WO2015099068A1 - 処置具 - Google Patents
処置具 Download PDFInfo
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- WO2015099068A1 WO2015099068A1 PCT/JP2014/084362 JP2014084362W WO2015099068A1 WO 2015099068 A1 WO2015099068 A1 WO 2015099068A1 JP 2014084362 W JP2014084362 W JP 2014084362W WO 2015099068 A1 WO2015099068 A1 WO 2015099068A1
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- WIPO (PCT)
- Prior art keywords
- gripping
- treatment tool
- opening
- grip
- end portion
- Prior art date
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- 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
- A61B18/08—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by means of electrically-heated probes
- A61B18/082—Probes or electrodes therefor
- A61B18/085—Forceps, scissors
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00353—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery one mechanical instrument performing multiple functions, e.g. cutting and grasping
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/320016—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes
- A61B2017/32004—Endoscopic cutting instruments, e.g. arthroscopes, resectoscopes having a laterally movable cutting member at its most distal end which remains within the contours of said end
-
- 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
- A61B2018/00053—Mechanical features of the instrument of device
- A61B2018/00059—Material properties
- A61B2018/00089—Thermal conductivity
- A61B2018/00101—Thermal conductivity low, i.e. thermally insulating
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- 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
- A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
- A61B2018/00601—Cutting
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B18/1442—Probes having pivoting end effectors, e.g. forceps
- A61B2018/1452—Probes having pivoting end effectors, e.g. forceps including means for cutting
- A61B2018/1455—Probes having pivoting end effectors, e.g. forceps including means for cutting having a moving blade for cutting tissue grasped by the jaws
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B18/1442—Probes having pivoting end effectors, e.g. forceps
- A61B2018/1452—Probes having pivoting end effectors, e.g. forceps including means for cutting
- A61B2018/1457—Probes having pivoting end effectors, e.g. forceps including means for cutting having opposing blades cutting tissue grasped by the jaws, i.e. combined scissors and pliers
Definitions
- the present invention relates to a treatment instrument used for performing a treatment such as cutting a living tissue.
- the treatment portion of the treatment tool disclosed in Japanese Patent Application Laid-Open No. 2001-170070 can cut the grasped living tissue by moving the cutter along the axial direction while grasping the living tissue.
- An object of the present invention is to provide a treatment tool suitable for cutting a living tissue at a relatively long distance.
- a treatment tool for treating a biological tissue has a longitudinal axis, and is capable of grasping the biological tissue therebetween by opening and closing in an opening and closing direction orthogonal to or substantially orthogonal to the longitudinal axis.
- a first and second gripping part each having a surface; and an action part having an edge part capable of cutting a biological tissue by rotating about a central axis that is the same as or substantially parallel to the longitudinal axis.
- a rotating body capable of moving a part from the first gripping part toward the second gripping part, and provided in the first gripping part, through the gripping surface of the first gripping part toward the second gripping part.
- a first guide portion capable of guiding an edge portion; and provided in the second grip portion, and capable of guiding the edge portion to the second grip portion through a grip surface of the first grip portion,
- the living tissue can be cut when guiding to the second gripping part through the gripping surface.
- a second guide section
- FIG. 1A is a schematic perspective view showing a treatment system according to the first embodiment.
- FIG. 1B is a schematic perspective view illustrating a modification example of the rotation operation unit arranged in the operation unit of the treatment tool of the treatment system according to the first embodiment.
- FIG. 2 is a schematic block diagram showing the treatment system according to the first embodiment.
- FIG. 3 is a schematic top view showing the first gripping part of the treatment tool of the treatment system according to the first embodiment.
- FIG. 4A is a schematic cross-sectional view showing a state in which the action part of the rotating body of the treatment tool of the treatment system according to the first embodiment is arranged in the first guide part of the first gripping part.
- FIG. 1A is a schematic perspective view showing a treatment system according to the first embodiment.
- FIG. 1B is a schematic perspective view illustrating a modification example of the rotation operation unit arranged in the operation unit of the treatment tool of the treatment system according to the first embodiment.
- FIG. 2 is a schematic block diagram showing the treatment system according
- FIG. 4B shows a state in which the action part of the rotating body of the treatment instrument of the treatment system according to the first embodiment is arranged from the first guide part of the first grip part shown in FIG. 4A to the second guide part of the second grip part. It is a rough cross-sectional view which shows the state which is moving toward.
- FIG. 4C shows a state in which the action part of the rotating body of the treatment tool of the treatment system according to the first embodiment is arranged on the first guide part of the first grip part shown in FIG. 4A and the second part of the second grip part shown in FIG. 4B.
- FIG. 2 is a schematic cross-sectional view showing a state in which the second guide portion is disposed after being moved toward the two guide portions.
- FIG. 5A is a schematic perspective view illustrating a distal end portion and an action portion of a drive unit of a rotating body of the treatment tool of the treatment system according to the first embodiment.
- FIG. 5B is a schematic side view showing a state in which the blade of the action part shown in FIG. 5A of the rotating body of the treatment tool of the treatment system according to the first embodiment is protruded from the gripping surface of the first gripping part.
- FIG. 6A is a schematic perspective view showing a distal end portion and an action portion of a drive unit of a rotating body of a treatment tool of a treatment system according to a modification of the first embodiment.
- 6B is a schematic diagram illustrating a state in which the blade of the action unit illustrated in FIG.
- FIG. 7A is a schematic perspective view showing a distal end portion and an action portion of a drive unit of a rotating body of a treatment tool of a treatment system according to a modification of the first embodiment.
- 7B is a schematic diagram illustrating a state in which the blade of the action unit illustrated in FIG. 7A of the rotating body of the treatment tool of the treatment system according to the modification of the first embodiment is protruded with respect to the grasping surface of the first grasping unit.
- FIG. 8A is a schematic perspective view showing a distal end portion and an action portion of a drive unit of a rotating body of a treatment tool of a treatment system according to a modification of the first embodiment.
- FIG. 8B is a schematic diagram illustrating a state in which the blade of the action unit illustrated in FIG. 8A of the rotating body of the treatment tool of the treatment system according to the modification of the first embodiment is protruded from the grasping surface of the first grasping unit.
- FIG. 9A is a schematic perspective view showing the distal end portion and the action portion of the drive unit of the rotating body of the treatment instrument of the treatment system according to the modification of the first embodiment.
- 9B is a schematic diagram illustrating a state in which the blade of the action unit illustrated in FIG.
- FIG. 9A of the rotating body of the treatment tool of the treatment system according to the modification of the first embodiment is protruded with respect to the grasping surface of the first grasping unit.
- FIG. FIG. 10 is a schematic diagram showing a state in which the action part of the rotating body of the treatment tool of the treatment system according to the second embodiment is moved from the state of being arranged on the first guide part of the first gripping part and arranged on the second guide part.
- FIG. FIG. 11A is a schematic side view of the operation unit of the treatment tool of the treatment system according to the third embodiment.
- FIG. 11B is a schematic top view of the operation unit of the treatment tool of the treatment system according to the third embodiment.
- FIG. 12A shows the operating state of the open / close knob, drive knob, and interlocking body provided in the operation unit of the treatment tool of the treatment system according to the third embodiment with respect to the operation unit main body, and the other end of the operation unit main body.
- FIG. 6 is a schematic side view showing a state in which the opening / closing knob and the drive knob are separated and opened, and the fitting portion of the interlocking body is released from the fitting receiving portion of the operation portion main body.
- FIG. 12B shows the operating state of the open / close knob, drive knob, and interlocking body provided in the operation unit of the treatment tool of the treatment system according to the third embodiment with respect to the operation unit main body, and the other end of the operation unit main body.
- FIG. 12C shows the operating state of the open / close knob, the drive knob, and the interlocking body provided in the operation unit of the treatment tool of the treatment system according to the third embodiment with respect to the operation unit main body, with respect to the other end of the operation unit main body.
- Drive the knob immediately after releasing the fitting to the fitting receiving part of the operation unit body, and close the driving knob while closing the opening and closing knob.
