WO2018150548A1 - Energy applying structure and treatment tool - Google Patents

Energy applying structure and treatment tool Download PDF

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Publication number
WO2018150548A1
WO2018150548A1 PCT/JP2017/005958 JP2017005958W WO2018150548A1 WO 2018150548 A1 WO2018150548 A1 WO 2018150548A1 JP 2017005958 W JP2017005958 W JP 2017005958W WO 2018150548 A1 WO2018150548 A1 WO 2018150548A1
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WO
WIPO (PCT)
Prior art keywords
heat transfer
transfer plate
energy application
reinforcing member
application structure
Prior art date
Application number
PCT/JP2017/005958
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French (fr)
Japanese (ja)
Inventor
工藤　貢一
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オリンパス株式会社
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Publication date
Application filed by オリンパス株式会社 filed Critical オリンパス株式会社
Priority to PCT/JP2017/005958 priority Critical patent/WO2018150548A1/en
Publication of WO2018150548A1 publication Critical patent/WO2018150548A1/en

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/08—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by means of electrically-heated probes

Definitions

  • the present invention relates to an energy application structure and a treatment instrument.
  • Patent Document 1 There has been known a treatment instrument that is provided with an energy applying structure that applies energy to a living tissue, and that treats the living tissue (joining (or anastomosis), cutting, etc.) by applying the energy (for example, Patent Document 1). reference).
  • the energy application structure described in Patent Document 1 includes the following flexible substrate, heat transfer plate, and adhesive member.
  • the flexible substrate is a portion that functions as a sheet heater, on one surface of the substrate, where a wiring pattern having a resistance pattern that generates heat when energized and a connection portion that conducts to the resistance pattern and is connected to a lead wire are formed. is there.
  • the heat transfer plate is made of a conductor such as copper.
  • the heat transfer plate is disposed so as to face one surface (resistance pattern) of the flexible substrate, and transfers heat from the resistance pattern to the living tissue (giving thermal energy to the living tissue).
  • the adhesive member is a sheet having good thermal conductivity and insulation.
  • the adhesive member is interposed between the flexible substrate and the heat transfer plate, and bonds and fixes them.
  • the adhesive member has a first region that covers the entire resistance pattern, and a second region that protrudes from the heat transfer plate and covers a part of the connection portion. That is, the adhesive member is responsible for the thermal coupling of the heat transfer plate and the resistance pattern by the first region and prevents the heat transfer plate and the resistance pattern from being short-circuited, and the second region also prevents the heat transfer plate and the connection portion from being short-circuited. To do.
  • FIGS. 10A and 10B are diagrams for explaining a problem in the conventional energy application structure 100.
  • FIGS. 10A and 10B are views of the energy application structure 100 as viewed from the side.
  • reference numeral “110” denotes the above-described heat transfer plate.
  • Reference numeral “120” denotes the flexible substrate described above.
  • Reference numeral “1210” denotes the substrate described above.
  • Reference numeral “1220” is the wiring pattern described above.
  • Reference numeral “130” denotes the adhesive member described above.
  • the left side is described as the “front end side” and the right side is described as the “base end side”.
  • the proximal end side of the adhesive member 130 projects beyond the heat transfer plate 110 to the proximal end side. Further, the base end side of the flexible substrate 120 protrudes to the base end side from the adhesive member 130.
  • the flexible substrate 120 and the adhesive member 130 have flexibility (flexibility).
  • external force from the heat transfer plate 110 side external force downward in FIG. 10A
  • substrate 1210 side with respect to the base end side of the flexible substrate 120 Is assumed to be applied (external force upward in FIG. 10B).
  • the base end side portion of the flexible substrate 120 together with the base end side portion of the adhesive member 130, has a base end side end portion of the heat transfer plate 110 as a fulcrum as shown in FIG. 10A or 10B. It will be bent as Fu1. Therefore, there is a problem that a load is applied to a portion of the adhesive member 130 that faces the end portion on the proximal end side of the heat transfer plate 110.
  • the present invention has been made in view of the above, and an object thereof is to provide an energy application structure and a treatment instrument that can reduce the load on the adhesive member.
  • the energy application structure includes a resistance pattern that generates heat by energization, and a connection portion that conducts to the resistance pattern and is connected to a lead wire.
  • the treatment tool according to the present invention includes the above-described energy application structure.
  • FIG. 1 is a diagram schematically showing a treatment system according to the present embodiment.
  • FIG. 2 is an enlarged view of the distal end portion of the treatment instrument.
  • FIG. 3 is a diagram illustrating a cover member and an energy application structure.
  • FIG. 4 is a diagram illustrating a cover member and an energy application structure.
  • FIG. 5 is a side view of the energy application structure.
  • FIG. 6A is a diagram for explaining the effect of the present embodiment.
  • FIG. 6B is a diagram for explaining the effect of the present embodiment.
  • FIG. 7 is a diagram showing an energy application structure according to Modification 1 of the present embodiment.
  • FIG. 8 is a diagram showing an energy application structure according to the second modification of the present embodiment.
  • FIG. 9 is a diagram showing an energy application structure according to Modification 3 of the present embodiment.
  • FIG. 10A is a diagram illustrating a problem in the conventional energy application structure.
  • FIG. 10B is a diagram illustrating a problem in the conventional energy application structure.
  • FIG. 1 is a diagram schematically showing a treatment system 1 according to the present embodiment.
  • the treatment system 1 treats (joins (or anastomoses) and detaches, etc.) the living tissue by applying thermal energy to the living tissue to be treated.
  • the treatment system 1 includes a treatment tool 2, a control device 3, and a foot switch 4.
  • the treatment tool 2 is, for example, a linear type surgical treatment tool for performing treatment on a living tissue through the abdominal wall.
  • the treatment tool 2 includes a handle 5, a shaft 6, and a grip portion 7.
  • the handle 5 is a part that the surgeon holds by hand.
  • the handle 5 is provided with an operation knob 51 as shown in FIG.
  • 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.
  • FIG. 2 is an enlarged view of the distal end portion of the treatment instrument 2.
  • the gripping part 7 is a part that grips a living tissue and treats the living tissue.
  • 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 (left end portion in FIGS. 1 and 2) so as to be openable and closable in the direction of the arrow R1 (FIG. 2).
  • the living tissue can be grasped according to the operation.
  • the first and second jaws 8 and 8 ′ are provided with cover members 9 and 9 ′ and energy application structures 10 and 10 ′, respectively.
  • cover members 9 and 9 ' have the same configuration and are different only in that the vertical postures are reversed.
  • energy application structures 10 and 10 ′ have the same configuration and are different only in that the vertical posture is reversed.
  • cover member 9 and the energy provision structure 10 is mainly demonstrated.
  • cover member 9 'and energy provision structure 10' the same code
  • FIG. 3 and 4 are views showing the cover member 9 and the energy applying structure 10.
  • FIG. 3 is a perspective view of the cover member 9 and the energy application structure 10 as viewed from above in FIG.
  • FIG. 4 is an exploded perspective view of FIG.
  • the “tip side” described below is the tip side of the gripping part 7 and means the left side in FIGS. 3 to 5.
  • the “base end side” described below means the shaft 6 side of the gripping portion 7 and the right side in FIGS. 3 to 5.
  • the cover member 9 supports the energy application structure 10 and has a posture in which the energy application structure 10 faces upward with respect to the upper surface of the first jaw 8 disposed on the lower side in FIGS. 1 and 2. It is attached with. That is, the energy application structure 10 is attached in a posture facing the direction of the gripping surface that grips the living tissue between the first and second jaws 8 and 8 ′.
  • the cover member 9 has a long shape having a recess 91 on one plate surface (the plate surface on the upper side in FIG. 4) (from the distal end of the gripping portion 7 toward the proximal end). It is comprised with the plate body of the longitudinal direction (elongate shape extended in the left-right direction in FIG.1 and FIG.2).
  • the recess 91 is located at the center of the cover member 9 in the width direction and extends along the longitudinal direction of the cover member 9. Further, among the side wall portions constituting the recess 91, the side wall portion on the proximal end side is omitted.
  • the energy provision structure 10 is accommodated in the recessed part 91 in the state which one part protruded from the recessed part 91 to the base end side, as shown in FIG. Further, the other plate surface of the cover member 9 in which the concave portion 91 is not formed is attached to the first jaw 8 (FIG. 2).
  • FIG. 5 is a view of the energy application structure 10 as viewed from the side.
  • the energy applying structure 10 generates heat energy under the control of the control device 3.
  • the energy applying structure 10 includes a heat transfer plate 11, a flexible substrate 12, an adhesive member 13, and a reinforcing member (reinforcing plate) 14.
  • the heat transfer plate 11 is a thin plate having a long shape (long shape extending in the longitudinal direction of the grip portion 7) made of a material such as copper, and is attached to the first jaw 8 via the cover member 9.
  • the treatment surface 111 (FIG. 2), which is one plate surface, faces the second jaw 8 ′ side.
  • the heat transfer plate 11 holds the living tissue with the first and second jaws 8 and 8 ′, the treatment surface 111 comes into contact with the living tissue, and heat from the flexible substrate 12 is applied to the living tissue. Transmit (apply thermal energy to living tissue).
  • the flexible substrate 12 generates heat and functions as a sheet heater (resistance heater) that heats the heat transfer plate 11 by the generated heat. That is, the flexible substrate 12 corresponds to the heater according to the present invention.
  • the flexible substrate 12 includes a substrate 121 and a wiring pattern 122.
  • the substrate 121 is a long sheet (long shape extending in the longitudinal direction of the grip portion 7) made of an insulating material such as polyimide, and has flexibility (flexibility).
  • the material of the substrate 121 is not limited to polyimide, and for example, a high heat insulating material such as aluminum nitride, alumina, glass, zirconia, etc. may be adopted.
  • the width dimension of the substrate 121 is set to be substantially the same as the width dimension of the heat transfer plate 11.
  • the length dimension of the substrate 121 (length dimension in the longitudinal direction (left and right direction in FIGS. 4 and 5)) is the same as the length dimension of the heat transfer plate 11 (longitudinal direction (left and right direction in FIGS. 4 and 5). ) Is set to be longer than the length dimension).
  • the wiring pattern 122 is obtained by processing stainless steel (SUS304), which is a conductive material. As shown in FIGS. 3 to 5, a pair of connection parts 1221 and a resistance pattern 1222 (FIGS. 4 and 5) are provided. Prepare. The wiring pattern 122 is bonded to one surface 1211 (FIGS. 3 to 5) of the substrate 121 by thermocompression bonding.
  • the material of the wiring pattern 122 is not limited to stainless steel (SUS304), and other stainless steel materials (for example, No. 400 series) may be used, or conductive materials such as platinum and tungsten may be adopted.
  • the wiring pattern 122 is not limited to a configuration in which the wiring pattern 122 is bonded to one surface 1211 of the substrate 121 by thermocompression bonding, and a configuration in which the one surface 1211 is formed by vapor deposition or the like may be employed.
