JPH0592009A - Hand piece for surgical operation - Google Patents

Abstract

PURPOSE:To allow an effective blood stopping operation to be safely and surely executed together with the treatment, such as incision and excision, of the vital tissue. CONSTITUTION:A sheath 3 formed by an insulating material is connected to a gripping part 2. A nozzle pipe 6 having an injection nozzle 6a for fluid injection at its front end and a suction passage 7 are disposed in a sheath 3. This nozzle pipe 6 is functioned as a high-frequency electrode part for a high-frequency treatment.

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a surgical hand piece for performing procedures such as incision, excision and washing by jetting a fluid.

[0002]

2. Description of the Related Art Generally, as a kind of surgical operation apparatus, for example, one disclosed in Japanese Utility Model Laid-Open No. 1-144007 is known. This is one in which a nozzle pipe is provided in the center of the handpiece body, the periphery thereof is covered with a suction pipe, and the gap between these suction pipe and nozzle pipe is used as a suction passage. In this case, a jet nozzle for jetting a fluid is formed at the tip of the nozzle pipe.

When the hand piece is used, a living tissue is incised, excised, washed or the like by a high pressure fluid ejected from an ejection nozzle at the tip of a nozzle pipe.
It functions as a so-called water jet knife, and at the same time, tissue pieces, blood and the like generated by this treatment are sucked and removed together with the jet fluid through the suction passage.

Further, for example, EP 0280972A1 discloses a structure in which an end member for a water jet knife, which is connected to a handpiece body and has a fluid passage formed in an axial center thereof, is used as a high frequency coagulation electrode. There is.

[0005]

In the water jet knife having the above structure, when a high-pressure fluid is jetted from the jet nozzle at the tip of the nozzle pipe by using a handpiece, the living tissue is subjected to incisions, excisions and the like. For example, when the injection pressure of the injected high-pressure fluid is higher than an appropriate value, there is a risk that the blood vessels and the like around the treatment target site may be damaged. However, in the case of Japanese Utility Model Laid-Open No. 1-144007, there is a problem that the hemostatic work cannot be effectively performed because the hemostatic means is not specially provided in the handpiece.

[0006] In addition, FIG. 1 of EP0280972A1
In the cases of 3 to 3, the end member for the water jet knife is used as a high-frequency coagulation electrode, and when bleeding is caused by damage to a blood vessel or the like, the high-frequency coagulation electrode can be used to perform hemostasis work. .. However,
In this case, the work connected to the handpiece body
Since the entire end member for the tadget scalpel functions as a high-frequency coagulation electrode, for example, in the case where a portion other than the tip of the end member that is actually brought into contact with living tissue during hemostasis work is brought into contact with living tissue, an unnecessary living tissue portion There was a risk that it would be solidified.

[0007] Fig. 4 of EP0280972A1
When a treatment such as forming an insulating layer on the outer surface portion other than the tip end portion of the end member is performed as in Nos. 6 to 6, only a narrow range of the tip end portion of the end member can function as the high frequency coagulation electrode. For example, there is a problem that the coagulation work by high frequency cannot be effectively performed when the treatment part requiring the hemostasis work covers a relatively wide range.

Furthermore, since no suction passage is formed in the handpiece body of EP0280972A1, the tissue piece, blood, and
There is a problem that the jetted fluid cannot be removed by suction. Therefore, the periphery of the treated portion of the water jet knife is flooded and the field of view of the treated portion is obstructed, which causes a problem in the surgical operation using the water jet knife.

The present invention has been made in view of the above circumstances, and provides a surgical handpiece capable of safely and reliably performing effective hemostasis work as well as treatment such as incision and excision of living tissue. It is intended to be provided.

[0010]

According to the present invention, a sheath made of an insulating material is connected to a grip portion of a handpiece body, and a nozzle pipe having a jet nozzle for jetting a fluid at a tip, a suction passage and a high frequency wave. A high-frequency electrode part that can be used as a treatment electrode is arranged in the sheath.

[0011]

With the above structure, the biological tissue is subjected to treatment such as incision and excision by the fluid jet from the jet nozzle, and at the same time, the tissue piece, blood, jet fluid, etc. generated during the fluid jet from the jet nozzle are sucked through the suction passage. It is possible to prevent the field of view of the treatment area from being blocked by sucking and removing it via the high-frequency electrode section, and to ensure effective hemostatic work,
It is designed to be performed reliably.

