WO2021234793A1 - Outil de traitement, capuchon et procédé de production d'un outil de traitement - Google Patents

Outil de traitement, capuchon et procédé de production d'un outil de traitement Download PDF

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Publication number
WO2021234793A1
WO2021234793A1 PCT/JP2020/019691 JP2020019691W WO2021234793A1 WO 2021234793 A1 WO2021234793 A1 WO 2021234793A1 JP 2020019691 W JP2020019691 W JP 2020019691W WO 2021234793 A1 WO2021234793 A1 WO 2021234793A1
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WO
WIPO (PCT)
Prior art keywords
cap
tip
sheath
treatment tool
peripheral surface
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Application number
PCT/JP2020/019691
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English (en)
Japanese (ja)
Inventor
拓志 南
正美 押田
雅人 井上
Original Assignee
オリンパス株式会社
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Filing date
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/JP2020/019691 priority Critical patent/WO2021234793A1/fr
Publication of WO2021234793A1 publication Critical patent/WO2021234793A1/fr

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/32—Surgical cutting instruments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—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 treatment tool, a cap, and a method for manufacturing the treatment tool.
  • a treatment tool for treating a target site (hereinafter referred to as a target site) in a living tissue by applying energy to the target site has been known (see, for example, Patent Document 1).
  • the treatment tool described in Patent Document 1 is an ultrasonic treatment tool, and includes a vibration transmission member that transmits ultrasonic vibration from the base end to the tip end. This vibration transmitting member is inserted into a tubular sheath with its tip exposed to the outside. Further, a cap for preventing contact with the vibration transmitting member is attached to the tip of the sheath.
  • the cap attached to the tip of the sheath may fall off from the sheath in the following situations, for example.
  • the treatment tool is configured as a treatment tool used under a laparoscope
  • the cap is caught on the trocca when the tip portion of the treatment tool is inserted and removed from the trocca. This may cause the cap to fall off the sheath.
  • the cap comes into contact with another device and receives an external force from the other device. This may cause the cap to fall off the sheath.
  • the biological tissue is squeezed by the tip (end effector) of the vibration transmission member, the cap comes into contact with the biological tissue and receives an external force from the biological tissue. This may cause the cap to fall off the sheath. Therefore, there is a demand for a technique capable of suppressing the cap from falling off from the sheath.
  • the present invention has been made in view of the above, and an object of the present invention is to provide a treatment tool, a cap, and a method for manufacturing the treatment tool capable of suppressing the cap from coming off from the sheath.
  • the treatment tool according to the present invention has a tubular sheath that defines the longitudinal axis direction by extending from the tip to the proximal end, and the tip of the sheath.
  • a cylindrical cap attached to the sheath, an end effector protruding from the tip of the cap and treating a living tissue, and an outer peripheral surface of the sheath and an outer peripheral surface of the cap straddling the boundary between the sheath and the cap.
  • a tube provided at a position covering each of the above-mentioned tubes and contracting in the radial direction orthogonal to the longitudinal axis direction is provided.
  • the cap according to the present invention is a tubular cap used for a treatment tool provided with an end effector for treating a living tissue, and has a tubular shape that defines a longitudinal axis direction by extending from the tip to the proximal end.
  • the outer peripheral surface of the cap is provided with an engaging portion that engages with the tip of the sheath, and the radial dimension orthogonal to the longitudinal axis direction becomes smaller from the engaging portion toward the tip of the cap.
  • the outer surface of the engaging portion and the reduced diameter portion are provided at positions straddling the boundary between the sheath and the cap, and are provided together with the outer peripheral surface of the sheath by a tube that contracts in the radial direction. Be covered.
  • the method for manufacturing a treatment tool according to the present invention is a shaft in which an end effector for treating a living tissue is provided at the tip in a cylindrical sheath that extends from the tip to the base end to define a longitudinal axis direction.
  • a step of arranging the tube and a step of contracting the tube in the radial direction orthogonal to the longitudinal axis direction are provided.
  • the cap According to the treatment tool, the cap, and the method for manufacturing the treatment tool according to the present invention, it is possible to prevent the cap from falling off from the sheath.
  • FIG. 1 is a diagram showing a treatment system according to the first embodiment.
  • FIG. 2 is a diagram showing the inside of the housing.
  • FIG. 3 is a diagram showing the inside of the housing.
  • FIG. 4 is a diagram showing a tip portion of the treatment tool main body.
  • FIG. 5 is a diagram showing a tip portion of the treatment tool main body.
  • FIG. 6 is a diagram showing a cap.
  • FIG. 7 is a diagram showing a cap.
  • FIG. 8 is a flowchart showing a method of manufacturing a treatment tool.
  • FIG. 9 is a diagram illustrating a method for manufacturing a treatment tool.
  • FIG. 10 is a diagram illustrating a method for manufacturing a treatment tool.
  • FIG. 11 is a diagram illustrating a method for manufacturing a treatment tool.
  • FIG. 9 is a diagram showing a method for manufacturing a treatment tool.
  • FIG. 12 is a diagram illustrating a method for manufacturing a treatment tool.
  • FIG. 13 is a diagram illustrating a method for manufacturing a treatment tool.
  • FIG. 14 is a diagram illustrating a method for manufacturing a treatment tool.
  • FIG. 15 is a diagram illustrating a method for manufacturing a treatment tool.
  • FIG. 16 is a diagram illustrating a method for manufacturing a treatment tool.
  • FIG. 17 is a diagram showing a tip portion of the treatment tool main body according to the second embodiment.
  • FIG. 18 is a diagram showing a tip portion of the treatment tool main body according to the second embodiment.
  • FIG. 19 is a diagram showing a tip portion of the treatment tool main body according to the second embodiment.
  • FIG. 20 is a diagram showing a tip portion of the treatment tool main body according to the third embodiment.
  • FIG. 20 is a diagram showing a tip portion of the treatment tool main body according to the third embodiment.
  • FIG. 21 is a diagram showing a tip portion of the treatment tool main body according to the third embodiment.
  • FIG. 22 is a diagram showing a tip portion of the treatment tool main body according to the third embodiment.
  • FIG. 23 is a diagram showing the shape of the sheath according to the fourth embodiment.
  • FIG. 24 is a diagram showing a tip portion of the treatment tool main body according to the fifth embodiment.
  • FIG. 25 is a diagram showing a tip portion of the treatment tool main body according to the fifth embodiment.
  • FIG. 26 is a diagram showing a tip portion of the treatment tool main body according to the fifth embodiment.
  • FIG. 27 is a diagram showing a tip portion of the treatment tool main body according to the sixth embodiment.
  • FIG. 28 is a diagram showing a tip portion of the treatment tool main body according to the sixth embodiment.
  • FIG. 29 is a diagram showing a tip portion of the treatment tool main body according to the sixth embodiment.
  • FIG. 30 is a diagram showing a tip portion of the treatment tool main body according to the seventh embodiment.
  • FIG. 31 is a diagram showing a tip portion of the treatment tool main body according to the seventh embodiment.
  • FIG. 32 is a diagram showing a tip portion of the treatment tool main body according to the seventh embodiment.
  • FIG. 33 is a diagram showing a tip portion of the treatment tool main body according to the eighth embodiment.
  • FIG. 34 is a diagram showing a tip portion of the treatment tool main body according to the eighth embodiment.
  • FIG. 35 is a diagram showing a tip portion of the treatment tool main body according to the eighth embodiment.
  • FIG. 36 is a diagram showing a first cap.
  • FIG. 37 is a diagram showing a tip portion of the treatment tool main body according to the ninth embodiment.
  • FIG. 38 is a diagram showing a tip portion of the treatment tool main body according to the ninth embodiment.
  • FIG. 39 is a diagram showing a tip portion of the treatment tool main body according to the ninth embodiment.
  • FIG. 40 is a diagram showing a tip portion of the treatment tool main body according to the tenth embodiment.
  • FIG. 41 is a diagram showing a tip portion of the treatment tool main body according to the tenth embodiment.
  • FIG. 42 is a diagram showing a cap.
  • FIG. 43 is a diagram showing a cap.
  • FIG. 44 is a diagram showing a tip portion of the treatment tool main body according to the eleventh embodiment.
  • FIG. 45 is a diagram showing a tip portion of the vibration transmission member.
  • FIG. 46 is a diagram showing a tip portion of the vibration transmission member.
  • FIG. 47 is a diagram showing a tip portion of the treatment tool main body according to the twelfth embodiment.
  • FIG. 48 is a diagram showing a tip portion of the treatment tool main body according to the twelfth embodiment.
  • 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).
  • the target site In the first embodiment, ultrasonic energy and high frequency energy are adopted as the treatment energy. Further, as the treatment, coagulation or incision of the target site can be exemplified.
  • the treatment system 1 includes a treatment tool 2 and a control device 3.
  • the treatment tool 2 is an ultrasonic treatment tool that treats the target site by applying at least ultrasonic energy to the target site.
  • the treatment tool 2 includes a treatment tool main body 4 and an ultrasonic transducer 5.
  • the treatment tool main body 4 is a portion that applies treatment energy to the target site.
  • the treatment tool main body 4 includes a housing 6, a rotary knob 7, a sheath 8 (see FIG. 2), a holding portion 9 (see FIGS. 2 and 3), and a vibration transmitting member 10. , With a cap 11.
  • FIGS. 2 and 3 are views showing the inside of the housing 6.
  • the X-axis is an axis parallel to the central axis Ax of the sheath 8.
  • the central axis Ax corresponds to the longitudinal axis according to the present invention.
  • one side 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.
  • FIG. 2 is a cross-sectional view of the treatment tool main body 4 cut by an XZ plane including the central axis Ax. Further, FIG.
  • FIGS. 1 to 3 is a cross-sectional view of the treatment tool main body 4 cut along the XY plane including the central axis Ax.
  • the housing 6 has a substantially cylindrical shape coaxial with the central axis Ax. Then, the housing 6 supports the entire treatment tool main body 4.
  • the housing 6 is composed of two bodies, the first and second housings 61 and 62, as shown in FIGS. 1 to 3.
  • the first housing 61 includes a base end side housing portion 611 and a tip end side housing portion 612 (FIGS. 1 and 3).
  • the base end side housing portion 611 is located at the base end side Ar2 with respect to the tip end side housing portion 612, and has a cylindrical shape coaxial with the central axis Ax.
  • the ultrasonic transducer 5 is inserted into the base end side housing portion 611.
  • the distal end side housing portion 612 is a portion integrally formed at the end portion of the distal end side Ar1 in the proximal end side housing portion 611, and the cross section cut by the plane orthogonal to the central axis Ax has a substantially semicircular shape.
  • the second housing 62 has a substantially semicircular cross section cut by a plane orthogonal to the central axis Ax. As shown in FIG. 2, a plurality of bosses 621 protruding along the Y axis are provided on the edge of the second housing 62. Then, the second housing 62 presses the plurality of bosses 621 into the plurality of recesses (not shown) provided at the end edge of the tip side housing portion 612, respectively, so that the second housing portion 62 has the tip side housing portion 612. It is attached. That is, the base end side housing portion 611 through which the ultrasonic transducer 5 is inserted is not provided with a boss or the like.
  • the housing 6 is provided with a switch 63 which is provided in a state of being exposed to the outside and accepts a treatment start operation by an operator.
  • the switch 63 outputs an operation signal corresponding to the treatment start operation to the control device 3 via an electric cable C (FIG. 1) that electrically connects the treatment tool 2 and the control device 3. do.
  • the rotary knob 7 has a substantially cylindrical shape coaxial with the central axis Ax, and is provided on Ar1 on the tip end side of the housing 6.
  • the rotation knob 7 accepts a rotation operation by the operator.
  • the rotation operation is an operation of rotating the vibration transmission member 10 around the central axis Ax. Then, the rotation knob 7 and the vibration transmission member 10 rotate about the central axis Ax by the rotation operation.
  • the sheath 8 is a cylindrical pipe made of a material such as metal. Then, the vibration transmission member 10 is inserted through the sheath 8. The structure of the end portion of the tip side Ar1 in the sheath 8 will be described later in “About the tip portion of the treatment tool main body”.
