JP3986127B2 - Endoscopic surgical instruments - Google Patents

Endoscopic surgical instruments Download PDF

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Publication number
JP3986127B2
JP3986127B2 JP21198697A JP21198697A JP3986127B2 JP 3986127 B2 JP3986127 B2 JP 3986127B2 JP 21198697 A JP21198697 A JP 21198697A JP 21198697 A JP21198697 A JP 21198697A JP 3986127 B2 JP3986127 B2 JP 3986127B2
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Prior art keywords
gripping
member
portion
incision
knife
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JPH1147150A (en
Inventor
幸治 山内
康彦 菊地
直己 関野
浩司 飯田
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オリンパス株式会社
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【0001】 [0001]
【発明の属する技術分野】 BACKGROUND OF THE INVENTION
この発明は生体組織を把持する把持部材及び把持した生体組織を切開する切開部を備えた内視鏡下手術器械に関する。 This invention relates to an endoscopic surgical instruments having an incision for incising the gripping member and the grasped living tissue gripping the biological tissue.
【0002】 [0002]
【従来の技術】 BACKGROUND OF THE INVENTION
一般に、生体組織を把持する一対の把持部材を備え、各把持部材に高周波通電用の電極が配設されたバイポーラ鉗子が知られている。 In general, a pair of gripping members for gripping the body tissue, the bipolar forceps having electrodes arranged for high-frequency current is known in the gripping member. そして、このバイポーラ鉗子の使用時には一対の把持部材間に処置対象の生体組織を把持させた状態で、各把持部材の電極間に高周波電流を通電して把持部材間の生体組織を凝固させるようになっている。 As this is the use of a bipolar forceps while being gripped treatment target living tissue between a pair of gripping members, to coagulate the living tissue between the grasping member and a high-frequency current between the electrodes of each gripping member going on.
【0003】 [0003]
この種のバイポーラ鉗子は、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の症例に用いられる。 This kind of bipolar forceps 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 the various cases of clogging tubal for the purpose of contraception. そして、バイポーラ鉗子が血管の止血や、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 hemostatic and bipolar forceps vessel, 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.
【0004】 [0004]
従来、この種の内視鏡下手術器械として、例えば米国特許第4655216号明細書、米国特許第5445638号明細書、米国特許第5431674号明細書、米国特許第5484436号明細書、米国特許第5558671号明細書、米国特許第5267998号明細書等で知られている。 Conventionally, as an endoscopic surgical instruments of this type, for example, U.S. Pat. No. 4655216, U.S. Patent No. 5445638, U.S. Patent No. 5431674, U.S. Patent No. 5484436, U.S. Patent No. 5558671 Pat, are known in U.S. Pat. No. 5267998 Pat like.
【0005】 [0005]
米国特許第4655216号明細書は、開閉自在な一対の把持部材の間に枢支ピンを支点として回動自在な略L字状の切開刃が設けられ、生体組織を把持して状態で一対の把持部材間に凝固電流を流して生体組織を凝固させた後、切開刃を回動して生体組織を切開するようになっている。 U.S. Patent No. 4655216 is rotatable substantially L-shaped incision blade is provided as a fulcrum pivot pin between the openable pair of gripping members, a pair of a state to grasp the living tissue after flowing coagulation current between the gripping members to coagulate the living tissue, and the incision blade rotates so as to incise the body tissue.
【0006】 [0006]
米国特許第5445638号明細書及び米国特許第5558671号明細書は、シースの先端部から突出する一対の把持部材と、この把持部材間に進退自在な切開ナイフとを備え、手元操作部の操作によって一対の把持部材を閉じて処置対象の生体組織を把持した状態で、一対の把持部材間に凝固電流を流して生体組織を凝固させた後、切開ナイフを前進させて生体組織を切開するようになっている。 U.S. Patent No. 5445638 and U.S. Patent No. 5558671 includes a pair of gripping members projecting from the distal end of the sheath, and a freely incision knife back and forth between the gripping member, by operating the operation portion while gripping the living tissue as a treatment target by closing the pair of gripping members, after coagulating the living tissue by supplying a coagulation current between the pair of gripping members, the incision knife is advanced so as to incise the body tissue going on.
【0007】 [0007]
米国特許第5431674号明細書は、シースの先端部に固定されたアンビルと進退及び回動自在な切開刃とを備え、切開刃を閉じながら引き込み、生体組織を切開するようになっている。 U.S. Patent No. 5431674 is provided with a retractable and rotatable incision blade and the anvil that is fixed to the distal end of the sheath, retraction while closing the incision blade, so as to incise the body tissue.
【0008】 [0008]
米国特許第5484436号明細書は、シースの先端部に一対の切開刃を回動自在に設け、一対の切開刃に凝固電流を流して生体組織を凝固させた後、切開刃によって生体組織を切開するようになっている。 U.S. Patent No. 5484436, after a pair of dissecting blades at the tip portion of the sheath is provided rotatably, to coagulate the living tissue by supplying a coagulation current to the pair of incision blades, incised body tissue by dissection blades It has become way.
【0009】 [0009]
米国特許第5267998号明細書は、一対の凝固電極と移動可能な切開電極を有し、一対の凝固電極間に凝固電流を流して生体組織を凝固させた後、手元操作部の操作によって切開電極を移動させるとともに、切開電流を流して生体組織を切開するようになっている。 U.S. Patent No. 5267998 has a cutting electrode movable with the pair of the coagulation electrodes, after coagulating the coagulating current flowing in body tissue between a pair of coagulating electrodes, the cutting electrode by manipulating the operation portion moves the by flowing an incision current is adapted to incise the body tissue.
【0010】 [0010]
【発明が解決しようとする課題】 [Problems that the Invention is to Solve
しかしながら、前述した米国特許第4655216号明細書は、一対の把持部材の間に切開刃が突出しているため、正常な生体組織に傷を付ける虞があり、細心の注意を払う必要があることから操作性が悪いという欠点がある。 However, since the U.S. Patent No. 4655216 described above, the order incision blade between a pair of gripping members is protruded, there is a possibility that damaging the normal biological tissues, it is necessary to pay close attention operability is there is a disadvantage that bad.
【0011】 [0011]
米国特許第5445638号明細書及び米国特許第5558671号明細書は、一対の把持部材間に進退自在な切開ナイフを備えたものであり、切開ナイフの切れ味が劣化すると、切開ナイフを前進させて切開する際に把持した生体組織を押し出してしまうという不都合があり、切開ナイフを頻繁に交換する必要がある。 U.S. Patent No. 5445638 Pat and U.S. Patent No. 5558671 are those having a freely incision knife back and forth between a pair of gripping members, the sharpness of the incision knife is deteriorated, to advance the incision knife incision There is inconvenience that extruding the grasped living tissue when it is necessary to frequently replace the incision knife. また、把持部材の間に切開ナイフを進退自在に配置する複雑な構造で、洗浄性も悪いという欠点がある。 Furthermore, a complex structure that retractably disposed incision knife between the gripping members, detergency also has a disadvantage of poor.
【0012】 [0012]
米国特許第5431674号明細書、米国特許第5484436号明細書及び米国特許第5267998号明細書は、生体組織を把持する機能がないため、処置対象部位を確実に切開することができない。 U.S. Patent No. 5431674, U.S. Pat. No. 5484436 and U.S. Patent No. 5267998, there is no ability to grip the biological tissue can not be reliably incised surgical target portion.
【0013】 [0013]
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、体腔内に挿入したとき正常な生体組織に傷を付ける虞がなく、また切開性能を維持できる内視鏡下手術器械を提供することにある。 The present invention has been made in view of the above circumstances, it is an object when inserted into a body cavity without fear that scratch the normal biological tissues, also endoscopic the incision performance can be maintained It is to provide a surgical instrument.
【0014】 [0014]
【課題を解決するための手段】 In order to solve the problems]
本発明の第1実施態様の内視鏡下手術器械は、互いに開閉され把持面を形成する一対の把持部材と、前記一対の把持部材に設けられている双極電極と、切開部材と、前記把持部材に設けられ前記把持面側に開口し前記把持面に対向する内壁により規定され前記切開部材の全体を収容可能な空間部と、前記切開部材を前記一対の把持部材間で前記把持部材の開閉方向に移動自在に支持し前記内壁へと付勢している弾性部材と、進退操作可能であり、進退操作されて前記弾性部材を押圧して前記開閉方向へと弾性変形させることにより前記切開部材を前記切開部材の少なくとも一部分が前記把持面を通過するように前記把持部材の開閉方向に移動可能な操作部材と、を具備することを特徴とする。 Endoscopic surgical instruments of the first embodiment of the present invention includes a bipolar electrode provided with a pair of gripping members forming a gripping surface is opened and closed to each other, the pair of gripping members, and the cutting member, the grasping a whole can accommodate a space of defined by the inner wall of provided member open to the gripping surface side opposite to the gripping surface the cutting member, the opening and closing of the gripping member said cutting member between said pair of gripping members an elastic member which is biased to the inner wall movably supported in the direction a can advance and retreat operation, said incision member by a is elastically deformed to retreat operation has been the closing direction to press the elastic member the characterized by comprising: an operation member movable in the closing direction of the gripping member so as to pass through at least a portion said gripping surface of the cutting member.
本発明の第2実施態様の内視鏡下手術器械は、互いに開閉され把持面を形成する一対の把持部材と、前記一対の把持部材に設けられている双極電極と、切開部材と、前記把持部材に設けられ前記把持面側に開口し前記把持面に対向する内壁により規定され前記切開部材の全体を収容可能な空間部と、前記切開部材を前記一対の把持部材間で前記把持部材の開閉方向に移動自在に支持し前記内壁へと付勢し、前記切開部材と共に進退操作可能な弾性操作部材と、前記内壁に設けられ、前記切開部材の進退方向に対して前記開閉方向に傾斜している斜面と、を具備し、前記切開部材は、前記弾性操作部材によって前記斜面に沿って進退されることにより前記切開部材の少なくとも一部分が前記把持面を通過可能である、ことを特徴とする。 Endoscopic surgical instruments of the second embodiment of the present invention includes a bipolar electrode provided with a pair of gripping members forming a gripping surface is opened and closed to each other, the pair of gripping members, and the cutting member, the grasping a whole can accommodate a space of defined by the inner wall of provided member open to the gripping surface side opposite to the gripping surface the cutting member, the opening and closing of the gripping member said cutting member between said pair of gripping members movably supported in a direction to urge to the inner wall, the elastic operation member that can advance and retreat operation with incision member, provided in the inner wall, inclined in the closing direction to the moving direction of said cutting member comprising a slope are the said cutting member, said at least a portion of said cutting member by being advanced and retracted along the inclined surface by a resilient operating member can pass through the gripping surface, characterized in that.
本発明の第3実施態様の内視鏡下手術器械は、互いに開閉され把持面を形成する一対の把持部材と、前記一対の把持部材に設けられている双極電極と、切開部材と、前記把持部材に設けられ前記把持面側に開口し前記把持面に対向する内壁により規定され前記切開部材の全体を収容可能な空間部と、前記切開部材が一体的に設けられ、 進退操作可能であり、先端部が前記一対の把持部材の一方の把持部材に固定され、前記切開部材を前記一方の把持部材の前記内壁へと付勢し、前記一対の把持部材の他方の把持部材に向かって湾曲するように曲がり癖が付けられ、進退操作によって弾性変形されて前記切開部材を前記切開部材の少なくとも一部分が前記把持面を通過するように前記一対の把持部材の開閉方向に移動可能な弾性操作部材と、を Endoscopic surgical instruments of the third embodiment of the present invention includes a bipolar electrode provided with a pair of gripping members forming a gripping surface is opened and closed to each other, the pair of gripping members, and the cutting member, the grasping a space capable of accommodating the whole of the cutting member is defined by an inner wall provided in the member to open the gripping surface side opposite to the gripping surface, the cutting member is integrally provided with a retractable operation, tip fixed to one of the gripping members of the pair of gripping members, said cutting member is biased to the inner wall of the one gripping member is curved toward the other of the gripping member of the pair of gripping members as the bending is given a habit, with the pair of resilient operating member movable in the opening and closing direction of the gripping member such that at least a portion of the cutting member the cutting member is elastically deformed to pass through the gripping surface by the advancing and retracting operation , the 備することを特徴とする。 Characterized in that it Bei.
【0015】 [0015]
そして、生体組織の凝固止血等の処置時に把持部材によって生体組織を把持した状態で把持部材間に凝固電流を流して生体組織を凝固させ、次に、切開手段を一対の把持部材で形成される把持面に移動して生体組織を切開することができるようにしたものである。 Then, the gripping member during the treatment of coagulation hemostasis such a living tissue by supplying a coagulation current between the gripping member while gripping the living tissue to coagulate the living tissue, then, is formed an incision means of a pair of gripping members Go to the gripping surface is obtained to be able to incise the body tissue.
