WO2006129465A1 - 手術器具 - Google Patents
手術器具 Download PDFInfo
- Publication number
- WO2006129465A1 WO2006129465A1 PCT/JP2006/309588 JP2006309588W WO2006129465A1 WO 2006129465 A1 WO2006129465 A1 WO 2006129465A1 JP 2006309588 W JP2006309588 W JP 2006309588W WO 2006129465 A1 WO2006129465 A1 WO 2006129465A1
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- WO
- WIPO (PCT)
- Prior art keywords
- ultrasonic
- probe
- conductive member
- surgical instrument
- ultrasonic probe
- Prior art date
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Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B18/1442—Probes having pivoting end effectors, e.g. forceps
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
- A61B17/320092—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw
- A61B2017/320095—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw with sealing or cauterizing means
Definitions
- the present invention relates to a surgical instrument capable of performing a treatment with a high-frequency current in addition to a treatment for excising or coagulating a living tissue by ultrasonic vibration.
- Japanese Patent Laid-Open No. 2004-216180 discloses a device in which an ultrasonic coagulation / cutting device and an electric knife are combined.
- the treatment section is composed of a gripping member and a probe, and the tissue is coagulated and incised by gripping the tissue with both members and ultrasonically vibrating the probe.
- a method of coagulating tissue by grasping a living tissue between a grasping member and a probe and applying a high-frequency current of an electric knife to one or both of the grasping member and the probe.
- a technique is disclosed in which a living tissue without using a counter electrode plate of an electric knife is grasped by a grasping member and a probe, and a high-frequency current of the electric knife is passed between the grasping member and the probe.
- Document 2 Japanese Patent Application Laid-Open No. 11-318919 discloses a device in which an ultrasonic coagulation / cutting device and an electric knife are combined.
- the treatment section is composed of a joint and a probe, and the tissue is coagulated and incised by grasping the tissue with both members and ultrasonically vibrating the probe.
- a method of coagulating the tissue by gripping the living tissue between the jaw and the probe and applying a high frequency current of an electric knife between the jaw and the probe.
- a foot switch for output control can be connected to the device of Document 2, and when one pedal is depressed, high ultrasonic output and low electric knife output are generated, and when the other pedal is depressed, low ultrasonic wave is generated.
- An output control method for generating an output and a high electric knife output is disclosed.
- an ultrasonic coagulation incision An invention relating to the structure of scissors is disclosed.
- the living tissue is grasped between the joint and the probe, and the living tissue is coagulated and incised by ultrasonically vibrating the probe.
- a portion (probe side) that comes into contact with the living tissue of the jaw is made of greaves in order to appropriately coagulate and incise the living tissue.
- Documents 1 and 2 disclose an apparatus for coagulating a living tissue by supplying a high-frequency current between a gripping member (a jaw) and a probe.
- the gripping member of such an ultrasonic coagulation / incision treatment tool is usually made of greaves as disclosed in Document 3.
- the fat constituting the grasping member is indispensable for appropriately grasping a living tissue with the tip of the probe, denaturing the tissue with frictional heat due to ultrasonic vibration of the probe, and coagulating and incising the tissue. Is. Furthermore, the gripping member and the probe come into contact after excising the living tissue. Even if the gripping member comes into contact with the probe that vibrates ultrasonically, the wear of the device is minimized and the destruction is prevented. It is what you have.
- the present invention has been made in view of a problem that has been devised, and by constituting the gripping member with a grease and a current-carrying member, a living tissue gripped between the gripping member and the probe can be obtained.
- an object of the present invention is to provide a surgical instrument that can effectively energize a high-frequency current.
- the surgical instrument includes an ultrasonic transducer that generates ultrasonic vibrations, an ultrasonic probe that transmits ultrasonic vibrations generated by the ultrasonic transducers to a distal end portion, and the ultrasonic waves.
- a gripping member configured to move between a proximity position and a separation position with respect to a distal end portion of the probe and grip a living tissue to be treated between the distal end portion of the ultrasonic probe, and the gripping member From a conductive material that is provided and supplies high frequency current to the living tissue
- a non-conductive member having a non-conductive material force formed in a shape exposing a part of one surface.
- FIG. 1 is an explanatory diagram showing an ultrasonic scissor with an electric knife, which is a surgical instrument according to a first embodiment of the present invention.
- FIG. 2 is a block diagram showing a configuration of the entire system including the surgical instrument in FIG.
- FIG. 3 is an explanatory diagram for explaining the operation of the embodiment.
- FIG. 4 is an explanatory diagram for explaining the operation of the embodiment.
- FIG. 5 is an explanatory view showing a second embodiment of the present invention.
- FIG. 6 is an explanatory view showing a second embodiment of the present invention.
- FIG. 7 is an explanatory view showing a third embodiment of the present invention.
- FIG. 8 is an explanatory view showing a third embodiment of the present invention.
- FIG. 9 is an explanatory view showing a modification of the second and third embodiments.
- FIG. 10 is an explanatory view showing a modification of the second and third embodiments.
- FIG. 1 is an explanatory view showing an ultrasonic scissor with an electric scalpel, which is a surgical instrument according to the first embodiment of the present invention.
- FIG. 2 is a block diagram showing the configuration of the entire system including the surgical instrument of FIG.
- the ultrasonic scissors 4 with the electric knife is connected to the ultrasonic output device 2 via the ultrasonic cable 3.
- An ultrasonic foot switch 1 is connected to the ultrasonic output device 2.
- the ultrasonic foot switch 1 instructs the ultrasonic output device 2 to turn on / off the ultrasonic output based on a user operation.
- the ultrasonic output device 2 generates an ultrasonic output based on an on / off instruction by the ultrasonic foot switch 1.
- This ultrasonic wave is supplied to the ultrasonic scissors 4 with an electric knife through the ultrasonic cable 3.
- the ultrasonic scissors 4 with the electric knife is connected to the electric knife output device 6 via the electric knife cable 7.
- An electric knife foot switch 5 is connected to the electric knife output device 6.
- the electric knife foot switch 5 instructs the electric knife output device 6 to turn on / off the high-frequency current output based on a user operation.
- the electric knife output device 6 generates a high-frequency current based on an on / off instruction from the electric knife foot switch 5. This high-frequency current is supplied to the ultrasonic scissors 4 with the electric knife through the electric knife cable 7.
- the ultrasonic scissors 4 with an electric knife converts the supplied ultrasonic output from electrical energy to mechanical energy by an ultrasonic vibrator 12 described later, and generates ultrasonic vibration in a distal treatment section 15 described later. generate. Further, the ultrasonic scissors 4 with the electric knife transmits the supplied high-frequency current from the distal treatment section 15 to the living tissue.
