WO2019186656A1

WO2019186656A1 - Treatment instrument

Info

Publication number: WO2019186656A1
Application number: PCT/JP2018/012197
Authority: WO
Inventors: 幸太郎中村
Original assignee: オリンパス株式会社
Priority date: 2018-03-26
Filing date: 2018-03-26
Publication date: 2019-10-03

Abstract

This treatment instrument 2 is provided with: a treatment section 11 that has a heater 15 that heats by electrification and a transmission plate 14 that transmits heat from the heater 15 to biotissue; a jaw 10 that faces the transmission plate 14 with the heater 15 interposed therebetween; and a plurality of first plate members 13 that are provided between the treatment section 11 and the jaw 10, and that have a thermal conductivity lower than that of the transmission plate 14. The plurality of first plate members 13 are stacked in a direction A1 that connects the treatment section 11 and the jaw 10.

Description

Treatment tool

The present invention relates to a treatment instrument.

2. Description of the Related Art Conventionally, there has been known a treatment tool that treats a target portion by applying energy to a portion to be treated in a living tissue (hereinafter referred to as a target portion) (for example, see Patent Document 1).
In the treatment tool described in Patent Literature 1, a target site is gripped by a pair of gripping members that can be opened and closed. In addition, one gripping member, in order from the side that grips the target site, a heat transfer plate that transmits heat to the target site while being in contact with the target site, and a treatment unit that includes a heater that generates heat, It has a laminated structure in which jaws facing the heat transfer plate are laminated with a heater interposed therebetween. And in the said treatment tool, a heat exchanger plate is heated by heat-generating a heater in the state which hold | gripped the object site | part with a pair of holding member. Thereby, the object site | part which contacted with respect to the heat exchanger plate is treated.

By the way, when the treatment of the living tissue is performed by applying energy, the temperature of the outer surface that makes the support surface supporting the treatment portion and the outer surface of the jaw rises. When the outer surface of the jaw is in a high temperature and the outer surface comes into contact with a part other than the target part in the living tissue, an unintended action is exerted on the living tissue.
Therefore, in the treatment tool described in Patent Document 1, a heat insulating portion made of a resin having low thermal conductivity is provided between the treatment portion and the jaw. That is, the structure which heat-insulates the heat | fever from a treatment part to a jaw with the heat insulation part is employ | adopted.

International Publication No. 2017/043120

However, even if it is a treatment tool given in patent documents 1 which provided a heat insulation part, for example, when there was continuous use for a long time, the effect beyond the material property value of the heat insulation part cannot be expected. . As a result, the temperature of the outer surface of the jaw may not be below the desired temperature. That is, there is a possibility that an unintended action may be exerted on the living tissue.

The present invention has been made in view of the above, and an object of the present invention is to provide a treatment tool that can effectively avoid an unintended action on a living tissue.

In order to solve the above-described problems and achieve the object, a treatment tool according to the present invention includes a treatment unit including a heater that generates heat by energization, and a heat transfer plate that transmits heat from the heater to a living tissue. A jaw opposed to the heat transfer plate with the heater interposed therebetween, and a plurality of first plate members provided between the treatment portion and the jaw and having a lower thermal conductivity than the heat transfer plate. The plurality of first plate members are stacked along a direction connecting the treatment portion and the jaws.

The treatment instrument according to the present invention can effectively avoid an unintended action on a living tissue.

FIG. 1 is a diagram showing a treatment system according to the first embodiment. FIG. 2 is a diagram illustrating the gripping portion. FIG. 3 is a diagram illustrating the first gripping member. FIG. 4 is a diagram illustrating the first gripping member. FIG. 5 is a diagram showing a first plate member according to the second embodiment. FIG. 6 is a diagram showing a first plate member according to the second embodiment. FIG. 7 is a diagram illustrating a first gripping member according to the third embodiment. FIG. 8 is a diagram illustrating a first gripping member according to the third embodiment. FIG. 9 is a diagram showing a modification of the third embodiment. FIG. 10 is a diagram illustrating a first gripping member according to the fourth embodiment. FIG. 11 is a diagram illustrating a first gripping member according to the fifth embodiment. FIG. 12 is a diagram illustrating a first gripping member according to the fifth embodiment. FIG. 13 is a diagram illustrating a first gripping member according to the fifth embodiment. FIG. 14 is a diagram showing a modification of the fifth embodiment.

