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WO2020054037A1 - Outil chirurgical - Google Patents

Outil chirurgical Download PDF

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Publication number
WO2020054037A1
WO2020054037A1 PCT/JP2018/034032 JP2018034032W WO2020054037A1 WO 2020054037 A1 WO2020054037 A1 WO 2020054037A1 JP 2018034032 W JP2018034032 W JP 2018034032W WO 2020054037 A1 WO2020054037 A1 WO 2020054037A1
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WO
WIPO (PCT)
Prior art keywords
thermal
sheet
back surface
thermal anisotropic
anisotropic
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/JP2018/034032
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English (en)
Japanese (ja)
Inventor
岩崎　誠二
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Olympus Corp
Original Assignee
Olympus Corp
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Olympus Corp filed Critical Olympus Corp
Priority to PCT/JP2018/034032 priority Critical patent/WO2020054037A1/fr
Publication of WO2020054037A1 publication Critical patent/WO2020054037A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current

Definitions

  • the present invention relates to a treatment tool.
  • Patent Literature 1 a treatment tool that treats a target portion of a living tissue by applying energy to the portion to be treated (hereinafter, referred to as a target portion) has been known (for example, see Patent Literature 1).
  • the treatment tool described in Patent Literature 1 includes a pair of grip members that grip a target site.
  • the gripping member includes a blade having a treatment surface that comes into contact with the target site when the target site is gripped by the pair of gripping members, and a heater that heats the blade. Then, in the treatment tool, heat from the heater is transmitted from the treatment surface to the target portion gripped by the pair of gripping members via the blade. Thereby, the target site is treated.
  • the present invention has been made in view of the above, and has as its object to provide a treatment tool capable of efficiently collecting heat of a heater toward a treatment surface.
  • a treatment tool has a treatment surface that comes into contact with a living tissue, a blade having a back surface that forms the front and back of the treatment surface, and a blade facing the back surface.
  • a first thermal anisotropy constituted by a heater for heating the blade by generating heat in accordance with the supplied electric power, and one first thermal anisotropic sheet having a first end face
  • the first thermal anisotropic sheet has a higher thermal conductivity in the in-plane direction of the sheet than in the thickness direction
  • the first thermal anisotropic body has a thermal conductivity in the longitudinal direction of the heater.
  • said first end surface is opposed to the rear.
  • the heat of the heater can be efficiently collected toward the treatment surface.
  • FIG. 1 is a diagram illustrating a treatment tool according to the first embodiment.
  • FIG. 2 is a sectional view taken along line II-II shown in FIG.
  • FIG. 3 is a diagram illustrating the shape of the first thermally anisotropic body.
  • FIG. 4 is a diagram illustrating the shape of the first thermal anisotropic body.
  • FIG. 5 is a diagram illustrating the shape of the first thermal anisotropic body.
  • FIG. 6 is a cross-sectional view illustrating a configuration of the distal end portion according to the second embodiment.
  • FIG. 7 is a view showing a treatment tool according to the third embodiment.
  • FIG. 8 is an enlarged view of the distal end portion of the treatment tool.
  • FIG. 9 is a cross-sectional view illustrating the configuration of the first gripping member.
  • FIG. 10 is a diagram illustrating the shape of the first thermal anisotropic body.
  • FIG. 11 is a diagram illustrating the shape of the first thermally anisotropic body.
  • FIG. 12 is a diagram illustrating the shape of the first thermally anisotropic body.
  • FIG. 13 is a diagram illustrating the shape of the second thermal anisotropic body.
  • FIG. 14 is a diagram illustrating the shape of the second thermal anisotropic body.
  • FIG. 15 is a cross-sectional view illustrating a configuration of a first gripping member according to the fourth embodiment.
  • FIG. 16 is a diagram illustrating the shape of the second thermally anisotropic body.
  • FIG. 17 is a diagram illustrating the shape of the second thermal anisotropic body.
  • FIG. 18 is a diagram illustrating the shape of the first thermally anisotropic body.
  • FIG. 19 is a diagram illustrating the shape of the second heat anisotropic body.
  • FIG. 20 is a diagram illustrating the shape of
  • FIG. 1 is a view showing a treatment tool 1 according to the first embodiment.
  • the treatment tool 1 treats a target part of a living tissue by applying thermal energy to the part to be treated (hereinafter, referred to as a target part).
  • the treatment means, for example, coagulation and incision of the target site.
  • the treatment tool 1 includes a shaft 2, an operation unit 3, and a grip unit 4.
  • the shaft 2 has a substantially cylindrical shape.
  • one end side along the center axis Ax of the shaft 2 is referred to as a distal end side Ar1 (FIG.
  • a grip 4 is attached to an end of the distal end Ar ⁇ b> 1 of the shaft 2.
  • an operation section 3 is attached to an end of the base end side Ar2 of the shaft 2.
  • a wire Wi (FIG. 1) for opening and closing the first and second gripping members 41 and 42 (FIG. 1) constituting the gripping section 4 in response to the operation of the operating section 3 by the operator. ) Is provided.
  • An electric cable C (see FIG. 4) connected to a control device (not shown) for controlling the operation of the treatment tool 1 is disposed inside the shaft 2 from the base end Ar2 to the distal end Ar1. ing.
  • the operation unit 3 is a part operated by the operator, and a part of the distal end side Ar1 is inserted into the inside of the shaft 2.
  • One end of a wire Wi is fixed to the operation unit 3. Then, the operation unit 3 advances and retreats along the central axis Ax according to the operation by the operator, and pulls out the wire Wi to the proximal end Ar2 or pushes the wire Wi back to the distal end Ar1.
  • the gripper 4 is a part that treats the target site while holding the target site.
  • the grip 4 includes first and second gripping members 41 and 42.
