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WO2018131126A1 - Outil de traitement thermique - Google Patents

Outil de traitement thermique Download PDF

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Publication number
WO2018131126A1
WO2018131126A1 PCT/JP2017/000849 JP2017000849W WO2018131126A1 WO 2018131126 A1 WO2018131126 A1 WO 2018131126A1 JP 2017000849 W JP2017000849 W JP 2017000849W WO 2018131126 A1 WO2018131126 A1 WO 2018131126A1
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WO
WIPO (PCT)
Prior art keywords
distance
gripping piece
width direction
treatment
heat
Prior art date
Application number
PCT/JP2017/000849
Other languages
English (en)
Japanese (ja)
Inventor
武井　祐介
千博 田中
智之 高篠
庸高 銅
岡田　光正
Original Assignee
オリンパス株式会社
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 オリンパス株式会社 filed Critical オリンパス株式会社
Priority to PCT/JP2017/000849 priority Critical patent/WO2018131126A1/fr
Publication of WO2018131126A1 publication Critical patent/WO2018131126A1/fr

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Classifications

    • 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
    • A61B18/08—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by means of electrically-heated probes
    • 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
    • A61B18/14—Probes or electrodes therefor

Definitions

  • the present invention relates to a thermal treatment instrument that treats a treatment target using heat.
  • a thermal treatment instrument that grasps a treatment target such as a living tissue between a pair of grasping pieces (jaws) and treats the grasped treatment target with heat.
  • a treatment target such as a living tissue between a pair of grasping pieces (jaws) and treats the grasped treatment target with heat.
  • one of the grip pieces includes a facing surface facing the other of the grip pieces and a blade (heat transfer member) that forms a part of the facing surface.
  • the center part protrudes toward the other holding piece.
  • a heating part (heater) that generates heat when a current flows is attached to the central part of the blade on a surface facing the opposite side of the opposing surface. The heat generated in the heat generating part is transmitted to the blade and applied to the treatment target grasped through the opposing surface of the blade. By applying heat to the treatment target, the treatment target is coagulated and incised.
  • the facing surface is inclined toward the back side of the gripping piece from the center toward the outside. For this reason, the distance between the blade and the back surface is reduced in the side portion of the gripping piece. In this case, the heat of the blade is easily transmitted to the back surface of the gripping piece.
  • This invention was made in order to solve the said subject, and the place made into the objective is providing the heat treatment tool by which heat was suppressed to be transmitted to the back surface of a holding piece.
  • a thermal treatment instrument includes a first grip piece, a second grip piece that opens and closes with respect to the first grip piece, and the first grip piece. And a heat generating portion that generates heat when an electric current flows, and a treatment surface that is provided on the first gripping piece to transmit heat from the heat generating portion and that faces the second gripping piece.
  • a heat transfer member that is provided on the outer surface of the first gripping piece and facing the opposite side of the treatment surface; and provided on the second gripping piece, facing the treatment surface, and Having a contact position that contacts the treatment surface in a state where the gap between one grip piece and the second grip piece is closed, and the width direction intersecting the opening / closing direction of the second grip piece
  • An inclined surface that moves away from the first gripping piece as it moves away from the contact position, and the first gripping And the second gripping piece are closed, the distance between the contact position and the back surface in the opening / closing direction is a first distance
  • the treatment surface is The distance in the opening / closing direction between the distal end farthest in the width direction and the back surface is a second distance, and the distal end farthest in the width direction from the contact position on the inclined surface
  • the second distance is equal to or greater than the first distance
  • the third distance is greater than the second distance.
  • FIG. 1 is a schematic diagram showing a treatment system in which the thermal treatment tool according to the first embodiment is used.
  • FIG. 2 is a perspective view schematically showing the end effector according to the first embodiment.
  • FIG. 3 is a diagram schematically showing a cross section substantially perpendicular to the longitudinal axis of the end effector according to the first embodiment.
  • FIG. 4 is a diagram schematically showing a cross section substantially perpendicular to the longitudinal axis of the end effector according to the first modification example of the first embodiment.
  • FIG. 5 is a diagram schematically showing a cross section substantially perpendicular to the longitudinal axis of the end effector according to the second embodiment.
  • FIG. 1 is a schematic diagram showing a treatment system in which the thermal treatment tool according to the first embodiment is used.
  • FIG. 2 is a perspective view schematically showing the end effector according to the first embodiment.
