WO2018198209A1 - Treatment tool - Google Patents

Abstract

In a treatment tool 2, when a cross section orthogonal to the longitudinal direction of first and second jaws 8, 9 in a closed state of the first and second jaws 8, 9 is divided into a first region and a second region in the width direction of first and second holding surfaces 121, 151, and a third region positioned between the first region and the second region, a first separation distance between the first and second holding surfaces 121, 151 at a predetermined position in the width direction in the first region and a second separation distance between the first and second holding surfaces 121, 151 at a predetermined position in the width direction in the second region are equal to or greater than a third separation distance between the first and second holding surfaces 121, 151 in the third region, and are each smaller toward a proximal end than toward a distal end.

Description

Treatment tool

The present invention relates to a treatment tool.

BACKGROUND Conventionally, a treatment tool for treating (joining (or anastomizing), cutting or the like) a living tissue by applying energy to the living tissue is known (see, for example, Patent Document 1).
The treatment tool (surgical treatment tool) described in Patent Document 1 includes first and second jaws that open and close via a pivot pin provided on the proximal side to grip a living tissue, and a first jaw. And a heat generating blade that contacts the living tissue to apply heat energy. Here, the heat generating blade is rotatably supported on the first jaw by a single support pin extending in the width direction of the first jaw. That is, in the treatment tool described in Patent Document 1, by providing the heat generating blade as described above, the gripping force applied to the living tissue from the first and second jaws is made in the longitudinal direction of the first and second jaws. A uniform and uniform treatment of living tissue is realized in the longitudinal direction.

JP, 2005-185656, A

However, in the treatment tool described in Patent Document 1, since it is necessary to make the heat generating blade turnable to the first jaw via the support pin, the configuration becomes complicated, which hinders miniaturization. There is.

The present invention has been made in view of the above, and it is an object of the present invention to provide a treatment tool capable of uniformly treating living tissue in the longitudinal direction of the first and second jaws while achieving downsizing. To aim.

In order to solve the problems described above and achieve the object, the treatment tool according to the present invention grips a living tissue between a first jaw having a first gripping surface and the first gripping surface A second jaw having a second gripping surface, and at least one of the first and second jaws, the living body from at least one of the first gripping surface and the second gripping surface And an energy generating unit for generating energy to be applied to the tissue, wherein the first jaw and the second jaw have the first jaw and the second jaw centered on a fulcrum provided on the proximal side. The first jaw and the second jaw are closed by opening and closing at least one of the first jaw and the second jaw, and a cross section orthogonal to the longitudinal direction of the first jaw and the second jaw is Of the second gripping surface and the second gripping surface When the direction is divided into a first area, a second area, and a third area located between the first area and the second area, the width direction in the first area A first separation distance between the first grip surface and the second grip surface at a predetermined position, and the first grip surface and the first grip at a predetermined position in the width direction in the second region. The second separation distance between the two gripping surfaces is equal to or greater than the third separation distance between the first gripping surface and the second gripping surface in the third region, and is based on the tip side. Each end is smaller.

The treatment tool according to the present invention has the effect of being able to uniformly treat living tissue in the longitudinal direction of the first and second jaws while achieving downsizing.

FIG. 1 is a view schematically showing a treatment system according to the first embodiment. FIG. 2 is a view showing a distal end portion of the treatment tool. FIG. 3 is a cross-sectional view taken along line III-III shown in FIG. FIG. 4 is a cross-sectional view taken along the line IV-IV shown in FIG. FIG. 5 is a view showing the distal end portion of the treatment tool according to the second embodiment. 6 is a cross-sectional view taken along the line VI-VI shown in FIG. FIG. 7 is a cross-sectional view taken along the line VII-VII shown in FIG. FIG. 8 is a view showing a gripping portion according to a first modification of the first and second embodiments. FIG. 9 is a view showing a gripping portion according to a first modification of the first and second embodiments. FIG. 10 is a view showing a gripping portion according to a second modification of the first and second embodiments. FIG. 11 is a view showing a gripping portion according to a second modification of the first and second embodiments. FIG. 12 is a view showing a gripping portion according to a second modification of the first and second embodiments. FIG. 13 is a view showing a gripping portion according to a third modification of the first and second embodiments. FIG. 14 is a view showing a gripping portion according to a third modification of the first and second embodiments.

Hereinafter, with reference to the drawings, modes for carrying out the present invention (hereinafter referred to as embodiments) will be described. The present invention is not limited by the embodiments described below. Furthermore, in the description of the drawings, the same parts are given the same reference numerals.

