WO2015159600A1 - エネルギー処置具 - Google Patents
エネルギー処置具 Download PDFInfo
- Publication number
- WO2015159600A1 WO2015159600A1 PCT/JP2015/056229 JP2015056229W WO2015159600A1 WO 2015159600 A1 WO2015159600 A1 WO 2015159600A1 JP 2015056229 W JP2015056229 W JP 2015056229W WO 2015159600 A1 WO2015159600 A1 WO 2015159600A1
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- WIPO (PCT)
- Prior art keywords
- opening
- sheath
- jaw
- closing
- disposed
- Prior art date
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/320068—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic
- A61B17/320092—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw
-
- 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
- A61B17/2816—Pivots
-
- 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
-
- 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
-
- 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
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B18/1442—Probes having pivoting end effectors, e.g. forceps
- A61B18/1445—Probes having pivoting end effectors, e.g. forceps at the distal end of a shaft, e.g. forceps or scissors at the end of a rigid rod
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/1206—Generators therefor
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B2017/0046—Surgical instruments, devices or methods, e.g. tourniquets with a releasable handle; with handle and operating part separable
- A61B2017/00473—Distal part, e.g. tip or head
-
- 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
- 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
- A61B2017/320094—Surgical cutting instruments using mechanical vibrations, e.g. ultrasonic with additional movable means for clamping or cutting tissue, e.g. with a pivoting jaw additional movable means performing clamping operation
-
- 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
- A61B2018/00071—Electrical conductivity
- A61B2018/00083—Electrical conductivity low, i.e. electrically insulating
-
- 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
- A61B2018/00636—Sensing and controlling the application of energy
- A61B2018/00696—Controlled or regulated parameters
- A61B2018/0072—Current
-
- 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
- A61B2018/0091—Handpieces of the surgical instrument or device
- A61B2018/00916—Handpieces of the surgical instrument or device with means for switching or controlling the main function of the instrument or device
- A61B2018/00922—Handpieces of the surgical instrument or device with means for switching or controlling the main function of the instrument or device by switching or controlling the treatment energy directly within the hand-piece
-
- 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
- A61B18/1206—Generators therefor
- A61B2018/1246—Generators therefor characterised by the output polarity
- A61B2018/126—Generators therefor characterised by the output polarity bipolar
-
- 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
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/03—Automatic limiting or abutting means, e.g. for safety
- A61B2090/033—Abutting means, stops, e.g. abutting on tissue or skin
- A61B2090/034—Abutting means, stops, e.g. abutting on tissue or skin abutting on parts of the device itself
- A61B2090/035—Abutting means, stops, e.g. abutting on tissue or skin abutting on parts of the device itself preventing further rotation
Definitions
- the present invention relates to a forceps-type energy treatment device in which a distal end portion of a jaw is opened and closed with respect to a distal end portion of a probe by opening and closing a movable handle with respect to a fixed handle.
- Patent Document 1 discloses a forceps-type energy treatment device having a probe.
- This treatment tool includes a probe that is inserted through a sheath and a jaw that can be opened and closed with respect to the probe.
- the sheath and probe extend along the longitudinal axis.
- the jaw is attached to the distal end portion of the sheath so that the jaw can be rotated (opened / closed) around the opening / closing axis.
- the opening / closing shaft is disposed orthogonal to the longitudinal axis. The above-described attachment is performed by a pair of bearings disposed between the outer peripheral surface of the sheath and the inner peripheral surface of the jaw.
- the tip of the jaw is closed with respect to the tip of the probe so that the tip of the jaw and the tip of the probe sandwich and hold the treatment target such as a living tissue.
- the tip of the jaw opens with respect to the tip of the probe so that the tip of the jaw and the tip of the probe are pushed into the treatment object, for example, and the treatment object is spread and separated.
- Patent Document 1 in the mounting performed by a pair of bearings, the configuration of the mounting is complicated. For this reason, rattling occurs at the mounting portion, and the relative position between the tip of the probe and the tip of the jaw is shifted. In this state, in the meshing of the tip of the probe and the tip of the jaw with each other, the meshing accuracy is lowered. Therefore, in the treatment operations such as the gripping operation and the peeling operation, the treatment forces such as the gripping force and the peeling force are reduced, and desired treatment characteristics cannot be obtained.
- the present invention has been made in view of these circumstances, and provides an energy treatment device capable of preventing the occurrence of looseness in the attachment portion between the jaw and the sheath and capable of reliably obtaining desired treatment characteristics. With the goal.
- One aspect of the energy treatment device of the present invention includes a probe disposed along a longitudinal axis, and a sheath having a hollow portion through which the probe is inserted in a state where the distal end portion of the probe protrudes from the distal end portion of the sheath.
- An opening / closing direction that is attached to the sheath so that the jaw is rotatable about the axis of the opening / closing axis, and intersects the longitudinal axis direction and the opening / closing axis direction with respect to the distal end portion of the probe by rotating the jaw.
- a jaw that is openable and closable, and the open / close shaft, and the jaw can be opened and closed with respect to the distal end portion of the sheath by rotating the jaw around the open / close shaft.
- An opening / closing shaft member attached to the opening / closing shaft member, and the opening / closing shaft member having the opening / closing shaft is disposed in the opening / closing direction so that the opening / closing shaft member does not overlap the hollow portion in the opening / closing direction.
- the sheath and the jaw which are arranged in parallel in the opening / closing axis direction, are arranged with respect to the hollow portion in the opening / closing direction with respect to the hollow portion in a state of being arranged at a position offset with respect to the hollow portion.
- the jaw and the sheath are inserted so as to pierce at the offset position, and the opening / closing shaft member attaches the jaw to the sheath by insertion.
- FIG. 1 is a schematic view of a medical treatment apparatus according to the first embodiment of the present invention.
- FIG. 2 is a cross-sectional view showing the configuration of the vibrator unit.
- FIG. 3 is a side view including a partial cross section of the probe.
- FIG. 4 is a schematic cross-sectional view showing an internal configuration of the fixed handle.
- FIG. 5 is a schematic diagram illustrating an electrical connection state in the vibrator case, the cylindrical member, and the electrical connection ring.
- 6 is a cross-sectional view taken along the line VI-VI shown in FIG.
- FIG. 7A is a schematic view of a medical treatment apparatus showing an example of the arrangement of the attachment portion of the present invention.
- FIG. 7B is a cross-sectional view taken along the line VIIB-VIIB shown in FIG.
- FIG. 8A is a cross-sectional view taken along the line VI-VI shown in FIG. 1, and is a diagram showing an example of the arrangement of prevention members.
- FIG. 8B is a cross-sectional view taken along the line VI-VI shown in FIG. 1, and is a diagram showing an example of the arrangement of the prevention members.
- FIG. 9A is a perspective view of the jaw shown in FIG. 1 in the first embodiment, and is a view showing a regulating mechanism according to the second embodiment.
- FIG. 9B shows that the opening / closing angle ⁇ is restricted by the restriction mechanism according to the second embodiment so that the opening / closing angle ⁇ of the movable handle with respect to the fixed side is minimized, and the minimum closed position of the movable handle is related to the second embodiment.
- FIG. 10A is a perspective view of the jaw shown in FIG. 7A in the first embodiment, and is a view showing a regulating mechanism according to a modified example of the second embodiment.
- FIG. 10A is a perspective view of the jaw shown in FIG. 7A in the first embodiment, and is a view showing a regulating mechanism according to a modified example of the second embodiment.
- FIG. 10B shows that the opening / closing angle ⁇ is restricted by the restriction mechanism according to the modification of the second embodiment so that the opening / closing angle ⁇ of the movable handle with respect to the fixed side is minimized, and the minimum closed position of the movable handle is the second embodiment. It is a figure showing the state where the regulation mechanism concerning the modification of a form has positioned.
- FIG. 10C the opening / closing angle ⁇ is restricted by the restriction mechanism according to the modification of the second embodiment so that the opening / closing angle ⁇ of the movable handle with respect to the fixed side is maximized, and the maximum opening position of the movable handle is the second embodiment. It is a figure showing the state where the regulation mechanism concerning the modification of a form has positioned.
- a medical treatment apparatus 1 shown in FIG. 1 includes a first electrode that functions as a distal end portion of a probe 3 in a probe 3 and a jaw 52 that are disposed in an energy treatment tool (hereinafter referred to as a treatment tool 10) described later.
- a treatment target such as a living tissue is sandwiched and held between the portion 21 and the second electrode portion 53 that functions as a tip portion of the jaw 52.
- the gripping is performed by closing (approaching) the second electrode portion 53 with respect to the first electrode portion 21.
- the medical treatment apparatus 1 can treat the grasped treatment target with energy such as ultrasonic waves, high frequencies, and heat.
- Such a medical treatment apparatus 1 is a grasping treatment apparatus.
- the medical treatment apparatus 1 of the present embodiment is also used as a bipolar treatment apparatus that treats with a high-frequency current using the distal end portion of the probe 3 and the jaw 52 as electrodes.
- the medical treatment apparatus 1 is also used as an ultrasonic treatment apparatus that performs treatment by ultrasonic vibration.
- the medical treatment apparatus 1 peels off the treatment target by the tip portion of the probe 3 pushed into the treatment target and the jaw 52.
- the peeling is performed by opening (separating) the second electrode portion 53 from the first electrode portion 21.
- the medical treatment apparatus 1 includes a power supply unit 7 that functions as a supply unit that supplies electric power for energy, and a treatment instrument 10 that treats a treatment target with the energy supplied from the power supply unit 7.
- a power supply unit 7 that functions as a supply unit that supplies electric power for energy
- a treatment instrument 10 that treats a treatment target with the energy supplied from the power supply unit 7.
