WO2021064864A1

WO2021064864A1 - Treatment tool

Info

Publication number: WO2021064864A1
Application number: PCT/JP2019/038760
Authority: WO
Inventors: 聖河野
Original assignee: オリンパス株式会社
Priority date: 2019-10-01
Filing date: 2019-10-01
Publication date: 2021-04-08

Abstract

This treatment tool comprises: a sheath 22 constituted by an elongated cylinder; a rod 23 that extends in the longitudinal direction of the sheath 22 and is inserted into the sheath 22 in a state in which the distal end of the rod 23 is exposed to the outside; and an end effector 231 that is provided to the distal end of the rod 23 and treats biological tissue by applying treatment energy to the biological tissue, wherein a length D in the longitudinal direction from the position of the distal end of the end effector 231 to the position of the distal end of the sheath 22 can be changed.

Description

Treatment tool

The present invention relates to a treatment tool.

Conventionally, a treatment tool for treating a target site in a living tissue by applying treatment 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 has a sheath formed of a long tubular body and extends along the longitudinal direction of the sheath, and is inserted into the sheath with the tip exposed to the outside. Equipped with a rod. Then, in the treatment tool, the target part is treated by applying treatment energy to the target part from the end portion on the tip side exposed to the outside from the sheath (hereinafter, referred to as an end effector) in the rod.

Japanese Patent No. 5465353

By the way, in order to secure the field of view to the target site (to avoid blocking the field of view by the sheath) or to perform treatment on a wide area such as stopping bleeding, the length dimension in the longitudinal direction of the end effector. (Hereinafter referred to as the treatment manager) is preferably long. On the other hand, in order to suppress an unintended effect on the living tissue by applying treatment energy to a site other than the target site, it is preferable that the length of the treatment section is short.
The treatment tool described in Patent Document 1 has a problem that it is difficult to improve convenience because the treatment manager cannot be changed.

The present invention has been made in view of the above, and an object of the present invention is to provide a treatment tool capable of improving convenience.

In order to solve the above-mentioned problems and achieve the object, the treatment tool according to the present invention has a sheath formed of a long tubular body and extends along the longitudinal direction of the sheath, and the tip is external. The end is provided with a rod that is inserted into the sheath in a state of being exposed to the sheath, and an end effector that is provided at the tip of the rod and treats the living tissue by applying treatment energy to the living tissue. The length in the longitudinal direction from the position of the tip of the effector to the position of the tip of the sheath can be changed.

According to the treatment tool according to the present invention, convenience can be improved.

FIG. 1 is a diagram showing a treatment system according to the first embodiment. FIG. 2 is a diagram showing the internal configuration of the treatment tool. FIG. 3 is a diagram showing the configuration of the sheath. FIG. 4 is a diagram showing the configuration of the sheath. FIG. 5 is a diagram showing the configuration of the sheath according to the second embodiment. FIG. 6 is a diagram showing the configuration of the sheath according to the second embodiment. FIG. 7 is a diagram showing the configuration of the sheath according to the third embodiment. FIG. 8 is a cross-sectional view taken along the line VIII-VIII of FIG. FIG. 9 is a cross-sectional view taken along the line IX-IX of FIG.

Hereinafter, embodiments for carrying out the present invention (hereinafter referred to as embodiments) will be described with reference to the drawings. The present invention is not limited to the embodiments described below. Further, in the description of the drawings, the same parts are designated by the same reference numerals.

(Embodiment 1)
[Outline 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 site in the living tissue by applying treatment energy to the target site (hereinafter referred to as the target site). In the first embodiment, ultrasonic energy and high frequency energy are adopted as the treatment energy. In addition, as the treatment, coagulation or incision of the target site can be exemplified. As shown in FIG. 1, the treatment system 1 includes a treatment tool 2 and a control device 3.

