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WO2017014110A1 - Outil de traitement de forceps - Google Patents

Outil de traitement de forceps Download PDF

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Publication number
WO2017014110A1
WO2017014110A1 PCT/JP2016/070583 JP2016070583W WO2017014110A1 WO 2017014110 A1 WO2017014110 A1 WO 2017014110A1 JP 2016070583 W JP2016070583 W JP 2016070583W WO 2017014110 A1 WO2017014110 A1 WO 2017014110A1
Authority
WO
WIPO (PCT)
Prior art keywords
handle
movement
end effector
clamp
engagement
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/JP2016/070583
Other languages
English (en)
Japanese (ja)
Inventor
彰人 加納
龍 大沼
みずき 小宮
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 JP2017504112A priority Critical patent/JP6242536B2/ja
Publication of WO2017014110A1 publication Critical patent/WO2017014110A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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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
    • A61B18/12—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 forceps treatment instrument in which a separation distance between two clamp portions in an end effector changes when the end effector operates.
  • the present invention has been made paying attention to the above-mentioned problems, and an object of the present invention is to provide a forceps treatment tool in which an end effector is easily and appropriately maintained at a position in the middle of changing from the most distant position to the closest position. It is to provide.
  • a forceps treatment instrument includes a first clamp unit including a first electrode having a first potential when high-frequency electric energy is supplied, and the high-frequency electric device.
  • An end effector operating at a position, a holdable housing, and movable relative to the housing between a first movement position and a second movement position, and by moving to the first movement position
  • a handle for moving the end effector to the closest position by moving the end effector to the most distant position, and moving the end effector to the closest position by moving to the second moving position, and the second moving position from the first moving position.
  • An engagement portion that is provided in the middle of the movement path of the handle toward the handlebar, and is engageable with the handle to restrict the movement of the handle and to regulate the operation of the end effector. Is provided.
  • the forceps treatment tool includes a first clamp part and a second clamp part that can change a relative position with respect to the first clamp part.
  • An end effector that operates between a most distant position at which the second clamp portion is farthest and a closest position at which the second clamp portion is closest to the first clamp portion, and the end effector And an urging member that causes the urging force to act on the end effector, and at least one of the first clamp portion and the second clamp portion of the end effector.
  • a pressing portion that regulates the operation of the end effector to the most distant position by pressing the end effector.
  • FIG. 1 is a schematic view showing a treatment system in which the forceps treatment tool according to the first embodiment is used.
  • FIG. 2 is a schematic diagram illustrating a state where the handle piece of the handle according to the first embodiment is engaged with the protrusion.
  • FIG. 3 is a schematic view showing the end effector in a state where the handle piece of the handle according to the first embodiment is engaged with the protrusion.
  • FIG. 4 is a schematic view showing the handle piece and the protrusion of the handle in a state where the protrusion according to the first embodiment is located at the engagement position and the handle is located at the second movement position.
  • FIG. 5 is a schematic view showing the end effector according to the first embodiment in a state where the end effector is located at the closest position.
  • FIG. 6 is a schematic diagram illustrating an example of treatment performed in a state where the end effector according to the first embodiment is maintained at a position in the middle of changing from the most distant position to the closest position.
  • FIG. 7 is a schematic diagram illustrating the configuration of the handle piece and the protrusion of the handle according to the first modification of the first embodiment.
  • FIG. 8 is a schematic diagram illustrating the configuration of a housing and a handle according to a second modification of the first embodiment.
  • FIG. 9 is a schematic view of a handle according to a second modification of the first embodiment viewed from the distal end side.
  • FIG. 10 is a schematic diagram illustrating a configuration of a rotating member according to a second modification of the first embodiment.
  • FIG. 11 is a schematic diagram for explaining the operation of the handle piece and the rotating member when the handle according to the second modification of the first embodiment moves from the first movement position to the second movement position. is there.
  • FIG. 12 is a schematic diagram for explaining the operation of the handle piece and the rotating member when the handle according to the second modification of the first embodiment is moved from the second movement position to the first movement position. is there.
  • FIG. 13 is a schematic diagram for explaining the operation of the handle piece when the handle according to the third modification of the first embodiment is moved from the first movement position to the second movement position.
  • FIG. 14 is a schematic diagram for explaining the operation of the handle piece when the handle according to the third modification of the first embodiment is moved from the second movement position to the first movement position.
  • FIG. 15 is a schematic diagram illustrating a forceps treatment tool according to a fourth modification of the first embodiment in a state where the handle is located at the first movement position.
  • FIG. 16 is a schematic view showing a forceps treatment instrument according to a fourth modification of the first embodiment in a state where the handle is located at a position where the handle piece engages with the protrusion.
  • FIG. 17 shows the forceps treatment device according to the fourth modification of the first embodiment in a state where the handle is positioned at a reference position between the position where the handle piece engages with the protrusion and the second movement position.
  • FIG. FIG. 18 is a schematic diagram illustrating a forceps treatment tool according to a fourth modification of the first embodiment in a state where the handle is located at the second movement position.
  • FIG. 19 is a schematic view showing the forceps treatment device according to the second embodiment in a state where the movable sheath is located at the non-pressing position.
  • FIG. 20 is a schematic view showing the forceps treatment device according to the second embodiment in a state where the movable sheath is located at the pressing position.
  • 21 is a cross-sectional view taken along line XXI-XXI in FIG.
  • FIG. 22 is a schematic view showing a forceps treatment device according to a modification of the second embodiment in a state where the movable sheath is located at the pressing position.
  • FIG. 23 is a cross-sectional view schematically showing an internal configuration of a movable sheath according to a modification of the second embodiment.
  • FIG. 1 is a view showing a treatment system (bipolar treatment system) 1 in which a forceps treatment tool (bipolar treatment tool) 2 of the present embodiment is used.
  • the forceps treatment tool 2 has a longitudinal axis C.
  • one side in the direction along the longitudinal axis C is the distal end side (arrow C1 side in FIG. 1), and the opposite side to the distal end side is the proximal end side (arrow C2 side in FIG. 1).
  • the forceps treatment tool 2 treats a treatment target using high-frequency electrical energy (high-frequency current) as energy.
  • the forceps treatment instrument 2 includes a housing 3 that can be held.
  • the housing 3 extends from the housing body 5 in a direction intersecting the longitudinal axis C, and a housing body 5 that extends along the longitudinal axis C.
  • a grip (fixed handle) 6 to be provided.
  • a handle (movable handle) 7 is rotatably attached to the housing 3 via a fulcrum pin 8, and the handle 7 is rotated about the fulcrum pin 8 with respect to the housing 3. Open or close to grip 6.
  • the handle 7 is movable between a first movement position that is the farthest away from the grip 6 and a second movement position that is the closest to the grip 6. In FIG. 1, the handle 7 is located at the first movement position. In the present embodiment, the handle 7 moves substantially parallel to the longitudinal axis C, and the handle 7 is positioned on the distal end side with respect to the grip 6.
