JPH1147149A - Endoscopic surgery appliance - Google Patents

Endoscopic surgery appliance

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Publication number
JPH1147149A
JPH1147149A JP20912097A JP20912097A JPH1147149A JP H1147149 A JPH1147149 A JP H1147149A JP 20912097 A JP20912097 A JP 20912097A JP 20912097 A JP20912097 A JP 20912097A JP H1147149 A JPH1147149 A JP H1147149A
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JP
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Patent type
Prior art keywords
incision
portion
current
embodiment
gripping
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Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
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JP20912097A
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Japanese (ja)
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JP3986126B2 (en )
Inventor
Koji Iida
Yasuhiko Kikuchi
Naoki Sekino
Koji Yamauchi
幸治 山内
康彦 菊地
直己 関野
浩司 飯田
Original Assignee
Olympus Optical Co Ltd
オリンパス光学工業株式会社
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Abstract

PROBLEM TO BE SOLVED: To enable surely clamping and solidifying the part of a living tissue for treatment and incising the same. SOLUTION: An endoscopic surgery appliance has a pair of clamping members 11a, 11b which open and close relatively and an incising knife 16 moving in the gap between the clamping members 11a, 11b, the clamping members 11a, 11b and the incising knife 16 being formed as electrodes and provided with a current conduction means by which a solidifying current and an incising current are switchably conducted between the clamping members 11a, 11b and between each of the clamping members 11a, 11b and the incising knife 16.

Description

【発明の詳細な説明】 DETAILED DESCRIPTION OF THE INVENTION

【0001】 [0001]

【発明の属する技術分野】この発明は生体組織を把持する把持部及び把持した生体組織を切開する切開部を備えた内視鏡下手術器械に関する。 TECHNICAL FIELD The present invention relates to an endoscopic surgical instruments having an incision for incising the grip portion and the grasped living tissue gripping the biological tissue.

【0002】 [0002]

【従来の技術】一般に、生体組織を把持する一対の把持部材を備え、各把持部材に高周波通電用の電極が配設されたバイポーラ鉗子が知られている。 In general, comprises a pair of gripping members for gripping the body tissue, the bipolar forceps having electrodes arranged for high-frequency current is known in the gripping member. そして、このバイポーラ鉗子の使用時には一対の把持部材間に処置対象の生体組織を把持させた状態で、各把持部材の電極間に高周波電流を通電して把持部材間の生体組織を凝固させるようになっている。 As this is the use of a bipolar forceps while being gripped treatment target living tissue between a pair of gripping members, to coagulate the living tissue between the grasping member and a high-frequency current between the electrodes of each gripping member going on.

【0003】この種のバイポーラ鉗子は、通常、生体組織に含まれる血管の止血、生体組織の表層の病変部、出血点の焼灼、避妊を目的とした卵管の閉塞等の多種の症例に用いられる。 [0003] This type of bipolar forceps, usually used, hemostasis of the blood vessel contained in a biological tissue, lesion of the surface layer of the living tissue, cauterization of the bleeding point, the various cases of clogging tubal intended for contraception It is. そして、バイポーラ鉗子が血管の止血や、卵管の閉塞を目的として用いられ、患者の処置対象の生体組織を凝固できるようになっており、また凝固した生体組織を切開することができるようになっている。 The hemostatic and bipolar forceps vessel, used for the purpose of occlusion of fallopian tube, making it possible to incise the are adapted to be coagulate patient treatment target living tissue, also coagulated biological tissue ing.

【0004】従来、この種の内視鏡下手術器械として、 [0004] Conventionally, as an endoscopic surgical instruments of this kind,
例えば米国特許第5269780号明細書、米国特許第5445638号明細書、米国特許第5267998号明細書等で知られている。 For example U.S. Pat. No. 5269780, U.S. Patent No. 5445638, are known in U.S. Pat. No. 5267998 Pat like.

【0005】米国特許第5269780号明細書は、シースの先端部から突出する一対の凝固電極と可動する1 [0005] U.S. Pat. No. 5,269,780, the movable pair of coagulation electrodes that protrude from the distal end of the sheath 1
本の切開電極とを備え、一対の凝固電極間に凝固電流を流して生体組織を凝固させた後、切開電極と凝固電極との間に切開電流を流して生体組織を切開するようになっている。 And a book of cutting electrode, after flowing coagulation current between a pair of coagulation electrodes to coagulate the living tissue, so as to incise the body tissue by passing an incision current between the cutting electrode and the coagulation electrode there.

【0006】米国特許第5445638号明細書は、シースの先端部から突出する一対の把持部材と、この把持部材間に進退自在な切開ナイフとを備え、手元操作部の操作によって一対の把持部材を閉じて処置対象の生体組織を把持した状態で、一対の把持部材間に凝固電流を流して生体組織を凝固させた後、切開ナイフを前進させて生体組織を切開するようになっている。 [0006] U.S. Patent No. 5,445,638 Pat includes a pair of gripping members projecting from the distal end of the sheath, and a freely incision knife back and forth between the gripping member, a pair of gripping members by operating the operation portion closed while gripping the living tissue to be treated, after flowing coagulation current to coagulate the living tissue between a pair of gripping members, the incision knife is advanced so that the incising biological tissue.

【0007】米国特許第5267998号明細書は、シースの先端部に固定された一対の凝固電極と移動可能な切開電極とを備え、一対の凝固電極間に凝固電流を流して生体組織を凝固させた後、手元操作部の操作によって切開電極を移動させるとともに、切開電流を流して生体組織を切開するようになっている。 [0007] U.S. Patent No. 5,267,998 is provided with a pair of coagulating electrode and movable cutting electrode which is fixed to the distal end of the sheath, to coagulate the living tissue by supplying a coagulation current between a pair of the coagulation electrodes after it moves the cutting electrode by manipulating the operation portion, by passing an incision current is adapted to incise the body tissue.

【0008】 [0008]

【発明が解決しようとする課題】しかしながら、前述した米国特許第5269780号明細書は、一対の凝固電極と可動する1本の切開電極とを備えているものの、生体組織を把持する機能がないため、処置対象部位を確実に把持して切開することができない。 However [0007], U.S. Pat. No. 5269780 mentioned above, although a single cutting electrode for moving a pair of coagulation electrodes, since there is no ability to grip the biological tissue , it can not be dissected reliably grip the object part.

【0009】米国特許第5445638号明細書は、一対の把持部材間に進退自在な切開ナイフを備えたものであり、切開ナイフの切れ味が劣化すると、切開ナイフを前進させて切開する際に把持した生体組織を押し出してしまうという不都合があり、切開ナイフを頻繁に交換する必要がある。 [0009] U.S. Patent No. 5,445,638 are those having a retractably incision knife between the pair of gripping members, sharpness of the incision knife when degraded, grasped when incisions advancing the incision knife There is inconvenience that extruding the biological tissue, it is necessary to frequently replace the incision knife.

【0010】米国特許第5267998号明細書は、切開電極を移動させるとともに、切開電流を流して生体組織を切開するようになっているが、生体組織を把持する機能がないため、処置対象部位を確実に切開することができない。 [0010] U.S. Patent No. 5,267,998, along with moving the cutting electrode, but by supplying an incision current is adapted to incise the living tissue, since there is no ability to grasp the living tissue, a treatment target portion it is not possible to reliably incision.

【0011】この発明は、前記事情に着目してなされたもので、その目的とするところは、生体組織の処置対象部位を確実に把持して凝固でき、また切開できる内視鏡下手術器械を提供することにある。 [0011] The present invention has been made in view of the above circumstances, it is an object of the treatment target part of a living body tissue can be coagulated and securely grip the, also endoscopic surgical instruments that can be incised It is to provide.

【0012】 [0012]

【課題を解決するための手段】この発明は、前記目的を達成するために、相対的に開閉する一対の把持部と前記把持部の間隙を移動する切開部を備えた内視鏡下手術器械において、前記把持部及び切開部が各々電極として構成され、前記把持部同士間及び把持部と前記切開部との間に通電する通電手段を設けたことを特徴とする。 SUMMARY OF THE INVENTION The present invention, in order to achieve the above object, an endoscopic surgical instruments having an incision for moving gap between the grip portion and a pair of gripping portions for relatively opening and closing in the grip portion and the incision is configured as respective electrodes, characterized in that a current supply means for energizing between the inter-gripping portions and the grip portion and the incision.

【0013】そして、生体組織の凝固止血等の処置時に把持部によって生体組織を把持した状態で把持部間に凝固電流を流して生体組織を凝固させ、次に、把持部と切開部との間に切開電流を流して生体組織を切開することができるようにしたものである。 [0013] Then, by applying a coagulation current between the grip portion while gripping the living tissue by the grip portion during the treatment of coagulation hemostasis such a living tissue to coagulate the living tissue, then, between the grip portion and the incision flowing an incision current is obtained to be able to incise the body tissue.