- FIG. 1 shows a specific configuration of the ultrasonic scissors 4 with an electric knife.
- an ultrasonic scissor 4 with an electric knife has a built-in vibrator 12.
- the ultrasonic output from the ultrasonic output device 2 is supplied to the vibrator 12 via the ultrasonic cable 3.
- the vibrator 12 ultrasonically vibrates by converting an electrical signal, which is an ultrasonic output generated by the ultrasonic output device 2, into mechanical vibration.
- One end of an ultrasonic probe 13 is connected to the vibrator 12.
- the other end of the probe 13 protrudes from the main body 16 of the ultrasonic scissor 4 with the electrosurgical knife, and the probe 13 can transmit the ultrasonic vibration generated in the vibrator 12!
- the ultrasonic scissors 4 with the electric knife also incorporates the transmission member 10.
- the high frequency current of the boiler from the electric knife output device 6 is input to the vibrator 12 and the transmission member 10 via the electric knife cable 7.
- the vibrator 12 transmits the input bipolar high-frequency current to the probe 13.
- the transmission member 10 made of a conductive material has a distal end extending to the distal end of the main body 6 of the ultrasonic scissors 4 with an electric knife. The distal end of the transmission member 10 is connected to the gripping member 11. The transmission member 10 is configured to transmit the input Pibor high-frequency current to the gripping member 11.
- the distal treatment section 15 is configured by the distal end portion of the probe 13 and the grasping member 11. tip Ultrasonic vibration is transmitted to the distal end portion of the probe 13 constituting the treatment section 15, and the biological tissue comes into contact with the distal end portion of the probe 13, so that the ultrasonic vibration can be transmitted to the biological tissue. ing.
- the gripping member 11 constituting the distal treatment section 15 has a two-layer structure including a current-carrying member 1la as a conductive member and a grease member 1lb as a non-conductive member.
- the current-carrying member 11a is connected to the transmission member 10, and a high-frequency current is supplied via the transmission member 10.
- the current-carrying member 11a has a grease member l ib attached to one surface of the probe 13 side.
- the grease member l ib is smaller in size than the current-carrying member 11a, and the current-carrying member 1 la is covered with 1 lb of the oil-fed member 1 lb. Have.
- the gripping member 11 is supported at its base end side so as to be rotatable by a pivot (not shown).
- a pivot not shown
- the tip end portion of the probe 13 and the gripping member 11 are configured to face each other.
- the grease member l ib of the gripping member 11 has a tip located at a position where the tip force of the probe 13 is also a predetermined length, and the energizing member 11a is located at a position where the tip is substantially equal to the tip of the probe 13. .
- the current-carrying member 11a of the gripping member 11 is opposed to the probe 13 with a portion of a predetermined length on the distal end side passing through the grease member ib.
- the gripping member 11 facing the probe 13, the gripping member 11 is configured with a grease member l ib, and a living tissue can be sandwiched between the resin member l ib and the probe 13.
- the distal end side of the gripping member 11 is covered with 1 lb of the grease member, and the energizing member 1 la faces the probe 13 so that the living tissue is also sandwiched between the probe 13 and the energizing member 11a. It can be done.
- a living tissue can be sandwiched between the probe 13 and the oil-absorbing member ib, and the living tissue is also sandwiched between the probe 13 and the energizing member 11a. Now that I can do it!
- the probe 1 By interposing a living tissue between the probe 13 and the resin member l ib, the probe 1 The ultrasonic treatment such as coagulation and incision treatment of the living tissue can be performed by transmitting the ultrasonic vibration of 3 to the living tissue. Further, by sandwiching the living tissue between the probe 13 and the energizing member 11a, a high-frequency current can be passed through the living tissue between the probe 13 and the energizing member 11a, and an electrocautery treatment such as cauterization or coagulation is performed. be able to.
- FIG. 3 and FIG. 3 and FIG. 4 are explanatory diagrams for explaining a treatment using ultrasonic waves and a treatment using an electric knife for a living tissue, respectively.
- FIG. 3 shows this state, in which the living tissue 23 is sandwiched between the distal end portion of the probe 13 and the resin member ib in the distal treatment section 15.
- the sound wave output device 2 When the operator operates the ultrasonic foot switch 1 in this state, the sound wave output device 2 generates an ultrasonic output. This ultrasonic wave is supplied to an ultrasonic scissor 4 with an electric knife through an ultrasonic cable 3.
- an ultrasonic output is given to the vibrator 12.
- the vibrator 12 converts the ultrasonic output into ultrasonic vibration and transmits it to the probe 13.
- the ultrasonic vibration transmitted to the probe 13 is transmitted from the distal end portion of the probe 13 to a living tissue sandwiched between the grease member ib and the probe 13.
- the living tissue 23 is sandwiched between the probe 13 and the oil-absorbing member l ib.
- the grease member l ib makes it possible to appropriately hold the living tissue 23 between the distal end portion of the probe 13 due to the properties of the grease.
- the living tissue 23 can be reliably coagulated and incised by the frictional heat generated by the ultrasonic vibration of the probe 13.
- an electrocautery treatment is performed on a living tissue.
- the living tissue is sandwiched between the probe 23 and the energizing member 11a of the grasping member 11.
- FIG. 4 shows this state, and the living tissue 23 ′ is sandwiched between the distal end portion of the probe 13 and the energizing member 11 a in the distal treatment section 15.
- the electric knife output device 6 outputs a high-frequency current.
- the high-frequency current from the electric knife output device 6 is supplied to the ultrasonic scissors 4 with the electric knife through the electric knife cable 7.
- a high-frequency current is applied to the transmission member 10 and the vibrator 12.
- the transmission member 10 transmits a high-frequency current to the distal end side and applies it to the current-carrying member 11a of the gripping member 11. Further, the high-frequency current supplied to the vibrator 12 is transmitted to the probe 13. Thus, a high frequency current is passed through the living tissue 23 ′ sandwiched between the probe 13 and the energizing member 11 a to perform the electric knife treatment.
- the living tissue 23 ′ since the energizing member 1 la faces the probe 13 without being covered with the resin member 1 lb on the distal end side, the living tissue is treated as 23 ′. Even when sandwiched between the probe 23 and the current-carrying member 11a of the gripping member 11, the living tissue 23 'can be brought into direct contact with the current-carrying member 1la without going through the 1 lb.
- a high resistance member is not interposed between the living tissue 23 ′ and the probe 13 and between the living tissue 23 ′ and the energizing member 11 a, so that a high-frequency current is effectively passed through the living tissue 23 ′. And a highly efficient electric scalpel treatment is possible.
