WO2015029518A1 - 把持処置装置及び把持ユニット - Google Patents
把持処置装置及び把持ユニット Download PDFInfo
- Publication number
- WO2015029518A1 WO2015029518A1 PCT/JP2014/063812 JP2014063812W WO2015029518A1 WO 2015029518 A1 WO2015029518 A1 WO 2015029518A1 JP 2014063812 W JP2014063812 W JP 2014063812W WO 2015029518 A1 WO2015029518 A1 WO 2015029518A1
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- WO
- WIPO (PCT)
- Prior art keywords
- distal treatment
- jaw
- distal
- contact
- section
- Prior art date
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Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B18/1442—Probes having pivoting end effectors, e.g. forceps
- 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
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/28—Surgical forceps
- A61B17/2812—Surgical forceps with a single pivotal connection
- A61B17/282—Jaws
- A61B2017/2825—Inserts of different material in jaws
-
- 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
- A61B17/2909—Handles
- A61B2017/2912—Handles transmission of forces to actuating rod or piston
- A61B2017/2913—Handles transmission of forces to actuating rod or piston cams or guiding means
- A61B2017/2916—Handles transmission of forces to actuating rod or piston cams or guiding means 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
-
- 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
- A61B2017/320069—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic for ablating tissue
-
- 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
- A61B2017/320071—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with articulating means for working tip
-
- 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
- A61B2017/320088—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with acoustic insulation, e.g. elements for damping vibrations between horn and surrounding sheath
-
- 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
- A61B2017/320089—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic node location
-
- 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
- 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
Definitions
- the present invention includes a distal treatment section to which ultrasonic vibration is transmitted, and a jaw (gripping unit) that can be opened and closed with respect to the distal treatment section, and a treatment target grasped between the distal treatment section and the jaw.
- the present invention relates to a grasping treatment apparatus to be treated.
- Patent Document 1 discloses a grasping treatment device including an ultrasonic probe serving as a vibration transmission unit provided with a distal treatment part at a distal part, and a jaw (gripping unit) that can be opened and closed with respect to the distal treatment part.
- ultrasonic probe serving as a vibration transmission unit provided with a distal treatment part at a distal part
- a jaw grip unit
- the ultrasonic probe ultrasonic vibration is transmitted from the proximal direction toward the distal direction toward the distal treatment section.
- the distal treatment section functions as a probe electrode section by transmitting a high-frequency current through the ultrasonic probe.
- the ultrasonic probe is inserted through the sheath in a state where the distal treatment section projects in the distal direction.
- the jaw is attached to the distal end of the sheath.
- the jaw is provided with an abutting portion that can abut against the distal treatment section in a state of being closed with respect to the distal treatment section.
- the contact portion is made of an insulating material.
- the jaw is provided with a jaw electrode portion formed of a conductive material. A high frequency current is transmitted to the jaw electrode portion through the sheath. In a state where the contact portion is in contact with the distal treatment portion, the jaw electrode portion is not in contact with the distal treatment portion.
- the treatment target is treated using ultrasonic vibration and high-frequency current in a state where the treatment target such as a living tissue is grasped between the distal treatment section and the jaw.
- the ultrasonic probe (vibration transmission unit) provided in the grasping treatment apparatus as in Patent Document 1 vibrates by transmitting ultrasonic vibration, it is supported with respect to the sheath only at the node position of the vibration.
- the distal end of the ultrasonic probe is an anti-vibration position of the vibration, and the distal treatment portion provided at the distal end of the ultrasonic probe is located away from the node position supported with respect to the sheath. For this reason, the distal treatment section is not firmly fixed to the sheath.
- the distal treatment section is twisted about the central axis by the pressing force acting on the distal treatment section from the jaw, or with respect to the jaw in the width direction. Or move.
- the distal treatment section is twisted or moved in one of the width directions, so that the distal treatment section serving as the probe electrode section may come into contact with the jaw electrode section of the jaw.
- the ultrasonic treatment is transmitted to the distal treatment section and the high frequency current is transmitted to the distal treatment section and the jaw electrode section of the jaw, the distal treatment section comes into contact with the jaw electrode section. A spark is generated between the electrodes. Then, due to the occurrence of the spark, a crack is generated in the distal treatment portion of the ultrasonic probe.
- the present invention has been made paying attention to the above-mentioned problems, and the object of the present invention is to effectively prevent the distal treatment portion from contacting the jaw electrode portion by twisting or movement of the distal treatment portion in the width direction.
- a grasping treatment device includes a vibration transmission unit that extends along a central axis and transmits ultrasonic vibration from a proximal direction to a distal direction, and the vibration transmission unit A distal treatment section that functions as a probe electrode section having a first potential by transmitting a high-frequency current, a jaw that can be opened and closed with respect to the distal treatment section, and one of the jaws.
- a contact portion that is formed of an insulating material and can be brought into contact with the distal treatment portion in a state in which the jaw is closed with respect to the distal treatment portion; and a conductive material in a portion different from the contact portion in the jaw
- the contact portion is in contact with the distal treatment portion in a state where the contact portion is in contact with the distal treatment portion.
- a jaw electrode portion including an electrode facing surface that is spaced apart from the distal treatment portion and faces the distal treatment portion, and the central axis
- a jaw insulating portion formed of an insulating material at a position away from the abutting portion in the first width direction and the second width direction, wherein the abutting portion abuts on the distal treatment portion
- the insulation facing surface is spaced apart from the distal treatment portion and opposed to the distal treatment portion.
- a distal treatment portion that functions as a probe electrode portion having a first potential is provided at the distal portion, and extends along the central axis.
- a gripping treatment apparatus including a vibration transmitting unit that transmits ultrasonic vibration from an end direction to a distal direction, wherein the gripping unit is openable and closable with respect to the distal treatment unit, and is formed of an insulating material.
- a contact portion that can be in contact with the distal treatment portion in a state of being closed with respect to the treatment portion, and a conductive material that is formed on a portion different from the contact portion, and a high-frequency current is transmitted to the first treatment portion.
- the jaw electrode part having an electrode facing surface that is spaced apart from the distal treatment part and faces the distal treatment part, and perpendicular to the central axis and perpendicular to the opening direction and the closing direction of the gripping unit
- the contact portion in the first width direction and the second width direction A jaw insulating portion formed of an insulating material at a position away from the distal treatment portion, spaced apart from the distal treatment portion in the state where the contact portion is in contact with the distal treatment portion
- An insulating facing surface is provided, and at least a part of the insulating facing surface is spaced apart from the distal treatment portion than any position of the electrode facing surface in the state where the
- the present invention it is possible to provide a gripping treatment device and a gripping unit that can effectively prevent the tip treatment portion from coming into contact with the jaw electrode portion by twisting or movement of the tip treatment portion in the width direction.
- FIG. 3 is a cross-sectional view schematically illustrating a configuration of a vibrator unit according to the first embodiment. It is sectional drawing which shows schematically the internal structure of the holding
- FIG. 6 is a sectional view taken along line VI-VI in FIG. 3.
- FIG. 8 is a cross-sectional view schematically showing a state in which the distal treatment section according to the first embodiment is twisted about the central axis in the first twist direction from the state of FIG. 7. It is sectional drawing which shows schematically the state which the front-end
- FIG. 1 is a diagram showing a treatment system using the grasping treatment device 1 of the present embodiment.
- the grasping treatment apparatus 1 has a longitudinal axis L parallel to the longitudinal direction.