[Structure of treatment tool]
FIG. 2 is a diagram showing an internal configuration of the treatment tool 2.
As shown in FIG. 1 or 2, the treatment tool 2 includes a housing 21, a sheath 22, a vibration transmitting member 23, and an ultrasonic transducer 24 (FIG. 2).
In the following, as shown in FIG. 1 or 2, one side of the sheath 22 and the vibration transmitting member 23 along the central axis Ax will be referred to as the distal end side Ar1, and the other side will be referred to as the proximal end side Ar2.
The housing 21 is made of an electrically insulating material and has a substantially cylindrical shape extending along the central axis Ax. The housing 21 then supports the sheath 22, the vibration transmission member 23, and the ultrasonic transducer 24.
As shown in FIG. 1, the housing 21 is provided with a switch 211 which is exposed to the outside and receives a procedure start operation by an operator. Then, the switch 211 responds to the treatment start operation with respect to the control device 3 by passing through an electric cable C (FIGS. 1 and 2) that electrically connects the treatment tool 2 and the control device 3. Outputs the operation signal.

The sheath 22 is a tubular body made of an electrically insulating material and extending along the central axis Ax. As shown in FIG. 2, the sheath 22 is supported with respect to the housing 21 by connecting the end portion of the base end side Ar2 to the housing 21.
The details of the configuration of the sheath 22 will be described later.

The vibration transmission member 23 corresponds to the rod according to the present invention. The vibration transmitting member 23 is made of a conductive material and has an elongated shape extending along the central axis Ax. The vibration transmission member 23 is inserted into the sheath 22 and mounted in the housing 21 in a state where the end portion of the tip side Ar1 is exposed to the outside. Further, the vibration transmission member 23 is connected to a BLT (bolt-tightened Langevin type oscillator) in which the end portion of Ar2 on the proximal end side constitutes the ultrasonic transducer 24. Then, the vibration transmission member 23 transmits the ultrasonic vibration generated by the BLT from the end portion of the proximal end side Ar2 to the end portion of the distal end side Ar1. In the present embodiment, the ultrasonic vibration is a longitudinal vibration that vibrates in a direction along the central axis Ax.

Here, on the outer peripheral surface of the vibration transmitting member 23, an annular lining LI (see FIG. 3), which has electrical insulation and elasticity and extends along the circumferential direction about the central axis Ax, is formed. There are multiple. The plurality of lining LIs are positioned at each position P (see FIG. 3) of the longitudinal vibration node of the vibration transmitting member 23.
Hereinafter, for convenience of explanation, the end portion of the distal end side Ar1 exposed to the outside from the sheath 22 will be referred to as an end effector 231 (FIG. 1).
In the first embodiment, the vibration transmission member 23 has a circular cross section orthogonal to the central axis Ax. Further, the vibration transmission member 23 is tapered toward the tip end side Ar1.

The ultrasonic transducer 24 is inserted into the housing 21 from the base end side Ar2 of the housing 21 and is detachably connected to the housing 21. Although the specific illustration is omitted, the ultrasonic transducer 24 includes a BLT that generates ultrasonic vibration in response to the supply of a drive signal that is AC power.

[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 comprehensively controls the operation of the treatment tool 2 as shown below in response to the operation signal (treatment start operation) input from the switch 211 via the electric cable C.
The control device 3 outputs a drive signal to the BLT constituting the ultrasonic transducer 24 via the electric cable C. As a result, the BLT generates ultrasonic vibration (longitudinal vibration). Further, the end effector 231 vibrates with a desired amplitude due to the longitudinal vibration. Then, ultrasonic vibration is applied from the end effector 231 to the target portion in contact with the end effector 231. In other words, ultrasonic energy is applied to the target site from the end effector 231.
Here, the control device 3 is connected to a counter electrode plate (not shown) attached to the surface of the subject by an electric cable (not shown). Then, the control device 3 outputs a high-frequency signal, which is high-frequency power, between the vibration transmission member 23 and the counter electrode plate via the electric cable C. As a result, a high-frequency current flows through the target portion located between the end effector 231 and the counter electrode plate. In other words, high frequency energy is applied to the target portion from the end effector 231.

