Treatment tool and production method

Abstract

This treatment tool has treatment surfaces 1212, 1213 for treating a treatment target. The treatment surfaces 1212, 1213 are provided with a plurality of recesses 1221, each having a first resin 1222 disposed therein. A surface 1224 of the treatment surfaces 1212, 1213 not covered by the first resin 1222 functions as a first electrode for treating the treatment target by supplying a high-frequency current to the treatment target.

Description

Treatment tool and manufacturing method

[0001] The present invention relates to a treatment tool and a manufacturing method thereof.

[0002] Conventionally, a treatment tool that applies treatment energy to a region of biological tissue to be treated (hereinafter referred to as a treatment target) to treat the treatment target has been known (see, for example, Patent Document 1). The treatment tool described in Patent Document 1 employs ultrasonic energy (ultrasonic vibration) as the treatment energy.

[0003] Special Publication No. 2011-505198

[0004] In a treatment tool, a thermal insulating coating may be applied to the treatment surface to reduce residual heat on the treatment surface used to treat a treatment target. Here, residual heat refers to heat that remains on the treatment surface even after treatment, but is not actually required for the treatment. However, when high-frequency energy is used as the treatment energy, the thermal insulating coating may prevent high-frequency current from being supplied to the treatment target. Therefore, there is a need for a technology that can supply high-frequency current to the treatment target while reducing residual heat on the treatment surface.

[0005] The present invention has been made in view of the above, and has an object to provide a treatment tool and a manufacturing method that can supply high-frequency current to a treatment target while reducing residual heat on the treatment surface.

[0006] In order to solve the above-mentioned problems and achieve the object, the treatment instrument of the present invention has a treatment surface for treating a treatment target, and at least a portion of the treatment surface is provided with a plurality of recesses each having a first resin disposed therein, and the surface of the treatment surface that is not covered by the first resin functions as a first electrode for treating the treatment target by supplying a high-frequency current to the treatment target.

[0007] The manufacturing method of the present invention is a method for manufacturing a treatment instrument having a treatment surface for treating a treatment target, and includes the steps of providing multiple recesses on the treatment surface, applying a first resin to the treatment surface, and removing the first resin applied to the treatment surface except for the insides of the multiple recesses.

[0008] According to the treatment tool and manufacturing method of the present invention, it is possible to supply high-frequency current to a treatment target while reducing residual heat on the treatment surface.

[0009] 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 a treatment tool. FIG. 3 is a diagram illustrating the configuration of a jaw and a vibration transmission member. FIG. 4 is a diagram illustrating the structure of the outer surface of the vibration transmission member. FIG. 5 is a diagram illustrating the structure of the outer surface of the vibration transmission member. FIG. 6 is a diagram illustrating a method of forming a thermal insulation reinforcement section. FIG. 7 is a diagram illustrating a first modified example of the embodiment. FIG. 8 is a diagram illustrating a second modified example of the embodiment. FIG. 9 is a diagram illustrating a third modified example of the embodiment. FIG. 10 is a diagram illustrating a fourth modified example of the embodiment. FIG. 11 is a diagram illustrating the fourth modified example of the embodiment. FIG. 12 is a diagram illustrating the fourth modified example of the embodiment.

[0010] 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.

[0011] [Overall Configuration 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 a 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 and incision of the treatment target. Coagulation and incision may be performed simultaneously. The treatment energy applied to the treatment target is not limited to both ultrasonic energy and high-frequency energy, and may be high-frequency energy only. As shown in FIG. 1, the treatment system 1 includes a treatment tool 2 and a control device 3.

[0012] [Configuration of Treatment Tool] In the following, one side along the central axis Ax1 of the sheath 10 will be referred to as the distal side Ar1, and the other side will be referred to as the proximal side Ar2 ( FIG. 1 ). Also, as described below, the "width direction" 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 refers to a direction perpendicular to the paper surface of FIGS. 1 and 2, and the left-right direction in FIG. 3. FIG. 2 is a diagram illustrating the configuration of the distal end portion of the treatment tool 2. Specifically, FIG. 2 is a diagram illustrating the distal end portion of the treatment tool 2 viewed along the width direction.

[0013] The treatment tool 2 is a treatment tool 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.

[0014] As shown in Figures 1 to 3, the handpiece 4 includes a holding case 6 (Figure 1), an operating handle 7 (Figure 1), a switch 8 (Figure 1), a rotating knob 9 (Figure 1), a sheath 10, a jaw 11, and a vibration transmission member 12.

[0015] The holding case 6 supports the entire treatment tool 2. The operating handle 7 is movably attached to the holding case 6 and receives opening and closing operations by an operator such as a surgeon. The switch 8 is provided in an exposed state on the outside of the holding case 6 and receives treatment operations by an operator such as a surgeon.

[0016] 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 holding case 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 holding case 6. Furthermore, the rotation of the rotation knob 9 causes the sheath 10, the jaw 11, and the vibration transmission member 12 to rotate about the central axis Ax1.