  • the first and second gripping members 41 and 42 are configured to be openable and closable in an arrow R1 (FIG. 1) direction according to an operation performed on the operation unit 3 by an operator.
  • the first and second gripping members 41 and 42 have a symmetrical configuration with respect to the central axis Ax. Therefore, hereinafter, the configuration of the first gripping member 41 will be mainly described, and the description of the second gripping member 42 will be given by assigning the same reference numerals to the same components as those of the first gripping member 41. Omitted.
  • the first gripping member 41 is disposed below the second gripping member 42 in FIG. As shown in FIG. 1, the first gripping member 41 is connected to the proximal end 5 located on the proximal end Ar2 and the distal end 6 located on the distal end Ar1 at a predetermined angle. It has a generally L-shape. As shown in FIG. 1, the base end portion 5 is rotatably supported by a rotation shaft Ra so as to be rotatable with respect to the end portion of the distal end side Ar1 of the shaft 2. The other end of the wire Wi is connected to the base end 5 at a position separated from the distal end 6 with respect to the rotation axis Ra.
  • the first gripping member 41 rotates clockwise in FIG. 1 around the rotation axis Ra. Rotate.
  • the second gripping member 42 rotates counterclockwise in FIG. 1 around the rotation axis Ra, contrary to the first gripping member 41.
  • the respective distal end portions 6 of the first and second gripping members 41 and 42 come close to each other (close), and can grip the target portion.
  • the direction in which the tip portions 6 face each other in a closed state is referred to as a direction A1 (FIG. 2).
  • the first gripping member 41 rotates counterclockwise in FIG. 1 around the rotation axis Ra.
  • the second gripping member 42 rotates clockwise in FIG. 1 around the rotation axis Ra, contrary to the first gripping member 41.
  • the distal ends 6 of the first and second gripping members 41 and 42 are separated from each other (open).
  • FIG. 2 is a cross-sectional view illustrating a configuration of the distal end portion 6 of the first gripping member 41. Specifically, FIG. 2 is a cross-sectional view of the distal end portion 6 cut by a plane orthogonal to the longitudinal direction of the distal end portion 6. Note that the longitudinal direction of the distal end portion 6 is substantially parallel to the central axis Ax in a state where the first and second gripping members 41 and 42 are closed.
  • the tip portion 6 includes a blade 7, a heater 8, and a first thermal anisotropic body 9, as shown in FIG.
  • the blade 7 is a long plate formed of copper, silver, aluminum, molybdenum, tungsten, graphite, or a composite material thereof having high thermal conductivity and extending along the longitudinal direction of the tip 6.
  • the blade 7 is arranged in a posture in which the thickness direction is orthogonal to the direction A1, that is, in a posture in which the two plate surfaces 71 and 72 are along the direction A1.
  • a side surface that intersects the two plate surfaces 71 and 72, and an upper side surface in FIGS. In a state of being held, it comes into contact with the target part. Then, the side surface transmits heat from the heater 8 to the target portion. That is, the side surface functions as the treatment surface 73 (FIGS. 1 and 2) according to the present invention that applies thermal energy to the target portion.
  • the treatment surface 73 is configured by a flat surface orthogonal to the direction A1. The corner between the treatment surface 73 and the left plate surface 71 in FIG.
  • the treatment surface 73 has a width dimension (length dimension in the left-right direction in FIG. 2) shorter than the separation dimension between the two plate faces 71, 72.
  • the treatment surface 73 is configured by a flat surface, but is not limited thereto, and may be configured by another shape such as a convex shape or a concave shape.
  • a recess 74 is formed in the right plate surface 72 in FIG. 2 among the two plate surfaces 71 and 72.
  • the recess 74 is located at the center of the plate surface 72 in the direction A ⁇ b> 1 and extends along the longitudinal direction of the distal end portion 6. Further, of the side walls forming the recess 74, the side wall on the base end side Ar2 is omitted.
  • the inner surface on the upper side in FIG. 2 among the inner surfaces of the concave portion 74 corresponds to the back surface 75 according to the present invention, which forms the front and back of the treatment surface 73.
  • the heater 8 generates heat according to electric power supplied from an external control device (not shown) via the electric cable C.
  • the heater 8 includes a heater main body 81 and a flexible substrate 82 (see FIG. 4).
  • the heater main body 81 is a portion that generates heat when energized, and is configured by a sheet heater such as a ceramic heater extending along the longitudinal direction of the distal end portion 6.
  • the heater main body 81 is accommodated in the concave portion 74 in a posture in which the thickness direction is orthogonal to the direction A1, that is, in a posture in which the two sheet surfaces 811 and 812 are along the direction A1.
  • each of the surfaces 811 to 814 is formed of a flat surface, but is not limited thereto, and may be formed of another shape such as a convex shape or a concave shape.
  • the flexible substrate 82 has one end fixed to the base side Ar2 of the left seat surface 811 in the heater main body 81 in FIG. 2 and the other end extending from the heater main body 81 toward the base end Ar2. (See FIG. 4). Then, the flexible board 82 relays a pair of lead wires C1 (see FIG. 4) constituting the electric cable C disposed inside the shaft 2 and the heater main body 81. That is, the electric power supplied from the external control device (not shown) via the electric cable C is supplied to the heater main body 81 after passing through the flexible substrate 82. Thereby, the heater main body 81 generates heat.
  • the heater 8 (the heater body 81) is not limited to the ceramic heater and may be another heater as long as it generates heat in accordance with the supplied power.
  • FIGS. 3 to 5 are diagrams illustrating the shape of the first thermal anisotropic body 9.
  • FIG. 3 is a diagram illustrating a state before the first thermal anisotropic body 9 is folded.
  • FIGS. 4 and 5 are perspective views showing a state after the first thermal anisotropic body 9 is folded.
  • a state before folding the first thermal anisotropic body 9 is referred to as a first thermal anisotropic sheet 90 (FIG. 3), and a state after folding is referred to as a first thermal anisotropic sheet 90.