【0016】 [0016]
【発明の実施の形態】 DETAILED DESCRIPTION OF THE INVENTION
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。 Will be described below with reference the embodiments of the invention with reference to the drawings.
【0017】 [0017]
図1〜図6は第1の実施形態を示し、図1は内視鏡下手術器械としてのバイポーラ鉗子1を示す。 Figures 1-6 show a first embodiment, FIG. 1 shows the bipolar forceps 1 as endoscopic surgical instruments. バイポーラ鉗子1には患者の体腔内に挿入される細長い挿入部2と、この挿入部2の先端部に配置され、体腔内で生体組織を把持、凝固するための通電可能な処置部3と、挿入部2の基端部に連結された操作部4とが設けられている。 The bipolar forceps 1 an elongated insertion portion 2 to be inserted into a body cavity of a patient, is disposed at the distal end of the insertion portion 2, gripping the living tissue in a body cavity, an electrically heatable treatment section 3 for coagulation, coupled with the operation portion 4 is provided at the proximal end of the insertion portion 2.
【0018】 [0018]
挿入部2は、図4〜図6に示すように、シース5と、このシース5の内部に軸方向に進退自在に挿入されたロッド6とからなり、シース5の先端部には絶縁材料からなる係合部材7が固定され、シース5の基端部は操作部4を構成するグリップ8に固定されている。 The insertion portion 2, as shown in FIGS. 4 to 6, the sheath 5, made from inside the inserted movably in the axial direction the rods 6 which in this sheath 5, an insulating material in the distal end portion of the sheath 5 the engagement member 7 is fixed comprising, a base end portion of the sheath 5 is fixed to the grip 8 constituting the operation unit 4. ロッド6の基端部は、図1に示すように、操作部4に設けられたロッド駆動部材9に固定されている。 Proximal end of the rod 6, as shown in FIG. 1, is fixed to the rod driving member 9 provided in the operation section 4.
【0019】 [0019]
処置部3は、電極を構成する一対の把持部材11a,11bと、これらの把持部材11a,11bを支持し、拡開させる方向に付勢する上下2本ずつの弾性部材12a,12bとからなり、これら弾性部材12a,12bの基端部がロッド6の先端部に固定されている。 Treatment portion 3 includes a pair of gripping members 11a, 11b constituting the electrode, these gripping members 11a, supports 11b, elastic members 12a of each two vertically for urging in a direction to spreading it consists of a 12b the base end portion of the elastic members 12a, 12b are fixed to the distal end of the rod 6. 弾性部材12a,12bはばね鋼等によって形成され、先端部には略くの字状に屈曲された屈曲部13a,13bが形成され、表面は絶縁被膜によって被覆されている。 Elastic members 12a, 12b are formed by a spring steel or the like, the bent portion 13a at the tip portion which is bent in the shape of substantially L, 13b are formed, the surface is covered with an insulating coating.
【0020】 [0020]
図5及び図6に示すように、把持部材11a,11bは閉じたときに内部に空間部14が形成されるように断面が略コ字状の凹溝14a,14bが形成され、互いに対向する端縁は閉じたときに互いに噛合する鋸歯状部が形成され、生体組織Aを確実に把持できるように形成されている。 As shown in FIGS. 5 and 6, the gripping member 11a, in cross-section substantially U-shaped groove 14a such that the space portion 14 is formed within the time 11b is closed, 14b are formed, facing each other edge is serrated portion to mesh with each other when closed is formed, is formed to the body tissue a can be reliably gripped.
【0021】 [0021]
さらに、図4〜図6に示すように、ロッド6にはばね鋼等によって形成されたナイフロッド15が挿通されており、このナイフロッド15の先端部には切開手段としての切開ナイフ16が設けられている。 Furthermore, as shown in FIGS. 4 to 6, the rod 6 is inserted through the knife rod 15 formed by a spring steel or the like, is the incision knife 16 of the incision means provided at the distal end of the knife rod 15 It is. さらに、ナイフロッド15はロッド6の先端部においては下側の弾性部材12b,12bの間に位置し、ロッド6の軸心より下側に位置しているが、ロッド6の先端部から延出した部分は上側の把持部材11aに向かって斜めに曲り癖が付けられ、先端の切開ナイフ16は上側の把持部材11aの凹溝14aの内部に収容されている。 Furthermore, the knife rod 15 is located between the lower side of the elastic member 12b, 12b in the distal end portion of the rod 6, but is located below the axis of the rod 6, extends from the distal end of the rod 6 portion is attached habit bend obliquely towards the upper side of the gripping member 11a, the incision knife 16 of the tip is housed inside the concave groove 14a of the upper gripping member 11a. すなわち、通常時においては、ナイフロッド15の弾性によって切開ナイフ16が生体組織Aと接触しないように退避している。 That is, in the normal, the incision knife 16 by the elasticity of the knife rod 15 is retracted so as not to contact the biological tissue A. また、切開ナイフ16は矩形板状体で、その下側に前後方向に延びる切刃16aを有する片刃ナイフであり、先端側に向かって上り勾配の斜面が形成されている。 Moreover, the incision knife 16 in a rectangular plate-like body, a single-edged knife with a cutting edge 16a extending in the longitudinal direction on its underside, are formed slopes upward gradient toward the tip side.
【0022】 [0022]
さらに、ロッド6の軸心より上側には軸方向に亘って貫通孔6aが設けられ、この貫通孔6aにはナイフ操作ロッド17が進退自在に挿通されている。 Further, on the upper side than the axis of the rod 6 through hole 6a is provided over the axial direction, the knife operating rod 17 is inserted retractably in the through hole 6a. このナイフ操作ロッド17の先端部にはナイフロッド15と係合する係合溝18aを有した操作ヘッド18が設けられている。 Operating head 18 having a engagement groove 18a to be engaged with the knife rod 15 is provided at the distal end portion of the knife operating rod 17. そして、ナイフ操作ロッド17の前進によって操作ヘッド18によりナイフロッド15の弾性力に抗して押し下げ、切開ナイフ16を把持部材11aの内部から下側に移動させ、把持部材11a,11bの把持面を通過させることができるようになっている。 Then, it pushed down against the elastic force of the knife rod 15 by the operating head 18 by advancing the knife operating rod 17 is moved to the lower side of the incision knife 16 from the interior of the gripping member 11a, the gripping member 11a, a gripping surface of the 11b and it is capable of passing.
【0023】 [0023]
このように構成された処置部3の把持部材11a,11bのロッド6、切開ナイフ16のナイフロッド15及びナイフ操作ロッド17は前記挿入部3を構成するシース5に内挿され、シース5の基端部から突出して操作部4まで延長している。 Gripping member 11a of the treatment section 3 configured as described above, the rod 6 of 11b, knife rod 15 and the knife actuating rod 17 of the incision knife 16 is inserted into the sheath 5 which constitutes the insertion portion 3, groups of the sheath 5 projecting from the end portion is extended to the operation unit 4.
【0024】 [0024]
また、図1〜図3に示すように、操作部4のグリップ8には先端部側に延出された先端側延出部8aが設けられている。 Further, as shown in FIGS. 1 to 3, the grip 8 of the operation portion 4 extends out the distal end side extending portion 8a is provided at the tip portion side. この先端側延出部8aにはシース5の基端部に連結固定される連結リング8bが設けられている。 Connecting ring 8b is provided which is fixedly connected to the proximal end of the sheath 5 to the distal end side extending portion 8a. さらに、先端側延出部8aの後方には処置部3の後端部と電気、機械的に接続するための処置部ユニット接続部19が配設されている。 Furthermore, the electrical and the rear end portion of the treatment portion 3, the treatment section unit connection 19 for mechanically connecting is disposed in the rear of the front end side extending portion 8a. ここで、処置部ユニット接続部19には処置部3のロッド6の後端部を収納する内腔と、この内腔に収納したロッド6の後端部に接続される接続手段とが設けられている。 Here, a lumen for housing the rear end portion of the rod 6 of the treatment portion 3 to the treatment portion unit connection portion 19, and connecting means to be connected is provided at a rear end portion of the rod 6 that is housed in the lumen ing.
【0025】 [0025]
また、処置部ユニット接続部19には処置部3の把持部材11a,11bと電気的に接続されるガイドロッド20を介して電極ピン21が設けられ、この電極ピン21は高周波ケーブル21aを介して高周波焼灼電源装置(図示しない)に接続されるようになっている。 Further, the gripping member 11a of the treatment section 3 to the treatment portion unit connection part 19, electrode pins 21 are provided via 11b electrically connected to the guide rod 20, the electrode pin 21 through a high frequency cable 21a It is adapted to be connected to a high frequency cautery power source device (not shown).
【0026】 [0026]
また、グリップ8には処置部ユニット接続部19の操作用のトリガー22が設けられている。 Further, the trigger 22 for operation of the treatment section unit connection 19 is provided in the grip 8. このトリガー22はグリップ8の上端部に回動ピン23を中心に回動自在に連結されている。 The trigger 22 is pivotally connected to the centered pivot pin 23 to the upper end portion of the grip 8. さらに、このトリガー22には回動支点の上方に長孔24が形成されている。 Further, the elongated hole 24 is formed above the rotational fulcrum to the trigger 22. この長孔24にはロッド駆動部材9の側面に突設された係合ピン25が挿入されている。 Engaging pin 25 is inserted protruding from the side surface of the rod driving member 9 is in the elongated hole 24. なお、26は回転ノブであり、シース5内でロッド6を円周方向に回転させることにより、把持部材11a,11bの向きを任意に変更できるようになっている。 Incidentally, 26 is a rotary knob, by rotating the rod 6 in the circumferential direction in the sheath 5, the gripping member 11a, so that the can arbitrarily change the direction of 11b.
【0027】 [0027]
また、グリップ8の内部にはトリガー22の下端部の手掛け部22aをグリップ8から離れる方向(図1において回動ピン23を中心に時計回り方向)に付勢する付勢部材(図示しない)が配設されている。 Further, the biasing member is in the grip 8 for urging in a direction away worked portion 22a of the lower end portion of the trigger 22 from the grip 8 (clockwise direction about the pivot pin 23 in FIG. 1) (not shown) It is disposed. そして、トリガー22は付勢部材のばね力によって常時グリップ8から最も離れた定位置(解放位置)で保持されている。 Then, the trigger 22 is held in the most distant position from the always grip 8 by the spring force of the biasing member (release position).
【0028】 [0028]
さらに、グリップ8の後端上部における側面にはナイフ操作レバー27が設けられている。 Furthermore, the knife operating lever 27 on the side surface of the rear end upper portion of the grip 8 are provided. このナイフ操作レバー27はグリップ8に対して回動ピン28を中心に回動自在に連結されている。 The knife operating lever 27 is pivotally connected to the centered pivot pin 28 relative to the grip 8. さらに、ナイフ操作レバー27の回動中心より上方には長孔29が形成され、この長孔29には前記ナイフ操作ロッド17の後端側面から突設された係合ピン30が挿入されている。 Further, the elongated hole 29 is formed above the center of rotation of the knife lever 27, the engaging pin 30 projecting from the rear end side of the knife operating rod 17 is inserted into the long hole 29 .
【0029】 [0029]
ナイフ操作レバー27には略V字状に配置された上下のアーム部31,32が設けられている。 The upper and lower arm portions 31 and 32 are provided which are arranged in a substantially V-shape in the knife lever 27. そして、一方のアーム部31には指掛け部33が他方のアーム32はストッパピン34と当接してナイフ操作レバー27の回動範囲を規制する役目をしている。 Then, the arm 32 finger grips 33 and the other on one of the arm portion 31 has a role of restricting the rotation range of the knife lever 27 in contact with the stopper pin 34 equivalents. さらに、回動ピン28にはナイフ操作レバー27を時計回り方向に付勢する付勢部材(図示しない)が装着されている。 Further, biasing member for biasing the knife operating lever 27 in the clockwise direction (not shown) is attached to the pivot pin 28.
【0030】 [0030]
ここで、トリガー22の手掛け部22aを付勢部材のばね力に抗してグリップ8側に引き込み操作することにより、ロッド駆動部材9を介してロッド6がシース5の軸方向前方へ移動する。 Here, by operating pull the grip 8 side against the finger receiving portion 22a of the trigger 22 the spring force of the biasing member, the rod 6 via a rod driving member 9 is moved axially forward of the sheath 5. ロッド6の前進に伴って弾性部材12a,12bがシース5から突出し、弾性部材12a,12bの弾性復元力によって拡開して把持部材11a,11bが開く。 Elastic member 12a with the forward movement of the rod 6, 12b protrude from the sheath 5, the elastic member 12a, the gripping and expanded by the elastic restoring force of 12b member 11a, 11b is opened. また、トリガー22が解放されるとグリップ8内の付勢部材のばね力によって定位置に戻り、弾性部材12a,12bが弾性復元力に抗してシース5内に引き込まれ、把持部材11a,11bが閉じるようになっている。 Further, when the trigger 22 is released to return to the home position by the spring force of the biasing member in the grip 8, the elastic members 12a, 12b is drawn into the sheath 5 against the elastic restoring force, the gripping member 11a, 11b They have become close as.
