WO2015194261A1 - エネルギー処置ユニット、エネルギー処置具及びエネルギー処置システム - Google Patents
エネルギー処置ユニット、エネルギー処置具及びエネルギー処置システム Download PDFInfo
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- WO2015194261A1 WO2015194261A1 PCT/JP2015/062864 JP2015062864W WO2015194261A1 WO 2015194261 A1 WO2015194261 A1 WO 2015194261A1 JP 2015062864 W JP2015062864 W JP 2015062864W WO 2015194261 A1 WO2015194261 A1 WO 2015194261A1
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- probe
- treatment
- suction
- energy
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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
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B17/22004—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves
- A61B17/22012—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves in direct contact with, or very close to, the obstruction or concrement
- A61B17/2202—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves in direct contact with, or very close to, the obstruction or concrement the ultrasound transducer being inside patient's body at the distal end of the catheter
-
- 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
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B17/22004—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for using mechanical vibrations, e.g. ultrasonic shock waves
-
- 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
- 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
- A61B2018/00005—Cooling or heating of the probe or tissue immediately surrounding the probe
- A61B2018/00011—Cooling or heating of the probe or tissue immediately surrounding the probe with fluids
- A61B2018/00029—Cooling or heating of the probe or tissue immediately surrounding the probe with fluids open
- A61B2018/00035—Cooling or heating of the probe or tissue immediately surrounding the probe with fluids open with return means
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00994—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body combining two or more different kinds of non-mechanical energy or combining one or more non-mechanical energies with ultrasound
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B2217/00—General characteristics of surgical instruments
- A61B2217/002—Auxiliary appliance
- A61B2217/005—Auxiliary appliance with suction drainage system
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B2217/00—General characteristics of surgical instruments
- A61B2217/002—Auxiliary appliance
- A61B2217/007—Auxiliary appliance with irrigation system
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B2218/00—Details of surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2218/001—Details of surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body having means for irrigation and/or aspiration of substances to and/or from the surgical site
- A61B2218/002—Irrigation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B2218/00—Details of surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2218/001—Details of surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body having means for irrigation and/or aspiration of substances to and/or from the surgical site
- A61B2218/007—Aspiration
Definitions
- the present invention relates to an energy treatment unit in which a treatment portion that performs treatment using transmitted energy is provided at a distal end portion of a probe capable of transmitting energy, and a suction conduit is extended in a hollow portion inside the probe. Moreover, it is related with an energy treatment tool and an energy treatment system provided with the energy treatment unit.
- Patent Document 1 discloses a treatment instrument (energy treatment instrument) including a probe extending along a longitudinal axis.
- the probe transmits ultrasonic vibration as energy used for the treatment from the proximal direction to the distal direction, and the treatment unit provided at the distal end of the probe uses the transmitted ultrasonic vibration to treat a treatment target such as a living tissue. Take action.
- the probe is inserted through the sheath in a state where the treatment portion protrudes in the distal direction.
- a space is formed between the probe and the sheath, and a liquid such as physiological saline is supplied toward the distal direction side in the space. That is, the space between the probe and the sheath serves as a liquid supply conduit through which liquid is supplied toward the distal direction side.
- cavitation is generated in the vicinity of the distal end surface of the probe by ejecting the liquid supplied from the distal end of the liquid feeding conduit toward the distal direction side while the probe is ultrasonically vibrated. Cavitation disrupts and emulsifies biological tissue having low elasticity such as hepatocytes.
- a hollow portion is formed along the longitudinal axis inside the probe, and the hollow portion is an opening at the distal end surface of the probe and opens to the outside of the probe.
- the treatment target (living tissue) crushed and emulsified by cavitation is sucked into the hollow portion through the opening, and moves toward the proximal end in the hollow portion. That is, the hollow portion inside the probe becomes a suction conduit through which the sucked material moves in the proximal direction.
- the present invention has been made paying attention to the above-mentioned problems, and the object of the present invention is to effectively prevent clogging from occurring in a suction line extending inside a probe that transmits energy used for treatment. It is to provide an energy treatment unit to be provided. Moreover, it is providing the energy treatment tool and energy treatment system provided with the energy treatment unit.
- an energy treatment unit includes a probe distal end portion and a probe proximal end portion, extends along a longitudinal axis, and has a hollow portion along the longitudinal axis therein. And a probe capable of transferring energy from the probe base end toward the probe tip, and provided at the probe tip of the probe, and the hollow portion opens to the outside of the probe.
- An opening is formed on the outer surface, and a treatment portion that performs treatment using the energy transmitted through the probe, and extends from the probe proximal end direction to the probe distal end portion through the hollow portion,
- a suction port that is formed at the tip of the suction port located in the hollow portion and generates a suction force from the suction port toward the probe proximal end; It extends from the probe proximal end direction to the probe distal end direction through the hollow portion, and a jet outlet located at the hollow portion is formed at the tip, from the jet outlet toward the probe distal end direction side.
- a liquid supply line for ejecting liquid and provided in the probe in a state facing at least a part of the ejection port, and located on the probe tip portion side from the suction port and the ejection port, A collision surface on which at least a part of the liquid ejected from the ejection port collides in the hollow portion.
- an energy treatment unit in which clogging is effectively prevented from occurring in a suction conduit extending inside a probe that transmits energy used for treatment.
- an energy treatment tool and an energy treatment system provided with the energy treatment unit can be provided.
- FIG. 3 is a cross-sectional view schematically illustrating a configuration of a vibrator unit according to the first embodiment. It is sectional drawing which shows roughly the structure of the front-end
- sectional drawing which shows schematically the cross section which passes along the opening part of the treatment part which concerns on a 7th modification, and is perpendicular
- FIG. 1 is a diagram showing a configuration of an energy treatment system 1 of the present embodiment.
- the energy treatment system 1 includes an energy treatment tool (handpiece) 2.
- the energy treatment device 2 has a longitudinal axis C.
- the direction parallel to the longitudinal axis C be a longitudinal direction.
- One side in the longitudinal direction is the distal direction (the direction of the arrow C1 in FIG. 1), and the opposite side to the distal direction is the proximal direction (the direction of the arrow C2 in FIG. 1).
- the energy treatment tool 2 is an ultrasonic treatment tool that performs treatment of a treatment target such as a living tissue using ultrasonic vibration as energy, and a treatment target using high-frequency power (high-frequency current) as energy. This is a high-frequency treatment tool that performs the above-mentioned treatment.
- the energy treatment device 2 includes a holding unit (handle unit) 3.
- the holding unit 3 includes a cylindrical case portion 5 extending along the longitudinal axis C, and a fixed handle 6 extending from the cylindrical case portion 5 in a certain direction intersecting the longitudinal axis C. And comprising.
- the cylindrical case part 5 and the fixed handle 6 are integrally formed.
- a movable handle 7 is rotatably attached to the cylindrical case portion 5.
- the movable handle 7 opens or closes the fixed handle 6 by rotating the movable handle 7 around the attachment position to the cylindrical case portion 5.
- the movable handle 7 is located on the distal direction side of the fixed handle 6.
- the holding unit 3 also includes a rotation operation knob 8 that is a rotation operation input unit attached to the distal direction side of the cylindrical case unit 5.
- the rotation operation knob 8 is rotatable about the longitudinal axis C with respect to the cylindrical case portion 5.
- the cylindrical case portion 5 of the holding unit 3 is provided with energy operation input buttons 9A to 9C which are energy operation input portions.
- the energy operation input buttons 9A and 9B are located on the side where the fixed handle 6 is located with the longitudinal axis C as the center.
- the energy operation input buttons 9 ⁇ / b> A and 9 ⁇ / b> B are located on the distal direction side with respect to the fixed handle 6.
- the energy operation input button 9C is located on the opposite side of the longitudinal axis C from the side on which the fixed handle 6 is located.
- the energy operation input buttons 9A to 9C are detachable from the cylindrical case portion 5.
- the energy treatment device 2 includes a vibrator unit 11.
- the vibrator unit 11 includes a vibrator case 12.
- the vibrator case 12 is rotatable with respect to the cylindrical case portion 5 around the longitudinal axis C integrally with the rotation operation knob 8.
- the vibrator case 12 is attached to the holding unit 3 by inserting the vibrator case 12 into the cylindrical case portion 5 from the proximal direction side.
- One end of a cable 13 is connected to the vibrator case 12.
- the energy treatment system 1 includes an energy source unit 15 that is, for example, an energy control device.
- the other end of the cable 13 is connected to the energy source unit 15.
- the energy source unit 15 includes an ultrasonic energy source 16, a high frequency energy source 17, and a control unit 18.
- the ultrasonic energy source 16 and the high frequency energy source 17 are formed from, for example, a power source and a conversion circuit.
- the control unit 18 is formed of, for example, a processor including a CPU (Central Processing Unit) or an ASIC (Application Specific Integrated Circuit).
- the energy source unit 15 is electrically connected to an energy operation input switch 10 such as a foot switch that is an energy operation input unit.
- the energy operation input switch 10 is provided separately from the energy treatment tool 2.
- FIG. 2 is a diagram showing a configuration of the vibrator unit 11.
- the transducer unit 11 includes an ultrasonic transducer 21 that is a vibration generating unit provided inside the transducer case 12.
- the ultrasonic transducer 21 includes a plurality (six in this embodiment) of piezoelectric elements 22 that convert electric current (alternating current) into ultrasonic vibration.
- One end of each electrical path portion 23A, 23B is connected to the ultrasonic transducer 21.
- the electric path portions 23A and 23B are extended through the inside of the cable 13, and the other ends of the electric path portions 23A and 23B are connected to the ultrasonic energy source 16 of the energy source unit 15.
- the electrical path portions 23 ⁇ / b> A and 23 ⁇ / b> B are formed by electrical wiring extending inside the transducer case 12, electrical wiring extending inside the cable 13, and the like.
- the ultrasonic transducer 21 is attached to a cylindrical element mounting member 25.
- the ultrasonic transducer 21 including the piezoelectric element 22 is fixed to the outer peripheral surface of the element mounting member 25.
- a cylindrical horn member 26 is connected to the distal end side of the element mounting member 25.
- the horn member 26 is continuous to the tip direction side of the ultrasonic transducer 21.
- the horn member 26 includes a cross-sectional area changing portion 27 in which a cross-sectional area perpendicular to the longitudinal axis C decreases in the distal direction.
- the ultrasonic vibration generated by the ultrasonic vibrator 21 is transmitted to the horn member 26 and is transmitted from the proximal direction to the distal direction in the horn member 26.
- the amplitude of the ultrasonic vibration transmitted to the horn member 26 is enlarged by the cross-sectional area changing unit 27. Further, since the horn member 26 and the element mounting member 25 are formed in a cylindrical shape, a cavity 28 is formed inside the horn member 26 and inside the element mounting member 25. The cavity 28 extends along the longitudinal axis C from the proximal end of the element mounting member 25 to the distal end of the horn member 26.
- the vibrator case 12 is provided with a case base end wall 31 that forms the base end of the vibrator case 12, and a cylindrical connection member 32 is fixed to the case base end wall 31. ing.
- the connection member 32 protrudes from the case base end wall 31 in the distal direction inside the vibrator case 12.
- the connection member 32 is coupled to the element mounting member 25 from the proximal direction side through a cylindrical vibration damping member 33.
- the vibration damping member 33 is sandwiched between the connection member 32 and the retaining member 35 in the longitudinal direction parallel to the longitudinal axis C, and the vibration damping member 33 is connected to the connection member 32 and the element mounting member 25 in the longitudinal direction. Movement is restricted.
- a space 36 is formed inside the connecting member 32 and inside the vibration damping member 33.
- the space 36 extends along the longitudinal axis C from the base end of the connection member 32 to the tip of the vibration damping member 33.
- the distal end of the space portion 36 communicates with the proximal end of the cavity portion 28 that extends inside the element mounting member 25.
- the base end of the space 36 is open to the outside of the transducer unit 11 (the outside of the transducer case 12).
- the energy treatment device 2 includes a sheath 40 that extends along the longitudinal axis C.
