WO2019123607A1 - Outil de traitement par énergie et procédé de fabrication d'outil de traitement par énergie - Google Patents

Outil de traitement par énergie et procédé de fabrication d'outil de traitement par énergie Download PDF

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Publication number
WO2019123607A1
WO2019123607A1 PCT/JP2017/045937 JP2017045937W WO2019123607A1 WO 2019123607 A1 WO2019123607 A1 WO 2019123607A1 JP 2017045937 W JP2017045937 W JP 2017045937W WO 2019123607 A1 WO2019123607 A1 WO 2019123607A1
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WO
WIPO (PCT)
Prior art keywords
coating layer
base material
treatment
organic layer
treatment tool
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PCT/JP2017/045937
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English (en)
Japanese (ja)
Inventor
庸高 銅
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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/JP2017/045937 priority Critical patent/WO2019123607A1/fr
Publication of WO2019123607A1 publication Critical patent/WO2019123607A1/fr

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • 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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor

Definitions

  • the present invention relates to an energy treatment tool that treats a treatment target using treatment energy, and a method of manufacturing the energy treatment tool.
  • US2016 / 0144204A1 discloses an energy treatment tool for treating a treatment target such as a living tissue using ultrasonic vibration.
  • This energy treatment tool includes a vibration transmission member (ultrasound probe) to which ultrasonic vibration generated by the ultrasonic transducer is transmitted.
  • the vibration transfer member forms a treatment surface of the end effector.
  • the treatment of the treatment target is performed by applying the ultrasonic vibration transmitted to the vibration transmission member to the treatment target from the treatment surface.
  • a coating layer is formed on the back surface of the end effector by a coating having heat insulation and electrical insulation.
  • a coating layer By providing the coating layer, heat invasion to the unintended biological tissue from the back surface is suppressed.
  • the adhesion strength of the coating layer to the end effector may affect the treatment performance and durability of the energy treatment device.
  • the present invention has been made in view of the above problems, and an object of the present invention is an energy treatment tool in which the adhesion strength to the end effector of the heat insulating coating having the heat insulating property and the electric insulating property is secured, An object of the present invention is to provide a method of manufacturing an energy treatment tool.
  • an energy treatment tool is formed of metal and provided on a surface of a base material provided with a treatment surface for treating an object to be treated;
  • a base material provided with a treatment surface for treating a treatment target is formed of metal, and a coupling structure of a coupling agent is bonded to the surface of the base material Forming an organic layer on the surface of the matrix and bonding a coating agent to the surface of the organic layer, thereby forming a coating layer having thermal insulation and electrical insulation on the surface of the matrix And forming the adhesion strength between the coating layer and the surface of the base material by raising the temperature of the base material.
  • FIG. 1A is a view schematically showing an energy treatment tool according to a first embodiment.
  • FIG. 1B is a schematic view of the first grip piece according to the first embodiment as viewed from the treatment surface side.
  • FIG. 2 is a view schematically showing the end effector according to the first embodiment in a cross section intersecting a longitudinal axis.
  • FIG. 3 is a view schematically showing how an organic layer is formed on the treatment surface according to the first embodiment.
  • FIG. 4 is a view schematically showing a state in which the organic layer and the coating layer are formed on the treatment surface according to the first embodiment.
  • FIG. 5 is a view showing a sticking state of the coating layer before the oscillation of the ultrasonic vibration in an example of the evaluation of the adhesion strength of the coating layer according to the comparative example of the first embodiment.
  • FIG. 6 is a view showing a sticking state of the coating layer when ultrasonic vibration is oscillated for 30 minutes in one example of evaluation of the adhesion strength of the coating layer according to the comparative example of the first embodiment.
  • FIG. 7 is a view showing a sticking state of the coating layer before the oscillation of the ultrasonic vibration in an example of the evaluation of the adhesion strength of the coating layer according to the first embodiment.
  • FIG. 6 is a view showing a sticking state of the coating layer when ultrasonic vibration is oscillated for 30 minutes in one example of evaluation of the adhesion strength of the coating layer according to the comparative example of the first embodiment.
  • FIG. 7 is a view showing a sticking state of the coating layer before the oscillation of the ultrasonic vibration in an example of the evaluation of the adhesion
  • FIG. 8 is a view showing a sticking state of the coating layer when ultrasonic vibration is oscillated for 120 minutes in an example of evaluation of adhesion strength of the coating layer according to the first embodiment.
  • FIG. 9 is a view schematically showing an end effector according to a second embodiment in a cross section intersecting a longitudinal axis.