  • the first thermal anisotropic body 9 has a higher thermal conductivity in the in-plane direction of the sheet (the direction along the paper surface of FIG. 3) than the thickness direction (the direction perpendicular to the paper surface of FIG. 3).
  • the first thermal anisotropic sheet 90 is a rectangular graphite sheet extending along the longitudinal direction of the distal end portion 6.
  • the first thermal anisotropic sheet 90 is not limited to a graphite sheet as long as the sheet has thermal anisotropy having a higher thermal conductivity in the in-plane direction of the sheet than in the thickness direction. You may adopt it.
  • a notch Cu is inserted from the end face of the base end side Ar2 toward the front end side Ar1 at the center position in the width direction (vertical direction in FIG. 3).
  • the end face constituting the outer edge of the first thermal anisotropic sheet 90 corresponds to the first end face EF1 (FIGS.
  • the position of the first end surface EF1 is represented by a dashed line.
  • the end face of the portion where the cut Cu is formed corresponds to the second end face EF2 (FIGS. 3 and 4) according to the present invention.
  • the position of the second end surface EF2 is represented by a two-dot chain line.
  • the first thermal anisotropic member 9 folds the first thermal anisotropic sheet 90 based on the folding line Ln indicated by the broken line in FIG.
  • the base side Ar2 is formed in the shape of an open container.
  • the second end face EF2 is located inside the container of the first thermal anisotropic body 9.
  • the heater 8 is housed inside the first thermal anisotropic body 9 with the first facing surface 813 facing upward in FIGS. 4 and 5.
  • the first thermal anisotropic body 9 has all surfaces (except for the first facing surface 813 and the base end surface 815 of the base end side Ar2 (FIG. 4)) among the outer surfaces constituting the heater main body 81.
  • the two sheet surfaces 811 and 812, the front end surface 816 of the front end side Ar1 (FIG. 4), and the first opposing back surface 814) are opposed to and cover all the surfaces.
  • the first thermal anisotropic body 9 in which the heater 8 is accommodated is accommodated in the concave portion 74 with the opening on the upper side facing the back surface 75 in FIGS. In this state, the first end surface EF1 faces the back surface 75.
  • the first end surface EF1 is located at a position substantially flush with the first opposing surface 813 as shown in FIG. Then, by filling the sealing member Se (FIG. 2) in the concave portion 74, the heater 8 and the first thermal anisotropic member 9 are fixed to the blade 7.
  • the treatment tool 1 described above operates as described below.
  • the surgeon holds the treatment tool 1 by hand.
  • the surgeon operates the operation unit 3 to open and close the first and second gripping members 41 and 42, thereby gripping the target site with each tip 6.
  • the surgeon presses a switch (not shown) electrically connected to an external control device (not shown).
  • the control device executes the following control according to the operation signal from the switch.
  • the control device supplies electric power to the heater main body 81 via the electric cable C. Thereby, the heater main body 81 generates heat.
  • the heat of the heater main body 81 is transferred to the treatment surface 73 by following a first heat transfer path from the first facing surface 813 to the back surface 75 to the blade 7 to the treatment surface 73.
  • the heat of the heater body 81 is generated by the two sheet surfaces 811, 812, the leading end surface 816, the first opposed back surface 814, the first thermal anisotropic body 9, the first end surface EF1, the back surface 75, and the blade 7.
  • the heat is transmitted to the treatment surface 73 by following the second heat transfer path leading to the treatment surface 73.
  • thermal energy is applied from the treatment surface 73 to the target portion gripped between the distal ends 6. Thereby, the target site is incised while coagulating.
  • the treatment tool 1 according to Embodiment 1 has a first heat anisotropy sheet 90 having a higher thermal conductivity in the in-plane direction of the sheet than in the thickness direction, and is formed by folding the first thermal anisotropic sheet 90.
  • An anisotropic body 9 is provided.
  • the first thermal anisotropic member 9 is provided on all the surfaces (the two sheet surfaces 811 and 812 and the front surface 816) of the outer surface of the heater main body 81 other than the first facing surface 813 and the base end surface 815. , And the first opposing back surface 814), and covers all the surfaces. Further, the first end surface EF1 faces the back surface 75.
  • the heat of the heater main body 81 is transferred to the first facing surface 813-the back surface 75-the blade 7-the treatment surface 73, as well as the two sheet surfaces 811 and 812, the leading end surface 816, and The heat is transmitted to the treatment surface 73 by following a second heat transfer path from the first opposing back surface 814 to the first thermal anisotropic body 9 to the first end surface EF1 to the back surface 75 to the blade 7 to the treatment surface 73.
  • the heat of the heater main body 81 can be efficiently collected toward the treatment surface 73. That is, even when the blade 7 is downsized, the blade 7 can be sufficiently heated, and the target portion can be continuously treated.
  • the first thermal anisotropic body 9 is configured by folding one first thermal anisotropic sheet 90 having a higher thermal conductivity in the in-plane direction of the sheet than in the thickness direction. Therefore, the heat transmitted to the first thermal anisotropic body 9 is easily radiated to the outside from the end face.
  • the end surface of the first thermal anisotropic body 9 is the same as the first thermal anisotropic body 9 in addition to the first end surface EF1 facing the back surface. And a second end face EF2 located inside the container. Therefore, the heat transmitted to the first thermal anisotropic body 9 is transmitted from the first end face EF1 to the treatment surface 73 by following the above-described second heat transfer path.
  • the heat transmitted to the first thermal anisotropic body 9 and radiated from the second end face EF2 is transmitted again to the first thermal anisotropic body 9, and then the second thermal anisotropic body 9 described above. It is transmitted to the treatment surface 73 along the transmission path. Therefore, the heat of the heater main body 81 is more efficiently collected toward the treatment surface 73 as compared with the configuration in which the second end face EF2 faces the outside of the container in the first thermal anisotropic body 9. Can be.