【0031】 [0031]
また、ナイフ操作レバー27の指掛け部33に指を掛け、付勢部材の付勢力に抗してナイフ操作レバー27を反時計回り方向に回動すると、長孔29に挿入されている係合ピン30を介してナイフ操作ロッド17が前進駆動し、ナイフ操作ロッド17の先端部の操作ヘッド18によりナイフロッド15の弾性力に抗して押し下げ、切開ナイフ16を把持部材11aの内部から下側に移動させ、把持部材11a,11bの把持面を通過させることができるようになっている。 Also, over a finger on the finger hook portion 33 of the knife lever 27, when rotating the knife operating lever 27 in the counterclockwise direction against the biasing force of the biasing member, the engaging pin which is inserted into the long hole 29 knife operating rod 17 is driven forward through a 30, pushed down against the elastic force of the knife rod 15 by the operating head 18 of the distal end portion of the knife operating rod 17, the lower the incision knife 16 from the interior of the gripping member 11a the moved, the gripping member 11a, and is capable of passing a gripping surface of 11b.
【0032】 [0032]
また、ナイフ操作レバー27が解放されると付勢部材のばね力によって定位置に戻り、ナイフ操作ロッド17は相対的にシース6に引き込まれてナイフロッド15が解放されて弾性復元力により上方に移動して切開ナイフ16が上側の把持部材11aの内部に収容され、アーム部32はストッパピン34に当接すると停止するようになっている。 Further, when the knife operating lever 27 is released to return to the home position by the spring force of the biasing member, upward by a knife operation rod 17 is released knife rod 15 is drawn relatively sheath 6 elastic restoring force moving to the incision knife 16 is accommodated in the interior of the upper gripping member 11a, the arm portion 32 is adapted to stop that abuts against the stopper pin 34.
【0033】 [0033]
次に、第1の実施形態の作用について説明する。 Next, the operation of the first embodiment.
【0034】 [0034]
バイポーラ鉗子1の電極ピン21に高周波ケーブル21aを接続し、バイポーラ鉗子1と高周波焼灼電源装置とを電気的に接続する。 The high frequency cable 21a connected to the electrode pin 21 of the bipolar forceps 1, for electrically connecting the bipolar forceps 1 and the high-frequency cautery power source device. 初期状態では操作部4のトリガー22の手掛け部22aは図1(a)(b)に示すようにグリップ8から最も離れた定位置で保持され、処置部ユニット接続部19は挿入部3の軸方向の移動範囲の最後端位置で保持される。 Finger receiving portion 22a of the trigger 22 in the initial state operating part 4 is held in the most distant position from the grip 8, as shown in FIG. 1 (a) (b), the treatment section unit connection portion 19 of the insertion portion 3 axes It is held at the last end position of the movement range of directions. この状態では処置部3の一対の弾性部材12a,12bがシース6内に没入して把持部材11a,11bが閉じた状態にある。 A pair of elastic members 12a of the treatment section 3 in this state, 12b gripping member 11a and retracted into the sheath 6 in a state in which 11b is closed.
【0035】 [0035]
この状態で、バイポーラ鉗子1の挿入部2を患者の体内に挿入し、この挿入部2の先端の処置部3を体内の処置対象の生体組織Aの近傍位置まで誘導する。 In this state, the insertion portion 2 of the bipolar forceps 1 is inserted into the patient, to induce the treatment portion 3 at the tip of the insertion portion 2 to a position near the treatment target living tissue A within the body. そこで、トリガー22の手掛け部22aを付勢部材の付勢力に抗してグリップ8側に引き込み操作することにより、ロッド駆動部材9を介してロッド6がシース5の軸方向前方へ移動する。 Therefore, by operating pull the grip 8 side against the finger receiving portion 22a of the trigger 22 the biasing force of the biasing member, the rod 6 via a rod driving member 9 is moved axially forward of the sheath 5. ロッド6の前進に伴って弾性部材12a,12bがシース6から突出し、弾性部材12a,12bの弾性復元力によって把持部材11a,11bが開く(図2参照)。 Elastic member 12a with the forward movement of the rod 6, 12b protrude from the sheath 6, the elastic member 12a, the gripping member 11a by the elastic restoring force of 12b, 11b is opened (see FIG. 2).
【0036】 [0036]
続いて、拡開した把持部材11a,11bの間に生体組織Aを挿入した後、トリガー22を解放するとグリップ8内の付勢部材のばね力によって定位置に戻り、弾性部材12a,12bがシース6内に引き込まれ、把持部材11a,11bが図3に示すように、閉じ、生体組織Aが図5に示すように、一対の把持部材11a,11b間に把持される。 Subsequently, flared gripping member 11a, after insertion of the body tissue A during 11b, when releasing the trigger 22 returns to the home position by the spring force of the biasing member in the grip 8, the elastic members 12a, 12b sheath drawn into the 6, the gripping member 11a, 11b is as shown in FIG. 3, closed, biological tissue a is as shown in FIG. 5, a pair of gripping members 11a, it is gripped between 11b.
【0037】 [0037]
このとき、把持部材11a,11bには閉じたときに互いに噛合する鋸歯状部に形成され、生体組織Aを確実に把持できる。 In this case, the gripping member 11a, is formed on the serrations which mesh with each other when closed to 11b, can be reliably grasp the body tissue A. この状態で、高周波焼灼電源装置から高周波ケーブル21aを介して電極ピン21に高周波電流が流れ、さらに弾性部材12a,12bを介して把持部材11aと11bとの間に凝固電流が流れ、生体組織Aの凝固が行われる。 In this state, the high-frequency current flows through the electrode pin 21 from the high-frequency cauterization power supply apparatus via the high frequency cable 21a, the coagulation current flows between the gripping members 11a and 11b via further elastic member 12a, a 12b, the body tissue A coagulation is made of.
【0038】 [0038]
一定時間凝固電流を流して生体組織Aを凝固(図6(b)の生体組織Aのクロス線部分は、凝固電流によって凝固された部分を示す。)させた後、ナイフ操作レバー27の指掛け部33に指を掛け、付勢部材の付勢力に抗してナイフ操作レバー27を反時計回り方向に回動すると、長孔29に挿入されている係合ピン30を介してナイフ操作ロッド17が前進駆動する。 Coagulating biological tissue A by flowing a certain time coagulation current (cross line portion of the body tissue A in FIG. 6 (b) shows a solidified portion by coagulation current.) After, finger holder of the knife lever 27 33 over a finger and rotating the knife operating lever 27 in the counterclockwise direction against the biasing force of the biasing member, the knife operating rod 17 through the engagement pin 30 which is inserted into the long hole 29 forward to drive. ナイフ操作ロッド17の前進によって操作ヘッド18によりナイフロッド15を弾性力に抗して押し下げ、切開ナイフ16を把持部材11aの内部から下側に移動させる。 Pressed down against the knife rod 15 to the elastic force by the operating head 18 by advancing the knife operating rod 17 is moved to the lower side of the incision knife 16 from the interior of the gripping member 11a.
【0039】 [0039]
そして、図6(a)(b)に示すように、切開ナイフ16が把持部材11a,11bの把持面を通過すると、把持部材11a,11b間に把持された生体組織Aの凝固された部分の内部が切開ナイフ16の切刃16aによって機械的に切開される。 Then, as shown in FIG. 6 (a) (b), the incision knife 16 is gripping member 11a, passes through the 11b gripping surface of the gripping member 11a, the solidified portion of the grasped living body tissue A between 11b inside it is mechanically dissected by cutting 16a of the incision knife 16.
【0040】 [0040]
切開が完了した後、ナイフ操作レバー27を解放すると、付勢部材のばね力によって定位置に戻り、ナイフ操作ロッド17は相対的にシース6に引き込まれて操作ヘッド18が後退し、切開ナイフ16はナイフロッド15の弾性力によって上昇して上側の把持部材11aの内部に収容され、アーム部32はストッパピン34に当接すると停止する。 After dissection is complete, releases the knife operating lever 27 returns to the home position by the spring force of the biasing member, the knife operating rod 17 retracts operating head 18 is drawn to the relative sheath 6, the incision knife 16 It is housed within the upper gripping member 11a rises by the elastic force of the knife rod 15, the arm 32 stops to abut against the stopper pin 34.
【0041】 [0041]
また、トリガー22を解放するとグリップ8内の付勢部材のばね力によって定位置に戻り、弾性部材12a,12bがシース6から突出して把持部材11a,11bは弾性部材12a,12bの弾性復元力によって開き、把持部材11a,11bは生体組織Aから解放される。 Further, when releasing the trigger 22 returns to the home position by the spring force of the biasing member in the grip 8, the elastic members 12a, 12b gripping member 11a projects from the sheath 6, 11b the elastic member 12a, by the elastic restoring force of 12b open, the gripping member 11a, 11b is released from the body tissue A.
【0042】 [0042]
本実施形態によれば、通常時には、切開ナイフ16が把持部材11aの内部に収容された状態に退避しているため、処置部3を体腔内に目的部位に誘導する際に、切開ナイフ16によって正常な組織に傷を付ける虞がなく、操作性を向上できる。 According to this embodiment, in the normal, since the incision knife 16 is retracted in a state of being accommodated inside the gripping member 11a, the treatment portion 3 in inducing the target site within the body cavity, the incision knife 16 no fear that scratch the normal tissues, the operability can be improved. また、切開ナイフ16の切れ味が低下しても切開時に生体組織Aを逃がすことなく、確実に切開できる。 Further, even if sharpness of the incision knife 16 is lowered without releasing the body tissue A at the incision, it can be reliably incised.
【0043】 [0043]
図7〜図11は第2の実施形態を示し、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。 7 to 11 show a second embodiment, the same components as those of the first embodiment will be omitted with denoted by the same numbers. 図7〜図11に示すように、シース5に進退自在に内挿されたロッド6の先端部には弾性部材12a,12bによって一対の把持部材41a,41bが設けられている。 As shown in FIGS. 7 to 11, the elastic member 12a in the distal end portion of the rod 6 which interpolated retractably into the sheath 5, a pair of gripping members 41a by 12b, 41b are provided. 把持部材41a,41bは閉じたときに内部に空間部42が形成されるように互いに対向する面に凹溝43a,43bが形成され、その周縁には閉じたときに互いに噛合する鋸歯状部が形成され、生体組織Aを確実に把持できるように形成されている。 Gripping member 41a, groove 43a in the surface opposed to each other as 41b has a space portion 42 therein when closed is formed, 43b are formed, the serrations which mesh with each other when closed at its periphery is formed, is formed to the body tissue a can be reliably gripped.
【0044】 [0044]
上側の把持部材41aの凹溝43aは手前側に向かって漸次浅くなるように斜面に形成され、切開ナイフ44を案内する案内面45に形成されている。 Grooves 43a of the upper gripping member 41a is formed on the inclined surface so as to gradually shallow toward the front side, are formed on the guide surface 45 for guiding the incision knife 44. 切開ナイフ44は矩形板状体で、下部手前側に斜めに切刃44aを有しており、この切開ナイフ44は上側の把持部材41aの凹溝43aおける最も深い先端側に位置しているときには生体組織Aと接触しないように退避している。 The incision knife 44 in a rectangular plate-like body has a cutting edge 44a at an angle on the lower front side, the incision knife 44 when located at the deepest distal definitive groove 43a of the upper gripping member 41a side It is retracted so as not to contact the biological tissue a.
【0045】 [0045]
一方、ロッド6の軸心より下側に偏倚した位置には軸方向に亘って貫通孔46が設けられている。 On the other hand, the through-holes 46 over the axial direction is provided at a position offset below the axis of the rod 6. この貫通孔46にはばね鋼からなるナイフ操作ロッド47が進退自在に挿通されている。 Knife operating rod 47 made of spring steel is inserted retractably in the through hole 46. ナイフ操作ロッド47のロッド6の先端部から延出した部分は上側の把持部材41aに向かって斜めに曲り癖が付けられ、先端部には前記切開ナイフ44が固定されている。 Portion extending from the distal end of the rod 6 of the knives operating rod 47 is given a habit bend obliquely towards the upper side of the gripping member 41a, is the incision knife 44 is fixed to the tip portion. ナイフ操作ロッド47の基端部は操作部4まで延長しており、操作部4に設けられたナイフ操作レバー27と連結されている。 Proximal end of the knife operating rod 47 is extended to the operation portion 4 is coupled with the knife lever 27 provided in the operation section 4. このナイフ操作レバー27はグリップ8に対して回動ピン28を中心に回動自在に連結され、付勢部材(図示しない)によって反時計回り方向に付勢され、ナイフ操作ロッド47を前進させる方向に付勢している。 The knife operating lever 27 is pivotally connected to the centered pivot pin 28 relative to the grip 8 is urged in the counterclockwise direction by the urging member (not shown), the direction of advancing the knife operating rod 47 It urges to.