  • the holding portion 9 is made of, for example, a resin material having electrical insulation, and has a substantially cylindrical shape coaxial with the central axis Ax. As shown in FIG. 2 or 3, the holding portion 9 is rotatably housed in the housing 6 with the end portion of the distal end side Ar1 protruding from the housing 6 and centered on the central axis Ax. Then, the holding portion 9 holds the vibration transmitting member 10 with the vibration transmitting member 10 inserted therein. Further, the holding portion 9 holds the sheath 8 in a state where the end portion of the base end side Ar2 of the sheath 8 is inserted into the inside from the distal end side Ar1.
  • the flange portion 91 protruding outward is provided on the tip side Ar1 as shown in FIG.
  • the rotary knob 7 is attached to the holding portion 9 by inserting the end portion of the tip end side Ar1 of the holding portion 9 from the proximal end side Ar2 and locking the claw portion 72 to the flange portion 91. Be done. That is, the rotary knob 7 is attached to the holding portion 9 by the snap-fit method. Therefore, the switch 63 can be provided closer to the rotary knob 7 as compared with the structure in which the rotary knob 7 is attached to the housing 6.
  • the holding portion 9 rotates with the rotary knob 7 about the central axis Ax. Further, since the vibration transmission member 10 and the sheath 8 are attached to the holding portion 9, they rotate together with the holding portion 9 about the central axis Ax.
  • An elastic O-ring 92 (FIG. 3) is attached. The O-ring 92 abuts on the inner peripheral surface of the housing 6. That is, the friction between the O-ring 92 and the housing 6 is used to prevent the rotary knob 7 and the like from unintentionally rotating around the central axis Ax.
  • the cap 11 is made of a resin material such as PEEK (polyetheretherketone) having electrical insulation, and has a substantially cylindrical shape surrounding the central axis Ax.
  • the cap 11 is attached to the tip of the sheath 8. The detailed shape of the cap 11 will be described later in “About the tip portion of the treatment tool main body”.
  • the vibration transmission member 10 corresponds to the shaft member according to the present invention.
  • the vibration transmitting member 10 is made of a conductive material and has an elongated shape extending along the central axis Ax. Further, the vibration transmission member 10 is inserted into the sheath 8, the holding portion 9, and the cap 11 in a state where the end portion 101 (hereinafter referred to as an end effector 101) of the tip side Ar1 is exposed to the outside, and the holding thereof is held. It is fixed to the portion 9. Further, the vibration transmission member 10 is connected to a BLT (bolt-tightened Langevin type oscillator) in which the end portion of the proximal end side Ar2 constitutes the ultrasonic transducer 5.
  • BLT bolt-tightened Langevin type oscillator
  • the vibration transmission member 10 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.
  • the ultrasonic vibration is a longitudinal vibration that vibrates in a direction along the central axis Ax.
  • the detailed shape of the end effector 101 will be described later in “About the tip portion of the treatment tool main body”.
  • the ultrasonic transducer 5 is inserted from the proximal end side Ar2 of the proximal end side housing portion 611 into the proximal end side housing portion 611, and is detachably connected to the proximal end side housing portion 611. Although the specific illustration is omitted, the ultrasonic transducer 5 includes a BLT that generates ultrasonic vibration in response to the supply of a drive signal which is AC power.
  • 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 63 via the electric cable C.
  • the control device 3 outputs a drive signal to the BLT constituting the ultrasonic transducer 5 via the electric cable C.
  • the BLT generates ultrasonic vibration (longitudinal vibration).
  • the end effector 101 vibrates with a desired amplitude due to the longitudinal vibration. Then, ultrasonic vibration is applied from the end effector 101 to the target portion in contact with the end effector 101. In other words, ultrasonic energy is applied to the target site from the end effector 101.
  • control device 3 is connected to the counter electrode plate (not shown) by an electric cable (not shown).
  • the counter electrode plate is attached to the surface of the subject.
  • the control device 3 outputs a high-frequency signal, which is high-frequency power, between the vibration transmission member 10 and the counter electrode plate via the electric cable C.
  • a high-frequency current flows through the target portion located between the end effector 101 and the counter electrode plate. In other words, high frequency energy is applied to the target portion from the end effector 101.
  • FIG. 4 is a diagram showing the appearance of the tip portion of the treatment tool main body 4.
  • the tube TU is shown by a alternate long and short dash line for convenience of explanation.
  • FIG. 5 is a cross-sectional view of the VV line shown in FIG.
  • the two directions orthogonal to the central axis Ax are the first direction Ar3 and the second direction Ar4.
  • the first direction Ar3 is the vertical direction in FIG.
  • the second direction Ar4 is the vertical direction in FIG.
  • the shape of the end effector 101 will be described. As shown in FIG.
  • the end effector 101 is a first columnar portion 1011 extending along the central axis Ax and substantially orthogonal to the columnar portion 1011 from the end portion of Ar1 on the tip end side of the columnar portion 1011.
  • a hook portion 1012 projecting along the direction Ar3 (lower side in FIG. 4) is provided. That is, the external dimension of the first direction Ar3 in the hook portion 1012 is larger than the external dimension of the first direction Ar3 in the columnar portion 1011. Further, the external dimension of the second direction Ar4 in the hook portion 1012 is smaller than the external dimension of the first direction Ar3.
  • the cap 11 includes an engaging portion 111, a connecting portion 112, and an exposed portion 113.
  • the engaging portion 111 has a cylindrical shape coaxial with the central axis Ax.
  • the outer diameter dimension of the engaging portion 111 is slightly smaller than the inner diameter dimension of the sheath 8.
  • the inner diameter of each of the engaging portion 111, the connecting portion 112, and the exposed portion 113 is smaller than the external dimension of the first direction Ar3 in the hook portion 1012.
  • the engaging portion 111 is provided with a pair of notched portions 1111 penetrating from the outer peripheral surface to the inner peripheral surface.
  • Each of these pair of notch portions 1111 has a U-shape. Then, inside the U-shape of the notch portion 1111, it extends from the tip end side Ar1 toward the proximal end side Ar2, and can be elastically deformed in the radial direction of the engaging portion 111 with the base portion of the distal end side Ar1 as a base point.
  • the claw portion 1112 is formed.
  • the pair of notch portions 1111 (pair of claw portions 1112) are provided at 180 ° rotationally symmetric positions about the central axis Ax.
  • the connecting portion 112 is a portion that connects the end portion of the distal end side Ar1 in the engaging portion 111 and the end portion of the proximal end side Ar2 in the exposed portion 113, and has a substantially cylindrical shape surrounding the central axis Ax.
  • the end portion of the base end side Ar2 connected to the engaging portion 111 has a larger outer diameter than the engaging portion 111. That is, on the outer peripheral surface of the cap 11, a first step portion 114 (FIGS. 4 to 7) is provided between the connecting portion 112 and the engaging portion 111.
  • a positioning portion 1113 (FIGS. 4, FIG. 6, FIG. 7) that bulges and extends from the first step portion 114 toward the proximal end side Ar2 is provided. Has been done.
  • the outer peripheral surface of the connecting portion 112 is such that the first inclined surface 1121 and the first tip outer peripheral surface 1122 are continuously provided from the proximal end side Ar2 toward the distal end side Ar1. It is composed of things.
  • the first inclined surface 1121 is a surface whose diameter dimension decreases toward the tip end side Ar1 from a position in contact with the first step portion 114.
  • the first tip outer peripheral surface 1122 is a surface extending linearly from a position in contact with the first inclined surface 1121 toward the tip side Ar1 along the central axis Ax.
  • the exposed portion 113 has a substantially cylindrical shape surrounding the central axis Ax, and is provided at the end portion of the distal end side Ar1 in the connecting portion 112.
  • the end portion of the proximal end side Ar2 connected to the connecting portion 112 has a larger outer diameter than the first outer peripheral surface 1122. That is, on the outer peripheral surface of the cap 11, a second step portion 115 (FIGS. 4 to 7) is provided between the exposed portion 113 and the connecting portion 112.
  • the outer peripheral surface of the exposed portion 113 has an overhanging surface 1131 that projects outward in the radial direction of the exposed portion 113.
  • the overhanging surface 1131 is a surface in contact with the second step portion 115 and corresponds to the overhanging portion according to the present invention.
  • the outer peripheral surface of the exposed portion 113 has the overhanging surface 1131, the second inclined surface 1132, and the second tip outer peripheral surface 1133 directed from the proximal end side Ar2 to the distal end side Ar1. It is configured by being connected in series.
  • the overhanging surface 1131 is a surface extending linearly from a position in contact with the second step portion 115 toward the tip end side Ar1 along the central axis Ax.
  • the second inclined surface 1132 is a surface whose diameter dimension decreases toward the tip end side Ar1 from the position in contact with the overhanging surface 1131.
  • the second tip outer peripheral surface 1133 is a surface extending substantially linearly from a position in contact with the second inclined surface 1132 toward the tip side Ar1 along the central axis Ax.
  • the outer diameter dimension of the tip portion 110 (FIGS. 4 to 7) having the second tip outer peripheral surface 1133 is smaller than the outer diameter dimension of the engaging portion 111 which is the base end portion of the cap 11. Further, as shown in FIG. 4, the outer diameter dimension of the tip portion 110 is smaller than the outer diameter dimension of the hook portion 1012 in the first direction Ar3.
  • the tip portion 110 has a function of securing a field of view of an operator or the like who uses the treatment tool main body 4 by reducing the diameter.
  • the cap 11 described above has a first slit 116 (FIG. 6) and a second slit 117 (FIG. 7) on one end side (lower side in FIGS. 6 and 7) in the first direction Ar3. Is provided. These first and second slits 116 and 117 correspond to the slits according to the present invention.
  • the first slit 116 is a slit cut out linearly along the central axis Ax from the tip of the cap 11 to the front of the overhanging surface 1131.
  • the second slit 117 is a slit cut out linearly along the central axis Ax from the base end of the cap 11 to the front side of the first outer peripheral surface 1122.
  • the width dimension of these first and second slits 116 and 117 is slightly larger than the external dimension of the second direction Ar4 in the hook portion 1012.
  • a pair of locking openings 811 penetrating the end of the distal end side Ar1 of the sheath 8 from the outer peripheral surface toward the inner peripheral surface and locking the pair of claw portions 1112, respectively (FIGS. 4 and 5).
  • the sheath 8 is provided with a positioning cutout portion 812 (FIG. 4) that is cut out from the tip end toward the proximal end side Ar2 and through which the positioning portion 1113 is inserted.
  • a tube TU (FIGS. 4 and 5) is attached to the outer peripheral surface of the sheath 8 or the like.
  • This tube TU is a heat-shrinkable tube made of a resin material having electrical insulation.
  • FIG. 8 is a flowchart showing a method of manufacturing the treatment tool 2.
  • 9 to 16 are views illustrating a method for manufacturing the treatment tool 2.
  • 12 to 16 are cross-sectional views of the vibration transmitting member 10 and the like cut along a plane including the tip of the hook portion 1012 (the lower end in FIGS. 12 to 16) and the central axis Ax. ..
  • the operator inserts the end portion of the proximal end side Ar2 of the sheath 8 from the distal end side Ar1 of the holding portion 9 into the inside of the holding portion 9 (step S1). Thereby, as shown in FIG. 10, the sheath 8 is attached to the holding portion 9.
  • step S1 the operator inserts the end portion of the distal end side Ar1 of the vibration transmission member 10 from the proximal end side Ar2 of the holding portion 9 into the holding portion 9 and the sheath 8.
  • step S2 the vibration transmission member 10 is attached to the holding portion 9 with the end effector 101 protruding from the tip end side Ar1 of the sheath 8.
  • step S3 the operator attaches the cap 11 to the sheath 8 as shown below (step S3).
  • the operator positions the first and second slits 116 and 117 on the lower side (the tip side of the hook portion 1012) in FIG. 12, and the cap 11 is shown so that the tip side Ar1 is relative to the base end side Ar2. In the middle of 12, it is tilted in a posture located on the lower side. Then, the operator inserts the hook portion 1012 from the second slit 117 in the cap 11 in the posture into the inside of the cap 11.
  • the operator rotates the cap 11 and inserts the columnar portion 1011 from the second slit 117 into the inside of the cap 11.
  • the tip of the hook portion 1012 projects from the first slit 116 to the outside of the cap 11. That is, the first and second slits 116 and 117 are slits provided to prevent interference with the end effector 101.
