Surgical cutting instruments, forceps, surgical systems, medical systems, robots, surgical medical robots, and surgical systems

Abstract

With the objective of providing a cutter, forceps, a surgical system, a medical system, a robot, a medical robot for surgery, and a surgical system, capable of being brought in contact against (grasping) a target site and cutting the target site in one series of operations, the cutter (1) is constituted in such a manner as to comprise: a first abutting member (14) and a second abutting member (116) assembled to allow for opening and closing; an abutting mechanism (17) rotating the first abutting member (14) toward the second abutting member (116), causing the first abutting member (14) and the second abutting member (116) to be in contact against the target site (B); and a cutting mechanism (10) cutting the target site (B) in a state wherein the abutting mechanism (17) has caused the first abutting member (14) and the second abutting member (116) to be in contact against the target site (B).

Description

[Technical field]

[0001] The present invention relates to a cutting instrument that contacts and cuts a target site, and in particular to forceps, surgical systems, medical systems, robots, surgical medical robots, and surgical systems that are capable of performing surgical operations of contact (grasping), incision, dissection, coagulation (hemostasis), and cutting. [Background technology]

[0002] The basic operation of the extraction surgery is the repetition of the operation of dissection, coagulation (hemostasis), and cutting. During this time, the operation of grasping the target area is also required. In surgery, it is desirable to perform each operation consecutively, and ideally, it would be possible to continue the operation without changing the device.

[0003] However, the Ligasure, which is famous for its high-frequency energy, has a two-stage structure in which a wide blade like a waterfowl's beak is used to grasp the biological tissue (target area), high-frequency energy is passed through it to coagulate it, and then the coagulated part with a cutting edge is cut with a scalpel or scissors-like tool, making it a two-stage operation.

[0004] In detail, as per the patent document, a scissor-type mechanical forceps of a bipolar forceps having a pair of openable and closable shaft members with surgical handles, each shaft having a jaw member with an electrode extending from its distal end, the handles are arranged to cooperate to grasp tissue between both jaw members, the electrodes form an electrode assembly adapted to be connected to a source of electrosurgical energy to enable selective conduction of electrosurgical energy, and a scissor-type mechanical forceps equipped with a knife actuation mechanism having a trigger configured to selectively advance a knife blade provided for cutting tissue grasped between the jaw members has been proposed.

[0005] With this forceps, the jaw members can be gripped by gripping the handle to grasp tissue and coagulate (stop bleeding), but in order to cut the grasped coagulated tissue, a separate trigger must be manually operated to advance the knife blade, in addition to operating the handle. [Prior art documents] [Patent documents]

[0006] [Patent Document 1] JP 2017-060846 A Summary of the Invention [Problem to be solved by the invention]

[0007] No instrument has been developed that can contact and cut tissue in a single operation, and so a multi-function device is needed to ensure smooth, continuous surgical procedures and to reduce time by changing instruments, which is particularly important in laparoscopic and robotic surgeries where the surgeon's hands cannot reach. There is a demand for a device that can cut while maintaining coagulation and hemostasis functions, and also grasp tissue.

[0008] An object of the present invention is to provide a cutting instrument that can contact (grasp) a target portion and cut the target portion in a single operation. Sara The present invention aims to provide forceps, a surgical system, a medical system, a robot, a surgical medical robot, and a surgical system that can contact and cut tissue in a single operation. [Means for solving the problem]

[0009] To solve the above problems, surgical The cutter includes a first abutment member and a second abutment member assembled to be openable and closable, and a cutter that rotates the first abutment member toward the second abutment member to close the first abutment member and the second abutment member. Biological tissue a contact mechanism for contacting the first contact member and the second contact member with the Biological tissue In the state where the above Biological tissue and a cutting mechanism for cutting the the first contact member and the second contact member are a first gripping member and a second gripping member that grip the biological tissue, the contact mechanism is a gripping mechanism that rotates the first gripping member toward the second gripping member and grips the biological tissue with the first gripping member and the second gripping member, a cutting member is provided adjacent to the first gripping member, and the cutting mechanism cuts the biological tissue by rotating the cutting member along the first gripping member and in the same direction as the rotation of the first gripping member and joining it to the second gripping member in a state in which the biological tissue is gripped by the gripping mechanism with the first gripping member and the second gripping member. do.

[0010] According to this configuration, the gripping mechanism and the cutting mechanism are operated in a series to contact the target site and cut the contacted target site without requiring an independent operating member. The cutting mechanism may be provided with a cutting member, which is rotated in the same direction as the rotational drive of the first gripping member and joined to the second gripping member to cut the target site.

[0011] The first gripping member may be provided with a protrusion restricting portion that restricts the cutting member, which rotates in the same direction, from protruding beyond the first gripping member in a direction opposite to the cutting direction. Moreover, in the cutting mechanism, the cutting member may be configured to slide forward in parallel with the second gripping member and cut the target site with a blade edge of the cutting member.

[0012] The cutting instrument is a surgical forceps, and the forceps of the present invention include the above-mentioned cutting instrument, the target site is biological tissue, the first and second gripping members are a first jaw member and a second jaw member, respectively, and the forceps is provided with a drive mechanism that grasps and coagulates the biological tissue by rotating the first jaw member toward the second jaw member, and an operating unit that operates the drive mechanism, and by a series of operations of the operating unit, the biological tissue is grasped and coagulated by the first and second jaw members, and the cutting mechanism cuts it.

[0013] The cutting instrument (forceps) may be configured to have electrodes for irradiating electromagnetic waves at at least one of a gripping portion of the first gripping member (first jaw member) that grips the target site and a vicinity of a cutting blade of the cutting member, and at a gripping portion of the second gripping member that grips the target site. The electrodes are branched and connected to a coaxial cable that supplies electromagnetic waves.

[0014] The cutting instrument or the forceps may comprise a first cutting member and a second cutting member each having a cutting blade for cutting the target area, and may be configured such that electrodes for irradiating electromagnetic waves are provided along each of the cutting blades, the electrodes being branched and connected to a coaxial cable that supplies the electromagnetic waves.

[0015] The electrodes provided on the first jaw member (or the first cutting member) and the second jaw member (or the second cutting member) may be configured to be connected in a homopolar or heteropolar direction to a coaxial cable branched in parallel from the coaxial cable.

[0016] The present invention provides a method for grasping biological tissue by rotating the first jaw member toward the second jaw member and grasping the biological tissue with the first jaw member and the second jaw member, a method for coagulating the tissue by irradiating electromagnetic waves from the electrode, and a method for cutting the tissue by the adjacent cutting member.

[0017] The robot of the present invention includes an input / output unit connected to the cutting tool or forceps by wire and / or wirelessly, an input unit receiving an operation signal in real time, a calculation unit executing a predetermined operation program based on the operation signal, and an output unit generating a drive signal for causing the first and second contact members of the cutting tool to contact the target site and / or cut the target site based on the output from the calculation unit, enabling a cutting method having a robot arm movement, a tool movement, and a cutting step. The output unit generates an irradiation signal for irradiating the electromagnetic wave from the electrode. Also provided is a surgical system including a plurality of surgeon consoles for controlling the robot.

[0018] The cutting device described in paragraph 0009, wherein the first abutment member and the second abutment member are a first cutting member and a second cutting member having cutting blades at the abutment points where the first abutment member and the second abutment member abut against the target portion and cut the target portion, and the corresponding contact mechanism is a cutting mechanism that cuts the target portion by the first cutting member and the second cutting member, and electrodes for irradiating electromagnetic waves are provided along the cutting blades of the first cutting member and the second cutting member.

[0019] The electrode is a coaxial electrode having a center electrode and an outer electrode surrounding the center electrode via an insulator, and a coaxial cable connecting an irradiation device that irradiates the electromagnetic waves to the electrode is branched into multiple parallel cables, and each of the coaxial electrodes is electrically connected to the center conductor and outer conductor of the coaxial cable.

[0020] The cutter according to paragraph 0019, wherein the coaxial electrodes are connected in opposite polarity to the coaxial cable.

[0021] A forceps comprising the cutting device described in any of paragraphs 0018 to 0020, wherein the target site is biological tissue, and the first and second abutment members are a first jaw member and a second jaw member, respectively, and the forceps is provided with a drive mechanism that rotates the first jaw member toward the second jaw member to abut against the biological tissue, coagulate the biological tissue, and cut it, and an operating unit that operates the drive mechanism, and a series of operations of the operating unit causes the first and second jaw members to abut against the biological tissue and coagulate it, and the cutting mechanism cuts it. Effect of the Invention

[0022] According to the present invention, it is possible to provide a cutting instrument, forceps, surgical system, medical system, robot, surgical medical robot, and surgical system that can contact (grasp) a target site and cut the target site in a series of operations. [Brief description of the drawings]

[0023] [Figure 1] 1(a) is a front view of the forceps in an open state according to a first embodiment, FIG. 1(b) is a partial plan view of a cutting mechanism in the forceps, and FIG. 1(c) is a partial front view of the cutting mechanism in FIG. [Diagram 2] Rear view of the forceps in Figure 1. [Diagram 3] Schematic diagram of the forceps in Fig. 1. Fig. 3(a) is a side cross-sectional view taken along the line AA in Fig. 2, Fig. 3(b) is a partial longitudinal cross-sectional view of the forceps, and Fig. 3(c) is an enlarged view of the electrode part taken along the line BB in Fig. 3(b). [Figure 4] FIG. 4(a) is a front view of the forceps in the gripping state with the gripping mechanism closed, and FIG. 4(b) is a rear view of the forceps in the same state. [Diagram 5] An explanatory diagram of the cutting state of the forceps in Figure 1. Figure 5(a) is a front view of the forceps in a cutting state with the cutting cutter of the cutting mechanism closed, and Figure 5(b) is a rear view of the forceps in the same state. [Figure 6] Fig. 6(a) is a cross-sectional view taken along the line AA in Fig. 2 before the forceps is gripped by the gripping mechanism, Fig. 6(b) is a cross-sectional view taken along the line CC in Fig. 4(b) after the target part is gripped by the gripping mechanism, Fig. 6(c) is a cross-sectional view taken along the line DD in Fig. 5(b) after the target part is cut by the cutting cutter, and Fig. 6(d) is a schematic right side view of the forceps gripped by the gripping mechanism of another embodiment of the cutting mechanism. [Figure 7] FIG. 11 is a front view of the forceps according to the second embodiment. [Figure 8] An explanatory diagram of the forceps in Fig. 7. Fig. 8(a) is a rear view of the forceps, and Fig. 8(b) is a side view of the cutting mechanism side of the forceps. [Figure 9] FIG. 9(b) is a rear view of the forceps in FIG. 8. FIG. 9(b) is a partial cross-sectional view taken along the arrow EE in FIG. [Figure 10] Fig. 10 is an explanatory diagram of the gripping state of the forceps in Fig. 7. Fig. 10(a) is a front view of the forceps in the gripping state, Fig. 10(b) is a rear view of the forceps in the same state, Fig. 10(c) is a side view of the cutting mechanism side of the forceps in the same state, and Fig. 10(d) is a partial cross-sectional view taken along the line FF in Fig. 10(c). [Figure 11]Fig. 11 is an explanatory diagram of the cutting state of the forceps in Fig. 7. Fig. 11(a) is a front view of the forceps in the cutting state, Fig. 11(b) is a rear view of the forceps in the same state, Fig. 11(c) is a side view of the cutting mechanism side of the forceps in the same state, and Fig. 11(d) is a partial cross-sectional view taken along the line GG in Fig. 11(c). [Figure 12] FIG. 13 is a front view of the forceps according to the third embodiment. [Figure 13] FIG. 13 is a rear view of the forceps of FIG. [Figure 14] 14 is an explanatory diagram of the gripping state of the forceps in Fig. 12. Fig. 14(a) is a front view of the forceps in the gripping state, and Fig. 14(b) is a rear view of the forceps in the same state. [Figure 15] FIG. 15(a) is a front view of the forceps in the cutting state, and FIG. 15(b) is a rear view of the forceps in the same state. [Figure 16] FIG. 13 is a schematic front view of an end effector according to a fourth embodiment. [Figure 17] Fig. 17 is a schematic explanatory diagram of the end effector of Fig. 16. Fig. 17(a) is a side sectional view taken along the line HH in Fig. 16, Fig. 17(b) is a partial vertical sectional view of the end effector, and Fig. 17(c) is an enlarged plan view taken along the line II in Fig. 16. [Figure 18] 18A and 18B are schematic explanatory diagrams of an end effector according to a fifth embodiment, in which Fig. 18A is a schematic front view of the end effector in a normal state, and Fig. 18B is a schematic front view of the end effector in a cutting state. [Figure 19] 19 is a schematic explanatory diagram of the end effector in Fig. 18. Fig. 19(a) is a schematic cross-sectional view of the cutting mechanism in the end effector in a normal state, Fig. 19(b) is a schematic cross-sectional view of the end effector in a cutting state, and Fig. 19(c) is a schematic cross-sectional view of a cutting mechanism with a different arrangement of coaxial electrodes. [Figure 20] 20(a) is a side cross-sectional view of the end effector showing the electrode schematic of a modified example of the connection between the coaxial electrode and the coaxial cable, and FIG. 20(b) is a partial vertical cross-sectional view of the end effector showing the electrode schematic of the modified example of the connection between the coaxial electrode and the coaxial cable. [Figure 21] Fig. 21 is a schematic explanatory diagram of an end effector which is a modified example of the end effector of Fig. 17. Fig. 21(a) is a side sectional view taken along the line HH in Fig. 16, Fig. 21(b) is a partial vertical sectional view of the end effector, and Fig. 21(c) is an enlarged plan view taken along the line II in Fig. 16. [Figure 22] 22(a) is a rear view of the forceps of FIG. 1 equipped with a coaxial electrode, FIG. 22(b) is a front view of the forceps of FIG. 7 equipped with a coaxial electrode, and FIG. 22(c) is a front view of the forceps of FIG. 12 equipped with a coaxial electrode. [Figure 23] 23(a) is a rear view of the forceps of FIG. 1 not provided with electrodes, FIG. 23(b) is a front view of the forceps of FIG. 7 not provided with electrodes, and FIG. 23(c) is a front view of the forceps of FIG. 12 not provided with electrodes. [Figure 24] FIG. 13 is an explanatory diagram showing a schematic image of the experimental results of microwave irradiation from electrodes in an end effector. [Diagram 25] FIG. 11 is a schematic diagram of a medical device according to another embodiment. [Figure 26] 13 is a schematic diagram of a telesurgery system according to another embodiment. [Figure 27] FIG. 1 is a schematic diagram illustrating a surgical device in a remote surgical system. [Figure 28] FIG. 1 is an explanatory diagram of a remote surgery system. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0024] Hereinafter, an embodiment of the present invention will be described with reference to the drawings. In the following description, the same parts and components are denoted by the same reference numerals. The present embodiment includes, for example, the following disclosure.