Embodiment 1
[Schematic Configuration of Treatment System]
FIG. 1 is a view schematically showing a treatment system 1 according to the first embodiment.
The treatment system 1 treats (such as bonding (or anastomosis) and dissection) a living tissue by applying thermal energy to the living tissue to be treated. The treatment system 1 includes a treatment tool 2, a control device 3 and a foot switch 4 as shown in FIG.

[Configuration of treatment tool]
The treatment tool 2 is, for example, a linear surgical treatment tool for treating a living tissue through the abdominal wall. As shown in FIG. 1, the treatment tool 2 includes a handle 5, a shaft 6, and a grip 7.
The handle 5 is a part held by the operator by hand. Further, as shown in FIG. 1, the handle 5 is provided with an operation knob 51.
As shown in FIG. 1, the shaft 6 has a substantially cylindrical shape, and one end (the right end in FIG. 1) is connected to the handle 5. Further, a grip 7 is attached to the other end (left end in FIG. 1) of the shaft 6. An opening / closing mechanism (not shown) for opening and closing the first and second jaws 8 and 9 (FIG. 1) constituting the gripping portion 7 in accordance with the operation of the operation knob 51 by the operator inside the shaft 6 ) Is provided. Also, inside the shaft 6, an electric cable C (FIG. 1) connected to the control device 3 passes from the one end side (right end portion side in FIG. 1) to the other end side (in FIG. 1) It is disposed up to the left end side).

[Configuration of gripping portion]
FIG. 2 is a view showing the distal end portion of the treatment tool 2.
The gripping portion 7 is a portion that grips a living tissue to treat the living tissue. The gripping portion 7 is provided with first and second jaws 8 and 9 as shown in FIG. 1 or 2.
The first and second jaws 8 and 9 are supported by the other end (left end in FIGS. 1 and 2) of the shaft 6 so as to be able to open and close in the direction of arrow R1 (FIG. 2) Depending on the operation, the living tissue can be grasped.

[Structure of the first jaw]
In addition, "the front end side" described below is the front end side of the holding part 7, Comprising: The left side is meant in FIG. 1, FIG. Further, “proximal side” described below means the right side in FIGS. 1 and 2 on the side of the shaft 6 of the grip 7.
The first jaw 8 is disposed below the second jaw 9 in FIGS. 1 and 2. The first jaw 8 includes a first support member 10 and a heat generating structure 11 as shown in FIG.
The first support member 10 is a portion in which a part of the shaft 6 is extended to the distal end side, and in FIG. 2, the upper surface is a flat surface, and the longitudinal direction from the distal end to the proximal end of the grip 7 It is formed in a long shape extending in the left and right direction (in FIGS. 1 and 2).

The heat generating structure 11 is attached to the upper surface of the first support member 10 in FIG. The heat generating structure 11 generates thermal energy under the control of the control device 3. As shown in FIG. 2, the heat generating structure 11 includes a treatment member 12 and an energy generating unit 13.
The treatment member 12 is a long plate (long plate extending in the longitudinal direction of the grip portion 7) made of high thermal conductivity copper, silver, aluminum, molybdenum, tungsten, graphite, or a composite material thereof. It is a body.
In the treatment member 12, the upper surface in FIG. 2 contacts the living tissue in a state where the living tissue is gripped by the first and second jaws 8 and 9, and the heat from the energy generation unit 13 Function as the first gripping surface 121 for transferring heat energy to the living tissue (applying thermal energy to the living tissue).
The detailed shape of the first gripping surface 121 will be described later.

The energy generating unit 13 generates energy (thermal energy) to be applied to the living tissue under the control of the control device 3.
In the first embodiment, the energy generation unit 13 functions as a seat heater that generates heat and heats the treatment member 12 by the heat generation. Specifically, the energy generating unit 13 has a configuration in which a resistance pattern made of a conductive material such as platinum is formed on a high thermal conductivity ceramic substrate such as aluminum nitride or alumina, for example. The resistance pattern is not limited to platinum, and aluminum, SUS or the like may be used. Then, the energy generation unit 13 is provided with the treatment member 12 via the bonding metal layer (for example, a multilayer film made of titanium, platinum and gold) provided on the back side of the surface of the substrate on which the resistance pattern is formed. The back surface of the first holding surface 121 is fixed by using a bonding material having high thermal conductivity which is mainly composed of a ceramic such as AuSn alloy, silver paste, or alumina. Further, two lead wires (not shown) constituting the electric cable C are joined (connected) to both ends (electrode portions) of the resistance pattern. The resistance pattern generates heat when a voltage is applied (energized) through the two lead wires under the control of the control device 3.
Here, as the energy generation part 13, the heat generation method is not limited to the above-described resistance heating, and a configuration in which heat is generated by another heat generation method may be adopted.

