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WO2016009703A1 - Outil de traitement médical et son unité de traitement - Google Patents

Outil de traitement médical et son unité de traitement Download PDF

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Publication number
WO2016009703A1
WO2016009703A1 PCT/JP2015/063170 JP2015063170W WO2016009703A1 WO 2016009703 A1 WO2016009703 A1 WO 2016009703A1 JP 2015063170 W JP2015063170 W JP 2015063170W WO 2016009703 A1 WO2016009703 A1 WO 2016009703A1
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WO
WIPO (PCT)
Prior art keywords
forceps
pair
forceps member
portions
treatment
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/JP2015/063170
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English (en)
Japanese (ja)
Inventor
宮城　邦彦
澤井　貴司
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.)
JIMRO Co Ltd
Original Assignee
JIMRO Co Ltd
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 JIMRO Co Ltd filed Critical JIMRO Co Ltd
Priority to JP2016534304A priority Critical patent/JP6294964B2/ja
Publication of WO2016009703A1 publication Critical patent/WO2016009703A1/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
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current

Definitions

  • the present invention relates to a medical treatment tool for performing treatments such as treatment and surgery on a living tissue and a treatment portion thereof, and in particular, the treatment portion includes a pair of forceps members that can be opened and closed.
  • the present invention relates to a medical treatment instrument that is a bipolar electrode and generates a high-frequency electric field such as a microwave, and a treatment section thereof.
  • the treatment portion is provided at the distal end portion of the insertion portion.
  • the treatment section includes a fixed forceps member and a rotatable forceps member, and can be opened and closed.
  • the pair of forceps members are made of a bipolar electrode by being made of metal, and a high-frequency electric field is formed between the forceps members.
  • a living tissue can be baked by this high-frequency electric field to provide hemostasis and coagulation.
  • a living tissue can be cut (including incision, excision, etc.) by using a pair of forceps members like scissors.
  • a medical treatment tool is provided at the distal end of an insertion portion, and includes a treatment portion that can be opened and closed including first and second forceps members, and the first,
  • the second forceps member constitutes a pair of electrodes capable of forming an electric field between each other
  • the first forceps member includes a pair of first forceps portions facing each other in a facing direction orthogonal to the extending direction;
  • the second forceps member is provided so as to be rotatable relative to the first forceps member in an angular range in which the second forceps member can enter and leave a gap between the pair of first forceps portions around a rotation axis along the facing direction. It is characterized by being.
  • the treatment section of the medical treatment instrument according to the present invention is provided at the distal end of the insertion section of the medical treatment instrument, and can be opened and closed including the first and second forceps members.
  • the first forceps member includes a pair of first forceps portions facing each other in a facing direction orthogonal to the extending direction;
  • the second forceps member is provided so as to be rotatable relative to the first forceps member in an angular range in which the second forceps member can enter and leave a gap between the pair of first forceps portions around a rotation axis along the facing direction. It is characterized by being.
  • the treatment portion can be opened and closed by allowing the second forceps member to rotate relative to the first forceps member. That is, the treatment part is opened by bringing the second forceps member out of the gap between the pair of first forceps parts. By setting the second forceps member to enter the gap between the pair of first forceps portions, the treatment portion is closed.
  • this medical treatment instrument when a high-frequency electric field is formed between the forceps members in a state where the treatment portion is opened and the biological tissue is sandwiched between the first and second forceps members, the medical tissue approaches the living tissue. The two parts can be burned and solidified most.
  • a base end portion of the second forceps member is disposed inside a gap portion (base end portion of the gap) between the base end portions of the pair of first forceps portions, and the first forceps member is
  • the second forceps member is connected to the distal end portion of the second forceps member so that the distal end portion of the second forceps member is between the distal end portions of the pair of first forceps portions. It is preferable to be able to enter and exit the gap portion (the tip side portion from the base end portion of the gap). As a result, the treatment section can be made compact.
  • the first and second forceps members are connected to a microwave power source that outputs a microwave via a coaxial cable housed in the insertion portion. Accordingly, by forming a microwave electric field between the first and second forceps members, it is possible to supply the microwave energy to the treatment target site and perform the treatment.
  • treatments including coagulation and hemostasis treatments such as surgery can be performed satisfactorily.
