WO2017216909A1

WO2017216909A1 - Treatment tool and control device

Info

Publication number: WO2017216909A1
Application number: PCT/JP2016/067811
Authority: WO
Inventors: 宮崎　章
Original assignee: オリンパス株式会社
Priority date: 2016-06-15
Filing date: 2016-06-15
Publication date: 2017-12-21

Abstract

According to the present invention, in a switching mechanism, a manipulation member is moved to a first movement position spaced apart a first distance in a predetermined direction from a neutral position, so that a first switch is switched to an ON state to allow a processor to perform a sound-emitting process. In the switching mechanism, the operating member is moved to a second movement position spaced apart in the predetermined direction from the neutral position by a second distance which is greater than the first distance, so that a second switch is switched to an ON state to allow the processor perform a process of outputting electrical energy to a treatment tool.

Description

Treatment tool and control device

The present invention relates to a treatment instrument that treats a treatment target and a control device that controls the supply of electrical energy to the treatment instrument.

WO2013 / 154922 discloses a treatment tool for treating a treatment object by grasping a treatment object such as a living tissue between a pair of grasping pieces in an end effector and applying treatment energy to the treatment object to be grasped. ing. In this treatment instrument, two operation members (operation buttons) are attached to a holdable housing. For example, when an operation input is performed with one operation member, ultrasonic vibration and high-frequency current are applied to the treatment target as treatment energy. When an operation input is performed with the other operation member, only the high-frequency current is applied to the treatment target as treatment energy.

When performing treatment using a treatment tool in a body cavity such as the abdominal cavity, the treatment is performed while visually observing an image observed with a rigid endoscope. For this reason, the operation input may be performed on the operation member in a state where the operation member and the vicinity thereof are not visually recognized. If operation input is performed without visually recognizing the operation member and the vicinity thereof, in a configuration in which a plurality of operation members are provided as in WO2013 / 154922, there is a possibility that operation input may be performed with an operation member different from the intended operation member There is. When an operation input is performed with an operation member other than the intended operation member, the treatment tool is operated in an operation state different from the intended operation state. For example, treatment energy different from the intended treatment energy is applied to the treatment target. It may not be.

The present invention has been made to solve the above-described problems, and the object of the present invention is to operate a treatment instrument in an operation state different from an intended operation state in a configuration in which a plurality of operation members are provided. This is to provide a treatment tool in which this is effectively prevented. Moreover, it is providing the control apparatus which controls supply of the electrical energy to the treatment tool.

In order to achieve the above object, an aspect of the present invention provides a treatment tool used together with a control device including a processor, the end effector treating a treatment target, and the treatment tool in the treatment with the end effector. A switch mechanism for performing an operation input to be operated, wherein the operation member moves in a predetermined direction from a neutral position based on the operation input; and the operation member moves the neutral position from the neutral position to the predetermined direction by the operation input. A first switch that causes the processor to perform a process of transmitting a sound by switching to the ON state by moving to a first movement position separated by a distance of 1, and switching to the ON state; Upon input, the operating member moves from the neutral position to a second movement position that is separated from the neutral position by a second distance greater than the first distance in the predetermined direction. A second switch that causes the processor to perform a process of outputting electrical energy to the treatment instrument and operating the treatment instrument by switching to the ON state. Prepare.

Another aspect of the present invention is provided with a switch mechanism including an operation member, a first switch, and a second switch, and is used together with a treatment instrument including an end effector for treating a treatment target. A control device for controlling the supply of energy, an energy output source capable of outputting the electrical energy to the treatment instrument, a sound transmission source capable of transmitting sound, and an operation for operating the treatment instrument with the switch mechanism By detecting that the operating member moves from the neutral position to a first moving position away from the neutral position by a first distance based on the input and the first switch is switched to the ON state, The sound is transmitted from a sound transmission source, and based on the operation input, the operation member is separated from the neutral position in the predetermined direction by a second distance greater than the first distance. A processor that moves to a movement position and detects that the second switch is switched to an ON state, thereby outputting the electrical energy from the energy output source to the treatment instrument, and operating the treatment instrument; Is provided.

FIG. 1 is a schematic view showing a treatment system according to the first embodiment. FIG. 2 is a block diagram showing a configuration for supplying electrical energy from the control device according to the first embodiment to the treatment instrument. FIG. 3 is a cross-sectional view schematically showing a switch mechanism according to the first embodiment in a state where the operation member is located at a neutral position. FIG. 4 is a cross-sectional view schematically showing a switch mechanism according to the first embodiment in a state where the operation member is located at the first movement position. FIG. 5 is a cross-sectional view schematically showing a switch mechanism according to the first embodiment in a state where the operation member is located at the second movement position. FIG. 6 shows a configuration in which the processor according to the first embodiment detects whether each of the first switch and the second switch is in an OFF state (open state) or an ON state (closed state). FIG. FIG. 7 is a schematic diagram illustrating processing of the processor in each ON state of the switch according to the first embodiment.