[0012]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS A first embodiment of the present invention will now be described with reference to FIG.
This will be described with reference to (B). In FIG. 1, reference numeral 1 is a handpiece body of the surgical operating apparatus. The handpiece body 1 is provided with a grip portion 2, and the grip portion 2 is connected to a substantially cylindrical sheath 3 made of an insulating material. In this case, a substantially columnar sheath is provided on one end side of the grip portion 2.
The sheath connecting portion 2a is formed, and a cylindrical connecting cylinder 3a is formed on the base end side of the sheath 3. The connecting cylinder body 3a of the sheath 3 is fitted onto the sheath connecting portion 2a of the grip portion 2 so as to be slidable in the axial direction.

A metal nozzle pipe 6 which also serves as a high-frequency electrode portion which can be used as an electrode for high-frequency treatment is provided in the sheath 3. The base end side of the nozzle pipe 6 is fixed in a state of being inserted into a nozzle pipe insertion hole 2b penetrating an axial center portion in the grip portion 2.

Further, the base end of the nozzle pipe 6 is connected to the tip of the liquid feeding tube 20, and the tip of the nozzle pipe 6 is formed with a jet nozzle 6a for jetting a fluid. There is. The injection nozzle 6a is formed by a small diameter portion that has a diameter smaller than the inner diameter of the nozzle pipe 6.

On the other hand, a position adjusting portion 4 of the sheath 3 is provided on the outer peripheral surface of the connecting cylindrical body 3a of the sheath 3. A base end portion of a cam pin 5 protruding inward is fixed to the position adjusting portion 4. In this case, a cam groove 2c that extends in the axial direction and limits the sliding operation range of the sheath 3 is formed in the sheath connecting portion 2a of the grip portion 2.
Then, the cam pin 5 on the side of the sheath 3 is inserted into the cam groove 2c on the side of the grip portion 2, and the sheath 3 moves in correspondence with the amount of movement of the cam pin 5 in the cam groove 2c on the side of the grip portion 2. It is slidable in the axial direction along the sheath connecting portion 2a by the amount.

Here, for example, as shown in FIG. 1A, the position where the injection nozzle 6a at the tip of the nozzle pipe 6 is housed inside the case 3 is set as a reference position for normal operation. Then, the position adjusting portion 4 on the side of the sheath 3 is pulled from the reference position to the side of the grip portion 2 and the injection nozzle 6a at the tip of the nozzle pipe 6 is moved to the sheath 3 as shown in FIG.
The sheath 3 is slidable in a range up to a position where it is projected outside by a predetermined maximum projection amount.

Further, an O-ring mounting groove is formed in the sheath connecting portion 2a of the grip portion 2 at a portion closer to the tip side than the cam groove 2c, and the grip portion 2 side seat is formed in the O-ring mounting groove. −
An O-ring 8 that seals a gap between the sleeve connecting portion 2a and the connecting cylinder 3a on the side of the sheath 3 is fitted.

An annular suction passage 7 is formed between the sheath 3 and the nozzle pipe 6. In this case, a branch pipe line 3b is formed at the base end of the sheath 3, one end of which is connected to the tip of the connecting cylinder 3a. One end of the suction tube 22 is connected to the other end of the branch pipe line 3b.

At least the outer peripheral surface of the grip portion 2 of the handpiece body 1 is made of an insulating material. On the outer peripheral surface of the grip portion 2, a water jet female switch 2 for performing on / off operations of fluid ejection from the ejection nozzle 6a of the nozzle pipe 6 and adjusting the fluid flow rate.
1 is provided. Further, the position adjusting section 4 is provided with an electric knife switch 18 for turning on and off the supply of the high frequency current to the nozzle pipe 6.

Further, a high frequency power source 12, a fluid source 13, a pressurizing pump 14, a suction pump 15, a suction container 16 and the like are provided in the main body 11 of the surgical operating apparatus. The electric female switch 18 of the position adjusting section 4 is connected to the first connecting terminal 12a of the high frequency power source 12 at the first connecting code 1
It is connected via 7. Furthermore, this high frequency power source 1
The second second connecting terminal 12b is connected to the nozzle pipe 6 of the handpiece body 1 via a second connecting cord 19. When the electric knife switch 18 is turned on, a high-frequency current is supplied from the high-frequency power source 12 to the second connection cord 1
It is supplied to the nozzle pipe 6 of the handpiece body 1 via 9 and this nozzle pipe 6 is used as a high frequency electrode part for high frequency treatment.