[Sheath configuration]
3 and 4 are views showing the configuration of the sheath 22. Specifically, FIG. 3 is a diagram showing a state in which the end effector 231 is lengthened. FIG. 4 is a diagram showing a state in which the end effector 231 is shortened. In FIGS. 3 and 4, the lining LI is shaded for convenience of explanation. The same applies to the subsequent drawings.
As shown in FIG. 3 or 4, the sheath 22 includes a first sheath 221 and a second sheath 222 that is configured to be displaceable with respect to the first sheath 221. Then, the sheath 22 makes it possible to change the length D along the central axis Ax of the end effector 231 by the displacement of the second sheath 222. In the following, for convenience of explanation, the length D will be referred to as a treatment unit manager D.

The first sheath 221 is a cylindrical body extending along the central axis Ax, through which the vibration transmission member 23 is inserted. As described above, since the lining LI is attached to the outer peripheral surface of the vibration transmission member 23, the vibration transmission member 23 and the first sheath 221 do not come into contact with each other due to the lining LI. The first sheath 221 is a portion of the sheath 22 on the proximal end side, and the end portion of the proximal end side Ar2 is connected to the housing 21.

The second sheath 222 is a cylindrical body extending along the central axis Ax, through which the vibration transmission member 23 is inserted. Further, the second sheath 222 is tapered toward the tip end side Ar1 following the shape of the vibration transmission member 23. The vibration transmission member 23 and the second sheath 222 do not come into contact with each other due to the lining LI, similarly to the vibration transmission member 23 and the first sheath 221. The outer diameter of the second sheath 222 is set to be slightly smaller than the inner diameter of the first sheath 221. Further, the outer diameter dimension of the second sheath 222 may be set to be the same as or slightly larger than the inner diameter dimension of the first sheath 221. In this case, watertightness between the outer surface of the second sheath 222 and the inner surface of the first sheath 221 can be ensured. Then, the end portion of the base end side Ar2 in the second sheath 222 is inserted into the space between the end portion of the tip end side Ar1 in the first sheath 221 and the vibration transmission member 23.

As shown in the enlarged view of the region A0 of FIG. 4, the first and

second sheaths

221 and 222 described above have a second sheath with respect to the first sheath 221 at a specific position in the direction along the central axis Ax. An adjusting portion 223 for fixing the sheath 222 of 2 is provided.

As shown in the enlarged view of the region A0 of FIG. 4, the adjusting portion 223 is composed of a convex portion 224 and a plurality of concave portions 225.
As shown in the enlarged view of the region A0 of FIG. 4, the convex portion 224 is located at the end of the proximal end side Ar2 of the second sheath 222, and is located from the outer peripheral surface of the second sheath 222 to the first sheath 221. It is a part that protrudes toward. The convex portion 224 has an arc shape extending along the circumferential direction centered on the central axis Ax. The convex portion 224 is not limited to the arc shape, and may have an annular shape extending along the circumferential direction centered on the central axis Ax.

As shown in the enlarged view of the region A0 of FIG. 4, the plurality of recesses 225 are located at the end portions of the distal end side Ar1 of the first sheath 221 from the inner peripheral surface to the outer peripheral surface of the first sheath 221. It is a recessed part toward each other. These plurality of recesses 225 have the same shape. Specifically, the recess 225 extends in an arc shape along the circumferential direction centered on the central axis Ax. The recess 225 is not limited to the configuration extending in an arc shape, and a configuration extending in an annular shape along the circumferential direction centered on the central axis Ax may be adopted. Further, the plurality of recesses 225 are arranged in parallel at a predetermined pitch in the direction along the central axis Ax. Then, the concave portion 225 engages with the convex portion 224 (the convex portion 224 fits in the concave portion 225) to fix the second sheath 222 to the first sheath 221 at a specific position. In other words, the concave portion 225 fixes the treated portion length D to a specific length by engaging with the convex portion 224.