  • FIG. 6 is a cross-sectional view illustrating the configuration of the distal end portion 6A according to the second embodiment. Specifically, FIG. 6 is a cross-sectional view corresponding to FIG.
  • a blade 7A having a shape different from that of the blade 7 and the first thermal anisotropic body 9 is used instead of the tip 6 described in the first embodiment.
  • a tip portion 6A having a first thermal anisotropic body 9A is used instead of the tip 6 described in the first embodiment.
  • the corner between the treatment surface 73 and the plate surface 71 on the left side in FIG. 6 is largely chamfered with respect to the blade 7 described in the first embodiment. That is, the treatment surface 73 according to the second embodiment has a shorter width (length in the left-right direction in FIG. 6) than the treatment surface 73 described in the first embodiment.
  • the first thermal anisotropic body 9A has a U-shaped cross-section with both ends facing the back surface 75 rather than the first opposing surface 813 in a cross section orthogonal to the longitudinal direction of the tip portion 6A. Protruding. The distance between the two ends (the distance in the left-right direction in FIG.
  • the first thermal anisotropic member 9A is formed on all surfaces (the first opposing surface 813, the two sheet surfaces 811 and 812, and the distal end surface 816) of the outer surface of the heater main body 81 other than the base end surface 815. , And the first opposing back surface 814), and covers all the surfaces.
  • both ends of the U-shaped cross section face the back surface 75 rather than the first opposing surface 813. Protruding. For this reason, by reducing the width dimension of the treatment surface 73, even if the first opposing surface 813 cannot be arranged at a position close to the rear surface 75 due to design, the first end surface EF1 is moved to the rear surface. 75. That is, even when the width of the treatment surface 73 is reduced, the heat of the heater main body 81 can be efficiently collected toward the treatment surface 73 as in the first embodiment.
  • FIG. 7 is a view showing a treatment tool 1B according to the third embodiment.
  • a treatment tool 1B different from the treatment tool 1 described in the first embodiment is employed.
  • the treatment tool 1B includes a handle 10, a shaft 2B, and a grip 4B.
  • the handle 10 is a part that the operator holds by hand.
  • the handle 10 is provided with an operation knob 101, as shown in FIG.
  • the shaft 2B has a substantially cylindrical shape.
  • one end side along the central axis Ax (FIG. 7) of the shaft 2B is referred to as a distal end side Ar1 (FIG. 7), and the other end side is referred to as a proximal end side Ar2 (FIG. 7). I do.
  • the end of the shaft 2B on the base end side Ar2 is connected to the handle 10.
  • a grip 4B is attached to the end of the shaft 2B at the front end Ar1.
  • An opening / closing mechanism (not shown) for opening and closing the first and second gripping members 41B and 42B (FIG. 7) constituting the gripping portion 4B according to the operation of the operation knob 101 by the operator inside the shaft 2B. ) Is provided.
  • An electric cable C is disposed inside the shaft 2B from the proximal end Ar2 to the distal end Ar1 via the handle 10.
  • FIG. 8 is an enlarged view of the distal end portion of the treatment tool 1B.
  • the grip part 4B is a part that treats the target site while holding the target site.
  • the grip 4B includes first and second gripping members 41B and 42B.
  • the first and second gripping members 41B and 42B are configured to be openable and closable in the direction of arrow R1 (FIG. 8) in accordance with the operation of the operation knob 101 by the operator.
  • the first and second gripping members 41B and 42B have a symmetrical configuration with respect to the central axis Ax. Therefore, hereinafter, the configuration of the first gripping member 41B will be mainly described, and the description of the second gripping member 42B will be given by assigning the same reference numerals to the same components as those of the first gripping member 41B. Omitted.
  • FIG. 9 is a cross-sectional view illustrating the configuration of the first gripping member 41B.
  • FIG. 9 is a cross-sectional view of the first gripping member 41B cut along a plane orthogonal to the longitudinal direction of the first gripping member 41B.
  • the longitudinal direction of the first gripping member 41B is substantially parallel to the central axis Ax when the first and second gripping members 41B and 42B are closed.
  • the first holding member 41B is disposed below the second holding member 42B in FIG. 7 or 8.
  • the first holding member 41B includes a jaw 11, a heat generating structure 12, and a support member 13.
  • the jaw 11 is formed in a long shape extending along the longitudinal direction of the first gripping member 41B, and the end of the proximal end Ar2 is rotatable with respect to the end of the distal end Ar1 of the shaft 2B. It is pivoted.
  • the jaws 11 constituting the first and second gripping members 41B and 42B move closer to each other (close) or separate from each other (open) according to the operation of the operation knob 101 by the operator.
  • the jaw 11 supports the heat generating structure 12 and the support member 13 on the upper surface in FIG. 8 or 9.
  • a direction in which the first and second gripping members 41B and 42B face each other in a closed state will be referred to as a direction A1 (FIGS. 8 and 9).
  • a coating material 111 is provided on the outer surface of the jaw 11 except for the upper surface in FIG. 9. Examples of the coating material 111 include Teflon (registered trademark).
  • the heat generating structure 12 includes a blade 7B, a heater 8, a first thermal anisotropic body 9B, and a second thermal anisotropic body 14.
  • the blade 7B is a long plate made of the same material as the blade 7 described in the first embodiment, and extending along the longitudinal direction of the first gripping member 41B.
  • the blade 7B is arranged so that the thickness direction is along the direction A1, that is, the two plate surfaces 71B and 72B are orthogonal to the direction A1.
  • the upper plate surface 71B in FIG. 9 holds the target portion in a state where the target portion is gripped by the first and second gripping members 41B and 42B.
