JPH1024051A - Coagulation forceps with separating function - Google Patents

Abstract

PROBLEM TO BE SOLVED: To enhance controllability by providing a coagulating part, which comprises a pair of gripping means which grips a tissue and can carry currents, and a separating means for separating the tissue gripped and coagulated by the coagulating part, and enabling either a coagulating part opening/closing means or a separating means to be selectively operated. SOLUTION: A surgical forceps 1 includes a hollow insertion pipe 3 forming an inserted part 2 that is inserted into a selom and an at-hand control part 4 connected to the first end of the insertion pipe 3. The end portion of the insertion pipe 3 has an end gripping part 5 for gripping and coagulating a tissue inside a celom for hemostasis, and a separation means for separating the tissue gripped is passed through the insertion pipe 3. The at-hand control part 4 is provided with a gripping mechanism part 11, a feeding connection 12, and a separating part 13, a gripping operation and a separating operation are selectively performed by means of an operation selecting mechanism part 14, and a handle 11 made of a U-shaped plate spring member is provided between the support member 16 of the at-hand control part 4 and an opening/ closing slider 91.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a coagulation forceps having a detachment function used for performing a surgical operation on a site in a body cavity under observation by an endoscope.

[0002]

2. Description of the Related Art This type of coagulating forceps having a separating function is disclosed in USP.
No. 2,031,682 and USP 4,655,
As is known from the specification of Japanese Patent No. 216, it is provided with a high-frequency coagulation unit having electrodes that can be opened and closed and energized, and a separating means for moving or turning in the region of the high-frequency coagulation unit.

[0003] In these coagulation forceps, the tissue to be cut is usually coagulated by energizing while holding the electrode of the high-frequency coagulation unit, and then the cutting means is operated while holding the tissue, whereby the tissue is cut. Is electrically or mechanically cut off at the site where the coagulation is stopped. By performing such a process, a desired tissue portion can be cut off without bleeding.

[0004]

[Problems to be solved by the invention]

(Disadvantages of the prior art) In the conventional coagulation forceps, the operation by the grasping member serving also as the coagulation electrode for grasping the tissue and the operation of separating the grasped tissue are related to each other by the operation means individually provided on the hand side. And operate independently.

[0005] For this reason, for example, if the operator inadvertently operates the separating means before coagulation and hemostasis of the tissue, the tissue may be cut off and bleeding may occur. During this operation, care must be taken so as not to inadvertently activate the separating means, and the operability is not always good.

(Object of the Invention) The present invention has been made in view of the above-mentioned problem, and an object of the present invention is to inadvertently operate the separating means to cause bleeding during tissue grasping and coagulation and hemostasis. Such things can be avoided, grasping tissue,
An object of the present invention is to provide a coagulation forceps with a separation function with good operability, which can reliably operate each operation of coagulation hemostasis and tissue separation according to a procedure.

[0007]

According to the present invention, there is provided an operation portion main body having an insertion portion to be inserted into a body cavity, and a pair of energizable gripping portions for gripping a tissue provided near a distal end of the insertion portion. A coagulation portion comprising: a coagulation portion opening / closing operation means for holding and opening the coagulation portion provided on the operation portion main body side; It is permissible to select one of the separation operation means provided on the operation part body side and operating the separation means, and one of the coagulation part opening and closing operation means and the separation operation means and perform only the operation of the operation means. Coagulation forceps with a detachment function, comprising:

[0008]

BEST MODE FOR CARRYING OUT THE INVENTION

(Structure) FIG. 1 shows the entire appearance of a surgical forceps 1 according to a first embodiment of the present invention. The surgical forceps 1 is roughly classified into a hollow insertion pipe 3 forming an insertion section 2 to be inserted into a body cavity, and a hand operation section 4 connected to a proximal end side of the insertion pipe 3. The distal end portion of the insertion pipe 3 is provided with a distal end gripping portion 5 for gripping and coagulating the tissue in a body cavity, and a separating means 6 for separating the gripped tissue is inserted through the insertion pipe 3. . Tip gripper 5 and separation means 6
Is operated by a plurality of mechanisms provided in the hand operation unit 4 as described later, and necessary power is supplied through a power supply connection unit also provided in the hand operation unit 4.

The surgical forceps 1 has a structure in which disassembly and reassembly thereof can be easily performed on the user side in units of the following units. That is, as shown in FIG. 2, the hand operation unit 4 connected to the insertion pipe 3, the separation unit 6, a grip unit main body 8 including the distal grip unit 5, and the distal grip unit 5.
Can be disassembled into four sets of an opening and closing operation body 9 having a hollow tubular member for opening and closing operations, and the disassembled sets are immediately returned to an assembled state as shown in FIG. It has a structure that can be assembled.

FIG. 3 (a) shows an opening / closing operation body 9 for opening / closing the distal end gripping portion 5, and FIG.
Is shown. 4 to 14 show the gripper body 8 including the distal gripper 5. The separating means 6 is inserted into the lumen of the gripper body 8 along its axial direction. An opening / closing operation body 9 is fitted around the outer periphery of the gripper body 8. In this assembled state, the separating means 6, the gripper main body 8, and the opening / closing operation body 9 are inserted from the insertion pipe 3 and are mounted and attached to the respective operating means in the hand operation unit 4.

The hand operation unit 4 includes a grip operation mechanism 11
And a power supply connection unit 12 and a disconnection operation unit 13, and an operation selection mechanism unit 14. Gripping operation mechanism section 11, power supply connection section 12, and separation operation section 13
Are arranged in a line coaxially with the insertion pipe 3 along the central axis of the hand operation unit 4, while the operation selection mechanism 1
Reference numeral 4 is located below the central axis of the hand operation unit 4 and is arranged adjacent to another mechanism unit.

Next, each of these mechanisms will be described in detail. As shown in FIG. 2, at the rear end of the insertion pipe 3, a first support member 16 made of a tubular member as one member of the operation section main body 15 is fixedly attached. A second support member 17 fixedly installed is connected to 16. The second support member 17 is displaced downward from the central axis of the hand operation unit 4 and has an intermediate portion 17a parallel to the central axis of the hand operation unit 4 and bent portions 17b formed at both ends thereof.
17c, and has a substantially U-shape as a whole when viewed from the side of the forceps 1. One bent portion 17b of the second support member 17 is fixedly attached to the first support member 16, and the other bent portion 17c rotatably holds the member of the power supply connection portion 12. The second support member 17 is connected to the power supply connection portion 1.
2 is positioned in the axial direction of the forceps 1 at a fixed interval with respect to the first support member 16, and is rotatably held on the axis.

Next, the configuration of the gripper body 8 will be described with reference to FIGS. That is, this gripper body 8
Has a hollow rod portion 40 formed of a hard material, and has two gripping members 42a and 42b held by two linear elastic members 41 at the distal end portion of the rod portion 40, respectively. Are provided to constitute the distal end gripping portion 5. The elastic member 41 includes two gripping members 42a, 4
2b is elastically urged in a direction to expand. further,
The gripper main body 8 is provided with a knife guide 44 having protrusions 44a protruding left and right in directions parallel to the gripping surfaces 43 of the two gripping members 42a and 42b at the distal end portion of the rod portion 40.

At the proximal end of the rod portion 40, two electric connection portions 45, each formed of a tubular conductive member, are provided.
46 are provided at intervals. At this time, a notched flat portion 48 is formed on the outer periphery of at least one of the two electric connection portions 45 and 46 so as to be engaged with a fixing screw 127 described later of the power supply connection portion 7. In this embodiment, a notch flat portion 48 is formed on the peripheral surface of one electric connection portion 45 located forward.

As shown in FIG. 5, two gripping members 42
The elastic members 41 supporting the members a and 42b are respectively formed by applying an insulating coating 50 to a conductive member 49. Two grip members 42 held by the elastic member 41
a and 42b are, for example, polyetheretherketone (PE
EK) or the like, which is formed of a resin having an electrical insulation property, and forms a slit 51 into which the cutting-off portion of the cutting means 6 is inserted except for the cutting-end portion, as shown in FIGS. Thus, as shown in FIG. 6, when viewed from a plane, it is formed in a substantially U-shape. A plate made of a conductive material is disposed on both sides of the slit 51 in a direction parallel to the axial direction from a rear end portion in the middle of the slit 51 to a position forward of the most distal position of the slit 51. Each of the coagulated electrodes 52 is embedded. And only a part of these coagulation electrodes 52 is exposed on the grip surface 43.

As shown in FIG. 7, a pair of gripping members 42
When the gripping members 42a, 42b are closed, the coagulation electrode 52 provided on one of the gripping members 42a, 42b,
Each of the coagulation electrodes 52 provided at 42b is opposed to and coincides with each other, and the exposed ends thereof face each other without coming into close contact with each other. Therefore, when the gripping members 42a and 42b are closed, when a current flows while the coagulation electrodes 52 having different polarities are in direct contact with each other, it is possible to avoid a risk of overloading the high-frequency power supply and causing damage. As shown in FIG. 6, each coagulation electrode 52 is electrically and mechanically connected to the corresponding conductive member 49 of the elastic member 41 in the holding members 42a and 42b.

The gripping surfaces 43 of the gripping members 42a and 42b are provided with a projection 54 for gripping and capturing tissue and a groove 55 for receiving the projection 54 so as to mesh with each other. The groove 55 contacts the coagulation electrodes 52 before they come into contact with each other, particularly when the gripping members 42a and 42b are closed as shown in FIG. 7, so as to prevent the coagulation electrodes 52 from directly contacting each other. It is arranged. Further, as shown in FIG.
When the opening 42b is closed, the height H of the combined front ends is designed to be higher than the height h of the front end of the separating means 6.

