hand-side operation unit 13 for opening and closing the pair of opening and closing elements 8 and 9 is formed by the finger insertion rings 11 and 12.

A grasping portion 14 for grasping a living tissue is disposed on each of the opening and closing elements 8 and 9 of the forceps body 4 at a distal end side, for example, about 2 cm from the distal end of each of the opening and closing elements 8 and 9. . As shown in FIG. 3, a substantially flat wide contact plate 15 is disposed on the inner surface (the surface facing the other gripping portion 14) of the gripping portion 14. The contact plate 15 is formed of a metal material having high thermal conductivity, for example, brass (brass). Further, on the outer surface of the contact plate 15, a substantially saw-toothed gripping surface 16 in which a plurality of convex portions and concave portions are arranged is formed. Note that a Teflon coating layer 17 for preventing sticking of the living tissue is formed on the outer surface of the contact plate 15 (contact surface with the living tissue).

Further, as shown in FIG. 4, a heat generating element (heat generating portion) 18 is disposed inside the grip portion 14 of each of the opening / closing elements 8, 9. The heat generating element 18 is formed by a heating element that generates heat by being energized and heated, such as a ceramic heater or a metal resistor. And
The heat generating elements 18 are fixed to the inner surfaces of the contact plates 15, respectively. Thereby, when the heat generating element 18 is energized and heated, the heat of the heat generating element 18 is transferred to the contact plate 1.
The heat is transmitted through the holding member 5 and the living tissue held between the holding portions 14 is coagulated.

Further, a back plate member 1 made of, for example, stainless steel is provided on the opposite side of each grip portion 14 from the contact plate 15.
9 are provided. On the outer surface of the stainless steel of the back plate member 19, a coating layer 20 coated with heat resistance is formed.

One end of a lead wire 21 is connected to the heat generating element 18. The other end of the lead wire 21 extends toward the operation unit 13 on the hand side. Here, a cord connection portion 22 is provided on the operation portion 13 so as to protrude from an outer peripheral surface of one finger insertion ring 11. The other end of the lead wire 21 is connected to the inner end of the cord connection part 22.

Further, a connector 24 disposed at the other end of a connection cord 23 having one end connected to the generator 3 is detachably connected to the cord connection portion 22. When the scissors forceps 2 are used, the heat generating element 1 is supplied from the generator 3 via the connection cord 23 and the lead wire 21.
8, the heat generating element 18 is energized and heated to generate heat. A switch 25 for turning on and off the heat generation by the heat generating element 18 is provided on one scissor constituting member 5 near the finger insertion ring 11.

Further, the gripping portion 1 of each of the opening / closing elements 8 and 9 is provided.
A single-sided scissor blade (cutting portion) 26 is formed on the rear side of each of the four. The scissor blades 26 are integrally formed of, for example, a stainless steel material with the back plate member 19 in each grip portion 14. The scissor blade 26 has a coating layer 2
0 is not formed, and the stainless metal surface is exposed. Further, an incision 27 is provided by scissors made of a metal material for incising a living tissue by the scissor blades 26 of the opening and closing elements 8 and 9. Further, portions of the forceps body 4 of the scissors forceps 2 other than the gripping portions 14 and the scissor blades 26 are formed of, for example, heat-resistant plastic.

Next, the operation of the medical treatment instrument 1 according to the present embodiment having the above configuration will be described. Here, an example of an operation of treating an affected part such as a blood vessel that is in close contact with a living tissue such as a body organ using the scissors forceps 2 of the present embodiment will be described with reference to FIGS. I will explain it.

First, as shown in FIG. 5A, the treatment section 10 at the tip of the scissors forceps 2 is inserted between the living tissue H and a blood vessel H1 which is in close contact with the living tissue H such as an internal organ. At this time, in a state where the pair of opening and closing elements 8 and 9 of the treatment section 10 are closed in advance, both are inserted between the blood vessel H1 and the living tissue H, and then the pair of opening and closing elements 8 and 9 are opened.
The blood vessel H1 is separated from the living tissue H.