The types of the high-frequency current supplied from the high-frequency power source 12 include, for example, an incision current for incising a living tissue, a coagulation current for coagulating a living tissue, and a blend current in which an incision current and a coagulation current are mixed. Each of these high-frequency currents is selectively supplied as the electric knife switch 18 is operated.

Further, the fluid source 13 is connected to the base end of a liquid delivery tube 20 whose tip is connected to the base end of the nozzle pipe 6. A pressurizing pump 14 is provided in the middle of the liquid feeding tube 20. The pressurizing pump 14 is a water jet female switch 21 of the handpiece body 1.
The operation is controlled by. And
When the pressurizing pump 14 is driven in accordance with the operation of the water jet female switch 21, a high-pressure fluid is supplied from the fluid source 13 to the nozzle pipe 6 side via the liquid feeding tube 20.

Further, the base end of the suction tube 22 is connected to the suction pump 15. This suction tube 22
A suction container 16 is provided midway. And
When the treatment of the water jet scalpel is performed in accordance with the operation of the water jet scalpel switch 21, the suction pump 15 is driven, and the tissue piece, blood, etc. generated by the treatment of the water jet scalpel are driven by the driving of the suction pump 15. The jet fluid or the like is sucked and removed from the suction passage 7 between the sheath 3 and the nozzle pipe 6 through the branch pipe 3b and the suction tube 22 in this order.

The water jet female switch 21
The electric knife switch 18 may be configured as a hand switch mounted on the handpiece body 1 side, or may be configured as a foot-operated foot switch or pad switch.

A code accommodating chamber is provided in the grip portion 2 of the handpiece main body 1, and the first connecting code 17 is accommodated in the code accommodating chamber when the handpiece main body 1 is not used. It may be configured to.

Next, the operation of the above configuration will be described.
First, when the handpiece body 1 is used as a water jet knife, a water jet knife switch 21
Turn on.

When the water jet knife switch 21 is turned on, the pressure pump 14 is driven. Along with the driving of the pressurizing pump 14, a fluid delivery tube from the fluid source 13 is sent.
The high-pressure fluid is pressure-fed to the nozzle pipe 6 side via the nozzle 20. Therefore, the high-pressure fluid is jetted from the jet nozzle 6a of the nozzle pipe 6 and jetted, and treatments such as incision and excision of biological tissue are performed.

Further, the suction pump 15 is driven during the treatment of the water jet knife. Therefore, as the suction pump 15 is driven, tissue pieces, blood, jet fluid, etc., generated by the treatment of the water jet knife from the suction passage 7 between the sheath 3 and the nozzle pipe 6 to the branch passage 3b and the suction tube. -Suction and removal is performed through the blade 22.

In this case, the position adjusting unit 4 is operated in accordance with the distance between the living tissue and the tip of the nozzle pipe 6 to move the sheath 3 from the normal reference position shown in FIG. (B)
As shown in FIG. 5, the tip end of the nozzle pipe 6 is slid to an appropriate slide position up to the maximum slide position where the nozzle pipe 6 protrudes by the maximum protrusion amount. By changing the injection nozzle 6a of the nozzle pipe 6 and the tip position of the sheath 3 by this operation, the fluid reflected by the living tissue can be effectively sucked and removed, and the visual field of the treated portion is always kept. It can be held in a state where it can be seen well.

During the treatment of the water jet knife,
When performing high-frequency treatment such as when a blood vessel is damaged and bleeding, the position adjusting unit 4 is operated to move the sheath 3 to the position shown in FIG.
The nozzle pipe is slid to an appropriate slide position between the normal reference position shown in (A) and the maximum slide position where the tip of the nozzle pipe 6 is projected by the maximum projection amount as shown in FIG. The required amount of the tip of 6 is projected to the outside of the sheath 3.