  • the pair of connection portions 1221 are provided on the base end side of the substrate 121, respectively extend from the base end side toward the tip end side, and extend along the width direction of the substrate 121. So as to face each other. Then, two lead wires C1 (FIGS. 3 to 5) constituting the electric cable C are joined (connected) to the pair of connecting portions 1221, respectively.
  • One end of the resistance pattern 1222 is connected (conducted) to one connecting portion 1221, and extends from the one end along a U-shape following the outer edge shape of the substrate 121 while meandering in a wavy shape, and the other end is connected to the other end
  • the connection portion 1221 is connected (conductive).
  • the resistance pattern 1222 generates heat when a voltage is applied (energized) to the pair of connection parts 1221 by the control device 3 via the two lead wires C1.
  • the adhesive member 13 is interposed between the heat transfer plate 11 and the flexible substrate 12, and a part of the flexible substrate 12 extends from the proximal end of the heat transfer plate 11.
  • the rear surface (surface opposite to the treatment surface 111) of the heat transfer plate 11 and one surface 1211 (surface on the wiring pattern 122 side) of the substrate 121 are bonded and fixed in a state of projecting to the base end side.
  • This adhesive member 13 is a long sheet (long shape extending in the longitudinal direction of the gripping portion 7) having good thermal conductivity and insulation, withstanding high temperatures, and having adhesiveness.
  • a high thermal conductive filler such as alumina, boron nitride, graphite, or aluminum nitride is mixed with a resin such as epoxy or polyurethane.
  • the width dimension of the adhesive member 13 is set to be substantially the same as the width dimension of the substrate 121.
  • the length dimension of the adhesive member 13 (length dimension in the longitudinal direction (left and right direction in FIGS. 4 and 5)) is the same as the length dimension of the heat transfer plate 11 (longitudinal direction (left and right directions in FIGS. 4 and 5). It is set to be longer than the length dimension (direction) and shorter than the length dimension of the substrate 121 (length dimension in the longitudinal direction (left and right direction in FIGS. 4 and 5)).
  • the adhesive member 13 includes a first region Ar1 (FIG. 4) that covers the entire heat transfer plate 11, the entire resistance pattern 1222, and part of the pair of connection portions 1221, and an end portion on the proximal end side of the heat transfer plate 11. And a second region Ar2 (FIGS. 3 and 4) covering the base end side and covering a part of the pair of connection parts 1221.
  • the first region Ar1 may be a region that covers at least the entire resistance pattern 1222. Then, the two lead wires C1 are joined (connected) to portions exposed to the outside (portions not covered with the adhesive member 13) in the pair of connecting portions 1221.
  • the reinforcing member 14 is a long sheet (long shape extending in the longitudinal direction of the grip portion 7) made of a metal material such as aluminum, ceramic such as alumina, or the like. Then, as shown in FIGS. 3 to 5, the reinforcing member 14 is bonded and fixed to the other surface 1212 of the substrate 121 (the surface opposite to the wiring pattern 122).
  • the width dimension of the reinforcing member 14 is set to be substantially the same as the width dimension of the substrate 121.
  • the length dimension of the reinforcing member 14 (length dimension in the longitudinal direction (left and right direction in FIGS. 4 and 5)) is the same as the length dimension of the adhesive member 13 (longitudinal direction (left and right direction in FIGS. 4 and 5). ) And is shorter than the length dimension of the substrate 121 (length dimension in the longitudinal direction (left and right direction in FIGS. 4 and 5)).
  • the reinforcing member 14 is in a state where the end portion on the front end side substantially coincides with the end portion on the front end side in the substrate 121 and the base end side protrudes from the end portion on the base end side in the adhesive member 13 to the base end side.
  • the entire plate surface (the upper plate surface in FIGS. 4 and 5) is bonded and fixed to the other surface 1212.
  • the proximal end portion of the reinforcing member 14 is located at a position shifted toward the distal end side with respect to the contact point CO between the connecting portion 1221 and the lead wire C1, as shown in FIG.
  • the reinforcing member 14 has the heat transfer plate 11 on the other surface 1212 of the substrate 121 as shown in FIG. 5 when the reinforcing member 14 and the flexible substrate 12 are viewed from the side.
  • the second position that sandwiches the boundary position P0 between the first position P1 that is located on the proximal side of the boundary position P0 and the first position P1 with the end on the proximal end side in FIG. It is set so as to come into contact with P2.
  • the first position P ⁇ b> 1 is a position facing the proximal end of the reinforcing member 14.
  • the second position P2 is a position facing the end portion on the distal end side of the reinforcing member 14.
  • a length L1 (FIG.
  • the reinforcing member 14 has a bending rigidity higher than the bending rigidity of the flexible substrate 12 and the adhesive member 13 as a whole.
  • the substrate 121, the wiring pattern 122, and the adhesive member 13 were each configured with the materials, width dimensions, and thickness dimensions shown in Table 1 below. And when comprised in this way, the bending rigidity of the flexible substrate 12 and the adhesive member 13 whole will be about 30 [N * mm ⁇ 2 >].
  • the reinforcing member 14 is composed of the material, width dimension, and thickness dimension shown in Table 1 below. In this case, the bending rigidity of the reinforcing member 14 is about 500 [N ⁇ mm 2 ]. When the material of the reinforcing member 14 is changed from aluminum to alumina, the bending rigidity of the reinforcing member 14 is about 100 [N ⁇ mm 2 ].
  • the foot switch 4 is a part operated by the operator with his / her foot. And according to the said operation to the foot switch 4, on / off of the electricity supply from the control apparatus 3 to the treatment tool 2 (resistance pattern 1222) is switched. Note that the means for switching on and off is not limited to the foot switch 4, and a switch operated by hand or the like may be employed.
  • the control device 3 includes a CPU (Central Processing Unit) and the like, and comprehensively controls the operation of the treatment instrument 2 according to a predetermined control program. More specifically, the control device 3 applies a voltage to the wiring pattern 122 via the electric cable C in response to an operation to the foot switch 4 by the operator (operation to turn on the power), thereby causing the heat transfer plate 11 to move. Heat.
  • CPU Central Processing Unit
  • the energy application structure 10 (10 ′) according to the present embodiment described above has the following effects.
  • 6A and 6B are diagrams for explaining the effect of the present embodiment. Specifically, FIGS. 6A and 6B correspond to FIG.
  • the other surface 1212 of the substrate 121 has a base end side of the base plate side of the heat transfer plate 11 as a boundary position P0.
  • Reinforcing members 14 that abut on the first position P1 located on the side and the second position P2 sandwiching the boundary position P0 between the first position P1 are provided.
  • an external force from the heat transfer plate 11 side an external force downward in FIG.
  • the reinforcing member 14 is joined (adhered and fixed) to the first and second positions P1 and P2 on the other surface 1212.
  • the substrate 121 side is opposite to the above case (the case shown in FIG. 6A) with respect to the proximal end side of the flexible substrate 12. Is assumed to be applied (external force upward in FIG. 6B).
  • the proximal end portion of the flexible substrate 12 is not the proximal end portion of the heat transfer plate 11 but the proximal end portion of the reinforcing member 14 as shown in FIG. 6B.
  • the end portion is bent as a fulcrum Fu2. For this reason, even if it is a case where external force is applied to any direction of the side away from the heat exchanger plate 11, and the heat exchanger plate 11, the edge part of the base end side of the heat exchanger plate 11 in the adhesive member 13 No load is applied to the portion facing the.
  • the reinforcing member 14 is in contact with the entire reinforcing area Ar including the first and second positions P1 and P2 and the boundary position P0, and is joined (adhered and fixed) to the entire reinforcing area Ar. Further, the reinforcing member 14 has a bending rigidity higher than the bending rigidity of the flexible substrate 12 and the adhesive member 13 as a whole.
  • the bending rigidity of the region on the distal end side with respect to the first position P1 is dramatically higher than the bending rigidity of the region on the proximal end side with respect to the first position P1.
  • the end portion on the proximal end side of the reinforcing member 14 can be bent more reliably as the fulcrum Fu2.
  • the reinforcing member 14 projects from the proximal end portion of the adhesive member 13 to the proximal end side. For this reason, in each of the above cases (in each case shown in FIGS. 6A and 6B), the end portion on the proximal end side of the reinforcing member 14 is bent as the fulcrum Fu2, so that the adhesive member 13 is not bent at all. Therefore, the load on the adhesive member 13 can be effectively reduced.
  • the end portion on the proximal end side of the reinforcing member 14 is on the other surface 1212 with respect to the contact point CO between the connection portion 1221 and the lead wire C1. Located at the position shifted to the tip side. For this reason, in each of the above cases (in each case shown in FIGS. 6A and 6B), the end on the proximal end side of the reinforcing member 14 is bent as the fulcrum Fu2, so that the contact point CO does not become a fulcrum of bending. . Therefore, no load is applied to the contact point CO, and the possibility of peeling of the lead wire C1 can be reduced.
  • the length L1 from the boundary position P0 to the first position P1 is longer than the length L2 from the boundary position P0 to the second position P2. short.
  • the base end side of the heat transfer plate 11 may be a fulcrum of bending.
  • the bending fulcrum Fu ⁇ b> 2 can be used as an end portion on the proximal end side of the reinforcing member 14.
  • FIG. 7 is a diagram showing an energy application structure 10A according to Modification 1 of the present embodiment. Specifically, FIG. 7 corresponds to FIG.
  • the reinforcing member 14 is disposed in a state where the base end side protrudes from the base end side end portion of the adhesive member 13 to the base end side.
  • 14 A of reinforcement members which comprise 10 A of energy provision structures which concern on this modification 1 are set shorter than the length dimension of the reinforcement member 14 demonstrated in embodiment mentioned above. Then, as shown in FIG.
  • the reinforcing member 14A has an end on the distal end side of the reinforcing member 14A facing the second position P2, and an end on the proximal end side of the reinforcing member 14A is a boundary position P0. And the first position P1A located between the proximal end of the adhesive member 13 and the first end P1A.
  • FIG. 8 is a diagram illustrating an energy application structure 10B according to Modification 2 of the present embodiment. Specifically, FIG. 8 corresponds to FIG.
  • the proximal end of the reinforcing member 14 is located at a position shifted to the distal end side with respect to the contact CO between the connecting portion 1221 and the lead wire C1. It was.
  • the reinforcing member 14B constituting the energy application structure 10B according to the second modification is set longer than the length dimension of the reinforcing member 14 described in the above-described embodiment. Then, as shown in FIG. 8, the reinforcing member 14B is located at a position where the proximal end portion is shifted to the proximal end side with respect to the contact point CO between the connecting portion 1221 and the lead wire C1.
  • FIG. 9 is a diagram illustrating an energy application structure 10C according to the third modification of the present embodiment. Specifically, FIG. 9 corresponds to FIG.
  • the reinforcing member 14C constituting the energy application structure 10C according to the third modification is set to be shorter than the length dimension of the reinforcing member 14 described in the above-described embodiment.
