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WO2018198209A1 - Outil de traitement - Google Patents

Outil de traitement Download PDF

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Publication number
WO2018198209A1
WO2018198209A1 PCT/JP2017/016430 JP2017016430W WO2018198209A1 WO 2018198209 A1 WO2018198209 A1 WO 2018198209A1 JP 2017016430 W JP2017016430 W JP 2017016430W WO 2018198209 A1 WO2018198209 A1 WO 2018198209A1
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WO
WIPO (PCT)
Prior art keywords
jaw
gripping
gripping surface
separation distance
region
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/JP2017/016430
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English (en)
Japanese (ja)
Inventor
智史 堀江
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Olympus Corp
Original Assignee
Olympus Corp
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Olympus Corp filed Critical Olympus Corp
Priority to PCT/JP2017/016430 priority Critical patent/WO2018198209A1/fr
Publication of WO2018198209A1 publication Critical patent/WO2018198209A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/28—Surgical forceps
    • 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

Definitions

  • the present invention relates to a treatment tool.
  • Patent Document 1 a treatment tool for treating (joining (or anastomizing), cutting or the like) a living tissue by applying energy to the living tissue is known (see, for example, Patent Document 1).
  • the treatment tool (surgical treatment tool) described in Patent Document 1 includes first and second jaws that open and close via a pivot pin provided on the proximal side to grip a living tissue, and a first jaw. And a heat generating blade that contacts the living tissue to apply heat energy.
  • the heat generating blade is rotatably supported on the first jaw by a single support pin extending in the width direction of the first jaw.
  • the gripping force applied to the living tissue from the first and second jaws is made in the longitudinal direction of the first and second jaws.
  • a uniform and uniform treatment of living tissue is realized in the longitudinal direction.
  • the present invention has been made in view of the above, and it is an object of the present invention to provide a treatment tool capable of uniformly treating living tissue in the longitudinal direction of the first and second jaws while achieving downsizing. To aim.
  • the treatment tool grips a living tissue between a first jaw having a first gripping surface and the first gripping surface A second jaw having a second gripping surface, and at least one of the first and second jaws, the living body from at least one of the first gripping surface and the second gripping surface And an energy generating unit for generating energy to be applied to the tissue, wherein the first jaw and the second jaw have the first jaw and the second jaw centered on a fulcrum provided on the proximal side.
  • the first jaw and the second jaw are closed by opening and closing at least one of the first jaw and the second jaw, and a cross section orthogonal to the longitudinal direction of the first jaw and the second jaw is Of the second gripping surface and the second gripping surface
  • the direction is divided into a first area, a second area, and a third area located between the first area and the second area, the width direction in the first area
  • the second separation distance between the two gripping surfaces is equal to or greater than the third separation distance between the first gripping surface and the second gripping surface in the third region, and is based on the tip side. Each end is smaller.
  • the treatment tool according to the present invention has the effect of being able to uniformly treat living tissue in the longitudinal direction of the first and second jaws while achieving downsizing.
  • FIG. 1 is a view schematically showing a treatment system according to the first embodiment.
  • FIG. 2 is a view showing a distal end portion of the treatment tool.
  • FIG. 3 is a cross-sectional view taken along line III-III shown in FIG.
  • FIG. 4 is a cross-sectional view taken along the line IV-IV shown in FIG.
  • FIG. 5 is a view showing the distal end portion of the treatment tool according to the second embodiment.
  • 6 is a cross-sectional view taken along the line VI-VI shown in FIG.
  • FIG. 7 is a cross-sectional view taken along the line VII-VII shown in FIG.
  • FIG. 8 is a view showing a gripping portion according to a first modification of the first and second embodiments.
  • FIG. 9 is a view showing a gripping portion according to a first modification of the first and second embodiments.
  • FIG. 10 is a view showing a gripping portion according to a second modification of the first and second embodiments.
  • FIG. 11 is a view showing a gripping portion according to a second modification of the first and second embodiments.
  • FIG. 12 is a view showing a gripping portion according to a second modification of the first and second embodiments.
  • FIG. 13 is a view showing a gripping portion according to a third modification of the first and second embodiments.