[0017] The sheath 10 is a cylindrical pipe made of a conductive material such as metal. A cylindrical first pin Pi1 (FIGS. 1 and 2) extending in the width direction is fixed to the end of the distal end side Ar1 of the sheath 10. The outer circumferential surface of the sheath 10 is covered by an electrically insulating outer tube TO (FIG. 2). The inner circumferential surface of the sheath 10 is covered by an electrically insulating inner tube (not shown).

[0018] Fig. 3 is a diagram illustrating the configuration of the jaw 11 and the vibration transmission member 12. Specifically, Fig. 3 is a cross-sectional view of the jaw 11 and the vibration transmission member 12 cut along a plane perpendicular to the central axis Ax1. Note that the cover RC is not illustrated in Fig. 3. In the following, when describing the configuration of the jaw 11 and the vibration transmission member 12, of the opening and closing directions of the jaw 11 relative to the treatment section 121, the opening direction of the jaw 11 (upper side in Fig. 3) is referred to as an open side Ar3, and the closing direction of the jaw 11 (lower side in Fig. 3) is referred to as a closed side Ar4.

[0019] The jaw 11 is pivotally supported by a first pin Pi1 at an end of the distal end side Ar1 of the sheath 10, and is configured to be rotatable about the central axis of the first pin Pi1 (an axis along a direction perpendicular to the paper surface of FIGS. 1 and 2 ). The jaw 11 rotates about the central axis of the first pin Pi1, thereby opening and closing with respect to a treatment portion 121 provided at the end of the distal end side Ar1 of the vibration transmission member 12. When the jaw 11 closes with respect to the treatment portion 121, a treatment target is grasped between the jaw 11 and the treatment portion 121.

[0020] As shown in Fig. 3, the jaw 11 includes a jaw body 111 and a pad 112. The jaw body 111 is made of a conductive material. As shown in Figs. 2 and 3, the jaw body 111 is a member in which a base 113 (Fig. 3), a plurality of first teeth 114 (Fig. 3), a plurality of second teeth 115 (Fig. 3), and a bearing 116 (Fig. 2) are integrally formed.

[0021] The base 113 is configured as a long, approximately plate-like body. In this embodiment, the longitudinal direction of the base 113 is a direction along a curve that approaches leftward as it approaches the distal end side Ar1 when viewed from the proximal end side Ar2 with the jaw 11 positioned above the treatment section 121.

[0022] A cover RC (FIG. 2) made of an electrically insulating resin is integrally formed on the surface of the open side Ar3 of the base 113 so as to cover the surface of the open side Ar3. In this embodiment, the cover RC is insert-molded into the base 113, but this is not limiting. For example, a configuration in which the cover RC is fixed to the base 113 by a snap fit or a metal pin may also be employed.

[0023] The plurality of first tooth portions 114 each protrude from one side in the width direction on the surface of the closed side Ar4 of the base 113 toward the closed side Ar4, and are arranged side by side along the longitudinal direction of the base 113.

[0024] The plurality of second tooth portions 115 each protrude from the other side in the width direction on the surface of the closed side Ar4 of the base 113 toward the closed side Ar4, and are arranged side by side along the longitudinal direction of the base 113.

[0025] Here, on the surface of the closed side Ar4 of the base 113, in the central portion in the width direction located between the plurality of first tooth portions 114 and the plurality of second tooth portions 115, as shown in Figure 3, there is provided a concave groove 1131 that is recessed toward the open side Ar3 and extends along the longitudinal direction of the base 113.

[0026] The bearing portion 116 is provided at the proximal end of the base body 113 and is pivotally supported relative to the sheath 10 by a first pin Pi1. A cylindrical second pin Pi2 ( FIG. 2 ) extending in the width direction is fixed to the bearing portion 116 by welding. The second pin Pi2 is connected to an opening / closing mechanism D1 ( FIG. 2 ) inserted inside the sheath 10. The jaw 11 rotates about the central axis of the first pin Pi1 in conjunction with movement of the opening / closing mechanism D1 toward the distal end side Ar1 or the proximal end side Ar2 in response to an opening / closing operation of the operating handle 7 by an operator such as a surgeon, thereby opening and closing the jaw 11 relative to the treatment portion 121.

[0027] The pad 112 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 base 113. As shown in Fig. 3, the pad 112 is fixed to a concave groove 1131 in the base 113. When the jaw 11 is brought close to the treatment portion 121, the pad 112 abuts against the treatment portion 121.

[0028] The vibration transmission member 12 has an elongated shape and is made of a conductive material such as a titanium alloy. As shown in FIG. 2 , the vibration transmission member 12 is inserted into the sheath 10 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 that vibrate in a direction along the central axis Ax1.