Then, the surgeon performs the following operation when lengthening the treatment manager D in order to secure a field of view to the target site or to perform treatment on a wide area such as stopping bleeding.
That is, the operator performs an operation of pushing the second sheath 222 toward the proximal end side Ar2 with respect to the first sheath 221 (hereinafter, referred to as the first operation). As a result, the convex portion 224 slides on the inner peripheral surface of the first sheath 221 toward the proximal end side Ar2 while repeatedly engaging with and disengaging from any of the plurality of concave portions 225. .. Then, the operator ends the first operation when the convex portion 224 engages with any of the plurality of concave portions 225 and the treatment portion length D reaches a desired length. As a result, the second sheath 222 is in the state shown in FIG.

In addition, the operator performs the following operations when shortening the treatment section manager D in order to suppress an unintended effect on the living tissue by applying treatment energy to a site other than the target site. ..
That is, the operator performs an operation of pulling the second sheath 222 toward the tip side Ar1 with respect to the first sheath 221 (hereinafter, referred to as a second operation). As a result, the convex portion 224 slides on the inner peripheral surface of the first sheath 221 toward the tip end side Ar1 while repeatedly engaging with and disengaging from any of the plurality of concave portions 225. Then, the operator ends the second operation when the convex portion 224 engages with any of the plurality of concave portions 225 and the treatment portion length D reaches a desired length. As a result, the second sheath 222 is in the state shown in FIG.

The first and

second sheaths

211 and 222 described above are slippery when expanded and contracted (slipperiness between the first and second sheaths 221,222, slipperiness between the second sheath 222 and the lining LI). In order to secure the above), it is preferable to use a low friction material such as PTFE (polytetrafluoroethylene).

According to the first embodiment described above, the following effects are obtained.
In the treatment tool 2 according to the first embodiment, the treatment unit manager D can be changed. Therefore, the surgeon can lengthen the treatment manager D in order to secure a field of view to the target site or to perform treatment on a wide area such as stopping bleeding. In addition, the surgeon can shorten the treatment section manager D in order to suppress an unintended effect on the living tissue by applying the treatment energy to a site other than the target site.
Therefore, according to the treatment tool 2 according to the first embodiment, the convenience can be improved.
In particular, the sheath 22 includes first and second sheaths 221,222. Then, in the treatment tool 2, the treatment unit manager D can be changed by moving the second sheath 222 with respect to the first sheath 221 along the central axis Ax. Therefore, a configuration in which the treatment unit manager D can be changed can be realized by a simple configuration.

Further, in the treatment tool 2 according to the first embodiment, the sheath 22 includes an adjusting portion 223 for fixing the second sheath 222 to the first sheath 221. Therefore, it is possible to prevent the treatment unit manager D from deviating from the desired length.
In particular, the adjusting portion 223 includes a convex portion 224 and a plurality of concave portions 225 that engage with each other. Therefore, a configuration for maintaining the treatment unit manager D at a desired length can be realized by a simple configuration.

(Embodiment 2)
Next, the second embodiment will be described.
In the following description, the same components as those in the first embodiment will be designated by the same reference numerals, and detailed description thereof will be omitted or simplified.
5 and 6 are views showing the configuration of the sheath 22A according to the second embodiment. Specifically, FIG. 5 is a diagram showing a state in which the treatment unit manager D is lengthened. FIG. 6 is a diagram showing a state in which the treatment unit manager D is shortened.
In the second embodiment, as shown in FIG. 5 or 6, a sheath 22A different from the sheath 22 described in the above-described first embodiment is adopted.

As shown in FIG. 5 or 6, the sheath 22A is composed of a single sheath unlike the sheath 22 described in the first embodiment described above. More specifically, the sheath 22A has a shape similar to the shape in which the second sheath 222 described in the above-described first embodiment is extended by the base end side Ar2 for a long time, and the end portion of the base end side Ar2 is a housing. Connected to 21. Further, the sheath 22A includes an expansion / contraction portion 226 that can be expanded / contracted along the central axis Ax.
The telescopic portion 226 is formed in a stretchable bellows shape as shown in FIG. 5 or FIG. The telescopic portion 226 is provided at a position deviated from the arrangement position of the lining LI in the direction along the central axis Ax. That is, the expansion / contraction portion 226 does not mechanically interfere with the lining LI when it expands / contracts.