(First embodiment)
A first embodiment of the present invention will be described with reference to FIGS. FIG. 1 is a diagram showing a treatment system 1 of the present embodiment. As shown in FIG. 1, the treatment system 1 includes a treatment tool 2 and a control device 3 that controls the supply of electrical energy to the treatment tool 2. Here, in FIG. 1, the arrow C1 side is the distal end side, and the arrow C2 side (the opposite side to the distal end side) is the proximal end side.

The treatment instrument 2 includes a housing 5 that can be held, a shaft 6 that is coupled to the distal end side of the housing 5, and an end effector 7 that is provided at the distal end of the shaft 6. The housing 5 has an outer surface 18. The housing 5 is provided with a grip 11 and a handle 12 is rotatably attached. When the handle 12 is rotated with respect to the housing 5, the handle 12 is opened or closed with respect to the grip 11. In the shaft 6, the side toward the housing 5 is a proximal end side, and the side toward the end effector 7 is a distal end side.

In this embodiment, the end effector 7 includes a first grip piece 15 and a second grip piece 16. By opening or closing the handle 12 with respect to the grip 11, the space between the pair of

gripping pieces

15 and 16 is opened or closed. By closing the pair of

gripping pieces

15 and 16, it is possible to grip a treatment target such as a living tissue between the

gripping pieces

15 and 16. In the end effector 7, a treatment target grasped between the

grasping pieces

15 and 16 is treated. In the present embodiment, the rotary knob 17 is rotatably attached to the housing 5. As the rotary knob 17 rotates with respect to the housing 5, the shaft 6 and the end effector 7 rotate with the rotary knob 17 about the central axis of the shaft 6 with respect to the housing 5.

One end of a cable 13 is connected to the housing 5. The other end of the cable 13 is detachably connected to the control device 3. Further, operation members (operation buttons) 21 A and 21 B are attached to the housing 5. On the outer surface of the housing 5, the

operation members

21A and 21B are arranged in parallel. In each of the

operation members

21A and 21B, an operation for operating the treatment instrument 2 is input.

FIG. 2 is a diagram showing a configuration for supplying electric energy from the control device 3 to the treatment instrument 2. As shown in FIG. 2, the control device 3 includes a processor 25 and a storage medium 26. The processor (control unit) 25 is formed from an integrated circuit including a CPU (Central Processing Unit), an ASIC (Application Specific Integrated Circuit), an FPGA (Field Programmable Gate Array), or the like. The processor 25 may be formed from one integrated circuit, or may be formed from a plurality of integrated circuits. The processing in the processor 25 is performed according to a program stored in the processor 25 or the storage medium 26. In addition, the storage medium 26 stores a processing program used by the processor 25, parameters and tables used for calculation by the processor 25, and the like.

In addition, the control device 3 includes a power source 31 and an energy output source 32. The power source 31 includes a battery or a plug. The energy output source 32 includes a conversion circuit that converts electric power from the power source 31 into electric energy supplied to the treatment instrument 2. The energy output source 32 can convert electric power from the power source and output the converted electric energy to the treatment instrument 2. The processor 25 controls the output state of electric energy from the energy output source 32 and detects the output state of electric energy from the energy output source 32.

In this embodiment, an ultrasonic transducer 35 is provided inside the housing 5. The energy output source 32 is electrically connected to the ultrasonic transducer 35 via electrical paths E1 and E2 extending through the inside of the cable 13. In the present embodiment, AC power having a predetermined frequency is supplied from the energy output source 32 to the ultrasonic transducer 35 as electrical energy. By supplying electric energy to the ultrasonic transducer 35, the treatment instrument 2 is operated, and ultrasonic vibration is generated in the ultrasonic transducer 35. In the present embodiment, the rod member (10) in which the first gripping piece 15 is formed at the distal end portion inside the housing 5 is connected to the ultrasonic transducer 35 from the distal end side. The ultrasonic vibration generated by the ultrasonic transducer 35 is transmitted to the first gripping piece 15 through the rod member (10). Ultrasonic vibration is transmitted to the first gripping piece 15 in a state where the treatment target is gripped between the

gripping pieces

15, 16, whereby the ultrasonic vibration is applied to the gripped treatment target as treatment energy.