- the power supply unit 7 includes an ultrasonic control unit 8 that controls a current for ultrasonic vibration, a high-frequency current control unit 9 that controls a current for high frequency, and an ultrasonic control unit 8. It has the cable 6 which electrically connects the treatment tool 10 and electrically connects the high frequency current control part 9 and the treatment tool 10. One end of the cable 6 is connected to the power supply unit 7, and the other end of the cable 6 is connected to a base end of a transducer case 11 described later.
- the treatment instrument 10 includes a transducer unit 2, a probe 3, a sheath unit 4, and a movable handle unit 5.
- the transducer unit 2, the probe 3, and the sheath unit 4 are fixed sides, and the movable handle unit 5 is a movable side that is movable so as to be rotatable with respect to the fixed side.
- the vibrator unit 2 As shown in FIGS. 1 and 2, the vibrator unit 2 has a vibrator case 11. As described above, the base end of the vibrator case 11 is connected to the end of the cable 6.
- the transducer unit 2 has an ultrasonic transducer 12 disposed inside the transducer case 11.
- the ultrasonic transducer 12 has a piezoelectric element that converts the current supplied from the ultrasonic control unit 8 into ultrasonic vibration.
- the ultrasonic transducer 12 is connected to one end of the electric signal lines 13A and 13B.
- the electric signal lines 13 ⁇ / b> A and 13 ⁇ / b> B are disposed inside the cable 6.
- the other ends of the electrical signal lines 13A and 13B are connected to the ultrasonic control unit 8.
- an electric current is supplied from the ultrasonic control unit 8 to the ultrasonic transducer 12 via the electric signal lines 13 ⁇ / b> A and 13 ⁇ / b> B, ultrasonic vibration is generated in the ultrasonic transducer 12.
- the ultrasonic transducer 12 is connected to one end of the electric signal line 17 separately from the electric signal lines 13A and 13B.
- the electric signal line 17 is disposed inside the cable 6.
- the other end of the electric signal line 17 is connected to the high frequency current control unit 9.
- the electric signal lines 13A, 13B, and 17 are included in the cable 6.
- the transducer unit 2 further includes a horn 15 that expands the amplitude of the ultrasonic vibration generated by the ultrasonic transducer 12.
- the horn 15 is coupled to the tip of the ultrasonic transducer 12 such that the horn 15 is located at the tip of the ultrasonic transducer 12.
- the horn 15 is attached to the vibrator case 11 via an insulating member 15a, and is electrically insulated from the vibrator case 11 by the insulating member 15a.
- the horn 15 has a female screw portion 16 formed at the tip of the horn 15.
- the probe 3 is disposed along the longitudinal axis C.
- the longitudinal axis C functions as the central axis of the probe 3.
- the probe 3 has a column shape.
- the probe 3 has a male screw portion 19 that is formed at the base end portion of the probe 3 and is screwed into the female screw portion 16.
- the probe 3 is attached to the horn 15 by screwing. Thereby, the ultrasonic vibration generated by the ultrasonic vibrator 12 is transmitted to the tip of the probe 3 through the horn 15 and the probe 3. That is, the ultrasonic vibration is transmitted from the proximal end of the probe 3 to the distal end of the probe 3.
- the ultrasonic vibration is longitudinal vibration in which the vibration transmission direction and the vibration direction coincide with each other.
- a probe-side current path of the high-frequency current is formed from the high-frequency current control unit 9 through the electric signal line 17, the ultrasonic transducer 12, and the horn 15 to the tip of the probe 3. Is done.
- the probe-side current path indicates a path through which high-frequency current flows.
- the probe 3 has a first electrode portion 21 that functions as a tip portion of the probe 3. That is, the high-frequency current is transmitted along the longitudinal axis C between the high-frequency current control unit 9 and the first electrode unit 21 by the probe-side current path.
- Sheath unit 4 As shown in FIG. 1, the sheath unit 4 extends along the longitudinal axis C.
- the sheath unit 4 includes a fixed handle 22 and a sheath 23 attached to the distal end of the fixed handle 22.
- the fixed handle 22 has a handle casing 27 that functions as an exterior part.
- the handle casing 27 has a fixed handle ring 28 that is disposed at a portion of the handle casing 27 on the second direction side, which will be described later, and functions as a fixed side finger rest.
- the fixed handle ring 28 protrudes in the second direction with respect to the longitudinal axis C.
- the fixed handle ring 28 is disposed outside the opening / closing shaft member 100 described later in the second direction.
- the handle casing 27 has a cylindrical member 29 that is disposed inside the handle casing 27 and fixed to the handle casing 27.
- the proximal end of the probe 3 extends to the inside of the cylindrical member 29.
- the probe 3 is attached to the horn 15 as described above.
- the tubular member 29 supports the probe 3 and the horn 15 via the insulating member 31. Thereby, the contact between the probe 3 and the horn 15 and the cylindrical member 29 is prevented, and the probe 3 and the horn 15 and the cylindrical member 29 are electrically insulated.
- An electrical connection ring 32 is disposed on the outer peripheral side of the cylindrical member 29.
- the electrical connection ring 32 is disposed in a state of being fixed to the inner peripheral surface of the handle casing 27. Between the cylindrical member 29 and the electrical connection ring 32, the distal end portion of the transducer case 11 is engaged.
- the vibrator case 11 is coupled to the fixed handle 22 (the sheath unit 4 and the handle casing 27) by engaging the distal end portion of the vibrator case 11 between the tubular member 29 and the electrical connection ring 32.
- the outer peripheral portion of the tip portion of the vibrator case 11 is in contact with the electrical connection ring 32, and the inner peripheral portion of the tip portion of the vibrator case 11 is the cylindrical member 29. Contact with.
- the handle casing 27 is disposed at a portion of the handle casing 27 (fixed handle 22) on the second direction side (the direction of the arrow A ⁇ b> 2 shown in FIGS. 1 and 4).
- an inclined plane 33 inclined with respect to the longitudinal axis C is disposed on the distal direction side of the fixed handle ring 28.
- the inclined plane 33 is located on the proximal direction side as it goes from the first direction (the direction of the arrow A1 shown in FIGS. 1 and 4) to the second direction.
- the inclined plane 33 is inclined upward from the distal direction side of the handle casing 27 toward the proximal direction side. For this reason, the angle between the inclined plane 33 and the longitudinal axis C has an acute angle ⁇ .
- the handle casing 27 has input buttons 35 ⁇ / b> A and 35 ⁇ / b> B that are two operation input units disposed on the inclined plane 33.
- the operator's operation is input by pressing the input buttons 35A and 35B.
- the pressing direction of the input buttons 35A and 35B is orthogonal to the inclined plane 33, for example.
- the handle casing 27 includes switch portions 37 ⁇ / b> A and 37 ⁇ / b> B and an electric circuit board 38 disposed on the inner circumferential direction side of the inclined plane 33.
- the switch unit 37A is switched between open and closed states by an input operation using the input button 35A.
- the switching state of the switch unit 37B is switched by an input operation with the input button 35B.
- FIG. 5 is a diagram schematically showing an electrical connection state in the vibrator case 11, the cylindrical member 29, and the electrical connection ring 32.
- the handle casing 27 has three electric signal lines 39 ⁇ / b> A, 39 ⁇ / b> B, and 39 ⁇ / b> C disposed inside the handle casing 27.
- the electric signal line 39A is electrically connected to the switch unit 37A via the electric circuit board 38.
- the electric signal line 39B is electrically connected to the switch unit 37B via the electric circuit board 38.
- the electric signal line 39C is electrically connected to the switch unit 37A and the switch unit 37B via the electric circuit board 38.
- the electric signal line 39C is a common line shared as a ground line for the switch unit 37A and the switch unit 37B.
- the electrical connection ring 32 includes a first electrical connection portion 42A, a second electrical connection portion 42B, and a third electrical connection portion 42C. Between the first electrical connection part 42A and the second electrical connection part 42B, between the second electrical connection part 42B and the third electrical connection part 42C, and between the first electrical connection part 42A and the third electrical connection part.
- the connection portion 42C is electrically insulated.
- the electric signal line 39A is connected to the first electric connecting portion 42A.
- the electrical signal line 39B is connected to the second electrical connection portion 42B.
- the electrical signal line 39C is connected to the third electrical connection portion 42C.
- the vibrator case 11 has a first conductive portion 43A, a second conductive portion 43B, and a third conductive portion 43C.
- the first conductive portion 43A, the second conductive portion 43B, and the third conductive portion 43C extend along the longitudinal axis C. Between the first conductive part 43A and the second conductive part 43B, between the second conductive part 43B and the third conductive part 43C, and between the first conductive part 43A and the third conductive part 43C. are electrically isolated.
- the distal end portion of the first conductive portion 43A is in electrical contact only with the first electrical connection portion 42A.
- the tip of the second conductive portion 43B is in electrical contact only with the second electrical connection portion 42B.
- the tip of the third conductive portion 43C is in electrical contact only with the third electrical connection portion 42C.
- the base end portion of the first conductive portion 43 ⁇ / b> A is connected to one end of the electric signal line 45.
- the proximal end portion of the second conductive portion 43B is connected to one end of the electric signal line 46.
- the base end portion of the third conductive portion 43 ⁇ / b> C is connected to one end of the electric signal line 47.
- the electric signal lines 45, 46 and 47 are disposed inside the cable 6. The other ends of the electric signal lines 45, 46 and 47 are connected to the power supply unit 7.
- the first electrical signal path is formed from the switch portion 37A to the power supply unit 7 through the electrical signal line 39A, the first electrical connection portion 42A, the first conductive portion 43A, and the electrical signal line 45. Is done.