The knife guide 44 has a single bore 56 as shown in FIGS. 9 and 10, and the cross-sectional shape of the knife guide 44, including the protrusions 44a projecting right and left, has a substantially cross shape. . In particular, as shown in FIG. 10, the rear end portion of the knife guide 44 is connected to the distal end tube portion 57 of the rod portion 40 so as to be fitted and positioned. Each of the elastic members 41 is individually arranged in each of the four corners in the distal end tubular portion 57.

The rod portion 40 is mainly composed of an insulating pipe 59 made of an electrically insulating and hard material. As shown in FIG. 12, the rod portion 40 penetrates the insulating pipe 59 on its central axis. The lumen 61 and four lumens 62 penetrated independently in parallel with the central axis are formed.
The elastic members 41 with the insulating coating 50 applied are inserted into the four inner cavities 62 near the distal end of the insulating pipe 59. Further, as shown in FIG. 5, the conductive member 49 of each elastic member 41 is connected to the insulated wire 63 through a conductive connection pipe member 58, and the insulated wire 63 is inserted into the inner cavity 62 thereof. I have.

As shown in FIG. 13, at the rear end of the insulating pipe 59 of the rod portion 40, there is provided a conductive tube having a central lumen 61 and four peripheral lumens 62 arranged similarly to the insulating pipe 59. A first electrode member 65 made of a material is connected. A first electrode member 6 is provided at the rear end of the first electrode member 65.
5, an insulating spacer 66 having a through hole 67 arranged in the same manner as two of the four lumens 62 provided in the first electrode member 65 and the central lumen 61 is connected. I have. Further, as shown in FIG.
At the rear end, like the insulating spacer 66, the lumen 6 on the central axis
1 and a second electrode member 68 made of a conductive material are connected. A holding member 69 made of an insulating material and having a lumen 61 disposed on one central axis is connected to the rear end of the second electrode member 68. Then, the first electrode member 65
Constitutes the electric connection portion 45, and the second electrode member 68 constitutes the electric connection portion 46.

Further, as shown in FIG.
5 is electrically connected to the power cord connecting pin 124 via the fixing screw 127 and the conductive member 121, while the second electrode member 46 is electrically connected to the power cord connecting pin 125 via the second conductive member 122. When the four units are assembled, one of the coagulation electrodes 52 is connected to the power cord connection pin 12.
4 and the remaining set of coagulation electrodes 52
25 are electrically connected to each other.

By the way, the lumens 61 on the central axis provided in each member constituting the rod portion 40 are aligned on the same straight line,
Channel 7 penetrating from the front end to the rear end of rod part 40
Functions as 0. An O-ring 71 is provided at the rear end of the channel 70 to prevent gas in the body cavity from leaking out of the body. The O-ring 71 is held by the holding member 69.

Further, a plurality of lumens 62 and through holes 67 parallel to the central axis provided in each member of the rod portion 40 are also in communication with each other. An insulated wire 63 in which each of the lumens is insulated except at both ends, and one end of which is electrically and mechanically connected to the elastic member 41 via the connection pipe member 58 shown in FIG. Is inserted. The other ends of the two electric wires 63 electrically connected to the two coagulation electrodes 52 provided on one gripping member 42 a via the elastic member 41 among the four electric wires 63 are connected to the first electrode member 65. , And the other ends of the two electric wires 63 electrically connected to the remaining coagulation electrode 52 are connected to the second electrode member 68.

Next, the opening and closing operation body 9 will be described. As shown in FIG. 3 (a), the opening / closing operation body 9 is formed of a pipe-shaped member having a lumen 75 through which the rod portion 40 of the gripper body 8 is inserted. Tip 9a of opening / closing operation body 9
In this case, the inner diameter of the inner cavity 75 is slightly larger, and the leading edge is tapered so as to smoothly engage with the outer surfaces of the gripping members 42a and 42b. Opening / closing operation body 9
The slot 9 is engaged with a projection 44a provided on the tip side of the gripping body 8 at the tip end 9a of the gripping part body 8.
6 are formed. On the rear end side of the opening / closing operation body 9, there is provided a snap-fit mechanism having a projection 77 which engages with a rear opening of the opening / closing operation slider 91 of the gripping operation mechanism section 11 described later. Connected to the operating means of the opening and closing operation body 9. Also, the protrusion 77
The opening / closing operation body 9 is provided with a flat portion 79 which is engaged with a linear portion of the elongated hole 103 provided in the opening / closing slider 91 at a position closer to the distal end side than the elastic portion 78 formed. At this time, the slot 76 and the flat portion 79 are determined to have the same positional relationship as shown in FIG.

The separating means 6 is configured as shown in FIG. The separating means 6 is composed of a knife member 81 having a sharpened tip, and a knife fixing member 82 made of an insulating material.
And a knife rod 83 which is insulated with a tube 80 made of an insulating material, and a knife connecting member 85 provided with a flat notch 84 on both sides for engaging the knife fixing screw of the knife slider. A separating means is configured.

Next, the grip operation mechanism 11, the power supply connection 12, the disconnection operation 13 and the operation selection mechanism 14 in the hand operation unit 4 will be described. First, referring to FIG. 16, the grip operation mechanism 11 of the means for operating the opening / closing operation body 9 will be described.
Will be described. The gripping operation mechanism section 11 is provided with a tubular opening / closing slider 91, and the opening / closing slider 91 has a distal end portion as a slider fitting section 92, which is provided on the first support member 16 of the hand operation section 4. It is provided so as to fit into the cavity 93 and thereby be capable of rotating and moving back and forth in the axial direction. The opening / closing slider 91 is rotatably held by a slider support member 95. That is, the open / close slider 9
An annular groove 96 is formed on the outer periphery of the slider 1, and a slider support member 95 made of an annular member is fitted in the annular groove 96. That is, the opening / closing slider 91 is fixed so as not to move relative to the slider supporting member 95 in the axial direction, but can rotate about the axis.
At this time, an O-ring (not shown) for airtightness is provided between the inner cavity 93 of the first support member 16 and the slider 91 so that the airtightness of the portion therebetween is maintained. .

A ratchet claw 9 is provided on the slider support member 95.
The ratchet pawl 97 is engaged with a plurality of grooves 99 provided in a ratchet 98 pivotally attached to the second support member 17 while being biased toward the slider support member 95. A matching detent mechanism is configured.
As shown in FIG. 2, the ratchet 98 is elastically urged by the leaf spring 100 in the above-described direction. The release operation part 98 a of the ratchet 98 is located below the first support member 16 of the hand operation part 4.

The opening / closing operation slider 91 has a lumen 101 coaxial with the lumen 93 in the first support member 16 of the hand operation section 4, and a part of the lumen 101 is a perfect circle as shown in FIG. Instead, there is a long hole 103 including a straight portion 102, and around the portion of the long hole 103, a recess 104a for hitting the surgeon's index finger, for example, and a projection 104b are provided.
Are provided alternately. The opening and closing operation of the slider 9 is performed by the finger rest 104.
1 can be operated to efficiently apply a rotational torque. The depression 104a and the protrusion 104b in the finger rest 104 have two types having different depths and lengths.
The arrangement is not arbitrary with respect to the direction of the long hole 103, but is uniquely determined. The operator engages with the long hole 103 in the direction of the long hole 103 in the arrangement state of the finger pad 104. The direction of the flat portion 79 of the opening / closing operation body 9, that is, the current direction of the rotatable opening / closing operation body 9, can be recognized.

Further, as shown in FIG. 16, a rubber cap 105 for preventing insufflation gas in the body cavity from flowing out of the body is detachably attached to the proximal end of the opening / closing operation slider 91 as shown in FIG. You. The rubber cap 105 hermetically surrounds the projection 77 of the opening / closing operation body 9 as well. When the gripper body 8 is assembled as shown in FIG. 4, the opening / closing operation body 9 and the projection 77 cannot move inward, and the opening / closing operation body 9 is not removed.

On the other hand, the first support member 16 of the hand operation section 4
A handle 111 formed of a U-shaped single leaf spring member is provided between the opening and closing slider 91. One end of the handle 111 is fixed to the first support member 16 via the second support member 17, and the other end of the handle 111 is pivotally attached to the slider support member 95. Then, the opening / closing operation slider 91 is elastically urged by the elastic urging force of the handle 111 so as to be retracted to the rear hand side.

As shown in FIG. 18, the power supply connection section 12 is configured. That is, the power supply connection portion 12 includes a connection portion main body 115 made of an insulating material such as polysulfone. The connection portion main body 115 has a lumen 116 coaxial with the central axis of the hand operation portion 4. The rod portion 40 of the gripper body 8 is inserted into the lumen 116. Further, the rear end portion of the knife rod 83 of the separating means 6 inserted through the grip portion main body 8 is penetrated.

In this connection part main body 115, a space corresponding to the space between the electric connection parts 45 and 46 of the grip part body 8 is provided in the front and rear, and a part thereof is slightly projected into the lumen 116 and is exposed. A first conductive member 121 and a second conductive member 122 made of a built-in conductive material are provided.
In addition, the conductive member 121, 1
Two power cord connection pins 124 and 125 are mechanically and electrically connected to each other by screwing the tip end of each of the power cords 22 and 22 individually. The root portions of the power cord connection pins 124 and 125 are covered with a cover 126 made of an electrically insulating material, and the conductive portions of the power cord connection pins 124 and 125 protruding from the outer surface of the connection portion main body 115 are directly exposed. doing.

