WO2018087837A1

WO2018087837A1 - Medical device and medical device manufacturing method

Info

Publication number: WO2018087837A1
Application number: PCT/JP2016/083224
Authority: WO
Inventors: 庸高銅
Original assignee: オリンパス株式会社
Priority date: 2016-11-09
Filing date: 2016-11-09
Publication date: 2018-05-17
Also published as: JPWO2018087837A1; JP6746708B2

Abstract

Using metal to conduct electricity in medical devices is sometimes problematic. For example, if heat from a treatment, etc., builds up, a thermal insult can result upon contact with tissue. The purpose of the present invention is to provide a medical device that solves this problem. This medical device is provided with: a structure (21) which has a nonconductive section in at least a portion thereof; a conductive coating (34) which is formed on at least a part of the structure (21) and which is conductive and water repellent; and an energy transfer unit (28) which transfers electric energy to the coating (34). The conductive coating (34) is coated on at least the nonconductive section of the structure (21), and even in the nonconductive section of the structure (21), electric energy is supplied through the conductive coating (34).

Description

Medical device, method for manufacturing medical device

The present invention relates to a medical device having electrical conductivity, in particular, a medical device that performs treatment on a living tissue with energy and a method for manufacturing the medical device.

International Patent Publication No. 2014/141530 discloses a therapeutic treatment tool that prevents adhesion of a living tissue to an energy application surface. Ni-PTFE is used for the coating formed on the energy application surface.

JP 2006-288425 A discloses a bipolar tweezers in which the amount of protein attached to the tip portion is reduced. A composite plating film made of a noble metal material and non-conductive fine particles and a multilayer plating film made of a noble metal material are provided on the opposing surfaces of the pair of arm-shaped tip portions.

Japanese Patent Application Laid-Open No. 2010-227462 discloses a medical electrode provided with a coating layer for preventing adhesion of a living tissue. The coat layer is composed of a mixture of a plurality of materials such as a material having higher heat-resistant oxidation characteristics than metal and a material having higher electrochemical oxidation resistance than metal.

International Publication No. 2014/141530 Specification JP 2006-288425 A JP 2010-227462 A

In medical equipment, there may be a problem in energizing itself with metal. For example, contact with tissue in a state where heat due to treatment or the like is accumulated leads to thermal invasion.

In order to achieve the above object, a medical device according to one aspect of the present invention has a structure part having a non-conduction part at least in part, and conductivity and water repellency formed in at least part of the structure part. An electrically conductive coating part, and an energy transmission part for transmitting electrical energy to the coating part, wherein the electrically conductive coating part is applied to at least the non-conductive part of the structural part, and in the non-conductive part of the structural part Also, electric energy is supplied through the conductive coating portion.

According to the above configuration, electric energy can flow to the living tissue through the conductive coating portion.

FIG. 1 is a schematic diagram illustrating the overall configuration of the treatment instrument according to the first embodiment. FIG. 2 is a side view showing a distal end portion of a rod member and a jaw member of the handpiece of the treatment instrument shown in FIG. FIG. 3 is an enlarged cross-sectional view of the rod member (jaw member) shown in FIG. FIG. 4 is a cross-sectional view showing a manufacturing process of the rod member (jaw member) shown in FIG. FIG. 5 is a cross-sectional view showing a state in which the rod member is bent along the surface of the living tissue in the modified example of the treatment instrument of the first embodiment.

[First Embodiment]
1st Embodiment of the treatment tool which is an example of the medical device of this invention is described with reference to FIG. 1 thru | or FIG.

As shown in FIG. 1, the treatment instrument 11 (medical device) includes a handpiece 12, a power supply unit 13, and a cable 14 that connects the handpiece 12 and the power supply unit 13.

As shown in FIGS. 1 and 2, the handpiece 12 includes a housing 15 constituting an outer shell, a fixed handle 16 provided integrally with the housing 15, a handle 17 rotatable with respect to the housing 15, and a housing. 15, a plurality of operation buttons 18, a rod-shaped rod member 21 (treatment section, probe), at least one first electrode 22 formed on the outer surface of the rod member 21, and a proximal end of the rod member 21 A cylindrical shaft 23 (sheath) that covers the periphery of the side and protects the rod member 21, and a ring-like shape that is provided between the rod member 21 and the shaft 23 and prevents liquid from entering the shaft 23. A watertight member, a rotating knob 24 fixed to the shaft 23, a jaw member 25 configured to be rotatable with respect to the rod member 21, and an outer surface of the jaw member 25 Comprising at least one second electrode 26 is formed, the forward and reverse part 27 of the cylindrical being retractable when opening and closing the jaw member 25 provided inside the shaft 23, to.

