Ultrasonic treatment instrument

Abstract

This ultrasonic treatment instrument comprises: a vibration transmission member 12 in which ultrasonic vibration is transmitted from the base end toward the leading end; a tube TI into which the vibration transmission member 12 is inserted; a hard member 18 that is made of a resin material harder than the tube TI, that is provided to a node position P3 of the ultrasonic vibration and the outer circumferential surface of the vibration transmission member 12, and that abuts against the inner circumferential surface of the tube TI; and a pipe PI that covers the outer circumferential surface of the tube TI. In the tube TI, the thickness dimension of a portion compressed between the pipe PI and the hard member 18 is smaller than the thickness of other portions.

Description

Ultrasonic Treatment Device

[0001] The present invention relates to an ultrasonic treatment device.

[0002] Conventionally, ultrasonic treatment devices have been known that treat a target area in biological tissue (hereinafter referred to as a target area) by applying ultrasonic energy as treatment energy to the target area (see, for example, Patent Document 1).

[0003] The ultrasonic treatment device described in Patent Document 1 is provided with a vibration transmission member (probe), jaws, a rubber lining (sealing portion), and a pipe (sheath) as shown below. The vibration transmission member transmits ultrasonic vibrations from the base end to the tip. The jaws open and close relative to the vibration transmission member. The rubber lining has a ring shape and is provided on the outer peripheral surface of the vibration transmission member. More specifically, the rubber lining is provided at a node position of the ultrasonic vibration. The vibration transmission member is inserted into the pipe, and the outer peripheral surface of the rubber lining is pressed against the inner peripheral surface via a tube. Then, by having the outer peripheral surface of the rubber lining pressed against the inner peripheral surface of the pipe, airtightness and watertightness are ensured.

[0004] International Publication No. 2016 / 080303

[0005] However, when a rubber lining is molded onto the outer peripheral surface of the vibration transmission member, burrs are generated, and these burrs must be removed manually. This manual work increases the processing cost, making it difficult to reduce the cost of the ultrasonic treatment device.

[0006] The present invention has been made in view of the above, and an object of the present invention is to provide an ultrasonic treatment device that can ensure airtightness and watertightness while reducing costs.

[0007] In order to solve the above-mentioned problems and achieve the object, the ultrasonic treatment device of the present invention comprises a vibration transmission member that transmits ultrasonic vibrations from a base end to a tip end, a tube into which the vibration transmission member is inserted, a hard member made of a resin material harder than the tube and provided on the outer surface of the vibration transmission member at a node position of the ultrasonic vibration and in contact with the inner surface of the tube, and a pipe covering the outer surface of the tube, wherein the thickness dimension of the tube at the point compressed between the pipe and the hard member is smaller than the thickness dimension of other points.

[0008] Furthermore, the ultrasonic treatment instrument according to the present invention comprises a vibration transmission member that transmits ultrasonic vibrations from the base end to the tip end, a jaw that opens and closes relative to the vibration transmission member, a hard member provided on the outer peripheral surface of the vibration transmission member, a tube into which the vibration transmission member is inserted and whose inner peripheral surface the hard member abuts, and a pipe that covers the outer peripheral surface of the tube, wherein the hard member is made of a resin material that is harder than the tube and is provided at the most proximal nodal position of the ultrasonic vibrations, and the tube is partially expanded by the hard member and abuts against the inner peripheral surface of the pipe at a position spaced apart from the hard member in the longitudinal direction of the vibration transmission member.

[0009] According to the ultrasonic treatment device of the present invention, it is possible to ensure airtightness and watertightness while reducing costs.

[0010] FIG. 1 is a diagram showing a treatment system according to an embodiment. FIG. 2 is a diagram illustrating the configuration of a distal end portion of an ultrasonic treatment device. FIG. 3 is a diagram illustrating the configuration of a support member. FIG. 4 is a diagram illustrating a change in shape of an inner tube due to a third support member. FIG. 5 is a diagram illustrating a first modified example of the embodiment. FIG. 6 is a diagram illustrating a second modified example of the embodiment. FIG. 7 is a diagram illustrating a third modified example of the embodiment. FIG. 8 is a diagram illustrating a fourth modified example of the embodiment. FIG. 9 is a diagram illustrating a fifth modified example of the embodiment. FIG. 10 is a diagram illustrating a sixth modified example of the embodiment. FIG. 11 is a diagram illustrating a seventh modified example of the embodiment. FIG. 12 is a diagram illustrating an eighth modified example of the embodiment. FIG. 13 is a diagram illustrating an eighth modified example of the embodiment. FIG. 14 is a diagram illustrating a ninth modified example of the embodiment.

[0011] Hereinafter, a mode for carrying out the present invention (hereinafter referred to as an embodiment) will be described with reference to the drawings. Note that the present invention is not limited to the embodiment described below. Furthermore, in the description of the drawings, the same parts are given the same reference numerals.

[0012] [Overview of Treatment System] Fig. 1 is a diagram showing a treatment system 1 according to an embodiment. The treatment system 1 applies treatment energy to a region of biological tissue to be treated (hereinafter referred to as the treatment target) to treat the treatment target. The treatment energy in this embodiment is ultrasonic energy and high-frequency energy. Treatments that can be performed by the treatment system 1 according to this embodiment include coagulation (sealing) of the treatment target or incision of the treatment target. Coagulation and incision may also be performed simultaneously. As shown in Fig. 1, the treatment system 1 includes an ultrasonic treatment instrument 2 and a control device 3.

