Treatment tool

Abstract

Treatment tool (1, 1A), comprising: a long and elongated shaft (3); a gripper element (6, 6A) that protrudes from a distal end of the shaft (3); a movable jaw (31) which is rotatably mounted; and a oscillating element (41) attached to the movable jaw (31), wherein the oscillating element (41) is configured to grasp living tissue with the gripper element (6, 6A) and oscillates in relation to the movable jaw (31), wherein the movable jaw (31) comprises a first controlled surface (34) that comes into contact with a proximal end section of the oscillating element (41) in order to regulate the oscillation of the oscillating element (41) in one direction, and a second controlled surface (35) that comes into contact with an area that differs from a contact area of ​​the first controlled surface (34) in the proximal end section of the oscillating element (41) in order to regulate the oscillation of the oscillating element (41) in a different direction, characterized by the fact that the first controlled surface (34) and the second controlled surface (35) are arranged on a proximal end side of the movable jaw (31) relative to a pivot point (42) about which the oscillating element (41) can be pivoted relative to the movable jaw (31).

Description

Area

[0001] The present invention relates to a treatment tool. background

[0002] A treatment tool is commonly known in which a piezoelectric unit is arranged which applies ultrasound energy (ultrasound vibration) to living tissue, and which performs a treatment (suture (or anastomosis), dissection and the like) on the living tissue by applying the ultrasound vibration (see e.g. patent literature 1).

[0003] Patent 1 describes a treatment tool comprising two gripping elements for grasping living tissue. In this treatment tool, the two gripping elements form an end effector. Patent 1 describes a vibrating element mounted on one of the gripping elements, which vibrates about a predetermined axis. The vibrating element has a distal end contact surface, which is close to a distal end section of the gripping element, and a proximal end contact surface, which is close to a proximal end section of the gripping element. Patent 1 describes a vibration range regulated by the contact between the distal end contact surface or the proximal end contact surface of the vibrating element and the gripping element. List of citations from patent literature

[0004] Patent literature 1: International Publication No. WO 2014 / 148281A1 Summary Technical Problem

[0005] To prevent play in the oscillating element during use of the treatment tool, it is advantageous to separate the contact surface at the distal end from the axis of rotation. However, in particular, if the contact surface of the oscillating element at the distal end is separated from the axis of rotation at the distal end, the size of the distal end section of the treatment tool increases.

[0006] The WO 2014 / 148 280 A1 concerns a surgical treatment tool with a swiveling / rotating treatment or gripping element and stop or regulating elements formed on it, which limit the movement and enable a defined energy transfer to tissue.

[0007] The present invention was conceived in view of the above situation, and one objective of the present invention is to provide a treatment tool that is able to prevent an enlargement of an end effector and avoid play in a vibrating element. Solution to the problem

[0008] To solve the problem described above and achieve the objective, a treatment tool according to claim 1 of the present invention comprises: a long and elongated shaft; a gripping element projecting from a distal end of the shaft; a movable jaw rotatably mounted; and an oscillating element attached to the movable jaw, the oscillating element being configured to grasp living tissue with the gripping element and to oscillate relative to the movable jaw. The movable jaw comprises a first control surface that comes into contact with a proximal end section of the oscillating element to regulate the oscillation of the oscillating element in one direction, and a second control surface that comes into contact with an area in the proximal end section of the oscillating element that differs from a contact area of ​​the first control surface to regulate the oscillation of the oscillating element in another direction.

[0009] In the treatment tool according to the invention, the second control surface is formed on two projecting sections which are arranged inside the movable jaw and which project in directions facing each other.

[0010] In the treatment tool according to the present invention, the oscillating element comprises a cushioning element which comes into contact with the gripper element when the movable jaw approaches the gripper element.

[0011] In the treatment tool according to the present invention, the gripper element, the oscillating element and the movable jaw bend in relation to a longitudinal direction of the shaft.

[0012] In the treatment tool according to the present invention, the oscillating element comprises a projection at the proximal end section of the oscillating element, which projects in a direction perpendicular to a longitudinal direction of the oscillating element and in a direction perpendicular to an oscillation direction of the oscillating element, the projection comes into contact with the second controlled surface, and a part of the proximal end section between the projecting sections is inserted in a state in which the projection comes into contact with the second controlled surface.

[0013] In the treatment tool according to the present invention, the cushioning element reaches a proximal end of the oscillating element.