In addition, in order to efficiently transmit the heat generated in the energy generation unit 13 to the treatment member 12, the first support member 10 is made of a material having a thermal conductivity lower than that of the treatment member 12 and the energy generation unit 13. Is preferred. Further, a heat insulating member made of a resin or the like having a low thermal conductivity may be disposed between the first support member 10 and the heat generating structure 11.

[Configuration of second jaw]
The second jaw 9 comprises a second support member 14 and an opposing plate 15 as shown in FIG.
The second support member 14 has a flat surface on the lower surface in FIG. 2 and is formed in an elongated shape extending in the longitudinal direction of the grip portion 7. The second support member 14 is pivotally supported on the shaft 6 at the base end side thereof via the fulcrum P1 and is opened and closed with respect to the first jaw 8 by rotating.
In the first embodiment, the first jaw 8 (first support member 10) is fixed to the shaft 6, and the second jaw 9 (second support member 14) is pivotally supported on the shaft 6. Although it has composition, it is not restricted to this. For example, both of the first and second jaws 8 and 9 (first and second support members 10 and 14) are pivotally supported by the shaft 6 and are respectively pivoted to thereby rotate the first and second jaws 8 and You may employ | adopt the structure which 9 opens and closes. Also, for example, the first jaw 8 (first support member 10) is pivotally supported by the shaft 6, and the second jaw 9 (second support member 14) is fixed to the shaft 6, and the first jaw 8 The structure which opens and closes with respect to the 2nd jaw 9 may be adopted by rotating.

The opposing plate 15 is a long plate (long plate extending in the longitudinal direction of the grip portion 7), and is attached to the flat surface on the lower side of the second support member 14 in FIG. .
In the opposite plate 15, the lower surface in FIG. 2 functions as a second gripping surface 151 that grips a living tissue between itself and the first gripping surface 121.
In the first embodiment, the second gripping surface 151 is configured as a flat surface.

[Shape of first gripping surface]
Next, the shape of the first gripping surface 121 will be described.
FIG. 3 is a cross-sectional view taken along line III-III shown in FIG. FIG. 4 is a cross-sectional view taken along the line IV-IV shown in FIG. Specifically, FIG. 3 and FIG. 4 are views in which the gripping portion 7 in a state in which the first and second jaws 8 and 9 are closed is cut at a cutting plane orthogonal to the longitudinal direction of the gripping portion 7. The III-III line shown in FIG. 2 is a line passing through the tip of the grip 7. Further, the IV-IV line shown in FIG. 2 is a line passing through the proximal end of the grip portion 7.
Here, in a state in which the first and second jaws 8 and 9 are closed, a cross section perpendicular to the longitudinal direction of the gripping portion 7 is a first to third regions in the width direction (left and right direction in FIGS. 3 and 4) Partition into Ar1 to Ar3 (FIGS. 3 and 4). Note that the third area Ar3 is an area located between the first and second areas Ar1 and Ar2, and in the first embodiment, it passes the central position in the width direction of the gripping portion 7 and the width It is a plane CP orthogonal to the direction.

When viewed in a cross section orthogonal to the longitudinal direction of the gripping portion 7, the first gripping surface 121 has a mountain-like shape having the third region Ar3 as the apex 122 as shown in FIG. 3 or FIG. . And in the 1st grasping side 121, each side of the both sides of peak 122 functions as the 1st and 2nd slope 123 and 124 concerning the present invention, respectively.
The apex 122 is set to abut on the second gripping surface 151 from the distal end to the proximal end with the first and second jaws 8 and 9 closed, as shown in FIG. 3 or 4. .
The first and second inclined surfaces 123 and 124 are flat surfaces. In addition, a first angle θ1 (an intersecting angle when the first and second inclined surfaces 123 and 124 are extended respectively) formed by the first and second inclined surfaces 123 and 124 is directed from the distal end to the proximal end It is set to become large according to. For example, the first angle θ1 is the angle θ11 (FIG. 3) at the distal end, whereas the first angle θ1 is the angle θ12 (FIG. 4) larger than the angle θ11 at the proximal end. Here, the angle θ11 is, for example, an angle larger than 90 °. Also, the angle θ12 is an angle smaller than 180 °.