  • the energy control apparatus 10 includes a conversion circuit that converts electric power from a battery or an outlet into high-frequency electric energy, a processor including a CPU (Central Processing Unit) or an ASIC (application specific integrated circuit), and a storage medium such as a memory. .
  • a foot switch 13 is electrically connected to the energy control device 10 as an operation input unit.
  • the energy control device 10 outputs high-frequency electrical energy based on the detection of an operation input with the foot switch 13.
  • the operation input unit is not limited to the foot switch 13 and may be, for example, an operation button attached to the housing 3.
  • a rotation knob (rotation operation unit) 15 is connected to the housing body 5 of the housing 3 from the front end side.
  • the rotary knob 15 is rotatable about the longitudinal axis C with respect to the housing 3.
  • a sheath (fixed sheath) 16 is fixed to the rotary knob 15 in a state of being inserted into the rotary knob 15 from the distal end side.
  • the sheath 16 extends along the longitudinal axis C. Further, as the rotary knob 15 rotates, the sheath 16 rotates around the longitudinal axis C with respect to the housing 3 together with the rotary knob 15.
  • a conductive rod (probe) 17 is extended toward the tip side through the inside of the sheath 16.
  • the longitudinal axis C extends from the distal end side to the proximal end side through the inside of the conductive rod 17.
  • a first clamp portion (rod treatment portion) 21 is formed at the distal end portion of the conductive rod 17.
  • a first clamp portion 21 of the conductive rod 17 protrudes from the distal end of the sheath 16 toward the distal end side.
  • a second clamp portion (jaw) 22 is attached to the distal end portion of the sheath 16 via a fulcrum pin 23, and the second clamp portion (second clamp portion) 22 is attached to the sheath 16 around the fulcrum pin 23. And can be rotated.
  • the end effector 20 that treats the treatment target is formed by the first clamp part 21 and the second clamp part 22 (a pair of clamp parts 21 and 22).
  • a movable body (movable portion) 18 extends from the inside of the housing body 5 toward the distal end side through the inside of the sheath 16.
  • the movable body 18 is made of a conductive material and is movable with respect to the housing 3, the rotary knob 15, the sheath 16 and the conductive rod 17 in the direction along the longitudinal axis C.
  • the handle 7 is connected to the proximal end portion of the movable body 18.
  • the distal end portion of the movable body 18 is connected to the second clamp portion 22 via the connection pin 25.
  • the movable body 18 By moving the handle 7 between the first movement position and the second movement position with respect to the housing 3 (grip 6), the movable body 18 in the direction along the longitudinal axis C, the housing 3, the rotary knob 15, It moves relative to the sheath 16 and the conductive rod 17.
  • the second clamp portion 22 rotates with respect to the sheath 16, and the second clamp portion 22 moves (opens or closes) with respect to the first clamp portion 21. That is, by moving the handle 7 with respect to the housing 3, the end effector 20 operates.
  • the end effector 20 When the end effector 20 operates, the relative position of the second clamp part 22 with respect to the first clamp part 21 changes, and the separation distance between the first clamp part 21 and the second clamp part 22 changes. To do.
  • the second clamp portion 22 is the farthest away from the first clamp portion 21 (the distance between the first clamp portion 21 and the second clamp portion 22 is the largest).
  • the second clamp portion 22 is closest to the separation position and the first clamp portion 21 (the separation distance between the first clamp portion 21 and the second clamp portion 22 is the smallest). Operate between position.
  • the end effector 20 moves to the farthest position.
  • the end effector 20 moves to the closest position. In FIG. 1, the end effector 20 is located at the most separated position.
  • the conductive rod 17 (including the first clamp part 21), the movable body 18, and the second clamp part 22 are rotatable about the longitudinal axis C with respect to the housing 3 together with the rotary knob 15 and the sheath 16. . For this reason, when the rotary knob 15 is rotated, the angular position around the longitudinal axis C of the end effector 20 changes.
  • the first electrode 31 is formed by the first clamp portion 21. High-frequency electrical energy (high-frequency power) output from the energy control device 10 is supplied to the first electrode 31 (first clamp portion 21) through the electrical wiring 26 and the conductive rod 17. By supplying high-frequency electrical energy to the first electrode 31, the first electrode 31 has the first potential E1.
  • the first electrode 31 includes a first electrode facing surface 35 that faces the second clamp portion 22.
  • the second clamp portion 22 includes a second electrode 32 formed of a conductive material and a pad portion (contact portion) 33 formed of an electrically insulating material.
  • the high frequency electrical energy (high frequency power) output from the energy control device 10 is supplied to the second electrode 32 of the second clamp portion 22 through the electrical wiring 27 and the movable body 18.
  • the second electrode 32 has a second potential E2 different from the first potential E1.
  • the second electrode 32 includes a second electrode facing surface 36 that faces the first clamp portion 21 (first electrode facing surface 35).
  • a leaf spring 37 is provided as an urging member.
  • a biasing force acts on the leaf spring 37 so that the handle 7 is separated from the grip 6. That is, the leaf spring 37 applies an urging force to the handle to move the handle 7 toward the first movement position.
  • a biasing force that moves the end effector 20 (second clamp portion 22) toward the most spaced position acts on the end effector 20.
  • the biasing member that applies a biasing force to the handle 7 and the end effector 20 is not limited to the leaf spring 37, and for example, a coil spring connected between the housing 3 and the handle 7 is provided instead of the leaf spring 37.
  • the urging force described above may be applied to the handle 7 and the end effector 20.
  • the handle 7 is provided with a handle piece (handle hook) 41.
  • the handle piece 41 moves along the movement path P0.
  • a guide groove 42 is formed on the inner peripheral surface of the housing 3.
  • a protrusion (engaging portion) 43 is provided inside the housing 3, and the protrusion 43 can move in the guide groove 42.
  • the protrusion 43 is movable between an engagement position indicated by a solid line in FIG. 1 and a non-engagement position indicated by a broken line in FIG.
  • the operation of moving the protrusion (engaging portion) 43 is manually performed by, for example, a lever (not shown) attached to the housing 3.
  • the protrusion 43 includes a restriction surface 45 facing the proximal end side. In a state where the protrusion 43 is located at the engaging position, the protrusion (engaging portion) 43 can be engaged with the handle piece 41 of the handle 7.
  • FIG. 2 is a view showing a state in which the handle piece 41 of the handle 7 is engaged with the protrusion (engagement portion) 43.
  • FIG. 3 is a view showing the end effector 20 in a state where the handle piece 41 of the handle 7 is engaged with the protrusion 43.
