WO2015022842A1 - Instrument de traitement à haute fréquence - Google Patents

Instrument de traitement à haute fréquence Download PDF

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Publication number
WO2015022842A1
WO2015022842A1 PCT/JP2014/069283 JP2014069283W WO2015022842A1 WO 2015022842 A1 WO2015022842 A1 WO 2015022842A1 JP 2014069283 W JP2014069283 W JP 2014069283W WO 2015022842 A1 WO2015022842 A1 WO 2015022842A1
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WO
WIPO (PCT)
Prior art keywords
treatment
stainless steel
frequency
tissue
forceps
Prior art date
Application number
PCT/JP2014/069283
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English (en)
Japanese (ja)
Inventor
渉 大塚
Original Assignee
住友ベークライト株式会社
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Filing date
Publication date
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Publication of WO2015022842A1 publication Critical patent/WO2015022842A1/fr

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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
    • 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
    • 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
    • A61B18/1492—Probes or electrodes therefor having a flexible, catheter-like structure, e.g. for heart ablation
    • 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
    • A61B2018/1405—Electrodes having a specific shape
    • A61B2018/1407—Loop
    • A61B2018/141—Snare
    • 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
    • A61B2018/1405—Electrodes having a specific shape
    • A61B2018/1417—Ball
    • 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
    • A61B2018/1405—Electrodes having a specific shape
    • A61B2018/1422—Hook
    • 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
    • A61B2018/1405—Electrodes having a specific shape
    • A61B2018/144—Wire