[0025] [Configuration 1] A first contact member (14, 14a, 14b) and a second contact member (116, 116a, 119b) are assembled so as to be openable and closable, and the first contact member (14, 14a, 14b) is rotated toward the second contact member (116, 116a, 119b) to bring the first contact member (14, 14a, 14b) and the second contact member (116, 116a, 119b) into contact with a target site (B). A cutting instrument, forceps, or medical instrument (1, 1X, 1Y, 10a, 10b, 220) having an abutment mechanism (17, 17a) and a cutting mechanism (10, 10X, 19) for cutting the target part (B) in a state where the first abutment member (14, 14a, 14b) and the second abutment member (116, 116a, 119b) are abutted against the target part (B) by the abutment mechanism (17, 17a). With this configuration, it is possible to grasp an external member such as a plate, pipe, rod, or tissue, and cut the grasped member. In addition, it is possible to process the grasped member by heating or irradiating it with energy such as microwaves, and then cut it with the cutting member in the grasped state. This allows for many uses as a cutting instrument.

[0026] [Configuration 2] The first abutment member (14, 14a) and the second abutment member (116, 116a) are a first gripping member (14, 14a, 14b) and a second gripping member (116, 116a) that grip the target portion (B), and the abutment mechanism (17, 17a) is a gripping mechanism (17, 17a) that rotates the first gripping member (14, 14a) toward the second gripping member (116, 116a) and grips the target portion (B) with the first gripping member (14, 14a) and the second gripping member (116, 116a), and a cutting mechanism (17, 17a) provided next to the first gripping member (14, 14a) is provided to grip the target portion (B). a cutting member (15, 15a, 15Y) is provided, and in a state in which the target portion (B) is gripped by the first gripping member (14, 14a) and the second gripping member (116, 116a) using the gripping mechanism (17, 17a), the cutting member (15, 15a, 15Y) is moved by rotating or sliding along the first gripping member (14, 14a) to join with the second gripping member (116, 116a) to cut the target portion (B).

[0027] [Configuration 3] A cutting instrument, forceps, or medical instrument (1, 1X, 1Y, 10a, 10b, 220) according to configuration 1 or configuration 2, in which electrodes (20, 24a, 24b, 24c) for irradiating electromagnetic waves are provided at at least one of a gripping portion of the first gripping member (14, 14a) that grips the target portion (B) and a vicinity of the cutting blade of the cutting member (15, 15a, 15Y), and a gripping portion of the second gripping member (116, 116a) that grips the target portion (B), and a method for gripping, coagulating, and cutting biological tissue using the same instrument.

[0028] [Configuration 4] The electrode (20) is a coaxial electrode (20) provided with a central electrode (21) and an outer electrode (23) surrounding the central electrode (21) via an insulator, and a coaxial cable (40) connecting an irradiation device (30) that irradiates the electromagnetic waves and the electrode (20) is branched into a plurality of parallel cables, and the coaxial electrodes (20) are electrically connected to a central conductor (41) and an outer conductor (43) of the coaxial cable (40) with the same polarity or opposite polarity, respectively.

[0029] [Configuration 5] a forceps (1, 1X, 1Y, 10a) comprising a cutting instrument (1, 1X, 1Y) according to any one of configurations 2 to 4, wherein the first gripping member (14, 14a) and the second gripping member (116, 116a) are a first jaw member (14, 14a) and a second jaw member (116, 116a), respectively; a drive mechanism for gripping and coagulating a target site (B) by rotating the first jaw member (14, 14a) toward the second jaw member (116); and a single operation unit (13) for operating the drive mechanism and the cutting mechanism, wherein the living tissue (B) is gripped by the first jaw member (14, 14a) and the second jaw member (116, 116a) through a series of operations of the operation unit (13) and then cut by a cutting mechanism (10, 10X); and a method of gripping, coagulating, and cutting using the same instrument.

[0030] In this configuration, the gripping mechanism (17, 17a) and the cutting mechanism (10, 10X) may be operated together until gripping is performed by operation of the operation unit (13), and a differential mechanism (142, 16X, 16Y) may be provided in which the cutting mechanism (10, 10X) is differentially moved relative to the gripping mechanism (17, 17a) in a gripping state gripping the target portion (B) by further operation of the operation unit (13). Also, a notification unit (118, 123) may be provided that notifies a user of the operation of the differential mechanism (142, 16X, 16Y) by a series of operations of the operation unit (13).

[0031] [Configuration 6] The first abutment member and the second abutment member are a first cutting member (14b) and a second cutting member (119b) having cutting blades (153a, 153b) for cutting the target portion (B) at abutment points where the first abutment member and the second cutting member (119b) are abutted against the target portion (B), the abutment mechanism is the cutting mechanism (19) that cuts the target portion (B) by the first cutting member (14b) and the second cutting member (119b), and an electrode (20) for irradiating electromagnetic waves is provided along the cutting blades (153a, 153b) of the first cutting member (14b) and the second cutting member (119b).

[0032] [Configuration 7] The electrode (20) is a coaxial electrode (20) having a central electrode (21) and an outer electrode (23) surrounding the central electrode (21) via an insulator, a coaxial cable (40) connecting an irradiation device (30) that irradiates the electromagnetic wave and the electrode (20) is branched into a plurality of parallel cables, and the coaxial electrodes (20) are electrically connected to the central conductor and the outer conductor of the coaxial cable (40) with the same polarity or opposite polarity, respectively. The cutting instrument, forceps, or medical instrument (10b, 220) according to configuration 6. The first cutting member (14b) and the second cutting member (119b) have the functions of coagulating, cutting, and separating biological tissue.

[0033] [Configuration 8] The electrode (20) provided on the forceps (1, 1X, 1Y, 10a, 10b) is an electrode (20) for microwave irradiation, and a microwave irradiation unit is provided on each of the forceps (1, 1X, 1Y), and the period of the microwaves applied to each electrode (20) from the coaxial cable (40) is the same.

[0034] [Configuration 9] a robot (210) including an input / output unit (210a) connected to the cutting devices (10a, 10b) by wire and / or wirelessly, an input unit (210a) that receives operation signals in real time, a calculation unit (CPU) that executes a predetermined operation program based on the operation signals, and an output unit (210a) that generates, based on an output from the calculation unit, a drive signal for causing the first contact member (14, 14a, 14b) and the second contact member (116, 116a, 119b) of the cutting devices (10a, 10b) to contact and / or cut a target site (B), and / or an irradiation signal for irradiating the electromagnetic waves from the electrodes (20, 24a, 24b, 24c).

[0035] [Configuration 10] A robot control method comprising the steps of: generating a command by operating a master control unit (202); moving an arm assembly (212) of a robot (210) to a treatment position by the command; moving a tool (217) attached to the arm assembly (212) of the robot (210) to the treatment position; and controlling the movement of the cutting devices (10a, 10b) attached to the tip of the tool (217) and the irradiation of electromagnetic waves.

[0036] [Configuration 11] A surgical system (200) having multiple surgeon consoles (201) serving as stations for multiple operators, a master control unit (202) operated by multiple operators, and a robot (210) as described in configuration 9, which is a patient side cart.

[0037] The following embodiment describes the cutting device of the present invention as an example of a medical device, and the embodiment will be described below as a pair of forceps. However, the present invention provides a cutting device that is not limited to medical devices.

[0038] For example, Fig. 1 is an explanatory diagram of the forceps 1 in an open state according to the first embodiment. Fig. 1(a) shows a front view of the forceps 1, Fig. 1(b) shows a partial plan view of a cutting mechanism 10 in the forceps 1, and Fig. 1(c) shows a partial front view of the cutting mechanism 10 in Fig. 1(b). FIG. 2 shows a rear view of the forceps 1 of FIG.

[0039] Figure 3 shows a schematic diagram of the forceps 1 in Figure 1. Figure 3(a) shows a side cross-sectional view taken along the line AA in Figure 2, Figure 3(b) shows a partial vertical cross-sectional view of the forceps 1, and Figure 3(c) shows an enlarged view of the electrode portion taken along the line BB in Figure 3(b).

[0040] Figure 4 shows an explanatory diagram of the gripping state of the forceps 1 in Figure 1. Figure 4(a) shows a front view of the forceps 1 in the gripping state with the gripping mechanism 17 closed, and Figure 4(b) shows a rear view of the forceps 1 in the same state. Fig. 5 shows an explanatory diagram of the cutting state of the forceps 1 in Fig. 1. Fig. 5(a) shows a front view of the forceps 1 in the cutting state with the cutting cutter 15 of the cutting mechanism 10 closed, and Fig. 5(b) shows a rear view of the forceps 1 in the same state.

[0041] Fig. 6 shows explanatory diagrams of the gripping and cutting states of the cutting mechanism 10 in the forceps 1. Fig. 6(a) shows a side cross-sectional view taken along the line AA in Fig. 2 before gripping by the gripping mechanism 17, Fig. 6(b) shows a side cross-sectional view taken along the line CC in Fig. 4(b) when the blood vessel B is gripped by the gripping mechanism 17, and Fig. 6(c) shows a side cross-sectional view taken along the line DD in Fig. 5(b) when the blood vessel B has been cut by the cutting cutter 15.

[0042] 1 to 6, the forceps 1 includes a main body frame 11, a slide frame 12, a trigger handle 13, an upper jaw portion 14, a cutting cutter 15, and a spring 16. As shown in FIG. The main body frame 11 is roughly composed of two sides intersecting at an obtuse angle, one of which is a fixed handle frame 111 that functions as an operating section together with the trigger handle 13, and the other is a reference frame 112. The main body frame 11 thus configured is made of metal such as stainless steel.

[0043] The end of the fixed handle frame 111 is provided with a ring portion 113 into which the finger of the user who operates the forceps 1 is inserted. In addition, the portion where the fixed handle frame 111 and the reference frame 112 intersect at an obtuse angle is defined as a corner 114, and the base of the reference frame 112 (near the above-mentioned corner 114) is provided with a support shaft 115 that supports the trigger handle 13 described later.

[0044] Furthermore, a lower jaw 116 is provided at the end of the tip side F of the reference frame 112 to constitute a gripping mechanism 17 that cooperates with the trigger handle 13 to grip a target site such as a blood vessel B to be treated. The lower jaw 116 is configured to have a tapered shape toward the tip side F when viewed from the front. The lower jaw 116 is also called a jaw. Further, a tip support shaft 117 that supports the upper jaw portion 14 and the cutting cutter 15 is provided on the tip side F of the reference frame 112 .

[0045] Furthermore, a click protrusion 118 that protrudes toward the bottom surface of the slide frame 12 is provided on the upper surface of the reference frame 112 in the middle portion in the longitudinal direction L. The click protrusion 118 has a triangular shape when viewed from the front and protrudes toward the bottom surface of the slide frame 12, but is formed into a substantially right-angled triangular shape when viewed from the front, with the inclined surface on the base end side R having a steeper inclination angle than the inclined surface on the tip end side F. In addition, the click protrusion 118, which has a triangular shape when viewed from the front and protrudes toward the bottom surface of the slide frame 12, is supported so as to bend downward when a predetermined force is applied.

[0046] The slide frame 12 is provided so as to be slidable in the longitudinal direction L along a reference frame 112 of the main body frame 11, and is made of the same material as the main body frame 11 in the shape of a rectangular column. An upper support shaft 121 that axially supports the tip end of the trigger handle 13 is provided on the base end side R of the slide frame 12 (the left side in FIG. 1).