  • FIG. 14 is a view showing a gripping portion according to a third modification of the first and second embodiments.
  • FIG. 1 is a view schematically showing a treatment system 1 according to the first embodiment.
  • the treatment system 1 treats (such as bonding (or anastomosis) and dissection) a living tissue by applying thermal energy to the living tissue to be treated.
  • the treatment system 1 includes a treatment tool 2, a control device 3 and a foot switch 4 as shown in FIG.
  • the treatment tool 2 is, for example, a linear surgical treatment tool for treating a living tissue through the abdominal wall.
  • the treatment tool 2 includes a handle 5, a shaft 6, and a grip 7.
  • the handle 5 is a part held by the operator by hand. Further, as shown in FIG. 1, the handle 5 is provided with an operation knob 51.
  • the shaft 6 has a substantially cylindrical shape, and one end (the right end in FIG. 1) is connected to the handle 5. Further, a grip 7 is attached to the other end (left end in FIG. 1) of the shaft 6.
  • An opening / closing mechanism (not shown) for opening and closing the first and second jaws 8 and 9 (FIG.
  • an electric cable C (FIG. 1) connected to the control device 3 passes from the one end side (right end portion side in FIG. 1) to the other end side (in FIG. 1) It is disposed up to the left end side).
  • FIG. 2 is a view showing the distal end portion of the treatment tool 2.
  • the gripping portion 7 is a portion that grips a living tissue to treat the living tissue.
  • the gripping portion 7 is provided with first and second jaws 8 and 9 as shown in FIG. 1 or 2.
  • the first and second jaws 8 and 9 are supported by the other end (left end in FIGS. 1 and 2) of the shaft 6 so as to be able to open and close in the direction of arrow R1 (FIG. 2) Depending on the operation, the living tissue can be grasped.
  • the front end side is the front end side of the holding part 7, Comprising: The left side is meant in FIG. 1, FIG. Further, “proximal side” described below means the right side in FIGS. 1 and 2 on the side of the shaft 6 of the grip 7.
  • the first jaw 8 is disposed below the second jaw 9 in FIGS. 1 and 2.
  • the first jaw 8 includes a first support member 10 and a heat generating structure 11 as shown in FIG.
  • the first support member 10 is a portion in which a part of the shaft 6 is extended to the distal end side, and in FIG. 2, the upper surface is a flat surface, and the longitudinal direction from the distal end to the proximal end of the grip 7 It is formed in a long shape extending in the left and right direction (in FIGS. 1 and 2).
  • the heat generating structure 11 is attached to the upper surface of the first support member 10 in FIG.
  • the heat generating structure 11 generates thermal energy under the control of the control device 3.
  • the heat generating structure 11 includes a treatment member 12 and an energy generating unit 13.
  • the treatment member 12 is a long plate (long plate extending in the longitudinal direction of the grip portion 7) made of high thermal conductivity copper, silver, aluminum, molybdenum, tungsten, graphite, or a composite material thereof. It is a body.
  • first gripping surface 121 for transferring heat energy to the living tissue (applying thermal energy to the living tissue).
  • the detailed shape of the first gripping surface 121 will be described later.
  • the energy generating unit 13 generates energy (thermal energy) to be applied to the living tissue under the control of the control device 3.
  • the energy generation unit 13 functions as a seat heater that generates heat and heats the treatment member 12 by the heat generation.
  • the energy generating unit 13 has a configuration in which a resistance pattern made of a conductive material such as platinum is formed on a high thermal conductivity ceramic substrate such as aluminum nitride or alumina, for example.
  • the resistance pattern is not limited to platinum, and aluminum, SUS or the like may be used.
  • the energy generation unit 13 is provided with the treatment member 12 via the bonding metal layer (for example, a multilayer film made of titanium, platinum and gold) provided on the back side of the surface of the substrate on which the resistance pattern is formed.
  • the back surface of the first holding surface 121 is fixed by using a bonding material having high thermal conductivity which is mainly composed of a ceramic such as AuSn alloy, silver paste, or alumina.
  • two lead wires (not shown) constituting the electric cable C are joined (connected) to both ends (electrode portions) of the resistance pattern.
  • the resistance pattern generates heat when a voltage is applied (energized) through the two lead wires under the control of the control device 3.
  • the heat generation method is not limited to the above-described resistance heating, and a configuration in which heat is generated by another heat generation method may be adopted.
  • the first support member 10 is made of a material having a thermal conductivity lower than that of the treatment member 12 and the energy generation unit 13. Is preferred. Further, a heat insulating member made of a resin or the like having a low thermal conductivity may be disposed between the first support member 10 and the heat generating structure 11.