[0014] In the treatment tool according to the present invention, the oscillating element comprises a cushioning element which comes into contact with the gripper element when the movable jaw approaches the gripper element, and the width of the cushioning element is less than the distance between the foregoing sections.

[0015] The treatment tool according to the present invention further comprises: an ultrasonic transducer configured to generate ultrasonic vibrations. The gripper element is configured to vibrate in a longitudinal direction along the shaft due to the ultrasonic vibration generated by the ultrasonic transducer.

[0016] In the treatment tool according to the present invention, a high-frequency electric current flows into the gripper element, and the gripper element and the vibrating element form an electrode pair that provides a conductor for the high-frequency electric current. Advantageous effects of the invention

[0017] According to the present invention, it is possible to prevent an enlargement of an end effector and to avoid play in a vibrating element that is arranged at a distal end. Brief description of the drawings Fig. Figure 1 is a schematic representation of a treatment tool according to an embodiment of the present invention. Fig. Figure 2 is an enlarged view of a distal end part of the treatment tool according to an embodiment of the present invention. Fig. Figure 3 is a diagram illustrating a configuration of a gripper part included in the treatment tool according to an embodiment of the present invention. Fig. 4 is a top view of the gripper part in the direction of the Fig. 3 arrows shown A1 seen. Fig. 5 is a cross-sectional view of the in Fig. 3 shown gripper part. Fig. Figure 6 is a diagram illustrating a configuration of the gripper part contained in the treatment tool according to an embodiment of the present invention, and is a diagram illustrating a state in which a vibrating element is in a first controlled state. Fig. 7 is a top view of the gripper part in the direction of the Fig. 6 shown arrow A2 seen. Fig. Figure 8 is a diagram illustrating a configuration of the gripper part included in the treatment tool according to an embodiment of the present invention, and is a diagram illustrating a state in which the oscillating element is in a second controlled state. Fig. 9 is a top view of the gripper part in the direction of the in Fig. 8 shown arrow A3 seen. Fig. 10 is a cross-sectional view, taken along a line in Fig. The line BB shown in section 9 is cut. Fig. Figure 11 is a schematic representation showing a treatment tool according to a modification of an embodiment of the present invention. Description of the embodiments

[0018] Embodiments of a treatment tool according to the present invention are described below with reference to the drawings. The present invention is not limited by the following exemplary embodiments. Furthermore, identical components in the drawings are designated by the same reference numerals in the description. embodiment

[0019] Fig. Figure 1 is a schematic representation of a treatment tool according to an embodiment of the present invention. A treatment tool 1 comprises a housing 2, a shaft 3, a transducer unit 5, and a rod element (probe) 6. The shaft 3 has a longitudinal axis C as its central axis. One side in a direction along the longitudinal axis C is a distal end (arrow side C1), and a side opposite the distal end is a proximal end (arrow side C2).

[0020] The housing 2 is connected to a proximal end face of the shaft 3. The housing 2 comprises a main body 7 extending along the longitudinal axis C and a handle 8 extending from the main body 7 in a direction intersecting the longitudinal axis C. A handgrip 11 is rotatably attached to the housing 2. The handle 8 and the handgrip 11 are parts held by hand by an operator. The handgrip 11 rotates about a mounting position on the housing 2 relative to the housing 2, such that the handgrip 11 moves closer to or further away from the handle 8. In the present embodiment, the handgrip 11 is positioned at its distal end face relative to the handle 8, and one direction of movement of the handgrip 11 relative to the handle 8 is approximately parallel to the longitudinal axis C, but embodiments are not limited to this example.For example, the handle 11 can be positioned at the proximal end relative to the handle 8, or the direction of movement of the handle 11 with respect to the handle 8 can be approximately perpendicular to the longitudinal axis C.

[0021] Furthermore, in the present embodiment, a rotary element (knob) 12 is attached to the main housing body 7 from the distal end. The shaft 3 is inserted into the rotary element 12 from the distal end. The shaft 3 is attached to the rotary element 12 and is rotatable together with the rotary element 12 about the longitudinal axis C with respect to the housing 2.