  • FIG. 3 is a diagram schematically showing a cross section substantially perpendicular to the longitudinal axis of the end effector according
  • FIG. 6 is a diagram schematically showing a cross section substantially perpendicular to the longitudinal axis of the end effector according to the first modification example of the second embodiment.
  • FIG. 7 is a diagram schematically showing a cross section substantially perpendicular to the longitudinal axis of the end effector according to the second modification example of the second embodiment.
  • FIG. 8 is a diagram schematically showing a cross section substantially perpendicular to the longitudinal axis of the end effector according to the third modification example of the second embodiment.
  • FIG. 1 is a diagram illustrating a treatment system in which an energy treatment device 1 that is a thermal treatment device of the present embodiment is used.
  • the energy treatment device 1 has a longitudinal axis C.
  • a direction along the longitudinal axis C is defined as a longitudinal direction.
  • One side in the longitudinal direction is defined as the distal end side (arrow C1 side), and the opposite side to the distal end side is defined as the proximal end side (arrow C2 side).
  • the energy treatment device 1 of this embodiment is a heat treatment device that treats a treatment target grasped using heat, and includes two treatment electrodes, and a high-frequency current (high-frequency energy) that flows between these electrodes. ) Is a bipolar high-frequency treatment instrument that treats a treatment target grasped using the In addition, the structure for using a high frequency current (high frequency energy) does not need to be provided.
  • the energy treatment device 1 includes a housing 4 that can be held, a shaft 5 that is connected to the distal end side of the housing 4, and an end effector 6 that is provided at the distal end of the shaft 5.
  • One end of a cable 7 is connected to the housing 4.
  • the other end of the cable 7 is detachably connected to the power supply unit 3.
  • the power supply unit 3 converts electric power from the battery power supply or the outlet power supply into electric energy supplied to the energy treatment device 1, and outputs the converted electric energy to the energy treatment device 1.
  • An operation button 19 is attached to the housing 4 as an energy operation input unit. By pressing the operation button 19, an operation (signal) for outputting electric energy to the energy treatment tool 1 is input to the power supply unit 3.
  • a foot switch or the like separate from the energy treatment device 1 may be provided as the energy operation input unit.
  • the housing 4 is provided with a grip (fixed handle) 11 and a handle (movable handle) 12 that is rotatably attached.
  • the handle 12 When the handle 12 is rotated with respect to the housing 4, the handle 12 is opened or closed with respect to the grip 11.
  • the handle 12 is positioned on the distal end side with respect to the grip 11, and moves substantially parallel to the longitudinal axis C in the opening or closing operation with respect to the grip 11, but this is not restrictive. Absent.
  • the handle 12 may be located proximal to the grip 11.
  • the handle 12 is located on the side opposite to the grip 11 with respect to the longitudinal axis C, and the moving direction in the opening or closing operation with respect to the grip 11 intersects with the longitudinal axis C. (It may be substantially vertical).
  • the shaft 5 is extended along the longitudinal axis C.
  • the end effector 6 includes a first gripping piece 13 and a second gripping piece 14 that opens and closes between the first gripping piece 13.
  • the outer surface of the first gripping piece 13 includes a first facing surface 16 that faces the second gripping piece 14, and a back surface 20 that faces away from the first facing surface 16.
  • the outer surface of the second gripping piece 14 includes a second facing surface 17 that faces the first facing surface 16 of the first gripping piece 13.
  • the handle 12 and the second gripping piece 14 are connected via a movable member 18 extending along the longitudinal axis C inside the shaft 5.
  • the movable member 18 moves along the longitudinal axis C with respect to the shaft 5 and the housing 4 by opening or closing the handle 12 that is an opening / closing operation input unit with respect to the grip 11, and between the pair of gripping pieces 13 and 14. Opens or closes.
  • a living tissue such as a blood vessel is gripped as a treatment target between the first gripping piece 13 and the second gripping piece 14.
  • the gripping pieces 13 and 14 are extended along the longitudinal direction.
  • the first gripping piece 13 is fixed to the shaft 5, and the second gripping piece 14 is rotatably attached to the distal end portion of the shaft 5.
  • the first grip piece 13 and the second grip piece 14 are provided at the tip of the shaft 5 and can be opened and closed between the first grip piece 13 and the second grip piece 14.
  • the first gripping piece 13 is formed integrally with the shaft 5.
  • the 2nd holding piece 14 is attached to the front-end
  • both the first grip piece 13 and the second grip piece 14 are pivotally attached to the tip of the shaft 5.
  • FIG. 2 is a perspective view showing the first gripping piece 13.