Further, the protruding portion of the tip of the nozzle pipe 6 protruding outside the sheath 3 is brought into contact with a treated portion such as a bleeding portion of a blood vessel. In this state, the electric knife switch 18 is subsequently operated. Along with the operation of the electric knife switch 18, a high-frequency current is supplied from the high-frequency power source 12 to the nozzle pipe 6 of the handpiece main body 1 through the second connection cord 19, and the nozzle pipe 6 is used for high-frequency treatment. A high frequency treatment used as an electrode part is performed.

Therefore, in the case of the above construction, when the water jet knife is treated by the handpiece body 1, a treatment such as incision or excision is made in the living tissue by the fluid ejection from the ejection nozzle 6a at the tip of the nozzle pipe 6. And at the same time a tissue piece produced during the fluid ejection from the ejection nozzle 6a,
Since blood, jet fluid, etc. can be sucked and removed through the suction passage 7 between the sheath 3 and the nozzle pipe 6,
It is possible to prevent the view of the treatment area from being blocked,
The visual field of the treated portion can always be kept in a good visible state.

During the treatment of the water jet knife,
When the blood vessel is damaged and bleeds, the nozzle pipe 6 can be used as a high-frequency electrode section to perform high-frequency treatment, so that an effective hemostasis operation can be performed safely and reliably. In this case, since high-frequency coagulation can be performed while suctioning bleeding from the bleeding site, coagulation efficiency is improved and reliable hemostasis work can be performed.

Further, during high frequency treatment, the outer peripheral surface portion of the nozzle pipe 6 other than the protruding portion at the tip of the nozzle pipe 6 protruding to the outside of the sheath 3 is covered with the sheath 3 made of an insulating material. Therefore, only the protruding portion at the tip of the nozzle pipe 6 protruding outside the sheath 3 can locally act as an electrode. for that reason,
Unlike the conventional case, there is no danger of burning unnecessary parts other than the treated part, so that effective hemostatic work can be safely and reliably performed.

Further, since the type of the high frequency current output from the high frequency power source 12 in accordance with the operation of the electric knife switch 18 can be appropriately selected from the incision current, the coagulation current and the blend current, it can be selected according to the condition of the treated area. An accurate high frequency treatment can be performed.

Furthermore, the treatment of the water jet scalpel and the high frequency treatment can be arbitrarily selected, and each treatment can be performed independently.
Alternatively, since they can be performed simultaneously, the surgical effect and efficiency can be improved. Therefore, by simultaneously performing the incision / ablation treatment with a water jet knife and the incision treatment with a high frequency, the incision / ablation treatment can be performed smoothly and easily even with a hard tissue.

In addition, an incision with a water jet knife,
By simultaneously performing the excision procedure and the high-frequency coagulation procedure using the nozzle pipe 6 as the high-frequency electrode section, the incision and excision procedure can be advanced while hemostasis is performed, and the efficiency of the operation can be significantly improved.

FIG. 2 shows a second embodiment of the present invention. This is provided with a projecting portion 31 projecting to the outside of the grip portion 2 on the base end side of the nozzle pipe 6, and a tube connecting portion 31a to which the tip of the liquid feeding tube 20 is connected. And the tube connecting portion 31
A treatment instrument insertion port body 31b branched from a is provided, and the high frequency electrode 33 formed at the tip of the lead wire 32 is inserted into the nozzle pipe 6 from the treatment instrument insertion port body 31b.

In this case, when high frequency treatment is required, the high frequency electrode 33 is inserted from the treatment instrument insertion port body 31b into the nozzle pipe 6.
Since the high frequency treatment can be performed by inserting the same, it is possible to obtain the same effect as that of the first embodiment in this case as well.

Further, FIG. 3 shows a third embodiment of the present invention. This is provided with a tube connecting portion 41a to which the suction tube 22 is connected, at the tip end portion 41 of the branch conduit 3b provided at the base end portion of the sheath 3, and the tube connecting portion 41a. Treatment instrument insertion port body 41b branched from
A high frequency electrode 33 formed at the tip of the lead wire 32 is inserted from the treatment instrument insertion port 41b into the suction passage 7 between the sheath 3 and the nozzle pipe 6. .. Therefore, also in this case, the same effect as that of the second embodiment can be obtained.

In each of the second and third embodiments, the high frequency electrode 33 formed at the tip of the lead wire 32 is inserted into the nozzle pipe 6 and the suction passage 7, but the high frequency is used. Instead of the electrode 33, a laser probe, a microwave probe or the like may be inserted.