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

(Embodiment 1)
[Schematic configuration of treatment system]
FIG. 1 is a diagram showing a treatment system 1 according to the first embodiment.
The treatment system 1 treats the target portion by applying thermal energy to a portion to be treated in the living tissue (hereinafter referred to as a target portion). Here, the said treatment means joining and incision of an object part, for example. As illustrated in FIG. 1, the treatment system 1 includes a treatment tool 2, a control device 3, and a foot switch 4.

[Configuration of treatment tool]
The treatment tool 2 is, for example, a linear-type surgical treatment tool for treating a target site 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.
The shaft 6 has a substantially cylindrical shape, and one end is connected to the handle 5 (FIG. 1). In addition, a grip portion 7 is attached to the other end of the shaft 6. An opening / closing mechanism (illustrated) is provided inside the shaft 6 for opening and closing the first and second gripping members 8 and 9 (FIG. 1) constituting the gripping portion 7 in accordance with the operation of the operation knob 51 by the operator. Abbreviation) is provided. In addition, an electric cable C (FIG. 1) connected to the control device 3 is disposed inside the shaft 6 from one end side to the other end side via the handle 5.

(Configuration of gripping part)
FIG. 2 is a diagram illustrating the gripping unit 7.
The gripping part 7 is a part that treats the target part while holding the target part. As shown in FIG. 1 or FIG. 2, the grip portion 7 includes first and

second grip members

8 and 9.
The first and second grasping

members

8 and 9 are configured to be openable and closable in the direction of the arrow R1 (FIG. 2) according to the operation of the operation knob 51 by the operator.

[Configuration of first gripping member]
3 and 4 are views showing the first gripping member 8. Specifically, FIG. 3 is an exploded perspective view of the first gripping member 8. FIG. 4 is a cross-sectional view of the first gripping member 8 cut along a plane perpendicular to the longitudinal direction from the distal end to the proximal end of the gripping portion 7.
The “tip side” described below is the tip side of the gripping part 7 and means the left side in FIGS. 1 to 3. Further, the “base end side” described below is the shaft 6 side of the gripping portion 7 and means the right side in FIGS. 1 to 3. Further, in the following, for convenience of explanation, the vertical direction in FIG. 4 is described as a stacking direction A1. The stacking direction A1 corresponds to the “direction connecting the treatment portion and the jaw” according to the present invention.

The first gripping member 8 is disposed at a position facing the second gripping member 9. As shown in FIG. 3 or FIG. 4, the first gripping member 8 includes a jaw 10, a treatment portion 11, a support member 12, and a plurality of first plate members 13.
The jaw 10 is a portion in which a part of the shaft 6 extends to the distal end side, and is formed in a long shape extending in the longitudinal direction from the distal end of the grip portion 7 toward the proximal end.
Here, the surface 101 of the jaw 10 on the second gripping member 9 side is a flat surface perpendicular to the stacking direction A1. The jaw 10 supports the treatment portion 11, the support member 12, and the plurality of first plate members 13 by the surface 101.
Examples of the material constituting the jaw 10 described above include metal materials such as stainless steel and titanium.

The treatment unit 11 generates thermal energy under the control of the control device 3. As shown in FIG. 3 or FIG. 4, the treatment section 11 includes a heat transfer plate 14 and a heater 15.
The heat transfer plate 14 extends in the longitudinal direction of the grip portion 7. Here, the longitudinal dimension of the heat transfer plate 14 is set to be smaller than the longitudinal dimension of the surface 101 of the jaw 10. Further, the width dimension (the length dimension in the left-right direction in FIG. 4) of the heat transfer plate 14 is set smaller than the width dimension of the surface 101.

In the heat transfer plate 14, the surface on the second gripping member 9 side is in contact with the target part in a state where the target part is gripped by the first and second

gripping members

8 and 9. That is, the said surface functions as the 1st holding surface 141 (FIG. 3, FIG. 4) which transmits the heat | fever from the heater 15 to the said object site | part. Note that “applying thermal energy to the target part” means that heat from the heater 15 is transmitted to the target part. In the first embodiment, as shown in FIG. 3 or FIG. 4, the first gripping surface 141 has a convex cross-sectional shape in which the central portion in the width direction (left-right direction in FIG. 4) protrudes upward. Have.
In addition, in the heat transfer plate 14, the center portion in the width direction of the surface that forms the front and back surfaces with the first gripping surface 141 is recessed upward, as shown in FIG. 4, in the longitudinal direction of the heat transfer plate 14. A storage recess 142 extending from the proximal end to the distal end side is provided.
Examples of the material constituting the heat transfer plate 14 described above include high thermal conductivity copper, silver, aluminum, molybdenum, tungsten, graphite, or a composite material thereof.