[0022] The transducer unit 5 comprises a transducer housing 15 and an ultrasonic transducer 16 (ultrasonic transducer). The transducer housing 15 is mounted on the main housing body 7 from its proximal end. One end of a cable 17 is also connected to the transducer housing 15. The other end of the cable 17 is detachably connected to an ultrasonic power supply unit 30, which performs the energy control. The ultrasonic transducer 16 contains a piezoelectric element (not shown) that generates ultrasonic vibrations and is located inside the transducer housing 15. The ultrasonic transducer 16 extends along the longitudinal axis C. The ultrasonic transducer 16 is connected from its proximal end inside the main housing body 7 to the rod element 6. Meanwhile, one end of the cable 17 can be connected to the housing 2.

[0023] The rod element 6 transmits ultrasonic vibrations. The rod element 6 extends along the longitudinal axis C from the inside of the housing 2 through the inside of the shaft 3 to the distal end. A treatment unit (rod treatment unit) 13 is arranged at a distal end section of the rod element 6. The rod element 6 is inserted into the shaft 3 and positioned such that the treatment unit 13 protrudes from a distal end of the shaft 3. The rod element 6 is made, for example, of a titanium alloy or a stainless alloy. The rod element 6 corresponds to a gripper element.

[0024] Furthermore, a control knob 18 is attached to the housing 2. When the control knob 18 is pressed by an operator, an operating command is entered to cause the ultrasonic power supply unit 30 to output electrical energy. When a command is entered via the control knob 18, the ultrasonic power supply unit 30 delivers alternating current at a predetermined frequency to the ultrasonic transducer 16 via electrical wiring (not shown) or similar within the cable 17. With the supply of electrical energy, the ultrasonic transducer 16 (piezoelectric element) converts the electrical energy into ultrasonic vibrations and generates the ultrasonic vibration. The ultrasonic vibration generated by the ultrasonic transducer 16 is transmitted from the proximal end to the distal end in the rod element 6. Subsequently, the ultrasonic vibration is transmitted to the treatment unit 13 of the rod element 6.Through the transmission of the ultrasonic vibration, the ultrasonic transducer 16 and the rod element 6 oscillate at specific frequencies within a predetermined frequency range. In this case, the directions of oscillation of the rod element 6 and the ultrasonic transducer 16 are approximately parallel to the longitudinal axis C. It may now be possible to input an operating command via a foot switch or similar device separate from the treatment tool 1, instead of using the control knob 18.

[0025] A gripper part 21 is rotatably mounted on a distal end section of the shaft 3. A movable element 23 extends along the longitudinal axis C inside the shaft 3. A distal end section of the movable element 23 is connected to the gripper part 21. The movable element 23 extends into the interior of the housing 2. The handle 11 is connected to the movable element 23 inside the main housing body 7. The handle 11 moves towards or away from the handle 8, causing the movable element 23 to move along the longitudinal axis C. This movement of the movable element 23 exerts a driving force on the gripper part 21, causing the gripper part 21 to rotate about one mounting position on the shaft 3. Accordingly, the gripper part 21 is opened or closed relative to the treatment unit 13.By closing a gap between the gripper part 21 and the treatment unit 13, a treatment target, such as living tissue, is gripped between the gripper part 21 and the treatment unit 13. During this process, an opening direction (one direction of arrow Y1) and a closing direction (one direction of arrow Y2) of the gripper part 21 intersect the longitudinal axis C. Furthermore, when the gap between the gripper part 21 and the treatment unit 13 is closed, a longitudinal direction of the gripper part 21 is approximately parallel to the longitudinal axis C of the shaft 3. In this case, the movable element 23 can extend to the outside of the shaft 3. If, for example, the movable element 23 is located outside the shaft 3, the shaft 3 is extended within the movable element 23.

[0026] In the present embodiment, the treatment unit 13 and the gripper part 21 form an end effector 10, and the gripper part 21 can be opened and closed relative to the treatment unit 13 within the end effector 10. Furthermore, the end effector 10 and the rod element 6, together with the shaft 3 and the rotating element 12, are rotatable about the longitudinal axis C with respect to the housing 2. It may be possible to attach the shaft 3, the end effector 10, and the rod element 6 to the housing 2 without arranging the rotating element 12.