FIG. 4 shows a fourth embodiment of the present invention. This is a sheet made of insulating material.
A nozzle pipe 51 having an injection nozzle 51a for ejecting a fluid at the tip and a suction pipe 52 for suction are arranged in parallel in substantially parallel to each other in the space 3.

In this case, one of the nozzle pipe 51 and the suction pipe 52 is a high frequency electrode portion that can be used as an electrode for high frequency treatment. In addition,
The holding portion 2 of the main body 1 is provided with a through hole 52 through which the nozzle pipe 51 and the suction pipe 52 are arranged side by side, and on the outer peripheral surface of the holding portion 2, the ejection of fluid from the jet nozzle 51a is turned on. A water jet female switch 53 for turning off and adjusting the flow rate of the fluid and an electric female switch 54 for turning on and off the supply of a high frequency current to the high frequency electrode portion are provided. Therefore, also in this case, the same effect as that of the first embodiment can be obtained.

Further, FIGS. 5A and 5B show a fifth embodiment of the present invention. This is a pair of claw members 61, in the suction passage 7 between the sheath 3 and the nozzle pipe 6.
62 is provided, and these claw members 61 and 62 are accommodated in the grip portion 2 of the handpiece body 1 from the accommodation position where they are accommodated in the case 3 as shown in FIG. As shown in FIG. 3, an operating handle 63 is provided for moving the operating position to a protruding position that is protruded to the outside of the case 3. in this case,
The claw members 61 and 62 are formed by leaf spring members that expand in the directions in which the tip end sides are separated from each other at the protruding position where they are protruded to the outside of the case 3.

When the handpiece main body 1 is used and the treated portion is obstructed by other tissues, which interferes with the treatment, the claw member 6 is operated by the operating handle 63.
1 and 62 are projected to the outside of the sheath 3, and these claw members 61 and 62 allow other tissues that are in the way of treatment to the place where they are not in the way of treatment as shown in FIG. 5B. By excluding it, only the part to be treated can be accurately treated. The claw members 61 and 62 may form a high-frequency electrode portion that can be used as an electrode for high-frequency treatment. Therefore, also in this case, the same effect as that of the first embodiment can be obtained.

FIG. 6 shows another example of the structure of the handpiece. This is a cam pin projecting inwardly on the outer peripheral surface of the connecting cylinder 3a of the sheath (nozzle pipe) 3 connected to the sheath connecting portion 2a of the grip portion 2 of the handpiece body 1. In the cam groove 2c which fixes the base end portion of 71 and extends the tip end of the cam pin 71 in the axial direction to the sheath connecting portion 2a of the grip portion 2 and regulates the sliding operation range of the sheath 3. It was inserted into.

In this case, for example, as shown in FIG. 6, a state in which the position of the injection nozzle 6a at the tip of the nozzle pipe 6 is held at substantially the same position as the tip position of the sheath 3 is set as a normal reference position. Has been done. Then, the sheath 3 is moved from this reference position in a direction to be pulled out from the grip portion 2 side, and the tip end portion of the sheath 3 is protruded forward from the tip end position of the nozzle pipe 6 by a predetermined maximum protrusion amount. The sheath 3 is slidable up to the position.

Further, on the outer peripheral surface of the grip portion 2 of the handpiece main body 1, a water jet female switch 21 for performing on / off operation of the fluid jet from the jet nozzle 6a of the nozzle pipe 6 and adjusting the fluid flow rate, etc. Is provided.

An annular suction passage 7 is formed between the sheath 3 and the nozzle pipe 6. In this case, a branch pipe line 3b is formed at the base end of the sheath 3, one end of which is connected to the tip of the connecting cylinder 3a. One end of the suction tube 22 is connected to the other end of the branch pipe line 3b.

Therefore, in the case of the above-described structure, as shown in FIG. 6, the position of the injection nozzle 6a at the tip of the nozzle pipe 6 is maintained at substantially the same position as the tip position of the sheath 3 in a normal state. At the reference position, the injection nozzle 6a at the tip of the nozzle pipe 6 can be brought close to the living tissue and a large injection pressure can be applied to the living tissue from the injection nozzle 6a. it can.