- the grasping treatment apparatus 1 includes a transducer unit 2, an ultrasonic probe 3, and a holding unit 4.
- the grasping treatment device 1 has a central axis C that passes through the center of the ultrasonic probe 3.
- One of the directions parallel to the central axis C is the distal direction (the direction of the arrow C1 in FIG. 1), and the opposite direction to the distal direction is the proximal direction (the direction of the arrow C2 in FIG. 1).
- tip direction and a base end direction be an axis parallel direction.
- the grasping treatment apparatus 1 is an ultrasonic coagulation / cutting apparatus that performs a coagulation / cutting of a treatment target such as a living tissue using ultrasonic vibration.
- the grasping treatment device 1 is a high-frequency treatment device (bipolar treatment device) that performs treatment of a treatment target using a high-frequency current.
- the holding unit 4 has a cylindrical case portion 5 extending along the central axis C (longitudinal axis L), a fixed handle 6 formed integrally with the cylindrical case portion 5, and the cylindrical case portion 5. And a movable handle 7 that is rotatably attached.
- the movable handle 7 opens or closes the fixed handle 6 by rotating the movable handle 7 around the attachment position to the cylindrical case portion 5.
- the holding unit 4 includes a rotation operation knob 8 attached to the distal direction side of the cylindrical case portion 5.
- the rotation operation knob 8 can rotate around the longitudinal axis L (center axis C) with respect to the cylindrical case portion 5.
- an energy operation input button 9 that is an energy operation input unit is attached to the fixed handle 6.
- the vibrator unit 2 includes a vibrator case 11. One end of a cable 12 is connected to the base end of the vibrator case 11. The other end of the cable 12 is connected to the power supply unit 15.
- the power supply unit 15 includes an ultrasonic current supply unit 16, a high frequency current supply unit 17, and a supply control unit 18.
- the control unit 15 is an energy generator including, for example, a CPU (Central Processing Unit), an ASIC (Application Specific Specific Integrated Circuit), and the like.
- the ultrasonic current supply unit 16 and the high-frequency current supply unit 17 are power supplies provided in, for example, an energy generator, and the energy control unit 18 is formed by an electronic circuit (control circuit) provided in, for example, a CPU, ASIC, or the like. ing.
- FIG. 2 is a diagram showing the configuration of the vibrator unit 2.
- the transducer unit 2 includes an ultrasonic transducer 21 that is an ultrasonic generation unit that generates ultrasonic vibration when supplied with electric current (electric power).
- the ultrasonic transducer 21 is provided inside the transducer case 11.
- the ultrasonic transducer 21 includes a plurality (four in this embodiment) of piezoelectric elements 22A to 22D that convert current (alternating current) into vibration.
- a horn member 23 extending along the central axis C (longitudinal axis L) is provided inside the vibrator case 11.
- the horn member 23 includes a vibrator mounting portion 25.
- a member for forming the ultrasonic vibrator 21 such as the piezoelectric elements 22A to 22D is attached to the vibrator mounting portion 25.
- the horn member 23 is formed with a cross-sectional area changing portion 26. In the cross-sectional area changing portion 26, the cross-sectional area perpendicular to the central axis C (longitudinal axis L) becomes smaller toward the front end direction.
- the cross-sectional area changing unit 26 increases the amplitude of the ultrasonic vibration.
- a female screw portion 27 is provided at the tip of the horn member 23.
- a male screw portion 28 is provided at the proximal end portion of the ultrasonic probe 3.
- the ultrasonic probe 3 is connected to the distal direction side of the horn member 23.
- the ultrasonic probe 3 extends along the central axis C.
- the ultrasonic probe 3 is inserted through a sheath 31.
- a distal treatment section 32 is provided at the distal end of the ultrasonic probe 3.
- the ultrasonic probe 3 is inserted into the sheath 31 with the distal treatment section 32 protruding from the distal end of the sheath 31 in the distal direction.
- a jaw 33 as a gripping unit is rotatably attached to the distal end portion of the sheath 31. When the jaw 33 rotates with respect to the sheath 31, the jaw 33 performs an opening operation or a closing operation with respect to the distal treatment section 32.
- one end of electrical wirings 35 ⁇ / b> A and 35 ⁇ / b> B is connected to the ultrasonic transducer 21.
- the electrical wirings 35 ⁇ / b> A and 35 ⁇ / b> B pass through the inside of the cable 12, and the other end is connected to the ultrasonic current supply unit 16 of the power supply unit 15.
- An ultrasonic vibration is generated in the ultrasonic transducer 21 by supplying an ultrasonic generation current from the ultrasonic current supply unit 16 to the ultrasonic transducer 21 via the electrical wirings 35 ⁇ / b> A and 35 ⁇ / b> B.
- the generated ultrasonic vibration is transmitted from the ultrasonic transducer 21 to the ultrasonic probe 3 via the horn member 23.
- ultrasonic vibration is transmitted from the proximal direction to the distal direction in the ultrasonic probe 3 to the distal treatment section 32. That is, the ultrasonic probe 3 serves as a vibration transmission unit that transmits ultrasonic vibration from the proximal direction to the distal direction.
- the distal treatment section 32 performs treatment of a treatment target such as a living tissue using the transmitted ultrasonic vibration.
- the ultrasonic probe 3 transmits the ultrasonic vibration to perform a vertical vibration whose vibration direction is parallel to the central axis C in a predetermined vibration mode used at the time of treatment.
- the distal end of the ultrasonic probe 3 (the distal end of the distal treatment section 32) is the most advanced antinode position A1, which is one of the antinode positions of longitudinal vibration.
- the most advanced antinode position A1 is the antinode position located on the most distal direction side among the antinode positions of the longitudinal vibration. That is, the resonance frequency is adjusted so that the tip of the ultrasonic probe 3 vibrates in a predetermined vibration mode that is the most advanced antinode position A1.
- the proximal end of the horn member 23 and the distal end of the ultrasonic probe 3 are antinodes, and at least one longitudinal vibration node position is provided between the proximal end of the horn member 23 and the ultrasonic probe 3.
- One end of an electrical wiring 36 is connected to the horn member 23.
- the electrical wiring 36 passes through the inside of the cable 12, and the other end is connected to the high-frequency current supply unit 17 of the power supply unit 15.
- a probe-side current path of the high-frequency current supplied from the high-frequency current supply unit 17 is formed from the high-frequency current supply unit 17 through the electrical wiring 36, the horn member 23, and the ultrasonic probe 3 to the distal treatment section 32.
- the distal treatment section 32 functions as a probe-side electrode section having the first potential E1.
- FIG. 3 is a diagram showing an internal configuration of the holding unit 4.
- the sheath 31 and the ultrasonic probe 3 are inserted into the cylindrical case portion 5 from the distal direction side, and the transducer unit 2 is inserted into the cylindrical case portion 5 from the proximal direction side. Has been inserted.
- the proximal end portion of the sheath 31 is connected to the distal end portion of the transducer case 11 inside the cylindrical case portion 5.
- the ultrasonic probe 3 is connected to the horn member 23 inside the cylindrical case portion 5.
- the sheath 31 has a fixed cylindrical member 41 fixed to the rotation operation knob 8 via the engagement pins 38A and 38B, and a central axis C with respect to the cylindrical case portion 5, the rotation operation knob 8, and the fixed cylinder member 41. And a movable cylindrical member 42 movable along (longitudinal axis L).