[0013] [Configuration of Ultrasonic Treatment Instrument] In the following, one side along the central axis Ax1 (FIG. 1) of the outer pipe 10 will be referred to as the distal side Ar1, and the other side will be referred to as the proximal side Ar2. In addition, the "width direction" described below refers to a direction perpendicular to the central axis Ax1 and the opening / closing direction of the jaw 11 relative to the treatment portion 121, and is perpendicular to the plane of the paper in FIGS. 1 and 2.

[0014] Fig. 2 is a diagram illustrating the configuration of the distal end portion of the ultrasonic treatment instrument 2. Specifically, Fig. 2 is a cross-sectional view of the distal end portion of the ultrasonic treatment instrument 2 cut along a plane including the central axis Ax1 of the outer pipe 10, with the jaw 11 and the vibration transmission member 12 included in the plane.

[0015] The ultrasonic treatment device 2 is a treatment device that applies ultrasonic energy and high-frequency energy to a treatment target, and includes a handpiece 4 and an ultrasonic transducer 5, as shown in FIG.

[0016] As shown in Figures 1 and 2, the handpiece 4 includes a fixed handle 6 (Figure 1), an operating handle 7 (Figure 1), a switch 8 (Figure 1), a rotating knob 9 (Figure 1), an outer pipe 10, a jaw 11, and a vibration transmission member 12.

[0017] The fixed handle 6 supports the entire ultrasonic treatment instrument 2 and is a part that is held by an operator (user) such as a surgeon.

[0018] The operating handle 7 is movably attached to the fixed handle 6 and receives opening and closing operations by an operator such as a surgeon.

[0019] The switch 8 is provided in an exposed state on the outside of the fixed handle 6 and receives treatment operations from an operator such as a surgeon.

[0020] The rotation knob 9 has a generally cylindrical shape coaxial with the central axis Ax1 and is provided on the distal end side Ar1 of the fixed handle 6. The rotation knob 9 is rotated by an operator such as a surgeon. This rotation causes the rotation knob 9 to rotate about the central axis Ax1 relative to the fixed handle 6. Furthermore, the rotation of the rotation knob 9 causes the outer pipe 10, the jaw 11, and the vibration transmission member 12 to rotate about the central axis Ax1.

[0021] The outer pipe 10 has a tubular shape. In this embodiment, the outer pipe 10 is a cylindrical pipe made of a conductive material such as metal.

[0022] In this outer pipe 10, a pivot axis Pi1 (FIGS. 1 and 2) is fixed to the end of the tip side Ar1. The pivot axis Pi1 is formed of a cylindrical pin extending in a direction perpendicular to the paper surface of FIGS. 1 and 2, and engages with the jaw 11 and rotatably supports the jaw 11.

[0023] The outer circumferential surface of the outer pipe 10 is covered with an electrically insulating outer tube TO ( FIG. 2 ). A tubular inner pipe PI ( FIG. 2 ) is inserted into the outer pipe 10 and moves back and forth along the longitudinal direction of the outer pipe 10 in response to an operator's opening or closing operation of the operating handle 7. This inner pipe PI corresponds to the pipe according to the present invention. A drive shaft Pi2 ( FIG. 2 ), which is a cylindrical pin extending in a direction perpendicular to the plane of FIGS. 1 and 2 , and engages with the jaw 11, is fixed to the end of the distal end side Ar1 of the inner pipe PI. In this embodiment, the drive shaft Pi2 is located on the upper side of the rotation shaft Pi1 in FIG. 2 (the side where the arm body 131 is located relative to the treatment unit 121).

[0024] In this embodiment, the jaw 11 is partially made of a conductive material and includes an arm 13 and a pad 14, as shown in FIG.

[0025] In this embodiment, the arm 13 is made of a conductive material and is a member in which an arm body 131 and a pair of bearing portions 132 are integrally formed, as shown in FIG.

[0026] The arm body 131 is formed of a long plate body, and is disposed in a position where one plate surface faces the vibration transmission member 12 .

[0027] The pair of bearings 132 are provided at the ends of the base end side Ar2 of the arm body 131, and are each composed of a plate body that faces each other in the width direction of the arm body 131. Note that Fig. 2 shows only one of the pair of bearings 132. Since the pair of bearings 132 have the same configuration, the following will describe the configuration of only one of the bearings 132.

[0028] The bearing portion 132 is connected to the outer pipe 10 by a rotation axis Pi1, and is also connected to the inner pipe PI by a drive axis Pi2.

[0029] The arm 13 rotates about the rotation axis Pi1 relative to the outer pipe 10 in response to the forward / backward movement of the inner pipe PI in response to the opening / closing operation of the operating handle 7 by an operator such as a surgeon. As a result, the jaw 11 opens and closes with respect to the treatment unit 121, which is the distal end of the vibration transmission member 12, and can grasp a treatment target between the jaw 11 and the treatment unit 121. In this embodiment, the jaw 11 rotates about the rotation axis Pi1 in a direction approaching the treatment unit 121 in response to the movement of the inner pipe PI toward the distal end side Ar1. That is, the jaw 11 closes with respect to the treatment unit 121. Furthermore, the jaw 11 rotates about the rotation axis Pi1 in a direction away from the treatment unit 121 in response to the movement of the inner pipe PI toward the proximal end side Ar2. That is, the jaw 11 opens with respect to the treatment unit 121. As described above, in this embodiment, the ultrasonic treatment instrument 2 is configured as a so-called push-close type.

[0030] The pad 14 is made of an electrically insulating and biocompatible resin material, such as polytetrafluoroethylene (PTFE), and has a generally rectangular parallelepiped shape extending along the longitudinal direction of the arm 13. As shown in FIG. 2 , the pad 14 is fixed to the surface of the arm body 131 facing the treatment section 121, and comes into contact with the treatment section 121 when the jaw 11 is closed over the treatment section 121. Because the pad 14 is electrically insulating, it has the function of preventing a short circuit between the arm 13 and the vibration transmission member 12. Furthermore, the pad 14 has the function of preventing the ultrasonically vibrating treatment section 121 from colliding with the arm 13 and being damaged when the incision of the treatment target using ultrasonic vibrations is completed.