In the present embodiment, the electrode 36 is provided on the first gripping piece 15, and the electrode 37 is provided on the second gripping piece 16. The energy output source 32 is electrically connected to the electrode 36 via an electric path E3 extending through the inside of the cable 13. The energy output source 32 is electrically connected to the electrode 37 via an electric path E4 extending through the cable 13. In the present embodiment, high frequency power is supplied from the energy output source 32 to the

electrodes

36 and 37 as electric energy. By supplying electric energy to the

electrodes

36 and 37, the treatment instrument 2 is operated, and the

electrodes

36 and 37 have different potentials with respect to each other. When electric energy is supplied to the

electrodes

36 and 37 while the treatment object is grasped between the grasping

pieces

15 and 16, a high-frequency current flows through the treatment object to be grasped, and the high-frequency current is supplied as treatment energy to the treatment object. Is granted.

The control device 3 includes a sound transmission source 33. The sound transmission source 33 is a buzzer or the like, for example, and can transmit a sound. The processor 25 controls the sound transmission state from the sound transmission source 33 and detects the sound transmission state from the sound transmission source 33.

Also, in the housing 5 of the treatment instrument 2,

first switches

22A and 22B and

second switches

23A and 23B are provided. The processor 25 detects whether each of the

first switches

22A and 22B and the

second switches

23A and 23B is in an OFF state (open state) or an ON state (closed state). Here, the first switch 22A and the second switch 23A together with the aforementioned operation member 21A form a switch mechanism (first switch mechanism) 20A. The first switch 22B and the second switch 23B together with the operation member 21B described above form a switch mechanism (second switch mechanism) 20B different from the switch mechanism 20A. Therefore, in this embodiment, a plurality of

switch mechanisms

20A and 20B are provided.

3 to 5 are diagrams showing the configuration of the switch mechanism 20A. In the following description, the switch mechanism 20A will be described, but the switch mechanism 20B has the same configuration as the switch mechanism 20A. As shown in FIGS. 3 to 5, in the switch mechanism 20 A, the second switch 23 A is located farther from the operation member 21 A disposed on the outer surface 18 of the housing 5 than the first switch 22 A. The first switch 22 A includes a first sheet 42, a second sheet 43, and a third sheet 45. In the first switch 22A, the first sheet 42, the second sheet 43, and the third sheet 45 are stacked in this order from the side close to the operation member 21A. Here, the first sheet 42 and the third sheet 45 are conductive sheets, and the second sheet 43 is an insulating sheet. A signal path wiring is connected to the third sheet 45. This wiring is connected to the processor 25. The second sheet 43 is formed with a hole 46 that penetrates the second sheet 43. The first switch 22 A is switched from the OFF state (open state) to the ON state (closed state) when the first sheet 42 contacts the third sheet 45 in the hole 46. Further, an elastic member (first elastic member) 47 is provided between the operation member 21A and the first sheet 42 of the first switch 22A.

Inside the housing 5, a substrate 41 fixed to the housing 5 is provided. The substrate 41 is located farther from the operation member 21A than the first switch 22A. The second switch 23 A includes a contact member 51 fixed on the substrate 41 and a metal dome 52 attached to the substrate 41. The metal dome 52 is an elastic member that can be elastically deformed. The metal dome (second elastic member) 52 covers the contact member 51 from the side close to the operation member 21A. Signal line wiring is connected to the contact member 51. This wiring is connected to the processor 25. The second switch 23 A is switched from the OFF state (open state) to the ON state (closed state) when the metal dome 52 contacts the contact member 51.

Here, in a state where no operating force is applied to the operating member 21A, that is, in a state where no operation input is performed, the operating member 21A is positioned at the neutral position shown in FIG. In the state where the operation member 21A is located at the neutral position, the first switch 22A does not come into contact with the third sheet 45 in the first switch 22A, and the first switch 22A is maintained in the OFF state. Further, in the second switch 23A, the metal dome 52 does not contact the contact member 51, and the second switch 23A is maintained in the OFF state.

When an operation input for operating the treatment instrument 2 is performed in the switch mechanism 20A and an operation force is applied to the operation member 21A, the operation member 21A moves toward the inside of the housing 5, that is, toward a predetermined direction (direction of arrow T). Move from the neutral position. Thereby, the operation member 21A presses the elastic member 47, and the elastic member 47 is elastically deformed. Then, the first sheet 42 is pressed by the elastic member 47 that is elastically deformed. When the operation member 21A moves from the neutral position to the first movement position shown in FIG. 4 in the predetermined direction in the predetermined direction, the first sheet 42 is moved in the hole 46 by the pressure from the elastic member 47. Contact the third sheet 45. Thereby, the first switch 22A is switched from the OFF state to the ON state. However, even in the state where the operation member 21A is located at the first movement position, the metal dome 52 does not contact the contact member 51 in the second switch 23A, and the second switch 23A is maintained in the OFF state.