Definitions

  • the present invention relates to a high-frequency treatment instrument.
  • This application claims priority based on Japanese Patent Application No. 2013-169025 for which it applied to Japan on August 16, 2013, and uses the content here.
  • a high-frequency treatment instrument includes a sheath portion (insertion portion) that is inserted into a body cavity, an operation wire that is inserted into the sheath portion so as to freely advance and retract, and a living tissue that is disposed at the distal end portion of the operation wire by applying a high-frequency current.
  • the treatment section includes a treatment section, a high-frequency application section that abuts on the operation wire and applies a high-frequency current, and an operation section that is attached to the proximal end portion of the sheath section and operates the treatment section via the operation wire.
  • the high-frequency treatment instrument connects a high-frequency power supply connection cord connected to a high-frequency power supply device to a high-frequency terminal of the operation unit, and causes a high-frequency current to flow from the high-frequency power supply device to the operation wire and the treatment portion attached to the distal end portion of the operation wire This makes it possible to perform treatments such as separation and hemostasis of living tissue.
  • Patent Document 1 is known as a high-frequency treatment instrument having a grasping forceps function in a treatment portion.
  • a pair of forceps pieces provided at the distal end of a treatment section is opened and closed by remote control, and has a grasping forceps function for collecting a body tissue, extracting a living tissue, and performing other treatments.
  • a high frequency treatment device is disclosed.
  • the high-frequency treatment tool includes a pair of forceps pieces configured as a high-frequency electrode, and a treatment in which a high-frequency current is passed through the grasping forceps to cauterize the body tissue, that is, a treatment such as incision of a living tissue, Treatments such as coagulation and hemostasis are possible.
  • the present invention has been made in view of the above circumstances, and an object of the present invention is to provide a high-frequency treatment instrument in which tissue is difficult to adhere during tissue cauterization treatment.
  • the present invention employs the following configuration. That is, the present invention includes an insertion portion that is inserted into a body cavity; An operation wire inserted through the insertion portion so as to freely advance and retract; A treatment section disposed at the distal end of the operation wire and treating a living tissue by application of a high-frequency current; An operation unit attached to a proximal end portion of the insertion unit and operating the treatment unit,
  • the high-frequency treatment instrument is characterized in that a material having a thermal conductivity at 100 ° C. of 18 W / m ⁇ K or more and 30 W / m ⁇ K or less is used for at least an electrode portion in contact with a body tissue of the treatment section.
  • the treatment portion is a grasping forceps portion having a pair of forceps pieces that can be opened and closed with each other, and inner surfaces of the pair of forceps pieces facing each other serve as the electrode portions.
  • the material of the said treatment part is stainless steel.
  • the said stainless steel is chromium type stainless steel.
  • the stainless steel is preferably martensitic stainless steel.
  • the stainless steel is preferably ferritic stainless steel.
  • the stainless steel is preferably a duplex stainless steel.
  • a material having a thermal conductivity of 18 W / m ⁇ K or more and 30 W / m ⁇ K or less at 100 ° C. is used for at least an electrode portion of the treatment portion that is in contact with the body tissue.
  • FIG. 1 is a diagram illustrating an example of a high-frequency treatment instrument 1 according to a first embodiment to which the present invention is applied.
  • a high-frequency treatment instrument 1 includes a sheath part (insertion part) 2 inserted into a body cavity, a conductive operation wire (not shown) inserted through the sheath part 2 so as to freely advance and retract, and an operation
  • the treatment unit 3 is disposed at the distal end of the wire and treats a living tissue by applying a high-frequency current, and the operation unit 4 is attached to the sheath unit 2 and operates the treatment unit 3.
  • the high-frequency treatment instrument 1 is used by passing the treatment portion 3 and the sheath portion 2 through which the operation wire is inserted to a forceps port of an endoscope (not shown).
  • the sheath part 2 connects the operation part 4 and the treatment part 3 to enable the treatment part 3 to access the lesion site.
  • the sheath part 2 should just have flexibility,
  • the material is not specifically limited.
  • a conductive material such as stainless steel, a fluorine resin, a polyolefin resin such as a polyethylene resin or a polypropylene resin, a polyamide resin, a polyimide resin, a polyurethane resin, Examples include polycarbonate resins.
  • a fluorine-based resin as the material of the sheath portion 2 because it is excellent in slidability with the forceps hole of the endoscope through which the sheath portion 2 is inserted.
  • a conductive material it is preferable to coat the inner surface of the sheath portion 2 having conductivity with a thin film of an insulating material.
  • the dimensions of the sheath part 2 vary depending on the endoscope to be used, but for example, the length is preferably in the range of 1500 to 2500 mm and the outer diameter is in the range of 1.5 to 3 mm. If the length is within the above range, the high-frequency treatment instrument 1 can be used by being inserted into the forceps opening of the endoscope. Moreover, if an outer diameter is below the said upper limit, the penetration property to the forceps hole of an endoscope will become more favorable.
  • the treatment part 3 is provided at the distal end of the sheath part 2 and has a function of treating a living tissue such as an affected part by application of a high-frequency current.
  • the treatment section 3 is driven by the advancement and retraction of an operation wire (not shown) passed through the sheath section 2.
  • an operation wire (not shown) passed through the sheath section 2.
  • a power supply terminal 12 to which a high-frequency current cord (not shown) is attached is protruded in the operation section 4 in a direction perpendicular to the axial direction of the high-frequency treatment instrument 1. (See FIG. 3).
  • the biological tissue to be treated is not limited to an affected part having a lesion or trauma, but may be a normal biological tissue that can be included as a target for pathological examination or the like.