[0029] In this embodiment, the treatment portion 121, like the jaw 11, extends along a curve that curves leftward toward the distal end side Ar1 when viewed from the proximal end side Ar2 with the jaw 11 positioned upward. As shown in FIG. 3 , the treatment portion 121 has a substantially octagonal cross section cut by a plane perpendicular to the central axis Ax1. Note that the octagonal cross section of the treatment portion 121 is merely an example, and other shapes, such as a circle, may also be used. Hereinafter, for ease of explanation, the cross section of the treatment portion 121 will be described as being octagonal.

[0030] Hereinafter, in the treatment portion 121, a flat surface located on the open side Ar3 will be referred to as a first surface 1211. This first surface 1211 is a surface that abuts against the pad 112 when the jaw 11 is closed on the treatment portion 121. Furthermore, surfaces adjacent to the first surface 1211 in the circumferential direction about the central axis of the treatment portion 121 will be referred to as second and third surfaces 1212 and 1213. Furthermore, surfaces adjacent to the second and third surfaces 1212 and 1213 in the circumferential direction about the central axis of the treatment portion 121 will be referred to as fourth and fifth surfaces 1214 and 1215. Furthermore, surfaces adjacent to the fourth and fifth surfaces 1214 and 1215 in the circumferential direction about the central axis of the treatment portion 121 will be referred to as sixth and seventh surfaces 1216 and 1217. Furthermore, the surface located between the sixth and seventh surfaces 1216 and 1217 and opposite to the first surface 1211 will be referred to as an eighth surface 1218 .

[0031] The first to third surfaces 1211 to 1213 described above are surfaces that treat a treatment target, and correspond to the treatment surface 1210 (FIG. 3) according to the present invention. The first surface 1211 corresponds to the contact surface according to the present invention.

[0032] The detailed structure of the outer surface of the vibration transmission member 12, including the treatment portion 121, will be described later in the section "Structure of the outer surface of the vibration transmission member."

[0033] 1, the ultrasonic transducer 5 includes a TD (transducer) case 51 and an ultrasonic vibrator 52. The TD case 51 supports the ultrasonic vibrator 52 and is detachably connected to the holding case 6. The ultrasonic vibrator 52 generates ultrasonic vibrations under the control of the control device 3. In this embodiment, the ultrasonic vibrator 52 is configured as a BLT (bolt-tightened Langevin type vibrator).

[0034] [Configuration of the control device] The control device 3 comprehensively controls the operation of the treatment tool 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.

[0035] 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 (pad 112) and the treatment unit 121. In other words, ultrasonic energy is applied from the treatment unit 121 to the treatment target.

[0036] Furthermore, for example, when applying high-frequency energy to a treatment target, the control device 3 supplies high-frequency power between the jaw body 111 and the vibration transmission member 12 via the electric cable C. When high-frequency power is supplied between the jaw body 111 and the vibration transmission member 12, a high-frequency current is supplied to the treatment target located between the jaw body 111 and the treatment section 121. In other words, high-frequency energy is applied to the treatment target.

[0037] [Structure of the Outer Surface of the Vibration Transmission Member] Next, the structure of the outer surface of the vibration transmission member 12, including the treatment section 121, will be described. FIGS. 4 and 5 are views illustrating the structure of the outer surface of the vibration transmission member 12. Specifically, FIG. 4 is a view of the vibration transmission member 12 viewed from the first surface 1211 side along the normal direction of the first surface 1211. Note that in FIG. 4, the portion where the insulation reinforcement section 122, described later, is provided is shaded. FIG. 5 is a view of the tip portion of the vibration transmission member 12 viewed along the width direction. Note that in FIG. 5, the portion where the insulation reinforcement section 122 is provided is shaded. Also, in FIG. 5, the portion where the coating layer CO, described later, is provided is dotted. Furthermore, in FIG. 5, the sheath 10 is illustrated by a dashed line.

[0038] The heat insulation reinforcement portion 122 is a portion that reinforces the heat insulation effect on the treatment surface 1210. In this embodiment, the heat insulation reinforcement portion 122 is provided on the second and third surfaces 1212 and 1213 of the treatment surface 1210, excluding the first surface 1211, as shown in FIG.

[0039] As shown in Fig. 4, the insulation reinforcement section 122 is configured by a plurality of recesses 1221 and first resins 1222 respectively disposed inside the plurality of recesses 1221. Note that in Fig. 4, dots are added to the portions where the first resins 1222 are disposed.

[0040] In this embodiment, the plurality of recesses 1221 are formed in the second and third surfaces 1212 and 1213 by laser processing using a short-pulse laser, and each has a circular shape. In the example of Fig. 4, the plurality of recesses 1221 are arranged in a direction perpendicular to the longitudinal direction of the vibration transmission member 12 so that the recesses 1221 overlap each other (are connected to each other), and a plurality of rows of the recesses 1221 (hereinafter referred to as grooves 1223) are arranged parallel to each other along the longitudinal direction.