The heater 15 is a sheet heater that generates heat when energized, and has an outer shape substantially the same as the shape of the housing recess 142. The heater 15 is stored in the storage recess 142. And the surface of the downward side of FIG. 4 of the treatment part 11 turns into a flat surface orthogonal to the lamination direction A1.
Although not specifically shown, the heater 15 is formed by vapor-depositing an electric resistance pattern on a sheet-like substrate made of an insulating material such as polyimide.
The electrical resistance pattern is formed, for example, along a U shape that follows the outer edge shape of the heater 15, and a pair of lead wires (not shown) constituting the electrical cable C are joined to both ends, respectively. A voltage is applied from the control device 3 to the electrical resistance pattern via a pair of lead wires. Thereby, the electrical resistance pattern generates heat.

The support member 12 is a long flat plate extending in the longitudinal direction of the grasping portion 7 and is provided between the treatment portion 11 and the surface 101. Here, the support member 12 has substantially the same outer shape as the surface 101 when viewed along the stacking direction A1. That is, the length dimension in the longitudinal direction of the support member 12 is set larger than the length dimension in the longitudinal direction of the heat transfer plate 14. Further, the width dimension of the support member 12 is set larger than the width dimension of the heat transfer plate 14.
As shown in FIG. 3 or FIG. 4, in the support member 12, a notch 121 extending from the proximal end to the distal end side along the longitudinal direction of the support member 12 is formed at the center in the width direction. . Here, the length dimension in the longitudinal direction of the notch 121 is set larger than the length dimension in the longitudinal direction of the heater 15. Further, the width dimension of the notch 121 is set to be larger than the width dimension of the heater 15.

The support member 12 is fixed to the surface 101 in a state where the outer shape position substantially matches the outer shape position of the surface 101. Further, the treatment portion 11 is fixed to the upper surface of the support member 12 in FIG. 4 in a state where the center position in the width direction substantially matches the center position in the width direction of the support member 12. In this state, the heater 15 is located in the notch 121 when viewed from the direction along the stacking direction A1. Further, the heat transfer plate 14 protrudes outside the notch 121. And the heat exchanger plate 14 is fixed to the surface of the upper side in FIG. Thereby, the notch 121 is closed by the treatment part 11 and the surface 101 from both sides in the stacking direction A1. That is, the surface 101, the support member 12, and the treatment portion 11 form a first space Sp1 (FIG. 4) corresponding to the cutout portion 121. The first space Sp1 corresponds to a space according to the present invention.
Examples of the material constituting the support member 12 described above include a material having a lower thermal conductivity than the jaw 10 and the heat transfer plate 14, for example, a resin material such as PEEK (polyether ether ketone).

The plurality of first plate members 13 are each constituted by a long flat plate extending in the longitudinal direction of the grip portion 7 and have the same shape. And the some 1st board member 13 is laminated | stacked along the lamination direction A1, as shown in FIG. Here, the overall shape in a state where the plurality of first plate members 13 are stacked is set to be substantially the same as the shape of the notch 121. And the some 1st board member 13 is arrange | positioned in 1st space Sp1, in the state laminated | stacked along lamination direction A1. In this state, the plurality of first plate members 13 are positioned to cover the entire surface of the heater 15 when viewed along the stacking direction A1. In addition, the some 1st board member 13 is not mutually fixed with the adhesive agent, but was only piled up along lamination direction A1. Further, no adhesive is used in arranging the plurality of first plate members 13 in the first space Sp1.
As a material which comprises the 1st board member 13 demonstrated above, the material whose heat conductivity is lower than the jaw 10 and the heat exchanger plate 14, for example, resin, a ceramic, etc. can be illustrated.

[Configuration of Second Holding Member]
The second grip member 9 has a long shape extending in the longitudinal direction of the grip portion 7. The second gripping member 9 is pivotally supported at the base end side so as to be rotatable with respect to the shaft 6 about the fulcrum P0 (FIG. 2), and opens and closes with respect to the first gripping member 8. To do.
In the first embodiment, the first gripping member 8 (jaw 10) is fixed to the shaft 6 and the second gripping member 9 is pivotally supported by the shaft 6. However, the present invention is not limited to this. For example, a configuration may be adopted in which both the first and second

gripping members

8 and 9 are pivotally supported by the shaft 6 and the first and second

gripping members

8 and 9 are opened and closed by rotating. Absent. In addition, for example, the first gripping member 8 is pivotally supported by the shaft 6, the second gripping member 9 is fixed to the shaft 6, and the first gripping member 8 is rotated to rotate the second gripping member 9. Alternatively, a configuration that opens and closes may be adopted.