  • the reinforcing member 14 ⁇ / b> C is positioned at the second position P ⁇ b> 2 ⁇ / b> C where the end portion on the distal end side is located closer to the first position P ⁇ b> 1 than the second position P ⁇ b> 2 described in the embodiment described above. While facing each other, the end portion on the base end side faces the first position P1.
  • the length L1 (FIG. 9) from the boundary position P0 to the first position P1 is shorter than the length L2C (FIG. 9) from the boundary position P0 to the second position P2C.
  • the entire surface of one plate of the reinforcing member 14 (14A to 14C) is bonded and fixed to the other surface 1212.
  • the present invention is not limited to this.
  • the reinforcing member according to the present invention as long as the reinforcing members are in contact with the first and second positions P1 (P1A) and P2 (P2C), respectively, one plate surface does not have to be bonded and fixed to the other surface 1212. Good.
  • the reinforcing member 14 (14A to 14C) may be fixed to the flexible substrate 12 by using other bonding means instead of adhesive fixing.
  • the reinforcing member 14 (14A to 14C) has a flat plate shape.
  • the present invention is not limited to this, and the first and second positions P1 (P1A), As long as it has contact
  • the first and second jaws 8 and 8 ′ are opened and closed as the gripping portion 7.
  • the second jaw 8 ′ cover You may employ
  • the energy applying structures 10 and 10 ' are provided on both the first and second jaws 8 and 8'. You may employ
  • the treatment instrument 2 is configured to apply thermal energy to a living tissue.
  • the present invention is not limited to this, and in addition to thermal energy, high-frequency energy or ultrasonic energy is used. It is also possible to adopt a configuration that further provides

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Abstract

The purpose of the present invention is to provide an energy applying structure and a treatment tool which can reduce load on an adhesive member. The energy applying structure (10 (10')) includes: a heat transfer plate (11); a heater (12) on which a resistance pattern (1222) and a connecting part (1221) are formed; an adhesive member (13); and a reinforcing member (14) which is disposed facing the other surface (1212) of the substrate (121). The adhesive member (13) has a first area for bonding the heater (12) to the heat transfer plate (11) and a second area that juts out beyond the heat transfer plate (11) on the connecting part (1221) side and covers a portion of the connecting part (1221). The reinforcing member (14) comes into contact, on the other surface (1212), with a first position (P1) which is positioned more toward the connecting part (1221) than a boundary position (P0), the boundary position (P0) being an end of the heat transfer plate (11) on the connecting part (1221) side, and with a second position (P2) which sandwiches the boundary position (P0) with the first position (P1).

Description

エネルギ付与構造及び処置具Energy application structure and treatment tool
　本発明は、エネルギ付与構造及び処置具に関する。 The present invention relates to an energy application structure and a treatment instrument.
　従来、生体組織にエネルギを付与するエネルギ付与構造が設けられ、当該エネルギの付与により生体組織を処置（接合（若しくは吻合）及び切離等）する処置具が知られている（例えば、特許文献１参照）。
　特許文献１に記載のエネルギ付与構造は、以下に示すフレキシブル基板、伝熱板、及び接着部材を備える。
　フレキシブル基板は、基板の一方の面に、通電により発熱する抵抗パターンと、当該抵抗パターンに導通するとともにリード線が接続される接続部とを有する配線パターンが形成され、シートヒータとして機能する部分である。
　伝熱板は、銅等の導体で構成されている。そして、伝熱板は、フレキシブル基板の一方の面（抵抗パターン）に対向して配設され、抵抗パターンからの熱を生体組織に伝達する（熱エネルギを生体組織に付与する）。
　接着部材は、良好な熱伝導性及び絶縁性を有するシートである。そして、接着部材は、フレキシブル基板及び伝熱板の間に介装され、これらを接着固定する。
　ここで、接着部材は、抵抗パターン全体を覆う第１領域と、伝熱板から張り出すとともに接続部の一部を覆う第２領域とを有する。すなわち、接着部材は、第１領域により伝熱板及び抵抗パターンの熱的な結合を担うとともに伝熱板及び抵抗パターンの短絡を防止し、第２領域により伝熱板及び接続部の短絡も防止する。 2. Description of the Related Art Conventionally, there has been known a treatment instrument that is provided with an energy applying structure that applies energy to a living tissue, and that treats the living tissue (joining (or anastomosis), cutting, etc.) by applying the energy (for example, Patent Document 1). reference).
The energy application structure described in Patent Document 1 includes the following flexible substrate, heat transfer plate, and adhesive member.
The flexible substrate is a portion that functions as a sheet heater, on one surface of the substrate, where a wiring pattern having a resistance pattern that generates heat when energized and a connection portion that conducts to the resistance pattern and is connected to a lead wire are formed. is there.
The heat transfer plate is made of a conductor such as copper. The heat transfer plate is disposed so as to face one surface (resistance pattern) of the flexible substrate, and transfers heat from the resistance pattern to the living tissue (giving thermal energy to the living tissue).
The adhesive member is a sheet having good thermal conductivity and insulation. The adhesive member is interposed between the flexible substrate and the heat transfer plate, and bonds and fixes them.
Here, the adhesive member has a first region that covers the entire resistance pattern, and a second region that protrudes from the heat transfer plate and covers a part of the connection portion. That is, the adhesive member is responsible for the thermal coupling of the heat transfer plate and the resistance pattern by the first region and prevents the heat transfer plate and the resistance pattern from being short-circuited, and the second region also prevents the heat transfer plate and the connection portion from being short-circuited. To do.
特開２０１４－１２４４９１号公報JP 2014-124491 A
　図１０Ａ及び図１０Ｂは、従来のエネルギ付与構造１００における問題を説明する図である。具体的に、図１０Ａ及び図１０Ｂは、エネルギ付与構造１００を側方からそれぞれ見た図である。
　なお、図１０Ａ及び図１０Ｂにおいて、符号「１１０」は、上述した伝熱板である。符号「１２０」は、上述したフレキシブル基板である。符号「１２１０」は、上述した基板である。符号「１２２０」は、上述した配線パターンである。符号「１３０」は、上述した接着部材である。また、以下では、説明の便宜上、図１０Ａ及び図１０Ｂ中、左側を「先端側」と記載し、右側を「基端側」と記載する。 10A and 10B are diagrams for explaining a problem in the conventional energy application structure 100. Specifically, FIGS. 10A and 10B are views of the energy application structure 100 as viewed from the side.
In FIGS. 10A and 10B, reference numeral “110” denotes the above-described heat transfer plate. Reference numeral “120” denotes the flexible substrate described above. Reference numeral “1210” denotes the substrate described above. Reference numeral “1220” is the wiring pattern described above. Reference numeral “130” denotes the adhesive member described above. In the following, for convenience of explanation, in FIGS. 10A and 10B, the left side is described as the “front end side” and the right side is described as the “base end side”.
　上述したように、従来のエネルギ付与構造１００では、接着部材１３０の基端側は、伝熱板１１０よりも基端側に張り出している。また、フレキシブル基板１２０の基端側は、接着部材１３０よりも基端側に張り出している。そして、フレキシブル基板１２０や接着部材１３０は、可撓性（屈曲性）を有する。
　ここで、例えば、エネルギ付与構造１００の運搬時等において、フレキシブル基板１２０の基端側に対して、伝熱板１１０側からの外力（図１０Ａ中、下方側への外力）または基板１２１０側からの外力（図１０Ｂ中、上方側への外力）が加えられた場合を想定する。この場合には、フレキシブル基板１２０における基端側の部分は、接着部材１３０における基端側の部分とともに、図１０Ａまたは図１０Ｂに示すように、伝熱板１１０における基端側の端部を支点Ｆｕ１として屈曲することとなる。したがって、接着部材１３０において、伝熱板１１０の基端側の端部に対向する部分に負荷が掛かってしまう、という問題がある。 As described above, in the conventional energy application structure 100, the proximal end side of the adhesive member 130 projects beyond the heat transfer plate 110 to the proximal end side. Further, the base end side of the flexible substrate 120 protrudes to the base end side from the adhesive member 130. The flexible substrate 120 and the adhesive member 130 have flexibility (flexibility).
Here, for example, during transportation of the energy application structure 100, external force from the heat transfer plate 110 side (external force downward in FIG. 10A) or from the substrate 1210 side with respect to the base end side of the flexible substrate 120. Is assumed to be applied (external force upward in FIG. 10B). In this case, the base end side portion of the flexible substrate 120, together with the base end side portion of the adhesive member 130, has a base end side end portion of the heat transfer plate 110 as a fulcrum as shown in FIG. 10A or 10B. It will be bent as Fu1. Therefore, there is a problem that a load is applied to a portion of the adhesive member 130 that faces the end portion on the proximal end side of the heat transfer plate 110.
　本発明は、上記に鑑みてなされたものであって、接着部材への負荷を軽減することができるエネルギ付与構造及び処置具を提供することを目的とする。 The present invention has been made in view of the above, and an object thereof is to provide an energy application structure and a treatment instrument that can reduce the load on the adhesive member.
　上述した課題を解決し、目的を達成するために、本発明に係るエネルギ付与構造は、通電により発熱する抵抗パターンと、当該抵抗パターンに導通するとともにリード線が接続される接続部と、が形成されたヒータと、前記抵抗パターンからの熱が伝達される伝熱板と、前記ヒータと前記伝熱板との間に介装され、前記ヒータと前記伝熱板とを接着固定する接着部材と、前記ヒータにおける前記接着部材が配置される面とは反対側の面に対向して配設される補強部材と、を備え、前記接着部材は、前記ヒータと前記伝熱板とを接着する第１領域と、前記伝熱板から前記接続部側に張り出すとともに当該接続部の一部を覆う第２領域と、を有し、前記補強部材は、前記反対側の面において、前記伝熱板の前記接続部側の端部を境界位置として、当該境界位置よりも前記接続部側に位置する第１の位置と、当該第１の位置との間で当該境界位置を挟む第２の位置とにそれぞれ当接する。 In order to solve the above-described problems and achieve the object, the energy application structure according to the present invention includes a resistance pattern that generates heat by energization, and a connection portion that conducts to the resistance pattern and is connected to a lead wire. A heater, a heat transfer plate to which heat from the resistance pattern is transmitted, and an adhesive member interposed between the heater and the heat transfer plate to bond and fix the heater and the heat transfer plate; A reinforcing member disposed opposite to the surface of the heater opposite to the surface on which the adhesive member is disposed, and the adhesive member bonds the heater and the heat transfer plate to each other. A first region and a second region that projects from the heat transfer plate to the connection portion side and covers a part of the connection portion, and the reinforcing member is disposed on the opposite surface of the heat transfer plate. The end on the connection side of the A first position located at the connecting portion side from the boundary position, abuts each of the second positions sandwiching the boundary position between the said first position.
　また、本発明に係る処置具は、上述したエネルギ付与構造を備える。 Moreover, the treatment tool according to the present invention includes the above-described energy application structure.