[0041] In the following description, the portions of the second and third surfaces 1212 and 1213 other than the portions where the grooves 1223 are formed will be referred to as surfaces 1224 (FIG. 4).

[0042] The first resin 1222 is an electrically insulating material, such as polyetheretherketone (PEEK), polyimide (PI), perfluoroalkoxyalkane (PFA), or fluororesin such as PTFE. The first resin 1222 is disposed inside the groove 1223 so as to be substantially flush with the surface 1224.

[0043] The method for forming the thermal insulation reinforced portion 122 described above will be described later in the "Method for forming the thermal insulation reinforced portion" section.

[0044] In this embodiment, the surfaces 1211 and 1224 of the treatment surface 1210 that are not covered by the first resin 1222 function as a first electrode that supplies the high-frequency current to the treatment target without the path of the high-frequency current to the treatment target being restricted by the first resin 1222. The jaw body 111 also functions as a second electrode that supplies the high-frequency current to the treatment target between itself and the first electrode.

[0045] The coating layer CO is a layer coated with a second resin. Examples of the coating layer CO (second resin) include an electrically insulating material, such as fluororesin such as PEEK, PI, PFA, or PTFE. In this embodiment, as shown in FIG. 5 , the coating layer CO is provided on the outer surface of the distal end Ar1, from the distal end node position P1 of the longitudinal vibration nodes of the vibration transmission member 12, excluding the treatment surface 1210 (including the fourth to eighth surfaces 1214 to 1218).

[0046] [Method of Forming the Thermal Insulation Reinforced Portion] Next, a method of forming the thermal insulation reinforced portion 122 will be described. This formation method corresponds to a method of manufacturing the treatment tool 2 according to the present invention. Fig. 6 is a diagram illustrating the method of forming the thermal insulation reinforced portion 122. Specifically, Fig. 6 is a cross-sectional view of the vibration transmission member 12 cut along a plane perpendicular to the extension direction of the groove portion 1223. First, as shown in Fig. 6(a), an operator forms a plurality of recesses 1221 (grooves 1223) in the second and third surfaces 1212 and 1213 by, for example, laser processing (hereinafter referred to as a first step).

[0047] Next, as shown in FIG. 6B, the worker applies uncured first resin 1222 to the second and third surfaces 1212 and 1213 (hereinafter referred to as the second step).

[0048] Next, as shown in (c) of Figure 6, the worker removes the first resin 1222 applied to the second and third surfaces 1212, 1213 except for the first resin 1222 inside the multiple recesses 1221 (groove portions 1223) (hereinafter referred to as the third step).

[0049] In the third step, for example, as shown below, the first resin 1222 is removed from areas other than the interiors of the plurality of recesses 1221. For example, if the first resin 1222 is uncured, the worker traces the second and third surfaces 1212, 1213 with a spatula or the like to remove the first resin 1222 from areas other than the interiors of the plurality of recesses 1221. Furthermore, for example, if the first resin 1222 has already cured, the worker removes the first resin 1222 from areas other than the interiors of the plurality of recesses 1221 by polishing such as buffing.

[0050] For example, when the first resin 1222 and the coating layer CO are made of the same material, the insulation reinforcement portion 122 and the coating layer CO can be formed as follows. For example, after the first step, in a second step, with the first surface 1211 masked, the uncured first resin 1222 is applied from the node position P1 to the entire outer surface of the vibration transmission member 12 on the tip side Ar1. Then, in a third step, the first resin 1222 on the second and third surfaces 1212 and 1213 is removed except for the insides of the multiple recesses 1221 (grooves 1223). Furthermore, for example, after the first step, in a second step, the uncured first resin 1222 is applied from the node position P1 to the entire outer surface of the vibration transmission member 12 on the tip side Ar1. Then, in the third process, the first resin 1222 on the first surface 1211 is removed, and the first resin 1222 on the second and third surfaces 1212 and 1213 is removed except for the insides of the multiple recesses 1221 (groove portions 1223).

[0051] The above-described embodiment of the present invention provides the following advantages. In the treatment tool 2 according to the present embodiment, at least a portion of the treatment surface 1210 is provided with a plurality of recesses 1221, each having a first resin 1222 disposed therein. The surfaces 1211 and 1224 of the treatment surface 1210 that are not covered with the first resin 1222 function as first electrodes that supply the high-frequency current to the treatment target without the path of the high-frequency current to the treatment target being restricted by the first resin 1222. Therefore, the treatment tool 2 according to the present embodiment can supply the high-frequency current to the treatment target while reducing residual heat on the treatment surface 1210 due to the thermal insulation reinforcement portion 122 provided on a portion of the treatment surface 1210.

[0052] In particular, the first resin 1222 is disposed inside the recess 1221. Therefore, compared to a configuration in which the first resin 1222 is simply provided on the treatment surface 1210, a structure can be realized in which the first resin 1222 is less likely to peel off even due to friction caused by ultrasonic vibrations. In other words, the durability of the heat insulation reinforcement part 122 can be improved.