  • FIG. 1 is a schematic configuration diagram of a medical treatment instrument according to the first embodiment of the present invention.
  • FIG. 2A shows the insertion part of the medical treatment instrument, and is a cross-sectional view taken along the line IIa-IIa in FIG.
  • FIG. 2B is a longitudinal sectional view of the insertion portion taken along line IIb-IIb in FIG.
  • FIG. 3 is a longitudinal sectional view of the insertion portion and the treatment portion of the medical treatment instrument.
  • FIG. 4 is a perspective view showing a part of the insertion portion and the treatment portion in cross section.
  • FIG. 5 is an exploded perspective view of the first forceps member of the insertion portion and the treatment portion.
  • FIG. 6 is an exploded perspective view of the second forceps member and the connecting portion of the treatment portion.
  • FIG. 7A is an exploded perspective view of the first and second forceps members of the insertion portion and the treatment portion.
  • FIG. 7B is a perspective view of the insertion portion and the treatment portion.
  • FIG. 8A is a front view of the holder member of the connecting portion along the line VIIIa-VIIIa in FIG.
  • FIG. 8B is a cross-sectional view of the holder member taken along line VIIIb-VIIIb in FIG.
  • FIG.8 (c) is a perspective view of the holder which combined a pair of holder member.
  • FIG. 9 is a cross-sectional view of the treatment section taken along line IX-IX in FIG.
  • FIG. 10A and 10B show the medical treatment instrument according to the second embodiment of the present invention in a state where the treatment portion at the distal end of the medical treatment tool is substantially closed.
  • FIG. 10A is a plan view and FIG. 10B is a front view.
  • (C) is a bottom view
  • (d) is a view taken along line Xd-Xd in FIG. (B)
  • (e) is a view taken along line Xe-Xe in (b).
  • FIG. 11 shows the treatment section of the second embodiment, in which FIG. 11 (a) is a front view in an open state, FIG. 11 (b) is a front view in a closed state than FIG. 11 (c) is a front view in a more closed state than FIG. 11 (b), FIG.
  • FIGS. 12A and 12B show the medical treatment instrument according to the third embodiment of the present invention in a state where the treatment portion at the distal end of the medical treatment instrument is substantially closed, in which FIG. 12A is a plan view and FIG. 12B is a front view.
  • the figure and the figure (c) are bottom views.
  • the medical treatment tool 1 of this embodiment is a forceps that is used by being inserted into a channel of an endoscope (not shown), and includes a hand operation unit 10, an insertion unit 20, The treatment part 30 is provided.
  • the hand operation unit 10 includes an operation main body unit 11 and a slide knob 12.
  • a slide knob 12 is slidably provided on the operation main body 11.
  • the insertion portion 20 includes a lumen tube 21 (insertion main body portion), a coaxial cable 22 (microwave energy supply line), and an operation wire 23 and extends long.
  • a hand operation unit 10 is provided at the proximal end of the insertion unit 20.
  • a treatment portion 30 is provided at the distal end of the insertion portion 20. This insertion part 20 is inserted into the channel of the endoscope.
  • the lumen tube 21 is made of an insulating resin such as polytetrafluoroethylene (PTFE). Inside the lumen tube 21, a large-diameter lumen 21a having a relatively large cross section and a small-diameter lumen 21b having a relatively small cross section are formed in parallel with each other along the axis. As shown in FIG. 3, a lumen communication portion 21 c is formed at a portion between the large and small lumens 21 a and 21 b at the distal end portion of the lumen tube 21. The two lumens 21a and 21b are communicated with each other via the lumen communication portion 21c.
  • PTFE polytetrafluoroethylene
  • a coaxial cable 22 is accommodated in the large-diameter lumen 21a.
  • the coaxial cable 22 is accommodated in the insertion part 20.
  • the coaxial cable 22 includes a linear inner conductor 22a, an outer conductor 22b made of a tubular braid, a tubular dielectric layer 22c between the inner and outer conductors 22a and 22b, and an outer conductor 22b. And a tubular protective coating 22d that covers the entire length of the insertion portion 20.
  • the proximal end portion of the coaxial cable 22 is connected to the microwave power source 2.
  • the proximal end portion of the internal conductor 22a is electrically connected to the high-voltage side terminal of the microwave power source 2.