　本発明に係るエネルギ付与構造及び処置具によれば、接着部材への負荷を軽減することができる、という効果を奏する。 According to the energy application structure and the treatment tool according to the present invention, there is an effect that the load on the adhesive member can be reduced.
図１は、本実施の形態に係る処置システムを模式的に示す図である。FIG. 1 is a diagram schematically showing a treatment system according to the present embodiment. 図２は、処置具の先端部分を拡大した図である。FIG. 2 is an enlarged view of the distal end portion of the treatment instrument. 図３は、カバー部材及びエネルギ付与構造を示す図である。FIG. 3 is a diagram illustrating a cover member and an energy application structure. 図４は、カバー部材及びエネルギ付与構造を示す図である。FIG. 4 is a diagram illustrating a cover member and an energy application structure. 図５は、エネルギ付与構造を側方から見た図である。FIG. 5 is a side view of the energy application structure. 図６Ａは、本実施の形態の効果を説明する図である。FIG. 6A is a diagram for explaining the effect of the present embodiment. 図６Ｂは、本実施の形態の効果を説明する図である。FIG. 6B is a diagram for explaining the effect of the present embodiment. 図７は、本実施の形態の変形例１に係るエネルギ付与構造を示す図である。FIG. 7 is a diagram showing an energy application structure according to Modification 1 of the present embodiment. 図８は、本実施の形態の変形例２に係るエネルギ付与構造を示す図である。FIG. 8 is a diagram showing an energy application structure according to the second modification of the present embodiment. 図９は、本実施の形態の変形例３に係るエネルギ付与構造を示す図である。FIG. 9 is a diagram showing an energy application structure according to Modification 3 of the present embodiment. 図１０Ａは、従来のエネルギ付与構造における問題を説明する図である。FIG. 10A is a diagram illustrating a problem in the conventional energy application structure. 図１０Ｂは、従来のエネルギ付与構造における問題を説明する図である。FIG. 10B is a diagram illustrating a problem in the conventional energy application structure.
　以下、図面を参照して、本発明を実施するための形態（以下、実施の形態）について説明する。なお、以下に説明する実施の形態によって本発明が限定されるものではない。さらに、図面の記載において、同一の部分には同一の符号を付している。 Hereinafter, embodiments 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.
　〔処置システムの概略構成〕
　図１は、本実施の形態に係る処置システム１を模式的に示す図である。
　処置システム１は、処置対象である生体組織に熱エネルギを付与することにより、当該生体組織を処置（接合（若しくは吻合）及び切離等）する。この処置システム１は、図１に示すように、処置具２と、制御装置３と、フットスイッチ４とを備える。 [Schematic configuration of treatment system]
FIG. 1 is a diagram schematically showing a treatment system 1 according to the present embodiment.
The treatment system 1 treats (joins (or anastomoses) and detaches, etc.) the living tissue by applying thermal energy to the living tissue to be treated. As illustrated in FIG. 1, the treatment system 1 includes a treatment tool 2, a control device 3, and a foot switch 4.
　〔処置具の構成〕
　処置具２は、例えば、腹壁を通して生体組織に処置を行うためのリニアタイプの外科医療用処置具である。この処置具２は、図１に示すように、ハンドル５と、シャフト６と、把持部７とを備える。
　ハンドル５は、術者が手で持つ部分である。そして、このハンドル５には、図１に示すように、操作ノブ５１が設けられている。
　シャフト６は、図１に示すように、略円筒形状を有し、一端（図１中、右端部）がハンドル５に接続されている。また、シャフト６の他端（図１中、左端部）には、把持部７が取り付けられている。そして、このシャフト６の内部には、術者による操作ノブ５１の操作に応じて、把持部７を構成する第１，第２ジョー８，８´（図１）を開閉させる開閉機構（図示略）が設けられている。また、このシャフト６の内部には、制御装置３に接続された電気ケーブルＣ（図１）がハンドル５を介して一端側（図１中、右端部側）から他端側（図１中、左端部側）まで配設されている。 [Configuration of treatment tool]
The treatment tool 2 is, for example, a linear type surgical treatment tool for performing treatment on a living tissue through the abdominal wall. As shown in FIG. 1, the treatment tool 2 includes a handle 5, a shaft 6, and a grip portion 7.
The handle 5 is a part that the surgeon holds by hand. 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).
　〔把持部の構成〕
　図２は、処置具２の先端部分を拡大した図である。
　把持部７は、生体組織を把持して、当該生体組織を処置する部分である。この把持部７は、図１または図２に示すように、第１，第２ジョー８，８´を備える。
　第１，第２ジョー８，８´は、矢印Ｒ１（図２）方向に開閉可能にシャフト６の他端（図１及び図２中、左端部）に軸支され、術者による操作ノブ５１の操作に応じて、生体組織を把持可能とする。
　そして、第１，第２ジョー８，８´には、図２に示すように、カバー部材９，９´及びエネルギ付与構造１０，１０´がそれぞれ設けられている。
　なお、カバー部材９，９´は、同一の構成を有し、上下の姿勢が逆になる点のみが異なる。また、エネルギ付与構造１０，１０´も同様に、同一の構成を有し、上下の姿勢が逆になる点のみが異なる。このため、以下では、カバー部材９及びエネルギ付与構造１０の構成を主に説明する。そして、カバー部材９´及びエネルギ付与構造１０´については、カバー部材９及びエネルギ付与構造１０と同一の構成に同一の符号を付してその説明を省略する。 (Configuration of gripping part)
FIG. 2 is an enlarged view of the distal end portion of the treatment instrument 2.
The gripping part 7 is a part that grips a living tissue and treats the living tissue. As shown in FIG. 1 or 2, 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 (left end portion in FIGS. 1 and 2) so as to be openable and closable in the direction of the arrow R1 (FIG. 2). The living tissue can be grasped according to the operation.
As shown in FIG. 2, the first and second jaws 8 and 8 ′ are provided with cover members 9 and 9 ′ and energy application structures 10 and 10 ′, respectively.
Note that the cover members 9 and 9 'have the same configuration and are different only in that the vertical postures are reversed. Similarly, the energy application structures 10 and 10 ′ have the same configuration and are different only in that the vertical posture is reversed. For this reason, below, the structure of the cover member 9 and the energy provision structure 10 is mainly demonstrated. And about cover member 9 'and energy provision structure 10', the same code | symbol is attached | subjected to the structure same as cover member 9 and energy provision structure 10, and the description is abbreviate | omitted.
　〔カバー部材及びエネルギ付与構造の構成〕
　図３及び図４は、カバー部材９及びエネルギ付与構造１０を示す図である。具体的に、図３は、図２中、上方側からカバー部材９及びエネルギ付与構造１０を見た斜視図である。図４は、図３の分解斜視図である。
　なお、以下で記載する「先端側」は、把持部７の先端側であって、図３ないし図５中、左側を意味する。また、以下で記載する「基端側」は、把持部７のシャフト６側であって、図３ないし図５中、右側を意味する。
　カバー部材９は、エネルギ付与構造１０を支持しつつ、図１及び図２中、下方側に配設された第１ジョー８における上方側の面に対して、エネルギ付与構造１０が上方に向く姿勢で取り付けられる。すなわち、エネルギ付与構造１０は、第１，第２ジョー８，８´との間で生体組織を把持する把持面の方向に向く姿勢で取り付けられている。 [Configuration of cover member and energy application structure]
3 and 4 are views showing the cover member 9 and the energy applying structure 10. Specifically, FIG. 3 is a perspective view of the cover member 9 and the energy application structure 10 as viewed from above in FIG. FIG. 4 is an exploded perspective view of FIG.
The “tip side” described below is the tip side of the gripping part 7 and means the left side in FIGS. 3 to 5. Further, the “base end side” described below means the shaft 6 side of the gripping portion 7 and the right side in FIGS. 3 to 5.
The cover member 9 supports the energy application structure 10 and has a posture in which the energy application structure 10 faces upward with respect to the upper surface of the first jaw 8 disposed on the lower side in FIGS. 1 and 2. It is attached with. That is, the energy application structure 10 is attached in a posture facing the direction of the gripping surface that grips the living tissue between the first and second jaws 8 and 8 ′.
　このカバー部材９は、図３または図４に示すように、一方の板面（図４中、上方側の板面）に凹部９１を有する長尺状（把持部７の先端から基端に向かう長手方向（図１及び図２中、左右方向）に延在する長尺状）の板体で構成されている。
　凹部９１は、カバー部材９における幅方向の中心に位置し、当該カバー部材９の長手方向に沿って延在する。また、凹部９１を構成する側壁部のうち、基端側の側壁部は、省略されている。そして、エネルギ付与構造１０は、図３に示すように、一部が凹部９１から基端側に突出した状態で、凹部９１に収容される。また、カバー部材９は、凹部９１が形成されていない他方の板面が第１ジョー８に取り付けられる（図２）。 As shown in FIG. 3 or FIG. 4, the cover member 9 has a long shape having a recess 91 on one plate surface (the plate surface on the upper side in FIG. 4) (from the distal end of the gripping portion 7 toward the proximal end). It is comprised with the plate body of the longitudinal direction (elongate shape extended in the left-right direction in FIG.1 and FIG.2).
The recess 91 is located at the center of the cover member 9 in the width direction and extends along the longitudinal direction of the cover member 9. Further, among the side wall portions constituting the recess 91, the side wall portion on the proximal end side is omitted. And the energy provision structure 10 is accommodated in the recessed part 91 in the state which one part protruded from the recessed part 91 to the base end side, as shown in FIG. Further, the other plate surface of the cover member 9 in which the concave portion 91 is not formed is attached to the first jaw 8 (FIG. 2).
　図５は、エネルギ付与構造１０を側方から見た図である。
　エネルギ付与構造１０は、制御装置３による制御の下、熱エネルギを発生する。このエネルギ付与構造１０は、図３ないし図５に示すように、伝熱板１１と、フレキシブル基板１２と、接着部材１３と、補強部材（補強板）１４とを備える。
　伝熱板１１は、例えば銅等の材料で構成された長尺状（把持部７の長手方向に延在する長尺状）の薄板であり、カバー部材９を介して第１ジョー８に取り付けられた状態で、一方の板面である処置面１１１（図２）が第２ジョー８´側を向く。そして、伝熱板１１は、第１，第２ジョー８，８´にて生体組織を把持した状態で、処置面１１１が当該生体組織に接触し、フレキシブル基板１２からの熱を当該生体組織に伝達する（熱エネルギを生体組織に付与する）。 FIG. 5 is a view of the energy application structure 10 as viewed from the side.
The energy applying structure 10 generates heat energy under the control of the control device 3. As shown in FIGS. 3 to 5, the energy applying structure 10 includes a heat transfer plate 11, a flexible substrate 12, an adhesive member 13, and a reinforcing member (reinforcing plate) 14.