Thereafter, as shown in FIG. 5B, the detached blood vessel H1 is grasped between the grasping portions 14 of the opening / closing elements 8, 9 of the scissors forceps 2. At this time, the blood vessel H1 is
It is held in a state where it is compressed with an appropriate pressing force between the four.

In this state, the switch 25 is turned on to heat and heat the heat generating element 18. At this time, the heat of the heat generating element 18 is transferred to the blood vessel H1 between the grip portions 14 via the contact plate 15. Thereby, the tube wall of the blood vessel H1 grasped between the grasping portions 14 is solidified and welded to form a solidified welded portion H2.

Further, after the tube wall of the blood vessel H1 is coagulated and welded, as shown in FIG. 5C, the blood vessel H1 is cut by a scissor blade 26 of an incision 27 on the rear side of the grip portion 14 in each of the opening and closing elements 8, 9. The solidified welding portion H2 of H1 is cut off.

Therefore, the above configuration has the following effects. That is, the medical treatment tool 1 of the present embodiment
In the first embodiment, the substantially flat wide contact plate 15 is disposed on the gripping portion 14 of each of the opening / closing elements 8 and 9 of the forceps body 4 so that the blood vessel H1 is gripped between the two contact plates 15.
By energizing and heating the heat generating element 18 on the distal end side of the treatment section 10, the living tissue such as the blood vessel H <b> 1 gripped between the pair of gripping parts 14 can be reliably thermally coagulated by the heat of the heat generating element 18. it can.

Further, after the living tissue such as the blood vessel H1 is thermally coagulated, the coagulated welded portion H2 of the blood vessel H1 is incised by an incision 27 by a scissor blade 26 made of a metal material on the rear side of the grasping portion 14 in the treatment section 10. The incision ability is less likely to be gradually deteriorated due to friction between the sliding portions of the scissor portion during use, such as when a ceramic scissor portion is used. Therefore, the incision ability of the incision 27 due to the scissors blade 26 during use of the scissors forceps 2 is reduced, and the sharpness of the incision 27 can be maintained for a long time.

Further, in the present embodiment, the work of peeling off the blood vessel H1 that is in close contact with the living tissue H such as a body organ, the coagulation of the vessel wall of the blood vessel H1, the welding work, the coagulation of the blood vessel H1 and the like. Since the operation of separating the welded portion H2 and the like can be performed with one scissors forceps 2, the operation of exchanging the treatment tools as in the case where each of the above operations is performed using a different treatment tool can be omitted. , Easy to use. Furthermore, since the number of treatment tools used in the above treatment can be reduced, the cost can be reduced and the cost can be reduced.

In the present embodiment, the forceps body 4 of the scissors forceps 2 is formed of, for example, heat-resistant plastic except for the grips 14 and the scissor blades 26. The living tissue adjacent to the treatment section to be performed can be protected, and the operator's own hand can be protected.

FIG. 6 shows a second embodiment of the present invention. In the present embodiment, the configuration of the scissors forceps 2 in the medical treatment tool 1 of the first embodiment (see FIGS. 1 to 5A to 5C) is changed as follows.

That is, in the scissors forceps 2 of the present embodiment, a curved portion 31 that is gently curved in a substantially arc shape is formed in the grip portion 14 disposed at the tip of the forceps body 4. In addition,
The configuration of other parts is the same as that of the first embodiment, and the same parts as those of the first embodiment are denoted by the same reference numerals and description thereof is omitted.

Therefore, according to the present embodiment, substantially the same effects as in the first embodiment can be obtained. Furthermore, in the present embodiment, in particular, since the curved portion 31 which is loosely curved in a substantially arc shape is formed in the grip portion 14 disposed at the distal end portion of the forceps main body 4 of the scissors forceps 2, as shown in FIG. H1 and living tissue H that are in close contact with living tissue H such as internal organs
The operation of inserting the treatment section 10 at the distal end of the scissors forceps 2 can be performed more easily.

