WO2020183681A1 - Dispositif de chauffage médical et instrument de traitement - Google Patents

Dispositif de chauffage médical et instrument de traitement Download PDF

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Publication number
WO2020183681A1
WO2020183681A1 PCT/JP2019/010403 JP2019010403W WO2020183681A1 WO 2020183681 A1 WO2020183681 A1 WO 2020183681A1 JP 2019010403 W JP2019010403 W JP 2019010403W WO 2020183681 A1 WO2020183681 A1 WO 2020183681A1
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WIPO (PCT)
Prior art keywords
substrate
heat generating
medical heater
generating portion
medical
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PCT/JP2019/010403
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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/JP2019/010403 priority Critical patent/WO2020183681A1/fr
Publication of WO2020183681A1 publication Critical patent/WO2020183681A1/fr

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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
    • A61B18/12—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

Definitions

  • the present invention relates to a medical heater and a treatment tool.
  • Patent Document 1 a treatment tool for treating a target site in a living tissue by applying energy to a target site (hereinafter referred to as a target site) has been known (see, for example, Patent Document 1).
  • the treatment tool described in Patent Document 1 includes a pair of gripping members that grip the target portion.
  • the gripping member is provided with a medical heater that generates heat when energized, and a blade that comes into contact with the target portion when the target portion is gripped by a pair of gripping members. Then, in the treatment tool, the heat of the medical heater is transferred to the target portion gripped by the pair of gripping members via the blade. As a result, the target site is treated.
  • the medical heater described in Patent Document 1 includes a substrate and a conductive portion provided on the substrate by vapor deposition.
  • the conductive portion includes first and second connecting portions to which the wiring members are electrically connected, and a heat generating portion that generates heat when energized.
  • the first and second connecting portions are arranged side by side in the width direction of the substrate on the base end side of the substrate.
  • the heat generating portion has a substantially U-shape extending from the proximal end side toward the distal end side, folded back on the distal end side, and extending toward the proximal end side on the substrate. Then, both ends of the heat generating portion are connected to the first and second connecting portions, respectively.
  • the present invention has been made in view of the above, and an object of the present invention is to provide a medical heater and a treatment tool capable of ensuring the durability of a conductive portion.
  • the medical heater according to the present invention has a substrate made of a material having electrical insulation and a heat generating portion that generates heat when energized, and at least the heat generating portion. Is provided with a conductive portion provided on the substrate, and at least a part of the conductive portion is composed of a metal sheet in which a plurality of metal fibers are entangled with each other.
  • the treatment tool according to the present invention includes a treatment surface for treating a living tissue, a blade having a mounting surface having a front-back relationship with the treatment surface, and a medical heater for heating the blade.
  • the medical heater includes a substrate made of a material having electrical insulation, a heat generating portion that generates heat when energized, and at least a conductive portion in which the heat generating portion is provided on the substrate. At least a part of the above is composed of a metal sheet in which a plurality of metal fibers are entwined with each other.
  • the durability of the conductive portion can be ensured.
  • FIG. 1 is a diagram showing a treatment system according to the first embodiment.
  • FIG. 2 is a diagram showing a grip portion.
  • FIG. 3 is a diagram showing a first gripping member.
  • FIG. 4 is a diagram showing a first gripping member.
  • FIG. 5 is a diagram showing a medical heater.
  • FIG. 6 is a diagram showing a medical heater.
  • FIG. 7 is an enlarged view of the metal sheet.
  • FIG. 8 is a diagram showing a medical heater according to the second embodiment.
  • FIG. 9 is a diagram showing a medical heater according to the third embodiment.
  • FIG. 10 is a diagram showing a medical heater according to the fourth embodiment.
  • FIG. 11 is a diagram showing a medical heater according to the fourth embodiment.
  • FIG. 1 is a diagram showing a treatment system 1 according to the first embodiment.
  • the treatment system 1 treats a target site in a living tissue by applying energy to a target site (hereinafter referred to as a target site).