- a grease member l ib is provided between the energizing member 11a and the probe 13, and even when the grasping member 11 and the probe 13 are opposed to each other without interposing the living tissue 23 '.
- the conducting member 11a and the probe 13 are not in contact with each other. As a result, an electric scalpel can be treated with a bipolar high-frequency current.
- the gripping member has a two-layer structure of the energizing member and the grease member, and the length of the distal end side of the grease member is made shorter than that of the energizing member. Accordingly, it is possible to hold the living tissue between the oil-absorbing member and the probe at the time of ultrasonic coagulation incision, and to hold the living tissue between the current-carrying member and the probe at the time of the electric knife treatment. This facilitates the flow of high-frequency current to the living tissue when the electric knife is treated. In this way, it is possible to coagulate living tissue by using a high-frequency bipolar current that does not impair the function of dissipating ultrasonic coagulation.
- the length of the grease member 1 lb relative to the current-carrying member 1 la can be reduced by making the length of the resin member l ib relative to the axial direction of the probe 13 shorter than the length of the current-carrying member 11a. It goes without saying that the length by which the living tissue can be coagulated and incised by ultrasonic vibration and the length by which the living tissue can be coagulated by the high frequency electric current can be changed.
- a monopolar high-frequency current is used by using the gripping member in the present embodiment. It is also possible to configure an electric knife device.
- FIG. 5 and FIG. 6 are explanatory views showing a second embodiment of the present invention.
- FIG. 5 is an explanatory view corresponding to FIG. 3, and
- FIG. 6 shows the state of FIG.
- the present embodiment differs from the first embodiment in that a gripping member 31 is employed instead of the gripping member 11.
- the gripping member 31 has a two-layer structure including a current-carrying member 3la and a resin member 3lb, 31c.
- a transmission member 10 (see FIG. 1) is connected to the energization member 31a, and a high-frequency current is supplied via the transmission member 10.
- the current-carrying member 11a has grease members 31b and 31c attached to one surface of the probe 13 side.
- the grease members 31b and 31c have portions that are smaller in size than the current members 31a and are not covered with the grease members 31b and 31c.
- the gripping member 31 is rotatably supported on the base end side by a pivot (not shown).
- a pivot not shown.
- the tip end portion of the probe 13 and the gripping member 31 are configured to be able to face each other.
- the grease members 31b and 31c of the gripping member 31 are provided on the proximal end side and the distal end side of the energizing member 3la, respectively, and the probe of the energizing member 31a in the 13-axis direction In the center, the grease members 31b and 31c are not provided, and the surface of the energizing member 31a is exposed at the center. As a result, the energizing member 31a of the gripping member 31 is opposed to the probe 13 with the central portion of the predetermined length passing through the grease members 31b and 31c.
- the biological tissue 33 when the biological tissue 33 is sandwiched between the probe 13 and the gripping member 31, the biological tissue 33 is pushed and deformed by the grease members 31b and 31c, and the biological tissue 33 is deformed. A part of the tissue 33 enters between the grease members 31b and 31c and comes into contact with the energizing member 31a. That is, in the present embodiment, the living tissue 33 is sandwiched between the probe 13 and the grease members 31b and 31c. As a result, the living tissue 33 comes into direct contact not only with the probe 13 and the resin members 31b and 31c but also with the conductive member 31a.
- the ultrasonic vibration generated in the vibrator 12 is transmitted to the probe 13 by the ultrasonic output from the sound output device 2. Due to the ultrasonic vibration transmitted to the probe 13, the living tissue 33 sandwiched between the probe 13 and the grease member 3 lb, 31c is subjected to ultrasonic coagulation and incision treatment.
- a high-frequency current from the electric knife output device 6 is given to the transmission member 10 and the vibrator 12.
- the high-frequency current applied to the transmission member 10 and the vibrator 12 is transmitted to the energizing member 31a and the probe 13, respectively, and flows through the living tissue 33 sandwiched between the probe 13 and the energizing member 31. In this way, an electrocautery treatment is performed on the living tissue 33.
- the gripping member has a two-layer structure of the energizing member and the plurality of grease members, and the energizing member is exposed between the grease members.
- the living tissue can be grasped between the member and the probe, and at the same time, the living tissue can be brought into direct contact with the electric member and the probe. This facilitates the flow of high-frequency current to the living tissue during the electrosurgical treatment. In this way, a highly efficient electric scalpel treatment with a nopolar high-frequency current that does not impair the function of transmitting ultrasonic coagulation and incision is possible.
- FIG. 7 and FIG. 8 are explanatory views showing a third embodiment of the present invention.
- Figures 7 and 8 are husbands This corresponds to FIG. 5 and FIG.
- the present embodiment is different from the second embodiment in that a gripping member 41 is used instead of the gripping member 31.
- the gripping member 41 has a two-layer structure including an energizing member 41a and grease members 41b and 41c.
- a transmission member 10 (see FIG. 1) is connected to the energizing member 41a, and a high-frequency current is supplied via the transmission member 10.
- the grease members 41b and 41c are attached to one surface of the probe 13 side.
- the grease members 41b and 41c are smaller in size than the current conducting member 41a, and the current conducting member 41a has a portion that is not covered with the grease members 41b and 41c.
- the gripping member 41 is rotatably supported on the base end side by a pivot (not shown).
- the gripping member 41 is configured such that the tip end portion of the probe 13 and the gripping member 41 can face each other by rotating the gripping member 41 around the pivot axis toward the probe 13. By rotating the gripping member 41 to the probe 13 side about the pivot axis, it becomes possible to sandwich biological tissue between the gripping member 41 and the probe 13!
- the grease members 4 lb and 41c of the gripping member 41 are provided on both sides of the energizing member 4 la, respectively, and the probe of the energizing member 41a is in the direction perpendicular to the axial direction of the probe 13 In the center, the grease members 41b and 41c are not provided, and the surface of the energizing member 4la is exposed in this central portion (see FIG. 8). As a result, the current-carrying member 41a of the gripping member 41 is opposed to the probe 13 with the central portion having a predetermined length through the grease members 41b and 41c.
- the ultrasonic vibration generated in the vibrator 12 is transmitted to the probe 13 by the ultrasonic output from the sound output device 2.
- the ultrasonic vibration transmitted to the probe 13 the living tissue 43 sandwiched between the probe 13 and the grease members 41b and 41c is subjected to ultrasonic coagulation and incision treatment.
- a high-frequency current from the electric knife output device 6 is given to the transmission member 10 and the vibrator 12.
- the high-frequency current given to the transmission member 10 and the vibrator 12 is transmitted to the energizing member 41a and the probe 13, respectively, and flows through the living tissue 43 sandwiched between the probe 13 and the energizing member 4la.