- the movable cylindrical member 42 is provided on the outer peripheral direction side of the fixed cylindrical member 41 and is connected to the rotary operation knob 8 via the engagement pins 38A and 38B.
- the fixed cylindrical member 41 is made of an insulating material
- the movable cylindrical member 42 is made of a conductive material.
- the movable cylindrical member 42 is movable along the central axis C with respect to the rotation operation knob 8, but is restricted so as not to rotate about the longitudinal axis L with respect to the rotation operation knob 8. Due to the above-described configuration, the fixed cylindrical member 41 and the movable cylindrical member 42 rotate with respect to the cylindrical case portion 5 around the longitudinal axis L (central axis C) integrally with the rotation operation knob 8. Is possible.
- the movable cylindrical member 42 is engaged with the transducer case 11 with the movable cylindrical member 42 inserted into the transducer case 11.
- the sheath 31 is coupled to the transducer case 11.
- the movable cylindrical member 42 and the transducer case 11 are restricted so as not to rotate about the longitudinal axis L with respect to each other.
- the movable cylindrical member 42 is movable along the central axis C (longitudinal axis L) with respect to the transducer case 11.
- a slider member 43 formed of an insulating material is provided on the outer peripheral direction side (the off-axis direction side) of the movable cylindrical member 42.
- the slider member 43 is disposed on the outer peripheral surface of the movable cylindrical member 42.
- a movable handle 7 is attached to the slider member 43.
- a coil spring 45 is provided on the outer peripheral direction side of the movable cylindrical member 42. The proximal end of the coil spring 45 is connected to the slider member 43, and the distal end of the coil spring 45 is connected to the movable cylindrical member 42.
- the coil spring 45 extends between the slider member 43 and the coil spring 45 in a state where the coil spring 45 is contracted by a certain contraction amount from the natural state.
- the operating force on the movable handle 7 is transmitted to the movable cylindrical member 42 via the slider member 43 and the coil spring 45.
- the movable cylindrical member 42 moves along the central axis C with respect to the ultrasonic probe 3 and the holding unit 4.
- the sheath 31 includes an outer tube 46 that is fixed to the distal end of the fixed cylindrical member 41, and an inner tube 47 that is provided on the inner circumferential direction side (axial direction side) from the outer tube 46.
- the inner tube 47 is fixed to the distal end portion of the fixed cylindrical member 41. Since the outer tube 46 and the inner tube 47 are fixed to the fixed cylindrical member 41, the outer tube 46 and the inner tube 47 are integrated with the rotary operation knob 8 and have a longitudinal axis L with respect to the cylindrical case portion 5. It can rotate around (center axis C).
- the sheath 31 includes a movable pipe 51 that is fixed to the distal end portion of the movable cylindrical member 42.
- the movable pipe 51 extends along the central axis C (longitudinal axis L) between the outer tube 46 and the inner tube 47 in the radial direction (inner circumferential direction and outer circumferential direction).
- the movable pipe 51 is fixed to the movable cylindrical member 42 via the connection member 52.
- the movable pipe 51 is made of a conductive material.
- FIGS. 4 and 5 are diagrams showing the configuration of the distal end portion of the grasping treatment device 1.
- the outer tube 46, the inner tube 47, and the movable pipe 51 are extended to the distal end portion of the sheath 31.
- the jaw 33 as a gripping unit is connected to the outer tube 46 via a connecting pin 53.
- the tip of the movable pipe 51 is connected to the jaw 33 via a connection pin 55.
- the jaw 33 rotates about the connecting pin 53.
- the jaw 33 performs an opening operation or a closing operation on the distal treatment section 32.
- a treatment target such as a living tissue is grasped between the jaw 33 and the distal treatment section 32.
- the vibrator case 11 is formed with a conductive portion 56.
- One end of an electrical wiring 57 is connected to the conductive portion 56.
- the electrical wiring 57 passes through the inside of the cable 12, and the other end is connected to the high-frequency current supply unit 17 of the power supply unit 15.
- the jaw side current path is formed.
- the supply control unit 18 determines the supply state of the ultrasonic generation current from the ultrasonic current supply unit 16 and the supply state of the high frequency current from the high frequency current supply unit 17 based on the input of the energy operation with the energy operation input button 9.
- I have control.
- an electric circuit board 61 is provided inside the fixed handle 6.
- the electric circuit board 61 is provided with a switch 62.
- the switch 62 is closed.
- One end of an electric signal line 63 is connected to the switch 62.
- An electrical connection ring 65 is fixed to the inner peripheral surface of the cylindrical case portion 5.
- the other end of the electrical signal line 63 is connected to a conductive portion (not shown) of the electrical connection ring 65.
- the switch 62 is electrically connected to the supply control unit 18 through an electric signal path formed by the electric signal line 63, the conductive portion of the electric connection ring 65, and the like.
- an electric signal is transmitted to the supply control unit 18 and an energy operation input is detected.
- an ultrasonic generation current is supplied from the ultrasonic current supply unit 16, and a high frequency current is supplied from the high frequency current supply unit 17.
- the ultrasonic probe 3 is fixed to the fixed cylindrical member 41 of the sheath 31 at a fixed node position N1 which is one of the vertical vibration node positions in the predetermined vibration mode. .
- the fixed node position N1 is located at the proximal end portion of the ultrasonic probe 3.
- 6 is a cross-sectional view taken along the line VI-VI in FIG. 3, and shows the ultrasonic probe 3 and the sheath 31 at the fixed node position N1 in a cross section perpendicular to the central axis C (longitudinal axis L). As shown in FIG.
- the ultrasonic probe 3 is provided with engagement grooves 66 ⁇ / b> A and 66 ⁇ / b> B and engagement protrusions 67 at positions corresponding to the fixed node position N ⁇ b> 1 in the direction parallel to the central axis C.
- the fixed cylindrical member 41 of the sheath 31 is provided with engagement protrusions 71A and 71B and an engagement groove 72 at positions corresponding to the engagement grooves 66A and 66B and the engagement protrusion 67 in the axis parallel direction. .
- the engagement protrusion 71A engages with the engagement groove 66A
- the engagement protrusion 71B engages with the engagement groove 66B
- the engagement protrusion 67 engages with the engagement groove 72.
- the acoustic probe 3 is fixed to the fixed cylindrical member 41.
- an insulating material is formed between the ultrasonic probe 3 and the sheath 31 at the most advanced node position N2, which is one of the longitudinal vibration node positions in the predetermined vibration mode.
- a support member 73 is provided.
- the most advanced node position N2 is a node position that is located closest to the distal direction among the node positions of the longitudinal vibration in the predetermined vibration mode.
- the ultrasonic probe 3 is supported with respect to the sheath 31 by the support member 73. Further, the ultrasonic probe 3 is supported by the sheath 31 by a support member (not shown) similar to the support member 73 also at the longitudinal vibration node positions other than the fixed node position N1 and the most distal node position N2.
- the ultrasonic probe 3 is not fixed to the sheath 31 and is not supported by the sheath 31. Since the ultrasonic probe 3 is fixed or supported with respect to the sheath 31 only at the node position of the vertical vibration where the amplitude is zero, the ultrasonic probe 3 appropriately performs the vertical vibration by transmitting the ultrasonic vibration.
- the distal treatment section 32 includes a coaxial extension 75 that extends in a state where the central axis C is coaxial with the longitudinal axis L.