- the sheath 40 is attached to the holding unit 3 by inserting the sheath 40 into the inside of the rotary operation knob 8 and the inside of the cylindrical case portion 5 from the distal direction side. That is, the holding unit 3 is connected to the proximal direction side of the sheath 40.
- a sheath 40 is attached to the distal side of the transducer case 12 inside the cylindrical case portion 5.
- the energy treatment device 2 includes a probe (ultrasonic probe) 41 inserted through the sheath 40.
- the probe 41 extends from the inside of the holding unit 3 (inside the cylindrical case portion 5) through the inside of the sheath 40 toward the distal end along the longitudinal axis C.
- the longitudinal axis C coincides with the central axis of the probe 41.
- the probe 41 has a probe distal end portion and a probe proximal end portion, and extends along the longitudinal axis C from the probe proximal end portion toward the probe distal end portion.
- a treatment portion 42 is provided at the probe tip of the probe 41.
- the direction toward the probe distal end in the probe 41 is defined as the probe distal end direction
- the direction toward the probe proximal end in the probe 41 is defined as the probe proximal end direction.
- the probe distal end direction coincides with the aforementioned distal end direction
- the probe proximal end direction coincides with the aforementioned proximal direction.
- the treatment portion 42 protrudes from the distal end of the sheath 40 toward the probe distal end portion.
- a jaw 43 is rotatably attached to the distal end portion of the sheath 40.
- a movable part (not shown) provided in the sheath 40 moves along the longitudinal axis C.
- the jaw 43 rotates and the jaw 43 opens or closes the treatment portion 42 of the probe 41.
- the sheath 40, the probe 41, and the jaw 43 are rotatable about the longitudinal axis C with respect to the cylindrical case portion 5 integrally with the rotation operation knob 8.
- FIG. 3 is a diagram showing the configuration of the tip portions of the probe 41 and the horn member 26.
- the probe 41 extends along the longitudinal axis C.
- a female screw portion 45 ⁇ / b> A is formed at the distal end portion of the horn member 26, and a male screw portion 45 ⁇ / b> B is formed at the proximal end portion of the probe 41.
- the male screw portion 45B is screwed into the female screw portion 45A, the probe 41 is connected to the distal direction side of the horn member 26.
- the probe 41 is connected to the horn member 26 inside the cylindrical case portion 5 of the holding unit 3.
- a hollow portion 46 is formed along the longitudinal axis C inside the probe 41.
- the hollow portion 46 extends from the probe proximal end portion of the probe 41 to the probe distal end portion (treatment portion 42) of the probe 41.
- the hollow portion 46 is an opening 47 located on the outer surface of the treatment portion 42 and opens to the outside of the probe 41.
- the opening 47 allows the hollow portion 46 inside the probe 41 to communicate with the outside of the probe 41.
- the base end of the hollow portion 46 communicates with the tip of the hollow portion 28 that extends inside the horn member 26. Therefore, when the probe 41 is connected to the horn member 26, the opening 47 of the hollow portion 46 and the base end of the space portion 36 communicate with each other via the hollow portion 46, the cavity portion 28, and the space portion 36. ing.
- the vibration transmitted from the ultrasonic transducer 21 to the horn member 26 is transmitted to the ultrasonic probe 41.
- the probe 41 which is an ultrasonic probe, transmits ultrasonic vibration, which is energy, from the probe proximal end direction to the probe distal end portion direction.
- the treatment unit 42 performs treatment using the transmitted ultrasonic vibration.
- the element mounting member 25, the horn member 26, and the probe 41 form the vibrating body unit 20 that transmits the ultrasonic vibration generated by the ultrasonic vibrator 21 and vibrates by the ultrasonic vibration. It should be noted that the amplitude of vibration due to ultrasonic vibration does not increase in the element mounting member 25 located on the base end side from the cross-sectional area changing portion 27 of the horn member 26.
- the ultrasonic vibration transmitted from the element mounting member 25 toward the probe proximal end is attenuated by the vibration attenuating member 33. For this reason, ultrasonic vibration is not transmitted from the element mounting member 25 (vibrating body unit 20) to the connection member 32 and the transducer case 12, and the connection member 32 and the transducer case 12 are not vibrated by the ultrasonic vibration.
- the vibrating body unit 20 vibrates in a predetermined vibration mode (vibration state) used at the time of treatment by transmitting the ultrasonic vibration generated by the ultrasonic vibrator 21.
- the vibrating body unit 20 performs longitudinal vibration whose vibration direction is parallel to the longitudinal axis C (longitudinal direction).
- the distal end of the vibrating body unit 20 (the distal end of the probe 41) and the proximal end of the vibrating body unit 20 (the proximal end of the element mounting member 25) are antinodes of longitudinal vibration.
- the antinode position A1 located at the distal end of the vibrating body unit 20 is located closest to the probe distal end direction side among the antinode positions of longitudinal vibration
- the antinode position A2 located at the proximal end of the vibrating body unit 20 is It is located closest to the probe proximal end side in the antinode position of longitudinal vibration.
- the number of antinodes of longitudinal vibration and the number of node positions of longitudinal vibration between the distal end of the vibrator unit 20 and the base end of the vibrator unit 20 are determined, and the vibrator unit There is at least one longitudinal vibration node position between the distal end of 20 and the proximal end of the vibrating body unit 20.
- the controller 18 adjusts the resonance frequency of the vibrating body unit 20 by adjusting the frequency of the current (alternating current) supplied from the ultrasonic energy source 16 to the ultrasonic transducer 21, and vibrates in a predetermined vibration mode.
- the body unit 20 is vibrated longitudinally.
- the predetermined vibration mode that is, the number of node positions and antinode positions of the longitudinal vibration
- the element mounting member 25 is electrically connected to the high frequency energy source 17 of the energy source unit 15 through an electric path portion (not shown).
- the electrical path portion is formed by electrical wiring extending inside the vibrator case 12, electrical wiring extending inside the cable 13, and the like.
- the high frequency energy source 17 outputs high frequency power (high frequency energy) as energy used for treatment.
- the high frequency power output from the high frequency energy source 17 is supplied to the treatment section 42 through an electrical path section (not shown), the element mounting member 25, the horn member 26, and the probe 41. That is, the electric path portion (not shown), the element mounting member 25, the horn member 26, and the probe 41 form a probe-side electric supply path P1 for high-frequency power output from the high-frequency energy source 17.
- the treatment unit 42 functions as an electrode.
- the vibrator case 12 is provided with a conductive portion (not shown), and the conductive portion of the vibrator case 12 is connected to a conductive portion (not shown) of the jaw 43 via a conductive portion (not shown) of the sheath 40. Electrically connected.
- the conductive portion of the vibrator case 12 is electrically connected to the high frequency energy source 17 of the energy source unit 15 via an electrical path portion (not shown).
- the electrical path portion is formed from a part different from the part that forms the probe-side electrical path P1, and is formed from electrical wiring extending inside the transducer case 12, electrical wiring extending inside the cable 13, and the like. Has been.
- the high frequency power output from the high frequency energy source 17 is supplied to the conductive portion of the jaw 43 through an electrical path portion (not shown), the conductive portion of the vibrator case 12 and the conductive portion of the sheath 40. That is, the electric path portion (not shown), the conductive portion of the vibrator case 12 and the conductive portion of the sheath 40 form a jaw-side electric supply path P2 for the high-frequency power output from the high-frequency energy source 17.
- the conductive portion of the jaw 43 functions as an electrode having a different potential from the treatment portion 42.
- the probe 41 is supported by the sheath 40 via a support member (not shown) formed of an insulating material, and the horn member 26 is a vibrator case via a support member (not shown) formed of an insulating material. 12 is supported. For this reason, contact of the probe 41 with the sheath 40 is prevented, and contact of the horn member 26 with the transducer case 12 is prevented. Therefore, a short circuit between the probe side electric supply path P1 and the jaw side electric supply path P2 is prevented. Further, the above-described support member is located at a node position of longitudinal vibration in a state where the vibrating body unit 20 vibrates in a predetermined vibration mode, and the support member is formed of a material having low vibration transmission and damping vibration. Yes. For this reason, ultrasonic vibration is not transmitted from the probe 41 and the horn member 26 (vibrating body unit 20) to the sheath 40 and the vibrator case 12, and the sheath 40 and vibrator case 12 are not vibrated by the ultrasonic vibration.
- FIG. 4 is a view showing the configuration of the distal end portion of the energy treatment device 2 including the treatment portion 42 and the jaw 43.
- a liquid feeding tube 51 and a suction tube 52 are extended from the probe proximal end direction to the probe distal end portion direction.
- the conduit unit 50 including the liquid feeding tube 51 and the suction tube 52 is detachably connected to the probe 41, the holding unit 3, and the vibrator unit 11.
- the probe 41 and the pipe line unit 50 form an energy treatment unit 30 in which treatment is performed using energy in the treatment unit 42.
- FIG. 5 is a diagram showing the configuration of the pipeline unit 50.
- a suction tube 52 is inserted into the liquid supply tube 51.
- a suction pipe 55 extends from the probe proximal end direction to the probe distal end direction.
- the pipe axis (suction pipe axis) S2 that is the central axis of the suction pipe 55 is coaxial with the longitudinal axis C.
- a liquid feed pipe line 53 extends from the probe proximal end direction to the probe distal end part direction between the inner peripheral face of the liquid feed tube 51 and the outer peripheral face of the suction tube 52. .
- the pipe axis (liquid supply pipe axis) S1 that is the central axis of the liquid supply pipe 53 is coaxial with the longitudinal axis C.
- the suction pipe 55 has a circular shape with the longitudinal axis C (pipeline axis S2) as a center and a cross section perpendicular to the longitudinal axis C.
- the liquid supply pipe 53 is a suction pipe.
- a cross section perpendicular to the longitudinal axis C is formed in a cylindrical shape (cylindrical shape) surrounding the outer peripheral side of 55.
- a spout 56 is formed at the tip of the liquid supply conduit 53.
- a suction port 57 is formed at the tip of the suction pipe 55.
- the jet port 56 and the suction port 57 are located at the distal end portion of the hollow portion 46 formed inside the probe 41.
- the liquid supply conduit 53 and the suction conduit 55 are extended toward the probe tip toward the inside of the treatment section 42.
- the suction port 57 of the suction conduit 55 is located on the probe tip direction side from the jet port 56 of the liquid supply conduit 53.
- FIG. 6 is a diagram showing the configuration of the proximal end portion of the pipeline unit 50 and the transducer unit 11 in a state where the pipeline unit 50 is connected to the probe 41, the holding unit 3 and the transducer unit 11.
- FIG. 7 is a diagram illustrating a configuration in which the duct unit 50 is detachably coupled to the probe 41, the holding unit 3, and the vibrator unit 11.
- the liquid feed pipe 53 liquid feed tube 51
- the suction pipe 55 suction tube 52
- the conduit unit 50 includes a tubular tube fixing member (liquid feeding tube fixing member) 61 to which the proximal end of the liquid feeding tube 51 is fixed by adhesion or the like.
- a tubular relay member 62 is attached to the tube fixing member 61, and a tube fixing member (suction tube fixing member) 63 is fixed to the relay member 62.
- the suction tube 52 extends toward the probe proximal end portion through the inside of the tube fixing member 61, and the proximal end of the suction tube 52 is fixed to the tube fixing member 63 by adhesion or the like.
- the liquid feed relay path 65 is formed by the tube fixing member 61, the relay member 62, and the tube fixing member 63, and the suction relay path 66 is formed by the tube fixing member 63.
- the distal end of the liquid feeding relay path 65 communicates with the proximal end of the liquid feeding conduit 53, and the distal end of the suction relay path 66 communicates with the proximal end of the suction conduit 55.
- a connection base (liquid feeding base) 67 and a connection base (suction base) 68 are fixed to the tube fixing member 63.
- the relay member 62 has a female screw portion 71A.
- the connection member 32 of the vibrator unit 11 has a male screw portion 71B.
- the pipe line unit 50 is detachably connected to the probe 41, the holding unit 3, and the vibrator unit 11. That is, the female threaded portion 71A of the relay member 62 and the male threaded portion 71B of the connecting member 32 connect the liquid feeding conduit 53 and the suction conduit 55 to the probe 41 and the holding unit 3 in a detachable manner. It becomes.
