WO2014148281A1 - 処置具 - Google Patents
処置具 Download PDFInfo
- Publication number
- WO2014148281A1 WO2014148281A1 PCT/JP2014/056001 JP2014056001W WO2014148281A1 WO 2014148281 A1 WO2014148281 A1 WO 2014148281A1 JP 2014056001 W JP2014056001 W JP 2014056001W WO 2014148281 A1 WO2014148281 A1 WO 2014148281A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- distal end
- rotating member
- clamping member
- treatment
- proximal end
- Prior art date
Links
Images
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
- A61B18/1445—Probes having pivoting end effectors, e.g. forceps at the distal end of a shaft, e.g. forceps or scissors at the end of a rigid rod
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/03—Automatic limiting or abutting means, e.g. for safety
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2926—Details of heads or jaws
- A61B2017/2932—Transmission of forces to jaw members
- A61B2017/2933—Transmission of forces to jaw members camming or guiding means
- A61B2017/2936—Pins in guiding slots
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/29—Forceps for use in minimally invasive surgery
- A61B2017/2926—Details of heads or jaws
- A61B2017/2932—Transmission of forces to jaw members
- A61B2017/2939—Details of linkages or pivot points
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
- A61B17/320092—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw
- A61B2017/320093—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw additional movable means performing cutting operation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
- A61B17/320092—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw
- A61B2017/320095—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw with sealing or cauterizing means
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- 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
- A61B2018/1452—Probes having pivoting end effectors, e.g. forceps including means for cutting
- A61B2018/1455—Probes having pivoting end effectors, e.g. forceps including means for cutting having a moving blade for cutting tissue grasped by the jaws
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/03—Automatic limiting or abutting means, e.g. for safety
- A61B2090/033—Abutting means, stops, e.g. abutting on tissue or skin
- A61B2090/034—Abutting means, stops, e.g. abutting on tissue or skin abutting on parts of the device itself
- A61B2090/035—Abutting means, stops, e.g. abutting on tissue or skin abutting on parts of the device itself preventing further rotation
Definitions
- the present invention relates to a treatment instrument having a grasping surface for grasping a living tissue.
- US 2010/0057117 A1 discloses a first holding member that can be opened and closed with respect to a second holding member (probe).
- the first clamping member is provided with a rotating member having a biological tissue gripping surface for clamping the biological tissue with the second clamping member. For this reason, it is possible to hold the living tissue with a more uniform force between the living tissue holding surface of the rotating member and the living tissue holding surface of the second holding member.
- the rotating member provided in the first clamping member rotates, when performing an operation of grasping the living tissue, the living tissue may easily escape to the distal end side of the rotating member.
- An object of the present invention is to provide a treatment instrument that can prevent the living tissue from escaping to the distal end side of the rotating member as much as possible when performing an operation of grasping the living tissue.
- a treatment instrument capable of grasping a living tissue has a distal end portion, a proximal end portion, and a longitudinal axis defined by the distal end portion and the proximal end portion, and can be opened and closed relative to each other.
- First and second clamping members and supported between the distal end portion and the proximal end portion of the first clamping member, in a direction perpendicular to the longitudinal axis and in the opening and closing direction of the first and second clamping members.
- a rotation axis extending in a direction orthogonal to the first direction and a second direction opposite to the first direction, the front end close to the front end of the first clamping member and the first direction can be rotated.
- a rotating member having a proximal end adjacent to a proximal end portion of one clamping member, the rotating shaft being supported on a side close to the distal end including the distal end and a central position of the proximal end, and the rotating member A first gripping surface that is provided on the side close to the second clamping member and grips the living tissue; A second gripping surface that is provided on the side of the second clamping member that is close to the pivoting member and that faces the first gripping surface and cooperates with the first gripping surface of the pivoting member to grip a living tissue. And have.
- FIG. 1 is a schematic diagram showing a treatment system according to the first to third embodiments.
- FIG. 2A is a schematic diagram illustrating the structure of the shaft and the treatment unit of the treatment tool according to the first embodiment, in a state where the treatment unit is closed.
- FIG. 2B is a schematic diagram illustrating the structure of the shaft and the treatment portion of the treatment tool according to the first embodiment, and showing a state in which the treatment portion is opened.
- FIG. 3A is a schematic top view showing a first holding member of the treatment portion of the treatment tool according to the first embodiment.
- FIG. 3B is a schematic top view showing a state in which the rotating member is attached to the first holding member of the treatment portion of the treatment instrument according to the first embodiment.
- FIG. 1 is a schematic diagram showing a treatment system according to the first to third embodiments.
- FIG. 2A is a schematic diagram illustrating the structure of the shaft and the treatment unit of the treatment tool according to the first embodiment, in a state where the treatment unit is closed.
- FIG. 4A is a schematic diagram illustrating a rotating member of the treatment portion of the treatment tool according to the first embodiment from the first gripping surface and the first high-frequency electrode side.
- FIG. 4B is a schematic longitudinal sectional view of the rotating member of the treatment portion of the treatment instrument according to the first embodiment, taken along line 4B-4B in FIG. 4A.
- FIG. 4C is a schematic cross-sectional view taken along line 4C-4C in FIGS. 4A and 4B of the rotating member of the treatment portion of the treatment instrument according to the first embodiment.
- FIG. 5A is a schematic view showing the second holding member of the treatment portion of the treatment tool according to the first embodiment from the second gripping surface and the second high-frequency electrode side.
- FIG. 5B is a schematic longitudinal sectional view of the second clamping member of the treatment portion of the treatment tool according to the first embodiment, taken along line 5B-5B in FIG. 5A.
- 5C is a schematic cross-sectional view of the second holding member of the treatment portion of the treatment tool according to the first embodiment, taken along line 5C-5C in FIG. 5A.
- FIG. 6A shows a state in which the first holding member of the treatment portion of the treatment instrument according to the first embodiment is being closed with respect to the second holding member, and the first holding surface of the rotating member is attached to the living tissue. It is the schematic which shows the moment which contacted.
- FIG. 6B shows a state in which the first holding member of the treatment portion of the treatment instrument according to the first embodiment is being closed with respect to the second holding member, and the first gripping surface of the rotating member is attached to the living tissue. It is the schematic which shows the state rotated so that the front-end
- FIG. 6C shows the first gripping surface of the rotating member and the second gripping surface of the second clamping member when the first clamping member of the treatment portion of the treatment instrument according to the first embodiment is closed with respect to the second clamping member. It is the schematic which shows the state which hold
- FIG. 7A shows the first gripping surface and the second clamping member of the rotating member in a state where the first clamping member of the treatment portion of the treatment instrument according to the modification of the first embodiment is closed with respect to the second clamping member. It is the schematic which shows the relationship with this 2nd holding surface, and shows the state which brought the rotation axis
- FIG. 7B is an example of a treatment portion of a treatment tool that is not preferable, and the first holding surface of the rotating member and the second holding member second in a state where the first holding member is closed with respect to the second holding member.
- FIG. 8A shows the relationship between the first clamping member and the rotating member of the treatment portion of the treatment instrument according to the second embodiment, and the distal end portion of the first clamping member and the distal end of the rotating member are connected by a compression spring. It is the schematic which shows a state.
- FIG. 8B shows the relationship between the first clamping member and the rotating member of the treatment section of the treatment instrument according to the second embodiment, and the base end of the first clamping member and the base end of the rotating member are connected by a tension spring.
- FIG. 8C shows the relationship between the first holding member and the rotating member of the treatment portion of the treatment instrument according to the second embodiment, and a torsion spring is provided on the rotating shaft of the first holding member and the rotating member.
