JP3523839B2 - Surgical instruments - Google Patents

Surgical instruments

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JP3523839B2
JP3523839B2 JP2000330709A JP2000330709A JP3523839B2 JP 3523839 B2 JP3523839 B2 JP 3523839B2 JP 2000330709 A JP2000330709 A JP 2000330709A JP 2000330709 A JP2000330709 A JP 2000330709A JP 3523839 B2 JP3523839 B2 JP 3523839B2
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portion
jaw
heating
provided
gripping
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JP2002136525A (en )
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典彦 晴山
浩司 飯田
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オリンパス株式会社
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【発明の詳細な説明】 【0001】 【発明の属する技術分野】この発明は、生体組織を把持し、凝固及び切開することができる手術器械に関する。 BACKGROUND OF THE INVENTION [0001] [Technical Field of the Invention The present invention is a biological tissue grasping relates surgical instruments capable of coagulation and incision. 【0002】 【従来の技術】一般に、生体組織を把持する一対の把持部を備え、把持部の一方または両方に発熱体を設け、生体組織を把持した状態で発熱体を発熱させて生体組織を凝固及び凝固部位を切開する手術器械が知られている。 [0002] In general, a pair of gripping portions for gripping the body tissue, the heating element is provided on one or both of the grip, the while holding the living tissue by heating the heating element body tissue coagulation and surgical instruments for incising coagulation sites are known.
この種の手術器械は、通常、生体組織に含まれる血管の止血、生体組織の表層の病変部、出血点の焼灼、避妊を目的とした卵管の閉塞等の多種症例に用いられる。 Surgical instruments of this kind are usually hemostasis of the blood vessel contained in a biological tissue, lesion of the surface layer of the living tissue, cauterization of the bleeding point, used in a wide cases of clogging tubal for the purpose of contraception. そして、手術器械が血管の止血や、卵管の閉塞を目的として用いられ、患者の処置対象の生体組織を凝固できるようになっており、また凝固した生体組織を切開することができるようになっている。 The surgical instruments hemostasis and blood vessels used for the purpose of occlusion of fallopian tube, making it possible to incise the are adapted to be coagulate patient treatment target living tissue, also coagulated biological tissue ing. 【0003】例えば、USP5792137は、把持鉗子の把持部に鋭利なメス切刃を有する発熱体としてのシリコン半導体を備え、シリコン半導体に通電し、抵抗発熱させて生体組織を凝固するとともに切開を行うものである。 For example, USP5792137 are those comprising a silicon semiconductor as a heat generating member having a sharp knife cutting the gripping portion of the grasping forceps, by energizing the silicon semiconductor, by resistance heating performing with incision coagulating biological tissue it is. 【0004】USP4219025及びUSP4231 [0004] USP4219025 and USP4231
371は、電気絶縁体からなる切断刃に複数のヒータエレメントを設け、各ヒータエレメントに対して独立して制御可能として刃先の温度を一定に保つようにしたものである。 371, a plurality of heater elements to the cutting blade made of an electrically insulating material, in which to keep the temperature of the cutting edge constant as possible independently controlled for each heating element. 【0005】USP5593406は、挿入部の先端部にフック形状の抵抗加熱部分を設け、生体組織を加熱しながら切開するものである。 [0005] USP5593406 is a resistance heating portion of the hook-shaped is provided in the distal end of the insertion portion, in which an incision while heating the biological tissue. 【0006】USP5308311は、先端部に鋭利なメス切刃を設け、このメス切刃の側面に加熱素子を設けて、生体組織を側面で凝固しながら切開するものである。 [0006] USP5308311 is provided with a sharp scalpel cutting the tip portion, provided with a heating element on a side surface of the female cutting edge is intended to incise while coagulating the living tissue side. 【0007】なお、特開平6−7366号公報及び独実G8809437号には、把持鉗子において、ハンドル部に調整可能なストッパ機構を設けたものが開示されているが、生体組織を把持する把持部に発熱体を設けて強固、切開するものではない。 [0007] Incidentally, Japanese Unexamined Patent Publication and Dokumi No. G8809437 6-7366, in grasping forceps, but those having a adjustable stop mechanism is disclosed in the handle portion, the grip portion for gripping a living tissue a heating element is provided firmly, but not incised. 【0008】 【発明が解決しようとする課題】しかしながら、前述したUSP5792137は、発熱体が1個であるため、 [0008] The present invention is, however, since USP5792137 described above, the heating element is one,
温度ムラが生じるという問題がある。 There is a problem in that the temperature unevenness. すなわち、通常、 That is, usually,
電気抵抗により発熱する発熱体は正の温度係数を有する。 Heating element which generates heat by electrical resistance has a positive temperature coefficient. つまり、温度が上昇すると電気抵抗が上昇し、温度が下がると抵抗が低下する。 In other words, the electrical resistance increases when the temperature rises, the resistance and the temperature is lowered is lowered. よって、生体組織を発熱部の一部で把持すると、生体組織の接触している部分の温度が下がり、部分的に電気抵抗が低下する。 Therefore, when a living body tissue is held part of the heat generating portion, lowered temperature in the portion provided in contact with living tissue, partly electrical resistance decreases. 発熱量はR Calorific value is R
×I×I(Rは抵抗値、Iは電流値)で決まるため、生体組織に接触している部分の発熱量が低下・温度が低くなる。 × I × I (R is the resistance, I is the current value) determined depending on a reduction amount of heat generation in the portion provided in contact with the living tissue, temperature decreases. これを補うため、出力を増しても、生体組織に接触している部分の温度が上がらず、接触していない部分の温度だけ上がることになる。 To compensate for this, even if increasing the output, the temperature of the portion in contact with the living tissue does not rise, so that rises by the temperature of the portion not in contact. このため、結果的に温度ムラが生じ、凝固、切開するのに時間がかかるという問題がある。 Thus, resulting in uneven temperature occurs, coagulation, there is a problem that it takes time to incision. 【0009】また、把持部に発熱体が全面で接合されているため、この接合方法では接触面積が大きいため、把持部に熱伝導して放熱するという問題がある。 Further, since the heating element grip part are joined over the entire surface, due to the large contact area in this bonding method, there is a problem of heat dissipation by thermal conduction to the grip portion. さらに、 further,
接触面が金属で硬質であるため、把持部が閉じたときに少しでも隙間ができると、生体組織が確実に処置(特に切開)できないという問題がある。 Since the contact surface is hard, metal, if there is a gap a little when the gripper is closed, there is a problem that the living tissue can not be reliably treated (especially incision). 【0010】また、USP4219025及びUSP4 [0010] In addition, USP4219025 and USP4