  • the operator moves the cap 11 toward the base end side Ar2, inserts the positioning portion 1113 through the positioning notch 812, and sheaths the engaging portion 111. Insert into the inside of 8.
  • the hook portion 1012 is in a state of protruding from the cap 11 to the tip side Ar1.
  • the cap 11 is attached to the sheath 8 by locking the claw portion 1112 to the locking opening 811. That is, the cap 11 is attached to the sheath 8 by the snap-fit method.
  • step S3 the operator inserts the end effector 101, the cap 11, the sheath 8, and the end portion of the distal end side Ar1 in the holding portion 9 from the proximal end side Ar2 of the tube TU into the inside of the tube TU. .. Then, the operator applies heat to the tube TU to contract the tube TU in the radial direction of the tube TU (step S4).
  • the tip of the tube TU is located between the overhanging surface 1131 and the first inclined surface 1121, that is, on the first tip outer peripheral surface 1122, as shown in FIG. 4 or FIG.
  • the diameter dimension on the overhanging surface 1131 is substantially the same as the outer diameter dimension at the tip of the tube TU, as shown in FIG.
  • the diameter dimension of the overhanging surface 1131 may be equal to or less than the outer diameter dimension at the tip of the tube TU, or may be greater than or equal to the outer diameter dimension at the tip of the tube TU.
  • the base end of the tube TU is located on the outer peripheral surface of the end portion of the distal end side Ar1 in the holding portion 9, as shown in the enlarged view of FIG. That is, the gap between the sheath 8 and the holding portion 9 is protected by the tube TU.
  • the tube TU is provided at a position that straddles the boundary between the sheath 8 and the cap 11 and covers the outer peripheral surface of the sheath 8 and the outer peripheral surface of the cap 11, respectively.
  • the engaging portion 111 and the portion of the first inclined surface 1121 correspond to the overlapping region according to the present invention that overlaps in the radial direction. Then, the tube TU covers the overlap region. That is, the first inclined surface 1121 corresponds to the reduced diameter portion according to the present invention.
  • the treatment tool 2 according to the first embodiment is provided at a position that straddles the boundary between the sheath 8 and the cap 11 and covers the outer peripheral surface of the sheath 8 and the outer peripheral surface of the cap 11, respectively, and has a diameter orthogonal to the central axis Ax.
  • a tube TU that contracts in the direction is provided. That is, the cap 11 is in a state of being tightened by the contraction force of the tube TU. Therefore, according to the treatment tool 2 according to the first embodiment, it is possible to prevent the cap 11 from falling off from the sheath 8.
  • the cap 11 is attached to the sheath 8 by the engaging portion 111 by a snap-fit method. Therefore, the cap 11 can be easily attached to the sheath 8. Then, the tube TU covers the overlap region which is a portion of the engaging portion 111. Therefore, the overlap region can be protected by the tube TU, and the engagement state of the cap 11 with the sheath 8 can be well maintained even when an external force is applied to the overlap region. That is, it is possible to effectively suppress the cap 11 from falling off from the sheath 8.
  • the tube TU covers the first inclined surface 1121. Therefore, the structure is such that the first inclined surface 1121 is caught on the tube TU, and the cap 11 can be effectively suppressed from falling off from the sheath 8.
  • the structure is not limited to the inclined surface as long as it is a structure that is hooked on the tube TU.
  • the tip side Ar1 may be a step having a smaller radial dimension than the base end side Ar2.
  • the diameter dimension on the overhanging surface 1131 is substantially the same as the outer diameter dimension at the tip of the tube TU. Therefore, the outer peripheral surface of the cap 11 and the outer peripheral surface of the tube TU can be connected flush with each other without a step. That is, the cap 11 does not fall off from the sheath 8 due to something being caught on the step. Further, the tube TU does not roll up due to something being caught on the tip of the tube TU.
  • the cap 11 is made of an electrically insulating resin material. Therefore, it is not necessary to cover the tip of the cap 11 with the tube TU. That is, since the tip portion is not covered by the tube TU, the diameter of the tip portion can be reduced, and the field of view of the operator or the like using the treatment tool main body 4 can be secured. Further, the outer peripheral surface of the cap 11 becomes smaller in radial dimension from the overhanging surface 1131 toward the tip of the cap 11. Therefore, similarly to the above, the field of view of the operator or the like who uses the treatment tool main body 4 can be secured by reducing the diameter.
  • the cap 11 is provided with first and second slits 116 and 117. Therefore, the end effector 101 can be inserted into the cap 11 while preventing interference with the end effector 101.
  • the first and second slits 116 and 117 are not slits penetrating from the tip end to the base end of the cap 11. Therefore, it is possible to prevent the strength of the cap 11 from being lowered more than necessary. Further, since the cap 11 can be prevented from being deformed more than necessary, it is possible to prevent the cap 11 from falling off due to the deformation.
  • the configuration of the tip portion of the treatment tool main body 4 (the configuration of the sheath 8 and the cap 11) is different from that of the first embodiment described above.
  • the treatment tool 2 according to the second embodiment will be referred to as the treatment tool 2A.
  • the treatment tool main body 4 according to the second embodiment is referred to as a treatment tool main body 4A.
  • the sheath 8 according to the second embodiment is referred to as a sheath 8A.
  • the cap 11 according to the second embodiment is referred to as a cap 11A.
  • FIGS. 17 to 19 are views showing a tip portion of the treatment tool main body 4A according to the second embodiment. Specifically, FIGS. 17 and 18 are views showing the appearance of the tip portion of the treatment tool main body 4A. In FIG. 17, the tube TU is removed, whereas in FIG. 18, the tube TU is attached. FIG. 19 is a cross-sectional view in which the tip portion of the treatment tool main body 4A is cut by a plane including the tip of the hook portion 1012 and the central axis Ax.
  • the cap 11A is made of a resin material such as PEEK having electrical insulation. As shown in FIGS. 17 to 19, the cap 11A includes an engaging portion 121 and an exposed portion 122.
  • the engaging portion 121 includes an engaging portion main body 1211 and a pair of arm portions 1212.
  • the engaging portion main body 1211 has a cylindrical shape coaxial with the central axis Ax.
  • the inner diameter of the engaging portion main body 1211 is slightly larger than the outer diameter of the sheath 8A.
  • the pair of arm portions 1212 project from the base end of the engaging portion main body 1211 toward the base end side Ar2 while facing each other, and are elastically deformable in a direction in which they are close to each other with the base portion of the tip end side Ar1 as the base point.
  • convex portions 1213 (FIG. 17) are provided on the proximal end side Ar2 of the surfaces facing each other.
  • the exposed portion 122 has a substantially cylindrical shape surrounding the central axis Ax, and is provided at the end portion of the distal end side Ar1 in the engaging portion main body 1211.
  • the inner diameter dimension of the exposed portion 122 is smaller than the outer diameter dimension of the first direction Ar3 in the hook portion 1012.
  • the end portion of the base end side Ar2 connected to the engaging portion main body 1211 has a larger outer diameter than the engaging portion main body 1211. That is, on the outer peripheral surface of the cap 11A, a step portion 123 (FIGS. 17 to 19) is provided between the exposed portion 122 and the engaging portion main body 1211.
  • the outer peripheral surface of the exposed portion 122 has an overhanging surface 1221 that projects outward in the radial direction of the exposed portion 122.
  • the overhanging surface 1221 is a surface in contact with the stepped portion 123 and corresponds to the overhanging portion according to the present invention.
  • the overhanging surface 1221, the inclined surface 1222, and the tip outer peripheral surface 1223 are continuously provided from the proximal end side Ar2 toward the distal end side Ar1. It is composed of.
  • the overhanging surface 1221 is a surface extending linearly from a position in contact with the step portion 123 toward the tip end side Ar1 along the central axis Ax.
  • the inclined surface 1222 is a surface whose diameter dimension decreases toward the tip side Ar1 from a position in contact with the overhanging surface 1221.
  • the tip outer peripheral surface 1223 is a surface extending linearly from a position in contact with the inclined surface 1222 toward the tip side Ar1 along the central axis Ax.
  • the outer diameter dimension of the tip portion 120 (FIGS. 17 to 19) having the tip outer peripheral surface 1223 is smaller than the outer diameter dimension of the engaging portion main body 1211 which is the base end portion of the cap 11A. Further, the outer diameter dimension of the tip portion 120 is smaller than the outer diameter dimension of the hook portion 1012 in the first direction Ar3.
  • the tip portion 120 has a function of securing a field of view of an operator or the like who uses the treatment tool main body 4A by reducing the diameter.
  • the cap 11A described above is provided with a slit 124 (FIGS. 17 and 18) linearly cut out along the central axis Ax from the tip end to the base end on one end side in the first direction Ar3. ..
  • the width dimension of the slit 124 is slightly larger than the external dimension of the second direction Ar4 in the hook portion 1012.
  • a pair of flat portions 821 are provided at the end portion of the distal end side Ar1 in the sheath 8A by processing a side wall portion.
  • the pair of flat portions 821 are flat plate-shaped portions extending from the tip end of the sheath 8A toward the proximal end side Ar2 and parallel to each other.
  • the distance between the outer surfaces of the pair of flat portions 821 is substantially the same as the distance between the surfaces facing each other in the pair of arm portions 1212.
  • Each of the pair of flat portions 821 is provided with a pair of locking openings 822 (FIG. 17) that penetrate the front and back surfaces and lock the pair of convex portions 1213.
  • step S3 is different from the method for manufacturing the treatment tool 2 described in the above-described first embodiment (FIG. 8).
  • the operator inserts the end effector 101 from the base end side Ar2 of the cap 11A into the inside of the cap 11A with the tip of the hook portion 1012 inserted into the slit 124. Then, the operator causes the hook portion 1012 to protrude from the tip end side Ar1 of the cap 11A. Further, the operator moves the cap 11A to the base end side Ar2, slides the pair of convex portions 1213 on the outer surface of the pair of flat portions 821, and inside the engaging portion main body 1211 on the tip end side of the sheath 8A. Insert the end of Ar1. Then, the cap 11A is attached to the sheath 8A by locking the convex portion 1213 to the locking opening 822. That is, the cap 11A is attached to the sheath 8A by a snap-fit method.
  • the diameter dimension of the overhanging surface 1221 is substantially the same as the outer diameter dimension at the tip of the tube TU, as shown in FIG. Further, the diameter dimension of the overhanging surface 1221 may be equal to or less than the outer diameter dimension at the tip of the tube TU, or may be greater than or equal to the outer diameter dimension at the tip of the tube TU.
  • the tube TU is provided at a position that straddles the boundary between the sheath 8A and the cap 11A and covers the outer peripheral surface of the sheath 8A and the outer peripheral surface of the cap 11A, respectively. Further, in the sheath 8A and the cap 11A, the portion of the engaging portion 121 corresponds to the overlapping region according to the present invention that overlaps in the radial direction. Then, the tube TU covers the overlap region.
  • the third embodiment Next, the third embodiment will be described.
  • the configuration of the tip portion of the treatment tool main body 4 (the configuration of the sheath 8 and the cap 11) is different from that of the first embodiment described above.
  • the treatment tool 2 according to the third embodiment will be referred to as the treatment tool 2B.
  • the treatment tool main body 4 according to the third embodiment is referred to as a treatment tool main body 4B.
  • the sheath 8 according to the third embodiment is referred to as a sheath 8B.
  • the cap 11 according to the third embodiment is referred to as a cap 11B.
  • FIGS. 20 to 22 are views showing a tip portion of the treatment tool main body 4B according to the third embodiment. Specifically, FIGS. 20 and 21 are views showing the appearance of the tip portion of the treatment tool main body 4B. In FIG. 20, the tube TU is removed, whereas in FIG. 21, the tube TU is attached.
  • FIG. 22 is a cross-sectional view in which the tip portion of the treatment tool main body 4B is cut by a plane including the tip of the hook portion 1012 and the central axis Ax.
  • the cap 11B is made of a resin material such as PTFE (polytetrafluoroethylene) or PFA (tetrafluoroethylene / perfluoroalkyl vinyl ether copolymer) having electrical insulating properties. As shown in FIGS. 20 to 22, the cap 11B includes an engaging portion 131 and an exposed portion 132.
  • the engaging portion 131 has a cylindrical shape coaxial with the central axis Ax.