- FIG. 6 is a schematic view showing a state where an urging force can be generated so that the distal end of the rotating member is brought close to the second gripping surface and the proximal end of the rotating member is separated from the second gripping surface.
- FIG. 8D shows the relationship between the first clamping member and the rotating member of the treatment portion of the treatment instrument according to the second embodiment, and the base end of the first clamping member and the proximal end of the rotating member are connected by a leaf spring.
- FIG. 9A shows a state in which the first holding member of the treatment portion of the treatment instrument according to the second embodiment is being closed with respect to the second holding member, and the base end of the rotating member is first moved by the leaf spring. It is the schematic which shows the state which is trying to exhibit urging
- FIG. 9B shows a state in which the first holding member of the treatment portion of the treatment instrument according to the second embodiment is being closed with respect to the second holding member, and the base end of the rotating member is set to the first by the leaf spring.
- the urging force is exerted so as to be close to the proximal end portion of the clamping member, and the distal end of the rotating member is rotated so as to be close to the second gripping surface, and the proximal end of the rotating member is the second gripping surface.
- FIG. 9C is a schematic diagram illustrating a state in which the first clamping member of the treatment unit of the treatment instrument according to the second embodiment is closed with respect to the second clamping member.
- FIG. 10A shows a state in which a covering portion that covers the opposite side of the first holding member of the treatment portion of the treatment instrument according to the third embodiment with respect to the side on which the first gripping surface of the rotating member exists is arranged. It is a schematic top view shown.
- FIG. 10B shows a state in which the covering portion that covers the opposite side of the first holding member of the treatment portion of the treatment instrument according to the third embodiment with respect to the side where the first gripping surface of the rotation member exists is arranged.
- FIG. 10B is a schematic longitudinal sectional view taken along line 10B-10B in FIG. 10A.
- the first embodiment will be described with reference to FIGS. 1 to 7A.
- a treatment tool for performing treatment by applying energy to living tissue
- a linear type bipolar treatment tool 12 for performing treatment through the abdominal wall will be described as an example.
- the treatment system 10 includes a treatment tool (treatment tool) 12, an energy source 14, and a foot switch 16 having a pedal 16a.
- the treatment instrument 12 includes a handle 22, a shaft 24 having a central axis C, and a treatment portion 26.
- the energy source 14 is connected to the handle 22 via a cable 28.
- a foot switch 16 is connected to the energy source 14. When the operator (user) operates the pedal 16a of the foot switch 16 with his / her foot, ON / OFF of the supply of energy from the energy source 14 to the treatment portion 26 of the treatment instrument 12 is switched.
- the handle 22 is formed in a substantially L shape.
- a shaft 24 is disposed at one end (tip) 22 a of the handle 22.
- the cable 28 described above extends from the proximal end of the handle 22 substantially coaxial with the shaft 24.
- the other end 22b of the handle 22 is a gripping part that is gripped by the operator.
- the handle 22 includes a treatment section opening / closing knob (first operation element) 32 so as to be arranged in parallel with the other end 22b.
- a treatment section opening / closing knob 32 is disposed on the front side of the other end 22 b of the handle 22.
- the treatment portion opening / closing knob 32 can be rotated by a pivot shaft (not shown) inside the handle 22, that is, can be moved closer to and away from the other end of the handle 22.
- the treatment section opening / closing knob 32 is connected to a proximal end of an outer cylinder 44 (described later) of the shaft 24 at a substantially central portion of the handle 22.
- the handle 22 further includes a cutter driving knob (second operating element) 34 for moving a cutter 54 described later in a state where the handle 22 is juxtaposed with the treatment section opening / closing knob 32.
- the cutter driving knob 34 can be rotated inside the handle 22 by a pivot shaft (not shown), that is, can be moved close to and away from the other end 22 b of the handle 22.
- the cutter drive knob 34 is on the front side of the treatment section opening / closing knob 32 of the handle 22 and is connected to a base end of a drive rod 52 described later. For this reason, when the cutter drive knob 34 is brought close to the other end of the handle 22, the drive rod 52 is advanced along the axial direction to advance a cutter 54 described later, and the cutter drive knob 34 is moved to the other end of the handle 22. When separated from 22b, the drive rod 52 is retracted along the axial direction, and the cutter 54 is retracted.
- the shaft 24 includes an inner cylinder 42 and an outer cylinder 44 that is slidably disposed on the outer side of the inner cylinder 42. It is preferable that the center axes C of the inner cylinder 42 and the outer cylinder 44 coincide.
- the inner cylinder 42 and the outer cylinder 44 are preferably coated on the inner peripheral surface and the outer peripheral surface with a material having electrical insulation properties.
- the inner cylinder 42 is fixed to the handle 22 at its proximal end.
- the outer cylinder 44 is slidable along the axial direction of the inner cylinder 42.
- a drive rod 52 is disposed in the inner cylinder 42 of the shaft 24 (hollow portion) so as to be movable along the axial direction thereof.
- the central axis C of the drive rod 52 preferably coincides with the central axis C of the shaft 24, that is, the inner cylinder 42 and the outer cylinder 44.
- a thin plate-like cutter (treatment aid) 54 is disposed at the tip of the drive rod 52.
- the cutter 54 has a blade 54a formed at the tip thereof. Therefore, when the cutter driving knob 34 is operated and the driving rod 52 is moved forward, the cutter 54 moves forward, and when the driving rod 52 is moved backward, the cutter 54 moves backward.
- first and second cutter guide grooves flow paths, fluid discharge grooves
- the distal end of the cutter 54 is slightly in the position of the proximal end side with respect to the distal ends of the cutter guide grooves 152 and 154.
- the distal end of the cutter 54 is located on the inner side of the distal end of the inner cylinder 42, depending on how the first sandwiching member 72 is opened with respect to a second sandwiching member 74, which will be described later.
- the cutter guide grooves 152 and 154 are set at the base end positions so as not to hit the living tissue.
- the treatment portion 26 is disposed at the tip of the shaft 24.
- the treatment section 26 includes first and second clamping members 72 and 74, a rotation member 76, first and second gripping surfaces 80 and 82, and first and second.
- Energy acting portions (high-frequency electrodes) 84 and 86 and protrusions 88 are included.
- the first and second holding members 72 and 74 have electrical insulation at least on the outer peripheral surface.
- first clamping member 72 can be opened and closed with respect to the second clamping member 74
- a structure in which both the first and second clamping members 72 and 74 can be opened and closed with respect to each other is adopted. You may do it.
- the outer surfaces opposite to the first and second gripping surfaces 80 and 82 are formed in a smooth curved surface.
- a rotation fulcrum S1 that rotatably supports the proximal end portion of the first clamping member 72.
- long holes 104a and 104b are formed at the tips of the outer cylinder 44 on the outer periphery of the inner cylinder 42, respectively, and are parallel to each other.
- a pair of flat surfaces 102a and 102b are formed in FIG. 3B.
- the long holes 104a and 104b are formed long in a direction deviating from a direction parallel to the central axis C, for example.
- a pair of arms 122a and 122b, which will be described later, of the first holding member 72 are movably supported between the pair of flat surfaces 102a and 102b by the long holes 104a and 104b.
- a second clamping member 74 is integrally disposed at the tip of the outer cylinder 44.
- the first clamping member 72 has a distal end portion 72a, a proximal end portion 72b, and a longitudinal axis L1 defined by the distal end portion 72a and the proximal end portion 72b.