FIGS. 7 and 8A and 8B show a third embodiment of the present invention. In the present embodiment, the configuration of the scissors forceps 2 in the medical treatment tool 1 of the first embodiment (see FIGS. 1 to 5A to 5C) is changed as follows.

That is, in the scissors forceps 2 of the present embodiment, a pair of opening / closing elements 8 on the distal end side of the forceps body 4 with respect to the support shaft 7,
The grip portion 41a, which is loosely curved into a substantially arc shape, is
41b are respectively formed.

Further, the gripper 41 of each of the opening / closing elements 8, 9 is provided.
The heat generating element 18 shown in FIG. 4 is disposed inside the a and 41b as in the first embodiment. When the heat-generating element 18 is energized and heated, the heat of the heat-generating element 18 is transferred to the front side of the grips 41 a and 41 b via the contact plate 15, and the grips 41 a and 41 b of each of the opening / closing elements 8 and 9.
The living tissue grasped in between is coagulated.

In the scissors forceps 2 of the present embodiment, FIG.
As shown in (A) and (B), an incision blade portion 42 that incises a living tissue toward one grip portion 41a is protruded from one grip portion 41b. This blade portion 42 is a surface 41 of one grip portion 41b facing the other grip portion 41a.
It is arranged at a substantially central portion of b1 and extends in the longitudinal direction of the grip portion 41b.

Further, on the other grip portion 41a side, a concave long groove portion (recess portion) 4 which engages with the blade portion 42 of the grip portion 41b.
3 are formed. Here, as shown in FIG. 8 (B), the depth L1 of the long groove portion 43 is set to be lower than the height L2 of the blade portion 42 of the grip portion 41b (L1 <L2). Then, when the operation unit 13 on the hand side is strongly squeezed and moved in a direction to close between the grip portions 41a and 41b, the apex portion of the blade portion 42 of the grip portion 41b contacts the inner bottom portion of the long groove portion 43, and The contact portion has the highest pressing force.

Next, the operation of the above configuration will be described.
In the case where the scissors forceps 2 according to the present embodiment is used to perform an operation for treating an affected part such as a blood vessel that is in close contact with a living tissue such as a body organ, similarly to the first embodiment, the first embodiment The separation step between the blood vessel H1 and the living tissue H shown in FIG.

Thereafter, as shown in FIG. 5 (B), the detached blood vessel H1 is gripped between the grippers 41a and 41b of the opening / closing elements 8 and 9 of the scissors forceps 2. At this time, the gripper 41
The blood vessel H1 is pressed between the two gripping parts 41a and 41b with a relatively light pressure that does not cut off the blood vessel H1 by the blade part 42b.

In this state, when the heat generating element 18 is electrically heated, the heat of the heat generating element 18 is
Is transferred to the blood vessel H1 between the two gripping portions 41a and 41b through the nip. Thereby, the tube wall of the blood vessel H1 gripped between both grip portions 41a and 41b is solidified and welded to form a solidified welded portion H2.

Further, after the vessel wall of the blood vessel H1 is solidified and welded, the operating section 13 on the hand side is strongly squeezed to grip the holding section 41.
a and 41b are further moved in the closing direction. At this time, the vertex portion of the blade part 42 of the grip part 41b is
5 is strongly pressed in the direction of contact with the inner bottom portion of the long groove portion 43 of FIG.
As shown in (C), the coagulated welded portion H2 of the blood vessel H1 is cut off.