  • the outer diameter dimension of the engaging portion 131 is slightly larger than the outer diameter dimension of the end portion of the distal end side Ar1 in the sheath 8B.
  • the inner diameter of the engaging portion 131 is slightly larger than the outer dimension of the first direction Ar3 in the hook portion 1012.
  • the engaging portion 131 is provided with a pair of notched portions 1311 penetrating from the outer peripheral surface to the inner peripheral surface. Each of these pair of notch portions 1311 has a U-shape.
  • the notch 1311 extends from the proximal end side Ar2 toward the distal end side Ar1, and is elastically deformed in the radial direction of the engaging portion 131 with the base portion of the proximal end side Ar2 as a base point.
  • the claw portion 1312 that enables it is formed.
  • the pair of notch portions 1311 (pair of claw portions 1312) are provided at 180 ° rotationally symmetric positions about the central axis Ax.
  • the exposed portion 132 has a substantially cylindrical shape surrounding the central axis Ax, and is provided at the end portion of the distal end side Ar1 in the engaging portion 131.
  • the end portion of the base end side Ar2 connected to the engaging portion 131 has a larger outer diameter than the engaging portion 131. That is, on the outer peripheral surface of the cap 11B, a step portion 133 (FIGS. 20 to 22) is provided between the exposed portion 132 and the engaging portion 131.
  • the outer peripheral surface of the exposed portion 132 has an overhanging surface 1321 protruding outward in the radial direction of the exposed portion 132.
  • the overhanging surface 1321 is a surface in contact with the stepped portion 133 and corresponds to the overhanging portion according to the present invention.
  • the overhanging surface 1321, the inclined surface 1322, and the tip outer peripheral surface 1323 are continuously provided from the proximal end side Ar2 toward the distal end side Ar1. It is composed of.
  • the overhanging surface 1321 is a surface extending linearly from a position in contact with the step portion 133 toward the tip end side Ar1 along the central axis Ax.
  • the inclined surface 1322 is a surface whose diameter dimension decreases toward the tip side Ar1 from a position in contact with the overhanging surface 1321.
  • the tip outer peripheral surface 1323 is a surface extending linearly from a position in contact with the inclined surface 1322 toward the tip side Ar1 along the central axis Ax.
  • the inner diameter dimension of the end portion of the tip side Ar1 in the exposed portion 132 is smaller than the outer diameter dimension of the first direction Ar3 in the hook portion 1012.
  • the outer diameter dimension of the tip portion 130 (FIGS. 20 to 22) having the tip outer peripheral surface 1323 is smaller than the outer diameter dimension of the engaging portion 131 which is the base end portion of the cap 11B. Further, the outer diameter dimension of the tip portion 130 is smaller than the outer diameter dimension of the hook portion 1012 in the first direction Ar3.
  • the tip 130 has a function of securing a field of view of an operator or the like who uses the treatment tool main body 4B by reducing the diameter.
  • the cap 11B described above has a slit 134 (FIGS. 20 to 20) cut out linearly along the central axis Ax from the base end of the exposed portion 132 toward the tip end side Ar1 on one end side in the first direction Ar3. FIG. 22) is provided.
  • the width dimension of the slit 134 is slightly larger than the external dimension of the second direction Ar4 in the hook portion 1012.
  • the outer diameter dimension and inner diameter dimension of the end portion of the tip side Ar1 in the sheath 8B becomes smaller toward the tip side Ar1.
  • the inner diameter dimension of the end portion of the tip end side Ar1 is smaller than the outer diameter dimension of the first direction Ar3 in the hook portion 1012. Then, the end portion of the distal end side Ar1 penetrates from the outer peripheral surface to the inner peripheral surface and extends from the distal end side of the sheath 8B toward the proximal end side Ar2, and when performing step S2, the hook portion 1012 is used.
  • a slit 831 (FIG. 20) is provided to prevent interference.
  • a pair of locking openings are provided at the end of the distal end side Ar1 so as to penetrate from the outer peripheral surface to the inner peripheral surface and to lock the pair of claw portions 1312 respectively. ..
  • step S3 is different from the method for manufacturing the treatment tool 2 described in the above-described first embodiment (FIG. 8).
  • the operator inserts the end effector 101 from the base end side Ar2 of the cap 11B into the inside of the cap 11B. Then, since the cap 11B is made of a relatively soft material such as PTFE or PFA, the operator moves the cap 11B to the proximal end side Ar2 while deforming the cap 11B, and hooks the hook portion 1012. Is projected from Ar1 on the tip end side of the cap 11B.
  • the operator inserts the end portion of Ar1 on the distal end side of the sheath 8B into the inside of the engaging portion 131. Then, the cap 11B is attached to the sheath 8B by locking the claw portion 1312 to the locking opening (not shown) provided in the sheath 8B. That is, the cap 11B is attached to the sheath 8B by the snap-fit method.
  • step S4 when the tube TU is attached, the tip of the tube TU is located on the outer peripheral surface of the engaging portion 131 as shown in FIG. 21 or FIG. 22.
  • the diameter dimension of the overhanging surface 1321 is substantially the same as the outer diameter dimension at the tip of the tube TU, as shown in FIG. 22. Further, the diameter dimension of the overhanging surface 1321 may be equal to or less than the outer diameter dimension at the tip of the tube TU, or may be greater than or equal to the outer diameter dimension at the tip of the tube TU.
  • the tube TU is provided at a position that straddles the boundary between the sheath 8B and the cap 11B and covers the outer peripheral surface of the sheath 8B and the outer peripheral surface of the cap 11B, respectively. Further, in the sheath 8B and the cap 11B, the portion of the engaging portion 131 corresponds to the overlapping region according to the present invention that overlaps in the radial direction. Then, the tube TU covers the overlap region.
  • FIG. 23 is a diagram showing the shape of the sheath 8C according to the fourth embodiment.
  • the sheath 8C As shown in FIG. 23, between the end portion of the distal end side Ar1 connected to the cap 11 and the end portion of the proximal end side Ar2 connected to the holding portion 9, the sheath 8C is directed toward the proximal end side Ar2. Therefore, an inclined surface 841 having a small outer diameter is provided.
  • the sheath 8C is provided with the inclined surface 841, it is possible to prevent the tube TU from shifting to the distal end side Ar1 with respect to the sheath 8C.
  • the configuration of the tip portion of the treatment tool main body 4 (the configuration of the sheath 8 and the cap 11) is different from that of the first embodiment described above.
  • the treatment tool 2 according to the fifth embodiment will be referred to as the treatment tool 2D.
  • the treatment tool main body 4 according to the fifth embodiment is referred to as a treatment tool main body 4D.
  • the sheath 8 according to the fifth embodiment is referred to as a sheath 8D.
  • the cap 11 according to the fifth embodiment is referred to as a cap 11D.
  • FIGS. 24 to 26 are views showing the tip portion of the treatment tool main body 4D according to the fifth embodiment. Specifically, FIGS. 24 and 25 are views showing the appearance of the tip portion of the treatment tool main body 4D. In FIG. 24, the tube TU is removed, whereas in FIG. 25, the tube TU is attached.
  • FIG. 26 is a cross-sectional view in which the tip portion of the treatment tool main body 4D is cut by a plane including the tip of the hook portion 1012 and the central axis Ax.
  • the cap 11D is made of a resin material such as PEEK having electrical insulation. As shown in FIGS. 24 to 26, the cap 11D includes an engaging portion 141 (FIG. 26), a connecting portion 142 (FIGS. 24 and 26), and an exposed portion 143.
  • the engaging portion 141 has a cylindrical shape coaxial with the central axis Ax.
  • the outer diameter dimension of the engaging portion 141 is slightly smaller than the inner diameter dimension of the sheath 8D.
  • each inner diameter dimension of the engaging portion 141 and the connecting portion 142 is slightly larger than the outer diameter dimension of the first direction Ar3 in the hook portion 1012.
  • the outer peripheral surface of the engaging portion 141 is provided with an annular recess 1411 having a ring shape centered on the central axis Ax and recessed toward the central axis Ax.
  • the connecting portion 142 is a portion that connects the end portion of the distal end side Ar1 in the engaging portion 141 and the end portion of the proximal end side Ar2 in the exposed portion 143, and has a substantially cylindrical shape surrounding the central axis Ax.
  • the end portion of the base end side Ar2 connected to the engaging portion 141 has a larger outer diameter than the engaging portion 141. That is, on the outer peripheral surface of the cap 11D, a first step portion 144 (FIG. 26) is provided between the connecting portion 142 and the engaging portion 141.
  • the outer peripheral surface of the connecting portion 142 has the proximal outer peripheral surface 1421, the first inclined surface 1422, and the first distal outer peripheral surface 1423 from the proximal end side Ar2 toward the distal end side Ar1. It is configured by being serially installed.
  • the base end outer peripheral surface 1421 is a surface extending linearly from a position in contact with the first step portion 144 toward the tip end side Ar1 along the central axis Ax.
  • the first inclined surface 1422 is a surface whose diameter dimension decreases toward the tip side Ar1 from a position in contact with the base end outer peripheral surface 1421.
  • the first tip outer peripheral surface 1423 is a surface extending linearly from a position in contact with the first inclined surface 1422 toward the tip side Ar1 along the central axis Ax.
  • the exposed portion 143 has a substantially cylindrical shape surrounding the central axis Ax, and is provided at the end portion of the distal end side Ar1 in the connecting portion 142.
  • the end portion of the proximal end side Ar2 connected to the connecting portion 142 has a larger outer diameter than the first outer peripheral surface 1423. That is, on the outer peripheral surface of the cap 11D, a second step portion 145 (FIGS. 25 and 26) is provided between the exposed portion 143 and the connecting portion 142.
  • the outer peripheral surface of the exposed portion 143 has an overhanging surface 1431 that projects outward in the radial direction of the exposed portion 143.
  • the overhanging surface 1431 is a surface in contact with the second step portion 145 and corresponds to the overhanging portion according to the present invention.
  • the outer peripheral surface of the exposed portion 143 has an overhanging surface 1431, a second inclined surface 1432, and a second tip outer peripheral surface 1433 directed from the proximal end side Ar2 to the distal end side Ar1. It is configured by being connected in series.
  • the overhanging surface 1431 is a surface extending linearly from a position in contact with the second step portion 145 toward the tip end side Ar1 along the central axis Ax.
  • the second inclined surface 1432 is a surface whose diameter dimension decreases toward the tip end side Ar1 from a position in contact with the overhanging surface 1431.
  • the second tip outer peripheral surface 1433 is a surface extending substantially linearly from a position in contact with the second inclined surface 1432 toward the tip side Ar1 along the central axis Ax.
  • the inner diameter dimension of the end portion of the tip side Ar1 in the exposed portion 143 is smaller than the outer diameter dimension of the first direction Ar3 in the hook portion 1012.
  • the outer diameter dimension of the tip portion 140 (FIGS. 24 to 26) having the second tip outer peripheral surface 1433 is smaller than the outer diameter dimension of the engaging portion 141 which is the base end portion of the cap 11D. Further, the outer diameter dimension of the tip portion 140 is smaller than the outer diameter dimension of the hook portion 1012 in the first direction Ar3.
  • the tip portion 140 has a function of securing a field of view of an operator or the like who uses the treatment tool main body 4D by reducing the diameter.
  • the cap 11D described above has a slit 146 (FIGS. 24 to 24) cut out linearly along the central axis Ax from the tip of the exposed portion 143 toward the proximal end side Ar2 on one end side in the first direction Ar3. FIG. 26) is provided.
  • the width dimension of the slit 146 is slightly larger than the external dimension of the second direction Ar4 in the hook portion 1012.
  • the sheath 8D does not have a pair of locking openings 811 and a positioning notch 812 at the end of the distal end side Ar1.
  • step S3 is different from the method for manufacturing the treatment tool 2 described in the above-described first embodiment (FIG. 8).
  • the operator inserts the end effector 101 from the base end side Ar2 of the cap 11D into the inside of the cap 11D. Then, the operator causes the hook portion 1012 to protrude from the tip end side Ar1 of the cap 11D by moving the cap 11D to the proximal end side Ar2 while inserting the tip of the hook portion 1012 into the slit 146. Further, the operator moves the cap 11D to the base end side Ar2 and inserts the engaging portion 141 into the inside of the sheath 8D.