【0014】 [0014]

【発明の実施の形態】以下、この発明の各実施の形態を図面に基づいて説明する。 BEST MODE FOR CARRYING OUT THE INVENTION Hereinafter, will be explained with reference to the embodiments of the invention with reference to the drawings. 図1〜図4は第1の実施形態を示し、図1は内視鏡下手術器械の全体構成図である。 1 to 4 show a first embodiment, FIG. 1 is an overall configuration diagram of an endoscopic surgical instruments.
図1に示すように、内視鏡下手術器械としてのバイポーラ鉗子1と高周波焼灼電源装置2とから構成されている。 As shown in FIG. 1, it is composed of a bipolar forceps 1 as an endoscopic surgical instruments frequency cauterization power supply apparatus 2.

【0015】バイポーラ鉗子1には患者の体腔内に挿入される細長い挿入部3と、この挿入部3の先端部に配置され、体腔内で生体組織を把持、凝固するための通電可能な処置部4と、挿入部3の基端部に連結された操作部5とが設けられている。 [0015] The bipolar forceps 1 an elongated insertion portion 3 to be inserted into a body cavity of a patient, is disposed at the distal end of the insertion portion 3, grasping the living tissue in a body cavity, energizable treatment portion to coagulate 4, an operation unit 5 connected is provided at the proximal end of the insertion portion 3.

【0016】挿入部3は、外シース6と、この外シース6の内部に軸方向に進退自在に挿入された内シース7とからなり、外シース6の基端部は操作部5を構成するグリップ8に固定され、内シース7の基端部は操作部5に設けられた内シース駆動部材9に固定されている。 The insertion portion 3 includes an outer sheath 6, the inside of the outer sheath 6 consists among sheath 7 for being inserted movably in the axial direction, the base end portion of the outer sheath 6 constituting the operation unit 5 is fixed to the grip 8, the proximal end portion of the inner sheath 7 is fixed to the sheath drive member 9 among which is provided on the operation unit 5.

【0017】処置部4には内シース7に内挿される細長いロッド10が設けられている。 The elongated rod 10 which is inserted into the inner sheath 7 to the treatment section 4 is provided. このロッド10の先端部には電極を構成する把持部としての一対の把持部材1 A pair of gripping members as a gripper thereof constituting the electrode on the distal end of the rod 10 1
1a,11bと、これらの把持部材11a,11bを拡開させる方向に付勢する弾性部材12a,12bとが設けられている。 1a, a 11b, these gripping members 11a, elastic member 12a for urging in a direction to spread apart the 11b, and the 12b are provided. 弾性部材12a,12bはばね鋼等によって形成され、先端部には略くの字状に屈曲された屈曲部13a,13bが形成され、表面は絶縁被膜によって被覆されている。 Elastic members 12a, 12b are formed by a spring steel or the like, the bent portion 13a at the tip portion which is bent in the shape of substantially L, 13b are formed, the surface is covered with an insulating coating.

【0018】図2に示すように、把持部材11a,11 As shown in FIG. 2, the gripping member 11a, 11
bは閉じたときに内部に空間部14が形成されるように断面が略コ字状に形成され、互いに対向する端縁は閉じたときに互いに噛合する鋸歯状部が形成され、生体組織を確実に把持できるように形成されている。 b cross section such that a space portion 14 therein is formed when the closing is formed in a substantially U-shaped, serrated portion are formed to mesh with each other when closed edges that face each other, a biological tissue It is formed so as to be securely grasped.

【0019】さらに、図2に示すように、処置部4のロッド10と平行にナイフロッド15が設けられ、このナイフロッド15の先端部には切開部としての切開ナイフ16が設けられている。 Furthermore, as shown in FIG. 2, parallel to the knife rod 15 is provided with a rod 10 of the treatment unit 4, is the incision knife 16 of the incision is provided at the tip of the knife rod 15. この切開ナイフ16はナイフロッド15の軸方向と直角に、かつ上下方向に延びる切刃16aを有し、把持部材11a,11bが閉じたときの空間部14に侵入できる大きさに形成されている。 The incision knife 16 is perpendicular to the axial direction of the knife rod 15, and has a cutting edge 16a extending in the vertical direction, the gripping members 11a, 11b are formed to a size that can penetrate the space 14 when closing .

【0020】このように構成された処置部4の把持部材11a,11bのロッド10及び切開ナイフ16のナイフロッド15は前記挿入部3を構成する内シース7に内挿されており、ロッド10及びナイフロッド15は内シース7の基端部から突出して操作部5まで延長している。 The gripping member 11a of the thus configured treatment section 4, the knife rod 15 of the rod 10 and the incision knife 16 and 11b are inserted into the inner sheath 7 constituting the insertion portion 3, the rod 10 and knife rod 15 is extended to the operation portion 5 projects from the proximal end of the inner sheath 7.

【0021】また、操作部5のグリップ8には先端部側に延出された先端側延出部17が設けられている。 Further, the grip 8 of the operation portion 5 extends out the distal end side extending portion 17 on the distal end side. この先端側延出部17には外シース6の基端部に連結固定される連結リング18が設けられている。 Connecting ring 18 which is fixedly connected to the proximal end of the outer sheath 6 is provided on the distal end side extending portion 17. さらに、先端側延出部17の後方には処置部4の後端部と電気、機械的に接続するための処置部ユニット接続部19が配設されている。 Furthermore, the electrical and the rear end portion of the treatment section 4, the treatment section unit connection 19 for mechanically connecting is disposed in the rear of the front end side extending portion 17. ここで、処置部ユニット接続部19には処置部4のロッド10の後端部を収納する内腔と、この内腔に収納したロッド10の後端部に接続される接続手段とが設けられている。 Here, a lumen for housing the rear end portion of the rod 10 of the treatment unit 4 in the treatment unit unit connection part 19, and a connecting means connected to the rear end portion of the rod 10 housed in the lumen is provided ing.

【0022】また、処置部ユニット接続部19には後述する電極切換え部38を介してケーブル接続部20が設けられ、このケーブル接続部20には接続ケーブル21 Further, connected to the treatment portion cable connection 20 is provided through the electrode switching unit 38 to be described later to the unit connector 19, the cable connection portion 20 cable 21
が接続されている。 There has been connected. このケーブル接続部21は前記高周波焼灼電源装置2に接続されている。 The cable connection portion 21 is connected to the high-frequency cauterization power supply apparatus 2.

【0023】また、グリップ8には処置部ユニット接続部19の操作用のトリガー22が設けられている。 Further, the trigger 22 for operation of the treatment section unit connection 19 is provided in the grip 8. このトリガー22はグリップ8の上端部に回動ピン23を中心に回動自在に連結されている。 The trigger 22 is pivotally connected to the centered pivot pin 23 to the upper end portion of the grip 8. さらに、このトリガー22には回動支点の上方に長孔24が形成されている。 Further, the elongated hole 24 is formed above the rotational fulcrum to the trigger 22.
この長孔24には内シース駆動部材9の側面に突設された係合ピン25が挿入されている。 Engaging pin 25 is inserted protruding from the side surface of the inner sheath driving member 9 is in the elongated hole 24.

【0024】また、グリップ8の内部にはトリガー22 [0024] In addition, the trigger is in the interior of the grip 8 22
の下端部の手掛け部22aをグリップ8から離れる方向(図1において回動ピン23を中心に時計回り方向)に付勢する付勢部材(図示しない)が配設されている。 Away the lower portion of the finger receiving portion 22a from the grip 8 (not shown) urging member for urging (clockwise direction about the pivot pin 23 in FIG. 1) is disposed. そして、トリガー22は付勢部材のばね力によって常時グリップ8から最も離れた定位置(解放位置)で保持されている。 Then, the trigger 22 is held in the most distant position from the always grip 8 by the spring force of the biasing member (release position).

【0025】さらに、グリップ8の後端上部における側面にはナイフ操作レバー27が設けられている。 Furthermore, the knife operating lever 27 on the side surface of the rear end upper portion of the grip 8 are provided. このナイフ操作レバー27はグリップ8に対して回動ピン28 The knife operation lever 27 pivot pin 28 against the grip 8
を中心に回動自在に連結されている。 It is pivotally connected about a. さらに、ナイフ操作レバー27の回動中心より上方には長孔29が形成され、この長孔29には前記ナイフロッド15の後端側面から突設された係合ピン30が挿入されている。 Further, the elongated hole 29 is formed above the center of rotation of the knife lever 27, the engaging pin 30 is inserted which protrudes from the rear end side of the knife rod 15 in the elongated hole 29.

【0026】ナイフ操作レバー27には略V字状に配置された上下のアーム部31,32が設けられている。 The arm portions 31 and 32 of the upper and lower disposed substantially V-shape in the knife lever 27 is provided. そして、一方のアーム部31には指掛け部33が他方のアーム32はストッパピン34と当接してナイフ操作レバー27の回動範囲を規制する役目をしている。 Then, the arm 32 finger grips 33 and the other on one of the arm portion 31 has a role of restricting the rotation range of the knife lever 27 in contact with the stopper pin 34 equivalents. さらに、 further,
回動ピン28にはナイフ操作レバー27を時計回り方向に付勢する付勢部材(図示しない)が装着されている。 Biasing member for biasing the knife operating lever 27 in the clockwise direction to the rotation pin 28 (not shown) is mounted.