  • the second jaw 9 comprises a second support member 14 and an opposing plate 15 as shown in FIG.
  • the second support member 14 has a flat surface on the lower surface in FIG. 2 and is formed in an elongated shape extending in the longitudinal direction of the grip portion 7.
  • the second support member 14 is pivotally supported on the shaft 6 at the base end side thereof via the fulcrum P1 and is opened and closed with respect to the first jaw 8 by rotating.
  • the first jaw 8 (first support member 10) is fixed to the shaft 6, and the second jaw 9 (second support member 14) is pivotally supported on the shaft 6.
  • it has composition, it is not restricted to this.
  • both of the first and second jaws 8 and 9 are pivotally supported by the shaft 6 and are respectively pivoted to thereby rotate the first and second jaws 8 and You may employ
  • the first jaw 8 first support member 10
  • the second jaw 9 second support member 14
  • the first jaw 8 The structure which opens and closes with respect to the 2nd jaw 9 may be adopted by rotating.
  • the opposing plate 15 is a long plate (long plate extending in the longitudinal direction of the grip portion 7), and is attached to the flat surface on the lower side of the second support member 14 in FIG. .
  • the lower surface in FIG. 2 functions as a second gripping surface 151 that grips a living tissue between itself and the first gripping surface 121.
  • the second gripping surface 151 is configured as a flat surface.
  • FIG. 3 is a cross-sectional view taken along line III-III shown in FIG.
  • FIG. 4 is a cross-sectional view taken along the line IV-IV shown in FIG.
  • FIG. 3 and FIG. 4 are views in which the gripping portion 7 in a state in which the first and second jaws 8 and 9 are closed is cut at a cutting plane orthogonal to the longitudinal direction of the gripping portion 7.
  • the III-III line shown in FIG. 2 is a line passing through the tip of the grip 7.
  • the IV-IV line shown in FIG. 2 is a line passing through the proximal end of the grip portion 7.
  • a cross section perpendicular to the longitudinal direction of the gripping portion 7 is a first to third regions in the width direction (left and right direction in FIGS. 3 and 4) Partition into Ar1 to Ar3 (FIGS. 3 and 4).
  • the third area Ar3 is an area located between the first and second areas Ar1 and Ar2, and in the first embodiment, it passes the central position in the width direction of the gripping portion 7 and the width It is a plane CP orthogonal to the direction.
  • the first gripping surface 121 When viewed in a cross section orthogonal to the longitudinal direction of the gripping portion 7, the first gripping surface 121 has a mountain-like shape having the third region Ar3 as the apex 122 as shown in FIG. 3 or FIG. . And in the 1st grasping side 121, each side of the both sides of peak 122 functions as the 1st and 2nd slope 123 and 124 concerning the present invention, respectively.
  • the apex 122 is set to abut on the second gripping surface 151 from the distal end to the proximal end with the first and second jaws 8 and 9 closed, as shown in FIG. 3 or 4. .
  • the first and second inclined surfaces 123 and 124 are flat surfaces.
  • a first angle ⁇ 1 (an intersecting angle when the first and second inclined surfaces 123 and 124 are extended respectively) formed by the first and second inclined surfaces 123 and 124 is directed from the distal end to the proximal end It is set to become large according to.
  • the first angle ⁇ 1 is the angle ⁇ 11 (FIG. 3) at the distal end
  • the first angle ⁇ 1 is the angle ⁇ 12 (FIG. 4) larger than the angle ⁇ 11 at the proximal end.
  • the angle ⁇ 11 is, for example, an angle larger than 90 °.
  • the angle ⁇ 12 is an angle smaller than 180 °.
  • the first and second gripping surfaces 121 and 151 By forming the first and second gripping surfaces 121 and 151 as described above, the first and second gripping surfaces 121 and 151 in a state in which the first and second jaws 8 and 9 are closed.
  • the positional relationship is as follows.
  • the first separation distance D1 (FIGS. 3 and 4) between the first and second gripping surfaces 121 and 151 at each position in the width direction of the first inclined surface 123 is the first and second
  • the third separation distance D3 (FIGS. 3 and 4) between the gripping surfaces 121 and 151 of the second embodiment is larger than In the first embodiment, the third separation distance D3 is zero.
  • a second separation distance D2 (FIGS.
  • first and second separation distances D1 and D2 are respectively smaller on the proximal side than on the distal side. More specifically, the first and second separation distances D1 and D2 decrease in the direction from the distal end to the proximal end. For example, while the first separation distance D1 at a position separated by a distance D4 (FIGS. 3 and 4) from the apex 122 in the width direction is the distance D11 (FIG. 3) at the distal end, the distance at the proximal end The distance D12 (FIG. 4) is smaller than D11.