[0053] Furthermore, in the treatment tool 2 according to the present embodiment, the outer surface of the vibration transmission member 12 from the most distal node position P1 to the distal end side Ar1 is provided with a coating layer CO, except for the treatment surface 1210. This makes it possible to further reduce the influence of thermal invasion on unintended regions of biological tissue.

[0054] Furthermore, in the treatment tool 2 according to the present embodiment, the heat insulation reinforcement portion 122 is not provided on the first surface 1211 that abuts against the jaw 11 when the jaw 11 is closed against the treatment surface 1210. In other words, the heat insulation reinforcement portion 122 is not provided on the first surface 1211 where there is a risk that the first resin 1222 will peel off due to friction caused by ultrasonic vibrations on the treatment surface 1210. Therefore, the heat insulation reinforcement portion 122 can be provided only in an appropriate position.

[0055] Other Embodiments While the embodiments for carrying out the present invention have been described above, the present invention should not be limited to the above-described embodiments. In the above-described embodiments, the groove portion 1223 is formed by overlapping a plurality of recesses 1221, but this is not limiting, and a plurality of recesses 1221 may be provided so as not to overlap each other.

[0056] In the above-described embodiment, the first resin 1222 and the coating layer CO function as a heat insulating coating, but the present invention is not limited to this and may function as an anti-stick coating.

[0057] In the above-described embodiment, the opening / closing mechanism D1 is provided inside the sheath 10, but this is not limiting. For example, the jaw 11 may be opened and closed relative to the treatment portion 121 by moving the sheath 10 itself to the distal end side Ar1 or the proximal end side Ar2. The jaw 11 may be opened and closed relative to the treatment portion 121 when the opening / closing mechanism D1 or the sheath 10 moves to the distal end side Ar1, or may be closed relative to the treatment portion 121 when the opening / closing mechanism D1 or the sheath 10 moves to the proximal end side Ar2.

[0058] In the above-described embodiment, the ultrasonic transducer 5 is configured to be detachable from the handpiece 4, but this is not limiting and a configuration in which the ultrasonic transducer 5 is built into the handpiece 4 may be adopted. In the above-described embodiment, the number of switches 8 is not limited to two as shown in Fig. 1, but may be one, or three or more. In the above-described embodiment, when high-frequency power is supplied between the jaw 11 and the vibration transmission member 12, the jaw 11 side may be used as the reference voltage, or conversely, the vibration transmission member 12 side may be used as the reference voltage.

[0059] In the above-described embodiment, the following modifications 1 to 4 may be adopted.

[0060] (Variation 1) FIG. 7 is a diagram illustrating Variation 1 of the embodiment. Specifically, FIG. 7 corresponds to FIG. 4. Note that in FIG. 7, the portions where the insulation reinforcement portion 122 is provided are shaded. Also, in FIG. 7, the portions where the first resin 1222 is disposed are dotted. In the above-described embodiment, the insulation reinforcement portion 122 is provided on the second and third surfaces 1212 and 1213 of the treatment surface 1210. However, this is not limiting, and the insulation reinforcement portion 122 may be provided on the first to third surfaces 1211 to 1213, as in Variation 1 shown in FIG. 7. Even when the configuration of Variation 1 described above is adopted, the same effects as those of the above-described embodiment are achieved.

[0061] (Variation 2) FIG. 8 is a diagram illustrating Variation 2 of the embodiment. Specifically, FIG. 8 corresponds to FIG. 4 . Note that in FIG. 8 , the portions where the insulation reinforcement portion 122 is provided are shaded. Also, in FIG. 8 , the portions where the first resin 1222 is disposed are dotted. In the above-described embodiment, the multiple grooves 1223 constituting the insulation reinforcement portion 122 each extend in a direction perpendicular to the longitudinal direction of the vibration transmission member 12 and are aligned parallel to each other along the longitudinal direction. However, this is not limited thereto. For example, as in Variation 2 shown in FIG. 8 , the multiple grooves 1223 may each extend in a direction that forms an angle other than 90° with respect to the longitudinal direction of the vibration transmission member 12 and be aligned parallel to each other along the longitudinal direction. Even when the configuration of Variation 2 described above is adopted, the same effects as those of the above-described embodiment can be achieved.

[0062] (Modification 3) Fig. 9 is a diagram showing Modification 3 of the embodiment. Specifically, Fig. 9 is a diagram showing the jaw 11 as viewed from the blocking side Ar4. Note that in Fig. 9, the portion where the thermal insulation reinforcement portion 117 is provided is shaded. In the above-described embodiment, the thermal insulation reinforcement portion 117 may be provided on the jaw 11, as in Modification 3 shown in Fig. 9.

[0063] 9 , the heat insulation reinforcement parts 117 are located on both sides of the pad 112 in the width direction of the closed side Ar4 of the jaw body 111, and are provided in a pair of regions 118 that face the treatment surfaces 1210 of the plurality of first teeth 114 and the plurality of second teeth 115. The closed side Ar4 of the jaw body 111 corresponds to the treatment surface according to the present invention.

[0064] Similar to the insulation reinforcement portion 122, the insulation reinforcement portion 117 is a portion that reinforces the insulation effect of the pair of regions 118 in the jaw 11. As shown in Fig. 9 , the insulation reinforcement portion 117 is configured by a plurality of recesses 1171 and first resins 1172 disposed inside the plurality of recesses 1171, respectively.

[0065] In the present modified example 3, the plurality of recesses 1171 are formed in a pair of regions 118 by laser processing using a short-pulse laser, and each has a circular shape. In the example of Fig. 9 , the plurality of recesses 1171 are arranged in a direction perpendicular to the longitudinal direction of the jaw 11 so as to overlap each other (become connected to each other), and a plurality of rows of the plurality of recesses 1171 (hereinafter referred to as grooves 1173) are arranged in parallel to each other along the longitudinal direction.

[0066] In the following description, the portions of the pair of regions 118 other than the portions where the grooves 1173 are formed will be referred to as surfaces 1174 (FIG. 9).

[0067] The first resin 1172 is an electrically insulating material, such as a fluororesin such as PEEK, PI, PFA, or PTFE. The first resin 1172 is disposed inside the groove 1173 so as to be substantially flush with the surface 1174.

[0068] In this third variant, the surface 1174 in the pair of regions 118 that is not covered by the first resin 1172 does not have the path of the high-frequency current to the treatment target restricted by the first resin 1172, and functions as an electrode (the first electrode or the second electrode according to the present invention) that treats the treatment target by supplying the high-frequency current to the treatment target.

[0069] The method for forming the insulation reinforced portion 117 is the same as the method for forming the insulation reinforced portion 122, and therefore the description thereof will be omitted.

[0070] The same effects as those of the above-described embodiment can be achieved even when the configuration of the present modified example 3 described above is adopted. Note that the treatment tool 2 may be configured to be provided with both the thermal insulation reinforcement sections 117 and 122, or may be configured to be provided with only the thermal insulation reinforcement section 117 of the thermal insulation reinforcement sections 117 and 122.

[0071] (Modification 4) FIGS. 10 to 12 are diagrams illustrating Modification 4 of the embodiment. Specifically, FIG. 10 corresponds to FIG. 1 and illustrates a treatment system 1A according to Modification 4. FIG. 11 corresponds to FIG. 3 and illustrates a cross-sectional view of the first and second jaws 11A and 12A cut along a plane perpendicular to the central axis Ax1. FIG. 12 illustrates the first treatment unit 133 as viewed from the second jaw 12A side. Note that an area OA is hatched in FIG. 12. In the treatment system 1A according to Modification 4, as shown in FIG. 10 or 11, a first jaw 11A is employed instead of the jaw 11, and a second jaw 12A is employed instead of the vibration transmission member 12. These first and second jaws 11A and 12A correspond to a pair of jaws according to the present invention.

[0072] As shown in FIG. 11 , the first jaw 11A includes a first jaw body 131, a first support member 132, a first treatment portion 133, and an abutment portion 134. The first jaw body 131 is formed in an elongated shape extending along a central axis Ax1. An end portion of the first jaw body 131 on the proximal side Ar2 is pivotally supported on the sheath 10 by a first pin Pi1. The first jaw 11A rotates about the central axis of the first pin Pi1 in conjunction with movement of the opening / closing mechanism D1 toward the distal side Ar1 or the proximal side Ar2 in response to an opening / closing operation of the operating handle 7 by an operator such as a surgeon, thereby opening and closing the first jaw 11A relative to the second jaw 12A. A portion of the first jaw body 131 is made of a metal material such as a titanium alloy to provide a predetermined rigidity.

[0073] As shown in FIG. 11, the first jaw body 131 has a housing recess 1311 on the surface facing the second jaw 12A, which is located in the center in the width direction and extends along the central axis Ax1.

[0074] The first support member 132 is a long, flat plate extending along the central axis Ax1, and has an outer shape that is substantially the same as the inner shape of the storage recess 1311. The first support member 132 is fitted into the storage recess 1311. The first support member 132 is made of an electrically insulating material with low thermal conductivity, such as PEEK. The first support member 132 is disposed between the first treatment portion 133 and the first jaw body 131. That is, by providing the first support member 132, the first jaw body 131 and the first treatment portion 133 are electrically insulated from each other.

[0075] As shown in FIG. 11, the first support member 132 has a cutter groove 1321 extending along the central axis Ax1 at the approximate center in the width direction of the surface on the second jaw 12A side.