  • FIG. 1A is a view showing a treatment tool 1 which is an energy treatment tool of the present embodiment.
  • the treatment instrument 1 includes a housing 4 and a cylindrical shaft 5 connected to the housing 4.
  • the housing 4 can be held.
  • One end of a cable 7 is connected to the housing 4.
  • the other end of the cable 7 is detachably connected to the power supply 3.
  • the shaft 5 defines a longitudinal axis L.
  • the direction along the longitudinal axis L is taken as the longitudinal direction.
  • One side in the longitudinal direction is the tip side (arrow L1 side in FIG. 1A), and the side opposite to the tip side is the proximal side (arrow L2 side in FIG. 1A).
  • the shaft 5 is extended from the proximal end side to the distal end side along the longitudinal axis L and is connected to the distal end side of the housing 4.
  • the end effector 6 is provided at the tip of the shaft 5.
  • the end effector 6 includes a first gripping piece 13 and a second gripping piece 14. Between the first grip piece 13 and the second grip piece 14 can be opened and closed.
  • the first gripping piece 13 is supported by the shaft 5, and the second gripping piece 14 is rotatably attached to the shaft 5 with respect to the first gripping piece 13.
  • the first grip piece 13 is provided with a treatment surface (facing surface) 17 that faces the second grip piece 14 and applies treatment energy to the treatment target.
  • the second gripping piece 14 is provided with a treatment surface (facing surface) 18 that faces the treatment surface 17 of the first gripping piece 13 and applies treatment energy to the treatment target.
  • the open / close direction of the end effector 6 intersects (is perpendicular or substantially perpendicular) to the longitudinal axis L.
  • the side in which the second gripping piece 14 opens with respect to the first gripping piece 13 is the opening direction (arrow Y1) of the second gripping piece 14, and the second gripping piece 14 is The side closed with respect to the first gripping piece 13 is taken as the closing direction (arrow Y2) of the second gripping piece 14.
  • a direction intersecting (perpendicularly or substantially perpendicular) to the longitudinal axis L and intersecting (perpendicular or nearly perpendicular) to the opening / closing direction of the end effector 6 is The width direction (arrows B1 and B2).
  • the first grip piece 13 includes a bending portion 25.
  • the bending portion 25 is provided at the tip of the first grip piece 13 and is curved to one side in the width direction of the end effector 6 with respect to the longitudinal axis L.
  • the housing 4 includes a housing body 10 and a grip (fixed handle) 11.
  • the housing body 10 extends along the longitudinal axis L.
  • the grip 11 is extended from the housing body 10 in a direction away from the longitudinal axis L.
  • the shaft 5 is connected to the housing body 10 from the tip side.
  • a movable handle 12 is rotatably attached to the housing body 10.
  • the movable handle 12 is located on the side where the grip 11 is located with respect to the longitudinal axis L, and is located on the distal side with respect to the grip 11 in the present embodiment.
  • the movable handle 12 rotates with respect to the housing body 10
  • the movable handle 12 opens or closes with respect to the grip 11.
  • an operation for opening or closing the end effector 6 as described above is input at the movable handle 12. That is, the movable handle 12 is an open / close operation input unit.
  • the movable handle 12 and the second grip piece 14 are connected via the movable member 16.
  • the movable member 16 is extended along the longitudinal axis L inside the shaft 5.
  • the movable member 16 moves along the longitudinal axis L with respect to the shaft 5 and the housing 4, and the second grip piece 14 rotates with respect to the shaft 5 Do.
  • the holding pieces 13 and 14 are opened or closed.
  • the treatment target is held between the holding pieces 13 and 14 by closing between the holding pieces 13 and 14.
  • the movable handle 12 is proximal to the grip 11. In another embodiment, the movable handle 12 is located on the opposite side of the longitudinal axis L to the side where the grip 11 is located, and intersects the longitudinal axis L in the opening operation and the closing operation. Vertically or nearly vertically).
  • the power supply device 3 includes a high frequency power supply and an ultrasonic power supply.
  • the high frequency power supply includes a waveform generator, a conversion circuit, a transformer, and the like, and converts power from a battery power supply or an outlet power supply to high frequency power.
  • each of the first grip piece 13 and the second grip piece 14 is at least partially formed of a conductive material.
  • the high frequency power source is electrically connected to the conductive material of each of the first gripping piece 13 and the second gripping piece 14 through an electrical path provided through the inside of the cable 7, the inside of the housing 4 and the inside of the shaft 5. Connected to The high frequency power supply outputs the converted high frequency power through the aforementioned electric path, and supplies the first holding piece 13 and the second holding piece 14 with high frequency power as electric energy.