  • the second separation distance D2 at a position separated by a distance D4 from the apex 122 in the width direction is the distance D21 (FIG. 3) at the tip, a distance smaller than the distance D21 at the base It becomes D22 (FIG. 4).
  • the distance D11 and the distance D21 are the same.
  • the distance D12 and the distance D22 are the same. That is, the first gripping surface 121 has a shape that is symmetrical with respect to the plane CP.
  • the foot switch 4 is a portion operated by the operator with a foot. And according to the operation concerned to foot switch 4, ON and OFF of energization from control device 3 to treatment implement 2 (energy generating part 13 (resistance pattern)) are changed. In addition, as a means to switch the said on and off, you may employ
  • the control device 3 is configured to include a CPU (Central Processing Unit) or the like, and centrally controls the operation of the treatment tool 2 in accordance with a predetermined control program. Specifically, the control device 3 applies a voltage to the energy generation unit 13 (resistance pattern) through the electric cable C in response to the operation (operation of power on) of the operator by the operator (operation of power on). The member 12 is heated.
  • a CPU Central Processing Unit
  • the treatment tool 2 according to the first embodiment adopts a structure in which the first and second jaws 8 and 9 are opened and closed via the fulcrum P1 provided on the proximal end side. Therefore, the gripping force applied to the living tissue from the first and second jaws 8 and 9 is strong on the proximal side and weak on the distal side.
  • the first and second separation distances D1 and D2 are respectively larger than the third separation distance D3 and smaller on the proximal side than the distal side.
  • the pressure applied to the living tissue is weakened on the proximal end side where the gripping force is strong
  • the pressure applied to the living tissue is intensified on the tip side where the gripping force is weak.
  • the first and second separation distances D1 and D2 decrease from the distal end toward the proximal end. Therefore, when the biological tissue is gripped by the first and second jaws 8 and 9, the pressure applied to the biological tissue can be made uniform in the longitudinal direction of the first and second jaws 8 and 9. It is possible to treat the living tissue uniformly.
  • the living tissue can be treated uniformly in the longitudinal direction of the first and second jaws 8 and 9 while achieving downsizing. An effect of.
  • the first and second gripping surfaces 121 and 151 have shapes that are symmetrical with respect to the plane CP. Therefore, living tissues can be treated symmetrically with reference to the plane CP.
  • the first and second gripping surfaces 121 and 151 in the third region Ar3 close the first and second jaws 8 and 9, respectively. Contact each other in the state. Therefore, the living tissue can be effectively cut in the plane CP.
  • the energy generating unit 13 is disposed on the back surface of the first gripping surface 121 of the treatment member 12 having the first gripping surface 121 having a mountain shape. It is done. For this reason, in contrast to the configuration in which the energy generating portion 13 is provided on the back surface of the second gripping surface 151 in the opposing plate 15 having the second gripping surface 151 which is a flat surface unlike the first embodiment described above. , Can be effectively dissected living tissue.
  • FIG. 5 is a view showing a distal end portion of a treatment tool 2A according to the second embodiment.
  • 6 is a cross-sectional view taken along the line VI-VI shown in FIG.
  • FIG. 7 is a cross-sectional view taken along the line VII-VII shown in FIG. 5 to 7 correspond to FIGS. 2 to 4, respectively. That is, FIG. 6 is a cross-sectional view showing the tip of the grip 7A.
  • FIG. 7 is a cross-sectional view showing the proximal end of the grip 7A. As shown in FIGS.
  • a treatment tool 2A according to the second embodiment has a shape different from that of the first gripping surface 121 with respect to the treatment tool 2 described in the first embodiment described above.
  • a gripping portion 7A first jaw 8A (heat generating structure 11A (treatment member 12A)) having one gripping surface 121A is employed.
  • the first gripping surface 121A according to the second embodiment is similar to the first gripping surface 121 described in the first embodiment when viewed in a cross section orthogonal to the longitudinal direction of the gripping portion 7A. It has an apex 122 and first and second inclined surfaces 123 and 124. And in the 1st grasping side 121A, as shown in Drawing 6 or Drawing 7, the 1st angle theta1 which the 1st, 2nd slope 123, 124 constitutes is the base end (angle from angle (theta) 11) It becomes large as it goes to (theta) 13 (angle larger than angle (theta) 11), and it is set so that it may become 180 degrees in a proximal end.
  • the first separation distance D1 (FIG. 6, FIG. 7) between the first and second holding surfaces 121A and 151 at each position in the width direction of the first inclined surface 123 and the width of the second inclined surface 124