  • the handle piece 41 in a state where the protrusion 43 is located at the engagement position, the handle piece 41 is in a state where the handle 7 is moved from the first movement position to the second movement position. In the middle of the movement path P0, the restriction surface 45 of the protrusion (engagement portion) 43 is located. For this reason, the handle piece 41 of the handle 7 can be engaged with the protrusion 43.
  • the protrusion 43 including the restriction surface 45 is located away from the movement path P0 of the handle piece 41. For this reason, the handle piece 41 of the handle 7 does not engage with the protrusion 43.
  • the handle piece 41 When the handle piece 41 is engaged with the protrusion 43, the handle piece 41 comes into contact with the restriction surface 45 of the protrusion 43 from the proximal end side, and the movement of the handle piece 41 toward the distal end side is restricted by the restriction surface 45. By restricting the movement of the handle piece 41 toward the distal end side, the movement of the handle 7 to the first movement position is restricted. For this reason, as long as the protrusion 43 does not move to the non-engagement position, it does not move to the first movement position of the handle 7 by the action of the urging force from the leaf spring (biasing member) 37.
  • the handle 7 since the handle 7 is biased to move toward the first movement position, when the handle piece 41 is engaged with the protrusion 43, the handle 7 has an operating force toward the proximal end ( Unless an operating force that moves the handle 7 toward the second movement position is applied, the handle 7 does not move toward the second movement position. Therefore, as long as no operating force toward the proximal end is applied to the handle 7 and the protrusion 43 does not move to the disengaged position, the state where the handle piece 41 is engaged with the protrusion 43 is maintained.
  • the second clamp portion 22 including the second electrode 32 and the pad portion 33 is the first clamp portion.
  • the first clamp part 21 and the second clamp part 22 are spaced apart from each other.
  • the first electrode facing surface 35 of the first electrode 31 and the second electrode 32 of the second electrode 32 in a state where the handle piece 41 is engaged with the protrusion (engagement portion) 43, the first electrode facing surface 35 of the first electrode 31 and the second electrode 32 of the second electrode 32.
  • a predetermined separation distance ⁇ 0 is formed between the electrode facing surface 36 and the electrode facing surface 36.
  • the predetermined separation distance ⁇ 0 is smaller than the separation distance between the first electrode facing surface 35 and the second electrode facing surface 36 at the most spaced position of the end effector 20, and is the first distance at the closest position of the end effector 20. It is larger than the separation distance between the first electrode facing surface 35 and the second electrode facing surface 36.
  • the end effector 20 does not move to the closest position unless an operating force that moves 7 toward the second movement position is applied. Therefore, as long as the operating force to the proximal end side is not applied to the handle 7 and the protrusion 43 does not move to the disengaged position, the first electrode facing surface 35 of the first electrode 31 and the second electrode 32.
  • the second electrode facing surface 36 is maintained at a predetermined separation distance ⁇ 0.
  • FIG. 4 is a view showing the handle piece 41 and the protrusion (engagement portion) 43 of the handle 7 in a state where the protrusion 43 is located at the engagement position and the handle 7 is located at the second movement position.
  • FIG. 5 is a diagram showing the end effector 20 in a state where it is located at the closest position.
  • the handle piece 41 is movable from the state engaged with the protrusion 43 (the state contacting the restriction surface 45 from the base end side) toward the base end side. For this reason, when the operating force is applied to the handle 7 from the state in which the handle piece 41 is engaged with the protrusion 43, the handle 7 moves to the second movement position against the urging force from the leaf spring 37. Moving. By moving the handle 7 to the second movement position, the end effector 20 moves from the position where the predetermined distance ⁇ 0 is between the first electrode facing surface 35 and the second electrode facing surface 36 to the closest position. Operate.
  • the pad portion 33 contacts the first clamp portion 21 (first electrode facing surface 35).
  • the second electrode 32 is separated from the first electrode 31. Therefore, in this embodiment, the contact of the first electrode 31 and the second electrode 32 having different potentials (E1, E2) with respect to each other is prevented by supplying high-frequency electrical energy.
  • the separation distance between the first electrode facing surface 35 and the second electrode facing surface 36 is smaller than the predetermined separation distance ⁇ 0.
  • the action and effect of the forceps treatment tool 2 of the present embodiment will be described.
  • the operator holds the housing 3 and inserts the end effector 20 into a body cavity such as the abdominal cavity. Then, the end effector 20 is moved to the vicinity of the treatment target in the body cavity. At this time, the handle 7 is located at the first movement position, and the end effector 20 is located at the most separated position. Further, the protrusion (engagement portion) 43 is located at the non-engagement position.
  • the handle piece 41 In a state where the handle piece 41 is engaged with the protrusion 43, as described above, unless the operating force to the proximal end side is applied to the handle 7 and the protrusion 43 does not move to the non-engagement position, the handle piece 41 Is kept engaged with the protrusion 43.
  • the handle 7 By maintaining the state in which the handle piece 41 is engaged with the protrusion 43, the handle 7 is maintained at a position in the middle of the movement path P0 that moves from the first movement position to the second movement position. Thereby, the end effector 20 is maintained at a position in the middle of changing from the most distant position to the closest position, and the first electrode facing surface 35 of the first electrode 31 and the second electrode facing surface of the second electrode 32. 36 is maintained at a predetermined separation distance ⁇ 0.
  • FIG. 6 is a diagram illustrating an example of a treatment performed in a state where the end effector 20 is maintained at a position on the way from the most distant position to the closest position.
  • a liquid L such as physiological saline is fed to the surface of the treatment target T using an auxiliary tool different from the forceps treatment tool 2.
  • the first electrode 31 is in a state where the handle piece 41 of the handle 7 is engaged with the protrusion 43 (the end effector 20 is maintained at a position in the middle of changing from the most distant position to the closest position).
  • permeates the liquid L sent.
  • the first electrode 31 and the second electrode 32 are operated. Is supplied with high frequency electrical energy. Thereby, a high frequency current flows between the first electrode 31 and the second electrode 32 having different potentials (E1, E2) with respect to each other.
  • E1, E2 different potentials
  • the Joule heat is generated to evaporate the liquid L, and the treatment target is hemostatic (coagulated).
  • the treatment shown in FIG. 6 is performed when hemostasis is performed using a parenchymal organ such as a liver having fine blood vessels as a treatment target.
  • the liquid L can be fed to the surface of the treatment target T without using an auxiliary tool. It becomes.
  • the liquid L is fed to the surface of the treatment target T from a liquid feed source (not shown) including a liquid storage tank and a pump through the inside of the liquid feed tube and the lumen.
  • the end effector 20 is maintained at a position in the middle of changing from the most distant position to the closest position.
  • the distance between the first electrode facing surface 35 of the electrode 31 and the second electrode facing surface 36 of the second electrode 32 is maintained at a predetermined separation distance ⁇ 0.
  • the handle 7 is moved from the state in which the handle piece 41 is engaged with the protrusion 43 to the second movement position, and the end effector 20 is moved to the closest position.
  • the separation distance between the first electrode facing surface 35 and the second electrode facing surface 36 is reduced from the predetermined spacing distance ⁇ 0, and the distance between the first clamp portion 21 and the second clamp portion 22 is reduced.
  • the object is gripped appropriately. At this time, the operator only needs to apply an operating force toward the second movement position (base end side) to the handle 7.
  • the end effector 20 is changed from a state where the end effector 20 is maintained at a position in the middle of changing from the most distant position to the closest position (a state where the handle piece 41 is engaged with the protrusion 43). Can be easily and appropriately operated toward the closest position.
  • the end effector 20 is moved from the state where the end effector 20 is maintained at a position in the middle of changing from the most distant position to the closest position.
  • the surgeon moves the projection 43 to the disengaged position (for example, manually).
  • the engagement of the handle piece 41 with the protrusion (engagement portion) 43 is released, and the handle 7 is moved to the first movement position by the biasing force from the leaf spring (biasing member) 37.
  • the end effector 20 is appropriately moved to the most separated position.
  • the end effector 20 is changed from a state where the end effector 20 is maintained at a position in the middle of changing from the most distant position to the closest position (a state where the handle piece 41 is engaged with the protrusion 43). Can be operated easily and appropriately toward the most spaced position.
  • the guide groove 42 is provided in the housing 3 as in the first embodiment, and the protrusion (engagement portion) 43 has the guide groove 42. It is movable. However, in this modification, the protrusion 43 can be engaged with the handle piece 41 of the handle 7 at the three engagement positions S1 to S3. Regardless of whether the protrusion 43 is located at any of the engagement positions S1 to S3, in the middle of the movement path P0 of the handle piece 41 with the handle 7 moving from the first movement position to the second movement position, The restriction surface 45 of the protrusion (engagement portion) 43 is located. Therefore, the protrusion 43 can be engaged with the handle piece 41 at the engagement positions S1 to S3.
  • the handle piece 41 is located at the engagement position (second engagement position) S2 as compared to the state where the handle piece 41 is engaged with the protrusion 43 located at the engagement position (first engagement position) S1.
  • the handle 7 In a state where the protrusions 43 are engaged, the handle 7 is positioned on the proximal end side (side closer to the second movement position). Further, the handle piece 41 is in the engagement position (third engagement position) S3 as compared with the state in which the handle piece 41 is engaged with the protrusion 43 located in the engagement position (second engagement position) S2.
  • the handle 7 In a state where the projection 7 is engaged with the handle 7, the handle 7 is located on the proximal end side (side closer to the second movement position). Therefore, in this modification, when the protrusion (engaging portion) 43 moves, the protrusion 43 and the handle piece 41 in the middle of the movement path P0 of the handle from the first movement position to the second movement position.
  • the engagement positions S1 to S3 change.
  • the position at which the end effector 20 is maintained during the change from the most distant position to the closest position changes.
  • the separation distance between the first clamp part 21 and the second clamp part 22 in a state in which 41 is engaged with the protrusion (engagement part) 43 changes.
  • the end effector is compared with the state where the handle piece 41 is engaged with the protrusion 43 positioned at the engagement position S1. 20 approaches the closest position, and the separation distance between the first clamp part 21 and the second clamp part 22 becomes small.
  • the end effector is compared with the state where the handle piece 41 is engaged with the protrusion 43 positioned at the engagement position S2. 20 approaches the closest position, and the separation distance between the first clamp part 21 and the second clamp part 22 becomes small.
  • the engagement positions S1 to S3 of the protrusion (engagement portion) 43 with the handle piece 41 can be changed, and the engagement positions S1 to S3 of the protrusion 43 and the handle piece 41 are changed.
  • the position at which the end effector 20 is maintained in the middle of changing from the most distant position to the closest position changes.
  • the operator changes the position where the end effector 20 is maintained in accordance with the environment in which the treatment is performed, the state of the treatment target, and the like, and the handle piece 41 is engaged with the protrusion 43.
  • the separation distance between the first clamp part 21 and the second clamp part 22 can be adjusted.
  • the protrusion 43 can be engaged with the handle piece 41 at three engagement positions S1 to S3.
  • the protrusion (engagement portion) 43 has a plurality of engagement positions at the handle piece 41. If it is the structure which can be engaged, there exists an effect
  • FIG. 8 is a view showing the configuration of the housing 3 and the handle 7 of this modification
  • FIG. 9 is a view of the handle 7 as viewed from the distal end side.
  • the handle 7 is provided with a handle piece (handle protrusion) 51 instead of the handle piece (handle hook) 41.
  • the handle piece 51 is located on one side in the width direction of the housing 3 (this deformation). In the example, it protrudes toward the arrow W2 side.
  • the handle piece 51 moves along the movement path P′0.
  • a rotating member (engagement portion) 52 is attached to the inner peripheral surface of the housing 3 via a support shaft 53.
  • the handle piece (handle protrusion) 51 protrudes toward the side where the rotation member 52 is positioned in the width direction of the housing 3.
  • FIG. 10 is a diagram showing a configuration of the rotating member 52.
  • FIG. 6 is a diagram showing a configuration of a rotating member (engagement portion) 52.
  • the rotation member 52 is attached to the housing 3 so as to be rotatable about a rotation axis R that is a central axis of the support shaft 53.
  • the rotation axis R extends substantially parallel to the width direction of the housing 3.
  • the support shaft 53 is connected to the inner peripheral surface of the housing 3 via a coil spring 55 that is an urging member.
  • an intersecting direction (direction indicated by arrows Y1 and Y2 in FIG.
  • the coil spring 55 causes the urging force that moves the rotating member (engagement portion) 52 toward the neutral position in the intersecting direction to act on the rotating member 52 and the support shaft 53.
  • the pressing of the rotating member 52 is released after the rotating member 52 moves from the neutral position toward one side (the arrow Y1 side in FIG. 10) in the crossing direction by pressing, the attachment from the coil spring 55 is performed. Due to the force, the rotating member 52 moves toward the other side (arrow Y2 side in FIG. 10) in the crossing direction. In FIG. 10, the rotating member 52 is located at the neutral position.
  • a leaf spring 56 is provided in the housing 3 as a biasing member different from the leaf spring 37 (see FIG. 1) and the coil spring 55.
  • the leaf spring 56 causes the urging force to rotate the rotation member (engagement portion) 52 about the rotation axis R toward the neutral position on the rotation member 52.
  • the plate With the urging force from the spring 56, the rotating member 52 rotates (moves) toward the other side (the arrow R2 side in FIG. 10) about the rotation axis R.
  • the rotating member 52 includes an extended surface (first extended surface) 61 and an extended surface (second extended surface) 62 facing the arrow Y2 side (the other side in the crossing direction) in FIG.
  • the extending surface 62 is located on the base end side (arrow C2 side in FIG. 10) from the extending surface 61, and a regulating surface 63 facing the base end side is formed between the extending surface 61 and the extending surface 62. Is formed.
  • the regulating surface 63 forms a step in the rotating member 52 in the intersecting direction.
  • the extended surface 62 is positioned closer to the arrow Y ⁇ b> 1 in FIG. 10 than the extended surface 61 due to the level difference on the regulating surface 63.
  • the rotating member 52 is provided with an extending surface (third extending surface) 65 facing the side opposite to the extending surfaces 61 and 62 (arrow Y1 side in FIG. 10) in the intersecting direction.
  • the handle 7 In a state where the rotating member 52 is located at the neutral position, the handle 7 is moved from the first movement position to the second movement position (moved from the second movement position to the first movement position).
  • the regulating surface 63 is not positioned in the middle of the movement path P′0 of the handle piece 51 in the state of For this reason, the neutral position of the rotation member 52 is a non-engagement position where the handle member 51 of the handle 7 is not engaged.
  • FIG. 11 is a diagram for explaining the operation of the handle piece 51 and the rotating member (engagement portion) 52 when the handle 7 is moved from the first movement position to the second movement position.
  • the handle piece 51 is moved. Comes into contact with the extended surface (first extended surface) 61 of the rotating member 52.
  • the handle piece 51 moves toward the base end side along the extending surface 61 of the rotating member 52.
  • the handle piece 51 presses the rotating member (engagement portion) 52 via the extended surface 61.
  • the rotating member 52 moves from the neutral position (non-engagement position) to one side in the crossing direction (arrow Y1 side in FIG. 11) against the urging force from the coil spring 55, and is applied from the leaf spring 56.
  • the rotating member 52 rotates from the neutral position (non-engagement position) to one side (the arrow R1 side in FIG. 11) around the rotation axis R against the force.
  • the turning member 52 is moved and turned by the pressing from the handle piece 51, the turning member 52 is moved to an engagement position where the turning piece 52 can be engaged with the handle piece 51.
  • the rotation member 52 moves to the engagement position, the movement path P ′ 0 of the handle piece 51 passes through the regulation surface 63.
  • the handle piece 51 When the handle 7 is further moved toward the second movement position, the handle piece 51 passes through the regulating surface 63 and comes into contact with the extended surface (second extended surface) 62. At this time, the handle piece 51 presses the rotating member (engagement portion) 52 via the extended surface 62. For this reason, contrary to the urging force from the coil spring 55 and the urging force from the leaf spring 56, the rotating member 52 is maintained in the above-mentioned engagement position. For this reason, by stopping the application of the operating force to the handle 7 in a state where the handle piece 51 is in contact with the extended surface 62, the handle piece 51 is brought into contact with the restricting surface 63 of the rotating member 52 on the base end side (the first side). 2 (side closer to the movement position).
  • the handle piece 51 is engaged with the rotating member 52. That is, the handle piece 51 of the handle 7 is engaged with the rotating member 52 in the middle of the movement path P ′ 0 from the first movement position of the handle 7 to the second movement position.
  • the handle piece 51 is in contact with the restriction surface 63 from the base end side, whereby the movement of the handle 7 to the first movement position is restricted. For this reason, the handle 7 does not move to the first movement position by the action of the biasing force from the leaf spring (biasing member) 37.
  • the handle piece 51 is maintained in the engaged state with the rotating member 52 unless the operating force to the proximal end is applied to the handle 7.
  • the handle 7 is maintained at a position in the middle of the movement path P'0 that moves from the first movement position to the second movement position. Is done.
  • the end effector 20 is maintained at a position in the middle of changing from the most distant position to the closest position, and the first electrode facing surface 35 of the first electrode 31 and the second electrode facing surface of the second electrode 32. 36 is maintained at a predetermined separation distance ⁇ 0.
  • the handle piece 51 When an operating force is applied to the handle 7 from the state in which the handle piece 51 is engaged with the rotating member 52 toward the proximal end (toward the second movement position), the handle piece 51 is moved to the rotating member 52. It moves toward the base end side along the extended surface 62. When the handle piece 51 passes through the extended surface 62, the handle piece 51 is separated from the rotating member 52 and moves to the second movement position. When the handle piece 51 passes through the extended surface 62, the rotating member (engagement portion) 52 is not pressed from the handle piece 51. For this reason, the rotating member 52 moves from the engagement position to the neutral position (non-engagement position) by the urging force from the coil spring 55 and the urging force from the leaf spring 56.
  • FIG. 12 is a diagram for explaining the operation of the handle piece 51 and the rotating member (engagement portion) 52 when the handle 7 is moved from the second movement position to the first movement position.
  • the handle 7 is biased by the urging force from the leaf spring 37. 7 moves toward the first movement position.
  • the handle piece 51 is moved. Comes into contact with the extended surface (third extended surface) 65 of the rotating member 52. Then, the handle piece 51 moves toward the distal end side (the arrow C1 side in FIG. 12) along the extending surface 65 of the rotating member 52.
  • the handle piece 51 presses the rotating member (engagement portion) 52 via the extended surface 65.
  • the rotating member 52 rotates from the neutral position (non-engaging position) to one side around the rotation axis R (arrow R1 side in FIG. 12) against the urging force from the leaf spring 56.
  • the handle piece 51 moves on the extending surface 65 toward the distal end side in the rotating member 52 that is rotated from the neutral position to one side around the rotation axis R.
  • the handle piece 51 When the handle 7 is further moved toward the first movement position by the urging force from the leaf spring 37, the handle piece 51 passes through the extended surface 65. Then, the handle piece 51 moves away from the rotating member 52 and moves to the first movement position. When the handle piece 51 passes through the extended surface 65, the rotating member (engagement portion) 52 is not pressed from the handle piece 51. For this reason, the rotation member 52 moves to the neutral position (non-engagement position) by the urging force from the leaf spring 56. As described above, the handle 7 moves from the second movement position to the first movement position. Therefore, when the handle 7 moves from the second movement position to the first movement position, the handle piece 51 has the restriction surface 63. Will not abut.
  • the handle piece 51 is moved to the rotating member (engagement) by stopping the application of the operating force to the handle 7 after moving the handle 7 from the first movement position to the second movement position to some extent.
  • the end effector 20 is maintained at a position in the middle of changing from the most distant position to the closest position. Further, by moving the handle 7 from the state where the handle piece 51 is engaged with the rotating member 52 to the second moving position, the engagement between the handle piece 51 and the rotating member 52 is released. In the movement of the handle 7 from the second movement position to the first movement position, the handle piece 51 does not come into contact with the regulating surface 63 and the handle piece 51 does not engage with the rotating member 52.
  • the operator can maintain the end effector 20 at a position in the middle of changing from the most distant position to the closest position by operating only the handle 7 and changes from the most distant position to the closest position.
  • the end effector 20 can be moved from the state in which the end effector 20 is maintained at a midway position to the farthest position. Thereby, workability and efficiency in the treatment are improved.
  • a fixing portion (engagement portion) 70 is provided on the front side.
  • the crossing direction (directions indicated by arrows Y1 and Y2 in FIGS. 13 and 14) is defined as in the modified examples of FIGS.
  • fixed part 70 has the extended surface (1st extended surface) 71 and extended surface (the 1st extended surface) which face the arrow Y2 side (other side of a cross direction) of FIG.13 and FIG.14. 2nd extended surface) 72 is provided.
  • the extending surface 72 is located on the base end side (the arrow C2 side in FIGS. 13 and 14) from the extending surface 71, and between the extending surface 71 and the extending surface 72, a restriction facing the base end side. A surface 73 is formed. Due to the restriction surface 73, a step is formed in the fixed portion 70 in the intersecting direction.
  • the extended surface 72 is positioned on the arrow Y1 side in FIGS. 13 and 14 as compared to the extended surface 71 due to the level difference on the regulating surface 73.
  • the fixing portion 70 is provided with an extending surface (third extending surface) 75 facing the opposite side to the extending surfaces 71 and 72 (the arrow Y1 side in FIGS. 13 and 14) in the intersecting direction. Yes.
  • a handle piece 51 that protrudes toward one side in the width direction of the housing 3 is provided, and the handle piece 51 is moved by moving the handle 7 from the first movement position to the second movement position. Moves along the movement path P′0.
  • the handle piece 51 has elasticity and is easily bent in a direction perpendicular to the movement path P′0 (crossing direction).
  • the handle piece 51 is difficult to bend in the direction parallel to the movement path P′0 (the direction along the longitudinal axis C).
  • the handle piece 51 is moved. Comes into contact with the extending surface (first extending surface) 71 of the fixing portion 70, and the handle piece 51 moves toward the proximal end side along the extending surface 71 of the fixing portion 70. At this time, the handle piece 51 is pressed from the fixed portion (engagement portion) 70 through the extending surface 71, and toward the arrow Y2 side (the other side in the crossing direction) in FIG. 13 in the direction perpendicular to the movement path P′0. Bend.
  • the handle piece 51 When the handle 7 is further moved toward the second movement position, the handle piece 51 passes through the restriction surface 73 and comes into contact with the extended surface (second extended surface) 72. At this time, the handle piece 51 is pressed from the fixed portion (engagement portion) 70 via the extended surface 72 and is directed to the arrow Y2 side (the other side in the crossing direction) in FIG. 13 in the direction perpendicular to the movement path P′0. Bend.
  • the handle piece 51 is placed on the base surface side (second movement position) on the regulating surface 73 of the fixing portion 70. Abut from the side close to.
  • the handle piece 51 is pressed toward the base end side from the fixed portion 70 via the restriction surface 73.
  • the handle piece 51 is difficult to bend in the direction parallel to the movement path P′0 (the direction along the longitudinal axis C), so even if the handle piece 51 is pressed from the fixed portion 70 via the restriction surface 73, the handle The piece 51 does not bend toward the base end side.
  • the handle piece 51 is engaged with the fixing portion 70. That is, the handle piece 51 of the handle 7 is engaged with the fixed portion 70 in the middle of the movement path P ′ 0 from the first movement position of the handle 7 to the second movement position.
  • the handle piece 51 is engaged with the fixed portion 70 at the restriction surface 73, so that the movement of the handle 7 to the first movement position is restricted. For this reason, the handle 7 does not move to the first movement position by the action of the biasing force from the leaf spring (biasing member) 37.
  • the handle piece 51 is maintained in the engaged state with the fixed portion 70 as long as the operating force toward the proximal end is not applied to the handle 7.
  • the handle 7 is maintained at a position in the middle of the movement path P'0 moving from the first movement position to the second movement position.
  • the end effector 20 is maintained at a position in the middle of changing from the most distant position to the closest position, and the first electrode facing surface 35 of the first electrode 31 and the second electrode facing surface of the second electrode 32. 36 is maintained at a predetermined separation distance ⁇ 0.
  • the handle piece 51 When an operating force is applied to the handle 7 from the state in which the handle piece 51 is engaged with the fixing portion 70 toward the proximal end (toward the second movement position), the handle piece 51 is extended from the fixing portion 70. It moves toward the base end side along the installation surface 72. When the handle piece 51 passes through the extended surface 72, the handle piece 51 is separated from the fixed portion 70 and moves to the second movement position. When the handle piece 51 passes through the extended surface 72, the handle piece 51 is not pressed from the fixing portion 70. For this reason, the handle piece 51 is not bent.
  • the handle piece 51 is moved. Comes into contact with the extended surface (third extended surface) 75 of the fixed portion 70. Then, the handle piece 51 moves toward the distal end side (the arrow C1 side in FIG. 14) along the extending surface 75 of the fixing portion 70. At this time, the handle piece 51 is pressed from the fixed portion (engagement portion) 70 through the extended surface 75, and is directed to the arrow Y1 side (one side in the crossing direction) in FIG. 14 in the direction perpendicular to the movement path P′0. Bend.
  • the handle piece 51 When the handle 7 further moves toward the first movement position by the urging force from the leaf spring 37, the handle piece 51 passes through the extended surface 75. Then, the handle piece 51 moves away from the fixed portion 70 and moves to the first movement position. When the handle piece 51 passes through the extended surface 75, the handle piece 51 is not pressed from the fixing portion (engagement portion) 70. For this reason, the handle piece 51 is not bent. As described above, the handle 7 moves from the second movement position to the first movement position. Therefore, when the handle 7 moves from the second movement position to the first movement position, the handle piece 51 has the restriction surface 73. Will not abut.
  • 15 to 18 show a fourth modification of the first embodiment.
  • the end effector 20 is positioned at the closest position as the handle 7 moves to the second movement position.
  • the handle piece 41 is engaged with the protrusion 43 when the handle 7 moves from the first movement position (position X1 in FIG. 15) to the second movement position (position X4 in FIG. 18).
  • the end effector 20 is positioned at the closest position (most recent position). Move to close position).
  • a movable body 180 is provided instead of providing the movable body 18 in the first embodiment shown in FIG. 1, a movable body 180 is provided.
  • an elastic member (spring) 100, a ring (slider) 101, A pin 104 is provided inside the housing 3.
  • a holder 106 is provided at the base end of the rotary knob 15, and the holder 106 rotates about the longitudinal axis C as the rotary knob 15 rotates.
  • a hole through which the movable body 180 is inserted is formed in the holder 106, and a pin 104 that engages with the movable body 180 is fixed.
  • the movable body 180 has a pin groove 105 engaged with the pin 104 extending along the longitudinal axis C, and the pin groove 105 of the movable body 180 is movable along the longitudinal axis C with respect to the pin 104. .