[Configuration of control device and foot switch]
The foot switch 4 is a part operated by a surgeon with a 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 (heater 15) 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.

[Action system action]
Next, operation | movement of the treatment system 1 mentioned above is demonstrated.
The surgeon holds the treatment tool 2 by hand, and inserts the distal end portion of the treatment tool 2 (a part of the gripping portion 7 and the shaft 6) through the abdominal wall using, for example, a trocar or the like and into the abdominal cavity. Then, the surgeon grips the target site by the grip portion 7 by operating the operation knob 51.
Next, the surgeon operates the foot switch 4 to switch on the energization from the control device 3 to the treatment instrument 2. When switched on, the control device 3 applies a voltage to the heater 15 via the electric cable C. Thereby, the heat exchanger plate 14 is heated. Moreover, the target site | part which is contacting the said heat exchanger plate 14 is treated by heating to target temperature.

According to the first embodiment described above, the following effects are obtained.
In the first gripping member 8 according to the first embodiment, a plurality of first plate members 13 having a thermal conductivity lower than that of the heat transfer plate 14 are provided between the treatment portion 11 and the jaw 10. ing. The plurality of first plate members 13 are stacked along the stacking direction A1.
Here, when the plurality of first plate members 13 are overlapped along the stacking direction A 1, a minute gap is generated between the first plate members 13. For this reason, the air which exists in the said gap | interval can be functioned as a heat insulation layer, and the heat which goes to the jaw 10 can be insulated from the treatment part 11 via the some 1st board member 13. FIG. Thus, by superimposing the several 1st board member 13 along lamination direction A1, the heat insulation effect higher than the physical-property value which the material which comprises the said 1st board member 13 has can be anticipated. .
Therefore, according to the 1st holding member 8 which concerns on this Embodiment 1, even if it is a case where there is continuous use for a long time, for example, the temperature of the outer surface which makes the surface 101 in front and back in the jaw 10 Can be kept below the desired temperature, and an unintended action on living tissue can be effectively avoided.

Moreover, in the 1st holding member 8 which concerns on this Embodiment 1, the some 1st board member 13 is provided in the position which covers the whole surface of the heater 15, when it sees along lamination direction A1. .
For this reason, the plurality of first plate members 13 can effectively insulate the heat from the heater 15 toward the jaw 10 via the plurality of first plate members 13, and the outer surface of the jaw 10 can be insulated. The temperature can be further reduced.

In the first gripping member 8 according to the first embodiment, the plurality of first plate members 13 are arranged in the first space Sp1 surrounded by the surface 101, the support member 12, and the treatment portion 11. Has been.
For this reason, the plurality of first plate members 13 can be overlapped along the stacking direction A1 without being fixed to each other by the adhesive. Further, it is not necessary to use an adhesive when arranging the plurality of first plate members 13 in the first space Sp1. That is, the above-described gap is not filled with the adhesive, and the above-mentioned effect of “effectively avoiding an unintended action on the living tissue” can be suitably realized. .

(Embodiment 2)
Next, the second embodiment will be described.
In the following description, the same reference numerals are given to the same components as those in the first embodiment described above, and detailed description thereof will be omitted or simplified.
5 and 6 are views showing the first plate member 13A according to the second embodiment. Specifically, FIG. 5 is a view of a part of the first plate member 13A viewed along the stacking direction A1. FIG. 5 is a cross-sectional view of the first plate member 13A.
In the first gripping member 8A according to the second embodiment, as shown in FIG. 5 or FIG. 6, the first plate member 13 is different from the first gripping member 8 described in the first embodiment. Instead, the first plate member 13 A provided with a through-hole 131 that penetrates the front and back surfaces of the first plate member 13 is different.
Specifically, a plurality of through holes 131 are provided in all the first plate members 13A. Further, the through holes 131 formed in the first plate members 13A adjacent to each other along the stacking direction A1 do not overlap each other as shown in FIGS. That is, the through hole 131 is closed by another first plate member 13A adjacent to the first plate member 13A having the through hole 131.