  • the operator deforms the sheath 8D in the direction of reducing the diameter by crimping the sheath 8D using a jig (not shown), and the deformed portion 851 (FIGS. 24 and 26) is formed into the annular recess 1411. To fit into. Thereby, the cap 11D is attached to the sheath 8D.
  • step S4 when the tube TU is attached, the tip of the tube TU is located between the overhanging surface 1431 and the first inclined surface 1422, that is, the first outer peripheral surface of the tip, as shown in FIG. Located on 1423.
  • the diameter dimension on the overhanging surface 1431 is substantially the same as the outer diameter dimension at the tip of the tube TU, as shown in FIG. 26. Further, the diameter dimension of the overhanging surface 1431 may be equal to or less than the outer diameter dimension at the tip of the tube TU, or may be greater than or equal to the outer diameter dimension at the tip of the tube TU.
  • the tube TU is provided at a position that straddles the boundary between the sheath 8D and the cap 11D and covers the outer peripheral surface of the sheath 8D and the outer peripheral surface of the cap 11D, respectively. Further, in the sheath 8D and the cap 11D, the portion of the engaging portion 141 and the first inclined surface 1422 corresponds to the overlapping region according to the present invention that overlaps in the radial direction. Then, the tube TU covers the overlap region. That is, the first inclined surface 1422 corresponds to the reduced diameter portion according to the present invention.
  • the configuration of the tip portion of the treatment tool main body 4 (the configuration of the sheath 8 and the cap 11) is different from that of the first embodiment described above.
  • the treatment tool 2 according to the sixth embodiment will be referred to as the treatment tool 2E.
  • the treatment tool main body 4 according to the sixth embodiment is referred to as a treatment tool main body 4E.
  • the cap 11 according to the sixth embodiment is referred to as a cap 11E.
  • the sheath 8 according to the sixth embodiment is referred to as the sheath 8D because it is the same as the sheath 8D described in the above-described fifth embodiment.
  • FIGS. 27 and 28 are views showing the appearance of the tip portion of the treatment tool main body 4E.
  • FIG. 27 the tube TU is removed, whereas in FIG. 28, the tube TU is attached.
  • FIG. 29 is a cross-sectional view in which the tip portion of the treatment tool main body 4E is cut by a plane including the tip of the hook portion 1012 and the central axis Ax.
  • the cap 11E is made of a resin material such as PEEK having electrical insulation. As shown in FIG.
  • the cap 11E is divided into two bodies, the first and second caps 11E1 and 11E2, with a plane including the tip of the hook portion 1012 and the central axis Ax as a boundary. be. These first and second caps 11E1 and 11E2 have a shape symmetrical with respect to the plane. Then, in the state where the first and second caps 11E1 and 11E2 are combined, the cap 11E has the engaging portion 151 (FIG. 29) and the connecting portion 152 (FIG. 27, as shown in FIGS. 27 to 29). FIG. 29) and a tip portion 153 are provided.
  • the engaging portion 151 has a cylindrical shape coaxial with the central axis Ax.
  • the outer diameter dimension of the engaging portion 151 is slightly smaller than the inner diameter dimension of the sheath 8D.
  • the outer peripheral surface of the engaging portion 151 is provided with an annular recess 1511 having a ring shape centered on the central axis Ax and recessed toward the central axis Ax.
  • the connecting portion 152 is a portion that connects the end portion of the distal end side Ar1 in the engaging portion 151 and the end portion of the proximal end side Ar2 in the distal end portion 153, and has a substantially cylindrical shape surrounding the central axis Ax.
  • the end portion of the base end side Ar2 connected to the engaging portion 151 has a larger outer diameter than the engaging portion 151. That is, on the outer peripheral surface of the cap 11E, a first step portion 154 (FIGS. 27 and 29) is provided between the connecting portion 152 and the engaging portion 151.
  • the outer peripheral surface of the connecting portion 152 has a proximal outer peripheral surface 1521, an inclined surface 1522, and a tip outer peripheral surface 1523 continuously provided from the proximal end side Ar2 toward the distal end side Ar1. It is composed of things.
  • the base end outer peripheral surface 1521 is a surface extending linearly from a position in contact with the first step portion 154 toward the tip end side Ar1 along the central axis Ax.
  • the inclined surface 1522 is a surface whose diameter dimension decreases toward the tip side Ar1 from a position in contact with the base end outer peripheral surface 1521.
  • the tip outer peripheral surface 1523 is a surface extending linearly from a position in contact with the inclined surface 1522 toward the tip side Ar1 along the central axis Ax.
  • the tip portion 153 has a substantially cylindrical shape surrounding the central axis Ax, and is provided at the end portion of the tip side Ar1 in the connection portion 152.
  • the tip portion 153 has a larger outer diameter than the tip outer peripheral surface 1523. That is, on the outer peripheral surface of the cap 11E, a second step portion 155 (FIGS. 27 and 29) is provided between the tip portion 153 and the connecting portion 152.
  • the outer peripheral surface of the tip portion 153 will be referred to as an overhanging surface 1531.
  • This overhanging surface 1531 corresponds to the overhanging portion according to the present invention.
  • the overhanging surface 1531 is a surface extending substantially linearly from a position in contact with the second step portion 155 toward the tip end side Ar1 along the central axis Ax.
  • the outer diameter dimension of the tip portion 153 is smaller than the outer diameter dimension of the engaging portion 151 which is the base end portion of the cap 11E. Further, the outer diameter dimension of the tip portion 153 is smaller than the outer diameter dimension of the first direction Ar3 of the hook portion 1012.
  • the tip portion 153 has a function of securing a field of view of an operator or the like who uses the treatment tool main body 4E by reducing the diameter.
  • step S3 is different from the method for manufacturing the treatment tool 2 described in the above-described first embodiment (FIG. 8).
  • the operator combines the first and second caps 11E1 and 11E2 in a state where the columnar portion 1011 is located between the first and second caps 11E1 and 11E2. .. In this state, the hook portion 1012 is in a state of protruding from the tip end side Ar1 of the cap 11E in which the first and second caps 11E1 and 11E2 are combined. Then, the operator moves the cap 11E to the base end side Ar2 and inserts the engaging portion 151 into the inside of the sheath 8D.
  • the operator deforms the sheath 8D in the direction of reducing the diameter by crimping the sheath 8D using a jig (not shown), and the deformed portion 851 (FIGS. 27 and 29) is formed into the annular recess 1511. To fit into. Thereby, the cap 11E is attached to the sheath 8D.
  • step S4 when the tube TU is attached, the tip of the tube TU is located between the overhanging surface 1531 and the inclined surface 1522, that is, on the tip outer peripheral surface 1523, as shown in FIG. 29.
  • the diameter dimension on the overhanging surface 1531 is substantially the same as the outer diameter dimension at the tip of the tube TU, as shown in FIG. 29.
  • the diameter dimension of the overhanging surface 1531 may be equal to or less than the outer diameter dimension at the tip of the tube TU, or may be greater than or equal to the outer diameter dimension at the tip of the tube TU.
  • the tube TU is provided at a position that straddles the boundary between the sheath 8D and the cap 11E and covers the outer peripheral surface of the sheath 8D and the outer peripheral surface of the cap 11E, respectively. Further, in the sheath 8D and the cap 11E, the engaging portion 151 and the inclined surface 1522 portion correspond to the overlapping region according to the present invention that overlaps in the radial direction. Then, the tube TU covers the overlap region. That is, the inclined surface 1522 corresponds to the reduced diameter portion according to the present invention.
  • the cap 11E is composed of two members, the first and second caps 11E1 and 11E2. Therefore, in step S3, it is not necessary to insert the end effector 101 into the cap 11E, and the cap 11E can be easily assembled.
  • the seventh embodiment will be described.
  • 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.
  • the configuration of the tip portion of the treatment tool main body 4 (the configuration of the sheath 8 and the cap 11) is different from that of the first embodiment described above.
  • the treatment tool 2 according to the seventh embodiment will be referred to as the treatment tool 2F.
  • the treatment tool main body 4 according to the seventh embodiment is referred to as a treatment tool main body 4F.
  • the sheath 8 according to the seventh embodiment is referred to as a sheath 8F.
  • the cap 11 according to the seventh embodiment is referred to as a cap 11F.
  • FIGS. 30 to 32 are views showing a tip portion of the treatment tool main body 4F according to the seventh embodiment. Specifically, FIGS. 30 and 31 are views showing the appearance of the tip portion of the treatment tool main body 4F. In FIG. 30, the tube TU is removed, whereas in FIG. 31, the tube TU is attached.
  • FIG. 32 is a cross-sectional view in which the tip portion of the treatment tool main body 4F is cut by a plane including the tip of the hook portion 1012 and the central axis Ax.
  • the cap 11F is made of a resin material such as PEEK having electrical insulation. As shown in FIGS. 30 to 32, the cap 11D includes an engaging portion 161, a connecting portion 162, and an exposed portion 163.
  • the engaging portion 161 has a cylindrical shape coaxial with the central axis Ax.
  • the outer diameter dimension of the engaging portion 161 is slightly larger than the outer diameter dimension of the end portion of the distal end side Ar1 in the sheath 8F.
  • the inner diameter dimension of the engaging portion 161 is slightly larger than the outer diameter dimension of the first direction Ar3 in the hook portion 1012.
  • the inner peripheral surface of the engaging portion 161 is provided with an annular recess 1611 having a ring shape centered on the central axis Ax and recessed in a direction away from the central axis Ax. There is.
  • the connecting portion 162 is a portion that connects the end portion of the distal end side Ar1 in the engaging portion 161 and the end portion of the proximal end side Ar2 in the exposed portion 163, and has a substantially cylindrical shape surrounding the central axis Ax.
  • the inner diameter dimension of the connecting portion 162 is substantially the same as the inner diameter dimension of the engaging portion 161.
  • the outer peripheral surface of the connecting portion 162 has a first inclined surface 1621 and a first tip outer peripheral surface 1622 continuously provided from the proximal end side Ar2 toward the distal end side Ar1. It is composed of things.
  • the first inclined surface 1621 is a surface whose diameter dimension decreases toward the tip end side Ar1 from a position in contact with the engaging portion 161.
  • the first tip outer peripheral surface 1622 is a surface extending linearly from a position in contact with the first inclined surface 1621 toward the tip side Ar1 along the central axis Ax.
  • the exposed portion 163 has a substantially cylindrical shape surrounding the central axis Ax, and is provided at the end portion of the distal end side Ar1 in the connecting portion 162.
  • the end portion of the base end side Ar2 connected to the connecting portion 162 has a larger outer diameter than the first outer peripheral surface 1622. That is, on the outer peripheral surface of the cap 11F, a step portion 164 (FIGS. 30 and 32) is provided between the exposed portion 163 and the connecting portion 162.
  • the outer peripheral surface of the exposed portion 163 has an overhanging surface 1631 that projects outward in the radial direction of the exposed portion 163.
  • the overhanging surface 1631 is a surface in contact with the stepped portion 164 and corresponds to the overhanging portion according to the present invention.
  • the outer peripheral surface of the exposed portion 163 has an overhanging surface 1631, a second inclined surface 1632, and a second tip outer peripheral surface 1633 directed from the proximal end side Ar2 to the distal end side Ar1. It is configured by being connected in a row.
  • the overhanging surface 1631 is a surface extending linearly from a position in contact with the step portion 164 toward the tip end side Ar1 along the central axis Ax.
  • the second inclined surface 1632 is a surface whose diameter dimension decreases toward the tip side Ar1 from a position in contact with the overhanging surface 1631.
  • the second tip outer peripheral surface 1633 is a surface extending substantially linearly from a position in contact with the second inclined surface 1632 toward the tip side Ar1 along the central axis Ax.
  • the inner diameter dimension of the end portion of the tip end side Ar1 in the exposed portion 163 is smaller than the outer diameter dimension of the first direction Ar3 in the hook portion 1012.
  • the outer diameter dimension of the tip portion 160 (FIGS. 30 to 32) having the second tip outer peripheral surface 1633 is smaller than the outer diameter dimension of the engaging portion 161 which is the base end portion of the cap 11F. Further, the outer diameter dimension of the tip portion 160 is smaller than the outer diameter dimension of the hook portion 1012 in the first direction Ar3.