[Positional relationship between first and second gripping surfaces]
By forming the first and second gripping surfaces 121 and 151 as described above, the first and second gripping surfaces 121 and 151 in a state in which the first and second jaws 8 and 9 are closed. The positional relationship is as follows.
The first separation distance D1 (FIGS. 3 and 4) between the first and second gripping surfaces 121 and 151 at each position in the width direction of the first inclined surface 123 is the first and second The third separation distance D3 (FIGS. 3 and 4) between the gripping surfaces 121 and 151 of the second embodiment is larger than In the first embodiment, the third separation distance D3 is zero. Similarly, a second separation distance D2 (FIGS. 3 and 4) between the first and second gripping surfaces 121 and 151 at each position in the width direction of the second inclined surface 124 is a third separation distance. It becomes larger than D3.
Further, the first and second separation distances D1 and D2 are respectively smaller on the proximal side than on the distal side. More specifically, the first and second separation distances D1 and D2 decrease in the direction from the distal end to the proximal end. For example, while the first separation distance D1 at a position separated by a distance D4 (FIGS. 3 and 4) from the apex 122 in the width direction is the distance D11 (FIG. 3) at the distal end, the distance at the proximal end The distance D12 (FIG. 4) is smaller than D11. Also, for example, while the second separation distance D2 at a position separated by a distance D4 from the apex 122 in the width direction is the distance D21 (FIG. 3) at the tip, a distance smaller than the distance D21 at the base It becomes D22 (FIG. 4). Here, the distance D11 and the distance D21 are the same. Further, the distance D12 and the distance D22 are the same. That is, the first gripping surface 121 has a shape that is symmetrical with respect to the plane CP.

[Configuration of Control Device and Foot Switch]
The foot switch 4 is a portion operated by the operator with a foot. And according to the operation concerned to foot switch 4, ON and OFF of energization from control device 3 to treatment implement 2 (energy generating part 13 (resistance pattern)) are changed.
In addition, as a means to switch the said on and off, you may employ | adopt not only the foot switch 4 but the switch etc. which are operated by hand other than that.
The control device 3 is configured to include a CPU (Central Processing Unit) or the like, and centrally controls the operation of the treatment tool 2 in accordance with a predetermined control program. Specifically, the control device 3 applies a voltage to the energy generation unit 13 (resistance pattern) through the electric cable C in response to the operation (operation of power on) of the operator by the operator (operation of power on). The member 12 is heated.

[Operation of treatment system]
Next, the operation of the treatment system 1 described above will be described.
The operator holds the treatment tool 2 by hand, and inserts the distal end portion (a part of the grip 7 and the shaft 6) of the treatment tool 2 into the abdominal cavity through the abdominal wall using, for example, a trocar. Then, the operator operates the operation knob 51 and grips the living tissue to be treated with the holding unit 7 (the treatment member 12 and the counter plate 15).
Next, the operator operates the foot switch 4 to switch on energization of the treatment instrument 2 from the control device 3. When switched on, the control device 3 applies a voltage to the energy generating unit 13 (resistance pattern) via the electric cable C, and heats the treatment member 12. The living tissue in contact with the treatment member 12 is heated to a target temperature and solidified. In addition, when the living tissue is compressed by the gripping force of the gripping unit 7, the incision of the living tissue is performed.

According to the first embodiment described above, the following effects can be obtained.
The treatment tool 2 according to the first embodiment adopts a structure in which the first and second jaws 8 and 9 are opened and closed via the fulcrum P1 provided on the proximal end side. Therefore, the gripping force applied to the living tissue from the first and second jaws 8 and 9 is strong on the proximal side and weak on the distal side. In the treatment tool 2 according to the first embodiment, the first and second separation distances D1 and D2 are respectively larger than the third separation distance D3 and smaller on the proximal side than the distal side. That is, in the treatment tool 2 according to the first embodiment, when the living tissue is gripped by the first and second jaws 8 and 9, the pressure applied to the living tissue is weakened on the proximal end side where the gripping force is strong, The pressure applied to the living tissue is intensified on the tip side where the gripping force is weak. In particular, the first and second separation distances D1 and D2 decrease from the distal end toward the proximal end. Therefore, when the biological tissue is gripped by the first and second jaws 8 and 9, the pressure applied to the biological tissue can be made uniform in the longitudinal direction of the first and second jaws 8 and 9. It is possible to treat the living tissue uniformly.
Further, by forming the shape of the first gripping surface 121 as described above, uniform treatment of the living tissue in the longitudinal direction of the first and second jaws 8 and 9 is realized, so that the structure is simple. And the size of the gripping portion 7 can be reduced.
From the above, according to the treatment tool 2 according to the first embodiment, the living tissue can be treated uniformly in the longitudinal direction of the first and second jaws 8 and 9 while achieving downsizing. An effect of.