According to the second embodiment described above, the following effects are obtained in addition to the same effects as those of the first embodiment.
In the first gripping member 8A according to the second embodiment, the first plate member 13A is provided with a through hole 131. For this reason, in addition to the air present in the gaps between the first plate members 13A, the air present in the through holes 131 functions as a heat insulating layer, and the treatment section 11 passes through the plurality of first plate members 13A. By doing so, the heat toward the jaw 10 can be effectively insulated.
In particular, the through hole 131 is closed by another first plate member 13A adjacent to the first plate member 13A having the through hole 131. For this reason, for example, in a state where a plurality of first plate members 13A are stacked in the stacking direction A1, compared to a configuration in which the through holes 131 formed in all the first plate members 13A overlap each other, The effect of.
That is, the contact area between the first plate members 13A can be reduced while ensuring the strength of the plurality of first plate members 13A stacked along the stacking direction A1, and the heat insulation effect can be enhanced.

(Embodiment 3)
Next, the third embodiment will be described.
In the following description, the same reference numerals are given to the same components as those in the first embodiment described above, and detailed description thereof will be omitted or simplified.
7 and 8 are views showing the first gripping member 8B according to the third embodiment. Specifically, FIG. 7 corresponds to FIG. FIG. 8 corresponds to FIG.
In the first gripping member 8B according to the third embodiment, as shown in FIG. 7 or FIG. 8, the first plate member 13 is different from the first gripping member 8 described in the first embodiment. Instead of the first plate member 13, a first plate member 13B having a different shape from that of the first plate member 13 is employed, and a plurality of second plate members 16 are added.

The second plate member 16 is made of the same material as the first plate member 13 described in the first embodiment and has the same outer shape. In the third embodiment, as shown in FIG. 8, a plurality of second plate members 16 are provided and stacked along the stacking direction A1. Further, the overall shape in a state in which the plurality of second plate members 16 are stacked is substantially the same as the overall shape in the state in which the plurality of first plate members 13 described in the first embodiment is stacked. And the several 2nd board member 16 is arrange | positioned in 1st space Sp1 in the state laminated | stacked along lamination direction A1. In addition, the several 2nd board member 16 is not mutually fixed with the adhesive agent, but was only piled up along lamination direction A1. Further, no adhesive is used in arranging the plurality of second plate members 16 in the first space Sp1.

In the second plate member 16, as shown in FIG. 7 or FIG. 8, the widthwise center portion penetrates the front and back, and extends from the proximal side to the distal side along the longitudinal direction of the second plate member 16. A storage hole 161 extending to the top is formed. Here, the storage hole 161 has substantially the same planar shape as the heater 15 when viewed along the stacking direction A1. In a state where the plurality of second plate members 16 are stacked in the stacking direction A1, the storage holes 161 formed in all the second plate members 16 overlap each other. The storage holes 161 communicate with each other to form a second space Sp2 (FIG. 8). Moreover, the heater 15 is located in the position which overlaps with 2nd space Sp2, when it sees from the direction in alignment with the lamination direction A1.

The planar shape of the first plate member 13B is smaller than that of the first plate member 13 described in the first embodiment. Specifically, the first plate member 13B has substantially the same planar shape as the second space Sp2 when viewed along the stacking direction A1. The overall shape of the plurality of first plate members 13B stacked is set to be substantially the same as the shape of the second space Sp2. The plurality of first plate members 13B are arranged in the second space Sp2 in a state of being stacked along the stacking direction A1, as shown in FIG. That is, the second plate member 16 is provided at a position surrounding the plurality of first plate members 13B when viewed along the stacking direction A1. Note that the plurality of first plate members 13B are not fixed to each other by the adhesive as in the case of the plurality of first plate members 13 described in the first embodiment, and are along the stacking direction A1. It was just overlaid. Further, no adhesive is used in arranging the plurality of first plate members 13B in the second space Sp2.

With the above configuration, the plurality of first plate members 13B can cover the entire surface of the heater 15 when viewed along the stacking direction A1, similarly to the first plate member 13 described in the first embodiment. Located in the covering position. In addition, the heat exchanger plate 14 is provided in the position which protrudes outside the notch part 121 similarly to Embodiment 1 mentioned above. That is, the heat transfer plate 14 is provided at a position overlapping the plurality of second plate members 16 when viewed along the stacking direction A1.