  • the ultrasonic power source includes a waveform generator, a conversion circuit, a transformer, and the like, and converts power from a battery power source or an outlet power source to AC power. Further, inside the housing main body 10, an ultrasonic transducer 9 and a vibration transmitting member (ultrasonic probe) 8 connected to the ultrasonic transducer 9 from the tip side are provided.
  • the ultrasound power source is electrically connected to the ultrasound transducer 9 via an electrical path provided through the interior of the cable 7 and the interior of the housing 4.
  • the supply of electric energy (AC power) from the ultrasonic power supply generates ultrasonic vibration in the ultrasonic transducer 9.
  • the ultrasonic vibration generated by the ultrasonic transducer 9 is transmitted to the vibration transmitting member 8.
  • the vibration transmitting member 8 is extended from the inside of the housing body 10 to the tip side, passes through the inside of the shaft 5, and protrudes from the tip of the shaft 5 to the tip side. And the 1st holding piece 13 is formed of the protrusion part from the shaft 5 of the vibration transmission member 8 to the front end side.
  • the ultrasonic vibration generated by the ultrasonic transducer 9 is transmitted to the tip of the vibration transmitting member 8 forming the first gripping piece 13. Thereby, ultrasonic vibration is transmitted to the 1st holding piece 13 as treatment energy.
  • the vibration transfer member 8 is preferably made of a material having conductivity and high vibration transferability.
  • the vibration transfer member 8 is formed of a titanium alloy which is compatible with living tissue.
  • the vibration transfer member 8 may be formed of a metal material other than a titanium alloy such as duralmin or stainless steel.
  • the shape and material including the length and the diameter are appropriately set so that the vibration transfer member 8 vibrates at the resonance frequency of the ultrasonic transducer 9 and the frequency at the output of the ultrasonic power source.
  • the total length of the vibrator including the ultrasonic transducer 9 and the vibration transmitting member 8 is preferably, for example, a length that is an integral multiple of a half wavelength of the ultrasonic vibration to be transmitted.
  • the half wavelength of the ultrasonic vibration is determined by the resonance frequency of the vibrator including the ultrasonic transducer 9 and the vibration transmitting member 8.
  • the vibrator including the ultrasonic transducer 9 and the vibration transfer member 8 vibrates at any resonance frequency of, for example, 46 kHz to 48 kHz, and vibrates at any resonance frequency of 46.5 kHz to 47.5 kHz. It is preferable to do.
  • the tip end of the first gripping piece 13 becomes an antinode A1 of vibration. Further, inside the distal end portion of the shaft 5, the vibration transfer member 8 is supported by the shaft 5 at the position of the node of vibration.
  • the housing main body 10 is provided with an operation button 15.
  • the operation button 15 is an energy operation input unit. In the state where the treatment object is held between the holding pieces 13 and 14, by inputting an operation with the operation button 15, for example, electric energy is supplied to the treatment tool 1 from each of the high frequency power supply and the ultrasonic power supply. . Then, high frequency current and ultrasonic vibration are applied as treatment energy to the grasped treatment target.
  • a foot switch electrically connected to the power supply device 3 is provided separately from the treatment tool 1 instead of or in addition to the operation button 15.
  • the housing body 10 is provided with a plurality of operation buttons 15.
  • a high frequency current is given to the treatment target as treatment energy.
  • an operation with another one of the plurality of operation buttons 15, for example, high frequency current and ultrasonic vibration can be used as treatment energy in the treatment object Granted.
  • an operating member such as a rotation knob is attached to the housing body 10.
  • the shaft 5 and the end effector 6 together with the operating member rotate about the longitudinal axis L relative to the housing 4 .
  • FIG. 2 is a view showing the end effector 6 in a cross section (vertical or substantially vertical) intersecting the longitudinal axis L.
  • the first grip piece 13 has conductivity.
  • the first grip piece 13 is formed of, for example, metal.
  • the first gripping piece 13 is formed by a projecting portion of the vibration transmitting member 8 from the shaft 5 to the tip side, and is formed of a titanium alloy.
  • the first gripping piece 13 includes a treatment surface 17, a back surface 19 facing the treatment surface 17, and a pair of side surfaces 20 facing outward in the width direction of the end effector 6.
  • the vibration transfer member 8 is a base material having conductivity and forming the treatment surface 17. Further, in the present embodiment, the first grip piece 13 is formed of a base material.