【0027】ここで、トリガー22の手掛け部22aを付勢部材のばね力に抗してグリップ8側に引き込み操作することにより、内シース駆動部材9を介して内シース7が外シース6の軸方向前方へ移動して外シース6の前端から突出する。 [0027] Here, by operating pull the grip 8 side against the finger receiving portion 22a of the trigger 22 the spring force of the biasing member, the inner sheath 7 through the inner sheath drive member 9 of the outer sheath 6 axes projecting from the front end of the outer sheath 6 is moved in the forward direction. 内シース7の前進に伴って弾性部材1 The elastic member 1 along with the advancement of the inner sheath 7
2a,12bが相対的に内シース7内に引き込まれた状態となり、把持部材11a,11bが閉じる。 2a, 12b is in the state of being drawn into the relatively inside the sheath 7, the gripping member 11a, 11b is closed. また、トリガー22が解放されるとグリップ8内の付勢部材のばね力によって定位置に戻り、弾性部材12a,12bが相対的に内シース7から突出して把持部材11a,11 Further, when the trigger 22 is released to return to the home position by the spring force of the biasing member in the grip 8, the elastic members 12a, 12b are gripped protrudes from relatively sheath 7 members 11a, 11
bは弾性部材12a,12bの弾性復元力によって開くようになっている。 b is adapted to open by the elastic restoring force of the elastic member 12a, 12b.

【0028】また、ナイフ操作レバー27の指掛け部3 [0028] In addition, the finger hook portion 3 of the knife operation lever 27
3に指を掛け、付勢部材の付勢力に抗してナイフ操作レバー27を反時計回り方向に回動すると、長孔29に挿入されている係合ピン30を介してナイフロッド15が前進駆動し、ナイフロッド15の先端部の切開ナイフ1 3 to your finger, when rotating the knife operating lever 27 in the counterclockwise direction against the biasing force of the biasing member, the knife rod 15 through the engagement pin 30 which is inserted into the long hole 29 moves forward driven, the incision knife 1 of the tip of the knife rod 15
6が前進して把持部材11a,11bによって形成される空間部14に侵入するようになっている。 6 is adapted to penetrate into the space 14 formed by the gripping member 11a, 11b to advance. ナイフ操作レバー27が解放されると付勢部材のばね力によって定位置に戻り、ナイフロッド15は相対的に内シース7に引き込まれて切開ナイフ16が後退し、アーム部32がストッパピン34に当接すると停止するようになっている。 When the knife operating lever 27 is released to return to the home position by the spring force of the biasing member, the knife rod 15 is drawn into relatively the sheath 7 incision knife 16 is retracted, the arm portion 32 to the stopper pin 34 It is adapted to stop the contacts.

【0029】また、前記高周波焼灼電源装置2にはフットスイッチ36が接続されており、このフットスイッチ36には凝固電流を流すための第1のスイッチ37aと切開電流を流すための第2のスイッチ37bが設けられている。 Further, said high-frequency cauterization power supply device 2 is connected to the foot switch 36, second switch for feeding a first switch 37a and the incision current for supplying coagulation current to the foot switch 36 37b is provided.

【0030】さらに、操作部5の電極切換え部38について説明すると、図3に示すように把持部材11a,1 Furthermore, to describe the electrode switching unit 38 of the operation unit 5, the gripping member 11a, as shown in FIG. 3, 1
1bと導通する把持側接点39a,39bと切開ナイフ16と導通する切開側接点35を有するとともに、接続ケーブル21と導通するケーブル側接続接点40a,4 Gripping side contact 39a for conducting the 1b, which has an incision side contact 35 which conducts 39b and the incision knife 16, the cable-side connection contact 40a which conducts the connection cable 21, 4
0bを有している。 Have a 0b.

【0031】図3(a)に示すように、凝固時には把持側接点39a,39bとケーブル側接続接点40a,4 As shown in FIG. 3 (a), the grip-side contacts 39a at the time of solidification, 39 b and cable-side connection contact 40a, 4
0bとを接続し、切開側接点35を開放して把持部材1 Connecting the 0b, gripping and opening the incision side contact 35 member 1
1aと11bとの間に凝固電流を流す。 Flowing a coagulation current between 1a and 11b. 図3(b)に示すように、切開時には把持側接点39aと39bとをケーブル側接続接点40aに接続し、切開側接点35とケーブル側接続接点40bとを接続して把持部材11a, As shown in FIG. 3 (b), at the time of incision connects the gripping side contact 39a and 39b on the cable-side connection contact 40a, incision side contact 35 and connects the cable-side connection contact 40b and the gripping member 11a,
11bと切開ナイフ16との間に切開電流を流す。 11b and passed an incision current between the incision knife 16.

【0032】凝固電流とは、図4(a)に示すように、 [0032] The coagulation current, as shown in FIG. 4 (a),
インピーダンスが焼灼に伴って上昇すると出力が低下する負荷特性を持つモードによる出力である。 Output impedance increases with ablation is output by the mode with the load characteristics to deteriorate. 切開電流とは、図4(b)に示すように、インピーダンスが上昇しても出力が低下しない定電力出力モードである。 The incision current, as shown in FIG. 4 (b), the output the impedance is increased is constant power output mode does not decrease. 図4 Figure 4
(c)に示すように、インピーダンス制御では焼灼の時間経過と共に一旦下がったインピーダンスが再度上昇する時点aで凝固完了を判断することにより、凝固モードから切開モードに自動的に切換えることができる。 (C), the in impedance control by determining coagulation complete when a once lowered impedance with time of ablation is raised again, it is possible to automatically switch from the coagulation mode to the cut mode.

【0033】次に、第1の実施形態の作用について説明する。 The following is a description of the operation of the first embodiment. バイポーラ鉗子1のケーブル接続部20に接続ケーブル21を接続し、バイポーラ鉗子1と高周波焼灼電源装置2とを電気的に接続する。 Connect the connection cable 21 to the cable connecting portion 20 of the bipolar forceps 1, for electrically connecting the bipolar forceps 1 and the high-frequency cautery power source device 2. 初期状態では操作部5 In the initial state control unit 5
のトリガー22の手掛け部22aは図1に示すようにグリップ8から最も離れた定位置で保持され、処置部ユニット接続部19は挿入部3の軸方向の移動範囲の最後端位置で保持される。 The finger receiving portion 22a of the trigger 22 is held in the most distant position from the grip 8, as shown in FIG. 1, the treatment section unit connection part 19 is held at the last end position of the movement range of the axial direction of the insertion portion 3 . この状態では処置部4の一対の弾性部材12a,12bが内シース7から突出して把持部材11a,11bが開いた状態にある。 A pair of elastic members 12a of the treatment section 4 in this state, 12b protrudes from the inner sheath 7 gripping member 11a, in a state in which 11b is opened.

【0034】そこで、トリガー22の手掛け部22aを板ばね部材のばね力に抗してグリップ8側に引き込み操作することにより、内シース駆動部材9を介して内シース7が外シース6の軸方向前方へ移動して外シース6の前端から突出する。 [0034] Therefore, by operating pull the grip 8 side against the finger receiving portion 22a of the trigger 22 the spring force of the leaf spring member, the inner sheath 7 through the inner sheath driving member 9 in the axial direction of the outer sheath 6 move forward projecting from the front end of the outer sheath 6. 内シース7の前進に伴って弾性部材12a,12bが相対的に内シース7内に引き込まれた状態となり、把持部材11a,11bが閉じる。 Elastic member 12a with the advancement of the inner sheath 7, 12b is in the state of being drawn into the relatively inside the sheath 7, the gripping member 11a, 11b is closed.

【0035】この状態で、バイポーラ鉗子1の挿入部3 [0035] In this state, the insertion section 3 of the bipolar forceps 1
を患者の体内に挿入され、この挿入部3の先端の処置部4が体内の処置対象の生体組織の近傍位置まで誘導する。 The inserted into the body of the patient, the treatment portion 4 at the tip of the insertion portion 3 is guided to a position near the treatment target living tissue in the body. この状態で、トリガー22が解放されるとグリップ8内の付勢部材のばね力によって定位置に戻り、弾性部材12a,12bが相対的に内シース7から突出して把持部材11a,11bは弾性部材12a,12bの弾性復元力によって開く。 In this state, when the trigger 22 is released to return to the home position by the spring force of the biasing member in the grip 8, the elastic members 12a, 12b are gripped protrudes from relatively sheath 7 members 11a, 11b are elastic members 12a, opened by the elastic restoring force of 12b.