- the base end portion 72b of the first clamping member 72 has a pair of arms 122a and 122b in a direction deviating from the longitudinal axis L1.
- the pair of arms 122a and 122b of the first clamping member 72 is supported by a rotation fulcrum S1 so as to be rotatable with respect to the tip of the inner cylinder 42.
- the pair of arms 122a and 122b has a working fulcrum S2 that can move in the long holes 104a and 104b at the tip of the outer cylinder 44. These action fulcrums S2 protrude outward from the pair of arms 122a and 122b.
- the action fulcrum S2 of the pair of arms 122a and 122b is disposed between the flat surfaces 102a and 102b at the tip of the outer cylinder 44, and is movable in the long holes 104a and 104b of the flat surfaces 102a and 102b.
- the first clamping member 72 when the outer cylinder 44 is in the retracted position with respect to the inner cylinder 42, the first clamping member 72 is in the closed position shown in FIG. 2A. When the outer cylinder 44 is in the advanced position with respect to the inner cylinder 42, the first clamping member 72 is in the open position shown in FIG. 2B. For this reason, the first clamping member 72 can be opened and closed with respect to the second clamping member 74.
- the distal end portion 72a of the first clamping member 72 has a support recess 132 that rotatably supports the rotation member 76 and a screw hole 134 that passes through the support recess 132.
- the screw hole 134 extends in a direction orthogonal to the longitudinal axis L ⁇ b> 1 and orthogonal to the opening / closing direction of the first and second clamping members 72 and 74.
- a rotating member 76 formed of a material having electrical insulation and heat resistance is pivotally supported on the first clamping member 72 by a rotating shaft S3.
- the rotating member 76 has a distal end 76a, a proximal end 76b, and a longitudinal axis L11 defined by the distal end 76a and the proximal end 76b.
- the distal end 76 a of the rotating member 76 is in a position close to the distal end portion 72 a of the first clamping member 72.
- the base end 76 b of the rotation member 76 is in a position close to the base end portion 72 b of the first clamping member 72.
- the rotation member 76 is perpendicular to the longitudinal axis L1 of the first clamping member 72 and the longitudinal axis L11 of the rotation member 76, and is orthogonal to the opening and closing directions of the first and second clamping members 72, 74.
- a support convex portion 142 that rotates about a rotation axis S3 that extends in the direction of the axis.
- the support convex portion 142 has a through hole 144 having the rotation axis S3 as a central axis.
- the support convex portion 142 of the rotating member 76 is fitted into the support concave portion 132 of the first holding member 72, the screw hole 134 of the support concave portion 132 and the through hole 144 of the support convex portion 142 are aligned, and the screw 146 is screwed. Match. Therefore, the rotation member 76 can rotate in the first direction (clockwise direction) D1 and the second direction (counterclockwise direction) D2 in FIG. 4B with the rotation axis S3 as a fulcrum.
- the case where the rotating member 76 rotates in the first direction (clockwise direction) D1 in FIG. 4B means that the rotating member 76 is in a state where the first holding member 72 is closed with respect to the second holding member 74, for example.
- the case where the rotating member 76 rotates in the second direction (counterclockwise direction) D2 in FIG. 4B means that the rotating member 76 is in a state where the first holding member 72 is closed with respect to the second holding member 74, for example.
- the rotation axis S3 of the rotation member 76, the rotation fulcrum S1 at the tip of the inner cylinder 42, and the action fulcrum S2 at the tip of the outer cylinder 44 are preferably parallel to each other.
- the rotation axis S3 is located at the center position along the longitudinal axis L11 between the distal end 76a and the base end 76b of the rotation member 76, or closer to the distal end 76a than the central position. That is, the rotation shaft S3 is supported in a region on the side close to the distal end 76a including the central position between the distal end 76a and the proximal end 76b of the rotational member 76.
- FIG. 6A here, it is assumed that the rotation shaft S3 is at a central position along the longitudinal axis L11 between the distal end 76a and the proximal end 76b of the rotation member 76. .
- the first clamping member 72 is closed with respect to the second clamping member 74, and the living tissue is positioned closer to the proximal end 76b than the central position of the longitudinal axis L11 between the distal end 76a and the proximal end 76b of the rotating member 76.
- a moment is generated so that the distal end 76a of the rotating member 76 can be closed first and the proximal end 76b can be closed after that.
- a first gripping surface 80 that grips a living tissue in cooperation with a second gripping surface 82 described later is provided on the side of the rotating member 76 that is close to the second clamping member 74. It has been.
- the first gripping surface 80 is formed as an outer edge portion of the rotating member 76, but is appropriately changed depending on the shape and size of the first high-frequency electrode 84.
- the first gripping surface 80 is a thin plate-shaped first high-frequency electrode (first energy) that applies high-frequency energy to the living tissue gripped between the first and second gripping surfaces 80 and 82 to generate heat in the living tissue.
- the action portion 84 is fixed.
- the surface of the first high-frequency electrode 84 is formed in a substantially U shape, and a first cutter guide groove (treatment auxiliary instrument guide groove) 152 for guiding the cutter 54 in cooperation with the first gripping surface 80 is formed.
- the first gripping surface 80 and the first high-frequency electrode 84 have a linear first cutter guide groove (treatment auxiliary instrument guide groove) 152 at a position along the central axis C.
- the width of the first cutter guide groove 152 is preferably formed as small as possible.
- the distal end of the first high-frequency electrode 84 is closed near the distal end of the rotating member 76, and the proximal end is divided into two near the proximal end of the rotating member 76. Yes.
- the inner edge of the first high-frequency electrode 84 is formed as a cutter guide groove 152. It is preferable that the back surface and the outer edge of the first high-frequency electrode 84 are covered with the rotating member 76.
- the second clamping member 74 has a distal end portion 74a, a proximal end portion 74b, and a longitudinal axis L12 defined by the distal end portion 74a and the proximal end portion 74b.
- the second clamping member 74 is preferably formed integrally with the tip of the outer cylinder 44.
- a second gripping surface 82 that grips the living tissue in cooperation with the first gripping surface 80 is provided on the side of the second clamping member 74 that is close to the first clamping member 72 and the rotating member 76.
- the second gripping surface 82 is formed as an outer edge portion of the second clamping member 74, but is appropriately changed depending on the shape and size of the second high-frequency electrode 86.
- the second gripping surface 82 is a thin plate-like second high-frequency electrode (second energy) that applies high-frequency energy to the living tissue gripped between the first and second gripping surfaces 80 and 82 to generate heat in the living tissue.
- the action portion 86 is fixed.
- the second high-frequency electrode 86 is formed in a substantially U shape similarly to the first high-frequency electrode 84, and a second cutter guide groove (treatment aid) for guiding the cutter 54 in cooperation with the second gripping surface 82.
- Guide groove) 154 is formed.
- the second gripping surface 82 and the second high-frequency electrode 86 have a linear second cutter guide groove (treatment auxiliary instrument guide groove) 154 at a position along the central axis C.
- the width of the second cutter guide groove 154 is preferably as small as possible.
- the second high-frequency electrode 86 is substantially U-shaped, the distal end of the second high-frequency electrode 86 is closed near the distal end of the second clamping member 74, and the proximal end is divided into two near the proximal end of the second clamping member 74. I know. For this reason, the inner edge of the second high-frequency electrode 86 is formed as a cutter guide groove 154. It is preferable that the back surface and the outer edge of the second high-frequency electrode 86 are covered with the second clamping member 74.
- first high-frequency electrode 84 is electrically connected to the energy source 14 through the inside of the inner cylinder 42 or between the inner cylinder 42 and the outer cylinder 44 and inside the cable 28 by a lead wire (not shown).