Then, when the operation member 21A further moves from the first movement position in a predetermined direction (the direction of the arrow T), the third sheet 45 presses the metal dome 52, and the metal dome 52 is elastically deformed. Then, when the operation member 21A moves from the neutral position to a second movement position shown in FIG. 5 that is a second distance L2 larger than the first distance L1 in a predetermined direction, the metal dome 52 contacts the contact member 51. . As a result, the second switch 23A is switched from the OFF state to the ON state. At this time, in the first switch 22A, the first sheet 42 contacts the third sheet 45, and the first switch 22A is maintained in the ON state.

As described above, in each of the

switch mechanisms

20A and 20B, the operating member (21A; 21B) is separated from the neutral position (position in FIG. 3) by the first distance L1 in the predetermined direction (direction of arrow T). The first switch (22A; 22B) is switched to the ON state by moving to the movement (position in FIG. 4). In each of the

switch mechanisms

20A and 20B, the operation member (21A; 21B) is moved away from the neutral position in a predetermined direction by a second distance L2 that is larger than the first distance L1 (position in FIG. 5). ), The second switch (23A; 23B) is switched to the ON state. As long as this configuration is satisfied, each of the

switch mechanisms

20A and 20B is not limited to the above-described configuration.

In each of the

switch mechanisms

20A and 20B, the elastic member (first elastic member) 47 is elastically deformed while moving from the neutral position to the first movement position of the operation member (21A; 21B). For this reason, the operating member (21A; 21B) is moved to the first movement position, and the first switch (22A; 22B) is switched to the ON state (closed state), whereby the operating force (21A; 21B; The operator applying to 21B) can obtain a click feeling due to the elastic deformation of the elastic member 47. Similarly, in each of the

switch mechanisms

20A and 20B, the metal dome (second elastic member) 52 is elastically deformed while the operation member (21A; 21B) moves from the first movement position to the second movement position. To do. For this reason, the operating member (21A; 21B) moves to the second movement position, and the second switch (23A; 23B) is switched to the ON state (closed state), so that the operating force is applied to the operating member (21A; The operator applying to 21B) can feel a click due to the elastic deformation of the metal dome 52.

Further, in each of the

switch mechanisms

20A and 20B, the first force amount F1 is required as the minimum force amount in order to move the operation member (21A; 21B) from the neutral position to the first movement position. Then, in order to move the operation member (21A; 21B) from the first movement position to the second movement position, the second force amount F2 is required as the minimum force amount. In each of the

switch mechanisms

20A and 20B, the first force amount F1 is smaller than the second force amount F2. The first force amount F1 is determined by the dimensions, materials, and the like of the

sheets

42, 43, 45, the elastic member 47, and the like. Similarly, the second force amount F2 is determined by the dimensions and materials of the contact member 51, the metal dome 52, and the like.

FIG. 6 shows a configuration in which the processor 25 detects whether each of the

first switches

22A and 22B and the

second switches

23A and 23B is in an OFF state (open state) or an ON state (closed state). FIG. As shown in FIG. 6, the processor 25 is electrically connected to the first switch 22A via the signal path P1, and is also electrically connected to the first switch 22B via the signal path P2. The processor 25 is electrically connected to the second switch 23A via the signal path P3 and is electrically connected to the second switch 23B via the signal path P4. The processor 25 is electrically connected to the

first switches

22A and 22B and the

second switches

23A and 23B via the ground path P5.

The processor 25 detects that the first switch 22A is in the ON state based on the detection current (current) flowing through the signal path P1 and the ground path P5. Similarly, the processor 25 detects that the first switch 22B is in the ON state based on the detection current flowing through the signal path P2 and the ground path P5. Then, the processor 25 detects that the second switch 23A is ON based on the detection current flowing through the signal path P3 and the ground path P5, and the detection current is detected through the signal path P4 and the ground path P5. Based on the flow, it is detected that the second switch 23B is in the ON state. Thus, the processor 25 can detect whether or not each of the

switches

22A, 22B, 23A, and 23B has been switched from the OFF state to the ON state.

In addition, the configuration for detecting whether each of the

switches

22A, 22B, 23A, and 23B is in the OFF state or the ON state is not limited to the above-described configuration. For example, the

switches

22A, 22B, 23A, and 23B may be electrically arranged in parallel between one signal path and one ground path. In this case, the processor 25 passes the detection current through the signal path and the ground path. Then, the processor 25 determines whether each of the

switches

22A, 22B, 23A, and 23B is in an OFF state or an ON state based on the magnitude of the current flowing through each of the

switches

22A, 22B, 23A, and 23B. To detect.