231371は、切断刃が片刃であり、生体組織に軽く押し付けて止血凝固するものであり、生体組織を把持して処置することは考慮されていない構造であり、凝固力が弱いという問題がある。 231371 is a cutting blade single-edged, is intended to hemostatic slightly pressed against the living tissue, treating gripping the biological tissue is a structure which is not taken into consideration, there is a problem coagulation force being weak. 【0011】さらに、USP5308311も片刃であり、生体組織に軽く押し付けて止血凝固するものであり、生体組織を把持して処置することは考慮されていない構造であり、生体組織を凝固するのに時間がかかるという問題がある。 Furthermore, USP5308311 also a single-edged, is intended to hemostatic slightly pressed against the living tissue, treating gripping the biological tissue is a structure that has not been considered, time to coagulate the living tissue there is a problem that it takes. 【0012】この発明は、前記事情に着目してなされたもので、その目的とするところは、生体組織を迅速かつ確実に凝固しながら切開でき、手術時間を短縮できる手術器械を提供することにある。 [0012] The present invention has been made in view of the above circumstances, it is an object of living tissue quickly and reliably solidified while incision to provide a surgical instrument which can shorten the operation time is there. 【0013】 【課題を解決するための手段】この発明は、前記目的を達成するために、被検体を把持する第1の把持手段と、 [0013] According to an aspect of this invention, in order to achieve the above object, a first gripping means for gripping the object,
前記第1の把持手段に対し相対的に移動して開閉動作する第2の把持手段と、 前記第1の把持手段と前記第2の A second gripping means for opening and closing operation by relatively moving with respect to the first gripping means, said first gripping means and the second
把持手段を互いに開閉する操作部と、前記第2の把持手 An operation unit for opening and closing the gripping means with each other, the second gripping hand
段の表面に設けられた発熱する発熱部と、前記第1の把持手段と前記発熱部とを閉状態にしたときに前記発熱部 The heating unit when the heating unit for heating provided on the surface of the stage, and the first gripping means and the heating unit was closed
に当接される前記第1の把持手段の表面に設けられた柔軟性部材からなる受け部材と、 前記操作部により前記第1の把持手段と第2の把持手段を閉状態にしたときに A receiving member comprising a flexible member disposed on a surface of said first gripping means is brought into contact, prior to when the first gripping means and second gripping means is closed by said operating unit
記発熱部を前記受け部材が変形する位置まで閉操作を停 Stop the closing operation of the serial heating unit to a position where said receiving member is deformed
止可能としたストッパ手段とを具備したことを特徴とする手術器械にある。 In surgical instruments, characterized by comprising a stop possible with the stopper means. 【0014】 【発明の実施の形態】以下、この発明の各実施の形態を図面に基づいて説明する。 DETAILED DESCRIPTION OF THE INVENTION Hereinafter, will be explained with reference to the embodiments of the invention with reference to the drawings. 【0015】図1〜図4は第1の実施形態を示す。 [0015] FIGS. 1-4 show a first embodiment. 図1 Figure 1
は手術器械としての熱凝固切開鉗子を示し、(a)は先端部を開いた状態の側面図、(b)は上面図、(c)は先端部を閉じた状態の側面図、(d)は(a)のA−A Represents the thermal coagulation and cutting forceps as surgical instruments, (a) shows the side view of the opened tip part, (b) top view, (c) In a side view of a state of closing the tip, (d) the a-a of (a)
線に沿う断面図、図2は先端部を示し、(a)は縦断側面図、(b)は(a)のB−B線に沿う断面図、図3 Sectional view taken along the line, Figure 2 shows the distal end portion, (a) shows the longitudinal sectional side view, (b) is a sectional view taken along the line B-B of (a), FIG. 3
(a)は図2のC−C線に沿う断面図、(b)は図2のD−D線に沿う断面図、(c)は図2のE−E線に沿う断面図、(d)は生体組織Xを把持したときの図2のD (A) is a sectional view taken along the line C-C in FIG. 2, (b) is a sectional view taken along the line D-D in FIG. 2, (c) is a sectional view taken along the line E-E in FIG. 2, (d ) of D of FIG. 2 when gripping the living tissue X
−D線に沿う断面図、図4は電源装置の電気回路図である。 Sectional view taken along -D line, FIG. 4 is an electric circuit diagram of a power supply device. 【0016】図1に示すように、手術器械としての鋏型の熱凝固切開鉗子1の本体2には2つの鋏構成部材3, [0016] As shown in FIG. 1, the main body 2 of the heat coagulation and incision forceps 1 of scissor as surgical instruments two scissor constituting member 3,
4が設けられている。 4 is provided. これらの鋏構成部材3,4は中途部分が略交叉する状態に重ねられている。 These pincers members 3 and 4 are superimposed in a state where the middle portion substantially cross. さらに、両鋏構成部材3,4の交叉部には両鋏構成部材3,4を回動自在に連結する支点ピン5が設けられている。 Furthermore, the intersection of the two scissor constituting members 3,4 fulcrum pin 5 that connects both pincers members 3 and 4 in a pivotal fashion. 【0017】また、本体2の先端部には生体組織Xを把持する開閉可能な第1の把持手段としての第1のジョー7と第2の把持手段としての第2のジョー6を備えた処置部8が設けられている。 Further, the treatment at the distal end of the main body 2 having a second jaw 6 as a first jaw 7 and a second gripping means as the first gripping means which can be opened and closed to grip the biological tissue X section 8 is provided. さらに、各鋏構成部材3,4 Furthermore, the pincers members 3 and 4
の基端部には略円形状の手指挿入リング9,10が設けられている。 The proximal end substantially circular finger inserting rings 9, 10 are provided. そして、これらの手指挿入リング9,10 And, these hand finger insertion ring 9, 10
の部分によって第1のジョー7と第2のジョー6を開閉操作する手元操作部11が形成されている。 Hand control unit 11 to operate by the portion between the first jaw 7 open and close the second jaw 6 is formed. 【0018】また、処置部8を構成する第2のジョー6 Further, a second jaw constituting the treatment portion 8 6
の把持面、つまり生体組織Xとの接触面側には熱伝導性の優れた銅等の薄板状の発熱板12が設けられ、第1のジョー7の把持面には鋸歯状の滑り止め部13aが設けられている。 The gripping surface, i.e. the contact surface with the biological tissue X lamellar heating plate 12, such as superior copper thermally conductive is provided on the gripping surface of the first jaw 7 serrated slip portion 13a is provided. さらに、第1のジョー7の把持面には後述する受け部材13が設けられている。 Furthermore, the gripping surface of the first jaw 7 is provided with receiving members 13 which will be described later. なお、滑り止め部13aは生体組織Xとの切り分かれ易いように受け部材13の先端側に設けられているが、全長に亘って設けてもよい。 Incidentally, slip portion 13a is provided on the distal end side of the cut-divided easily as receiving member 13 with the living tissue X, may be provided over the entire length. さらに、第1のジョー7の両側面で、基端側(支点ピン5寄り)には第2のジョー6側に突出する組織ストッパ14が突設されており、生体組織Xが第1のジョー7と第2のジョー6の基端側に奥深く進入するのを防止するようになっている。 Further, at both sides of the first jaw 7, the base end side (fulcrum pin 5 toward) are organized stopper 14 is protruded projecting second jaw 6 side, the living tissue X is first jaw 7 and so as to prevent from entering deep into the base end side of the second jaw 6. 【0019】また、手元操作部11を構成する一方の手指挿入リング9には他方の手指挿入リング10側に突出するストッパ15が設けられ、これと対向する手指挿入リング10にはストッパ受け部材16が設けられている。 Further, on one hand insert ring 9 which constitutes the operation portion 11 is provided a stopper 15 which projects on the other hand the insertion ring 10, the stopper receiving the finger inserting ring 10 facing the member 16 It is provided. ストッパ15はねじ込み式であり、ねじ込み量によって高さが調節でき、第1のジョー7と第2のジョー6 Stopper 15 is screw-height can be adjusted by the screwing amount, a first jaw 7 and the second jaw 6