  • the plate surface 71B transmits heat from the heater 8 to the target portion. That is, the plate surface 71B functions as a treatment surface according to the present invention for applying thermal energy to the target portion.
  • the plate surface 71B is referred to as a treatment surface 71B for convenience of description.
  • the treatment surface 71B is configured by a flat surface orthogonal to the direction A1.
  • the treatment surface 71B is configured by a flat surface, but is not limited thereto, and may be configured by another shape such as a convex shape or a concave shape.
  • a recess 74B is formed in the lower plate surface 72B in FIG. 9 of the two plate surfaces 71B and 72B.
  • the concave portion 74B is located at the center in the width direction (the horizontal direction in FIG. 9) of the plate surface 72B, and extends along the longitudinal direction of the first holding member 41B. Further, among the side walls forming the recess 74B, the side wall on the base end side Ar2 is omitted.
  • the bottom surface of the concave portion 74B corresponds to the back surface 75B according to the present invention, which forms the front and back of the treatment surface 71B.
  • the heater 8 (the heater main body 81) is arranged so that the thickness direction is along the direction A1, that is, the two sheet surfaces 811 and 812 are orthogonal to the direction A1.
  • the upper seat surface 812 in FIG. 9 corresponds to a first facing surface according to the present invention facing the back surface 75B.
  • the sheet surface 812 is referred to as a first opposing surface 812 for convenience of description.
  • the lower sheet surface 811 corresponds to the first opposing back surface according to the present invention, which faces the first opposing surface 812.
  • the left and right side surfaces 813 and 814 in FIG. 9 connect the first opposing surface 812 and the first opposing back surface (sheet surface 811). 1 connection surface.
  • FIGS. 10 to 12 are diagrams illustrating the shape of the first thermal anisotropic body 9B.
  • FIG. 10 is a diagram illustrating a state before the first thermal anisotropic member 9B is folded.
  • FIGS. 11 and 12 are perspective views showing a state after the first thermal anisotropic body 9B is folded.
  • a state before folding the first thermal anisotropic body 9B is referred to as a first thermal anisotropic sheet 90B (FIG. 10), and a state after folding is referred to as a first thermal anisotropic sheet 90B. It is assumed to be an isotropic body 9B.
  • the first thermal anisotropic body 9B has a higher thermal conductivity in the in-plane direction of the sheet (the direction along the plane of FIG. 10) than in the thickness direction (the direction perpendicular to the plane of FIG. 10). Is formed by folding the thermally anisotropic sheet 90B.
  • the first thermal anisotropic sheet 90B is a rectangular graphite sheet extending along the longitudinal direction of the first holding member 41B.
  • the first thermal anisotropic sheet 90B is not limited to a graphite sheet as long as the sheet has thermal anisotropy in which the thermal conductivity in the in-plane direction of the sheet is higher than the thickness direction. You may adopt it.
  • the first thermal anisotropic sheet 90B of the four edges that are rectangular outer edges, two edges along the longitudinal direction of the first gripping member 41B and the edge of the front side Ar1 are formed.
  • the end face corresponds to the first end face EF1 (FIGS. 10 to 12) according to the present invention.
  • the position of the first end surface EF1 is represented by a dashed line.
  • the edge that constitutes the edge on the base end side Ar2 is the second edge EF2 (see FIG. 10 to FIG. 12).
  • the position of the second end surface EF2 is represented by a two-dot chain line.
  • the first thermal anisotropic member 9B folds the first thermal anisotropic sheet 90B with reference to the fold line Ln indicated by the broken line in FIG.
  • the base side Ar2 is formed in the shape of an open container. In this state, the second end face EF2 is located inside the container in the first thermal anisotropic body 9B.
  • FIG. 13 and FIG. 14 are diagrams illustrating the shape of the second thermal anisotropic body 14.
  • FIG. 13 is a diagram schematically illustrating a state before the second thermal anisotropic member 14 is folded.
  • FIG. 14 is a diagram schematically illustrating a state in which the second thermal anisotropic member 14 is folded.
  • the state before folding the second thermal anisotropic body 14 is referred to as a second thermal anisotropic sheet 140 (FIG. 13), and the state after folding is referred to as a second thermal anisotropic sheet.
  • the second thermal anisotropic body 14 has a higher thermal conductivity in the in-plane direction of the sheet (the direction along the plane of FIG. 13) than in the thickness direction (the direction perpendicular to the plane of FIG. 13).
  • the second heat anisotropic sheet 140 is a long and rectangular graphite sheet.
  • the second thermal anisotropic sheet 140 is not limited to a graphite sheet as long as the sheet has thermal anisotropy in which the thermal conductivity in the in-plane direction of the sheet is higher than the thickness direction. You may adopt it.
  • the second thermal anisotropic body 14 has a substantially rectangular parallelepiped shape by folding the second thermal anisotropic sheet 140 in a bellows shape with reference to the folding line Ln indicated by a broken line in FIG.
  • the left and right portions of each fold line Ln in FIG. 13 correspond to the thermally anisotropic layer 141 according to the present invention.
  • the second thermal anisotropic member 14 has a configuration in which a plurality of thermal anisotropic layers 141 are stacked by folding the thermal anisotropic member 14 in a bellows shape as described above.
  • both ends in the longitudinal direction are located between the thermal anisotropic layers 141 adjacent to each other by being folded on the basis of each folding line Ln1 (FIG. 13).
  • the upper surface in FIG. 9 that intersects each folding line Ln corresponds to the second facing surface 142 according to the present invention.
  • FIG. 9 corresponds to the second opposing back surface 143 according to the present invention, which faces the second opposing surface 142. Further, in the second thermal anisotropic body 14, the left and right surfaces in FIG. 9 are the second connection surface 144 according to the present invention for connecting the second opposing surface 142 and the second opposing back surface 143. Is equivalent to
  • the heater 8 is housed inside the first thermal anisotropic body 9B with the first facing surface 812 facing upward in FIGS. 11 and 12.