Further, in the treatment tool 2 according to the first embodiment, the first and second gripping surfaces 121 and 151 have shapes that are symmetrical with respect to the plane CP. Therefore, living tissues can be treated symmetrically with reference to the plane CP.

Moreover, in the treatment tool 2 according to the first embodiment, the first and second gripping surfaces 121 and 151 in the third region Ar3 (plane CP) close the first and second jaws 8 and 9, respectively. Contact each other in the state. Therefore, the living tissue can be effectively cut in the plane CP.

Further, in the treatment tool 2 according to the first embodiment, the energy generating unit 13 is disposed on the back surface of the first gripping surface 121 of the treatment member 12 having the first gripping surface 121 having a mountain shape. It is done. For this reason, in contrast to the configuration in which the energy generating portion 13 is provided on the back surface of the second gripping surface 151 in the opposing plate 15 having the second gripping surface 151 which is a flat surface unlike the first embodiment described above. , Can be effectively dissected living tissue.

Second Embodiment
Next, the second embodiment will be described.
In the following description, the same components as those in the first embodiment described above are denoted by the same reference numerals, and the detailed description thereof is omitted or simplified.
FIG. 5 is a view showing a distal end portion of a treatment tool 2A according to the second embodiment. 6 is a cross-sectional view taken along the line VI-VI shown in FIG. FIG. 7 is a cross-sectional view taken along the line VII-VII shown in FIG. 5 to 7 correspond to FIGS. 2 to 4, respectively. That is, FIG. 6 is a cross-sectional view showing the tip of the grip 7A. FIG. 7 is a cross-sectional view showing the proximal end of the grip 7A.
As shown in FIGS. 5 to 7, a treatment tool 2A according to the second embodiment has a shape different from that of the first gripping surface 121 with respect to the treatment tool 2 described in the first embodiment described above. A gripping portion 7A (first jaw 8A (heat generating structure 11A (treatment member 12A))) having one gripping surface 121A is employed.

The first gripping surface 121A according to the second embodiment is similar to the first gripping surface 121 described in the first embodiment when viewed in a cross section orthogonal to the longitudinal direction of the gripping portion 7A. It has an apex 122 and first and second inclined surfaces 123 and 124. And in the 1st grasping side 121A, as shown in Drawing 6 or Drawing 7, the 1st angle theta1 which the 1st, 2nd slope 123, 124 constitutes is the base end (angle from angle (theta) 11) It becomes large as it goes to (theta) 13 (angle larger than angle (theta) 11), and it is set so that it may become 180 degrees in a proximal end.

Then, by forming the first gripping surface 121A as described above, the positional relationship between the first and second gripping surfaces 121A and 151 in the state in which the first and second jaws 8A and 9 are closed is It becomes as follows.
The first separation distance D1 (FIG. 6, FIG. 7) between the first and second holding surfaces 121A and 151 at each position in the width direction of the first inclined surface 123 and the width of the second inclined surface 124 The second separation distance D2 (FIG. 6, FIG. 7) between the first and second gripping surfaces 121A, 151 at each position in the direction is not less than the third separation distance D3 (FIG. 6, FIG. 7) Become.
Further, as in the first embodiment described above, the first and second separation distances D1 and D2 become smaller as going from the tip to the base. The first to third separation distances D1 (D13), D2 (D23), and D3 at the proximal end are zero as shown in FIG. That is, areas ArP (FIG. 5) for meshing adjustment of the first and second gripping surfaces 121A and 151 are provided at the proximal ends of the first and second gripping surfaces 121A and 151, respectively. The first gripping surface 121A has a shape that is symmetrical with respect to the plane CP.

According to the second embodiment described above, in addition to the effects similar to the first embodiment described above, the following effects can be obtained.
In the treatment tool 2A according to the second embodiment, the first to third separation distances D1 to D3 become 0 at the proximal ends of the first and second gripping surfaces 121A and 151, respectively. An area ArP for meshing adjustment of the holding surfaces 121A and 151 is provided. Therefore, when the living tissue is gripped by the first and second jaws 8A and 9, the first and second jaws 8A and 9 do not twist or the like, and the living tissue is gripped stably. can do.