The heat transfer plate 11 is a thin plate having a long shape (long shape extending in the longitudinal direction of the grip portion 7) made of a material such as copper, and is attached to the first jaw 8 via the cover member 9. In this state, the treatment surface 111 (FIG. 2), which is one plate surface, faces the second jaw 8 ′ side. The heat transfer plate 11 holds the living tissue with the first and second jaws 8 and 8 ′, the treatment surface 111 comes into contact with the living tissue, and heat from the flexible substrate 12 is applied to the living tissue. Transmit (apply thermal energy to living tissue).
　フレキシブル基板１２は、一部が発熱し、当該発熱により伝熱板１１を加熱するシートヒータ（抵抗ヒータ）として機能する。すなわち、フレキシブル基板１２は、本発明に係るヒータに相当する。このフレキシブル基板１２は、図３ないし図５に示すように、基板１２１と、配線パターン１２２とを備える。
　基板１２１は、ポリイミド等の絶縁材料から構成された長尺状（把持部７の長手方向に延在する長尺状）のシートであり、可撓性（屈曲性）を有する。
　なお、基板１２１の材料としては、ポリイミドに限らず、例えば、窒化アルミ、アルミナ、ガラス、ジルコニア等の高耐熱絶縁性材料を採用しても構わない。
　ここで、基板１２１の幅寸法は、伝熱板１１の幅寸法と略同一となるように設定されている。また、基板１２１の長さ寸法（長手方向（図４及び図５中、左右方向）の長さ寸法）は、伝熱板１１の長さ寸法（長手方向（図４及び図５中、左右方向）の長さ寸法）よりも長くなるように設定されている。 A part of the flexible substrate 12 generates heat and functions as a sheet heater (resistance heater) that heats the heat transfer plate 11 by the generated heat. That is, the flexible substrate 12 corresponds to the heater according to the present invention. As shown in FIGS. 3 to 5, the flexible substrate 12 includes a substrate 121 and a wiring pattern 122.
The substrate 121 is a long sheet (long shape extending in the longitudinal direction of the grip portion 7) made of an insulating material such as polyimide, and has flexibility (flexibility).
The material of the substrate 121 is not limited to polyimide, and for example, a high heat insulating material such as aluminum nitride, alumina, glass, zirconia, etc. may be adopted.
Here, the width dimension of the substrate 121 is set to be substantially the same as the width dimension of the heat transfer plate 11. The length dimension of the substrate 121 (length dimension in the longitudinal direction (left and right direction in FIGS. 4 and 5)) is the same as the length dimension of the heat transfer plate 11 (longitudinal direction (left and right direction in FIGS. 4 and 5). ) Is set to be longer than the length dimension).
　配線パターン１２２は、導電性材料であるステンレス（ＳＵＳ３０４）を加工したものであり、図３ないし図５に示すように、一対の接続部１２２１と、抵抗パターン１２２２（図４，図５）とを備える。そして、配線パターン１２２は、基板１２１の一方の面１２１１（図３～図５）に熱圧着により貼り合わせられる。
　なお、配線パターン１２２の材料としては、ステンレス（ＳＵＳ３０４）に限らず、他のステンレス材料（例えば４００番系）でもよいし、プラチナや、タングステン等の導電性材料を採用しても構わない。また、配線パターン１２２としては、基板１２１の一方の面１２１１に熱圧着により貼り合わせた構成に限らず、当該一方の面１２１１に蒸着等により形成した構成を採用しても構わない。 The wiring pattern 122 is obtained by processing stainless steel (SUS304), which is a conductive material. As shown in FIGS. 3 to 5, a pair of connection parts 1221 and a resistance pattern 1222 (FIGS. 4 and 5) are provided. Prepare. The wiring pattern 122 is bonded to one surface 1211 (FIGS. 3 to 5) of the substrate 121 by thermocompression bonding.
The material of the wiring pattern 122 is not limited to stainless steel (SUS304), and other stainless steel materials (for example, No. 400 series) may be used, or conductive materials such as platinum and tungsten may be adopted. Further, the wiring pattern 122 is not limited to a configuration in which the wiring pattern 122 is bonded to one surface 1211 of the substrate 121 by thermocompression bonding, and a configuration in which the one surface 1211 is formed by vapor deposition or the like may be employed.
　一対の接続部１２２１は、図３または図４に示すように、基板１２１の基端側にそれぞれ設けられ、当該基端側から先端側に向けてそれぞれ延在し、基板１２１の幅方向に沿って互いに対向するように設けられている。そして、一対の接続部１２２１には、電気ケーブルＣを構成する２つのリード線Ｃ１（図３～図５）がそれぞれ接合（接続）される。
　抵抗パターン１２２２は、一端が一方の接続部１２２１に接続（導通）し、当該一端から、波状に蛇行しながら、基板１２１の外縁形状に倣うＵ字形状に沿って延在し、他端が他方の接続部１２２１に接続（導通）する。
　そして、抵抗パターン１２２２は、２つのリード線Ｃ１を介して制御装置３により一対の接続部１２２１に電圧が印加（通電）されることにより、発熱する。 As shown in FIG. 3 or FIG. 4, the pair of connection portions 1221 are provided on the base end side of the substrate 121, respectively extend from the base end side toward the tip end side, and extend along the width direction of the substrate 121. So as to face each other. Then, two lead wires C1 (FIGS. 3 to 5) constituting the electric cable C are joined (connected) to the pair of connecting portions 1221, respectively.
One end of the resistance pattern 1222 is connected (conducted) to one connecting portion 1221, and extends from the one end along a U-shape following the outer edge shape of the substrate 121 while meandering in a wavy shape, and the other end is connected to the other end The connection portion 1221 is connected (conductive).
The resistance pattern 1222 generates heat when a voltage is applied (energized) to the pair of connection parts 1221 by the control device 3 via the two lead wires C1.
　接着部材１３は、図３ないし図５に示すように、伝熱板１１とフレキシブル基板１２との間に介装され、フレキシブル基板１２の一部が伝熱板１１における基端側の端部から基端側に張り出した状態で伝熱板１１の裏面（処置面１１１とは反対側の面）と基板１２１の一方の面１２１１（配線パターン１２２側の面）とを接着固定する。この接着部材１３は、良好な熱伝導性及び絶縁性を有し、かつ、高温に耐え、接着性を有する長尺状（把持部７の長手方向に延在する長尺状）のシートであり、例えば、アルミナ、窒化ホウ素、グラファイト、窒化アルミ等の高熱伝導フィラー（非導電性材料）をエポキシやポリウレタン等の樹脂と混合することにより形成されている。
　ここで、接着部材１３の幅寸法は、基板１２１の幅寸法と略同一となるように設定されている。また、接着部材１３の長さ寸法（長手方向（図４及び図５中、左右方向）の長さ寸法）は、伝熱板１１の長さ寸法（長手方向（図４及び図５中、左右方向）の長さ寸法）よりも長く、基板１２１の長さ寸法（長手方向（図４及び図５中、左右方向）の長さ寸法）よりも短くなるように設定されている。 As shown in FIGS. 3 to 5, the adhesive member 13 is interposed between the heat transfer plate 11 and the flexible substrate 12, and a part of the flexible substrate 12 extends from the proximal end of the heat transfer plate 11. The rear surface (surface opposite to the treatment surface 111) of the heat transfer plate 11 and one surface 1211 (surface on the wiring pattern 122 side) of the substrate 121 are bonded and fixed in a state of projecting to the base end side. This adhesive member 13 is a long sheet (long shape extending in the longitudinal direction of the gripping portion 7) having good thermal conductivity and insulation, withstanding high temperatures, and having adhesiveness. For example, a high thermal conductive filler (non-conductive material) such as alumina, boron nitride, graphite, or aluminum nitride is mixed with a resin such as epoxy or polyurethane.
Here, the width dimension of the adhesive member 13 is set to be substantially the same as the width dimension of the substrate 121. The length dimension of the adhesive member 13 (length dimension in the longitudinal direction (left and right direction in FIGS. 4 and 5)) is the same as the length dimension of the heat transfer plate 11 (longitudinal direction (left and right directions in FIGS. 4 and 5). It is set to be longer than the length dimension (direction) and shorter than the length dimension of the substrate 121 (length dimension in the longitudinal direction (left and right direction in FIGS. 4 and 5)).
　そして、伝熱板１１は、図５に示すように、抵抗パターン１２２２全体を覆うように配置される。また、接着部材１３は、伝熱板１１全体、抵抗パターン１２２２全体、及び一対の接続部１２２１の一部を覆う第１領域Ａｒ１（図４）と、伝熱板１１における基端側の端部から基端側に張り出すとともに一対の接続部１２２１の一部を覆う第２領域Ａｒ２（図３，図４）との２つの領域を有する。なお、第１領域Ａｒ１については、少なくとも抵抗パターン１２２２全体を覆っている領域であればよい。そして、２つのリード線Ｃ１は、一対の接続部１２２１における外部に露出した部位（接着部材１３にて覆われていない部位）にそれぞれ接合（接続）される。 And the heat-transfer plate 11 is arrange | positioned so that the whole resistance pattern 1222 may be covered, as shown in FIG. The adhesive member 13 includes a first region Ar1 (FIG. 4) that covers the entire heat transfer plate 11, the entire resistance pattern 1222, and part of the pair of connection portions 1221, and an end portion on the proximal end side of the heat transfer plate 11. And a second region Ar2 (FIGS. 3 and 4) covering the base end side and covering a part of the pair of connection parts 1221. The first region Ar1 may be a region that covers at least the entire resistance pattern 1222. Then, the two lead wires C1 are joined (connected) to portions exposed to the outside (portions not covered with the adhesive member 13) in the pair of connecting portions 1221.
　補強部材１４は、アルミニウム等の金属材料やアルミナ等のセラミック等から構成された長尺状（把持部７の長手方向に延在する長尺状）のシートである。そして、補強部材１４は、図３ないし図５に示すように、基板１２１の他方の面１２１２（配線パターン１２２とは反対側の面）に接着固定される。
　ここで、補強部材１４の幅寸法は、基板１２１の幅寸法と略同一となるように設定されている。また、補強部材１４の長さ寸法（長手方向（図４及び図５中、左右方向）の長さ寸法）は、接着部材１３の長さ寸法（長手方向（図４及び図５中、左右方向）の長さ寸法）よりも長く、基板１２１の長さ寸法（長手方向（図４及び図５中、左右方向）の長さ寸法）よりも短くなるように設定されている。 The reinforcing member 14 is a long sheet (long shape extending in the longitudinal direction of the grip portion 7) made of a metal material such as aluminum, ceramic such as alumina, or the like. Then, as shown in FIGS. 3 to 5, the reinforcing member 14 is bonded and fixed to the other surface 1212 of the substrate 121 (the surface opposite to the wiring pattern 122).