Then, the surgeon performs the following operation when lengthening the treatment manager D in order to secure a field of view to the target site or to perform treatment on a wide area such as stopping bleeding.
That is, the operator performs an operation (hereinafter, referred to as a third operation) in the sheath 22A to push the portion of Ar1 on the distal end side of the telescopic portion 226 toward the portion of Ar2 on the proximal end side of the telescopic portion 226. .. Then, the operator ends the third operation when the treatment manager D reaches a desired length. As a result, the sheath 22A is in the state shown in FIG. 5 in which the expansion / contraction portion 226 is contracted.

In addition, the operator performs the following operations when shortening the treatment section manager D in order to suppress an unintended effect on the living tissue by applying treatment energy to a site other than the target site. ..
That is, the operator performs an operation of pulling the portion of Ar1 on the distal end side of the telescopic portion 226 with respect to the portion of Ar2 on the proximal end side of the telescopic portion 226 in the sheath 22A (hereinafter referred to as the fourth operation). .. Then, the operator ends the fourth operation when the treatment manager D reaches a desired length. As a result, the sheath 22A is in the state shown in FIG. 6 in which the expansion / contraction portion 226 is extended.

The sheath 22A described above has a low PTFE or the like, similarly to the sheath 22 described in the first embodiment described above, in order to ensure slipperiness during expansion and contraction (slipperiness between the sheath 22A and the lining LI). It is preferably composed of a friction material.

Even when the treatment unit length D can be changed by providing the expansion / contraction portion 226 with respect to the sheath 22A as in the second embodiment described above, the same effect as that of the first embodiment described above can be obtained.
Further, the expansion / contraction portion 226 is provided at a position deviated from the arrangement position of the lining LI in the direction along the central axis Ax. Therefore, the support state of the vibration transmitting member 23 with respect to the sheath 22A is not changed by the expansion / contraction state of the sheath 22A. That is, the vibration characteristics of the vibration transmission member 23 are not changed by the expansion / contraction state of the sheath 22A.

(Embodiment 3)
Next, the third embodiment will be described.
In the following description, the same components as those in the first embodiment will be designated by the same reference numerals, and detailed description thereof will be omitted or simplified.
FIG. 7 is a diagram showing the configuration of the sheath 22B according to the third embodiment. FIG. 8 is a cross-sectional view taken along the line VIII-VIII of FIG. FIG. 9 is a cross-sectional view taken along the line IX-IX of FIG.
In the third embodiment, as shown in FIGS. 7 to 9, a vibration transmitting member 23B in which the shape of the portion of the tip side Ar1 is changed is adopted with respect to the vibration transmitting member 23 described in the above-described first embodiment. doing. Further, in the third embodiment, a sheath 22B different from the sheath 22 described in the first embodiment described above is adopted.

The portion of Ar2 on the proximal end side of the vibration transmitting member 23B has a circular cross section orthogonal to the central axis Ax (FIG. 8). On the other hand, the portion of the vibration transmitting member 23B on the tip side Ar1 has an elliptical cross section orthogonal to the central axis Ax (FIG. 9).

As shown in FIG. 7 or 8, the sheath 22B includes first and

second sheaths

221B and 222B, and a rotation restricting unit 227.
The first sheath 221B is different from the first sheath 221 described in the first embodiment described above in that a fitting hole 2211 (enlarged view of region A1 in FIG. 7, FIG. 8) is formed. ..
The fitting hole 2211 is a through hole provided at the end of Ar1 on the distal end side of the first sheath 221B and penetrates the inside and outside of the first sheath 221B, and is an outer shape of the base portion 2271 constituting the rotation restricting portion 227. It has an internal shape that is almost the same as the shape.