- a second electrical signal path is formed from the switch portion 37 ⁇ / b> B to the power supply unit 7 through the electrical signal line 39 ⁇ / b> B, the second electrical connection portion 42 ⁇ / b> B, the second conductive portion 43 ⁇ / b> B, and the electrical signal line 46.
- a ground path is formed from the switch unit 37A and the switch unit 37B to the power supply unit 7 through the electrical signal line 39C, the third electrical connection unit 42C, the third conductive unit 43C, and the electrical signal line 47.
- the switch unit 37A When the input button 35A is pressed, the switch unit 37A is closed, and the first electrical signal path and the ground path are electrically connected by the switch unit 37A. Thereby, an electrical signal is transmitted from the switch part 37 ⁇ / b> A to the power supply unit 7. Then, for example, current is supplied from the ultrasonic control unit 8 to the ultrasonic transducer 12 via the electric signal lines 13A and 13B. At the same time as the ultrasonic vibration is generated in the ultrasonic vibrator 12, the high-frequency current control unit 9 is switched to a state in which a high-frequency current is output.
- the switch unit 37B When the input button 35B is pressed, the switch unit 37B is closed, and the second electrical signal path and the ground path are electrically connected by the switch unit 37B.
- an electrical signal is transmitted from the switch unit 37 ⁇ / b> B to the power supply unit 7.
- a high-frequency current is output only from the high-frequency current control unit 9 and the state is switched to a state in which no ultrasonic vibration is generated.
- the vibrator case 11 further includes a fourth conductive portion 43D extending along the longitudinal axis C.
- the first conductive portion 43A, the second conductive portion 43B, and the third conductive portion 43C are all electrically insulated from the fourth conductive portion 43D.
- a base end portion of the fourth conductive portion 43 ⁇ / b> D is connected to one end of the electric signal line 48.
- the electric signal line 48 is disposed inside the cable 6.
- the other end of the electric signal line 48 is connected to the high frequency current control unit 9. In a state where the transducer case 11 is connected to the fixed handle 22 (sheath unit 4), only the tip end portion of the fourth conductive portion 43D is in electrical contact with the cylindrical member 29.
- the tubular member 29 is connected to one end of an electric signal line 49.
- the other end of the electric signal line 49 is connected to the sheath 23.
- a high-frequency current is transmitted between the high-frequency current control unit 9 and the sheath 23 via the electric signal line 48, the fourth conductive unit 43 ⁇ / b> D, the tubular member 29, and the electric signal line 49. .
- the sheath 23 is disposed on the outer circumferential direction side from the probe 3.
- the sheath 23 has a hollow portion 23 a through which the probe 3 is inserted in a state where the first electrode portion 21 that functions as the distal end portion of the probe 3 protrudes from the distal end portion of the sheath 23.
- Such a sheath 23 functions as a cylindrical member through which the probe 3 is inserted, and is disposed along the longitudinal axis C.
- the sheath 23 is disposed between the probe 3 and the sheath 23 in the radial direction of the sheath 23 and has a support member (not shown) that supports the probe 3.
- the support member is formed of an insulating material.
- the support member prevents contact between the probe 3 and the sheath 23 and electrically insulates the probe 3 and the sheath 23 from each other.
- the support member is disposed at a node position of ultrasonic vibration. Thereby, the contact between the probe 3 and the sheath 23 is prevented more effectively.
- the number of support members may be one or more, and it is sufficient that at least one support member is provided.
- the movable handle unit 5 can be opened and closed with respect to a fixed side including the probe 3 and the sheath unit 4 for a treatment operation for treating a treatment target.
- the movable handle unit 5 has a movable handle 25 that is disposed at the base end portion of the movable handle unit and functions as a power point in the treatment operation.
- the movable handle 25 can be opened / closed in the opening / closing direction with respect to the fixed handle 22 around the opening / closing axis about an opening / closing axis 101 described later. That is, the movable handle 25 rotates around the opening / closing shaft 101.
- the movable handle 25 has a movable handle ring 26 that functions as a movable side finger rest.
- the movable handle 25 indicates a direction indicated by an arrow A1 in FIG. 1, indicates a first direction orthogonal to the longitudinal axis C, and indicates a direction indicated by an arrow A2 in FIG. 1, and is a second direction opposite to the first direction.
- the fixed handle 22 can be opened and closed.
- the movable handle 25 is located closer to the first direction than the fixed handle 22.
- the central axis C1 of the movable handle 25 is inclined with an acute angle ⁇ with respect to the longitudinal axis C.
- the movable handle unit 5 further includes, for example, a jaw 52 rotatably attached to the distal end portion of the sheath 23 and a relay member 57 disposed between the movable handle 25 and the jaw 52.
- a jaw 52 By attaching the jaw 52 to the sheath 23, the movable handle unit 5 is connected to the sheath unit 4.
- the jaw 52 is disposed at the distal end portion of the movable handle unit 5 and has a second electrode portion 53 that functions as an action point in the treatment operation and functions as the distal end portion of the jaw.
- the jaw 52 is attached to the distal end portion of the sheath 23 so that the jaw 52 can rotate around the opening / closing axis 101 around the opening / closing axis 101.
- the jaw 52 rotates about the opening / closing axis 101 as the movable handle 25 is opened / closed, whereby the jaw 52 rotates in the longitudinal axis direction and the opening / closing axis direction with respect to the first electrode portion 21 that functions as the distal end portion of the probe 3.
- the details intersecting with can be opened and closed in an orthogonal opening and closing direction.
- the jaw 52 including the second electrode portion 53 can be opened and closed with respect to the first electrode portion 21.
- the second electrode portion 53 is located on the second direction (direction of arrow A2 shown in FIG. 1) side from the first electrode portion 21.
- the second electrode portion 53 is electrically connected to the sheath 23.
- the second electrode portion 53 is disposed on the outer surface of the second electrode portion 53 (jaw 52) and at a site on the first direction (direction of arrow A1 shown in FIG. 1) side, and the first electrode portion 21 is disposed. And a probe facing portion 55 facing the surface.
- the first electrode portion 21 is disposed on the outer surface of the first electrode portion 21 and on the second direction side (the direction of the arrow A2 shown in FIG. 1).
- An opposing jaw facing portion 58 is provided.
- the jaw 52 including the second electrode portion 53 moves in the second direction.
- the jaw 52 including the second electrode portion 53 is in an open position with respect to the first electrode portion 21.
- the jaw 52 including the second electrode portion 53 is moved in the first direction.
- the jaw 52 including the second electrode portion 53 is in a closed position with respect to the first electrode portion 21. That is, the jaw 52 opens and closes with respect to the first electrode portion 21 between the open position and the closed position when the jaw 52 rotates with respect to the sheath 23 about the open / close shaft 101.
- the movable handle 25 can be opened and closed with respect to the fixed handle 22 by operating the jaw 52 to open and close.
- the second electrode portion 53 is electrically connected to the sheath 23. For this reason, a high frequency current is transmitted between the sheath 23 and the second electrode portion 53.
- a high frequency current is transmitted between the high frequency current control unit 9 and the sheath 23 via the electric signal line 48, the fourth conductive portion 43 ⁇ / b> D, and the electric signal line 49. Therefore, a jaw-side current path is formed from the high-frequency current control unit 9 to the second electrode unit 53 of the jaw 52 through the electrical signal line 48, the fourth conductive unit 43D, the electrical signal line 49, and the sheath 23.
- the jaw side current path indicates a path through which a high frequency current flows. That is, the high-frequency current is transmitted between the high-frequency current control unit 9 and the second electrode unit 53 through the jaw-side current path.
- an insulating coating is applied to the outer surface of the sheath 23 and the outer surface of the jaw 52 other than the probe facing portion 55. For this reason, even when an operator's hand etc. contact the outer surface of the sheath 23 or the outer surface of the jaw 52, an electric shock is prevented.
- the relay member 57 between the jaw 52 and the movable handle 25 is formed of an insulating material. This prevents high-frequency current from being transmitted from the jaw 52 to the movable handle 25.
- the treatment instrument 10 has an opening / closing shaft 101, and the jaw 52 can be opened / closed with respect to the sheath 23 by rotating the jaw 52 around the opening / closing shaft. It further has an opening / closing shaft member 100 for attaching the jaw 52 to the sheath 23.
- the opening / closing shaft 101 corresponds to the central axis of the opening / closing shaft member 100.
- the opening / closing shaft member 100 including the opening / closing shaft 101 may be included in the movable handle unit 5 in the treatment instrument 10.
- an opening / closing direction such as a first direction (direction of arrow A1 shown in FIG. 1) and a second direction (direction of arrow A2 shown in FIG. 1), and a longitudinal axis C direction
- An axis that is disposed along the orthogonal direction orthogonal to the axis and is orthogonal to the longitudinal axis C is defined as an orthogonal axis 201.
- the orthogonal direction is the opening / closing axis direction shown in FIG.
- the orthogonal axis 201 is disposed along the radial direction of the probe 3 and the radial direction of the sheath 23.
- the orthogonal axis 201 intersects the longitudinal axis C and penetrates the hollow portion 23a.
- the orthogonal axis 201 is arranged in front of the intersecting axis 301 in the longitudinal axis C direction, for example.
- the front side indicates the first electrode portion 21 side that functions as the tip portion of the probe 3 in the longitudinal axis C direction.
- the intersecting axis 301 is disposed along the opening / closing axis direction orthogonal to the opening / closing direction and the longitudinal axis C direction, and is an axis orthogonal to the longitudinal axis C.
- the intersecting axis 301 intersects the central axis C1 of the movable handle 25.
- the opening / closing shaft 101 of this embodiment is disposed so as to be shifted from the intersecting axis 301 in the longitudinal axis C direction.