In the present embodiment, description will be given with one of the two directions parallel to the longitudinal direction L of the rod member 21 as the distal end side and the opposite side to the distal end side as the proximal end side. The longitudinal direction L is a direction along the central axis C of the rod member 21. The rod member 21 and the jaw member 25 constitute an end effector 30 that performs treatment on a living tissue (tissue). The treatment instrument 11 constitutes a treatment instrument including at least two electrodes, a first electrode 22 on the rod member 21 side and a second electrode 26 on the jaw member 25 side.

The handpiece 12 has a conducting wire 28 connected to the first electrode 22 and a conducting wire 28 connected to the second electrode 26. As shown in FIG. 3, each of the conducting wires 28 includes a conducting wire body 32 having one end connected to the high-frequency power supply unit 31 and a terminal 33 provided on the other end opposite to the one end of the conducting wire body 32. Have. Each of the conductive wires 28 may be formed of a general electric wire (a copper core wire is covered with a resin or the like), or a part of a metal pipe or rod may be used instead of the electric wire. You may be comprised with what was made into the electric supply path | route. The terminal 33 is electrically connected to either the first electrode 22 or the second electrode 26. The terminal 33 may be composed of a metal plate attached to the other end of the conducting wire body 32, or an exposed portion formed by peeling the coating of the electric wire at the other end to expose the core wire of the electric wire. May be. The conducting wire 28 is an example of an energy transmission unit that transmits high-frequency energy for treating living tissue to the conductive coating unit 34. As another embodiment of the present invention, the energy transmission unit supplies energy to the second conductive coating part 35 (contact of the conductive part of the structure part) that is a contact point with the conductive coating part 34 and the structure part. It may be composed of a conductor 28 (supply path). Furthermore, as another embodiment of the present invention, the energy transmission part is connected to the overlapping part formed by the conductive coating part 34 being formed on the conductive part of the rod member 21 (structure part) and the rod member 21 (structure part). And a supply path (conductive wire 28) to which energy is supplied.

The shaft 23 has a cylindrical shape and protects the rod member 21 located inside. The shaft 23 is attached to the housing 15 so as to be rotatable with respect to the housing 15 on the proximal end side. The rotating knob 24 is fixed to the shaft 23. By rotating the rotation knob 24 with respect to the housing 15, the shaft 23, the rod member 21, and the jaw member 25 can be rotated integrally around the central axis C. The shaft 23 has a support pin 36 for supporting the jaw member 25 at the tip.

2, the jaw member 25 is rotatable around the support pin 36 between a facing position facing the rod member 21 and a separated position separated from the rod member 21 as indicated by an arrow in FIG. 2. The support pin 36 is attached to the shaft 23. The surgeon can open and close the jaw member 25 by rotating the handle 17 with respect to the housing 15. That is, when the operator operates the handle 17, the advance / retreat portion 27 provided inside the shaft 23 moves forward and backward along the central axis C of the shaft 23, thereby opening and closing the jaw member 25. In the present embodiment, the jaw member 25 is provided, but an electric knife-like structure (monopolar treatment tool) in which the jaw member 25 is omitted and the treatment portion is configured only by the rod member 21 may be used.

The rod member 21 is formed of, for example, a heat-resistant resin material (for example, polyimide, LCP, PEEK, etc.) or ceramic and has an insulating property. Part of the rod member 21 may be made of a resin material, and as a result of securing performances such as heat insulation and low thermal conductivity, the part may become insulating (may be a non-conductive part). The insulating rod member 21 is an example of a structure part having a non-conduction part at least in part. The rod member 21 has a treatment portion (treatment surface) for treating tissue on at least a part of its outer surface. The rod member 21 can be manufactured in large quantities at a low cost by, for example, injection molding. Moreover, the thermal conductivity of the rod member 21 formed of a resin material is smaller than the thermal conductivity of metal. As shown in FIG. 2, the rod member 21 has a first surface 41 on the side facing the jaw member 25. In addition, the heat-resistant temperature of general PEEK is about 343 degreeC. As another embodiment of the present invention, the rod member 21 (structure part) has a structure having a non-conductive part (resin material part) and a conductive part (metal material part) provided adjacent to the non-conductive part. There may be.