  • the treatment part 3 in the high-frequency treatment instrument 1 of the present embodiment constitutes a grasping forceps part having a pair of forceps pieces 5 and 5 that can be opened and closed with respect to each other, as shown in FIG. More specifically, the treatment portion 3 has serrated irregularities in which convex portions and concave portions are alternately arranged on the inner surfaces (that is, opposite surfaces) of the pair of upper and lower forceps pieces 5 and 5. Yes.
  • the treatment section 3 is provided so that the inner surfaces 5a and 5a facing each other in a pair of forceps pieces 5 and 5 are at least partially in contact with each other. As a result, the treatment section 3 functions as a grasping forceps called an inguinal forceps that grips the body tissue between the forceps pieces 5 and 5.
  • the forceps pieces 5 and 5 are connected to a link mechanism 6, and the link mechanism 6 performs an opening / closing operation.
  • the link mechanism 6 is connected to an operating member (not shown) that operates in the axial direction of the high-frequency treatment instrument 1, and is further connected to a conductive operation wire (not shown) through this operating member. Thereby, the operation wire and the operating member are moved in the axial direction by the operation of the operation unit 4, the link mechanism 6 is operated, and the forceps pieces 5 and 5 constituting the treatment unit 3 are opened and closed.
  • the forceps pieces 5 and 5 are connected to the operation wire via the link mechanism 6 and the operation member, and each of these members is formed of a conductive member. Therefore, these members constitute a power feeding path from the power terminal 12 provided in the operation unit 4 to the forceps pieces 5 and 5.
  • the inner surfaces 5a and 5a of the forceps pieces 5 and 5 are exposed, but portions other than the inner surfaces 5a and 5a are covered with insulation. Thereby, the mutually opposing inner surfaces 5a, 5a of the pair of forceps pieces 5, 5 serve as electrode portions, and a high-frequency current can flow.
  • the high-frequency treatment instrument 1 of the present embodiment uses a material having a thermal conductivity of 18 W / m ⁇ K or more and 30 W / m ⁇ K or less for the forceps pieces 5 and 5 constituting the treatment section 3. It is a feature.
  • the thermal conductivity means the thermal conductivity at 100 ° C., and can be measured by, for example, a temperature gradient method, a laser flash method, or a hot wire method.
  • the lower limit value of the thermal conductivity is preferably 18 W / m ⁇ K or more, more preferably 20 W / m ⁇ K or more, and further preferably 22 W / m ⁇ K or more.
  • the upper limit value of the thermal conductivity is preferably 30 W / m ⁇ K or less, more preferably 28 W / m ⁇ K or less, and further preferably 27 W / m ⁇ K or less.
  • the thermal conductivity of the material of the electrode portion of the treatment portion 3 is 18 to 30 W / m ⁇ K, preferably 18 to 28 W / m ⁇ K, more preferably 20 to 28 W / m ⁇ K. 20 to 27 W / m ⁇ K is more preferable, and 22 to 27 W / m ⁇ K is particularly preferable.
  • the upper limit exceeds 30 W / m ⁇ K excessive heat is applied to the cautery treatment part, and the visibility is hindered by water vapor generated during treatment of the body tissue, and work efficiency decreases until the water vapor clears. Therefore, the treatment may take time, which is not preferable.
  • the thermal conductivity of the material used for the forceps pieces 5 and 5 is within the above range, the tissue does not adhere to the forceps pieces 5 and 5 when the internal tissue is cauterized. This is preferable because there is no fear of lowering.
  • the material used for the forceps pieces 5 and 5 is not particularly limited as long as the thermal conductivity is within the above range.
  • Specific examples of such materials include stainless steel, titanium, monel metal, constantan, and the like.
  • stainless steel is preferable in terms of price, workability, biocompatibility, and conductivity.
  • stainless steel is austenitic stainless steel (chromium nickel), martensitic stainless steel (chromium), ferrite stainless steel (chromium), duplex stainless steel (chromium nickel), precipitation hardening stainless steel according to JIS standards. Five systems (chromium nickel system) are defined.
  • stainless steel used for the forceps pieces 5 and 5 for example, SUS403 (JIS standard steel type symbol, the same shall apply hereinafter), SUS410, SUS410S, SUS420J1, SUS420J2, SUS440A, SUS440C, or other martensitic stainless steel (chromium); SUS405, SUS410L, SUS429, SUS430, SUS430LX, SUS430J1L, SUS434, SUS436L, SUS436J1L, SUS445J1, SUS445J2, SUS444, SUS447J1, SUSXM27, etc. ) Based stainless steel (chromium nickel based) is preferred.
  • SUS440C and SUS444 are particularly preferable.
  • SUS440C is used as the material for the forceps pieces 5 and 5
  • the tissue is difficult to adhere to the electrode part during cauterization, and the forceps piece as the electrode part is easily peeled off from the tissue. Because of this material, the property of excellent durability can be obtained.
  • SUS444 is used, it is excellent in corrosion resistance.
  • Table 1 shows the thermal conductivity of typical stainless steel. Of the stainless steels shown in Table 1, stainless steel having a thermal conductivity of 18 to 30 W / m ⁇ K can be preferably used.
  • this embodiment demonstrated the case where the material of required heat conductivity was applied to the forceps pieces 5 and 5 which comprise the treatment part 3 whole, it is not limited to this. Specifically, a material having a required thermal conductivity may be applied only to the electrode portion (that is, the inner surfaces 5a and 5a of the forceps pieces 5 and 5 facing each other) of the treatment portion 3 that are in contact with the body tissue.
  • the operation wire (not shown) is a metal wire inserted into the lumen of the sheath portion 2.
  • the distal end of the operation wire is connected to the treatment unit 3.
  • the proximal end of the operation wire is connected to the operation unit 4. Accordingly, the treatment section 3 can be driven and operated via the operation wire by operating the operation section 4.
  • a torque wire or a torque rope made of a conductive material such as stainless steel and having a high torque performance as the operation wire.
  • the rotation to the treatment section 3 can be transmitted without loss by using an operation wire having high torque performance.