The two power cord connection pins 124,
At least one of the conductive members 121 and 122 corresponding to the power cord 125 has a power cord connecting pin 124 or 125 thereof.
The fixing screw 127 for the gripping part main body is provided at a position symmetrical to the above. The fixing screw 127 includes a metal screw portion 128 that can be screwed into the conductive member 121 and an insulating knob 129 having an insulating property. Then, by screwing the fixing screw 127, the flat distal end surface of the screw portion 128 is pressed against the notch flat portion 48 of the hollow rod portion 40 of the grip portion main body 8, and the grip portion main body 8 and the connection portion main body 115 is mechanically fixed, and at the same time, the conductive members 121 and 122 are brought into contact with the electric connection portions 45 and 46 of the gripper body 8 to be electrically connected. Since the inner diameter of the second conductive member 122 is designed to be always smaller than the inner diameters of the connecting portion main body 115 and the first conductive member 121, the second electrode member 122 is necessarily tightened by the forceps fixing screw 127. Touch 122.

A relatively small-diameter male screw portion 131 is formed on the outer periphery of the rear end portion of the connecting portion main body 115.
, A fitting portion 133 formed at the front end of the guide member 132 of the separating operation portion 13 is screwed and fixed. Further, a small-diameter stepped portion 134 is formed on the outer peripheral portion of the rear end of the connection portion main body 115 so as to be adjacent to the intermediate portion side from the male screw portion 131.
4, an annular member 135 connected to the bent portion 17c of the second support member 17 is slidably fitted. For this reason, the connection part main body 115 is rotatable without moving relative to the second support member 17 in the axial direction. The fitted portion 133 prevents the annular member 135 of the second support member 17 from coming off.

As shown in FIG. 19, the separating operation section 13 has a knife slider 142 provided on the guide member 132 to slide in the axial direction. The guide member 132 forms a slit 141 along its axial direction, and the knife slider 142 engages a screw receiving member 143 and a tip of a knife fixing screw 144 described later with the slit 141 to slide on the guide member 132 in the axial direction. It is provided to be. This knife slider 142 has a screw receiving member 143.
And a knife fixing screw 144. The screw receiving member 143 and the knife fixing screw 144 are disposed at symmetrical positions that face each other linearly through the wall of the knife slider 142. A flange 142a is formed on each of the front and rear ends of the knife slider 142. Also,
The screw receiving member 143 and the tip of the knife fixing screw 144 have flat surfaces 143a and 144a facing each other. The screw receiving member 143 is fixedly installed, and the amount of screwing of the knife fixing screw 144 can be selected by a knob 145. Then, the screw receiving member 143
And flat surfaces 143 of the knife fixing screws 144 facing each other.
a, 144a, the knife rod 8 of the separating means 6
The third notch 84 is sandwiched therebetween. At this time, the knife member 81 or the knife fixing member 82 at the tip is engaged with the knife guide 44 so as to move in a rotational direction about the insertion axis. By loosening the knife fixing screw 144, the fixing of the knife rod 83 can be released.

The insertion pipe 3, the first support member 1
6, the opening / closing operation body 9, the gripper body 8, and the guide members 132 are all arranged on the same axis. In addition, the orientation of the gripper body 8, the fixing screw 127, and the slit 141 in the rotation direction is also determined by the positional relationship shown in FIG.

Next, the configuration of the operation selecting mechanism section 14 will be described. One end of a hook member 151 made of a single leaf spring material is fixed to the proximal portion of the second support member 17, and the tip of the free end of the hook member 151 is attached to the slider support member 95. A hook portion 153 having a J-shaped hook shape is formed so as to engage with a long hole 152 provided at one end of the handle 111 in a detachable manner. A small hole 15 is provided in the middle part of the hook member 151.
4 are formed.

Further, a stop selection lever 156 is provided on the second support member 17 so as to be pivotable. The stop selection lever 156 is connected to the small hole 1 of the hook member 151.
An engagement / disengagement arm end 155 having a projection 155a at the distal end engaging with the arm 54 and a stop arm end 157 described later are provided. The engagement / disengagement arm end 155 and a stop arm end 157 described later are provided with a shaft 158. It is designed to rotate integrally as a center.

The end portion 155 of the disengagement arm is connected to the hook member 1.
51, and the projections 155a of the hook members 151
A first position engaging the small hole 154 of the hook member 1;
51. The disengagement arm end 155 having a projection 155a from
The retractable second position can be alternatively selected, and when in the first position, the protrusion 155a pushes up the hook member 151, and the hook portion 153 engages with the long hole 152 of the handle 111. To the position where it cannot be stopped,
Enters the forward movement region of the front flange 142a of the knife slider 142, and comes to a position where the knife slider 142 is prevented from sliding forward. When in the second position, the hook member 151 is free, the hook portion 153 can be engaged with the elongated hole 152 of the handle 111, and the stop arm end portion 15
7 retreats from the front area of the collar 142a in front of the knife slider 142, and allows the knife slider 142 to slide forward.

The opening / closing operation body 9 is inserted into the inner cavity of the operation section main body 15, and as shown in FIGS. By engaging the rear end opening and the long hole 103,
The opening / closing operation body 9 is fixed to the opening / closing slider 91 in an insertion axis direction and a rotation direction about the insertion axis. The grip portion main body 8 is inserted into the lumen of the power supply connection portion 12 through the lumen 75 of the opening / closing operation body 9 as shown in FIG. 16, and a fixing screw 127 is screwed in as shown in FIG. By engaging with the flat part 48, it is mechanically fixed to the power supply connection part 7.

Further, as shown in FIG. 15, the protrusion 44a of the knife guide 44 is fitted into and engaged with the slot 76 at the distal end of the opening / closing operation body 9, as shown in FIG. It is fixed to the opening / closing operation body 9 only in the rotation direction.

(Operation) As shown in FIG. 1, in the forceps 1 in a state where four units are assembled, when a rotational torque is applied to the opening / closing operation slider 91, the rotation direction is directly or indirectly applied to the slider 91. As shown in FIG. 20, the gripper body 8, the opening / closing operation body 9, the power supply connection part 12, the separation operation part 13, and the whole separation means 6 engaged or fixed to the insertion pipe 3 are independent of the insertion pipe 3. And can be integrally rotated.

As shown in FIG. 21, the projection 155a of the engagement / disengagement arm end 155 of the stop selection lever 156 is engaged with the small hole 154 on the hook member 151, and the hook member 151 is inserted into the long hole 152. When the first position is in the disengaged state, the stop arm end 157 enters the front area of the flange 142a in front of the knife slider 142, and even if the knife slider 142 is advanced, Stop arm end 15
7 prevents the knife slider 142 from moving forward.

On the other hand, since the engagement / disengagement arm ends 155 are aligned with the hook members 151 and the projections 155a thereof are engaged with the small holes 154 of the hook members 151, the hook members 151 are disengaged from the long holes 152 of the handle 111. Since the handle 111 is retracted and is not engaged with the handle 111, the handle 111 can be operated. When the handle 111 is gripped and the upper end is slid forward, the opening / closing operation slider 91 is interlocked with this movement. When only the opening / closing operation body 9 moves forward and the tip of the opening / closing operation body 9 is pressed against and engaged with the proximal ends of the two gripping members 42a and 42b, the two gripping members 42a and 42b move forward and backward. Approach each other in place without closing. That is, the tip grip 5 can be opened and closed at a fixed position without moving back and forth.
Since the grip members 42a and 42b are held via the elastic member 41, the grip members 42a and 42b are closed so that the grip surfaces 43 of the grip members 42a and 42b are as parallel as possible.

At this time, the pawl 97 attached to the slider supporting member 95 also advances forward, engages with the groove 99 of the ratchet 98 shown in FIG. 16, and returns so that the opening / closing operation slider 91 does not slide toward the hand. The stopping effect is exhibited.

Normally, the forceps 1 is inserted into a body cavity through a trocar (not shown) with the gripping members 42a and 42b closed. When the distal end of the forceps 1 is inserted into the body cavity, the operator turns the ratchet 98 in the direction of the arrow in FIG. 16 to release the engagement between the claw 97 and the groove 99. When the engagement is released, the handle 1 connected to the opening / closing operation slider 91
The upper end of the slider 11 slides toward the user's hand by elastic force, and the slider 91 for opening / closing operation and the opening / closing operation body 9 also retract. Therefore, the engagement state is released, and the gripping member 42 is released.
a and 42b are in a state of being expanded again by the elastic member 41 in the body cavity.

The tissue that the surgeon intends to cut in the body cavity 1
For example, as shown in FIG. 22, 61 (especially one including a blood vessel, which is considered to be necessary for hemostasis) is drawn between the two open gripping members 42a and 42b,
42b is closed again by the above-described operation as shown in FIG. 23, and the tissue 161 is grasped. When a high-frequency current is supplied to the forceps 1 while the tissue 161 is grasped, a current flows between the coagulation electrodes 52 provided at the distal end, and the heat generated by this current causes at least the tissue portion 162 around the electrodes to appear as shown in FIG. Coagulated. After the tissue 161 is coagulated in this way, when the stop arm end 157 of the stop selection lever 156 is turned in the direction of arrow a as shown in FIG. 25A, the protrusion 155a of the engagement / disengagement arm end 155 becomes Removed from small hole 154, knife slider 1
Reference numeral 42 is slid forward, and the knife member 81 provided at the distal end of the separating means 6 also advances, and cuts off the portion between the tissue coagulation portions 162 shown in FIG.