  • the second separation distance D2 (FIG. 6, FIG. 7) between the first and second gripping surfaces 121A, 151 at each position in the direction is not less than the third separation distance D3 (FIG. 6, FIG. 7) Become.
  • the first and second separation distances D1 and D2 become smaller as going from the tip to the base.
  • the first to third separation distances D1 (D13), D2 (D23), and D3 at the proximal end are zero as shown in FIG. That is, areas ArP (FIG. 5) for meshing adjustment of the first and second gripping surfaces 121A and 151 are provided at the proximal ends of the first and second gripping surfaces 121A and 151, respectively.
  • the first gripping surface 121A has a shape that is symmetrical with respect to the plane CP.
  • the first to third separation distances D1 to D3 become 0 at the proximal ends of the first and second gripping surfaces 121A and 151, respectively.
  • An area ArP for meshing adjustment of the holding surfaces 121A and 151 is provided. Therefore, when the living tissue is gripped by the first and second jaws 8A and 9, the first and second jaws 8A and 9 do not twist or the like, and the living tissue is gripped stably. can do.
  • FIGS. 8 and 9 are views showing a gripping portion 7B according to the first modification of the first and second embodiments.
  • FIG. 8 is a view corresponding to FIG. 3 and FIG. 6, respectively, and is a cross-sectional view showing the tip of the grip 7B.
  • FIG. 9 is a view corresponding to FIGS. 4 and 7, and is a cross-sectional view showing a proximal end of the grip 7B.
  • the first jaw 8B heat generating structure 11B (treatment member 12B)
  • the first gripping surface 121B according to the present modification 1 has curved first and second inclined surfaces 123 and 124 described in the first and second embodiments, respectively. It has the 1st, 2nd curved surface 123B, 124B comprised.
  • the 1st, 2nd grasping sides 121B and 151 in the state where the 1st, 2nd jaws 8B and 9 were closed have the following physical relationships.
  • the second separation distance D2 (FIGS. 8 and 9) between the first and second gripping surfaces 121B and 151 at each position is the third separation distance D3 (see FIG. 8) as in the first embodiment described above. 8, 9), respectively.
  • the first and second separation distances D1 and D2 become smaller as going from the distal end to the proximal end.
  • the first separation distance D1 at a position separated by a distance D4 (FIGS. 8 and 9) from the apex 122 in the width direction is the distance D14 (FIG. 8) at the tip
  • the distance is The distance D15 (FIG. 9) is smaller than D14.
  • the second separation distance D2 at a position separated by a distance D4 in the width direction from the apex 122 is the distance D24 (FIG. 8) at the tip, a distance smaller than the distance D24 at the base It becomes D25 (FIG. 9).
  • the distance D14 and the distance D24 are the same.
  • the distance D15 and the distance D25 are the same. That is, the first gripping surface 121B has a shape that is symmetrical with respect to the plane CP.
  • FIGS. 10 to 12 are views showing a gripping portion 7C according to the second modification of the first and second embodiments.
  • FIG. 10 is a view corresponding to each of FIGS. 3 and 6, and is a cross-sectional view showing the tip of the grip 7C.
  • FIG. 12 is a view corresponding to FIGS. 4 and 7, and is a cross-sectional view showing the proximal end of the grip 7C.
  • FIG. 11 shows a grip 7C in a state in which the first and second jaws 8C and 9 are closed, passing through the central position in the longitudinal direction of the grip 7C, and in a cutting plane orthogonal to the longitudinal direction of the grip 7 FIG.
  • FIGS. 10 to 12 are views showing a gripping portion 7C according to the second modification of the first and second embodiments.
  • the first jaw 8C heat generating structure 11C (treatment member 12C)
  • the first gripping surface 121C according to the second modification is, as shown in FIGS. 10 to 12, the shapes of the first and second inclined surfaces 123 and 124 described in the first and second embodiments described above. It has the modified first and second surfaces 123C and 124C.
  • the first surface 123C is adjacent to the first inclined surface 1231 adjacent to the apex 122 and the first inclined surface 1231, as shown in FIG. 10 to FIG. 12, and the first and second jaws 8C, And 9 has a first flat surface 1232 parallel to the second gripping surface 151 in the closed state.
  • the second surface 124C is adjacent to the second inclined surface 1241 adjacent to the apex 122 and the second inclined surface 1241, and the first and second jaws 8C and 9 are closed.
  • a second flat surface 1242 parallel to the two gripping surfaces 151.
  • the first and second inclined surfaces 1231 and 1241 are flat surfaces.
  • a first angle ⁇ 1 formed by the first and second inclined surfaces 1231 and 1241 is set to increase as it goes from the tip to the base.
  • the first angle ⁇ is the angle ⁇ 16 (FIG. 10) at the distal end, the angle ⁇ 17 (FIG. 11) larger than the angle ⁇ 16 at the central position in the longitudinal direction, and the angle ⁇ 18 (the distance) It becomes FIG. 12).