- the electrosurgical treatment is performed on the living tissue 43.
- the present embodiment can provide the same effects as those of the second embodiment.
- the example in which the resin member is configured by two members has been described. However, it is apparent that the same effect can be obtained even if the resin member is configured by three or more members.
- the ultrasonic treatment and the electrosurgical treatment on the living tissue grasped by the grasping member and the probe are performed on substantially the same part of each other. Applied. Therefore, by supplying ultrasonic vibration and bipolar high-frequency current simultaneously or selectively to a living tissue, it is possible to expect improvement in coagulation and incision ability that cannot be obtained by a single procedure.
- FIG. 9 and FIG. 10 are explanatory diagrams showing modifications of the second and third embodiments.
- 9 and 10 are views of the gripping member also viewed from the probe side force.
- the mesh portion indicates the exposed part of the current-carrying member!
- the gripping member is composed of a current-carrying member 50 having a rectangular planar shape and six grease members 51a to 51f arranged in a distributed manner on one surface of the current-carrying member 50. .
- one surface of the energizing member 50 is exposed in the gap between the grease members 5 la to 5 If.
- FIG. 9 shows an example in which the resin member is divided into six, it is clear that the number of divisions is not limited to this.
- the gripping member is constituted by a current-carrying member and a resin member 61 having a rectangular planar shape.
- the resin member 61 has circular openings at six power points, and the portions 60a to 60f of the current-carrying members are exposed at the openings as shown by the mesh lines.
- the example of FIG. 10 is one in which circular holes are formed in the grease member in order to expose the current-carrying member.
- the number of force holes shown in the example in which holes are made in six locations of the grease member is not limited to this.
Abstract
超音波振動を発生する超音波振動子と、前記超音波振動子にて発生した超音波振動を先端部に伝達する超音波プローブと、前記超音波プローブの先端部に対して近接位置と離間位置とを移動して処置対象の生体組織を前記超音波プローブの先端部との間に把持可能に構成された把持部材と、前記把持部材に設けられて前記生体組織へ高周波電流を供給する導電性の材料からなる導電部材と、前記導電部材と前記超音波プローブとの間の前記把持部材に設けられて、前記導電部材と前記超音波プローブとの接触を阻止すると共に前記導電部材の前記超音波プローブ側の一面の一部を露出させる形状に形成された非導電性の材料からなる非導電部材と、を具備し、生体組織に対して高周波電流を効果的に通電可能にする。
Description
明 細 書
手術器具
技術分野
[0001] 本発明は、超音波振動によって生体組織の切除あるいは凝固する処置にカ卩え、高 周波電流による処置を行える手術器具に関する。
背景技術
[0002] 従来、体腔内に細長の挿入部を挿入することにより、体腔内臓器等を観察する内 視鏡を利用し、必要に応じて内視鏡観察下で各種治療処理を可能にする手術器具 が開発されている。
[0003] 例えば、特開 2004— 216180公報(以下、文献 1)では、超音波凝固切開装置と 電気メスを組合わせた装置が開示されている。文献 1の装置は、処置部が、把持部 材とプローブからなり、組織をこの両部材で把持して、プローブを超音波振動すること により、該当組織を凝固切開するものである。また、把持部材とプローブの間に、生 体組織を把持して把持部材あるいはプローブの一方又は両方に電気メスの高周波 電流を通電することで、組織を凝固する手法も開示されている。更に、電気メスの対 極板を使用することなぐ生体組織を把持部材とプローブとによって把持し、把持部 材とブロープの間に電気メスの高周波電流を流して処置する手法も開示されている。
[0004] また、特開平 11— 318919号公報 (以下、文献 2)においても、超音波凝固切開装 置と電気メスを組合わせた装置が開示されている。文献 2の装置は、処置部が、ジョ 一とプローブからなり、組織をこの両部材で把持して、プローブを超音波振動すること により、該当組織を凝固切開するものである。また、ジョ一とプローブの間に、生体組 織を把持して、ジョ一とプローブの間に電気メスの高周波電流を通電することで、組 織を凝固する手法も開示されている。また、文献 2の装置には、出力制御用のフットス イッチを接続することができ、一方のペダルを踏むと高い超音波出力と低い電気メス 出力が発生し、他方のペダルを踏むと低い超音波出力と高い電気メス出力が発生す る出力制御の手法が開示されている。
[0005] また、特開 2000— 126198公報(以下、文献 3)においては、超音波凝固切開用の