  • the treatment means, for example, coagulation and incision of a target site.
  • the treatment system 1 includes a treatment tool 2 and a control device 3.
  • the treatment tool 2 is, for example, a surgical treatment tool for treating a target site while passing 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 held by the operator.
  • the handle 5 is provided with an operation knob 51 and a switch 52.
  • the operation knob 51 accepts an opening / closing operation by the operator.
  • the switch 52 receives an output start operation by the operator. Then, the switch 52 outputs an operation signal corresponding to the output start operation to the control device 3 via the electric cable C (FIG. 1).
  • the shaft 6 has a substantially cylindrical shape.
  • the central axis of the shaft 6 will be referred to as the central axis Ax (FIG. 1).
  • one side along the central axis Ax will be referred to as the distal end side Ar1 (FIG. 1), and the other side will be referred to as the proximal end side Ar2 (FIG. 1).
  • the end of the base end side Ar2 of the shaft 6 is connected to the handle 5.
  • a grip portion 7 is attached to the end portion of the tip end side Ar1 of the shaft 6. Then, inside the shaft 6, an opening / closing mechanism for opening / closing the first and second gripping members 8 and 9 (FIG.
  • FIG. 2 is a diagram showing a grip portion 7.
  • the grip portion 7 is a portion that treats the target portion while gripping the target portion.
  • the grip portion 7 includes first and second grip members 8 and 9.
  • the first and second gripping members 8 and 9 are configured to be openable and closable in the direction of arrow R1 (FIG. 2) in response to an opening and closing operation of the operation knob 51 by the operator.
  • FIGS. 3 and 4 are views showing the first gripping member 8.
  • FIG. 3 is a cross-sectional view of the first gripping member 8 cut by a plane including the central axis Ax.
  • FIG. 4 is a cross-sectional view of the first gripping member 8 cut along a plane orthogonal to the central axis Ax.
  • the first gripping member 8 is arranged at a position facing the second gripping member 9.
  • the first gripping member 8 includes a first jaw 10, a first support member 11, a blade 12, and a medical heater 13 (FIGS. 3 and 4). , Block 14 (FIGS. 3 and 4).
  • the first jaw 10 is a portion in which a part of the shaft 6 extends to the tip end side Ar1, and is formed in a long shape extending along the central axis Ax.
  • the first jaw 10 is made of a metal material such as a stainless alloy or a titanium alloy.
  • the first support member 11 has an elongated shape extending along the central axis Ax, and is fixed to the upper surface in FIGS. 3 and 4 of the first jaw 10.
  • a recess 111 extending from the base end of the first support member 11 toward the tip end side Ar1 is formed on the upper surface in FIGS. 3 and 4. .
  • the first support member 11 supports the blade 12, the medical heater 13, and the block 14 in the recess 111.
  • a resin material having electrical insulation such as PEEK (polyetheretherketone) and having a low thermal conductivity can be exemplified. That is, by disposing the first support member 11 having a low thermal conductivity between the blade 12 and the medical heater 13 and the first jaw 10, the heat directed from the medical heater 13 to the first jaw 10 It is possible to efficiently transfer the heat from the medical heater 13 to the blade 12.
  • PEEK polyetheretherketone
  • the blade 12 has an elongated shape extending along the central axis Ax and is fixed in the recess 111.
  • the blade 12 is made of a material having conductivity and excellent thermal conductivity, such as copper, aluminum, a copper alloy, and an aluminum alloy.
  • the upper surface in FIGS. 3 and 4 comes into contact with the target portion while the target portion is gripped by the first and second gripping members 8 and 9. That is, the surface functions as a treatment surface 121 (FIGS. 2 to 4) for treating the target site.
  • the treatment surface 121 has a direction A1 (in which the first and second gripping members 8 and 9 face each other in a state where the target portion is gripped by the first and second gripping members 8 and 9).
  • the treatment surface 121 is formed of a flat surface, but the treatment surface 121 is not limited to this, and may be formed of other shapes such as a convex shape and a concave shape. The same applies to the gripping surface 931 described later in the second gripping member 9.