  • the vibration transfer member 8 is connected to one end of an electrical path formed of an electrical wiring or the like inside the housing main body 10. This electrical path extends through the interior of the housing 4 and the interior of the cable 7, and the other end is connected to the high frequency power supply of the power supply 3.
  • the vibration transfer member 8 and the high frequency power source are electrically connected via this electrical path. Thereby, high frequency power can be supplied from the high frequency power source to the first gripping piece 13.
  • the first grip piece 13 functions as a first electrode by being supplied with high frequency power.
  • the second gripping piece (gripping member) 14 comprises a support (jaw) 21.
  • the support 21 is rotatably connected to the shaft 5.
  • the support 21 has conductivity.
  • the support (conductive member) 21 is made of, for example, metal or the like.
  • the support 21 forms part of the treatment surface 18.
  • the support 21 is connected to one end of an electrical path formed of an electrical wiring or the like. This electrical path extends through the interior of the shaft 5, the interior of the housing 4 and the interior of the cable 7, and the other end is connected to the high frequency power supply of the power supply 3.
  • the support 21 and the high frequency power source are electrically connected via this electrical path. Thereby, high frequency power can be supplied from the high frequency power source to the support 21.
  • the support 21 functions as a second electrode different from the first electrode by being supplied with high frequency power.
  • the second grip piece 14 includes a short circuit preventing member (pad member) 23.
  • the short circuit preventing member 23 is attached to the support 21 from the side of the gripping piece 13.
  • the short circuit preventing member 23 is disposed at the central portion of the gripping piece 14 in the width direction, and forms a central portion of the treatment surface 18.
  • the short circuit prevention member 23 has electrical insulation.
  • the short circuit prevention member 23 is formed of, for example, a resin material.
  • the short circuit preventing member 23 of the gripping piece 14 abuts on the treatment surface 17 of the gripping piece 13. In this state, a gap is formed between the support 21 and the treatment surface 17 of the gripping piece 13, and the treatment surface 17 of the gripping piece 13 does not contact the support 21. Therefore, in a state where the support 21 and the grip piece 13 function as electrodes, a short circuit in an electric circuit in which high frequency power is output from the power supply device 3 to the support 21 and the grip piece 13 is effectively prevented.
  • an organic layer 41 and a coating layer 51 are formed on the surface of the first grip piece 13.
  • the coating layer 51 is exposed to the outside on the surface of the first grip piece 13.
  • the first gripping piece 13 is covered by the coating layer 51 in a region (first region) where the coating layer 51 is provided.
  • the first grip piece 13 is exposed to the outside in a region (second region) in which the coating layer 51 is not provided.
  • the organic layer 41 is provided between the coating layer 51 and the surface of the first gripping piece 13.
  • the organic layer 41 is a monomolecular film formed on the surface of the first gripping piece 13 by a surface modifier.
  • the organic layer 41 adheres the first gripping piece 13 to the coating layer 51 by bonding with the surface of the first gripping piece 13 and each of the coating layer 51.
  • the coating layer 51 has electrical insulation and thermal insulation.
  • the coating agent forming the coating layer 51 is formed of an organic material such as a resin material.
  • the coating layer 51 is formed of PEEK (polyether ether ketone) resin which is highly biocompatible.
  • the coating layer 51 is preferably formed of a material containing PEEK resin.
  • the coating layer 51 does not have to be formed of only PEEK resin, and is preferably formed of a composite material containing PEEK resin.
  • the organic layer 41 and the coating layer 51 are formed on the surface of the first grip piece 13 in a region including the back surface 19 around an axis (peripheral surface) around the longitudinal axis L.
  • the organic layer 41 and the coating layer 51 pass through the back surface 19 from a part of the side surface 20 on one side about the axis (outer peripheral surface) centered on the longitudinal axis L in the outer peripheral surface of the first grip piece 13 It is provided continuously over the range to a part of the side of the other side.
  • the organic layer 41 and the coating layer 51 are provided over the entire first gripping piece 13 in the longitudinal direction. Therefore, the organic layer 41 and the coating layer 51 are formed in the first gripping piece 13 in a range including the bending portion 25 and the position of the antinode A1 of the vibration when the ultrasonic vibration is transmitted.
  • the organic layer 41 and the coating layer 51 will be described using FIGS. 3 to 4.
  • the surface of the first grip piece 13 is covered with hydroxyl group (hydroxyl group) OH by the metal group M reacting with oxygen and moisture in the air.
  • the metal group M is titanium.