- the opening / closing shaft 101 is disposed in front of the intersecting axis 301 in the longitudinal axis C direction.
- the opening / closing shaft 101 is not disposed on the orthogonal shaft 201.
- the opening / closing shaft 101 is disposed so as to be shifted from the orthogonal shaft 201 in the opening / closing direction.
- the opening / closing shaft 101 is separated from the orthogonal shaft 201 in the opening / closing direction, and is disposed parallel to the orthogonal shaft 201 in the opening / closing axis direction.
- the opening / closing axis 101 is offset with respect to the orthogonal axis 201 in the opening / closing direction.
- the opening / closing shaft 101 is disposed on the second direction side with respect to the orthogonal shaft 201. For this reason, the open / close shaft 101 does not cross the orthogonal shaft 201 and does not penetrate the hollow portion 23a.
- the opening / closing shaft member 100 is disposed at a position offset with respect to the hollow portion 23a in the opening / closing direction so as not to overlap the hollow portion 23a in the opening / closing direction.
- the opening / closing shaft member 100 having the opening / closing shaft 101 is offset with respect to the hollow portion 23a in the opening / closing direction by opening and closing the sheath 23 and the jaw 52 disposed adjacent to each other in the opening / closing axis direction. It is inserted into the jaw 52 and the sheath 23 so as to be stabbed (skewed) at the position.
- the opening / closing shaft member 100 attaches the jaw 52 to the sheath 23.
- the treatment instrument 10 further includes a sheath side mounting portion 23 b disposed on the sheath 23 and a jaw side mounting portion 52 b disposed on the jaw 52.
- the sheath side mounting portion 23b and the jaw side mounting portion 52b are the sheath side mounting portion 23b and the jaw side mounting portion in the opening / closing axis direction at a position where one opening / closing shaft member 100 is offset from the hollow portion 23a in the opening / closing direction. 52b is pierced.
- the sheath side attachment portion 23b and the jaw side attachment portion 52b are disposed at a position offset with respect to the hollow portion 23a in the opening / closing direction, and are adjacent to each other and further overlap each other in the opening / closing axis direction.
- the opening / closing shaft member 100 including the opening / closing shaft 101, the sheath side mounting portion 23b, and the jaw side mounting portion 52b are, for example, closer to the fixed handle 22 side than the movable handle 25 side in the opening / closing direction. It is arranged. Details of these positions will be described later.
- the sheath side attachment portion 23b penetrates the sheath side attachment portion 23b in the opening / closing axis direction, and is disposed away from the hollow portion 23a in the opening / closing axis direction and the opening / closing direction.
- the jaw-side attachment portion 52b penetrates the jaw-side attachment portion 52b in the opening / closing axis direction and is disposed away from the hollow portion 23a in the opening / closing axis direction and the opening / closing direction. 52c.
- the jaw side through hole 52c is in communication with the sheath side through hole 23c in the opening / closing axis direction.
- the opening / closing shaft member 100 is inserted into the sheath side through hole 23c and the jaw side through hole 52c.
- One open / close shaft member 100 is opened and closed with respect to the sheath 23 by inserting one open / close shaft member 100 into the sheath side through hole portion 23c and the jaw side through hole portion 52c.
- 100 attaches the jaw 52 to the sheath 23.
- both end faces of the opening / closing axis member 100 are disposed on the same plane as the outer peripheral surface of the jaw side mounting portion 52b. That is, in the opening / closing axis direction, both end portions of the opening / closing axis member 100 do not protrude with respect to the jaw side attachment portion 52b.
- only the opening / closing shaft member 100 is inserted into the sheath side through hole 23c and the jaw side through hole 52c.
- the diameter of the hollow portion 23a of the sheath 23 is defined as D1
- the diameter of the sheath side through hole 23c is defined as D2
- the distance between the center position of the hollow portion 23a in the opening and closing direction and the sheath side through hole portion 23c is defined as L1
- the following expression (1) is established. (D1 + D2) / 2 ⁇ L1 ... Formula (1).
- L1 corresponds to the distance between the orthogonal axis 201 and the opening / closing axis 101 in the opening / closing direction.
- the sheath side through hole 23c, the jaw side through hole 52c, and the opening / closing shaft member 100 are reliably offset with respect to the hollow portion 23a in the opening / closing direction.
- the opening / closing shaft member 100 including the opening / closing shaft 101 is not disposed on the orthogonal shaft 201 and is not inserted into the hollow portion 23a.
- the opening / closing shaft member 100 is not fixed to both the sheath side attachment portion 23b and the jaw side attachment portion 52b, or is fixed to either the sheath side attachment portion 23b or the jaw side attachment portion 52b. Is done. That is, the opening / closing shaft member 100 is not fixed to at least one of the sheath side attachment portion 23b and the jaw side attachment portion 52b.
- the jaw side mounting portion 52b and the jaw 52 are connected to the opening / closing shaft member 100, the sheath side mounting portion 23b, and the sheath 23. And can be rotated around the opening / closing axis.
- the jaw side mounting portion 52b and the jaw 52 include the opening / closing shaft member 100, the sheath side mounting portion 23b, and the sheath. 23 can be rotated around the opening / closing axis.
- the opening / closing shaft member 100 is not fixed to the sheath side mounting portion 23b but is fixed to the jaw side mounting portion 52b, the jaw side mounting portion 52b, the jaw 52, and the opening / closing shaft member 100 are integrally attached to the sheath side. With respect to the part 23 b and the sheath 23, it can be rotated around the opening / closing axis.
- the jaw 52 can be rotated about the opening / closing axis by the jaw 52 by the sheath side mounting portion 23 b, the jaw side mounting portion 52 b and the single opening / closing shaft member 100.
- the single opening / closing shaft member 100 is attached to the sheath 23.
- the opening / closing shaft member 100 having the opening / closing shaft 101, the sheath side attachment portion 23b having the sheath side through hole portion 23c, and the jaw side attachment portion 52b having the jaw side through hole portion 52c It functions as an attachment part attached to 23.
- the attachment portion attaches the movable handle unit 5 to the fixed side so that the movable handle unit 5 rotates around the opening / closing axis.
- This attachment portion is disposed between the sheath 23 and the jaw 52, and also functions as an electrical contact unit that maintains a state in which a high-frequency current is always transmitted between the sheath 23 and the second electrode portion of the jaw 52.
- the outer peripheral surface of the open / close shaft member 100 is the inner peripheral surface of the sheath side attachment portion 23b and the jaw side attachment portion 52b. By contacting the inner peripheral surface, a high frequency current is transmitted between the sheath 23 and the second electrode portion of the jaw 52.
- the exposed portion of the opening / closing shaft member 100 exposed to the outside from the sheath side mounting portion 23b and the jaw side mounting portion 52b, the outer surface of the sheath side mounting portion 23b, and the outer surface of the jaw side mounting portion 52b are: For example, an insulating coating process is performed. For this reason, even when an operator's hand etc. contact these, an electric shock is prevented.
- sheath side mounting portion 23b As shown in FIG. 6, as an example of the position of the sheath side attachment portion 23b, the sheath side attachment portion 23b is disposed coaxially in the opening / closing direction with respect to the hollow portion 23a of the sheath 23 through which the probe 3 is inserted, for example. Is done.
- the sheath side attaching portion 23b is disposed, for example, below the hollow portion 23a in the opening / closing direction.
- the sheath side attachment portion 23b is formed, for example, by extending the thick portion of the sheath 23 from the longitudinal axis C in the opening / closing direction toward the second direction.
- the sheath side attaching portion 23b is disposed on the fixed handle 22 side in the opening / closing direction.
- the sheath-side attachment portion 23 b is preferably disposed at a part of the distal end portion of the sheath 23.
- the sheath side attaching part 23b of this embodiment is a part of the sheath 23 and is integral with the sheath 23, for example.
- the sheath side through hole 23c is not communicated with the hollow portion 23a in the opening / closing axis direction and the opening / closing direction, and is isolated from the hollow portion 23a.
- the sheath side through-hole part 23c is offset and disposed so as not to overlap the hollow part 23a in the opening / closing direction.
- the thick part of the sheath side attachment part 23b is interposed between the hollow part 23a and the sheath side through hole part 23c.
- the sheath side through-hole portion 23c is disposed, for example, below the hollow portion 23a in the opening / closing direction, and is disposed, for example, on the fixed handle 22 side rather than the movable handle 25 side.
- the jaw side attachment portions 52 b are a part of the jaw 52 and are provided in a pair.
- the jaw side attachment portions 52b are disposed on both sides of the sheath side attachment portion 23b in the opening / closing axis direction, and sandwich the sheath side attachment portion 23b.
- the jaw side attachment portion 52b sandwiches a pair of side surface portions disposed on both sides of the sheath side attachment portion 23b in the opening / closing axis direction.
- the jaw side attachment portion 52b clamps the sheath side attachment portion 23b so that the jaw side through hole portion 52c communicates with the sheath side through hole portion 23c in the opening / closing axis direction.
- the jaw side attachment portion 52b is formed by arranging a through hole portion 59 (see FIG. 9A) in the jaw 52 described later, for example.
- the jaw side attachment portion 52b functions as a pair of arm portions of the jaw 52 formed by providing the through hole portion 59.
- the jaw 52 is divided into two forks by the through-hole portion 59.
- the through hole portion 59 penetrates the jaw 52 in the longitudinal axis C direction.
- the through-hole portion 59 is interposed between the jaw side attachment portions 52b in the opening / closing axis direction.
- the sheath 23 can be inserted through the through hole 59.