  • FIG. 3 is a view showing the first gripping piece 13 and the second gripping piece 14.
  • FIG. 3 shows a cross section substantially perpendicular to the longitudinal axis C.
  • the opening and closing directions of the first grip piece 13 and the second grip piece 14 are substantially perpendicular to (intersect) the longitudinal axis C.
  • the side where the second gripping piece 14 is located with respect to the first gripping piece 13 is the upper side (the arrow Y1 side in FIGS. 1 and 3), and the first gripping piece 14 is the first side.
  • the side on which the grip piece 13 is located is the lower side (the arrow Y2 side in FIGS. 1 and 3).
  • a direction intersecting the longitudinal axis C (substantially perpendicular) and intersecting the opening / closing direction (substantially perpendicular) is defined as a width direction of the first gripping piece 13 and the second gripping piece 14.
  • the first gripping piece 13 includes a support member 41 and a heat generating unit 30.
  • the heat generating unit 30 is provided on the upper side of the support member 41.
  • the support member 41 is made of a material having low thermal conductivity and low conductivity (that is, high electrical resistance).
  • the support member 41 is preferably formed from a material having electrical insulation.
  • the support member 41 is made of, for example, a heat resistant resin.
  • the support member 41 includes a support surface 42 facing upward. Further, the back surface 20 is formed by the support member 41 on the outer surface of the first gripping piece 13.
  • the heat generating unit 30 includes a blade (heat transfer member) 43 and a heat generating unit 40.
  • the blade 43 is a plate-like member that extends from the proximal end portion to the distal end portion of the first gripping piece 13.
  • the blade 43 is attached to the support surface 42 of the support member 41 from above.
  • the blade 43 is formed of a material having high thermal conductivity and conductivity.
  • a copper alloy, an aluminum alloy, or the like is used.
  • the first facing surface 16 includes a treatment surface 47 formed by the blade 43. On the treatment surface 47, heat and high-frequency current (high-frequency energy) are applied to the treatment object held between the second facing surface 17.
  • the treatment surface 47 is provided at the center of the first facing surface 16 in the width direction. In the present embodiment, a part of the first facing surface 16 is formed by the treatment surface 47 of the blade 43.
  • the first facing surface 16 and the blade 43 extend substantially parallel to the longitudinal direction and substantially parallel to the width direction of the first gripping piece 13.
  • the treatment surface 47 is a plane substantially parallel to the width direction of the first grip piece 13.
  • the blade 43 includes an installation surface 45 on the side opposite to the treatment surface 47.
  • the installation surface 45 is a surface facing away from the first facing surface 16, that is, a lower side.
  • the installation surface 45 is in contact with the support surface 42 of the support member 41 from above.
  • the heating surface (heater) 40 that generates heat when an electric current flows is attached to the installation surface 45.
  • the heat generating portion 40 is disposed between the support surface 42 of the support member 41 and the installation surface 45 of the blade 43.
  • the heat generating unit 40 includes a reference surface 52 that faces away from a surface (facing surface) that contacts the installation surface 45 of the blade 43.
  • the reference surface 52 is a surface facing downward.
  • the reference surface 52 faces or is in close contact with the support surface 42 of the support member 41.
  • the heat generating part 40 is electrically connected to the power supply unit 3 via an electric path (not shown) extending through the inside of the first gripping piece 13, the inside of the shaft 5, the inside of the housing 4 and the inside of the cable 7. It is connected to the. Heat is generated in the heat generating part 40 by supplying electric energy (DC power or AC power) from the power supply unit 3 to the heat generating part 40 via this electric path. The heat generated in the heat generating part 40 is transmitted to the blade 43 through the installation surface 45. The heat transferred to the blade 43 is transferred to the entire blade 43.
  • the blade 43 is electrically connected to the power supply unit 3 through an electric path (not shown) extending through the inside of the first gripping piece 13, the inside of the shaft 5, the inside of the housing 4, and the inside of the cable 7. Connected.
  • the blade 43 functions as a (first) electrode when electric energy (high-frequency power) is supplied from the power supply unit 3.
  • the second gripping piece 14 includes a support member 31.
  • the support member 31 is formed of a material having electrical insulation.
  • a heat resistant resin such as PTFE (polytetrafluorethylene) is used.
  • the support member 31 forms the back surface of the second gripping piece 14 on the outer surface of the second gripping piece 14.
  • the conductive member 36 is fixed to the support member 31.
  • the conductive member 36 is fixed to the support member 31 from below.
  • the conductive member 36 is made of a conductive material such as metal.