  • the base end portion of the external conductor 22 b is electrically connected to the ground side terminal of the microwave power source 2.
  • the microwave power source 2 outputs a microwave.
  • the microwave means an electromagnetic wave of several hundred MHz to several hundred GHz, preferably an electromagnetic wave of 1 GHz to 10 GHz.
  • the portion on the distal end side (the treatment section 30 side) of the coaxial cable 22 protrudes toward the distal end as the member on the more central side.
  • the distal end portion of the inner conductor 22a is electrically connected to the first forceps member 31 described later on the treatment portion 30, and the distal end portion of the outer conductor 22b is electrically connected to the second forceps member 32 described later on the treatment portion 30. Connected.
  • the operation wire 23 is accommodated in the small diameter lumen 21 b of the lumen tube 21. As shown in FIG. 1, the operation wire 23 extends over substantially the entire length of the insertion portion 20. A proximal end portion of the operation wire 23 is connected to the slide knob 12. The distal end portion of the operation wire 23 is connected to a second forceps member 32 described later.
  • the treatment section 30 includes a pair of forceps members 31 and 32 and can be opened and closed.
  • the forceps members 31 and 32 are made of metal such as stainless steel and have conductivity.
  • the first forceps member 31 integrally includes a base tube portion 31b and a pair of first forceps portions 31a and 31a.
  • the base tube portion 31 b has a cylindrical shape that is coaxial with the insertion portion 20.
  • the base tube portion 31 b is fitted on the outer periphery of the distal end portion of the lumen tube 21. Thereby, the first forceps member 31 is fixed to the distal end portion of the insertion portion 20.
  • the first forceps portion 31a has a plate shape extending in the distal direction from the base tube portion 31b.
  • the pair of first forceps 31a, 31a are parallel to each other and face each other in the facing direction orthogonal to the extending direction.
  • a slit-like gap 39 is formed between the first forceps 31a and 31a.
  • the outer surface of the first forceps portion 31a is a partial cylindrical surface having a slightly smaller diameter than the outer diameter of the base tube portion 31b.
  • the inner surface of the first forceps portion 31a (the surface facing the other first forceps portion 31a) is flat, but may be a concave curved surface or a convex curved surface.
  • a shaft hole 31h is formed in the base end portion 31d (the portion on the base tube portion 31b side) of the first forceps portion 31a.
  • a recessed portion is formed at one edge of the width direction (direction orthogonal to both the extending direction and the opposing direction) of the portion 31 f on the distal end side of the proximal end portion 31 d of the first forceps portion 31 a.
  • 31 g is formed.
  • the inner surface of the recessed portion 31g is a flat receiving surface 31i. Due to the recessed portion 31g, the distal end portion 31f of the first forceps portion 31a is narrower than the proximal end portion 31d.
  • a protrusion 31e is provided at the tip of the tip end portion 31f.
  • the protrusion 31e protrudes from the tip end portion 31f to one side in the width direction. Accordingly, the distal end portion of the first forceps portion 31a has an L shape.
  • the gap 39 between the first forceps 31a and 31a includes a gap portion 39b on the proximal end side and a gap portion 39f on the distal end side than that.
  • the gap portion 39b is formed between the base end portions 31d and 31d of the pair of first forceps portions 31a and 31a.
  • the gap portion 39f is formed between the distal end portions 31f and 31f of the pair of first forceps portions 31a and 31a.
  • the second forceps member 32 has an elongated plate shape.
  • a shaft hole 32 h is formed in the proximal end portion 32 d of the second forceps member 32.
  • a flat receiving surface 32 i is formed at one edge of the portion 32 f on the distal end side of the proximal end portion 32 d of the second forceps member 32.
  • a protrusion 32e is formed at the tip of the second forceps member 32 so as to protrude from the receiving surface 32i.
  • tip part of the 2nd forceps member 32 is L-shaped.
  • the protruding direction of the protruding portion 32 e is directed to the opposite side to the protruding portion 31 e of the first forceps member 31.
  • the proximal end portion 32d of the second forceps member 32 is disposed inside the gap portion 39b at the proximal end of the gap 39 between the pair of first forceps portions 31a and 31a. , via a connecting portion 5 which will be described later, it is rotatably connected around a rotation axis L 5 relative to the first forceps member 31.
  • the distal end side portion 32f of the second forceps member 32 can enter and exit the distal end side gap portion 39f. That is, the second forceps member 32 is rotatable relative to the first forceps member 31 within an angular range in which the gap portion 39f and thus the gap 39 can enter and exit.
  • the treatment section 30 can be opened and closed between an open position (open state) and a closed position (closed state).
  • the tip end portion 32f of the second forceps member 32 is protruded obliquely outward from the first forceps member 31, the direction along the rotational axis L 5
  • the receiving surfaces 31i and 32i and the protrusions 31e and 32e face each other.
  • the entire second forceps member 32 is sandwiched between the pair of first forceps portions 31a and 31a of the first forceps member 31.
  • it is accommodated in the gap 39.
  • Rotation axis L 5 represents, together with the orthogonal to the extending direction and the width direction of the forceps members 31 and 32, the first gripper 31a, along the opposing direction of and what 31a, and the opposing direction of the base end portion to each other of the forceps members 31, 32 It is along. Proximal end to each other of the forceps members 31 and 32, are stacked along the rotation axis L 5.
  • a connecting protrusion 32 b is formed integrally with the base end portion 32 d of the second forceps member 32.
  • the connecting protrusion 32 b protrudes obliquely and rearward with respect to the extending direction of the second forceps member 32.
  • a metal connection press 35 having the same shape as the connection protrusion 32b is joined to the proximal end portion 32d of the second forceps member 32 by welding or the like.
  • the interlocking protrusion 32b and interlocking retainer 35 has opposed in a direction parallel to the rotational axis L 5.
  • the 2nd forceps member 32 may have a pair of connection protrusion 32b, 32b integrally.
  • the pair of connection pressers 35, 35 may be joined to the second forceps member 32 by welding or the like.
  • a metal connecting piece 33 is joined to the distal end portion of the operation wire 23 by welding or the like.
  • the connecting piece 33 is inserted between the connecting protrusion 32 b and the connecting presser 35 and is rotatably connected to the connecting protrusion 32 b and the connecting presser 35 through a metal connecting pin 34. Axis and thus the axis of rotation of the interlocking piece 33 of the connection pin 34 is parallel to the rotation axis L 5.
  • the treatment part 30 can be opened and closed. Since the first forceps member 31 is fixed and the second forceps member 32 is movable, the treatment section 30 is a single-opening type forceps.
  • the first and second forceps members 31, 32 of the treatment unit 30 constitute a pair of electrodes of the treatment unit 30 by being connected to the microwave power source 2 via the coaxial cable 22.
  • the first forceps member 31 is connected to the high-voltage side terminal of the microwave power source 2 via the inner conductor 22 a of the coaxial cable 22.
  • the second forceps member 32 is connected to the ground-side terminal of the microwave power source 2 via the outer conductor 22 b of the coaxial cable 22. Therefore, the first forceps member 31 is a high-voltage electrode, and the second forceps member 32 is a ground electrode.
  • a microwave electric field high frequency electric field
  • the first forceps member 31 is connected to the internal conductor 22a as follows.
  • a metal inner connection pipe 41 is fitted on the outer periphery of the exposed portion of the tip of the inner conductor 22a.
  • the outer peripheral surface of the inner connection pipe 41 and the outer peripheral surface of the dielectric layer 22c are flush with each other.
  • a slit 41 a is formed in the peripheral side portion of the inner connection pipe 41.
  • the inner connection pipe 41 and the inner conductor 22a are integrated by soldering through the slit 41a.
  • a metal outer connecting pipe 42 is fitted into the base tube portion 31b.
  • the base cylinder part 31b and the outer connection pipe 42 are integrated by welding or the like.
  • the outer connection pipe 42 protrudes to the proximal end side (left side in FIG. 3) from the first forceps member 31.
  • the outer connection pipe 42 is inserted into the large-diameter lumen 21a, is fitted into the outer periphery of the inner connection pipe 41, and is further fitted into the outer periphery of the exposed portion at the tip of the dielectric layer 22c. Yes.
  • the inner connection pipe 41 and the outer connection pipe 42 are integrated by laser welding or the like.
  • the inner conductor 22a is electrically connected to the first forceps member 31 through the inner connection pipe 41 and the outer connection pipe 42 in order.
  • An insulating coating layer 44 made of a heat shrinkable tube is provided on the outer periphery of the outer connection pipe 42.
  • the front end surface of the outer connection pipe 42 is cut obliquely to avoid interference with the connection protrusion 32b and the connection presser 35.
  • an insulating tube 43 is provided on the outer periphery of the dielectric layer 22c between the proximal end portion (the left end portion in FIG. 5) of the outer connection pipe 42 and the distal end portion (the right end portion in FIG. 5) of the external conductor 22b. ing.
  • the second forceps member 32 is connected to the outer conductor 22b as follows.
  • a connection ring 24 is provided at the tip of the coaxial cable 22.
  • the connection ring 24 includes a large-diameter ring portion 24a, a small-diameter ring portion 24b, and a ring connection portion 24c.
  • the axes of the large and small ring portions 24a and 24b are parallel to each other.
  • These ring portions 24a and 24b are integrally connected via a ring connection portion 24c. As shown in FIG.
  • the large-diameter ring portion 24a is fitted and fixed to the outer periphery of the exposed portion of the tip of the outer conductor 22b, and is accommodated in the large-diameter lumen 21a.
  • the ring connection portion 24c is passed through the lumen communication portion 21c.
  • the small diameter ring 24b is accommodated in the small diameter lumen 21b.
  • An operation wire 23 is slidably passed through the small diameter ring portion 24b.
  • the outer conductor 22 b and the operation wire 23 are electrically connected via the connection ring 24.
  • the outer conductor 22 b is electrically connected to the second forceps member 32 through the connection ring 24, the operation wire 23, and the connecting piece 33 in order.
  • the insulation coating layer 25 which consists of a heat-shrinkable tube is coat
  • the insulation coating layer 25 and the insulation coating layer 44 of the outer connection pipe 42 prevent the operation wire 23 and the outer connection pipe 42 from being short-circuited via the lumen communication portion 21c.
  • the connecting portion 5 includes a holder 50 and a shaft pin 53.
  • the holder 50 includes a pair of holder members 51 and 51. These holder members 51 and 51 are comprised with insulators, such as polyetheretherketone (PEEK), and are mutually the same shape.
  • PEEK polyetheretherketone
  • each holder member 51 integrally includes a clamping plate portion 51a and a half cylinder portion 51b. Holding plate portion 51a is adapted to a circular plate shape perpendicular to the rotational axis L 5.
  • a hole 51h is formed at the center of the sandwiching plate 51a.
  • the hole 51h integrally includes a large-diameter semicircular portion 51d and a small-diameter semicircular portion 51e.
  • a protrusion 51f is formed on the inner periphery of the large-diameter semicircular portion 51d.
  • the half cylinder portion 51 b has a half-cylindrical shape, and the rotation axis L 5 (from the inner side surface of the sandwich plate portion 51 a (the surface facing the other sandwich plate portion 51 a)). It protrudes along the above-mentioned facing direction.
  • the inner peripheral surface of the half cylinder portion 51b is continuous with the inner peripheral surface of the small-diameter semicircular portion 51e.
  • a half end surface 51c of the half cylinder portion 51b (a surface facing the other half cylinder portion 51b) is flat.
  • a concave portion 51g is formed on the distal end surface of the half cylinder portion 51b.
  • the clamping plate portion 51 a is interposed between the base end portions of the forceps members 31 and 32. That is, the holding plate portion 51 a of one holder member 51 is interposed between the proximal end portion 31 d of one first forceps portion 31 a and the proximal end portion 32 d of the second forceps member 32. The holding plate portion 51 a of the other holder member 51 is interposed between the proximal end portion 31 d of the other first forceps portion 31 a and the proximal end portion 32 d of the second forceps member 32. Therefore, the pair of sandwiching plate portions 51a and 51a sandwich the proximal end portion 32d of the second forceps member 32 from both sides. Each clamping plate portion 51a constitutes an insulating plate that insulates the forceps members 31 and 32 from each other.
  • each holder member 51 is inserted into the shaft hole 32h from both sides with the second forceps member 32 interposed therebetween.
  • the two half cylinder portions 51 b and 51 b are combined inside the shaft hole 32 h to constitute an insulating shaft cylinder 52.
  • the holder 50 includes a pair of sandwiching plate portions 51 a and 51 a (insulating plate) and an insulating shaft cylinder 52.
  • the insulating shaft cylinder 52 has a cylindrical shape orthogonal to the sandwiching plate portions 51a and 51a, and is spanned between the sandwiching plate portions 51a and 51a.
  • the insulating shaft cylinder 52 is inserted through the shaft hole 32h, thereby penetrating the proximal end portion 32d of the second forceps member 32. Insulation barrel 52 and thus the holder 50 is adapted to rotate relative about the axis of rotation L 5 with respect to the forceps members 31, 32.
  • each half cylinder 51 b is fitted into the large-diameter semicircle 51 d of the other holder member 51. Furthermore, the other protrusion 51f is fitted in the recess 51g of the one half cylinder portion 51b.
  • the pair of holder members 51 and 51 are fitted so as not to be relatively rotatable. Further, the flat halved end surfaces 51c and 51c of the pair of halved cylinder portions 51b and 51b are in close contact with each other.
  • the shaft pin 53 is made of a rigid metal and has a thin cylindrical shape. As shown in FIG. 9, the shaft pin 53, disposed on the rotational axis L 5, it extends through a hole 51h of the clamping plate portion 51a while being inserted into the insulating barrel 52. The intermediate portion of the shaft pin 53 is insulated from the second forceps member 32 by being covered with the holder 50. Furthermore, both end portions of the shaft pin 53 are inserted into shaft holes 31h and 31h of the first forceps portions 31a and 31a, respectively, and are connected to the base end portions of the first forceps portions 31a and 31a by caulking, welding, or the like. Accordingly, the shaft pin 53 is supported by the first forceps member 31 in a both-end supported state.
  • the medical treatment tool 1 is used as follows.
  • the insertion part 20 is inserted into the channel of the endoscope, and the treatment part 30 is projected into the living body from the tip of this channel.
  • the treatment unit 30 is opened and closed via the operation wire 23, and the treatment member 30 is addressed, and the microwave power source 2 outputs a microwave, whereby the forceps member 31. , 32 form a microwave (high frequency) electric field.
  • the microwave power source 2 outputs a microwave, whereby the forceps member 31. , 32 form a microwave (high frequency) electric field.
  • it is possible to perform treatment such as burning the treatment target site and stopping hemostasis.
  • Providing the protrusions 31e and 32e at the distal ends of the forceps members 31 and 32 not only facilitates locking of the treatment part 30 to the treatment target site, but also concentrates the microwave electric field between the protrusions 31e and 32e. be able to.
  • the electric power from the microwave power source is transmitted by the coaxial cable 22 up to the vicinity of the distal end portion of the insertion portion 20.
  • Only the tip portion of the operation wire 23 serves as a conductive wire.
  • transmission loss can be sufficiently suppressed. Therefore, the microwave energy formed between the forceps members 31 and 32 can be sufficiently increased. As a result, the treatment time can be shortened.
  • the operation wire 23 can be made of a steel material (for example, stainless steel) that is suitable only for opening and closing the treatment section 30, the treatment section 30 can be reliably opened and closed.
  • the living tissue is sandwiched between the first and second forceps members 31 and 32, and is coagulated and stopped by the microwave, and then cut (removed). Specifically, first, as shown by the solid line in FIG. 7B, the living tissue is sandwiched between the first and second forceps members 31 and 32 by opening the treatment portion 30. In the open position, the distal end side portion 32f of the second forceps member 32 projects obliquely outward with respect to the first forceps member 31, and the space between the protrusions 31e and 32e at the distal end opens, so that the living tissue is securely sandwiched. Can do.
  • the treatment unit 30 is closed. Then, as indicated by a two-dot chain line in FIG. 7B, the distal end side portion 32f of the second forceps member 32 enters the gap portion 39f between the first forceps portions 31b and 31b. Thereby, the region between the two most burned and solidified sites is cut (including incision and excision). Accordingly, the most burned and solidified portions face the cut surfaces on both sides of the cut portion. Therefore, bleeding from the cut surface can be prevented, or the amount of bleeding can be suppressed to a small extent. As a result, treatments including coagulation and hemostasis, treatments such as surgery can be performed satisfactorily.