【0036】続いて、拡開した把持部材11a,11b [0036] Subsequently, flared gripping member 11a, 11b
の間に生体組織Aを挿入した後、トリガー22の手掛け部22aを付勢部材のばね力に抗してグリップ8側に引き込み操作することにより、内シース駆動部材9を介して内シース7が外シース6の軸方向前方へ移動して外シース6の前端から突出する。 After inserting the body tissue A between by operating pull the grip 8 side against the finger receiving portion 22a of the trigger 22 the spring force of the biasing member, the inner sheath 7 through the inner sheath driving member 9 It moved axially forward of the outer sheath 6 projects from the front end of the outer sheath 6. 内シース7の前進に伴って弾性部材12a,12bが相対的に内シース7内に引き込まれた状態となり、把持部材11a,11bが閉じ、 Elastic member 12a with the advancement of the inner sheath 7, 12b is in the state of being drawn into the relatively inside the sheath 7, the gripping member 11a, 11b is closed,
生体組織Aが図2に示すように、一対の把持部材11 As biological tissue A is shown in FIG. 2, a pair of gripping members 11
a,11b間に把持される。 a, it is gripped between 11b.

【0037】このとき、把持部材11a,11bには閉じたときに互いに噛合する鋸歯状部に形成され、生体組織Aを確実に把持できる。 [0037] In this case, the gripping member 11a, is formed on the serrations which mesh with each other when closed to 11b, can be reliably grasp the body tissue A. この状態で、フットスイッチ36の第1のスイッチ37aをオンすると、高周波焼灼電源装置2から接続ケーブル21を介してコード接続部20に高周波電流が流れ、さらに電極切換え部38を介して把持部材11aと11bとの間に凝固電流が流れ、 In this state, when turning on the first switch 37a of the foot switch 36, the high-frequency current flows through the cord connecting portion 20 from the high-frequency cauterization power supply apparatus 2 through the connection cable 21, the gripping member 11a further through the electrode switching unit 38 coagulation current flows between the 11b,
生体組織Aの凝固が行われる。 Coagulation of biological tissue A is performed.

【0038】一定時間凝固電流を流して生体組織Aを凝固させた後、第1のスイッチ37aをオフとする。 [0038] After coagulating biological tissue A by flowing a certain time coagulation current, turning off the first switch 37a. そして、電極切換え部38が、図3(b)に示すように、把持側接点39aと39bとをケーブル側接続接点40a The electrode switching unit 38 is, as shown in FIG. 3 (b), and a grip-side contact 39a and 39b the cable-side connection contact 40a
に接続し、切開側接点35とケーブル側接続接点40b Connected to, incision side contact 35 and the cable-side connection contact 40b
とを接続し、第2のスイッチ37bをオンして把持部材11a,11bと切開ナイフ16との間に切開電流を流す。 Connect the door, gripping member 11a by turning on the second switch 37b, passing an incision current between 11b and the incision knife 16.

【0039】また、ナイフ操作レバー27の指掛け部3 [0039] In addition, the finger hook portion 3 of the knife operation lever 27
3に指を掛け、付勢部材の付勢力に抗してナイフ操作レバー27を反時計回り方向に回動すると、長孔29に挿入されている係合ピン30を介してナイフロッド15が前進駆動し、ナイフロッド15の先端部の切開ナイフ1 3 to your finger, when rotating the knife operating lever 27 in the counterclockwise direction against the biasing force of the biasing member, the knife rod 15 through the engagement pin 30 which is inserted into the long hole 29 moves forward driven, the incision knife 1 of the tip of the knife rod 15
6が前進する。 6 is advanced. したがって、把持部材11a,11b間に把持された生体組織Aは切開ナイフ16の切刃16a Thus, the gripping member 11a, is gripped living tissue A between 11b the cutting edge 16a of the incision knife 16
によって機械的に切開されると共に、切開電流によって電気的に切開される。 While it is mechanically dissected by electrically dissection by dissection current.

【0040】切開が完了した後、ナイフ操作レバー27 [0040] After the incision is complete, knife operation lever 27
を解放すると、付勢部材のばね力によって定位置に戻り、ナイフロッド15は相対的に内シース7に引き込まれて切開ナイフ16が後退し、アーム部32がストッパピン34に当接すると停止する。 Releasing returns to the home position by the spring force of the biasing member, the knife rod 15 is drawn into relatively the sheath 7 incision knife 16 is retracted, and stops the arm portion 32 abuts against the stopper pin 34 . また、トリガー22を解放するとグリップ8内の付勢部材のばね力によって定位置に戻り、弾性部材12a,12bが相対的に内シース7から突出して把持部材11a,11bは弾性部材1 Further, when releasing the trigger 22 returns to the home position by the spring force of the biasing member in the grip 8, the elastic members 12a, 12b are gripped protrudes from relatively sheath 7 members 11a, 11b are elastic members 1
2a,12bの弾性復元力によって開き、把持部材11 2a, open by the elastic restoring force of 12b, gripping member 11
a,11bは生体組織Aから開放される。 a, 11b is released from the body tissue A.

【0041】なお、前記実施形態においては、フットスイッチ36の第1のスイッチ37aと第2のスイッチ3 [0041] In the above embodiment, the first switch 37a and second switch 3 of the foot switch 36
7bとのオン・オフによって凝固電流と切開電流を切換えたが、図4(c)に示すように、インピーダンス制御では焼灼の時間経過と共に一旦下がったインピーダンスが再度上昇する時点aで凝固完了を判断することにより、凝固モードから切開モードに自動的に切換えることができる。 While switching the coagulation current and the incision current by on-off between 7b, as shown in FIG. 4 (c), determining a coagulation complete when a once lowered impedance with time of ablation increases again in the impedance control by, it can be automatically switched from the coagulation mode to the cut mode.

【0042】図5は第2の実施形態を示し、第1の実施形態と同一構成部分は同一番号を付して説明を省略する。 [0042] Figure 5 shows a second embodiment, the same components as those of the first embodiment will be omitted with denoted by the same numbers. 本実施形態は、第1の実施形態のフットスイッチ3 This embodiment, the foot switch 3 of the first embodiment
6に代って操作部5のグリップ8には、凝固電流を流すための第1のスイッチ41aと切開電流を流すための第2のスイッチ41bが設けられている。 The grip 8 of the operation portion 5 on behalf of 6, is provided a second switch 41b for passing a first switch 41a and the incision current for supplying coagulation current.

【0043】図6は第3の実施形態を示し、第1の実施形態と同一構成部分は同一番号を付して説明を省略する。 [0043] Figure 6 shows a third embodiment, the same components as those of the first embodiment will be omitted with denoted by the same numbers. 本実施形態は、第1の実施形態のフットスイッチ3 This embodiment, the foot switch 3 of the first embodiment
6に代って操作部5のグリップ8には、凝固電流を流すための第1のスイッチ41aと切開電流を流すための第2のスイッチ41bが設けられている。 The grip 8 of the operation portion 5 on behalf of 6, is provided a second switch 41b for passing a first switch 41a and the incision current for supplying coagulation current. そして、第2のスイッチ41bは、ナイフ操作レバー27を操作して切開ナイフ16を前進させたときにアーム部32によってオンされ、ナイフ操作レバー27と同期して切開電流が流れるようになっている。 Then, the second switch 41b is turned on by the arm portion 32 when advancing the incision knife 16 by operating the knife lever 27, so that the incision current flows in synchronism with the knife lever 27 .

【0044】図7は第4の実施形態を示し、第1の実施形態と同一構成部分は同一番号を付して説明を省略する。 [0044] Figure 7 shows a fourth embodiment, the same components as those of the first embodiment will be omitted with denoted by the same numbers. 本実施形態は、第1の実施形態の切刃16aを有する切開ナイフ16に代って一対のワイヤロッド42a, This embodiment, the pair in place of the incision knife 16 having a cutting edge 16a of the first embodiment wire rods 42a,
42b間にワイヤループからなるワイヤカッタ42が設けられている。 Wire cutters 42 made of wire loop is provided between 42b.

【0045】図8及び図9は第5の実施形態を示し、第1の実施形態と同一構成部分は同一番号を付して説明を省略する。 [0045] FIGS. 8 and 9 show a fifth embodiment, the same components as those of the first embodiment will be omitted with denoted by the same numbers. 本実施形態は、図8に示すように、第4の実施形態の一対のワイヤロッド42a,42b間にワイヤを張設した第1の電極43aが設けられ、ワイヤロッド42bに第2の電極43bが設けられている。 This embodiment, as shown in FIG. 8, a fourth embodiment of a pair of wire rods 42a, the first electrode 43a stretched over the wire between 42b provided, the second electrode 43b to the wire rod 42b It is provided. 図9は電極切換え部を示し、同図(a)に示すように、凝固時には把持側接点39a,39bとケーブル側接続接点40 Figure 9 illustrates the electrode switching unit, as shown in FIG. 6 (a), the grip-side contacts 39a at the time of solidification, 39 b and cable-side connection contact 40
a,40bとを接続し、第1及び第2の電極43a,4 Connect a, and 40b, first and second electrodes 43a, 4
3bと導通する接点44a,44bを開放して把持部材11aと11bとの間に凝固電流を流す。 Contact 44a which conducts the 3b, by opening the 44b flow coagulation current between the gripping members 11a and 11b. 同図(b)に示すように、切開時には第1と第2の電極43a,43 As shown in FIG. (B), at the time of dissection the first and second electrodes 43a, 43
bに導通する接点44a,44bを独立してケーブル側接続接点40a,40bに接続し、第1と第2の電極4 Contact 44a which conducts the b, the cable-side connection contact 40a independently 44b, connects to 40b, the first and second electrode 4
3aと43bとの間に切開電流を流すようにしたものである。 3a and is obtained by a flow a dissection current between 43b.