The jaw member 25 is formed into a rod shape with, for example, a heat-resistant resin material (for example, polyimide, LCP, PEEK, etc.) or ceramic, and has an insulating property. As a result of securing a performance such as heat insulation and low thermal conductivity by forming a part of the jaw member 25 from a resin material, the part may be insulative (may be a non-conductive part). The jaw member 25 can be manufactured in large quantities at a low cost by, for example, injection molding. Moreover, the thermal conductivity of the jaw member 25 formed of a resin material is smaller than the thermal conductivity of metal. The jaw member 25 has a shape that can be engaged with the rod member 21 (for example, a shape having a recess capable of accommodating a part of the rod member 21). The jaw member 25 is an example of a structural part (treatment part) having a non-conducting part at least in part. The jaw member 25 has a treatment portion (treatment surface) for treating tissue on at least a part of its outer surface. The jaw member 25 can be engaged with the rod member 21 at a position facing the rod member 21. The jaw member 25 can be formed by injection molding, for example. The jaw member 25 has a second surface 43 on the side facing the rod member 21. As another form of the present invention, the jaw member 25 (structure part) has a structure having a non-conductive part (resin material part) and a conductive part (metal material part) provided adjacent to the non-conductive part. There may be.

2, the first electrode 22 is formed in a flat plate shape on the first surface 41 (treatment portion, treatment surface) of the rod member 21. As shown in FIG. 3, the first electrode 22 is a second electrode provided to connect the conductive coating portion 34 formed on the outer surface of the rod member 21, and the conductive coating portion 34 and the terminal 33 of the conductive wire 28. And a conductive coating portion 35. Most of the conductive coating portions 34 constituting the first electrode 22 constitute a first treatment surface 42 that is in direct contact with the living tissue. The second conductive coating portion 35 is provided at a position (for example, a position inside the cylindrical shaft 23) that deviates from the first treatment surface 42 of the conductive coating portion 34. In addition, after the main curing (baking) process described later, the conductive coating part 34 and the second conductive coating part 35 can constitute an integrated conductive coating part.

The conductive coating portion 34 is made of a conductive material formed by diffusing and distributing a plurality of metal particles in a synthetic resin base material having insulating properties and water repellency. More specifically, the base material of the conductive coating portion 34 is composed of, for example, a mixture of a fluororesin such as PTFE and a binder such as polyamideimide. As shown in FIG. 3, the conductive coating portion 34 is formed on at least a part of the outer surface of the rod member 21 so as to constitute a treatment portion (first treatment surface 42) that comes into contact with a living tissue. The conductive coating portion 34 is applied to at least the non-conductive portion of the rod member 21. The plurality of metal particles are composed of, for example, silver particles, but may be other types of metal particles such as other highly conductive copper particles. The plurality of metal particles (silver particles) include metal particles having various shapes such as spherical metal particles and scale-shaped metal particles.

As shown in FIG. 3, the second conductive coating portion 35 is interposed between the conductive coating portion 34 and the conductive wire 28 (terminal 33) and integrally fixes the conductive coating portion 34 and the conductive wire 28. The second conductive coating portion 35 is made of a conductive material having the same composition as the conductive coating portion 34. The second conductive coating portion 35 constitutes a connection portion between the conductive wire 28 and the conductive coating portion 34. As shown in FIG. 3, the second conductive coating portion 35 is provided on the outer surface of the conductive coating portion 34 and is formed so as to overlap the conductive coating portion 34. Therefore, the dimension L2 from the outer surface of the rod member 21 to the outer surface of the second conductive coating portion 35 is larger than the dimension L1 from the outer surface of the rod member 21 to the outer surface of the conductive coating portion 34. Further, the length of the second conductive coating portion 35 is smaller than the length of the conductive coating portion 34 with respect to the longitudinal direction L of the rod member 21 (structure portion).

In the state where the conductive coating portion 34 and the second conductive coating portion 35 are fully cured (baked), the organic component (liquid component) contained in these base materials is vaporized and the metal particles are in communication with each other. Accordingly, the conductive coating portion 34 and the second conductive coating portion 35 can exhibit conductivity as a whole.