  • the medical treatment tool by disposing the base end portion to each other of the first forceps member 31 and the second forceps member 32 to overlap along the rotational axis L 5, and a compact treatment unit 30 The diameter can be reduced.
  • the first forceps member 31 and the second forceps member 32 can be reliably insulated.
  • the creepage distance can be increased, and a short circuit between the first forceps member 31 and the second forceps member 32 can be reliably prevented. Thereby, energy loss can be further suppressed.
  • the twist of the second forceps member 32 can be suppressed, and as a result, a short circuit between the forceps members 31 and 32 can be reliably prevented. can do.
  • the base end portion 32 d of the second forceps member 32 can be protected by the holder 50.
  • On the rotation axis L 5 represents by providing a metal shaft pin 53 can be sufficiently ensured strength of the rotary shaft. Also, by placing both ends of the shaft pin 53 in a state of being supported by the pair of forceps portions 31a, 31a, a load such as a bending moment applied to the shaft pin 53 can be reduced. By surrounding the shaft pin 53 with the insulating shaft cylinder 52, the inner peripheral surface of the shaft hole 32h of the second forceps member 32 and the shaft pin 53 can be reliably insulated.
  • the pair of holder members 51 and 51 can be easily connected. Further, for example, compared to the case where one holder member 51 is provided with a large-diameter cylinder and the other holder member 51 is provided with a small-diameter cylinder, and the large-diameter cylinder and the small-diameter cylinder are fitted together, these large-diameter cylinders and The thickness of each half cylinder part 51b can be made larger than the thickness of a small diameter cylinder. Accordingly, the rigidity of the insulating shaft cylinder 52 can be ensured. Further, by making the pair of holder members 51 have the same shape, the manufacturing cost can be reduced and the parts management can be facilitated.
  • 10 and 11 show a second embodiment of the present invention.
  • 10 and 12 the treatment section 30 is shown upside down with respect to the first embodiment (FIGS. 1 to 9).
  • the receiving surface 31i of a pair of 1st forceps part 31a and the receiving surface 32i of the 2nd forceps member 32 are each sawtooth-shaped. Specifically, a plurality of projecting tooth portions 31k, 31k,... Are formed on the receiving surface 31i of each first forceps portion 31a.
  • Each ⁇ portion 31k when viewed from the thickness direction of the gripper 31a (the direction along the rotational axis L 5), has become smaller triangular or chevron-shaped.
  • a plurality of protruding tooth portions 31k, 31k,... are continuously arranged in the extending direction of the first forceps portion 31a.
  • the second forceps member 32 of the second embodiment is curved in an arcuate shape so that the central portion is convex toward the opening direction (upward in FIG. 10B).
  • the receiving surface 32i of the second forceps member 32 is also curved in an arcuate shape.
  • a plurality of teeth 32k, 32k,... Are formed on the receiving surface 32i.
  • Each ⁇ portion 32k, when viewed from the thickness direction of the second forceps member 32 (the direction along the rotational axis L 5), has become smaller triangular or chevron-shaped.
  • a plurality of projecting tooth portions 32k, 32k,... are continuously arranged in the extending direction of the second forceps member 32.
  • the distal side portion 32f of the second forceps member 32 is placed between the first forceps portions 31a and 31a.
  • the treatment portion 30 is opened.
  • the living tissue is sandwiched between the saw-shaped receiving surfaces 31i and 32i.
  • the projecting tooth portions 31k and 32k of the receiving surfaces 31i and 32i are locked to the living tissue.
  • the living tissue can be firmly grasped, and slipping of the forceps members 31 and 32 can be suppressed or prevented.
  • a microwave electric field is formed between the forceps members 31 and 32 to burn and coagulate two adjacent sites in the living tissue.
  • the distal end portion 32f of the second forceps member 32 is closed by the first forceps 31a, It enters the gap 39f between 31a.
  • FIG. 12 shows a third embodiment of the present invention.
  • the receiving surfaces 31i and 31i of the first forceps 31a and 31a are flat.
  • the receiving surface 32i of the second forceps member 32 has a saw blade shape.
  • the first forceps member 31 may be a movable side, and the second forceps member 32 may be a fixed side.
  • a double-open type in which both forceps members 31 and 32 rotate and open and close may be used.