As a result of this separating operation, the separated tissue 16
In No. 1, as shown in FIG. 28, the vicinity of the cut end of the cut-off portion 164 is coagulated, so that even if the blood vessel 165 is contained in the tissue, the hemostasis is completed and thus no bleeding occurs. After the tissue dissection, as shown in FIG.
Is retracted, the leading knife member 81 is drawn into the insertion pipe 3, the ratchet 98 is turned as described above, and the opening / closing operation slider 91 is retracted to hold the gripping members 42a, 42.
Open b to release the tissue. At this time, the hook member 15
As shown in FIG. 29 (b), the first hook portion 153 is engaged with the elongated hole 152 on the handle 111, thereby preventing the handle 111 from advancing the slider 91 to open and close. When it is desired to open and close the distal end portion 3 again, the stop selection lever 156 is turned in the direction of arrow a as shown in FIG. 29A, and the protrusion 1 is turned as shown in FIG.
55a may be engaged with the small hole 154.

When the used forceps 1 is to be washed, it is disassembled into a plurality of units as shown in FIG. 2 and each is washed.

(Effect) Since the forceps 1 shown in this embodiment is configured to be disassembled into a plurality of unit parts, when the forceps 1 is washed, the forceps 1 is disassembled into a plurality of units, and each is washed. In addition, the inside of a complicated forceps can be easily washed. In addition, since the coagulation electrode 52 is exposed only on the grip surface 43 and is bipolar, it is possible to avoid the inconvenience of flowing unnecessary current to an unintended tissue site as much as possible. Further, the coagulation electrode 52 is connected to the gripping members 42a, 42.
Since the slit 51 is disposed on both sides of the slit 51 provided from the rear end to the front of the tip of the slit 51, when the separating means 6 slides through the slit 51 to separate the tissue, the cutting is performed. The area around it is always coagulated and does not bleed when cut.

Since the gripping members 42a and 42b of the tip gripping portion 5 rotate independently of the insertion pipe 3, it is not affected by the friction generated between the airtight means provided on the trocar and the insertion pipe 3. No matter what trocar, you can always operate it with the same feeling.

Since the separating means 6 is always contained in the insertion pipe 3 or the gripping members 42a and 42b, it does not touch and damage an unintended tissue part.

When the rotary operating parts are directly provided on the gripping members 42a and 42b, the operating parts are located closer to the handle than the handle, and it is difficult to operate the rotary operating parts with one hand. When connected to the main unit, the rotation operation unit can be operated with the index finger of the hand holding the forceps, and can be opened and closed and rotated with one hand.

A cutting operation and a closing operation are selected so that the separating means 6 can be prevented from operating during the normal opening / closing operation of the distal end gripping part, and new tissues can be prevented from being held when the separating means 6 is operable. Since the mechanism is provided, the user does not inadvertently cut tissue having insufficient hemostasis.

The grasping portion main body is fixed to the operation portion, and does not move with respect to the operation portion even during the opening / closing operation, so that the tissue can be easily grasped as intended.

Even when the tip grip 5 is closed, the coagulation electrodes 52 come into contact with each other and do not conduct, so that no current flows unless the tissue is gripped.

In the separating means 6, since the knife member 81 at the distal end and the fixing member on the hand side are completely insulated, the operating part is made of a durable metal, and the user erroneously supplies electricity during the separating. The user does not get an electric shock.

The shape of the fingering of the opening / closing operation slider 91 is unified, and the arrangement and the direction of the long slot 103 in the interior are always in a predetermined positional relationship, so that the user can open and close using the fingering as a mark. The operation body 9 can be easily attached to the operation section.

(Modification) The material of the member of the tip gripping portion may be polyetherimide (PEI), polyphenylene sulfide (PPS), polysulfone (PSU) or a fluororesin (for example, PTFE). Further, the material of the member of the tip grip may be a ceramic material having an insulating property, alumina (Al ₂ O ₃ ), or zirconia (ZrO ₂ ). Further, the member of the tip grip may be manufactured by insert molding with respect to the assembly of the coagulated electrode and the elastic member. In the above-described embodiment, an example of the bipolar coagulation forceps with a separating function in which a bipolar electrode is incorporated in a gripping member of the gripping portion main body is shown, but the present invention is not limited to this, and a monopolar electrode is provided on the gripping member. It may be a monopolar coagulation forceps with a separating function.

FIGS. 30A to 35B show a second embodiment of the present invention. FIG.
(A) and (B) show a schematic configuration of the entire coagulation forceps 201 with a separating function according to the present embodiment.

The coagulation forceps 20 with a separating function according to the present embodiment
An elongated, substantially axial insertion portion 202 inserted into a body cavity of a patient, and an energizable treatment portion 203 disposed at the distal end of the insertion portion 202 for grasping and coagulating a living tissue in the body cavity. And the operation unit 2 connected to the base end of the insertion unit 202
04 is provided.

Further, FIG.
, A forceps unit 206 shown in FIG. 31B, and an operation unit 207 shown in FIG. 31C. here,
The knife unit 205 and the forceps unit 206 are removably assembled to the operation unit 207, and the coagulated forceps 201 is configured in this assembled state.

FIG. 31 shows the knife unit 205.
An elongated rod 208 is provided as shown in FIG. A knife member (cutting means) 209 is fixed to the tip of the rod 208. Further, a unit connection part 210 connected to the operation unit 207 is formed at the rear end of the rod 208.

The forceps unit 206 is provided with an elongated tube 211 through which the knife unit 205 is inserted. A pair of conductive spring members 212a and 212b are protruded from the distal end of the tube body 211. The outer surfaces of the spring members 212a and 212b are coated with an insulating material 213 as shown in FIG.

Further, the first gripping member 214a is attached to the tip of one spring member 212a, and the other spring member 212b
A second gripping member 214b is fixed to each of the distal ends. Here, the first gripping member 214a and the second
Is formed of an insulating material such as PEEK (polyether ether ketone). Then, both gripping members 214a, 214b
The space is urged outward (in a direction away from each other) by spring members 212a and 212b.

As shown in FIG. 32A, slits 215 and 216 into which the knife member 209 of the knife unit 205 is inserted are formed in each of the gripping members 214a and 214b and the spring members 212a and 212b. Further, a pair of electrodes 217a, 217b, 218a, 218b are embedded in each of the gripping members 214a, 214b. In this case, as shown in FIG. 32 (B), the electrodes 217a and 217b of the first gripping member 214a are embedded in both sides of the slit 215, respectively.
Similarly, the electrodes 218a, 218 of the second gripping member 214b
b are embedded in both sides of the slit 215, respectively.

The proximal ends of the spring members 212a and 212b pass through the inside of the tube 211 of the forceps unit 206 and extend to the rear end of the tube 211. Further, two electric contact portions 219 and 220 are provided near the rear end of the tube 211 of the forceps unit 206. One of the electrical contact portions 219 and 220 is connected to the electrodes 217a and 217b of the holding member 214a via the spring member 212a, and the other is connected to the electrode 2 of the holding member 214b via the spring member 212b.
18a, 218b, and at this time, between the electrical contact portions 219, 220, the spring members 212a, 21
2b and the electrodes 217 (a, b) and 218 (a, b) are electrically insulated from each other.
218 (a, b) are arranged as bipolar electrodes in the treatment section 203, and constitute the gripping coagulation means 21 together with the gripping members 214a, 214b.

FIG. 31 shows the operation unit 207.
As shown in (C), an elongated insertion tube 222 and a grip portion 223 connected to the base end of the insertion tube 222 are provided. Here, the forceps unit 206 is inserted into the lumen of the insertion tube 222. Further, a gripping member 214a,
Ring-shaped engaging member 224 made of the same material as 214b
Is provided.

FIG. 31C shows the grip portion 223.
Tip side extension part 225 extended to the tip end side at the upper end portion inside
Is provided. A connecting ring 226 that is connected and fixed to the base end of the insertion tube 222 is provided at the front end of the front extension 225.

Further, a forceps connection portion 227 and a knife connection portion 228 are provided behind the distal end extension portion 225. Here, the forceps connection unit 227 includes the forceps unit 20.
6 is provided with a lumen for accommodating the rear end of the tube 211 and a connecting means connected to the rear end of the tube 211 accommodated in the lumen.

A guide rod 229 projects rearward from the rear end of the forceps connection portion 227. A pair of electrode pins 230 is provided at the rear end of the guide rod 229.
a, 230b are projected. These electrode pins 23
Reference numerals 0a and 230b denote electric contact portions 219 and 22 near the rear end of the forceps unit 206 housed in the lumen of the forceps connection portion 227 via a conductive member provided in the guide rod 229.
0 is electrically connected.

The knife connection portion 228 is provided with a slider 231 slidably disposed with respect to the guide rod 229 of the forceps connection portion 227. This slider 2
At the rear end of the slider 31, as shown in FIG.
A rod engaging member 232 is provided that is movable in a direction substantially perpendicular to the moving direction of 31. A tapered hole 233 is formed at a substantially central portion of the rod engaging member 232 so as to be oblique to the axial direction of the slider 231. The rear end of the rod 208 of the knife unit 205 extending through the channel of the forceps unit 206 is detachably engaged with the tapered hole 233 of the rod engaging member 232.

The front end of the leaf spring member 234 is fixed to the front end of the slider 231. The rear end of the plate spring member 234 is fixed to one end of the rod engaging member 232. The opening of the tapered hole 233 of the rod engaging member 232 is
It is urged in a direction away from the axis of the shaft 31.

The grip portion 223 has a forceps connection portion 2.
27 is provided with a trigger (opening / closing operation means) 235 for operation and a pair of levers (disconnection operation means) 236a and 236b for operating the knife connection portion 228. here,
The trigger 235 is connected to the upper end of the grip portion 223 so as to be rotatable around a rotation pin 237. Further, the trigger 235 has an elongated hole 238 formed above the pivot point. An engagement pin 239 projecting from the side surface of the forceps connection portion 227 is inserted into the elongated hole 238.