[0031] Examples of methods for fixing the pad 14 to the arm body 131 include a method of mechanically fixing the pad 14 by protruding a claw portion from the surface of the arm body 131 facing the treatment section 121 and engaging the pad 14 with the claw portion, or insert molding.

[0032] The vibration transmission member 12 is made of a conductive material and has an elongated shape extending along the central axis Ax1. As shown in FIG. 2 , the vibration transmission member 12 is inserted into the inner pipe PI with the treatment portion 121 protruding outward. At this time, the end of the base end side Ar2 of the vibration transmission member 12 is mechanically connected to the ultrasonic vibrator 52 constituting the ultrasonic transducer 5, as shown in FIG. 1 . The vibration transmission member 12 transmits ultrasonic vibrations generated by the ultrasonic transducer 5 from the end of the base end side Ar2 to the treatment portion 121. In this embodiment, the ultrasonic vibrations are longitudinal vibrations vibrating in a direction along the central axis Ax1. The outer surface of the vibration transmission member 12, excluding the treatment portion 121, is covered by an electrically insulating inner tube TI ( FIG. 2 ). This inner tube TI can be a heat-shrinkable tube made of a fluororesin such as perfluoroethylene propene copolymer (FEP). This inner tube TI corresponds to the tube according to the present invention.

[0033] A support member 15 (see FIG. 3) is provided on the outer peripheral surface of the vibration transmission member 12 described above. The detailed configuration of the support member 15 will be described later in the section "Configuration of the Support Member."

[0034] As shown in FIG. 1 , the ultrasonic transducer 5 includes a TD (transducer) case 51 and an ultrasonic vibrator 52 .

[0035] The TD case 51 supports the ultrasonic transducer 52 and is detachably connected to the fixed handle 6 .

[0036] The ultrasonic vibrator 52 generates ultrasonic vibrations under the control of the control device 3. In this embodiment, the ultrasonic vibrator 52 is configured by a BLT (bolt-tightened Langevin type vibrator).

[0037] [Configuration of the Control Device] The control device 3 comprehensively controls the operation of the ultrasonic treatment instrument 2 via the electric cable C (FIG. 1). Specifically, the control device 3 detects a treatment operation on the switch 8 by an operator such as a surgeon via the electric cable C. When the control device 3 detects the treatment operation, it applies treatment energy to the treatment target grasped between the jaw 11 and the treatment section 121 via the electric cable C. In other words, the control device 3 treats the treatment target.

[0038] For example, when ultrasonic energy is applied to a treatment target, the control device 3 supplies driving power to the ultrasonic vibrator 52 via the electric cable C. This causes the ultrasonic vibrator 52 to generate longitudinal vibrations (ultrasonic vibrations) that vibrate in a direction along the central axis Ax1. The treatment unit 121 also vibrates at a desired amplitude due to the longitudinal vibrations. Then, ultrasonic vibrations are applied from the treatment unit 121 to the treatment target grasped between the jaw 11 and the treatment unit 121. In other words, ultrasonic energy is applied from the treatment unit 121 to the treatment target.

[0039] Furthermore, for example, when applying high-frequency energy to a treatment target, the control device 3 supplies high-frequency power between the arm 13 and the vibration transmission member 12 via the electric cable C, the outer pipe 10, etc. When high-frequency power is supplied between the arm 13 and the vibration transmission member 12, a high-frequency current flows through the treatment target grasped between the jaw 11 and the treatment section 121. In other words, high-frequency energy is applied to the treatment target. That is, the arm 13 and the treatment section 121 function as electrodes according to the present invention.

[0040] [Configuration of Support Member] Next, the configuration of the above-mentioned support member 15 will be described. Fig. 3 is a diagram showing the configuration of the support member 15. Specifically, Fig. 3 is a cross-sectional view of the jaw 11, vibration transmission member 12, inner pipe PI, inner tube TI, and support member 15 cut along the same plane as Fig. 2. As shown in Fig. 3, the support member 15 includes first to third support members 16 to 18.

[0041] In this embodiment, the first and second support members 16, 17 are each made of an elastic rubber member and have an annular shape through which the vibration transmission member 12 is inserted. More specifically, the first and second support members 16, 17 are disposed at node position P1 (FIG. 3) closest to the distal end side Ar1 and node position P2 (FIG. 3) second from the distal end side Ar1, among the node positions of the ultrasonic vibration (longitudinal vibration). The first and second support members 16, 17 abut against the inner circumferential surface of the inner tube TI.

[0042] The third support member 18 is made of a resin material that is harder than the inner tube TI and has a circular ring shape through which the vibration transmission member 12 is inserted. Examples of the resin material include polytetrafluoroethylene (PTFE), polyetheretherketone (PEEK), polyphenylsulfone (PPSU), and polyoxymethylene (POM). More specifically, the third support member 18 is disposed at node position P3 ( FIG. 3 ), which is the node position of the ultrasonic vibration (longitudinal vibration) closest to the base end Ar2. This third support member 18 corresponds to the hard member according to the present invention.

[0043] As shown in FIG. 3, annular grooves 122 to 124 are provided at each of the nodal positions P1 to P3 on the outer peripheral surface of the vibration transmission member 12, to which the first to third support members 16 to 18 are attached.