Therefore, the above configuration has the following effects. That is, in the scissors forceps 2 of the present embodiment, the detached blood vessel H1 is used to open and close the opening / closing elements 8, 9 of the scissors forceps 2.
When gripping between the gripping portions 41a and 41b,
The heat generating element 18 is energized and heated in a state where the blood vessel H1 is pressed between the two grip portions 41a and 41b with a relatively light pressure that does not cut off the blood vessel H1 by the blade portion 42b of FIG. , 41b can be coagulated and welded. further,
After the vessel wall of the blood vessel H1 is coagulated and welded, the operation unit 13 on the hand side is strongly squeezed and further moved in a direction to close the gap between the grips 41a and 41b, and the vertex of the blade 42 of the grip 41b is gripped by the grip 41a. By strongly pressing in the direction of contact with the inner bottom of the long groove portion 43, the blade portion 4 of the grip portion 41b is pressed.
2, the coagulated welded portion H2 of the blood vessel H1 can be cut off. Therefore, the scissors forceps 2 of the present embodiment also
Work to peel off the blood vessel H1 which is in close contact with the living tissue H such as an internal organ, etc.
The coagulation and welding work of the vessel wall of the blood vessel H1 and the work of separating the coagulated welded portion H2 of the blood vessel H1 can be performed with one scissors forceps 2, so that each of the above works is performed using a different treatment tool. The operation of exchanging the treatment tools as in the case of performing the treatment can be omitted, the convenience is good, and the cost is low, which is advantageous.

Further, in the scissors forceps 2 of the present embodiment, the coagulated and welded portion H2 of the blood vessel H1 is also formed by the blade 42 made of a metal material.
The incision is less likely to be gradually reduced due to friction between the sliding portions of the scissor portion during use, such as when a ceramic scissor portion is used. Therefore, in the scissors forceps 2 of the present embodiment, similarly to the first embodiment, deterioration of the cutting ability of the blade portion 42 during use of the scissors forceps 2 is reduced, and the sharpness of the blade portion 42 is improved for a long time. Can be kept.

FIGS. 9A and 9B show the fourth embodiment of the present invention.
1 shows an embodiment of the present invention. FIG. 9 (A) shows a schematic configuration of the entire surgical treatment tool 51 used for endoscopic surgery, which is a medical treatment tool of the present embodiment. The treatment tool 51 according to the present embodiment includes an elongated insertion portion 52 that is inserted into a living body through a trocar mantle tube (not shown), and a proximal operation portion 53 connected to a base end of the insertion portion 52.
Are provided.

The insertion portion 52 has a tubular insertion tube 54
Is provided. The insertion portion 52 is provided in the insertion tube 54.
The drive shaft 55 which is relatively moved in the axial direction is inserted. Further, a treatment section 56 is provided at the distal end of the insertion section 52. The treatment section 56 is provided with a pair of gripping members (opening / closing elements) 57a and 57b that can be opened and closed. Here, the pair of gripping members 57a and 57b are connected to the distal end of the drive shaft 55 via a drive mechanism (not shown) such as a cam mechanism. Then, the gripping members 57a, 5a of the treatment section 56 are driven via the drive mechanism in accordance with the forward and backward movement of the drive shaft 55.
Opening / closing drive is performed between 7b.

Further, the gripping member 57 of this embodiment is the first type.
The structure is substantially the same as that of the gripping portions 14 of the opening / closing elements 8 and 9 in the scissors forceps 2 of the embodiment (see FIGS. 1 to 4).

That is, the heat generating element 18 shown in FIG. 4 is disposed inside the gripping member 57 of the present embodiment, similarly to the first embodiment. When the heat generating element 18 is energized and heated, the heat of the heat generating element 18 is transferred to the contact plate 1.
The heat is transferred to the front side of the gripping members 57 via the support 5 and the living tissue gripped between the gripping members 57 is coagulated.

In the treatment tool 51 according to the present embodiment, a single-sided scissor blade (incision portion) is provided on the rear side of the gripping member 57a.
26 'are formed.

The operation section 53 on the hand side has an insertion section 52.
An operation section main body 58 that rotatably holds the base end of the operation section is provided. A fixed handle 59 is formed integrally with the operation section main body 58. A rotation operation knob 60 for rotating the base end of the insertion section 52 is provided at the distal end of the operation section main body 58.

Further, a connecting portion of a movable handle 61 is rotatably connected to the fixed handle 59 via a support shaft 62. The base end of the drive shaft 55 is connected to the movable handle 61.

A first finger support ring 59a into which an operator's finger can be inserted is formed at the end of the fixed handle 59. Further, a second finger rest ring 61 into which the operator's finger can be similarly inserted is provided at the end of the movable handle 61.
a is formed. When the movable handle 61 is opened and closed (rotated) with respect to the fixed handle 59, the drive shaft 55 is driven forward and backward along the axial direction to open and close the gripping members 57 of the treatment section 56. .