Also, a grip 35 a at the lower end of the trigger 235 is provided inside the grip 223.
30 (B) and 31 (C) in a clockwise direction around the pivot pin 237. And the trigger 23
5 is always at a level shown in FIG.
0 (B) and FIG. 31 (C), the grip 2
23 is held at a fixed position furthest from the position 23. here,
The forceps connection portion 227 is driven forward in the axial direction of the insertion portion 202 by pulling the handle portion 35 a of the trigger 235 toward the grip portion 223 against the spring force of the leaf spring member 240, and the forceps unit 206 Gripping member 2
14a and 214b are projected forward of the insertion tube 222, and are gripped by the spring members 212a and 212b.
a, 214b are moved in the opening direction.

A pair of levers 236a and 236b are arranged on both sides of the grip portion 223, and are connected to the grip portion 223 so as to be rotatable around a rotation pin 241 similarly to the trigger 235. Further, each lever 236a, 2
An elongated hole 242 is formed above the rotation fulcrum at 36b. An engagement pin 243 projecting from the side surface of the slider 231 of the knife connection portion 228 is inserted into the elongated hole 242.

The levers 236a and 236b on both sides of the grip 223 are provided with upper and lower arms 244 and 245 arranged in a substantially V shape. A pivot pin 241 is disposed on the lower arm 245 of each lever 236a, 236b. Further, each lever 236
A hand bending part 246 bent toward the side of the grip part 223 is formed at the tip of the arm part 244 on the upper side of a and 236b.

Each lever 236a, 236b is connected to the pivot pin 241 of each lever 236a, 236b in FIG.
A spring member 247 for urging in the clockwise direction around the rotation pin 241 is mounted in (B) and FIG. 31 (C).

Further, the rotating pin 2 is attached to the grip portion 223.
A pin guide groove 248 is formed at a position near 41. An operation pin 249 is movably inserted into the pin guide groove 248. One end of a link member 250 provided in the grip portion 223 is connected to the operation pin 249. The other end of the link member 250 is rotatably connected to a handle 35 a of the trigger 235 around a pivot pin 251.

Further, a guide slit 252 is provided at the end of the arm 245 on the lower side of each lever 236a, 236b.
Are formed. This slit 252 is connected to each lever 23
6a and 236b are moved by the spring force of the spring member 247 in FIG.
It is set so as to match the pin guide groove 248 of the grip portion 223 in a state where it is held at the fixed position shown in FIG.

When the trigger 235 is rotated, the operating pin 249 moves along the pin guide groove 248 of the grip portion 223 via the link member 250, and is inserted into the slit 252 of each of the levers 236a and 236b so as to be able to be inserted and removed. It is supposed to be. That is, the operation pin 24 is moved through the link member 250 in accordance with the movement of the trigger 235.
9 moves on the slit 252, whereby the grip members 214 a and 214 b of the treatment section 203 are moved.
A separating operation control means 253 for controlling the separating operation of the knife member 209 according to the operating state of the knife member 209 is formed.

Next, the coagulating forceps 2 having the above-described structure with a separating function is used.
01 will be described. The coagulation forceps 201 having a separating function according to the present embodiment includes an operation unit 207, a forceps unit 206, and a knife unit 205 as shown in FIG.
(A) and (B) are used in an assembled state. Then, by operating the trigger 235 of the operation unit 204, the forceps connection unit 227 is moved in the axial direction of the insertion unit 202, and the levers 236a and 236b are operated.
Is operated to move the knife connection portion 228 in the axial direction of the insertion portion 202.

Here, in the initial state, the handle 35a of the trigger 235 of the operation unit 204 is in the state shown in FIG.
As shown in FIG. 1 (C), the forceps connection portion 227 is held at the fixed position furthest from the grip portion 223, and the forceps connection portion 227 is held at the rearmost position in the axial movement range of the insertion portion 202. In this state, the pair of spring members 212a and 212b of the treatment section 203
The whole is inserted into the lumen of the insertion tube 222 of the operation section unit 207, and the rear ends of the gripping members 214a and 214b are engaged with the engagement members 224 at the distal ends of the insertion tubes 222, so that the two gripping members 214a and 214b The gap is kept closed.
At this time, the levers 236a and 236b are similarly
(B) and the fixed position shown in FIG. 31 (C), and the knife connection part 228 is held at the rearmost position of the axial movement range of the insertion part 202. In this state, the knife member 209 of the knife unit 205 is held in a state of being inserted into the lumen of the insertion tube 222.

When the coagulation forceps 201 is used, the insertion portion 202 of the coagulation forceps 201 is inserted into the patient's body,
The treatment section 203 at the distal end of the insertion section 202 is guided to a position near the living tissue to be treated in the body. In this state,
As shown by an arrow a in FIG. 30 (B), by pulling in the grip 35a of the trigger 235 toward the grip 223, the grip members 214a, 21 of the treatment section 203 are operated.
4b is opened as follows. That is, trigger 2
The forceps connection portion 227 moves forward in the axial direction with the operation of 35 rotating in the counterclockwise direction about the rotation pin 237 in FIG. 31C. Thereby, the forceps connecting portion 227
Together with the forceps unit 206, the gripping members 214a and 214 of the treatment section 203 are pushed forward.
34B is disengaged from the engaging member 224 at the tip of the insertion tube 222, and spring members 212a, 212b are projected forward of the insertion tube 222 as shown in FIGS. 34 (A) and 30 (C).
The portion between the gripping members 214a and 214b is expanded by the 212b.

Subsequently, the expanded gripping members 214a, 21
The living tissue H is inserted between 4b. Further, after the living tissue H is inserted between the holding members 214a and 214b, the trigger 235 is released. At this time, the trigger 235
34A is rotated in the direction of arrow b in FIG. 34A by the spring force of the leaf spring member 240, and the entire forceps unit 206 is moved to the near side together with the forceps connection portion 227. for that reason,
The entire spring members 212a, 212b are drawn into the insertion tube 222, and the grip members 214a, 214
33B is closed by engaging with the engaging member 224 at the distal end of the insertion tube 222, and as shown in FIG.
The living tissue H is gripped between a and 214b.

The living tissue H is held by the gripping members 214a, 214a.
14b, the high-frequency power source (not shown) connected to the electrode pins 230a and 230b of the forceps connection portion 227, the electrode pins 230a and 230b, and the guide rod 22 are held.
9, the electrical contact portion 21 of the forceps unit 206
A high-frequency current flows between the electrodes 217 (a, b) and the electrodes 218 (a, b) of the gripping members 214a, 214b through the spring members 9, 220 and the spring members 212a, 212b, respectively. Thereby, the living tissue H gripped between the gripping members 214a and 214b is moved to the electrode 2 as shown in FIG.
The portions H ₁ and H ₂ between the electrodes 17a and 218a and between the electrodes 217b and 218b are coagulated, and as shown in FIG. 33B, the blood vessel B in the living tissue H is near the coagulated portion H ₁ between the electrodes 217a and 218a. and electrodes 217b, are closed by two locations in the vicinity of the solidified portion of H ₂ between 218b.

Further, the flow of the blood vessel B
Are closed, the levers 236a and 236 of the operation unit 204 are closed.
6B is rotated counterclockwise in FIG. 30B around the rotation pin 241. At this time, the lever 236
a, 236b is turned to the turning position shown in FIG.
, And the entire knife unit 205 moves forward together with the knife connection portion 228. As a result, the knife member 209 of the knife unit 205 advances along the slits 216 of the spring members 212a and 212b and the slits 215 of the gripping members 214a and 214b, and the living tissue H is moved to two places as shown in FIG. Is cut off between the solidified portions H ₁ and H ₂ of the solid.

After the living tissue H is cut off, the lever 236 is turned off.
a, 236b are released. At this time, the lever 236
34a and 236b are caused by the spring force of the spring member 247 in FIG.
(B) rotates in the direction of arrow c, and the knife connection portion 228
Together with the knife unit 205 is moved to the near side. Therefore, the knife member 20 of the knife unit 205
9 is pulled into the insertion tube 222 and stored.

The coagulation forceps 201 of the present embodiment can rotate the forceps connecting portion 227 as shown by the arrow in FIG. The rotation angle can be adjusted.

As shown in FIGS. 35 (A) and 35 (B), when the gap between the grasping members 214a and 214b of the treatment section 203 is longer than a predetermined interval, that is, the trigger 235 is rotated by a predetermined angle or more. When the link member 250 is
The operation pin 249 is moved along the pin guide groove 248 of the grip portion 223 to the slit 252 side of each lever 236a, 236b by the operation pin 249, so that each lever 236a, 236b
Is engaged with the slit 252. Therefore, in this state, the rotation of the levers 236a and 236b
Therefore, the forward movement of the knife member 209 can be reliably prevented.

Therefore, the above configuration has the following effects. That is, in the coagulation forceps 201 with the detachment function of the present embodiment, after operating the trigger 235 of the operation unit 204 to open and close the gripping members 214a and 214b of the treatment unit 203 to grip the living tissue H, the gripping member 214
a, 214b of the electrode 217 (a, b) and the electrode 218
When the levers 236a and 236b are actuated in a state where the living tissue H has been coagulated and stopped by high-frequency electricity between (a, b), the link member is in a state where the gap between the gripping members 214a and 214b is longer than a predetermined interval. The operation pin 249 is moved along the pin guide groove 248 of the grip portion 223 to the slit 252 side of each of the levers 236a and 236b by the 250, and the slit 25 of each of the levers 236a and 236b is moved.
2 so that each lever 236a, 23
The rotation of the knife member 209 can be reliably prevented by preventing the rotation of the knife member 209 by the operation pin 249. Therefore, a pair of gripping members 214a, 214
When the thickness of the living tissue H gripped between the points b and b is larger than the appropriate thickness, the next living body H cannot be completely coagulated (hemostatic) by the high-frequency current as in the related art. Since there is no possibility that the tissue H is continuously cut off, it is possible to reliably and easily avoid unintended bleeding by cutting off the thick biological tissue H in which the coagulation and hemostasis is difficult due to the high-frequency current in the incomplete coagulation and hemostasis state. it can.