As shown in FIG. 2, the second electrode 26 is formed in a flat plate shape on the second surface 43 of the jaw member 25. Similar to the first electrode 22, the second electrode 26 includes a conductive coating portion 34 and a second conductive coating portion 35, and their structures and the materials constituting them are the same as those of the first electrode 22. Therefore, FIG. 3 is also used for explaining the second electrode 26. The second electrode 26 includes a conductive coating portion 34 formed on the outer surface of the jaw member 25, and a second conductive coating portion 35 provided so as to connect the conductive coating portion 34 and the terminal 33 of the conductive wire 28. Have. Most of the conductive coating portion 34 constituting the second electrode 26 constitutes a second treatment surface 44 that is in direct contact with the living tissue. The conductive coating portion 34 is applied to at least the non-conductive portion of the jaw member 25. The second conductive coating portion 35 is provided at a position (for example, a position inside the cylindrical shaft 23) that deviates from the second treatment surface 44 of the conductive coating portion 34. In addition, after the main curing (baking) process described later, the conductive coating part 34 and the second conductive coating part 35 can constitute an integrated conductive coating part.

As shown in FIG. 1, the power supply unit 13 includes a high-frequency power supply unit 31 and a control unit 45 that controls the high-frequency power supply unit 31. The control unit 45 can control power supply from the high-frequency power supply unit 31 to the first electrode 22 and the second electrode 26. When the operator operates the operation button 18, the control unit 45 supplies power from the high frequency power supply unit 31 to the first electrode 22 and the second electrode 26. The plurality of operation buttons 18 include, for example, a first operation button 18A that outputs high-frequency energy with high output to biological tissue, and a second operation button 18B that outputs high-frequency energy with low output to biological tissue. It is. The high frequency energy is an example of electrical energy transmitted to the conductive coating portion 34.

With reference to FIG. 3, FIG. 4, the manufacturing method of the treatment tool of this embodiment is demonstrated.
The rod member 21 and the jaw member 25 are molded from a resin material or the like by injection molding or the like. The rod member 21 and the jaw member 25 may be formed by processing a metal material such as a titanium alloy or an aluminum alloy (in this case, the rod member 21 and the jaw member 25 are made of resin on the surface of the metal material). The resin material part is included in part, such as a structure provided with a material, but may be a structure formed of a metal material as a whole). The first electrode 22 is formed in a flat plate shape on the first surface 41 (treatment portion, treatment surface) of the rod member 21. As shown in FIG. 3, the first electrode 22 is a second electrode provided to connect the conductive coating portion 34 formed on the outer surface of the rod member 21, and the conductive coating portion 34 and the terminal 33 of the conductive wire 28. And a conductive coating portion 35. In a subsequent step, a conductive material is applied to at least a part of the rod member 21 (first surface 41 shown in FIG. 2) to form a conductive coating portion 34. Similarly, a conductive material is applied to at least a part of the jaw member 25 (second surface 43 shown in FIG. 2) to form the conductive coating portion 34. In the subsequent step, as shown in FIG. 4, a second conductive coating portion 35 is formed by applying a conductive material to at least a part (one surface 33 </ b> A) of the terminals 33 of the plurality of conductive wires 28.

In the next step, heat treatment is performed to temporarily cure (temporarily dry) the conductive coating portion 34 applied to the rod member 21 and the jaw member 25 and the second conductive coating portion 35 applied to the terminals 33 of the plurality of conductive wires 28. . This heat treatment is performed, for example, by leaving it in a furnace set at 60 to 120 ° C. for a predetermined time.

In the subsequent process after the completion of the temporary curing, as shown in FIG. 4, the second conductive coating portion 35 of the terminal is abutted against the conductive coating portion 34 of the rod member 21 to obtain the state shown in FIG. 3. In parallel with this, as shown in FIG. 4, the second conductive coating portion 35 of the conductive wire 28 is abutted against the conductive coating portion 34 of the jaw member 25 to obtain the state shown in FIG. 3. Note that a connecting conductive coating may be interposed between the conductive coating portion 34 and the second conductive coating portion 35. The bridging conductive coating is a conductive material having the same composition as that of the conductive coating portion 34, but before the heat treatment.