[0047] Further, on the tip side (left side in FIG. 1) of the slide frame 12, a tip upper support shaft 122 that axially supports the upper jaw portion 14 and the cutting cutter 15 is provided. Furthermore, a click protrusion 123 that protrudes toward the upper surface of the reference frame 112 is provided on the bottom surface of the slide frame 12 in the middle portion in the longitudinal direction L.

[0048] The click protrusion 123 has a triangular shape when viewed from the front and protrudes toward the upper surface of the reference frame 112, and is formed into a substantially right-angled triangular shape when viewed from the front, with the inclined surface on the tip side F facing the click protrusion 118 in the longitudinal direction L having a steeper inclination angle than the inclined surface on the base end side R. In addition, the click protrusion 123, which has a triangular shape when viewed from the front and protrudes toward the upper surface of the reference frame 112, is supported so as to bend upward with a predetermined force. The click convex portion 123 is not limited to a triangular shape, and may be of other shapes such as a polygonal shape or a semicircular shape that provides a function of notifying the user of a click sound or vibration.

[0049] It should be noted that the click protrusions 118 and the click protrusions 123 are disposed slightly spaced apart from each other in the longitudinal direction L of the reference frame 112 and the slide frame 12 when the forceps 1 is in the initial state (open state).

[0050] The trigger handle 13 is an operating part for sliding the slide frame 12 along the reference frame 112, and is provided at its lower end with a ring part 131 into which the user's finger is inserted. In addition, near the upper end of the trigger handle 13, there is a pivot portion 132 that is pivotally supported on the support shaft 115 of the main frame 11, and further above the pivot portion 132, there is an upper pivot portion 133 that is pivotally supported on the upper support shaft 121 of the slide frame 12.

[0051] A compression coil spring 13a (not shown in FIG. 5) for automatically returning the slide frame 12 and the trigger handle 13 is provided between the fixed handle frame 111 and the trigger handle 13. The compression coil spring 13a may be omitted depending on the specifications.

[0052] The upper jaw portion 14 is provided at the end portion on the tip side F of the slide frame 12, and constitutes a gripping mechanism 17 together with a lower jaw portion 116 of the main body frame 11. The upper jaw portion 14 is also called a jaw. The base end (left side in Fig. 1) of the upper jaw 14 is provided with a shafted portion 141 journaled on the tip support shaft 117 of the main body frame 11, and a rotating bearing portion 142 journaled on the tip upper support shaft 122 of the slide frame 12 above the shafted portion 141. As shown in Fig. 1(c), which is an enlarged view of the part enclosed in a square in Fig. 1(a), the rotating bearing portion 142 is formed in the shape of an elongated hole into which the tip upper support shaft 122 fits loosely.

[0053] In addition, the tip side of the rear side of the upper jaw portion 14 is provided with a protrusion control portion 143 that protrudes toward the rear side and controls the cutting cutter 15, which rotates along the side surface of the rear side of the upper jaw portion 14, from protruding above the upper surface of the upper jaw portion 14.

[0054] 1 and 2, the cutting cutter 15 is disposed on the back side of the upper jaw 14, and includes a shafted portion 151 journaled on the tip support shaft 117 of the main frame 11, and a rotating shaft portion 152 journaled on the tip upper support shaft 122 of the slide frame 12 above the shafted portion 151. The cutting cutter 15 thus configured has a cutting blade 153 formed along its lower end. The cutting cutter 15 is plate-shaped, and configured to rotate along the side of the upper jaw 14 around the shafted portion 151.

[0055] The spring 16 is disposed along the front side of the upper jaw portion 14 and configured to bias the upper jaw portion 14 and the cutting cutter 15 . More specifically, the spring 16 is a torsion spring fitted onto the tip support shaft 122, with one arm fitted onto the upper jaw 14 and the other arm fitted onto a part of the cutting cutter 15. Therefore, the spring 16 is configured to bias the upper jaw 14 and the cutting cutter 15 in a rotational direction in which they move away from each other when the upper jaw 14 and the cutting cutter 15 rotate differentially about the tip support shaft 122 toward the adjacent side.

[0056] In the forceps 1 configured in this manner, a lower jaw 116 provided at the end of the tip side F of the main body frame 11 and an upper jaw 14 whose base is supported on the main body frame 11 by a tip support shaft 117 constitute a gripping mechanism 17 for gripping the target area. Further, the cutting cutter 15 which rotates along the side surface of the upper jaw portion 14 to cut the target site gripped by the gripping mechanism 17 constitutes the cutting mechanism 10 together with the gripping mechanism 17 .

[0057] The forceps 1 is provided with irradiation electrodes 24 (24a, 24b, 24c) and a microwave generator for emitting microwaves. Shake A coaxial cable 40 is connected between the device 30 and the irradiation electrode 24 . Specifically, the upper jaw 14 is provided with an irradiation electrode 24a, the lower jaw 116 is provided with an irradiation electrode 24b, and the inside of the cutting cutter 15 is provided with an irradiation electrode 24c, and they are connected to a coaxial cable 40. Although not shown, the irradiation electrodes 24 (24a, 24b, 24c) arranged on the upper jaw 14, the cutting cutter 15, and the lower jaw 116 have an insulating layer arranged on the outside, and are insulated from the upper jaw 14, the cutting cutter 15, and the lower jaw 116.

[0058] As shown in the enlarged cross-sectional view of Figure 3(b), the coaxial cable 40 is composed of a central conductor 41, an insulator 42, an outer conductor 43, and an insulating coating 44 sandwiched between the central conductor 41, and is arranged in this order from the center toward the radially outer side. Central conductor 41 is a linear conductor disposed at the center of coaxial cable 40, and may be a single conductor of an appropriate diameter, or may be composed of multiple core wires.

[0059] The insulator 42 is , medium It is made of resin, surrounds the outside of the central conductor 41, insulates the central conductors 41 and 43, and is cylindrical with a predetermined thickness. The outer conductor 43 is made of a braided wire provided along the outer peripheral surface of the insulator 42 .

[0060] The insulating coating 44 is an insulating coating that surrounds the outside of the outer conductor 43 . Thus, the coaxial cable 40 in which the central conductor 41, the insulator 42, the outer conductor 43 and the insulating coating 44 are arranged in this order from the center side has appropriate flexibility.

[0061] As shown in Fig. 3, the irradiation electrodes 24a and 24c are connected to a central conductor 41 of a coaxial cable 40, and the irradiation electrode 24b is connected to an outer conductor 43, so that electromagnetic waves (microwaves) are irradiated from the irradiation electrodes 24a and 24c to the irradiation electrode 24b. The electrode structure may be a coaxial structure as shown in Figs. 16 and 17, and the connection polarity may be a different polarity connection structure as shown in Fig. 20.

[0062] The first electrode portion of the irradiation electrodes 24a, 24c of the upper jaw portion 14 and the cutting cutter 15, and the second electrode portion of the irradiation electrode 24b provided on the lower jaw portion 116 are connected to the central conductor 41 of the coaxial cable 40 on one side, and connected to the outer conductor 43 on the other side. In this way, the forceps 1 provided with the irradiation electrodes 24a, 24c can irradiate microwaves from one side to the other side of the first electrode portion of the irradiation electrodes 24a, 24c and the second electrode portion of the irradiation electrode 24b. This allows the target site grasped by the grasping mechanism 17 composed of the lower jaw portion 116 and the upper jaw portion 14 to be irradiated with microwaves to coagulate the target site. In addition, if necessary, the irradiation electrode 24c may be electrically connected to the irradiation electrode 24b to irradiate microwaves between the upper jaw portion 14 and the cutting cutter 15 to coagulate the living tissue.

[0063] The operation of the forceps 1 having the above-described components will be described below. A user inserts his or her fingers into the finger ring portion 113 of the main frame 11 and the finger ring portion 131 of the trigger handle 13, and rotates the trigger handle 13 around the pivot portion 132 supported by the support shaft 115 in a direction that brings the trigger handle 13 closer to the fixed handle frame 111 (in a direction in which the bottom of the trigger handle 13 moves to the left in Figure 1).

[0064] When the trigger handle 13 rotates about the pivot part 132 in a direction approaching the fixed handle frame 111, the upper pivot part 133 protruding upward from the pivot part 132 moves toward the tip side (right side in FIG. 1). When the upper pivot part 133 moves to the tip side F, the slide frame 12, which supports the upper pivot part 133 with the upper support shaft 121, slides and moves along the reference frame 112 to the tip side F.

[0065] When the slide frame 12 moves to the tip side F, the tip upper support shaft 122 supporting the rotational bearing portion 142 of the upper jaw portion 14 also moves to the tip side F. Then, in the upper jaw portion 14, whose lower axially supported portion 141 is supported by the tip support shaft 117 of the main body frame 11 and whose upper rotational bearing portion 142 is supported by the tip upper support shaft 122, the tip side F pivots about the tip support shaft 117 in a direction approaching the lower jaw portion 116 as the tip upper support shaft 122 moves to the tip side F (see FIG. 4).

[0066] As described above, the lower shaft receiving portion 151 of the cutting cutter 15 is supported by the tip support shaft 117 of the main body frame 11, and the upper rotating shaft portion 152 is supported by the tip upper support shaft 122. Therefore, as the tip upper support shaft 122 moves toward the tip side F, the cutting cutter 15 pivots about the tip support shaft 117 together with the upper jaw 14 in a direction in which the tip side F approaches the lower jaw 116 (see FIG. 4).

[0067] At this time, the upper end of the cutting cutter 15 is regulated by the protrusion regulating portion 143 of the upper jaw portion 14. Therefore, as described above, as the tip upper support shaft 122 moves toward the tip side F, the cutting cutter 15 pivots together with the upper jaw portion 14 around the tip support shaft 117 in a direction in which the tip side F approaches the lower jaw portion 116. However, even if the pivoting of the cutting cutter 15 lags behind the pivoting of the upper jaw portion 14, the protrusion regulating portion 143 allows both the upper jaw portion 14 and the cutting cutter 15 to pivot together.

[0068] As a result, in the initial state (open state) as shown in Figure 6(a), blood vessel B, which is the target site in the biological tissue, is placed between the upper jaw portion 14 and the lower jaw portion 116, and as shown in Figure 6(b), blood vessel B can be clamped between the upper surface of the lower jaw portion 116 and the bottom surface of the upper jaw portion 14, thereby allowing blood vessel B to be grasped by the grasping mechanism 17 formed by the lower jaw portion 116 and the upper jaw portion 14.

[0069] Although the tip support shaft 122 is loosely fitted into the rotating bearing portion 142, which is formed in a long hole shape, the upper jaw portion 14 and the cutting cutter 15 are urged in a direction away from the lower jaw portion 116 by the spring 16, so that the tip support shaft 122 does not move within the rotating bearing portion 142, and the upper jaw portion 14 and the cutting cutter 15 rotate as described above.

[0070] At this time, the click protrusion 118 provided on the upper surface of the reference frame 112 and the click protrusion 123 provided on the bottom surface of the slide frame 12 are spaced apart in the longitudinal direction L in the initial state (open state), but as shown in the enlarged view of part A in Figure 4 (b), the sliding movement of the slide frame 12 toward the tip side F relative to the reference frame 112 brings them close to each other in the longitudinal direction L and causes them to abut.

[0071] As described above, the state shown in Figures 4 and 6(b) in which the trigger handle 13 is operated to bring the upper jaw 14 close to the lower jaw 116 is referred to as a grasping state in which the target area, such as blood vessel B, is grasped by the grasping mechanism 17. From this gripping state ,Sara When the trigger handle 13 is operated in a direction to approach the fixed handle frame 111, the slide frame 12 moves relative to the reference frame 112. Sara Then, the tip F moves to the

[0072] Furthermore, when the slide frame 12 moves to the tip side F, the cutting cutter 15 pivots about the tip support shaft 117 so that the cutting blade 153 passes over the upper surface of the lower jaw 116, as shown in FIG. 5(b). As a result, as shown in FIG. 6(c), the cutting cutter 15 moves along the side surface of the upper jaw portion 14, and the blood vessel B gripped by the gripping mechanism 17 can be cut by the cutting blade 153 of the cutting cutter 15.

[0073] As described above, when the trigger handle 13 is further operated to rotate the cutter 15 so that the cutting blade 153 passes over the upper surface of the lower jaw 116 as shown in FIG. 5(b), this state is referred to as the cutting state.

[0074] However, the upper jaw portion 14 is Lower jaw 116 Therefore, even if the slide frame 12 slides further, the tip upper support shaft 122 moves within the elongated rotary bearing portion 142, and the slide frame 12 moves relative to the upper jaw portion 14.

[0075] As described above, the cutting cutter 15 further rotates due to further movement of the slide frame 12, but the upper jaw 14 does not rotate because the tip upper support shaft 122 moves on the rotating bearing 142. In other words, the upper jaw 14 and the cutting cutter 15 are differentially rotated around the tip support shaft 117 by the differential mechanism in which the tip upper support shaft 122 moves on the elongated rotating bearing 142. This differential between the upper jaw 14 and the cutting cutter 15 causes the spring 16 to deform in a contracting direction. Therefore, when the force to operate the trigger handle 13 is released, the compression of the compression coil spring 13a shown in FIG. 1 is released, the slide frame 12 moves to the base end side R, and the upper jaw 14 also moves in the opening direction due to the biasing force of the spring 16, i.e., both members 14 and 15 work together to automatically return to the open state shown in FIG. 1.

[0076] Furthermore, even if the pivoting of the cutting cutter 15 in the opening direction is faster than the pivoting of the upper jaw 14 in the opening direction due to the biasing force of the spring 16, etc., the upper end of the cutting cutter 15 is regulated by the protrusion regulating portion 143, so that both the upper jaw 14 and the cutting cutter 15 pivot in the opening direction, and the upper part of the cutting cutter 15 is prevented from protruding above the upper surface of the upper jaw 14.

[0077] In this disconnected state, as shown in the enlarged view of part A in FIG. 5(b), the click protrusions 118 and 123, which are in contact with each other in the gripped state, bend as one of them overcomes the other, creating a clicking sensation. This clicking sensation is transmitted to the user via the main body frame 11 and the trigger handle 13, so the user recognizes that the disconnected state has been reached; in other words, the click protrusions 118, 123 can notify the user that a series of operations on the trigger handle 13 has transitioned from the gripped state to the disconnected state.

[0078] Furthermore, when the force operating the trigger handle 13 is released and the slide frame 12 moves to the base end side R and returns to the initial state (open state), the inclination angle occurs first from the gentler surface side, so no clicking sensation is generated as occurs when two steeply inclined surfaces overcome each other.

[0079] As described above, the forceps 1 can grasp a target site such as a blood vessel B with the upper jaw portion 14 and the lower jaw portion 116 constituting the grasping mechanism 17, and cut the target site with the cutting cutter 15 in the grasped state, by a series of operations using the trigger handle 13. During the grasping and cutting of the target site by the series of operations of the trigger handle 13, microwaves are irradiated from the irradiating electrode 24 to the target site to cause coagulation. solid It can be done.

[0080] In addition, since a differential mechanism is provided by the long hole-shaped rotary bearing portion 142 into which the tip support shaft 122 is loosely fitted, in a series of operations of the trigger handle 13, the target part can be cut by the cutting cutter 15 after being gripped by the gripping mechanism 17. Furthermore, a notification portion can be provided that notifies the user by the click protrusions 118, 123 of the transition from the gripping state to the cutting state in a series of operations of the trigger handle 13.

[0081] The notification unit may be configured to notify the user by an electronic signal or an optical signal by attaching a movement sensor instead of the click convex portions 118 and 123. According to this embodiment, a multifunctional forceps capable of grasping, coagulating, and cutting, either alone or in combination, can be provided.

[0082] Next, forceps 1X according to a second embodiment is shown in FIGS. Fig. 7 shows a front view of the forceps 1X of the second embodiment. Fig. 8 shows an explanatory diagram of the forceps 1X of Fig. 7. Fig. 8(a) shows a rear view of the forceps 1X, and Fig. 8(b) shows a side view of the cutting mechanism side of the forceps 1X.

[0083] Fig. 9 shows a rear view of the forceps 1X in Fig. 8. It shows a partial cross-sectional view taken along the line EE in Fig. 8(b). Fig. 10 shows an explanatory diagram of the forceps 1X in a grasping state. Fig. 10(a) shows a front view of the forceps 1X in a grasping state, Fig. 10(b) shows a rear view of the forceps 1X in the same state, Fig. 10(c) shows a side view of the cutting mechanism side of the forceps 1X in the same state, and Fig. 10(d) shows a partial cross-sectional view as viewed from the arrow FF in Fig. 10(c).

[0084] Fig. 11 shows an explanatory diagram of the forceps 1X in the cutting state. Fig. 11(a) shows a front view of the forceps 1X in the cutting state, Fig. 11(b) shows a rear view of the forceps 1X in the same state, Fig. 11(c) shows a side view of the cutting mechanism side of the forceps 1X in the same state, and Fig. 11(d) shows a partial cross-sectional view taken along the arrow GG in Fig. 11(c).

[0085] In the following description of the forceps 1X, the same components as those of the forceps 1 are given the same reference numerals and detailed description thereof will be omitted. The forceps 1X includes a main body frame 11X, a first slide plate 12Xa, a second slide plate 12Xb, a trigger handle 13X, an upper jaw portion 14, a cutting cutter 15, and a coil spring 16X.

[0086] In contrast to the forceps 1 in which the slide frame 12 slides in the longitudinal direction L on the upper surface of the reference frame 112 of the main body frame 11, the forceps 1X is configured so that the first slide plate 12Xa and the second slide plate 12Xb slide relative to the reference frame 112, causing the upper jaw 14 and the cutting cutter 15 to rotate.

[0087] More specifically, like the main body frame 11 which is composed of a fixed handle frame 111 and a reference frame 112, the main body frame 11X is composed of a fixed handle frame 111 and a reference frame 112X which intersect at an obtuse angle.

[0088] With respect to the reference frame 112 along whose upper surface the slide frame 12 slides, the reference frame 112X has a slide groove (not shown) formed in the upper half of the rear side, along which the first slide plate 12Xa and the second slide plate 12Xb slide.

[0089] The first slide plate 12Xa and the second slide plate 12Xb are formed in a plate shape, and are stacked in a thickness direction and housed in a slide groove provided in the reference frame 112X so as to be able to slide independently.

[0090] A middle support shaft 121Xa that supports an upper pivot portion 133 provided on the trigger handle 13X is provided on the base end side R of the first slide plate 12Xa, and a tip upper support shaft 122Xa that supports the cutting cutter 15 is provided on the tip end side F.

[0091] The tip side F of the second slide plate 12Xb is provided with a tip upper support shaft 122X which supports the cutting cutter 15. b Further, the base end side R is provided with an abutment ring portion 124Xb with which the coil spring 16X abuts and through which an insertion shaft 161X that passes through the inside of the coil spring 16X is inserted. The second slide plate 12Xb thus configured is formed with a length that is shorter on the base end side R than the first slide plate 12Xa by approximately the length of a coil spring 16X, which will be described later.

[0092] The first slide plate 12Xa and the second slide plate 12Xb are stacked in the thickness direction in a slide groove provided in the reference frame 112X, and are arranged so that the first slide plate 12Xa faces the back surface. Therefore, the second slide plate 12Xb is sandwiched between the reference frame 112X and the first slide plate 12Xa in the front-back direction.

[0093] The first slide plate 12Xa and the second slide plate 12Xb are provided with restriction holes 123X that are elongated in the longitudinal direction L and into which the slide frame 112Xa provided in the slide groove of the reference frame 112X fits loosely.

[0094] The trigger handle 13X has a pivot portion 132 and an upper pivot portion 133 provided on the upper end side of the pivot portion 132. 2nd grade and upper pivot 13 3 to In addition, upper pivot 13 3. The upper pivot part 13 is 4 Further, the upper pivot portion 13 of the trigger handle 13X is to 4 The pressing block 13 has an insertion shaft 161X. 5 The trigger handle 13X is rotatably mounted on the fixed handle frame 111 of the main body frame 11X. figure The compression coil spring 13a described in 1 may be provided.

[0095] The insertion shaft 161X is inserted through the inside of the coil spring 16X and through the abutment ring portion 124Xb. The end portion on the tip side F of the insertion shaft 161X is provided with a flange portion 162X having a diameter larger than that of the abutment ring portion 124Xb.

[0096] The forceps 1X having the above-mentioned components are configured such that, when the trigger handle 13X is operated, the pivot portion 13 2 As a pivot, the upper pivot part 13 3rd grade and upper pivot 13 4 is Move to the tip side F. Upper pivot 13 3 isWhen moving to the tip side F, the upper pivot part 13 3 The first slide plate 12Xa, which has the intermediate support shaft 121Xa pivotally supported thereon, slides toward the tip end side F relative to the reference frame 112X.

[0097] When the first slide plate 12Xa moves to the tip side F, the cutting cutter 15, whose rotating shaft portion 152 is supported by the tip upper support shaft 122Xa, rotates along the side of the upper jaw portion 14 around the shaft portion 151 supported by the tip support shaft 117 (see Figure 10).

[0098] In contrast, the upper pivot 13 4 is When moving to the tip side F, the upper pivot part 13 to 4 The pressing block 135X, which is provided so as to be rotatable, also moves to the tip side F. When the pressing block 135X moves, it presses the coil spring 16X, through which the insertion shaft 161X is inserted, toward the tip side F. Since the tip side F of the coil spring 16X pressed toward the tip side F by the pressing block 135X abuts against the abutment ring portion 124Xb, it presses the abutment ring portion 124Xb toward the tip side F, thereby moving the second slide plate 12Xb.

[0099] When the second slide plate 12Xb moves to the tip side F, the upper jaw 14, whose lower shaft receiving portion 141 is pivotally supported by the tip support shaft 117 of the main body frame 11X and whose upper rotary bearing portion 142 is pivotally supported by the tip upper support shaft 122Xb, moves the tip upper support shaft 122Xb to the tip side F. As a result, the tip side F pivots about the tip support shaft 117 in a direction approaching the lower jaw 116, and the gripping mechanism 17 composed of the lower jaw 116 and the upper jaw 14 enters a gripping state in which it can grip a target site such as a blood vessel B (see FIG. 10).

[0100] The first slide plate 12Xa and the second slide plate 12Xb, which move to the tip side F by operating the trigger handle 13X, are supported by the pivot portion 133X from the first slide plate 12Xa, which supports the upper pivot portion 133X. 2 or The distance from the upper pivot 13 to the upper pivot 13 is longer than that of the upper pivot 133X. 4The sliding distance of the pivotally supported second slide plate 12Xb becomes large.

[0101] From this gripping state ,Sara When the trigger handle 13X is operated in a direction to approach the fixed handle frame 111, the first slide plate 12Xa moves toward the reference frame 112. ,Sara Then, the tip F moves to the

[0102] Furthermore, when the first slide plate 12Xa moves to the tip side F, the cutting cutter 15 pivots around the tip support shaft 117, with the cutting blade 153 passing over the upper surface of the lower jaw 116, as shown in the enlarged view of portion B in Figure 11(b). As a result, the cutting cutter 15 moves along the upper jaw portion 14, and the blood vessel B gripped by the gripping mechanism 17 is brought into a cutting state in which it can be cut by the cutting blade 153 of the cutting cutter 15.

[0103] However, the upper jaw 14 abuts against the upper surface of the lower jaw 116, and cannot rotate even if the second slide plate 12Xb slides further. When the trigger handle 13X is further operated in a direction approaching the fixed handle frame 111, the upper pivot portion 13 4 too Move to the tip side F and the upper pivot part 13 4 and At the same time, the pressing block 135X also moves to the tip side F. However, as described above, when the upper jaw portion 14 Sara Since it cannot rotate, the second slide plate 12Xb cannot slide either.

[0104] Therefore, the abutment ring portion 124Xb of the second slide plate 12Xb, which cannot slide, and the pressing block 135X approach each other as the coil spring 16X contracts. In other words, the abutment ring portion 124Xb and the pressing block 135X move differentially when the coil spring 16X contracts, and the trigger handle 13X is operated in a direction to bring it further closer to the fixed handle frame 111, so that the cutting cutter 15 rotates but the upper jaw 14 does not rotate.

[0105] As described above, in the cutting state in which the cutting cutter 15 and the upper jaw 14 are moved by further operation of the trigger handle 13X, the coil spring 16X is deformed in the contracting direction. Therefore, when the force for operating the trigger handle 13X is released, the trigger handle 13X moves in the expanding direction via the pressing block 135X due to the biasing force of the coil spring 16X.

[0106] The opposing surfaces of the first slide plate 12Xa and the second slide plate 12Xb may be provided with a configuration similar to the click protrusions 118 and 123 in the above-described forceps 1. Even in this case, the user can be made aware of the cutting state by the clicking sensation that occurs when one plate overcomes the other.

[0107] As described above, in the forceps 1X, like the forceps 1, the upper jaw portion 14 and the lower jaw portion 116 constituting the gripping mechanism 17 grip a target portion such as a blood vessel B, and the cutting cutter 15 in the gripped state cuts the target portion, and the trigger handle 13 is used to grip the target portion. X The trigger handle 13 can be operated in a series of operations. X During the series of operations of grasping and cutting the target part, microwaves are irradiated from the irradiation electrode 24 to the target part to cause coagulation. solid It can be done.

[0108] In addition, the trigger handle 13 is equipped with a differential mechanism that uses the compression of the coil spring 16X. X In the series of operations, after the target site is gripped by the gripping mechanism 17, it can be cut by the cutting cutter 15.

[0109] In addition, the upper jaw portion 14 of the forceps 1X may be provided with a protrusion restriction portion 143 that restricts the cutting cutter 15 from protruding from the upper surface of the upper jaw portion 14. This prevents the cutting cutter 15 from protruding from the upper surface of the upper jaw portion 14, allowing for safe use.