  • the operation unit 4 includes a rotation operation unit 9 that rotates integrally with the treatment unit 3 via a high-frequency application unit 8 and an operation wire (not shown) inserted into the main body 7. And a slider portion 10 that is slidably supported in the axial direction of the rotation operation portion 9 and assists the operation of the treatment portion 3, and a handle portion 11 that assists the operation of the slider portion 10. .
  • the high frequency application section 8 is provided with an electrode terminal 12 connected to a high frequency current cord (not shown).
  • the high frequency application unit 8 is rotatable independently of the rotation operation unit 9.
  • the shape of the slider portion 10 is not particularly limited, but it is preferable that the slider can be engaged with the middle finger and the index finger of the operator's hand.
  • the shape of the handle portion 11 is not particularly limited, but is preferably a ring shape so that the operator's thumb can be inserted.
  • the slider portion 10 and the treatment portion 3 are connected to an operation wire that is inserted into the main body 7. Accordingly, the treatment unit 3 can be operated by sliding the slider unit 10 in the axial direction with respect to the main body 7. In addition, the treatment unit 3 can be rotated by rotating the rotation operation unit 9.
  • the high-frequency treatment tool 1 of the present embodiment has a function of grasping a body tissue as grasping forceps.
  • the high-frequency treatment instrument 1 is used without being connected to a high-frequency power source.
  • the treatment portion 3 provided at the distal end of the sheath portion 2 is inserted into the body, and is faced to an organ or tissue to be grasped, and the slider portion 10 is moved along the axial direction of the main body 7.
  • the forceps pieces 5 and 5 are opened and closed.
  • the conventional high-frequency treatment instrument has a problem that the forceps piece is difficult to be peeled off from the tissue because the tissue adheres to the forceps piece serving as the electrode portion when performing a treatment for cauterizing the body tissue.
  • the electrode part is to be peeled from the tissue, the attached tissue follows the movement of the electrode part, and the workability may be reduced.
  • the ring-shaped operation wires 25a to 25c constituting the treatment portion 23 (23A to 23C) of the present embodiment, or at least the portion in contact with the tissue in the body, are required as described in the first embodiment.
  • a material with thermal conductivity is applied. Thereby, the effect similar to 1st Embodiment is acquired.
  • the shapes and sizes of the ring-shaped operation wires 25a to 25c constituting the treatment portion 23 (23A to 23C) of the present embodiment shown in FIGS. 4A to 4C are merely examples, and are limited to this. It is not a thing.
  • FIGS. 5A to 5C show enlarged views of the treatment portion constituting the high-frequency treatment device of the third embodiment.
  • the treatment portions 33 (33A to 33C) of the present embodiment are treatment portions having different shapes at the distal end portions 35a to 35c.
  • the knife-type treatment portion 33A having the bent distal end portion 35a shown in FIG. 5A has a treatment portion while applying a high-frequency current to the living tissue while the bent distal end portion 35a is hooked on the living tissue.
  • the biological tissue is incised by pulling 33A proximally.
  • the treatment portion 33B having a needle-shaped tip portion 35b shown in FIG. 5B the tip portion 35b is pressed against the living tissue, and an incision is made while applying high-frequency current to the living tissue.
  • the treatment portion 33C has a needle-like portion and a substantially hemispherical portion with an enlarged diameter provided at the forefront of the needle-like portion, the treatment portion 33C is replaced with a living tissue.
  • the treatment portion 33C is pulled toward the proximal end while applying a high-frequency current to the living tissue, and the living tissue is incised.
  • the required thermal conductivity described in the first embodiment is applied to the entirety of the distal end portions 35a to 35c constituting the treatment portion 33 (33A to 33C) of this embodiment, or at least the portion in contact with the body tissue. Material has been applied. Thereby, the same effect as the first and second embodiments can be obtained.
  • the shapes and sizes of the distal end portions 35a to 35c constituting the treatment portion 33 (33A to 33C) of the present embodiment shown in FIGS. 5A to 5C are merely examples, and the present invention is not limited thereto. .
  • a high frequency current is applied in the state which hold
  • the material having the required thermal conductivity described in the first embodiment is applied to the tip forceps pieces 45 and 45 constituting the treatment portion 43 of the present embodiment. Thereby, the same effects as those of the first to third embodiments can be obtained.
  • this embodiment demonstrated the case where the material of required heat conductivity was applied to the front-end
  • the tissue adhesion was evaluated using the produced mouth-holding forceps.
  • the operating procedure, the conditions of the high frequency power supply, the ablation object, and the judgment criteria are as shown below.
  • [Operating procedure] (1) Place an ablation object (pig esophageal mucosa) on the counter electrode. (2) The ablation object is sandwiched between the electrode parts, and ablation is performed for 10 seconds while the electrode part is drawn in the opposite direction with respect to the ablation object. (3) The state of the electrode part after cauterization is observed. (4) The above operations 2 and 3 are repeated by changing the location of the ablation object. (5) From the result of (3), “ ⁇ ”, “ ⁇ ”, and “ ⁇ ” are determined according to the following criteria.
  • High frequency power supply VIO300D (manufactured by Elbe)
  • Output Soft coag E5 50W
  • test Example 1 and Test Example 2 forceps pieces were made of a material having a thermal conductivity of 16.3 (W / m ⁇ K) at 100 ° C.
  • a forceps piece was made of a material having a thermal conductivity of 50 (W / m ⁇ K) at 100 ° C.
  • water vapor was generated during the cauterization treatment of the living tissue, obstructing the view of the operator, and the work efficiency was lowered, so the test was stopped.
  • Test Example 3 Test Example 4 and Test Example 5
  • the forceps pieces are made of materials having thermal conductivities at 100 ° C. of 24.3, 25.9 and 27.2 (W / m ⁇ K), respectively. It was produced.
  • the grasping forceps of Test Example 3, Test Example 4, and Test Example 5 it was confirmed that when the living tissue was cauterized, the tissue did not adhere to the forceps piece as the electrode portion.
  • the grasping forceps of Test Example 3 and Test Example 4 it was observed that the tissue was not attached at all visually.