- one of the directions perpendicular to the central axis C and perpendicular to the opening direction of the jaw 33 (the direction of the arrow I1 in FIG. 5) and the closing direction (the direction of the arrow I2 in FIG. 5) is the first width direction (
- a direction opposite to the first width direction is a second width direction (a direction indicated by an arrow B2 in FIG. 5).
- the distal treatment section 32 includes a curved extending portion 76 in which the central axis C is curved with respect to the longitudinal axis L from the second width direction toward the first width direction.
- the curved extending portion 76 is continuous to the distal direction side of the coaxial extending portion 75.
- the center of gravity of the distal treatment portion 32 is located on the first width direction side from the longitudinal axis L.
- the central axis C passing through the center of the horn member 23 and the center of the ultrasonic probe 3 is coaxial with the longitudinal axis L in portions other than the curved extending portion 76.
- the jaw 33 includes a jaw main body 81 formed of a conductive material, and a jaw electrode portion 83 attached to the jaw main body 81 via a connection pin 82.
- the proximal end portion of the jaw body 81 is attached to the distal end portion of the sheath 31.
- the jaw electrode portion 83 is made of a conductive material.
- a pad member 85 made of an insulating material is attached to the jaw electrode portion 83.
- the high-frequency current transmitted to the jaw 33 through the jaw-side current path is transmitted to the jaw electrode portion 83 through the jaw body 81 and the connection pin 82.
- the jaw electrode portion 83 has a second potential E2 different from the first potential E1.
- FIG. 7 is a view showing the distal treatment section 32 and the jaw 33 in a cross section perpendicular to the central axis C.
- the jaw 33 is closed with respect to the distal treatment section 32 in a state where there is no treatment target between the jaw 33 and the distal treatment section 32.
- the contact portion 87 of the pad member 85 is moved to the distal treatment section. 32. That is, the pad member 85 of the jaw 33 is formed with a contact portion 87 that can contact the distal treatment portion 32 with the jaw 33 closed with respect to the distal treatment portion 32 as a part of the jaw 33.
- the cross section perpendicular to the central axis C of the distal treatment section 32 is formed in a substantially octagonal shape.
- the distal treatment section 32 includes a treatment section facing surface 91 that faces the jaw 33.
- the treatment portion facing surface 91 includes a receiving surface 92 with which the contact portion 87 of the pad member 85 contacts, and inclined surfaces 93A and 93B inclined with respect to the receiving surface 92.
- the inclined surface 93A is continuous with the first width direction side (the direction of the arrow B1 in FIG. 7) of the receiving surface 92, and the inclined surface 93B is the second width direction side of the receiving surface 92 (the arrow B2 in FIG. 7). (Direction side).
- the jaw electrode part 83 does not come into contact with the distal treatment part 32 in a state where the contact part 87 is in contact with the receiving surface 92 of the distal treatment part 32.
- the jaw electrode portion 83 includes an electrode facing surface 88A that faces the inclined surface 93A of the distal treatment section 32, and an electrode facing surface 88B that faces the inclined surface 93B of the distal treatment section 32.
- the electrode facing surfaces 88 ⁇ / b> A and 88 ⁇ / b> B are separated from the distal treatment section 32 and face the distal treatment section 32 in a state where the contact section 87 is in contact with the distal treatment section 32.
- Each electrode facing surface 88A, 88B is formed in a planar shape. However, the electrode facing surface 88A is not parallel to the inclined surface 93A, and the electrode facing surface 88B is not parallel to the inclined surface 93B. For this reason, in each electrode opposing surface 88A, 88B, the separation distance from the front-end
- the dimension in the first width direction and the second width direction between the distal treatment section 32 and the jaw 33 is defined as a width direction separation dimension.
- the dimension is indicated by the widthwise separation dimension. Since the electrode facing surface 88A is not parallel to the inclined surface 93A and the electrode facing surface 88B is not parallel to the inclined surface 93B, each electrode facing surface 88A, 88B has a separation distance from the distal treatment section 32. Similarly, the dimension in the width direction away from the distal treatment section 32 changes corresponding to the position.
- a position where the width direction separation dimension from the distal treatment section 32 in a state where the contact section 87 is in contact with the distal treatment section 32 is the smallest electrode width separation position ( Q1, Q2).
- the width direction separation dimension from the distal treatment portion 32 is large at the electrode minimum width direction separation positions (Q1, Q2) of the respective electrode facing surfaces 88A, 88B. It becomes T1.
- jaw insulating portions 95A and 95B made of an insulating material are attached to the jaw electrode portion 83.
- the jaw insulating portion 95A is formed at a position away from the contact portion 87 in the first width direction
- the jaw insulating portion 95B is formed at a position away from the contact portion 87 in the second width direction. That is, the jaw insulating portions 95A and 95B are provided at positions away from the contact portion 87 in the first width direction and the second width direction. Therefore, the gap between the jaw insulating portions 95A and 95B and the abutting portion 87 is not continuous, and the conductive material is not between the jaw insulating portions 95A and 95B and the abutting portion 87.
- a jaw electrode portion 83 is provided. Further, the jaw insulating portion 95A is located on the first width direction side from the central axis C, and the jaw insulating portion 95B is located on the second width direction side from the central axis C.
- the jaw insulating portions 95A and 95B do not come into contact with the distal treatment portion 32 in a state where the contact portion 87 is in contact with the receiving surface 92 of the distal treatment portion 32.
- the jaw insulating portion 95A includes an insulating protruding portion 97A that protrudes from the electrode facing surface 88A toward the inclined surface 93A of the distal treatment portion 32, and the jaw insulating portion 95B includes the inclined surface 93B of the distal treatment portion 32 from the electrode facing surface 88B. Insulating protrusion 97B that protrudes toward the end.
- the insulating protrusion 97A includes an insulating facing surface 98A that faces the inclined surface 93A of the distal treatment section 32
- the insulating protrusion 97B includes an insulating facing surface 98B that faces the inclined surface 93B of the distal treatment section 32.
- the insulating facing surfaces 98A and 98B are spaced apart from the distal treatment section 32 and opposed to the distal treatment section 32 in a state where the contact section 87 is in contact with the distal treatment section 32.
- Each insulating facing surface 98A, 98B is formed in a planar shape. However, the insulating facing surface 98A is not parallel to the inclined surface 93A, and the insulating facing surface 98B is not parallel to the inclined surface 93B. For this reason, in each insulation opposing surface 98A, 98B, the separation distance from the front treatment part 32 changes according to a position. In each of the insulation facing surfaces 98A and 98B, the position where the separation distance from the distal treatment section 32 in the state where the contact section 87 is in contact with the distal treatment section 32 is the smallest insulation separation position (P3, P4).
- the distance from the distal treatment portion 32 is the size D2 at the minimum insulation separation positions (P3, P4) of the respective insulation facing surfaces 98A and 98B.
- the magnitude D2 of the separation distance from the distal treatment section 32 at the insulation minimum separation position (P3, P4) of each insulation facing surface 98A, 98B is the minimum electrode separation position (P1, P1) of each electrode facing surface 88A, 88B. It becomes smaller than the magnitude D1 of the separation distance from the distal treatment section 32 in P2).
- each of the insulating facing surfaces 98A and 98B is more distant from the distal treatment portion 32 than any position of the electrode facing surfaces 88A and 88B in a state where the contact portion 87 is in contact with the distal treatment portion 32.
- the separation distance is reduced.
- the dimension is indicated by the widthwise separation dimension. Since the insulating facing surface 98A is not parallel to the inclined surface 93A and the insulating facing surface 98B is not parallel to the inclined surface 93B, each of the insulating facing surfaces 98A and 98B has a separation distance from the distal treatment section 32. Similarly, the dimension in the width direction away from the distal treatment section 32 changes corresponding to the position.
- the position where the width direction separation dimension from the distal treatment section 32 is smallest when the contact section 87 is in contact with the distal treatment section 32 is the minimum insulation width direction separation position ( Q3, Q4).
- the widthwise separation dimension from the distal treatment portion 32 is large at the insulation minimum width direction separation positions (Q3, Q4) of the respective insulation facing surfaces 98A, 98B. It becomes T2.
- the size T2 of the width direction separation dimension from the distal treatment section 32 at the insulation minimum separation position (Q3, Q4) of each insulation facing surface 98A, 98B is the separation in the electrode minimum width direction of each electrode facing surface 88A, 88B.
- each of the insulating facing surfaces 98A and 98B has a first width direction and a position greater than the position of the electrode facing surfaces 88A and 88B in a state where the contact portion 87 is in contact with the distal treatment portion 32.
- the distance in the width direction from the distal treatment section 32 in the second width direction is reduced.
- the operation and effect of the grasping treatment device 1 of the present embodiment will be described.
- the ultrasonic probe 3, the sheath 31, and the jaw 33 are inserted into the body cavity.
- the movable handle 7 is closed with respect to the fixed handle 6 in a state where the treatment target is located between the jaw 33 and the distal treatment section 32.
- the movable cylindrical member 42 and the movable pipe 51 move along the central axis C, and the jaw 33 performs a closing operation on the distal treatment section 32.
- the treatment target is grasped between the jaw 33 and the distal treatment section 32.
- an ultrasonic generation current is supplied from the ultrasonic current supply unit 16 to the ultrasonic transducer 21, and the probe-side current path and jaws are supplied from the high-frequency current supply unit 17.
- a high-frequency current is supplied to the side current path.
- Friction heat is generated between the distal treatment section 32 and the treatment target when the distal treatment section 32 vibrates longitudinally while the treatment target is gripped between the jaw 33 and the distal treatment section 32. Frictional heat causes the treatment object to be cut simultaneously with coagulation. Further, high-frequency power is transmitted to the distal treatment section (probe electrode section) 32 through the probe-side current path, and high-frequency power is transmitted to the jaw electrode section 83 of the jaw 33 through the jaw-side current path. For this reason, in a state where the treatment target is gripped between the distal treatment section 32 and the jaw 33, a high-frequency current flows between the distal treatment section 32 and the jaw electrode section 83 through the treatment target. Thereby, the treatment target is transformed and the coagulation of the treatment target is promoted.
- the ultrasonic probe 3 is fixed or supported with respect to the sheath 31 only at the node position of the longitudinal vibration.
- the fixed node position N1 where the ultrasonic probe 3 is fixed to the sheath 31 is located at the proximal end portion of the ultrasonic probe 3 in the axial parallel direction, and the sheath 31 of the ultrasonic probe 3 on the most distal direction side.
- the distal treatment section 32 located at the distal end of the ultrasonic probe 3 and protruding from the sheath 31 in the distal direction has the ultrasonic probe 3 fixed or supported with respect to the sheath 31. It is located away from the node position in the axial parallel direction. For this reason, the distal treatment section 32 is not firmly fixed to the sheath 31. In a state where the treatment target is gripped between the distal treatment section 32 and the jaw 33, a pressing force acts on the distal treatment section 32 from the jaw 33. Since the distal treatment section 32 is not firmly fixed to the sheath 31, the distal treatment section 32 is twisted around the central axis C due to the pressing force from the jaw 33, or the first width direction and the second width. Or move with respect to the jaw 33 in the direction.
- FIG. 8 shows the distal end treatment centering on the central axis C from the state where the jaw 33 is in contact with the receiving surface 92 of the distal end treatment portion 32 (state shown in FIG. 7) to the first twist direction (direction of arrow R1 in FIG. 8). It is a figure which shows the state which the part 32 twisted.
- the jaw 33 and the distal treatment section 32 are shown in a cross section perpendicular to the central axis C.
- the distal treatment section 32 is changed from the state in which the jaw 33 is in contact with the receiving surface 92 of the distal treatment section 32 to the state in which the inclined surface 93A is directed to the jaw 33. 32 is twisted.
- the inclined surface 93B is moved from the state in which the jaw 33 is in contact with the receiving surface 92 of the distal treatment section 32 to the jaw 33.
- the distal treatment section 32 is twisted in a state toward the front.
- the insulating facing surface 98A has a smaller distance from the distal treatment portion 32 than any position of the electrode facing surface 88A in a state where the contact portion 87 is in contact with the distal treatment portion 32. . Therefore, in a state where the distal treatment portion 32 is in contact with the insulation facing surface 98A of the jaw insulating portion 95A by twisting of the distal treatment portion 32 in the first twist direction, the electrode facing surface 88A of the jaw electrode portion 83 is in any position. Is also spaced from the distal treatment section 32.
- the insulation surface 98B of the jaw insulation portion 95B is The inclined surface 93B of the distal treatment section 32 comes into contact.
- the electrode facing surface 88B of the jaw electrode portion 83 is positioned at any position in a state where the distal treatment portion 32 is in contact with the insulation facing surface 98B of the jaw insulating portion 95B. Is also spaced from the distal treatment section 32.
- the distal treatment section 32 is the jaw insulating section. It abuts against the insulating facing surface 98A of 95A or the insulating facing surface 98B of the jaw insulating portion 95B. Thereby, even when the distal treatment section 32 is twisted, it is possible to prevent the distal treatment section 32 that functions as a probe-side electrode section and performs longitudinal vibration from contacting the jaw electrode section 83. Thereby, the occurrence of spark due to the contact of the distal treatment section 32 with the jaw electrode section 83 is effectively prevented, and the occurrence of cracks in the distal treatment section 32 can be effectively prevented.
- FIG. 9 is a view showing a state in which the distal treatment section 32 is moved relative to the jaw 33 in the first width direction from a state where the jaw 33 is in contact with the receiving surface 92 of the distal treatment section 32 (state of FIG. 7). is there.
- the jaw 33 and the distal treatment section 32 are shown in a cross section perpendicular to the central axis C.
- the distal treatment section 32 moves from the state where the jaw 33 is in contact with the receiving surface 92 of the distal treatment section 32 (the state shown in FIG. 7) to the first width direction (the direction of arrow B ⁇ b> 1 in FIG. 9).
- the inclined surface 93A of the distal treatment section 32 contacts the insulating facing surface 98A of the jaw insulating section 95A.
- the distance D2 from the distal treatment section 32 at the insulation minimum separation position P3 of the insulation facing surface 98A is the separation distance magnitude D1 from the distal treatment section 32 at the electrode minimum separation position P1 of the electrode facing surface 88A. It becomes smaller.
- the size T2 of the width direction separation dimension from the distal treatment section 32 at the insulation minimum width direction separation position Q3 of the insulation facing surface 98A is the tip treatment section at the electrode minimum width direction separation position Q1 of the electrode facing surface 88A. It becomes smaller than the size T1 of the dimension in the width direction away from 32.
- at least a part of the insulating facing surface 98A has a widthwise separation dimension from the distal treatment section 32 that is larger than any position of the electrode facing surface 88A in a state where the contact section 87 is in contact with the distal treatment section 32. Get smaller.
- the electrode facing surface 88A of the jaw electrode portion 83 is In any position, it is separated from the distal treatment section 32.
- the distal treatment section 32 moves in the first width direction and the second width direction by the pressing force from the jaw 33 in the treatment of the treatment target grasped between the jaw 33 and the distal treatment section 32. Even in this case, the distal treatment section 32 contacts the insulating facing surface 98A of the jaw insulating portion 95A or the insulating facing surface 98B of the jaw insulating portion 95B. Thereby, even when the distal treatment section 32 moves in the first width direction and the second width direction, the distal treatment section 32 functions as a probe side electrode section and performs longitudinal vibration to the jaw electrode section 83. Contact can be prevented. Thereby, the occurrence of spark due to the contact of the distal treatment section 32 with the jaw electrode section 83 is effectively prevented, and the occurrence of cracks in the distal treatment section 32 can be effectively prevented.
- the center of gravity of the distal treatment section 32 is first from the longitudinal axis L. Located on the width direction side. For this reason, when the pressing force is applied from the jaw 33, the distal treatment section 32 is easily twisted in a state in which a portion on the first width direction side from the central axis C is directed to the jaw 33. That is, when the pressing force acts from the jaw 33, the distal treatment section 32 is easily twisted in the first twisting direction.
- the jaw insulating portion 95A is located on the first width direction side from the central axis C.
- the distal treatment section 32 even when the distal treatment section 32 is twisted in the first twisting direction, the distal treatment section 32 reliably contacts the insulating facing surface 98A of the jaw insulating section 95A. Therefore, contact of the distal treatment section 32 serving as the probe electrode section with the jaw electrode section 83 can be prevented more reliably.
- FIG. 10 is a view showing the distal treatment section 32 and the jaw 33 of the present embodiment in a cross section perpendicular to the central axis C.
- the jaw 33 is provided with a contact portion 87, a jaw electrode portion 83, and jaw insulating portions 95A and 95B.
- the distance from the distal treatment section 32 in the state where the contact section 87 is in contact with the distal treatment section 32 on the electrode facing surfaces 88A and 88B of the jaw electrode section 83 corresponds to the position. Change.
- the insulating protrusion 97A protrudes toward the distal treatment portion 32 from the electrode minimum separation position P1, which is the location where the separation distance from the distal treatment portion 32 is minimized on the electrode facing surface 88A.
- the insulating protrusion 97B protrudes toward the distal treatment portion 32 from the electrode minimum separation position P2 where the separation distance from the distal treatment portion 32 is minimized on the electrode facing surface 88B.
- the electrodes face each other.
- the distal treatment section 32 which is a probe electrode section, easily comes into contact with the minimum electrode separation position P1 on the surface 88A.
- the insulating protrusion 97A protrudes toward the distal treatment section 32 from the electrode minimum separation position P1 of the electrode facing surface 88A.
- the distal treatment section 32 when the distal treatment section 32 is twisted about the central axis C from the state in which the contact portion 87 of the jaw 33 is in contact with the distal treatment section 32 in the second twist direction (the direction of the arrow R2 in FIG. 10),
- the distal treatment section 32 which is a probe electrode section, easily comes into contact with the electrode minimum separation position P2 on the electrode facing surface 88B.
- the insulating protrusion 97B protrudes toward the distal treatment section 32 from the electrode minimum separation position P2 of the electrode facing surface 88B.
- the distal treatment section 32 when the distal treatment section 32 is twisted in the first twist direction or the second twist direction, the distal treatment section 32 serving as the probe electrode section is brought into contact with the jaw electrode section 83. Further, it can be surely prevented.
- FIG. 11 is a view showing the distal treatment section 32 and the jaw 33 of the present embodiment in a cross section perpendicular to the central axis C.
- the jaw 33 is provided with a contact portion 87, a jaw electrode portion 83, and jaw insulating portions 95A and 95B.
- the distal treatment section 32 includes a treatment section facing surface 91 that faces the jaw 33, and the treatment section facing surface 91 includes a receiving surface 92 and inclined surfaces 93A and 93B.
- the position where the distance from the central axis C is the largest on the treatment portion facing surface 91 is defined as the axially separated position (S1, S2).
- the shaft most distant position S1 is located at the end of the inclined surface 93A on the first width direction side (the direction side of the arrow B1 in FIG. 11), and the shaft most distant position S2 is the first surface of the inclined surface 93B. 2 is located at the end of the width direction side (the direction side of the arrow B2 in FIG. 11).
- the jaw insulating portion 95A is disposed in a state where the insulating facing surface 98A faces the shaft most spaced position S1.
- the jaw insulating portion 95B is disposed in a state where the insulating facing surface 98B faces the shaft most spaced position S2. That is, the insulating facing surface 98A of the jaw insulating portion 95A is provided at a position facing the axially spaced position S1 of the treatment portion facing surface 91, and the insulating facing surface 98B of the jaw insulating portion 95B is the farthest axis of the treating portion facing surface 91. It is provided at a position facing the position S2.
- each of the insulating facing surfaces 98A and 98B is formed on the electrode facing surfaces 88A and 88B in a state where the contact portion 87 is in contact with the distal treatment portion 32.
- the distance from the distal treatment section 32 is smaller than any position.
- the distal treatment section 32 When the distal treatment section 32 is twisted about the central axis C in the first twist direction from the state in which the abutment section 87 of the jaw 33 is in contact with the distal treatment section 32, the most axially separated position S1 of the treatment section facing surface 91 becomes easy to contact the electrode facing surface 88A.
- the insulating facing surface 98A of the jaw insulating portion 95A is opposed to the axially spaced position S1 of the treatment portion facing surface 91. For this reason, even when the distal treatment section 32 is twisted in the first twisting direction, the axially most spaced position S1 of the distal treatment section 32 is surely insulated from the jaw insulation section 95A without contacting the electrode facing surface 88A.
- Contact surface 98A
- the axial separation of the treatment section facing surface 91 is most The position S2 can easily come into contact with the electrode facing surface 88B.
- the insulating facing surface 98B of the jaw insulating portion 95B is opposed to the axially spaced position S2 of the treatment portion facing surface 91.
- the distal treatment section 32 when the distal treatment section 32 is twisted in the first twist direction or the second twist direction, the distal treatment section 32 serving as the probe electrode section is brought into contact with the jaw electrode section 83. Further, it can be surely prevented.
- the cross section perpendicular to the central axis C of the distal treatment section 32 is formed in a substantially octagonal shape, but the present invention is not limited to this.
- the cross section perpendicular to the central axis C of the distal treatment section 32 may be formed in a substantially circular shape.
- the cross section perpendicular to the central axis C of the distal treatment section 32 may be formed in a substantially rectangular shape. 12 and 13 also, the jaw 33 is provided with a contact portion 87, a jaw electrode portion 83, and jaw insulating portions 95A and 95B.
- At least a part of each of the insulating facing surfaces 98A and 98B is separated from the distal treatment section 32 more than any position of the electrode facing surfaces 88A and 88B in a state in which the contact portion 87 is in contact with the distal treatment section 32. Becomes smaller.
- the distal treatment section 32 is placed on the insulating facing surface 98A of the jaw insulating section 95A or the insulating facing surface 98B of the jaw insulating section 95B. Abut. Thereby, even when the distal treatment section 32 is twisted, it is possible to prevent the distal treatment section 32 that functions as a probe-side electrode section and performs longitudinal vibration from contacting the jaw electrode section 83. Further, with such a configuration, even when the distal treatment section 32 moves in the first width direction and the second width direction, the distal treatment section 32 can be used as the insulation facing surface 98A of the jaw insulating section 95A or the jaw insulation.
- the distal treatment section 32 functions as a probe side electrode section and performs longitudinal vibration to the jaw electrode section 83. Contact can be prevented.
- the jaw (33) of the grasping treatment device (1) is formed of an insulating material, and the distal treatment section (32) is in a state where the jaw (33) is closed with respect to the distal treatment section (32).
- a contact portion (87) that can be in contact with the contact portion (87) are formed of a conductive material in a different part from the contact portion (87), and the contact portion (87) is in contact with the distal treatment portion (32).
- a jaw electrode part (83) that does not come into contact with the distal treatment part (32).
- the jaw electrode part (83) is spaced apart from the distal treatment part (32) and faces the distal treatment part (32) in a state where the contact part (87) is in contact with the distal treatment part (32).
- Opposing surfaces (88A, 88B) are provided.
- the jaw (33) of the grasping treatment device (1) is formed of an insulating material at a position away from the contact portion (87) in the first width direction (B1) and the second width direction (B2). Jaw insulation (95A, 95B) is provided.
- the jaw insulating portions (95A, 95B) are insulated from the distal treatment portion (32) and separated from the distal treatment portion (32) in a state where the contact portion (87) is in contact with the distal treatment portion (32).
- An opposing surface (98A, 98B) is provided, and at least a part of the insulating opposing surface (98A, 98B) is in the state where the contact portion (87) is in contact with the distal treatment portion (32).
- the distance from the distal treatment section (32) is smaller than any of the positions.
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Abstract
Description
本発明の第1の実施形態について、図1乃至図9を参照して説明する。
次に、本発明の第2の実施形態について、図10を参照して説明する。第2の実施形態は、第1の実施形態を以下のように変更したものである。なお、第1の実施形態と同一の部分については、同一の符号を付して、その説明は省略する。
次に、本発明の第3の実施形態について、図11を参照して説明する。第3の実施形態は、第1の実施形態を以下のように変更したものである。なお、第1の実施形態と同一の部分については、同一の符号を付して、その説明は省略する。
なお、前述の実施形態では、先端処置部32の中心軸Cに垂直な断面が略八角形状に形成されているが、これに限るものではない。例えば、第1の変形例として図12に示すように、先端処置部32の中心軸Cに垂直な断面が、略円形状に形成されてもよい。また、例えば、第2の変形例として図13に示すように、先端処置部32の中心軸Cに垂直な断面が、略長方形状に形成されてもよい。図12及び図13に示す変形例においても、ジョー33には、当接部87、ジョー電極部83及びジョー絶縁部95A,95Bが設けられている。それぞれの絶縁対向表面98A,98Bの少なくとも一部は、当接部87が先端処置部32に当接する状態において、電極対向表面88A,88Bのいずれの位置よりも、先端処置部32からの離間距離が小さくなる。
Claims (7)
- 中心軸に沿って延設され、基端方向から先端方向へ超音波振動を伝達する振動伝達部と、
前記振動伝達部の先端部に設けられ、高周波電流が伝達されることにより、第1の電位を有するプローブ電極部として機能する先端処置部と、
前記先端処置部に対して開閉可能なジョーと、
前記ジョーの一部に絶縁材料から形成され、前記ジョーを前記先端処置部に対して閉じた状態で前記先端処置部に当接可能な当接部と、
前記ジョーにおいて前記当接部とは異なる部位に導電材料から形成され、高周波電流が伝達されることにより、前記第1の電位とは異なる第2の電位を有し、前記当接部が前記先端処置部に当接する状態において、前記先端処置部と接触しないジョー電極部であって、前記当接部が前記先端処置部に当接する前記状態において、前記先端処置部から離間して前記先端処置部に対して対向する電極対向表面を備えるジョー電極部と、
前記中心軸に垂直、かつ、前記ジョーの開方向及び閉方向に垂直な方向の一方を第1の幅方向とし、前記第1の幅方向とは反対方向を第2の幅方向とした場合に、前記ジョーにおいて前記第1の幅方向及び前記第2の幅方向について前記当接部から離れた位置に絶縁材料から形成されるジョー絶縁部であって、前記当接部が前記先端処置部に当接する前記状態において前記先端処置部から離間して前記先端処置部に対して対向する絶縁対向表面を備え、前記絶縁対向表面の少なくとも一部は、前記当接部が前記先端処置部に当接する前記状態において、前記電極対向表面のいずれの位置よりも前記先端処置部からの離間距離が小さくなるジョー絶縁部と、
を具備する把持処置装置。 - 長手方向に平行な長手軸を規定した場合に、前記先端処置部は、前記中心軸が前記長手軸に対して前記第2の幅方向から前記第1の幅方向に向かって湾曲する状態に延設される湾曲延設部を備え、
前記ジョー絶縁部は、前記先端処置部を通過する前記中心軸より第1の幅方向側の部位に少なくとも設けられている、
請求項1の把持処置装置。 - 前記ジョー絶縁部の前記絶縁対向表面は、前記当接部が前記先端処置部に当接した前記状態から前記先端処置部が前記中心軸を中心として捻れるか、又は、前記第1の幅方向及び前記第2の幅方向について前記先端処置部が前記ジョーに対して移動することにより、前記先端処置部が当接し、
前記ジョー電極部の前記電極対向表面は、前記絶縁対向表面に前記先端処置部が当接した状態において、前記先端処置部から離間している、
請求項1の把持処置装置。 - 前記ジョー電極部の前記電極対向表面は、平面状に形成され、
前記ジョー絶縁部は、前記電極対向表面から前記先端処置部に向かって突出する絶縁突出部を備え、
前記絶縁対向表面は、前記絶縁突出部に設けられている、
請求項1の把持処置装置。 - 前記電極対向表面は、前記当接部が前記先端処置部に当接した前記状態での前記先端処置部からの前記離間距離が、位置に対応して変化し、
前記絶縁突出部は、前記電極対向表面において前記当接部が前記先端処置部に当接した前記状態での前記先端処置部からの前記離間距離が最小となる箇所から、前記先端処置部に向かって突出する、
請求項4の把持処置装置。 - 前記先端処置部は、前記ジョーに対して対向する処置部対向表面を備え、
前記処置部対向表面において前記中心軸からの距離が最も大きくなる位置を軸最離間位置とした場合に、前記ジョー絶縁部の前記絶縁対向表面は、前記軸最離間位置と対向する位置に設けられる、
請求項1の把持処置装置。 - 高周波電流が伝達されることにより、第1の電位を有するプローブ電極部として機能する先端処置部が先端部に設けられ、中心軸に沿って延設され、基端方向から先端方向へ超音波振動を伝達する振動伝達部を備える把持処置装置において、前記先端処置部に対して開閉可能な把持ユニットであって、
絶縁材料から形成され、前記把持ユニットを前記先端処置部に対して閉じた状態で前記先端処置部に当接可能な当接部と、
前記当接部とは異なる部位に導電材料から形成され、高周波電流が伝達されることにより、前記第1の電位とは異なる第2の電位を有し、前記当接部が前記先端処置部に当接する状態において、前記先端処置部と接触しないジョー電極部であって、前記当接部が前記先端処置部に当接する前記状態において、前記先端処置部から離間して前記先端処置部に対して対向する電極対向表面を備えるジョー電極部と、
前記中心軸に垂直、かつ、前記把持ユニットの開方向及び閉方向に垂直な方向の一方を第1の幅方向とし、前記第1の幅方向とは反対方向を第2の幅方向とした場合に、前記第1の幅方向及び前記第2の幅方向について前記当接部から離れた位置に絶縁材料から形成されるジョー絶縁部であって、前記当接部が前記先端処置部に当接する前記状態において前記先端処置部から離間して前記先端処置部に対して対向する絶縁対向表面を備え、前記絶縁対向表面の少なくとも一部は、前記当接部が前記先端処置部に当接する前記状態において、前記電極対向表面のいずれの位置よりも前記先端処置部からの離間距離が小さくなるジョー絶縁部と、
を具備する把持ユニット。
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JP2015509661A JP5797353B2 (ja) | 2013-08-29 | 2014-05-26 | 把持処置装置及び把持ユニット |
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Cited By (5)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO2016190173A1 (ja) * | 2015-05-27 | 2016-12-01 | オリンパス株式会社 | 外科手術装置 |
JPWO2017014110A1 (ja) * | 2015-07-21 | 2017-07-20 | オリンパス株式会社 | 鉗子処置具 |
CN108135629A (zh) * | 2015-10-19 | 2018-06-08 | 伊西康有限责任公司 | 具有双模端部执行器和模块化夹持臂组件的外科器械 |
CN108156804A (zh) * | 2015-05-21 | 2018-06-12 | 蛇牌股份公司 | 电外科凝固器械 |
JP2019509775A (ja) * | 2016-01-15 | 2019-04-11 | エシコン エルエルシーEthicon LLC | ジョーとブレードとの間に非対称係合を有する湾曲したエンドエフェクタを有するモジュール電池式手持ち型外科用器具 |
Families Citing this family (73)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US11229472B2 (en) | 2001-06-12 | 2022-01-25 | Cilag Gmbh International | Modular battery powered handheld surgical instrument with multiple magnetic position sensors |
US9089360B2 (en) | 2008-08-06 | 2015-07-28 | Ethicon Endo-Surgery, Inc. | Devices and techniques for cutting and coagulating tissue |
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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 (4)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
JP2000102545A (ja) * | 1997-06-18 | 2000-04-11 | Eggers & Associates Inc | 電気外科用ピンセット |
JP2009082711A (ja) * | 2007-09-28 | 2009-04-23 | Olympus Medical Systems Corp | 外科手術装置 |
JP2009240773A (ja) | 2008-03-28 | 2009-10-22 | Olympus Medical Systems Corp | 外科手術装置 |
WO2012108295A1 (ja) * | 2011-02-10 | 2012-08-16 | オリンパスメディカルシステムズ株式会社 | 高周波手術装置及び手術装置 |
Family Cites Families (5)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5403312A (en) * | 1993-07-22 | 1995-04-04 | Ethicon, Inc. | Electrosurgical hemostatic device |
US20040097911A1 (en) * | 2001-02-13 | 2004-05-20 | Olympus Optical Co., Ltd. | Ultrasonic operating apparartus and tool for changing tip thereof |
AU2004241092B2 (en) * | 2003-05-15 | 2009-06-04 | Covidien Ag | Tissue sealer with non-conductive variable stop members and method of sealing tissue |
JP4436698B2 (ja) * | 2004-02-25 | 2010-03-24 | オリンパス株式会社 | 高周波処置具 |
JP4157574B2 (ja) * | 2006-07-04 | 2008-10-01 | オリンパスメディカルシステムズ株式会社 | 外科用処置具 |
-
2014
- 2014-05-26 CN CN201480031351.7A patent/CN105246423B/zh active Active
- 2014-05-26 EP EP14841277.8A patent/EP3040040A4/en not_active Withdrawn
- 2014-05-26 WO PCT/JP2014/063812 patent/WO2015029518A1/ja active Application Filing
- 2014-05-26 JP JP2015509661A patent/JP5797353B2/ja active Active
-
2015
- 2015-10-30 US US14/928,197 patent/US9901754B2/en active Active
Patent Citations (4)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
JP2000102545A (ja) * | 1997-06-18 | 2000-04-11 | Eggers & Associates Inc | 電気外科用ピンセット |
JP2009082711A (ja) * | 2007-09-28 | 2009-04-23 | Olympus Medical Systems Corp | 外科手術装置 |
JP2009240773A (ja) | 2008-03-28 | 2009-10-22 | Olympus Medical Systems Corp | 外科手術装置 |
WO2012108295A1 (ja) * | 2011-02-10 | 2012-08-16 | オリンパスメディカルシステムズ株式会社 | 高周波手術装置及び手術装置 |
Non-Patent Citations (1)
Title |
---|
See also references of EP3040040A4 * |
Cited By (13)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
CN108156804A (zh) * | 2015-05-21 | 2018-06-12 | 蛇牌股份公司 | 电外科凝固器械 |
CN108156804B (zh) * | 2015-05-21 | 2021-07-16 | 蛇牌股份公司 | 电外科凝固器械 |
US10660664B2 (en) | 2015-05-27 | 2020-05-26 | Olympus Corporation | Surgical apparatus |
CN107405162A (zh) * | 2015-05-27 | 2017-11-28 | 奥林巴斯株式会社 | 外科手术装置 |
EP3305223A4 (en) * | 2015-05-27 | 2019-02-20 | Olympus Corporation | SURGICAL ACTUATOR |
WO2016190173A1 (ja) * | 2015-05-27 | 2016-12-01 | オリンパス株式会社 | 外科手術装置 |
JPWO2016190173A1 (ja) * | 2015-05-27 | 2017-06-08 | オリンパス株式会社 | 外科手術装置 |
JPWO2017014110A1 (ja) * | 2015-07-21 | 2017-07-20 | オリンパス株式会社 | 鉗子処置具 |
CN108135629A (zh) * | 2015-10-19 | 2018-06-08 | 伊西康有限责任公司 | 具有双模端部执行器和模块化夹持臂组件的外科器械 |
CN108348271A (zh) * | 2015-10-19 | 2018-07-31 | 伊西康有限责任公司 | 具有双模式端部执行器和侧装夹持臂组件的外科器械 |
CN108348271B (zh) * | 2015-10-19 | 2021-07-20 | 伊西康有限责任公司 | 具有双模式端部执行器和侧装夹持臂组件的外科器械 |
CN108135629B (zh) * | 2015-10-19 | 2021-07-30 | 伊西康有限责任公司 | 具有双模端部执行器和模块化夹持臂组件的外科器械 |
JP2019509775A (ja) * | 2016-01-15 | 2019-04-11 | エシコン エルエルシーEthicon LLC | ジョーとブレードとの間に非対称係合を有する湾曲したエンドエフェクタを有するモジュール電池式手持ち型外科用器具 |
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US20160045770A1 (en) | 2016-02-18 |
JP5797353B2 (ja) | 2015-10-21 |
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JPWO2015029518A1 (ja) | 2017-03-02 |
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US9901754B2 (en) | 2018-02-27 |
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