【0046】図10は第6の実施形態を示し、第1の実施形態と同一構成部分は同一番号を付して説明を省略する。 [0046] Figure 10 shows a sixth embodiment, the same components as those of the first embodiment will be omitted with denoted by the same numbers. 本実施形態は、第1の実施形態の切刃16aを有する切開ナイフ16に代って一対のワイヤループからなる第1のワイヤ電極45aと第2のワイヤ電極45bが設けられている。 This embodiment, the first wire electrode 45a and the second wire electrode 45b which in place of the incision knife 16 having a cutting edge 16a of the first embodiment consists of a pair of wire loops are provided. そして、切開時には第1と第2のワイヤ電極45aと45bとの間に切開電流を流すようにしたものである。 Then, at the time of incision is obtained so as to flow the incision current between the first and second wire electrodes 45a and 45b.

【0047】図11及び図12は第7の実施形態を示し、第1の実施形態と同一構成部分は同一番号を付して説明を省略する。 [0047] Figures 11 and 12 show a seventh embodiment, the same components as those of the first embodiment will be omitted with denoted by the same numbers. 本実施形態は、第1の実施形態の処置部4を構成する一対の把持部材11a,11bに代って図11に示すように、第1の把持部材46a第2の把持部材46bとからなり、第2の把持部材46bの内部に絶縁部材47を介して上方に突出する切開部材48が設けられている。 This embodiment includes a pair of gripping members 11a constituting the treatment portion 4 of the first embodiment, in place of 11b as shown in FIG. 11, comprises a first gripping member 46a a second gripping member 46b , cutting member 48 which projects upwardly inside via an insulating member 47 of the second gripping member 46b is provided.

【0048】図12は電極切換え部を示し、同図(a) [0048] Figure 12 illustrates the electrode switching unit, FIG. (A)
に示すように、凝固時には把持側接点39a,39bとケーブル側接続接点40a,40bとを接続し、切開部材48と導通する接点49を開放して第1と第2の把持部材46aと46bとの間に凝固電流を流す。 As shown in, the gripping side contact 39a at the time of solidification, 39 b and cable-side connection contact 40a, connects the 40b, the first and second gripping members 46a and 46b by opening the contact 49 which conducts the cutting member 48 passing a coagulation current between. 同図(b)に示すように、切開時には把持側接点39aと切開部材48を独立してケーブル側接続接点40a,40 As shown in FIG. (B), at the time of dissection independently gripping side contact 39a and the cutting member 48 cable-side connection contact 40a, 40
bに接続し、第1の把持部材46aと切開部材48との間に切開電流を流すようにしたものである。 Connected to b, it is obtained by a flow a dissection current between the cutting member 48 and the first gripping member 46a.

【0049】図13は第8の実施形態を示し、処置部4 [0049] Figure 13 shows the eighth embodiment, the treatment section 4
の変形例である。 Modification of a. すなわち、第1の把持部材50aと第2の把持部材50bとからなり、第2の把持部材50b That consists of a first gripping member 50a and the second gripping member 50b, the second gripping member 50b
の内部には断面が三角形状で、上方に突出する切開部5 Inside the cross section triangular incision 5 projecting upward
1が一体に設けられている。 1 is integrally provided. 第1の把持部材50aの内面と切開部51の頂部との間隔をg 1 、第1と第2の把持部材50a,50bの端縁間の間隔をg 2とすると、 When the distance between the inner surface and the top portion of the incision 51 of the first gripping member 50a g 1, first and second gripping members 50a, the distance between the edges of 50b and g 2,
1 <g 2になっている。 g 1 has become <g 2. 本実施形態によれば、電極の切換えは行わず、凝固電流から切開電流に切換えることにより、切開部51の頂部に電流が集中するので切開電流を流すと中心部分だけ切開できる。 According to the present embodiment, switching of the electrode is not performed, by switching the incision current from the coagulation current can only incised central portion is flowed an incision current because the current is concentrated on the top portion of the incision 51.

【0050】図14及び図15は第9の実施形態であり、図14は高周波焼灼電源装置2を示し、図15はインピーダンスの時間変化例を示すグラフである。 [0050] FIGS. 14 and 15 are the ninth embodiment, FIG. 14 shows the high-frequency cauterization power supply device 2, FIG. 15 is a graph showing time variations in impedance. 第1の実施形態においては、インピーダンス制御において、焼灼の時間経過と共に一旦下がったインピーダンスが再度上昇する時点aで凝固完了を判断することにより、凝固モードから切開モードに自動的に切換えることを述べたが、本実施形態においては、焼灼時間t 1 〜t 3に変化によるインピーダンス変化量ΔZ 1 〜ΔZ 2を測定し、 In the first embodiment, the impedance control, by temporarily lowered impedance with time of ablation to determine coagulation complete when a rising again, said automatically switched by the cut mode from the coagulation mode but in the present embodiment, by measuring the impedance variation ΔZ 1 ~ΔZ 2 due to the change in the ablation time t 1 ~t 3,
記憶しておくことにより、2回目以降の制御を行うことができるようにしたものである。 By storing, in which to be able to control the second and subsequent.

【0051】すなわち、高周波焼灼電源装置2には制御回路52からの制御信号によって高周波電流を出力する出力回路53及び出力時に焼灼時間、インピーダンスを検出する検出回路54が設けられ、検出信号は制御回路52に入力される。 [0051] That is, the high-frequency cautery power source device output circuit 53, and ablation time during output and outputs a high-frequency current by a control signal from the control circuit 52 to 2, the detection circuit 54 for detecting the impedance provided, the detection signal the control circuit 52 is input to. さらに、設定手段55が設けられ、 Moreover, setting means 55 is provided,
この設定手段55によって焼灼時間t 1 〜t 3を選択することにより、所望するインピーダンスに達したとき、 By selecting the ablation time t 1 ~t 3 This setting means 55, when it reaches a desired impedance,
制御回路52に焼灼停止信号を入力して高周波電流の出力を停止することができる。 It is possible to stop the output of high-frequency current to input ablation stop signal to the control circuit 52.

【0052】したがって、焼灼時間t 1 〜t 3とインピーダンス変化量ΔZ 1 〜ΔZ 2のパラメータに基づき2 [0052] Thus, ablation time t 1 ~t 3 and the impedance change amount [Delta] Z 2 based on 1 ~ΔZ 2 parameters
回目以降の制御を正確に行うことができ、また術者によって凝固のレベルに差があっても、設定手段55によって焼灼時間t 1 〜t 3を選択することにより、所望のインピーダンスに達したとき焼灼を停止し、凝固モードから切開モードに自動的に切換えることができる。 It can be performed times subsequent control accurately and even if there is a difference in level of the coagulation by the surgeon, by selecting the ablation time t 1 ~t 3 by setting means 55, upon reaching a desired impedance the ablation is stopped, it is possible to automatically switch from the coagulation mode to the cut mode.

【0053】図16〜図19は第10の実施形態を示し、図16は内視鏡下手術器械の全体構成図、図17は内視鏡下手術器械の先端側の縦断側面図である。 [0053] FIGS. 16 to 19 show a tenth embodiment, FIG. 16 is an overall configuration diagram of a endoscopic surgical instruments, and FIG. 17 is a vertical sectional side view of the distal end side of the endoscopic surgical instruments. 内視鏡下手術器械61はパイプ状の挿入部62と、この挿入部62の手元側に設けられた操作部63とから構成されている。 Endoscopic surgical instruments 61 is a pipe-shaped insertion portion 62, and an operation unit 63 provided on the proximal side of the insertion portion 62. 操作部63には挿入部62をその軸心を中心として回転操作する挿入部回転ノブ64が設けられている。 The operation unit 63 is inserted portion rotation knob 64 for rotating the insertion section 62 about its axis are provided.

【0054】挿入部62には軸方向に進退自在な操作軸65と回転軸66が内挿されている。 [0054] Rotation shaft 66 and freely operating shaft 65 forward and backward in the axial direction is inserted into the insertion portion 62. 挿入部62の先端部には把持部を構成する第1のジョー67aが枢支ピン68を支点として回動自在に設けられ、この基端部は操作軸65と連結ピン69によって連結され、先端部は挿入部62の前端より突出している。 First jaw 67a is rotatably provided a pivot pin 68 as a fulcrum at the tip portion of the insertion portion 62 constituting the gripper, the base end portion is connected by a connecting pin 69 and the operating shaft 65, the distal end parts protrudes from the front end of the insertion portion 62. 操作軸65の基端部は操作部63に設けられた可動ハンドル70と連結されている。 Proximal end of the operating shaft 65 is coupled to the movable handle 70 provided in the operation unit 63.

【0055】回転軸66の先端部は挿入部62の前端より突出しており、この突出部には把持部を構成する第2 [0055] distal end portion of the rotary shaft 66 is projected from the front end of the insertion portion 62, the second constituting a grip portion to the projecting portion
のジョー67bが一体に設けられている。 Joe 67b is provided integrally. そして、第1 Then, the first
と第2のジョー67a,67bによって生体組織Aを把持して処置する処置部を構成している。 When gripping the body tissue A constitutes a treatment portion for treating the second jaw 67a, 67b.

【0056】第2のジョー67bは図18及び図19に示すように、横断面が台形もしくは略三角形状で、その底辺部に凝固部71が形成され、その頂部に切開部72 [0056] The second jaw 67b, as shown in FIGS. 18 and 19, in cross-section trapezoidal or shaped substantially triangular, solidified portion 71 is formed on the bottom side, the incision 72 in the top thereof
が形成されている。 There has been formed. すなわち、回転軸66を軸心を中心として回転し、第2のジョー67bの凝固部71を上向きにして第1のジョー67aと対向させて生体組織Aを把持することにより、生体組織Aを凝固させることができ、回転軸66を軸心を中心として回転し、第2のジョー67bの切開部72を上向きにして第1のジョー67 That is, by rotating the rotary shaft 66 about the axis, by the solidified portion 71 of the second jaw 67b to face the first jaw 67a facing upward to grasp the body tissue A, coagulating biological tissue A It can be, by rotating the rotary shaft 66 about the axis, the first jaw 67 and the incision 72 of the second jaw 67b upwards
aと対向させて生体組織Aを把持することにより、生体組織Aを切開できるようになっている。 By a facing by gripping the body tissue A, and to be able to incise the body tissue A.

【0057】第2のジョー67bと一体の回転軸66は挿入部62内の支持パイプ73によって回転自在に支持されており、その基端部は操作部63に設けられたジョー回転ノブ74に連結され、ジョー回転ノブ74を操作することにより、第1のジョー70の向きを任意に変更できるようになっている。 [0057] The second jaw 67b integral with the rotary shaft 66 is rotatably supported by the supporting pipe 73 of the insertion portion 62, connected to the jaw rotation knob 74 is a base end portion provided in the operation unit 63 is, by operating the jaw rotation knob 74, which is to be arbitrarily change the direction of the first jaw 70.

【0058】次に、第10の実施形態の作用について説明する。 Next, a description will be given of the operation of the tenth embodiment. まず、ジョー回転ノブ74を操作して回転軸6 First, the rotating shaft 6 by operating the jaw rotation knob 74
6を回転し、第2のジョー67bの凝固部71を上向きにして第1のジョー67aと対向させる。 6 rotates, to the first jaw 67a facing to the solidified portion 71 of the second jaw 67b upward. この状態で、 In this state,
可動ハンドル70を操作して操作軸65を後退させると、第1のジョー67aが枢支ピン68を支点として回動し、第2のジョー67bの凝固部71との間で図18 When retracting the operating shaft 65 by operating the movable handle 70, the first jaw 67a is rotated the pivot pin 68 as a fulcrum, Figure between the solidified portion 71 of the second jaw 67b 18
に示すように、生体組織Aを把持する。 As shown in, to grip the body tissue A. そこで、第1と第2のジョー67a,67b間に凝固電流を流すと生体組織Aの凝固が行われる。 Therefore, the coagulation of the living tissue A is performed when the flow first and second jaws 67a, a coagulation current between 67b.

【0059】次に、第1と第2のジョー67a,67b Next, the first and second jaw 67a, 67b
をいったん開き、ジョー回転ノブ74を操作して回転軸66を180゜回転し、第2のジョー70の切開部72 Once opened, the rotating shaft 66 by operating the jaw rotation knob 74 is rotated 180 degrees, the cutouts 72 of the second jaw 70
を上向きにして第1のジョー67aと対向させて生体組織Aを把持することにより、生体組織Aは第1のジョー67aと第2のジョー67bの切開部72との間で把持する。 Was allowed to face the first jaw 67a facing upward by grasping the biological tissue A, the biological tissue A is gripped between the cutouts 72 of the first jaw 67a and a second jaw 67b. そこで、第1と第2のジョー67a,67b間に切開電流を流すと生体組織Aの切開が行われる。 Therefore, the incision of the body tissue A is performed when the flow first and second jaws 67a, an incision current between 67b.

【0060】なお、第2のジョー67bを横断面が台形もしくは略三角形状で、その底辺部に凝固部71、その頂部に切開部72を形成したが、凝固部71と切開部7 [0060] In the second jaw 67b a cross-section is trapezoidal or shaped substantially triangular, solidified portion 71 at its bottom portion has formed the incision 72 in the top thereof, it solidified portion 71 and the incision 7
2とを2か所ずつ設け、90゜回転することにより、凝固と切開が切換えられるようにしてもよい。 And 2 is provided by two, by 90 ° rotation, it may be solidified and the incision is switched.

【0061】図20は第11の実施形態を示し、第10 [0061] Figure 20 shows an embodiment of the eleventh, tenth
の実施形態と同一構成部分は同一番号を付して説明を省略する。 Embodiment the same components will be omitted the description of those same numbers. 本実施形態は、挿入部62の先端部に第2のジョー67bを覆う断面が略円弧状の保護カバー75が設けられている。 This embodiment, the second protective cover 75 the cross section is substantially arc shape covering the jaw 67b is provided at the distal end of the insertion portion 62. このように保護カバー75によって第2 The protective cover 75 in this way a second
のジョー67bを覆うことにより、体腔内に挿入時に第2のジョー67bによって生体に傷を付けるのを防止できる。 By covering the jaw 67b, it is possible to prevent the scratching the vivo by the second jaw 67b when inserted into a body cavity.

【0062】図21は第12の実施形態を示し、第10 [0062] Figure 21 shows a twelfth embodiment of the tenth
の実施形態と同一構成部分は同一番号を付して説明を省略する。 Embodiment the same components will be omitted the description of those same numbers. 本実施形態は、挿入部62の先端部に絶縁部材からなる先端パイプ76を設けると共に、操作軸65及び回転軸66を絶縁カバー65a,66aによって覆い、第1と第2のジョー67a,67bを電気的絶縁状態に構成したものである。 This embodiment is provided with a pipe end 76 made of an insulating member to the distal end of the insertion portion 62, the insulating cover 65a of the operation shaft 65 and the rotary shaft 66, covered by 66a, the first and second jaws 67a, a 67b it is obtained by constituting the electrically insulated state.

【0063】図22及び図23は第13の実施形態を示し、第10の実施形態と同一構成部分は同一番号を付して説明を省略する。 [0063] Figures 22 and 23 show a thirteenth embodiment, embodiment the same components of the first 10 will be omitted with denoted by the same numbers. 本実施形態は、操作部63に電流切換え機構77を設けたものである。 The present embodiment is provided with a current switching mechanism 77 to the operation unit 63. 第2のジョー67b The second jaw 67b
と一体の回転軸66の基端部にはスイッチ操作カム78 Switch operating cam 78 to the proximal end portion of the rotary shaft 66 of the integral when
が設けられている。 It is provided. スイッチ操作カム78は第2のジョー67bの凝固部71に対応する大径部78aと切開部72に対応する小径部78bが設けられている。 The switch operating cam 78 small diameter portion 78b is provided corresponding to the large diameter portion 78a and the incision 72 corresponding to the solidified portion 71 of the second jaw 67b.

【0064】一方、操作部63にはスイッチ操作カム7 [0064] On the other hand, the operation unit 63 switches the operation cam 7
8に対向して貫通孔79が穿設され、この貫通孔79にはスプリング80によってスイッチ操作カム78のカム面に当接する方向に付勢されたプランジャ81が設けられている。 8 opposite to the through hole 79 is bored in the plunger 81 which is biased in a direction in contact with the cam surface of the switch operating cam 78 by a spring 80 is provided in the through hole 79. 貫通孔79の上部にはプランジャ81に対向して電流切換えスイッチ82が設けられている。 The top of the through-hole 79 is a current changeover switch 82 is provided opposite to the plunger 81.