- the second high-frequency electrode 86 is electrically connected to the energy source 14 through the inside of the inner cylinder 42, between the inner cylinder 42 and the outer cylinder 44, and inside the cable 28 by a lead wire (not shown).
- the living tissue grasped between the first and second high-frequency electrodes 84 and 86 can be treated by, for example, coagulation or sealing.
- the first and second high-frequency electrodes 84 and 86 are preferably formed longer in the direction parallel to the longitudinal axis L than in the direction orthogonal to the longitudinal axis L.
- the living tissue disposed between the first and second high-frequency electrodes 84 and 86 can be continuously sealed without breaks.
- the sealed living tissue can be separated into two by guiding the cutter 54 to the first and second cutter guide grooves 152 and 154.
- the surface of the second high-frequency electrode 86 has a distance between the first high-frequency electrode 84 and the second high-frequency electrode 86 with the first and second holding members 72 and 74 closed.
- a protrusion (spacer) 88 is provided to prevent the contact and contact.
- the protrusion 88 is made of a material having heat resistance and electrical insulation.
- the protrusion 88 is made of, for example, a resin material such as PTFE or PEEK, ceramics, or a metal material whose outer periphery is covered with a material having heat resistance and electrical insulation properties such as PTFE. When a resin material is used, the height and hardness are adjusted in consideration of being deformed by being pressed by the first high-frequency electrode 84 and the living tissue.
- the protrusion 88 is in a position close to the tip of the cutter guide groove 154. Moreover, it is preferable that the protrusion 88 is in a position that does not obstruct the continuous sealing of the living tissue by the second high-frequency electrode 86 without interruption. In this embodiment, the protrusion 88 is in the vicinity of the tip of the surface of the second high-frequency electrode 84, 86, and in a position closer to the inner edge (second cutter guide groove 154) than its outer edge.
- the number of the protrusions 88 is not limited to one, and may be two or more as long as it does not interfere with the continuous sealing of the living tissue by the second high-frequency electrode 86 without interruption.
- the protrusion 88 shows a state in which it is fixed in a state of being placed on the second high-frequency electrode 86.
- the protrusion 88 has heat resistance and electrical insulation, it penetrates through the second high-frequency electrode 86. It is also suitable that it is fixed to the second clamping member 74.
- the first and second cutter guide grooves 152 and 154 communicate with the inside of the inner cylinder 42 in which the drive rod 52 of the cutter 54 is disposed, and are also used as a fluid discharge groove into which a fluid generated from a living tissue is placed.
- the limiting portion 90 is formed at the distal end portion 72a of the first clamping member 72.
- the restricting portion 90 can suppress or restrict the turning member 76 from turning clockwise in FIG. 6A.
- the limiting portion 90 is not limited to being formed at the distal end portion 72 a of the first clamping member 72, and is preferably formed at the rotating member 76.
- the treatment section 26 has a structure described below.
- the first clamping member 72 has a distal end portion 72a, a proximal end portion 72b, and a longitudinal axis L1 defined by the distal end portion 72a and the proximal end portion 72b.
- the rotating member 76 is supported between the distal end portion 72a and the proximal end portion 72b of the first clamping member 72.
- the rotation member 76 has the first direction D1 and the first direction with the rotation axis S3 extending in the direction perpendicular to the longitudinal axis L11 and perpendicular to the opening and closing directions of the first and second holding members 72 and 74 as fulcrums. It can rotate in the second direction D2 opposite to the direction D1.
- the 1st clamping member 72 and the rotation member 76 form what is called a seesaw jaw.
- the rotation shaft S3 of the rotation member 76 is supported at a central position between the distal end 76a and the base end 76b of the rotation member 76.
- the first gripping surface 80 is provided on the side of the rotating member 76 that is close to the second clamping member 74, and can grip biological tissue.
- the second gripping surface 82 is provided on the side of the second clamping member 74 that is close to the rotating member 76, faces the first gripping surface 80, and cooperates with the first gripping surface 80 of the rotating member 76 to form a living body. The tissue can be grasped.
- the treatment section 26 of the treatment instrument 12 is provided on the first and second gripping surfaces 80 and 82, and acts on the living tissue gripped between the first and second gripping surfaces 80 and 82.
- the first and second gripping surfaces 80 and 82 are provided on the second gripping surface 82 and the first and second gripping surfaces 80 and 82 are closed. It has the protrusion 88 which forms a clearance gap between them.
- the treatment portion 26 of the treatment instrument 12 includes a position between the rotating member 76 and the second holding member 74 and a position between the rotating member 76 and the second holding member 74.
- a cutter (treatment aid) 54 movable between a retreat position, a first guide groove 152 provided on the first gripping surface 80 and guiding the cutter 54 between the first and second gripping surfaces 80 and 82;
- the second guide groove 154 is provided on the second gripping surface 82 and guides the cutter 54 in cooperation with the first guide groove 152.
- the treatment section 26 is inserted into a tube hole such as a body cavity with the first holding member 72 closed with respect to the second holding member 74. And the treatment part 26 is made to oppose the biological tissue of treatment object.
- the outer cylinder 44 is advanced relative to the inner cylinder 42.
- the first clamping member 72 opens with respect to the second clamping member 74.
- the biological tissue to be treated is placed between the first and second gripping surfaces 80 and 82. That is, the living tissue to be treated is disposed between the first and second high-frequency electrodes 84 and 86.
- the treatment section opening / closing knob 32 located on the front side of the handle 22 is moved to the front side, and the outer cylinder 44 is moved backward with respect to the inner cylinder 42.
- the first clamping member 72 is closed with respect to the second clamping member 74. That is, the biological tissue to be treated is grasped between the first and second high-frequency electrodes 84 and 86.
- the treatment portion 26 of the treatment instrument 12 includes, for example, a position closer to the proximal end 76b than a central portion between the distal end 76a and the proximal end 76b of the first gripping surface 80 of the rotating member 76;
- the biological tissue to be treated is gripped by the second gripping surface 82 facing the first gripping surface 80.
- Figure 6A shows the moment when brought into contact with the living tissue L T to both the first and second gripping surfaces 80, 82. In the state shown in FIG. 6A, momentum is applied to the second clamping member 74 so as to close the first clamping member 72.
- the distal end side of the rotation shaft S3 is lowered out of the rotating member 76, since the base end side is gradually presses the living tissue L T while rising, the living tissue L T is prevented from escaping to the distal end side, Add, or toward the proximal end side of the second holding member 74 a force (closing direction of the first clamping member 72) below the gripping surface 82 of the second gripping surface 82 with respect to the living tissue L T. Therefore, the moment of gripping the living tissue L T between the first and second gripping surfaces 80, 82, a force to move the living tissue L T as the base end side of the rotating member 76 and the second holding member 74 Append.
- the distal end 76a of the rotating member 76 is closed earlier than the proximal end 76b with respect to the second gripping surface 82. Therefore, the first gripping surface 80 or the first high-frequency electrode 86 is rotated while the rotation member 76 is rotated so as to close the first gripping surface 80 or the first high-frequency electrode 84 with respect to the second gripping surface 82 or the second high-frequency electrode 86.
- the high-frequency electrode 84 has a living tissue in a direction perpendicular to the surface of the second gripping surface 82 or the second high-frequency electrode 86 (particularly in the closing direction of the first clamping member 72) or on the proximal end side of the second clamping member 74. Immediately after applying the force, the living tissue is gripped with a uniform gripping force.
