JP5165163B2 - 把持処置装置 - Google Patents
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/2812—Surgical forceps with a single pivotal connection
- A61B17/2816—Pivots
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B18/1442—Probes having pivoting end effectors, e.g. forceps
- A61B18/1445—Probes having pivoting end effectors, e.g. forceps at the distal end of a shaft, e.g. forceps or scissors at the end of a rigid rod
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/2812—Surgical forceps with a single pivotal connection
- A61B17/282—Jaws
- A61B2017/2825—Inserts of different material in jaws
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
- A61B2017/320088—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with acoustic insulation, e.g. elements for damping vibrations between horn and surrounding sheath
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
- A61B17/320092—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw
- A61B2017/320093—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw additional movable means performing cutting operation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
- A61B17/320092—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw
- A61B2017/320095—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw with sealing or cauterizing means
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00053—Mechanical features of the instrument of device
- A61B2018/00172—Connectors and adapters therefor
- A61B2018/00178—Electrical connectors
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- General Health & Medical Sciences (AREA)
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- Surgical Instruments (AREA)
Description
本発明の第1の実施形態について図1乃至図20を参照して説明する。図1は、本実施形態の医療用処置装置1を示す図である。この医療用処置装置1は、プローブ3(後述する)の先端部とジョー52(後述する)との間で生体組織等の把持対象を把持し、把持した把持対象を、例えば、超音波、高周波、熱等のエネルギーによって処置可能な把持処置装置である。なお、本実施形態の医療用処置装置1は、プローブ3の先端部及びジョー52を電極として高周波電流による処置を行うバイポーラ処置装置として用いられる。また、医療用処置装置1は、超音波振動による処置を行う超音波処置装置としても用いられる。図1に示すように、医療用処置装置1は、振動子ユニット2と、プローブ3と、シースユニット4と、可動ハンドルユニット5とを備える。
なお、第1の実施形態では、突起部63A,63Bは、シース側接触部71まで回動軸Rに沿って半球状に設けられる突起側半球部75を備えるが、これに限るものではない。例えば第1の変形例として図21に示すように、突起側半球部75の代わりに、第1の突起部63Aは、シース側接触部71まで回動軸Rに沿ってテーパ状に設けられる突起側テーパ部77を備えてもよい。突起側テーパ部77は、回動軸Rに沿って第1の突起部63Aの突出端69に向かうにつれて回動軸Rに垂直な断面積が減少する突起側断面変化部である。突起側テーパ部77により、シース側接触部71とジョー側接触部73との接触面積を減少させている。第2の突起部63Bについても第1の突起部63Aと同様に、突起側テーパ部77が設けられている。
図28は、第1の参照例に係る医療用処置装置110を示す図である。図28に示すように、医療用処置装置110は、振動子ユニット112と、プローブ113と、シースユニット114と、ハンドルユニット115とを備える。振動子ユニット112は、第1の実施形態の振動子ユニット2と同様の構成であり、超音波振動を発生させる。プローブ113は、第1の実施形態のプローブ3と同様の構成であり、超音波振動を基端から先端へ伝達する。
記
(付記項1)
固定側指置き部を備え、長手軸に沿って延設される固定ハンドルと、
可動側指置き部を備え、前記長手軸に垂直な第1の開閉方向及び前記第1の開閉方向とは反対方向である第2の開閉方向に前記固定ハンドルに対して開閉可能な可動ハンドルであって、前記固定ハンドルより前記第1の開閉方向側に位置している可動ハンドルと、
前記固定側指置き部より先端方向側の部位で、かつ、前記固定ハンドルの前記第2の開閉方向側の部位に設けられ、前記長手軸に対して傾斜する傾斜平面であって、前記第1の開閉方向から前記第2の開閉方向に向かうにつれて、基端方向側に位置している傾斜平面と、
前記傾斜平面に設けられ、押圧方向が前記傾斜面に対して垂直である操作入力部と、
を具備する医療用処置装置。
前記操作入力部は、第1の操作入力部と、第2の操作入力部と、を備え、
前記傾斜平面は、前記第1の操作入力部が設けられ、前記第1の操作入力部の押圧方向に垂直な第1の傾斜平面と、前記第2の操作入力部が設けられ、前記第2の操作入力部の押圧方向に垂直な第2の傾斜平面であって、前記第1の傾斜平面より前記基端方向側に位置する第2の傾斜平面と、を備える、
付記項1の医療用処置装置。
前記第1の傾斜平面と前記長手軸との間の鋭角の第1の角度は、前記第2の傾斜平面と前記長手軸との間の鋭角の第2の角度より、大きい、付記項2の医療用処置装置。
Claims (9)
- 長手軸に沿って延設されるプローブと、
前記プローブが先端方向に突出する状態で前記プローブが挿通されるシースと、