The processor 25 controls the sound transmission state from the sound transmission source 33 based on whether or not each of the

first switches

22A and 22B is in the ON state. Further, the processor 25 controls the output state of electrical energy from the energy output source 32 to the treatment instrument 2 based on whether or not each of the

second switches

23A and 23B is in the ON state.

FIG. 7 is a diagram illustrating processing of the processor 25 in the ON state (closed state) of each of the

switches

22A, 22B, 23A, and 23B. As shown in FIG. 7, when detecting that the first switch 22 A is switched to the ON state, the processor 25 transmits a sound from the sound transmission source 33 in the first transmission state. In addition, when detecting that the first switch 22B has been switched to the ON state, the processor 25 causes the sound transmission source 33 to transmit sound in a second transmission state different from the first transmission state. In the first transmission state and the second transmission state, at least one of the volume and level of the sound to be transmitted is different from each other. Further, when sound is intermittently and periodically transmitted from the sound transmission source 33, the sound transmission cycle or the transmission time in one cycle differs between the first transmission state and the second transmission state. As described above, in the present embodiment, each of the

first switches

22A and 22B is switched to the ON state, thereby causing the processor 25 to perform a process of transmitting a sound. Further, the processor 25 changes the sound transmission state from the sound transmission source 33 when the first switch (22A; 22B) is switched to the ON state for each switch mechanism (20A, 20B). Make it.

In some embodiments, sound is transmitted from the sound transmission source 33 only in one of the first transmission state and the second transmission state, and no sound may be transmitted on the other side. In this case, when the processor 25 detects that the first switch 22A has been switched to the ON state, or when it has detected that the first switch 22B has been switched to the ON state, the sound transmission source 33 Make a sound from.

When detecting that the second switch 23A is switched to the ON state, the processor 25 causes the energy output source 32 to output electric energy in the first output state. Further, when detecting that the second switch 23B is switched to the ON state, the processor 25 causes the energy output source 32 to output electrical energy in a second output state different from the first output state. That is, each of the

second switches

23A and 23B is switched to the ON state, thereby outputting the treatment tool 2 electrical energy and causing the processor 25 to perform processing for operating the treatment tool 2. In the first output state and the second output state, the supply state of electrical energy to the treatment instrument 2 is different from each other. For this reason, in the 1st output state and the 2nd output state, the operation state of treatment implement 2 differs with respect to each other.

For example, in the first output state, electric energy (AC power having a predetermined frequency) is supplied from the energy output source 32 to the ultrasonic transducer 35. As a result, ultrasonic vibration is generated by the ultrasonic transducer 35, and the ultrasonic vibration is applied to the treatment target to be grasped as described above. At this time, in addition to applying ultrasonic vibration to the treatment target, electric energy (high-frequency power) is also supplied to the

electrodes

36 and 37, and a high-frequency current is applied to the treatment target held as described above. May be. In the second output state, electrical energy is supplied only from the energy output source 32 to the

electrodes

36 and 37, and no electrical energy is supplied to the ultrasonic transducer 35. For this reason, only the high frequency current is applied to the treatment target to be grasped, and no ultrasonic vibration is applied.

In another embodiment, the treatment instrument 2 is not provided with the

electrodes

36 and 37, and only the ultrasonic transducer 35 is provided. Then, electrical energy is supplied to the ultrasonic transducer 35 in both the first output state and the second output state. However, in the second output state, the current value of the current supplied to the ultrasonic transducer 35 is larger than that in the first output state. For this reason, in the second output state, the amplitude of the ultrasonic vibration generated by the ultrasonic transducer 35 is larger than that in the first output state.

In another embodiment, the treatment instrument 2 is not provided with the ultrasonic transducer 35, and only the

electrodes

36 and 37 are provided. Then, electric energy is supplied to the

electrodes

36 and 37 in both the first output state and the second output state. However, in the second output state, the output power is larger than that in the first output state. For this reason, in the second output state, the high-frequency current flowing through the treatment object between the

electrodes

36 and 37 is larger than that in the first output state. As described above, in this embodiment, the processor 25 switches the output state of the electric energy from the energy output source 32 when it is detected that the second switch (23A; 23B) is switched to the ON state. Different for each mechanism (20A, 20B).

Next, functions and effects of the treatment tool 2 and the control device 3 of the present embodiment will be described. When performing a treatment using the treatment system 1, the operator inserts the end effector 7 into a body cavity such as the abdominal cavity. Then, a treatment target such as a living tissue is grasped between the grasping

pieces

15 and 16 as described above. In a state where the treatment target is grasped between the grasping

pieces

15 and 16, the operator performs an operation input for operating the treatment instrument 2 with the

operation member

21A or 21B. As a result, treatment energy such as ultrasonic vibration or high-frequency current is applied to the treatment target to be grasped to treat the treatment target. At this time, the operator performs treatment while visually recognizing an observation image with a rigid endoscope (not shown). For this reason, operation input may be performed in the

operation member

21A or 21B in a state where the

operation members

21A and 21B and the vicinity thereof are not visually recognized.