  • the conductive member 36 includes an electrode surface 37 that forms a part of the second facing surface 17.
  • the electrode surface 37 is formed in a state of separating from the first facing surface 16 as it departs from the center in the width direction.
  • the electrode surface 37 is an inclined surface that is inclined with respect to the width direction. That is, the electrode surface 37 is inclined so as to go to the back side of the second gripping piece 14 as it goes outward in the width direction.
  • the support member 31 includes a protrusion 35 that protrudes from between the electrode surfaces 37 of the conductive member 36 toward the first gripping piece 13 on the second facing surface 17.
  • the protruding portion 35 forms a central portion of the second facing surface 17 in the width direction, and the center protrudes toward the first facing surface 16 side.
  • the projecting portion 35 is formed in a state of separating from the first facing surface 16 as it departs from the center in the width direction. That is, the projecting end surface of the projecting portion 35 is inclined so as to be directed toward the back side of the second gripping piece 14 toward the outside in the width direction.
  • the protrusion 35 is provided at the center of the second facing surface 17 in the width direction.
  • the electrode surface 37 is arranged with the protruding portion 35 sandwiched from both sides in the width direction. Therefore, the portion formed by the electrode surface 37 and the protruding portion 35 in the second facing surface 17 is an inclined surface that is inclined in a state toward the opposite side to the first gripping piece 13 from the center to the outside in the width direction. 38. That is, the second facing surface 17 includes an inclined surface 38 that is inclined toward the back side of the second gripping piece 14 toward the outside in the width direction.
  • the conductive member 36 is electrically connected to the power supply unit 3 through an electric path (not shown) extending through the inside of the second gripping piece 14, the inside of the shaft 5, the inside of the housing 4, and the inside of the cable 7. It is connected to the.
  • the conductive member 36 functions as a (second) electrode different from the first electrode (43) provided on the first gripping piece 13 when electric energy (high-frequency power) is supplied from the power supply unit 3. .
  • Electric energy (high frequency) is applied to each of the first electrode (blade 43) and the second electrode (conductive member 36) in a state where the treatment target is held between the first holding piece 13 and the second holding piece 14. Is supplied between the treatment surface 47 of the first facing surface 16 and the electrode surface 37 of the second facing surface 17 through the treatment target to be grasped.
  • the treatment surface 47 is a high-frequency treatment surface that applies a high-frequency current (high-frequency energy) to the treatment target grasped between the first grasping piece 13 and the second grasping piece 14.
  • the second facing The protruding portion 35 of the surface 17 contacts the center of the treatment surface 47 of the first facing surface 16.
  • the treatment surface 47 of the first facing surface 16 and the electrode surface 37 of the second facing surface 17 are not in contact with each other. That is, the 1st electrode (43) provided in the 1st holding piece 13 and the 2nd electrode (36) provided in the 2nd holding piece 14 do not contact.
  • the protrusion part 35 has electrical insulation. That is, an insulating part is formed on the inclined surface 38 by the protrusion 35. For this reason, a short circuit due to contact between the first electrode and the second electrode is prevented. That is, the protrusion 35 is an abutting member provided on the second facing surface 17 (the inclined surface 38) and having electrical insulation.
  • the first facing surface 16 is in contact with the second facing surface 17 of the second gripping piece 14 in a state where the space between the first gripping piece 13 and the second gripping piece 14 is closed.
  • the contact position P1 is provided.
  • the first contact position P1 is located at the center of the first facing surface 16 in the width direction.
  • the second facing surface 17 is a first contact position P1 of the first facing surface 16 of the first gripping piece 13 in a state where the space between the first gripping piece 13 and the second gripping piece 14 is closed. Is provided with a second contact position P2.
  • the second contact position P2 is located at the center of the second facing surface 17 in the width direction.
  • the position located on the lowermost side of the reference surface 52 of the heat generating portion 40 is defined as P3.
  • the blade 43 is formed substantially parallel to the width direction on the upper side of the heat generating portion 40. Therefore, the heat generating part 40 is located below the blade 43.
  • the position P3 is a position located on the lowermost side in the heat generating unit 30. That is, the position P3 is the position closest to the back surface 20 in the heat generating unit 30, and at the position P3, the distance in the opening / closing direction from the back surface 20 in the heat generating unit 30 is minimum.
  • the position located on the lowermost side of the back surface 20 is P4.
  • the position P4 is located at the center of the back surface 20 in the width direction.