[0027] Fig. Figure 2 is an enlarged view of a distal end part of the treatment tool according to an embodiment of the present invention. Fig. Figure 3 is a diagram illustrating a configuration of the gripper part included in the treatment tool according to an embodiment of the present invention. Fig. 4 is a top view of the gripper part, seen in the direction of the Fig. 3 arrow A1 shown. Fig. 5 is a cross-sectional view of the in Fig. 3 shown gripper part. Fig. Figure 5 is a cross-sectional view cut along a plane parallel to the longitudinal axis C and passing through the rod element 6 and the gripper part 21. In the following, a direction intersecting the longitudinal axis C (which is approximately perpendicular to it) and intersecting the opening and closing directions of the gripper part 21 (which is approximately perpendicular to it) is considered the width direction (directions indicated by an arrow W1 and an arrow W2 in the figure). Fig. 2 are shown) of the end effector 10. Fig. 3, Fig. 4 to Fig. Figure 5 shows states in which a holding element 41, to be described later, is arranged in a neutral position.

[0028] The treatment unit 13 comprises a treatment surface (treatment unit front) 25, which faces the gripper part 21, and a rear surface (treatment unit back) 27, which faces a side opposite the treatment surface 25. A treatment unit inclined surface 28 is arranged at a distal end section of the treatment surface 25 and is inclined with respect to the longitudinal axis C. The treatment unit inclined surface (a rod-side inclined surface) 28 is inclined such that it approaches the rear surface 27 of the treatment unit 13 in the direction of the distal end. In the present embodiment, the treatment unit inclined surface 28 forms a distal end of the treatment surface 25 of the treatment unit 13 and extends from the distal end of the treatment surface 25 to the proximal end.Furthermore, in the present embodiment, a curved, extended section (rod bending section) 29 is arranged at a distal end section of the treatment unit 13 in the lateral direction of the end effector 10, extending in a bending manner with respect to the longitudinal axis C. Furthermore, analogous to the treatment unit 13, the gripper part 21 is arranged in a bending manner with respect to the longitudinal axis C in the lateral direction of the end effector 10.

[0029] The gripper part 21 comprises a gripper surface 21a facing the treatment unit 13 (gripper part facing surface) and a rear surface 21b opposite gripper surface 21a (gripper part rear surface). Within the gripper part 21, the gripper surface 21a is oriented towards a side on which the gripper part 21 is closed, and the rear surface 21b is oriented towards a side on which the gripper part 21 is open (side of arrow Y2). Furthermore, a curved, extended section (gripper part bending section) 21c is arranged at a distal end section of the gripper part 21, extending such that it bends in the lateral direction of the end effector 10 with respect to the longitudinal direction (the longitudinal axis C). The curved extended section 21c of the gripper part 21 bends in the width direction so that it is opposite the curved extended section 29 of the treatment unit 13.

[0030] The gripper part 21 comprises a jaw (movable jaw) 31, which is made, for example, of metal. The jaw 31 is rotatably mounted on the shaft 3. A proximal end section of the jaw 31 is connected to the distal end section of the movable element 23. The jaw 31 extends from the proximal end section to a central section in the gripper part 21.

[0031] Furthermore, the gripper part 21 comprises a proximal end cover 32 and a distal end cover 33, both made of plastic. In the present embodiment, the jaw 31 is integrated with the proximal end cover 32. The jaw 31 and the proximal end cover 32 are formed as an integrated unit, for example, by overmolding. The proximal end cover 32 is firmly connected to a large portion of the outer surface of the jaw 31. In the configuration described above, the large portion of the outer surface of the jaw 31 is not exposed to the outside of the gripper part 21 on the rear surface 21b of the gripper part 21, and a large portion of the rear surface 21b of the gripper part 21 is formed by the proximal end cover 32 and the distal end cover 33.Meanwhile, the proximal end cover 32 can be configured as a separate element from the jaw 31, and the proximal end cover 32 can be attached to the outer surface of the jaw 31. Furthermore, it may be possible to provide the outer surface of the jaw 31 with a resin coating instead of permanently attaching the proximal end cover 32 to the outer surface of the jaw 31. Here, the materials of the proximal end cover 32, the distal end cover 33, and the coating are not limited to plastic but can also be ceramic, rubber, or similar materials.

[0032] The clamping jaw 31 has a concave section 32a that is recessed towards the side (direction of arrow Y2) where the gripper part 21 opens. The concave section 32a extends from a proximal end section to a distal end section of the proximal end-side cover 32. The concave section 32a passes through a central position of the gripper 21 in the width direction of the end effector 10. A distal end section of the distal end-side cover 33 forms the curved, extended section 21c of the gripper part 21. Therefore, the distal end section of the distal end-side cover 33 is extended in the width direction of the end effector 10 such that it bends with respect to the longitudinal direction of the gripper part 21.