If the sheath 3 is moved from the reference position on the side of the grip portion 2 in a direction of pulling the distal end portion of the sheath 3 forward of the distal end position of the nozzle pipe 6, the nozzle 3 Since the injection nozzle 6a at the tip of the pipe 6 can be held at a position separated from the living tissue and the injection pressure applied to the living tissue from the injection nozzle 6a can be reduced, in this case, delicate incision, excision work and washing are performed. Work can be performed efficiently.

In the above embodiment, the nozzle pipe 6 is fixed to the grip portion 2 side and the sheath 3 is slid, but the sheath 3 is fixed to the grip portion 2 side. The nozzle pipe 6 may be configured to slide.

Further, FIGS. 7A and 7B show a handpiece.
It shows another example of the configuration of the table. This is provided with a nozzle pipe 81 having a jet nozzle 81a for jetting a fluid at the tip fixed to the grip portion 2 side of the handpiece body 1, and a suction pipe 82 provided in parallel with the nozzle pipe 81. A slide member 83 fixed to 82 is movable in the axial direction along the nozzle pipe 81.

In this case, the slide member 83 is shown in FIG.
As shown in (B), an insertion hole 84a of the suction pipe 82 and an insertion hole 84b of the nozzle pipe 81 are formed. Further, the slide member 83 is formed with a pair of projecting portions 84c and 84d which are spaced apart and opposed to each other. The slit 85 between the protruding portions 84c and 84d is communicated with the insertion hole 84b of the nozzle pipe 81.

A screw hole is formed in one of the protruding portions 84c, and an insertion hole for the fixing screw 86 is formed in the other protruding portion 84d. Then, according to the screwing amount of the fixing screw 86 screwed into the screw hole of the protruding portion 84c, the protruding portion 84c
The tightening force between c and 84d is adjusted so that the fixed state between the slide member 83 and the nozzle pipe 81 is adjusted.

Therefore, also in this case, the tip position of the suction pipe 82 and the tip position of the nozzle pipe 81 can be arbitrarily changed, so that effective incision, excision work and cleaning work can be performed.

The present invention is not limited to the above-mentioned embodiments, and it goes without saying that various modifications can be made without departing from the gist of the present invention.

[0058]

According to the present invention, the sheath formed of the insulating material is connected to the grip portion of the handpiece body, and the nozzle pipe having the injection nozzle for ejecting the fluid at the tip, the suction passage and the high frequency treatment. Since a high-frequency electrode portion that can be used as an electrode of the above is disposed in the sheath, it is possible to perform effective hemostasis work along with treatments such as incision and excision in living tissue.
It can be done reliably.

[Brief description of drawings]

FIG. 1 shows a first embodiment of the present invention,
(A) is a vertical cross-sectional view of a main part showing a hand piece in a treatment work state by fluid ejection from an injection nozzle, and (B) is a vertical cross-sectional view of a main part showing a hand piece during high-frequency treatment.

FIG. 2 is a vertical cross-sectional view of a main part showing a second embodiment of the present invention.

FIG. 3 is a vertical cross-sectional view of a main part showing a third embodiment of the present invention.

FIG. 4 is a vertical cross-sectional view of a main part showing a fourth embodiment of the present invention.

FIG. 5 shows a fifth embodiment of the present invention,
(A) is a vertical cross-sectional view of a main part showing a hand piece in a treatment work state by fluid injection from an injection nozzle, and (B) is a vertical cross-sectional view of a main part showing a usage state of a spreading claw member.

FIG. 6 is a vertical cross-sectional view of a main part showing another example of the configuration of the handpiece.

FIG. 7 shows still another example of the structure of the hand piece, (A) is a longitudinal sectional view of the main part of the hand piece, and (B).
Is a cross-sectional view taken along line XX of (A).

[Explanation of symbols]

1 ... Handpiece body, 2 ... Gripping portion, 3 ... Sheath, 6,
51 ... Nozzle pipe (high frequency electrode part), 6a, 51a ...
Injection nozzle, 7 ... Suction passage, 33 ... High frequency electrode, 52 ...
Suction pipe (suction passage).

Claims (1)

[Claims] 1. A sheath formed of an insulating material is connected to a grip portion of a handpiece body, and can be used as a nozzle pipe having a jet nozzle for jetting fluid at a tip, a suction passage and an electrode for high frequency treatment. A high-frequency electrode part is provided in the sheath to provide a surgical handpiece.