シザースの構成に関する発明が開示されている。文献 3の装置では、ジョ一とプロ一 ブの間に、生体組織を把持して、プローブを超音波振動することで、生体組織を凝固 、切開する。また、生体組織を適切に凝固、切開するために、ジョ一の生体組織と接 触する部分 (プローブ側)は、榭脂で構成されて 、ることが開示されて 、る。
[0006] 上述したように、文献 1, 2においては、把持部材 (ジョ一)とプローブの間に高周波 電流を通電して、生体組織を凝固する装置が開示されている。このような超音波凝固 切開処置具の把持部材は、通常、文献 3に示されているように、榭脂で構成されてい る。
[0007] 把持部材を構成する榭脂は、プローブ先端との間で生体組織を適切に把持して、 プローブの超音波振動による摩擦熱で組織をタンパク質変性させ、凝固切開するの に必要不可欠なものである。更に、生体組織を切除後に、把持部材とプローブとが接 触することになるが、超音波振動するプローブに把持部材が接触しても、機器の磨耗 を最小限に抑え、破壊を防ぐ効果を有するものである。
[0008] ところで、電気メス利用時には、把持部材とプローブの間の生体組織に対して高周 波電流を通電する必要がある。し力しながら、榭脂の電気抵抗は比較的高いことから 、高周波電流を流しにくぐ電気メスとしての動作を阻害してしまうという問題があった
[0009] 本発明は力かる問題点に鑑みてなされたものであって、把持部材を榭脂と通電部 材とによって構成することにより、把持部材とプローブとの間に把持された生体組織 に対して高周波電流を効果的に通電可能にすることができる手術器具を提供するこ とを目的とする。
発明の開示
課題を解決するための手段
[0010] 本発明に係る手術器具は、超音波振動を発生する超音波振動子と、前記超音波 振動子にて発生した超音波振動を先端部に伝達する超音波プローブと、前記超音 波プローブの先端部に対して近接位置と離間位置とを移動して処置対象の生体組 織を前記超音波プローブの先端部との間に把持可能に構成された把持部材と、前 記把持部材に設けられて前記生体組織へ高周波電流を供給する導電性の材料から
なる導電部材と、前記導電部材と前記超音波プローブとの間の前記把持部材に設け られて、前記導電部材と前記超音波プローブとの接触を阻止すると共に前記導電部 材の前記超音波プローブ側の一面の一部を露出させる形状に形成された非導電性 の材料力もなる非導電部材と、を具備したことを特徴とする。
図面の簡単な説明
[0011] [図 1]本発明の第 1の実施の形態に係る手術器具である電気メス付き超音波シザース を示す説明図。
[図 2]図 1の手術器具を含むシステム全体の構成を示すブロック図。
[図 3]実施の形態の作用を説明するための説明図。
[図 4]実施の形態の作用を説明するための説明図。
[図 5]本発明の第 2の実施の形態を示す説明図。
[図 6]本発明の第 2の実施の形態を示す説明図。
[図 7]本発明の第 3の実施の形態を示す説明図。
[図 8]本発明の第 3の実施の形態を示す説明図。
[図 9]第 2及び第 3の実施の形態の変形例を示す説明図。
[図 10]第 2及び第 3の実施の形態の変形例を示す説明図。
発明を実施するための最良の形態
[0012] 以下、図面を参照して本発明の実施の形態について詳細に説明する。図 1は本発 明の第 1の実施の形態に係る手術器具である電気メス付き超音波シザースを示す説 明図である。また、図 2は図 1の手術器具を含むシステム全体の構成を示すブロック 図である。
[0013] 先ず、図 2を参照してシステム全体の構成について説明する。
[0014] 電気メス付き超音波シザース 4は、超音波ケーブル 3を介して超音波出力装置 2に 接続される。超音波出力装置 2には、超音波フットスィッチ 1が接続されている。超音 波フットスィッチ 1は、ユーザ操作に基づいて、超音波出力装置 2に対して、超音波 出力のオンオフを指示する。超音波出力装置 2は、超音波フットスィッチ 1によるオン オフの指示に基づいて、超音波出力を発生する。この超音波は、超音波ケーブル 3 を介して電気メス付き超音波シザース 4に供給されるようになって 、る。
[0015] また、電気メス付き超音波シザース 4は、電気メスケーブル 7を介して電気メス出力 装置 6に接続される。電気メス出力装置 6には、電気メスフットスィッチ 5が接続されて いる。電気メスフットスィッチ 5は、ユーザ操作に基づいて、電気メス出力装置 6に対し て、高周波電流出力のオンオフを指示する。電気メス出力装置 6は、電気メスフットス イッチ 5によるオンオフの指示に基づいて、高周波電流を発生する。この高周波電流 は、電気メスケーブル 7を介して電気メス付き超音波シザース 4に供給されるようにな つている。
[0016] 電気メス付き超音波シザース 4は、供給された超音波出力を、後述する超音波振動 子 12により、電気エネルギーから機械的エネルギーに変換し、後述する先端処置部 15において超音波振動を発生させる。また、電気メス付き超音波シザース 4は、供給 された高周波電流を、先端処置部 15から生体組織に伝達する。
[0017] 図 1は電気メス付き超音波シザース 4の具体的な構成を示して ヽる。
[0018] 図 1において、電気メス付き超音波シザース 4には、振動子 12が内蔵されている。こ の振動子 12には、超音波ケーブル 3を介して、超音波出力装置 2からの超音波出力 が供給される。振動子 12は、超音波出力装置 2で発生した超音波出力である電気信 号を機械的振動に変換することで超音波振動する。
[0019] 振動子 12は超音波プローブ 13の一端が接続されている。プローブ 13の他端は電 気メス付き超音波シザース 4の本体 16から突出しており、プローブ 13は、振動子 12 に発生した超音波振動が伝達されるようになって!/ヽる。
[0020] また、電気メス付き超音波シザース 4には、伝達部材 10も内蔵されて ヽる。電気メス 出力装置 6からのパイボーラ高周波電流は、電気メスケーブル 7を介して、振動子 12 及び伝達部材 10に入力される。振動子 12は、入力されたバイポーラ高周波電流を プローブ 13に伝達するようになっている。
[0021] 導電材料で構成された伝達部材 10は先端側が電気メス付き超音波シザース 4の本 体 6先端に延出している。伝達部材 10の先端は、把持部材 11に接続されている。伝 達部材 10は、入力されたパイボーラ高周波電流を把持部材 11に伝達するようになつ ている。
[0022] プローブ 13の先端部と把持部材 11とによって先端処置部 15が構成される。先端
処置部 15を構成するプローブ 13の先端部には超音波振動が伝達され、プローブ 13 の先端部に生体組織が接触することで、超音波振動を生体組織に伝達することがで きるようになつている。
[0023] 本実施の形態においては、先端処置部 15を構成する把持部材 11は、導電部材と しての通電部材 1 la及び非導電部材としての榭脂部材 1 lbによる 2層構造を有する 。通電部材 11aは、伝達部材 10が接続されており、伝達部材 10を介して高周波電 流が供給されるようになっている。通電部材 11aは、プローブ 13側の一面に榭脂部 材 l ibが取り付けられている。榭脂部材 l ibは、通電部材 11aよりもサイズが小さぐ 電気メス付き超音波シザース 4の先端側にぉ 、て、通電部材 1 laは榭脂部材 1 lbに 覆われて 、な 、部分を有する。