  • a recess 123 (FIGS. 3 and 4) extending from the base end to the tip of the blade 12 is formed on the mounting surface 122 having a front-back relationship with the treatment surface 121.
  • the blade 12 then supports the medical heater 13 and the block 14 by the bottom surface of the recess 123.
  • FIG. 5 and 6 are views showing the medical heater 13. Specifically, FIG. 5 is a view of the state before the medical heater 13 is folded back, as viewed from the first plate surface 150a side of the substrate 15.
  • FIG. 6 is a cross-sectional view of the state after the medical heater 13 is folded back, cut by a plane orthogonal to the width direction (left-right direction in FIG. 4) of the medical heater 13. Note that, in FIG. 6, the block 14 is also shown for convenience of explanation. A part of the medical heater 13 generates heat when energized. As shown in FIG. 5 or 6, the medical heater 13 includes a substrate 15 and a conductive portion 16.
  • the substrate 15 is a sheet-shaped flexible substrate made of a resin material having electrical insulation such as polyimide.
  • the substrate 15 is formed in a long shape, and has first and second wide portions 151 and 152 located at both ends in the longitudinal direction (left-right direction in FIG. 5), and the first and second wide portions. It is located between 151 and 152, and includes a narrow portion 153 that connects the first and second wide portions 151 and 152.
  • the width dimension (length dimension in the vertical direction in FIG. 4) of the narrow portion 153 is set substantially uniformly along the longitudinal direction of the substrate 15. Further, the width dimension of the narrow portion 153 is set to be smaller than that of the first and second wide portions 151 and 152.
  • the conductive portion 16 is a metal sheet on the first plate surface 150a of the first plate surface 150a (FIGS. 5 and 6) and the second plate surface 150b (FIG. 6) having a front-back relationship with each other on the substrate 15. It is formed by pasting an MS (see FIG. 7) and patterning the metal sheet MS with a laser or the like. The details of the metal sheet MS will be described later. As shown in FIG. 5 or 6, the conductive portion 16 includes first and second connecting portions 161, 162, a heat generating portion 163, and an electric path portion 164.
  • the first connecting portion 161 is located at the right end portion of the conductive portion 16 in FIG. 5, and is provided in the first wide portion 151. Then, the first lead wire C1 (FIG. 6) constituting the electric cable C is electrically connected to the first connecting portion 161.
  • the first lead wire C1 corresponds to the first wiring member according to the present invention.
  • the second connecting portion 162 is located at the left end portion of the conductive portion 16 in FIG. 5, and is provided in the second wide portion 152. Then, the second lead wire C2 (FIG. 6) constituting the electric cable C is electrically connected to the second connecting portion 162.
  • the second lead wire C2 corresponds to the second wiring member according to the present invention.
  • the heat generating portion 163 is connected to the first connecting portion 161 and the other end side extends toward the second connecting portion 162 side while meandering in a wavy shape, for example.
  • the heat generating portion 163 is not limited to a shape that extends while meandering in a wavy shape, and may have a shape that extends linearly from the first connecting portion 161 toward the second connecting portion 162 side.
  • the electric path portion 164 is a portion that serves as an energizing path between the second connecting portion 162 and the heat generating portion 163. That is, one end of the electric path portion 164 is connected to the other end of the heat generating portion 163.
  • the end portion on the one end side will be referred to as the heat generation side end portion 164a (FIGS. 5 and 6).
  • the electric path portion 164 extends linearly from the heat generating side end portion 164a toward the second connecting portion 162 side, and the other end is connected to the second connecting portion 162.
  • the conductive portion 16 extends along the longitudinal direction of the substrate 15 on the first plate surface 150a. More specifically, the conductive portion 16 is connected in series in the order of the first connecting portion 161, the heat generating portion 163, the electric path portion 164, and the second connecting portion 162 along the longitudinal direction of the substrate 15. It is provided on the first plate surface 150a.