- It is a schematic side view which shows the state which contact
- FIG. 12D is a schematic cross-sectional view of the treatment tool of the treatment system according to the third embodiment taken along line 12D-12D of the opening / closing lever and the drive lever in FIG. 12C.
- FIG. 13A is a schematic side view of the operation unit of the treatment tool of the treatment system according to the fourth embodiment.
- FIG. 13B is a schematic block diagram when the operation unit of the treatment tool of the treatment system according to the fourth embodiment is viewed from above.
- FIG. 14 is a schematic perspective view showing a treatment system according to the fifth embodiment.
- FIG. 15A shows an operation part of the treatment tool of the treatment system according to the sixth embodiment, and shows a state in which the first and second gripping parts are opened by separating the open / close knob from the other end of the operation part main body.
- FIG. 15B is a schematic diagram showing the operation unit viewed from the direction of the arrow 15B in FIG. 15A.
- FIG. 15C shows an operation part of the treatment tool of the treatment system according to the sixth embodiment, and schematically shows a state where the first and second gripping parts are closed by bringing the open / close knob close to the other end of the operation part main body.
- FIG. FIG. 16A shows an operation part of the treatment tool of the treatment system according to the seventh embodiment, and schematically shows a state in which the first and second gripping parts are opened by separating the opening / closing knob from the other end of the operation part main body.
- FIG. FIG. 16B shows an operation part of the treatment tool of the treatment system according to the seventh embodiment, and schematically shows a state in which the first and second gripping parts are closed by bringing the open / close knob close to the other end of the operation part main body.
- FIG. 16A shows an operation part of the treatment tool of the treatment system according to the seventh embodiment, and schematically shows a state in which
- the treatment system 10 includes a treatment tool 12 and a controller 14 that applies energy to the treatment tool 12.
- the controller 14 controls the temperature of first and second energy output units 62 and 64 (described later) of the treatment instrument 12 to an appropriate temperature.
- first and second energy output units 62 and 64 described later are not necessarily required.
- the controller 14 is connected to a foot switch 16 having a pedal 16 a for switching ON / OFF of thermal energy applied to the treatment instrument 12.
- the treatment instrument 12 and the controller 14 are electrically connected by a first cable 18a in which a plurality of lead wires and signal wires are bundled, and a plurality of lead wires and signal wires are connected between the controller 14 and the foot switch 16. They are electrically connected by the bundled second cable 18b.
- the foot switch 16 can input a signal to the controller 14 by operating the pedal 16a, and the controller 14 can control the energy applied to the treatment instrument 12 based on the operation of the pedal 16a of the foot switch 16. .
- the controller 14 includes a control unit (CPU) 22, an energy output circuit (heat generation unit drive circuit) 24, and a display unit 26.
- the energy output circuit 24 and the display unit 26 are controlled by the control unit 22.
- the display unit 26 is used when displaying the state of the controller 14 or making various settings.
- the display unit 26 is preferably a touch panel, for example.
- the treatment instrument 12 includes a treatment unit 42 that treats a living tissue L, an insertion unit 44, and an operation unit 46. It is also preferable that the operation unit 46 is disposed directly at the proximal end of the treatment unit 42.
- the treatment section 42 includes a pair of openable and closable jaws (first and second jaws) 52 and 54 as biological tissue holding sections, And energy output portions (first and second energy output portions) 62 and 64 disposed at 54.
- the first jaw 52 and the first energy output part 62 form a first grip 72 (see FIG. 1A) shown in FIG. 3, and the second jaw 54 and the second energy output part 64 are a second grip 74 (FIG. 1A). Reference).
- the jaws 52 and 54 of the first and second gripping portions 72 and 74 are appropriately made of, for example, ceramic, heat-resistant and electrically insulating resin, or an insulating metal material.
- the jaws 52 and 54 of the first and second gripping portions 72 and 74 are preferably made of a heat-insulating material.
- the first gripping portion 72 has a longitudinal axis (longitudinal direction) Y defined by the distal end portion 76 a and the proximal end portion 76 b and a width direction defined in a direction orthogonal to the longitudinal axis Y. X.
- the width direction X has a left end (one end) 78a on the left side and a right end (other end) 78b on the right when the treatment section 42 is viewed from the operation unit 46. That is, the width direction is defined by the left end (one end) 78a and the right end (other end) 78b.
- the 1st holding part 72 prescribes
- the second gripping portion 74 defines a second gripping surface 74a that faces the first gripping surface 72a in parallel or substantially in parallel.
- the energy output units 62 and 64 of the first and second grasping units 72 and 74 face each other and are used as grasping surfaces 72a and 72b that can grasp the living tissue L to be treated. It is preferable that the first and second energy output units 62 and 64 start to increase in temperature at the same time and increase to approximately the same temperature in approximately the same time.
- the gripping surface 72a of the first gripping portion 72 is formed in a substantially flat plate shape that is long in the direction along the central axis C of the insertion portion 44, for example, and whose width direction X orthogonal to the longitudinal direction Y is smaller than the longitudinal direction Y. Yes.
- the second grip 74 is formed symmetrically or substantially symmetrically with the first grip 72. That is, the gripping surface 74a of the second gripping portion 74 is formed in a substantially flat plate shape that is substantially symmetrical with the first gripping surface 72a.
- the holding surfaces 72a and 74a of the 1st and 2nd holding parts 72 and 74 have an opening-closing direction (Z direction) in the direction orthogonal or substantially orthogonal to the width direction X, as shown to FIG. 1A. That is, the opening and closing direction in which the first and second gripping portions 72 and 74 are opened is orthogonal or substantially orthogonal to the width direction X.
- the operation unit 46 has an operation unit main body 82 formed in a substantially L shape.
- An insertion portion 44 is disposed at one end (tip) 82 a of the operation portion main body 82.
- the cable 18 a described above is extended from the proximal end of the operation portion main body 82 substantially coaxial with the insertion portion 44.
- the other end 82b of the operation section main body 82 is a gripping section that is gripped by an operator (user).
- the operation portion main body 82 includes a treatment portion opening / closing knob (opening / closing operation portion) 84 so as to be juxtaposed with the other end 82b.
- a knob 84 is arranged on the front side of the other end 82b of the operation portion main body 82.
- the knob 84 can be rotated inside the operation portion main body 82 by a pivot shaft (not shown), that is, can be moved closer to and away from the other end of the operation portion main body 82.
- the first and second gripping portions 72 and 74 of the treatment portion 42 can be separated and opened or closed in close proximity using a known mechanism.
- the knob 84 When the knob 84 is operated, the first and second gripping portions 72 and 74 are opened and closed in the Z direction shown in FIG. 1A by a known means such as a wire or a rod disposed inside the insertion portion 44.
- a known means such as a wire or a rod disposed inside the insertion portion 44.
- the operation section main body 82 further includes a drive dial (rotation operation section) 86 for rotating a rotating body 92, which will be described later, about its central axis C1.
- the dial 86 is not limited to a disk shape, but is preferably a fan shape.
- the dial 86 can be rotated inside the operation portion main body 82 by a pivot shaft (not shown).
- the dial 86 is inside the operation portion main body 82, and a part of the dial 86 protrudes to the outside of the operation portion main body 82 and is exposed. For this reason, the rotating body 92 can be rotated around the central axis C by operating the dial 86 in an appropriate direction with the user's finger. For example, when the dial 86 is rotated from the lower side to the upper side in FIG.
- a living body tissue can be cut by moving a blade 98 described later from the first gripping part 72 to the second gripping part 74.
- the blade 98 can be accommodated in the first grip 72 from the second grip 74.
- the rotation amount of the dial 86 preferably corresponds to the rotation amount of the rotating body 92 on a one-to-one basis. Further, the dial 86 is adjusted so that it is prevented from rotating in a natural state such as friction, and is rotated by a user operation.
- a rotating body 92 having a central axis C1 that is preferably parallel to the longitudinal axis Y is disposed inside the treatment section 42 and the insertion section 44.