[0110] Next, a forceps 1Y according to a third embodiment will be described with reference to FIGS.

[0111] 12 is a front view of the forceps 1Y of the third embodiment, and FIG. 13 is a rear view of the forceps 1Y of FIG.

[0112] Fig. 14 shows an explanatory diagram of the forceps 1Y in a grasping state, in which Fig. 14(a) shows a front view of the forceps 1Y in a grasping state, and Fig. 14(b) shows a rear view of the forceps 1Y in the same state. Fig. 15 shows an explanatory diagram of the forceps 1Y in the cutting state. Fig. 15(a) shows a front view of the forceps 1Y in the cutting state, and Fig. 15(b) shows a rear view of the forceps 1Y in the same state.

[0113] In the following description of the forceps 1Y, the same components as those of the forceps 1 and the forceps 1X will be given the same reference numerals and detailed description thereof will be omitted. The forceps 1Y includes a main body frame 11Y, a first slide plate 12Ya, a second slide plate 12Yb, a trigger handle 13Y, an upper jaw portion 14, a slide cutter 15Y, and a coil spring 16Y.

[0114] In the forceps 1, the slide frame 12 slides in the longitudinal direction L over the upper surface of the reference frame 112 of the main body frame 11. The forceps 1Y is configured such that the second slide plate 12Yb slides relative to the reference frame 112Y to rotate the upper jaw 14, and the slide cutter 15Y slides and cuts in conjunction with the sliding of the first slide plate 12Ya provided at the end of the tip side F.

[0115] More specifically, like the main body frame 11 which is composed of a fixed handle frame 111 and a reference frame 112, the main body frame 11Y is composed of a fixed handle frame 111 and a reference frame 112Y which intersect at an obtuse angle.

[0116] The first slide plate 12Ya and the second slide plate 12Yb are configured to slide along the upper surface of the reference frame 112Y in the same manner as the reference frame 112 along which the slide frame 12 slides. Note that the reference frame 112Y includes a restriction frame 12Y that restricts the first slide plate 12Ya and the second slide plate 12Yb that slide along the upper surface so that they can slide. 4 It is prepared.

[0117] The first slide plate 12Ya and the second slide plate 12Yb are formed in a plate shape, stacked in the thickness direction, and are independently slidable along the upper surface of the reference frame 112Y. to 4 So it is regulated.

[0118] A slide cutter 15Y is provided at the end of the tip side F of the first slide plate 12Ya, and an upper support shaft 121Ya that supports a drive shaft 181Y of an arm 18Y (described later) is provided at the middle portion. An upper support shaft 121Yb that supports a drive shaft 181Y of an arm 18Y, which will be described later, is provided at the middle portion of the second slide plate 12Yb, the tip of which is connected to the upper jaw portion 14.

[0119] The upper support shaft 121Yb has an elongated hole shape that is long in the longitudinal direction L, and can support the drive shaft 181Y movably in the longitudinal direction L. Furthermore, inside the upper support shaft 121Yb, a coil spring 16Y is arranged on the tip side F of the drive shaft 181Y to bias the drive shaft 181Y toward the base end side R (the left side in FIG. 12).

[0120] The trigger handle 13Y is attached to the upper pivot portion 13Y above the pivot portion 132 supported by the reference frame 112Y in such a manner that the upper pivot portion 13Y protrudes upward from the first slide plate 12Ya and the second slide plate 12Yb. 3 It has been established. Upper pivot 13 3 to An arm 18Y inclined downward on the tip side F is connected to the drive shaft 181Y, and the drive shaft 181Y is provided at the tip of the arm 18Y.

[0121] In the forceps 1Y having the above-mentioned components, when the trigger handle 13Y is operated, the pivot portion 13 2 As a pivot, the upper pivot part 13 3 is Move to the tip side F. Upper pivot 13 3 is When moving to the tip side F, the upper pivot part 13 3 to The connected arm 18Y also moves toward the tip side F while changing its inclination angle. When the arm 18Y moves toward the tip side F while changing its inclination angle, the first slide plate 12Ya, which supports the drive shaft 181Y of the arm 18Y by the upper support shaft 121Ya, slides toward the tip side F relative to the reference frame 112Y.

[0122] When the first slide plate 12Ya moves to the tip side F, the slide cutter 15Y provided on the tip side F of the first slide plate 12Ya also moves to the tip side F along the upper surface of the lower jaw portion 116 in the reference frame 112Y. However, the cutting blade 153 of the slide cutter 15Y moving to the tip side F Y However, as shown in the enlarged view of part A in FIG. 14(a), it moves to such an extent that it does not engage with the middle part of the upper jaw portion 14.

[0123] In addition, the upper pivot 13 of 3 As described above, when the arm 18Y moves toward the tip side F while the inclination angle changes, the drive shaft 181Y is loosely fitted into the upper support shaft 121Yb and is biased toward the base end side R along the coil spring 16Y, so that the second slide plate 12Yb also moves toward the tip side F, as shown in the enlarged view of portion B in Figure 14(b).

[0124] When the second slide plate 12Yb moves to the tip side F, the upper jaw 14, whose lower shaft receiving portion 141 is pivotally supported by the tip support shaft 117 of the main body frame 11Y and whose upper rotary bearing portion 142 is pivotally supported by the tip upper support shaft 122Yb, moves the tip upper support shaft 122Yb to the tip side F. As a result, the tip side F pivots about the tip support shaft 117 in a direction approaching the lower jaw 116, and the gripping mechanism 17 composed of the lower jaw 116 and the upper jaw 14 enters a gripping state in which it can grip a target site such as a blood vessel B (see FIG. 14).

[0125] From this gripping state ,Sara When the trigger handle 13Y is operated in a direction to approach the fixed handle frame 111, the first slide plate 12Ya moves toward the reference frame 112. ,Sara Then, the tip F moves to the

[0126] Furthermore, when the first slide plate 12Ya moves toward the tip side F, the slide cutter 15Y provided at the tip of the first slide plate 12Ya moves around the tip support shaft 117, as shown in Figure 15(a), so that the cutting blade 153Y moves to the vicinity of the tip surface of the upper jaw portion 14. As a result, the slide cutter 15Y moves along the reference frame 112Y, and the blood vessel B gripped by the gripping mechanism 17 is cut by the cutting blade 153 of the slide cutter 15Y. Y The disconnection state is reached and the connection can be cut off.

[0127] However, the upper jaw 14 abuts against the upper surface of the lower jaw 116, and cannot rotate even if the second slide plate 12Yb slides further. When the trigger handle 13Y is further operated in a direction approaching the fixed handle frame 111, the upper pivot portion 13 3 toThe drive shaft 181Y of the pivotally supported arm 18Y also moves to the tip side F. However, as described above, the second slide plate 12Yb cannot slide to the tip side F. Therefore, against the biasing force of the coil spring 16Y that biases the drive shaft 181Y to the base end side R, the drive shaft 181Y presses the coil spring 16Y to the tip side F to contract it. That is, as shown in FIG. 15(b), which is an enlarged view of a portion A in FIG. 15(a), when the trigger handle 13Y is operated in a direction to be further closer to the fixed handle frame 111 and the coil spring 16Y contracts, the slide cutter 15Y slides to the tip side F, but the upper jaw 14 does not rotate, so that a differential motion can be generated.

[0128] As described above, in the cutting state in which the slide cutter 15Y and the upper jaw 14 are moved differentially by further operation of the trigger handle 13Y, the coil spring 16Y is deformed in the contracting direction. Therefore, when the force operating the trigger handle 13Y is released, the trigger handle 13Y moves in the expanding direction via the arm 18Y due to the biasing force of the compression coil spring 13a.

[0129] The opposing surfaces of the first slide plate 12Ya and the second slide plate 12Yb may be provided with a configuration similar to the click convex portion 118 and the click convex portion 123 in the above-described forceps 1. Even in this case, the user can be made aware of the cutting state by the clicking sensation that occurs when one plate overcomes the other.

[0130] As described above, like the forceps 1 and the forceps 1X, the forceps 1Y can grasp a target site such as a blood vessel B with the upper jaw portion 14 and the lower jaw portion 116 constituting the grasping mechanism 17, and cut the grasped target site with the slide cutter 15Y by a series of operations using the trigger handle 13. During the grasping and cutting of the target site by the series of operations using the trigger handle 13, microwaves are irradiated from the irradiation electrode 24 to the target site to cause coagulation. solid It can be done.

[0131] In addition, since a differential mechanism is provided by the compression of the coil spring 16X, in a series of operations of the trigger handle 13, after the target site is gripped by the gripping mechanism 17, it is possible to cut the target site by the slide cutter 15Y.

[0132] Next, as a fourth embodiment, an end effector 10a for irradiating biological tissue with microwaves will be described with reference to Fig. 16 and Fig. 17. The above-mentioned forceps 1, 1X, and 1Y are all provided with an irradiation electrode 24 for irradiating electromagnetic waves, and a specific electrode structure will be described in this embodiment.

[0133] FIG. 16 shows a schematic front view of an end effector 10a according to the fourth embodiment.

[0134] Figure 17 shows a schematic diagram of the end effector 10a in Figure 16. Figure 17(a) shows a side cross-sectional view taken along the line HH in Figure 16, Figure 17(b) shows a partial vertical cross-sectional view of the end effector 10a, and Figure 17(c) shows an enlarged plan view taken along the line II in Figure 16.

[0135] The end effector 10a is used in a scissors-type multifunctional surgical instrument, and corresponds to the cutting mechanism 10 in the above-described forceps 1. Therefore, the same components as those in the above-described forceps 1 are denoted by the same reference numerals. Also, the end effector in this embodiment can constitute the above-described cutter, cutting mechanism, and forceps, and includes other similar components.

[0136] 16 and 17, a part of the tip side F of the end effector 10a is shown. The end effector 10a has a reference axis 11a (corresponding to the reference frame 112 in the cutting mechanism 10) that passes through a bellows-shaped flexible portion 101 provided at the tip of a tubular support tool 100 attached to a scissors-type multifunction surgical instrument, and a movable frame 12a (corresponding to the slide frame 12 in the cutting mechanism 10) on whose tip an upper jaw portion 14a (corresponding to the upper jaw portion 14 in the cutting mechanism 10) and a cutting cutter 15a (corresponding to the cutting cutter 15 in the cutting mechanism 10) are provided.

[0137] In addition, the reference axis 11a and the movable frame 12a, the portions corresponding to the inside of the flexible portion 101 having flexibility, are configured to have flexibility that allows them to deform in accordance with the movable flexible portion 101, but wires may also be used for drive.

[0138] The operation of the upper jaw 14a and cutting cutter 15a in the end effector 10a configured in this manner is similar to that of the upper jaw 14 and cutting cutter 15 of the cutting mechanism 10 in the forceps 1 described above, and by moving the movable frame 12a in the longitudinal direction L relative to the reference axis 11a, the target area can be grasped by the grasping mechanism 17a consisting of the upper jaw 14a and lower jaw 116a provided at the end on the tip side F of the reference axis 11a, and can be cut by the cutting cutter 15.

[0139] The tip side on the rear side of the upper jaw 14a is provided with a protrusion restriction portion 143 that protrudes toward the rear side and restricts the cutting cutter 15a, which rotates along the side surface on the rear side of the upper jaw 14a, from protruding upward from the upper surface of the upper jaw 14a. As a result, even if the pivoting of the cutting cutter 15a in the opening direction is faster than the pivoting of the upper jaw 14a in the opening direction, the upper end of the cutting cutter 15a is restricted by the protrusion restriction portion 143, and both the upper jaw 14a and the cutting cutter 15a pivot in the opening direction, preventing the upper part of the cutting cutter 15a from protruding upward from the upper surface of the upper jaw 14a.

[0140] In the end effector 10a configured in this manner, a coaxial electrode 20 is provided along the longitudinal direction L on the upper surface of the lower jaw 116a and the bottom surface of the upper jaw 14a. The end effector 10a is provided with a microwave generator for irradiating microwaves. Shake A coaxial cable 40 is connected between the coaxial electrode 20 and the microwave generator 30. Shake The device 30 may be provided inside the end effector 10a.

[0141] As shown in the enlarged cross-sectional view of portion A in Figure 16, the coaxial cable 40 is composed of a central conductor 41, an insulator 42, an outer conductor 43, and an insulating coating 44 sandwiched between the central conductor 41, which are arranged in this order from the center to the radially outward, and has appropriate flexibility.

[0142] The coaxial electrode 20 provided on the bottom surface of the upper jaw portion 14a and the top surface of the lower jaw portion 116a is composed of a central conductor 21, a semicircular insulator 22 having a semicircular cross-section, and a semicircular tube conductor 23 arranged outside the semicircular insulator 22, as shown in the enlarged view of part A in Figure 17(a).

[0143] The coaxial electrode 20 thus configured is semi-cylindrical and of a predetermined length as shown in Fig. 17(a), and is arranged along the longitudinal direction so that the flat surfaces face each other on the bottom surface of the upper jaw 14a and the top surface of the lower jaw 116a as shown in Fig. 17(c). Although not shown, the coaxial electrode 20 arranged on the upper jaw 14a and the lower jaw 116a has an insulating layer arranged on the outside, and is insulated from the upper jaw 14a and the lower jaw 116a.

[0144] 17(b), the central conductor 21 of each of the coaxial electrodes 20 provided on the upper jaw 14a and the lower jaw 116a is connected to the central conductor 41 of the coaxial cable 40, and the semicircular tube conductor 23 of the coaxial electrode 20 is connected to the outer conductor 43 of the coaxial cable 40, resulting in a homopolar connection. If necessary, one of the electrodes may be connected to the opposite polarity as shown in FIG. 20.

[0145] In this way, the microwave is emitted through the coaxial cable 40. Shake The coaxial electrode 20 connected to the microwave generator 30 Shake When the device 30 is operated, microwaves can be irradiated between the central conductor 21 and the semicircular tube conductor 23 of the coaxial electrode 20 via the coaxial cable 40.

[0146] When a microwave is irradiated from the coaxial electrode 20 while the blood vessel B, which is a target site, is grasped by the grasping mechanism 17a, the blood vessel B grasped by the grasping mechanism 17a is coagulated by the microwave. solidThen, in the blood vessel B, the coaxial electrode 20 emits microwaves to coagulate the blood vessel B. solid The cut portion can be cut off by a cutting cutter 15a. As a modification of this embodiment, an embodiment in which an electronic module 31 is built in the end effector 10a is shown in FIG.

[0147] The aforementioned microwave Shake However, it is also possible to incorporate a microwave irradiation module 222 shown in Fig. 25, or to use an electronic module that appropriately incorporates the electronic circuit of a surgical device 221 shown in Fig. 27(b). By providing the electronic module 31 in the end effector 10a, it is possible to miniaturize the medical equipment, improving the convenience of surgery.

[0148] Next, an end effector 10b according to a fifth embodiment will be described with reference to FIGS. Fig. 18 shows a schematic explanatory view of an end effector 10b of the fifth embodiment. Fig. 18(a) shows a schematic front view of the end effector 10b in a normal state, and Fig. 18(b) shows a schematic front view of the end effector 10b in a cutting state.

[0149] Figure 19 shows a schematic explanatory diagram of the end effector 10b. Figure 19(a) shows a schematic cross-sectional view of the cutting mechanism in the end effector 10b in the normal state, Figure 19(b) shows a schematic cross-sectional view of the end effector 10b in the cutting state, and Figure 19(c) shows a schematic cross-sectional view of the cutting mechanism with a different arrangement of the coaxial electrodes.

[0150] In contrast to end effector 10a in FIG. 16, which further includes a cutting cutter 15a in addition to a gripping mechanism 17a consisting of lower jaw portion 116a and upper jaw portion 14a, and cuts the target area gripped by gripping mechanism 17a with cutting cutter 15a, end effector 10b in FIG. 18 is provided with a fixed blade 119b instead of lower jaw portion 116a at the tip of reference shaft 11b, and includes a movable blade 14b instead of upper jaw portion 14a, thereby constituting a cutting mechanism 19.

[0151] In the end effector 10b configured in this manner, by moving the movable frame 12b toward the tip side F relative to the reference shaft 11b, the movable blade 14b connected to the movable frame 12b rotates in a direction approaching the fixed blade 119b around the shaft-receiving portion 141b supported by the tip support shaft 117b provided on the reference shaft 11b. Then, as shown in Fig. 18(b) and Fig. 19(b), the fixed blade 119b and the movable blade 14b close, and the target site can be cut by the cutting blades 153b, 153a provided on each of them.

[0152] The end effector 10b configured in this manner is provided with a coaxial electrode 20 on the side surface facing the fixed blade 119b and the movable blade 14b. As shown in Fig. 19(a), the central conductor 21 of each of the coaxial electrodes 20 provided on the side surfaces of the fixed blade 119b and the movable blade 14b is electrically connected to the central conductor 41 of the coaxial cable 40, and the semicircular tube conductor 23 of the coaxial electrode 20 is electrically connected to the outer conductor 43 of the coaxial cable 40.

[0153] Therefore, in the cutting mechanism 19 of the end effector 10b, microwaves can be irradiated from the coaxial electrodes 20 provided on the side surfaces of the fixed blade 119b and the movable blade 14b.

[0154] In the end effector 10b configured in this manner, in a state where the blood vessel B, which is the target site, is placed between the fixed blade 119b and the movable blade 14b, microwaves are irradiated from each of the fixed blade 119b and the movable blade 14b. As a result, the blood vessel B placed between the fixed blade 119b and the movable blade 14b is coagulated. solid Then, blood vessel B is clotted. solid The cut portion can be cut by the cutting mechanism 19 by operating the movable blade 14b.

[0155] In addition, the blood vessel B is brought into contact with the movable blade 14b and the reference shaft 11b, and microwaves are irradiated from the coaxial electrode 20, so that the blood vessel B is efficiently coagulated. solid However, the movable blade 14b and the fixed blade 119b may be spaced slightly from the blood vessel B.

[0156] In addition, in the end effector 10b, as shown in Figures 19(a) and (b), a coaxial electrode 20 is provided on the opposing sides of the fixed blade 119b and the movable blade 14b, but as shown in Figure 19(c), the coaxial electrode 20 may also be arranged on the outer side of the fixed blade 119b and the movable blade 14b, which is the side that is spaced apart.

[0157] Furthermore, in the end effector 10b, as described above, the central conductor 21 of the coaxial electrode 20 provided on the side of the fixed blade 119b and the movable blade 14b is electrically connected to the central conductor 41 of the coaxial cable 40, and the semicircular tube conductor 23 of the coaxial electrode 20 is electrically connected to the outer conductor 43 of the coaxial cable 40.

[0158] 20(a), one central conductor 21 of the coaxial electrode 20 provided on the side surface of the fixed blade 119b and the movable blade 14b may be electrically connected to the outer conductor 43 of the coaxial cable 40, and the semicircular tube conductor 23 of the coaxial electrode 20 may be electrically connected to the central conductor 41 of the coaxial cable 40. In this case, the polarities of the coaxial electrodes 20 provided on the side surfaces of the fixed blade 119b and the movable blade 14b are reversed.

[0159] In this case too, Shake When the device 30 is operated, microwaves can be irradiated between the central conductor 21 and the semicircular tube conductor 23 in the coaxial electrodes 20 provided on the sides of the fixed blade 119b and the movable blade 14b, respectively, and microwaves are also irradiated between the central conductor 21 of one coaxial electrode 20 and the central conductor 21 of the other coaxial electrode 20, which have opposite polarities, and between the semicircular tube conductor 23 of one coaxial electrode 20 and the semicircular tube conductor 23 of the other coaxial electrode 20.

[0160] In addition, the end effector 10a shown in FIG. 17(b) may be configured such that the coaxial electrodes 20 provided on the opposing surfaces of the lower jaw portion 116a and the upper jaw portion 14a are connected to have opposite polarities, as shown in FIG. 20(b).

[0161] Furthermore, although not shown, in the end effector 10a, the coaxial electrode 20 may be provided on the side surface of the cutting cutter 15a in addition to the opposing surfaces of the lower jaw 116a and the upper jaw 14a, or the coaxial electrode 20 may not be provided on the upper jaw 14a but may be provided on the upper surface of the lower jaw 116a and the side surface of the cutting cutter 15a. Furthermore, as shown in Figures 24(f) to 24(h), the coaxial electrode 20 may be provided only on one of the opposing surfaces of the upper jaw 14a and the lower jaw 116a.

[0162] 21, the above-mentioned irradiation electrodes 24a, 24b may be provided instead of the coaxial electrode 20 provided on the upper jaw 14 and the lower jaw 116a of the end effector 10a. Furthermore, an irradiation electrode 24c may be provided on the side surface of the cutting cutter 15. Note that FIG. 21(a) shows a vertical cross-sectional view of the end effector 10a equipped with the irradiation electrodes 24 (24a, 24b, 24c), and FIG. 21(b) shows a partially enlarged vertical cross-sectional view of the end effector 10a equipped with the irradiation electrode 24.

[0163] Furthermore, as shown in FIG. 22, a microwave generator is connected to at least one of the upper jaw 14, the cutting cutter 15 and the lower jaw 116 of the forceps 1, 1X and 1Y by a coaxial cable 40. Shake A coaxial electrode 20 connected to the transducer 30 may be provided.

[0164] 22(a) shows a front view of the forceps 1 in which the coaxial electrodes 20 are provided on the upper jaw 14 and the lower jaw 116. FIG. 22(b) shows a front view of the forceps 1X in which the coaxial electrodes 20 are provided on the upper jaw 14 and the lower jaw 116, and FIG. 22(c) shows a front view of the forceps 1Y in which the coaxial electrodes 20 are provided on the upper jaw 14 and the lower jaw 116. In this way, the forceps 1, 1X, 1Y in which the coaxial electrodes 20 are provided on the gripping mechanism 17 consisting of the upper jaw 14 and the lower jaw 116 can irradiate microwaves from both coaxial electrodes 20 to a target site gripped by the gripping mechanism 17 by operating the trigger handle 13 to coagulate the target site, and then cut the target site with the cutter 15, 15Y.

[0165] In addition, in FIG. 22, a coaxial electrode 20 is provided on both the upper jaw portion 14 and the lower jaw portion 116 that constitute the gripping mechanism 17, but a coaxial electrode 20 may be provided on one of the upper jaw portion 14 and the lower jaw portion 116, or a coaxial electrode 20 may be provided on the cutter 15, 15Y.

[0166] Furthermore, as shown in FIG. 23, depending on the specifications, the coaxial electrode 20 and the irradiation electrode 24 may not be provided on the upper jaw 14, the cutting cutter 15 and the lower jaw 116 of the forceps 1, 1X and 1Y as described above as a cutting device.

[0167] Fig. 23(a) shows a front view of forceps 1 in which the coaxial electrode 20 and the irradiation electrode 24 are not provided on the upper jaw 14, the cutting cutter 15, and the lower jaw 116. Fig. 23(b) shows a front view of forceps 1X in which the coaxial electrode 20 and the irradiation electrode 24 are not provided on the upper jaw 14, the cutting cutter 15, and the lower jaw 116, and Fig. 23(c) shows a front view of forceps 1Y in which the coaxial electrode 20 and the irradiation electrode 24 are not provided on the upper jaw 14, the cutting cutter 15, and the lower jaw 116.

[0168] Fig. 24 is a schematic diagram of a confirmation test to confirm coagulation by microwaves irradiated from the coaxial electrode 20. Specifically, Fig. 24(a) to Fig. 24(e) show test conditions in which microwaves were irradiated from the coaxial electrode 20 provided on the fixed blade 119b and movable blade 14b of the end effector 10b within the egg white, and the coagulated egg white M was cut. Fig. 24(f) to Fig. 24(h) show test conditions in which the coaxial electrode 20 was provided only on the lower jaw 116a of the end effector 10a, that is, the coaxial electrode 20 was provided on one blade.

[0169] As shown in FIG. 24(a), an end effector 10b having coaxial electrodes 20 on both blades is placed in the egg white, and microwaves are generated. Shake When the device 30 is operated and microwaves are irradiated from the coaxial electrodes 20 provided on both blades, coagulation begins from the base side where the gap between the coaxial electrodes 20 is narrow between the fixed blade 119b and the movable blade 14b that constitute the cutting mechanism 19, and coagulation of coagulated egg white M is formed, as shown in Figure 24(b).

[0170] As microwave irradiation from coaxial electrodes 20 provided on both blades continues, coagulated egg white M expands along coaxial electrodes 20 provided on fixed blade 119b and movable blade 14b, as shown in Fig. 24(c). Then, when movable blade 14b is rotated relative to fixed blade 119b that constitutes cutting mechanism 19, coagulated egg white M can be cut by the cutting blades provided on fixed blade 119b and movable blade 14b, as shown in Fig. 24(d).

[0171] When cutting the coagulated egg white M with the cutting blade, the cutting may be performed while irradiating microwaves from the coaxial electrode 20 provided on the fixed blade 119b and the movable blade 14b, or the cutting may be performed without irradiating microwaves from the coaxial electrode 20.

[0172] Then, as shown in Figure 24(e), movable blade 14b constituting cutting mechanism 19 is opened, advanced in the direction of the arrow to the portion where coagulated egg white M was cut, and microwaves are again irradiated from coaxial electrode 20, forming coagulated egg white M as shown in Figure 24(b). By repeating this process, it was confirmed that cutting mechanism 19 in end effector 10b can cut the coagulated portion of blood vessel B, for example. It is presumed that this result suppresses the deterioration of hemostatic function in blood pools caused by bleeding during surgery.

[0173] In addition, when a coaxial electrode 20 is provided on both the lower jaw 116a and the upper jaw 14a of the end effector 10a, or when a coaxial electrode 20 is provided on the lower jaw 116a and the cutting cutter 15a, or even when a coaxial electrode 20 is provided on all of the lower jaw 116a, the upper jaw 14a, and the cutting cutter 15a, the cutting mechanism 19 of the end effector 10a can cut, for example, a coagulated portion of a blood vessel B, in the same manner as the end effector 10b in which the coaxial electrode 20 is provided on both blades described above.