  • a ring 101 that is movable along the longitudinal axis C with respect to the movable body 180 is provided at the base end portion of the movable body 180, and the ring 101 also rotates around the longitudinal axis C when the movable body 180 rotates.
  • a circumferential groove 103 is formed on the ring (slider) 101, and a protrusion 102 provided on the handle 7 engages with the circumferential groove 103.
  • the elastic member (spring) 100 has one end (base end) connected to the ring 101 and the other end (tip end) connected to the movable body 180.
  • the handle 7 when the handle 7 is grasped with respect to the grip 6 (moved from the first movement position to the second movement position), the following operation is performed. As shown in FIG. 15, even in the present modification, the end effector 20 is located at the most separated position when the handle 7 is located at the first movement position. Then, when the handle 7 is moved from the first movement position toward the second movement position, as shown in FIG. 16, the handle 7 is moved from the first movement position (initial position) X1 to the protrusion 43. It moves to the position X2 where it engages.
  • the ring 101 and the movable body 180 move together along the longitudinal axis C toward the distal end side by pressing from the protrusion 102 of the handle 7 To do.
  • the end effector 20 moves toward the closest position.
  • the elastic member 100 contracts, the elastic member 100 generates a predetermined elastic force in a state where the handle has moved to the second movement position X4. Thereby, in the state where the handle has moved to the second movement position X4, the first clamp portion 21 and the second clamp portion 22 of the end effector 20 located at the closest position are caused by the elastic force from the elastic member 100.
  • a predetermined gripping force acts between the two. That is, in a state where the handle is moved to the second movement position X4, a substantially constant gripping force is always applied between the first clamp part 21 and the second clamp part 22.
  • both the pair of clamp parts (21, 22) rotate with respect to the sheath (16) in response to the movement of the handle (7), so that the clamp parts (21, 22) In the forceps treatment instrument (2) in which the distance between the end effectors (2) changes, the end effector (20) can be moved to the most distant position by engaging the engaging portion (43; 52; 70) of the handle (7). May be applied).
  • the handle 7 is positioned on the distal end side with respect to the grip 6.
  • the handle (7) may be positioned on the proximal end side with respect to the grip (6). Good.
  • the handle (7) in the movement of the handle (7) from the first movement position to the second movement position (operation from the most separated position of the end effector (20) to the closest position), the handle (7) is moved to the distal end side. Move towards.
  • the handle (7) may move in a direction intersecting the longitudinal axis (C) (substantially perpendicular to the longitudinal axis (C)).
  • the end effector (20) provided in the forceps treatment instrument (2) changes in relative position with respect to the first clamp part (21) and the first clamp part (21).
  • the second clamp part (22) operates between the closest position with respect to the one clamp part (21).
  • the forceps treatment instrument (2) includes a holdable housing (3), and a handle (7) movable with respect to the housing (3) between a first movement position and a second movement position.
  • the handle (7) moves the end effector (20) to the most distant position by moving to the first moving position, and moves the end effector (20) to the closest position by moving to the second moving position.
  • the engaging portion (43; 52; which can be engaged with the handle (7) in the middle of the movement path of the handle (7) from the first movement position to the second movement position. 70) is provided, and the engagement portion (43; 52; 70) is engaged with the handle (7), so that the movement of the handle (7) to the first movement position is restricted, and the end effector (20). The movement to the most distant position is restricted.
  • FIGS. 19 and 20 are diagrams showing the configuration of the forceps treatment instrument 2 of the present embodiment.
  • FIG. 21 is a cross-sectional view taken along line XXI-XXI in FIG.
  • the outer peripheral side of the sheath (fixed sheath) 16 is covered with a movable sheath 80.
  • the movable sheath 80 is movable with respect to the longitudinal axis C with respect to the housing 3, the sheath 16 and the conductive rod 17.
  • the movable sheath 80 includes an engaging claw 81 formed by patching, for example.
  • Two engaging grooves 82 and 83 are formed on the outer surface of the housing 3 (housing body 5).
  • the engagement groove (second engagement groove) 83 is located on the distal end side with respect to the engagement groove (first engagement groove) 82.
  • the engagement claw 81 is engaged with the engagement groove (82 or 83)
  • the movement of the movable sheath 80 along the longitudinal axis C is restricted.
  • the movable sheath 80 is moved manually, for example, and the engagement between the engagement claw 81 and the engagement groove (82 or 83) is released manually, for example.
  • a pressing portion 85 capable of pressing the second clamp portion 22 of the end effector 20 is provided on the inner peripheral surface of the distal end portion of the movable sheath 80.
  • the movable sheath 80 including the pressing portion 85 does not come into contact with the end effector 20, and the movable sheath 80 (pressing portion 85) makes the second.
  • the clamp part 22 is not pressed.
  • the pressing portion 85 can come into contact with the second clamp portion 22 of the end effector 20, and the second clamp portion 22 is moved to the second position. It becomes possible to press toward one clamp part 21.
  • the movable sheath 80 is movable between a non-pressing position where the end effector 20 is not pressed (position shown in FIG. 19) and a pressing position where the second clamp part 22 of the end effector 20 can be pressed by the pressing part 85. It is.
  • a plate spring 37 is provided as a biasing member that causes the end effector 20 to act on the end effector 20 so as to operate the end effector 20 toward the farthest distance position. Therefore, when no operating force is applied to the handle 7 in a state where the movable sheath 80 is located at the non-pressing position, the end effector 20 is located at the most separated position.
  • the pressing portion 85 of the movable sheath 80 can press the second clamp portion 22 of the end effector 20 toward the first clamp portion 21.
  • the second clamp portion 22 contacts the pressing portion 85 of the movable sheath 80.
  • the 2nd clamp part 22 is pressed by the press part 85 toward the 1st clamp part 21, and the movement to the most separated position of the end effector 20 (2nd clamp part 22) is controlled. For this reason, as long as the movable sheath 80 is positioned at the pressing position, the end effector 20 is not positioned at the most separated position by the urging force from the leaf spring 37.
  • the end effector 20 is biased to the state of moving toward the furthest distance position, the end effector 20 is positioned closest to the end effector 20 unless an operating force that moves the handle 7 toward the second movement position is applied. Does not move to position. Therefore, in a state where the movable sheath 80 is positioned at the pressing position, the end effector 20 is maintained at a position in the middle of changing from the most separated position to the closest position unless an operating force is applied to the handle 7. By maintaining the end effector 20 at a position in the middle of changing from the most distant position to the closest position, the first electrode facing surface 35 of the first electrode 31 and the second electrode facing surface of the second electrode 32 36 is maintained at a predetermined separation distance ⁇ 0.
  • the end effector 20 In the state where the movable sheath 80 is located at the pressing position, the end effector 20 has a predetermined separation distance between the first electrode facing surface 35 and the second electrode facing surface 36 corresponding to the movement of the handle 7. It operates between the position that becomes ⁇ 0 and the closest position.