の閉鎖位置を調節できるようになっている。 It has to be able to adjust the closed position. 【0020】さらに、一方の鋏構成部材3にはその長手方向に沿って凹溝17が設けられ、この凹溝17の内部にはリード線18が挿通されている。 Furthermore, on one of the scissor constituting member 3 is recessed groove 17 provided along the longitudinal direction, the lead wire 18 is inserted through the inside of the groove 17. このリード線18 The lead wire 18
の一端部は発熱板12に埋設された後述する発熱体に接続され、他端部は一方の手指挿入リング9に設けられたコネクタ19を介してコネクタケーブル20に接続されている。 One end being connected to the heating element to be described later is embedded in the heating plate 12, the other end is connected to the connector cable 20 through a connector 19 provided on the one hand finger insertion ring 9. 【0021】コネクタケーブル20は、図4に示す電源装置21に接続されている。 The connector cable 20 is connected to the power supply 21 shown in FIG. 電源装置21には商用電源と接続する電源部22が設けられ、この電源部22は出力部23を介してコネクタケーブル20に接続されている。 Power supply unit 22 to be connected to the commercial power source is provided in the power supply 21, the power supply unit 22 is connected to the connector cable 20 via the output unit 23. 出力部23はフットスイッチ24と接続する制御部25に接続され、制御部25は発熱温度を設定する設定手段26に接続されている。 The output unit 23 is connected to a control unit 25 for connecting the foot switch 24, the control unit 25 is connected to a setting means 26 for setting the heating temperature. 【0022】次に、前記処置部8について図2及び図3 Next, FIGS. 2 and 3 for the treatment section 8
に基づいて説明する。 It will be described with reference to. 【0023】第2のジョー6に設けられた発熱板12は第2のジョー6の長手方向に沿って配置された長方形状の金属板であり、その下辺部には先端に向かって肉薄になるようにテーパを有した突部31が長手方向に亘って設けられている。 [0023] The heating plate 12 provided on the second jaw 6 is a rectangular metal plate arranged along the longitudinal direction of the second jaw 6, it becomes thinner toward the tip on its lower side projection 31 has a tapered is provided in the longitudinal direction as. 【0024】発熱板12の上辺部には長手方向に所定間隔を存して複数個、本実施形態においては3個の突出片32a,32b,32cが上方に突出して設けられている。 [0024] The upper portion of the heating plate 12 a plurality at predetermined intervals in the longitudinal direction, three projecting pieces 32a in the present embodiment, 32b, 32c are provided to protrude upward. これら突出片32a,32b,32cには縦方向にすり割りが設けられ、このすり割りによって熱結合部3 These projecting pieces 32a, 32b, slit in the longitudinal direction is provided on 32c, thermal coupling unit 3 by this slit
3が形成されている。 3 is formed. 【0025】第2のジョー6の先端側に位置する突出片32aには横方向に貫通する貫通孔34が設けられ、第2のジョー6の基端側に位置する突出片32cには他の突出片32a,32bより上方に突出する固定板35が一体に設けられている。 [0025] The projecting piece 32a located at the distal end side of the second jaw 6 through hole 34 penetrating in the lateral direction is provided, the protruding piece 32c positioned on the base end side of the second jaw 6 of other projecting pieces 32a, the fixing plate 35 projecting from the upper 32b is integrally provided. 【0026】前記突出片32a,32b,32cの各熱結合部33には熱発生手段としての薄膜加熱抵抗素子等の発熱体36a,36b,36cがその一部をすり割りの内部に挿入した状態で熱結合固定されている。 The state of being inserted the projecting piece 32a, 32b, the heating element 36a of the thin-film heating resistor element such as a heat generating means in the thermal coupling portion 33 of the 32c, 36b, 36c within the interior of slitting a part in is thermally coupled fixed. これら発熱体36a,36b,36cは温度分布が均一となるように等間隔に設置され、これらはそれぞれ独立して前述したリード線18が接続されている。 These heating elements 36a, 36b, 36c are equally spaced so that the temperature distribution is uniform, they lead 18 described above independently are connected. さらに、リード線18の先端部の導電部は絶縁カバー37によって覆われている。 Further, the conductive portion of the distal end portion of the lead wire 18 is covered with an insulating cover 37. 【0027】さらに、前記発熱板12には突出片32 Furthermore, the the heating plate 12 protruding pieces 32
a,32b,32cの各熱結合部33及び発熱体36 a, 32b, 32c each heat coupling portion 33 and the heating element 36
a,36b,36cの左右両側部及び上部を覆うカバー38が設けられている。 a, 36b, a cover 38 for covering the right and left side portions and upper 36c are provided. このカバー38は第2のジョー6の先端側と基端側の2ヶ所で発熱板12に固定されている。 The cover 38 is fixed to the heating plate 12 at two points of the front end side and the proximal side of the second jaw 6. カバー38の材質は、ステンレス等の熱伝導性の悪いものの方が発熱板12の放熱を防止できる。 The material of the cover 38 towards the poor thermal conductivity of stainless steel or the like can be prevented radiator of the heating plate 12. 【0028】すなわち、第2のジョー6の先端側においては貫通孔34に横方向に貫通して設けられた固定ピン39の両端部にカバー38が固定されている。 [0028] That is, the cover 38 at both ends of the second fixing pin 39 in the distal end which penetrates transversely into the through hole 34 of the jaw 6 is fixed. 第2のジョー6の基端側においては固定板35の両側面に対向してカバー38の両側面にねじ孔40が設けられている。 Screw holes 40 are provided on both sides of the cover 38 facing to both sides of the fixing plate 35 at the proximal end side of the second jaw 6.
これらねじ孔40には固定ねじ41が螺合され、2本の固定ねじ41の先端部で固定板35を挟持している。 These fixing screws 41 into the screw hole 40 is screwed, which clamp the fixing plate 35 at the tip of the two fixing screws 41. 固定ねじ41の先端部は円錐状で、固定板35に点接触しており、発熱板12の熱が固定板35及び固定ねじ41 Tip of the fixing screw 41 is conical, in contact fixed plate 35 two points, heat of the heating plate 12 is fixed plate 35 and the fixing screw 41
を介してカバー38に伝導するのを防止している。 It is prevented from conducting to the cover 38 through the. 【0029】カバー38の左右両側縁部における下縁は発熱板12に当接しており、発熱板12の突部31のみがカバー38から露出するようになっている。 The lower edges of the left and right side edges of the cover 38 is in contact with the heating plate 12, only the projections 31 of the heating plate 12 is adapted to be exposed from the cover 38. また、カバー38の先端開口部は固定ピン39に枢支固定されたキャップ42によって覆われている。 The tip opening of the cover 38 is covered by a cap 42 which is pivotally secured to the fixing pin 39. 【0030】また、前記第1のジョー7の受け部材13 Further, the receiving member 13 of the first jaw 7
はゴム等の柔軟性部材からなり、第1のジョー7の上面に設けられた凹陥部43の内部に収納されており、受け部材13の把持面は平坦面に形成されている。 Consists of a flexible material such as rubber, is housed inside the recessed portion 43 provided on the upper surface of the first jaw 7, the gripping surface of the receiving member 13 is formed into a flat surface. そして、 And,
滑り止め部13aは受け部材13の把持面より上方に突出している。 Slip portion 13a protrudes upward from the gripping surface of the receiving member 13. 第1のジョー7と第2のジョー6の閉鎖時に、受け部材13が発熱板12で押圧され、若干変形するように前記ストッパ15は調整されている。 Upon closing of the first jaw 7 second jaw 6, the receiving member 13 is pressed by the heating plate 12, the stopper 15 so as to slightly deform is adjusted. 【0031】次に、前述のように構成された熱凝固切開鉗子1の作用について説明する。 Next, a description will be given of the operation of the heat coagulation and incision forceps 1 configured as described above. まず、本体2の先端部の処置部8を閉じた状態で図示しない血管等の被処置部を含む生体組織Xに差し込む。 First, plug into the biological tissue X including the treatment portion of the blood vessel or the like (not shown) with closed treatment portion 8 of the distal end portion of the main body 2. その後、手元操作部11 Then, the hand control unit 11