According to the third embodiment described above, the following effects are obtained in addition to the same effects as those of the first embodiment.
The first gripping member 8B according to the third embodiment further includes a second plate member 16 provided between the treatment portion 11 and the jaw 10 and having a lower thermal conductivity than the heat transfer plate 14. The second plate member 16 is provided at a position that surrounds the plurality of first plate members 13B when viewed along the stacking direction A1.
Here, a gap is generated between the first and

second plate members

13B and 16. For this reason, the air which exists in the said clearance gap can be functioned as a heat insulation layer, and the heat which goes to the support member 12 along the width direction from the 1st board member 13B can be thermally insulated. That is, the heat toward the jaw 10 can be insulated from the first plate member 13 B via the support member 12. Therefore, the temperature of the outer surface of the jaw 10 can be further reduced.

Further, in the first gripping member 8B according to the third embodiment, the heat transfer plate 14 is provided at a position overlapping the second plate member 16 when viewed along the stacking direction A1. . And the 2nd board member 16 is provided with two or more, and is laminated | stacked along lamination direction A1.
Here, when the plurality of second plate members 16 are overlapped along the stacking direction A 1, a minute gap is generated between the second plate members 16. For this reason, the air which exists in the said clearance gap functions as a heat insulation layer, and the heat which goes to the jaw 10 can be insulated from the heat-transfer board 14 via the several 2nd board member 16. FIG. Therefore, the temperature of the outer surface of the jaw 10 can be further reduced.

(Modification of Embodiment 3)
FIG. 9 is a diagram showing a modification of the third embodiment. Specifically, FIG. 9 corresponds to FIG.
In the third embodiment described above, instead of the plurality of second plate members 16 as in the first gripping member 8C according to the present modification shown in FIG. The single second plate member 16C may be used.

(Embodiment 4)
Next, the fourth embodiment will be described.
In the following description, the same reference numerals are given to the same components as those in the first embodiment described above, and detailed description thereof will be omitted or simplified.
FIG. 10 is a diagram illustrating the first gripping member 8D according to the fourth embodiment. Specifically, FIG. 10 is a cross-sectional view of the first gripping member 8D cut by a plane orthogonal to the width direction.
In the first gripping member 8D according to the fourth embodiment, as shown in FIG. 10, a heat absorbing member 17 is added to the first gripping member 8 described in the first embodiment.

The heat absorbing member 17 is made of a highly heat conductive metal material such as copper. As shown in FIG. 10, the heat absorbing member 17 includes a plurality of fins 171 and a heat sink 172.
In the fourth embodiment, three fins 171 are provided. These three fins 171 are each constituted by a long flat plate having a length in the longitudinal direction smaller than that of the first plate member 13 described in the first embodiment, and have the same shape. The three fins 171 are arranged side by side along the stacking direction A1 with a gap therebetween. Here, of the three fins 171, the fin 171 positioned closest to the jaw 10 side comes into contact with the surface 101 of the jaw 10. The other two fins 171 are disposed between the plurality of first plate members 13. The two first plate members 13 disposed between the three fins 171 are smaller in length in the longitudinal direction than the other first plate members 13, and the three fins 171 and The length is set to be substantially the same in the longitudinal direction.

The heat sink 172 is integrally provided at the proximal end of the three fins 171 and is fixed to the surface 101.
The heat transmitted from the treatment unit 11 to the plurality of first plate members 13 and the heat transmitted from the treatment unit 11 to the jaws 10 via the plurality of first plate members 13 and the support member 12 are as follows. Heat is absorbed by the three fins 171. The heat absorbed by the three fins 171 is radiated from the shaft 6 to the outside through the heat sink 172.

According to the fourth embodiment described above, the following effects are obtained in addition to the same effects as those of the first embodiment.
The first gripping member 8D according to the fourth embodiment further includes a heat absorbing member 17 having fins 171 and a heat sink 172.
Therefore, heat transmitted from the treatment section 11 to the plurality of first plate members 13 and heat transmitted from the treatment section 11 to the jaws 10 via the plurality of first plate members 13 and the support member 12. Can be dissipated and the shaft 6 can dissipate heat. Therefore, the temperature of the outer surface of the jaw 10 can be further reduced.