- the tightening degree (loosening condition) between the female screw part 71A and the male screw part 71B By changing the tightening degree (loosening condition) between the female screw part 71A and the male screw part 71B, the entire pipe unit 50 (including the liquid feeding pipe line 53 and the suction pipe line 55) in the longitudinal direction can be obtained. Move relative to the probe 41.
- the relay member 62 has a female screw portion 72A
- the tube fixing member 61 has a male screw portion 72B.
- the relay member 62 is attached to the tube fixing member 61 by screwing the female screw portion 72A with the male screw portion 72B. Further, by changing the tightening degree (loosening condition) between the female screw part 72 ⁇ / b> A and the male screw part 72 ⁇ / b> B, the liquid supply line 53 moves relative to the suction line 55 in the longitudinal direction. Therefore, by adjusting the tightening degree between the female threaded portion 72A and the male threaded portion 72B, in the hollow portion 46 inside the treatment portion 42 (inside the probe 41), the jet outlet 56 of the liquid feeding conduit 53 is formed. The position of the suction conduit 55 in the longitudinal direction with respect to the suction port 57 is adjusted.
- one end of an external liquid feeding tube 73 can be connected to the connection base (liquid feeding base) 67 of the conduit unit 50.
- connection base liquid feeding base
- the inside of the external liquid supply tube 73 communicates with the proximal end of the liquid supply relay path 65.
- an external suction tube 75 can be connected to the connection base (suction base) 68 of the conduit unit 50. By connecting the external suction tube 75 to the connection base 68, the inside of the external suction tube 75 communicates with the proximal end of the suction relay path 66.
- the other end of the external liquid feeding tube 73 is connected to a liquid feeding source 76.
- the liquid supply source 76 includes a liquid supply operation unit 77 such as a liquid supply pump, and a liquid storage tank 78.
- the liquid feeding operation unit 77 is electrically connected to the control unit 18 of the energy source unit 15, and the operation state of the liquid feeding operation unit 77 is controlled by the control unit 18.
- a liquid such as physiological saline stored in the liquid storage tank 78 passes through the inside of the external liquid feeding tube 73 and the liquid feeding relay path 65 to the liquid feeding pipe line 53.
- Supply liquid feeding
- the liquid is supplied from the probe proximal end direction toward the probe distal end portion.
- the suction source 81 includes a suction operation unit 82 such as a suction pump, and a recovery tank 83.
- the suction operation unit 82 is electrically connected to the control unit 18 of the energy source unit 15, and the operation state of the suction operation unit 82 is controlled by the control unit 18.
- a flow (suction force) toward the suction source 81 is generated in the external suction tube 75, the suction relay path 66, and the suction pipe 55. That is, when the suction operation unit 82 is operated, a flow in the suction pipe 55 toward the probe proximal end is generated.
- switch parts are provided corresponding to the respective energy operation input buttons 9A to 9C, and each switch part has a corresponding signal path. It is electrically connected to the control unit 18 of the energy source unit 15 through a unit (not shown). Each signal path portion is formed by a conductive portion (not shown) of the transducer case 12, an electric signal line (not shown) extending inside the cable 13, and the like.
- the energy operation input switch 10 is electrically connected to the control unit 18 of the energy source unit 15.
- each energy operation input button 9A to 9C that is, when each energy operation input button 9A to 9C is pressed
- the corresponding switch unit is closed, and the corresponding signal path An electric signal is transmitted to the control unit 18 through the unit.
- an energy operation is input with the energy operation input switch 10 (that is, when the energy operation input switch 10 is pressed)
- an electrical signal is transmitted from the energy operation input switch 10 to the control unit 18.
- the control unit 18 controls the output state of energy (ultrasonic power and high frequency power) from the energy source unit 15 based on the input of energy operation (transmitted electric signal). Further, the control unit 18 controls the operating state of the liquid feeding operating unit 77 and the operating state of the suction operating unit 82 based on the input of energy operation (transmitted electric signal). For example, when an energy operation is input with the energy operation input button 9A, energy is output from the energy source unit 15 in the first output mode, and when an energy operation is input with the energy operation input button 9B, an energy source is output. Energy is output from the unit 15 in the second output mode.
- the energy treatment system 1 includes a state setting unit 85, and the state setting unit 85 is electrically connected to the control unit 18 of the energy source unit 15.
- the state setting unit 85 is, for example, a touch panel or a button unit.
- FIG. 8 is a diagram showing a configuration of the state setting unit 85.
- the state setting unit 85 includes liquid feed switching units 86A to 86D, suction switching units 87A to 87D, supply amount setting units 88A to 88D, and supply amount display units 89A to 89D. .
- the liquid supply switching units 86A to 86D it is set whether or not to operate the liquid supply operation unit 77 in the corresponding output mode (the corresponding one of the first output mode to the fourth output mode). Is done. For example, in the liquid supply switching unit 86A, whether or not to operate the liquid supply operation unit 77 is set in the first output mode.
- each of the suction switching units 87A to 87D it is set whether or not to operate the suction operation unit 82 in the corresponding output mode (corresponding one of the first output mode to the fourth output mode). Is done. For example, in the suction switching unit 87A, whether or not to operate the suction operation unit 82 is set in the first output mode. Further, in each of the supply amount setting units 88A to 88D, when the liquid feeding operation unit 77 is operated in the corresponding output mode (corresponding one of the first output mode to the fourth output mode), In the corresponding output mode, the liquid supply amount (liquid supply amount) from the liquid supply operation unit 77 is set.
- the liquid supply amounts set by the respective supply amount setting units 88A to 88D are displayed on the corresponding supply amount display units (one corresponding among 89A to 89D).
- the supply amount setting unit 88A sets and sets the liquid supply amount from the liquid supply operation unit 77 in the first output mode when the liquid supply operation unit 77 is operated in the first output mode.
- the supplied amount is displayed on the supply amount display portion 89A.
- the control unit 18 controls the operation state of the liquid feeding operation unit 77 and the operation state of the suction operation unit 82 in each of the first output mode to the fourth output mode. ing.
- the treatment section 42 includes a probe tip wall 91 that forms the tip of the probe 41.
- the outer surface of the treatment portion 42 includes a treatment portion distal end surface 92 formed by the probe distal end wall 91 and a treatment portion side face 93 extending from the treatment portion distal end face 92 toward the probe proximal end portion.
- the treatment portion distal end surface 92 forms the distal end of the probe 41 and becomes the distal end surface of the probe 41.
- the treatment portion side surface 93 is an outer peripheral surface of the treatment portion 42.
- the opening 47 of the hollow portion 46 is located on the treatment portion distal end surface 92 of the probe 41.
- the treatment portion side surface 93 includes a probe-side facing surface 95 that faces the jaw 43.
- the probe-side facing surface 95 faces the opening direction of the jaw 43 (the direction of the arrow Y1 in FIG. 4). In FIG. 4, the direction of the arrow Y ⁇ b> 2 is the closing direction of the jaw 43.
- the suction operation unit 82 When the suction operation unit 82 is operated and a flow (suction force) toward the probe proximal end portion is generated in the suction pipe 55, the suction tube passes from the outside of the probe 41 through the opening 47 and the suction port 57 of the hollow portion 46. A suction force F1 toward the path 55 is generated. Further, when the liquid supply operation unit 77 is operated and the liquid is supplied toward the probe tip in the liquid supply line 53, the liquid supplied in the hollow part 46 flows from the jet port 56 toward the probe tip. Erupted toward.
- the collision surface (circulation generating part) 96 is provided on the probe distal end wall 91 of the treatment part 42.
- the collision surface 96 faces the probe proximal end direction and faces at least a part of the ejection port 56 of the liquid feeding conduit 53. That is, at least a part of the ejection port 56 does not face the opening 47 of the hollow portion 46 but faces the collision surface 96 of the probe tip wall 91.
- the collision surface 96 is located on the probe tip direction side from the ejection port 56 and the suction port 57.
- the collision surface 96 faces at least a part of the ejection port 56, at least a part of the liquid ejected from the ejection port 56 collides with the collision surface 96 in the hollow portion 46.
- the flow direction of the liquid is changed to a state toward the probe proximal end direction side. That is, a part of the liquid remains in the hollow portion 46 by the collision surface 96.
- the conduit unit 50 When performing treatment of a treatment target such as a living tissue by the energy treatment system 1, the conduit unit 50 is held by the conduit attaching / detaching portion (the female screw portion 71 ⁇ / b> A of the relay member 62 and the male screw portion 71 of the connecting member 32). It is connected to the unit 3 and the vibrator unit 11. Then, the cable 13 is connected to the energy source unit 15. Further, the conduit unit 50 is connected to the liquid supply source 76 by the external liquid supply tube 73, and the conduit unit 50 is connected to the suction source 81 by the external suction tube 75. In this state, the treatment portion 42 and the jaw 43 are inserted into the body.
- the conduit attaching / detaching portion the female screw portion 71 ⁇ / b> A of the relay member 62 and the male screw portion 71 of the connecting member 32. It is connected to the unit 3 and the vibrator unit 11. Then, the cable 13 is connected to the energy source unit 15. Further, the conduit unit 50 is connected to the liquid supply source 76 by the
- a treatment target is disposed between the treatment portion 42 and the jaw 43, and the movable handle 7 is closed with respect to the fixed handle 6, whereby the jaw 43 is closed with respect to the treatment portion 42, and the treatment is performed.
- a treatment target is grasped between the portion 42 and the jaw 43.
- an energy operation is input with the energy operation input button 9A, and energy is output from the energy source unit 15 in the first output mode.
- ultrasonic power is supplied from the ultrasonic energy source 16 to the ultrasonic vibrator 21, and ultrasonic vibration is generated in the ultrasonic vibrator 21.
- the generated vibration is transmitted to the treatment unit 42 via the ultrasonic probe 41 (vibrating body unit 20).
- high frequency power is output from the high frequency energy source 17. Then, high-frequency power is supplied to the treatment section 42 through the probe-side electric supply path P1, and high-frequency power is supplied to the conductive section (not shown) of the jaw 43 through the jaw-side electric supply path P2. Accordingly, the treatment portion 42 and the conductive portion of the jaw 43 function as electrodes having different potentials with respect to each other.
- the treatment part 42 is vibrated longitudinally, whereby frictional heat is generated between the treatment part 42 and the treatment target.
- the object to be treated is incised at the same time as it is solidified by frictional heat.
- the treatment portion 42 and the conductive portion of the jaw 43 function as electrodes while the treatment target is gripped between the jaw 43 and the treatment portion 42, so that the treatment portion 42 and the conductive portion of the jaw 43 are connected.
- a high-frequency current flows through the treatment target. Thereby, the treatment target is denatured and coagulation is promoted.
- an energy operation is input with the energy operation input button 9B, and energy is output from the energy source unit 15 in the second output mode.
- the second output mode high-frequency power is supplied to the treatment section 42 through the probe-side electric supply path P1, and high-frequency power is supplied to the conductive portion (not shown) of the jaw 43 through the jaw-side electric supply path P2.
- the treatment part 42 and the conductive part of the jaw 43 function as electrodes having different potentials with respect to each other, and a bipolar treatment is performed between the treatment part 42 and the conductive part of the jaw 43 to flow a high-frequency current through the treatment target.
- the second output mode no ultrasonic power is output from the ultrasonic energy source 16, and no ultrasonic vibration is generated.
- an energy operation is input with the energy operation input button 9C, and energy is output from the energy source unit 15 in the third output mode.
- high-frequency power is supplied to the treatment section 42 through the probe-side electric supply path P1, and high-frequency power is supplied to a counter electrode plate (not shown) arranged outside the body.
- the high frequency power is not supplied to the conductive portion (not shown) of the jaw 43 through the jaw side electric supply path P2.
- a monopolar treatment is performed between the treatment portion 42 and the counter electrode outside the body so that a high-frequency current flows through the treatment target.
- no ultrasonic power is output from the ultrasonic energy source 16 and no ultrasonic vibration is generated.
- the state setting unit 85 When the state setting unit 85 is set to the standard setting (initial setting), the liquid feeding operation unit 77 is not operated and the suction operation unit 82 is operated in each of the first output mode to the third output mode. Not. However, by changing the setting from the standard state by the state setting unit 85, the liquid feeding operation unit 77 can be operated in each of the first output mode to the third output mode, and the suction operation unit 82 is operated. Can be activated. In addition, in each of the first output mode to the third output mode, when the liquid feeding operation unit 77 is operated, the liquid supply amount from the liquid feeding operation unit 77 can be adjusted.
- a liquid feed operation input unit and a suction operation input unit may be provided.
- the liquid feeding operation input unit and the suction operation input unit are, for example, operation input buttons provided on the energy treatment device 2 or foot switches that are separate from the energy treatment device 2.
- the liquid feeding operation unit 77 is operated, and the liquid is supplied to the liquid feeding conduit 53.
- no energy is output from the energy source unit 15 and the suction operation unit 82 is not operated. That is, only the ejection of liquid from the ejection port 56 is performed.
- the suction operation unit 82 is operated, and a flow toward the probe proximal end portion is generated in the suction pipe 55. At this time, no energy is output from the energy source unit 15 and the liquid feeding operation unit 77 is not operated. That is, only suction through the suction port 57 is performed.
- an energy operation is input by the energy operation input switch 10, and energy is output from the energy source unit 15 in the fourth output mode.
- the fourth output mode ultrasonic power is supplied from the ultrasonic energy source 16 to the ultrasonic vibrator 21, and ultrasonic vibration is generated in the ultrasonic vibrator 21.
- the generated vibration is transmitted to the treatment unit 42 via the ultrasonic probe 41 (vibrating body unit 20).
- the state setting unit 85 is set to the standard setting (initial setting)
- the liquid feeding operation unit 77 is operated and the suction operation unit 82 is operated in the fourth output mode.
- the liquid is supplied toward the probe distal end portion in the liquid supply conduit 53, and the liquid supplied from the ejection port 56 toward the probe distal end portion is ejected in the hollow portion 46.
- a part of the liquid ejected from the ejection port 56 is ejected to the outside of the probe 41 from the opening 47 of the hollow portion 46 (arrow X2 in FIG. 4).
- cavitation is generated in the vicinity of the treatment portion distal end surface 92 by supplying liquid to the vicinity of the treatment portion distal end surface 92.
- the treatment target is crushed and emulsified.
- cavitation only a low-elasticity biological tissue such as a hepatocyte is selectively crushed, and a flexible biological tissue such as a blood vessel is not crushed.
- the liquid is supplied through the liquid supply conduit 53 extending inside the hollow portion 46, and the liquid supplied from the ejection port 56 is ejected in the hollow portion 46.
- a part of the liquid ejected from the ejection port 56 is ejected from the hollow portion 46 to the outside of the probe 41 through the opening 47 located on the treatment portion distal end surface 92.
- the liquid supplied from the liquid supply source 76 does not drop, for example, from the proximal end portion of the treatment portion 42 to a portion other than the treatment target, and is appropriately applied to the vicinity of the treatment portion distal end surface 92 outside the probe 41. Supplied. Thereby, cavitation occurs appropriately and the treatment target can be appropriately crushed and emulsified.
- the ejection port 56 of the liquid feeding conduit 53 is located on the probe base end direction side from the opening 47. Therefore, a part of the liquid ejected from the ejection port 56 toward the probe tip in the hollow portion 46 is appropriately ejected from the opening 47 to the outside of the probe 41. Therefore, the liquid up to the vicinity of the treatment portion distal end surface 92 outside the probe 41 is reliably supplied, and the treatment performance of the treatment for crushing and emulsifying the treatment target can be improved.
- FIG. 9 shows the longitudinal vibration over time at a position where the treatment unit 42 is located (a position different from the node position of the longitudinal vibration) in a state where energy is output from the energy source unit 15 in the fourth output mode. It shows a change.
- the amplitude of the treatment unit 42 is not constant over time. That is, in the fourth output mode, the ultrasonic power output from the ultrasonic energy source 16 is modulated by the control unit 18. For example, the modulation is performed by changing the amplitude, period, etc. of the current (alternating current) supplied to the ultrasonic transducer 21 over time.
- the state vibrates with the first amplitude V1, or the state vibrates with the second amplitude V2 smaller than the first amplitude V1.
- the amplitude of the longitudinal vibration changes with time.
- the period of longitudinal vibration changes with time.
- the amplitude of the longitudinal vibration changes over time to a state of vibrating with the first amplitude V1 or a state of vibrating with the second amplitude V2, it vibrates with the first amplitude V1 for a certain time ⁇ T.
- the ratio occupied by the time T1 or the ratio occupied by the time T2 that vibrates at the second amplitude V2 during the fixed time ⁇ T is defined as a duty ratio.
- the duty ratio changes with time.
- Blood vessels are extended inside the hepatocytes that are crushed by cavitation. Even when hepatocytes are crushed and emulsified by cavitation, the ultrasonic power is modulated and the vibration state of the treatment section 42 is changed over time, thereby effectively preventing damage to blood vessels extending inside the hepatocytes. can do.
- a suction force (arrow F1 in FIG. 4) acts from the outside of the probe 41 toward the suction conduit 55 through the opening 47 and the suction port 57 of the hollow portion 46.
- the treatment target crushed and emulsified by cavitation is sucked toward the suction conduit 55 through the opening 47 and the suction port 57.
- an aspirated material (a crushed and emulsified treatment target) is aspirated toward the probe proximal end in the aspirating line 55, and the aspirated material is collected in the collection tank 83 of the aspiration source 81.
- the opening 47 of the hollow portion 46 is provided on the treatment portion distal end surface 92 different from the probe side facing surface 95 facing the jaw 43. For this reason, the opening 47 is not blocked by the jaw 43. Therefore, the crushed and emulsified treatment target (aspirated material) can be appropriately sucked into the suction conduit 55 through the opening 47.
- the suction port 57 of the suction pipe 55 is located on the probe base end direction side from the opening 47. Therefore, the sucked material sucked into the hollow portion 46 from the opening 47 is sucked into the suction pipe 55 appropriately from the suction port 57, and the suction property of the treatment target (sucked material) that has been crushed and emulsified can be improved. it can.
- the probe 41 by using energy (ultrasonic vibration, high frequency power) in the treatment, the probe 41 generates heat such as frictional heat due to the ultrasonic vibration described above. For this reason, the probe 41 (especially the treatment part 42) becomes high temperature by the generated heat, and the suction pipe 55 extended to the hollow part 46 inside the probe 41 also becomes high temperature.
- the suction pipe 55 becomes high temperature, the sucked material sucked through the suction pipe 55 is burnt, and is easily attached to the inner peripheral surface of the suction pipe 55 (the inner peripheral surface of the suction tube 52).
- suction material crushed biological tissue or the like
- a collision surface 96 is provided on the probe tip wall 91, and the collision surface 96 is opposed to at least a part of the ejection port 56. For this reason, in the hollow part 46, a part of liquid ejected from the ejection port 56 collides with the collision surface 96, and the flow direction of the liquid is changed to a state toward the probe proximal end direction side. As a result, a liquid flow (arrow X1 in FIG. 4) from the collision surface 96 toward the suction pipe 55 through the suction port 57 is formed in the hollow portion 46. Then, the liquid flowing in from the suction port 57 moves from the probe distal end direction to the probe proximal end direction in the suction conduit 55.
- the sucked material is hardly burnt in the suction pipe 55. Thereby, sticking of the sucked material to the inner peripheral surface of the suction conduit 55 is prevented, and the occurrence of clogging in the suction conduit 55 can be effectively prevented.
- the collision surface 96 is located on the probe distal end direction side from the ejection port 56 of the liquid feeding line 53 and the suction port 57 of the suction line 55.
- the liquid supply line 53 is formed in a cylindrical shape surrounding the outer peripheral side of the suction line 55 and has a cross section perpendicular to the longitudinal axis C.
- the suction port 57 of the suction line 55 is an outlet of the liquid supply line 53.
- 56 is located on the probe tip direction side.
- the conduit unit 50 can be detached from the probe 41 and the holding unit 3. For this reason, even when clogging occurs in the suction pipe 55, it is possible to remove the pipe unit 50 from the probe 41 and remove the suction substance clogged in the suction pipe 55. It is also possible to replace the duct unit 50 in which the suction duct 55 is clogged with a new duct unit 50. That is, in the energy treatment tool 2 of the present embodiment, even when the suction pipe 55 is clogged, it can be easily dealt with.
- the liquid supply line 53 is formed in a cylindrical shape surrounding the outer peripheral side of the suction line 55 and has a cross section perpendicular to the longitudinal axis C, but is not limited thereto.
- the first embodiment only one opening 47 of the hollow portion 46 is provided, but the present invention is not limited to this.
- FIGS. 10 shows the configuration of the treatment portion 42 and the distal end portion of the conduit unit 50 according to this modification
- FIG. 11 shows the configuration of the treatment portion distal end surface 92 of the treatment portion 42.
- the liquid feeding tube 51 is inserted into the inside of the suction tube 52.
- the suction line 55 extends between the inner peripheral surface of the suction tube 52 and the outer peripheral surface of the liquid feeding tube 51.
- the pipeline axis (liquid feed pipeline axis) S1 of the liquid feed pipeline 53 and the pipeline axis (suction pipeline axis) S2 of the suction pipeline 55 are coaxial with the longitudinal axis C.
- the liquid supply conduit 53 is formed in a circular shape with the longitudinal axis C (the conduit axis S1) as a center, and a cross section perpendicular to the longitudinal axis C is formed.
- a cross section perpendicular to the longitudinal axis C is formed in a cylindrical shape (cylindrical shape) surrounding the outer peripheral side of the liquid feeding conduit 53. Further, in the present modification, the ejection port 56 of the liquid feeding conduit 53 is located closer to the probe tip portion side than the suction port 57 of the suction conduit 55.
- the probe distal end wall 91 of the treatment section 42 is provided with a collision surface 96, and the collision surface 96 faces the probe proximal end direction and is at least a part of the ejection port 56 of the liquid supply conduit 53. It is opposite.
- the collision surface 96 is located on the probe tip direction side from the ejection port 56 and the suction port 57. For this reason, at least a part of the liquid ejected from the ejection port 56 collides with the collision surface 96 in the hollow portion 46. Thereby, a flow (arrow X1 in FIG. 10) in which at least a part of the liquid ejected from the ejection port 56 moves from the collision surface 96 to the suction pipe 55 through the suction port 57 is formed in the hollow portion 46.
- the longitudinal axis C coaxial with the pipe axis S 1 of the liquid feeding pipe 53 passes through the collision surface 96. For this reason, at least a part of the liquid ejected from the ejection port 56 can easily collide with the collision surface 96.
- two (a plurality of) openings 47A and 47B are provided in the treatment portion distal end surface 92.
- the hollow portion 46 is open to the outside of the probe 41 at openings 47A and 47B.
- the openings 47A and 47B are located at positions where the longitudinal axis C (the pipe line axis S1 of the liquid supply pipe line 53) does not pass through the treatment part distal end surface 92.
- the openings 47A and 47B are arranged approximately 180 ° apart from each other about the longitudinal axis C.
- the treatment target living tissue crushed and emulsified by cavitation is sucked into the hollow portion 46 through the openings 47A and 47B.
- the openings 47A and 47B are located at a position where the pipe axis S1 of the liquid feeding line 53 does not pass on the distal end surface 92 of the treatment portion, the aspirate (biological tissue) that flows into the hollow portion 46 Or the like) is effectively prevented from flowing into the liquid supply conduit 53 from the ejection port 56.
- the treatment portion 42 and the jaw 43 are punctured into a living tissue (hepatocyte), and then the jaw 43 is closed with respect to the treatment portion 42 and grasped.
- Subject may be treated.
- the treatment target is grasped between the treatment portion 42 and the jaw 43 in a state where the treatment portion 42 is punctured into the living tissue, and the grasped living tissue is incised simultaneously with coagulation by ultrasonic vibration.
- the treatment portion 42 is replaced with the living tissue ( When the hepatocytes are punctured, it is possible to effectively prevent the living tissue from entering the liquid supply conduit 53 from the ejection port 56.
- openings 47A to 47D may be provided in the treatment portion distal end surface 92.
- the liquid feeding tube 51 is inserted into the suction tube 52, and the pipe axis S1 of the liquid feeding pipe 53 is coaxial with the longitudinal axis C.
- Each of the openings 47A to 47D is located approximately 90 ° away from adjacent openings (two corresponding ones of 47A to 47D) around the longitudinal axis C.
- the longitudinal axis C coaxial with the pipeline axis S1 of the liquid feeding conduit 53 passes through the collision surface 96, as in the first modified example.
- the collision surface 96 is opposed to at least a part of the ejection port 56 of the liquid supply conduit 53.
- the openings 47A to 47D are located on the treatment portion distal end surface 92 at positions where the longitudinal axis C (the pipe line axis S1) does not pass.
- the treatment portion distal end surface 92 may be provided with two openings 47A and 47B formed in the shape of a slot along the direction around the longitudinal axis C. Good.
- the liquid feeding tube 51 is inserted into the suction tube 52, and the pipe axis S1 of the liquid feeding pipe 53 is coaxial with the longitudinal axis C.
- Each of the openings 47A and 47B extends over an angle range of about 120 ° around the longitudinal axis C.
- the openings 47A and 47B are located approximately 180 ° apart from each other.
- the longitudinal axis C coaxial with the pipeline axis S1 of the liquid feeding conduit 53 passes through the collision surface 96, as in the first modified example.
- the collision surface 96 is opposed to at least a part of the ejection port 56 of the liquid supply conduit 53.
- the openings 47A and 47B are located at positions where the longitudinal axis C (the channel axis S1) does not pass on the treatment portion distal end surface 92.
- one of the liquid feeding tube 51 and the suction tube 52 is inserted into the other of the liquid feeding tube 51 and the suction tube 52, but this is not restrictive.
- the suction tube 52 extends outside the liquid feeding tube 51, and the liquid feeding tube 51 extends outside the suction tube 52. . Therefore, the pipeline axis S1 of the liquid feeding pipeline 53 is not coaxial with the pipeline axis S2 of the suction pipeline 55.
- the pipe axis S1 of the liquid supply pipe 53 and the pipe axis S2 of the suction pipe 55 are not coaxial with the longitudinal axis C.
- the opening 47 of the hollow portion 46 is formed in the treatment portion distal end surface 92.
- the pipe axis S ⁇ b> 2 of the suction pipe 55 passes through the opening 47. Therefore, the treatment target crushed and emulsified by cavitation flows into the suction pipe 55 by the suction force (arrow F1 in FIG. 14) from the outside of the probe 41 through the opening 47 and the suction port 57 to the suction pipe 55. It becomes easy.
- the probe distal wall 91 of the treatment section 42 is provided with a collision surface 96, and the collision surface 96 faces the probe proximal end direction, and is at least one of the ejection ports 56 of the liquid supply conduit 53. It faces the part.
- the collision surface 96 is located on the probe tip direction side from the ejection port 56 and the suction port 57. For this reason, at least a part of the liquid ejected from the ejection port 56 collides with the collision surface 96 in the hollow portion 46. Thereby, a flow (arrow X1 in FIG. 14) in which at least a part of the liquid ejected from the ejection port 56 is directed from the collision surface 96 to the suction pipe 55 through the suction port 57 is formed in the hollow portion 46.
- the opening 47 is located at a position where the pipe axis S1 of the liquid supply pipe 53 passes through the collision surface 96 and the pipe axis S1 of the liquid supply pipe 53 does not pass through the distal end surface 92 of the treatment section. Yes. For this reason, it is possible to effectively prevent the suctioned material (such as crushed and emulsified biological tissue) that has flowed into the hollow portion 46 from flowing into the liquid supply conduit 53 from the jet port 56.
- the suctioned material such as crushed and emulsified biological tissue
- the opening portions (47; 47A, 47B; 47A to 47D) of the hollow portion 46 are provided on the treatment portion distal end surface 92, but this is not restrictive.
- an opening 97 where the hollow portion 46 opens to the outside may be provided on the treatment portion side surface 93.
- the treatment portion distal end surface 92 is not provided with an opening.
- the opening 97 is located at the distal end of the treatment portion 42, and in this modification, is located at a portion facing the closing direction of the jaw 43 (the direction of the arrow Y2 in FIG. 15).
- the opening 97 is located at a position other than the probe-side facing surface 95 on the treatment portion side surface 93. For this reason, the opening 47 is not blocked by the jaw 43. Therefore, the crushed and emulsified treatment target (aspirated material) can be appropriately sucked into the suction conduit 55 through the opening 47.
- the suction tube 52 extends outside the liquid feeding tube 51 and the liquid feeding tube 51 extends outside the suction tube 52 in the hollow portion 46.
- the jet outlet 56 at the distal end of the liquid feeding conduit 53 coincides with the base end of the opening 97 in the longitudinal direction parallel to the longitudinal axis C.
- the suction port 57 at the distal end of the suction conduit 55 is aligned with the proximal end of the opening 97 in the longitudinal direction. Note that the jet port 56 and the suction port 57 may be located on the probe base end direction side with respect to the base end of the opening 97.
- the probe distal wall 91 of the treatment section 42 is provided with a collision surface 96, the collision surface 96 faces the probe proximal end direction, and the entire ejection port 56 (at least one of the liquid supply conduits 53). Part).
- the collision surface 96 is located on the probe tip direction side from the ejection port 56 and the suction port 57. For this reason, in the hollow portion 46, at least a part of the liquid ejected from the ejection port 56 does not eject from the opening 97 to the outside of the probe 41 and collides with the collision surface 96. Thereby, a flow (arrow X1 in FIG. 15) in which at least a part of the liquid ejected from the ejection port 56 is directed from the collision surface 96 to the suction pipe 55 through the suction port 57 is formed in the hollow portion 46.
- the liquid is supplied through the liquid supply conduit 53 extending inside the hollow portion 46, and the liquid supplied from the ejection port 56 is ejected in the hollow portion 46.
- a part of the liquid ejected from the ejection port 56 is ejected from the hollow portion 46 to the outside of the probe 41 through the opening 97 positioned on the treatment portion side surface 93 (arrow X2 in FIG. 15).
- the opening 97 is located at a portion of the treatment portion 42 on the probe tip portion side (tip portion of the treatment portion side surface 93).
- the liquid supplied from the liquid supply source 76 does not drop, for example, from the proximal end portion of the treatment portion 42 to a portion other than the treatment target, and is appropriately applied to the vicinity of the treatment portion distal end surface 92 outside the probe 41. Supplied.
- two (plural) openings 97A and 97B may be provided on the treatment portion side surface 93 as shown in FIGS. Also in this modified example, as in the fifth modified example, no opening is provided in the treatment portion distal end surface 92. Also in this modified example, similarly to the fourth modified example and the fifth modified example, in the hollow portion 46, the suction tube 52 extends outside the liquid feeding tube 51, and the liquid feeding is performed outside the suction tube 52. A tube 51 is extended. The openings 97A and 97B are positioned at an angular position that is approximately 180 ° away from each other in the direction around the longitudinal axis C, and the positions of the openings 97A and 97B in the longitudinal direction coincide with each other.
- the jet outlet 56 at the distal end of the liquid supply conduit 53 is aligned with the proximal end of the opening 97A (the proximal end of the opening 97B) in the longitudinal direction parallel to the longitudinal axis C.
- the suction port 57 at the distal end of the suction conduit 55 is aligned with the proximal end of the opening 97A in the longitudinal direction. Note that the ejection port 56 and the suction port 57 may be located closer to the probe proximal end side than the proximal end of the opening 97A (the proximal end of the opening 97B).
- the openings 97A and 97B are located at positions different from the probe-side facing surface 95 on the treatment portion side surface 93. It should be noted that at least one of the openings 97A and 97B only needs to be located at a position different from the probe-side facing surface 95 on the treatment portion side surface 93. Thereby, at least one of the openings 97 ⁇ / b> A and 97 ⁇ / b> B is not blocked by the jaw 43.
- the upward direction perpendicular to the paper surface is the opening direction of the jaw 43.
- 17 shows a cross section passing through the openings 97A and 97B and perpendicular to the longitudinal axis C.
- the direction of the arrow Y1 is the opening direction of the jaw 43
- the direction of the arrow Y2 is the closing direction of the jaw 43. is there.
- a plurality of openings 97A and 97B are provided. For this reason, even when one of the openings 97A and 97B is clogged due to a crushed tissue or the like, the suction pipe passes through the other of the openings 97A and 97B (one that is not clogged in the openings 97A and 97B). The suction to the passage 55 is performed, and the liquid supplied through the liquid feeding conduit 53 is ejected to the outside of the probe 41.
- the opening (first opening) 97A the distance from the suction port 57 of the suction pipe 55 is smaller than the distance from the jet outlet 56 of the liquid supply pipe 53. That is, the suction port 57 is closer to the opening 97 ⁇ / b> A than the ejection port 56. Therefore, the suction force (arrow F1 in FIG. 16) from the outside of the probe 41 to the suction pipe 55 through the opening 97A and the suction port 57 is the suction force from the outside of the probe 41 to the suction pipe 55 through the opening 97B.
- the opening 97 ⁇ / b> A is mainly used as an opening through which a pulverized suction object such as a treatment target flows into the hollow portion 46.
- the opening (second opening) 97B the distance from the ejection port 56 of the liquid supply conduit 53 is smaller than the distance from the suction port 57 of the suction conduit 55. That is, the ejection port 56 is closer to the opening 97 ⁇ / b> B than the suction port 57.
- the opening 97 ⁇ / b> B is mainly used as an opening that ejects liquid to the outside of the probe 41 and supplies the liquid to the vicinity of the treatment portion distal end surface 92.
- the opening (outlet for ejecting liquid to the outside of the probe 41 (Second opening) 97B is provided.
- the openings 97A and 97B are located away from each other. For this reason, the supply performance of the liquid to the vicinity of the treatment portion distal end surface 92 is improved, and the suction performance through the suction conduit 55 is also improved.
- FIG. 18 as a seventh modification, four (plural) openings 97A to 97D may be provided on the treatment portion side surface 93. Also in this modified example, as in the fifth modified example, no opening is provided in the treatment portion distal end surface 92. Also in this modified example, similarly to the fourth modified example and the fifth modified example, in the hollow portion 46, the suction tube 52 extends outside the liquid feeding tube 51, and the liquid feeding is performed outside the suction tube 52. A tube 51 is extended. The positions in the longitudinal direction of the openings 97A to 97D are the same. Each of the openings 97A to 97D is located approximately 90 ° away from the adjacent openings (two corresponding ones of 97A to 97D) around the longitudinal axis C. In this modification, only the opening 97D is located on the probe side facing surface 95 facing the jaw 43, and the openings 97A to 97C are located on the treatment side surface 93 at positions different from the probe side facing surface 95. Yes.
- two (a plurality of) openings 97A and 97B are provided on the treatment section side surface 93, and the openings 97A and 97B are positioned away from each other in the longitudinal direction. May be.
- the opening (first opening) 97A is located closer to the probe tip than the opening (second opening) 97B.
- the suction port 57 is located closer to the opening 97 ⁇ / b> A than the ejection port 56, and the ejection port 56 is located closer to the opening 97 ⁇ / b> B than the suction port 57.
- the openings 97A and 97B are arranged approximately 180 ° apart from each other about the longitudinal axis C, but the openings 97A and 97B are angular positions separated from each other about the longitudinal axis C.
- the openings 97A and 97B may be disposed about 90 ° apart from each other about the longitudinal axis C.
- at least one of the openings 97 ⁇ / b> A and 97 ⁇ / b> B is located at a position other than the probe-side facing surface 95 on the treatment portion side surface 93.
- the outlet 56 of the liquid supply line 53 and the suction port 57 of the suction line 55 are aligned with the base end of the opening 97B in the longitudinal direction.
- the suction port 57 may be positioned at the proximal end of the opening (first opening) 97A in the longitudinal direction or positioned closer to the probe proximal end than the opening 97A.
- the spout 56 may be positioned at the proximal end of the opening (second opening) 97B in the longitudinal direction or positioned closer to the probe proximal end than the opening 97B.
- two openings 47A and 47B are provided on the treatment portion distal end surface 92, and two openings 97A and 97B are provided on the treatment portion side surface 93.
- the openings 47A and 47B have the same position and shape as in the first modification (see FIGS. 10 and 11) and are provided on the treatment portion distal end surface 92.
- the openings 97A and 97B are provided in the treatment portion side surface 93 at the same position and shape as in the sixth modification (see FIGS. 16 and 17).
- the liquid feeding tube 51 is inserted into the suction tube 52, and the pipe axis S1 of the liquid feeding pipe 53 is coaxial with the longitudinal axis C.
- the openings 47A and 47B are located at positions where the pipe axis S1 (longitudinal axis C) does not pass on the treatment portion distal end surface 92, and the pipe axis S1 is the collision surface 96. Pass through.
- the suction port 57 at the distal end of the suction conduit 55 is aligned with the base end of the opening 97A (the base end of the opening 97B) in the longitudinal direction or from the base end of the opening 97A. It is located on the probe base end direction side. Further, the jet outlet 56 at the distal end of the liquid feeding conduit 53 is located on the probe distal end side with respect to the opening 97A, and on the probe proximal end side with respect to the openings 47A and 47B. Therefore, in the present modification, the sucked material flows into the hollow portion 46 mainly from the openings 97A and 97B (arrow F1 in FIG. 20), and the liquid is mainly ejected from the openings 47A and 47B to the outside of the probe 41. (Arrow X2 in FIG. 20).
- an opening 47 is provided on the treatment portion distal end surface 92 and two openings 97A and 97B are provided on the treatment portion side surface 93.
- the opening 47 is provided on the distal end surface 92 of the treatment portion at the same position and shape as in the fourth modification (see FIG. 14).
- the openings 97A and 97B are provided in the treatment portion side surface 93 at the same position and shape as in the sixth modification (see FIGS. 16 and 17).
- the liquid feeding tube 51 extends outside the suction tube 52, and the suction tube 52 extends outside the liquid feeding tube 51.
- the opening 47 is located at a position where the pipe axis S1 of the liquid supply pipe line 53 does not pass on the treatment section distal end surface 92, and the pipe axis S1 has a collision surface 96. pass.
- both the liquid feeding tube 51 and the suction tube 52 are extended to the hollow portion 46, but this is not restrictive.
- a liquid feeding conduit 53 is formed between the outer peripheral surface of the suction tube 52 and the inner peripheral surface of the probe 41. Therefore, a jet port 56 of the liquid supply conduit 53 is formed on the outer peripheral side of the tip of the suction tube 52.
- the probe distal end wall 91 of the treatment section 42 is provided with a collision surface 96, and the collision surface 96 faces the probe proximal end direction and is at least a part of the ejection port 56 of the liquid supply conduit 53. It is opposite.
- a suction conduit 55 is formed between the outer peripheral surface of the liquid feeding tube 51 and the inner peripheral surface of the probe 41. Accordingly, a suction port 57 of the suction pipe 55 is formed on the outer peripheral side of the tip of the liquid feeding tube 51.
- the probe distal end wall 91 of the treatment section 42 is provided with a collision surface 96, and the collision surface 96 faces the probe proximal end direction and is at least a part of the ejection port 56 of the liquid supply conduit 53. It is opposite.
- the communication portion 101 ⁇ / b> A that communicates between the liquid supply conduit 53 and the suction conduit 55 on the probe base end direction side from the jet outlet 56 and the suction aperture 57. 101B is provided.
- the suction tube 52 is inserted into the liquid supply tube 51 as in the first embodiment.
- the opening part 47 is provided in the treatment part front end surface 92 by the position and shape similar to 1st Embodiment (refer FIG. 4).
- a part of the liquid supplied from the liquid feeding operation unit 77 flows from the liquid feeding line 53 to the suction line 55 through the communication parts 101A and 101B (see FIG. 24). Arrow X3).
- at least a part of the liquid supplied from the liquid supply operation unit 77 to the liquid supply line 53 does not flow into the suction line 55 from the communication parts 101 ⁇ / b> A and 101 ⁇ / b> B and is supplied to the jet port 56.
- the liquid supplied to the jet nozzle 56 is jetted from the jet nozzle 56 to the probe front-end
- the liquid supplied from the liquid supply operation unit 77 does not flow into the suction pipe 55 from the communication units 101A and 101B, and is discharged from the discharge port 56 in the hollow portion 46.
- the operation states of the unit 77 and the suction operation unit 82 are controlled by the control unit 18.
- At least a part of the liquid ejected from the ejection port 56 collides with the collision surface 96 as in the first embodiment. Accordingly, a flow (arrow X1 in FIG. 24) in which at least a part of the liquid ejected from the ejection port 56 is directed from the collision surface 96 to the suction pipe 55 through the suction port 57 is formed in the hollow portion 46. A part of the liquid ejected from the ejection port 56 does not collide with the collision surface 96 and is ejected from the opening 47 to the outside of the probe 41 (arrow X2 in FIG. 24).
- the liquid flows from the liquid supply line 53 to the suction line 55 through the communication portions 101A and 101B. For this reason, the liquid amount of the liquid flowing toward the probe proximal end portion in the suction conduit 55 increases. As a result, the viscosity of the aspirated material (crushed living tissue or the like) is lowered, and clogging is less likely to occur in the suction line 55. Further, at least a part of the liquid supplied through the liquid supply conduit 53 is supplied to the ejection port 56 and ejected from the ejection port 56 in the hollow portion 46. At least a part of the liquid ejected from the ejection port 56 collides with the collision surface 96 and flows into the suction conduit 55 through the suction port 57.
- the liquid flows toward the probe proximal end in the region between the suction port 57 and the communication portions 101A and 101B. Accordingly, even in the present modified example in which the communication portions 101A and 101B are provided, clogging is effectively prevented in the region between the suction port 57 of the suction pipe 55 and the communication portions 101A and 101B.
- the communication portion 101 ⁇ / b> A that communicates between the liquid supply conduit 53 and the suction conduit 55 on the probe base end direction side from the jet outlet 56 and the suction opening 57. , 101B.
- the liquid feeding tube 51 is inserted into the suction tube 52 as in the first modification.
- the openings 47A and 47B are provided on the distal end surface 92 of the treatment section at the same position and shape as in the first modification (see FIGS. 10 and 11).
- a part of the liquid supplied from the liquid feeding operation unit 77 passes through the communicating parts 101A and 101B from the liquid feeding line 53 to the suction line. 55 (arrow X3 in FIG. 25).
- at least a part of the liquid supplied from the liquid supply operation unit 77 to the liquid supply line 53 does not flow into the suction line 55 from the communication parts 101 ⁇ / b> A and 101 ⁇ / b> B and is supplied to the jet port 56.
- the liquid supplied to the jet nozzle 56 is jetted from the jet nozzle 56 to the probe front-end
- At least a part of the liquid ejected from the ejection port 56 collides with the collision surface 96 as in the thirteenth modification.
- a flow (arrow X1 in FIG. 25) in which at least a part of the liquid ejected from the ejection port 56 is directed from the collision surface 96 to the suction pipe 55 through the suction port 57 is formed in the hollow portion 46.
- a part of the liquid ejected from the ejection port 56 does not collide with the collision surface 96 and is ejected to the outside of the probe 41 from the openings 47A and 47B (arrow X2 in FIG. 25).
- the liquid supply line 53 and the suction line 55 are located closer to the probe proximal end side than the jet port 56 and the suction port 57.
- the suction tube 52 may be provided with communication portions (101A, 101B) that communicate with each other.
- the liquid supply line 53 and the suction line are located on the probe base end direction side from the jet port 56 and the suction port 57.
- the liquid feeding tube 51 may be provided with communication portions (101 ⁇ / b> A, 101 ⁇ / b> B) that allow communication with the liquid supply tube 55.
- the collision surface 96 is provided on the probe tip wall 91 of the probe 41 (treatment section 42).
- the present invention is not limited to this.
- a protrusion 102 is provided on the probe base end direction side of the probe 41 toward the inner peripheral side of the probe 41, and a collision surface 96 is formed on the protrusion 102. May be formed.
- the collision surface 96 faces the probe proximal end direction and faces at least a part of the ejection port 56 of the liquid supply conduit 53.
- an external liquid supply tube 103 may be extended outside the probe 41 from the probe proximal end direction toward the probe distal end portion.
- An external liquid feed pipe 105 is formed inside the external liquid feed tube 103. Therefore, the external liquid supply conduit 105 extends from the probe proximal end direction toward the probe distal end portion through the outside of the probe 41.
- the distal end of the external liquid supply pipe 105 is formed by an external jet 107 located outside the probe 41.
- the external jet 107 is located on the probe side facing surface 95 of the treatment portion side surface 93 of the treatment portion 42. Therefore, the external ejection port 107 is located closer to the probe distal end side than the distal end of the sheath 40.
- the external liquid supply conduit 105 (external liquid supply tube 103) extends between the outer peripheral surface of the probe 41 and the inner peripheral surface of the sheath 40 and extends toward the inside of the holding unit 3 toward the probe proximal end.
- one end of an external liquid supply tube (not shown) different from the external liquid supply tube 73 can be connected to the holding unit 3.
- the base end (one end) of the external liquid feeding line 105 communicates with the inside of the external liquid feeding tube.
- a liquid supply source (not shown) is provided in the energy treatment system 1 separately from the liquid supply source 76.
- the other end of the external liquid supply tube is connected to a liquid supply source.
- the liquid supply source is provided with a liquid supply operation unit (not shown) such as a liquid supply pump and a liquid storage tank (not shown).
- the operating state of the part is controlled.
- a liquid such as physiological saline stored in the liquid storage tank is supplied (liquid feeding) to the external liquid feeding conduit 105 through the inside of the external liquid feeding tube.
- the liquid is supplied from the probe proximal end direction toward the probe distal end portion.
- the liquid supplied from the external ejection port 107 toward the probe distal end side is ejected, and the liquid is supplied in the vicinity of the treatment section distal end surface 92.
- the external jet 107 is located on the probe-side facing surface 95. For this reason, by closing the jaw 43 with respect to the treatment portion 42, the ejection speed of the liquid ejected from the external ejection port 107 increases. For this reason, the liquid supplied from the liquid supply source does not drip, for example, from the base end of the treatment section 42 to a portion other than the treatment target, and is appropriately supplied to the vicinity of the treatment section distal end surface 92 outside the probe 41. Is done.
- the suction tube 52 is inserted into the liquid feeding tube 51 as in the first embodiment.
- the opening part 47 is provided in the treatment part front end surface 92 similarly to 1st Embodiment. Therefore, as in the first embodiment, the collision surface 96 provided on the probe distal end wall 91 faces at least a part of the ejection port 56.
- a part of the liquid ejected from the ejection port 56 collides with the collision surface 96 in the hollow portion 46. Thereby, a flow (arrow X1 in FIG.
- a part of the liquid ejected from the ejection port 56 of the liquid feeding pipe 53 is the opening (47; 47A, 47B; 47A to 47D; 97; 97A, 97B; 97A to 97D; 47, 97A, 97B; 47A, 47B, 97A, 97B) and ejected to the outside of the probe 41 and supplied to the vicinity of the treatment portion distal end surface 92, but is not limited thereto.
- the liquid ejected from the ejection port 56 is not ejected to the outside of the probe 41 through the opening 47.
- the liquid used for the treatment is treated outside the probe 41 separately from the liquid feeding conduit 53 that supplies the liquid that flows into the suction conduit 55 from the suction port 57.
- An external liquid supply pipe 105 is provided in the vicinity of the front end surface 92 of the head.
- all of the liquid ejected from the ejection port 56 collides with the collision surface 96. Accordingly, a flow (arrow X1 in FIG. 28) in which all of the liquid ejected from the ejection port 56 is directed from the collision surface 96 to the suction conduit 55 through the suction port 57 is formed in the hollow portion 46.
- the liquid supply pipe 53 supplies only the liquid that flows into the suction pipe 55 from the suction port 57, and separately from the liquid supply pipe 53, the liquid used for the treatment is treated outside the probe 41.
- An external liquid supply pipe 105 is provided in the vicinity of the front end surface 92 of the head. Therefore, by controlling the operating state of the liquid feeding operation unit 77 that supplies the liquid to the liquid feeding line 53 and the operating state of the liquid feeding unit (not shown) that supplies the liquid to the external liquid feeding line 105. Even in a treatment in which liquid (physiological saline) is not used, it is possible to allow liquid to flow from the suction port 57 in the suction conduit 55.
- the probe 41 transmits ultrasonic vibration
- the treatment unit 42 and the jaw 43 are electrically connected.
- the liquid feeding operation unit 77 that supplies liquid to the liquid feeding line 53 and the liquid feeding operation part that supplies liquid to the external liquid feeding line 105. Stop.
- no liquid is ejected from the external ejection port 107, and all of the liquid ejected from the ejection port 56 collides with the collision surface 96 and flows into the suction pipe 55 through the suction port 57. Therefore, the treatment performance of the treatment for incising the treatment object while coagulating is not reduced due to the liquid outside the probe 41, and the occurrence of clogging in the suction line 55 is prevented.
- FIG. 29 shows an example of changes over time in the presence / absence of input of energy operation at the energy operation input unit (9A to 9C, 10), the operation state of the liquid feeding operation unit 77, and the operation state of the suction operation unit 82.
- a change in the input of the energy operation is indicated by a solid line
- a change in the operation state of the liquid feeding operation unit 77 is indicated by a broken line
- a change in the operation state of the suction operation unit 82 is indicated by a one-dot chain line.
- an energy operation in the energy operation unit (one of 9A to 9C, 10) is input between time t1 and time t2 (energy operation input ON state).
- the output mode (1 of the first output mode to the fourth output mode) described in the first embodiment is used.
- the energy used for the treatment is output from the energy source unit 15, and the operation state of the liquid feeding operation unit 77 and the operation state of the suction operation unit 82 are controlled as described above in the first embodiment.
- the liquid supply operation unit 77 is automatically operated and the liquid is supplied through the liquid supply line 53. (Liquid feeding operation unit 77 is turned on). Then, at the time t3 when the predetermined time ⁇ W1 has elapsed from the time t2 when the operation of the liquid supply operation unit 77 is started (that is, the supply of the liquid from the liquid supply source 76 is started), the suction operation unit 82 is automatically (The suction operation unit 82 is turned on).
- the liquid feeding operation unit 77 and the suction operation unit 82 By operating the liquid feeding operation unit 77 and the suction operation unit 82, at least a part of the liquid ejected from the ejection port 56 collides with the collision surface 96 in the hollow portion 46 as described above. Thereby, a flow in which at least a part of the liquid ejected from the ejection port 56 is directed from the collision surface 96 to the suction pipe 55 through the suction port 57 is formed in the hollow portion 46. Then, the liquid feeding operation unit 77 is stopped after a certain time ⁇ W2 has elapsed from the time t2 (that is, after the operation of the liquid feeding operation unit 77 is started) (the liquid feeding operation unit 77 is turned off). .
- the suction operation unit 82 is stopped after a certain time ⁇ W2 has elapsed from time t3 (that is, after the operation of the suction operation unit 82 is started) (the suction operation unit 82 is turned off). For this reason, the operation of the suction operation unit 82 is stopped after a predetermined time ⁇ W1 has elapsed since the operation of the liquid feeding operation unit 77 was stopped.
- the liquid feeding operation unit 77 and the suction operation unit 82 by controlling the liquid feeding operation unit 77 and the suction operation unit 82, occurrence of clogging in the suction line 55 is more effectively prevented in the treatment using energy. Even when the liquid feeding operation or suction operation described in the first embodiment is input between time t1 and time t2 instead of the energy operation, after time t2 (that is, liquid feeding operation or suction). After the input of the operation is stopped), the operation state of the liquid feeding operation unit 77 and the operation state of the suction operation unit 82 may be controlled with time as described above in the present modification.
- the treatment target can be grasped between the jaw 43 and the treatment unit 42 by the energy treatment instrument 2, but the present invention is not limited to this.
- the jaw 43 may not be provided.
- the holding unit 3 is not provided with the fixed handle 6, the movable handle 7, and the rotation operation knob 8.
- a treatment for incising the treatment target grasped between the jaw 43 and the treatment unit 42 while coagulating by ultrasonic vibration is not performed.
- the probe 41 transmits ultrasonic vibration as energy used for the treatment.
- the treatment target is crushed and emulsified by cavitation as described above, and the crushed and emulsified treatment subject is sucked through the suction conduit 55.
- the probe 41 may not transmit ultrasonic vibration, and only high frequency power may be supplied to the treatment unit 42 through the probe 41 as energy.
- the probe 41 may not transmit ultrasonic vibration, and only high frequency power may be supplied to the treatment unit 42 through the probe 41 as energy.
- the high frequency power is supplied to the treatment unit 42
- a high frequency current is supplied to the treatment target, and the treatment target is excised with the high frequency current.
- the excised treatment target is sucked through the suction pipe 55 extending in the hollow portion 46 of the probe 41.
- the treatment section 42 may be provided with a heat generator (not shown) such as a thermocouple, and power may be supplied to the heat generator through the probe 41.
- a heat generator such as a thermocouple
- heat used for treatment is generated in the heat generator.
- the treatment target is excised using the generated heat, and the excised treatment target is sucked through the suction conduit 55 extending in the hollow portion 46 of the probe 41.
- a probe bending portion that bends in a certain direction intersecting the straight longitudinal axis C may be provided in the treatment portion 42 (probe tip portion) of the probe 41. Also in this case, in the same manner as in the above-described embodiment, the liquid supply pipe 53 and the suction pipe 55 are extended in the hollow portion 46 inside the probe 41, and a collision surface 96 is formed on the probe 41. .
- the probe (41) extends along the longitudinal axis (C) and can transmit energy. Further, the probe (41) includes a treatment portion (42) for performing treatment using the transmitted energy at the distal end portion, and the probe (41) has a hollow portion (46) along the longitudinal axis (C). ) Is formed.
- the hollow portion (46) has openings (47; 47A, 47B; 47A to 47D; 97; 97A, 97B; 97A to 97D; 47, 97A, 97B; 47A, 47B, 97A on the outer surface of the treatment portion (42). 97B) is open to the outside of the probe (41).
- a liquid supply conduit (53) and a suction conduit (55) are extended from the probe proximal end direction toward the probe distal end portion.
- the tip of the suction pipe (55) is formed by the suction port (57) located in the hollow part (46), and the liquid feed pipe (53) is formed by the jet outlet (56) located in the hollow part (46).
- a tip is formed.
- the probe (41) is provided with a collision surface (96) so as to face at least a part of the jet port (56). The collision surface (96) is located closer to the probe tip than the suction port (57) and the jet port (56).
- the number of openings (47; 47A, 47B; 47A to 47D; 97; 97A, 97B; 97A to 97D; 47, 97A, 97B; 47A, 47B, 97A, 97B)
- the shape, the extended state of the liquid feeding pipe (53) and the suction pipe (55) in the hollow portion (46), and the like can be changed as appropriate.
- FIG. 30 is a diagram showing the configuration of the probe 41 and the probe holder 117 to which the probe 41 is fixed.
- the probe 41 includes a distal probe 112 and a proximal probe 113 connected to the probe proximal portion direction side of the distal probe 112.
- the process of forming a hole penetrating along the longitudinal direction in an elongated columnar member requires labor and labor.
- the hollow part 46 which penetrates the probe 41 along the longitudinal axis C is formed inside by connecting two members (for example, the front end side probe 112 and the base end side probe 113) by screwing etc. Even in this case, labor and labor for manufacturing the probe 41 are reduced.
- FIG. 31 shows a cross section perpendicular to the longitudinal axis C of the treatment portion 42.
- the shape surrounded by the outer surface is a substantially pentagonal shape and is not point-symmetric about the longitudinal axis C. (Asymptotic).
- proximal end probe 113 is provided with a flange portion 115.
- a probe stopper member 116 is fixed to the flange portion 115.
- the sheath 40 is provided with a probe holder 117.
- the probe 41 is attached to the sheath 40 by fixing the probe stopper 116 to the probe holder 117.
- FIG. 32 shows a cross section perpendicular to the longitudinal axis C passing through the flange portion 115 and the probe holder 117 of the probe 41.
- an engagement outer peripheral surface 118 is formed by the outer peripheral surface of the flange portion 115.
- the shape surrounded by the engagement outer peripheral surface 118 of the flange portion 115 is not point-symmetrical (non-point-symmetrical) about the longitudinal axis C. That is, the engagement outer peripheral surface 118 of the flange portion 115 is formed asymmetric with respect to the longitudinal axis C.
- the angular position of the engagement outer peripheral surface 118 (flange portion 115) with respect to the treatment portion 42 about the longitudinal axis C is a product due to a design error or the like. Different for each.
- the engagement outer peripheral surface 118 is positioned at an angular position indicated by a solid line in FIG. 32 around the longitudinal axis C with respect to the treatment portion 42 at an angular position shown in FIG.
- the flange portion 115 is positioned at an angular position indicated by a broken line in FIG. 32 about the longitudinal axis C with respect to the treatment portion 42 at an angular position shown in FIG.
- an engagement inner peripheral surface 119 that engages with the engagement outer peripheral surface 118 is formed by the inner peripheral surface of the probe stopper member 116.
- the probe stopper member 116 is fixed to the probe 41 (proximal end side probe 113).
- the engagement inner peripheral surface 119 is formed in a shape corresponding to the engagement outer peripheral surface 118 (a shape that can be engaged with the engagement outer peripheral surface 118).
- the shape surrounded by the engagement inner peripheral surface 119 of the probe stopper member 116 is not point-symmetrical (non-point-symmetrical) about the longitudinal axis C. That is, the engagement inner peripheral surface 119 of the probe stopper member 116 is formed asymmetric with respect to the longitudinal axis C.
- the probe stopper member 116 When the probe stopper member 116 is fixed to the flange portion 115 of the probe 41, the probe stopper member 116 can be engaged with the engagement outer peripheral surface 118 in accordance with the angular position of the engagement outer peripheral surface 118 about the longitudinal axis C.
- the angular position about the longitudinal axis C of the engagement inner peripheral surface 119 is adjusted. Further, as described above, the angular position of the engagement outer peripheral surface 118 (flange portion 115) with respect to the treatment portion 42 about the longitudinal axis C differs for each product. Therefore, the angular position of the engagement inner peripheral surface 119 with respect to the treatment portion 42 about the longitudinal axis C varies from product to product.
- an uneven outer peripheral surface 121 is formed on the outer peripheral surface of the probe stopper member 116 over the entire circumference around the longitudinal axis C.
- the shape surrounded by the irregular outer peripheral surface 121 of the probe stopper 116 is point-symmetric about the longitudinal axis C. That is, the uneven outer peripheral surface 121 of the probe stopper member 116 is formed point-symmetrically about the longitudinal axis C. For this reason, even if the angular position of the engagement inner peripheral surface 119 (probe stop member 116) changes about the longitudinal axis C, the cross-sectional shape perpendicular to the longitudinal axis C of the uneven outer peripheral surface 121 does not change.
- the probe holder 117 includes holder forming members 122A and 122B.
- an uneven inner peripheral surface 123 is formed on the inner peripheral surface of the probe holder 117 over the entire circumference about the longitudinal axis C.
- the uneven inner peripheral surface 123 is formed in a shape corresponding to the uneven outer peripheral surface 121 (a shape that can be engaged with the uneven outer peripheral surface 121).
- the shape surrounded by the uneven inner circumferential surface 123 of the probe holder 117 is point-symmetric about the longitudinal axis C. That is, the uneven inner circumferential surface 123 of the probe holder 117 is formed point-symmetrically with respect to the longitudinal axis C.
- the uneven outer peripheral surface 121 and the uneven inner peripheral surface 123 are point-symmetric about the longitudinal axis C. For this reason, by attaching the holder forming members 122A and 122B to the probe stopper member 116, the concave and convex outer peripheral surface 121 has a concave and convex inner surface regardless of the angular position of the engagement inner peripheral surface 119 (probe stopper member 116).
- the peripheral surface 123 engages. That is, the probe holder 117 is fixed to the probe holding member 116 without adjusting the angular position of the uneven inner peripheral surface 123 with respect to the uneven outer peripheral surface 121 around the longitudinal axis C.
- the flange portion 115 is engaged with the treatment portion 42 positioned at a predetermined angular position about the longitudinal axis C.
- the engagement inner peripheral surface 119 of the probe stopper member 116 is engaged with the combined outer peripheral surface 118.
- the angular positions of the engaging outer peripheral surface 118 and the engaging inner peripheral surface 119 around the longitudinal axis C differ for each product, but the angle of the engaging inner peripheral surface 119 (probe stop member 116) around the longitudinal axis C is different.
- the uneven inner peripheral surface 123 engages with the uneven outer peripheral surface 121. For this reason, even when the angular positions of the engaging outer peripheral surface 118 and the engaging inner peripheral surface 119 about the longitudinal axis C are different for each product, the probe holder 117 is easily fixed to the probe fixing member 116.
- the probe stopper member 116 in a state where the probe stopper member 116 is fixed to the probe 41, the probe stopper member 116 is processed in accordance with the angular position of the probe stopper member 116 (flange 115) about the longitudinal axis C. do not have to.
- the probe stopper member in the configuration in which the probe holder (117) is fixed to the probe stopper member (116) with a fixing screw, the probe stopper member (about the longitudinal axis C) in a state where the probe stopper member (116) is fixed to the probe (41). 116) It is necessary to form a screw hole in the probe fixing member (116) corresponding to the angular position of 116).
- the probe 41 can be easily attached (fixed) to the probe holder 117 (sheath 40) in a state where the treatment portion 42 is located at a predetermined angular position about the longitudinal axis C.
- the uneven outer peripheral surface 121 of the probe stopper 116 and the uneven inner peripheral surface 123 of the probe holder 117 are engaged over the entire circumference about the longitudinal axis C. For this reason, the probe 41 is firmly fixed to the probe holder 117. Therefore, the strength of the probe 41 and the probe holder 117 is ensured.
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Abstract
Description
本発明の第1の実施形態について、図1乃至図9を参照して説明する。
第1の実施形態では、送液管路53は、吸引管路55の外周側を囲む筒状に長手軸Cに垂直な断面が形成されているが、これに限るものではない。また、第1の実施形態では、中空部46の開口部47は、1つのみ設けられるが、これに限るものではない。例えば、第1の変形例を、図10及び図11を参照して説明する。図10は、本変形例の処置部42及び管路ユニット50の先端部の構成を示し、図11は、処置部42の処置部先端面92の構成を示している。
口57は、長手方向について開口部97の基端と位置が一致している。なお、噴出口56及び吸引口57は、開口部97の基端よりプローブ基端部方向側に位置してもよい。
以下、参照例について図30乃至図32を参照にして説明する。図30は、プローブ41及びプローブ41が固定されるプローブホルダ117の構成を示す図である。図30に示すように、本参照例では、プローブ41は、先端側プローブ112と、先端側プローブ112のプローブ基端部方向側に接続される基端側プローブ113と、を備える。細長い柱状の部材に長手方向に沿って貫通する孔を形成する加工は手間及び労力を要する。このため、2つの部材(例えば、先端側プローブ112及び基端側プローブ113)を螺合等によって接続することにより、長手軸Cに沿ってプローブ41を貫通する中空部46が内部に形成される場合でも、プローブ41を製造する手間及び労力が削減される。
Claims (20)
- プローブ先端部及びプローブ基端部を備え、長手軸に沿って延設されるとともに、内部に前記長手軸に沿って中空部が形成され、前記プローブ基端部から前記プローブ先端部に向かってエネルギーを伝達可能なプローブと、
前記プローブの前記プローブ先端部に設けられるとともに、前記中空部が前記プローブの外部に対して開口する開口部が外表面に形成され、前記プローブを通して伝達された前記エネルギーを用いて処置を行う処置部と、
前記中空部を通ってプローブ基端部方向からプローブ先端部方向へ延設されるとともに、前記中空部に位置する吸引口が先端に形成され、前記吸引口から前記プローブ基端部方向へ向かう吸引力が発生する吸引管路と、
前記中空部を通って前記プローブ基端部方向から前記プローブ先端部方向へ延設されるとともに、前記中空部に位置する噴出口が先端に形成され、前記噴出口からプローブ先端部方向側に向かって液体を噴出する送液管路と、
前記噴出口の少なくとも一部に対して対向する状態で前記プローブに設けられるとともに、前記吸引口及び前記噴出口より前記プローブ先端部方向側に位置し、前記中空部において前記噴出口から噴出された前記液体の少なくとも一部が衝突する衝突面と、
を具備するエネルギー処置ユニット。 - 前記噴出口から噴出された前記液体の一部は、前記中空部から前記開口部を通して、前記プローブの前記外部に噴出される、請求項1のエネルギー処置ユニット。
- 前記処置部の前記外表面は、前記プローブの先端を形成する処置部先端面と、前記処置部先端面から前記プローブ基端部方向へ向かって延設される処置部側面と、を備え、
前記中空部の前記開口部は、前記処置部側面に位置する、
請求項2のエネルギー処置ユニット。 - 請求項3のエネルギー処置ユニットと、
前記処置部が前記プローブ先端部方向へ向かって突出する状態で前記プローブが挿通されるシースと、
前記シースに回動可能に取付けられ、前記シースに対して回動することにより、前記プローブの前記処置部に対して開動作又は閉動作するジョーと、
を具備し、
前記処置部の前記処置部側面は、前記ジョーに対して対向し、前記ジョーの開方向を向くプローブ側対向面を備え、
前記中空部の前記開口部は、前記処置部の前記処置部側面において前記プローブ側対向面以外の位置に位置する、
エネルギー処置具。 - 前記開口部は、前記処置部側面に形成される複数の開口部であり、
前記開口部の1つである第1の開口部では、前記吸引管路の前記吸引口からの距離が、前記送液管路の前記噴出口からの距離に比べて、小さくなり、
前記開口部の中で前記第1の開口部とは別の1つである第2の開口部では、前記送液管路の前記噴出口からの距離が、前記吸引管路の前記吸引口からの距離に比べて、小さくなる、
請求項3のエネルギー処置ユニット。 - 前記第1の開口部及び前記第2の開口部は、前記長手軸に平行な長手方向について、互いに対して離れて位置している、請求項5のエネルギー処置ユニット。
- 前記第1の開口部及び前記第2の開口部は、長手軸回り方向について、互いに対して離れた角度位置に位置している、請求項5のエネルギー処置ユニット。
- 前記処置部の前記外表面は、前記プローブの先端を形成する処置部先端面と、前記処置部先端面から前記プローブ基端部方向へ向かって延設される処置部側面と、を備え、
前記中空部の前記開口部は、前記処置部先端面に位置する、
請求項2のエネルギー処置ユニット。 - 前記送液管路の中心軸となる管路軸は、前記衝突面を通過し、
前記開口部は、前記処置部先端面において前記管路軸が通過しない位置に、位置している、
請求項8のエネルギー処置ユニット。 - 前記送液管路の前記管路軸は、前記プローブの前記長手軸と同軸であり、
前記開口部は、前記処置部先端面において前記長手軸が通過しない位置に、位置している、
請求項9のエネルギー処置ユニット。 - 前記吸引口及び前記噴出口よりプローブ基端部方向側で前記送液管路と前記吸引管路との間を連通させる連通部をさらに具備し、
前記送液管路を通過する前記液体の少なくとも一部は、前記連通部から前記吸引管路に流入せず、前記噴出口に供給される、
請求項1のエネルギー処置ユニット。 - 前記吸引管路は、前記送液管路の外周側を囲む筒状に前記長手軸に垂直な断面が形成され、
前記送液管路の前記噴出口は、前記吸引管路の前記吸引口より前記プローブ先端部方向側に位置する、
請求項1のエネルギー処置ユニット。 - 前記送液管路は、前記吸引管路の外周側を囲む筒状に前記長手軸に垂直な断面が形成され、
前記吸引管路の前記吸引口は、前記送液管路の前記噴出口より前記プローブ先端部方向側に位置する、
請求項1のエネルギー処置ユニット。 - 前記送液管路の前記噴出口は、前記長手軸に平行な長手方向についての位置が前記中空部の前記開口部と一致するか、又は、前記開口部よりプローブ基端部方向側に位置し、
前記吸引管路の前記吸引口は、前記長手方向についての位置が前記中空部の前記開口部と一致するか、又は、前記開口部より前記プローブ基端部方向側に位置する、
請求項1のエネルギー処置ユニット。 - 請求項1のエネルギー処置ユニットと、
前記処置部が前記プローブ先端部方向へ向かって突出する状態で前記プローブが挿通されるシースと、
前記シースのプローブ基端部方向側に連結される保持ユニットであって、前記プローブは、前記保持ユニットの内部から前記シースの内部を通って前記プローブ先端部方向へ向かって延設される保持ユニットと、
を具備するエネルギー処置具。 - 前記保持ユニットの内部において前記送液管路及び前記吸引管路を前記プローブ基端部方向側から前記プローブの前記中空部に挿入することにより、前記送液管路及び前記吸引管路を前記プローブ及び前記保持ユニットに対して取外し可能に連結する管路着脱部をさらに具備する、請求項15のエネルギー処置具。
- 前記プローブの前記外部を通って前記プローブ基端部方向から前記プローブ先端部方向へ延設され、前記プローブの前記外部に位置する外部噴出口が先端に形成され、供給された液体を前記外部噴出口から前記プローブ先端部方向側に向かって噴出する外部送液管路をさらに具備する、請求項1のエネルギー処置ユニット。
- 請求項17のエネルギー処置ユニットと、
前記処置部が前記プローブ先端部方向へ向かって突出する状態で前記プローブが挿通されるシースと、
前記シースに回動可能に取付けられ、前記シースに対して回動することにより、前記プローブの前記処置部に対して開動作又は閉動作するジョーと、
を具備し、
前記処置部の前記外表面は、前記ジョーに対して対向し、前記ジョーの開方向を向くプローブ側対向面を備え、
前記外部送液管路は、前記プローブと前記シースとの間を通って延設され、
前記外部送液管路の前記外部噴出口は、前記シースの先端より前記プローブ先端部方向側で、かつ、前記プローブ側対向面上に位置する、
エネルギー処置具。 - 請求項1のエネルギー処置ユニットと、
前記処置部での前記処置に用いられる前記エネルギーを出力し、出力された前記エネルギーが前記プローブを通して前記処置部に伝達されるエネルギー源ユニットと、
を具備する、エネルギー処置システム。 - 電力が供給されることにより超音波振動を発生する振動発生部をさらに具備し、
前記エネルギー源ユニットは、前記エネルギーとして前記振動発生部に供給される電力を出力する超音波エネルギー源を備え、
前記プローブは、前記振動発生部で発生した前記超音波振動を前記プローブ基端部方向から前記プローブ先端部方向へ伝達し、
前記処置部は、伝達された前記超音波振動を用いて、前記処置を行う、
請求項19のエネルギー処置システム。
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EP15810613.8A EP3158959A4 (en) | 2014-06-19 | 2015-04-28 | Energy treatment unit, energy treatment instrument, and energy treatment system |
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CN109152602A (zh) * | 2016-05-25 | 2019-01-04 | 奥林巴斯株式会社 | 送液器具、处置器具单元和处置系统 |
EP3225201B1 (en) * | 2016-03-29 | 2021-08-25 | Covidien LP | Device for cooling a surgical instrument |
JP7462616B2 (ja) | 2018-09-28 | 2024-04-05 | コーニンクレッカ フィリップス エヌ ヴェ | 体腔から生物学的物質を吸引するためのシステム、デバイス及び方法 |
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US10478211B2 (en) * | 2017-07-07 | 2019-11-19 | Ethicon Llc | Features to promote removal of debris from within ultrasonic surgical instrument |
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JP6022128B2 (ja) | 2016-11-09 |
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