In this state, a heat treatment is performed to fully cure (fire) the conductive coating portion 34 applied to the rod member 21 and the jaw member 25 and the second conductive coating portion 35 applied to the terminal 33. This heat treatment is performed by leaving it for a predetermined time in a furnace set at a temperature higher than that of the pre-curing heat treatment, for example, 200 to 330 ° C. Through this process, the conductive coating portion 34 of the rod member 21 or the jaw member 25 and the second conductive coating portion 35 applied to the terminals 33 of the plurality of conductive wires 28 are integrally joined (fixed) and electrically. Connected. Similarly, when the conductive conductive coating is interposed between the conductive coating portion 34 and the second conductive coating portion 35, the conductive coating portion 34 and the second conductive coating portion 35 are integrally joined, and The reliability of the bonding strength and the reliability of the conductivity are improved.

The conductive coating portion 34 of the rod member 21 constitutes the first electrode 22 by main curing, and most of the conductive coating portion 34 becomes the first treatment surface 42. Further, the conductive coating portion 34 of the jaw member 25 constitutes the second electrode 26 by the main curing, and most of the conductive coating portion 34 becomes the second treatment surface 44. From the above, the manufacturing process of the first electrode 22 for the rod member 21 and the manufacturing process of the second electrode 26 for the jaw member 25 are completed.

Then, with reference to FIGS. 1-3, the effect | action of the treatment tool 11 of this embodiment is demonstrated.
In the treatment, the operator can sandwich the living tissue between the rod member 21 and the jaw member 25 by operating the handle 17. Further, the surgeon operates the first operation button 18A or the second operation button 18B to input high-frequency energy to the sandwiched biological tissue to perform treatment such as coagulation of the biological tissue or coagulation / incision. It can be carried out.

For example, when the surgeon operates the first operation button 18A, high-frequency energy is supplied to the living tissue between the first electrode 22 and the second electrode 26 under the control of the control unit 45. As a result, a high-frequency current is applied to a wide range of the living tissue (the entire living tissue grasped between the rod member 21 and the jaw member 25), thereby coagulating or coagulating / incising the living tissue. At this time, it is possible to energize only between the first electrode 22 and the second electrode 26, and the back side of the rod member 21 (the side opposite to the side facing the jaw member 25) or the back side of the jaw member 25 (rod member). Since the current does not flow in an unnecessary place such as the side opposite to the side facing the side 21), an efficient high-frequency treatment can be performed.

For example, when the operator operates the second operation button 18B, high-frequency energy is supplied to the living tissue at a position between the first electrode 22 and the second electrode 26 on the distal end side under the control of the control unit 45. Is done. At this time, the power supplied to the first electrode 22 and the second electrode 26 is smaller than the normal power supplied by operating the first operation button 18A (that is, a low output smaller than the normal output). ). Also in this case, electricity is supplied only between the first electrode 22 and the second electrode 26, and an efficient high-frequency treatment is possible.

According to the first embodiment, the following can be said. The treatment instrument 11 includes a structure part having a non-conduction part at least in part, a conductive coating part 34 having conductivity and water repellency formed in at least a part of the structure part, and electric energy to the conductive coating part. 34, and the conductive coating portion 34 is applied to at least the non-conductive portion of the structure portion, and the electric energy is also passed through the conductive coating portion 34 in the non-conductive portion of the structure portion. Is supplied.
The energy transmission part is a conductive wire 28 connected to the conductive coating part 34, and the connection part between the conductive wire 28 and the conductive coating part 34 is integrally fixed by a second conductive coating part 35.

Generally, when a water-repellent coating is applied to an object, it is often difficult to fix (adhere) another object to the object. According to said structure, an energy transmission part can be fixed with respect to the surface which gave the water-repellent conductive coating part (adhesion). Accordingly, high frequency energy can be supplied to the conductive coating portion via the energy transmission portion, and the conductive coating portion can be utilized as an electrode during high frequency power treatment. In addition, the conductive coating portion can take an arbitrary shape with respect to the structure portion by changing a region to be applied. For this reason, the shape of the conductive coating portion can be appropriately changed according to the organ, organ, tissue, or the like to be treated. As a result, a conductive coating portion (electrode) having an optimal shape can be realized in accordance with the target treatment.

The thermal conductivity of the structure is smaller than that of metal. For example, when treatment with high-frequency energy is performed, the temperature of the structure portion adjacent to the conductive coating portion 34 may increase. According to this structure, the temperature rise of a structure part can be suppressed. Even if the temperature of the structural part has risen, the thermal conductivity of the structural part is lower than that of the metal. Since heat is not applied, damage due to heat can be prevented.

The resin base material of the conductive coating portion contains at least a fluororesin. According to this configuration, sticking of the biological tissue piece to the conductive coating portion 34 can be prevented by the water repellency and slipperiness of the fluororesin.