[0033] The retaining element 41 is attached to the jaw 31. The retaining element 41 is connected to a Fig. The support pin 42 shown in Figure 2 is attached to the jaw 31. The retaining element 41 is made of, for example, metal and extends from the proximal end section to the distal end section in the gripper part 21. An outer surface of the retaining element 41 on the distal end side, in particular an outer surface on the side of the rear surface 21b, is covered with the distal end cover 33. Furthermore, the retaining element 41 forms part of the gripper surface 21a. In addition, a distal end section of the retaining element 41 forms the curved, extended section 21c of the gripper part 21. Therefore, the distal end section of the retaining element 41 is extended in the lateral direction of the end effector 10 such that it bends with respect to the longitudinal direction of the gripper part 21. Furthermore, the retaining element 41 is attached to the jaw 31 in such a way that it is inserted into the concave sections of the proximal end cover 32 and the distal end cover 33 (or the jaw 31).

[0034] The retaining element 41 oscillates with respect to the jaw 31 and the proximal end cover 32 by using the support pin 42 as its central axis. The retaining element 41 is a oscillating element. Furthermore, the support pin 42 extends in the lateral direction of the end effector 10. Therefore, the retaining element 41 oscillates with respect to the jaw 31 by using an oscillation axis X extending in the lateral direction of the end effector 10 as its central axis. In this case, the distal end cover 33 oscillates in conjunction with the retaining element 41. Additionally, the support pin 42 is located in the central region of the gripper part 21 in the longitudinal direction (direction of the longitudinal axis C) of the gripper part 21.

[0035] In the neutral position (see Fig. 3, Fig. 4 to Fig. 5), in which the retaining element 41 extends approximately parallel to the jaw 31, the retaining element 41 has a gap with respect to a concave section (for example, a recessed bottom surface 32b (see Fig. 5) of the concave section 32a) of the proximal end side cover 32 and the distal end side cover 33 and does not come into contact with the recessed bottom surface 32b.

[0036] Furthermore, the length of a proximal end face (on the side of arrow C2) of the clamping jaw 31 with respect to the support pin 42 as the base point is longer than the length of a distal end face (on the side of arrow C1) in the direction of the longitudinal axis C. Meanwhile, the proximal end face cover 32 has the same length ratio. Here, the length of a proximal end face of the retaining element 41 with respect to the support pin 42 as the base point is approximately equal to the length of a distal end face in the direction of the longitudinal axis C. A pivot point (the support pin 42) is located near the center, allowing the retaining element 41 to rotate smoothly.

[0037] Fig. Figure 6 is a diagram illustrating a configuration of the gripper included in the treatment tool according to an embodiment of the present invention, and is a diagram illustrating a case in which the oscillating element is in a first regulated state. Fig. 7 is a top view of the gripper part, seen in the direction of the Fig. 6 shown arrow A2. Fig. 6 and Fig. Figure 7 are diagrams illustrating a case in which the retaining element 41 is in one direction of a Fig. 5 illustrated arrow X1 swings.

[0038] Fig. Figure 8 is a diagram illustrating a configuration of the gripper included in the treatment tool according to an embodiment of the present invention, and is a diagram illustrating a case in which the oscillating element is in a second regulated state. Fig. 9 is a top view of the gripper part, seen in the direction of the Fig. 8 shown arrow A3. Fig. 10 is a cross-sectional view, taken along a line in Fig. The line BB shown in section 9 is cut. Fig. 8, Fig. 9 to Fig. Figure 10 are diagrams that represent a case in which the retaining element 41 moves in the direction of a Fig. Arrow X2, as shown in point 5, swings.

[0039] When the retaining element 41 oscillates from the neutral position in one direction to one side (arrow side X1), the retaining element 41 comes close to the treatment unit 13 at its distal end relative to the support pin 42. Then, in an area at the proximal end relative to the support pin 42, a first contact surface 43 of the retaining element 41 comes into contact with a first regulating surface 34 of the jaw 31 (see Fig. 6 and Fig. 7) In the state in which the first contact surface 43 comes into contact with the first regulating surface 34 (the first regulated state), the oscillation of the holding element 41 to one side in the direction of oscillation is regulated.