  • the distance in the opening / closing direction from the reference surface 52 to the back surface 20 of the heat generating unit 40 of the heat generating unit 30 is L.
  • the distance L is a distance between the position P3 and the position P4. In the present embodiment, the distance L is the distance from the position (P3) closest to the back surface 20 to the back surface 20 (P4) in the heat generating unit 30.
  • the distance in the opening / closing direction from the contact position P1 of the first facing surface 16 to the back surface 20 is defined as A0 (first distance).
  • the distance A0 is a distance between the position P1 and the position P4.
  • the dimension (thickness) of the heat generating unit 30 in the opening / closing direction is sufficiently thinner than the dimension (thickness) of the first gripping piece 13 in the opening / closing direction.
  • the thickness T of the heat generating unit 30 is formed to be not more than one fifth of the thickness (T + L) of the first gripping piece 13.
  • position P5 is located on the treatment surface 47 at the distal end from the center in the width direction.
  • the distance in the opening / closing direction from the distal end (P5) to the center (P1) is B1 (not shown).
  • the treatment surface 47 is formed substantially parallel to the width direction. For this reason, the distal end (P5) and the center (P1) of the treatment surface 47 are located at substantially the same position in the opening / closing direction. Therefore, the distance B1 in the opening / closing direction between the position P5 and the position P1 is zero.
  • the distance in the opening / closing direction from the distal end (P5) of the treatment surface 47 to the back surface 20 (P4) is A1 (second distance).
  • the distance A1 is a distance in the opening / closing direction between the position P5 and the position P4.
  • the angle ⁇ 1 (not shown) of the treatment surface 47 with respect to the width direction is zero.
  • the second facing surface 17 is inclined with respect to the width direction.
  • the inclination angle ⁇ 2 (not shown) of the second facing surface 17 with respect to the width direction is larger than the angle ⁇ 1 of the treatment surface 47 with respect to the width direction. That is, ⁇ 2> ⁇ 1.
  • a position of the inclined surface 38 of the second facing surface 17 that is farthest from the contact position P2 with the first gripping piece 13 in the width direction is defined as a position P6.
  • the position P6 is located on the inclined surface 38 of the second facing surface 17 at the distal end from the center (P2) in the width direction.
  • the position P6 is located above the contact position P2.
  • the position P6 is located above the position P5 of the treatment surface 47.
  • the distance in the opening / closing direction from the distal end (P6) to the center (P2) from the center is B2.
  • the distance B1 in the opening / closing direction between the position P5 and the position P1 on the treatment surface 47 is substantially zero. For this reason, B2> B1 holds.
  • the distance in the opening / closing direction from the distal end (P6) of the inclined surface 38 to the back surface 20 (P4) is A2 (third distance).
  • the distal end P5 of the treatment surface 47 may be a distal end farthest in the width direction from the contact position P1 on the first facing surface 16. In this case, both edges in the width direction of the first facing surface 16 are formed by the treatment surface 47. Further, the distal end P5 of the treatment surface 47 may be located at a position closer to the contact position P1 than the distal end of the first facing surface 16. In this case, a portion of the first facing surface 16 between the distal end P5 of the treatment surface 47 and the distal end of the first facing surface 16 is formed by the support member 41, for example.
  • the distal end P6 of the inclined surface 38 may be the distal end farthest in the width direction from the contact position P2 on the second facing surface 17. In this case, both edges in the width direction of the second facing surface 17 are formed by the inclined surfaces 38. Further, the distal end P6 of the inclined surface 38 may be located at a position closer to the contact position P2 than the distal end of the second facing surface 17. In this case, on the second facing surface 17, a plane substantially parallel to the width direction is formed between the distal end P ⁇ b> 6 of the inclined surface 38 and the distal end of the second facing surface 17. The flat surface extends from the distal end P6 of the inclined surface 38 toward the side away from the contact position P2 in the width direction. Further, the second facing surface 17 may be inclined with respect to the width direction over the entire width direction, and a part from the contact position P2 is inclined with respect to the width direction in the width direction. Also good.
  • the operation and effect of the energy treatment device 1 of the present embodiment will be described.
  • the operator holds the housing 4 of the energy treatment device 1 and inserts the end effector 6 into a body cavity such as the abdominal cavity.
  • a treatment target such as a blood vessel is disposed between the gripping pieces 13 and 14, and the handle 12 is closed with respect to the grip 11 to close the space between the gripping pieces 13 and 14.
  • a living tissue such as a blood vessel is gripped between the gripping pieces 13 and 14.