【0046】 [0046]
次に、第2の実施形態の作用について説明する。 Next, the operation of the second embodiment. 把持部材41aと41bとを閉じて生体組織Aを把持し、把持部材41a,41b間に凝固電流を流して生体組織Aを凝固するまでは第1の実施形態と同様であり、図11(b)の生体組織Aのクロス線部分は、凝固電流によって凝固された部分を示す。 Close the gripping member 41a and 41b to grip the biological tissue A, the gripping member 41a, until by applying a coagulation current between 41b coagulates the living tissue A is the same as the first embodiment, FIG. 11 (b cross line portion of the body tissue a of) shows a solidified portion by coagulation current. 生体組織Aを凝固させた後、ナイフ操作レバー27の指掛け部33に指を掛け、付勢部材の付勢力に抗してナイフ操作レバー27を時計回り方向に回動すると、長孔29に挿入されている係合ピン30を介してナイフ操作ロッド47が後退駆動する。 After coagulating biological tissue A, over a finger on the finger hook portion 33 of the knife lever 27, when rotating the knife operating lever 27 in the clockwise direction against the urging force of the urging member, inserted into the long hole 29 by knife actuating rod 47 through the engagement pin 30 is to drive backward. ナイフ操作ロッド47の後退によってナイフ操作ロッド47の先端部に設けられた切開ナイフ44が手前側に引かれ、把持部材41aの案内面45に案内されて凹溝43aの深い位置から浅い位置に移動する。 Incision knife 44 provided at the tip of the knife the operating rod 47 by the retraction of the knife operating rod 47 is pulled to the front side, moving by being guided by the guide surface 45 of the gripping member 41a and a shallow position from the deep position of the groove 43a to.
【0047】 [0047]
したがって、図11に示すように、切開ナイフ44の切刃44aが把持部材41a,41bの把持面を通過し、把持部材41a,41b間に把持された生体組織Aの凝固された部分の内部が切開ナイフ44の切刃44aによって機械的に切開される。 Accordingly, as shown in FIG. 11, the cutting edge 44a is gripping member 41a of the incision knife 44, passes through the gripping surface of the 41b, the gripping member 41a, the interior of the solidified portion of the grasped living body tissue A between 41b It is mechanically dissected by cutting 44a of the incision knife 44.
【0048】 [0048]
切開が完了した後、ナイフ操作レバー27を解放すると、付勢部材のばね力によって定位置に戻り、ナイフ操作ロッド47は前進し、切開ナイフ44はナイフ操作ロッド47の弾性力によって徐々に上昇して上側の把持部材41aの凹溝43aの内部に収容され、アーム部32はストッパピン34に当接すると停止する。 After dissection is complete, it releases the knife operating lever 27 returns to the home position by the spring force of the biasing member, the knife operating rod 47 is advanced, the incision knife 44 is gradually raised by the elastic force of the knife operating rod 47 Te housed inside the concave groove 43a of the upper gripping member 41a, the arm portion 32 is stopped and abuts against the stopper pin 34.
【0049】 [0049]
なお、第2の実施形態においては、切開ナイフ44は矩形板状体で、下部手前側に斜めに切刃44aを有した形状であるが、図12に示すように、下部手前側に略L字状の切刃48aを有した切開ナイフ48とすることにより、生体組織Aを一層良好に切開できる。 In the second embodiment, the incision knife 44 in a rectangular plate-like body, is a shape having a cutting edge 44a at an angle on the lower front side, as shown in FIG. 12, a substantially L on the lower front side with the incision knife 48 having a shaped cutting edge 48a, the body tissue a can be more satisfactorily incised.
【0050】 [0050]
本実施形態によれば、通常時には、切開ナイフ44が把持部材41aの内部に収容された状態に退避しているため、処置部3を体腔内に目的部位に誘導する際に、切開ナイフ44によって正常な組織に傷を付ける虞がなく、操作性を向上できる。 According to this embodiment, in the normal, since the incision knife 44 is retracted in a state of being accommodated inside the gripping member 41a, the treatment portion 3 in inducing the target site within the body cavity, the incision knife 44 no fear that scratch the normal tissues, the operability can be improved. また、切開ナイフ16の切れ味が低下しても切開時に生体組織Aを逃がすことなく、確実に切開できる。 Further, even if sharpness of the incision knife 16 is lowered without releasing the body tissue A at the incision, it can be reliably incised.
【0051】 [0051]
図13〜図17は第3の実施形態を示し、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。 13 to 17 show a third embodiment, the same components as those of the first embodiment will be omitted with denoted by the same numbers. 本実施形態は、第1の実施形態の切開ナイフ16に代ってナイフワイヤ50を設けたものである。 The present embodiment is provided with a knife wire 50 in place of the incision knife 16 of the first embodiment. ロッド6の軸心より下側に偏倚した位置には軸方向に亘って貫通孔51が設けられ、この貫通孔51にはばね鋼からなるナイフ操作ロッド52が進退自在に挿通されている。 The position offset below the axis of the rod 6 through hole 51 provided along the axial direction, the knife operating rod 52 made of spring steel is inserted retractably in the through hole 51. ナイフ操作ロッド52のロッド6の先端部から延出した部分は一体にナイフワイヤ50が設けられている。 Portion extending from the distal end of the rod 6 of the knives operating rod 52 is knife wire 50 is integrally provided. このナイフワイヤ50は、断面が角軸状で、上側面を鋭角に形成した切刃50aが設けられている。 The knife wire 50 in cross section in square shaft-shaped cutting edge 50a formed on the side surfaces at an acute angle is provided. また、ナイフ操作ロッド52の基端部は操作部4まで延長しており、操作部4に設けられたナイフ操作レバー27と連結されている。 The base end portion of the knife operating rod 52 is extended to the operation portion 4 is coupled with the knife lever 27 provided in the operation section 4.
【0052】 [0052]
そして、このナイフワイヤ50の先端部は下側の把持部材11bの内底部に溶接等によって固定されており、ナイフワイヤ50の把持部材11bの内部に位置する部分は上側の把持部材11aに向かって円弧状に湾曲するように曲り癖が付けられている。 The distal end of the knife wire 50 is fixed by welding or the like to the inner bottom portion of the gripping member 11b of the lower, portion positioned inside the gripping member 11b of the knife wire 50 toward the upper side of the gripping member 11a habit bend to be curved in an arc shape is attached.
【0053】 [0053]
次に、第3の実施形態の作用について説明する。 Next, the operation of the third embodiment. 把持部材11aと11bとを閉じて生体組織Aを把持し、把持部材11a,11b間に凝固電流を流して生体組織Aを凝固するまでは第1の実施形態と同様であり、図15(b)の生体組織Aのクロス線部分は、凝固電流によって凝固された部分を示す。 Close the gripping member 11a, 11b to grip the biological tissue A, the gripping member 11a, until by applying a coagulation current between 11b coagulates the living tissue A is the same as the first embodiment, FIG. 15 (b cross line portion of the body tissue a of) shows a solidified portion by coagulation current. 生体組織Aを凝固させた後、ナイフ操作レバー27の指掛け部33に指を掛け、付勢部材の付勢力に抗してナイフ操作レバー27を半時計回り方向に回動すると、長孔29に挿入されている係合ピン30を介してナイフ操作ロッド52が前進駆動する。 After coagulating biological tissue A, over a finger on the finger hook portion 33 of the knife lever 27, when rotating the knife lever 27 counterclockwise direction against the biasing force of the biasing member, the long holes 29 knife operating rod 52 is driven forward through the engaging pin 30 being inserted. ナイフ操作ロッド52の前進によってナイフ操作ロッド52の先端部に一体に設けられたナイフワイヤ50が前方に押され、ナイフワイヤ50の先端部が把持部材11bに固定されていることと、円弧状に湾曲するように曲り癖が付けられていることから、把持部材11aに向かって円弧状に湾曲する。 Knife wire 50 provided integrally with the distal end of the knife operating rod 52 by advancement of the knife operating rod 52 is pushed forward, and the tip of the knife wire 50 is fixed to the gripping member 11b, in an arc since the habit bend to be curved is attached, it is curved in an arc shape toward the gripping member 11a.
【0054】 [0054]
したがって、図15に示すように、ナイフワイヤ50の切刃50aが把持部材11a,11bの把持面を通過し、把持部材11a,11b間に把持された生体組織Aの凝固された部分の内部がナイフワイヤ50の切刃50aによって機械的に切開される。 Accordingly, as shown in FIG. 15, the cutting edge 50a is gripping member 11a of the knife wire 50, passed through the gripping surface of the 11b, the gripping member 11a, the interior of the solidified portion of the grasped living body tissue A between 11b It is mechanically dissected by cutting 50a of the knife wire 50.
【0055】 [0055]
切開が完了した後、ナイフ操作レバー27を解放すると、付勢部材のばね力によって定位置に戻り、ナイフ操作ロッド52は後退し、ナイフワイヤ50は弾性復元力によって略真っ直ぐに復元して下側の把持部材11bの凹溝の内部に収容され、アーム部32はストッパピン34に当接すると停止する。 After dissection is complete, releases the knife operating lever 27 returns to the home position by the spring force of the biasing member, the knife operating rod 52 is retracted, the knife wire 50 lower by substantially straight restored by an elastic restoring force is a accommodated in the groove of the gripping member 11b, the arm 32 stops to abut against the stopper pin 34.
【0056】 [0056]
本実施形態によれば、通常時には、ナイフワイヤ50が把持部材11bの内部に収容された状態に退避しているため、処置部3を体腔内に目的部位に誘導する際に、ナイフワイヤ50によって正常な組織に傷を付ける虞がなく、操作性を向上できる。 According to this embodiment, in the normal, since the retreated state knife wire 50 is accommodated in the interior of the gripping member 11b, and the treatment portion 3 in inducing the target site within the body cavity, the knife wire 50 no fear that scratch the normal tissues, the operability can be improved. また、切開ナイフ16の切れ味が低下しても切開時に生体組織Aを逃がすことなく、確実に切開できる。 Further, even if sharpness of the incision knife 16 is lowered without releasing the body tissue A at the incision, it can be reliably incised.
【0057】 [0057]
図18〜図23は第4の実施形態を示し、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。 18 to 23 show a fourth embodiment, the same components as those of the first embodiment will be omitted with denoted by the same numbers. 図21〜図23に示すように、挿入部2は、ロッド55と、このロッド55に軸方向に進退自在に外嵌されれたシース56とからなり、シース56の先端部には絶縁材料からなる係合部材57が固定され、ロッド55の基端部は操作部4を構成するグリップ8に固定されている。 As shown in FIGS. 21 to 23, the insertion portion 2 is provided with a rod 55, made from this are fitted retractably in the axial direction to the rod 55 the sheath 56, an insulating material in the distal end portion of the sheath 56 the engaging member 57 is fixed comprising, a base end portion of the rod 55 is fixed to the grip 8 constituting the operation unit 4. シース56の基端部は操作部4に設けられたシース駆動部材59に固定されている。 Proximal end of the sheath 56 is fixed to the sheath drive member 59 provided in the operation section 4.
【0058】 [0058]
処置部3は、電極を構成する一対の把持部材61a,61bと、これらの把持部材61a,61bを支持し、拡開させる方向に付勢する上下2本ずつの弾性部材62a,62bとからなり、これら弾性部材62a,62bの基端部がロッド55の先端部に固定されている。 Treatment portion 3 includes a pair of gripping members 61a, 61b constituting the electrode, these gripping members 61a, supports 61b, elastic members 62a of each two vertically for urging in a direction to spreading it consists of a 62b these elastic members 62a, the base end portion of 62b is fixed to the distal end of the rod 55. 弾性部材62a,62bはばね鋼等によって形成され、先端部には略くの字状に屈曲された屈曲部63a,63bが形成され、表面は絶縁被膜によって被覆されている。 Elastic members 62a, 62b are formed by a spring steel or the like, the bent portion 63a at the tip portion which is bent in the shape of substantially L, 63 b are formed, the surface is covered with an insulating coating.