[0024] 把持部材 11は、基端側が図示しない枢軸によって回動自在に支持されている。把 持部材 11が枢軸を中心にプローブ 13側に回動することによって、プローブ 13の先 端部と把持部材 11とは対畤可能に構成されている。この場合において、把持部材 1 1の榭脂部材 l ibは、先端がプローブ 13の先端力も所定長さの位置に位置し、通電 部材 11aは、先端がプローブ 13の先端と略等しい位置に位置する。これにより、把持 部材 11の通電部材 11aは、先端側の所定長さの部分が榭脂部材 l ibを介すること なぐプローブ 13に対向することになる。把持部材 11が枢軸を中心にプローブ 13側 に回動することによって、把持部材 11とプローブ 13との間に生体組織を挟み込むこ とができるようになって!/、る。
[0025] 即ち、プローブ 13に面して、把持部材 11には榭脂部材 l ibが構成されており、榭 脂部材 l ibとプローブ 13との間に生体組織を挟み込むことができる。また、把持部材 11の先端側は、榭脂部材 1 lbに覆われて 、な 、通電部材 1 laがプローブ 13に面し ており、プローブ 13と通電部材 11aとの間にも生体組織を挟み込むことができるよう になっている。
[0026] つまり、本実施の形態においては、プローブ 13と榭脂部材 l ibとの間に生体組織 を挟み込むことができると共に、プローブ 13と通電部材 11aとの間にも生体組織を挟 み込むことができるようになって!/、る。
[0027] プローブ 13と榭脂部材 l ibとの間に生体組織を挟み込むことによって、プローブ 1
3の超音波振動を生体組織に伝達して、生体組織を凝固及び切開処置する等の超 音波処置を施すことができる。また、プローブ 13と通電部材 11aとの間に生体組織を 挟み込むことによって、プローブ 13と通電部材 11aとの間の生体組織に高周波電流 を流すことができ、焼灼、凝固等の電気メス処置を施すことができる。
[0028] 次に、このように構成された実施の形態の作用について図 3及び図 4を参照して説 明する。図 3及び図 4は夫々生体組織に対する超音波を用いた処置及び電気メスを 用いた処置を説明するための説明図である。
[0029] いま、生体組織に対して超音波処置を施すものとする。この場合には、プローブ 13 と把持部材 11の榭脂部材 l ibとの間に、生体組織を挟み込む。図 3はこの状態を示 しており、生体組織 23は、先端処置部 15において、プローブ 13の先端部と榭脂部 材 l ibとの間に挟み込まれている。この状態で、オペレータが超音波フットスィッチ 1 を操作すると、音波出力装置 2は超音波出力を発生する。この超音波は、超音波ケ 一ブル 3を介して電気メス付き超音波シザース 4に供給される。
[0030] 電気メス付き超音波シザース 4では、振動子 12に超音波出力が与えられる。振動 子 12は超音波出力を超音波振動に変換してプローブ 13に伝達する。プローブ 13に 伝達された超音波振動は、プローブ 13の先端部から、榭脂部材 l ibとプローブ 13と の間に挟まれた生体組織に伝達される。
[0031] 生体組織 23は、プローブ 13と榭脂部材 l ibとの間に挟み込まれている。榭脂部材 l ibは、榭脂の特性によって、プローブ 13の先端部との間で適切に生体組織 23を 把持することを可能にする。これにより、プローブ 13の超音波振動による摩擦熱によ つて、生体組織 23を確実に凝固、切開処理することができる。
[0032] また、生体組織に対して電気メス処置を施すものとする。この場合には、プローブ 2 3と把持部材 11の通電部材 11aとの間に、生体組織を挟み込む。図 4はこの状態を 示しており、生体組織 23 'は、先端処置部 15において、プローブ 13の先端部と通電 部材 11 aとの間に挟み込まれている。この状態で、オペレータが電気メスフットスイツ チ 5を操作すると、電気メス出力装置 6は高周波電流を出力する。電気メス出力装置 6からの高周波電流は、電気メスケーブル 7を介して電気メス付き超音波シザース 4に 供給される。
[0033] 電気メス付き超音波シザース 4では、高周波電流は伝達部材 10及び振動子 12に 与えられる。伝達部材 10は高周波電流を先端側に伝送して把持部材 11の通電部 材 11aに与える。また、振動子 12に供給された高周波電流はプローブ 13に伝達され る。こうして、プローブ 13と通電部材 11aとの間に挟み込まれた生体組織 23 'に高周 波電流を流して、電気メス処置が行われる。
[0034] 本実施の形態にぉ 、ては、通電部材 1 laが先端側にぉ 、て榭脂部材 1 lbに覆わ れることなくプローブ 13に面していることから、生体組織を 23 'をプローブ 23と把持 部材 11の通電部材 11aとの間に挟み込む場合においても、生体組織 23 'を榭脂部 材 1 lbを介することなぐ直接通電部材 1 laに接触させることができる。
[0035] 即ち、生体組織 23 'とプローブ 13との間及び生体組織 23 'と通電部材 11aとの間 には高抵抗の部材が介在しないので、生体組織 23 'に効果的に高周波電流を流す ことができ、高効率の電気メス処置が可能である。
[0036] また、通電部材 11aとプローブ 13との間には榭脂部材 l ibが設けられており、把持 部材 11とプローブ 13とを生体組織 23 'を介在させることなく対畤させた場合でも、通 電部材 11aとプローブ 13とは接触しない。これにより、バイポーラ高周波電流による 電気メス処置が可能である。
[0037] このように本実施の形態にお!、ては、把持部材を通電部材と榭脂部材との 2層構造 とし、榭脂部材の先端側の長さを通電部材よりも短くすることにより、超音波凝固切開 時には榭脂部材とプローブとの間に生体組織を把持し、電気メス処置時には通電部 材とプローブとの間に生体組織を把持することを可能にする。これにより、電気メス処 置時において高周波電流を生体組織に流しやすくする。こうして、伝達超音波凝固 切開機能を損なうことなぐパイポーラ高周波電流による、生体組織の凝固等を可能 にしている。
[0038] なお、プローブ 13の軸方向に対する榭脂部材 l ibの長さを通電部材 11aの長さよ りも短くしておけばよぐこの榭脂部材 1 lbの通電部材 1 laに対する長さを変えること で、超音波振動により生体組織を凝固切開できる長さ、パイボーラ高周波電流より生 体組織を凝固できる長さを、変更することができることは言うまでもない。
[0039] また、本実施の形態における把持部材を用いてモノポーラ高周波電流を利用した
電気メス装置を構成することも可能である。
[0040] 図 5及び図 6は本発明の第 2の実施の形態を示す説明図である。図 5は図 3に対応 した説明図であり、図 6は図 5をプローブ 13の先端方向から見た状態を示している。
[0041] 本実施の形態は把持部材 11に代えて把持部材 31を採用した点が第 1の実施の形 態と異なる。
[0042] 把持部材 31は、通電部材 3 la及び榭脂部材 3 lb, 31cによる 2層構造を有する。
通電部材 31aには、伝達部材 10 (図 1参照)が接続されており、伝達部材 10を介して 高周波電流が供給されるようになっている。通電部材 11aは、プローブ 13側の一面 に榭脂部材 31b, 31cが取り付けられている。榭脂部材 31b, 31cは、通電部材 31a よりもサイズが小さぐ通電部材 31aは榭脂部材 31b, 31cに覆われていない部分を 有する。
[0043] 把持部材 31は、基端側が図示しない枢軸によって回動自在に支持されている。把 持部材 31が枢軸を中心にプローブ 13側に回動することによって、プローブ 13の先 端部と把持部材 31とは対畤可能に構成されて 、る。把持部材 31が枢軸を中心にプ ローブ 13側に回動することによって、把持部材 31とプローブ 13との間に生体組織を 挟み込むことができるようになって!/、る。