  • the organic layer 41 is formed of a material containing a titanate coupling agent.
  • the titanate coupling agent of the present embodiment comprises a titanium atom Ti, one or more hydrolyzable groups OR, and an organic functional group Y.
  • the titanium atom Ti and the three hydrolyzable groups OR form a coupling structure of a titanate coupling agent.
  • Each of the hydrolysable groups OR is chemically bonded to the titanium atom Ti.
  • the hydrolyzable group OR is a reactive group which is chemically bonded to the inorganic material by hydrolysis or the like, and is, for example, an alkoxy group such as a methoxy group or an ethoxy group.
  • the organic functional group Y is chemically bonded to the titanium atom Ti.
  • the organic functional group Y is a functional group to be bonded to an organic material, and is, for example, a vinyl group, an epoxy group, an amino group, a methacryl group, a mercapto group or the like.
  • an amino group (amine-based reactive group) is used as the organic functional group Y.
  • OC2H4NHC2H4NH2 is used as the organic functional group Y, for example.
  • the coupling structure of the titanate coupling agent and the surface of the first grip piece 13 are coupled. Then, the coupling structure of the titanate coupling agent and the surface of the first grip piece 13 are combined to form the organic layer 41 on the surface of the first grip piece 13.
  • the bond between the coupling structure of the titanate coupling agent and the surface of the first gripping piece 13 is the hydrolyzable group OR of the titanate coupling agent and the hydroxyl group OH of the surface of the first gripping piece 13 Chemical bonds (hydrolysis), bonds by chemisorption, bonds by intermolecular force, bonds by other interactions, and the like. Further, in the organic layer 41, the hydrolyzable group OR of the coupling structure is chemically bonded to the hydrolyzable group OR of another coupling structure by hydrolysis.
  • a modified surface 42 is formed on the surface of the first grip piece 13 by the organic functional group Y of the titanate coupling agent.
  • the modified surface 42 is formed of an organic functional group Y such as an amino group.
  • the coating layer 51 formed of an organic material and an organic functional group Y (for example, an amino group) forming the modified surface 42 of the organic layer 41 are bonded.
  • the coating layer 51 formed of an organic material and the organic layer 41 are bonded to each other, whereby the coating layer 51 is formed on the surface of the first grip piece 13 via the organic layer 41.
  • the bonding between the coating layer 51 and the modified surface 42 of the organic layer 41 includes bonding by chemisorption, bonding by intermolecular force, bonding by other interaction, and the like.
  • the worker first makes the surface roughness by sand blast in the area on the surface of the first gripping piece 13 where the coating layer 51 is to be formed.
  • Surface treatment blasting treatment
  • the oxide film is removed, and the surface is formed in a concavo-convex shape.
  • the worker applies a titanate coupling agent to the area on the surface of the first grip piece 13 where the coating layer 51 is to be formed (see FIG. 3).
  • the titanate coupling agent is bonded to the surface of the first grip piece 13 to form the organic layer 41.
  • the modified surface 42 is formed on the surface of the first grip piece 13 by the organic layer 41.
  • the operator applies a liquid coating agent that forms the coating layer 51 on the modified surface 42 formed on the surface of the first grip piece 13.
  • the coupling structure of the silane coupling agent is bonded to the modified surface 42 of the organic layer 41 to form the coating layer 51 (see FIG. 4).
  • the organic layer 41 and the coating layer 51 include a part of the side surface 20 and the back surface 19 on the outer peripheral surface of the first gripping piece 13 centered on the extension axis of the first gripping piece 13 It is formed in the area (see FIG. 2).
  • the organic layer 41 and the coating layer 51 for example, by applying mask processing to portions other than the portions where the organic layer 41 and the coating layer 51 are desired to be formed, the organic layer is formed on the desired area 41 and the coating layer 51 are formed.
  • the end effector 6 When performing treatment using the treatment tool 1, first, the end effector 6 is inserted into a body cavity such as the abdominal cavity. Then, a treatment target such as a blood vessel is disposed between the pair of grasping pieces 13 and 14, and the end effector 6 is closed. Thereby, the treatment target is gripped between the gripping pieces 13 and 14. In the state where the treatment object is gripped between the gripping pieces 13 and 14, an operation input for supplying electric energy from the power supply device 3 to the treatment tool 1 is performed, whereby the high frequency current and the ultrasonic vibration are generated as described above. At least one of them is given as treatment energy to the grasped treatment object.