【0065】ジョー回転ノブ74を操作して回転軸66 [0065] In operation the jaws rotating knob 74 rotating shaft 66
を回転させると、スイッチ操作カム78が一体に回転し、大径部78aによってプランジャ81が押し上げられると電流切換えスイッチ82がオンし、小径部78b Rotation of the switch operating cam 78 is rotated integrally, when the plunger 81 is pushed up current switching switch 82 is turned on by the large diameter portion 78a, a small diameter portion 78b
がプランジャ81に対向してスプリング81によって押し下げられると、電流切換えスイッチ82がオフするようになっている。 There the opposite to the plunger 81 is depressed by the spring 81, the current change-over switch 82 is adapted to turn off. この電流切換えスイッチ82は電流切換えコード83を介して高周波焼灼電源装置2に内蔵された電流切換え回路(図示しない)に接続され、電流切換えスイッチ82のオン・オフによって高周波焼灼電源装置2から出力される電流を凝固電流から切開電流またはその逆に切換えできる。 This current changeover switch 82 is connected through a current switching code 83 to the high-frequency cauterization power supply current switching circuit incorporated in the 2 (not shown), is output from the high-frequency cauterization power supply apparatus 2 by turning on and off the current switching switch 82 current can be switched from the coagulating current incision current or vice versa that.

【0066】前記実施の形態によれば、次のような構成が得られる。 [0066] According to the embodiment, a structure such as the following are obtained. (付記1)相対的に開閉する一対の把持部と前記把持部の間隙を移動する切開部を備えた内視鏡下手術器械において、前記把持部及び切開部が各々電極として構成され、前記把持部同士間及び把持部と前記切開部との間に通電する通電手段を設けたことを特徴とする内視鏡下手術器械。 (Supplementary Note 1) In the endoscopic surgical instruments having an incision for moving a pair of gripping portions for relatively opening and closing the gap between the grip portion, the grip portion and the incision is configured as each electrode, the grasping endoscopic surgical instruments, characterized in that a current supply means for energizing between parts between and between the grip portion and the incision.

【0067】(付記2)相対的に開閉する一対の把持部と前記把持部の間隙を移動する切開部を備えた内視鏡下手術器械において、前記把持部及び切開部が各々電極として構成され、把持部同士の間、及び把持部と切開部との間の通電を切り換える電極切り換え部を備えたことを特徴とする内視鏡下手術器械。 [0067] (Note 2) In an endoscopic surgical instruments having an incision for moving a pair of gripping portions for relatively opening and closing the gap between the grip portion, the grip portion and the incision is configured as respective electrodes , between the grip portions, and an endoscopic surgical instruments, characterized in that an electrode switching unit switching a conduction between the gripping portion and the incision.

【0068】(付記3)付記1または2記載の内視鏡手術器械に、高周波焼灼電源装置の切開出力と凝固出力の操作スイッチを設けたことを特徴とする内視鏡下手術器械。 [0068] (Supplementary Note 3) Appendix 1 or endoscopic surgical instruments 2, wherein, endoscopic surgical instruments, characterized in that a manipulation switch of the incision Output coagulation output of the high-frequency cauterization power supply apparatus. (付記4)付記1または2記載の内視鏡手術器械において、操作部の把持動作と同期して凝固出力し、操作部の切開操作と同期して切開出力を行う操作スイッチを設けたことを特徴とする内視鏡手術器械。 In (Supplementary Note 4) Appendix 1 or 2 endoscopic surgical instruments according, that solidified outputted in synchronism with the gripping action of the operating unit, provided with a manipulation switch for dissection output in synchronization with the incision operation of the operating unit endoscopic surgical instruments, wherein. (付記5)付記1または2記載の内視鏡手術器械において、切開部の電極をワイヤ形状で構成したことを特徴とする内視鏡手術器械。 (Supplementary Note 5) Appendix 1 or in endoscopic surgical instruments 2, wherein, endoscopic surgical instruments, characterized in that the electrode of the incision constitutes a wire shape.

【0069】(付記6)相対的に開閉する一対の把持部と前記把持部の間隙を移動する切開部を備えた内視鏡下手術器械において、前記把持部及び切開部が各々電極として構成され、把持部、電極同士の間及び切開部電極同士間の通電を切り換える電極切り換え部を備えたことを特徴とする内視鏡手術器械。 [0069] (Supplementary Note 6) In the pair of gripping portions for relatively opening and closing an endoscopic surgical instruments having an incision for moving gap of the grip portion, the grip portion and the incision is configured as respective electrodes grip portion, an endoscopic surgical instrument characterized by comprising an electrode switching unit for switching the current between and between the cutouts electrodes of the electrode to each other.

【0070】(付記7)相対的に開閉する一対の把持部と、一方の把持部に電気的に絶縁された切開部を有し、 [0070] (Supplementary Note 7) comprises a pair of gripping portions for relatively opening and closing, the electrically insulated incision on one of the grip portion,
前記把持部及び切開部が各々電極として構成され、把持部同士の間及び把持部と切開部との間の通電を切り換える電極切り換え部を備えたことを特徴とする内視鏡手術器械。 The configured as gripper and cutting unit are each electrode, an endoscopic surgical instrument characterized by comprising an electrode switching unit for switching the current supply and between the grip portion of the gripping portions with the incision.

【0071】(付記8)高周波焼灼電源装置において、 [0071] In (Supplementary Note 8) high-frequency cauterization power supply apparatus,
凝固電流を出力する手段と、凝固完了を検出する手段と、凝固完了の検出に伴い凝固電流を停止すると同時に切開電流を出力する手段とを備えたことを特徴とする高周波焼灼電源装置。 Means for outputting a coagulation current, means for detecting the completion of solidification, high-frequency cauterization power supply apparatus characterized by comprising a means for outputting simultaneously incision current is stopped coagulation current with the detection of the solidification completion.

【0072】(付記9)付記8記載の高周波焼灼電源装置と組み合わせて使用する内視鏡下手術器械において、 [0072] In (Supplementary Note 9) an endoscopic surgical instruments used in combination with the high-frequency cauterization power supply apparatus according appendix 8,
相対的に開閉する一対の把持部を有し、更にその一方の把持部に切開部を有し、前記把持部同士の接触面積に対して、前記切開部と他方の把持部との接触面積が小さいことを特徴とする内視鏡下手術器械。 It has a pair of gripping portions for relatively opening and closing, further comprising an incision in the gripping portion of the hand, to the contact area between the grip portion, the contact area between the incision and the other gripping portion endoscopic surgical instruments, characterized in that small.

【0073】(付記10)高周波焼灼電源装置において、生体組織の計測清報を記憶する手段と、記憶した条件にしたがって組織の焼灼を再生させる手段とを備えたことを特徴とする高周波焼灼電源装置。 [0073] (Note 10) In the high-frequency cauterization power supply apparatus, a high-frequency cauterization power supply apparatus characterized means for storing the measurement Shinho living tissue, further comprising a means for reproducing the tissue ablation according to the stored condition .

【0074】(付記11)相対的に開閉する一対のジョーを挿入部の先端に有する内視鏡下手術器械において、 [0074] In (Supplementary Note 11) an endoscopic surgical instruments having a pair of jaws relative opening and closing the distal end of the insertion portion,
第1のジョーには組識を処置する処置部を有し、第2のジョーには凝固部と切開部が異なる面上に形成され、第2のジョーを挿入部に平行な軸を中心に選択的に回転することで第1のジョ一と、凝固部・切開部の一方を向き合せ、各々のジョーに高周波電流を通電して、組織を処置可能な内視鏡下手術用器械。 The first jaw has a treatment portion for treating the organizational, the second jaw incision and solidified portion is formed on a different plane, about an axis parallel to the second jaw to the insertion portion a first jaw one be selectively rotated, combined orientation one of the solidified portion-incision, and a high-frequency current to each of the jaws, endoscopic surgical instruments that can treat tissue.

【0075】(付記12)付記11の記載の内視鏡下手術用器械において、第1のジョーだけが開閉することを特徴とする内視鏡下手術用器械。 [0075] (Supplementary Note 12) In the endoscopic surgical instrument according to Supplementary Note 11, an endoscopic surgical instrument, characterized in that only the first jaw is opened and closed. (付記13)付記11または12の記載の内視鏡下手術用器械において、凝固部の面積は切開部の面積より大きいことを特徴とする内視鏡下手術用器械。 (Supplementary Note 13) Appendix 11 or 12 endoscopic in a mirror under surgical instruments, the area of ​​the solidified portion is an endoscopic surgical instrument being greater than the area of ​​the incision described. (付記14)付記11,12または13の記載の内視鏡下手術用器械において、第2のジョーの断面形状は台形であることを特徴とする内視鏡下手術用器械。 (Supplementary Note 14) In the endoscopic surgical instrument according to Appendix 11, 12 or 13, an endoscopic surgical instruments, wherein the cross-sectional shape of the second jaw is trapezoidal. (付記15)付記11,12または13の記載の内視鏡下手術用器械において、第2のジョーの断面形状は略三角形状であることを特徴とする内視鏡下手術用器械。 (Supplementary Note 15) Appendix 11, 12 or in 13 endoscopic surgical instruments according to, endoscopic surgical instruments, wherein the cross-sectional shape of the second jaw are substantially triangular.