  • the resistance value of the heat generating portion 163 is set to the first and second connecting portions 161, 162, the heating portion 163, and the electric path portion 164 to have a predetermined total length and cross-sectional area, respectively. It is set higher than the connection portions 161, 162 and the electric path portion 164 of the above. Specifically, the first and second connecting portions 161, 162 and the electric path portion 164 have a larger cross-sectional area than the heat generating portion 163. Therefore, when a voltage is applied to the first and second connection portions 161, 162 by passing through the first and second lead wires C1 and C2 under the control of the control device 3, heat is generated. Part 163 mainly generates heat.
  • FIG. 7 is an enlarged view of the metal sheet MS.
  • the metal sheet MS is made of a non-woven fabric in which a plurality of metal fiber FIs are entwined with each other, and has a large number of voids between the metal fiber FIs. That is, the metal sheet MS is different from a woven fabric woven with a plurality of metal fiber FIs such as a mesh and a metal foil.
  • the metal sheet according to the present invention is not limited to the non-woven fabric, and a woven fabric woven with a plurality of metal fibers FI may be used.
  • the material of the metal fiber FI is not particularly limited, and examples thereof include metals such as aluminum, copper, titanium, nickel, gold, platinum, and lead, and alloys such as stainless steel and brass. Of these, stainless steel can be preferably used because of its appropriate conductivity, difficulty in oxidation, processing suitability, and the like.
  • the metal fiber FI may be composed of only one type, or a plurality of types may be used in combination. Further, the diameter of the metal fiber FI is set to 1/2 or less of the line width WL (FIG. 5) of the heat generating portion 163.
  • the medical heater 13 described above is fixed to the bottom surface of the recess 123 by the adhesive sheet 17 (FIGS. 3 and 4) in a folded state.
  • the adhesive sheet 17 is located between the bottom surface of the recess 123 and the medical heater 13, and adheres the bottom surface and the medical heater 13.
  • the adhesive sheet 17 is formed by mixing a material having high thermal conductivity, high temperature resistance, and adhesiveness, for example, epoxy resin, with a ceramic having high thermal conductivity such as alumina and aluminum nitride. Has been done.
  • the medical heater 13 is orthogonal to the longitudinal direction of the substrate 15 and is located substantially in the center of the longitudinal direction in a state where the first plate surface 150a constitutes the outer surface of the medical heater 13.
  • the folding line Ln is not limited to a line Ln that is exactly orthogonal to the longitudinal direction of the substrate 15, but also includes a line that intersects the longitudinal direction within a predetermined angle range.
  • the region on the first connecting portion 161 side with respect to the folding line Ln is referred to as the treatment side region Sp1
  • the region on the second connecting portion 162 side with respect to the folding line Ln is referred to as the back side region Sp2.
  • the electric path portion 164 is provided so as to straddle the turnaround line Ln. Therefore, the first connecting portion 161, the heat generating portion 163, and the heat generating side end portion 164a are located in the treatment side region Sp1. Further, in the back surface side region Sp2, the second connecting portion 162 and the region of the electric path portion 164 other than the heat generating side end portion 164a are located. Then, the medical heater 13 is folded back along the folding line Ln as described above, and is fixed to the bottom surface by the adhesive sheet 17 in a state where the treatment side region Sp1 faces the bottom surface of the recess 123.
  • the block 14 is an elongated flat plate extending along the central axis Ax, and is arranged inside the folded medical heater 13 as shown in FIG. Then, the block 14 prevents the conductive portion 16 from being disconnected at the folded portion of the medical heater 13.
  • the end face of the distal end side Ar1 is formed by a curved surface 141 having a specific radius of curvature and whose center of curvature is parallel to the folding line Ln. Then, as shown in FIG. 6, the curved surface 141 abuts on the folded portion of the medical heater 13. That is, the seat heater 13 is folded back along the curved surface 141 of the block 14.