の手指挿入リング9,10を開き、支点ピン5を支点として鋏構成部材3,4を回動させて第1のジョー7と第2のジョー6を開くことにより、血管等の被処置部を他の生体組織Xから剥離して露出させる。 Open the finger insertion ring 9, by opening the first jaw 7 by rotating the pincers members 3 and 4 the pivot pin 5 as a fulcrum second jaw 6, a treatment target portion such as a blood vessel exposing peeled from other biological tissue X. 【0032】続いて、剥離した血管等を第1のジョー7 [0032] Subsequently, the peeling vessel, such as the first jaw 7
と第2のジョー6の間で凝固処置に適する比較的小さい適正な加圧力で圧迫した状態で把持する。 When gripped in a state of being squeezed smaller proper pressure suitable for coagulation treatment between the second jaw 6. この状態で、 In this state,
電源装置21を出力すると、コネクタケーブル20を介してコネクタ19、リード線18を介して第1のジョー7の発熱板12に設けられた発熱体36a,36b,3 And outputs the power supply 21, a connector 19 through a connector cable 20, the heating element 36a provided in the heating plate 12 of the first jaw 7 via a lead wire 18, 36b, 3
6cに電流が通電される。 Current is supplied to 6c. この通電時の電気抵抗により発熱体36a,36b,36cが発熱し、発熱板12の表面に接触している血管等の被処置部の生体組織Xが凝固・切開される。 Heating element 36a by the electrical resistance at the time of energization, 36b, 36c generates heat, the living tissue X of the treatment portion of such vessel which is in contact with the surface of the heating plate 12 is coagulation and incision. 【0033】このとき、第2のジョー6には3個の発熱体36a,36b,36cが設けられ、各発熱体36 [0033] In this case, three heating elements 36a to the second jaw 6, 36b, 36c are provided, each heating element 36
a,36b,36cには独立してリード線18が接続されて電源装置21に接続されている。 a, 36b, are separate lead wire 18 is connected is connected to the power supply 21 to 36c. 従って、各発熱体36a,36b,36cを電源装置21の設定手段26 Therefore, setting means 26 of each heating element 36a, the power supply device 21 36b, a 36c
によって設定された発熱温度に独立して制御できる。 It can be independently controlled to the set heating temperature by. すなわち、発熱板12の生体組織Xに接触している部分、 That is, the portion in contact with the living tissue X of the heating plate 12,
例えば発熱板12の先端側の発熱量が低下し、温度が低下した場合には、先端側の発熱体36aの抵抗値を検出して出力部23から発熱体36aへの出力を増す制御を行ない、生体組織Xに接触していない部分、例えば発熱板12の基端側の発熱量が上昇した場合、基端側の発熱体36cの出力を低下させる制御を行なうことができ、 For example the heating value of the distal end side of the heating plate 12 is lowered, when the temperature is lowered, it performs control to increase the output of detecting the resistance value of the distal end side of the heating element 36a from the output unit 23 to the heating element 36a , the portion not in contact with the body tissue X, for example if the heating value of the base end side of the heating plate 12 is increased, it is possible to perform the control for reducing the output of the heating element 36c of the base end side,
結果的に発熱板12の温度ムラを防止して凝固及び切開を迅速かつ確実に行なうことができる。 The results in preventing coagulation and incision uneven temperature of the heating plate 12 can be performed quickly and reliably. 【0034】さらに、第1のジョー7と第2のジョー6 [0034] In addition, the first jaw 7 second jaw 6
によって生体組織Xを把持する際、第1のジョー7には第2のジョー6側に突出する組織ストッパ14が突設されているため、生体組織Xが第1のジョー7と第2のジョー6の基端側に奥深く進入するのを防止することができる。 When gripping the biological tissue X by, the first jaw 7 for tissue stop 14 projecting into the second jaw 6 side is projected, the biological tissue X is a first jaw 7 second jaw from being deeply enters the proximal side of the 6 can be prevented. 【0035】また、手元操作部11を構成する一方の手指挿入リング9には他方の手指挿入リング10側に突出するストッパ15が設けられているため、第1のジョー7と第2のジョー6を閉鎖したとき、ストッパ15がこれと対向するストッパ受け部材16に当接し、第1のジョー7と第2のジョー6が完全に閉鎖したことを確認でき、第1のジョー7と第2のジョー6の全長に亘って生体組織Xを切開できる。 Further, the stopper 15 protruding on the other hand finger insertion ring 10 side on one finger insert ring 9 which constitutes the operation portion 11 is provided, a first jaw 7 and the second jaw 6 when closed, it abuts the stopper receiving member 16 a stopper 15 is opposed to this, a first jaw 7 can confirm that the second jaw 6 is completely closed, the first jaw 7 second You can incised body tissue X over the entire length of the jaw 6. 【0036】さらに、発熱板12の外表面及びカバー3 Furthermore, the outer surface and the cover 3 of the heating plate 12
8の外表面にはテフロンコーティングがされているため生体組織Xの貼りつきを防止することができる。 The 8 outer surface of the can to prevent sticking of the living tissue X because it is Teflon coated. 【0037】なお、発熱板12は銅、銀、タングステン等の熱伝導性のよい材質が望ましく、発熱体36a,3 [0037] Incidentally, the heating plate 12 is copper, silver, good material thermal conductivity such as tungsten desirably, the heating element 36a, 3
6b,36cは、薄膜抵抗加熱素子、セラミックヒーター、カートリッヂヒーター、PTCヒーター等でもよい。 6b, 36c is a thin film resistive heating element, ceramic heater, cart Riddji heater may be a PTC heater or the like. 【0038】また、受け部材13の材質例を挙げると、 [0038] In addition, a material example of the receiving member 13,
ゴム(シリコンゴム、フッ素ゴム、エチレンプロピレンゴム、ブチルゴム等)、ゲル(シリコンをベースとしたαゲル等)テフロンがある。 Rubber (silicone rubber, fluorine rubber, ethylene propylene rubber, butyl rubber, etc.), gel (silicon-based α gels, and the like) is Teflon. また、鋸歯状の滑り止め部13aにも生体組織Xの貼りつきを防止するため、テフロンコーティングをしてもよい。 Furthermore, since the sawtooth slip portion 13a to prevent the sticking of the living tissue X, it may be a Teflon coating. 【0039】図5は第2の実施形態を示し、(a)は先端部の縦断側面図、(b)は(a)のF−F線に沿う断面図である。 FIG. 5 shows a second embodiment, a cross-sectional view taken along the line F-F of (a) is a vertical sectional side view of the distal end portion, (b) is (a). 第1の実施形態と同一構成部分は同一番号を付して説明を省略する。 The same components as those of the first embodiment will be omitted with denoted by the same numbers. 第1の実施形態においては、 In the first embodiment,
第2のジョー6の発熱板12における把持面及び第1のジョー7の把持面に互いに噛み合う鋸歯状の滑り止め部44,45を設けたものである。 It is provided with a second serrated slip portions 44 and 45 meshing with each other in the gripping surface of the gripping surface and the first jaw 7 in the heat generating plate 12 of the jaw 6. 発熱板12の把持面は幅の広い平坦面に形成され、凝固用に適した構造であり、他は第1の実施形態と同様である。 Gripping surfaces of the heating plate 12 is formed in a large flat face width, a structure suitable for coagulation and the other is the same as in the first embodiment. 【0040】図6は第3の実施形態を示し、(a)は先端部の縦断側面図、(b)は(a)のG−G線に沿う断面図、(c)は(a)のH−H線に沿う断面図である。 [0040] Figure 6 shows a third embodiment, the (a) longitudinal side view of the distal end portion, (b) is a sectional view taken along the line G-G of (a), (c) is (a) it is a sectional view taken along the line H-H.