  • the first grip piece 13 and the vibration transfer member 8 are formed of a titanium alloy having good vibration transferability. For this reason, the vibration generated by the ultrasonic transducer is effectively transmitted to the treatment surface 17 via the vibration transfer member 8 and the first grip piece 13.
  • the coating layer 51 is provided in a region including the back surface 19 in the first grip piece 13. As described above, the coating layer 51 has thermal insulation and electrical insulation. For this reason, by providing the coating layer 51, the heat invasion from the part in which the coating layer 51 was provided in the surface of the 1st holding piece 13 is suppressed. This prevents the heat generated due to the treatment from affecting unintended body tissue.
  • an organic layer 41 is provided between the coating layer 51 and the surface of the first grip piece 13.
  • the organic layer 41 bonds the coating layer 51 to the surface of the first gripping piece 13 by bonding to each of the coating layer 51 and the surface of the first gripping piece 13.
  • the surface of the first grip piece 13 is the modified surface of the organic layer 41 with the organic functional group Y. 42 are formed.
  • organic materials such as PEEK resin are known to have better bonding to organic materials than to titanium. Therefore, a coating agent formed of an organic material such as PEEK resin is directly bonded to the surface of the first gripping piece 13 by forming the modified surface 42 with the organic layer 41 on the surface of the first gripping piece 13
  • the adhesion structure of the coating layer 51 to the surface of the first grip piece 13 is improved, and the adhesion strength (adhesive strength) of the coating layer 51 to the surface of the first grip piece 13 is improved.
  • the adhesion strength of the coating layer 51 to the surface of the first grip piece 13 is improved, the coating layer 51 is less likely to be peeled off, and the deterioration rate of the coating layer 51 due to friction and heat during treatment is reduced.
  • the adhesion strength of the coating layer 51 to the surface of the first grip piece 13 is improved, whereby the water tightness between the coating layer 51 and the surface of the first grip piece 13 is improved.
  • the interface between the coating layer 51 and the organic layer 41, and the organic layer 41 and the first gripping piece 13 The penetration of liquid from the interface with the surface is prevented. Thereby, peeling from the surface of the 1st holding piece 13 of the coating layer 51 is prevented, and the durability of the treatment tool 1 improves.
  • an amino group is used as the organic functional group Y possessed by the titanate coupling agent. Therefore, the durability of the coating layer 51 is improved as compared with the case where another functional group is used as the organic functional group Y.
  • the organic layer 41 is formed of a titanate coupling agent.
  • the first grip piece 13 is formed of a titanium alloy.
  • the titanate coupling agent has better bonding to titanium than a coating agent formed of an organic material such as PEEK resin. Therefore, by providing the organic layer 41 between the coating layer 51 and the surface of the first gripping piece 13, a coating agent formed of an organic material such as PEEK resin is directly applied to the surface of the first gripping piece 13.
  • the adhesion strength of the coating layer 51 formed of an organic material such as PEEK resin to the surface of the first grip piece 13 is improved as compared with the case of bonding.
  • the adhesion strength of the coating layer 51 to the surface of the grip piece 13 is likely to decrease due to the transmission of ultrasonic vibration or the like.
  • the organic layer 41 is provided in a region including the curved portion 25 of the first grip piece 13. For this reason, the water resistance and durability of the treatment instrument 1 can be effectively improved by providing the organic layer 41 for improving the adhesion strength of the coating layer 51 in the region where the adhesion strength tends to decrease. .
  • the organic layer 41 is provided on the surface of the gripping piece 13 in a region including the antinode position A1 of the vibration. For this reason, by providing the organic layer 41 for improving the adhesion strength of the coating layer 51 in the region where the adhesion strength is likely to be reduced, the vibration followability to the first grip piece 13 of the coating layer 51 is improved. The water resistance and durability of the treatment instrument 1 can be effectively improved.
  • the organic layer 41 and the coating layer 51 are in close contact with the surface of the first gripping piece 13 in a state along the uneven shape formed on the surface of the first gripping piece 13 by blast processing. Therefore, an anchor effect acts between the surface of the first grip piece 13 and the organic layer 41 and the coating layer 51. Due to this anchor effect, the adhesion strength of the organic layer 41 and the coating layer 51 to the surface of the first gripping piece 13 is increased.
  • the adhesion structure between the coating layer 51 and the surface of the first gripping piece 13 is improved, whereby the adhesion strength of the coating layer 51 to the surface of the first gripping piece 13 is improved.
  • the water tightness between the coating layer 51 and the surface of the first gripping piece 13 is improved.