  • the movable sheath 80 is moved to the pressing position where the second clamp portion 22 can be pressed by the pressing portion 85, so that the movable sheath 80 is moved from the most distant position to the closest position.
  • the end effector 20 is maintained, and a distance between the first electrode facing surface 35 of the first electrode 31 and the second electrode facing surface 36 of the second electrode 32 is maintained at a predetermined separation distance ⁇ 0.
  • the operator does not need to apply an operating force to the handle 7. Therefore, similarly to the first embodiment, the operator can easily and appropriately maintain the end effector 20 at a position on the way from the most distant position to the closest position. Accordingly, as in the first embodiment, workability and efficiency are ensured in the procedure shown in FIG.
  • the handle 7 In a state where the movable sheath 80 is positioned at the pressing position, the handle 7 is moved to the second movement position, whereby the first electrode facing surface 35 and the second electrode facing surface 36 are separated by a predetermined distance.
  • the end effector operates from the position where the distance is ⁇ 0 to the closest position.
  • the separation distance between the first electrode facing surface 35 and the second electrode facing surface 36 is reduced from the predetermined spacing distance ⁇ 0, and the distance between the first clamp portion 21 and the second clamp portion 22 is reduced.
  • the object is gripped appropriately. At this time, the operator only needs to apply an operating force toward the second movement position to the handle 7.
  • the end effector 20 is moved toward the closest position from the state where the end effector 20 is maintained at a position on the way from the most distant position to the closest position. Can be operated easily and appropriately.
  • the operator when operating the end effector 20 from the state where the end effector 20 is maintained at a position in the middle of changing from the most distant position to the closest position, the operator (for example, manually) the movable sheath 80 is moved to the non-pressing position. Thereby, the movable sheath 80 (pressing portion 85) does not press the end effector 20, and the end effector 20 is appropriately moved to the most separated position by the urging force from the leaf spring (biasing member) 37.
  • the end effector 20 is moved from the state where the end effector 20 is maintained at a position in the middle of changing from the most distant position to the closest position, and then the end effector 20 is moved toward the most distant position. It can be operated easily and appropriately.
  • the movable sheath 80 is provided with a connection base 86, and one end of a liquid feeding tube 87 is connected to the connection base 86.
  • the other end of the liquid feeding tube 87 is connected to a liquid feeding source (not shown) including a liquid storage tank and a pump.
  • a lumen (liquid feeding lumen) 90 is formed along the longitudinal axis C in the movable sheath 80.
  • the connection base 86 the inside of the liquid feeding tube 87 communicates with the lumen 90.
  • a spout 91 of the lumen 90 is formed at the tip of the movable sheath 80.
  • a liquid (fluid) such as physiological saline is supplied from the liquid supply source to the lumen 90 through the inside of the liquid supply tube 87 in the state where the treatment shown in FIG. 6 is performed. Then, in the lumen 90, liquid (fluid) is supplied from the proximal end side toward the distal end side, and the liquid supplied from the ejection port 91 is ejected (arrow F1 in FIG. 23).
  • the movable sheath 80 pressing portion 85
  • the end effector 20 second clamp portion 22
  • the jet outlet 91 located at the distal end of the movable sheath 80 is located closer to the distal end than the distal end of the sheath (fixed sheath) 16. Accordingly, since the liquid is ejected at a position closer to the treatment target T than the distal end of the sheath 16, the liquid L is appropriately fed to the surface of the treatment target T in the treatment of FIG. Thereby, the treatment performance in the treatment of FIG. 6 is improved.
  • both of a pair of clamp part (21, 22) rotate with respect to a sheath (16) corresponding to a movement of a handle (7), and a clamp part (21, 22) of it is carried out.
  • a movable sheath (80) similar to that of the second embodiment may be provided.
  • the pressing portion (85) may be able to press only one of the clamp portions (21, 22), and the clamp portions (21, 22) Both of them may be pressed.
  • the end effector (20) (one or the other of the clamp portions (21, 22)) is pressed by the pressing portion (85) located at the pressing position, and similarly to the second embodiment, The movement of the end effector (20) to the most separated position is restricted.
  • both the clamp parts (21, 22) can be pressed by the pressing part (85), the clamp parts (21, 22) are pressed toward a direction close to each other.
  • the position of the handle 7 with respect to the housing 3 and the moving direction of the handle 7 are not limited.
  • the end effector (20) provided in the forceps treatment instrument (2) changes in relative position with respect to the first clamp part (21) and the first clamp part (21).
  • a second clamp portion (22) that is possible, and the end effector (20) includes a first clamp portion (21) and a second clamp portion (22) that are farthest apart from the first clamp portion (21).
  • the second clamp part (22) operates between the closest position with respect to the one clamp part (21).
  • the urging force that is operated toward the most separated position is applied to the end effector (20) by the urging member (37).
  • the forceps treatment instrument (2) includes a pressing portion (85) that can press at least one of the first clamp portion (21) and the second clamp portion (22) of the end effector (20). When the part (85) presses the end effector (20), the operation of the end effector (20) to the most separated position is restricted.
  • high-frequency electrical energy is supplied to the end effector 20 as energy used for treatment, but is not limited thereto.
  • high frequency electrical energy can be supplied to the end effector (20) and ultrasonic vibrations can be transmitted to the end effector (20).
  • a vibration generating unit such as a piezoelectric element is provided inside the housing (3), and vibration is generated by supplying electric energy different from the above-described high-frequency electric energy from the energy control device 10 to the vibration generating unit. Ultrasonic vibration is generated at the part. Then, ultrasonic vibration is transmitted to the first clamp part (21) through the conductive rod (18).
  • high-frequency electric energy can be supplied to the end effector (20), and a heater may be provided in the end effector (20). In this case, heat is generated in the heater when electric energy different from the above-described high-frequency electric energy is supplied to the heater.

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Abstract

L'invention concerne un outil de traitement de forceps qui comprend un effecteur final ayant une première partie de pince, ainsi qu'une seconde partie de pince qui peut changer sa position par rapport à la première partie de pince. L'effecteur final fonctionne dans une position entre la position la plus éloignée, dans laquelle la seconde partie de pince est positionnée le plus loin de la première partie de pince, et la position la plus proche, dans laquelle la seconde partie de pince est positionnée le plus près de la première pince. L'outil de traitement de forceps, en limitant le mouvement de l'effecteur final vers la position la plus éloignée, retient l'effecteur final pendant un changement de positions de la position la plus éloignée à la position la plus proche.
PCT/JP2016/070583 2015-07-21 2016-07-12 Outil de traitement de forceps Ceased WO2017014110A1 (fr)

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CN114732487A (zh) * 2021-01-07 2022-07-12 苏州佳世达电通有限公司 谐波刀

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