The length of the second conductive coating portion 35 is smaller than the length of the conductive coating portion 34 with respect to the longitudinal direction of the structure portion. According to this configuration, the area of the conductive coating portion 34 serving as a treatment surface can be secured with a sufficient width.

In the method for manufacturing a treatment instrument according to this embodiment, a conductive coating portion 34 is formed by applying a conductive material in which metal particles are diffused and distributed in a base material having insulating properties and water repellency to at least a part of a structure portion. Applying the conductive material to at least a part of the energy transmission unit for transmitting high-frequency energy to the conductive coating unit 34 to form the second conductive coating unit 35; and the conductive coating unit 34 and the second conductive coating In a state where the part 35 is heat-treated and temporarily cured, and the conductive coating part 34 and the second conductive coating part 35 are in contact with each other, heat treatment is performed at a temperature higher than that of the provisional curing process so that they are integrated. And a main curing step.

According to this configuration, the surface provided with the water-repellent conductive coating portion 34 that is difficult to fix (adhere) by abutting the second conductive coating portion 35 before the main curing with the conductive coating portion 34 before the main curing. The energy transmission part can be fixed to Thereby, the conductive coating part 34 can be utilized as an electrode at the time of treatment by high frequency energy. Moreover, the conductive coating part 34 can take an arbitrary shape with respect to the structure part by changing the area | region to apply | coat. Therefore, the shape of the conductive coating portion 34 can be appropriately changed according to the organ, organ, tissue, etc. to be treated, and the conductive coating portion 34 (electrode) having the optimum shape according to the target treatment is realized. it can.

(Modification)
Then, with reference to FIG. 5, the modification of the treatment tool 11 of 1st Embodiment is demonstrated. Here, parts different from those of the first embodiment will be mainly described, and descriptions of parts common to the first embodiment will be omitted.

In this modification, the handpiece 12 does not have the jaw member 25. For this reason, the end effector 30 of the handpiece 12 is configured only by the rod member 21. For this reason, the treatment tool 11 of this modification has an electric knife-like structure and constitutes a so-called monopolar treatment tool.

The rod member 21 is formed into a rod shape having a smaller diameter than the rod member 21 of the first embodiment, for example, by a resin material (for example, PEEK). For this reason, the rod member 21 is not only insulative, but also has greater flexibility than the rod member 21 of the first embodiment. The rod member 21 can be manufactured in large quantities at a low cost by, for example, injection molding. The rod member 21 is an example of a structure part. The rod member 21 has a first surface 41 on the side facing the jaw member 25.

Then, with reference to FIG. 5, the effect | action of the treatment tool 11 of this embodiment is demonstrated.
In this modification, since the rod member 21 is elongated, it can be bent so as to follow the shape of the outer surface of the living tissue as shown in FIG. Therefore, in this modification, a large contact area of the first electrode 22 (conductive coating portion 34) with the outer surface of the living tissue is ensured. Further, since the rod member 21 is configured to have flexibility, the risk of damaging the living tissue is reduced without accidentally piercing the living tissue with the tip of the rod member 21.

Furthermore, the surgeon operates the first operation button 18A or the second operation button 18B to input high-frequency energy to the living tissue that is in contact with the treatment, such as coagulation of the living tissue or coagulation / incision. It can be performed.

For example, when the surgeon operates the first operation button 18A, high-frequency energy is supplied to the living tissue between the first electrode 22 and the counter electrode plate outside the patient's body under the control of the control unit 45. The As a result, a high-frequency current is applied to the living tissue at the first electrode 22, and the living tissue in the vicinity of the first electrode 22 is coagulated.

For example, when the operator operates the second operation button 18B, high frequency is applied to the living tissue between the first electrode 22 on the distal end side and the counter electrode plate outside the patient's body under the control of the control unit 45. Energy is supplied. At this time, the power supplied to the first electrode 22 is smaller than the normal power supplied by operating the first operation button 18A (that is, a low output smaller than the normal output). As a result, a high-frequency current is applied to the living tissue at the first electrode 22, and the living tissue in the vicinity of the first electrode 22 is coagulated.