The second sheath 222B has an elliptical cross section perpendicular to the central axis Ax with respect to the second sheath 222 described in the first embodiment, in which the portion of the distal end side Ar1 follows the vibration transmitting member 23B. The difference is that the point (FIG. 9) and the engagement groove 2221 (enlarged view of region A1 in FIG. 7, FIG. 8) are formed.
The engaging groove 2221 is provided at the end of Ar2 on the base end side of the second sheath 222B, and is a groove recessed from the outer peripheral surface to the inner peripheral surface of the second sheath 222B. Further, the engaging groove 2221 has substantially the same depth dimension as the protruding dimension of the engaging projection 2272 constituting the rotation restricting portion 227, and the width dimension of the engaging projection 2272 (centered on the central axis Ax). It has substantially the same width dimension as the length dimension in the rotation direction (FIG. 8). Further, in the engaging groove 2221, the length dimension along the central axis Ax is longer than that of the engaging projection 2272 (enlarged view of region A1 in FIG. 7).

The rotation control unit 227 includes a base portion 2271 and an engaging protrusion 2272 as shown in an enlarged view of the region A1 in FIG. 7 or FIG.
As shown in the enlarged view of the region A1 in FIG. 7 or FIG. 8, the base portion 2271 is a portion having an arc shape in a cross section orthogonal to the central axis Ax and fitting into the fitting hole 2211.
As shown in the enlarged view of the region A1 in FIG. 7 or FIG. 8, the engaging projection 2272 is a portion that protrudes from the inner peripheral surface of the base portion 2271 toward the central axis Ax and is inserted into the engaging groove 2221. That is, by inserting the engaging projection 2272 into the engaging groove 2221, the movement of the second sheath 222B with respect to the first sheath 221B along the central axis Ax is allowed, and the second sheath with respect to the first sheath 221B is allowed to move. The rotation of the sheath 222B around the central axis Ax is restricted.

According to the third embodiment described above, in addition to the same effects as those of the first embodiment described above, the following effects are exhibited.
In the third embodiment, the sheath 22B includes a rotation regulating unit 227 that regulates the rotation of the second sheath 222B with respect to the first sheath 221B around the central axis Ax.
Therefore, when the second sheath 222B is moved along the central axis Ax with respect to the first sheath 221B in order to change the treatment unit manager D, the second sheath 222B is moved with respect to the first sheath 221B. It does not rotate around the central axis Ax. That is, it is possible to prevent the second sheath 222B from coming into contact with the vibration transmitting member 23B by rotating the second sheath 222B around the central axis Ax with respect to the first sheath 221B. it can.

(Other embodiments)
Although the embodiments for carrying out the present invention have been described so far, the present invention should not be limited only to the above-described first to third embodiments.
In the above-described first to third embodiments, both ultrasonic energy and high-frequency energy can be applied to the target portion, but the present invention is not limited to this, and the ultrasonic energy and high-frequency energy can be applied to the target portion. A configuration in which only one is given may be adopted. Further, the treatment energy according to the present invention may be at least one of ultrasonic energy, high frequency energy, and thermal energy. Here, applying thermal energy to the target portion means transferring heat of a heater or the like to the target portion. Even when high-frequency energy or thermal energy is used instead of ultrasonic energy as the treatment energy according to the present invention, the vibration transmission member is considered in consideration of the ease of expansion and contraction of the

sheaths

22, 22A, and 22B. It is preferable to provide a lining LI for 23 and 23B.

In the above-described first to third embodiments, the treatment unit manager D is changed by expanding and contracting the

sheaths

22, 22A, and 22B, but the present invention is not limited to this. For example, the treatment unit manager D may be changed by changing the relative positions of the

sheaths

22, 22A, 22B and the

vibration transmission members

23, 23B in the direction along the central axis Ax.