- the space G is maintained between the first and second high-frequency electrodes 84 and 86 by the protrusion 88 and the restriction portion 90, and the first The first and second high-frequency electrodes 84 and 86 are prevented from contacting and short-circuiting.
- the pedal 16a of the foot switch 16 is stepped on with a foot while the living tissue to be treated is held while maintaining the space G between the first and second high-frequency electrodes 84 and 86. Then, high-frequency energy is applied to the living tissue between the first and second high-frequency electrodes 84 and 86 from the energy source 14 to heat the living tissue to coagulate the living tissue. At this time, since the first and second cutter guide grooves 152 and 154 are narrowly formed, the living tissue is coagulated ignoring the width of the cutter guide grooves 152 and 154. Then, if necessary, the cutter 54 is moved along the cutter guide grooves 152 and 154 to cut the treated living tissue.
- a rotation member 76 is pivotally supported on a first clamping member 72 by a rotation axis S3, and a so-called seesaw jaw is formed by the first clamping member 72 and the rotation member 76. Forming. Therefore, the gripping force amount for gripping the living tissue between the first gripping surface 80 and the first high-frequency electrode 84 of the rotating member 76 and the second gripping surface 82 and the second high-frequency electrode 86 of the second clamping member 74 is uniform.
- the rotating member 76 When the rotating member 76 is rotated to close the first gripping surface 80 with respect to the second gripping surface 82, the distal end 76a of the rotating member 76 is brought closer to the second gripping surface 82 first than the base end 76b. be able to. For this reason, when the biological tissue is gripped, the biological tissue can be prevented from escaping to the distal end side of the rotating member 76. That is, when the treatment tool 12 of this embodiment performs an operation of grasping a living tissue, the living tissue is on the distal end 76a side of the rotating member 76 and the distal end side of the second holding member 74, that is, the first and second grasping surfaces. Escape to the tip side of 80, 82 can be prevented as much as possible.
- the protrusion 88 also functions as a slip stopper, and can prevent the living tissue from sliding toward the distal end side or the proximal end side of the first and second gripping surfaces 80 and 82.
- the rotation shaft S3 is arranged at a substantially central portion between the distal end 76a and the base end 76b of the rotating member 76, that is, a substantially central portion between the distal end 76a and the base end 76b of the first gripping surface 80.
- the rotation shaft S ⁇ b> 3 is disposed between the central portion of the distal end 76 a and the base end 76 b of the rotation member 76 and the distal end 76 a of the rotation member 76. .
- the living body extends from the position including the central portion between the distal end 76a and the proximal end 76b of the first gripping surface 80, for example, from the position close to the distal end 76a to the position adjacent to the proximal end 76b.
- Grasping tissue Since the rotation axis S3 is on the distal end side with respect to the central portion between the distal end 76a and the proximal end 76b of the first gripping surface 80, the first gripping surface 80 contacts the living tissue and the rotational member 76 rotates.
- the distal end 76a of the first gripping surface 80 is closer to the second gripping surface 82 than the base end 76b by rotating about the dynamic axis S3 (counterclockwise around the rotational axis S3 in FIG. 7A). For this reason, the living tissue is prevented from escaping to the distal end side with respect to the first gripping surface 80.
- the first gripping surface 80 is brought close to the second gripping surface 82, the living tissue can be gripped with a uniform gripping force.
- FIG. 7B shows an example of the treatment section 26a which is not preferable.
- the rotation shaft S ⁇ b> 3 is disposed between the central portion of the distal end 76 a and the base end 76 b of the rotation member 76 and the base end 76 b of the rotation member 76.
- the rotating member 76 rotates.
- the distal end 76a of the first gripping surface 80 is separated from the second gripping surface 82 rather than the base end 76b by rotating around the moving axis S3 (clockwise around the rotational axis S3 in FIG. 7B). For this reason, when the treatment portion 26 shown in FIG. 7B is used, the distal end 76a of the first gripping surface 80 is easily raised with respect to the proximal end 76b, and the living tissue is easily pushed out to the distal end side of the first gripping surface 80.
- FIGS. 8A to 9C This embodiment is a modification of the first embodiment, and the same members as those described in the first embodiment or members having the same functions are denoted by the same reference numerals as much as possible, and detailed description thereof is omitted.
- the rotation shaft S3 is drawn at the center of the distal end 76a and the base end 76b of the rotation member 76.
- the rotation axis S3 may be disposed at a position closer to the distal end 76a than the center of the distal end 76a and the proximal end 76b. That is, the rotation shaft S3 is on the tip side including the center of the rotation member 76.
- a compression spring (elastic member) 212 is disposed between the distal end portion 72a of the first clamping member 72 and the distal end 76a of the rotating member 76.
- the compression spring 212 urges the distal end portion 76 a of the first clamping member 72 so that the distal end 76 a of the rotating member 76 is closer to the second clamping member 74 than the proximal end 76 b of the rotating member 76. That is, the compression spring 212 is disposed between the side closer to the distal end portion 72a of the first clamping member 72 and the side closer to the distal end 76a of the rotational member 76 than the rotational axis S3.
- the side close to the tip end portion 72a of the rotating member 76 and the side close to the tip end 76a of the rotating member 76 are spaced apart.
- the compression spring 212 functions as a connecting member that connects between the distal end portion 72 a of the first clamping member 72 and the distal end 76 a of the rotating member 76.
- the tension spring 214 is disposed between the proximal end portion 72b of the first clamping member 72 and the proximal end 76b of the rotating member 76.
- the tension spring 214 urges the base end portion 72 b of the first holding member 72 so that the base end 76 b of the rotating member 76 is separated from the second holding member 74 rather than the distal end 76 a of the rotating member 76. . That is, the tension spring 214 is disposed between the side closer to the base end portion 72b of the first holding member 72 and the side closer to the base end 76b of the rotating member 76 than the rotating shaft S3.
- the side close to the base end portion 72b of the member 72 and the side close to the base end 76b of the rotating member 76 are brought close to each other.
- the tension spring 214 functions as a connecting member that connects the base end portion 72 b of the first clamping member 72 and the base end 76 b of the rotating member 76.
- a torsion spring (elastic member) 216 is disposed on a rotation axis S3 between the first clamping member 72 and the rotation member 76.
- the treatment portion 26 shown in FIG. The torsion spring 216 urges the distal end 76 a of the rotating member 76 toward the side closer to the second holding member 74 than the proximal end 76 b of the rotating member 76, and rotates the proximal end 76 b of the rotating member 76.
- the member 76 is urged toward the side away from the distal end 76a of the member 76 toward the second clamping member 74.
- the torsion spring 216 functions as a connecting member that connects the first holding member 72 and the rotating member 76.
- a plate spring (elastic member) 218 is disposed between the rotation member 76 and the rotation fulcrum S1.
- the leaf spring 218 according to this embodiment includes, for example, a first surface 222a connected to the rotation member 76, a second surface 222b connected to the rotation fulcrum S1, and the first and second surfaces 222a and 222b. And a third surface 222c disposed on the surface.
- the first surface 222a biases the base end 76b of the rotation member 76 to the side away from the tip 76a to the second clamping member 74.
- the leaf spring 218 functions as a connecting member that connects the first clamping member 72 and the rotating member 76.
- the 1st and 2nd surface 222a, 222b is formed in the substantially no load state, for example, substantially parallel.
- the third surface 222c is formed as an inclined surface that is inclined with respect to the first and second surfaces 222a and 222b.
- the first clamping member 72 is closed with respect to the second clamping member 74.