  • the first gripping piece 13 is cooled using dry ice, carbon dioxide gas, liquid nitrogen or the like until the temperature of the first gripping piece 13 becomes 0 ° C. or less (eg, ⁇ 80 ° C.) Do.
  • the temperature of the first gripping piece 13 is rapidly raised by putting the cooled first gripping piece 13 into water such as hot water.
  • the temperature of the first gripping piece 13 is raised, for example, from 0 ° C. or less to 0 ° C. or more, and the first gripping piece 13 is continued until the temperature increase of the first gripping piece 13 reaches 100 ° C.
  • the space between the coating layer 51 and the surface of the first gripping piece 13 is obtained.
  • Water tightness is improved.
  • the coating layer 51 and the first gripping piece 13 even when the first gripping piece 13 is introduced into a liquid such as water, the coating layer 51 and the first gripping The entry of liquid to the surface of the piece 13 is suppressed. This makes it possible to perform the above-mentioned subzero processing on the first gripping piece 13 on which the coating layer 51 is provided. As a result, the adhesion strength between the surface of the first grip piece 13 and the coating layer 51 is further improved.
  • an operation input for transmitting ultrasonic vibration to the first grip piece 13 is performed by an operation input, and the treatment tool 1 is oscillated.
  • ultrasonic vibration of a predetermined resonance frequency and a predetermined vibration velocity was transmitted to the first grip piece 13.
  • the vibration velocity is calculated by the formula 2 ⁇ ⁇ ⁇ resonance frequency ⁇ amplitude (half amplitude).
  • the predetermined resonance frequency is 20 to 100 kHz.
  • the predetermined vibration velocity is 3 m / s to 15 m / s.
  • the resonant frequency is 47 kHz and the amplitude (half amplitude) is 80 ⁇ m.
  • the vibration velocity is 11.8 m / s.
  • the occurrence of blisters (air vesicles) in the portion where the coating layer 51 was provided was observed over time.
  • the liquid that has entered between the coating layer 51 and the surface of the gripping piece 13 volatilizes or evaporates, and the coating layer 51 swells with respect to the surface of the gripping piece 13, whereby the surfaces of the coating layer 51 and the gripping piece 13 And an air layer formed between them.
  • the occurrence of blisters between the coating layer 51 and the surface of the gripping piece 13 may reduce the adhesion strength of the coating layer 51 and affect the treatment performance using the treatment tool 1. For this reason, the water resistance and durability of the treatment tool 1 can be evaluated by observing the blister.
  • the coating layer 51 is directly applied to the surface of the first gripping piece 13, that is, the coating layer 51 is formed on the surface of the first gripping piece 13 without the organic layer 41 of this embodiment.
  • the state of FIG. 6 is obtained by oscillating the treatment tool 1 in water for 30 minutes.
  • blisters 60 were observed after the treatment instrument 1 oscillated in water for 30 minutes.
  • Second Embodiment A second embodiment of the present invention will be described with reference to FIG.
  • the second embodiment is a modification of the configuration of the first embodiment as follows.
  • the same parts as those of the first embodiment are denoted by the same reference numerals, and the description thereof is omitted.
  • the coating layer 51 is one of the side surfaces 20 on one side about the axis (peripheral surface) centered on the longitudinal axis L on the surface of the first gripping piece 13. It is provided continuously from the part through the back surface 19 to a part of the other side surface.
  • the organic layer 41 may not be provided over the entire region where the coating layer 51 is formed around the axis (peripheral surface) around the longitudinal axis L. As shown in FIG. 9, the organic layer 41 is provided on the surface of the first gripping piece 13 with at least a region (first surface) in which the coating layer 51 is provided around an axis (peripheral surface) centered on the longitudinal axis L. It may be provided at the boundary portion (interface) between the region) and the region (second region) where the coating layer 51 is not provided.
  • both ends of the coating layer 51 are located on each of the side surfaces 20 about an axis (peripheral surface) around the longitudinal axis L. Therefore, on the surface of the first gripping piece 13, the boundary between the area where the coating layer 51 is provided and the area where the coating layer 51 is not provided is located on each of the side surfaces 20.
  • the organic layer 41 is provided only at both ends of the region where the coating layer 51 is provided around each of the side surfaces 20 of the first gripping piece 13 about an axis (peripheral surface) around the longitudinal axis L. There is.
  • the coating layer 51 is bonded to the surface of the first gripping piece 13 via the organic layer 41 at the boundary between the region where the coating layer 51 is provided and the region where the coating layer 51 is not provided.