[0044] [Shape change of inner tube due to third support member] Next, a description will be given of a shape change of the inner tube TI due to the above-mentioned third support member 18. Fig. 4 is a diagram showing a shape change of the inner tube TI due to the third support member 18. Specifically, Fig. 4(a) is an enlarged view of a portion of Fig. 3. Fig. 4(b) is an enlarged view of a region including a portion TIP of the inner tube TI in Fig. 4(a).

[0045] As shown in FIG. 4A , the third support member 18 is a circular member with a rectangular cross section. The inner diameter of the third support member 18 is approximately the same as the outer diameter of the groove 124. To prevent a gap from forming between the third support member 18 and the vibration transmission member 12, the inner diameter of the third support member 18 is preferably smaller than the outer diameter of the groove 124. The outer diameter of the third support member 18 is larger than the inner diameter of the inner tube TI before assembly. Therefore, the inner tube TI is expanded by the third support member 18 in the assembled state, as shown in FIG. 4A . The difference between the inner diameter of the inner pipe PI and the outer diameter of the third support member 18 is less than twice the thickness of the inner tube TI before assembly. Therefore, a portion TIP ( FIG. 4 ) of the inner tube TI is compressed between the inner pipe PI and the third support member 18. The thickness TH1 of the portion TIP is smaller than the thickness TH2 of the other portion of the inner tube TI (FIG. 4(b)).

[0046] The above-described embodiment of the present invention provides the following advantages. In the ultrasonic treatment device 2 according to this embodiment, the third support member 18 is made of a resin material harder than the inner tube TI, and compresses the portion TIP of the inner tube TI between the third support member 18 and the inner pipe PI as described above. This prevents gas or liquid that has entered the inner pipe PI from the distal end thereof and enters the inner pipe PI from advancing toward the proximal end Ar2 at the portion TIP. Furthermore, compared to conventional configurations using a rubber lining, the need for deburring can be eliminated, reducing processing costs. Therefore, the ultrasonic treatment device 2 according to this embodiment can ensure airtightness and watertightness while reducing costs.

[0047] Other Embodiments Although the embodiments for carrying out the present invention have been described above, the present invention should not be limited to only the above-described embodiments. In the above-described embodiments, ultrasonic energy and high-frequency energy are used as the treatment energy applied to the treatment target by the ultrasonic treatment device 2, but the present invention is not limited to this, and only ultrasonic energy may be used.

[0048] In the above-described embodiment, the ultrasonic treatment tool 2 is configured as a so-called push-close type, but the present invention is not limited to this and may be configured as a so-called pull-close type. Specifically, the jaw 11 rotates about the rotation axis Pi1 in a direction approaching the treatment portion 121 in conjunction with the movement of the inner pipe PI toward the base end side Ar2. That is, the jaw 11 closes with respect to the treatment portion 121. Also, the jaw 11 rotates about the rotation axis Pi1 in a direction away from the treatment portion 121 in conjunction with the movement of the inner pipe PI toward the tip end side Ar1. That is, the jaw 11 opens with respect to the treatment portion 121.

[0049] In the above-described embodiment, the jaw 11 opens and closes relative to the treatment portion 121 in conjunction with the forward and backward movement of the inner pipe PI along the central axis Ax1, but this is not limiting. A configuration in which the jaw 11 opens and closes relative to the treatment portion 121 in conjunction with the forward and backward movement of the outer pipe 10 along the central axis Ax1 may also be employed.

[0050] In the above-described embodiment, the first and second support members 16, 17 may also be made of a resin material, similar to the third support member 18. When the first and second support members 16, 17 are made of a resin material in this way, the amount of deformation of the first and second support members 16, 17 can be reduced when the jaw 11 is closed, and deflection of the vibration transmission member 12 can be suppressed, compared to when the first and second support members 16, 17 are made of a rubber lining. In other words, the treatment target can be securely grasped between the jaw 11 and the vibration transmission member 12.

[0051] In addition, in the above-described embodiment, the following modified examples 1 to 4 may be adopted.

[0052] (Variation 1) Figure 5 is a diagram illustrating Variation 1 of the embodiment. Specifically, (a) of Figure 5 corresponds to (a) of Figure 4. (b) of Figure 5 is an enlarged view of a region including a portion TIP of the inner tube TI in (a) of Figure 5. In the above-described embodiment, a third support member 18A according to Variation 1 shown in Figure 5 may be employed instead of the third support member 18.

[0053] The third support member 18A has a different outer shape from the third support member 18 described in the above embodiment. Specifically, as shown in Fig. 5(a), the third support member 18A is composed of a large diameter portion 181 and a small diameter portion 182.

[0054] The large diameter portion 181 has a circular ring shape.

[0055] The small diameter portion 182 has an annular shape and is integrally provided on the tip side Ar1 of the large diameter portion 181 in a state where it is coaxial with the large diameter portion 181. The outer diameter dimension of the small diameter portion 182 is smaller than the outer diameter dimension of the large diameter portion 181, as shown in FIG.

[0056] As shown in FIG. 5A, the inner tube TI is assembled with the small diameter portion 182 inserted therein and the end of the base end side Ar2 abutting against the stepped portion 180 between the large diameter portion 181 and the small diameter portion 182. The outer diameter of the small diameter portion 182 is larger than the inner diameter of the inner tube TI before assembly. Therefore, the inner tube TI is expanded by the small diameter portion 182 in the assembled state. Furthermore, the difference between the inner diameter of the inner pipe PI and the outer diameter of the small diameter portion 182 is smaller than twice the thickness of the inner tube TI before assembly. Therefore, a portion TIP (FIG. 5) of the inner tube TI is compressed between the inner pipe PI and the small diameter portion 182. The thickness TH1 of the portion TIP is smaller than the thickness TH2 of the remaining portion of the inner tube TI (FIG. 5B).