Abstract

L'invention concerne un instrument de traitement à haute fréquence qui comprend: une section d'insertion qui doit être insérée dans une cavité du corps; un fil d'actionnement qui est inséré à travers la section d'insertion de manière à être capable d'être avancé et rétracté; une section de traitement qui est disposée à l'extrémité distale du fil d'actionnement et qui traite un tissu d'organisme vivant par application d'un courant électrique haute fréquence au tissu de l'organisme vivant; et une section d'actionnement qui est attachée à l'extrémité proximale de la section d'insertion et qui actionne la section de traitement. Un matériau ayant une conductivité thermique dans la plage de 18 W/m·K à 30 W/m·K, y compris, à 100°C est utilisé pour la portion d'électrode de la section de traitement, la portion d'électrode venant en contact avec au moins le tissu corporel.
PCT/JP2014/069283 2013-08-16 2014-07-22 Instrument de traitement à haute fréquence WO2015022842A1 (fr)

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JP2013-169025 2013-08-16
JP2013169025 2013-08-16

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WO2015022842A1 true WO2015022842A1 (fr) 2015-02-19

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Publication number Priority date Publication date Assignee Title
US10980402B2 (en) * 2019-04-03 2021-04-20 Olympus Corporation Diathermic endotherapeutic device

Citations (3)

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Publication number Priority date Publication date Assignee Title
JPH0838495A (ja) * 1994-07-29 1996-02-13 Olympus Optical Co Ltd 内視鏡用処置具
JP2005512726A (ja) * 2001-12-27 2005-05-12 ジラス グループ パブリック リミティド カンパニー 外科手術用器具
JP2011072324A (ja) * 2009-09-29 2011-04-14 Olympus Corp 医療用処置具および医療用処置具の製造方法

Family Cites Families (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5324289A (en) * 1991-06-07 1994-06-28 Hemostatic Surgery Corporation Hemostatic bi-polar electrosurgical cutting apparatus and methods of use
US7235073B2 (en) * 2000-07-06 2007-06-26 Ethicon Endo-Surgery, Inc. Cooled electrosurgical forceps

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPH0838495A (ja) * 1994-07-29 1996-02-13 Olympus Optical Co Ltd 内視鏡用処置具
JP2005512726A (ja) * 2001-12-27 2005-05-12 ジラス グループ パブリック リミティド カンパニー 外科手術用器具
JP2011072324A (ja) * 2009-09-29 2011-04-14 Olympus Corp 医療用処置具および医療用処置具の製造方法

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JP2015057089A (ja) 2015-03-26

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