Further, since the living tissue H can be stopped and cut off with one coagulation forceps 201, the living tissue H including the blood vessel B can be cut off during the operation without exchanging the forceps. , Operation time can be shortened.

Further, since the main body of the coagulation forceps 201 can be disassembled into three constituent units including a knife unit 205, a forceps unit 206, and an operation unit 207, the inside of the forceps 201, which is usually difficult to clean, can be easily obtained. Can be washed.

Furthermore, the sharpness of the coagulation forceps 201 can be maintained by appropriately replacing only the knife unit 205, whose sharpness is easily deteriorated. Therefore, the main body of the coagulation forceps 201 can be repeatedly used in a state where only the knife unit 205 is appropriately replaced as needed, so that the cost for the user can be reduced.

Further, the holding member 21 of the forceps unit 206
4a, 214b and the insertion tube 2 of the operation unit 207
Since the engaging members 224 at the tips of the 22 are made of the same material, wear of the gripping members 214a and 214b due to sliding can be minimized, and a decrease in gripping force due to wear can be avoided.

FIGS. 36A and 36B show a third embodiment of the present invention. This embodiment is the second
The configuration of the treatment section 203 of the coagulation forceps 201 with a separating function of the embodiment (see FIGS. 30A to 35B) is changed as follows. That is, in the present embodiment, the fixed arm 61 protrudes from the distal end of the tube 211 of the forceps unit 206, and one of the two gripping members 214a and 214b of the treatment section 203 is provided at the distal end of the fixed arm 61. The holding member 214b is fixed, and only the other holding member 214a is supported by the spring member 212a so as to expand in a direction away from the holding member 214b on the fixed side. The other parts are the same as in the second embodiment.

For this reason, when the coagulating forceps 201 with the separating function is operated, the two gripping members 214a and 214b of the treatment section 203 perform the double-opening operation in the second embodiment, whereas the gripping member 214a in the present embodiment. Only the point that only the opening operation is performed in which the spring member 212a expands in the direction away from the fixed gripping member 214b by the spring member 212a is different, and other operations are the same as those of the second embodiment.

Therefore, even with the above configuration, the same effects as those of the second embodiment can be obtained, and in this embodiment, the following effects are particularly obtained. That is, in the present embodiment, one of the two gripping members 214a and 214b of the treatment section 203 is fixed, so that, for example, a soft biological tissue such as a membrane tissue is coagulated with the forceps 201.
One gripping member 214 fixed when gripping with
After capturing the living tissue in a b-like manner, an operation of closing between the two gripping members 214a and 214b of the treatment section 203 can be performed. Therefore, the two gripping members 214a,
At the time of the closing operation between the 214b, the gripping member 214b that captures the living tissue does not move much, so that the soft biological tissue does not come off the gripping member 214b and can be reliably gripped.

FIGS. 37A and 37B show a fourth embodiment of the present invention. This embodiment is the second
The configuration of the treatment section 203 of the coagulation forceps 201 with a separating function of the embodiment (see FIGS. 30A to 35B) is changed as follows. That is, in this embodiment, the two gripping members 21 of the treatment section 203 are attached to the distal end of the engagement member 224 of the insertion tube 222 in the operation section unit 207.
4a and 214b, one of the gripping members 214b is fixed, and only the other gripping member 214a is separated from the fixed gripping member 214b by the spring member 212a at the distal end of the tube 211 of the forceps unit 206. It is configured to be supported to expand. The other parts are the same as in the second embodiment.

Therefore, when the coagulating forceps 201 with the separating function is in operation, only one of the gripping members 214a is attached to the spring member 2 as in the third embodiment (see FIGS. 36A and 36B).
The only difference is that the opening operation is performed in such a manner as to expand in the direction away from the holding member 214b on the fixed side depending on 12a, and the other operations are the same as those in the second embodiment.

Therefore, even with the above configuration, the second,
In addition to obtaining the same effects as the third embodiment, the present embodiment has the following effects. That is, in the present embodiment, since the treatment section 203 is always at a fixed position with respect to the user's hand, the user can easily grasp the living tissue.

FIGS. 38A to 38C show a fifth embodiment of the present invention. This embodiment is the second
The configuration of the operation unit 204 of the coagulation forceps 201 with a separating function of the embodiment (see FIGS. 30A to 35B) is changed as follows. That is, in the present embodiment, a pair of manual levers 236a and 236b for operating the knife connection portion 228 of the second embodiment is used instead of FIG.
As shown in (A) and (B), an electric operation lever 72 driven by a driving means 71 such as a motor for driving the knife connection portion 228 is provided, and the driving means 71 is electrically connected to a high frequency power supply. In addition, a switch (not shown) for measuring the impedance of the living tissue and selecting whether to drive the driving unit 71 based on the measurement result is provided. The other parts are the same as in the second embodiment.

In this embodiment, the coagulation forceps 201
At the time of use, as in the second embodiment, the living tissue is grasped and coagulated by energization, and then the switch is turned on. At this time, a minute current flows from the high-frequency power supply, and the impedance of the living tissue is measured. When the impedance has a value equal to or higher than a certain value, the driving unit 71 is driven, and the living tissue is separated.

Therefore, even with the above configuration, the same effects as those of the second embodiment can be obtained, and in this embodiment, the following effects are particularly exhibited. That is, in the present embodiment, by setting the reference value of the impedance to a value larger than the impedance when the blood vessel in the living tissue is occluded by coagulation, the blood vessel that is not occluded (haemostasis) is not cut off, A living tissue including a blood vessel can be safely separated.

The present invention is not limited to the above embodiment. For example, the fifth embodiment (FIG. 38)
A switch for driving the driving means 71 of (A) to (C) need not be particularly provided.

In this case, when the coagulation forceps 201 are used, after grasping the living tissue in the same manner as in the second embodiment, a high-frequency current is supplied to the forceps 201 from the high-frequency power supply to coagulate the living tissue. At this time, while the high-frequency current is being supplied, the impedance of the living tissue is measured from this current value. When the impedance exceeds a certain value, the supply of the high-frequency current for coagulation of the living tissue is stopped, and the driving means 71 Is supplied with current. Thereby, the driving means 7
1 automatically drives the electric operation lever 72, so that the knife unit 2 is connected via the knife connection portion 228.
By operating the knife member 209 of 05, the living tissue is cut off.

Therefore, in the above configuration, by setting the impedance reference value as in the fifth embodiment, the user can easily and safely cut the living tissue including blood vessels without bleeding. Can be released.

Further, when the coagulation forceps 201 is used, the operation of separating the living tissue is automatically performed following the operation of coagulating and stopping the living tissue, so that there is no time loss and the operation time is further reduced.

[Supplementary Notes] An operation unit main body having an insertion unit inserted into a body cavity,
A coagulation unit comprising a pair of energizable grasping means for grasping a tissue provided near the distal end of the insertion unit, a separating means for separating the tissue grasped and coagulated by the coagulation unit, and the operation unit body side A coagulation unit opening / closing operation unit provided on the operation unit main body side for operating the separation unit, a coagulation unit opening / closing operation unit, and a separation operation An operation selecting means for allowing any one of the means to be selected to perform only the operation of the operating means.

[0110] 2. The operation selecting means interrupts the operation of the separating means and enables the gripping operation of the coagulation unit at a first position, and the operation selection means hinders the gripping operation of the coagulation unit and enables the operation of the separating means at the second position.
2. The coagulation forceps with a detachment function according to claim 1, wherein a position is selected.

3. A hook member attached to the operation unit main body and engaged with and disengaged from a moving member of the coagulation unit opening / closing operation unit; and a hook member attached pivotably to the operation unit main body and retracting one end from the hook member. A selection that selects the restriction on the coagulation unit opening / closing operation means and the separation operation means by turning and forming the other end as a stop arm end for restricting the operation movement of the separation operation means. Item 4. The coagulation forceps with a detachment function according to Additional Items 1 and 2, further comprising a lever.

4. The hook member is provided with a hook portion which is engaged with a hole formed on the handle side for operating the coagulating portion opening / closing operation means, and the hook portion is engaged with the hole by being pushed by the end of the disengagement arm of the selection lever. While the end of the stop arm prevents the operation of the separating operation means, while the end of the disengagement arm of the selection lever releases the hook member, the end of the stop arm stops the operation of the separating operation means. Item 4. The coagulation forceps with a detachment function according to Item 3, wherein the forceps are retracted to an allowable position.

[0113] 5. The gripping means includes a gripping member made of an electrically insulating material and an electrode made of a conductive material, and the electrode is covered with the gripping member except for an electrode surface facing a gripping surface. Item 5. The coagulation forceps with a detachment function according to any one of additional items 1 to 4.

6. 5. The coagulation forceps with separation function according to claim 4, wherein the electrodes constituting the pair of gripping means are bipolar electrodes insulated from each other.

7. An insertion portion to be inserted into a body cavity, a treatment portion disposed at a distal end portion of the insertion portion, and an operation portion connected to a base end portion of the insertion portion, a pair of switches that can be energized and can be opened and closed. A grasping and coagulating means for grasping and coagulating the living tissue by the grasping member, and a separating means for separating the living tissue grasped and coagulated by the grasping and coagulating means are provided in the treatment section, and the grasping member is opened and closed. Opening and closing operation means for operating, and a separation operation means for operating the separation means, in a coagulation forceps with a separation function provided in the operation unit, the separation means of the separation means according to the operation state of the gripping member A coagulating forceps with a separating function, comprising a separating operation control means for controlling a separating operation.