Here, the width dimension of the reinforcing member 14 is set to be substantially the same as the width dimension of the substrate 121. The length dimension of the reinforcing member 14 (length dimension in the longitudinal direction (left and right direction in FIGS. 4 and 5)) is the same as the length dimension of the adhesive member 13 (longitudinal direction (left and right direction in FIGS. 4 and 5). ) And is shorter than the length dimension of the substrate 121 (length dimension in the longitudinal direction (left and right direction in FIGS. 4 and 5)).
　そして、補強部材１４は、先端側の端部が基板１２１における先端側の端部に略一致するとともに基端側が接着部材１３における基端側の端部から基端側に張り出した状態で、一方の板面（図４及び図５中、上方側の板面）全面が他方の面１２１２に接着固定される。この際、補強部材１４における基端側の端部は、図５に示すように、接続部１２２１とリード線Ｃ１との接点ＣＯに対して、先端側にずれた位置に位置する。 The reinforcing member 14 is in a state where the end portion on the front end side substantially coincides with the end portion on the front end side in the substrate 121 and the base end side protrudes from the end portion on the base end side in the adhesive member 13 to the base end side. The entire plate surface (the upper plate surface in FIGS. 4 and 5) is bonded and fixed to the other surface 1212. At this time, the proximal end portion of the reinforcing member 14 is located at a position shifted toward the distal end side with respect to the contact point CO between the connecting portion 1221 and the lead wire C1, as shown in FIG.
　すなわち、本実施の形態では、補強部材１４は、当該補強部材１４及びフレキシブル基板１２を側方から見た場合に、図５に示すように、基板１２１の他方の面１２１２において、伝熱板１１における基端側の端部を境界位置Ｐ０として、境界位置Ｐ０よりも基端側に位置する第１の位置Ｐ１と、当該第１の位置Ｐ１との間で境界位置Ｐ０を挟む第２の位置Ｐ２とにそれぞれ当接するように設定されている。ここで、第１の位置Ｐ１は、補強部材１４における基端側の端部に対向する位置である。また、第２の位置Ｐ２は、補強部材１４における先端側の端部に対向する位置である。そして、境界位置Ｐ０から第１の位置Ｐ１までの長さＬ１（図５）は、境界位置Ｐ０から第２の位置Ｐ２までの長さＬ２（図５）よりも短い。また、補強部材１４は、他方の面１２１２において、第１，第２の位置Ｐ１，Ｐ２、及び境界位置Ｐ０を含む補強領域Ａｒ（図５）全体に当接するとともに、当該補強領域Ａｒ全体に接合（接着固定）されている。 That is, in the present embodiment, the reinforcing member 14 has the heat transfer plate 11 on the other surface 1212 of the substrate 121 as shown in FIG. 5 when the reinforcing member 14 and the flexible substrate 12 are viewed from the side. The second position that sandwiches the boundary position P0 between the first position P1 that is located on the proximal side of the boundary position P0 and the first position P1 with the end on the proximal end side in FIG. It is set so as to come into contact with P2. Here, the first position P <b> 1 is a position facing the proximal end of the reinforcing member 14. Further, the second position P2 is a position facing the end portion on the distal end side of the reinforcing member 14. A length L1 (FIG. 5) from the boundary position P0 to the first position P1 is shorter than a length L2 (FIG. 5) from the boundary position P0 to the second position P2. Further, the reinforcing member 14 abuts the entire reinforcing region Ar (FIG. 5) including the first and second positions P1 and P2 and the boundary position P0 on the other surface 1212 and is joined to the entire reinforcing region Ar. (Adhesion fixed).
　〔フレキシブル基板、接着部材、及び補強部材の曲げ剛性〕
　本実施の形態では、補強部材１４は、フレキシブル基板１２及び接着部材１３全体の曲げ剛性よりも高い曲げ剛性を有する。
　具体的に、基板１２１、配線パターン１２２、接着部材１３として、以下の表１に示す材質、幅寸法、及び厚み寸法でそれぞれ構成した。そして、このように構成した場合には、フレキシブル基板１２及び接着部材１３全体の曲げ剛性は、約３０[Ｎ・ｍｍ２]となる。また、補強部材１４として、以下の表１に示す材質、幅寸法、及び厚み寸法で構成した。このように構成した場合には、補強部材１４の曲げ剛性は、約５００[Ｎ・ｍｍ２]となる。なお、補強部材１４の材質をアルミニウムからアルミナに変更した場合には、補強部材１４の曲げ剛性は、約１００[Ｎ・ｍｍ２]となる。 [Bending rigidity of flexible substrate, adhesive member, and reinforcing member]
In the present embodiment, the reinforcing member 14 has a bending rigidity higher than the bending rigidity of the flexible substrate 12 and the adhesive member 13 as a whole.
Specifically, the substrate 121, the wiring pattern 122, and the adhesive member 13 were each configured with the materials, width dimensions, and thickness dimensions shown in Table 1 below. And when comprised in this way, the bending rigidity of the flexible substrate 12 and the adhesive member 13 whole will be about 30 [N * mm < 2 >]. Further, the reinforcing member 14 is composed of the material, width dimension, and thickness dimension shown in Table 1 below. In this case, the bending rigidity of the reinforcing member 14 is about 500 [N · mm 2 ]. When the material of the reinforcing member 14 is changed from aluminum to alumina, the bending rigidity of the reinforcing member 14 is about 100 [N · mm 2 ].
Figure JPOXMLDOC01-appb-T000001
Figure JPOXMLDOC01-appb-T000001
　〔制御装置及びフットスイッチの構成〕
　フットスイッチ４は、術者が足で操作する部分である。そして、フットスイッチ４への当該操作に応じて、制御装置３から処置具２（抵抗パターン１２２２）への通電のオン及びオフが切り替えられる。
　なお、当該オン及びオフを切り替える手段としては、フットスイッチ４に限らず、その他、手で操作するスイッチ等を採用しても構わない。
　制御装置３は、ＣＰＵ（Central　Processing　Unit）等を含んで構成され、所定の制御プログラムにしたがって、処置具２の動作を統括的に制御する。より具体的に、制御装置３は、術者によるフットスイッチ４への操作（通電オンの操作）に応じて、電気ケーブルＣを介して配線パターン１２２に電圧を印加して、伝熱板１１を加熱する。 [Configuration of control device and foot switch]
The foot switch 4 is a part operated by the operator with his / her foot. And according to the said operation to the foot switch 4, on / off of the electricity supply from the control apparatus 3 to the treatment tool 2 (resistance pattern 1222) is switched.
Note that the means for switching on and off is not limited to the foot switch 4, and a switch operated by hand or the like may be employed.
The control device 3 includes a CPU (Central Processing Unit) and the like, and comprehensively controls the operation of the treatment instrument 2 according to a predetermined control program. More specifically, the control device 3 applies a voltage to the wiring pattern 122 via the electric cable C in response to an operation to the foot switch 4 by the operator (operation to turn on the power), thereby causing the heat transfer plate 11 to move. Heat.
　〔処置システムの動作〕
　次に、上述した処置システム１の動作について説明する。
　術者は、処置具２を手で持ち、当該処置具２の先端部分（把持部７及びシャフト６の一部）を、例えば、トロッカ等を用いて腹壁を通して腹腔内に挿入する。そして、術者は、操作ノブ５１を操作し、把持部７にて処置対象の生体組織を把持する。
　次に、術者は、フットスイッチ４を操作し、制御装置３から処置具２への通電をオンに切り替える。当該オンに切り替えられると、制御装置３は、電気ケーブルＣを介して配線パターン１２２に電圧を印加し、伝熱板１１を加熱する。そして、伝熱板１１の熱により、当該伝熱板１１に接触している生体組織は処置される。 [Action system action]
Next, operation | movement of the treatment system 1 mentioned above is demonstrated.
The surgeon holds the treatment instrument 2 by hand, and inserts the distal end portion of the treatment instrument 2 (a part of the gripping portion 7 and the shaft 6) into the abdominal cavity through the abdominal wall using, for example, a trocar. Then, the surgeon operates the operation knob 51 and grips the living tissue to be treated by the grip portion 7.
Next, the surgeon operates the foot switch 4 to turn on the power supply from the control device 3 to the treatment instrument 2. When switched on, the control device 3 applies a voltage to the wiring pattern 122 via the electric cable C and heats the heat transfer plate 11. Then, the living tissue in contact with the heat transfer plate 11 is treated by the heat of the heat transfer plate 11.
　以上説明した本実施の形態に係るエネルギ付与構造１０（１０´）によれば、以下の効果がある。
　図６Ａ及び図６Ｂは、本実施の形態の効果を説明する図である。具体的に、図６Ａ及び図６Ｂは、図５に対応した図である。
　本実施の形態に係るエネルギ付与構造１０（１０´）では、基板１２１における他方の面１２１２には、伝熱板１１における基端側の端部を境界位置Ｐ０として、境界位置Ｐ０よりも基端側に位置する第１の位置Ｐ１と、当該第１の位置Ｐ１との間で境界位置Ｐ０を挟む第２の位置Ｐ２とにそれぞれ当接する補強部材１４が設けられている。
　ここで、例えば、エネルギ付与構造１０（１０´）の運搬時等において、フレキシブル基板１２の基端側に対して、伝熱板１１側からの外力（図６Ａ中、下方側への外力）が加えられた場合を想定する。この場合には、フレキシブル基板１２における基端側の部分は、図６Ａに示すように、伝熱板１１における基端側の端部ではなく、補強部材１４における基端側の端部を支点Ｆｕ２として屈曲することとなる。このため、接着部材１３において、伝熱板１１の基端側の端部に対向する部分に負荷が掛かることがない。
　したがって、本実施の形態に係るエネルギ付与構造１０（１０´）によれば、接着部材１３への負荷を軽減することができる、という効果を奏する。 The energy application structure 10 (10 ′) according to the present embodiment described above has the following effects.
6A and 6B are diagrams for explaining the effect of the present embodiment. Specifically, FIGS. 6A and 6B correspond to FIG.
In the energy application structure 10 (10 ′) according to the present embodiment, the other surface 1212 of the substrate 121 has a base end side of the base plate side of the heat transfer plate 11 as a boundary position P0. Reinforcing members 14 that abut on the first position P1 located on the side and the second position P2 sandwiching the boundary position P0 between the first position P1 are provided.
Here, for example, when the energy application structure 10 (10 ′) is transported, an external force from the heat transfer plate 11 side (an external force downward in FIG. 6A) is applied to the base end side of the flexible substrate 12. Assume that it has been added. In this case, as shown in FIG. 6A, the base end side portion of the flexible substrate 12 is not the base end side end portion of the heat transfer plate 11, but the base end side end portion of the reinforcing member 14 as a fulcrum Fu2. Will be bent. For this reason, in the adhesive member 13, a load is not applied to a portion facing the end portion on the proximal end side of the heat transfer plate 11.
Therefore, according to the energy application structure 10 (10 ′) according to the present embodiment, there is an effect that the load on the adhesive member 13 can be reduced.