[0040] If, on the other hand, the retaining element 41 swings from the neutral position to the other side (arrow X2 side) in the direction of swing, the retaining element 41 approaches the support pin 42 of the treatment unit 13 at its proximal end. Then, in an area at the proximal end relative to the support pin 42, a second contact surface 44 of the retaining element 41 comes into contact with a second contact surface 35 of the jaw 31 (see Fig. 8, Fig. 9 to Fig. 10) The second regulating surface 35 is formed here from two regulating surfaces (regulating surfaces 35a and 35b). The regulating surfaces 35a and 35b are each formed on two projecting sections (projecting sections 351 and 352) that extend inside the jaw 31 in directions approaching each other. The regulating surfaces 35a and 35b correspond to the upper surfaces of the projections that extend in mutually approaching directions on an inner surface of the jaw 31. The second contact surface is formed by two contact surfaces (contact surfaces 44a and 44b) that are arranged at positions that come into contact with the two regulating surfaces (the regulating surfaces 35a and 35b). The contact surfaces 44a and 44b correspond to the lower surfaces of the projections 441 and 442, which project in a width direction onto the side surfaces of a proximal end section of a main body 443, which forms a main body of the retaining element 41.In a state in which the second contact surface 44 comes into contact with the second regulating surface 35 (second regulated state), the oscillation of the holding element 41 to the other side in the direction of oscillation is regulated.

[0041] In order to avoid unnecessary impairment of the projections 441 and 442, it is advantageous that the distal end sections of the preceding sections 351 and 352 are chamfered at least on the sides that come into contact with the projections 441 and 442.

[0042] In the present embodiment, the first regulating surface 34 and the second regulating surface 35, which regulate the oscillation range of the holding element 41, are arranged at the proximal end of the jaw 31. Furthermore, the first regulating surface 34 and the second regulating surface 35 are arranged at the proximal end in the longitudinal direction of the gripper part 21, at positions separated from the support pin 42. By regulating the oscillation of the holding element 41 at positions separated from the support pin 42, it is possible to reduce the oscillation variation (an angle with respect to the longitudinal axis C) due to tolerance variations of the individual components of the gripper part 21.

[0043] Furthermore, the proximal end section of the retaining element 41 has a T-shape (see Fig. 4), and a portion of the proximal end section is inserted into a gap between the preceding sections 351 and 352 during a transition from the first regulated state to the second regulated state, or vice versa. With the configuration in which a holder housing unit 353 is arranged such that a portion of the retaining element 41 is inserted into the gap between the preceding sections 351 and 352, it is possible to ensure an adequate stroke of the jaw 31 within a limited space.

[0044] In the meantime, it is advantageous to form a gap between each of the preceding sections 351 and 352 and the main body 443 to prevent unnecessary interference between each of the preceding sections 351 and 352 and the main body 443. The gap is, for example, equal to or greater than 0.05 millimeters (mm) and equal to or less than 0.5 mm. In this case, an extremely large gap prevents a reduction in the size of the end effector 10.

[0045] Furthermore, a cushioning element 51 is attached to the retaining part 41 (see Fig. 4 and Fig. 5) The cushioning element 51 forms part of the gripping surface 21a of the gripper part 21. The cushioning element 51 oscillates together with the holding element 41 relative to the jaw 31, with the oscillation axis X serving as the central axis. The cushioning element 51 is made of a resin material, such as polytetrafluoroethylene (PTFE). The cushioning element 51 is made of a material that prevents abrasion from friction with the treatment unit 13 of the rod element 6 as far as possible and that has heat-resistant properties. It is also advantageous that the cushioning element 51 is electrically insulating.

[0046] The width of the cushioning element 51 is less than the distance between the preceding sections 351 and 352. Therefore, the cushioning element 51 is inserted into the gap between the preceding sections 351 and 352 (the holder housing unit 353) when the holder element 41, for example, transitions from the first controlled state to the second controlled state. With the configuration in which the cushioning element 51 is inserted into the gap between the preceding sections 351 and 352, it is possible to ensure a sufficient stroke of the jaw 31 within a limited space.

[0047] A distal end section of the padding element 51 is an inclined surface 51a, which is inclined with respect to the longitudinal direction of the gripper part 21. The inclined surface 51a approaches the treatment unit 13 in the direction of its distal end. The treatment unit's inclined surface 28 faces the padding element 51. Then, in a state where a contact surface of the padding element 51 comes into contact with the treatment surface 25 of the treatment unit 13, the inclined surface 51a comes into contact with the inclined surface 28 of the treatment unit. Preferably, the inclined surface 51a is approximately parallel to the inclined surface 28 of the treatment unit when the padding element 51 comes into contact with the treatment unit 13. Furthermore, the inclined surface 51a projects towards the side of the treatment unit 13 relative to a different area than the inclined surface 51a on the contact surface of the padding element 51.