第1の実施形態と同一構成部分は同一番号を付して説明を省略する。 The same components as those of the first embodiment will be omitted with denoted by the same numbers. 【0041】本実施形態においては、発熱板12の上辺部には長手方向に所定間隔で、しかも平面視で、千鳥状に複数個、本実施形態においては3個の突出片46a, [0041] In this embodiment, the upper portion of the heating plate 12 at predetermined intervals in the longitudinal direction, moreover in a plan view, a zigzag shape in a plurality, three projecting pieces 46a in the present embodiment,
46b,46cが設けられている。 46b, 46c is provided. これら突出片46 These projecting pieces 46
a,46b,46cには横方向にすり割りが設けられ、 a, 46b, slit in the lateral direction is provided on 46c,
このすり割りによって熱結合部47が形成されている。 Thermal coupling portion 47 is formed by this slit. 【0042】各熱結合部47には発熱体36a,36 The heating element 36a to the heat coupling portions 47, 36
b,36cがその一部をすり割りの内部に挿入した状態で熱結合固定されており、これら発熱体36a,36 b, 36c are thermally bonded fixed in a state of inserting a part into the interior of the slit, these heating elements 36a, 36
b,36cにはそれぞれ独立して前述したリード線18 b, it leads described above independently to 36c 18
が接続されている。 There has been connected. さらに、リード線18の先端部の導電部は絶縁カバー37によって覆われている。 Further, the conductive portion of the distal end portion of the lead wire 18 is covered with an insulating cover 37. 【0043】本実施形態においては、突出片46a,4 [0043] In this embodiment, the projecting pieces 46a, 4
6b,46cに横方向にすり割りが設けられ、このすり割りによって熱結合部47が形成されているため、第2 6b, a slit in the transverse direction is provided in 46c, since the heat coupling portion 47 is formed by the slitting, the second
のジョー6の上下方向の肉厚を薄く構成できるとともに、発熱体36a,36b,36cがジョー6の幅方向にオフセットされているため、リード線18の配線が容易に行なえるという効果がある。 It is possible to thin in the thickness of the vertical jaw 6 of the heating element 36a, 36b, 36c is because it is offset in the width direction of the jaws 6, there is an effect that the wiring can be easily performed in the lead 18. 【0044】図7は第4の実施形態を示し、(a)は先端部の縦断側面図、(b)は発熱体ユニットの側面図である。 [0044] Figure 7 shows a fourth embodiment, (a) is a vertical sectional side view of the tip is a side view of (b) is the heat generating unit. 第1の実施形態と同一構成部分は同一番号を付して説明を省略する。 The same components as those of the first embodiment will be omitted with denoted by the same numbers. 【0045】本実施形態においては、発熱板12の上面には発熱基板48が設けられ、この発熱基板48には先端部に向かって縦幅が漸次狭幅となるテーパ状の1つの発熱体50が設けられている。 [0045] In this embodiment, the upper surface of the heating plate 12 heating the substrate 48 is provided, tapered one heating element 50 to the vertical width toward the tip in the heating substrate 48 is gradually narrowed It is provided. この発熱体50には長手方向に離間して複数個、本実施形態においては、3個の発熱部49a,49b,49cが独立して設けられている。 Plurality This heating element 50 spaced apart in the longitudinal direction, in the present embodiment, three heat-generating portion 49a, 49b, 49c are provided independently. これら発熱部49a,49b,49cは発熱基板4 These heating portion 49a, 49b, 49c are heating the substrate 4
8の幅に倣って先端側の発熱部49aが最も狭幅で、基端側の発熱部49cが最も広幅に形成され、これらは発熱基板48の通電回路51に独立して電気的に接続されている。 The most narrow width of the heat generating portion 49a of the front end side following the 8 wide, heating portion 49c of the base end side is formed on the widest, it is electrically connected independently to the energizing circuit 51 of the heating substrate 48 ing. 発熱基板48の基端側においては、通電回路5 In the proximal end side of the exothermic substrate 48, the energizing circuit 5
1がリード線18と接続されており、この接続部は絶縁カバー52によって覆われている。 1 is connected to the lead wire 18, the connecting portion is covered with an insulating cover 52. 【0046】本実施形態においては、発熱体50の構成が簡素化するとともに、発熱部49a,49b,49c [0046] In this embodiment, as well as simplifying construction of the heating element 50, heating unit 49a, 49b, 49c
が発熱基板48の幅に倣って先端側の発熱部49aが最も狭幅で、基端側の発熱部49cが最も広幅に形成されているため、第2のジョー6の上下方向の肉厚を薄く構成できるとともに、リード線18の接続が1ヶ所となり、配線が容易に行なえるという効果がある。 There exothermic portion 49a is narrowest at the tip side following the width of the heat generating substrate 48, since the heating portion 49c of the base end side is formed on the widest, the thickness in the vertical direction of the second jaw 6 it is possible to thin configuration, connection of the lead wire 18 becomes one place, wiring easily there is an effect that performed. さらに、 further,
発熱体50がユニット化されているため、修理の際に発熱体ユニット毎交換できるという効果もある。 Since the heating elements 50 are unitized, an effect that the heat generating unit for each exchange at the time of repair certain. 【0047】図8は第5の実施形態を示し、(a)は先端部の縦断側面図、(b)は(a)のI−I線に沿う断面図、(c)は発熱板の拡大した断面図であり、第1の実施形態と同一構成部分は同一番号を付して説明を省略する。 [0047] Figure 8 shows a fifth embodiment, enlarged cross-sectional view, (c) the heating plate along a line I-I of (a) a vertical sectional side view of the tip, the (b) is (a) a cross-sectional view, the same components as those of the first embodiment will be omitted with denoted by the same numbers. 本実施形態においては、発熱板12は下端縁に向かって狭幅となるテーパ状に形成され、この発熱板12 In the present embodiment, the heating plate 12 is tapered to be narrower toward the lower edge, the heating plate 12
の両側面には第2のジョー6の長手方向に離間して薄膜抵抗加熱素子53a,53b,53cが設けられている。 On both sides of the longitudinal direction spaced thin-film resistive heating element 53a, 53b, 53c are provided in the second jaw 6. これら薄膜抵抗加熱素子53a,53b,53cは第2のジョー6の基端側においてリード線18と電気的に接続されている。 These thin-film resistive heating element 53a, 53b, 53c are electrically connected to the lead 18 at the proximal end side of the second jaw 6. 【0048】薄膜抵抗加熱素子53a,53b,53c The thin-film resistance heating element 53a, 53b, 53c
は、発熱板12の両側面に絶縁層54、抵抗体55及びテフロンコーティング層56の順に三層構造に形成されている。 It is formed in this order on the three-layer structure on both sides in the insulating layer 54, the resistor 55 and the Teflon coating layer 56 of the heating plate 12. 【0049】本実施形態によれば、リード線18の接続が1ヶ所となり、配線が容易に行なえるという効果がある。 In accordance with the present embodiment, connection of the lead wire 18 becomes one place, wiring easily there is an effect that performed. さらに、発熱板12に薄膜抵抗加熱素子53a,5 Furthermore, thin-film resistive heating element to the heating plate 12 53a, 5
3b,53cが一体化されているため、修理の際に発熱板12毎交換できるという効果もある。 3b, because 53c are integrated, an effect that heating plate 12 each be replaced during repair certain. また、薄膜抵抗(半導体技術により製造)だけでなく、厚膜抵抗(印刷法により製造)による素子でもよい。 Further, not only the thin film resistor (manufactured by semiconductor technology), or a device according to the thick film resistor (prepared by printing). 【0050】図9は第6の実施形態を示し、熱凝固切開鉗子57の平面図であり、第1の実施形態と同一構成部分は同一番号を付して説明を省略する。 [0050] Figure 9 shows a sixth embodiment, a plan view of a heat coagulation and incision forceps 57, the same components as those of the first embodiment will be omitted with denoted by the same numbers. 本実施形態においては、本体2の軸線に対して処置部8を構成する第1 In the present embodiment, the constituting the treatment portion 8 with respect to the axis of the main body 2 1