[0044] 本実施の形態においては、把持部材 31の榭脂部材 31b, 31cは、夫々通電部材 3 laの基端側と先端側とに設けられており、通電部材 31aのプローブ 13軸方向の中央 には榭脂部材 31b, 31cが設けられておらず、この中央部分において、通電部材 31 aは表面が露出している。これにより、把持部材 31の通電部材 31aは、中央の所定長 さの部分が榭脂部材 31b, 31cを介することなぐプローブ 13に対向することになる。
[0045] このように構成された実施の形態にお!、ては、超音波処置及び電気メス処置の!/、 ずれの場合においても、生体組織 33をプローブ 13と榭脂部材 31b, 31c相互間に 挟み込む。
[0046] 図 5に示すように、生体組織 33をプローブ 13と把持部材 31との間に挟み込んだ場 合には、生体組織 33が榭脂部材 31b, 31cに押されて変形して、生体組織 33の一 部が榭脂部材 31b, 31c相互間に入り込み、通電部材 31aに接触する。つまり、本実 施の形態においては、プローブ 13と榭脂部材 31b, 31cとの間に生体組織 33を挟み
込むことによって、生体組織 33はプローブ 13及び榭脂部材 31b, 31cだけでなく通 電部材 31aにも直接接触することになる。
[0047] この状態で、オペレータが超音波フットスィッチ 1を操作すると、音波出力装置 2から の超音波出力によって、振動子 12に発生した超音波振動がプローブ 13に伝達され る。プローブ 13に伝達された超音波振動によって、プローブ 13と榭脂部材 3 lb, 31 cとの間に挟まれた生体組織 33が超音波凝固、切開処置される。
[0048] 超音波振動による凝固切開が完了した場合でも、プローブ 13と通電部材 31aとの 間には榭脂部材 31b, 31cが介在しており、プローブ 13と通電部材 31aとが接触する ことはない。これにより、本実施の形態においても第 1の実施の形態と同様に、電気メ ス付き超音波シザース 4が短絡によって破壊されることはない。
[0049] また、図 5の状態において、オペレータが電気メスフットスィッチ 5を操作すると、電 気メス出力装置 6からの高周波電流が伝達部材 10及び振動子 12に与えられる。伝 達部材 10及び振動子 12に与えられた高周波電流は、夫々通電部材 31a及びプロ ーブ 13に伝達され、プローブ 13と通電部材 31との間に挟み込まれた生体組織 33を 流れる。こうして、生体組織 33に電気メス処置が施される。
[0050] この場合には、生体組織 33がプローブ 13と通電部材 31aとの両方に直接接触して いるので、生体組織 33には効率よく高周波電流が流れ、高効率の電気メス処置が可 能である。
[0051] このように本実施の形態においては、把持部材を通電部材と複数の榭脂部材との 2 層構造とし、榭脂部材相互間において通電部材を露出させる構成としていることから 、榭脂部材とプローブとの間に生体組織を把持可能にすると同時に、生体組織を通 電部材とプローブとに直接接触させることができる。これにより、電気メス処置時にお いて高周波電流を生体組織に流しやすくする。こうして、伝達超音波凝固切開機能 を損なうことなぐノ ィポーラ高周波電流による、高効率の電気メス処置を可能にして いる。
[0052] なお、上記実施の形態にお!、ては、榭脂部材を 2つの部材で構成する例を説明し た力 2つ以上の部材で構成すれば、同様の効果が得られることは明らかである。
[0053] 図 7及び図 8は本発明の第 3の実施の形態を示す説明図である。図 7及び図 8は夫
々図 5及び図 6に対応したものである。
[0054] 本実施の形態は把持部材 31に代えて把持部材 41を採用した点が第 2の実施の形 態と異なる。
[0055] 把持部材 41は、通電部材 41a及び榭脂部材 41b, 41cによる 2層構造を有する。
通電部材 41aには、伝達部材 10 (図 1参照)が接続されており、伝達部材 10を介して 高周波電流が供給されるようになっている。通電部材 11aは、プローブ 13側の一面 に榭脂部材 41b, 41cが取り付けられている。榭脂部材 41b, 41cは、通電部材 41a よりもサイズが小さぐ通電部材 41aは榭脂部材 41b, 41cに覆われていない部分を 有する。
[0056] 把持部材 41は、基端側が図示しない枢軸によって回動自在に支持されている。把 持部材 41が枢軸を中心にプローブ 13側に回動することによって、プローブ 13の先 端部と把持部材 41とは対畤可能に構成されて 、る。把持部材 41が枢軸を中心にプ ローブ 13側に回動することによって、把持部材 41とプローブ 13との間に生体組織を 挟み込むことができるようになって!/、る。
[0057] 本実施の形態においては、把持部材 41の榭脂部材 4 lb, 41cは、夫々通電部材 4 laの両側に設けられており、通電部材 41aのプローブ 13軸方向に垂直な方向の中 央には榭脂部材 41b, 41cが設けられておらず、この中央部分において、通電部材 4 laは表面が露出している(図 8参照)。これにより、把持部材 41の通電部材 41aは、 中央の所定長さの部分が榭脂部材 41b, 41cを介することなぐプローブ 13に対向 すること〖こなる。
[0058] このように構成された実施の形態にお!、ては、超音波処置及び電気メス処置の!/、 ずれの場合においても、生体組織 43をプローブ 13と榭脂部材 41b, 41c相互間に 挟み込む。
[0059] 図 8に示すように、生体組織 43をプローブ 13と把持部材 41との間に挟み込んだ場 合には、生体組織 43が榭脂部材 41b, 41cに押されて変形して、生体組織 43の一 部が榭脂部材 41b, 41c相互間に入り込み、通電部材 41aに接触する。つまり、本実 施の形態においては、プローブ 13と榭脂部材 41b, 41cとの間に生体組織 43を挟み 込むことによって、生体組織 43はプローブ 13及び榭脂部材 41b, 41cだけでなく通
電部材 41aにも直接接触することになる。
[0060] この状態で、オペレータが超音波フットスィッチ 1を操作すると、音波出力装置 2から の超音波出力によって、振動子 12に発生した超音波振動がプローブ 13に伝達する 。プローブ 13に伝達された超音波振動によって、プローブ 13と榭脂部材 41b, 41cと の間に挟まれた生体組織 43が超音波凝固、切開処置される。
[0061] 超音波振動による凝固切開が完了した場合でも、プローブ 13と通電部材 41aとの 間には榭脂部材 41b, 41cが介在しており、プローブ 13と通電部材 41aとが接触する ことはない。これにより、本実施の形態においても第 2の実施の形態と同様に、電気メ ス付き超音波シザース 4が短絡によって破壊されることはない。
[0062] また、図 8の状態において、オペレータが電気メスフットスィッチ 5を操作すると、電 気メス出力装置 6からの高周波電流が伝達部材 10及び振動子 12に与えられる。伝 達部材 10及び振動子 12に与えられた高周波電流は、夫々通電部材 41a及びプロ ーブ 13に伝達され、プローブ 13と通電部材 4 laとの間に挟み込まれた生体組織 43 を流れる。こうして、生体組織 43に電気メス処置が施される。
[0063] この場合には、生体組織 43がプローブ 13と通電部材 41aとの両方に直接接触して いるので、生体組織 43には効率よく高周波電流が流れ、高効率の電気メス処置が可 能である。