  • the angle ⁇ 16 is, for example, an angle larger than 90 °.
  • the angle ⁇ 17 is, for example, an angle smaller than 180 °.
  • the first and second flat surfaces 1232 and 1242 are set to be substantially flush.
  • first and second inclined surfaces 1231 and 1241 move from the tip to the base, the length dimension in the width direction increases.
  • first and second flat surfaces 1232 and 1242 decrease in length in the width direction as they go from the distal end to the proximal end.
  • the first separation distance D1 (FIGS. 10 to 12) between the first and second holding surfaces 121C and 151 at each position in the width direction of the first inclined surface 1231 and the width of the second inclined surface 1241
  • the second separation distance D2 (FIGS. 10 to 12) between the first and second gripping surfaces 121C and 151 at each position in the second direction is the third separation distance D3 as in the first embodiment described above. (FIGS. 10 to 12).
  • the first and second separation distances D1 and D2 become smaller as going from the distal end to the proximal end.
  • the first separation distance D1 at a position separated by a distance D4 (FIGS. 10 to 12) from the apex 122 in the width direction is the distance D16 (FIG. 10) at the tip, and from the distance D16 at the central position in the longitudinal direction
  • the distance D18 (FIG. 12) is smaller than the distance D17 at the proximal end.
  • the second separation distance D2 at a position separated by a distance D4 in the width direction from the apex 122 is the distance D26 (FIG.
  • the distance D28 (FIG. 22) is smaller than the distance D27.
  • the distance D16 and the distance D26 are the same.
  • the distance D17 and the distance D27 are the same.
  • the distance 18 and the distance D28 are the same. That is, the first gripping surface 121C has a shape that is symmetrical with respect to the plane CP.
  • FIG. 13 and 14 are views showing a gripping portion 7D according to the third modification of the first and second embodiments.
  • FIG. 13 is a view corresponding to FIG. 3 and FIG. 6, and is a cross-sectional view showing the tip of the grip 7D.
  • FIG. 14 is a view corresponding to FIGS. 4 and 7, and is a cross-sectional view showing the proximal end of the grip 7D.
  • Two jaws 9D (counter plate 15D) may be adopted. As shown in FIG.
  • the second gripping surface 151D takes the third region Ar3 as the vertex 152 when viewed in a cross section orthogonal to the longitudinal direction of the gripping portion 7D. It has a mountain shape.
  • the first and second inclined surfaces 153 and 154 located on both sides of the apex 152 are flat surfaces. Further, the angle formed by the first and second inclined surfaces 153 and 154 is set to the same angle from the tip to the base. In addition, the said angle is an angle larger than 90 degrees, for example.
  • the first separation distance D1 (FIGS. 13 and 14) between the first and second holding surfaces 121 and 151D at each position in the width direction of the first inclined surface 123 and the width of the second inclined surface 124
  • the second separation distance D2 (FIGS. 13 and 14) between the first and second gripping surfaces 121 and 151D at each position in the direction is the third separation distance D3 as in the first embodiment described above. (FIGS. 13 and 14) respectively.
  • the first and second separation distances D1 and D2 become smaller as going from the distal end to the proximal end.
  • the first separation distance D1 at a position separated by a distance D4 (FIGS. 13 and 14) from the apex 122 in the width direction is the distance D19 (FIG. 13) at the tip
  • the distance is The distance D10 (FIG. 14) is smaller than D19.
  • the second separation distance D2 at a position separated by a distance D4 from the apex 122 in the width direction is the distance D29 (FIG. 13) at the tip, a distance smaller than the distance D29 at the base It becomes D20 (FIG. 14).
  • the distance D19 and the distance D29 are the same. Further, the distance D10 and the distance D20 are the same. That is, the second gripping surface 151D has a shape that is symmetrical with respect to the plane CP. Even when the configurations of the first to third modifications described above are adopted, the same effects as those of the first and second embodiments can be obtained.
  • the width of the third area Ar3 is increased, and the first gripping surfaces 121 and 121A to 121C in the third area Ar3 are orthogonal to the plane CP. It may be configured with a flat surface. Further, the third area Ar3 is not limited to the center position in the width direction of the gripping portions 7, 7A to 7D, and may be a position shifted to one side in the width direction. Although the third separation distance D3 is set to 0 in the first and second embodiments and the first to third modifications described above, the third separation distance D3 is not limited to this and may be set to a distance larger than 0. Absent.
  • the configuration for generating thermal energy has been exemplified as the energy generation unit according to the present invention.
  • the present invention is not limited thereto. You may adopt the structure which generate