  • Electric energy is supplied from the power supply unit 3 to the heat generating unit 40 by performing an operation input with the energy operation input unit (operation button 19) in a state where the treatment target is held between the holding pieces 13 and 14.
  • the By supplying electrical energy to the heat generating part 40 heat is generated in the heat generating part 40.
  • Heat generated in the heat generating part 40 is transmitted to the blade 43.
  • the blade 43 is made of a material having a high thermal conductivity. For this reason, the heat transmitted from the heat generating part 40 is transmitted to the entire blade 43. Then, heat is applied to the living tissue from the treatment surface 47 of the blade 43 on the first facing surface 16.
  • the treatment surface 47 is a heat application unit that supplies (applies) heat to the treatment object gripped on the first facing surface 16.
  • the blade 43 as the first electrode and the conductive member 36 as the second electrode are supplied with power. Electric energy (high frequency power) is supplied from the unit 3.
  • Electric energy high frequency power
  • the treatment surface 47 between the treatment surface 47 of the first facing surface 16 and the electrode surface 37 of the second facing surface 17 pass through the treatment target to be grasped.
  • High-frequency current flows through
  • a high frequency current is applied to the treatment target gripped between the first facing surface 16 and the second facing surface 17. That is, high frequency energy is supplied between the first facing surface 16 and the second facing surface 17.
  • the treatment surface 47 is a high-frequency application unit that supplies (applies) high-frequency current (high-frequency energy) to the treatment target gripped on the first facing surface 16.
  • the blade 43 forming the heat application portion (47) is formed in a convex shape with the center portion protruding toward the other gripping piece (14) side,
  • the 2nd opposing surface 17 is formed in the concave shape where a center part is dented.
  • the treatment surface 47 of the blade 43 is inclined downward as it goes away from the center in the width direction. For this reason, the blade 43 approaches the back surface 20 at the side portion (outer portion) of the first gripping piece 13 in the width direction.
  • the heat transfer path formed between the blade 43 and the back surface 20 is shortened. For this reason, heat is easily transferred from the blade 43 to the back surface 20.
  • the blade 43 extends substantially parallel to the width direction. Therefore, the distance in the opening / closing direction from the blade 43 to the back surface 20 does not change from the center to the side in the width direction. For this reason, compared with the case where the blade 43 approaches the back surface 20 in the side portion, the distance from the blade 43 to the back surface 20 in the side portion becomes longer. That is, the blade 43 moves away from the back surface 20 in the side portion.
  • the heat transfer path formed between the blade 43 and the back surface 20 becomes long. Since the heat transfer path between the blade 43 and the back surface 20 becomes long, heat transfer from the blade 43 (heat generating unit 30) to the back surface 20 is suppressed. Thereby, the residual heat in the back surface 20 is reduced. By reducing the residual heat on the back surface 20, it is possible to prevent heat from being applied from the back surface 20 to an unintended portion of the living tissue in a treatment using heat.
  • the thickness of the heat generating unit 30 in the opening / closing direction is formed sufficiently thinner than the thickness of the first gripping piece 13 in the opening / closing direction. For this reason, the heat transfer path formed between the heat generating unit 30 and the back surface 20 is sufficiently secured. Thereby, also in the center part in the width direction of the 1st holding piece 13, it is suppressed that heat is transmitted from the heat generating unit 30 to the back surface 20, and the residual heat in the back surface 20 is reduced.
  • An insulating part for preventing a short circuit may be provided on the first facing surface 16 (treatment surface 47).
  • an insulating member 60 having electrical insulation may be attached as a contact member at a position including the contact position P1 of the first facing surface 16.
  • a projecting portion that projects toward the first facing surface 16 is formed by the electrode surface 37 of the conductive member 36 instead of the projecting portion 35 formed by the support member 31.
  • the protruding portion of the second facing surface 17 is insulated from the first facing surface 16 (treatment surface 47). It contacts the member 60. For this reason, a short circuit due to contact between the blade 43 as the first electrode and the conductive member 36 as the second electrode is prevented.
  • the insulating member 60 is made of a material having high thermal conductivity and electrical insulation.
  • FIG. 5 is a diagram showing the first gripping piece 13 and the second gripping piece 14 in the present embodiment.
  • FIG. 5 shows a cross section substantially perpendicular to the longitudinal axis C.
  • the energy treatment tool 1 is not provided with a configuration for applying a high-frequency current to the treatment target.
  • the blade 43 is extended in a state toward the second gripping piece 14 as it is away from the center in the width direction.