According to this modification, the structural part is formed of a resin material. According to this configuration, the thermal conductivity of the structure portion can be reduced, and the structure portion can have sufficient flexibility. As a result, the rod member 21 can follow the outer surface of the living tissue, and a large area where the conductive coating portion 34 contacts the living tissue can be ensured. Accordingly, it is possible to secure a large area for performing treatment on the living tissue, and to improve the operator's workability. In addition, by providing the structure with flexibility, the treatment tool 11 can be provided in consideration of safety during treatment without accidentally piercing the structure with living tissue during treatment.

The present invention is not limited to the above-described embodiment, and can be appropriately modified without departing from the gist thereof. The present invention can also be applied to medical devices other than the above-described treatment tool 11 such as a treatment tool, forceps, and electric knife capable of supplying electrical energy in a state of direct contact with a living body. Further, the energy supplied to the rod member 21 is not limited to high-frequency energy, and may be other energy. In other words, any energy of ultrasonic energy, thermal energy, light energy, and electromagnetic waves may be output as energy used for treatment alone, or may be configured to output high frequency energy, ultrasonic energy, thermal energy, light energy, electromagnetic waves. Any one of them may be output in combination as appropriate. In this case, in particular, one energy selected from the group consisting of ultrasonic energy, thermal energy, light energy, and electromagnetic waves, and high-frequency energy may be output simultaneously or individually. In addition, when using ultrasonic energy as energy supplied to a rod member, it is desirable to use a metal material for a part of structure part so that the load (high stress) by ultrasonic vibration may be endured.

DESCRIPTION OF SYMBOLS 11 ... Treatment tool, 28 ... Wiring, 31 ... High frequency electric power supply part, 32 ... Wiring main body, 33 ... Terminal, 33A ... One side, 34 ... Conductive coating part, 35 ... Second conductive coating part, 51 ... Conductive coating part .

Claims

A structural part having a non-conductive part at least in part;
A conductive coating portion having conductivity and water repellency formed on at least a part of the structure portion;
An energy transmission unit for transmitting electrical energy to the conductive coating unit;
With
The conductive coating portion is applied to at least a non-conductive portion of the structure portion, and electrical energy is supplied through the conductive coating portion even in the non-conductive portion of the structure portion.
The medical device is a treatment tool, the electrical energy is high-frequency energy for treating tissue, and has a treatment portion for treating the tissue formed on at least a part of the outer surface of the structure portion, The medical device according to claim 1, wherein the conductive coating portion is formed on at least a part of the treatment portion.
2. The energy transmission part is an overlap part formed by the conductive coating part being formed on a conductive part of the structure part, and a supply path through which energy is supplied to the structure part. Medical device as described in.
The energy transmission part is a conductive wire connected to the conductive coating part, and a connection part between the conductive wire and the conductive coating part is integrally fixed by a second conductive coating part. Item 1. A medical device according to Item 1.
The medical device according to claim 1, wherein the thermal conductivity of the non-conductive portion of the structure portion is smaller than the thermal conductivity of the metal.
The medical device according to claim 3, wherein the non-conductive portion of the structure portion is formed of a resin material.
The medical device according to claim 1, wherein the conductive coating portion includes a resin having water repellency as a base material and includes metal particles.
The medical device according to claim 7, wherein the base material includes at least a fluororesin.
The medical device according to claim 7, wherein the metal particles are silver particles.
The medical device according to claim 4, wherein a length of the second conductive coating portion is smaller than a length of the conductive coating portion with respect to a longitudinal direction of the structure portion.
The medical device according to claim 4, wherein a dimension from an outer surface of the structure part to an outer surface of the second conductive coating part is larger than a dimension from the outer surface of the structure part to the outer surface of the conductive coating part.
The medical device according to claim 2, wherein one or more energy other than the high frequency energy can be output simultaneously or individually.
The structure portion has a material and a shape that can be deformed by an external force, and is characterized by contributing to improvement of treatment properties by reducing damage to the tissue by deformation due to external force or increasing a contact area. The medical device according to claim 2.
Applying a conductive material in which metal particles are diffused and distributed in a base material having insulating properties and water repellency to at least a part of the structure portion to form a conductive coating portion;
Applying the conductive material to at least a part of an energy transmission unit for transmitting high-frequency energy to the conductive coating unit to form a second conductive coating unit;
Heat-treating and pre-curing the conductive coating portion and the second conductive coating portion;
In the state where the conductive coating portion and the second conductive coating portion are abutted together, a step of heat-curing at a higher temperature than the step of pre-curing and performing a main curing so that they are integrated,
A method of manufacturing a medical device comprising: