Blood vessel sampling device

Abstract

To provide a blood vessel sampling device excellent in operability which is capable of performing hemostasis by restarting electric conduction immediately in the case that hemorrhage is recognized when a tissue is cut with a cutter blade.SOLUTION: A blood vessel sampling device 24 includes: a cylindrical body 24a; a jaw structure 26 which is fitted to an end of the cylindrical body 24a and in which an upper jaw part 40 and a lower jaw part 50 open / close; and a cutter blade 34 which moves along a cutter groove 49 of the upper jaw part 40 and the lower jaw part 50. The jaw structure 26 has: a pair of pinching faces 41 formed in a part where the upper jaw part 40 and the lower jaw part 50 face each other in a closed state; and a flat surface electrode 48 formed in each of the pair of the pinching faces 41. The cutter groove 49 is formed through the flat surface electrode 48 and has in the cutter groove 49 an insulator separating the flat surface electrode 48 and the cutter blade 34.SELECTED DRAWING: Figure 2

Description

Technical Field

[0001] The present invention relates to a blood vessel harvesting device.

Background Art

[0002] In coronary artery bypass grafting (CABG), a blood vessel harvested from a patient is connected so as to bypass a diseased site. The blood vessel to be used is harvested from, for example, the lower limb of the patient. For harvesting the blood vessel, an endoscopic vessel harvesting system (EVH system) is used.

[0003] The endoscopic vessel harvesting system includes an endoscope system, a pneumoperitoneum device, a vessel dissection device, and a blood vessel harvesting device. For harvesting the blood vessel, while sending carbon dioxide gas with the pneumoperitoneum device, the vessel dissection device is advanced along the blood vessel to dissect the blood vessel from the surrounding adipose tissue. Then, with the blood vessel harvesting device, the branch blood vessels branching from the blood vessel are cut while hemostasis is performed. The cutting of the branch blood vessels is performed while observing with an endoscope. Then, the blood vessel harvesting device is withdrawn, and the blood vessel is withdrawn from the incision, thereby completing the harvesting of the blood vessel.

[0004] For example, Patent Document 1 discloses a device for cutting tissue under observation with an endoscope.

Prior Art Documents

Patent Documents

[0005]

Patent Document 1

Summary of the Invention

Problems to be Solved by the Invention

[0006] The device of Patent Document 1 has electrodes on the clamping surface of a jaw structure that sandwiches tissue. The electrodes stop bleeding of the tissue by passing an electric current through the tissue to heat it. A cutter groove through which a cutter blade passes is formed in the clamping surface. In such a device, the tissue that has been stopped from bleeding by heating with the electrodes is cut by the cutter blade.

[0007] In the device of Patent Document 1, the cutter blade can come into contact with the electrode. Therefore, when energizing between the electrodes, it is necessary to retract the cutter blade to the proximal side of the cutter groove to prevent a short circuit. However, during the process of performing a blood vessel cutting procedure, bleeding may occur due to insufficient hemostasis when the blood vessel is cut with the cutter blade. In such a case, with the device of Patent Document 1, energization cannot be performed immediately, and an operation to retract the cutter blade to the proximal side is required.

[0008] An object of the present invention is to solve the above-described problems.

Means for Solving the Problems

[0009] One aspect of the following disclosure is a blood vessel harvesting device including a cylindrical body extending along an axis, a jaw structure attached to the tip of the cylindrical body and having an upper jaw portion and a lower jaw portion, the upper jaw portion and the lower jaw portion being openable and closable, a cutter blade disposed between the upper jaw portion and the lower jaw portion and moving in the direction of the axis along the cutter grooves of the upper jaw portion and the lower jaw portion. The jaw structure has a pair of clamping surfaces formed at a portion where the upper jaw portion and the lower jaw portion face each other in a closed state, and planar electrodes formed on each of the pair of clamping surfaces. The cutter groove is formed to penetrate the planar electrode, the width of the cutter groove of at least one of the planar electrodes is larger than the thickness of the cutter blade, and the cutter groove has an insulator separating the planar electrode and the cutter blade.

[0010] Another aspect is a cylindrical body extending along an axis, a jaw structure attached to the tip of the cylindrical body, having an upper jaw portion and a lower jaw portion, and the upper jaw portion and the lower jaw portion opening and closing, and disposed between the upper jaw portion and the lower jaw portion, a cutter blade moving in the direction of the axis along cutter grooves of the upper jaw portion and the lower jaw portion. The jaw structure has a pair of clamping surfaces formed at a portion where the upper jaw portion and the lower jaw portion face each other in a closed state, and planar electrodes formed on each of the pair of clamping surfaces. The cutter groove is formed to penetrate the planar electrode, and has a spacer made of an insulating material covering the inside of the cutter groove penetrating one of the planar electrodes of the upper jaw portion and the lower jaw portion. The spacer has an insulating cutter groove through which the cutter blade is inserted and insulated from the planar electrode, and the width of the insulating cutter groove is narrower than the width of the cutter groove penetrating the other of the planar electrodes of the upper jaw portion and the lower jaw portion. It is in a blood vessel collection device.

Advantages of the Invention

[0011] In the blood vessel collection device of the above aspect, since the width of the cutter groove is larger than the thickness of the cutter blade, the cutter blade and the planar electrode can be separated and insulated. Therefore, the blood vessel collection device can perform energization heating with the cutter blade protruding into the cutter groove. When bleeding is observed when the tissue is cut with the cutter blade of this blood vessel collection device, energization can be immediately restarted to stop bleeding, and the operability is excellent.

Brief Description of the Drawings

[0012]

Figure 1

Figure 2

Figure 3

Figure 4

Figure 5

Figure 6

Embodiments for Carrying Out the Invention

[0013] The blood vessel harvesting system 10 shown in FIG. 1 is an EVH system used for EVH (Endoscopic Vessel Harvesting). The blood vessel harvesting system 10 includes a display device 12, a high-frequency power source 14, a pneumoperitoneum device 16, a trocar 18, an imaging device 20 (endoscope), a blood vessel peeling device 22, and a blood vessel harvesting device 24. Among these, the display device 12 is connected to the imaging device 20. The display device 12 displays the image captured by the imaging device 20. The high-frequency power source 14 supplies high-frequency power for cauterizing tissue (blood vessel 90 or branch blood vessel 96) to the blood vessel harvesting device 24. The pneumoperitoneum device 16 supplies carbon dioxide gas to the blood vessel peeling device 22. The imaging device 20 has a cylindrical body 20a and a camera 20b attached to the tip of the cylindrical body 20a. The imaging device 20 is inserted into the patient's body together with the blood vessel peeling device 22 or the blood vessel harvesting device 24 to image the working site.

[0014] The trocar 18 is inserted into an incision near the blood vessel 90. The trocar 18 facilitates the introduction of the imaging device 20, the blood vessel peeling device 22, and the blood vessel harvesting device 24 into the body. The trocar 18 is fixed to the skin by a clip 18a.

[0015] The blood vessel dissection device 22 has a cylindrical body 22a and a conical dissection part 22b attached to the tip of the cylindrical body 22a. The cylindrical body 22a has an ejection hole 22c for ejecting carbon dioxide gas near the tip. The blood vessel dissection device 22 dissects the blood vessel 90 and the surrounding peripheral tissue 92 at the dissection part 22b. The blood vessel dissection device 22 forms a cavity 94 around the blood vessel 90 by the carbon dioxide gas ejected from the ejection hole 22c (see Fig. 5B).

[0016] The blood vessel harvesting device 24 of the present embodiment has a cylindrical body 24a and a jaw structure 26 attached to the tip of the cylindrical body 24a. The cylindrical body 24a is a cylindrical member extending in the axial direction, and houses a wiring (not shown) for flowing high-frequency power and an operation wire (not shown) or an operation rod (not shown) for operating the jaw structure 26 inside.

[0017] The blood vessel harvesting device 24 cuts the branch blood vessels 96 of the blood vessel 90 dissected by the jaw structure 26. The jaw structure 26 has a function of cauterizing and cutting the branch blood vessels 96 with high-frequency power to stop bleeding. The details of the jaw structure 26 will be described later.

[0018] The blood vessel harvesting device 24 has an operation hub 28 at the base end. The operation hub 28 has a cutter operation part 28a, a jaw operation part 28b, and a power supply switch 28c. The cutter operation part 28a performs a moving operation in the axial direction of a cutter blade 34 described later. The jaw operation part 28b performs an opening and closing operation of the jaw structure 26. The power supply switch 28c switches the supply and stop of high-frequency power to the jaw structure 26. The jaw structure 26 has the following configuration in detail.

[0019] As shown in Fig. 2A, the jaw structure 26 is attached to the tip of the cylindrical body 24a. As shown in Fig. 2B, the cylindrical body 24a has a pair of notch grooves 24b with a part of the circumferential direction cut out at its tip. The pair of notch grooves 24b are arranged at positions 180° apart in the circumferential direction. Each notch groove 24b extends in the axial direction. The jaw structure 26 is housed in the notch groove 24b.

[0020] The cylindrical body 24a has a pair of support portions 24c that extend toward the tip between a pair of guide grooves 24d. The support portions 24c support the jaw structure 26. The support portions 24c have the guide grooves 24d and the opening / closing pin mounting holes 24e. The guide grooves 24d are located on the tip side of the opening / closing pin mounting holes 24e. The guide grooves 24d extend in the axial direction. The opening / closing pin mounting holes 24e are circular. The central positions of the guide grooves 24d and the opening / closing pin mounting holes 24e are shifted by 90° in the circumferential direction of the cylindrical body 24a with respect to the center of the notch groove portion 24b.

[0021] As shown in FIG. 2B, the jaw structure 26 includes an upper jaw assembly 30, a lower jaw assembly 32, and a cutter blade 34. The upper jaw assembly 30 and the lower jaw assembly 32 are connected via a shaft pin 36 and an opening / closing pin 38. The shaft pin 36 is fixed to the upper jaw assembly 30 and the lower jaw assembly 32. The shaft pin 36 serves as the rotation center of the upper jaw assembly 30 and the lower jaw assembly 32. The shaft pin 36 is inserted into the guide groove 24d of the cylindrical body 24a. The guide groove 24d is a groove that extends in the axial direction and allows the axial movement of the shaft pin 36. The shaft pin 36 moves in the guide groove 24d as the jaw structure 26 is displaced in the axial direction.

[0022] The opening / closing pin 38 is a pin fixed to the cylindrical body 24a. When the jaw structure 26 is displaced in the axial direction, the opening / closing pin 38 is displaced relative to the upper jaw assembly 30 and the lower jaw assembly 32. As shown in FIG. 2B, the opening / closing pin 38 is inserted into the first sliding groove 30a of the upper jaw assembly 30 and the second sliding groove 32a of the lower jaw assembly 32. When the jaw structure 26 moves forward or backward with respect to the axial direction of the cylindrical body 24a, the opening / closing pin 38 slides in the first sliding groove 30a and the second sliding groove 32a. The upper jaw assembly 30 and the lower jaw assembly 32 rotate according to the position of the opening / closing pin 38 in the first sliding groove 30a and the second sliding groove 32a, and the jaw structure 26 opens and closes.

[0023] As shown in Fig. 2A, the upper jaw assembly 30 has an upper jaw portion 40 and a base portion 42. The upper jaw portion 40 is located on the tip side and has a clamping surface 41 orthogonal to the rotation direction. The base portion 42 is located on the proximal end side of the upper jaw portion 40 and is integrally connected to the upper jaw portion 40. The base portion 42 has a flat sliding surface 42a in a direction orthogonal to the clamping surface 41. The sliding surface 42a has a shaft hole 42c and a first sliding groove 30a. The shaft hole 42c is where the shaft pin 36 is inserted. The shaft hole 42c serves as the rotation center of the upper jaw assembly 30. The first sliding groove 30a extends obliquely with respect to the axial direction. The first sliding groove 30a is penetrated by the opening and closing pin 38.

[0024] As shown in Fig. 2A, the upper jaw portion 40 has a support 44, a main body portion 46, and a planar electrode 48. As shown in Fig. 2B, the support 44 is integrally connected to the base portion 42 and is formed of the same material (e.g., metal) as the base portion 42. The support 44 supports the main body portion 46. The main body portion 46 is formed of an insulating material such as resin. The main body portion 46 occupies most of the upper jaw portion 40. As shown in Fig. 3A, the main body portion 46 extends with a slight inclination with respect to the axial direction.

[0025] As shown in Fig. 3A, the upper jaw portion 40 has a first side surface 43a in a first direction orthogonal to the axis, and a second side surface 43b in a second direction opposite to the first direction. The center line of the main body portion 46 is inclined toward the first direction with respect to the axis of the cylindrical body 24a. The first side surface 43a has a gently arcuate curved surface 45a that protrudes with respect to the cutter groove 49. The curved surface 45a of the first side surface 43a has a top portion 45b that is closest to the cutter groove 49 at the base end portion. The second side surface 43b extends parallel to the cutter groove 49 (the direction of the axis of the cylindrical body 24a).

[0026] The main body part 46 has a tip part 46c that protrudes from the support 44 at its tip. The tip part 46c has a first inclined surface 47a and a second inclined surface 47b that are inclined with respect to the direction of the axis, and a ridge line part 47c. The first inclined surface 47a is a surface inclined in the first direction and is adjacent to the first side surface 43a. The second inclined surface 47b is a surface inclined in the second direction and is adjacent to the second side surface 43b. The ridge line part 47c is formed as a side where the first inclined surface 47a and the second inclined surface 47b intersect. The ridge line part 47c is located at the tip of the upper jaw assembly 30 and extends in a direction orthogonal to the clamping surface 41.

[0027] As shown in FIG. 3A, the first inclined surface 47a and the second inclined surface 47b intersect at an acute angle at the ridge line part 47c. Such a ridge line part 47c can preferably separate the blood vessel 90 and the surrounding tissue 92. In the upper jaw part 40, the position of the ridge line part 47c at the tip is spaced apart from the direction of the axis toward the first direction. In the upper jaw part 40 of the present embodiment, since the position of the ridge line part 47c is close to the position of the first side surface 43a, the visibility of the position where the separation operation is performed is improved.

[0028] As shown in FIG. 3A, the upper jaw part 40 has a clamping surface 41 facing the lower jaw part 50. The clamping surface 41 of the upper jaw part 40 has a planar electrode 48. The planar electrode 48 is formed of a plate-shaped metal plate attached to the main body part 46. The surface of the planar electrode 48 constitutes the clamping surface 41.

[0029] The clamping surface 41 of the upper jaw part 40 has an upper cutter groove 49a extending along the axis. The upper cutter groove 49a penetrates the planar electrode 48 and reaches the inside of the main body part 46. The width (dimensions in the first and second directions) of the upper cutter groove 49a is larger than the thickness of the cutter blade 34. The upper cutter groove 49a extends along the axis of the cylindrical body 24a when the Joe structure 26 is closed. The upper cutter groove 49a guides the movement of the cutter blade 34 in the direction of the axis. In the following description, the cutter groove 49 is used as a general term for the upper cutter groove 49a, the lower cutter groove 49b, and the insulating cutter groove 49c.

[0030] As shown in FIGS. 2B and 3B, the lower jaw assembly 32 has a lower jaw portion 50 and a base portion 52. The lower jaw portion 50 is located on the distal end side of the base portion 52 and has a clamping surface 41 facing the upper jaw portion 40. The base portion 52 is located on the proximal end side of the lower jaw portion 50 and is integrally connected to the lower jaw portion 50. The base portion 52 has a flat sliding surface 52a in a direction perpendicular to the clamping surface 41. The sliding surface 52a slides with the sliding surface 42a of the upper jaw assembly 30. The base portion 52 has a shaft hole 52c and a second sliding groove 32a. The shaft hole 52c allows the shaft pin 36 to pass through. The shaft hole 52c serves as the rotation center of the lower jaw assembly 32. The second sliding groove 32a extends obliquely in a direction opposite to the first sliding groove 30a. The second sliding groove 32a allows the opening and closing pin 38 to pass through.

[0031] As shown in FIG. 3B, the lower jaw portion 50 has a support 44, a main body portion 46, a planar electrode 48, a lower cutter groove 49b, and a spacer 60. Since the lower jaw portion 50 has a shape that is vertically symmetric with respect to the upper jaw portion 40, a detailed description of its shape is omitted. In the lower jaw portion 50, the same components as those in the upper jaw portion 40 are given the same reference numerals. The lower jaw portion 50 has a lower cutter groove 49b formed in the planar electrode 48. The lower cutter groove 49b extends in the axial direction. The lower cutter groove 49b penetrates the planar electrode 48 of the lower jaw portion 50 in the thickness direction. The width of the lower cutter groove 49b is larger than the width of the upper cutter groove 49a. Therefore, the lower cutter groove 49b forms a gap with the cutter blade 34, enabling electrical insulation between the cutter blade 34 and the planar electrode 48 of the lower jaw portion 50.

[0032] The spacer 60 is disposed inside the lower cutter groove 49b and covers the inside of the lower cutter groove 49b. The spacer 60 has a pair of side wall portions 60a protruding from the main body portion 46. The spacer 60 has an insulating cutter groove 49c between the pair of side wall portions 60a. As shown in FIG. 4A, the insulating cutter groove 49c extends in the axial direction and guides the axial movement of the cutter blade 34. The width of the insulating cutter groove 49c is the same as or slightly larger than the thickness (dimension in the width direction) of the cutter blade 34. The spacer 60 is disposed between the cutter blade 34 and the planar electrode 48 of the lower jaw portion 50 to insulate the cutter blade 34 from the planar electrode 48 of the lower jaw portion 50.

[0033] The width of the insulating cutter groove 49c is narrower than the width of the upper cutter groove 49a. When the cutter blade 34 slides along the insulating cutter groove 49c and the upper cutter groove 49a, such an insulating cutter groove 49c restricts the displacement of the cutter blade 34 in the width direction. Therefore, the insulating cutter groove 49c prevents the cutter blade 34 from contacting the upper cutter groove 49a. Therefore, the cutter blade 34 is kept separated from the planar electrode 48 forming the upper cutter groove 49a, and the cutter blade 34 can be insulated from the planar electrode 48.

[0034] As shown in FIG. 3B, the pair of side wall portions 60a of the spacer 60 are set such that the protruding height from the main body portion 46 is larger than the thickness of the planar electrode 48. In a state where the planar electrode 48 is assembled to the main body portion 46 of the lower jaw portion 50, the spacer 60 protrudes above the planar electrode 48. As shown in FIG. 4B, in a state where the jaw structure 26 is closed, the spacer 60 prevents the planar electrode 48 of the upper jaw portion 40 from contacting the planar electrode 48 of the lower jaw portion 50.

[0035] As shown in FIG. 2B, the upper jaw assembly 30 and the lower jaw assembly 32 are rotatably connected by a shaft pin 36 and an opening / closing pin 38 at their respective base portions 42 and 52. As shown in FIG. 2B, a cutter blade 34 is disposed between the base portion 42 of the upper jaw assembly 30 and the base portion 52 of the lower jaw assembly 32. The jaw structure 26 is displaceable in the axial direction with respect to the cylindrical body 24a. When the jaw structure 26 is located on the proximal end side, as shown in FIG. 2A, the jaw structure 26 opens and the upper jaw portion 40 and the lower jaw portion 50 separate. When the jaw structure 26 is displaced to the tip in the axial direction, as shown in FIG. 4B, the jaw structure 26 closes. The movement of the jaw structure 26 is performed by the jaw operation portion 28b of the operation hub 28 in FIG. 1.

[0036] As shown in FIG. 4B, when the Joe structure 26 is in the closed state, the clamping surface 41 of the upper jaw portion 40 and the clamping surface 41 of the lower jaw portion 50 are in contact with each other via the spacer 60. The spacer 60 prevents a short circuit between the planar electrode 48 of the upper jaw portion 40 and the planar electrode 48 of the lower jaw portion 50. Note that the clamping surface 41 of the upper jaw portion 40 and the clamping surface 41 of the lower jaw portion 50 may have an inclination angle such that the gap widens toward the proximal end side. In this case, when the upper jaw portion 40 and the lower jaw portion 50 are strongly brought into contact with each other, the clamping surfaces 41 are aligned substantially parallel to each other.

[0037] As shown in FIG. 4A, the cutter blade 34 extends in the axial direction of the cylindrical body 24a. The cutter blade 34 projects while sliding along the upper cutter groove 49a and the insulating cutter groove 49c toward the tip in the axial direction by the cutter operation portion 28a of the operation hub 28 shown in FIG. 1. The cutter blade 34 is biased toward the proximal end side and is located on the proximal end side in the initial state as shown in FIG. 2B. When the cutter blade 34 is projected with the Joe structure 26 closed, the cutter blade 34 is displaced toward the tip as shown in FIG. 4A. The cutter blade 34 cuts the branch blood vessel 96 or the blood vessel 90 sandwiched by the Joe structure 26.

[0038] The blood vessel collection device 24 of the present embodiment is configured as described above. The blood vessel collection system 10 is used, for example, in the following blood vessel collection method.

[0039] The blood vessel collection method includes a marking step as shown in FIG. 5A. This step includes a step of confirming the position of the saphenous vein lying on the tibia and a step of making a mark about 2.5 cm at the position below the knee joint.

[0040] Next, the blood vessel collection method proceeds to the step of inserting the trocar 18. In this step, an incision is made at the marked position, and then the trocar 18 is inserted. The trocar 18 is fixed to the skin by the clip 18a.

[0041] Next, as shown in FIG. 5B, the blood vessel extraction method proceeds to the blood vessel peeling step. In this step, the blood vessel peeling device 22 and the imaging device 20 are inserted through the trocar 18. This step includes an operation of peeling the peripheral tissue 92 from the blood vessel 90 with the peeling portion 22b while imaging the blood vessel 90 with the imaging device 20. The peeling of the blood vessel 90 by the blood vessel peeling device 22 is performed while ejecting carbon dioxide gas from the ejection hole 22c near the peeling portion 22b. By this step, a cavity is formed around the blood vessel 90. After a predetermined range of the blood vessel 90 is peeled from the peripheral tissue 92, the blood vessel peeling device 22 and the imaging device 20 are removed from the body.

[0042] Next, as shown in FIG. 6, the blood vessel extraction method proceeds to the blood vessel extraction step. The blood vessel extraction step is performed using the blood vessel extraction device 24. This step includes a step of cutting the branch blood vessel 96 with the blood vessel extraction device 24. The blood vessel extraction device 24 and the imaging device 20 are inserted through the trocar 18 into the cavity around the blood vessel 90. The imaging device 20 is disposed on the proximal end side of the blood vessel extraction device 24 and images the jaw structure 26 of the blood vessel extraction device 24 from the proximal end side.

[0043] The cutting of the branch blood vessel 96 using the blood vessel extraction device 24 is performed by the following steps. First, while observing with the imaging device 20, a step of disposing the open jaw structure 26 at the position of the branch blood vessel 96 is performed. Then, a step of closing the jaw structure 26 and sandwiching the branch blood vessel 96 between the upper jaw portion 40 and the lower jaw portion 50 is performed. Next, a step of supplying high-frequency power to the blood vessel extraction device 24 is performed. High-frequency power is supplied between the planar electrode 48 of the upper jaw portion 40 and the planar electrode 48 of the lower jaw portion 50, and the sandwiched branch blood vessel 96 is cauterized to stop bleeding. Next, a step of cutting the branch blood vessel 96 by advancing the cutter blade 34 along the cutter groove 49 is performed.

[0044] Thereafter, an operation is performed to further advance the blood vessel harvesting device 24 to cut another branch blood vessel 96. When the jaw structure 26 of the blood vessel harvesting device 24 of the present embodiment is closed, a ridge line portion 47c appears at the tip. Therefore, in the blood vessel harvesting process, when a portion where the peripheral tissue 92 is not sufficiently peeled off is found in a part of the blood vessel 90, the peripheral tissue 92 can be peeled off using the ridge line portion 47c.

[0045] The step of cutting the branch blood vessel 96 includes an operation of sandwiching between the upper jaw portion 40 and the lower jaw portion 50 of the jaw structure 26. By this operation, the branch blood vessel 96 is sandwiched between a pair of clamping surfaces 41 of the jaw structure 26. The spacer 60 protruding from the clamping surface 41 can surely sandwich even a thin branch blood vessel 96. Thereafter, an operation of passing high-frequency power between the planar electrode 48 of the upper jaw portion 40 and the planar electrode 48 of the lower jaw portion 50 is performed. The branch blood vessel 96 between the planar electrodes 48 is cauterized by the high-frequency power to stop bleeding.

[0046] Thereafter, the supply of high-frequency power to the jaw structure 26 is stopped, and an operation is performed to advance the cutter blade 34 to cut the branch blood vessel 96. By this intersection, the branch blood vessel 96 is cut. At that time, if the hemostasis of the branch blood vessel 96 is insufficient, bleeding may occur. In the blood vessel harvesting method using the blood vessel harvesting device 24 of the present embodiment, when such bleeding is recognized, an operation to immediately resume the supply of high-frequency power is performed. Since the cutter blade 34 is insulated from the planar electrode 48 of the lower jaw portion 50 by the spacer 60, even when the cutter blade 34 is located in the cutter groove 49, the branch blood vessel 96 can be cauterized with high-frequency power. Thus, the blood vessel harvesting device 24 of the present embodiment can perform hemostasis of the branch blood vessel 96 by high-frequency power while minimizing bleeding.

[0047] Thereafter, after the cutting of the branch blood vessel 96 and the blood vessel 90 in the desired range is completed, the blood vessel harvesting device 24 and the imaging device 20 are withdrawn from the patient's body. Thereafter, the blood vessel 90 is withdrawn from the incision, and the blood vessel harvesting method is completed.

[0048] The blood vessel harvesting device 24 of the above-described present embodiment is summarized as follows.

[0049] One aspect includes a cylindrical body 24a extending along an axis, a jaw structure 26 attached to the tip of the cylindrical body and having an upper jaw portion 40 and a lower jaw portion 50, the upper jaw portion and the lower jaw portion of which open and close, a cutter blade 34 disposed between the upper jaw portion and the lower jaw portion and moving in the direction of the axis along cutter grooves 49 of the upper jaw portion and the lower jaw portion. The jaw structure has a pair of clamping surfaces 41 formed at a portion where the upper jaw portion and the lower jaw portion face each other in a closed state, and planar electrodes 48 formed on each of the pair of clamping surfaces. The cutter grooves are formed to penetrate the planar electrodes, the width of the cutter grooves of at least one of the planar electrodes being larger than the thickness of the cutter blade, and the cutter grooves having an insulator separating the planar electrodes and the cutter blade, in a blood vessel harvesting device 24.

[0050] In the above blood vessel harvesting device, since the width of the cutter groove is larger than the thickness of the cutter blade, the cutter blade and the planar electrode can be separated and insulated. Therefore, the blood vessel harvesting device can perform energization heating with the cutter blade protruding into the cutter groove. When bleeding is observed when the tissue is cut with the cutter blade, this blood vessel harvesting device can immediately resume energization to stop bleeding, and has excellent operability.

[0051] The above blood vessel harvesting device may have a spacer 60 made of an insulating material that covers the inside of the cutter groove penetrating at least one of the planar electrodes of the upper jaw portion and the lower jaw portion. The above blood vessel harvesting device can prevent a short circuit between a pair of planar electrodes via the cutter blade by the spacer, and high-frequency power can flow through the planar electrodes even when the cutter blade is located in the cutter groove.

[0052] In the above blood vessel harvesting device, the spacer may have a pair of side wall portions 60a protruding from the surface of the planar electrode to prevent a short circuit between the planar electrode of the upper jaw portion and the planar electrode of the lower jaw portion.

[0053] In the above-described blood vessel collection device, the spacer has an insulated cutter groove 49c through which the cutter blade is inserted between the pair of side wall portions, and the width of the insulated cutter groove may be narrower than the width of the cutter groove penetrating the planar electrode. In this blood vessel collection device, since the cutter blade can be insulated from the planar electrode through the insulated cutter groove, high-frequency power can be passed even when the cutter blade is protruded.

[0054] In the above-described blood vessel collection device, the clamping surface of the upper jaw portion and the clamping surface of the lower jaw portion may be in contact with each other via the spacer. In this blood vessel collection device, the spacer can prevent a short circuit between the planar electrode of the upper jaw portion and the planar electrode of the lower jaw portion.