のジョー7と第2のジョー6が左側に屈曲している。 Jaw 7 and a second jaw 6 is bent to the left. 但し、構造簡略化のため発熱板12、カバー38は直線形状である(破線はカバーを示す)。 However, heating plate 12 for structural simplicity, the cover 38 is linear shape (broken lines show the cover). 本実施形態においては、第1のジョー7と第2のジョー6で生体組織Xを把持するとき、その把持状態を術者が目視し易く、生体組織Xの把持が容易に行なえ、使い勝手を向上できる。 In the present embodiment, when the first jaw 7 for gripping a living tissue X in the second jaw 6, easily the gripping state surgeon visually performed easily grasping the living tissue X, improve the usability it can. 【0051】図10は第7の実施形態を示し、内視鏡下手術用の熱凝固切開鉗子の側面図である。 [0051] Figure 10 shows a seventh embodiment, a side view of a heat coagulation and incision forceps for endoscopic surgery. 手術器械としての熱凝固切開鉗子61はコネクタケーブル62を介して電源装置(図示しない)に接続されている。 Heat coagulation and incision forceps 61 as a surgical instrument is connected to the power supply via a connector cable 62 (not shown). 熱凝固切開鉗子61は把持部駆動手段としての手元操作部65、 Heat coagulation and cutting forceps 61 hand operation portion 65 of the grip part driving means,
挿入部66、挿入部66の先端に設けられた一対の把持部67,68とから構成されている。 And a insertion portion 66, a pair provided at the distal end of the insertion portion 66 gripping portion 67 and 68 Metropolitan. 【0052】手元操作部65は、操作部本体72と、操作部本体72と一体に設けられた固定ハンドル69と、 [0052] the operation portion 65 includes an operation portion main body 72, an operation portion main body 72 and the fixed handle 69 provided integrally,
操作部本体72に枢支軸70を支点として回動自在に設けられた可動ハンドル71とから構成されている。 And it is configured to pivot shaft 70 from the rotatably provided a movable handle 71. As the fulcrum to the operation portion main body 72. 操作部本体72には回転操作部73によって挿入部66が軸心を中心として回転可能に設けられている。 The operation portion main body 72 insertion portion 66 by the rotation operation portion 73 is rotatably provided about an axis. 【0053】挿入部66は細径パイプによって形成され、この挿入部66の内部には軸方向に進退自在な駆動軸74が内挿されている。 [0053] insertion portion 66 is formed by small-diameter pipes, retractably drive shaft 74 is inserted into the axially inside of the insertion portion 66. 駆動軸7の基端部は可動ハンドル7に連結され、先端部には一対の把持部67,68 Proximal end of the drive shaft 7 is connected to the movable handle 7, a pair of gripping portions on the tip portion 67 and 68
が設けられている。 It is provided. 把持部67,68は枢支ピン75を支点として開閉可能であり、可動ハンドル71をa方向に回動すると、駆動軸74が後退して一対の把持部6 Gripper 67 is capable of opening and closing the pivot pin 75 as the fulcrum, when rotating the movable handle 71 in a direction, the driving shaft 74 is retracted pair of gripping portions 6
7,68が閉じ、b方向に回動すると、駆動軸74が前進して一対の把持部67,68が開くようになっている。 7,68 closes, when rotated in the b direction, the drive shaft 74 is adapted to open the pair of grip sections 67, 68 to advance. 【0054】また、前記操作部本体72にはコネクタ接続部76が設けられ、このコネクタ接続部76にはコネクタケーブル62のコネクタ77が着脱自在に接続されるようになっている。 [0054] The on the operation portion main body 72 is provided a connector connecting portion 76, the connector 77 of the connector cable 62 to the connector connection portion 76 is adapted to be detachably connected. コネクタ接続部76は駆動軸74 Connector assembly 76 drive shaft 74
に沿って把持部67に設けられた発熱体(図示しない) Heating body provided in the grip portion 67 along the (not shown)
に電気的に接続されている。 It is electrically connected to. 【0055】従って、手元操作部65を把持し、固定ハンドル69に対して可動ハンドル71を矢印b方向に回動すると、駆動軸74が前進して把持部67,68が開く。 [0055] Accordingly, gripping the operation portion 65, when rotating the movable handle 71 in the direction of the arrow b with respect to the fixed handle 69, the gripping portions 67 and 68 open the drive shaft 74 moves forward. この状態で、熱凝固切開鉗子61を前進させて、生体組織Xの凝固切開部位を把持部67,68間に介在した状態で、可動ハンドル71を矢印a方向に回動すると、駆動軸74が後退して把持部67,68が閉じる。 In this state, advancing the heat coagulation and incision forceps 61, while interposing the coagulation incision of the living tissue X between the grip portion 67 and 68, when rotating the movable handle 71 in the direction of arrow a, the driving shaft 74 is retreat to the gripping part 67 and 68 close.
従って、第1の実施形態と同様に生体組織Xを凝固、切開することができる。 Therefore, it is possible to similarly to the first embodiment coagulate biological tissue X, incised. 【0056】図11は第8の実施形態を示し、(a)は先端部の縦断側面図、(b)は(a)のJ−J線に沿う断面図であり、第1の実施形態と同一構成部分は同一番号を付して説明を省略する。 [0056] Figure 11 shows the eighth embodiment, and (a) is a vertical sectional side view of the distal end portion, (b) is a sectional view taken along the line J-J of (a), the first embodiment same components will be omitted with denoted by the same numbers. 本実施形態においては、第1のジョー7と第2のジョー6の両方に発熱手段を設けたものである。 In the present embodiment, it is provided with a heating means and a first jaw 7 to both of the second jaw 6. 第1のジョー7においては、柔軟性を有する受け部材13の下側に発熱板80が設けられ、この発熱板80に対して第1の実施形態と同様な構造で発熱体36a,36b,36cが設けられている。 In the first jaw 7, heating plate 80 is provided below the receiving member 13 having a flexible heating element 36a against the heating plate 80 in the same structure as the first embodiment, 36b, 36c It is provided. 【0057】本実施形態においては、第1のジョー7と第2のジョー6によって生体組織Xを把持して凝固、切開する際に、把持した両面側から生体組織Xを加熱することができ、凝固、切開の効率が一層向上し、手術時間の短縮を図ることができる。 [0057] In this embodiment, the first jaw 7 by grasping the living tissue X by the second jaw 6 solidification, the time of incision, it is possible to heat the body tissue X from grasped both sides, coagulation, the efficiency of the incision is further improved, thereby shortening the operation time. 【0058】図12〜図14は第9の実施形態を示し、 [0058] FIGS. 12 to 14 show a ninth embodiment,
図12(a)は手術器械の側面図、(b)は先端部の上面図、(c)は先端部が閉鎖した状態の側面図、図13 12 (a) is a side view of the surgical instrument, (b) is a top view of the distal end portion, (c) is a side view illustrating a state where the tip portion is closed, FIG. 13
(a)は(b)のK−K線に沿う断面図、(b)は(a)のL−L線に沿う断面図、図14(a)は図13 (A) is a sectional view taken along the line K-K of (b), (b) is a sectional view taken along the line L-L of (a), FIG. 14 (a) 13
のM−M線に沿う断面図、(b)はN−N線に沿う断面図、(c)はO−O線に沿う断面図、(d)はP−P線に沿う断面図であり、第1の実施形態と同一構成部分は同一番号を付して説明を省略する。 Sectional view taken along the line M-M, (b) is a sectional view taken along the line N-N, (c) is a sectional view taken along the line O-O, (d) is a sectional view taken along the line P-P , the same components as those of the first embodiment will be omitted with denoted by the same numbers. 【0059】本実施形態においては、図12に示すように、熱凝固切開鉗子100は、ストッパ15の強度を考慮して鋏構成部材3の長手方向の略中間位置に鋏構成部材4方向に突出して設けられている。 [0059] In this embodiment, as shown in FIG. 12, heat coagulation and cutting forceps 100 protrude pincers member four directions in consideration of the strength of the stopper 15 in the longitudinal direction of the substantially middle position of the scissor constituting members 3 It is provided Te. また、コネクタケーブル20は折れ止め部101に固定され、図示しないコネクタを介して電源に接続されている。 The connector cable 20 is fixed to the stopper portion 101 folded and connected to a power supply via a connector (not shown). さらに、支点ピン5は頭部を小型化して鋏構成部材3,4からの突出を少なくしているとともに、手指挿入リング9,10は鋏構成部材3,4と別体で、確実に固定するため、少なくとも2本のねじで固定されている。 Further, the fulcrum pin 5 with have less protrusion from the scissor constituting members 3 is miniaturized head, the finger inserting rings 9, 10 separately from the scissor constituting members 3, to reliably fix Therefore, it is fixed by at least two screws. さらに、図12 In addition, as shown in FIG. 12