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  • Surgical Instruments (AREA)

Abstract

La présente invention concerne un outil de traitement (2) selon lequel, lorsqu'une coupe transversale orthogonale au sens longitudinal des première et seconde mâchoire (8, 9) en un état fermé des première et seconde mâchoire (8, 9) est divisée en une première région et une seconde région dans le sens de la largeur des première et seconde surface de maintien (121, 151), et une troisième région positionnée entre la première région et la seconde région, une première distance de séparation entre les première et seconde surface de maintien (121, 151) à une position prédéterminée dans le sens de la largeur dans la première région et une seconde distance de séparation entre les première et seconde surface de maintien (121, 151) à une position prédéterminée dans le sens de la largeur dans la seconde région égale ou supérieure à une troisième distance de séparation entre les première et seconde surface de maintien (121, 151) dans la troisième région, et qui sont plus petites vers une extrémité proximale que vers une extrémité distale.
PCT/JP2017/016430 2017-04-25 2017-04-25 Outil de traitement Ceased WO2018198209A1 (fr)

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PCT/JP2017/016430 WO2018198209A1 (fr) 2017-04-25 2017-04-25 Outil de traitement

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/JP2017/016430 WO2018198209A1 (fr) 2017-04-25 2017-04-25 Outil de traitement

Publications (1)

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WO2018198209A1 true WO2018198209A1 (fr) 2018-11-01

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PCT/JP2017/016430 Ceased WO2018198209A1 (fr) 2017-04-25 2017-04-25 Outil de traitement

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Country Link
WO (1) WO2018198209A1 (fr)

Citations (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2005177238A (ja) * 2003-12-22 2005-07-07 Olympus Corp 医療器械

Patent Citations (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2005177238A (ja) * 2003-12-22 2005-07-07 Olympus Corp 医療器械

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