[0048] The retaining element 41 comprises a concave section 41a that is recessed on the side where the gripper 21 is open. The concave section 41a extends from the proximal end section to the distal end section of the gripper part 21. In the present embodiment, the distal end section of the retaining element 41 is extended such that it bends with respect to the longitudinal direction of the gripper part 21, so that a distal end section of the concave section 41a is also extended such that it bends with respect to the longitudinal direction of the gripper part 21. Furthermore, the concave section 41a passes through a central position in the width direction of the end effector 10. The cushioning element 51 is attached to the retaining element 41 in a state in which it is inserted into the concave section 41a. The cushioning element 51 is attached to the retaining element 41 by locking, bonding, or similar means.

[0049] To avoid play, it is desirable to position the control surfaces as far away as possible from the support pin 42. However, if the reflective surfaces are to be positioned at the distal end of the retaining element 41, the size of the distal end section of the end effector 10 increases. To allow for fine-tuning, it is preferable to reduce the size of the distal end of the end effector 10.

[0050] According to the embodiment described above, the first control surface 34 and the second control surface 35, which are arranged at the proximal end side of the gripper part 21, regulate the oscillation of the holding element 41. Furthermore, in the present embodiment, the first control surface 34 and the second control surface 35 are arranged at specific positions that are separated from the support pin 42, which serves as the central axis of the oscillation of the holding element 41, i.e., at specific positions that come into contact with the contact surfaces (the first contact surface 43 and the second contact surface 44) that are arranged at the proximal end section of the holding element 41.According to the present embodiment, by regulating the oscillation range of the retaining element 41 at the proximal end of the gripper 21, it is possible to arrange the first control surface 34 and the second control surface 35 at specific positions that are separated from the support pin 42, and it is possible to prevent play in the retaining element 41 (oscillating element).

[0051] Furthermore, in the embodiment described above, the length of the proximal end side (arrow C2 side) of the jaw 31 in the longitudinal axis C is set longer than the length of the distal end side (arrow C1 side) when using the support pin 42 as a base point, so that it is possible to reduce the size of the end effector 10, in particular to reduce the size of the distal end section.

[0052] In contrast, in a configuration where regulating units for the jaw's rotation range are arranged at both the distal and proximal ends, and where the length of the distal end is shorter in the longitudinal axis direction when using a rotation axis as the base point, it is difficult to ensure the accuracy of the regulating positions, and the rotation width is likely to be variable. Increasing the length of the distal end of the jaw makes it possible to ensure the accuracy of the regulating positions, but the size of the distal end section increases. Therefore, it is possible to ensure accuracy and prevent an increase in the size of the distal end section by adopting the configuration where the regulating units are arranged only at the proximal end of the jaw 31, as in the present embodiment.

[0053] While the embodiment of the present invention has been explained above, the present invention is not limited to the embodiment described above. The present invention may include various embodiments and the like, which are not described here. In the embodiment described above, the treatment tool 1 is configured to apply ultrasonic vibration to living tissue, but the present invention is not limited to this example, and it may be possible to adopt a configuration in which radio frequency energy or thermal energy is applied in addition to ultrasonic vibration, or it may be possible to adopt a configuration in which ultrasonic vibration, radio frequency energy, and thermal energy can be applied selectively.

[0054] Fig.Figure 11 is a schematic diagram showing a treatment tool according to a modification of the embodiment of the present invention. For example, in a configuration where high-frequency energy is applied, a high-frequency generating unit 5A and a rod element 6A are arranged instead of the transducer unit 5 and the rod element 6, and high-frequency electric current is transmitted to the rod element 6A as high-frequency energy. Specifically, a treatment tool 1A comprises the housing 2, the shaft 3, the high-frequency generating unit 5A, and the rod element (probe) 6A. The high-frequency generating unit 5A comprises a housing 15A. The housing 15A is mounted on the main housing body 7 from the proximal end. Furthermore, one end of a cable 17A is connected to the housing 15A. The other end of the cable 17A is detachably connected to an electrical high-frequency power supply unit 31, which provides electrical energy.In this case, a conducting wire (not shown) is arranged between cable 17A and rod element 6A, as well as between cable 17A and the main housing body 7, so that the high-frequency electric current flows into a treatment unit 13A at a distal end of rod element 6A and the holding element 41. The treatment unit 13A and the holding element 41 act as an electrode pair that conducts the high-frequency electric current. A treatment target is treated in the treatment tool 1A by conducting the high-frequency electric current into the treatment unit 13A and the holding element 41. Industrial applicability