  • the second thermal anisotropic member 14 has a posture in which the second opposing surface 142 faces upward in FIGS. 11 and 12, that is, each fold line Ln has a vertical direction in FIGS. 11 and 12. It is arranged on the first facing surface 812 in a posture along.
  • the first thermal anisotropic member 9B includes all the surfaces (the sheet surface 811, the side surfaces 813 and 814, and the outer surface of the heater body 81) other than the first facing surface 812 and the base end surface 815. And the front surface 816), and covers all the surfaces.
  • the first thermal anisotropic body 9 ⁇ / b> B includes all the outer surfaces of the second thermal anisotropic body 14 other than the second facing surface 142 and the surface of the base end side Ar ⁇ b> 2 (not shown).
  • the surface (the surface (not shown) of the front end Ar1 (not shown), the second opposing back surface 143, and the pair of second connection surfaces 144) is opposed to and covers all the surfaces.
  • the first thermal anisotropic body 9B in which the heater 8 and the second thermal anisotropic body 14 are housed has a posture in which the upper opening portion faces the back surface 75B in FIGS. Is accommodated in the concave portion 74B. In this state, the first end surface EF1 faces the back surface 75B.
  • the first end surface EF1 is located at a position substantially flush with the second facing surface 142. Further, the first thermal anisotropic member 9B is in a state in which the portion where the heater 8 is disposed protrudes outside the concave portion 74B.
  • the support member 13 is located between the jaw 11 and the heat generating structure 12, and fixes the jaw 11 and the heat generating structure 12 in a state where the concave portion 74B is closed from below in FIG.
  • the support member 13 is made of, for example, a resin material having low thermal conductivity such as PEEK (polyetheretherketone). That is, by disposing the supporting member 13 having a low thermal conductivity on the side opposite to the blade 7B with respect to the heater 8, the heat generated by the heater 8 can be efficiently transmitted to the blade 7B.
  • the treatment tool 1B described above operates as described below.
  • the surgeon holds the treatment tool 1B by hand.
  • the operator operates the operation knob 101 to open and close the first and second gripping members 41B and 42B to grip the target site.
  • the surgeon presses a switch (not shown) electrically connected to an external control device (not shown).
  • the control device executes the following control according to the operation signal from the switch.
  • the control device supplies electric power to the heater main body 81 via the electric cable C.
  • the heater main body 81 generates heat.
  • the heat of the heater main body 81 is transferred to the first heat transfer path from the first facing surface 812 to the second thermal anisotropic body 14 to the second facing surface 142 to the back surface 75B to the blade 7B to the treatment surface 71B. Is transmitted to the treatment surface 71B. Further, the heat of the heater main body 81 reaches the sheet surface 811, the side surfaces 813, 814, and the front end surface 816 to the first thermal anisotropic body 9B to the first end surface EF1 to the back surface 75B to the blade 7B to the treatment surface 71B. Following the second heat transfer path, the heat is transferred to the treatment surface 71B. Then, heat energy is applied to the target portion gripped between the first and second gripping members 41B and 42B from the treatment surface 71B. Thereby, the target site is incised while coagulating.
  • the treatment tool 1B according to the third embodiment is configured by folding one second heat anisotropic sheet 140 having a higher heat conductivity in the in-plane direction of the sheet than in the thickness direction, and the second heat is formed by folding the second heat anisotropic sheet 140.
  • An anisotropic body 14 is further provided.
  • the second thermal anisotropic member 14 is arranged in such a manner that the folding line Ln of the second thermal anisotropic sheet 140 extends along the direction from the first facing surface 812 to the back surface 75B.
  • the heat of the first facing surface 812 of the heater main body 81 is transferred from the first facing surface 812 to the second thermal anisotropic material.
  • the heat can be transmitted to the treatment surface 71B by following a first heat transfer path from the sex body 14, the second facing surface 142, the back surface 75B, the blade 7B, and the treatment surface 71B.
  • the second thermal anisotropic body 14 is configured by folding one second thermal anisotropic sheet 140 having a higher thermal conductivity in the in-plane direction of the sheet than in the thickness direction. For this reason, the heat transmitted to the second thermal anisotropic body 14 is easily radiated to the outside from the end face.
  • a part of the end surface of the second thermal anisotropic body 14 (the second opposing surface 142 and the second opposing back surface 143) is connected to the back surface 75B and the first back surface 143. Oppose each other.
  • the second thermal anisotropic member 14 receives the heat of the first facing surface 812 of the heater main body 81 at the second facing back surface 143 and can transfer the heat from the second facing surface 142 to the back surface 75B. it can. Further, both ends in the longitudinal direction of the second heat anisotropic sheet 140 are folded so as to be located between the heat anisotropic layers 141 adjacent to each other. For this reason, the heat transmitted to the second thermal anisotropic body 14 and radiated from the both end faces in the longitudinal direction of the second thermal anisotropic sheet 140 is again applied to the second thermal anisotropic body 14. After that, it can be transmitted from the second facing surface 142 to the back surface 75B.
  • the heat of the heater main body 81 is treated by the treatment surface 71B. Can be collected more efficiently.
  • the first thermal anisotropic member 9B includes the second facing surface 142 and the base end of the outer surface of the second thermal anisotropic member 14. All the surfaces (the surface of the front end side Ar1 (not shown), the second opposing back surface 143, and the pair of second connection surfaces 144) are opposed to all the surfaces other than the surface Ar2 (not shown). Cover. For this reason, the heat transmitted to the second thermal anisotropic body 14 and radiated from the surface (not shown) of the front end side Ar1 and the pair of second connecting surfaces 144 is transferred to the first thermal anisotropic body 9B. By passing through, the light can be transmitted from the first end face EF1 to the back face 75B. Therefore, the heat of the heater main body 81 can be more efficiently collected toward the treatment surface 71B.