[0174] In contrast, in the case of end effector 10a which is a single-edged electrode in which coaxial electrode 20 is provided only on one of lower jaw 116a and upper jaw 14a constituting cutting mechanism 19, coagulated egg white M is formed by irradiating microwaves from coaxial electrode 20 provided on one blade, and coagulated egg white M which has expanded along coaxial electrode 20 provided on one blade can be cut by cutting cutter 15a, as shown in Fig. 24(g). However, as shown in Fig. 24(c), the rate at which coagulated egg white M is formed is slower and the size of the coagulated egg white M that is formed is smaller than when coaxial electrode 20 is provided on both blades.

[0175] In addition, surgical instruments such as the end effector 10a and the end effector 10b that irradiate microwaves emit little smoke or mist, have a strong hemostatic function, and are ideal for supporting surgery in closed spaces such as laparoscopic surgery and robotic surgery. However, the hemostatic power in a blood pool when there is a lot of bleeding and in liquids is weakened, just like other energy devices.

[0176] In the above-mentioned effectiveness confirmation test, although not shown in the figure, in the case of an end effector in which one of the central conductor 21 and semicircular tube conductor 23 of the coaxial electrode 20 is arranged on one of the blades to form an electrode, and the other of the central conductor 21 and semicircular tube conductor 23 of the coaxial electrode 20 is arranged on the other of the blades to form an electrode, microwaves are irradiated from the electrode on one of the blades to the electrode on the other of the blades, so that in air, coagulation begins in the middle part of the tissue held between the open blades, but in the egg white, coagulation progresses only to the electrode part on the side where the microwaves are irradiated, and it was confirmed that the rate at which the surrounding egg white is coagulated at the other electrode is significantly delayed, weakening the hemostatic effect.

[0177] In contrast, as described above, when microwaves are irradiated from the coaxial electrodes 20 provided on both blades of end effector 10b, coagulation proceeds from the coaxial electrodes 20 provided on both blades (see Figs. 24(b) and (c)), and the egg white coagulates and coagulated egg white M is formed in twice the time it takes in the air. In addition, in the case of end effector 10a, which has a coaxial electrode 20 provided on only one of the blades, coagulated egg white M is formed, but the formation of coagulated egg white M over the entire surface is not completed even after three times the time. In this way, the arrangement of coaxial electrodes 20, which affect the formation of coagulated egg white M, can be selected according to the usage environment and the treatment target.

[0178] Figure 25 shows a medical instrument 220 in another embodiment of the present invention. In Figure 25(a), the medical instrument 220 includes a surgical device 221 that drives an end effector 10a of a scissors-type multifunctional surgical instrument (medical processing tool) as described in the embodiment of Figures 16 to 24. Note that the medical instrument 220 may be provided with an end effector 10b instead of the end effector 10a.

[0179] The surgical device 221 includes a microwave irradiation module 222 including a microwave control circuit such as an irradiator and an amplifier, and a drive unit 224 of a mechanical mechanism that drives the end effector 10a by manually operating a lever 223. Specifically, the trigger handle 13 of the forceps shown in Figures 1 to 15 may be used as the lever 223, and the mechanical mechanism extending from the trigger handle 13 to the end effectors 10a and 10b may be incorporated into the surgical device 221.

[0180] A microwave irradiation module 222 having an irradiator is provided inside the surgical device 221, but if necessary, it can be provided inside the shaft portion 225, or in a bending portion 226 having a wrist function (such as the flexible portion 101 in Figure 16), or in the end effector 10a (Figures 1 and 2, or the electronic module 31 in Figure 16(a)), making it possible to make the medical device 220 ultra-compact.

[0181] When an operator manually grips and operates a lever 223 of a grip portion of the surgical device 221, a drive unit 224 operates the end effector 10a of FIG.

[0182] The surgical device 221 receives power supply from an adapter 227. The microwave irradiation module 222 included in the surgical device 221 may be configured to be directly or indirectly connected to an irradiator installed in the robot body, in addition to the conventional stationary type, shoulder type, and built-in type.

[0183] In the above embodiment, microwave irradiation does not cause coagulation when gripping with the lower jaw 116 and upper jaw 14 (hereinafter referred to as the double-edged forceps) of the end effector 10a, but rather coagulates the target tissue when the upper jaw 14 rotates relative to the lower jaw 116, thereby enabling coagulation, hemostasis, and cutting of the tissue. Furthermore, microwaves may be irradiated when the tissue is gripped by the gripping mechanism 17a in the end effector 10a and cut by the cutting cutter 15.

[0184] With such forceps, the grasping function can be used to open and remove tissue, grasp and remove obstacles, and prepare the surgical field, and it is also possible to grasp the part to be coagulated and cut with the forceps and perform the coagulation and cutting in one go. The coagulation and cutting operations do not require multiple re-grasping of tissue or re-clamping, but rather the operation is completed with a single grip on what has already been clamped. Therefore, surgical operations such as grasping, coagulation, and cutting can be performed with a single device. This is the entire series of steps required for a typical resection surgery, and the surgery can be completed with a single instrument, eliminating the need to exchange for other instruments.

[0185] As a modified example of this embodiment, the microwave irradiation module 222 may be provided with an execution program memory, and the drive unit 224 may be configured as an electric mechanical mechanism controlled by the execution program. In operation, when the lever 223 is gripped, the execution program moves the drive unit 224 based on the position data of the lever 223, and by configuring the end effector 10a in Fig. 1, the slide frame 12 is moved to rotate the upper jaw 14 in the direction of the lower jaw 116 in cooperation with the cutting cutter 15 (see Fig. 2), and the program sends a microwave signal to the irradiation electrode 24, and the living tissue can be coagulated by irradiating microwaves.

[0186] Lever 223 ,Sara When the robot is gripped by the robot arm, the movable frame 12a moves in accordance with the position data by the program as described above. ,Sara and grasps the living tissue with upper jaw 14a and lower jaw 116a. Lever 223 ,Sara When the tissue is gripped in the suction hole, the movable frame 12a advances further according to the program in response to the lever position data, and the cutting cutter 15 is rotated to cut the coagulated biological tissue. After cutting, the lever 223 is released, and the medical device 220 returns to the initial state (open state) according to the lever position data.

[0187] FIG. 25(b) is a schematic diagram of a surgical system including a plurality of medical devices 220 shown in FIG. 25(a). The internal configuration of each is similar to that of FIG. 25(a), but each microwave irradiation module 222 of the medical devices 220 has ,Sara Each includes a unit for synchronizing the microwave wavelengths of the two devices, and the synchronization is performed via an adapter 227 or wirelessly.

[0188] Therefore, when two medical devices 220 are operated inside a patient by one or two operators, the wavelengths of the microwaves of both devices are synchronized, thereby preventing the occurrence of sparks and the like between the two medical devices 220, thereby increasing safety.

[0189] 26 shows a remote surgery system 200 according to an embodiment of the present invention. The remote surgery system 200 includes a surgeon console 201 serving as a station for each of two operators D (D1, D2), a master control unit 202 operated by the operator D, a viewing angle / core cart 240, and a patient side cart 210, which is a patient side cart.

[0190] The surgeon console 201 includes a viewer 201a in which an image of the surgical site is displayed to an operator D. When using the surgeon console 201, operators D1 and / or D2 typically sit in a chair at the surgeon console, position their eyes in front of the viewer 201a, and hold the master control unit 202 in one hand.

[0191] The remote surgery system 200 can be operated by two operators simultaneously, but can also be operated by a single operator. When two operators operate simultaneously, they can cooperate with each other, which has the advantage of shortening the total surgery time for the patient. The system may be provided with three or more surgeon consoles 201 and master control units 202, if necessary.

[0192] The robot on the Patient Side Cart 210 is placed adjacent to the patient. During use, the Patient Side Cart 210 is placed near the patient requiring surgery. The robot on the Patient Side Cart 210 is stationary during the surgical procedure but has casters on the base 211 to allow for mobility. The Surgeon Console 201 is used in the same operating room as the Patient Side Cart, but may be located remotely from the Patient Side Cart 210.

[0193] The patient side cart 210 includes four robot arm assemblies 212, but the number of the robot arm assemblies 212 is arbitrary. Each robot arm assembly 212 is connected to and driven and controlled by a drive unit 213 that enables three-dimensional movement.

[0194] A display 214 displays image data related to the surgery. The drive unit 213 is controlled by a master control unit 202 on the surgeon console 201. The movement of the manipulator portion of the robotic arm assembly 212 is controlled by operation of the master control unit 202.

[0195] An image capture device 215, such as an endoscope, is disposed on one of the four robotic arm assemblies 212, robotic arm assembly 212a. The remote end of image capture device 215 includes a viewing camera 216. Image capture device 215 is an elongated shaft that allows for insertion of viewing camera 216 through a surgical entry port in a patient (not shown). The image capture device 215 is operatively connected to the viewer 201 a of the surgeon console 201 for displaying images captured by its viewing camera 216 .

[0196] Each of the other robotic arm assemblies 212 is a linkage that supports and includes a respective detachable surgical instrument, tool 217. The tools 217 of the robotic arm assemblies 212 each include an end effector 10a (10b).

[0197] The tool 217 has an elongated shaft to allow for insertion of the end effector 10a (10b) through a surgical entry port in the patient. Movement of the end effector 10a (10b) is controlled by the master control unit 202 of the surgeon console 201.

[0198] When the end effector 10a (10b) uses the microwave irradiation electrodes (20, 24) and the microwave irradiation unit as the tool 217, the wavelengths of the microwaves irradiated from the end effector 10a (10b) are synchronized.

[0199] For example, when one or two operators D operate multiple tools 217 inside a patient, the wavelengths of the irradiated microwaves are synchronized to prevent sparks and the like from occurring between the multiple tools 217 or the multiple end effectors 10a (10b), thereby improving safety. Simultaneous operation of multiple end effectors 10a (10b) not only enables advanced surgery but also shortens the surgery time.

[0200] Figure 27 shows a configuration of a tool 217 that can be loaded onto the robot arm assembly 212 of the telesurgery system 200 of Figure 26 as a representative example of a surgical device. The tools 217 attached to other robot arm assemblies 212 may have a similar configuration, or may be surgical devices of other configurations.

[0201] 27(a) shows a plan view of a tool 217. The tool 217 has an end effector 10a of a scissors-type multifunctional surgical instrument, a bending portion 226, a shaft portion 225, a surgical device 221 that drives, controls, and monitors the tool 217, and a connector 228 that connects to a robot. The bending portion 226 increases the degree of freedom of the operation angle of the effector, improving the accuracy of robot control.

[0202] Fig. 27(b) shows the internal configuration of the tool 217 in Fig. 27(a). A medical system is shown that is composed of a surgical device 221 that drives the end effector 10a directly connected to the slide shaft in Fig. 16 via a shaft portion 225, and a robot of a patient side cart 210 that controls the surgical device 221.

[0203] The end effector 10a includes a first gripping member and a fixed second gripping member that are held openably and closably, and a cutting device having a movable cutting member attached to the first gripping member and the second member. The surgical device 221 connected to the end effector 10a includes an alignment unit 231 with the tool 217, a reflected wave monitor 232, a control circuit 233 that controls signals in the surgical device, an irradiation / driving unit 234 that has an amplifier and a microwave irradiator that mechanically drives the cutting device of the tool 217 via a shaft portion 225 of the tool 217, and a signal interface 235 with the robot of the patient side cart 210.

[0204] 28, the robot of the patient side cart 210 is connected to the surgical device 221 by wire and / or wirelessly via a signal interface 235 and a connector 228, and the robot of the patient side cart 210 is provided with an input unit 210a that receives an operation signal from the master control unit 201, a calculation unit CPU that executes a predetermined operation program based on the operation signal, and an output unit 210a that generates a drive signal for driving the first gripping member and the cutting member of the end effector 10a via the surgical device 221 based on the output from the calculation unit. The input unit and the output unit are composed of an input / output unit 210a (I / O).

[0205] Fig. 28 is an explanatory diagram of the remote surgery system 200. Fig. 28(a) is a block diagram showing the connection relationship between each unit, and Fig. 28(b) is an operation flow diagram of the remote surgery system 200.

[0206] The vision core cart 240 has a function related to the image capture device. When the remote surgery system 200 is started for surgery, the surgeon operates the master control unit 202 of the surgeon console 201, and in the case of two surgeons, the surgeon also operates the master control unit 202 of the surgeon console 201 (step S1), and the command generated by the operation is sent to the vision core cart 240 (step S2). The vision core cart 240 then interprets the signals and moves the desired robotic arm assembly 212 to the patient's surgical area (step S3).

[0207] Next, the tool 217 attached to the selected robot arm assembly 212 is inserted into the patient through the long and thin pipe (step S4), and the end effector 10a (10b) of the above embodiment is caused to grasp, coagulate, and cut the tissue (step S5), thereby completing the surgery on the living tissue.