(Embodiment 5)
Next, the fifth embodiment will be described.
In the following description, the same components as those in the first and third embodiments described above are denoted by the same reference numerals, and detailed description thereof is omitted or simplified.
11 to 13 are views showing the first gripping member 8E according to the fifth embodiment. Specifically, FIG. 11 is a diagram corresponding to FIGS. 3 and 7. FIG. 12 is a cross-sectional view of the first gripping member 8E cut by a plane passing through the position P1 (FIG. 11) where the support member 12E is disposed and orthogonal to the longitudinal direction. FIG. 13 is a cross-sectional view of the first gripping member 8E cut by a plane that passes through the position P2 (FIG. 11) avoiding the support member 12E and is orthogonal to the longitudinal direction.
In the first gripping member 8E according to the fifth embodiment, as shown in FIGS. 11 to 13, the second plate member 16 is different from the first gripping member 8B described in the third embodiment described above. Instead of the support member 12, the second plate member 16E and the support member 12E having different shapes from the second plate member 16 and the support member 12 are employed.

The second plate member 16E has a larger outer shape than the second plate member 16 described in the third embodiment. Specifically, the outer shape of the second plate member 16 E has substantially the same planar shape as the surface 101 when viewed along the stacking direction A 1. That is, the length dimension in the longitudinal direction of the second plate member 16 E is set larger than the length dimension in the longitudinal direction of the heat transfer plate 14. Further, the width dimension of the second plate member 16 E is set larger than the width dimension of the heat transfer plate 14.
Here, in the second plate member 16E, the outer edge portion is provided with a notch portion 162 that is notched inward. In addition, two sets of notches 162 are provided, with two as one set. Of the four notches 162, one set of

notches

162a and 162b are arranged in parallel on both sides in the width direction of the second plate member 16E. The other set of notches 162c and 162d are positioned on the base end side with respect to the set of

notches

162a and 162b, and are arranged in parallel on both sides in the width direction of the second plate member 16E. The four cutouts 162a to 162d have the same planar shape. When the plurality of second plate members 16E are stacked in the stacking direction A1, the notches 162 (162a to 162d) formed in all the second plate members 16E overlap each other. The respective notches 162 (162a to 162d) communicate with each other to form four third spaces Sp3a to Sp3d (FIGS. 11 and 12).

Four support members 12E are provided. The four support members 12E have substantially the same shape as the third spaces Sp3a to Sp3d, and are arranged in the third spaces Sp3a to Sp3d, respectively. The support member 12E is fixed to the surface 101 of the jaw 10. The heat transfer plate 14 is fixed to the upper surface of the support member 12E in FIG. That is, the surface 101, the support member 12, and the treatment portion 11 form a fourth space Sp4 (FIG. 12). The plurality of first plate members 13 and the plurality of second plate members 16E are arranged in the fourth space Sp4. The fourth space Sp4 corresponds to the space according to the present invention. Note that the plurality of second plate members 16E are not fixed to each other by the adhesive, and are along the stacking direction A1, similarly to the plurality of second plate members 16 described in the third embodiment. It was just overlaid. Further, no adhesive is used in arranging the plurality of second plate members 16E in the fourth space Sp4.

According to the fifth embodiment described above, the following effects are obtained in addition to the same effects as those of the first and third embodiments.
In the first gripping member 8E according to the fifth embodiment, the support member 12E is disposed on both sides of the plurality of first and

second plate members

13 and 16E. That is, the volume of the support member 12E is made smaller than that of the support member 12 described in the first and third embodiments, and the planar shape of the second plate member 16E is made larger.
For this reason, the heat which goes to the jaw 10 can be reduced by passing through the support member 12E from the treatment part 11. FIG. Therefore, the temperature of the outer surface of the jaw 10 can be further reduced.

(Modification of Embodiment 5)
FIG. 14 is a diagram showing a modification of the fifth embodiment. Specifically, FIG. 14 is a diagram corresponding to FIG.
In the fifth embodiment described above, the first and second plates instead of the first and

second plate members

13 and 16E as in the first gripping member 8F according to the present modification shown in FIG. You may employ | adopt the 1st board member 13F which used the

members

13 and 16E as one board member.