[0057] The first modification described above provides the same effects as the above-described embodiment, as well as the following effects. In the third support member 18A according to the first modification, the stepped portion 180 can function as a positioning surface for the inner tube TI in the direction along the central axis Ax1. This improves the ease of assembly of the ultrasonic treatment device 2.

[0058] (Modification 2) Figure 6 is a diagram illustrating Modification 2 of the embodiment. Specifically, (a) of Figure 6 corresponds to (a) of Figure 4. (b) of Figure 6 is an enlarged view of a region including a portion TIP of the inner tube TI in (a) of Figure 6. In the above-described embodiment, a third support member 18B according to Modification 2 shown in Figure 6 may be employed instead of the third support member 18.

[0059] The third support member 18B has a different outer shape from the third support member 18 described in the above embodiment. Specifically, as shown in Fig. 6, the third support member 18B is composed of a support member main body 183 and a truncated cone portion 184.

[0060] The support member body 183 has a circular ring shape.

[0061] The truncated cone portion 184 has an outer shape like a truncated cone, an outer diameter dimension of which decreases toward the tip end side Ar1, and is provided integrally with the tip end side Ar1 of the support member main body 183 in a state of being coaxial with the support member main body 183. The largest outer diameter dimension of the truncated cone portion 184 is the same as the outer diameter dimension of the support member main body 183, as shown in Fig. 6. In other words, the truncated cone portion 184 corresponds to the tapered portion according to the present invention.

[0062] As shown in FIG. 6A, the inner tube TI is assembled with the third support member 18B inserted therein. The outer diameters of the truncated cone portion 184 and the support member main body 183 are larger than the inner diameter of the inner tube TI before assembly. Therefore, the inner tube TI is expanded by the third support member 18B when assembled. The difference between the inner diameter of the inner pipe PI and the outer diameter of the support member main body 183 is less than twice the thickness of the inner tube TI before assembly. Therefore, a portion TIP (FIG. 6) of the inner tube TI is compressed between the inner pipe PI and the support member main body 183. The thickness TH1 of the portion TIP is smaller than the thickness TH2 of the remaining portion of the inner tube TI (FIG. 6B).

[0063] The above-described second modification provides the same effects as the above-described embodiment, as well as the following effects. In the third support member 18B according to the second modification, the outer peripheral surface of the truncated cone portion 184 has a tapered shape. This facilitates insertion of the third support member 18B into the inner tube TI, improving the ease of assembly of the ultrasonic treatment device 2. Furthermore, the adhesion between the inner peripheral surface of the inner tube TI and the outer peripheral surface of the third support member 18B is improved, ensuring sufficient airtightness and watertightness.

[0064] (Modification 3) Figure 7 is a diagram illustrating Modification 3 of the embodiment. Specifically, (a) of Figure 7 corresponds to (a) of Figure 4. (b) of Figure 7 is an enlarged view of a region including a portion TIP of the inner tube TI in (a) of Figure 7. In the above-described embodiment, a third support member 18C according to Modification 3 shown in Figure 7 may be employed instead of the third support member 18.

[0065] The third support member 18C has a different outer shape from the third support member 18 described in the above embodiment. Specifically, as shown in Fig. 7, the third support member 18C is composed of a support member main body 185 and first and second truncated cone portions 186 and 187.

[0066] The support member body 185 has a circular ring shape.

[0067] The first truncated cone portion 186 has a truncated cone-like outer shape, an outer diameter dimension of which decreases toward the tip end side Ar1, and is provided integrally with the tip end side Ar1 of the support member main body 185 in a state of being coaxial with the support member main body 185. The largest outer diameter dimension of this first truncated cone portion 186 is the same as the outer diameter dimension of the support member main body 185, as shown in Fig. 7. In other words, the first truncated cone portion 186 corresponds to the tapered portion according to the present invention.

[0068] The second truncated cone portion 187 has a truncated cone-like outer shape, an outer diameter dimension of which decreases toward the base end side Ar2, and is provided integrally with the base end side Ar2 of the support member main body 185 in a state coaxial with the support member main body 185. The largest outer diameter dimension of this second truncated cone portion 187 is the same as the outer diameter dimension of the support member main body 185, as shown in Fig. 7. In other words, the second truncated cone portion 187 corresponds to the tapered portion according to the present invention.

[0069] As shown in FIG. 7A, the inner tube TI is assembled with the third support member 18C inserted therein. The outer diameters of the first and second truncated cone portions 186, 187 and the support member main body 185 are larger than the inner diameter of the inner tube TI before assembly. Therefore, the inner tube TI is expanded by the third support member 18C in the assembled state. Furthermore, the difference between the inner diameter of the inner pipe PI and the outer diameter of the support member main body 185 is less than twice the thickness of the inner tube TI before assembly. Therefore, a portion TIP (FIG. 7) of the inner tube TI is compressed between the inner pipe PI and the support member main body 185. The thickness TH1 of the portion TIP is smaller than the thickness TH2 of the remaining portion of the inner tube TI (FIG. 7B).

[0070] The third modification as described above provides the same effects as those of the embodiment and the second modification as described above, as well as the following effect. In the third modification, the length of the part TIP of the inner tube TI in the direction along the central axis Ax1 can be shortened. This reduces the sliding resistance when the inner pipe PI is moved back and forth along the central axis Ax1 to open and close the jaw 11 relative to the treatment portion 121.

[0071] (Modification 4) Figure 8 is a diagram illustrating Modification 4 of the embodiment. Specifically, (a) of Figure 8 corresponds to (a) of Figure 4. (b) of Figure 8 is an enlarged view of a region including a portion TIP of the inner tube TI in (a) of Figure 8. In the above-described embodiment, a third support member 18D according to Modification 4 shown in Figure 8 may be employed instead of the third support member 18.