　また、本実施の形態に係るエネルギ付与構造１０（１０´）では、補強部材１４は、他方の面１２１２において、第１，第２の位置Ｐ１，Ｐ２に接合（接着固定）されている。
　ここで、例えば、エネルギ付与構造１０（１０´）の運搬時等において、フレキシブル基板１２の基端側に対して、上記の場合（図６Ａに示した場合）とは逆に、基板１２１側からの外力（図６Ｂ中、上方側への外力）が加えられた場合を想定する。この場合も上記の場合と同様に、フレキシブル基板１２における基端側の部分は、図６Ｂに示すように、伝熱板１１における基端側の端部ではなく、補強部材１４における基端側の端部を支点Ｆｕ２として屈曲することとなる。このため、伝熱板１１から離間する側と伝熱板１１側とのいずれの方向に外力が加えられた場合であっても、接着部材１３において、伝熱板１１の基端側の端部に対向する部分に負荷が掛かることがない。
　特に、補強部材１４は、第１，第２の位置Ｐ１，Ｐ２、及び境界位置Ｐ０を含む補強領域Ａｒ全体に当接するとともに、当該補強領域Ａｒ全体に接合（接着固定）されている。また、補強部材１４は、フレキシブル基板１２及び接着部材１３全体の曲げ剛性よりも高い曲げ剛性を有する。このため、エネルギ付与構造１０（１０´）において、第１の位置Ｐ１に対して先端側の領域の曲げ剛性を第１の位置Ｐ１に対して基端側の領域の曲げ剛性よりも飛躍的に高めることができ、上記の各場合（図６Ａ及び図６Ｂに示した各場合）において、より確実に、補強部材１４における基端側の端部を支点Ｆｕ２として屈曲させることができる。 In the energy application structure 10 (10 ′) according to the present embodiment, the reinforcing member 14 is joined (adhered and fixed) to the first and second positions P1 and P2 on the other surface 1212.
Here, for example, when the energy application structure 10 (10 ′) is transported, the substrate 121 side is opposite to the above case (the case shown in FIG. 6A) with respect to the proximal end side of the flexible substrate 12. Is assumed to be applied (external force upward in FIG. 6B). Also in this case, as in the case described above, the proximal end portion of the flexible substrate 12 is not the proximal end portion of the heat transfer plate 11 but the proximal end portion of the reinforcing member 14 as shown in FIG. 6B. The end portion is bent as a fulcrum Fu2. For this reason, even if it is a case where external force is applied to any direction of the side away from the heat exchanger plate 11, and the heat exchanger plate 11, the edge part of the base end side of the heat exchanger plate 11 in the adhesive member 13 No load is applied to the portion facing the.
In particular, the reinforcing member 14 is in contact with the entire reinforcing area Ar including the first and second positions P1 and P2 and the boundary position P0, and is joined (adhered and fixed) to the entire reinforcing area Ar. Further, the reinforcing member 14 has a bending rigidity higher than the bending rigidity of the flexible substrate 12 and the adhesive member 13 as a whole. For this reason, in the energy application structure 10 (10 ′), the bending rigidity of the region on the distal end side with respect to the first position P1 is dramatically higher than the bending rigidity of the region on the proximal end side with respect to the first position P1. In each case described above (in each case shown in FIGS. 6A and 6B), the end portion on the proximal end side of the reinforcing member 14 can be bent more reliably as the fulcrum Fu2.
　また、本実施の形態に係るエネルギ付与構造１０（１０´）では、補強部材１４は、接着部材１３における基端側の端部から基端側に張り出している。
　このため、上記の各場合（図６Ａ及び図６Ｂに示した各場合）において、補強部材１４における基端側の端部を支点Ｆｕ２として屈曲するため、接着部材１３は一切、屈曲しない。したがって、接着部材１３への負荷を効果的に軽減することができる。 Further, in the energy application structure 10 (10 ′) according to the present embodiment, the reinforcing member 14 projects from the proximal end portion of the adhesive member 13 to the proximal end side.
For this reason, in each of the above cases (in each case shown in FIGS. 6A and 6B), the end portion on the proximal end side of the reinforcing member 14 is bent as the fulcrum Fu2, so that the adhesive member 13 is not bent at all. Therefore, the load on the adhesive member 13 can be effectively reduced.
　また、本実施の形態に係るエネルギ付与構造１０（１０´）では、補強部材１４における基端側の端部は、他方の面１２１２において、接続部１２２１とリード線Ｃ１との接点ＣＯに対して先端側にずれた位置に位置する。
　このため、上記の各場合（図６Ａ及び図６Ｂに示した各場合）において、補強部材１４における基端側の端部を支点Ｆｕ２として屈曲するため、接点ＣＯが屈曲の支点となることがない。したがって、接点ＣＯに負荷が掛かることがなく、リード線Ｃ１の剥離等の可能性を低減することができる。 Further, in the energy application structure 10 (10 ′) according to the present embodiment, the end portion on the proximal end side of the reinforcing member 14 is on the other surface 1212 with respect to the contact point CO between the connection portion 1221 and the lead wire C1. Located at the position shifted to the tip side.
For this reason, in each of the above cases (in each case shown in FIGS. 6A and 6B), the end on the proximal end side of the reinforcing member 14 is bent as the fulcrum Fu2, so that the contact point CO does not become a fulcrum of bending. . Therefore, no load is applied to the contact point CO, and the possibility of peeling of the lead wire C1 can be reduced.
　また、本実施の形態に係るエネルギ付与構造１０（１０´）では、境界位置Ｐ０から第１の位置Ｐ１までの長さＬ１は、境界位置Ｐ０から第２の位置Ｐ２までの長さＬ２よりも短い。このため、長さＬ１が長さＬ２よりも長い場合には、伝熱板１１における基端側の端部が屈曲の支点となる可能性があるところ、Ｌ１＜Ｌ２の関係とすることで、屈曲の支点Ｆｕ２を補強部材１４における基端側の端部とすることができる。 In the energy application structure 10 (10 ′) according to the present embodiment, the length L1 from the boundary position P0 to the first position P1 is longer than the length L2 from the boundary position P0 to the second position P2. short. For this reason, when the length L1 is longer than the length L2, the base end side of the heat transfer plate 11 may be a fulcrum of bending. The bending fulcrum Fu <b> 2 can be used as an end portion on the proximal end side of the reinforcing member 14.
（その他の実施形態）
　ここまで、本発明を実施するための形態を説明してきたが、本発明は上述した実施の形態によってのみ限定されるべきものではない。
　図７は、本実施の形態の変形例１に係るエネルギ付与構造１０Ａを示す図である。具体的に、図７は、図５に対応した図である。
　上述した実施の形態に係るエネルギ付与構造１０では、補強部材１４は、基端側が接着部材１３における基端側の端部から基端側に張り出した状態で配設されていた。
　これに対して、本変形例１に係るエネルギ付与構造１０Ａを構成する補強部材１４Ａは、上述した実施の形態で説明した補強部材１４の長さ寸法よりも短く設定されている。そして、補強部材１４Ａは、図７に示すように、当該補強部材１４Ａの先端側の端部が第２の位置Ｐ２に対向するとともに、当該補強部材１４Ａの基端側の端部が境界位置Ｐ０と接着部材１３における基端側の端部との間に位置する第１の位置Ｐ１Ａに対向する。 (Other embodiments)
So far, the embodiment for carrying out the present invention has been described, but the present invention should not be limited only by the embodiment described above.
FIG. 7 is a diagram showing an energy application structure 10A according to Modification 1 of the present embodiment. Specifically, FIG. 7 corresponds to FIG.
In the energy application structure 10 according to the above-described embodiment, the reinforcing member 14 is disposed in a state where the base end side protrudes from the base end side end portion of the adhesive member 13 to the base end side.
On the other hand, 14 A of reinforcement members which comprise 10 A of energy provision structures which concern on this modification 1 are set shorter than the length dimension of the reinforcement member 14 demonstrated in embodiment mentioned above. Then, as shown in FIG. 7, the reinforcing member 14A has an end on the distal end side of the reinforcing member 14A facing the second position P2, and an end on the proximal end side of the reinforcing member 14A is a boundary position P0. And the first position P1A located between the proximal end of the adhesive member 13 and the first end P1A.
　図８は、本実施の形態の変形例２に係るエネルギ付与構造１０Ｂを示す図である。具体的に、図８は、図５に対応した図である。
　上述した実施の形態に係るエネルギ付与構造１０では、補強部材１４における基端側の端部は、接続部１２２１とリード線Ｃ１との接点ＣＯに対して、先端側にずれた位置に位置していた。
　これに対して、本変形例２に係るエネルギ付与構造１０Ｂを構成する補強部材１４Ｂは、上述した実施の形態で説明した補強部材１４の長さ寸法よりも長く設定されている。そして、補強部材１４Ｂは、図８に示すように、基端側の端部が接続部１２２１とリード線Ｃ１との接点ＣＯに対して、基端側にずれた位置に位置する。 FIG. 8 is a diagram illustrating an energy application structure 10B according to Modification 2 of the present embodiment. Specifically, FIG. 8 corresponds to FIG.
In the energy application structure 10 according to the above-described embodiment, the proximal end of the reinforcing member 14 is located at a position shifted to the distal end side with respect to the contact CO between the connecting portion 1221 and the lead wire C1. It was.
In contrast, the reinforcing member 14B constituting the energy application structure 10B according to the second modification is set longer than the length dimension of the reinforcing member 14 described in the above-described embodiment. Then, as shown in FIG. 8, the reinforcing member 14B is located at a position where the proximal end portion is shifted to the proximal end side with respect to the contact point CO between the connecting portion 1221 and the lead wire C1.
　図９は、本実施の形態の変形例３に係るエネルギ付与構造１０Ｃを示す図である。具体的に、図９は、図５に対応した図である。
　本変形例３に係るエネルギ付与構造１０Ｃを構成する補強部材１４Ｃは、上述した実施の形態で説明した補強部材１４の長さ寸法よりも短く設定されている。そして、補強部材１４Ｃは、図９に示すように、先端側の端部が上述した実施の形態で説明した第２の位置Ｐ２よりも第１の位置Ｐ１側に位置する第２の位置Ｐ２Ｃに対向するとともに、基端側の端部が第１の位置Ｐ１に対向する。ここで、境界位置Ｐ０から第１の位置Ｐ１までの長さＬ１（図９）は、境界位置Ｐ０から第２の位置Ｐ２Ｃまでの長さＬ２Ｃ（図９）よりも短い。 FIG. 9 is a diagram illustrating an energy application structure 10C according to the third modification of the present embodiment. Specifically, FIG. 9 corresponds to FIG.
The reinforcing member 14C constituting the energy application structure 10C according to the third modification is set to be shorter than the length dimension of the reinforcing member 14 described in the above-described embodiment. Then, as shown in FIG. 9, the reinforcing member 14 </ b> C is positioned at the second position P <b> 2 </ b> C where the end portion on the distal end side is located closer to the first position P <b> 1 than the second position P <b> 2 described in the embodiment described above. While facing each other, the end portion on the base end side faces the first position P1. Here, the length L1 (FIG. 9) from the boundary position P0 to the first position P1 is shorter than the length L2C (FIG. 9) from the boundary position P0 to the second position P2C.