【0059】 [0059]
図20に示すように、下側の把持部材61bの把持面における幅方向の中間部には鋭利な切開刃64が前後方向に亘って設けられ、この切開刃64の両側は平坦面に形成されている。 As shown in FIG. 20, sharp dissection blade 64 is provided along the longitudinal direction in the middle portion in the width direction of the grasping surface of the lower side of the gripping member 61b, both sides of the incision blade 64 is formed on the flat surface ing. 下側の把持部材61bの把持面にはシリコンゴム等の複数個の弾性体65が設けられ、この弾性体65の高さ寸法は、切開刃64の高さ寸法よりも大きく、通常時においては、切開刃64が弾性体65の間の内部にあり、組織に傷を付けないようになっている。 A plurality of elastic bodies 65 of silicone rubber or the like is provided on the gripping surface of the lower gripping member 61b, the height of the elastic member 65 is greater than the height dimension of the incision blade 64, in the normal state incision blade 64 is located inside between the elastic body 65, so as not to damage the tissue.
【0060】 [0060]
次に、第4の実施形態の作用について説明する。 Next, the operation of the fourth embodiment.
【0061】 [0061]
初期状態では操作部4のトリガー22の手掛け部22aは図21に示すようにグリップ8から最も離れた定位置で保持され、この状態ではシース56が後退位置にあることから一対の弾性部材62a,62bが弾性復元力で拡開し、図18に示すように、一対の把持部材61a,61bが開いた状態にある。 In the initial state, the finger receiving portion 22a of the trigger 22 of the operation section 4 is held at the most distant position from the grip 8, as shown in FIG. 21, a pair of elastic members 62a because the sheath 56 is in the retracted position in this state, 62b is expanded by elastic restoring force, as shown in FIG. 18, there pair of gripping members 61a, the state 61b is opened.
【0062】 [0062]
この状態で、挿入部2の先端の処置部3を体内の処置対象の生体組織Aの近傍位置まで誘導する。 In this state, to induce distal end treatment portion 3 of the insertion portion 2 to a position near the treatment target living tissue A within the body. 続いて、拡開した把持部材61a,61bの間に生体組織Aを挿入する。 Subsequently, it flared gripping member 61a, to insert the body tissue A during 61b. そこで、トリガー22の手掛け部22aを付勢部材の付勢力に抗してグリップ8側に引き込み操作することにより、シース駆動部材59を介してシース56の軸方向前方へ移動する。 Therefore, by operating pull the grip 8 side against the finger receiving portion 22a of the trigger 22 the biasing force of the biasing member, moves through the sheath drive member 59 axially forward of the sheath 56.
【0063】 [0063]
シース56の前進に伴って弾性部材62a,62bがシース56内に相対的に引き込まれ、弾性部材62a,62bの弾性復元力に抗して把持部材61a,61bが閉じ、生体組織Aが図19に示すように、一対の把持部材61a,61b間に把持される。 Elastic member 62a with the advancement of the sheath 56, 62b is pulled relatively to the sheath 56, the elastic member 62a, an elastic restoring force in opposition to the grip member 61a of 62b, 61b are closed, the biological tissue A is 19 as shown in, the pair of gripping members 61a, is gripped between 61b. この状態で、高周波焼灼電源装置から高周波ケーブル21aを介して電極ピン21に高周波電流が流れ、さらに弾性部材62a,62bを介して把持部材61aと61bとの間に凝固電流が流れ、生体組織Aの凝固が行われる。 In this state, the high-frequency current flows through the electrode pin 21 from the high-frequency cauterization power supply apparatus via the high frequency cable 21a, the coagulation current flows between the gripping members 61a and 61b via further elastic member 62a, a 62b, the body tissue A coagulation is made of.
【0064】 [0064]
一定時間凝固電流を流して生体組織Aを凝固させた後、図23に示すように、トリガー22の手掛け部22aを付勢部材の付勢力に抗してさらにグリップ8側に引き込み操作すること、つまりトリガー22をさらに強く引くと、シース駆動部材59を介してシース56がさらに軸方向前方へ移動する。 After coagulating the living body tissue A by flowing a certain time coagulation current, as shown in FIG. 23, further manipulating pull the grip 8 side against the finger receiving portion 22a of the trigger 22 the urging force of the urging member, that pull stronger the trigger 22, the sheath 56 via a sheath driving member 59 is moved further forward axial.
【0065】 [0065]
シース56の前進に伴って弾性部材62a,62bがシース56内に相対的にさらに深く引き込まれ、把持部材61a,61bが強く閉じられるため、弾性体65が圧縮され、相対的に切開刃64が突出する。 Elastic member 62a with the advancement of the sheath 56, 62b is pulled relatively deeper into the sheath 56, the gripping member 61a, because 61b is closed strong, the elastic body 65 is compressed, relatively incision blade 64 projects. したがって、切開刃64が把持部材61a,61bの把持面を通過して把持部材61a,61b間に把持された生体組織Aは切開刃64によって機械的に切開される。 Therefore, the incision blade 64 is gripping member 61a, passes to the gripping member 61a a gripping surface of the 61b, grasped living tissue A between 61b is mechanically dissected by incision blade 64.
【0066】 [0066]
切開が完了した後、トリガー22を解放すると、付勢部材のばね力によって定位置に戻り、シース56は後退し、弾性部材62a,62bの弾性復元力によって開き、把持部材61a,61bは生体組織Aから解放される。 After dissection is complete, release the trigger 22 to return to the home position by the spring force of the biasing member, the sheath 56 is retracted, open by the elastic restoring force of the elastic member 62a, 62b, gripping member 61a, 61b is biological tissue It is released from a.
【0067】 [0067]
本実施形態においては、グリップ8を握ってトリガー22の手掛け部22aを引き込む一連の動作によって生体組織Aを把持して凝固させ、その凝固部分を切開することができ、操作性を向上させることができる。 In the present embodiment, by gripping the grip 8 is coagulated by grasping a biological tissue A by a series of operations of pulling the finger receiving portion 22a of the trigger 22, it is possible to incise the solidified portion, it is possible to improve the operability it can. また、切開ナイフ16の切れ味が低下しても切開時に生体組織Aを逃がすことなく、確実に切開できる。 Further, even if sharpness of the incision knife 16 is lowered without releasing the body tissue A at the incision, it can be reliably incised.
なお、本実施形態においては、一対の把持部材61a,61bのうち、下側の把持部材61bのみに切開刃64及び弾性体65を設けたが、図24に示すように、一対の把持部材61a,61bの両方に切開刃64及び弾性体65を互いに対向して設けてもよく、図25に示すように、下側の把持部材61bもしくは一対の把持部材61a,61bの両方にばね66を介してブロック67を取り付け、通常時において、ブロック67の高さが切開刃64より高くなるようにしてもよい。 In the present embodiment, a pair of gripping members 61a, among 61b, is provided with the incision blade 64 and the elastic body 65 only to the gripping member 61b of the lower, as shown in FIG. 24, a pair of gripping members 61a It may be provided to face each other incision blade 64 and the elastic body 65 on both 61b, as shown in FIG. 25, through the spring 66 below the gripping member 61b or the pair of gripping members 61a, both of 61b mounting block 67 Te, during a normal, may be the height of the block 67 is higher than the incision blade 64.
【0068】 [0068]
本実施形態によれば、通常時には、切開刃64が弾性体65の間に没入された状態に退避しているため、処置部3を体腔内に目的部位に誘導する際に、切開刃64によって正常な組織に傷を付ける虞がなく、操作性を向上できる。 According to this embodiment, in the normal, since the incision blade 64 is retracted in a state of being retracted between the elastic body 65, the treatment portion 3 in inducing the target site within the body cavity, the incision blade 64 no fear that scratch the normal tissues, the operability can be improved.
【0069】 [0069]
また、前述した第1〜第4の実施形態においては、切開刃及びナイフワイヤにおける切開手段は、機械的な切開について説明したが、切開時に切開刃及びナイフワイヤに切開電流を流して機械的及び電気的に切開するようにしてもよい。 Further, in the first to fourth embodiments described above, incision means in the incision blade and knife wire has been described mechanical dissection, mechanical and flowing an incision current to the incision blade and knife wire during dissection it may be electrically incision.
【0070】 [0070]
図26〜図31は内視鏡下手術器械の第1の開示例を示し、図31は全体構成図である。 26 through 31 show a first example disclosed endoscopic surgical instruments, and FIG. 31 is an overall configuration diagram. 手術器械70は挿入部71と、この挿入部71の先端部に設けられた処置部72と、挿入部71の基端部に設けられた操作部73とから構成され、手術器械70は高周波焼灼電源装置74に接続されている。 Surgical instruments 70 to the insertion portion 71, a treatment portion 72 provided at the distal end of the insertion portion 71, is configured from the operation unit 73 provided at the proximal end of the insertion portion 71, the surgical instrument 70 is a high-frequency cauterization It is connected to a power supply 74.
【0071】 [0071]
図26〜図30に示すように、挿入部71は内シース75と、この内シース75に外嵌され軸方向に進退自在な外シース76とから二重管構造に構成されている。 As shown in FIGS. 26 to 30, an insertion portion 71 the inner sheath 75, it is configured from the inner sheath 75 retractably in fitted on axially outer sheath 76. the double pipe structure. 内シース75の先端部は外シース76の先端部より突出しており、この突出部には固定ジョー77が設けられている。 The distal end portion of the sheath 75 protrudes from the distal end portion of the outer sheath 76, the fixed jaw 77 is provided in the protruding portion. 固定ジョー77の上面には鋸歯状の凹凸面が形成されていると共に、幅方向の中間部には前後方向に亘って案内溝77aが設けられている。 With the upper surface of the fixed jaw 77 is formed serrated uneven surfaces, is provided with guide grooves 77a over the front-rear direction in the middle portion in the width direction. さらに、固定ジョー77の両側面には前後方向に長いスライド溝78が設けられ、このスライド溝78には外シース76の先端部に横方向に貫通して設けられた枢支ピン79が挿入されている。 Furthermore, the long sliding groove 78 in the longitudinal direction on both sides provided with a fixed jaw 77, the pivot pin 79 which penetrates laterally distal end portion of the outer sheath 76 is inserted into the slide groove 78 ing. したがって、外シース76はスライド溝78の長さの範囲内で進退自在である。 Thus, the outer sheath 76 is movable back and forth within the length of the slide groove 78.
【0072】 [0072]
さらに、枢支ピン79の中間部には可動ジョー80が回動自在に枢支されている。 Further, the movable jaw 80 is pivotally supported at an intermediate portion of the pivot pin 79. この可動ジョー80は固定ジョー77の案内溝77aに対向し、案内溝77aの溝幅より狭幅に形成されている。 The movable jaw 80 is opposed to the guide groove 77a of the fixed jaw 77, and is formed narrower than the groove width of the guide groove 77a. また、可動ジョー80の基端部で、枢支ピン79より下側に位置する部分には連結ピン81が設けられ、この連結ピン81にはジョー操作ロッド82の先端部が回動自在に連結されている。 Also, at the proximal end portion of the movable jaw 80, the portion located below the pivot pin 79 connecting pin 81 is provided, rotatably connected front end portion of the jaw operating rod 82 in the connecting pin 81 is rotated It is. ジョー操作ロッド82は内シース75の内部を貫通して前記操作部73まで延長しており、内シース75及び外シース76も操作部73まで延長している。 Joe operating rod 82 through the interior of the inner sheath 75 and extended to the operating portion 73, and extend also inner sheath 75 and outer sheath 76 to the operation unit 73.
【0073】 [0073]
操作部73は固定ハンドル83と、この固定ハンドル83に枢支軸84によって回動自在に枢支された可動ハンドル85及び可動ハンドル85を反時計回り方向に付勢する付勢部材(図示しない)とから構成されている。 Operation unit 73 includes a fixed handle 83, the biasing member for biasing the fixed handle 83 movable handle 85 and movable handle 85 which is rotatably supported by the pivot shaft 84 in the counterclockwise direction (not shown) It is composed of a. 固定ハンドル83には内シース75の基端部が連結され、外シース76の基端部は固定ハンドル83の近傍まで延長しており、この固定ハンドル83と外シース76の基端部との間には内シース75に対して嵌合するコイルばね86が設けられている。 Fixing a base end portion of the inner sheath 75 is connected to the handle 83, proximal portion of the outer sheath 76 is extended to the vicinity of the fixed handle 83, between the proximal end portion of the fixed handle 83 and the outer sheath 76 a coil spring 86 which fits are provided with respect to the inner sheath 75 in. そして、コイルばね86の復元力によって外シース76を前進する方向に付勢している。 Then, it is biased in a direction to advance the outer sheath 76 by the restoring force of the coil spring 86. また、可動ハンドル85にはジョー操作ロッド82の基端部が連結されている。 The base end portion of the jaw operating rod 82 is coupled to the movable handle 85.