[0072] The third support member 18D has a different outer shape from the third support member 18 described in the above embodiment. Specifically, as shown in Fig. 8, the outer diameter of the third support member 18D decreases toward the tip side Ar1. In other words, the third support member 18D corresponds to a tapered portion according to the present invention.

[0073] As shown in FIG. 8A, the inner tube TI is assembled with the third support member 18D inserted therein. The outer diameter of the third support member 18D is larger than the inner diameter of the inner tube TI before assembly. Therefore, the inner tube TI is expanded by the third support member 18D when assembled. The difference between the inner diameter of the inner pipe PI and the outer diameter of the end of the base end Ar2 of the third support member 18D is smaller than twice the thickness of the inner tube TI before assembly. Therefore, a portion TIP (FIG. 8) of the inner tube TI is compressed between the inner pipe PI and the end of the base end Ar2 of the third support member 18D. The thickness TH1 of the portion TIP is smaller than the thickness TH2 of the remaining portion of the inner tube TI (FIG. 8B).

[0074] Even when the configuration of the third support member 18D according to the fourth modification described above is adopted, the same effects as those of the embodiment and the third modification described above are achieved.

[0075] (Modification 5) Figure 9 is a diagram illustrating Modification 5 of the embodiment. Specifically, (a) of Figure 9 corresponds to (a) of Figure 4. (b) of Figure 9 is an enlarged view of a region including a portion TIP of the inner tube TI in (a) of Figure 9. In the above-described embodiment, a third support member 18E according to Modification 5 shown in Figure 9 may be employed instead of the third support member 18.

[0076] The third support member 18E has a different outer shape from the third support member 18 described in the above embodiment. Specifically, as shown in Fig. 9, the outer diameter of the third support member 18E decreases toward the tip side Ar1. In other words, the third support member 18E corresponds to a tapered portion according to the present invention.

[0077] As shown in FIG. 9A, the inner tube TI is assembled with the third support member 18E inserted therein. The outer diameter of the third support member 18E is larger than the inner diameter of the inner tube TI before assembly. Therefore, the inner tube TI is expanded by the third support member 18E when assembled. The difference between the inner diameter of the inner pipe PI and the outer diameter of the end of the third support member 18E on the base end side Ar2 is more than twice the thickness of the inner tube TI before assembly. Therefore, the inner tube TI is not compressed between the inner pipe PI and the end of the third support member 18E on the base end side Ar2. A portion TIP of the inner tube TI abuts against the inner circumferential surface of the inner pipe PI at a position spaced from the third support member 18E toward the base end side Ar2 (FIG. 9B).

[0078] The fifth modification described above provides the same effects as the above-described embodiment, as well as the following effects. In the fifth modification, the inner tube TI is not compressed between the inner pipe PI and the third support member 18E. A portion TIP of the inner tube TI abuts against the inner circumferential surface of the inner pipe PI at a position spaced from the third support member 18E toward the proximal end side Ar2. This allows the portion TIP of the inner tube TI to abut against the inner circumferential surface of the inner pipe PI with sufficient pressure to ensure watertightness and airtightness. Furthermore, sliding resistance can be reduced when the inner pipe PI is moved back and forth along the central axis Ax1 to open and close the jaw 11 relative to the treatment portion 121.

[0079] (Variation 6) FIG. 10 is a diagram illustrating Variation 6 of the embodiment. Specifically, FIG. 10A is a diagram corresponding to FIG. 4A. FIG. 10B is an enlarged view of a region including a portion TIP of the inner tube TI in FIG. 10A. In the above-described embodiment, a third support member 18F according to Variation 6 shown in FIG. 10 may be employed instead of the third support member 18. In Variation 6, the inner tube TI is divided into two parts along the central axis Ax1, as shown in FIG. 10A. Hereinafter, of the two parts, the inner tube TI located on the distal end side Ar1 will be referred to as the first inner tube TI1, and the inner tube TI located on the proximal end side Ar2 will be referred to as the second inner tube TI2.

[0080] The third support member 18F has a different outer shape from the third support member 18 described in the above embodiment. Specifically, as shown in Fig. 10, the third support member 18F is composed of a circular ring portion 188 and a truncated cone portion 189.

[0081] The annular portion 188 has an annular shape. As shown in Fig. 10A, the outer diameter of the annular portion 188 is approximately the same as the thickness of the first inner tube TI1 before assembly.

[0082] The truncated cone portion 189 has an outer shape like a truncated cone, an outer diameter dimension of which decreases toward the base end side Ar2, and is provided integrally with the base end side Ar2 of the annular portion 188 in a state of being coaxial with the annular portion 188. The largest outer diameter dimension of the truncated cone portion 189 is larger than the outer diameter dimension of the annular portion 188, as shown in Fig. 10. In other words, the truncated cone portion 189 corresponds to the tapered portion according to the present invention.

[0083] Then, as shown in Figure 10, the first inner tube TI1 is assembled with the annular portion 188 inserted inside and the end of the base end side Ar2 abutting against the stepped portion 190 between the annular portion 188 and the truncated cone portion 189.

[0084] On the other hand, as shown in FIG. 10 , the second inner tube TI2 is assembled with the truncated cone portion 189 inserted therein. The outer diameter of the truncated cone portion 189 is larger than the inner diameter of the second inner tube TI2 before assembly. Therefore, in the assembled state, the second inner tube TI2 is expanded toward the forward end side Ar1 by the truncated cone portion 189. Furthermore, the difference between the inner diameter of the inner pipe PI and the outer diameter of the end of the truncated cone portion 189 on the forward end side Ar1 is more than twice the thickness of the second inner tube TI2 before assembly. Therefore, the second inner tube TI2 is not compressed between the inner pipe PI and the end of the truncated cone portion 189 on the forward end side Ar1. A portion TIP of the second inner tube TI2 comes into contact with the inner circumferential surface of the inner pipe PI at a position spaced from the truncated cone portion 189 toward the tip side Ar1 (FIG. 10(b)).