[0064] このように本実施の形態においても第 2の実施の形態と同様の効果が得られる。な お、上記実施の形態においては、榭脂部材を 2つの部材で構成する例を説明したが 、 3つ以上の部材で構成しても同様の効果が得られることは明らかである。
[0065] また、上記第 2及び第 3の実施の形態にぉ 、ては、把持部材とプローブとで把持さ れた生体組織に対する超音波処置及び電気メス処置は、相互に略同一部位に対し て施される。従って、超音波振動とバイポーラ高周波電流とを同時に、又は、選択的 に生体組織に供給することで、単一の処置では得られない凝固切開能力の向上を 期待することができる。
[0066] 図 9及び図 10は上記第 2及び第 3の実施の形態の変形例を示す説明図である。図 9及び図 10は把持部材をプローブ側力も見た図である。図 9及び図 10において網線 部は通電部材の露出部分を示して!/、る。
[0067] 図 9においては、把持部材は、平面形状が長方形状の通電部材 50と、この通電部 材 50の一面に分散して配置される 6つの榭脂部材 51a〜51fによって構成されてい る。網線にて示すように、榭脂部材 5 la〜5 If相互間の隙間において通電部材 50の 一面が露出している。
[0068] 生体組織をプローブと図 9の把持部材とで挟み込むことにより、生体組織の一部が 図 9の網線部に接触する。こうして、図 9に示す把持部材を使用した場合でも、上記 図 5乃至図 8に示す実施の形態と同様の作用効果を得ることができる。
[0069] このように、図 9の例は、通電部材を露出させるために、榭脂部材に縦横組み合わ せて溝を形成したものである。なお、図 9では榭脂部材を 6分割した例を示したが、分 割数はこれに限定されるものではないことは明らかである。
[0070] 一方、図 10においては、把持部材は、平面形状が長方形状の通電部材及び榭脂 部材 61によって構成されている。榭脂部材 61は 6力所に円形状の開孔を有しており 、この開孔部において、網線に示すように、通電部材の各部 60a〜60fが露出してい る。
[0071] 生体組織をプローブと図 10の把持部材とで挟み込むことにより、生体組織の一部 が図 10の網線部に接触する。こうして、図 10に示す把持部材を使用した場合でも、 上記図 5乃至図 8に示す実施の形態と同様の作用効果を得ることができる。
[0072] このように、図 10の例は、通電部材を露出させるために、榭脂部材に円形状の開 孔を形成したものである。なお、図 10では榭脂部材の 6箇所に穴を開けた例を示し た力 穴の数はこれに限定されるものではないことは明らかである。
Claims
[1] 超音波振動を発生する超音波振動子と、
前記超音波振動子にて発生した超音波振動を先端部に伝達する超音波プローブ と、
前記超音波プローブの先端部に対して近接位置と離間位置とを移動して処置対象 の生体組織を前記超音波プローブの先端部との間に把持可能に構成された把持部 材と、
前記把持部材に設けられて前記生体組織へ高周波電流を供給する導電性の材料 からなる導電部材と、
前記導電部材と前記超音波プローブとの間の前記把持部材に設けられて、前記導 電部材と前記超音波プローブとの接触を阻止すると共に前記導電部材の前記超音 波プローブ側の一面の一部を露出させる形状に形成された非導電性の材料力 なる 非導電部材と、
を具備したことを特徴とする手術器具。
[2] 前記非導電部材は、前記導電部材よりも面積が小さ!、ことを特徴とする請求項 1に 記載の手術器具。
[3] 前記非導電部材は、前記導電部材を露出させるための溝形状を有することを特徴 とする請求項 1に記載の手術器具。
[4] 前記溝形状は、直線状であることを特徴とする請求項 3に記載の手術器具。
[5] 前記溝形状は、曲線状であることを特徴とする請求項 3に記載の手術器具。
[6] 前記非導電部材は、前記導電部材を露出させるために複数の部分に分割されて
V、ることを特徴とする請求項 1に記載の手術器具。
[7] 前記把持部材は、所定の支持部材に回動自在に支持されることで、前記超音波プ ローブの先端部に対して近接位置と離間位置とを移動可能であることを特徴とする 請求項 1に記載の手術器具。
[8] 前記導電部材は、前記超音波プローブの軸方向には前記非導電部材よりも長 、こ とを特徴とする請求項 1に記載の手術器具。
[9] 前記導電部材は、前記超音波プローブの軸方向には複数の部分に分割されて 、
ることを特徴とする請求項 8に記載の手術器具。
[10] 前記導電部材は、前記超音波プローブの軸方向に直交する方向には前記非導電 部材よりも長ぐ且つ、前記超音波プローブの軸方向に直交する方向には複数の部 分に分割されていることを特徴とする請求項 1に記載の手術器具。
[11] 前記超音波振動子に超音波出力を供給する超音波出力装置と、
前記前記超音波プローブ及び前記導電部材に高周波電流を供給する電気メス出 力装置とを更に具備したことを特徴とする手術器具。
Priority Applications (2)
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---|---|---|---|
US11/915,657 US20090270771A1 (en) | 2005-06-01 | 2006-05-12 | Surgical instrument |
CN2006800174257A CN101180002B (zh) | 2005-06-01 | 2006-05-12 | 手术器械 |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
JP2005161728A JP4398406B2 (ja) | 2005-06-01 | 2005-06-01 | 手術器具 |
JP2005-161728 | 2005-06-01 |
Publications (1)
Publication Number | Publication Date |
---|---|
WO2006129465A1 true WO2006129465A1 (ja) | 2006-12-07 |
Family
ID=37481396
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Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/JP2006/309588 WO2006129465A1 (ja) | 2005-06-01 | 2006-05-12 | 手術器具 |
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US (1) | US20090270771A1 (ja) |
JP (1) | JP4398406B2 (ja) |
CN (1) | CN101180002B (ja) |
WO (1) | WO2006129465A1 (ja) |
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Also Published As
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JP2006334094A (ja) | 2006-12-14 |
CN101180002B (zh) | 2010-05-19 |
JP4398406B2 (ja) | 2010-01-13 |
CN101180002A (zh) | 2008-05-14 |
US20090270771A1 (en) | 2009-10-29 |
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