(Other embodiments)
Although the modes for carrying out the present invention have been described above, the present invention is not to be limited only by the first and second embodiments described above.
FIGS. 8 and 9 are views showing a gripping portion 7B according to the first modification of the first and second embodiments. Specifically, FIG. 8 is a view corresponding to FIG. 3 and FIG. 6, respectively, and is a cross-sectional view showing the tip of the grip 7B. FIG. 9 is a view corresponding to FIGS. 4 and 7, and is a cross-sectional view showing a proximal end of the grip 7B.
In the first and second embodiments described above, as in the first modification shown in FIG. 8 or FIG. 9, a gripping portion 7B having a first gripping surface 121B different in shape from the first gripping surfaces 121 and 121A. (The first jaw 8B (heat generating structure 11B (treatment member 12B))) may be adopted.
As shown in FIG. 8 or FIG. 9, the first gripping surface 121B according to the present modification 1 has curved first and second inclined surfaces 123 and 124 described in the first and second embodiments, respectively. It has the 1st, 2nd curved surface 123B, 124B comprised.

And in this modification 1, the 1st, 2nd grasping sides 121B and 151 in the state where the 1st, 2nd jaws 8B and 9 were closed have the following physical relationships.
The first separation distance D1 (FIGS. 8 and 9) between the first and second gripping surfaces 121B and 151 at each position in the width direction of the first curved surface 123B, and the width direction of the second curved surface 124B The second separation distance D2 (FIGS. 8 and 9) between the first and second gripping surfaces 121B and 151 at each position is the third separation distance D3 (see FIG. 8) as in the first embodiment described above. 8, 9), respectively.
Further, as in the first and second embodiments described above, the first and second separation distances D1 and D2 become smaller as going from the distal end to the proximal end. For example, while the first separation distance D1 at a position separated by a distance D4 (FIGS. 8 and 9) from the apex 122 in the width direction is the distance D14 (FIG. 8) at the tip, the distance is The distance D15 (FIG. 9) is smaller than D14. Also, for example, while the second separation distance D2 at a position separated by a distance D4 in the width direction from the apex 122 is the distance D24 (FIG. 8) at the tip, a distance smaller than the distance D24 at the base It becomes D25 (FIG. 9). Here, the distance D14 and the distance D24 are the same. Further, the distance D15 and the distance D25 are the same. That is, the first gripping surface 121B has a shape that is symmetrical with respect to the plane CP.

10 to 12 are views showing a gripping portion 7C according to the second modification of the first and second embodiments. Specifically, FIG. 10 is a view corresponding to each of FIGS. 3 and 6, and is a cross-sectional view showing the tip of the grip 7C. FIG. 12 is a view corresponding to FIGS. 4 and 7, and is a cross-sectional view showing the proximal end of the grip 7C. FIG. 11 shows a grip 7C in a state in which the first and second jaws 8C and 9 are closed, passing through the central position in the longitudinal direction of the grip 7C, and in a cutting plane orthogonal to the longitudinal direction of the grip 7 FIG.
In the first and second embodiments described above, as in the second modification shown in FIGS. 10 to 12, a gripping portion 7C having a first gripping surface 121C having a shape different from that of the first gripping surfaces 121 and 121A. (The first jaw 8C (heat generating structure 11C (treatment member 12C))) may be adopted.
The first gripping surface 121C according to the second modification is, as shown in FIGS. 10 to 12, the shapes of the first and second inclined surfaces 123 and 124 described in the first and second embodiments described above. It has the modified first and second surfaces 123C and 124C.

The first surface 123C is adjacent to the first inclined surface 1231 adjacent to the apex 122 and the first inclined surface 1231, as shown in FIG. 10 to FIG. 12, and the first and second jaws 8C, And 9 has a first flat surface 1232 parallel to the second gripping surface 151 in the closed state. Similarly, the second surface 124C is adjacent to the second inclined surface 1241 adjacent to the apex 122 and the second inclined surface 1241, and the first and second jaws 8C and 9 are closed. And a second flat surface 1242 parallel to the two gripping surfaces 151.
The first and second inclined surfaces 1231 and 1241 are flat surfaces. Further, a first angle θ1 formed by the first and second inclined surfaces 1231 and 1241 is set to increase as it goes from the tip to the base. For example, the first angle θ is the angle θ16 (FIG. 10) at the distal end, the angle θ17 (FIG. 11) larger than the angle θ16 at the central position in the longitudinal direction, and the angle θ18 (the distance) It becomes FIG. 12). Here, the angle θ16 is, for example, an angle larger than 90 °. Further, the angle θ17 is, for example, an angle smaller than 180 °.
The first and second flat surfaces 1232 and 1242 are set to be substantially flush.
That is, as the first and second inclined surfaces 1231 and 1241 move from the tip to the base, the length dimension in the width direction increases. On the other hand, the first and second flat surfaces 1232 and 1242 decrease in length in the width direction as they go from the distal end to the proximal end.