　上述した実施の形態及びその変形例１～３では、補強部材１４（１４Ａ～１４Ｃ）における一方の板面全面が他方の面１２１２に接着固定されていたが、これに限らない。本発明に係る補強部材としては、第１，第２の位置Ｐ１（Ｐ１Ａ），Ｐ２（Ｐ２Ｃ）にそれぞれ当接していれば、一方の板面全面を他方の面１２１２に接着固定しなくてもよい。
　上述した実施の形態及びその変形例１～３において、接着固定ではなく、その他の接合手段を用いて、フレキシブル基板１２に対して補強部材１４（１４Ａ～１４Ｃ）を固定しても構わない。当該接合手段としては、例えば、ネジやカバー部材９（９´）を例示することができる。
　上述した実施の形態及びその変形例１～３では、補強部材１４（１４Ａ～１４Ｃ）は、平板形状を有していたが、これに限らず、第１，第２の位置Ｐ１（Ｐ１Ａ），Ｐ２（Ｐ２Ｃ）にそれぞれ当接していれば、湾曲した形状を有するように構成しても構わない。 In the above-described embodiment and modifications 1 to 3 thereof, the entire surface of one plate of the reinforcing member 14 (14A to 14C) is bonded and fixed to the other surface 1212. However, the present invention is not limited to this. As a reinforcing member according to the present invention, as long as the reinforcing members are in contact with the first and second positions P1 (P1A) and P2 (P2C), respectively, one plate surface does not have to be bonded and fixed to the other surface 1212. Good.
In the above-described embodiment and modifications 1 to 3 thereof, the reinforcing member 14 (14A to 14C) may be fixed to the flexible substrate 12 by using other bonding means instead of adhesive fixing. As the said joining means, a screw and the cover member 9 (9 ') can be illustrated, for example.
In the above-described embodiment and modifications 1 to 3 thereof, the reinforcing member 14 (14A to 14C) has a flat plate shape. However, the present invention is not limited to this, and the first and second positions P1 (P1A), As long as it has contact | abutted to P2 (P2C), respectively, you may comprise so that it may have a curved shape.
　上述した実施の形態及びその変形例１～３では、把持部７として、第１，第２ジョー８，８´を開閉させていたが、これに限らず、例えば、第２ジョー８´（カバー部材９´及びエネルギ付与構造１０´を含む）を省略した構成を採用しても構わない。
　上述した実施の形態及びその変形例１～３では、エネルギ付与構造１０，１０´を第１，第２ジョー８，８´の双方にそれぞれ設けていたが、これに限らず、第１，第２ジョー８，８´の一方にのみ設けた構成を採用しても構わない。
　上述した実施の形態及びその変形例１～３では、処置具２は、生体組織に対して熱エネルギを付与する構成としていたが、これに限らず、熱エネルギの他、高周波エネルギや超音波エネルギをさらに付与する構成を採用しても構わない。 In the above-described embodiment and modifications 1 to 3 thereof, the first and second jaws 8 and 8 ′ are opened and closed as the gripping portion 7. However, the present invention is not limited to this, and for example, the second jaw 8 ′ (cover You may employ | adopt the structure which abbreviate | omitted member 9 'and energy provision structure 10').
In the above-described embodiment and modifications 1 to 3 thereof, the energy applying structures 10 and 10 'are provided on both the first and second jaws 8 and 8'. You may employ | adopt the structure provided only in one of 2 jaws 8 and 8 '.
In the above-described embodiment and modifications 1 to 3 thereof, the treatment instrument 2 is configured to apply thermal energy to a living tissue. However, the present invention is not limited to this, and in addition to thermal energy, high-frequency energy or ultrasonic energy is used. It is also possible to adopt a configuration that further provides
　１　処置システム
　２　処置具
　３　制御装置
　４　フットスイッチ
　５　ハンドル
　６　シャフト
　７　把持部
　８，８´　第１，第２ジョー
　９，９´　カバー部材
　１０，１０´，１０Ａ～１０Ｃ，１００　エネルギ付与構造
　１１，１１０　伝熱板
　１２，１２０　フレキシブル基板
　１３，１３０　接着部材
　１４，１４Ａ～１４Ｃ　補強部材
　５１　操作ノブ
　９１　凹部
　１１１　処置面
　１２１，１２１０　基板
　１２２，１２２０　配線パターン
　１２１１　一方の面
　１２１２　他方の面
　１２２１　接続部
　１２２２　抵抗パターン
　Ａｒ　補強領域
　Ａｒ１，Ａｒ２　第１，第２領域
　Ｃ　電気ケーブル
　Ｃ１　リード線
　ＣＯ　接点
　Ｆｕ１，Ｆｕ２　支点
　Ｌ１，Ｌ２，Ｌ２Ｃ　長さ
　Ｐ０　境界位置
　Ｐ１，Ｐ１Ａ　第１の位置
　Ｐ２，Ｐ２Ｃ　第２の位置
　Ｒ１　矢印 DESCRIPTION OF SYMBOLS 1 Treatment system 2 Treatment tool 3 Control apparatus 4 Foot switch 5 Handle 6 Shaft 7 Grip part 8,8 '1st, 2nd jaw 9,9' Cover member 10,10 ', 10A-10C, 100 Energy provision structure 11, 110 Heat transfer plate 12, 120 Flexible substrate 13, 130 Adhesive member 14, 14A-14C Reinforcing member 51 Operation knob 91 Recess 111 Treatment surface 121, 1210 Substrate 122, 1220 Wiring pattern 1211 One surface 1212 The other surface 1221 Connection portion 1222 Resistance pattern Ar Reinforcement area Ar1, Ar2 First and second area C Electric cable C1 Lead wire CO Contact point Fu1, Fu2 Support point L1, L2, L2C Length P0 Boundary position P1, P1A First position P2, P2C Second position R1 arrow

Claims (9)

  1. 　通電により発熱する抵抗パターンと、当該抵抗パターンに導通するとともにリード線が接続される接続部と、が形成されたヒータと、
    　前記抵抗パターンからの熱が伝達される伝熱板と、
    　前記ヒータと前記伝熱板との間に介装され、前記ヒータと前記伝熱板とを接着固定する接着部材と、
    　前記ヒータにおける前記接着部材が配置される面とは反対側の面に対向して配設される補強部材と、を備え、
    　前記接着部材は、前記ヒータと前記伝熱板とを接着する第１領域と、前記伝熱板から前記接続部側に張り出すとともに当該接続部の一部を覆う第２領域と、を有し、
    　前記補強部材は、前記反対側の面において、前記伝熱板の前記接続部側の端部を境界位置として、当該境界位置よりも前記接続部側に位置する第１の位置と、当該第１の位置との間で当該境界位置を挟む第２の位置とにそれぞれ当接するエネルギ付与構造。     A heater in which a resistance pattern that generates heat by energization, and a connection portion that conducts to the resistance pattern and is connected to a lead wire; and
    A heat transfer plate to which heat from the resistance pattern is transferred;
    An adhesive member interposed between the heater and the heat transfer plate, and bonding and fixing the heater and the heat transfer plate;
    A reinforcing member disposed opposite to a surface opposite to the surface on which the adhesive member is disposed in the heater,
    The adhesive member includes a first region that bonds the heater and the heat transfer plate, and a second region that protrudes from the heat transfer plate to the connection portion side and covers a part of the connection portion. ,
    The reinforcing member has, on the opposite surface, a first position located on the side of the connecting portion relative to the boundary position, with the end on the side of the connecting portion of the heat transfer plate as a boundary position, and the first An energy application structure that abuts against a second position that sandwiches the boundary position between the first position and the second position.
  2. 　前記補強部材は、前記反対側の面に対して、前記第１の位置と前記第２の位置とで接合されている
    　請求項１に記載のエネルギ付与構造。     The energy application structure according to claim 1, wherein the reinforcing member is joined to the opposite surface at the first position and the second position.
  3. 　前記補強部材は、前記反対側の面において、前記第１の位置、前記境界位置及び前記第２の位置を含む補強領域全体に当接する
    　請求項１または２に記載のエネルギ付与構造。     3. The energy application structure according to claim 1, wherein the reinforcing member is in contact with the entire reinforcing region including the first position, the boundary position, and the second position on the opposite surface.
  4. 　前記補強部材は、前記ヒータ及び前記接着部材全体の曲げ剛性よりも高い曲げ剛性を有する
    　請求項１～３のいずれか一つに記載のエネルギ付与構造。     The energy application structure according to any one of claims 1 to 3, wherein the reinforcing member has a bending rigidity higher than a bending rigidity of the heater and the whole adhesive member.
  5. 　前記補強部材は、前記反対側の面に対して接着固定されている
    　請求項１～４のいずれか一つに記載のエネルギ付与構造。     The energy application structure according to any one of claims 1 to 4, wherein the reinforcing member is bonded and fixed to the opposite surface.
  6. 　前記補強部材は、前記反対側の面において、前記接着部材の前記接続部側の端部から前記接続部側に張り出している
    　請求項１～５のいずれか一つに記載のエネルギ付与構造。     The energy application structure according to any one of claims 1 to 5, wherein the reinforcing member protrudes from an end portion of the adhesive member on the connection portion side to the connection portion side on the opposite surface.
  7. 　前記補強部材の端部は、前記反対側の面において、前記接続部と前記リード線との接点からずれた位置に位置する
    　請求項１～６のいずれか一つに記載のエネルギ付与構造。     The energy application structure according to any one of claims 1 to 6, wherein an end portion of the reinforcing member is located at a position shifted from a contact point between the connection portion and the lead wire on the opposite surface.
  8. 　前記境界位置から前記第１の位置までの長さは、前記境界位置から前記第２の位置までの長さよりも短い
    　請求項１～７のいずれか一つに記載のエネルギ付与構造。     The energy application structure according to any one of claims 1 to 7, wherein a length from the boundary position to the first position is shorter than a length from the boundary position to the second position.
  9. 　請求項１～８のいずれか一つに記載のエネルギ付与構造を備える処置具。 A treatment instrument comprising the energy application structure according to any one of claims 1 to 8.
PCT/JP2017/005958 2017-02-17 2017-02-17 Energy applying structure and treatment tool WO2018150548A1 (en)

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Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2016063376A1 (en) * 2014-10-22 2016-04-28 オリンパス株式会社 Medical treatment device
WO2016132548A1 (en) * 2015-02-20 2016-08-25 オリンパス株式会社 Therapeutic energy-applying structure and medical treatment apparatus

Patent Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2016063376A1 (en) * 2014-10-22 2016-04-28 オリンパス株式会社 Medical treatment device
WO2016132548A1 (en) * 2015-02-20 2016-08-25 オリンパス株式会社 Therapeutic energy-applying structure and medical treatment apparatus

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