[0208] The action of grasping, coagulating, and cutting the biological tissue in step S5 is the action of the end effector 10a (10b), and there are three action patterns: action pattern 1 in which the biological tissue is coagulated, grasped, and cut while irradiating microwaves from the electrode; action pattern 2 in which the biological tissue is grasped, coagulated by irradiating microwaves from the electrode, and cut while irradiating microwaves from the electrode; and action pattern 3 in which the biological tissue is grasped and coagulated while irradiating microwaves from the electrode, but the irradiation of microwaves from the electrode is stopped and the tissue is cut. These three action patterns are configured to be selectively taken depending on the contents of the surgery. In addition, a pattern in which the action is shared by multiple tools in FIG. 26, such as grasping or coagulating with a tool 217 and cutting with another tool 217, may be used.

[0209] In this embodiment, the operations of coagulating, grasping, and cutting tissue can be achieved by controlling the operation of the end effector 10a (10b) based on a control signal from the robot 210, instead of the controlled operation of the end effector 10a (10b) based on the position data of the lever 223 described as a modified example of the embodiment in Figure 25, so that a similar controlled operation flow can be obtained.

[0210] The above-mentioned examples and embodiments have been described using medical examples such as forceps and medical instruments, but the present invention is not limited to the above description, and the target site may be not only a part of an object but also a member, and includes a general-purpose cutting device that can grasp / contact and cut the target member. In addition, the energy wave irradiated from the electrodes of the forceps is not limited to microwaves and may include other electromagnetic waves.

[0211] For example, as described above, in the cutting mechanism 10 and end effector 10a of the forceps 1 etc., the gripping mechanism 17 is configured to be made up of the lower jaw portion 116 and the upper jaw portion 14, and the target portion such as the blood vessel B gripped by the gripping mechanism 17 is cut by the cutting cutter 15. However, as shown in FIG. 6(d), the gripping mechanism 17 made up of the lower jaw portion 116 and the upper jaw portion 14 may be provided on both sides of the cutting cutter 15, and the target portion between the gripped portions of the two gripping mechanisms 17 may be cut by the cutting cutter 15.

[0212] In addition, the horizontal movement of the forceps or end effector of the present invention is not limited to axial movement, and may be structured to be connected by a wire in order to increase the degree of freedom of the position and angle of the end effector. The spring mechanism for moving the upper jaw and the cutting cutter for grasping, coagulating and cutting biological tissue is not limited to the embodiment and may be provided at any position.

[0213] In addition, parts other than the electrodes and blade tips may be appropriately insulated to prevent corrosion and sparks. In the above embodiment, the tissue between the blades of both gripping members (upper and lower jaws, both blades) can be coagulated from both sides. The split part of the coaxial cable that supplies microwaves to the end effector allows for a structure that sends energy across multiple robot joints with a flexible cable without restricting the movement of multiple joints.

[0214] In addition, by using a metal blade, the rigidity and shape can be freely designed. The forceps and medical devices with end effectors of the present invention can be used under MR image guidance, and microwave energy can be introduced not only under endoscopy and with robotic hands, but also in endovascular surgery and fetal surgery.

[0215] In the forceps or end effector of the present invention, horizontal movement is not limited to axial movement, and in order to increase the degree of freedom in the position and angle of the end effector, a structure connected by a wire may be used. The upper jaw for gripping, coagulating and cutting biological tissue and the spring mechanism for moving the cutting cutter may be provided at any position other than that of the embodiment. In addition, parts other than the electrode and the cutting edge may be appropriately insulated to prevent corrosion and sparks.

[0216] In the above embodiment, the tissue between the blades of both gripping members (upper and lower jaws, double-edged blades) can be coagulated from both sides. The split section of the coaxial cable that supplies microwaves to the end effector allows energy to be sent across multiple robot joints via a flexible cable without restricting the movement of the multiple joints.

[0217] In addition, by using a metal blade, the rigidity and shape can be freely designed. The forceps and medical devices having the end effector of the present invention can be used under MR image guidance, and microwave energy can be introduced not only under endoscopy and with robotic hands, but also in endovascular surgery and fetal surgery.

[0218] The embodiments of the present invention are illustrative in all respects, and the scope of the present invention includes all modifications within the meaning and scope of the claims. [Explanation of symbols]

[0219] 1,1X,1Y…forceps 10,10X…cutting mechanism 10a, 10b...End effector 11, 11X, 11Y…Main frame 11a,11b...Reference axis 12...Upper slide shaft 12a, 12b…Movable axis 12Xa, 12Ya...First slide plate 12Xb, 12Yb…Second slide plate 13, 13X, 13Y...Trigger handle 14, 14a…Upper jaw 14b…Movable blade 15, 15a...Cutting cutter 15Y…Slide cutter 16…Spring 16X, 16Y... Coil spring 17,17a...gripping mechanism 18Y…Arm 19...Cutting mechanism 20…Coaxial electrode 21...Central conductor 22...Semicircular insulator 23...Semicircular tube conductor 24a, 24b, 24c…(irradiation) electrode 30...Microwave generation Shake vessel 31...Electronic module 35…Core Cart 40…Coaxial cable 41…Central conductor 42...Insulator 43…Outer conductor 44…Insulating coating 100...Support 101...Flexible part 111…Fixed handle frame 112,112X,112Y...reference frame 112Xa…Slide frame 113,131…Ring section 114…Corner 115...Support shaft 116,116a... lower jaw part 117,117b…Tip support shaft 118,123…Click protrusions 119b…Fixed blade 121,121Ya,121Yb…Top support shaft 121Xa…middle support shaft 122,122Xa,122Yb…Tip top support shaft 122Xb…Contact ring part 123X…Regulation hole 124Y…Regulation frame 13 2… Axis 13 3… Upper pivot 134…Upper pivot 135X…Press block 141,141b,151...Shafted part 142, 152... Rotating shaft 143...Protrusion regulation part 153,153a,153b,153Y…cutting blade 161X...Through shaft 162X…Flange part 181Y…Drive shaft 200...Remote surgery system 201…Surgeon console 201a…Viewer 202...Master control unit 210…Patient side cart 210a... Input / Output unit 211…Pedestal 212, 212a...Robot arm assembly 213...Drive unit 214…Display unit 215...Image capture device 216…Visibility camera 217…Tools 220…Medical equipment 221...Surgical equipment 222...Microwave irradiation module 223...Lever 224…Drive unit 225…Shaft section 226…Bend 227…Adapter 228…Connector 231…Integration unit 232...Reflected wave monitor 233...Control circuit 234… irradiation· Drive unit 235…Signal interface 240…Core Cart B...Vessel D,D1…Operator F…Tip side L…Longitudinal direction M…Coagulated egg white R…Proximal side

Claims

1. A first contact member and a second contact member assembled so as to be openable and closable; a contact mechanism that rotates the first contact member toward the second contact member to bring the first contact member and the second contact member into contact with biological tissue; a cutting mechanism for cutting the biological tissue in a state in which the first contact member and the second contact member are contacted with the biological tissue by the contact mechanism, the first contact member and the second contact member are a first gripping member and a second gripping member that grip the biological tissue, and the contact mechanism is a gripping mechanism that rotates the first gripping member toward the second gripping member and grips the biological tissue with the first gripping member and the second gripping member, A cutting member is provided adjacent to the first gripping member, The cutting mechanism includes: In a state where the biological tissue is gripped by the first gripping member and the second gripping member by the gripping mechanism, the cutting member is moved along the first gripping member and rotated in the same direction as the rotation of the first gripping member, and joined to the second gripping member to cut the biological tissue. Surgical cutting device.

2. A protrusion restriction portion is provided, which protrudes from the first gripping member toward the side where the cutting member is arranged, and comes into contact with the cutting member which rotates along the first gripping member in the same direction as the rotation of the first gripping member, thereby restricting the cutting member from protruding beyond the first gripping member in the direction opposite to the cutting direction.

2. The surgical cutter of claim 1.

3. Electrodes for irradiating electromagnetic waves are provided at least one of a gripping portion of the first gripping member that grips the biological tissue and a vicinity of a cutting blade of the cutting member, and at a gripping portion of the second gripping member that grips the biological tissue. A surgical cutter according to claim 1 or 2.

4. The electrode is A coaxial electrode includes a center electrode and an outer electrode surrounding the center electrode via an insulator, A coaxial cable connecting an irradiation device for irradiating the electromagnetic wave and the electrode is branched into a plurality of parallel branches, and the coaxial electrodes are electrically connected to the central conductor and the outer conductor of the coaxial cable, respectively.

4. The surgical cutter of claim 3.

5. The coaxial electrodes are connected in opposite polarity to the coaxial cable.

5. The surgical cutter of claim 4.

6. A surgical cutting instrument according to any one of claims 1 to 5, the first gripping member and the second gripping member are first jaw members and second jaw members, respectively; a drive mechanism for rotating the first jaw member toward the second jaw member to grasp and coagulate the biological tissue; and an operating unit for operating the drive mechanism and the cutting mechanism, Through a series of operations of the operating unit, the living tissue is grasped by the first jaw member and the second jaw member, and then cut by the cutting mechanism. forceps.

7. By operating the operation unit, the gripping mechanism and the cutting mechanism are operated together until the biological tissue is gripped, A differential mechanism is provided in which the cutting mechanism is differentially moved with respect to the gripping mechanism in a gripping state in which the cutting mechanism grips the biological tissue by further operation of the operating unit.

7. The forceps according to claim 6.

8. A notification unit is provided to notify a user of the operation of the differential mechanism by a series of operations of the operation unit.

8. The forceps according to claim 7.

9. A medical instrument including a plurality of forceps according to claim 7. The electrodes provided on each of the forceps are electrodes for irradiating microwaves, Each of the forceps is provided with a microwave irradiation unit, The period of the microwaves applied to each electrode from the coaxial cable is the same. Surgery system.

10. The forceps according to claim 6 or 7; a drive unit for driving the gripping mechanism and the cutting mechanism of the forceps; a medical robot connected to apply a drive signal to the drive unit. Healthcare system.

11. A rotatable upper jaw member connected to a movable shaft; a stationary lower jaw member supported by a main body frame; a rotatable cutting member disposed adjacent to said upper jaw member and engaging said upper jaw member and said stationary lower jaw member; a first electrode provided on a surface of the upper jaw member facing the stationary lower jaw member; a second electrode provided on a surface of the stationary lower jaw member facing the upper jaw member; A third electrode provided at or near the cutting edge of the cutting member; a coaxial cable connected to the first electrode, the second electrode, and the third electrode; A flexible portion having a bendable cover shape, In a state where the living tissue is grasped by the upper jaw member and the stationary lower jaw member, the cutting member is moved along the upper jaw member and rotated in the same direction as the rotation of the upper jaw member, and joined to the stationary lower jaw member to cut the living tissue. End effector.

12. an input / output unit connected by wire and / or wirelessly to the surgical cutting device according to claim 1 or 2; an input unit for receiving an operation signal in real time; a computing unit that executes a predetermined operation program based on the operation signal; an output unit that generates a drive signal for causing the first contact member and the second contact member of the surgical cutter to contact the biological tissue and / or cut the biological tissue based on an output from the arithmetic unit; robot.

13. an input / output unit connected by wire and / or wirelessly to the surgical cutting device according to any one of claims 3 to 5; an input unit for receiving an operation signal in real time; a computing unit that executes a predetermined operation program based on the operation signal; an output unit that generates, based on an output from the arithmetic unit, a drive signal for causing the first contact member and the second contact member of the surgical cutter to contact and / or cut the biological tissue, and / or an irradiation signal for irradiating the electromagnetic wave from the electrode. robot.

14. The robot according to claim 12 or 13, The output unit provides a drive signal to an external drive unit that mechanically drives the surgical cutter. Surgical medical robot.

15. generating commands through operation of a master control unit; a drive unit moving the robot arm assembly to a treatment position in response to said command; the drive moving a tool attached to a robotic arm assembly to a treatment position; and a step of controlling the movement of the forceps according to claim 6 or 7 attached to the tip of the tool and the generation of electromagnetic waves. A method for controlling a robot.

16. a plurality of surgeon consoles serving as stations for a plurality of operators; a master control unit operated by a plurality of operators; and a robot according to claim 12 or 13, which is a patient side cart. Surgery system.

17. One operation unit and A first gripping member and a second gripping member assembled so as to be openable and closable; A cutting member provided adjacent to the first gripping member; a gripping mechanism that rotates the first gripping member toward the second gripping member in response to movement of the operation unit and grips the biological tissue with the first gripping member and the second gripping member; a cutting mechanism for cutting the grasped biological tissue by moving the cutting member along the first grasping member and rotating the cutting member in the same direction as the rotation of the first grasping member in response to further movement of the operating unit while the living tissue is grasped by the grasping mechanism and joining the cutting member to the second grasping member. Surgical cutting device.

18. By operating the operation unit, the gripping mechanism and the cutting mechanism are operated together until the biological tissue is gripped, A differential mechanism is provided in which the cutting mechanism is differentially moved with respect to the gripping mechanism in a gripping state in which the cutting mechanism grips the biological tissue by further operation of the operating unit.

20. The surgical cutter of claim 17.

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