  • the blade 43 extends from the back surface 20 in the width direction from the center toward the outside.
  • the treatment surface 47 is a flat surface (inclined surface) that is inclined with respect to the width direction. Further, the treatment surface 47 is a concave surface in which the center in the width direction is recessed downward. In the treatment surface 47, the center is most depressed downward. When the space between the first gripping piece 13 and the second gripping piece 14 is closed, the center of the second facing surface 17 comes into contact with the most concave position on the concave surface of the treatment surface 47. Further, the heat generating portion 40 is attached along the blade 43 in the central portion of the installation surface 45.
  • the distance (second distance) in the opening / closing direction to the back surface 20 (P4) at the position (P5) farthest from the center in the width direction is the distance to the back surface 20 (P4) at the center (P1). It is larger than (first distance). Therefore, the distance A1 from the position P5 to the position P4 is larger than the distance A0 from the position P1 to the position P4. That is, A1> A0.
  • the inclined surface 38 of the second opposing surface 17 is inclined upward with respect to the width direction with respect to the treatment surface 47 of the first opposing surface 16. Therefore, the inclination angle (acute angle) ⁇ 2 of the second facing surface 17 with respect to the width direction is larger than the inclination angle ⁇ 1 of the treatment surface 47 with respect to the width direction. That is, ⁇ 2> ⁇ 1. For this reason, the distance G between the 1st opposing surface 16 and the 2nd opposing surface 17 becomes large as it leaves
  • the distal end (P6) from the center of the inclined surface 38 in the width direction is located above the distal end (P5) from the center (P1) of the treatment surface 47.
  • the distance B2 in the opening / closing direction from the distal end (P6) of the inclined surface 38 to the contact position P2 is larger than the distance B1 in the opening / closing direction from the distal end (P5) of the treatment surface 47 to the contact position P1. Is also big. That is, B2> B1.
  • the distance (third distance) in the opening / closing direction to the back surface 20 (P4) at the position (P6) farthest from the center on the inclined surface 38 is the back surface at the position (P5) farthest from the center on the treatment surface 47. It is larger than the distance (second distance) to 20 (P4). Therefore, the distance A2 from the position P6 to the position P4 is larger than the distance A1 from the position P5 to the position P4. That is, A2> A1.
  • the thickness of the heat generating unit 30 in the opening / closing direction is sufficiently thinner than the thickness of the first gripping piece 13 in the opening / closing direction. For this reason, similarly to the above-mentioned embodiment, also in the center part in the width direction of the 1st holding piece 13, it is suppressed that heat is transmitted from the heat generating unit 30 to the back surface 20, and the residual heat in the back surface 20 is reduced. Is done.
  • the blade 43 is formed in a state of separating from the back surface 20 from the center toward the outside in the width direction. As a result, the heat transfer path formed between the blade 43 and the back surface 20 in the side portion becomes longer than in the case where the blade 43 approaches the back surface 20 in the side portion of the first gripping piece 13. For this reason, also in this modification, it is suppressed that heat is transmitted from the blade 43 to the back surface 20, and the residual heat in the back surface 20 is reduced.
  • the distance G between the first facing surface 16 and the second facing surface 17 increases with increasing distance from the center in the width direction. For this reason, similarly to the first embodiment, the operator can appropriately recognize that the grasped biological tissue has been incised (cut).
  • the inclined surface 38 of the second facing surface 17 may be formed by a curved surface (inclined curved surface) that is inclined with respect to the width direction.
  • the inclined surface 38 is formed by an arcuate curved surface having a center position on the first gripping piece 13 side.
  • the blade 43 is formed in a state of separating from the back surface 20 from the center toward the outside in the width direction. Further, the distance G between the first facing surface 16 and the second facing surface 17 increases with increasing distance from the center in the width direction. For this reason, also in this modification, it has an effect similar to the above-mentioned embodiment etc.
  • FIG. 7 is a diagram illustrating a second modification of the second embodiment.
  • the inclined surface 38 is formed by an arcuate curved surface having a center position on the opposite side to the first gripping piece 13 side.
  • the blade 43 is formed in a state of separating from the back surface 20 from the center toward the outside in the width direction. Further, the distance G between the first facing surface 16 and the second facing surface 17 increases with increasing distance from the center in the width direction. For this reason, also in this modification, it has an effect similar to the above-mentioned embodiment etc.
  • the treatment surface 47 of the blade 43 may be formed by a curved surface (inclined curved surface) that is inclined with respect to the width direction.