  • the tip portion 160 has a function of securing a field of view of an operator or the like who uses the treatment tool main body 4 by reducing the diameter.
  • the cap 11F described above has a slit 165 (FIGS. 30 to 30), which is linearly cut along the central axis Ax from the tip of the exposed portion 163 toward the proximal end side Ar2 on one end side in the first direction Ar3. FIG. 32) is provided.
  • the width dimension of the slit 165 is slightly larger than the external dimension of the second direction Ar4 in the hook portion 1012.
  • the outer diameter dimension and the inner diameter dimension of the end portion of the tip side Ar1 in the sheath 8F becomes smaller toward the tip side Ar1.
  • the inner diameter dimension of the end portion of the tip end side Ar1 is smaller than the outer diameter dimension of the first direction Ar3 in the hook portion 1012. Then, the end portion of the distal end side Ar1 penetrates from the outer peripheral surface to the inner peripheral surface and extends from the distal end side of the sheath 8F toward the proximal end side Ar2, and when performing step S2, the hook portion 1012 is used.
  • a slit 861 (FIG. 30) is provided to prevent interference.
  • step S3 the operator inserts the end effector 101 from the base end side Ar2 of the cap 11F into the inside of the cap 11F. Then, the operator causes the hook portion 1012 to protrude from the tip end side Ar1 of the cap 11F by moving the cap 11F to the proximal end side Ar2 while inserting the tip of the hook portion 1012 into the slit 165. Further, the operator moves the cap 11F to the base end side Ar2 and inserts the end portion of the tip end side Ar1 of the sheath 8F into the inside of the engaging portion 161.
  • the operator uses a jig (not shown) to crimp the sheath 8F to deform the sheath 8F in the direction of increasing the diameter, and the deformed portion 862 (FIG. 32) is fitted into the annular recess 1611. Let me. Thereby, the cap 11F is attached to the sheath 8F.
  • step S4 when the tube TU is attached, the tip of the tube TU is between the overhanging surface 1631 and the first inclined surface 1621, that is, the first outer peripheral surface of the tip, as shown in FIG. Located on 1622.
  • the diameter dimension on the overhanging surface 1631 is substantially the same as the outer diameter dimension at the tip of the tube TU, as shown in FIG. 32. Further, the diameter dimension of the overhanging surface 1631 may be equal to or less than the outer diameter dimension at the tip of the tube TU, or may be greater than or equal to the outer diameter dimension at the tip of the tube TU.
  • the tube TU is provided at a position that straddles the boundary between the sheath 8F and the cap 11F and covers the outer peripheral surface of the sheath 8F and the outer peripheral surface of the cap 11F, respectively. Further, in the sheath 8F and the cap 11F, the portion of the engaging portion 161 and the first inclined surface 1621 corresponds to the overlapping region according to the present invention that overlaps in the radial direction. Then, the tube TU covers the overlap region. That is, the first inclined surface 1621 corresponds to the reduced diameter portion according to the present invention.
  • the eighth embodiment will be described.
  • the configuration of the tip portion of the treatment tool main body 4 (the configuration of the sheath 8 and the cap 11) is different from that of the first embodiment described above.
  • the treatment tool 2 according to the eighth embodiment will be referred to as the treatment tool 2G.
  • the treatment tool main body 4 according to the eighth embodiment is referred to as a treatment tool main body 4G.
  • the cap 11 according to the eighth embodiment is referred to as a cap 11G.
  • the sheath 8 according to the eighth embodiment is referred to as the sheath 8A because it has substantially the same shape as the sheath 8A described in the second embodiment described above.
  • FIGS. 33 to 35 are views showing the tip portion of the treatment tool main body 4G according to the eighth embodiment.
  • FIG. 36 is a diagram showing the first cap 11G1.
  • FIGS. 33 and 34 are views showing the appearance of the tip portion of the treatment tool main body 4G.
  • the tube TU is removed, whereas in FIG. 34, the tube TU is attached.
  • FIG. 35 is a cross-sectional view in which the tip portion of the treatment tool main body 4G is cut by a plane including the tip of the hook portion 1012 and the central axis Ax.
  • the cap 11G is made of a resin material such as PEEK having electrical insulation. As shown in FIGS.
  • the cap 11G is divided into two bodies, the first and second caps 11G1 and 11G2, with a plane including the tip of the hook portion 1012 and the central axis Ax as a boundary. It was done. These first and second caps 11G1 and 11G2 have a shape symmetrical with respect to the plane. Then, in the state where the first and second caps 11G1 and 11G2 are combined, the cap 11G is connected to the engaging portion 171 (FIGS. 33, 35, 36) as shown in FIGS. 33 to 36. A portion 172 (FIG. 33, 35, 36) and a tip portion 173 are provided.
  • the engaging portion 171 has a substantially cylindrical shape coaxial with the central axis Ax.
  • the outer diameter dimension of the engaging portion 171 is slightly smaller than the inner diameter dimension of the sheath 8A.
  • the outer peripheral surface of the engaging portion 171 is provided with a pair of convex portions 1711 protruding in directions away from the central axis Ax. These pair of convex portions 1711 are provided on the first and second caps 11G1 and 11G2, respectively, and are located at positions that are 180 ° rotationally symmetric with respect to the central axis Ax.
  • the connecting portion 172 is a portion that connects the end portion of the distal end side Ar1 in the engaging portion 171 and the end portion of the proximal end side Ar2 in the distal end portion 153, and has a substantially cylindrical shape surrounding the central axis Ax.
  • the end portion of the base end side Ar2 connected to the engaging portion 171 has a larger outer diameter than the engaging portion 171. That is, on the outer peripheral surface of the cap 11G, a first step portion 174 (FIGS. 35 and 36) is provided between the connecting portion 172 and the engaging portion 171.
  • the proximal outer peripheral surface 1721, the inclined surface 1722, and the distal outer peripheral surface 1723 are continuously provided from the proximal end side Ar2 toward the distal end side Ar1. It is composed of things.
  • the base end outer peripheral surface 1721 is a surface extending linearly from a position in contact with the first step portion 174 toward the tip end side Ar1 along the central axis Ax.
  • the inclined surface 1722 is a surface whose diameter dimension decreases toward the tip end side Ar1 from a position in contact with the base end outer peripheral surface 1721.
  • the tip outer peripheral surface 1723 is a surface extending linearly from a position in contact with the inclined surface 1722 toward the tip side Ar1 along the central axis Ax.
  • the tip portion 173 has a substantially cylindrical shape surrounding the central axis Ax, and is provided at the end portion of the tip side Ar1 in the connection portion 172.
  • the tip portion 173 has a larger outer diameter than the tip outer peripheral surface 1723. That is, on the outer peripheral surface of the cap 11G, a second step portion 175 (FIGS. 33, 35, 36) is provided between the tip portion 173 and the connecting portion 172.
  • the outer peripheral surface of the tip portion 173 will be referred to as an overhanging surface 1731.
  • This overhanging surface 1731 corresponds to the overhanging portion according to the present invention.
  • the overhanging surface 1731 is a surface extending substantially linearly from a position in contact with the second step portion 175 toward the tip end side Ar1 along the central axis Ax.
  • the outer diameter dimension of the tip portion 173 is smaller than the outer diameter dimension of the engaging portion 171 which is the base end portion of the cap 11G. Further, the outer diameter dimension of the tip portion 173 is smaller than the outer diameter dimension of the first direction Ar3 of the hook portion 1012.
  • the tip portion 173 has a function of securing a field of view of an operator or the like who uses the treatment tool main body 4G by reducing the diameter.
  • step S3 is different from the method for manufacturing the treatment tool 2 described in the above-described first embodiment (FIG. 8).
  • the operator combines the first and second caps 11G1 and 11G2 in a state where the columnar portion 1011 is located between the first and second caps 11G1 and 11G2. .. In this state, the hook portion 1012 is in a state of protruding from the tip end side Ar1 of the cap 11G in which the first and second caps 11G1 and 11G2 are combined.
  • the operator moves the cap 11G to the base end side Ar2 and inserts the engaging portion 171 into the inside of the sheath 8A.
  • the cap 11G is attached to the sheath 8A by locking the convex portion 1711 to the locking opening 822. That is, the cap 11G is attached to the sheath 8A by the snap-fit method.
  • step S4 when the tube TU is attached, the tip of the tube TU is located between the overhanging surface 1731 and the inclined surface 1722, that is, on the tip outer peripheral surface 1723, as shown in FIG. 35.
  • the diameter dimension on the overhanging surface 1731 is substantially the same as the outer diameter dimension at the tip of the tube TU, as shown in FIG. 35.
  • the diameter dimension of the overhanging surface 1731 may be equal to or less than the outer diameter dimension at the tip of the tube TU, or may be greater than or equal to the outer diameter dimension at the tip of the tube TU.
  • the tube TU is provided at a position that straddles the boundary between the sheath 8A and the cap 11G and covers the outer peripheral surface of the sheath 8A and the outer peripheral surface of the cap 11G, respectively. Further, in the sheath 8A and the cap 11G, the engaging portion 171 and the inclined surface 1722 portion correspond to the overlapping region according to the present invention that overlaps in the radial direction. Then, the tube TU covers the overlap region. That is, the inclined surface 1722 corresponds to the reduced diameter portion according to the present invention.
  • the ninth embodiment will be described.
  • 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.
  • the configuration of the tip portion of the treatment tool main body 4 (the configuration of the sheath 8 and the cap 11) is different from that of the first embodiment described above.
  • the treatment tool 2 according to the ninth embodiment will be referred to as the treatment tool 2H.
  • the treatment tool main body 4 according to the ninth embodiment is referred to as a treatment tool main body 4H.
  • the cap 11 according to the ninth embodiment is referred to as a cap 11H.
  • the sheath 8 according to the ninth embodiment is referred to as the sheath 8A because it has substantially the same shape as the sheath 8A described in the second embodiment described above.
  • FIGS. 37 and 38 are views showing the appearance of the tip portion of the treatment tool main body 4H.
  • FIG. 37 the tube TU is removed, whereas in FIG. 38, the tube TU is attached.
  • FIG. 39 is a cross-sectional view in which the tip portion of the treatment tool main body 4H is cut by a plane including the tip of the hook portion 1012 and the central axis Ax.
  • the cap 11H is made of a resin material such as PEEK having electrical insulation. As shown in FIG. 37 or FIG.
  • the cap 11H is divided into two bodies, the first and second caps 11H1 and 11H2, with a plane including the tip of the hook portion 1012 and the central axis Ax as a boundary. be. These first and second caps 11H1 and 11H2 have a shape symmetrical with respect to the plane. Then, in the state where the first and second caps 11H1 and 11H2 are combined, the cap 11H has the engaging portion 181 (FIG. 37, 39) and the connecting portion 182 (as shown in FIGS. 37 to 39). 37, 39) and a tip portion 183 are provided.
  • the engaging portion 181 includes an engaging portion main body 1811 and a pair of arm portions 1812.
  • the engaging portion main body 1811 has a cylindrical shape coaxial with the central axis Ax.
  • the outer diameter dimension of the engaging portion main body 1811 is substantially the same as the outer diameter dimension of the sheath 8A.
  • the pair of arm portions 1812 are provided on the first and second caps 11H1 and 11H2, respectively, and are located at positions that are 180 ° rotationally symmetric with respect to the central axis Ax.
  • the pair of arm portions 1812 project from the base end of the engaging portion main body 1811 toward the base end side Ar2 while facing each other, and are elastic in a direction in which they are close to each other with the base portion of the tip end side Ar1 as the base point. Make it deformable.
  • the distance between the faces facing each other in the pair of arm portions 1812 is substantially the same as the distance between the outer surfaces of the pair of flat portions 821 in the sheath 8A.
  • convex portions (not shown) are provided on the proximal end side Ar2 of the surfaces facing each other.
  • the connecting portion 182 is a portion that connects the end portion of the distal end side Ar1 in the engaging portion 181 and the end portion of the proximal end side Ar2 in the distal end portion 183, and has a substantially cylindrical shape surrounding the central axis Ax. Further, as shown in FIG. 37 or FIG. 39, the outer peripheral surface of the connecting portion 182 is configured such that the inclined surface 1821 and the tip outer peripheral surface 1822 are continuously provided from the proximal end side Ar2 toward the distal end side Ar1. There is.