前記シースの先端部に前記長手軸に垂直な回動軸を中心に回動可能に取付けられ、前記プローブの先端部に対して前記長手軸に垂直かつ前記回動軸に垂直な開閉方向に開閉可能なジョーと、
前記プローブと前記シースとの間に設けられ、前記プローブと前記シースとの間の接触を防止する支持部材と、
を具備し、
前記支持部材は、最も前記先端方向側に位置する前記支持部材であって、前記長手軸に平行な方向について前記ジョーの前記回動軸と位置が一致する最先端支持部材を含む、把持処置装置。 - 前記プローブの前記先端部は、前記ジョーと対向するジョー対向部を備え、
前記ジョーは、前記プローブの前記先端部と対向するプローブ対向部を備え、
前記ジョーの前記プローブ対向部と前記プローブの前記ジョー対向部とが平行な状態では、前記プローブ対向部は前記ジョー対向部から所定距離だけ離れている、請求項1の把持処置装置。 - 前記プローブは、基端から先端へ前記長手軸に沿って超音波振動を伝達し、
前記長手軸に平行な前記方向について、前記ジョーの前記回動軸の位置及び前記軸位置支持部材の位置は、前記超音波振動の節位置と一致している、請求項1の把持処置装置。 - 前記プローブは、前記先端部に設けられる第1の電極部を備え、前記長手軸に沿って高周波電流を伝達し、
前記シースは、前記プローブより外周方向側に前記プローブとの間が絶縁した状態で設けられ、前記第1の電極部が先端方向に突出する状態で前記プローブが挿通され、
前記ジョーは、前記シースと電気的に接続される第2の電極部を備え、前記第1の電極部に対して前記開閉方向に開閉可能である、請求項1の把持処置装置。 - 前記シースの外周部に設けられるシース側接触部と、前記ジョーの内周部に設けられ、前記シース側接触部に摺動可能に接触するジョー側接触部と、を備え、前記ジョー側接触部と前記シース側接触部との間を常に接触させた状態で保持することにより、前記シースと前記ジョーの前記第2の電極部との間で常に前記高周波電流が伝達される状態を保持する電気接触ユニットを、さらに具備し、
前記電気接触ユニットは、
前記ジョーに前記回動軸に沿って外周方向に凹んだ状態で設けられる溝状部を規定する溝規定部であって、前記ジョー側接触部が位置する溝底面を備える溝規定部と、前記シースの前記外周部に前記回動軸に沿って前記外周方向に突出した状態で設けられ、前記溝状部に挿入される突起部であって、前記シース側接触部が位置する突出端を備える突起部と、を備えるか、
又は、
前記シースの前記外周部に前記回動軸に沿って内周方向に凹んだ状態で設けられる溝状部を規定する溝規定部であって、前記シース側接触部が位置する溝底面を備える溝規定部と、前記ジョーに前記回動軸に沿って前記内周方向に突出した状態で設けられ、前記溝状部に挿入される突起部であって、前記ジョー側接触部が位置する突出端を備える突起部と、を備えるか、
であり、
前記突起部は、前記回転軸に沿って前記突出端に向かうにつれて前記回転軸に垂直な断面積が減少し、前記シース側接触部と前記ジョー側接触部との接触面積を減少させる突起側断面変化部を備えるか、
及び、
前記溝規定部は、前記シース側接触部又は前記ジョー側接触部が前記突起部の前記突出端に向かって突出する状態に前記溝底面を規定する凸部を備え、
前記凸部は、前記回転軸に沿って前記シース側接触部又は前記ジョー側接触部に向かうにつれて前記回転軸に垂直な断面積が減少し、前記シース側接触部と前記ジョー側接触部との接触面積を減少させる溝側断面変化部を備えるか、
の少なくともいずれか一方である、請求項4の把持処置装置。 - 前記シースに前記ジョーが取付けられていない状態では、前記長手軸から前記シース側接触部までの前記回転軸に沿った第1の寸法が、前記長手軸から前記ジョー側接触部までの前記回転軸に沿った第2の寸法より大きい、請求項5の把持処置装置。
- 前記溝規定部は、前記回動軸に平行な第1の回動軸方向に向かって凹む第1の溝状部を規定する第1の溝規定部と、前記第1の回動軸方向とは反対方向である第2の回動軸方向に向かって凹む第2の溝状部を規定する第2の溝規定部と、を含み、
前記突起部は、前記第1の回動軸方向に向かって突出し、前記第1の溝状部に挿入される第1の突起部と、前記第2の回動軸方向に向かって突出し、前記第2の溝状部に挿入される第2の突起部と、を含む、請求項5の把持処置装置。 - 前記突起側断面変化部は、前記シース側接触部又は前記ジョー側接触部まで前記回転軸に沿って半球状に設けられる突起側半球部である請求項5の把持処置装置。
- 前記溝側断面変化部は、前記シース側接触部又は前記ジョー側接触部まで前記回転軸に沿って半球状に設けられる溝側半球部である請求項5の把持処置装置。
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Application Number | Priority Date | Filing Date | Title |
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US201161467119P | 2011-03-24 | 2011-03-24 | |
US61/467,119 | 2011-03-24 | ||
PCT/JP2012/057595 WO2012128362A1 (ja) | 2011-03-24 | 2012-03-23 | 把持処置装置 |
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JP5165163B2 true JP5165163B2 (ja) | 2013-03-21 |
JPWO2012128362A1 JPWO2012128362A1 (ja) | 2014-07-24 |
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US (1) | US8652132B2 (ja) |
EP (1) | EP2589347B1 (ja) |
JP (1) | JP5165163B2 (ja) |
CN (1) | CN103108600B (ja) |
WO (1) | WO2012128362A1 (ja) |
Cited By (1)
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WO2016152306A1 (ja) * | 2015-03-24 | 2016-09-29 | オリンパス株式会社 | 医療処置具 |
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CN103108600B (zh) | 2015-07-22 |
EP2589347B1 (en) | 2015-09-09 |
US8652132B2 (en) | 2014-02-18 |
EP2589347A1 (en) | 2013-05-08 |
JPWO2012128362A1 (ja) | 2014-07-24 |
US20130110155A1 (en) | 2013-05-02 |
EP2589347A4 (en) | 2013-05-08 |
CN103108600A (zh) | 2013-05-15 |
WO2012128362A1 (ja) | 2012-09-27 |
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