  • the radius of curvature of the curved surface 141 is in the range of, for example, about 0.2 to 0.6 mm from the size of the device. By doing so, it is possible to prevent the heater from becoming large and prevent the electric path portion 164 from bending at a sharp angle at the turn-back line Ln. Further, since the distance between the heat generating portion 163 and the electric path portion 164 can be secured, a short circuit can be prevented.
  • the block 14 extends from the curved surface 141 toward the proximal end side Ar2 to a position facing the first connecting portion 161. Then, each part of the first and second connecting portions 161 and 162 (first and second wide portions 151 and 152) is in a state of projecting from the block 14 to the proximal end side Ar2, respectively.
  • a material having electrical insulation and heat resistance is preferable, and a resin material such as PEEK, ceramic or the like can be exemplified.
  • the second gripping member 9 includes a second jaw 91, a second support member 92, and a facing plate 93.
  • the second jaw 91 has an elongated shape extending along the central axis Ax. Then, in the second jaw 91, the end portion of the base end side Ar2 is rotatably supported with respect to the shaft 6 about the fulcrum P0 (FIG. 2), and by rotating, the first gripping member 8 Opens and closes against.
  • the first gripping member 8 is fixed to the shaft 6, and the second gripping member 9 is pivotally supported by the shaft 6, but the present invention is not limited to this.
  • 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 each of them. Absent. Further, 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 rotates to the second gripping member 9. On the other hand, a configuration that opens and closes may be adopted.
  • the second support member 92 is made of a resin material having electrical insulation such as PEEK and having a low thermal conductivity, and is arranged between the second jaw 91 and the facing plate 93. ing.
  • the facing plate 93 is made of a conductive material such as copper, and is fixed on a surface of the second supporting member 92 facing the first gripping member 8. In the facing plate 93, the surface on the side of the first gripping member 8 functions as a gripping surface 931 (FIG. 2) for gripping the target portion with the treatment surface 121.
  • Control device configuration The treatment tool 2 is detachably connected to the control device 3 by the electric cable C. Then, the control device 3 is electrically connected to the switch 52 via the electric cable C. Further, the control device 3 is electrically connected to the conductive portion 16 via the electric cables C (first and second lead wires C1 and C2). Further, the control device 3 is electrically connected to the blade 12 and the facing plate 93, respectively, via the electric cable C. Then, the control device 3 executes the following treatment control in response to the operation signal from the switch 52.
  • the control device 3 applies a voltage to the first and second connection portions 161, 162 by passing through the first and second lead wires C1 and C2.
  • the control device 3 measures the resistance value of the conductive portion 16 (hereinafter referred to as heater resistance) from the voltage value and the current value supplied to the conductive portion 16 by using, for example, a voltage drop method.
  • the control device 3 refers to the resistance temperature characteristics measured in advance.
  • the resistance temperature characteristic is a characteristic showing the relationship between the heater resistance and the temperature of the heat generating portion 163 (hereinafter, referred to as the heater temperature). Then, the control device 3 controls the heater resistance to a target resistance value corresponding to the target temperature in the resistance temperature characteristic while changing the electric power supplied to the conductive unit 16.
  • the heater temperature is controlled to the target temperature.
  • the heat from the heat generating portion 163 controlled to the target temperature is transferred to the target portion gripped between the first and second gripping members 8 and 9 via the blade 12. In other words, thermal energy is applied to the target portion.
  • control device 3 supplies high-frequency power to the blade 12 and the facing plate 93 by passing through the electric cable C substantially at the same time as applying the thermal energy to the target portion described above.
  • a high-frequency current flows through the target portion gripped between the blade 12 and the facing plate 93.
  • high frequency energy is applied to the target portion.
  • the blade 12 and the counter plate 93 also have a function as an electrode to which high frequency power is supplied and a high frequency current is passed to the target portion.
  • the target portion is heated by the above-mentioned application of thermal energy.
  • Joule heat is generated by the high frequency current flowing through the target portion.
  • the target site is treated.