Next, the operation of the above configuration will be described.
When using the surgical treatment tool 51 of the present embodiment, the operator's fingers are inserted into the ring 59a of the fixed handle 59 and the ring 61a of the movable handle 61, respectively. In this state, the movable handle 61 is
Is rotated. At this time, the drive shaft 55 moves in the axial direction with respect to the insertion tube 54 of the insertion portion 52 in accordance with the turning operation of the movable handle 61, and the gripping member of the treatment portion 56 at the distal end of the insertion portion 52 via the drive mechanism. Opening / closing drive is performed between the portions 57.

When the treatment tool 51 of the present embodiment is used to treat a diseased part such as a blood vessel which is in close contact with a living tissue such as a body organ similarly to the first embodiment, By the same operation as in the first embodiment, a separation step between the blood vessel H1 and the living tissue H shown in FIG. 5A is performed.

Thereafter, as shown in FIG. 5B, the separated blood vessel H1 is gripped between the gripping members 57 of the treatment tool 51. At this time, the blood vessel H1 is held in a state where the blood vessel H1 is pressed between the two gripping members 57 with an appropriate pressing force.

In this state, when the heat generating element 18 is electrically heated, the heat of the heat generating element 18 is
Is transferred to the blood vessel H1 between the two gripping members 57 via the Thereby, the blood vessel H1 gripped between both gripping members 57
Is solidified and welded to form a solidified welded portion H2.

Further, after the tube wall of the blood vessel H1 is solidified and welded, the coagulated welded portion H2 is cut off by the scissors blade 26 'on the rear side of the gripping member 57.

Therefore, when the detached blood vessel H1 is gripped between the grasping members 57 of the treatment tool 51 in the treatment tool 51 of the present embodiment having the above-described configuration, the blood vessel H1 is moved between the two contact plates 15 of the grasping member 57. Since H1 is gripped, the wall of the blood vessel H1 gripped between the gripping members 57 can be reliably solidified and welded by energizing and heating the heat generating element 18.

Further, after the tube wall of the blood vessel H1 is solidified and welded, the scissor blade 26 'made of a metal material on the rear side of the gripping member 57 is formed.
The coagulated welded portion H2 of the blood vessel H1 is incised, so that the incision ability gradually deteriorates due to friction between the sliding portions of the scissors during use, as in the case of using ceramic scissors. It is less likely to end up. for that reason,
In the treatment tool 51 of the present embodiment, the operation of peeling off the blood vessel H1 that is in close contact with the living tissue H such as the internal organs from the living tissue H and the tube of the blood vessel H1 are substantially similar to the first and third embodiments. Since the solidification and welding of the wall, the operation of separating the solidified and welded portion H2 of the blood vessel H1, and the like can be performed by one treatment tool 51, the above operations are performed using different treatment tools. It is possible to omit the operation of replacing the treatment tool at the same time, it is easy to use and the cost is low,
This is advantageous.

FIG. 10 shows a fifth embodiment of the present invention. This embodiment is a medical treatment tool 1 according to the first embodiment (see FIGS. 1 to 5A to 5C).
Is provided with control means 71 for the heat generating element 18 of the scissors forceps 2 in FIG. The control means 71 of the present embodiment is provided with a temperature control section 72 connected to the heat generating element 18 of the scissors forceps 2. A CPU 74 is connected to the temperature control unit 72 via an amplifier 73. Further, the CPU 74
Is connected to an operation panel 75 for temperature setting.

Further, the resistance of the heat generating element 18 mounted on the scissors forceps 2 of the present embodiment changes with temperature, and the temperature and the resistance change linearly with a metal resistor such as molybdenum. Is formed.

The temperature control section 72 of the present embodiment controls the current amplified by the amplifier 73 so that the resistance value of the heat generating element 18 of the scissors forceps 2, that is, the temperature of the heat generating element 18 can be changed to an arbitrary temperature. Range, e.g., 60C to 150C
Can be adjusted.