[0085] The sixth modification described above provides the same effects as those of the above-described embodiment and the fifth modification, as well as the following effect. In the sixth modification, the second inner tube TI2 is expanded toward the distal end side Ar1 by the truncated cone portion 189. Furthermore, a portion TIP of the second inner tube TI2 abuts against the inner circumferential surface of the inner pipe PI at a position spaced from the truncated cone portion 189 toward the distal end side Ar1. Therefore, for example, in a surgery using an insufflator, when a procedure is performed with the abdominal cavity pressurized, if high-pressure gas flows into the inner pipe PI from the distal end of the inner pipe PI toward the proximal end side Ar2, the high-pressure gas presses the portion TIP of the second inner tube TI2 against the inner circumferential surface of the inner pipe PI. This effectively ensures airtightness and watertightness.

[0086] (Variation 7) Figure 11 is a diagram illustrating Variation 7 of the embodiment. Specifically, (a) of Figure 11 is a diagram corresponding to (a) of Figure 4. (b) of Figure 11 is an enlarged view of a region including a portion TIP of the inner tube TI in (a) of Figure 11. In the above-described embodiment, a third support member 18G according to Variation 7 shown in Figure 11 may be employed instead of the third support member 18.

[0087] The third support member 18G has a different outer shape from the third support member 18 described in the above-described embodiment. Specifically, as shown in Fig. 11 , the third support member 18G is recessed from the distal end side Ar1 toward the proximal end side Ar2 and is provided with a barb portion 191 that turns up the end of the inner tube TI on the proximal end side Ar2.

[0088] 11, the inner tube TI is assembled in a state in which the end portion on the base end side Ar2 is turned up by the barb portion 191. The turned-up portion TIP of the inner tube TI comes into contact with the inner circumferential surface of the inner pipe PI at a position spaced from the third support member 18G toward the tip end side Ar1 (FIG. 11(b)).

[0089] Even when the configuration of the third support member 18G according to the seventh modification described above is adopted, the same effects as those of the embodiment and the sixth modification described above can be achieved.

[0090] (Variation 8) Figures 12 and 13 are diagrams illustrating Variation 8 of the embodiment. Specifically, Figure 12 is an exploded perspective view showing a third support member 18H according to Variation 8. Figure 13 is a diagram showing the order in which the third support member 18H is assembled to the vibration transmission member 12. In the above-described embodiment, the third support member 18 may have the configuration of the third support member 18H according to Variation 8 shown in Figures 12 and 13.

[0091] As shown in FIGS. 12 and 13, the third support member 18H is made up of first and second C-rings 192 and 193.

[0092] The first and second C-rings 192, 193 are each made of the same resin material as the third support member 18 described in the above embodiment, and have the same shape as each other. Therefore, only the configuration of the first C-ring 192 will be described below, and for the second C-ring 193, the same components as those of the first C-ring 192 will be assigned the same reference numerals and descriptions thereof will be omitted.

[0093] As shown in FIG. 12, the first C-ring 192 includes a C-ring body 1921 and a protrusion 1922 .

[0094] The C-ring main body 1921 is a C-shaped member having an inner diameter dimension that is substantially the same as the outer diameter dimension of the groove 124 and a notch 1923 formed in part of the circumferential direction of the circular member.

[0095] The protrusion 1922 is a part that protrudes along the central axis of the C-ring main body 1921 from a position that is rotationally symmetrical by 180° around the central axis of the C-ring main body 1921 with respect to the location where the cutout 1923 is provided.

[0096] The third support member 18H is then assembled into the groove 124 as shown below. Specifically, first, the worker places the vibration transmission member 12 inside the C-shaped C-ring body 1921 while pushing both circumferential end portions (both edges of the cutout portion 1923) of the C-ring body 1921 of the first C-ring 192 apart (FIG. 13B). Similarly, the worker places the vibration transmission member 12 inside the C-shaped C-ring body 1921 while pushing both circumferential end portions (both edges of the cutout portion 1923) of the C-ring body 1921 of the second C-ring 193 apart (FIG. 13C). That is, the first and second C-rings 192, 193 are attached to the vibration transmitting member 12 by so-called snap fit.

[0097] The eighth modification described above provides the same advantages as the above-described embodiment, as well as the following advantages. The third support member 18H according to the eighth modification is composed of the first and second C-rings 192 and 193. Therefore, the first and second C-rings 192 and 193 can be attached to the vibration transmission member 12 by snap-fitting, improving the ease of assembly of the ultrasonic treatment instrument 2. This also reduces assembly time and reduces the cost of the ultrasonic treatment instrument 2. Furthermore, by constructing the third support member 18H from a resin material, the gap at the boundary between the first and second C-rings 192 and 193 can be narrowed, creating a long, complex path for liquid flow, thereby ensuring sufficient watertightness. In particular, because a portion of the boundary intersects (is perpendicular to) the direction along the central axis Ax1, liquid penetration can be effectively suppressed. Furthermore, by fabricating the third support member 18H made of a resin material using a 3D printer, the third support member 18H can be fabricated at low cost.

[0098] 14 is a diagram illustrating a ninth modification of the embodiment. Specifically, Fig. 14 is a diagram illustrating the order in which a third support member 18I according to the ninth modification is attached to the vibration transmission member 12. In the above-described embodiment, the third support member 18 may have the configuration of the third support member 18I according to the ninth modification shown in Fig. 14.