- the base end 76b of the rotating member 76 is raised so as to be close to the base end portion 72b of the first clamping member 72, and the distal end 76a of the rotating member 76 is the base end. It approaches the 2nd clamping member 74 ahead of 76b.
- FIG. 9C when the rotating member 76 is completely closed with respect to the second holding member 74, the first gripping surface 80 of the rotating member 76 and the second holding member 74 are second by the action of the leaf spring 218.
- the holding surface 82 is parallel.
- the protrusion 88 does not need to be provided on the second gripping surface 82, and is preferably provided on the first gripping surface 80 as shown in FIGS. 9A to 9C. That is, the protrusion 88 may be provided on at least one of the first and second gripping surfaces 80 and 82.
- the first embodiment described above it was placed the living tissue L T at a position close to the proximal end 76b than the center portion of the tip 76a and proximal 76b of rotating member 76 cases Explained.
- the distal end 76a of the second embodiment when using an elastic member as in the example shown in (FIGS 8A- Figure 8D), the living tissue L T the rotating member 76 and Even when the first gripping surface 80 is closed with respect to the second gripping surface 82, the tip 76a of the rotating member 76 is compared with the base end 76b even when the first gripping surface 80 is closed with respect to the second gripping surface 82.
- the tip can be brought close to the second gripping surface 82 first. That is, when closing the first gripping surface 80 shown in FIGS 8A- Figure 8C with respect to the second gripping surface 82, the living tissue L T central portion of the tip 76a and proximal 76b of rotating member 76, at its distal end 76a You may arrange
- the living tissue is disposed at any position between the distal end 76a and the proximal end 76b of the rotating member 76. Even in this case, the distal end 76a of the rotating member 76 can be brought closer to the second gripping surface 82 earlier than the proximal end 76b.
- FIGS. 10A and 10B This embodiment is a modification of the first and second embodiments, and the same members or members having the same functions as those described in the first and second embodiments are given the same reference numerals as much as possible. Detailed description is omitted.
- a covering member 232 may be disposed on the outer periphery of the first holding member 72 of the treatment portion 26.
- the covering member 232 covers a portion of the first clamping member 72 that is opposite to the rotating member 76. That is, the covering member 232 covers the opposite side of the distal end 76 a of the rotating member 76 with respect to the first gripping surface 80.
- This covering member 232 has a hollow region 234 between the tip 76 a of the rotating member 76. For this reason, the cavity region 234 of the covering member 232 functions as a heat insulating portion. For example, when high-frequency energy is applied to a living tissue, heat from the first gripping surface 80 is outside through the rotating member 76 and the first holding member 72.
- the covering member 232 covers the part of the first holding member 72 opposite to the rotating member 76 due to its heat insulation, so that the heat from the first gripping surface 80 is transferred to the rotating member 76 and the first member. Even if it is transmitted to the outside through the one clamping member 72, the temperature rise of the outer surface of the first clamping member 72 (the side opposite to the rotating member 76 of the first clamping member 72) can be suppressed.
- first high-frequency electrode 84 is present on the first gripping surface 80 and the second high-frequency electrode 86 is disposed on the second gripping surface 82 .
- the two high-frequency electrodes (energy acting portions) 84 and 86 may not be arranged.
- the cutter 54 and the cutter guide grooves 152 and 154 are not necessarily required.
- the shape of the high-frequency electrodes 84 and 86 is not limited to a substantially U shape, and can be set as appropriate.
- the treatment instrument 12 has been described on the assumption that the first and second high-frequency electrodes 84 and 86 are bipolar types.
- the treatment instrument 12 may be a monopolar type that uses a counter electrode plate (not shown) attached to a patient. .
- the example in which the thin plate-like high-frequency electrodes 84 and 86 are disposed on the gripping surfaces 80 and 82 as the treatment instrument 12 has been described.
- a thin-plate heater (Energy acting part) may be used.
- the treatment assisting tool used to assist the treatment is not limited to the cutter. Absent.
- an ultrasonic vibration probe or the like may be used instead of the cutter 54.
Landscapes
- Health & Medical Sciences (AREA)
- Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Engineering & Computer Science (AREA)
- Veterinary Medicine (AREA)
- General Health & Medical Sciences (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Public Health (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- Otolaryngology (AREA)
- Plasma & Fusion (AREA)
- Physics & Mathematics (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Pathology (AREA)
- Surgical Instruments (AREA)
- Dentistry (AREA)
- Mechanical Engineering (AREA)
Abstract
Description
Claims (9)
- 生体組織を把持可能な処置具であって、
先端部と、基端部と、前記先端部及び前記基端部により規定される長手軸とを有し、互いに相対的に開閉可能な第1及び第2挟持部材と、
前記第1挟持部材の前記先端部と前記基端部との間に支持され、前記長手軸に対して垂直方向かつ前記第1及び第2挟持部材の開閉方向に対して直交方向に延びる回動軸を支点として第1方向及び前記第1方向に対して反対側の第2方向に回動可能であり、前記第1挟持部材の先端部に近接する先端及び前記第1挟持部材の基端部に近接する基端を有し前記回動軸が前記先端と前記基端との間での中央位置を含む前記先端に近接する側に支持された回動部材と、
前記回動部材のうち前記第2挟持部材に近接する側に設けられ、生体組織を把持する第1把持面と、
前記第2挟持部材のうち前記回動部材に近接する側に設けられ、前記第1把持面に対向し前記回動部材の第1把持面と協働して生体組織を把持する第2把持面と
を具備する処置具。 - 前記第1挟持部材と前記回動部材とを連結し、前記第2挟持部材に対して前記第1挟持部材が閉じていく際に、前記回動部材の先端を前記第2挟持部材に向けるように前記回動軸を支点として回動させる連結部材をさらに具備する、請求項1に記載の処置具。
- 前記連結部材は、前記回動軸よりも前記第1挟持部材の先端部に近接する側と前記回動部材の先端に近接する側の間に、前記第1挟持部材の先端部に近接する側と前記回動部材の先端に近接する側とを離隔させる弾性部材を有する、請求項2に記載の処置具。
- 前記連結部材は、前記回動軸よりも前記第1挟持部材の基端部に近接する側と前記回動部材の基端に近接する側の間に、前記第1挟持部材の基端部に近接する側と前記回動部材の基端に近接する側とを近接させる弾性部材を有する、請求項2に記載の処置具。