  • the inclined surface 1821 is a surface whose diameter dimension decreases toward the tip end side Ar1 from a position in contact with the engaging portion 181.
  • the tip outer peripheral surface 1822 is a surface extending linearly from a position in contact with the inclined surface 1821 toward the tip side Ar1 along the central axis Ax.
  • the tip portion 183 has a substantially cylindrical shape surrounding the central axis Ax, and is provided at the end portion of the tip side Ar1 in the connection portion 182.
  • the tip portion 183 has a larger outer diameter than the tip outer peripheral surface 1822. That is, on the outer peripheral surface of the cap 11H, a step portion 184 (FIGS. 37 to 39) is provided between the tip portion 183 and the connection portion 182.
  • the outer peripheral surface of the tip portion 183 will be referred to as an overhanging surface 1831.
  • This overhanging surface 1831 corresponds to the overhanging portion according to the present invention.
  • the overhanging surface 1831 is a surface extending substantially linearly from a position in contact with the step portion 184 toward the tip end side Ar1 along the central axis Ax.
  • the outer diameter dimension of the tip portion 183 is smaller than the outer diameter dimension of the engaging portion main body 1811 which is the base end portion of the cap 11H. Further, the outer diameter dimension of the tip portion 183 is smaller than the outer diameter dimension of the first direction Ar3 of the hook portion 1012.
  • the tip portion 183 has a function of securing a field of view of an operator or the like who uses the treatment tool main body 4H by reducing the diameter.
  • step S3 is different from the method for manufacturing the treatment tool 2 described in the above-described first embodiment (FIG. 8).
  • the operator has the columnar portions 1011 and the sheath 8A located between the first and second caps 11H1 and 11H2, and the first and second caps 11H1 and the sheath 8A are located between the first and second caps 11H1 and 11H2.
  • 11H2 is combined, and each convex portion (not shown) in the pair of arm portions 1812 is locked with respect to the locking opening 822.
  • the cap 11H is attached to the sheath 8A by attaching the tube TU by step S4.
  • step S4 when the tube TU is attached, the tip of the tube TU is located between the overhanging surface 1831 and the inclined surface 1821, that is, on the tip outer peripheral surface 1822, as shown in FIG. 38 or FIG. 39.
  • the diameter dimension on the overhanging surface 1831 is substantially the same as the outer diameter dimension at the tip of the tube TU, as shown in FIG. 39. Further, the diameter dimension of the overhanging surface 1831 may be equal to or less than the outer diameter dimension at the tip of the tube TU, or may be greater than or equal to the outer diameter dimension at the tip of the tube TU.
  • the tube TU is provided at a position that straddles the boundary between the sheath 8A and the cap 11H and covers the outer peripheral surface of the sheath 8A and the outer peripheral surface of the cap 11H, respectively.
  • the pair of arm portions 1812 and the inclined surface 1821 portion correspond to the overlapping region according to the present invention that overlaps in the radial direction.
  • the tube TU covers the overlap region. That is, the inclined surface 1821 corresponds to the reduced diameter portion according to the present invention.
  • the tenth embodiment will be described.
  • 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.
  • the configuration of the tip portion of the treatment tool main body 4 (the configuration of the sheath 8 and the cap 11) is different from that of the first embodiment described above.
  • the treatment tool 2 according to the tenth embodiment will be referred to as a treatment tool 2I.
  • the treatment tool main body 4 according to the tenth embodiment is referred to as a treatment tool main body 4I.
  • the sheath 8 according to the tenth embodiment is referred to as a sheath 8I.
  • the cap 11 according to the tenth embodiment is referred to as a cap 11I.
  • FIGS. 40 and 41 are views showing the tip portion of the treatment tool main body 4I according to the tenth embodiment.
  • 42 and 43 are views showing the cap 11I.
  • FIGS. 40 and 41 are views showing the appearance of the tip portion of the treatment tool main body 4I.
  • the tube TU is removed, whereas in FIG. 41, the tube TU is attached.
  • FIG. 42 is a diagram showing the inside of the cap 11I before bending the pair of living hinges 11I3 and 11I4.
  • FIG. 43 is a diagram showing a cap 11I after bending a pair of living hinges 11I3 and 11I4.
  • the cap 11I is made of a resin material such as PEEK having electrical insulation. As shown in FIG. 42, the cap 11I includes first and second caps 11I1 and 11I2 connected to each other by a pair of living hinges 11I3 and 11I4. Then, by bending the pair of living hinges 11I3 and 11I4 and combining the first and second caps 11I1 and 11I2, a tubular cap 11I is formed as shown in FIG. 43.
  • the first and second caps 11I1 and 11I2 have a shape symmetrical with respect to a plane including the tip of the hook portion 1012 and the central axis Ax.
  • the cap 11I is connected to the engaging portion 191 (FIGS. 40, 42, 43) as shown in FIGS. 40 to 43.
  • a portion 192 (FIG. 40, 42, 43) and an exposed portion 193 are provided.
  • the engaging portion 191 has a cylindrical shape coaxial with the central axis Ax.
  • the outer diameter dimension of the engaging portion 191 is slightly smaller than the inner diameter dimension of the sheath 8I.
  • a pair of locking projections 1911 are provided on the outer peripheral surface of the engaging portion 191 as shown in FIGS. 40, 42, or 43.
  • the pair of locking projections 1911 are provided on the first and second caps 11I1 and 11I2, respectively. More specifically, the pair of locking projections 1911 project from the outer peripheral surface of the engaging portion 191 in a direction away from the central axis Ax, and face the distal end side Ar1 from the base end of the engaging portion 191. Each extends linearly toward each other.
  • the connecting portion 192 is a portion that connects the end portion of the distal end side Ar1 in the engaging portion 191 and the end portion of the proximal end side Ar2 in the exposed portion 193, and has a substantially cylindrical shape surrounding the central axis Ax.
  • the connecting portion 192 has a larger outer diameter than the engaging portion 171. That is, on the outer peripheral surface of the cap 11I, a first step portion 194 (FIGS. 40, 42, 43) is provided between the connecting portion 192 and the engaging portion 191.
  • the exposed portion 193 has a substantially cylindrical shape surrounding the central axis Ax, and is provided at the end portion of the distal end side Ar1 in the connecting portion 192.
  • the end portion of the base end side Ar2 connected to the connecting portion 192 has a larger outer diameter than the connecting portion 192. That is, on the outer peripheral surface of the cap 11I, a second step portion 195 (FIGS. 40 to 43) is provided between the exposed portion 193 and the connecting portion 192.
  • the outer peripheral surface of the exposed portion 193 has an overhanging surface 1931 that projects outward in the radial direction of the exposed portion 193. This overhanging surface 1931 is a surface in contact with the second stepped portion 195 and corresponds to the overhanging portion according to the present invention.
  • the overhanging surface 1931 is a surface extending linearly from a position in contact with the second step portion 195 toward the tip end side Ar1 along the central axis Ax.
  • the inclined surface 1932 is a surface whose diameter dimension decreases toward the tip side Ar1 from a position in contact with the overhanging surface 1931.
  • the tip outer peripheral surface 1933 is a surface extending substantially linearly from a position in contact with the inclined surface 1932 toward the tip side Ar1 along the central axis Ax.
  • the outer diameter dimension of the tip portion 190 (FIGS. 40, 41, 43) having the tip outer peripheral surface 1933 is smaller than the outer diameter dimension of the engaging portion 191 which is the base end portion of the cap 11I. Further, the outer diameter dimension of the tip portion 190 is smaller than the outer diameter dimension of the hook portion 1012 in the first direction Ar3.
  • the tip portion 190 has a function of securing a field of view of an operator or the like who uses the treatment tool main body 4I by reducing the diameter.
  • the locking notch 871 includes a narrow portion 8711 located on the distal end side Ar1 and a wide portion 8712 located on the proximal end side Ar2 and having a width larger than that of the narrow portion 8711.
  • step S3 is different from the method for manufacturing the treatment tool 2 described in the above-described first embodiment (FIG. 8).
  • the operator bends the pair of living hinges 11E3 and 11E4 with the columnar portion 1011 located inside the cap 11I (upper side in FIG. 42), and the first one. Combine the second caps 11I1 and 11I2.
  • the hook portion 1012 is in a state of protruding from the tip end side Ar1 of the cap 11I in which the first and second caps 11I1 and 11I2 are combined.
  • the operator moves the cap 11I to the base end side Ar2, inserts the engaging portion 191 into the sheath 8I while inserting the pair of locking projections 1911 into the locking notch 871. ..
  • the cap 11I is attached to the sheath 8I by a pair of locking projections 1911 locking to the wide portion 8712 in the locking notch 871.
  • step S4 when the tube TU is attached, the tip of the tube TU is located on the outer peripheral surface of the connecting portion 192.
  • the diameter dimension on the overhanging surface 1931 is substantially the same as the outer diameter dimension at the tip of the tube TU. Further, the diameter dimension on the overhanging surface 1931 may be equal to or less than the outer diameter dimension at the tip of the tube TU, or may be greater than or equal to the outer diameter dimension at the tip of the tube TU.
  • the tube TU is provided at a position that straddles the boundary between the sheath 8I and the cap 11I and covers the outer peripheral surface of the sheath 8I and the outer peripheral surface of the cap 11I, respectively. Further, in the sheath 8I and the cap 11I, the portion of the engaging portion 191 corresponds to the overlapping region according to the present invention that overlaps in the radial direction. Then, the tube TU covers the overlap region.
  • the eleventh embodiment Next, the eleventh 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.
  • the configuration of the tip portion of the treatment tool main body 4 (the configuration of the vibration transmission member 10 and the cap 11) is different from that of the first embodiment described above.
  • the treatment tool 2 according to the eleventh embodiment will be referred to as the treatment tool 2J.
  • the treatment tool main body 4 according to the eleventh embodiment is referred to as a treatment tool main body 4J.
  • the vibration transmission member 10 according to the eleventh embodiment is referred to as a vibration transmission member 10J.
  • the cap 11 according to the present embodiment 11 is referred to as a cap 11J.
  • FIG. 44 is a diagram showing a tip portion of the treatment tool main body 4J according to the eleventh embodiment.
  • the tube TU is shown by a alternate long and short dash line for convenience of explanation.
  • 45 and 46 are views showing the tip portion of the vibration transmission member 10J.
  • FIG. 45 is a view of the vibration transmitting member 10J along the second direction Ar4.
  • FIG. 46 is a view of the vibration transmitting member 10J along the first direction Ar3.
  • the vibration transmission member 10J has a different shape of the end effector 101 from the vibration transmission member 10 described in the first embodiment described above.
  • the end effector 101 according to the eleventh embodiment will be referred to as an end effector 101J.
  • the end effector 101J includes a columnar portion 1013 extending along the central axis Ax and a spatula portion 1014 provided at the end of the distal end side Ar1 in the columnar portion 1013. ..
  • the spatula portion 1014 has a width dimension (external dimension of the first direction Ar3) larger than the width dimension of the columnar portion 1013 (external dimension of the first direction Ar3), and the second is directed toward the tip side Ar1. It curves along the direction Ar4.
  • the cap 11J is made of a resin material such as PEEK, PTFE, or PFA having electrical insulation. As shown in FIG. 44, the cap 11J includes an engaging portion 201, a connecting portion 202, and a tip portion 203.
  • the engaging portion 201 has the same shape as the engaging portion 111 described in the first embodiment described above. That is, the engaging portion 201 includes a pair of claw portions 2011 (FIG. 44) similar to the pair of claw portions 1112 described in the first embodiment described above. In the eleventh embodiment, the inner diameter of the engaging portion 201 is slightly larger than the width dimension of the spatula portion 1014.
  • the connecting portion 202 is a portion that connects the end portion of the distal end side Ar1 in the engaging portion 201 and the end portion of the proximal end side Ar2 in the distal end portion 203, and has a tubular shape surrounding the central axis Ax.
  • the end portion of the base end side Ar2 connected to the engaging portion 201 has a larger outer diameter than the engaging portion 201. That is, on the outer peripheral surface of the cap 11J, a first step portion 204 (FIG. 44) is provided between the connecting portion 202 and the engaging portion 201.