【0074】 [0074]
さらに、固定ハンドル83の上部には凝固電流と切開電流とを切換える電流切換えスイッチ87が取り付けられている。 Furthermore, the current change-over switch 87 for switching between a coagulation current incision current is attached to the upper portion of the fixed handle 83. この電流切換えスイッチ87と対向する外シース76の基端部にはスイッチ操作レバー88が取り付けられている。 Switch operating lever 88 is attached to the proximal end of the outer sheath 76 opposite to the current switching switch 87. 電流切換えスイッチ87はケーブル89を介して前記高周波焼灼電源装置74に接続されている。 Current changeover switch 87 is connected to the high-frequency cauterization power supply apparatus 74 via the cable 89.
【0075】 [0075]
次に、前述のように構成された手術器械70の作用について説明する。 Next, the operation of the constructed surgical instruments 70 as previously described.
【0076】 [0076]
まず、体腔内に挿入部71を挿入して処置部72を処置対象部位に誘導する。 First, it induces the treatment section 72 to the treatment target portion by inserting the insertion portion 71 into the body cavity. 通常時においては、可動ハンドル85は付勢部材によって反時計回りに方向に付勢されているため、可動ハンドル85によってジョー操作ロッド82は前進状態にあり、可動ジョー80は枢支ピン79を支点として時計回り方向に回動して固定ジョー77に対して可動ジョー80が開いた状態にある。 In the normal, the fulcrum for the movable handle 85 is urged in a direction counterclockwise by the urging member, the jaw operating rod 82 by the movable handle 85 is in a forward drive state, the movable jaw 80 is a pivot pin 79 It is in a state where the movable jaw 80 is opened with respect to the fixed jaw 77 rotates in the clockwise direction.
【0077】 [0077]
そこで、図27に示すように、固定ジョー77と可動ジョー80との間に生体組織Aに入れ、可動ハンドル85の指掛け部に指を掛けて固定ハンドル83に接近する時計回り方向に回動すると、ジョー操作ロッド82は後退する。 Therefore, as shown in FIG. 27, placed in body tissue A between the fixed jaw 77 and a movable jaw 80, when rotated in the clockwise direction to approach the fixed handle 83 by applying a finger to the finger hook portion of the movable handle 85 , Joe operation rod 82 is retracted. ジョー操作ロッド82が手元側に引かれると、図28に示すように、連結ピン81を介して連結されている可動ジョー80は枢支ピン79を支点として反時計回り方向に回動し、固定ジョー77に対して可動ジョー80が閉じて生体組織Aを把持する。 The jaw operating rod 82 is pulled proximally, as shown in FIG. 28, the movable jaw 80 which is connected via a connecting pin 81 is rotated in the counterclockwise direction pivotal pin 79 as a fulcrum, the fixed movable jaw 80 to grip the body tissue a closed to the jaw 77.
【0078】 [0078]
そこで、高周波焼灼電源装置74から凝固電流を流すと、凝固電流はケーブル89、電流切換えスイッチ87を介して固定ジョー77と可動ジョー80との間に凝固電流が流れ、生体組織Aの凝固が行われる。 Therefore, the flow coagulation current from the high-frequency cauterization power supply apparatus 74, the coagulation current cable 89, the coagulation current flows between the fixed jaw 77 and movable jaw 80 via the current switching switch 87, solidification line of the body tissue A divide.
【0079】 [0079]
一定時間凝固電流を流して生体組織Aを凝固させた後、可動ハンドル85をさらに固定ハンドル83に接近する方向に回動させると、ジョー操作ロッド82はさらに後退する。 After coagulating the living body tissue A by flowing a certain time coagulation current, it is rotated in a direction approaching to further secure the handle 83 to the movable handle 85, the jaw operating rod 82 is further retracted. ジョー操作ロッド82がさらに手元側に引かれると、連結ピン81を介して連結されている可動ジョー80は手元側に引かれるため、枢支ピン79を介して連結されている外シース76もコイルばね86の復元力に抗して後退する。 The jaw operating rod 82 is pulled further proximally, the movable jaw 80 which is connected via a connecting pin 81 is pulled proximally, also the outer sheath 76 which is connected via a pivot pin 79 coil to retreat against the restoring force of the spring 86. このとき、枢支ピン79はスライド溝78に支持されているため、枢支ピン79はスライド溝78内をスライドして後退し、可動ジョー80が固定ジョー77の案内溝77aに沿って移動する。 At this time, since the pivot pin 79 is supported by the slide groove 78, the pivot pin 79 retreats to slide in the slide groove 78, the movable jaw 80 is moved along the guide groove 77a of the fixed jaw 77 . すなわち、可動ジョー80が凝固された生体組織Aを剪断力によって切開する動作に移り、このとき外シース76の後退によってスイッチ操作レバー88が電流切換えスイッチ87を押圧して電流を切換えるため、高周波焼灼電源装置74から固定ジョー77と可動ジョー80との間に切開電流が流れる。 In other words, move the body tissue A movable jaw 80 is solidified to an operation of incision by the shearing force, for switching the current at this time by pressing the switch operating lever 88 is a current switching switch 87 by the retraction of the outer sheath 76, a high frequency cauterization incision current flows between the fixed jaw 77 and movable jaw 80 from the power supply 74. したがって、可動ジョー80の移動による機械的な切開と切開電流との電気的切開が同時に行える。 Thus, enabling electrical incision and mechanical dissection and incision current by the movement of the movable jaw 80 at the same time.
【0080】 [0080]
切開が完了した後、可動ハンドル85を解放すると、付勢部材のばね力によって定位置に戻り、外シース76は前進すると共に、ジョー操作ロッド82が前進して可動ジョー80は前進すると共に固定ジョー77から離れる方向に開き、生体組織Aから解放される。 After dissection is complete, releases the movable handle 85 returns to the home position by the spring force of the biasing member, the fixed jaw together with the outer sheath 76 along with advances, the movable jaw 80 jaw operating rod 82 moves forward is advanced opening in a direction away from 77, is released from the body tissue a.
【0081】 [0081]
本実施形態においては、可動ハンドル85を固定ハンドル83側に接近方向に回動する一連の動作によって生体組織Aを把持して凝固させ、その凝固部分を切開することができ、操作性を向上させることができる。 In this embodiment, gripping the body tissue A by a series of operations that rotate in the approaching direction of the movable handle 85 to the fixed handle 83 side is solidified, it is possible to incise the solidified portion, thereby improving the operability be able to.
【0082】 [0082]
図32は手術器械の第2の開示例を示し、第1の開示例と同一構成部分は同一番号を付して説明を省略する。 Figure 32 shows a second example disclosed surgical instruments, the same components as those of the first disclosed embodiment will be omitted with denoted by the same numbers. 本開示例は、第1の開示例の操作部73にロック機構を設けたものである。 Examples The present disclosure is provided with a locking mechanism on the operation unit 73 of the first disclosed embodiment. 外シース76の基端部には手元側に延出する延出レバー90が設けられ、この延出レバー90の先端部には掛止部91が設けられている。 The proximal portion of the outer sheath 76 extending lever 90 is provided which extends proximally, hook portion 91 is provided at the distal end portion of the extending lever 90. 固定ハンドル83にはトリガー92によって回動自在な掛止爪93が設けられ、掛止爪93は掛止部91に掛止されている。 Pawl 93 freely rotate by the trigger 92 is provided on the fixed handle 83, pawl 93 is hooked on the hook portion 91. したがって、固定ハンドル83に対して外シース76が前後方向に移動不能にロックされ、可動ジョー80が不用意に前後方向に移動しないようになっている。 Thus, the outer sheath 76 is locked immovably in the longitudinal direction with respect to the fixed handle 83, the movable jaw 80 is prevented from moving carelessly in the front-rear direction.
【0083】 [0083]
このように構成することにより、生体組織Aを把持して凝固する際に、可動ハンドル85を過剰に操作しても外シース76が後退することはなく、可動ジョー80による不用意な切開動作を防止でき、切開時にはトリガー92を操作して掛止爪93を掛止部91から外してロック解除してから操作すればよい。 With this configuration, when the solidified gripping the biological tissue A, never outer sheath 76 is retracted even by manipulating the movable handle 85 too, inadvertent lancing operation by the movable jaw 80 prevention can, may operate from the unlocked to remove the pawl 93 by operating the trigger 92 from the hook member 91 at the time of dissection.
【0084】 [0084]
図33は手術器械の第3の開示例を示し、第1の開示例と同一構成部分は同一番号を付して説明を省略する。 Figure 33 shows a third example disclosed surgical instruments, the same components as those of the first disclosed embodiment will be omitted with denoted by the same numbers. 本開示例は、ジョー操作ロッド82を可動ハンドル85によって駆動し、外シース76は固定ハンドル83に設けたシーススライドアクチュエータ94によって駆動するようにしたものである。 Examples The present disclosure, a jaw operating rod 82 is driven by the movable handle 85, the outer sheath 76 is obtained so as to drive the sheath slide actuator 94 provided in the fixed handle 83.
【0085】 [0085]
高周波焼灼電源装置74にはインピーダンス検知器95が設けられ、このインピーダンス検知器95はシーススライドアクチュエータ94を駆動するアクチュエータ駆動装置96に接続されている。 Impedance detector 95 is provided in the high-frequency cauterization power supply apparatus 74, the impedance detector 95 is connected to the actuator driving unit 96 for driving the sheath slide actuator 94. 高周波焼灼電源装置74から凝固電流を流し、固定ジョー77と可動ジョー80との間に凝固電流を流して生体組織Aの凝固を行った後、生体組織Aのインピーダンスをインピーダンス検知器95によって検知して凝固が完全に行われたか否かを判断する。 Flowing a coagulation current from the high-frequency cauterization power supply apparatus 74, by supplying a coagulation current between the fixed jaw 77 and movable jaw 80 after the coagulation of biological tissue A, detects the impedance of the body tissue A by the impedance detector 95 coagulation Te is determined whether or not completely performed.
【0086】 [0086]
そして、生体組織Aのインピーダンスによって凝固が完全におこなわたことを判断したとき、インピーダンス検知器95はアクチュエータ駆動装置96に駆動信号を出力し、アクチュエータ駆動装置96はシーススライドアクチュエータ94を駆動して外シース76を後退移動させ、可動ジョー80を後方にスライドさせて生体組織Aの切開を行う。 When the coagulated by the impedance of the body tissue A has determined that it has completely performed, the impedance detector 95 outputs a drive signal to the actuator driving unit 96, the actuator driving device 96 drives the sheath slide actuator 94 outside the sheath 76 is moved backward, it performs an incision of the body tissue a and slide the movable jaw 80 at the rear. このように構成することにより、生体組織Aを把持して凝固する際に、可動ハンドル85を過剰に操作しても外シース76が後退することはなく、可動ジョー80による不用意な切開動作を防止できる。 With this configuration, when the solidified gripping the biological tissue A, never outer sheath 76 is retracted even by manipulating the movable handle 85 too, inadvertent lancing operation by the movable jaw 80 It can be prevented.
【0087】 [0087]
図34及び図35は第4の開示例を示し、第1の開示例と同一構成部分は同一番号を付して説明を省略する。 34 and 35 show a fourth disclosed embodiment, the same components as those of the first disclosed embodiment will be omitted with denoted by the same numbers. 本開示例は、枢支ピン79及びこの枢支ピン79に枢支された可動ジョー80に絶縁層79A,80Aを設け、固定ジョー77と可動ジョー80とを電気的絶縁状態にしてバイポーラ化したものである。 Examples The present disclosure, the insulating layer 79A to the pivoted movable jaw 80 to pivot pin 79 and the pivot pin 79, the 80A provided, and bipolar reduction by a fixed jaw 77 and movable jaw 80 to the electrically insulated state it is intended.
【0088】 [0088]
図36及び図37は第5の開示例を示す。 Figures 36 and 37 show the disclosure of the fifth. 本開示例は、挿入部としての軸方向に進退自在なスライドパイプ100の先端部に軸方向に進退自在な第1の可動ジョー101とアーム102に固定された第2の可動ジョー103とから構成されている。 Examples The present disclosure comprises a first of the second movable jaw 103 which is fixed to the movable jaw 101 and the arm 102 in the axial direction rotatively in the axial direction at the tip portion of the forward and backward freely slide pipe 100 as the insertion portion It is. アーム102は弾性部材によって形成され、拡開方向に曲り癖が付けられており、スライドパイプ100が後退することにより、第1の可動ジョー101に対して第2の可動ジョー103が開き、スライドパイプ100が前進することにより、第1の可動ジョー101に対して第2の可動ジョー103が閉じて生体組織Aを把持できるようになっている。 Arm 102 is formed of an elastic member, a bending tendency to the expansion direction and is attached, by a slide pipe 100 is retracted, the second movable jaw 103 is opened with respect to the first movable jaw 101, the slide pipe by 100 is advanced, first second movable jaw 103 with respect to the movable jaw 101 is enabled to grip the body tissue a closed.