- a base end of the rotating body 92 is connected to a dial (rotating operation unit) 86 of the operation unit 46.
- the dial 86 rotated, the rotating body 92 is rotated.
- the center axis C1 of the rotating body 92 and the center axis C of the insertion portion 44 may coincide with each other depending on the position of a blade 98 described later.
- an example in which the center axis C1 of the rotating body 92 and the center axis C of the insertion portion 44 are misaligned will be described.
- the rotating body 92 includes a drive unit 94 that is rotated by a dial 86, and a blade that is formed at the tip of the drive unit 94 and that is operated following the operation of the drive unit 94.
- Shaped action part 96 As shown in FIG. 5A, the driving unit 94 is preferably cylindrical, such as a cylindrical shape. However, the driving unit 94 is not limited to a cylindrical shape, and can be used to transmit the operation of the dial 86 to the action unit 96. For example, a 1/2 pipe is also suitable.
- the rotating body 92 is formed of a hard material, and for example, a stainless steel material is preferably used.
- the action part 96 has a pair of edge parts 96a and 96b at an angle in a range between about 1/2 pipe and 1/12 pipe, for example.
- the distal end edge portion 96c of the action portion 96 is preferably formed in an arc shape.
- one edge portion 96a of the pair of edge portions 96a, 96b has a blade (cutting portion) 98.
- the blade 98 is preferably formed continuously from the distal end portion 98a to the proximal end portion 98b of the edge portion 96a.
- the blade 98 is parallel to the central axis C1 of the rotating body 92 and parallel to the gripping surface 72a of the first gripping portion 72 as shown in FIG. 5B.
- the blade 98 can be formed to a desired length.
- the length of the blade 98 is preferably longer than the length in the width direction X, that is, between a left end (one end) 78a and a right end (other end) 78b described later. For this reason, it is preferable that the lengths of the first and second openings 112 and 114 and the lengths of the first and second concave grooves 122 and 124 along the longitudinal axis Y are also longer than the length in the width direction X.
- the blade 98 is not only formed on one edge 96a of the action part 96, but may be formed on the other edge 96b.
- the treatment section 42 is provided with first and second guide sections 102 and 104 capable of guiding the action section 96 of the rotating body 92.
- the first guide part 102 is provided in the first grip part 72
- the second guide part 104 is provided in the second grip part 74.
- the first and second guide portions 102 and 104 can guide the action portion 96, that is, the blade 98 to the second gripping portion 74 through the first gripping surface 72 a of the first gripping portion 72.
- the biological tissue can be cut when the blade 98 is guided to the second gripping portion 74 through the gripping surface 72 a of the first gripping portion 72.
- the first guide portion 102 is provided on the gripping surface 72 a of the first gripping portion 72, and the blade 98 is inserted and removed between the left end portion (one end) 78 a and the right end portion (other end) 78 b in the width direction X.
- a first opening 112 is provided.
- the second guide portion 104 is provided on the gripping surface 74 a of the second gripping portion 74, and a blade 98 is put in and out between the left end portion 78 a and the right end portion 78 b in the width direction X and faces the first opening 112.
- Two openings 114 are provided.
- the first opening 112 is formed at the approximate center between the left end 78a and the right end 78b in the width direction X.
- the first opening 112 may be close to the left end 78a in the width direction X or may be close to the right end 78b.
- the second opening 114 is preferably formed at the approximate center between the left end 78a and the right end 78b in the width direction X, but even if it is close to the left end 78a, the right end It may be close to 78b.
- the first and second openings 112 and 114 are opposed to each other.
- the first guide part 102 has a curved or inclined first concave groove 122 continuous with the first opening 112 from the gripping surface 72a of the first gripping part 72 toward the back surface 72b of the first gripping part 72.
- the second guide part 104 has a curved or inclined second concave groove 124 that is continuous with the second opening 114 from the gripping surface 74 a of the second gripping part 74 toward the back surface 74 b of the second gripping part 74.
- the first concave groove 122 extends from the gripping surface 72a of the first gripping portion 72 toward the left end (one end) 78a in the width direction X as it approaches the back surface 72b.
- the second groove 124 extends in the same direction as the direction in which the first groove 122 extends in the width direction X as it approaches the back surface 74b from the gripping surface 74a of the second gripping portion 74.
- the length of the blade 98 can be appropriately set, that is, the lengths of the first opening 112 and the second opening 114 along the longitudinal axis Y. It can also be set as appropriate.
- the edge 96a of the action part 96 of the rotating body 92, that is, the blade 98 is accommodated in the first guide part 102, and the edge 96a, that is, the blade 98 passes through the first opening 112 to the first gripping surface 72a. Keep it from protruding.
- the treatment part 42 is made to face the living tissue to be treated.
- the first and second gripping portions 72 and 74 are opened in the opening / closing direction Z to grip the living tissue between the first and second gripping surfaces 72a and 74a.
- Energy is output from the controller 14 to the first and second gripping surfaces 72a and 74a, that is, the first and second energy output units 62 and 64, and the living tissue in contact with the gripping surfaces 72a and 74a is appropriately heated. Dehydrate to denature. For this reason, the living tissue sandwiched between the first and second gripping portions 72 and 74 and in contact with the gripping surfaces 72a and 74a is solidified, for example.
- the dial 86 of the operation unit main body 82 is rotated from the lower side to the upper side in FIG.
- the rotating body 92 is rotated by rotating the dial 86.
- the drive unit 94 rotates about the central axis C thereof. For this reason, the action part 96 also rotates following the rotation of the drive part 94.
- the edge portion 96 a of the action portion 96 that is, the blade 98, includes the first concave groove 122 of the first guide portion 102, the first opening 112 of the first guide portion 102, and the second guide. It is guided to the second concave groove 124 of the second guide part 104 through the second opening 114 of the part 104. That is, the rotating body 92 can move the edge portion 96 a of the action portion 96 from the first grip portion 72 toward the second grip portion 74.
- the blade 98 is brought into contact with the living tissue substantially simultaneously by the length of the blade 98 extended in the longitudinal direction Y, and the blade 98 is moved to the second guide portion.
- the living tissue that has been touched can be cut simply by being moved to 104. Therefore, the living tissue can be cut only by moving the edge 96a, that is, the distance to move the blade 98 by the distance from the first opening 112 to the second opening 114.
- the blade when formed as a structure in which the blade is moved from the proximal end to the distal end of the first and second openings 112 and 114 (a structure in which the blade is moved along the longitudinal axis Y), the blade is moved to cut the living tissue. It is obvious that the distance to be made is longer than the distance between the first and second openings 112 and 114.
- the edge portion 96a that is, the blade 98 according to this embodiment can cut the living tissue only by moving between the first and second openings 112 and 114 and a distance slightly exceeding it. it can.
- the moving distance of the edge 96a that is, the blade 98, related to cutting when cutting a living tissue can be significantly reduced.
- the operating distance of the dial 86 of the operation unit 46 can also be shortened, and the living tissue can be easily cut.
- the dial 86 shown in FIG. 1A is arranged on the operation unit main body 82 of the operation unit 46
- the lever 132 shown in FIG. 1B can be used similarly.
- the rotation distance of the lever 132 may be a distance that can reliably cut the living tissue with the blade 98.
- the blade 98 has a distal end portion 98a and a proximal end portion 98b along the longitudinal axis Y. As illustrated in FIG. 6B, the blade 98 is not parallel to the gripping surface 72 a of the first gripping portion 72, and the blade 98 in the first guide portion 102 protrudes from the gripping surface 72 a of the first gripping portion 72. It is also preferable that the tip end portion 98a and the base end portion 98b are formed so as to protrude in this order.