- 前記連結部材は、前記回動軸に設けられ、前記回動部材の先端を前記第2挟持部材に向けるように付勢する弾性部材を有する、請求項2に記載の処置具。
- 前記第1及び第2把持面の少なくとも一方に設けられ、前記第1及び第2把持面間に把持した生体組織にエネルギを作用させるエネルギ作用部と、
前記第1及び第2把持面の少なくとも一方に設けられ、前記第1及び第2把持面同士を閉じた状態で前記第1及び第2把持面間に隙間を形成する突部と
をさらに具備する、請求項1に記載の処置具。 - 前記第1挟持部材は、前記回動部材に対して反対側の部位を覆い、前記第1把持面からの熱が前記回動部材及び前記第1挟持部材を通して外側に伝えられ、前記第1挟持部材の外表面の温度上昇を抑制するための被覆部を有する、請求項1に記載の処置具。
- 前記被覆部は、前記回動部材の先端のうち前記第1把持面に対して反対側を覆うとともに、前記回動部材の先端との間に空洞領域を有する、請求項7に記載の処置具。
- 前記回動部材と前記第2挟持部材との間に配置される位置と、前記回動部材と前記第2挟持部材との間から退避する位置との間を移動可能な処置補助具と、
前記第1把持面に設けられ前記第1及び第2把持面間に前記処置補助具を案内する第1案内溝と、
前記第2把持面に設けられ前記処置補助具を前記第1案内溝と協働して案内する第2案内溝と
をさらに具備する、請求項1に記載の処置具。
Priority Applications (4)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US14/635,623 US9993289B2 (en) | 2013-03-18 | 2014-03-07 | Treatment device |
JP2014541451A JP5663710B1 (ja) | 2013-03-18 | 2014-03-07 | 処置具 |
EP14769158.8A EP2977018A4 (en) | 2013-03-18 | 2014-03-07 | TREATMENT TOOL |
CN201480002597.1A CN104703555B (zh) | 2013-03-18 | 2014-03-07 | 处理器具 |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US201361802875P | 2013-03-18 | 2013-03-18 | |
US61/802,875 | 2013-03-18 |
Publications (1)
Publication Number | Publication Date |
---|---|
WO2014148281A1 true WO2014148281A1 (ja) | 2014-09-25 |
Family
ID=51579968
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/JP2014/056001 WO2014148281A1 (ja) | 2013-03-18 | 2014-03-07 | 処置具 |
Country Status (5)
Country | Link |
---|---|
US (1) | US9993289B2 (ja) |
EP (1) | EP2977018A4 (ja) |
JP (1) | JP5663710B1 (ja) |
CN (1) | CN104703555B (ja) |
WO (1) | WO2014148281A1 (ja) |
Cited By (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO2016171067A1 (ja) * | 2015-04-24 | 2016-10-27 | オリンパス株式会社 | 医療機器 |
WO2020084665A1 (ja) * | 2018-10-22 | 2020-04-30 | オリンパス株式会社 | 処置具 |
Families Citing this family (40)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US11090104B2 (en) | 2009-10-09 | 2021-08-17 | Cilag Gmbh International | Surgical generator for ultrasonic and electrosurgical devices |
GB2480498A (en) | 2010-05-21 | 2011-11-23 | Ethicon Endo Surgery Inc | Medical device comprising RF circuitry |
US20130123776A1 (en) | 2011-10-24 | 2013-05-16 | Ethicon Endo-Surgery, Inc. | Battery shut-off algorithm in a battery powered device |
US9408622B2 (en) | 2012-06-29 | 2016-08-09 | Ethicon Endo-Surgery, Llc | Surgical instruments with articulating shafts |
US10159524B2 (en) | 2014-12-22 | 2018-12-25 | Ethicon Llc | High power battery powered RF amplifier topology |
WO2017022287A1 (ja) * | 2015-08-05 | 2017-02-09 | オリンパス株式会社 | 処置具 |
JP6197148B2 (ja) * | 2015-09-17 | 2017-09-13 | オリンパス株式会社 | 把持処置具 |
US20170086909A1 (en) | 2015-09-30 | 2017-03-30 | Ethicon Endo-Surgery, Llc | Frequency agile generator for a surgical instrument |
US10959771B2 (en) | 2015-10-16 | 2021-03-30 | Ethicon Llc | Suction and irrigation sealing grasper |
US10959806B2 (en) | 2015-12-30 | 2021-03-30 | Ethicon Llc | Energized medical device with reusable handle |
US10842523B2 (en) | 2016-01-15 | 2020-11-24 | Ethicon Llc | Modular battery powered handheld surgical instrument and methods therefor |
US11229471B2 (en) | 2016-01-15 | 2022-01-25 | Cilag Gmbh International | Modular battery powered handheld surgical instrument with selective application of energy based on tissue characterization |
US20170312018A1 (en) * | 2016-04-29 | 2017-11-02 | Ethicon Endo-Surgery, Llc | Electrosurgical instrument with conductive gap setting member and insulative tissue engaging member having variable dimensions and stiffness |
US10987156B2 (en) | 2016-04-29 | 2021-04-27 | Ethicon Llc | Electrosurgical instrument with electrically conductive gap setting member and electrically insulative tissue engaging members |
US10856934B2 (en) | 2016-04-29 | 2020-12-08 | Ethicon Llc | Electrosurgical instrument with electrically conductive gap setting and tissue engaging members |
WO2017203628A1 (ja) * | 2016-05-25 | 2017-11-30 | オリンパス株式会社 | 把持処置具 |
US10751117B2 (en) | 2016-09-23 | 2020-08-25 | Ethicon Llc | Electrosurgical instrument with fluid diverter |
US11266430B2 (en) | 2016-11-29 | 2022-03-08 | Cilag Gmbh International | End effector control and calibration |
US11033325B2 (en) | 2017-02-16 | 2021-06-15 | Cilag Gmbh International | Electrosurgical instrument with telescoping suction port and debris cleaner |
US10799284B2 (en) | 2017-03-15 | 2020-10-13 | Ethicon Llc | Electrosurgical instrument with textured jaws |
US11497546B2 (en) | 2017-03-31 | 2022-11-15 | Cilag Gmbh International | Area ratios of patterned coatings on RF electrodes to reduce sticking |
US10603117B2 (en) | 2017-06-28 | 2020-03-31 | Ethicon Llc | Articulation state detection mechanisms |
US11484358B2 (en) | 2017-09-29 | 2022-11-01 | Cilag Gmbh International | Flexible electrosurgical instrument |
US11033323B2 (en) | 2017-09-29 | 2021-06-15 | Cilag Gmbh International | Systems and methods for managing fluid and suction in electrosurgical systems |
US11490951B2 (en) | 2017-09-29 | 2022-11-08 | Cilag Gmbh International | Saline contact with electrodes |
USD904611S1 (en) | 2018-10-10 | 2020-12-08 | Bolder Surgical, Llc | Jaw design for a surgical instrument |
US11812957B2 (en) | 2019-12-30 | 2023-11-14 | Cilag Gmbh International | Surgical instrument comprising a signal interference resolution system |
US11937863B2 (en) | 2019-12-30 | 2024-03-26 | Cilag Gmbh International | Deflectable electrode with variable compression bias along the length of the deflectable electrode |
US11950797B2 (en) | 2019-12-30 | 2024-04-09 | Cilag Gmbh International | Deflectable electrode with higher distal bias relative to proximal bias |
US11786294B2 (en) | 2019-12-30 | 2023-10-17 | Cilag Gmbh International | Control program for modular combination energy device |
US20210196357A1 (en) | 2019-12-30 | 2021-07-01 | Ethicon Llc | Electrosurgical instrument with asynchronous energizing electrodes |
US11779387B2 (en) | 2019-12-30 | 2023-10-10 | Cilag Gmbh International | Clamp arm jaw to minimize tissue sticking and improve tissue control |
US11911063B2 (en) * | 2019-12-30 | 2024-02-27 | Cilag Gmbh International | Techniques for detecting ultrasonic blade to electrode contact and reducing power to ultrasonic blade |