FIG. 11 shows a sixth embodiment of the present invention. This embodiment is a medical treatment tool 1 according to the first embodiment (see FIGS. 1 to 5A to 5C).
Is changed as follows.

That is, in the present embodiment, the battery accommodating portion 81 is connected to the cord connecting portion 22 of the finger insertion ring 11 of one scissor constituting member 5 in the scissors forceps 2 of the first embodiment.
And a drive current is supplied from the battery stored in the battery storage section 81 to the heat generating element 18 of the scissors forceps 2.

Therefore, in the above configuration, since the generator 3 used in the medical treatment tool 1 of the first embodiment is unnecessary, the connection between the scissors forceps 2 and the generator 3 is used. The code 23 is also unnecessary. Therefore, there is no possibility that the movement of the scissors forceps 2 is restricted by the connection cord 23 as in the first embodiment, so that the operability of the scissors forceps 2 can be further improved.

Further, the present invention is not limited to the above-described embodiment, and it goes without saying that various modifications can be made without departing from the spirit of the present invention. Next, other characteristic technical matters of the present application will be additionally described as follows. (Supplementary item 1) In a treatment tool that generates heat at the distal end by energizing electricity to coagulate living tissue, a heat generating portion is provided at the distal grip portion, and an incision portion made of metal scissors is provided at the rear end. A treatment tool characterized by the above-mentioned.

(Additional Item 2) The treatment tool according to additional item 1, wherein the heat generating portion is subjected to Teflon processing in order to prevent sticking of a living tissue.

(Additional Item 3) The treatment tool according to Additional Item 1, wherein the surgical instrument under the endoscope comprises a distal end portion, an insertion portion, and an operation portion.

(Additional Item 4) The treatment tool according to additional item 1, wherein the distal end gripping portion is formed with a curved portion curved in a substantially arc shape.

(Appendix 5) The treatment instrument according to Appendix 1, wherein the heat generating portion is connected to temperature control means for adjusting the temperature.

(Additional Item 6) The treatment tool according to additional item 1, wherein the distal end gripping portion is provided with a heat generating portion only in one of two components.

(Additional Item 7) The treatment tool according to additional item 1, wherein the distal end grip portion is provided with a heat generating portion for each of two components.

(Supplementary Item 8) In a treatment tool for coagulating a living tissue by generating heat by applying electricity to a distal end portion, a sharp protrusion is provided on one of a gripping portion of the distal end, and a recess is provided on the other, which engages with the protrusion. A medical treatment tool comprising a part.

(Additional Item 9) The treatment tool according to additional item 8, wherein the heat generating portion is subjected to Teflon processing in order to prevent sticking of a living tissue.

(Additional Item 10) The treatment tool according to additional item 8, wherein the surgical instrument under the endoscope comprises a distal end portion, an insertion portion, and an operation portion.

(Prior Art in Appendix 1) German Patent DE
297 02 608 U1 has an electrically heatable layer provided in a part of the scissors incision area. USP5,34
In No. 2,381, coagulation is performed by a high frequency current by a bipolar at a grip portion at the tip, and an incision is made with scissors at the rear end.

(Problem to be Solved by Additional Item 1) The scissors of German Patent DE 297 02 608 U1 cannot sufficiently compress tissues such as blood vessels, so that sufficient thermal coagulation cannot be performed. Further, in US Pat. No. 5,342,381, the scissors cannot be made of metal by flowing a high frequency in a bipolar manner. Therefore, the scissors are made of an insulating material made of ceramic. When the scissors are made of ceramic, the cutting ability gradually deteriorates due to friction.

[0075]

According to the present invention the biological tissue such as a blood vessel, which is gripped between a pair of gripping portions Ru can be reliably thermally coagulated by the heat of the heat generating element. In the invention of claim 1,
Further, deterioration of the incision ability of the incision by scissors during use can be reduced, and the sharpness of the incision can be maintained for a long time. Furthermore, in the invention of claim 2,
Strongly presses the gripping part in the direction of contact after solidification welding
Thereby, the living tissue can be separated.