  • connection portion 202 the external dimension (thickness dimension) of the second direction Ar4 is smaller in the substantially central portion in the direction along the central axis Ax than in the other portions.
  • the thickness of the connecting portion 202 increases from the substantially central portion toward the distal end side Ar1 and the proximal end side Ar2, respectively.
  • the outer dimension (width dimension) of the first direction Ar3 is smaller in the substantially central portion than in the other portions. Then, the width dimension of the connecting portion 202 increases from the substantially central portion toward the distal end side Ar1 and the proximal end side Ar2, respectively.
  • the substantially central portion having the smallest external dimensions in the first and second directions Ar3 and Ar4 will be referred to as an intermediate portion 205 (FIG. 44).
  • the external dimension of the first direction Ar3 in the intermediate portion 205 is smaller than the external dimension of the first direction Ar3 in the other portion of the cap 11J, and further smaller than the width dimension of the spatula portion 1014.
  • the intermediate portion 205 has a function of securing a field of view of an operator or the like who uses the treatment tool main body 4J by reducing the diameter.
  • the internal dimensions of the intermediate portion 205 are as follows. That is, the internal dimension of the first direction Ar3 in the intermediate portion 205 is smaller than the width dimension of the spatula portion 1014. Further, the internal dimension of the second direction Ar4 in the intermediate portion 205 is larger than the thickness dimension of the spatula portion 1014 (the external dimension of the second direction Ar4). On the other hand, in the connecting portion 202, the portions other than the intermediate portion 205 have internal dimensions that allow the spatula portion 1014 to be inserted.
  • connection portion 202 described above is provided with slits 206 (FIG. 44) extending linearly along the central axis Ax, straddling the intermediate portion 205 on both ends in the first direction Ar3.
  • the width dimension of the slit 206 is slightly larger than the thickness dimension of the spatula portion 1014.
  • the tip portion 203 has a tubular shape surrounding the central axis Ax, and is provided at the end portion of the tip side Ar1 in the connection portion 202.
  • the tip portion 203 has larger external dimensions in the first and second directions Ar3 and Ar4 than the end portion of the tip side Ar1 in the connection portion 202. That is, on the outer peripheral surface of the cap 11J, a second step portion 207 (FIG. 44) is provided between the tip portion 203 and the connection portion 202.
  • the outer peripheral surface of the tip portion 203 will be referred to as an overhanging surface 2031. This overhanging surface 2031 corresponds to the overhanging portion according to the present invention.
  • the tip portion 203 has an internal dimension that allows the spatula portion 1014 to be inserted.
  • the external dimension of the second direction Ar4 at the tip portion 203 is smaller than the outer diameter dimension of the engaging portion 201 which is the base end portion of the cap 11J.
  • the tip portion 203, together with the intermediate portion 205, has a function of securing a field of view of an operator or the like who uses the treatment tool main body 4J by reducing the diameter.
  • step S3 is different from the method for manufacturing the treatment tool 2 described in the above-described first embodiment (FIG. 8).
  • the operator inserts the end effector 101J from the base end side Ar2 of the cap 11J into the inside of the cap 11J. Then, the operator moves the cap 11J to the proximal end side Ar2 while inserting the end of the first direction Ar3 in the spatula portion 1014 into the slit 206, whereby the spatula portion 1014 is moved to the tip of the cap 11J. It protrudes from the side Ar1.
  • the operator moves the cap 11J to the base end side Ar2 and inserts the engaging portion 201 into the inside of the sheath 8. Then, the cap 11J is attached to the sheath 8 by locking the claw portion 2011 to the locking opening 811. That is, the cap 11J is attached to the sheath 8 by the snap-fit method.
  • step S4 when the tube TU is attached, the tip of the tube TU is located on the outer peripheral surface of the connecting portion 202 as shown in FIG. 44.
  • the external dimensions of the first and second directions Ar3 and Ar4 on the overhanging surface 2031 are abbreviated as the external dimensions of the first and second directions Ar3 and Ar4 at the tip of the tube TU. It is the same. Further, the external dimensions of the first and second directions Ar3 and Ar4 on the overhanging surface 2031 may be equal to or less than the external dimensions of the first and second directions Ar3 and Ar4 at the tip of the tube TU, respectively.
  • the tube TU is provided at a position that straddles the boundary between the sheath 8 and the cap 11J and covers the outer peripheral surface of the sheath 8 and the outer peripheral surface of the cap 11J, respectively. Further, in the sheath 8 and the cap 11J, the portion of the engaging portion 201 corresponds to the overlapping region according to the present invention that overlaps in the radial direction. Then, the tube TU covers the overlap region.
  • the twelfth embodiment will be described.
  • 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.
  • the configuration of the tip portion of the treatment tool main body 4 (the configuration of the vibration transmission member 10 and the cap 11) is different from that of the first embodiment described above.
  • the treatment tool 2 according to the twelfth embodiment will be referred to as a treatment tool 2K.
  • the treatment tool main body 4 according to the twelfth embodiment is referred to as a treatment tool main body 4K.
  • the cap 11 according to the twelfth embodiment is referred to as a cap 11K.
  • the vibration transmission member 10 according to the twelfth embodiment is referred to as the vibration transmission member 10J because it has the same shape as the vibration transmission member 10J described in the above-described eleventh embodiment.
  • FIG. 47 and 48 are views showing the tip portion of the treatment tool main body 4K according to the twelfth embodiment. Specifically, FIG. 47 is a diagram showing a state in which the spatula portion 1014 is inserted into the inside of the cap 11K.
  • FIG. 48 is a diagram showing the appearance of the treatment tool main body 4K.
  • the cap 11K is made of a resin material such as PTFE or PFA having electrical insulation. As shown in FIG. 47 or FIG. 48, the cap 11K includes a first member 211 and a second member 212.
  • the first member 211 is provided on the proximal end side Ar2 with respect to the second member 212. As shown in FIG. 47, the first member 211 includes an engaging portion 213 having the same shape as the engaging portion 201 described in the above-described eleventh embodiment. That is, the engaging portion 213 includes a pair of claw portions 2131 similar to the pair of claw portions 2011 described in the above-described eleventh embodiment.
  • the first member 212 is swingable along the second direction Ar4 by the connecting portion 214 (FIG. 47) extending from the end portion of the distal end side Ar1 in the engaging portion 213 toward the distal end side Ar1. It is connected to the member 211 of.
  • the second member 212 includes a connecting portion 215 and a tip portion 216.
  • the connecting portion 215 has a cylindrical shape coaxial with the central axis Ax, and is connected to the end portion of the distal end side Ar1 in the connecting portion 214. In the twelfth embodiment, the inner diameter dimension of the connecting portion 215 is smaller than the width dimension of the spatula portion 1014.
  • the tip portion 216 has a substantially cylindrical shape coaxial with the central axis Ax, and is provided at the end portion of the tip side Ar1 in the connection portion 215.
  • the tip portion 216 has a larger outer diameter than the connection portion 215. That is, on the outer peripheral surface of the second member 212, a step portion 217 (FIGS. 47 and 48) is provided between the tip portion 216 and the connecting portion 215.
  • the outer peripheral surface of the tip portion 216 has an overhanging surface 2161 (FIG. 48) that projects outward in the radial direction of the tip portion 216.
  • the overhanging surface 2161 is a surface in contact with the stepped portion 217 and corresponds to the overhanging portion according to the present invention.
  • the inner diameter dimension of the tip portion 216 is smaller than the width dimension of the spatula portion 1014.
  • the outer diameter dimension of the tip portion 216 is smaller than the outer diameter dimension of the engaging portion 213 which is the base end portion of the cap 11K. Further, the external dimension of the first direction Ar3 at the tip portion 216 is smaller than the width dimension of the spatula portion 1014.
  • the tip portion 216 has a function of securing a field of view of an operator or the like who uses the treatment tool main body 4K by reducing the diameter.
  • step S3 is different from the method for manufacturing the treatment tool 2 described in the above-described first embodiment (FIG. 8).
  • step S3 according to the twelfth embodiment as shown in FIG. 47, the operator inserts the end effector 101J from the proximal end side Ar2 of the engaging portion 213 into the inside of the engaging portion 213.
  • the cap 11K is made of a relatively soft material such as PTFE or PFA, the operator can deform the cap 11K and end the cap 11K from the base end side of the connection portion 215 to the inside of the connection portion 215. Insert the effector 101J.
  • the spatula portion 1014 protrudes from the tip end side Ar1 of the tip portion 216.
  • the second member 212 is the second member from the upper side to the lower side in FIG. 47, following the curved shape of the spatula portion 1014 as the end effector 101J is inserted into the inside. Move until the central axis of 212 matches the central axis Ax. Then, the cap 11K is attached to the sheath 8 by locking the claw portion 2131 to the locking opening 811. That is, the cap 11K is attached to the sheath 8 by the snap-fit method.
  • step S4 when the tube TU is attached, the tip of the tube TU is located on the outer peripheral surface of the connecting portion 215 as shown in FIG. 48.
  • the diameter dimension on the overhanging surface 2161 is substantially the same as the outer diameter dimension at the tip of the tube TU. Further, the diameter dimension of the overhanging surface 2161 may be equal to or less than the outer diameter dimension at the tip of the tube TU, or may be greater than or equal to the outer diameter dimension at the tip of the tube TU.
  • the tube TU is provided at a position that straddles the boundary between the sheath 8 and the cap 11K and covers the outer peripheral surface of the sheath 8 and the outer peripheral surface of the cap 11K, respectively. Further, in the sheath 8 and the cap 11K, the portion of the engaging portion 213 corresponds to the overlapping region according to the present invention that overlaps in the radial direction. Then, the tube TU covers the overlap region.
  • the treatment tool according to the present invention is configured to apply both ultrasonic energy and high frequency energy to the target portion, but the present invention is not limited to this, and ultrasonic energy and high frequency energy are not limited to this. , And at least one of the thermal energies may be applied.
  • "giving heat energy to the target portion” means transmitting the heat generated in the heater or the like to the target portion.
  • steps S2 and step S3 may be performed in reverse.
  • the cap 11 is configured not to have the first and second slits 116 and 117, and the cap 11 is configured by an elastic member. Then, in step S3, the end effector 101 is inserted into the inside of the cap 11 while deforming the cap 11, and the end effector 101 is projected from the tip end side Ar1 of the cap 11.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Abstract

La présente invention concerne un outil de traitement 2 équipé d'une gaine cylindrique 8 qui définit une direction d'axe long en s'étendant d'une extrémité de pointe vers une extrémité de base, un capuchon cylindrique 11 fixé à l'extrémité de pointe de la gaine 8, un effecteur terminal 101 qui traite un tissu biologique et qui fait saillie à partir de l'extrémité de pointe du capuchon 11, et un tube TU qui se contracte dans la direction radiale perpendiculaire à la direction d'axe long, et est disposé dans un emplacement qui recouvre la surface circonférentielle externe de la gaine 8 et la surface circonférentielle externe du capuchon 11 tout en chevauchant la limite entre la gaine 8 et le capuchon 11.
PCT/JP2020/019691 2020-05-18 2020-05-18 Outil de traitement, capuchon et procédé de production d'un outil de traitement WO2021234793A1 (fr)

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PCT/JP2020/019691 WO2021234793A1 (fr) 2020-05-18 2020-05-18 Outil de traitement, capuchon et procédé de production d'un outil de traitement

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Application Number Priority Date Filing Date Title
PCT/JP2020/019691 WO2021234793A1 (fr) 2020-05-18 2020-05-18 Outil de traitement, capuchon et procédé de production d'un outil de traitement

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Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2002209903A (ja) * 2001-01-24 2002-07-30 Olympus Optical Co Ltd 超音波処置装置
JP2012070793A (ja) * 2010-09-27 2012-04-12 Fujifilm Corp 内視鏡用処置具
WO2016203978A1 (fr) * 2015-06-18 2016-12-22 オリンパス株式会社 Instrument de traitement haute fréquence

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2002209903A (ja) * 2001-01-24 2002-07-30 Olympus Optical Co Ltd 超音波処置装置
JP2012070793A (ja) * 2010-09-27 2012-04-12 Fujifilm Corp 内視鏡用処置具
WO2016203978A1 (fr) * 2015-06-18 2016-12-22 オリンパス株式会社 Instrument de traitement haute fréquence

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