Here, a case where the operator intends to perform an operation input with the operation member 21A and apply ultrasonic vibration as treatment energy to the treatment target will be described. In this case, when the operator applies an operating force to the operating member 21A of the switch mechanism 20A and moves the operating member 21A from the neutral position to the first moving position in a predetermined direction (the direction of the arrow T), the first The switch 22A is turned on. At this time, since the elastic member 47 is elastically deformed by the movement of the operation member 21A from the neutral position to the first movement position, the operator can obtain a click feeling. Further, when the first switch 22A is turned on by the movement to the first movement position, the processor 25 causes the sound transmission source 33 to emit sound in the first transmission state. At this time, the surgeon recognizes that the operation force is applied to the intended operation member 21A based on the sound transmitted from the sound transmission source 33.

When recognizing that the operation input is performed with the intended operation member 21A, the surgeon continues to apply the operation force to the operation member 21A and moves the operation member 21 from the first movement position to the second movement position. Is further moved in a predetermined direction. As a result, the second switch 23A is turned on. At this time, since the metal dome 52 is elastically deformed by the movement of the operation member 21A from the second movement position to the second movement position, the operator can obtain a click feeling. Further, when the second switch 23A is turned on by the movement to the second movement position, the processor 25 causes the energy output source 32 to output electric energy in the first output state. Thereby, the treatment tool 2 is operated in the intended operation state, and the ultrasonic vibration generated by the ultrasonic transducer 35 is applied to the treatment target.

On the other hand, the surgeon may apply an operating force to an operating member 21B different from the intended operating member 21A. In this case, the operation member 21B of the switch mechanism 20B moves from the neutral position to the first movement position in a predetermined direction (the direction of the arrow T), and the first switch 22B is turned on. Also at this time, since the elastic member 47 is elastically deformed by the movement of the operation member 21B from the neutral position to the first movement position, the operator can obtain a click feeling. Further, when the first switch 22B is turned on by the movement to the first movement position, the processor 25 transmits a sound from the sound transmission source 33 in a second transmission state different from the first transmission state. . At this time, based on the fact that the sound is transmitted from the sound transmission source 33 in the second transmission state, the surgeon has applied an operation force to the operation member 21B different from the intended operation member 21A. Recognize Then, the application of the operating force to the operating member 21B is released.

In the state where the operation member 21B is located at the first movement position, the second switch 23B is in the OFF state. For this reason, the electric energy is not output from the energy output source 32 under the control of the processor 25. Therefore, for example, it is possible to prevent the treatment tool 2 from being operated in an operation state in which only a high-frequency current is applied to the treatment target, and it is effective that the treatment tool 2 is operated in an operation state different from the intended operation state. Is prevented.

As described above, in each of the

switch mechanisms

20A and 20B, the operation member (21A; 21B) is moved from the neutral position to the first position before the operation member (21A; 21B) is moved from the neutral position to the second movement position. The first switch (22A; 22B) is turned on in the state where it has moved to the moving position. That is, the first switch (22A; 22B) is turned on before the second switch (23A; 23B) is turned on. Then, based on the first switch (22A; 22B) being switched to the ON state, the processor 25 transmits a sound from the sound transmission source 33 in a predetermined transmission state. Based on the sound transmitted from the sound transmission source 33, the surgeon can recognize whether or not an operation input is performed with the intended operation member (21A or 21B). Further, in a state where the operation member (21A; 21B) is located at the first movement position, the second switch (23A; 23B) is in an OFF state. For this reason, even if an operation member different from the intended operation member (21A or 21B) is moved to the first movement position, electric energy is not output from the energy output source 32. Therefore, it is effectively prevented that the treatment instrument 2 is operated in an operation state different from the intended operation state, and treatment performance is ensured in treatment using treatment energy such as ultrasonic vibration and high-frequency current.

Note that, in one of the first transmission state and the second transmission state, the processor 25 may not transmit sound from the sound transmission source 33. In this case, based on whether or not sound is transmitted from the sound transmission source 33 at the timing when the operation member (21A; 21B) is moved to the first movement position, the operator operates the intended operation member (21A or 21A or 21B). In step 21B), it is determined whether or not an operation input has been performed.