  • the treatment surface 47 is formed by an arcuate curved surface having a center position on the back surface 20 side.
  • the blade 43 is formed in a state of separating from the back surface 20 from the center toward the outside in the width direction. Further, the distance G between the first facing surface 16 and the second facing surface 17 increases with increasing distance from the center in the width direction. For this reason, also in this modification, it has an effect similar to the above-mentioned embodiment etc.
  • the thermal treatment instrument (1) includes a first gripping piece (13), a second gripping piece (14) that opens and closes with respect to the first gripping piece (13), and A heat generating part (40) that is provided on the first gripping piece (13) and generates heat when current flows, and a heat generating part (40) that is provided on the first gripping piece (13) and that generates heat from the heat generating part (40).
  • the heat transfer member (43) forming a treatment surface (47) facing the second gripping piece (14) and on the outer surface of the first gripping piece (13), A back surface (20) facing away from the surface (47), and the second gripping piece (14), facing the treatment surface (47), the first gripping piece (13) and the A contact position (P2) that contacts the treatment surface (47) when the space between the second gripping piece (14) and the second gripping piece (14) is closed;
  • An inclined surface (38) that moves away from the first gripping piece (13) as it moves away from the contact position (P2) in the width direction intersecting the opening / closing direction of the holding piece (14), In the state where the gripping piece (13) and the second gripping piece (14) are closed, the distance in the opening / closing direction between the contact position (P2) and the back surface (20) is set to The opening / closing direction between the distal end (P5) farthest in the width direction from the contact position (P2) and the back surface (20) on the treatment surface (47) is set to a distance (A0)
  • the second distance (A1) is the distance between the distal end (P6) farthest in the width direction from the contact position (P2) and the back surface (20) on the inclined surface (38).
  • the second distance (A1) is a first distance (A0) above, wherein the third distance (A2) is greater than said second distance (A1).

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

Abstract

L'invention concerne un outil de traitement thermique pourvu d'une première pièce de préhension, d'une seconde pièce de préhension, d'un élément de transfert de chaleur disposé sur la première pièce de préhension et formant une surface de traitement où la chaleur est transférée, et une surface inclinée qui s'éloigne de la première pièce de préhension plus loin de la position de contact avec la surface de traitement. La première distance (A0) est définie en tant que distance entre ladite position de contact et la surface arrière de la première pièce de préhension, la deuxième distance (A1) est définie en tant que distance entre la surface arrière et l'extrémité sur la surface de traitement distale par rapport à la position de contact, et la troisième distance (A2) est définie en tant que distance entre la surface arrière et l'extrémité sur la surface inclinée distale par rapport à la position de contact, la deuxième distance (A1) étant supérieure ou égale à la première distance (A0), et la troisième distance (A2) étant supérieure à la deuxième distance (A1).
PCT/JP2017/000849 2017-01-12 2017-01-12 Outil de traitement thermique WO2018131126A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
PCT/JP2017/000849 WO2018131126A1 (fr) 2017-01-12 2017-01-12 Outil de traitement thermique

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/JP2017/000849 WO2018131126A1 (fr) 2017-01-12 2017-01-12 Outil de traitement thermique

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WO2018131126A1 true WO2018131126A1 (fr) 2018-07-19

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Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2004188012A (ja) * 2002-12-12 2004-07-08 Olympus Corp 医療器械
JP2005261916A (ja) * 2004-02-20 2005-09-29 Olympus Corp 発熱処置具
WO2015022919A1 (fr) * 2013-08-16 2015-02-19 オリンパスメディカルシステムズ株式会社 Instrument de traitement, et système de traitement
JP5977908B2 (ja) * 2014-09-05 2016-08-24 オリンパス株式会社 把持処置ユニット、把持処置具及び把持処置システム
WO2016167196A1 (fr) * 2015-04-13 2016-10-20 オリンパス株式会社 Unité de traitement de préhension

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2004188012A (ja) * 2002-12-12 2004-07-08 Olympus Corp 医療器械
JP2005261916A (ja) * 2004-02-20 2005-09-29 Olympus Corp 発熱処置具
WO2015022919A1 (fr) * 2013-08-16 2015-02-19 オリンパスメディカルシステムズ株式会社 Instrument de traitement, et système de traitement
JP5977908B2 (ja) * 2014-09-05 2016-08-24 オリンパス株式会社 把持処置ユニット、把持処置具及び把持処置システム
WO2016167196A1 (fr) * 2015-04-13 2016-10-20 オリンパス株式会社 Unité de traitement de préhension

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