(b)(c)に破線丸で囲んで示すように、第1のジョー7と第2のジョー6が閉じたとき、第1のジョー7と第2のジョー6の手元側は大きな段差・隙間が生じないように構成されている。 (B) (c) in as shown enclosed by a broken line circle, when the first jaw 7 second jaw 6 is closed, the first jaw 7 proximal large step-second jaw 6 and is configured so that no gap. 【0060】また、図14に示すように、受け部材13 [0060] Further, as shown in FIG. 14, the receiving member 13
はゴムライニングで成形されている。 It is molded in a rubber lining. また、図14 In addition, FIG. 14
(b)(c)に示すように、第1のジョー7に設けられた突出片32b,32cには上方へ突出する固定板35 (B) (c), the fixing plate 35 to the projecting piece 32b, 32c provided on the first jaw 7 projecting upwardly
が一体に設けられている。 There has been provided integrally. これら固定板35に対向するねじ孔40には固定ねじ41が螺合され、それぞれ2本の固定ねじ41の先端部で固定板35を挟持固定している。 The screw hole 40 facing each of the fixing plate 35 is screwed fixing screw 41, and a fixing plate 35 at respective two of the tip of the fixing screw 41 fixedly hold. すなわち、カバー38を複数箇所で固定することにより、固定を確実にしている。 That is, by fixing the cover 38 at a plurality of locations, and to ensure fixing. さらに、図14(d)に示すように、組織ストッパ14は構造の簡略化を図るために一つの部品によって形成され、カバー38には組織ストッパ14を案内する凹溝38aが設けられている。 Furthermore, as shown in FIG. 14 (d), the tissue stop 14 is formed by a single component in order to simplify the structure, the cover 38 is provided with a concave groove 38a that guides the tissue stop 14. 【0061】なお、前記各実施形態においては、ジョーに3個の発熱体をジョーの長手方向に離間して配置したが、発熱体の数は限定されるものではない。 [0061] Incidentally, in the above respective embodiments, three heating elements in the jaws and spaced in the longitudinal direction of the jaws, the number of heating elements is not intended to be limiting. 【0062】前記実施の形態によれば、次のような構成が得られる。 [0062] According to the embodiment, a structure such as the following are obtained. 【0063】(付記1)先端部に生体組織を把持する互いに開閉自在な一対の把持部を有し、前記把持部の少なくとも一方に発熱部を有し、前記発熱部により生体組織を処置する手術器械において、前記発熱部に独立して制御可能な複数の熱発生手段を設けたことを特徴とする手術器械。 [0063] (Note 1) tip has a mutually openable pair of gripping portions for gripping the biological tissue, has a heating unit to at least one of the gripping portion, treating the biological tissue by the heat generating portion Surgery in instruments, surgical instruments, characterized in that a separate plurality of heat generating means controllable by said heat generating portion. 【0064】(付記2)前記複数の熱発生手段は、独立した発熱体であることを特徴とする付記1記載の手術器械。 [0064] (Note 2) the plurality of heat generating means, the surgical instrument according to Note 1, wherein the an independent heating element. 【0065】(付記3)前記複数の熱発生手段は、独立した複数の発熱領域を有する単一の発熱体であることを特徴とする付記1記載の手術器械。 [0065] (Supplementary Note 3) The plurality of heat generating means, the surgical instrument according to Note 1, wherein it is a single heating element having a plurality of heating areas separate. 【0066】(付記4)前記熱発生手段は、薄膜抵抗加熱素子であることを特徴とする付記1記載の手術器械。 [0066] (Supplementary Note 4) the heat generating means, surgical instruments according to Note 1, wherein it is a thin-film resistive heating element. 【0067】(付記5)前記熱発生手段は、厚膜抵抗加熱素子であることを特徴とする付記1記載の手術器械。 [0067] (Supplementary Note 5) the heat generating means, surgical instruments according to Note 1, wherein it is a thick film resistive heating element. 【0068】(付記6)前記熱発生手段は、セラミックヒーターであることを特徴とする付記1記載の手術器械。 [0068] (Supplementary Note 6) the heat generating means, surgical instruments according to Note 1, wherein it is a ceramic heater. 【0069】(付記7)前記熱発生手段は、PTCヒーターであることを特徴とする付記1記載の手術器械。 [0069] (Supplementary Note 7) said heat generating means, surgical instruments according to Note 1, wherein it is a PTC heater. 【0070】(付記8)前記熱発生手段は、カートリッジヒーターであることを特徴とする付記1記載の手術器械。 [0070] (Supplementary Note 8) said heat generating means, surgical instruments according to Note 1, wherein it is a cartridge heater. 【0071】(付記9)先端部に生体組織を把持する互いに開閉する一対の把持部と、前記把持部を開閉する互いに開閉する操作部と、前記把持部の一方に設けられた発熱部とを有し、前記発熱部により生体組織を処置する手術器械において、前記把持部の他方に設けられ前記発熱部に当接する柔軟性部材からなる受け部材と、前記受け部材の少なくとも一部が変形する位置で、前記把持部の閉鎖載置を停止させるストッパ手段とを具備したことを特徴とする手術器械。 [0071] a pair of gripping portions for opening and closing each other to grip the living tissue (Supplementary Note 9) tip, and the operation unit to open and close to each other for opening and closing the gripping portion, and a heating unit provided on one of the gripping portions It has, in surgical instruments for treating a living tissue by the heat generating portion, and the receiving member made contact with the flexible member to the heating unit provided on the other of said holding part, at least partially deformed position of the receiving member in surgical instruments, characterized by comprising a stopper means for stopping the closing placement of the gripping portion. 【0072】(付記10)前記ストッパ手段が操作部に設けられ、把持部の閉鎖位置を調整可能であることを特徴とする付記9記載の手術器械。 [0072] (Supplementary Note 10) The stopper means is provided in the operation unit, the surgical instrument according to Note 9, wherein it is possible to adjust the closed position of the grip portion. 【0073】(付記11)前記ストッパ手段は、ねじ部材であることを特徴とする付記10記載の手術器械。 [0073] (Supplementary Note 11) The stopper means, surgical instruments according to Note 10, wherein it is a screw member. 【0074】(付記12)先端部に生体組織を把持する互いに開閉する一対の把持部を有し、把持部は生体組織に接触する発熱部を有し、発熱部により生体組織を処置する手術器械において、前記発熱部は発熱部より表面積の小さい接続部で把持部に接続されていることを特徴とする手術器械。 [0074] (Supplementary Note 12) has a pair of gripping portions for opening and closing each other to grip the leading end portion to the biological tissue, surgical instruments gripping portion has a heating portion in contact with the living tissue to treat the living tissue by heating unit in surgical instrument wherein the heating unit, characterized in that connected to the grip portion at the small connecting portion of surface area than the heat generating portion. 【0075】(付記13)前記接続部は発熱部から延びた板状部材であることを特徴とする付記12記載の手術器械。 [0075] (Supplementary Note 13) surgical instruments according to Note 12, wherein the connecting portion is a plate-like member extending from the heating unit. 【0076】(付記14)前記接続部と把持部の少なくとも1ヶ所はねじ部材で接合されていることを特徴とする付記12記載の手術器械。 [0076] (Supplementary Note 14) surgical instruments according to Note 12, wherein at least one position of the grip portion and the connecting portion, characterized in that it is joined by a screw member. 【0077】(付記15)先端部に生体組織を把持する互いに開閉する一対の把持部を有し、各把持部は生体組織に接触する発熱部を有し、発熱部により生体組織を処置する手術器械において、前記発熱部は少なくとも一方を柔軟性部材としたことを特徴とする手術器械。 [0077] (Supplementary Note 15) tip has a pair of gripping portions for opening and closing each other to grasp the body tissue, each gripping portion includes a heating unit in contact with the body tissue, surgery to treat a living tissue by heating unit surgical instruments in instrument, the heating unit being characterized in that the at least one flexible member. 【0078】(付記16)前記柔軟性部材は、合成樹脂であることを特徴とする付記15記載の手術器械。 [0078] (Supplementary Note 16) The flexible member may, surgical instruments according to Note 15, wherein it is a synthetic resin. 【0079】(付記17)前記柔軟性部材は、熱伝導率の良いゴムであることを特徴とする付記15記載の手術器械。 [0079] (Supplementary Note 17) The flexible member may, surgical instruments according to Note 15, wherein it is a good rubber thermal conductivity. 【0080】(付記18)前記柔軟性部材は、エポキシ樹脂であることを特徴とする付記15記載の手術器械。 [0080] (Supplementary Note 18) The flexible member may, surgical instruments according to Note 15, wherein the epoxy resin. 【0081】 【発明の効果】以上説明したように、この発明によれば、 第1の把持手段と第2の把持手段を互いに開閉する [0081] As has been described in the foregoing, according to the present invention, to open and close the first gripping means and second gripping means with each other