【0089】 [0089]
そして、高周波焼灼電源装置から第1の可動ジョー101と第2の可動ジョー103との間に凝固電流を流して生体組織Aを凝固させた後、第1の可動ジョー101と第2の可動ジョー103との間に切開電流を流すとともに、第1の可動ジョー101を後退させると、第1の可動ジョー101の移動による機械的な切開と切開電流との電気的切開が同時に行える。 Then, after the high-frequency cauterization power supply apparatus to flow to the first movable jaw 101 coagulation current between the second movable jaw 103 to coagulate body tissue A, and the first movable jaw 101 and the second movable jaw with flow incision current between 103 and retracting the first movable jaw 101, enabling electrical incision and mechanical dissection and incision current by the movement of the first movable jaw 101 at the same time.
【0090】 [0090]
切開が完了した後、スライドパイプ100を後退させると、アーム102の弾性力によって拡開して第2の可動ジョー103は第1の可動ジョー101から離れる方向に開き、生体組織Aから解放される。 After dissection is complete, to retract the slide pipe 100, a second movable jaw 103 is expanded by the elastic force of the arm 102 is open in a direction away from the first movable jaw 101 is released from the body tissue A .
【0091】 [0091]
前記実施の形態によれば、次のような構成が得られる。 According to the embodiment, a structure such as the following are obtained.
【0092】 [0092]
(付記1)組織を把持する一対の把持部材と、前記把持部材の把持面に設けられた双極電極と、組織を切開する切開手段とを備えた内視鏡下手術器械において、前記切開手段は、把持する組織に接触しないよう前記把持部材の内部に収容される第1の位置に配置され、切開時に切開手段の少なくとも一部が第1の位置から一対の把持部材で形成される把持面を通過するように移動自在であることを特徴とする内視鏡下手術器械。 (Supplementary Note 1) and a pair of gripping members for gripping the tissue, and a bipolar electrode provided on the gripping surface of the gripping member, in an endoscopic surgical instruments having a incision means for cutting tissue, said incision means , is disposed at the first position, which is accommodated inside the gripping member so as not to contact the gripping tissue, the gripping surface at least partially formed by a pair of gripping members from the first position of the cutting means during dissection endoscopic surgical instruments, which is a movable so as to pass.
【0093】 [0093]
(付記2)切開手段は、収納される把持部材の開閉動作に応じて移動可能なような弾性部材で支持されていることを特徴とする付記1記載の内視鏡下手術器械。 (Supplementary Note 2) incision means, endoscopic surgical instruments according to Supplementary Note 1, wherein the is supported by an elastic member such as movable in response to the opening and closing operation of the housing is being gripped member.
【0094】 [0094]
(付記3)切開手段は、切開操作部材を有し、この切開操作部材は、切開手段を付勢する弾性部材に係合しない第1の位置と弾性部材に係合してその付勢力に抗して切開手段を把持部材から突出させる第2の位置に移動可能であることを特徴とする付記1または2記載の内視鏡下手術器械。 (Supplementary Note 3) incision means has an incision operating member, the incision operation member is anti to the biasing force engaging the first position and the elastic member not engaged with the elastic member for urging the incision means Appendix 1 or 2 endoscopic surgical instrument, wherein the second position to project the incision means from the gripping member is movable.
【0095】 [0095]
(付記4)切開手段は、鋭利な切刃を有する切開刃であることを特徴とする付記1または2記載の内視鏡手術器械。 (Supplementary Note 4) incision means, Appendix 1 or 2 endoscopic surgical instruments according to characterized in that the incision blade having a sharp cutting edge.
【0096】 [0096]
(付記5)切開手段は、把持部材の内部に収納される第1の位置と挿入部内まで後退する第2の位置との間を移動可能であることを特徴とする付記1または2記載の内視鏡手術器械。 (Supplementary Note 5) incision means, among Appendix 1 or 2, wherein the to the first position and the insertion portion of which is accommodated inside the gripping member is movable between a second position retracted endoscopic surgical instruments.
【0097】 [0097]
(付記6)切開手段は、L字状の切刃を有する切開刃であることを特徴とする付記5記載の内視鏡手術器械。 (Supplementary Note 6) incision means, endoscopic surgical instruments according to Note 5, wherein the a incision blade having an L-shaped cutting edge.
【0098】 [0098]
(付記7)切開手段は、先端が一方の把持部材に固定され、後端が把持部材に対して移動可能な弾性を有するナイフワイヤで、このナイフワイヤは、前進動作に伴って湾曲して把持部材の把持面を通過することを特徴とする付記1記載の内視鏡手術器械。 (Supplementary Note 7) incision means, the leading end is fixed to one of the gripping members, a knife wire trailing end having a movable elastic relative gripping members, the knife wire bent to grip moves forward endoscopic surgical instruments according to Supplementary note 1, wherein the passing a gripping surface of the member.
【0099】 [0099]
(付記8)ナイフワイヤは、湾曲方向に鋭利な切刃を有していることを特徴とする付記7記載の内視鏡手術器械。 (Supplementary Note 8) knife wire endoscopic surgical instruments according to Supplementary Note 7, wherein the has a sharp cutting edge the curve direction.
【0100】 [0100]
(付記9)組織の凝固後に凝固部位を切開するための機能を有した高周波処置具において、通常の把持操作では組織に切開を行わないよう、組織把持部に組織の切開を制御する弾性部材を有していることを特徴とする高周波処置具。 In (Supplementary Note 9) high-frequency treatment instrument having a function for cutting coagulation site after tissue coagulation, so that in normal gripping operation is not performed incision in tissue, the elastic member for controlling the incision of a tissue to tissue grasping portion high-frequency treatment instrument, characterized in that it has.
【0101】 [0101]
(付記10)凝固操作と切開操作が一連の動作で行えることを特徴とする付記9記載の高周波処置具。 (Supplementary Note 10) high-frequency treatment instrument according to Note 9, wherein the perform coagulation operation and incision operations in a series of operations.
【0102】 [0102]
(付記11)操作部の操作により凝固操作と切開操作が一連の動作で行えることを特徴とする付記10記載の高周波処置具。 (Supplementary Note 11) high-frequency treatment instrument according to Note 10, wherein the perform coagulation operation as dissection operation by operating the operation unit is in a series of operations.
【0103】 [0103]
(付記12)弾性部材は、シリコンゴムであることを特徴とする付記9記載の高周波処置具。 (Supplementary Note 12) elastic members, high-frequency treatment instrument according to Note 9, wherein it is a silicone rubber.
【0104】 [0104]
(付記13)シリコンゴムはばねによって支持されていることを特徴とする付記12記載の高周波処置具。 (Supplementary Note 13) silicone rubber-surgical device according to Note 12, wherein the is supported by a spring.
【0105】 [0105]
(付記14)組織切開部は、組織把持面の一部に設けられ鋭利な切刃を有していることを特徴とする付記9記載の高周波処置具。 (Supplementary Note 14) tissue incision, the high-frequency treatment instrument according to Note 9, wherein a has a sharp cutting edge provided on a portion of the tissue gripping surface.
【0106】 [0106]
(付記15)組織切開部は、その両側に組織把持面を持っていることを特徴とする付記14記載の高周波処置具。 (Supplementary Note 15) tissue incision, the high-frequency treatment instrument according to Note 14, wherein the has a tissue gripping surface on both sides.
【0107】 [0107]
(付記16)相対的に開閉する一対のジョーを挿入部の先端に有し、組織を凝固する内視鏡下手術器械において、一方のジョーが他方のジョーに対して開閉するとともに近位側に挿入部と略平行にスライドし、一対のジョーの組織接触面には凝固面が形成され、凝固面に高周波電流を通電して組織の切開を行う内視鏡下手術器械。 (Supplementary Note 16) has a pair of jaws relative opening and closing the distal end of the insertion portion, the endoscopic surgical instruments of coagulating tissue proximally with one jaw is opened and closed with respect to the other jaw substantially parallel to the slide and the insertion portion, the tissue contacting surfaces of the pair of jaws coagulation surface is formed, endoscopic surgical instruments that by applying a high frequency current perform tissue dissection coagulation surface.
【0108】 [0108]
(付記17)一対のジョーは、第1のジョーと第2のジョーとからなり、第1のジョーは第2のジョーに対して回動自在に支点ピンで支持され、さらに支点ピンは第2のジョーに挿入部と略平行に設けられたスライド溝内をスライド可能であり、さらに支点ピンは第2のジョーに対してスライド可能に設けられたシースに接続され、シースにはスライド防止手段が設けられた付記16記載の内視鏡下手術器械。 (Supplementary Note 17) pair of jaws comprises a first jaw and a second jaw, the first jaw is supported in freely pivot pins rotate relative to the second jaw, further fulcrum pin second a the jaw can slide in a slide groove formed substantially parallel to the insertion portion, further fulcrum pin is connected to the sheath is slidable relative to the second jaw, the slide preventing means is a sheath It provided the appended 16 endoscopic surgical instruments according.
【0109】 [0109]
(付記18)第1のジョーは弾性変形可能なアームで支持され、アームにシースがスライドして係合することで開閉するとともに、第2のジョーは第1のジョー及びシースに対してスライドし、シースにはスライド防止手段が設けられた付記16記載の内視鏡下手術器械。 (Supplementary Note 18) The first jaw is supported by an elastically deformable arm, together with the sheath in the arm to open and close by engaging with the slide, the second jaw slides relative to the first jaw and the sheath , endoscopic surgical instruments according to note 16, wherein the slide prevention means is provided in the sheath.
【0110】 [0110]
(付記19)スライド防止手段は、シースを遠位方向に付勢するコイルばねからなる付記17または18記載の内視鏡下手術器械。 (Supplementary Note 19) slide preventing means, Appendix 17 or 18 endoscopic surgical instruments according a coil spring for biasing the sheath in the distal direction.
【0111】 [0111]
(付記20)スライド防止手段は、さらにシースに接続された掛止部及びこの掛止部に係脱に係合する掛止爪を有している付記19記載の内視鏡下手術器械。 (Supplementary Note 20) slide preventing means further endoscopic surgical instruments of that note 19, wherein has a locking pawl for engaging the disengaged to the engagement portion and the engagement portion is connected to the sheath.
【0112】 [0112]
(付記21)付記16乃至18記載の内視鏡下手術器械は、シーススライドアクチュエータからなるスライド防止手段と、生体組織のインピーダンスを検知するインピーダンス検知器と、アクチェエータ駆動装置とを有し、凝固された組織のインピ一ダンスが所定の値を超えたときにアクチェエータ駆動装置がシーススライドアクチュエータを作動させ、ジョーをスライドさせることを特徴とする内視鏡下手術器械。 (Supplementary Note 21) Supplementary Note 16 or 18 endoscopic surgical instruments according includes a slide preventing means consisting of the sheath slide actuator, an impedance detector for detecting the impedance of the living tissue, and a Akucheeta drive, coagulated endoscopic surgical instruments that Akucheeta driving device actuates the sheath slide actuator, characterized in that sliding the jaws when tissue Inpi one dance exceeds a predetermined value was.
【0113】 [0113]
(付記22)付記16〜21のいずれかに記載の内視鏡下手術器械は、一方のジョーを他方のジョーから絶縁する手段を含み、各々のジョーには異なる極の高周波電流を通電可能な内視鏡下手術器械。 (Supplementary Note 22) an endoscopic surgical instrument according to any one of appendices 16 to 21, including means for insulating one jaw from the other jaw, to each of the jaws can be a high-frequency current of different poles endoscopic surgical instruments.
【0114】 [0114]
(付記23)付記16〜21のいずれかに記載の内視鏡下手術器械は、ジョーが閉じて組織凝固時には凝固電流を、ジョーのスライド時に切開電流を通電することにより連続的に組織の凝固・切開が可能な内視鏡下手術器械。 (Supplementary Note 23) an endoscopic surgical instrument according to any one of appendices 16 to 21, the coagulation current during tissue coagulation jaws closed, continuous tissue coagulation by energizing an incision current when the slide jaw endoscopic surgical instruments that can-incision.
【0115】 [0115]
(付記24)付記23において、ジョーのスライド開始に応じて電流を凝固電流から切開電流に変化させる手段を持つ内視鏡下手術器械。 (Supplementary Note 24) In Addition 23, an endoscopic surgical instrument having means for varying the current from the coagulating current to the incision current according to the sliding start of the jaws.