- the jaw side through hole portion 52c is not communicated with the hollow portion 23a in the opening / closing axis direction and the opening / closing direction similarly to the sheath side through hole portion 23c. Isolated from.
- the sheath side through-hole part 23c is offset and disposed so as not to overlap the hollow part 23a in the opening / closing direction.
- the jaw side through-hole portion 52c is disposed, for example, below the hollow portion 23a in the opening / closing direction, for example, closer to the fixed handle 22 than the movable handle 25 side.
- the jaw side attachment portion 52b clamps the sheath side attachment portion 23b so that the jaw side through hole portion 52c communicates with the sheath side through hole portion 23c in the opening / closing axis direction.
- the sheath side through hole portion 23c and the jaw side through hole portion 52c are disposed at a position offset with respect to the hollow portion 23a in the opening / closing direction, and are adjacent to each other in the opening / closing axis direction, for example. In this state, as shown in FIG.
- the sheath side through hole portion 23c and the jaw side through hole portion 52c do not communicate with the hollow portion 23a in the opening / closing axis direction and the opening / closing direction, and the hollow portion in the opening / closing direction. It is offset with respect to the hollow part 23a so as not to overlap with 23a.
- the single opening / closing shaft member 100 has a sheath-side through hole 23c so that the single opening / closing shaft member 100 pierces (skews) the sheath-side attachment portion 23b and the jaw-side attachment portion 52b. And the jaw side through hole 52c.
- the single opening / closing shaft member 100 is not disposed on the orthogonal shaft 201, but is disposed at a position offset with respect to the hollow portion 23a in the opening / closing direction.
- One open / close shaft member 100 attaches the jaw 52 to the sheath 23 at an offset position.
- the single opening / closing shaft member 100 is not inserted into the hollow portion 23a.
- the jaw 52 does not communicate with the hollow portion 23a in the opening / closing axis direction and the opening / closing direction, and one jaw 52 is offset from the hollow portion 23a in the opening / closing direction.
- the opening / closing shaft member 100 is attached to the sheath 23.
- the jaw 52 is attached to the sheath 23 by the single opening / closing shaft member 100 so as to be rotatable around the opening / closing shaft.
- the single opening / closing shaft member 100 is disposed at a position offset with respect to the hollow portion 23a in the opening / closing direction. At this time, the single opening / closing shaft member 100 does not overlap the hollow portion 23a and does not penetrate the hollow portion 23a.
- One open / close shaft member 100 attaches the jaw 52 to the sheath 23 at an offset position.
- a pair of opening / closing shaft members 100 is not provided, that is, one opening / closing shaft member 100 is inserted into the sheath side through hole portion 23c and one jaw side through hole portion 52c, and the other The opening / closing shaft member 100 is not inserted into the sheath side through hole 23c and the other jaw side through hole 52c.
- the open / close shaft member 100 is sheathed so that one open / close shaft member 100 is inserted into one jaw side through hole portion 52c, the sheath side attachment portion 23b, and the other jaw side through hole portion 52c.
- the side attachment portion 23b and the jaw side attachment portion 52b are pierced. Therefore, in this embodiment, the number of parts for attachment can be kept to a minimum, and a highly accurate opening / closing shaft 101 can be provided.
- the mounting configuration can be simplified, and play at the mounting portion between the jaw 52 and the sheath 23 can be prevented. In this embodiment, even if the shape error of the product itself is large, it is possible to prevent the play at the attachment portion between the jaw 52 and the sheath 23.
- the present embodiment it is possible to prevent the relative position between the distal end portion of the probe 3 and the distal end portion of the jaw 52 from shifting due to the above. In this state, the distal end portion of the probe 3 and the distal end portion of the jaw 52 are mutually offset. It is possible to prevent the meshing accuracy from being lowered in the meshing. Therefore, in the present embodiment, it is possible to prevent the treatment forces such as the gripping force and the peeling force from being lowered in the treatment operations such as the gripping operation and the peeling operation, and it is possible to reliably obtain desired treatment characteristics.
- the treatment instrument 10 can obtain the same operational feeling as the treatment instrument 10 of the type in which the opening / closing axis 101 intersects the longitudinal axis C in the same manner as the orthogonal axis 201.
- the opening / closing shaft 101 is offset, but an operational feeling that is not different from the conventional one can be obtained.
- the sheath side through hole portion 23c and the jaw side through hole portion 52c communicate with each other. Therefore, in this embodiment, the opening / closing shaft member 100 can be easily inserted into and removed from the sheath 23 and the jaw 52, and attachment and removal can be easily performed.
- the offset can be surely performed by (D1 + D2) / 2 ⁇ L1.
- body fluid or the like that has entered the hollow portion 23a during the treatment operation leaks to the outside of the treatment instrument 10 through the sheath side through hole portion 23c and the jaw side through hole portion 52c. Can be surely prevented.
- the opening / closing shaft member 100 is inserted into the sheath side attachment portion 23 b that is a part of the sheath 23 and the jaw side attachment portion 52 b that is a part of the jaw 52. For this reason, in this embodiment, it is only necessary to prepare the opening / closing shaft member 100, the sheath side through hole portion 23c, and the jaw side through hole portion 52c for attachment. Therefore, in this embodiment, the number of parts for attachment can be reduced.
- the sheath side through hole 23c is disposed, for example, below the hollow portion 23a in the opening / closing direction, and is disposed on the fixed handle 22 side.
- the opening / closing shaft member 100 having the opening / closing shaft 101 and the jaw side through hole 52c are disposed, for example, below the hollow portion 23a in the opening / closing direction, for example, closer to the fixed handle 22 than the movable handle 25.
- the opening / closing shaft member 100, the sheath side through hole portion 23c, and the jaw side through hole portion 52c are disposed, for example, between the hollow portion 23a including the longitudinal axis C and the fixed handle ring 28 in the opening / closing direction.
- the sheath-side attachment portion 23b is disposed, for example, above the hollow portion 23a in the opening / closing direction, and is disposed, for example, on the movable handle 25 side rather than the fixed handle 22 side. May be.
- the sheath side through-hole part 23c is arrange
- the opening / closing shaft member 100 and the jaw side through-hole portion 52c are disposed, for example, above the hollow portion 23a in the opening / closing direction, for example, closer to the movable handle 25 than the fixed handle 22 side.
- the opening / closing shaft member 100, the sheath side through hole portion 23c, and the jaw side through hole portion 52c are disposed, for example, between the hollow portion 23a including the longitudinal axis C and the movable handle 25 in the opening / closing direction. .
- the opening / closing shaft 101 is disposed in front of the intersecting axis 301 in the longitudinal axis C direction, but is not limited thereto.
- the position of the axis of the opening / closing axis 101 with respect to the intersecting axis 301 in the longitudinal axis C direction is not particularly limited.
- the sheath side attaching portion 23b is integral with the sheath 23, but it is not necessary to be limited to this.
- the sheath side attachment portion 23b may be a separate member from the sheath 23.
- the sheath side attaching portion 23b may be attached to the outer peripheral surface of the distal end portion of the sheath 23 by, for example, adhesion or welding.
- the jaw side mounting portion 52b sandwiches the sheath side mounting portion 23b, but it is not necessary to be limited to this.
- the sheath side attachment portion 23b may sandwich the jaw side attachment portion 52b.
- the sheath side through hole portion 23c communicates with the jaw side through hole portion 52c, and the sheath side mounting portion 23b and the jaw side mounting portion 52b overlap each other. It is only necessary that one of the jaw side attachment portions 52b holds the other.
- the open / close shaft member 100 is disposed so that the open / close shaft member 100 pierces the sheath side mounting portion 23b and the jaw side mounting portion 52b, the sheath side mounting portion 23b and the jaw side mounting portion 52b
- This configuration need not be limited to the above-described sandwiching configuration.
- the open / close shaft member 100 is disposed so that the open / close shaft member 100 pierces the sheath side mounting portion 23b and the jaw side mounting portion 52b, the sheath side mounting portion 23b and the jaw side mounting portion 52b in the open / close axis direction. You may be arranged in parallel.
- a member (not shown) is interposed between the sheath side mounting portion 23b and the jaw side mounting portion 52b in the opening / closing axis direction, or the sheath side mounting portion 23b and the jaw side mounting portion 52b are disposed apart from each other. Or you may.
- the sheath-side attachment portion 23b In the opening / closing axis direction, the sheath-side attachment portion 23b only needs to be sandwiched between the jaw-side attachment portions 52b and may be interposed between the jaw-side attachment portions 52b, and is in close contact with the jaw-side attachment portion 52b. Alternatively, it may be separated from the jaw side mounting portion 52b.
- the treatment instrument 10 may further include a prevention member 103 that prevents the opening / closing shaft member 100 from falling out of the sheath side through hole portion 23c and the jaw side through hole portion 52c.
- the prevention member 103 is fitted in each jaw side through hole 52c, for example.
- the pair of prevention members 103 sandwich the opening / closing shaft member 100 in the opening / closing axis direction.
- the prevention members 103 are separate from each other.
- the opening / closing shaft member 100 is inserted into the sheath side through hole portion 23c and the jaw side through hole portion 52c, and the prevention member 103 is fitted into the jaw side through hole portion 52c.
- the prevention member 103 is disposed on the same plane as the outer peripheral surface of the jaw side attachment portion 52b. That is, the prevention member 103 does not protrude with respect to the jaw side attachment portion 52b in the opening / closing axis direction.
- the opening / closing shaft member 100 is a shaft-like member
- the prevention member 103 is a rod-like member thicker than the opening / closing shaft member 100 and functions as a cap.
- the jaw-side through hole 52c has a convex shape, and includes a first hole 52d into which the opening / closing shaft member 100 is inserted and a second hole 52e into which the prevention member 103 is inserted.