(Other embodiments)
The embodiments for carrying out the present invention have been described so far. However, the present invention should not be limited only by the above-described first to fifth embodiments and modifications thereof.
In the first to fifth embodiments and the modifications described above, only the first gripping member 8 (8A to 8F) is provided with the treatment portion according to the present invention, the plurality of first and second plate members, and the support member. However, it is not limited to this. Both the first and second gripping members 8 (8A to 8F) and 9 may be provided with the treatment section according to the present invention, a plurality of first and second plate members, and a support member.
In the first to fifth embodiments and the modifications thereof described above, the first gripping surface 141 is formed in a convex shape. However, the first holding surface 141 is not limited to this, and may be formed in a plane, or may have a concave shape or the like. You may comprise in another shape. The same applies to the second gripping member 9 side.
In the above-described Embodiments 1 to 5 and the modifications thereof, the configuration in which the thermal energy is applied to the target part is adopted. You may employ | adopt the structure to do. Note that “applying high-frequency energy to the target part” means flowing a high-frequency current to the target part. Further, “applying ultrasonic energy to the target part” means applying ultrasonic vibration to the target part.

In the first to fifth embodiments and the modifications thereof described above, the plurality of first plate members 13 (13A, 13B, 13F) may be made of the same material or may be made of different materials. I do not care. The same applies to the plurality of second plate members 16 (16C, 16E). Moreover, you may employ | adopt the structure which surface-treated to the some 1st, 2nd board member 13 (13A, 13B, 13F), 16 (16C, 16E), and made the surface accuracy worse. When comprised in this way, a clearance gap can be produced | generated effectively between adjacent members, and the air layer which exists in the said clearance gap can be functioned as a heat insulation layer.

In the second embodiment described above, the through holes 131 do not need to be provided in all the first plate members 13A, but are provided in at least one of the first plate members 13A among all the first plate members 13A. Just do it. Further, the through hole 131 may be provided in the second plate member 16 (16C, 16E). Furthermore, the size and shape of the through hole 131 are not particularly limited.

DESCRIPTION OF SYMBOLS 1 Treatment system 2 Treatment tool 3 Control apparatus 4 Foot switch 5 Handle 6 Shaft 7

Gripping part

8, 8A-8F 1st holding member 9 2nd holding member 10 Jaw 11

Treatment part

12,

12E Support member

13, 13A, 13B , 13F First plate member 14 Heat transfer plate 15

Heater

16, 16C, 16E Second plate member 17 Heat absorption member 51 Operation knob 101 Surface 121 Notch portion 131 Through hole 141 First grip surface 142 Storage recess 161

Storage hole

162, 162a to 162d Notch 171 Fin 172 Heat sink A1 Stack direction C Electric cable P0 Support point P1, P2 Position R1 Arrow Sp1 First space Sp2 Second space Sp3a to Sp3d Third space Sp4 Fourth space

Claims

A treatment section having a heater that generates heat by energization, and a heat transfer plate that transfers heat from the heater to the living tissue;
A jaw facing the heat transfer plate across the heater;
A plurality of first plate members provided between the treatment portion and the jaws and having a lower thermal conductivity than the heat transfer plate;
The plurality of first plate members are:
A treatment tool stacked along a direction connecting the treatment portion and the jaw.
The plurality of first plate members are:
The treatment tool according to claim 1, wherein the treatment tool is provided at a position covering the entire surface of the heater when viewed along a direction connecting the treatment portion and the jaw.
A second plate member provided between the treatment portion and the jaw and having a lower thermal conductivity than the heat transfer plate;
The second plate member is
The treatment tool according to claim 2, wherein the treatment tool is provided at a position surrounding the plurality of first plate members when viewed along a direction connecting the treatment portion and the jaw.
The heat transfer plate is
When viewed along the direction connecting the treatment portion and the jaw, provided at a position overlapping the second plate member,
The second plate member is
The treatment tool according to claim 3, wherein a plurality of treatment tools are provided and stacked in a direction connecting the treatment portion and the jaw.
The first plate member of at least one of the plurality of first plate members is
It has a through hole that penetrates the front and back,
The through hole is
The treatment tool according to claim 1, wherein the treatment tool is blocked by another first plate member adjacent to the first plate member having the through hole.
A heat absorbing member provided between the treatment portion and the jaw and having a higher thermal conductivity than the first plate member;
The endothermic member is
Fins provided between the plurality of first plate members;
The treatment tool according to claim 1, further comprising a heat sink connected to the fin.
The heat transfer plate has a lower thermal conductivity than the heat transfer plate, and further includes a support member that connects the heat transfer plate and the jaw to each other,
The plurality of first plate members are:
The treatment tool according to claim 1, wherein the treatment tool is disposed in a space surrounded by the heat transfer plate, the jaw, and the support member.
The support member is
The treatment tool according to claim 7, which is disposed on both sides of the plurality of first plate members in a cross section perpendicular to the longitudinal direction of the jaws.