  • FIG. 15 is a cross-sectional view illustrating a configuration of a first gripping member 41C according to the fourth embodiment. Specifically, FIG. 15 is a cross-sectional view corresponding to FIG.
  • the blade 7B and the first and second heat transfer members are used instead of the first gripping member 41B (the heat generating structure 12) described in the third embodiment.
  • each corner between the treatment surface 71B and the pair of left and right side surfaces 73B and 76 in FIG. 9 is different from the blade 7B described in the third embodiment.
  • the part is chamfered. That is, the treatment surface 71B according to the fourth embodiment has a shorter width (length in the left-right direction in FIG. 15) than the treatment surface 71B described in the third embodiment.
  • a recess 74C (FIG. 15) having a cross-sectional shape different from that of the recess 74B described in the third embodiment is formed on the blade 7C. As shown in FIG.
  • the recess 74 ⁇ / b> C has a first recess 741 having a rectangular cross section, and a rectangular recess having a rectangular section recessed from the central portion in the width direction toward the treatment surface 71 ⁇ / b> B on the bottom surface of the first recess 741.
  • a second concave portion 742 In addition, the bottom surface of the second concave portion 742 corresponds to the back surface 75C according to the present invention, which faces the treatment surface 71B.
  • FIG. 16 and 17 are diagrams illustrating the shape of the second thermal anisotropic body 14C.
  • FIG. 16 is a diagram illustrating a state before the second thermal anisotropic body 14C is folded.
  • FIG. 17 is a diagram illustrating a state in which the second thermal anisotropic member 14C is folded.
  • the state before folding second thermal anisotropic body 14C is referred to as second thermal anisotropic sheet 140C (FIG. 16), and the state after folding is referred to as second thermal anisotropic sheet 140C. It is assumed to be an isotropic body 14C. As shown in FIG.
  • the second thermal anisotropic sheet 140C is a sheet obtained by adding a protrusion forming body 145 to the second thermal anisotropic sheet 140 described in the third embodiment. is there.
  • the second thermal anisotropic sheet 140C portions other than the protruding portion forming body 145, that is, the second thermal anisotropic sheet 140 described in the third embodiment described above, A portion having the same shape is referred to as a base forming body 146.
  • the protruding portion forming body 145 has a rectangular shape having a shorter longitudinal dimension than the base forming body 146.
  • the protruding portion forming body 145 is integrally formed so as to protrude upward from the central portion in the longitudinal direction of the upper outer edge of the base forming body 146 in FIG.
  • cuts Cu are inserted from both left and right sides in FIG.
  • the second thermally anisotropic member 14C is formed by folding the second thermally anisotropic sheet 140C in a bellows shape with reference to the folding line Ln indicated by the broken line in FIG. Specifically, the base forming body 146 is folded with the folding line Ln as a reference, thereby forming a rectangular base 147 (FIG. 15). Further, the projection-forming body 145 is folded on the basis of the folding line Ln, so that a rectangular parallelepiped projection 148 (FIG. 15) is formed.
  • the protruding portion 148 has a shorter width (length in the left-right direction in FIG.
  • the second thermal anisotropic body 14 ⁇ / b> C includes the base 147 and the protrusion 148.
  • the left and right sides of each fold line Ln in FIG. 16 correspond to the thermal anisotropic layer 141C according to the present invention.
  • the second thermal anisotropic body 14C has a configuration in which a plurality of thermal anisotropic layers 141C are stacked, similarly to the second thermal anisotropic body 14 described in the third embodiment. .
  • base forming body 146 both ends in the longitudinal direction are located between thermally anisotropic layers 141C adjacent to each other by being folded with reference to each folding line Ln1 (FIG. 16).
  • protruding portion forming body 145 both ends in the longitudinal direction are located between the thermally anisotropic layers 141C adjacent to each other by being folded on the basis of each folding line Ln1C (FIG. 16).
  • the second connection surface 144C is a stepped surface having a step St1 (FIG. 15).
  • FIGS. 18 to 20 are diagrams illustrating the shape of the first thermal anisotropic body 9C.
  • FIG. 18 is a diagram illustrating a state before the first thermal anisotropic body 9C is folded.
  • FIGS. 19 and 20 are perspective views showing a state after the first thermal anisotropic body 9C is folded.
  • first thermal anisotropic sheet 90C FIG. 18
  • first thermal anisotropic sheet 90C FIG. 18
  • first thermal anisotropic sheet 90C It is assumed to be an isotropic body 9C.
  • the first thermal anisotropic sheet 90C is partially cut away from the first thermal anisotropic sheet 90B described in the third embodiment above.
  • first thermal anisotropic sheet 90C two cuts Cu are formed from the end surface of the cut portion toward the base end side Ar2.
  • a part of the end face of the cut portion and the outer edge of the first thermally anisotropic sheet 90C are along the longitudinal direction of the first gripping member 41C.
  • the end faces forming the two edges correspond to the first end face EF1 (FIGS. 18 to 20) according to the present invention.
  • the position of the first end surface EF1 is represented by a dashed line.
  • the first thermal anisotropic sheet 90C the other portion of the cut-out portion, the end face of the outer edge of the first thermal anisotropic sheet 90C that constitutes the edge of the base end side Ar2,
  • the end face of the portion where the cut Cu is formed corresponds to the second end face EF2 (FIGS. 18 to 20) according to the present invention.
  • the position of the second end surface EF2 is represented by a two-dot chain line.
  • the first thermal anisotropic member 9C folds the first thermal anisotropic sheet 90C with reference to the fold line Ln indicated by the broken line in FIG.
  • the base side Ar2 is formed in the shape of an open container.
  • the second end face EF2 is located inside the container of the first thermal anisotropic body 9C.