  • the adhesion strength of the coating layer 51 to the surface of the first gripping piece 13 is improved. This effectively prevents liquid or the like from invading between the coating layer 51 and the first gripping piece 13 from the interface between the coating layer 51 and the first gripping piece 13, and the coating layer 51 and the first gripping piece 13
  • the water tightness with the grip piece 13 is improved.
  • the durability of the treatment tool 1 is improved.
  • the adhesion strength of the coating layer 51 to the surface of the first gripping piece 13 can be achieved by performing the aforementioned subzero treatment or the like. It can be further improved.
  • the bipolar energy treatment tool (1) having the pair of gripping pieces (13, 14) and in which the electrodes are provided on each of the gripping pieces (13, 14) has been described.
  • the structure which concerns on embodiment of invention etc is applicable also to a monopolar energy treatment tool.
  • the energy treatment device includes a base material to which ultrasonic vibration is transmitted from the ultrasonic transducer, and the base material forms an end effector having a treatment surface and a back surface.
  • the above-mentioned organic layer (41) and a coating layer (51) are provided in the field which includes the back at least in the surface of a base material.
  • the energy treatment tool (1) is formed of metal and provided on a surface of the base material (8, 13) provided with a treatment surface (17) for treating the treatment target, and the surface of the base material (8, 13).
  • an organic layer (41) having thermal insulating properties and electrical insulating properties
  • the present invention is not limited to the above embodiment, and can be variously modified in the implementation stage without departing from the scope of the invention.
  • the embodiments may be implemented in combination as appropriate as possible, in which case the combined effect is obtained.
  • the above embodiments include inventions of various stages, and various inventions can be extracted by an appropriate combination of a plurality of disclosed configuration requirements.

Abstract

Cet outil de traitement d'énergie est pourvu : d'un matériau de base qui est formé à partir de métal et qui est pourvu d'une surface de traitement pour traiter un objet à traiter sur celle-ci; d'une couche de revêtement qui est disposée sur la surface du matériau de base et qui a des propriétés d'isolation thermique et des propriétés d'isolation électrique; et d'une couche organique qui est disposée entre la surface du matériau de base et la couche de revêtement, qui comprend un agent de couplage, et qui fait adhérer la couche de revêtement à la surface du matériau de base en liant l'agent de couplage à la surface du matériau de base et à la couche de revêtement.
PCT/JP2017/045937 2017-12-21 2017-12-21 Outil de traitement par énergie et procédé de fabrication d'outil de traitement par énergie WO2019123607A1 (fr)

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WO2022003810A1 (fr) * 2020-06-30 2022-01-06 オリンパス株式会社 Élément de transmission de vibration, instrument de traitement ultrasonore et procédé de production d'élément de transmission de vibration

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Publication number Priority date Publication date Assignee Title
US5380320A (en) * 1993-11-08 1995-01-10 Advanced Surgical Materials, Inc. Electrosurgical instrument having a parylene coating
JP2004520906A (ja) * 2000-12-29 2004-07-15 チーム メディカル エル．エル．シー． 改良された電気外科器具
US20060259032A1 (en) * 2005-05-12 2006-11-16 Bruce Nesbitt Electrosurgical electrode and method of manufacturing same
JP2010082144A (ja) * 2008-09-30 2010-04-15 Terumo Corp 医療用具およびその製造方法
US20120029514A1 (en) * 2009-04-10 2012-02-02 Fairbourn David C Silane coating for medical devices and associated methods
WO2017126051A1 (fr) * 2016-01-20 2017-07-27 オリンパス株式会社 Instrument chirurgical

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5380320A (en) * 1993-11-08 1995-01-10 Advanced Surgical Materials, Inc. Electrosurgical instrument having a parylene coating
JP2004520906A (ja) * 2000-12-29 2004-07-15 チーム メディカル エル．エル．シー． 改良された電気外科器具
US20060259032A1 (en) * 2005-05-12 2006-11-16 Bruce Nesbitt Electrosurgical electrode and method of manufacturing same
JP2010082144A (ja) * 2008-09-30 2010-04-15 Terumo Corp 医療用具およびその製造方法
US20120029514A1 (en) * 2009-04-10 2012-02-02 Fairbourn David C Silane coating for medical devices and associated methods
WO2017126051A1 (fr) * 2016-01-20 2017-07-27 オリンパス株式会社 Instrument chirurgical

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2022003810A1 (fr) * 2020-06-30 2022-01-06 オリンパス株式会社 Élément de transmission de vibration, instrument de traitement ultrasonore et procédé de production d'élément de transmission de vibration

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