- the grasping force amount of the living tissue by the treatment section 42 is larger on the side close to the proximal end portion 76b of the treatment section 42 than on the side close to the distal end section 76a of the treatment section 42. For this reason, it can prevent that a biological tissue moves between the 1st and 2nd holding surfaces 72a and 74a at the time of a cutting
- the blade 98 has a distal end portion 98a and a proximal end portion 98b along the longitudinal axis Y. As shown in FIG. 7B, the blade 98 is not parallel to the gripping surface 72 a of the first gripping portion 72, and the blade 98 in the first guide portion 102 protrudes from the gripping surface 72 a of the first gripping portion 72. It is also preferable to form the base end portion 98b and the front end portion 98a so as to protrude in this order.
- the blade 98 has a tip end portion 98a and a base end portion 98b along the longitudinal axis Y.
- the blade 98 has a central portion 98c between the distal end portion 98a and the proximal end portion 98b.
- FIG. 8B when the blade 98 in the first guide portion 102 is not parallel to the gripping surface 72 a of the first gripping portion 72 and protrudes from the gripping surface 72 a of the first gripping portion 72, the tip It is also preferable that the portion 98a and / or the base end portion 98b, and the central portion 98c between the tip end portion 98a and the base end portion 98b protrude in this order.
- the grasping force amount of the living tissue by the treatment section 42 is larger on the side close to the proximal end portion 76b of the treatment section 42 than on the side close to the distal end section 76a of the treatment section 42. For this reason, it is possible to prevent the living tissue from moving between the first and second gripping surfaces 72a and 74a when cutting the living tissue with the tip 98a of the blade 98, and it is possible to prevent cutting failure. Further, since the biological tissue is cut so as to be pushed out toward the distal end portion 76a of the treatment section 42, particularly at the proximal end portion 98b of the blade 98, the biological tissue is the base of the treatment section 42 during or after cutting the biological tissue. It is possible to prevent the end portion 76b from being clogged.
- the blade 98 has a distal end portion 98a and a proximal end portion 98b along the longitudinal axis Y.
- the blade 98 has a central portion 98c between the distal end portion 98a and the proximal end portion 98b.
- the blade 98 is not parallel to the gripping surface 72 a of the first gripping portion 72, and the blade 98 in the first guide portion 102 protrudes from the gripping surface 72 a of the first gripping portion 72.
- center portion 98c between the distal end portion 98a and the proximal end portion 98b, and the distal end portion 98a and / or the proximal end portion 98b are formed so as to protrude in this order.
- the energy output units 62 and 64 have been described by taking a heater as an example.
- various devices may be used as long as they can treat the living tissue by applying energy to the living tissue, such as a high-frequency electrode. Can be used.
- the first concave groove 122 of the first guide portion 102 and the second concave groove 124 of the second guide portion 104 are drawn as being substantially symmetrical.
- the first concave groove 122 of the first guide portion 102 is formed deeper than the second concave groove 124 of the second guide portion 104.
- the dial 86 is preferably disposed on the right side surface of the operation unit main body 82, not on the left side surface shown in FIG. 1A.
- This embodiment is a modification of the first embodiment, and the same members or members having the same functions as those described in the first embodiment are denoted by the same reference numerals, and detailed description thereof is omitted.
- the edge portion 96 a of the action portion 96 of the rotating body 92 has an energy output portion 142 together with the blade 98 or instead of the blade 98. That is, it is also preferable that the edge portion 96a of the action portion 96 has an energy output portion 142 such as a heater.
- the action part 96 of the rotating body 92 of the treatment instrument 12 is made of a material having appropriate thermal conductivity.
- the energy output unit 142 is connected to the controller 14, for example.
- the action part 96 can be heated by the energy output part 142 by the heat transfer action from the energy output part 142.
- the edge 96a of the action part 96 is brought into contact with the living tissue and dehydrated with the heat to make a cautery incision. Even if the action part 96 is heated, the living tissue can be cut in the same manner as described in the first embodiment.
- the edge portion 96a When the edge portion 96a has the blade 98, the living tissue can be cut more easily with the heating action by the energy output portion 142.
- the first energy output unit 62 is disposed in the first grip 72 and the second energy output unit 64 is disposed in the second grip 74. It is possible that the second energy output unit 64 is disposed on the second jaw 54 and the first energy output unit 62 is not disposed on the first jaw 52. Furthermore, the first energy output unit 62 may not be disposed in the first grip 72, and the second energy output unit 64 may not be disposed in the second grip 74.
- At least one of the first and second gripping portions 72 and 74 has been described as having energy output portions 62 and 64 that can treat the living tissue by applying energy to the living tissue.
- the energy output units 62 and 64 may not be disposed in the treatment unit 42. Instead, the living tissue can be easily cut by heating the action part 96 with the energy output part 142.
- FIGS. 11A to 12D This embodiment is a modification of the first embodiment, and the same members or members having the same functions as those described in the first embodiment are denoted by the same reference numerals, and detailed description thereof is omitted.
- a bevel gear 170 is arranged inside the operation unit main body 82 as a part of a rotation operation unit that rotates the rotation body 92.
- the operation unit main body 82 drives a bevel gear 170 that transmits power for rotating the rotating body 92 as a part of the rotating operation unit that rotates the rotating body 92, that is, the rotating body 92 is moved around the central axis C ⁇ b> 1.
- a drive knob (rotation operation unit) 182 for rotating around the axis is provided.
- the living tissue can be cut in the same manner as the treatment instrument 12 described in the first and second embodiments. .
- the drive knob 182 includes a pivot shaft 184 connected to the bevel gear 170, a finger hook portion 186 on which the index finger or the middle finger is hooked, and a pair of contacts with the opening / closing knob 84.
- the drive knob 182 can be rotated in the first direction ⁇ and the second direction ⁇ by a pivot shaft 184 disposed inside the operation unit main body 82.
- the finger hook portion 186 of the drive knob 182 protrudes outward from the lower end of the operation portion main body 82 and is disposed on the front side of the other end 82 b of the operation portion main body 82. For this reason, the finger hooking portion 186 of the drive knob 182 can be moved closer to and away from the other end 82 b of the operation portion main body 82.
- the bevel gear 170 is driven to rotate the rotating body 92 and the edge portion 96 a of the action portion 96 of the rotating body 92. Is moved from the first guide unit 102 to the second guide unit 104.
- the finger hooking portion 186 of the driving knob 182 is operated to be separated from the other end 82 b of the operation portion main body 82, the bevel gear 170 is driven to rotate the rotating body 92 and the edge portion 96 a of the operating portion 96 of the rotating body 92. Is moved from the second guide unit 104 to the first guide unit 102.
- the operation portion main body 82 has a fitting receiving portion (engagement) on which a fitting portion (engaging portion) 216 of the interlocking body 212 described later is placed or fitted or engaged.
- a support portion 204 having a receiving portion 202 is provided.
- the fitting receiving portion 202 is formed in a substantially L-shaped longitudinal section.
- the fitting receiving portion 202 has a concave shape on the inner side of the operation portion main body 82 and a convex shape on the lower end side (outer side).
- a treatment body opening / closing knob (opening / closing operation section) 84 supports an interlocking body 212 that moves in conjunction with a rotating shaft 214.
- the rotating shaft 214 is supported at the base end of the interlocking body 212.
- the interlocking body 212 can be rotated in the first direction ⁇ and the second direction ⁇ by the rotation shaft 214.
- the interlocking body 212 moves as an operation is input to the opening / closing knob 84, and when the opening / closing knob 84 is rotated in the first direction ⁇ around the pivot shaft 84a, the first direction ⁇ or the second direction.
- the opening / closing knob 84 is restricted from rotating in the second direction ⁇ when it is rotated by ⁇ and engaged with the operation portion main body 82.
- the interlocking body 212 has a fitting portion 216 that can be fitted to the fitting receiving portion 202 of the operation portion main body 82 at the tip thereof.
- An elastic body 218 that biases the fitting portion 216 of the interlocking body 212 toward the fitting receiving portion 202 of the operation portion main body 82 is disposed between the opening / closing operation lever 84 and the interlocking body 212.
- the interlocking body 212 has a protrusion 212a that protrudes toward the lower end of the operation section main body 82.
- the interlocking body 212 has a protrusion 212 a that protrudes toward the drive knob 182 so as to be in contact with the protrusion 190 of the drive knob (second operation input body) 182.