(Conventional technology of Appendix 7) Conventionally, as this type of forceps having both a separating function and a coagulating function, as shown in US Pat. No. 5,445,638 and US Pat. A high-frequency solidification unit including a pair of gripping members is provided, and a separating means such as a knife that moves along a slit provided in the high-frequency solidification unit.

With these coagulation forceps, usually, a living tissue including a blood vessel to be cut is gripped by a gripping member, a high-frequency current is applied to stop coagulation, and then the coagulated portion of the living tissue is gripped. The separation means is operated to perform the separation. In this case, by continuously performing hemostasis of the living tissue by coagulation with a single forceps and cutting off the living tissue, a desired living tissue portion can be cut in a short time without bleeding. It has become.

Further, in the conventional coagulation forceps, an opening / closing operation for opening / closing a gripping member serving also as a coagulation electrode for gripping a living tissue is provided on an operation unit on the proximal side connected to the base end of the insertion portion to be inserted into the body. An operating means and a separating operating means for separating the grasped living tissue by a separating means such as a knife are provided independently of each other. When the coagulation forceps are used, the opening / closing operation means of the gripping member and the separation operation means are individually and independently operated independently of each other by the operation unit on the hand side.

(Problem to be Solved by Supplementary Note 7) By the way, in the above-mentioned conventional structure, the one that limits the thickness of the living tissue grasped and coagulated between the pair of grasping members of the coagulation forceps is particularly provided. Therefore, the living tissue can be gripped up to a state where the pair of gripping members is expanded to the maximum opening width. However, when the thickness of the living tissue gripped between the pair of gripping members is large, the energization resistance when a high-frequency current is applied increases, and the current density decreases, so that the tissue is gripped between the pair of gripping members. The thicker the living tissue, the more difficult it is to coagulate and stop bleeding by high-frequency current. Therefore, when the thickness of the living tissue grasped between the pair of grasping members is larger than the appropriate thickness, the living tissue cannot be completely coagulated and stopped by the high-frequency current. If the tissue separation is continued, there is a possibility that the living tissue may bleed.

Further, when the coagulation forceps is used, it is actually determined by the operator's intuition whether or not the living tissue actually grasped between the pair of grasping members is thick enough to coagulate and stop bleeding by the high-frequency current. Therefore, the thickness of the living tissue gripped between the pair of gripping members may be larger than the appropriate thickness, and the biological tissue actually gripped between the pair of gripping members cannot be coagulated and stopped by the high-frequency current, and the biological If bleeding occurs from the tissue, a separate hemostasis operation is required, so that there is a problem that the original purpose of shortening the operation time cannot be fulfilled.

Further, when the operator operates the coagulation forceps, for example, an erroneous operation of inadvertently operating the cutting means before securely grasping the living tissue between the pair of grasping members is performed. However, there is a risk that the living tissue that has not been coagulated by the separating means that has been operated incorrectly may be cut off and cause bleeding. Therefore, during the work of grasping and coagulating the living tissue between the pair of grasping members, the operator needs to perform the work with great care so as not to inadvertently operate the separating means. There is a problem in improving operability.

(Purpose of Supplementary Note 7) It is an object of the present invention to provide a coagulation forceps having a detachment function with high safety and good operability by preventing erroneous operations during grasping of living tissue and coagulation and hemostasis work.

(Operation of Supplementary Note 7) At the time of grasping and coagulating the living tissue, the gripping member is opened and closed by the opening / closing operation means to grasp the living tissue, and then the separating operation means is operated in the state where the coagulation is stopped by energization. Let it. At this time, the separating operation of the separating means is controlled by the separating operation control means in accordance with the operation state of the grasping member, and the separating operation is performed if the thickness of the grasped and coagulated living tissue is equal to or less than a certain value. The coagulated hemostatic portion is cut off.

(Effect of Supplementary Note 7) Since the separating operation control means for controlling the separating operation of the separating means in accordance with the operation state of the gripping member is provided, erroneous operation during the gripping of the living tissue and the coagulation and hemostasis work is prevented. Thus, it is possible to provide a coagulation forceps having a separation function with high safety and high operability.

8. An operating portion main body having an insertion portion inserted into a body cavity, and an operating portion including a pair of openable and closable gripping members capable of conducting and coagulating and coagulating tissue in a body cavity disposed at a distal end of the insertion portion. Disconnecting means for separating the grasped and coagulated tissue, operating section operating means for opening and closing the gripping member provided on the operation section main body, and the separation provided on the operation section main body A forceps having a detachment operation means for operating the means, wherein a detachment operation control means for controlling whether or not the detachment operation is possible in accordance with a state of the operation section is provided. forceps.

9. The operating portion is a pair of elastic members disposed at the tip of a rod inserted so as to be able to advance and retreat into the insertion portion, and each end of the elastic member is engaged with the tip of the insertion portion when the rod is retracted. The coagulation forceps with a detachment function according to claim 8, comprising a pair of gripping members attached to the forceps.

10. The coagulation forceps with a separating function according to claim 8 or 9, wherein the gripping member comprises a gripping member main body made of an insulating material and an electrode provided on the gripping member main body.

11. 11. The coagulation forceps with a separating function according to claim 10, wherein the gripping member main body has a slit through which the separating means is inserted, and the electrodes are provided on both sides of the slit.

12. The electrode provided on one of the gripping member main bodies and the electrode provided on the other gripping member main body are configured as bipolar electrodes insulated from each other. Coagulation forceps.

13. Additional features 8 to 1 characterized in that the separating operation control means is provided in the operation section main body.
3. The coagulation forceps with a detachment function according to any one of 2. 14． A first range in which the disconnection operation control means interferes with the disconnection operation means in interlock with the operation section operation means and hinders the operation, and a second range in which the interference between the disconnection operation means is released and the operation is enabled. Item 14. The coagulation forceps with a detachment function according to Item 13, wherein the forceps is an interference member that moves in the range of.

15. The coagulation forceps with a separating function according to claim 14, wherein the position of the interference member is determined by an opening width of the pair of gripping members.

16. The disconnection operation control means comprises the interference member, a link mechanism disposed between the interference member and the operation part operation means, and a slit in which the interference member slides on the operation part body. Additional items 8 to 13
A coagulation forceps with a detachment function according to any one of the above.

(Problems to be Solved in Additional Items 8 to 16) In the conventional coagulation forceps, the operation of opening and closing the gripping member also serving as the coagulation electrode for gripping the tissue and the operation of separating the gripped tissue are individually performed at the hand side. It is configured to operate independently of each other by the provided operation means. Further, what limits the thickness of the tissue to be grasped and coagulated is only the opening width of the grasping member, and whether the actually grasped tissue is a thickness capable of coagulating and stopping bleeding by the high-frequency current is determined by the operator's intuition. For this reason, for example, before the operator securely grasps the tissue, if the cutting means is operated carelessly, there is a possibility that the tissue will be cut off and bleed, and while the operator grasps the tissue, The work must be performed with care so as not to unexpectedly activate the separating means, and the operability is not always good. In addition, the thicker the tissue, the more difficult it is to coagulate by high-frequency current (because the resistance is increased and the current density is low). However, if bleeding occurs, a separate hemostatic operation is required, so that the initial purpose of shortening the operation time could not always be achieved.

(Objects of Supplementary Items 8 to 16) The present invention has been made in view of the above-mentioned problem. The purpose of the present invention is to inadvertently operate the separating means during tissue grasping and coagulation and hemostasis. The present invention provides a coagulation forceps with a detaching function with good operability that can easily and reliably avoid unnecessary bleeding that occurs when a thick tissue that is difficult to stop coagulation is difficult to be coagulated by a high-frequency current. Is to do.

(Means for Solving the Problems of Supplementary Items 8 to 16) The present invention provides an operation portion main body having an insertion portion inserted into a body cavity, and a tissue inside the body cavity disposed at a distal end of the insertion portion. An operating section comprising a pair of openable and closable gripping members capable of gripping and coagulating, separating means for separating the gripped and coagulated tissue, and opening and closing operations of the gripping member provided on the operation portion main body Operating part operating means, and a forceps having a separating operation operating means for operating the separating means provided on the operating part body, there is an opening width between a pair of gripping members constituting the operating part. A coagulation forceps with a separating function, comprising a separating operation control means for preventing the separating operation when the width is not less than a certain width. Then, after the grasping member is opened and closed by the operating section operation means to grasp the tissue, coagulation and stasis are stopped by energization, and the separation operation means is operated. At this time, if the thickness of the grasped and coagulated tissue is equal to or less than a certain value, a separating operation is performed, and the coagulated hemostatic portion of the tissue is separated.

(Effects of Supplementary Items 8 to 16) According to the present invention, a surgeon can inadvertently operate a separating means during grasping of tissue and coagulation / hemostasis, or a thick coagulator which is difficult to coagulate with hemostatic current. It is possible to provide a highly safe coagulating forceps with a separating function that can reliably and easily avoid unintended bleeding by separating the tissue in an incompletely coagulated state.

17. An operating portion main body having an insertion portion to be inserted into a body cavity, an operating portion including a pair of energizable gripping members for gripping and coagulating tissue in a body cavity disposed at a distal end of the insertion portion; Operating means for operating the opening / closing operation of the gripping member provided on the operating section main body, and operating the operating section operating section provided on the operating section main body. Coagulating forceps with a separating function, wherein one of the gripping members is fixed so as not to expand.