【0116】 [0116]
【発明の効果】 【Effect of the invention】
以上説明したように、この発明によれば、切開手段を、把持する組織に接触しないよう把持部材の内部に収容し、切開時に切開手段の少なくとも一部が一対の把持部材で形成される把持面を通過するように移動自在にしたから、体腔内に挿入したとき、切開手段が正常な組織に接触して傷を付ける虞がなく、操作性の向上を図ることができる。 As described above, according to the present invention, gripping surface incision means, housed inside the gripping member so as not to contact the grasping tissue, the at least part of the cutting means when the incision is formed by a pair of gripping members because was movable so as to pass through, when inserted into a body cavity, there is no fear that put scratches in contact with normal tissue dissection device, it is possible to improve the operability. また、切開手段の切れ味が低下しても切開時に生体組織を逃がすことなく、確実に切開できるという効果がある。 Further, even if the sharpness of the cutting means is lowered without releasing the body tissue during the incision, there is an effect that can be reliably incised.
【図面の簡単な説明】 BRIEF DESCRIPTION OF THE DRAWINGS
【図1】この発明の第1の実施形態を示し、(a)は内視鏡下手術器械の全体の平面図、(b)は同側面図、(c)は把持部材が開いた状態の側面図。 [1] shows a first embodiment of the present invention, (a) is a plan view of the whole endoscopic surgical instruments, (b) is a side view of the same, (c) is a state in which the gripping members open Side view.
【図2】同実施形態の内視鏡下手術器械の動作説明図。 [2] Operation view of endoscopic surgical instruments according to the embodiment.
【図3】同実施形態の内視鏡下手術器械の動作説明図。 [3] Operation view of endoscopic surgical instruments according to the embodiment.
【図4】同実施形態を示し、把持部材が開いた状態の縦断側面図。 Figure 4 shows the same embodiment, longitudinal side view showing a state in which the gripping members open.
【図5】同実施形態を示し、(a)は把持部材が閉じて生体組織を凝固している状態の縦断側面図、(b)はA−A線に沿う断面図。 Figure 5 shows the same embodiment, (a) shows the longitudinal side view showing a state in which the gripping members are solidified body tissue to close, (b) is a sectional view taken along line A-A.
【図6】同実施形態を示し、(a)は生体組織の切開状態の縦断側面図、(b)はB−B線に沿う断面図。 6 shows the same embodiment, (a) shows the longitudinal side view of the dissecting state of biological tissue, (b) is a sectional view taken along line B-B.
【図7】この発明の第2の実施形態を示す内視鏡下手術器械の動作説明図。 [7] Operation Figure endoscopic surgical instruments according to a second embodiment of the present invention.
【図8】同実施形態の内視鏡下手術器械の動作説明図。 [8] diagram for describing operation of the endoscopic surgical instruments according to the embodiment.
【図9】同実施形態を示し、把持部材が開いた状態の縦断側面図。 9 shows the same embodiment, longitudinal side view showing a state in which the gripping members open.
【図10】同実施形態を示し、把持部材が閉じて生体組織を凝固している状態の縦断側面図。 [Figure 10] shows the same embodiment, longitudinal side view showing a state in which the gripping members are solidified body tissue closed.
【図11】同実施形態を示し、(a)は生体組織の切開状態の縦断側面図、(b)はC−C線に沿う断面図。 [Figure 11] shows the same embodiment, (a) shows the longitudinal side view of the dissecting state of biological tissue, (b) is a sectional view taken along line C-C.
【図12】同実施形態の切削刃の変形例を示す側面図。 Figure 12 is a side view showing a modification of the cutting edge of the embodiment.
【図13】この発明の第3の実施形態を示し、把持部材が開いた状態の縦断側面図。 [Figure 13] shows a third embodiment of the present invention, longitudinal side view showing a state in which the gripping members open.
【図14】同実施形態を示し、把持部材が閉じて生体組織を凝固している状態の縦断側面図。 [Figure 14] shows the same embodiment, longitudinal side view showing a state in which the gripping members are solidified body tissue closed.
【図15】同実施形態を示し、(a)は生体組織の切開状態の縦断側面図、(b)はD−D線に沿う断面図。 [Figure 15] shows the same embodiment, (a) shows the longitudinal side view of the dissecting state of biological tissue, (b) is a sectional view taken along the line D-D.
【図16】同実施形態の内視鏡下手術器械の動作説明図。 [16] Operation view of endoscopic surgical instruments according to the embodiment.
【図17】同実施形態の内視鏡下手術器械の動作説明図。 [17] Operation view of endoscopic surgical instruments according to the embodiment.
【図18】この発明の第4の実施形態を示し、把持部材が開いた状態の図20(b)のH−H線に沿う縦断側面図。 [18] Fourth shows an embodiment, longitudinal side view taken along the line H-H of FIG. 20 in a state where the gripping member opening (b) of the present invention.
【図19】同実施形態を示し、(a)把持部材が閉じて生体組織を凝固している状態の図20(b)のH−H線に沿う縦断側面図、(b)はE−E線に沿う断面図。 [Figure 19] shows the same embodiment, vertical sectional side view taken along the line H-H of (a) view of a state where the gripping member is solidified body tissue to close 20 (b), (b) the E-E sectional view taken along a line.
【図20】同実施形態を示し、(a)は生体組織の切開状態の縦断側面図、(b)はF−F線に沿う断面図。 [Figure 20] shows the same embodiment, (a) shows the longitudinal side view of the dissecting state of biological tissue, (b) is a sectional view taken along the line F-F.
【図21】同実施形態の内視鏡下手術器械の動作説明図。 [21] Operation view of endoscopic surgical instruments according to the embodiment.
【図22】同実施形態の内視鏡下手術器械の動作説明図。 [22] Operation view of endoscopic surgical instruments according to the embodiment.
【図23】同実施形態の内視鏡下手術器械の動作説明図。 [Figure 23] diagram for describing operation of the endoscopic surgical instruments according to the embodiment.
【図24】同実施形態の変形例を示す把持部材の断面図。 Figure 24 is a cross-sectional view of the gripping member showing a modification of the embodiment.
【図25】同実施形態の変形例を示す把持部材の断面図。 Figure 25 is a cross-sectional view of the gripping member showing a modification of the embodiment.
【図26】内視鏡下手術器械の第1の開示例を示す処置部の平面図。 [Figure 26] in view plan view of the treatment portion showing a first disclosed embodiment of the lens under surgical instruments.
【図27】同開示例の処置部の側面図。 Figure 27 is a side view of the treatment portion of the example disclosed.
【図28】同開示例の把持部材で生体組織を把持して凝固している状態の側面図。 Figure 28 is a side view of a state in which the solidified gripping the living tissue by the gripping members of the disclosed embodiment.
【図29】同開示例の把持部材で生体組織を切開している状態の側面図。 Figure 29 is a side view of a state where the incised body tissue by the gripping members of the disclosed embodiment.
【図30】同開示例の切開時の横断正面図。 Figure 30 is a cross front view at the time of dissection of the same disclosed examples.
【図31】同開示例の内視鏡下手術器械の全体構成を示す側面図。 Figure 31 is a side view showing the overall configuration of the endoscopic surgical instruments of the same disclosed examples.
【図32】内視鏡下手術器械の第2の開示例を示す操作部側の側面図。 [Figure 32] endoscopic second side view of the operation unit side showing the example disclosed a mirror under surgical instruments.
【図33】内視鏡下手術器械の第3の開示例を示す操作部側の側面図。 [Figure 33] endoscopic third side view of the operation unit side showing the example disclosed a mirror under surgical instruments.
【図34】内視鏡下手術器械の第4の開示例を示す処置部の縦断平面図。 [Figure 34] endoscopic longitudinal plan view of the treatment portion showing a fourth disclosed embodiment of the lens under surgical instruments.
【図35】同開示例を示す処置部の横断正面図。 Figure 35 is a cross front view of the treatment portion showing the same example disclosed.
【図36】内視鏡下手術器械の第5の開示例を示す処置部の側面図。 [Figure 36] endoscopic fifth side view of the treatment portion showing the example disclosed a mirror under surgical instruments.
【図37】同開示例を示し、生体組織を切開している状態を示す側面図。 [Figure 37] shows the same example disclosed a side view showing a state of incising the body tissue.
【符号の説明】 DESCRIPTION OF SYMBOLS
2…挿入部3…処置部4…操作部11a,11b…把持部材16…切開刃 2 ... insertion portion 3 ... treatment section 4 ... operating portion 11a, 11b ... gripping member 16 ... incision blade

Claims (3)

  1. 互いに開閉され把持面を形成する一対の把持部材と、 A pair of gripping members forming an opening by gripping surfaces to each other,
    前記一対の把持部材に設けられている双極電極と、 A bipolar electrode provided on the pair of gripping members,
    切開部材と、 And cutting member,
    前記把持部材に設けられ前記把持面側に開口し前記把持面に対向する内壁により規定され前記切開部材の全体を収容可能な空間部と、 Said provided gripping member above is open to the grasping surface defined by the inner wall facing the gripping surface entire accommodate space portion of the cutting member,
    前記切開部材を前記一対の把持部材間で前記把持部材の開閉方向に移動自在に支持し前記内壁へと付勢している弾性部材と、 An elastic member that the incision member movably supported in the closing direction of the gripping member between the pair of gripping members is biased to the inner wall,
    進退操作可能であり、進退操作されて前記弾性部材を押圧して前記開閉方向へと弾性変形させることにより前記切開部材を前記切開部材の少なくとも一部分が前記把持面を通過するように前記把持部材の開閉方向に移動可能な操作部材と、 Retractable and operable, at least a portion of the cutting member the cutting member by a is elastically deformed to retreat operation has been the closing direction to press the elastic member of the gripping member so as to pass through the gripping surface an operating member movable in the closing direction,
    を具備することを特徴とする内視鏡手術器械。 Endoscopic surgical instruments, characterized by comprising.
  2. 互いに開閉され把持面を形成する一対の把持部材と、 A pair of gripping members forming an opening by gripping surfaces to each other,
    前記一対の把持部材に設けられている双極電極と、 A bipolar electrode provided on the pair of gripping members,
    切開部材と、 And cutting member,
    前記把持部材に設けられ前記把持面側に開口し前記把持面に対向する内壁により規定され前記切開部材の全体を収容可能な空間部と、 Said provided gripping member above is open to the grasping surface defined by the inner wall facing the gripping surface entire accommodate space portion of the cutting member,
    前記切開部材を前記一対の把持部材間で前記把持部材の開閉方向に移動自在に支持し前記内壁へと付勢し、前記切開部材と共に進退操作可能な弾性操作部材と、 Wherein a cutting member and a movably supported in the closing direction of the gripping member between the pair of gripping members is biased to the inner wall, retractable operable resilient operating member with the cutting member,
    前記内壁に設けられ、前記切開部材の進退方向に対して前記開閉方向に傾斜している斜面と、を具備し、 Provided in the inner wall, anda slope is inclined to the opening and closing direction with respect to moving direction of said cutting member,
    前記切開部材は、前記弾性操作部材によって前記斜面に沿って進退されることにより前記切開部材の少なくとも一部分が前記把持面を通過可能である、 Said incision member, at least a portion of said cutting member by being advanced and retracted along the inclined surface by said resilient operating member can pass through the gripping surface,
    ことを特徴とする内視鏡手術器械。 Endoscopic surgical instruments, characterized in that.
  3. 互いに開閉され把持面を形成する一対の把持部材と、 A pair of gripping members forming an opening by gripping surfaces to each other,
    前記一対の把持部材に設けられている双極電極と、 A bipolar electrode provided on the pair of gripping members,
    切開部材と、 And cutting member,
    前記把持部材に設けられ前記把持面側に開口し前記把持面に対向する内壁により規定され前記切開部材の全体を収容可能な空間部と、 Said provided gripping member above is open to the grasping surface defined by the inner wall facing the gripping surface entire accommodate space portion of the cutting member,
    前記切開部材が一体的に設けられ、 進退操作可能であり、先端部が前記一対の把持部材の一方の把持部材に固定され、前記切開部材を前記一方の把持部材の前記内壁へと付勢し、前記一対の把持部材の他方の把持部材に向かって湾曲するように曲がり癖が付けられ、進退操作によって弾性変形されて前記切開部材を前記切開部材の少なくとも一部分が前記把持面を通過するように前記一対の把持部材の開閉方向に移動可能な弾性操作部材と、 The cutting member is integrally provided with a retractable operation, the tip portion is fixed to one of the gripping members of the pair of gripping members, and urged the cutting member to the inner wall of the one gripping member , the pair of the other bending tendency to be curved toward the gripping member of the gripping member is attached, such that at least a portion of the cutting member the cutting member is elastically deformed by advancing and retracting the operation passes through the gripping surface an elastic operating member movable in the closing direction of the pair of gripping members,
    を具備することを特徴とする内視鏡手術器械。 Endoscopic surgical instruments, characterized by comprising.
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