- the first hole portion 52d communicates with the second hole portion 52e and the sheath side through hole portion 23c.
- the diameter of the first hole 52d is the same as the diameter of the opening / closing shaft member 100 and the diameter of the sheath side through hole 23c, and is smaller than the diameter of the prevention member 103 and the diameter of the second hole 52e.
- the diameter of the second hole 52 e is the same as the diameter of the prevention member 103.
- the second hole 52e is disposed outside the first hole 52d in the opening / closing axis direction.
- the prevention member 103 since the prevention member 103 is fitted into the jaw side through hole portion 52c, the prevention member 103 prevents the opening / closing shaft member 100 from falling out of the sheath side through hole portion 23c and the jaw side through hole portion 52c. Can be prevented.
- the opening / closing shaft member 100 is formed of, for example, a hard material. This material is, for example, a metal or a resin.
- the prevention member 103 may be formed of an insulating material. In this case, the prevention member 103 is formed of rubber, ceramic, hard resin, or the like.
- the prevention member 103 may cover the outer peripheral surface of the jaw side mounting portion 52 b including the end surface of the opening / closing shaft member 100.
- the outer diameter of the opening / closing shaft member 100 is uniform, but it is not necessary to be limited to this. As shown in FIG. 6, the outer diameter of the opening / closing shaft member 100 may change so that the opening / closing shaft member 100 has a stepped portion. In accordance with the shape of the opening / closing shaft member 100, the shape of the jaw side through-hole portion 52c also changes as appropriate.
- the treatment instrument 10 further includes a regulating mechanism 150 that regulates the opening / closing angle of the jaw 52 with respect to the sheath 23.
- the restricting mechanism 150 is a sheath 23 that is inserted through the through-hole portion 59 disposed in the jaw 52, and a protrusion that is disposed on the outer peripheral surface of the sheath 23 and protrudes toward the outside of the sheath 23 in the radial direction of the sheath 23. Part 151.
- the protrusion 151 is disposed on the first direction side. Specifically, the protrusion 151 is disposed on the upper surface of the sheath 23 facing the movable handle unit 5.
- the protruding portion 151 is disposed on the opposite side of the opening / closing shaft member 100 with the sheath 23 interposed therebetween in the opening / closing direction.
- the protruding portion 151 is formed by projecting a part of the sheath 23 toward the outside of the sheath 23 in the radial direction of the sheath 23. For this reason, the protrusion 151 is integral with the sheath 23.
- the protruding portion 151 may be a separate body from the sheath 23.
- the relative position of the through hole 59 with respect to the protrusion 151 and the sheath 23 changes as the movable handle unit 5 opens and closes. To do.
- the inner peripheral surface 59a of the through-hole portion 59 is arranged so that the probe facing portion 55 contacts the jaw facing portion 58 when the movable handle unit 5 is closed with respect to the fixed side.
- the first contact portion 59b and the second contact portion 59c are disposed on the opposite side of the opening / closing shaft member 100 with the sheath 23 interposed therebetween in the opening / closing direction.
- the first contact portion 59 b is disposed on the lower surface side of the jaw 52
- the second contact portion 59 c is disposed on the upper surface side of the jaw 52.
- the lower surface of the jaw 52 is the surface opposite to the upper surface of the jaw 52 and faces the sheath 23.
- the first contact portion 59b and the second contact portion 59c are disposed at the proximal end portion of the through-hole portion 59.
- the first contact portion 59 b includes an inner peripheral edge portion on the lower surface side of the jaw 52
- the second contact portion 59 c includes an inner peripheral edge portion on the upper surface side of the jaw 52.
- the outer peripheral surface of the sheath 23 with which the first contact portion 59 b comes into contact is the upper surface portion of the sheath 23 that faces the movable handle unit 5.
- the outer peripheral surface of the sheath 23 with which the first contact portion 59b contacts is disposed on the same straight line as the protruding portion 151 in the longitudinal axis C direction.
- FIG. 9B in the state where the movable handle unit 5 is closed, the inner peripheral surface 59a is in the longitudinal axis C direction so that the second contact portion 59c is positioned forward of the first contact portion 59b. Inclined.
- the first contact portion 59 b contacts the outer peripheral surface of the sheath 23 by closing the movable handle unit 5 with respect to the fixed side.
- the probe facing portion 55 contacts the jaw facing portion 58, and the opening / closing angle ⁇ is regulated so that the opening / closing angle ⁇ of the movable handle unit 5 with respect to the fixed side is minimized.
- the outer peripheral surface of the sheath 23 functions as a stopper that prevents the movable handle unit 5 from being closed more than necessary.
- the second contact portion 59c contacts the protruding portion 151.
- the probe facing portion 55 opens with respect to the jaw facing portion 58, and the opening / closing angle ⁇ is regulated so that the opening / closing angle ⁇ of the movable handle unit 5 with respect to the fixed side is maximized.
- the protrusion 151 functions as a stopper that prevents the movable handle unit 5 from being opened more than necessary.
- the first contact part 59b contacts the outer peripheral surface of the sheath 23, and the second contact part 59c contacts the protrusion 151, so that the opening / closing angle ⁇ of the movable handle unit 5 with respect to the fixed side is increased. Be regulated. Furthermore, the movable handle unit 5 is prevented from being opened and closed more than necessary, and the open / close position of the movable handle unit 5 relative to the fixed side is positioned. Such regulation and positioning are performed in conjunction with the turning operation of the movable handle unit 5.
- the opening / closing angle ⁇ of the movable handle unit 5 with respect to the fixed side can be regulated by the sheath 23 serving as the regulation mechanism 150, the projecting portion 151, the first contact part 59b, and the second contact part 59c.
- the unit 5 can be prevented from being opened and closed more than necessary, and the open / close position of the movable handle unit 5 relative to the fixed side can be positioned.
- the restriction mechanism 150 includes the sheath 23, the protrusion 151, the first contact part 59b, and the second contact part 59c. If implemented in conjunction, the constituent members of the restriction mechanism 150 need not be limited to these.
- the present embodiment corresponds to the configuration shown in FIGS. 7A and 7B.
- the protrusion 151 is disposed in front of the opening / closing shaft member 100 in the longitudinal axis C direction.
- the first contact portion 59b and the second contact portion 59c are arranged such that the first contact portion 59b and the second contact portion 59c are adjacent to the opening / closing shaft member 100. Further, it is disposed around the opening / closing shaft member 100.
- the first contact portion 59b and the second contact portion 59c are disposed between the opening / closing shaft member 100 and the protruding portion 151 in the longitudinal axis C direction.
- the inner peripheral surface 59a is formed on the sheath 23 when the second contact portion 59c comes into contact with the projecting portion 151 by opening the movable handle unit 5 with respect to the fixed side. It further has a third contact portion 59d that contacts the outer peripheral surface.
- the third contact portion 59d is disposed on the opposite side of the first contact portion 59b across the through hole 59 in the opening / closing direction.
- the third contact portion 59d is disposed at the tip of the through hole portion 59.
- the third contact portion 59 d includes an inner peripheral edge portion on the lower surface side of the jaw 52.
- the outer peripheral surface of the sheath 23 with which the third contact portion 59d abuts is the lower surface portion of the sheath 23 opposite to the upper surface portion of the sheath 23.
- the first contact portion 59 b contacts the outer peripheral surface of the sheath 23 by closing the movable handle unit 5 with respect to the fixed side.
- the probe facing portion 55 contacts the jaw facing portion 58, and the opening / closing angle ⁇ is regulated so that the opening / closing angle ⁇ of the movable handle unit 5 with respect to the fixed side is minimized.
- the outer peripheral surface of the sheath 23 functions as a stopper that prevents the movable handle unit 5 from being closed more than necessary.
- the second contact portion 59c comes into contact with the protrusion 151, and at the same time, the third contact portion 59d is placed on the outer peripheral surface of the sheath 23. Abut.
- the probe facing portion 55 opens with respect to the jaw facing portion 58, and the opening / closing angle ⁇ is regulated so that the opening / closing angle ⁇ of the movable handle unit 5 with respect to the fixed side is maximized.
- the protrusion 151 and the outer peripheral surface of the sheath 23 function as a stopper that prevents the movable handle unit 5 from being opened more than necessary.
- the first contact portion 59b contacts the outer peripheral surface of the sheath 23
- the second contact portion 59c contacts the protruding portion 151
- the third contact portion 59d contacts the outer peripheral surface of the sheath 23.
- the opening / closing angle of the movable handle unit 5 with respect to the fixed side is determined by the sheath 23 serving as the restriction mechanism 150, the protruding portion 151, the first contact portion 59b, the second contact portion 59c, and the third contact portion 59d.
- ⁇ can be regulated, the movable handle unit 5 can be prevented from being opened and closed more than necessary, and the open / close position of the movable handle unit 5 relative to the fixed side can be positioned.
- the restriction mechanism 150 includes the sheath 23, the protrusion 151, the first contact part 59b, the second contact part 59c, and the third contact part 59d. If implemented in conjunction with the rotation operation of the unit 5, the constituent members of the restriction mechanism 150 need not be limited to these.
- the present invention is not limited to the above-described embodiment as it is, and can be embodied by modifying the constituent elements without departing from the scope of the invention in the implementation stage.
- Various inventions can be formed by appropriately combining a plurality of constituent elements disclosed in the embodiment.
Abstract
Description
[第1の実施形態]
[構成]
図1と図2と図3と図4と図5と図6とを参照して第1の実施形態について説明する。なお一部の図面では、図示の明瞭化のために、一部の部材の図示を省略する。
図1に示す医療用処置装置1は、後述するエネルギー処置具(以下、処置具10と称する)に配設されるプローブ3とジョー52とにおいて、プローブ3の先端部として機能する第1の電極部21とジョー52の先端部として機能する第2の電極部53とによって生体組織等の処置対象を挟み込んで把持する。把持は、第2の電極部53が第1の電極部21に対して閉じる(近づく)ことによって、実施される。そして医療用処置装置1は、把持した処置対象を、例えば、超音波、高周波、熱等のエネルギーによって処置可能となっている。このような医療用処置装置1は、把持処置装置である。なお、本実施形態の医療用処置装置1は、プローブ3の先端部及びジョー52を電極として高周波電流によって処置するバイポーラ処置装置としても用いられる。医療用処置装置1は、超音波振動によって処置する超音波処置装置としても用いられる。
図1に示すように、電源ユニット7は、超音波振動のための電流を制御する超音波制御部8と、高周波のための電流を制御する高周波電流制御部9と、超音波制御部8と処置具10とを電気的に接続し、高周波電流制御部9と処置具10とを電気的に接続するケーブル6とを有する。ケーブル6の一端は電源ユニット7に接続され、ケーブル6の他端は後述する振動子ケース11の基端に接続される。
図1に示すように、処置具10は、振動子ユニット2と、プローブ3と、シースユニット4と、可動ハンドルユニット5とを有する。振動子ユニット2とプローブ3とシースユニット4とは固定側であり、可動ハンドルユニット5は固定側に対して回動可能に可動する可動側である。
図1と図2とに示すように、振動子ユニット2は、振動子ケース11を有する。前記したように、振動子ケース11の基端は、ケーブル6の端部に接続される。
電気信号線13A,13B,17は、ケーブル6に含まれる。
図3に示すように、プローブ3は、長手軸Cに沿って配設される。長手軸Cは、プローブ3の中心軸として機能する。プローブ3は、柱状を有する。プローブ3は、プローブ3の基端部に形成され、雌ネジ部16と螺合する雄ネジ部19を有する。
図1に示すように、シースユニット4は、長手軸Cに沿って延設される。シースユニット4は、固定ハンドル22と、固定ハンドル22の先端に取付けられるシース23とを有する。
入力ボタン35Bが押圧されることにより、スイッチ部37Bが閉状態になり、スイッチ部37Bで第2の電気信号経路とグランド経路との間が電気的に接続される。これにより、スイッチ部37Bから電源ユニット7に電気信号が伝達される。そして、例えば高周波電流制御部9のみから高周波電流が出力され、超音波振動を発生しない状態に切替えられる。
図1に示すように、可動ハンドルユニット5は、処置対象を処置する処置動作のために、プローブ3とシースユニット4とを含む固定側に対して開閉可能となっている。可動ハンドルユニット5は、可動ハンドルユニットの基端部に配設され、処置動作において力点として機能する可動ハンドル25を有する。可動ハンドル25は、後述する開閉軸101を中心に開閉軸周りに沿って固定ハンドル22に対して開閉方向に開閉可能となっている。つまり可動ハンドル25は、開閉軸101周りに回動する。この可動ハンドル25は、可動側指置き部として機能する可動ハンドルリング26を有する。可動ハンドル25は、図1の矢印A1の方向を示し、長手軸Cに直交する第1の方向、及び、図1の矢印A2の方向を示し、第1の方向とは反対方向である第2の方向において、固定ハンドル22に対して開閉可能である。可動ハンドル25は、固定ハンドル22より第1の方向側に位置している。可動ハンドル25が固定側に対して閉じた際、可動ハンドル25の中心軸C1は、長手軸Cに対して鋭角の角度αを有する状態で傾斜している。
可動ハンドル25が第2の方向へ移動し、固定ハンドル22に対して可動ハンドル25が閉動作することにより、第2の電極部53を含むジョー52は第1の方向に移動する。これにより、第2の電極部53を含むジョー52が第1の電極部21に対して閉位置になる。
すなわち、ジョー52は、ジョー52が開閉軸101を中心にシース23に対して回動することにより、第1の電極部21に対して開位置と閉位置とに開閉動作する。このように、可動ハンドル25は、ジョー52の開閉を操作し、固定ハンドル22に対して開閉可能となっている。
図1と図6とに示すように、処置具10は、開閉軸101を有し、ジョー52が開閉軸周りに回動することによってジョー52がシース23に対して開閉可能となるように、ジョー52をシース23に取付ける開閉軸部材100をさらに有する。開閉軸101は、開閉軸部材100の中心軸に相当する。開閉軸101を含む開閉軸部材100は、処置具10における可動ハンドルユニット5に含まれてもよい。
図6に示すように、開閉軸部材100は、開閉方向において中空部23aに重ならないように開閉方向において中空部23aに対してオフセットされた位置に配設される。この状態で、開閉軸101を有する開閉軸部材100は、開閉軸方向において互いに隣り合って配設されるシース23とジョー52とを開閉軸部材100が開閉方向において中空部23aに対してオフセットされた位置において突き刺す(串刺す)ように、ジョー52とシース23とに挿入される。開閉軸部材100が挿入されることによって、開閉軸部材100はジョー52をシース23に取付ける。
図6に示すように、ジョー側取付部52bは、開閉軸方向においてジョー側取付部52bを貫通し、開閉軸方向と開閉方向とにおいて中空部23aから離れて配設されるジョー側貫通孔部52cを有する。
図6に示すように、本実施形態では、ジョー52がシース23に取付けられる際に、ジョー側貫通孔部52cが開閉軸方向においてシース側貫通孔部23cと連通している状態で、1本の開閉軸部材100はシース側貫通孔部23cとジョー側貫通孔部52cとに挿入される。1本の開閉軸部材100がシース側貫通孔部23cとジョー側貫通孔部52cとに挿入されることによって、ジョー52がシース23に対して開閉可能となるように、1本の開閉軸部材100はジョー52をシース23に取付ける。開閉軸方向において、開閉軸部材100の両端面は、ジョー側取付部52bの外周面と同一平面上に配設される。つまり、開閉軸方向において、開閉軸部材100の両端部は、ジョー側取付部52bに対して突出していない。本実施形態では、開閉軸部材100のみがシース側貫通孔部23cとジョー側貫通孔部52cとに挿入される。
シース側貫通孔部23cの直径をD2と定義し、
開閉方向における中空部23aの中心位置とシース側貫通孔部23cとの間の距離をL1と定義し、
前記において、オフセットを考慮すると、以下の式(1)が成り立つ。
(D1+D2)/2 < L1 ・・・ 式(1) 。
式(1)によって、シース側貫通孔部23cとジョー側貫通孔部52cと開閉軸部材100とは、開閉方向において、中空部23aに対して確実にオフセットされる。図6に示すように、開閉軸101を含む開閉軸部材100は、直交軸201上に配設されるのではなく、中空部23aに挿入されない。
開閉軸部材100がシース側取付部23bとジョー側取付部52bとの両方に固定されていない場合、ジョー側取付部52bとジョー52とは、開閉軸部材100とシース側取付部23bとシース23とに対して、開閉軸周りに回動可能となる。
開閉軸部材100が、シース側取付部23bに固定され、ジョー側取付部52bに固定されていない場合、ジョー側取付部52bとジョー52とは、開閉軸部材100とシース側取付部23bとシース23とに対して、開閉軸周りに回動可能となる。
開閉軸部材100がシース側取付部23bに固定されておらずジョー側取付部52bに固定される場合、ジョー側取付部52bとジョー52と開閉軸部材100とは、一体的に、シース側取付部23bとシース23とに対して、開閉軸周りに回動可能となる。
このように、開閉軸101を有する開閉軸部材100と、シース側貫通孔部23cを有するシース側取付部23bと、ジョー側貫通孔部52cを有するジョー側取付部52bとは、ジョー52をシース23に取付ける取付部として機能する。この取付部は、可動ハンドルユニット5が開閉軸周りに回動するように、可動ハンドルユニット5を固定側に取付ける。
図6に示すように、シース側取付部23bの位置の一例として、シース側取付部23bは、例えば、プローブ3が挿通するシース23の中空部23aに対して、開閉方向において同軸上に配設される。シース側取付部23bは、開閉方向において、例えば中空部23aの下方に配設される。この場合、シース側取付部23bは、例えば、シース23の肉厚部が開閉方向において長手軸Cから第2の方向に向かって延びることによって形成される。このように、シース側取付部23bは、開閉方向において、固定ハンドル22側に配設される。このシース側取付部23bは、例えば、シース23の先端部の一部に配設されることが好適である。このように本実施形態のシース側取付部23bは、例えば、シース23の一部であり、シース23と一体である。
図6に示すように、ジョー側取付部52bは、ジョー52の一部であり、一対配設されている。ジョー側取付部52bは、開閉軸方向において、シース側取付部23bの両側に配設されており、シース側取付部23bを挟持する。具体的には、ジョー側取付部52bは、開閉軸方向において、シース側取付部23bの両脇に配設される1対の側面部を挟持する。ジョー側取付部52bは、ジョー側貫通孔部52cが開閉軸方向においてシース側貫通孔部23cと連通するように、シース側取付部23bを挟持する。例えば、ジョー側取付部52bは、例えば後述するジョー52に貫通孔部59(図9A参照)が配設されることによって、形成される。ジョー側取付部52bは、貫通孔部59が配設されることによって形成されるジョー52の1対のアーム部として機能する。言い換えると、ジョー52は、貫通孔部59によって二股に分かれている。貫通孔部59は、長手軸C方向において、ジョー52を貫通する。貫通孔部59は、開閉軸方向においてジョー側取付部52bの間に介在する。シース23は、貫通孔部59を挿通可能である。
図6に示すように、ジョー側取付部52bは、ジョー側貫通孔部52cが開閉軸方向においてシース側貫通孔部23cと連通するように、シース側取付部23bを挟持する。このとき、シース側貫通孔部23cとジョー側貫通孔部52cとは、開閉方向において中空部23aに対してオフセットされた位置に配設され、開閉軸方向において例えば互いに隣り合う。
この状態において、図6に示すように、シース側貫通孔部23cとジョー側貫通孔部52cとは、開閉軸方向と開閉方向とにおいて中空部23aに連通しておらず、開閉方向において中空部23aと重ならないように中空部23aに対してオフセットされる。
これにより図6に示すように1本の開閉軸部材100は、直交軸201上に配設されるのではなく、開閉方向において中空部23aに対してオフセットされた位置に配設される。1本の開閉軸部材100は、オフセットされた位置において、ジョー52をシース23に取付ける。1本の開閉軸部材100は、中空部23aに挿入されない。
このように本実施形態では、1本の開閉軸部材100は、開閉方向において中空部23aに対してオフセットされた位置に配設される。このとき1本の開閉軸部材100は、中空部23aに重ならず、中空部23aを貫通しない。1本の開閉軸部材100は、オフセットされた位置において、ジョー52をシース23に取付ける。
本実施形態では、開閉軸部材100は1対配設されるのではなく、つまり、一方の開閉軸部材100がシース側貫通孔部23cと一方のジョー側貫通孔部52cとに挿入され、他方の開閉軸部材100がシース側貫通孔部23cと他方のジョー側貫通孔部52cとに挿入されるのではない。本実施形態では、1本の開閉軸部材100が一方のジョー側貫通孔部52cとシース側取付部23bと他方のジョー側貫通孔部52cとに挿入されるように、開閉軸部材100はシース側取付部23bとジョー側取付部52bとを突き刺す。
よって本実施形態では、取付のための部品点数を最小限にとどめることができ、高精度な開閉軸101を提供できる。本実施形態では、取付の構成を簡素にでき、ジョー52とシース23との取付部におけるガタの発生を防止できる。本実施形態では、製品自体の形状誤差が大きくても、ジョー52とシース23との取付部におけるガタの発生を防止できる。
本実施形態では、前記によって、プローブ3の先端部とジョー52の先端部との相対位置がずれてしまうことを防止でき、この状態では、プローブ3の先端部とジョー52の先端部との互いに対する噛み合わせにおいて、噛み合わせ精度が低下することを防止できる。よって本実施形態では、把持動作と剥離動作といった処置動作において、把持力及び剥離力といった処置力が低下することを防止でき、所望する処置特性を確実に得られることができる。
例えば、図7Aと図7Bとに示すように、シース側取付部23bは、開閉方向において、例えば中空部23aの上方に配設され、例えば固定ハンドル22側よりも可動ハンドル25側に配設されてもよい。これにより、シース側貫通孔部23cは、例えば中空部23aの上方に配設され、例えば固定ハンドル22側よりも可動ハンドル25側に配設される。開閉軸部材100とジョー側貫通孔部52cとは、開閉方向において、例えば中空部23aよりも上方に、例えば固定ハンドル22側よりも可動ハンドル25側に配設される。言い換えると、開閉軸部材100とシース側貫通孔部23cとジョー側貫通孔部52cとは、開閉方向において、例えば、長手軸Cを含む中空部23aと可動ハンドル25との間に配設される。
開閉軸部材100が例えば導電材料によって形成される場合、防止部材103は絶縁材料によって形成されてもよい。この場合、防止部材103は、ゴム、セラミック、または硬質樹脂などによって形成される。これにより、高周波電流がジョー52を流れても、高周波電流が開閉軸部材100を介して外部に流れることを防止できる。
[構成]
図9Aと図9Bと図9Cとを参照して第1の実施形態とは異なる点についてのみ説明する。本実施形態は、図1と図6とに示す構成に対応する。
図9Aと図9Bと図9Cとに示すように、処置具10は、シース23に対するジョー52の開閉角度を規制する規制機構150をさらに有する。
規制機構150は、ジョー52に配設される貫通孔部59を挿通するシース23と、シース23の外周面に配設され、シース23の径方向においてシース23の外側に向かって突出している突出部151とを有する。規制機構150は、図9Bに示すようにジョー52を含む可動ハンドルユニット5が固定側に対して閉じた際にシース23の外周面に当接し、図9Cに示すようにジョー52を含む可動ハンドルユニット5が固定側に対して開いた際に突出部151に当接する貫通孔部59の内周面59aをさらに有する。
図9Bに示すように、可動ハンドルユニット5が固定側に対して閉じられることによって、第1当接部位59bはシース23の外周面に当接する。これにより、プローブ対向部55がジョー対向部58に当接し、固定側に対する可動ハンドルユニット5の開閉角度αが最小となるように開閉角度αは規制される。シース23の外周面は、可動ハンドルユニット5が必要以上に閉じられることを防止するストッパーとして機能する。第1当接部位59bがシース23の外周面に当接することによって、可動ハンドルユニット5の最小閉位置が位置決めされる。
本実施形態では、規制機構150であるシース23と突出部151と第1当接部位59bと第2当接部位59cとによって、固定側に対する可動ハンドルユニット5の開閉角度αを規制でき、可動ハンドルユニット5が必要以上に開閉されることを防止でき、固定側に対する可動ハンドルユニット5の開閉位置を位置決めできる。
[構成]
図10Aと図10Bと図10Cとを参照して第1,2の実施形態とは異なる点についてのみ説明する。本実施形態は、図7Aと図7Bとに示す構成に対応する。
突出部151は、長手軸C方向において、開閉軸部材100よりも前方に配設される。
図10Bと図10Cとに示すように、第1当接部位59bと第2当接部位59cとは、第1当接部位59bと第2当接部位59cとが開閉軸部材100に隣り合うように、開閉軸部材100の周辺に配設される。詳細には、第1当接部位59bと第2当接部位59cとは、長手軸C方向において、開閉軸部材100と突出部151との間に配設される。
図10Bに示すように、可動ハンドルユニット5が固定側に対して閉じられることによって、第1当接部位59bはシース23の外周面に当接する。これにより、プローブ対向部55がジョー対向部58に当接し、固定側に対する可動ハンドルユニット5の開閉角度αが最小となるように開閉角度αは規制される。シース23の外周面は、可動ハンドルユニット5が必要以上に閉じられることを防止するストッパーとして機能する。第1当接部位59bがシース23の外周面に当接することによって、可動ハンドルユニット5の最小閉位置が位置決めされる。
本変形例では、規制機構150であるシース23と突出部151と第1当接部位59bと第2当接部位59cと第3当接部位59dとによって、固定側に対する可動ハンドルユニット5の開閉角度αを規制でき、可動ハンドルユニット5が必要以上に開閉されることを防止でき、固定側に対する可動ハンドルユニット5の開閉位置を位置決めできる。
Claims (5)
- 長手軸に沿って配設されるプローブと、
前記プローブの先端部がシースの先端部から突出する状態で前記プローブが挿通される中空部を有するシースと、
ジョーが開閉軸の軸周りに回動可能となるように前記シースに取付けられ、ジョーが回動することによって前記プローブの前記先端部に対して長手軸方向と開閉軸方向とに交差する開閉方向に開閉可能なジョーと、
前記開閉軸を有し、前記ジョーが開閉軸周りに回動することによって前記ジョーが前記シースの前記先端部に対して開閉可能となるように、前記ジョーを前記シースに取付ける開閉軸部材と、
を具備し、
前記開閉軸を有する前記開閉軸部材は、前記開閉軸部材が前記開閉方向において前記中空部に重ならないように前記開閉方向において前記中空部に対してオフセットされた位置に配設された状態で、前記開閉軸方向において互いに並設される前記シースと前記ジョーとを前記開閉軸部材が前記開閉方向において前記中空部に対してオフセットされた位置において突き刺すように、前記ジョーと前記シースとに挿入され、
前記開閉軸部材は、挿入によって前記ジョーを前記シースに取付けるエネルギー処置具。 - 前記シースに配設されるシース側取付部と、前記ジョーに配設されるジョー側取付部とをさらに具備し、
前記シース側取付部は、前記開閉軸方向において前記シース側取付部を貫通し、前記開閉軸方向と前記開閉方向とにおいて前記中空部から離れて配設されるシース側貫通孔部を有し、
前記ジョー側取付部は、前記開閉軸方向において前記ジョー側取付部を貫通し、前記開閉軸方向と前記開閉方向とにおいて前記中空部から離れて配設されるジョー側貫通孔部を有し、
前記ジョーが前記シースに取付けられる際に、前記ジョー側貫通孔部が前記開閉軸方向において前記シース側貫通孔部と連通している状態で、前記開閉軸部材は前記シース側貫通孔部と前記ジョー側貫通孔部とに挿入される請求項1に記載のエネルギー処置具。 - 前記中空部の直径をD1と定義し、
前記シース側貫通孔部の直径をD2と定義し、
前記開閉方向における前記中空部の中心位置と前記シース側貫通孔部との間の距離をL1と定義し、
(D1+D2)/2 < L1
となる請求項2に記載のエネルギー処置具。 - 前記シースの基端部に取付けられる固定ハンドルと、
前記ジョーの開閉を操作し、前記固定ハンドルに対して開閉可能な可動ハンドルと、
をさらに有し、
前記開閉軸を有する前記開閉軸部材は、前記固定ハンドル側、または前記可動ハンドル側に配設される請求項3に記載のエネルギー処置具。 - 前記シースに対する前記ジョーの開閉角度を規制する開閉規制機構をさらに具備する請求項1に記載のエネルギー処置具。
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