- the protrusion 190 of the drive knob 182 is located closer to the finger hooking portion 186 than the base side edge of the pair of contact surfaces 188, and the pair of contact surfaces 188. Is formed between. For this reason, a space 188 a is formed between the protrusion 190 and the contact surface 188.
- the interlocking body 212 does not contact the pair of contact surfaces 188 of the drive knob 182, and the protrusion 190 of the drive knob 182 and the protrusion 212 a of the interlocking body 212 contact each other.
- the contact surface 188 is formed as a flat cam, for example.
- the contact surface 188 formed as a flat cam maintains the closed state of the first and second gripping portions 72 and 74 as much as possible when the opening / closing knob 84 at the position shown in FIG. 12C is returned to the position shown in FIG. 12A.
- it is adjusted so that the blade 68 of the action part 96 can be moved from the second guide part 104 to the first guide part 102. For this reason, it can prevent that the action part 96 is guided toward the 2nd guide part 104 from the 1st guide part 102 in the state which does not hold
- the open / close knob 84 and the drive knob 182 are in the positions shown in FIG. 12A, the open / close knob 84 is moved in the first direction ⁇ to bring the open / close knob 84 close to the other end 82b of the operation portion main body 82.
- the interlocking body 212 is biased to the support portion 204 of the operation portion main body 82 by the elastic body 218.
- the fitting portion 216 of the interlocking body 212 comes close to the fitting receiving portion 202 of the support portion 204 while abutting against the support portion 204 of the operation portion main body 82.
- the fitting portion 216 of the interlocking body 212 supported by the rotating shaft 214 approaches the fitting receiving portion 202 of the operation portion main body 82.
- the interlocking body 212 may move in the second direction ⁇ relative to the opening / closing knob 84 by the rotation shaft 214. 12B, the fitting portion 216 of the interlocking body 212 is fitted or engaged with the fitting receiving portion 202 of the operation portion main body 82.
- the interlocking body 212 is rotated in the first direction ⁇ with respect to the opening / closing knob 84 by the rotation shaft 214.
- the elastic body 218 applies a biasing force to the interlocking body 212 so that the fitting part 216 of the interlocking body 212 is engaged with the fitting receiving part 202. For this reason, rotation of the opening / closing knob 84 in the second direction ⁇ is restricted.
- the living tissue can be grasped by the grasping surfaces 72a and 74a.
- the living tissue grasped by the grasping surfaces 72a and 74a can be appropriately treated using energy.
- the drive knob 182 is rotated in the first direction ⁇ and brought closer to the opening / closing knob 84.
- the drive knob 182 contacts the interlocking body 212 before contacting the opening / closing knob 84.
- the protrusion 190 of the drive knob 182 contacts the protrusion 212a of the interlocking body 212.
- the interlocking body 212 is flipped up in the second direction ⁇ around the axis of the rotating shaft 214 against the urging force of the elastic body 218, and the fitting portion 216 is fitted or engaged with the fitting receiving portion 202. Is released.
- the pair of contact portions 188 of the drive knob 182 are in contact with the opening / closing knob 84. That is, when the pair of abutting portions 188 of the drive knob 182 are abutted against the opening / closing knob 84, the interlocking member 212 has already been rotated in the second direction ⁇ around the axis of the rotating shaft 214, and the fitting receiving portion The state in which the fitting portion 216 is fitted or engaged with 202 has been released.
- the fitting portion 216 of the interlocking body 212 is the operation portion main body. 82 is not fitted to the fitting receiving portion 202 of 82. For this reason, the opening / closing knob 84 can be rotated in the second direction ⁇ .
- the drive knob 182 that is in contact with the opening / closing knob 84 is also rotated in the second direction ⁇ . Then, the fitting portion 216 of the interlocking body 212 interlocked with the opening / closing knob 84 is separated from the fitting receiving portion 202 of the support portion 204 of the operation portion main body 82.
- the blade 98 of the action part 96 moves from the second guide part 104 to the first guide part 102 and is extracted from the living tissue, and the second grip part 74 opens with respect to the first grip part 72. That is, the rotating body 92 is operated, and the treatment unit 42 is also operated.
- the first and second gripping portions 72, 74 in the opened state are advanced forward relative to the living tissue, and the first and second gripping portions 72, 72 are brought close to the other end 82 b of the operation portion main body 82 by moving the opening / closing knob 84. 74 is closed, and the biological tissue is treated with thermal energy by stepping on the pedal 16a of the foot switch 16. Thereafter, the driving knob 182 is operated to cut the living tissue with the blade 98 of the action portion 96 of the rotating body 92. Thereafter, the action portion 96 is drawn from the second guide portion 104 into the first guide portion 102 while the opening / closing knob 84 is rotated in the second direction ⁇ .
- the opening / closing knob 84 that can be turned in the first and second directions ⁇ and ⁇ is turned in the first direction ⁇ to operate the treatment portion 42.
- the function of the treatment section 42 is exerted on the living tissue.
- the opening / closing knob 84 is rotated, the interlocking body 212 that can be rotated in the third and fourth directions ⁇ and ⁇ is appropriately rotated to be engaged with the operation portion main body 82.
- the treatment unit 42 is operated to maintain a state in which the function is exerted on the living tissue.
- the drive knob 182 that can be rotated in the fifth and sixth directions ⁇ and ⁇ is rotated in the fifth direction ⁇ , and the rotating body 92 is the center of the rotating body 92.
- the function of the rotating body 92 is exerted on the living tissue by rotating around the axis of the axis C1.
- the drive knob 182 is rotated in the fifth direction ⁇
- the interlocking body 212 is rotated in the fourth direction ⁇
- the engagement of the interlocking body 212 with the operation portion main body 82 is released.
- the opening / closing knob 84 is rotated in the second direction ⁇ , the function of the treatment section 42 is stopped, and the drive knob 182 is rotated in the sixth direction ⁇ so that the rotating body 92 is The function that it has is stopped.
- the open / close knob 84 supported rotatably with respect to the operation unit main body 82 is rotated in the first direction ⁇ to hold the living tissue by the first and second gripping units 72 and 74, and then the pedal of the foot switch 16.
- Step 16a can be performed to add thermal energy to the living tissue grasped between the energy output portions 44 and 54.
- the drive knob 182 By operating the drive knob 182 in this state, the interlocking body 212 interlocked with the opening / closing knob 84 can be released from being engaged with the operation portion main body 82, and the living tissue is cut at the edge portion 96a of the action portion 96. can do.
- the interlocking body 212 in the state of being fitted to the operation portion main body 82 can be released by operating the drive knob 182, in this embodiment, the interlocking body 212 is simply interlocked with the opening / closing knob 84. Without being linked to the drive knob 182. Therefore, for example, after the drive knob 182 is moved forward to cut and retract the living tissue, it is possible to save the trouble of releasing the state in which the opening / closing knob 84 is fitted to the operation portion main body 82. Therefore, it is possible to efficiently perform a series of operations such as a treatment using energy for a living tissue and a cutting of the living tissue, and when a living tissue in front of the treated and cut living tissue is similarly treated and cut. The work efficiency can be greatly improved.
- the drive knob 182 When the drive knob 182 is rotated in the first direction ⁇ with the interlocking body 212 fitted to the operation portion main body 82, the drive knob 182 comes before the contact with the opening / closing knob 84. If the 182 is brought into contact, both or one of the protrusions 190 and 212a are not necessarily required.
- FIGS. 13A and 13B This embodiment is a modification of the first to third embodiments, and the same members or members having the same functions as those described in the first to third embodiments are denoted by the same reference numerals and detailed. Description is omitted.
- an actuator 252 such as a rotary motor is disposed inside the operation unit main body 82 of the operation unit 46.
- a switch (rotation operation unit) 254 for operating the rotation body 92 by the actuator 252 is disposed outside the operation unit main body 82.
- the switch 254 includes a lever 256, for example.
- the lever 256 can be switched between two modes.