In the above-described first to third embodiments, the operator manually changes the positions of the

sheaths

22, 22A and 22B, and expands and contracts the

sheaths

22, 22A and 22B to change the treatment unit manager D. Not exclusively. For example, the positions of the

sheaths

22, 22A, and 22B may be automatically changed. In this case, the positions of the

sheaths

22, 22A, and 22B are automatically changed by the operator operating a switch provided separately, and the treatment manager D can be changed. When the positions of the

sheaths

22, 22A and 22B are manually changed, the treatment tool is taken out from the treatment target position during the treatment, the positions of the

sheaths

22, 22A and 22B are manually changed, and then the

sheaths

22, 22A and 22B are returned to the treatment target position again. Take action. On the other hand, when the positions of the

sheaths

22, 22A and 22B are automatically changed during the treatment, the treatment manager D can be changed without removing the treatment tool from the treatment target position.

Further, the positions of the

sheaths

22, 22A and 22B may be automatically changed without the operator operating a switch provided separately. For example, the positions of the

sheaths

22, 22A, and 22B may be automatically changed by detecting the proximity of the end effector 231 to the target portion. The positions of the

sheaths

22, 22A, and 22B may be automatically changed at the same time when the operator operates the switch 211 to start the output, or before the output is started. Of course, the treatment unit manager D may be changed by automatically changing the relative positions of the

sheaths

22, 22A, 22B and the

vibration transmitting members

23, 23B in the direction along the central axis Ax.

1 Treatment system 2 Treatment tool 3 Control device 21

Housing

22, 22A,

22B Sheath

23, 23B Vibration transmission member 24 Ultrasonic transducer 211 Switch 221,221B

First sheath

222, 222B Second sheath 223 Adjusting part 224 Convex part 225 Recess 226 Telescopic part 227 Rotation regulation part 231 End effector 2211 Fitting hole 2221 Engagement groove 2221 Base part 2272 Engagement protrusion A0, A1 Area Ar1 Tip side Ar2 Base end side Ax Central axis C Electric cable D Treatment part length LI lining P position

Claims

A sheath made up of a long cylinder and
A rod that extends along the longitudinal direction of the sheath and is inserted into the sheath with the tip exposed to the outside.
An end effector provided at the tip of the rod to treat the living tissue by applying treatment energy to the living tissue is provided.
A treatment tool capable of changing the length in the longitudinal direction from the position of the tip of the end effector to the position of the tip of the sheath.
The sheath is
The treatment tool according to claim 1, wherein the position of the tip of the sheath can be displaced along the longitudinal direction with respect to the position of the tip of the end effector.
A support member to which the base end of the sheath is connected is further provided.
The sheath is
The treatment tool according to claim 2, wherein the position of the tip end in the sheath can be displaced along the longitudinal direction with respect to the position of the base end in the sheath.
The sheath is
A first sheath connected to the support member and
A second sheath connected to the first sheath is provided.
The second sheath is
The treatment tool according to claim 3, wherein the first sheath can be displaced along the longitudinal direction.
The second sheath is
The treatment tool according to claim 4, wherein the treatment tool is inserted into a space between the first sheath and the rod and can be displaced in the longitudinal direction in the space.
The sheath is
The treatment tool according to claim 5, further comprising an adjusting portion for fixing the second sheath to the first sheath at a specific position in the longitudinal direction.
The adjusting part
Convex portions provided on one of the inner peripheral surface of the first sheath and the outer peripheral surface of the second sheath,
A recess provided on the other side of the inner peripheral surface of the first sheath and the outer peripheral surface of the second sheath is provided.
The convex portion and the concave portion are
The treatment tool according to claim 6, wherein the second sheath is fixed to the first sheath by engaging with each other.
The recess is
The treatment tool according to claim 7, wherein a plurality of treatment tools are arranged side by side along the longitudinal direction.
The sheath is
The treatment tool according to claim 5, further comprising a rotation regulating portion that regulates rotation of the second sheath with respect to the first sheath around the central axis of the sheath.
The sheath is
The treatment tool according to claim 3, further comprising an elastic portion capable of expanding and contracting along the longitudinal direction.
The end effector is
Ultrasonic energy is applied to the living tissue as the treatment energy,
On the outer peripheral surface of the rod,
An annular lining extending along the circumferential direction around the central axis of the rod is attached.
The telescopic part
The treatment tool according to claim 10, which is provided at a position deviated from the arrangement position of the lining in the longitudinal direction.