18. The operating section is attached to a distal end of an elastic member disposed at a distal end of a rod inserted so as to be able to advance and retreat into the insertion section, and is attached to a distal end of the elastic member which engages with and closes a distal end of the insertion section when the rod retreats. 18. The coagulation forceps with a detachment function according to claim 17, comprising one gripping member and one gripping member fixed to a tip of the rod.

19. The operating part is attached to a tip of the elastic member disposed at a tip of a rod inserted so as to be able to advance and retreat into the insertion part, and is engaged with a tip of the insertion part and closed when the rod retreats. 18. The coagulation forceps with a separation function according to claim 17, comprising one gripping member and one gripping member fixed to a distal end of the insertion portion.

20. 20. The coagulation forceps with a separating function according to any one of additional items 17 to 19, wherein the gripping member includes a gripping member main body made of an insulating material and an electrode provided on the gripping member main body.

21. 21. The coagulation forceps with a separating function according to claim 20, wherein the gripping member body has a slit through which the separating means is inserted, and the electrodes are provided on both sides of the slit.

22. An electrode provided on one side of the gripping member main body and an electrode provided on the other gripping member main body are configured as bipolar electrodes insulated from each other. Coagulation forceps.

(Prior art of Supplementary items 17 to 22) In the coagulation forceps, a pair of gripping members are expanded together by an elastic member attached to the tip of a rod inserted so as to be able to advance and retreat in the insertion portion, and the rod is retracted. Then, the vicinity of the rear end of the gripping member is engaged with the front end of the insertion portion and closed.

(Problems to be Solved by Additional Notes 17 to 22) In the conventional coagulation forceps, a pair of grasping members for grasping tissue can be opened and closed together. For this reason, most of the tissues to be used by these forceps are intended to grasp a membrane-like soft tissue including blood vessels (for example, mesentery). Since it is easy to escape from the grasping member, it cannot be said that the grasping of the tissue is easy, and the operability is not always good.

(Objects of Supplementary Items 17 to 22) The present invention has been made in view of the above-mentioned problem, and an object thereof is to grasp a soft film-like tissue including blood vessels such as the mesentery. An object of the present invention is to provide a coagulation forceps with a detaching function that can be easily operated and has good operability.

(Means for Solving the Problems of Supplementary Items 17 to 22) The present invention provides an operation portion main body having an insertion portion inserted into a body cavity, and a tissue inside a body cavity arranged at a distal end of the insertion portion. An operating unit including a pair of energizable gripping members for gripping and coagulating, separating means for separating the gripped and coagulated tissue, and an operating unit operation for opening and closing the gripping member provided on the operating unit body Means, and a forceps having a separating operation operating means for operating the separating means provided on the operating portion main body, wherein one of the gripping members is fixed so as not to expand, and the other is expandable. It is a coagulation forceps with a separating function characterized by being arranged as follows. Then, one of the grip members is expanded by the operating section operating means, and after the tissue to be cut off is captured by the other of the gripping members, the movable gripping member is closed by the operating section operating means to grip the tissue. I do. Action after tissue grasping
Same as 9.

(Effects of Supplementary Items 17 to 22) According to the present invention, a coagulation forceps with a detaching function having a simple structure capable of easily grasping a soft film-like tissue including blood vessels such as the mesentery is provided. can do.

[0148]

As described above, according to the present invention, it is possible to prevent the surgeon from inadvertently operating the separating means and bleeding during grasping and coagulating hemostasis, and grasping the tissue. Thus, it is possible to provide a coagulation forceps having a separation function with good operability, which can reliably operate each operation of coagulation, hemostasis, and tissue separation according to the procedure. After the tissue is grasped, the tissue cannot be separated unless the cutting operation is selected by the operation selecting means, so that the tissue is not inadvertently cut and bleeding does not occur. When the separating operation is selected, the separating means can be operated, but even if the tissue is gripped, the tissue cannot be gripped.

[Brief description of the drawings]

FIG. 1 shows the overall appearance of a surgical forceps according to an embodiment of the present invention, where (a) is a side view and (b) is a plan view.

FIG. 2 is an explanatory view showing a configuration in a state where the surgical forceps is disassembled into units.

3A is a partial sectional view of an opening / closing operation body, and FIG. 3B is a partial sectional view of a separating unit.

FIG. 4A is a plan view of a gripper body, and FIG. 4B is a side view of the gripper body.

FIG. 5 is an enlarged cross-sectional view of the grip portion main body.

FIG. 6 is a sectional view of a gripping member of the gripper body.

FIG. 7 is a sectional view of the gripping member taken along line AA in FIG. 6;

FIG. 8 is a sectional view of the gripping member taken along line BB in FIG. 6;

FIG. 9 is a cross-sectional view of a portion of the gripper body taken along line AA in FIG. 5;

FIG. 10 is a cross-sectional view of a portion of the gripper body taken along line BB in FIG. 5;

FIG. 11 is a cross-sectional view of a portion of the gripper body taken along line CC in FIG. 5;

FIG. 12 is a cross-sectional view of a portion of the gripper body taken along line DD in FIG. 5;

FIG. 13 is a cross-sectional view of a portion of the gripper body taken along line EE in FIG. 5;

FIG. 14 is a cross-sectional view of a portion of the gripper body taken along line FF in FIG. 5;

FIG. 15 is a cross-sectional view of the tip portion along the line GG in FIG. 1;

FIG. 16 is a sectional view of an opening / closing operation unit.

FIG. 17 is a sectional view taken along the line AA in FIG. 16;

FIG. 18 is a cross-sectional view of a power supply connection portion.

FIG. 19 is a cross-sectional view of the operation unit of the separating unit.

FIG. 20 is an explanatory diagram showing an operation of rotating the tip.

21A is a side view of a forceps showing a gripping operation state, and FIG. 21B is a sectional view of a state of a stop selection lever at that time.

FIG. 22 is an explanatory diagram of a state immediately before a tissue is gripped by a gripping member.

FIG. 23 is an explanatory view of a state where a tissue is gripped by a gripping member.

24 is a sectional view taken along the line AA in FIG.

25A is a side view of the forceps showing a cutting operation state, and FIG. 25B is a cross-sectional view of a state of the stop selection lever at that time.

FIG. 26 is a side view of a disconnection operation state.

FIG. 27 is a sectional view taken along the line AA in FIG. 26;

FIG. 28 is a perspective view showing a state of coagulation and dissection of tissue.

FIG. 29 is a side view of the forceps in a state where the operation of the handle is regulated.

FIG. 30 shows a second embodiment of the present invention.
(A) is a plan view of the whole coagulation forceps, (B) is a side view thereof,
(C) is a side view showing the open state of the grasping member of the treatment section.

31A is a side view showing a knife unit of the coagulation forceps according to the second embodiment, FIG. 31B is a side view showing a forceps unit of the coagulation forceps according to the second embodiment, and FIG. Second
The side view which shows the operation part unit of the coagulation forceps of 2nd Embodiment, (D) is the top view which shows the holding member of the treatment part of 2nd Embodiment, (E) is the enlarged view of A part of (C). .

FIG. 32A is a cross-sectional view showing a gripping member of the treatment section according to the second embodiment, and FIG. 32B is a cross-sectional view taken along line L ₁ -L _{1 of} FIG.

FIG. 33 (A) is a longitudinal sectional view of a main part for explaining a coagulation state of a living tissue by the coagulation forceps of the second embodiment, and FIG. 33 (B) is a separation of a living tissue after coagulation by the coagulation forceps. The perspective view of the principal part for explaining a state.

FIG. 34A is a side view showing a pull-in operation state of the trigger of the coagulation forceps of the second embodiment, and FIG. 34B is a state in which the trigger of the coagulation forceps is released from the state of FIG. The side view which shows a state, (C) is a top view which shows the holding member of the treatment part of the coagulation forceps of the state of (B).

FIG. 35 (A) is a side view showing a state in which the holding members of the treatment section of the coagulation forceps according to the second embodiment are opened more than a set interval, and FIG. 35 (B) is an enlarged view of section A of FIG. .

FIG. 36 shows a third embodiment of the present invention,
(A) is a side view showing a grasping member of a treatment unit, and (B) is a side view of a main part showing a state where an operation unit unit and a forceps unit of coagulation forceps are combined.

FIG. 37 shows a fourth embodiment of the present invention.
(A) is a side view showing a grasping member of a treatment unit, and (B) is a side view of a main part showing a state where an operation unit unit and a forceps unit of coagulation forceps are combined.

FIG. 38 shows a fifth embodiment of the present invention.
(A) is a plan view of the whole coagulation forceps, (B) is a side view thereof,
(C) is a side view showing the open state of the grasping member of the treatment section.

[Explanation of symbols]

 DESCRIPTION OF SYMBOLS 1 Surgical forceps 2 Insertion part 3 Insertion pipe 4 Hand operation part 5 Tip holding part 6 Separation means 8 Holding part main body 9 Opening / closing operation body 11 Holding operation mechanism part 12 Power supply connection part 13 Separation operation part 14 Operation selection mechanism part 15 Operating part main body 40 Rod part 41 Elastic member 42a, 42b Holding member 43 Holding surface 51 Slit 52 Coagulation electrode

Claims (1)

[Claims] An operating portion main body having an insertion portion to be inserted into a body cavity; a coagulation portion including a pair of energizable gripping means for gripping a tissue provided near a distal end of the insertion portion; Gripping at the part, separating means for separating the coagulated tissue, coagulation part opening / closing operation means provided on the operation part main body side to open and close the gripping means of the coagulation part, and provided on the operation part main body side A separating operation means for operating the separating means; and an operation selecting means for selecting any one of the coagulation opening / closing operation means and the separating operation means and allowing only the operation of the operating means. A coagulation forceps with a detachment function, characterized in that: