WO2017122286A1 - Energy treatment tool - Google Patents

Abstract

This energy treatment tool is provided with: a first jaw 8 having a first gripping surface 821; a second jaw 8' having a second gripping surface 821'; a first electrode 83 provided to the first jaw 8 so as to sandwich a first central region Ar1 of the first gripping surface 821; a second electrode 83' provided to the second jaw 8' so as to sandwich a second central region Ar1' of the second gripping surface 821'; first and second cooling members 85, 85' which are in contact with the first and second electrodes 83, 83', respectively, and cool the same; and first and second thermal resistance members 84, 84' which constitute the first and second central regions Ar1, Ar1', respectively, and which have a higher thermal resistance with respect to a biological tissue than the first and second electrodes 83, 83'.

Description

Energy treatment tool

The present invention relates to an energy treatment device.

2. Description of the Related Art Conventionally, there is known an energy treatment device that treats biological tissues (joining (or anastomosis), cutting, etc.) by applying energy to the biological tissues (for example, see Patent Document 1).
The energy treatment tool described in Patent Literature 1 includes a pair of jaws that grip biological tissue. Each of the pair of jaws is provided with electrodes to which high-frequency power is supplied. In the energy treatment instrument, the living tissue is treated by holding the living tissue with a pair of jaws and supplying high frequency power to each electrode to generate Joule heat inside the living tissue.
Moreover, in the energy treatment tool described in Patent Document 1, in order to cool each electrode, a coolant line for circulating a cooling medium is provided inside each electrode.

JP 2007-37932 A (FIG. 11)

By the way, when the treatment of the living tissue is performed by applying energy, the treatment target tissue in the living tissue (the tissue grasped by the pair of jaws) and the surrounding tissue of the treatment target tissue due to heat conduction from each electrode. In addition, there is a possibility that the influence of heat may be exerted and the natural healing ability of the tissue around the tissue to be treated may be reduced.
In the energy treatment device described in Patent Document 1, it is possible to reduce the influence of heat on the surrounding tissue of the treatment target tissue in the living tissue by flowing the cooling medium through the coolant line and cooling each electrode. is there.
However, the pair of jaws is small, and the thickness dimension of the living tissue is also small. For this reason, the contribution of heat transfer by cooling cannot be ignored. That is, when each electrode is cooled by circulating a cooling medium through a coolant line as in the energy treatment device described in Patent Document 1, the heat generation part and the cooling part are close to each other. There is a problem that the tissue is also immediately cooled, and the temperature increase necessary for the treatment cannot be performed immediately.
Therefore, there is a demand for a technique that can appropriately treat a tissue to be treated while reducing the influence of heat on the tissue around the tissue to be treated in the living tissue.

The present invention has been made in view of the above, and an energy treatment device capable of appropriately treating a treatment target tissue while reducing the influence of heat on the tissue around the treatment target tissue in a living tissue. The purpose is to provide.

In order to solve the above-described problems and achieve the object, an energy treatment device according to the present invention includes a second jaw for grasping a living tissue between a first jaw having a first grasping surface and the first grasping surface. A second jaw having a gripping surface; a first electrode provided on the first jaw across the first central region of the first gripping surface; and the second jaw sandwiching a second central region of the second gripping surface. A second electrode provided on the jaw; and at least one of the first jaw and the second jaw; and the electrode in contact with at least one of the first electrode and the second electrode A cooling member for cooling the at least one jaw of the first jaw and the second jaw, constituting at least one of the first central region and the second central region, Electrode and second electrode Comprising a remote thermal resistance high thermal resistance portion to the biological tissue, a.

The energy treatment device according to the present invention produces an effect that the treatment target tissue can be appropriately treated while reducing the influence of heat on the tissue around the treatment target tissue in the living tissue.

FIG. 1 is a diagram showing an energy treatment system according to Embodiment 1 of the present invention. FIG. 2 is an enlarged view of the distal end portion of the energy treatment device shown in FIG. FIG. 3 is a diagram illustrating the gripping unit illustrated in FIG. 2. FIG. 4 is a diagram illustrating the grip portion illustrated in FIG. 2. FIG. 5 is a cross-sectional view illustrating a configuration of the first cooling member illustrated in FIG. 4. FIG. 6 is a diagram for explaining the operation of the energy treatment system shown in FIG. FIG. 7 is a diagram showing a first jaw constituting the energy treatment system (energy treatment tool) according to Embodiment 2 of the present invention. FIG. 8 is a diagram showing a first jaw constituting an energy treatment system (energy treatment tool) according to Embodiment 3 of the present invention. FIG. 9 is a view showing a first jaw constituting an energy treatment system (energy treatment tool) according to Embodiment 4 of the present invention. FIG. 10 is a view showing a first jaw constituting an energy treatment system (energy treatment tool) according to Embodiment 5 of the present invention. FIG. 11 is a diagram showing a first jaw constituting an energy treatment system (energy treatment tool) according to Embodiment 6 of the present invention. FIG. 12A is a diagram showing a first jaw constituting an energy treatment system (energy treatment tool) according to Embodiment 7 of the present invention. FIG. 12B is a diagram showing a first jaw constituting the energy treatment system (energy treatment device) according to Embodiment 7 of the present invention. FIG. 13A is a diagram showing a first jaw constituting an energy treatment system (energy treatment tool) according to Embodiment 8 of the present invention. FIG. 13B is a diagram showing a first jaw constituting the energy treatment system (energy treatment tool) according to Embodiment 8 of the present invention. FIG. 14 is a cross-sectional view showing the configuration of the first cooling member according to Embodiment 9 of the present invention. FIG. 15 is a diagram showing a gripping part constituting the energy treatment system (energy treatment tool) according to Embodiment 10 of the present invention. FIG. 16 is a diagram showing a first jaw constituting an energy treatment system (energy treatment tool) according to Embodiment 11 of the present invention. FIG. 17 shows a modification of the first to eleventh embodiments of the present invention.

DETAILED DESCRIPTION Hereinafter, modes for carrying out the present invention (hereinafter referred to as embodiments) will be described with reference to the drawings. The present invention is not limited to the embodiments described below. Furthermore, the same code | symbol is attached | subjected to the same part in description of drawing.

(Embodiment 1)
[Schematic configuration of energy treatment system]
FIG. 1 is a diagram showing an energy treatment system 1 according to Embodiment 1 of the present invention.
The energy treatment system 1 treats (joins (or anastomoses), detaches, etc.) the living tissue by applying energy (electric energy (high frequency energy) in the first embodiment) to the living tissue. . As shown in FIG. 1, the energy treatment system 1 includes an energy treatment tool 2, a control device 3, and a foot switch 4.

[Configuration of energy treatment device]
The energy treatment device 2 is, for example, a linear type surgical treatment device for performing treatment on a living tissue through an abdominal wall. As shown in FIG. 1, the energy treatment device 2 includes a handle 5, a shaft 6, and a grip portion 7.
The handle 5 is a portion that the operator holds. The handle 5 is provided with an operation knob 51 as shown in FIG.
As shown in FIG. 1, the shaft 6 has a substantially cylindrical shape, and one end (right end portion in FIG. 1) is connected to the handle 5. A gripping portion 7 is attached to the other end of the shaft 6 (left end portion in FIG. 1). An opening / closing mechanism (not shown) that opens and closes the first and second jaws 8 and 8 ′ (FIG. 1) constituting the gripping portion 7 in response to the operation of the operation knob 51 by the operator is provided inside the shaft 6. ) Is provided. Further, in the shaft 6, an electric cable C (FIG. 1) connected to the control device 3 is connected to the other end side (in FIG. 1) from one end side (right end side in FIG. 1) via the handle 5. (Up to the left end side).

(Configuration of gripping part)
FIG. 2 is an enlarged view of the distal end portion of the energy treatment device 2. 3 and 4 are diagrams showing the gripping portion 7. Specifically, FIG. 3 is a view of the first jaw 8 (second jaw 8 ′) viewed from the first gripping surface 821 (second gripping surface 821 ′) side. FIG. 4 is a cross-sectional view of the grip portion 7 cut along a cut surface along the width direction (left-right direction in FIG. 3).
1 to 4, the configuration indicated by the reference sign without “′” and the configuration indicated by the reference sign with “′” are the same. The same applies to the subsequent figures.
The gripping part 7 is a part that grips a living tissue and treats the living tissue. As shown in FIGS. 1 to 4, the grip portion 7 includes first and second jaws 8 and 8 ′.
The first and second jaws 8 and 8 'are pivotally supported on the other end of the shaft 6 so as to be openable and closable in the direction of the arrow R1 (FIG. 2). And

[Configuration of first jaw]
The first jaw 8 is disposed on the lower side in FIGS. 1 and 2 with respect to the second jaw 8 ′. As shown in FIGS. 2 to 4, the first jaw 8 includes a first support member 81 and a first treatment portion 82.
The first support member 81 has a substantially rectangular parallelepiped shape extending along the central axis of the shaft 6, and one end side (base end side) in the longitudinal direction is supported by the shaft 6. At a substantially central position of the first support member 81, there is provided a first recess 811 that is recessed downward and in which the first treatment portion 82 is installed.
The first support member 81 described above is formed by molding a resin material (fluorine resin or the like), for example.

The first treatment portion 82 has a substantially rectangular parallelepiped shape extending along the central axis of the shaft 6, and is installed in the first recess 811 in a state in which a part projects toward the second jaw 8 ′ side. The upper surface of the first treatment section 82 is formed in a flat shape, and a first gripping surface 821 (FIGS. 2 to 4) that grips a living tissue with the second jaw 8 ′ (second gripping surface 821 ′). ).
Here, in the first gripping surface 821, a region in the center in the width direction is defined as a first central region Ar1 (FIG. 3). The first central region Ar1 is a region including the center position CP (FIG. 3) of the first gripping surface 821 and extending along the longitudinal direction of the first gripping surface 821. In the first gripping surface 821, regions facing each other in the width direction across the first central region Ar1 (regions on the outer side in the width direction in the first central region Ar1) are respectively defined as first opposing regions Ar2 (FIG. 3). .
As shown in FIGS. 2 to 4, the first treatment section 82 includes a first electrode 83, a first thermal resistance member 84, and a first cooling member 85 (FIG. 4).

The first electrode 83 generates high frequency energy under the control of the control device 3. In the first embodiment, the first electrode 83 is configured as a pair as shown in FIGS.
Specifically, the pair of first electrodes 83 is made of a conductive material such as copper, for example. In addition, the pair of first electrodes 83 is configured by a substantially rectangular parallelepiped plate extending along the central axis of the shaft 6, and each upper surface configures the entire pair of first opposing regions Ar <b> 2 on the first gripping surface 821. Is arranged. Further, a pair of lead wires (not shown) constituting the electric cable C are joined to the pair of first electrodes 83, respectively.

The first heat resistance member 84 has a function as a heat resistance portion according to the present invention. In the first embodiment, the first thermal resistance member 84 is configured separately from the pair of first electrodes 83.
Specifically, the first thermal resistance member 84 is composed of a low thermal conductive member having a thermal conductivity lower than that of the pair of first electrodes 83. The first heat resistance member 84 extends along the central axis of the shaft 6, is configured by a substantially rectangular parallelepiped plate having the same thickness as the pair of first electrodes 83, and the upper surface thereof is a pair of first electrodes. It is disposed so as to be flush with each upper surface of 83 and constitute the entire first central region Ar1 in the first gripping surface 821.
The material of the first thermal resistance member 84 may be any material as long as it has a thermal conductivity lower than the thermal conductivity of the pair of first electrodes 83, for example, a low thermal conductivity metal such as titanium, Low density metal composed of porous material, resin such as PFA (tetrafluoroethylene / perfluoroalkoxyethylene copolymer) and PTFE (polytetrafluoroethylene), hollow resin, porous thermosetting plastic, Examples include low thermal conductive ceramics such as alumina, zirconia, and macerite, or porous ceramics.
That is, in the first embodiment, the first central region Ar1 (first thermal resistance member 84) is configured to have a lower thermal conductivity than the pair of first opposing regions Ar2 (first electrode 83). The thermal resistance to the living tissue in the central region Ar1 (first thermal resistance member 84) is higher than the thermal resistance to the living tissue in the pair of first opposing regions Ar2 (first electrode 83).

FIG. 5 is a cross-sectional view showing the configuration of the first cooling member 85.
The first cooling member 85 has a function of cooling as a cooling member according to the present invention, contacts at least the pair of first electrodes 83, and cools the pair of first electrodes 83.
In the first embodiment, as shown in FIG. 5, the first cooling member 85 includes a first latent heat storage material 851 and a first sealing member 852 that seals the first latent heat storage material 851. It is formed in a shape. The first latent heat storage material 851 has a function as a latent heat storage material according to the present invention. Moreover, the 1st sealing member 852 has a function as a sealing member which concerns on this invention. As shown in FIG. 4, the first cooling member 85 includes the first back surfaces 831 spaced apart from the first gripping surfaces 821 of the pair of first electrodes 83, and the first gripping surfaces 821 of the first thermal resistance members 84. Covering the entire three back surfaces 831 and 841 of the back surface 841 spaced apart from each other, the three back surfaces 831 and 841 are disposed.

Here, the first latent heat storage material 851 exhibits the same thermal behavior as that of other substances up to a certain temperature, but causes a phase transition at the certain temperature inherent to the substance, and utilizes the endothermic effect due to the latent heat associated therewith. Thus, it is a substance that can hold a larger amount of heat per unit volume than other substances. Examples of the material of the first latent heat storage material 851 include solid substances at room temperature such as paraffin, polylactic acid, magnesium hydroxide, erythritol, and mannitol. For example, the operating temperature of paraffin (the temperature that causes a phase transition from solid to liquid) is about 40 ° C. The operating temperature of erythritol is about 120 ° C. That is, the material of the first latent heat storage material 851 may be selected according to the operating temperature at which heat absorption is desired.

[Configuration of second jaw]
The second jaw 8 ′ has substantially the same outer shape and the same configuration as the first jaw 8. That is, as shown in FIGS. 2 to 4, the second jaw 8 ′ includes the first support member 81 (including the first recess 811) and the first treatment portion 82 (the first gripping surface 821 ( A first central region Ar1 and a pair of first opposing regions Ar2), a first electrode 83 (including a first back surface 831), a first thermal resistance member 84 (including a back surface 841), and a first cooling member 85 (including Second support member 81 ′ (including second recess 811 ′) and second treatment portion 82 ′ (second gripping surface 821), including the first latent heat storage material 851 and the first sealing member 852. '(Including the second central region Ar1' and the pair of second opposing regions Ar2 '), the second electrode 83' (including the second back surface 831 '), the second thermal resistance member 84' (including the back surface 841 ') , And second cooling member 85 ′ (second latent heat storage material 851 ′ and second sealing member 85 It comprises including) the including) a '.

Here, similarly to the pair of first electrodes 83, a pair of lead wires (not shown) constituting the electric cable C are joined to the pair of second electrodes 83 ′, respectively. The pair of first electrodes 83 and the pair of second electrodes 83 ′ generate high-frequency energy by being supplied with high-frequency power by the control device 3 via the electric cable C (lead wire). The high-frequency current is passed through the living tissue grasped between the first electrode 83 and the pair of second electrodes 83 ′). Note that when the high-frequency power is supplied, the pair of first electrodes 83 are at the same potential. Further, when the high frequency power is supplied, the pair of second electrodes 83 ′ have the same potential. That is, the high-frequency current flows in the vertical direction in FIG. 4 between the first and second electrodes 83 and 83 ′ facing each other (see FIG. 6).

[Configuration of control device and foot switch]
The foot switch 4 is a part operated by the operator with his / her foot. Then, according to the operation to the foot switch 4, energization (supply of high-frequency power) from the control device 3 to the energy treatment instrument 2 (a pair of first electrodes 83 and a pair of second electrodes 83 ′) is turned on and off. Is switched.
Note that the means for switching on and off is not limited to the foot switch 4, and other switches that are operated by hand may be employed.
The control device 3 includes a CPU (Central Processing Unit) and the like, and comprehensively controls the operation of the energy treatment device 2 according to a predetermined control program. More specifically, the control device 3 determines the pair of first electrodes 83 and the pair of second electrodes via the electric cable C (lead wire) in response to an operation of the foot switch 4 by the operator (operation to turn on the power). A high-frequency power having a preset output is supplied between the electrode 83 ′.

[Operation of energy treatment system]
Next, operation | movement (operation method) of the energy treatment system 1 mentioned above is demonstrated.
FIG. 6 is a diagram for explaining the operation of the energy treatment system 1. Specifically, FIG. 6 is a cross-sectional view corresponding to FIG. 4 and shows a state where the living tissue LT is grasped by the first and second jaws 8 and 8 ′.
The surgeon grasps the energy treatment instrument 2 and inserts the tip portion of the energy treatment instrument 2 (a part of the grasping portion 7 and the shaft 6) into the abdominal cavity through the abdominal wall using, for example, a trocar. Further, the surgeon operates the operation knob 51 to hold the living tissue LT with the first and second jaws 8 and 8 'as shown in FIG.
Next, the surgeon operates the foot switch 4 to switch on energization from the control device 3 to the energy treatment instrument 2. When switched on, the control device 3 supplies high-frequency power between the pair of first electrodes 83 and the pair of second electrodes 83 ′ via the electric cable C (lead wire). With the supply of the high-frequency power, a high-frequency current Cu (FIG. 6) flows between the first and second electrodes 83 and 83 ′ facing each other, and is sandwiched between the first and second electrodes 83 and 83 ′ in the living tissue LT. Joule heat is generated in each region LT1 (FIG. 6). Then, the living tissue LT is treated by the generation of the Joule heat.

In the energy treatment device 2 according to the first embodiment described above, in the first jaw 8, the pair of first electrodes 83 is the entire pair of first opposing regions Ar2 located on the outer side in the width direction of the first gripping surface 821. Each is composed. Further, the pair of first electrodes 83 is cooled by the first cooling member 85. The same applies to the second jaw 8 '.
For this reason, Joule heat generated in each region LT1 in the living tissue LT spreads by transferring heat in the living tissue LT, but the living tissue LT in the vicinity of the pair of first and second electrodes 83, 83 ' The first and second cooling media 85 and 85 ′ are used to cool the tissue to be treated (the first and second gripping surfaces 821 and 821) in the living tissue LT. The temperature of the tissue around the tissue) grasped at 821 'can be lowered. Further, since the temperature of the electrode inherently increases due to heat transfer to each region LT1 to the pair of first and second electrodes 83 and 83 ′, the pair of first and second electrodes 83 and 83 ′ to the living tissue LT. The influence of the heat transferred to the surrounding tissue of the treatment target tissue by following the heat transfer path to the surrounding tissue of the treatment target tissue in the first and second electrodes 83 and 83 'is also the first and first. Since it is cooled by the two cooling members 85 and 85 ', it can be reduced. Therefore, it is possible to reduce the influence of heat on the tissue around the tissue to be treated in the living tissue LT.

Further, in the first jaw 8, the first thermal resistance member 84 constitutes a first central region Ar <b> 1 located at the center in the width direction of the first gripping surface 821. In addition, the first thermal resistance member 84 has a lower thermal conductivity than the first electrode 83 and a higher thermal resistance to the living tissue LT than the first electrode 83. The same applies to the second jaw 8 '.
For this reason, the first and second electrodes 83 and 83 ′ from the living tissue LT (region LT1) take the amount of heat taken by the first and second heat resistance members 84 and 84 ′ from the living tissue LT (region LT2 (FIG. 6)). The amount of heat to be taken can be reduced, and in the tissue to be treated of the living tissue LT, it is possible to suppress a decrease in the temperature of the region LT2 in the center in the width direction where treatment is originally desired. Therefore, it is possible to appropriately treat the tissue to be treated in the living tissue LT.
From the above, according to the energy treatment device 2 according to the first embodiment, the treatment target tissue is appropriately treated while reducing the influence of heat on the tissue around the treatment target tissue in the living tissue LT. There is an effect that can be.

In the energy treatment device 2 according to the first embodiment, the first cooling member 85 cools the pair of first electrodes 83 using the first latent heat storage material 851. The same applies to the second cooling member 85 '.
For this reason, it is possible to execute the treatment until the operating temperature of the first and second latent heat storage materials 851 and 851 ′ is not significantly hindered from the temperature increase of the treatment target tissue in the living tissue LT. On the other hand, when the first and second latent heat storage materials 851 and 851 ′ reach the operating temperature or higher, the first and second latent heat storage materials 851 start to absorb heat by the non-linear thermal behavior, and the temperature exceeds that. Can prevent it from rising. Therefore, the treatment target tissue in the living tissue LT can be appropriately treated without increasing the treatment time.

In the energy treatment device 2 according to the first embodiment, the first cooling member 85 is formed in a sheet shape, and is disposed on each of the back surfaces 831 and 841 of the pair of first electrodes 83 and the first thermal resistance member 84. Has been. The same applies to the second cooling member 85 '.
For this reason, the thickness dimension of the 1st, 2nd jaws 8 and 8 'can be reduced, and the holding part 7 can be reduced in size.

(Embodiment 2)
Next, a second embodiment of the present invention will be described.
In the description of the second embodiment, the same reference numerals are given to the same components as those in the first embodiment, and the detailed description thereof is omitted or simplified.
FIG. 7 is a diagram showing a first jaw 8A constituting the energy treatment system 1A (energy treatment tool 2A) according to Embodiment 2 of the present invention. Specifically, FIG. 7 is a cross-sectional view corresponding to FIG.
As shown in FIG. 7, the energy treatment system 1A (energy treatment tool 2A) according to the second embodiment is different from the energy treatment system 1 (energy treatment tool 2) described in the first embodiment described above. Instead of the first jaw 8, a first jaw 8A having a first treatment portion 82A different from the first treatment portion 82 is employed.

Specifically, as shown in FIG. 7, the first treatment section 82A has a pair of first electrodes 83 and a first electrode compared to the first treatment section 82 (FIG. 4) described in the first embodiment. Instead of the cooling member 85, a pair of first electrodes 83A and a first cooling member 85A are employed.
The pair of first electrodes 83A has a substantially circular cross section inside the pair of first electrodes 83 described in the first embodiment, and is in the longitudinal direction (perpendicular to the plane of FIG. 7). A sealed space SpA extending along (direction) is formed.
The first cooling member 85A has a function as a cooling member according to the present invention, is made of the same material as the first latent heat storage material 851 described in the first embodiment, and is mounted in each sealed space SpA. Has been.
In addition, although illustration was abbreviate | omitted about the 2nd jaw which concerns on this Embodiment 2, it has the same structure as the 1st jaw 8A mentioned above.

Even when the first cooling member 85A is mounted inside the pair of first electrodes 83A as in the energy treatment tool 2A according to the second embodiment described above, the same effects as those of the first embodiment described above are obtained. Play.
Further, since the first cooling member 85A is mounted inside the pair of first electrodes 83A, the thickness dimension of the first jaw 8A can be reduced. The same applies to the second jaw.

(Embodiment 3)
Next, a third embodiment of the present invention will be described.
In the description of the third embodiment, the same reference numerals are given to the same components as those in the first embodiment described above, and the detailed description thereof will be omitted or simplified.
FIG. 8 is a diagram showing a first jaw 8B constituting the energy treatment system 1B (energy treatment tool 2B) according to Embodiment 3 of the present invention. Specifically, FIG. 8 is a cross-sectional view corresponding to FIG.
As shown in FIG. 8, the energy treatment system 1 </ b> B (energy treatment tool 2 </ b> B) according to the third embodiment has the following configuration with respect to the energy treatment system 1 (energy treatment tool 2) described in the first embodiment. Instead of the first jaw 8, a first jaw 8B having a first treatment portion 82B different from the first treatment portion 82 is employed.

Specifically, as shown in FIG. 8, the first treatment unit 82 </ b> B has a pair of first electrodes 83 and a first electrode compared to the first treatment unit 82 (FIG. 4) described in the first embodiment. Instead of the heat resistance member 84, the first electrode 83B and the first heat resistance member 84B are employed.
The first electrode 83B is made of the same material as that of the first electrode 83 described in the first embodiment, and is made of one member as shown in FIG. That is, in the third embodiment, since the first electrode 83B is a single member, only one lead wire (not shown) constituting the electric cable C is joined to the first electrode 83B. The first electrode 83B is formed in a substantially rectangular parallelepiped shape having the same outer shape as the unit obtained by combining the pair of first electrodes 83 and the first thermal resistance member 84 described in the first embodiment.

The first thermal resistance member 84B functions as a thermal resistance unit according to the present invention. In the third embodiment, the first thermal resistance member 84B is configured separately from the first electrode 83B, similarly to the first thermal resistance member 84 described in the first embodiment. Specifically, as shown in FIG. 8, the first thermal resistance member 84B is formed of a coating member formed on a part of the upper surface of the first electrode 83B. In addition, as a material of the 1st heat resistance member 84B, the same material as the 1st heat resistance member 84 demonstrated in Embodiment 1 mentioned above is employable.
The upper surface of the first thermal resistance member 84B and the region other than the first thermal resistance member 84B on the upper surface of the first electrode 83B grip the living tissue LT between the second jaw (second gripping surface). Functions as the first gripping surface 821B (FIG. 8). That is, the first gripping surface 821B has a stepped shape unlike the flat first gripping surface 821 described in the first embodiment. The first gripping surface 821B has the same planar shape as the first gripping surface 821 described in the first embodiment. That is, the first gripping surface 821B is planarly viewed (as viewed from the direction along the normal line of the first gripping surface 821B), and similarly to the first gripping surface 821, the first central region Ar1 and the pair of first gripping surfaces 821B 1 opposing region Ar2.

Here, the first thermal resistance member 84B is viewed in plan (from the direction along the normal line of the first gripping surfaces 821, 821B), and the first thermal resistance member 84 described in the first embodiment described above. Have the same shape. The first thermal resistance member 84B is formed so as to constitute the entire first central region Ar1 in the first gripping surface 821B among the upper surface of the first electrode 83B. That is, the region other than the first thermal resistance member 84B on the upper surface of the first electrode 83B constitutes the entire pair of first opposing regions Ar2 on the first gripping surface 821B.
Then, as shown in FIG. 8, the first cooling member 85 according to the third embodiment covers the entire first back surface 831B separated from the first gripping surface 821B of the first electrode 83B, and the first back surface 831B is covered with the first back surface 831B. It arrange | positions so that it may contact.
In addition, although illustration was abbreviate | omitted about the 2nd jaw which concerns on this Embodiment 3, it has the same structure as the 1st jaw 8B mentioned above.

Even when the first electrode 83B is constituted by one member and the first thermal resistance member 84B is constituted by a coating member as in the energy treatment instrument 2B according to the third embodiment described above, the above-described embodiment. 1 has the same effect.
In addition, since the first electrode 83B is composed of one member, the number of parts can be reduced. Furthermore, since the first heat resistance member 84B is formed of a coating member, the thickness dimension of the first jaw 8B can be reduced. The same applies to the second jaw.

(Embodiment 4)
Next, a fourth embodiment of the present invention will be described.
In the description of the fourth embodiment, the same reference numerals are given to the same components as those of the above-described first embodiment, and the detailed description thereof is omitted or simplified.
FIG. 9 is a diagram showing a first jaw 8C constituting an energy treatment system 1C (energy treatment tool 2C) according to Embodiment 3 of the present invention. Specifically, FIG. 9 is a cross-sectional view corresponding to FIG.
As shown in FIG. 9, the energy treatment system 1 </ b> C (energy treatment tool 2 </ b> C) according to the fourth embodiment is different from the energy treatment system 1 (energy treatment tool 2) described in the first embodiment described above. Instead of the first jaw 8, a first jaw 8C having a first treatment portion 82C different from the first treatment portion 82 is employed.

Specifically, as shown in FIG. 9, the first treatment unit 82 </ b> C has a pair of first electrodes 83 and a first electrode compared to the first treatment unit 82 (FIG. 4) described in the first embodiment. Instead of the heat resistance member 84, a first electrode 83C and a first heat resistance portion 84C are employed.
The first electrode 83C is made of the same material as the first electrode 83B described in the third embodiment and has the same outer shape.
In the fourth embodiment, the upper surface of the first electrode 83C functions as a first gripping surface 821C (FIG. 9) that grips the living tissue LT with the second jaw (second gripping surface). The first gripping surface 821C has the same planar shape as the first gripping surface 821 described in the first embodiment. That is, the first gripping surface 821C is planarly viewed (viewed from the direction along the normal line of the first gripping surface 821C), like the first gripping surface 821, the first central region Ar1 and the pair of first gripping surfaces 821C 1 opposing region Ar2.

The first thermal resistance portion 84C is formed by subjecting a part of the upper surface of the first electrode 83C (first central region Ar1 in the first gripping surface 821C) to surface processing (for example, etching, sandblasting, etc.). This is a region with a rough surface relative to other regions on the upper surface of the electrode 83C. And the area | regions other than the 1st thermal resistance part 84C (area | region where surface roughness is rough) among the upper surfaces of the 1st electrode 83C comprises the whole pair of 1st opposing area | region Ar2 in 821C of 1st each.
That is, in the fourth embodiment, the surface roughness of the first central region Ar1 (first thermal resistance portion 84C) is made rougher than that of the pair of first opposing regions Ar2 (first electrode 83C). The thermal resistance to the living tissue LT in the central region Ar1 (first thermal resistance member 84) is higher than the thermal resistance to the living tissue LT in the pair of first opposing regions Ar2 (first electrode 83C).

Then, as shown in FIG. 9, the first cooling member 85 according to the fourth embodiment has a first back surface 831C spaced from the first gripping surface 821C in the first electrode 83C, as in the third embodiment described above. The whole is covered and disposed so as to contact the first back surface 831C.
In addition, although illustration was abbreviate | omitted about the 2nd jaw which concerns on this Embodiment 4, it has the structure same as the 1st jaw 8C mentioned above.

Even when the first heat resistance portion 84C is a region having a rough surface roughness in the first electrode 83C as in the energy treatment tool 2C according to the fourth embodiment described above, the first embodiment described above 3 has the same effect.
Moreover, since the area | region where the surface roughness in the 1st electrode 83C is rough is made into the 1st thermal resistance part 84C, while being able to reduce a number of parts compared with the structure which provided the 1st thermal resistance member separately, The thickness dimension of the first jaw 8C can be reduced. The same applies to the second jaw.

(Embodiment 5)
Next, a fifth embodiment of the present invention will be described.
In the description of the fifth embodiment, the same reference numerals are given to the same components as those in the first embodiment described above, and the detailed description thereof will be omitted or simplified.
FIG. 10 is a diagram showing a first jaw 8D constituting an energy treatment system 1D (energy treatment tool 2D) according to Embodiment 5 of the present invention. Specifically, FIG. 10 is a cross-sectional view corresponding to FIG.
As shown in FIG. 10, the energy treatment system 1D (energy treatment tool 2D) according to the fifth embodiment is different from the energy treatment system 1 (energy treatment tool 2) described in the first embodiment described above. Instead of the first jaw 8, a first jaw 8D having a first treatment portion 82D different from the first treatment portion 82 is employed.

Specifically, as shown in FIG. 10, the first treatment unit 82D includes a pair of first electrodes 83 and a first electrode compared to the first treatment unit 82 (FIG. 4) described in the first embodiment. Instead of the thermal resistance member 84, a first electrode 83D and a first thermal resistance member 84D are employed.
The first electrode 83D is provided with a first recess 832D that is recessed downward in a region corresponding to the entire first central region Ar1 on the upper surface of the first electrode 83D described in the third embodiment. It has been.

The first heat resistance member 84D has a function as a heat resistance portion according to the present invention, and the outer shape of the first heat resistance member 84D in the first recess 832D is the same as that of the first heat resistance member 84 described in the first embodiment. The shape is changed so as to be the same as the shape, and is installed (fitted) in the first recess 832D.
That is, the upper surface of the first treatment portion 82D (the region other than the first recess 832D (the first thermal resistance member 84D) of the upper surface of the first thermal resistance member 84D and the upper surface of the first electrode 83D) is formed in a flat shape. It functions as a first gripping surface 821D (FIG. 10) for gripping the living tissue with the second jaw (second gripping surface). Here, the upper surface of the first thermal resistance member 84D constitutes the entire first central region Ar1 in the first gripping surface 821D. In addition, the region of the upper surface of the first electrode 83D other than the first recess 832D constitutes the entire pair of first opposing regions Ar2 on the first gripping surface 821D.

As shown in FIG. 10, the first cooling member 85 according to the fifth embodiment has a first back surface 831D spaced from the first gripping surface 821D in the first electrode 83D, as in the third embodiment described above. The whole is covered and disposed so as to be in contact with the first back surface 831D.
In addition, although illustration was abbreviate | omitted about the 2nd jaw which concerns on this Embodiment 5, it has the structure same as 1st jaw 8D mentioned above.

Even when the first thermal resistance member 84D is embedded in the upper surface of the first electrode 83D as in the energy treatment tool 2D according to the fifth embodiment described above, the same as in the first and third embodiments described above. There is an effect.
Further, since the first thermal resistance member 84D is embedded in the upper surface of the first electrode 83D, the thickness dimension of the first jaw 8D can be reduced. The same applies to the second jaw.

(Embodiment 6)
Next, a sixth embodiment of the present invention will be described.
In the description of the sixth embodiment, the same reference numerals are given to the same components as those of the fifth embodiment described above, and the detailed description thereof is omitted or simplified.
FIG. 11 is a diagram showing a first jaw 8E constituting an energy treatment system 1E (energy treatment tool 2E) according to Embodiment 6 of the present invention. Specifically, FIG. 11 is a cross-sectional view corresponding to FIG.
As shown in FIG. 11, the energy treatment system 1E (energy treatment tool 2E) according to the sixth embodiment is different from the energy treatment system 1D (energy treatment tool 2D) described in the fifth embodiment described above. Instead of the first jaw 8D, a first jaw 8E having a first treatment portion 82E different from the first treatment portion 82D is employed.

Specifically, as shown in FIG. 11, the first treatment portion 82E is obtained by omitting the first thermal resistance member 84D from the first treatment portion 82D (FIG. 10) described in the fifth embodiment. Yes. And the air layer in 1st recessed part 831D is comprised as the 1st heat resistance member 84E.
That is, in the sixth embodiment, similarly to the first embodiment described above, the first central region Ar1 rather than the pair of first opposing regions Ar2 (regions other than the first recess 832D on the upper surface of the first electrode 83D). By configuring the thermal conductivity of the (first thermal resistance member 84E (air layer)) to be low, the thermal resistance to the living tissue LT in the first central region Ar1 (first thermal resistance member 84E (air layer)) is paired. The first opposing region Ar2 (the region of the upper surface of the first electrode 83D other than the first recess 832D) is higher than the thermal resistance to the living tissue LT.

In addition, the 1st cooling member 85 which concerns on this Embodiment 6 is arrange | positioned in the same position as the 1st cooling member 5 demonstrated in Embodiment 5 mentioned above, as shown in FIG.
Further, the second jaw according to the sixth embodiment is omitted in illustration, but has the same configuration as the first jaw 8E described above.

Even when the first heat resistance member 84E is formed of an air layer as in the energy treatment device 2E according to the sixth embodiment described above, the same effects as those of the first and third embodiments described above are obtained.
In addition, since the first heat resistance member 84E is composed of an air layer, the number of parts can be reduced and the thickness of the first jaw 8E can be reduced as compared with a structure in which the first heat resistance member is separately provided. Dimensions can be reduced. The same applies to the second jaw.

(Embodiment 7)
Next, a seventh embodiment of the present invention will be described.
In the description of the seventh embodiment, the same reference numerals are given to the same components as those in the first embodiment described above, and the detailed description thereof will be omitted or simplified.
12A and 12B are views showing a first jaw 8F constituting an energy treatment system 1F (energy treatment tool 2F) according to Embodiment 7 of the present invention. Specifically, FIG. 12A is a cross-sectional view of the first jaw 8F cut along a cut surface along the longitudinal direction. 12B is a cross-sectional view corresponding to FIG.
In the energy treatment system 1F (energy treatment tool 2F) according to the seventh embodiment, as shown in FIGS. 12A and 12B, the energy treatment system 1 (energy treatment tool 2) described in the first embodiment is used. On the other hand, instead of the first jaw 8, a first jaw 8F having a first treatment portion 82F different from the first treatment portion 82 is employed.

Specifically, as shown in FIGS. 12A and 12B, the first treatment unit 82F has a pair of first electrodes 83 with respect to the first treatment unit 82 (FIG. 4) described in the first embodiment. Instead of the first thermal resistance member 84 and the first cooling member 85, a first electrode 83F, a first thermal resistance member 84F, and a first cooling member 85F are employed.
The first electrode 83F is made of the same material as the first electrode 83 described in the first embodiment, and is made of one member as shown in FIGS. 12A and 12B. That is, in the seventh embodiment, since the first electrode 83F is one member, only one lead wire (not shown) constituting the electric cable C is joined to the first electrode 83F. The first electrode 83F includes a first base portion 833F and a pair of electrode portions 834F.
The first base portion 833F has a rectangular parallelepiped shape and has a sealed space SpF inside. The first base portion 833F is disposed in the first recess 811 on the base end side of the first jaw 8F (the side where the first jaw 8F is supported by the shaft 6 (the right end side in FIG. 12A)). .
The pair of electrode portions 834F is a substantially rectangular parallelepiped plate that protrudes from the side end portion of the first base portion 833F toward the tip end (left end portion in FIG. 12A) of the first jaw 8F along the upper surface of the first base portion 833F. Each body is composed.

The first heat resistance member 84F has a function as a heat resistance portion according to the present invention, the outer dimensions are changed with respect to the first heat resistance member 84 described in the first embodiment, and the first base portion It is installed in an L-shaped inner portion surrounded by 833F and the pair of first electrode portions 834F.
And the area | region except a pair of 1st electrode part 834F among the upper surfaces of the 1st thermal resistance member 84F, and each upper surface of a pair of 1st electrode part 834F are between 2nd jaws (2nd holding surface). It functions as a first gripping surface 821F (FIGS. 12A and 12B) for gripping the living tissue LT. That is, the first gripping surface 821F has a stepped shape unlike the flat first gripping surface 821 described in the first embodiment. The first gripping surface 821F has the same planar shape as the first gripping surface 821 described in the first embodiment. That is, the first gripping surface 821F is seen in a plan view (viewed from the direction along the normal line of the first gripping surface 821F), like the first gripping surface 821, and the first central region Ar1 and the pair of first gripping surfaces 821F. 1 opposing region Ar2. The pair of first electrode portions 834F is formed so as to constitute the entire pair of first opposing regions Ar2 on the first gripping surface 821F. That is, the region other than the pair of first electrode portions 834F on the upper surface of the first thermal resistance member 84F constitutes the entire first central region Ar1 on the first gripping surface 821F.

The first cooling member 85F has a function as a cooling member according to the present invention, is made of the same material as the first latent heat storage material 851 described in the first embodiment, and is mounted in the sealed space SpF. Yes.
Although the second jaw according to the seventh embodiment is not shown, it has the same configuration as the first jaw 8F described above.

Even when the first jaw 8F is configured as in the energy treatment tool 2F according to the seventh embodiment described above, the same effects as those of the first embodiment described above can be obtained.
In addition, since the first cooling member 85F is provided on the proximal end side of the first jaw 8F, even if there is a design limitation in the width direction or the thickness direction on the distal end side of the first jaw 8F, A cooling structure for the one electrode 83F can be easily realized.

(Embodiment 8)
Next, an eighth embodiment of the present invention will be described.
In the description of the eighth embodiment, the same reference numerals are given to the same components as those in the above-described seventh embodiment, and the detailed description thereof is omitted or simplified.
FIGS. 13A and 13B are views showing a first jaw 8G constituting an energy treatment system 1G (energy treatment tool 2G) according to Embodiment 8 of the present invention. Specifically, FIGS. 13A and 13B are cross-sectional views corresponding to FIGS. 12A and 12B, respectively.
In the energy treatment system 1G (energy treatment tool 2G) according to the eighth embodiment, as shown in FIGS. 13A and 13B, the energy treatment system 1F (energy treatment tool 2F) described in the seventh embodiment is used. On the other hand, instead of the first jaw 8F, a first jaw 8G having a first treatment portion 82G different from the first treatment portion 82F is employed.

Specifically, as shown in FIGS. 13A and 13B, the first treatment section 82G has a first thermal resistance compared to the first treatment section 82F (FIGS. 12A and 12B) described in the seventh embodiment. A first heat resistance member 84G in which the shape of the member 84F is changed is employed.
The first thermal resistance member 84G includes a first expansion bulging upward in a region corresponding to the entire first central region Ar1 with respect to the first thermal resistance member 84G described in the seventh embodiment. A protruding portion 842G (FIG. 13B) is provided.
Here, the upper surface of the first bulging portion 842G is formed to be flush with the upper surfaces of the pair of first electrode portions 834F. That is, the first gripping surface 821G (FIGS. 13A and 13B) configured by the upper surface of the first bulging portion 842G and the upper surfaces of the pair of first electrode portions 834F is the same as that described in the first embodiment. Unlike the attached first gripping surface 821F, it is formed in a flat shape.
In addition, although illustration was abbreviate | omitted about the 2nd jaw which concerns on this Embodiment 8, it has the structure same as the 1st jaw 8G mentioned above.

Even when the first jaw 8G is configured as in the energy treatment tool 2G according to the eighth embodiment described above, the same effects as those of the seventh embodiment described above can be obtained.

(Embodiment 9)
Next, a ninth embodiment of the present invention will be described.
In the description of the ninth embodiment, the same reference numerals are given to the same components as those in the first embodiment described above, and the detailed description thereof is omitted or simplified.
FIG. 14 is a cross-sectional view showing a configuration of first cooling member 85H that constitutes the energy treatment system according to Embodiment 9 of the present invention.
In the energy treatment systems 1 and 1A to 1G according to Embodiments 1 to 8 described above, the first heat members 85, 85A, and 85F use the latent heat storage material that is made of a solid substance at room temperature.
On the other hand, in the energy treatment system according to the ninth embodiment, as shown in FIG. 14, a latent heat storage material composed of a liquid substance at room temperature instead of the first cooling members 85, 85A, 85F. The 1st cooling member 85H using is adopted.

Specifically, as shown in FIG. 14, the first cooling member 85H includes a first latent heat storage material 851H, a first sealing member 852H that seals the first latent heat storage material 851H, and a first sealing member 852H. It is comprised with what is called a heat pipe provided with the 1st wick 853H provided in the inner wall.
Examples of the material of the first latent heat storage material 851H include liquid substances at room temperature such as water and alternative chlorofluorocarbon. Moreover, as a material of the 1st sealing member 852H and the 1st wick 853H, high heat conductive members, such as copper, can be illustrated, for example.
The first cooling member 85H cools the first electrodes 83, 83A to 83D, 83F by repeating the following behavior.
That is, the liquid first latent heat storage material 851H absorbs heat from the first electrodes 83, 83A to 83D, and 83F via the first sealing member 852H and evaporates. Then, the vapor of the first latent heat storage material 851H moves to the low temperature space separated from the first electrodes 83, 83A to 83D, 83F inside the first sealing member 852H. The vapor | steam of the 1st latent heat storage material 851H cooled in the said low temperature space aggregates, returns to a liquid, and is absorbed by the 1st wick 853H. The liquid first latent heat storage material 851H follows the inner wall (first wick 853H) of the first sealing member 852H by capillarity, and enters the high-temperature space close to the first electrodes 83, 83A to 83D, 83F. Moving.
In addition, although illustration was abbreviate | omitted about the 2nd cooling member which concerns on this Embodiment 9, it has the same structure as the 1st cooling member 85H mentioned above.

Even when the first cooling member 85H configured by a heat pipe is employed as in the energy treatment device according to the ninth embodiment described above, the same effects as those of the first to eighth embodiments described above can be obtained. .

(Embodiment 10)
Next, an embodiment 10 of the invention will be described.
In the description of the tenth embodiment, the same reference numerals are given to the same components as those in the first embodiment, and the detailed description thereof will be omitted or simplified.
FIG. 15 is a diagram showing a gripping portion 7I that constitutes an energy treatment system 1I (energy treatment tool 2I) according to Embodiment 10 of the present invention. Specifically, FIG. 15 is a cross-sectional view corresponding to FIG.
As shown in FIG. 15, the energy treatment system 1I (energy treatment tool 2I) according to the tenth embodiment is different from the energy treatment system 1 (energy treatment tool 2) described in the first embodiment described above. A clamping unit 7I in which a cutter 9 is added to the clamping unit 7 is employed.

Specifically, the sandwiching portion 7I includes first and second jaws 8, 8 ′ and a cutter 9.
As shown in FIG. 15, the first and second jaws 8 and 8 ′ according to the tenth embodiment divide the first and second treatment sections 82 and 82 ′ into two at substantially the center position in the width direction. As a result, first and second cutter moving grooves 822 and 822 ′ serving as a moving path of the cutter 9 are formed.
The cutter 9 is attached to the other end of the shaft 6 (left end portion in FIGS. 1 and 2) so as to be movable in a direction along the central axis of the shaft 6 (a direction orthogonal to the paper surface of FIG. 15). It moves in response to an operation by the user (for example, an operation on the operation knob 51). And the cutter 9 cut | disconnects the biological tissue LT hold | gripped by the 1st, 2nd jaw 8, 8 'by the said movement.

Even when the cutter 9 is added as in the energy treatment instrument 2I according to the tenth embodiment described above, the same effects as those of the first embodiment described above can be obtained.
In addition, the structure which cut | disconnects the biological tissue LT mechanically with the cutter 9 is not restricted, You may employ | adopt the structure cut | disconnected by melting or evaporating the biological tissue LT using energy, such as electricity, chemistry, light, and heat. Absent.

(Embodiment 11)
Next, an eleventh embodiment of the present invention will be described.
In the description of the eleventh embodiment, the same reference numerals are given to the same components as those in the first embodiment, and the detailed description thereof will be omitted or simplified.
FIG. 16 is a diagram showing a first jaw 8J constituting an energy treatment system 1J (energy treatment tool 2J) according to Embodiment 11 of the present invention. Specifically, FIG. 16 is a cross-sectional view corresponding to FIG.
As shown in FIG. 16, the energy treatment system 1J (energy treatment tool 2J) according to the eleventh embodiment is different from the energy treatment system 1 (energy treatment tool 2) described in the first embodiment described above. Instead of the first jaw 8, a first jaw 8J having a first treatment portion 82J different from the first treatment portion 82 is employed.

Specifically, as shown in FIG. 16, the first treatment unit 82 </ b> J is a pair of the first treatment unit 82 (FIG. 4) described in the first embodiment, instead of the first cooling member 85. The first cooling member 85J is employed, and a pair of transverse members 86 are added.
The pair of transverse members 86 are formed of substantially rectangular parallelepiped plates extending along the central axis of the shaft 6 and having the same thickness as the pair of first electrodes 83. The pair of transverse members 86 are respectively disposed on the outer sides in the width direction of the pair of first electrodes 83 so that the upper surfaces thereof are flush with the upper surfaces of the pair of first electrodes 83.
The pair of transverse members 86 may be made of a material having the same thermal conductivity as that of the pair of electrodes 83, and have a thermal conductivity lower or higher than that of the pair of electrodes 83. You may comprise with material.

The pair of first cooling members 85J have the same configuration as the first cooling member 85 described in the first embodiment. The pair of first cooling members 85J are respectively arranged on the outer sides in the width direction of the pair of lateral members 86 so that the upper surfaces thereof are flush with the upper surfaces of the pair of lateral members 86. That is, the pair of first cooling members 85J does not contact the pair of electrodes 83.
In the eleventh embodiment, the upper surface of the first thermal resistance member 84, the upper surfaces of the pair of first electrodes 83, the upper surfaces of the pair of transverse members 86, and the pair of first cooling members 85J. The upper surface functions as a first gripping surface 821J (FIG. 16) that grips the living tissue LT with the second jaw (second gripping surface). In other words, the pair of first cooling members 85J can directly cool the tissue in contact with the outer side in the width direction of the first gripping surface 821J (tissue around the tissue to be treated in the living tissue LT) in the living tissue LT. And
In addition, although illustration was abbreviate | omitted about the 2nd jaw which concerns on this Embodiment 11, it has the same structure as the 1st jaw 8J mentioned above.

Even when the first jaw 8J is configured as in the energy treatment device 2J according to the eleventh embodiment described above, the same effects as those of the first embodiment described above can be obtained.

(Other embodiments)
The embodiments for carrying out the present invention have been described so far, but the present invention should not be limited only by the above-described first to eleventh embodiments.
In Embodiments 1 to 11 described above, the energy treatment device 2 (2A to 2G, 2I, 2J) is configured to perform treatment by applying only high-frequency energy to the living tissue LT, but is not limited thereto. A configuration may be adopted in which treatment is performed by applying at least one of ultrasonic energy, optical energy such as a laser, and thermal energy to the living tissue LT in addition to high-frequency energy.

In the first to eleventh embodiments described above, the first and second thermal resistance members 84 (84B, 84D to 84G, the first thermal resistance portion 84C), 84 ′, and the first and second cooling members 85 (85A, 85F). , 85H, 85J) and 85 'are provided on both the first and second jaws 8 (8A to 8G, 8J) and 8', but the present invention is not limited to this, and the first and second jaws 8 (8A ˜8G, 8J), 8 ′ may be provided only on one side. At this time, the heat resistance member and the cooling member may be provided on the same jaw, or may be provided on different jaws.

In the above-described first to eleventh embodiments, the first and second cooling members 85 (85A, 85F, 85H, 85J) and 85 ′ are configured using a latent heat storage material. However, the present invention is not limited to this. A coolant line is provided so as to be in contact with the inside or the outer surface of the first and second electrodes 83 (83A to 83D, 83F), 83 ′, and a cooling medium such as water, nitrogen, carbon dioxide or the like is circulated in the coolant line. A configuration may be adopted.
Further, as the cooling member according to the present invention, the first electrode 83 (83A to 83D, 83F) and the second electrode 83 ′ are connected to the first and second heat resistance members 84 (84B, 84D to 84G, the first heat resistance portion). 84C) and 84 ′ as long as they are in contact with each other with a lower thermal resistance, the position is not limited to the position described in the first to eleventh embodiments, and may be disposed at other positions.

In Embodiments 1 to 11 described above, the center positions CP of the first and second gripping faces 821 (821B to 821D, 821F, 821G, 821J) and 821 ′ are used as the first and second central regions according to the present invention. The first and second central regions Ar1 and Ar1 ′ including the above are employed, but the present invention is not limited to this, and other regions not including the center position may be used as the first and second central regions.

In the first to eleventh embodiments described above, the first and second jaws 8 (8A to 8G, 8J) and 8 ′ are configured to include the first and second support members 81 and 81 ′. However, the first and second support members 81 and 81 'are omitted, and the first and second treatment portions 82 (82A to 82G and 82J) and 82' are directly supported by the shaft 6. It doesn't matter.

In the first to eleventh embodiments described above, the shapes of the first and second gripping surfaces 821 and 821 ′ are not limited to the shapes described in the first to eleventh embodiments.
FIG. 17 shows a modification of the first to eleventh embodiments of the present invention. Specifically, FIG. 17 corresponds to FIG.
In the first to eleventh embodiments described above, the first gripping surface 821 (second gripping surface 821 ′) has a substantially rectangular shape when viewed in plan, as shown in FIG. Further, the first central region Ar1 (second central region Ar1 ′) configured by the upper surface of the first thermal resistance member 84 (second thermal resistance member 84 ′) is a first gripping surface 821 (second gripping surface 821 ′). ) And has a substantially rectangular shape extending along the longitudinal direction of the first gripping surface 821. Further, the first opposing region Ar2 (second opposing region Ar2 ′) configured by the upper surface of the first electrode 83 (second electrode 83 ′) sandwiches the first central region Ar1 (second central region Ar1 ′). They face each other in the width direction and have a substantially rectangular shape.

On the other hand, as shown in FIG. 17, the first gripping surface 821K (second gripping surface 821K ′) according to this modification is different from the first gripping surface 821 (second gripping surface 821 ′) described above. When viewed from above, the tip has a rounded arc shape. In this modification, the entire U-shaped region Ar2K (Ar2K ′) along the outer edge of the first gripping surface 821K (second gripping surface 821K ′) (a pair of first opposing regions Ar2 (second opposing regions Ar2 ′)) ) Is formed on the upper surface of the first electrode 83 (second electrode 83 ′). Further, the entire first central region Ar1K (second central region Ar1K ′) surrounded by the region Ar2K (Ar2K ′) in the first gripping surface 821K (second gripping surface 821K ′) (first central region Ar1 (second central) The entire region in which the tip of the region Ar2) has an arc shape) is configured by the upper surface of the first thermal resistance member 84 (second thermal resistance member 84 ′).

According to the above modification, treatment can be performed on the living tissue LT even on the distal end side. Further, the first electrode 83 (83A, second electrode 83 ′) can be formed of one member (in the first, second, tenth, and eleventh embodiments, a pair). That is, since the first electrode 83 (83A, second electrode 83 ′) is a single member, the first electrode 83 (83A, second electrode 83 ′) has only one lead constituting the electric cable C. Lines are joined.

1, 1A to 1G, 1I, 1J Energy treatment system 2, 2A to 2G, 2I, 2J Energy treatment tool 3 Control device 4 Foot switch 5 Handle 6 Shaft 7 Shaft 7, 7I Grip part 8, 8A to 8G, 8J First jaw 8 ′ Second jaw 9 Cutter 51 Operation knob 81 First support member 81 ′ Second support member 82, 82A to 82G, 82J First treatment portion 82 ′ Second treatment portion 83, 83A to 83D, 83F First electrode 83 ′ First Two electrodes 84, 84B, 84D to 84G First thermal resistance member 84C First thermal resistance portion 84 'Second thermal resistance member 85, 85A, 85F, 85H, 85J First cooling member 85' Second cooling member 86 Transverse member 811 1st recessed part 811 '2nd recessed part 821, 821B-821D, 821F, 821G, 821J, 821K 1st holding surface 821', 821K '2nd Holding surface 822, 822 'first and second cutter moving groove 831, 831B to 831D first back surface 831' second back surface 832D first recess 833F first base portion 834F electrode portion 841, 841 'back surface 842G first bulging portion 851 , 851H First latent heat storage material 851 ′ Second latent heat storage material 852, 852H First sealing member 852 ′ Second sealing member 853H First wick Ar1, Ar1K First central region Ar1 ′, Ar1K ′ Second central region Ar2 First opposing area Ar2 ′ Second opposing area Ar2K, Ar2K ′ area C electric cable CP center position Cu high frequency current LT biological tissue LT1, LT2 area R1 arrow SpA, SpF sealed space

Claims (10)

1. A first jaw having a first gripping surface;
   A second jaw having a second gripping surface for gripping a living tissue with the first gripping surface;
   A first electrode provided on the first jaw across a first central region of the first gripping surface;
   A second electrode provided on the second jaw across a second central region of the second gripping surface;
   A cooling member that is provided on at least one of the first jaw and the second jaw, and that cools the electrode by contacting at least one of the first electrode and the second electrode;
   Provided in at least one of the first jaw and the second jaw, and constitutes at least one of the first central region and the second central region, and includes the first electrode and the second electrode. And a heat resistance portion having high heat resistance to the living tissue,
   An energy treatment device comprising:
2. The first central region is a region including a center position on the first gripping surface,
   The energy treatment device according to claim 1, wherein the second central region is a region including a center position on the second gripping surface.
3. 3. The energy treatment device according to claim 1, wherein the thermal resistance portion is provided on a jaw provided with at least the cooling member among the first jaw and the second jaw.
4. The cooling member is a latent heat storage material, a sealing member for sealing the latent heat storage material,
   The energy treatment device according to any one of claims 1 to 3, further comprising:
5. 5. The energy treatment device according to claim 1, wherein the cooling member is mounted inside at least one of the first electrode and the second electrode.
6. The cooling member is disposed on at least one back surface of a first back surface of the first electrode separated from the first gripping surface and a second back surface of the second electrode spaced from the second back surface. Item 5. The energy treatment device according to any one of Items 1 to 4.
7. 7. The cooling member according to claim 1, wherein at least one of the first electrode and the second electrode is disposed on a proximal end side of the first jaw and the second jaw. The energy treatment device described in 1.
8. The heat resistance portion is configured separately from the first electrode and the second electrode, and has a thermal conductivity lower than that of the first electrode and the second electrode. The energy treatment device according to any one of the above.
9. The thermal resistance portion is a coating member that is formed separately from the first electrode and the second electrode, and is formed on at least one of the first electrode and the second electrode. The energy treatment tool according to any one of 8.
10. The thermal resistance portion is formed by subjecting at least one of the first electrode and the second electrode to surface processing, and is a region having a rough surface relative to the other surface region of the at least one electrode. The energy treatment device according to any one of claims 1 to 7, wherein:

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