- the first mode is a stop position where the operation of the actuator 252 is stopped, that is, an initial return position where the blade 98 of the action portion 96 of the rotating body 92 is moved into the first guide portion 102.
- the second mode is a cutting position where the actuator 252 is operated to move the blade 98 of the action part 96 of the rotating body 92 from the first guide part 102 to the second guide part 104 to cut the living tissue.
- the blade 98 of the action part 96 of the rotating body 92 is moved from the first guide part 102 to the second guide part 104. Thereafter, when the position of the lever 256 is switched from the second mode to the first mode, the blade 98 of the action portion 96 of the rotating body 92 is moved from the second guide portion 104 to the first guide portion 102.
- the actuator 252 and the switch 254 are preferably connected to the control unit 22 of the controller 14. For this reason, at the time of energy output from the energy output circuit 24, the actuator 252 can be appropriately controlled such that the actuator 252 is not operated even if the lever 256 is moved to the cut position.
- the example in which the actuator 252 is arranged in the operation unit main body 82 has been described.
- the actuator 252 is preferably arranged in the insertion unit 44.
- This embodiment is a modification of the first to fourth embodiments.
- the same members or members having the same functions as those described in the first to fourth embodiments are denoted by the same reference numerals, and detailed. Description is omitted.
- the example in which the insertion portion 44 is disposed between the treatment portion 42 and the operation portion 46 has been described.
- the part 44 is not always necessary.
- the actuator 252 (see FIG. 13B) is operated to move the edge portion 96a of the action portion 96 of the rotating body 92 toward the second guide groove 104, and when the press is released.
- the edge portion 96 a of the action portion 96 of the rotating body 92 can be moved toward the first guide groove 102.
- FIGS. 15A to 15C This embodiment is a modification of the first to fifth embodiments, and the same members or members having the same functions as those described in the first to fifth embodiments are denoted by the same reference numerals and detailed. Description is omitted.
- the treatment portion opening / closing knob 84 of the treatment instrument 12 is configured so that the treatment portion opening / closing knob 84 is brought close to the other end of the operation portion main body 82 and the first holding portion 72 and the second holding portion of the treatment portion 42.
- the dial 86 see FIG. 1A
- the lever 132 so that the edge 96a of the action portion 96 cannot move toward the second guide groove 104 (see FIGS. 4A to 4C).
- FIG. 1B See FIG. 1B
- a switch 254 see FIGS. 13A and 13B
- a cover 262 that covers the switch 254a (see FIG. 14).
- the cover 262 is formed so as to extend from the knob 84 along the outer peripheral surface of the operation portion main body 82.
- the cover 262 separates the knob 84 from the other end 82b of the operation portion main body 82, and in the state where the first gripping portion 72 and the second gripping portion 74 of the treatment portion 42 are spaced apart and opened, Instead of the dial 86, the lever 132 and the switches 254 and 254a may be covered in an inoperable manner.
- the cover 262 brings the knob 84 close to the other end 82b of the operation portion main body 82 and brings the first gripping portion 72 and the second gripping portion 74 of the treatment portion 42 close to each other.
- the dial 86 (the lever 132 and the switches 254 and 254a may be used instead of the dial 86) can be exposed. Further, the cover 262 is shown in FIG. 15A along the outer surface of the operation unit main body 82 so as not to interfere with the operation unit main body 82 according to the rotation of the knob 84 (proximity and separation with respect to the other end 82b of the operation unit main body 82). It is formed to move from the state to the state shown in FIG. 15C.
- the open / close knob (open / close operation unit) 84 is at least a part of the dial 86, the lever 132, and the switches 254 and 254a as the rotation operation unit in the state where the first and second gripping units 72 and 74 are close to each other and closed. It is comprised so that it may cover. Further, the opening / closing knob (opening / closing operation part) 84 does not cover the dial 86, the lever 132, and the switches 254, 254a as the rotation operation part when the first and second gripping parts 72, 74 are separated and opened. It is configured.
- the cover 262 is drawn so as to protect the left side surface and the right side surface of the operation unit main body 82.
- the dial 86 in place of the dial 86, the lever 132, the switches 254, 254a, It is also preferable that it is formed only on the left side surface when it is disposed on the left side surface of the operation unit main body 82 and only on the right side surface when disposed on the right side surface.
- the cover 262 extending from the knob 84 extends along the outer surface of the operation portion main body 82 to a position where the dial 86 (the lever 132 and the switches 254 and 254a may be used instead of the dial 86). .
- the cover 262 can take various configurations so as to prevent the operator from operating the dial 86 (the lever 132, the switches 254, and 254a may be used instead of the dial 86).
- the cover 262 extends along the dial 86, the lever 132, the switch 254, and the switch 254a, and has a width that covers the entire dial 86 (the lever 132, the switches 254, and 254a may be used instead of the dial 86). It can be configured as follows. If the cover 262 is in a state where the dial 86 (the lever 132 and the switches 254 and 254a may be used instead of the dial 86) cannot be operated, the dial 86 (the lever 132 and the switches 254 and 254a can be used instead of the dial 86). It may be configured to cover a part of (good).
- the operation portion main body 82 defines a position (see FIG. 15A) at which the opening / closing knob 84 is farthest from the other end 82b by the contact portion 264a and a position closest to the operation portion main body 82 (see FIG. 15C) by the contact portion 264b. can do.
- the surgeon moves the first gripping portion 72 and the second gripping portion 74 of the treatment portion 42 by bringing the knob 84 close to the other end 82 b of the operation portion main body 82.
- dial 86 (lever 132, switches 254 and 254a may be used instead of dial 86) cannot be operated.
- the edge 96a of the action portion 96 cannot move toward the second guide groove 104 in a state where the operator has separated the opening / closing knob 84 from the other end 82b of the operation portion main body 82.
- first gripping portion 72 and the second gripping portion 74 are opened apart from each other, and the edge portion 96a of the action portion 96 is exposed from the gripping surface 72a of the first gripping portion 72. 2 Opening and closing the grip 74 can be prevented.
- FIGS. 16A and 16B This embodiment is a modification of the first to sixth embodiments.
- the same members or members having the same functions as those described in the first to sixth embodiments are denoted by the same reference numerals, and detailed. Description is omitted.
- the treatment section opening / closing knob 84 of the treatment instrument 12 according to the seventh embodiment is configured so that the treatment section opening / closing knob 84 is brought close to the other end of the operation section main body 82, so that the first grasping section 72 and the second grasping section of the treatment section 42 are provided.
- the drive knob 182 Prior to closing 74 in close proximity, the drive knob 182 (from FIGS. 11A and 12A) is arranged so that the edge 96a of the action portion 96 cannot be moved toward the second guide groove 104 (see FIGS. 4A to 4C). (See FIG. 12C).
- the cover 266 is formed to extend forward from the knob 84.
- the cover 266 opens the drive knob 182 in a state where the knob 84 is spaced apart from the other end 82b of the operation portion main body 82 and the first gripping portion 72 and the second gripping portion 74 of the treatment portion 42 are spaced apart. Can be inoperably covered.
- the cover 266 brings the knob 84 close to the other end 82b of the operation portion main body 82 to bring the first gripping portion 72 and the second gripping portion 74 of the treatment portion 42 close to each other. In the closed state, the drive knob 182 can be exposed operably. Further, the cover 266 is shown in FIG.
- the open / close knob (open / close operation unit) 84 is configured to cover at least a part of the drive knob 182 as the rotation operation unit in a state where the first and second gripping units 72 and 74 are close to each other and closed. Yes.
- the opening / closing knob (opening / closing operation part) 84 is configured not to cover the drive knob 182 as the rotation operation part in a state where the first and second gripping parts 72, 74 are separated and opened.
- the cover 266 is drawn so as to cover the front side of the drive knob 182, but not only makes the drive knob 182 inoperable but also prevents the operator from touching it. It is also preferable to form not only the front side but also the left side surface and the right side surface.