US11786291B2 (en) | 2019-12-30 | 2023-10-17 | Cilag Gmbh International | Deflectable support of RF energy electrode with respect to opposing ultrasonic blade |
US11986201B2 (en) | 2019-12-30 | 2024-05-21 | Cilag Gmbh International | Method for operating a surgical instrument |
US20210196306A1 (en) * | 2019-12-30 | 2021-07-01 | Ethicon Llc | Non-biased deflectable electrode to minimize contact between ultrasonic blade and electrode |
US11944366B2 (en) | 2019-12-30 | 2024-04-02 | Cilag Gmbh International | Asymmetric segmented ultrasonic support pad for cooperative engagement with a movable RF electrode |
WO2021152753A1 (ja) * | 2020-01-29 | 2021-08-05 | オリンパス株式会社 | 処置具、及び処置具の製造方法 |
USD934423S1 (en) | 2020-09-11 | 2021-10-26 | Bolder Surgical, Llc | End effector for a surgical device |
US11957342B2 (en) | 2021-11-01 | 2024-04-16 | Cilag Gmbh International | Devices, systems, and methods for detecting tissue and foreign objects during a surgical operation |
Citations (6)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
JP2009045456A (ja) * | 2007-08-14 | 2009-03-05 | Olympus Medical Systems Corp | 電気処置システム及びその処置方法 |
US20100057117A1 (en) | 2008-08-29 | 2010-03-04 | Norihiro Yamada | Ultrasonic operating apparatus |
JP2010051802A (ja) * | 2008-08-28 | 2010-03-11 | Tyco Healthcare Group Lp | 組織が融着する顎角度の改良 |
US20110278343A1 (en) * | 2009-01-29 | 2011-11-17 | Cardica, Inc. | Clamping of Hybrid Surgical Instrument |
JP2012250079A (ja) * | 2005-03-25 | 2012-12-20 | Maquet Cardiovascular Llc | 組織溶接器の顎部を調整するための装置 |
JP2012254324A (ja) * | 2006-07-14 | 2012-12-27 | Covidien Ag | 予熱電極を有する脈管密封器具 |
Family Cites Families (9)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US20030171747A1 (en) * | 1999-01-25 | 2003-09-11 | Olympus Optical Co., Ltd. | Medical treatment instrument |
US7083618B2 (en) * | 2001-04-06 | 2006-08-01 | Sherwood Services Ag | Vessel sealer and divider |
EP1750608B1 (en) * | 2004-06-02 | 2012-10-03 | Medtronic, Inc. | Ablation device with jaws |
US7540872B2 (en) * | 2004-09-21 | 2009-06-02 | Covidien Ag | Articulating bipolar electrosurgical instrument |
US7717914B2 (en) * | 2006-07-11 | 2010-05-18 | Olympus Medical Systems Corporation | Treatment device |
US8784417B2 (en) | 2008-08-28 | 2014-07-22 | Covidien Lp | Tissue fusion jaw angle improvement |
US8444642B2 (en) * | 2009-04-03 | 2013-05-21 | Device Evolutions, Llc | Laparoscopic nephrectomy device |
CA2766945A1 (en) * | 2010-02-04 | 2011-08-11 | Aesculap Ag | Laparoscopic radiofrequency surgical device |
UA113412C2 (xx) * | 2011-06-30 | 2017-01-25 | 3-алкокси, тіоалкіл і аміно-4-аміно-6-(заміщені) піколінати та їхнє застосування як гербіцидів |
-
2014
- 2014-03-07 EP EP14769158.8A patent/EP2977018A4/en not_active Withdrawn
- 2014-03-07 JP JP2014541451A patent/JP5663710B1/ja active Active
- 2014-03-07 US US14/635,623 patent/US9993289B2/en active Active
- 2014-03-07 CN CN201480002597.1A patent/CN104703555B/zh active Active
- 2014-03-07 WO PCT/JP2014/056001 patent/WO2014148281A1/ja active Application Filing
Patent Citations (7)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
JP2012250079A (ja) * | 2005-03-25 | 2012-12-20 | Maquet Cardiovascular Llc | 組織溶接器の顎部を調整するための装置 |
JP2012254324A (ja) * | 2006-07-14 | 2012-12-27 | Covidien Ag | 予熱電極を有する脈管密封器具 |
JP2009045456A (ja) * | 2007-08-14 | 2009-03-05 | Olympus Medical Systems Corp | 電気処置システム及びその処置方法 |
JP2010051802A (ja) * | 2008-08-28 | 2010-03-11 | Tyco Healthcare Group Lp | 組織が融着する顎角度の改良 |
US20100057117A1 (en) | 2008-08-29 | 2010-03-04 | Norihiro Yamada | Ultrasonic operating apparatus |
JP2010051779A (ja) * | 2008-08-29 | 2010-03-11 | Olympus Medical Systems Corp | 超音波処置装置 |
US20110278343A1 (en) * | 2009-01-29 | 2011-11-17 | Cardica, Inc. | Clamping of Hybrid Surgical Instrument |
Non-Patent Citations (1)
Title |
---|
See also references of EP2977018A4 * |
Cited By (5)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO2016171067A1 (ja) * | 2015-04-24 | 2016-10-27 | オリンパス株式会社 | 医療機器 |
JPWO2016171067A1 (ja) * | 2015-04-24 | 2017-06-01 | オリンパス株式会社 | 医療機器 |
CN106999241A (zh) * | 2015-04-24 | 2017-08-01 | 奥林巴斯株式会社 | 医疗设备 |
US10064676B2 (en) | 2015-04-24 | 2018-09-04 | Olympus Corporation | Medical apparatus |
WO2020084665A1 (ja) * | 2018-10-22 | 2020-04-30 | オリンパス株式会社 | 処置具 |
Also Published As
Publication number | Publication date |
---|---|
CN104703555B (zh) | 2017-03-01 |
JPWO2014148281A1 (ja) | 2017-02-16 |
CN104703555A (zh) | 2015-06-10 |
EP2977018A1 (en) | 2016-01-27 |
EP2977018A4 (en) | 2016-11-30 |
US20150374428A1 (en) | 2015-12-31 |
JP5663710B1 (ja) | 2015-02-04 |
US9993289B2 (en) | 2018-06-12 |
Similar Documents
Publication | Publication Date | Title |
---|---|---|
JP5663710B1 (ja) | 処置具 | |
JP5666068B1 (ja) | 処置具 | |
JP6537567B2 (ja) | コードレスのパワーアシスト医療用焼灼および切断装置 | |
US11076908B2 (en) | Two-stage electrosurgical device for vessel sealing | |
US10335228B2 (en) | Surgical instrument with switch activation control | |
JP6461275B2 (ja) | 処置具及び処置システム | |
US20050149017A1 (en) | Movable handle for vessel sealer | |
JP6125117B2 (ja) | 医療機器 | |
JP2014527845A (ja) | 把持部に向かって可動な切断ワイヤを備えた電気手術用掴み器具 | |
US20230124774A1 (en) | Surgical instruments incorporating ultrasonic and electrosurgical functionality | |
JP6109459B2 (ja) | 医療機器 | |
US20220022944A1 (en) | Surgical instrument with increased lever stroke | |
WO2014073491A1 (ja) | 治療処置具および治療処置方法 | |
JP6903759B2 (ja) | 医療機器 | |
JP2004337187A (ja) | 超音波処置装置 | |
WO2018189884A1 (ja) | 処置具 | |
WO2018189883A1 (ja) | 処置具 | |
US20220346864A1 (en) | Energy activation switch for vessel sealer | |
WO2018225258A1 (ja) | 処置具及び処置システム |
Legal Events
Date | Code | Title | Description |
---|---|---|---|
ENP | Entry into the national phase |
Ref document number: 2014541451 Country of ref document: JP Kind code of ref document: A |
|
121 | Ep: the epo has been informed by wipo that ep was designated in this application |
Ref document number: 14769158 Country of ref document: EP Kind code of ref document: A1 |
|
WWE | Wipo information: entry into national phase |
Ref document number: 14635623 Country of ref document: US |
|
NENP | Non-entry into the national phase |
Ref country code: DE |
|
WWE | Wipo information: entry into national phase |
Ref document number: 2014769158 Country of ref document: EP |