  • the side wall portions on both sides in the width direction follow the pair of second connection surfaces 144C of the second thermal anisotropic body 14C. It is formed in a stepped shape having a step St2 (FIGS. 15, 19, and 20).
  • the heater 8 is disposed in the space below the step St2 with the first facing surface 812 facing upward in FIGS. 19 and 20 inside the first thermal anisotropic body 9C.
  • the second thermal anisotropic body 14C has a posture in which the second facing surface 142C faces upward in FIGS. 19 and 20, that is, each fold line Ln has a vertical direction in FIGS. 19 and 20. It is arranged on the first facing surface 812 in a posture along.
  • the first thermal anisotropic member 9C includes all surfaces (the sheet surface 811, the side surfaces 813 and 814, and the outer surface constituting the heater body 81) other than the first facing surface 812 and the base end surface 815. And the front surface 816), and covers all the surfaces.
  • the first thermal anisotropic body 9C includes all of the outer surfaces of the second thermal anisotropic body 14C other than the second facing surface 142C and the surface (not shown) of the base end side Ar2.
  • the surface (the surface of the front end Ar1 (not shown), the second opposing back surface 143C, and the pair of second connection surfaces 144C) are opposed to and cover all the surfaces.
  • the first thermal anisotropic body 9C in which the heater 8 and the second thermal anisotropic body 14C are housed has a posture in which the upper opening portion faces the back surface 75C in FIGS. Is accommodated in the concave portion 74C. In this state, the first end surface EF1 faces the back surface 75C.
  • the fourth embodiment as shown in FIG.
  • the first end surface EF1 is located at a position substantially flush with the second facing surface 142C.
  • the portion where the protrusion 148 is provided is located in the second recess 742, and the portion where the base 147 is provided is located in the first recess 741. Then, the portion where the heater 8 is disposed protrudes outside the concave portion 74C.
  • the heat of the heater main body 81 is transmitted to the treatment surface 71B by following the first and second heat transmission paths described below.
  • the first heat transfer path is a path from the first facing surface 812, the second thermal anisotropic body 14C, the second facing surface 142C, the back surface 75C, the blade 7C, and the treatment surface 71B.
  • the second heat transfer path is a path from the sheet surface 811, the side surfaces 813, 814, and the tip surface 816 to the first thermal anisotropic body 9C to the first end surface EF1 to the back surface 75C to the blade 7C to the treatment surface 71B. It is.
  • the first thermal anisotropic body 9 (9A to 9C) includes the first opposing back surface 814 (811) and the pair of first connection surfaces 811 and 812 (813 and 814). ), And may not be covered. Further, the first thermal anisotropic body 9 (9A to 9C) does not have to face the front end face 816.
  • the first thermal anisotropic body 9B (9C) is formed by a surface (not shown) of the tip side Ar1 in the second thermal anisotropic body 14 (14C) and a pair of The second connection surface 144 (144C) does not have to be opposed.
  • the thermally anisotropic layer 141 may be configured as independent layers. That is, the second thermal anisotropic member 14 (14C) does not have to have a configuration in which one second thermal anisotropic sheet 140 (140C) is folded.

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

Abstract

La présente invention concerne un outil chirurgical qui comporte : une lame 7 qui a une surface chirurgicale 73 qui vient en contact avec un tissu biologique, et une surface arrière 75 qui est dans une relation avant-arrière avec la surface chirurgicale 73 ; un élément chauffant 8 qui a une première surface de face 813 qui fait face à la surface arrière 75, une première surface arrière opposée 814 qui est dans une relation avant-arrière avec la première surface de face 813, et une paire de premières surfaces de liaison 811, 812 qui relient la première surface de face 813 et la première surface arrière opposée 814, l'élément chauffant 8 chauffant la lame 7 en générant de la chaleur en fonction de l'énergie électrique fournie ; et un premier corps anisotrope thermique 9 qui est configuré par une première feuille anisotrope thermique qui a une première surface d'extrémité EF1. La première feuille anisotrope thermique a une conductivité thermique dans la direction dans le plan de la feuille plus importante que dans la direction de l'épaisseur de celle-ci. Dans une section transversale orthogonale à la direction longitudinale de l'élément chauffant 8, le premier corps anisotrope thermique 9 fait face à la première surface arrière opposée 814 et à la paire de premières surfaces de liaison 811, 812, et la première surface d'extrémité EF1 fait face à la surface arrière 75.
PCT/JP2018/034032 2018-09-13 2018-09-13 Outil chirurgical Ceased WO2020054037A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
PCT/JP2018/034032 WO2020054037A1 (fr) 2018-09-13 2018-09-13 Outil chirurgical

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/JP2018/034032 WO2020054037A1 (fr) 2018-09-13 2018-09-13 Outil chirurgical

Publications (1)

Publication Number Publication Date
WO2020054037A1 true WO2020054037A1 (fr) 2020-03-19

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PCT/JP2018/034032 Ceased WO2020054037A1 (fr) 2018-09-13 2018-09-13 Outil chirurgical

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Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2016027843A (ja) * 2014-07-09 2016-02-25 オリンパス株式会社 医療用処置装置
WO2016166817A1 (fr) * 2015-04-14 2016-10-20 オリンパス株式会社 Structure de transmission d'énergie thérapeutique et dispositif de traitement médical
WO2018150533A1 (fr) * 2017-02-17 2018-08-23 オリンパス株式会社 Outil de traitement

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
JP2016027843A (ja) * 2014-07-09 2016-02-25 オリンパス株式会社 医療用処置装置
WO2016166817A1 (fr) * 2015-04-14 2016-10-20 オリンパス株式会社 Structure de transmission d'énergie thérapeutique et dispositif de traitement médical
WO2018150533A1 (fr) * 2017-02-17 2018-08-23 オリンパス株式会社 Outil de traitement

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