操作部により、第1の把持手段と第2の把持手段を閉状 By the operation unit,閉状the first gripping means and second gripping means
態にしたときに前記発熱部を前記受け部材が変形する位 Position in which the receiving said heat-generating unit member is deformed when the state
置まで閉操作を停止可能としたストッパ手段を設けたの Was provided with a stopper means that you can stop the closing operation to location
で、把持部における温度ムラを防止し、生体組織を迅速 In to prevent the temperature unevenness in the gripper, rapid biological tissue
かつ確実に凝固しながら切開でき、手術時間を短縮でき And it can reliably solidified while incision can reduce the operation time
るという効果がある。 There is an effect that that. 【0082】 [0082]

【図面の簡単な説明】 【図1】この発明の第1の実施形態の熱凝固切開鉗子を示し、(a)は先端部を開いた状態の側面図、(b)は上面図、(c)は先端部を閉じた状態の側面図、(d) BRIEF DESCRIPTION OF THE DRAWINGS [Figure 1] shows the first heat coagulation and incision forceps embodiments of the present invention, (a) represents a side view of the opened tip part, (b) is a top view, (c ) is a side view of a closed state of the tip portion, (d)
は(a)のA−A線に沿う断面図。 Is a sectional view taken along the line A-A of (a). 【図2】同実施形態の先端部を示し、(a)は縦断側面図、(b)は(a)のB−B線に沿う断面図。 Figure 2 shows the distal portion of the embodiment, (a) shows the longitudinal sectional side view, (b) is a sectional view taken along the line B-B of (a). 【図3】同実施形態を示し、(a)は図2のC−C線に沿う断面図、(b)は図2のD−D線に沿う断面図、 Figure 3 shows the same embodiment, (a) shows the cross-sectional view taken along the line C-C in FIG. 2, (b) is a sectional view taken along the line D-D in FIG. 2,
(c)は図2のE−E線に沿う断面図、(d)は生体組織Xを把持したときの図2のD−D線に沿う断面図。 (C) is a sectional view, (d) is a sectional view taken along the line D-D of FIG. 2 when gripping the biological tissue X along the line E-E in FIG. 【図4】同実施形態の電源装置の電気回路図。 [4] an electric circuit diagram of a power supply apparatus of the embodiment. 【図5】この発明の第2の実施形態を示し、(a)は先端部の縦断側面図、(b)は(a)のF−F線に沿う断面図。 Figure 5 shows a second embodiment of the present invention, (a) shows the longitudinal sectional side view of the distal end portion, (b) is a sectional view taken along the line F-F of (a). 【図6】この発明の第3の実施形態を示し、(a)は先端部の縦断側面図、(b)は(a)のG−G線に沿う断面図、(c)は(a)のH−H線に沿う断面図。 6 shows a third embodiment of the present invention, (a) shows the longitudinal sectional side view of the distal end portion, (b) is a sectional view taken along the line G-G of (a), (c) is (a) sectional view taken along the line H-H. 【図7】この発明の第4の実施形態を示し、(a)は先端部の縦断側面図、(b)は発熱体ユニットの側面図。 7 shows a fourth embodiment of the present invention, (a) shows the longitudinal sectional side view of the distal end portion, (b) is a side view of the heat generating unit. 【図8】この発明の第5の実施形態を示し、(a)は先端部の縦断側面図、(b)は(a)のI−I線に沿う断面図、(c)は発熱板の拡大した断面図。 8 shows a fifth embodiment of the present invention, (a) shows the longitudinal sectional side view of the distal end portion, (b) is a sectional view, (c) is a heating plate taken along line I-I of (a) enlarged cross-sectional view. 【図9】この発明の第6の実施形態を示し、熱凝固切開鉗子の平面図。 [9] Sixth shows an embodiment of a plan view of a heat coagulation and incision forceps of the invention. 【図10】この発明の第7の実施形態を示し、内視鏡下手術用の熱凝固切開鉗子の側面図。 [10] Seventh shows an embodiment of a side view of a heat coagulation and incision forceps for endoscopic surgery according to the present invention. 【図11】この発明の第8の実施形態を示し、(a)は先端部の縦断側面図、(b)は(a)のJ−J線に沿う断面図。 [11] Eighth illustrate embodiments of, (a) shows the longitudinal sectional side view of the distal end portion, (b) is a sectional view taken along the line J-J in (a) of the present invention. 【図12】この発明の第9の実施形態を示し、(a)は手術器械の側面図、(b)は先端部の上面図、(c)は先端部が閉鎖した状態の側面図。 [Figure 12] shows a ninth embodiment of the present invention, (a) represents a side view of the surgical instrument, (b) is a top view of the distal end portion, (c) is a side view illustrating a state where the tip portion is closed. 【図13】同実施形態を示し、(a)は(b)のK−K [Figure 13] shows the same embodiment, K-K in (a) is (b)
線に沿う断面図、(b)は(a)のL−L線に沿う断面図。 Sectional view taken along a line, (b) is a sectional view taken along the line L-L of (a). 【図14】同実施形態を示し、(a)は図13のM−M [Figure 14] shows the same embodiment, (a) shows the M-M in FIG. 13
線に沿う断面図、(b)はN−N線に沿う断面図、 Sectional view taken along a line, (b) is a sectional view taken along the line N-N,
(c)はO−O線に沿う断面図、(d)はP−P線に沿う断面図。 (C) is a sectional view taken along the line O-O, (d) is a sectional view taken along the line P-P. 【符号の説明】 1…熱凝固切開鉗子6…第2のジョー(第2の把持手段) 7…第1の…ジョー(第1の把持手段) 8…処置部12…発熱板13…受け部材36a,36b,36c…発熱体(熱発生手段) [Description of Reference Numerals] 1 ... heat coagulation and incision forceps 6 ... second jaw (second gripping means) 7 ... first ... jaw (first gripping means) 8 ... treatment section 12 ... heating plate 13 ... receiving member 36a, 36b, 36c ... heating element (heat generation means)

───────────────────────────────────────────────────── フロントページの続き (56)参考文献 特開2000−254135(JP,A) 特開 平6−217987(JP,A) 特開 平8−103449(JP,A) 特開 平6−30946(JP,A) 特開2000−210296(JP,A) 特表 平10−504485(JP,A) 米国特許4219025(US,A) 米国特許4231371(US,A) (58)調査した分野(Int.Cl. 7 ,DB名) A61B 18/12 ────────────────────────────────────────────────── ─── of the front page continued (56) reference Patent 2000-254135 (JP, a) JP flat 6-217987 (JP, a) JP flat 8-103449 (JP, a) JP flat 6-30946 (JP, a) JP 2000-210296 (JP, a) JP-T flat 10-504485 (JP, a) United States Patent 4219025 (US, a) United States Patent 4231371 (US, a) (58) investigated the field (Int .Cl. 7, DB name) A61B 18/12

Claims (1)

  1. (57)【特許請求の範囲】 【請求項1】 被検体を把持する第1の把持手段と、 前記第1の把持手段に対し相対的に移動して開閉動作する第2の把持手段と、 前記第1の把持手段と前記第2の把持手段を互いに開閉 (57) a first gripping means for gripping the Patent Claims 1. A subject, a second gripping means for opening and closing operation by relatively moving with respect to the first gripping means, together closing the second gripping means and the first gripping means
    する操作部と、 前記第2の把持手段の表面に設けられた発熱する発熱部 Operating element and the heat generating portion that generates heat provided on a surface of the second gripping means
    と、前記第1の把持手段と前記発熱部とを閉状態にしたときに前記発熱部に当接される前記第1の把持手段の表面に設けられた柔軟性部材からなる受け部材と、 前記操作部により 前記第1の把持手段と第2の把持手段を閉状態にしたときに前記発熱部を前記受け部材が変形 When the receiving member made of the first gripping means and the heat generating portion and a flexible member provided on a surface of said first gripping means is brought into contact with the heat generating portion when closed, the the receiving member is deformed the heating portion when the first gripping means and second gripping means is closed by the operation unit
    する位置まで閉操作を停止可能としたストッパ手段とを具備したことを特徴とする手術器械。 Surgical instruments, characterized by comprising a stopper means which enables stopping the closing operation to a position where the.
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