[0076] The first treatment portion 133 is made of a conductive material, and is a portion to which high-frequency power is supplied from a power source (not shown) to the second treatment portion 125 ( FIG. 11 ) constituting the second jaw 12A under the control of the control device 3. The first treatment portion 133 is a flat plate having a U-shape that planarly surrounds the cutter groove portion 1321. The first treatment portion 133 is fixed to the surface of the first support member 132 on the second jaw 12A side, with both ends of the U-shape facing the base end side Ar2.

[0077] The surface of the first treatment section 133 facing the second jaw 12A corresponds to a treatment surface 1331 according to the present invention. A heat insulation reinforcement section 135 is provided on a part of this treatment surface 1331, as shown in Fig. 12. In this fourth modification, the heat insulation reinforcement section 135 is provided in an outer region OA (Fig. 12) of the U-shape on the surface of the first treatment section 133 facing the second jaw 12A. The heat insulation reinforcement section 135 may be provided in a region other than the region OA described above.

[0078] Similar to the insulation reinforcing part 122, the insulation reinforcing part 135 is a part that reinforces the heat insulating effect of the treatment surface 1331. As shown in Fig. 12 , the insulation reinforcing part 135 is composed of a plurality of recesses 1351 and first resins 1352 disposed inside the recesses 1351, respectively.

[0079] In the present modification 4, the plurality of recesses 1351 are each formed in the region OA by laser processing using a short-pulse laser, and each have a circular shape. In the example of Fig. 12 , the plurality of recesses 1351 are arranged in a direction perpendicular to the longitudinal direction of the first jaw 11A (the extension direction of the cutter groove 1321), so that the recesses 1351 are overlapping (communicating with each other), and a plurality of rows of the recesses 1351 (hereinafter referred to as grooves 1353) are arranged parallel to each other along the longitudinal direction.

[0080] In the following description, the portion of the treatment surface 1331 other than the portion where the groove portion 1353 is formed will be referred to as a surface 1354 (FIG. 12).

[0081] The first resin 1352 is an electrically insulating material, such as a fluororesin such as PEEK, PI, PFA, or PTFE. The first resin 1352 is disposed inside the groove 1173 so as to be substantially flush with the surface 1354.

[0082] The contact portion 134 has a hemispherical shape and is made of an electrically insulating material, and is provided on the surface of the first treatment portion 133 on the second jaw 12A side. The contact portion 134 contacts the second treatment portion 125 when the first jaw 11A is closed with respect to the second jaw 12A. In other words, the contact portion 134 prevents the first and second treatment portions 133, 125 from being short-circuited to each other.

[0083] 11, the second jaw 12A includes a second jaw body 123, a second support member 124, and a second treatment portion 125. The second jaw body 123 is a portion of the sheath 10 extending toward the distal end side Ar1, and is formed in an elongated shape extending along the central axis Ax1. As shown in FIG. 11, the surface of the second jaw body 123 facing the first jaw 11A is provided with a storage recess 1231 that is located at the center in the width direction and extends along the central axis Ax1.

[0084] The second support member 124 is a long, flat plate extending along the central axis Ax1, and has an outer shape that is substantially the same as the inner shape of the storage recess 1231. The second support member 124 is fitted into the storage recess 1231. The second support member 124 is made of an electrically insulating material with low thermal conductivity, such as PEEK. The second support member 124 is disposed between the second treatment section 125 and the second jaw body 123. That is, by providing the second support member 124, the second jaw body 123 and the second treatment section 125 are electrically insulated from each other.

[0085] In this second support member 124, at approximately the center of the width direction of the surface on the first jaw 11A side, as shown in Figure 11, there is provided a cutter groove portion 1241 that extends along the central axis Ax1 and faces the cutter groove portion 1321 when the first jaw 11A is closed relative to the second jaw 12A.

[0086] The second treatment unit 125 is made of a conductive material, and is a part to which high-frequency power is supplied from a power source (not shown) to the first treatment unit 133 under the control of the control device 3. The second treatment unit 125 is a flat plate having a U-shape that planarly surrounds the cutter groove 1241. The second treatment unit 125 is fixed to the surface of the second support member 124 on the first jaw 11A side, with both ends of the U-shape facing the base end side Ar2.

[0087] In the following, the surface of the second treatment portion 125 on the side of the first jaw 11A will be referred to as a treatment surface 1251.

[0088] When applying high-frequency energy to the treatment target, the control device 3 supplies high-frequency power from a power source (not shown) between the first and second treatment units 133, 125 via the electric cable C. As a result, a high-frequency current is supplied to the treatment target held between the treatment surfaces 1331, 1251 from the surface (including the surface 1354) of the treatment surface 1331 that is not covered by the first resin 1352 and from the treatment surface 1251. In other words, high-frequency energy is applied to the treatment target. Therefore, the surface (including the surface 1354) of the treatment surface 1331 that is not covered by the first resin 1352 does not have the path of the high-frequency current to the treatment target restricted by the first resin 1352, and functions as a first electrode according to the present invention.