In each of the

switch mechanisms

20A and 20B, the elastic member (first elastic member) 47 is elastically deformed when the operation member (21A; 21B) is moved from the neutral position to the first movement position. Therefore, when the operating member (21A; 21B) moves to the first movement position, that is, when the first switch (22A; 22B) is switched to the ON state, or immediately after that, the operator clicks. Get a feeling. Therefore, the surgeon can recognize the timing at which sound transmission from the sound transmission source 33 is started, that is, the timing at which the first switch (22A; 22B) is switched to the ON state based on the click feeling. .

In each of the

switch mechanisms

20A and 20B, the metal dome (second elastic member) 52 is elastically deformed by the movement of the operation member (21A; 21B) from the first movement to the second movement position. Therefore, when the operating member (21A; 21B) moves to the second movement position, that is, when the second switch (23A; 23B) is switched to the ON state, or immediately after that, the operator clicks. Get a feeling. For this reason, the surgeon can recognize the timing at which the output of electrical energy from the energy output source 32 is started, that is, the timing at which the second switch (23A; 23B) is switched to the ON state based on the click feeling. Become.

In the present embodiment, the first force F1, which is the minimum force required to move the operation member (21A; 21B) from the neutral position to the first movement position, It is smaller than the second force amount F2, which is the minimum force amount necessary for moving from the first movement position to the second movement position. For this reason, even if the operation member (21A; 21B) is moved to the first movement position with a force amount equal to or greater than the first force amount F1, a force amount equal to or greater than the second force amount F2 is not applied to the operation member (21A; 21B). As long as the operating member (21A; 21B) is prevented from moving to the second moving position. This makes it difficult for the second switch (23A or 23B) to be switched to the ON state when an operation input is performed with an operation member different from the intended operation member (21A or 21B). Therefore, it is further effectively prevented that the treatment tool 2 is operated in an unintended operation state.

(Modification)
In the first embodiment, two

switch mechanisms

20A and 20B are provided. However, three or more switch mechanisms having the same configuration as the

switch mechanisms

20A and 20B may be provided. Also in this case, the processor 25 changes the sound transmission state from the sound transmission source 33 when the first switch (for example, 22A; 22B) is switched to the ON state, for each switch mechanism. Then, the processor 25 changes the output state of the electric energy from the energy output source 32 when it is detected that the second switch (for example, 23A; 23B) is switched to the ON state for each switch mechanism. Here, in one switch mechanism (for example, 20B) among a plurality of switch mechanisms (for example, 20A, 20B), even if the first switch (for example, 22B) is turned on, the sound is transmitted from the sound transmission source 33. It does not have to be sent. Also in this case, in each of the other switch mechanisms (for example, 20A), the processor 25 transmits a sound from the sound transmission source 33 based on the first switch (for example, 22A) being switched to the ON state.

In a modification, the end effector 7 of the treatment instrument 2 is provided with a heater (not shown), and in at least one of the first output state and the second output state, DC power or AC power is output as electrical energy. In this case, heater heat is generated by supplying electric energy to the heater. Then, the heater heat is applied as treatment energy to the treatment object grasped between the grasping

pieces

15 and 16. In an embodiment, electric energy is supplied to the heater in the first output state, and the heater heat is applied to the treatment target. In the second output state, electric energy is supplied to the

electrodes

36 and 37 as described above, and a high-frequency current is applied to the treatment target. In another embodiment, electrical energy is supplied to the heater in both the first output state and the second output state. In the second output state, the output power from the energy output source 32 to the heater is larger than that in the first output state. For this reason, in the second output state, the amount of heater heat generated by the heater is larger and the heater temperature is higher than in the first output state.

In a modification, the treatment instrument 2 is provided with an electric motor (not shown), and driving power is output as electric energy from the energy output source 32 to the electric motor in the first output state or the second output state. . In this case, the electric motor is driven by supplying electric energy to the electric motor. Thereby, the staple is punctured to the treatment target to be grasped. In one embodiment, in the first output state, electric energy is supplied to the

electrodes

36 and 37 as described above, and a high-frequency current is applied to the treatment target. In the second output state, electric energy is supplied to the electric motor, and staples are punctured into the treatment target.

Therefore, if the operation state of the treatment instrument 2 is different between the first output state and the second output state, the operation state of the treatment instrument 2 in each of the first output state and the second output state is the operation described above. It is not limited to the state.

In the above-described embodiment, the end effector 7 includes the

grip pieces

15 and 16, but the configuration of the end effector 7 is not limited to this. For example, the configuration of the above-described embodiment or the like can be applied to a configuration in which the end effector 7 is formed in a hook shape, a spatula shape, a blade shape, or the like. When the end effector 7 is formed in a hook shape, treatment energy such as ultrasonic vibration and high-frequency current is applied to the treatment target while the treatment target is hooked on the hook.

Further, the sound transmission source 33 does not need to be provided in the control device 3 and may be provided in the treatment instrument 2. The sound transmission source 33 may be provided separately from the treatment instrument 2 and the control device 3.