- the drive knob 182 is installed in the operation unit main body 82 so as to be located on the tip side of the position where the opening / closing knob 84 is attached to the operation unit main body 82.
- the drive knob 182 is configured to be capable of rotating or pushing from the distal end side to the proximal end side of the operation unit main body 82.
- the cover 266 extends from the knob 84 to the distal end side of the operation unit main body 82 and extends to a position where the drive knob 182 is installed. In the state of FIG. 16A, the cover 266 can take various configurations so as to prevent the operator from operating the drive knob 182.
- the cover 266 can be configured to extend along the drive knob 182 and have a width that covers the entire drive knob 182. As long as the drive knob 182 cannot be operated, a part of the drive knob 182 may be covered.
- the surgeon brings the knob 84 close to the other end 82b of the operation portion main body 82 and moves the first gripping portion 72 and the second gripping portion 74 of the treatment portion 42 together.
- the drive knob 182 cannot be operated unless it is closed close.
- the edge 96a of the action portion 96 cannot move toward the second guide groove 104 in a state where the operator has separated the opening / closing knob 84 from the other end 82b of the operation portion main body 82.
- the first gripping portion 72 and the second gripping portion 74 are opened apart from each other, and the edge portion 96a of the action portion 96 is exposed from the gripping surface 72a of the first gripping portion 72. 2 Opening and closing the grip 74 can be prevented.
- cover 262 described in the sixth embodiment shown in FIGS. 15A to 15C and the cover 266 described in the seventh embodiment shown in FIGS. It is also suitable that it is formed.
Abstract
Description
図1Aに示すように、この実施形態に係る処置システム10は、処置具12と、処置具12にエネルギを付与するコントローラ14とを有する。コントローラ14は処置具12の後述する第1及び第2エネルギ出力部62,64の温度を適宜の温度に制御する。なお、この実施形態では、コントローラ14を有する例について説明するが、コントローラ14は必ずしも必要ではない。すなわち、後述する第1及び第2エネルギ出力部62,64は必ずしも必要ではない。
コントローラ14には処置具12に付与する熱エネルギのON/OFFを切り替えるペダル16aを有するフットスイッチ16が接続されている。処置具12とコントローラ14との間は複数のリード線や信号線が束ねられた第1ケーブル18aにより電気的に接続され、コントローラ14とフットスイッチ16との間は複数のリード線や信号線が束ねられた第2ケーブル18bにより電気的に接続されている。フットスイッチ16はペダル16aの操作等によりコントローラ14に信号を入力することが可能であり、コントローラ14はフットスイッチ16のペダル16aの操作等に基づいて処置具12に付与するエネルギを制御可能である。
なお、フットスイッチ16と制御部22とが接続され、フットスイッチ16のペダル16aが押圧されると、エネルギ出力回路24から後述する第1及び第2エネルギ出力部62,64にそれぞれエネルギが同時に出力される。
図1A、及び、図3から図4Cに示すように、処置部42は、生体組織の保持部としての開閉可能な1対のジョー(第1及び第2ジョー)52,54と、ジョー52,54に配設されたエネルギ出力部(第1及び第2エネルギ出力部)62,64とを有する。第1ジョー52及び第1エネルギ出力部62は図3に示す第1把持部72(図1A参照)を形成し、第2ジョー54及び第2エネルギ出力部64は第2把持部74(図1A参照)を形成する。
この実施形態では1対の縁部96a,96bの一方の縁部96aには刃(切断部)98を有する。刃98は、その縁部96aの先端部98aから基端部98bにかけて連続的に形成されていることが好ましい。また、この実施形態では、刃98は、回動体92の中心軸C1に平行、且つ、図5Bに示すように第1把持部72の把持面72aに対して平行である。回動体92の中心軸C1はダイヤル86の枢支軸に一致することが好ましい。刃98は所望の長さに形成することが可能である。刃98の長さは、幅方向Xすなわち後述する左側端部(一端)78aと右側端部(他端)78bとの間の長さよりも長いことが好適である。このため、第1及び第2開口112,114の長さ、第1及び第2凹溝122,124の長手軸Yに沿った長さも、幅方向Xの長さよりも長いことが好適である。
図4Aに示すように、回動体92の作用部96の縁部96aすなわち刃98を第1案内部102内に収容し、縁部96aすなわち刃98が第1開口112を通して第1把持面72aに対して突出しないようにしておく。
開閉ノブ84及び駆動ノブ182が図12Aに示す位置にある状態から、開閉ノブ84を第1方向αに回動させるように操作して、開閉ノブ84を操作部本体82の他端82bに近接させる。このとき、連動体212は弾性体218により操作部本体82の支持部204に付勢されている。このため、連動体212の嵌合部216は操作部本体82の支持部204に当接しながら支持部204の嵌合受部202に近接していく。すなわち、開閉ノブ84の移動に伴って回転軸214に支持された連動体212の嵌合部216が操作部本体82の嵌合受部202に近接していく。このとき、連動体212は回転軸214により、開閉ノブ84に対して相対的に第2方向ζに移動することがあり得る。そして、図12Bに示すように、連動体212の嵌合部216が操作部本体82の嵌合受部202に嵌合又は係合される。このとき、連動体212は回転軸214により、開閉ノブ84に対して第1方向εに回動する。
すなわち、駆動ノブ182の1対の当接部188が開閉ノブ84に当接されたとき、既に、連動体212を回転軸214の軸回りの第2方向ζに回動させ、嵌合受部202に嵌合部216が嵌合又は係合された状態を解除し終わっている。
操作部本体82に対して回動可能に支持された開閉ノブ84を第1方向αに回動させて生体組織を第1及び第2把持部72,74で保持した後、フットスイッチ16のペダル16aを踏んで、エネルギ出力部44,54間に把持した生体組織に熱エネルギを付加する処置を行うことができる。この状態で駆動ノブ182を操作することで開閉ノブ84に連動した連動体212が操作部本体82に係合した状態を解除することができるとともに、作用部96の縁部96aで生体組織を切断することができる。
Claims (18)
- 生体組織を処置するための処置具であって、
長手軸を有し、前記長手軸に直交又は略直交する開閉方向に開閉することで生体組織をその間に把持可能な把持面をそれぞれ有する第1及び第2把持部と、
前記長手軸と同一又は略平行な中心軸の軸回りに回動することで生体組織を切断可能な縁部を有する作用部を備え、前記縁部を前記第1把持部から前記第2把持部に向かって移動可能な回動体と、
前記第1把持部に設けられ、前記第1把持部の把持面を通して前記第2把持部に向かって前記縁部を案内可能な第1案内部と、
前記第2把持部に設けられ、前記第1把持部の把持面を通して前記第2把持部に前記縁部を案内可能で、前記第1把持部の把持面を通して前記第2把持部に案内する際に前記生体組織を切断可能な第2案内部と
を具備する、処置具。 - 請求項1に記載の処置具であって、
前記第1及び第2把持部の前記把持面は、前記開閉方向に直交又は略直交する方向に幅方向を有し、
前記幅方向は一端及び他端により規定され、
前記第1案内部は、前記第1把持部の前記把持面に設けられ、前記幅方向の一端と他端との間に前記縁部が出し入れされる第1開口を有し、
前記第2案内部は、前記第2把持部の前記把持面に設けられ、前記幅方向の一端と他端との間に前記縁部が出し入れされ前記第1開口に対向する第2開口を有する、処置具。 - 請求項2に記載の処置具であって、
前記第1案内部は、前記第1把持部の前記把持面から前記第1把持部の裏面に向かって、前記第1開口に連続した曲面状又は斜面状の第1凹溝を有し、
前記第2案内部は、前記第2把持部の前記把持面から前記第2把持部の裏面に向かって、前記第2開口に連続した曲面状又は斜面状の第2凹溝を有する、処置具。 - 請求項3に記載の処置具であって、
前記第1凹溝は、前記第1把持部の前記裏面に近づくにつれて前記幅方向の一端及び他端の一方に向かって延出され、
前記第2凹溝は、前記第2把持部の前記裏面に近づくにつれて前記幅方向の、前記第1凹溝が延出された方向と同じ方向に延出されている、処置具。 - 請求項1に記載の処置具であって、
前記作用部の前記縁部は、前記第1把持部の前記把持面に対して平行である、処置具。 - 請求項1に記載の処置具であって、
前記作用部の前記縁部は、前記長手軸に沿って先端部及び基端部を有し、前記第1把持部の前記把持面に対して、前記先端部、前記基端部の順に突出する、処置具。 - 請求項1に記載の処置具であって、
前記作用部の前記縁部は、前記長手軸に沿って先端部及び基端部を有し、前記第1把持部の前記把持面に対して、前記基端部、前記先端部の順に突出する、処置具。 - 請求項1に記載の処置具であって、