Then, by forming the first gripping surface 121C as described above, the positional relationship between the first and second gripping surfaces 121C and 151 in the state in which the first and second jaws 8C and 9 are closed is It becomes as follows.
The first separation distance D1 (FIGS. 10 to 12) between the first and second holding surfaces 121C and 151 at each position in the width direction of the first inclined surface 1231 and the width of the second inclined surface 1241 The second separation distance D2 (FIGS. 10 to 12) between the first and second gripping surfaces 121C and 151 at each position in the second direction is the third separation distance D3 as in the first embodiment described above. (FIGS. 10 to 12).
Further, as in the first and second embodiments described above, the first and second separation distances D1 and D2 become smaller as going from the distal end to the proximal end. For example, the first separation distance D1 at a position separated by a distance D4 (FIGS. 10 to 12) from the apex 122 in the width direction is the distance D16 (FIG. 10) at the tip, and from the distance D16 at the central position in the longitudinal direction And the distance D18 (FIG. 12) is smaller than the distance D17 at the proximal end. Further, for example, the second separation distance D2 at a position separated by a distance D4 in the width direction from the apex 122 is the distance D26 (FIG. 10) at the tip, and the distance D27 (the distance D27) 11), and at the proximal end, the distance D28 (FIG. 22) is smaller than the distance D27. Here, the distance D16 and the distance D26 are the same. Further, the distance D17 and the distance D27 are the same. Furthermore, the distance 18 and the distance D28 are the same. That is, the first gripping surface 121C has a shape that is symmetrical with respect to the plane CP.

13 and 14 are views showing a gripping portion 7D according to the third modification of the first and second embodiments. Specifically, FIG. 13 is a view corresponding to FIG. 3 and FIG. 6, and is a cross-sectional view showing the tip of the grip 7D. FIG. 14 is a view corresponding to FIGS. 4 and 7, and is a cross-sectional view showing the proximal end of the grip 7D.
In the first and second embodiments described above, as in the third modification shown in FIG. 13 or FIG. 14, a gripping portion 7D having a second gripping surface 151D different in shape from the second gripping surface 151 Two jaws 9D (counter plate 15D) may be adopted.
As shown in FIG. 13 or 14, the second gripping surface 151D according to the third modification takes the third region Ar3 as the vertex 152 when viewed in a cross section orthogonal to the longitudinal direction of the gripping portion 7D. It has a mountain shape.
The first and second inclined surfaces 153 and 154 located on both sides of the apex 152 are flat surfaces. Further, the angle formed by the first and second inclined surfaces 153 and 154 is set to the same angle from the tip to the base. In addition, the said angle is an angle larger than 90 degrees, for example.

Then, by forming the second gripping surface 151D as described above, the positional relationship between the first and second gripping surfaces 121 and 151D in the state in which the first and second jaws 8 and 9D are closed is , It becomes as follows.
The first separation distance D1 (FIGS. 13 and 14) between the first and second holding surfaces 121 and 151D at each position in the width direction of the first inclined surface 123 and the width of the second inclined surface 124 The second separation distance D2 (FIGS. 13 and 14) between the first and second gripping surfaces 121 and 151D at each position in the direction is the third separation distance D3 as in the first embodiment described above. (FIGS. 13 and 14) respectively.
Further, as in the first and second embodiments described above, the first and second separation distances D1 and D2 become smaller as going from the distal end to the proximal end. For example, while the first separation distance D1 at a position separated by a distance D4 (FIGS. 13 and 14) from the apex 122 in the width direction is the distance D19 (FIG. 13) at the tip, the distance is The distance D10 (FIG. 14) is smaller than D19. Also, for example, while the second separation distance D2 at a position separated by a distance D4 from the apex 122 in the width direction is the distance D29 (FIG. 13) at the tip, a distance smaller than the distance D29 at the base It becomes D20 (FIG. 14). Here, the distance D19 and the distance D29 are the same. Further, the distance D10 and the distance D20 are the same. That is, the second gripping surface 151D has a shape that is symmetrical with respect to the plane CP.
Even when the configurations of the first to third modifications described above are adopted, the same effects as those of the first and second embodiments can be obtained.