【0076】(付記16)付記11〜15のいずれかに記載の内視鏡下手術用器械において、第1のジョーを第2のジョーから絶縁する手段を含み、各々のジョーには異なる極の高周波電流を通電可能なことを特徴とする内視鏡下手術用器械。 [0076] In (Supplementary Note 16) an endoscopic surgical instrument according to any one of appendices 11 to 15, comprising means for insulating the first jaw from the second jaw, the different poles in each of the jaws endoscopic surgical instruments, wherein the available frequency current. (付記17)付記11〜16のいずれかに記載の内視鏡下手術用器械において、第2のジョーの凝固部が第1のジョーの把持面と向き合うときは凝固電流を、第2のジョーの切開部が第1のジョーの把持面と向き合うときは切開電流を通電することにより連続的に組織の凝固・切開が可能なことを特徴とする内視鏡下手術用器械。 In endoscopic surgical instrument according to any one of (Supplementary Note 17) note 11-16, coagulation current when the solidified portion of the second jaw facing the gripping surface of the first jaw, the second jaw endoscopic surgical instruments, wherein capable of solidifying and incising continuously tissue incision by when facing the gripping surface of the first jaw for energizing an incision current.

【0077】(付記18)付記11〜16のいずれかに記載の内視鏡下手術用器械において、第2のジョーの回転に応じて電流を凝固電流から切開電流に変化させる手段を持つことを特徴とする内視鏡下手術用器械。 [0077] In (Supplementary Note 18) an endoscopic surgical instrument according to any one of appendices 11 to 16, to have a means for varying the current from the coagulating current to the incision current according to the rotation of the second jaw endoscopic surgical instruments, wherein.

【0078】 [0078]

【発明の効果】以上説明したように、この発明によれば、相対的に開閉する一対の把持部とこの把持部の間隙を移動する切開部を備え、把持部及び切開部を各々電極として構成し、把持部同士間及び把持部と切開部との間に通電する通電手段を設けたことにより、生体組織の処置対象部位を確実に把持して凝固でき、また切開でき、 As described in the foregoing, according to the present invention, comprises an incision to move the pair of grip portion relative opening and closing the gap of the gripping portion, each configured as electrodes gripper and cutting unit and, by providing the energizing means for energizing between the gripping portions and between the grip portion and the incision can be solidified reliably grip the surgical target portion of the living tissue, also can be incised,
さらに切開性能を長期間維持できることからランニングコストの低減を図ることができるという効果がある。 There is an effect that further incisions performance can be reduced running costs because it can long time maintained.

【図面の簡単な説明】 BRIEF DESCRIPTION OF THE DRAWINGS

【図1】この発明の第1の実施形態を示し、(a)は内視鏡下手術器械の全体の側面図、(b)は把持部材が閉じた状態の側面図。 [1] shows a first embodiment of the present invention, (a) represents a side view of the whole endoscopic surgical instruments, (b) is a side view showing a state in which the gripping members closed.

【図2】同実施形態を示す把持部材で生体組織を把持した状態の縦断側面図。 Figure 2 is a longitudinal side view of a state in which the living tissue is gripped gripping member showing the same embodiment.

【図3】同実施形態の電極切換え部の説明図。 Figure 3 is an illustration of an electrode switching unit of the embodiment.

【図4】同実施形態を示し、(a)は凝固時の負荷特性の説明図、(b)は切開時の負荷特性の説明図、(c) Figure 4 shows the same embodiment, (a) shows the explanatory diagram of a load characteristic during solidification, (b) is an explanatory view of a load characteristic when the incision, (c)
はインピーダンス制御の説明図。 Illustration of impedance control.

【図5】この発明の第2の実施形態を示し、(a)は内視鏡下手術器械の全体の側面図、(b)は把持部材が閉じた状態の側面図。 Figure 5 shows a second embodiment of the present invention, (a) represents a side view of the whole endoscopic surgical instruments, (b) is a side view showing a state in which the gripping members closed.

【図6】この発明の第3の実施形態を示し、(a)は内視鏡下手術器械の全体の側面図、(b)は把持部材が閉じた状態の側面図。 6 shows a third embodiment of the present invention, (a) represents a side view of the whole endoscopic surgical instruments, (b) is a side view showing a state in which the gripping members closed.

【図7】この発明の第4の実施形態を示す把持部材で生体組織を把持した状態の縦断側面図。 Figure 7 is a longitudinal side view of a state in which the living tissue is gripped gripping member showing a fourth embodiment of the present invention.

【図8】この発明の第5の実施形態を示す把持部材で生体組織を把持した状態の縦断側面図。 Figure 8 is a longitudinal side view of a state in which the living tissue is gripped fifth gripping member showing an embodiment of the present invention.

【図9】同実施形態の電極切換え部の説明図。 Figure 9 is an illustration of an electrode switching unit of the embodiment.

【図10】この発明の第6の実施形態を示す把持部材で生体組織を把持した状態の縦断側面図。 [10] Sixth longitudinal side view of a state in which the living tissue is gripped gripping member showing an embodiment of the present invention.

【図11】この発明の第7の実施形態を示す把持部材で生体組織を把持した状態の縦断側面図。 [11] Seventh longitudinal side view of a state in which the living tissue is gripped gripping member showing an embodiment of the present invention.

【図12】同実施形態の電極切換え部の説明図。 Figure 12 is an explanatory view of the electrode switching unit of the embodiment.

【図13】この発明の第8の実施形態を示す把持部材で生体組織を把持した状態の縦断正面図。 Figure 13 is a longitudinal front view of a state in which the living tissue is gripped gripping member shown an eighth embodiment of the present invention.

【図14】この発明の第9の実施形態を示す高周波焼灼電源装置のブロック図。 Figure 14 is a block diagram of a high-frequency cauterization power supply apparatus according to a ninth embodiment of the present invention.

【図15】インピーダンス制御の説明図。 FIG. 15 is an explanatory diagram of an impedance control.

【図16】この発明の第10の実施形態を示す内視鏡下手術器械の全体の側面図。 Figure 16 is a side view of a whole endoscopic surgical instruments showing a tenth embodiment of the present invention.

【図17】同実施形態の先端側の処置部を示す縦断側面図。 Figure 17 is a longitudinal side view showing the treatment portion of the distal end side of the same embodiment.

【図18】同実施形態の凝固時の縦断正面図。 Figure 18 is a longitudinal front view of the time of solidification of the embodiment.

【図19】同実施形態の切開時の縦断正面図。 Figure 19 is a longitudinal front view of when the incision of the embodiment.

【図20】この発明の第11の実施形態を示し、(a) [Figure 20] shows an eleventh embodiment of the present invention, (a)
は凝固時の縦断正面図、(b)は切開時の縦断正面図。 Longitudinal front view during solidification, (b) is a longitudinal sectional front view when the incision.

【図21】この発明の第12の実施形態を示す内視鏡下手術器械の先端部の縦断側面図。 Figure 21 is a longitudinal side view of the distal portion of the endoscopic surgical instrument showing a twelfth embodiment of the present invention.

【図22】この発明の第13の実施形態を示す内視鏡下手術器械の操作部の側面図。 [22] 13 a side view of the operating portion of the endoscopic surgical instrument illustrating an embodiment of the present invention.

【図23】図22のX−X線に沿う断面図。 Figure 23 is a cross-sectional view taken along the line X-X in Figure 22.

【符号の説明】 DESCRIPTION OF SYMBOLS

1…内視鏡下手術器械 2…高周波焼灼電源装置 3…挿入部 4…処置部ユニット 5…操作部 11…把持部材 16…切開ナイフ 1 ... endoscopic surgical instruments 2 ... high frequency cautery power source device 3 ... insertion portion 4 ... treatment section unit 5 ... operation section 11 ... gripping member 16 ... incision knife

───────────────────────────────────────────────────── フロントページの続き (72)発明者 山内 幸治 東京都渋谷区幡ヶ谷2丁目43番2号 オリ ンパス光学工業株式会社内 ────────────────────────────────────────────────── ─── of the front page continued (72) inventor Koji Yamauchi Shibuya-ku, Tokyo Hatagaya 2-chome No. 43 No. 2 Olympus optical industry Co., Ltd. in

Claims (1)

    【特許請求の範囲】 [The claims]
  1. 【請求項1】 相対的に開閉する一対の把持部と前記把持部の間隙を移動する切開部を備えた内視鏡下手術器械において、 前記把持部及び切開部が各々電極として構成され、前記把持部同士間及び把持部と前記切開部との間に通電する通電手段を設けたことを特徴とする内視鏡下手術器械。 1. A relatively open to endoscopic surgical instruments having an incision for moving gap between the grip portion and a pair of gripping portions, wherein the gripping portion and the incision is configured as each electrode, said endoscopic surgical instruments, characterized in that a current supply means for energizing between the gripping portions and between the grip portion and the incision.
JP20912097A 1997-08-04 1997-08-04 Endoscopic surgical instruments Expired - Fee Related JP3986126B2 (en)

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