  • the first forceps member 31 may be a ground electrode, and the second forceps member 32 may be a high-voltage electrode.
  • the power supply 2 is not limited to the microwave, and may be one that outputs millimeter waves, radio waves, or other high frequencies.
  • the present invention is applicable to, for example, medical forceps.

Landscapes

  • Health & Medical Sciences (AREA)
  • 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)
  • Molecular Biology (AREA)
  • 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 médical qui permet de réaliser un excellent traitement, y compris une chirurgie et des thérapies telles qu'une coagulation et une hémostase. Une unité de traitement (30) de l'outil de traitement médical (1) comprend des premier et second éléments de forceps (31, 32). Ces éléments de forceps (31, 32) configurent une paire d'électrodes entre lesquelles un champ électrique peut être formé. Le premier élément de forceps (31) comprend une paire de premières unités de forceps (31a, 31a) qui sont opposées dans une direction opposée qui est perpendiculaire à la direction d'extension. Dans une plage angulaire qui permet l'entrée et la sortie dans l'espace (39) entre les premières unités de forceps (31a, 31a), le second élément de forceps (32) peut tourner par rapport au premier élément de forceps (31) autour d'un axe de rotation (L5) selon la direction opposée mentionnée ci-dessus.
PCT/JP2015/063170 2014-07-15 2015-05-07 Outil de traitement médical et son unité de traitement Ceased WO2016009703A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
JP2016534304A JP6294964B2 (ja) 2014-07-15 2015-05-07 医療用処置具

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
JP2014-144892 2014-07-15
JP2014144892 2014-07-15
JP2014221421 2014-10-30
JP2014-221421 2014-10-30

Publications (1)

Publication Number Publication Date
WO2016009703A1 true WO2016009703A1 (fr) 2016-01-21

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JP (1) JP6294964B2 (fr)
WO (1) WO2016009703A1 (fr)

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JP2019205625A (ja) * 2018-05-29 2019-12-05 小林　真 内視鏡用バイポーラ型加熱処置装置
JP2020536636A (ja) * 2017-10-13 2020-12-17 クレオ・メディカル・リミテッドＣｒｅｏ Ｍｅｄｉｃａｌ Ｌｉｍｉｔｅｄ 電気手術切除器具
CN120814881A (zh) * 2025-09-16 2025-10-21 核工业总医院 一种妇科宫腔镜手术取物钳

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JPH10199A (ja) * 1996-03-12 1998-01-06 Ethicon Endo Surgery Inc ２極式切断及び凝固器具
JP2000139943A (ja) * 1998-09-02 2000-05-23 Olympus Optical Co Ltd 高周波処置具
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JP2009028541A (ja) * 2007-07-30 2009-02-12 Tyco Healthcare Group Lp ポリープ除去顎および使用方法
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JP2020536636A (ja) * 2017-10-13 2020-12-17 クレオ・メディカル・リミテッドＣｒｅｏ Ｍｅｄｉｃａｌ Ｌｉｍｉｔｅｄ 電気手術切除器具
JP7228916B2 (ja) 2017-10-13 2023-02-27 クレオ・メディカル・リミテッド 電気手術切除器具
JP2023058576A (ja) * 2017-10-13 2023-04-25 クレオ・メディカル・リミテッド 電気手術切除器具
JP2023058578A (ja) * 2017-10-13 2023-04-25 クレオ・メディカル・リミテッド 電気手術切除器具
JP2023058577A (ja) * 2017-10-13 2023-04-25 クレオ・メディカル・リミテッド 電気手術切除器具
JP7496159B2 (ja) 2017-10-13 2024-06-06 クレオ・メディカル・リミテッド 電気手術切除器具
JP7496158B2 (ja) 2017-10-13 2024-06-06 クレオ・メディカル・リミテッド 電気手術切除器具
JP7496157B2 (ja) 2017-10-13 2024-06-06 クレオ・メディカル・リミテッド 電気手術切除器具
JP2019205625A (ja) * 2018-05-29 2019-12-05 小林　真 内視鏡用バイポーラ型加熱処置装置
CN120814881A (zh) * 2025-09-16 2025-10-21 核工业总医院 一种妇科宫腔镜手术取物钳

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