In the first and second embodiments and the first to third modifications described above, the width of the third area Ar3 is increased, and the first gripping surfaces 121 and 121A to 121C in the third area Ar3 are orthogonal to the plane CP. It may be configured with a flat surface. Further, the third area Ar3 is not limited to the center position in the width direction of the gripping portions 7, 7A to 7D, and may be a position shifted to one side in the width direction.
Although the third separation distance D3 is set to 0 in the first and second embodiments and the first to third modifications described above, the third separation distance D3 is not limited to this and may be set to a distance larger than 0. Absent.
In the first and second embodiments and the first to third modifications described above, the configuration for generating thermal energy has been exemplified as the energy generation unit according to the present invention. However, the present invention is not limited thereto. You may adopt the structure which generate | occur | produces. Further, the energy generating portion according to the present invention may be provided to both the first and second jaws 8 (8A to 8C) and 9 (9D).

DESCRIPTION OF SYMBOLS 1 treatment system 2, 2A treatment tool 3 control apparatus 4 foot switch 5 handle 6 shaft 7, 7A-7D holding part 8, 8A-8C 1st jaw 9, 9D 2nd jaw 10 1st supporting member 11, 11A 11C heat generating structure 12, 12A to 12C treatment member 13 energy generating portion 14 second support member 15, 15D opposing plate 51 operation knob 121, 121A to 121C first grip surface 122 apex 123 first inclined surface 123B first 1 curved surface 123 C first surface 124 second inclined surface 124 B second curved surface 124 C second surface 151 second grip surface 152 apex 153 154 first and second inclined surface 1231 first inclined surface 1232 First flat surface 1241 Second inclined surface 1242 Second flat surface Ar1 to Ar3 First to third regions ArP meshing adjustment Region C Electrical cables CP plane D1-D3 first to third distance D4 of use, D10 ~ D19, D20 ~ D29 distance P1 fulcrum R1 arrow θ1 first angle θ11 ~ θ13, θ16 ~ θ18 angles

Claims (6)

A first jaw having a first gripping surface;
A second jaw having a second gripping surface for gripping living tissue with the first gripping surface;
An energy generating unit provided on at least one of the first jaw and the second jaw and generating energy to be applied to the living tissue from at least one of the first holding surface and the second holding surface; Equipped
The first jaw and the second jaw are:
Opening and closing by pivoting at least one of the first jaw and the second jaw about a fulcrum provided on the proximal end side;
With the first jaw and the second jaw closed, a cross section perpendicular to the longitudinal direction of the first jaw and the second jaw is the width of the first gripping surface and the second gripping surface When the direction is divided into a first area, a second area, and a third area located between the first area and the second area, the width direction in the first area A first separation distance between the first grip surface and the second grip surface at a predetermined position, and the first grip surface and the first grip at a predetermined position in the width direction in the second region. The second separation distance between the two gripping surfaces is equal to or greater than the third separation distance between the first gripping surface and the second gripping surface in the third region, and is based on the tip side. Each small treatment tool at the end. The first gripping surface and the second gripping surface are:
The treatment instrument according to claim 1, wherein each of the third regions has a shape that passes through a center position in the width direction and is symmetrical with respect to a plane orthogonal to the width direction. The first gripping surface and the second gripping surface in the third region are:
The treatment instrument according to claim 1, wherein the first jaw and the second jaw abut each other in a closed state. The first gripping surface is
It has a first inclined surface in the first area and a second inclined surface in the second area,
The first inclined surface and the second inclined surface are
When adjacent to the third region and extending the first inclined surface and the second inclined surface respectively, they intersect at a first angle,
The first angle is
It becomes larger as it goes from the tip to the proximal end,
The first separation distance at each position in the width direction on the first inclined surface, and the second separation distance at each position in the width direction on the second inclined surface,
The treatment tool according to any one of claims 1 to 3, which decreases as it goes from the tip to the proximal end. The proximal end sides of the first gripping surface and the second gripping surface,
The first separation distance, the second separation distance, and the third separation distance are zero, and areas for meshing adjustment between the first gripping surface and the second gripping surface are provided. The treatment tool according to any one of claims 1 to 4. The first jaw is
And a treatment member that has the first gripping surface and applies energy generated by the energy generation unit in contact with the living tissue to the living tissue.
The tip side of the first gripping surface is
The third region has a convex shape protruding toward the second gripping surface with respect to the first region and the second region,
The energy generating unit is
The treatment tool according to any one of claims 1 to 5, which is disposed on a surface that is opposite to the first gripping surface of the treatment member.

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