  • the conductive portion 16 is composed of a metal sheet MS in which a plurality of metal fiber FIs are entangled with each other. Therefore, for example, even when the cross-sectional area is reduced in order to increase the resistance value of the heat generating portion 163, the strength of the heat generating portion 163 can be sufficiently ensured. Therefore, according to the medical heater 13 according to the first embodiment, the durability of the conductive portion 16 can be ensured.
  • all of the conductive portions 16 are composed of the metal sheet MS. Therefore, for example, the conductive portion 16 can be easily manufactured as compared with the case where only the heat generating portion 163 of the conductive portion 16 is made of the metal sheet MS and the other parts are made of the metal foil.
  • the conductive portion 16 is made of a metal sheet MS having excellent bending resistance. Therefore, it is possible to prevent the conductive portion 16 from being disconnected at the folded portion.
  • the block 14 is arranged inside the folded medical heater 13. Therefore, the block 14 can limit the curvature of the folded portion of the medical heater 13 from becoming too small, and can effectively prevent the conductive portion 16 from being disconnected.
  • the medical heater 13 is folded back along the curved surface 141 of the block 14. Therefore, the curvature of the folded portion of the medical heater 13 can be set to be the same as the curvature of the curved surface 141. That is, the curvature of the folded portion can be set to a desired curvature, and the disconnection of the conductive portion 16 can be prevented more reliably.
  • the block 14 is made of a material having electrical insulation. Further, the block 14 extends from the curved surface 141 toward the proximal end side Ar2 to a position facing the first connecting portion 161. That is, between the treatment side region Sp1 in the conductive portion 16 and the back surface side region Sp2 in the conductive portion 16, there are a substrate 15 and a block 14 having electrical insulation properties, respectively. Therefore, a sufficient creepage distance between the treatment side region Sp1 in the conductive portion 16 and the back surface region Sp2 in the conductive portion 16 can be sufficiently secured, and a short circuit occurs between the treatment side region Sp1 and the back surface region Sp2. It can be prevented from occurring.
  • the first plate surface 150a of the medical heater 13 is fixed to the bottom surface of the recess 123 of the blade 12 by the adhesive sheet 17. That is, the treated side region Sp1 in the conductive portion 16 formed of the metal sheet MS is in close contact with the adhesive sheet 17. Therefore, a part of the adhesive sheet 17 is impregnated into the gaps between the metal fibers FI. As a result, the adhesive force of the medical heater 13 to the blade 12 can be improved, and the thermal resistance from the medical heater 13 to the blade 12 can be reduced. Similarly, since a part of the components of the substrate 15 are impregnated in the gaps between the metal fibers FI, the adhesive force of the conductive portion 16 to the substrate 15 can be improved.
  • FIG. 8 is a diagram showing a medical heater 13A according to the second embodiment. Specifically, FIG. 8 is a cross-sectional view corresponding to FIG. As shown in FIG. 8, the treatment tool 2A according to the second embodiment employs a medical heater 13A different from the medical heater 13 described in the first embodiment described above.
  • the medical heater 13A has a portion of the treatment side region Sp1 and a portion of the back side region Sp2 by deleting the folding line Ln portion in the medical heater 13 described in the first embodiment described above. It is divided into two bodies, and the two bodies are connected by an erection unit 165. That is, as shown in FIG. 8, the substrate 15A constituting the medical heater 13A according to the second embodiment is composed of the first and second substrates 15A1 and 15A2 arranged in a posture facing each other. ..
  • the first substrate 15A1 has substantially the same shape as the treatment-side region Sp1 in the substrate 15 described in the first embodiment described above.
  • the second substrate 15A2 has substantially the same shape as the back surface region Sp2 in the substrate 15 described in the first embodiment described above.
  • the conductive portions 16A constituting the medical heater 13A according to the second embodiment include the first and second connecting portions 161, 162, the heat generating portion 163, and the electric path portion 164. And the erection portion 165.
  • the first connecting portion 161 and the heat generating portion 163 are provided on the plate surface of the first substrate 15A1 on the side separated from the second substrate 15A2.
  • the second connecting portion 162 and the electric path portion 164 are provided on the plate surface of the second substrate 15A2 on the side separated from the first substrate 15A1.
  • the erection unit 165 is bridged from the first substrate 15A1 to the second substrate 15A2, and electrically connects the heat generating portion 163 and the electric path portion 164.
  • the erection portion 165 is composed of the metal sheet MS and has a resistance value sufficiently lower than that of the heat generating portion 163.
  • FIG. 9 is a diagram showing a medical heater 13B according to the third embodiment. Specifically, FIG. 9 is a cross-sectional view corresponding to FIG. As shown in FIG. 9, the treatment tool 2B according to the third embodiment employs the medical heater 13B in which the cover member 18 is added to the medical heater 13 described in the above-described first embodiment. ..
  • the cover member 18 is provided on the first plate surface 150a of the substrate 15 so as to straddle the folding line Ln. Specifically, the cover member 18 extends from a position with a predetermined gap from the heat generating side end portion 164a toward the second connecting portion 162 side to the second connecting portion 162 side, and extends from the electric path portion 164. Cover the surface. That is, the cover member 18 covers a region of the electric path portion 164 other than the heat generating side end portion 164a.
  • the cover member 18 described above is made of a material having electrical insulation such as a coverlay, a sealing material, or a melt layer of polyimide.
  • the medical heater 13B according to the third embodiment is provided with a cover member 18. Therefore, the cover member 18 can improve the watertightness of the back surface region Sp2 in the conductive portion 16. Further, since the cover member 18 has electrical insulation, even when a liquid enters the recess 111, a short circuit occurs between the treatment side region Sp1 in the conductive portion 16 and the back surface side region Sp2 in the conductive portion 16. It can be prevented from occurring. Further, the cover member 18 covers a region of the electric path portion 164 other than the heat generating side end portion 164a.
  • the cover member 18 since the cover member 18 is provided at a position avoiding the heat generating side end portion 164a, which tends to become hot, the cover member 18 does not become hot, and the cover member 18 can be moved from the first plate surface 150a. It is possible to prevent it from peeling off.
  • FIG. 10 is a view of the medical heater 13C viewed from the first plate surface 150a side.
  • FIG. 11 is a cross-sectional view corresponding to FIG.
  • the treatment tool 2C according to the fourth embodiment employs a medical heater 13C different from the medical heater 13 described in the first embodiment described above.
  • the medical heater 13C includes a substrate 15C and a conductive portion 16C (FIG. 10).
  • the substrate 15C is a sheet-like substrate made of a resin material having electrical insulation such as polyimide, and its width dimension (length dimension in the vertical direction in FIG. 10) is its longitudinal direction (left and right in FIG. 10). It is set almost uniformly along the direction). Note that the substrate 15C is not folded back unlike the substrate 15 described in the first embodiment described above.
  • the conductive portion 16C is a metal sheet on the first plate surface 150a of the first plate surface 150a (FIGS. 10 and 11) and the second plate surface 150b (FIG. 11) having a front-back relationship with each other in the substrate 15C. It is formed by pasting the MS and patterning the metal sheet MS with a laser or the like. As shown in FIG. 10, the conductive portion 16C includes first and second connecting portions 161C and 162C and a heat generating portion 163C.
  • the first and second connecting portions 161C and 162C extend along the longitudinal direction of the substrate 15C, and at the base end side Ar2 of the first plate surface 150a, the substrate 15C They are arranged side by side in the width direction. Then, the first lead wire C1 (FIGS. 10 and 11) constituting the electric cable C is electrically connected to the first connection portion 161C. Further, a second lead wire C2 (FIGS. 10 and 11) constituting the electric cable C is electrically connected to the second connection portion 162C.
  • the heat generating portion 163C extends on the first plate surface 150a while meandering from the proximal end side Ar2 toward the distal end side Ar1, and is folded back at the distal end side Ar1 to form a wavy shape toward the proximal end side Ar2. It has a substantially U-shape that extends while meandering. Then, both ends of the heat generating portion 163C are connected to the first and second connecting portions 161C and 162C, respectively.