[0055] Another aspect is a blood vessel collection device including a cylindrical body extending along an axis, a jaw structure attached to a tip of the cylindrical body and having an upper jaw portion and a lower jaw portion, the upper jaw portion and the lower jaw portion being openable and closable, a cutter blade disposed between the upper jaw portion and the lower jaw portion and moving in a direction of the axis along cutter grooves of the upper jaw portion and the lower jaw portion, the jaw structure having a pair of clamping surfaces formed at a portion where the upper jaw portion and the lower jaw portion face each other in a closed state, and planar electrodes formed on each of the pair of clamping surfaces, the cutter grooves being formed to penetrate the planar electrodes, the spacer made of an insulating material covering an inner side of the cutter groove penetrating one of the planar electrodes of the upper jaw portion and the lower jaw portion, the spacer having an insulated cutter groove 49c through which the cutter blade is inserted and insulated from the planar electrode, and the width of the insulated cutter groove being narrower than the width of the cutter groove penetrating the other of the planar electrodes of the upper jaw portion and the lower jaw portion.

[0056] In the above-described blood vessel collection device, when the cutter blade slides in the cutter groove, displacement in a width direction of the cutter blade can be restricted by the insulated cutter groove. Therefore, the blood vessel collection device can insulate the cutter blade and the planar electrode by separating them.

[0057] Note that the present invention is not limited to the above-described embodiments, and various configurations can be adopted without departing from the gist of the present invention.

Explanation of Signs

[0058] 20a, 22a, 24a... cylindrical bodies 24... blood vessel collection device 26... Joe structure 34... cutter blade 40... upper jaw part 41... clamping surface 48... planar electrode 49... cutter groove 49c... insulating cutter groove 50... lower jaw part 60... spacer 60a... side wall part

Claims

1. A cylindrical body extending along an axis, a jaw structure attached to the tip of the cylindrical body, having an upper jaw portion and a lower jaw portion, and the upper jaw portion and the lower jaw portion being opened and closed, a cutter blade disposed between the upper jaw portion and the lower jaw portion and moving in the direction of the axis along cutter grooves of the upper jaw portion and the lower jaw portion, wherein the jaw structure includes a pair of clamping surfaces formed at a portion where the upper jaw portion and the lower jaw portion face each other in a closed state, and planar electrodes formed on each of the pair of clamping surfaces, the cutter grooves are formed through the planar electrodes, the width of the cutter grooves of at least one of the planar electrodes is larger than the thickness of the cutter blade, and the cutter grooves have insulators separating the planar electrodes and the cutter blade, a blood vessel collection device.

2. The blood vessel collection device according to Claim 1, further comprising a spacer made of an insulating material that covers the inside of the cutter grooves penetrating at least one of the planar electrodes of the upper jaw portion and the lower jaw portion.

3. The blood vessel collection device according to Claim 2, wherein the spacer protrudes from the surface of the planar electrode and has a pair of side wall portions that prevent short - circuiting between the planar electrode of the upper jaw portion and the planar electrode of the lower jaw portion.

4. The blood vessel collection device according to Claim 3, wherein the spacer has an insulated cutter groove through which the cutter blade is inserted between the pair of side wall portions, and the width of the insulated cutter groove is narrower than the width of the cutter groove penetrating the planar electrode.

5. The blood vessel collection device according to any one of Claims 2 to 4, wherein the clamping surface of the upper jaw portion and the clamping surface of the lower jaw portion are in contact with each other via the spacer.

6. A cylindrical body extending along an axis, a jaw structure attached to the tip of the cylindrical body, having an upper jaw portion and a lower jaw portion, and the upper jaw portion and the lower jaw portion being opened and closed, a cutter blade disposed between the upper jaw portion and the lower jaw portion and moving in the direction of the axis along cutter grooves of the upper jaw portion and the lower jaw portion, wherein the jaw structure includes a pair of clamping surfaces formed at a portion where the upper jaw portion and the lower jaw portion face each other in a closed state, and planar electrodes formed on each of the pair of clamping surfaces, the cutter grooves are formed through the planar electrodes, It has a spacer made of an insulating material that covers the inside of the cutter groove penetrating one of the upper jaw part and the lower jaw part of the planar electrode. The spacer has an insulating cutter groove through which the cutter blade is inserted and insulated from the planar electrode. A blood vessel collection device, wherein the width of the insulating cutter groove is narrower than the width of the cutter groove penetrating the other planar electrode of the upper jaw part and the lower jaw part.

Images