In the above-described embodiment and the like, the control device 3 is provided separately from the treatment tool 2, but the control device 3 may be incorporated in the treatment tool 2. In this case, the power supply 31 such as a battery, the energy output source 32 including a conversion circuit, the processor 25, the storage medium 26, and the sound transmission source 33 are mounted, for example, inside the housing 5 of the treatment instrument 2.

In the above-described embodiment, the switch mechanism (20A; 20B) includes an operation member (21A; 21B) that moves in a predetermined direction (T) from the neutral position based on an operation input. In the switch mechanism (20A; 20B), the operation member (21A; 21B) is moved from the neutral position to the first movement position away from the neutral position in a predetermined direction (T) by the first distance (L1) by the operation input. The first switch (22A; 22B) is switched to the ON state, and the first switch (22A; 22B) is switched to the ON state, thereby causing the processor (25) to perform a process of transmitting a sound. Further, in the switch mechanism (20A; 20B), the operation member (21A; 21B) is separated from the neutral position in a predetermined direction (T) by a second distance (L2) larger than the first distance (L1) by the operation input. By moving to the second moving position, the second switch (23A; 23B) is switched to the ON state, and the second switch (23A; 23B) is switched to the ON state, whereby the treatment instrument (2 ) To output electric energy to cause the processor (25) to perform the process of operating the treatment instrument (2).

The embodiments of the present invention have been described above, but the present invention is not limited to the above-described embodiments, and various modifications can be made without departing from the spirit of the invention.

Claims

A treatment tool used together with a control device including a processor,
An end effector for treating a treatment object;
In the treatment with the end effector, a switch mechanism for performing an operation input for operating the treatment instrument,
An operation member that moves in a predetermined direction from a neutral position based on the operation input;
The operation member is switched to the ON state by moving the operation member from the neutral position to the first movement position away from the neutral position by a first distance in the predetermined direction. A first switch that causes the processor to perform a process of transmitting
The operation member is switched to an ON state by moving the operation member from the neutral position in the predetermined direction to a second movement position separated by a second distance larger than the first distance in response to the operation input. A second switch that outputs electrical energy to the treatment instrument and causes the processor to perform a process of operating the treatment instrument;
A switch mechanism comprising:
A treatment instrument comprising:
The switch mechanism includes a first elastic member that elastically deforms while the operation member moves from the neutral position to the first movement position, and moves from the first movement position to the second movement position. The treatment tool according to claim 1, further comprising a second elastic member that elastically deforms therebetween.
The first force amount, which is the minimum force amount required to move the operating member from the neutral position to the first moving position, moves the operating member from the first moving position to the second moving position. The treatment tool according to claim 1, wherein the treatment tool is smaller than a second force amount that is a minimum force amount necessary for the movement.
A plurality of the switch mechanisms are provided,
Each of the switch mechanisms includes the operation member, the first switch, and the second switch.
The treatment tool according to claim 1.
The switch mechanism is mounted and further includes a holdable housing,
The plurality of switch mechanisms include a first switch mechanism in which the operation member is disposed on an outer surface of the housing, and the operation member in parallel with the operation member of the first switch mechanism on the outer surface of the housing. A second switch mechanism arranged as
The treatment tool according to claim 4.
A control device that is provided with a switch mechanism including an operation member, a first switch, and a second switch, and that is used with a treatment instrument that includes an end effector that treats a treatment target, and that controls the supply of electrical energy to the treatment instrument. There,
An energy output source capable of outputting the electrical energy to the treatment instrument;
A sound transmission source capable of transmitting sound;
Based on an operation input for operating the treatment instrument by the switch mechanism, the operation member moves from a neutral position to a first movement position away from the neutral position by a first distance, and the first switch is in an ON state. The sound is transmitted from the sound transmission source, and the operation member is moved from the neutral position to the predetermined direction in the predetermined direction based on the operation input. The electrical energy is output from the energy output source to the treatment instrument by detecting that the second switch is switched to the ON state by moving to a second movement position separated by a distance of A processor for operating the tool;
A control device comprising:
The treatment instrument is provided with a plurality of the switch mechanisms, and each of the switch mechanisms includes the operation member, the first switch, and the second switch,
The processor varies the output state of the electrical energy from the energy output source when it is detected that the second switch is switched to the ON state for each switch mechanism.
The control device according to claim 6.
The treatment instrument is provided with a plurality of the switch mechanisms, and each of the switch mechanisms includes the operation member, the first switch, and the second switch,
The processor makes the sound transmission state from the sound transmission source different when detecting that the first switch is switched to the ON state for each switch mechanism.
The control device according to claim 6.