[Brief description of the drawings]

FIG. 1 is a schematic configuration diagram of an entire system of a medical treatment tool according to a first embodiment of the present invention.

FIG. 2 is a perspective view of scissors forceps in the medical treatment tool according to the first embodiment.

FIG. 3 is a perspective view showing a distal end grip portion and a blade portion of scissors forceps in the medical treatment tool according to the first embodiment.

FIG. 4 is a longitudinal sectional view showing an internal configuration of a distal end grip portion of the scissors forceps in the medical treatment tool according to the first embodiment.

FIGS. 5A and 5B show a use state of scissors forceps in the medical treatment tool according to the first embodiment, wherein FIG. 5A is an explanatory view for explaining a blood vessel detaching step, and FIG. FIG. 3C is an explanatory diagram for explaining a blood vessel incision step.

FIG. 6 is a perspective view showing a main configuration of scissors forceps in the medical treatment tool according to the second embodiment of the present invention.

FIG. 7 is a perspective view of scissors forceps in a medical treatment tool according to a third embodiment of the present invention.

8A is a cross-sectional perspective view of a distal end gripping portion of scissors forceps in the medical treatment tool according to the third embodiment, and FIG.
Sectional view on the AA line of FIG.

FIG. 9 shows a fourth embodiment of the present invention;
(A) is a side view of the whole surgical treatment tool, (B) is a side view of a main part showing an open state of a distal end gripping part.

FIG. 10 is a schematic configuration diagram of a main part showing a fifth embodiment of the present invention.

FIG. 11 is a perspective view of the entire medical treatment tool according to a sixth embodiment of the present invention.

[Explanation of symbols]

 4 Forceps body (treatment instrument body) 8, 9 Opening / closing element 10 Treatment section 13, 53 Hand-side operation section 14, 41a, 41b Grip section 18 Heat generating element (heat generating section) H Living tissue 26 Scissor blade (incision section) 42 blade part for incision 43 long groove part (recess) 57a, 57b gripping member (opening / closing element)

Continuation of the front page (56) References JP-A-6-343644 (JP, A) JP-A-8-154945 (JP, A) JP-A-9-173347 (JP, A) U.S. Pat. No. 3,518,511 (US, A) U.S. Pat. No. 5,342,381 (US, A) (58) Fields investigated (Int. Cl. ⁷ , DB name) A61B 18/04 A61B 17/28 A61B 17/32 320 A61B 17/26

Claims (2)

(57) [Claims] 1. A treatment section provided with a pair of openable and closable elements at a distal end portion of a treatment instrument main body, and a proximal side for opening and closing the pair of open / close elements at a proximal end portion of the treatment instrument main body. In a medical treatment tool provided with an operation unit, a grip unit that is disposed on the distal end side of each of the opening and closing elements of the treatment unit and grips a living tissue, and at least one of these grip units
Is provided inside the unit and generates heat by itself when energized.
A heat generating element that heats and solidifies the living tissue gripped between the gripping portions by the heat generated, and a metal material that is disposed behind the gripping portion in each of the opening / closing elements and cuts the living tissue. And an incision portion comprising scissors made of a medical device. 2. A treatment section provided with a pair of openable and closable elements at a distal end portion of a treatment instrument main body, and a proximal end for opening and closing the pair of open / close elements at a proximal end portion of the treatment instrument main body. In a medical treatment tool provided with an operation unit, a grip unit that is disposed on the distal end side of each of the opening and closing elements of the treatment unit and grips a living tissue, and at least one of these grip units
Is provided inside the unit and generates heat by itself when energized.
A heat generating element that heats and coagulates the living tissue gripped between the gripping portions by the heat generated , and extends in the longitudinal direction to one gripping portion side of the treatment section , and the other gripping portion Side, and an incision blade portion for incising the living tissue, and the other grip portion side in the longitudinal direction thereof
A medical treatment tool comprising: a recess formed to extend and mesh with the blade portion.