  • the resistance value of the heat generating portion 163C is determined by setting the first and second connecting portions 161C, 162C and the heating portion 163C to a predetermined total length and cross-sectional area, respectively, so that the first and second connecting portions 161C, It is set higher than 162C. Therefore, when a voltage is applied to the first and second connection portions 161C and 162C by passing through the first and second lead wires C1 and C2 under the control of the control device 3, heat is generated. Part 163C mainly generates heat.
  • the first plate surface 150a faces the bottom surface of the recess 123 by the adhesive sheet 17 arranged between the blade 12 and the medical heater 13C. It is fixed to the bottom surface in the state of being.
  • the present invention should not be limited only to the above-described embodiments 1 to 4.
  • all of the conductive portions 16, 16A and 16C are composed of the metal sheet MS, but the present invention is not limited to this, and for example, only a part of the heat generating portions 163, 163C and the like is formed of the metal sheet. It may be configured by MS.
  • the block 14 is not limited to the configuration in which the block 14 is in contact with the folded portion of the medical heaters 13, 13A, 13B, and a configuration in which the block 14 is not in contact with the folded portion may be adopted. Absent.
  • the block 14 may not be adopted.
  • both thermal energy and high frequency energy are applied to the target portion, but the present invention is not limited to this, and only thermal energy is applied. (A configuration in which the target site is treated only by the heat from the medical heaters 13, 13A to 13C) may be adopted.

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Abstract

Ce dispositif de chauffage médical (13) comprend : un substrat (15) formé à partir d'un matériau qui a des propriétés d'isolation électrique ; et une partie de conduction (16) qui a une partie de génération de chaleur (163) qui génère de la chaleur par conduction, et au moins la partie de génération de chaleur (163) étant disposée sur le substrat (15). Au moins une partie de la partie de conduction est formée à partir d'une feuille métallique obtenue par entrelacement d'une pluralité de fibres métalliques.
PCT/JP2019/010403 2019-03-13 2019-03-13 Dispositif de chauffage médical et instrument de traitement WO2020183681A1 (fr)

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Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPS5851463U (ja) * 1981-10-03 1983-04-07 松下電器産業株式会社 フレキシブル配線実装板
JP2002526901A (ja) * 1998-09-25 2002-08-20 アルカディ コックマン， 多心導電性柔軟発熱体
JP2003210482A (ja) * 2002-01-22 2003-07-29 Olympus Optical Co Ltd 加熱処置具
JP2010514514A (ja) * 2006-12-29 2010-05-06 セント・ジュード・メディカル・エイトリアル・フィブリレーション・ディヴィジョン・インコーポレーテッド 繊維電極ヘッド
WO2014148590A1 (fr) * 2013-03-22 2014-09-25 吉野川電線株式会社 Elément chauffant électrique et procédé pour fabriquer un élément chauffant électrique
WO2018185815A1 (fr) * 2017-04-03 2018-10-11 オリンパス株式会社 Outil de traitement thermique

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JPS5851463U (ja) * 1981-10-03 1983-04-07 松下電器産業株式会社 フレキシブル配線実装板
JP2002526901A (ja) * 1998-09-25 2002-08-20 アルカディ コックマン， 多心導電性柔軟発熱体
JP2003210482A (ja) * 2002-01-22 2003-07-29 Olympus Optical Co Ltd 加熱処置具
JP2010514514A (ja) * 2006-12-29 2010-05-06 セント・ジュード・メディカル・エイトリアル・フィブリレーション・ディヴィジョン・インコーポレーテッド 繊維電極ヘッド
WO2014148590A1 (fr) * 2013-03-22 2014-09-25 吉野川電線株式会社 Elément chauffant électrique et procédé pour fabriquer un élément chauffant électrique
WO2018185815A1 (fr) * 2017-04-03 2018-10-11 オリンパス株式会社 Outil de traitement thermique

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