[0099] The third support member 18I is made of the same resin material as the third support member 18 described in the above embodiment. Specifically, as shown in FIG. 14B, the third support member 18I has an inner diameter dimension that is substantially the same as the outer diameter dimension of the groove 124, and has an annular shape through which the vibration transmission member 12 is inserted. The third support member 18I is provided with a slit SL (FIG. 14B) that extends from one end to the other end in the direction along the central axis Ax1.

[0100] Then, the third support member 18I is assembled into the groove 124 as shown below. Specifically, the worker places the vibration transmission member 12 inside the third support member 18I while pushing apart both circumferential edge portions of the third support member 18I that are bounded by the slit SL (see (c) of FIG. 14 ).

[0101] Even when the third support member 18I is configured from a single member as in the ninth modification described above, the same effects as those of the embodiment and the eighth modification described above can be achieved.

[0102] 1 Treatment system 2 Ultrasonic treatment tool 3 Control device 4 Handpiece 5 Ultrasonic transducer 6 Fixed handle 7 Operating handle 8 Switch 9 Rotating knob 10 Outer pipe 11 Jaw 12 Vibration transmission member 13 Arm 14 Pad 15 Support member 16 First support member 17 Second support member 18, 18A to 18I Third support member 51 TD case 52 Ultrasonic vibrator 121 Treatment section 122 to 124 Groove 131 Arm body 132 Bearing section 180 Stepped portion 181 Large diameter section 182 Small diameter section 183 Support member body 184 Circular truncated cone section 185 Support member body 186 First circular truncated cone section 187 Second circular truncated cone section 188 Ring section 189 Circular truncated cone section 190 Stepped portion 191 Barb portion 192 First C-ring 193 Second C-ring 1921 C-ring body 1922 Projection portion 1923 Notch portion Ar1 Tip side Ar2 Base side Ax1 Central axis C Electric cable P1 to P3 Nodal position Pi1 Rotation axis Pi2 Drive axis PI Inner pipe SL Slit TH1, TH2 Thickness dimension TI Inner tube TI1 First inner tube TI2 Second inner tube TIP Part

Claims

1. An ultrasonic treatment device comprising: a vibration transmission member which transmits ultrasonic vibrations from a base end to a tip end; a tube into which the vibration transmission member is inserted; a hard member which is made of a resin material harder than the tube and is provided on the outer peripheral surface of the vibration transmission member at a node position of the ultrasonic vibration and which abuts against the inner peripheral surface of the tube; and a pipe which covers the outer peripheral surface of the tube, wherein the thickness dimension of the tube at a point compressed between the pipe and the hard member is smaller than the thickness dimension of other points.

2. An ultrasonic treatment device as described in claim 1, wherein the hard member is provided at the most proximal nodal position among the nodal positions of ultrasonic vibration on the outer peripheral surface of the vibration transmission member.

3. The ultrasonic treatment device according to claim 1, wherein the hard member has a configuration in which a first hard member and a second hard member are combined.

4. The ultrasonic treatment device according to claim 1, wherein the hard member is formed in an annular shape and has a slit extending from one end to the other end in the longitudinal direction of the vibration transmission member.

5. The ultrasonic treatment device according to claim 1, wherein the tube is made of a perfluoroethylene propene copolymer resin material.

6. The ultrasonic treatment device according to claim 1, wherein the hard member is made of any one of resin materials selected from the group consisting of polytetrafluoroethylene, polyether ether ketone, polyphenylsulfone, and polyoxymethylene.

7. The ultrasonic treatment device according to claim 1, wherein the tube is partially expanded by the hard member.

8. The ultrasonic treatment device according to claim 1, wherein the hard member is formed in an annular shape and has a tapered portion whose outer diameter dimension changes along the longitudinal direction of the vibration transmission member.

9. The ultrasonic treatment device according to claim 8, wherein the tapered portion has a first tapered portion whose outer diameter dimension decreases toward the tip side.

10. The ultrasonic treatment device according to claim 8, wherein the tapered portion has a second tapered portion whose outer diameter dimension decreases toward the base end side.

11. An ultrasonic treatment instrument as described in claim 1, further comprising a jaw that opens and closes relative to the vibration transmission member, wherein the vibration transmission member and the jaw are each provided with an electrode for passing a high-frequency current between the vibration transmission member and the jaw.

12. The ultrasonic treatment device according to claim 11, further comprising an operating handle provided on the base end side of the pipe for opening and closing the jaw relative to the vibration transmission member in response to a user's operation.

13. An ultrasonic treatment instrument comprising: a vibration transmission member which transmits ultrasonic vibrations from a base end to a tip end; a jaw which opens and closes with respect to the vibration transmission member; a hard member provided on an outer peripheral surface of the vibration transmission member; a tube into which the vibration transmission member is inserted and whose inner peripheral surface the hard member abuts; and a pipe covering the outer peripheral surface of the tube, wherein the hard member is made of a resin material which is harder than the tube and is provided at the most proximal nodal position of ultrasonic vibration nodal positions, and a portion of the tube is expanded by the hard member and abuts against the inner peripheral surface of the pipe at a position spaced from the hard member in the longitudinal direction of the vibration transmission member.

14. An ultrasonic treatment device as described in claim 13, wherein the tube is expanded toward the tip side by the hard member and abuts against the inner surface of the pipe at a position spaced away from the hard member toward the tip side.

15. An ultrasonic treatment device as described in claim 13, wherein the hard member is provided with a barb portion for turning up the tube, and the end of the tube turned up by the barb portion abuts against the inner surface of the pipe.

Images