[0055] As described above, the treatment tool according to the present invention is useful to prevent an enlargement of the end effector and to avoid play in the oscillating element. List of reference symbols 1, 1A Treatment tool 2 cases 3 shaft 5 converter unit 5A high-frequency generation unit 6, 6A Rod element 7 Main housing body 8 handle 11 Handle 12 rotating elements 13, 13A Treatment Unit 15 converter housings 16 ultrasound transducers 17, 17A cable 18 Control knob 21 Gripper part 31 cheek 32 proximal end cover 33 distal end coverage 34 first ruled surface 35 second ruled surface 41 Holding element 42 Support pin 43 first contact surface 44 second contact surface 51 Upholstered element 351, 352 preceding section 441, 442 lead

Claims

[1] Treatment tool (1, 1A), comprising: a long and elongated shaft (3); a gripper element (6, 6A) that protrudes from a distal end of the shaft (3); a movable jaw (31) which is rotatably mounted; and a oscillating element (41) attached to the movable jaw (31), wherein the oscillating element (41) is configured to grasp living tissue with the gripper element (6, 6A) and oscillates in relation to the movable jaw (31), wherein the movable jaw (31) comprises a first controlled surface (34) that comes into contact with a proximal end section of the oscillating element (41) in order to regulate the oscillation of the oscillating element (41) in one direction, and a second controlled surface (35) that comes into contact with an area that differs from a contact area of ​​the first controlled surface (34) in the proximal end section of the oscillating element (41) in order to regulate the oscillation of the oscillating element (41) in a different direction, characterized by , that the first controlled surface (34) and the second controlled surface (35) are arranged on a proximal end side of the movable jaw (31) relative to a pivot point (42) about which the oscillating element (41) can be pivoted relative to the movable jaw (31). [2] Treatment tool (1, 1A) according to claim 1, characterized by , that the second controlled surface (35) is formed on two projecting sections which are arranged inside the movable jaw (31) and which project in the directions facing each other. [3] Treatment tool (1, 1A) according to claim 1, wherein the oscillating element (41) includes a cushioning element (51) which comes into contact with the gripper element (6, 6A) when the movable jaw (31) approaches the gripper element (6, 6A). [4] Treatment tool (1, 1A) according to claim 1, wherein the gripper element (6, 6A), the oscillating element (41) and the movable jaw (31) bend in respect of a longitudinal direction of the shaft (3). [5] Treatment tool (1, 1A) according to claim 2, wherein the oscillating element (41) has a projection at the proximal end section of the oscillating element (41) which projects in a direction perpendicular to a longitudinal direction of the oscillating element (41) and in a direction perpendicular to an oscillation direction of the oscillating element (41), the lead comes into contact with the second ruled surface (35) and a part of the proximal end section between the preceding sections is inserted in a state in which the projection comes into contact with the second ruled surface (35). [6] Treatment tool (1, 1A) according to claim 3, wherein the cushioning element (51) reaches a proximal end of the oscillating element (41). [7] Treatment tool (1, 1A) according to claim 2, wherein the oscillating element (41) contains a cushioning element (51) which comes into contact with the gripper element (6, 6A) when the movable jaw (31) approaches the gripper element (6, 6A), and a width of the upholstery element (51) is smaller than a distance between the preceding sections. [8] Treatment tool (1, 1A) according to claim 1, further comprising: an ultrasonic transducer (16) configured to generate ultrasonic vibrations, wherein the gripper element (6, 6A) is configured such that it vibrates in a longitudinal direction of the shaft (3) due to the ultrasonic vibration generated by the ultrasonic transducer (16). [9] Treatment tool (1, 1A) according to claim 1, wherein a high-frequency electric current flows into the gripper element (6, 6A), and the gripper element (6, 6A) and the oscillating element (41) form an electrode pair that provides a conduction of the high-frequency electric current.

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