[0089] 11, the treatment tool 2 is provided with a cutter CT that is located in the cutter grooves 1321, 1241 and moves back and forth along the central axis Ax1 in response to operation of an operating lever (not shown) by an operator such as a surgeon. That is, the treatment target grasped between the first and second jaws 11A, 12A is incised by the advancement and retreat of the cutter CT.

[0090] The same effects as those of the above-described embodiment can be achieved even when the configuration of the present modified example 4 described above is adopted. Note that, in the above-described modified example 4, the heat insulation reinforcement part 135 is provided only on the treatment surface 1331, but this is not limiting, and the heat insulation reinforcement part may be provided on both the treatment surfaces 1331 and 1251, or only on the treatment surface 1251.

[0091] DESCRIPTION OF SYMBOLS 1, 1A Treatment system 2 Treatment tool 3 Control device 4 Handpiece 5 Ultrasonic transducer 6 Holding case 7 Operating handle 8 Switch 9 Rotating knob 10 Sheath 11 Jaw 11A First jaw 12 Vibration transmission member 12A Second jaw 51 TD case 52 Ultrasonic vibrator 111 Jaw body 112 Pad 113 Base body 114 First teeth portion 115 Second teeth portion 116 Bearing portion 117 Thermal insulation reinforcement portion 118 Pair of regions 121 Treatment portion 122 Thermal insulation reinforcement portion 123 Second jaw body 124 Second support member 125 Second treatment portion 131 First jaw body 132 First support member 133 First treatment portion 134 Contact portion 135 Thermal insulation reinforcement portion 1131 Groove 1171 Recess 1172 First resin 1173 Groove 1174 Surface 1210 Treatment surface 1211 First surface 1212 Second surface 1213 Third surface 1214 Fourth surface 1215 Fifth surface 1216 Sixth surface 1217 Seventh surface 1218 Eighth surface 1221 Recess 1222 First resin 1223 Groove 1224 Surface 1231 Storage recess 1241 Cutter groove 1251 Treatment surface 1311 Storage recess 1321 Cutter groove 1331 Treatment surface 1351 Recess 1352 First resin 1353 Groove 1354 Surface Ar1 Distal end side Ar2 Base end side Ar3 Open side Ar4 Closed side Ax1 Central axis C Electric cable CO Coating layer CT Cutter D1 Opening and closing mechanism OA Area P1 Nodal position Pi1 First pin Pi2 Second pin RC Cover TO Outer tube

Claims

1. A treatment tool having a treatment surface for treating a treatment target, wherein at least a portion of the treatment surface is provided with a plurality of recesses each having a first resin disposed therein, and the surface of the treatment surface not covered with the first resin functions as a first electrode for treating the treatment target by supplying a high-frequency current to the treatment target.

2. The treatment tool according to claim 1, further comprising a vibration transmission member that treats the treatment target with ultrasonic vibrations, wherein the treatment surface is provided on the vibration transmission member.

3. The treatment instrument according to claim 2, further comprising a jaw having a second electrode for grasping the treatment target between itself and the treatment surface and for supplying the high-frequency current to the treatment target between itself and the first electrode.

4. The treatment tool according to claim 3, wherein the treatment surface is a surface facing the jaw.

5. The treatment tool according to claim 4, wherein the surface of the vibration transmission member opposite the treatment surface is coated with a second resin.

6. A treatment instrument as claimed in claim 5, wherein at least a portion of the outer surface of said vibration transmission member from the most distal node position to the distal end side, excluding said treatment surface, is coated with said second resin.

7. A treatment instrument as described in claim 3, wherein the treatment surface has an abutment surface that abuts against the jaw when the jaw is closed against the treatment surface, and the abutment surface does not have the multiple recesses.

8. The treatment tool according to claim 2, wherein the vibration transmission member is made of a titanium alloy.

9. The treatment device according to claim 1, wherein the first resin is made of polyether ether ketone, polytetrafluoroethylene, perfluoroalkoxyalkane, or polyimide.

10. A treatment instrument as described in claim 1, further comprising a vibration transmission member that treats the treatment target by ultrasonic vibrations, and a jaw that grasps the treatment target between the vibration transmission member, the treatment surface being provided on the jaw, and the vibration transmission member functioning as a second electrode that supplies the high-frequency current to the treatment target between the first electrode and the jaw.

11. The treatment instrument according to claim 1, further comprising a pair of jaws for grasping the treatment object, wherein the treatment surface is provided on at least one of the pair of jaws.

12. A method for manufacturing a treatment tool having a treatment surface for treating a treatment target, comprising the steps of: providing a plurality of recesses on the treatment surface; applying a first resin to the treatment surface; and removing the first resin applied to the treatment surface except for the first resin inside the plurality of recesses.

13. The manufacturing method according to claim 12, wherein the plurality of recesses are formed by a laser.

Images