前記作用部の前記縁部は、前記長手軸に沿って先端部及び基端部を有し、前記第1把持部の前記把持面に対して、前記先端部及び/又は前記基端部、前記先端部及び前記基端部の間の中央部の順に突出する、処置具。 - 請求項1に記載の処置具であって、
前記作用部の前記縁部は、前記長手軸に沿って先端部及び基端部を有し、前記第1把持部の前記把持面に対して、前記先端部及び前記基端部の間の中央部、前記先端部及び/又は前記基端部の順に突出する、処置具。 - 請求項1に記載の処置具であって、
前記第1及び第2把持部を開閉させる開閉操作部と、
前記回動体を前記中心軸の軸回りに回動させる回動操作部と
を有する操作部本体をさらに具備する、処置具。 - 請求項10に記載の処置具であって、
前記開閉操作部は、前記第1及び第2把持部が近接し閉じた状態において少なくとも前記回動操作部の一部を覆うように構成されている、処置具。 - 請求項11に記載の処置具であって、
前記開閉操作部は、前記第1及び第2把持部が離隔し開いた状態において前記回動操作部を覆わないように構成されている、処置具。 - 請求項10に記載の処置具であって、
前記回動操作部は、前記操作部本体の外側に突出し、ユーザに操作されると前記回動体を前記中心軸の軸回りに回動させるダイヤル及びレバーの少なくとも一方を有する、処置具。 - 請求項10に記載の処置具であって、
前記回動操作部は、ユーザに操作されると動作されて前記回動体を回動させる動力を伝達するギヤを有する、処置具。 - 請求項14に記載の処置具であって、
前記回動操作部は、ユーザに操作され、前記ギヤを動作させるノブを有する、処置具。 - 請求項1に記載の処置具であって、
前記第1及び第2把持部を開閉させる開閉操作部と、
前記回動体を前記中心軸の軸回りに回動させるアクチュエータと、
前記アクチュエータを動作させるスイッチと
を有する操作部本体をさらに具備する、処置具。 - 請求項1に記載の処置具であって、
前記第1及び第2把持部の少なくとも一方は、前記生体組織にエネルギを付加することで前記生体組織を処置可能なエネルギ出力部を有する、処置具。 - 請求項1に記載の処置具であって、
前記回動体の前記作用部には、前記生体組織を処置可能なエネルギ出力部を有する、処置具。
Priority Applications (4)
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EP14874102.8A EP3087939A4 (en) | 2013-12-27 | 2014-12-25 | Treatment tool |
JP2015545576A JP5981048B2 (ja) | 2013-12-27 | 2014-12-25 | 処置具 |
CN201480071350.5A CN105848602B (zh) | 2013-12-27 | 2014-12-25 | 处理器具 |
US15/192,441 US9962216B2 (en) | 2013-12-27 | 2016-06-24 | Treatment device |
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US (1) | US9962216B2 (ja) |
EP (1) | EP3087939A4 (ja) |
JP (1) | JP5981048B2 (ja) |
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Citations (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
JP2001170070A (ja) | 1999-12-20 | 2001-06-26 | Olympus Optical Co Ltd | 医療用処置具 |
JP2002017738A (ja) * | 2000-07-06 | 2002-01-22 | Olympus Optical Co Ltd | 内視鏡用切除具 |
JP2010536398A (ja) * | 2007-08-14 | 2010-12-02 | オリンパスメディカルシステムズ株式会社 | 治療用処置具 |
Family Cites Families (18)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5693051A (en) * | 1993-07-22 | 1997-12-02 | Ethicon Endo-Surgery, Inc. | Electrosurgical hemostatic device with adaptive electrodes |
JP3686117B2 (ja) * | 1995-04-06 | 2005-08-24 | オリンパス株式会社 | 超音波切開凝固装置 |
US6241740B1 (en) * | 1998-04-09 | 2001-06-05 | Origin Medsystems, Inc. | System and method of use for ligating and cutting tissue |
US6332889B1 (en) * | 1998-08-27 | 2001-12-25 | Onux Medical, Inc. | Surgical suturing instrument and method of use |
US6786913B1 (en) * | 1999-02-01 | 2004-09-07 | Onux Medical, Inc. | Surgical suturing instrument and method of use |
US6117152A (en) * | 1999-06-18 | 2000-09-12 | Ethicon Endo-Surgery, Inc. | Multi-function ultrasonic surgical instrument |
US6527785B2 (en) * | 1999-08-03 | 2003-03-04 | Onux Medical, Inc. | Surgical suturing instrument and method of use |
US6767352B2 (en) * | 1999-08-03 | 2004-07-27 | Onux Medical, Inc. | Surgical suturing instrument and method of use |
ES2643763T3 (es) * | 2000-03-06 | 2017-11-24 | Salient Surgical Technologies, Inc. | Sistema de suministro de fluido y controlador para dispositivos electroquirúrgicos |
US7131980B1 (en) * | 2001-01-18 | 2006-11-07 | Dvl Acquisitions Sub, Inc. | Surgical suturing instrument and method of use |
AU2002326917A1 (en) * | 2001-09-14 | 2003-04-01 | Onux Medical, Inc. | Surgical suturing instrument and method of use |
JP4405165B2 (ja) * | 2002-03-19 | 2010-01-27 | オリンパス株式会社 | 内視鏡システム |
AU2003241521A1 (en) * | 2002-05-17 | 2003-12-02 | Onux Medical, Inc. | Surgical suturing instrument and method of use |
US8348947B2 (en) * | 2008-04-25 | 2013-01-08 | Olympus Medical Systems Corp. | Treatment system, and treatment method for living tissue using energy |
US9526502B2 (en) * | 2008-09-10 | 2016-12-27 | Unique Surgical Innovations Llc | Surgical string applicator for anastomosis surgery |
US20100185196A1 (en) * | 2009-01-21 | 2010-07-22 | Satomi Sakao | Medical treatment apparatus, treatment instrument and treatment method for living tissue using energy |
US8961547B2 (en) | 2010-02-11 | 2015-02-24 | Ethicon Endo-Surgery, Inc. | Ultrasonic surgical instruments with moving cutting implement |
US9770256B2 (en) * | 2011-09-28 | 2017-09-26 | Mitracore Technologies Inc. | Apparatuses and methods for cutting a tissue bridge and/or removing a heart valve clip or suture |
-
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Patent Citations (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
JP2001170070A (ja) | 1999-12-20 | 2001-06-26 | Olympus Optical Co Ltd | 医療用処置具 |
JP2002017738A (ja) * | 2000-07-06 | 2002-01-22 | Olympus Optical Co Ltd | 内視鏡用切除具 |
JP2010536398A (ja) * | 2007-08-14 | 2010-12-02 | オリンパスメディカルシステムズ株式会社 | 治療用処置具 |
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---|
See also references of EP3087939A4 * |
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US20160302845A1 (en) | 2016-10-20 |
CN105848602A (zh) | 2016-08-10 |
CN105848602B (zh) | 2018-06-05 |
EP3087939A1 (en) | 2016-11-02 |
JPWO2015099068A1 (ja) | 2017-03-23 |
EP3087939A4 (en) | 2017-09-27 |
JP5981048B2 (ja) | 2016-08-31 |
US9962216B2 (en) | 2018-05-08 |
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